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Assessment and evaluation of prescribing competences: a systematic review and recommendations
Get PDFAims: Since assessment of prescribing competence is a key promoter of student learning and achievement, we aim to summarise existing national-level approaches, provide a systematic review of current literature, indicate the frequency of various methodologies, and make recommendations to promote and extend existing practice.
Methods: Regulatory body websites were accessed for details of national examinations. PubMed®, Embase®, the Allied and Complementary Medicine and CINAHL databases were systematically searched in August 2023 for studies in English from Europe, North America, Australia and New Zealand reporting assessment of prescribing competencies among students/practitioners. Additional articles were identified through citation tracking.
Results: National approaches are described for a number of jurisdictions. A total of 20,514 articles were retrieved, of which 54 met the inclusion criteria. Most articles came from the United Kingdom, with medical students and qualified doctors most frequently featured. Multiple choice formats were most common, with short answer questions, calculations, and scenario-based skills tests also featured. Direct observations of skills through OSCEs and similar methods was less commonly described. Test reliability generally employed Classical Test Theory. Costs of developing and delivering assessments, differential attainment by demographics, and predictive validity were not indicated.
Conclusions: We recommend measurement of the predictive validity of prescribing competence assessments, the routine inclusion of performance by demographic characteristics, extension of competence assessments to professions other than medicine, and structured reporting of methods and findings, including costs and cost-effectiveness. Situational Judgement Tests would be a valuable addition to assessment practices
Two Channels of Metal-Rich Compact Stellar System Formation: Starbursts Under High Ram Pressure vs. Tidal Stripping
Get PDFMost galaxies follow well-defined scaling relations of metallicity and stellar mass; however, some outliers at the low mass end of the observed galaxy population exhibit unusually high metallicity for their mass. Understanding how these objects get to be so metal-rich is vital for understanding the role of feedback in galaxy formation. Using the TNG50 simulation, we explore the origins of this phenomenon. We identify 227 metal-rich, Compact Stellar Systems (CSSs) that deviate significantly from this scaling relation. These CSSs are satellites located in the vicinity of massive host galaxies, with stellar masses ranging from 108M⊙ to 1010M⊙ (including six systems that are close analogs of the M31-M32 system). Contrary to the previously assumed scenario that such objects are predominantly products of tidal stripping, our results suggest a more prevalent role for ram pressure in their formation. Indeed, 76\% (173) of these CSSs are formed through a burst of star formation occurring around the time of the first pericentric passage, typically at redshifts z≲1, aided by strong ram pressure and tidal forces. The high ram pressure, resulting from the CSSs' rapid motion near the halo center, facilitates metal enrichment, producing high-metallicity CSSs by confining the metal-rich gas from bursty star formation, which leads to distinct stellar populations characterized by enhanced metallicity as well as high α-abundance. Only the remaining 24\% (54) of metal-rich CSSs are generated through the tidal stripping of massive progenitors. Our results further indicate that M32 is more likely to have formed through intense star formation events rather than through gradual, tidal stripping, thereby providing crucial insights into the nature of low mass, compact galaxy formation
Solar energetic particles injected inside and outside a magnetic cloud: The widespread solar energetic particle event on 2022 January 20
Get PDFContext. On 2022 January 20, the Energetic Particle Detector (EPD) on board Solar Orbiter measured a solar energetic particle (SEP) event showing unusual first arriving particles from the anti-Sun direction. Near-Earth spacecraft separated 17° in longitude to the west from Solar Orbiter measured classic antisunward-directed fluxes. STEREO-A and MAVEN, separated 18° to the east and 143° to the west from Solar Orbiter respectively, also observed the event, suggesting that particles spread over at least 160° in the heliosphere.
Results. Solar Orbiter was embedded in a MC erupting on 16 January from the same active region as the one related to the SEP event on 20 January. The SEP event is related to a M5.5 flare and a fast CME-driven shock of 1433 km/s, which injected particles within and outside the MC. The hard SEP spectra, the presence of a Type II radio burst, and the co-temporal Type III radio bursts being observed from 80 MHz that seems to emanate from the Type II, points to the shock as the relevant accelerator of the particles.
