bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Safer Prescription of Opioids Tool (SPOT) — a novel clinical decision support digital health platform for opioid conversion in palliative and end-of-life care: a single centre pilot study
Authors: Flint Roger , Jamieson Scott , Buchanan Dean , Botros S , Forbes Joanna , Cuschieri Alfred , George J 
Published: June 2019

BackgroundOpioid conversion is complex and currently performed manually using tables of approximate equivalence, often in high pressure clinical situations. Apps that offer opioid dose conversion are available but there are concerns about their accuracy, reliability, and clinical validation.AimThe study evaluated a novel opioid dose conversion app, The Safer Prescription of Opioids Tool (SPOT), as a clinician decision support (CDS) platform. The secondary objective was to use SPOT to describe patterns of opioid dose conversion in palliative and end-of-life care.MethodThis prospective clinical utility single-centre pilot study followed a mixed methods design. Prescribers completed an initial survey exploring their current opioid prescribing practice. Thereafter prescribers used SPOT for opioid dosage conversions in parallel to their usual clinical practice. Lastly, prescribers evaluated SPOT through a survey and focus group. SPOT was evaluated using clinical data across primary, secondary and tertiary care in palliative care and end of life care settings at a Scottish Health Board in both out-of-hours and in-hours.ResultsSPOT correctly matched the Gold Standard result in 258 of 268 (96.3%) calculations. Users had a statistically significant increase in confidence in prescribing opioids after using SPOT. A majority (62%) of conversions were for cancer pain. Focus group feedback highlighted perceived benefits in Quality Improvement and Safety when using SPOT.ConclusionSPOT is a safe, reliable and validated CDS that has significant potential to reduce harms from opioid dosing errors, particularly in primary care, including rural primary care, and the out-of-hours setting.
Learning from diagnostic error when primary care services are located in or alongside emergency departments: a theory generating mixed-methods study
Authors: Cooper Alison , Carson-Stevens Andrew , Siriwardena Niro , Edwards Adrian 
Published: June 2019

BackgroundNew healthcare service models are being introduced to help manage increasing demand on emergency healthcare systems including the provision of primary care services in or alongside emergency departments. There is little research evidence to guide decisions about how service models can be most effective and safe.AimFocusing on diagnostic error, the aim was to learn why errors occur to identify priority interventions.MethodTwo data sources were used to identify diagnostic error reports including: coroners’ reports to prevent future deaths; and the National Reporting and Learning System (NRLS). A cross-sectional, mixed-methods theory-generating study which used a multi-axial PISA classification system based on the recursive model for incident analysis, was carried out.ResultsNine Coroners’ reports (from a total of 1347 community and hospital reports, 2013–2018) and 217 NRLS reports (from 13 million, 2005–2015) were identified describing diagnostic error with learning relevant to primary care services in or alongside emergency departments. Clinical presentations included musculoskeletal injuries; unwell infants; headaches; and chest pains. Findings highlighted a difficulty identifying appropriate patients for the primary care service; underinvestigation; misinterpretation of diagnostic tests; underuse of safeguarding protocols; and inadequate communication and referral pathways between the services.ConclusionPriority areas to minimise risk of diagnostic error when primary care services are located in or alongside emergency departments include clinical decision support to triage and stream patients to the appropriate care setting; contextualised, workplace-based education and training for primary care staff; and standardised computer systems, communication and referral pathways between emergency and primary care services.
C-reactive protein testing reduces antibiotics prescription in a community setting
Authors: Burahee Abdus , Hibberd Owen , Malladi Aneja 
Published: June 2019

