Validity and reliability of Turkish version of "Hospital Survey on Patient Safety Culture" and perception of patient safety in public hospitals in Turkey

<p>Abstract</p> <p>Background</p> <p>The Hospital Survey on Patient Safety Culture (HSOPS) is used to assess safety culture in many countries. Accordingly, the questionnaire has been translated into Turkish for the study of patient safety culture in Turkish hospitals. The aim of this study is threefold: to determine the validity and reliability of the translated form of HSOPS, to evaluate physicians' and nurses' perceptions of patient safety in Turkish public hospitals, and to compare finding with U.S. hospital settings.</p> <p>Methods</p> <p>Physicians and nurses working in all public hospitals in Konya, a large city in Turkey, were asked to complete a self-administrated patient safety culture survey (n = 309). Data collection was carried out using the Turkish version of HSOPS, developed by Agency for Healthcare Research and Quality (AHRQ). Data were summarized as percentages, means, and SD values. Factor analysis, correlation coefficient, Cronbach's alpha, ANOVA, and t tests were employed in statistical analyses. Items on patient safety were categorized into 10 factors. Factor loadings and internal consistencies of dimension items were high.</p> <p>Results</p> <p>Most of the scores related to dimensions, and the overall patient safety score (44%) were lower than the benchmark score. "Teamwork within hospital units" received the highest score (70%), and the lowest score belonged to the "frequency of events reported" (15%). The study revealed that more than three quarters of the physicians and nurses were not reporting errors.</p> <p>Conclusion</p> <p>The Turkish version of HSOPS was found to be valid and reliable in determining patient safety culture. This tool will be helpful in tracking improvements and in heightening awareness on patient safety culture in Turkey.</p

Effect of sitagliptin on cardiovascular outcomes in type 2 diabetes

BACKGROUND: Data are lacking on the long-term effect on cardiovascular events of adding sitagliptin, a dipeptidyl peptidase 4 inhibitor, to usual care in patients with type 2 diabetes and cardiovascular disease. METHODS: In this randomized, double-blind study, we assigned 14,671 patients to add either sitagliptin or placebo to their existing therapy. Open-label use of antihyperglycemic therapy was encouraged as required, aimed at reaching individually appropriate glycemic targets in all patients. To determine whether sitagliptin was noninferior to placebo, we used a relative risk of 1.3 as the marginal upper boundary. The primary cardiovascular outcome was a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina. RESULTS: During a median follow-up of 3.0 years, there was a small difference in glycated hemoglobin levels (least-squares mean difference for sitagliptin vs. placebo, -0.29 percentage points; 95% confidence interval [CI], -0.32 to -0.27). Overall, the primary outcome occurred in 839 patients in the sitagliptin group (11.4%; 4.06 per 100 person-years) and 851 patients in the placebo group (11.6%; 4.17 per 100 person-years). Sitagliptin was noninferior to placebo for the primary composite cardiovascular outcome (hazard ratio, 0.98; 95% CI, 0.88 to 1.09; P<0.001). Rates of hospitalization for heart failure did not differ between the two groups (hazard ratio, 1.00; 95% CI, 0.83 to 1.20; P = 0.98). There were no significant between-group differences in rates of acute pancreatitis (P = 0.07) or pancreatic cancer (P = 0.32). CONCLUSIONS: Among patients with type 2 diabetes and established cardiovascular disease, adding sitagliptin to usual care did not appear to increase the risk of major adverse cardiovascular events, hospitalization for heart failure, or other adverse events

What to Do with Unwanted Catches: Valorisation Options and Selection Strategies

27 pages, 8 figures, 7 tables.-- This chapter is licensed under the terms of the Creative Commons Attribution 4.0 International LicenseThe European Common Fisheries Policy (CFP) has established a landing obligation (LO) and the need for proper management of bycatches without incentivising their capture. Food use is the priority option but only unwanted catches (UWC) above minimum conservation reference size (MCRS) can be used for direct human consumption. As a result, other options, such as animal feeds, industrial uses or energy, should be considered to valorise landed < MCRS individuals. Two approaches have been developed to help select the best available option for processing UWC. The first methodology is based on a multi-criteria decision analysis (MCDA) using an analytic hierarchy process (AHP) that considers technical, economic and market criteria. As a sample case, we chose the Basque fleet fishing in the Bay of Biscay, developed within the H2020 DiscardLess project. The second approach is based on the simultaneous analysis of both economic and environmental aspects. This was applied to the case of Spanish bottom trawlers operating in ICES sub-Divisions VIIIc and IXa. Finally, various food products and bio compounds from typical UWC biomass were obtained in a pilot food processing plant developed within the LIFE iSEAS projectDiscardLess project has received funding from the European Union’s Horizon 2020 Framework Programme for Research and Innovation under grant agreement no. 633680. Life iSEAS has been co-funded under the LIFE+Environment Program of the European Union (LIFE13 ENV/ES/000131)Peer reviewe