Prognosemethode für das Schutzgut ‚Landschaft’ im Rahmen der Strategischen Umweltprüfung

Im Mittelpunkt der Dissertation stehen das Schutzgut ‚Landschaft’ sowie ‚Prognosemethoden in der Umweltprüfung’. Mit beiden Themenbereichen verbinden sich bereits heute ungelöste methodische Probleme, die mit der Umsetzung der Richtlinie zur Strategischen Umweltprüfung (SUP) zusätzlich komplexer und deren Lösung mithin anspruchsvoller werden. Dies hängt einerseits damit zusammen, dass eine gesetzeskonforme Gleichbehandlung aller Schutzgüter zunehmend eingefordert wird und gerade das Schutzgut ‚Landschaft’ in einer SUP methodisch besondere Aufmerksamkeit verlangt. Zum anderen führt die gängige planungsmethodische Diskussion allein nicht zu geeigneten Antworten auf o.g. Fragen, und es bedarf der Prüfung verschiedener Methodenbausteine, auch aus anderen Wissensgebieten, um – über ein eindimensionales Landschaftsverständnis einerseits und die bisher bekannten linearen Wirkungsprognosen andererseits hinaus gehend – mehrfach verknüpfte Prognoseschritte zur Anwendung in der SUP zu entwickeln, in denen das Schutzgut ‚Landschaft’ modellhaft für Bewertungsschritte nachvollziehbar abgebildet wird. Hierbei müssen entscheidungsrelevante Prognosezeiträume ebenso beachtet werden, wie in diesen Zeiträumen möglicherweise auftretende sekundäre, kumulative, synergetische, positive und negative Auswirkungen der zu beurteilenden Planung. Dieser Ziel- und Aufgabenstellung entsprechend erfolgt die theoretische Herangehensweise der Arbeit von zwei Seiten: 1. Die Funktionen und Stellung von Prognosen innerhalb der SUP wird erläutert (Kap. 2), und es wird der Frage nachgegangen, welche Anforderungen an Prognosemethoden zu stellen sind (Kap. 2.4) und welche Prognosemethoden in der SUP Verwendung finden bzw. finden können (Kap. 3). Der Schwerpunkt wird dabei auf die Anwendung der Szenariotechnik gelegt. 2. Es wird dargestellt wie Landschaft für Aufgaben der Landschaftsplanung und Umweltprüfung bisher üblicherweise erfasst und analysiert wird, um in Prognoseschritten handhabbar behandelt zu werden (Kap. 4). Beide Zugänge werden sodann zusammengeführt (Kap. 5), um am Beispiel einer Hochwasserschutzkonzeption im Rahmen der SUP Landschaftliche Prognosen zu erarbeiten. Die Prognose setzt methodisch mit der Beschreibung des zu verwendenden Landschaftsmodells und der Klärung des Modellzwecks ein. Bezugsbasis ist die Beschreibung des Charakters einzelner logisch hergeleiteter Landschaftseinheiten bzw. Landschaftsräume, die typisiert werden. Die Prognose selber unterscheidet zwischen der Abschätzung zu erwartender Landschaftsveränderungen im Sinne der ‚Status-quo-Prognose’ (einschließlich der Entwicklung von drei Szenarien möglicher Zukunftslandschaften bis 2030) und der Wirkungsabschätzungen verschiedener Maßnahmen bzw. Planungsalternativen und zwar zunächst raumunabhängig, und dann raumkonkret. Besondere Bedeutung bei den Wirkungsabschätzungen erhält die klare Trennung von Sach- und Wertebene, eine angemessene Visualisierung und die Dokumentation von Informationslücken und Unsicherheiten bei der Prognose. Diskutiert wird u.a. (Kap. 6) · die Bildung und Abgrenzung landschaftlicher Einheiten und Typen in Bezug zu der Aufgabe, landschaftliche Eigenart zu definieren und planerisch handhabbar und anwendbar zu bestimmen, · die Bedeutung angemessener Visualisierung zur Unterstützung von Beteiligungsverfahren und · die Bestimmung des so genannten ‚Raumwiderstandes’. Beigefügt sind zwei Karten des gesamten Bearbeitungsgebietes: Karte 1 „Landschaftstypen“, Karte 2 „Maßnahmentypen des Hochwasserschutzes mit möglichen Synergieeffekten für die Landschaft“.

