Training pharmacists to deliver a complex information technology intervention (PINCER) using the principles of educational outreach and root cause analysis

Objective: To describe the training undertaken by pharmacists employed in a pharmacist-led information technology-based intervention study to reduce medication errors in primary care (PINCER Trial), evaluate pharmacists’ assessment of the training, and the time implications of undertaking the training. Methods: Six pharmacists received training, which included training on root cause analysis and educational outreach, to enable them to deliver the PINCER Trial intervention. This was evaluated using self-report questionnaires at the end of each training session. The time taken to complete each session was recorded. Data from the evaluation forms were entered onto a Microsoft Excel spreadsheet, independently checked and the summary of results further verified. Frequencies were calculated for responses to the three-point Likert scale questions. Free-text comments from the evaluation forms and pharmacists’ diaries were analysed thematically. Key findings: All six pharmacists received 22 hours of training over five sessions. In four out of the five sessions, the pharmacists who completed an evaluation form (27 out of 30 were completed) stated they were satisfied or very satisfied with the various elements of the training package. Analysis of free-text comments and the pharmacists’ diaries showed that the principles of root cause analysis and educational outreach were viewed as useful tools to help pharmacists conduct pharmaceutical interventions in both the study and other pharmacy roles that they undertook. The opportunity to undertake role play was a valuable part of the training received. Conclusions: Findings presented in this paper suggest that providing the PINCER pharmacists with training in root cause analysis and educational outreach contributed to the successful delivery of PINCER interventions and could potentially be utilised by other pharmacists based in general practice to deliver pharmaceutical interventions to improve patient safety.

Enhancing fieldwork learning with technology: practitioner's perspectives

This research paper reports the findings from an international survey of fieldwork practitioners on their use of technology to enhance fieldwork teaching and learning. It was found that there was high information technology usage before and after time in the field, but some were also using portable devices such as smartphones and global positioning system whilst out in the field. The main pedagogic reasons cited for the use of technology were the need for efficient data processing and to develop students' technological skills. The influencing factors and barriers to the use of technology as well as the importance of emerging technologies are discussed.

Description and process evaluation of pharmacists’ interventions in a pharmacist-led information technology-enabled multicentre cluster randomised controlled trial for reducing medication errors in general practice (PINCER trial)

Objective To undertake a process evaluation of pharmacists' recommendations arising in the context of a complex IT-enabled pharmacist-delivered randomised controlled trial (PINCER trial) to reduce the risk of hazardous medicines management in general practices. Methods PINCER pharmacists manually recorded patients’ demographics, details of interventions recommended, actions undertaken by practice staff and time taken to manage individual cases of hazardous medicines management. Data were coded and double entered into SPSS v15, and then summarised using percentages for categorical data (with 95% CI) and, as appropriate, means (SD) or medians (IQR) for continuous data. Key findings Pharmacists spent a median of 20 minutes (IQR 10, 30) reviewing medical records, recommending interventions and completing actions in each case of hazardous medicines management. Pharmacists judged 72% (95%CI 70, 74) (1463/2026) of cases of hazardous medicines management to be clinically relevant. Pharmacists recommended 2105 interventions in 74% (95%CI 73, 76) (1516/2038) of cases and 1685 actions were taken in 61% (95%CI 59, 63) (1246/2038) of cases; 66% (95%CI 64, 68) (1383/2105) of interventions recommended by pharmacists were completed and 5% (95%CI 4, 6) (104/2105) of recommendations were accepted by general practitioners (GPs), but not completed at the end of the pharmacists’ placement; the remaining recommendations were rejected or considered not relevant by GPs. Conclusions The outcome measures were used to target pharmacist activity in general practice towards patients at risk from hazardous medicines management. Recommendations from trained PINCER pharmacists were found to be broadly acceptable to GPs and led to ameliorative action in the majority of cases. It seems likely that the approach used by the PINCER pharmacists could be employed by other practice pharmacists following appropriate training.

Strategic positioning and grand strategies for high-technology SMEs

Firm size is found to affect strategic decisions significantly, whereas technology and market stability stimulate product development and innovation.

RedGloo: Experiences of developing and using an emerging technology in higher education

Student life has change a lot since 2005 when the idea to create a Social Network Service (SNS) for students in the School of Systems Engineering at the University of Reading was conceived and went live in 2006, called RedGloo.

Natural caprine whey oligosaccharides separated by membrane technology and profile evaluation by capillary electrophoresis

The functional food market is growing rapidly and membrane processing offers several advantages over conventional methods for separation, fractionation and recovery of bioactive components. The aim of the present study was to select a process that could be implemented easily on an industrial scale for the isolation of natural lactose-derived oligosaccharides (OS) from caprine whey, enabling the development of functional foods for clinical and infant nutrition. The most efficient process was the combination of a pre-treatment to eliminate proteins and fat, using an ultrafiltration (UF) membrane of 25 kDa molecular weight cut off (MWCO), followed by a tighter UF membrane with 1 kDa MWCO. Circa 90% of the carbohydrates recovered in the final retentate were OS. Capillary electrophoresis was used to evaluate the OS profile in this retentate. The combined membrane-processing system is thus a promising technique for obtaining natural concentrated OS from whey. Powered

Older people's perceptions of assistive technology — An exploratory pan-European study

This paper describes a study undertaken to explore how assistive technology in the form of a wrist-worn device is perceived by older people for whom it has been devised.

