Swedish translation and psychometric testing of the safety attitudes questionnaire (operating room version)

Background: Tens of millions of patients worldwide suffer from avoidable disabling injuries and death every year. Measuring the safety climate in health care is an important step in improving patient safety. The most commonly used instrument to measure safety climate is the Safety Attitudes Questionnaire (SAQ). The aim of the present study was to establish the validity and reliability of the translated version of the SAQ. Methods: The SAQ was translated and adapted to the Swedish context. The survey was then carried out with 374 respondents in the operating room (OR) setting. Data was received from three hospitals, a total of 237 responses. Cronbach's alpha and confirmatory factor analysis (CFA) was used to evaluate the reliability and validity of the instrument. Results: The Cronbach's alpha values for each of the factors of the SAQ ranged between 0.59 and 0.83. The CFA and its goodness-of-fit indices (SRMR 0.055, RMSEA 0.043, CFI 0.98) showed good model fit. Intercorrelations between the factors safety climate, teamwork climate, job satisfaction, perceptions of management, and working conditions showed moderate to high correlation with each other. The factor stress recognition had no significant correlation with teamwork climate, perception of management, or job satisfaction. Conclusions: Therefore, the Swedish translation and psychometric testing of the SAQ (OR version) has good construct validity. However, the reliability analysis suggested that some of the items need further refinement to establish sound internal consistency. As suggested by previous research, the SAQ is potentially a useful tool for evaluating safety climate. However, further psychometric testing is required with larger samples to establish the psychometric properties of the instrument for use in Sweden.

Modelling the Provenance of Data in Autonomous Systems

Determining the provenance of data, i.e. the process that led to that data, is vital in many disciplines. For example, in science, the process that produced a given result must be demonstrably rigorous for the result to be deemed reliable. A provenance system supports applications in recording adequate documentation about process executions to answer queries regarding provenance, and provides functionality to perform those queries. Several provenance systems are being developed, but all focus on systems in which the components are textitreactive, for example Web Services that act on the basis of a request, job submission system, etc. This limitation means that questions regarding the motives of autonomous actors, or textitagents, in such systems remain unanswerable in the general case. Such questions include: who was ultimately responsible for a given effect, what was their reason for initiating the process and does the effect of a process match what was intended to occur by those initiating the process? In this paper, we address this limitation by integrating two solutions: a generic, re-usable framework for representing the provenance of data in service-oriented architectures and a model for describing the goal-oriented delegation and engagement of agents in multi-agent systems. Using these solutions, we present algorithms to answer common questions regarding responsibility and success of a process and evaluate the approach with a simulated healthcare example.

Extracting Causal Graphs from an Open Provenance Data Model

The open provenance architecture (OPA) approach to the challenge was distinct in several regards. In particular, it is based on an open, well-defined data model and architecture, allowing different components of the challenge workflow to independently record documentation, and for the workflow to be executed in any environment. Another noticeable feature is that we distinguish between the data recorded about what has occurred, emphprocess documentation, and the emphprovenance of a data item, which is all that caused the data item to be as it is and is obtained as the result of a query over process documentation. This distinction allows us to tailor the system to separately best address the requirements of recording and querying documentation. Other notable features include the explicit recording of causal relationships between both events and data items, an interaction-based world model, intensional definition of data items in queries rather than relying on explicit naming mechanisms, and emphstyling of documentation to support non-functional application requirements such as reducing storage costs or ensuring privacy of data. In this paper we describe how each of these features aid us in answering the challenge provenance queries.

