Evaluation of the Heart of Birmingham teaching Primary Care Trust (HoBtPCT): My Choice Weight Management Programme:report commissioned by Heart of Birmingham teaching Primary Care Trust

This report details an evaluation of the My Choice Weight Management Programme undertaken by a research team from the School of Pharmacy at Aston University. The My Choice Weight Management Programme is delivered through community pharmacies and general practitioners (GPs) contracted to provide services by the Heart of Birmingham teaching Primary Care Trust. It is designed to support individuals who are ‘ready to change’ by enabling the individual to work with a trained healthcare worker (for example, a healthcare assistant, practice nurse or pharmacy assistant) to develop a care plan designed to enable the individual to lose 5-10% of their current weight. The Programme aims to reduce adult obesity levels; improve access to overweight and obesity management services in primary care; improve diet and nutrition; promote healthy weight and increased levels of physical activity in overweight or obese patients; and support patients to make lifestyle changes to enable them to lose weight. The Programme is available for obese patients over 18 years old who have a Body Mass Index (BMI) greater than 30 kg/m2 (greater than 25 kg/m2 in Asian patients) or greater than 28 kg/m2 (greater than 23.5 kg/m2 in Asian patients) in patients with co-morbidities (diabetes, high blood pressure, cardiovascular disease). Each participant attends weekly consultations over a twelve session period (the final iteration of these weekly sessions is referred to as ‘session twelve’ in this report). They are then offered up to three follow up appointments for up to six months at two monthly intervals (the final of these follow ups, taking place at approximately nine months post recruitment, is referred to as ‘session fifteen’ in this report). A review of the literature highlights the dearth of published research on the effectiveness of primary care- or community-based weight management interventions. This report may help to address this knowledge deficit. A total of 451 individuals were recruited on to the My Choice Weight Management Programme. More participants were recruited at GP surgeries (n=268) than at community pharmacies (n=183). In total, 204 participants (GP n=102; pharmacy n=102) attended session twelve and 82 participants (GP n=22; pharmacy 60) attended session fifteen. The unique demographic characteristics of My Choice Weight Management Programme participants – participants were recruited from areas with high levels of socioeconomic deprivation and over four-fifths of participants were from Black and Minority Ethnic groups; populations which are traditionally underserved by healthcare interventions – make the achievements of the Programme particularly notable. The mean weight loss at session 12 was 3.8 kg (equivalent to a reduction of 4.0% of initial weight) among GP surgery participants and 2.4 kg (2.8%) among pharmacy participants. At session 15 mean weight loss was 2.3 kg (2.2%) among GP surgery participants and 3.4 kg (4.0%) among pharmacy participants. The My Choice Weight Management Programme improved the general health status of participants between recruitment and session twelve as measured by the validated SF-12 questionnaire. While cost data is presented in this report, it is unclear which provider type delivered the Programme more cost-effectively. Attendance rates on the Programme were consistently better among pharmacy participants than among GP participants. The opinions of programme participants (both those who attended regularly and those who failed to attend as expected) and programme providers were explored via semi-structured interviews and, in the case of the participants, a selfcompletion postal questionnaire. These data suggest that the Programme was almost uniformly popular with both the deliverers of the Programme and participants on the Programme with 83% of questionnaire respondents indicating that they would be happy to recommend the Programme to other people looking to lose weight. Our recommendations, based on the evidence provided in this report, include: a. Any consideration of an extension to the study also giving comparable consideration to an extension of the Programme evaluation. The feasibility of assigning participants to a pharmacy provider or a GP provider via a central allocation system should also be examined. This would address imbalances in participant recruitment levels between provider type and allow for more accurate comparison of the effectiveness in the delivery of the Programme between GP surgeries and community pharmacies by increasing the homogeneity of participants at each type of site and increasing the number of Programme participants overall. b. Widespread dissemination of the findings from this review of the My Choice Weight Management Project should be undertaken through a variety of channels. c. Consideration of the inclusion of the following key aspects of the My Choice Weight Management Project in any extension to the Programme: i. The provision of training to staff in GP surgeries and community pharmacies responsible for delivery of the Programme prior to patient recruitment. ii. Maintaining the level of healthcare staff input to the Programme. iii. The regular schedule of appointments with Programme participants. iv. The provision of an increased variety of printed material. d. A simplification of the data collection method used by the Programme commissioners at the individual Programme delivery sites.

