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Study shows older, poorer people at greater risk from adverse drug reactions

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A review by academics at Swansea University has found that older, poorer people who are socially distanced from their doctors or pharmacists, suffer more adverse drug reactions than the general population and that systematic monitoring is needed to protect these patients suffering from reactions which could result in over-sedation, falls, or drug-induced Parkinsonism.

The paper, published in the Geriatrics journal, acknowledges that despite modern efforts to move towards “patient-centred medicine”, doctors tend to treat their patients at a distance. The emphasis on prescribing treatment for patients while having limited contact with them, is especially true in relation the treatment of older patients in long-term care facilities. The problem is amplified by the overall lack of regular systematic reviews of the patient meaning opportunities are being missed to identify medication errors and undetected adverse drug reactions.

(Photo by Matthias Zomer on Pexels.com)

Professor David Hughes, who led the paper said: “It is very unfortunate that the combination of social distance between doctors and older and often poorer patients, and treatment centring on drugs prescribed without regular patient contact and checks, increases the risks of medication mistakes and adverse drug reactions. I am also very concerned that is a much more common scenario during the pandemic, given that patients in care homes are more likely to be living in lockdown, often without direct contact with their doctors.”

The study recommends the use of the Adverse Drug Reaction Profile as a solution. The Adverse Drug Reaction Profile, is a carer administered systematic checklist that makes the detection of common ADRs easier and provides staff and nurses with information to link signs and symptoms on the checklist to prescription medicines. This multi-disciplinary approach allows home care staff and nurses to link in with prescribers such as doctors and pharmacists, to provide them with personalised patient information and evidence so that prescribers are able to respond quickly to identified problems and adjust prescribing.

(Photo by RF._.studio on Pexels.com)

Paper co-author, Professor Sue Jordan said: “The profile identifies and documents patients’ signs and symptoms of adverse drug reactions and better monitoring allows professionals to respond with agility. While we realise that the implementation of the adverse drug reactions monitoring system will require changes to the regulatory regime at inspectorate level, it will make for better inter-professional cooperation. Providing carers, nurses and pharmacists with a structured system to monitor patients would democratise relevant medical knowledge and also help address ageism and the socio-economic health divide.”

(Lead Image: Swansea University)


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Environment

Swansea animal movement expert awarded prestigious medal for scientific contribution

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Professor Emily Shepard, an expert in the movement ecology of wild animals, has been awarded the prestigious Zoological Society of London (ZSL) Scientific Medal, in recognition of her outstanding research.

The ZSL Scientific Medal is awarded for outstanding contributions by an early career researcher, with up to three awarded annually.

Professor Shepard’s work focuses on how bird flight is affected by airflows, using biologging technologies in the field, experimental work in wind tunnels, and theoretical models of airflows and flight mechanics.

This novel research has combined bird tracking data with the use of computational fluid dynamics to model airflows at local scale. She has looked at how airflows affect where birds fly, the ability to land, and where seabirds nest.

In addition, Professor Shepard’s use of high-frequency tagging data has provided fascinating insights into the flight strategies of condors. This involved using high-frequency sensors to quantify the amount of time spent flapping, and when and where birds extract energy from the air by circling in thermal updrafts or soaring along windward slopes.

Professor Shepard said: “It’s a huge honour to receive the ZSL Scientific Medal. It has also been a delight to team up with collaborators in biology, meteorology and engineering, which has been fundamental to much of this work.”

Founded in 1826, the Zoological Society of London (ZSL) is an international scientific, conservation and educational charity whose mission is to promote and achieve the worldwide conservation of animals and their habitats.

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On presenting the award to Professor Shepard, the ZSL said: “Emily is recognised as a global leader in this research area, and her contributions to the scientific literature simply cannot be missed. Many of her papers are already seen as classics, and bound to become timeless achievements in the realm of zoological scientific discoveries”.

(Lead image: Swansea University)

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Research

£1.73m additional funding to expand project in semiconductor technology and applications

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The Welsh Government has announced additional funding of £1.73 million for a project, which involves Swansea University and partners, developing world-leading semiconductor process technologies.

Applications include autonomous vehicles, novel devices for clean energy, future mobility, artificial intelligence, advanced packaging, and biosensors and wearable sensors.

ASSET (Application Specific Semiconductor Etching Technology) is an industrially driven, collaborative project with partners across south Wales, including: SPTS Technologies (a KLA company), IQE, The Compound Semiconductor Centre (CSC), Biovici, BioMEMS, Swansea and Cardiff universities and Integrated Compound Semiconductors Ltd (Manchester).

ASSET is partly funded by the European Regional Development Fund (ERDF), under the Welsh Government’s SMART Expertise programme.

The ASSET industrial partners provide advanced technologies for almost all the world’s smartphones. By developing a host of new semiconductor process technologies using compound semiconductors and next generation materials, ASSET will service new and emerging applications in automotive sensing, 6G, photonics and healthcare.

The expanded ASSET project involves additional industry partners from the South Wales Compound Semiconductor Cluster including: CSconnected, smart sensors and networks producers UtterBerry, photonics company Wave Photonics, and the National Physical Laboratory (NPL) which is the UK’s national metrology institute.

