Be SMART:examining the experience of implementing the NHS Health Check in UK primary care

Background: The NHS Health Check was designed by UK Department of Health to address increased prevalence of cardiovascular disease by identifying risk levels and facilitating behaviour change. It constituted biomedical testing, personalised advice and lifestyle support. The objective of the study was to explore Health Care Professionals' (HCPs) and patients' experiences of delivering and receiving the NHS Health Check in an inner-city region of England. Methods: Patients and HCPs in primary care were interviewed using semi-structured schedules. Data were analysed using Thematic Analysis. Results: Four themes were identified. Firstly, Health Check as a test of 'roadworthiness' for people. The roadworthiness metaphor resonated with some patients but it signified a passive stance toward illness. Some patients described the check as useful in the theme, Health check as revelatory. HCPs found visual aids demonstrating levels of salt/fat/sugar in everyday foods and a 'traffic light' tape measure helpful in communicating such 'revelations' with patients. Being SMART and following the protocolrevealed that few HCPs used SMART goals and few patients spoke of them. HCPs require training to understand their rationale compared with traditional advice-giving. The need for further follow-up revealed disparity in follow-ups and patients were not systematically monitored over time. Conclusions: HCPs' training needs to include the use and evidence of the effectiveness of SMART goals in changing health behaviours. The significance of fidelity to protocol needs to be communicated to HCPs and commissioners to ensure consistency. Monitoring and measurement of follow-up, e.g., tracking of referrals, need to be resourced to provide evidence of the success of the NHS Health Check in terms of healthier lifestyles and reduced CVD risk.

Comparative administrative reform: The rhetoric and reality of the Civil Service reform programs in Uganda and Tanzania

Administrative reform is a challenging endeavor for both developed and developing countries alike. For developing countries, the challenge is greater because numerous reforms are implemented concurrently sometimes under conditions of resource scarcity and political instability. So far there is no consensus as to what makes some reforms succeed and others fail. The current study seeks to fill that gap by offering an empirical comparative analysis of the administrative reforms initiated in Uganda and Tanzania since the early 1990s. The purpose of the study is to explain the similarities and differences, and give reasons for the successes and failures of the reform programs in the two countries. It focuses on four major areas; the size of the civil service, pay reform, capacity building, and ethics and accountability. Data were collected via in-depth face to face interviews with 35 key government officials and the content analysis of various documents. The results indicate that the reforms generated initial substantial reduction in the size of the public services in both countries. In Uganda, the traditional civil service was reduced from 140,500 in 1990 to 41,730 in 2004; while in Tanzania Ministries, Departments, and Agencies were reduced by 25%. Pay reform has generated substantial increases in civil servants' salaries in both countries but in Uganda, the government has not been able to abide by the pay strategy while in Tanzania the strategy guides the increments. Civil Service capacity building efforts have focused on enhancing the skills of the personnel. Training needs assessments were undertaken in all ministries in Uganda and a training policy was formulated. In Tanzania, the training needs assessments are still under way and a training policy has not yet been developed. Ethics and accountability are great challenges in both countries, but in Tanzania, there is more political will and commitment to improve the integrity of the civil service. The findings reveal that although Uganda started the reform with much more rigor and initial success, Tanzania has surpassed it and has a more stable, consistent, and promising reform record. This is because Uganda's leadership lacks political legitimacy. The country has since the late 1990s experienced a civil war in the northern and western parts of the country while Tanzania has benefitted from relative peace and high level political legitimacy.

