The training experience of primary care pharmacists

Objectives — To map the tasks, activities and training provision for primary care pharmacists (PCPs) and to identify perceived future training needs. Methods — Survey undertaken in 1998/1999 using a pre-piloted, postal, self-completion questionnaire to two samples of PCPs. Setting — PCPs in (a) the West Midlands and (b) England (outside West Midlands). Key findings — The response rate was 66 per cent. A majority (68 per cent) had worked in the role for less than two years. Eighty per cent had some form of continuing education or training for the role although only 50 per cent had a formal qualification. Over two-thirds had contributed to the funding of their training, with one-third providing all funding. Seventy-four per cent of PCPs agreed that pharmacists should go through a procedure to ensure competence (accreditation) before being allowed to work for a general medical practice or primary care group. Views on the need for formal education/training prior to work differed: 82 per cent of those with formal qualifications, but only 46 per cent of those without, considered that this should be a requirement. There was general agreement that training/education had met training needs. Views on future training closely reflected previous training experiences, with a focus upon pharmaceutical roles rather than upon generic skill development and the acquisition of management skills. Conclusions — The study provides a snapshot in time of the experience of pioneer PCPs and the training available to them. PCPs will need further training or updating if they are to provide the wider roles required by the developing needs of the National Health Service. Consideration should be given to formal recognition of the training of PCPs in order to assure competence. The expectation that pharmacists should fund their own training is likely to be a barrier to uptake of training and uncertainties over funding will militate against consistency of training.

From experience to knowledge in ELT

From Experience to Knowledge in ELT investigates the developing discourses of English Language teachers in a variety of international contexts. By analysing how professional development takes place through participation in professional discourse, the chapters shed light on what teachers do and why they do it. - Better understand what they have already learned through their teaching - use that new understanding to develop their teaching - prepare to gain a recognised qualification (such as the Cambridge Teacher Knowledge Test) Using short extracts from published course books as examples, From Experience to Knowledge in ELT offers the teacher reliable procedures and alternatives, as well as ways of thinking about developing a personal teaching style.

An investigation into formal and functional characteristics of qualifications in legislative writing and its application to English for academic legal purposes.

The present investigation is based on a linguistic analysis of the 'Housing Act 1980' and attempts to examine the role of qualifications in the structuring of the legislative statement. The introductory chapter isolates legislative writing as a "sub-variety “of legal language and provides an overview of the controversies surrounding the way it is written and the problems it poses to its readers. Chapter two emphasizes the limitations of the available work on the description of language-varieties for the analysis of legislative writing and outlines the approach adopted for the present analysis. This chapter also gives some idea of the information-structuring of legislative provisions and establishes qualification as a key element in their textualisation. The next three chapters offer a detailed account of the ten major qualification-types identified in the corpus, concentrating on the surface form they take, the features of legislative statements they textualize and the syntactic positions to which they are generally assigned in the statement of legislative provisions. The emerging hypotheses in these chapters have often been verified through a specialist reaction from a Parliamentary Counsel, largely responsible for the writing of the ‘Housing Act 1980’• The findings suggest useful correlations between a number of qualificational initiators and the various aspects of the legislative statement. They also reveal that many of these qualifications typically occur in those clause-medial syntactic positions which are sparingly used in other specialist discourse, thus creating syntactic discontinuity in the legislative sentence. Such syntactic discontinuities, on the evidence from psycholinguistic experiments reported in chapter six, create special problems in the processing and comprehension of legislative statements. The final chapter converts the main linguistic findings into a series of pedagogical generalizations, offers indications of how this may be applied in EALP situations and concludes with other considerations of possible applications.

