Medical errors : Healthcare professionals’ perspective at a tertiary hospital in Kuwait

Medical errors are of economic importance and can contribute to serious adverse events for patients. Medical errors refer to preventable events resulting from healthcare interactions, whether these events harm the patient or not. In Kuwait, there is a paucity literature detailing the causes, forms, and risks of medical errors in their state-funded healthcare facilities. This study aimed to explore medical errors, their causes and preventive strategies in a Kuwait tertiary hospital based on the perceptions and experience of a cross-section of healthcare professionals using a questionnaire with 27 open (n = 10) and closed (n = 17) questions. The recruited healthcare professionals in this study included pharmacists, nurses, physicians, dentists, radiographers, hospital administrators, surgeons, nutritionists, and physiotherapists. The collected data were analysed quantitatively using descriptive statistics. A total of 203 participants filled and completed the survey questionnaire. The frequency of medical errors in Kuwait was found to be high at 60.3% ranging from incidences of prolonged hospital stays (32.9%), adverse events and life-threatening complications (32.3%), and fatalities (20.9%). The common medical errors result from incomplete instructions, incorrect dosage, and incorrect route of administration, diagnosis errors, and labelling errors. The perceived causes of these medical errors include high workload, lack of support systems, stress, medical negligence, inadequate training, miscommunication, poor collaboration, and non-adherence to safety guidelines among the healthcare professionals.Peer reviewe

Dispersion and Filter Cake Removal of Manganese Tetroxide-Based Drilling Fluids

Linear and other structures of particle aggregations were identified in Mn 3O4 - based filter cake. Several dispersants showed high potent ial to disperse manganese tetraoxide particles in water -based drilling fluids. Groups A and B dispersants showed particle settling times of 24 and 1 to 3 hrs, respectively. Laser particle analysis showed that aggregation of particles was reduced in the presence of lignosulfonate based dispersant. Zeta potential measurements showed a region of dispersion stability at pH of 6 to 11 based on Mn3O4 /C31 dispersant aqueous solutions . Zeta potential and transparency experiments showed that the optimum dispersant concentration was below 1 wt% and nearly 0.5 wt% based on Mn3O4 /dispersant aqueous solutions . SEM images of filter cake showed that the aggregation of particles was reduced when acrylic/maleicbased dispersant was used in clay contaminated drilling fluids . In most cases, the rheological behavior and sagging tendency of the contaminated and noncontaminated drilling fluids (17.5 and 20 lbm/gal) before/after heat aging at 400°F were improved in the presence of dispersants. The presence of NaCl and CaCl 2 had varying interactions with compatibility and particle settling. Dispersants for oil -based systems were sorted in Appendix B by the highest potential to disperse manganese tetraoxide particles in mineral oil –based solutions. Particle settling indicated that the optimum concentration for dispersants were nearly between 0.2 and 2 wt% based on Mn3O4 /dispersant S9 mineral oil -based solutions. Viscosity measurements showed a lower viscosity of 13.8 lbm/gal Mn3O4 oil -based drilling fluids at 1 wt% dispersant S9 than that of drilling fluids at 0.25 wt%. In most cases, the rheological behavior and sagging tendency of the contaminated and non-contaminated drilling fluids (17.5 and 20 lbm/gal) before/after heat aging at 400 °F were improved in the presence of dispersants. I lmenite and API barite oil -based drilling fluids showed higher sagging tendencies than those of manganese tetraoxide oil -based drilling fluids, indicating dispersant S5 was more effective with manganese tetraoxide fluids although the three drilling fluids have nearly similar rheological behavior. Glycolic or HCl acids (4 wt%) dissolved 75 wt% of manganese tetroxide particles. The dissolved manganese ions were higher with glycolic acid ( i .e. 10,000 mg/l) than that of HCl acid (8,500 mg/l). The reaction time when using HCl was nearly 5 times faster than that of glycolic acid reaction with manganese tetroxide particles. The Mn3O4 -based filter removal efficiency was nearly 90 wt% when glycolic acid was used in the single or two -step procedure to dissolve the f ilter cake. Glycolic acid concentrations were 7 and 10 wt% d uring the single and two-step filter cake removal procedures, respectively. The removal efficiencies by flow rate were higher with sandstone core samples ( i .e. 125 vol%) than those of limestone core samples ( i .e. 100 vol%)

Influence of intestinal efflux pumps on the absorption and transport of furosemide

