Establishing and operating grower-owned organizations for integrated pest management /

Includes appendix.

Healthy waterways: Healthy catchments - An integrated research/management program to understand and reduce impacts of sediments and nutrients on waterways in Queensland, Australia

The Moreton Bay Waterways and Catchments Partnership, now branded the Healthy Waterways Partnership, has built on the experience of the past 15 years here in South East Queensland (SEQ). It focuses on water quality and the ecosystem health of our freshwater, estuarine and marine systems through the implementation of actions by individual partners and the collective oversight of a regional work program that assists partners to prioritise their investments and address emerging issues. This regional program includes monitoring, reporting, marketing and communication, development of decision support tools, research that is directed to problem solving, and maintaining extensive consultative and engagement arrangements. The Partnership has produced information-based outcomes which have led to significant cost savings in the protection of water quality and ecosystem resources by its stakeholders. This has been achieved by: – providing a clear focus for management actions that has ownership of governments, industry and community; – targeted scientific research to address issues requiring appropriate management actions; – management actions based on a sound understanding of the waterways and rigorous public consultation; and, – development and implementation of a strategy that incorporates commitments from all levels of stakeholders. While focusing on our waterways, the Partnership’s approach includes addressing catchment management issues particularly relating to the management of diffuse pollution sources in both urban and rural landscapes as well as point source loads. We are now working with other stakeholders to develop a framework for integrated water management that will link water quality and water quantity goals and priorities.

Medicines management across the primary-hospital healthcare interface: a study of paediatric patients

A comparison of medicines management documents in use by NHS organisations in the West Midlands confirms that there are important differences between the primary care and hospital sectors in respect to medicines management interface issues. Of these, two aspects important to paediatric patients have been studied. These are the transfer of information as a patient is admitted to hospital, and access to long-term medicines for home-patients. National guidance provided by NICE requires medication reconciliation to be undertaken on admission to hospital for adults. A study of paediatric admissions, reported in this thesis, demonstrates that the clinical importance of this process is at least as important for children as for adults, and challenges current UK guidance. The transfer of essential medication information on hospital admission is central to the medication reconciliation process. Two surveys of PCTs in 2007 and again in 2009 demonstrate that very few PCTs provide guidance to GPs to support this process. Provision of guidance is increasing slowly but remains the exception. The provision of long-term medicines for children at home is hindered by this patient population often needing unlicensed drugs. Further studies demonstrate that primary care processes regularly fail to maintain access to essential drugs and patients and their carers frequently turn to hospitals for help. Surveys of hospital medical staff (single site) and hospital nurses (six UK sites) demonstrates the activity these healthcare workers perform to help children get the medicines they need. A similar survey of why carers turn to a hospital pharmacy department for urgent supplies (usually termed rescue-medicines) adds to the understanding of these problems and supports identifying service changes. A large survey of community pharmacies demonstrates the difficulties they have when dispensing hospital prescriptions and identifies practical solutions. This programme concludes by recommending service changes to support medication management for children.

Medicines management strategies to improve antibiotic prescribing

A systematic review was conducted to explicitly identify interventions that alone, or in combination, were effective in improving antibiotic prescribing. The citation search strategy used in the present review provided a database of 365077 studies, of which only twenty-five were included in the final review (“review studies”). Analysis of the interventions used within the review studies indicated that a combination of “guidelines” and “pharmacy” interventions have the greatest potential to improve antibiotic prescribing. Two types of qualitative research were conducted, semi-structured interviews and the collection of naturally occurring data. Semi-structured interviews were conducted in order to determine NHS managers? perceptions of current policies used to improve antibiotic prescribing within selected Primary Care Trusts and highlighted the importance of pharmacy intervention, formularies or guidelines and improved prescribing analysis (IT based intervention) on improving antibiotic prescribing. This was supported by the collection of naturally occurring data, which was used to provide further insight into interventions used to improve antibiotic prescribing. The Specialist Antibiotic Pharmacist (HD) produced and implemented an innovative electronic antibiotic prescribing analysis tool (the Antibiotic Database) to analyse and improve antibiotic prescribing in a consistent manner. The key advantage of the Antibiotic Database was the time and money saved on producing visual electronic outputs containing an inaccurate outcome measure or time period for analysis. The results concluded that an IT based intervention, such as the Antibiotic Database should be used, in addition to the use of antibiotic guidelines and pharmacy intervention, within all sectors of the NHS in order to improve antibiotic prescribing and its analysis.

