The impact of a closed-loop electronic prescribing and automated dispensing system on the ward pharmacist’s time and activities

Objective To assess the impact of a closed-loop electronic prescribing and automated dispensing system on the time spent providing a ward pharmacy service and the activities carried out. Setting Surgical ward, London teaching hospital. Method All data were collected two months pre- and one year post-intervention. First, the ward pharmacist recorded the time taken each day for four weeks. Second, an observational study was conducted over 10 weekdays, using two-dimensional work sampling, to identify the ward pharmacist's activities. Finally, medication orders were examined to identify pharmacists' endorsements that should have been, and were actually, made. Key findings Mean time to provide a weekday ward pharmacy service increased from 1 h 8 min to 1 h 38 min per day (P = 0.001; unpaired t-test). There were significant increases in time spent prescription monitoring, recommending changes in therapy/monitoring, giving advice or information, and non-productive time. There were decreases for supply, looking for charts and checking patients' own drugs. There was an increase in the amount of time spent with medical and pharmacy staff, and with 'self'. Seventy-eight per cent of patients' medication records could be assessed for endorsements pre- and 100% post-intervention. Endorsements were required for 390 (50%) of 787 medication orders pre-intervention and 190 (21%) of 897 afterwards (P < 0.0001; chi-square test). Endorsements were made for 214 (55%) of endorsement opportunities pre-intervention and 57 (30%) afterwards (P < 0.0001; chi-square test). Conclusion The intervention increased the overall time required to provide a ward pharmacy service and changed the types of activity undertaken. Contact time with medical and pharmacy staff increased. There was no significant change in time spent with patients. Fewer pharmacy endorsements were required post-intervention, but a lower percentage were actually made. The findings have important implications for the design, introduction and use of similar systems.

Information system evolvability, feedback and pattern languages

Information systems for business are frequently heavily reliant on software. Two important feedback-related effects of embedding software in a business process are identified. First, the system dynamics of the software maintenance process can become complex, particularly in the number and scope of the feedback loops. Secondly, responsiveness to feedback can have a big effect on the evolvability of the information system. Ways have been explored to provide an effective mechanism for improving the quality of feedback between stakeholders during software maintenance. Understanding can be improved by using representations of information systems that are both service-based and architectural in scope. The conflicting forces that encourage change or stability can be resolved using patterns and pattern languages. A morphology of information systems pattern languages has been described to facilitate the identification and reuse of patterns and pattern languages. The kind of planning process needed to achieve consensus on a system's evolution is also considered.

Investigation of Petasis and Ugi reactions in series in an automated microreactor system

Petasis and Ugi reactions are used successively without intermediate purification, effectively accomplishing a six-component reaction. The examined reactions are transferred from traditional batch reactors to an automated continuous flow microreactor setup, where optimization and kinetic analyses are performed, proposed mechanisms evaluated, and rate-limiting steps determined.

Proof of concept of automated mapping of weeds in arable fields

The project investigated whether it would be possible to remove the main technical hindrance to precision application of herbicides to arable crops in the UK, namely creating geo-referenced weed maps for each field. The ultimate goal is an information system so that agronomists and farmers can plan precision weed control and create spraying maps. The project focussed on black-grass in wheat, but research was also carried out on barley and beans and on wild-oats, barren brome, rye-grass, cleavers and thistles which form stable patches in arable fields. Farmers may also make special efforts to control them. Using cameras mounted on farm machinery, the project explored the feasibility of automating the process of mapping black-grass in fields. Geo-referenced images were captured from June to December 2009, using sprayers, a tractor, combine harvesters and on foot. Cameras were mounted on the sprayer boom, on windows or on top of tractor and combine cabs and images were captured with a range of vibration levels and at speeds up to 20 km h-1. For acceptability to farmers, it was important that every image containing black-grass was classified as containing black-grass; false negatives are highly undesirable. The software algorithms recorded no false negatives in sample images analysed to date, although some black-grass heads were unclassified and there were also false positives. The density of black-grass heads per unit area estimated by machine vision increased as a linear function of the actual density with a mean detection rate of 47% of black-grass heads in sample images at T3 within a density range of 13 to 1230 heads m-2. A final part of the project was to create geo-referenced weed maps using software written in previous HGCA-funded projects and two examples show that geo-location by machine vision compares well with manually-mapped weed patches. The consortium therefore demonstrated for the first time the feasibility of using a GPS-linked computer-controlled camera system mounted on farm machinery (tractor, sprayer or combine) to geo-reference black-grass in winter wheat between black-grass head emergence and seed shedding.

