The hospital survey on patient safety culture in Portuguese hospitals: instrument validity and reliability

Purpose – Quantitative instruments to assess patient safety culture have been developed recently and a few review articles have been published. Measuring safety culture enables healthcare managers and staff to improve safety behaviours and outcomes for patients and staff. The study aims to determine the AHRQ Hospital Survey on Patient Safety Culture (HSPSC) Portuguese version's validity and reliability. Design/methodology/approach – A missing-value analysis and item analysis was performed to identify problematic items. Reliability analysis, inter-item correlations and inter-scale correlations were done to check internal consistency, composite scores. Inter-correlations were examined to assess construct validity. A confirmatory factor analysis was performed to investigate the observed data's fit to the dimensional structure proposed in the AHRQ HSPSC Portuguese version. To analyse differences between hospitals concerning composites scores, an ANOVA analysis and multiple comparisons were done. Findings – Eight of 12 dimensions had Cronbach's alphas higher than 0.7. The instrument as a whole achieved a high Cronbach's alpha (0.91). Inter-correlations showed that there is no dimension with redundant items, however dimension 10 increased its internal consistency when one item is removed. Originality/value – This study is the first to evaluate an American patient safety culture survey using Portuguese data. The survey has satisfactory reliability and construct validity.

Public health and the knowledge industry

Knowledge plays an important role in health care. The production and diffusion of health-related knowledge are increasingly under the control of private commercial interests, which are characterized by conflicts of interests that result in abuses of power. Considerable research has been done on the medical-industrial complex and its role in the production of power imbalances and the consequent abuses, but little attention has been dedicated to the role played by the publishing industry, which can be subject to the same problems. The widely diffused idea that "frequent and major changes" occur in medicine, albeit unsupported by clearcut evidence, is an effective marketing tool for both the pharmaceutical and publishing industries, who feed and thrive on physicians' insecurities. The production and distribution of knowledge should be addressed as a strategic component of public health.

Locus of control and contraceptive knowledge, attitude and practice among university students

OBJECTIVE: To assess the relationship between locus of control and knowledge, attitude and practice regarding pill and condom use among university students. METHODS: The inquiry was developed in Campinas, a city in Southeastern Brazil, in 2006. A total of 295 adolescent newcomers to a public university answered a structured questionnaire and Levenson's multidimensional locus of control scale. The scores of the dimensions of locus of control were calculated and Spearman's correlation coefficient was used to assess their correlation with knowledge and practice concerning pill and condom use. In order to assess the relationship between the dimensions of locus of control and sociodemographic variables and variables related to the individuals' sex life, Kruskal-Wallis and Mann-Whitney tests were used. RESULTS: Male adolescents had higher scores of powerful others externality when compared to female adolescents (p=0.01). Students living alone had lower internality (p=0.01). When locus of control was compared to condom use in the first intercourse, considering only the 102 students who informed the age of the beginning of sexual activity, greater internality was found among male adolescents who did not use condoms (p<0.05). When the locus of control scores were correlated with contraceptive knowledge and practice, it was found that the higher the powerful others externality locus, the lower the adequate use of contraceptive methods (r = -0.22, p=0.03). CONCLUSIONS: The powerful others externality locus influences the practice of contraceptive use in this group of adolescents.

The invisible factors that can make the difference. Language management and knowledge transfer in multinational sites

The knowledge-based society we live in has stressed the importance of human capital and brought talent to the top of most wanted skills, especially to companies who want to succeed in turbulent environments worldwide. In fact, streams, sequences of decisions and resource commitments characterize the day-to-day of multinational companies (MNCs). Such decision-making activities encompass major strategic moves like internationalization and new market entries or diversification and acquisitions. In most companies, these strategic decisions are extensively discussed and debated and are generally framed, formulated, and articulated in specialized language often developed by the best minds in the company. Yet the language used in such deliberations, in detailing and enacting the implementation strategy is usually taken for granted and receives little if any explicit attention (Brannen & Doz, 2012) an can still be a “forgotten factor” (Marschan et al. 1997). Literature on language management and international business refers to lack of awareness of business managers of the impact that language can have not only in communication effectiveness but especially in knowledge transfer and knowledge management in business environments. In the context of MNCs, management is, for many different reasons, more complex and demanding than that of a national company, mainly because of diversity factors inherent to internationalization, namely geographical and cultural spaces, i.e, varied mindsets. Moreover, the way of functioning, and managing language, of the MNC depends on its vision, its values and its internationalization model, i.e on in the way the MNE adapts to and controls the new markets, which can vary essentially from a more ethnocentric to a more pluricentric focus. Regardless of the internationalization model followed by the MNC, communication between different business units is essential to achieve unity in diversity and business sustainability. For the business flow and prosperity, inter-subsidiary, intra-company and company-client (customers, suppliers, governments, municipalities, etc..) communication must work in various directions and levels of the organization. If not well managed, this diversity can be a barrier to global coordination and create turbulent environments, even if a good technological support is available (Feely et al., 2002: 4). According to Marchan-Piekkari (1999) the tongue can be both (i) a barrier, (ii) a facilitator and (iii) a source of power. Moreover, the lack of preparation for the barriers of linguistic diversity can lead to various costs, including negotiations’ failure and failure on internationalization.. On the other hand, communication and language fluency is not just a message transfer procedure, but above all a knowledge transfer process, which requires extra-linguistic skills (persuasion, assertiveness …) in order to promote credibility of both parties. For this reason, MNCs need a common code to communicate and trade information inside and outside the company, which will require one or more strategies, in order to overcome possible barriers and organization distortions.

