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.     

A free-enzyme catalyst for the bioremediation of environmental atrazine contamination

Herbicide contamination from agriculture is a major issue worldwide, and has been identified as a threat to freshwater and marine environments in the Great Barrier Reef World Heritage Area in Australia. The triazine herbicides are of particular concern because of potential adverse effects, both on photosynthetic organisms and upon vertebrate development. To date a number of bioremediation strategies have been proposed for triazine herbicides, but are unlikely to be implemented due to their reliance upon the release of genetically modified organisms. We propose an alternative strategy using a free-enzyme bioremediant, which is unconstrained by the issues surrounding the use of live organisms. Here we report an initial field trial with an enzyme-based product, demonstrating that the technology is technically capable of remediating water bodies contaminated with the most common triazine herbicide, atrazine.     

The effects of triclopyr on 2,4‐D mineralization in two soils

Abstract

The effects of the herbicide triclopyr (3,5,6‐trichloro‐2‐pyridinyloxyacetic acid) on the mineralization of 2,4‐D (2,4‐dichlorophenoyxacetic acid) in two soils which differed in their histories of prior exposure to the two herbicides were investigated. The relative effects of triclopyr on 2,4‐D mineralization and most probable numbers of 2,4‐D degraders were dependent upon the soil. Triclopyr was shown to increase 2,4‐D mineralization rates in a soil which had been exposed to both 2,4‐D and triclopyr, but decreased the mineralization rate of 2,4‐D and inhibited the increase of most probable numbers of 2,4‐D degraders in a soil that had not been directly exposed to either herbicide.     

Management of traditional hunting of dugongs [Dugong dugon (Müller, 1776)] in the northern Great Barrier Reef,Australia

Some of the largest concentrations of dugongs (Dugong dugon) occur in the coastal waters of eastern Cape York Peninsula, Queensland, Designation of the Great Barrier Reef Marine Park has prompted the development of a program for management of dugong hunting by the aboriginal communities of the region. Assessment of the population by aerial surveys combined with monitoring of the aboriginal hunters' harvest suggest that the take is well below the sustainable yield. However, the reproductive rate of dugongs is so low that it will be a decade before the status of the population can be established. Therefore, a conservative management policy for dugongs is recommended while acknowledging the rights of traditional hunters. Greater participation of the aboriginal communities in the management program is sought to overcome initial misunderstandings and hostility.     

Toward an applied phenomenology: The case of abandoned pier use in Hoboken,New Jersey,USA

This research demonstrates the contribution of phenomenological inquiry within the realm of geographic and environmental planning. The contention is that a focus on the wide range of individual meanings and values ascribed to landscapes, a marginalized element in many planning assessments, can bring out data to more substantively inform decision making, A case study of user meanings imparted to residual waterfront land in Hoboken, New Jersey, USA, suggests that such property provides an array of amenities to residents. Most importantly, it expands the range of recreational activities, creates visual relief from the monotonous urban milieu, and provides scenic vistas to promote an awareness of the quality of life still possible in cities. The study concludes that planners can use phenomenology to generate data for more judicious decision making.     

Screening method for locating groundwater monitoring wells

The traditional approach to characterizing the extent of groundwater contamination is often phased over a period of several years. A screening method has been developed that allows the investigation process to be reduced to a single phase. Existing data are used to develop a preliminary estimate of the extent of contamination, which is refined by the screening method using groundwater data collected and analyzed in the field. The screening method is applicable at sites with volatile organic compound contamination. Groundwater samples are collected using direct push or drill rig assisted methods, and the groundwater headspace gas is analyzed for the contaminant of interest. The refined estimate is used to locate all of the groundwater monitoring wells necessary to finalize the estimate of the extent of contamination. Therefore, only one investigation phase is required, and time and cost savings are realized with respect to the traditional multiphase approach. The screening method was successfully applied at a CERCLA site in Nebraska with two distinct plumes of TCE-contaminated groundwater. The Nebraska remedial investigation was completed approximately 18 months earlier than the estimated completion of a comparable phased investigation, with a corresponding cost reduction estimated at approximately 10 percent. If data from the screening method were used instead of data from monitoring wells, the estimated cost savings would be over 50 percent. Additional applications and evaluations may lead to industry and regulatory acceptance of the method as a primary characterization tool.     

