Waterford Institute of Technology

<h3>Background and Importance</h3> The European Statements of Hospital Pharmacy recommend <i>‘A European-wide framework for initial post graduate education and training in hospital pharmacy with an assessment of individual competence is essential’</i>.¹ To facilitate the development of evidence-informed recommendations for improving hospital pharmacist education, national data outlining current practice were required. <h3>Aim and Objectives</h3> Evaluate current standards of practice relating to education within hospital pharmacy. Outline perceived barriers to pharmacist engagement in education. <h3>Material and Methods</h3> A national online survey was developed and distributed to hospital pharmacy managers between May and August 2025 inclusive. The survey was distributed via various methods, including central emailing lists and contacts of the research team. Survey questions addressed Staffing structures. Current levels of education provided. Types of educational activities conducted. Perceived gaps in hospital pharmacist education. Barriers to engagement in pharmacist education. Responses results were analysed descriptively. <h3>Results</h3> Fifty-five (65%) pharmacy managers responded. Key findings included: Only 27% of participants reported having a pharmacist responsible for education. Almost two–thirds (63%) reported having a structured induction for pharmacists. Pharmacist induction included dispensary training (91%), clinical training (85%), and corporate induction (79%). Over three–quarters (79%) of inductions lasted &lt;6 weeks. Seventy percent (70%) provided ongoing departmental education, most through journal clubs (77%), case presentations (60%), and near–miss/error meetings (57%). Over two–thirds (69%) of institutions currently support pharmacists on postgraduate courses, mostly in clinical pharmacy (86%) Formal education was provided by pharmacy to nursing (88%), medical (76%) and allied health professionals (33%), as well as undergraduate (47%) and postgraduate (27%) pharmacy students. Perceived gaps in hospital pharmacy education included advanced practice, inpatient and outpatient medication reviews, and clinical skills. Reported barriers to hospital pharmacy education include lack of funding, time constraints, workload and lack of a structured competency framework specific to hospital pharmacy practice. <h3>Conclusion and Relevance</h3> Hospital pharmacy departments display significant commitment to, and engagement with, education activities nationally. Efforts to introduce a standardised hospital-specific competency framework for new-to-hospital pharmacists, and validated accreditation for advanced practice will help further facilitate this. <h3>References and/or Acknowledgements</h3> 1. The European Statements of Hospital Pharmacy. <i>European Journal of Hospital Pharmacy</i> 2014;<b>21</b>:256–258. <h3>Conflict of Interest</h3> Conflict of interest Corporate sponsored research or other substantive relationships: No conflicts of interest

Minimizing the use of artificial fertilizer nitrogen (AFN) and optimizing conditions for biologically fixed nitrogen (BFN) in association with clover is a cost-effective strategy for lowering emissions from dairy farms. The objectives of the present study were to examine the productivity of clover-BFN-grassland for pasture and milk production, to quantify the BFN that underpinned this productivity, spring growth and the length of the growing season, nutritive value of pasture at different stages of the growing season and feed budgets. Data were collected from systems-scale experiments at Solohead Research Farm (Co. Tipperary, Ireland; 52°51'N, 08°21'W). There were 3 systems that had an average of 27 cows per system per year and an average stocking rate of 2.53 cows∙ha-1. The intensive control (INT) included average annual AFN input of 265 kg∙ha-1, the average clover content of herbage DM was 110 g∙kg-1, and slurry was applied by splash plate. Best practices including AFN (BPN) included average annual AFN input of 99 kg∙ha-1, clover content averaged 230 g∙kg-1 and slurry was applied by trailing shoe. Best practices with minimal AFN (BPO) received minimal (<5 kg∙ha-1) inputs of AFN, clover content averaged 280 g∙kg-1 and slurry was applied by trailing shoe. There were no differences in herbage DM production per hectare and milk production per cow or per hectare between systems. Annual BFN ranged between 60 and 252 kg∙ha-1 depending on AFN input and clover herbage DM production, which were inversely related to each other. There were no differences between systems in spring herbage DM production, in the lengths of the grazing seasons and in each of the annual average quantities of pasture, silage, and concentrates consumed per cow. There was no evidence that annual herbage DM production was more variable from year to year on the clover-BFN-grassland (BPN and BPO) compared with INT. Under current and likely future restrictions on AFN use within the European Union and elsewhere, optimizing clover-BFN-grassland receiving little or no AFN input can maintain herbage and milk production on pasture-based dairy farms.

