Through the looking glass: public and professional perspectives on patient-centred professionalism in modern-day community pharmacy

This paper presents five consultation workshops with 29 community pharmacists, stakeholders and patients that examined "patient-centred professionalism" in terms of pharmacists' working day and environment. The concept is ill-defined in both medical and pharmacy literature and the study aimed to clarify the situated nature of the term for patients and health professionals across settings. Workshops were supported by bio-photographic datasets of "in-situ" practice and Nominal Group Work. The thematic content analyses led to the following aspects: building caring relationships; managing external forces; the effects of space and environment, and different roles and expectations. The study reveals how patient-centred professionalism cannot be defined in any singular or stationary sense, but should be seen as a "moveable feast", best understood through everyday examples of practice and interaction, in relation to whose experience is being expressed, and whose needs considered. The phrase is being mobilised by a whole set of interests and stakeholders to reshape practice, the effect of which remains both uncertain and contested. Whilst patients prioritise a quick and efficient dispensing service from knowledgeable pharmacists, pharmacists rail against increasing public demands and overtly formalised consultations that take them away from the dispensary where the defining aspects of their professionalism lie. URN: urn:nbn:de:0114-fqs100177Unser Beitrag stellt die Ergebnisse aus insgesamt fünf Workshops mit 29 Apotheker/innen, Patient/innen und weiteren Akteuren vor, die sich mit "Patient/innen-zentrierter Versorgung" in der Alltagsarbeit und -umgebung von Apotheker/innen befassten. Dieses Konzept ist in der relevanten Literatur nur ungenügend definiert, und ein Ziel der Studie war, dessen situativen Charakter für Patient/innen und im Gesundheitssystem Tätige zu präzisieren. In den Workshops kamen Fotografien aus der Alltagspraxis und spezifische Gruppenarbeitsverfahren zum Einsatz. Im Beitrag werden nach einer Information über die Teilnehmenden die Ergebnisse der thematischen Inhaltsanalyse zusammengefasst, die die folgenden Schwerpunkte erbrachte: Aufbau von Beziehungen mit Patient/innen, Umgang mit externen Einflussgrößen, (räumliche) Umgebungseffekte und Unterschiedlichkeit von Rollen und Erwartungen. Die Ergebnisse zeigen, dass "Patient/innen-zentrierte Versorgung" nicht in einer singulären oder statischen Weise definiert werden kann, sondern am besten nachvollziehbar ist entlang von Beispielen aus der Alltagspraxis und von Alltagsinteraktionen, abhängig davon, wessen Erfahrungen ausgedrückt und wessen Bedürfnisse im Fokus stehen sollen. Dieses Verständnis trifft für eine Vielzahl an Interessen und Akteuren zu, um Praxis zu rekonzeptualisieren, die zugleich auch fragil und strittig ist: Während Patient/innen möglichst schnelle und effektive Dienstleistungen von sachkundigen Apotheker/innen erwarten, wenden diese sich gegen wachsende öffentliche Ansprüche und zunehmend formalisierte Beratungen, die sie von der Art von Arbeit entfernen, die Kern ihrer professionellen Identität ist. URN: urn:nbn:de:0114-fqs100177Este documento presenta cinco talleres de consulta con 29 farmacéuticos comunitarios, los promotores y los pacientes que examinaron "el profesionalismo centrado en el paciente" en términos de jornada de trabajo de los farmacéuticos y el medio ambiente. El concepto está mal definido, tanto en la literatura médica y farmacéutica, y el estudio tuvo como objetivo aclarar la naturaleza situada del término en los pacientes y en los profesionales de la salud en diferentes contextos. Los talleres fueron apoyados por conjuntos de datos bio-fotográficas de la práctica "in-situ" y el Grupo Nominal de Trabajo. El análisis de contenido temático c a los siguientes aspectos: creación de relaciones afectuosas; gestión de fuerzas externas; los efectos del espacio y el medio ambiente, y roles y expectativas diferentes. El estudio revela cómo el profesionalismo centrado en el paciente no puede definirse en un sentido singular o estacional, pero debe ser visto como “fiesta ambulante”, mejor entendida a través de ejemplos de la vida diaria y la interacción, en relación con cuya experiencia se expresa, y cuyas necesidades considera. La frase está siendo movilizada por un juego entero de intereses y de los promotores para reformar la práctica, el efecto del cual sigue siendo incierto y puesto en debate. Mientras los pacientes priorizan un servicio de distribución rápido y eficiente de parte de farmacéuticos bien informados, los farmacéuticos critican severamente las crecientes demandas públicas y abiertamente formalizan consultas que se los llevan lejos del dispensario donde radican los aspectos de definición de su profesionalismo. URN: urn:nbn:de:0114-fqs10017

