Patient safety in Europe: medication errors and hospital-acquired infections

The Report was commissioned by the European Federation of Nurses Associations (EFN) in November 2007 in order to support its policy statements on Patient Safety (June 2004). In that statement the EFN declares its belief that European Union health services should operate within a culture of safety that is based on working towards an open culture and the immediate reporting of mistakes; exchanging best practice and research; and lobbying for the systematic collection of information and dissemination of research findings. This Report adressess specifically the culture of highly reliable organisations using the work of James Reason (2000). Medication errors and hospital-acquired infections are examined in line with the Reprt´s parameters and a range of European studies are used as evidence. An extensive reference list is provided that allows EFN to explore work in greater detail as required

HRS1 Acts as a Negative Regulator of Abscisic Acid Signaling to Promote Timely Germination of Arabidopsis Seeds

In this work, we conducted functional analysis of Arabidopsis HRS1 gene in order to provide new insights into the mechanisms governing seed germination. Compared with wild type (WT) control, HRS1 knockout mutant (hrs1-1) exhibited significant germination delays on either normal medium or those supplemented with abscisic acid (ABA) or sodium chloride (NaCl), with the magnitude of the delay being substantially larger on the latter media. The hypersensitivity of hrs1-1 germination to ABA and NaCl required ABI3, ABI4 and ABI5, and was aggravated in the double mutant hrs1-1abi1-2 and triple mutant hrs1-1hab1-1abi1-2, indicating that HRS1 acts as a negative regulator of ABA signaling during seed germination. Consistent with this notion, HRS1 expression was found in the embryo axis, and was regulated both temporally and spatially, during seed germination. Further analysis showed that the delay of hrs1-1 germination under normal conditions was associated with reduction in the elongation of the cells located in the lower hypocotyl (LH) and transition zone (TZ) of embryo axis. Interestingly, the germination rate of hrs1-1 was more severely reduced by the inhibitor of cell elongation, and more significantly decreased by the suppressors of plasmalemma H+-ATPase activity, than that of WT control. The plasmalemma H+-ATPase activity in the germinating seeds of hrs1-1 was substantially lower than that exhibited by WT control, and fusicoccin, an activator of this pump, corrected the transient germination delay of hrs1-1. Together, our data suggest that HRS1 may be needed for suppressing ABA signaling in germinating embryo axis, which promotes the timely germination of Arabidopsis seeds probably by facilitating the proper function of plasmalemma H+-ATPase and the efficient elongation of LH and TZ cells

Avanços recentes em nutrição de larvas de peixes

Os requisitos nutricionais de larvas de peixes são ainda mal compreendidos, o que leva a altas mortalidades e problemas de qualidade no seu cultivo. Este trabalho pretende fazer uma revisão de novas metodologias de investigação, tais como estudos com marcadores, genómica populacional, programação nutricional, génomica e proteómica funcionais, e fornecer ainda alguns exemplos das utilizações presentes e perspectivas futuras em estudos de nutrição de larvas de peixes

Comparative Treatment Outcomes for Patients With Idiopathic Subglottic Stenosis.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadImportance: Surgical treatment comparisons in rare diseases are difficult secondary to the geographic distribution of patients. Fortunately, emerging technologies offer promise to reduce these barriers for research. Objective: To prospectively compare the outcomes of the 3 most common surgical approaches for idiopathic subglottic stenosis (iSGS), a rare airway disease. Design, setting, and participants: In this international, prospective, 3-year multicenter cohort study, 810 patients with untreated, newly diagnosed, or previously treated iSGS were enrolled after undergoing a surgical procedure (endoscopic dilation [ED], endoscopic resection with adjuvant medical therapy [ERMT], or cricotracheal resection [CTR]). Patients were recruited from clinician practices in the North American Airway Collaborative and an online iSGS community on Facebook. Main outcomes and measures: The primary end point was days from initial surgical procedure to recurrent surgical procedure. Secondary end points included quality of life using the Clinical COPD (chronic obstructive pulmonary disease) Questionnaire (CCQ), Voice Handicap Index-10 (VHI-10), Eating Assessment Test-10 (EAT-10), the 12-Item Short-Form Version 2 (SF-12v2), and postoperative complications. Results: Of 810 patients in this cohort, 798 (98.5%) were female and 787 (97.2%) were white, with a median age of 50 years (interquartile range, 43-58 years). Index surgical procedures were ED (n = 603; 74.4%), ERMT (n = 121; 14.9%), and CTR (n = 86; 10.6%). Overall, 185 patients (22.8%) had a recurrent surgical procedure during the 3-year study, but recurrence differed by modality (CTR, 1 patient [1.2%]; ERMT, 15 [12.4%]; and ED, 169 [28.0%]). Weighted, propensity score-matched, Cox proportional hazards regression models showed ED was inferior to ERMT (hazard ratio [HR], 3.16; 95% CI, 1.8-5.5). Among successfully treated patients without recurrence, those treated with CTR had the best CCQ (0.75 points) and SF-12v2 (54 points) scores and worst VHI-10 score (13 points) 360 days after enrollment as well as the greatest perioperative risk. Conclusions and relevance: In this cohort study of 810 patients with iSGS, endoscopic dilation, the most popular surgical approach for iSGS, was associated with a higher recurrence rate compared with other procedures. Cricotracheal resection offered the most durable results but showed the greatest perioperative risk and the worst long-term voice outcomes. Endoscopic resection with medical therapy was associated with better disease control compared with ED and had minimal association with vocal function. These results may be used to inform individual patient treatment decision-making.Patient-Centered Outcomes Research Institute - PCOR