The use of critical loads maps to assess the effects of sulphur pollution control policies on nature conservation sites in England

Maps showing the critical loads for soil acidification and their exceedence produced by the UK Department of the Environment were examined for the potential impacts on nature conservation in England. Consideration was given to modelled depositions in 2005, after full implementation of the EC Large Combustion Plant Directive (i.e. a 60% reduction in UK sulphur emissions from 1980 levels). A second scenario was also examined, in which the remaining deposition was further reduced by 50% (i.e. an 80% reduction from 1980 levels). No examination was made of the impacts of present day deposition. Critical load exceedence maps for soil acidification were studied at the 1 km square scale for all of England. All SSSIs in England within squares where the critical load will remain exceeded were identified; geological SSSIs were excluded. In these squares 736 biological SSSIs were found to occur. The special interest for 136 of these was not considered to be susceptible to soil acidification damage. The remaining 600 sites are, therefore, considered to be at risk from continued acidification. The 600 sites represent 16.3% of the total number of SSSIs in England. The actual ‘exceeded’ area on these sites was found to represent 26.2% of the total SSSI area of Britain. If emissions are further reduced by 50% the proportions drop to 6.8% and 15.6% respectively. The sites are located throughout England, especially in upland areas of the north and west. However, a large number of sites also occur on exceeded areas on the dry acidic soils of southern and eastern parts of the country. These sites exhibit a wide range of habitat types. Most common are woodlands, peatlands and heathlands. A significant proportion of the nature conservation resource of England will remain at risk from acidification even after full implementation of existing UK government policy commitments. Even a major reduction beyond that commitment is not sufficient to prevent exceedence of critical loads on 250 of these SSSIs. Protection of Britain's natural environment would, therefore, require a very significant reduction in acid emissions beyond that which is currently agreed.     

Water quality management worldwide

This article analyzes water quality on a global scale. An overview of the global water supply and demand situation is presented first, including regional and country information, as well as data on selected water use patterns. The focus then shifts to a discussion of water pollution, its various causes, impact, and remedies, with emphasis on legal and administrative solutions. Water pollution control expenditures and the resultant achievements are dealt with in the final third of the article, with projections to 1995. A wide variety of published sources was dovetailed to obtain a composite picture and most likely scenario; this was supplemented with primary interviews by the author conducted in North America, Western and Eastern Europe, and Oceania at the start of the 1980s.     

A dynamic model for intertemporal allocation of old-growth forests in the Pacific Northwest

Across the globe, continued policy debates regarding the management of old-growth forests center around the difficult task of balancing economic and ecological considerations. Though the forests of the Pacific Northwest United States are among the most studied old-growth ecosystems, ecological and economic analyses have yielded public land management directives that remain controversial. Specifically, the recently adopted Northwest Forest Plan lacks explicit goals for maintaining intergenerational equity for the use of forest resources and the diversity of old-growth ecosystems. Unlike previous studies which rely on monetary quantification of costs and benefits, this study develops and applies a conceptual framework for evaluating socially optimal Pacific Northwest old-growth forest utilization strategies. Conditions for the optimal management of old-growth forests are derived using dynamic programming. The objective function synthesizes relevant biological and economic attributes of the old-growth allocation problem. Results in the form of extraction paths are compared given social pressure for consumptive and non-consumptive benefits, as well as different planning horizons, rates of social time preference, and environmental variance. Lengthening the planning horizon results in a vast divergence of optimal policies in the absence of discounting. Extraction rates appear to approach zero as the planning horizon approaches infinity. While higher rates of social time preference increase the rate of extraction, forest stocks remaining at the terminal time period equal levels remaining with a lower discount rate. Increasing environmental variance results in a higher level of stock remaining at the terminal time period. This analysis, while specific to the old-growth controversy of the Pacific Northwest, does provide general guidelines for addressing similar problems of multiple uses of natural areas, particularly where such uses are mutually incompatible, or where one use may be irreversibly destructive to another.