User-centered healthcare IT: meaningful or meaningless?

This panel aims to discuss concepts, assumptions and visions of user- centered information technology for healthcare. It presents two opposite views on the subject. The discussion is informed by findings of three research projects evaluating the implementation of e-prescribing systems, electronic transmission of prescriptions, and electronic health records in the UK. The timeliness and perhaps urgency of such a debate are due to the incessantly increasing worldwide computerization of healthcare, concurrent to an ambiguity of the effect of IT on care processes, outcomes and user satisfaction

A national survey of inpatient medication systems in English NHS hospitals

Systems and processes for prescribing, supplying and administering inpatient medications can have substantial impact on medication administration errors (MAEs). However, little is known about the medication systems and processes currently used within the English National Health Service (NHS). This presents a challenge for developing NHS-wide interventions to increase medication safety. We therefore conducted a cross-sectional postal census of medication systems and processes in English NHS hospitals to address this knowledge gap

Assessment of the Impact of Radioactive Disposals and Discharges from the United Kingdom Low Level Waste Repository on the Ecosystem -9051

ABSTRACT This paper describes an assessment of the impacts to ecosystems and wildlife species from radioactive discharges and disposals at the United Kingdom's low level waste disposal facility in West Cumbria. The assessment was undertaken in response to a requirement in the site's current authorisation and comprised a detailed desk based review along with an exercise to screen relevant monitoring data from the site against generic assessment criteria and undertake a numerical risk assessment. Much of the site is vegetated, comprising a variety of habitats including grassland, relict dune heath and surface water bodies. Furthermore, the site is located adjacent to a coastal/estuarine area which is protected as it provides a habitat of high ecological value and species of animals and plants are present that are rare, endangered or vulnerable. However, the current impact of aerial and liquid radioactive discharges from the low level waste repository on ecosystems and wildlife species is considered to be low. Site monitoring data also indicate that there has been a reduction of radionuclide activities in ground and surface water and leachates over time, a result of measures initiated to minimise rainwater infiltration and improve leachate management associated with the disposal area. A quantitative assessment was undertaken to assess future impacts to relevant terrestrial, fresh water and marine ecosystems. This showed that modelled peak radionuclide concentrations in the first 4,000 years after site closure were not sufficiently high to cause potential impact to any of these ecosystems or associated wildlife. This cut-off date was chosen as it is considered probable that, due to the effects of future climate and landscape change and, unless actions are taken to defend the coastline, the site is likely to be disrupted by coastal erosion in the next 4,000 years

Investigating the prevalence and causes of prescribing errors in general practice : the PRACtICe Study

Report prepared by the University of Nottingham, University of Reading and University of Hertfordshir

Improving Data Infrastructure to Reduce Firearms Violence

In the fall of 2020, Arnold Ventures, a philanthropy dedicated to maximizing opportunity and minimizing injustice, and NORC at University of Chicago, an objective nonpartisan research institution, released the Blueprint for a US Firearms Infrastructure (Roman, 2020). The Blueprint is the consensus report of an expert panel of distinguished academics, trailblazing practitioners, and government leaders. It describes 17 critical reforms required to modernize how data about firearms violence of all types (intentional, accidental, and self-inflicted) are collected, integrated and disseminated. This project, which is also supported by Arnold Ventures, takes the conceptual priorities described in the Blueprint and proposes specific new steps for implementation.The first step in building a better firearms data infrastructure is to acknowledge where we currently stand. In The State of Firearm Data in 2019 (Roman, 2019), the expert panel found that while there are a substantial number of data sources that collect data on firearms violence, existing datasets and data collections are limited, particularly around intentional injuries. There is some surveillance data, but health data on firearms injuries are kept separately from data on crimes, and there are few straightforward ways to link those data. Data that provide context for a shooting--where the event took place, and what the relationship was between victim and shooter--are not available alongside data on the nature of injuries. Valuable data collections have been discontinued, data are restricted by policy, important data are not collected, data are often difficult to access, and contemporary data are often not released in a timely fashion or not available outside of specialized settings. As a result, researchers face vast gaps in knowledge and are unable to leverage existing data to build the evidence base necessary to adequately answer key policy questions and inform firearms policymaking.In the Blueprint, the expert panel developed a set of recommendations organized around a reconceptualization of how data are collected and who collects data. The broad themes from the Blueprint are as follows:Almost all surveillance data in health and criminal justice is generated locally. It is a high priority to provide information, technical assistance, implementation supports, and funding to state and local governments to improve their collections.Comprehensive monitoring of all federal data collections is needed to ensure that important data elements are being collected, data gaps are being addressed, and quality issues are quickly resolved.Timely dissemination of key data is important, including the development of guidelines to ensure consistency across collections and that resources are made available to speed reporting for collections with historical delays.Improvement is needed in strategic communication about the purpose and use of data to federal agencies, researchers and to the general public.The current report builds on the Blueprint by developing implementation guidance for key recommendations. Where the Blueprint included actionable recommendations, such as naming discontinued surveys that should be resurrected, this report develops specific recommendations for implementation. The report is centered on three topics that were the highest priority for the expert panel but that required additional research before guidance could be disseminated. The research findings from that additional investigation are reported here, and recommendations to facilitate implementation are described. The three topic areas are as follows:The creation of a nonfatal firearms injury databaseIncreasing the quality, availability, and usefulness of firearms data for research and policyPractical steps for building state capacity and infrastructure to use data for evidence-based decision-makin

Reproductive Failure in UK Harbour Porpoises Phocoena phocoena : Legacy of Pollutant Exposure?

This research was supported by a Marie Curie International Outgoing Fellowship within the Seventh European Community Framework Programme (Project Cetacean-stressors, PIOF-GA-2010-276145 to PDJ and SM). Additional funding was provided through the Agreement on the Conservation of Small Cetaceans of the Baltic, North East Atlantic, Irish and North Seas (ASCOBANS) (Grants SSFA/2008 and SSFA / ASCOBANS / 2010 / 5 to SM). Analysis of Scottish reproductive and teeth samples was funded by the EC-funded BIOCET project (BIOaccumulation of persistent organic pollutants in small CETaceans in European waters: transport pathways and impact on reproduction, grant EVK3-2000-00027 to GJP), and Marine Scotland (GJP). Samples examined in this research were collected under the collaborative Cetacean Strandings Investigation Programme (http://ukstrandings.org/), which is funded by the Department for Environment, Food and Rural Affairs (Defra) and the UK’s Devolved Administrations in Scotland and Wales (http://sciencesearch.defra.gov.uk/Defaul​t.aspx?Menu=Menu&Module=More&Location=No​ne&Completed=0&ProjectID=15331) (grants to PDJ, RD). UK Defra also funded the chemical analysis under a service-level agreement with the Centre for Environment, Fisheries and Aquaculture Science (grants to RJL, JB). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Peer reviewedPublisher PD