Housing design and sustainable economic development in the East Midlands

Investigates the economic, social and environmental benefits of good housing design and the extent to which these benefits are evident in recent developments in the East Midlands. Includes a series of detailed case studies

Sickness certification system in the United Kingdom: qualitative study of views of general practitioners in Scotland

Objectives: To explore how general practitioners operate the sickness certification system, their views on the system, and suggestions for change. Design: Qualitative focus group study consisting of 11 focus groups with 67 participants. Setting: General practitioners in practices in Glasgow, Tayside, and Highland regions, Scotland. Sample: Purposive sample of general practitioners, with further theoretical sampling of key informant general practitioners to examine emerging themes. Results: General practitioners believed that the sickness certification system failed to address complex, chronic, or doubtful cases. They seemed to develop various operational strategies for its implementation. There appeared to be important deliberate misuse of the system by general practitioners, possibly related to conflicts about roles and incongruities in the system. The doctor-patient relationship was perceived to conflict with the current role of general practitioners in sickness certification. When making decisions about certification, the general practitioners considered a wide variety of factors. They experienced contradictory demands from other system stakeholders and felt blamed for failing to make impossible reconciliations. They clearly identified the difficulties of operating the system when there was no continuity of patient care. Many wished either to relinquish their gatekeeper role or to continue only with major changes. Conclusions: Policy makers need to recognise and accommodate the range and complexity of factors that influence the behaviour of general practitioners operating as gatekeepers to the sickness certification system, before making changes. Such changes are otherwise unlikely to result in improvement. Models other than the primary care gatekeeper model should be considered

The Unfulfilled Potential of Data-Driven Decision Making in Agile Software Development

With the general trend towards data-driven decision making (DDDM), organizations are looking for ways to use DDDM to improve their decisions. However, few studies have looked into the practitioners view of DDDM, in particular for agile organizations. In this paper we investigated the experiences of using DDDM, and how data can improve decision making. An emailed questionnaire was sent out to 124 industry practitioners in agile software developing companies, of which 84 answered. The results show that few practitioners indicated a widespread use of DDDM in their current decision making practices. The practitioners were more positive to its future use for higher-level and more general decision making, fairly positive to its use for requirements elicitation and prioritization decisions, while being less positive to its future use at the team level. The practitioners do see a lot of potential for DDDM in an agile context; however, currently unfulfilled

Assessment of Knowledge and Practices of Referring Private Practitioners Regarding Revised National Tuberculosis Control Programme in Nagpur City - A Cross Sectional Study

Objectives: To assess knowledge, diagnostic and treatment practices of the referring private practitioners of Nagpur city regarding Revised National Tuberculosis Control Programme (RNTCP). Methods: The study involved interview of 103 Private Practitioners (PPs) of Nagpur city. Knowledge of private practitioners was assessed based on questions related to diagnosis, categorization, treatment regimens & follow up. Practices of private practitioners were assessed based on which investigations and treatment regimen they advise & whether they offer supervised treatment. Their willingness to get involved in the programme was also recorded. Results: Only 49 (47.6%) private practitioners knew sputum smear examination as primary tool of diagnosis of TB. Only half, 52 (50.5%) of the private practitioners knew number of categories of tuberculosis correctly and 64 (62.1%) private practitioners did know how to categorize TB patients. Chest X-ray and Mantoux test (38.5%) was mainly used by the PPs for TB diagnosis. 42.7% of PPs were prescribing treatment for TB and among them only 8 were prescribing as per RNTCP guidelines and just one provided treatment under direct observation. Different combination of HRZE and HRZES was prescribed for variable period ranges from 2-8 months. And only 12 (11.6%) private practitioners expressed their willingness to get involved in RNTCP for TB control. Conclusion: There is lack of adequate knowledge, diagnostic and treatment practice among PPs as per RNTCP guidelines and further encouragement is required for their participation in the programme

Sexuality and the Aging Adult: The Attitude and Practice of Physicians and Nurse Practitioners

Background: As the population ages, many quality of life issues will generate discussion. One such issue is sexuality of the aging adult. While there is substantial documentation related to the physiology and desires of the aging adult, little is known about medical practitioners\u27 beliefs and practices regarding sexuality. Method: A 14 question survey with a comment section was developed and mailed to 269 physicians and nurse practitioners in Santa Clara County, California. The responses were evaluated using descriptive statistics. The comments received were grouped related to intent or topic. Results: There was no discernible difference between the beliefs and practices of physicians and nurse practitioners. The responses to the questions that concerned beliefs were very homogenous indicating that practitioners believe sexuality is important across the life span and that the natural and physiological changes that occur do cause concern for aging patients. In addition, there was agreement related to treatment options for sexual dysfunction. While most indicated there are adequate treatment options for men, few felt there were for women. The number of practitioners that indicated they include questions related to sexuality as a part of the initial history and physical were substantially more than was described in the literature. Conclusions: This study confirms that practitioners regard sexuality as an important aspect of an aging adult\u27s life. More research is needed about treatment options for women, as well as additional investigation regarding the number of practitioners who actually inquire about sexual concerns during the initial intake of the aged adult

