The culture of patient safety from the perspective of the pediatric emergency nursing team

OBJETIVO Identificar la cultura de seguridad del paciente en urgencias pediátricas, en la perspectiva del equipo de enfermería. MÉTODO Investigación cuantitativa, tipo survey transversal. Muestra compuesta de 75 profesionales del equipo de enfermería. Datos recolectados entre septiembre y noviembre de 2014, en tres Urgencias Pediátricas, aplicando el instrumento Hospital SurveyonPatient Safety Culture. Datos sometidos al análisis descriptivo. RESULTADOS No fueron encontradas áreas de fuerza para la seguridad del paciente, siendo identificadas áreas con potencial de convertirse así: Expectativas y acciones del supervisor/jefatura para promoción de la seguridad del paciente y Trabajo en equipo. Como área crítica se identificaron: Respuesta no punitiva al error y Apoyo de la gestión hospitalaria para seguridad del paciente. El estudio señaló alejamiento entre la cultura de seguridad y las urgencias pediátricas; sin embargo, vislumbró posibilidades de transformación que contribuirán a la seguridad del paciente pediátrico. CONCLUSIÓN Los profesionales de enfermería necesitan hacerse protagonistas en el proceso de reemplazo del actual paradigma hacia una cultura enfocada en la seguridad. Se sugiere la replicación de este estudio en otras instituciones a fin de perfeccionar el actual escenario de asistencia sanitaria.OBJECTIVE To identify the patient safety culture in pediatric emergencies from the perspective of the nursing team. METHOD A quantitative, cross-sectional survey research study with a sample composed of 75 professionals of the nursing team. Data was collected between September and November 2014 in three Pediatric Emergency units by applying the Hospital Survey on Patient Safety Culture instrument. Data were submitted to descriptive analysis. RESULTS Strong areas for patient safety were not found, with areas identified having potential being: Expectations and actions from supervisors/management to promote patient safety and teamwork. Areas identified as critical were: Non-punitive response to error and support from hospital management for patient safety. The study found a gap between the safety culture and pediatric emergencies, but it found possibilities of transformation that will contribute to the safety of pediatric patients. CONCLUSION Nursing professionals need to become protagonists in the process of replacing the current paradigm for a culture focused on safety. The replication of this study in other institutions is suggested in order to improve the current health care scenario.OBJETIVO Identificar a cultura de segurança do paciente em emergências pediátricas, na perspectiva da equipe de enfermagem. MÉTODO Pesquisa quantitativa, tipo survey transversal. Amostra composta por 75 profissionais da equipe de enfermagem. Dados coletados entre setembro e novembro de 2014, em três Emergências Pediátricas, aplicando o instrumento Hospital Survey on Patient Safety Culture. Dados submetidos à análise descritiva. RESULTADOS Não foram encontradas áreas de força para a segurança do paciente, sendo identificadas áreas com potencial de assim se tornarem: Expectativas e ações do supervisor/chefia para promoção da segurança do paciente e Trabalho em equipe. Como área crítica identificaram-se: Resposta não punitiva ao erro e Apoio da gestão hospitalar para segurança do paciente. O estudo apontou distanciamento entre a cultura de segurança e as emergências pediátricas, porém vislumbrou possibilidades de transformação, que contribuirão para segurança do paciente pediátrico. CONCLUSÃO Os profissionais de enfermagem precisam se tornar protagonistas no processo de substituição do atual paradigma para uma cultura focada na segurança. Sugere-se replicação deste estudo em outras instituições a fim de aprimorar o atual cenário de assistência à saúde

Dissociation of the effects of ethanol on memory, anxiety, and motor behavior in mice tested in the plus-maze discriminative avoidance task