Química em cena: uma proposta para formação inicial de professores de química

In educational observed difficulty in train teachers to meet the medium and higher education needs, and one reason for this is the different experiences in the training of educators in relation to those found in the classroom. So often arise criticisms related to relevance and efficiency of degree courses, as regards the performance of its natural mission, which weakens the teacher training. Thus, improving the quality of education is very dependent on the initiatives of teachers, creating teaching alternatives to strengthen their performance in school. From this reflection, it is concluded that teacher training needs new educational proposals that qualify, and so can promote the formation of his students more adequately. Among the educational proposals as alternatives to initial teacher training may use the scientific theater (TC). Considering this possibility, this work has been proposed as investigate and discuss the influence of TC combined with experimentation in the initial training of future teachers in Chemistry who participate in the Groups Fanatics chemistry Theatre (UERN) and Chemistry on Stage (UFRN). Therefore, there was, in a first stage, theatrical essays based on the theater of the oppressed, and written dramaturgical scripts, a collaborative proposal. To incorporate experimentation in chemistry to theater rehearsals, there was a systematic literature search and after content analysis, were selected categories, materials and reagents easily accessible, easy procedures and implementation with low risk of accidents and easy care chemical waste. In the second part we identified: a) the beliefs of student teachers in the use of TC ally trial for initial training of chemistry teachers; b) the influence of TC ally to trial on learning of chemical concepts of high school students who attended the shows; c) the reasons for using or not TC ally to trial by chemistry teachers who participated in the TC group and currently work in the classroom. In this study, questionnaires and interviews were used, compounds, respectively, by a Likert scale and open questions. Quantitative data were analyzed by classical statistics the media, using as centrality measures the average, the concordance argument and the average deviation. Qualitative data were discussed according to content analysis, with categories that emerged from reading the answers. These analyzes concluded that the licensees have a positive view on the use of scientific theater for disclosure of the chemical for use in the learning of chemical concepts, pedagogical and disciplinary knowledge, and to form promotion strategy for research and extension at the University. They credit improvements in their initial training on the use of scientific theater combined with experimentation. The TC provides motivation for the construction of conceptual thinking in an informal way of chemical communication, allowing the student to expand their knowledge, not only favoring the phenomenological approach, but also the construction of chemical knowledge and the internalization of scientific concepts.

Necessidades formativas em Matemática representadas nas vozes de um grupo de professoras dos anos iniciais da rede pública de ensino

Teacher training processes, initial and continuing, and professional practice of teachers who teach Mathematics in the early years are highlighted in the literature as complex, but also are regarded as the way to overcome many difficulties in teaching this component curriculum in the school stage in question. The aim of the study was to investigate how the training needs in Mathematics are represented by a group of teachers in the early years of elementary school of public health system of the city of Uberlândia, State of Minas Gerais. The research, qualitative approach, had as object of study the training needs, in Mathematics, of teachers in the early years. The research involved 16 teachers from two schools in the municipal public schools of that city. Data were collected through questionnaires, non-participant observations, semi-structured interviews followed by group and individual. Analyses were performed by means of thematic categories, founded by content analysis. Data interpretation allowed to understand training needs in mathematics that are presented to the collaborating group from their professional practice, considering the knowledge and skills necessary to teaching. It is understood that the teachers of the study group have major limitations in relation to the specific content and didactic knowledge of Mathematics content, however, the concern is that demonstrated not always being aware of it. Moreover, the difficulties experienced in teaching practice proven to be overcome by sources and non-formal training activities, primarily through more experienced colleagues in the profession. Thus, it becomes difficult to think the initial and continuing training courses for teachers without the training needs of the teaching practice is appreciated as an object of study.

Sales resource management training:a guide to developing effective salespeople

This paper adopts a sales resource management (SRM) framework to provide guidance on how to develop effective salespeople via sales training. SRM can be used to identify the individual training needs based on the individual-based modelling data. The individual-based modelling data can also be used to evaluate the outcome of sales training. This paper also gives some suggestions on the forms of sales training which are most likely to develop effective salespeople. © 2010 IEEE.

Comparative Administrative Reform: The Rhetoric and Reality of the Civil Service Reform Programs in Uganda and Tanzania

Administrative reform is a challenging endeavor for both developed and developing countries alike. For developing countries, the challenge is greater because numerous reforms are implemented concurrently sometimes under conditions of resource scarcity and political instability. So far there is no consensus as to what makes some reforms succeed and others fail. The current study seeks to fill that gap by offering an empirical comparative analysis of the administrative reforms initiated in Uganda and Tanzania since the early 1990s. The purpose of the study is to explain the similarities and differences, and give reasons for the successes and failures of the reform programs in the two countries. It focuses on four major areas; the size of the civil service, pay reform, capacity building, and ethics and accountability. Data were collected via in-depth face to face interviews with 35 key government officials and the content analysis of various documents. The results indicate that the reforms generated initial substantial reduction in the size of the public services in both countries. In Uganda, the traditional civil service was reduced from 140,500 in 1990 to 41,730 in 2004; while in Tanzania Ministries, Departments, and Agencies were reduced by 25%. Pay reform has generated substantial increases in civil servants’ salaries in both countries but in Uganda, the government has not been able to abide by the pay strategy while in Tanzania the strategy guides the increments. Civil Service capacity building efforts have focused on enhancing the skills of the personnel. Training needs assessments were undertaken in all ministries in Uganda and a training policy was formulated. In Tanzania, the training needs assessments are still under way and a training policy has not yet been developed. Ethics and accountability are great challenges in both countries, but in Tanzania, there is more political will and commitment to improve the integrity of the civil service. The findings reveal that although Uganda started the reform with much more rigor and initial success, Tanzania has surpassed it and has a more stable, consistent, and promising reform record. This is because Uganda’s leadership lacks political legitimacy. The country has since the late 1990s experienced a civil war in the northern and western parts of the country while Tanzania has benefitted from relative peace and high level political legitimacy.

