Information Technology Development Needs in Community Pharmacies : A Strategic Approach

In the context of health care, information technology (IT) has an important role in the operational infrastructure, ranging from business management to patient care. An essential part of the system is medication management in inpatient and outpatient care. Community pharmacists strategy has been to extend practice responsibilities beyond dispensing towards patient care services. Few studies have evaluated the strategic development of IT systems to support this vision. The objectives of this study were to assess and compare independent Finnish community pharmacy owners and staff pharmacists priorities concerning the content and structure of the next generation of community pharmacy IT systems, to explore international experts visions and strategic views on IT development needs in relation to services provided in community pharmacies, to identify IT innovations facilitating patient care services and to evaluate their development and implementation processes, and to assess community pharmacists readiness to adopt innovations. This study applied both qualitative and quantitative methods. A qualitative personal interview of 14 experts in community pharmacy services and related IT from eight countries and a national survey of Finnish community pharmacy owners (mail survey, response rate 53%, n=308), and of a representative sample of staff pharmacists (online survey, response rate 22%, n=373) were conducted. Finnish independent community pharmacy owners gave priority to logistical functions but also to those related to medication information and patient care. The managers and staff pharmacists have different views of the importance of IT features, reflecting their different professional duties in the community pharmacy. This indicates the need for involving different occupation groups in planning the new IT systems for community pharmacies. A majority of the international experts shared the vision of community pharmacy adopting a patient care orientation; supported by IT-based documentation, new technological solutions, access to information, and shared patient data. Community pharmacy IT innovations were rare, which is paradoxical because owners and staff pharmacists perception of their innovativeness was seen as being high. Community pharmacy IT systems development processes usually had not undergone systematic needs assessment research beforehand or evaluation after the implementation and were most often coordinated by national governments without subsequent commercialization. Specifically, community pharmacy IT developments lack research, organization, leadership and user involvement in the process. Those responsible for IT development in the community pharmacy sector should create long-term IT development strategies that are in line with community pharmacy service development strategies. This could provide systematic guidance for future projects to ensure that potential innovations are based on a sufficient understanding of pharmacy practice problems that they are intended to solve, and to encourage strong leadership in research, development of innovations so that community pharmacists potential innovativeness is used, and that professional needs and strategic priorities will be considered even if the development process is led by those outside the profession.

Costs and Benefits of a Shared Digital Long-Term Preservation System

This paper describes the cost-benefit analysis of digital long-term preservation (LTP) that was carried out in the context of the Finnish National Digital Library Project (NDL) in 2010. The analysis was based on the assumption that as many as 200 archives, libraries, and museums will share an LTP system. The term ‘system’ shall be understood as encompassing not only information technology, but also human resources, organizational structures, policies and funding mechanisms. The cost analysis shows that an LTP system will incur, over the first 12 years, cumulative costs of €42 million, i.e. an average of €3.5 million per annum. Human resources and investments in information technology are the major cost factors. After the initial stages, the analysis predicts annual costs of circa €4 million. The analysis compared scenarios with and without a shared LTP system. The results indicate that a shared system will have remarkable benefits. At the development and implementation stages, a shared system shows an advantage of €30 million against the alternative scenario consisting of five independent LTP solutions. During the later stages, the advantage is estimated at €10 million per annum. The cumulative cost benefit over the first 12 years would amount to circa €100 million.

Molecular theory of underdamped dielectric relaxation: understanding collective effects in dipolar liquids

A molecular theory of underdamped dielectric relaxation of a dense dipolar liquid is presented. This theory properly takes into account the collective effects that are present (due to strong intermolecular correlations) in a dipolar liquid. For small rigid molecules, the theory again leads to a three-variable description which, however, is somewhat different from the traditional version. In particular, two of the three parameters are collective in nature and are determined by the orientational pair correlation function. A detailed comparison between the theory and the computer simulation results of Neria and Nitzan is performed and an excellent agreement is obtained without the use of any adjustable or free parameter - the calculation is fully microscopic. The theory can also provide a systematic description of the Poley absorption often observed in dipolar liquids in the high-frequency regime.

The variants of the protein toxins abrin and ricin A useful guide to understanding the processing events in the toxin transport

Kinetic data on inhibition of protein synthesis in thymocyte by three abrins and ricin have been obtained. The intrinsic efficiencies of A chains of four toxins to inactivate ribosomes, as analyzed by k1-versus-concentration plots were abrin II, III > ricin > abrin I. The lag times were 90, 66, 75 and 105 min at a 0.0744 nM concentration of each of abrin I, II, III and ricin, respectively. To account for the observed differences in the dose-dependent lag time, functional and structural variables of toxins such as binding efficiency of B chains to receptors and low-pH-induced structural alterations have been analyzed. The association constants obtained by stopped flow studies showed that abrin-I (4.13 × 105 M−1 s−1) association with putative receptor (4-methylumbelliferyl-α-D-galactoside) is nearly two times more often than abrin III (2.6 × 105 M−1 s−1) at 20°C. Equillibrium binding constants of abrin I and II to thymocyte at 37°C were 2.26 × 107 M−1 and 2.8 × 107 M−1 respectively. pH-induced structural alterations as studied by a parallel enhancement in 8-anilino-L-naphthalene sulfonate fluorescence revealed a high degree of qualitative similarity. These results taken with a nearly identical concentration-independent lag time (minimum lag of 41–42 min) indicated that the binding efficiencies and internalization efficiencies of these toxins are the same and that the observed difference in the dose-dependent lag time is causally related to the proposed processing event. The rates of reduction of inter-subunit disulfide bond, an obligatory step in the intoxication process, have been measured and compared under a variety of conditions. Intersubunit disulfide reduction of abrin I is fourfold faster than that of abrin II at pH 7.2. The rate of disulfide reduction in abrin I could be decreased 1 I-fold by adding lactose, compared to that without lactose. The observed differences in the efficiencies of A chains, the dose-dependent lag period, the modulating effect of lactose on the rates of disulfide reduction and similarity in binding properties make the variants a valuable tool to probe the processing events in toxin transport in detail.

