Avaliação da cultura de segurança do paciente na Amazônia Ocidental

Introdução: A cultura de segurança do paciente é fator contribuinte para a manutenção do bem-estar do usuário no sistema de saúde, pois por meio dela obtém-se uma sistematização organizada e de qualidade do cuidado ao paciente, prevenindo possíveis intercorrências que possam trazer danos. Objetivo: Analisar a Cultura de Segurança do Paciente (CSP) na perspectiva dos profissionais de saúde no Hospital de Referência do Alto Rio Juruá, na Amazônia Ocidental Brasileira. Método: Trata-se de um estudo transversal desenvolvido em um hospital público de médio porte em um município da Amazônia Ocidental. O questionário Hospital Survey on Patient Safety Culture, da Agency for Healthcare Research and Quality foi aplicado em 280 profissionais, no período dezembro de 2016 a fevereiro de 2017. Foi realizada a análise descritiva dos dados e a consistência interna do instrumento. Resultados: Os resultados apontam as melhores avaliações nas dimensões de Trabalho em equipe nos âmbitos das unidades (60%) e Aprendizado organizacional (60%). Os aspectos com os piores resultados foram as dimensões de Respostas não punitivas aos erros (18%) e Frequência de eventos relatados (32%). A análise de confiabilidade interna (Alpha de Cronbach) das dimensões variou entre 0,35 a 0,90. Conclusão: A cultura do medo parece predominar nesse hospital, contudo o estudo demonstrou que há possibilidades de melhoria em todas as dimensões da CSP. Os valores do Alpha de Cronbach apresentaram semelhança com os resultados obtidos pelo processo de validação.Introduction: The safety culture of the patient is a contributing factor for the maintenance of the user’s well-being in the health system because, through it, an organized systematization and quality of patient care are obtained, preventing possible intercurrences that can cause damages. Objective: To analyze the Patient Safety Culture (PSC) from the perspective of health professionals at the Reference Hospital of the Upper Juruá River, in the Brazilian Western Amazon. Methods: This is a cross-sectional study developed in a medium-sized public hospital in a municipality in Western Amazonia. The Survey for Patient Safety Culture survey of the Agency for Healthcare Research and Quality was applied to 280 professionals from December 2016 to February 2017. Descriptive analysis of the data and the internal consistency of the instrument were performed. Results: The results indicate the best evaluations in the dimensions of Teamwork in the scopes of the units (60%) and Organizational learning (60%). The aspects with the worst results were the dimensions of non-punitive responses to errors (18%) and frequency of events reported (32%). The internal reliability (Cronbach’s Alpha) analysis of the dimensions ranged from 0.35 to 0.90. Conclusion: The "culture of fear" seems to predominate in this hospital, however, the study showed that there is scope for improvement in all dimensions of CSP. The values of Cronbach’s Alpha presented similarity to the results obtained by the validation process

Dengue Infection Increases the Locomotor Activity of Aedes aegypti Females

BACKGROUND: Aedes aegypti is the main vector of the virus causing Dengue fever, a disease that has increased dramatically in importance in recent decades, affecting many tropical and sub-tropical areas of the globe. It is known that viruses and other parasites can potentially alter vector behavior. We investigated whether infection with Dengue virus modifies the behavior of Aedes aegypti females with respect to their activity level. METHODS/PRINCIPAL FINDINGS: We carried out intrathoracic Dengue 2 virus (DENV-2) infections in Aedes aegypti females and recorded their locomotor activity behavior. We observed an increase of up to ∼50% in the activity of infected mosquitoes compared to the uninfected controls. CONCLUSIONS: Dengue infection alters mosquito locomotor activity behavior. We speculate that the higher levels of activity observed in infected Aedes aegypti females might involve the circadian clock. Further studies are needed to assess whether this behavioral change could have implications for the dynamics of Dengue virus transmission

Near-infrared spectroscopy of blood plasma with chemometrics towards HIV discrimination during pregnancy

Abstract: Prevention of mother-to-child transmission programs have been one of the hallmarks of success in the fight against HIV/AIDS. In Brazil, access to antiretroviral therapy (ART) during pregnancy has increased, leading to a reduction in new infections among children. Currently, lifelong ART is available to all pregnant, however yet challenges remain in eliminating mother-to-child transmission. In this paper, we focus on the role of near-infrared (NIR) spectroscopy to analyse blood plasma samples of pregnant women with HIV infection to differentiate pregnant women without HIV infection. Seventy-seven samples (39 HIV-infected patient and 38 healthy control samples) were analysed. Multivariate classification of resultant NIR spectra facilitated diagnostic segregation of both sample categories in a fast and non-destructive fashion, generating good accuracy, sensitivity and specificity. This method is simple and low-cost, and can be easily adapted to point-of-care screening, which can be essential to monitor pregnancy risks in remote locations or in the developing world. Therefore, it opens a new perspective to investigate vertical transmission (VT). The approach described here, can be useful for the identification and exploration of VT under various pathophysiological conditions of maternal HIV. These findings demonstrate, for the first time, the potential of NIR spectroscopy combined with multivariate analysis as a screening tool for fast and low-cost HIV detection

