Reconfiguring or reproducing intra-professional boundaries? Specialist expertise, generalist knowledge and the ‘modernization’ of the medical workforce

Efforts to ‘modernize’ the clinical workforce of the English National Health Service have sought to reconfigure the responsibilities of professional groups in pursuit of more effective, joined-up service provision. Such efforts have met resistance from professions eager to protect their jurisdictions, deploying legitimacy claims familiar from the insights of the sociology of professions. Yet to date few studies of professional boundaries have grounded these insights in the specific context of policy challenges to the inter- and intra-professional division of labour, in relation the medical profession and other health-related occupations. In this paper we address this gap by considering the experience of newly instituted general practitioners (family physicians) with a special interest (GPSIs) in genetics, introduced to improve genetics knowledge and practice in primary care. Using qualitative data from four comparative case studies, we discuss how an established intra-professional division of labour within medicine—between clinical geneticists and GPs—was opened, negotiated and reclosed in these sites. We discuss the contrasting attitudes towards the nature of genetics knowledge and its application of GPSIs and geneticists, and how these were used to advance conflicting visions of what the nascent GPSI role should involve. In particular, we show how the claims to knowledge of geneticists and GPSIs interacted with wider policy pressures to produce a rather more conservative redistribution of power and responsibility across the intra-professional boundary than the rhetoric of modernization might suggest.

Pharmacists’ knowledge and perception of topical antibacterial drug dispensing in community pharmacy setting in Kedah, Malaysia

Purpose: To assess Pharmacists’ Perceptions and Experiences of Topical Antibacterial Drug Dispensing in Community Pharmacy Setting in Kedah State, Malaysia in order to minimize drug resistance issues. Methods: A cross-sectional study involving a pre-validated questionnaire was conducted in community pharmacies within Kedah State, Malaysia. Descriptive statistics and Spearman’s correlation coefficient were used for data analysis. The collected were analysed using statistical package for social sciences (SPSS) version 18.0. Results: The result shows that, 53.4 % of CPs in Kedah State perceived that topical antibacterial is not necessary for every topical bacterial infection. Fusidic acid was the most frequently dispensed topical antibacterial drug while superficial wound was reported to be the most frequently encountered topical bacterial infection. CPs (12.60 %) encountered antibacterial resistance cases but none reported them. The drug that had resistance issue was neomycin. Conclusion: CPs in Kedah State, Malaysia generally have the right perceptions on the dispensing of topical antibacterial drugs. However, their knowledge on the rational use of topical antibacterial drugs and vigilance on antibacterial resistance issue need improvement.

Part-time and fractional staff in the learning and skills sector

This Universities and College Union Launch Event presentation reported on the findings of Learning and Skills Research Network (LSRN) London and South East (LSE) Regional Research Project. The presentation reflected on research carried out during 2002-06 on the development and deployment of part-time staff in the Learning and Skills Sector. Although the lifelong learning sector is the largest UK education sector, little attention has as yet been paid to the role of LSC sector part-time staff. Worrying trends of an increasing casualisation of staffing have been reported. The role of part-timers as highly committed (philanthropic) but generally underpaid and exploited staff (ragged-trousered) emerged from the data collected by this investigation, which examined the role of part-timers in several colleges and adult education institutions in London and the South East. The metaphor of the 'ragged-trousered philanthropist' was consciously selected to investigate the interactivity between philantrophy, employment practices for PT staff, and education as social action, in addressing the need for good practice to achieve quality outcomes in learning and teaching. The results are to some extent transferable to other education and training sectors employing part-time staff, e.g. higher education institutions and work-based training organisations.

Semantics, knowledge and grids on big data

Semantics, knowledge and Grids represent three spaces where people interact, understand, learn and create. Grids represent the advanced cyber-infrastructures and evolution. Big data influence the evolution of semantics, knowledge and Grids. Exploring semantics, knowledge and Grids on big data helps accelerate the shift of scientific paradigm, the fourth industrial revolution, and the transformational innovation of technologies.

