How was patient empowerment portrayed in information leaflets describing the community pharmacy Medicines Use Review service in the UK?

Objective The Medicines Use Review (MUR) community pharmacy service was introduced in 2005 to enhance patient empowerment but the service has not been taken up as widely as expected. We investigated the depiction of the patient–pharmacist power relationship within MUR patient information leaflets. Methods We identified 11 MUR leaflets including the official Department of Health MUR booklet and through discourse analysis examined the way language and imagery had been used to symbolise and give meaning to the MUR service, especially the portrayal of the patient–pharmacist interactions and the implied power relations. Results A variety of terminology was used to describe the MUR, a service that aimed ultimately to produce more informed patients through the information imparted by knowledgeable, skilled pharmacists. Conclusion The educational role of the MUR overshadowed the intended patient empowerment that would take place with a true concordance-centred approach. Although patient empowerment was implied, this was within the boundaries of the biomedical model with the pharmacist as the expert provider of medicines information. Practice implications If patient empowerment is to be conveyed this needs to be communicated to patients through consistent use of language and imagery that portrays the inclusivity intended.

A framework for revitalisation of rural education and training systems in sub-Saharan Africa: Strengthening the human resource base for food security and sustainable livelihoods

Recent studies of the current state of rural education and training (RET) systems in sub-Saharan Africa have assessed their ability to provide for the learning needs essential for more knowledgeable and productive small-scale rural households. These are most necessary if the endemic causes of rural poverty (poor nutrition, lack of sustainable livelihoods, etc.) are to be overcome. A brief historical background and analysis of the major current constraints to improvement in the sector are discussed. Paramount among those factors leading to its present 'malaise' is the lack of a whole-systems perspective and the absence of any coherent policy framework in most countries. There is evidence of some recent innovations, both in the public sector and through the work of non-governmental organisations (NGOs), civil society organisations (CSOs) and other private bodies. These provide hope of a new sense of direction that could lead towards meaningful 'revitalisation' of the sector. A suggested framework offers 10 key steps which, it is argued, could largely be achieved with modest internal resources and very little external support, provided that the necessary leadership and managerial capacities are in place. (C) 2006 Elsevier Ltd. All rights reserved.

Educational and psychosocial programmes for adolescents with diabetes: approaches, outcomes and cost-effectiveness

Diabetes incurs heavy personal and health system costs. Self-management is required if complications are to be avoided. Adolescents face particular challenges as they learn to take responsibility for their diabetes. A systematic review of educational and psychosocial programmes for adolescents with diabetes was undertaken. This aimed to: identify and categorise the types of programmes that have been evaluated; assess the cost-effectiveness of interventions; identify areas where further research is required. Sixty-two papers were identified and Subjected to a narrative review. Generic programmes focus on knowledge/skills, psychosocial issues, and behaviour/self-management. They result in modest improvements across a range of outcomes but improvements are often not sustained, suggesting a need for continuous support, possibly integrated into normal care. In-hospital education at diagnosis confers few advantages over home treatment. The greatest returns may be obtained by targeting poorly controlled individuals. Few studies addressed resourcing issues and robust cost-effectiveness appraisals are required to identify interventions that generate the greatest returns on expenditure. (C) 2004 Elsevier Ireland Ltd. All rights reserved.

Overview of an innovative EU-China collaboration in education and research in sustainable built environment

This paper introduces an international collaboration of EU and Asia in education, training and research in the field of sustainable built environment, which attempts to develop a network of practical and intellectual knowledge and training exchange between Chinese and European Universities in the field of sustainable building design and construction. The projects funded by the European Commission Asia Link program, UK Foreign & Commonwealth Office, British Council and the UK Engineering Physical Sciences Council (EPSRC) have been introduced. The projects have significant impacts on promoting sustainable development in built environment in China. The aim of this paper is to share the experiences with those who are interested and searching the ways to collaborate with China in education and research.

