Errors associated with preparation of adult and paediatric parenteral nutrition in UK hospital pharmacies

Rationale: In UK hospitals, the preparation of all total parenteral nutrition (TPN) products must be made in the pharmacy as TPNs are categorised as high-risk injectables (NPSA/2007/20). The National Aseptic Error Reporting Scheme has been collecting data on pharmacy compounding errors in the UK since August 2003. This study reports on types of error associated with the preparation of TPNs, including the stage at which these were identified and potential and actual patient outcomes. Methods: Reports of compounding errors for the period 1/2004 - 3/2007 were analysed on an Excel spreadsheet. Results: Of a total of 3691 compounding error reports, 674 (18%) related to TPN products; 548 adult vs. 126 paediatric. A significantly higher proportion of adult TPNs (28% vs. 13% paediatric) were associated with labelling errors and a significantly higher proportion of paediatric TPNs (25% vs. 15% adult) were associated with incorrect transcriptions (Chi-Square Test; p<0.005). Labelling errors were identified equally by pharmacists (42%) and technicians (48%) with technicians detecting mainly at first check and pharmacists at final check. Transcription errors were identified mainly by technicians (65% vs. 27% pharmacist) at first check. Incorrect drug selection (13%) and calculation errors (9%) were associated with adult and paediatric TPN preparations in the same ratio. One paediatric TPN error detected at first check was considered potentially catastrophic; 31 (5%) errors were considered of major and 38 (6%) of moderate potential consequence. Five errors (2 moderate, 1 minor) were identified during or after administration. Conclusions: While recent UK patient safety initiatives are aimed at improving the safety of injectable medicines in clinical areas, the current study highlights safety problems that exist within pharmacy production units. This could be used in the creation of an error management tool for TPN compounding processes within hospital pharmacies.

Religious and spiritual identity and citizenship education in the UK

If education is to be about ‘human flourishing’ (De Ruyter, 2004) as well as preparation for adulthood and work, then religious and citizenship education would seem to have a key contribution towards this goal, both offering opportunities for the exploration and development of a robust sense of identity. However, despite the opposition of most religious educators, religious education has been treated by successive UK governments simply as a form of inculcation into a homogenous notion of citizenship based on nominal church attendance. Moreover, the teaching of the relatively new subject of citizenship education, whilst recognising that the sense of identity and allegiance is complex, has not regularly included faith perspectives. I argue that the concept of ‘spiritual development’, which centres on an existential sense of identity, offers a justification for combining lessons in both religious and citizenship education. I conclude on a cautionary note, arguing that pupils need to be given a critical awareness of ways in which such identities can be provided for them by default, particularly since consumer culture increasingly makes use of ‘spiritual’ language and imagery.

Differential effects of thyroid hormone manipulation and ß adrenoceptor agonist administration on uncoupling protein mRNA abundance in adipose tissue and thermoregulation in neonatal pigs

We have shown that there is significant disparity in the expression of uncoupling proteins (UCP) 2 and 3 between modern-commercial and ancient-Meishan porcine genotypes, commercial pigs also have higher plasma triiodothyronine (T(3)) in on the first day of life. T(3) and the sympathetic nervous system are both known to regulate UCPs in rodents and humans; their role in regulating these proteins in the pig is unknown. This study examined whether thyroid hormone manipulation or administration of a selective beta3 adrenoceptor agonist (ZD) influenced plasma hormones, colonic temperature and UCP expression in adipose tissue of two breeds of pig. To mimic the differences observed in thyroid hormone status, piglets from Meishan and commercial litters were randomly assigned to control (1 ml/kg water), T(3) (10 mg/kg) (Meishan only), methimazole (a commonly used antithyroid drug) (50 mg/kg) (commercial only) or ZD (10 mg/kg) oral administration for the first 4 days of postnatal life. Adipose tissue UCP2/3 mRNA abundance was measured on day 4 using PCR. T(3) administration raised plasma T(3) concentrations and increased colonic temperature on day 4. UCP3 mRNA abundance was higher in Meishan, than commercial piglets (p = 0.042) and was downregulated following T(3) administration (p = 0.014). Irrespective of genotype, ZD increased UCP2 mRNA abundance (Meishan p = 0.05, commercial p = 0.03). Expression of neither UCP2 nor 3 was related to colonic temperature, regardless of treatment. In conclusion, we have demonstrated a dissociation between thyroid hormones and the sympathetic nervous system in the regulation of UCPs in porcine adipose tissue. We have also suggested that expression of adipose tissue UCP2 and 3 are not related to body temperature in piglets.