Prediction of the bulking phenomenon in wastewater treatment plants

The control and prediction of wastewater treatment plants poses an important goal: to avoid breaking the environmental balance by always keeping the system in stable operating conditions. It is known that qualitative information — coming from microscopic examinations and subjective remarks — has a deep influence on the activated sludge process. In particular, on the total amount of effluent suspended solids, one of the measures of overall plant performance. The search for an input–output model of this variable and the prediction of sudden increases (bulking episodes) is thus a central concern to ensure the fulfillment of current discharge limitations. Unfortunately, the strong interrelation between variables, their heterogeneity and the very high amount of missing information makes the use of traditional techniques difficult, or even impossible. Through the combined use of several methods — rough set theory and artificial neural networks, mainly — reasonable prediction models are found, which also serve to show the different importance of variables and provide insight into the process dynamics

Complementarity of neutron reflectometry and ellipsometry for the study of atmospheric reactions at the air–water interface

The combined application of neutron reflectometry (NR) and ellipsometry to determine the oxidation kinetics of organic monolayers at the air–water interface is described for the first time. This advance was possible thanks to a new miniaturised reaction chamber that is compatible with the two techniques and has controlled gas delivery. The rate coefficient for the oxidation of methyl oleate monolayers by gas-phase O3 determined using NR is (5.4 ± 0.6) × 10−10 cm2 per molecule per s, which is consistent with the value reported in the literature but is now better constrained. This highlights the potential for the investigation of faster atmospheric reactions in future studies. The rate coefficient determined using ellipsometry is (5.0 ± 0.9) × 10−10 cm2 per molecule per s, which indicates the potential of this more economical, laboratory-based technique to be employed in parallel with NR. In this case, temporal fluctuations in the optical signal are attributed to the mobility of islands of reaction products. We outline how such information may provide critical missing information in the identification of transient reaction products in a range of atmospheric surface reactions in the future.

Mobile agent tracking with single frequency continuous wave radar : a linear robust filtering based approach

3-alkylpyrrole to the fabric surface. Direct applications of a conductive paint to the textile surface eliminate the exposure of the substrate to damaging oxidizing agents which allow the coating of more sensitive and delicate substrates. All textiles produced are tested for abrasion resistance and conductivity. For alkyl polypyrrole coated fabrics, the optimum carbon chain lengths are between n=10 and n=14, which result in optimum values of conductivity and solubility. The darkness of the tone is inversely related to the surface resistivity of the resulting conductive fabric. Therefore, deep black coatings have low resistivity whereas light gray coatings on a white fabric surface have higher surface resistivity. Longer alkyl chains result in higher surface resistivity in fabrics. The conductive coating of poly(3-decanylpyrrole) on the textile surface has a better abrasion resistance compared to that of an unsubstituted polypyrrole coating.

Multi-target tracking via space transformations using a single frequency continuous wave radar

This paper investigates the location and velocity estimation problem involving multiple targets using the phase difference and frequency shift of the returned Doppler modulated signal. The minimal receiver configuration that addresses the data association and missing information problem is presented for the case of linear arrays. Non-linearly modeled Doppler radar measurements are used to obtain an accurate estimate of the target dynamics progressively in a linear framework utilizing a recently developed robust state estimation approach.

Morphological characters and karyology of Miogryllus piracicabensis Piza (Orthoptera: Gryllidae)

O gênero Miogryllus inclui um número considerável de espécies, sendo que a maioria delas ainda não está descrita. A quantidade de detalhes morfológicos sobre as espécies conhecidas nem sempre é suficiente para seu reconhecimento, faltando dados sobre as estruturas fálicas e da pars stridens, bem como aqueles referentes à cariologia. O presente trabalho tem o propósito de suprir tal situação para o caso de M. piracicabensis.