Using Neo4J geospatial data storage and integration

Online geographic-databases have been growing increasingly as they have become a crucial source of information for both social networks and safety-critical systems. Since the quality of such applications is largely related to the richness and completeness of their data, it becomes imperative to develop adaptable and persistent storage systems, able to make use of several sources of information as well as enabling the fastest possible response from them. This work will create a shared and extensible geographic model, able to retrieve and store information from the major spatial sources available. A geographic-based system also has very high requirements in terms of scalability, computational power and domain complexity, causing several difficulties for a traditional relational database as the number of results increases. NoSQL systems provide valuable advantages for this scenario, in particular graph databases which are capable of modeling vast amounts of inter-connected data while providing a very substantial increase of performance for several spatial requests, such as finding shortestpath routes and performing relationship lookups with high concurrency. In this work, we will analyze the current state of geographic information systems and develop a unified geographic model, named GeoPlace Explorer (GE). GE is able to import and store spatial data from several online sources at a symbolic level in both a relational and a graph databases, where several stress tests were performed in order to find the advantages and disadvantages of each database paradigm.

Portable MP3 player as low-cost data logger

Non-audio signals have been recorded in the flash ROM memory of a portable MP3 player, in WAV format file, to examine the possibility of using these cheap and small instruments as general-purpose portable data loggers. A 1200-Hz FM carrier modulated by the non-audio signal has replaced the microphone signal, while using the REC operating mode of the MP3 player, which triggers the voice recording function. The signal recovery was carried out by a PLL-based FM demodulator whose input is the FM signal captured in the coil leads of the MP3 player's earphone. Sinusoidal and electrocardiogram signals have been used in the system evaluation. Although the quality of low frequency signals needs improvement, overall the results indicate the viability of the proposal. Suggestions are made for improvements and extensions of the work.

Long-Term Safety and Efficacy of Abatacept in Children With Juvenile Idiopathic Arthritis

Objective. We previously documented that abatacept was effective and safe in patients with juvenile idiopathic arthritis (JIA) who had not previously achieved a satisfactory clinical response with disease-modifying antirheumatic drugs or tumor necrosis factor blockade. Here, we report results from the long-term extension (LTE) phase of that study.Methods. This report describes the long-term, open-label extension phase of a double-blind, randomized, controlled withdrawal trial in 190 patients with JIA ages 6-17 years. Children were treated with 10 mg/kg abatacept administered intravenously every 4 weeks, with or without methotrexate. Efficacy results were based on data derived from the 153 patients who entered the open-label LTE phase and reflect >= 21 months (589 days) of treatment. Safety results include all available open-label data as of May 7, 2008.Results. of the 190 enrolled patients, 153 entered the LTE. By day 589, 90%, 88%, 75%, 57%, and 39% of patients treated with abatacept during the double-blind and LTE phases achieved responses according to the American College of Rheumatology (ACR) Pediatric 30 (Pedi 30), Pedi 50, Pedi 70, Pedi 90, and Pedi 100 criteria for improvement, respectively. Similar response rates were observed by day 589 among patients previously treated with placebo. Among patients who had not achieved an ACR Pedi 30 response at the end of the open-label lead-in phase and who proceeded directly into the LTE, 73%, 64%, 46%, 18%, and 5% achieved ACR Pedi 30, Pedi 50, Pedi 70, Pedi 90, and Pedi 100 responses, respectively, by day 589 of the LTE. No cases of tuberculosis and no malignancies were reported during the LTE. Pneumonia developed in 3 patients, and multiple sclerosis developed in 1 patient.Conclusion. Abatacept provided clinically significant and durable efficacy in patients with JIA, including those who did not initially achieve an ACR Pedi 30 response during the initial 4-month open-label lead-in phase.

Studies of gastric mucosa regeneration and safety promoted by Mouriri pusa treatment in acetic acid ulcer model

