While collaborative, team-based care has the potential to improve medication use and reduce adverse drug events and cost, less attention is paid to understanding the processes of well functioning teams. This paper presents the findings from key informant interviews and reflective journaling from pharmacists, physicians and nurse practitioners participating in a multicentre, controlled clinical trial of team-based pharmacist care in hospitalized medical patients. A phenomenological approach guided the data analysis and content analysis was the primary tool for unitizing, categorizing and identifying emerging themes. Pharmacists experienced highs (developing trusting relationships and making positive contributions to patient care) and lows (struggling with documentation and workload) during integration into the medical care team. From the perspective of the participating pharmacists, nurse practitioners and physicians, the integration of pharmacists into the teams was felt to have facilitated positive patient outcomes by improving team drug-therapy decision-making, continuity of care and patient safety. Additionally, the study increased the awareness of all team members' potential roles so that pharmacists, nurses and physicians could play a part in and benefit from working together as a team. Focussed attention on how practice is structured, team process and ongoing support would enable successful implementation of team-based care in a larger context. (ClinicalTrials.gov number, NCT00351676).

We presume that models and theory in instructional design inform professional practice, but theory has not been consistently built from the professional experiences of instructional designers. This study draws on the observations of five instructional designers who discuss their professional identities, their communities of practice and their roles as agents of social and institutional change. This study is embedded in two theoretical positions: instructional design as a social construct that is expressed in professional communities of practice, and critical pedagogy, in which designers act as agents of social change.

This article considers transformative learning within the context of the Partnership Program, an instructional development initiative of the Academic Technologies forLearning unit at the University of Alberta. This initiative focused on introducing faculty to technology-enhanced teaching and learning strategies and tools, developing educational resources through a collaborative instructional development process, promoting faculty use of educational technologies within the university, and supporting faculty to change their teaching practice through participation in an instructional development project. One question asked in this study was: Does the involvement of faculty members in an instructional development project facilitate a transformation in their teaching philosophy and practice? This article focuses on three themes that emerged from the study-alignment/misalignment of expectations with experience, change in attitudes toward technology-enhanced instruction, and change in pedagogical style-and how they may relate to the presence or lack of transformative learning experiences for faculty participating in instructional development projects.This article considers the experience of faculty members and instructional development staff within the context of the Partnership Program, a 5-year instructional development initiative of the Academic Technologies for Learning (ATL) unit at the University of Alberta. At its inception, several outcomes were pursued across this program, including (a) introducing faculty to technology-enhanced teaching strategies and tools, (b) creating technology-enhanced educational re-A Au ut th ho or rs s' ' N No ot te e: : The authors gratefully acknowledge the significant contribution of Danielle Law, research assistant with Academic Technologies for Learning, who participated in the data analysis, and who first described the practice models and associated contextual indicators that guide our discussion of perspectives transformation.

Summary Objective B lymphocyte activating factor (BAFF), a member of the tumour necrosis factor superfamily, is essential for B cell activation, differentiation and survival. Elevated circulating BAFF levels have been found in patients with several autoimmune conditions, including Graves’ disease. In addition, BAFF gene variants have been associated with Graves’ disease in a Taiwanese cohort, and with several other autoimmune conditions in non‐Taiwanese populations. Design and methods We performed a case‐control association study to investigate two BAFF polymorphisms (rs9514828 and rs4000607) in a UK cohort of 444 patients with Graves’ disease. Genotype frequencies were compared to those from 447 local controls and more than 5000 healthy controls from the Wellcome Trust case‐control consortium (WTCCC2). Results There was a significant difference in the frequency of the AA genotype at rs4000607 between the Graves’ disease cohort and both the local controls (P = 0.045) and the WTCCC2 controls (P = 4.56 × 10−6). Furthermore, the frequency of the A allele was found to be increased in the Graves’ disease group compared to WTCCC2 controls (P = 0.02, OR 1.20 (95% CI 1.03‐1.41). No association was observed at the rs9514828 locus. Conclusion Dysfunction of the humoral immune system is an obligatory pathophysiological component of Graves’ disease, hence BAFF is an excellent functional candidate gene. We have demonstrated, for the first time, a significant association of the BAFF polymorphism rs4000607 with Graves’ disease in a UK cohort. Further work to elucidate the role of BAFF in the pathogenesis of Graves’ disease is now warranted.

Instructional designers regularly engage in a process of professional and personal transformation that has the potential to transform the culture of institutions through faculty-client relationships. Instructional designers promote new ideas and understandings in social contexts that include other designers and clients, among others. This research program attempts to understand this process, using narrative inquiry and instructional designers' stories of practice to explore two interconnected theoretical frames. One frame is methodological and offers a case for narrative inquiryas an alternative approach to research in educational technology. The second frame is practice-based, and uses narrative inquiry to explore the themes of reflexivity, voice, strong subjectivity and power/authority through the stories of three instructional designers.