990 resultados para medication systems


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In this paper we present an update on our novel visualization technologies based on cellular immune interaction from both large-scale spatial and temporal perspectives. We do so with a primary motive: to present a visually and behaviourally realistic environment to the community of experimental biologists and physicians such that their knowledge and expertise may be more readily integrated into the model creation and calibration process. Visualization aids understanding as we rely on visual perception to make crucial decisions. For example, with our initial model, we can visualize the dynamics of an idealized lymphatic compartment, with antigen presenting cells (APC) and cytotoxic T lymphocyte (CTL) cells. The visualization technology presented here offers the researcher the ability to start, pause, zoom-in, zoom-out and navigate in 3-dimensions through an idealised lymphatic compartment.

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The influence of constructivism and the ongoing drive for convergence, both of career theories and between theory and practice, have been key drivers in the career development literature for two decades (Patton, International Handbook of Career Guidance, 2008). Both contextual action theory and systems theory are derived from the root metaphor of contextualism, which has been proffered as a worldview to assist scientists and practitioners in organizing day-to-day experiential data. This chapter identifies the theoretical contributions of the Systems Theory Framework (STF) (Patton and McMahon, Career development and systems theory: A new development, 1999, Career psychology in South Africa, 2006) and Contextual Action Theory (Young and Valach, The future of career, 2000, Journal of Vocational Behavior 64:499–514, 2004; Young et al., Career choice and development, 1996, Career choice and development, 2002), each of which has advanced thinking in theory integration and in the integration between theory and practice in the career development and counseling field. Young et al. (Career development in childhood and adolescence, 2007) noted the connections between the Patton and McMahon systems theory approach and the contextual action theory approach and these connections will be highlighted in terms of the application of these theoretical developments to practice in career counseling, with a particular focus on the commonalities between the two approaches and what counselors can learn from each of them. In particular, this chapter will discuss common conceptual understandings and practice dimensions.

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Pre-service teacher education institutions are large and complex organizations, which are notoriously difficult to change. One factor is that many change efforts focus largely on individual pre-service teacher educators altering their practice. We report here on our experience using a model for effecting change, which views pre-service teacher education institutions and educators as a part of a much broader system. We identified numerous possibilities for, and constraints on, embedding change, but focus only on two in this paper: participants’ knowledge of change strategies and their leadership capacities. As a result of our study findings and researcher reflections, we argue that being a leader in an academic area within pre-service teacher education does not equate to leadership knowledge or skills to initiate and enact systems-wide change. Furthermore, such leadership capacities must be explicitly developed if education for sustainability is to become embedded in pre-service teacher education.

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Fire safety design of buildings is essential to safeguard lives and minimize the loss of damage to properties. Light-weight cold-formed steel channel sections along with fire resistive plasterboards are used to construct light gauge steel frame floor systems to provide the required fire resistance rating. However, simply adding more plasterboard layers is not an efficient method to increase FRR. Hence this research focuses on using joists with improved joist section profiles such as hollow flange sections to increase the structural capacity of floor systems under fire conditions and thus their FRR. In this research, the structural and thermal behaviour of LSF floor systems made of LiteSteel Beams with different plasterboard and insulation configurations was investigated using four full scale tests under standard fires. Based on the ultimate failure load of the floor joist at ambient temperature, transient state fire tests were conducted for different Load Ratios. These fire tests showed that the new LSF floor system has improved the FRR well above that of those made of lipped channel sections. The joist failure was predominantly due to local buckling of LSB compression flanges near mid-span with severe yielding of tension flanges. Fire tests have provided valuable structural and thermal performance data of tested floor systems that included time-temperature profiles, and failure times and temperatures. Average failure temperatures of LSB joists and reduced yield strengths were used to predict their ultimate moment capacities, which were compared with corresponding test capacities. This allowed an assessment in relation to the accuracy of current design rules for steel joists at elevated temperatures. This paper presents the details of full scale fire tests of LSF floor systems made of LSB joists with different plasterboard and insulation configurations and their results along with some important findings.

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Organizational and technological systems analysis and design practices such as process modeling have received much attention in recent years. However, while knowledge about related artifacts such as models, tools, or grammars has substantially matured, little is known about the actual tasks and interaction activities that are conducted as part of analysis and design acts. In particular, key role of the facilitator has not been researched extensively to date. In this paper, we propose a new conceptual framework that can be used to examine facilitation behaviors in process modeling projects. The framework distinguishes four behavioral styles in facilitation (the driving engineer, the driving artist, the catalyzing engineer, and the catalyzing artist) that a facilitator can adopt. To distinguish between the four styles, we provide a set of ten behavioral anchors that underpin facilitation behaviors. We also report on a preliminary empirical exploration of our framework through interviews with experienced analysts in six modeling cases. Our research provides a conceptual foundation for an emerging theory for describing and explaining different behaviors associated with process modeling facilitation, provides first preliminary empirical results about facilitation in modeling projects, and provides a fertile basis for examining facilitation in other conceptual modeling activities.

