Implementation of individualised medication administration guides for patients with dysphagia: Results from a pilot controlled trial

Introduction Patients with dysphagia (PWDs) have been shown to be four times more likely to suffer medication administration errors (MAEs).1 2 Individualised medication administration guides (I-MAGs) which outline how each formulation should be administered, have been developed to standardise medication administration by nurses on the ward and reduce the likelihood of errors. This pilot study aimed to determine the recruitment rates, estimate effect on errors and develop the intervention to design a future full scale randomised controlled trial to determine the costs and effects of I-MAG implementation. Ethical approval was granted by local ethics committee. Method Software was developed to enable I-MAG production (based on current best practice)3 4 for all PWDs on two care of the older person wards admitted during a six month period from January to July 2011. I-MAGs were attached to the medication administration record charts to be utilised by nurses when administering medicines. Staff training was provided for all staff on the intervention wards. Two care of the older person wards in the same hospital were used for control purposes. All patients with dysphagia were recruited for follow up purposes at discharge. Four ward rounds at each intervention and control ward were observed pre and post I-MAG implementation to determine the level of medication administration errors. NHS ethical approval for the study was obtained. Results 164 I-MAGs were provided for 75 patients with dysphagia (PWDs) in the two intervention wards. At discharge, 23 patients in the intervention wards and 7 patients in the control wards were approached for recruitment of which 17 (74%) & 5 (71.5%) respectively consented. Discussion Recruitment rates were low on discharge due to the dysphagia remitting during hospitalisation. The introduction of the I-MAG demonstrated no effect on the quality of administration on the intervention ward and interestingly practice improved on the control ward. The observation of medication rounds at least one month post I-MAG removal may have identified a reversal to normal practice and ideally observations should have been undertaken with I-MAGs in place. Identification of the reason for the improvement in the control ward is warranted.

Uncovering misconceptions through text analysis

Assessing students’ conceptual understanding of technical content is important for instructors as well as students to learn content and apply knowledge in various contexts. Concept inventories that identify possible misconceptions through validated multiple-choice questions are helpful in identifying a misconception that may exist, but do not provide a meaningful assessment of why they exist or the nature of the students’ understanding. We conducted a case study with undergraduate students in an electrical engineering course by testing a validated multiple-choice response concept inventory that we augmented with a component for students to provide written explanations for their multiple-choice selection. Results revealed that correctly chosen multiple-choice selections did not always match correct conceptual understanding for question testing a specific concept. The addition of a text-response to multiple-choice concept inventory questions provided an enhanced and meaningful assessment of students’ conceptual understanding and highlighted variables associated with current concept inventories or multiple choice questions.

Engineering education and sustainable development: Rapid curriculum renewal

The issue of engineering education and how it can systemically embed sustainable development knowledge and skills is now a major consideration for engineering educators globally. In this plenary presentation Ms Desha will begin by highlighting the rapidly changing market and regulatory environment and the time lag dilemma facing higher education with regard to delivering professionals who can address societal needs. She will then briefly present a series of elements of curriculum renewal to support engineering educators who are grappling with how programs of study can be rapidly renewed to address such emerging 21st Century challenges. The presentation will conclude with a discussion of the need for astrategic approach by higher education institutions, to ensure that the latest research and opportunities are communicated, while being sufficiently pragmatic and realistic with regard to the scale of the challenges, and existing inertia within the higher education system.

A New Full-diversity Criterion and Low-complexity STBCs with Partial Interference Cancellation Decoding

Recently, Guo and Xia gave sufficient conditions for an STBC to achieve full diversity when a PIC (Partial Interference Cancellation) or a PIC-SIC (PIC with Successive Interference Cancellation) decoder is used at the receiver. In this paper, we give alternative conditions for an STBC to achieve full diversity with PIC and PIC-SIC decoders, which are equivalent to Guo and Xia's conditions, but are much easier to check. Using these conditions, we construct a new class of full diversity PIC-SIC decodable codes, which contain the Toeplitz codes and a family of codes recently proposed by Zhang, Xu et. al. as proper subclasses. With the help of the new criteria, we also show that a class of PIC-SIC decodable codes recently proposed by Zhang, Shi et. al. can be decoded with much lower complexity than what is reported, without compromising on full diversity.

Improving query focused summarization using look-ahead strategy

Query focused summarization is the task of producing a compressed text of original set of documents based on a query. Documents can be viewed as graph with sentences as nodes and edges can be added based on sentence similarity. Graph based ranking algorithms which use 'Biased random surfer model' like topic-sensitive LexRank have been successfully applied to query focused summarization. In these algorithms, random walk will be biased towards the sentences which contain query relevant words. Specifically, it is assumed that random surfer knows the query relevance score of the sentence to where he jumps. However, neighbourhood information of the sentence to where he jumps is completely ignored. In this paper, we propose look-ahead version of topic-sensitive LexRank. We assume that random surfer not only knows the query relevance of the sentence to where he jumps but he can also look N-step ahead from that sentence to find query relevance scores of future set of sentences. Using this look ahead information, we figure out the sentences which are indirectly related to the query by looking at number of hops to reach a sentence which has query relevant words. Then we make the random walk biased towards even to the indirect query relevant sentences along with the sentences which have query relevant words. Experimental results show 20.2% increase in ROUGE-2 score compared to topic-sensitive LexRank on DUC 2007 data set. Further, our system outperforms best systems in DUC 2006 and results are comparable to state of the art systems.