Knowledge and attitudes towards dietary fibers - romania vs other european countries

Aim: The aim of our study was to evaluate the Romanian’s knowledge and attitudes regarding dietary fibers compared with other European countries. Materials and methods: We made a cross-sectional survey (part of multinational project from CI&DETS Research Centre, Instituto Politecnico Viseu, Portugal, with reference PROJ/CI&DETS/2014/0001) based on a questionnaire applied in 2015, over 670 Romanian consumers, focused on the attitudes and knowledge towards ingestion of foods rich in fibers. We used the software SPSS for statistics. Results: Our results showed that the knowledge about dietary fibers and also the ingestion of food products rich in fibers were low. The female participants ate more whole grains and fruits than males and pay more attention to food labelling, the Romanian people prefer to stay and eat home than at restaurants especially in rural areas, and the knowledge about fiber’s benefits was significantly related to high education and urban location. Comparing to other European countries, Romania had the highest level of knowledge about dietary fibers definition followed by Portugal, Turkey and Hungary, but the lowest regarding the fibers importance for health after Macedonia, Turkey and Latvia. Conclusion: We sustain the needs for more efficient community interventions and proper information about the importance of dietary fibers for our health and also for the dissemination of the nutritional standards among Romanian population.

Romanian Knowledge and Attitudes regarding Dietary Fibers

Presently, the scientists recognize the health benefits of food fibers in the menu and also plant food sources are at high interest both for general population and food companies. The food companies are responsible for a clear nutrition labelling that will assist consumers to make informed and healthy choices and health providers has to inform the population about the benefits of fibers.The aim of our study was to evaluate the Romanian knowledge and attitudes regarding dietary fibers from food products. We made a qualitative survey based on a questionnaire applied in 2015, over a period of 6 months, over 670 Romanian consumers. It was focused on testing the attitudes and knowledge towards ingestion of foods rich in fibers. For all data analysis we used the software SPSS, from IBM Inc. Our results showed that the knowledge about dietary fibers and also the ingestion of food products rich in fibers were low, and most of the subjects didn’t have any interest to read the nutritional information from food labels. The female participants ate more whole grains and fruits than males and pay more attention to food labelling. Romanian people prefer to stay and eat home than at restaurants especially in rural areas, and the knowledge about fibers benefits was significantly related to education and urban location. We underline the needs for more efficient community interventions and proper information about the importance of dietary fibers for our health and also to improve and disseminate nutritional standards and diet recommendation among population.

Traditional Toys and Student Motivation and Commitment in Technological Education

Problem Statement: This research aims to understand the contribution of traditional toys as catalysts for motivation and student commitment in the development of Technological Education projects and activities. Research Questions: To what extent do work units related to traditional toys promote student motivation and commitment in the subject of Technological Education. Purpose of Study: Technological Education requires students to gain knowledge and know-how such that motivation and commitment are crucial for the development of classroom projects and activities. It is in this context that traditional toys are assumed to be catalysts for motivation and student interest. Research Methods: In terms of methodology, an exploratory research of a qualitative nature was carried out, based on semi-structured interviews to teachers and students within a 2nd cycle of Basic Education environment, encompassing five state schools in the Viseu municipality, Portugal. Nine teachers and forty-five technological education pupils, aged between 10 and 12, attending the 5th and 6th years of schooling participated. Findings: Content analysis of the answers revealed that the implementation of work units involving the construction of traditional toys are conducive to student motivation and commitment. Starting off with an initial idea, pupils are enabled to experience all the stages of toy building, from conception to completion, contributing to greater student satisfaction in the teaching-learning process. Conclusions: The traditional toys constitute an added value in the subject of Technological Education, promoting student motivation and commitment in the development of projects and activities. Students acquire knowledge and skills, which will enable them to analyze and thus resolve specific situations and prepare them for an increasingly technological world.

Knowledge and writing in school mathematics : a communicational approach

This thesis is about young students’ writing in school mathematics and the ways in which this writing is designed, interpreted and understood. Students’ communication can act as a source from which teachers can make inferences regarding students’ mathematical knowledge and understanding. In mathematics education previous research indicates that teachers assume that the process of interpreting and judging students’ writing is unproblematic. The relationship between what students’ write, and what they know or understand, is theoretical as well as empirical. In an era of increased focus on assessment and measurement in education it is necessary for teachers to know more about the relationship between communication and achievement. To add to this knowledge, the thesis has adopted a broad approach, and the thesis consists of four studies. The aim of these studies is to reach a deep understanding of writing in school mathematics. Such an understanding is dependent on examining different aspects of writing. The four studies together examine how the concept of communication is described in authoritative texts, how students’ writing is viewed by teachers and how students make use of different communicational resources in their writing. The results of the four studies indicate that students’ writing is more complex than is acknowledged by teachers and authoritative texts in mathematics education. Results point to a sophistication in students’ approach to the merging of the two functions of writing, writing for oneself and writing for others. Results also suggest that students attend, to various extents, to questions regarding how, what and for whom they are writing in school mathematics. The relationship between writing and achievement is dependent on students’ ability to have their writing reflect their knowledge and on teachers’ thorough knowledge of the different features of writing and their awareness of its complexity. From a communicational perspective the ability to communicate [in writing] in mathematics can and should be distinguished from other mathematical abilities. By acknowledging that mathematical communication integrates mathematical language and natural language, teachers have an opportunity to turn writing in mathematics into an object of learning. This offers teachers the potential to add to their assessment literacy and offers students the potential to develop their communicational ability in order to write in a way that better reflects their mathematical knowledge.