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Background: An inpatient medication chart review at the Gold Coast Hospital identified shortcomings with the prescribing and monitoring of antiepileptic medications. Aim: To evaluate medication management of patients with epilepsy, seizure or convulsion; to map their transition through the health system; and to identify lifestyle behaviours that may lead to overt risks for seizure occurrence. Method: A retrospective observational audit of adult patients (16 years and over) admitted to hospital with a diagnosis of epilepsy, seizure or convulsion from 1 to 31 January 2012. Results: Majority of the 62 episodes of care investigated involved patients who were discharged directly from the ED (68%). Only 30% of all patients discharged from an inpatient unit received a discharge medication record from a pharmacist. Non-adherence with antiepileptic medications, alcohol and/ or recreational drug use and prescription medication misuse were identified as overt risks for seizure occurrence. Conclusion: Valuable insights were gained into the management of seizure patients. The role of the ED pharmacist was reviewed to focus on high-risk seizure patients. An increase in the provision of discharge medication records and patient education on the overt risks for seizure occurrence is needed.

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This paper investigates how community based media organisations are co-creative storytelling institutions, and how they learn to disseminate knowledge in a social learning system. Organisations involved in story co-creation are learning to create in fluid environments.They are project based, with a constant turnover of volunteers or staff. These organisations have to meet the needs of their funding bodies and their communities to remain sustainable. Learning is seen as dialogical, and this is also reflected in the nature of storytelling itself. These organisations must learn to meet the needs of their communities, who in turn learn from the organisation’s expertise in a facilitated setting. This learning is participatory and collaborative, and is often a mix of virtual and offline interaction. Such community-based organisations sit in the realm of a hybrid-learning environment; they are neither a formal educational institution like a college, nor do their volunteers produce outcomes in a professional capacity. Yet, they must maintain a certain level of quality outcomes from their contributors to be of continued value in their communities. Drawing from a larger research study, one particular example is that of the CitizenJ project. CitizenJ is hosted by a state cultural centre, and partnered with publishing partners in the community broadcasting sector. This paper explores how this project is a Community of Practice, and how it promotes ethical and best practice, meets contributors’ needs, emphasises the importance of facilitation in achieving quality outcomes, and the creation of projects for wider community and public interest.

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Background: The inconsistent definition of non-therapeutic medication omissions, under-reporting, and a poor understanding of their associated factors hamper efforts to improve medication administration practices. Aim: To examine the incidence of non-therapeutic medication omissions among acutely ill medical and surgical adult patients; and to identify the patient-, drug- and system-related predictors of these omissions. Method: A medication chart audit of 288 acutely ill adult medical and surgical patients admitted to 4 target wards (2 surgical and 2 medical) at an Australian hospital. Patients admitted to these wards from December 2008 to November 2009, with at least one regularly prescribed medication, were eligible. The sample was stratified according to gender, season and ward. A medication chart audit identified medication omissions, and data were collected on gender, age, length of stay, comorbidities, medication history and clinical pharmacy review. Results: Of the 288 medication charts audited, 220 (75%) had one or more medication omissions. Of the 15 020 medication administration episodes, there were 1687 omissions, resulting in an omission rate per medication administration episode of 11%. Analgesics and aperients were the most frequently omitted medications, with failure to sign the medication record and patient refusal, the main reasons for omission. Female gender (p < 0.001) and the number of medication administration episodes (p < 0.001) were statistically significant predictors of non-therapeutic medication omissions. Conclusion: The high incidence of medication omissions suggests there is need for an agreed definition of medication omission and its inclusion as a reportable incident. Increasing medication reconciliation via implementation of the Medication Management Plan may also reduce the opportunity for error. J Pharm Pract Res 2011; 41: 188-91.

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Background People may alter their solid oral medication dosage forms to make it easier to swallow. However, modification of solid medication dosage forms can lead to adverse effects, and people may alter the dosage forms without informing the health professionals involved in their care. Aim To estimate the prevalence of swallowing difficulties and medication dosage form modification among community pharmacy consumers, and to investigate consumer views, attitudes and interactions with health professionals regarding such issues. Method Consumers were recruited from five community pharmacies in Brisbane, Australia and invited to participate in a structured interview. Results A total of 369 consumers participated in the study. Overall, 16.5% of people reported experiencing swallowing difficulties, and 10.6% of all respondents reported modifying medication dosage forms. Almost half (44.2%) of those surveyed did not think there would be issues with modifying medication dosage forms. Some consumers would not seek advice from health professionals if they experienced swallowing problems and/or would not seek advice from health professionals before modifying their medication dosage forms, regardless of their thoughts about any problems associated with this practice. Conclusion Some consumers appeared to be accustomed to modifying medication dosage forms, even when there was no apparent or obvious need. People were also reluctant to seek advice from health professionals regarding swallowing difficulties, or modifying medication dosage forms. Health professionals must be assertive in educating consumers about swallowing problems, and medication dosage form modification.