Atrophic gastritis: Risk factor for esophageal squamous cell carcinoma in a Latin-American population

AIM: To study the association between atrophic gastritis (AG) and esophageal squamous cell carcinoma (ESCC) in a Latin-America population. METHODS: A case-control study was performed at two reference Brazilian hospitals including patients diagnosed with advanced ESCC and dyspeptic patients who had been subjected to upper gastrointestinal endoscopy, with biopsies of the gastric antrum and body. All cases with ESCC were reviewed by a single pathologist, who applied standard criteria for the diagnosis of mucosal atrophy, intestinal metaplasia, and dysplasia, all classified as AG. The data on the patients' age, sex, smoking status, and alcohol consumption were collected from clinical records, and any missing information was completed by telephone interview. The association between AG and ESCC was assessed by means of univariate and multiple conditional logistic regressions. RESULTS: Most patients were male, and the median age was 59 years (range: 37-79 years) in both the ESCC and control groups. Univariate analysis showed that an intake of ethanol greater than 32 g/d was an independent risk factor that increased the odds of ESCC 7.57 times (P = 0.014); upon multiple analysis, alcohol intake of ethanol greater than 32 g/d exhibited a risk of 4.54 (P = 0.081), as adjusted for AG and smoking. Smoking was shown to be an independent risk factor that increased the odds of ESCC 14.55 times (P = 0.011) for individuals who smoked 0 to 51 packs/year and 21.40 times (P = 0.006) for those who smoked more than 51 packs/year. Upon multiple analyses, those who smoked up to 51 packs/year exhibited a risk of 7.85 (P = 0.058), and those who smoked more than 51 packs/year had a risk 11.57 times higher (P = 0.04), as adjusted for AG and alcohol consumption. AG proved to be a risk factor that increased the odds of ESCC 5.33 times (95%CI: 1.55-18.30, P = 0.008) according to the results of univariate conditional logistic regression. CONCLUSION: There was an association by univariate conditional logistic regression between AG and ECSS in this sample of Latin-American population. © 2013 Baishideng.

Thin-Film Sparse Boundary Array Design for Passive Acoustic Mapping During Ultrasound Therapy

A new 2-D hydrophone array for ultrasound therapy monitoring is presented, along with a novel algorithm for passive acoustic mapping using a sparse weighted aperture. The array is constructed using existing polyvinylidene fluoride (PVDF) ultrasound sensor technology, and is utilized for its broadband characteristics and its high receive sensitivity. For most 2-D arrays, high-resolution imagery is desired, which requires a large aperture at the cost of a large number of elements. The proposed array's geometry is sparse, with elements only on the boundary of the rectangular aperture. The missing information from the interior is filled in using linear imaging techniques. After receiving acoustic emissions during ultrasound therapy, this algorithm applies an apodization to the sparse aperture to limit side lobes and then reconstructs acoustic activity with high spatiotemporal resolution. Experiments show verification of the theoretical point spread function, and cavitation maps in agar phantoms correspond closely to predicted areas, showing the validity of the array and methodology.

Chemotherapy alone versus chemotherapy plus radiotherapy for early stage Hodgkin lymphoma

Background Combined modality treatment (CMT) consisting of chemotherapy followed by localised radiotherapy is standard treatment for patients with early stage Hodgkin lymphoma (HL). However, due to long term adverse effects such as secondary malignancies, the role of radiotherapy has been questioned recently and some clinical study groups advocate chemotherapy only for this indication. Objectives We performed a systematic review with meta-analysis of randomised controlled trials (RCTs) comparing chemotherapy alone with CMT in patients with early stage Hodgkin lymphoma with respect to response rate, progression-free survival (alternatively tumour control) and overall survival (OS). Search methods We searched MEDLINE, EMBASE and CENTRAL as well as conference proceedings from January 1980 to November 2010 for randomised controlled trials comparing chemotherapy alone to the same chemotherapy regimen plus radiotherapy. Selection criteria Randomised controlled trials comparing chemotherapy alone with CMT in patients with early stage HL. Trials in which the chemotherapy differed between treatment arms were excluded. Trials with more than 20% of patients in advanced stage were also excluded. Data collection and analysis Effect measures used were hazard ratios (HR) for tumour control and OS as well as relative risks for response rates. Two review authors independently extracted data and assessed quality of trials. We contacted study authors to obtain missing information. Since none of the trials reported progression-free survival according to our definitions, all similar outcomes were evaluated as tumour control. Main results Five RCTs involving 1245 patients were included. The HR was 0.41 (95% confidence interval (CI) 0.25 to 0.66) for tumour control and 0.40 (95% CI 0.27 to 0.61) for OS for patients receiving CMT compared to chemotherapy alone. Complete response rates were similar between treatment groups. In sensitivity analyses another six trials were included that did not fulfil the inclusion criteria of our protocol but were considered relevant to the topic. These trials underlined the results of the main analysis. Authors' conclusions Adding radiotherapy to chemotherapy improves tumour control and overall survival in patients with early stage Hodgkin lymphoma.

