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Innovative Practice (innovative + practice)
Selected AbstractsLatest news and product developmentsPRESCRIBER, Issue 2 2008Article first published online: 11 FEB 200 NICE should evaluate all new medicines NICE should determine the cost effectiveness of all new medicines, the Health Select Committee has concluded in its second review of the Institute. The review, prompted by criticisms from patients, health professionals and the pharmaceutical industry, found that NICE is doing ,a vital job in difficult circumstances'. The Committee called for the costs to carers and society to be included in cost effectiveness estimates (this is currently prohibited) and for cost per QALY thresholds to be aligned with NHS affordability. NICE should publish brief appraisals at the time of a product launch , these could be used to negotiate prices. GPs responsible for unlicensed co-proxamol GPs who prescribe co-proxamol are now responsible for the consequences, the MHRA warns. The Agency agrees that the drug may be needed by ,a small group of patients who are likely to find it very difficult to change from co-proxamol or where alternatives appear not to be effective or suitable'. Following the withdrawal of product licences, stock that is currently in the supply chain may be dispensed but no new stock should be released by suppliers. The Drug Tariff price of co-proxamol has now increased from £2.79 to £20.36 per 100 tablets. Vitamin D deficiency on the increase Pregnant and breastfeeding women may need vitamin D supplements, the Department of Health has warned, and GPs are seeing increasing numbers of patients with vitamin D deficiency. Endogenous synthesis may be low in some ethnic groups and dark-skinned people, and north of Birmingham there is no light of the appropriate wavelength for the synthesis of vitamin D during the winter. The Department says free vitamin supplements are available for eligible patients through its Healthy Start Scheme (www.healthystart.nhs.uk) and may also be supplied at low cost by some PCTs. Innovation and good practice recognised Innovative practice and better outcomes for patients have been recognised through awards from the NHS Alliance and Improvement Foundation presented by the Secretary of State for Health, Rt Hon Alan Johnson, at the annual NHS Alliance conference held in Manchester. The Mountwood Surgery in Northwood, Middlesex, won the CHD QOF GP Practice Award sponsored by Schering Plough for their outstanding multidisciplinary approach to tackling CHD. In addition to having a highly organised in-house cardiology team, they have produced an interactive, patient-empowering booklet for CHD. Mountwood Surgery achieved blood pressure targets of 96.79 per cent in their CHD patients. North Tees PCT wins the CHD QOF PCO Award, also sponsored by Schering Plough, for their support and encouragement to GP practices to ,own' CHD care. They provide timely feedback of performance data using funnel plots and regular communication by the CHD LIT and Cardiac Network. Even though North Tees PCT has a high CHD prevalence, 4.2 per cent vs 3.6 per cent nationally, across the 27 practices 85 per cent of patients achieved cholesterol targets and 91 per cent reached the QOF blood pressure target. The St Benedict's Hospice Day Centre Project (for the Sunderland Teaching Primary Care Trust) won the Guy Rotherham Award for its excellent multidisciplinary team improvement of the palliative care provided. This team demonstrated a thorough understanding of the use of quality improvement methods to improve patient care, and carefully measured the individual improvements they made. Through the use of a referral ,decision tree', nonattenders were reduced by 300 per cent and average waiting times halved. The Extended Primary Care (EPC) Gynaecology Service (for the Practice Based Commissioning Consortium South Manchester Hub) was highly commended for its development of an effective and innovative service offering gynaecological treatment managed within a primary care setting, allowing patients improved access closer to home. The Salford Perinatal Mental Health Project was also highly commended for effectively challenging the high levels of maternal suicides. The awards were also supported by Prescriber, the British Cardiac Patients Association and the British Cardiac Society. Anastrozole superior to tamoxifen in long term A new analysis of the ATAC trial (Lancet Oncology 2008;9:45-53) shows that the advantages of the aromatase inhibitor anastrozole (Arimidex) over tamoxifen as adjuvant therapy for breast cancer persist for at least four years after the end of treatment. After primary treatment with surgery, chemotherapy or radiotherapy, postmenopausal women with localised invasive breast cancer were randomised to five years' treatment with anastrozole or tamoxifen. Among 5216 women who were hormone-receptor positive, anastrozole increased disease-free survival by 15 per cent after 100 months. Time to recurrence and distant recurrence were also increased, though overall survival was similar; the absolute difference in time to recurrence was greater at nine years (4.8 per cent) than at five years (2.8 per