Are community pharmacists prepared to work extended opening hours?

Focal points: A 5 per cent cross-sectional sample of the Royal Pharmaceutical Society's membership was targeted with a self-completion questionnaire Community pharmacy respondents were asked questions on their views on current pharmacy opening hours and their willingness to work extended opening hours Around one fifth of the community pharmacists sampled believed that patients should have access to at least one community pharmacy 24 hours a day Only 3.4 per cent of community pharmacists sampled were prepared to work at any time over a 24-hour period With the introduction of more 24-hour health care services (eg, NHS Direct), there may need to be a change in the attitudes of community pharmacists towards working extended opening hours

Partnering with governments and other institutions:driving change in diabetes care

The human and material cost of type 2 diabetes is a cause of increasing concern for health professionals, representative organisations and governments worldwide. The scale of morbidity and mortality has led the United Nations to issue a resolution on diabetes, calling for national policies for prevention, treatment and care. There is clearly an urgent need for a concerted response from all interested parties at the community, national and international level to work towards the goals of the resolution and create effective, sustainable treatment models, care systems and prevention strategies. Action requires both a 'bottom-up' approach of public awareness campaigns and pressure from healthcare professionals, coupled with a 'top-down' drive for change, via partnerships with governments, third sector (non-governmental) organisations and other institutions. In this review, we examine how existing collaborative initiatives serve as examples for those seeking to implement change in health policy and practice in the quest to alleviate the health and economic burden of diabetes. Efforts are underway to provide continuous and comprehensive care models for those who already have type 2 diabetes; in some cases, national plans extend to prevention strategies in attempts to improve overall public health. In the spirit of partnership, collaborations with governments that incorporate sustainability, long-term goals and a holistic approach continue to be a driving force for change. It is now critical to maintain this momentum and use the growing body of compelling evidence to educate, inform and deliver a long-term, lasting impact on patient and public health worldwide. © 2007 The Authors.

Psychotherapy and social change:utilizing principles of cognitive-behavioral therapy to help develop new prejudice-reduction interventions

We propose that key concepts from clinical psychotherapy can inform science-based initiatives aimed at building tolerance and community cohesion. Commonalities in social and clinical psychology are identified regarding (1) distorted thinking (intergroup bias and cognitive bias), (2) stress and coping (at intergroup level and intrapersonal level), and (3) anxiety (intergroup anxiety and pathological anxiety). On this basis we introduce a new cognitive-behavioral model of social change. Mental imagery is the conceptual point of synthesis, and anxiety is at the core, through which new treatment-based approaches to reducing prejudice can be developed. More generally, we argue that this integration is illustrative of broader potential for cross-disciplinary integration in the social and clinical sciences, and has the potential to open up new possibilities and opportunities for both disciplines.

An examination of the UK community pharmacist's role in facilitating patient self-management of cardiovascular disease through lifestyle behaviours

The progression of cardiovascular disease (CVD) is largely modifiable through lifestyle behaviours. UK pharmacists are contractually obliged to facilitate patient self-management of chronic conditions such as CVD. Pharmacists are easily accessible health professionals who are well placed to identify “at risk” patients through medication regimes. Research has identified varying attitudes towards and levels of involvement in pharmacist-led health promotion activity. Given the diverse and exploratory nature of the work, a pragmatic, mixed methods approach was used to explore community pharmacists’ role in facilitating patient self-management of CVD. The thesis presents four studies: a qualitative study with pharmacists; a cross sectional questionnaire of community pharmacists; a systematic review and a qualitative study with patients with CVD. The qualitative study with pharmacists gave an insight into pharmacists’ experiences of giving patients with CVD lifestyle advice and the factors underpinning commonly cited barriers to providing public health services. This informed the development of the cross-sectional questionnaire which identified the predictors of pharmacists’ intentions to give two different types of advice to facilitate patient self-management. The systematic review identified a small number of interventions to prepare pharmacists to facilitate patient lifestyle behaviour change and evaluated the theories and behaviour change techniques used in successful interventions; however due to poor study quality and poor reporting of the interventions limited conclusions about the efficacy of the interventions could reliably be drawn. Finally, the qualitative study gave an insight into the experiences of patients with CVD using community pharmacy services and their expectations of the service they receive from community pharmacists. Recommendations about changes to pharmacy policy and practice in order to support pharmacists’ provision of CVD self-management advice are made.