[Experiences of patients and family members during the stay on a nursing unit]

In 2004, the university hospital of Berne ran a pilot project with a Nursing Unit (NU). In this unit patients who no longer needed a close surveillance by physicians were cared for. They needed primarily complex professional nursing care which could not be provided by other hospitals, nursing homes, home care or family members. The nurses were responsible for the coordination of care. This qualitative study investigated experiences of patients and family members with the care concept of the NU. Thematically focused interviews were conducted with nine patients and five family members. Qualitative content analysis was used for data analysis. Results show that patients and family members mostly accepted the new care concept. They positively experienced the quiet and restful atmosphere, the patient-centred and continuous care by competent nurses, the education and the discharge planning. Some study participants reported missing information at the time of their transfer to the NU, insufficient assessments or unsuitable educational scripts. The study provides evidence to positive effects of a patient-centred care approach.

Multivariate modelling of responses to conditional items: New possibilities for latent class analysis

Questionnaire data may contain missing values because certain questions do not apply to all respondents. For instance, questions addressing particular attributes of a symptom, such as frequency, triggers or seasonality, are only applicable to those who have experienced the symptom, while for those who have not, responses to these items will be missing. This missing information does not fall into the category 'missing by design', rather the features of interest do not exist and cannot be measured regardless of survey design. Analysis of responses to such conditional items is therefore typically restricted to the subpopulation in which they apply. This article is concerned with joint multivariate modelling of responses to both unconditional and conditional items without restricting the analysis to this subpopulation. Such an approach is of interest when the distributions of both types of responses are thought to be determined by common parameters affecting the whole population. By integrating the conditional item structure into the model, inference can be based both on unconditional data from the entire population and on conditional data from subjects for whom they exist. This approach opens new possibilities for multivariate analysis of such data. We apply this approach to latent class modelling and provide an example using data on respiratory symptoms (wheeze and cough) in children. Conditional data structures such as that considered here are common in medical research settings and, although our focus is on latent class models, the approach can be applied to other multivariate models.

Prostate cancer in Texas: Addressing racial and ethnic disparities

Racial disparities in prostate cancer are of public health concern. This dissertation used Texas Cancer Registry data to examine racial disparities in prostate cancer incidence for Texas over the period 1995–1998 and subsequent mortality through the year 2001. Incidence, mortality, treatment, and risk factors for survival were examined. It was found that non-Hispanic blacks have higher incidence and mortality from prostate cancer than non-Hispanic whites, and that Hispanics and non-Hispanic Asians are roughly similar to non-Hispanic whites in cancer survival. The incidence rates in non-Hispanic whites were spread more evenly across the age spectrum compared to other racial and ethnic groups. Non-Hispanic blacks were more often diagnosed at a higher stage of disease. All racial and ethnic groups in the Registry had lower death rates from non-prostate cancer causes than non-Hispanic whites. Age, stage and grade all conferred about the same relative risks of all-cause and prostate cancer survival within each racial and ethnic group examined. Radiation treatment for non-Hispanic blacks and Hispanics did not confer a relative risk of survival statistically significantly different from surgery, whereas it conferred greater survival in non-Hispanic whites. However, non-Hispanic blacks were statistically significantly less likely to have received radiation treatment, while controlling for age, stage, and grade. Among only those who died of prostate cancer, non-Hispanic blacks were less likely to have received radiation than were non-Hispanic whites, whereas among those who had not died, non-Hispanic blacks were more likely to have received this treatment. Hispanics were less likely to have received radiation whether they died from prostate cancer or not. All racial and ethnic groups were less likely than Non-Hispanic whites to have received surgery. Non-Hispanic blacks and Hispanics were more likely than non-Hispanic whites to have received hormonal treatment. The findings are interpreted with caution with regard to the limitations of data quality and missing information. Results are discussed in the context of previous work, and public health implications are pondered. This study confirms some earlier findings, identifies treatment as one possible source of disparity in prostate cancer mortality, and contributes to understanding the epidemiology of prostate cancer in Hispanics. ^

