The corporatization of community pharmacy:implications for service provision, the public health function, and pharmacy's claims to professional status in the United Kingdom

Background Pharmacy has experienced both incomplete professionalization and deprofessionalization. Since the late 1970s, a concerted attempt has been made to re-professionalize pharmacy in the United Kingdom (UK) through role extension—a key feature of which has been a drive for greater pharmacy involvement in public health. However, the continual corporatization of the UK community pharmacy sector may reduce the professional autonomy of pharmacists and may threaten to constrain attempts at reprofessionalization. Objectives The objectives of the research: to examine the public health activities of community pharmacists in the UK; to explore the attitudes of community pharmacists toward recent relevant UK policy and barriers to the development of their public health function; and, to investigate associations between activity, attitudes, and the type of community pharmacy worked in (eg, supermarket, chain, independent). Methods A self-completion postal questionnaire was sent to a random sample of practicing community pharmacists, stratified for country and sex, within Great Britain (n = 1998), with a follow-up to nonresponders 4 weeks later. Data were analyzed using SPSS (SPSS Inc., Chicago, IL, USA) (v12.0). A final response rate of 51% (n = 1023/1998) was achieved. Results The level of provision of emergency hormonal contraception on a patient group direction, supervised administration of medicines, and needle-exchange schemes was lower in supermarket pharmacies than in the other types of pharmacy. Respondents believed that supermarkets and the major multiple pharmacy chains held an advantageous position in terms of attracting financing for service development despite suggesting that the premises of such pharmacies may not be the most suitable for the provision of such services. Conclusions A mixed market in community pharmacy may be required to maintain a comprehensive range of pharmacy-based public health services and provide maximum benefit to all patients. Longitudinal monitoring is recommended to ensure that service provision is adequate across the pharmacy network.

Seasonal dynamic pattern analysis in service of climate change research. A methodical case-study - monitoring and simulation based on an aquatic insect community

Our aim was to approach an important and well-investigable phenomenon – connected to a relatively simple but real field situation – in such a way, that the results of field observations could be directly comparable with the predictions of a simulation model-system which uses a simple mathematical apparatus and to simultaneously gain such a hypothesis-system, which creates the theoretical opportunity for a later experimental series of studies. As a phenomenon of the study, we chose the seasonal coenological changes of aquatic and semiaquatic Heteroptera community. Based on the observed data, we developed such an ecological model-system, which is suitable for generating realistic patterns highly resembling to the observed temporal patterns, and by the help of which predictions can be given to alternative situations of climatic circumstances not experienced before (e.g. climate changes), and furthermore; which can simulate experimental circumstances. The stable coenological state-plane, which was constructed based on the principle of indirect ordination is suitable for unified handling of data series of monitoring and simulation, and also fits for their comparison. On the state-plane, such deviations of empirical and model-generated data can be observed and analysed, which could otherwise remain hidden.

A study of the effects of a service-learning experience on student success at an urban community college

The purpose of this study was to explore the effects of a service-learning experience on student success as measured by class attendance, course completion, final course grades, and end-of-term evaluation data.^ Though many outcomes of service-learning experiences have been studied, including ethical values, self-esteem, student personal development, and career preparation, relatively few studies have been conducted on the effects of such experiences on academic achievement, and the studies that have been done have primarily studied students at traditional, four-year, residential universities.^ The study consisted of 286 students enrolled in six paired courses taught by five instructors at a community college in the Fall term 1996. One section of each pair (the control group) was taught using traditional subject matter and course materials and the other section of each pair (the treatment group) participated in a 20-hour required service-learning activity in addition to the regular course curriculum. The courses in the study included American History, Sociology, College Preparatory English, and Introduction to English Composition.^ The results of this study indicate that, overall, students who participated in a class in which service-learning was a requirement, achieved higher final course grades and reported greater satisfaction with the course, the instructor, the reading assignments, and the grading system, and the treatment section of one course pair had fewer absences. In addition, the faculty members reported that, in the treatment sections, class discussions were more stimulating, the sections seemed more vital in terms of student involvement, the students seemed more challenged academically, more motivated to learn, and seemed to exert more effort in the course. ^

An interview study of community college student perspectives on service -learning

