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.

Beyond personal Leader Member Exchange (LMX) quality:the effects of perceived LMX variability on employee reactions

A fundamental tenet of Leader–Member Exchange (LMX) theory is that leaders develop different quality relationships with their employees; however, little research has investigated the impact of LMX differentiation on employee reactions. The current research investigates whether perceptions of LMX variability (the extent to which LMX relationships are perceived to vary within a team) affects employee job satisfaction and wellbeing beyond the effects of personal LMX quality. As LMX variability runs counter to principles of equality and consistency, which are important for maintaining social harmony in groups, it is hypothesized that perceptions of LMX variability will have a negative effect on employee reactions, via its negative impact on perceived team relations. Two samples of employed individuals were used to investigate the hypothesized relationships. In both samples, an individual's perception of LMX variability in their team was negatively related to employee job satisfaction and wellbeing (above the effects of LMX), and this relationship was mediated by reports of relational team conflict.

On waveform analysis, the adaptive task technique, and the effect of vibration on manual control skill

A re-examination of fundamental concepts and a formal structuring of the waveform analysis problem is presented in Part I. eg. the nature of frequency is examined and a novel alternative to the classical methods of detection proposed and implemented which has the advantage of speed and independence from amplitude. Waveform analysis provides the link between Parts I and II. Part II is devoted to Human Factors and the Adaptive Task Technique. The Historical, Technical and Intellectual development of the technique is traced in a review which examines the evidence of its advantages relative to non-adaptive fixed task methods of training, skill assessment and man-machine optimisation. A second review examines research evidence on the effect of vibration on manual control ability. Findings are presented in terms of percentage increment or decrement in performance relative to performance without vibration in the range 0-0.6Rms'g'. Primary task performance was found to vary by as much as 90% between tasks at the same Rms'g'. Differences in task difficulty accounted for this difference. Within tasks vibration-added-difficulty accounted for the effects of vibration intensity. Secondary tasks were found to be largely insensitive to vibration except secondaries which involved fine manual adjustment of minor controls. Three experiments are reported next in which an adaptive technique was used to measure the % task difficulty added by vertical random and sinusoidal vibration to a 'Critical Compensatory Tracking task. At vibration intensities between 0 - 0.09 Rms 'g' it was found that random vibration added (24.5 x Rms'g')/7.4 x 100% to the difficulty of the control task. An equivalence relationship between Random and Sinusoidal vibration effects was established based upon added task difficulty. Waveform Analyses which were applied to the experimental data served to validate Phase Plane analysis and uncovered the development of a control and possibly a vibration isolation strategy. The submission ends with an appraisal of subjects mentioned in the thesis title.

Dyslexia - towards diagnosis : the implications of corical laterality for children's reading difficulties

Dyslexia as a concept is defined and reviewed in a context of psychological, neurological and educational processes. In the present investigation these processes are recognised but emphasis is placed on dyslexia as a phenomenon of a written language system. The type of script system involved in the phenomenon is that of an alphabetic code representing phonological elements of language In script form related to meaning. The nature of this system is viewed In the light of current linguistic and psycholinguistic studies. These studies based as they are on an analysis of underlying written language structures provide a framework for examining the arbitrary and rule-governed system which a young child is expected to acquire. There appear to be fundamental implications for reading, spelling and writing processes; for example an alphabetic system requires recognition of consistent script-phonetic relationships, 'mediated word identification' and in particular uni-directional sensory and motor modes of perceiving. These are critical maturational factors in the young learner. The skills needed by the child for decoding and encoding such a phonemic script are described in a psychological and neuropsychological framework. Evidence for individual differences in these skills is noted and the category of the dyslexic-type learner emerges. Incidence is related to the probabilities of individual differences in lateralisation of brain function not favouring the acquisition of our script system In some cases. Dyslexia is therefore regarded as a primary difficulty consequent upon the incompatibility between:the written language system itself and the intrinsic, developmental skills of an individual's perceptual/motor system. It is recognised that secondary stresses e.g. socio-cultural deprivation, low intellectual potential or emotional trauma can further inhibit the learning process. Symptomology of a dyslexic syndrome is described.. The symptomology is seen by the writer to constitute a clinical entity. a specific category of learning difficulty for which predictive and diagnostic procedure could be devised for classroom use. Consequently an index of relevant test items has been compiled, based upon key clinical experiences and theoretical writings. This instrument knovn as the Aston Index is presented and discussed. The early stages of validation are reported and the proposed longtitudinal studies are described. The aim is to give teachers in the classroom the power and understanding to plan more effectively the earliest stages of teaching and learning; in particular to provide the means of matching the nature of the skill to be acquired with the underlying developmental patterns of each individual learner.

