Mistake Rate Research Articles

치위생과 학생의 치근단 촬영법 인식에 관한 조사 연구

Objectives : This study was carried out in order to obtain basic data for students` efficient acquirement and instruction of radiography technology in the future by surveying dental hygiene students` recognition of periapical radiography. Methods : This study carried out a questionnaire survey targeting dental hygiene students from December 2009 to December 2010, and obtained the following results. Results : 1. As a result of examining recognition on periapical radiography, the bisecting angle technique was indicated to be averagely points. The paralleling technique was indicated to be points. 2. As a result of examining about problems given the bisecting angle technique, what had been most difficult given the bisecting angle technique was indicated to be the highest in cone positioning with 34.2%. The most difficulty given deciding on the X-ray vertical-angel irradiation direction was indicated to be the highest with 66.9% in adjusting the cone direction on the virtual bisector. 3. As a result of examining about problems given the paralleling technique, what had been most difficult in the process of the paralleling technique was indicated to be the highest with 56.7% in fixing the film immobilization device inside the mouth. Conclusions : Examining the above results, it is considered that there is a need of understanding morphological and anatomical structure inside the mouth in order to reduce the mistake rate given the periapical radiography, and that it is important to increase skill level by repetitively shooting several times with having enough time.

DISTRIBUTION OF MISBELIEFS ABOUT BACK PAIN AMONG MEDICAL STAFF

The aim of this survey is the analysis of typical misbeliefs distribution about back pain among medical staff. Study design: cross-sectional discreptive study 110 medical professionals took part in this study. 48 of them were medical students (4th and 5th year of education), 62 were licensed medical doctors with ten years of experience in average. All participants were interviewed with special questionnarie containing 36 false statements about the spine and back pain. Every subject was asked to indicate whether he agrees or disagrees with each statement. The rate of incorrectly given answers was 63% in average for physicians (from 22% to 94%) and 60% in average for students (from 36% to 83%). In a small subgroup of neurosurgeons the rate of mistakes was 32% (varied from 11% to 47%). This study gives evidence of the high total level of misbeliefs about back pain among both licensed physicians and medical students. It is likely that majority of physicians do not use modern biopsychosocial model of back pain. Moreover they often act as carriers of irrational beliefs which could have negative influence on long therm effects of back pain.

Accident prevention in day-to-day clinical radiation therapy practice

Nearly 50–60% of cancer patients will undergo radiotherapy at some point in their treatment. Around 85% of the world’s population live in developing countries served by approximately 30% of the world’s radiotherapy facilities. It has been suggested that 1 megavoltage unit is required for every 500 new treatment courses per year, while others estimate that 1 megavoltage unit is needed for every 300 new treatments. However, these numbers do not necessarily take into account the development of new technologies and treatment modalities, which are more time- and resource-intensive. The International Commission on Radiological Protection has emphasised that ‘purchasing new equipment without a concomitant effort on education and training and on a programme of quality assurance is dangerous’, and ‘the decision to implement a new technology for radiation therapy should be based on a thorough evaluation of the expected benefits, rather than being driven by the technology itself’. It is estimated that the rate of serious mistakes could be as high as 0.2%, which is several orders of magnitude higher than the rate reported for commercial aviation. So, how safe is safe? It can be stated that the development of a culture of safety is critical and requires efforts in education and training, which could prove difficult in overloaded departments.

Changes of electrophysiological parameters and neuropsychological characteristics in children with psychic development disorders after transcranial direct current stimulation (tDCS)

Abstract Introduction Recently, school maladjustment that is associated with the cognitive decline in children with minor central nervous system disorders has become one of the topical issues. Aim The aim of this research was a retrospective analysis of changes concerning neurophysiological and neuropsychological parameters in children with psychic development disorders after treatment employing the transcranial direct current stimulation (tDCS) technique. Materials and methods Study data of 128 children with learning disorders and 48 children with mild mental retardation, aged 8–12 years old, who had undergone a course of tDCS, were analyzed. The data of neuropsychological testing and electroencephalography (EEG) of 22 healthy children and 42 children with psychic development disorders who had undergone conventional treatment, aged 8–12 years old, were used as a control. For tDCS procedures 60–120 μA direct current was used, the stimulating electrodes area ranged from 2.5 cm2 to 6.25 cm2. Treatment session duration (ranging from 25 min to 45 min), as well as stimulating electrodes localization onto the scalp and the time of the procedure, depended on clinical goals, age, and the severity of disorders. The entire treatment course duration lasted 4–5 weeks: 5–9 procedures with 2–3 day intervals. Results A neuropsychological study revealed statistically significant improvement of higher mental functions in patients undergoing tDCS compared to control groups. Verbal functions improvement was observed in 80.0% of children with such disorders. In patients with dysgraphia, after tDCS the rate of mistakes in writing reduced 3-fold, the process of writing quickened. The ability to fulfill tasks requiring visual spatial analysis and synthesis also considerably improved. After the course of tDCS no cases of negative changes of EEG parameters were noted. On the contrary, the improvement of EEG parameters, showing their approaching the age norms, was observed. Discussion The study results indicate that tDCS enables one to not only change directionally the functional status of brain areas lying under electrodes, but also to influence actively the functional status of deep regulatory brain systems through the changing of modulatory cortical areas status. Conclusions Having practically no adverse effects, tDCS appears to be an effective correction technique with respect to higher psychic disorders for children with psychic development disorders.

