Mental health pharmacists views on shared decision-making for antipsychotics in serious mental illness

Background People diagnosed with serious mental illnesses (SMIs) such as schizophrenia and bipolar affective disorder are frequently treated with antipsychotics. National guidance advises the use of shared decision-making (SDM) in antipsychotic prescribing. There is currently little data on the opinions of health professionals on the role of SDM. Objective To explore the views and experiences of UK mental health pharmacists regarding the use of SDM in antipsychotic prescribing in people diagnosed with SMI. Setting The study was conducted by interviewing secondary care mental health pharmacists in the UK to obtain qualitative data. Methods Semi-structured interviews were recorded. An inductive thematic analysis was conducted using the method of constant comparison. Main outcome measure Themes evolving from mental health pharmacists on SDM in relation to antipsychotic prescribing in people with SMI. Results Thirteen mental health pharmacists were interviewed. SDM was perceived to be linked to positive clinical outcomes including adherence, service user satisfaction and improved therapeutic relations. Despite more prescribers and service users supporting SDM, it was not seen as being practised as widely as it could be; this was attributed to a number of barriers, most predominantly issues surrounding service user’s lacking capacity to engage in SDM and time pressures on clinical staff. The need for greater effort to work around the issues, engage service users and adopt a more inter-professional approach was conveyed. Conclusion The mental health pharmacists support SDM for antipsychotic prescribing, believing that it improves outcomes. However, barriers are seen to limit implementation. More research is needed into overcoming the barriers and measuring the benefits of SDM, along with exploring a more inter-professional approach to SDM.

A gyógyszerkiadás és a betegek egészségi állapota a háziorvosi és szakorvosi kapcsolatok függvényében = Formal professional relations between general practitioners and specialists. Possible links with patient health and pharmacy cost

Arra a kérdésre keressük a választ, hogy a szoros háziorvosi-szakorvosi szakmai kapcsolatoknak van-e hatásuk a betegek gyógyszerkiadására, illetve egészségi állapotára. Az orvosok közötti szakmai kapcsolatok szorosságát a közösen gondozott betegek száma alapján határoztuk meg, míg a betegek egészségügyi állapotát a diagnosztizált és kezelt társbetegségek számával mértük. Hipotézisünk egyrészt az volt, hogy a hatékonyabb koordinációnak köszönhetően a szoros kapcsolatban kezelt betegek jobb egészségi állapotúak, másrészt kezelésük az erőforrások hatékonyabb felhasználása miatt kisebb gyógyszerköltséggel jár. E két hipotézist a cukorbetegekre teszteltük. Azért esett erre a krónikus betegségre a választásunk, mert itt a háziorvosok és a szakorvosok együttműködése elsődleges fontosságú. Magyarországon a cukorbetegek esetében a legnagyobb a közösen kezelt betegek populációja, valamint itt a legmagasabb a szakorvosi javaslatra felírt háziorvosi receptek száma. Azt az eredményt kaptuk, hogy a szoros kapcsolatban kezelt betegek nem rendelkeznek sem jobb, sem rosszabb egészségi állapottal, miközben a kapcsolódó gyógyszerkiadásuk szignifikánsan alacsonyabb. ____ The article considers whether strong formal professional relations between GPs and specialists in shared care affect either the health of patients or the pharmacy costs they incur. The strength of such relations is measured by the number of shared patients; patient health is proxied by number of co-morbidities diagnosed and treated. The first hypothesis is that patients treated amid strong GP-specialist relations have better health status than those treated amid weak ones, due to enhanced efficiency of care coordination. The second is that patients treated in such strong relations incur lower pharmacy costs high numbers of shared patients are assumed to promote appropriate, effective use of resources. The article tests these hypotheses and compares the outcomes of the strongest and weakest GP-specialist relations through the example of diabetes, a chronic condition where patient-care coordination is important. Diabetes generates the largest shared patient cohort in Hungary, with the highest number of specialist medication prescriptions. This article finds that stronger ties result in significantly lower pharmacy costs, but not a higher patient health status.

A comparative study of perceptions about social relations between black Caribbean nationals and African Americans in a black institution

The present study researched how first-generation black national Caribbean groups and native born black Americans perceived each other socially within an African American institution. Each group rated the other group on items dealing with perceived social relations. Two black ethnically-distinct communities totaling 151 participants were studied. Chi-square ($\chi\sp2$) and one-way analyses of variances (ANOVAs) were employed to test the collected data. The study yielded results about the researched groups that supported both the major findings in the review literature and the thesis's hypothesis; namely, that black Caribbean nationals tend to perceive that they relate socially more with their own group than with African Americans even as mutual participants in a monoracial institution. The present study was unique, as it incorporated a multinational Caribbean group and an African American group that the literature has not previously researched together, and especially as it surveyed these two groups in the context of a black-owned institution. ^

School Efficacy and Educational Leadership: How Principals Help Schools Get Smarter

Schools become learning communities when both teachers and students exert extraordinary commitment and performance. When shared leadership between administrators and teachers is fostered, students benefit academically. This is called school efficacy. In this action-research paper, two principals in low-performing, high-poverty urban schools share their recommendations for fostering higher student achievement, making their respective schools smarter.

