Patient removals from general practitioner lists in Northern Ireland:1987-1996

Being struck off a general practitioner's list is a major event for patients and a subject for much media attention. However, it has not hitherto received much research attention.

A comparison of the application of STOPP/START to patients' drug lists with and without clinical information

Background A European screening tool (STOPP/START) has been formulated to identify the prescribing of potentially inappropriate medicines (PIMs) and potential prescribing omissions (PPOs). Pharmacists working in community pharmacies could use STOPP/START as a guide to conducting medication use reviews; however, community pharmacists do not routinely have access to patients' clinical records. Objective To compare the PIM and PPO detection rates from application of the STOPP/START criteria to patients' medication details alone with the detection rates from application of STOPP/START to information on patients' medications combined with clinical information. Setting Community Pharmacy. Method Three pharmacists applied STOPP/START to 250 patient medication lists, containing information regarding dose, frequency and duration of treatment. The PIMs and PPOs identified by each pharmacist were compared with those identified by consensus agreement of two other pharmacists, who applied STOPP/START criteria using patients' full clinical records. Main outcome measure The main outcome measures were: (1) PIM and PPO detection rates among pharmacists with access to patients' clinical information compared to PIM and PPO detection rates among pharmacists using patients' medication information only, and (2) the levels of agreement (calculated using Cohen's kappa statistic (k)) for the three most commonly identified PIMs and PPOs. Results Pharmacists with access to patients' clinical records identified significantly fewer PIMs than pharmacists without (p = 0.002). The three most commonly identified PIMs were benzodiazepines, proton pump inhibitors and duplicate drug classes, with kappa (k) statistic agreement ranges of 0.87-0.97, 0.60-0.68 and 0.39-0.85 respectively. PPOs were identified more often (p 

The Senses of Muriel Rukeyser’s The Book of the Dead

When Muriel Rukeyser travelled to Gauley Bridge in 1936 to report on the industrial disaster that had led to the deaths of over 700 miners, her findings led her to write what is arguably her masterpiece – the 1938 poem series The Book of the Dead. Of all Rukeyser's writings, this hybrid work of documentary techniques and metaphors, of testimony and elegy, has attracted the most critical attention. However, analyses of the series have tended to focus on the ways in which the poet adopted and adapted documentary methods in order to offer a leftist ideological critique on capitalist-born social injustice. The purpose of this article is not to negate such readings, but to offer alongside them insight into a more ethical-philosophical approach that I believe guided Rukeyser's entire career. Via an examination of the ways in which Rukeyser employs the human senses to articulate the complexities of human political, metaphysical and social relations, this article explores the influence of the Zionist Martin Buber on the poet. Rukeyser acknowledged Buber's writings in her later work, but I contend here that they played a large part in the formation of her poetics, especially in connection with her documentary aesthetic. Whilst several critics have noted, albeit often superficially, the Marxist flavour of Rukeyser's poetry in The Book of the Dead, I argue for the influence of Buber over Marx in terms or responsibility, community and dialogue. Both Rukeyser's and Buber's methods of expressing and promoting these ethical necessities rely on a synaesthetic response to the world. Where Buber advances a dialogue between the self and alterity through transcendent personal encounter, Rukeyser locates such encounter in the poem, arguing for an exchange that leads to creation, and to personal and interpersonal growth.