Internet Media in Technological Risk Amplification: Plutonium on Board the Cassini-Huygens Spacecraft

The author discusses how the Cassini controversy demonstrates the power of the Internet, particularly listservs and Usenet groups, and how this resource offers political activists an opportunity to affect the agendas of risk management policy decision-makers

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Co-limitation towards lower latitudes shapes global forest diversity gradients

The latitudinal diversity gradient (LDG) is one of the most recognized global patterns of species richness exhibited across a wide range of taxa. Numerous hypotheses have been proposed in the past two centuries to explain LDG, but rigorous tests of the drivers of LDGs have been limited by a lack of high-quality global species richness data. Here we produce a high-resolution (0.025° × 0.025°) map of local tree species richness using a global forest inventory database with individual tree information and local biophysical characteristics from ~1.3 million sample plots. We then quantify drivers of local tree species richness patterns across latitudes. Generally, annual mean temperature was a dominant predictor of tree species richness, which is most consistent with the metabolic theory of biodiversity (MTB). However, MTB underestimated LDG in the tropics, where high species richness was also moderated by topographic, soil and anthropogenic factors operating at local scales. Given that local landscape variables operate synergistically with bioclimatic factors in shaping the global LDG pattern, we suggest that MTB be extended to account for co-limitation by subordinate drivers

Geography from the back of the 2008 AAG program: is geography what we say or what we do?

This paper compares and contrasts what California geographers say\ud geography is and what geographers actually do, both in California\ud and at our flagship national conference, the Association of American\ud Geographers. The paper begins with an examination of definitions\ud of geography placed on the Web pages of university departments of\ud geography in the State of California. It then characterizes the distribution of tenured and probationary faculty interests, as listed on\ud department Web pages. These 202 California geographers are then\ud categorized into broad specialties (e.g., physical, environmental,\ud human, GIScience, and regional geographers) and their proportions\ud discussed. Lastly, the distribution of topics for sessions at the Association\ud of American Geographers 2008 annual meeting is described.\ud Quite a disparity emerges among what California geographers tell\ud the public geography is, their own interests and specialties, and the\ud foci of the national conference. Implications for the health of the\ud discipline are disquieting

Care Providers’ Satisfaction with Restructured Clinical Pharmacy Services in a Tertiary Care Teaching Hospital

ABSTRACTBackground: At the time this study was undertaken, clinical pharmacy services at the authors’ institution, a tertiary care teaching hospital, were largely reactive in nature, with patients and units receiving inconsistent coverage.Objective: To develop an evidence-based model of proactive practice and to evaluate the satisfaction of pharmacists and other stakeholders after restructuring of clinical pharmacy services.Methods: The literature was reviewed to determine a core set of pharmacist services associated with the greatest beneficial impact on patients’ health. On the basis of established staffing levels, the work schedule was modified, and pharmacists were assigned to a limited number of patient care teams to proactively and consistently provide these core services. Other patient care teams continued to receive reactive troubleshooting-based services, as directed by staff in the pharmacy dispensary. A satisfaction survey was distributed to all pharmacists, nurses, and physicians 18 months after the restructuring.Results: Of the 26 pharmacists who responded to the survey, all agreed or strongly agreed that the restructuring of services had improved job satisfaction and patient safety and that other health care professionals valued their contribution to patient care. Nurses and physicians from units where pharmacists had been assigned to provide proactive services perceived pharmacist services more favourably than those from units where pharmacist services were reactive. Pharmacists, nurses, and physicians all felt that proactive pharmacist services should be more widely available. Challenges reported by pharmacists included increased expectations for documentation and guilt about “cutting back” services where they had previously been provided.Conclusions: Restructuring clinical pharmacy services in an evidencebased manner improved pharmacists’ satisfaction and created demand from other stakeholders to provide this level of service for all patients.RÉSUMÉContexte : Au moment où cette étude a été menée, les services de pharmacie clinique à l’établissement des auteurs, un hôpital universitaire de soins tertiaires, étaient en grande partie de nature réactive, les patients et les unités recevant des services inégaux.Objectif : Créer un modèle de pratique proactive, fondé sur des données probantes, et évaluer la satisfaction des pharmaciens et des autres parties prenantes après la restructuration des services de pharmacie clinique.Méthodes : On a effectué une revue de la littérature pour déterminer une série de services de pharmacie de base associés aux plus importantes répercussions bénéfiques sur la santé des patients. À partir des niveaux d’effectifs établis, l’horaire de travail a été modifié, et les pharmaciens ont été assignés à un nombre limité d’équipes de soins aux patients pour assurer de façon proactive et constante ces services de base. D’autres équipes ont continué à recevoir des services de dépannage de nature réactive, aiguillés par le personnel à la pharmacie. Un sondage sur la satisfaction a été distribué à tous les pharmaciens, médecins, infirmières et infirmiers, 18 mois après la restructuration.Résultats : Des 26 pharmaciens ayant répondu au sondage, tous étaient d’accord ou tout à fait d’accord pour dire que la restructuration des services avait amélioré la satisfaction au travail et la sécurité des patients et que les autres professionnels de la santé reconnaissaient leur contribution aux soins aux patients. Le personnel infirmier et les médecins des unités où les pharmaciens avaient été assignés pour fournir des services de nature proactive avaient une perception plus favorable de leurs services que ceux des unités retenues pour y fournir des services de nature réactive. Les pharmaciens, le personnel infirmier et les médecins ont tous estimé que les services pharmaceutiques proactifs devraient être offerts à plus grande échelle. Les défis soulignés par les pharmaciens incluaient des attentes plus élevées en matière de consignation et le fait de se sentir coupables de « couper » des services auparavant offerts.Conclusions : La restructuration des services de pharmacie clinique fondée sur des données probantes a amélioré la satisfaction des pharmaciens et créé une demande de la part des autres parties prenantes pour la prestation de ce niveau de services pour tous les patients