BackgroundOveruse of antimicrobials and the threats posed by resistance are concerning. Most patients in primary care with respiratory tract symptoms are prescribed antibiotics, amounting between 80–90% of all prescriptions. The National Institute for Health and Care Excellence (NICE) recommends point-of-care (POC) testing of C-reactive protein (CRP) where there is uncertainty about prescribing antibiotics. Studies evaluating the use of POC CRP to reduce antibiotic prescribing for self-limiting respiratory illness in primary care have demonstrated heterogeneity in their results.AimTo evaluate the impact of POC CRP testing on antibiotic prescribing.MethodA retrospective case analysis was undertaken at a GP practice. Alere Afinion AS100 was used for POC CRP testing. Data were collected on patients presenting with cough or sore throat who had POC CRP testing used in their clinical decision making. Eighty-four cases were selected for inclusion. NICE clinical guideline CG191 was used as a standard comparator for antibiotic prescribing and patients were followed up over a 2-month period.ResultsPatients presented with cough (n = 56) and sore throat (n = 28). At initial presentation 23/84 (27.4%) of patients were prescribed antibiotics. Over the 2-month follow-up period 15/84 (17.8%) of patients had at least one further consultation related to their initial respiratory complaint with 6/84 (7.1%) being prescribed antibiotics. The overall effect was a reduction of antibiotic prescriptions by 65.5%.ConclusionThe use of POC CRP testing helped GPs reduce the rate of antibiotic prescription and improve antimicrobial stewardship by being an addition to their diagnostic armoury. It has also shown potential role in patient reassurance and modifying health seeking behaviour.
Management of type 2 diabetes in general practice in Ireland: effect of the ‘Cycle of Care’ programme
Authors: O’Connor Raymond , O’Driscoll Rory , O’Doherty Jane , O’Neill Aoife , Teljeur Conor , O’Regan Andrew 
Published: June 2019

BackgroundDiabetes is a major cause of death and disability worldwide and is associated with vascular complications, which are reduced by control of risk factors. The introduction of the diabetes ‘cycle of care’ pay-for-performance programme in Ireland in January 2016 means that GPs have been resourced to provide structured care to patients with type 2 disease.AimTo examine the effectiveness of the ‘cycle of care’ programme.MethodA computerised search was developed for diabetes data. Forty-one practices returned data for a 12-month period before (2014) and after (2017) the introduction of the ‘cycle of care’. International guidelines informed the analysis.ResultsIn total, 3189 patients were examined from 41 practices for the years 2014 and 2017. Nine practices were located in an urban setting (22%), 16 rural (39%), and 16 in a mixed location (39%); 1781 males (55.8%) and 1408 females (44.2%). In 2017, the mean age of participants was 68.5 years (standard deviation [SD] = 12.3) and 2277 (71.4%) patients had clinical data provided for both 2017 and 2014, 875 (27.4%) for 2017 only, 5 (0.2%) for 2014 only, and 32 (1.0%) for neither year. Substantial improvements in rates of recording and in levels of missing data were shown for HbA1c, lipids, renal function, blood pressure, and body mass index. Rates of foot review, retinopathy screening, treatment review, influenza immunisation, and patient education were recorded for the first time in 2017.ConclusionThe ‘cycle of care’ programme has resulted in substantial improvements in type 2 diabetes care in Ireland, supporting pay for performance.
Evaluating reflection in postgraduate GP training post Bawa-Garba: a qualitative approach
Authors: Emery Laura 
Published: June 2019

BackgroundIt has been suggested that reflection within healthcare training bears little resemblance to theoretical approaches to reflective practice described in academia. Concerns have been raised about students producing artificial entries rather than an honest review of incidents encountered. The Bawa-Garba case is anticipated to have had a significant impact on the reflective practice of postgraduate medical trainees.AimTo evaluate the use of reflective learning logs in postgraduate general practice training in the context of the recent Bawa-Garba case.MethodUsing constructivist theory, a phenomenological approach to qualitative research was applied. During February to June 2018, 11 participants were recruited — seven trainees and four trainers — from the Doncaster GP Training scheme. Semi-structured interviews were performed and the data collected was transcribed for thematic analysis as described by Attride Sterling.ResultsDifficulty and challenge were identified as common themes for reflective log entries. There is support for previous findings regarding artifice, which commonly occurred in the context of evidencing curriculum coverage. All trainees expressed anxiety about the confidentiality of their reflective entries, with many describing a defensive approach to reflection following the Bawa-Garba case. International medical graduates (IMGs) were identified as being at a significant disadvantage in the current training scheme due to difficulties with language, cultural barriers, and previous experience of reflection.ConclusionA global theme identified from the data was that reflection within GP training needs to change in order to remove bias and prevent further devaluation of reflective learning.
What are the opportunities for cancer care and related research in primary care? A qualitative study of the views of patients, carers, and practice staff
Authors: Clark Joseph , Amoakwa Elvis , Blenkinsopp John , Reedy Florence , Johnson Miriam 
Published: June 2019

