Contexto y retraso mental : SEC-UAM, Sistema de Evaluación de Centros.

Construir un sistema de evaluación de centros para sujetos con retraso mental. Diseñar y desarrollar un cuestionario utilizable en centros de Educacion Especial. Diversos centros de Educación Especial. El sistema evalúa 3 componentes genéricos: el centro, su entorno, los escenarios del centro y las diversas variables subcomponentes. El centro se toma como un sistema compuesto por diversos componentes (escenarios), relacionado con su marco socioambiental (entorno). Se han seguido los procedimientos estándar para la elaboración de los cuestionarios: elaboración del marco procedimental. Desarrollo de ítems ajustados al marco elaborado. Puesta a prueba del prototipo. Depuración del prototipo mediante acuerdo inter-jueces. Aplicación piloto del sistema. Revisión y re-estructuración. Aplicación y estudio piloto. Estructuración definitiva del cuestionario. Variables: localización y accesibilidad, congruencia, estética y conservación, equipamiento, riesgos, clima de relación, organización del centro, sociodemografía-alumnos, sociodemografía-profesorado, elementos psicosociales, impacto, clima social, servicio de comedor, aulas, talleres, aseos, internado, pasillos y escaleras y salones comunitarios. Cuaderno de corrección, inventario. El sistema, por sus propias características, no puede dar respuesta a las garantías clásicas exigidas por aquellos instrumentos destinados a medir estabilidad a lo largo del tiempo o de situaciones. Su principal virtud, debido al sistema de inventario, es su sensibilidad al cambio, y por lo tanto, entra en contradicción con medidas de estabilidad y predicción. Por esto, las garantías que se pueden ofrecer son en cuanto a su estructura y contenido. El sistema facilita la detección de los componentes susceptibles de modificación. El cuestionario evalúa los siguientes aspectos: entorno, centro, servicio de comedor, aulas y talleres. El prototipo del sistema se presenta como un instrumento útil para la evaluación de centros para personas con retraso mental. Su utilidad resulta interesante tanto si se aplica el sistema de forma global, como si sólo se aplica parcialmente. El sistema es útil también como instrumento para la planificación de la intervención en el centro. El cuestionario presenta una fácil aplicación y un cómodo y sencillo método de puntuación. El cuestionario presenta dos grandes virtudes. Por un lado, su exhaustividad, ya que evalúa de forma pormenorizada la mayor parte de los aspectos del funcionamiento, ubicación, clima social, etc., presentes en el centro y su entorno inmediato. Por otro lado, resulta un instrumento flexible en cuanto a su aplicación.

El diccionario : material para el aprendizaje.

El artículo forma parte de una sección de la revista dedicada a innovación educativa, en este número, a los materiales como recursos para el aprendizaje

Proyecto de centro para un colegio con ractacterísticas singulares.

El artículo forma parte de una sección de intercambio de experiencias dedicada a organización y gestión educativa

Análisis de materiales virtuales para la enseñanza de la economía.

Este artículo pertenece a una sección monográfica de la revista dedicada a la enseñanza de una ciencia social: la economía

Las murallas de Madrid : arqueología medieval urbana : guía arqueológica.

Este trabajo recoge información sobre las murallas de Madrid y su aportación al conocimiento de la sociedad medieval madrileña. En primer lugar, realiza un recorrido histórico-arqueológico sobre la ciudad, tanto del Madrid Andalusí, ciudad islámica, como del Madrid ciudad cristiana. Se ofrece también una guía de los recintos amurallados de la ciudad. El primer recorrido describe la ciudad islámica, situada junto al Viaducto, declarada Monumento Histórico-Artístico. En los cinco recorridos restantes, el itinerario es Puerta de Moros, Puerta Cerrada, Puerta de Guadalajara, Puerta de Balnadú, Alcázar y Palacio Real. Por último, incluye un glosario de términos.

Los equipos de atención educativa hospitalaria y domiciliaria en Castilla-La Mancha.

Análisis del proyecto de Atención Educativa Hospitalaria y Domiciliaria en Castilla-La Mancha. Se destina a niños de 3 a 18 años, enfermos y que no pueden asistir a clase por un período superior a 30 días. Mediante actividades específicas, se pretende la normalización de la situación escolar del niño compensando el aislamiento social e integrando los contextos familiar, escolar y social.

Supervisi??n e inspecci??n, a trav??s del tiempo

El art??culo forma parte de un dossier titulado: La inspecci??n educativa.

La nueva brecha digital. El futuro de las nuevas tecnolog??as en Primaria desde la formaci??n del profesorado

Monogr??fico con el t??tulo: " Formaci??n de profesores. Perspectivas de Brasil, Colombia, Espa??a y Portugal"

How was patient empowerment portrayed in information leaflets describing the community pharmacy Medicines Use Review service in the UK?

