An evaluation of patient safety culture in a secondary care setting in Kuwait

Objectives: To improve patient safety outcomes, it is considered essential to create a positive culture of patient safety. This study carried out an initial evaluation of the patient safety culture in a secondary care setting in Kuwait. Methods: This cross-sectional questionnaire study was conducted in a general hospital medical department in Kuwait, using the Hospital Survey on Patient Safety Culture (HSPSC). Multiple linear regression analyses were used to identify patient safety culture predictors. Both an ANOVA and a Kruskal Wallis test were carried out to assess the differences between participants' total scores and the scores they achieved in each dimension, categorized by nationality. Results: A total of 1008 completed questionnaires were received, yielding a response rate of 75.2%. Three dimensions of patient safety culture were found to be priority areas for improvement: non-punitive responses to errors, staffing, and communication openness. Teamwork within units and organizational learning with continuous improvement were identified as areas of strength. Respondents from Kuwait and the Gulf State countries had a less positive perception of the hospital's patient safety culture than did Asian respondents. A regression analysis showed that the respondents' countries of origin, professions, age, and patient safety course/lecture attendance were significantly correlated with their perceptions of the hospital's patient safety culture. Conclusion: This study demonstrates that patient safety is perceived differently by medical staff members from different countries of origin, professional groups, and age groups. These variables must be acknowledged and addressed when planning or evaluating patient safety initiatives

A 20 year observational cohort of a 5 million patient population - tonsillectomy rates in the context of two national policy changes

AIM: To report national trends for tonsillectomy, tonsillitis, peri-tonsillar abscess and deep neck space infection in secondary care. To report national trends in sore throat consultations in primary care. To report national trends in antibiotic prescribing in both primary and secondary care between 2011 and 2015. DESIGN: Retrospective nationwide cohort study. Data requested from Information Statistics Department (ISD) Scotland for tonsillectomy, tonsillitis admissions, peri-tonsillar abscess admissions and deep neck space infection (DNSI) admissions in Scotland, between 1993/94 and 2015/16. Data for antibiotic prescriptions in general practice and hospital admissions between 2011 - 2015. SETTING: Scottish ENT departments and GP practices. PARTICIPANTS: Scottish patients who underwent tonsillectomy, or were admitted to hospital with tonsillitis, peritonsillar abscess or deep neck space infection. Scottish patients that attended their GP with tonsillitis. RESULTS: Tonsillectomy rates between 1993/94 and 2015/16 decreased by 48% (p<0.001). Over the same time period there has been a corresponding 136% increase in tonsillitis admission(p<0.001) and a 167% increase in peri-tonsillar abscess admissions, (p<0.001). Between 1996/97 and 2015/16 there was a 500% increase in deep neck space abscesses (p<0.001). CONCLUSION: There has been a significant decrease in tonsillectomy rates over the past two decades. Over the same time period there has been a significant increase in admissions to secondary care with tonsillitis, peri-tonsillar abscess and deep neck space infection. These changes have happened in the context of two separate national policies being introduced - SIGN guidelines for management of sore throat and the Scottish Reduction in Antibiotic Prescribing

Synthesis of palm oil-based fatty methylhydrazide

Fatty methylydrazides (FMHs) have been successfully synthesized from palm oil. Glycerol was produced as a by-product. The synthesis was carried out by reflux palm oil with methylhydrazine in hexane. FMHs have been characterized using elemental analysis, Fourier transform infrared spectroscopy and 1H nuclear magnetic resonance technique. The results showed that a 6:1 molar ratio of palm oil to methylhydrazine, a round 78 % maximum conversion of palm oil into FMHs and a 10 h reaction time are the optimum reaction conditions

