State Medical Boards (SMBs) can take severe disciplinary actions (e.g., license revocation or suspension) against physicians who commit egregious wrongdoing in order to protect the public. However, there is noteworthy variability in the extent to which SMBs impose severe disciplinary action. In this manuscript, we present and synthesize a subset of 11 recommendations based on findings from our team’s larger consensus-building project that identified a list of 56 policies and legal provisions SMBs can use to better protect patients from egregious wrongdoing by physicians.

Buffelgrass [Pennisetum ciliare (L.) Link] is an invasive C4 perennial bunchgrass that is a threat to biodiversity in aridlands in the Americas and Australia. Topography influences P. ciliare occurrence at large spatial scales, but further investigation into the relationship between local-scale topography and P. ciliare growth and reproduction would be beneficial. Further, density-dependent effects on P. ciliare growth and reproduction have been demonstrated in greenhouse experiments, but the extent to which density dependence influences P. ciliare in natural populations warrants further investigation. Here we present a study on the relationships between local-scale topography (aspect and slope gradient) and vegetation characteristics (shrub cover, P. ciliare cover, and P. ciliare density) and their interactions on individual P. ciliare plant size and reproduction. We measured slope gradient, aspect, shrub cover, P. ciliare cover, P. ciliare density, and the total number of live culms and reproductive culms of 10 P. ciliare plants in 33 4 by 4 m plots located in 11 transects at the Desert Laboratory at Tumamoc Hill, Tucson, AZ, USA. We modeled the relationships at the local scale of (1) P. ciliare cover and density with aspect and slope gradient and (2) P. ciliare size and reproduction with abiotic (slope gradient and aspect) and biotic (P. ciliare cover and density and native shrub and cacti cover) characteristics. Aspect and slope gradient were poor predictors of P. ciliare cover and density in already invaded sites at the scale of our plots. However, aspect had a significant relationship with P. ciliare plant size and reproduction. Pennisetum ciliare plants on south-facing aspects were larger and produced more reproductive culms than plants on other aspects. Further, we found no relationship between P. ciliare density and P. ciliare plant size and reproduction. Shrub cover was positively correlated with P. ciliare reproduction. South-facing aspects are likely most vulnerable to fast spread and infilling by new P. ciliare introductions.

The history of London has long been entwined with expansions of financial capital and the machinations of global plutocrats and their more proximate counterparts.1 However, what has happened in the decade since the global financial crisis is without precedent. London has been transformed into a city for global capital rather than one designed to meet the needs and aspirations of the majority of its denizens.2

Low energy and protein intakes have been associated with an increased risk of malnutrition in outpatients with chronic obstructive pulmonary disease (COPD). We aimed to assess the energy and protein intakes of hospitalised COPD patients according to nutritional risk status and requirements, and the relative contribution from meals, snacks, drinks and oral nutritional supplements (ONS), and to examine whether either energy or protein intake predicts outcomes. Subjects were COPD patients (n 99) admitted to Landspitali University Hospital in 1 year (March 2015–March 2016). Patients were screened for nutritional risk using a validated screening tool, and energy and protein intake for 3 d, 1–5 d after admission to the hospital, was estimated using a validated plate diagram sheet. The percentage of patients reaching energy and protein intake ≥75 % of requirements was on average 59 and 37 %, respectively. Malnourished patients consumed less at mealtimes and more from ONS than lower-risk patients, resulting in no difference in total energy and protein intakes between groups. No clear associations between energy or protein intake and outcomes were found, although the association between energy intake, as percentage of requirement, and mortality at 12 months of follow-up was of borderline significance (OR 0·12; 95 % CI 0·01, 1·15; P=0·066). Energy and protein intakes during hospitalisation in the study population failed to meet requirements. Further studies are needed on how to increase energy and protein intakes during hospitalisation and after discharge and to assess whether higher intake in relation to requirement of hospitalised COPD patients results in better outcomes.

Why did the Ghanaian state go to such extraordinary lengths to facilitate the reliable broadcast of the World Cup in 2014? During a period of frequent power outages, Ghana swapped power with regional neighbours and directed major domestic industries to reduce production in order to allow Ghanaians to watch their national soccer team compete in the World Cup. This paper investigates the politics of the public service provision of electricity in Ghana. We focus on the short-term crisis during the 2014 World Cup to reveal the citizens' and politicians' expectations about electricity as a public good. Drawing on an analysis of archival documents, Ghanaian newspapers, and interviews with government, business, and NGO officials in the energy sector, we argue that the Ghanaian state historically has created the expectation of electricity as a right of national citizenship and explore how this intersects with competitive party politics today.

The aim of this review paper is to consider how the principles of clinical audit could be applied to the development of an audit of nutritional care in hospitals and care homes, based on criteria derived from the Essence of Care: Food and Drink. A literature review identified fifteen key papers that included guidance or standards for nutritional care in hospitals or care homes. These were used to supplement the ten factors suggested by the Essence of Care to develop a set of potential audit criteria covering all aspects of the nutritional care pathway including the identification of risk of malnutrition, implementation of nutritional care plans, referral to healthcare professionals for further nutritional assessment and nutritional support strategies. A series of audit tools have been developed, including an organisational level audit tool, a staff questionnaire, a patients' and residents' records audit tool and a patients' and residents' experiences questionnaire. Further issues to consider in designing a national nutritional audit include the potential role of direct observation of care, the use of trained auditors and the scope for including the results of pre-existing local audits. In conclusion, a national audit would need to encompass a very large number of health and care organisations of widely varying sizes and types and a diverse range of people.