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.

Placement year academic benefit revisited:effects of demographics, prior achievement and degree programme

Investigations of whether students taking undergraduate work placements show greater academic improvement than those who do not have shown inconsistent results. In most studies, sample sizes have been relatively small and few studies have taken into account pre-existing student differences.Here data from over 6000 students at one university over six cohorts and a range of programmes are analysed. Consistent academic benefit from placement experience, regardless of ethnicity, gender, socioeconomic background and subject is shown. However the impact of demographic factors on both achievement and on the probability of taking a placement suggests that future research should take these factors into account. The role of placements in promoting employability is contextualised as a secondary benefit to the primary goal of educating the mind in the Newman (1852) tradition. Possible causes of, and further research into, the improved academic performance identified are discussed.

Postgraduate study and managers' subsequent work experience:an exploratory evaluation

Drawing on an exploratory qualitative study, this article considers the link between business school teaching at graduate level and subsequent work behaviour and experiences of former students. It evaluates the student experience some time after graduation. The findings of the retrospective evaluation point to the value of classroom peer discussion, the testing of ideas against prior work experience and the opportunity to make sense of organisational issues by setting them into broader context. The importance of andragogical approaches to teaching is discussed as well as the implications of the study findings for teaching quality enhancement. © 2009 Taylor & Francis.

Intergenerational associations between a consensual childhood sexual experience and adult substance abuse among Latina mothers and daughters

Purpose: Early onset of sexual activity has been linked to later substance abuse. Our study aimed to further describe the associations between Latina mothers’ and daughters’ early sexual activity and adult substance abuse. Methods: A survey was conducted with 92 Latina mother–daughter dyads whose members never experienced sexual abuse. Childhood sexual experience was defined as the occurrence of a consensual sexual encounter at the age of 15 years or younger. Substance abusers were identified by the extent of substance use during the 12 months prior to the interview. Path analysis was used to fit our conceptual models to the data. Main findings: Daughters’ current, adult substance abuse was associated independently with: their own childhood sexual experience (odds ratio [OR] = 6.0) and mothers’ current, adult substance abuse (OR = 2.0). Compared with daughters who first experienced sex after the age of 19, the odds of using substances were 17.7 times higher among daughters who had childhood sexual experience and 3.8 times higher among daughters who first experienced sex between the age of 16–19 years. Explicitly, sexual experiences between the ages of 16–19 years were also risk factors for later adult substance abuse. Mothers’ childhood sexual experience (OR = 7.3) was a strong predictor for daughters’ childhood sexual experience. Conclusions: Our study supported a link between mother and daughter childhood sexual experience among Latinas, and indicated it is a correlate of adult substance abuse. Family based substance abuse prevention efforts and future longitudinal studies should consider maternal childhood sexual experience as a potential indication of risk for Latina daughters.

Ethical reasoning through simulation: a phenomenological analysis of student experience

Background
Medical students transitioning into professional practice feel underprepared to deal with the emotional complexities of real-life ethical situations. Simulation-based learning (SBL) may provide a safe environment for students to probe the boundaries of ethical encounters. Published studies of ethics simulation have not generated sufficiently deep accounts of student experience to inform pedagogy. The aim of this study was to understand students’ lived experiences as they engaged with the emotional challenges of managing clinical ethical dilemmas within a SBL environment.

Methods
This qualitative study was underpinned by an interpretivist epistemology. Eight senior medical students participated in an interprofessional ward-based SBL activity incorporating a series of ethically challenging encounters. Each student wore digital video glasses to capture point-of-view (PoV) film footage. Students were interviewed immediately after the simulation and the PoV footage played back to them. Interviews were transcribed verbatim. An interpretative phenomenological approach, using an established template analysis approach, was used to iteratively analyse the data.

Results
Four main themes emerged from the analysis: (1) ‘Authentic on all levels?’, (2)‘Letting the emotions flow’, (3) ‘Ethical alarm bells’ and (4) ‘Voices of children and ghosts’. Students recognised many explicit ethical dilemmas during the SBL activity but had difficulty navigating more subtle ethical and professional boundaries. In emotionally complex situations, instances of moral compromise were observed (such as telling an untruth). Some participants felt unable to raise concerns or challenge unethical behaviour within the scenarios due to prior negative undergraduate experiences.

Conclusions
This study provided deep insights into medical students’ immersive and embodied experiences of ethical reasoning during an authentic SBL activity. By layering on the human dimensions of ethical decision-making, students can understand their personal responses to emotion, complexity and interprofessional working. This could assist them in framing and observing appropriate ethical and professional boundaries and help smooth the transition into clinical practice.

The Lived Experience of People with Mental Health and Substance Misuse Problems: Dimensions of Belonging

Introduction: People with co-occurring mental health and substance misuse problems are among the most excluded in society. A need to feel connected to others has been articulated in the occupational science literature although the concept of belonging itself has not been extensively explored within this paradigm. This paper reports findings from research that explored the meaning and experience of belonging for four people living with dual diagnosis in the United Kingdom. Method: Researchers employed an interpretative phenomenological approach to the study. Four semi-structured interviews were carried out. The interviews were guided by questions around the meaning of belonging, barriers to belonging and how belonging and not belonging impacted on participants’ lives. Data analysis facilitated the identification of themes across individual accounts and enabled comparisons. Findings: Data analysis identified four themes – belonging in family, belonging in place, embodied understandings of belonging and barriers to belonging. Conclusion: The findings add further insights into the mutable nature of belonging. A link between sense of belonging and attachment theory has been proposed, along with a way to understand the changeable and dependent nature of belonging through ‘dimensions of belonging’.

