Under the carpet : the politics and trauma of patient harm

Few studies have investigated iatrogenic outcomes from the viewpoint of patient experience. To address this anomaly, the broad aim of this research is to explore the lived experience of patient harm. Patient harm is defined as major harm to the patient, either psychosocial or physical in nature, resulting from any aspect of health care. Utilising the method of Consensual Qualitative Research (CQR), in-depth interviews are conducted with twenty-four volunteer research participants who self-report having been severely harmed by an invasive medical procedure. A standardised measure of emotional distress, the Impact of Event Scale (IES), is additionally employed for purposes of triangulation. Thematic analysis of transcript data indicate numerous findings including: (i) difficulties regarding patients‘ prior understanding of risks involved with their medical procedure; (ii) the problematic response of the health system post-procedure; (iii) multiple adverse effects upon life functioning; (iv) limited recourse options for patients; and (v) the approach desired in terms of how patient harm should be systemically handled. In addition, IES results indicate a clinically significant level of distress in the sample as a whole. To discuss findings, a cross-disciplinary approach is adopted that draws upon sociology, medicine, medical anthropology, psychology, philosophy, history, ethics, law, and political theory. Furthermore, an overall explanatory framework is proposed in terms of the master themes of power and trauma. In terms of the theme of power, a postmodernist analysis explores the politics of patient harm, particularly the dynamics surrounding the politics of knowledge (e.g., notions of subjective versus objective knowledge, informed consent, and open disclosure). This analysis suggests that patient care is not the prime function of the health system, which appears more focussed upon serving the interests of those in the upper levels of its hierarchy. In terms of the master theme of trauma, current understandings of posttraumatic stress disorder (PTSD) are critiqued, and based on data from this research as well as the international literature, a new model of trauma is proposed. This model is based upon the principle of homeostasis observed in biology, whereby within every cell or organism a state of equilibrium is sought and maintained. The proposed model identifies several bio-psychosocial markers of trauma across its three main phases. These trauma markers include: (i) a profound sense of loss; (ii) a lack of perceived control; (iii) passive trauma processing responses; (iv) an identity crisis; (v) a quest to fully understand the trauma event; (vi) a need for social validation of the traumatic experience; and (vii) posttraumatic adaption with the possibility of positive change. To further explore the master themes of power and trauma, a natural group interview is carried out at a meeting of a patient support group for arachnoiditis. Observations at this meeting and members‘ stories in general support the homeostatic model of trauma, particularly the quest to find answers in the face of distressing experience, as well as the need for social recognition of that experience. In addition, the sociopolitical response to arachnoiditis highlights how public domains of knowledge are largely constructed and controlled by vested interests. Implications of the data overall are discussed in terms of a cultural revolution being needed in health care to position core values around a prime focus upon patients as human beings.

Low backscattered dual-polarised metallo-dielectric structure based on sierpinski carpet

A novel technique for backscattering reduction for both TE and TM polarisation, employing a metallo-dielectric structure based on Sierpinski carpet fractal geometry, is reported. A reduction in backscattered power of --30 dB is obtained for normal incidence in the X-band for the structure using the third iterated stage of the fractal geometry

Effect of daminozide, paclobutrazol and chlormequat on development and quality of potted 'persian carpet' zinnia

In Brazil zinnias have good prospect for the flowering potted plant market, once consumers demand for new forms of products is stimulated by novelty. 'Persian Carpet' is a highly ornamental plant, with fast growth, minimal labor requirements and low cost seeds. The present study evaluated the effect of growth regulators on development and quality of 'Persian Carpet' grown as a potted plant. Growth regulators are commonly used to control growth and produce short and compact plants. Paclobutrazol (0.5, 0.75 and 1.0 mg a.i./pot) and chlormequat (1.0, 2.0 and 3.0 g. L-1) were applied as a single drench, and daminozide (2.5, 3.75 and 5.0 g. L-1) as a single foliar spray to runoff. Regulators were applied at apical flower bud stage. Daminozide (5.0 g. L-1), paclobutrazol (0.5, 0.75 and 1.0 mg a.i./pot) and chlormequat (1.0 g. L-1) significantly reduced plant height and side branches length compared to the control. Plant height showed a negative linear response to the increasing concentration of daminozide or paclobutrazol. Paclobutrazol (1.0 mg a.i./pot) and chlormequat (1.0 g. L-1) increased foliage and flowers harvest index. Plant spread diameter and canopy shape were improved with paclobutrazol (0.75 mg a.i./pot). Chlormequat (2.0 and 3.0 g. L-1) caused phytotoxicity symptoms, turning plants unsuitable for commercialization. Studied regulators concentrations did not affect flower diameter and production cycle. Although regulators controlled height and side branches growth significantly, plants were not short and compact enough to attend market quality.

Cadaver dogs--a study on detection of contaminated carpet squares

INTRODUCTION: Cadaver dogs are known as valuable forensic tools in crime scene investigations. Scientific research attempting to verify their value is largely lacking, specifically for scents associated with the early postmortem interval. The aim of our investigation was the comparative evaluation of the reliability, accuracy, and specificity of three cadaver dogs belonging to the Hamburg State Police in the detection of scents during the early postmortem interval. MATERIAL AND METHODS: Carpet squares were used as an odor transporting media after they had been contaminated with the scent of two recently deceased bodies (PMI<3h). The contamination occurred for 2 min as well as 10 min without any direct contact between the carpet and the corpse. Comparative searches by the dogs were performed over a time period of 65 days (10 min contamination) and 35 days (2 min contamination). RESULTS: The results of this study indicate that the well-trained cadaver dog is an outstanding tool for crime scene investigation displaying excellent sensitivity (75-100), specificity (91-100), and having a positive predictive value (90-100), negative predictive value (90-100) as well as accuracy (92-100).

Transport : the magic carpet of industry, briefly describing the history and development of transport by sea, road, canal and railway /

Mode of access: Internet.

The essentials of modern carpet installation.

At head of title: Carpet and Rug Institute.

National Voluntary Laboratory Accreditation Program : carpet and carpet cushion /

"October 1994."

Amy Oakly; or, The reign of the carpet-bagger. A story ...

Mode of access: Internet.

Clothes moths and carpet beetles.

"1/09"--Colophon.

Case studies in reduced-fare transit -- Seattle's Magic Carpet /

Mode of access: Internet.

Classification of the Dermestidae (larder, hide, and carpet beetles) based on larval characters : with a key to the North American genera /

Contribution from Bureau of Entomology and Plant Quarantine.

Labor relations at the Amsterdam plant of the Bigelow-Sanford Carpet Company, inc.

Bibliography: l. 199-201.