A review of medical error taxonomies: A human factors perspective

Although a large number of medical error taxonomies have been published, there is little evidence to suggest that these taxonomies have been systematically compared. This paper describes a study comparing 26 medical error taxonomies using a human factors perspective. The taxonomies were examined to determine if they classified systemic factors of medical errors and if they utilized theoretical error concepts in their classifications. Scope of classification was also examined. It was found that two-thirds of the taxonomies classified systemic factors of medical errors and only a third utilized theoretical error concepts. Medical error taxonomies based on theoretical error concepts were more likely to be generic in applicability and also more likely to classify systemic factors and psychological error mechanisms of medical errors. In addition to terminology, the medical error taxonomies also varied in terms of domain-specificity, granularity, and developmental process. Different medical error taxonomies provide different information; how these differences affect medical error management needs to be investigated.     

Workplace aerosol mass concentration measurement using optical particle counters

Direct-reading aerosol measurement usually uses the optical properties of airborne particles to detect and measure particle concentration. In the case of occupational hygiene, mass concentration measurement is often required. Two aerosol monitoring methods are based on the principle of light scattering: optical particle counting (OPC) and photometry. The former analyses the light scattered by a single particle, the latter by a cloud of particles. Both methods need calibration to transform the quantity of scattered light detected into particle concentration. Photometers are simpler to use and can be directly calibrated to measure mass concentration. However, their response varies not only with aerosol concentration but also with particle size distribution, which frequently contributes to biased measurement. Optical particle counters directly measure the particle number concentration and particle size that allows assessment of the particle mass provided the particles are spherical and of known density. An integrating algorithm is used to calculate the mass concentration of any conventional health-related aerosol fraction. The concentrations calculated thus have been compared with simultaneous measurements by conventional gravimetric sampling to check the possibility of field OPC calibration with real workplace aerosols with a view to further monitoring particle mass concentration. Aerosol concentrations were measured in the food industry using the OPC GRIMM? 1.108 and the CIP 10-Inhalable and CIP 10-Respirable (ARELCO?) aerosol samplers while meat sausages were being brushed and coated with calcium carbonate. Previously, the original OPC inlet had been adapted to sample inhalable aerosol. A mixed aerosol of calcium carbonate and fungi spores was present in the workplace. The OPC particle-size distribution and an estimated average particle density of both aerosol components were used to calculate the mass concentration. The inhalable and respirable aerosol fractions calculated from the OPC data are closely correlated with the results of the particle size-selective sampling using the CIP 10. Furthermore, the OPC data allow calculation of the thoracic fraction of workplace aerosol (not measured by sampling), which is interesting in the presence of allergenic particles like fungi spores. The results also show that the modified COP inlet adequately samples inhalable aerosol in the range of workplace particle-size distribution.     

Characterization of organic chemical contaminants in sediments from Jobos Bay, Puerto Rico

Jobos Bay, located on the southeastern coast of Puerto Rico, contains a variety of habitats including mangroves, seagrass meadows, and coral reefs. The watershed surrounding the bay includes a number of towns, agricultural areas, and the Jobos Bay National Estuarine Research Reserve (NERR). Jobos Bay and the surrounding watershed are part of a Conservation Effects Assessment Project (CEAP), involving the Jobos Bay NERR, the US Department of Agriculture, and the National Oceanic and Atmospheric Administration (NOAA) to assess the benefits of agricultural best management practices (BMPs) on the terrestrial and marine environments. As part of the Jobos Bay CEAP, NOAA collected sediment samples in May 2008 to characterize over 130 organic chemical contaminants. This paper presents the results of the organic contaminant analysis. The organic contaminants detected in the sediments included polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls, and the pesticide DDT. PAHs at one site in the inner bay near a boat yard were significantly elevated; however, all organic contaminant classes measured were below NOAA sediment quality guidelines that would have indicated that impacts were likely. The results of this work provide an important baseline assessment of the marine environment that will assist in understanding the benefits of implementing BMPs on water quality in Jobos Bay.     

Essential and toxic elements in infant foods from Spain, UK, China and USA

Spanish gluten-free rice, cereals with gluten, and pureed baby foods were analysed for essential macro-elements (Ca and Na), essential trace elements (Fe, Cu, Zn, Mn, Se, Cr, Co and Ni) and non-essential trace elements (As, Pb, Cd and Hg) using ICP-MS and AAS. Baby cereals were an excellent source of most of the essential elements (Ca, Fe, Cu, Mn and Zn). Sodium content was high in pureed foods to improve their flavour; fish products were also rich in Se. USA pure baby rice samples had the highest contents of all studied essential elements, showing a different nutrient pattern compared to those of other countries. Mineral fortification was not always properly stated in the labelling of infant foods. Complementary infant foods may also contain significant amounts of contaminants. The contents of Hg and Cd were low enough to guarantee the safety of these infant foods. However, it will be necessary to identify the source and reduce the levels of Pb, Cr and As in Spanish foods. Pure baby rice samples contained too much: Pb in Spain; As in UK; As, Cr and Ni in USA; and Cr and Cd in China.     

