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To increase the proportion of patients with no psychotropic drug discrepancies at the community mental health team (CMHT)–general practice interface. Three CMHTs participated. Over a 14 month period, quality improvement methodologies were used: individual patient-level feedback to patient's prescribers, run charts and meetings with CMHTs.
One CMHT improved medicines reconciliation accuracy and demonstrated significant reductions in prescribing discrepancies. One in three (119/356) patients had ≥1 discrepancy involving 20% (166/847) of all prescribed psychotropics. Discrepancies were graded as: ‘fatal’ (0%), ‘serious’ (17%) and ‘negligible/minor harm’ (83%) but were associated with extra avoidable prescribing costs. For medicines routinely supplied by secondary care, 68% were not recorded in general practice electronic prescribing systems.
Improvements in medicines reconciliation accuracy were achieved for one CMHT. This may have been partly owing to a multidisciplinary team approach to sharing and addressing prescribing discrepancies. Improving prescribing accuracy may help to reduce avoidable drug-related harms to patients.
Many of the ice-coring objectives in the Ice Drilling Program Office (IDPO) Long Range Science Plan, such as those in the International Partnerships in Ice Core Sciences (IPICS) 2k array and 40k network, are attainable in many locations with an intermediate depth drill (IDD) that can collect core from a fluid-filled hole down to 1500 m depth. The Ice Drilling Design and Operations (IDDO) group has designed and is in the process of building an agile IDD to meet this objective. The drill tent, power distribution and core-processing systems are an integral part of the IDD, which can be deployed by small aircraft and assembled by hand to minimize logistic requirements. The new drill system will be ready for testing in Greenland beginning in late spring 2014. The first production drilling is scheduled for the 2014/15 field season at the South Pole.
The drilling of a deep borehole in ice is an undertaking that spans several seasons. Over recent decades such drilling has become widespread in both polar regions. Owing to the remoteness of the drill sites, considerable cost is associated with the drilling of a deep borehole of several thousand meters. The replicate coring system allows re-drilling of ice core at select depths within an existing parent borehole. This effectively increases the yield of the existing borehole and permits re-sampling of ice in areas of high scientific value. The replicate coring system achieves this through the combination of actuators, motors, sensors and a computerized control system. The replicate coring drill is a further development of the deep ice-sheet coring (DISC) drill, extending the capabilities of the DISC drill to include replicate coring.
The Blue Ice Drill (BID) is a large-diameter agile drill system designed by the Ice Drilling Design and Operations group of the University of Wisconsin–Madison to quickly core-clean 241 mm diameter ice samples from near-surface sites. It consists of a down-hole motor/gear reducer rotating a coring cutter and core barrel inside an outer barrel for efficient cuttings transport in solid ice. A variable-frequency drive and custom control box regulates electrical power to the drill. Torque reaction is accomplished on the surface via handles attached to a torsion stem. Core recovery is achieved with either core dogs in the sonde or with a separate core recovery tool. All down-hole tools are suspended on a collapsible tripod via ropes running on a capstan winch. The BID is operated by a minimum of two people and has been used successfully during two seasons of coring on a blue ice area of Taylor Glacier, Antarctica. An updated version of the drill system, BID-Deep, has been designed to recover cores to depths up to 200 m.
Objectives: Visuospatial processing deficits have been reported in Huntington’s disease (HD). To date, no study has examined associations between visuospatial cognition and posterior brain findings in HD. Methods: We compared 119 premanifest (55> and 64<10.8 years to expected disease onset) and 104 early symptomatic (59 stage-1 and 45 stage-2) gene carriers, with 110 controls on visual search and mental rotation performance at baseline and 12 months. In the disease groups, we also examined associations between task performance and disease severity, functional capacity and structural brain measures. Results: Cross-sectionally, there were strong differences between all disease groups and controls on visual search, and between diagnosed groups and controls on mental rotation accuracy. Only the premanifest participants close to onset took longer than controls to respond correctly to mental rotation. Visual search negatively correlated with disease burden and motor symptoms in diagnosed individuals, and positively correlated with functional capacity. Mental rotation (“same”) was negatively correlated with motor symptoms in stage-2 individuals, and positively correlated with functional capacity. Visual search and mental rotation were associated with parieto-occipital (pre-/cuneus, calcarine, lingual) and temporal (posterior fusiform) volume and cortical thickness. Longitudinally, visual search deteriorated over 12 months in stage-2 individuals, with no evidence of declines in mental rotation. Conclusions: Our findings provide evidence linking early visuospatial deficits to functioning and posterior cortical dysfunction in HD. The findings are important since large research efforts have focused on fronto-striatal mediated cognitive changes, with little attention given to aspects of cognition outside of these areas. (JINS, 2016, 22, 595–608)
Nitride-based device structures for electronic and optoelectronic applications usually incor-porate layers of AlxGa1−xN, and n- and p-type doping of these alloys is typically required. Experimental results indicate that doping efficiencies in AlxGa1−xN are lower than in GaN. We address the cause of these doping difficulties, based on results from first-principles density-functional-pseudopotential calculations. For n-type doping we will discuss doping with oxygen, the most common unintentional donor, and with silicon. For oxygen, a DX transition occurs which converts the shallow donor into a negatively charged deep level. We present experimental evidence that oxygen is a DX center in AlxGa1−xN for x>∼0.3. For p-type doping, we find that compensation by nitrogen vacancies becomes increasingly important as the Al content is in-creased. We also find that the ionization energy of the Mg acceptor increases with alloy composition x. To address the limitations on p-type doping we have performed a comprehensive investigation of alternative acceptor impurities; none of the candidates exhibits characteristics that surpass those of Mg in all respects.
