Epidemiology of medication discrepancies upon hospital admission in children - a systematic review

Objectives: NICE/NPSA excluded children under 16 from their guidance concerning medicines reconciliation (MR) upon admission.1 Our aims and objectives of conducting the literature review was to identify the epidemiology of medication discrepancies upon admission, transfer and discharge in children, and if they require MR. Method: Six bibliographical databases (Medline, Embase, CINAHL, International Pharmaceutical Abstracts, Web of Science and Biosis Previews) and selected key words were used to find epidemiological studies on medication discrepancies in children upon hospital admission, transfer and discharge (key words included ‘medication discrepancy’; ‘medication reconciliation’; ‘hospital admission’; ‘hospital discharge’; ‘hospital transfer’); studies where the data for children could be extracted were included. Results: From the 1239 articles found (in May 2011), eight of the articles had extractable paediatric information, (five from Canada, two from USA, one from UK). Five of the studies involved discrepancies on admission, one involved discrepancies on admission and transfer, one involved discrepancies at transfer and one considered discharge. The reference point used to compare against the admission, transfer and the discharge order differed in each of the studies. Four studies used a rating scale to assess the clinical significance of the discrepancies to demonstrate the potential adverse clinical outcome of patients in the absence of clinical intervention. Two studies2 3 used a rating scale that was used in adults.4 A study of paediatric neurosurgical patients found that initial hospital prescriptions for children differed from the preadmission prescriptions in 39% of occasions and 50% of all prescribing variations had the potential to cause moderate or severe discomfort or clinical deterioration.2 A study by Coffey et al in general paediatric admissions in Canada showed 22% of patients experienced at least one discrepancy and 29% of the discrepancies had the potential to cause moderate or severe discomfort or clinical deterioration.3 By comparison an epidemiological study in discrepancies in adults on admission had 38.6% of the discrepancies identified with a potential to cause moderate or severe discomfort or clinical deterioration.4 All the studies involved small samples or specific patient groups such as medically complex patients. However all of the studies demonstrated that discrepancies occurred among paediatric populations during transitions in care settings and mentioned MR as an intervention. Conclusion: The results have shown that discrepancies of medication upon hospital admission, transfer and discharge occur regularly in children. With only one published study in the UK looking at hospital admission in children, and no published articles on the incidence and epidemiology of medication discrepancies upon hospital transfer or discharge further research is required in a wider paediatric population. Further work is also required to define the required interventions to improve practice.

IT as enabler of sustainable farming:an empirical analysis of farmers' adoption decision of precision agriculture technology

Precision agriculture (PA) describes a suite of IT based tools which allow farmers to electronically monitor soil and crop conditions and analyze treatment options. This study tests a model explaining the difficulties of PA technology adoption. The model draws on theories of technology acceptance and diffusion of innovation and is validated using survey data from farms in Canada. Findings highlight the importance of compatibility among PA technology components and the crucial role of farmers' expertise. The model provides the theoretical and empirical basis for developing policies and initiatives to support PA technology adoption.

Competitive edge through operations management

A view has emerged within manufacturing and service organizations that the operations management function can hold the key to achieving competitive edge. This has recently been emphasized by the demands for greater variety and higher quality which must be set against a background of increasing cost of resources. As nations' trade barriers are progressively lowered and removed, so producers of goods and service products are becoming more exposed to competition that may come from virtually anywhere around the world. To simply survive in this climate many organizations have found it necessary to improve their manufacturing or service delivery systems. To become real ''winners'' some have adopted a strategic approach to operations and completely reviewed and restructured their approach to production system design and operations planning and control. The articles in this issue of the International journal of Operations & Production Management have been selected to illustrate current thinking and practice in relation to this situation. They are all based on papers presented to the Sixth International Conference of the Operations Management Association-UK which was held at Aston University in June 1991. The theme of the conference was "Achieving Competitive Edge" and authors from 15 countries around the world contributed to more than 80 presented papers. Within this special issue five topic areas are addressed with two articles relating to each. The topics are: strategic management of operations; managing change; production system design; production control; and service operations. Under strategic management of operations De Toni, Filippini and Forza propose a conceptual model which considers the performance of an operating system as a source of competitive advantage through the ''operation value chain'' of design, purchasing, production and distribution. Their model is set within the context of the tendency towards globalization. New's article is somewhat in contrast to the more fashionable literature on operations strategy. It challenges the validity of the current idea of ''world-class manufacturing'' and, instead, urges a reconsideration of the view that strategic ''trade-offs'' are necessary to achieve a competitive edge. The importance of managing change has for some time been recognized within the field of organization studies but its relevance in operations management is now being realized. Berger considers the use of "organization design", ''sociotechnical systems'' and change strategies and contrasts these with the more recent idea of the ''dialogue perspective''. A tentative model is suggested to improve the analysis of different strategies in a situation specific context. Neely and Wilson look at an essential prerequisite if change is to be effected in an efficient way, namely product goal congruence. Using a case study as its basis, their article suggests a method of measuring goal congruence as a means of identifying the extent to which key performance criteria relating to quality, time, cost and flexibility are understood within an organization. The two articles on production systems design represent important contributions to the debate on flexible production organization and autonomous group working. Rosander uses the results from cases to test the applicability of ''flow groups'' as the optimal way of organizing batch production. Schuring also examines cases to determine the reasons behind the adoption of ''autonomous work groups'' in The Netherlands and Sweden. Both these contributions help to provide a greater understanding of the production philosophies which have emerged as alternatives to more conventional systems -------for intermittent and continuous production. The production control articles are both concerned with the concepts of ''push'' and ''pull'' which are the two broad approaches to material planning and control. Hirakawa, Hoshino and Katayama have developed a hybrid model, suitable for multistage manufacturing processes, which combines the benefits of both systems. They discuss the theoretical arguments in support of the system and illustrate its performance with numerical studies. Slack and Correa's concern is with the flexibility characteristics of push and pull material planning and control systems. They use the case of two plants using the different systems to compare their performance within a number of predefined flexibility types. The two final contributions on service operations are complementary. The article by Voss really relates to manufacturing but examines the application of service industry concepts within the UK manufacturing sector. His studies in a number of companies support the idea of the ''service factory'' and offer a new perspective for manufacturing. Harvey's contribution by contrast, is concerned with the application of operations management principles in the delivery of professional services. Using the case of social-service provision in Canada, it demonstrates how concepts such as ''just-in-time'' can be used to improve service performance. The ten articles in this special issue of the journal address a wide range of issues and situations. Their common aspect is that, together, they demonstrate the extent to which competitiveness can be improved via the application of operations management concepts and techniques.

