BackgroundAccess to emergency contraception (EC) has been a core component of attempts to address high teenage pregnancy rates in Wales. A national service was commissioned in 2011, allowing supply of EC free of charge from community pharmacies (CPs). This study investigated 5 years of the EC service, to describe its use and investigate changes in the pattern of use over time.MethodsSecondary analyses of data from all National Health Service funded CP EC consultations in Wales between 1 August 2012 and 31 July 2017 (n=181 359). Data comprised standardised clinical and demographic information, in the form of predefined service user responses, submitted for reimbursement by CPs.ResultsOverall service provision remained relatively consistent over the study period, with women aged between 13 and 59 years accessing the service. An association was observed between the time since unprotected sexual intercourse and the day on which the service was accessed (Χ2(18)=16 292.327, p<0.001). Almost half (47.9%) of requests were because no contraception had been used, with a strong and positive association for teenagers and women aged 40+ years. A statistically significant and increasing percentage of consultations were accompanied by further sexual health advice (r=0.7, p<0.01).ConclusionsAccess to EC through CPs is contributing to reducing teenage conceptions and termination rates. However, action is needed to increase contraception use in all age groups. Reduced availability of CP services on Sundays is a barrier to timely EC access. Findings support an expanded role for community pharmacists in provision of regular contraception.
Using a case study of a pharmacy department rebuild in the South West of England, this article examines the use of evidence-based design to improve the efficiency and staff well-being with a new design. This article compares three designs, the current design, an anecdotal design, and an evidence-based design, to identify how evidence-based design can improve efficiency and staff well-being by reducing walking time and distance. Data were collected from the existing building and used to measure the efficiency of the department in its current state. These data were then mapped onto an anecdotal design, produced by architects from interviews and workshops with the end users, and an evidence-based design, produced by highlighting functions with high adjacencies. This changed the view on the working processes within the department, shifting away from a focus on the existing robotic dispensing system. Using evidence-based design was found to decrease the walking time and distance for staff by 24%, as opposed to the anecdotal design, which increased these parameters by 9%, and is predicted to save the department 248 min across 2 days in staff time spent walking.
Abstract-This paper describes the simulation of stairs on a treadmill style locomotion interface using torso force feedback. The active mechanical tether of the Sarcos Treadport locomotion interface applies a specialized force profile to simulate the forces of stair walking. The biomechanics of subjects walking on real stairs versus walking under the specialized force profile were compared. It was found that the tether force was able to adjust the subject's motion from standard slope walking towards that of stairs.
Navigating a healthcare facility can prove challenging to both new and existing patients and visitors. Poor or ineffective use of signage within the facility may enhance navigational difficulties. Signage strategies within facility design tend to be produced without consideration of how people typically navigate a space. Thus, strategies that ‘work on paper’ may not, in reality, aid or optimize patient and visitor wayfinding. Existing strategies for determining signage placement may also prove costly in terms of time spent on manual analysis of a facility’s floor space, including the potential for overlooking prime signage locations when analysing large floor plans. This paper presents a tool which aims to aid signage placement strategies by analysing facility design and routes within it, based on natural wayfinding metrics found in existing literature. The tool is designed to enable quick analysis of large designs for analysing multiple routes, highlighting areas where signage placement would aid natural wayfinding. The outputs of the tool are presented as a colour map which overlays the original 3D model design, highlighting the key areas where signage may be appropriate. An example of how the tool can be utilised to aid effective sign strategy is demonstrated on a small healthcare facility design.
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