Over the past two decades, the community college in the United States has boasted a leadership role in the movement to make education community-based and performance-oriented. This has led to an intensification in attempts to search for more innovative means to make education more experiential and relevant to students' lived experiences. ^ One such innovative program that holds promise to meet this challenge is service-learning. This paradigm attempts to relate the academic education in the classroom to community-based problems, which fits in neatly with the community-based characteristics of the community college. It promises to link ideas developed in the classroom and their practical application within the community through guided reflection. It is designed to enhance and enrich student learning of course material by combining citizenship, academic subjects, skills, and values. ^ Though many studies have been carried out in regard to the outcomes of service-learning through quantitative means, relatively few qualitative studies are available, and those available have primarily studied traditional students at four-year residential colleges or universities. Therefore, there is an urgent need to study non-traditional students' perspectives at the community college level. ^ The purpose of this study was to describe and explain the perspectives of five students at Broward Community College, Central Campus, Ft. Lauderdale, Florida. The following exploratory questions guided this study: (1) What elements constitute these students' perspectives? (2) What variables influence their perspectives? (3) What beliefs do these students hold about their service-learning experience which support or are contrary to their perspectives? ^ This ethnographic interview study was conducted over a period of twelve months and consisted of three interviews for each of the five participants. The analysis of the data was conducted following the stringent principles of ethnographic research which included constant comparative analysis. The interviews were tape recorded with the participants' permission, transcribed verbatim, and organized into categories for in-depth understanding. Furthermore, these categories were developed from the data collected and an organizational scheme for understanding and interpreting of these perspectives emerged. The researcher, as well, kept a reflective journal of the research process as part of the data set. ^ The results of this study show the need for a better grasp of the concepts of service-learning on the part of all involved with its implementation. In spite of this, all of the participants displayed gains to a greater or lesser degree in personal growth, academic skills, and citizenship skills. ^

A study of the effects of a service-learning experience on student success at an urban community college

The purpose of this study was to explore the effects of a service-learning experience on student success as measured by class attendance, course completion, final course grades, and end-of-term evaluation data. Though many outcomes of service-learning experiences have been studied, including ethical values, self-esteem, student personal development, and career preparation, relatively few studies have been conducted on the effects of such experiences on academic achievement, and the studies that have been done have primarily studied students at traditional, four-year, residential universities. The study consisted of 286 students enrolled in six paired courses taught by five instructors at a community college in the Fall term 1996. One section of each pair (the control group) was taught using traditional subject matter and course materials and the other section of each pair (the treatment group) participated in a 20-hour required service- learning activity in addition to the regular course curriculum. The courses in the study included American History, Sociology, College Preparatory English, and Introduction to English Composition. The results of this study indicate that, overall, students who participated in a class in which service-learning was a requirement, achieved higher final course grades and reported greater satisfaction with the course, the instructor, the reading assignments, and the grading system, and the treatment section of one course pair had fewer absences. In addition, the faculty members reported that, in the treatment sections, class discussions were more stimulating, the sections seemed more vital in terms of student involvement, the students seemed more challenged academically, more motivated to learn, and seemed to exert more effort in the course.

An interview study of community college student perspectives on service-learning

Over the past two decades, the community college in the United States has boasted a leadership role in the movement to make education community-based and performance-oriented. This has led to an intensification in attempts to search for more innovative means to make education more experiential and relevant to students' lived experiences. One such innovative program that holds promise to meet this challenge is service- learning. This paradigm attempts to relate the academic education in the classroom to community-based problems, which fits in neatly with the community-based characteristics of the community college. It promises to link ideas developed in the classroom and their practical application within the community through guided reflection. It is designed to enhance and enrich student learning of course material by combining citizenship, academic subjects, skills, and values. Though many studies have been carried out in regard to the outcomes of service-learning through quantitative means, relatively few qualitative studies are available, and those available have primarily studied traditional students at four-year residential colleges or universities. Therefore, there is an urgent need to study non-traditional students' perspectives at the community college level. The purpose of this study was to describe and explain the perspectives of five students at Broward Community College, Central Campus, Ft. Lauderdale, Florida. The following exploratory questions guided this study: 1. What elements constitute these students' perspectives? 2. What variables influence their perspectives? 3. What beliefs do these students hold about their service-learning experience which support or are contrary to their perspectives? This ethnographic interview study was conducted over a period of twelve months and consisted of three interviews for each of the five participants. The analysis of the data was conducted following the stringent principles of ethnographic research which included constant comparative analysis. The interviews were tape recorded with the participants' permission, transcribed verbatim, and organized into categories for in-depth understanding. Furthermore, these categories were developed from the data collected and an organizational scheme for understanding and interpreting of these perspectives emerged. The researcher, as well, kept a reflective journal of the research process as part of the data set. The results of this study show the need for a better grasp of the concepts of service-learning on the part of all involved with its implementation. In spite of this, all of the participants displayed gains to a greater or lesser degree in personal growth, academic skills, and citizenship skills.

Effectiveness of Community versus Hospital Eye Service follow-up for patients with neovascular age-related macular degeneration with quiescent disease (ECHoES): a virtual non-inferiority trial

OBJECTIVES: To compare the ability of ophthalmologists versus optometrists to correctly classify retinal lesions due to neovascular age-related macular degeneration (nAMD).

DESIGN: Randomised balanced incomplete block trial. Optometrists in the community and ophthalmologists in the Hospital Eye Service classified lesions from vignettes comprising clinical information, colour fundus photographs and optical coherence tomographic images. Participants' classifications were validated against experts' classifications (reference standard).

