The impact of a closed-loop electronic prescribing and automated dispensing system on the ward pharmacist’s time and activities

Objective To assess the impact of a closed-loop electronic prescribing and automated dispensing system on the time spent providing a ward pharmacy service and the activities carried out. Setting Surgical ward, London teaching hospital. Method All data were collected two months pre- and one year post-intervention. First, the ward pharmacist recorded the time taken each day for four weeks. Second, an observational study was conducted over 10 weekdays, using two-dimensional work sampling, to identify the ward pharmacist's activities. Finally, medication orders were examined to identify pharmacists' endorsements that should have been, and were actually, made. Key findings Mean time to provide a weekday ward pharmacy service increased from 1 h 8 min to 1 h 38 min per day (P = 0.001; unpaired t-test). There were significant increases in time spent prescription monitoring, recommending changes in therapy/monitoring, giving advice or information, and non-productive time. There were decreases for supply, looking for charts and checking patients' own drugs. There was an increase in the amount of time spent with medical and pharmacy staff, and with 'self'. Seventy-eight per cent of patients' medication records could be assessed for endorsements pre- and 100% post-intervention. Endorsements were required for 390 (50%) of 787 medication orders pre-intervention and 190 (21%) of 897 afterwards (P < 0.0001; chi-square test). Endorsements were made for 214 (55%) of endorsement opportunities pre-intervention and 57 (30%) afterwards (P < 0.0001; chi-square test). Conclusion The intervention increased the overall time required to provide a ward pharmacy service and changed the types of activity undertaken. Contact time with medical and pharmacy staff increased. There was no significant change in time spent with patients. Fewer pharmacy endorsements were required post-intervention, but a lower percentage were actually made. The findings have important implications for the design, introduction and use of similar systems.

Hybrid fault detection and isolation in an heater bank of an HVAC system

In this work a hybrid technique that includes probabilistic and optimization based methods is presented. The method is applied, both in simulation and by means of real-time experiments, to the heating unit of a Heating, Ventilation Air Conditioning (HVAC) system. It is shown that the addition of the probabilistic approach improves the fault diagnosis accuracy.

A novel blind channel estimation method for MIMO system

Channel estimation method is a key issue in MIMO system. In recent years, a lot of papers on subspace(SS)-based blind channel estimation have been published, and in this paper, combining SS method with a space-time coding scheme, we proposed a novel blind channel estimation method in MIMO system. Simulation result demonstrates the effectiveness of this method.

A Mobile Agent Based Spam Filter System

A new distributed spam filter system based on mobile agent is proposed in this paper. We introduce the application of mobile agent technology to the spam filter system. The system architecture, the work process, the pivotal technology of the distributed spam filter system based on mobile agent, and the Naive Bayesian filter method are described in detail. The experiment results indicate that the system can prevent spam emails effectively.

A mathematical model, implementation and study of a swarm system

The work reported in this paper is motivated towards the development of a mathematical model for swarm systems based on macroscopic primitives. A pattern formation and transformation model is proposed. The pattern transformation model comprises two general methods for pattern transformation, namely a macroscopic transformation method and a mathematical transformation method. The problem of transformation is formally expressed and four special cases of transformation are considered. Simulations to confirm the feasibility of the proposed models and transformation methods are presented. Comparison between the two transformation methods is also reported.

Evaluation of dichroic material for enhancing light pipe/natural ventilation and daylighting in an integrated system

Integration of natural ventilation and daylighting in a single installation would make both technologies more attractive. One method for the integration is the use of concentric light pipe and ventilation stack. By constructing the light pipe using dichroic materials, the infrared part of the solar radiation is allowed to be transmitted to the stack but the visible light is guided by the light pipe into a room. The heat gain to the interior can be reduced and the thermal stack effect strengthened. Work presented here involved the experimental and computational evaluation of dichroic materials for enhancing both natural stack ventilation and daylighting. The transmittance of a dichroic light pipe was found to be similar to that of a light pipe with a 95% specular reflectance. The infra-red radiation transmitted through the dichroic material into a passive stack was found to enhance the natural ventilation flow by up to 14%. The effect is greater in summer than in winter, which is highly desirable as there is often a lack of driving force for natural stack ventilation in summer.

The ERA-Interim reanalysis: configuration and performance of the data assimilation system

ERA-Interim is the latest global atmospheric reanalysis produced by the European Centre for Medium-Range Weather Forecasts (ECMWF). The ERA-Interim project was conducted in part to prepare for a new atmospheric reanalysis to replace ERA-40, which will extend back to the early part of the twentieth century. This article describes the forecast model, data assimilation method, and input datasets used to produce ERA-Interim, and discusses the performance of the system. Special emphasis is placed on various difficulties encountered in the production of ERA-40, including the representation of the hydrological cycle, the quality of the stratospheric circulation, and the consistency in time of the reanalysed fields. We provide evidence for substantial improvements in each of these aspects. We also identify areas where further work is needed and describe opportunities and objectives for future reanalysis projects at ECMWF

Determination of the density of the multiple access interference of a CDMA system from its moments

A standard CDMA system is considered and an extension of Pearson's results is used to determine the density function of the interference. The method is shown to work well in some cases, but not so in others. However this approach can be useful in further determining the probability of error of the system with minimal computational requirements.