Ateliê biográfico de formação profissional: prática socioeducativa em Escola Judicial

In recent decades, debates have intensified about (auto) biographical narratives as devices of socio-educational practices, aligned to the educational setting of the XXI century which have stimulated a new educational perspective woven with epistemological and methodological training throughout life. Towards that scenario, the continued training in Judicial School has occupied important space for constitutional effectiveness and, on the other hand, has grown the demands of expanding knowledge and enhancing training practices, in turn, judicial practices. The aim is to analyze the reflective Group through "Professional Training biographical Workshop" with Bailiffs such as socio-educational practices in socio Judicial School, in the city of Natal /RN. It has highlighted the questions that guided this study: 1. What paths of experiences and knowledge shared by the Law Officials, Federal Appraisers in "Professional Training biographical Workshop" as reflective Group? 2. How is organized the reflective Group as practice in socio-professional training setting? 3. What contributions narratives of themselves bring to the bailiff in reflective Group on Judicial School? The theoretical assumptions are supported in the lifelong training in methodological and epistemological dimension of (auto) biographical knowledge (JOSSO, 2008, 2010, 2012; PINEAU, 2005, 2006; DOMINICÉ, 2010; DELORY-MOMBERGER, 2006, 2008; FREIRE, 1987, 1996, 2001; PASSEGGI, 2008; 2010; 2011; 2012). In 2009, 09 (nine) civil servants in post of Federal Appraiser Justice Official, law graduates participated in this research through eight (08) "Biographical Workshops of Professional Training", consisting of biographical practices and scenarios, enabling oral and written narratives about a memory that has meaning, relationship and tessituras between files, facts and feelings that reveal the perception of self and other, as well as mobilize and weave the training process. The experiences of speaking, writing and reading were constituted of spaces that facilitating the reconstruction of the trajectory of training and career awareness-making, helping to re-signify labor relations and lead to their own professional design. From this study, the reflective properties of groups have emerged, consisting of Reflexivity, Experience, Historicity, Reversibility, dialog and formability processes, with paths to social and educational practices in which professionals identify the meaning and significance of self and of the profession that are exercising. The expectation is to continue with the spirit of research to emerge from the participants responses to training practices in Judicial School, aligned with the new knowledge of understanding the human being, not only an object of his work, but also a social subject, co-participant in the process of re-signifying life and work in a permanent way.

Le sentiment d'appartenance à l'école : un regard conceptuel, psychométrique et théorique

