A randomised controlled trial of cognitive behaviour therapy for psychosis in a routine clinical service

Objective: To evaluate CBTp delivered by non-expert therapists, using CBT relevant measures. Methods: Participants (N=74) were randomised into immediate therapy or waiting list control groups. The therapy group was offered six months of therapy and followed up three months later. The waiting list group received therapy after waiting nine months (becoming the delayed therapy group). Results: Depression improved in the combined therapy group at both the end of therapy and follow-up. Other significant effects were found in only one of the two therapy groups (positive symptoms; cognitive flexibility; uncontrollability of thoughts) or one of the two timepoints (end of therapy: PANSS general symptoms, anxiety, suicidal ideation, social functioning, resistance to voices; follow-up: power beliefs about voices, negative symptoms). There was no difference in costs between the groups. Conclusions: The only robust improvement was in depression. Nevertheless, there were further encouraging but modest improvements in both emotional and cognitive variables, in addition to psychotic symptoms.

In-service and pre-service teachers' opinion on the use of models in teaching chemistry

The presented study examined the opinion of in-service and prospective chemistry teachers about the importance of usage of molecular and crystal models in secondary-level school practice, and investigated some of the reasons for their (non-) usage. The majority of participants stated that the use of models plays an important role in chemistry education and that they would use them more often if the circumstances were more favourable. Many teachers claimed that three-dimensional (3d) models are still not available in sufficient number at their schools; they also pointed to the lack of available computer facilities during chemistry lessons. The research revealed that, besides the inadequate material circumstances, less than one third of participants are able to use simple (freeware) computer programs for drawing molecular structures and their presentation in virtual space; however both groups of teachers expressed the willingness to improve their knowledge in the subject area. The investigation points to several actions which could be undertaken to improve the current situation.

Non-standard working time: an international and comparative analysis

This paper uses the large-scale Cranet data to explore the extent of non-standard working time (NSWT) across Europe and to highlight the contrasts and similarities between two different varieties of capitalism (coordinated market economies and liberal market economies). We explore variations in the extent of different forms of NSWT (overtime, shift working and weekend working) within these two different forms of capitalism, controlling for firm size, sector and the extent of employee voice. Overall, there was no strong link between the variety of capitalism and the use of overtime and weekend working though shift working showed a clear distinction between the two varieties of capitalism. Usage of NSWT in some service sectors was particularly high under both forms of capitalism and service sector activities had a particularly marked influence on the use of overtime in liberal market economies. Surprisingly, strong employee voice was associated with greater use of NSWT.

A conceptual life event framework for government-to-citizen electronic service provision

In recent years, life event approach has been widely used by governments all over the world for designing and providing web services to citizens through their e-government portals. Despite the wide usage of this approach, there is still a challenge of how to use this approach to design e-government portals in order to automatically provide personalised services to citizens. We propose a conceptual framework for e-government service provision based on life event approach and the use of citizen profile to capture the citizen needs, since the process of finding Web services from a government-to-citizen (G2C) system involves understanding the citizens’ needs and demands, selecting the relevant services, and delivering services that matches the requirements. The proposed framework that incorporates the citizen profile is based on three components that complement each other, namely, anticipatory life events, non-anticipatory life events and recurring services.

The relationship between well-being, future planning and intentions to utilise intervention programmes: what can be learned from homeless service users?

There has been an increasing interest in the impact of individual well-being on the attitudes and actions of people receiving services designed to offer support. If well-being factors are important in the uptake and success of service programmes it is important that the nature of the relationships involved is understood by service designers and implementers. As a contribution to understanding, this paper examines the impact of well-being on the uptake of intervention programmes for homeless people. From the literature on well-being a number of factors are identified that contribute towards overall well-being, which include personal efficacy and identity, but also more directly well-being can be viewed as personal or group/collective esteem. The impact of these factors on service use is assessed by means of two studies of homelessness service users, comparing the implementation of two research tools: a shortened and a fuller one. The conclusions are that the factors identified are related to service use. The higher the collective esteem – esteem drawn from identification with services and their users and providers – and the less that they feel isolated, the more benefits that homeless people will perceive with service use, and in turn the more likely they are to be motivated to use services. However, the most important factors in explaining service use are a real sense that it is appropriate to accept social support from others, a rejection of the social identity as homeless but a cultivation of being valued as part of a non-homeless community, and a positive perception of the impact of the service.

