Patient safety ethics and human error management in ED contexts part I : development of the global patient safety movement

In recent years there has been increasing recognition internationally that health care is not as safe as it ought to be and that patient safety outcomes need to be improved. To this end patient safety has become the focus of a world-wide endeavour aimed at reducing the incidence and impact of preventable human errors and related adverse events in health care domains. The emergency department has been identified as a significant site of preventable human errors and adverse events in the health care system, raising important questions about the nature of human error management and patient safety ethics in rapidly changing environments. In this article (the first of a two-part discussion on the subject) an overview of the incidence and impact of preventable adverse events in ED contexts is explored. The development of a ‘culture of safety’ in other hazardous industries and the ‘lessons learned’ and applied to the health care industry are also briefly examined. In a second article (to be presented as Part II), some of the ethical tensions that have arisen in the context of implementing patient safety processes and their possible implications for ED contexts are explored.

π-Selective stationary phases: (I) Influence of the spacer chain length of phenyl type phases on the aromatic and methylene selectivity of aromatic compounds in reversed phase high performance liquid chromatography

Phenyl type stationary phases of increasing spacer chain length (phenyl, methyl phenyl, ethyl phenyl, propyl phenyl and butyl phenyl, with 0–4 carbon atoms in the spacer chain, respectively) were synthesised and packed in house to determine the impact that the spacer chain length has on the retention process. Two trends in the aromatic selectivity, q_aromatic, were observed, depending on whether the number of carbon atoms in the spacer chain is even or odd. Linear log k′ vs ϕ plots were obtained for each stationary phase and the S coefficient was determined from the gradient of these plots. For the phenyl type phases, the S vs n_c plots of the retention factors of linear polycyclic aromatic hydrocarbons vs the number of rings exhibit a distinct discontinuity that between 3 and 4 rings, which increases with increasing spacer chain length for even phases but decreases for odd phases. Accordingly, we suggest that the retention factors depend differently on the number of carbon atoms in the spacer chain depending on whether this number is even or odd and that this effect is caused by different orientations of the aromatic ring relative to the silica surface.

Room-temperature insertion of elemental tellurium into the Cspł-Br and -I bonds of α-bromo-and α-iodopinacolone

Pinacolyltellurium(IV) dihalides, (t-BuCOCH₂)₂TeX₂ (X ) Br (1b), I (1c)) and Ar(t-BuCOCH₂)TeCl₂ (Ar == 1-C₁₀H₇ (Np) (2a), 2,4,6-Me₃C₆H₂ (Mes) (3a)), are readily prepared at room temperature by the oxidative insertion of elemental tellurium into the C_sp³-Br or -I bond of the α-halopinacolone and by the reaction of ArTeCl₃ with the pinacolone t-BuCOCH₃. The bromides Np(t-BuCOCH₂)TeBr₂ (2b) and Mes(t-BuCOCH₂)TeBr₂ (3b) can be prepared by the addition of bromine to the telluride Ar(t-BuCOCH₂)-Te or of α-bromopinacolone to ArTeBr. Variable-temperature ¹H and ¹³C NMR of the separate signals for the o-Me groups in 3a,b indicate a very high barrier to rotation about the Te-C(aryl) bond. Crystal diffraction data for 1c, 2a-c, and 3b show that intramolecular 1,4-Te …O(C) secondary bonding interactions (SBIs) are retained even in the presence of bulky aryl groups and intermolecular Te …X SBIs are subject to electronic population and steric congestion around the Te(IV) center in the solid state.

Policy and practice impacts of applied research: a case study analysis of the New South Wales Health Promotion Demonstration Research Grants Scheme 2000-2006

Background
Intervention research provides important information regarding feasible and effective interventions for health policy makers, but few empirical studies have explored the mechanisms by which these studies influence policy and practice. This study provides an exploratory case series analysis of the policy, practice and other related impacts of the 15 research projects funded through the New South Wales Health Promotion Demonstration Research Grants Scheme during the period 2000 to 2006, and explored the factors mediating impacts.

Methods
Data collection included semi-structured interviews with the chief investigators (n = 17) and end-users (n = 29) of each of the 15 projects to explore if, how and under what circumstances the findings had been used, as well as bibliometric analysis and verification using documentary evidence. Data analysis involved thematic coding of interview data and triangulation with other data sources to produce case summaries of impacts for each project. Case summaries were then individually assessed against four impact criteria and discussed at a verification panel meeting where final group assessments of the impact of research projects were made and key influences of research impact identified.

Results
Funded projects had variable impacts on policy and practice. Project findings were used for agenda setting (raising awareness of issues), identifying areas and target groups for interventions, informing new policies, and supporting and justifying existing policies and programs across sectors. Reported factors influencing the use of findings were: i) nature of the intervention; ii) leadership and champions; iii) research quality; iv) effective partnerships; v) dissemination strategies used; and, vi) contextual factors.