SETTING: Internet-based application.

PARTICIPANTS: Ophthalmologists with experience in the age-related macular degeneration service; fully qualified optometrists not participating in nAMD shared care.

INTERVENTIONS: The trial emulated a conventional trial comparing optometrists' and ophthalmologists' decision-making, but vignettes, not patients, were assessed. Therefore, there were no interventions and the trial was virtual. Participants received training before assessing vignettes.

MAIN OUTCOME MEASURES: Primary outcome-correct classification of the activity status of a lesion based on a vignette, compared with a reference standard. Secondary outcomes-potentially sight-threatening errors, judgements about specific lesion components and participants' confidence in their decisions.

RESULTS: In total, 155 participants registered for the trial; 96 (48 in each group) completed all assessments and formed the analysis population. Optometrists and ophthalmologists achieved 1702/2016 (84.4%) and 1722/2016 (85.4%) correct classifications, respectively (OR 0.91, 95% CI 0.66 to 1.25; p=0.543). Optometrists' decision-making was non-inferior to ophthalmologists' with respect to the prespecified limit of 10% absolute difference (0.298 on the odds scale). Optometrists and ophthalmologists made similar numbers of sight-threatening errors (57/994 (5.7%) vs 62/994 (6.2%), OR 0.93, 95% CI 0.55 to 1.57; p=0.789). Ophthalmologists assessed lesion components as present less often than optometrists and were more confident about their classifications than optometrists.

CONCLUSIONS: Optometrists' ability to make nAMD retreatment decisions from vignettes is not inferior to ophthalmologists' ability. Shared care with optometrists monitoring quiescent nAMD lesions has the potential to reduce workload in hospitals.

TRIAL REGISTRATION NUMBER: ISRCTN07479761; pre-results registration.

At the Crossroads: Pre-service Teachers, Community Mentors, and the Dialectic

Thesis (Ph.D.)--University of Washington, 2016-06

Project AWARE Sets New Records in 2015: 1,000 to Service, Friendships & Community

Project AWARE is the Iowa DNR's volunteer river cleanup.

Toward Self-Organising Service Communities

This paper discusses a framework in which catalog service communities are built, linked for interaction, and constantly monitored and adapted over time. A catalog service community (represented as a peer node in a peer-to-peer network) in our system can be viewed as domain specific data integration mediators representing the domain knowledge and the registry information. The query routing among communities is performed to identify a set of data sources that are relevant to answering a given query. The system monitors the interactions between the communities to discover patterns that may lead to restructuring of the network (e.g., irrelevant peers removed, new relationships created, etc.).

Taking a 'reality' check : expanding pre-service teachers' views on pedagogy and diversity

The outcomes of a two-pronged 'real-world' learning project, which aimed to expand the views of pre-service teachers about learning, pedagogy and diversity, will be discussed in this paper. Seventy-two fourth-year and 22 first-year students, enrolled in a Bachelor of Education degree in Queensland, Australia, were engaged in community sites outside of university lectures, and separate from their practicum. Using Butin's conceptual framework for service learning, we show evidence that this approach can enable pre-service teachers to see new realities about the dilemmas and ambiguities of performing as learners and as teachers. We contend that when such 'real-world' experiences have different foci at different times in their four-year degree, pre-service teachers have more opportunities to develop sophisticated understandings of pedagogy in diverse contexts for diverse learners.

Work engagement and its antecedents in high-risk occupations : a police service case study

Introduction: Work engagement is a recent application of positive psychology and refers to a positive, fulfilling, work-related state of mind characterized by vigor, dedication and absorption. Despite theoretical assumptions, there is little published research on work engagement, due primarily to its recent emergence as a psychological construct. Furthermore, examining work engagement among high-stress occupations, such as police, is useful because police officers are generally characterized as having a high level of work engagement. Previous research has identified job resources (e.g. social support) as antecedents of work engagement. However detailed evaluation of job demands as an antecedent of work engagement within high-stress occupations has been scarce. Thus our second aim was to test job demands (i.e. monitoring demands and problem-solving demands) and job resources (i.e. time control, method control, supervisory support, colleague support, and friend and family support) as antecedents of work engagement among police officers. Method: Data were collected via a self-report online survey from one Australian state police service (n = 1,419). Due to the high number of hypothesized antecedent variables, hierarchical multiple regression analysis was employed rather than structural equation modelling. Results: Work engagement reported by police officers was high. Female officers had significantly higher levels of work engagement than male officers, while officers at mid-level ranks (sergeant) reported the lowest levels of work engagement. Job resources (method control, supervisor support and colleague support) were significant antecedents of three dimensions of work engagement. Only monitoring demands were significant antecedent of the absorption. Conclusion: Having healthy and engaged police officers is important for community security and economic growth. This study identified some common factors which influence work engagement experienced by police officers. However, we also note that excessive work engagement can yield negative outcomes such as psychological distress.