First human hNT neurons patterned on parylene-C/silicon dioxide substrates: Combining an accessible cell line and robust patterning technology for the study of the pathological adult human brain

In this communication, we describe a new method which has enabled the first patterning of human neurons (derived from the human teratocarcinoma cell line (hNT)) on parylene-C/silicon dioxide substrates. We reveal the details of the nanofabrication processes, cell differentiation and culturing protocols necessary to successfully pattern hNT neurons which are each key aspects of this new method. The benefits in patterning human neurons on silicon chip using an accessible cell line and robust patterning technology are of widespread value. Thus, using a combined technology such as this will facilitate the detailed study of the pathological human brain at both the single cell and network level.

Cooperative R&D with endogenous technology differentiation

We study a nontournament R&D duopoly. Before the standard R&D investment and quantity-setting stages, we consider a stage in which firms choose their R&D technologies. Spillovers negatively depend on R&D technology differentiation. We show that, in equilibrium, firms will choose identical or very similar R&D processes. Such equilibria may entail less differentiation than would be dictated by social welfare maximization.

The invisible hand guiding technology: crossing the boundary of technology

This paper examines attitudes towards Radio Frequency Identification (RFID) technology and explores the wider concerns of the ever increasing prospect of social tagging. Capturing vignettes and narratives from a sample of study participants, the paper highlights concerns about adopting RFID implements now and in the future. The views captured through qualitative methodology act as the platform for a wider argument concerning the human rights and privacy intrusion concerns over IT applications. Intended as an insight into the reality of technology impact, this paper lists a series of questions for leaders to consider over matters of human rights specifically concerning RFID adoption. The authors conclude that caution, naivety and fear are the underlying reasons for society accepting RFIDs without question and that RFIDs will be a part of everyday working and domestic life in the near future.

Technology acceptance and care self-management: consideration in context of chronic care management

With an aging global population, the number of people living with a chronic illness is expected to increase significantly by 2050. If left unmanaged, chronic care leads to serious health complications, resulting in poor patient quality of life and a costly time bomb for care providers. If effectively managed, patients with chronic care tend to live a richer and more healthy life, resulting in a less costly total care solution. This chapter considers literature from the areas of technology acceptance and care self-management, which aims to alleviate symptoms and/or reason for non-acceptance of care, and thus minimise the risk of long-term complications, which in turn reduces the chance of spiralling health expenditure. By bringing together these areas, the chapter highlights areas where self-management is failing so that changes can be made in care in advance of health deterioration.

Calculating the application criticality and business risk from technology obsolescence

The problem of technology obsolescence in information intensive businesses (software and hardware no longer being supported and replaced by improved and different solutions) and a cost constrained market can severely increase costs and operational, and ultimately reputation risk. Although many businesses recognise technological obsolescence, the pervasive nature of technology often means they have little information to identify the risk and location of pending obsolescence and little money to apply to the solution. This paper presents a low cost structured method to identify obsolete software and the risk of their obsolescence where the structure of a business and its supporting IT resources can be captured, modelled, analysed and the risk to the business of technology obsolescence identified to enable remedial action using qualified obsolescence information. The technique is based on a structured modelling approach using enterprise architecture models and a heatmap algorithm to highlight high risk obsolescent elements. The method has been tested and applied in practice in three consulting studies carried out by Capgemini involving four UK police forces. However the generic technique could be applied to any industry based on plans to improve it using ontology framework methods. This paper contains details of enterprise architecture meta-models and related modelling.

Persuasive technology and users acceptance of e-commerce: users perceptions of website persuasiveness

Persuasive technologies have been extensively applied in the context of e-commerce for the purpose of marketing, enhancing system credibility, and motivating users to adopt the systems. Recognising that persuasion impacts on consumer behaviour to purchase online have not been investigated previously. This study reviews theories of technology acceptance, and identifies their limitation in not considering the effect of persuasive technologies when determining user online technology acceptance. The study proposes a theoretical model that considers the effect of persuasive technologies on consumer acceptance of e-commerce websites; with consideration of other related variables, i.e. trust and technological attributes. Moreover the paper proposes a model based on the UTAUT2, which contains relevant contributing factors; including the concept of perceived persuasiveness.

The spaces of the Wednesday Play (BBC TV 1964–1970): production, technology and style

The BBC television drama anthology The Wednesday Play, broadcast from 1964-70 on the BBC1 channel, was high-profile and often controversial in its time and has since been central to accounts of British television’s ‘golden age’. This article demonstrates that production technologies and methods were more diverse at that time than is now acknowledged, and that The Wednesday Play dramas drew both approving but also very critical responses from contemporary viewers and professional reviewers. This article analyses the ways that the physical spaces of production for different dramas in the series, and the different technologies of shooting and recording that were adopted in these production spaces, are associated with but do not determine aesthetic style. The adoption of single-camera location filming rather than the established production method of multi-camera studio videotaping in some of the dramas in the series has been important to The Wednesday Play’s significance, but each production method was used in different ways. The dramas drew their dramatic forms and aesthetic emphases from both theatre and cinema, as well as connecting with debates about the nature of drama for television. Institutional and regulatory frameworks such as control over staff working away from base, budgetary considerations and union agreements also impacted on decisions about how programmes were made. The article makes use of records from the BBC Written Archives Centre, as well as published scholarship. By placing The Wednesday Play in a range of overlapping historical contexts, its identity can be understood as transitional, differentiated and contested.