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Design, planning, and management of the urban soundscape require various interacting fields of knowledge given the fact that it is the human person that experiences and provides meaning to the urban places and their acoustic environments. The process of environmental perception involves contextual information that conditions people's responses and outcomes through the relationship between the variables Person, Activity, and Place. This research focuses on the interaction between Person and Place and its impact on responses and outcomes from listeners with different geographical origin and background. Laboratory studies were conducted in the cities of Lisbon (Portugal) and Bogotá (Colombia), where local listeners were introduced to known and unknown acoustic environments. Sound data recorded in the two cities allowed comparison of responses and outcomes of the listeners according to the Person-Place Interaction, leading to different meanings depending on the contextual variables. The results clearly show a relationship between site, acoustic environment, soundscape, Person-Place Interaction, and meaning of the place. This information can be useful for urban technicians and designers dealing with planning and management of urban soundscapes.

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BACKGROUND: Patient safety is a leading item on the policy agenda of both major international health organizations and advanced countries generally. The quantitative description of the phenomena has given rise to intense concern with the issue in institutions and organizations, leading to a number of initiatives and research projects and the promotion of patient safety culture, with training becoming a priority both in Spain and internationally. To date, most studies have been conducted in a hospital setting, even though primary care is the type most commonly used by the public, in our experience. Our study aims to achieve the following:--Assess the registry of adverse events as an education tool to improve patient safety culture in the Family and Community Teaching Units of Galicia.--Find and analyze educational tools to improve patient safety culture in primary care.--Evaluate the applicability of the Hospital Survey on Patient Safety Culture by the Agency for Healthcare Research and Quality, Spanish version, in the context of primary health care. DESIGN: Experimental unifactorial study of two groups, control and intervention. STUDY POPULATION: Tutors and residents in Family and Community Medicine in last year of studies in Galicia, Spain. SAMPLE: From the population universe through voluntary participation. Twenty-seven tutor-resident units in each group required, randomly assigned. INTERVENTION: Residents and their respective tutor (tutor-resident pair) in teaching units on Family and Community Medicine from throughout Galicia will be invited to participate. Tutor-resident pair that agrees to participate will be sent the Hospital Survey on Patient Safety Culture. Then, tutor-resident pair will be assigned to each group--either intervention or control--through simple random sampling. The intervention group will receive specific training to record the adverse effects found in patients under their care, with subsequent feedback, after receiving instruction on the process. No action will be taken in the control group. After the intervention has ended, the survey will once again be provided to all participants. OUTCOME MEASURES: Change in safety culture as measured by Hospital Survey on Patient Safety CultureCONSORT Extension for Non-Pharmacologic Treatments 2008 was applied. DISCUSSION: The most significant limitations on the project are related to selecting a tool to measure the safety environment, the training calendar of residents in Family and Community Medicine in last year of studies and the no-answer bias inherent to research conducted through self-administered surveys.The development and application of a safety culture in the health sector, specifically in primary care, is as yet limited. Thus, identifying the strengths and weaknesses in the safety environment may assist in designing strategies for improvement in the primary care health centers of our region. TRIAL REGISTRATION: ISRCTN: ISRCTN41911128.

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BACKGROUND: The Krackow stitch, commonly used for Achilles tendon repair, leaves the bulk of the stitch on the surface of the tendon as a possible nidus for adhesion. The proposed core weave stitch leaves a minimal amount of suture material on the tendon surface. The functional strength of the core weave stitch compared with the Krackow and the optimal number of throws, or stitches crossing the surface of the tendon, with this stitch are not known. MATERIALS AND METHODS: Twenty-one matched pairs of fresh-frozen cadaveric Achilles tendons were transected and randomly assigned to receive a 4-stranded stitch, either Krackow or core weave, with three, five, or seven throws. The samples were cyclically loaded to 75, 125 and 175 N for 1000 cycles at each load until failure, defined as 5 mm of elongation. RESULTS: No significant difference in failure load was observed between the Krackow and core weave groups at any number of throws or within the groups based on number of throws. Failure load for the different number of throws in the Krackow group approached significance (p = 0.10), with higher failure load with three throws. CONCLUSION: Functional strength of the core weave stitch and the Krackow stitch did not differ between groups with three, five, and seven throws. There was no significant difference in strength based on throws in either group. CLINICAL RELEVANCE: The proposed core weave stitch provides functional strength similar to that of the Krackow stitch for tendon repair with reduced suture material on the tendon surface.

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