Do health inquiries lead to health system change? What have we learnt from recent health inquiries and will the same mistakes happen again?

Since 2001 there have been numerous Commissions of Inquiry into health system failures across the world. While the Inquiries were established to examine poor patient outcomes, each has identified a range of leadership and management shortcomings that have contributed to a poor standard of patient care. While there is an acknowledgement that different heath systems have different contexts, this paper highlights a number of themes that are common across Inquiries. It will discuss a number of common system failures in Inquiries spanning from 2001 to 2013 and pose questions as to why these types of failures are likely to re-occur, as well as possible learnings for health service management and leadership to address a number of these common themes.

Glass transition. A new approach based on cluster model of glasses

The structure of real glasses has been considered to be microheterogeneous, composed of clusters and connective tissue. Particles in the cluster are assumed to be highly correlated in positions. The tissue is considered to have a truly amorphous structure with its particles vibrating in highly anharmonic potentials. Glass transition is recognized as corresponding to the melting of clusters. A simple mathematical model has been developed which accounts for various known features associated with glass transition, such as range of glass transition temperature,T g, variation ofT g with pressure, etc. Expressions for configurational thermodynamic properties and transport properties of glass forming systems are derived from the model. The relevence and limitations of the model are also discussed.

Thermal properties of 3BaO-3TiO(2)-B2O3 glasses

Transparent glasses in the system 3BaO-3TiO2-B2O3 (BTBO) were fabricated via the conventional melt-quenching technique. The as-quenched samples were confirmed to be non-crystalline by differential thermal analysis (DTA). Thermal parameters were evaluated using non-isothermal DTA experiments. The Kauzmann temperature was found to be 759 K based on heating-rate-dependent glass transition and crystallization temperatures. A theoretical relation for the temperature-dependent viscosity is proposed for these glasses and glass-ceramics.

A neutron diffraction investigation of the structure of PBO-PBCL2 glasses

Neutron diffraction techniques have been employed to investigate the structure of PbO-PbCl2 glasses as a function of composition in the nominal range PbO.PbCl2 to 9PbO.PbCl2. It is concluded that, whereas the first Pb-O distance is well defined, the distribution of Pb-Cl distances is much broader, in agreement with a previous EXAFS study.

Zinc, cadmium and lead resistance mechanisms in bacteria and their contribution to biosensing

In bacteria resistance to heavy metals is mainly achieved through active efflux, but also sequestration with proteins or as insoluble compounds is used. Although numerous studies have dealt with zinc, cadmium and lead resistance mechanisms in bacteria, it has still remained unclear how different transporters are integrated into an effective homeostasis/resistance network and whether specific mechanisms for lead sequestration exist. Furthermore, since metals are toxic not only to bacteria but to higher organisms as well, it is important to be able to estimate possible biological effects of heavy metals in the environment. This could be done by determining the bioavailable amount of the metals in the environment with bacterial bioreporters. That is, one can employ bacteria that respond to metal contamination by a measurable signal to assess the property of metals to cross biological membranes and to cause harmful effects in a possibly polluted environment. In this thesis a new lead resistance mechanism is described, interplay between CBA transporters and P-type ATPases in zinc and cadmium resistance is presented and finally the acquired knowledge is used to construct bacterial bioreporters for heavy metals with increased sensitivity and specificity. The new lead resistance model employs a P-type ATPase that removes Pb2+ ions from the cytoplasm and a phosphatase that produces inorganic phosphate for lead sequestration in the periplasm. This was the first study where the molecular mechanism of lead sequestration has been described. Characterization of two P-type ATPases and two CBA transporters showed that resistance mechanisms for Zn2+ and Cd2+ are somewhat different than for Pb2+ as these metals cannot be sequestered as insoluble compounds as easily. Resistance to Zn2+ was conferred merely by the CBA transporter that could export both cytoplasmic and periplasmic ions; whereas, full resistance to Cd2+ required interplay of a P-type ATPase that exported cytoplasmic ions to periplasm and a CBA transporter that further exported periplasmic ions to the outside. The knowledge on functionality of the transporters and metal-inducible promoters was exploited in bioreporter technology. A transporter-deficient bioreporter strain that lacked exporters for Zn2+/Cd2+/Pb2+ could detect up to 45-fold lower metal concentrations than its wild type counterpart due to the accumulation of metals in the cell. The broad specificity issue of bioreporters was overcome by using Zn-specific promoter as a sensor element, thus achieving Zn-specific bioreporter.