BackgroundResearch to identify the role of primary care in cancer care is important. However, trials in primary care are difficult.AimTo understand how patients, families, and primary care clinicians view their role in cancer care and identify opportunities for cancer primary care research.MethodQualitative study embedded within a feasibility cluster randomised controlled trial of a primary care based needs assessment intervention. The Supportive Cancer Needs Survey (SCNS) was the main outcome. In-depth interviews with patients/carers and focus groups with primary care staff explored views on cancer care and trial participation. Data were recorded, transcribed verbatim, and analysed thematically by three independent researchers.ResultsFifteen cancer patients and three carers were interviewed and four focus groups (n = 11) were conducted. Three themes were generated satisfaction with current care; key time-points for improved cancer care; and information and research. Satisfaction with current care among patients was high in spite of 72% reporting at least one moderate-high unmet need at baseline. Most patients undergoing cancer treatment were unsure when to access primary care. Patients and carers highly valued proactive contact from their practice following diagnosis though this was uncommon. Post-oncology discharge was a key time-point for information needs and support for patients. Patients were reluctant to consider palliative care in spite of palliative care needs. Some felt therapeutic benefit from completing study measures.ConclusionPatients are satisfied with cancer primary care despite unmet needs. Palliative care is poorly understood by many who may benefit. Research participation may benefit some patients.
Evaluating the impact of ‘Be Clear on Cancer’ awareness campaigns on GP attendances
Authors: Lawrence Christopher , Gildea Carolynn , Watters Ann , Tudge Isobel 
Published: June 2019

BackgroundThe ‘Be Clear on Cancer’ awareness campaigns aim to raise awareness of cancer symptoms and encourage people with these symptoms to ‘tell their doctor’. GP attendances are therefore a key metric for evaluating the impact of a campaign. We considered the impact on GP attendances of several campaigns since 2013, including the 2015 national oesophagogastric cancer campaign, the 2016 national respiratory symptoms campaign and campaigns for lung cancer, ‘blood in pee’, and breast cancer in women aged >70 years.AimTo consider the impact on GP attendances of several campaigns since 2013, including the 2015 national oesophagogastric cancer campaign, the 2016 national respiratory symptoms campaign and others.MethodData on the weekly numbers of GP attendances and practices were extracted from The Health Improvement Network (THIN) database. For patients reporting campaign symptoms or a control symptom (back pain), the average number of GP attendances per practice per week was calculated. Analysis considered the trend in GP attendances, calculated the change in attendances for the campaign period compared to the same period in an earlier year, and assessed this change using a χ2 test.ResultsThe 2015 oesophagogastric cancer campaign, resulted in a statistically significant 29% increase (P<0.001) in the number of attendances for symptoms of dyspepsia and dysphagia, compared with the same period in 2013. Conversely, there was no significant change in attendances for back pain. Results for other campaigns will be presented.ConclusionThe THIN database has provided primary care data which can be used to assess the impact of awareness campaigns on primary care activity. Results demonstrate increases in GP attendances following some of the campaigns, suggesting that some patients responded to the campaigns’ call to action.
CONCEPÇÕES DE LINGUAGEM E AVALIAÇÃO DO ALUNO COM DIAGNÓSTICO DE DEFICIÊNCIA INTELECTUAL
Authors: Fronza Catia de Azevedo , Haag Cassiano Ricardo , Didó Andréia Gulielmin 
Published: June 2019

Neste artigo, trazemos discussões sobre a avaliação na escola, voltando-nos ao que temos chamado de contexto de diferenças. Inicialmente, compartilhamos reflexões acerca da avaliação no processo de ensino-aprendizagem, apontamentos sobre concepções de avaliação e algumas de suas consequências. Dando continuidade ao texto, propomos uma discussão sobre a avaliação do indivíduo com suspeita e/ou diagnóstico de deficiência intelectual. Essa discussão traz a avaliação da deficiência intelectual a partir da definição postulada pela American Association on Intellectual and Developmental Disabilities (AAIDD), problematizando-a no sentido de compreender de que maneira a concepção de linguagem interfere na reflexão sobre a definição de deficiência intelectual. Por meio dessas ponderações, colocamos algumas de nossas inquietações e perspectivas, cientes de que há muito mais a discutir sobre o contexto de diferenças e a avaliação nesse cotidiano escolar.
Entrevista com Maria Tereza Esteban do Valle
Authors: Olh@res Equipe 
Published: June 2019