Purpose This study aims to examine how the French biopharmaceutical company IPSEN adapted the Shingo model to address the challenges of Industry 4.0 (I4.0) and the rise of Industry 5.0 (I5.0), focusing on sustaining cultural principles such as respect for people, continuous improvement and sustainable value creation in the digital age. Design/methodology/approach The research is based on an in-depth qualitative case study, including semi-structured interviews and document analysis, conducted at IPSEN’s Signes facility in France. This approach allows for a detailed examination of how the organization has embedded Shingo principles into its transformation journey, while simultaneously deploying digital tools and developing a custom adaptation of the model known internally as “Shingo 2.0.” Findings IPSEN’s Shingo 4.0 and 5.0 Framework combines human-centric values with digital transformation, ensuring a balance between cultural and technological advancements. Key elements include cultural reinforcement first, data-driven thinking, ecosystem-based improvement, real-time feedback and digital leadership enablement. This framework integrates traditional Shingo principles with modern digital practices, fostering continuous improvement, emotional engagement and leadership evolution. It provides a flexible, holistic model for organizations to align human values with digital innovation, ensuring sustainable operational excellence. Originality/value To the best of the authors’ knowledge, this case study is among the first to document the real-world integration of the Shingo Model with digital transformation initiatives in a European manufacturing context. It offers both theoretical insight and practical guidance for organizations seeking to align excellence models with I4.0 and I5.0 principles. By proposing a human-centered, digitally enabled vision of Shingo, this research advances the debate on the future of operational excellence.

To (1) compare 5-year survivorship (avoiding repeat hip arthroscopy (HA)/total hip replacement conversion) between those undergoing routine capsular repair compared with where no repair was performed; (2) compare patient-reported outcome measures (PROMs) and achievability of metrics of clinically important improvement between these groups; and (3) evaluate the moderating influence of age and sex on outcomes. Review of prospectively collected data from an institutional hip preservation registry, of cases undergoing hip arthroscopy (HA) for femoroacetabular impingement between January 2011 and September 2018, with minimum 5-year follow-up, was undertaken. Cases undergoing routine interportal capsular repair (CR) were matched in a 1:1 ratio (age ± 2 years, sex, Tönnis grade) to hips with no capsular repair (NR). Exclusion criteria were dysplasia, Tönnis grade >1, age >50 years, and concomitant hip pathologies. Group survival was evaluated using Kaplan-Meier analysis and for levels of sex and age. Where revision surgery (repeat HA/total hip replacement) was avoided, PROMs (modified Harris Hip Score, University of California and Los Angeles Activity Scale [UCLA], Short Form 36 [SF-36]) were assessed at minimum 5 years, and proportion of cases achieving minimal clinically important difference (MCID) and substantial clinical benefit (SCB) determined. In total, 285 CR cases were matched with 285 NR cases. The average age was 27.0 ± 5.9 years, and most patients (90%) were male. The overall total hip replacement rate was 0.7% (0.4% NR; 0.9% CR, P = .619) and was not significantly different between groups when adjusting for sex (χ2 = 0.474, P = .491), or age (χ2 = 0.463, P = .496). The overall repeat HA rate was 12.0% (12.9% NR; 11.1% CR, P = .538), which was not significantly different between groups when adjusting for sex (χ2 = 0.479, P = .489), or age (χ2 = 0.448, P = .503). Significant improvement in all PROMs was noted for both the NR and CR groups (P < .001 for all). At 5 years postoperatively, SF-36 was marginally greater for the NR group (P = .006, r = 0.169). No significant difference between groups at 5 years postoperatively were found: modified Harris Hip Score (P = .476), UCLA (P = .188). A greater proportion of CR cases achieved MCID in UCLA (69.4% vs 56.5%, P = .032, Φ = 0.131). MCID achievement rates were similar between groups for all other PROMs (P > .05). A greater proportion of patients in the NR group achieved SCB in SF-36 (54.0% vs 41.9%, P = .049, Φ = 0.127). SCB achievement rates were similar between groups for all other PROMs (P > .05). Routine repair of an interportal capsulotomy makes no difference to survivorship at minimum 5 years post-HA compared with nonrepair, with marginal differences in PROMs, and achievability of MCID and SCB thresholds of clinically significant improvement. The impact of capsular management (repair/nonrepair) may be more apparent for specific patient cohorts rather than routine repair in all cases. Level III, retrospective matched comparative case series.

Exact nonlinear mountain waves described using Lagrangian variables are considered with constant enthalpy of vapourisation in a moist atmosphere. It is shown that if a streamline in the flow with a given temperature is saturated, then the dynamics of the flow are sufficient to deduce the temperature at which any other streamline in the flow becomes saturated. The equation of state for vapour is then applied to deduce the saturation pressure for the water component of the atmospheric flow also. The first law of thermodynamics is then used to deduce the heat gain within a region due to precipitation from the flow. This heat loss is also used to obtain an estimate for the rate of hydrometeor fallout from this region of the flow.