...health ministries will be invited to convene experts in their countries to design specific programmes of action for improving safety in each of four domains in which a medications can cause ...inadvertant harm: health care professionals' behaviour; systems and practices of medication; medicines; patients and the public. ...WHO will use its global convening and advocacy role to pursue successful outcomes in a range of areas, including: strengthening the quality of data to monitor medication-related harm; providing guidance and developing strategies, plans, and tools to ensure that the medication process has the safety of patients at its core in all health-care settings; producing a strategy for setting out research priorities; monitoring and evaluating the impact of the challenge; continuing to engage with regulatory agencies and international actors to improve medication safety through improved packaging and labelling; and designing tools and technologies that empower patients to safely manage their own medications. 2 MA Safren, A Chapanis, A critical incident study of hospital medication errors, Hospitals, Vol. 34, Iss. 53, 1960, 65-66, 68 3 B Allegranzi, J Storr, G Dziekan, The first global patient safety challenge “Clean care is safer care”: from launch to current progress and achievements, J Hosp Infect, Vol. 65,...
ObjectivesThere is little consensus regarding the burden of pain in the UK. The purpose of this review was to synthesise existing data on the prevalence of various chronic pain phenotypes in order to ...produce accurate and contemporary national estimates.DesignMajor electronic databases were searched for articles published after 1990, reporting population-based prevalence estimates of chronic pain (pain lasting >3 months), chronic widespread pain, fibromyalgia and chronic neuropathic pain. Pooled prevalence estimates were calculated for chronic pain and chronic widespread pain.ResultsOf the 1737 articles generated through our searches, 19 studies matched our inclusion criteria, presenting data from 139 933 adult residents of the UK. The prevalence of chronic pain, derived from 7 studies, ranged from 35.0% to 51.3% (pooled estimate 43.5%, 95% CIs 38.4% to 48.6%). The prevalence of moderate-severely disabling chronic pain (Von Korff grades III/IV), based on 4 studies, ranged from 10.4% to 14.3%. 12 studies stratified chronic pain prevalence by age group, demonstrating a trend towards increasing prevalence with increasing age from 14.3% in 18–25 years old, to 62% in the over 75 age group, although the prevalence of chronic pain in young people (18–39 years old) may be as high as 30%. Reported prevalence estimates were summarised for chronic widespread pain (pooled estimate 14.2%, 95% CI 12.3% to 16.1%; 5 studies), chronic neuropathic pain (8.2% to 8.9%; 2 studies) and fibromyalgia (5.4%; 1 study). Chronic pain was more common in female than male participants, across all measured phenotypes.ConclusionsChronic pain affects between one-third and one-half of the population of the UK, corresponding to just under 28 million adults, based on data from the best available published studies. This figure is likely to increase further in line with an ageing population.
A look at atmospheric photochemistry is presented. Topics discussed free radicals and UV radiation as the primary drivers of chemistry in the atmosphere and photosensitized processes and ...photochemistry driven by visible radiation.
Oxidative stress and the subsequent oxidative damage to lens proteins is a known causative factor in the initiation and progression of cataract formation, the leading cause of blindness in the world ...today. Due to the role of oxidative damage in the etiology of cataract, antioxidants have been prompted as therapeutic options to delay and/or prevent disease progression. However, many exogenous antioxidant interventions have to date produced mixed results as anti-cataract therapies. The aim of this review is to critically evaluate the efficacy of a sample of dietary and topical antioxidant interventions in the light of our current understanding of lens structure and function. Situated in the eye behind the blood-eye barrier, the lens receives it nutrients and antioxidants from the aqueous and vitreous humors. Furthermore, being a relatively large avascular tissue the lens cannot rely of passive diffusion alone to deliver nutrients and antioxidants to the distinctly different metabolic regions of the lens. We instead propose that the lens utilizes a unique internal microcirculation system to actively deliver antioxidants to these different regions, and that selecting antioxidants that can utilize this system is the key to developing novel nutritional therapies to delay the onset and progression of lens cataract.
The fate of NO x (=NO + NO2) is important to understand because NO x is a significant player in air quality determination through its role in O3 formation. Here we show that renoxification of the ...urban atmosphere may occur through the photolysis of HNO3 deposited onto urban grime. The photolysis occurs 4 orders of magnitude faster than in water with J values at noon on July 1 in Toronto of 1.2 × 10–3 s–1 for nitrate on urban grime and 1.0 × 10–7 s–1 for aqueous nitrate. Photolysis of nitrate present on urban grime probably follows the same mechanism as aqueous nitrate photolysis, involving the formation of NO2, OH, and possibly HONO. Thus NO x may be rapidly returned to the atmosphere rather than being ultimately removed from the atmosphere through film wash off.
Hospital mortality is increasingly being regarded as a key indicator of patient safety, yet methodologies for assessing mortality are frequently contested and seldom point directly to areas of risk ...and solutions. The aim of our study was to classify reports of deaths due to unsafe care into broad areas of systemic failure capable of being addressed by stronger policies, procedures, and practices. The deaths were reported to a patient safety incident reporting system after mandatory reporting of such incidents was introduced.