A report on patient safety in Europe: medication errors and hospital-acquired infection

The report ‘Patient Safety in Europe: Medication Errors and Hospital-acquired Infection' was commissioned by the European Federation of Nurses Associations (EFN) in order to support its policy statement on Patient Safety. The report is authored by a working-group within the Workgroup of European Nurse Researchers and it is a snapshot of current work in the European areas surveyed. Medication errors and hospital-acquired infections are examined and a range of European studies are used as evidence. The result shows that studies on medication safety and nursing are few and they are heterogeneous in design making comparability between research reports difficult. Future research should capture the environmental and human context of error. WHO has identified hand hygiene as a major patient safety issue in relation to health care associated infections (HCAI) and there is general agreement in the literature that effective hand hygiene remains the most important initiative in the control of infection. To maximize EFNs lobbying function EFN and WENR should work together

Utan veggja skólans : útikennsla í myndmennt

Markmið þessa verkefnis er að þróa námsefni í myndmennt utan veggja hinnar hefðbundnu skólastofu. Verkefnið er bæði sett fram sem fræðileg greinargerð og námsefni með tillögum að verkefnum sem tengjast útikennslu myndmenntar í grunnskóla. Í fræðilega hluta verkefnisins er fjallað um útikennslu og náttúruna. Enn fremur er gerð grein fyrir kennslufræðilegum áherslum sem gætu stutt útikennslu í myndmennt; svo sem sköpun, gagnrýna hugsun og samþættingu í námi. Í greinargerðinni er fjallað um kenningar fimm fræðimanna sem gætu stutt við viðfangsefnið. Þetta eru hugmyndir Elliot Eisner, Rita L. Irwin, Anna Craft, Mihaly Csikezentmihaliyi og Anna Bamford sem öll hafa margvíslegar hugmyndir fram að færa sem hægt er að flétta inn í útikennslu myndmenntar. Einnig eru nokkrir listamenn taldir upp, bæði íslenskir og erlendir sem notast við náttúruna í sköpun sinni. Að lokum er kennsluefninu lýst ásamt markmiðum þess og framkvæmt kennslunnar. Námsefna hluti verkefnisins er hugmyndabanki af verkefnum í myndmennt sem hægt er að vinna utan veggja skólans. Lögð er áhersla á að nýta náttúruna í sköpunarvinnu nemenda og að efla tengsl þeirra við nærumhverfi sitt. Verkefnasafnið felur í sér tillögur af verkefnum sem kennarar geta aðlagað eftir þörfum, áhuga og fjölda nemenda sinna. Námsefninu er skipt eftir árstíðum og íslensku veðurfari. Höfundar vonast til þess, að með verkefnasafninu færist myndmenntakennsla meira út í náttúruna, veiti kennurum innblástur og hvatningu til að þróa hugmyndirnar og gera að sínum eigin

Prevalence of musuloskelectal symptoms in the Icelandic population. Survey of a random sample I