Comparative and international education: policy transfer, context sensitivity and professional development

This paper examines the intellectual and professional contribution of comparative and international studies to the field of education. It explores the nature of the challenges that are currently being faced, and assesses its potential for the advancement of future teaching, research and professional development. Attention is paid to the place of comparative and international education (CIE)-past and present-in teacher education, in postgraduate studies, and in the realms of policy and practice, theory and research. Consideration is first given to the nature and history of CIE, to its initial contributions to the field of education in the UK, and to its chief mechanisms and sites of production. Influential methodological and theoretical developments are examined, followed by an exploration of emergent questions, controversies and dilemmas that could benefit from sustained comparative analysis in the future. Conclusions consider implications for the place of CIE in the future of educational studies as a whole; for relations between and beyond the 'disciplines of education'; and for the development of sustainable research capacity in this field.

Modelling: promoting creativity whilst forging links between science education and design and technology education

Educational reforms in many countries currently call for the development of knowledge-based societies. In particular, emphasis is placed on the promotion of creativity, especially in the areas of science education and of design and technology education. In this paper, perceptions of the nature of creativity and of the conditions for its realization are discussed. The notion of modelling as a creative act is outlined and the scope for using modelling as a bridge between science education and design and technology education explored. A model for the creative act of modelling is proposed and its major aspects elaborated upon. Finally, strategies for forging links between the two subjects are outlined.

Learners’ perceptions of being identified as very able: insights from Modern Foreign Languages and Physical Education

While learners’ attitudes to Modern Foreign Languages (MFL) and to Physical Education (PE) in the UK have been widely investigated in previous research, an under-explored area is learners’ feelings about being highly able in these subjects. The present study explored this issue, among 78 learners (aged 12-13) from two schools in England, a Specialist Language College, and a Specialist Sports College. Learners completed a questionnaire exploring their feelings about the prospect of being identified as gifted/talented in these subjects, and their perceptions of the characteristics of highly able learners in MFL and PE. Questionnaires were chosen as the data collection method to encourage more open responses from these young learners than might have been elicited in an interview. While learners were enthusiastic about the idea of being highly able in both subjects, this enthusiasm was more muted for MFL. School specialism was related to learners’ enthusiasm only in the Sports College. Learners expressed fairly stereotypical views of the characteristics of the highly able in MFL and PE. The relevance of these findings for motivation and curriculum design within both subjects is discussed.

Issues in language and development in multilingual settings: a case-study of knowledge exchange and teacher education in South Africa

The quality of a country’s human-resource base can be said to determine its level of success in social and economic development. This study focuses on some␣of the major human-resource development issues that surround the implementation of South Africa’s policy of multilingualism in education. It begins by discussing the relationship between knowledge, language, and human-resource, social and economic development within the global cultural economy. It then considers the situation in South Africa and, in particular, the implications of that country’s colonial and neo-colonial past for attempts to implement the new policy. Drawing on the linguistic-diversity-in-education debate in the United Kingdom of the past three decades, it assesses the first phase of an in-service teacher-education programme that was carried out at the Project for Alternative Education in South Africa (PRAESA) based at the University of Cape Town. The authors identify key short- and long-term issues related to knowledge exchange in education in multilingual societies, especially concerning the use of African languages as mediums for teaching and learning.