High Rate Of Positive Responses Research Articles

Patient Safety Culture in Pre-Post Partum and Perinatology Units

Introduction: Effective patient safety practices in pre-post partum and perinatology units are crucial for ensuring high-quality care for mothers and children. These practices are expected to reduce maternal and child mortality rates, which remain significant. Patient safety implementation in hospitals depends largely on the patient safety culture within each institution. Objective: This study aimed to assess the application of patient safety culture in pre-post partum and perinatology wards. Methods: The research employed a mixed-methods approach with a sequential explanatory design. Quantitative data were gathered using the AHRQ (Agency for Health Research and Quality) questionnaire. Meanwhile, the qualitative research used an instrumental case study approach insights were derived from in-depth interviews with 52 nurses working in these units. Results: Results show an overall positive response rate of 67.8% across the 12 dimensions of patient safety culture, indicating satisfactory levels. The dimension with the highest positive response rate is teamwork at 38%, while openness had the lowest at 6%. Challenges in patient safety program implementation include lack of safety culture surveys, inadequate incident reporting systems, high blaming culture, lack of support, delayed case reporting, and financial constraints. Reporting, analysis, and evaluation are predominantly limited to internal hospital processes. Conclusion: The obstacles encountered in implementing a patient safety culture are the behavior of healthcare workers and the lack of optimal support from management. The recommendations given are the formation of a Patient Safety Committee, education about safety culture for healthcare workers, Monitoring and evaluation of the patient safety program that has been implemented.

Organizational learning in surgery in Tanzania's health system: a descriptive cross-sectional study.

Organizational learning is critical for delivering safe, high-quality surgical care, especially in low- and middle-income countries (LMICs) where perioperative outcomes remain poor. While current investments in LMICs prioritize physical infrastructure, equipment, and staffing, investments in organizational learning are equally important to support innovation, creativity, and continuous improvement of surgical quality. This study aims to assess the extent to which health facilities in Tanzania's Lake Zone perform as learning organizations from the perspectives of surgical providers. The insights gained from this study can motivate future quality improvement initiatives and investments to improve surgical outcomes. We conducted a cross-sectional analysis using data from an adapted survey to explore the key components of organizational learning, including a supportive learning environment, effective learning processes, and encouraging leadership. Our sample included surgical team members and leaders at 20 facilities (health centers, district hospitals, and regional hospitals). We calculated the average of the responses at individual facilities. Responses that were 5+ on a 7-point scale or 4+ on a 5-point scale were considered positive. We examined the variation in responses by facility characteristics using a one-way ANOVA or Student's t-test. We used univariate and multiple regression to assess relationships between facility characteristics and perceptions of organizational learning. Ninety-eight surgical providers and leaders participated in the survey. The mean facility positive response rate was 95.1% (SD 6.1%). Time for reflection was the least favorable domain with a score of 62.5% (SD 35.8%). There was variation by facility characteristics including differences in time for reflection when comparing by level of care (P = .02) and location (P = .01), and differences in trying new approaches (P = .008), capacity building (P = .008), and information transfer (P = .01) when comparing public versus faith-based facilities. In multivariable analysis, suburban centers had less time for reflection than urban facilities (adjusted difference = -0.48; 95% CI: -0.95, -0.01; P = .046). Surgical team members reported more positive responses compared to surgical team leaders. We found a high overall positive response rate in characterizing organizational learning in surgery in 20 health facilities in Tanzania's Lake Zone. Our findings identify areas for improvement and provide a baseline for assessing the effectiveness of change initiatives. Future research should focus on validating the adapted survey and exploring the impact of strong learning environments on surgical outcomes in LMICs. Organizational learning is crucial in surgery and further research, funding, and policy work should be dedicated to improving learning cultures in health facilities.

Practices Used to Improve Patient Safety Culture Among Healthcare Professionals in a Tertiary Care Hospital.