Transition from community dwelling to retirement village in older adults:cognitive functioning and psychological health outcomes

Supported living and retirement villages are becoming a significant option for older adults with impairments, with independence concerns or for forward planning in older age, but evidence as to psychological benefits for residents is sparse. This study examined the hypothesis that the multi-component advantages of moving into a supported and physically and socially accessible “extra care” independent living environment will impact on psychological and functioning measures. Using an observational longitudinal design, 161 new residents were assessed initially and three months later, in comparison to 33 older adults staying in their original homes. Initial group differences were apparent but some reduced after three months. Residents showed improvement in depression, perceived health, aspects of cognitive function, and reduced functional limitations, while controls showed increased functional limitations (worsening). Ability to recall specific autobiographical memories, known to be related to social-problem solving, depression and functioning in social relationships, predicted change in communication limitations, and cognitive change predicted changes in recreational limitations. Change in anxiety and memory predicted change in depression. Findings suggest that older adults with independent living concerns who move to an independent but supported environment can show significant benefits in psychological outcomes and reduction in perceived impact of health on functional limitations in a short period. Targets for focussed rehabilitation are indicated, but findings also validate development of untargeted general supportive environments.

Engineering education research - the UK perspective at a time of change

Engineering education in the United Kingdom is at the point of embarking upon an interesting journey into uncharted waters. At no point in the past have there been so many drivers for change and so many opportunities for the development of engineering pedagogy. This paper will look at how Engineering Education Research (EER) has developed within the UK and what differentiates it from the many small scale practitioner interventions, perhaps without a clear research question or with little evaluation, which are presented at numerous staff development sessions, workshops and conferences. From this position some examples of current projects will be described, outcomes of funding opportunities will be summarised and the benefits of collaboration with other disciplines illustrated. In this study, I will account for how the design of task structure according to variation theory, as well as the probe-ware technology, make the laws of force and motion visible and learnable and, especially, in the lab studied make Newton's third law visible and learnable. I will also, as a comparison, include data from a mechanics lab that use the same probe-ware technology and deal with the same topics in mechanics, but uses a differently designed task structure. I will argue that the lower achievements on the FMCE-test in this latter case can be attributed to these differences in task structure in the lab instructions. According to my analysis, the necessary pattern of variation is not included in the design. I will also present a microanalysis of 15 hours collected from engineering students' activities in a lab about impulse and collisions based on video recordings of student's activities in a lab about impulse and collisions. The important object of learning in this lab is the development of an understanding of Newton's third law. The approach analysing students interaction using video data is inspired by ethnomethodology and conversation analysis, i.e. I will focus on students practical, contingent and embodied inquiry in the setting of the lab. I argue that my result corroborates variation theory and show this theory can be used as a 'tool' for designing labs as well as for analysing labs and lab instructions. Thus my results have implications outside the domain of this study and have implications for understanding critical features for student learning in labs. Engineering higher education is well used to change. As technology develops the abilities expected by employers of graduates expand, yet our understanding of how to make informed decisions about learning and teaching strategies does not without a conscious effort to do so. With the numerous demands of academic life, we often fail to acknowledge our incomplete understanding of how our students learn within our discipline. The journey facing engineering education in the UK is being driven by two classes of driver. Firstly there are those which we have been working to expand our understanding of, such as retention and employability, and secondly the new challenges such as substantial changes to funding systems allied with an increase in student expectations. Only through continued research can priorities be identified, addressed and a coherent and strong voice for informed change be heard within the wider engineering education community. This new position makes it even more important that through EER we acquire the knowledge and understanding needed to make informed decisions regarding approaches to teaching, curriculum design and measures to promote effective student learning. This then raises the question 'how does EER function within a diverse academic community?' Within an existing community of academics interested in taking meaningful steps towards understanding the ongoing challenges of engineering education a Special Interest Group (SIG) has formed in the UK. The formation of this group has itself been part of the rapidly changing environment through its facilitation by the Higher Education Academy's Engineering Subject Centre, an entity which through the Academy's current restructuring will no longer exist as a discrete Centre dedicated to supporting engineering academics. The aims of this group, the activities it is currently undertaking and how it expects to network and collaborate with the global EER community will be reported in this paper. This will include explanation of how the group has identified barriers to the progress of EER and how it is seeking, through a series of activities, to facilitate recognition and growth of EER both within the UK and with our valued international colleagues.

