Validation of the patient reported experiences and outcomes of safety in primary care compact Form Brazil.

OBJECTIVE: To analyze the psychometric properties of the cross-culturally adapted version of the Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) Compact Form Brazil. METHODS: A methodological study was conducted with 281 adult Primary Health Care users. Data collection took place online. Confirmatory Factor Analysis (CFA) was used to evaluate the psychometric properties of the PREOS-PC after the process of cross-cultural adaptation to the Brazilian context. Internal consistency was evaluated through Cronbach's alpha coefficient (α) and McDonald's omega coefficient (ω). RESULTS: The sample consisted of 73.3% women. The mean age was 36.1 years (SD = 12.2). Of the 23 items of the PREOS-PC that were eligible for CFA, a model with four correlated domains and 16 items presented satisfactory fit indexes. The domains were Practice Activation (PrA) (four items), Patient Activation (PaA) (two items), Experiences of patient safety events (EPaS) (five items) and Outcomes of patient safety (OPaS) (six items). One domain (GPeS) presented one question with a 0 to 10 response scale and two open questions, which cannot be inserted in the CPA due to the nature of the items, but can be included in the application of the scale, being evaluated individually. In this factorial model, five items (EPaS2, EPaS3, EPaS4, EPaS5, EPaS6 and EPaS8) presented factor loadings ≤ 0.30. The α and ω values demonstrated good internal consistency for all domains of the PREOS-PC. CONCLUSIONS: The Brazilian version of the PREOS-PC Compact Form Brazil composed of four domains (PrA, PA, EPaS and OPaS) and 16 items presented evidence of validation of its psychometric properties and can be used to evaluate the experiences and results of patient safety in Primary Health Care in the Brazilian context.

Factors influencing the patient safety climate in intensive care units: cross-sectional study.

BACKGROUND: Measuring the patient safety climate of a health service provides important information about the safety status at a given time. This study aimed to determine the factors influencing the patient safety climate in Intensive Care Units. METHODS: An analytical and cross-sectional study conducted in 2017 and 2018 in two adult Intensive Care Units of a Brazilian Teaching Hospital. The Safety Attitudes Questionnaire instrument was applied with the multidisciplinary teams to determine the factors influencing the patient safety climate. Data were double entered into a database and processed using the R (version 3.5.0) statistical software. Position, central tendency and dispersion measures were taken and absolute and relative frequencies, mean and confidence intervals were calculated for the quantitative variables. Linear regression was performed to verify the effect of variables on the SAQ domains. Variables with a p-value of less than 0.25 were selected for multivariate analysis. RESULTS: A total of 84 healthcare providers participated in the study. The mean Safety Attitudes Questionnaire score was 59.5, evidencing a negative climate. The following factors influenced the safety climate: time since course completion, professional category, type of employment contract, complementary professional training, and weekly workload. CONCLUSIONS: The factors identified indicate items for planning improvements in communication, teamwork, work processes, and management involvement, aiming to ensure care safety and construct a supportive safety climate.

Factors related to the patient safety climate in an emergency hospital.

OBJECTIVE: to verify the relationship between the socio-demographic and work profile of the nursing professionals and the patient safety climate in a public emergency hospital. METHOD: a cross-sectional study carried out with 177 nursing professionals from a public emergency hospital. For data collection, the Safety Attitudes Questionnaire - Short Form 2006 was used, validated and cross-culturally adapted to the Portuguese language. To check the factors related to the instrument's domains, bivariate and multivariate analyses were performed. RESULTS: working in the medical and surgical clinic or emergency room, on a night shift, and having the intention to leave nursing, reduced the general safety climate in the multiple regression analysis. The younger professionals, with less than four years in the institution, and those who worked in the night shift had a lower safety climate related to the perception of the management. On the other hand, having a work contract with a hired worker improved the general safety climate and workplace satisfaction. CONCLUSION: identifying predictors on patient safety scores is an important management tool that allows diagnosing, planning and executing activities from the domains that need to be improved.