A patient safety culture primarily refers to the values, beliefs, attitudes, and behaviors within a healthcare setup in a community that assists in prioritizing patient safety and encouraging the reporting of errors and near-misses in that facility. There is a direct impact of patient safety culture on how well patient safety and quality improvement programs work. The aim of this cross-sectional descriptive study was to investigate the practices to improve patient safety culture and adverse event reporting practices among healthcare professionals in a tertiary care hospital located in Mirpur Azad Jammu and Kashmir. In the non-probability convenience sampling of this cross-sectional study, Divisional Headquarters Teaching Hospital in Mirpur, Azad Kashmir used the Agency for Healthcare Research and Quality Surveys on Patient Safety Culture Hospital Survey to collect data about the perceptions of healthcare professionals regarding patient safety culture within their hospital to assess the trends of patient safety culture by obtaining longitudinal data. A pre-validated questionnaire that has undergone a rigorous trial of testing to maximize the reliability and accuracy of the outcomes was distributed among clinical staff (healthcare professionals who interact with patients on a daily basis, such as nurses, doctors, pharmacists, and laboratory technicians) and administrative staff (medical superintendent, deputy medical superintendent, assistant medical superintendent, heads of departments). A total of 312 questionnaires were returned (response rate, 76%). The study found that the dimension "supervisor/manager expectation and action promoting safety" had the highest positive response rate (65.16%), and "nonpunitive response" had the lowest (27.4%). Higher scores in "nonpunitive response to error" were associated with lower rates of medication errors, pressure ulcers, and surgical site infections, and higher scores in "frequency of event reporting" were associated with lower rates of medication errors, pressure ulcers, falls, hospital-acquired infections, and urinary tract infections. We suggest that in order for hospital staff to continue providing excellent, clinically safe treatment, a well-structured hospital culture promoting patient safety is necessary. Moreover, further study is needed to determine strategies to improve patient safety expertise and awareness, and lower the frequency of adverse occurrences.

Assessment of Patient Safety Culture in Midwives

Although there may be different definitions in national and international literature, patient safety, in general terms, encompasses all the precautions taken by healthcare professionals in healthcare institutions to prevent harm to individuals as a result of care delivery. It is an indispensable component of quality healthcare services. Patient safety, crucial in all healthcare services, becomes even more significant during the pivotal period of pregnancy, which is a physiological process but also involves a delicate balance between health and illness. Therefore, it is expected that midwives working in the delivery room, in particular, handle patient safety with utmost care. In recent years, with the increase in studies related to the culture of patient safety, the quality, satisfaction, and safety of care provided by midwives have also become subjects of investigation. This thesis aims to assess the levels of patient safety culture perception among midwives working in the delivery room, as well as to evaluate their opinions regarding patient safety and identify the behaviors influencing these opinions. The population of the study consists of midwives working in the delivery rooms of Muş and Bitlis provinces. The sample selection was not applied; all midwives who wished to participate in the study were included. Data analysis was conducted using the computer-assisted SPSS 22.0 software package. Percentage distributions were used in statistical evaluation, and for group comparisons, the significance was determined by the "Chi-square (X2) test" for categorical variables, the "t-test" for comparing means between two groups, and the "one-way ANOVA test" for evaluating the significance of differences among more than two group means. The level of statistical significance was accepted as p< 0.05 for all tests. Midwives' perceptions of patient safety culture were rated as moderate with 57%, and their patient safety ratings were determined to be "very good" with 44.4%. Within the scope of the hospital survey, among the 12 sub-areas of patient safety culture, "teamwork within units" had the highest positive response rate at 79.7%, while "non-punitive response to error" stood out with the lowest positive response percentage at 27.4%. The highest percentage of positive responses in the hospital survey regarding patient safety culture was determined to belong to the statement 'We work together as a team when there is a lot of work that needs to be done urgently, with 85.6%. The lowest percentage of positive responses was for the statement 'We work in crisis mode when there is a lot of work to be done and it needs to be done very quickly,' which was 12.2%." In the conducted comparisons, a significant relationship was found between midwives' working province, age groups, marital status, duration of employment in the institution, duration of work in the unit, professional experience, weekly working hours, and employment status parameters with the percentages of positive responses given to the sub-areas of the hospital survey on patient safety culture. When evaluating patient safety practices in the delivery room, factors affecting working conditions, adequacy of staff numbers, and patient safety should also be taken into consideration. In order for patient safety practices to be carried out comprehensively, regular training, involvement of midwives in the process, and active participation are required.

