CPD records for revalidation: assessing fitness-to-practise using ‘revalidation standards’ and an Outcomes Framework

Background: Currently, all pharmacists and technicians registered with the Royal Pharmaceutical Society of Great Britain must complete a minimum of nine Continuing Professional Development (CPD) record (entries) each year. From September 2010 a new regulatory body, the General Pharmaceutical Council, will oversee the regulation (including revalidation) of all pharmacy registrants in Great Britain. CPD may provide part of the supporting evidence that a practitioner submits to the regulator as part of the revalidation process. Gaps in knowledge necessitated further research to examine the usefulness of CPD in a pharmacy revalidation Project aims: The overall aims of this project were to summarise pharmacy professionals’ past involvement in CPD, examine the usability of current CPD entries for the purpose of revalidation, and to examine the impact of ‘revalidation standards’ and a bespoke Outcomes Framework on the conduct and construction of CPD entries for future revalidation of pharmacy professionals. We completed a comprehensive review of the literature, devised, validated and tested the impact of a new CPD Outcomes Framework and related training material in an empirical investigation involving volunteer pharmacy professionals and also spoke with our participants to bring meaning and understanding to the process of CPD conduct and recording and to gain feedback on the study itself. Key findings: The comprehensive literature review identified perceived barriers to CPD and resulted in recommendations that could potentially rectify pharmacy professionals’ perceptions and facilitate participation in CPD. The CPD Outcomes Framework can be used to score CPD entries Compared to a control (CPD and ‘revalidation standards’ only), we found that training participants to apply the CPD Outcomes Framework resulted in entries that scored significantly higher in the context of a quantitative method of CPD assessment. Feedback from participants who had received the CPD Outcomes Framework was positive and a number of useful suggestions were made about improvements to the Framework and related training. Entries scored higher because participants had consciously applied concepts linked to the CPD Outcomes Framework whereas entries scored low where participants had been unable to apply the concepts of the Framework for a variety of reasons including limitations posed by the ‘Plan & Record’ template. Feedback about the nature of the ‘revalidation standards’ and their application to CPD was not positive and participants had not in the main sought to apply the standards to their CPD entries – but those in the intervention group were more likely to have referred to the revalidation standards for their CPD. As assessors, we too found the process of selecting and assigning ‘revalidation standards’ to individual CPD entries burdensome and somewhat unspecific. We believe that addressing the perceived barriers and drawing on the facilitators will help deal with the apparent lack of engagement with the revalidation standards and have been able to make a set of relevant recommendations. We devised a model to explain and tell the story of CPD behaviour. Based on the concepts of purpose, action and results, the model centres on explaining two types of CPD behaviour, one following the traditional CE pathway and the other a more genuine CPD pathway. Entries which scored higher when we applied the CPD Outcomes Framework were more likely to follow the CPD pathway in the model above. Significant to our finding is that while participants following both models of practice took part in this study, the CPD Outcomes Framework was able to change people’s CPD behaviour to make it more inline with the CPD pathway. The CPD Outcomes Framework in defining the CPD criteria, the training pack in teaching the basis and use of the Framework and the process of assessment in using the CPD Outcomes Framework, would have interacted to improve participants’ CPD through a collective process. Participants were keen to receive a curriculum against which certainly CE-type activities could be conducted and another important observation relates to whether CE has any role to play in pharmacy professionals’ revalidation. We would recommend that the CPD Outcomes Framework is used in the revalidation of pharmacy professionals in the future provided the requirement to submit 9 CPD entries per annum is re-examined and expressed more clearly in relation to what specifically participants are being asked to submit – i.e. the ratio of CE to CPD entries. We can foresee a benefit in setting more regular intervals which would act as deadlines for CPD submission in the future. On the whole, there is value in using CPD for the purpose of pharmacy professionals’ revalidation in the future.

