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

Schizophrenia and cardiometabolic abnormalities: A Mendelian randomization study

Background: Individuals with a diagnosis of schizophrenia are known to be at high risk of premature mortality due to poor physical health, especially cardiovascular disease, diabetes, and obesity. The reasons for these physical health outcomes within this patient population are complex. Despite well-documented cardiometabolic adverse effects of certain antipsychotic drugs and lifestyle factors, schizophrenia may have an independent effect. / Aims: To investigate if there is evidence that schizophrenia is causally related to cardiometabolic traits (blood lipids, anthropometric traits, glycaemic traits, blood pressure) and vice versa using bi-directional two-sample Mendelian randomization (MR) analysis. / Methods: We used 185 genetic variants associated with schizophrenia from the latest Psychiatric Genomics Consortium GWAS (n = 130,644) in the forward analysis (schizophrenia to cardiometabolic traits) and genetic variants associated with the cardiometabolic traits from various consortia in the reverse analysis (cardiometabolic traits to schizophrenia), both at genome-wide significance (5 × 10−8). The primary method was inverse-variance weighted MR, supported by supplementary methods such as MR-Egger, as well as median and mode-based methods. / Results: In the forward analysis, schizophrenia was associated with slightly higher low-density lipoprotein (LDL) cholesterol levels (0.013 SD change in LDL per log odds increase in schizophrenia risk, 95% CI, 0.001–0.024 SD; p = 0.027) and total cholesterol levels (0.013 SD change in total cholesterol per log odds increase in schizophrenia risk, 95% CI, 0.002–0.025 SD; p = 0.023). However, these associations did not survive multiple testing corrections. There was no evidence of a causal effect of cardiometabolic traits on schizophrenia in the reverse analysis. / Discussion: Dyslipidemia and obesity in schizophrenia patients are unlikely to be driven primarily by schizophrenia itself. Therefore, lifestyle, diet, antipsychotic drugs side effects, as well as shared mechanisms for metabolic dysfunction and schizophrenia such as low-grade systemic inflammation could be possible reasons for the apparent increased risk of metabolic disease in people with schizophrenia. Further research is needed to examine the shared immune mechanism hypothesis

Petroleum hydrocarbon assessment in the wastewaters of petrochemical special economic zone and sediment benchmark calculation of the coastal area - northwest of the Persian Gulf

Petrochemical industries can potentially impact the environment due to their activities and products. This case study has considered adverse effects of petrochemical industries that are located inside the PETZONE with respect to the presence of polycyclic aromatic hydrocarbons and total petroleum hydrocarbon in wastewater effluents. The average concentrations of ∑PAHs group I and II were lower than the guideline values, thus the effluents of the study area can be considered unpolluted. Also, the average concentration of TPH was lower than the guideline value at all almost stations except the effluent outlets of the Razi and Imam Khomeini petrochemical (BI-PC) companies which are proximal to Khowr-e Musa Bay. Thus, they may have an adverse impact on the aquatic ecosystem of the Bay. Therefore, the concentration of TPH was monitored in the sediments of the Bay (around the PETZONE coastal area) which was relatively moderate compared in the study area. Also, the sum of Chronic Potency Ratio of PAHs in sediments showed that the chronic benchmark was not more than the guideline at all stations (it is exceeded when the sum exceeds 1.0) except in the vicinity of the Aromatic effluent outlet of BI-PC. Thus, the chronic benchmark at this station indicates that it has the potential to cause a chronic effect on sediment-residence organisms like crabs, clams and worms. Moreover, PAHs concentration level in this station approached the NOAA sediment quality guideline value (ERL) of 4000 (ng/g dry weight)

Recepteurs de rake adaptatifs pour transmission DS-CDMA sur des canaux sélectifs en fréquence

- Dans ce papier, nous examinons les performances d'égaliseurs utilisables en liaison descendante DS/CDMA. Nous montrons qu'il est possible, à l'aide de récepteurs RAKE pré-combinant, d'obtenir des récepteurs simples et résistants à l'effet près-loin

Non-invasive MRI quantification of cerebrospinal fluid dynamics in amyotrophic lateral sclerosis patients.

BACKGROUND: Developing novel therapeutic agents to treat amyotrophic lateral sclerosis (ALS) has been difficult due to multifactorial pathophysiologic processes at work. Intrathecal drug administration shows promise due to close proximity of cerebrospinal fluid (CSF) to affected tissues. Development of effective intrathecal pharmaceuticals will rely on accurate models of how drugs are dispersed in the CSF. Therefore, a method to quantify these dynamics and a characterization of differences across disease states is needed. METHODS: Complete intrathecal 3D CSF geometry and CSF flow velocities at six axial locations in the spinal canal were collected by T2-weighted and phase-contrast MRI, respectively. Scans were completed for eight people with ALS and ten healthy controls. Manual segmentation of the spinal subarachnoid space was performed and coupled with an interpolated model of CSF flow within the spinal canal. Geometric and hydrodynamic parameters were then generated at 1 mm slice intervals along the entire spine. Temporal analysis of the waveform spectral content and feature points was also completed. RESULTS: Comparison of ALS and control groups revealed a reduction in CSF flow magnitude and increased flow propagation velocities in the ALS cohort. Other differences in spectral harmonic content and geometric comparisons may support an overall decrease in intrathecal compliance in the ALS group. Notably, there was a high degree of variability between cases, with one ALS patient displaying nearly zero CSF flow along the entire spinal canal. CONCLUSION: While our sample size limits statistical confidence about the differences observed in this study, it was possible to measure and quantify inter-individual and cohort variability in a non-invasive manner. Our study also shows the potential for MRI based measurements of CSF geometry and flow to provide information about the hydrodynamic environment of the spinal subarachnoid space. These dynamics may be studied further to understand the behavior of CSF solute transport in healthy and diseased states