스쿠버다이빙 초보자의 부력조절기 사용에 따른 공기사용량과 실패횟수 분석

스쿠버다이빙 초보자의 부력조절기 사용에 따른 공기사용량과 실패횟수 분석

Information technology for healthcare transformation

Rising costs, decreasing quality of care, diminishing productivity, and increasing complexity have all contributed to the present state of the healthcare industry. The interactions between payers (e.g., insurance companies and health plans) and providers (e.g., hospitals and laboratories) are growing and are becoming more complicated. The constant upsurge in and enhanced complexity of diagnostic and treatment information has made the clinical decision-making process more difficult. Medical transaction charges are greater than ever. Population-specific financial requirements are increasing the economic burden on the entire system. Medical insurance and identity theft frauds are on the rise. The current lack of comparative cost analytics hampers systematic efficiency. Redundant and unnecessary interventions add to medical expenditures that add no value. Contemporary payment models are antithetic to outcome-driven medicine. The rate of medical errors and mistakes is high. Slow inefficient processes and the lack of best practice support for care delivery do not create productive settings. Information technology has an important role to play in approaching these problems. This paper describes IBM Research's approach to helping address these issues, i.e., the evidence-based healthcare platform.

Biomedical journal editing: elements of success

The current pace of developments in virtually every aspect of our life and scientific innovations pose ever increasing challenges in ensuring the highest possible quality of publications, satisfying the needs of both publishers and readers. Scholarly journals are essential tools for communication between experts and for advancement of research and practice in various fields of science (1). By communicating original research data, comprehensively covering emerging scientific concepts and directions and analyzing news reports, journals are being increasingly recognized as educational tools. Relevant examples are top general medical journals, such as The Lancet, The New England Journal of Medicine, and The British Medical Journal, reflecting developments in science and educating physicians and eventually changing clinical practice worldwide. Multiple functions assigned to scholarly journals raise the issues of trustworthiness and quality of the publications. The latter is of particular importance in view of recent trends in information flow, digitalization, and acceleration of the publishing process, which may increase the rate of errors and mistakes.

Training of trainers on epinephrine autoinjector use

The majority of physicians do not know how to use epinephrine autoinjectors. This displays that current education of physicians on anaphylaxis is inadequate for a thorough practice. We hypothesize that a theoretical lecture together with a practical session on epinephrine autoinjector use will improve its proper use by physicians. Residents, specialists, and consultants from General Pediatrics excluding allergists and allergy fellows were included in this study. All physicians were given an eight-item questionnaire followed by a practical session scoring and timing ability to use epinephrine autoinjector trainer. This ensued with one-to-one hands-on training on correct autoinjector use. Finally, a joint theoretical lecture on anaphylaxis including re-demonstration of epinephrine autoinjector use was given. All physicians were scored a second time on use of epinephrine autoinjector 6 months later. One hundred fifty-one of 196 participants completed all steps of the study in four tertiary hospitals. Correct use of epinephrine autoinjector improved from 23.3% to 74.2%, mean score from 3.49 ± 1.14 to 4.66 ± 0.65, need for prospectus from 91.4% to 29.1%, and mean time to administer autoinjector from 28.01 ± 6.22 s to 19.62 ± 5.01 s (p < 0.001 for each). The rate of most common mistakes during autoinjector use decreased but the ranking did not change. An integrated theoretical and practical education increased correct of epinephrine autoinjector use by physicians. Ongoing mistakes despite this education may be related with its design.

