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A medication administration error will be considered to be any deviation in the administration of an intravenous infusion from a doctor's written medication order, the hospital's intravenous policy and guidelines, or the manufacturer's instructions. This will be taken to include the administration of medication to which the patient had a documented allergy or sensitivity; other aspects of the clinical appropriateness of the medication order and its administration will not be assessed. We will also collect data on other procedural or documentation discrepancies which do not meet the definition of a medication administration error but which may increase the likelihood of administration errors occurring. These will include patients not wearing an identification wristband with the correct information, tubing not being tagged and labelled in accordance with local policy, and failure to document the administration of the medication in line with hospital policy. Definitions of error and discrepancy types are given in table 2 .

View this table:
Table2

Definitions of error and discrepancy types

Point prevalence study

At each study site, these data will be collected by two clinicians who are employees of the participating site, usually a nurse and a pharmacist or experienced pharmacy technician, following training by the research team. The training will include the study protocol, data collection and documentation procedures.

Data will be collected on 1 day or an equivalent period in each clinical area. On selected observation days, the local data collectors will move systematically around each ward, gathering data from each patient with an infusion running. The aim will be to gather data from every infusion that is being administered at that time. Wards will be selected with the aim of gathering data from 30 to 40 infusions from each clinical area in each hospital. The data collectors will compare the medication being administered against the patient's prescribed medication and relevant medication administration records to identify any discrepancies. This will include a comparison of the medication or fluid name, the concentration and rate of infusion. Relevant data such as patient allergies, pump type and any procedural or documentation errors will also be recorded. Where it appears that one discrepancy has been introduced to compensate for another discrepancy, data gatherers are being trained to note this. Data collectors are also expected to have familiarised themselves with their hospital's policies and to check guidelines and manufacturers’ instructions for themselves when in doubt. The two observers will work together, each checking the data collected with the other and agreeing whether or not any medication administration error or other discrepancy has been identified. Multiple errors and discrepancies may be identified for a single infusion.

Contextual interviews

Once data from the point prevalence study have been analysed, we will liaise with key staff in participating hospitals to share our findings and explore potential explanatory factors behind those findings (eg, nursing practices, equipment, policies and processes, staff management, training and competency assessment). This will involve a two-way dialogue with relevant members of staff including ward managers, senior nursing staff, patient safety specialists, medical electronics personnel, trainers, those with responsibility for procurement, and senior managers. We will invite a purposive sample of these staff (typically 3–5 per hospital) to participate in individual or group semistructured qualitative interviews, aiming for maximum variation in staff roles and responsibilities. The interview will focus on the participant's views of local policy and practice, what works well and less well, and what changes are under consideration. They will be used to clarify any queries from the observational data and will focus primarily on normal practice rather than extreme events. If there appear to be inconsistencies between the ways that data gathering has been done across sites (despite consistent training), this will also be explored during interviews and data will be adjusted if deemed necessary to improve consistency across sites. Subject to participants giving consent, interviews will be recorded and professionally transcribed.

Data will be either recorded on a standardised paper form ( figure 1 ) and subsequently uploaded to a secure web-based REDCap data collection tool 21 or entered directly into REDCap, depending on which better fits local practices. No patient-identifiable data will be entered. The data collection forms and online database have been adapted from that used in the USA and piloted to ensure they are applicable and relevant in the UK hospital context. Each site will be able to access their own data, while the central research team will be able to access data across all sites.

HIV did not enter and integrate into the host
Figure 3
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Viral-entry analysis on Ect1 cells. HOS.CD4.R5 HOS.CD4.X4 or Ect1 cell monolayers were exposed to 50 ng/mL p24 (or p27 for SIV) of luciferase reporter virus overnight in 300 μL of culture medium containing 1 ng/mL polybrene. The culture was then replaced with 1 mL of fresh medium and was cultured for up to 7 days. Luciferase activity was measured in 100-μL cell lysates by use of commercial reagents. Each data point represents mean of duplicate wells. Viral replication was inhibited by zidovudine (AZT) at 1 μmol/L 10 μmol/L or no-AZT control Polymerase chain reaction amplification of proviral DNA. Cells were exposed to 100 ng/mL p24 of RF virus, and total genomic DNA was isolated 6 days after infection. Human immunodeficiency virus (HIV) sequence was amplified by use of primer pairs SK38/39, was analyzed on 1% agarose gel electrophoresis, and was detected by ethidium bromide staining. DNA marker; infected H9 cells; uninfected H9 cells; infected Ect1 cells; and uninfected Ect1 cells. A-MuLV, amphotropic murine leukeamic virus envelope. Relative light units of ∼100 were considered as background noise