AbstractPurposeFurosemide is a commonly used diuretic which is used in the treatment of edema, congestive heart failure, hypertension and renal failure. Its absorption exhibits inter- and intra-subject variability that can be attributed to many factors including the intestinal efflux pumps such as the P-glycoprotein (P-gp). This study was done due to the great disagreement between what is published in the literature regarding the influence of P-gp on furosemide and at the same time due to the importance of this drug in the treatment of different conditions as described above. In addition, an investigation of the effect of two of the commonly used pharmaceutical excipients (hydroxypropyl β-cyclodextrin [HPβCD] and Tween 80) and also a P-gp inhibitor (verapamil hydrochloride) on the intestinal absorption of this drug were also done.MethodsThe study utilized the everted intestinal sacs technique to investigate both the effect of the efflux transporter (P-gp) on furosemide absorption and also the effect of the chosen excipients.ResultsThe absorption of furosemide was significantly influenced by the P-gp as confirmed by the everted vis the non-everted sacs together with the verapamil study in which the transport of furosemide was inhibited by verapamil. In addition, Tween 80 was also shown to inhibit the P-gp pump whereas the HPβCD did not significantly influence the efflux of furosemide in this study.ConclusionsP-glycoprotein and some of the used excipients in the formulation play a very important role in the transport of furosemide and other drugs. Thus excipients that affect the activity of P-gp should be avoided when formulating drugs that are substrate for the P-gp or other efflux pumps

Applying Information Technology-Based Knowledge Management (KM) Simulation in the Airline Industry

In previous studies, some of the KM enablers documented include leadership operations in the form of a KM officer, financial aspects, and the organizational culture. On the other hand, the major barrier involves resistance to change due to the traditional culture emphasizing socialization and the establishment of trust before fostering business operations. From the gap analysis, some of the strategies that the Emirates Group could embrace include investing more in training sessions and workshops, designing the KM program in a manner that enables it to protect tacit knowledge from loss, and engaging in virtual team formation to foster an awareness of the value lying in KM program support. In so doing, it is projected that the company’s employee operations will be closely linked or aligned to the leading goals and objectives, upon which desirable degrees of productivity and competitiveness might be achieved. This paper has examined the aspect of knowledge management by gaining specific insights from the context of the Emirates Group. Whereas KM at the firm level comes in the form of articles presentations, reports and memos, group levels have seen KM emerge via an operational information system responsible for guiding the airline company’s daily operations. On the other hand, individual-level KM at this company exists in terms of the exRez software through which travelers can add destination activities, car rentals and hotel rooms to their flights, a process that occurs during online booking. In the future, there is a need for the company to remove the aforementioned barriers or obstacles perceived to stall progress, including organizational silos that are documented to set teams and individuals apart; besides hindering problem identification and solving on a collaborative basis

Universal human rights : a comparative study of the Charter of Medina and the Universal Declaration of Human Rights

Islam often receives criticism, particularly from right-wing movements, sections of media, governments, and the wider community in the West, for its lack of respect for respect human rights. In order to dispel such common myths about Islam, this study compares the Charter of Medina and the Universal Declaration of Human Rights (UDHR) in terms of basic human rights, civil and political rights, and economic and social human rights. It also analyses the contents, concepts and principles of the Medina Charter, highlights the opinions and translations of Orientalists regarding the Charter, and identifies mistakes and shortcomings in those translations. To achieve these objectives, this study adopts a qualitative approach to analyse the Medina Charter and the UDHR. Document analysis, content analysis and thematic analysis were undertaken. These analyses show that the Orientalists are not proficient in Arabic and, at times, they have even relied on controversial Arabic books such as Al-Aghani (The Book of Songs) to understand and interpret the Medina Charter. The findings of the study also reveal that the Medina Charter could be used to establish universal legal frameworks that include both the individual and the tribe in order to achieve a level of political stability. The data analysis indicates that the Medina Charter considered the cultural and religious differences among people, unlike the Universal Declaration, which was drafted solely on the basis of Western thought. More importantly, the analysis shows that all the political and civil rights tenets stated in the UDHR were originally derived from the Medina Charter. This is indicative of the precedents set in the Sharia and their influence on the determination and preservation of human rights. Further, the data analysis reveals that the Sharia could be used to develop legal and policy mechanisms to protect all human rights of individuals, and that the rights relating to safety and social security in the UDHR in practice are less desirable than those in the Medina Charter. The research argues that the West can learn from Islam by knowing and understanding its approach to, and application of, human rights. This may enable Orientalists and Western-centric cultures to change their ill-informed stance. The study concluded that human rights embodied in the UDHR are less universal and overarching than those in the Sharia. Consequently, the reforms needed in the UDHR would benefit from the existing legislation in the Medina Charter that consider the cultural and religious differences in society