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Discounted Cumulative Gain (DCG) is a well-known ranking evaluation measure for models built with multiple relevance graded data. By handling tagging data used in recommendation systems as an ordinal relevance set of {negative,null,positive}, we propose to build a DCG based recommendation model. We present an efficient and novel learning-to-rank method by optimizing DCG for a recommendation model using the tagging data interpretation scheme. Evaluating the proposed method on real-world datasets, we demonstrate that the method is scalable and outperforms the benchmarking methods by generating a quality top-N item recommendation list.

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This paper reviews a variety of advanced signal processing algorithms that have been developed at the University of Southampton as part of the Prometheus (PROgraMme for European Traffic flow with Highest Efficiency and Unprecedented Safety) research programme to achieve an intelligent driver warning system (IDWS). The IDWS includes: visual detection of both generic obstacles and other vehicles, together with their tracking and identification, estimates of time to collision and behavioural modelling of drivers for a variety of scenarios. These application areas are used to show the applicability of neurofuzzy techniques to the wide range of problems required to support an IDWS, and for future fully autonomous vehicles.

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In this paper we discuss some preliminary results of an ethnographic study focused on the ways money and financial issues are collaboratively handled within families. Families develop ‘systems’ or methods through which they organize and manage their everyday financial activities. These systems not only organize everyday family finances, but represent and shape family relationships. Through analysis of our ethnographic field study data, we develop four types of financial systems that we observed in the field: banking arrangements, physical hubs, goal-oriented systems and spatio-temporal organization. In this paper, we discuss examples of these systems and their implications for designing tools to support household financial practices.

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Introduction Patients with dysphagia (PWDs) have been shown to be four times more likely to suffer medication administration errors (MAEs).1 2 Individualised medication administration guides (I-MAGs) which outline how each formulation should be administered, have been developed to standardise medication administration by nurses on the ward and reduce the likelihood of errors. This pilot study aimed to determine the recruitment rates, estimate effect on errors and develop the intervention to design a future full scale randomised controlled trial to determine the costs and effects of I-MAG implementation. Ethical approval was granted by local ethics committee. Method Software was developed to enable I-MAG production (based on current best practice)3 4 for all PWDs on two care of the older person wards admitted during a six month period from January to July 2011. I-MAGs were attached to the medication administration record charts to be utilised by nurses when administering medicines. Staff training was provided for all staff on the intervention wards. Two care of the older person wards in the same hospital were used for control purposes. All patients with dysphagia were recruited for follow up purposes at discharge. Four ward rounds at each intervention and control ward were observed pre and post I-MAG implementation to determine the level of medication administration errors. NHS ethical approval for the study was obtained. Results 164 I-MAGs were provided for 75 patients with dysphagia (PWDs) in the two intervention wards. At discharge, 23 patients in the intervention wards and 7 patients in the control wards were approached for recruitment of which 17 (74%) & 5 (71.5%) respectively consented. Discussion Recruitment rates were low on discharge due to the dysphagia remitting during hospitalisation. The introduction of the I-MAG demonstrated no effect on the quality of administration on the intervention ward and interestingly practice improved on the control ward. The observation of medication rounds at least one month post I-MAG removal may have identified a reversal to normal practice and ideally observations should have been undertaken with I-MAGs in place. Identification of the reason for the improvement in the control ward is warranted.

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This important new book draws lessons from a large-scale initiative to bring about the improvement of an urban education system. Written from an insider perspective by an internationally recognized researcher, it presents a new way of thinking about system change. This builds on the idea that there are untapped resources within schools and the communities they serve that can be mobilized in order to transform schools from places that do well for some children so that they can do well for many more. Towards Self-improving School Systems presents a strategic framework that can help to foster new, more fruitful working relationships: between national and local government; within and between schools; and between schools and their local communities. What is distinctive in the approach is that this is mainly led from within schools, with senior staff having a central role as system leaders. The book will be relevant to a wide range of readers throughout the world who are concerned with the strengthening of their national educational systems, including teachers, school leaders, policy makers and researchers. The argument it presents is particularly important for the growing number of countries where increased emphasis on school autonomy, competition and choice is leading to fragmentation within education provision.