Analysis of organisational climate to improve the adequacy of primary health care in the State of Kuwait

This study covers two areas of contribution to the knowledge, firstly it tried to investigate rigourously the relationships of a number of factors believed that they may affect the climate perception, classified into three types to arrive to prove a hypothesis of the important role that qualification and personal factors play in shaping the climate perception, this is in contrast with situational factors. Secondly, the study tries to recluster the items of a wide-range applied scale for the measurement of climate named HAY in order to overcome the cross-cultural differences between the Kuwaiti and the American society, and to achieve a modified dimensions of climate for a civil service organisation in Kuwait. Furthermore, the study attempts to carry out a diagnostic test for the climate of the Ministry of Public Health in Kuwait, aiming to diagnose the perceived characteristics of the MoPH organisation, and suggests a number of areas to be given attention if an improvement is to be introduced. The study used extensively the statistical and the computer facilities to make the analysis more representing the field data, on the other hand this study is characterised by the very highly responsive rate of the main survey which would affect the findings reliability. Three main field studies are included, the first one was to conduct the main questionnaire where the second was to measure the "should be" climate by the experts of MoPH using the DELPHI technique, and the third was to conduct an extensive meeting with the very top management team in MoPH. Results of the first stage were subject to CLUSTER analysis for the reconstruction of the HAY tool, whereas comparative analysis was carried on between the results of the second and third stages on one side, the first from the other.

Status and professional association councils. Available in 4 volumes.

This thesis examines the predictive value of a conceptual distinction between status-seeking associations and status-maintaining associations for enhancing understanding of ten selected professional associations and of the attitudes, values, behaviour and policies of their governing organs. Thirty four specific hypotheses have been tested by such research methods as questionnaires administered to individuals and associations, participant observation and an examination of association minutes and publications. Certain hypotheses have been found to be valid for particular matched pairs and/or groups of associations. The findings of the study suggest that the present conceptualisation of profession, the individual professional, professionalism, professionalisation, professional status and that relating to the role of the professions in society needs to be refined and modified in varying degrees in application to accounting associations, business graduate associations and management associations. The concept of the `ideal type' profession is shown to be of limited value in understanding certain aspects of the activities of business graduate and management associations. The findings of the study suggest that in future the professional associations examined may attach less importance to their qualifying role and lay more stress upon their representational role. The professional association faces a managerial challenge to adjust and adapt to a range of `external' pressures and `internal' demands from members and may increasingly need to be regarded as an organisation that possesses certain combinations or sets of characteristics rather than as a type of organisation that possesses a particular or relatively exclusive set. With a blurring of the distinction between the professional and state sector vocational education, and a growing customer/market orientation associated with the changing nature of work, membership of a professional association may, in future, come to be associated rather more with securing access to a relevant range of services and less with qualification for a particular career.

The far right vote in France:from consolidation to collapse?

The presidential and legislative elections of 2007 are widely seen to have marked the end of the far right as a major political force in France. How could this occur only five years after Le Pen’s qualification for the presidential run-off, and with his party seemingly in the ascendant? This article discusses recent fluctuations in far-right electoral performance in France. It focuses largely on the presidential elections of 2002 and 2007, re-examining the (supposed) upswell of far-right support in 2002 and its (supposed) subsidence in 2007. Both elections require nuanced interpretation. Both confounded poll predictions, which in 2007 failed to measure the effect of Sarkozy’s hard-right campaign and, crucially, the extent to which the border between “mainstream right” and “far right” had shifted since 2002. This allowed Sarkozy to drain part of Le Pen’s electorate, and raises questions over the longer-term impact of Le Pen and the FN on the political agenda in France.

Assessing the efficacy of structural merger remedies:choosing between theories of harm?

