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Introduction. Polypharmacy is associated with potentially inappropriate medicine prescribing and avoidable medicine-related harm. Polypharmacy should not be perceived as inherently harmful. Instead, priority should be placed on reducing inappropriate prescribing. Aim. The study aimed to develop and validate PolyScan, a primary care information technology tool, to triage older adults with polypharmacy who are prescribed potentially inappropriate medicines. Methods. Twenty-one indicators from a New Zealand criteria of potentially inappropriate medicines to correct for older adults with polypharmacy were developed into a set of implementable definitions. The definitions were applied as algorithmic logic statements used to interrogate hospital and emergency department records and pharmaceutical collection data to classify whether each indicator was present at an individual patient level, and then triage individuals based on the number of indicators met. Validity was evaluated by comparing PolyScan’s accuracy against a manual review of healthcare records for 300 older adults. Results. PolyScan was successfully implemented as a tool that can be used to identify potentially inappropriate prescribing in older adults with polypharmacy at different levels of aggregation. The tool has utility for individual practitioners delivering patient care, primary care organisations undertaking quality improvement programmes, and policymakers considering system-level interventions for medicines-related safety. During the validity assessment, PolyScan identified nine individuals (3%) with polypharmacy and indicators of potentially inappropriate medicine. Five unique indicators were detected. PolyScan achieved 100% sensitivity, specificity, and positive and negative predictive values. Discussion. PolyScan can support clinicians, clinics, and policymakers with allocation of resources, rational medicine campaigns, and identifying individuals prescribed potentially inappropriate medicines for review. [ABSTRACT FROM AUTHOR]

Originally drawing from a "country club" community in Gwinnett County, Georgia, Creekland Middle School has undergone significant changes in the past decade. The percentage of students receiving free and reduced-price lunch has risen--and continues to do so. This year, 46% of its student population is economically disadvantaged, up 20% from 2006-07. Creekland has become more ethnically diverse as well. A majority of Creekland's students were not being purposefully engaged in learning because they were different from the students whom the faculty and staff members had become accustomed to teaching. Their students were diverse learners, but the teachers were by and large not prepared to differentiate their teaching styles and instructional strategies to accommodate the many learning styles present in their classrooms. The administrators and faculty decided that they needed a change, and the administrators met almost every Friday morning at the local IHOP to discuss what that change would look like. They decided it would take the form of a new initiative that demanded that teachers alter their lesson planning. The initiative--180 Days of Wow!--was introduced to the faculty in January 2008 and included a vision of delivering 180 days of lessons that were planned with purpose and consistency. The explanation was simple and direct: Give the students a reason to want to be at school. Give them a reason to want to be in classrooms. The means of doing so were plain and to the point: wow the students. Now into their third full year of the initiative, they can look back at the results from their first two years with both excitement and pride. The positive results of planning have touched their students and faculty members. The teachers have embraced collaboration and say that planning for authentic student engagement has changed how they teach their students. Students--and many parents--have expressed their growing satisfaction with the reality of authentic engagement and its role in developing more responsible and motivated learners

Introduction. The link between polypharmacy, risk of potentially inappropriate medication exposure, and avoidable medicines-related harm is well recognised. Not all polypharmacy is harmful, and contemporary multimodal approaches to managing long-term conditions are evidence-based and commonplace. What is needed is a focus on reducing inappropriate medication prescribing in polypharmacy. Aim. This study aims to develop the New Zealand criteria, a set of New Zealand-specific potentially inappropriate medication indicators to correct for older adults with polypharmacy. Methods. A mixed-methods approach was used. An expert panel group comprising four clinical pharmacists, two general practitioners, one geriatrician, and two nurse practitioners generated a collection of ideas via the nominal group technique, which combined with published criteria from literature, provided the list of potential criteria. These potential criteria were reviewed, validated, and ranked for importance via a two-round modified Delphi analysis with the same panel. Results. The nominal group technique generated 35 indicators, of which 23 were rated as important. Fifty-nine of 91 indicators from literature were rated as relevant and important. This generated 82 indicators for the modified Delphi analysis, from which 61 achieved consensus. Overall, 21 unique criteria were judged 'very important', 31 were judged 'important', and nine were judged 'somewhat important'. No indicators were judged 'low importance'. Discussion. The New Zealand criteria provides 61 medication indicators, which New Zealand experts recommend should prompt formal, documented review. The criteria can be used to systematically identify patients at the highest risk of avoidable medication-related harm for proactive review. [ABSTRACT FROM AUTHOR]