Scotland and alternatives to neoliberalism

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Assessment of patient safety culture in an adult oncology department in Saudi Arabia

Objectives: The aim of this research was to evaluate patient safety culture across different healthcare professionals from different countries of origin working in an adult oncology department at King Fahad Medical City. Methods: This was a cross-sectional survey of 130 healthcare staff (doctors, pharmacists, nurses) working in an adult oncology department in Saudi Arabia. We used the Hospital Survey of Patient Safety Culture (HSOPSC) to examine perceptions of safety culture during the month of February 2017. Data were analysed using SPSS v24 for descriptive statistical analysis, calculating composite positivity, and running t-test, ANOVA test, and linear regression to identify factors influencing the patient safety culture. Result: 127 of 130 questionnaires were returned, yielding a response rate of 97.7%. Eight out of the twelve HSOPSC composites were considered as areas for improvement (percent positivity < 50%). Significantly different mean scores were observed across the three professional groups in all twelve HSOPSC composites. Doctors tended to rate patient safety culture significantly more positively than nurses or pharmacists. Nurses scored significantly lower than pharmacists in the majority of HSOPSC composites. No significant differences in patient safety culture composite scores were observed between Saudi/Gulf Cooperation Council (GCC) and non-Saudi/GCC groups. Regression analysis showed that frequency of reported events is predicted by feedback and communication about errors, and teamwork across units, while perception of patient safety is associated with respondents’ profession and teamwork across units. Conclusion: This study brings to the fore the assumption that all healthcare professionals have a shared understanding of patient safety. We urge healthcare leaders and policy makers to look at patient safety culture at this granular level in their contexts, and use this information to develop strategies and training to improve patient safety culture

Exploring healthcare professionals’ perceptions of medication errors in an adult oncology department in Saudi Arabia: A qualitative study

Objective: Adverse events which result from medication errors are considered to be one of the most frequently encountered patient safety issues in clinical settings. We undertook a qualitative investigation to identify and explore factors relating to medication error in an adult oncology department in Saudi Arabia from the perspective of healthcare professionals.\ud Methods: This was a qualitative study conducted in an adult oncology department in Saudi Arabia. After obtaining required ethical approvals and written consents from the participants, semi-structured interviews and focus group discussions were carried out for data collection. A stratified purposive sampling strategy was used to recruit medical doctors, pharmacists, and nurses. NVivo Pro version 11 was used for data analyses. Inductive thematic analysis was adopted in the primary coding of data while secondary coding of data was carried out deductively applying the Hospital Survey of Patient Safety Culture (HSOPSC) framework. Result: The total number of participants were 38. Majority of the participants were nurses (n = 24), females (n = 30), and not of Saudi nationality (n = 31) with an average age of 36 years old. Causes of medication errors were categorized into 6 themes. These causes were related teamwork across units, staffing, handover of medication related information, accepted behavioural norms, frequency of events reported, and non-punitive response to error. Conclusion: There were numerous causes for medication errors in the adult oncology department. This means substantive improvement in medication safety is likely to require multiple, inter-relating, complex interventions. More research should be conducted to examine context-specific interventions that may have the potential to improve medication safety in this and similar departments

Women’s responses to changes in U.S. preventive task force’s mammography screening guidelines: results of focus groups with ethnically diverse women

Background: The 2009 U.S. Preventive Services Task Force (USPSTF) changed mammography guidelines to recommend routine biennial screening starting at age 50. This study describes women’s awareness of, attitudes toward, and intention to comply with these new guidelines. Methods: Women ages 40–50 years old were recruited from the Boston area to participate in focus groups (k = 8; n = 77). Groups were segmented by race/ethnicity (Caucasian = 39%; African American = 35%; Latina = 26%), audio-taped, and transcribed. Thematic content analysis was used. Results: Participants were largely unaware of the revised guidelines and suspicious that it was a cost-savings measure by insurers and/or providers. Most did not intend to comply with the change, viewing screening as obligatory. Few felt prepared to participate in shared decision-making or advocate for their preferences with respect to screening. Conclusions: Communication about the rationale for mammography guideline changes has left many women unconvinced about potential disadvantages or limitations of screening. Since further guideline changes are likely to occur with advances in technology and science, it is important to help women become informed consumers of health information and active participants in shared decision-making with providers. Additional research is needed to determine the impact of the USPSTF change on women’s screening behaviors and on breast cancer outcomes