Objective The Medicines Use Review (MUR) community pharmacy service was introduced in 2005 to enhance patient empowerment but the service has not been taken up as widely as expected. We investigated the depiction of the patient–pharmacist power relationship within MUR patient information leaflets. Methods We identified 11 MUR leaflets including the official Department of Health MUR booklet and through discourse analysis examined the way language and imagery had been used to symbolise and give meaning to the MUR service, especially the portrayal of the patient–pharmacist interactions and the implied power relations. Results A variety of terminology was used to describe the MUR, a service that aimed ultimately to produce more informed patients through the information imparted by knowledgeable, skilled pharmacists. Conclusion The educational role of the MUR overshadowed the intended patient empowerment that would take place with a true concordance-centred approach. Although patient empowerment was implied, this was within the boundaries of the biomedical model with the pharmacist as the expert provider of medicines information. Practice implications If patient empowerment is to be conveyed this needs to be communicated to patients through consistent use of language and imagery that portrays the inclusivity intended.

What is the new medicines use review ‘patient survey’ attempting to capture in the context of existing patient satisfaction with pharmacy questionnaires and a new conceptual framework?

The community pharmacy service medicines use review (MUR) was introduced in 2005 ‘to improve patient knowledge, concordance and use of medicines’ through a private patient–pharmacist consultation. The MUR presents a fundamental change in community pharmacy service provision. While traditionally pharmacists are dispensers of medicines and providers of medicines advice, and patients as recipients, the MUR considers pharmacists providing consultation-type activities and patients as active participants. The MUR facilitates a two-way discussion about medicines use. Traditional patient–pharmacist behaviours transform into a new set of behaviours involving the booking of appointments, consultation processes and form completion, and the physical environment of the patient–pharmacist interaction moves from the traditional setting of the dispensary and medicines counter to a private consultation room. Thus, the new service challenges traditional identities and behaviours of the patient and the pharmacist as well as the environment in which the interaction takes place. In 2008, the UK government concluded there is at present too much emphasis on the quantity of MURs rather than on their quality.[1] A number of plans to remedy the perceived imbalance included a suggestion to reward ‘health outcomes’ achieved, with calls for a more focussed and scientific approach to the evaluation of pharmacy services using outcomes research. Specifically, the UK government set out the main principal research areas for the evaluation of pharmacy services to include ‘patient and public perceptions and satisfaction’as well as ‘impact on care and outcomes’. A limited number of ‘patient satisfaction with pharmacy services’ type questionnaires are available, of varying quality, measuring dimensions relating to pharmacists’ technical competence, behavioural impressions and general satisfaction. For example, an often cited paper by Larson[2] uses two factors to measure satisfaction, namely ‘friendly explanation’ and ‘managing therapy’; the factors are highly interrelated and the questions somewhat awkwardly phrased, but more importantly, we believe the questionnaire excludes some specific domains unique to the MUR. By conducting patient interviews with recent MUR recipients, we have been working to identify relevant concepts and develop a conceptual framework to inform item development for a Patient Reported Outcome Measure questionnaire bespoke to the MUR. We note with interest the recent launch of a multidisciplinary audit template by the Royal Pharmaceutical Society of Great Britain (RPSGB) in an attempt to review the effectiveness of MURs and improve their quality.[3] This template includes an MUR ‘patient survey’. We will discuss this ‘patient survey’ in light of our work and existing patient satisfaction with pharmacy questionnaires, outlining a new conceptual framework as a basis for measuring patient satisfaction with the MUR. Ethical approval for the study was obtained from the NHS Surrey Research Ethics Committee on 2 June 2008. References 1. Department of Health (2008). Pharmacy in England: Building on Strengths – Delivering the Future. London: HMSO. www. official-documents.gov.uk/document/cm73/7341/7341.pdf (accessed 29 September 2009). 2. Larson LN et al. Patient satisfaction with pharmaceutical care: update of a validated instrument. JAmPharmAssoc 2002; 42: 44–50. 3. Royal Pharmaceutical Society of Great Britain (2009). Pharmacy Medicines Use Review – Patient Audit. London: RPSGB. http:// qi4pd.org.uk/index.php/Medicines-Use-Review-Patient-Audit. html (accessed 29 September 2009).

A retrospective audit of medicines use review forms

The medicines use review (MUR) service was introduced in England and Wales in 2005 to improve patients’ knowledge and use of medicines through a private, patient–pharmacist consultation. The pharmacist completes a standard form as a record of the MUR consultation and the patient receives a copy. The 2008 White Paper, Pharmacy in England[1] notes some MURs are of poor or questionable quality and there are anecdotal reports that pharmacists elect to conduct ‘easy’ MURs with patients on a single prescribed medicine only.[2] In 2009, the Royal Pharmaceutical Society of Great Britain (RPSGB) launched a multi-disciplinary audit template to review the effectiveness of MURs and improve their quality.[3] Prior to this, we conducted a retrospective MUR audit in a 1-month period in 2008. Our aims were to report on findings from this audit and the validity of using MUR forms as data for audit.

How is the language of medicines use review leaflets symbolising the service?