Dalbavancin real-life utilization among diabetic patients suffering from infections in Italy and Spain: The DALBADIA retrospective cohort study

ObjectivesTo retrospectively describe the patterns of use of dalbavancin for treating infections in diabetic patients in Italian and Spanish standard clinical practice. MethodsDALBADIA [NCT04959799] was a multicentre, observational, retrospective cohort study, conducted in Italy and Spain. The study enrolled 97 adults with type 1 or 2 diabetes mellitus, treated with dalbavancin as per standard clinical practice for a Gram-positive bacterial infection or the Gram-positive component of a mixed infection. ResultsDalbavancin was used to treat cellulitis (18/92 patients, 19.6%), followed by prosthetic joint infection (14 patients, 15.2%), endocarditis (13 patients, 14.1%), and primary bacteraemia (10 patients, 10.9%); 78/92 (84.8%) patients had Gram-positive infections only, and 14 (15.2%) had mixed infections. The most frequently isolated microorganisms were Staphylococcus aureus in 43 (55.8% of the patients with microbial isolation), 25.6% of which methicillin-resistant; Staphylococcus epidermidis in 13 (16.9%), 53.8% of which methicillin-resistant; Enterococcus faecalis in 11 (14.3%). The main reason for the dalbavancin choice was the intent to simplify the antibiotic regimen (81.5% of cases). A multidisciplinary team participated in the treatment choice process for 53 (57.6%) patients. Dalbavancin was given as first-line antibiotic in 34 (37.0%) patients and administered as one infusion in 32 (34.8%), and as two infusions in 39 (42.4%). In total, 57/62 (91.9%) eligible patients with available assessment were judged clinically cured or improved at the end of observation. ConclusionIn clinical practice, dalbavancin was used in diabetic patients to treat ABSSSIs and other difficult-to-treat infections with a favourable safety profile and a high rate of positive clinical responses.

Patient Safety Culture in the Southern Region of Saudi Arabia: A Survey among Community Pharmacies.

Measuring patient safety culture in the community pharmacy can help with identifying areas for development. The current study is a descriptive, cross-sectional, electronic survey conducted among pharmacists working in community pharmacies located in the southern region of Saudi Arabia. The community pharmacy version of the "Pharmacy Survey on Patient Safety Culture" (PSOPSC) was used to collect data. The positive response rate (PRR) was calculated as per the guidance provided by the Agency for Healthcare Research and Quality (AHRQ). Based on the PRR, two least-achieved items (<25%) were taken for further analysis to identify the possible predictors. A sum of 195 pharmacists were included in this study and most of them were working in chain pharmacies. The highest PRRs were observed with teamwork (94.99), and patient counseling (94.13), followed by physical space and environment (93.07). The lowest PRRs were observed with staffing, work pressure, and pace (47.70), followed by communication openness (72.60). Specific characteristics, such as experience and the number of working hours, are significantly related to a poor PRR. The current study results indicate that the scope for improving patient safety exists in various areas of community pharmacies. However, it is necessary to prioritize the need based on a positive response rate.

Racial Differences and Pedestrian Safety: Some Evidence from Maryland and Implications for Policy

In the 1990s, federal legislation was passed requiring transportation planning to incorporate the interests of all stakeholder groups. One urban transportation mode that is often ignored is pedestrian movement. A group particularly susceptible to difficulties in this mode is the elderly. This study surveys the attitudes of senior citizens in regard to pedestrian safety and motorist interactions. We examine the attitudes of elderly pedestrians concerning many aspects of pedestrian travel. The study finds that this group often views itself as disenfranchised. This study provides insight into what areas of pedestrian activity the elderly find troublesome and looks at the differences between urban and rural attitudes in regard to this issue.The results show that African Americans and Asians have a much higher rate of positive (safety conscious) responses to the questions in the survey. This indicates that they believe that they are more aware of pedestrian safety and that they comply with laws regarding pedestrian safety at a higher rate than their Caucasian counterparts. In addition, gender and geographical location seem to impact the responses. Urban seniors have a much higher positive response rate than suburban and ex-urban seniors.A comparison with previous work finds that these attitudes expressed in the survey are at odds with the known demographic data concerning who is at higher risk to be involved in a pedestrian accident. The increased awareness on the part of urban respondents is compatible with the more pedestrian-friendly environment of urban areas, but the racial difference in responses is not compatible with the accident data.

