Dal Bes ad Urbes: I piani di performance e di trasparenza nelle citta'

Obiettivo del lavoro è quello di legare tra di loro due aspetti che storicamente sono sempre stati scollegati. Il primo è il lungo dibattito sul tema “oltre il PIL”, che prosegue ininterrottamente da circa mezzo secolo. Il secondo riguarda l’utilizzo dei sistemi di misurazione e valutazione della performance nel settore pubblico italiano. Si illustra l’evoluzione del dibattito sul PIL facendo un excursus storico del pensiero critico che si è sviluppato nel corso di circa cinquanta anni analizzando le ragioni assunte dagli studiosi per confutare l’utilizzo del PIL quale misura universale del benessere. Cogliendo questa suggestione l’Istat, in collaborazione con il CNEL, ha avviato un progetto per individuare nuovi indicatori da affiancare al PIL, in grado di misurare il livello non solo della crescita economica, ma anche del benessere sociale e sostenibile, con l’analisi degli indicatori riferiti a 12 domini di benessere individuati. Al progetto Istat-CNEL si è affiancato il progetto UrBES, promosso dall’Istat e dal Coordinamento dei sindaci metropolitani dell’ANCI, che hanno costituito una rete di città metropolitane per sperimentare la misurazione e il confronto sulla base di indicatori di benessere urbano equo e sostenibile, facendo proprio un progetto del Comune di Bologna e di Laboratorio Urbano (Centro di documentazione, ricerca e proposta sulle città), che ha sottoposto a differenti target un questionario on line, i cui risultati, con riferimento alle risposte fornite alle domande aperte, sono stati elaborati attraverso l’utilizzo di Taltac, un software per l’analisi dei testi, al fine di individuare i “profili” dei rispondenti, associando i risultati dell’elaborazione alle variabili strutturali del questionario. Nell’ultima parte i servizi e progetti erogati dal comune di Bologna sono stati associati alle dimensioni UrBES, per valutare l’impatto delle politiche pubbliche sulla qualità della vita e sul benessere dei cittadini, indicando le criticità legate alla mancanza di dati adeguati.

