Prescription Audit and Dispensing Errors in the Outpatient Pharmacy of Tertiary Care Multispecialty Teaching Hospital

Background: Although errors occurring during the process of dispensing may affect the goal of the treatment, they also can be the significant cause of morbidity and mortality. There are only few published evidences which focuses on the errors of dispensing that occurs in the pharmacy. This study focuses on identifying the dispensing errors, impact of brand substitution on cost and DDIs. Objective: To identify the dispensing errors, impact of brand substitution on cost and DDIs. Methodology: Prospective observational study conducted over a period of eight weeks in outpatient hospital pharmacy of tertiary care multispecialty teaching hospital, Tamil Nadu. Prescriptions and medication bills and dispensed medicines are collected from the hospital pharmacy to obtain data required for the study. Prescription containing only medical devices were excluded from the study. Results: Out of 1010 prescriptions, dispensing errors were present in 419 (41.48%) prescriptions which consist of 557 errors. The errors include dispensing multi-pills to make the required dose is 3.77%,tablet splitting is 0.8%, incorrect strength is 1.07%, omission error due to unavailability is 31.4%,dispensing drugs with brands other than prescribed brands is 63.7%. Prescriptions which had more than three drugs were analyzed for drug-drug interactions (n=389). DDIs were present in 156(40.1%) prescriptions which had a total of 281 interactions. Conclusion: The brand substitution and omission errors are the major causes of dispensing errors. Brand substitution is not always recommended as it may have some adverse effects because of salt and excipients variation. Pharmacists are in the position to identify and reduce DDIs by discussing with the physicians.

Facilitating Word Retrieval in Aphasia: Which Type of Cues for Which Aphasic Speakers?

Background: Even if both phonological and semantic cues can facilitate word retrieval in aphasia, it remains unclear if their respective effectiveness varies according to the underlying anomic profile.Aim: The aim of the present facilitation study is to compare the effect of phonological and semantic cues on picture naming accuracy and speed in different types of anomia.Methods: In the present within-subject design study, 15 aphasic persons following brain damage underwent picture naming paradigms with semantic cues (categorically- or associatively related) and phonological cues (initial phoneme presented auditorily, visually or both).Results: At the group level, semantic cueing was as effective as phonological cueing to significantly speed up picture naming. However, while phonological cues were effective regardless of the anomic profile, semantic cueing effects varied depending on the type of anomia. Participants with mixed anomia showed facilitation after both semantic categorical and associative cues, but individuals with lexical-phonological anomia only after categorical cues. Crucially, semantic cues were ineffective for participants with lexical-semantic anomia. These disparities were confirmed by categorical semantic facilitation decreasing when semantic/omission errors prevailed in the anomic profile, but increasing alongside phonological errors.Conclusion: The effectiveness of phonological vs semantic cues seems related to the underlying anomic profile: phonological cues benefit any type of anomia, but semantic cues only lexical-phonological or mixed anomia.

Medication omissions in the first 48 hours after admission: failure in prescribed medicines reaching in-patients in paediatrics wards at the University Teaching Hospitals, Children’s Hospital in Lusaka, Zambia

Background: The first few days of in-patient care are possibly the most significant in a patient’s recovery and any omitted medications during this period may harm the patient or increase their hospital length of stay. Therefore, our study aimed at assessing the frequency of medication administration omission errors and their reasons for the omission in the paediatric wards after admission at University Teaching Children’s Hospital.Methods: This was a descriptive study in which 259 patient files and drug charts were reviewed. Admission prescription charts were studied in detail over a period of four weeks and all drugs prescribed but then not given in the first 48 hours were recorded as omitted medications, along with the reason given for their omission.Results: From the 259 drug charts, a total of 1598 doses of drugs were ordered within 48 hours of admission. However, from this, only a total of 1132 doses were administered with the remaining 466 doses omitted, which accounted for a frequency of 29.2%. When the frequency of medication omission errors was compared, parenteral drugs (70.8% vs. 25.3%, [p=0.0001]), afternoon shift (48.5% vs. 15.8%, [p=0.0001]), and anti-infective medications (69.1% vs. 39.4%, [p=0.0001]) were found to be the most frequently omitted medications. There were also considerably more medication omissions in patients prescribed with more medications (median number: 4, I QR [2, 6] vs. median number: 2, IQR [2, 4], [p=0. 0.001]). The most common reason for the omission was medication unavailability (89.3%), followed by work overload (71.4%), and the patient is off the ward (71.4%).Conclusions: This study revealed that medication omissions are a continuing problem and this may result in increased morbidity and mortality rates. There is a need to put in place specific strategies to reduce this problem.