Journalistic organisations with regard to training and professional changes. Parallelisms with academic discourse

The present paper analyses the parallelism existing between academic and professional discourse regarding three interrelated subjects: journalists´ training needs, their adaptation to multimedia profile changes and recognition of University graduates via professional regulation. This study relies on a bibliographical review and brings together the opinion of five professional groups by means of an interview using an openended questionnaire. The results show a coincidence in both discourses regarding the need for firmly grounded training of the journalists with study plans which integrate the new profiles. At the same time, it reflects the discrepancy of the journalistic groups with regard to professional regulation based on the University degree, whose vindication does not appear to be a priority in academic circles.

Nurses' experiences of pain management for people with advanced dementia approaching the end of life: a qualitative study

AIMS AND OBJECTIVES: To explore hospice, acute care and nursing home nurses' experiences of pain management for people with advanced dementia in the final month of life. To identify the challenges, facilitators and practice areas requiring further support.

BACKGROUND: Pain management in end-stage dementia is a fundamental aspect of end of life care; however, it is unclear what challenges and facilitators nurses experience in practice, whether these differ across care settings, and whether training needs to be tailored to the context of care.

DESIGN: A qualitative study using semi-structured interviews and thematic analysis to examine data.

METHODS: 24 registered nurses caring for people dying with advanced dementia were recruited from ten nursing homes, three hospices, and two acute hospitals across a region of the United Kingdom. Interviews were conducted between June 2014 and September 2015.

RESULTS: Three core themes were identified: challenges administering analgesia, the nurse-physician relationship, and interactive learning and practice development. Patient-related challenges to pain management were universal across care settings; nurse- and organisation-related barriers differed between settings. A need for interactive learning and practice development, particularly in pharmacology, was identified.

CONCLUSIONS: Achieving pain management in practice was highly challenging. A number of barriers were identified; however, the manner and extent to which these impacted on nurses differed across hospice, nursing home and acute care settings. Needs-based training to support and promote practice development in pain management in end-stage dementia is required.

RELEVANCE TO CLINICAL PRACTICE: Nurses considered pain management fundamental to end of life care provision; however, nurses working in acute care and nursing home settings may be under-supported and under-resourced to adequately manage pain in people dying with advanced dementia. Nurse-to-nurse mentoring and ongoing needs-assessed interactive case-based learning could help promote practice development in this area. Nurses require continuing professional development in pharmacology. This article is protected by copyright. All rights reserved.

“There’s a Catch-22”. The complexities of pain management for people with advanced dementia nearing the end of life: a qualitative exploration of physicians’ perspectives

Background: Pain management is a cornerstone of palliative care. The clinical issues encountered by physicians when managing pain in patients dying with advanced dementia, and how these may impact on prescribing and treatment, are unknown. Aim: To explore physicians’ experiences of pain management for patients nearing the end of life, the impact of these on prescribing and treatment approaches, and the methods employed to overcome these challenges. Design: Qualitative, semi-structured interview study exploring: barriers to and facilitators of pain management, prescribing and treatment decisions, and training needs. Thematic analysis was used to elicit key themes. Settings/Participants: Twenty-three physicians, responsible for treating patients with advanced dementia approaching the end of life, were recruited from primary care (n=9), psychiatry (n=7) and hospice care (n=7). Results: Six themes emerged: diagnosing pain, complex prescribing and treatment approaches, side-effects and adverse events, route of administration, importance of sharing knowledge and training needs. Knowledge exchange was often practised through liaison with physicians from other specialties. Cross-specialty mentoring, and the creation of knowledge networks were believed to improve pain management in this patient population. Conclusions: Pain management in end-stage dementia is complex, requiring cross-population of knowledge between palliative care specialists and non-specialists, in addition to collateral information provided by other health professionals and patients’ families. Regular, cost- and time-effective mentoring and ongoing professional development are perceived to be essential in empowering physicians to meet clinical challenges in this area.

