Electronic prescribing - how does it affect the ward pharmacist?

It is likely that electronic prescribing will be a common feature in tomorrow’s hospitals. However, we do not yet know how its introduction will affect the practice of hospital pharmacists. We are evaluating a closed-loop electronic prescribing, automated dispensing, bar-coded administration system (ServeRx) on one surgical ward. As part of this evaluation, we wanted to explore its impact on the ward pharmacist. Our objectives were to assess the impact of ServeRx on the time spent providing a ward pharmacy service, and on the activities undertaken

KMT-2016-BLG-2052L: Microlensing Binary Composed of M Dwarfs Revealed from a Very Long Time-scale Event

We present the analysis of a binary microlensing event KMT-2016-BLG-2052, for which the lensing-induced brightening of the source star lasted for 2 seasons. We determine the lens mass from the combined measurements of the microlens parallax \pie and angular Einstein radius \thetae. The measured mass indicates that the lens is a binary composed of M dwarfs with masses of $M_1\sim 0.34~M_\odot$ and $M_2\sim 0.17~M_\odot$. The measured relative lens-source proper motion of $\mu\sim 3.9~{\rm mas}~{\rm yr}^{-1}$ is smaller than $\sim 5~{\rm mas}~{\rm yr}^{-1}$ of typical Galactic lensing events, while the estimated angular Einstein radius of \thetae\sim 1.2~{\rm mas} is substantially greater than the typical value of $\sim 0.5~{\rm mas}$. Therefore, it turns out that the long time scale of the event is caused by the combination of the slow $\mu$ and large \thetae rather than the heavy mass of the lens. From the simulation of Galactic lensing events with very long time scales ($t_{\rm E}\gtrsim 100$ days), we find that the probabilities that long time-scale events are produced by lenses with masses $\geq 1.0~M_\odot$ and $\geq 3.0~M_\odot$ are $\sim 19\%$ and 2.6\%, respectively, indicating that events produced by heavy lenses comprise a minor fraction of long time-scale events. The results indicate that it is essential to determine lens masses by measuring both \pie and \thetae in order to firmly identify heavy stellar remnants such as neutron stars and black holes.Comment: 9 pages, 11 figure

Is health care getting safer?

Patient safety has been high on the national and international agenda in health care for almost a decade. In the United Kingdom, reviews of case records have shown that over 10% of patients experience an adverse event while in hospital,1 2 a figure reflected in similar studies around the world.3 Considerable efforts have been made to improve safety, and it is natural to ask whether these efforts have been well directed. Are patients any safer? The answer to this simple question is curiously elusive. Although some aspects of safety are difficult to measure for technical reasons (defining preventability for instance), the main problem is that measurement and evaluation have not been high on the agenda. We believe that the lack of reliable information on safety and quality of care is hindering improvement in safety across the world. The principal approach to patient safety in the UK, United States, and many other countries has been to establish local and national reporting systems; these systems invite voluntary reporting of unspecified safety incidents with the aim of learning lessons and feeding back the findings into the system. However, these reporting systems do not effectively detect adverse events. In the most recent comparison, reporting systems detected only about 6% of adverse events found by systematic review of records.2 Reporting systems are a valuable component of a safety system, but they are essentially systems for warning and communication inside an organisation and, if large scale, of detecting rare events not easily detectable by other means. They cannot and never will act as a measurement system for safety. Here, we use the example of the UK National Health Service to determine whether it is possible to assess change in several core areas that reflect the safety of health care and, if so, what changes are apparent. We focus on measures of outcome, in the sense of definable events that happen to patients (infections, morbidity, mortality) and on key measures of process (such as drug errors). We have not considered concepts such as culture or resilience that are held to reflect safety but are not proved indices of clinical process or outcome. Defining safety is itself a challenge, and we do not pretend that the indicators can provide more than a crude measure of overall levels of safety. The indicators we have chosen are, however, all important to patients