cent). Joint symptoms and fractures were more frequent with anastrozole during treatment but not thereafter. Use a steroid with a LABA , MHRA reminder The MHRA has reminded clinicians that patients treated with an inhaled long-acting beta-agonist (LABA) should also use an inhaled steroid. In the latest edition of Drug Safety Update (2008;1:No.6), the Agency reviews the implications of the SMART study (Chest 2006;129:15-26), which reported an increased risk of respiratory- and asthma-related deaths among patients using salmeterol (Serevent). This is contradicted by epidemiological data suggesting that asthma-related admissions have declined since LABAs were introduced. Randomised trials also do not support such a risk, probably because inhaled steroids are used more consistently in trial settings. The latest Update notes that product licences for carisoprodol (Carisoma) have been suspended due to concerns about the risk of abuse and psychomotor effects. It also includes a comprehensive summary of drug interactions with statins, a warning that methylene blue should not be prescribed for a patient taking a drug with serotonergic activity, and a reminder that only oral formulations of desmopressin are now licensed for primary nocturnal enuresis. This issue of Update is available at www.mhra.gov.uk. Copyright © 2008 Wiley Interface Ltd [source] Innovative practices in service-learning and curricular engagementNEW DIRECTIONS FOR HIGHER EDUCATION, Issue 147 2009Robert G. Bringle This chapter summarizes institutional best practices in the assessment of service-learning. [source] The Audit Commission review of diabetes services in England and Wales, 1998,2001DIABETIC MEDICINE, Issue 2002B. Fitzsimons Abstract Aims of the Audit Commission The Audit Commission has a statutory duty to promote the best use of public money. It does this through value for money studies, such as that reported in Testing Times[1]. This work has been followed with a review of innovative practice in commissioning. These initiatives aim to support the implementation of the diabetes national service framework. The Audit Commission also appoints external auditors to NHS organizations who assess probity and value for money in the NHS; the latter by applying national studies locally and by carrying out local studies. Methods Research for Testing Times consisted of structured visits to nine acute trusts, a telephone survey of 26 health authorities and a postal survey of 1400 people with diabetes and 250 general practitioners. Local audits used a subset of the original research tools. Case studies were identified through a cascade approach to contacts established during Testing Times and through self-nomination. Results Rising numbers of people with diabetes are placing increasing pressure on hospital services. Some health authorities and primary care organizations have reviewed patterns of service provision in the light of the increasing demands. These reviews show wide variations in patterns of routine care. In addition, there is a widespread lack of data on the delivery of structured care to people with diabetes. People with diabetes report delays in gaining access to services, and insufficient time with staff. There are insufficient arrangements in place for providing information and learning opportunities to support self-management. Conclusion As the number of people with diabetes continues to rise, the potential for providing more care in a primary care setting needs to be explored. This will enable specialist services to focus more effectively on those with the most complex needs. [source] Qualitative case studies of innovative pedagogical practices using ICTJOURNAL OF COMPUTER ASSISTED LEARNING, Issue 4 2002R.B. Kozma Abstract The Second Instructional Technology in Education Study: Module 2 (SITES M2) is a series of qualitative studies that identify and describe innovative pedagogical practices in 28 participating countries that use technology. The project resulted in 174 case study reports of innovative practice that are currently being analysed. This paper describes the goals, research questions, and methodology for this study and provides a context for the other papers that are published in this issue. Given the large number of case studies, a combined qualitative and quantitative approach to the research is described. [source] Doctors' perspectives on their innovations in daily practice: implications for knowledge building in health careMEDICAL EDUCATION, Issue 10 2008Maria Mylopoulos Context, When individuals adapt their practice in order to solve novel or unexpected problems of practice, they are creating new knowledge. This form of innovation development is understood as a core competency of adaptive expertise and the basis for knowledge building community practice. However, little is known about the ways in which this knowledge, produced through daily, innovative problem solving, is developed, identified and shared by health care professionals. Methods, Following this line of inquiry, we conducted semi-structured interviews with a saturation sample of 15 clinical faculty staff at the University of Toronto. Results, A grounded theory analysis of the results showed that our