Defining avoidable healthcare-associated harm in prisons: A mixed-method development study.

Background: Reducing avoidable healthcare-associated harm is a global health priority. Progress in evaluating the burden and aetiology of avoidable harm in prisons is limited compared with other healthcare sectors. To address this gap, this study aimed to develop a definition of avoidable harm to facilitate future epidemiological studies in prisons.

Patients' experiences of attending emergency departments where primary care services are located: qualitative findings from patient and clinician interviews from a realist evaluation.

Background: Patient experience is an important outcome and indicator of healthcare quality, and patient reported experiences are key to improving quality of care. While patient experience in emergency departments (EDs) has been reported in research, there is limited evidence about patients' specific experiences with primary care services located in or alongside EDs. We aim to identify theories about patient experience and acceptability of being streamed to a primary care clinician in an ED.

Acute respiratory compromise due to bilateral pneumothoraces in a patient with Rett syndrome.

This is a case of acute respiratory distress in a nine-year-old with severe Rett syndrome who required immediate anaesthetic assistance in the emergency department and during her subsequent hospital stay. Rett syndrome is a rare inherited neurodevelopmental disease that more commonly affects females. It is characterised by a period of normal development up to between six and 18 months of age, followed by a gradual but progressive loss of developmental skills leading to severe cognitive and physical decline.

Application of monoclonal antibodies in quantifying fungal growth dynamics during aerobic spoilage of silage.

Proliferation of filamentous fungi following ingress of oxygen to silage is an important cause of dry matter losses, resulting in significant waste. In addition, the production of mycotoxins by some filamentous fungi poses a risk to animal health through mycotoxicosis. Quantitative assessment of fungal growth in silage, through measurement of ergosterol content, colony-forming units or temperature increase is limiting in representing fungal growth dynamics during aerobic spoilage due to being deficient in either representing fungal biomass or being able to identify specific genera.

Roles of instrumented farm-scale trials in trade-off assessments of pasture-based ruminant production systems.

For livestock production systems to play a positive role in global food security, the balance between their benefits and disbenefits to society must be appropriately managed. Based on the evidence provided by field-scale randomised controlled trials around the world, this debate has traditionally centred on the concept of economic-environmental trade-offs, of which existence is theoretically assured when resource allocation is perfect on the farm. Recent research conducted on commercial farms indicates, however, that the economic-environmental nexus is not nearly as straightforward in the real world, with environmental performances of enterprises often positively correlated with their economic profitability.

Effects of out-of-hours and winter admissions and number of patients per unit on mortality in pediatric intensive care.

Objective: To investigate the effect of out-of-hours and winter admissions, and unit size on risk adjusted mortality in pediatric intensive care.

Study Design: A national pediatric intensive care clinical audit provided data on over 86000 admissions to 29 pediatric intensive care units (2006-2011). Multivariate logistic regression modeled risk adjusted mortality prior to discharge with out-of-hours (night, weekend, public holiday) admissions, admissions per unit, winter admission, and potential confounders, overall and separately for emergency and planned admissions.

Specialist team retrieval of head injured patients: fact, fiction, or formula?

Objective: This feasibility study aimed to determine the maximum theoretical distance the Edinburgh Paediatric Retrieval Team (EPRT) could travel to retrieve head injured children without additional delay in reaching definitive care.

Design: A prospective audit was conducted over 2 years to determine the current practice for paediatric head injury transfers (stabilisation, referral, and transfer time) undertaken by primary hospital staff, and the performance (mobilisation and travel time) of the EPRT. A novel formula was devised and used to determine the theoretical maximum radius within which the EPRT could reach a referring hospital during their stabilisation of head injured patients.

The role of high frequency oscillatory ventilation in the management of children with severe traumatic brain injury and concomitant lung pathology.

Objective: To report the use of high frequency oscillatory ventilation (HFOV) in two children with severe traumatic brain injury and concurrent lung pathology where conventional mechanical ventilation was ineffective.

Design: : Case report.

Setting: Regional intensive care unit in a pediatric teaching hospital.

A survey of the use of capnography for the confirmation of correct placement of tracheal tubes in pediatric intensive care units in the UK.

Background: The Royal College of Anaesthetists and the Association of Anaesthetists of Great Britain and Ireland recommend the use of capnography to ensure correct tracheal tube placement in the theater environment. Correct tracheal tube placement is essential in the care of ventilated patient, even more vital if the patient is critically ill, if serious morbidity and mortality is to be avoided. This survey examined the availability and use of capnography to confirm correct tracheal tube placement in the pediatric intensive care unit (PICU) in the UK.

Confirmation of direct epidural catheter placement using nerve stimulation in pediatric anesthesia.

Unlabelled: We evaluated the success rate of using low current electrical stimulation (the Tsui test) to identify and confirm direct epidural catheter placement in a pediatric population. Thirty subjects received a standard anesthetic and administration of the Tsui test on epidural placement. The distribution of myotomal activity was recorded.

An admixture of 3 mg x kg(-1) of propofol and 3 mg x kg(-1) of thiopentone reduces pain on injection in pediatric anesthesia.

Purpose: To evaluate the incidence of pain on injection in children during anesthetic induction with a 3:1.2 volume admixture of 1% propofol and 2.5% thiopentone (P/T) compared to a 10:1 volume admixture of 1% propofol and 2% lidocaine (P/L).

The treatment of soil infested with the human whipworm, Trichuris trichiura.

The soil fumigants methyl bromide, chloropircrin and Basamid or mixtures of Basamid and chloropicrin proved to be of no use in filling T. trichiura ova in soil. However, on untreated plots the eggs died at a rate such than only 20% of the ova remained viable after 18 months.

The fate of metronidazole and tis implications in chemotherapy.

1. [14C]Metronidazole was rapidly absorbed from the gastro-intestinal tract of rats giving maximum blood levels of radioactivity, equivalent to 6-4 and 6-7 mug metronidazole per ml blood, 1 h after oral dosing. 2.

Human studies with "high dose" metronidazole: a non-toxic radiosensitizer of hypoxic cells.

The serum concentrations of the radiosensitizer metronidazole have been determined in mice for both oral and intraperitoneal doses of the drug and these have been related to radiosensitization studies in murine tumour systems. In preliminary work before a possible clinical trail the serum metronidazole concentration/time curves have been determined in 7 patients using single doses of metronidazole of up to 15 g. The data suggest that a linear relationship exists between the metronidazole dose expressed in mg/kg and the peak serum concentration.