A framework of brand value in B2B markets: the contributing role of functional and emotional components

The creation of value is admittedly a critical task for marketers regardless of industry. This paper focuses on a type of value that has traditionally been perceived as irrelevant to industrial markets and argues that brand value facilitates the progression from goods and services value to relationship value. To address the limited amount of research on B2B branding from the suppliers' point of view, we complement insights gained from a literature review with ten exploratory interviews with B2B supplier managers, and develop a framework of brand value applicable to industrial markets. This identifies both the functional (i.e., quality, technology, capacity, infrastructure, after sales service, capabilities, reliability, innovation) and emotional qualities (i.e., risk reduction, reassurance, trust) important for the development of industrial brand equity. Situational (e.g. nature of the purchase) and environmental factors (e.g. the economic situation) affecting suppliers' perceptions of the importance of brand in a B2B context and the role of functional versus emotional brand qualities are discussed. The value of the brand as a driver for the development of business to business relationships is also highlighted. The framework provides a basis for B2B practitioners to build their brands in such a way as to make a functional as well as an emotional connection with buyers that is more likely to lead to a supplier–buyer relationship.

A proposal for a new scenario framework to support research and assessment in different climate research communities

In this paper, we propose a scenario framework that could provide a scenario “thread” through the different climate research communities (climate change – vulnerability, impact, and adaptation (VIA) and mitigation) in order to provide assessment of mitigation and adaptation strategies and other VIA challenges. The scenario framework is organised around a matrix with two main axes: radiative forcing levels and socio-economic conditions. The radiative forcing levels (and the associated climate signal) are described by the new Representative Concentration Pathways. The second axis, socio-economic developments, comprises elements that affect the capacity for mitigation and adaptation, as well as the exposure to climate impacts. The proposed scenarios derived from this framework are limited in number, allow for comparison across various mitigation and adaptation levels, address a range of vulnerability characteristics, provide information across climate forcing and vulnerability states and span a full century time scale. Assessments based on the proposed scenario framework would strengthen cooperation between integrated-assessment modelers, climate modelers and vulnerability, impact and adaptation researchers, and most importantly, facilitate the development of more consistent and comparable research within and across communities.

Volatility persistence and time-varying betas in the UK real estate market

This paper investigates the degree of return volatility persistence and the time-varying behaviour of systematic risk (beta) for 31 market segments in the UK real estate market. The findings suggest that different property types exhibit differences in volatility persistence and time variability. There is also evidence that the volatility persistence of each market segment and its systematic risk are significantly positively related. Thus, the systematic risks of different property types tend to move in different directions during periods of increased market volatility. Finally, the market segments with systematic risks less than one tend to show negative time variability, while market segments with systematic risk greater than one generally show positive time variability, indicating a positive relationship between the volatility of the market and the systematic risk of individual market segments. Consequently safer and riskier market segments are affected differently by increases in market volatility.

Persistence of UK Real Estate returns: a Markov chain analysis

The persistence of investment performance is a topic of perennial interest to investors. Efficient Markets theory tells us that past performance can not be used to predict future performance yet investors appear to be influenced by the historical performance in making their investment allocation decisions. The problem has been of particular interest to investors in real estate; not least because reported returns from investment in real estate are serially correlated thus implying some persistence in investment performance. This paper applies the established approach of Markov Chain analysis to investigate the relationship between past and present performance of UK real estate over the period 1981 to 1996. The data are analysed by sector, region and size. Furthermore some variations in investment performance classification are reported and the results are shown to be robust.

Valuation and arbitrage

The use of discounted cash flow (DCF) methods in investment valuation and appraisal is argued by many academics as being rational and more rigorous than the traditional capitalisation model. However those advocates of DCF should be cautious in their claims for rationality. The various DCF models all rely upon an all-encompassing equated yield (IRR) within the calculation. This paper will argue that this is a simplification of the risk perception which the investor places on the income profile from property. In determining the long term capital value of a property an 'average' DCF method will produce the 'correct' price, however, the individual short term values of each cash-flow may differ significantly. In the UK property market today, where we are facing a period in which prices are not expected to rise generally at the same rate or with such persistence as hitherto, investors and tenants are increasingly concerned with the down side implications of rental growth and investors may indeed be interested in trading property over a shorter investment horizon than they had originally planned. The purpose of this paper is therefore to bring to the analysis a rigorous framework which can be used to analyse the constituent cash flows within the freehold valuation. We show that the arbitrage analysis lends itself to segregating the capital value of the cash flows in a way which is more appropriate for financial investors