Conclusions
The case series analysis provides new insights into how and under what circumstances intervention research is used to influence real world policy and practice. The findings highlight that intervention research projects can achieve the greatest policy and practice impacts if they address proximal needs of the policy context by engaging end-users from the inception of projects and utilizing existing policy networks and structures, and using a range of strategies to disseminate findings that go beond traditional peer review publications.

Fusulinoideans from the early Midian (late Middle Permian) Metadoliolina dutkevitchi-Monodiexodina sutchanica Zone of the Senkina Shapka section, South Primorye, Far East Russia.

Fusulinoideans from the Metadoliolina dutkevitchi-Monodiexodina sutchanica Zone of the lower part of the Chandalaz Formation in the Senkina Shapka section in South Primorye, Far East Russia, are described. The fusulinoidean zone is assigned to the early Midian (=Capitanian: late Middle Permian) based mainly on the morphologie and biostratigraphic characteristics of Metadoliolina dutkevitchi. Previously, a Midian age has been established for the Metadoliolina dutkevitchi-Monodiexodina sutchanica Zone by the coexistence of Lepidolina species. However, the occurrence of Lepidolina with the two zonal species in this area has not been verified by the illustration of Lepidolina specimens. We examined a fusulinoidean-bearing sample from the Metadoliolina dutkevitchi-Monodiexodina sutchanica Zone, and three fusulinoidean species, Monodiexodina sutchanica, Pseudofusulina sp. and Metadoliolina dutkevitchi, are de-scribed and illustrated.

In the name of the Father : God in Lacan, Judaic or Christian?

This essay challenges the widespread notion that Lacanian psychoanalysis represents a 'Christianing' of psychoanalysis. It argues that Lacanian psychoanalysis brings to psychoanalysis a broadly "Averroist" attitude towards religion which develops out of and transcends Freud's position in Totem and Taboo. For Lacan, religious texts are an invaluable source of pre-psychoanalytic insight or another regal road into the champ Freudien: the dynamic of human beings' desire, in its co-conformity with language and Law. The text focuses on trying to decipher the missing content of the Names of the Father seminar: the seminar that "does not exist" (Miller, 2006) beyond its opening, esoteric and dramatic session. The force of doing this will be to show how much, and how fundamental, the things are that Lacan thinks the bible, and the first Abrahamic monotheism in particular, can teach us about human subjectivity and the instance of the Law that shapes it - insights which go to explain Freud's unmistakable attachment, despite himself, to the civilizational importance of his fathers.

Cadmium, copper, mercury, and zinc concentrations in tissues of the King Crab (Pseudocarcinus gigas) from southeast Australian waters

The concentrations of cadmium, copper, mercury, and zinc were determined in muscle (body, claw, and leg), hepatopancreas, and gill tissues of Pseudocarcinus gigas, an exceptionally large, long-lived, and deep-dwelling crab species. The accumulation patterns observed are discussed in terms of both intra- and interspecies variations, with particular attention to the possible consequences of the extreme size and depth range of P. gigas. Metal concentrations did not depend significantly on sex of the crab. Significant differences between tissues were detected for all metals, and the distribution of metal between the tissues was different for each metal. Significant correlations were found between metal concentrations in the various tissues and crab size, and these are discussed and rationalised. The concentrations of mercury and zinc in muscle tissue increased with crab size and were high compared to other crab species. The concentrations of cadmium and copper present in edible tissues were not especially high compared to other crab species, but the concentration of cadmium in the hepatopancreas is of dietary concern.

China in a book: Victorian representations of the 'celestial kingdom' in William Dalton’s 'The wolf boy of China'

Despite the wealth of material related to China in Victorian and Edwardian children’s literature, relatively few scholarly works have been published on the subject. Critics who have discussed the topic have tended to emphasize the negative discourse and stereotypical images of the Chinese in late nineteenth-century children’s literature. I use the case of William Dalton’s The Wolf Boy of China (1857), one of the earliest full-length Victorian children’s novels set in China, to complicate previous generalizations about negative representations of China and the Chinese and to highlight the unpredictable nature of child readers’ reactions to a text. First, in order to trace the complicated process of how information about the country was disseminated, edited, framed, and translated before reaching Victorian and Edwardian readers, I analyse how Dalton wove fragments from his reading of a large archive of texts on China into his novel.
Although Dalton may have preserved and transmitted some ‘factual’ information about China from his sources, he also transformed material that he read in innovative ways. These are reflected in the more subversive and radical parts of the novel, which are discussed in the second part of the essay. In the final section, I provide examples of historical readers of The Wolf Boy of China to challenge the notion that children passively accept the imperialist messages in books of empire.