Professor Owen Guy, head of chemistry at Swansea University and lead for the ASSET project, said: “The expanded ASSET project is a timely boost to the UK semiconductor industry, with exciting developments planned with several of our regional industry partners, and the opening of our £90m Centre for Integrative Semiconductor Materials (CISM) – a new state-of-the-art semiconductor facility at Swansea University – in 2022.”

Vaughan Gething, Welsh Government Economy Minister, said: “We are immensely proud of the world-leading compound semiconductor ecosystem we helped foster here in Wales. It is a high potential network translating state-of-the-art research and innovation capabilities into world-class Welsh manufacturing for new and emerging global technology markets. This “next generation” technology shapes our lives today and will improve our experiences of tomorrow – from electric vehicles, to face recognition in smart phones, and space applications.

“The sector is of huge significance to Wales, providing high value employment and a real magnet for foreign direct investment. It also underpins development in so many other industries, and we believe it can deliver against our Programme for Government by driving a stronger, greener economy, and contributing to the net-zero, decarbonisation challenge.

“I’m very proud of the Welsh Government’s track record on supporting businesses to innovate and introduce new products and services, to trade with the UK and the rest of the world, to improve our skills base and to ensure that Wales remains competitive in the fourth industrial age.”

Dr Matt Elwin, Operations Director for CISM / Dr. Mike Jennings, Associate Professor in Electronic Engineering at Swansea, said: “The ASSET expansion links with our new ‘Driving the Electric Revolution (DER)’ Industrialisation Centres (IC) initiative to create a new sovereign supply chain for the UK in next generation power electronics components for transport electrification. This funding, plus the £4.82 million from the DER Industrialisation Centres programme, will help us deliver common goals for increased economic growth, developing clean and resilient supply chains in power electronics, machines and drives.”

Paul Rich, Executive Vice President of Product Engineering and Technology at SPTS Technologies, said: “The ASSET project gives the consortium the ability to work with the extensive fabrication supply chain in the region to further expand our capabilities and capitalise on new and exciting market opportunities.”

Wyn Meredith from the Compound Semiconductor Centre said: “The South Wales semiconductor industry employs over 1,400 highly skilled people in the region and is set to expand rapidly over the next five years with the growth of 5G, AI and other mega-trend markets. ASSET will support these markets by developing a range of advanced semiconductor processes and expertise to overcome technical and industry challenges.”

Heba Bevan from UtterBerry said: “UtterBerry is proud to be working with Professor Owen Guy and his team at Swansea University on the project, to revolutionise chip manufacturing and to become one of the most advanced centres in the UK. We also look forward to the broader positive changes the team at UtterBerry will make to the area, including job creation, a more efficient transportation network, enhanced connectivity and automation in the clean energy sector.”

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Health

Software to reduce emergency hospital admissions of limited use and benefit to patients new survey of GPs shows

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A software tool meant to help reduce emergency hospital admissions is of limited use and benefit to patients, a new study of GPs’ views and experiences has revealed.

The study builds on earlier research by the same team showing that emergency admissions had gone up – not down – when the tool was introduced in Wales, which led to its rollout being halted, though it continues to be used widely in England, Scotland and Northern Ireland.

Researchers say the new study reinforces the need for more evidence and research on the implementation of the software and its effects.

The software is a risk prediction tool, which in Wales is called PRISM. It identifies people who are most at risk of needing emergency care, based on past use of healthcare, diagnoses and medications. The thinking is that targeted management of these patients can reduce emergency admissions to hospital, improve patient outcomes and experience, and provide better value for money.

However, researchers at Swansea University Medical School, who evaluated the use of PRISM in Wales, found that there is little evidence to suggest that it meets these objectives.

Now, to shed more light on how the tool is used in practice, the same team have published a second study, exploring the views and experiences of GPs and practice managers who used PRISM.

They interviewed 22 GPs and practice managers in 18 practices in south Wales, between three and six months after they began using PRISM and then again 18 months later.

They found that GPs generally judged it unlikely that PRISM had any effect on emergency admissions, with a widespread feeling that admissions initiated by GPs were already low with little scope for further reductions

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Respondents reported the decision to use PRISM was based mainly on wanting to secure incentives offered by the Welsh Government under its Quality and Outcome Framework for improving care.

The survey also found that the use of PRISM was inhibited by it not being integrated with practice systems and most doubted any large-scale impact from PRISM, but cited examples of impact on individual patient care.

The majority of respondents reported that PRISM had made them more aware of high-risk patients, flagging up some patients who had not previously been considered to be in the high-risk category.

The researchers’ overall conclusions were that views of PRISM in general practice were mixed, and that policymakers need more information about how these tools are used in practice, and the effects of these tools on decision-making as well as patient outcomes.

Professor Helen Snooks from the project team at Swansea University Medical School said: “Tools like PRISM are used widely by the NHS in primary and community care, with the aim of reducing emergency hospital admissions. However, there is a lack of evidence to support the view that they enable proactive care and improve patient outcomes.

“Our research highlighted very mixed views and experiences among GPs and practice managers about use of PRISM. This was often short-term and driven by external factors rather than embedded in new ways of working.

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“Decision-makers need more information about the implementation and effects of such tools in primary and community settings to inform future policy on their use.

Given the current context of rising emergency admissions, and Department of Health incentives in England to use these risk tools in community services, our findings are important and timely.”

(Lead image: Swansea University)

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