Handwritten Character Recognition Research Based on Adaptive Minimum Distance Classifiers Integration

It is difficulty to gain completely satisfactory effect if a single classification is used to check a complicated recognition classification problem. Using the complementarities between the different classify method, integrating many classifiers, it can reduce the identification mistake and strengthen recognition robustness. Taking a offline handwritten number recognition system as an example, adopting Bayesian discriminate function based on minimal mistake rate, uniting recognition algorithm of RBF kernel function, using Bagging technology, adaptive minimum distance classifiers integration is designed in which there is minimal mistake rate. Furthermore, an offline handwritten number recognition system in high accuracy is exploited in which there is adaptive and self-learning function. It can be used for important economic fields such as financial statement and bank paper.

Variation in hormone receptor and HER-2 status between primary and metastatic breast cancer: review of the literature

Importance of the field: Hormone and human epidermal growth factor receptor 2 (HER-2) receptors are two important pharmaceutical targets that affect the survival of patients with metastatic breast cancer. Discordance of hormone and HER-2 receptors were reported in a series of studies. Receptor status was reported to change in both directions, yet alteration occurs mostly in the loss of positivity for both receptors. We do not know both the exact mechanism of this process or the contribution rate of technical mistakes; a number of mechanisms might be responsible. Factors suggested include: tumor heterogeneity, clonal selection of tumor cell subpopulations, genetic instability of tumor cells, local or systemic treatments, the time interval between primary tumor and metastasis, receptor status determination techniques, and the site of metastasis.Areas covered in this review: Studies of estrogen, progesterone and HER-2 receptor discordance between primary and metastasis of breast cancer are summarized. Laboratory evaluation of estrogen, progesterone and HER-2 receptors, and possible causes of receptor discordance, are summarized. Literature data are reviewed; the major shortcoming of these studies is that they are mostly retrospective.What the reader will gain: The reader will read a concise literature review about the studies on estrogen, progesterone and HER-2 receptor discordances between primary and metastasis of breast cancer.Take home message: We do not know whether the changes in receptor expression account for a true biological phenomenon or may result from inconsistent measurement. However, in light of current data, for the treatment plans that target the receptors, biopsy specimen from the metastatis of breast cancer must also be evaulated for alterations in the receptor status.

The Effects Of An Endurance Event On HRV And Cognitive Performance In Ironman Triathletes

PURPOSE: HRV is enhanced with long term aerobic exercise training. The intensity of the exercise impacts on HRV. Previous research is limited since only exercise bouts of up to120 minutes have been studied. Our objective was to determine the effects of an ultra duration exercise (10 - 15 hours) event on HRV and cognitive performance. METHODS: We recruited one female and 13 male competing tri-athlete (IRON; ages 33.7±7.9) and 7 control subjects (CON; 2 female and 5 males aged 42 ± 4.5).All subjects completed a Modified Stroop Task pre and post event. The individual HRV parameters, heart rate (HR), respiratory frequency (RF), reaction time (RT) and percentage of mistakes made were recorded via a Biopac MP150WSW System. Additional calculations included the peak frequencies in both the LF and HF bands. RESULTS: The IRON group had significant decrements in all HRV parameters post compared to pre event: pNN50 (20.6 ± 20.0% to 1.3 ± 1.9%, p < 0.001), RMSSD (43.8 ± 24.4 to 14.2 ± 7.3 ms, p < 0.001), SDNN (43 ± 16 to 20 ± 11 ms, p < 0.001), VLF power (276 ± 224 to 26 ± 28 ms2, p< 0.001) and HF power (270 ± 424 to 21 ± 24 ms2, p < 0.001). Post event total power (VLF + LF + HF) recovered to only a third of pre event values after 60-200 minutes, with ∼ 70% represented in the LF band (%LF 36 ± 16% to 69 ± 22%, p < 0.005). This accounted for the 6-fold increase in the LF/HF ratio in the IRON group (2 ± 1 to 12 ± 9, p <0.001) vs. only a 0.5 fold increase in the CON group. The %HF recovery at the time of testing correlated well with a decreased RF. LF peak Hz increased in the CON group (0.09 ± 0.01 to 0.10 ± 0.02 Hz), but decreased in the IRON group (0.10 ± 0.01 to 0.09 ± 0.01Hz) post event, a significant interaction (p < 0.015). There were no significant changes in the cognitive performance parameters in either of the groups. CONCLUSIONS: This study suggests that HRV parameters are significantly reduced for an undetermined period following an Ironman Triathlon. These changes may in part explain the changes in the markers of cardiac dysfunction observed in previous studies after Ironman events. Cognitive performance during the Stroop task, was unaffected by participation in this event.