A descriptive structural approach to the teaching of written English to foreign students.

DUE TO COPYRIGHT RESTRICTIONS ONLY AVAILABLE FOR CONSULTATION AT ASTON UNIVERSITY LIBRARY AND INFORMATION SERVICES WITH PRIOR ARRANGEMENT

Collaborative alliances and organisational innovation : a study of the innovation process

Despite the voluminous studies written about organisational innovation over the last 30-40 years our understanding of this phenomenon continues to be inconsistent and inconclusive (Wolfe, 1994). An assessment of the theoretical and methodological issues influencing the explanatory utility of many studies has led scholars (e.g. Slappendel, 1996) to re-evaluate the assumptions used to ground studies. Building on these criticisms the current study contributes to the development of an interactive perspective of organisational innovation. This work contributes empirically and theoretically to an improved understanding of the innovation process and the interaction between the realm of action and the mediating effects of pre-existing contingencies i.e. social control, economic exchange and the communicability of knowledge (Scarbrough, 1996). Building on recent advances in institutional theory (see Barley, 1986; 1990; Barley and Tolbert, 1997) and critical theory (Morrow, 1994, Sayer, 1992) the study aims to demonstrate, via longitudinal intensive research, the process through which ideas are translated into reality. This is significant because, despite a growing recognition of the implicit link between the strategic conduct of actors and the institutional realm in organisational analysis, there are few examples that theorise and empirically test these connections. By assessing an under researched example of technology transfer; the government's Teaching Company Scheme (TCS) this project provides a critique of the innovation process that contributes to theory and our appreciation of change in the UK government's premier technology transfer scheme (QR, 1996). Critical moments during the translation of ideas illustrate how elements that are linked to social control, economic exchange and communicability mediate the innovation process. Using analytical categories i.e. contradiction, slippage and dysfunctionality these are assessed in relation to the actions (coping strategies) of programme members over a two-year period. Drawing on Giddens' (1995) notion of the duality of structure this study explores the nature of the relationship between the task environment and institutional environment demonstrating how and why knowledge is both an enabler and barrier to organisational innovation.

Person-oriented and process-oriented teachers : an investigation of the links between ESOL teachers' personal belief systems and approaches to teaching

This thesis looks to two traditions in research into language teaching, teacher beliefs and classroom interaction, in order to investigate the question: Do teachers of ESOL have an identifiable and coherent system of beliefs about teaching and learning that may account for different approaches to teaching? A qualitative approach to research is taken, following a case study tradition, in order to carry out an in-depth study into the beliefs of six ESOL teachers. Five teachers participated in an initial pilot study and two subsequently became the main case studies for the research. The beliefs of a sixth teacher were then investigated to verify the findings. Semi-structured interviews and classroom observations were carried out with all the teachers. The teachers in the study were found to have personal belief systems that cohere around two orientations to teaching and learning - a person orientation and a process orientation. Moreover, the findings suggest that underlying the orientations is the perception that teachers have of their teacher identity, in terms of whether this is seen as a separate identity or as part of their personality. It is suggested that the two orientations may offer a powerful tool for teacher education as it is increasingly recognised that, in order to be effective, teacher educators must take into account the beliefs that teachers bring with them to training and development programmes. An initial investigations into the teachers’ classroom behaviour suggests that while their methodologies approach may be very similar there are fundamental differences in their interactions patterns and these differences may be a result of their own orientation. However, while teachers’ personal belief systems undoubtedly underlie their approach to teaching, further research is needed to establish the extent and the nature of the relationship between orientation and classroom interaction.