A framework for graphic description in book design

This project is concerned with the way that illustrations, photographs, diagrams and graphs, and typographic elements interact to convey ideas on the book page. A framework for graphic description is proposed to elucidate this graphic language of ‘complex texts’. The model is built up from three main areas of study, with reference to a corpus of contemporary children’s science books. First, a historical survey puts the subjects for study in context. Then a multidisciplinary discussion of graphic communication provides a theoretical underpinning for the model; this leads to various proposals, such as the central importance of ratios and relationships among parts in creating meaning in graphic communication. Lastly a series of trials in description contribute to the structure of the model itself. At the heart of the framework is an organising principle that integrates descriptive models from fields of design, literary criticism, art history, and linguistics, among others, as well as novel categories designed specifically for book design. Broadly, design features are described in terms of elemental component parts (micro-level), larger groupings of these (macro-level), and finally in terms of overarching, ‘whole book’ qualities (meta-level). Various features of book design emerge at different levels; for instance, the presence of nested discursive structures, a form of graphic recursion in editorial design, is proposed at the macro-level. Across these three levels are the intersecting categories of ‘rule’ and ‘context’, offering different perspectives with which to describe graphic characteristics. Contextbased features are contingent on social and cultural environment, the reader’s previous knowledge, and the actual conditions of reading; rule-based features relate to the systematic or codified aspects of graphic language. The model aims to be a frame of reference for graphic description, of use in different forms of qualitative or quantitative research and as a heuristic tool in practice and teaching.

Persistence of a wild type Escherichia coli and its multiple antibiotic-resistant (MAR) derivatives in the abattoir and on chilled pig carcasses

The aim of this study was to evaluate the ability of an Escherichia coli with the multiple antibiotic resistance (MAR) phenotype to withstand the stresses of slaughter compared to an isogenic progenitor strain. A wild type E. coli isolate (345-2RifC) of porcine origin was used to derive 3 isogenic MAR mutants. Escherichia coli 345-2RifC and its MAR derivatives were inoculated into separate groups of pigs. Once colonisation was established, the pigs were slaughtered and persistence of the E. coli strains in the abattoir environment and on the pig carcasses was monitored and compared. No significant difference (P>0.05) was detected between the shedding of the different E. coli strains from the live pigs. Both the parent strain and its MAR derivatives persisted in the abattoir environment, however the parent strain was recovered from 6 of the 13 locations sampled while the MAR derivatives were recovered from 11 of 13 and the number of MAR E. coil recovered was 10-fold higher than the parent strain at half of the locations. The parent strain was not recovered from any of the 6 chilled carcasses whereas the MAR derivatives were recovered from 3 out of 5 (P<0.001). This study demonstrates that the expression of MAR in 345-2RifC increased its ability to survive the stresses of the slaughter and chilling processes. Therefore in E. coli, MAR can give a selective advantage, compared to non-MAR strains, for persistence on chilled carcasses thereby facilitating transit of these strains through the food chain. (C) 2010 Elsevier B.V. All rights reserved.

Intergenerational persistence in health in developing countries : the penalty of gender inequality?

This paper is motivated to investigate the often neglected payoff to investments in the health of girls and women in terms of next generation outcomes. This paper investigates the intergenerational persistence of health across time and region as well as across the distribution of maternal health. It uses comparable microdata on as many as 2.24 million children born of about 0.6 million mothers in 38 developing countries in the 31 year period, 1970–2000. Mother's health is indicated by her height, BMI and anemia status. Child health is indicated by mortality risk and anthropometric failure. We find a positive relationship between maternal and child health across indicators and highlight non-linearities in these relationships. The results suggest that both contemporary and childhood health of the mother matter and that the benefits to the next generation are likely to be persistent. Averaging across the sample, persistence shows a considerable decline over time. Disaggregation shows that the decline is only significant in Latin America. Persistence has remained largely constant in Asia and has risen in Africa. The paper provides the first cross-country estimates of the intergenerational persistence in health and the first estimates of trends.