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn Skoða/Opna(view/open)In order to survey the prevalence of musculoskeletal symptoms in the Icelandic population this study was carried out on a random sample of men and women of the ages 16 to 65 years. The aim was to gather a reference material for future use in comparison with results from different subgroups of the working population. The cohort comprised 855 subjects, 421 men and 434 women. Questionnaires developed by a working group supported by the Nordic Council of Ministers were used. The questionnaires were sent by mail and if not answered they were recalled thrice. The participation rate was 73.5%, 301 men and 326 women filled in the questionnaires. The age, sex and geographical distribution of the non-participants were similar as in the whole cohort. The highest prevalence of symptoms during the last 12 months among the men were reported from the neck, shoulders, low back and head. The percentages were 37.7, 42.5, 56.3 and 34.8 in the regions respectively. The highest prevalence of symptoms during the last 12 months among women were from the same regions as among men. The percentages were 62.9, 65.3, 64.8 and 59.1 in the regions respectively. The lowest prevalence of symptoms during the last 12 months among men were from fingers, 11.6% and among women from the elbow regions 12.6%. The prevalence of the symptoms in each region differed considerable between age groups. We are not aware of any other study performed with these questionnaires on a representative sample of a nation. The prevalence of symptoms in this sample are high in both sexes as compared to those found in variety of populations representing many different occupations and work tasks, which have been studied in Sweden. However, these Swedish subpopulations are most likely selected as a study material because of the awareness of some musculoskeletal trouble among them.Einkenni frá hreyfi- og stoðkerfi eru talin algeng meðal íslendinga. Hingað til hafa þó ekki verið birtar niðurstöður margra athugana sem sýna tíðni þessara einkenna hérlendis, né hversu mikil áhrif þau hafa á fjarvistir úr vinnu. Á vegum Vinnueftirlits ríkisins hefur farið fram athugun á einkennum frá hreyfi- og stoðkerfi meðal úrtaks íslendinga á aldrinum 16-65 ára. Notaður var spurningalisti, unninn af samstarfshópi á vegum Norrænu embættismannanefndarinnar um vinnuverndarmálefni (1,2) (viðauki I). Listinn var þýddur á íslensku og jafnframt bætt við spurningum um einkenni frá höfði, fingrum og húð. Okkur er ekki kunnugt um að spurningalistinn hafi áður verið notaður við athuganir, sem byggja á úrtaki þjóðar. Niðurstöður rannsóknarinnar verða birtar í þrem greinum. í þessari grein er sagt frá niðurstöðum sem fram koma í yfirliti og viðbótarhluta listans. í hinum greinunum verður fjallað nánar um einkenni frá hálsi eða hnakka, herðum eða öxlum og neðri hluta baks. Meginmarkmiðið var að fá vitneskju um algengi (prevalence) einkenna frá hreyfi- og stoðkerfi meðal íslendinga. Upplýsingarnar verður hægt að nota síðar til samanburðar við niðurstöður, sem fást þegar spurningalistinn verður lagður fyrir ýmsa starfshópa

Prevalence of musuloskelectal symptoms in the Icelandic population. Survey of a random sample I

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn Skoða/Opna(view/open)In order to survey the prevalence of musculoskeletal symptoms in the Icelandic population this study was carried out on a random sample of men and women of the ages 16 to 65 years. The aim was to gather a reference material for future use in comparison with results from different subgroups of the working population. The cohort comprised 855 subjects, 421 men and 434 women. Questionnaires developed by a working group supported by the Nordic Council of Ministers were used. The questionnaires were sent by mail and if not answered they were recalled thrice. The participation rate was 73.5%, 301 men and 326 women filled in the questionnaires. The age, sex and geographical distribution of the non-participants were similar as in the whole cohort. The highest prevalence of symptoms during the last 12 months among the men were reported from the neck, shoulders, low back and head. The percentages were 37.7, 42.5, 56.3 and 34.8 in the regions respectively. The highest prevalence of symptoms during the last 12 months among women were from the same regions as among men. The percentages were 62.9, 65.3, 64.8 and 59.1 in the regions respectively. The lowest prevalence of symptoms during the last 12 months among men were from fingers, 11.6% and among women from the elbow regions 12.6%. The prevalence of the symptoms in each region differed considerable between age groups. We are not aware of any other study performed with these questionnaires on a representative sample of a nation. The prevalence of symptoms in this sample are high in both sexes as compared to those found in variety of populations representing many different occupations and work tasks, which have been studied in Sweden. However, these Swedish subpopulations are most likely selected as a study material because of the awareness of some musculoskeletal trouble among them.Einkenni frá hreyfi- og stoðkerfi eru talin algeng meðal íslendinga. Hingað til hafa þó ekki verið birtar niðurstöður margra athugana sem sýna tíðni þessara einkenna hérlendis, né hversu mikil áhrif þau hafa á fjarvistir úr vinnu. Á vegum Vinnueftirlits ríkisins hefur farið fram athugun á einkennum frá hreyfi- og stoðkerfi meðal úrtaks íslendinga á aldrinum 16-65 ára. Notaður var spurningalisti, unninn af samstarfshópi á vegum Norrænu embættismannanefndarinnar um vinnuverndarmálefni (1,2) (viðauki I). Listinn var þýddur á íslensku og jafnframt bætt við spurningum um einkenni frá höfði, fingrum og húð. Okkur er ekki kunnugt um að spurningalistinn hafi áður verið notaður við athuganir, sem byggja á úrtaki þjóðar. Niðurstöður rannsóknarinnar verða birtar í þrem greinum. í þessari grein er sagt frá niðurstöðum sem fram koma í yfirliti og viðbótarhluta listans. í hinum greinunum verður fjallað nánar um einkenni frá hálsi eða hnakka, herðum eða öxlum og neðri hluta baks. Meginmarkmiðið var að fá vitneskju um algengi (prevalence) einkenna frá hreyfi- og stoðkerfi meðal íslendinga. Upplýsingarnar verður hægt að nota síðar til samanburðar við niðurstöður, sem fást þegar spurningalistinn verður lagður fyrir ýmsa starfshópa