Intrusion detection model for RFID system based on immune network

It is very hard to develop encryption technology used in cheap Radio Frequency Identification (RFID) tags. In this paper, intrusion detection, as a new methodology, was adopted to create security model for RFID system. By analyzing typical security attacks on RFID systems, and based on artificial immune network, a solution to extract intrusion characteristics and to identify intrusion was proposed. A self-adaptive intrusion detection model for RFID system was designed. The model can enhance the defense capabilities of RFID systems by cooperating with encryption technology, but has no need to amend the technical standards of RFID. Stimulation results prove that the mistake rate and miss rate of the model are fairly low.

Individual Sequence Prediction Using Memory-Efficient Context Trees

Context trees are a popular and effective tool for tasks such as compression, sequential prediction, and language modeling. We present an algebraic perspective of context trees for the task of individual sequence prediction. Our approach stems from a generalization of the notion of margin used for linear predictors. By exporting the concept of margin to context trees, we are able to cast the individual sequence prediction problem as the task of finding a linear separator in a Hilbert space, and to apply techniques from machine learning and online optimization to this problem. Our main contribution is a memory efficient adaptation of the perceptron algorithm for individual sequence prediction. We name our algorithm the shallow perceptron and prove a shifting mistake bound, which relates its performance with the performance of any sequence of context trees. We also prove that the shallow perceptron grows a context tree at a rate that is upper bounded by its mistake rate, which imposes an upper bound on the size of the trees grown by our algorithm.

Checklists save lives

woman had severe arthritis and she needed a new knee. Dr Atul Gawande, writer, surgeon and Associate Professor at Harvard Medical School, tells the story in the matter-of-fact tone of someone who has seen way too many examples of the error he's about describe. She was given an antibiotic and wheeled into the OR [operating room], where she was anaesthetized. The surgeon, for whom a knee replacement was a routine procedure, was about make the first incision. But then he was told stop. A mistake had been made. It wasn't life-threatening, but it would have made it impossible operate successfully and could have resulted in complications--the kind that, according the World Alliance for Patient Safety (WAPS), a World Health Organization (WHO) initiative launched in 2004, result in around seven million people disabled every year. There are roughly 234 million interventions every year--one intervention for every 25 people on the planet, says Dr Gerald Dziekan, who is WAPS safe surgery project manager in Geneva. And while there is a clear correlation between economic standing and the number of interventions per capita (for example, in the United Kingdom the ratio is one operation for every eight people) globally speaking, there are no countries without a high rate of mistakes by operating teams. Whether it's a matter of leaving a sponge inside a patient or failing ensure sterility, more than 60% of patients worldwide have one of six key safety measures missed during surgery. In the words of Gawande, who leads the work develop this initiative, what almost happened the lady with the bad knee could have happened in Amman or London. Mistakes occur partly because of developments in surgical procedure and the technology that supports it. Medicine is becoming more complex, says Dr Cyrus Engineer, a member of the WAPS team. You can have the best of technology, but if you fail calibrate an instrument that is supposed tell you the blood sugar level, you are going get a wrong result which is going send you down the wrong path. Engineer compares the situation faced by operating room teams with that confronting pilots civil and military aviation in the 1930s. answer was introduce checklists, he says, to break down complex tasks their component parts, and ensure that nothing was left out. It was a process that eventually brought about standardization within the cockpit. [ILLUSTRATION OMITTED] WAPS launched its Second Global Patient Safety Challenge, Safe Surgery Saves Lives, on 25 June in Washington and it does exactly the same thing--introducing checklists into the operating room in the hope that nothing gets forgotten. A simple one-page surgery checklist, developed in consultation with international experts in surgery, anaesthesiology, nursing and patient safety over a period of 18 months, divides surgical procedures into three phases. In the first phase, the period before anaesthesia, a designated checklist coordinator confirms basics such as the patient's identity, the type of procedure planned, and whether or not consent has been given. In the second phase, the period after anaesthesia and before surgical incision, the coordinator reviews issues such as anticipated critical events--blood loss, for example--and makes sure basics such as prophylactic antibiotics have been given within an hour before surgery. In the third phase, which occurs during or immediately after wound closure, but before removing the patient from the operating room, the coordinator checks, among other things, that all instruments are accounted for and that pathological specimens have been properly labelled. The one-page checklist is currently in its first edition, and is being field-tested in eight hospitals in developed and developing countries spread over the six WHO regions, before being disseminated as a part of a set of WHO guidelines. …

