Training on the use of a bespoke continuing professional development framework improves the quality of CPD records

BACKGROUND: Using continuing professional development (CPD) as part of the revalidation of pharmacy professionals has been proposed in the UK but not implemented. We developed a CPD Outcomes Framework (‘the framework’) for scoring CPD records, where the score range was -100 to +150 based on demonstrable relevance and impact of the CPD on practice. OBJECTIVE: This exploratory study aimed to test the outcome of training people to use the framework, through distance-learning material (active intervention), by comparing CPD scores before and after training. SETTING: Pharmacy professionals were recruited in the UK in Reading, Banbury, Southampton, Kingston-upon-Thames and Guildford in 2009. METHOD: We conducted a randomised, double-blinded, parallel-group, before and after study. The control group simply received information on new CPD requirements through the post; the active intervention group also received the framework and associated training. Altogether 48 participants (25 control, 23 active) completed the study. All participants submitted CPD records to the research team before and after receiving the posted resources. The records (n=226) were scored blindly by the researchers using the framework. A subgroup of CPD records (n=96) submitted first (before-stage) and rewritten (after-stage) were analysed separately. MAIN OUTCOME MEASURE: Scores for CPD records received before and after distributing group-dependent material through the post. RESULTS: Using a linear-regression model both analyses found an increase in CPD scores in favour of the active intervention group. For the complete set of records, the effect was a mean difference of 9.9 (95% CI = 0.4 to 19.3), p-value = 0.04. For the subgroup of rewritten records, the effect was a mean difference of 17.3 (95% CI = 5.6 to 28.9), p-value = 0.0048. CONCLUSION: The intervention improved participants’ CPD behaviour. Training pharmacy professionals to use the framework resulted in better CPD activities and CPD records, potentially helpful for revalidation of pharmacy professionals. IMPACT: • Using a bespoke Continuing Professional Development outcomes framework improves the value of pharmacy professionals’ CPD activities and CPD records, with the potential to improve patient care. • The CPD outcomes framework could be helpful to pharmacy professionals internationally who want to improve the quality of their CPD activities and CPD records. • Regulators and officials across Europe and beyond can assess the suitability of the CPD outcomes framework for use in pharmacy CPD and revalidation in their own setting.

Variation in dynamic elastic shear modulus of sandstone upon fluid saturation and substitution

Experimental acoustic measurements on sandstone rocks at both sonic and ultrasonic frequencies show that fluid saturation can cause a noticeable change in both the dynamic bulk and shear elastic moduli of sandstones. We observed that the change in dynamic shear modulus upon fluid saturation is highly dependent on the type of saturant, its viscosity, rock microstructure, and applied pressures. Frequency dispersion has some influence on dynamic elastic moduli too, but its effect is limited to the ultrasonic frequency ranges and above. We propose that viscous coupling, reduction in free surface energy, and, to a limited extent, frequency dispersion due to both local and global flow are the main mechanisms responsible for the change in dynamic shear elastic modulus upon fluid saturation and substitution, and we quantify influences.

Rainfall and runoff water quality of the Pang and Lambourn, tributaries of the River Thames, south-eastern England

The water quality of rainfall and runoff is described for two catchments of two tributaries of the River Thames, the Pang and Lambourn. Rainfall chemistry is variable and concentrations of most determinands decrease with increasing volume of catch probably due to 'wash out' processes. Two rainfall sites have been monitored, one for each catchment. The rainfall site on the Lambourn shows higher chemical concentrations than the one for the Pang which probably reflects higher amounts of local inputs from agricultural activity, Rainfall quality data at a long-term rainfall site on the Pang (UK National Air Quality Archive) shows chemistries similar to that for the Lambourn site. but with some clear differences. Rainfall chemistries show considerable variation on an event-to-event basis. Average water quality concentrations and flow-weighted concentrations as well as fluxes vary across the sites, typically by about 30%. Stream chemistry is much less variable due to the main Source of water coming from aquifer sources of high storage. The relationship between rainfall and runoff chemistry at the catchment outlet is described in terms of the relative proportions of atmospheric and within-catchment sources. Remarkably, in view of the quantity of agricultural and sewage inputs to the streams, the catchments appear to be retaining both P and N.

Impacts of climate change scenarios on dissolved oxygen in the River Thames, UK

A water quality model is used to assess the impact of possible climate change on dissolved oxygen (DO) in the Thames. The Thames catchment is densely populated and, typically, many pressures are anthropogenic. However, that same population also relies on the river for potable water supply and as a disposal route for treated wastewater. Thus, future water quality will be highly dependent on future activity. Dynamic and stochastic modelling has been used to assess the likely impacts on DO dynamics along the river system and the probability distributions associated with future variability. The modelling predictions indicate that warmer river temperatures and drought act to reduce dissolved oxygen concentrations in lowland river systems

Does gym use impact upon nutritional knowledge?