The making of an ideology of the third way:the evolution of christian democracy in Germany (with special reference to 1945-49)

This study investigates the search for the third way in the history of German Christian Democracy. Today, in the United Kingdom, the 'third way' is seen as a new phenomenon, a synthesis of post-war belief in the welfare state and neo-liberal conservatism. Yet it insufficiently acknowledges that the origins of third way thinking, the marriage of social justice with free market economics, of individualism with collective responsibility, are found in the early philosophies of Catholic Social Theory and Protestant Social Ethical Teaching in Germany. This study shows that in the hundred years from the 1840s to the end of the 1940s, there were Catholic and Protestant socio-ethical thinkers and political reformists in Germany who attempted to bridge the philosophical differences between liberalism and socialism, to develop a socio-economic order based on Christian moral values. It will focus on the period 1945-1949, when the CDU was founded as the first interdenominational, Christian party. The study provides the first comprehensive account of the political debates in Christian democratic groups in the Soviet, British, French and American allied occupied zones, also giving equal attention to the contribution from the Protestant wing, alongside the more widely acknowledged role of Catholics in the birth of the CDU. It examines how Christian Democrats envisaged correcting the aberrations of German history, by uniting all social classes and Christian religions in one all-embracing Volkspartei, and transforming party politics from its earlier obsession with sectarian and ideological interests towards a more pragmatic 'third way' programme. The study argues that through the making of its ideology, the CDU modified the nation's understanding of its history, re-interpreted its traditions, and redefined the meaning and perception of established political philosophies. This reveals how the ambiguity of political terminology, and the flexible practice of 'third way' politics, were an invaluable political resource in the CDU's campaign for unity, ideological legitimisation and political power.

Cortical mechanisms of attention in time:neural correlates of the Lag-1-sparing phenomenon

If humans monitor streams of rapidly presented (approximately 100-ms intervals) visual stimuli, which are typically specific single letters of the alphabet, for two targets (T1 and T2), they often miss T2 if it follows T1 within an interval of 200-500 ms. If T2 follows T1 directly (within 100 ms; described as occurring at 'Lag 1'), however, performance is often excellent: the so-called 'Lag-1 sparing' phenomenon. Lag-1 sparing might result from the integration of the two targets into the same 'event representation', which fits with the observation that sparing is often accompanied by a loss of T1-T2 order information. Alternatively, this might point to competition between the two targets (implying a trade-off between performance on T1 and T2) and Lag-1 sparing might solely emerge from conditional data analysis (i.e. T2 performance given T1 correct). We investigated the neural correlates of Lag-1 sparing by carrying out magnetoencephalography (MEG) recordings during an attentional blink (AB) task, by presenting two targets with a temporal lag of either 1 or 2 and, in the case of Lag 2, with a nontarget or a blank intervening between T1 and T2. In contrast to Lag 2, where two distinct neural responses were observed, at Lag 1 the two targets produced one common neural response in the left temporo-parieto-frontal (TPF) area but not in the right TPF or prefrontal areas. We discuss the implications of this result with respect to competition and integration hypotheses, and with respect to the different functional roles of the cortical areas considered. We suggest that more than one target can be identified in parallel in left TPF, at least in the absence of intervening nontarget information (i.e. masks), yet identified targets are processed and consolidated as two separate events by other cortical areas (right TPF and PFC, respectively).

New lecturers' beliefs about learning, teaching and assessment in higher education:the role of the PGCLTHE programme

This study was carried out with new lecturers on a two year Post Graduate Certificate in Learning and Teaching in Higher Education programme in a UK university. The aim was to establish their beliefs about how studying on the programme aligned with their teaching and learning philosophy and what, if anything, had changed or constrained those beliefs. Ten lecturers took part in an in-depth semi-structured interview. Content analysis of the transcripts suggested positive reactions to the programme but lecturers’ new insights were sometimes constrained by departments and university bureaucracy, particularly in the area of assessment. The conflicting roles of research and teaching were also a major issue facing these new professionals.

The Localization Procedures of the Vector of Weighting Coefficients on the Set of Teaching Experts in the Tasks of Consuming

In terms of binary relations the author analyses the task of an individual consumers’ choice on the teaching excerpts set. It is suggested to analyse the function of consumer’s value as additive reduction. For localization of the vector of weighting coefficients of additive reduction the procedures based on metrics of object distance towards the ideal point are suggested.

About Electronic Assessment, Accreditation and Management of the Quality of Teaching in Higher Education

The article examines the main approaches to external evaluation and accreditation in higher education. It also presents COMPASS-OK: a social network for electronic evaluation and management of the quality of education, which utilizes mechanisms for management of documentation flows and supports tools for modeling of evaluation methods and procedures.