Integrated soil fertility management in eastern and western Africa: The role of knowledge and innovation systems, its adoption and impact

The rise in population growth, as well as nutrient mining, has contributed to low agricultural productivity in Sub-Saharan Africa (SSA). A plethora of technologies to boost agricultural production have been developed but the dissemination of these agricultural innovations and subsequent uptake by smallholder farmers has remained a challenge. Scientists and philanthropists have adopted the Integrated Soil Fertility Management (ISFM) paradigm as a means to promote sustainable intensification of African farming systems. This comparative study aimed: 1) To assess the efficacy of Agricultural Knowledge and Innovation Systems (AKIS) in East (Kenya) and West (Ghana) Africa in the communication and dissemination of ISFM (Study I); 2) To investigate how specifically soil quality, and more broadly socio-economic status and institutional factors, influence farmer adoption of ISFM (Study II); and 3) To assess the effect of ISFM on maize yield and total household income of smallholder farmers (Study III). To address these aims, a mixed methodology approach was employed for study I. AKIS actors were subjected to social network analysis methods and in-depth interviews. Structured questionnaires were administered to 285 farming households in Tamale and 300 households in Kakamega selected using a stratified random sampling approach. There was a positive relationship between complete ISFM awareness among farmers and weak knowledge ties to both formal and informal actors at both research locations. The Kakamega AKIS revealed a relationship between complete ISFM awareness among farmers and them having strong knowledge ties to formal actors implying that further integration of formal actors with farmers’ local knowledge is crucial for the agricultural development progress. The structured questionnaire was also utilized to answer the query pertaining to study II. Soil samples (0-20 cm depth) were drawn from 322 (Tamale, Ghana) and 459 (Kakamega, Kenya) maize plots and analysed non-destructively for various soil fertility indicators. Ordinal regression modeling was applied to assess the cumulative adoption of ISFM. According to model estimates, soil carbon seemed to preclude farmers from intensifying input use in Tamale, whereas in Kakamega it spurred complete adoption. This varied response by farmers to soil quality conditions is multifaceted. From the Tamale perspective, it is consistent with farmers’ tendency to judiciously allocate scarce resources. Viewed from the Kakamega perspective, it points to a need for farmers here to intensify agricultural production in order to foster food security. In Kakamega, farmers with more acidic soils were more likely to adopt ISFM. Other household and farm-level factors necessary for ISFM adoption included off-farm income, livestock ownership, farmer associations, and market inter-linkages. Finally, in study III a counterfactual model was used to calculate the difference in outcomes (yield and household income) of the treatment (ISFM adoption) in order to estimate causal effects of ISFM adoption. Adoption of ISFM contributed to a yield increase of 16% in both Tamale and Kakamega. The innovation affected total household income only in Tamale, where ISFM adopters had an income gain of 20%. This may be attributable to the different policy contexts under which the two sets of farmers operate. The main recommendations underscored the need to: (1) improve the functioning of AKIS, (2) enhance farmer access to hybrid maize seed and credit, (3) and conduct additional multi-locational studies as farmers operate under varying contexts.