Beneath a learning management system: understanding the human information interaction in information systems

Studies on learning management systems have largely been technical in nature with an emphasis on the evaluation of the human computer interaction (HCI) processes in using the LMS. This paper reports a study that evaluates the information interaction processes on an eLearning course used in teaching an applied Statistics course. The eLearning course is used as a synonym for information systems. The study explores issues of missing context in stored information in information systems. Using the semiotic framework as a guide, the researchers evaluated an existing eLearning course with the view to proposing a model for designing improved eLearning courses for future eLearning programmes. In this exploratory study, a survey questionnaire is used to collect data from 160 participants on an eLearning course in Statistics in Applied Climatology. The views of the participants are analysed with a focus on only the human information interaction issues. Using the semiotic framework as a guide, syntactic, semantic, pragmatic and social context gaps or problems were identified. The information interactions problems identified include ambiguous instructions, inadequate information, lack of sound, interface design problems among others. These problems affected the quality of new knowledge created by the participants. The researchers thus highlighted the challenges of missing information context when data is stored in an information system. The study concludes by proposing a human information interaction model for improving the information interaction quality issues in the design of eLearning course on learning management platforms and those other information systems.

WREN: electronic management system for facilities management

This paper describes a case study of an electronic data management system developed in-house by the Facilities Management Directorate (FMD) of an educational institution in the UK. The FMD Maintenance and Business Services department is responsible for the maintenance of the built-estate owned by the university. The department needs to have a clear definition of the type of work undertaken and the administration that enables any maintenance work to be carried out. These include the management of resources, budget, cash flow and workflow of reactive, preventative and planned maintenance of the campus. In order to be more efficient in supporting the business process, the FMD had decided to move from a paper-based information system to an electronic system, WREN, to support the business process of the FMD. Some of the main advantages of WREN are that it is tailor-made to fit the purpose of the users; it is cost effective when it comes to modifications on the system; and the database can also be used as a knowledge management tool. There is a trade-off; as WREN is tailored to the specific requirements of the FMD, it may not be easy to implement within a different institution without extensive modifications. However, WREN is successful in not only allowing the FMD to carry out the tasks of maintaining and looking after the built-estate of the university, but also has achieved its aim to minimise costs and maximise efficiency.

Capturing temporality and intentionality in information systems

Information modelling is a topic that has been researched a great deal, but still many questions around it have not been solved. An information model is essential in the design of a database which is the core of an information system. Currently most of databases only deal with information that represents facts, or asserted information. The ability of capturing semantic aspect has to be improved, and yet other types, such as temporal and intentional information, should be considered. Semantic Analysis, a method of information modelling, has offered a way to handle various aspects of information. It employs the domain knowledge and communication acts as sources of information modelling. It lends itself to a uniform structure whereby semantic, temporal and intentional information can be captured, which builds a sound foundation for building a semantic temporal database.

Modeling requirement driven architecture of adaptive healthcare system based on semiotics

In order to improve the quality of healthcare services, the integrated large-scale medical information system is needed to adapt to the changing medical environment. In this paper, we propose a requirement driven architecture of healthcare information system with hierarchical architecture. The system operates through the mapping mechanism between these layers and thus can organize functions dynamically adapting to user’s requirement. Furthermore, we introduce the organizational semiotics methods to capture and analyze user’s requirement through ontology chart and norms. Based on these results, the structure of user’s requirement pattern (URP) is established as the driven factor of our system. Our research makes a contribution to design architecture of healthcare system which can adapt to the changing medical environment.

NeuroHub: a research information environment for neuroscientists

The NeuroHub project aims to develop a research information system for neuroscientists at three different partner institutions: Oxford, Reading and Southampton. Each research group has different working practices, research methodologies and user requirements, which have lead to the development of a system that supports a wide variety of tasks in the neuroscience research life cycle. In this paper, we present how these user requirements have been translated in a research information environment that supports a community of over 70 researchers using the system for day-to-day research tasks.

