CPD records for revalidation: assessing fitness-to-practise using ‘revalidation standards’ and an Outcomes Framework

Background: Currently, all pharmacists and technicians registered with the Royal Pharmaceutical Society of Great Britain must complete a minimum of nine Continuing Professional Development (CPD) record (entries) each year. From September 2010 a new regulatory body, the General Pharmaceutical Council, will oversee the regulation (including revalidation) of all pharmacy registrants in Great Britain. CPD may provide part of the supporting evidence that a practitioner submits to the regulator as part of the revalidation process. Gaps in knowledge necessitated further research to examine the usefulness of CPD in a pharmacy revalidation Project aims: The overall aims of this project were to summarise pharmacy professionals’ past involvement in CPD, examine the usability of current CPD entries for the purpose of revalidation, and to examine the impact of ‘revalidation standards’ and a bespoke Outcomes Framework on the conduct and construction of CPD entries for future revalidation of pharmacy professionals. We completed a comprehensive review of the literature, devised, validated and tested the impact of a new CPD Outcomes Framework and related training material in an empirical investigation involving volunteer pharmacy professionals and also spoke with our participants to bring meaning and understanding to the process of CPD conduct and recording and to gain feedback on the study itself. Key findings: The comprehensive literature review identified perceived barriers to CPD and resulted in recommendations that could potentially rectify pharmacy professionals’ perceptions and facilitate participation in CPD. The CPD Outcomes Framework can be used to score CPD entries Compared to a control (CPD and ‘revalidation standards’ only), we found that training participants to apply the CPD Outcomes Framework resulted in entries that scored significantly higher in the context of a quantitative method of CPD assessment. Feedback from participants who had received the CPD Outcomes Framework was positive and a number of useful suggestions were made about improvements to the Framework and related training. Entries scored higher because participants had consciously applied concepts linked to the CPD Outcomes Framework whereas entries scored low where participants had been unable to apply the concepts of the Framework for a variety of reasons including limitations posed by the ‘Plan & Record’ template. Feedback about the nature of the ‘revalidation standards’ and their application to CPD was not positive and participants had not in the main sought to apply the standards to their CPD entries – but those in the intervention group were more likely to have referred to the revalidation standards for their CPD. As assessors, we too found the process of selecting and assigning ‘revalidation standards’ to individual CPD entries burdensome and somewhat unspecific. We believe that addressing the perceived barriers and drawing on the facilitators will help deal with the apparent lack of engagement with the revalidation standards and have been able to make a set of relevant recommendations. We devised a model to explain and tell the story of CPD behaviour. Based on the concepts of purpose, action and results, the model centres on explaining two types of CPD behaviour, one following the traditional CE pathway and the other a more genuine CPD pathway. Entries which scored higher when we applied the CPD Outcomes Framework were more likely to follow the CPD pathway in the model above. Significant to our finding is that while participants following both models of practice took part in this study, the CPD Outcomes Framework was able to change people’s CPD behaviour to make it more inline with the CPD pathway. The CPD Outcomes Framework in defining the CPD criteria, the training pack in teaching the basis and use of the Framework and the process of assessment in using the CPD Outcomes Framework, would have interacted to improve participants’ CPD through a collective process. Participants were keen to receive a curriculum against which certainly CE-type activities could be conducted and another important observation relates to whether CE has any role to play in pharmacy professionals’ revalidation. We would recommend that the CPD Outcomes Framework is used in the revalidation of pharmacy professionals in the future provided the requirement to submit 9 CPD entries per annum is re-examined and expressed more clearly in relation to what specifically participants are being asked to submit – i.e. the ratio of CE to CPD entries. We can foresee a benefit in setting more regular intervals which would act as deadlines for CPD submission in the future. On the whole, there is value in using CPD for the purpose of pharmacy professionals’ revalidation in the future.