The COVID-19 Pandemic and Patient Safety Culture: A Cross-Sectional Study among Community Pharmacies in Jordan.

The COVID-19 pandemic has dramatically imposed stressful conditions that may impact the ability of healthcare staff to provide safe and effective care. Research on patient safety culture among community pharmacies during the pandemic is limited. This study aimed to assess the patient safety culture among community pharmacies in Jordan during the COVID-19 pandemic. Pharmacists and pharmacy assistants from 450 community pharmacies were approached through online means, with 378 answering the questionnaire written in Arabic that had been adapted from the Community Pharmacy Survey on Patient Safety Culture (PSOPSC). This study showed that various patient safety standards were addressed to a high degree during the COVID-19 pandemic, as represented by the high positive response rate (PRR) measures that were mainly observed in the dimensions “Teamwork” (90.1%), “Patient Counseling” (85.2%), and “Staff Training and Skills” (82.7%). Furthermore, significantly higher PRR scores for the “Teamwork”, “Staffing, Work Pressure, and Pace”, “Response to Mistakes”, “Organizational Learning—Continuous Improvement”, and “Overall Perceptions of Patient Safety” dimensions were observed among participants who worked in independent pharmacies than those who worked in chain pharmacies. Despite an overall positive patient safety culture in the current context of community pharmacies in Jordan during the COVID-19 pandemic, pitfalls were observed in the “Staffing, Work Pressure, and Pace” dimension.

Abstract 3923: Ubiquitin ligases implicated as predictive biomarkers for poor outcome to immunotherapy in melanoma patients

Abstract Background From a medical standpoint, melanoma is considered the most serious form of skin cancer. Immunotherapy treatment regimes frequently target the PD1 pathway and can be highly effective. Despite successes some patients remain unresponsive and a better understanding of what underlies these non-responders could enable better patient treatment stratification and an overall higher positive response rate. Here using unbiased mass spectrometry (LC-MS) proteomics profiling, we sought to identify protein biomarker signatures in patients with metastatic melanoma that correlate with the patients’ intervention responses. Via this discovery-based approach we identify a panel of protein biomarkers that correlate with an improved treatment response and could serve as a panel for patient stratification prior to commencement of immunotherapy regimes. Methods Formalin-fixed paraffin-embedded (FFPE) tumor samples were used for unbiased quantification of proteins using data-independent acquisition (DIA) LC-MS technology and Biognosys’ Spectronaut software. Patient samples were analyzed at the start of treatment (PD1 inhibitor) and classified as responders (n = 9) or non-responders (n = 15) at 3 months post-treatment. Significant protein expression changes between the two groups was determined by t-test (p &amp;lt; 0.01, log2 fold-change &amp;gt; 0.58) and further machine learning-assisted analysis was conducted. Additionally, patient’s tumor mutational burden (TMB) was analyzed. Results Analysis of the FFPE samples from anti-PD1-treated metastatic melanoma patients resulted in the identification and quantification of more than 9,000 proteins in total with an average of nearly 8,000 proteins per sample. Stratification of the patients into responders and non-responders led to the identification of 103 proteins that are significantly up- or down-regulated between the groups. Interestingly, proteins associated with ubiquitination pathways were significantly enriched among the identified regulated proteins with 7 proteins having significantly lower abundance in responders when compared to non-responders including various members of the ubiquitin ligase family. Further, a proteomic signature was identified that characterizes the responder and non-responder groups. Conclusions In this study we demonstrate the power of unbiased proteomic profiling for the characterization of melanoma patients and their responses to PD1-targeted immunotherapy. We identify a set of biomarkers associated with ubiquitination pathways that correlate with treatment outcome although these findings need to further be confirmed in orthogonal cohorts. Citation Format: Nigel Beaton, Tobias Treiber, Anna Juncker-Jensen, Xin-Xing Tan, Julia Martinez Gomez, Mitchell Levesque, Jakob Vowinkel. Ubiquitin ligases implicated as predictive biomarkers for poor outcome to immunotherapy in melanoma patients [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 3923.

