Methodology for assessing the appropriateness of Continuing Professional Development for pharmacy professionals’ revalidation

From April 2010, the General Pharmaceutical Council (GPhC) will be responsible for the statutory regulation of pharmacists and pharmacy technicians in Great Britain (GB).[1] All statutorily regulated health professionals will need to periodically demonstrate their fitness-to-practise through a process of revalidation.[2] One option being considered in GB is that continuing professional development (CPD) records will form a part of the evidence submitted for revalidation, similar to the system in New Zealand.[3] At present, pharmacy professionals must make a minimum of nine CPD entries per annum from 1 March 2009 using the Royal Pharmaceutical Society of Great Britain (RPSGB) CPD framework. Our aim was to explore the applicability of new revalidation standards within the current CPD framework. We also wanted to review the content of CPD portfolios to assess strengths and qualities and identify any information gaps for the purpose of revalidation.

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.

Museum robots: multi-robot systems for public exhibition

Mobile robots provide a versatile platform for research, however they can also provide an interesting educational platform for public exhibition at museums. In general museums require exhibits that are both eye catching and exciting to the public whilst requiring a minimum of maintenance time from museum technicians. In many cases it is simply not possible to continuously change batteries and some method of supplying continous power is required. A powered flooring system is described that is capable of providing power continuously to a group of robots. Three different museum exhibit applications are described. All three robot exhibits are of a similar basic design although the exhibits are very different in appearance and behaviour. The durability and versatility of the robots also makes them extremely good candidates for long duration experiments such as those required by evolutionary robotics.

CPD records for revalidation: assessing fitness-to-practise using ‘revalidation standards’ and an Outcomes Framework

Background: Currently, all pharmacists and technicians registered with the Royal Pharmaceutical Society of Great Britain must complete a minimum of nine Continuing Professional Development (CPD) record (entries) each year. From September 2010 a new regulatory body, the General Pharmaceutical Council, will oversee the regulation (including revalidation) of all pharmacy registrants in Great Britain. CPD may provide part of the supporting evidence that a practitioner submits to the regulator as part of the revalidation process. Gaps in knowledge necessitated further research to examine the usefulness of CPD in a pharmacy revalidation Project aims: The overall aims of this project were to summarise pharmacy professionals’ past involvement in CPD, examine the usability of current CPD entries for the purpose of revalidation, and to examine the impact of ‘revalidation standards’ and a bespoke Outcomes Framework on the conduct and construction of CPD entries for future revalidation of pharmacy professionals. We completed a comprehensive review of the literature, devised, validated and tested the impact of a new CPD Outcomes Framework and related training material in an empirical investigation involving volunteer pharmacy professionals and also spoke with our participants to bring meaning and understanding to the process of CPD conduct and recording and to gain feedback on the study itself. Key findings: The comprehensive literature review identified perceived barriers to CPD and resulted in recommendations that could potentially rectify pharmacy professionals’ perceptions and facilitate participation in CPD. The CPD Outcomes Framework can be used to score CPD entries Compared to a control (CPD and ‘revalidation standards’ only), we found that training participants to apply the CPD Outcomes Framework resulted in entries that scored significantly higher in the context of a quantitative method of CPD assessment. Feedback from participants who had received the CPD Outcomes Framework was positive and a number of useful suggestions were made about improvements to the Framework and related training. Entries scored higher because participants had consciously applied concepts linked to the CPD Outcomes Framework whereas entries scored low where participants had been unable to apply the concepts of the Framework for a variety of reasons including limitations posed by the ‘Plan & Record’ template. Feedback about the nature of the ‘revalidation standards’ and their application to CPD was not positive and participants had not in the main sought to apply the standards to their CPD entries – but those in the intervention group were more likely to have referred to the revalidation standards for their CPD. As assessors, we too found the process of selecting and assigning ‘revalidation standards’ to individual CPD entries burdensome and somewhat unspecific. We believe that addressing the perceived barriers and drawing on the facilitators will help deal with the apparent lack of engagement with the revalidation standards and have been able to make a set of relevant recommendations. We devised a model to explain and tell the story of CPD behaviour. Based on the concepts of purpose, action and results, the model centres on explaining two types of CPD behaviour, one following the traditional CE pathway and the other a more genuine CPD pathway. Entries which scored higher when we applied the CPD Outcomes Framework were more likely to follow the CPD pathway in the model above. Significant to our finding is that while participants following both models of practice took part in this study, the CPD Outcomes Framework was able to change people’s CPD behaviour to make it more inline with the CPD pathway. The CPD Outcomes Framework in defining the CPD criteria, the training pack in teaching the basis and use of the Framework and the process of assessment in using the CPD Outcomes Framework, would have interacted to improve participants’ CPD through a collective process. Participants were keen to receive a curriculum against which certainly CE-type activities could be conducted and another important observation relates to whether CE has any role to play in pharmacy professionals’ revalidation. We would recommend that the CPD Outcomes Framework is used in the revalidation of pharmacy professionals in the future provided the requirement to submit 9 CPD entries per annum is re-examined and expressed more clearly in relation to what specifically participants are being asked to submit – i.e. the ratio of CE to CPD entries. We can foresee a benefit in setting more regular intervals which would act as deadlines for CPD submission in the future. On the whole, there is value in using CPD for the purpose of pharmacy professionals’ revalidation in the future.