Na seção Entrevista da Revista Olh@res, Maria Tereza Esteban do Valle, pesquisadora de grande expressão no campo da Avaliação, expõe suas reflexões sobre os múltiplos desafios que se apresentam à área.Em suas considerações, assevera o potencial das pesquisas com o cotidiano para o desenho de novas possibilidades de compreensão dos sujeitos, no processo educacional, e, por conseguinte, de alterações significativas na avaliação. Ao discorrer sobre as implicações da avaliação em larga escala no cotidiano escolar e no trabalho docente e ao dissertar a respeito da relação entre as práticas de avaliação nas licenciaturas e na educação básica, a autora sinaliza a centralidade do campo da avaliação, para o fortalecimento do diálogo entre universidade e escola pública.
O CENÁRIO DAS PESQUISAS INTERNACIONAIS SOBRE A INCLUSÃO E ESCOLARIZAÇÃO DO ALUNO COM DEFICIÊNCIA INTELECTUAL
Authors: Maturana Ana Paula Pacheco Moraes , Mendes Enicéia Gonçalves 
Published: June 2019

ResumoO presente trabalho tem como objetivo identificar e apresentar o que a literatura científica internacional recente traz sobre a escolha do tipo de escolarização para alunos com deficiência intelectual. Para tal, realizou-se uma pesquisa bibliográfica na base de dados Web of Science selecioando pesquisas dos últimos 10 anos com os descritores: special education e inclusion. Ao todo foram encontrados 70 produções. A leitura permitiu a identificação de dez produções relevantes para o tema, que foram apresentadas de acordo com seu respectivo país. De modo geral, os artigos abordaram a importância da participação dos pais na escolha do tipo de escolarização, o quanto a gravidade da deficiência influencia a percepção do tipo de escola adequada e a necessidade de medidas que façam com que os professores sintam-se atuantes e responsáveis pelo processo de inclusão do aluno com deficiência intelectual. Palavras-chave: inclusão; deficiência intelectual; educação especial
EL SWARMING COMO MODELO ANALÍTICO PARA PENSAR LAS POLÍTICAS EDUCATIVAS
Authors: Tello César 
Published: June 2019

Resumen. En este trabajo se presentan algunas reflexiones de carácter teórico-analítico sobre el modelo del swarming como un modo posible, entre otros, para comprender el objeto de estudio de la política educacional, esto es: las políticas educacionales. Estas reflexiones se desarrollan en el marco de lo que hemos denominado el Campo de los estudios Epistemológicos en Política Educacional. Así, se propone un modelo teórico para el análisis de las políticas educacionales desde una perspectiva epistemológica pluralista. Realizando en primer término una caracterización de los modelos empleados para el análisis de las políticas públicas provenientes del desarrollo teórico de las ciencias políticas y concibiendo, desde nuestra perspectiva, a las políticas educacionales como multidimensionales, complejas y rizomáticas que se manifiestan modélicamente a través del swarming. Palabras Clave: investigación; políticas educacionales; modelizaciones teóricas; swarming.
PESQUISA E FORMAÇÃO EM POLÍTICA EDUCACIONAL: UM DESAFIO INTERDISCIPLINAR
Authors: Krawczyk Nora 
Published: June 2019

Conferência de Abertura do I Encuentro Latinoamericano de Profesores de Política Educativa. Organizado pela RELEPE e realizado 6 e 7 de julho de 2014, na Unifesp, em Guarulhos-SP.
A NARRATIVA AUTOBIOGRÁFICA DE ALUNOS DE EJA COMO PRÁTICA PEDAGÓGICA
Authors: Almeida Alessandra Rodrigues de , Godoy Eliete Aparecida de 
Published: June 2019

Este relato aborda a experiência da produção de narrativas autobiográficas por alunos na Educação de Jovens e Adultos como prática pedagógica adotada por uma rede de ensino. Para favorecer o pertencimento e a valorização da experiência dos alunos no contexto escolar, buscou-se ampliar a (re)significação da relação com a escola e as aprendizagens dos estudantes envolvidos. Descreve-se qualitativamente a organização de dois livros autobiográficos como produto de uma reorganização de práticas pedagógicas para EJA. Os resultados revelaram que a escrita de narrativas autobiográficas pelos estudantes como prática pedagógica contribui para o trabalho com a Língua Portuguesa e a importância da produção dos livros como ação voltada à permanência do jovem e do adulto na escola. Além disso, corroboraram com a orientação de que a educação-formação é um processo permanente que se realiza a partir das relações, acontecimentos, experiências e contextos que acompanham a vida de cada um. PALAVRAS-CHAVE: EJA. Narrativas autobiográficas. Prática de ensino.
FORMAÇÃO CONTINUADA DE DOCENTES PARA A EDUCAÇÃO DE JOVENS E ADULTOS - EJA: UMA EXPERIÊNCIA DE CURSO DE APERFEIÇOAMENTO
Authors: Menino Sergio Eugenio , Belezia Eva Chow , Peterossi Helena Gemignani , Fernandez Senira Anie Ferraz 
Published: June 2019

