Secondary prevention of cardiovascular disease in different primary healthcare systems with and without pay-for-performance

Objective: To compare baseline cardiovascular risk management between people recruited from two different healthcare systems, to a research trial of an intervention to optimize secondary prevention. Design: Cross-sectional study. Setting: General practices, randomly selected: 16 in Northern Ireland (NI) (UK NHS, ‘strong’ infrastructure); 32 in Republic of Ireland (RoI) (mixed healthcare economy, less infrastructure). Patients: 903 (mean age 67.5 years; 69.9% male); randomly selected, known coronary heart disease. Main outcome measures: Blood pressure, cholesterol, medications; validated questionnaires for diet (DINE), exercise (Godin), quality of life (SF12); healthcare usage. Results: More RoI than NI participants had systolic BP>140 mmHg (37% v 28%, p=0.01) and cholesterol >5mmol/l (24% v 17%, p=0.02): RoI mean systolic BP was higher (139 v 132 mm Hg). More RoI participants reported a high fibre intake (35% v 23%), higher levels of physical activity (62% v 44%), and better physical and mental health (SF12); they had more GP (5.6 v 4.4) and fewer nurse visits (1.6 v 2.1) in the previous year. Fewer in RoI (55% v 70%) were prescribed B blockers. Both groups’ ACE inhibitor (41%; 48%) prescribing was similar; high proportions were prescribed statins (84%; 85%) and aspirin (83%; 77%). Conclusions Blood pressure and cholesterol are better controlled among patients in a primary healthcare system with a ‘strong’ infrastructure supporting computerization and rewarding measured performance but this is not associated with healthier lifestyle or better quality of life. Further exploration of differences in professionals’ and patients’ engagement in secondary prevention in different healthcare systems is needed.

Enhancing the teaching of professional practice and key skills in engineering through the use of computer animation

This paper presents some observations on how computer animation was used in the early years of a degree program in Electrical and Electronic Engineering to enhance the teaching of key skills and professional practice. This paper presents the results from two case studies. First, in a first year course which seeks to teach students how to manage and report on group projects in a professional way. Secondly, in a technical course on virtual reality, where the students are asked to use computer animation in a way that subliminally coerces them to come to terms with the fine detail of the mathematical principles that underlie 3D graphics, geometry, etc. as well as the most significant principles of computer architecture and software engineering. In addition, the findings reveal that by including a significant element of self and peer review processes into the assessment procedure students became more engaged with the course and achieved a deeper level of comprehension of the material in the course.

Preparing students for interprofessional practice: exploring the intra-personal dimension

This paper appears in the Canadian-based, leading interprofessional education journal. Pre-qualification healthcare education can be viewed as having three inter-related components, intra-professional, interprofessional and intra-personal learning; the third of these underpinning the other two. Understanding more about personal learning needs can contribute to preparation for interprofessional interaction. A Studying and Learning Preferences Inventory (SALPI) was developed and validated for use with a range of healthcare professionals to assist in this process.

'Research Training and Professional Social Work Education: Developing Research-Minded Practice' Social Work Education, .

The movement towards developing practice more firmly grounded on empirical research has, arguably, been one of the most significant international trends in social work during the past decade. However, in the UK the implications of this trend for pedagogical practices and the design of educational programmes have still to be fully explored. This paper reports on the findings of a repeated cross-sectional survey of MSW students in Queen's University Belfast which focused on their perceptions of the value of research training to professional practice. The study, conducted over a four year period, explored students' awareness of the relationship between research and practice and their readiness to engage with research training. The findings suggested that the majority of students perceived research training as a valuable component of professional development. However, the study also found a level of scepticism among students about its practical utility along with some resistance towards actively embracing a research agenda. The paper evaluates the significance of these findings for developing research and evidence-based practice as integral components of the new degrees in social work in the UK and for social work education programmes in other countries aiming to develop research-minded practice.