Data Communications for Engineers

Written for communications and electronic engineers, technicians and students, this book begins with an introduction to data communications, and goes on to explain the concept of layered communications. Other chapters deal with physical communications channels, baseband digital transmission, analog data transmission, error control and data compression codes, physical layer standards, the data link layer, the higher layers of the protocol hierarchy, and local are networks (LANS). Finally, the book explores some likely future developments.

ATD: a multiplatform for semiautomatic 3-D detection of kidneys and their pathology in real time

This research presents a novel multi-functional system for medical Imaging-enabled Assistive Diagnosis (IAD). Although the IAD demonstrator has focused on abdominal images and supports the clinical diagnosis of kidneys using CT/MRI imaging, it can be adapted to work on image delineation, annotation and 3D real-size volumetric modelling of other organ structures such as the brain, spine, etc. The IAD provides advanced real-time 3D visualisation and measurements with fully automated functionalities as developed in two stages. In the first stage, via the clinically driven user interface, specialist clinicians use CT/MRI imaging datasets to accurately delineate and annotate the kidneys and their possible abnormalities, thus creating “3D Golden Standard Models”. Based on these models, in the second stage, clinical support staff i.e. medical technicians interactively define model-based rules and parameters for the integrated “Automatic Recognition Framework” to achieve results which are closest to that of the clinicians. These specific rules and parameters are stored in “Templates” and can later be used by any clinician to automatically identify organ structures i.e. kidneys and their possible abnormalities. The system also supports the transmission of these “Templates” to another expert for a second opinion. A 3D model of the body, the organs and their possible pathology with real metrics is also integrated. The automatic functionality was tested on eleven MRI datasets (comprising of 286 images) and the 3D models were validated by comparing them with the metrics from the corresponding “3D Golden Standard Models”. The system provides metrics for the evaluation of the results, in terms of Accuracy, Precision, Sensitivity, Specificity and Dice Similarity Coefficient (DSC) so as to enable benchmarking of its performance. The first IAD prototype has produced promising results as its performance accuracy based on the most widely deployed evaluation metric, DSC, yields 97% for the recognition of kidneys and 96% for their abnormalities; whilst across all the above evaluation metrics its performance ranges between 96% and 100%. Further development of the IAD system is in progress to extend and evaluate its clinical diagnostic support capability through development and integration of additional algorithms to offer fully computer-aided identification of other organs and their abnormalities based on CT/MRI/Ultra-sound Imaging.

When 1+1=3

A survey of the techniques, uses, and meanings of colour overprinting as employed by printers, graphic arts technicians, and graphic designers, principally in the twentieth century.

