Experimenting the hospital survey on patient safety culture in prevention facilities in Italy: psychometric properties.

OBJECTIVE: The Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture (HSOPS) was designed to assess staff views on patient safety culture in hospital. This study examines psychometrics of the Italian translation of the HSOPS for use in territorial prevention facilities. DESIGN: After minimal adjustments and pre-test of the Italian version, a qualitative cross-sectional study was carried out. SETTING: Departments of Prevention (DPs) of four Local Health Authorities in Northern Italy. PARTICIPANTS: Census of medical and non-medical staff (n. 479). INTERVENTION: Web-based self-administered questionnaire. MAIN OUTCOME MEASURES: Descriptive statistics, internal reliability, Confirmatory Factor Analysis (CFA) and intercorrelations among survey composites. RESULTS: Initial CFA of the 12 patient safety culture composites and 42 items included in the original version of the questionnaire revealed that two dimensions (Staffing and Overall Perception of Patient Safety) and nine individual items did not perform well among Italian territorial Prevention staff. After dropping those composites and items, psychometric properties were acceptable (comparative fit index = 0.94; root mean square error of approximation = 0.04; standardized root mean square residual = 0.04). Internal consistency for each remaining composite met or exceeded the criterion 0.70. Intercorrelations were all statistically significant. CONCLUSIONS: Psychometric analyses provided overall support for 10 of the 12 initial patient safety culture composites and 33 of the 42 initial composite items. Although the original instrument was intended for US Hospitals, the Italian translation of the HSOPS adapted for use in territorial prevention facilities performed adequately in Italian DPs.

Polychlorobiphenyls (PCBs), polychlorinated dibenzo-p-dioxins (PCDDs) and dibenzofurans (PCDFs) in fruit and vegetables from an industrial area in northern Italy.

Polychlorobiphenyls (PCBs), polychlorinated dibenzo-p-dioxins (PCDDs) and dibenzofurans (PCDFs) were measured in fruit and vegetables (n=113) harvested in different parts of the Mantua district, in northern Italy, and levels were used for assessing the exposure of the population to the contaminants through these food items. Concentrations in fruit and vegetables were in the range 33.39-10130pgg(-1)fresh weight (fw) for the sum of the 26PCBs analyzed (Sigma(26PCBs)), 14.86-4504pgg(-1)fw for the six "indicator" non-dioxin-like PCBs (Sigma(6 NDL-PCBs)), and 0.0004-1.398pg toxic equivalent (TEQ)g(-1)fw for the dioxin-like PCBs (SigmaTEQ(DL-PCBs)). Altogether fruit and vegetables made only a limited contribution to total dietary PCB intake, as the estimated total mean daily intake (TMDI) of Sigma(26PCBs) through these food items was 10.1% in children and 10.4% in adults of the minimal risk level (MRL) for PCBs, while the TMDI of SigmaTEQ(DL-PCBs) was 3.3% in children and 3.7% in adults of the tolerable daily intake (TDI) for dioxin-like compounds. The contribution of fruit and vegetables to total PCDD and PCDF dietary intake could not be assessed because concentrations of these congeners were almost all below the limit of detection in most of the crops analyzed. This study also found that PCB levels in rosemary were much higher than in any other crop, suggesting that rosemary leaves accumulate PCBs and that this plant might be proposed as a "sentinel" of the presence of these contaminants in the environment.