An evaluation of the epidemiology of medication discrepancies and clinical significance of medicines reconciliation in children admitted to hospital

Aims: To determine the incidence of unintended medication discrepancies in paediatric patients at the time of hospital admission; evaluate the process of medicines reconciliation; assess the benefit of medicines reconciliation in preventing clinical harm. Method: A 5 month prospective multisite study. Pharmacists at four English hospitals conducted admission medicines reconciliation in children using a standardised data collection form. A discrepancy was defined as a difference between the patient's preadmission medication (PAM), compared with the initial admission medication orders written by the hospital doctor. The discrepancies were classified into intentional and unintentional discrepancies. The unintentional discrepancies were assessed for potential clinical harm by a team of healthcare professionals, which included doctors, pharmacists and nurses. Results: Medicines reconciliation was conducted in 244 children admitted to hospital. 45% (109/244) of the children had at least one unintentional medication discrepancy between the PAM and admission medication order. The overall results indicated that 32% (78/244) of patients had at least one clinically significant unintentional medication discrepancy with potential to cause moderate 20% (50/244) or severe 11% (28/244) harm. No single source of information provided all the relevant details of a patient's medication history. Parents/carers provided the most accurate details of a patient's medication history in 81% of cases. Conclusions: This study demonstrates that in the absence of medicines reconciliation, children admitted to hospitals across England are at risk of harm from unintended medication discrepancies at the transition of care from the community to hospital. No single source of information provided a reliable medication history.

The impact of regulation and ownership structure on market orientation in the tourism industry in China

The nature of market orientation and its impact on business performance and other related outcomes have been extensively researched in a range of service contexts including tourism. In contrast, our understanding of the factors that influence market orientation is still limited. This paper reports on a study that contributes to our understanding of the determinants of market orientation within the tourism sector by focusing specifically on the role played by two strategically important variables, namely government regulation and ownership structure. The study analyses two national samples of hotels and travel services in the rapidly growing tourism industry in China. The hotel sector has been open to foreign investment for two decades and has a diversified ownership structure, whereas the travel services sector has been dominated by government owned firms and relatively closed to foreign investment. The results of the survey suggest that of the two new antecedents, only government regulation has a significant role to play in driving market orientation. Internally, access to appropriate managerial and marketing capabilities was identified as a significant predictor of the development of market orientation.

Collocations

J R Firth first gave prominence to collacation in linguistic theory. Halliday, Sinclair, Stubbs, and Hoey have all extended Firth's ideas. Palmer and Hornby recognized the pedagogical value of collocation, and incorporated it into their early EFL dictionaries. More recent EFL dictionaries, based on large, computerized language corpora, have used complex software and statistical measures to gain further insights into the way that collocational patterns are woven into language, and the results are visible in the dictionary entries of later editions. This has fed back into language pedagogy, and is also influencing translation and computational research. © 2006 Elsevier Ltd. All rights reserved.

English collocation studies:the OSTI report

This is the first published edition of John Sinclair, Susan Jones and Robert Daley's research on collocation undertaken in 1970. The unpublished report was circulated amongst a small group of academics and was enormously influential, sparking a growth of interest in collocation amongst researchers in linguistics. Collocation was first viewed as important in computational linguistics in the work of Harold Palmer in Japan. Later M.A.K. Halliday and John Sinclair published on collocation in the 1960s. English Collocation Studies is a report on empirical research into collocation, devised by Halliday with Sinclair acting as the Principal Investigator and editor of the resultant OSTI report. The present edition contains an introduction by Professor Wolfgang Teubert based on his interview with John Sinclair. The introduction assesses the extent to which the findings of the original research have developed in the intervening years, and how some of the techniques mentioned in the report were implemented in the COBUILD project at Birmingham University in the 1980s.

Corpus, collocation, and lexical sets

This paper is a progress report on a research path I first outlined in my contribution to “Words in Context: A Tribute to John Sinclair on his Retirement” (Heffer and Sauntson, 2000). Therefore, I first summarize that paper here, in order to provide the relevant background. The second half of the current paper consists of some further manual analyses, exploring various parameters and procedures that might assist in the design of an automated computational process for the identification of lexical sets. The automation itself is beyond the scope of the current paper.

