Call to Action: Addressing Pediatric Fall Safety in Ambulatory Environments.

BACKGROUND: Pediatric falls in the ambulatory environment are a patient safety concern. Historically, fall safety efforts have focused on inpatient settings and are not transferrable to ambulatory environments. Minimal research and absence of ambulatory-specific guidelines from regulatory and global benchmarking bodies contribute to the void of knowledge. Consequently, there has been minimal progress in developing fall reduction strategies for the ambulatory environment. PURPOSE: To review research evidence and findings from environmental assessments that included interprofessional stakeholder feedback to make recommendations for improving fall safety in the pediatric ambulatory environment. METHODS: Implementation science was employed in two large pediatric quaternary hospitals to identify existing gaps and provided the foundation for translation of findings in the development of fall safety practice recommendations in the ambulatory environment. RESULTS: Recommendations from the findings included identified barriers and tangible interventions within three broad categories: equipment and furniture, environment, and people. Purposeful inclusion of all areas in the ambulatory environment, integration of high reliability concepts, and partnering with parents were identified as pertinent factors associated with these recommendations. CONCLUSION: This call to action recognizes the importance of utilizing an evidence-based approach for improvement and provides a framework for conducting an environmental assessment, which is an essential starting point to improve fall safety in the pediatric ambulatory environment. Guidance and support from research, regulatory and collaborative bodies, and healthcare organizations remains a critical need in improving fall safety.

Rapid restoration of cognition in Alzheimer's transgenic mice with 8-hydroxy quinoline analogs is associated with decreased interstitial Abeta.

As a disease-modifying approach for Alzheimer's disease (AD), clioquinol (CQ) targets beta-amyloid (Abeta) reactions with synaptic Zn and Cu yet promotes metal uptake. Here we characterize the second-generation 8-hydroxy quinoline analog PBT2, which also targets metal-induced aggregation of Abeta, but is more effective as a Zn/Cu ionophore and has greater blood-brain barrier permeability. Given orally to two types of amyloid-bearing transgenic mouse models of AD, PBT2 outperformed CQ by markedly decreasing soluble interstitial brain Abeta within hours and improving cognitive performance to exceed that of normal littermate controls within days. Nontransgenic mice were unaffected by PBT2. The current data demonstrate that ionophore activity, inhibition of in vitro metal-mediated Abeta reactions, and blood-brain barrier permeability are indices that predict a potential disease-modifying drug for AD. The speed of recovery of the animals underscores the acutely reversible nature of the cognitive deficits associated with transgenic models of AD.

Dealing with disaster.

FOR MANY PEOPLE in London, July 7 2005 will always be recalled as the day that terrorist bombs were detonated on the capital's transport system. This will be especially true of the staff of the NHS acute trusts and emergency services who implemented major incident plans in response to the bombings.