Conclusions. The detailed analysis of the SEP event strongly suggest that the energetic particles are injected mainly by a CME-driven shock into and outside of a previous MC present in the heliosphere at the time of the particle onset. The sunward propagating SEPs measured by Solar Orbiter are produced by the injection of particles along the longer (western) leg of the MC still connected to the Sun at the time of the release of the particles. The determined electron propagation path length inside the MC is around 30% longer than the estimated length of the loop leg of the MC itself (based on the graduated cylindrical shell model) consistent with a low number of field line rotations
Developing group-based psychoeducation intervention for adoptive parents and foster carers in a specialist child and adolescent mental health service setting
No full textChildren and young people in foster and adoptive families are considered more vulnerable to a high level of mental health need when compared to peers who are not care-experienced or adopted. Acceptance of this view amongst clinical providers and policy makers has necessitated the development of specialist provision and dedicated care pathways within child and adolescent mental health services (CAMHSs). In this provision, practitioner-initiated quality improvement projects help in appraising the effectiveness of clinical interventions in local contexts, as well as identifying areas for service learning and practice reflection. This article reports on evaluation of a mentalisation-based psychoeducation group intervention for adoptive parents and foster carers. The evaluation activity took place in a single CAMHS setting, starting during the COVID-19 pandemic, with the intervention being implemented online via videoconferencing. In the article, after introducing the intervention (based on the Family Minds model), an analysis of clinical data collected pre- and post-intervention is reported. Few results of the analysis regarding the two pre- and post-measures reached statistical significance, indicating only changes in the magnitude of stress in the parent/carer-child system. A series of reflections are posed that consider what this finding means in developing fit-for-purpose support for adoptive parents and foster carers in CAMHS contexts
Impact of Ownership Structure and Cross-listing on the role of Female Audit Committee Financial Experts in mitigating Earnings Management
Get PDFThis study investigates whether female Audit Committee Financial Experts (ACFEs) at Chinese listed companies reduce earnings management by examining their influence under different ownership structures and cross-listing scenarios. Our findings reveal that female ACFEs negatively affect earnings management, with their impact varying by ownership type. Specifically, female ACFEs in privately-owned enterprises (non-SOEs) are more effective at reducing earnings management than those in state-owned enterprises (SOEs). Furthermore, our analysis indicates that female ACFEs in cross-listed firms are better at mitigating earnings management compared to their counterparts in domestically listed firms. These results have significant implications for regulators, market authorities, investors, and corporate managers, highlighting the crucial role of female ACFEs in improving corporate transparency across diverse ownership frameworks and cross-listing conditions
Understanding occupational therapy perinatal mental health practice in mothers from ethnic minorities: a qualitative study of practitioner perceived barriers and enablers
Get PDFIntroduction: In the United Kingdom, ethnic minority mothers experience increased risk of mental illness compared to white women of British heritage. However, there is insufficient research to guide perinatal mental health occupational therapists to develop services that are accessible and meet the diverse needs of service users. This study explored perinatal mental health occupational therapists’ perceptions of the barriers and enablers to an inclusive service provision for ethnic minority mothers.
Methods: A qualitative study, was undertaken. Recruitment via social media used non-probability sampling. Semi-structured interviews collected data which were then analysed thematically.
Results: Eight occupational therapist participated in the study. Three main themes were identified: observation of caseloads; experience of providing occupational therapy; influence of the therapist’s culture. Participants perceived stigma, fear, language and cultural perceptions created barriers for ethnic minority mothers.
