Barriers and facilitators to chemotherapy patients' engagement in medical error prevention

Background: Medical errors are a serious threat to chemotherapy patients. Patients can make contributions to safety but little is known about the acceptability of error-preventing behaviors and its predictors. Patients and methods: A cross-sectional survey study among chemotherapy patients treated at the oncology/hematology unit of a regional hospital was conducted. Patients were presented vignettes of errors and unsafe acts and responded to measures of attitudes, behavioral control, norms, barriers, and anticipated reaction. Results: A total of 479 patients completed the survey (52% response rate). Patients reported a high level of anticipated activity but intentions to engage for safety varied considerably between the hypothetical scenarios (range: 57%-96%, χ2 P < 0.001). Health, knowledge and staff time pressure were perceived as most important barriers. Instrumental [odds ratio (OR) = 1.3, P = 0.046] and experiential attitudes (OR = 1.4, P < 0.001), expectations attributed to clinical staff (OR = 1.2, P = 0.024) and behavioral control (OR = 1.8, P < 0.001) were predictors for patients' behaviors. Conclusions: Patients are affirmative toward engaging for safety but perceive considerable barriers. Intentions to engage in error prevention vary by clinical context and are strongly influenced by attitudes, normative and control beliefs. To successfully involve patients in medical error, prevention clinicians need to address their patients' beliefs and reduce barriers through educatio

Main nutrient patterns and colorectal cancer risk in the European Prospective Investigation into Cancer and Nutrition study.

BACKGROUND: Much of the current literature on diet-colorectal cancer (CRC) associations focused on studies of single foods/nutrients, whereas less is known about nutrient patterns. We investigated the association between major nutrient patterns and CRC risk in participants of the European Prospective Investigation into Cancer and Nutrition (EPIC) study. METHODS: Among 477 312 participants, intakes of 23 nutrients were estimated from validated dietary questionnaires. Using results from a previous principal component (PC) analysis, four major nutrient patterns were identified. Hazard ratios (HRs) and 95% confidence intervals (CIs) were computed for the association of each of the four patterns and CRC incidence using multivariate Cox proportional hazards models with adjustment for established CRC risk factors. RESULTS: During an average of 11 years of follow-up, 4517 incident cases of CRC were documented. A nutrient pattern characterised by high intakes of vitamins and minerals was inversely associated with CRC (HR per 1 s.d.=0.94, 95% CI: 0.92-0.98) as was a pattern characterised by total protein, riboflavin, phosphorus and calcium (HR (1 s.d.)=0.96, 95% CI: 0.93-0.99). The remaining two patterns were not significantly associated with CRC risk. CONCLUSIONS: Analysing nutrient patterns may improve our understanding of how groups of nutrients relate to CRC

Authoritarianism's inquiry in childhood: Correlations with social dominance orientation and values in boys and girls from Córdoba City (Argentina)

