Survey of General Aviation Pilot Reports (PIREPs) Conformity, Consistency, and Quality

Understanding barriers to submitting pilot weather reports (PIREPs) has been the focus of recent attention in the general aviation community. The goal is to help increase the submission frequency of these reports, which are valuable for aviation operations and situational awareness. Additionally, the perception of the quality of these reports by pilots can impact the level of trust users have in the data. This study aims to evaluate aspects of the reporting frequency and quality of PIREPs particularly from the general aviation perspective. PIREPs were subjected to a range of logical, qualitative, and quantitative tests. Commercial applications are shown to improve the data quantity transmitted in the reports, particularly the non-mandatory sections such as sky and weather conditions, as well as to help alleviate some of the transcription errors. Reported times of the PIREPs indicate impacts from rounding that may limit the utility of the data in some instances. Analysis of individual geophysical measurements show varying quality with potential gaps noted in the icing type assessment and a bias towards higher turbulence intensity reporting, though air temperature compares well to independent data.

Analysis of the Implementation of Patient Safety Culture with the AHRQ Model at Mitra Medika Hospital Tanjung Mulia Medan

Safety Culture is a collaborative environment where clinical staff treat one another with respect by involving or empowering patients and families so that each Professional provides patient-focused care. The purpose of this study was to determine the implementation of a patient safety culture with the AHRQ model in Mitra Medika Tanjung Mulia General Hospital Medan. This research uses a mix of methods, namely qualitative and quantitative. The population of this study were all staff on duty in each hospital unit associated with 450 patients at MItra Medika Hospital, so the sample was 75 people using simple random sampling technique. The main research informants were one officer each in each installation.Unit Mitra Medika Tanjung Mulia General Hospital Medan, namely 10 people, one key informant, and one triangulation informant.The results of the study show that the description of expectations and managerial actions of patient safety is 68%, organizational learning is 100%, cooperation in units is 76%, communication open by 80%, feedback about the error of 75%, the dimension of non-punitive response to errors is 55%,Staffing 51%, management support for patient safety efforts by 77%, cooperation between units of 61%, handsoff work and changing patients was 71%,the overall perception of hospital staff about patient safety was 63%, reporting frequency was 63%. With the research results, it is expected that Mitra Media Tanjung Mulia General Hospital Medan is expected to be able to initiate, maintain, and develop an ongoing patient safety program and implement the existing safety culture.

An evaluation of knowledge, attitude and perception about adverse drug reactions and pharmacovigilance among intern doctors in a medical college teaching hospital of Sangli

Background: Underreporting of various adverse drug reactions (ADRs) by consultants is a common incurable problem. National pharmacovigilance program is one of the ongoing programs to monitor the adverse drug reactions & reporting at the earliest to the nearby AMCs. As medical interns are budding doctors, the focus of this study was to evaluate the knowledge, attitude and perception about ADRs and pharmacovigilance in them.Methods: A cross section questionnaire-based study was conducted after approval by our institutional ethics committee pretested and validated questions consisting of 20 questions (knowledge, attitude, perception) were administrated to medical interns. The filled questionnaires were collected and analysed.Results: In our study, medical interns have fair enough idea about ADR and pharmacovigilance. In knowledge domain they were aware of term ADRs (100%), pharmacovigilance (72.6%). In attitude domain majority of interns (80.6%) known availability of ADR forms, compulsory of pharmacovigilance unit (90.3%). In perception domain very poor response from interns, not even a single intern had reported any ADR filled form and they don’t know meaning of re-challenge and de-challenge, very few interns (9.7%) know how to manage the ADRs in emergency conditions.Conclusions: Under reporting problem can be improved by doing more teaching activities at undergraduate level and intern’s level including various workshops, CMEs, problem-based teaching of adverse reactions in their curriculum. These exercises will improve their reporting frequency and sensitize the interns from the undergraduate days itself in their upcoming clinical practice in community.

Underreporting of Symptomatic Adverse Events in Phase I Clinical Trials

Background Clinician reporting of symptomatic adverse events (AEs) in phase I trials uses the Common Terminology Criteria for Adverse Events (CTCAE). The utility of the patient-reported outcomes (PROs) version of the CTCAE (PRO-CTCAE) in this setting is unknown. This prospective, observational study compared patient- and clinician-reported symptomatic AEs in phase I patients. Methods Phase I study–eligible patients at Princess Margaret were surveyed with the PRO-CTCAE full-item library (78 symptomatic AEs) at baseline (BL), mid-cycle 1, and mid-cycle 2 (C2). Patient and trial characteristics, best response, and survival data were collected. Presence or absence of patient- (PRO-CTCAE) or clinician-reported symptomatic AEs were compared (kappa) at defined timepoints and overall (BL+ mid-cycle 1 + C2). Results Of 292 patients approached from May 2017 to January 2019, a total of 265 (90.8%) were consented, with 243 (91.7%) evaluable and 552 PRO-CTCAE surveys (completion rate = 98.7%) included in analyses. Evaluation of overall patient-reported symptomatic AEs identified 50 PRO-CTCAE and 11 CTCAE items with 10% or greater reporting frequency. Nineteen CTCAE items were reported as 1% or less despite matched PRO-CTCAE items reporting as 10% or greater. Underreported categories included sexual health, bodily emissions, and cognition. Clinician- relative to patient-reporting frequency (ratio) demonstrated 9 symptomatic AEs with a 50-fold or more lower clinician reporting rate. Overall patient–clinician agreement for individual symptomatic AEs ranged from poor (κ = 0.00-0.19) to moderate (κ = 0.40-0.59), with discordance driven by lack of clinician reporting. Dyspnea (κ = 0.54) and peripheral neuropathy (κ = 0.63) at BL and limb edema (κ = 0.55) at C2 demonstrated the highest patient–clinician agreement. Conclusions Poor to moderate patient–clinician agreement for symptomatic AEs suggests clinician underreporting in phase I trials. Analyses of severity and interference PRO categories are ongoing.