Southern portraits

Photography to me is a passion for recording fractions in time, which evoke a deep response in myself, and the viewer. The response can be one of wonder, love, hate, laughter, or camaraderie. While living and photographing in the gentle South, I am most concerned with and intrigued by portraying her people. My intent is to explore man, his familial characteristics, his sense of community, and his relationship with those around him

Improving reporting of adverse drug reactions: Systematic review

BACKGROUND: Adverse drug reactions (ADRs) are a significant cause of morbidity and mortality, with many being identified post-marketing. Improvement in current ADR reporting, including utility of underused or innovative methods, is crucial to improve patient safety and public health. OBJECTIVES: To evaluate methods to improve ADR reporting via a systematic literature review. METHODS: Data sources were Medline, Embase, Cochrane Library and National Library for health searches on ADR reporting (January 1997 to August 2007) including cross-referenced articles. Twenty-four out of 260 eligible studies were identified and critically assessed. Studies were grouped as follows: i) spontaneous reporting (11); ii) medical chart/note review (2); iii) patient interviews/questionnaires (3); and iv) combination methods including computer-assisted methods (8). RESULTS: Using computerized monitoring systems (CMS) to generate signals associated with changes in laboratory results with other methods can improve ADR reporting. Educational interventions combined with reminders and/or prescription card reports can improve hospital-based ADR reporting, and showed short to medium term improvement. CONCLUSIONS: The use of electronic health data combined with other methods for ADR reporting can improve efficiency and accuracy for detecting ADRs and can be extended to other health care settings. Although methods with educational intervention appear to be effective, few studies have reviewed long-term effects to assess if the improvements can be sustained

Climate duties, human rights and historic emissions

The problem of global climate change cannot be resolved without the cooperation of both China and the USA. However, neither government appears close to signing up to mandatory emissions reductions. Both nations defend their climate policies by appealing to ideas of fairness, equity and justice. This paper outlines the arguments offered by Chinese opponents of mandatory emissions reductions, highlighting three central claims about historical responsibility, ability to pay and the right to development. The first part of the paper examines these claims, the arguments supporting them, the relationships among them and their implications for a just global climate regime. Two different interpretations are suggested – the ‘overlapping consensus’ account and the ‘hybrid’ account. It is argued that only the hybrid account offers a coherent ethical position. The second part of the paper critically examines the hybrid account of global climate justice. On this account, the historical responsibility claim appears central to the Chinese argument that the West should pay the costs of tackling climate change. Several arguments against the historical responsibility claim are considered and detailed attention is paid to the argument from excusable ignorance, which suggests that the West should not be held responsible for those emissions generated before the risks of anthropogenic climate change were widely recognised. It is argued that many of the common replies to the argument from excusable ignorance are not convincing. However, a new (but limited) reply, which draws on the link between basic human rights and energy use, is proposed. The final part of the paper shows how the new reply requires a re-formulation of the hybrid account. The paper concludes by considering the implications of this new account for a just global climate regime and, in particular, China’s duties t

How many calories do nurses burn at work? A real-time study of nurses’ energy expenditure

Funding The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: These data were collected as part of a Scottish Government Chief Scientist Office funded study (CZH/4/460). Julia Allan is currently (2018) an Royal Society of Edinburgh (RSE) sabbatical grant holder.Peer reviewedPostprin

Understanding what matters to patients – identifying key patients' perceptions of quality

OBJECTIVES: To demonstrate a statistical method to enable the identification of key drivers of quality from a patient perspective that can be used by service providers to help drive improvement. DESIGN: Cross-tabulation, Chi-square analysis and Cramers V calculation using SPSS software of NHS Inpatient Surveys 2006 and 2007. SETTING: The NHS Inpatient Survey is a standardized survey designed by the Picker Institute conducted on a sample of patients across all acute care hospital trusts in England. PARTICIPANTS: The surveys (available from the UK Data Archive) provide anonymized patient data for over 77,000 patients in 2006 and 72,000 patients in 2007. MAIN OUTCOME MEASURES: Cramers V score testing associations between patient ratings on multiple components of care and ratings on the overall quality of care. RESULTS: Of the 58 questions analysed, some questions correlate more strongly with overall satisfaction of care than others and there is strong agreement of results over the two years. Of the top 20 rated components, communication (both between professionals and between professionals and patients) and trust engendered by that communication is a recurring theme. CONCLUSIONS: Hospital trusts are required to develop quality indicators and collate detailed feedback from patients in addition to the annual inpatient survey to measure these. To make best use of resources, additional data collection should focus on those aspects of care of most importance to patients locally. This analysis demonstrates a statistical technique that can help to identify such priority areas by showing those aspects of care most strongly associated with the overall rating of care. The analysis uses national level data to demonstrate how this can be achieved. This shows the importance to patients of being treated with dignity and respect, and good communication between staff and between staff and patients

Noise Pollution Exhibit at the EcoTarium

Our project team designed, developed, and tested an educational interactive display about noise pollution as part of the new City Science exhibit at the EcoTarium Museum of Science and Nature. Collaborating with the museum staff, we created a Java application to run on a touch screen computer. After we tested the application and developed it into a working prototype, we made recommendations for further ways to enhance the exhibit. Our results show that the exhibit successfully demonstrated how people’s responses to noise are subjective, and visitors who used the exhibit often engaged each other in dialogue concerning noise pollution

Delta opioid receptor stimulation mimics ischemic preconditioning in human heart muscle

AbstractOBJECTIVESThe objective of this study was to examine whether the delta (δ) opioid receptor isoform is expressed in the human heart and whether this receptor improves contractile function after hypoxic/reoxygenation injury.BACKGROUNDDelta opioid receptor agonists mimic preconditioning (PC) in rat myocardium, corresponding to known cardiac δ opioid receptor expression in this species.METHODSThe messenger RNA transcript encoding the δ opioid receptor was identified in human atria and ventricles. To evaluate the cardioprotective role of the opioid receptor, human atrial trabeculae from patients undergoing coronary bypass grafting were isolated and superfused with Tyrode’s solution. A control group underwent 90 min of simulated ischemia and 120 min of reoxygenation. A second group was preconditioned with 3 min simulated ischemia and 7 min reoxygenation. Additional groups included: superfusion with the δ receptor agonist (DADLE) (10 nM), with the δ receptor antagonist naltrindole (10 nM) and with the mitochondrial KATP channel blocker 5-hydroxydecanoate (5HD) (100 μM) either with or without PC, respectively. A final group was superfused with 5HD before DADLE. The end point used was percentage of developed force after 120 min of reoxygenation.RESULTSResults, expressed as means ± SEM, were: control = 32.6 ± 3.8%; PC = 50.5% ± 1.8∗; DADLE = 46.0 ± 3.9%∗; PC + naltrindole = 25.5 ± 3.9%; naltrindole alone = 25.5 ± 4.3%; 5HD + PC = 28.9 ± 7.4%; 5HD alone = 24.1 ± 3.0%; 5HD + DADLE = 26.9 ± 4.4% (∗p < 0.001 vs. controls).CONCLUSIONSHuman myocardium expresses the δ opioid receptor transcript. Stimulation of this receptor appears to protects human muscle from simulated ischemia, similar to PC, and via opening of the mitochondrial KATP channel