metaboprep: an R package for pre-analysis data description and processing.

Motivation Metabolomics is an increasingly common part of health research and there is need for pre-analytical data processing. Researchers typically need to characterize the data and to exclude errors within the context of the intended analysis. While some pre-processing steps are common, there is currently a lack of standardization and reporting transparency for these procedures. Results Here we introduce metaboprep, a standardized data processing workflow to extract and characterize high quality metabolomics data sets. The package extracts data from pre-formed worksheets, provides summary statistics and enables the user to select samples and metabolites for their analysis based on a set of quality metrics. A report summarizing quality metrics and the influence of available batch variables on the data is generated for the purpose of open disclosure. Where possible, we provide users flexibility in defining their own selection thresholds. Availability and implementation metaboprep is an open-source R package available at https://github.com/MRCIEU/metaboprep

A practical example of an open disclosure process for people with intellectual disabilities in the Republic of Ireland

Literature pertaining to open disclosure predominantly refers to acute care settings; this is the case in, for example, the UK, Republic of Ireland, Australia, Korea and the USA. There is, however, a dearth of literature regarding open disclosure related to people with intellectual disabilities. A practice example of open disclosure is presented here, following a serious adverse event in an organisation supporting adults with intellectual disabilities. The aim of the process was to openly disclose in a meaningful way to adults with significant intellectual disabilities and communication difficulties. An apology pathway was developed by a multidisciplinary team based on individual communication needs. A suite of resources was developed including easy read-picture agendas and sign language to support increased understanding of the apology. Service users received the apology first, followed by meetings with their families. This practice example has positive implications for service providers for people with intellectual disabilities.

Pendampingan Perangkat Desa untuk Pelatihan Pembuatan Infografis Data Kependudukan Desa

Keterbukaan informasi merupakan hal yang sangat penting di era digital saat ini. Pengabdian kepada masyarakat yang dilakukan bertujuan untuk peningkatan skill perangkat desa sehingga mampu memberikan informasi yang valid, informatif dan terperinci tentang kependudukan desa. Informasi data desa yang tersaji secara menarik, informatif dan terperinci akan menjelaskan kondisi desa kepada seluruh masyarakat desa dan umum. Lokasi pendampingan ialah Desa Pekik Nyaring Kecamatan Pondok Kelapa, Kabupaten Bengkulu Tengah. Desa ini termasuk kedalam daerah pemekaran menjadi kabupaten baru sehingga keterbukaan data penduduk sangat penting. Pelatihan pembuatan publikasi data desa dilakukan dalam tiga tahap yaitu sosialisasi, pelatihan, publikasi hasil pelatihan. Sosialisasi yang disambut baik oleh kepala desa dan perangkatnya menjadikan pelatihan dapat dilaksanakan dengan baik. Data kependudkan desa yang dianalisis secara statistik deskriptif menggunakan Ms.Excel dengan pivot table, chart, data validation, dan fungsi statistika yang telah tersedia. Selanjutnya hasil analisis deskriptif di analisis dan di desain menjadi menarik dan dipublikasikan. Hasil publikasi dapat menjelaskan semua informasi kependudukan desa seperti jumlah penduduk, pekerjaan, agama, tingkat pendidikan, demografi desa, kepala keluarga dan jumlah penduduk. Pendampingan yang mendapat respon positif dengan ditunjukkannya adanya publikasi data desa pertama kali yang berbentuk infografis desa yang dapat diperoleh di tempat umum.Kata Kunci: data kependudukan; infografis; pendampingan. Assistance of Village Apparatus for Training on Making Village Population Data Infographics ABSTRACTInformation disclosure is very important in the digital era. Community service aims to improve the skills of village officials so that they are able to provide valid, informative and detailed information on village population. The village data information presented in an interesting, informative and detailed manner will explain the condition of the village to all village communities and the general public. The location of the assistance was Pekik Nyaring Village, Pondok Kelapa District, Bengkulu Tengah Regency. This village is a region that has become a new regency so open disclosure of population data is very important. The training on making village data publications was carried out in three stages: socialization, training, publication. The socialization was welcomed by the village head and his apparatus. Village population data were analyzed using descriptive statistics using Ms. Excel with pivot tables, charts, validation data, and statistical functions that were available. Furthermore, the results of descriptive analysis are analyzed and designed to be interesting and published. The results of the publication can explain all village population information such as population, occupation, religion, education level, village demographics, family heads and population. Assistance that received a positive response by showing the existence of the first village data publication in the form of village infographics that can be obtained in public places.Keywords: population data; infographic; accompaniment.

