Leadership to promote patient safety culture in public hospitals managed by social health organizations.

PURPOSE: This paper aims to identify the kind of internal climate leaders should offer health-care professionals to promote a patient safety culture in public hospitals managed by social health organizations in Brazil. DESIGN/METHODOLOGY/APPROACH: Two surveys were applied to health-care professionals working at three Brazilian public hospitals. The internal climate survey reached 1,013 respondents, and the patient safety culture survey reached 1,302 participants. Both factor and regression analyses were used to analyze the study model and determine how internal climate influences patient safety culture. FINDINGS: Results indicate that to promote a patient safety culture among health-care professionals, leaders should generate an internal climate based on trust to foster pride in working in the hospital. Possibly, the trust dimension is the most important one and must be developed to achieve job satisfaction and provide better services to patients. RESEARCH LIMITATIONS/IMPLICATIONS: All the hospitals studied were managed by the same Organização Social de Saúde. Due to the limited responses concerning the respondents' profiles, demographic variables were not analyzed. PRACTICAL IMPLICATIONS: This research reveals that the trust and pride dimensions can most strongly influence a positive patient safety culture, helping hospital leaders face this huge managerial challenge of consistently delivering high standards of patient safety. ORIGINALITY/VALUE: This research studies the promotion of a patient safety culture in public hospitals managed by social health organizations, characterized by greater flexibility and autonomy in health-care management and by a greater need for accountability.

Trends, Limits, and Challenges of Computer Technologies in Attention Deficit Hyperactivity Disorder Diagnosis and Treatment.

Attention deficit hyperactivity disorder (ADHD) is a neurobiological condition that appears during an individual's childhood and may follow her/him for life. The research objective was to understand better how and which computer technologies have been applied to support ADHD diagnosis and treatment. The research used the systematic literature review method: a rigorous, verifiable, and repeatable approach that follows well-defined steps. Six well-known academic data sources have been consulted, including search engines and bibliographic databases, from technology and health care areas. After a rigorous research protocol, 1,239 articles were analyzed. For the diagnosis, the use of machine learning techniques was verified in 61 percent of the articles. Neurofeedback was ranked second with 9.3 percent participation, followed by serious games and eye tracking with 5.6 percent each. For the treatment, neurofeedback was present in 50 percent of the articles, whereas some studies combined both approaches, accounting for 31 percent of the total. Nine percent of the articles reported remote assistance technology, whereas another 9 percent have used virtual reality. By highlighting the leading computer technologies used, their applications, results, and challenges, this literature review breaks ground for further investigations. Moreover, the study highlighted the lack of consensus on ADHD biomarkers. The approaches using machine learning call attention to the probable occurrence of overfitting in several studies, thus demonstrating limitations of this technology on small-sized bases. This research also presented the convergence of evidence from different studies on the persistence of long-term effects of using neurofeedback in treating ADHD.