Room for Experiment: The Countess of Arundel’s "Site of Medication"

The so-called Dutch Pranketing Room of Alethea Talbot, Countess of Arundel, at Tart Hall was a site of domestic experiments, courtly splendour and global ambition. Lady Arundel, the probable author of a famous recipe book, would have used Tart Hall for cooking and experiments as well as for impressive dinner parties, and she would have used large amounts of sugar to create intricate imitations of meat and vegetables to astonish, entertain and delight her guests. Linking household practice with global trade as well as artistic creation, Lady Arundel’s banquets are situated not only between a national tradition of cooking, as it appears in Markham’s manuals, and the new possibilities the arising global trade provided, but also played with a mismatch between taste and sight. This mediating role could be compared to that played by the artists the Countess employed. Within this context it is worth noting that a series of paintings displayed in the building’s gallery showed still lifes, markets, and a cook. The inventory of Tart Hall gives an insight into the world of the widely travelled collector and patron of Van Dyck and Rubens, but raises also a number of questions. In my talk I would like to explore the Countess’ Pranketing Room as a site of mediation between alimentary and painterly experiments, considering the use of recipes, experience, invention and transformation

Medication double-checking procedures in clinical practice: a cross-sectional survey of oncology nurses' experiences.

BACKGROUND Double-checking is widely recommended as an essential method to prevent medication errors. However, prior research has shown that the concept of double-checking is not clearly defined, and that little is known about actual practice in oncology, for example, what kind of checking procedures are applied. OBJECTIVE To study the practice of different double-checking procedures in chemotherapy administration and to explore nurses' experiences, for example, how often they actually find errors using a certain procedure. General evaluations regarding double-checking, for example, frequency of interruptions during and caused by a check, or what is regarded as its essential feature was assessed. METHODS In a cross-sectional survey, qualified nurses working in oncology departments of 3 hospitals were asked to rate 5 different scenarios of double-checking procedures regarding dimensions such as frequency of use in practice and appropriateness to prevent medication errors; they were also asked general questions about double-checking. RESULTS Overall, 274 nurses (70% response rate) participated in the survey. The procedure of jointly double-checking (read-read back) was most commonly used (69% of respondents) and rated as very appropriate to prevent medication errors. Jointly checking medication was seen as the essential characteristic of double-checking-more frequently than 'carrying out checks independently' (54% vs 24%). Most nurses (78%) found the frequency of double-checking in their department appropriate. Being interrupted in one's own current activity for supporting a double-check was reported to occur frequently. Regression analysis revealed a strong preference towards checks that are currently implemented at the responders' workplace. CONCLUSIONS Double-checking is well regarded by oncology nurses as a procedure to help prevent errors, with jointly checking being used most frequently. Our results show that the notion of independent checking needs to be transferred more actively into clinical practice. The high frequency of reported interruptions during and caused by double-checks is of concern.

Virtual car accidents of epilepsy patients, interictal epileptic activity, and medication.

OBJECTIVE To investigate effects of interictal epileptic activity (IEA) and antiepileptic drugs (AEDs) on reactivity and aspects of the fitness to drive for epilepsy patients. METHODS Forty-six adult patients with demonstration of focal or generalized bursts of IEA in electroencephalography (EEG) readings within 1 year prior to inclusion irrespective of medication performed a car driving computer test or a single light flash test (39 patients performed both). Reaction times (RTs), virtual crashes, or lapses (RT ≥ 1 s in the car or flash test) were measured in an IEA burst-triggered fashion during IEA and compared with RT-measurements during unremarkable EEG findings in the same session. RESULTS IEA prolonged RTs both in the flash and car test (p < 0.001) in individual patients up to 200 ms. Generalized IEA with spike/waves (s/w) had the largest effect on RT prolongation (p < 0.001, both tests), whereas mean RT during normal EEG, age, gender, and number of AEDs had no effect. The car test was better than the flash test in detecting RT prolongations (p = 0.030). IEA increased crashes/lapses >26% in sessions with generalized IEA with s/w. The frequency of IEA-associated RT >1 s exceeded predictions (p < 0.001) based on simple RT shift, suggesting functional impairment beyond progressive RT prolongation by IEA. The number of AEDs correlated with prolonged RTs during normal EEG (p < 0.021) but not with IEA-associated RT prolongation or crashes/lapses. SIGNIFICANCE IEA prolonged RTs to varying extents, dependent on IEA type. IEA-associated RTs >1 s were more frequent than predicted, suggesting beginning cerebral decompensation of visual stimulus processing. AEDs somewhat reduced psychomotor speed, but it was mainly the IEA that contributed to an excess of virtual accidents.