487 research outputs found
The views of non-medical prescribing students and medical mentors on interprofessional competency assessment: a qualitative exploration.
Get PDFThe United Kingdom (UK) is one of the least restrictive countries in terms of scope of prescribing practice for non-medical prescribers and is a rapidly expanding group of professionals. In the United Kingdom nurse prescribers are assessed in practice by Designated Medical Practitioners (DMP) (doctors) which is a unique approach. In light of proposals to permit nurses to assess each other the benefits and challenges associated with current approach to interprofessional assessment warranted further exploration. The aim was to explore interprofessional competency assessment with nurse non-medical prescribing students and their DMPs. A descriptive qualitative research design was undertaken using semi-structured interviews and focus groups. The study was completed in a Scottish University that provides non-medical prescribing education to nurses, midwives and allied health professionals. Students (n = 6) participated in two focus groups at the start and end of their supervised learning and assessment in practice. DMPs (n = 6) participated in semi structured telephone interviews on completion of supervision. Utilising Clark's theory of interprofessional education, a thematic analysis was conducted. Professional identity influenced interpretation of prescribing competence with regards assessment and scope of practice. Students and DMPs learned with, from and about each other, and provided a platform for two-way learning and mutual professional respect. The interprofessional learning experience developed relationships and provided ratification for the prescribing role post qualification. Further exploration with key stakeholders and service users is recommended, prior to any changes to the designated professional group assigned to assessing non-medical prescribing competence
Time-resolved photoelectron imaging of excited state relaxation dynamics in phenol, catechol, resorcinol and hydroquinone
Get PDFTime-resolved photoelectron imaging was used to investigate the dynamical evolution of the initially prepared S1 (\u3c0\u3c0*) excited state of phenol (hydroxybenzene), catechol (1,2-dihydroxybenzene), resorcinol (1,3-dihydroxybenzene), and hydroquinone (1,4-dihydroxybenzene) following excitation at 267 nm. Our analysis was supported by ab initio calculations at the coupled-cluster and CASSCF levels of theory. In all cases, we observe rapid (<1 ps) intramolecular vibrational redistribution on the S1potential surface. In catechol, the overall S1 state lifetime was observed to be 12.1 ps, which is 1\u20132 orders of magnitude shorter than in the other three molecules studied. This may be attributed to differences in the H atom tunnelling rate under the barrier formed by a conical intersection between the S1 state and the close lying S2 (\u3c0\u3c3*) state, which is dissociative along the O\u2013H stretching coordinate. Further evidence of this S1/S2 interaction is also seen in the time-dependent anisotropy of the photoelectron angular distributions we have observed. Our data analysis was assisted by a matrix inversion method for processing photoelectron images that is significantly faster than most other previously reported approaches and is extremely quick and easy to implement.Peer reviewed: YesNRC publication: Ye
Following the excited state relaxation dynamics of indole and 5-hydroxyindole using time-resolved photoelectron spectroscopy
Get PDFTime-resolved photoelectron spectroscopy was used to obtain new information about the dynamics of electronic relaxation in gas-phase indole and 5-hydroxyindole following UV excitation with femtosecond laser pulses centred at 249 nm and 273 nm. Our analysis of the data was supported by ab initio calculations at the coupled cluster and complete-active-space self-consistent-field levels. The optically bright 1La and 1Lb electronic states of 1\u3c0\u3c0* character and spectroscopically dark and dissociative 1\u3c0\u3c3* states were all found to play a role in the overall relaxation process. In both molecules we conclude that the initially excited 1La state decays non-adiabatically on a sub 100 fs timescale via two competing pathways, populating either the subsequently long-lived 1Lb state or the 1\u3c0\u3c3* state localised along the N-H coordinate, which exhibits a lifetime on the order of 1 ps. In the case of 5-hydroxyindole, we conclude that the 1\u3c0\u3c3* state localised along the O-H coordinate plays little or no role in the relaxation dynamics at the two excitation wavelengths studied.Peer reviewed: YesNRC publication: Ye
Communications strategy : project - the impacts of COVID-19 responses on the political economy of African food systems
Get PDFThe project survey revealed that national ministries of land, agriculture and fisheries, as well as local governments, were considered to be the two most important targets for communication strategies. In general, results show that communications efforts should shift from one understanding of food systems (shaped largely by the idea of “food security” and the interests of big corporate players) to another perhaps more democratic, local, inclusive and sustainable conceptualisation. For example, in South Africa the response to food shortages under COVID was to deliver industrially farmed and manufactured food relief, which had the effect of reinforcing corporate power in the food system
Development and evaluation of a theoretical model to predict medicines adherence in people with mild to moderate intellectual disability and diabetes: a mixed methods study.
