Poor drug history documentation in admission medical notes: clerking prompts and junior doctor education alone do not significantly reduce errors.

INTRODUCTION: Poor drug history documentation on admission may lead to medication errors; a leading cause of avoidable harm. AIMS: To assess the quality of drug histories in the notes of patients admitted to an emergency assessment unit and impact of interventions to improve documentation. METHODS: Data were collected on the accuracy of documentation in 281 drug histories including errors of omission, frequency and dose. RESULTS: The mean error rate was high at more than five per drug history. Omitted drugs included warfarin and long-term steroids, the consequences of which were potentially serious. Clerking prompts and education alone did not improve errors significantly. CONCLUSION: The error rate in drug histories is unacceptably high. More research is needed to explore factors involved in such documentation errors.

Adaptación y evidencias de validez de la Escala de Estilos de Respuesta en niños argentinos / Adaptation and evidence of validity of the Response Styles Scale in Argentinian children

La rumiación se considera un marcador estable de la aparición de la depresión, la recurrencia de episodios depresivos y el mantenimiento del afecto negativo. A pesar de su importancia clínica, esta cuestión no es abordada en profundidad en población infantil. Entre los factores relacionados con la falta de estudios, se encuentra la escasez de instrumentos para evaluar estas variables en niños. Por este motivo, este trabajo se propuso traducir la Escala de Estilos de Respuesta para Niños de Ziegert y Kistner (CRSS, 2002), adaptarla en población infantil con desarrollo típico de Argentina (Escala de Estilos de Respuesta en Niños-Argentina, EERN-A) y analizar sus propiedades psicométricas. Para ello, se evaluó a 434 niños argentinos de 8 a 12 años de edad y se analizó la estructura factorial de la escala y su confiabilidad. También se evaluó la validez concurrente del instrumento mediante su asociación con otras medidas de rumiación y distracción, y su validez convergente con medidas teóricamente relacionadas (ansiedad y depresión). Los resultados apoyan la multidimensionalidad e independencia de la rumiación y la distracción. Asimismo, las subescalas muestran relaciones con variables relacionadas, así como una adecuada estructura interna y fiabilidad. De este modo, este estudio supone un aporte para la evaluación de los estilos de respuestas en población infantil, debido a que permite contar con un instrumento válido para la evaluación de la rumiación y la distracción en niños

Rumination is considered a stable marker of the onset of depression, the recurrence of depressive episodes and the maintenance of negative affect. Despite its clinical importance, this issue is not properly addressed in children. Among the factors related to the lack of studies, is the lack of instruments to evaluate these variables in children. For this reason, this work had the aim to translate the Children's Response Styles Scale of Ziegert and Kistner (CRSS, 2002), adapt it in children with typical development of Argentina (Escala de Estilos de Respuesta en Niños-Argentina-EERN-A-) and analyze its psychometric properties. To this end, 434 Argentinian children aged 8 to 12 were evaluated. The factorial structure of the scale and its reliability were analyzed. The concurrent validity of the instrument was also evaluated through its association with other measures of rumination and distraction. Its convergent validity was evaluated through relationships with theoretically related variables (anxiety and depression). The results support the multidimensionality and independence of rumination and distraction. Likewise, the subscales show relationships with related variables as well as an adequate internal structure and reliability. Thus, this study is a contribution to the evaluation of response styles in children, because it provides a valid instrument for the assessment of rumination and distraction in children

Development patterns of executive functions in children.

Executive Functions (EF) exercise control over an individual's conduct and thinking through a set of functionally independent processes, among which are cognitive flexibility (reactive and spontaneous), working memory and planning. The development patterns of these components appear to have stages of acceleration and deceleration during childhood. Studies analyzing their development in Spanish-speaking children were not found in our area. Therefore, this study will analyze the development patterns of the cited executive functions with the objective of establishing relationships and comparisons, and identifying the stages of acceleration and stagnation for each component. The study's sample consists of 274 schoolchildren between the ages of 6 and 8 (119 in first grade, 61 in second grade and 94 in third grade). Participants were evaluated using the following instruments from the Neuropsychological Assessment of Children test battery (known by the acronym ENI in Spanish): Verbal Fluency (semantic and phonemic); Cognitive Flexibility; Mexican Pyramid; and Backward Digit Span. Three different development patterns were detected, as well as different interactions between the executive components. Additionally, three empirical types were established based on the patterns and relationships between components.

