6 resultados para Accreditation: What It Is . . .and Is Not


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The use of multiple medicines (polypharmacy) is increasingly common in middle-aged and older populations. Ensuring the correct balance between the prescribing of many drugs and too many drugs is a significant challenge. Clinicians are tasked with ensuring that patients receive the most appropriate combinations of medications based on the best available evidence, and that medication use is optimised according to patients clinical needs (appropriate polypharmacy). Historically, polypharmacy has been viewed negatively because of the associated medication safety risks, such as drug interactions and adverse drug events. More recently, polypharmacy has been identified as a risk factor for under-prescribing, such that patients do not receive necessary medications and this can also pose risks to patients safety and well-being. The negative connotations that have long been associated with the term polypharmacy could potentially be acting as a driving factor for under-prescribing, whereby clinicians are reluctant to prescribe necessary medicines for patients who are already receiving many medicines. It is now recognised that the prescribing of many medicines can be entirely appropriate in patients with several chronic conditions and that the risks of adverse drug events that have been associated with polypharmacy may be greatly reduced when patients clinical context is taken into consideration. In this article, we outline the current perspectives on polypharmacy and make the case for adopting the term appropriate polypharmacy in differentiating between the prescribing of many drugs and too many drugs. We also outline the inherent challenges in doing so and provide recommendations for future clinical practice and research.

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Our key contribution is a flexible, automated marking system that adds desirable functionality to existing E-Assessment systems. In our approach, any given E-Assessment system is relegated to a data-collection mechanism, whereas marking and the generation and distribution of personalised per-student feedback is handled separately by our own system. This allows content-rich Microsoft Word feedback documents to be generated and distributed to every student simultaneously according to a per-assessment schedule. <br/><br/>The feedback is adaptive in that it corresponds to the answers given by the student and provides guidance on where they may have gone wrong. It is not limited to simple multiple choice which are the most prescriptive question type offered by most E-Assessment Systems and as such most straightforward to mark consistently and provide individual per-alternative feedback strings. It is also better equipped to handle the use of mathematical symbols and images within the feedback documents which is more flexible than existing E-Assessment systems, which can only handle simple text strings.<br/><br/>As well as MCQs the system reliably and robustly handles Multiple Response, Text Matching and Numeric style questions in a more flexible manner than Questionmark: Perception and other E-Assessment Systems. It can also reliably handle multi-part questions where the response to an earlier question influences the answer to a later one and can adjust both scoring and feedback appropriately.<br/><br/>New question formats can be added at any time provided a corresponding marking method conforming to certain templates can also be programmed. Indeed, any question type for which a programmatic method of marking can be devised may be supported by our system. Furthermore, since the students response to each is question is marked programmatically, our system can be set to allow for minor deviations from the correct answer, and if appropriate award partial marks.<br/>

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50 years after publishing his seminal work on play and its role in child development, Vygotskian theory is still highly influential in education, and particularly in early years. This paper presents two examples of full integration of Vygotskian principles into schools in two very different settings. Both report improvements in learning and in well-being, and exemplify the theory-practice-theory cycle, highlighting the development of new theoretical constructs arising out of putting theory firmly into practice. In both settings, the positive results have come from years of effort, in which school personnel who may have been skeptical at first, have been inspired by the impact of adopting Vygotskian play on the children they teach. The Northern Ireland study shows that at least some of the Golden Key principles (mixed-age play and enhanced home-school links) translate perfectly into very different cultural-historical contexts.

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Research has consistently found sex differences in mental rotation. Twin research has suggested that females with male co-twins perform better than females with female co-twins on mental rotation. Because twins share both pre-natal and post-natal environments, it is not possible to test whether this advantage is due to in-uterine transmission of testosterone from males to females or due to socialisation processes. The present study explored whether the advantage of females with brothers can be observed in non-twin siblings. Participants (N = 1799) were assessed on mental rotation. The observed group differences were overall small: males performed significantly better than females; females with sisters performed similarly to females with brothers; importantly, males with brothers performed significantly better than both female groups. The results suggest that sex differences in mental rotation are driven by the group of males with brothers.

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Labour and capital mobility from globalisation has given rise to significant increases in the reliance of migrant labour in established gateways, but also in new migration destinations. Many aspects of migrant incorporation in new migration destinations have received some attention, not least regarding employer and employee relations. Less attention has been focused on the construction of migrant as a marker of identification, although identities, particularly regarding gender and ethnicity, in the workplace have received considerable attention. This article aims to illuminate knowledge on how migration produces social change thereby responding to a call from Batnitzky et al. (2009, p. 1290) for additional attention on what the practical and symbolic effects of migration are as people move across different structures and institutions of social control. Mindful of Goffmans (1969, 1983) emphasis on individual interactions and experiences, it examines what it means to be a migrant in terms of everyday encounters and experiences. It investigates the array and interplay of internal and external processes that create migrant identities and the implications of this for social integration.<br/><br/>The paper argues that one of the paradoxes of globalisation, and of the associated increased levels of migrant labour, is the construction of the migrant identity that ultimately impedes social integration. It shows how the application of migrant identity (internally and externally) bestows a particular status that affects (options for) individual behaviour and subsequent actions and outcomes. The paper argues that while migrants value the migrant identity status because of the benefits that it brings, this status can also cause high levels of dissatisfaction among migrants and it can exclude migrants from wider benefits of full citizenship. Migrants have individual identification processes, but external forces, including social structures and institutions, also affect migrant identity. These forces help to shape individual expectations and standards, contributing to identity interruption and dissonance.<br/> <br/>The paper is structured as follows: it uses social identity theory as a means of understanding what it is to be a migrant in a new destination, while simultaneously recognising the inevitability of this generic label - migrants are an extremely heterogeneous group, made up of individuals with different experiences, values and so forth. The analysis considers the significance of context and of social interactions, thus paying attention to how identity is constructed and performed by the individual and also assigned by others. Empirical evidence is used to examine how having a migrant status affects individual prospects. The paper evaluates the extent to which patterns and processes of migration present an opportunity for social change, positive or negative.<br/>

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Political, religious and national divisions in Northern Ireland go back many hundreds of years so it is not surprising that the lack of a common national narrative has made the teaching of history in schools difficult. The fact that schools have largely been organized on a denominational basis has added to the challenge. When political violence broke out in the late 1960s many looked to schools to contribute to the promotion of reconciliation and the way history had been taught received significant critical attention. This chapter will outline the evolving nature of the history curriculum and review evidence on the impact of this curriculum on the historical understanding of students and young people. In addition, the chapter will briefly consider other ways in which students engage with historical issues through the teaching of citizenship, and wider family and community influences. Whereas the teaching of history in the past either was largely absent or often took on a partisan character, the development of a statutory curriculum in the 1990s helped promote a more dispassionate, skills-based approach which emphasized critical engagement with evidence and a multiperspectivity. While this represented a significant improvement on what had gone before, evaluation of the impact of this approach has highlighted the need for a consideration of the emotional impact of historical understanding and the need better to connect the lessons of history to contemporary society.