An analysis of the development and implementation of a smartphone application for the delivery of antimicrobial prescribing policy: lessons learnt

Objectives: Smartphone usage amongst clinicians is widespread. Yet smartphones are not widely used for the dissemination of policy or as clinical decision support systems. We report here on the development, adoption and implementation process of the Imperial Antimicrobial Prescribing Application across five teaching hospitals in London. Methods: Doctors and clinical pharmacists were recruited to this study, which employed a mixed methods indepth case-study design with focus groups, structured pre- and post-intervention survey questionnaires and live data on application uptake. The primary outcome measure was uptake of the application by doctors and its acceptability. The development and implementation processes were also mapped. Results: The application was downloaded by 40% (376) of junior doctors with smartphones (primary target user group) within the first month and by 100% within 12 months. There was an average of 1900 individual access sessions per month, compared with 221 hits on the Intranet version of the policy. Clinicians (71%) reported that using the application improved their antibiotic knowledge. Conclusions: Clinicians rapidly adopted the mobile application for antimicrobial prescribing at the point of care, enabling the policy to reach a much wider audience in comparison with paper- and desktop-based versions of the policy. Organizations seeking to optimize antimicrobial prescribing should consider utilizing mobile technology to deliver point-of-care decision support. The process revealed a series of barriers, which will need to be addressed at individual and organizational levels to ensure safe and high-quality delivery of local policy at the point of care

Jak zachować wiarę poza granicami kraju ojczystego ? – w świetle korespondencji kard. Stefana Wyszyńskiego z Rektorem Polskiej Misji Katolickiej we Francji

Après la Seconde Guerre mondiale, plus de 400 000 personnes d’origine polonaise vivaient en France. La plupart d’entre eux y est venue dans l’entre-deux-guerres à la recherche de travail. Ils considéraient leur séjour sur cette terre comme temporaire, par conséquent, en vue de retourner dans leur pays d’origine, ils cultivaient également les coutumes et les rituels polonais dans le domaine religieux. Leur présence était favorisée par l’existence de prêtres polonais dans les colonies ouvrières. Avec le temps, le lien de l’émigration polonaise en France avec le pays d’origine s’est affaibli. Les travailleurs polonais venant en France étaient en voie de disparition, le nombre d’associations polonaises a donc diminué. Dans les années 60 et 70 du XXe siècle, les troisième et quatrième générations d’émigrants polonais ne connaissaient leur pays d’origine que grâce aux histoires racontées par leurs parents et grands-parents. Comment préserver dans cette situation la tradition nationale et religieuse polonaise? Le Cardinal Wyszyński a tenté de répondre à cette question. Il voit un moyen de préserver l’identité religieuse des Polonais en France en maintenant la langue maternelle, l’adhésion au culte marial et la promotion du mouvement de pèlerinage. Afin de maintenir l’unité avec l’Eglise en Pologne, il a encouragé ses compatriotes à l’étranger à connaitre l’enseignement des évêques polonais et à participer à l’aide matérielle pour la Pologne.Po II wojnie światowej we Francji mieszkało ponad 400 tys. osób polskiego pochodzenia. W większości przybyli oni do Francji w okresie międzywojennym w poszukiwaniu pracy. Pobyt na tej ziemi traktowali jako tymczasowy, dlatego z myślą o powrocie do kraju ojczystego kultywowali polskie zwyczaje i obrzędy również w sferze religijnej. Ich utrzymaniu sprzyjała obecność polskich księży w koloniach robotniczych. Wraz z upływem czasu słabła więź polskiej emigracji we Francji z krajem pochodzenia. Liczba polskich robotników przybyłych do Francji wymierała, tym samym zmniejszyła się liczebność stowarzyszeń polskich. W latach 60. i 70. XX w. trzecie i czwarte pokolenie polskich wychodźców znało kraj ojczysty jedynie z opowieści rodziców i dziadków. Jak zachować w takiej sytuacji polską tradycję narodową i religijną? Na to pytanie próbował odpowiedzieć kard. Stefan Wyszyński. W zachowaniu języka ojczystego, przywiązaniu do kultu maryjnego i propagowaniu ruchu pielgrzymkowego widział sposób na zachowanie tożsamości religijnej Polaków we Francji. Celem zachowania jedności z Kościołem w Polsce zachęcał rodaków na obczyźnie do zapoznawania się z nauczaniem polskich biskupów oraz włączeniem się w dzieło pomocy materialnej na rzecz Polski

The use of a cone calorimeter for the preliminary determination of the extinguishing efficiency of bulk materials

Determining the extinguishing effectiveness of extinguishing agents against solid fires is difficult. This is mainly due to the large variety of combustible materials. These difficulties also concern the determination of the effectiveness of various extinguishing agents for gas, fat and metal fires. However, extinguishing tests for liquid fires are defined very precisely. The tests of the effectiveness of powder materials, such as extinguishing powders, are based on relatively simple and methods used to extinguishers testing. It does not eliminate the very significant impact of the human factor on the test effect. A cone calorimeter was used for comparative evaluation of the extinguishing efficiency of bulk materials. For this purpose, bulk materials e.g. salt, sand and dry chemicals were applied to the surface of standard pine wood samples and the differences in their flammability were examined. Based on the analysis of HRR, weight loss curves and time to achieve flame combustion, it was found that a cone calorimeter can be used to pre-assess the effectiveness of extinguishing the dry powders and dry chemicals for solid fires. There were clear differences between chemical and only physical effects

The use of a cone calorimeter for the preliminary determination of the extinguishing efficiency of bulk materials

Determining the extinguishing effectiveness of extinguishing agents against solid fires is difficult. This is mainly due to the large variety of combustible materials. These difficulties also concern the determination of the effectiveness of various extinguishing agents for gas, fat and metal fires. However, extinguishing tests for liquid fires are defined very precisely. The tests of the effectiveness of powder materials, such as extinguishing powders, are based on relatively simple and methods used to extinguishers testing. It does not eliminate the very significant impact of the human factor on the test effect. A cone calorimeter was used for comparative evaluation of the extinguishing efficiency of bulk materials. For this purpose, bulk materials e.g. salt, sand and dry chemicals were applied to the surface of standard pine wood samples and the differences in their flammability were examined. Based on the analysis of HRR, weight loss curves and time to achieve flame combustion, it was found that a cone calorimeter can be used to pre-assess the effectiveness of extinguishing the dry powders and dry chemicals for solid fires. There were clear differences between chemical and only physical effects