A theoretical framework for energy and momentum consistency in subgrid-scale parameterization for climate models

A theoretical framework for the joint conservation of energy and momentum in the parameterization of subgrid-scale processes in climate models is presented. The framework couples a hydrostatic resolved (planetary scale) flow to a nonhydrostatic subgrid-scale (mesoscale) flow. The temporal and horizontal spatial scale separation between the planetary scale and mesoscale is imposed using multiple-scale asymptotics. Energy and momentum are exchanged through subgrid-scale flux convergences of heat, pressure, and momentum. The generation and dissipation of subgrid-scale energy and momentum is understood using wave-activity conservation laws that are derived by exploiting the (mesoscale) temporal and horizontal spatial homogeneities in the planetary-scale flow. The relations between these conservation laws and the planetary-scale dynamics represent generalized nonacceleration theorems. A derived relationship between the wave-activity fluxes-which represents a generalization of the second Eliassen-Palm theorem-is key to ensuring consistency between energy and momentum conservation. The framework includes a consistent formulation of heating and entropy production due to kinetic energy dissipation.

A conceptual life event framework for government-to-citizen electronic service provision

In recent years, life event approach has been widely used by governments all over the world for designing and providing web services to citizens through their e-government portals. Despite the wide usage of this approach, there is still a challenge of how to use this approach to design e-government portals in order to automatically provide personalised services to citizens. We propose a conceptual framework for e-government service provision based on life event approach and the use of citizen profile to capture the citizen needs, since the process of finding Web services from a government-to-citizen (G2C) system involves understanding the citizens’ needs and demands, selecting the relevant services, and delivering services that matches the requirements. The proposed framework that incorporates the citizen profile is based on three components that complement each other, namely, anticipatory life events, non-anticipatory life events and recurring services.

A framework for agricultural adaptation to climate change in Southern Nigeria

The agricultural sector which contributes between 20-50% of gross domestic product in Africa and employs about 60% of the population is greatly affected by climate change impacts. Agricultural productivity and food prices are expected to rise due to this impact thereby worsening the food insecurity and poor nutritional health conditions in the continent. Incidentally, the capacity in the continent to adapt is very low. Addressing these challenges will therefore require a holistic and integrated adaptation framework hence this study. A total of 360 respondents selected through a multi-stage random sampling technique participated in the study that took place in Southern Nigeria from 2008-2011. Results showed that majority of respondents (84%) were aware that some climate change characteristics such as uncertainties at the onset of farming season, extreme weather events including flooding and droughts, pests, diseases, weed infestation, and land degradation have all been on the increase. The most significant effects of climate change that manifested in the area were declining soil fertility and weed infestation. Some of the adaptation strategies adopted by farmers include increased weeding, changing the timing of farm operations, and processing of crops to reduce post-harvest losses. Although majority of respondents were aware of government policies aimed at protecting the environment, most of them agreed that these policies were not being effectively implemented. A mutually inclusive framework comprising of both indigenous and modern techniques, processes, practices and technologies was then developed from the study in order to guide farmers in adapting to climate change effects/impacts.

Towards a life-event oriented G2C e-service provision: the NoBLE Framework

One of the primary features of modern government-to-citizen (G2C) service provision is the ability to offer a citizen-centric view of the e-government portal. Life-event approach is one of the most widely adopted paradigms supporting the idea of solving a complex event in a citizen’s life through a single service provision. Several studies have used this approach to design e-government portals. However, they were limited in terms of use and scalability. There were no mechanisms that show how to specify a life-event for structuring public e-services, or how to systematically match life-events with these services taking into consideration the citizen needs. We introduce the NOrm-Based Life-Event (NoBLE) framework for G2C e-service provision with a set of mechanisms as a guide for designing active life-event oriented e-government portals.