Future-proofing the pharmacy profession in a hypercompetitive market

This paper highlights the hypercompetitive nature of the current pharmacy landscape in Australia and to suggest either a superior level of differentiation strategy or a focused differentiation strategy targeting a niche market as two viable, alternative business models to cost leadership for small, independent community pharmacies. A description of the Australian health care system is provided as well as background information on the current community pharmacy environment in Australia. The authors propose a differentiation or focused differentiation strategy based on cognitive professional services (CPS) which must be executed well and of a superior quality to competitors' services. Market research to determine the services valued by target customers and that they are willing to pay for is vital. To achieve the superior level of quality that will engender high patient satisfaction levels and loyalty, pharmacy owners and managers need to develop, maintain and clearly communicate service quality specifications to the staff delivering these services. Otherwise, there will be a proliferation of pharmacies offering the same professional services with no evident service differential. However, to sustain competitive advantage over the long-term, these smaller, independent community pharmacies will need to exploit a broad core competency base in order to be able to continuously introduce new sources of competitive advantage. With the right expertise, the authors argue that smaller, independent community pharmacies can successfully deliver CPS and sustain profitability in a hypercompetitive market.

Expanded scope roles in primary health – what makes them work?

Introduction The demand for better integration between primary and secondary healthcare frequently leads to discussion about expanded scope of practice for nursing, paramedic and allied health professionals and the role these clinicians could play in facilitating improved access to timely and appropriate healthcare. From workforce perspective, expanded scope of practice has also been advocated as a mean of fostering workforce retention. Models of expanded scope roles in nursing and paramedicine have been trialled nationally and internationally in both acute and community care settings. Where they have been successful, trials have resulted in reduction in hospital presentation and admission; improved patient access and timeliness; and patient satisfaction. This paper will examine the characteristics of successful expanded scope programs. Method Exploratory case-study analysis of successful integration of expanded health care roles across primary healthcare settings in rural Australia. Results & Conclusions One size does not fill all. Successful models of integrated expanded health care roles in primary health care settings are built on stakeholder’s capacity and preference; community need; and political will. Collaborative, congruent, multi-disciplinary care teams that prioritise patient-centred care within a dynamic primary care setting have merit and are more likely to foster flexibility and sustainability.

E-motion diaries : blogging emotional responses to online learning in higher education

Emotions are inherently social, and are central to learning, online interaction and literacy practices (Shen, Wang, & Shen, 2009). Demonstrating the dynamic sociality of literacy practice, we used e-motion diaries or web logs to explore the emotional states of pre-service high school teachers’ experiences of online learning activities. This is because the methods of communication used by university educators in online learning and writing environments play an important role in fulfilling students’ need for social interaction and inclusion (McInnerney & Roberts, 2004). Feelings of isolation and frustration are common emotions experienced by students in many online learning environments, and are associated with the success or failure of online interactions and learning (Su, et al., 2005). The purpose of the study was to answer the research question: What are the trajectories of pre-service teachers’ emotional states during online learning experiences? This is important because emotions are central to learning, and the current trend toward Massive Open Online Courses (MOOCs) needs research about students’ emotional connections in online learning environments (Kop, 2011). The project was conducted with a graduate class of 64 high school science pre-service teachers in Science Education Curriculum Studies in a large Australian university, including males and females from a variety of cultural backgrounds, aged 22-55 years. Online activities involved the students watching a series of streamed live lectures for the first 5 weeks providing a varied set of learning experiences, such as viewing science demonstrations (e.g., modeling the use of discrepant events). Each week, students provided feedback on learning by writing and posting an e-motion diary or web log about their emotional response. Students answered the question: What emotions did you experience during this learning experience? The descriptive data set included 284 online posts, with students contributing multiple entries. Linguistic appraisal theory, following Martin and White (2005), was used to regroup the 22 different discrete emotions reported by students into the six main affect groups – three positive and three negative: unhappiness/happiness, insecurity/security, and dissatisfaction/satisfaction. The findings demonstrated that the pre-service teachers’ emotional responses to the streamed lectures tended towards happiness, security, and satisfaction within the typology of affect groups – un/happiness, in/security, and dis/satisfaction. Fewer students reported that the streamed lectures triggered negative feelings of frustration, powerlessness, and inadequacy, and when this occurred, it often pertained to expectations of themselves in the forthcoming field experience in classrooms. Exceptions to this pattern of responses occurred in relation to the fifth streamed lecture presented in a non-interactive slideshow format that compressed a large amount of content. Many students responded to the content of the lecture rather than providing their emotional responses to this lecture, and one student felt “completely disengaged”. The social practice of online writing as blogs enabled the students to articulate their emotions. The findings primarily contribute new understanding about students' wide range of differing emotional states, both positive and negative, experienced in response to streamed live lectures and other learning activities in higher education external coursework. The is important because the majority of previous studies have focused on particular negative emotions, such as anxiety in test taking. The research also highlights the potentials of appraisal theory for studying human emotions in online learning and writing.