The effectiveness and tolerability of clobazam in the pediatric population: Adjunctive therapy and monotherapy in a large-cohort multicenter study

ObjectiveTo evaluate the effectiveness and tolerability of clobazam therapy in the pediatric population in terms of seizure semiology, epileptic syndromes, and etiological subgroups. MethodsA retrospective cohort study was conducted consisting of 1710 epileptic children from eight centers in seven geographic regions of Turkey. The initial efficacy of clobazam therapy was evaluated after three months of treatment. The long-term effectiveness of the drug, overall seizure outcomes, and overall therapeutic outcomes were evaluated during 12 months of therapy. ResultsAnalysis of initial efficacy after the first three months of clobazam therapy showed that 320 (18.7 %) patients were seizure-free, 683 (39.9 %) had > 50 % seizure reductions, and 297 (17.4 %) had < 50 % seizure reductions. A positive response (seizure-free and >50 % seizure reduction) was determined for focal-onset (62.3 %) seizures, epileptic spasms (61.5 %), and generalized onset seisures (57.4). The highest positive response rate among the epileptıc syndromes was for self-limited epilepsy with centrotemporal spikes (SeLECTS). The highest negative response rate was for developmental and/or epileptic encephalopathies (DEEs). Magnetic resonance imaging (MRI) revealed a structural etiological diagnosis in 25.8 % of the cohort. A higher positive response rate was observed at MRI in patients with sequelae lesions than in those with congenital lesions. The seizure recurrence rate was higher in the patient group with epilepsy wıth genetic and metabolic causes, in individuals with more than one seizure type, and in those using three or more antiseizure drugs. ConclusionsThis cohort study provides additional evidence that clobazam is an effective and well-tolerable drug with a high seizure-free rate (18.7 %), a significant seizure reduction rate (57.3 %), and with excellent overall therapeutic outcomes with a low seizure relapse rate and considerable reversible benefits in the pediatric population.

Knowledge, attitudes, and practice with respect to antibiotic use among pharmacy students: a cross-sectional study.

Antibiotic resistance is a major health threat and efforts should be intensified to reduce its burden. Healthcare providers, especially pharmacists, can be actively involved in the reduction of antibiotic resistance. However, negative practices among pharmacists have been observed. This study evaluated knowledge, attitudes, and practices (KAP) among Jordanian pharmacy students. A cross-sectional study used an online questionnaire that was developed and distributed to Jordanian pharmacy students from five different universities. KAP scores were calculated, with students categorized into low and high levels based on each score mean. A total of 890 pharmacy students completed the questionnaire. High positive response rate (PR%) for the majority of the knowledge items was observed, exceeding 60% in all knowledge items, and similar PR% was observed in attitude items. The variables significantly associated with attitude were age [OR=0.92 (95% CI 0.87: 0.98), p=0.01] and knowledge [OR=1.35 (95% CI 1.01:1.82), p=0.04], while knowledge was significantly associated with practice [OR=0.23 (95% CI 0.16:0.31), p<0.001]. Jordanian pharmacy students showed adequate KAP toward the use of antibiotics although several aspects of malpractice were identified. Hence, adequate knowledge about antibiotics among pharmacy students should be ensured as knowledge is associated with attitudes and practices.

Văn hóa an toàn người bệnh của nhân viên y tế tại Bệnh viện Nhi Trung ương năm 2020- 2021 và một số yếu tố liên quan

Objective: Describe the views and opinions of health staffs and analyse some related factors on patient safety culture at the National Children's Hospital in 2020-2021. Methods: A cross-sectional descriptive study was performed on 252 medical staffs of the National Children's Hospital from October 1st, 2020 to May 31st, 2021. Results: The percentage of medical staffs with a positive feedback about the overall patient safety culture was 67.5%. The high rate of positive responses were in the areas of faculty feedback and communication (97.6%); views and actions of managers (97.6%); general awareness of patient safety (94.4%) and the relationship and working with the team in the same department (96.2%). Some feedbacks are not active in areas such as open communication (73%), personnel (61.5%), culture of punishment when making mistakes (44.4%) and frequency of recording receive incidents (19.4%). Factors related to patient safety culture are the number of years of medical staff experience (OR= 2.56, CI 95%: 1.46- 4.5), average working hours (OR=6.3, CI 95%: 1.83 - 22.01), department facilities (OR=3.06, CI 95%: 1,7- 5.52), and patient safety training (OR=3 .64, CI 95%: 1.66-7.98). Keywords: Patients safety culture, health staff, National Children's Hospital.