Burning questions, but no burning answers: collocation and idiomaticity

The attention of linguists has increasingly shifted from grammar to lexis. Collocation has emerged as a key feature of lexis. Research using large language corpora has not only helped to identify the significant collocates of individual words but also to confirm the importance of collocation in the language system. John Sinclair has suggested that language operates on two principles: open choice and idiom. If so, then collocation would appear to be the minimal level of idiomaticity. One problem with collocation is that words that habitually co-occur form less distinct, often discontinuous, idiomatic units, whereas grammar generally works with more precisely delineated and contiguous structural units. This paper uses examples from corpus evidence to look at various aspects of collocation.

Organizational and textual structuring of radio news discourse in English and Arabic.

The present work studies the overall structuring of radio news discourse via investigating three metatextual/interactive functions: (1) Discourse Organizing Elements (DOEs), (2) Attribution and (3) Sentential and Nominal Background Information (SBI & NBI). An extended corpus of about 73,000 words from BBC and Radio Damascus news is used to study DOEs and a restricted corpus of 38,000 words for Attribution and S & NBI. A situational approach is adopted to assess the influence of factors such as medium and audience on these functions and their frequence. It is found that: (1) DOEs are organizational and their frequency is determined by length of text; (2) Attribution Function in accordance with the editor's strategy and its frequency is audience sensitive; and (3) BI provides background information and is determined by audience and news topics. Secondly, the salient grammatical elements in DOEs are discourse deictic demonstratives, address pronouns and nouns referring to `the news'. Attribution is realized in reporting/reported clauses, and BI in a sentence, a clause or a nominal group. Thirdly, DOEs establish a hierarchy of (1) news, (2) summary/expansion and (3) item: including topic introduction and details. While Attribution is generally, and SBI solely, a function of detailing, NBI and proper names are generally a function of summary and topic introduction. Being primarily addressed to audience and referring metatextually, the functions investigated support Sinclair's interactive and autonomous planes of discourse. They also shed light on the part(s) of the linguistic system which realize the metatextual/interactive function. Strictly, `discourse structure' inevitably involves a rank-scale; but news discourse also shows a convention of item `listing'. Hence only within the boundary of variety (ultimately interpreted across language and in its situation) can textual functions and discourse structure be studied. Finally, interlingual variety study provides invaluable insights into a level of translation that goes beyond matching grammatical systems or situational factors, an interpretive level which has to be described in linguistic analysis of translation data.

Truth values and truth-commitment in interdiscursive dating ads

In this article, I explore issues of commitment to truth in dating ads that use apparently impossible categorizations to project identities for ad writers and their desired others. The article begins with a brief overview of relevant aspects of Text World Theory (especially Gavins's work on dating ads), Sinclair's model of fictional worlds and Routledge and Chapman's account of truth-commitment in discourse, and proposes the need for a framework that allows for a partial suspension of commitment to truth. I then draw on the work of Ivanič and Weldon on identity in writing, in order to develop an account that offers a discourse- and genre-based discussion of how the intertextual metaphors in such ads are interpreted in relation to truth values. I suggest the default stance is that of positive commitment to literal truth and that, when this is not possible, a fall-back mode of negative commitment to metaphorical truth is preferred over an interpretation in which questions of truth are truly suspended. Finally, I consider a related category, of apparently negative dating ad identities, in order to suggest a functional motivation for the inclusion of elements that cannot be interpreted in truth-committed mode. Copyright © 2008 SAGE Publications.

Secret commissions:unauthorised profits

Considers ability of beneficiaries to trace into unauthorised profits following ruling in Sinclair v Versaille and other recent case law.