(Re)examinando horizontes en los estudios feministas de traducción:¿hacia una tercera ola?

Los feminismos son una de esas teorías marco cuyas contribuciones son perceptibles en todos los ámbitos de la sociedad, incluidos los estudios de traducción. La materialización más evidente de esta interacción es el surgimiento, en los 80, de una corriente de traducción feminista en Canadá, capaz de colocar el género en el centro del debate sobre traducción. En la actualidad, y pese a las críticas y posteriores redefiniciones del concepto de traducción feminista, la propuesta canadiense sigue concibiéndose por lo general como paradigma de interacción entre feminismos y traducción. En este artículo propongo nuevas aproximaciones a la práctica de traducir y paratraducir desde los feminismos, dentro de una tercera ola de traducción feminista. Además, pretendo abrir el debate (re)examinando áreas de interés mutuo para los estudios de traducción y los feminismos en el plano conceptual, historiográfico y crítico, con el propósito de que sugieran nuevas líneas de investigación futura. Feminisms are one of those framework theories that have contributed powerfully to all areas of society, including Translation Studies. The most evident outcome of this interplay is the emergence, in the 1980s, of a Feminist Translation school in Canada, which placed gender in the spotlight. Despite criticism and subsequent redefinitions of the notion of feminist translation, the Canadian school is still generally regarded as the paradigm of interaction between feminisms and translation. The aim of this article is two-fold: firstly, to advance new approaches to the practice of translation and paratranslation from a feminist perspective (within the context of a third wave of feminist translation). Secondly, to open new debates by means of (re)examining topics of mutual interest for both Translation Studies and Feminisms on a conceptual, historical and critical plane, so that subsequent studies can be fostered. Feminisms are one of those framework theories that have contributed powerfully to all areas of society, including Translation Studies. The most evident outcome of this interplay is the emergence, in the 1980s, of a Feminist Translation school in Canada, which placed gender in the spotlight. Despite criticism and subsequent redefinitions of the notion of feminist translation, the Canadian school is still generally regarded as the paradigm of interaction between feminisms and translation. The aim of this article is two-fold: firstly, to advance new approaches to the practice of translation and paratranslation from a feminist perspective (within the context of a third wave of feminist translation). Secondly, to open new debates by means of (re)examining topics of mutual interest for both Translation Studies and Feminisms on a conceptual, historical and critical plane, so that subsequent studies can be fostered.

Using knowledge management to give context to analytics and big data and reduce strategic risk

At the moment, the phrases “big data” and “analytics” are often being used as if they were magic incantations that will solve all an organization’s problems at a stroke. The reality is that data on its own, even with the application of analytics, will not solve any problems. The resources that analytics and big data can consume represent a significant strategic risk if applied ineffectively. Any analysis of data needs to be guided, and to lead to action. So while analytics may lead to knowledge and intelligence (in the military sense of that term), it also needs the input of knowledge and intelligence (in the human sense of that term). And somebody then has to do something new or different as a result of the new insights, or it won’t have been done to any purpose. Using an analytics example concerning accounts payable in the public sector in Canada, this paper reviews thinking from the domains of analytics, risk management and knowledge management, to show some of the pitfalls, and to present a holistic picture of how knowledge management might help tackle the challenges of big data and analytics.