Transportation of Children in Ground Ambulances: Professionals' Knowledge and Safety Measures

Background: The transport of children in ground ambulances is a rarely studied topic worldwide. The ambulance vehicle is a unique and complex environment with particular challenges for the safe, correct and effective transportation of patients. Unlike the well developed and readily available guidelines on the safe transportation of a child in motor vehicles, there is a lack on consistent specifications for transporting children in ambulances. Nurses are called daily to transfer children to hospitals or other care centers, so safe transport practices should be a major concern. Purpose: to know which are the safety precautions and specific measures used in the transport of children in ground ambulances by nurses and firefighters and to identify what knowledge these professionals had about safe modes of children transportation in ground ambulances. Methods: In this context, an exploratory - descriptive study and quantitative analysis was conducted. A questionnaire was completed by 135 nurses and firefighters / ambulance crew based on 4 possible children transport scenarios proposed by the NHTSA (National Highway Traffic Safety Administration) and covered 5 different children´s age groups (new born children, 1 to 12 months; 1 to 3 years old; 4 to 7 years old and 8 to 12 years old). Results: The main results showed a variety of safety measures used by the professionals and a significant difference between their actual mode of transportation and the mode they consider to be the ideal considering security goals. In addition, findings showed that achieved scores related to what ambulance crews do in the considered scenarios reflect mostly satisfactory levels of transportation rather than optimum levels of safety, according to NHTSA recommendations. Variables as gender, educational qualifications, occupational group and local where professionals work seem to influence the transport options. Female professionals and nurses from pediatric units appear to do a safer transportation of children in ground ambulances than other professionals. Conclusion: Several professionals refereed unawareness of the safest transportation options for children in ambulances and did not to know the existence of specific recommendations for this type of transportation. The dispersion of the results suggests the need for investment in professional training and further regulation for this type of transportation.

Transportation of Children In Ground Ambulances: Professionals' Knowledge and Safety Measures.

Summary The transport of children in ground ambulances is a rarely studied topic worldwide. The ambulance vehicle is a unique environment with particular challenges for the safe, correct and effective transportation of patients. Unlike the well developed and available guidelines on the transportation of children in motor vehicles, there is a lack on specifications for transporting children in ambulances. Nurses are called daily to transfer children to hospitals or other care centres, so safe transport practices should be a major concern. Methods An exploratory - descriptive study and quantitative analysis was conducted. The safety measures used by the professionals in the transportation of children in ambulances were analysed based on the NHTSA (National Highway Traffic Safety Administration) recommendations. A questionnaire was applied to 135 nurses and firefighters/crew of Portuguese ambulances using 4 possible transport situations and covering 5 paediatric age groups. Results There are a variety of safety measures used by professionals and a significant difference between actual mode of transportation and the mode they consider to be the ideal. In addition, findings showed that scores related to what ambulance crews do in these scenarios reflect most satisfactory levels of transportation rather than the optimum levels, according to NHTSA recommendations. Variables as gender, educational qualifications, occupational group and local where professionals work seem to influence the transport options. Female professionals and pediatric nurses do a safer transportation of children in ambulances than other professionals. Conclusion The results suggest the need for investment in professional training and further regulation for this type of transportation.

E-Procurement and Innovation in the Portuguese Municipalities: When Change Is Mandatory

Changing the traditional pattern of public procurement for an electronic paradigm is a radical innovation involving major organizational changes, the breaking up of traditional processes and practices, obsolescence of knowledge and skills. Going beyond the European Commission's recommendations, in 2009 Portugal pioneered in making e-procurement mandatory in the pre-award phase, in a European context of multiple technical standards and lack of interoperability of electronic platforms across the EU countries. Six years later, when the creation of a European e-procurement single market is a EU mission and a major legislative amendment is underway in Portugal, this study looks at the relationship between e-procurement and innovation in the Portuguese municipalities aiming to understand the extent into which the adoption of e-procurement embraced a real organizational change or, on the other hand, if it just represented a mere adaptation of the usual procurement practices. The study draws on data from an electronic survey to all municipalities in mainland Portugal and the analysis is mainly descriptive and exploratory. The paradigm shift in public procurement involves major organizational changes but, overall, the results suggest that most municipalities do not have a clear understanding of the innovative scope (depth and diversity) implied by e-procurement. E-procurement shows advantages over the paper-based model but an unbalanced perception of the innovation dimensions has influenced the implementation of e-procurement and the degree of organizational change.

