RESUMEN
OBJECTIVES: To: 1) develop/adapt and validate an instrument to measure patient safety attitudes and opinions of community-based spinal manipulative therapy (SMT) providers; 2) implement the instrument; and 3) compare results among healthcare professions. METHODS: A review of the literature and content validation were used for the survey development. Community-based chiropractors and physiotherapists in 4 Canadian provinces were invited. RESULTS: The Agency for Healthcare Research and Quality's (AHRQ) Medical Office Survey on Patient Safety Culture was the preferred instrument. The survey was modified and validated, measuring 14 patient safety dimensions. 276 SMT providers volunteered to respond to the survey. Generally, SMT providers had similar or better patient safety dimension scores compared to the AHRQ 2016 medical offices database. DISCUSSION: We developed the first instrument measuring patient safety attitudes and opinions of community-based SMT providers. This instrument provides understanding of SMT providers' opinions and attitudes on patient safety and identifies potential areas for improvement.
OBJECTIFS: 1) Élaborer/adapter et valider un instrument servant à évaluer les attitudes à l'égard de la sécurité du patient et les opinions des praticiens effectuant des manipulations vertébrales (MV); 2) adopter cet instrument; et 3) comparer les résultats obtenus entre les professionnels de la santé. MÉTHODOLOGIE: Pour élaborer le sondage, on a revu la littérature, on a validé le contenu et on a invité des chiropraticiens et des physiothérapeutes de quatre provinces canadiennes à participer. RÉSULTATS: Le Medical Office Survey on Patient Safety Culture de l'Agency for Healthcare Research and Quality's (AHRQ) était l'instrument préféré. Le sondage a été modifié et validé et a servi à mesurer 14 aspects de la sécurité du patient. 276 professionnels effectuant des MV ont accepté de répondre au sondage. En règle générale, les cotes obtenues chez les professionnels effectuant des MV pour ce qui des aspects de la sécurité étaient comparables ou meilleurs que celles des professionnels de la santé enregistrés dans la base de données de 2016 de l'AHRQ. DISCUSSION: On a élaboré le premier instrument servant à évaluer les attitudes à l'égard de la sécurité et les opinions des praticiens effectuant des MV dans une collectivité. Cet instrument permet de comprendre les opinions et les attitudes à l'égard de la sécurité du patient des professionnels effectuant des MV et de cerner les aspects qui pourraient être améliorés.
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High-coverage whole-genome sequence studies have so far focused on a limited number of geographically restricted populations, or been targeted at specific diseases, such as cancer. Nevertheless, the availability of high-resolution genomic data has led to the development of new methodologies for inferring population history and refuelled the debate on the mutation rate in humans. Here we present the Estonian Biocentre Human Genome Diversity Panel (EGDP), a dataset of 483 high-coverage human genomes from 148 populations worldwide, including 379 new genomes from 125 populations, which we group into diversity and selection sets. We analyse this dataset to refine estimates of continent-wide patterns of heterozygosity, long- and short-distance gene flow, archaic admixture, and changes in effective population size through time as well as for signals of positive or balancing selection. We find a genetic signature in present-day Papuans that suggests that at least 2% of their genome originates from an early and largely extinct expansion of anatomically modern humans (AMHs) out of Africa. Together with evidence from the western Asian fossil record, and admixture between AMHs and Neanderthals predating the main Eurasian expansion, our results contribute to the mounting evidence for the presence of AMHs out of Africa earlier than 75,000 years ago.
Asunto(s)
Genoma Humano/genética , Genómica , Migración Humana/historia , Grupos Raciales/genética , África/etnología , Animales , Asia , Conjuntos de Datos como Asunto , Estonia , Europa (Continente) , Fósiles , Flujo Génico , Genética de Población , Heterocigoto , Historia Antigua , Humanos , Nativos de Hawái y Otras Islas del Pacífico/genética , Hombre de Neandertal/genética , Nueva Guinea , Dinámica PoblacionalRESUMEN
The population history of Aboriginal Australians remains largely uncharacterized. Here we generate high-coverage genomes for 83 Aboriginal Australians (speakers of Pama-Nyungan languages) and 25 Papuans from the New Guinea Highlands. We find that Papuan and Aboriginal Australian ancestors diversified 25-40 thousand years ago (kya), suggesting pre-Holocene population structure in the ancient continent of Sahul (Australia, New Guinea and Tasmania). However, all of the studied Aboriginal Australians descend from a single founding population that differentiated ~10-32 kya. We infer a population expansion in northeast Australia during the Holocene epoch (past 10,000 years) associated with limited gene flow from this region to the rest of Australia, consistent with the spread of the Pama-Nyungan languages. We estimate that Aboriginal Australians and Papuans diverged from Eurasians 51-72 kya, following a single out-of-Africa dispersal, and subsequently admixed with archaic populations. Finally, we report evidence of selection in Aboriginal Australians potentially associated with living in the desert.
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Genoma Humano/genética , Genómica , Nativos de Hawái y Otras Islas del Pacífico/genética , Filogenia , Grupos Raciales/genética , África/etnología , Australia , Conjuntos de Datos como Asunto , Clima Desértico , Flujo Génico , Genética de Población , Historia Antigua , Migración Humana/historia , Humanos , Lenguaje , Nueva Guinea , Dinámica Poblacional , TasmaniaRESUMEN
The origin of contemporary Europeans remains contentious. We obtained a genome sequence from Kostenki 14 in European Russia dating from 38,700 to 36,200 years ago, one of the oldest fossils of anatomically modern humans from Europe. We find that Kostenki 14 shares a close ancestry with the 24,000-year-old Mal'ta boy from central Siberia, European Mesolithic hunter-gatherers, some contemporary western Siberians, and many Europeans, but not eastern Asians. Additionally, the Kostenki 14 genome shows evidence of shared ancestry with a population basal to all Eurasians that also relates to later European Neolithic farmers. We find that Kostenki 14 contains more Neandertal DNA that is contained in longer tracts than present Europeans. Our findings reveal the timing of divergence of western Eurasians and East Asians to be more than 36,200 years ago and that European genomic structure today dates back to the Upper Paleolithic and derives from a metapopulation that at times stretched from Europe to central Asia.