Information sharing and reporting systems in the UK and Ireland: Professional barriers to reporting child maltreatment concerns

Across the UK recent policy developments have focused on improved information sharing and inter-agency cooperation. Professional non-reporting of child maltreatment concerns has been consistently highlighted as a problem in a range of countries and the research literature indicates that this can happen for a variety of reasons. Characteristics such as the type of abuse and the threshold of evidence available are key factors, as are concerns that reporting will damage the professional-client relationship. Professional discipline can also impact on willingness to report, as can personal beliefs about abuse, attitudes towards child protection services and experiences of court processes. Research examining the role of organisational factors in information sharing and reporting emphasises the importance of training and there are some positive indications that training can increase professional awareness of reporting processes and requirements and help to increase knowledge of child abuse and its symptoms. Nonetheless, this is a complex issue and the need for training to go beyond simple awareness raising is recognised. In order to tackle non-reporting in a meaningful way, childcare professionals need access to on-going multidisciplinary training which is specifically tailored to address the range of different factors which impact on reporting attitudes and behaviours.

Accounting Undergraduates’ Perceptions of Cooperative Learning as a Model for Enhancing their Interpersonal and Communication Skills to Interface Successfully with Professional Accountancy Education and Training

To interface effectively with professional accountancy training, accounting educationalists should ensure that they turn out graduates who possess the interpersonal and communication skills required of today's accountant. Attainment of these skills is promoted by group work. However, little empirical evidence exists to help academics make an informed choice about which form of group learning enhances interpersonal and communication skills. This paper addresses this deficiency by comparing perceptions of skills enhancement between accounting students who experienced traditional or simple group learning and those who undertook cooperative learning. The findings reveal that the cooperative learning cohort perceived their learning experience to be significantly more effective at enhancing interpersonal and communication skills than that of the simple group learning cohort. This study provides evidence that cooperative learning is a more effective model for delivering interpersonal and communication skills than simple group learning, thereby creating a more successful interface between academic accounting and professional accountancy training.

Factors That Impact Technology Innovation Adoption Among Irish Professional Service Sector SMEs

This paper disseminates the findings from a study into the factors impacting technological innovation adoption and diffusion specific to the deployment of electronic-commerce strategies within professional service sector SMEs in Ireland. Confirmatory factor analysis was performed and seven factors relating to a firm's external/internal environment were found to underpin adoption. These are: electronic-commerce capability; willingness to change/rate of response to new technologies; technological opportunity recognition; customer orientation; sensitivity to competitive/customer environments; perceptions of technology feasibility; and e-skills development mechanisms. t-tests revealed differences between adopters and non-adopters, and forward stepwise logistic regression is used to assess the extent to which these seven factors actually predict electronic-commerce adoption. It was found that electronic-commerce capability and the willingness to change/rate of response to new technologies are the two most important factors affecting adoption behaviours. © Imperial College Press.

Living with children diagnosed with Autism Spectrum Disorder: Parental and professional views

The number of children diagnosed with an autistic spectrum disorder (ASD) is rising and is now thought to be as high as 1:100. While the debate about best treatment continues, the effects of having a child diagnosed with ASD on family life remain relatively unexplored. This article, by Karola Dillenburger of Queens University Belfast, Mickey Keenan of the University of Ulster, Alvin Doherty from the Health Service Executive Western Region, Tony Byrne of Parents’ Education as Autism Therapists (PEAT) and Stephen Gallagher of the University of Ulster, sets out to adjust that balance. Drawing upon data from a comprehensive study of parental needs, these authors argue that parental and professional views do not always concur; that families make extraordinary sacrifices; that siblings are affected; and that parents are under tremendous stress. Parents argue that educational and social service supports are not efficient and that they are forced to rely largely on support from within the family or from friends. In particular, some important differences between parental and professional perceptions became apparent in relation to interventions based on Applied Behaviour Analysis (ABA). The authors of this article propose that these differences need to be taken seriously by teachers and other professionals as well as by policy-makers.