Error minimization strategy in clinical and translational studies (CTS) through the development of a data management routine (DMR)

17567 Background: Clinical studies are the basis for the decision making process in health care. So quality assurance is mandatory. In CTS, of intervention or descriptive nature, the use of spreadsheets as databases is frequent among investigators favoring mistakes during data entry, mainly due to the matricial distribution of data, urging strategies to error minimization. Creation of complex systems by informatics technologists is viable, but expensive and unnecessary for medium and small sized studies. Otherwise, there are systems that allow databases to be built by non-programmers upon training. But the customization of those tools requires knowledge on CTS. Our aim wasto ensure the quality of CTS conducted at Instituto Nacional de Cancer of Brazil (INCA) through the development of a DMR. Methods: DMR is based upon MS Word 2003, MS Access 2003 and SPSS 13.0. Content variables were defined based upon studies running at Clinical and Translational Research Division (CTRD). For its development, 8 different studies (retrospective, molecular correlation, formal clinical trials) were used. Results: We generated a DMR based upon two pillars: a) a multi-step standard operational procedure that includes meetings with the investigators and data collection training; establishment of clinical report forms supported by guidelines for its use; a pivotal pilot data collection for identification and clarification of eventual misunderstanding; a revision of 30% of the cases enrolled; b) a backbone relational database customized for each study by health professionals trained in our service with a friendly easy-to-use interface and several validation rules to reduce data entry mistakes. It stores, organizes, encodes data, filters eligibility criteria, calculates data, generates reports to investigators for proper follow-up and generates spreadsheets easily imported by SPSS for statistical analysis. Since 2004 this routine has been applied to all the studies referred to CTRD, decreasing the intra-mural historical 15% mistake rate in patient inclusion to nearly 0%. Conclusions: In a low-cost and simple manner an effective DMR has been generated, decreasing the likelihood of mistakes with great impact on the quality of the data generated in CTS at INCA. No significant financial relationships to disclose.

Finding blunders in thyroid testing: experience in newborns

We evaluated thyroxin (T4) and thyroid-stimulating hormone (TSH) data along with clinical information from 600,000 newborns. We looked for certain combinations of tests and clinical data that were questionable and possibly mistaken. Our approach suggests that certain combinations of test results, especially the presence of missing results deserved further evaluation for possible blunders. We found that missing tests were frequently the result of oversight. The laboratory used the well-known standard blood-spot-on-filter paper methods for TSH and T4. For quantitation of TSH and T4, we used the time-resolved fluoroimmunoassay available from Perkin Elmer. We found 56 babies with confirmed primary congenital hypothyroidism (PCH) in a total of 600,000 patients. We also found 18 sets of results in the same 600,000 babies that gave inconsistent findings, had missing values, and (or) possible misinterpretations of the clinical and (or) laboratory data. What is an acceptable mistake rate? All mistakes are unacceptable, but there is likely some irreducible mistake rate, and efforts to reduce the mistake or blunder rate still further may not be cost-effective. What can be done is to study the mistake rate per 600,000 babies from year to year; the mistake rate should be decreasing or not changing. This assumes a stable cohort of babies; an assumption that may be acceptable. We applied a form of pattern recognition to identify cases of possible blunders and missing values in either the laboratory or clinical data. What is clear is that we apparently identified some blunders. The 18 mistakes per 600,000 babies may be "very low" and acceptable. We recommend that seeking ever decreasing mistakes is the way to go, and the level of monitoring the data should be very intense given the serious consequences of mis-diagnosed thyroid disorders.

Causes of errors in the electrocardiographic diagnosis of atrial fibrillation by physicians

Background The emphasis of most large studies has been placed on the treatment and prevention of atrial fibrillation (AF) and its complications. Little is known about the accuracy of physicians in the electrocardiographic (ECG) diagnosis of AF and the possible causes of the diagnostic errors. Methods Over a period of 10 months, a total of 35 508 ECGs (28 356 patients) were overread in a 385-bed community hospital within 24 hours of the initial reading. Corrected ECGs were returned to the patient file. The gold standard for the final diagnosis was based on the consensus by the cardiologist readers. Results In all, 35 508 ECGs were reviewed. A total of 2809 cases of AF were studied. Incorrect diagnoses related to AF were found in 219 cases. Type I errors (overdiagnosis) occurred in 137 cases. Rhythms with irregular R-R intervals (sinus rhythm with premature atrial contractions and atrial tachycardia or flutter with variable atrioventricular conduction) were misdiagnosed as AF. The presence of low-amplitude atrial activity and/or baseline artifact significantly increased the likelihood of the erroneous diagnosis, whereas ventricular rates of 130 beats/min did not influence the rate of error. Type II errors (missed AF) occurred in 82 cases where AF was either missed or confused with atrial tachycardia/flutter. Finally, ventricular pacing significantly increased the likelihood of type II errors. Conclusions In our institution, about 900 ECGs are read each week and 5 of them carry a wrong interpretation related to AF. More attention to common sources of errors as reinforced by an ongoing quality improvement program may reduce the rate of mistakes and thus prevent serious consequences.