Introduction The medicines use review (MUR), a new community pharmacy ‘service’, was launched in England and Wales to improve patients’ knowledge and use of medicines through a private, patient–pharmacist appointment. After 18 months, only 30% of pharmacies are providing MURs; at an average of 120 per annum (maximum 400 allowed).1 One reason linked to low delivery is patient recruitment.2 Our aim was to examine how the MUR is symbolised and given meaning via printed patient information, and potential implications. Method The language of 10 MUR patient leaflets, including the NHS booklet,3 and leaflets from multiples and wholesalers was evaluated by discourse analysis. Results and Discussion Before experiencing MURs, patients conceivably ‘categorise’ relationships with pharmacists based on traditional interactions.4 Yet none of the leaflets explicitly describe the MUR as ‘new’ and presuppose patients would become involved in activities outside of their pre-existing relationship with pharmacists such as appointments, self-completion of charts, and pharmacy action plans. The MUR process is described inconsistently, with interchangeable use of formal (‘review meeting‘) and informal (‘friendly’) terminology, the latter presumably to portray an intended ‘negotiation model’ of interaction.5 Assumptions exist about attitudes (‘not understanding’; ‘problems’) that might lead patients to an appointment. However, research has identified a multitude of reasons why patients choose (or not) to consult practitioners,6 and marketing of MURs should also consider other barriers. For example, it may be prudent to remove time limits to avoid implying patients might not be listened to fully, during what is for them an additional practitioner consultation.

A conceptual framework of patient satisfaction with a pharmacy adherence service

Background Patients do not adhere to their medicines for a host of reasons which can include their underlying beliefs as well as the quality of their interactions with healthcare professionals. One way of measuring the outcome of pharmacy adherence services is to assess patient satisfaction but no questionnaire exists that truly captures patients' experiences with these relatively new services. Objective Our objective was to develop a conceptual framework specific to patient satisfaction with a community pharmacy adherence service based on criteria used by patients themselves. Setting The study was based in community pharmacies in one large geographical area of the UK (Surrey). All the work was conducted between October 2008 and September 2010. Methods This study involved qualitative non-participant observation and semi-structured interviewing. We observed the recruitment of patients to the Medicines Use Review (MUR) service and also actual MUR consultations (7). We also interviewed patients (15). Data collection continued until no new themes were identified during analysis. We analysed interviews to firstly create a comprehensive account of themes which had significance within the transcripts, then created sub-themes within super-ordinate categories. We used a structure-process-outcome approach to develop a conceptual framework relating to patient satisfaction with the MUR. Favourable ethical opinion for this study was received from the NHS Surrey Research Ethics Committee on 2nd June 2008. Results Five super-ordinate themes linked to patient satisfaction with the MUR service were identified, including relationships with healthcare providers; attitudes towards healthcare providers; patients' experience of health, healthcare and medicines; patients' views of the MUR service; the logistics of the MUR service. In the conceptual framework, structure was conceptualised as existing relationships, environment, and time; process was conceptualised as related to recruitment and consultation stages; and outcome as two concepts of immediate patient outcomes and satisfaction on reflection. Conclusion We identified and highlighted factors that can influence patient satisfaction with the MUR service and this led to the development of a conceptual framework of patient satisfaction with the MUR service. This can form the basis for developing a questionnaire for measuring patient satisfaction with this and similar pharmacy adherence services. Impact of findings on practice * Pharmacists and researchers can access the relevant ideas presented here in relation to patient satisfaction with pharmacy adherence services. * Researcher can use the conceptual framework as a basis for measuring the quality of pharmacy adherence services. * Community pharmacists can improve the quality of healthcare they provide by realizing concepts relevant to patient satisfaction with adherence services.

Ex Situ Scanning Electrochemical Microscopy (SECM) Investigation of Bismuth- and Bismuth/Lead Alloy Film-Modified Gold Electrodes in Alkaline Medium

Scanning electrochemical microscopy (SECM) in feedback mode was employed to characterise the reactivity and microscopic peculiarities of bismuth and bismuth/lead alloys plated onto gold disk substrates in 0.1 molL(-1) NaOH solutions. Methyl viologen was used as redox mediator, while a platinum microelectrode was employed as the SECM tip. The metal films were electrodeposited ex situ from NaOH solutions containing either bismuth ions only or both bismuth and lead ions. Approach curves and SECM images indicated that the metal films were conductive and locally reactive with oxygen to provide Bi(3+) and Pb(2+) ions. The occurrence of the latter chemical reactions was verified by local anodic stripping voltammetry (ASV) at the substrate solution interface by using a mercury-coated platinum SECM tip. The latter types of measurements allowed also verifying that lead was not uniformly distributed onto the bismuth film electrode substrate. These findings were confirmed by scanning electron microscopy images. The surface heterogeneity produced during the metal deposition process, however, did not affect the analytical performance of the bismuth coated gold electrode in anodic stripping voltammetry for the determination of lead in alkaline media, even in aerated aqueous solutions. Under the latter conditions, stripping peak currents proportional to lead concentration with a satisfactory reproducibility (within 5% RSD) were obtained.