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.

Kangaroo Mother Care in a Mozambican perinatal ward : a clinical case study

Kangaroo mother care (KMC) was first introduced in Mozambique in 1984. The aim of this study was to describe Mozambican mothers’ experiences of going through admission, passing from an intensive care ward to a nursery ward with their premature baby, undergoing KMC training before early discharge. A clinical case study was conducted, involving naturalistic observations and a face-to-face interview with 41 mothers participating to complete a questionnaire. Descriptive statistics and manifest content analysis were used in this study. The results show that the mothers were of low socio-economic standing and felt that they did not have enough information on KMC. The hierarchical organization within the hospital setting as well as communalistic behaviours influenced the mothers’ support of KMC, including information, communication, relationships and actions. The conclusion is that there is an important challenge for trained neonatal nurses to improve the guidelines for KMC and to empower mothers and their families to adopt KMC.

SPATIAL ANALYSIS OF COLBY COLLEGE TRAILS: PERKINS ARBORETUM AND RUNNALS HILL

http://digitalcommons.colby.edu/atlasofmaine2006/1021/thumbnail.jpg

Spatial Analysis of Colby College Trails: Perkins Arboretum and Runnals Hill

I created an updated map of trails at Colby College using global positioning system data that were then edited in ArcGIS. The map background, obtained from the Maine Office of GIS, was created from digital orthophotographs produced from aerial photos collected over southwest Maine in Spring 2003. Trail difficulty was determined by creating a slope layer and taking other factors into consideration such as ground surface and path width. The map will eventually be available online, enabling interactive selection of trails where users can access additional trail information.

Campus Life: In Perkins Arboretum there are birds of all feathers, trees that tell a story, and even romance (especially if you're a frog)

To the uninitiated, Perkins Arboretum is the edge of campus. For those familiar with its flora and fauna, the arboretum is a wondrous classroom and refuge.

Components of Turnera diffusa Willd. var. afrodisiaca (Ward) Urb. essential oil

Turnera diffusa Willd. var. afrodisiaca (Ward) Urb. (syn. T aphrodisiaca) (Turneraceae) is a common aromatic plant growing wild in the subtropical regions of America and Africa. Its essential oil was studied by GC and GC-MS. Fifty-four components were characterized and identified, the most abundant being 1,8-cineol (11.4%), opoplenone (10.3%) cadalene (5.1%) and epi-cubenol (4.1%). Copyright (C) 2002 John Wiley Sons, Ltd.

Light-front zero-mode contribution to the Ward Identity

In a covariant gauge we implicitly assume that the Green's function propagates information from one point of the space-time to another, so that the Green's function is responsible for the dynamics of the relativistic particle. In the light front form one would naively expect, that this feature would be preserved. In this manner, the fermionic field propagator can be split into a propagating piece and a non-propagating (contact) term. Since the latter (contact) one does not propagate information; and therefore, supposedly can be discarded with no harm to the field dynamics we wanted to know what would be the impact of dropping it off. To do that, we investigated its role in the Ward identity in the light front. Here we use the terminology Ward identity to identify the limiting case of photon's zero momentum transfer in the vertex from the more general Ward-Takahashi identity with nonzero momentum transfer.

Application of low-pressure gas chromatography-ion-trap mass spectrometry to the analysis of the essential oil of Turnera diffusa (Ward.) Urb.

Turnera diffusa Willd. var. afrodisiaca (Ward) Urb. (syn. T. aphrodisiaca) belongs to the family of Turneraceae and is an aromatic plant growing wild in the subtropical regions of America and Africa. It is widely used in the traditional medicine as e.g. anti-cough, diuretic, and aphrodisiac agent. This work presents a 3 min chromatographic analysis using low-pressure (LP) gas chromatography (GC)-ion-trap (IT) mass spectrometry (MS). The combination of a deactivated 0.6 m x 0.10 mm i.d., restrictor with a wide-bore CP-Wax 52 capillary column (10 m x 0.53 mm i.d., 1 mum) reduces the analysis time by a factor of 3-7 in comparison to the use of a conventional narrow bore column. Chromatographic conditions have been optimized to achieve the fastest separation with the highest signal/noise ratio in MS detection. These results allow fast and reliable quality control of the essential oil to be achieved. (C) 2003 Elsevier B.V. All rights reserved.

As manifestações do gótico em Lovecraft: do Castelo de Otranto ao solar de Ward

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Robert M. Ward Photograph Collection - Accession 502

The Robert M. Ward Photograph Collection consists of approximately 400 prints and 900 negatives from the photographs that he took in the 1940s, 1950s, and 1960s. Most of the events and individuals pictured are from the York County, SC area and include the Latta House in York, South Carolina, downtown Rock Hill, parades, baseball, military, aviation, sports, and other York County buildings and scenes. Also included are photographs of Landsford Canal State Park, York Technical College, Winthrop University, Catawba Indian chieftain King Haigler’s memorial, Andrew Jackson State Park, Kings Mountain State Park, Hall of Fame Golfer Sam Sneed's visit to Rock Hill, SC, and Charleston, South Carolina. The collection also contains newspaper articles from the York Observer, dated from 1988 to 1992, which helped to identify some of the people and events in the pictures.