An evaluation of the epidemiology of medication discrepancies and clinical significance of medicines reconciliation in children admitted to hospital

Aims: To determine the incidence of unintended medication discrepancies in paediatric patients at the time of hospital admission; evaluate the process of medicines reconciliation; assess the benefit of medicines reconciliation in preventing clinical harm. Method: A 5 month prospective multisite study. Pharmacists at four English hospitals conducted admission medicines reconciliation in children using a standardised data collection form. A discrepancy was defined as a difference between the patient's preadmission medication (PAM), compared with the initial admission medication orders written by the hospital doctor. The discrepancies were classified into intentional and unintentional discrepancies. The unintentional discrepancies were assessed for potential clinical harm by a team of healthcare professionals, which included doctors, pharmacists and nurses. Results: Medicines reconciliation was conducted in 244 children admitted to hospital. 45% (109/244) of the children had at least one unintentional medication discrepancy between the PAM and admission medication order. The overall results indicated that 32% (78/244) of patients had at least one clinically significant unintentional medication discrepancy with potential to cause moderate 20% (50/244) or severe 11% (28/244) harm. No single source of information provided all the relevant details of a patient's medication history. Parents/carers provided the most accurate details of a patient's medication history in 81% of cases. Conclusions: This study demonstrates that in the absence of medicines reconciliation, children admitted to hospitals across England are at risk of harm from unintended medication discrepancies at the transition of care from the community to hospital. No single source of information provided a reliable medication history.

The impact of regulation and ownership structure on market orientation in the tourism industry in China

The nature of market orientation and its impact on business performance and other related outcomes have been extensively researched in a range of service contexts including tourism. In contrast, our understanding of the factors that influence market orientation is still limited. This paper reports on a study that contributes to our understanding of the determinants of market orientation within the tourism sector by focusing specifically on the role played by two strategically important variables, namely government regulation and ownership structure. The study analyses two national samples of hotels and travel services in the rapidly growing tourism industry in China. The hotel sector has been open to foreign investment for two decades and has a diversified ownership structure, whereas the travel services sector has been dominated by government owned firms and relatively closed to foreign investment. The results of the survey suggest that of the two new antecedents, only government regulation has a significant role to play in driving market orientation. Internally, access to appropriate managerial and marketing capabilities was identified as a significant predictor of the development of market orientation.

Collocations

J R Firth first gave prominence to collacation in linguistic theory. Halliday, Sinclair, Stubbs, and Hoey have all extended Firth's ideas. Palmer and Hornby recognized the pedagogical value of collocation, and incorporated it into their early EFL dictionaries. More recent EFL dictionaries, based on large, computerized language corpora, have used complex software and statistical measures to gain further insights into the way that collocational patterns are woven into language, and the results are visible in the dictionary entries of later editions. This has fed back into language pedagogy, and is also influencing translation and computational research. © 2006 Elsevier Ltd. All rights reserved.

English collocation studies:the OSTI report

This is the first published edition of John Sinclair, Susan Jones and Robert Daley's research on collocation undertaken in 1970. The unpublished report was circulated amongst a small group of academics and was enormously influential, sparking a growth of interest in collocation amongst researchers in linguistics. Collocation was first viewed as important in computational linguistics in the work of Harold Palmer in Japan. Later M.A.K. Halliday and John Sinclair published on collocation in the 1960s. English Collocation Studies is a report on empirical research into collocation, devised by Halliday with Sinclair acting as the Principal Investigator and editor of the resultant OSTI report. The present edition contains an introduction by Professor Wolfgang Teubert based on his interview with John Sinclair. The introduction assesses the extent to which the findings of the original research have developed in the intervening years, and how some of the techniques mentioned in the report were implemented in the COBUILD project at Birmingham University in the 1980s.

Corpus, collocation, and lexical sets

This paper is a progress report on a research path I first outlined in my contribution to “Words in Context: A Tribute to John Sinclair on his Retirement” (Heffer and Sauntson, 2000). Therefore, I first summarize that paper here, in order to provide the relevant background. The second half of the current paper consists of some further manual analyses, exploring various parameters and procedures that might assist in the design of an automated computational process for the identification of lexical sets. The automation itself is beyond the scope of the current paper.

Burning questions, but no burning answers: collocation and idiomaticity

The attention of linguists has increasingly shifted from grammar to lexis. Collocation has emerged as a key feature of lexis. Research using large language corpora has not only helped to identify the significant collocates of individual words but also to confirm the importance of collocation in the language system. John Sinclair has suggested that language operates on two principles: open choice and idiom. If so, then collocation would appear to be the minimal level of idiomaticity. One problem with collocation is that words that habitually co-occur form less distinct, often discontinuous, idiomatic units, whereas grammar generally works with more precisely delineated and contiguous structural units. This paper uses examples from corpus evidence to look at various aspects of collocation.

Organizational and textual structuring of radio news discourse in English and Arabic.

The present work studies the overall structuring of radio news discourse via investigating three metatextual/interactive functions: (1) Discourse Organizing Elements (DOEs), (2) Attribution and (3) Sentential and Nominal Background Information (SBI & NBI). An extended corpus of about 73,000 words from BBC and Radio Damascus news is used to study DOEs and a restricted corpus of 38,000 words for Attribution and S & NBI. A situational approach is adopted to assess the influence of factors such as medium and audience on these functions and their frequence. It is found that: (1) DOEs are organizational and their frequency is determined by length of text; (2) Attribution Function in accordance with the editor's strategy and its frequency is audience sensitive; and (3) BI provides background information and is determined by audience and news topics. Secondly, the salient grammatical elements in DOEs are discourse deictic demonstratives, address pronouns and nouns referring to `the news'. Attribution is realized in reporting/reported clauses, and BI in a sentence, a clause or a nominal group. Thirdly, DOEs establish a hierarchy of (1) news, (2) summary/expansion and (3) item: including topic introduction and details. While Attribution is generally, and SBI solely, a function of detailing, NBI and proper names are generally a function of summary and topic introduction. Being primarily addressed to audience and referring metatextually, the functions investigated support Sinclair's interactive and autonomous planes of discourse. They also shed light on the part(s) of the linguistic system which realize the metatextual/interactive function. Strictly, `discourse structure' inevitably involves a rank-scale; but news discourse also shows a convention of item `listing'. Hence only within the boundary of variety (ultimately interpreted across language and in its situation) can textual functions and discourse structure be studied. Finally, interlingual variety study provides invaluable insights into a level of translation that goes beyond matching grammatical systems or situational factors, an interpretive level which has to be described in linguistic analysis of translation data.