Vegetation NDVI Linked to Temperature and Precipitation in the Upper Catchments of Yellow River

Vegetation in the upper catchment of Yellow River is critical for the ecological stability of the whole watershed. The dominant vegetation cover types in this region are grassland and forest, which can strongly influence the eco-environmental status of the whole watershed. The normalized difference vegetation index (NDVI) for grassland and forest has been calculated and its daily correlation models were deduced by Moderate Resolution Imaging Spectroradiometer products on 12 dates in 2000, 2003, and 2006. The responses of the NDVI values with the inter-annual grassland and forest to three climatic indices (i.e., yearly precipitation and highest and lowest temperature) were analyzed showing that, except for the lowest temperature, the yearly precipitation and highest temperature had close correlations with the NDVI values of the two vegetation communities. The value of correlation coefficients ranged from 0.815 to 0.951 (p?<?0.01). Furthermore, the interactions of NDVI values of vegetation with the climatic indicators at monthly interval were analyzed. The NDVI of vegetation and three climatic indices had strong positive correlations (larger than 0.733, p?<?0.01). The monthly correlations also provided the threshold values for the three climatic indictors, to be used for simulating vegetation growth grassland under different climate features, which is essential for the assessment of the vegetation growth and for regional environmental management.     

Estimating the aquatic emissions and fate of perfluorooctane sulfonate (PFOS) into the river Rhine

The sources, distribution, levels and sinks of perfluorooctane sulfonate (PFOS) estimated to be released from areas of high population density, have been explored using the river Rhine as a case study. A comparison between modelled and measured data is presented, along with analysis of the importance of PFOS sorption in riverine systems. PFOS releases into the Rhine were estimated to be 325-690 kg/yr based on per capita emission rates of 27-57 μg day(-1) from a population of 33 million living within a 50 km zone either side of the river. Sorption of PFOS to suspended particles and sediments may alter its fate in the aquatic environment. Therefore available measured and modelled partitioning data was assessed, and K(d) values (sorption coefficient) of 7.5 and 20 were selected. This resulted in sediment-water ratios of 23-76 : 1, which are similar to ratios reported in the literature, and resulted in modelled estimates that <20% of the total PFOS entering the Rhine binds to sediments or suspended particles. The calculated discharge from the Rhine to the North Sea based on measured data was 420-2200 kg/yr; our model predictions are in good agreement with these estimates. Emission trends were accurately predicted, suggesting population density can be effectively used as a surrogate for diffuse PFOS emissions from product use, while predicted concentrations were a factor of 2-4 below measured data showing the importance of other sources. Transfer of PFOS to sediment is estimated to be minimal, and consequently discharges to the North Sea are roughly equal to PFOS releases to river water.     

Correlations in polycyclic aromatic hydrocarbon (PAH) concentrations in UK ambient air and implications for source apportionment

The extent of correlation in polycyclic aromatic hydrocarbon (PAH) concentration data obtained by the UK PAH Monitoring and Analysis Air Quality Network from March 2008 to November 2010 has been assessed. Application of principal component analysis (PCA) to the dataset has revealed that the concentrations of the vast majority of PAHs are very highly correlated. The use of diagnostic PAH ratios (including a new benzo[b]naph[2,1-d]thiophene/benzo[a]pyrene diagnostic ratio), and a novel 'combined diagnostic ratio - PCA' approach has revealed information about the main sources of PAH at individual Network sites, allowing the sites to be grouped in terms of those influenced by solid fuel use, industry and traffic, and those of an urban or rural nature. Solid fuel use has also been delineated from other fuel burning. Conclusions are drawn about a number of UK PAH Network sites - four sites are shown to be influenced significantly by solid fuel use, and the sites in South Wales and at London Marylebone Road are found to be located in distinct and unusual PAH pollution climates - the identification of a unique PAH pollution climate in South Wales is a key and novel conclusion of the work.     

Prenatal diagnosis of pericentric inversion of chromosome no. 17 in a twin pregnancy

Although prenatal genetic diagnosis can usually provide prospective parents with information as to whether their fetus is affected with certain genetic conditions, the presence of twins and the uncertainty about the phenotype of some chromosome variations pose a major dilemma and make genetic counselling very difficult. Here, a case report of an unusual chromosome aberration (pericentric inversion of chromosome no. 17) in a twin pregnancy which was originally suspected to be monoamniotic but later proved to have two sacs was presented.