Psychometric properties of the Hospital Survey on Patient Safety Culture: findings from the UK

Background: Patient safety culture is measured using a range of survey tools. Many provide limited data on psychometric properties and few report findings outside of the USA healthcare context. This study reports an assessment of the psychometric properties and suitability of the American Hospital Survey on Patient Safety Culture (HSOPC) for use within the UK. Methods: A questionnaire survey of three hospitals within a large UK Acute NHS Trust. 1,437 questionnaires were completed (37% response rate). Exploratory factor analysis, confirmatory factor analysis, and reliability analyses were carried out to assess the psychometric performance of this survey instrument and explore potential improvements. Results: Reliability analysis of the items within each proposed scale showed that over half failed to achieve satisfactory internal consistency (Cronbach’s Alpha < 0.7). Furthermore, a confirmatory factor analysis carried out on the UK dataset achieved a poor fit when compared to the original American model. An optimal measurement model was then constructed via exploratory and confirmatory factor analysis with split-half sample validation, and consisted of 9 dimensions compared to the original 12 in the American model. Conclusion: This is one of the few studies to provide an evaluation of an American patient safety culture survey using data from the UK. The results indicate that there is need for caution in using the HSOPC survey in the UK and underline the importance of appropriate validation of safety culture surveys before extending their usage to populations outside of the specific geographical and health care contexts in which they were developed

Automatic Epileptic Seizure Detection Using Scalp EEG and Advanced Artificial Intelligence Techniques

The epilepsies are a heterogeneous group of neurological disorders and syndromes characterised by recurrent, involuntary, paroxysmal seizure activity, which is often associated with a clinicoelectrical correlate on the electroencephalogram. The diagnosis of epilepsy is usually made by a neurologist but can be difficult to be made in the early stages. Supporting paraclinical evidence obtained from magnetic resonance imaging and electroencephalography may enable clinicians to make a diagnosis of epilepsy and investigate treatment earlier. However, electroencephalogram capture and interpretation are time consuming and can be expensive due to the need for trained specialists to perform the interpretation. Automated detection of correlates of seizure activity may be a solution. In this paper, we present a supervised machine learning approach that classifies seizure and nonseizure records using an open dataset containing 342 records. Our results show an improvement on existing studies by as much as 10% in most cases with a sensitivity of 93%, specificity of 94%, and area under the curve of 98% with a 6% global error using a k-class nearest neighbour classifier.We propose that such an approach could have clinical applications in the investigation of patients with suspected seizure disorders

Patient safety in dentistry: development of a candidate 'never event' list for primary care

Introduction The 'never event' concept is often used in secondary care and refers to an agreed list of patient safety incidents that 'should not happen if the necessary preventative measures are in place'. Such an intervention may raise awareness of patient safety issues and inform team learning and system improvements in primary care dentistry. Objective To identify and develop a candidate never event list for primary care dentistry. Methods A literature review, eight workshops with dental practitioners and a modified Delphi with 'expert' groups were used to identify and agree candidate never events. Results Two-hundred and fifty dental practitioners suggested 507 never events, reduced to 27 distinct possibilities grouped across seven themes. Most frequently occurring themes were: 'checking medical history and prescribing' (119, 23.5%) and 'infection control and decontamination' (71, 14%). 'Experts' endorsed nine candidate never event statements with one graded as 'extreme risk' (failure to check past medical history) and four as 'high risk' (for example, extracting wrong tooth). Conclusion Consensus on a preliminary list of never events was developed. This is the first known attempt to develop this approach and an important step in determining its value to patient safety. Further work is necessary to develop the utility of this method

A cross-sector analysis of human and organisational factors in the deployment of data-driven predictive maintenance

Domains such as utilities, power generation, manufacturing and transport are increasingly turning to data-driven tools for management and maintenance of key assets. Whole ecosystems of sensors and analytical tools can provide complex, predictive views of network asset performance. Much research in this area has looked at the technology to provide both sensing and analysis tools. The reality in the field, however, is that the deployment of these technologies can be problematic due to user issues, such as interpretation of data or embedding within processes, and organisational issues, such as business change to gain value from asset analysis. 13 experts from the field of remote condition monitoring, asset management and predictive analytics across multiple sectors were interviewed to ascertain their experience of supplying data-driven applications. The results of these interviews are summarised as a framework based on a predictive maintenance project lifecycle covering project motivations and conception, design and development, and operation. These results identified critical themes for success around having a target or decision-led, rather than data-led, approach to design; long-term resourcing of the deployment; the complexity of supply chains to provide data-driven solutions and the need to maintain knowledge across the supply chain; the importance of fostering technical competency in end-user organisations; and the importance of a maintenance-driven strategy in the deployment of data-driven asset management. Emerging from these themes are recommendations related to culture, delivery process, resourcing, supply chain collaboration and industry-wide cooperation

Aerosol Characteristics at a High Altitude Location in Central Himalayas: Optical Properties and Radiative Forcing