Financial crisis and the change in the practice of applying common charge costs

The global financial crisis has not left the members of the EU untouched. Financial results have significantly dropped, businesses were folded in great numbers, the rate of employment decreased, social tension got fortified, and so did the national deficits in the budget in the majority of the countries. The decisive members of the community reacted fairly quickly to the challenges of the global economic crisis, and among the steps taken there were simultaneously ones to boost the economy and others to lower the expenses of the expenditure. The author examines what role was given to the steps in taxation policy as indirect regulating tools, and that how the decisions brought touch upon the previously issued harmonization strategy.

Analysis of climate change scenarios based on modelling of the seasonal dynamics of a Danubian copepod species

Climate change is one of the most crucial ecological problems of our age with great influence. Seasonal dynamics of aquatic communities are — among others — regulated by the climate, especially by temperature. In this case study we attempted the simulation modelling of the seasonal dynamics of a copepod species, Cyclops vicinus, which ranks among the zooplankton community, based on a quantitative database containing ten years of data from the Danube’s Göd area. We set up a simulation model predicting the abundance of Cyclops vicinus by considering only temperature as it affects the abundance of population. The model was adapted to eight years of daily temperature data observed between 1981 and 1994 and was tested successfully with the additional data of two further years. The model was run with the data series of climate change scenarios specified for the period around 2070- 2100. On the other hand we looked for the geographically analogous areas with the Göd region which are mostly similar to the future climate of the Göd area. By means of the above-mentioned points we can get a view how the climate of the region will change by the end of the 21st century, and the way the seasonal dynamics of a chosen planktonic crustacean species may follow this change. According to our results the area of Göd will be similar to the northern region of Greece. The maximum abundance of the examined species occurs a month to one and a half months earlier, moreover larger variances are expected between years in respect of the abundance. The deviations are expected in the direction of smaller or significantly larger abundance not observed earlier.

Seasonal change of oribatid mite communities (Acari, Oribatida) in three different types of microhabitats in an oak forest

Oribatid mites are one of the most abundant groups of the ground-dwelling mesofauna. They can be found in almost every terrestrial habitat all over the world and they are characterized by great species richness and great number of individuals. In spite of that not enough is known about their behaviour on community level and their spatial and temporal pattern in different habitats of the world. In our present study the seasonal behaviour of oribatid mite communities was analysed in three types of microhabitats in a temperate deciduous forest: in leaf litter, soil and moss. Samples were collected at a given site in a year and a half and the oribatid mite communities living there were studied on genus level along with the changes of meteorological factors characteristic of the area. The results show that corresponding to similar previous researches, the communities in our study do not have a seasonally changing, returning pattern either. Based on this, we can conclude that climatic differences and differences in other seasonally changing factors between the seasons do not have a significant role in the annual change of communities. Besides that we discovered that the communities of the three microhabitats are not completely the same. It is the oribatid mite community of the moss which differs mostly from communities in the leaf litter and in the soil. Our study calls attention among others to the fact that compositional changes of the oribatid mite communities living all over the world and their causes are unclear to date.

Climate change and freshwater zooplankton: what does it boil down to?

Recently, major advances in the climate–zooplankton interface have been made some of which appeared to receive much attention in a broader audience of ecologists as well. In contrast to the marine realm, however, we still lack a more holistic summary of recent knowledge in freshwater. We discuss climate change-related variation in physical and biological attributes of lakes and running waters, high-order ecological functions, and subsequent alteration in zooplankton abundance, phenology, distribution, body size, community structure, life history parameters, and behavior by focusing on community level responses. The adequacy of large-scale climatic indices in ecology has received considerable support and provided a framework for the interpretation of community and species level responses in freshwater zooplankton. Modeling perspectives deserve particular consideration, since this promising stream of ecology is of particular applicability in climate change research owing to the inherently predictive nature of this field. In the future, ecologists should expand their research on species beyond daphnids, should address questions as to how different intrinsic and extrinsic drivers interact, should move beyond correlative approaches toward more mechanistic explanations, and last but not least, should facilitate transfer of biological data both across space and time.

