Ward-based in situ simulation: lessons learnt from a UK District General Hospital.

Introduction: In situ simulation (ISS) enables multiprofessional healthcare teams to train for real emergencies in their own working environment and identify latent patient safety threats. This study aimed to determine ISS impact on teamwork, technical skill performance, healthcare staff perception and latent error identification during simulated medical emergencies.

Materials And Methods: Unannounced ISS sessions (n=14, n=75 staff members) using a high-fidelity mannequin were conducted in medical, paediatric and rehabilitation wards at Stepping Hill Hospital (Stockport National Health Service Foundation Trust, UK).

To replace or not to replace? - Partial coning and a sixth nerve palsy secondary due to displacement of a tunnelled intrathecal catheter for pain control.

We report the displacement of a tunnelled intrathecal catheter causing significant cerebrospinal fluid (CSF) leak, resulting in partial coning and a sixth nerve palsy. The patient had advanced malignant mesothelioma and all other methods of pain control had been unsuccessful. As far as we are aware, there are no published reports of early replacement of an intrathecal catheter in patients with neurological sequelae.

"I wish I'd never heard of Banbury": the relationship between 'place' and the health impacts from flooding.

This paper focuses upon a small qualitative study of two communities in England that were flooded over the Easter weekend in 1998. It reports on the only known longitudinal study of flood-affected respondents in the UK with the same participants over a 4 1/2-year period. It examines how 'place', both as a physical location within the floodplain and in terms of social places, may impact upon the health of those affected.

The health effects of flooding: Social research results from England and Wales.

This paper presents interview survey data by social scientists using established health measures on the health effects of flooding for residents in 30 locations in England and Wales. Firstly, it examines the extent to which flooded residents reported suffering physical and psychological health effects during and after the event. Secondly, it explores the issue of whether these effects were long-lasting by comparisons with the general population and with those at risk but not flooded.

Vulnerability to flooding: health and social dimensions.

This paper presents research results on the impacts that floods can have on the people affected, thus complementing the existing data on the monetary losses liable to occur in flood events. Both datasets should be used when deciding on investment in flood defence measures. We report on research on the vulnerability of flood-affected communities to adverse health effects, and the development of an index of community vulnerability based on extensive focus-group research and secondary-source census data.

ZD9583, an orally effective thromboxane A2 synthase inhibitor and receptor antagonist with a sustained duration of action in rat and dog.

The thromboxane A2 (TXA2) synthase inhibitory activity and the TXA2 receptor (TP-receptor) blocking action of ZD9583 ((4Z)-6-[(2S,4S,5R)-2-(1-[2-cyano-4-methylphenoxy]-1-methylethyl) -4-(3-pyridyl)-1,3-dioxan-5-yl]hex-4-enoic acid) has been evaluated in-vitro by use of whole blood and platelets from man, and ex-vivo by use of platelets and whole blood from rats and dogs. ZD9583 caused concentration-dependent inhibition of human platelet microsomal TXA2 production with an IC50 of 0.017 +/- 0.

ZD1542, a potent thromboxane A2 synthase inhibitor and receptor antagonist in vitro.

1. The thromboxane A2 synthase (TXS) inhibitory activity and the thromboxane A2 (TP)-receptor blocking action of ZD1542 (4(Z)-6-[2S,4S,5R)-2-[1-methyl-1-(2-nitro-4-tolyloxy)ethyl]-4-(3- pyridyl)-1,3-dioxan-5-yl]hex-4-enoic acid) has been evaluated in vitro on platelets and whole blood from a range of species including man. Antagonist activity has also been investigated in vascular and pulmonary smooth muscle preparations in vitro.

The risks from flooding: which risks and whose perception?

Four main groups are considered in relation to the risk from flooding: the engineers involved in the design of flood alleviation schemes, emergency planners, the public, including both the population at risk from flooding and the rest of the population who will bear all or most of the cost of flood alleviation schemes and the researchers, such as geographers and economists concerned with flood hazards and scheme appraisal. It is argued that these different groups vary significantly in their selection and definition of risks from flooding as a focus of concern and that their definition of risk influences their expectations about future events and the appropriate response to those events. But the different groups share two tendencies: the expectation that the future will be a replication of the past; and the neglect of "uncertain uncertainties" in favour of known uncertainties of risk.