Pharmaceutical review - Queensland Health’s experience

In 1990 Charles Hepler and Linda Strand published a sentinel paper and coined the term ‘Pharmaceutical Care’. This was defined as ‘that component of pharmacy practice which entails the direct interaction of the pharmacist with the patient for the purpose of caring for that patient’s drug-related needs’.1 In 1996 the Regional Pharmaceutical Officers’ Statement of Principles and Standards of Good Practice for Hospital Pharmacy in the UK stated that ‘All patients will receive the medicines to meet their agreed therapeutic objectives throughout the course of their treatment. This requires that the care plan for each patient identifies the correct choice of medication and is supported by systems for the provision of medicines…’

A review on prognostic techniques for non-stationary and non-linear rotating systems

The field of prognostics has attracted significant interest from the research community in recent times. Prognostics enables the prediction of failures in machines resulting in benefits to plant operators such as shorter downtimes, higher operation reliability, reduced operations and maintenance cost, and more effective maintenance and logistics planning. Prognostic systems have been successfully deployed for the monitoring of relatively simple rotating machines. However, machines and associated systems today are increasingly complex. As such, there is an urgent need to develop prognostic techniques for such complex systems operating in the real world. This review paper focuses on prognostic techniques that can be applied to rotating machinery operating under non-linear and non-stationary conditions. The general concept of these techniques, the pros and cons of applying these methods, as well as their applications in the research field are discussed. Finally, the opportunities and challenges in implementing prognostic systems and developing effective techniques for monitoring machines operating under non-stationary and non-linear conditions are also discussed.

Fuzzy-logic based frequency controller for wind farms augmented with energy storage systems

Displacement of conventional synchronous generators by non-inertial units such as wind or solar generators will result in reduced-system inertia affecting under-frequency response. Frequency control is important to avoid equipment damage, load shedding, and possible blackouts. Wind generators along with energy storage systems can be used to improve the frequency response of low-inertia power system. This paper proposes a fuzzy-logic based frequency controller (FFC) for wind farms augmented with energy storage systems (wind-storage system) to improve the primary frequency response in future low-inertia hybrid power system. The proposed controller provides bidirectional real power injection using system frequency deviations and rate of change of frequency (RoCoF). Moreover, FFC ensures optimal use of energy from wind farms and storage units by eliminating the inflexible de-loading of wind energy and minimizing the required storage capacity. The efficacy of the proposed FFC is verified on the low-inertia hybrid power system.

Systems-based approach to investigate unsafe pedestrian behaviour at level crossings

Crashes at level crossings are a major issue worldwide. In Australia, as well as in other countries, the number of crashes with vehicles has declined in the past years, while the number of crashes involving pedestrians seems to have remained unchanged. A systematic review of research related to pedestrian behaviour highlighted a number of important scientific gaps in current knowledge. The complexity of such intersections imposes particular constraints to the understanding of pedestrians’ crossing behaviour. A new systems-based framework, called Pedestrian Unsafe Level Crossing framework (PULC) was developed. The PULC organises contributing factors to crossing behaviour on different system levels as per the hierarchical classification of Jens Rasmussen’s Framework for Risk Management. In addition, the framework adapts James Reason’s classification to distinguish between different types of unsafe behaviour. The framework was developed as a tool for collection of generalizable data that could be used to predict current or future system failures or to identify aspects of the system that require further safety improvement. To give it an initial support, the PULC was applied to the analysis of qualitative data from focus groups discussions. A total number of 12 pedestrians who regularly crossed the same level crossing were asked about their daily experience and their observations of others’ behaviour which allowed the extraction and classification of factors associated with errors and violations. Two case studies using Rasmussen’s AcciMap technique are presented as an example of potential application of the framework. A discussion on the identified multiple risk contributing factors and their interactions is provided, in light of the benefits of applying a systems approach to the understanding of the origins of individual’s behaviour. Potential actions towards safety improvement are discussed.

Inappropriate formulation choices in the administration of medication to elderly patients with dysphagia in nursing homes

Inappropriate food or medication texture in patients with dysphagia is the most significant risk factor for pneumonia. Dysphagia is prevalent within care homes for the older person as it is largely found in conditions associated with ageing. This study was designed to determine the appropriateness of medication formulation choices in elderly patients with dysphagia in care homes.

