Asthma management by New Zealand pharmacists: a pharmaceutical care demonstration project

Background: Pharmaceutical care services became recognized in New Zealand in the mid-1990s, albeit with limited evidence of the acceptability and effectiveness of the model. An asthma-specific pharmaceutical care service was trialled in southern New Zealand, based on a 'problem-action-outcome' method, with pharmacists adopting a patient-centred, outcome-focused approach with multidisciplinary consultation. Objective: To report on the implementation and outcomes of a specialist asthma service offered by community pharmacists. Design: Pharmacists in five pharmacies, servicing predominantly rural, established clientele, received training in the asthma service and research documentation. Ten patients per pharmacy were recruited in each year (years 1 and 2) of the study. The patients were entered into the study in cohorts of five per pharmacy twice yearly, with year 2 mirroring year 1. The phase-in design minimized the impact on the pharmacists. The patients acted as their own controls. All patients received individualized care and had approximately monthly consultations with the pharmacist, with clinical and quality of life (QoL) monitoring. Results: A total of 100 patients were recruited. On average, 4.3 medication-related problems were identified per patient; two-thirds of them were compliance-related. The most common interventions were revision of patients' asthma action plans, referral and medication counselling. Clinical outcomes included reduced bronchodilator use and improved symptom control in around two-thirds of patients. Asthma-specific QoL changes were more positive and correlated well with clinical indicators. Conclusion: Further research is warranted to integrate this service into daily practice. Clinical outcomes were generally positive and supported by QoL indicators. Characteristics of New Zealand practice and this sample of pharmacies may limit the generalizability of these findings.

The International Consortium on Mental Health Policy and Services: objectives, design and project implementation

The concept of the burden of disease, introduced and estimated for a broad range of diseases in the World Bank report of 1993 illustrated that mental and neurological disorders not only entail a higher burden than cancer, but are responsible, in developed and developing countries, for more than 15% of the total burden of all diseases. As a consequence, over the past decade, mental disorders have ranked increasingly highly on the international agenda for health. However, the fact that mental health and nervous system disorders are now high on the international health agenda is by no means a guarantee that the fate of patients suffering from these disorders in developing countries will improve. In most developing countries the treatment gap for mental and neurological disorders is still unacceptably high. To address this problem, an international network of collaborating institutions in low-income countries has been set up. The establishment and the achievements of this network-the International Consortium on Mental Health Policy and Services-are reported. Sixteen institutions in developing countries collaborate (supported by a small number of scientific resource centres in industrialized nations) in projects on applied mental health systems research. Over a two-year period, the network produced the key elements of a national mental health policy; provided tools and methods for assessing a country's current mental health status (context, needs and demands, programmes, services and care and outcomes); established a global network of expertise, i.e., institutions and experts, for use by countries wishing to reform their mental health policy, services and care; and generated guidelines and examples for upgrading mental health policy with due regard to the existing mental health delivery system and demographic, cultural and economic factors.

Impact of Australia's Better Outcomes in Mental Health Care program on psychologists

The aim of this paper was to consider the impact on psychologists of one component of the Australian Government's Better Outcomes in Mental Health Care (BOiMHC) program, namely the Access to Allied Psychological Services (ATAPS) component. This supports psychologists and general practitioners (GPs) to work together to provide optimal mental health care, via 102 projects being conducted by Divisions of General Practice. The paper was informed by data from five sources: a project-based minimum dataset; local project evaluation reports; a forum; a survey of projects: and a survey of Australian Psychological Society (APS) members. Taken together, the data from these sources showed that a significant number of psychologists are providing services through the projects, and the majority are finding it a positive and professionally rewarding experience. There is considerable variability regarding models of retaining, locating and referring to psychologists, and there are pros and cons associated with each. The major problem identified by psychologists is the level of remuneration. BOiMHC is currently moving into a new phase of continuation and expansion, and consideration was given to whether the data point to any changes that could be made to the ATAPS projects during this period of transition. In the main, the data suggest that the status quo should be retained, but the issue of remuneration must be addressed.