Ouch! Recruitment of Overweight and Obese Adolescent Boys for Qualitative Research

The purpose of this study is to examine the complexities of recruiting overweight and obese adolescent boys for qualitative research, discuss specific recruitment considerations for this population, and offer guidance to researchers interested in recruiting overweight adolescent boys. Three overweight adolescent boys and six community professionals participated in this study. Data collection methods included fieldwork observations (60 hours) and person-centered interviews (N=9). Emergent themes revealed that establishing trust, understanding the sensitivities of discussing obesity, and considering adolescent boys’ fears of sharing personal information may have enhanced recruitment success. Researchers should consider the importance of building relationships with professionals who can recruit vulnerable adolescents, as well as the time required to establish trust with both overweight adolescent boys and their parents

Causes and consequences of spatial variation in sex ratios in a declining bird species

1. Male-biased sex ratios occur in many bird species, particularly in those with small or declining populations, but the causes of these skews and their consequences for local population demography are rarely known. Within-species variation in sex ratios can help to identify the demographic and behavioural processes associated with such biases. 2. Small populations may be more likely to have skewed sex ratios if sex differences in survival, recruitment or dispersal vary with local abundance. Analyses of species with highly variable local abundances can help to identify these mechanisms and the implications for spatial variation in demography. Many migratory bird species are currently undergoing rapid and severe declines in abundance in parts of their breeding ranges, and thus have sufficient spatial variation in abundance to explore the extent of sex ratio biases, their causes and implications. 3. Using national-scale bird ringing data for one such species (willow warbler, Phylloscopus trochilus), we show that sex ratios vary greatly across Britain, and that male-biased sites are more frequent in areas of low abundance, which are now widespread across much of south and east England. These sex ratio biases are sufficient to impact local productivity, as the relative number of juveniles caught at survey sites declines significantly with increasing sex ratio skew. 4. Sex differences in survival could influence this sex ratio variation, but we find little evidence for sex differences in survival increasing with sex ratio skew. In addition, sex ratios have become male-biased over the last two decades but there are no such trends in adult survival rates for males or females. This suggests that lower female recruitment into low abundance sites is contributing to these skews. 5. These findings suggest that male-biased sex ratios in small and declining populations can arise through local-scale sex-differences in survival and dispersal, with females recruiting disproportionately into larger populations. Given the high level of spatial variation in population declines and abundance of many migratory bird species across Europe at present, male-biased small populations may be increasingly common. As singing males are the primary records used in surveys of these species, and as unpaired males often sing throughout the breeding season, local sex ratio biases could also be masking the true extent of these population declines

Comparing leakage currents and dark count rates in Geiger-mode avalanche photodiodes

This letter presents an experimental study of dark count rates and leakage current in Geiger-mode avalanche photodiodes (GM APD). Experimental results from circular diodes over a range of areas (20-500 mum diam), exhibit leakage current levels orders of magnitude higher than anticipated from dark count rates. Measurements of the area and peripheral components of the leakage current indicate that the majority of the current in reverse bias does not enter the high-field region of the diode, and therefore, does not contribute to the dark count rate. Extraction of the area leakage current term from large-area devices (500 mum) corresponds well with the measured dark count rates on smaller devices (20 mum). Finally, the work indicates how dark count measurements represent 10(-18) A levels of leakage current detection in GM APDs. (C) 2002 American Institute of Physics. (DOI: 10.1063/1.1483119