"Ever-growing Amman", Jordan: Urban expansion, social polarisation and contemporary urban planning issues

Amman the primate capital city of the Hashemite Kingdom of Jordan currently has a population in excess of 2 million, but in 1924 it consisted of little more than a collection of dwellings and some 2000-3000 inhabitants. The present paper sets out to document and explain the phenomenal expansion of "ever-growing Amman". The physical geography of the urban region and the early growth of the city are considered at the outset and this leads directly to consideration of the highly polarised social structuring that characterises contemporary Amman. In doing this, original data derived from the recent Greater Amman Municipality's Geographical Information System are presented. In this respect, the essential modernity of the city is exemplified. The employment and industrial bases of the city and a range of pressing contemporary issues are then considered, including transport and congestion, the provision of urban water under conditions of water stress and privatisation, and urban and regional development planning for the city. The paper concludes by emphasizing the growing regional and international geopolitical salience of the city of Amman at the start of the 21st century. (C) 2008 Elsevier Ltd. All rights reserved.

A GIS-based empirical model for vegetation prediction in Lefka Ori, Crete

The aim of the study was to establish and verify a predictive vegetation model for plant community distribution in the alti-Mediterranean zone of the Lefka Ori massif, western Crete. Based on previous work three variables were identified as significant determinants of plant community distribution, namely altitude, slope angle and geomorphic landform. The response of four community types against these variables was tested using classification trees analysis in order to model community type occurrence. V-fold cross-validation plots were used to determine the length of the best fitting tree. The final 9node tree selected, classified correctly 92.5% of the samples. The results were used to provide decision rules for the construction of a spatial model for each community type. The model was implemented within a Geographical Information System (GIS) to predict the distribution of each community type in the study site. The evaluation of the model in the field using an error matrix gave an overall accuracy of 71%. The user's accuracy was higher for the Crepis-Cirsium (100%) and Telephium-Herniaria community type (66.7%) and relatively lower for the Peucedanum-Alyssum and Dianthus-Lomelosia community types (63.2% and 62.5%, respectively). Misclassification and field validation points to the need for improved geomorphological mapping and suggests the presence of transitional communities between existing community types.

Establishment of a Cross-European Field Site Network in the ALARM Project for Assessing Large-Scale Changes in Biodiversity

The field site network (FSN) plays a central role in conducting joint research within all Assessing Large-scale Risks for biodiversity with tested Methods (ALARM) modules and provides a mechanism for integrating research on different topics in ALARM on the same site for measuring multiple impacts on biodiversity. The network covers most European climates and biogeographic regions, from Mediterranean through central European and boreal to subarctic. The project links databases with the European-wide field site network FSN, including geographic information system (GIS)-based information to characterise the test location for ALARM researchers for joint on-site research. Maps are provided in a standardised way and merged with other site-specific information. The application of GIS for these field sites and the information management promotes the use of the FSN for research and to disseminate the results. We conclude that ALARM FSN sites together with other research sites in Europe jointly could be used as a future backbone for research proposals

A GIS-based empirical model for vegetation prediction in Lefka Ori, Crete

The aim of the study was to establish and verify a predictive vegetation model for plant community distribution in the alti-Mediterranean zone of the Lefka Ori massif, western Crete. Based on previous work three variables were identified as significant determinants of plant community distribution, namely altitude, slope angle and geomorphic landform. The response of four community types against these variables was tested using classification trees analysis in order to model community type occurrence. V-fold cross-validation plots were used to determine the length of the best fitting tree. The final 9node tree selected, classified correctly 92.5% of the samples. The results were used to provide decision rules for the construction of a spatial model for each community type. The model was implemented within a Geographical Information System (GIS) to predict the distribution of each community type in the study site. The evaluation of the model in the field using an error matrix gave an overall accuracy of 71%. The user's accuracy was higher for the Crepis-Cirsium (100%) and Telephium-Herniaria community type (66.7%) and relatively lower for the Peucedanum-Alyssum and Dianthus-Lomelosia community types (63.2% and 62.5%, respectively). Misclassification and field validation points to the need for improved geomorphological mapping and suggests the presence of transitional communities between existing community types.