Purpose – The purpose of this paper is to investigate gym and non-gym users' use and understanding of nutrition labels. Design/methodology/approach – A consumer survey in the form of a questionnaire conducted in the Greater London area in February/March 2005. Subject recruitment process took place in both a gym and university setting. Frequency tables and ?2-test are used to assess relationships between variables (p=0.05). Findings – The resulting sample consisted of 187 subjects, with predominance of females and gym users. Of the subjects, 88 per cent reported to at least occasionally read nutrition labels, with higher reading rates amongst women, irrespective of gym user status. Total and saturated fats are the most often information viewed on labels, however the overall knowledge of the calorie content of fat is low, with 53 per cent of subjects responding saturated fat contains more calories per gram when compared with other types of fats. This paper does not find significant differences in the use and understanding of nutrition labels between gym and non-gym users, but highlights the publics' continued lack of understanding of nutrition labels. Originality/value – This paper is unique as it investigates whether there is any difference between gym/non-gym users' use and interpretation of use of nutrition labels. It finds gender impacted more on nutritional labels knowledge than gym user's status. This points to a gender issue and questions the quality of information available to the general public. This paper is valuable as it highlights and identifies an area that requires further research and assessment, and is therefore useful to key stakeholders responsible for public health nutrition.

Effect of two opposing changes in photoperiod upon age at first egg in layer-hybrid pullets

An experiment was designed to test the response of growing pullets to two changes in photoperiod (an increase from 8 to 14 h followed 5 weeks later by the reverse change, or a decrease from 14 to 8 h followed by an increase). The first change was made either at 35 days or at 56 days of age, to test the influence of age on the responses observed. Control groups were kept oil constant 8-h and constant 14-h photoperiods and the responses to appropriate single changes were also tested. Mean age at first egg varied from 111 days for birds given a single increment at 56 days to 166 days for pullets given an increase in photoperiod at 35 days followed by a reduction at 70 days. Responses to the single changes confirmed earlier reports that sensitivity to change in photoperiod varies with age ill a manner that is quantitatively predictable. Responses to the double changes could be explained by Postulating that the initial change altered the 'physiological age' of the bird to all extent that was also quantitatively predictable. An early increase in photoperiod advances sexual development and makes the bird more sensitive to a subsequent decrease than would be expected by reference to its chronological age. An early decrease in photoperiod delays sexual development, which can have the effect of making the bird more or less sensitive to a subsequent increase since, ill layer-strain pullets, sensitivity to an increment in photoperiod normally increases Lip to about 9 weeks of age but decreases thereafter. Mean age at first egg predicted using these concepts was very highly correlated with observed age at first egg. The results provide a rational basis for constructing a model to predict age at first egg for any combination of increases and decreases in photoperiod applied to growing pullets.

Does gym use impact upon nutritional knowledge?

Purpose - The purpose of this paper is to investigate gym and non-gym users' use and understanding of nutrition labels. Design/methodology/approach - A consumer survey in the form of a questionnaire conducted in the Greater London area in February/March 2005. Subject recruitment process took place in both a gym and university setting. Frequency tables and chi(2)-test are used to assess relationships between variables (p = 0.05). Findings - The resulting sample consisted of 187 subjects, with predominance of females and gym users. Of the subjects, 88 per cent reported to at least occasionally read nutrition labels, with higher reading rates amongst women, irrespective of gym user status. Total and saturated fats are the most often information viewed on labels, however the overall knowledge of the calorie content of fat is low, with 53 per cent of subjects responding saturated fat contains more calories per gram when compared with other types of fats. This paper does not find significant differences in the use and understanding of nutrition labels between gym and non-gym users, but highlights the publics' continued lack of understanding of nutrition labels. Originality/value - This paper is unique as it investigates whether there is any difference between gym/non-gym users' use and interpretation of use of nutrition labels. It finds gender impacted more on nutritional labels knowledge than gym user's status. This points to a gender issue and questions the quality of information available to the general public. This paper is valuable as it highlights and identifies an area that requires further research and assessment, and is therefore useful to key stakeholders responsible for public health nutrition.