Integrated project management in Indian petroleum industry

The Indian Petroleum Industry is passing through a very dynamic business environment due to liberalization. Effective project management for developing new infrastructures and maintaining the existing facilities has been considered as one of the means for remaining competitive but these practices suffer from many shortcomings, as time, cost and quality non-achievements are part and parcel of almost every project. This study focuses on identifying the specific causes of project failure by demonstrating first the characteristics of projects in Indian Petroleum industry and suggests some remedial measures for resolving these issues. The suggested project management model is integrated through information management system and demonstrated through a case study.

A comparison of antibiotic prescribing indicators and medicines management scoring in secondary care

Poster: - Robust prescribing indicators analogous to those used in primary care are not available currently in NHS hospital trusts - The Department of Health has recently implemented a scheme for self-assessment scoring medicines management processes (maximum 23) in NHS hospitals - There is no clear relationship between average values for two antibiotic prescribing indicators obtained in ten NHS hospital trusts in the West Midlands - There is no clear relationship between either indicator value and the corresponding self-assessment medicines management score - This study highlights the difficulties involved in assessing the medicines management processes in NHS hospitals; better medicines management evaluation systems are needed

Egységes kockázatkezelési módszertan kialakítása a villamosenergia-ipari átviteli rendszerirányító társaságnál (Development of an integrated risk management methodology for an electricity transmission system operator (TSO) company)

A felelős vállalatirányítás egyik stratégiai jelentőségű tényezője a vállalati szintű kockázatkezelés, mely napjaink egyik legnagyobb kihívást jelentő területe a vállalatvezetés számára. A hatékony vállalati kockázatkezelés nem valósulhat meg kizárólag az általános, nemzetközi és hazai szakirodalomban megfogalmazott kockázatkezelési alapelvek követése mentén, a kockázatkezelési rendszer kialakítása során figyelembe kell venni mind az iparági, mind az adott vállalatra jellemző sajátosságokat. Mindez különösen fontos egy olyan speciális tevékenységet folytató vállalatnál, mint a villamosenergia-ipari átviteli rendszerirányító társaság (transmission system operator, TSO). A cikkben a magyar villamosenergia-ipari átviteli rendszerirányító társasággal együttműködésben készített kutatás keretében előálló olyan komplex elméleti és gyakorlati keretrendszert mutatnak be a szerzők, mely alapján az átviteli rendszerirányító társaság számára kialakítottak egy új, területenként egységes kockázatkezelési módszertant (fókuszban a kockázatok azonosításának és számszerűsítésének módszertani lépéseivel), mely alkalmas a vállalati szintű kockázati kitettség meghatározására. _______ This study handles one of today’s most challenging areas of enterprise management: the development and introduction of an integrated and efficient risk management system. For companies operating in specific network industries with a dominant market share and a key role in the national economy, such as electricity TSO’s, risk management is of stressed importance. The study introduces an innovative, mathematically and statistically grounded as well as economically reasoned management approach for the identification, individual effect calculation and summation of risk factors. Every building block is customized for the organizational structure and operating environment of the TSO. While the identification phase guarantees all-inclusivity, the calculation phase incorporates expert techniques and Monte Carlo simulation and the summation phase presents an expected combined distribution and value effect of risks on the company’s profit lines based on the previously undiscovered correlations between individual risk factors.

A cross-sectional evaluation of community pharmacists’ perceptions of intermediate care and medicines management across the healthcare interface

Background Despite the importance placed on the concept of the multidisciplinary team in relation to intermediate care (IC), little is known about community pharmacists’ (CPs) involvement. 
Objective To determine CPs’ awareness of and involvement with IC services, perceptions of the transfer of patients’ medication information between healthcare settings and views of the development of a CP–IC service. 
Setting Community pharmacies in Northern Ireland. 
Methods A postal questionnaire, informed by previous qualitative work was developed and piloted. 
Main outcome measure CPs’ awareness of and involvement with IC. Results The response rate was 35.3 % (190/539). Under half (47.4 %) of CPs ‘agreed/strongly agreed’ that they understood the term ‘intermediate care’. Three quarters of respondents were either not involved or unsure if they were involved with providing services to IC. A small minority (1.2 %) of CPs reported that they received communication regarding medication changes made in hospital or IC settings ‘all of the time’. Only 9.5 and 0.5 % of respondents ‘strongly agreed’ that communication from hospital and IC, respectively, was sufficiently detailed. In total, 155 (81.6 %) CPs indicated that they would like to have greater involvement with IC services. ‘Current workload’ was ranked as the most important barrier to service development.
Conclusion It was revealed that CPs had little awareness of, or involvement with, IC. Communication of information relating to patients’ medicines between settings was perceived as insufficient, especially between IC and community pharmacy settings. CPs demonstrated willingness to be involved with IC and services aimed at bridging the communication gap between healthcare settings.