Modellkomplexe zur Sauerstoffaktivierung auf Basis des 1,3,4-Thiadiazols

Das Ziel der vorliegenden Arbeit waren die Synthese und Untersuchung von Modellverbindungen zur Sauerstoffaktivierung auf der Basis neuer Ligandensysteme des 1,3,4-Thiadiazols unter Ausarbeitung einer Synthesestrategie zur Derivatisierung der heteroaromatischen 1,3,4-Thiadiazol-Liganden, deren Koordinationsverhalten in Abhängigkeit ihres 2,5-Substitutionsmusters untersucht wurde, sowie die fortführende Bearbeitung bereits bekannter Ligandensysteme zur Erzeugung von homo- und heterovalenten Übergangsmetallkomplexverbindungen.rnDie unter der Verwendung der modifizierten Liganden TPDE, H1TPDP und H1BPMP resultierenden dinuklearen Komplexverbindungen zeigen unterschiedlich starke antiferromagnetische Wechselwirkungen in Abhängigkeit der vorhandenen Brückenliganden. In der Verbindung [Fe6O2(OH)(L´)2(OOCMe3)9(OEt)2] trat eine Fragmentierung des Liganden H1TPDP auf. Das cisoide Ligandensubstitutionsmuster der entstandenen sechskernigen Verbindung ist verantwortlich für die interessanten magnetischen Eigenschaften des Komplexes. rnNeue Perspektiven zur Erzeugung von Modellverbindungen zur Sauerstoffaktivierung wurden mit dem Mono-Chelatliganden H1ETHP und den Bis-Chelatliganden HL2H, H2L2H und H2BATP aufgezeigt. Die Umsetzung von H1ETHP mit verschiedenen Übergangsmetallsalzen resultierte für die Metalle Cr(III), Fe(III), Co(III) und Ni(II) in mononuklearen Verbindungen des Typs [M(ETHP)2]X (X = ClO4, FeCl4, OMe, Cl, Br) sowie in zwei tetranuklearen Verbindungen mit Mn(II) und Cu(II). [Mn4(ETHP)6] besitzt ein propellerförmiges, planares [Mn4O6]2+-System mit einen Spingrundzustand von S = 5. In allen Verbindungen von H1ETHP konnte eine mono-κN-Koordination des 1,3,4-Thiadiazol-Rückgrates über eines seiner beiden endozyklischen Stickstoffdonoratome beobachtet werden. rnAus Umsetzungen der Bis-Chelatliganden wurden fast ausschließlich polynukleare Übergangsmetallkomplexe erhalten. Insbesondere der Ligand H2L2H zeigt eine ausgeprägte Tendenz zur Ausbildung trinuklearer, linearer Komplexe, welche auf Grund ihrer ungeraden Anzahl von Übergangsmetallionen einen Spingrundzustand S ≠ 0 aufweisen.rn Die mit dem Liganden HL2H erhaltenen Verbindungen unterstreichen die hohe Flexibilität dieser Systeme hinsichtlich der Erzeugung polynuklearer und heterovalenter Komplexverbindungen. So konnten in Abhängigkeit vom verwendeten Übergangsmetallsalz trinukleare, pentanukleare, aber auch hepta- und oktanukleare Verbindungen synthetisiert werden. Insbesondere die Komplexe des Mangans und des Cobalts zeigen ein heterovalentes [MnIIMnIII4]- bzw. [CoII2CoIII3]-Motiv, was sich in Spingrundzuständen von S ≠ 0 äußert. Der diamagnetische, achtkernige Fe8-Cluster besitzt eine pseudo C3-symmetrische Anordnung der Metall-Zentren, während für die heptanukleare Cu7-Kette durch ihre stark unterschiedlichen Kupfer-Koordinationsgeometrien interessante magnetische Austauschwechselwirkungen beobachtet werden konnten. Der dreikernige µ3-oxo-verbrückte Komplex des Liganden H2BATP zeigt als interessante strukturelle Eigenschaft ein ein µ3-Verbrückungsmuster des eingesetzten Sulfat-Anions. rnIn allen Komplexen der Bis-Chelatliganden HL2H, H2L2H und H2BATP konnte ein µ2-κN,κN-Koordiantionsmodus des 1,3,4-Thiadiazols und somit eine Abhängigkeit der Verbrückung vom Ligandensubstitutionsmuster beobachtet werden.rn

Phosphonate ligands in extended inorganic hybrids and as radical units in complexes

Phosphonatliganden in erweiterten anorganischen Hybridmaterialien undrnals Radikalträgern in KomplexenrnrnAnorganisch-organische Hybridmaterialien sind in der Regel extrem vielseitig. Die systematische Darstellung von niederdimensionalen Materialien (eindimensionale Kettenverbindungen oder zweidimensionalen Schichtverbindungen) mit einer Kontrolle über die Art der Verbindung,rnbietet neue Möglichkeiten im Bereich des molekularen Magnetismus. Hier im Fall von Metall-Phosphonat Verbindungen in erweiterten anorganischen Hybriden wurde der pH - Wert während der Reaktion eingestellt, wodurch der Grad der Protonierung des Phosphonatliganden kontrolliert wurde. Aufgrund der Tatsache, dass alle erhaltenen Metall Phosphonatverbindungen neutral waren, konnte das Ligand zu Metallverhältnis erstmals vorhergesagt werden. So wurden mehrere neue Metall–Phosphonat Verbindungen im Bereich von Null-dimensionalen (I0O0, Co-Kristallisation von M(H2O)6 mitrndeprotonierten Phosphonatligand), über eindimensionalen (I1O0, Kettenstrukturen) bis hin zu zweidimensionalen (I2O0, Schichtstrukturen) ausführlich diskutiert in Bezug auf ihr magnetisches Verhalten. Im Allgemeinen sind die erwarteten Austauschwechselwirkungen in einem erweiterten anorganischen Hybridmaterial stark, weil oft ein Superaustausch durch ein einzelnes Sauerstoffatom möglich ist. Hier waren oft mehrere konkurrierende Austauschwechselwirkungen vorhanden, so dass kompliziertere magnetische Verhalten beobachtet wurden.rnrnDarüber hinaus wurden drei neue Beispiele von Nitronyl-Nitroxidradikale dargestellt, in denen eine zusätzliche saure Funktionalität eingeführt war. Die Auswirkungen des sauren Charakters der zusätzlich eingeführten Sulfonsäure oder Phosphonsäure-Gruppe auf das Nitronyl-Nitroxidradikal wurden im Detail zum ersten Mal untersucht. Die mit der Phosphonsäure-Gruppe versehenen Nitronyl-Nitroxidradikale sind perfekte Proben für die Untersuchung einer Spin-Verschiebung in Nitronyl-Nitroxidradikale durch EPR-Spektroskopie, aufgrund des eingeführten Phosphors. Auch der Protonierungsgrad der zusätzlich eingeführten Phosphonsäure-Gruppe wurde berücksichtigt. In dieser Arbeit wurden die ersten Metallkomplexe der neuen substituierten sauren Nitronyl-Nitroxidradikale vorgestellt. Die Koordination von Nickel(II) Metallionen an die saure, zweite funktionelle Gruppe des Nitronyl–Nitroxid Radikal wurde beschrieben. Die magnetische Austauschwechselwirkung der Metallionen untereinander und die Metall-Radikal-Austauschwechselwirkungen wurden untersucht. rnrnIm Allgemeinen können interessante molekulare magnetische Materialien dadurch dargestellt werden, dass die Dimension der Metall-Phosphonat-Verbindungen als Beispiele für die erweiterten anorganischen Hybridmaterialien gesteuert werden kann. Mit Nitronyl-Nitroxidradikale als organische Liganden können in Zukunft noch mehr Spin-Träger in anorganisch-organischen Gerüstmaterialien integriert werden um die magnetischen Eigenschaften zu verbesseren.rn