Previous empirical assessments of the effectiveness of structural merger remedies have focused mainly on the subsequent viability of the divested assets. Here, we take a different approach by examining how competitive are the market structures which result from the divestments. We employ a tightly specified sample of markets in which the European Commission (EC) has imposed structural merger remedies. It has two key features: (i) it includes all mergers in which the EC appears to have seriously considered, simultaneously, the possibility of collective dominance, as well as single dominance; (ii) in a previous paper, for the same sample, we estimated a model which proved very successful in predicting the Commission’s merger decisions, in terms of the market shares of the leading firms. The former allows us to explore the choices between alternative theories of harm, and the latter provides a yardstick for evaluating whether markets are competitive or not – at least in the eyes of the Commission. Running the hypothetical post-remedy market shares through the model, we can predict whether the EC would have judged the markets concerned to be competitive, had they been the result of a merger rather than a remedy. We find that a significant proportion were not competitive in this sense. One explanation is that the EC has simply been inconsistent – using different criteria for assessing remedies from those for assessing the mergers in the first place. However, a more sympathetic – and in our opinion, more likely – explanation is that the Commission is severely constrained by the pre-merger market structures in many markets. We show that, typically, divestment remedies return the market to the same structure as existed before the proposed merger. Indeed, one can argue that any competition authority should never do more than this. Crucially, however, we find that this pre-merger structure is often itself not competitive. We also observe an analogous picture in a number of markets where the Commission chose not to intervene: while the post-merger structure was not competitive, nor was the pre-merger structure. In those cases, however, the Commission preferred the former to the latter. In effect, in both scenarios, the EC was faced with a no-win decision. This immediately raises a follow-up question: why did the EC intervene for some, but not for others – given that in all these cases, some sort of anticompetitive structure would prevail? We show that, in this sample at least, the answer is often tied to the prospective rank of the merged firm post-merger. In particular, in those markets where the merged firm would not be the largest post-merger, we find a reluctance to intervene even where the resulting market structure is likely to be conducive to collective dominance. We explain this by a willingness to tolerate an outcome which may be conducive to tacit collusion if the alternative is the possibility of an enhanced position of single dominance by the market leader. Finally, because the sample is confined to cases brought under the ‘old’ EC Merger Regulation, we go on to consider how, if at all, these conclusions require qualification following the 2004 revisions, which, amongst other things, made interventions for non-coordinated behaviour possible without requiring that the merged firm be a dominant market leader. Our main conclusions here are that the Commission appears to have been less inclined to intervene in general, but particularly for Collective Dominance (or ‘coordinated effects’ as it is now known in Europe as well as the US.) Moreover, perhaps contrary to expectation, where the merged firm is #2, the Commission has to date rarely made a unilateral effects decision and never made a coordinated effects decision.

Specialist contact lens fitting

What is meant by the term ‘specialist contact lens fitting’? Or put another way, what would be considered non-specialist contact lens fitting? Is there such a thing as routine contact lens fitting? Soft or silicone hydrogel fitting for daily wear would probably be considered as routine contact lens fitting, but would extended or flexible wear remain in the same category or would they be considered a specialist fit? Different eras will classify different products as being ‘specialist’. Certainly twenty years ago soft toric contact lenses were considered as being speciality lenses but today would be thought of as routine lenses. Conversely, gas permeable lenses were thought of as mainstream twenty years ago but now are considered as speciality lenses. Although this would not be the same globally, as in some countries (such as Netherlands, France and Japan) gas permeable lens fitting remains popular and is not on the decline as in other countries (Canada, Australia and Sweden) [1]. Bandage soft lenses applied after surface laser refractive procedures would be considered as therapeutic lenses but in reality they are just plano thin hydrogel lenses worn constantly for 3–4 days to allow the underlying epithelium to convalesce and are then removed [2]. Some patients find that wearing hydrogel lenses during periods when they suffer from seasonal allergies actually improves their ocular comfort as the contact lens acts as a barrier to the allergen [3] and [4]. Scleral lenses have long been considered speciality lenses, apart from a time when they were the only lenses available but at that time all contact lens work would have been considered speciality practice! Nowadays we see the advent of mini-scleral designs and we see large diameter gas permeable lenses too. It is possible that these lenses increase the popularity of gas permeable lenses again and they become more main stream. So it would seem that the lines between routine and speciality contact lens fitting are not clear. Whether a lens is classed a specialist fit or not would depend on the lens type, why it was fitted, where in the world the fitting was being done and even the era in which it was fitted. This begs the question as to what would be considered entry level knowledge in contact lens fitting. This may not be an issue for most BCLA members or CLAE readers but certainly would be for bodies such as the College of Optometrists (UK) or the Association of British Dispensing Opticians when they are planning the final registration examinations for budding practitioners or when planning the level of higher level qualifications such as College Certificates or Diplomas. Similarly for training institutions when they are planning their course content. This becomes even trickier when trying to devise a qualification that spans across many countries, like the European Diploma in Optometry and Optics. How do we know if the training and examination level is correct? One way would be to analyse things when they go wrong and if patterns of malpractice are seen then maybe that could be used as an indicator to more training being needed. There were 162 Fitness to Practice Hearing at the General Optical Council between 2001 and 2010. Forty-seven of these were clinically related case, 39 fraud related, and 76 others. Of the clinical ones only 3 were contact lens related. So it would appear that as whole, in the profession, contact lens clinical skills are not being questioned too often (although it seems a few of us can’t keep our hands out the cookie jar!).

