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Purpose: This paper aims at identifying obstacles, benefits, leading practices and lessons learned in the transition/certification of the revised standard for quality management systems ISO 9001:2015 for organizations in various sector, countries and spanning a range of sizes.Design/methodology/approach: Based on literature review and inputs from experts in management systems certification, a quantitative survey was launched in Portugal, Romania, Switzerland, and Turkey in April 2018, addressed at quality and organizational managers and CEOs from ISO 9001:2015-certified organizations by certification bodies partners of the leading International Quality Network (IQNet). The answers were collected anonymously through an automated online database, until the end of April 2018. The overall response rate was 3.1%, encompassing 222 organizations already certified according to ISO 9001:2015.Findings: The surveyed organizations reported significant benefits from ISO 9001:2015 implementation. Only 3.9% of the respondents considered the 3-year transition period (from September 15, 2015, to September 15, 2018) as too short. The respondents’ organizations attended ISO 9001:2015 training and seminars, and collected information from websites, newsletters, books and interpretation guides and directly from certification bodies. Some (29.8%) relied on their own internal resources for the transition processes, while external consultants supported 22.7%. The respondents considered the adoption of risk-based thinking the major difficulty to be overcome, but simultaneously as the major benefit to be realized. The alignment with other management systems, the increased top management commitment, the identification of risks and opportunities and the knowledge management were also reported as significant benefits.The initial timing when organizations started working on the transition process and the activities carried out seem to differ between countries, while the adjustments performed to the existing management systems seem to differ by sector and size of the organization. The benefits attained by the organizations vary according to the perception regarding the information resources made available and organizations should be aware of the advantages of early planning. The organizations that rated the benefits of ISO 9001:2015 adoption higher considered the information resources as adequate and started working with ISO 9001:2015 at an earlier stage, while those that rated the benefits lower stated that the information resources were made available too late. The organizations that successfully managed the ISO 9001:2015 transition/certification process were the ones that attended ISO 9001:2015 training courses and seminars and got useful information from their certification body.This research highlights the relevance of the geographical context, of the organization size and the sector for successful adoption of ISO 9001:2015. The identification and promotion of resources that led to the highest benefits are worth pursuing. The replication of this study can add a time perspective and the assessment if these perceptions are expected to materialize into tangible results such as cost benefits and higher customer satisfaction.Research limitations/implications: Due to the novelty of ISO 9001:2015, these results should be subjected to additional validation and longitudinal analyses. Although measures have been taken to minimize possible bias errors from both non-respondents’, and respondents’ subjectivity, these limitations of the survey methodology should be acknowledged.Practical implications: The findings of this research provide standardization and certification bodies and quality management systems practitioners with leading practices in the implementation of ISO 9001:2015 and guidance for an efficient and effective transition/adoption.Originality/value: This investigation contributes to the ISO 9001:2015 body of knowledge by mapping the transition/certification processes with a multi-country perspective. The results empirically validate the potential value of transitioning or adopting ISO 9001:2015 and give insights on the implementation methodologies, leading practices to follow, difficulties to overcome and benefits to realize, to maximize the success of ISO 9001:2015 adoption.

The production of extended-spectrum β-lactamases (ESBLs) is the main defense mechanism found in Gram negative bacteria. Among all the ESBLs, the CTX-M enzymes appear as the most efficient in terms of dissemination in different epidemiological contexts. CTX-M enzymes exhibit a striking plasticity, with a large number of allelic variants distributed in several sublineages, which can be associated with functional heterogeneity of clinical relevance. This observational analytical study provides an update of this family, currently with more than 200 variants described, from a phylogenetic, molecular, and structural point of view through homology in amino acid sequences. Our data, combined with described literature, provide phylogenetic and structural evidence of a new group. Thus, herein, we propose six groups among CTX-M enzymes: the already stablished CTX-M-1, CTX-M-2, CTX-M-8, CTX-M-9, and CTX-M-25 clusters, as well as CTX-M-151 as the new cluster.

Healthcare workers are exposed to workplace violence such as physical assaults, psychological violence and threats of violence. It is crucial to understand factors associated with workplace violence to prevent and mitigate its consequences. This study aims to identify work-related factors that might influence workplace violence in healthcare settings. A cross-sectional study was developed between March and April of 2022 with healthcare workers. The Aggression and Violence at Work Scale was used to assess workplace violence, and psychosocial risks were assessed through the Health and Work Survey—INSAT. Statistical analysis using bivariate analysis was performed to identify the psychosocial risk factors related to physical violence, psychological violence and vicarious violence. Subsequently, a multiple linear regression was performed to identify the models that better explained the relationship between psychosocial risk factors and the three dimensions of violence. Psychological violence was frequently experienced by the healthcare workers. Significant associations were found between psychosocial risk factors and physical, psychological and vicarious violence, namely working hours, work relationships, employment relations, high demands and work intensity. These findings highlight the importance of taking into consideration work-related factors when designing interventions to prevent and address workplace violence in healthcare settings.

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Despite the primary function of pioglitazone in antidiabetic treatment, this drug is a potent inducer of PPAR-γ, a crucial receptor that is involved in adipocyte differentiation. In this work, we propose an optimized methodology to enhance the differentiation of 3T3-L1 fibroblasts into adipocytes. This process is crucial for adipocyte secretome release, which is fundamental for understanding the molecular mechanisms that are involved in obesity for in vitro studies. To achieve this, a pioglitazone dose-response assay was determined over a range varying from 0 to 10 µM. Lipid accumulation was evaluated using Oil-Red-O. The results showed that 10 µM pioglitazone enhanced differentiation and increased secretome production. This secretome was then added into two cell lines: PC3 and RAW264.7. In the PC3 cells, an increase of aggressiveness was observed in terms of viability and proliferation, with the increase of anti-inflammatory cytokines. Conversely, in RAW264.7 cells, a reduction of viability and proliferation was observed, with a decrease in the overexpression of pro-inflammatory cytokines. Overall, the present work constitutes an improved method for adipocyte secretome production that is suitable for experimental biology studies and that could help with our understanding of the molecular mechanisms underlying adiposity influence in other cells.

The World Health Organization defends prevention and health promotion among communities as a driver of economic and social development, where the individual level of health literacy determines health choices such as adopting healthy lifestyles, managing individual healthcare and preventing chronic diseases. Currently, health promotion is guided by a set of values, being these principles essential for identifying needs and priorities, planning, implementing, evaluating and determining the health promotion programs, that can be defined as a set of programmed, integrated and interrelated strategies and actions that aim to promote health, prevent risks, reduce years of life lost due to disability and increase quality of life. There are several models for planning health promotion programs, such as the Precede-Proceed Model, the Multivariate Approach to Community Health (MATCH) Model, the Mapped Intervention Model and the Social Marketing Model. A good planning of a health promotion program can effectively reduce the health costs.