Developing open disclosure strategies to medical error using simulation in final-year medical students: linking mindset and experiential learning to lifelong reflective practice

Introduction and objectivesOpen disclosure is a policy outlining how healthcare practitioners should apologise for mistakes, discussing them with the harmed parties. Simulation is a training and feedback method in which learners practise tasks and processes in lifelike circumstances. We explore how final-year medical students experience the learning of open disclosure.MethodsA qualitative study of final-year medical students who had been involved a high-fidelity simulation session based on open disclosure after medication error was conducted. Students were selected using purposive sampling. Focus groups illuminated their experiences and interpretation of simulated open disclosure experiences. The data were analysed using interpretative phenomenological analysis and supported two superordinate themes: (1) identifying learning needs; and (2) learning to say sorryResultsThe medical students constructed their learning in three different ways: negotiating environmental relationships; embracing challenge and stress; and achieving learning outcomes. The data reinforced the need for psychological safety, emphasised the need for emotional arousal and demonstrated the need for both individual and collective reflective learning. Our data linked the benefits of experiential learning to the development of growth mindset and Jarvis’s theory.ConclusionsThe lived experience of the final-year medical student participants in this study reinforced the notions of continuous psychological safety and the need for emotional arousal during learning. Our data also demonstrated the variety of participant experiences when preparing to give open disclosure, reinforcing the need for facilitators to optimise learning for the whole group as well as the individuals, given that participants are at different parts of their learning cycle.

The relationship between the perception of open disclosure of patient safety incidents, perception of patient safety culture, and ethical awareness in nurses

Background Scientific advances have resulted in more complex medical systems, which in turn have led to an increase in the number of patient safety incidents (PSIs). In this environment, the importance of honest disclosure of PSIs is rising, which highlight the need to settle a reliable system. This study aimed to investigate the effects of patient safety culture and ethical awareness on open disclosure of PSIs. Methods Data were collected from 389 nurses using self-reported perceptions of open disclosure of PSIs, perceptions of patient safety culture, and ethical awareness. Results Perception of open disclosure of PSIs was significantly correlated with ethical awareness and perception of patient safety culture. Ethical awareness had the greatest impact on perception of PSIs, and two components of the perception of patient safety culture, namely overall knowledge about patient safety and staffing, were found to have significant effects. Conclusions To enhance nurses’ perception of open disclosure of PSIs, educational curriculum and programs that teach and practice fundamental ethical values are needed. Furthermore, it also calls for effort on the part of healthcare institutions and the government, as well as people’s trust, to implement a legal safety net and foster patient safety culture to promote honest disclosure of PSIs to patients.

Phenomenological study of medical interns reflecting on their experiences, of open disclosure communication after medication error: linking rationalisation to the conscious competency matrix

Introduction and objectivesErrors are common within healthcare, especially those involving the prescribing of medications. Open disclosure is a policy stating doctors should apologise for such errors, discussing them with the harmed parties. Many junior doctors take part in open disclosure without any formal training or experience, which can lead to failure of the apology, and increased patient/family frustration. In this study, we explore the ways in which interns perceive the relationship between medication error and their experience of open disclosure.MethodsUsing known theoretical frameworks of apology and moral rationalisation, a qualitative study of medical interns who had been involved in open disclosure was conducted. Twelve medical interns volunteered, and were selected using purposive sampling. Face-to-face semi-structured interviews illuminated their clinical experiences of open disclosure after medication error. The data was coded and analysed using Interpretative Phenomenological Analysis. Our data supported three super-ordinate themes: (1) Rationalisation of medical error, (2) Culture of medical error and (3) Apology in practice.ResultsThe interns in this study rationalised their observations, their subsequent actions and their language. Rather than reframing their thinking, they became part of a healthcare environment that culturally accepted, promoted and perpetuated error. Rationalisation can lead to loss of context in apologising, which can be perceived as unempathic by the patients/families. However, when reflection and unpacking of their errors, they acknowledged that their reasoning was problematic, recognised the reasons why and were able to reframe their approach to apology for a future occasion.ConclusionOur data suggests the utility of a learning framework around open disclosure following medication error, for having a supervisor conversation about aspects of the interns’ rationalisation of their clinical practice, in their contextualised clinical environment. Further research could clarify whether interns are ‘unconsciously incompetent’ or ‘consciously incompetent’, when addressing medication error and preparing to apologise.

Whistleblowing and Whistleblowers

Whistleblowing (also called good faith reporting, anonymous reporting, protected disclosure) is growing in importance as a corporate governance mechanism. It is increasingly recognized as a key internal control mechanism. Whistleblowing is a term used to describe an act whereby wrongdoing is exposed. It gained impetus following the collapse of Enron in 2001 arising from financial reporting fraud, which culminated in the U.S. Time magazine selecting three whistleblowers (all women) as its person of the year in 2002. The term was first used in 1966. Researchers have invoked a variety of theories and models attempting to explain whistleblowing. Elements that influence the process include the whistleblowers, the type of wrongdoing, the wrongdoers, the decision to blow the whistle, whistleblowing recipients, organizational factors, and finally the consequences of whistleblowing. Organizational processes, alternative to the more extreme step of whistleblowing, include silence (the other side of the coin to whistleblowing), speaking up, and open disclosure. An organizational response resisting an employee speaking up is the trigger that creates a whistleblower. The definition of whistleblowing only includes organizational members. Should it be extended to include external parties as well as organizational members? Social media has had an impact on whistleblowing. Questions remain as to the efficacy of whistleblowing: Is it a substantive or symbolic mechanism of governance?