The situation and related factors on patient safety culture of health workers at Vietnam – Cuba Friendship Hospital in 2020

Objective: To describe the situation and analyze some related factors on the patient safety culture of health workers at Vietnam - Cuba Friendship Hospital in 2020 Methods: This is a cross-sectional study that combines qualitative and quantitative methods, conducted at Vietnam - Cuba Friendship Hospital, from February to November 2020. The quantitative research was using HSOPSC toolkit to consult 165 doctors, nurses/technicians; and conducting 12 in-depth interviews. Quantitative data were analyzed by using SPSS software and the qualitative one was recorded, analyzed, and synthesized with each group of influencing factors. Main findings: The overall positive response rate with patient safety culture is 73.9%. The highest positive response rate is 94.2% with “Teamwork within units” dimension and the lowest rated dimension was 50.1% with “Nonpunitive response to error” dimension. The low and middle-income group rated the level of internal safety higher than the high-income group (p = 0.001), and positively response rate to patient safety culture of health workers at Internal Medicine Department is higher than that at Surgery and Subclinical Departments (p &lt;0.05). In-depth interviews showed management concerns, process/regulation systems, patient safety training, adverse event reporting systems, punishment mechanism and monitoring activities are factors affecting patient safety culture. Conclusions and recommendation: Communication about medical adverse event management for all health staff of the hospital and application of the patient safety culture should be improved. Keywords: patient safety culture, impacting factors, Vietnam – Cuba Friendship Hospital

Association of shared decision making with inpatient satisfaction: a cross-sectional study

BackgroundWe assessed inpatient perceived shared decision making (SDM) and tested the association of SDM with inpatient satisfaction in public tertiary hospitals in Shanghai, China.MethodsA cross-sectional survey of 2585 inpatients in 47 public tertiary hospitals in Shanghai in July and August 2018 was conducted. We assessed overall SDM and 4 aspects of SDM and tested the factors influencing SDM and the association of SDM with patient satisfaction (patient satisfaction with physician services, medical expenses, outcomes and overall inpatient care), by adopting linear or two-level regression models.ResultsThe positive response rate (PRR) and high positive response rate (HPRR) to overall SDM among the inpatients of public tertiary hospitals in Shanghai were relatively high (95.30% and 87.86%, respectively), while the HPRR to “My physician informed me of different treatment alternatives” was relatively low (80.09%). In addition, the inpatients who underwent surgery during admission had higher HPRRs and adjusted HPRRs to overall SDM than those who did not undergo surgery. The study showed that the adjusted high satisfaction rates (HSRs) with physician services, medical expenses, outcomes and overall inpatient care among the inpatients with high level of overall SDM were higher (96.50%, 68.44%, 89.50% and 92.60%) than those among the inpatients without a high level of overall SDM (71.77%, 35.19%, 57.30% and 67.49%). The greatest differences in the adjusted HSRs between the inpatients with and without a high level of SDM were found in inpatient satisfaction with medical expenses and informed consent in SDM. Moreover, 46.22% of the variances in the HSRs with overall inpatient care across the hospitals were attributed to the hospital type (general hospitals vs. specialty hospitals).ConclusionsInpatient PRRs and HPRRs to SDM in public tertiary hospitals in Shanghai are relatively high overall but lower to information regarding alternatives. SDM can be affected by the SDM preference of both the patients and physicians and medical condition. Patient satisfaction can be improved through better SDM and should be committed at the hospital level.

Road towards promoting patient safety practices among hospital pharmacists: Hospital-based baseline patient safety culture assessment cross-sectional survey.