Effect of altered dietary n-3 fatty acid intake upon plasma lipid fatty acid composition, conversion of [C-13]alpha-linolenic acid to longer-chain fatty acids and partitioning towards beta-oxidation in older men

The effect of increased dietary intakes of alpha-linolenic acid (ALNA) or eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) for 2 months upon plasma lipid composition and capacity for conversion of ALNA to longer-chain metabolites was investigated in healthy men (52 (SD 12) years). After a 4-week baseline period when the subjects substituted a control spread, a test meal containing [U-C-13]ALNA (700 mg) was consumed to measure conversion to EPA, docosapentaenoic acid (DPA) and DHA over 48 h. Subjects were then randomised to one of three groups for 8 weeks before repeating the tracer study: (1) continued on same intake (control, n 5); (2) increased ALNA intake (10 g/d, n 4); (3) increased EPA+DHA intake (1.5 g/d, n 5). At baseline, apparent fractional conversion of labelled ALNA was: EPA 2.80, DPA 1.20 and DRA 0.04%. After 8 weeks on the control diet, plasma lipid composition and [C-13]ALNA conversion remained unchanged compared with baseline. The high-ALNA diet resulted in raised plasma triacylglycerol-EPA and -DPA concentrations and phosphatidylcholine-EPA concentration, whilst [C-13]ALNA conversion was similar to baseline. The high-(EPA+DHA) diet raised plasma phosphatidylcholine-EPA and -DHA concentrations, decreased [C-13]ALNA conversion to EPA (2-fold) and DPA (4-fold), whilst [C-13]ALNA conversion to DHA was unchanged. The dietary interventions did not alter partitioning of ALNA towards beta-oxidation. The present results indicate ALNA conversion was down-regulated by increased product (EPA+DHA) availability, but was not up-regulated by increased substrate (ALNA) consumption. This suggests regulation of ALNA conversion may limit the influence of variations in dietary n-3 fatty acid intake on plasma lipid compositions.

Asymmetric synthesis using catalysts containing multiple stereogenic centres and a trans-1,2-diaminocyclohexane core; reversal of predominant enantioselectivity upon N-alkylation

N-Methylation of ligands containing a trans-1,2-diaminocyclohexane core and multiple stereogenic centres is shown to provide the product of the opposite configuration in significant enantiomeric excess, in the addition of diethylzinc to aldehydes. Some of the ligands were effective in an asymmetric Michael addition. (C) 2004 Elsevier Ltd. All rights reserved.

Redintegration and lexicality effects in children: do they depend upon the demands of the memory task?

The effect of long-term knowledge upon performance in short-term memory tasks was examined for children from 5 to 10 years of age. The emergence of a lexicality effect, in which familiar words were recalled more accurately than unfamiliar words, was found to depend upon the nature of the memory task. Lexicality effects were interpreted as reflecting the use of redintegration, or reconstruction processes, in short-term memory. Redintegration increased with age for tasks requiring spoken item recall and decreased with age when position information but not naming was required. In a second experiment, redintegration was found in a recognition task when some of the foils rhymed with the target. Older children were able to profit from a rhyming foil, whereas younger children were confused by it, suggesting that the older children make use of sublexical phonological information in reconstructing the target. It was proposed that redintegrative processes in their mature form support the reconstruction of detailed phonological knowledge of words.

Prevalence of disorders of the autism spectrum in a population cohort of children in South Thames: the special needs and autism project (SNAP)

Background Recent reports have suggested that the prevalence of autism and related spectrum disorders (ASDs) is substantially higher than previously recognised. We sought to quantify prevalence of ASDs in children in South Thames, UK. Methods Within a total population cohort of 56946 children aged 9-10 years, we screened all those with a current clinical diagnosis of ASD (n=255) or those judged to be at risk for being an undetected case (n=1515). A stratified subsample (n=255) received a comprehensive diagnostic assessment, including standardised clinical observation, and parent interview assessments of autistic symptoms, language, and intelligence quotient (IQ). Clinical consensus diagnoses of childhood autism and other ASDs were derived. We used a sample weighting procedure to estimate prevalence. Findings The prevalence of childhood autism was 38.9 per 10000 (95% CI 29.9-47.8) and that of other ASDs was 77.2 per 10000 (52.1-102.3), making the total prevalence of all AS Ds 116.1 per 10000 (90.4-141.8). A narrower definition of childhood autism, which combined clinical consensus with instrument criteria for past and current presentation, provided a prevalence of 24.8 per 10 000 (17.6-32.0). The rate of previous local identification was lowest for children of less educated parents. Interpretation Prevalence of autism and related ASDs is substantially greater than previously recognised. Whether the increase is due to better ascertainment, broadening diagnostic criteria, or increased incidence is unclear. Services in health, education, and social care will need to recognise the needs of children with some form of ASD, who constitute 1% of the child population.