A New Approach for Assessment of Mental Architecture: Repeated Tagging

A new approach to the study of a relatively neglected property of mental architecture—whether and when the already-processed elements are separated from the to-be-processed elements—is proposed. The process of numerical proportion discrimination between two sets of elements defined either by color or by orientation can be described as sampling with or without replacement (characterized by binomial or hypergeometric probability distributions respectively) depending on the possibility to tag an element once or repeatedly. All empirical psychometric functions were approximated by a theoretical model showing that the ability to keep track of the already tagged elements is not an inflexible part of the mental architecture but rather an individually variable strategy which also depends on conspicuity of perceptual attributes. Strong evidence is provided that in a considerable number of trials, observers tagged the same element repeatedly which can only be done serially at two separate time moments

Pharmacist non-medical prescribing in primary care. A systematic review of views, opinions and attitudes

Background: Uptake of non-medical prescribing by pharmacists working in primary care has been slow. This is despite benefits such as quicker and more efficient access to medicines for patients, a reduction in doctor workload and enhanced professional satisfaction. This systematic review explores the views, opinions and attitudes of pharmacists and graduates towards non-medical prescribing. Methods: Medline, ScienceDirect, Embase and the University of Reading Summon Service were searched to identify qualitative and mixed methods papers that examined the views, opinions and attitudes of pharmacists and graduates towards non-medical prescribing. Papers published between January 2003 and September 2017 were included. Studies were quality assessed using the CASP checklist and then analysed using thematic synthesis. Results: After 85 full text articles were assessed, a final 14 studies were eligible for inclusion. The included studies assessed pharmacists currently prescribing and other pharmacists and graduates with familiarity of non-medical prescribing. Thematic synthesis identified two themes: (1) practice environment, and (2) pharmacist’s role. Non-medical prescribing was considered a natural extension to the role of a pharmacist despite difficulties in completing the required training. The ability to then prescribe was dependent on funding and access to medical records, time and support staff. Pharmacists experienced professional rivalry with both support and resistance from members of the primary care team. The provision of training was frequently referred to as unsatisfactory. Pharmacists were motivated to prescribe, deriving increased job satisfaction and sense of professionalism, however, they often felt under prepared for the reality of unsupervised practice. Furthermore, pharmacists reported a cautious approach with a fear of making errors frequently discussed. Conclusions: This review has identified themes and subsequent barriers and facilitators to non-medical prescribing. Many of the barriers are more perceived than real and are diminishing. Consideration of these will assist and advance pharmacist prescribing in primary care, leading to positive outcomes for both patient care and the pharmacy profession

Assessing the responsiveness of the Asthma Quality of Life Questionnaire with pharmaceutical care

Objective: To assess the responsiveness of the Asthma Quality of Life Questionnaire (AQLQ) in the context of pharmaceutical care delivery New Zealand community pharmacy setting. Setting: Community pharmacy practices in three locations in the Otago and Southland region of New Zealand. Method: About 62 patients with asthma (17-80 years of age) were recruited in five community pharmacies in the Otago and the Southland region of New Zealand. Patients were randomly assigned to two groups (Group 1 and Group 2). The AQLQ and a study-specific outcomes questionnaire were administered to both groups at baseline (T1), then again (with an additional global Self-Assessment of change question) 3 months later (at T2) after providing the service to Group 1. Responsiveness of the AQLQ was assessed by measuring the ability of the AQLQ to detect within-subject change in patients who subjectively indicated change, and to distinguish between two groups of patients: those who indicated change and those who indicated no change. Additionally, the correlation between the change of the AQLQ scores at T2 and the patients' self-assessment of change at T2 was estimated and used as means for assessing the AQLQ responsiveness. Main outcome measure: Asthma-specific quality of life as measured by the AQLQ and change in quality of life as perceived by participants. Results: The results supported the responsiveness of three out of the four domains of the Asthma Quality of Life Questionnaire. The fourth domain, Environmental stimuli, showed weaker responsiveness, and the reasons of this were discussed. Conclusion: This study provided data supporting the responsiveness of the AQLQ when used in the context of pharmaceutical care. However, while the AQLQ's Activity Limitation, Symptoms and Emotional domains reflected adequate sensitivity to change in QoL over time, its Environmental domain was less sensitive. Researchers conducting longitudinal studies utilising the AQLQ in pharmaceutical care interventions should bear this in mind, and should consider the possible reasons for this apparent lack of responsiveness, and its implications