Increasing the options for reducing adverse events: Results from a modified Delphi technique

which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background: The aim of this paper is to illustrate a simple method for increasing the range of possible options for reducing adverse events in Australian hospitals, which could have been, but was not, adopted in the wake of the landmark 1995 'Quality in Australian Health Care ' study, and to report the suggestions and the estimated lapse time before they would impact upon mortality and morbidity. Method: The study used a modified Delphi technique that first elicited options for reducing adverse events from an invited panel selected on the basis of their knowledge of the area of adverse events and quality assurance. Initial suggestions were collated and returned to them for reconsideration and comment. Results: Completed responses from both stages were obtained from 20 of those initially approached. Forty-one options for reducing AEs were identified with an average lapse time of 3.5 years. Hospital regulation had the least delay (2.4 years) and out of hospital information the greatest (6.4 years). Conclusion: Following identification of the magnitude of the problem of adverse events in the 'Quality in Australian Health Care ' study a more rapid and broad ranging response was possible than occurred. Apparently viable options for reducing adverse events and associated mortality and morbidity remain unexploited

Composite-Concrete Interface Characterization by Lamb Waves

In recent years, significant attention is being paid to the nation’s dilapidated infrastructure. Examples of such structures include buildings that need to be retrofitted to resist seismic loads, bridges that must be strengthened to carry heavier traffic loads and concrete water and sewer pipes that have deteriorated due to corrosions. In most of these cases, the capacity of these structures can be increased by the introduction of additional tension-carrying materials. While steel has been traditionally used for such applications, fiber reinforced plastic (FRP) materials have been increasingly replacing steel in the last decade. The high tensile strength and corrosion resistance of FRPs make them an ideal substitute for steel.</p

Microbial oxidation of Fe2+ and pyrite exposed to flux of micromolar H2O2 in acidic media

At an initial pH of 2, while abiotic oxidation of aqueous Fe2+ was enhanced by a flux of H2O2 at micromolar concentrations, bio-oxidation of aqueous Fe2+ could be impeded due to oxidative stress/damage in Acidithiobacillus ferrooxidans caused by Fenton reaction-derived hydroxyl radical, particularly when the molar ratio of Fe 2+ to H2O2 was low. When pyrite cubes were intermittently exposed to fluxes of micromolar H2O2, the reduced Fe2+-Fe 3+ conversion rate in the solution (due to reduced microbial activity) weakened the Fe 3+-catalyzed oxidation of cubic pyrite and added to relative importance of H2O2-driven oxidation in the corrosion of mineral surfaces for the treatments with high H 2O2 doses. This had effects on reducing the build-up of a passivating coating layer on the mineral surfaces. Cell attachment to the mineral surfaces was only observed at the later stage of the experiment after the solutions became less favorable for the growth of planktonic bacteria