participants held the view that innovation was focused on outcomes, developed through research practice and diffused for adoption in the broader community. As a result, their own individual improvements to daily practice were excluded from this view of innovation. Furthermore, their perceptions of innovation limited participants' engagement in the sort of collaborative process that is central to the practice of knowledge-building communities. Conclusions, This research demonstrated that thinking about innovation and innovative practice must be changed in order to foster the development of knowledge-building communities in medicine. [source] Codification, patents and the geography of knowledge transfer in the electronic musical instrument industryTHE CANADIAN GEOGRAPHER/LE GEOGRAPHE CANADIEN, Issue 3 2006TIM REIFFENSTEIN Recent research in economic geography has emphasized tacit knowledge as the basis of industrial learning. In contrast, codification and the practices of industrial writing have received little attention for the roles they play in mobilizing knowledge across space. This paper offers insight into the geographies of codification through an examination of technology transfer in the electronic musical instrument industry between 1965 and 1995. The research draws on a variety of primary and secondary data that include interviews with inventors, biographical accounts and patent analysis. These sources offer perspective on the career trajectories of three U.S. inventors who transferred knowledge from various contexts in California's high-tech industry to the Japanese firm, Yamaha. Conceptually, the paper draws on the actor,network theory and Latour's idea of translation to highlight the detours inventors must take to register novelty. The analysis reveals the problematic nature of codified knowledge and its transfer; in this case codified knowledge was mobile internationally but not locally, at least until it reached Japan. The paper argues for the need to understand how texts such as patents are produced,the context of their authorship, the geographies of their circulation and their efficacy for shaping further innovative practice. Les recherches actuelles en géographie mettent l'accent sur les connaissances tacites comme fondement de l'apprentissage industriel. Cependant, la codification et les pratiques relatives à la composition industrielle ont été peu étudiées du point de vue de leurs rôles dans la mobilisation des connaissances dans l'espace. Cet article donne un aperçu des géographies de la codification suite à une analyse du transfert technologique dans l'industrie des instruments de musique électronique entre 1965 et 1995. Fondée sur un ensemble de données primaires et secondaires, cette étude présente une série d'entrevues réalisées auprès d'inventeurs, des comptes-rendus biographiques et des analyses de brevets. Ces données permettent de considérer avec recul le cheminement professionnel de trois inventeurs américains responsables du transfert des connaissances depuis différents secteurs de l'industrie de haute technologie californienne vers la société japonaise Yamaha. Sur un plan conceptuel, l'article reprend la théorie acteur-réseau et aborde la notion de traduction développée par Latour afin de mettre en relief les principaux détours qu'empruntent les inventeurs pour obtenir un brevet d'innovation. L'analyse fait ressortir le caractère problématique des connaissances codifiées et de leur transfert; dans ce cas, les connaissances codifiées étaient mobiles à l'échelle internationale et non à l'échelle locale avant qu'elles n'arrivent au Japon. Cet article plaide en faveur de la nécessité de comprendre comment les textes tels que les brevets sont élaborés: le contexte entourant la rédaction du document, les géographies de leur diffusion et les répercutions sur les pratiques novatrices. [source] Piercy Conner Architects & DesignersARCHITECTURAL DESIGN, Issue 6 2007Article first published online: 30 NOV 200 Abstract Piercy Conner, an innovative practice based in London, extends the theory and practice of architecture in a way ,that demonstrates a profound understanding of its cultural and communicational possibilities', and is the firm behind a number of microflat projects in and around London. Copyright © 2007 John Wiley & Sons, Ltd. [source] Stoma coloproctology nurse specialist: a case studyJOURNAL OF CLINICAL NURSING, Issue 6 2007Ursula Chaney DPSN Aims and objectives., The aim of this paper is to provide insight into the role of a Stoma Coloproctology Nurse Specialist. This paper presents the findings of an in-depth case study of a stoma coloproctology nurse specialist employed in one health board area in Northern Ireland. This case study was part of a larger study exploring innovative nursing and midwifery roles in Northern Ireland. Background., Specialist nursing roles have evolved and developed in response to changing health care needs, patient expectations, changes in professional regulation and government initiatives. Design., A case study approach was adopted. Method., Semi-structured interviews with the post holder (PH), her line manager and the human resource manager were undertaken. Non-participant observation of the