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Industrial Agricultural Environments
Published in Kezia Barker, Robert A. Francis, Routledge Handbook of Biosecurity and Invasive Species, 2021
Robert G. Wallace, Alex Liebman, David Weisberger, Tammi Jonas, Luke Bergmann, Richard Kock, Rodrick Wallace
Until now the fail-safe has worked as designed. For the 2015 outbreak of avian influenza H5N2 in the US Midwest, the direct costs of birds killed by the virus, for which a vaccine produced during the outbreak proved ineffective, fell on contract farmers, for whom no outbreak insurance is on offer (Wallace, 2016d). The costs of culling flocks as yet uninfected by H5N2 but in danger were paid for by federal taxpayers. In short, to the benefit of the deadliest pathogens, allowed to continue to circulate across a vast network of barns, farms and national borders, capitalism here, against its own characterisation, failed to punish the sector’s market failure. The system moves the damage off balance sheets and upon food animals, wildlife, famers, consumers and communities local and abroad instead. Foundational failures in biosecurity are tucked into production, to be offset by farmers and governments first, before a single hog or chicken batch makes it off the truck. One finds similar end-runs in crops.
Medication error *
Published in Paul Bowie, Carl de Wet, Aneez Esmail, Philip Cachia, Safety and Improvement in Primary Care: The Essential Guide, 2020
Repeat prescriptions improve efficiency in busy surgeries, but also pose potentially significant risks, as demonstrated by Case 8. Case 8. A patient was started on steroid eye drops by an ophthalmologist, and her GP was asked to issue repeat prescriptions. The ophthalmologist subsequently decided to wean and stop the steroid drops, but this decision was never communicated to the practice and the patient continued to receive the medication. She unfortunately developed bilateral steroid-induced glaucoma, required surgery and subsequently lost the vision in one eye. A successful case was brought against the GP and a body of experts concluded that ongoing repeat prescriptions should not have been given without ophthalmology advice. They also highlighted failings in communication between secondary and primary care and the lack of a computer fail-safe mechanism.20
Publication and Outcome Reporting Bias
Published in Christopher H. Schmid, Theo Stijnen, Ian R. White, Handbook of Meta-Analysis, 2020
Arielle Marks-Anglin, Rui Duan, Yong Chen, Orestis Panagiotou, Christopher H. Schmid
The fail-safe N has several serious drawbacks that limit its utility. First, it relies on test statistics derived only from study p-values, ignoring the size of effects and ignoring a study’s size except as it might affect its p-value. In other words, two studies with the same p-value will make the same contribution regardless of whether the study is small with a large effect or large with a small effect. It also assumes that the missing studies have no effect and ignores between-study heterogeneity. Finally, it is not based on any statistical model of study effect distributions and so can only provide heuristic guides to the importance of the size of N found (Becker, 2005).
Further development of spinal cord retreatment dose estimation: including radiotherapy with protons and light ions
Published in International Journal of Radiation Biology, 2021
Joshua W. Moore, Thomas E. Woolley, John W. Hopewell, Bleddyn Jones
The system aims to provide a safe upper limit to the retreatment dose per fraction for a given number of fractions, but continues to need considerable clinical input to define the acceptable risk level for a given retreatment situation, and to determine the degree of conservative factor allocation (a BED reduction allocation according to clinical circumstances, as discussed previously [Jones and Hopewell 2019; Woolley et al. 2018]). Further, clinical judgment may be required to operate in a ‘fail safe’ way, for example by using a lower number of retreatment fractions or a reduced dose per fraction than suggested by the model, if there is any doubt. The upper limit provided by the model is more appropriate for radical retreatment situations. For palliative situations there is considerable leeway for reductions in dose per fraction or fraction number in order to deliver a schedule that has a high probability of achieving the intended effect, such as relief of pain or bleeding, which require a lower BED. Such situations are often delivered using fraction sizes greater than 2 Gy and even single treatment sessions in some countries.
Letter to the Editor
Published in The Neurodiagnostic Journal, 2021
Regarding study design. Most concerning is that instead of presenting a prospective head-to-head study comparing the published mid-thigh and unpublished experimental distal-calf stimulation techniques, the authors monitored lateral lumbar surgeries with an experimental treatment (DSn-SSEPs) without the non-experimental standard (Sn-SSEPs) in conjunction. From my reading of this study, it appears the decision to incorporate experimental mid-calf stimulation into lateral lumbar monitoring without mid-thigh stimulation was based on the a priori assumption experimental mid-calf stimulation can detect a femoral nerve injury. A study design utilizing experimental techniques on humans without failsafe proven methods may put patients at risk, and publishing the findings retrospectively does not alleviate the risk.
Benefits of simulated General Practice clinics in the preparation of medical students for primary healthcare
Published in Education for Primary Care, 2019
Karryn Lytton, Torres Woolley, Roy Rasalam, Susan Gorton, Paula Heggarty
Thus, while a good real-life GP placement would be the preferred option for most students, some rated their real-life GP placement very poorly. The main advantage of including simGPclinics in a medical curriculum is to provide a ‘fail-safe’ option for all students to receive reliable, quality, structured, deliberate and well-supervised primary healthcare training that is not always available in real-world settings. Advantages for the students include: the provision of a safe environment where it’s acceptable to make mistakes (identified as a significant advantage by Young et al, 2015), [4] to receive feedback to improve their clinical and patient communication skills (identified as a significant advantage by Elley et al, 2012), [8] and practising in an authentic setting where they are pushed to ‘think on their feet’ under time pressures.