A microcompressor is a precision mechanical device that flattens and immobilizes living cells and small organisms for optical microscopy, allowing enhanced visualization of sub-cellular structures and organelles. We have developed an easily fabricated device, which can be equipped with microfluidics, permitting the addition of media or chemicals during observation. This device can be used on both upright and inverted microscopes. The apparatus permits micrometer precision flattening for nondestructive immobilization of specimens as small as a bacterium, while also accommodating larger specimens, such as Caenorhabditis elegans, for long-term observations. The compressor mount is removable and allows easy specimen addition and recovery for later observation. Several customized specimen beds can be incorporated into the base. To demonstrate the capabilities of the device, we have imaged numerous cellular events in several protozoan species, in yeast cells, and in Drosophila melanogaster embryos. We have been able to document previously unreported events, and also perform photobleaching experiments, in conjugating Tetrahymena thermophila.
Community archaeology is a rapidly expanding approach to archaeological research. Whilst the archaeology itself is central to individual projects, issues of community' may be heavily implicated within the agendas of many project partners. In this paper, I will argue that community archaeology projects are complex arenas in which a variety of agendas are interwoven within both the planned activities and the unplanned outcomes that occur during the life of a project. Drawing on ethnographic evidence of community archaeology from my recently completed doctoral research as well as from recent experience of the proactive delivery of community archaeology I will focus on the role of memory in relation to both the initial design of community archaeology projects and also the ways in which projects come to be understood and valued by those who have supported and/or participated in them. I will identify projects as being arenas in which aspects of social memory can be central to much that is both planned for and experienced by participants. The rediscovery of lost memories, the preserving of fragile memories and the making of new memories will be shown to be especially significant within the narratives aggregating around individual community projects. I identify ‘living memory'sites as being especially meaningful and effective for community archaeology and argue that the event of a community archaeology project can serve as an arena for the construction of community in the present.
Heritage, memory, community archaeology and the politics of the past form the main strands running through the papers in this volume. The authors tackle these subjects from a range of different philosophical perspectives, with many drawing on the experience of recent community, commercial and other projects. Throughout, there is a strong emphasis on both the philosophy of engagement and with its enactment in specific contexts; the essays deal with an interest in the meaning, value and contested nature of the recent past and in the theory and practice of archaeological engagements with that past.
Chris Dalglish is a lecturer in archaeology at the University of Glasgow. Contributors: Julia Beaumont, David Bowsher, Terry Brown, Jo Buckberry, Chris Dalglish, James Dixon, Audrey Horning, Robert Isherwood, Robert C Janaway, Melanie Johnson, Siân Jones, Catriona Mackie, Janet Montgomery, Harold Mytum, Michael Nevell, Natasha Powers, Biddy Simpson, Matt Town, Andrew Wilson
This volume publishes a selection of the papers first presented during the Society for Post-Medieval Archaeology's conference Engaging the Recent Past in 2010. This introductory paper seeks to situate the other contributions, placing them in the context of wider processes including the rise of Community Archaeology and the development of an explicit political consciousness in archaeology. Concepts of multivocality and memory are discussed, as are the practices of public participation. The paper argues that a more critical stance needs to be taken towards public engagement in archaeology, and this is discussed in relation to concepts of power and social learning. The paper advocates a move beyond limited participation (confined to particular activities, such as participatory site identification and recording, and to the context of particular projects) and it advocates a move towards participatory governance. Here, the archaeological professional is repositioned as a collaborator engaging with others, including relevant public constituencies and the relevant authorities, in the social process of creating knowledge about the past and defining how historic environments and relationships will be protected, managed or transformed in the future.
This volume arises from the Society for Post-Medieval Archaeology conference Engaging the Recent Past: Public, Political Post-Medieval Archaeology (Glasgow, September 2010). The focus of the conference was the contemporary context of post-medieval archaeology: the values, politics and ethics associated with the recent past, and the practices through which we engage with and construct that past. Contributors to the conference considered these issues in relation to the post-medieval and contemporary archaeologies of the U.K., Ireland and a number of other countries, and they promoted positions founded in a variety of philosophical, political and practice traditions.