Role of community pharmacists in the use of antipsychotics for behavioural and psychological symptoms of dementia (BPSD): A qualitative study

Objective This study aimed to use qualitative methodology to understand the current role of community pharmacists in limiting the use of antipsychotics prescribed inappropriately for behavioural and psychological symptoms of dementia. Design A qualitative study employing focus groups was conducted. Data were analysed using thematic analysis. Setting 3 different geographical locations in the England. Participants Community pharmacists (n=22). Results The focus groups identified an array of factors and constraints, which affect the ability of community pharmacists to contribute to initiatives to limit the use of antipsychotics. 3 key themes were revealed: (1) politics and the medical hierarchy, which created communication barriers; (2) how resources and remit impact the effectiveness of community pharmacy; and (3) understanding the nature of the treatment of dementia. Conclusions Our findings suggest that an improvement in communication between community pharmacists and healthcare professionals, especially general practitioners (GPs) must occur in order for community pharmacists to assist in limiting the use of antipsychotics in people with dementia. Additionally, extra training in working with people with dementia is required. Thus, an intervention which involves appropriately trained pharmacists working in collaboration with GPs and other caregivers is required. Overall, within the current environment, community pharmacists question the extent to which they can contribute in helping to reduce the prescription of antipsychotics

Impact of chromophores on colour appearance in a computational skin model

Early diagnosis of skin cancer offers the patient more favorable treatment options. Color fidelity of skin images is a major concern for dermatologists as adoption of digital dermatoscopes is increasing rapidly. Accurate color depiction of the lesion and surrounding skin are vital in diagnostic evaluation of a lesion. We previously introduced VCT-Derma, a pipeline for dermatological Virtual Clinical Trials (VCTs) including detailed and flexible models of human skin and lesions, which represent the patient in the entire dermatoscopy-based diagnostic process. However, those initial models of skin and lesions did not properly account for tissue colors. Our new skin model accounts for tissue color appearance by incorporating chromophores (e.g., melanin, blood) into the tissue model, and simulating the optical properties of the various skin layers. The physical properties of the skin and lesion were selected from clinically plausible values. The model and simulated dermatoscope images were created in open modelling software, assuming a linear camera model. We have assumed ambient white lighting, with a 6mm distance to the camera. Our model of color appearance was characterised by comparing the brightness of the lesion to its depth. The brightness of the lesion is compared through the variability of the mean gray values of a cropped region around the lesion. We compare two skin models, one without extensive chromophore content and one with. Our preliminary evaluation of increasing chromophore content shows promise based on the results presented here. Further refinement and validation of the model is ongoing

Post impact evaluation of an E-learning cross-infection control CD-ROM provided to all general dental practitioners in England

Aim To carry out a post-impact evaluation of a cross-infection control CD-ROM, developed for NHS dental teams as a continuing professional development e-learning tool. The program was commissioned by the Department of Health and developed by a project team through the UK Committee of Postgraduate Dental Deans. The Dental Practice Boardhad originally sent one copy of the CD-ROM to each dental practice in England in 2004. Method A quantitative statistical analysis of the results of 326 online respondents to the learning package and a survey of 118 dental practitioners drawn from the Dental Practice Board database. Results Practitioners felt the CD-ROM in this instance was well designed and appropriate for their needs. It is inclusive and accessible to a wide range of dental professionals including nurses and hygienists. Conclusions This form of continuing professional development is popular with dental practitioners, although it should not be the only form of continuing professional development available. However, whilst the project was generally regarded as successful, there were problems with the distribution of the CD-ROM. This suggests that anonline resource should be made available in the future

Crafting communities: promoting inclusion, empowerment, and learning between older women