What errors can be identified by Pharmacy-led medicines reconciliation? A prospective study.

AIM: To establish the nature and frequency of discrepancies identified by pharmacy staff during medicines reconciliation.(MR) METHODS: Pharmacy staff collected data prospectively from 161 patients over a 1 week period, including information on any prescription errors identified. RESULTS: In total, 62 patients (48%) taking one or more medications prior to admission to hospital had one or more discrepancies found by pharmacy staff during MR. The most common discrepancy was omission of one or more drugs. CONCLUSIONS: Pharmacy staff identified several unintentional discrepancies in prescribing of medications at admission to hospital. Doctors should ensure that intentional changes to patient prescriptions are clearly documented.

Memoria de trabajo, mecanismos inhibitorios y rendimiento lecto-comprensivo en grupos de comprendedores de secundaria básica / Working Memory, inhibitory processes and reading comprehension performance in groups of comprehenders of secondary school

La comprensión lectora es un proceso complejo que supone la intervención de un conjunto de variables interrelacionadas. Diversos estudios han planteado el rol de la memoria de trabajo y los mecanismos inhibitorios en la habilidad de comprender un texto. El propósito del presente trabajo es doble: por un lado, se propone evaluar las relaciones entre memoria de trabajo, mecanismos inhibitorios y comprensión lectora en adolescentes de primer año de la Educación Secundaria Básica (E.S.B.) de 12 y 13 años de edad, distribuidos en dos grupos de desempeño en comprensión lectora; y por otro, analizar las diferencias en los rendimientos ejecutivos de memoria de trabajo y mecanismos inhibitorios en función del nivel de comprensión lectora (alto y bajo rendimiento). Para ello, se administraron un conjunto de tareas para evaluar: comprensión de textos, fluidez lectora, habilidades verbales, memoria de trabajo y mecanismos inhibitorios. Los resultados señalan correlaciones entre rendimiento lecto-comprensivo, memoria de trabajo, mecanismos inhibitorios (supresión y restricción) y habilidades verbales. A su vez, la evidencia señala que los grupos de desempeño en comprensión lectora presentan diferencias estadísticamente significativas en sus correspondientes rendimientos en memoria de trabajo e inhibición.

The process of reading comprehension involves a group of interrelated variables. Several studies have presented the role of working memory and the inhibition process in reading comprehension skills. The aim of this research is double, on one side to assess the relationship between working memory, inhibitory processes and reading comprehension in adolescents belonging to the first year of secondary school of 12 and 13 years old, in two groups of comprehension levels; and on the other hand, to analyze the differences in executive performance of working memory and inhibitory processes in different levels of reading comprehension (high and poor performance). A number of tests were carried out to assess the level of reading comprehension, verbal skills, reading fluency, working memory and inhibitory processes. Results show that levels of reading comprehension, working memory, inhibitory processes (deletion and restraint) and verbal skills are related. The evidence suggests that the groups of different levels of reading comprehension show significant differences in their working memory, inhibitory processes and verbal skills performance.

Impact of enhanced geothermal systems on US energy supply in the twenty-first century.

Recent national focus on the value of increasing US supplies of indigenous renewable energy underscores the need for re-evaluating all alternatives, particularly those that are large and well distributed nationally. A panel was assembled in September 2005 to evaluate the technical and economic feasibility of geothermal becoming a major supplier of primary energy for US base-load generation capacity by 2050. Primary energy produced from both conventional hydrothermal and enhanced (or engineered) geothermal systems (EGS) was considered on a national scale. This paper summarizes the work of the panel which appears in complete form in a 2006 MIT report, 'The future of geothermal energy' parts 1 and 2. In the analysis, a comprehensive national assessment of US geothermal resources, evaluation of drilling and reservoir technologies and economic modelling was carried out. The methodologies employed to estimate geologic heat flow for a range of geothermal resources were utilized to provide detailed quantitative projections of the EGS resource base for the USA. Thirty years of field testing worldwide was evaluated to identify the remaining technology needs with respect to drilling and completing wells, stimulating EGS reservoirs and converting geothermal heat to electricity in surface power and energy recovery systems. Economic modelling was used to develop long-term projections of EGS in the USA for supplying electricity and thermal energy. Sensitivities to capital costs for drilling, stimulation and power plant construction, and financial factors, learning curve estimates, and uncertainties and risks were considered.

