Assessment of Patient Safety Culture in Primary Health Care Settings in Kuwait

Background Patient safety is critical component of health care quality. We aimed to assess the awareness of primary healthcare staff members about patient safety culture and explore the areas of deficiency and opportunities for improvement concerning this issue. Methods: This descriptive cross sectional study surveyed 369 staff members in four primary healthcare centers in Kuwait using self-administered “Hospital Survey on Patient Safety Culture” adopted questionnaire. The total number of respondents was 276 participants (response rate = 74.79%). Results: Five safety dimensions with lowest positivity (less than 50%) were identified and these are; the non – punitive response to errors, frequency of event reporting, staffing, communication openness, center handoffs and transitions with the following percentages of positivity 24%, 32%, 41%, 45% and 47% respectively. The dimensions of highest positivity were teamwork within the center’s units (82%) and organizational learning (75%). Conclusion: Patient safety culture in primary healthcare settings in Kuwait is not as strong as improvements for the provision of safe health care. Well-designed patient safety initiatives are needed to be integrated with organizational policies, particularly the pressing need to address the bioethical component of medical errors and their disclosure, communication openness and emotional issues related to them and investing the bright areas of skillful organizational learning and strong team working attitudes.   &nbsp

Consensus molecular subtyping of colorectal cancers is influenced by goblet cell content

A critical obstacle in the field of colorectal cancer (CRC) is the establishment of precise tumor subtypes to facilitate the development of targeted therapeutic regimens. While dysregulated mucin production is a histopathological feature of multiple CRC subtypes, it is not clear how well these pathologies are associated with the proportion of goblet cells in the tumor, or whether or not this proportion is variable across all CRC. This study demonstrates that consensus molecular subtype 3 (CMS3) CRC tumors and cell lines are enriched for the expression of goblet cell marker genes. Further, the proportion of goblet cells in the tumor is associated with the probability of CMS3 subtype assignment and these CMS3 subtype tumors are mutually exclusive from mucinous adenocarcinoma pathologies. This study provides proof of principle for the use of machine learning classification systems to subtype tumors based on cellular content, and provides further context regarding the features weighing CMS3 subtype assignment

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

Platinum-Induced Ubiquitination of Phosphorylated H2AX by RING1A is Mediated by Replication Protein A in Ovarian Cancer

Platinum resistance is a common occurrence in high-grade serous ovarian cancer and a major cause of ovarian cancer deaths. Platinum agents form DNA cross-links, which activate nucleotide excision repair (NER), Fanconi anemia, and homologous recombination repair (HRR) pathways. Chromatin modifications occur in the vicinity of DNA damage and play an integral role in the DNA damage response (DDR). Chromatin modifiers, including polycomb repressive complex 1 (PRC1) members, and chromatin structure are frequently dysregulated in ovarian cancer and can potentially contribute to platinum resistance. However, the role of chromatin modifiers in the repair of platinum DNA damage in ovarian cancer is not well understood. We demonstrate that the PRC1 complex member RING1A mediates monoubiquitination of lysine 119 of phosphorylated H2AX (γH2AXub1) at sites of platinum DNA damage in ovarian cancer cells. After platinum treatment, our results reveal that NER and HRR both contribute to RING1A localization and γH2AX monoubiquitination. Importantly, replication protein A, involved in both NER and HRR, mediates RING1A localization to sites of damage. Furthermore, RING1A deficiency impairs the activation of the G2-M DNA damage checkpoint, reduces the ability of ovarian cancer cells to repair platinum DNA damage, and increases sensitivity to platinum. IMPLICATIONS: Elucidating the role of RING1A in the DDR to platinum agents will allow for the identification of therapeutic targets to improve the response of ovarian cancer to standard chemotherapy regimens

Studies on symbiotic nitrogen fixation in white clover and field beans

ThesisThesis (M.Sc.), University College of Wales, 197

Investing of dynamic effect of immigration from rural to urban on income inequality: case study of rural regions in Iran