Nurses’ views on the implementation of Individualised Medication Administration Guides in patients with dysphagia in care homes

As conditions such as stroke, cancer, Parkinson's disease and Huntingdon's chorea are commonly found in care homes between 15% and 30% of residents in care homes have been found to have difficulties in swallowing their medicines.To address the difficulties associated with administering medicines to patients who cannot swallow (with dysphagia), Individualised Medication Administration Guides (I-MAGs) were introduced by a specialised pharmacist in Care for Elderly wards in a general hospital in East Anglia. The guides contained detailed information about how to administer each medication and they were individualised to the needs of the patient. The I-MAGs were printed in green forms and attached to the medication chart in order to be used in conjunction with it. The ward nurses reported an increase in their confidence when administering medication when I-MAGs were present in the ward. Some patients with I-MAG were discharged to care homes where the I-MAG might have been equally useful. However, the design of such guides is not known to be suitable for care homes environment where they have never been used before. This study aims to explore the opinions of nurses and carers within care homes on the relevance and acceptability of individualised medication administration guides for patients with dysphagia (PWD).

The dual nature of information systems in enabling a new wave of hardware ventures: Towards a theory

Hardware ventures are emerging entrepreneurial firms that create new market offerings based on development of digital devices. These ventures are important elements in the global economy but have not yet received much attention in the literature. Our interest in examining hardware ventures is specifically in the role that information system (IS) resources play in enabling them. We ask how the role of IS resources for hardware ventures can be conceptualized and develop a framework for assessment. Our framework builds on the distinction of operand and operant resources and distinguishes between two key lifecycle stages of hardware ventures: start-up and growth. We show how this framework can be used to discuss the role, nature, and use of IS for hardware ventures and outline empirical research strategies that flow from it. Our work contributes to broadening and enriching the IS field by drawing attention to its role in significant and novel phenomena.

Customer agility, smart shopping apps and their implications: Customer relationship management systems in the digital age

This thesis examines the complementarities and vulnerabilities of customer connectivity that contemporary firms achieved through ubiquitous digital technologies. Taking the example of deployment of smart shopping apps to connect with consumers in the context of Australian retail, the study examines how such customer connectivity positively influences firm performances through firm's customer agility whilst creating implications for firms' digital business strategy through altered customer cognitions. Employing Oliver's (1977) Expectation Confirmation Theory, this study empirically tests a conceptual model involving digital connectivity, digital expectations, experiences and satisfaction of the customers who uses smart shopping apps in Australian consumer retail.

A finite element modelling method for thin layer mortared masonry systems

This paper deals with a finite element modelling method for thin layer mortared masonry systems. In this method, the mortar layers including the interfaces are represented using a zero thickness interface element and the masonry units are modelled using an elasto-plastic, damaging solid element. The interface element is formulated using two regimes; i) shear-tension and ii) shearcompression. In the shear-tension regime, the failure of joint is consiedered through an eliptical failure criteria and in shear-compression it is considered through Mohr Coulomb type failure criterion. An explicit integration scheme is used in an implicit finite element framework for the formulation of the interface element. The model is calibrated with an experimental dataset from thin layer mortared masonry prism subjected to uniaxial compression, a triplet subjected to shear loads a beam subjected to flexural loads and used to predict the response of thin layer mortared masonry wallettes under orthotropic loading. The model is found to simulate the behaviour of a thin layer mortated masonry shear wall tested under pre-compression and inplane shear quite adequately. The model is shown to reproduce the failure of masonry panels under uniform biaxial state of stresses.

Substation Automation Systems – Future possibilities for commissioning

Substation Automation Systems have undergone many transformational changes triggered by improvements in technologies. Prior to the digital era, it made sense to confirm that the physical wiring matched the schematic design by meticulous and laborious point to point testing. In this way, human errors in either the design or the construction could be identified and fixed prior to entry into service. However, even though modern secondary systems today are largely computerised, we are still undertaking commissioning testing using the same philosophy as if each signal were hard wired. This is slow and tedious and doesn’t do justice to modern computer systems and software automation. One of the major architectural advantages of the IEC 61850 standard is that it “abstracts” the definition of data and services independently of any protocol allowing the mapping of them to any protocol that can meet the modelling and performance requirements. On this basis, any substation element can be defined using these common building blocks and are made available at the design, configuration and operational stages of the system. The primary advantage of accessing data using this methodology rather than the traditional position method (such as DNP 3.0) is that generic tools can be created to manipulate data. Self-describing data contains the information that these tools need to manipulate different data types correctly. More importantly, self-describing data makes the interface between programs robust and flexible. This paper proposes that the improved data definitions and methods for dealing with this data within a tightly bound and compliant IEC 61850 Substation Automation System could completely revolutionise the need to test systems when compared to traditional point to point methods. Using the outcomes of an undergraduate thesis project, we can demonstrate with some certainty that it is possible to automatically test the configuration of a protection relay by comparing the IEC 61850 configuration extracted from the relay against its SCL file for multiple relay vendors. The software tool provides a quick and automatic check that the data sets on a particular relay are correct according to its CID file, thus ensuring that no unexpected modifications are made at any stage of the commissioning process. This tool has been implemented in a Java programming environment using an open source IEC 61850 library to facilitate the server-client association with the relay.