Development and validation of a new MODIS snow-cover-extent product over China

Based on the MOD09GA/MYD09GA 500-m surface reflectance, a new MODIS snow-cover-extent (SCE) product over China has been produced by the Northwest Institute of Eco-Environment and Resources (NIEER), Chinese Academy of Sciences. The NIEER MODIS SCE product contains two preliminary clear-sky SCE datasets — Terra-MODIS and Aqua-MODIS SCE datasets, and a final daily cloud-gap-filled (CGF) SCE dataset. The formers are generated mainly through optimizing snow-cover discriminating rules over different land-cover types, and the latter is produced after a series of gap-filling processes such as aggregating the two preliminary datasets, reducing cloud gaps with adjacent information in space and time, and eliminating all gaps with auxiliary data. Validation against 362 China Meteorological Administration (CMA) stations shows during snow seasons the overall accuracies (OA) of the three datasets are all larger than 93 %, the omission errors (OE) are all constrained within 9 %, and the commission errors (CE) are all constrained within 10 %. Biases ranging from the lowest 0.98 to the medium 1.02, to the largest 1.03 demonstrate on a whole the SCEs given by the new product are neither overestimated nor underestimated significantly. Based on the same ground reference data, we found the new product’s accuracies are clearly higher than those of standard MODIS snow products, especially for Aqua-MODIS and CGF SCE. For examples, compared with the CE of 23.78 % that the standard MYD10A1 product shows, the CE of the new Aqua-MODIS SCE dataset is 6.78 %; the OA of the new CGF SCE dataset is up to 93.15 %, versus 89.54 % of the standard MOD10A1F product and 84.36 % of the standard MYD10A1F product. Besides, as expected snow discrimination in forest areas is also improved significantly. An isolated validation at four forest CMA stations demonstrates the OA has increased by 3–10 percentage points, the OE has dropped by 1–8 percentage points, and the CE has dropped by 4–21 percentage points. Therefore, our product has virtually provided more reliable snow knowledge over China, and thereby can better serve for hydrological, climatic, environmental, and other related studies there.

Multi-Sensor, Active Fire-Supervised, One-Class Burned Area Mapping in the Brazilian Savanna

Increasing efforts are being devoted to understanding fire patterns and changes highlighting the need for a consistent database about the location and extension of burned areas (BA). Satellite-derived BA mapping accuracy in the Brazilian savannas is limited by the underestimation of burn scars from small, fragmented fires and high cloudiness. Moreover, systematic mapping of BA is challenged by the need for human intervention in training sample acquisition, which precludes the development of automatic-generated products over large areas and long periods. Here, we developed a multi-sensor, active fire-supervised, one-class BA mapping algorithm to address several of these limitations. Our main objective is to generate a long-term, detailed BA atlas suitable to improve fire regime characterization and validation of coarse resolution products. We use composite images derived from the Landsat satellite to generate end-of-season maps of fire-affected areas for the entire Cerrado. Validation exercises and intercomparison with BA maps from a semi-automatic algorithm and visual photo interpretation were conducted for the year 2015. Our results improve the BA mapping by reducing omission errors, especially where there is high cloud frequency, few active fires are detected, and burned areas are small and fragmented. Finally, our approach represents at least a 45% increase in BA mapped in the Cerrado, in comparison to the annual extent detected by the current coarse global product from MODIS satellite (MCD64), and thus, it is capable of supporting improved regional emissions estimates.

A-30 Measures of Attention and Inhibitory Control: Comparing the TOVA to the NIH Toolbox Flanker Test in Children and Adolescents with ADHD

Objective The Attention Comparison Score for the Test of Variables of Attention (TOVA) was developed as a “single score” method of differentiating individuals with Attention-Deficit/Hyperactivity Disorder (ADHD) from controls (Leark, Greenburg, Kindschi, Dupuy & Hughes, 2008). Recent literature has documented that a more nuanced interpretation of TOVA scores, including the Attention Comparison Score, Commission Errors, and Omission Errors, can be more useful in describing the nature of impairment (e.g., sustained attention and/or inhibitory control) experienced by individuals diagnosed with ADHD (Winstone, Logid, Foley & Nicholls, 2019). The NIH Toolbox Cognition battery also assesses attention and inhibitory control by means of a Flanker Test. The current study examines whether the TOVA Attention Comparison Score predicts performance on the NIH Toolbox Flanker Test, and if adding TOVA Commission Error and Omission Error variables would predict greater amounts of variance on the Flanker Test in a pediatric sample. Method A sample of 64 pediatric patients (62.7% male, 37.3% female) diagnosed with ADHD aged 4–17 years (M = 11.25; SD = 3.74) was administered the NIH Toolbox Cognition Battery and TOVA as part of a comprehensive neuropsychological evaluation in a private practice in Scottsdale, Arizona. Results Our data found support that the more nuanced approach of adding commission and omission information better predicted Flanker scores than the Attention Comparison Score alone. Conclusion Based on the findings, clinicians utilizing the TOVA as a means of assessing for ADHD in pediatric populations should consider omission and commission errors to better understand attention and inhibitory control abilities.