Changes in emotional problems, hyperactivity and conduct problems in moderate to late preterm children and adolescents born between 1958 and 2002 in the United Kingdom

Background Preterm birth is a risk factor for the development of emotional and behavioural problems in childhood and adolescence. Given the substantial improvements in neonatal care across decades, it has been expected that the difference in emotional problems, hyperactivity, and conduct problems between moderate to late preterm (MLPT) and full term (FT) children and adolescents have declined in recent years. Methods Data from four UK population-based studies were used: The National Child Development Study (NCDS; 1958), the British Cohort Study (BCS70; 1970), the Avon Longitudinal Study of Parents and Children (ALSPAC, 1991?1992) and the Millennium Cohort Study (MCS; 2000?2002). Emotional problems, hyperactivity and conduct problems were assessed with mother-reports in early childhood (5?7 years), late childhood (10?11 years) and adolescence (14?16 years). Furthermore, emotional problems were self-reported in adolescence in BCS70, ALSPAC and MCS. Results In the most recent cohort, the MLPT group had higher mother-reported emotional problems than those born FT in late childhood and adolescence, whereas there were no differences in self-reported emotional problems in adolescence. Regarding mother-reported hyperactivity symptoms, the MLPT group had higher scores than the FT group in the two most recent cohorts in late childhood and in the most recent cohort in adolescence. Regarding mother-reported conduct problems, MLPT children had significantly higher scores than the FT children in the oldest and in the most recent cohort in late childhood. On the other hand, in adolescence, MLPT children had significantly lower scores in conduct problems in comparison to FT children in the cohort born in 1991?1992. Conclusions Mother-reported emotional problems and hyperactivity symptoms of those born MLPT have increased from the birth years 1958 to 2000?2002 during late childhood and adolescence, whereas self-reported emotional problems were similar in MLPT and FT groups during adolescence from 1970 to 2000?2002. Findings are less consistent regarding conduct problems. The current findings highlight the importance of raising the awareness of teachers about the association between MLPT birth and behavioural and emotional problems in late childhood and adolescence to prevent the long-term negative outcomes associated with the sequalae of MLPT birth.Peer reviewe

Preschool Mathematics and Literacy Skills and Educational Attainment in Adolescents Born Preterm and Full Term

Objectives: To test whether preschool academic skills were associated with educational attainment in adolescence and whether associations differed between individuals born preterm and at full term. Study design: This prospective cohort study comprised 6924 individuals, including n = 444 (6.4%) adolescents born preterm ( .05). Higher preschool academic skill scores in mathematics were associated with greater odds of attaining GCSE Mathematics and preschool literacy skills were associated with GCSE English. Adolescents born preterm with higher preschool mathematics (OR: 1.51, CI: 1.14, 2.00) and literacy skills (OR: 1.57, CI: 1.10, 2.25) were more likely to attain GCSEs in the respective subject than their term-born counterparts with equal levels of preschool skills. Conclusions: Preschool academic skills in mathematics and literacy are associated with educational attainment of preterm and term-born individuals in adolescence. Children born prematurely may benefit more from preschool mathematics and literacy skills for academic and educational success into adolescence than term-born individuals

Emotional problems and peer victimization in adolescents born very preterm and full-term : role of self-control skills in childhood

The aim of the current study was to examine whether self-control skills in childhood moderate the association between very preterm birth (<32 weeks of gestational age) and emotional problems and peer victimization in adolescence. We used data from four prospective cohort studies, which included 29,378 participants in total (N = 645 very preterm; N = 28,733 full-term). Self-control was mother-reported in childhood at 5–11 years whereas emotional problems and peer victimization were both self- and mother-reported at 12–17 years of age. Findings of individual participant data meta-analysis showed that self-control skills in childhood do not moderate the association between very preterm birth and adolescence emotional problems and peer victimization. It was shown that higher self-control skills in childhood predict lower emotional problems and peer victimization in adolescence similarly in very preterm and full-term borns

Physical Activity, Mental Health, and Well-Being in Very Pre-Term and Term Born Adolescents : An Individual Participant Data Meta-Analysis of Two Accelerometry Studies

This study examined whether physical activity is associated with better mental health and well-being among very preterm (≤32 weeks) and term born (≥37 weeks) adolescents alike or whether the associations are stronger in either of the groups. Physical activity was measured with accelerometry in children born very preterm and at term in two cohorts, the Basel Study of Preterm Children (BSPC; 40 adolescents born ≤32 weeks of gestation and 59 term born controls aged 12.3 years) and the Millennium Cohort Study (MCS; 45 adolescents born ≤32 weeks of gestation and 3137 term born controls aged 14.2 years on average). In both cohorts, emotional and behavioral problems were mother-reported using the Strengths and Difficulties Questionnaire. Subjective well-being was self-reported using the Kidscreen-52 Questionnaire in the BSPC and single items in the MCS. Hierarchical regressions with ‘preterm status × physical activity’-interaction effects were subjected to individual participant data (IPD) meta-analysis. IPD meta-analysis showed that higher levels of physical activity were associated with lower levels of peer problems, and higher levels of psychological well-being, better self-perception/body image, and school related well-being. Overall, the effect-sizes were small and the associations did not differ significantly between very preterm and term born adolescents. Future research may examine the mechanisms behind effects of physical activity on mental health and wellbeing in adolescence as well as which type of physical activity might be most beneficial for term and preterm born children