Reconstruction of gusty wind speed time series from autonomous data logger records

The collection of wind speed time series by means of digital data loggers occurs in many domains, including civil engineering, environmental sciences and wind turbine technology. Since averaging intervals are often significantly larger than typical system time scales, the information lost has to be recovered in order to reconstruct the true dynamics of the system. In the present work we present a simple algorithm capable of generating a real-time wind speed time series from data logger records containing the average, maximum, and minimum values of the wind speed in a fixed interval, as well as the standard deviation. The signal is generated from a generalized random Fourier series. The spectrum can be matched to any desired theoretical or measured frequency distribution. Extreme values are specified through a postprocessing step based on the concept of constrained simulation. Applications of the algorithm to 10-min wind speed records logged at a test site at 60 m height above the ground show that the recorded 10-min values can be reproduced by the simulated time series to a high degree of accuracy.

Timing and structure of the 8.2 kyr B.P. event inferred from δ18O records of stalagmites from China, Oman, and Brazil

Oxygen isotope records of stalagmites from China and Oman reveal a weak summer monsoon event, with a double-plunging structure, that started 8.21 ± 0.02 kyr B.P. An identical but antiphased pattern is also evident in two stalagmite records from eastern Brazil, indicating that the South American Summer Monsoon was intensified during the 8.2 kyr B.P. event. These records demonstrate that the event was of global extent and synchronous within dating errors of <50 years. In comparison with recent model simulations, it is plausible that the 8.2 kyr B.P. event can be tied in changes of the Atlantic Meridional Overturning Circulation triggered by a glacial lake draining event. This, in turn, affected North Atlantic climate and latitudinal position of the Intertropical Convergence Zone, resulting in the observed low-latitude monsoonal precipitation patterns.

Extending feature usage: a study of the post-adoption of electronic medical records

Technology Acceptance Model (TAM) posits that Perceived Ease of Use (PEOU) and Perceived Usefulness (PU) influence the ‘intention to use’. The Post-Acceptance Model (PAM) posits that continued use is influenced by prior experience. In order to study the factors that influence how professionals use complex systems, we create a tentative research model that builds on PAM and TAM. Specifically we include PEOU and the construct ‘Professional Association Guidance’. We postulate that feature usage is enhanced when professional associations influence PU by highlighting additional benefits. We explore the theory in the context of post-adoption use of Electronic Medical Records (EMRs) by primary care physicians in Ontario. The methodology can be extended to other professional environments and we suggest directions for future research.

Global biomass burning: a synthesis and review of Holocene paleofire records and their controls.

We synthesize existing sedimentary charcoal records to reconstruct Holocene fire history at regional, continental and global scales. The reconstructions are compared with the two potential controls of burning at these broad scales – changes in climate and human activities – to assess their relative importance on trends in biomass burning. Here we consider several hypotheses that have been advanced to explain the Holocene record of fire, including climate, human activities and synergies between the two. Our results suggest that 1) episodes of high fire activity were relatively common in the early Holocene and were consistent with climate changes despite low global temperatures and low levels of biomass burning globally; 2) there is little evidence from the paleofire record to support the Early Anthropocene Hypothesis of human modification of the global carbon cycle; 3) there was a nearly-global increase in fire activity from 3 to 2 ka that is difficult to explain with either climate or humans, but the widespread and synchronous nature of the increase suggests at least a partial climate forcing; and 4) burning during the past century generally decreased but was spatially variable; it declined sharply in many areas, but there were also large increases (e.g., Australia and parts of Europe). Our analysis does not exclude an important role for human activities on global biomass burning during the Holocene, but instead provides evidence for a pervasive influence of climate across multiple spatial and temporal scales.

Characterisation of Bolivian savanna ecosystems by their modern pollen rain and implications for fossil pollen records