Psicologia, diretrizes curriculares e processos educativos na Amazônia: um estudo da formação de psicólogos

Este estudo objetiva analisar a formação de psicólogos frente às Diretrizes Curriculares Nacionais para os Cursos de Psicologia no que tange aos processos educativos. Realizamos revisão da literatura pertinente ao tema, pesquisa documental e empírica com alunos, professores e coordenador de curso, utilizando questionário, entrevistas e adotando a estratégia de triangulação a partir das categorias: perfil sociocultural; nível de conhecimento acerca das mudanças oriundas das Diretrizes para o curso de Psicologia; percepção na qualidade da prática docente; nível de satisfação com relação à própria formação universitária, tomando como referência os conhecimentos, habilidades e competências adquiridas. Apresenta contribuições para a compreensão da formação de psicólogos no campo da educação na Amazônia no Ensino Superior, centrada na construção de um profissional de pensamento e prática críticos, capaz de analisar as transformações nos vários contextos educacionais e escolares, utilizando referenciais que permitam a compreensão do fenômeno educativo na sua complexidade.

e-learning in the classroom?

As teachers, we are challenged everyday to solve pedagogical problems and we have to fight for our students’ attention in a media rich world. I will talk about how we use ICT in Initial Teacher Training and give you some insight on what we are doing. The most important benefit of using ICT in education is that it makes us reflect on our practice. There is no doubt that our classrooms need to be updated, but we need to be critical about every peace of hardware, software or service that we bring into them. It is not only because our budgets are short, but also because e‐learning is primarily about learning, not technology. Therefore, we need to have the knowledge and skills required to act in different situations, and choose the best tool for the job. Not all subjects are suitable for e‐learning, nor do all students have the skills to organize themselves their own study times. Also not all teachers want to spend time programming or learning about instructional design and metadata. The promised land of easy use of authoring tools (e.g. eXe and Reload) that will lead to all teachers become Learning Objects authors and share these LO in Repositories, all this failed, like previously HyperCard, Toolbook and others. We need to know a little bit of many different technologies so we can mobilize this knowledge when a situation requires it: integrate e‐learning technologies in the classroom, not a flipped classroom, just simple tools. Lecture capture, mobile phones and smartphones, pocket size camcorders, VoIP, VLE, live video broadcast, screen sharing, free services for collaborative work, save, share and sync your files. Do not feel stressed to use everything, every time. Just because we have a whiteboard does not mean we have to make it the centre of the classroom. Start from where you are, with your preferred subject and the tools you master. Them go slowly and try some new tool in a non‐formal situation and with just one or two students. And you don’t need to be alone: subscribe a mailing list and share your thoughts with other teachers in a dedicated forum, even better if both are part of a community of practice, and share resources. We did that for music teachers and it was a success, in two years arriving at 1.000 members. Just do it.

O modelo transteórico de mudança de comportamentos na promoção da actividade física nas grávidas

Os hábitos de actividade física (AF) podem-se alterar consideravelmente durante a gravidez. O sucesso das estratégias que visam promover a AF das gestantes depende do modelo motivacional implementado. Objectivo: Determinar se o Modelo Transteórico de Mudança de Comportamento (MTMC) utilizado no Projecto “Mães em Movimento” é eficaz na promoção de mudança de comportamentos nas grávidas no sentido de aumentar os níveis de AF. Metodologia: Foi realizado um estudo, experimental do tipo Intervenção Comunitária, numa amostra consecutiva constituída por 20 grávidas que faziam Preparação para a Parentalidade (PP) em dois Centros de Saúde. O grupo experimental, constituído por 10 grávidas, além da preparação, participou no projecto “Mães em Movimento” baseado no MTMC. O grupo de controlo seguiu o programa de PP. Os instrumentos utilizados para 1ª avaliação foram: o Questionário de Actividade Física para Gestantes, a Escala de Estados de Mudança de Comportamento para o Exercício, o Questionário de Auto-Eficácia, o Behavioural Regulation in Exercise Questionnaire-2 e um Questionário de Hábitos e Conhecimentos. Resultados: Após a implementação do projecto “Mães em Movimento” no grupo experimental, 100% das mulheres referiram praticar AF regular. O gasto energético semanal em actividades desportivas/exercício aumentou aproximadamente 4 vezes (p=0,002) desde a 1ª avaliação até à 2ª avaliação. Verificou-se uma tendência de deslocação dos estadios de mudança de comportamento inactivos para os activos (p=0,007) e a motivação intrínseca aumentou significativamente (p=0,018). Observou-se, também, um aumento dos conhecimentos relativos a diversas dimensões da AF na gravidez (p=0,002). Conclusão: Neste estudo, o MTMC revelou-se um modelo eficaz na promoção de hábitos de AF em grávidas, realçando que o sucesso da mudança de comportamento é influenciado pela motivação individual, pelo empowerment (transferência de conhecimentos e competências) e pelas oportunidades criadas.