Season of birth is associated with anthropometric and neurocognitive outcomes during infancy and childhood in a general population birth cohort

The 'season of birth' effect is one of the most consistently replicated associations in schizophrenia epidemiology. In contrast, the association between season of birth and development in the general Population is relatively poorly understood. The aim of this study was to explore the impact of season of birth on various anthropometric and neurocognitive variables from birth to age seven in a large, community-based birth cohort. A sample of white singleton infants born after 37 weeks gestation (n =22,123) was drawn from the US Collaborative Perinatal Project. Anthropometric variables (weight, head circumference, length/height) and various measures of neurocognitive development, were assessed at birth, 8 months, 4 and 7 years of age. Compared to surnmer/autumn born infants, winter/spring born infants were significantly longer at birth, and at age seven were significantly heavier, taller and had larger head circumference. Winter/spring born infants were achieving significantly higher scores on the Bayley Motor Score at 8 months, the Graham-Ernhart Block Test at age 4, the Wechsler Intelligence Performance and Full Scale scores at age 7, but had significantly lower scores on the Bender-Gestalt Test at age 7 years. Winter/spring birth, while associated with an increased risk of schizophrenia, is generally associated with superior outcomes with respect to physical and cognitive development. (c) 2005 Elsevier B.V. All rights reserved.

Balancing curriculum processes and content in a project centred curriculum - In pursuit of graduate attributes

Chemical engineering education is challenged around the world by demands and rapid changes encompassing a wide range of technical and social drivers. Graduates must be prepared for practice in increasingly diverse workplace environments in which generic or transferable attributes such as communication and teamwork together with technical excellence are mandated by prospective employers and society at large. If academe is to successfully deliver on these graduate attributes, effective curriculum design needs to include appropriate educational processes as well as course content. Conventional teacher centred approaches, stand-alone courses and retro-fitted remedial modules have not delivered the desired outcomes. Development of the broader spectrum of attributes is more likely when students are engaged with realistic and relevant experiences that demand the integration and practice of these attributes in contexts that the students find meaningful. This paper describes and evaluates The University of Queensland's Project Centred Curriculum in Chemical Engineering (PCC), a programme-wide approach to meeting these requirements. PCC strategically integrates project-based learning with more traditional instruction. Data collected shows improved levels of student attainment of generic skills with institutional and nationally benchmarked indicators showing significant increases in student perceptions of teaching quality, and overall satisfaction with the undergraduate experience. Endorsements from Australian academic, professional and industry bodies also support the approach as more effectively aligning engineering education with professional practice requirements.

The impact of learning outcomes in business education: assessing value, relevance and graduate ability in a multi-country study of employers and business graduates

This paper discusses critical findings from a two-year EU-funded research project involving four European countries: Austria, England, Slovenia and Romania. The project had two primary aims. The first of these was to develop a systematic procedure for assessing the balance between learning outcomes acquired in education and the specific needs of the labour market. The second aim was to develop and test a set of meta-level quality indicators aimed at evaluating the linkages between education and employment. The project was distinctive in that it combined different partners from Higher Education, Vocational Training, Industry and Quality Assurance. One of the key emergent themes identified in exploratory interviews was that employers and recent business graduates in all four countries want a well-rounded education which delivers a broad foundation of key business knowledge across the various disciplines. Both groups also identified the need for personal development in critical skills and competencies. Following the exploratory study, a questionnaire was designed to address five functional business areas, as well as a cluster of 8 business competencies. Within the survey, questions relating to the meta-level quality indicators assessed the impact of these learning outcomes on the workplace, in terms of the following: 1) value, 2) relevance and 3) graduate ability. This paper provides an overview of the study findings from a sample of 900 business graduates and employers. Two theoretical models are proposed as tools for predicting satisfaction with work performance and satisfaction with business education. The implications of the study findings for education, employment and European public policy are discussed.