OGLE-2016-BLG-0613LABb: A Microlensing Planet in a Binary System

We present the analysis of OGLE-2016-BLG-0613, for which the lensing light curve appears to be that of a typical binary-lens event with two caustic spikes but with a discontinuous feature on the trough between the spikes. We find that the discontinuous feature was produced by a planetary companion to the binary lens. We find 4 degenerate triple-lens solution classes, each composed of a pair of solutions according to the well-known wide/close planetary degeneracy. One of these solution classes is excluded due to its relatively poor fit. For the remaining three pairs of solutions, the most-likely primary mass is about $M_1\sim 0.7\,M_\odot$ while the planet is a super-Jupiter. In all cases the system lies in the Galactic disk, about half-way toward the Galactic bulge. However, in one of these three solution classes, the secondary of the binary system is a low-mass brown dwarf, with relative mass ratios (1 : 0.03 : 0.003), while in the two others the masses of the binary components are comparable. These two possibilities can be distinguished in about 2024 when the measured lens-source relative proper motion will permit separate resolution of the lens and source.Comment: 14 pages, 9 figure

UKIRT under new management: status and plans

The United Kingdom Infrared Telescope (UKIRT) observatory has been transferred to the ownership of the University of Hawaii (UH) and is now being managed by UH. We have established partnerships with several organizations to utilize the UKIRT for science projects and to support its operation. Our main partners are the U.S. Naval Observatory (USNO), the East Asian Observatory (EAO), and the UKIRT microlensing team (JPL/IPAC/OSU/Vanderbilt). The USNO is working on deep northern hemisphere surveys in the H and K bands and the UKIRT microlensing team is running a monitoring campaign of the Galactic bulge. EAO, UH, and USNO have individual P.I. research programs. Most of the observations are using the Wide Field Camera (WFCAM), but the older suite of cassegrain instruments are still fully operational. Data processing and archiving continue to be done CASU and WSA in the UK. We are working on a concept to upgrade the WFCAM with new larger infrared detector arrays for substantially improved survey efficiency

Current trends in nursing informatics: Results of an international survey

© 2016 IMIA and IOS Press. Nursing informatics (NI) can help provide effective and safe healthcare. This study aimed to describe current research trends in NI. In the summer 2015, the IMIA-NI Students Working Group created and distributed an online international survey of the current NI trends. A total of 402 responses were submitted from 44 countries. We identified a top five NI research areas: standardized terminologies, mobile health, clinical decision support, patient safety and big data research. NI research funding was considered to be difficult to acquire by the respondents. Overall, current NI research on education, clinical practice, administration and theory is still scarce, with theory being the least common. Further research is needed to explain the impact of these trends and the needs from clinical practice

SpitzerSpitzer Parallax of OGLE-2018-BLG-0596: A Low-mass-ratio Planet around an M-dwarf

We report the discovery of a $Spitzer$ microlensing planet OGLE-2018-BLG-0596Lb, with preferred planet-host mass ratio $q \sim 2\times10^{-4}$. The planetary signal, which is characterized by a short $(\sim 1~{\rm day})$ "bump" on the rising side of the lensing light curve, was densely covered by ground-based surveys. We find that the signal can be explained by a bright source that fully envelops the planetary caustic, i.e., a "Hollywood" geometry. Combined with the source proper motion measured from $Gaia$, the $Spitzer$ satellite parallax measurement makes it possible to precisely constrain the lens physical parameters. The preferred solution, in which the planet perturbs the minor image due to lensing by the host, yields a Uranus-mass planet with a mass of $M_{\rm p} = 13.9\pm1.6~M_{\oplus}$ orbiting a mid M-dwarf with a mass of $M_{\rm h} = 0.23\pm0.03~M_{\odot}$. There is also a second possible solution that is substantially disfavored but cannot be ruled out, for which the planet perturbs the major image. The latter solution yields $M_{\rm p} = 1.2\pm0.2~M_{\oplus}$ and $M_{\rm h} = 0.15\pm0.02~M_{\odot}$. By combining the microlensing and $Gaia$ data together with a Galactic model, we find in either case that the lens lies on the near side of the Galactic bulge at a distance $D_{\rm L} \sim 6\pm1~{\rm kpc}$. Future adaptive optics observations may decisively resolve the major image/minor image degeneracy.Comment: 34 pages, 8 figures, Submitted to AAS journa