Beta frequency neuronal network activity in the primary motor cortex

In this study I investigated the mechanisms of neuronal network oscillatory activity in rat M1 using pharmacological manipulations and electrical stimulation protocols, employing the in vitro brain slice technique in rat and magnetoencephalography (MEG) in man. Co-application of kainic acid and carbachol generated in vitro beta oscillatory activity in all layers in M1. Analyses indicated that oscillations originated from deep layers and indicated significant involvement of GABAA receptors and gap junctions. A modulatory role of GABAB, NMDA, and dopamine receptors was also evident. Intracellular recordings from fast-spiking (FS) GABAergic inhibitory cells revealed phase-locked action potentials (APs) on every beta cycle. Glutamatergic excitatory regular-spiking (RS) and intrinsically-bursting (IB) cells both received phase locked inhibitory postsynaptic potentials, but did not fire APs on every cycle, suggesting the dynamic involvement of different pools of neurones in the overall population oscillations. Stimulation evoked activity at high frequency (HFS; 125Hz) evoked gamma oscillations and reduced ongoing beta activity. 20Hz stimulation promoted theta or gamma oscillations whilst 4Hz stimulation enhanced beta power at theta frequency. I also investigated the modulation of pathological slow wave (theta and beta) oscillatory activity using magnetoencephalography. Abnormal activity was suppressed by sub-sedative doses of GABAA receptor modulator zolpidem and the observed desynchronising effect correlated well with improved sensorimotor function. These studies indicate a fundamental role for inhibitory neuronal networks in the patterning beta activity and suggest that cortical HFS in PD re-patterns abnormally enhanced M1 network activity by modulating the activity of FS cells. Furthermore, pathological oscillation may be common to many neuropathologies and may be an important future therapeutic target.

Developing translation competence

This volume presents a comprehensive study of what constitutes Translation Competence, from the various sub-competences to the overall skill. Contributors combine experience as translation scholars with their experience as teachers of translation. The volume is organized into three sections: Defining, Building, and Assessing Translation Competence. The chapters offer insights into the nature of translation competence and its place in the translation training programme in an academic environment and show how theoretical considerations have contributed to defining, building and assessing translation competence, offering practical examples of how this can be achieved. The first section introduces major sub-competences, including linguistic, cultural, textual, subject, research, and transfer competence. The second section presents issues relating to course design, methodology and teaching practice. The third section reflects on criteria for quality assessment.

Characteristics of motor resonance predict the pattern of flash-lag effects for biological motion

Background - When a moving stimulus and a briefly flashed static stimulus are physically aligned in space the static stimulus is perceived as lagging behind the moving stimulus. This vastly replicated phenomenon is known as the Flash-Lag Effect (FLE). For the first time we employed biological motion as the moving stimulus, which is important for two reasons. Firstly, biological motion is processed by visual as well as somatosensory brain areas, which makes it a prime candidate for elucidating the interplay between the two systems with respect to the FLE. Secondly, discussions about the mechanisms of the FLE tend to recur to evolutionary arguments, while most studies employ highly artificial stimuli with constant velocities. Methodology/Principal Finding - Since biological motion is ecologically valid it follows complex patterns with changing velocity. We therefore compared biological to symbolic motion with the same acceleration profile. Our results with 16 observers revealed a qualitatively different pattern for biological compared to symbolic motion and this pattern was predicted by the characteristics of motor resonance: The amount of anticipatory processing of perceived actions based on the induced perspective and agency modulated the FLE. Conclusions/Significance - Our study provides first evidence for an FLE with non-linear motion in general and with biological motion in particular. Our results suggest that predictive coding within the sensorimotor system alone cannot explain the FLE. Our findings are compatible with visual prediction (Nijhawan, 2008) which assumes that extrapolated motion representations within the visual system generate the FLE. These representations are modulated by sudden visual input (e.g. offset signals) or by input from other systems (e.g. sensorimotor) that can boost or attenuate overshooting representations in accordance with biased neural competition (Desimone & Duncan, 1995).