Antecedents of consumer brand loyalty in the Australian wine industry

The wine industry has become fiercely competitive worldwide and as a result, consumers are increasingly exposed to a wider range of wines in retail outlets. This expanding consumer choice means that there is a need for Australian wineries to develop and build consumer loyalty toward their brands. This paper aims to empirically examine the factors influencing consumer loyalty to wine brands. Using data from Australian wine consumers, the authors empirically test a model of antecedents of wine brand loyalty. The model considers wine brand trust, wine brand satisfaction, wine knowledge, and wine experience. Hypotheses were tested with structural equation modeling. The findings of this study show that wine knowledge and wine experience affect wine brand loyalty indirectly through wine brand trust and wine brand satisfaction. In addition, it is demonstrated that consumer satisfaction with a wine brand is the strongest driver of wine brand loyalty. The result of this study has value for Australian wineries, wine retailers, and wine marketers.

Exploring mediated interactions : a design exercise

With the emergence of personal and ubiquitous computing systems in the last decade, interaction designers have started designing products by employing quality oriented aspects such as user experience, playfulness, enchantment and others. In order to explore novel forms of mediated interactions, designers need to focus beyond the basic user requirements and usability issues. We present a procedure and results of a design exercise that we carried out with students of a master's course on Visual Design. Our intention was to explore new forms of mediated interaction by using a specific design exercise. We provide the details of the resulted design concepts and discuss the usefulness of our design exercise.

Does DE need a C? A proposal for a DE curriculum

The vision of a digital earth (DE) is continuously evolving, and the next-generation infrastructures, platforms and applications are being implemented. In this article, we attempt to initiate a debate within the DE and with affine communities about 'why' a digital earth curriculum (DEC) is needed, 'how' it should be developed, and 'what' it could look like. It is impossible to do justice to the Herculean effort of DEC development without extensive consultations with the broader community. We propose a frame for the debate (what, why, and how of a DEC) and a rationale for and elements of a curriculum for educating the coming generations of digital natives and indicate possible realizations. We particularly argue that a DEC is not a déjà vu of classical research and training agendas of geographic information science, remote sensing, and similar fields by emphasizing its unique characteristics.

Translational approaches to medication development

Alcohol accounts for major disability worldwide and available treatments are insufficient. A massive growth in the area of addiction neuroscience over the last several decades has not resulted in a corresponding expansion of treatment options available to patients. In this chapter, we describe our experience with building translational research programs aimed at developing novel pharmacotherapies for alcoholism. The narrative is based on experience and considerations made in the course of building these programs, and work on four mechanisms targeted by our libraries: cholinergic nicotine receptors, receptors for corticotropin-releasing hormone (CRH), neurokinin 1 (NK1) receptors for substance P (SP) and hypocretin/orexin receptors. Around this experience, we discuss issues we believe to be critical for successful translation of basic addiction neuroscience into treatments, and complementarities between academic and other actors that in our assessment need to be harnessed in order to bring treatments to the clinic.

Do we need to prescribe exercise differently for premenopausal and postmenopausal women?