Soliton's eigenvalue based analysis on the generation mechanism of rogue wave phenomenon in optical fibers exhibiting weak third order dispersion

One of the extraordinary aspects of nonlinear wave evolution which has been observed as the spontaneous occurrence of astonishing and statistically extraordinary amplitude wave is called rogue wave. We show that the eigenvalues of the associated equation of nonlinear Schrödinger equation are almost constant in the vicinity of rogue wave and we validate that optical rogue waves are formed by the collision between quasi-solitons in anomalous dispersion fiber exhibiting weak third order dispersion.

E-blogspot in the teaching of strategic management

E-learning and e-learning applications/tools are available to all educators thanks to the evolution of technology and the internet. Although a great variety of technologies are available it is not always obvious how these can be integrated in traditional teaching to support and enhance the learning experience. The majority of the existing literature proposes the use of blogging as an activity that students should do in order to increase their active participation in learning. This article presents the use of blogspots in the teaching of Strategic Management as a tool used to create greater linkages between theory and practice, discussing the evolution of its utilisation in my modules, the current state of use and a series of reflections on experience gained from its use so far. Overall, I have found that there is limited literature on how blogging could link to teaching activities and its utilisation should be viewed as learning by doing which is evaluated and improved by critical reflection of the user.

A qualitative study of the impact of an educational intervention on older parents of adults with disabilities engaged in the phenomenon of future-care planning

This phenomenological study describes the impact of an educational intervention on the day-to-day experiences of older parent caregivers of adults with developmental disabilities who were engaged in the process of future-care planning. Qualitative strategies of individual and focus group interviewing were used with a purposive sample of older caregivers. Participants were members of an existing parent support group. Twenty-three caregivers representing 18 families were queried before and after the education program. The disabilities represented were mental retardation, cerebral palsy and autism. Parents whose children live at or away from home were included. The intervention was conducted on five Saturdays over a two month period; the duration of the study was five months. Findings used typical words of the respondents from their individual and focus group interviews to describe feelings, attitudes and experiences in making future-care plans. Data from verbatim transcriptions and researcher's field notes were coded, analyzed, sorted into themes, and subjected to interpretive analysis. Respondents showed a positive change in attitudes and actions after participating in the education program, regardless of their initial stage in care planning. Fears were replaced by hope and determination; hesitation and ineptitude by feelings of competence and confidence; and procrastination and delay by purposeful actions. Other key findings: use of a planning document greatly aided caregivers; barriers to planning were often intrinsic and amenable to education; residential plans were the most difficult aspect of planning; listening to the experiences of other parent caregivers was helpful; and making burial plans for their offspring was one aspect of planning parents wished to do themselves. ^

A comparison of the effects of social constructivist and traditional approaches to teaching on students' attitude and achievement in high school chemistry

Current views of the nature of knowledge and of learning suggest that instructional approaches in science education pay closer attention to how students learn rather than on teaching. This study examined the use of approaches to teaching science based on two contrasting perspectives in learning, social constructivist and traditional, and the effects they have on students' attitudes and achievement. Four categories of attitudes were measured using the Upper Secondary Attitude Questionnaire: Attitude towards school, towards the importance of science, towards science as a career, and towards science as a subject in school. Achievement was measured by average class grades and also with a researcher/teacher constructed 30-item test that involved three sub-scales of items based on knowledge, and applications involving near-transfer and far-transfer of concepts. The sample consisted of 202 students in nine intact classrooms in chemistry at a large high school in Miami, Florida, and involved two teachers. Results were analyzed using a two-way analysis of covariance (ANCOVA) with a pretest in attitude as the covariate for attitudes and prior achievement as the covariate for achievement. A comparison of the adjusted mean scores was made between the two groups and between females and males. ^ With constructivist-based teaching, students showed more favorable attitude towards science as a subject, obtained significantly higher scores in class achievement, total achievement and achievement on the knowledge sub-scale of the knowledge and application test. Students in the traditional group showed more favorable attitude towards school. Females showed significantly more positive attitude towards the importance of science and obtained significantly higher scores in class achievement. No significant interaction effects were obtained for method of instruction by gender. ^ This study lends some support to the view that constructivist-based approaches to teaching science is a viable alternative to traditional modes of teaching. It is suggested that in science education, more consideration be given to those aspects of classroom teaching that foster closer coordination between social influences and individual learning. ^