The effect of participation in a ``Greening the BCC Curriculum'' workshop series on the environmental literacy of a community college faculty

The purpose of this study was to develop a series of workshops designed to raise the environmental literacy of a community college faculty and facilitate infusion of an environmental perspective into the courses they teach. Data was gathered on the effect of the workshops on the level of environmental literacy of the participants as well as the persistence of any observed effect. How faculty infused an environmental perspective into their courses was also explored.^ The workshop model was developed by reviewing adult learning and change theories, case studies of workshops at other colleges, environmental education research, and results of a pilot study. Content, organization, and delivery methods from these sources were selected and integrated to create the 14 components of the model employed by the workshops in this study.^ Forty-two faculty from the North Campus of Broward Community College participated in the study. The 20 workshop participants from seven academic departments attended seven two hour workshops during the fall term of 1996, and implemented projects to infuse environmental topics into their courses the following term. A quasi-experimental pretest-posttest-delayed posttest nonequivalent control group design was employed in which the 22 members of the control group who did not attend the workshops were administered the Wisconsin Environmental Survey at the same time as the workshop participants (immediately before the first workshop, immediately following the last workshop, and four months following the completion of the workshop series). This instrument, an adaption of the Wisconsin High School Student Environmental Survey, yielded three measures of environmental literacy: Affective, Behavior, and Cognitive Subscale scores.^ The repeated measures MANOVA performed using the scores of the two groups on the three administrations of WES revealed a significant interaction for group by time, so repeated measures ANOVA were performed for each of the three subscales to investigate the interaction. Tukey-HSD post hoc comparisons indicated that for all three subscale scores, the two groups were not significantly different on the pretest, but on the posttest and the delayed posttest, the workshop participants demonstrated significantly higher levels of environmental literacy. All statistical tests were performed at $\alpha$ =.05. ^

A case study of the development of the Argentinean community college system

In the 1980's and 1990's, Argentina was undergoing significant political, social and economic changes as a result of the change over from a military driven government to elected governments. A major aspect of the change was an increased emphasis on privatization, and promotion of foreign and domestic investment in Argentina. Higher education leaders were increasingly drawn into developing a national strategy for changing the educational structure to help facilitate changes in other aspects of the society. Preliminary reviews by the Argentinean higher education leaders indicated that adaptation of the American community college promised to help achieve the national goals. ^ The purpose of this study was to determine: if and how the community college concept, an American invention, could be adapted to function in Argentina, a nation with a significantly different history of political, social, cultural and economic development. Achieving this purpose involved: identifying the key leaders in the movement that developed to apply the community college concept in Argentina; the study of their perspectives regarding the movement as it developed; and tracking the assistance given by selected American community college leaders. ^ The case study method was employed in this research, using interview and historical data collection. Key leaders from higher education in the United States and Argentina were interviewed in-depth, to determine their views. An interview protocol with appropriate sub-questions was followed to ensure complete coverage. The interviewees identified several major areas of education in need of change including, the system, access to the system, new areas of study, integration into the hemisphere and, in general, decentralization. Historical review revealed a steady development of the community college concept in Argentina reflected in documentation of events, conceptual writings and legal structures. ^ It was concluded that there is a community college structure beginning to emerge that, so far, in broad outline, follows the structure developed in the United States. It is anticipated however, that future developments will include conceptual aspects to the model reflective of Argentina. ^

A case study of a liberal Jewish day school's middle school transition

The Jacobson Sinai Academy is a Liberal Reform Jewish Day School, in North Miami Beach, Florida. When the Academy was started over 18 years ago it was designed as a K–6 school. This was in keeping with the existing model for Reform day schools at the time and met the needs and desires of the early founders. The philosophy of the school addressed meeting the needs of the individual child as well as the fostering of Judaic values and traditions in an academically nurturing and experiential setting. Upon graduation, students moved from the Academy to a variety of public and private options, all of which served the needs of the families at the time. In recent years, due to numerous factors within the community, parents voiced concerns as to where their children would continue their education during the critical middle school years. As a result of these concerns, and through the efforts of a dedicated group of parents and lay leaders, the decision was made to add an upper school component to the existing elementary configuration. This study is a qualitative case study which chronicles the organizational change effort that was undertaken for this purpose to determine facilitating conditions and impediments leading to the change. The analysis serves to inform others wishing to advance such an undertaking. ^ Results of the study indicated that certain conditions are necessary for the successful implementation of any change effort. The culture of the organization must be acknowledged and is a primary factor to be considered when advancing change. Collaboration with those committed to the enterprise must occur, and this in turn can lead to an agreed upon philosophy which expresses the diversity of needs and values of all of those involved. Resistance, while expected from certain individuals within the organization, can be overcome through the efforts of key players who assume leadership positions that are transformational in nature. Additionally, the rationale for middle schools, and the need for this one in particular, are factors which led to the success of this initiative. ^