Objective To assess the culture of patient safety in studies that employed the hospital survey on patient safety culture (HSOPS) in hospitals around the world. Method We searched MEDLINE, EMBASE, SCOPUS, CINAHL, and SciELO. Two researchers selected studies and extracted the following data: year of publication, country, percentage of physicians and nurses, sample size, and results for the 12 HSOPS dimensions. For each dimension, a random effects meta-analysis with double-arcsine transformation was performed, as well as meta-regressions to investigate heterogeneity, and tests for publication bias. Results 59 studies with 755,415 practitioners surveyed were included in the review. 29 studies were conducted in the Asian continent and 11 in the United States. On average studies scored 9 out of 10 methodological quality score. Of the 12 HSOPS dimensions, six scored under 50% of positivity, with “nonpunitive response to errors” the lowest one. In the meta-regression, three dimensions were shown to be influenced by the proportion of physicians and five by the continent where survey was held. Conclusions The HSOPS is widely used in several countries to assess the culture of patient safety in hospital settings. The culture of culpability is the main weakness across studies. Encouraging event reporting and learning from errors should be priorities in hospitals worldwide.

Resumo Introdução A doença renal crônica é um problema global de saúde pública, e no Brasil sua prevalência é incerta. Objetivo Estimar a prevalência de doença renal crônica em adultos do Brasil. Método Realizou-se revisão sistemática com buscas no MEDLINE, Embase e outras bases. Dois pesquisadores selecionaram os estudos, extraíram os dados e avaliaram a qualidade. Resultados Incluímos 16 estudos: inquéritos populacionais que utilizaram critério autorreferido encontraram prevalência nacional de 4,57% (1998) a 1,43% (2013); naqueles que usaram hipercreatininemia, a prevalência foi 3,46% em Bambuí (1997) e 3,13% em Salvador (2000). Estudos com amostras não representativas usaram critérios clínico-laboratoriais e tiveram maiores prevalências: entre 6,26-7,26% em campanhas de saúde (2002-2010), 8,94% em servidores públicos (2008-2010), 9,62% em usuários de laboratório privado (2003), 27,20% em pacientes hospitalizados (2013) e 1,35-13,63% na atenção primária (2010-2012). Pacientes em terapia dialítica representam 0,05% da população. Discussão Os estudos com representatividade populacional não aferiram a doença adequadamente, e investigações com melhores critérios diagnósticos tiveram amostragem por conveniência. A heterogeneidade entre pesquisas inviabilizou a elaboração de meta-análise. Conclusão A prevalência de doença renal crônica variou de acordo com o método empregado na definição da doença. Pelos critérios populacionais, 3-6 milhões teriam a doença. Aproximadamente 100.000 recebem diálise no Brasil.

BackgroundCountries in Latin America and the Caribbean (LAC) have experienced a rapid increase in their proportion of older people. This region is marked by a high prevalence of chronic diseases and disabilities among aging adults. Frailty appears in the context of LAC negatively affecting quality of life among many older people.AimTo investigate the prevalence of frailty among community-dwelling older people in LAC through a systematic review and meta-analysis.MethodsA literature search was performed in indexed databases and in the grey literature. Studies investigating the prevalence of frailty with representative samples of community-dwelling older people in Latin America and the Caribbean were retrieved. Independent investigators carried out the study selection process and the data extraction. A meta-analysis and meta-regression were performed using STATA 11 software. The systematic review was registered at the International Prospective Register of Systematic Reviews under the number CRD42014015203.ResultsA total of 29 studies and 43,083 individuals were included in the systematic review. The prevalence of frailty was 19.6% (95% CI: 15.4–24.3%) in the investigated region, with a range of 7.7% to 42.6% in the studies reviewed. The year of data collection influenced the heterogeneity between the studies.ConclusionFrailty is very common among older people in LAC. As a result, countries in the region need to adapt their health and social care systems to demands of an older population.

Objective: To estimate the prevalence of depressive symptoms and major depressive disorder, as assessed in population-based cross-sectional studies of Brazilian adults. Methods: We performed a systematic review of the literature. The major databases were searched up through October 2013. Two researchers selected the studies, extracted the data, and assessed their methodological quality. Meta-analyses were performed using random effects. Results: Of the 2,971 records retrieved, we selected 27 studies that assessed the prevalence of depression morbidity in 464,734 individuals (66% women). Eleven different screening tools were used to assess depression morbidity. The prevalence of depressive symptoms was 14% (95% confidence interval [95%CI] 13-16; I 2 = 99.5%), whereas the 1-year prevalence of major depressive disorder was 8% (95%CI 7-10; I 2 = 86.7%), and the lifetime prevalence of major depressive disorder was 17% (95%CI 14-19; I 2 = 91.6%). All rates were higher in women than in men. No causes of heterogeneity could be identified. Conclusion: Depression morbidity was common among Brazilian adults, and affects more women than men. Inconsistencies across studies highlight the need for standardization of future research. Clinicians should routinely investigate for the presence of depression morbidity in this population.

Objective:to assess patient safety culture in a university hospital. Method:cross-sectional study with data collection through the Hospital Survey on Patient Safety Culture applied in electronic device. A total of 381 employees were interviewed, corresponding to 46% of the sum of eligible professionals. Data were analyzed descriptively. the Cronbach’s alpha was used to calculate the frequency and reliability. Results:most were women (73%) from the nursing area (50%) and with direct contact with patients (82%). The composites related to “teamwork within units” (58%, α=0.68), “organizational learning - continuous improvement” (58%, α=0.63), “supervisor/manager expectations and actions promoting patient safety” (56%, α=0.73) had higher positive responses. Nine composites had low positive responses, with emphasis on “nonpunitive response to error” (18%, α=0.40). Only the item “in this unit, people treat each other with respect” had positive response above 70%. The patient safety assessment in the work unit was positive for 36% of employees, however only 22% reported events in past year. Conclusion:the findings revealed weaknesses in the safety culture at the hospital, with emphasis on culpability.

self-medication was associated to young adults and those with problems in performing daily activities.

ObjectiveThe aim of the present study was to assess the prevalence of hypertension and cardiovascular risk factors among the native indigenous of Jaguapiru village in Dourados, Mato Grosso do Sul, Brazil.MethodA cross-sectional, population-based study was conducted with adult indigenous aged 18 years or more. The subjects' blood pressure was measured twice, and the mean of the two measurements was calculated. Body weight, height, capillary blood glucose and waist circumference were measured. Pregnant women, individuals using glucocorticoids, and non-indigenous villagers and their offspring were excluded. Multivariate regression analyses were conducted on the socio-demographic and clinical independent variables. Interactions between independent variables were also tested.ResultsWe included 1,608 native indigenous eligible to the research. The prevalence of hypertension was 29.5% (95% CI: 27–31.5), with no significant difference between the genders. For both men and women, diastolic hypertension was more common than systolic hypertension. The prevalence of hypertension was higher among obese, diabetic, and older participants, as well as those who consumed alcohol, had a lower educational level, or had a family history of hypertension. There was no association between hypertension and tobacco smoking or family income.ConclusionHypertension among the indigenous from Jaguapiru village was similar to the prevalence in the Brazilians, but may have a more negative effect in such disadvantaged population. The associated factors we found can help drawing prevention policies.

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