While social policy and planning documents are replete with ominous warnings about the cost of an ageing population, this article tells a different story about the productive and self-sustaining networks that exist among older women in the community who do craftwork. From our research conducted in Victoria, Australia during 2007&ndash;2008 we discovered a resilient and committed group of older women quietly and steadily contributing to community fundraising, building social networks, and providing learning opportunities to each other in diverse ways. Through our conversations with nine craftswomen we have been able to articulate clear links between the theory and models commonly espoused in the community development literature and the life-enriching practices used in organising informal community craft group activities. From our interviews with the older women we provide evidence of sustained participation, the generation of social capital, and the fostering of life-long learning. While none of the women we spoke to were trained in community development and did not use language commonly associated with feminist ideology, the relationship between the informal group work with principles of empowerment and self-efficacy were unmistakeable. We conclude with a discussion of the implications of our findings for critical social work practice.<br /

The impact of emotions on practicum learning

Nine mature aged, experienced practitioners enrolled to gain a BSW qualification in social work were interviewed regarding a course requirement to complete the first placement. At the time of interview no recognition of prior learning for previous experience in the field was made possible for these students. As educators we had experienced considerable hostility from students who believed they should be exempt from completing this course requirement. This paper reports on interviews with the nine students, where we consider how student sentiment about completing the practice learning component might impact upon their learning experience. As anticipated, some students expressed strong negative views about being on placement. However, others were much more positive about the experience. These mixed views prompted us to explore further the relationship between emotion and practice learning. The article begins with a review of the literature concerning mature student engagement with tertiary education, followed by an overview of theory and research related to the ways feelings and emotion influence learning. Using passages from the interviews, expressions of participant anxiety, anger and excitement about the practicum are discussed with the view to extending discourse about practicum learning to include consideration of emotional intelligence and investment.<br /

An evaluation of clouds and precipitation in convection-permitting forecasts for South Africa

Since 2016, the South African Weather Service (SAWS) has been running convective-scale simulations to assist with forecast operations across southern Africa. These simulations are run with a tropical configuration of the Met Office Unified Model (UM), nested in the Met Office global model, but without data assimilation. For November 2016, convection-permitting simulations at 4.4-km and 1.5-km grid length are compared against a simulation at 10-km grid length with convection parametrization (the current UM global atmosphere configuration) to identify the benefits of increasing model resolution for forecasting convection across southern Africa. The simulations are evaluated against satellite rainfall estimates, CloudSat vertical cloud profiles, and SAWS radar data. In line with previous studies using the UM, on a monthly time scale, the diurnal cycle of convection and the distribution of rainfall rates compare better against observations when convection-permitting model configurations are used. The SAWS radar network provides a three-dimensional composite of radar reflectivity for northeast South Africa at 6-minute intervals, allowing the evaluation of the vertical development of precipitating clouds and of the timing of the onset of deep convection. Analysis of four case study days indicates that the 4.4-km simulations have a later onset of convection than the 1.5-km simulations, but there is no consistent bias of the simulations against the radar observations across the case studies

Estimation of Cooling Energy Demand and Carbon Emissions from Urban Buildings using a Quasi-dynamic Model

Global warming and the urban heat island effect in large towns and cities demand new approaches to cooling buildings in an efficient and sustainable way. Modern refrigeration, air conditioning and heat pump (RACHP) systems can achieve a high coefficient of performance and low emissions, but refrigeration technology already accounts for around 15% of worldwide electricity use and up to 10% of all greenhouse gas emissions, so in the context of international agreements to reduce global greenhouse gas emissions by up to 80% RACHP systems alone cannot provide a sustainable cooling solution for cities. The purpose of the model described in this paper is to provide a simple and easy to use tool to estimate the impact of different heating and cooling technologies, alternative building design and operating parameters and future global warming, on the energy demands and carbon emissions of buildings. Existing software tools for analysis of buildings can provide high quality results for a given scenario, but the determination of an optimal solution demands multiple simulations, which can be time consuming and require post processing to interpret the results. The Excel based tool uses a quasi-dynamic energy balance model and reduced weather data set to generate rapid results, allowing the user to view the building’s temperature profile, energy demands and carbon emissions in near real time and to develop an optimum cooling strategy. Results are presented for a single building version of the tool. When fully developed, it will allow the user to model clusters of buildings in an urban environment