Today, rural migration to urban areas, leads to an aggregate fall in welfare due to lack of infrastructure for integrating the newcomers into urban settings. Not only does it lead to reduction of the welfare of rural migrants and creation of social problems in urban areas, but it also undermines the welfare of rural residents through increasing inequality in rural incomes. In this paper, we apply the combined data (panel) method and use the generalized momentum econometric model (GMM), to analyze panel rural data of 30 provinces of Iran for the period 2005 to 2015 to see how rural migration affects rural inequality.  Our research results show that migration at the beginning increases rural income inequality but that it tends to decrease rural income inequality in subsequent periods

Agricultural Extensnon Techniques in the Sultanate of Oman, Present Prospect and Perspective

A study conducted during September 2003 included 80 participants grouped into 3 categories, who occupied different posts in the Agricultural (and Fisheries) Development Centers (ADC). A questionnaire covering various elements of extension methods and techniques was used. Result showed that participant's opinions were identical in 90.6% of the aspects put forward in the questionnaire. There were, however, significant differences in opinions between the three groups involved in the study regarding representation of ministry extension personnel at village levels, availability of media equipment and facilities in the ADC and level of training of extension staff. The study also showed the need for a complementary extension structure at ABC level, development of an appropriate relationship between extension and agricultural research and more technical and practical training for extension staff. The participants also emphasized the relative importance of providing extension means and outputs for demonstration of plots to target groups, the availability of media equipment and the necessity for developing techniques for better execution and evaluation of extension programs. Research priorities should also be linked with problems related to agricultural production at farm level in Oman

Satisfaction among Expectant Mothers with Antenatal Care Services in the Musandam Region of Oman

Objectives: As client feedback is useful to improve health service delivery, assessments should be undertaken periodically. This study aimed to determine the level of satisfaction among expectant mothers visiting health institutions for antenatal care services in the Ministry of Health, Musandam region of Oman in 2005. Methods: This was a cross sectional survey in a hospital setup. Women registered in the antenatal clinics of different health institutions of Musandam region were interviewed. Arabic speaking investigators in six health institutions of Musandum region collected personal profiles, details of different antenatal services offered and responses regarding the satisfaction with these services. The number and percentage of responses were calculated to grade the level of satisfaction. Results: Eighty-three registered women who visited antenatal clinics in six health institutions were interviewed. The overall satisfaction for antenatal care was of excellent grade in 49 (59% - 95% confidence interval 48.5 - 69.6) participants. Sixtyseven (81%) women were happy with services at antenatal clinics mainly because of the attitude of the doctors and nursing staff. The leading causes of dissatisfaction were the laboratory services and overcrowding during morning hours. Conclusion: The women attending antenatal care services in Musandam were highly satisfied with the services offered; however, there was scope for further improvement. The Ministry of Health in consultation with the caregivers should focus on improving antenatal services

Satisfaction among Expectant Mothers with Antenatal Care Services in the Musandam Region of Oman

Objectives: As client feedback is useful to improve health service delivery, assessments should be undertaken periodically. This study aimed to determine the level of satisfaction among expectant mothers visiting health institutions for antenatal care services in the Ministry of Health, Musandam region of Oman in 2005. Methods: This was a cross sectional survey in a hospital setup. Women registered in the antenatal clinics of different health institutions of Musandam region were interviewed. Arabic speaking investigators in six health institutions of Musandum region collected personal profiles, details of different antenatal services offered and responses regarding the satisfaction with these services. The number and percentage of responses were calculated to grade the level of satisfaction. Results: Eighty-three registered women who visited antenatal clinics in six health institutions were interviewed. The overall satisfaction for antenatal care was of excellent grade in 49 (59% - 95% confidence interval 48.5 - 69.6) participants. Sixtyseven (81%) women were happy with services at antenatal clinics mainly because of the attitude of the doctors and nursing staff. The leading causes of dissatisfaction were the laboratory services and overcrowding during morning hours. Conclusion: The women attending antenatal care services in Musandam were highly satisfied with the services offered; however, there was scope for further improvement. The Ministry of Health in consultation with the caregivers should focus on improving antenatal services