Life below water and the fate of humanity: with special reference to the efforts by adidas towards reducing the effects of plastic waste on the marine life.

Marine Pollution is all the human waste in terms of chemicals, unwanted substances, non-biodegradable waste such as plastic that is thrown into the Earth’s water. The origin of the marine pollution is varied human activity that takes place on land. Wherein industrialization on one has shown immense growth in the life of human beings on this planet, taking them to the era being ruled by artificial intelligence, this rapid and unprecedented growth has also lead to the demolish of the treasures of our oceans and water bodies. The Pacific Ocean has a plastic “garbage patch” of approximately 6, 20,000 sq miles. The plastic pollution, notedly, is the most harmful of the other pollution sources as it directly affects the life of corals through fibres, poisoning and trapping of sea animals in nets, wires etc. In 1972, London Convention was the first international agreement on protecting the oceans and the oceanic life. The 2006 London Protocol bans all the hazardous waste from being disposed in the sea. Companies like Adidas have started finding solutions to control, if not yet eliminate, hazardous human actions. Keywords: marine life, pollution, human actions, water bodies

Patient Safety in a First-Level Hospital in Colombia, According to London Protocol

The objective of this study is to identify the adherence of the health personnel of the state social enterprise Norte 2 institution, Caloto, Department of Cauca, Colombia, in the application of the London protocol, referring to patient safety policy, where a quantitative investigation was conducted; observational, descriptive through a census of 92 officials of the institution through a survey designed to measure adherence to protocol, all information was tabulated in the Epi-info 7.2 program and presented by descriptive statistics; the results of this study showed that the population is composed of 60% of female nursing assistants who are more than 1-year old and that the protocol is partially met, where it was found that only 52% of adverse events are reported, concluding that there is no defined patient safety culture, which means that adverse events are not documented.

Establishment of the Greek state (1830)

At the beginning of the 19th century, under the influence of the French bourgeois revolution and nationalist ideas, the Greeks revolted to secede from the Ottoman Empire and gain independence. It was no coincidence that the main members of the Filiki Etheriya Society, which led the uprising, as well as its secret leaders were Greeks who served the Russian government. Russia, which wanted to break up the Ottoman Empire and gain a foothold in the seas, had been embroiled in various conflicts with the Austrian alliance since the 18th century, before the uprising. Russia, which managed to isolate the Ottoman Empire from the West through the Greek uprising, also acquired large tracts of land through the Edirne Peace Treaty, which was signed as a result of the Russo-Turkish War. However, although Britain, France, Austria, and Prussia agreed with Russia on granting autonomy to Greece, they did not intend to transfer control of the newly formed state to Russia. The revolt of the Greeks against the Ottoman Empire in 1821-1830 resulted in the victory of the Greeks. The revolt was organized and intensified with the help of great powers. The article discusses Greece's independence as a result of the uprising. In this regard, the London Protocol of April 3, 1830, signed by Russia, France and England, is of special importance. The newly established Greek state was revived as the Aegean state. Greece's borders have become clearer. The article also deals with the redefinition of the Ottoman-Greek borders by the Treaty of Constantinople of 1832. Although the London Protocol of 1830 formally established the Greek state, the Great Powers and the Greeks were not content with that. Russia, as during the uprising, remained a state that influenced the "Eastern policy" of European states after the uprising. This study was dedicated to all these factors.

Investigation of Surgical Site Infection Outbreak Among Neurosurgical Patients

Background: The infection control service of a private hospital in Belo Horizonte, Brazil, performs continuous surveillance of surgical patients according to the CDC NHSN protocols. In a routine analysis of the neurosurgical service, we identified a subtle increase in the incidence of surgical site infection (SSI): in 5 months (June–October 2018), 6 patients developed an SSI. From January 2017 until May 2018, there were no cases of infection in neurosurgery, which led us to suspect an outbreak. Methods: A cohort study was used to investigate the factors associated with risk of SSI. We investigated the following variables: ASA score, number of hospital admissions, age, preoperative hospital length of stay, duration of surgery, wound class, general anesthesia, emergency, trauma, prosthesis, surgical procedures, surgeon. Furthermore, 9 key steps were followed to investigate the outbreak: case definition (step 1), search for new SSI cases (step 2); confirmation of the outbreak (step 3); analysis of SSI cases by London Protocol (step 4); analysis of the cohort data (step 5); inspections in the surgical ward (step 6); qualitative and quantitative reports sent to the neurosurgical departments (step 7); continuing with active surveillance (stage 8); announcement of research findings (step 9). Results: The outbreak was confirmed: SSI incidence in the pre-epidemic period (January–May 2018) was 0 of 218 (0%); in the epidemic period (June–October 2018), SSI incidence was 6 of 94 (6.4%) (P < .001). We identified 3 SSI etiologic agents: 2 Klebsiella pneumoniae, 2 S. aureus, and 1 Serratia marcescens. It was unlikely that there was a common source for the outbreak. We identified the following risk factors: second or third hospital admissions (RR, 3.7; P = .041), and preoperative hospital length of stay: SSI patients (4.3±5.7 days) versus control patients (0.7 ± 2.1 days) (P = .048). None of the surgeons presented an SSI rate significantly different from each other. We used the London protocol to identify antibiotic prophylaxis failures in most cases. Conclusions: New cases of infections can be prevented if the length of preoperative hospital stay becomes as short as possible and, most importantly, if antibiotic prophylaxis does not fail.Funding: NoneDisclosures: None

