GPs’ and community pharmacists’ opinions on medication management at transitions of care in Ireland

Objective. The aim of this study was to survey GPs and community pharmacists (CPs) in Ireland regarding current practices of medication management, specifically medication reconciliation, communication between health care providers and medication errors as patients transition in care.
Methods. A national cross-sectional survey was distributed electronically to 2364 GPs, 311 GP Registrars and 2382 CPs. Multivariable associations comparing GPs to CPs were generated and content analysis of free text responses was undertaken.
Results. There was an overall response rate of 17.7% (897 respondents—554 GPs/Registrars and 343 CPs). More than 90% of GPs and CPs were positive about the effects of medication reconciliation on medication safety and adherence. Sixty per cent of GPs reported having no formal system of medication reconciliation. Communication between GPs and CPs was identified as good/very good by >90% of GPs and CPs. The majority (>80%) of both groups could clearly recall prescribing errors, following a transition of care, they had witnessed in the previous 6 months. Free text content analysis corroborated the positive relationship between GPs and CPs, a frustration with secondary care communication, with many examples given of prescribing errors.
Conclusions. While there is enthusiasm for the benefits of medication reconciliation there are limited formal structures in primary care to support it. Challenges in relation to systems that support inter-professional communication and reduce medication errors are features of the primary/secondary care transition. There is a need for an improved medication management system. Future research should focus on the identified barriers in implementing medication reconciliation and systems that can improve it.

Medición con Sistema de Posicionamiento Global (GPS) de las distancias recorridas por puestos en competencias de rugby (URBA)

En el siguiente artículo se evidenciaran las distancias totales recorridas por jugadores de rugby, las cuales se desprenden de datos empíricos (cuantificación de las mismas a través de GPS) de un total de veintiún (N=21)jugadores pertenecientes al grupo I de la URBA. Los datos recogidos nos indican que, independientemente de su puesto dentro de la cancha, los jugadores recorren en promedio 5115 metros por partido. Sin embargo, los datos de mayor importancia, como se verán, son los valores registrados específicamente por cada puesto de juego, ya queel mínimo valor de desplazamiento requerido para un jugadoren este deporte, es el que registran los pilares, de 4092 mts y el mayor valor alcanzado, se da para los puestos de loswings y el full back, donde recorren 5856 mts. El GPS además, nos da la posibilidad de contabilizar las distancias registradas a velocidades de desplazamiento >a los 18 km/h, donde aquí también cada puesto mostrara distintos valores, como se veráen diferentes cuadros. Debido a que ?los requerimientos físicos del rugby son bien diferentes y variados para cada jugador? (Delovo, 2013: 4) ¿resulta necesario diferenciar los entrenamientos para cada puesto específico de este deporte?

GPS - PET : aplicación web para la geolocalización de mascotas

[ES]Este proyecto trata de desarrollar una aplicación web en Ruby on Rails, donde el usuario pueda visualizar en “tiempo real” la ubicación de su animal haciendo uso de su identificador con GPS (microchip con GPS), si existiera tal dispositivo, o un dispositivo de geolocalización GPS incrustado en el collar del perro, para hacer un seguimiento del mismo cuando otra persona que ha sido contratada lo pasea. Al no disponer de microchips o collares con GPS, así como los respectivos animales para hacer el estudio y, por tanto, su posterior seguimiento, se realizará una simulación del mismo, de ahí que el tiempo real esté puesto entre comillas.

Estimación del estado de flujo de tráfico mediante técnicas de preprocesamiento y minería de datos : aplicación a Dataset de posiciones GPS de taxis en Porto

[ES]Uno de los elementos de más importancia en la movilidad de las ciudades desarrolladas es la gestión del tráfico rodado. La movilidad tiene una influencia determinante en la calidad de vida de los ciudadanos por diversas razones, entre la que destacan la seguridad, la eficiencia y el impacto medioambiental. Por ello es preciso dotar a los gestores de esa movilidad de herramientas que les permitan disponer de una idea precisa de la situación actual y si es posible, estimaciones del estado futuro. Esas herramientas les facilitan la toma de decisiones y el planeamiento de la movilidad. En este punto concreto se enmarca este Trabajo Fin de Grado...