Preschool mathematics and literacy skills and educational attainment in adolescents born preterm and full term

Objectives To test whether preschool academic skills were associated with educational attainment in adolescence and whether associations differed between individuals born preterm and at full term. Study design This prospective cohort study comprised 6924 individuals, including n = 444 (6.4%) adolescents born preterm (<37 weeks of gestation) from the Avon Longitudinal Study of Parents and Children. Preschool academic (mathematics and literacy) skills were rated by teachers at 4-5 years. Educational attainment at 16 years was informed by attaining a General Certificate of Secondary Education (GCSE) in key subjects mathematics and English. Logistic regressions assessed the association between preterm birth, preschool mathematics, and GCSE Mathematics and between preterm birth, preschool literacy, and GCSE English. Results Similar numbers of adolescents born preterm and at term achieved a GCSE in mathematics and English (53.6 % vs 57.4% and 59.5% vs 63.9%, respectively; P values > .05). Higher preschool academic skill scores in mathematics were associated with greater odds of attaining GCSE Mathematics and preschool literacy skills were associated with GCSE English. Adolescents born preterm with higher preschool mathematics (OR: 1.51, CI: 1.14, 2.00) and literacy skills (OR: 1.57, CI: 1.10, 2.25) were more likely to attain GCSEs in the respective subject than their term-born counterparts with equal levels of preschool skills. Conclusions Preschool academic skills in mathematics and literacy are associated with educational attainment of preterm and term-born individuals in adolescence. Children born prematurely may benefit more from preschool mathematics and literacy skills for academic and educational success into adolescence than term-born individuals

An experimental study of executive function and social impairment in Cornelia de Lange syndrome

Background Extreme shyness and social anxiety is reported to be characteristic of adolescents and adults with Cornelia de Lange syndrome (CdLS); however, the nature of these characteristics is not well documented. In this study, we develop and apply an experimental assessment of social anxiety in a group of adolescents and adults with CdLS to determine the nature of the social difficulties and whether they are related to impairments in executive functioning. Methods A familiar and unfamiliar examiner separately engaged in socially demanding tasks comprising three experimental conditions with a group of individuals with CdLS (n = 25; % male = 44; mean age = 22.16; SD = 8.81) and a comparable group of individuals with Down syndrome (DS; n = 20; % male = 35; mean age = 24.35; SD = 5.97). Behaviours indicative of social anxiety were coded. The Behavior Rating Inventory of Executive Function-Preschool version, an informant measure of executive function, was completed by participants’ caregivers. Results Significantly less verbalisation was observed in the CdLS group than the DS group in conditions requiring the initiation of speech. In the CdLS group, impairments in verbalisation were not associated with a greater degree of intellectual disability but were significantly correlated with impairments in both planning and working memory. This association was not evident in the DS group. Conclusions Adolescents and adults with CdLS have a specific difficulty with the initiation of speech when social demands are placed upon them. This impairment in verbalisation may be underpinned by specific cognitive deficits, although further research is needed to investigate this fully

Teaching music to support students : how autonomy-supportive music teachers increase students’ well-being

According to self-determination theory (SDT), the learning experiences of music students can be explained partly by the autonomy-supportive style adopted by their music teachers. To provide the first in-depth understanding of how music performance teachers support the autonomy of their students and how this support is related to students’ well-being, we adopted SDT and the PERMA model of well-being. We provide answers to three fundamental questions about teacher-student relationships in music: (1) Do music performance teachers support the autonomy of their students in higher music education? (2) How do students perceive this support? and (3) How does autonomy support affect music students’ well-being? Music performance teachers (n = 35) and students (n = 190) were recruited from higher music education institutions in the United Kingdom. Analyses included mean comparisons of teachers’ and students’ answers to survey questions, correlational analyses of teacher-student dyads’ responses on measures, and qualitative analyses of open-ended questions. Results showed that teachers and students mostly agreed that teachers provide autonomy support to their students. Teachers’ transmission of passion for music and autonomy-supportive behaviors were related to students’ well-being, whereas controlling behaviors hindered well-being. Qualitative results showed that although students put well-being at the core of their concerns, music teachers seemed unaware or ill-prepared to face those concerns