Risk assessment of drug management process in women surgery department of qaem educational hospital (QEH) using HFMEA method (2013)

Evaluation and improvement of drug management process are essential for patient safety. The present study was performed whit the aim of assessing risk of drug management process in Women Surgery Department of QEH using HFMEA method in 2013. A mixed method was used to analyze failure modes and their effects with HFMEA. To classify failure modes; nursing errors in clinical management model, for classifying factors affecting error; approved model by the UK National Health System, and for determining solutions for improvement; Theory of Inventive Problem Solving, were used. 48 failure modes were identified for 14 sub-process of five steps drug management process. The frequency of failure modes were as follow:35.3 in supplying step, 20.75 in prescription step, 10.4 in preparing step, 22.9 in distribution step and 10.35 in follow up and monitoring step. Seventeen failure modes (35.14) were considered as non-acceptable risk (hazard score� 8) and were transferred to decision tree. Among 51 Influencing factors, the most common reasons for error were related to environmental factors (21.5), and the less common reasons for error were related to patient factors (4.3). HFMEA is a useful tool to evaluating, prioritization and analyzing failure modes in drug management process. Revision drug management process based focus-PDCA, assessing adverse drug reactions (ADR), USE patient identification bracelet, holding periodical pharmaceutical conferences to improve personnel knowledge, patient contribution in drug therapy; are performance solutions which were placed in work order. © 2015 by School of Pharmac

An early Little Ice Age brackish water invasion along the south coast of the Caspian Sea (sediment of Langarud wetland) and its wider impacts on environment and people

Caspian Sea level has undergone significant changes through time with major impacts not only on the surrounding coasts, but also offshore. This study reports a brackish water invasion on the southern coast of the Caspian Sea constructed from a multi-proxy analysis of sediment retrieved from the Langarud wetland. The ground surface level of wetland is >6 m higher than the current Caspian Sea level (at -27.41 m in 2014) and located >11 km far from the coast. A sequence covering the last millennium was dated by three radiocarbon dates. The results from this new study suggest that Caspian Sea level rose up to at least -21.44 m (i.e. >6 m above the present water level) during the early Little Ice Age. Although previous studies in the southern coast of the Caspian Sea have detected a high-stand during the Little Ice Age period, this study presents the first evidence that this high-stand reached so far inland and at such a high altitude. Moreover, it confirms one of the very few earlier estimates of a high-stand at -21 m for the second half of the 14th century. The effects of this large-scale brackish water invasion on soil properties would have caused severe disruption to regional agriculture, thereby destabilizing local dynasties and facilitating a rapid Turko-Mongol expansion of Tamerlane’s armies from the east.N Ghasemi (INIOAS), V Jahani (Gilan Province Cultural Heritage and Tourism Organisation) and A Naqinezhad (University of Mazandaran), INQUA QuickLakeH project (no. 1227) and to the European project Marie Curie, CLIMSEAS-PIRSES-GA-2009-24751

The feed-in tariff in the UK : a case study focus on domestic photovoltaic systems

This paper explores the photovoltaic (PV) industry in the United Kingdom (UK) as experienced by those who are working with it directly and with consideration of current standards, module efficiencies and future environmental trends. The government's consultation on the comprehensive review for solar PV tariffs, proposes a reduction of the generation tariff for PV installations in the UK of more than 50%. The introduction of the Feed-In Tariffs scheme (FITs) has rapidly increased deployment of PV technologies at small scale since its introduction in April 2010. The central principle of FIT policies is to offer guaranteed prices for fixed periods to enable greater number of investors. A financial analysis was performed on two real-life installations in Cornwall, UK to determine the impact of proposed cuts to the FIT will make to a typical domestic PV system under 4 kW. The results show that a healthy Return on Investment (ROI) can still be made but that future installations should focus on off-setting electricity required from the national grid as a long term push for true sustainability rather than subsidised schemes. The profitability of future installations will have to be featured within in-service and end-of-service considerations such as the feed-in tariff, module efficiencies and the implications of costs associated with end-of-life disposal

The Janus Nature of Human Rights in Iran: Understanding Progress and Setbacks on Human Rights Protections since the Revolution

There have been serious concerns raised both internally and externally about human rights violations in Iran over the past 30 years. Is there any reason to believe there will be an improvement in the protection of human rights in the future? Risse and Sikkink have suggested that states can be socialized to improve at least part of their human rights record. They argue that Western states, advocacy networks, and international norms can have a positive impact on rights of personal integrity in most if not all non-Western developing countries. Will Iran be socialized to improve its human rights record? This chapter examines both the progress on and the violations of human rights in Iran over the past 30 years. I want to explain why the Islamic regime has restricted the basic rights of its citizens, as well as what accounts for the progress made on some second generation rights. To see further improvements in the protection of human rights this chapter suggests that minimizing threats is a necessary step for further progress. Therefore, this chapter examines Iran’s human rights record in the framework of the interplay of international human rights norms and perceived threats

Antibiotic treatment leads to the elimination of Wolbachia endosymbionts and sterility in the diplodiploid collembolan Folsomia candida

<p>Abstract</p> <p>Background</p> <p><it>Wolbachia </it>is an extremely widespread bacterial endosymbiont of arthropods and nematodes that causes a variety of reproductive peculiarities. Parthenogenesis is one such peculiarity but it has been hypothesised that this phenomenon may be functionally restricted to organisms that employ haplodiploid sex determination. Using two antibiotics, tetracycline and rifampicin, we attempted to eliminate <it>Wolbachia </it>from the diplodiploid host <it>Folsomia candida</it>, a species of springtail which is a widely used study organism.</p> <p>Results</p> <p>Molecular assays confirmed that elimination of <it>Wolbachia </it>was successfully achieved through continuous exposure of populations (over two generations and several weeks) to rifampicin administered as 2.7% dry weight of their yeast food source. The consequence of this elimination was total sterility of all individuals, despite the continuation of normal egg production.</p> <p>Conclusion</p> <p>Microbial endosymbionts play an obligatory role in the reproduction of their diplodiploid host, most likely one in which the parthenogenetic process is facilitated by <it>Wolbachia</it>. A hitherto unknown level of host-parasite interdependence is thus recorded.</p

Patients with artificial joints: do they need antibiotic cover for dental treatment?