Using non-personal computers for eLearning: Sri Lankan experience

Communal Internet access facilities or telecentres are considered a good way to provide connectivity to people who do not possess home connectivity. Attempts are underway to utilize telecentres as eLearning centres providing access to learning materials to students who would otherwise not be able to take up eLearning. This paper reports on the findings of qualitative interviews conducted with 18 undergraduate students from two Sri Lankan universities on their eLearning experiences using communal Internet access centres. The findings suggest that despite the efforts by telecentres to provide a good service to eLearners, there are various problems faced by students including: costs, logistics, scarcity of resources, connectivity speeds, excessive procedures, and lack of support. The experiences of these Sri Lankan students suggest that there is much that needs to be understood about user perspectives in using telecentres, which could help formulate better policies and strategies to support eLearners who depend on communal access facilities.

A conceptual framework of patient satisfaction with a pharmacy adherence service

Background Patients do not adhere to their medicines for a host of reasons which can include their underlying beliefs as well as the quality of their interactions with healthcare professionals. One way of measuring the outcome of pharmacy adherence services is to assess patient satisfaction but no questionnaire exists that truly captures patients' experiences with these relatively new services. Objective Our objective was to develop a conceptual framework specific to patient satisfaction with a community pharmacy adherence service based on criteria used by patients themselves. Setting The study was based in community pharmacies in one large geographical area of the UK (Surrey). All the work was conducted between October 2008 and September 2010. Methods This study involved qualitative non-participant observation and semi-structured interviewing. We observed the recruitment of patients to the Medicines Use Review (MUR) service and also actual MUR consultations (7). We also interviewed patients (15). Data collection continued until no new themes were identified during analysis. We analysed interviews to firstly create a comprehensive account of themes which had significance within the transcripts, then created sub-themes within super-ordinate categories. We used a structure-process-outcome approach to develop a conceptual framework relating to patient satisfaction with the MUR. Favourable ethical opinion for this study was received from the NHS Surrey Research Ethics Committee on 2nd June 2008. Results Five super-ordinate themes linked to patient satisfaction with the MUR service were identified, including relationships with healthcare providers; attitudes towards healthcare providers; patients' experience of health, healthcare and medicines; patients' views of the MUR service; the logistics of the MUR service. In the conceptual framework, structure was conceptualised as existing relationships, environment, and time; process was conceptualised as related to recruitment and consultation stages; and outcome as two concepts of immediate patient outcomes and satisfaction on reflection. Conclusion We identified and highlighted factors that can influence patient satisfaction with the MUR service and this led to the development of a conceptual framework of patient satisfaction with the MUR service. This can form the basis for developing a questionnaire for measuring patient satisfaction with this and similar pharmacy adherence services. Impact of findings on practice * Pharmacists and researchers can access the relevant ideas presented here in relation to patient satisfaction with pharmacy adherence services. * Researcher can use the conceptual framework as a basis for measuring the quality of pharmacy adherence services. * Community pharmacists can improve the quality of healthcare they provide by realizing concepts relevant to patient satisfaction with adherence services.

A stated preference valuation of the non-market benefits of pollination services in the UK

Using a choice experiment survey this study examines the UK public's willingness to pay to conserve insect pollinators in relation to the levels of two pollination service benefits: maintaining local produce supplies and the aesthetic benefits of diverse wildflower assemblages. Willingness to pay was estimated using a Bayesian mixed logit with two contrasting controls for attribute non-attendance, exclusion and shrinkage. The results suggest that the UK public have an extremely strong preference to avoid a status quo scenario where pollinator populations and pollination services decline. Total willingness to pay was high and did not significantly vary between the two pollination service outputs, producing a conservative total of £379M over a sample of the tax-paying population of the UK, equivalent to £13.4 per UK taxpayer. Using a basic production function approach, the marginal value of pollination services to these attributes is also extrapolated. The study discusses the implications of these findings and directions for related future research into the non-market value of pollination and other ecosystem services.