South Asians' cardiac medication adherence

Aim This paper is a report of a narrative review examining the current state of knowledge regarding adherence with cardiac medication among South Asian cardiac patients. Background South Asians experience higher rates of cardiovascular disease than any other ethnic group. South Asians may be less adherent with a cardiac medication regimen than Caucasians. The factors contributing to adherence are important to discover to assist South Asians to optimize their cardiac health. Data sources CINAHL, Medline (Ovid), PsychINFO, EMB Reviews-(Cochrane), and EMBASE were accessed using the key words: 'South Asian', 'Asia', 'East India', 'India', 'Pakistan', 'Bangladesh', 'Sri Lanka', 'medication compliance', 'medication noncompliance' and 'medication adherence'. English language papers published from January 1980 to January 2013 were eligible for inclusion. Review methods Abstracts were reviewed for redundancy and eligibility by the primary author. Manuscripts were then retrieved and reviewed for eligibility and validity by the first and last authors. Content analysis strategies were used for the synthesis. Results Thirteen papers were in the final data set; most were conducted in India and Pakistan. Medication side-effects, cost, forgetfulness and higher frequency of dosing contributed to non-adherence. South Asian immigrants also faced language barriers, which contributed to non-adherence. Knowledge regarding the medications prescribed was a factor that increased adherence. Conclusion South Asians' non-adherence to cardiac medications is multifaceted. How South Asians who newly immigrate to Western countries make decisions regarding their cardiac medication adherence ought to be explored in greater detail.

Design and evaluation of decision and control strategies for autonomous vision-based see and avoid systems

This paper details the design and performance assessment of a unique collision avoidance decision and control strategy for autonomous vision-based See and Avoid systems. The general approach revolves around re-positioning a collision object in the image using image-based visual servoing, without estimating range or time to collision. The decision strategy thus involves determining where to move the collision object, to induce a safe avoidance manuever, and when to cease the avoidance behaviour. These tasks are accomplished by exploiting human navigation models, spiral motion properties, expected image feature uncertainty and the rules of the air. The result is a simple threshold based system that can be tuned and statistically evaluated by extending performance assessment techniques derived for alerting systems. Our results demonstrate how autonomous vision-only See and Avoid systems may be designed under realistic problem constraints, and then evaluated in a manner consistent to aviation expectations.

Good for the environment good for health

“First do no harm”. This phrase, attributed to the 19th century surgeon, Thomas Inman, 1 reflects an equivalent phrase found in Epidemics, Book I of the Hippocratic School, “Practise two things in your dealings with disease: either help or do not harm the patient”. Pharmacists have played, and continue to play, an important role in reducing patient harm from medication misadventures. Now, they have a new role to play. The delivery of pharmaceutical care contributes to climate change (e.g. through the embedded carbon in the manufacture and distribution of medicines, disposal of waste, and energy and water use),2 which in turn has a negative impact on health. 3,4 This paradox argues a moral and ethical obligation by pharmacists, to deliver pharmaceutical care more sustainably – do no harm. Sustainability “…. is concerned, on one hand, with resources and how we can preserve them, and, on the other hand, with waste products and how we can best reduce or dispose of them.” 5(p.37) It is about preserving and nurturing Earth’s resources and systems for this generation and future generations to enjoy. Pharmacists play an important role in preventative health strategies such as smoking cessation, promotion of healthier lifestyles and vaccination/immunisation programmes and have the potential to also play a significant role in delivering pharmaceutical care more sustainably. Sustainable pharmaceutical care may be considered a virtuous cycle - what is good for the environment is also good for our health. 5 The good news for community pharmacy owners and managers is that implementing sustainability initiatives in the pharmacy can also have significant financial co-benefits.

Systems thinking and the 'factor five' payoff

Government efforts to help our economy through the global financial crisis could be eroded by the future economic impacts of global warming. The good news is that a ‘factor five’ approach to productivity – delivering five times more value with the same input, or using one-fifth the resources to deliver the same value – will not only help cut greenhouse gas emissions but, done effectively, bring economic benefits.