A semantic approach for learning objects repositories with knowledge reuse

In this paper we discuss how the inclusion of semantic functionalities in a Learning Objects Repository allows a better characterization of the learning materials enclosed and improves their retrieval through the adoption of some query expansion strategies. Thus, we started to regard the use of ontologies to automatically suggest additional concepts when users are filling some metadata fields and add new terms to the ones initially provided when users specify the keywords with interest in a query. Dealing with different domain areas and having considered impractical the development of many different ontologies, we adopted some strategies for reusing ontologies in order to have the knowledge necessary in our institutional repository. In this paper we make a review of the area of knowledge reuse and discuss our approach.

Análise descritiva das práticas e contextos em fisioterapia respiratória nos hospitais centrais públicos de Luanda

Mestrado em Fisioterapia

Traditional knowledge for promotion of socioeconomic inclusion of local communities

This paper discusses the key role played by public research institutes for promoting socioeconomic inclusion of local communities based on traditional knowledge and traditional medicine. Nongovernmental organizations and cooperatives have had an important role in raising financial resources, being involved with advocacy of local communities and advancing legislation changes. But strict best manufacturing practices regulations imposed by the Brazilian National Health Surveillance Agency on the requirements for approval and commercialization of drugs based on herbal medicine products call for the involvement of strong public research institutes capable of supporting community-based pharmacies. Thus, public research institutes are pivotal as they can conduct scientific research studies to evidence the efficacy of herbal medicine products and help building the capacity of local communities to comply with current regulations.

A decisão técnica num serviço de radiologia de urgência hospitalar: o caso dos técnicos de radiologia do Hospital de São José (Centro Hospitalar de Lisboa — Zona Central)

Mestrado em Intervenção Sócio-Organizacional na Saúde - Ramo de especialização: Políticas de Administração e Gestão de Serviços de Saúde

A checklist for patient safety rounds at the care pathway level

Objective - To define a checklist that can be used to assess the performance of a department and evaluate the implementation of quality management (QM) activities across departments or pathways in acute care hospitals. Design - We developed and tested a checklist for the assessment of QM activities at department level in a cross-sectional study using on-site visits by trained external auditors. Setting and Participants - A sample of 292 hospital departments of 74 acute care hospitals across seven European countries. In every hospital, four departments for the conditions: acute myocardial infarction (AMI), stroke, hip fracture and deliveries participated. Main outcome measures - Four measures of QM activities were evaluated at care pathway level focusing on specialized expertise and responsibility (SER), evidence-based organization of pathways (EBOP), patient safety strategies and clinical review (CR). Results - Participating departments attained mean values on the various scales between 1.2 and 3.7. The theoretical range was 0-4. Three of the four QM measures are identical for the four conditions, whereas one scale (EBOP) has condition-specific items. Correlations showed that every factor was related, but also distinct, and added to the overall picture of QM at pathway level. Conclusion - The newly developed checklist can be used across various types of departments and pathways in acute care hospitals like AMI, deliveries, stroke and hip fracture. The anticipated users of the checklist are internal (e.g. peers within the hospital and hospital executive board) and external auditors (e.g. healthcare inspectorate, professional or patient organizations).

The Gap Between Knowledge and Action: Obstacles, Restraints and Deficits During the Execution of Refurbishments

This article outlines the initial draft of a PhD project which investigates refurbishment or rehabilitation projects in two German cities. The study focuses on obstacles, restraints and deficits as well as factors of success, which can be identified during the execution of the refurbishments. Moreover the study examines the process of the refurbishment itself, the general conditions under which the refurbishments are being executed as well as the implementation of sustainability criteria. First the article gives a short summary of the theoretical considerations of the study. In this respect it shortly outlines the global conditions of urban development and conducting challenges for cities in the 21st century, guiding principles of a sustainable urban development as well as goals of sustainable refurbishments. Finally the article shortly describes the case studies and presents the initial results of the empirical work.

