Measuring the patient safety culture at a tertiary care hospital in Pakistan using the hospital survey on patient safety culture (HSOPSC)

Background: Patient safety is a top priority for many healthcare organisations worldwide. However, most of the initiatives aimed at the measurement and improvement of patient safety culture have been undertaken in developed countries. The purpose of this study was to measure the patient safety culture at a tertiary care hospital in Pakistan using the Hospital Survey on Patient Safety Culture (HSOPSC).Methods: The HSOPSC was used to measure the patient safety culture across 12 dimensions at Aga Khan University Hospital, Karachi. 2,959 individuals, who had been working at the hospital, were administered the HSOPSC in paper form between June and September 2019.Results: The response rate of the survey was 50%. In the past 12 months, 979 respondents (33.1%) had submitted at least one event report. Results showed that the personnel viewed the patient safety culture at their hospital favourably. Overall, respondents scored highest in the following dimensions: \u27feedback and communication on error\u27 (91%), \u27organisational learning and continuous improvement\u27 (85%), \u27teamwork within units\u27 (83%), \u27teamwork across units\u27 (76%). The dimensions with the lowest positive per cent scores included \u27staffing\u27 (40%) and \u27non-punitive response to error\u27 (41%). Only the reliability of the \u27handoffs and transitions\u27, \u27frequency of events reported\u27, \u27organisational learning\u27 and \u27teamwork within units\u27 was higher than Cronbach\u27s alpha of 0.7. Upon regression analysis of positive responses, physicians and nurses were found to have responded less favourably than the remaining professional groups for most dimensions.Conclusion: The measurement of safety culture is both feasible and informative in developing countries and could be broadly implemented to inform patient safety efforts. Current data suggest that it compares favourably with benchmarks from hospitals in the USA. Like the USA, high staff workload is a significant safety concern among staff. This study lays the foundation for further context-specific research on patient safety culture in developing countries

Surface engineered mesoporous silica carriers for the controlled delivery of anticancer drug 5-fluorouracil: Computational approach for the drug-carrier interactions using density functional theory

Introduction: Drug delivery systems are the topmost priority to increase drug safety and efficacy. In this study, hybrid porous silicates SBA-15 and its derivatives SBA@N and SBA@3N were synthesized and loaded with an anticancer drug, 5-fluorouracil. The drug release was studied in a simulated physiological environment.Method: These materials were characterized for their textural and physio-chemical properties by scanning electron microscopy (SEM), nuclear magnetic resonance (NMR), Fourier transform infrared spectroscopy (FTIR), small-angle X-ray diffraction (SAX), and nitrogen adsorption/desorption techniques. The surface electrostatics of the materials was measured by zeta potential.Results: The drug loading efficiency of the prepared hybrid materials was about 10%. In vitro drug release profiles were obtained in simulated fluids. Slow drug release kinetics was observed for SBA@3N, which released 7.5% of the entrapped drug in simulated intestinal fluid (SIF, pH 7.2) and 33% in simulated body fluid (SBF, pH 7.2) for 72 h. The material SBA@N presented an initial burst release of 13% in simulated intestinal fluid and 32.6% in simulated gastric fluid (SGF, pH 1.2), while about 70% of the drug was released within the next 72 h. Density functional theory (DFT) calculations have also supported the slow drug release from the SBA@3N material. The release mechanism of the drug from the prepared carriers was studied by first-order, second-order, Korsmeyer–Peppas, Hixson–Crowell, and Higuchi kinetic models. The drug release from these carriers follows Fickian diffusion and zero-order kinetics in SGF and SBF, whereas first-order, non-Fickian diffusion, and case-II transport were observed in SIF.Discussion: Based on these findings, the proposed synthesized hybrid materials may be suggested as a potential drug delivery system for anti-cancer drugs such as 5-fluorouracil

Unsteady Flow of an MHD Tangent Hyperbolic Nanofluid Over a Stretching Sheet

Abstract The recent article addresses the unsteady flow of MHD incompressible tangent hyperbolic fluid with Nanofluid particles in the direction of a stretching surface. Nano-fluid is related to thermo-phoretic and Brownian movement. With proper help through the transformation procedure, the set of non-linear (PDEs) is re-framed into (ODEs). The initiate expressions of momentum, temperature field, and nano-particle concentration are composed into groups of nonlinear equations. That consequential terminology is computed shooting system. The impact of fundamental parameters on the flow field, thermal circulation, and meditation is described. Moreover, the flow field behavior due to the Wall friction, local Nusselt, and Sherwood numbers are examined. This study is significant as this transformation determined the shooting technique’s numerical result and ensured the physical parameters’ behavior graphically. The results show that the velocity field diminishes by escalating the Weissenberg (We) figure and power-law index (n), while thermal and concentration fields remain to detect elevating at similar parameters. Furthermore, the computed result is compared with existing literature and gets accuracy

Neural minimization methods (NMM) for solving variable order fractional delay differential equations (FDDEs) with simulated annealing (SA).