Petitions by medical practitioners 1632-1732

The very humble suppliche or petitions addressed by subjects to the Grand Masters constitute a major source of information about everyday life in Malta at the time of the knights. Seventeen large volumes of them have been preserved,1 ranging from the year 1603 to the end of the Order's rule. Rarely do they deal with matters of great historical import, but rather document private matters which have, at most, a social relevance.peer-reviewe

Mobile Digiquest: Developing rich media reflective practitioners

Mobile technologies, well-established as business tools, have now become more educationally-appropriate through integration of improved multimedia functionality. User-generated content and related activities have encouraged a transition from academic content creation to greater student collaboration across a range of platforms, which are increasingly mobile. With a greater awareness of 'citizen journalism' approaches, our students are becoming more familiar with using mobile technology in recounting their experiences. Our own staff surveys have indicated that these techniques are not commonplace internally, and while the greater majority of staff use their camera phones, few feel confident in transferring their rich media elsewhere. Within a wider framework of institutional knowledge-sharing, the OU's Digilab and educational professional development have included opportunities to explore m-learning further. Supported by device loans and emulation tools, the Digilab has provided a range of self-exploratory facilities which have been leveraged by increasing numbers of guided sessions and hands-on Digiquest activities. Other project work in the university has explored capturing local environments and language in residential schools, and a framework for remote fieldwork. Through offering sessions using commonly available technologies, including participants' camera phones, MMS and online mobile-blogging tools, our activities have demonstrated the ease with which rich media can enhance group work and reflection. Building on case studies from other institutions and related research in the field we have constructed two main themes: * Location-based approach, making use of existing physical trails around the campus, integrating with GPS/geocaching activity; * Scenario-based approach, working within a teaching and learning context, capturing practice through use of participant role-play. A number of considerations have arisen for further exploration. Technically, it is difficult to filter content and transcode/modify media sent by MMS so that all participants can access the same material. In creating the activities it was essential to take a more guided peer-learning approach, pairing, where possible, a more adept participant with novice users. The activity worked better when blended with a purpose e.g. creating practice-based course activities. Participants were able to reflect and extend their experiences after the face-to-face session through the mobile-blog. In this presentation we aim to outline the steps taken in providing these staff development opportunities and our future expectations of providing a return path for user-generated mobile rich media

Reclaiming professional identity through postgraduate professional development: Career practitioners reclaiming their professional selves

Careers advisers in the UK have experienced significant change and upheaval within their professional practice. This research explores the role of postgraduate level professional development in contributing to professional identity. The research utilises a case study approach and adopts multiple tools to provide an in-depth examination of practitioners’ perceptions of themselves as professionals within their lived world experience. It presents a group of practitioners struggling to define themselves as professionals due to changing occupational nomenclature resulting from shifting government policy. Postgraduate professional development generated a perceived enhancement in professional identity through exposure to theory, policy and opportunities for reflection, thus contributing to more confident and empowered practitioners. Engagement with study facilitated development of confident, empowered practitioners with a strengthened sense of professional self

An Assessment of Knowledge and Practices Regarding Tuberculosis in the Context of RNTCP Among Non Allopathic Practitioners in Gwalior District

Introduction: India has the highest TB burden accounting for one-fifth of the global incidence with an estimated 1.98 million cases. Non- allopathic practitioners are the major service providers especially in rural and peri-urban areas, treating not just patients of diarrhea, respiratory infections and abdominal Pain but also of tuberculosis. Objectives: To assess the knowledge of sign and symptoms of TB and its management as per the RNTCP guidelines and to assess the practicing pattern regarding tuberculosis. Material & Methods: The present was carried out among the registered non allopathic practitioners providing their services in Gwalior District during the study period. A total of 150 non allopathic practitioners of various methods from both government and private sectors were interviewed using a pre-designed, pre-tested semi-structured questionnaire. The information was collected on the General profile of the participant, knowledge about signs and symptoms of TB and its management, practices commonly adopted in the management and their views on involvement of non allopathic practitioners in RNTCP programme. Result: The average score of government practitioners was 7.3 compared to 4.6 by private practitioners. There was a statistically significant difference between the two group on issue related to the management of TB patients as per the RNTCP guidelines. Government practitioners relied mostly on sputum examination for diagnosis and follow up compared to private practitioners who chose other modalities like X-ray, blood examination for this work. Conclusion: There is a gap in knowledge and practices of practitioners of both the sectors. Some serious efforts were required to upgrade the knowledge of non allopathic practitioners if the government is serious about controlling tuberculosis in India