The Fifth Data Release of the Sloan Digital Sky Survey

This paper describes the Fifth Data Release (DR5) of the Sloan Digital Sky Survey (SDSS). DR5 includes all survey quality data taken through June 2005 and represents the completion of the SDSS-I project (whose successor, SDSS-II will continue through mid-2008). It includes five-band photometric data for 217 million objects selected over 8000 square degrees, and 1,048,960 spectra of galaxies, quasars, and stars selected from 5713 square degrees of that imaging data. These numbers represent a roughly 20% increment over those of the Fourth Data Release; all the data from previous data releases are included in the present release. In addition to "standard" SDSS observations, DR5 includes repeat scans of the southern equatorial stripe, imaging scans across M31 and the core of the Perseus cluster of galaxies, and the first spectroscopic data from SEGUE, a survey to explore the kinematics and chemical evolution of the Galaxy. The catalog database incorporates several new features, including photometric redshifts of galaxies, tables of matched objects in overlap regions of the imaging survey, and tools that allow precise computations of survey geometry for statistical investigations.Comment: ApJ Supp, in press, October 2007. This paper describes DR5. The SDSS Sixth Data Release (DR6) is now public, available from http://www.sdss.or

The Society for Immunotherapy of Cancer consensus statement on immunotherapy for the treatment of hematologic malignancies: multiple myeloma, lymphoma, and acute leukemia

Increasing knowledge concerning the biology of hematologic malignancies as well as the role of the immune system in the control of these diseases has led to the development and approval of immunotherapies that are resulting in impressive clinical responses. Therefore, the Society for Immunotherapy of Cancer (SITC) convened a hematologic malignancy Cancer Immunotherapy Guidelines panel consisting of physicians, nurses, patient advocates, and patients to develop consensus recommendations for the clinical application of immunotherapy for patients with multiple myeloma, lymphoma, and acute leukemia. These recommendations were developed following the previously established process based on the Institute of Medicine’s clinical practice guidelines. In doing so, a systematic literature search was performed for high-impact studies from 2004 to 2014 and was supplemented with further literature as identified by the panel. The consensus panel met in December of 2014 with the goal to generate consensus recommendations for the clinical use of immunotherapy in patients with hematologic malignancies. During this meeting, consensus panel voting along with discussion were used to rate and review the strength of the supporting evidence from the literature search. These consensus recommendations focus on issues related to patient selection, toxicity management, clinical endpoints, and the sequencing or combination of therapies. Overall, immunotherapy is rapidly emerging as an effective therapeutic strategy for the management of hematologic malignances. Evidence-based consensus recommendations for its clinical application are provided and will be updated as the field evolves

Diversity, Loss, and Gain of Malaria Parasites in a Globally Invasive Bird

Invasive species can displace natives, and thus identifying the traits that make aliens successful is crucial for predicting and preventing biodiversity loss. Pathogens may play an important role in the invasive process, facilitating colonization of their hosts in new continents and islands. According to the Novel Weapon Hypothesis, colonizers may out-compete local native species by bringing with them novel pathogens to which native species are not adapted. In contrast, the Enemy Release Hypothesis suggests that flourishing colonizers are successful because they have left their pathogens behind. To assess the role of avian malaria and related haemosporidian parasites in the global spread of a common invasive bird, we examined the prevalence and genetic diversity of haemosporidian parasites (order Haemosporida, genera Plasmodium and Haemoproteus) infecting house sparrows (Passer domesticus). We sampled house sparrows (N = 1820) from 58 locations on 6 continents. All the samples were tested using PCR-based methods; blood films from the PCR-positive birds were examined microscopically to identify parasite species. The results show that haemosporidian parasites in the house sparrows' native range are replaced by species from local host-generalist parasite fauna in the alien environments of North and South America. Furthermore, sparrows in colonized regions displayed a lower diversity and prevalence of parasite infections. Because the house sparrow lost its native parasites when colonizing the American continents, the release from these natural enemies may have facilitated its invasion in the last two centuries. Our findings therefore reject the Novel Weapon Hypothesis and are concordant with the Enemy Release Hypothesis