Ethnopharmacological Relevance: Mouriri pusa Gardn. (Melastomataceae) is a medicinal plant commonly used by people living in the Cerrado to treat gastrointestinal disturbances. This medicinal plant has shown intense gastroprotective action in rodent gastric lesion, but still there are no data about its healing effect on gastric mucosa.Aim of the Study: To evaluate the methanolic extract (MeOH) obtained from Mouriri pusa leaves for its effect on the cicatrisation process of gastric ulcer.Mterials and Methods: The healing effects on gastric ulcers inducted by subserosal injection of acetic acid were evaluated by macroscopic and microscopic measures, imunohistochemistry and cell counting in rats treated with MeOH extract of Mouriri pusa (250 mg/kg, p.o./daily) for 14 or 30 days. The toxicity of Mouriri pusa was also evaluated by body and organ weight measure and clinical biochemical parameters.Results: Mouriri pusa treatments lasting 14 and 30 days showed elevated mucus secretion (PAS) and thicker regenerative gastric mucosa, denoting increased cell proliferation, which was confirmed by PCNA immunohistochemical analysis. Moreover, there was important cell recruitment (neutrophils and mast cells) to the site of the ulcer, which is an important factor in ulcer healing. No toxic effect was observed in all parameters evaluated. Phenolic compounds present in the MeOH extract like tannins, flavonoids and epicatechin are the probable agents involved in the healing effects of this medicinal plant.Conclusions: These findings showed a potential effect of Mouriri pusa in increasing regeneration of damaged gastric mucosa with safety for human use. (C) 2007 Elsevier B.V. All rights reserved.

Photorefractive two-wave mixing phase coupling measurement in a self-stabilized recording regime

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Effectiveness and safety of a new vaginal misoprostol product specifically labeled for cervical ripening and labor induction

Objective. The purpose of this study was to evaluate the effectiveness and safety of misoprostol in two different formulations: vaginal tablets of 25 mu g and one-eighth of a 200-mu g oral tablet, also administered intravaginally, for cervical ripening and labor induction of term pregnancies with an indication for that. Methods. A single-blind, randomized, controlled clinical trial was carried out in 120 pregnant women who randomly received one of the two formulations. The main dependent variables were mode of delivery, need for additional oxytocin, time between beginning of induction and delivery, perinatal results, complications, and maternal side effects. Student's t, Mann-Whitney, chi(2), Fisher's Exact, Wilcoxon and Kolmogorov-Smirnoff tests, as well as survival analysis, were used in the data analysis. Results. There were no significant differences between the groups in terms of general characteristics, uterine contractility, and fetal well-being during labor, cesarean section rates, perinatal outcomes, or maternal adverse events. The mean time between the beginning of cervical ripening and delivery was 31.3 h in the vaginal tablet group and 30.1 h in the oral tablet group, a difference that was not statistically significant. Conclusion. The results showed that the 25-mu g vaginal tablets of misoprostol were as effective and safe for cervical ripening and labor induction as the dose-equivalent fraction of 200-mu g oral tablets.

Assessment of pharmacotherapeutic safety of medical prescriptions for elderly residents in a long-term care facility

The present study aimed to estimate the prevalence of elderly using potentially inappropriate medications (PIM) and with occurrence of potentially hazardous drug interactions (PHDI), to identify the risk factors for the prescription of PIM and to evaluate the impact of pharmaceutical intervention (PI) for the prescription of safer therapeutic alternatives. Therefore, a cross-sectional study was performed in a long-term care facility in São Paulo State, between December/2010 and January/2011. The medical records of the patients >= 60 years old who took any drugs were consulted to assess the pharmacotherapeutic safety of the medical prescriptions, in order to identify PIM and PHDI, according to the Beers (2003) and World Health Organization criteria, respectively. PI consisted of a guidance letter to the physician responsible for the institution, with the suggestions of safer equivalent therapeutics. Approximately 88% of the elderly took at least one drug, and for 30% of them the PIM had been prescribed. Most of the PIM identified (53.4%) act on the central nervous system. Among the 13 different DI detected, 6 are considered PHDI. Polypharmacy was detected as a risk factor for PIM prescription. After the PI there was no change in medical prescriptions of patients who had been prescribed PIM or PHDI. The data suggests that PI performed by letter, as the only interventional, method was ineffective. To contribute it a wide dissemination of PIM and PHDI among prescriber professionals is necessary for the selection of safer treatment for elderly. Additionally, a pharmacist should be part of the health care team in order to help promote rational use of medicines.