To enrich any model and its dynamics introduction of delay is useful, that models a precise description of real-life phenomena. Differential equations in which current time derivatives count on the solution and its derivatives at a prior time are known as delay differential equations (DDEs). In this study, we are introducing new techniques for finding the numerical solution of fractional delay differential equations (FDDEs) based on the application of neural minimization (NM) by utilizing Chebyshev simulated annealing neural network (ChSANN) and Legendre simulated annealing neural network (LSANN). The main purpose of using Chebyshev and Legendre polynomials, along with simulated annealing (SA), is to reduce mean square error (MSE) that leads to more accurate numerical approximations. This study provides the application of ChSANN and LSANN for solving DDEs and FDDEs. Proposed schemes can be effortlessly executed by using Mathematica or MATLAB software to get explicit solutions. Computational outcomes are depicted, for various numerical experiments, numerically and graphically with error analysis to demonstrate the accuracy and efficiency of the methods

Series solution of fractional Pantograph equations via Taylor series

This article is devoted to develop a numerical approximation called Taylor minimization method for initial and boundary value fractional Pantograph equations, which governs the modelling of the train system, with neutral and multi-term delays. Taylor optimization technique is basically composed of truncated Taylor series approximation of unknown function while employment of procedure is accompanied by an optimization strategy that is simulated annealing for carrying out the learning phase of unknown Taylor series coefficients. The proposed technique is implemented on various models of Pantograph equations to study the applicability and effectiveness of the planned scheme while error analysis and comparison with previous methods are performed to validate the results. To measure the capability of convergence the data for 100 numbers of independent runs is demonstrated in the form of pictorial presentation

Incorporating patient safety and quality into the medical school curriculum: An assessment of student gains

Background: Global efforts are being made to improve health care standards and the quality of care provided. It has been shown through research that the introduction of patient safety (PS) and quality improvement (QI) concepts in the medical curriculum prepares medical students to face future challenges in their professional careers.Purpose: This study aimed to evaluate how a brief course on QI and PS affects the knowledge, efficacy, and system thinking of medical students.Methods: A 5-day QI and PS intervention course was implemented at the Aga Khan University medical college for 98 third-year medical students in March 2021. This weeklong course of lectures, interactive sessions, and hands-on skill workshops was conducted before the students began their clinical rotations. Students\u27 knowledge, self-efficacy, and system thinking were assessed with pretest and posttest. Students were also asked to write personal reflections and fill out a satisfaction survey at the end of the intervention.Results: Comparisons of pretest and posttest scores showed that the course significantly improved students\u27 knowledge by a mean of 2.92 points (95% confidence interval, 2.30-3.53; P \u3c 0.001) and system thinking by 0.16 points (95% confidence interval, 0.03-0.29; P = 0.018) of the maximum scores of 20 and 5 points, respectively. The students\u27 self-assessment of PS knowledge also reflected statistically significant increases in all 9 domains (P \u3c 0.001). Students reported positive experiences with this course in their personal reflections.Conclusions: The medical students exhibited increases in knowledge, self-efficacy, and system thinking after this weeklong intervention. The design of the course can be modified as needed and implemented at other institutions in low- and middle-income countries. A targeted long-term assessment of knowledge and attitudes is needed to fully evaluate the impact of this course

Estimating the frequency of inpatient adverse events using a two-step retrospective chart review: A study protocol

Introduction: Adverse events are a major cause of patient harm in the hospitalised setting. Low-income and middle-income countries account for a disproportionate share of the global burden of adverse events. However, patient safety research is still centred around high-income countries and high-resource health systems. The methods and data produced from these efforts are ill-suited to low-income and middle-income systems due to the social and technical differences between these settings. We aim to use our pilot-tested, locally developed methodology to estimate the frequency and characteristics of adverse events in hospitalised patients in a lower-middle-income country to inform patient safety policies and initiatives.Methods and analysis: This multi-centre study will employ a two-step chart review methodology to identify adverse events in a representative sample of patients admitted at five hospitals between 1 January 2019 and 31 December 2019. The first step will include assessing patient files against a list of triggers to detect adverse events and the second step will involve an in-depth review of the events to capture pertinent characteristics. The triggers have been adapted from validated tools used in other studies. The reviewing team will be trained on the use of research tools and operational definitions to ensure that data are collected uniformly. The main outcome of interest is the rate at which adverse events occur in hospitalised patients. Further analysis will look to identify and quantify associations between the main outcome of interest and a variety of variables such as patient age and gender using tests of independence and regression techniques.Ethics and dissemination: This study protocol has been approved by the Ethics Review Committee at Aga Khan University (Reference number: 2023-6324-24566). The findings of this study will be published in a peer-reviewed journal and disseminated to the public through national and international conferences, workshops, websites and social media

Sorting of mesoporous silica derivatives by random optical fields

Mesoporous silica particles are promising candidates for drug delivery applications. In this paper, we first synthesize mesoporous silica MCM-41 and its derivative MCM-41GA with anchored glutaraldehyde bridges, and characterize them using a variety of techniques, including nitrogen adsorption/desorption, X-ray diffraction, NMR spectroscopy, scanning electron microscopy, and thermogravimetric analysis. Then, we employ random optical fields to sort mesoporous silica particles. Random optical fields by containing local intensity gradients throughout a wide range of field of view provide an elegant, easy-to-implement, and low-cost variant of multiple optical tweezers, which is known as speckle tweezers (ST). ST, similar to multiple optical tweezers, for manipulation tasks, such as trapping, sorting, and guiding of collection of micro and sub-micro objects in several disciplines including statistical physics, chemistry, microfluidics and material science. We show that ST can restrict, sieve, and sort MCM-41 and MCM-41GA particles. The different interaction of mesoporous silica variations with the applied ST may be attributed to the pre-applied modification and the differences in the porosity structure and distribution. Therefore, the results provide insight into the textural and chemical characteristics of mesoporous materials, contributing to a deeper understanding of their potential applications