Heart failure management programmes in Europe

Background The ESC guidelines recommend that an organised system of specialist heart failure (HF) care should be established to improve outcomes of HF patients. The aim of this study was therefore to identify the number and the content of HF management programmes in Europe. Method A two-phase descriptive study was conducted: an initial screening to identify the existence of HF management programmes; and a survey to describe the content in countries where at least 30% of the hospitals had a programme. Results Of the 43 European countries approached, 26 (60%) estimated the percentage of HF management programmes. Seven countries reported that they had such programmes in more than 30% of their hospitals. Of the 673 hospitals responding to the questionnaire, 426 (63%) had a HF management programme. Half of the programmes (n = 205) were located in an outpatient clinic. In the UK a combination of hospital and home-based programmes was common (75%). The most programmes included physical examination, telephone consultation, patient education, drug titration and diagnostic testing. Most (89%) programmes involved nurses and physicians. Multi-disciplinary teams were active in 56% of the HF programmes. The most prominent differences between the 7 countries were the degree of collaboration with home care and GP's, the role in palliative care and the funding. Conclusion Only a few European countries have a large number of organised programmes for HF care and follow up. To improve outcomes of HF patients throughout Europe more effort should be taken to increase the number of these programmes in all countries.

Advances in optoelectronics in Europe - the RACE and ESPRIT programmes

Editorial

Adverse drug reaction teaching in UK undergraduate medical and pharmacy programmes

Objectives: To assess the extent of teaching about the Committee on Safety of Medicine's Yellow Card scheme and adverse drug reactions within UK Schools of Medicine and Pharmacy. Methods: A self-completed questionnaire sent to all heads of undergraduate schools of medicine and pharmacy within the UK. Results: The majority of undergraduate syllabuses feature the Yellow Card Scheme. Knowledge of the Yellow Card Scheme was assessed in 79% of pharmacy programmes and 57% of medical schools. Specialist speakers on the Yellow Card Scheme were infrequently used. Fewer than half of respondents provided students with a guide to reporting ADRs (43% pharmacy and 43% medical). There is some disagreement about the value of supplying students with printed material about the Yellow Card Scheme. Half of medical Schools did not think that supplying 'Current Problems In Pharmacovigilance' would be useful. Conclusions: It was found that in both medicine and pharmacy, courses differed substantially in teaching about the Yellow Card Scheme and adverse drug reactions (ADRs). There is scope for increased involvement of the Medicines and Healthcare products Regulatory Agency in undergraduate education, in line with recommendations from the National Audit Office.

Priority evaluation in transportation policies and programmes

This work is concerned with the development of techniques for the evaluation of large-scale highway schemes with particular reference to the assessment of their costs and benefits in the context of the current transport planning (T.P.P.) process. It has been carried out in close cooperation with West Midlands County Council, although its application and results are applicable elsewhere. The background to highway evaluation and its development in recent years has been described and the emergence of a number of deficiencies in current planning practise noted. One deficiency in particular stood out, that stemming from inadequate methods of scheme generation and the research has concentrated upon improving this stage of appraisal, to ensure that subsequent stages of design, assessment and implementation are based upon a consistent and responsive foundation. Deficiencies of scheme evaluation were found to stem from inadequate development of appraisal methodologies suffering from difficulties of valuation, measurement and aggregation of the disparate variables that characterise highway evaluation. A failure to respond to local policy priorities was also noted. A 'problem' rather than 'goals' based approach to scheme generation was taken, as it represented the current and foreseeable resource allocation context more realistically. A review of techniques with potential for highway problem based scheme generation, which would work within a series of practical and theoretical constraints were assessed and that of multivariate analysis, and classical factor analysis in particular, was selected, because it offerred considerable application to the difficulties of valuation, measurement and aggregation that existed. Computer programs were written to adapt classical factor analysis to the requirements of T.P.P. highway evaluation, using it to derive a limited number of factors which described the extensive quantity of highway problem data. From this, a series of composite problem scores for 1979 were derived for a case study area of south Birmingham, based upon the factorial solutions, and used to assess highway sites in terms of local policy issues. The methodology was assessed in the light of its ability to describe highway problems in both aggregate and disaggregate terms, to guide scheme design, coordinate with current scheme evaluation methods, and in general to improve upon current appraisal. Analysis of the results was both in subjective, 'common-sense' terms and using statistical methods to assess the changes in problem definition, distribution and priorities that emerged. Overall, the technique was found to improve upon current scheme generation methods in all respects and in particular in overcoming the problems of valuation, measurement and aggregation without recourse to unsubstantiated and questionable assumptions. A number of deficiencies which remained have been outlined and a series of research priorities described which need to be reviewed in the light of current and future evaluation needs.

