The prevalence and nature of prescribing and monitoring errors in English general practice – a retrospective case note review

Objective To determine the prevalence and nature of prescribing and monitoring errors in general practices in England. Design Retrospective case note review of unique medication items prescribed over a 12 month period to a 2% random sample of patients. Mixed effects logistic regression was used to analyse the data. Setting Fifteen general practices across three primary care trusts in England. Data sources Examination of 6048 unique prescription items prescribed over the previous 12 months for 1777 patients. Main outcome measures Prevalence of prescribing and monitoring errors, and severity of errors, using validated definitions. Results Prescribing and/or monitoring errors were detected in 4.9% (296/6048) of all prescription items (95% confidence interval 4.4 - 5.5%). The vast majority of errors were of mild to moderate severity, with 0.2% (11/6048) of items having a severe error. After adjusting for covariates, patient-related factors associated with an increased risk of prescribing and/or monitoring errors were: age less than 15 (Odds Ratio (OR) 1.87, 1.19 to 2.94, p=0.006) or greater than 64 years (OR 1.68, 1.04 to 2.73, p=0.035), and higher numbers of unique medication items prescribed (OR 1.16, 1.12 to 1.19, p<0.001). Conclusion Prescribing and monitoring errors are common in English general practice, although severe errors are unusual. Many factors increase the risk of error. Having identified the most common and important errors, and the factors associated with these, strategies to prevent future errors should be developed based on the study findings.

“Bad talk” made good: language variety in four Caribbean British children’s poets

This article looks at how four British-based poets born in the Caribbean exploit the rich language repertoire available to them in their work for children and young people. Following initial consideration of questions of definition and terminology, poetry collections by James Berry, John Agard, Grace Nichols and Valerie Bloom are discussed, with a focus on the interplay and creative tension between the different varieties of Caribbean creoles (“Bad Talk”) and standard English evident in their work. Variation both between the four poets’ usage and within each individual poet’s work is considered, and a trend over time towards the inclusion of fewer creole-influenced poems is noted. This and other issues, such as the labelling of the four poets’ work as ‘performance poetry’ and the nature of the poets’ contribution to British children’s literature, are considered in the conclusion.

The causes of prescribing errors in English general practices: a qualitative study

Aim: To examine the causes of prescribing and monitoring errors in English general practices and provide recommendations for how they may be overcome. Design: Qualitative interview and focus group study with purposive sampling and thematic analysis informed by Reason’s accident causation model. Participants: General practice staff participated in a combination of semi-structured interviews (n=34) and six focus groups (n=46). Setting: Fifteen general practices across three primary care trusts in England. Results: We identified seven categories of high-level error-producing conditions: the prescriber, the patient, the team, the task, the working environment, the computer system, and the primary-secondary care interface. Each of these was further broken down to reveal various error-producing conditions. The prescriber’s therapeutic training, drug knowledge and experience, knowledge of the patient, perception of risk, and their physical and emotional health, were all identified as possible causes. The patient’s characteristics and the complexity of the individual clinical case were also found to have contributed to prescribing errors. The importance of feeling comfortable within the practice team was highlighted, as well as the safety of general practitioners (GPs) in signing prescriptions generated by nurses when they had not seen the patient for themselves. The working environment with its high workload, time pressures, and interruptions, and computer related issues associated with mis-selecting drugs from electronic pick-lists and overriding alerts, were all highlighted as possible causes of prescribing errors and often interconnected. Conclusion: This study has highlighted the complex underlying causes of prescribing and monitoring errors in general practices, several of which are amenable to intervention.

Writing in French in secondary schools in England and Germany: are the British really 'bad language learners’?

