Interoperability for eLearning Service Management and Provision

Learning Objects offer flexibility and adaptability for users to request personalised information for learning. There are standards to guide the development of learning objects. However, individual developers may customise these standards for serving different purposes when defining, describing, managing and providing learning objects, which are normally stored in heterogeneous repositories. Barriers to interoperability hinder sharing of learning services and subsequently affect quality of instructional design as learners expect to be able to receive their personalised learning content. All these impose difficulties to the users in getting the right information from the right sources. This paper investigates the interoperability issues in eLearning services management and provision and presents an approach to resolve interoperability at three levels.

The Soil: Nature, Sustainable Use, Management, and Protection - An Overview

Soil forms the outer skin of the earth's land surface. Often less than a metre in depth, it is essential to sustain natural terrestrial ecosystems and human life. Soils result from the interactions over time between climate, parent material, topography, vegetation, and biota. They vary from place to place. Mineral soils are composed of mineral matter, organic matter, and gas- or liquid-filled pores in varying proportions. Soils perform a wide range of functions and provide many ecosystem or environmental services; with the climate problem, the soil is increasingly being recognised as a potential sink for carbon from the atmosphere. In part because of humankind's (over)use of soils and in part because of natural and human-induced environmental change, there is a widespread decline in soil quality and an increasing number of threats to soil, which jeopardise both the soil's natural functions and its use by humans. As a limited resource, soils must be used sustainably. Soil protection strategies have been indirectly embodied in a number of United Nations conventions, and there are now national and supranational developments towards specific regulations and legislation to protect soils and their functions.

The impact of a closed-loop electronic prescribing and administration system on prescribing errors, administration errors and staff time: a before-and-after study

Objectives: To assess the impact of a closed-loop electronic prescribing, automated dispensing, barcode patient identification and electronic medication administration record (EMAR) system on prescribing and administration errors, confirmation of patient identity before administration, and staff time. Design, setting and participants: Before-and-after study in a surgical ward of a teaching hospital, involving patients and staff of that ward. Intervention: Closed-loop electronic prescribing, automated dispensing, barcode patient identification and EMAR system. Main outcome measures: Percentage of new medication orders with a prescribing error, percentage of doses with medication administration errors (MAEs) and percentage given without checking patient identity. Time spent prescribing and providing a ward pharmacy service. Nursing time on medication tasks. Results: Prescribing errors were identified in 3.8% of 2450 medication orders pre-intervention and 2.0% of 2353 orders afterwards (p<0.001; χ2 test). MAEs occurred in 7.0% of 1473 non-intravenous doses pre-intervention and 4.3% of 1139 afterwards (p = 0.005; χ2 test). Patient identity was not checked for 82.6% of 1344 doses pre-intervention and 18.9% of 1291 afterwards (p<0.001; χ2 test). Medical staff required 15 s to prescribe a regular inpatient drug pre-intervention and 39 s afterwards (p = 0.03; t test). Time spent providing a ward pharmacy service increased from 68 min to 98 min each weekday (p = 0.001; t test); 22% of drug charts were unavailable pre-intervention. Time per drug administration round decreased from 50 min to 40 min (p = 0.006; t test); nursing time on medication tasks outside of drug rounds increased from 21.1% to 28.7% (p = 0.006; χ2 test). Conclusions: A closed-loop electronic prescribing, dispensing and barcode patient identification system reduced prescribing errors and MAEs, and increased confirmation of patient identity before administration. Time spent on medication-related tasks increased.