The association between compliance and persistence with bisphosphonate therapy and fracture risk: A review

BACKGROUND: Sub optimal levels of compliance and persistence with bisphosphonates are potentially compromising the reduction of post menopausal osteoporotic (PMO) fracture risk. METHODS: A structured literature search (1990–2006) was performed to identify primary research studies evaluating the relationship between compliance and persistence with bisphosphonates and post menopausal osteoporotic (PMO) fracture risk in clinical practice. Search criteria were: bisphosphonates; osteoporosis/osteopenia in postmenopausal women; all types of fractures; compliance and persistence. RESULTS: Only two retrospective studies using prescription databases have specifically evaluated bisphosphonates. A cohort study tracking 35,537 women reported that in those with a Medication Possession Ratio (MPR) of ≥80% over 24 months the risk of fracture was lower than in those with an MPR of <80% (8.5% v 10.7%, p < 0.001, Relative Risk Reduction (RRR) 21%). In women who persisted with treatment (refill gap <30 days) the risk of fracture was also lower (7.7% v 10.3%, p < 0.001, RRR 29%). A nested case control study reported that 12 months persistence (refill gap <50% previous prescription (Rx) length) was associated with a 26% reduced risk of fracture (p < 0.05) and 24 months with a 32% reduced risk (p < 0.05). Four other studies, not specific to bisphosphonates, reported that compliance ≥12 months decreased fracture risk by ~25%. CONCLUSION: Sub optimal compliance and persistence with bisphosphonates is not providing the best possible protection against the risk of PMO fracture, however, more research is needed to delineate this relationship in clinical practice

An Evaluation of the Assessment of Graphical Education at Junior Cycle in the Irish System

Junior Certificate Technical Graphics was introduced in Ireland in 1991 and aimed to develop innovative problem solving aptitudes and knowledge of plane and descriptive geometry (NCCA 1991). Despite the philosophy of breadth and balance (NCCA 2004) associated with educational outcomes in the Junior Certificate curriculum, many subjects, Technical Graphics included, employ a summative assessment strategy (Griffin 1998). The summative measurement model portrays a limited view of student learning (Lin and Dwyer 2006, Williams 2011) and has been found to exert significant influence on teaching and learning throughout the course of study (Bloxham and Boyd 2007). This research study aims to evaluate the types of approach to assessment of two different year groups at different stages of the Junior Cycle. The core hypothesis being investigated is whether there is a more sophisticated approach to the assessment evident among the older year groups. In order to achieve this aim a visual protocol similar to Middleton (2008) and Lane et al. (2010) was employed to capture the approach in solving a prescribed graphical task among first and second year students in the Technical Graphics classroom. Findings indicate that the use of a traditional summative approach to assessment has significant limitations within the subject of Technical Graphics. There are also notable trends occurring in students’ approach to the assessment, which seem to rely on a low level of graphical knowledge and problem solving skills. The findings confirm that the older year group adopted a more efficient approach to the assessment but displayed unsophisticated approaches to the application of graphical principles. Some limitations of the summative measurement model are supported by the results of this paper

Trialling HyFlex at TU Dublin – stakeholders’ voices and experiences

HyFlex is a multi-modal instructional approach that offers students the opportunity to engage with modules face-to-face and online in a mode that best suits their learning style and situation. Covid-19 forced many universities and lecturers to offer HyFlex opportunities. This emergency flip and required agility to deliver HyFlex provides the opportunity to learn from the experiences of using this mode of teaching and learning. This research presents the results of a survey of 44 lecturers who were part of the HyFlex Community of Practice (COP) or who were employing HyFlex in their practice, and 490 students who engaged with HyFlex at Technological University Dublin (TU Dublin), Ireland. Mini vignettes are used to provide deeper insight. Key findings are that HyFlex was viewed positively by both students and lecturers, and 92% of students would recommend this form of attendance in the future. From a lecturer\u27s perspective, key challenges related to the technology, student engagement and high cognitive load. The research showed that some students who avail of university learning supports preferred the HyFlex approach as it felt that it gave them equal opportunity and allowed them to learn in a way that suited them best. While the majority of students believe that the HyFlex approach resulted in the same level of academic rigour and quality as face-to-face delivery, several lecturers had some concerns. This research is valuable as it positions HyFlex as a feasible form of delivery at a time when a new University Educational Model (UEM) is being developed for TU Dublin. However, it is particularly valuable as it identifies key issues and gives voice to various stakeholders, which is important in terms of contributing to international and institutional debates and policies going forward regarding the changing pedagogical landscape post-Covid

Students’ Experiences Of Reflecting On Their Development Of Professional Skills In An Engineering Programme.

Engineers play a central role in addressing the challenges which face society, and recent literature highlights the need for emphasis on the development of professional skills in engineering programmes. This paper describes the outcomes of a study which investigated students’ experiences of reflecting on the development of their professional skills using an ePortfolio in a pilot project. A focus group was used to capture students’ experiences of the reflection process and the use of the ePortfolio. Transcripts were analysed thematically to draw out the key experiences and to provide feed-forward advice for the next iteration of the project. The findings show that students need support in the reflection process, and clearer signposting between each skill and the modules relevant to their development. Students also found it difficult to ascertain their competency levels and felt that industry experience was needed to help score themselves accurately. Feed-forward advice included incorporating an ePortfolio throughout all years of the programme which would track their improvement in a range of skills, and providing a rubric to help assess their competency. The outcome of this study can be used by educators who wish to incorporate a professional skills ePortfolio in their engineering programmes

THE IDENTIFICATION OF FUTURE PROFESSIONAL SKILLS FOR THE GRADUATE STRUCTURAL ENGINEER AND THE CO-CREATION OF THEIR DEFINITIONS.

Employers recognise that the future is changing and as such the structural engineer’s role is changing along with the skill set required. The skills gap has been acknowledged yet there is no consensus on which skills are most important for these engineers. This research presents the outcome of a project which proposes future professional skills needs for the structural engineer and the co-creation of their definitions. A review of the most recent relevant literature alongside chartership requirements of the Institution of Structural Engineers (IStructE) and Engineers Ireland (EI), as well as consideration of three seminal consultation and analysis reports on the future skills in the sector, led to the identification of 7 skills. These are the traditional, though evolving skills related to communication, technical ability, management and engineering practice as well as emerging skills related to sustainability, technology and digitisation and society. It is accepted, however, that there may be different conceptions of each term, therefore, the presented research describes the co-creation of definitions for each of these skills with undergraduate structural engineering students. The work describes how focus groups were used to engage students in a conversation around the meaning and importance of each skill resulting in specific action orientated definitions for each skill. These definitions will then be used in the next phases of the project which engage the same students in a reflective e-portfolio exercise and structural engineering educators in a review of the programme outcomes in relation to such skills

An Approach to Mapping the Development of Professional Skills in a Structural Engineering Programme

Engineers of the future will be presented with complicated, complex problems and their role in the development of sustainable solutions to global problems will become even more critical. Recent literature highlights the need for the development of a set of professional skills in order to address these challenges. These skills include technical, non-technical and attitudinal skills. This paper describes a case study of a whole-of-programme review of teaching and assessment of professional skills in a structural engineering programme. In a systematic process, lecturing staff mapped the modules they teach against a set of professional skills, which were distilled from literature review. The programme map was then analysed to provide insight into the depth to which professional skills are being taught and assessed. This analysis underpinned a review of the teaching of professional skills and led to the identification of both gaps and opportunities to introduce new learning outcomes, teaching activities and assessment techniques