Automated Collection of Sign Inventory Information by Integrating Global Positioning System (GPS) with Videologging Data Collection Activities, 1995

Advances in communication, navigation and imaging technologies are expected to fundamentally change methods currently used to collect data. Electronic data interchange strategies will also minimize data handling and automatically update files at the point of capture. This report summarizes the outcome of using a multi-camera platform as a method to collect roadway inventory data. It defines basic system requirements as expressed by users, who applied these techniques and examines how the application of the technology met those needs. A sign inventory case study was used to determine the advantages of creating and maintaining the database and provides the capability to monitor performance criteria for a Safety Management System. The project identified at least 75 percent of the data elements needed for a sign inventory can be gathered by viewing a high resolution image.

What do GPs and Bereaved Parents Think About Paediatric Oncologists and Palliative Care?

Aim The aim of the study was to examine the experiences of bereaved parents and general practitioners (GPs) following the death of a child with cancer within the family home. This presenta-tion focuses on one of the findings; the parent and GP views on the hospital consultants’ involvement in the palliative care. Design A community based qualitative study.Setting West Midlands region, UK. Participants Purposeful sample of 18 GPs and 11 bereaved families. The sample was drawn from the families and GPs of children who had been treated for cancer at a regional childhood cancer centre and who subsequently died within the family home. Methods One-to-one semi-structured tape-recorded interviews were undertaken with GPs and bereaved parents following the death at home of a child with cancer. GPs were contacted three months after the death of the child and the parents at six months. Thematic analysis of the transcriptions was undertaken. Findings Parents described feeling abandoned at the transition to palliation when management of care transferred to the GP. Families did not perceive a seamless service of medical care between hospital and community. Where offered consultant contact was valued by families and GPs. Text and email were used by families as a means of asking the consultant questions. The GPs lacked role clarity where the consultant continued involvement in the care. Conclusions The transition to palliation and the transfer of care to community services needs to be sensitively and actively man-aged for the family and the GP. Medical care between tertiary andprimary care should be seen as a continuum. Improving GP: consultant communication could aid role clarity, identify mecha-nisms for support and advice, and promote the active engagement of the GP in the care. Exploring opportunities for integrated con-sultant: GP working could maximise mutual learning and support and enhance care provision. The level, access and duration of ongoing contact between consultants and families/GPs require clarity.

Providing Palliative Care for the Child with Cancer: The Experience of GPs

Background Childhood cancers are rare and general practitioners (GPs) have limited experience in caring for these children and even less in providing their palliative care. Most families prefer that their child is cared for at home in the palliative phase of their illness, with professional support from those known to them (Chambers and Oakhill 1995, Vickers and Carlisle 2000, Craft and Killen 2007). A community based qualitative study examined the experiences of ten GPs following their involvement in the care of a child with cancer receiving palliative care within the family home. Methods Data collection was through 1:1 in-depth interviews and facilitated case discussion supported by field notes and grounded theory analysis (chronological comparative data analysis identifying generated themes). Social worlds theory was used as a framework to aid examination, and facilitate critical understanding, of the experiences of the GPs. Findings This presentation focuses on five of the findings relating to the experiences of the GP; the impact of minimal contact; lack of knowledge and experience, uncertain role, out of hours service provision and the emotional toll. Findings highlighted that GPs often have to re-establish their role at the child’s transition to palliative care. Factors hindering the GP in this process include a deficit of specialist knowledge and experience of paediatric palliative care and lack of role clarity. Conclusions/points of interest Strategies for enhancing the role of the Macmillan team in supporting GPs have been identified by this study, such as enhanced collaborative working. Findings have also provided further confirmation of the substantial variation in out of hours medical palliative care provision; with evidence that some GPs work beyond their remit in providing informal out of hours care. This presentation details the findings of one aspect (the experiences of GPs) of a wider study that explored the experiences of 54 community based health professionals (GPs, community nurses and allied health professionals) who had been involved in caring for a dying with cancer receiving palliative care at home (Neilson 2009).