O presente artigo relata uma experiência de formação de professores para a Educação de Jovens e Adultos – EJA por meio de curso de Pós-Graduação em Aperfeiçoamento na categoria de Ensino à Distância - EAD, mediado por computador, utilizando a Plataforma Moodle como sistema. Após uma demonstração da fundamentação legal da modalidade Aperfeiçoamento, descreve o curso propriamente dito e apresenta as pesquisas realizadas com os professores-cursistas, incluindo desistentes e reprovados. Conclui-se que a experiência do curso atingiu seus objetivos de atender à demanda significativa neste campo e como aprendizado para a organização para a oferta de novas modalidades de formação continuada. PALAVRAS-CHAVE: Aperfeiçoamento. Formação de Professores. Educação Profissional.
Representações sobre a escola para estudantes do ensino médio das redes pública e particular
Authors: Carrer Laércio da Costa , Penna Marieta Gouvêa de Oliveira 
Published: June 2019

O presente artigo apresenta parte do resultado de pesquisa que visou identificar semelhanças e/ou constatar diferenças na representação sobre a escola entre estudantes do 3º ano do ensino médio de uma escola da rede pública e de uma escola da rede particular da cidade de São Paulo. Para tanto, utilizou-se o referencial teórico de Pierre Bourdieu (conceito de representação) e de Phillippe Perrenoud (ofício de aluno). As informações foram coletadas por meio da aplicação de questionário contendo perguntas abertas e fechadas. Os resultados abrem possibilidades de se estabelecerem convergências e explicitam antagonismos nas representações que os jovens possuem sobre o universo escolar, relacionadas às condições objetivas de escolarização dos estudantes e por sua condição juvenil.
Palavras chaves: Ensino Médio. Juventude e Educação. Representação social.
Desarrollo del Proceso de Enseñanza Aprendizaje del Idioma Inglés En El ITF
Authors: Bonilla Tenesaca Josue Reinaldo , Lema Cachinell Belinda Marta , Batista Medina Isabel 
Published: June 2019

La enseñanza del idioma inglés, además de su significación social y cultural, constituye una disciplina cada vez más importante en el mundo de hoy, por el alto nivel de desarrollo científico-técnico y la colaboración internacional entre los pueblos. Sin embargo, no resulta encontrar una estrategia adecuado para la enseñanza de las lenguas extranjeras, y del inglés en particular. La gran cantidad de diferente estrategia hace que las preferencias de los docentes se encuentren dividida.
Mientras tanto, el gran colectivo de estudiantes de inglés es incapaces de comunicarse correctamente tras años de aprendizaje, por lo cual mediante la estrategia a investigar se pretende revelar un proceso de enseñanza aprendizaje con un enfoque multicultural debido que nuestro país posee una diversidad de culturas que merecen un tratamiento más específico para un mejor aprendizaje del idioma ingles
Capacitación Docente en el Uso de las Funcionalidades de las TIC’S
Authors: Delgado Saeteros Emma Zulay , Lema Cachinell Belinda Marta , Alzate Peralta Luis Alberto 
Published: June 2019

La enseñanza del idioma inglés, además de su significación social y cultural, constituye una disciplina cada vez más importante en el mundo de hoy, por el alto nivel de desarrollo científico-técnico y la colaboración internacional entre los pueblos. Sin embargo, no resulta encontrar una estrategia adecuado para la enseñanza de las lenguas extranjeras, y del inglés en particular. La gran cantidad de diferente estrategia hace que las preferencias de los docentes se encuentren dividida.
Mientras tanto, el gran colectivo de estudiantes de inglés es incapaces de comunicarse correctamente tras años de aprendizaje, por lo cual mediante la estrategia a investigar se pretende revelar un proceso de enseñanza aprendizaje con un enfoque multicultural debido que nuestro país posee una diversidad de culturas que merecen un tratamiento más específico para un mejor aprendizaje del idioma ingles