Parce qu’il est notamment lié à des facteurs de réussite scolaire et d’adaptation sociale (Eccles & Roeser, 2009; Finn, 1989; Janosz, Georges, & Parent, 1998), le sentiment d’appartenance des élèves est considéré comme étant un élément de première instance qui doit d’être développé et maintenu par les professionnels de l’éducation (MELS, 2012). L'objectif général visait à approfondir notre compréhension du sentiment d’appartenance à l’école. Pour répondre à cet objectif général, trois articles de recherche distincts ont été élaborés. Le premier article présente une analyse conceptuelle visant à clarifier la compréhension du concept de sentiment d’appartenance à l’école. La méthode conceptuelle privilégiée dans cet article est celle de Walker et Avant (2011). La recension des écrits et les référents empiriques répertoriés indiquent que ce concept est de nature multidimensionnelle. L’analyse des données indique quatre attributs définitionnels. L’élève doit : (1) ressentir une émotion positive à l’égard du milieu scolaire; (2) entretenir des relations sociales de qualité avec les membres du milieu scolaire; (3) s’impliquer activement dans les activités de la classe ou celles de l’école; (4) percevoir une certaine synergie (harmonisation), voir même une similarité, avec les membres de son groupe. À la suite de cette étude permettant de mieux comprendre le sentiment d’appartenance à l’école, le deuxième article visait à examiner la structure factorielle et l'invariance de l’instrument de mesure du sentiment d’appartenance Psychological Sense of School Membership (PSSM) au regard du sexe des élèves. Cette étude a été menée chez un échantillon composé de 766 filles et de 391 garçons de troisième secondaire. Les analyses factorielles confirmatoires ont indiqué une structure à trois facteurs : (1) la qualité des relations entre les élèves; (2) la qualité des relations entre les élèves et l’enseignant; ainsi que (3) le sentiment d’acceptation par le milieu. Les analyses factorielles multigroupes ont indiqué pour leur part que le PSSM est un instrument invariant chez les filles et les garçons de troisième secondaire. Finalement, le troisième article a été mené chez un échantillon de 4166 élèves de niveau secondaire afin d’examiner les processus psychologiques complexes s’opérant entre le sentiment d’appartenance et le rendement scolaire (Anderman & Freeman, 2004; Connell & et al., 1994; Roeser et al., 1996). Afin d’examiner ces processus psychologiques, quatre hypothèses issues du modèle de Freeman-Anderman ont été validées par le biais d’analyses acheminatoires : H1 Les affects positifs médiatisent partiellement et positivement l’effet du sentiment d’appartenance sur l’engagement comportemental; H2 Les affects positifs médiatisent partiellement et positivement l’effet du sentiment d’appartenance sur l’engagement affectif; H3 Les affects positifs médiatisent partiellement et positivement l’effet du sentiment d’appartenance sur l’engagement cognitif; H4 Les engagements affectif, cognitif et comportemental médiatisent partiellement et positivement l’effet du sentiment d’appartenance sur le rendement scolaire. Nos résultats appuient partiellement la première hypothèse de recherche tout en soutenant les hypothèses deux, trois et quatre. Spécifiquement, la relation entre le sentiment d’appartenance et l’engagement émotionnel montre davantage un effet direct qu’un effet indirect (H2). L’étude a produit des résultats similaires pour l’engagement cognitif (H3). Finalement, la relation entre le sentiment d’appartenance et le rendement scolaire indique un effet indirect plus grand qu’un effet direct (H4). À la lumière de ces résultats, des recommandations à l’intention des professionnels de l’éducation sont offertes en guise de conclusion.

Étude des relations entre le développement professionnel des enseignants du postsecondaire et leur bien-être psychologique au travail

Réalisé en milieu collégial (cégep)

The object binary interface: C++ objects for evolvable shared class libraries

Object-oriented design and object-oriented languages support the development of independent software components such as class libraries. When using such components, versioning becomes a key issue. While various ad-hoc techniques and coding idioms have been used to provide versioning, all of these techniques have deficiencies - ambiguity, the necessity of recompilation or re-coding, or the loss of binary compatibility of programs. Components from different software vendors are versioned at different times. Maintaining compatibility between versions must be consciously engineered. New technologies such as distributed objects further complicate libraries by requiring multiple implementations of a type simultaneously in a program. This paper describes a new C++ object model called the Shared Object Model for C++ users and a new implementation model called the Object Binary Interface for C++ implementors. These techniques provide a mechanism for allowing multiple implementations of an object in a program. Early analysis of this approach has shown it to have performance broadly comparable to conventional implementations.

Étude des relations entre le développement professionnel des enseignants du postsecondaire et leur bien-être psychologique au travail

Réalisé en milieu collégial (cégep)

The Influence of the Guatemalan Municipal Orchestra's Curriculum on the Social Relations of its Members

The purpose of this case study is to determine the influence of the curriculum used by the Guatemalan Municipal Orchestra (GMO) upon the social interactions of its members. Social interactions include relations with families, teachers, and music colleagues. To determine this influence, the researcher framed the study using three main components: the impact of music in the development of children’s social skills; the curricula forming educational processes; and the characteristics of the Venezuela musical program, El Sistema. These foundations are explored via the tenets of participatory literacy. The data collection included interviews, surveys, and observation of students, parents, teachers, and administrative personnel. Two primary themes emerged from the data analysis: the development of a sense of community and the presence of intrinsic and external motivators implicit in the GMO environment. The final analysis suggests that curricular practices in the GMO positively influenced the development of students’ social interactions.

The Concept of Transparency in International Relations: towards a critical approach

Transparency is an important concept in International Relations. The possibility of realizing transparency in practice operates as a central analytical axis defining distinct positions on core theoretical problems within the field, from the security dilemma to the function of international institutions and beyond. As a political practice the pursuit of transparent governance is a dominant feature of global politics, promoted by a wide range of actors across a vast range of issue areas, from nuclear proliferation to Internet governance to the politics of foreign aid. Yet, despite its importance, precisely what transparency means or how the concept is understood is frequently ill-defined by academics and policy-makers alike. As a result, the epistemological and ontological underpinnings of approaches to transparency in IR often sit in tension with their wider theoretical commitments. This article will examine the three primary understandings of transparency used in IR in order to unpack these commitments. It finds that while transparency is often explicitly conceptualized as a property of information, particularly within rationalist scholarship, this understanding rests upon an unarticulated set of sociological assumptions. This analysis suggests that conceptualizing ‘transparency-as-information’ without a wider sociology of knowledge production is highly problematic, potentially obscuring our ability to recognize transparent practices in global governance. Understanding transparency as dialogue, as a social practice rooted in shared cognitive capacities and epistemic frameworks, provides a firmer analytical ground from which to examine transparency in International Relations.