The document attached has been archived with permission from the Australian Dental Association. An external link to the publisher’s copy is included.This study reviews whether patients with artificial joints need antibiotic cover for dental treatment. Generally in Australia the practice has developed of giving most patients with artificial joints antibiotic prophylaxis for a wide range of dental procedures. This is partly on anecdotal grounds, partly historical and partly for legal concerns. It has been encouraged by some guidelines. Scientifically, the risk and the benefit of each step in the process needs to be analysed. This review shows that the risk of an artificial joint becoming infected from a bacteraemia of oral origin is exceedingly low whereas the risk of an adverse reaction to the antibiotic prophylaxis is higher than the risk of infection. If all patients with artificial joints receive antibiotic prophylaxis then more will die from anaphylaxis than develop infections. Factors which balance the risk benefit are if the patient is seriously immunocompromised, if the joint prosthesis is failing or chronically inflamed and if the dental procedures, such as from extractions and deep periodontal scaling, produce high level bacteraemias. Recommendations to rationalize antibiotic prophylaxis for patients with artificial joints are presented.JF Scott, D Morgan, M Avent, S Graves and AN Gos

Quantum critical dynamics in a 5000-qubit programmable spin glass

Experiments on disordered alloys suggest that spin glasses can be brought into low-energy states faster by annealing quantum fluctuations than by conventional thermal annealing. Due to the importance of spin glasses as a paradigmatic computational testbed, reproducing this phenomenon in a programmable system has remained a central challenge in quantum optimization. Here we achieve this goal by realizing quantum critical spin-glass dynamics on thousands of qubits with a superconducting quantum annealer. We first demonstrate quantitative agreement between quantum annealing and time-evolution of the Schr\"odinger equation in small spin glasses. We then measure dynamics in 3D spin glasses on thousands of qubits, where simulation of many-body quantum dynamics is intractable. We extract critical exponents that clearly distinguish quantum annealing from the slower stochastic dynamics of analogous Monte Carlo algorithms, providing both theoretical and experimental support for a scaling advantage in reducing energy as a function of annealing time

Riboflavin alleviates cardiac failure in Type I diabetic cardiomyopathy

Heart failure (HF) is a common and serious comorbidity of diabetes. Oxidative stress has been associated with the pathogenesis of chronic diabetic complications including cardiomyopathy. The ability of antioxidants to inhibit injury has raised the possibility of new therapeutic treatment for diabetic heart diseases. Riboflavin constitutes an essential nutrient for humans and animals and it is an important food additive. Riboflavin, a precursor of flavin mononucleotide (FMN) and flavin adenine dinucleotide (FAD), enhances the oxidative folding and subsequent secretion of proteins. The objective of this study was to investigate the cardioprotective effect of riboflavin in diabetic rats. Diabetes was induced in 30 rats by a single injection of streptozotocin (STZ) (70 mg /kg). Riboflavin (20 mg/kg) was orally administered to animals immediately after induction of diabetes and was continued for eight weeks. Rats were examined for diabetic cardiomyopathy by left ventricular (LV) remadynamic function. Myocardial oxidative stress was assessed by measuring the activity of superoxide dismutase (SOD), the level of malondialdehyde (MDA) as well as heme oxygenase-1 (HO-1) protein level. Myocardial connective tissue growth factor (CTGF) level was measured by Western blot in all rats at the end of the study. In the untreated diabetic rats, left ventricular systolic pressure (LVSP) rate of pressure rose (+dp/dt), and rate of pressure decay (−dp/dt) were depressed while left ventricular end-diastolic pressure (LVEDP) was increased, which indicated the reduced left ventricular contractility and slowing of left ventricular relaxation. The level of SOD decreased, CTGF and HO-1 protein expression and MDA content rose. Riboflavin treatment significantly improved left ventricular systolic and diastolic function in diabetic rats, there were persistent increases in significant activation of SOD and the level of HO-1 protein, and a decrease in the level of CTGF. These results suggest that riboflavin treatment ameliorates myocardial function and improves heart oxidant status, whereas raising myocardial HO-1 and decreasing myocardial CTGF levels have beneficial effects on diabetic cardiomyopathy

Re-branding Abu Dhabi: From oil giant to energy titan

This article presents a case study of Abu Dhabi\u27s \u27energy re-branding\u27 since 2005 when it declared its intention to transform itself from an oil exporter to a total energy giant that also embraces alternative (renewable and nuclear) energy. The first part of the article identifies the benefits of this policy for Abu Dhabi\u27s external diplomacy but argues that the real driver is the emirate\u27s domestic gas shortage and its effects on economic diversification and political legitimacy. The second part of the article discusses the motivations and interactions of local and foreign agents by focusing on the implementation of alternative energy platforms. It therefore provides a rare glimpse of the policy-making process in Abu Dhabi. The final part of the article examines the extent to which energy re-branding may be linked to a process by the government to reiterate, reinterpret and repudiate Emirati identity in order to enhance regime legitimacy in the twenty-first century. © 2012 Macmillan Publishers Ltd