Nurse practitioner and physician collaboration in long-term care homes:Survey results

This survey assessed the extent of and satisfaction with collaboration between physicians and nurse practitioners (NPs) working in Ontario long-term care homes. Questionnaires, which included the Measure of Current Collaboration and Provider Satisfaction with Current Collaboration instruments, were mailed to NPs and physicians with whom the NP most frequently worked. The 14 matched-pairs of NPs and physicians reported similar levels of collaboration; however, physicians were significantly more satisfied with collaboration than were NPs (z = -2.67, p = 0.008). The majority of physicians (85%) and NPs (86%) indicated that collaboration was occurring, and 96 per cent of physicians and 79 per cent of NPs were satisfied with their collaboration. About one third of physicians reported that the NP had a negative effect on their income, but their satisfaction with collaboration did not differ from those who reported a positive effect. Overall, these physicians and NPs collaborate in delivering care and are satisfied with their collaboration. © 2009 Canadian Association on Gerontology.

Evaluating program integration and the rise in collaboration:Case study of a palliative care network

Introduction: There is increasing global interest in using regional palliative care networks (PCNs) to integrate care and create systems that are more costeffective and responsive. We examined a PCN that used a community development approach to build capacity for palliative care in each distinct community in a region of southern Ontario, Canada, with the goal of achieving a competent integrated system. Methods: Using a case study methodology, we examined a PCN at the structural level through a document review, a survey of 20 organizational administrators, and an interview with the network director. Results: The PCN identified 14 distinct communities at different stages of development within the region. Despite the lack of some key features that would facilitate efficient palliative care delivery across these communities, administrators largely viewed the network partnership as beneficial and collaborative. Conclusion: The PCN has attempted to recognize specific needs in each local area. Change Is gradual but participatory. There remain structural issues that may negatively affect the functioning of the PCN.

Factors affecting collaboration between general practitioners and community pharmacists:a qualitative study

Although general practitioners (GPs) and community pharmacists (CPs) are encouraged to collaborate, a true collaborative relationship does not exist between them. Our objective was to identify and analyze factors affecting GP-CP collaboration.

The Queen's Shilling:A collaboration with Goldin+Senneby

A performance art piece in the Centre for Contemporary Art, Derry/Londonderry as part of the City of Culture. International conceptual artists Goldin+Senneby commissioned me to write a short play inspired by their obsessions with alchemy, royalty and the financial markets. The play dramatises the suffering of Queen Elizabeth II as she confronts her own mortality in a world where she is an immortal symbol. Through a conversation with her predecessor Elizabeth I, she reveals that the whole stability of the financial system rests on the weight of her daily effluvia.

A Note on Networks of Collaboration in Multimarket Oligopolies

In this note, we extend the Goyal and Joshi’s model of collaboration networks in oligopoly to multi-market situations. We examine the incentive of firms to form links and the architectures of the resulting equilibrium networks in this setting. We then present some results on efficient networks.

On sea level change in the North Sea influenced by the North Atlantic Oscillation: local and remote steric effects

In this study, contributions of both local steric and remote baroclinic effects (i.e., steric variations external to the region of interest) to the inter-annual variability of winter sea level in the North Sea, with respect to the North Atlantic Oscillation (NAO), for the period of 1953–2010 are investigated. On inter-annual time scales in this period, the NAO is significantly correlated to sea level variations in the North Sea only in the winter months (December–March), while its correlation to sea temperature over much of the North Sea is only significant in January and February. The discrepancy in sea level between observations and barotropic tide and surge models forced by tides and local atmospheric forcing, i.e., local atmospheric pressure effects and winds, in the present study are found to be consistent with previous studies. In the North Sea, local thermosteric effects caused by thermal expansion play a minor role on winter-mean NAO related sea level variability compared with atmospheric forcing. This is particularly true in the southeastern North Sea where water depths are mostly less than 25 m. Our calculations demonstrate that the discrepancy can be mostly explained by remote baroclinic effects, which appear as water mass exchanges on the continental shelf and are therefore only apparent in ocean bottom pressure. In the North Sea, NAO related sea level variations seem to be a hybrid of barotropic and baroclinic processes. Hence, they can only be adequately modelled with three-dimensional baroclinic ocean models that include contributions of baroclinic effects and large-scale atmospheric forcing external to the region of interest.

Perceptions of collaboration between general practitioners and community pharmacists: Findings from a qualitative study based in Spain

According to the theory of reasoned action (TRA), collaboration is only possible when it is perceived as useful by the participants involved. This paper describes a qualitative study using semi-structured interviews to explore the preceived usefulness of general practitioner (GPs)-community pharmacists (CPs)' collaboration from these professionals' perspectives based in two Spanish regions. Thirty-seven interviews were conducted with GPs and CPs with and without previous experience of collaborating with the other groups of professionals. Analysis of the data indicated that the GPs and CPs considered that collaboration between practitioners and pharmacists to have different forms of usefulness, ranging from positive to negative perceptions of usefulness. Negative and neutral opinions (collaboration generates conflict and/or is not benefitial) could prevent practitioners from initiating collaboration with the other group of professionals, which is explained by the TRA. These perceptions were only found among those participants without experience in collaboration. When collaboration was perceived as advantageous, it could be beneficial on three levels: health system (i.e. provision of integrated care, increased efficiency of the system), GPs and CPs (i.e. increased job satisfaction and patient loyalty) and patients (i.e. improved patient safety). Although GPs and CPs with experience identified benefits using a range of examples, GPs and CPs who had never collaborated also believed that if collaboration was undertaken there would be benefits for the health system, patients and health professionals. These results should be considered when developing strategies to encourage and improve the implementation of collaborative working relationships between GPs and pharmacists in primary care.