Large-Scale Model-Based Assessment of Deer-Vehicle Collision Risk

Ungulates, in particular the Central European roe deer Capreolus capreolus and the North American white-tailed deer Odocoileus virginianus, are economically and ecologically important. The two species are risk factors for deer–vehicle collisions and as browsers of palatable trees have implications for forest regeneration. However, no large-scale management systems for ungulates have been implemented, mainly because of the high efforts and costs associated with attempts to estimate population sizes of free-living ungulates living in a complex landscape. Attempts to directly estimate population sizes of deer are problematic owing to poor data quality and lack of spatial representation on larger scales. We used data on 74,000 deer–vehicle collisions observed in 2006 and 2009 in Bavaria, Germany, to model the local risk of deer–vehicle collisions and to investigate the relationship between deer–vehicle collisions and both environmental conditions and browsing intensities. An innovative modelling approach for the number of deer–vehicle collisions, which allows nonlinear environment–deer relationships and assessment of spatial heterogeneity, was the basis for estimating the local risk of collisions for specific road types on the scale of Bavarian municipalities. Based on this risk model, we propose a new “deer–vehicle collision index” for deer management. We show that the risk of deer–vehicle collisions is positively correlated to browsing intensity and to harvest numbers. Overall, our results demonstrate that the number of deer–vehicle collisions can be predicted with high precision on the scale of municipalities. In the densely populated and intensively used landscapes of Central Europe and North America, a model-based risk assessment for deer–vehicle collisions provides a cost-efficient instrument for deer management on the landscape scale. The measures derived from our model provide valuable information for planning road protection and defining hunting quota. Open-source software implementing the model can be used to transfer our modelling approach to wildlife–vehicle collisions elsewhere

Osteochondral defects in the ankle: why painful?

Osteochondral defects of the ankle can either heal and remain asymptomatic or progress to deep ankle pain on weight bearing and formation of subchondral bone cysts. The development of a symptomatic OD depends on various factors, including the damage and insufficient repair of the subchondral bone plate. The ankle joint has a high congruency. During loading, compressed cartilage forces its water into the microfractured subchondral bone, leading to a localized high increased flow and pressure of fluid in the subchondral bone. This will result in local osteolysis and can explain the slow development of a subchondral cyst. The pain does not arise from the cartilage lesion, but is most probably caused by repetitive high fluid pressure during walking, which results in stimulation of the highly innervated subchondral bone underneath the cartilage defect. Understanding the natural history of osteochondral defects could lead to the development of strategies for preventing progressive joint damage

Evidence for widespread hydrated minerals on asteroid (101955) Bennu

Early spectral data from the Origins, Spectral Interpretation, Resource Identification, and Security-Regolith Explorer (OSIRIS-REx) mission reveal evidence for abundant hydrated minerals on the surface of near-Earth asteroid (101955) Bennu in the form of a near-infrared absorption near 2.7 µm and thermal infrared spectral features that are most similar to those of aqueously altered CM-type carbonaceous chondrites. We observe these spectral features across the surface of Bennu, and there is no evidence of substantial rotational variability at the spatial scales of tens to hundreds of metres observed to date. In the visible and near-infrared (0.4 to 2.4 µm) Bennu’s spectrum appears featureless and with a blue (negative) slope, confirming previous ground-based observations. Bennu may represent a class of objects that could have brought volatiles and organic chemistry to Earth

Properties of Rubble-Pile Asteroid (101955) Bennu from OSIRIS-REx Imaging and Thermal Analysis

Establishing the abundance and physical properties of regolith and boulders on asteroids is crucial for understanding the formation and degradation mechanisms at work on their surfaces. Using images and thermal data from NASA's Origins, Spectral Interpretation, Resource Identification, and Security-Regolith Explorer (OSIRIS-REx) spacecraft, we show that asteroid (101955) Bennu's surface is globally rough, dense with boulders, and low in albedo. The number of boulders is surprising given Bennu's moderate thermal inertia, suggesting that simple models linking thermal inertia to particle size do not adequately capture the complexity relating these properties. At the same time, we find evidence for a wide range of particle sizes with distinct albedo characteristics. Our findings imply that ages of Bennu's surface particles span from the disruption of the asteroid's parent body (boulders) to recent in situ production (micrometre-scale particles)