The UK National Health Service database was searched for incidents resulting in a reported death of an adult over the period of the study. The study population comprised 2,010 incidents involving patients aged 16 y and over in acute hospital settings. Each incident report was reviewed by two of the authors, and, by scrutinising the structured information together with the free text, a main reason for the harm was identified and recorded as one of 18 incident types. These incident types were then aggregated into six areas of apparent systemic failure: mismanagement of deterioration (35%), failure of prevention (26%), deficient checking and oversight (11%), dysfunctional patient flow (10%), equipment-related errors (6%), and other (12%). The most common incident types were failure to act on or recognise deterioration (23%), inpatient falls (10%), healthcare-associated infections (10%), unexpected per-operative death (6%), and poor or inadequate handover (5%). Analysis of these 2,010 fatal incidents reveals patterns of issues that point to actionable areas for improvement.
Our approach demonstrates the potential utility of patient safety incident reports in identifying areas of service failure and highlights opportunities for corrective action to save lives.
The air−water interface in atmospheric water films of aerosols and hydrometeors (fog, mist, ice, rain, and snow) presents an important surface for the adsorption and reaction of many organic trace ...gases and gaseous reactive oxidants (hydroxyl radical (OH·), ozone (O3), singlet oxygen (O2(1Δg)), nitrate radicals (NO3 ·), and peroxy radicals (RO2 ·). Knowledge of the air−water interface partition constant of hydrophobic organic species is necessary for elucidating the significance of the interface in atmospheric fate and transport. Various methods of assessing both experimental and theoretical values of the thermodynamic partition constant and adsorption isotherm are described in this review. Further, the reactivity of trace gases with gas-phase oxidants (ozone and singlet oxygen) at the interface is summarized. Oxidation products are likely to be more water-soluble and precursors for secondary organic aerosols in hydrometeors. Estimation of characteristic times shows that heterogeneous photooxidation in water films can compete effectively with homogeneous gas-phase reactions for molecules in the atmosphere. This provides further support to the existing thesis that reactions of organic compounds at the air−water interface should be considered in gas-phase tropospheric chemistry.
The abundance of organic compounds at the surface of oceans provides a link between ocean biogeochemistry and the atmospheric chemistry of the marine boundary layer through physicochemical processes ...at and near the air−water interface. These processes, in turn, affect the formation and growth of marine boundary layer aerosols, being involved in primary and secondary aerosol formation and evolution in the atmosphere. The photochemistry and photosensitizing properties of the kinds of biogenically derived organic coatings present at the ocean surface have until now only been suggested but never fully addressed. We present the current state of understanding, and make some suggestions for where the field may go, for greater understanding of the possible feedbacks of air/sea exchanges on air quality and climate change.
Cellular homeostasis relies on having dedicated and coordinated responses to a variety of stresses. The accumulation of unfolded proteins in the endoplasmic reticulum (ER) is a common stress that ...triggers a conserved pathway called the unfolded protein response (UPR) that mitigates damage, and dysregulation of UPR underlies several debilitating diseases. Here, we discover that a previously uncharacterized 54-amino acid microprotein PIGBOS regulates UPR. PIGBOS localizes to the mitochondrial outer membrane where it interacts with the ER protein CLCC1 at ER-mitochondria contact sites. Functional studies reveal that the loss of PIGBOS leads to heightened UPR and increased cell death. The characterization of PIGBOS reveals an undiscovered role for a mitochondrial protein, in this case a microprotein, in the regulation of UPR originating in the ER. This study demonstrates microproteins to be an unappreciated class of genes that are critical for inter-organelle communication, homeostasis, and cell survival.
Exocometary Gas in the HD 181327 Debris Ring Marino, S.; Matra, L.; Stark, C. ...
Monthly notices of the Royal Astronomical Society,
08/2016, Volume:
460, Issue:
3
Journal Article
Peer reviewed
Open access
An increasing number of observations have shown that gaseous debris discs are not an exception. However, until now, we only knew of cases around A stars. Here we present the first detection of 12CO ...(2-1) disc emission around an F star, HD 181327, obtained with the Atacama Large Millimeter/submillimeter Array (ALMA) observations at 1.3 mm. The continuum and CO emission are resolved into an axisymmetric disc with ring-like morphology. Using a Markov chain Monte Carlo method coupled with radiative transfer calculations, we study the dust and CO mass distribution. We find the dust is distributed in a ring with a radius of 86.0 +/- 0.4 au and a radial width of 23.2 +/- 1.0 au. At this frequency, the ring radius is smaller than in the optical, revealing grain size segregation expected due to radiation pressure. We also report on the detection of low-level continuum emission beyond the main ring out to approximately 200 au. We model the CO emission in the non-local thermodynamic equilibrium regime and we find that the CO is co-located with the dust, with a total CO gas mass ranging between 1.2 x 10(exp -6) solar mass and 2.9 x 10(exp -6) solar mass, depending on the gas kinetic temperature and collisional partners densities. The CO densities and location suggest a secondary origin, i.e. released from icy planetesimals in the ring. We derive a CO+CO2 cometary composition that is consistent with Solar system comets. Due to the low gas densities, it is unlikely that the gas is shaping the dust distribution.
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