Figure 3
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Viral-entry analysis on Ect1 cells. HOS.CD4.R5 HOS.CD4.X4 or Ect1 cell monolayers were exposed to 50 ng/mL p24 (or p27 for SIV) of luciferase reporter virus overnight in 300 μL of culture medium containing 1 ng/mL polybrene. The culture was then replaced with 1 mL of fresh medium and was cultured for up to 7 days. Luciferase activity was measured in 100-μL cell lysates by use of commercial reagents. Each data point represents mean of duplicate wells. Viral replication was inhibited by zidovudine (AZT) at 1 μmol/L 10 μmol/L or no-AZT control Polymerase chain reaction amplification of proviral DNA. Cells were exposed to 100 ng/mL p24 of RF virus, and total genomic DNA was isolated 6 days after infection. Human immunodeficiency virus (HIV) sequence was amplified by use of primer pairs SK38/39, was analyzed on 1% agarose gel electrophoresis, and was detected by ethidium bromide staining. DNA marker; infected H9 cells; uninfected H9 cells; infected Ect1 cells; and uninfected Ect1 cells. A-MuLV, amphotropic murine leukeamic virus envelope. Relative light units of ∼100 were considered as background noise

PCR analysis of total cellular DNA purified from HIV-exposed Ect1 cells also failed to detect proviral DNA. The primer pairs used were SK38/39 derived from a highly conserved gag sequence and amplify a 115-bp sequence in the HIV-1 gag region. A similar fragment was detected in the HIV-1–infected H9 cells but was absent from uninfected H9 and Ect1 cells. The result was consistent with that of the pseudovirus study and confirmed that HIV did not integrate into the Ect1 genome

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To Feinstein's/54 Below

February 20, 2017

This President’s Day, come crack the glass ceiling with Feinstein’s/54 Below as we present an all-female cast singing Sherman Edward’s seminal piece, 1776 . Enjoy this contemporary take on one of Broadway’s beloved classics, performed by some of New York’s finest leading ladies. America’s birth has never felt so fresh, or so feminine.The concert will serve as a benefit for DC based non-profitRunning Start, which grew out of the Women Under Forty Political Action Committee (WUFPAC), and financially supports young women running for office. For more information or to supportRunning Start, visit them at www. Clearance Footlocker DESIGN Ultimate Tanning Micro Triangle Bikini Top Black Asos Big Discount For Sale Discount Cheapest Price New Lower Prices Cgqvh0Qglc
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Carolee Carmello ( Tuck Everlasting , Finding Neverland ) as John Adams Rema Webb ( The Color Purple , Violet ) as Abigail Adams Arielle Jacobs ( Aladdin , Wicked ) as Martha Jefferson Britney Coleman ( Sunset Boulevard, Beautiful ) as Thomas Jefferson Krystina Alabado ( American Psycho ) as the Courier Bonnie Milligan ( Gigantic , Kinky Boots ) as Richard Henry Lee Andréa Burns ( On Your Feet , In the Heights ) as Edward Rutledge Kate Rockwell ( If/Then, Wicked ) as John Dickinson Mary Testa ( First Daughter Suite, Xanadu ) as Benjamin Franklin

Carolee Carmello John Adams Rema Webb Abigail Adams Arielle Jacobs Martha Jefferson Britney Coleman Thomas Jefferson Krystina Alabado Courier Bonnie Milligan Richard Henry Lee Andréa Burns Edward Rutledge John Dickinson Mary Testa Benjamin Franklin

Also Featuring:

Amy Jo Jackson ( Dani Girl ) as John Hancock Bre Jackson ( The Color Purple ) as Robert Livingston Allison Posner as Dr. Lyman Hall Amanda Savan as James Wilson Sharone Sayegh ( The Band’s Visit ) as Roger Sherman AngelaTravino as Charles Thomson

Annual Disability Statistics Compendium

Funding for this project is made possible by:

The StatsRRTC is funded by the Department of Health and Human Services, Administration for Community Living, NIDILRR – Rehabilitation Research and Training Centers (RRTCs) Program under grant number 90RT5022-02-00, from 2013 - 2018.

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