A multilevel investigation of the mediating role of trust in the relationships between leadership and follower outcomes

The following research project investigated the mediating effects of individual trust in the relationships between eight leadership dimensions and follower motivation and efficacy. The research comprised of a total of three studies of which two are individual level analyses investigating the above relationship for individual followers, while the final study established the relationship between the eight dimensions and collective efficacy and group cohesion. A new measure of trust — collective vertical trust — was developed and tested and formed the mediator for the final study. The findings showed that leadership is indeed mediated through trust on both individual and collective level in the majority of relationships. In addition it was shown that individual and collective vertical trust are significantly related. Finally, the final study showed an absence of a significant relationship between trust on both the individual and collective level and organizational performance. The findings contributed to existing research in various ways: 1) the mediating effect of individual trust was established for eight separate leadership dimensions; 2) the studies established that while the indirect effects of leadership on follower motivation are similar amongst all age groups and levels of work experience, more work experienced individuals draw their beliefs in their abilities (i.e., self-efficacy) from alternative sources than leadership or trust in the leader; 3) a new measure of collective trust —collective vertical trust was established; 4) the mediating effect of collective trust was shown to be crucial in leadership effects on collective efficacy and group cohesion; and finally 5) a leadership measure initially designed for executive leaders was refined and tested for non-executive leaders.

A prediction of outcomes: a psychological investigation into cognitive and affective development within the framework of adult literacy provision

This investigation seeks to explore the hypothesis, derived from observation and practice, that there is a strong relationship between the development of literacy skills and the growth of confidence in adult literacy students. Implicit in the developmental approach is the notion of progression towards some cognitive goal. Such a goal necessitates the establishment of a base line of existing attainment, together with subsequent assessment so that progress and development can be measured. The study includes an evaluation of existing formal and informal methods of initial and subsequent assessment and diagnosis available at the time for Adult Literacy Scheme Co-ordinators. Underlying the funding by Cheshire County Council for the project is the assumption that the results will be available for all practitioners and that the tools of measurement may be used by other Adult Literacy Co-ordinators in the County. It is intended, therefore, that this research should result in practical outcomes in which methods of assessment will involve active participation by students as well as by tutors, becoming part of the learning process. It is hypothesised that this kind of co-operation could lead ultimately to self-directed learning and student-independence. For the purposes of this research, a balance is attempted in the use of assessment tools, between standardised tests and informal methods. The study provides facts about students! reading habits; as well as their reading levels, their spelling levels, their handwriting, their writing skills and their writing habits. The study seeks to show the students' feelings towards education, their educational attainments and the type of school which they attended. The study also attempts to come to some measurement of those aspects of student personality which relate to confidence, by means of tests and questionnaires. The study concludes with an examination of the link between cognitive and affective progress.

Project financing 8th edition

The eighth edition is a fundamental and essential update to the seventh edition published in 2000. This new edition examines a comprehensive range of existing and newer topics that are relevant to project financing in 2012 and explores current trends in the project finance and leasing industries. Contributors are experienced academics and practitioners. Since the first edition was published, the financial markets have undergone tremendous upheavals and many new structures and instruments have been created to meet the financing needs of business. This edition considers the wider world of project finance, applicable to such diverse situations as venture capital and leveraged buyouts, and using new approaches such as Islamic finance techniques. The eighth edition is an essential and over-due update to the previous edition published in 2000. The eighth edition updates a comprehensive review of financial and related topics which are relevant to project financing in 2012 and explores current trends in financial modelling of a project, risk management and the private finance initiatives. This is a comprehensive and practical book full of advice and tips for successful project financing, including leasing, offering a clear, easy to understand guide to a complex area with examples. The topic coverage is well organized and complete moving from the fundamentals to the more complex issues. There is an extensive glossary to support readers. Finally the use of 12 practitioner case studies brings many of these complex issues to life. This is the new edition of the clear, easy-to-understand industry-standard text on project financing. With a good overview of a broad area and using principles of project financing to explain complex structures, this book includes lots of examples and case studies (including Eurotunnel, Dabhol, multiple Paiton deals and other recent deals along with subsequent developments) to show the concepts in use, examine outcomes and to ensure you understand important issues such as effective project structuring and financing, financial modelling for project valuation, and risk management. Substantially updated and expanded to provide the latest developments in all aspects of project financing. An important manual reference, this book is a must-have for every project financier's desk. The text unites the domain of project financing with a wealth of project management techniques, supported by diagrams and charts and other pictorial features, where appropriate. All these supporting features facilitate a better understanding of the accompanying text for the reader. In many chapters there are diagrams to clarify the specific transaction structure discussed in the accompanying text. These diagrams enable the reader to get a very clear idea of the transaction structure, which is particularly useful where it is complex or unusual. There are also a number of checklists to assist stakeholders in the project and resource management of complex project financings. The new financial modelling chapters allow exploration of some of the pitfalls project models encounter, challenging the accurate replication of the project cash flows for stakeholders to evaluate. In the later new risk management chapters, worked examples are included to illustrate the techniques in practice. The new public private partnership/private finance initiatives chapter introduces readers to this new approach to public projects. References are made to useful websites throughout the text. Cases are included at the end of the main text to encourage examination of real-life examples of project financing in practice and also highlight specific issues of current interest. The book will be helpful to project finance sponsors, lawyers, host governments, bankers and providers of capital