El estudio que se informa apuntó a analizar las relaciones existentes entre los niveles de autoritarismo y de orientación de dominancia social y los valores sociales en población infantil. Se trabajó con una muestra no probabilística de tipo accidental de 280 niños de la ciudad de Córdoba, de ambos sexos, que tenían entre 9 y 11 años. Se administró un cuestionario compuesto por tres escalas que indagaban las variables en estudio, previo consentimiento informado de los padres y autorizaciones de los niños y de las autoridades de las instituciones escolares, atendiendo a las variables sociodemográficas de edad y sexo de los participantes. Se efectuaron análisis uni y bivariados de las variables estudiadas. Los resultados confirman la relación positiva existente entre la Agresión autoritaria con la Orientación a la dominancia grupal, entre el autoritarismo en sus dos dimensiones (Agresión autoritaria y Sumisión autoritaria) y la Orientación a la dominancia grupal con los valores sociales de Conservación, y entre la Orientación a la dominancia grupal con los valores de Autopromoción. También complementariamente y de acuerdo a lo esperado, se ratificaron relaciones inversas entre la Oposición a la igualdad con los valores de Apertura al cambio y de Autotrascendencia y entre la Orientación a la dominancia grupal, con los valores de Autotrascendencia. No obstante e inesperadamente se evidenció una relación inversa entre la Sumisión autoritaria con la Oposición a la igualdad y con los valores de Apertura al cambio y entre la Oposición a la igualdad con los valores de Conservación. En función de los resultados obtenidos se discute acerca de las particularidades que adquiere esta articulación a los fines de realizar un aporte a la comprensión de actitudes autoritarias en la niñez, debido a que es una etapa crucial para la adquisición de actitudes que impactan directamente en el comportamiento político y social (Huerta, Bañuelos, Rodríguez, Luz & Gómez, 2006, en Imhoff & Brussino, 2010).This research, developed in the field of Political Psychology, aims to contribute to the understanding of authoritarian attitudes in during childhood, focusing on the relationships with other psychosocial and psycho-political variables such as social values and social dominance orientation. It's important to study the authoritarianism nowadays, due to the fact that it would obstruct the progress to a new political and economic model that allows the human development and the citizen's participation and involvement, favouring solidarity bonds and social identity (Zaiter, 2002). Thus, the scientific approach of this phenomenon makes its understanding possible and would give tools that can be used for the strengthening of democracy and the acquisition of values and democratic attitudes. Additionally, it's relevant to study the authoritarian attitudes in childhood owing to the fact that is an area of vacancy in the authoritarianism's field because most of the investigations study the authoritarianism in adults or teenagers. The research aims to analyze the relationships between the authoritarianism's level, the social dominance orientation's level and social values in children's population. This inquiry is a co-relational study in which the sample was selected using a non-random accidental sampling of 280 children from Córdoba city, male and female, from 9 to 11years old. The sample consists of 52.3% of girls and a 47.7% of boys, whereas in relation to the age distribution, there are 27.7% of 9 year old children, 32.6 % of 10 year old and 39.8% of 11 year old. The questionnaire was composed of three scales which inquiry into the variables involved and was applied with a previous parents' and head teachers' consent. These scales were: The adaptation of Altemeyer's (2006) Right-Wing Authoritarianism (RWA) Scale to children from Córdoba city by Imhoff and Brussino (2011a); the adaptation of Sidanius and Pratto's (1999) Social Dominance Orientation (SDO) Scale to children's population from Córdoba city by Imhoff and Brussino (2012), and the adaptation of Schwartz and Rubel-Lifschitz's (2009) Portrait Values Questionnaire (PVQ) to children's population from Córdoba city by Imhoff and Brussino (2011b). In addition, socio-demographic variables such as sex and age were asked. Furthermore, the questionnaires were administered orally and individually to each child. Afterwards, univariate and bivariate analysis were performed using the Statistical Package for the Social Sciences (SPSS). Regarding the results, unvaried analysis showed a higher level of Authoritarian submission than Authoritarian aggression. In relation to social dominance orientation, high scores in Opposition to equality were obtained and a homogeneous distribution in the level of Group based-dominance. Meanwhile, concerning to the children's valorative preference, high scores were found in Self-enhancement, low scores in Self-transcendence and regarding to Conservation and Openness to change, significant differences were not found between high and low levels. Concerning the relationships between the variables, results confirmed a positive relation between Authoritarian aggression with Group based-dominance; between authoritarianism (both dimensions Authoritarian aggression and Authoritarian submission) and group based-dominance with Conservation; and between group based-dominance with Self-enhancement. Moreover, results also demonstrated a negative relationship between Opposition to equality with Openness to change and Self-transcendence; and between Groups based- dominance with Self-transcendence. On the other hand, results revealed a negative relationship between Authoritarian submission with Opposition to equality and Openness to change; and also between Opposition to equality with Conservation values. According to these results, the peculiarities that acquire this articulation are discussed in order to contribute to the understanding of authoritarian attitudes in childhood. Due to the fact that is a crucial stage for the acquisition of attitudes that impact directly in political and social behaviour (Huerta, Bañuelos, Rodríguez, Luz & Gómez, 2006).Fil: Marasca, María Micaela. Universidad Nacional de Córdoba; ArgentinaFil: Marasca, Roxana. Universidad Nacional de Córdoba; ArgentinaFil: Imhoff, Débora Soledad. Universidad Nacional de Córdoba. Facultad de Psicología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Clinical Research in Britain 1950-1980