ARTICLE Care Providers ’ Satisfaction with Restructured Clinical Pharmacy Services in a Tertiary Care Teaching Hospital

Background: At the time this study was undertaken, clinical pharmacy services at the authors ’ institution, a tertiary care teaching hospital, were largely reactive in nature, with patients and units receiving inconsistent coverage. Objective: To develop an evidence-based model of proactive practice and to evaluate the satisfaction of pharmacists and other stakeholders after restructuring of clinical pharmacy services. Methods: The literature was reviewed to determine a core set of pharmacist services associated with the greatest beneficial impact on patients ’ health. On the basis of established staffing levels, the work schedule was modified, and pharmacists were assigned to a limited number of patient care teams to proactively and consistently provide these core services. Other patient care teams continued to receive reactive troubleshooting-based services, as directed by staff in the pharmacy dispensary. A satisfaction survey was distributed to all pharmacists, nurses, and physicians 18 months after the restructuring. Results: Of the 26 pharmacists who responded to the survey, all agreed or strongly agreed that the restructuring of services had improved job satisfaction and patient safety and that other health care professionals valued their contribution to patient care. Nurses and physicians from units where pharmacists had been assigned to provide proactive services perceived pharmacist services more favourably than those from units where pharmacist services were reactive. Pharmacists, nurses, and physicians all felt that proactive pharmacist services should be more widely available. Challenges reported by pharmacists included increased expectations for documentation and guilt about “cutting back ” services where they had previously been provided. Conclusions: Restructuring clinical pharmacy services in an evidencebased manner improved pharmacists ’ satisfaction and created demand from other stakeholders to provide this level of service for all patients. Key words: clinical pharmacy, restructuring, tertiary care hospital, evidence-based, practice deliver

Development and Evaluation of a Checklist for Medication Order Review by Pharmacists