Advancing nursing informatics in the next decade: Recommendations from an international survey

© 2016 IMIA and IOS Press. In the summer of 2015, the International Medical Informatics Association Nursing Informatics Special Interest Group (IMIA NISIG) Student Working Group developed and distributed an international survey of current and future trends in nursing informatics. The survey was developed based on current literature on nursing informatics trends and translated into six languages. Respondents were from 31 different countries in Asia, Africa, North and Central America, South America, Europe, and Australia. This paper presents the results of responses to the survey question: "What should be done (at a country or organizational level) to advance nursing informatics in the next 5-10 years?" (n responders=272). Using thematic qualitative analysis, responses were grouped into five key themes: 1) Education and training; 2) Research; 3) Practice; 4) Visibility; and 5) Collaboration and integration. We also provide actionable recommendations for advancing nursing informatics in the next decade

The current state of Nursing Informatics – An international cross-sectional survey

An international survey to explore current and future trends in Nursing Informatics (NI) was done in 2015. This article explores responses to questions about: what should be done to further develop NI as an independent discipline; existing policies and standards influencing NI; perceived support towards NI as a discipline; and advice from NI specialists to students and emerging professionals. Nurse and allied health professionals in academia and practice were reached with snowball sampling. Open-ended questions were analysed with thematic content analysis and the mean and standard deviation is reported for the perceived support towards NI (scale ranging from 1 (not at all supportive) to 10 (very supportive)). A total of 507 respondents from 46 countries responded to the survey. Respondents reported mediocre support towards NI from the environment (M 5.79, SD 2.60). Results showed that NI education needs development to better meet practice demands, that current NI resources seem insufficient, that NI expertise is not used to its full potential in health institutions and the community, and that NI needs to show its value through research and increase visibility to be recognised among stakeholders worldwide. In conclusion, there is a need to clarify NI as a discipline and a need for strong leadership to impact policy making. An increase in NI teaching at undergraduate level in nursing as well as an increase in postgraduate NI programmes worldwide would better support practice demands. National policies and international white papers in NI are needed to guide resource distribution to better support practice.An international survey to explore current and future trends in Nursing Informatics (NI) was done in 2015. This article explores responses to questions about: what should be done to further develop NI as an independent discipline; existing policies and standards influencing NI; perceived support towards NI as a discipline; and advice from NI specialists to students and emerging professionals. Nurse and allied health professionals in academia and practice were reached with snowball sampling. Open-ended questions were analysed with thematic content analysis and the mean and standard deviation is reported for the perceived support towards NI (scale ranging from 1 (not at all supportive) to 10 (very supportive)). A total of 507 respondents from 46 countries responded to the survey. Respondents reported mediocre support towards NI from the environment (M 5.79, SD 2.60). Results showed that NI education needs development to better meet practice demands, that current NI resources seem insufficient, that NI expertise is not used to its full potential in health institutions and the community, and that NI needs to show its value through research and increase visibility to be recognised among stakeholders worldwide. In conclusion, there is a need to clarify NI as a discipline and a need for strong leadership to impact policy making. An increase in NI teaching at undergraduate level in nursing as well as an increase in postgraduate NI programmes worldwide would better support practice demands. National policies and international white papers in NI are needed to guide resource distribution to better support practice

Incidence and prevalence of dementia in linked administrative health data in Saskatchewan, Canada: a retrospective cohort study.

Determining the epidemiology of dementia among the population as a whole in specific jurisdictions - including the long-term care population-is essential to providing appropriate care. The objectives of this study were to use linked administrative databases in the province of Saskatchewan to determine the 12-month incidence and prevalence of dementia for the 2012/13 period (1) among individuals aged 45 and older in the province of Saskatchewan, (2) according to age group and sex, and (3) according to diagnosis code and other case definition criteria