Patient safety is a fundamental aspect of a healthcare system. The aim of this study was to assess the perception and determinants of the patient safety culture of pharmacists in hospitals, in Riyadh, Saudi Arabia.A survey was conducted with pharmacists in the pharmacies of governmental, /military and private hospitals in Riyadh, Saudi Arabia. The pharmacy survey on patient safety culture questionnaire developed by Agency for Healthcare Research and Qualtity, a hard copy was distriuted to the pharmacists. The positive response rate (RR) was calculated and compared across hospitals using a chi-square test. The predictors of patient safety grades were identified using the generalized estimating equation. The data was analyzed using SAS.A total of 538 questionnaires were distributed, of which 411 responded (RR 76.4%). Of the participants, 229 (56%) were females. The majority 255 (62%) were in the 18 to 34 years age range, and 361 (88%) had a bachelor's degree. The majority of the sample 376 (92%) was a pharmacist. The Positive RR (PRR) ranged between (25.6%–74%). The highest PRR was observed in teamwork (74.4%), followed by ‘staff, training and skills’ (68%), and ‘organizational learning continuous improvement’ (66%). The lowest PRR was observed in ‘staffing, work pressure, and pace’ (25.5%). Comparing the PPR of the various healthcare sectors, the governmental hospitals scored the highest in all patient safety domains. Generalized Estimating Equation analysis showed that with increase in scores of all patient safety culture domains increased the likelihood of reporting a better patient safety grade, whereas respondents’ demographic characteristics had no effect except the working experience years 6 years and above had odds of poor reporting of the patient safety grade (odds ratio = 2.54, 95% confience interval (1.543, 4.194), (P = .0003).The grades achieved in the various domains of patient safety culture by pharmacists in Riyadh are below the expected standard. The highest scores were achieved in teamwork, with the lowest scores in staffing, work pressure and pace. Overall, pharmacists in government hospital settings have a better perception of patient safety than their peers in other settings. These results provide the baseline evidence for developing future interventional studies aiming at improving patient safety culture in hospital pharmacy settings.

Predictors for Positive Response to Home Kinematic Training in Chronic Neck Pain

ObjectivesThere is strong evidence for exercise therapy in neck pain, but a wide variety of protocols. Predictors for outcome are unknown and current practice is based on trial and error. The objective of this study was to identify predictors for response to home kinematic training (KT) considering improvement in both self-reported and kinematic measures. MethodsA continuing analysis of data from the second phase of a randomized controlled trial, which included 4 weeks of KT using laser or virtual reality, with baseline, postintervention, and 3-month follow-up measures. Positive self-reported response was defined as a ≥50% pain reduction, ≥7% reduction in neck disability index (NDI), or a global perceived effect of 3 to 5 of 5. A second model defined improvement by ≥40% increase in cervical velocity. ResultsData were retrieved from 79 participants with chronic neck pain who completed the postintervention evaluation and 52 who completed the 3-month follow-up. Self-reported response was 71% to 73% and kinematic response was 41% to 46%. Prediction models indicated an immediate increase in self-reported measures in men with NDI ≥ 20% slower (≤65°/s), and less accurate (≥16° error) cervical motion at baseline. In the longer term, older patients with higher NDI seemed to benefit more. In the second model, no factors significantly predicted improvement in kinematic measures at either time point. ConclusionA high positive response rate to home KT was found by self-reported criteria. Males with poorer clinical and kinematic presentation at baseline, that is greater disability and slower neck motion, were more likely to respond.

Evaluation of patient safety culture among community pharmacists in Ethiopia: A cross-sectional study.

ObjectiveThe study was aimed to explore patient safety culture of community pharmacists working in Dessie and Gondar towns, Northern Ethiopia.MethodsA cross-sectional study was conducted from 1st to 31st March 2018. In this cross-sectional survey, the Pharmacy Survey on Patient Safety Culture (PSOPSC), developed by the Agency for Healthcare Research and Quality (AHRQ), was used to collect data. PSOPSC is a self-administered questionnaire. The questionnaire was distributed among staffs who work in community pharmacies of Dessie and Gondar towns. All staffs available on data collection period in the pharmacy were included. The Statistical Package for Social Science (SPSS) software version 25 was used to enter and analyze the data.ResultsA total of 120 participants were approached and completed the questionnaire. Results from the study showed that high positive response rate was demonstrated in the domains of “Teamwork” (90.2%) followed by physical space and environment (83.1%). On the other hand, the result also identified that there is an enormous problem related to mistake communication (44.8%) and work pressure (45%). In addition, significant difference of percent positive responses were obtained across towns and staff working hours.ConclusionsThe patient safety culture of community pharmacists is appreciable especially with respect to their teamwork. Besides, urgent attention should be given to areas of weakness, mainly in the domain of “mistake communication” and “staffing and work pressure”.