Factors related to the patient safety climate in an emergency hospital / Fatores relacionados ao clima de segurança do paciente em hospital de urgências / Factores relacionados con el clima de seguridad del paciente en un hospital de urgencias

Objective: to verify the relationship between the socio-demographic and work profile of the nursing professionals and the patient safety climate in a public emergency hospital. Method: a cross-sectional study carried out with 177 nursing professionals from a public emergency hospital. For data collection, the Safety Attitudes Questionnaire - Short Form 2006 was used, validated and cross-culturally adapted to the Portuguese language. To check the factors related to the instrument's domains, bivariate and multivariate analyses were performed. Results: working in the medical and surgical clinic or emergency room, on a night shift, and having the intention to leave nursing, reduced the general safety climate in the multiple regression analysis. The younger professionals, with less than four years in the institution, and those who worked in the night shift had a lower safety climate related to the perception of the management. On the other hand, having a work contract with a hired worker improved the general safety climate and workplace satisfaction. Conclusion: identifying predictors on patient safety scores is an important management tool that allows diagnosing, planning and executing activities from the domains that need to be improved.

Objetivo: verificar a relação entre o perfil sociodemográfico e laboral dos profissionais de enfermagem e o clima de segurança do paciente de um hospital público de urgências. Método: estudo transversal realizado com 177 profissionais de enfermagem de um hospital público de urgências. Para a coleta de dados, foi utilizado o Safety Attitudes Questionnaire - Short Form 2006, validado e adaptado transculturalmente para a língua portuguesa. Para verificar os fatores relacionados aos domínios do instrumento, foram realizadas análises bivariadas e multivariáveis. Resultados: atuar na clínica médica e cirúrgica ou pronto-socorro, em turno noturno e possuir intenção de sair da enfermagem diminuiu o clima de segurança geral, em análise de regressão múltipla. Os profissionais mais novos, com menos de quatro anos na instituição e os que atuavam no turno noturno apresentaram menor clima de segurança relacionado à percepção da gerência. Em contrapartida, ter vínculo de trabalho celetista melhorou o clima de segurança geral e a satisfação no trabalho. Conclusão: identificar preditores sobre os escores de segurança do paciente é uma importante ferramenta gerencial que permite diagnosticar, planejar e executar atividades a partir dos domínios que precisam ser aprimorados.

Objetivo: verificar la relación entre el perfil sociodemográfico y laboral de los profesionales de enfermería y el clima de seguridad del paciente en un hospital público de urgencias. Método: estudio transversal realizado con 177 profesionales de enfermería de un hospital público de urgencias. Para la recopilación de datos, se utilizó el Safety Attitudes Questionnaire - Short Form 2006, validado y adaptado transculturalmente al idioma portugués. Para verificar los factores relacionados con los dominios del instrumento se realizaron análisis bivariados y multivariados. Resultados: actuar en la clínica médica y quirúrgica o en la sala de emergencias, en un turno nocturno, y tener la intención de abandonar la enfermería, redujo el clima de seguridad general en el análisis de regresión múltiple. Los profesionales más jóvenes, con menos de cuatro años en la institución, y aquellos que trabajaban en el turno nocturno tuvieron un clima menor de seguridad relacionado con la percepción de la gerencia. Por otro lado, tener un contrato de trabajo con un trabajador contratado mejoró el clima general de seguridad y la satisfacción laboral. Conclusión: identificar los predictores en las puntuaciones de seguridad del paciente es una herramienta de gestión importante que permite diagnosticar, planificar y ejecutar actividades desde los dominios que deben mejorarse.

Early diagenesis and clay mineral adsorption as driving factors of metal pollution in sediments: the case of Aveiro Lagoon (Portugal).