Understanding changes in the Himalayan cryosphere using remote sensing techniques

In the Himalayas, a large area is covered by glaciers and seasonal snow and changes in its extent can influence availability of water in the Himalayan Rivers. In this paper, changes in glacial extent, glacial mass balance and seasonal snow cover are discussed. Glacial retreat was estimated for 1868 glaciers in 11 basins distributed in the Indian Himalaya since 1962. The investigation has shown an overall reduction in glacier area from 6332 to 5329km2 from 1962 to 2001/2 - an overall deglaciation of 16%. Snow line at the end of ablation season on the Chhota Shigri glacier observed using field and satellite methods suggests a change in altitude from 4900 to 5200m from the late 1970s to present. Seasonal snow cover was monitored in the 28 river sub-basins using normalized difference snow index (NDSI) technique in Central and Western Himalaya. The investigation has shown that in the early part of winter, i.e. from October to December, a large amount of snow retreat was observed. For many basins located in lower altitude and in the south of the Pir Panjal range, snow ablation was observed throughout the winter season. In addition, average stream runoff of the Baspa basin for the month of December increased by 75%. This combination of glacial retreat, negative mass balance, early melting of seasonal snow cover and winter-time increase in stream runoff might suggest an influence of global warming on the Himalayan cryosphere.

Hierarchical Directory-Based Shared Memory Architecture

We describe the design of a directory-based shared memory architecture on a hierarchical network of hypercubes. The distributed directory scheme comprises two separate hierarchical networks for handling cache requests and transfers. Further, the scheme assumes a single address space and each processing element views the entire network as contiguous memory space. The size of individual directories stored at each node of the network remains constant throughout the network. Although the size of the directory increases with the network size, the architecture is scalable. The results of the analytical studies demonstrate superior performance characteristics of our scheme compared with those of other schemes.

RS and GIS in mapping of geomorphic records and understanding the local controls of glacial retreat from the Baspa Valley, Himachal Pradesh, India

We report here the role of remote sensing (RS) and geographical information system (GIS) in the identification of geomorphic records and understanding of the local controls on the retreat of glaciers of the Baspa Valley, Himachal Pradesh, India. The geomorphic records mapped are accumulation zone, exposed ablation zone, moraine-covered ablation zone, snout, deglaciated valley, lateral moraine, medial moraine, terminal moraine and hanging glacier. Details of these features and stages of deglaciation have been extracted from RS data and mapped in a GIS environment. Glacial geomorphic data have been generated for 22 glaciers of the Baspa Valley. The retreat of glaciers has been estimated using the glacial maxima observed on satellite images. On the basis of percentage of retreat and the critical analysis of glacial geomorphic data for 22 glaciers of the Baspa Valley, they are classified into seven categories of very low to very very high retreat. From the analysis of the above 22 glaciers, it has been found that other than global warming, the retreat of glaciers of the Baspa Valley is inversely proportional to the size of the accumulation zone and the ratio of the moraine covered ablation/exposed ablation zone.

Thermodynamic constraints along isograms in ternary systems: application to three-phase equilibria

Thermodynamic constraints on component chemical potentials in three-phase fields introduced by the various isograms suggested in the literature are derived for a ternary system containing compounds. When compositions of two compounds lie on an isogram, it is associated with specific characteristics which can be used to obtain further understanding of the interplay of thermodynamic factors that determine phase equilibria. When two compounds are shared by adjacent three-phase fields, the constraints are dictated by binary compositions generated by the intersection of a line passing through the shared compounds with the sides of the ternary triangle. Generalized expressions for an arbitrary line through the triangle are presented. These are consistent with special relations obtained along Kohler, Colinet and Jacob isograms. Five axioms are introduced and proved. They provide valuable tools for checking consistency of thermodynamic measurements and for deriving thermodynamic properties from phase diagrams. (C) 1997 Elsevier Science S.A.

Understanding glassy dynamics from the free-energy landscape

Many interesting features of the dynamics of simple liquids near the glass transition may be understood in terms of properties of the free-energy landscape obtained from numerical studies of a model free-energy functional. Main results obtained from this approach are summarized and a list of references to relevant publications is provided. (C) 2002 Elsevier Science B.V. All rights reserved.

Understanding the building-up process of three dimensional open-framework metal phosphates: Acid degradation of the 3D structures to lower dimensional structures

Acid degradation of 3D zinc phosphates primarily yields a one-dimensional ladder compound, an observation that is significant considering that the latter forms 3D structures on heating in water.