The article by Kretzschmar et al 1 in this issue of Menopause details a study investigating the effect of a mild-intensity aerobic exercise training program on markers of mortality risk in both pre- and post-menopausal African American women. The findings of this study showed that aerobic exercise training was successful in improving some markers of cardiovascular disease (CVD) and mortality in post-menopausal women. The premise of this study, however, does suggest that increased exercise intensity may be required in post-menopausal women as opposed to pre-menopausal women to achieve the same decreased changes in CVD markers. The outcome of the study is thus of interest to the readers of Menopause and to all those who provide health care to postmenopausal women, as it suggests that higher levels of exercise intensity or perhaps additional interventions may need to be considered in this population to further decrease mortality risk. The study therefore, has greater implications than simply the suggestion of tailoring exercise interventions generally; rather, the publication highlights the importance of prescribing exercise as medicine in a tailored fashion for women depending on their menopausal status.

The development of a simple multi-nodal tool to identify performance issues in existing commercial buildings

Australia’s building stock includes many older commercial buildings with numerous factors that impact energy performance and indoor environment quality. The built environment industry has generally focused heavily on improving physical building design elements for greater energy efficiency (such as retrofits and environmental upgrades), however there are noticeable ‘upper limits’ to performance improvements in these areas. To achieve a stepchange improvement in building performance, the authors propose that additional components need to be addressed in a whole of building approach, including the way building design elements are managed and the level of stakeholder engagement between owners, tenants and building managers. This paper focuses on the opportunities provided by this whole-of-building approach, presenting the findings of a research project undertaken through the Sustainable Built Environment National Research Centre (SBEnrc) in Australia. Researchers worked with a number of industry partners over two years to investigate issues facing stakeholders at base building and tenancy levels, and the barriers to improving building performance. Through a mixed-method, industry-led research approach, five ‘nodes’ were identified in whole-of-building performance evaluation, each with interlinking and overlapping complexities that can influence performance. The nodes cover building management, occupant experience, indoor environment quality, agreements and culture, and design elements. This paper outlines the development and testing of these nodes and their interactions, and the resultant multi-nodal tool, called the ‘Performance Nexus’ tool. The tool is intended to be of most benefit in evaluating opportunities for performance improvement in the vast number of existing low-performing building stock.

Understanding chromosome disorders and their implications for special educators

More children are now being diagnosed with chromosome abnormalities. Some chromosome disorder syndromes are relatively well known; while others are so rare that there is only limited evidence about their likely impact on learning and development. For educators, a basic level of knowledge about chromosome abnormalities is important for understanding the literature and communicating with families and professionals. This paper describes chromosomes, and the numerical and structural anomalies that can occur, usually spontaneously during early cell division. Distinctive features of various chromosome syndromes are summarised before a discussion of the rare chromosome disorders that are labelled, not with a syndrome name, but simply by a description of the chromosome number, size and shape. Because of the potential within-group variability that characterises syndromes, and the scarcity of literature about the rare chromosome disorders, expectations for learning and development of individual students need to be based on the range of possible outcomes that may be achievable.

Sharpening our tools – translating research into practice

Providing culturally appropriate health communication tools at a community level, whilst meeting funding objectives set by Government led initiatives, can be challenging. Literature states that a translational research framework fostering community communication can encourage the development of appropriate communication tools to facilitate transfer of health information between community and researchers. Reflections from initial Need for Feed cooking and nutrition education program trials in remote Indigenous communities across Cape York indicated program resources were neither meeting community nor researchers needs. In response, a translational research framework was modelled with collaborative partnerships formed between researchers and community with the aim of modifying current resources. Local working groups were established to facilitate communication and guide continual remodelling and retrial of resources for successive programs. Feedback from working groups indicated community members wanted resources with more pictures and less words. Partnership with Chronic Disease Resources Online (CDRO) led to the development of pictorial resources including 3 evaluation tools, 27 recipe sets and 10 education support materials. Between June to December 2012 resources were trialled across 4 Cape York communities with 69 school aged children and 4 community elders. Qualitative data has indicated high satisfaction with modified pictorial resources, proving pictorial resources to be an effective and culturally appropriate method to both communicate health messages to community and facilitate flow of evaluation data to researchers. A translational research framework fostering communication between community and researchers can potentially enhance the quality of health communication tools.