Reading strategies in Stargardt's disease with foveal sparing

ABSTRACT: BACKGROUND: Subjects with a ring scotoma can use two retinal loci, a foveal and a peripheral, for reading. Our aim was to investigate the relative use of both retinal loci as a function of the spared foveal area size and the spatial resolution at both retinal loci. FINDINGS: Two patients with Stargardt's disease and ring scotomas read through a scanning laser ophthalmoscope a series of letters and words at various character sizes. The number of fixations made using each retinal locus was quantified. The relative use of each retinal locus depended on character size of the stimulus. Both patients used exclusively the eccentric retinal locus to read words of large character sizes. At small character sizes, the central retinal locus was predominantly used. For reading letters or words, once foveal fixation was used, patients did not shift back to the eccentric retinal locus. When spatial resolution allowed deciphering at both the eccentric and the central areas, patients consistently fixated with the eccentric retinal locus. CONCLUSIONS: Spatial resolution at the eccentric locus appears as a determinant factor to select the retinal area for reading. Reading strategies in patients with Stargardt's disease and a ring scotoma demonstrate a pattern of coordination of both eccentric and central retinal loci, reflecting a high degree of adaptation.

The Mountain Research Initiative Reaches Outward and Clombs Upward

Mountain regions provide a multitude of goods and services for much of humanity (Price and Butt 2000; Becker and Bugmann 2001), especially in the realms of water supply, biodiversity, and other ecosystem services (Schimel et al 2002; Körner et al 2005; Viviroli et al 2007; Viviroli et al 2011). However, the future ability of mountain regions to provide goods and services to both highland and lowland residents is seriously threatened by climatic changes, environmental pollution, unsustainable management of natural resources, and serious gaps in understanding of mountain systems (Huber et al 2005). Disciplinary, interdisciplinary, and transdisciplinary research is required to maintain these goods and services in the face of these forces. The global mountain research community, however, has historically operated at a suboptimal level because of insufficient communication across geographic and linguistic barriers, less than desirable coordination of research frameworks, and a lack of funding.

State Pharmaceutical Assisstance for the Elderly and Disabled: Planning Issues for Program and Non-Program States

The Medicare Catastrophic Coverage Act (MCCA) would have mandated federal assistance for Medicare beneficiaries who have high annual prescription medication costs, High national expenditures for such drugs have encouraged the development of private and state insurance programs to help with these costs. Ten state pharmaceutical assistance programs (SPAPs), designed to help certain elderly, low income, or disabled people, exist for those ineligible for Medicaid or unable to purchase coverage privately. Coordination of state and federal benefits was a consideration for established programs, and programs being planned needed to determine the feasibity of integration of federal assistance. But the enactment and subsequent appeal of the Act affected both planning and policy implications for these SPAPs. All U.S. states and territories were surveyed before the bill's repeal to collect data on the effects of MCCA for those with prescription drug programs and those without. The repeal of the federal program places pressure on the nonprogram states to proceed, perhaps more cautiously, to initiate program; for their own residents, given increasing out-of-pocket and insurance costs, and no federal program.