The majority of vegetation reconstructions from the Neotropics are derived from fossil pollen records extracted from lake sediments. However, the interpretation of these records is restricted by limited knowledge of the contemporary relationships between the vegetation and pollen rain of Neotropical ecosystems, especially for more open vegetation such as savannas. This research aims to improve the interpretation of these records by investigating the vegetation and modern pollen rain of different savanna ecosystems in Bolivia using vegetation inventories, artificial pollen traps and surface lake sediments. Two types of savanna were studied, upland savannas (cerrado), occurring on well drained soils, and seasonally-inundated savannas occurring on seasonally water-logged soils. Quantitative vegetation data are used to identify taxa that are floristically important in the different savanna types and to allow modern pollen/vegetation ratios to be calculated. Artificial pollen traps from the upland savanna site are dominated by Moraceae (35%), Poaceae (30%), Alchornea (6%) and Cecropia (4%). The two seasonally-inundated savanna sites are dominated by Moraceae (37%), Poaceae (20%), Alchornea (8%) and Cecropia (7%), and Moraceae (25%), Cyperaceae (22%), Poaceae (19%) and Cecropia (9%), respectively. The modern pollen rain of seasonally-inundated savannas from surface lake sediments is dominated by Cyperaceae (35%), Poaceae (33%), Moraceae (9%) and Asteraceae (5%). Upland and seasonally-flooded savannas were found to be only subtly distinct from each other palynologically. All sites have a high proportion of Moraceae pollen due to effective wind dispersal of this pollen type from areas of evergreen forest close to the study sites. Modern pollen/vegetation ratios show that many key woody plant taxa are absent/under-represented in the modern pollen rain (e.g., Caryocar and Tabebuia). The lower-than-expected percentages of Poaceae pollen, and the scarcity of savanna indicators, in the modern pollen rain of these ecosystems mean that savannas could potentially be overlooked in fossil pollen records without consideration of the full pollen spectrum available.

The margin of appreciation, domestic irregularity and domestic court rulings in ECHR environmental jurisprudence: Global legal pluralism in action

Global legal pluralism is concerned, inter alia, with the growing multiplicity of normative legal orders and the ways in which these different orders intersect and are accommodated with one another. The different means used for accommodation will have a critical bearing on how individuals fare within them. This article examines the recent environmental jurisprudence of the European Court of Human Rights to explore some of the means of reaching an accommodation between national legal orders and the European Convention. Certain types of accommodation – such as the margin of appreciation given to states by the Court – are well known. In essence, such mechanisms of legal pluralism raise a presumptive barrier which generally works for the state and against the individual rights-bearer. However, the principal focus of the current article is on a less well-known, recent set of pluralistic devices employed by the Court, which typically operate presumptively in the other direction, in favour of the individual. First, the Court looks to instances of breaches of domestic environmental law (albeit not in isolation); and second, it places an emphasis on whether domestic courts have ruled against the relevant activity. Where domestic standards have been breached or national courts have ruled against the state, then, presumptive weight is typically shifted towards the individual.

Content validation for level of use of feature rich systems: a Delphi study of electronic medical records systems

Introduction. Feature usage is a pre-requisite to realising the benefits of investments in feature rich systems. We propose that conceptualising the dependent variable 'system use' as 'level of use' and specifying it as a formative construct has greater value for measuring the post-adoption use of feature rich systems. We then validate the content of the construct as a first step in developing a research instrument to measure it. The context of our study is the post-adoption use of electronic medical records (EMR) by primary care physicians. Method. Initially, a literature review of the empirical context defines the scope based on prior studies. Having identified core features from the literature, they are further refined with the help of experts in a consensus seeking process that follows the Delphi technique. Results.The methodology was successfully applied to EMRs, which were selected as an example of feature rich systems. A review of EMR usage and regulatory standards provided the feature input for the first round of the Delphi process. A panel of experts then reached consensus after four rounds, identifying ten task-based features that would be indicators of level of use. Conclusions. To study why some users deploy more advanced features than others, theories of post-adoption require a rich formative dependent variable that measures level of use. We have demonstrated that a context sensitive literature review followed by refinement through a consensus seeking process is a suitable methodology to validate the content of this dependent variable. This is the first step of instrument development prior to statistical confirmation with a larger sample.

Chess endgame records

This dataset is an evolving collection of chess endgame record scenarios illustrating the extremes of the game including the deepest positions in various metrics. Optimal lines in consonant strategies are given and annotated. The two attached files are (a) a pgn file of the chess positions and lines, and (b) an annotated version of the pgn file.