The sociological perspective on the knowledge-based society: assumptions, facts and visions

The paper will present the central discourse of the knowledge-based society. Already in the 1960s the debate of the industrial society already raised the question whether there can be considered a paradigm shift towards a knowledge-based society. Some prominent authors already foreseen ‘knowledge’ as the main indicator in order to displace ‘labour’ and ‘capital’ as the main driving forces of the capitalistic development. Today on the political level and also in many scientific disciplines the assumption that we are already living in a knowledge-based society seems obvious. Although we still do not have a theory of the knowledge-based society and there still exist a methodological gap about the empirical indicators, the vision of a knowledge-based society determines at least the perception of the Western societies. In a first step the author will pinpoint the assumptions about the knowledge-based society on three levels: on the societal, on the organisational and on the individual level. These assumptions are relied on the following topics: a) The role of the information and communication technologies; b) The dynamic development of globalisation as an ‘evolutionary’ process; c) The increasing importance of knowledge management within organisations; d) The changing role of the state within the economic processes. Not only the differentiation between the levels but also the revision of the assumptions of a knowledge-based society will show that the ‘topics raised in the debates’ cannot be considered as the results of a profound societal paradigm shift. However what seems very impressive is the normative and virtual shift towards a concept of modernity, which strongly focuses on the role of technology as a driving force as well as on the global economic markets, which has to be accepted. Therefore – according to the official debate - the successful adaptation of these processes seems the only way to meet the knowledge-based society. Analysing the societal changes on the three levels, the label ‘knowledge-based society’ can be seen critically. Therefore the main question of Theodor W. Adorno during the 16th Congress of Sociology in 1968 did not loose its actuality. Facing the societal changes he asked whether we are still living in the industrial society or already in a post-industrial state. Thinking about the knowledge-based society according to these two options, this exercise would enrich the whole debate in terms of social inequality, political, economic exclusion processes and at least the power relationship between social groups.

Change Processes and Future Perspectives in the Knowledge Society. The Example of Clothing and Textile Industry

The paper examines change processes und future perspectives in the knowledge society. It presents the clothing and textile industry as an example for a transforming industry in a global economy. The paper reviews existing future studies, which have surveyed change processes and future developments in the clothing and textile industry. Main goals of the review are the identification of changes in work and the description of the restructuring of global value chains within the clothing and textile sector. The paper also highlights major current trends, drivers of change and future prospects in this sector.

The First WORKS Conference on Transformation of Work in a Global Knowledge Economy

The relationship between the changes of the global economy and individual working conditions formed the background of the first WORKS conference “The transformation of work in a global knowledge economy: towards a conceptual framework”, held in Chania, Greece from 21st – 22nd September, 2006 and attended by around 50 European researchers. Experts from academia and trade unions from all over the world were invited to give insights into their field of research, contributing to one of the main topics of the conference: (i) globalisation and organisational restructuring, (ii) workers’ organisation, the quality of working life and the gender dimension and (iii) global experiences and recommendations.

Into a new phase of the research on restructuring of work in the knowledge society: the Third WORKS General Assembly in Sofia (Bulgaria)

The WORKS Project started two years ago (2005), involving the efforts of research institutes of 13 European countries with the main purpose of improving the understanding of the major changes in work in the knowledge-based society, taking account both of global forces and the regional diversity within Europe. This research meeting in Sofia (Bulgaria) aimed to present synthetically the massive amount of data collected in the case studies (occupational and organisational) and with the quantitative research during last year.

International Conference on “Foresight Studies on Work in the Knowledge Society“ in Monte de Caparica (FCT-UNL) on 19-20 October 2006

On 19 and 20 October 2006, the Research Centre on Enterprise and Work Organisation (IET) organised the first international conference on “Foresight Studies on Work in the Knowledge Society”. It took place at the auditorium of the new Library of FCT-UNL and had the support of the research project “CodeWork@VO” (financed by FCT-MCTES and co-ordinated by INESC, Porto). The conference related to the European research project “Work Organisation and Restructuring in the Knowledge Society” (WORKS), which is financed by the European Commission. The main objective of the conference was to analyse and discuss research findings on the trends of work structures in the knowledge society, and to debate on new work organisation models and new forms of work supported by ICT.