α-Ketoglutarate regulates acid-base balance through an intrarenal paracrine mechanism

Paracrine communication between different parts of the renal tubule is increasingly recognized as an important determinant of renal function. Previous studies have shown that changes in dietary acid-base load can reverse the direction of apical α-ketoglutarate (αKG) transport in the proximal tubule and Henle's loop from reabsorption (acid load) to secretion (base load). Here we show that the resulting changes in the luminal concentrations of αKG are sensed by the αKG receptor OXGR1 expressed in the type B and non-A-non-B intercalated cells of the connecting tubule (CNT) and the cortical collecting duct (CCD). The addition of 1 mM αKG to the tubular lumen strongly stimulated Cl--dependent HCO3- secretion and electroneutral transepithelial NaCl reabsorption in microperfused CCDs of wild-type mice but not Oxgr1-/- mice. Analysis of alkali-loaded mice revealed a significantly reduced ability of Oxgr1-/- mice to maintain acid-base balance. Collectively, these results demonstrate that OXGR1 is involved in the adaptive regulation of HCO3- secretion and NaCl reabsorption in the CNT/CCD under acid-base stress and establish αKG as a paracrine mediator involved in the functional coordination of the proximal and the distal parts of the renal tubule.

Family satisfaction in the intensive care unit: what makes the difference?

PURPOSE: To assess family satisfaction in the ICU and to identify parameters for improvement. METHODS: Multicenter study in Swiss ICUs. Families were given a questionnaire covering overall satisfaction, satisfaction with care and satisfaction with information/decision-making. Demographic, medical and institutional data were gathered from patients, visitors and ICUs. RESULTS: A total of 996 questionnaires from family members were analyzed. Individual questions were assessed, and summary measures (range 0-100) were calculated, with higher scores indicating greater satisfaction. Summary score was 78 +/- 14 (mean +/- SD) for overall satisfaction, 79 +/- 14 for care and 77 +/- 15 for information/decision-making. In multivariable multilevel linear regression analyses, higher severity of illness was associated with higher satisfaction, while a higher patient:nurse ratio and written admission/discharge criteria were associated with lower overall satisfaction. Using performance-importance plots, items with high impact on overall satisfaction but low satisfaction were identified. They included: emotional support, providing understandable, complete, consistent information and coordination of care. CONCLUSIONS: Overall, proxies were satisfied with care and with information/decision-making. Still, several factors, such as emotional support, coordination of care and communication, are associated with poor satisfaction, suggesting the need for improvement. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00134-009-1611-4) contains supplementary material, which is available to authorized users.

Polychoral performance practice and maestro di cappella conducting

Abstract This article disputes some basic questions concerning the coordination of seventeenth century sacred music, approaching the phenomenon through a musical species of particular interest, though largely unstudied from a performance practice point of view. Roman polychorality with its specific performing conditions offers an illuminating perspective on principles of musical direction and interaction which differ significantly from our modern access path towards these topics. The inquiry ranges from basics of performance (such as sheet music, rehearsals, direction technics, models and stylistic conditioning of the performers) over the concrete role of the maestro di cappella as well as the tactus as cornerstones of sacred music practice, up to the philosophical content the particular 'system of values', shining though this overall picture, seems to represent. On this groundwork the essay opens a discussion on conventions which have remained literally unchallenged by generations of researchers and performers.

Family Preservation Journal, 1999, Volume 4, Issue 2. (Entire issue)

Entire issue (large pdf file) Articles include: Behavior Problems of Maltreated Children Receiving In-Home Child Welfare Services. Ferol Mennen, William Meezan, Gino Aisenberg, and Jacquelyn McCroskey Measuring Consumer Satisfaction in Family Preservation Services: Identifying Instrument Domains. Stephen A. Kapp and Rebecca H Vela Intensive In-Home Family-Based Services: Reactions from Consumers and Providers Elaine Walton, and Alfred C. Dodini Coordination of Family Preservation Services in a Rural Community: A Case Study. Richard Freer and Kathleen Wells The Effectiveness of Court Mandated Intervention Versus Voluntary Services in Child Protective Services: Abbreviated Version. Loring Jones, Irene Becker, and Krista F alk