This work aims to define the factors driving the accumulation of metals in the sediment of the lagoon of Aveiro (Portugal). The role of initial diagenetic processes in controlling trace metal retention in surface sediment is traced by mineralogy, magnetic susceptibility and geochemical analyses. Although several studies have focused on the metal distribution in this polihaline and anthropized coastal lagoon, most of them have been solely focused on the total metal concentrations. This study instead represents the first attempt to evaluate in a vast area of the Aveiro Lagoon the role of biogeochemical processes in metal availability and distribution in three extracted phases: exchangeable cations adsorbed by clay and elements co-precipitated with carbonates (S1), organic matter (S2) and amorphous Mn hydroxides (S3). According to the sediment guideline values, the sediment is polluted by, for instance, As and Hg in the inner area of the Murtosa Channel, Pb in the Espinheiro Channel, Aveiro City canals and Aveiro Harbour, and Zn in the northern area of the Ovar Channel. These sites are located near the source areas of pollutants and have the highest total available concentrations in each extracted phase. The total available concentrations of all toxic metals are however associated, firstly, with the production of amorphous Mn hydroxides in most of the areas and, secondly, with adsorption by organic compounds. The interplay of the different processes implies that not all of the sites near pollution sources have polluted surface sediment. The accumulation of metals depends on not only the pollution source but also the changing in the redox state of the sediments that may cause alterations in the sediment retention or releasing of redox-sensitive metals. Results of this work suggest that the biogeochemical processes may play a significant role in the increase of the pollutants in the sediment of the Aveiro Lagoon.

Assessment of the health quality of Ria de Aveiro (Portugal): heavy metals and benthic foraminifera.

This work analyses the distribution of heavy metals in the sediments of Ria de Aveiro (Portugal) assessed by total digestion and sequential chemical extraction of the sediments. The influence of environmental parameters on the living benthic foraminiferal assemblages was studied. The most polluted parts in the Ria de Aveiro are areas where the residence time is high and cohesive sediments are deposited. Organic matter, which is an excellent scavenger for a number of metals, is in general more abundant in the finer deposits of this lagoon, which act as sinks of anthropogenic pollutants. This condition is observed in Aveiro canals and Murtosa channel where sediments with the highest concentrations of Zn, Pb, Cu, and Cr are found. The sediments of Murtosa channel are also enriched in As, Co and Hg. In Aveiro canals the enrichment of heavy metals is mostly related to the past industrial production at their margins (ceramic and metallurgy), whereas in Murtosa channel with effluent discharges of the Chemical Complex of Estarreja. Foraminiferal density and diversity reach higher values near the lagoon mouth under higher marine influence and decline in general under very low-oxygen conditions. Some species seems to be indifferent to the increasing of TOC (e.g. Haynesina germanica and Ammonia tepida) and some have an opportunistic behaviour in areas with very depressed levels of oxygen (e.g. A. tepida and Quinqueloculina seminulum) whereas other species can better tolerate sulphide/reducing conditions (e.g. H. germanica, Bolivina ordinaria, Buliminella elegantissima, Bulimina elongata/gibba and Nonionella stella) a widespread condition in this lagoon. Foraminiferal density and some species are negatively correlated with concentrations of heavy metals. A most sensitive group of species to higher concentrations of heavy metals is identified (such as B. ordinaria, B. pseudoplicata and B. elongata/gibba) and another one of more tolerant species (such as H. germanica A. tepida and Q. seminulum). Foraminifera are more tolerate higher available concentrations (AC) of Zn in any phase than higher AC of Cu adsorbed do clay minerals (F1) and associated with Fe and Mn oxides (F2) and of Pb in F2; the phase F2, probably the most mobile phase, and even phase F1 seems to be more toxic than the increasing of metals in organic matter (F3).

New land-based method for surveying sandy shores and extracting DEMs: the INSHORE system.