The National Health Service’s ‘special measures’: Cambridge – A case study

The United Kingdom’s (UK) National Health Service (NHS) has a procedure, ‘special measures’, which is used to implement changes to a Trust when there are concerns about the quality of care being delivered. This case study uses the London Protocol to analyse how a plethora of factors contributed to an ‘inadequate’ rating and the subsequent initiation of the special measures procedure at Cambridge University Hospitals (CUH) in September 2015. External factors such as legal and political reform have a strong influence on healthcare as well as the substantial internal forces within the state-led NHS including finance, culture and management. Factors specific to CUH also had a significant role to play: the early adoption of a complete digital record system, costing over £200 m, adversely affected CUH Trust at this time and was implicated as a major factor in its inadequate performance. In addition, the Care Quality Commission (CQC) identified many other important shortcomings at CUH. The London Protocol is used to bring clarity and structure to the complexities of the Health Services Industry, both within and surrounding CUH during this period.

Foundation year one and year two doctors’ prescribing errors: a comparison of their causes

ObjectiveJunior doctors have the highest rates of prescribing errors, yet no study has set out to understand the differences between completely novice prescribers (Foundation year one (FY1) doctors) and those who have gained some experience (Foundation year two (FY2) doctors). The objective of this study was to uncover the causes of prescribing errors made by FY2 doctors and compare them with previously collected data of the causes of errors made by FY1 doctors.DesignQualitative interviews, using the critical incident technique, conducted with 19 FY2 doctors on the causes of their prescribing errors and compared with interviews previously conducted with 30 FY1 doctors. Data were analysed using a constant comparison approach after categorisation of the data using Reason’s model of accident causation and the London protocol.ResultsCommon contributory factors in both FY1 and FY2 doctors’ prescribing errors included working on call, tiredness and complex patients. Yet, important differences were revealed in terms of application of prescribing knowledge, with FY1 doctors lacking knowledge and FY2 misplacing their knowledge. Due to the rotation of foundation doctors, both groups are faced with novel prescribing contexts, yet the previous experience that FY2 doctors gained led to misplaced confidence when caution would have been expedient.ConclusionsDifferences in the contributory factors of prescribing errors should be taken into account when designing interventions to improve the prescribing of foundation doctors. Furthermore, careful consideration should be taken when inferring expertise in FY2 doctors, who are likely to prescribe in contexts in which their experience is little different to an FY1 doctor.

Implementing the London Dumping Convention in East Asia

In 1972, the Convention on the Prevention of Marine Pollution by Dumping of Wastes and Other Matter (London Convention) was negotiated. It is a global treaty, for the first time, to regulate dumping of waste at sea worldwide. Following this global endeavor, the Protocol to the London Convention (London Protocol) was later agreed to further modernize the London Convention so as to reinforce the management of dumping of waste at sea. While in East Asia, only China, Japan, the Republic of Korea (South Korea) and the Philippines have acceded to the Convention and its Protocol, other countries do not show their willingness to sign them. Against this background, this article will address the responses of these East Asian states to the implementation of the London Convention, and analyze and assess their relevant laws and regulations with particular reference to China’s practice. In addition, it will focus on new challenges, such as offshore carbon storage, to the London Convention.

Morbidity and mortality meetings at Australian major trauma centres: A proof of concept study

Background Morbidity and mortality meetings are held at all Australian major trauma centres and provide a forum to identify problems and improve practices. Meetings should focus on addressing factors in the system to prevent similar errors occurring, rather than individual culpability. This paper describes current meeting practices and assesses the use of a systems approach. Methods This proof of concept study used a convenience sample of four Australian major trauma centres. Trauma leaders at each centre were surveyed regarding morbidity and mortality meeting practices. The use of a systems approach was measured by assessing practices against the London Protocol for Systems Analysis of Clinical Incidents. Meeting participants were also surveyed regarding perceptions of the objectives and effectiveness of meetings. Results This study found variable utilisation of a systems approach. Cases are not routinely analysed for contributing system factors and effective processes are not always used to correct problems that are identified. Meeting practices also vary between centres in terms of frequency, case selection criteria and use of audit filters. Participants generally view quality improvement as the most important objective of meetings. Conclusion Morbidity and mortality meeting practices vary between Australian major trauma centres and a systems approach has not been fully adopted.