Get PDFBackground: Fifty percent of medications are not taken as prescribed. This is a major public health issue yet there is very limited evidence on the factors associated with medicines adherence in people with mild to moderate Intellectually Disabilities and diabetes (IDD). This study evaluated the frequency of, and factors associated with, medicines non-adherence in this group compared to people without ID but with diabetes (non-IDD).Methods: A systematic review of the literature informed the theoretical model tested. A two-stage, sequential mixed methods study with 111 people with type 1 and 2 diabetes, (IDD = 33, non-IDD = 78) was then carried out. Stage one (quantitative) compared frequency of medication adherence in the group overall, IDD and non-IDD. Univariate and multiple regression analysis evaluated associations between factors (ID, depression, side effects, self-efficacy and perceived level of social support) and medicines non-adherence. Stage two (qualitative) explored findings of stage one with 12 stage one participants’ carers using semi-structured interviews.Results: Data were collected between July 2014 and May 2016. The frequency of medicines adherence was similar in the IDD and non-IDD population (70% vs 62%, p = 0.41). The theoretical model did not predict medicines non-adherence. After controlling for support with medicines and complexity of regime (number of medications and use of insulin), depression was an independent predictor in the non-IDD and group overall (p < 0.001). In the IDD group, perceived side effects was an important, but non-significant, predictor of non-adherence (p = 0.06). Carers’ perceptions of adherence and depression were consistent with stage one findings.Conclusions: Optimising adherence to diabetes medicines is equally challenging in IDD and non-IDD populations. Associations between independent factors and adherence differed between the two groups: in the non-IDD population, depressive symptoms were associated with non-adherence whereas in the IDD population perceived level of side effects appeared most dominant. Due to small sample sizes findings were inconclusive therefore, a sufficiently powered study further investigating the relationship between adherence and side effects in people with ID and diabetes is recommended
Is the sanitation sector ready for the post 2015 goals? Lessons learnt from Zambia
Get PDFThe new post 2015 targets and indicators for sanitation pose a new challenge for the sector. Developing countries will have to achieve sanitation service provision which goes beyond access to a toilet and ensures the adequate management of excreta beyond the containment facility. To establish whether the sector is ready for such a challenge, this paper looks to draw upon research findings from informal settlements in Lusaka, Zambia. The presentation will define factors which should be addressed that may directly impact on the achievement of the post 2015 indicators and how successfully they can be monitored
Identifying educational practices that promote inclusion for students with a hearing loss
Get PDFThe project being described in this paper used both quantitative and qualitative methods of analysis to assess the perceived effectiveness of the work of itinerant teachers of the deaf in promoting inclusion in mainstream classrooms for students with significant hearing loss. Methods of data collection used include questionnaires and semi-structured interviews. The results of the study identified factors that enhanced or inhibited the effectiveness of their interventions as well as the perceived effectiveness of the strategies used in intervention. Ages/grades of the students affected the type and perceived importance of direct intervention strategies used with students, but more specifically the students' individual educational circumstances and needs relating to accessing information delivered primarily through spoken language. The assistance offered to the classroom teacher appeared to be less influenced by a student's age or grade, and related to the imperative of curriculum delivery and time available to assist the teacher in developing the skills to adequately accommodate the students' needs
The views of non-medical prescribing students and medical mentors on interprofessional competency assessment – A qualitative exploration
Get PDFBackgroundThe United Kingdom (UK) is one of the least restrictive countries in terms of scope of prescribing practice for non-medical prescribers and is a rapidly expanding group of professionals. In the United Kingdom nurse prescribers are assessed in practice by Designated Medical Practitioners (DMP) (doctors) which is a unique approach. In light of proposals to permit nurses to assess each other the benefits and challenges associated with current approach to interprofessional assessment warranted further exploration.ObjectiveThe aim was to explore interprofessional competency assessment with nurse non-medical prescribing students and their DMPs.DesignA descriptive qualitative research design was undertaken using semi-structured interviews and focus groups.SettingThe study was completed in a Scottish University that provides non-medical prescribing education to nurses, midwives and allied health professionals.Participants and methodsStudents (n?=?6) participated in two focus groups at the start and end of their supervised learning and assessment in practice. DMPs (n?=?6) participated in semi structured telephone interviews on completion of supervision. Utilising Clark's theory of interprofessional education, a thematic analysis was conducted.FindingsProfessional identity influenced interpretation of prescribing competence with regards assessment and scope of practice. Students and DMPs learned with, from and about each other, and provided a platform for two-way learning and mutual professional respect. The interprofessional learning experience developed relationships and provided ratification for the prescribing role post qualification.ConclusionsFurther exploration with key stakeholders and service users is recommended, prior to any changes to the designated professional group assigned to assessing non-medical prescribing competence
Characteristics of prescribing activity within primary care in Scotland 2013–2022 of general practitioners, nurse, pharmacist and allied health prescribers: A retrospective cross-sectional study
Get PDFBackgroundIndependent prescribing by nurses, pharmacists and allied health professionals is diversifying into a variety of healthcare settings as pressures mount on existing resources. Primary care was an early adopter of prescribing by non-medical professionals with resulting improvements in accessibility and flexibility of services but also noted barriers. Exploring existing prescribing activity within primary care can support future initiatives that are cognisant of the needs of this specific population and targeted in the use of finite resources.AimTo explore the characteristics of prescribing activity of common drugs dispensed by community pharmacies in Scotland by prescribing groups of general practitioners, nurses, pharmacist and allied health professionals. Specifically, to compare overall drug prescribing frequency by prescriber group and identify emergent prescribing patterns of individual drugs.DesignA cross-sectional study.MethodsThe data from Public Health Scotland on frequency of the ten most common drugs prescribed and dispensed from community pharmacies between 2013 and 2022 by prescriber group were examined, applying descriptive statistics using secondary data analysis.ResultsPrescribing activity in non-medical prescribing groups accounted for 2%–3% of overall prescribing activity in primary care. There is a growing interprofessional approach to prescribing in chronic disease. Proton pump inhibitors were the most commonly prescribed medication overall with a 4-fold increase in nurse prescribing. The decline in prescribing frequency caused by COVID 19 restrictions has since returned to pre-pandemic levels.ConclusionThere is a growing contribution of nurse independent prescriber activity within primary care although still a relatively small proportion compared to medical practitioners. The pattern of increased prescribing of medications for long term and chronic conditions such as proton pump inhibitors by all prescribers is suggestive of multi-disciplinary professionals supporting increased patient demand. This study provides a baseline to evaluate current service provision in further research and enable professional, service and policy development
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