Design and control of multi-finger haptic devices for dexterous manipulation

En la interacción con el entorno que nos rodea durante nuestra vida diaria (utilizar un cepillo de dientes, abrir puertas, utilizar el teléfono móvil, etc.) y en situaciones profesionales (intervenciones médicas, procesos de producción, etc.), típicamente realizamos manipulaciones avanzadas que incluyen la utilización de los dedos de ambas manos. De esta forma el desarrollo de métodos de interacción háptica multi-dedo dan lugar a interfaces hombre-máquina más naturales y realistas. No obstante, la mayoría de interfaces hápticas disponibles en el mercado están basadas en interacciones con un solo punto de contacto; esto puede ser suficiente para la exploración o palpación del entorno pero no permite la realización de tareas más avanzadas como agarres. En esta tesis, se investiga el diseño mecánico, control y aplicaciones de dispositivos hápticos modulares con capacidad de reflexión de fuerzas en los dedos índice, corazón y pulgar del usuario. El diseño mecánico de la interfaz diseñada, ha sido optimizado con funciones multi-objetivo para conseguir una baja inercia, un amplio espacio de trabajo, alta manipulabilidad y reflexión de fuerzas superiores a 3 N en el espacio de trabajo. El ancho de banda y la rigidez del dispositivo se han evaluado mediante simulación y experimentación real. Una de las áreas más importantes en el diseño de estos dispositivos es el efector final, ya que es la parte que está en contacto con el usuario. Durante este trabajo se ha diseñado un dedal de bajo peso, adaptable a diferentes usuarios que, mediante la incorporación de sensores de contacto, permite estimar fuerzas normales y tangenciales durante la interacción con entornos reales y virtuales. Para el diseño de la arquitectura de control, se estudiaron los principales requisitos para estos dispositivos. Entre estos, cabe destacar la adquisición, procesado e intercambio a través de internet de numerosas señales de control e instrumentación; la computación de equaciones matemáticas incluyendo la cinemática directa e inversa, jacobiana, algoritmos de detección de agarres, etc. Todos estos componentes deben calcularse en tiempo real garantizando una frecuencia mínima de 1 KHz. Además, se describen sistemas para manipulación de precisión virtual y remota; así como el diseño de un método denominado "desacoplo cinemático iterativo" para computar la cinemática inversa de robots y la comparación con otros métodos actuales. Para entender la importancia de la interacción multimodal, se ha llevado a cabo un estudio para comprobar qué estímulos sensoriales se correlacionan con tiempos de respuesta más rápidos y de mayor precisión. Estos experimentos se desarrollaron en colaboración con neurocientíficos del instituto Technion Israel Institute of Technology. Comparando los tiempos de respuesta en la interacción unimodal (auditiva, visual y háptica) con combinaciones bimodales y trimodales de los mismos, se demuestra que el movimiento sincronizado de los dedos para generar respuestas de agarre se basa principalmente en la percepción háptica. La ventaja en el tiempo de procesamiento de los estímulos hápticos, sugiere que los entornos virtuales que incluyen esta componente sensorial generan mejores contingencias motoras y mejoran la credibilidad de los eventos. Se concluye que, los sistemas que incluyen percepción háptica dotan a los usuarios de más tiempo en las etapas cognitivas para rellenar información de forma creativa y formar una experiencia más rica. Una aplicación interesante de los dispositivos hápticos es el diseño de nuevos simuladores que permitan entrenar habilidades manuales en el sector médico. En colaboración con fisioterapeutas de Griffith University en Australia, se desarrolló un simulador que permite realizar ejercicios de rehabilitación de la mano. Las propiedades de rigidez no lineales de la articulación metacarpofalange del dedo índice se estimaron mediante la utilización del efector final diseñado. Estos parámetros, se han implementado en un escenario que simula el comportamiento de la mano humana y que permite la interacción háptica a través de esta interfaz. Las aplicaciones potenciales de este simulador están relacionadas con entrenamiento y educación de estudiantes de fisioterapia. En esta tesis, se han desarrollado nuevos métodos que permiten el control simultáneo de robots y manos robóticas en la interacción con entornos reales. El espacio de trabajo alcanzable por el dispositivo háptico, se extiende mediante el cambio de modo de control automático entre posición y velocidad. Además, estos métodos permiten reconocer el gesto del usuario durante las primeras etapas de aproximación al objeto para su agarre. Mediante experimentos de manipulación avanzada de objetos con un manipulador y diferentes manos robóticas, se muestra que el tiempo en realizar una tarea se reduce y que el sistema permite la realización de la tarea con precisión. Este trabajo, es el resultado de una colaboración con investigadores de Harvard BioRobotics Laboratory. ABSTRACT When we interact with the environment in our daily life (using a