The INSHORE system (INtegrated System for High Operational REsolution in shore monitoring) is a land-base survey system designed and developed for the specific task of monitoring the evolution in time of sandy shores. This system was developed with two main objectives: (1) to produce highly accurate 3D coordinates of surface points (in the order of 0.02 to 0.03 m); and (2) to be extremely efficient in surveying a beach stretch of several kilometres. Previous tests have demonstrated that INSHORE systems fulfil such objectives. Now, the usefulness of the INSHORE system as a survey tool for the production of Digital Elevation Models (DEMs) of sandy shores is demonstrated. For this purpose, the comparison of DEMs obtained with the INSHORE system and with other relevant survey techniques is presented. This comparison focuses on the final DEM accuracy and also on the survey efficiency and its impact on the costs associated with regular monitoring programmes. The field survey method of the INSHORE system, based on profile networks, has a productivity of about 30 to 40 ha/h, depending on the beach surface characteristics. The final DEM precision, after interpolation of the global positioning system profile network, is approximately 0.08 to 0.12 m (RMS), depending on the profile network's density. Thus, this is a useful method for 3D representation of sandy shore surfaces and can permit, after interpolation, reliable calculations of volume and other physical parameters.

The validation analysis of the INSHORE system--a precise and efficient coastal survey system.

Government and environmental entities are becoming increasingly concerned with qualifying and quantifying the erosion effects that are observed in sandy shores. Correspondingly, survey methodologies that gather data for such erosion studies are increasingly being demanded. The responsible entities are continually broadening their areas of interest, are concerned in the establishment of regular monitoring programmes and are demanding high accuracy from the geo-spatial data that is collected. The budget available for such monitoring activities, however, does not parallel the trend in the increasing demand for quality specifications. Survey methodologies need improvement to meet these requirements. We have developed a new land-based survey system--the INSHORE system--that is ideal for low cost, highly efficient and highly precise coastal surveys. The INSHORE system uses hi-tech hardware that is based on high-grade global positioning system (GPS) receivers and a laser distance sensor combined with advanced software algorithms. This system enables the determination of the ground coordinates of the surveyed areas with a precision of 1 to 2 cm, without having a sensor in contact with the ground surface. The absence of physical contact with the ground makes this system suitable for high-efficiency surveys. The accuracy of the positioning, which is based on advanced differential GPS processing, is enhanced by considering the estimated attitude of the GPS receiver holding structure and eliminates undesirable offsets. This paper describes the INSHORE survey system and presents the results of validation tests that were performed in a sandy shore environment.

Direct determination of trans-resveratrol in human plasma by spectrofluorimetry and second-order standard addition.

Trans-resveratrol (RVT) is an antioxidant found in red grapes and their derivatives, which has been related to the reduction of cardiovascular diseases and cancer incidence. This work developed a new spectrofluorimetric-chemometric method for the direct determination of RVT in human plasma. For each measurement, excitation-emission matrices were obtained from 280 to 360 nm (excitation) and from 380 to 550 nm (emission). The strategy adopted in this work combined data treatment with parallel factor analysis (PARAFAC), for extracting the pure analyte signal, using the standard addition method, which permits determinations in the presence of a strong matrix effect caused by plasma analyte-protein binding. Plasma samples were diluted 10 times and, for each, four standard additions of RVT were performed, in triplicate. A specific PARAFAC model was built for the three replicates of each sample, from three-way arrays formed by five measurements (initial sample plus four additions), 17 excitation wavelengths and 86 emission wavelengths. The best models were selected with four factors and accounted for more than 99.90% of the data variance. The loadings obtained were related to RVT and three interferences. The scores related to the analyte were used for linear regressions and all standard addition curves presented correlation coefficients equal or greater than 0.99. Good results were obtained in the concentration range from 0.10 to 5.00 microg mL(-1), with recoveries between 94.0 and 110.0%. The proposed method was also validated through the estimates of several figures of merit: sensitivity, analytical sensitivity, selectivity, precision, and limits of detection and quantitation.