Hyalotekite, (Ba,Pb,K)(4)(Ca,Y)(2)Si-8(B,Be)(2)(Si,B)(2)O28F, a Tectosilicate Related to Scapolite: New Structure Refinement, Phase Transitions and a Short-Range Ordered 3B Superstructure

Hyalotekite, a framework silicate of composition (Ba,Pb,K)(4)(Ca,Y)(2)Si-8(B,Be)(2) (Si,B)(2)O28F, is found in relatively high-temperature(greater than or equal to 500 degrees C) Mn skarns at Langban, Sweden, and peralkaline pegmatites at Dara-i-Pioz, Tajikistan. A new paragenesis at Dara-i-Pioz is pegmatite consisting of the Ba borosilicates leucosphenite and tienshanite, as well as caesium kupletskite, aegirine, pyrochlore, microcline and quartz. Hyalotekite has been partially replaced by barylite and danburite. This hyalotekite contains 1.29-1.78 wt.% Y2O3, equivalent to 0.172-0.238 Y pfu or 8-11% Y on the Ca site; its Pb/(Pb+Ba) ratio ranges 0.36-0.44. Electron microprobe F contents of Langban and Dara-i-Pioz hyalotekite range 1.04-1.45 wt.%, consistent with full occupancy of the F site. A new refinement of the structure factor data used in the original structural determination of a Langban hyalotekite resulted in a structural formula, (Pb1.96Ba1.86K0.18)Ca-2(B1.76Be0.24)(Si1.56B0.44)Si8O28F, consistent with chemical data and all cations with positive-definite thermal parameters, although with a slight excess of positive charge (+57.14 as opposed to the ideal +57.00). An unusual feature of the hyalotekite framework is that 4 of 28 oxygens are non-bridging; by merging these 4 oxygens into two, the framework topology of scapolite is obtained. The triclinic symmetry of hyalotekite observed at room temperature is obtained from a hypothetical tetragonal parent structure via a sequence of displacive phase transitions. Some of these transitions are associated with cation ordering, either Pb-Ba ordering in the large cation sites, or B-Be and Si-B ordering on tetrahedral sites. Others are largely displacive but affect the coordination of the large cations (Pb, Ba, K, Ca). High-resolution electron microscopy suggests that the undulatory extinction characteristic of hyalotekite is due to a fine mosaic microstructure. This suggests that at least one of these transitions occurs in nature during cooling, and that it is first order with a large volume change. A diffuse superstructure observed by electron diffraction implies the existence of a further stage of short-range cation ordering which probably involves both (Pb,K)-Ba and (BeSi,BB)-BSi.

Virtual Infrastructures as a Service enabling Converged Optical Networks and Data Centres

Abstract Cloud computing service emerged as an essential component of the Enterprise {IT} infrastructure. Migration towards a full range and large-scale convergence of Cloud and network services has become the current trend for addressing requirements of the Cloud environment. Our approach takes the infrastructure as a service paradigm to build converged virtual infrastructures, which allow offering tailored performance and enable multi-tenancy over a common physical infrastructure. Thanks to virtualization, new exploitation activities of the physical infrastructures may arise for both transport network and Data Centres services. This approach makes network and Data Centres’ resources dedicated to Cloud Computing to converge on the same flexible and scalable level. The work presented here is based on the automation of the virtual infrastructure provisioning service. On top of the virtual infrastructures, a coordinated operation and control of the different resources is performed with the objective of automatically tailoring connectivity services to the Cloud service dynamics. Furthermore, in order to support elasticity of the Cloud services through the optical network, dynamic re-planning features have been provided to the virtual infrastructure service, which allows scaling up or down existing virtual infrastructures to optimize resource utilisation and dynamically adapt to users’ demands. Thus, the dynamic re-planning of the service becomes key component for the coordination of Cloud and optical network resource in an optimal way in terms of resource utilisation. The presented work is complemented with a use case of the virtual infrastructure service being adopted in a distributed Enterprise Information System, that scales up and down as a function of the application requests.