Discussion: Limited workforce diversity, ineffective mandatory training and insufficient referral to occupational therapy by other healthcare professionals were believed to negatively impact service delivery. Cultural experience, and reflective practice were felt to enable inclusive practice. Recommendations to inform perinatal mental health occupational therapy practice in the UK and internationally include collaborations to gain a more diverse workforce, improved mandatory training, and strategies to increase cultural sensitivity and competence
Hedging political risk in international portfolios
Get PDFWe show that internationally diversified portfolios carry sizeable political risk premia and expose investors to tail risk. We obtain political efficient frontiers with and without hedging political risk using a portfolio selection model for skewed distributions and develop a new asymptotic inference test to compare portfolio performance. Politically hedged portfolios outperform a broad market index and the equally weighted portfolio for US, Eurozone, and Japanese investors. Political risk hedging is not subsumed by currency hedging, and the diversification gains of politically hedged portfolios persist under currency hedging and transaction cost frictions. Hedging political risk induces equity home bias but does not fully explain the puzzle
Heart2Heart: a digital peer support programme for people with heart disease: protocol for a community-based, investigator-blinded randomised controlled trial conducted in Australia
Get PDFIntroduction: Cardiac rehabilitation is known to reduce morbidity and improve quality of life in people living with heart disease, however, adherence, access and completion of these programmes is suboptimal. Peer support may offer an opportunity to close this service gap. The aim of the study is to determine whether the effectiveness of a digital peer support programme for people living with heart disease is effective in improving social connectedness, clinical and patient-reported outcomes and experience measures. Methods and analysis: Heart2Heart is a community-based randomised controlled trial with 6 months follow-up for the primary outcome and 6 and 12 months for secondary outcomes. Approximately 752 adults with a diagnosis of heart disease in the past 12 months will be recruited from the general community and Australian cardiac rehabilitation programmes. Control group will participate in usual care, while intervention group will have access to a 6 months intervention that enables peer support via an interactive mobile application, in addition to usual care. The intervention includes online discussion groups, access to resources and facilitated conversations with health professionals. Primary outcome is social connectedness at 6 months follow-up. Secondary outcomes (6 and 12 months) will be all-cause/cardiovascular disease hospital admissions, all-cause mortality, lifestyle (sufficiently physically active, not smoking, sufficient fruit and vegetable consumption), proportion taking prescribed medications and health service utilisation (medical appointments, cardiac rehabilitation, participation in any other in-person peer support activities). Patient-reported outcome and experience measures including self-efficacy, quality of life, satisfaction and programme engagement will be analysed at 6 months. Process measures will include application analytics, barriers and facilitators to engagement with the intervention from participant’s perspective. An intention-to-treat analysis will be used. Ethics and dissemination: Ethical clearance was obtained from Western Sydney Local Health District Ethics Committee. Heart2Heart has potential to improve social connectedness and provide a valuable addition to traditional cardiac rehabilitation. Trial registration number: ACTRN12624000386538
The Development of Superheavy Syllables in Jordanian Child Speech: Acoustic and Computational Analyses
Get PDFThe study investigates syllable structure development in Jordanian Arabic (JA) child speech, focusing on superheavy syllables, which are often avoided in the literature due to their complexity. JA provides unique typological features for phonological analysis but remains under-researched compared to other Arabic dialects and West Germanic languages. The effects of age group, lexical stress, syllable structure, and syllable position on syllable and vowel durations were analysed. JA durational patterns contribute to the understanding of normal phonological development, typological variation, and stress assignment in Arabic dialectical phonology.
Twenty-one children aged between 24 and 72 months old and four adults were recruited. Adults carried out semi-spontaneous speech and repetition tasks whereas children completed an additional picture-elicitation task. For data analysis, a quantitative approach was employed, which involved acoustic analysis and Bayesian modelling of raw durations. An analysis of type and frequency of phonological processes was reported demonstrating an aspect of the normal developmental trajectory.
Results revealed that durations decreased with maturation, reflecting improved articulatory control, although the oldest child group did not match adult-like patterns. Lexical stress was not a strong predictor for duration as stress is determined by syllable weight and position. However, consistent word-final lengthening was observed. Syllable structure was a key predictor for durations, with superheavy syllables being longer than heavy and light syllables. Vowel shortening in non-final superheavy syllables was evident, rendering them bimoraic and not trimoraic. With maturation, superheavy syllables increased in frequency and complexity, demonstrating increased prosodic variability. Phonological processes were more frequent in younger age groups, particularly in stressed, final, and superheavy syllables.
The findings emphasize the role of syllable development in informing practical implications for speech-language pathology. Superheavy syllable durational patterns may serve as early indicators of speech production delays and deficits, aiding in the diagnosis and intervention of speech disorders in JA children
What Is Justice? Perspectives of Victims-Survivors of Gender-Based Violence
Get PDFThis article explores “how do victims-survivors of gender-based violence (GBV) experience and perceive justice?” based on interviews with 251 victims-survivors with experience of different types of GBV and criminal, civil, and family justice systems. Victims-survivors were found to have multiple perceptions of justice, related to different points in their journey following abuse and regarding individual, community, and societal responses. Perceptions relate to accountability; fairness in outcome and process; protection from future harm; recognition; agency; empowerment; affective justice; reparation; and social transformation. Current understandings of justice in legislative and policy approaches reproduce the “justice gap” by failing to take account of how survivors themselves understand and demand justice