This paper describes the largest retrospective study of hospital falls incidents and draws on data from almost 500 institutions of varying types. It describes wide variations in falls recording and reporting, and in recorded falls rates between institutions of different types and between institutions of ostensibly similar case-mix. As falls are the commonest reported patient safety incident, there is a pressing need for improvements in local reporting, recording and focused analysis of incident data, and for these data to be used at local and national level better to inform and target falls prevention, as well as to explore the reasons for large apparent differences in falls rates between institutions.

Primary Biliary Cirrhosis (PBC) is very closely associated with the presence of antimitochondrial antibodies (AMA); indeed, the presence of these antibodies is virtually disease specific. Despite the major advances made during the last decade in identifying the antigens with which these antibodies react, the reason for the close association remains uncertain. In this review, we examine the clinical correlates of AMA with features of PBC and discuss the possible implications of the association. CLINICAL CORRELATES Epidemiology of PBCThere is geographical variation in the prevalence of PBC, being highest in areas such as the north of England and parts of North America but rare in Africa and the Indian subcontinent. 1 Studies from the north of England suggest that the incidence of PBC is increasing. Clustering of cases is well described. 2 PBC may occur in families, and up to 4% of first-degree relatives may have PBC. Where PBC does occur in families, it may be related to maternally inherited factors and tends to present earlier in the second generation. 3 AMA Are Detectable Before the Clinical and Histological Features of PBCOf 29 asymptomatic patients who were found to have AMA in serum (later confirmed to be reactive with E2 components of pyruvate dehydrogenase) but with normal liver tests only two had normal liver histology. 4 A decade later, 76% had developed symptoms of PBC and 83% had cholestatic liver tests. None had progressed to cirrhosis. 5

We study the temperature dependence of discretization errors in nuclear lattice simulations. We find that for systems with strong attractive interactions the predominant error arises from the breaking of Galilean invariance. We propose a local "well-tempered" lattice action which eliminates much of this error. The well-tempered action can be readily implemented in lattice simulations for nuclear systems as well as cold atomic Fermi systems.Comment: 33 pages, 17 figure

We present the results of calculations analyzing nucleon Compton scattering to lowest order using perturbative QCD (pQCD) methods. Two scenarios are considered: (1) the incoming photon is real; and (2) the incoming photon is virtual. The case of a real photon has been previously analyzed at least 5 times using pQCD, but no two results are in agreement. Here it is shown that our result agrees with that of Brooks and Dixon published in 2000. The case of a virtual photon has been previously analyzed only once using pQCD. However, doubt has been cast on the validity of that result. The results presented here for virtual photon are believed to be more reliable. Some consideration is given of how to compare these results with experiment. Following the lead of Brooks and Dixon, for the proton, this involves normalizing the cross section using the Dirac proton form factor, which we also calculate. Finally, there is a comparison of our results with recent experiments.

Early identification of clinical deterioration in hospitalised patients is important to prevent subsequent cardiopulmonary arrest and reduce mortality. Understanding where and why the care process fails, resulting in the inability to recognise patient deterioration, can help healthcare staff and organisations to prioritise and improve patient safety. This article is based on interagency work undertaken by the National Patient Safety Agency and guidelines produced by the National Institute for Health and Clinical Excellence.