Designing and evaluating an online role play in conflict management

Purpose This paper aims to identify, through a literature review, key issues regarding how online role plays can be designed and to apply them when designing a role play on conflict management. Design/methodology/approach By drawing on the key issues identified in the literature review, a role play on conflict management was designed and evaluated. Data were collected by developing a survey that focused on perceived learning, participation and satisfaction. Findings Overall, a majority of the students felt that they learned and participated in the role play. The most positive finding was that the students were satisfied with their role play experience. Research limitations/implications Researchers are urged to further develop the dimensions and measures of online role play success. The measures that were developed for evaluating perceived learning, participation and satisfaction with role plays can be further developed and tested. It is suggested that the effects on learning need to be further explored. Practical implications It is suggested that teachers take the identified key issues of online role play design into account. An important challenge seems to be to encourage students to reflect and do additional reading and research in relation with online role plays. Originality/value Online collaboration is commonly argued as beneficial from an e-learning perspective. However, a challenge for research and practice is to learn how collaborative e-learning activities may be developed. This paper contributes by focusing on how online role plays can be designed and evaluated.

The stress-buffering effects of control on task satisfaction and perceived goal attainment : an experimental study of the moderating influence of desire for control

The purpose of the present study was to examine the extent to which Desire for Control (DFC) interacts with experimental manipulations of demand and control, and the consequences of these interactions on task satisfaction and perceived goal attainment (i.e. task performance and task mastery). It was expected that the proposed stress-buffering effects of control would be evident only for individuals high in DFC. Moreover, it was anticipated that control may have a stress-exacerbating effect for those low in DFC. These hypotheses were tested on a sample of 137 first year psychology students who participated in an in-basket activity under low and high conditions of demand and control. Results revealed that the proposed stress-buffering effect of control was found only for those high in DFC and a stress-exacerbating effect of increased control was evident for those low in DFC on task performance and task mastery perceptions. Future research directions and the implications of these findings to applied settings are discussed.

Organizational factors impacting on patient satisfaction : a cross sectional examination of service climate and linkages to nurses' effort and performance

Background Patient satisfaction is influenced by the setting in which patients are treated and the employees providing care. However, to date, limited research has explained how health care organizations or nurses influence patient satisfaction. Objectives The purpose of this study was to test the model that service climate would increase the effort and performance of nursing groups and, in turn, increase patient satisfaction. Method This study incorporated data from 156 nurses, 28 supervisors, and 171 patients. A cross-sectional design was utilized to examine the relationship between service climate, nurse effort, nurse performance and patient satisfaction. Structural equation modeling was conducted to test the proposed relationships. Results Service climate was associated with the effort that nurses directed towards technical care and extra-role behaviors. In turn, the effort that nurses exerted predicted their performance, as rated by their supervisors. Finally, task performance was a significant predictor of patient satisfaction. Conclusions This study suggests that both hospital management and nurses play a role in promoting patient satisfaction. By focusing on creating a climate for service, health care managers can improve nursing performance and patient satisfaction with care.

Eldercare demands, mental health, and work performance : the moderating role of satisfaction with eldercare tasks

Due to demographic changes, a growing number of employees provide in-home care to an elderly family member. Previous research suggested a negative relationship between employees' eldercare demands and their work performance. However, the empirical nature of this relationship and its boundary conditions and mediating mechanisms have been neglected. The goal of this multisource study was to examine a mediated-moderation model of eldercare demands, mental health, and work performance. Drawing on the theory of conservation of resources (Hobfoll, 1989), it was expected that employees' satisfaction with eldercare tasks would buffer the negative relationship between eldercare demands and work performance, and that mental health would mediate this moderating effect. Data were collected from 165 employees providing in-home eldercare, as well as from one colleague and one family member of each employee. Results of mediated-moderation analyses supported the hypothesized model. The findings suggest that interventions that aim to increase employees' satisfaction with eldercare tasks may help protect employees from the negative effects of high eldercare demands on mental health and, subsequently, on work performance.