BackgroundAlthough a modest body of literature exists on accreditation, little research was conducted on the impact of accreditation on primary healthcare organizations in the Middle East. This study assessed the changes resulting from the integration of Accreditation Canada International’s accreditation program in a primary healthcare organization in the State of Qatar.MethodsThe study investigated how accreditation helped introduce organizational changes through promoting organizational learning as well as quality improvement initiatives. Applying a quantitative design, a structured questionnaire was used to collect data from 500 staff. The study used Spearman’s correlation coefficient to analyze the collected survey data.ResultsOverall employees agreed on the positive impact of accreditation. The results showed a significantly positive correlation between staff perception of accreditation and of quality of care. The two dominant cultures at Primary Health Care Corporation were “group” (with a score of 28.61) and “hierarchical” (with a score of 26.59). The results showed a positive correlation between staff perception of accreditation and their perception of culture type whenever the culture was identified as “group”.ConclusionsThis study provided much-needed insight on the possible changes that organizations might go through in relation to quality improvement and organizational learning.

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Objectives: Primary Health Care Corporation (PHCC) is the public primary health care provider in Qatar. Having a patient safety culture (PSC) is the keystone to enabling a continuous process to improve the quality of services and to reduce errors. The objective of this study was to assess the impact of accreditation, quality improvement trainings, and patient safety (PS) trainings on the improvement of the PSC at the PHCC in Qatar. Methods:The Medical Office Survey on Patient Safety Culture from the Agency for Healthcare Research and Quality was used in 2012 and 2015 to assess the culture of PS and health care quality in the 21 health centers. The results of the two surveys were compared using the χ 2 test. A P value of less than 0.05 was considered significant.Results: Out of 2689 staff working in the 21 health centers, 1810 (67.3%) completed the survey in 2012, and 2616 (70.0%) of 3735 completed the survey in 2015. The comparison between 2012 and 2015 survey's results showed a statistically significant improvement for all the 10 dimensions (P < 0.05). Although a statistically significant difference was observed between 2012 and 2015 results for work pressure and pace, three of the four questions of the work pressure and pace dimension presented nonsignificant differences. Conclusions:The survey was a good tool to raise awareness on PS and quality issues at PHCC. There is evidence that the implementation of accreditation program, the quality improvement trainings, and PS trainings helped the organization improve its PS culture.

BackgroundTobacco smoking is the main cause of lung cancer, but it is not the sole causal factor. Significant proportions of workers are smokers and exposed to occupational lung carcinogens. This study aims to systematically review the statistical interaction between occupational lung carcinogens and tobacco smoking, in particular asbestos, crystalline silica and diesel engine exhaust emissions.MethodsArticles were identified using Scopus, PubMed, and Web of Science, and were limited to those published in English or French, without limitation of time. The reference list of selected studies was reviewed to identify other relevant papers. One reviewer selected the articles based on the inclusion and exclusion criteria. Two reviewers checked the eligibility of articles to be included in the systematic review. Data were extracted by one reviewer and revised by two other reviewers. Cohorts and case–control studies were analyzed separately. The risk of bias was evaluated for each study based on the outcome. The results of the interaction between the tobacco smoking and each carcinogen was evaluated and reported separately.ResultsFifteen original studies were included for asbestos-smoking interaction, seven for silica-smoking interaction and two for diesel-smoking interaction. The results suggested the absence of multiplicative interaction between the three occupational lung carcinogens and smoking. There is no enough evidence from the literature to conclude for the additive interaction. We believe there is a limited risk of publication bias as several studies reporting negative results were published.ConclusionThere are no multiplicative interactions between tobacco smoking and occupational lung carcinogens, in particular asbestos, crystalline silica and diesel engine exhaust emissions. Even though, specific programs should be developed and promoted to reduce concomitantly the exposure to occupational lung carcinogens and tobacco smoking.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-017-4025-1) contains supplementary material, which is available to authorized users.

INTRODUCTION Tobacco use has become a global health concern. Almost a third of the adolescents of the Eastern Mediterranean Region (EMR) have reported tobacco use and the percentage is expected to rise in the future, making tobacco consumption a main public health issue among students, 13-15 years old, in the region's countries. We aimed to conduct an analysis of the previous Global Youth Tobacco Surveys (GYTS) in Qatar to detect any significant changes that might inform decision makers on planning policies and interventions accordingly. METHODS This study presents a retrospective data analysis, based on three GYTS conducted in Qatar during 2004, 2007, and 2013. All analyses were weighted to account for the complex survey design and for differential non-response at school, class and student levels, with the exception of the analysis of sociodemographic characteristics. The differences between the proportions were tested by Pearson's chi-squared test. Data were analyzed using the statistical software SPSS (Statistical Package for Social Sciences), version 21.0 (Chicago, IL). A p-value <0.05 was considered to be significant. RESULTS There was an overall increase in the prevalence of smoking, the accessibility, and the availability of cigarettes. Additionally, the percentage of participants who desired to stop smoking decreased between 2004 and 2013, while that of students who reported 'exposure to free tobacco promotion' was highest in 2013. CONCLUSIONS Despite the effort made by the local authorities in Qatar to reverse the spread or limit the growing tobacco epidemic, there is a need for multidisciplinary interventions through tobacco prevention and control programs targeting youths.