Paternal low protein diet affects adult offspring cardiovascular and metabolic function in mice

Although the association between maternal periconceptional diet and adult offspring health is well characterised, our understanding of the impact of paternal nutrition at the time of conception on offspring phenotype remains poorly defined. Therefore, we determined the effect of a paternal preconception low protein diet (LPD on adult offspring cardiovascular and metabolic health in mice. Male C57BL/6 mice were fed either normal protein diet (NPD; 18% casein or LPD (9% casein for 7 wk before mating. At birth, a reduced male-to-female ratio (P = 0.03 and increased male offspring weight (P = 0.009 were observed in litters from LPD compared with NPD stud males with no differences in mean litter size. LPD offspring were heavier than NPD offspring at 2 and 3 wk of age (P <0.02. However, no subsequent differences in body weight were observed. Adult male offspring derived from LPD studs developed relative hypotension (decreased by 9.2 mmHg and elevated heart rate (P <0.05, whereas both male and female offspring displayed vascular dysfunction and impaired glucose tolerance relative to NPD offspring. At cull (24 wk, LPD males had elevated adiposity (P = 0.04, reduced heart-to-body weight ratio (P = 0.04, and elevated circulating TNF-α levels (P = 0.015 compared with NPD males. Transcript expression in offspring heart and liver tissue was reduced for genes involved in calcium signaling (Adcy, Plcb, Prkcb and metabolism (Fto in LPD offspring (P <0.03. These novel data reveal the impact of suboptimal paternal nutrition on adult offspring cardiovascular and metabolic homeostasis, and provide some insight into the underlying regulatory mechanisms.

Parental diet, pregnancy outcomes and offspring health:metabolic determinants in developing oocytes and embryos

The periconceptional period, embracing the terminal stages of oocyte growth and post-fertilisation development up to implantation, is sensitive to parental nutrition. Deficiencies or excesses in a range of macro- and micronutrients during this period can lead to impairments in fertility, fetal development and long-term offspring health. Obesity and genotype-related differences in regional adiposity are associated with impaired liver function and insulin resistance, and contribute to fatty acid-mediated impairments in sperm viability and oocyte and embryo quality, all of which are associated with endoplasmic reticulum stress and compromised fertility. Disturbances to maternal protein metabolism can elevate ammonium concentrations in reproductive tissues and disturb embryo and fetal development. Associated with this are disturbances to one-carbon metabolism, which can lead to epigenetic modifications to DNA and associated proteins in offspring that are both insulin resistant and hypertensive. Many enzymes involved in epigenetic gene regulation use metabolic cosubstrates (e.g. acetyl CoA and S-adenosyl methionine) to modify DNA and associated proteins, and so act as 'metabolic sensors' providing a link between parental nutritional status and gene regulation. Separate to their genomic contribution, spermatozoa can also influence embryo development via direct interactions with the egg and by seminal plasma components that act on oviductal and uterine tissues. © IETS 2014.

The structure of the rare-earth phosphate glass(Sm2O3)0.205(P2O5)0.795 studied by anomalous dispersion neutron diffraction

The role of the Sm3+ ions in the structure of vitreous Sm2O3•4P2O5 has been investigated using the neutron diffraction anomalous dispersion technique, which employs the wavelength dependence of the real and imaginary parts of the neutron scattering length close to an absorption resonance. The data described here represent the first successful complete neutron anomalous dispersion study on an amorphous material. This experimental methodology permits one to determine exclusively the closest Sm• •• Sm separation. Knowledge of the R•••R (R = rare-earth) pairwise correlation is key to understanding the optical and magnetic properties of rare-earth phosphate glasses. The anomalous difference correlation function, ΔT''(r), shows a dominant feature pertaining to a Sm•••Sm separation, centred at 4.8 Å. The substantial width and marked asymmetry of this peak indicates that the minimum approach of Sm3+ ions could be as close as 4 Å. Information on other pairwise correlations is also revealed via analysis of T (r) and ΔT (r) correlation functions: Sm3+ ions display an average co-ordination number, n Sm(O), of 7, with a mean Sm–O bond length of 2.375(5) Å whilst the PO4 tetrahedra have a mean P–O bond length of 1.538(2) Å. Second- and third-neighbour correlations are also identified. These results corroborate previous findings. Such consistency lends support to the application of the anomalous dispersion technique to determine separations.