Entrance surface dose measurements in pediatric radiological examinations

A survey of pediatric radiological examinations was carried out in a reference pediatric hospital of the city of Sao Paulo. in order to investigate the doses to children undergoing conventional X-ray examinations. The results showed that the majority of pediatric patients are below 4 years, and that about 80% of the examinations correspond to chest projections. Doses to typical radiological examinations were measured in vivo with thermoluminescent dosimeters (LiF: Mg, Ti and LiF: Mg, Cu, P) attached to the skin of the children to determine entrance surface dose (ESD). Also homogeneous phantoms were used to obtain ESD to younger children, because the technique uses a so small kVp that the dosimeters would produce an artifact image in the patient radiograph. Four kinds of pediatric examinations were investigated: three conventional examinations (chest, skull and abdomen) and a fluoroscopic procedure (barium swallow). Relevant information about kVp and mAs values used in the examinations was collected, and we discuss how these parameters can affect the ESD. The ESD values measured in this work are compared to reference levels published by the European Commission for pediatric patients. The results obtained (third-quartile of the ESD distribution) for chest AP examinations in three age groups were: 0.056 mGy (2-4 years old); 0,068 mGy (5-9 years old)-. 0.069 mGy (10-15 years old). All of them are below the European reference level (0.100mGy). ESD values measured to the older age group in skull and abdomen AP radiographs (mean values 3.44 and 1.20mGy, respectively) are above the European reference levels (1.5mGy to skull and 1.0 mGy to abdomen). ESD values measured in the barium swallow examination reached 10 mGy in skin regions corresponding to thyroid and esophagus. It was noticed during this survey that some technicians use, improperly, X-ray fluoroscopy in conventional examinations to help them in positioning the patient. The results presented here are a preliminary survey of doses in pediatric radiological examinations and they show that it is necessary to investigate the technical parameters to perform the radiographs. to introduce practices to control pediatric patient`s doses and to improve the personnel training to perform a pediatric examination. (c) 2007 Elsevier Ltd. All rights reserved.

A study visit to a vitual company

To integrate study visits to different workplaces in higher education implies important benefits for the course quality. The study visit gives the students a better understanding for the real situations they will meet in working life. However for practical and economical reasons is that not always possible. The purpose of this project is to create a virtual company that shall replace the real one for study visits. The goal is to create a realistic picture and that intended use of it can come as close as possible to a real study visit. It is also important to facilitate linking theory and practice. The virtual company is built up by pictures, videos and text. All material is made available on a web page and when entering the students will meet a layout of the company. From that position is it possible to walk around and look at videos from different workstations. Besides that can they also listen to interviews with managers and representatives of staff as well as reading reports concerning productivity and the work environment. The focus of the study visit is work sciences, therefore the material also include some visualized information about work hazards. On the web page there are also a number of tasks for the students to carry out. Until the autumn 2011, 132 students at Dalarna University have visited and produced reports from the virtual company. They were studying in programs for mechanical engineering, production technicians and human resource management. An evaluation among some ten students showed that the study visit to the virtual company is flexible in time and effective, but that students wish to have even more detailed information about the company. Experiences from four years of use in a number of classes show that the concept is worth further development. Furthermore with production of new material the concept is likely to be applicable for other purposes.

Ed Tilin, Specialist Product Service, General Electric Company

Ed Tilin a graduate of the New York Trade School's Advanced Television program is pictured here as part of the General Electric Company. Original caption reads, "Ed Tilin - Advanced Television 1954, joined G.E. in 1956 and has risen rapidly. He now supervises all television product service, product training and consumer relations activities for the New York district. He is a member of the exemtive [sic] board of CETA (Certified Electronic Technicians Association). Black and white photograph with original caption glued to reverse.

Robert Cornell, Technical Editor, Electronic Technician Magazine

New York Trade School graduate Robert Cornell is pictured at his desk in his position of Technical Editor, Electronic Technician Magazine. Original caption reads "Robert Cornell - Advanced Television 1954, was appointed Technical Editor of Electronic Technician Magazine in 1956 and has served with distinction since. He is President of CETA (Certified Electronic Technicians Association), which consists of alumni of the New York Trade School who are graduates of the Advanced Television Course. He was recently invited to serve a a member of the Attorney General's Committee seeking to establish safeguards to protect the public in the field of television servicing." Black and white photograph with caption to glued to reverse.