Possibilidades de alteridade: o Livro Vermelho e elementos da arte contemporânea / Possibilities of alterity: the Red Book and aspects of contemporary art

Este texto focaliza a atitude de abertura ao inconsciente demonstrada por Jung no Livro Vermelho. Aproximando o livro de nossa época e considerando que ele trata da questão de acolher, transformar e expressar a criatividade que se apresenta autonomamente, é traçado um paralelo entre três personagens: o fotógrafo da natureza em sua atitude frente ao inesperado; a fotógrafa Diane Arbus que, de maneira afetiva, nos apresenta o diferente; e o músico brasileiro Itamar Assumpção, cuja criatividade era simultaneamente rigorosa, irreverente, inovadora e sempre enraizada na realidade brasileira. O fio condutor é a atitude psicológica que fomenta a criatividade (AU)

The focus of this study is the attitude of openness to the unconscious demonstrated by Jung at the Red Book. Reading the book in our own time point of view considering that it brings the issue of sheltering, transforming and expressing the creativity that presents itself, a parallel is drawn between three personages: the nature photographer in his attitude towards the unexpected; photographer Diane Arbus who presents the different in an affectionate way; and Brazilian musician Itamar Assumpção, whose creativity was very strict, irreverent, innovative and personally attached to Brazilian reality. The guiding thread is the psychological attitude that foments creativity (AU)

Possibilidades de alteridade: o Livro Vermelho e elementos da arte contemporânea / Possibilities of alterity: the Red Book and aspects of contemporary art

Este texto focaliza a atitude de abertura ao inconsciente demonstrada por Jung no Livro Vermelho. Aproximando o livro de nossa época e considerando que ele trata da questão de acolher, transformar e expressar a criatividade que se apresenta autonomamente, é traçado um paralelo entre três personagens: o fotógrafo da natureza em sua atitude frente ao inesperado; a fotógrafa Diane Arbus que, de maneira afetiva, nos apresenta o diferente; e o músico brasileiro Itamar Assumpção, cuja criatividade era simultaneamente rigorosa, irreverente, inovadora e sempre enraizada na realidade brasileira. O fio condutor é a atitude psicológica que fomenta a criatividade.

The focus of this study is the attitude of openness to the unconscious demonstrated by Jung at the Red Book. Reading the book in our own time point of view considering that it brings the issue of sheltering, transforming and expressing the creativity that presents itself, a parallel is drawn between three personages: the nature photographer in his attitude towards the unexpected; photographer Diane Arbus who presents the different in an affectionate way; and Brazilian musician Itamar Assumpção, whose creativity was very strict, irreverent, innovative and personally attached to Brazilian reality. The guiding thread is the psychological attitude that foments creativity.

Development patterns of executive functions in children

Executive Functions (EF) exercise control over an individual’s conduct and thinking through a set of functionally independent processes, among which are cognitive flexibility (reactive and spontaneous), working memory and planning. The development patterns of these components appear to have stages of acceleration and deceleration during childhood. Studies analyzing their development in Spanish-speaking children were not found in our area. Therefore, this study will analyze the development patterns of the cited executive functions with the objective of establishing relationships and comparisons, and identifying the stages of acceleration and stagnation for each component. The study’s sample consists of 274 schoolchildren between the ages of 6 and 8 (119 in first grade, 61 in second grade and 94 in third grade). Participants were evaluated using the following instruments from the Neuropsychological Assessment of Children test battery (known by the acronym ENI in Spanish): Verbal Fluency (semantic and phonemic); Cognitive Flexibility; Mexican Pyramid; and Backward Digit Span. Three different development patterns were detected, as well as different interactions between the executive components. Additionally, three empirical types were established based on the patterns and relationships between components (AU)

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