Work-based HE pathways for the electrical power engineering industry

Aston University has been working closely with key companies from within the electricity industry for several years, initially in the development and delivery of an employer-led foundation degree programme in electrical power engineering, and more recently, in the development of a progression pathway for foundation degree graduates to achieve a Bachelors-level qualification. The Electrical Power Engineering foundation degree was developed in close consultation with the industry such that the programme is essentially owned by the sector. Programme delivery has required significant shifts away from traditional HE teaching patterns whilst maintaining the quality requirement and without compromise of the academic degree standard. Block teaching (2-week slots), partnership delivery, off-site student support and work-based learning have all presented challenges as we have sought to maximise the student learning experience and to ensure that the graduates are fit-for purpose and "hit the ground running" within a defined career structure for sponsoring companies. This paper will outline the skills challenges facing the sector; describe programme developments and delivery challenges; before articulating some observations and conclusions around programme effectiveness, impact of foundation degree graduates in the workplace and the significance of the close working relationship with key sponsoring companies. Copyright © 2012, September.

Support tools for paediatric inpatient prescribers:a review

Prescribing support for paediatrics is diverse and includes both standard texts and electronic tools. Evidence concerning who should be supported and by what method is limited. This review aims to collate the current information available on prescribing support in paediatrics. Many tools designed to support prescribers are technology based. For example, electronic prescribing and smart phone applications. There is a focus on prescriber education both at undergraduate and postgraduate level. In the UK, the majority of inpatient prescribing is done by junior medical staff. It is important to ensure they are competent on qualification and supported in this role. A UK national prescribing assessment is being trialled to test for competence on graduation and there are also tools available to test paediatric prescribing after qualification. No information is available on the tools and resources UK prescribers currently use to support their decision making. One US study reported a decrease in the availability of paediatric prescribing information in a popular reference text. There is limited evidence to show that decisionsupport tools improve patient outcomes, however, there is growing confirmation that electronic prescribing reduces medication errors. There have been reports of new error types, such as selection errors, occurring with the use of electronic prescribing. Another concern with computerised decision-support systems is deciding what alerts should be presented to the prescriber and when/how often in order to avoid alert fatigue. There is little published concerning paediatric alerts perhaps as a consequence of commercial systems often not including paediatric specific support.

Characterization of Acanthamoeba-microsphere association by multiparameter flow cytometry and confocal microscopy

Background: Acanthamoebae, in common with other protozoa, readily endocytose particulate material, which in turn may lead to the spread of infectious disease. Methods: Evaluation and quantification of plain and carboxylate FITC-microsphere association with acanthamoebal trophzoites was undertaken using a combination of flow cytometry and confocal microscopy. Trophozoites from strains and species of Acanthamoeba were exposed to plain and carboxylate FITC-microspheres. Microsphere size and aspects such as trophozoite starvation, maturity, and exposure to metabolic inhibitors were assessed. Results: All species and strains of Acanthamoeba readily endocytosed plain and carboxylate microspheres. Starving trophozoites significantly increased binding and potential ingestion of microspheres, whereas trophozoites of increasing maturity lost such abilities. Trophozoites showed a significant preference for 2.0- and 3.0-μm-diameter microspheres when compared with other sizes, which in turn could occupy much of the cytoplasm. The physiological inhibitors sodium azide, 2,4-clinitrophenol, and cytochalasin B reduced microsphere association with trophozoites; however, some microspheres still bound and associated with trophozoites after inhibitor exposure, a manifestation of both active and inactive agent involvement in microsphere endocytosis. Conclusions: Even though the origins of microsphere binding by acanthamoebal trophozoite remains shrouded, the combination of flow cytometry and confocal microscopy supported synergistic quantification and qualification of trophozoite-microsphere endocytosis. © 2006 International Society for Analytical Cytology.