Fault diagnosis scheme for open-circuit faults in switched reluctance motor drives using fast Fourier transform algorithm with bus current detection

Reliability of power converters is of crucial importance in switched reluctance motor drives used for safety-critical applications. Open-circuit faults in power converters will cause the motor to run in unbalanced states, and if left untreated, they will lead to damage to the motor and power modules, and even cause a catastrophic failure of the whole drive system. This study is focused on using a single current sensor to detect open-circuit faults accurately. An asymmetrical half-bridge converter is considered in this study and the faults of single-phase open and two-phase open are analysed. Three different bus positions are defined. On the basis of a fast Fourier transform algorithm with Blackman window interpolation, the bus current spectrums before and after open-circuit faults are analysed in details. Their fault characteristics are extracted accurately by the normalisations of the phase fundamental frequency component and double phase fundamental frequency component, and the fault characteristics of the three bus detection schemes are also compared. The open-circuit faults can be located by finding the relationship between the bus current and rotor position. The effectiveness of the proposed diagnosis method is validated by the simulation results and experimental tests.

Effects of worked examples and algebra problem -solving skill on error and cognitive load

This study determined the levels of algebra problem solving skill at which worked examples promoted learning of further problem solving skill and reduction of cognitive load in college developmental algebra students. Problem solving skill was objectively measured as error production; cognitive load was subjectively measured as perceived mental effort. ^ Sixty-three Ss were pretested, received homework of worked examples or mass problem solving, and posttested. Univarate ANCOVA (covariate = previous grade) were performed on the practice and posttest data. The factors used in the analysis were practice strategy (worked examples vs. mass problem solving) and algebra problem solving skill (low vs. moderate vs. high). Students in the practice phase who studied worked examples exhibited (a) fewer errors and reduced cognitive load, at moderate skill; (b) neither fewer errors nor reduced cognitive load, at low skill; and (c) only reduced cognitive load, at high skill. In the posttest, only cognitive load was reduced. ^ The results suggested that worked examples be emphasized for developmental students with moderate problem solving skill. Areas for further research were discussed. ^

The self-perceived effects on faculty that result from the experience of serving in a residential college

The purpose of this phenomenological study was to examine the effects that faculty who live in residence with college students perceive result from their experience. This study examined the perspectives from current and recent residential faculty members. Data were gathered through structured interviews with current and former residential faculty who gave firsthand accounts of how they felt that experience impacted them. A pilot study had been previously conducted that enabled the researcher to modify and adjust the dissertation methodology accordingly, based upon the findings of the pilot study. The pilot study, in short, found that residential faculty members felt they gained from the experience in terms of relationships with students and other faculty while facing a few small challenges. Literature consistently showed that faculty-student interaction is very important to the development and success of students (Astin, 1993). Research has clearly demonstrated positive outcomes that result for students; the literature review revealed this information is plentiful. There is a dearth of research, however, regarding this impact on the faculty members themselves. Given the importance of faculty-student interaction outside of the classroom, it is crucial to recruit faculty for these communities. Thus, more information regarding this experience will be valuable. The study was conducted at a mid-sized private university in the Southeastern United States. The reason for this choice was the fact that this school has a 25-year history as a residential college system and utilizes 12–15 residential faculty members yearly. The researcher conducted interviews with 13 faculty members and coded and analyzed the data, then prepared the findings of the study based on the results. The data resulting from the study indicated that faculty perceived great benefits from serving as residential college faculty members. Perceived benefits as described by the participants included increased skill in teaching, feeling a sense of community, stronger relationships with other faculty members and students, and an increased affinity toward the university. While there were some challenges such as lack of training, politics, and loss of privacy all participants in the study felt they gained from the opportunity and would do it again in the same situation. This study enhanced the limited formal knowledge available regarding how faculty experience living in residential colleges with students.

Estimulação transcraniana por corrente contínua (ETCC) sobre o córtex motor na modulação autonômica em pessoas com lesão medular com diferentes graus e níveis de lesão