Practically oriented design projects in mechatronics engineering:a case study of design experiences and outcomes

This paper discusses and presents a case study of a practically oriented design project together with a few examples of implemented design projects recently incorporated into an undergraduate system course at the mechatronics engineering department in Ah-Balqa’ Applied University. These projects have had a positive impact on both the department and its graduates. The focus of these projects is the design and implementation of processor-based system. This helps graduate students cross the border between hardware design and software design. Our case study discusses the research methodology adopted for the physical development of the project, the technology used in the project, and the design experiences and outcomes.

The Impact of Project Manager on Project Success – The Case of ICT Sector

The project management literature on project success is rich. Numerous papers focus on the evolution of the understanding of project success, identification of success criteria and critical success factors. Critical success factors increase the potential for achieving project success, while project success can be evaluated with the help of success criteria. Although the interrelationships between critical success factors and success criteria are rarely analyzed, yet there is a strong demand for it. The aim of this paper is twofold. One of the aims is to identify the impact of one of the critical success factors, the project manager’s project management attitude on project success. The other aim is to highlight the interrelationship between the project manager’s personal characteristics and project management attitude and leadership style, which are three critical success factors. These aim to address the shortcoming mentioned above, which is considering the lack of the interrelationships between critical success factors and success criteria. The research outcomes are drawn from qualitative field research at the Hungarian subsidiaries of multinational companies operating in the ICT sector.

Investigating positive identity development in a school-based youth development project

Adolescence is a pivotal period offering both opportunities and constraints on individual development. It is during this important time that one decides upon and commits to the values, goals, and beliefs which will form one's identity and guide one throughout the lifespan. Positive youth development programs, such as the Miami Youth Development Project's Changing Lives Program, target the formation of a positive sense of identity as a critical intervention point. Through developing a coherent and positive sense of self, adolescents take control of and responsibility for their lives and their decisions. Furthermore, a positive identity has been found to be a developmental asset and is linked to lower risk behaviors and positive outcomes including increased self-esteem, sense of purpose, and a positive view of the future. Positive youth development programs, which promote positive identity development, have been found to be more strongly tied to positive outcomes including skills, values, and competencies than have contextual opportunities. As such, it is critical to determine what leads to positive identity development. ^ The current study used structural equation modeling to evaluate three potential mediators of identity development. Findings indicated good model fit where change in identity commitment and change in identity exploration were mediated by informational identity style, personal expressiveness, and identity distress. There were also significant differences found between the control and intervention groups indicative of intervention effects. The findings of the current study suggest potential areas of intervention as well as the need for further research including longitudinal study and the use of qualitative methodology. ^

How did varying levels of intensity of the 2005 Pakistan earthquake differentially affect women’s fertility decisions and children’s health outcomes?

This paper uses a difference in difference model to investigate the impact of a large scale and high mortality 2005 earthquake in Pakistan on women’s fertility decisions and children’s health outcomes. Using a nationally representative, cross sectional DHS data from 2006 and geographical data from USGS, this paper investigates how variation in earthquake intensity levels can differentially impact total fertility for women and the likelihood of children suffering from diseases such as diarrhea, Acute Respiratory Infections (ARI) and fever. The post-earthquake results demonstrate a statistically significant increase in total fertility for areas closer to the epicenter of the earthquake, within a 100km radius of the rupture surface and at higher altitudes. Similarly, for children who were in-utero at the time of the earthquake, the probability of having early symptoms of ARI or fever was much smaller in lower earthquake intensity zones compared to the highest intensity zone.