Portrait of Albert Einstein wearing glasses Portraits Men

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No more glasses! (Not)

As he approaches the end of his epic ophthalmic journey of retinopexy, cryopexy, vitrectomy and IOL surgery, Professor Nathan Efron rues the fact that he is still partially dependent on glasses.

Dr. Bernhard Bardach clinking glasses with unidentified officers and civilian; Isola Military; Portraits

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Influence of Sm2O3 doping on formation and structure of SrBi2Nb2O9 nanocrystals in lithium borate glasses

New glasses of 16.66SrO–16.66[(1 − x)Bi2O3–xSm2O3]–16.66Nb2O5–50Li2B4O7 (0 ≤ x ≤ 0.5, in molar ratio), i.e., the pseudo-binary Sm2O3-doped SrBi2Nb2O9–Li2B4O7 glass system, giving the crystallization of Sm3+-doped SrBi2Nb2O9 nanocrystals are developed. It is found that the thermal stability of the glasses against the crystallization and the optical band gap energy increases with increasing Sm2O3 content. The formation of fluorite-type Sm3+-doped SrBi2Nb2O9 nanocrystals (diameters: 13–37 nm) with a cubic structure is confirmed in the crystallized (530 °C, 3 h) samples from X-ray powder diffraction analyses, Raman scattering spectrum measurements, and transmission electron microscope observations. The effect of Sm3+-doping on the microstructure, Raman scattering peak positions, and dielectric properties of composites comprising of fluorite-type SrBi2Nb2O9 nanocrystals and the Li2B4O7 glassy phase is clarified. It is found that fluorite-type SrBi2Nb2O9 nanocrystals transform to stable perovskite-type SrBi2Nb2O9 crystals with an orthorhombic structure by heat treatments at around 630 °C.

Crystallization Kinetics and Electrical Relaxation of BaO-0.5Li(2)O-4.5B(2)O(3) Glasses

Transparent glasses in the composition BaO-0.5Li(2)O-4.5B(2)O(3) (BLBO) were fabricated via the conventional melt-quenching technique. X-ray powder diffraction combined with differential scanning calorimetric (DSC) studies carried out on the as-quenched samples confirmed their amorphous and glassy nature, respectively. The crystallization behavior of these glasses has been studied by isothermal and nonisothermal methods using DSC. Crystallization kinetic parameters were evaluated from the Johnson-Mehl-Avrami equation. The value of the Avrami exponent (n) was found to be 3.6 +/- 0.1, suggesting that the process involves three-dimensional bulk crystallization. The average value of activation energy associated with the crystallization of BLBO glasses was 317 +/- 10 kJ/mol. Transparent glass-ceramics were fabricated by controlled heat-treatment of the as-quenched glasses at 845 K/40 min. The dielectric constants for BLBO glasses and glass-ceramics in the 100 Hz-10 MHz frequency range were measured as a function of the temperature (300-925 K). The electrical relaxation and dc conductivity characteristics were rationalized using electric modulus formalism. The imaginary part of the electric modulus spectra was modeled using an approximate solution of the Kohlrausch-Williams-Watts relation. The temperature-dependent behavior of stretched exponent (beta) was discussed for the as-quenched and heat-treated BLBO glasses.

Dielectric studies of As-Se glasses

Dielectric constants and loss tangents of As-Se glasses have been measured between 300 K and the respective glass transition temperatures and between 1 kHz and 20 kHz. The variation of dielectric constants has been interpreted in terms of both heteropolarity of bonds and average bond energies employing a chemically ordered network model. Various contributions to total molar polarizations have been estimated. Rapid rise of loss tangent in the vicinity of glass transitions has been interpreted in terms of rapid increase; of d.c. conductivity.