Introduction: Transcranial Direct Current Stimulation (tDCS) has been used in studies for the treatment of chronic pain, but their effects on the autonomic nervous system (ANS) are non-existent. Therefore, the need for studies is of fundamental importance, as these individuals have autonomic imbalance and the intensity of this is dependent on the degree and level of injury. Objective: We investigated the effect of tDCS on the ANS in people with spinal cord injury (SCI) with different degrees and levels of injury. Methods: Randomized, placebo-controlled, double-blind, applied anodal tDCS or sham on the primary motor cortex (M1), bilaterally. The subjects (lower incomplete injury, n = 7; lower complete injury, n = 9; and high complete thoracic injury, n = 3) visited the laboratory three times and received active or sham tDCS for 13min. The heart rate variability (HRV) was measured before, during and after stimulation and analyzed the variables LF, HF and LF / HF. Results: The tDCS modulated the ANS in different ways among the groups. In individuals with SCI high complete thoracic the tDCS did not change the HRV. However, for individuals with SCI low incomplete, tDCS changed the HRV in order to increase sympathetic (LF, p = 0.046) and reduced parasympathetic (HF, p = 0.046). For individuals SCI low complete to tDCS changed the HRV reduction sympathetic (LF, p = 0.017) and increased parasympathetic (HF, p = 0.017). Conclusions: The present study suggests that anodal tDCS applied on the motor cortex bilaterally could modulate the ANS balance in people with spinal cord injury and that this effect is dependent on the degree and level of injury.

A competência leitora de alunos do ensino fundamental: uma proposta de intervenção

Reading is a activity of paramount importance in the life of every human being, since this practice is essential condition for the exercise of citizenship. Therefore, it is through reading that the student has access to the knowledge that part of the world around him. However, given the complexity involved in the process of learning to read, teach students to read is not an easy task because often they do not acquire the skills necessary to understand the texts. According to this view, the present study focuses on an educational intervention who aim at contribut to the development of reading competence of students in 6th grade "U" of the State School Senador José Bernardo, in São João do Sabugi - RN. The activities which were of that intervention process were conducted in Portuguese Language classroom and developed through didactic sequences drawn from reading strategies, based on the genres tale and news, since students had serious problems with regard to reading comprehension. Given the importance of meeting the aforementioned difficulty, we seek to develop a proposal for interactive reading activities through genres as a language of social practices, whose goal aimed read to understand and make sense of texts. This intervention proposal falls under the Applied Linguistics and to perform it, were taken as a basis some theories focused on the notion of language as sociointerativa practice, such as studies of Bakhtin (2006, 2011), Bronckart (2012) and targeted contributions to the teaching of reading activity, including, Solé (1998), Oliveira (2010), Kleiman (2013), Leffa (1996, 1999), Silveira (2005). Discussions about genres followed the studies of Bakhtin (2011), Marcuschi (2008), as well as other theoretical; the didactic sequences were constructed from Bronckart (2012), Dolz; Noverraz; Schneuwly (2013) and, with regard to the teaching of Portuguese Language, the guidelines were adopted contained in PCN / LP (1998), as well as in Antunes (2003, 2009) and other authors. The results showed that students in the 6th grade increased their understanding capacity of the read texts, by implementing the didactic and pedagogical actions, thereby acquiring the reading competence they needed to keep learning.

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

Réalisé en milieu collégial (cégep)

Nurses’ perceptions of nursing presence and the relationship between nursing presence and moral sensitivity in nurses working with people with dementia in residential care

Aim: The aim of this study was to measure nursing presence among nurses caring for people with dementia in residential care settings, and to investigate the relationship between nursing presence and moral sensitivity. Background: Nursing presence is a core relational skill in nursing and holds many benefits for nurses and their patients. Moral sensitivity is defined as how one recognises the moral elements of a situation, and how one’s moral or ethical decision making may impact on an individual. Methods: A descriptive, cross sectional quantitative methodology was used with a sample of 150 registered nurses. The Presence of Nursing Scale for Registered Nurses was used to investigate nursing presence, and the Moral Sensitivity Questionnaire for moral sensitivity. Results: Findings from the study demonstrated that participants agreed with the majority of elements of nursing presence, (mean 76.97, SD= 7.51). A mean score of 36.22 was evidence of a well developed level of moral sensitivity in participants. Nurses who perceived themselves to be highly present to their patients also scored highest on certain elements of moral sensitivity such as moral strength. Nursing presence was also found to be more developed in those participants that rated themselves as having higher levels of expertise based on Benner’s (1984) definitions. Older nurses also scored higher on nursing presence. There was a high level of agreement that factors such as lack of time (n=133), and heavy workload influenced nursing presence. Nurses, who were older and had longer clinical experience, were shown to have greater moral strength. There were differences in elements of moral sensitivity between groups of nurses who ranked themselves according to Benner’s (1984) competence framework with higher scores evident in the more expert groups. Conclusion: Overall, this study showed that participants had a well developed level of nursing presence, and certain elements of moral sensitivity are positively related to nursing presence. Nursing presence appears to be linked to the level of expertise of the nurse but factors such as time and workload do influence nursing presence.

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

Réalisé en milieu collégial (cégep)