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BackgroundPatient safety in primary care is an emerging field of research with a growing evidence base in western countries but little has been explored in the Gulf Cooperation Council Countries (GCC) including the Sultanate of Oman. This study aimed to review the literature on the safety culture and patient safety measures used globally to inform the development of safety culture among health care workers in primary care with a particular focus on the Middle East.MethodsA systematic review of the literature. Searches were undertaken using Medline, EMBASE, CINAHL and Scopus from the year 2000 to 2014. Terms defining safety culture were combined with terms identifying patient safety and primary care.ResultsThe database searches identified 3072 papers that were screened for inclusion in the review. After the screening and verification, data were extracted from 28 papers that described safety culture in primary care. The global distribution of the articles is as follows: the Netherlands (7), the United States (5), Germany (4), the United Kingdom (1), Australia, Canada and Brazil (two for each country), and with one each from Turkey, Iran, Saudi Arabia and Kuwait. The characteristics of the included studies were grouped under the following themes: safety culture in primary care, incident reporting, safety climate and adverse events. The most common theme from 2011 onwards was the assessment of safety culture in primary care (13 studies, 46%). The most commonly used safety culture assessment tool is the Hospital survey on patient safety culture (HSOPSC) which has been used in developing countries in the Middle East.ConclusionsThis systematic review reveals that the most important first step is the assessment of safety culture in primary care which will provide a basic understanding to safety-related perceptions of health care providers. The HSOPSC has been commonly used in Kuwait, Turkey, and Iran.Electronic supplementary materialThe online version of this article (10.1186/s12875-018-0793-7) contains supplementary material, which is available to authorized users.

For analysis of respiratory system mechanics the very complex structure of the respiratory system is strongly simplified to a simple resistance-compliance-model. While for most patients this simplification seems sufficient, in patients with pulmonary disease this model is inappropriate. Additionally, to regional inhomogeneity throughout the lung, large volume accelerations due to the strongly decreased respiratory system compliance together with a mass increase of the patients' lungs, i.e. an increased respiratory system inertance Irs, result in a significant inertive pressure contribution. The aim of this study was to develop a physical inertance model, and its description by conventional methods of respiratory monitoring. Its parameters are adjustable within the physiological range, with Irs between 0.06 and 0.2 mbar.s2.l-1. The model proved well with static and dynamic analysis of respiratory system parameters. Using our physical model it is possible to evaluate new methods of respiratory monitoring and to investigate experimentally the interrelationship of respiratory system parameters.

The promotion of choice is a common theme in both policy discourses and commercial marketing claims about healthcare. However, within the multiple potential pathways of the healthcare 'maze', how do healthcare 'consumers' or patients understand and experience choice? What is meant by 'choice' in the policy context, and, importantly from a sociological perspective, how are such choices socially produced and structured? In this theoretical article, the authors consider the interplay of Bourdieu's three key, interlinked concepts -capital, habitus and field -in the structuring of healthcare choice. These are offered as an alternative to rational choice theory, where 'choice' is regarded uncritically as a fundamental 'good' and able to provide a solution to the problems of the healthcare system. The authors argue that sociological analyses of healthcare choice

Background: Competency frameworks are being taken up by a growing number of sectors and for a broad range of applications. However, the topic of competency frameworks is characterised by conceptual ambiguity, misunderstanding and debate. Lack of consistency in the conceptualisation and use of key terminology creates a barrier to research and development, consensus, communication and collaboration, limiting the potential that competency frameworks have to deal with real workforce challenges. This paper aims to advance the field by conducting a detailed review of the literature to understand the underlying causes of conceptual differences and divergent views and proposing a re-conceptualisation of competency framework terminology for use by the health sector. Methods: A broad scoping review of literature was conducted to identify publications relating to the conceptualisation of competency frameworks and key terms, examine how they are conceptualised and determine how this evolved. In addition, a purposive sample of health-related competency frameworks was chosen to illustrate how the terms and concepts are currently being applied in the health context. Results:Of the 4 155 records identified, 623 underwent text searches and broad quantitative analysis, and 70 were included for qualitative analysis. Quantitative analysis identified 26 key terms, which were coded under six thematic headings. Qualitative analysis using the thematic areas revealed two distinct conceptualisations of competency frameworks and their terminology emerging concurrently in the education and employment sectors, with different underpinnings and purposes. As competency frameworks have developed, these two conceptualisations intertwined, resulting in the same terms being used to convey different concepts. Examination of health-related frameworks showed that this merging of concepts is prominent, with lack of consistency in definitions and use of key terms even within a single organisation. Discussion and conclusions: Building on previous efforts to address the lack of conceptual clarity surrounding competency frameworks, this paper proposes a re-conceptualisation of the terminology that encompasses two distinct competency framework interpretations, using a glossary of mutually exclusive terms to differentiate concepts. The re-conceptualisation holds relevance for multiple competency framework applications within health, enabling harmonisation, clear communication, consensus-building and effective implementation of competency frameworks.