ObjectiveTo evaluate the prevalence, type and severity of prescribing errors observed between grades of prescriber, ward area, admission or discharge and type of medication prescribed.DesignWard-based clinical pharmacists prospectively documented prescribing errors at the point of clinically checking admission or discharge prescriptions. Error categories and severities were assigned at the point of data collection, and verified independently by the study team.SettingProspective study of nine diverse National Health Service hospitals in North West England, including teaching hospitals, district hospitals and specialist services for paediatrics, women and mental health.ResultsOf 4238 prescriptions evaluated, one or more error was observed in 1857 (43.8%) prescriptions, with a total of 3011 errors observed. Of these, 1264 (41.9%) were minor, 1629 (54.1%) were significant, 109 (3.6%) were serious and 9 (0.30%) were potentially life threatening. The majority of errors considered to be potentially lethal (n=9) were dosing errors (n=8), mostly relating to overdose (n=7). The rate of error was not significantly different between newly qualified doctors compared with junior, middle grade or senior doctors. Multivariable analyses revealed the strongest predictor of error was the number of items on a prescription (risk of error increased 14% for each additional item). We observed a high rate of error from medication omission, particularly among patients admitted acutely into hospital. Electronic prescribing systems could potentially have prevented up to a quarter of (but not all) errors.ConclusionsIn contrast to other studies, prescriber experience did not impact on overall error rate (although there were qualitative differences in error category). Given that multiple drug therapies are now the norm for many medical conditions, health systems should introduce and retain safeguards which detect and prevent error, in addition to continuing training and education, and migration to electronic prescribing systems.

heumatic heart disease (RHD) is prevalent among young people in many sites of social disadvantage globally, with one location being Aboriginal towns and communities in northern Australia. RHD is a complex condition requiring good health communication to enable families to build effective health literacy for their situation. 1 Schools are a logical entry point for health communication about acute rheumatic fever (ARF) and RHD because the population most at risk of ARF -the precursor to RHD -is school-aged children. 2,3 Yet just how to approach health communication and what methods are most effective remain unclear. 4 For Aboriginal families, explanations about RHD are often provided in English by healthcare providers with high levels of western education and health training structured around biomedical ways of thinking. Uncritical use of the biomedical lens when teaching about RHD, even if simplified, can impede health communication so that messages are not understood by Aboriginal people as intended. 5 This is especially so where there is significant language and cultural difference between healthcare providers and clientele. 6,7 In the context of post-colonisation, disempowering health communication may deepen a sense of subjugation or invoke passivity. 8 Empowering pedagogies are urgently needed for RHD because it significantly impacts school-aged children's quality of life and life expectancy, while being largely preventable. 9

This paper explores how emotions are expressed in the endangered Gunwinyguan language Kunbarlang and compares these expressions to those in the neighbouring Gunwinyguan language Bininj Kunwok, and neighbouring languages from other language families, Mawng (Iwaidjan) and Ndjébbana (Maningridan). As well as considering body-based emotion expressions and the tropes (metaphors and metonymies) they instantiate, we consider the range of other (non-body-based) expressions and tropes available in each language. These provide an important point of comparison with the body-part expressions, which are limited to expressions based on noun incorporation in the Gunwinyguan languages and, correspondingly, a more limited range of tropes. By outlining and comparing the linguistic tropes used to express emotions in these four languages in the highly multilingual yet socioculturally unified context of western Arnhem Land, we aim to shed further light on the relationships between linguistic figurative features and conceptual representations of emotions.

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