How well do the theory of reasoned action and theory of planned behaviour predict intentions and attendance at screening programmes? A meta-analysis

Meta-analysis was used to quantify how well the Theories of Reasoned Action and Planned Behaviour have predicted intentions to attend screening programmes and actual attendance behaviour. Systematic literature searches identified 33 studies that were included in the review. Across the studies as a whole, attitudes had a large-sized relationship with intention, while subjective norms and perceived behavioural control (PBC) possessed medium-sized relationships with intention. Intention had a medium-sized relationship with attendance, whereas the PBC-attendance relationship was small sized. Due to heterogeneity in results between studies, moderator analyses were conducted. The moderator variables were (a) type of screening test, (b) location of recruitment, (c) screening cost and (d) invitation to screen. All moderators affected theory of planned behaviour relationships. Suggestions for future research emerging from these results include targeting attitudes to promote intention to screen, a greater use of implementation intentions in screening information and examining the credibility of different screening providers.

Peer mentoring in higher education:a multidimensional approach to conceptualising the role of peer mentoring programmes in enhancing the first year undergraduate experience

Across the literature researchers agree that the concept of mentoring results in positive outcomes for both mentors and mentees alike (Enrich et al, 2004). From a pedagogical perspective, student focused mentoring activities in Higher Education are generally perceived to comprise dyadic or triadic relationships that encapsulate a diverse range of learning strategies and/or support mechanisms. Whilst there exists a significant amount of literature regarding the wider value of Peer Mentoring in Higher Education, there remains a notable gap in knowledge about the value of such programmes in enhancing the first year undergraduate experience and thus promoting a smooth transition to University. Using the emergent study findings of a large international project, a multidimensional conceptual framework bringing together the theoretical, conceptual and contextual determinants of Peer Mentoring is proposed. This framework makes a distinctive contribution to current pedagogical theory and practice – particularly in relation to the first year experience.

Exploring supply chain related graduate programmes in the UK:a view on their structure, content and approaches

Research in skill requirements needed by supply chain/logistics (SCL) managers has been published since the early nineties, however, research on what is really taught (e.g. curriculum, learning philosophies) by universities is scant. This paper's aim is to fill in this gap by analysing SCL graduate teaching in the UK. Data from 50 SCL MSc programmes were collected from 43 universities. Findings indicate that there seems to be a gap emerging between industry's needs and the content of the programmes being offered. This gap concerns employability, problem based learning, international business and the acquisition of softer interpersonal and problem solving skills.

Appropriate wage rate and related issues for employment intensive public works programmes in Timor Leste

Employment generating public works (EGPW) are an important part of GoTL’s strategy to reduce unemployment, underemployment and poverty and contribute to social stability. The term EGPW is used in this report as a generic term to encompass labour intensive (LI) and labourbased (LB) approaches. The distinction between these approaches is made below. SEFOPE is being supported by a number of international agencies to develop and implement employment generating public works programmes (EGPWPs). Other government ministries and agencies and NGOs offering different wage rates are also engaged in such programmes and projects. In setting wage rates for such programmes, it is necessary to take account of (a) the nature of benefits they offer (e.g. the balance between employment creation and effective use of labour); (b) the beneficiaries to be targeted, and (c) any adverse impacts on other economic activities. The purposes of this assignment are: (a) to make recommendations on appropriate wage rates for unskilled casual employment on public works programmes, and (b) make a broad assessment of the labour supply response to the employment opportunities created by employment intensive programmes. The latter would help in gauging the scale of such activities required.