Assessing diets of 3-year-old children:evaluation of an FFQ

OBJECTIVE: To evaluate the use of an administered eighty-item FFQ to assess nutrient intake and diet quality in 3-year-old children. DESIGN: Frequency of consumption and portion size of the foods listed on the FFQ during the 3 months preceding the interview were reported by the child's main caregiver; after the interview a 2 d prospective food diary (FD) was completed on behalf of the child. Nutrient intakes from the FFQ and FD were estimated using UK food composition data. Diet quality was assessed from the FFQ and FD according to the child's scores for a principal component analysis-defined dietary pattern ('prudent' pattern), characterised by high consumption of fruit, vegetables, water and wholemeal cereals. SETTING: Southampton, UK. SUBJECTS: Children (n 892) aged 3 years in the Southampton Women's Survey. RESULTS: Intakes of all nutrients assessed by the FFQ were higher than FD estimates, but there was reasonable agreement in terms of ranking of children (range of Spearman rank correlations for energy-adjusted nutrient intakes, r s = 0·41 to 0·59). Prudent diet scores estimated from the FFQ and FD were highly correlated (r = 0·72). Some family and child characteristics appeared to influence the ability of the FFQ to rank children, most notably the number of child's meals eaten away from home. CONCLUSIONS: The FFQ provides useful information to allow ranking of children at this age with respect to nutrient intake and quality of diet, but may overestimate absolute intakes. Dietary studies of young children need to consider family and child characteristics that may impact on reporting error associated with an FFQ

Davidson on Self‐Knowledge: A Transcendental Explanation

Davidson has attempted to offer his own solution to the problem of self-knowledge, but there has been no consensus between his commentators on what this solution is. Many have claimed that Davidson’s account stems from his remarks on disquotational specifications of self-ascriptions of meaning and mental content, the account which I will call the “Disquotational Explanation”. It has also been claimed that Davidson’s account rather rests on his version of content externalism, which I will call the “Externalist Explanation”. I will argue that not only are these explanations of self-knowledge implausible, but Davidson himself has already rejected them. Thus, neither can be attributed to Davidson as his suggested account of self-knowledge. I will then introduce and support what I take to be Davidson’s official and independent account of self-knowledge, that is, his “Transcendental Explanation”. I will defend this view against certain potential objections and finally against the objections made by William Child

The impact of intellectual disabilities on elite sports performance

Athletes with intellectual disabilities (ID) were re-introduced into the Paralympics in London 2012. As part of this development a classification system had to be established evidencing the impact this impairment has on elite sports performance. This review examines the research behind this issue. Firstly it examines the limited literature comparing the standards reached by top-level athletes with ID with those without disabilities, and then moves on to look at the research demonstrating differences in both the cognitive and physical skills needed for elite performance. The article then reviews the factors that may be implicated to account for this disparity, from a range of perspectives. A case is made for the importance of looking at this area in terms of the potential for the transferability of research findings from this group to talent identification in mainstream athletes and the benefits of integrating neuropsychological concepts and approaches to understanding the cognitive components behind the development of particular skills associated with high-level performance in specific sports

Fruit and vegetable intake and risk of cancer in the Swedish women’s lifestyle and health cohort

Objective To investigate whether intake of fruits and vegetables is associated with overall cancer incidence in a large prospective cohort of women in Sweden characterised by young age at enrolment (30–49 years) and relatively low intake of fruits and vegetables. Methods We followed prospectively 49,261 women, who completed a food frequency questionnaire in 1991–1992. A total of 2,347 incident invasive cancer cases were identified until December 2006. The occurrence of cancer was analysed by fitting Poisson regression models, estimating incidence rate ratios (RR) and 95% confidence intervals (CI). Results The median intake of fruits and vegetables was 204 g/day (10th; 90th percentile: 37; 564 g/day). Intake of fruits and vegetables was not statistically significantly associated with overall cancer incidence. When we compared women in the highest quintile of fruit and vegetable intake to women in the lowest quintile, the RR for overall cancer was 1.01 (95% CI: 0.88–1.16). Similar results were obtained when investigating the effect of intake of fruits and vegetables separately and when we stratified women by age at follow-up. Conclusion Fruit and vegetable intake was not associated with risk of total cancer in this prospective cohort of women in Sweden