Exploiting alternative subcellular location for replication: Tombusvirus replication switches to the endoplasmic reticulum in the absence of peroxisomes

Plus-strand RNA virus replication takes place on distinct membranous surfaces in infected cells via the assembly of viral replicase complexes involving multiple viral and host proteins. One group of tombusviruses, such as Tomato bushy stunt virus (TBSV), replicate on the surfaces of peroxisomal membranes in plant and yeast cells. Surprisingly, previous genome-wide screen performed in yeast demonstrated that a TBSV replicon RNA replicated as efficiently in yeast defective in peroxisome biogenesis as in the wt yeast (Panavas et al., Proc Natl Acad Sci U S A, 2005). To further test how the lack of peroxisomes could affect tombusvirus replication, we used yeast cells missing either PEX3 or PEX19 genes, which are absolutely essential for peroxisome biogenesis. Confocal microscopy-based approach revealed that the wild-type tombusvirus p33 replication protein accumulated in the endoplasmic reticulum (ER) in pex3Δ or pex19Δ yeast, suggesting that tombusvirus replication could take place on the surface of ER membrane. The activities of the isolated tombusvirus replicase preparations from wt, pex3Δ or pex19Δ yeasts were comparable, demonstrating that the assembly of the replicase was as efficient in the ER as in the authentic subcellular environments. The generation/accumulation of tombusvirus recombinants was similar in wt, pex3Δ and pex19Δ yeasts, suggesting that the rate of mistakes occurring during tombusvirus replication is comparable in the presence or absence of peroxisomes. Overall, this work demonstrates that a tombusvirus, relying on the wt replication proteins, can efficiently replicate on an alternative intracellular membrane. This suggests that RNA viruses might have remarkable flexibility for using various host membranes for their replication.

Patterns of driver stress and coping strategies in a Greek sample and their relationship to aberrant behaviors and traffic accidents

This paper presents an investigation into the relationship between driver stress, coping strategies and aberrant driving of a Greek sample of company employees ( N = 714). The results supported the main factor structures of the Driver Behavior Inventory (Matthews, G., Tsuda, A., Xin, G., Ozeki, Y., 1999. Individual differences in driver stress vulnerability in a Japanese sample. Ergonomics 42, 401–415) and Driver Behavior Questionnaire (Kontogiannis, T., Kossiavelou, Z., Marmaras, N., 2002. Self-reports of aberrant behavior on the roads: errors and violations in a sample of Greek drivers. Accident Anal. Prev. 34, 391–399). An inventory of coping strategies was also examined in terms of self reports. Confrontive coping was characteristic of drivers high on aggression who also had higher rates of mistakes and violations. Coping in terms of self-criticism was exhibited by drivers high on dislike of driving (i.e., anxiety) who reported a higher incidence of mistakes. Task-focus coping was characteristic of alertness and had a weak correlation with confidence. Drivers high in confidence reported fewer mistakes and violations which, in association with low perception of risk, was a particularly worrying aspect of driving. A contextual model of accident involvement was tested with LISREL in which violations yielded a direct effect whilst aggression yielded an indirect effect mediated by violations. Alertness and confidence were both related to safety orientation but failed to predict accident rates and speeding convictions.

Kolorektales Karzinom: Histopathologische Fehler - Welche Bedeutung haben sie für die Stadieneinteilung und Therapie?

There is a variety of mistake sources of histopathological workup of biopsies and resection specimen. Among those are the incorrect or missing transmission of clinical findings and data. The most critical opportunities for producing mistakes are the histopathological examination, diagnosis and classifications. Many of these mistakes bear the potential to induce a wrong therapy. Generally, the use of forms, check lists and standardized diagnosis sheets may help to reduce the mistake rates. Comparison of own data with quality indicators enables pathologists to validate their own findings.