Food and fuel microalgae applications: insights from portuguese experience [Resumo]

Microalgae have a wide range of application fields, from food to fuels, to pharmaceuticals & fine chemicals, aquaculture and environmental bioremediation, among others. Spirulina and Chlorella have been used as food sources since ancient times, due to their high and balanced nutritional value. Our research group in Lisbon has developed a range of food products (emulsions, gelled desserts, biscuits and pastas) enriched with freshwater and marine microalgae (Spirulina, Chlorella, Haematococcus, Isochrysis and Diacronema). The developed products presented attractive and stable colours, high resistance to oxidation and enhanced rheological properties. Some of these products will be prepared at the Post-Congress Course “Functional Foods Development” at the University of Antofagasta. More recently, a great interest has arisen on using microalgae for biofuel production. The same group has also been exploring several marine and freshwater species for biofuel production (e.g., biodiesel, bioethanol, biohydrogen and biomethane) within a biorefinery approach, in order to obtain high and low-value co-products using integral biomass maximizing the energy revenue. Namely, supercritical fluid extraction of Nannochloropsis sp. allowed the recovery of valuable carotenoids and lipids, prior to bioH2 production through dark fermentation of the residual biomass. Also, Scenedesmus obliquus residues after sugars (for bioethanol) and lipids (for biodiesel) extraction has been anaerobically digested attaining high biomethane yields. Regarding sustainability issues, the current trend of our group is now focused on using liquid effluents and high CO2 levels for low cost microalgae growth, contributing to a lower water demand, primary energy consumption and global warming potential by reducing the need for potable water and fertilizers (P, N) and increasing CO2 mitigation. Microalgae biomass has been successfully used for urban wastewater treatment with subsequent bioH2 production, in a biorefinery approach. Presently, ammonium-rich raw effluents from piggeries and poultry industry are being effectively used for microalgae growth avoiding any pre-treatment step.

Searching for knowledge in the belly of the beast: diversity, social equity and the African graduate student mother's experience in US higher education

Diversity has become a buzz word in public discourse and in educational circles. Higher education institutions in the US have increasingly used this word as a cornerstone of their mission statements and have made increasing efforts to attract students from different backgrounds. As part of the increase in diversity efforts among US colleges, is a significant rise in the number of international students. Attracting international students has become a priority for U.S. universities regardless of size or location. This study examines the intersection between the structure of American educational environment and the blended identities of African Graduate Student Mothers. Within the context of contemporary diversity efforts in US educational institutions, this study examines both the structural environments and the socio-cultural constructs that affect the experiences of African graduate student mothers. Based on a qualitative research interview design, a total of nineteen African graduate student mothers at a Mid-Western University in the US were interviewed individually and in groups over a six weeks period. Results from this study show that apart from the difficult and often dehumanizing treatment African student mothers endure from immigration and consular officials in their various countries and ports of entry, they often find themselves at the margins of their various programs and departments with very little support if any. This is because most of them enroll into graduate programs after arriving as dependants of their spouses; a process that does not allow them to negotiate for departmental commitments and support prior to their arrival. Not only do these women face racial discrimination from white professors, staff and fellow students, but they also experience discrimination and hostilities from African Americans and other minority groups who see them as threats to the limited resources that are often set aside for minority groups in such institutions.

Co-creation of tourism experience: attention, involvement and memorability

Tese de Doutoramento, Turismo, Faculdade de Economia, Universidade do Algarve, 2016

SAP-Related Education - Status-Quo and Experience

Integrating Enterprise Systems solutions in the curriculum of not only universities but all types of institutes of higher learning has been a major challenge for nearly ten years. Enterprise Systems education is surprisingly well documented in a number of papers on Information Systems education. However, most publications in this area report on the individual experiences of an institution or an academic. This paper focuses on the most popular Enterprise System - SAP - and summarizes the outcomes of a global survey on the status quo of SAP-related education. Based on feedback of 305 lecturers and more than 700 students, it reports on the main factors of Enterprise Systems education including, critical success factors, alternative hosting models, and students’ perceptions. The results show among others an overall increasing interest in advanced SAP solutions and international collaboration, and a high satisfaction with the concept of using Application Hosting Centers.

Best after rain : waterfall discharges and the tourist experience

Waterfalls attract tourists because they are aesthetically appealing landscape features that are not part of everyday experience. It is generally understood that falls are usually seen at their best when there is a copious flow of water, especially after heavy rain. Guidebooks often contain this observation when referring to waterfalls, sometimes warning readers that the flow may be severely reduced during dry periods. Indeed, many visitors are disappointed when they see falls at such times. Some are saddened when the discharge of a waterfall has been depleted by the abstraction of water upstream for power generation or other purposes. While, for those in search of the Sublime or merely the superlative, size is often important, small waterfalls can give great pleasure to lovers of landscape beauty. According to guidebooks, however, even these falls are usually best seen after rain. Drawing on tourist and travel literature and personal journals from the eighteenth century to the present, and with reference to examples from different parts of the world, this paper discusses the importance of discharge in the tourist experience of waterfalls.