It is widely assumed that the British are poorer modern foreign language (MFL) learners than their fellow Europeans. Motivation has often been seen as the main cause of this perceived disparity in language learning success. However, there have also been suggestions that curricular and pedagogical factors may play a part. This article reports a research project investigating how German and English 14- to 16-year-old learners of French as a first foreign language compare to one another in their vocabulary knowledge and in the lexical diversity, accuracy and syntactic complexity of their writing. Students from comparable schools in Germany and England were set two writing tasks which were marked by three French native speakers using standardised criteria aligned to the Common European Framework of Reference (CEF). Receptive vocabulary size and lexical diversity were established by the X_lex test and a verb types measure respectively. Syntactic complexity and formal accuracy were respectively assessed using the mean length of T-units (MLTU) and words/error metrics. Students' and teachers' questionnaires and semi-structured interviews were used to provide information and participants' views on classroom practices, while typical textbooks and feedback samples were analysed to establish differences in materials-related input and feedback in the two countries. The German groups were found to be superior in vocabulary size, and in the accuracy, lexical diversity and overall quality – but not the syntactic complexity – of their writing. The differences in performance outcomes are analysed and discussed with regard to variables related to the educational contexts (e.g. curriculum design and methodology).

Where have all the linguists gone? The position of Linguistics in British German Studies from the mid-19th century until 2000

Retrospectively, Linguistics - understood as a scientific study of language - has been an important part of British German Studies. In fact, the establishment of modern language as academic disciplines in the UK is closely related to the Germanic philology and the interest in the history, and structure of languages. However, over the last few decades, a demise of Linguistics in the departments of modern languages has been observed. The aim of this paper is to survey the position of linguistic research and teaching in the discipline of German Studies in the UK. To begin with, I will give a brief account of the history of linguistic/ language studies in the discipline. Subsequently, the current position of Linguistics in research and teaching will be scrutinised. Finally, this paper will discuss the importance of linguistic insights for the discipline of German Studies, with particular reference to teaching.

Negotiating the British landscape

According to many accounts, a key paradigm for understanding art in Post WWII Britain is one of Englishness versus internationalism or abstraction versus realism . These terms have a rich inflection of meanings that have been subject to interrogation over the last few decades. Anwar Shemza came to Britain and practiced his art at a time when these competing claims were at their height. In a postcolonial reading entitled “Black Diaspora Artists in Britain: Three ‘Moments’ in Post-War Britain” Stuart Hall recently used David Scott’s framework of a ‘problem space’, that is discursively defined through questions, tensions and conjunctures, that couched the entry of what he describes as first waive British commonwealth artists into critical visibility in Britain. This can be characterized in part by the reviews of WG Archer and GM Butcher, both supporters of Shemza and prominent critics of the period. Hall includes Shemza in this framework that defines the work and his aspirations as constituted through the tensions of what was perceived to be anti-colonialist aims of modernism through universalism and the ‘nativist’ current in anti-colonial nationalism . This text will focus particularly on the problematic of Landscape as a ‘problem space’ of vernacular and modernism, over here and over there. The aim is not to define Shemza within the tradition of English landscape nor to exclude him but to position him within a discursive field of landscape and modernism in mid twentieth Century art.

Acoustic Detections of Singing Humpback Whales in Deep Waters Off The British Isles

From October 1996 through September 1998, we used bottom-mounted hydrophone arrays to monitor deep-water areas north and west of the British Isles for songs of humpback whales (Megaptera novaeangliae). Singing humpbacks were consistently detected between October and March from the Shetland- Faroe Islands south to waters west of the English Channel. Temporal and geographic patterns of song detections, and movements of individually tracked whales, exhibited a southwesterly trend over this period, but with no corresponding northward trend between April and September. These results, together with a review of historical data from this area, suggest that the offshore waters of the British Isles represent a migration corridor for humpbacks, at least some of which summer in Norwegian (and possibly eastern Icelandic) waters. The migratory destination of the detected animals remains unknown, but the limited data suggest that these whales are bound primarily for the West Indies rather than historical breeding areas off the northwestern coast of Africa. Humpbacks detected in British waters after early to mid- March probably do not undertake a full migration to the tropics. These data provide further evidence that singing is not confined to tropical waters in winter, but occurs commonly on migration even in high latitudes.