Learning for development: Learners’ perceptions of the impact of the Kha Ri Gude Literacy Campaign

Abstract This article describes how the Kha Ri Gude Literacy Campaign in South Africa utilized an enriched literacy curriculum in enliterating 4.7 million adult learners who, as a result of the legacy of apartheid in South Africa, had little or no education. The article uses a mixed-methods approach—mixing quantitative and qualitative data—to determine what adult learners considered to be important benefits of initial literacy. Moreover, it explores the extent to which these benefits correlated with the developmental intent which aimed, by using MDG/SDG inspired themes, to impact on the social, economic and developmental opportunities that might be afforded by literacy acquisition. The article analyzes the responses obtained from a sample of 485,941 literacy learners to a 24-item instrument which sought to establish learner perceptions of the benefits (or lack thereof) of their participation in the literacy campaign. The high rate of positive responses showed that the majority of the learners perceived the campaign to have benefited them with regard to their feelings of self-confidence, their ability to participate in community matters, increased understandings of health issues, increased involvement in income generation, technological abilities, as well as in increasing their appetite for lifelong learning. The quantitative findings were triangulated with the findings of the learner interviews conducted with learners who had completed the program in the previous two to five years. In addition to focusing on the responses of learners who perceived the campaign to have had positive impacts, further quantitative analyses were conducted on the responses of those learners who gave negative feedback. It is believed that both the positive impact and the non-impactful findings reported in this article will allow for a closer tailoring of literacy programs in order to maximize their developmental potential.

Design and development of a spatial mixed reality touring guide to the Egyptian museum

Many public services and entertainment industries utilise Mixed Reality (MR) devices to develop highly immersive and interactive applications. However, recent advancements in MR processing has prompted the tourist and events industry to invest and develop commercial applications. The museum environment provides an accessible platform for MR guidance systems by taking advantage of the ergonomic freedom of spatial holographical Head-mounted Displays (HMD). The application of MR systems in museums can enhance the typical visitor experience by amalgamating historical interactive visualisations simultaneously with related physical artefacts and displays. Current approaches in MR guidance research primarily focus on visitor engagement with specific content. This paper describes the design and development of a novel museum guidance system based on the immersion and presence theory. This approach examines the influence of interactivity, spatial mobility, and perceptual awareness of individuals within MR environments. The developmental framework of a prototype MR tour guide program named MuseumEye incorporates the sociological needs, behavioural patterns, and accessibility of the user. This study aims to create an alternative tour guidance system to enhance customer experience and reduce the number of human tour guides in museums. The data gathering procedure examines the functionality of the MuseumEye application in conjunction with pre-existing pharaonic exhibits in a museum environment. This methodology includes a qualitative questionnaire sampling 102 random visitors to the Egyptian Museum in Cairo. Results of this research study indicate a high rate of positive responses to the MR tour guide system, and the functionality of AR HMD in a museum environment. This outcome reinforces the suitability of the touring system to increase visitor experience in museums, galleries and cultural heritage sites.

Smart exercise application to improve leg function and short-term memory through game-like lunge exercises

The purpose of this study was to evaluate the functionality, accuracy, and usability of a novel smart exercise application (SEA). The functionality such as counting lunges, providing task-related auditory feedback, and testing short-term memory was examined while thirteen young adults (six men, age 25.4 ± 8.3 years) performed the lunge exercise with the SEA. The accuracy of logged motion data including angles and accelerations were also tested. Another twenty-five participants (11 men, age 23.2 ± 5.7 years) evaluated the usability of the SEA interest, motivation, convenience, and strength/cognitive benefit via a questionnaire. The SEA assessed the lunge motion correctly, provided auditory feedback, and tested users’ short-term memory as required. High correlations (r = 0.90 to 0.99) with low RMSE (4.85˚ for direction angle, 0.13 to 0.22 m/s2 for acceleration) were observed between the sensor output and the reference output. Bland-Altman plot also showed a low discrepancy between each of the two measures. Most participants positively answered all questions about interest (60%), motivation (40%), convenience (80%), strength benefits (92%), and cognitive benefits (88%) of the SEA. The SEA demonstrated accurate kinematic assessment of accelerations and directions, assessed the lunge motion correctly, and created the appropriate auditory feedback on the short-term memory task. The high rate of positive responses suggested the potential of the application in future use.