PH's practice was also carried out. Analysis was undertaken on secondary data such as job specification, annual reports and other documentation relating to the post. Results., Findings illustrate the PH's function and the impact of the role on patient care. Examples of innovative practices relating to providing care, support and guidance for patients and their families were identified; however, limitations to her role were also identified. Conclusions., The PH provides an invaluable service to patients, demonstrating a positive impact on care. However, the findings suggest the importance of establishing clear role boundaries, which may lead to professional growth and practice development. Relevance to clinical practice., Although this study provides a valuable insight into the role of a Stoma Coloproctology Nurse Specialist a number of challenges exist, as the CNS role requires policy and appropriate educational preparation to practice at an advanced level. Further research investigating the development of the CNS role in the clinical setting and its relationship to members of the multi-professional team would be beneficial. [source] Managing innovation through social architecture, learning, and competencies: a new conceptual approachKNOWLEDGE AND PROCESS MANAGEMENT: THE JOURNAL OF CORPORATE TRANSFORMATION, Issue 3 2006Peter Murray Traditional innovative narratives are presented in a structured, almost prescribed, fashion in the innovation literature. This structural approach treats knowledge as a commodity that can be easily developed and shared. In this paper we argue the opposite, suggesting that developing competencies is fundamentally linked to socially constructed innovative practices and processes developed over time as the organisation evolves and learns new ways. We suggest that the latter is better reflected by a processual view of knowledge management; how it evolves, how it leads to innovation. While the innovation literature is familiar with the importance of learning and knowledge practices, we contend that the learning routines themselves are not practised in a systematic fashion. We argue that innovation is seldom of a breakthrough type. Instead, we call for an integrative approach that combines social processes with learning and innovation. Socially crafted routines we suggest lead to greater innovative outcomes and effectiveness. This paper explores and investigates these ideas by matching different contexts to processes. The paper develops a theoretical framework which indicates the integrative and interactive forces required for successful innovation implementation. Copyright © 2006 John Wiley & Sons, Ltd. [source] How Design Experiments Can Inform Teaching and Learning: Teacher-Researchers as Collaborators in Educational ResearchLEARNING DISABILITIES RESEARCH & PRACTICE, Issue 4 2005Asha K. Jitendra In this commentary, I summarize my own research with colleagues to affirm Dr. Gersten's call for considering design experiments prior to conducting intervention research. I describe how design experiments not only can inform teaching and the learning of innovative approaches, but also hold the promise of effectively bridging the research-to-practice gap to produce meaningful change in practice when innovative practices are fine-tuned and validated by partnerships with teacher-researchers. [source] Community colleges and their communities: Collaboration for workforce developmentNEW DIRECTIONS FOR COMMUNITY COLLEGES, Issue 115 2001Margaret Terry Orr Community colleges are forging a wide range of partnerships and collaborations with other community interests and resources to create a variety of vocational education opportunities. Examples are provided to illustrate new directions and innovative practices. Limitations of collaborations are also discussed. [source] Psychological research in educational technology in ChinaBRITISH JOURNAL OF EDUCATIONAL TECHNOLOGY, Issue 4 2010Ru-De Liu Information and communication technology (ICT) has increasingly been bringing about significant changes in education in an ongoing process. The educational reform is not a mere technological issue but rather is based on an empirical grounding in a psychological research approach to learning and instruction. This paper introduces the research work on the application of ICT in education from the psychological perspective in China in the past three decades. The introduction focuses on four important issues with systemic theoretical thinking based on continuous empirical research and innovative practices. The first is dialectic constructivism which has offered some dialectic explanation for knowledge, learning and teaching, and balanced various contradictory aspects of learning and teaching. The second is theoretical thinking and instructional practice about the principles of learning environment design which emphasises learners' higher-order thinking, deep understanding, collaboration and self-regulated learning. The third is a model for the effectiveness and conditions of Computer-Assisted Instruction. The fourth is a framework for the integration of ICT and education and a zigzag training model for teacher training for integration. [source] | |||||||||||||