Mental health nurses’ attitudes, behaviour, experience and knowledge regarding adults with a diagnosis of borderline personality disorder: systematic, integrative literature review

Aims and objectives To establish whether mental health nurses responses to people with borderline personality disorder are problematic and, if so, to inform solutions to support change. Background There is some evidence that people diagnosed with borderline personality disorder are unpopular among mental health nurses who respond to them in ways which could be counter-therapeutic. Interventions to improve nurses’ attitudes have had limited success. Design Systematic, integrative literature review. Methods Computerised databases were searched from inception to April 2015 for papers describing primary research focused on mental health nurses’ attitudes, behaviour, experience, and knowledge regarding adults diagnosed with borderline personality disorder. Analysis of qualitative studies employed metasynthesis; analysis of quantitative studies was informed by the theory of planned behaviour. Results Forty studies were included. Only one used direct observation of clinical practice. Nurses’ knowledge and experiences vary widely. They find the group very challenging to work with, report having many training needs, and, objectively, their attitudes are poorer than other professionals’ and poorer than towards other diagnostic groups. Nurses say they need a coherent therapeutic framework to guide their practice, and their experience of caregiving seems improved where this exists. Conclusions Mental health nurses’ responses to people with borderline personality disorder are sometimes counter-therapeutic. As interventions to change them have had limited success there is a need for fresh thinking. Observational research to better understand the link between attitudes and clinical practice is required. Evidence-based education about borderline personality disorder is necessary, but developing nurses to lead in the design, implementation and teaching of coherent therapeutic frameworks may have greater benefits. Relevance to clinical practice There should be greater focus on development and implementation of a team-wide approach, with nurses as equal partners, when working with patients with borderline personality disorder.

A história da ciência como subsídio para a construção do conhecimento do conceito da dupla hélice

Acompanha: Dupla-hélice: a construção de um conhecimento

A operacionalização do programa de matemática em vigor no 1.º Ciclo do Ensino Básico pelos professores do concelho de Machico

Trabalho de projeto apresentado à Escola Superior de Educação de Paula Frassinetti para obtenção do grau de Mestre em Ciências da Educação Especialização em Supervisão Pedagógica

Between Stimulation and Overwhelming: Reflections on the Usage of Videos for Teacher Training in Tanzania

The article reflects on a pilot teacher training programme in Tanzania, where videos are used for implementing new teaching methods, but also for initiating a discourse about corporal punishment. The culture of instruction in Tanzania is strictly based on a teacher-centred approach which leaves all activity to the teacher and turns students into passive listeners. In most cases, teachers deal with up to 80 students in one classroom. Therefore, discipline is an important matter of instruction and many teachers still use corporal punishment that is widely accepted in Tanzania. The launched training programme has the aim of implementing learner-centred teaching methods without using corporal punishment and offers Tanzanian teachers the possibility to participate in a workshop that connects these methods with subject-related topics. In the English teaching workshop, the facilitator used filmed English lessons from a German school to discuss with the participants both the application of learner-centred methods and the absence of corporal punishment. The use of these German videos shows advantages but also limitations that are strongly related to the European versus African setting. The article discusses these dimensions on the basis of data that are generated by ethnographical observation and audiotranscripts of the piloted workshop.

Relatório final de estágio realizado na Escola Básica Eugénio dos Santos

O estágio pedagógico é o culminar de todo um processo que teve início na formação inicial e no qual, o futuro professor pode pôr em prática as competências adquiridas ao longo dessa formação. Este compreende um conjunto de tarefas que proporcionam a organização, estruturação e realização do processo de ensino-aprendizagem. O presente relatório visa realizar de forma reflexiva e projetiva, a análise de todo o processo formativo decorrente do estágio pedagógico em Educação Física. Este momento de formação foi determinante para o desenvolvimento de conhecimentos e competências que me permitem resolver os problemas do processo de ensino-aprendizagem de modo mais eficaz e adequado, promovendo melhores condições para a aprendizagem dos alunos. Ao longo do estágio pedagógico destaco as dificuldades iniciais e a progressão percecionada em competências fundamentais para o desenvolvimento das funções de professor, como um superior conhecimento pedagógico do conteúdo, capacidade de planear conteúdos, e capacidade de realizar um real acompanhamento ativo das aprendizagens dos alunos, fomentando a avaliação formativa. Para o meu futuro profissional, considero necessário continuar a desenvolver esforços para apresentar capacidade de autocrítica, promover o trabalho colaborativo e cooperativo, e ainda manter uma procura incessante de superação e reflexão contínua. Estes são no meu entender fatores que têm um efeito muito importante no desempenho do professor e no processo de ensino-aprendizagem dos alunos.