Edited transcript of a Witness Seminar held at the Wellcome Institute for the History of Medicine, London, on 9 June 1998. First published by the Wellcome Trust, 2000. ©The Trustee of the Wellcome Trust, London, 2000. All volumes are freely available online at www.history.qmul.ac.uk/research/modbiomed/wellcome_witnesses/Annotated and edited transcript of a Witness Seminar held on 9 June 1998. Introduction by Dr David Gordon.Annotated and edited transcript of a Witness Seminar held on 9 June 1998. Introduction by Dr David Gordon.Annotated and edited transcript of a Witness Seminar held on 9 June 1998. Introduction by Dr David Gordon.Annotated and edited transcript of a Witness Seminar held on 9 June 1998. Introduction by Dr David Gordon.What is clinical research? The growth of clinical research in the UK since the Second World War is examined, including the 1953 Cohen Report and the subsequent creation of the Medical Research Council’s Clinical Research Board. Lord Walton of Detchant, as Chairman, guided the discussion on the inter-relationships between the MRC, the NHS, the Royal Colleges, other professional bodies and other funding organizations. Among other issues were the changes imposed by Government policy over the period, the influence of the early clinical research fellowships, growth of clinical career structures, planning of the Clinical Research Centre at Northwick Park, the tropical research units, and the effects of the Rothschild and Dainton reports on funding for clinical research and the role of the Chief Scientist. Participants include: Sir Douglas Black, Sir John Gray, Sir Raymond Hoffenberg, Dr Sheila Howarth, Professor Peter Lachmann, Sir Patrick Nairne, Professor Sir Stanley Peart and Dr Peter Williams. Reynolds L A, Tansey E M. (eds) (2000) Clinical research in Britain, 1950–1980, Wellcome Witnesses to Twentieth Century Medicine, vol. 7. London: The Wellcome Trust.The Wellcome Trust is a registered charity, no. 210183

Concerning Disposal of Hazardous Wastes, and Providing for a Study Relating Thereto, and Making an Appropriation Therefor

https://scholar.law.colorado.edu/session-laws-1951-2000/9357/thumbnail.jp

Market-Mediated Effects: What Are they? And why are They Important for Geospatial Analysis of Sustainability Policies

Market-mediated effects can mitigate or amplify the intended effects of sustainability policies. They can also have unintended consequences, including inducing new sustainability stresses or threatening food security. It is important to understand these effects when designing sustainability policies. This paper provides prominent examples of market-mediated effects of a variety of sustainability policies in the food, energy, land and water nexus. This paper reviews the empirical evidence on market-mediated impacts of economic policies generally and then provides a review of recent geospatial modeling aimed at capturing these impacts in the context of local and regional land and water sustainability policies. The paper also discusses the challenges of designing sustainability policies that are effective in the face of market-mediated effects

Palliative care in public policy: results from a global survey

Background: Public policy has been a foundational component of the World Health Organization public health model for palliative care development since 1990. There is, however, limited evidence on the existence and character of palliative care policy at the country level. Objective: To identify, report on, and map the presence of national palliative care strategies, plans, legislation, and dedicated government resources in 198 countries. Design: An online survey generated 2017 data on indicators of national policy for palliative care. Subjects: In-country experts on palliative care. Measurements: The survey included specific questions on the existence and status of national strategies or plans, recognition of palliative care in national law, and dedicated government support. Results: Fifty-five countries have a national strategy or plan for palliative care of some sort, though levels of implementation vary. Forty-seven countries have some reference to palliative care in national law, and 24 have some form of stand-alone national law on palliative care provision or recognize it as a right in the constitution. Sixty-six countries have a dedicated section within government with responsibility for palliative care. Conclusions: There is a long way to go before palliative care around the world is universally supported by public policy intentions that will support its required development

Discussion on “The central role of the identifying assumption in population size estimation” by Serge Aleshin-Guendel, Mauricio Sadinle, and Jon Wakefield

Summary: In this discussion response we consider some practical implications of the authors’ consideration of the no highest order interaction model for multiple systems estimation which permits the authors to derive the explicit (albeit untestable) identifying assumption related to the unobserved (or missing) individuals. In particular, we discuss several aspects, from the standard process of model selection to potential poor predictive performance due to over- fitting and the implications of data reduction. We discuss these aspects in relation to the case study presented by the authors relating to the number of civilian casualties within the Kosovo war, and conduct further preliminary simulations to investigate these issues further. The results suggest that the no highest order interaction models considered, despite having a potentially useful theoretical result in relation to the underlying identifying assumption, may perform poorly in practice