Nicholas Colon, Jr, Proprietor Tele-FM Television and Advanced Television Techniques graduate, 1954.

This is a photograph showing Nicholas Colon, Jr. a New York Trade School, Advanced Television Techniques graduate with an unnamed worker at his Tele-FM Television company. Original caption reads, "Nicholas Colon, Jr. - Advanced Television Techniques 1954, operates and up-to-date and successful television service shop. He is on the executive board of CETA (Certified Electronic Technicians Association). He prefers to employ graduate technicians of the New York Trade School Advanced Television Techniques course." Black and white photograph with caption glued to reverse.

O Processo de Concessão dos Sistemas de Transporte de Massa na Região Metropolitana do Rio de Janeiro: Implicações na Organização e na Gestão de Transporte de Passageiros

O presente estudo procurou descrever e analisar o contexto em que se desenvolveu o processo de concessão dos sistemas de transporte de massa na Região Metropolitana do Rio de Janeiro, promovido pelo Programa Estadual de Desestatização ¿ PED, na gestão governamental compreendida entre os anos de 1995 e 1998, bem como avaliar suas implicações sobre o modelo de organização e gestão do transporte público regional então vigente. Seu desenvolvimento enfatizou três aspectos desse processo: a caracterização do cenário anterior à proposta de mudança, a análise substantiva da política representada pelo programa de concessões e a avaliação do novo cenário criado como conseqüência do programa. Sua metodologia pautou-se em consulta bibliográfica, volumosa análise documental, observação dos fatos e entrevistas desestruturadas com administradores e técnicos envolvidos no processo. Seus resultados evidenciaram as limitações dos modelos de análise e de planejamento tradicionalmente adotados para a formulação das políticas setoriais, a precariedade dos sistemas de transporte de passageiros regionais e a situação pelos sistemas de metrô, trens e barcas, consubstanciando um ambiente propício às propostas de sua transferência à gestão privada. Evidenciaram, ainda, que a iniciativa foi influenciada pelo contexto dos projetos de reforma do Estado patrocinados pelo Banco Mundial (BIRD), desenvolvendo-se sem referências relevantes na comunidade técnica setorial e gerando um cenário institucional frágil diante da tarefa de gerir os contratos dela resultantes. Embora pautado em estratégias de retomada de investimentos condizentes com as diretrizes do Plano de Transporte de Massa ¿ PTM, elaborado em 1994, a insipiência do programa não permite constatar, ainda tendências significativas no desempenho dos sistemas concedidos. São evidentes, entretanto, seus reflexos na desentruturação do modelo de gestão pública do transporte metropolitano sob responsabilidade do Estado.

O Sistema de Comunicação Digital (SICODI) como instrumento para efetivação do teletrabalho na fiscalização a cargo do Tribunal de Contas do Estado do Rio de Janeiro

The acts of public administration personnel are of great importance and various laws have been passed in attempt to limit the related expenses. The management of Public administration personnel is based on the principle of efficiency. The TCE/RJ (State of Rio de Janeiro/Audit Court) digital communication system is expected through telework to facilitate its auditing duties in compliance with the terms of the Federal and State constitutions. The TCE/RJ, the superior judicial body of auditing, has done more than just reduce costs and use flextime; it applies telework as an instrument to optimize public service through SICODI digital certification to maximize the resources applied to this constitutional act with greater efficiency for effective auditing. The focus of the first part of this study is to evaluate the tasks of positions that forward the TCE/RJ objectives and the profile characteristics of employees of the inspection area on personnel performance beginning with defined concepts and purposes. Questionnaires for auditors and technicians of the area were approved for this specific purpose to analyze the duties of positions and employee profiles. The second part of this study evaluates the TCE/RJ digital communication system according to theoretical reference and ISO/IEC Standard No. 9126-1, observing three dimensions: the content, usability and functionality. The results obtained, with the use of qualitative methods complemented by quantitative analysis, were positive for the implementation of telework in the inspection of personnel performance in relation to the analysts and technicians involved in this type of auditing as well as in relation to the TCE/RJ digital communication system.