toothbrush, opening doors, using cell-phones, etc.), or in professional situations (medical interventions, manufacturing processes, etc.) we typically perform dexterous manipulations that involve multiple fingers and palm for both hands. Therefore, multi-Finger haptic methods can provide a realistic and natural human-machine interface to enhance immersion when interacting with simulated or remote environments. Most commercial devices allow haptic interaction with only one contact point, which may be sufficient for some exploration or palpation tasks but are not enough to perform advanced object manipulations such as grasping. In this thesis, I investigate the mechanical design, control and applications of a modular haptic device that can provide force feedback to the index, thumb and middle fingers of the user. The designed mechanical device is optimized with a multi-objective design function to achieve a low inertia, a large workspace, manipulability, and force-feedback of up to 3 N within the workspace; the bandwidth and rigidity for the device is assessed through simulation and real experimentation. One of the most important areas when designing haptic devices is the end-effector, since it is in contact with the user. In this thesis the design and evaluation of a thimble-like, lightweight, user-adaptable, and cost-effective device that incorporates four contact force sensors is described. This design allows estimation of the forces applied by a user during manipulation of virtual and real objects. The design of a real-time, modular control architecture for multi-finger haptic interaction is described. Requirements for control of multi-finger haptic devices are explored. Moreover, a large number of signals have to be acquired, processed, sent over the network and mathematical computations such as device direct and inverse kinematics, jacobian, grasp detection algorithms, etc. have to be calculated in Real Time to assure the required high fidelity for the haptic interaction. The Hardware control architecture has different modules and consists of an FPGA for the low-level controller and a RT controller for managing all the complex calculations (jacobian, kinematics, etc.); this provides a compact and scalable solution for the required high computation capabilities assuring a correct frequency rate for the control loop of 1 kHz. A set-up for dexterous virtual and real manipulation is described. Moreover, a new algorithm named the iterative kinematic decoupling method was implemented to solve the inverse kinematics of a robotic manipulator. In order to understand the importance of multi-modal interaction including haptics, a subject study was carried out to look for sensory stimuli that correlate with fast response time and enhanced accuracy. This experiment was carried out in collaboration with neuro-scientists from Technion Israel Institute of Technology. By comparing the grasping response times in unimodal (auditory, visual, and haptic) events with the response times in events with bimodal and trimodal combinations. It is concluded that in grasping tasks the synchronized motion of the fingers to generate the grasping response relies on haptic cues. This processing-speed advantage of haptic cues suggests that multimodalhaptic virtual environments are superior in generating motor contingencies, enhancing the plausibility of events. Applications that include haptics provide users with more time at the cognitive stages to fill in missing information creatively and form a richer experience. A major application of haptic devices is the design of new simulators to train manual skills for the medical sector. In collaboration with physical therapists from Griffith University in Australia, we developed a simulator to allow hand rehabilitation manipulations. First, the non-linear stiffness properties of the metacarpophalangeal joint of the index finger were estimated by using the designed end-effector; these parameters are implemented in a scenario that simulates the behavior of the human hand and that allows haptic interaction through the designed haptic device. The potential application of this work is related to educational and medical training purposes. In this thesis, new methods to simultaneously control the position and orientation of a robotic manipulator and the grasp of a robotic hand when interacting with large real environments are studied. The reachable workspace is extended by automatically switching between rate and position control modes. Moreover, the human hand gesture is recognized by reading the relative movements of the index, thumb and middle fingers of the user during the early stages of the approximation-to-the-object phase and then mapped to the robotic hand actuators. These methods are validated to perform dexterous manipulation of objects with a robotic manipulator, and different robotic hands. This work is the result of a research collaboration with researchers from the Harvard BioRobotics Laboratory. The developed experiments show that the overall task time is reduced and that the developed methods allow for full dexterity and correct completion of dexterous manipulations.