How education should link with career paths

How good is your pharmacy practice? And what does “good” look like? Take a look back at the education and training you have received in your career to date. Has it stood you in good stead? Certainly there is a need to establish a model of professional education and development that produces good pharmacists — you should be able to demonstrate your competence regardless of your sector of work. It may help if we move away from the view that excellence in pharmacy practice is primarily defined by where you practise and the kind of job that you do. The Modernising Pharmacy Careers programme’s aspirations to integrate the undergraduate degree with the preregistration training year are bold and to be applauded — provided the outcome delivers changes that are more than superficial. The new model needs to deliver greater integration of education with practice, while retaining an adequate science base. Theory should be put into the context of practice-based, cross-sector learning needs and opportunities. For example, is the classroom really the best environment in which to learn dispensing? Pharmacokinetic theory could be put into context through creatively designed work placements. And it might make more sense to learn patient counselling in a community pharmacy, and so on. Is it resources we lack to make this happen? Or do we lack the collective will to be imaginative, to be radical and to conceive new approaches to professional education? Implicit in this new approach to education is the expectation that pharmacists should teach and mentor and, conversely, that those who teach should also engage in relevant practice. University education must produce graduates whose knowledge and competence are useful to employers. Moreover, graduates must be adequately prepared to enter any area of the profession endowed with professional self-confidence (something, arguably, that needs further development within the pharmacy psyche). Of course, becoming qualified is just the beginning. Post-qualification, pharmacists need structured career paths that foster this professional confidence, support learning and ensure recognition. To this end, the Royal Pharmaceutical Society-led professional curriculum group is working to define knowledge, skills and experience for all areas of advanced practice. More than ever, the profession needs to adopt a culture of learning, teaching and practice research that is unified. The question is: how do we move away from merely collecting qualifications (trophies) to developing meaningful careers? Pharmacists in all areas and at all levels of the profession need to consider their own willingness to make this shift. The RPS and MPC are leading the way, but are we following?

Inspiring young people to engage in engineering education:The Aston University Engineering Academy Birmingham

This paper initially reports concerns about the falling interest in engineering and mathematical disciplines and looks at some of the reasons for this. It then discusses the aims of the Engineering Diploma - a qualification for 14-19 year olds in the UK - and the pedagogical research that that has informed the design and development. The paper highlights the key learning theories that support the delivery of this qualification and provides an example of how this pedagogy has been applied effectively through the curriculum partnership that has been developed between a consortium of schools in the Birmingham local authority, Aston University and employers. It establishes the importance of aligning the curriculum and articulating clear engineering progression routes from the age of fourteen to enable young people to be inspired and motivated towards careers in engineering. The paper presents the view of parents, teachers and pupils involved with the Diploma, during the first year, and the way in which the partnership is informing future developments in the delivery of engineering curriculum within the region. The success of this regional partnership model has resulted in the Department of Children, Schools and Families agreeing to fund the development of the Aston University Engineering Academy Birmingham. This is a school for 14-19 year olds that will open in 2012 on the Aston Science Park adjacent to the University. The final part of the paper looks at the benefits to the young local engineers of this initiative. © 2009 Authors.

Development of a work-based learning MSc course which incorporates the development and demonstration of professional engineering competence standards

UK engineering standards are regulated by the Engineering Council (EC) using a set of generic threshold competence standards which all professionally registered Chartered Engineers in the UK must demonstrate, underpinned by a separate academic qualification at Masters Level. As part of an EC-led national project for the development of work-based learning (WBL) courses leading to Chartered Engineer registration, Aston University has started an MSc Professional Engineering programme, a development of a model originally designed by Kingston University, and build around a set of generic modules which map onto the competence standards. The learning pedagogy of these modules conforms to a widely recognised experiential learning model, with refinements incorporated from a number of other learning models. In particular, the use of workplace mentoring to support the development of critical reflection and to overcome barriers to learning is being incorporated into the learning space. This discussion paper explains the work that was done in collaboration with the EC and a number of Professional Engineering Institutions, to design a course structure and curricular framework that optimises the engineering learning process for engineers already working across a wide range of industries, and to address issues of engineering sustainability. It also explains the thinking behind the work that has been started to provide an international version of the course, built around a set of globalised engineering competences. © 2010 W J Glew, E F Elsworth.