Rationale Several studies have shown the amnestic effects of ethanol (ETOH). However, while memory tasks in rodents can be markedly influenced by anxiety-like behavior and motor function, ETOH induces anxiolysis and different effects on locomotion, depending on the dose.Objective Verify the effects of ETOH in mice tested in the plus-maze discriminative avoidance task (PMDAT) concomitantly evaluating memory, anxiety-like behavior, and motor behavior.Methods ETOH acutely or repeatedly treated mice were submitted to the training session in a modified elevated plus-maze with two open and two enclosed arms, aversive stimuli in one of the enclosed arms, and tested 24 h later without aversive stimuli. Learning/memory, locomotion, and anxiety-related behavior were evaluated by aversive arm exploration, number of entries in all the arms and open arms exploration, respectively.Results Acute ETOH: (1) either increased (1.2-1.8 g/kg) or decreased (3.0 g/kg) locomotion; (2) decreased anxiety levels (1.2-3.0 g/kg); and (3) induced learning deficits (1.2-3.0 g/kg) and memory deficits (0.3-3.0 g/kg). After repeated treatment, sensitization and tolerance to hyperlocomotion and anxiolysis induced by 1.8 g/kg ETOH were observed, respectively, and tolerance to the amnestic effect of 0.6 (but not 1.8) g/kg ETOH occurred.Conclusion Neither the anxiolytic nor the locomotor effects of ETOH seem to be related to its amnestic effect in the PMDAT. Additionally, data give support to the effectiveness of the PMDAT in simultaneously evaluating learning, memory, anxiety-like behavior, and motor activity by different parameters. Possible relationships between the behavioral alterations found are discussed.Univ Fed Rio Grande do Norte, Dept Fisiol, BR-59072970 Natal, RN, BrazilUniversidade Federal de São Paulo, Dept Pediat, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Farmacol, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Pediat, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Farmacol, São Paulo, BrazilWeb of Scienc

Spider–Plant Interactions: An Ecological Approach

Spiders are among the most common animals in diverse terrestrial environments, and display a variety of lifestyles and foraging modes. This chapter represents an overview of our knowledge of spider–plant interactions. Spiders are strongly influenced by plant architecture, rather than being randomly distributed in the vegetation; structures such as rosette-shaped clusters of leaves or glandular trichomes are particularly common in plants that have associations with spiders. Spiders derive benefits from plants such as shelter and access to insect prey. In turn, they can protect plants against herbivory. However, they may also consume or deter pollinators, imposing a cost that can exceed their benefit to the plant. Specific spider–plant associations are mutualistic if spiders provide protective or nutritional benefits, thus improving plant fitness, and if plants provide shelter and suitable foraging sites to spiders. We examine several case studies of spiders living in association with plants, and describe spatial/temporal adaptations in spider–plant relationships

Anthropogenic effects on interaction outcomes: examples from insect-microbial symbioses in forest and savanna ecosystems

The influence of humans on ecosystem dynamics has been, and continues to be, profound. Anthropogenic effects are expected to amplify as human populations continue to increase. Concern over these effects has given rise to a large number of studies focusing on impacts of human activities on individual species or on biotic community structure and composition. Lacking are studies on interactions, particularly mutualisms. Because of the role of mutualisms in ecosystem stability, such studies are critically needed if we are to begin to better understand and predict the responses of ecosystems to anthropogenic change. Most organisms are involved in at least one mutualism, and many in several. Mutualisms facilitate the ability of partners to exploit particular habitats and resources, and play a large role in determining ecological boundaries. When change disrupts, enhances, or introduces new organisms into a mutualism, the outcome and stability of the original partnership(s) is altered as are effects of the symbiosis on the community and ecosystem as a whole. In this paper, using examples from six microbe-insect mutualisms in forest and savanna settings, we showcase how varied and complex the responses of mutualisms can be to an equally varied set of anthropogenic influences. We also show how alterations of mutualisms may ramify throughout affected systems. We stress that researchers must be cognizant that many observed changes in the behaviors, abundances, and distributions of organisms due to human activities are likely to be mediated by mutualists which may alter predictions and actual outcomes in significant ways.Department of Science and Technology/National Research Foundation Centre of Excellence in Tree Health Biotechnology, The Carlsberg Foundatio