Development, implementation and evaluation of the digital transformation of renal services in Wales: the journey from local to national

Background Treatment for people with kidney disease is often associated with complicated combinations of medicines. Logistical challenges with traditiona paper-based prescribing means that these patients are particularly susceptible to medication-relation errors and harm. Aim To improve the quality of care that people with kidney disease receive across Wales through a Value-Based digital transformation programme. Setting Renal units within the National Welsh Renal Clinical Network (WRCN). Development A novel Electronic Prescribing & Medicines Administration (EPMA) system, integrated into a patient care record and linked to a patient portal was developed in South West Wales (SWW) region of the WRCN, enabled by the Welsh Government (WG) Efficiency Through Technology Fund. National upscale was enabled through the WG Transformation Fund. Implementation EPMA was designed and rolled out initially in SWW region of the WRCN (2018). A dedicated delivery team used the blueprint to finalise and implement a strategy for successful national roll-out eventually across all Wales (completed 2021). Evaluation A multi-factorial approach was employed, as both the technology itself and the healthcare system within which it would be introduced, were complex. Continuous cycles of action research involving informal and formal qualitative interviews with service-users ensured that EPMA was accessible and optimally engaging to all target stakeholders (patients and staff). Results confirmed that EPMA was successful in improving the quality of care that people with kidney disease receive across Wales, contributed to Value-Based outcomes, and put people who deliver and access care at the heart of transformation. Conclusion Key findings of this study align directly with the national design principles to drive change and transformation, put forward by the WG in their plan for Health and Social Care: prevention and early intervention; safety; independence; voice; seamless care

NACA Research Memorandums

Report presenting a laboratory-scale vapor-deposition coating facility used in the field of high-temperature coatings. The vapor-deposition coatings were produced by the hydrogen reduction of halides and not by vacuum plating methods. The coated model was found to reach equilibrium temperature of about 3100 degrees Fahrenheit and was undamaged after 470 seconds at equilibrium temperature, while an uncoated model was destroyed in less than 6 seconds

Measurement of Enkephalin Peptides in Canine Brain Regions, Teeth, and Cerebrospinal Fluid With High-Performance Liquid Chromatography and Mass Spectrometry

Endogenous enkephalin pentapeptides are measured with unambiguous molecular specificity in canine and human tissue and fluid extracts. Both field desorption and fast atom bombardment mass spectrometry have been used to produce a protonated molecular ion of the peptide high-performance liquid chromatography fraction. The protonated molecular ion is subjected to collision-activated dissociation processes and a linked-field scan (B/E) selects a unique amino acid sequence-determining ion for monitoring and measurement. Stable isotope-incorporated peptide internal standards are used for quantification. Endogenous enkephalins are measured in hypothalamus, cerebrospinal fluid, pituitary, caudate nucleus, and tooth pulp extracts. Part-per-billion levels of endogenous peptide are measured