A normative method to analyse workarounds in a healthcare environment: motivations, consequences, and constraints

Healthcare information systems have the potential to enhance productivity, lower costs, and reduce medication errors by automating business processes. However, various issues such as system complexity and system abilities in a relation to user requirements as well as rapid changes in business needs have an impact on the use of these systems. In many cases failure of a system to meet business process needs has pushed users to develop alternative work processes (workarounds) to fill this gap. Some research has been undertaken on why users are motivated to perform and create workarounds. However, very little research has assessed the consequences on patient safety. Moreover, the impact of performing these workarounds on the organisation and how to quantify risks and benefits is not well analysed. Generally, there is a lack of rigorous understanding and qualitative and quantitative studies on healthcare IS workarounds and their outcomes. This project applies A Normative Approach for Modelling Workarounds to develop A Model of Motivation, Constraints, and Consequences. It aims to understand the phenomenon in-depth and provide guidelines to organisations on how to deal with workarounds. Finally the method is demonstrated on a case study example and its relative merits discussed.

The capability-affordance model: a method for analysis and modelling of capabilities and affordances

Existing capability models lack qualitative and quantitative means to compare business capabilities. This paper extends previous work and uses affordance theories to consistently model and analyse capabilities. We use the concept of objective and subjective affordances to model capability as a tuple of a set of resource affordance system mechanisms and action paths, dependent on one or more critical affordance factors. We identify an affordance chain of subjective affordances by which affordances work together to enable an action and an affordance path that links action affordances to create a capability system. We define the mechanism and path underlying capability. We show how affordance modelling notation, AMN, can represent affordances comprising a capability. We propose a method to quantitatively and qualitatively compare capabilities using efficiency, effectiveness and quality metrics. The method is demonstrated by a medical example comparing the capability of syringe and needless anaesthetic systems.

Estimating interchannel observation-error correlations for IASI radiance data in the Met Office system

The optimal utilisation of hyper-spectral satellite observations in numerical weather prediction is often inhibited by incorrectly assuming independent interchannel observation errors. However, in order to represent these observation-error covariance structures, an accurate knowledge of the true variances and correlations is needed. This structure is likely to vary with observation type and assimilation system. The work in this article presents the initial results for the estimation of IASI interchannel observation-error correlations when the data are processed in the Met Office one-dimensional (1D-Var) and four-dimensional (4D-Var) variational assimilation systems. The method used to calculate the observation errors is a post-analysis diagnostic which utilises the background and analysis departures from the two systems. The results show significant differences in the source and structure of the observation errors when processed in the two different assimilation systems, but also highlight some common features. When the observations are processed in 1D-Var, the diagnosed error variances are approximately half the size of the error variances used in the current operational system and are very close in size to the instrument noise, suggesting that this is the main source of error. The errors contain no consistent correlations, with the exception of a handful of spectrally close channels. When the observations are processed in 4D-Var, we again find that the observation errors are being overestimated operationally, but the overestimation is significantly larger for many channels. In contrast to 1D-Var, the diagnosed error variances are often larger than the instrument noise in 4D-Var. It is postulated that horizontal errors of representation, not seen in 1D-Var, are a significant contributor to the overall error here. Finally, observation errors diagnosed from 4D-Var are found to contain strong, consistent correlation structures for channels sensitive to water vapour and surface properties.

Proposal of a floating mechanism based on magnetic levitation method toward EEG-driven robotic system

We discussed a floating mechanism based on quasi-magnetic levitation method that can be attached at the endpoint of a robot arm in order to construct a novel redundant robot arm for producing compliant motions. The floating mechanism can be composed of magnets and a constraint mechanism such that the repelling force of the magnets floats the endpoint part of the mechanism stable for the guided motions. The analytical and experimental results show that the proposed floating mechanism can produce stable floating motions with small inertia and viscosity. The results also show that the proposed mechanism can detect small force applied to the endpoint part because the friction force of the mechanism is very small.

A simple method for integrating a complex model into an ensemble data assimilation system using MPI

This paper details a strategy for modifying the source code of a complex model so that the model may be used in a data assimilation context, {and gives the standards for implementing a data assimilation code to use such a model}. The strategy relies on keeping the model separate from any data assimilation code, and coupling the two through the use of Message Passing Interface (MPI) {functionality}. This strategy limits the changes necessary to the model and as such is rapid to program, at the expense of ultimate performance. The implementation technique is applied in different models with state dimension up to $2.7 \times 10^8$. The overheads added by using this implementation strategy in a coupled ocean-atmosphere climate model are shown to be an order of magnitude smaller than the addition of correlated stochastic random errors necessary for some nonlinear data assimilation techniques.

An alternative method to study the cooling of glasses from melt to solid phase

The aim of this preliminary work was to present a novel method, suitable to investigate the glass cooling, from melt to solid state, based on a fast, non-usual and easy microwave method. The following glass system xBaO . (100-x)B(2)O(3) (x = 0% and 40%) was selected as an example for this study. The melt was poured inside a piece of waveguide and then, its cooling was monitored by the microwave signal as a function of time. The variations in the signal can provide valuable informations about some structural changes that take place during the cooling stages, such as relaxation processes. This method can be useful to investigate the cooling and heating of other materials, opening new possibilities for investigation of dielectric behavior of materials under high temperatures. (C) 2008 Elsevier Inc. All rights reserved.

Improving ultimate convergence of an augmented Lagrangian method

Optimization methods that employ the classical Powell-Hestenes-Rockafellar augmented Lagrangian are useful tools for solving nonlinear programming problems. Their reputation decreased in the last 10 years due to the comparative success of interior-point Newtonian algorithms, which are asymptotically faster. In this research, a combination of both approaches is evaluated. The idea is to produce a competitive method, being more robust and efficient than its `pure` counterparts for critical problems. Moreover, an additional hybrid algorithm is defined, in which the interior-point method is replaced by the Newtonian resolution of a Karush-Kuhn-Tucker (KKT) system identified by the augmented Lagrangian algorithm. The software used in this work is freely available through the Tango Project web page:http://www.ime.usp.br/similar to egbirgin/tango/.