Instant restore after a media failure

Media failures usually leave database systems unavailable for several hours until recovery is complete, especially in applications with large devices and high transaction volume. Previous work introduced a technique called single-pass restore, which increases restore bandwidth and thus substantially decreases time to repair. Instant restore goes further as it permits read/write access to any data on a device undergoing restore--even data not yet restored--by restoring individual data segments on demand. Thus, the restore process is guided primarily by the needs of applications, and the observed mean time to repair is effectively reduced from several hours to a few seconds. This paper presents an implementation and evaluation of instant restore. The technique is incrementally implemented on a system starting with the traditional ARIES design for logging and recovery. Experiments show that the transaction latency perceived after a media failure can be cut down to less than a second and that the overhead imposed by the technique on normal processing is minimal. The net effect is that a few "nines" of availability are added to the system using simple and low-overhead software techniques

The resettlement of women offenders: learning the lessons: a research project focusing on the experience of the female offender.

Part of the Cornwall VSF Promoting Change Project. The research was jointly funded by The Lankelly Chase Foundation and the Devon and Cornwall Police and Crime Commissioner. Some additional facilitation grants were received from the University of Plymouth

Iatrogenic medication errors in a paediatric intensive care unit in Durban, South Africa

Background. Iatrogenic medication errors due to calculation errors are an under-reported concern in children.Objective. To determine the incidence and source of iatrogenic medication errors in a paediatric intensive care unit (PICU).Methods. A prospective study was conducted in the PICU at Inkosi Albert Luthuli Hospital, Durban, South Africa, over a 3-month period in 2014. Medication-related calculation skills of medical practitioners and nurses were assessed through the voluntary anonymous completion of a questionnaire. Medication errors were recorded either spontaneously or by review of all electronic records of admissions. Errors were classified as delays in the decision to prescribe, prescribing mistakes, dispensing errors and administration issues.Results. Of 25 staff members sampled, only 6 (24.0%) were able to complete all medication calculations accurately, while 44.0% (n=11) were unable to answer three or more questions correctly. Errors most frequently encountered included failure to calculate rates of infusion and the conversion of mL to mEq or mL to mg for potassium, phenobarbitone and digoxin. Of the 117 children admitted, 111 (94.9%) were exposed to at least one medication error. Two or more medication errors occurred in 34.1% of cases. Of the errors, 73.8% were detected on chart review and 26.2% by spontaneous reporting. Overall, 89.2% of errors occurred during prescribing, with 10.0% having a ≥10-fold increase or decrease in dosage calculations. Only 2.7% of medication errors were reported as resulting in adverse events.Conclusion. Therapeutic skills of healthcare professionals working in the PICU need to be improved to decrease iatrogenic medication errors

Confidentiality and cultural competence? The realities of engaging young British Pakistanis and Bangladeshis into substance use services

This paper focusses on the reasons for the under-representation of British South Asians in substance use services. Based on a small-scale evaluation of a substance use service that delivers targeted outreach support within two predominantly Pakistani and Bangladeshi communities in the north west of England, this paper contributes to the debate around how substance use services can best engage with young British Pakistani and Bangladeshi substance users. The paper highlights the importance of what Fountain terms low threshold/open access services. Alongside this, the paper argues that the building of trust and confidence in a substance use service are key when it comes to engaging with young Pakistani and Bangladeshi substance users. Yet this necessary process takes time: something that is at odds with the current trend towards short-term funding regimes and ‘quick wins’. The paper concludes by advocating the need for, not only a diverse range of engagement strategies, but also a longer-term approach when it comes to developing and delivering substance use services aimed at successfully engaging with this particular group of substance users

New psychoactive substances: new service provider challenges

This paper presents findings from a 6-month study of New Psychoactive Substance (NPS) use in Manchester, UK. Drawing on interviews with 53 NPS users and 31 stakeholders, the paper documents a notable shift in the drug using landscape. It highlights how the homeless community – traditionally associated with alcohol dependency and problematic intravenous heroin and/or crack cocaine use – are now switching to smoking synthetic cannabinoid receptor agonists, while men who have sex with men (MSM) and engage in chemsex – who have traditionally been strongly associated with the recreational use of ecstasy and other stimulants – are now developing problematic intravenous drug using habits. The paper goes on to discuss the implications of this shift for existing models of treatment service delivery. In particular, it outlines the necessity for treatment services to develop innovative engagement strategies, alongside clearer referral pathways and improved service integration

Post impact evaluation of an E-learning cross-infection control CD-ROM provided to all general dental practitioners in England

Aim To carry out a post-impact evaluation of a cross-infection control CD-ROM, developed for NHS dental teams as a continuing professional development e-learning tool. The program was commissioned by the Department of Health and developed by a project team through the UK Committee of Postgraduate Dental Deans. The Dental Practice Boardhad originally sent one copy of the CD-ROM to each dental practice in England in 2004. Method A quantitative statistical analysis of the results of 326 online respondents to the learning package and a survey of 118 dental practitioners drawn from the Dental Practice Board database. Results Practitioners felt the CD-ROM in this instance was well designed and appropriate for their needs. It is inclusive and accessible to a wide range of dental professionals including nurses and hygienists. Conclusions This form of continuing professional development is popular with dental practitioners, although it should not be the only form of continuing professional development available. However, whilst the project was generally regarded as successful, there were problems with the distribution of the CD-ROM. This suggests that anonline resource should be made available in the future

A standardised sampling protocol for robust assessment of reach-scale fish community diversity in wadeable New Zealand streams

The New Zealand fish fauna contains species that are affected not only by river system connectivity, but also by catchment and local-scale changes in landcover, water quality and habitat quality. Consequently, native fish have potential as multi-scale bioindicators of human pressure on stream ecosystems, yet no standardised, repeatable and scientifically defensible methods currently exist for effectively quantifying their abundance or diversity in New Zealand stream reaches. Here we report on the testing of a back-pack electrofishing method, modified from that used by the United States Environmental Protection Agency, on a wide variety of wadeable stream reaches throughout New Zealand. Seventy-three first- to third-order stream reaches were fished with a single pass over 150-345 m length. Time taken to sample a reach using single-pass electrofishing ranged from 1-8 h. Species accumulation curves indicated that, irrespective of location, continuous sampling of 150 stream metres is required to accurately describe reach-scale fish species richness using this approach. Additional species detection beyond 150 m was rare (<10%) with a single additional species detected at only two out of the 17 reaches sampled beyond this distance. A positive relationship was also evident between species detection and area fished, although stream length rather than area appeared to be the better predictor. The method tested provides a standardised and repeatable approach for regional and/or national reporting on the state of New Zealand's freshwater fish communities and trends in richness and abundance over time