CP-036 evaluation of outpatient clinic letters for medication errors

Background - It is well recognised that errors are more likely to occur during transitions of care, especially medicines errors. Clinic letters are used as a communication tool during a transition from hospital (outpatient clinics) to primary care (general practitioners). Little is known about medicines errors in clinic letters, as previous studies in this area have focused on medicines errors in inpatient or outpatient prescriptions. Published studies concerning clinic letters largely focus on perceptions of patients or general practitioners in respect to overall quality. Purpose - To investigate medicines errors contained in outpatient clinic letters generated by prescribers within the Neurology Department of a specialist paediatric hospital in the UK.Materials and methods - Single site, retrospective, cross-sectional review of 100 clinic letters generated during March–July 2013 in response to an outpatient consultation. Clinic letters were conveniently selected from the most recent visit of each patient. An evaluation tool with a 10-point scale, where 10 was no error and 0 was significant error, was developed and refined throughout the study to facilitate identification and characterisation of medicines errors. The tool was tested for a relationship between scores and number of medicines errors using a regression analysis.Results - Of 315 items related to neurology mentioned within the letters, 212 items were associated with 602 errors. Common missing information was allergy (97%, n = 97), formulation (60.3%, n = 190), strength/concentration (59%, n = 186) and weight (53%, n = 53). Ninety-nine letters were associated with at least one error. Scores were in range of 4–10 with 42% of letters scored as 7. Statistically significant relationships were observed between scores and number of medicines errors (R2 = 0.4168, p < 0.05) as well as between number of medicines and number of drug-related errors (R2 = 0.9719, p < 0.05). Conclusions - Nearly all clinic letters were associated with medicines errors. The 10-point evaluation tool may be a useful device to categorise clinic letter errors.

Processing Argo oxygen data at the DAC level cookbook

This document does NOT address the issue of oxygen data quality control (either real-time or delayed mode). As a preliminary step towards that goal, this document seeks to ensure that all countries deploying floats equipped with oxygen sensors document the data and metadata related to these floats properly. We produced this document in response to action item 14 from the AST-10 meeting in Hangzhou (March 22-23, 2009). Action item 14: Denis Gilbert to work with Taiyo Kobayashi and Virginie Thierry to ensure DACs are processing oxygen data according to recommendations. If the recommendations contained herein are followed, we will end up with a more uniform set of oxygen data within the Argo data system, allowing users to begin analysing not only their own oxygen data, but also those of others, in the true spirit of Argo data sharing. Indications provided in this document are valid as of the date of writing this document. It is very likely that changes in sensors, calibrations and conversions equations will occur in the future. Please contact V. Thierry (vthierry@ifremer.fr) for any inconsistencies or missing information. A dedicated webpage on the Argo Data Management website (www) contains all information regarding Argo oxygen data management : current and previous version of this cookbook, oxygen sensor manuals, calibration sheet examples, examples of matlab code to process oxygen data, test data, etc..