EPA-1380 – Coordinated body-movement reflects psychotherapy outcome

Social interaction is a core aspect of human life that affects individuals’ physical and mental health. Social interaction usually leads to mutual engagement in diverse areas of mental, emotional, physiological and physical activity involving both interacting persons and subsequently impacting the outcome of interactions. A common approach to the analysis of social interaction is the study of the verbal content transmitted between sender and receiver. However, additional important processes and dynamics are occurring in other domains too, for example in the area of nonverbal behaviour: In a series of studies, we have looked at nonverbal synchrony – the coordination of two persons’ movement patterns – and it‘s association with relationship quality and with the outcome of interactions. Using a computer-based algorithm (Motion Energy Analysis, MEA: Ramseyer & Tschacher, 2011), which automatically quantifies a person‘s body-movement, we were able to objectively calculate nonverbal synchrony in a large number of dyads interacting in various settings. In a first step, we showed that the phenomenon of nonverbal synchrony exists at a level that is significantly higher than expected by chance. In a second step, we ascertained that across different settings – including patient-therapist dyads and healthy dyads – more synchronized movement was associated with better relationship quality and better interactional outcomes. The quality of a relationship is thus embodied by the synchronized movement patterns emerging between partners. Our studies suggest that embodied cognition is a valuable approach to research in social interaction, providing important clues for an improved understanding of interaction dynamics.

HMG-CoA Reductase Inhibition Promotes Neurological Recovery, Peri-Lesional Tissue Remodeling, and Contralesional Pyramidal Tract Plasticity after Focal Cerebral Ischemia

3-Hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors are widely used for secondary stroke prevention. Besides their lipid-lowering activity, pleiotropic effects on neuronal survival, angiogenesis, and neurogenesis have been described. In view of these observations, we were interested whether HMG-CoA reductase inhibition in the post-acute stroke phase promotes neurological recovery, peri-lesional, and contralesional neuronal plasticity. We examined effects of the HMG-CoA reductase inhibitor rosuvastatin (0.2 or 2.0 mg/kg/day i.c.v.), administered starting 3 days after 30 min of middle cerebral artery occlusion for 30 days. Here, we show that rosuvastatin treatment significantly increased the grip strength and motor coordination of animals, promoted exploration behavior, and reduced anxiety. It was associated with structural remodeling of peri-lesional brain tissue, reflected by increased neuronal survival, enhanced capillary density, and reduced striatal and corpus callosum atrophy. Increased sprouting of contralesional pyramidal tract fibers crossing the midline in order to innervate the ipsilesional red nucleus was noticed in rosuvastatin compared with vehicle-treated mice, as shown by anterograde tract tracing experiments. Western blot analysis revealed that the abundance of HMG-CoA reductase was increased in the contralesional hemisphere at 14 and 28 days post-ischemia. Our data support the idea that HMG-CoA reductase inhibition promotes brain remodeling and plasticity far beyond the acute stroke phase, resulting in neurological recovery.

Risk factors for patient-reported medical errors in eleven countries

OBJECTIVES The aim of this study was to identify common risk factors for patient-reported medical errors across countries. In country-level analyses, differences in risks associated with error between health care systems were investigated. The joint effects of risks on error-reporting probability were modelled for hypothetical patients with different health care utilization patterns. DESIGN Data from the Commonwealth Fund's 2010 lnternational Survey of the General Public's Views of their Health Care System's Performance in 11 Countries. SETTING Representative population samples of 11 countries were surveyed (total sample = 19,738 adults). Utilization of health care, coordination of care problems and reported errors were assessed. Regression analyses were conducted to identify risk factors for patients' reports of medical, medication and laboratory errors across countries and in country-specific models. RESULTS Error was reported by 11.2% of patients but with marked differences between countries (range: 5.4-17.0%). Poor coordination of care was reported by 27.3%. The risk of patient-reported error was determined mainly by health care utilization: Emergency care (OR = 1.7, P < 0.001), hospitalization (OR = 1.6, P < 0.001) and the number of providers involved (OR three doctors = 2.0, P < 0.001) are important predictors. Poor care coordination is the single most important risk factor for reporting error (OR = 3.9, P < 0.001). Country-specific models yielded common and country-specific predictors for self-reported error. For high utilizers of care, the probability that errors are reported rises up to P = 0.68. CONCLUSIONS Safety remains a global challenge affecting many patients throughout the world. Large variability exists in the frequency of patient-reported error across countries. To learn from others' errors is not only essential within countries but may also prove a promising strategy internationally.