Modelling: promoting creativity whilst forging links between science education and design and technology education

Educational reforms in many countries currently call for the development of knowledge-based societies. In particular, emphasis is placed on the promotion of creativity, especially in the areas of science education and of design and technology education. In this paper, perceptions of the nature of creativity and of the conditions for its realization are discussed. The notion of modelling as a creative act is outlined and the scope for using modelling as a bridge between science education and design and technology education explored. A model for the creative act of modelling is proposed and its major aspects elaborated upon. Finally, strategies for forging links between the two subjects are outlined.

Language, education and ethnicity: whose rights will prevail in an age of globalisation?

Education and ethnicity cannot be discussed without taking language into account. This paper will argue that any discussion of ethnic minorities cannot ignore the question of language, nor can any discussion of human rights ignore the question of language rights. Unfortunately, in today's globalised world, governments and minorities are faced with conflicting pressures: on the one hand, for the development and use of education in a global/international language; on the other for the use and development of mother tongue, local or indigenous languages in education. Language complexity and ethnic plurality were largely brought about as a result of the creation of nation-states, which were spread around the world as a result of European colonialism. European languages and formal education systems were used as a means of political and economic control. The legacy that was left by the colonial powers has complicated ethnic relations and has frequently led to conflict. While there is now greater recognition of the importance of language both for economic and educational development, as well as for human rights, the forces of globalisation are leading towards uniformity in the languages used, in culture and even in education. They are working against the development of language rights for smaller groups. We are witnessing a sharp decline in the number of languages spoken. Only those languages which are numerically, economically and politically strong are likely to survive. As a result many linguistic and ethnic groups are in danger of being further marginalised. This paper will illustrate this thesis both historically and from several contemporary societies, showing how certain policies have exacerbated ethnic conflict while others are seeking to promote harmony and reconciliation. Why this should be so will be explored. (c) 2006 Elsevier Ltd. All rights reserved.

Expressing medicine side effects: assessing the effectiveness of absolute risk, relative risk, and number needed to harm, and the provision of baseline risk information

Objective: To assess the effectiveness of absolute risk, relative risk, and number needed to harm formats for medicine side effects, with and without the provision of baseline risk information. Methods: A two factor, risk increase format (relative, absolute and NNH) x baseline (present/absent) between participants design was used. A sample of 268 women was given a scenario about increase in side effect risk with third generation oral contraceptives, and were required to answer written questions to assess their understanding, satisfaction, and likelihood of continuing to take the drug. Results: Provision of baseline information significantly improved risk estimates and increased satisfaction, although the estimates were still considerably higher than the actual risk. No differences between presentation formats were observed when baseline information was presented. Without baseline information, absolute risk led to the most accurate performance. Conclusion: The findings support the importance of informing people about baseline level of risk when describing risk increases. In contrast, they offer no support for using number needed to harm. Practice implications: Health professionals should provide baseline risk information when presenting information about risk increases or decreases. More research is needed before numbers needed to harm (or treat) should be given to members of the general populations. (c) 2005 Elsevier Ireland Ltd. All rights reserved.

Over the counter medicines and the need for immediate action: a further evaluation of European Commission recommended wordings for communicating risk

A study examined people's interpretation of European Commission (EC) recommended verbal descriptors for risk of medicine side effects, and actions to take if they do occur. Members of the general public were presented with a fictitious (but realistic) scenario about suffering from a stiff neck, visiting the local pharmacy and purchasing an over the counter (OTC) medicine (Ibruprofen). The medicine came with an information leaflet which included information about the medicine's side effects, their risk of occurrence, and recommended actions to take if adverse effects are experienced. Probability of occurrence was presented numerically (6%) or verbally, using the recommended EC descriptor (common). Results showed that, in line with findings of our earlier work with prescribed medicines, participants significantly overestimated side effect risk. Furthermore, the differences in interpretation were reflected in their judgements of satisfaction, side effect severity, risk to health, and intention to take the medicine. Finally, we observed no significant difference between people's interpretation of the recommended action descriptors ('immediately' and 'as soon as possible'). (C) 2003 Elsevier Science Ireland Ltd. All rights reserved.