Kesalahan Berbahasa Indonesia dalam Karya Tulis Mahasiswa Asing di Universitas Negeri Malang (UM)

In learning a new language, mistakes are common as a part of language acquisition.This research aims to describe the kinds of Indonesian language mistakes. Data analysis used the Miles and Huberman model with three activity lines, namely (1) data reduction, (2) data presentation, and (3) conclusion drawing. The data from this research are in the form of Indonesian language mistakes from research papers that are written by foreign students at Universitas Negeri Malang. The source of data comes from 15 research papers by foreign students at Universitas Negeri Malang that come in the form of essays and daily journals. The final result of Indonesian language mistakes in research papers that are written by foreign students (1) spelling mistakes, (2) word choices, (3) morphology, and (4) syntax. The kind of spelling are (1) wrong use of capital letters and (2) word writing errors. Indonesian language mistakes of morphology are (1) affix omission errors and (2) affix shortening errors. Indonesian language mistakes of syntax are (1) use of foreign terms, (2) word addition errors, and (3) word order errors. Keywords: mistake, research paper, foreign student Abstrak: Adanya kesalahan dalam mempelajari sebuah bahasa baru merupakan hal yang wajar terjadi dalam proses pemerolehan bahasa.Penelitian ini bertujuan untuk mendeskripsikan bentuk kesalahan berbahasa Indonesia mahasiswa Asing di UM. Penelitian ini menggunakan model analisis interaktif Miles dan Huberman melalui 3 tahap, yaitu (1) reduksi data, (2) penyajian data, dan (3) penarikan kesimpulan. Data penelitian ini berupa kesalahan berbahasa Indonesia dalam karya tulis mahasiswa Asing Universitas Negeri Malang. Sumber data berasal dari 15 karya tulis mahasiswa Asing di UM berupa esai dan jurnal harian. Hasil penelitian kesalahan berbahasa Indonesia dalam karya tulis mahasiswa Asing UM meliputi (1) kesalahan ejaan, (2) pemilihan kata, (3) morfologis, dan (4) sintaksis. Kesalahan berbahasa Indonesia pada tataran ejaan meliputi (1) penggunaan huruf kapital dan (2) kesalahan penulisan kata. Kesalahan morfologis berbahasa pada tataran, meliputi (1) kesalahan penghilangan afiks dan (2) kesalahan penyingkatan afiks. Kesalahan berbahasa pada tataran sintaksis, meliputi (1)penggunaan istilah asing, (2) kesalahan penambahan dan (3) kesalahan pengurutan kata. Kata kunci: kesalahan, karya tulis, mahasiswa asing

No negative impact of word retraining on vocabulary use or clarity of communication in Semantic Dementia

Word retraining techniques can improve picture naming of treated items in people with semantic dementia (SD). The utility of this, however, has been questioned given the propensity for under- and overgeneralisation errors in naming in SD. Few studies have investigated the occurrence of such errors. This study examined whether, following tailored word retraining: 1) misuse of words increases, 2) the type of naming errors changes, and/or 3) clarity of communication is reduced. Performance on trained and untrained word naming from nine participants with SD who completed a word retraining program were analysed. Responses from baseline and post-intervention assessments were coded for misuse (i.e., trained word produced for another target item), error type, and communication clarity. All participants showed significant improvement for trained vocabulary. There was no significant increase in misuse of words, with such errors occurring rarely. At a group level, there was an increased tendency toward omission errors for untrained items, and a reduction in semantically related responses. However, this did not impact on clarity scores with no consistent change across participants. In sum, we found no negative impacts following tailored word retraining, providing further evidence of the benefit of these programs for individuals with SD.

Error analysis of the students’ English written descriptive text

Making errors is a natural process of learning. Writing as a productive skill is important for students to express their ideas. However, students conducted errors in the productive skills. Therefore, this study is intended to find out types of errors made by students in written English. This study employed the qualitative method where the Error Analysis was implemented. The subject of this study is students in first grade of SMAN 1 Abdya and the object of this study were the errors found in written English. The population of this research was all of students in first grade which consists of 208 students from all study programs where 25 % of the populations were taken as the sample. To collect the data, written tests were conducted. The written test shows the percentage of writing errors, including omission errors, which is 58.38%, misformation errors with a total of 16.48%, misordering error 13.89%, and addition of 11.26%. The errors were found when students omitted 'to be' as main verb. Second, students tend to add 'to' after modal auxiliaries such as 'can' or 'will'. Third, misformation errors happened when students could not form the verb correctly. Last, the misordering errors were produced when students put words randomly. Consequently, it was discovered that the errors made by students were impacted by their native language, and this is the interlanguage move.