Morpho-physical Recording of Bovine Conceptus (Bos indicus) and Placenta from Days 20 to 70 of Pregnancy

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Efficacy, safety and tolerability of terbinafine for Tinea capitis in children: Brazilian multicentric study with daily oral tablets for 1, 2 and 4 weeks

Background: Tinea capitis is a common skin disease seen predominantly in children. The standard therapies for this disease are griseofulvin and ketoconazole. Nevertheless, these drugs have drawbacks in that they are only fungistatic and require treatment for at least 6 weeks. Previous studies with oral terbinafine for the treatment of Tinea capitis have shown that this agent is effective when given for 4 weeks, comparable to an 8-week regimen with griseofulvin. To date there is no data on the use of oral terbinafine in Brazilian children. Objectives: To assess the efficacy, safety and tolerability of oral terbinafine in short-term treatments (1-, 2- and 4-week treatment) of Tinea capitis in children. Patients and methods: One hundred and thirty-two children aged 1-14 years were enrolled in this study, but only 107 were considered for the final efficacy analysis. Diagnosis included clinical assessment and examination by Wood's light. Confirmation was obtained by direct microscopy and culture for fungus. Terbinafine dosage (125 or 250 mg/day) was adjusted according to patient weight. Efficacy was evaluated both by clinical and mycological assessment. Safety and tolerability variables included data on adverse reaction and clinical laboratory evaluations. Results: Mycological evaluation in the follow-up visit at week 12 showed negative direct microscopy and culture results in 48.6, 60.5 and 69.7% patients in groups 1-, 2- and 4-week, respectively (n.s.). At week 12, 84.8% patients in group 4-week achieved clinical cure with a significant difference compared to groups 1- and 2-week, 54.3 and 60.5%, respectively (P < 0.01). Adverse reactions were present in 4.8, 6.8 and 10.9% of patients in groups 1-, 2- and 4-week, respectively. Terbinafine was not associated with clinically relevant increases in liver function tests. Conclusions: Terbinafine is an effective, well tolerated and safe antifungal agent for the treatment of Tinea capitis m children. The shorter duration of treatment resulted in lower cure rates. However, it is important to note that depending on the severity of the disease, a 1-week-only treatment can also be effective in this indication.

GIS_EM (Geographic information system for environmental monitoring) - A software implemented at Paulínia refinery (REPLAN) for management of environmental data

The computational program called GIS_EM (Geographic Information System for Environmental Monitoring), a software devised to manage geographic information for monitoring soil, surface, and ground water, developed for use in the Health, Safety, and Environment Division of Paulinia Refinery is presented. This program enables registering and management of alphanumeric information pertaining to specific themes such as drilling performed for sample collection and for installation of monitoring wells, geophysical and other tests, results of chemical analyses of soil, surface, and groundwater, as well as reference values providing orientation for soil and water quality, such as EPA, Dutch List, etc. Management of such themes is performed by means of alphanumeric search tools, with specific filters and, in the case of spatial search, through the selection of spatial elements (themes) in map view. Documents existing in digital form, such as reports, photos, maps, may be registered and managed in the network environment. As the system centralizes information generated upon environmental investigations, it expedites access to and search of documents produced and stored in the network environment, minimizing search time and the need to file printed documents. This is an abstract of a paper presented at the AIChE Annual Meeting and Fall Showcase (Cincinnati, OH 10/30/2005-11/4/2005).

CMS data processing workflows during an extended cosmic ray run

The CMS Collaboration conducted a month-long data taking exercise, the Cosmic Run At Four Tesla, during October-November 2008, with the goal of commissioning the experiment for extended operation. With all installed detector systems participating, CMS recorded 270 million cosmic ray events with the solenoid at a magnetic field strength of 3.8 T. This paper describes the data flow from the detector through the various online and offline computing systems, as well as the workflows used for recording the data, for aligning and calibrating the detector, and for analysis of the data. © 2010 IOP Publishing Ltd and SISSA.

Estimating the effects of United States food safety and agricultural health standards on agro-food exports from Latin America and the Caribbean

Includes bibliography