Early Medieval Settlement in North County Antrim: the significance of Doonmore and Drumadoon

The excavated north Antrim sites of Doonmore and Drumadoon are compared and attention is drawn to a group of like monuments in the same barony, here termed fortified outcrops. These are argued to be a type influenced by settlements in Argyll and introduced by the Dál Riata to Ulster through ‘counterstream migration’.

Spatial allocation of material flow analysis in residential developments: a case study of Kildare County, Ireland

Studies of urban metabolism provide important insights for environmental management of cities, but are not widely used in planning practice due to a mismatch of data scale and coverage. This paper introduces the Spatial Allocation of Material Flow Analysis (SAMFA) model as a potential decision support tool aimed as a contribution to overcome some of these difficulties and describes its pilot use at the county level in the Republic of Ireland. The results suggest that SAMFA is capable of identifying hotspots of higher material and energy use to support targeted planning initiatives, while its ability to visualise different policy scenarios supports more effective multi-stakeholder engagement. The paper evaluates this pilot use and sets out how this model can act as an analytical platform for the industrial ecology–spatial planning nexus.

Prevalence, Nature, Severity and Risk Factors for Prescribing Errors in Hospital Inpatients: Prospective Study in 20 UK Hospitals

Introduction: It has been suggested that doctors in their first year of post-graduate training make a disproportionate number of prescribing errors.

Obkective: This study aimed to compare the prevalence of prescribing errors made by first-year post-graduate doctors with that of errors by senior doctors and non-medical prescribers and to investigate the predictors of potentially serious prescribing errors.

Methods: Pharmacists in 20 hospitals over 7 prospectively selected days collected data on the number of medication orders checked, the grade of prescriber and details of any prescribing errors. Logistic regression models (adjusted for clustering by hospital) identified factors predicting the likelihood of prescribing erroneously and the severity of prescribing errors.

Results: Pharmacists reviewed 26,019 patients and 124,260 medication orders; 11,235 prescribing errors were detected in 10,986 orders. The mean error rate was 8.8 % (95 % confidence interval [CI] 8.6-9.1) errors per 100 medication orders. Rates of errors for all doctors in training were significantly higher than rates for medical consultants. Doctors who were 1 year (odds ratio [OR] 2.13; 95 % CI 1.80-2.52) or 2 years in training (OR 2.23; 95 % CI 1.89-2.65) were more than twice as likely to prescribe erroneously. Prescribing errors were 70 % (OR 1.70; 95 % CI 1.61-1.80) more likely to occur at the time of hospital admission than when medication orders were issued during the hospital stay. No significant differences in severity of error were observed between grades of prescriber. Potentially serious errors were more likely to be associated with prescriptions for parenteral administration, especially for cardiovascular or endocrine disorders.

Conclusions: The problem of prescribing errors in hospitals is substantial and not solely a problem of the most junior medical prescribers, particularly for those errors most likely to cause significant patient harm. Interventions are needed to target these high-risk errors by all grades of staff and hence improve patient safety.