Teaching patient safety and human factors in undergraduate nursing curricula in England: a pilot survey.

Patient safety is a key priority for all healthcare systems, and there is growing recognition for the need to educate tomorrow's nurses about the role of human factors in reducing avoidable harm to patients. A pilot survey was sent to 20 schools of nursing in England to explore the teaching of patient safety and human factors. All 13 schools that responded (65% response rate) stated that patient safety was covered in their curricula and was allocated more than 4 hours; all the classes included human factors. Only two respondents indicated their teaching to be multi-professional. Awareness of the World Health Organization's multiprofessional patient safety curriculum guide was poor. Faculties also seemed unaware that the Institute for Healthcare Improvement provides free online patient safety modules for students and that there is a global network of student patient safety chapters.

Behavioral assessment of children with Down syndrome using the Reiss psychopathology scale.

The behavior of 60 children with Down syndrome (cDS), aged 4 to 21 years, was assessed by parent and teacher report using the Reiss psychopathology rating scale for dual diagnosis (mental disability plus mental illness). Standard forms contained 12 categories of abnormal behavior (e.g., Psychosis), each with five descriptive items (e.g., bizarre ideas) that could be scored as no problem, problem, and major problem (0, 1, or 2 points). Total scores for individual cDS (mean of two raters) ranged from 3 to 43 out of a potential 120 points, with a mean of 14.8 points and a standard deviation of 9.5. There were no significant differences by sex, age, or ethnicity. The highest aggregate scores among the 60 cDS were in the psychometric categories of Attention-Deficit (156 points), Anger/Self Control (154.5), and Psychosis (109) and for component items such as communication problems (55 points) under the Psychosis category; distracted (48.5) or disobedient (42.5) under the Attention-Deficit category; and temper tantrums (36.5), impulsive (32), or impatient (31.5) under the Anger/Self-Control category. Agreement between parent and teacher raters was over 75% for 38 of the 60 items and above 60% for an additional 15. Selection of cDS with scores over 10 points yielded 24 families who chose parental guidance and 14 who chose professional referral. The structure of the Reiss instrument was useful for cDS, distinguishing behaviors potentially related to medical problems from true psychopathology.

A major breakpoint cluster domain in murine radiation-induced acute myeloid leukemia.

Cytogenetic and molecular studies have provided evidence of the clustering of chromosome 2 deletion breakpoints in radiation-induced murine acute myeloid leukemia (AML). Moreover, clustering occurs in at least two fragile domains rich in telomere-like arrays. Here we describe a physical map of the distal breakpoint cluster and confirm the presence of inverted head-to-head telomeric sequence arrays. These potentially recombinogenic sequences were not, however, the direct focus for post-irradiation chromosome breakage in AML. Instead, the two arrays bordered a 2.5-kb sequence with properties expected of a nuclear matrix attachment region (MAR). The putative MAR co-localized in the fragile domain with genes important to the hemopoietic system (leukocyte tyrosine kinase, zinc finger protein 106, erythrocyte protein band 4.2, and beta(2)-microglobulin (beta2m)); the beta2m subdomain was a particular focus of breakage. On the basis of these and other data, we suggest that AML-associated chromosome 2 fragility in the mouse is a consequence of domain-specific fragility in genomic domains containing numerous genes critical to the hemopoietic system. Recorded with the permission of the controller of Her Majesty's Stationery Office. Published by Wiley-Liss, Inc.