O currículo de matemática do 1º ciclo doensino secundário de Cabo Verde na perspectiva de professores

Este estudo tem por objetivo compreender a perspetiva de professores sobre o currículo de Matemática do 1º ciclo do Ensino Secundário cabo-verdiano e conhecer necessidades de formação que identificam, para um melhor desempenho na sua catividade profissional. As questões de estudo são: 1) Como se reveem os professores de Matemática no currículo do 1º ciclo do Ensino Secundário, enquanto agentes que interpretam e implementam esse currículo? 2) Que potencialidades e dificuldades reconhecem nesse currículo? 3) Que áreas consideram haver necessidade de formação, para a melhoria da sua prática docente, nesse nível de ensino? O desenvolvimento do referencial teórico integra duas áreas temáticas como eixos centrais: o currículo, o professor e o professor de Matemática. Foi feita uma análise de normativos cabo-verdianos para a educação, entre os quais se destacam a Lei de Bases do Sistema Educativo, o Plano de estudos para o ensino secundário e o Programa de Matemática do 1o ciclo do Ensino Secundário. A metodologia adotada na investigação segue uma abordagem interpretativa e descritiva, suportada por um design de estudo de caso. São estudados três casos, relativos a professores de Matemática cabo-verdianos do 1º ciclo do Ensino Secundário. A recolha de dados recorre a urna entrevista semiestruturada a cada professor, à observação de três aulas por professor participante e à recolha documental. A análise de dados foi feita utilizando principalmente a técnica de análise de conteúdos. Os professores revêem-se como executores de um currículo uniforme, de cumprimento obrigatório, normativo, emanado centralmente e do qual procuram interpretar as intenções. A sua visão de currículo é centrada nos conteúdos do programa, um dos motivos para que o enquadramento ao nível dos meios institucionais e as competências esperadas ao nível do saber fazer e ao nível do saber ser nem sempre serem conhecidas e/ou cumpridas. Em Acão, revêem-se como figuras centrais do currículo. Todos se reveem com mais competência na implementação curricular à medida que vão adquirindo experiência profissional. Concordam com os temas do programa e um deles sugere a inclusão de um tema. Consideram que os conteúdos nem sempre estão bem organizados e mostram a necessidade de a metodologia do programa ser mais detalhada, evidenciando claramente os seus propósitos. Eventualmente, podem não concordar com a estrutura de currículo em espiral do programa. Os professores identificam mais formação com melhor desempenho. As necessidades de formação são: Metodologia do Ensino da Matemática, Resolução de Problemas, Avaliação e a Geometria ligada à utilização de materiais pedagógicos. O estudo parece indicar que os professores não desenvolvem práticas diferentes por não terem essa vivência e aponta os professores mais jovens como mais abertos à mudança. ABSTRACT: The aim of this study is to understand the perspective of the teacher in relation to the Mathematics curriculum of the 1st cycle of Secondary School of Cape Verde (grades 7-8) and to learn about his/her training needs to develop better skills and performance in their professional activity. The key questions in this study are: 1) how do Mathematics teachers, acting in the capacity of agents who interpret and implement the 1st cycle of Secondary School curriculum, see themselves in this curriculum? 2) What potentialities and difficulties can they recognize in the curriculum? 3) What areas do they consider in need of training to improve teaching capacity within such education grade? The theoretical framework of this investigation integrates two main areas: the curriculum and the teacher. An analysis of Cape-Verdian normative texts for education has been made, including the Lei de Bases do Sistema Educativo (Basis Law of the Educational System), the Study plan for secondary school and the Mathematics program of the 1st cycle of secondary school. ln terms of methodology, we opted for an interpretative approach to our investigation, namely the case study. We looked at three case studies concerning the Cape-Verdian mathematics teacher of the 1st cycle of secondary school. The data collection uses a semi­structured interview for each teacher, the observation of three classes per participating teacher and the documental collection. Content analysis is the main technique used for analyzing the data. Teachers see themselves as practitioners of a uniform curriculum with mandatory compliance and delineated guidelines set by the administration, and they follow their own understanding of its intended purpose. Their vision of the curriculum is focused on program contents, one of the reasons why the expected skills at the level of "how to do" and "how to be" are not always known and/or done. ln their professional setting they see themselves with professional skills growing in tandem with professional experience. They all agree with the program contents but one of them suggests one content to add. ln their opinion the program is not always well organized and they suggest the need for a more comprehensive and detailed methodology of program contents. ln addition, they might not agree with the spiral structure of the program curriculum. They also identified the need for more elaborate professional training including: A Methodology for Mathematics Education, solving problems, Evaluation and the Geometry related to the utilization of pedagogical materials. The study seems to indicate that teachers refrain from developing different practices because of lack of experience but also demonstrates that younger teachers are more open to change.