Patient safety culture improvements depend on basic healthcare education:a longitudinal simulation-based intervention study at two Danish hospitals

BACKGROUND: A growing body of evidence supports the existence of an association between patient safety culture (PSC) and patient outcomes. PSC refers to shared perceptions and attitudes towards norms, policies and procedures related to patient safety. Existing literature shows that PSC varies among health professionals depending on their specific profession and specialty. However, these studies did not investigate whether PSC can be improved. This study investigates whether length of education is associated with improvements in PCS following a simulation intervention. METHODS: From April 2017 to November 2018, a cross-sectional intervention study was conducted at two regional hospitals in Denmark. Two groups with altogether 1230 health professionals were invited to participate. One group included nurses, midwives and radiographers; the other group included doctors. A train-the-trainer intervention approach was applied consisting of a 4-day simulation instructor course that emphasised team training, communication and leadership. Fifty-three healthcare professionals were trained as instructors. After the course, instructors performed in situ simulation in their own hospital environment. OUTCOMES: The Safety Attitude Questionnaire (SAQ), which has 6 dimensions and 32 items, was used to collect main outcome variables. All employees from both groups were surveyed before the intervention and again four and nine months after the intervention. RESULTS: Mean baseline scores were higher among doctors than among nurses, midwives and radiographers for all SAQ dimensions. At the second follow-up, four of six dimensions improved significantly (p ≤ 0.05) among nurses, midwives and radiographers, whereas no dimensions improved significantly among doctors. CONCLUSION: Over time, nurses, midwives and radiographers improved more in PSC attitudes than doctors did

Multi-trait analysis characterizes the genetics of thyroid function and identifies causal associations with clinical implications

To date only a fraction of the genetic footprint of thyroid function has been clarified. We report a genome-wide association study meta-analysis of thyroid function in up to 271,040 individuals of European ancestry, including reference range thyrotropin (TSH), free thyroxine (FT4), free and total triiodothyronine (T3), proxies for metabolism (T3/FT4 ratio) as well as dichotomized high and low TSH levels. We revealed 259 independent significant associations for TSH (61% novel), 85 for FT4 (67% novel), and 62 novel signals for the T3 related traits. The loci explained 14.1%, 6.0%, 9.5% and 1.1% of the total variation in TSH, FT4, total T3 and free T3 concentrations, respectively. Genetic correlations indicate that TSH associated loci reflect the thyroid function determined by free T3, whereas the FT4 associations represent the thyroid hormone metabolism. Polygenic risk score and Mendelian randomization analyses showed the effects of genetically determined variation in thyroid function on various clinical outcomes, including cardiovascular risk factors and diseases, autoimmune diseases, and cancer. In conclusion, our results improve the understanding of thyroid hormone physiology and highlight the pleiotropic effects of thyroid function on various diseases

Sustainable phosphorus remediation and recycling technologies in the landscape

vokMTT, Viestintä ja informaatiopalvelut, 31600 Jokioine

Modeling Solute Mass Exchange between Pore Regions in Slurry-Injected Soil Columns during Intermittent Irrigation

Animal slurry application to agricultural land can be a threat to the quality of groundwater and nearby surface water bodies by percolation of solutes from slurry sources. We hypothesized that local-scale processes, such as mass exchange between preferential flow paths and matrix pore regions, can play a substantial role in relation to slurry application and nutrient leaching. To improve understanding of these mass exchange mechanisms, soil column leaching data of nonreactive slurry components after injection of dairy slurry were analyzed under different initial and boundary conditions with single- and double-porosity model approaches. The data set was from nine intact soil columns (20-cm i.d., 20-cm height) of the plow layer of arable loamy topsoil that were percolated under unsaturated steady-flow conditions with a suction of 5 cm applied at the bottom. Both single- and double-porosity water flow and mobile–immobile solute transport models could describe these experimental breakthrough curves. Rainfall interruptions mimicking more natural conditions and variably saturated intermittent flow led to higher leaching of injected slurry compounds than steady-flow conditions. These observations could be explained by an increased mass exchange of dissolved injected slurry components from the immobile to the mobile pore water regions during interruptions. The results suggest that column tests under steady-flow conditions could lead to false predictions of solute leaching after slurry injection in structured soils. Furthermore, local-scale processes, such as mass exchange between pore regions, should be included in larger scale model predictions of nutrient losses from agricultural fields

Phosphorus dynamics in wetlands and riparian areas

vokMAAMY