Roles of the non-medical prescribing leads within organisations across a Strategic Health Authority: perceived functions and factors supporting the role

Objectives Extending the roles of nurses, pharmacists and allied health professionals to include prescribing has been identified as one way of improving service provision. In the UK, over 50 000 non-medical healthcare professionals are now qualified to prescribe. Implementation of non-medical prescribing ( NMP) is crucial to realise the potential return on investment. The UK Department of Health recommends a NMP lead to be responsible for the implementation of NMP within organisations. The aim of this study was to explore the role of NMP leads in organisations across one Strategic Health Authority (SHA) and to inform future planning with regards to the criteria for those adopting this role, the scope of the role and factors enabling the successful execution of the role. Methods Thirty-nine NMP leads across one SHA were approached. Semi-structured telephone interviews were conducted. Issues explored included the perceived role of the NMP lead, safety and clinical governance procedures and facilitators to the role. Transcribed audiotapes were coded and analysed using thematic analytical techniques. Key findings In total, 27/39 (69.2%) NMP leads were interviewed. The findings highlight the key role that the NMP lead plays with regards to the support and development of NMP within National Health Service trusts. Processes used to appoint NMP leads lacked clarity and varied between trusts. Only two NMP leads had designated or protected time for their role. Strategic influence, operational management and clinical governance were identified as key functions. Factors that supported the role included organisational support, level of influence and dedicated time. Conclusion The NMP lead plays a significant role in the development and implementation of NMP. Clear national guidance is needed with regards to the functions of this role, the necessary attributes for individuals recruited into this post and the time that should be designated to it. This is important as prescribing is extended to include other groups of non-medical healthcare professionals.

Translation practices in political institutions: a comparison of national, supranational, and non-governmental organisations

This paper explores the settings and practices of translation at three types of political institutions, i.e. national, supranational, and non-governmental organisations. The three institutions are the translation service of the German Foreign Office, the translation department of the European Central Bank, and translation provision by the non-governmental organisation Amnesty International. The three case studies describe the specific translation practices in place at these institutions and illustrate some characteristic translation strategies. In this way, we reflect on how different translation practices can impact on translation agency and how these practices in turn are influenced by the type of institution and its organisational structure. The article also aims to explore to which extent the characteristics of collectivity, anonymity and standardisation, and of institutional translation as self-translation are applicable to the institutions under discussion.

Non-bee insects are important contributors to global crop pollination

Wild and managed bees are well documented as effective pollinators of global crops of economic importance. However, the contributions by pollinators other than bees have been little explored despite their potential to contribute to crop production and stability in the face of environmental change. Non-bee pollinators include flies, beetles, moths, butterflies, wasps, ants, birds, and bats, among others. Here we focus on non-bee insects and synthesize 39 field studies from five continents that directly measured the crop pollination services provided by non-bees, honey bees, and other bees to compare the relative contributions of these taxa. Non-bees performed 25–50% of the total number of flower visits. Although non-bees were less effective pollinators than bees per flower visit, they made more visits; thus these two factors compensated for each other, resulting in pollination services rendered by non-bees that were similar to those provided by bees. In the subset of studies that measured fruit set, fruit set increased with non-bee insect visits independently of bee visitation rates, indicating that non-bee insects provide a unique benefit that is not provided by bees. We also show that non-bee insects are not as reliant as bees on the presence of remnant natural or seminatural habitat in the surrounding landscape. These results strongly suggest that non-bee insect pollinators play a significant role in global crop production and respond differently than bees to landscape structure, probably making their crop pollination services more robust to changes in land use. Non-bee insects provide a valuable service and provide potential insurance against bee population declines.