Port employment in eastern Saudi Arabia: problems and prospects

Social, cultural and economic influences have combined to create a shortage of national manpower in Saudi Arabia. This study aims to investigate the extent of those shortages in port labour. The main focus is on port labour problems and prospects in the ports of Eastern Saudi Arabia on the Arabian Gulf, the selected ports being Jubail, Ras Tannurah and Dammam. The thesis is divided into two main parts. The first deals with setting the scene including analysis of development planning and manpower problems as well as the impacts of cultural and social background on labour supply. This part also includes an analysis of port hinterland and an investigation of port labour management of the studied ports. The second part includes field investigation starting with general characteristics of port labour, training problems, the problems of housing and the journey to work and how employees from various organisations in ports suffer from commuting problems. This part also includes discussion of employees' perceptions of various factors leading to shortage of indigenous manpower in port work. Finally, in order to present a clear understanding of employment problems and port labour prospects, investigation of employees' job satisfaction is undertaken. This will be particularly relevant during the transfer of port operations to the private sector. The study findings indicate that the majority of port employees are expatriates. Little has been achieved to increase recruitment of national manpower among port private contractors. It was found that the manufacturing sector was prominent in the port and port-related industries, particularly in Ras Tannurah and Jubail ports. The increased use of new cargo handling techniques in those ports reduced the dependence on low paid labour-intensive work, which is mainly carried out by expatriate labourers. However, trade sector activities continued to depend on foreign labour in stevedoring, containerisation and other technical port work which is mainly conducted by port contractors. There was little evidence that privatisation of port operation will increase recruitment of domestic manpower. This study shows that most public vocational schools and training centres did not provide the port sector with adequate skilled national manpower. A model was suggested to benefit from those institutions by on- the-job training leading to full-time employment. However, due to the tribal background of most of Saudi individuals, it has been found that several behavioural attitudes prevail which have a negative effect on training and other work issues. It was revealed that long distance and time of commuting, along with weather conditions clearly make training rather unattractive to most port employees. Regarding national manpower shortages in the port sector, it was revealed that the beneficial effect of the lower cost of hiring foreign employees was seen as affecting the recruitment of Saudis in ports. However all segments of employees showed low levels of satisfaction with pay and other port job benefits

The Use of Photomedicine in Musculoskeletal Pain

Musculoskeletal pain is a major cause of disability. Myofascial trigger points (MTrPs) in particular are a common source of pain in a substantial number of patients presenting at a pain clinic. Many different invasive and non-invasive forms have been advocated to the treatment of MTrPs. However, favourable outcome rates are inconsistent and some of these treatment forms described are often painful and have potentially dangerous side effects. Photomedicine including the coherent light sources (lasers) and more recently, non-coherent light sources have been reported to be beneficial in soft tissue lesions including MTrPs. Their beneficial therapeutic effects can be obtained without undesired effects. The main intentions of this chapter are to bring the attention of the doctors and physical therapists to the scientific approach of photomedicine, in particular laser therapy for the relief of pain arising from MTrPs, and to demonstrate how this type of therapy can be utilized in a rational manner for the relief of musculoskeletal pain. In addition, it has been found necessary to include or to start with an overview of the recently recognized diagnostic and therapeutic importance of MTrPs. Attention will therefore first be drawn mainly to incidence, types, aetiology, clinical diagnostic criteria and conventional forms of MTrPs

Essential aspects of power system planning in developing countries

AbstractIn developing countries, power system planning faces enormous challenges and problems as, for example, future load growth in the face of uncertainties, the constraints imposed on investment, the type and availability of fuel for the generating units, the need for consolidating the dispersed electric utilities in the isolated regions as a prerequisite for future interconnecting these regions via local national grids and with other neighboring countries. Also, how an optimal reliability level can be achieved that will guarantee a continuous power flow with a reasonable costs. All these obstacles made power systems planners and concerned agencies face tremendous difficulties in planning electric power facilities and making sound and appropriate decisions in constructing new power plants or adding new generating units or reinforcing the transmission and distribution networks. The proposed work attempts to display the most tedious and prominent problems and challenges that face the electric power systems in developing countries and influence the decision-making process which must be based on two major factors, namely, reliability and cost