Digital anthropology and educational eGames: learning through behavioural patterns in digital, game-based contexts

The selected publications are focused on the relations between users, eGames and the educational context, and how they interact together, so that both learning and user performance are improved through feedback provision. A key part of this analysis is the identification of behavioural, anthropological patterns, so that users can be clustered based on their actions, and the steps taken in the system (e.g. social network, online community, or virtual campus). In doing so, we can analyse large data sets of information made by a broad user sample,which will provide more accurate statistical reports and readings. Furthermore, this research is focused on how users can be clustered based on individual and group behaviour, so that a personalized support through feedback is provided, and the personal learning process is improved as well as the group interaction. We take inputs from every person and from the group they belong to, cluster the contributions, find behavioural patterns and provide personalized feedback to the individual and the group, based on personal and group findings. And we do all this in the context of educational games integrated in learning communities and learning management systems. To carry out this research we design a set of research questions along the 10-year published work presented in this thesis. We ask if the users can be clustered together based on the inputs provided by them and their groups; if and how these data are useful to improve the learner performance and the group interaction; if and how feedback becomes a useful tool for such pedagogical goal; if and how eGames become a powerful context to deploy the pedagogical methodology and the various research methods and activities that make use of that feedback to encourage learning and interaction; if and how a game design and a learning design must be defined and implemented to achieve these objectives, and to facilitate the productive authoring and integration of eGames in pedagogical contexts and frameworks. We conclude that educational games are a resourceful tool to provide a user experience towards a better personalized learning performance and an enhance group interaction along the way. To do so, eGames, while integrated in an educational context, must follow a specific set of user and technical requirements, so that the playful context supports the pedagogical model underneath. We also conclude that, while playing, users can be clustered based on their personal behaviour and interaction with others, thanks to the pattern identification. Based on this information, a set of recommendations are provided Digital Anthropology and educational eGames 6 /216 to the user and the group in the form of personalized feedback, timely managed for an optimum impact on learning performance and group interaction level. In this research, Digital Anthropology is introduced as a concept at a late stage to provide a backbone across various academic fields including: Social Science, Cognitive Science, Behavioural Science, Educational games and, of course, Technology-enhance learning. Although just recently described as an evolution of traditional anthropology, this approach to digital behaviour and social structure facilitates the understanding amongst fields and a comprehensive view towards a combined approach. This research takes forward the already existing work and published research onusers and eGames for learning, and turns the focus onto the next step — the clustering of users based on their behaviour and offering proper, personalized feedback to the user based on that clustering, rather than just on isolated inputs from every user. Indeed, this pattern recognition in the described context of eGames in educational contexts, and towards the presented aim of personalized counselling to the user and the group through feedback, is something that has not been accomplished before.

Shared education in Northern Ireland: school collaboration in divided societies

During the years of political violence in Northern Ireland many looked to schools to contribute to reconciliation. A variety of interventions were attempted throughout those years, but there was little evidence that any had produced systemic change. The peace process provided an opportunity for renewed efforts. This paper outlines the experience of a series of projects on 'shared education', or the establishment of collaborative networks of Protestant, Catholic and integrated schools in which teachers and pupils moved between schools to take classes and share experiences. The paper outlines the genesis of the idea and the research which helped inform the shape of the shared education project. The paper also outlines the corpus of research which has examined various aspects of shared education practice and lays out the emergent model which is helping to inform current government practice in Northern Ireland, and is being adopted in other jurisdictions. The paper concludes by looking at the prospects for real transformation of education in Northern Ireland.

Balancing cultural diversity and social cohesion in education: The potential of shared education in divided contexts

This article considers how the education systems of divided societies have been shaped in response to the experience of ethnic and religious conflict. The analysis identifies two competing priorities in such contexts – the development of social cohesion and the protection of cultural, ethnic and religious identities - and explores how these may be reconciled through a model of ‘shared education’. Drawing on research evidence and recent experience of shared education in relation to Northern Ireland, the Former Yugoslav Republic of Macedonia and Cyprus, we reflect on the advantages and challenges of this model in areas experiencing conflict and division.