Naresuan University Journal
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Prevalence, Nature, Severity and Risk Factors for Prescribing Errors in Hospital Inpatients: Prospective Study in 20 UK Hospitals.
No full textINTRODUCTION: It has been suggested that doctors in their first year of post-graduate training make a disproportionate number of prescribing errors. OBJECTIVE: This study aimed to compare the prevalence of prescribing errors made by first-year post-graduate doctors with that of errors by senior doctors and non-medical prescribers and to investigate the predictors of potentially serious prescribing errors. METHODS: Pharmacists in 20 hospitals over 7 prospectively selected days collected data on the number of medication orders checked, the grade of prescriber and details of any prescribing errors. Logistic regression models (adjusted for clustering by hospital) identified factors predicting the likelihood of prescribing erroneously and the severity of prescribing errors. RESULTS: Pharmacists reviewed 26,019 patients and 124,260 medication orders; 11,235 prescribing errors were detected in 10,986 orders. The mean error rate was 8.8 % (95 % confidence interval [CI] 8.6-9.1) errors per 100 medication orders. Rates of errors for all doctors in training were significantly higher than rates for medical consultants. Doctors who were 1 year (odds ratio [OR] 2.13; 95 % CI 1.80-2.52) or 2 years in training (OR 2.23; 95 % CI 1.89-2.65) were more than twice as likely to prescribe erroneously. Prescribing errors were 70 % (OR 1.70; 95 % CI 1.61-1.80) more likely to occur at the time of hospital admission than when medication orders were issued during the hospital stay. No significant differences in severity of error were observed between grades of prescriber. Potentially serious errors were more likely to be associated with prescriptions for parenteral administration, especially for cardiovascular or endocrine disorders. CONCLUSION: The problem of prescribing errors in hospitals is substantial and not solely a problem of the most junior medical prescribers, particularly for those errors most likely to cause significant patient harm. Interventions are needed to target these high-risk errors by all grades of staff and hence improve patient safety
Comment on ‘Continuing need for and provision of a service for non-standard implant removal’
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Russia’s ‘Last Barren Islands’: The Southern Kurils and the territorialisation of regional memory
No full textClinical Drug Development Using Dynamic Biomarkers to Enable Personalized Health Care in COPD.
No full textDespite massive investments in the development of novel treatments for heterogeneous diseases such as COPD, the resources spent have only benefited a fraction of the population treated. Personalized health care to guide selection of a suitable patient population already in the clinical development of new compounds could offer a solution. This review discusses past successes and failures in drug development and biomarker research in COPD, describes research in COPD phenotypes and the required characteristics of a suitable biomarker for identifying patients at higher risk of progression, and examines the role of extracellular matrix proteins found to be upregulated in COPD. Novel biomarkers of connective tissue remodeling that may provide added value for a personalized approach by detecting subgroups of patients with active disease suitable for pharmacologic intervention are discussed
The role of re-aggregation on the performance of electrochemically exfoliated many-layer graphene for Li-ion batteries
No full textTwo potential pathways for Li+ diffusion occur within graphitic carbon with typically in-plane diffusion dominating (similar to 10(-7) cm(2) s(-1)) over diffusion along the crystallite grain boundaries (similar to 10(-11) cm(2) s(-1)). Reducing the flake thickness of microcrystalline graphite powders via electrochemical exfoliation offers a method to overcome the latter, sluggish grain boundary Li+ diffusion, thereby increasing the overall rate capability of the graphite negative electrode in a the Li-ion battery. Six micron particulate graphite was electrochemically exfoliated to give flakes of which similar to 90% had a thickness o