Collocated measurements of the mass concentrations of aerosol black carbon (BC) and composite aerosols near the surface were carried out along with spectral aerosol optical depths (AODs) from a high altitude station, Manora Peak in Central Himalayas, during a comprehensive aerosol field campaign in December 2004. Despite being a pristine location in the Shivalik Ranges of Central Himalayas, and having a monthly mean AOD (at 500 nm) of 0.059 $\pm$ 0.033 (typical to this site), total suspended particulate (TSP) concentration was in the range 15 - 40 micro g m^(-3) (mean value 27.1 $\pm$ 8.3 micro g m^(-3)). Interestingly, aerosol BC had a mean concentration of 1.36 $\pm$ 0.99 micro g m^(-3), contributed to ~5.0 $\pm$ 1.3 % to the composite aerosol mass. This large abundance of BC is found to have linkages to the human activities in the adjoining valley and to the boundary layer dynamics. Consequently, the inferred single scattering albedo lies in the range of 0.87 to 0.94 (mean value 0.90 $\pm$ 0.03), indicating significant aerosol absorption. The estimated aerosol radiative forcing was as low as 4.2 W m^(-2) at the surface, +0.7 W m^(-2) at the top of the atmosphere, implying an atmospheric forcing of +4.9 W m^(-2). Though absolute value of the atmospheric forcing is quite small, which arises primarily from the very low AOD (or the column abundance of aerosols), the forcing efficiency (forcing per unit optical depth) was $\sim$88 W m^(-2), which is attributed to the high BC mass fraction.Comment: 32 Pages, Accepted in JGR (Atmosphere

A rotating annulus driven by localized convective forcing: a new atmosphere-like experiment

We present an experimental study of flows in a cylindrical rotating annulus convectively forced by local heating in an annular ring at the bottom near the external wall and via a cooled circular disk near the axis at the top surface of the annulus. This new configuration is distinct from the classical thermally-driven annulus analogue of the atmosphere circulation, in which thermal forcing is applied uniformly on the sidewalls, but with a similar aim to investigate the baroclinic instability of a rotating, stratified flow subject to zonally symmetric forcing. Two vertically and horizontally displaced heat sources/sinks are arranged so that, in the absence of background rotation, statically unstable Rayleigh-Bénard convection would be induced above the source and beneath the sink, thereby relaxing strong constraints placed on background temperature gradients in previous experimental configurations based on the conventional rotating annulus. This better emulates local vigorous convection in the tropics and polar regions of the atmosphere whilst also allowing stably-stratified baroclinic motion in the central zone of the annulus, as in midlatitude regions in the Earth’s atmosphere. Regimes of flow are identified, depending mainly upon control parameters that in turn depend on rotation rate and the strength of differential heating. Several regimes exhibit baroclinically unstable flows which are qualitatively similar to those previously observed in the classical thermally-driven annulus, However, in contrast to the classical configuration, they typically exhibit more spatiotemporal complexity. Thus, several regimes of flow demonstrate the equilibrated co-existence of, and interaction between, free convection and baroclinic wave modes. These new features were not previously observed in the classical annulus and validate the new setup as a tool for exploring fundamental atmosphere-like dynamics in a more realistic framework. Thermal structure in the fluid is investigated and found to be qualitatively consistent with previous numerical results, with nearly isothermal conditions respectively above and below the heat source and sink, and stably-stratified, sloping isotherms in the near-adiabatic interior

Life values as predictors of pain, disability and sick leave among Swedish registered nurses: a longitudinal study

<p>Abstract</p> <p>Background</p> <p>Prospective studies on high-risk populations, such as subgroups of health care staff, are limited, especially prospective studies among staff not on sick-leave. This paper is a report of a longitudinal study conducted to describe and compare the importance and consistency of life domains among registered nurses (RNs) working in a Swedish hospital and evaluate a model based on the consistency of valued life domains for prediction of pain, disability and sick leave.</p> <p>Method</p> <p>Importance and consistency ratings of life values, in 9 domains, were collected during 2003 and 2006 from 196 RNs using the Valued Living Questionnaire (VLQ). Logistic regression analyses were used for prediction of pain, disability and sick leave at the three-year follow-up. The predictors family relations, marriage couples/intimate relations, parenting, friends/social life, work, education, leisure time, psychological well-being, and physical self-care were used at baseline.</p> <p>Results</p> <p>RNs rated life values regarding parenting as most important and with the highest consistency both at baseline and at follow-up. No significant differences were found between RNs' ratings of importance and consistency over the three-year period, except for friends/social relations that revealed a significant decrease in importance at follow-up. The explanatory models for pain, disability and sick leave significantly predicted pain and disability at follow-up. The odds of having pain were significantly increased by one consistency rating (psychological well-being), while the odds were significantly decreased by physical self-care. In the model predicting disability, consistency in psychological well-being and education significantly increased the odds of being disabled, while consistency in physical self-care significantly decreased the odds.</p> <p>Conclusion</p> <p>The results suggest that there might be a link between intra-individual factors reflecting different aspects of appraised life values and musculoskeletal pain (MSP).</p

Smart garment for trunk posture monitoring: A preliminary study

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