ABSTRACTBackground: To create a checklist of the tasks that a pharmacist must perform during medication order review in the hospital setting and to evaluate the utility of and pharmacists' satisfaction with the checklist.Methods: An evidence-based checklist for medication order review was developed, with items related to order urgency, verification of patients' identity, therapeutic review, and actionable items. Pharmacists were educated about the checklist, and it was made available at 2 community hospitals in an urban setting. Pharmacists completed a nonvalidated satisfaction survey and participated in focus groups or interviews within 3 months after implementation of the checklist. Qualitative descriptive theory was used to identify themes within the data. Near-miss occurrence reports for the 3 months before and after implementation of the checklist were quantified.Results: Of 16 pharmacists who were involved in the implementation phase, 14 participated in focus groups or an interview, and 11 responded to the survey. All respondents felt that the primary role of the checklist was for training. They felt that the checklist could be useful when reviewing high-alert or unfamiliar medications or therapy for patients with complex medications. The checklist was most helpful when it was used as a reminder, on an as-needed basis. Nine (82%) of the 11 survey respondents indicated that the checklist standardized the process of medication order review, the same number felt that it prevented accidental omission of critical checks, and 8 (73%) felt that it improved patient safety. Education was necessary to reinforce the purpose of the checklist and its self-check nature. There was no difference in the number of near misses in the pharmacy between the 3-month periods before and after implementation of the checklist.Conclusion: Pharmacists participating in the study felt that a checklist for medication order review had a role in training new pharmacists and standardizing processes.RÉSUMÉContexte : Créer une liste de contrôle des tâches que doit exécuter un pharmacien dans le cadre de la validation des ordonnances de médicaments en milieu hospitalier et évaluer l'utilité de cette liste ainsi que le niveau de satisfaction du pharmacien.Méthodes : Une liste de contrôle factuelle pour la validation des ordonnances de médicaments comportant des éléments liés au niveau d'urgence de l'ordonnance, à la vérification de l'identité des patients, à l'examen thérapeutique et aux questions décisionnelles a été développée. Les pharmaciens ont été formés à l'utilisation de cette liste qui a été mise en oeuvre dans deux hôpitaux communautaires en milieu urbain. Ils ont par la suite répondu à un sondage non validé sur leur satisfaction à l'égard de cet outil et participé à des groupes de discussion ou à des entrevues au cours des trois mois suivant la mise en oeuvre de la liste de contrôle. On a eu recours à une théorie descriptive qualitative pour regrouper les données par thèmes. On a quantifié les déclarations de quasi-accidents de médication pendant les trois mois précédant et suivant la mise en oeuvre de la liste de contrôle.Résultats : Des 16 pharmaciens qui ont utilisé la liste de contrôle, 14 ont participé aux groupes de discussion ou à une entrevue et 11 ont répondu au sondage. Tous les répondants étaient d'avis que la liste de contrôle servait tout d'abord à des fins de formation. Ils estimaient que cette liste pouvait être utile lors de la validation des ordonnances de médicaments ou de traitements sous haute vigilance ou inusités chez des patients sous pharmacothérapie complexe. Elle s'est révélée très utile comme aidemémoire, au besoin. Neuf (82 %) des 11 sondés ont déclaré que la liste de contrôle avait standardisé le processus de validation des ordonnances de médicaments, le même nombre estimait qu'elle avait prévenu l'omission accidentelle de vérifications essentielles et huit (73 %) répondants étaient d'avis qu'elle avait amélioré la sécurité des patients. Il a été nécessaire de sensibiliser davantage les pharmaciens à la raison d'être de la liste de contrôle et à son aspect d'autocontrôle. On n'a observé aucun changement dans le nombre de quasi-accidents de médication dans la pharmacie par suite de la mise en oeuvre de la liste de contrôle.Conclusion : Les pharmaciens qui ont participé à cette étude estimaient qu'une liste de contrôle pour la validation des ordonnances de médicaments jouait un rôle dans la formation des nouveaux pharmaciens et dans la standardisation des processus

The Pyrogeography of Methane Emissions from Seasonal Mosaic Burning Regimes in a West African Landscape

People have set fire to the savannas of West Africa for millennia, creating a pyrogeography. Fires render the landscape useful for many productive activities, but there is also a long history of efforts to regulate indigenous burning practices. Today, savanna fires are under scrutiny because they contribute to greenhouse gas emissions, especially methane. Policy efforts aimed at reducing emissions by shifting fire regimes earlier are untested. Most emissions estimates contain high levels of uncertainty because they are based on generalizations of diverse landscapes burned by complex fire regimes. To examine the importance of seasonality and other factors on methane emissions, we used an approach grounded in the practices of people who set fires. We conducted 107 experimental fires, collecting data for methane emissions and a suite of environmental variables. We sampled emissions using a portable gas analyzer, recording values for CO, CO2, and CH4. The fires were set both as head and backfires for three fire periods—the early, middle, and late dry season. We also set fires randomly to test whether the emissions differed from those set according to traditional practices. We found that methane emission factors and densities did not increase over the dry season but rather peaked mid-season due to higher winds and fuel moisture as well as green leaves on small trees. The findings demonstrate the complexity of emissions from fires and cast doubt on efforts to reduce emissions based on simplified characterizations of fire regimes and landscapes

The Pyrogeography of Methane Emissions from Seasonal Mosaic Burning Regimes in a West African Landscape

People have set fire to the savannas of West Africa for millennia, creating a pyrogeography. Fires render the landscape useful for many productive activities, but there is also a long history of efforts to regulate indigenous burning practices. Today, savanna fires are under scrutiny because they contribute to greenhouse gas emissions, especially methane. Policy efforts aimed at reducing emissions by shifting fire regimes earlier are untested. Most emissions estimates contain high levels of uncertainty because they are based on generalizations of diverse landscapes burned by complex fire regimes. To examine the importance of seasonality and other factors on methane emissions, we used an approach grounded in the practices of people who set fires. We conducted 107 experimental fires, collecting data for methane emissions and a suite of environmental variables. We sampled emissions using a portable gas analyzer, recording values for CO, CO2, and CH4. The fires were set both as head and backfires for three fire periods—the early, middle, and late dry season. We also set fires randomly to test whether the emissions differed from those set according to traditional practices. We found that methane emission factors and densities did not increase over the dry season but rather peaked mid-season due to higher winds and fuel moisture as well as green leaves on small trees. The findings demonstrate the complexity of emissions from fires and cast doubt on efforts to reduce emissions based on simplified characterizations of fire regimes and landscapes