Patient Safety: Preventing Patient Harm and Building Capacity for Patient Safety

Patient safety is a global public health concern. It is a health care discipline with ever evolving advancement and complexity resulting in consequential rise in patient harm. Since the pandemic, patient safety has been threatened even more by laying bare the inadequacies of health systems. Many unsafe care practices, risks, and errors contribute to patient harm and overall economic burden. These include medical, diagnostic, and radiation errors, healthcare associated infections, unsafe surgical procedures and transfusion practices, sepsis, venous thromboembolism, and falls. Although patient safety has become an integral part of the healthcare delivery model and resources have been dedicated towards it, much still needs to be achieved. An attitude of inclusivity for all care teams and anyone in contact with the patient, including the patients themselves, would enhance patient safety. Incorporating this attitude from educational infancy will allow for better identification of medical errors and inculcate critical analysis of process improvement. Implementing the ‘Just Culture’ by health care organizations can build the infrastructure to eliminate avoidable harm. To reduce avoidable harm and improve safety, a constant flow of information and knowledge should be available to mitigate the risks. Lastly, proper communication and effective leadership can play an imperative role to engage stakeholders and reduce harm

Off-label use of rituximab for systemic lupus erythematosus in Europe

Objectives: Rituximab (RTX) is a biological treatment used off-label in patients with systemic lupus erythematosus (SLE). This survey aimed to investigate the off-label use of RTX in Europe and compare the characteristics of patients receiving RTX with those receiving conventional therapy. Methods: Data on patients with SLE receiving RTX were taken from the International Registry for Biologics in SLE retrospective registry and complemented with data on patients with SLE treated with conventional therapy. For nationwide estimates of RTX use in patients with SLE, investigators were asked to provide data through case report forms (CRFs). Countries for which no data were submitted through CRFs, published literature and/or personal communication were used, and for European countries where no data were available, estimates were made on the assumption of similarities with neighbouring countries. Results: The estimated off-label use of RTX in Europe was 0.5%-1.5% of all patients with SLE. In comparison with patients with SLE on conventional therapy, patients treated with RTX had longer disease duration, higher disease activity and were more often treated with immunosuppressives. The most frequent organ manifestations for which either RTX or conventional therapy was initiated were lupus nephritis followed by musculoskeletal and haematological. The reason for treatment was, besides disease control, corticosteroid-sparing for patients treated with conventional therapy. Conclusions: RTX use for SLE in Europe is restrictive and appears to be used as a last resort in patients for whom other reasonable options have been exhausted

SREB, a GATA Transcription Factor That Directs Disparate Fates in Blastomyces dermatitidis Including Morphogenesis and Siderophore Biosynthesis

Blastomyces dermatitidis belongs to a group of human pathogenic fungi that exhibit thermal dimorphism. At 22°C, these fungi grow as mold that produce conidia or infectious particles, whereas at 37°C they convert to budding yeast. The ability to switch between these forms is essential for virulence in mammals and may enable these organisms to survive in the soil. To identify genes that regulate this phase transition, we used Agrobacterium tumefaciens to mutagenize B. dermatitidis conidia and screened transformants for defects in morphogenesis. We found that the GATA transcription factor SREB governs multiple fates in B. dermatitidis: phase transition from yeast to mold, cell growth at 22°C, and biosynthesis of siderophores under iron-replete conditions. Insertional and null mutants fail to convert to mold, do not accumulate significant biomass at 22°C, and are unable to suppress siderophore biosynthesis under iron-replete conditions. The defect in morphogenesis in the SREB mutant was independent of exogenous iron concentration, suggesting that SREB promotes the phase transition by altering the expression of genes that are unrelated to siderophore biosynthesis. Using bioinformatic and gene expression analyses, we identified candidate genes with upstream GATA sites whose expression is altered in the null mutant that may be direct or indirect targets of SREB and promote the phase transition. We conclude that SREB functions as a transcription factor that promotes morphogenesis and regulates siderophore biosynthesis. To our knowledge, this is the first gene identified that promotes the conversion from yeast to mold in the dimorphic fungi, and may shed light on environmental persistence of these pathogens

Sport in Cold War America: The Diplomatic and Political Use of Sport in the Eisenhower and Kennedy Administrations

During the years when Suez and Sputnik, Berlin and the Bay of Pigs made the headlines, many Americans turned to sport as a subject. which could be pursued for relaxation in the midst of the stress of the Cold War. An investigation of American sport during the critical years 1953-1963, however, discloses that Cold, War pressures increased the traditional usefulness of sport as an instrumentality for accomplishing something else. This study examines the extent to which the Eisenhower and Kennedy Administrations utilized the diplomatic and political potential of sport to mobilize foreign and domestic opinion behind Administration policy objectives. By illuminating one salient aspect of America\u27s Cold Way response to a perceived communist threat, and by revealing new techniques in United States politics and diplomacy, this study can enhance significantly current impressions of American sport and the nature of the Cold War. Despite the magnitude of public commitment to sport (as illustrated by the amounts of time and money spent on sport), its historical significance has until recently received little study and acquired even less academic respectability. Viewing sport as a diversion from the more serious functions of life, social scientists did not regard sport as posing problems which warranted study or required an explanation. In response to such sports parochialism, this study indicates that government officials in post World War II America slowly came to recognize the more sophisticated functions of sport as builder of national solidarity, source of communication, and ambassador in international diplomacy. More effective use of these special functions of sport did not fully occur to government and sports officials, however, until the military and political dimensions of the Cold War began to crystallize in the early 1950\u27s. Only then did officials seize upon sport in their search for more creative responses to \u27 peaceful coexistence and for novel diplomatic overtures for a sustained cultural and ideological struggle..

SPORT IN COLD WAR AMERICA, 1953-1963: THE DIPLOMATIC AND POLITICAL USE OF SPORT IN THE EISENHOWER AND KENNEDY ADMINISTRATIONS

During the years when Suez and Sputnik, Berlin and the Bay of Pigs made the headlines, many Americans turned to sport as a subject. which could be pursued for relaxation in the midst of the stress of the Cold War. An investigation of American sport during the critical years 1953-1963, however, discloses that Cold, War pressures increased the traditional usefulness of sport as an instrumentality for accomplishing something else. This study examines the extent to which the Eisenhower and Kennedy Administrations utilized the diplomatic and political potential of sport to mobilize foreign and domestic opinion behind Administration policy objectives. By illuminating one salient aspect of America\u27s Cold Way response to a perceived communist threat, and by revealing new techniques in United States politics and diplomacy, this study can enhance significantly current impressions of American sport and the nature of the Cold War. Despite the magnitude of public commitment to sport (as illustrated by the amounts of time and money spent on sport), its historical significance has until recently received little study and acquired even less academic respectability. Viewing sport as a diversion from the more serious functions of life, social scientists did not regard sport as posing problems which warranted study or required an explanation. In response to such sports parochialism, this study indicates that government officials in post World War II America slowly came to recognize the more sophisticated functions of sport as builder of national solidarity, source of communication, and ambassador in international diplomacy. More effective use of these special functions of sport did not fully occur to government and sports officials, however, until the military and political dimensions of the Cold War began to crystallize in the early 1950\u27s. Only then did officials seize upon sport in their search for more creative responses to \u27 peaceful coexistence and for novel diplomatic overtures for a sustained cultural and ideological struggle..