Role of community pharmacists in the use of antipsychotics for behavioural and psychological symptoms of dementia (BPSD):a qualitative study

OBJECTIVE: This study aimed to use qualitative methodology to understand the current role of community pharmacists in limiting the use of antipsychotics prescribed inappropriately for behavioural and psychological symptoms of dementia. DESIGN: A qualitative study employing focus groups was conducted. Data were analysed using thematic analysis. SETTING: 3 different geographical locations in the England. PARTICIPANTS: Community pharmacists (n=22). RESULTS: The focus groups identified an array of factors and constraints, which affect the ability of community pharmacists to contribute to initiatives to limit the use of antipsychotics. 3 key themes were revealed: (1) politics and the medical hierarchy, which created communication barriers; (2) how resources and remit impact the effectiveness of community pharmacy; and (3) understanding the nature of the treatment of dementia. CONCLUSIONS: Our findings suggest that an improvement in communication between community pharmacists and healthcare professionals, especially general practitioners (GPs) must occur in order for community pharmacists to assist in limiting the use of antipsychotics in people with dementia. Additionally, extra training in working with people with dementia is required. Thus, an intervention which involves appropriately trained pharmacists working in collaboration with GPs and other caregivers is required. Overall, within the current environment, community pharmacists question the extent to which they can contribute in helping to reduce the prescription of antipsychotics.

Applications of the behavioural homogeneity evaluation framework: the predictive ability of consumer involvement for international food market segmentation

This article proposes a framework of alternative international marketing strategies, based on the evaluation of intra- and inter-cultural behavioural homogeneity for market segmentation. The framework developed in this study provides a generic structure to behavioural homogeneity, proposing consumer involvement as a construct with unique predictive ability for international marketing strategy decisions. A model-based segmentation process, using structural equation models, is implemented to illustrate the application of the framework.

The behavioural homogeneity evaluation framework:Multi-level evaluations of consumer involvement in international segmentation

This paper presents a generic strategic framework of alternative international marketing strategies and market segmentation based on intra- and inter-cultural behavioural homogeneity. Consumer involvement (CI) is proposed as a pivotal construct to capture behavioural homogeneity, for the identification of market segments. Results from a five-country study demonstrate how the strategic framework can be valuable in managerial decision-making. First, there is evidence for the cultural invariance of the measurement of CI, allowing a true comparison of inter- and intra-cultural behavioural homogeneity. Second, CI influences purchase behaviour, and its evaluation provides a rich source of information for responsive market segmentation. Finally, a decomposition of behavioural variance suggests that national-cultural environment and nationally transcendent variables explain differences in behaviour. The Behavioural Homogeneity Evaluation Framework therefore suggests appropriate international marketing strategies, providing practical guidance for implementing involvement-contingent strategies. © 2007 Academy of International Business. All rights reserved.

A qualitative investigation into leader behavioural flexibility

Purpose – The current research aims to determine to what extent Australian managers are behaviourally flexible and to identify what factors are associated with the development of leader behavioural flexibility (LBF) and its contribution to positive organisational outcomes. Design/methodology/approach – Because of the exploratory nature of the questions to be addressed, a qualitative approach to data collection was selected. In particular, the grounded theory methodology was utilised due to its ability to aid with the theory building process. Semi-structured interviews based on the critical incident interview technique were used as the data source. Findings – The findings illustrate that the Australian managers who participated in this study exhibited significant degrees of LBF. The results also suggest that education level and group size may be antecedents to LBF. In addition, it appears that leader-member exchange may mediate the relationship between LBF and positive organisational outcomes, while social intelligence may moderate this relationship. Research limitations/implications – The current research makes several contributions in terms of theoretical development and reveals a richer insight into the underlying processes associated with the relationship between LBF and positive organisational outcomes. Practical implications – As the current research was conducted in the field with 20 practising organisational managers, the findings also highlight some important practical applications regarding LBF. Originality/value – Although previous studies have been able to establish a relationship between LBF and positive organisational outcomes, they have explained very little about the processes associated with this relationship. The present study attempted to uncover some of these processes.

An analysis of the effectiveness of a behavioural based safety intervention in a UK paper mill

This research examines a behavioural based safety (BBS) intervention within a paper mill in the South East of England. Further to this intervention two other mills are examined for the purposes of comparison — one an established BBS programme and the other an improving safety management system through management ownership. BBS programmes have become popular within the UK, but most of the research about their efficacy is carried out by the BBS providers themselves. This thesis aims to evaluate a BBS intervention from a standpoint which is not commercially biased in favour of BBS schemes. The aim of a BBS scheme is to either change personnel behaviours or attitudes, which in turn will positively affect the organisation's safety culture. The research framework involved a qualitative methodology in order to examine the effects of the intervention on the paper mill's safety culture. The techniques used were questionnaires and semi structured interviews, in addition to observation and discussions which were possible because of the author's position as participant observer. The results demonstrated a failure to improve any aspect of the mill's safety culture, which worsened following the BBS intervention. Issues such as trust, morale, communication and support of management showed significant signs of negative workforce response. The paper mill where the safety management system approach was utilised demonstrated a significantly improved safety culture and achieved site ownership from middle managers and supervisors. Research has demonstrated that a solid foundation is required prior to successfully implementing a BBS programme. For a programme to work there must be middle management support in addition to senior management commitment. If a trade union actively distances itself from BBS, it is also unlikely to be effective. This thesis proposes that BBS observation programmes are not suitable for the papermaking industry, particularly when staffing levels are low due to challenging economic conditions. Observers are not available when there are high hazard situations and this suggests that BBS implementation is not the correct intervention for the paper industry.

An investigation of the relationships between service quality, customer satisfaction, perceived value and behavioural intentions

Customer satisfaction and service quality are two important concepts in the marketing literature. However, there has been some confusion about the conceptualisation and measurement of these two concepts and the nature of the relationship between them. The primary objective of this research was to develop a more thorough understanding of these concepts, and a model that could help to explain the links between them and their relationships with post-purchase behaviour. A preliminary theoretical model was developed, based on an exhaustive review of the literature. Following exploratory research, the model was revised by incorporating "Perceived Value" and "Perceived Sacrifice" to help explain customer's post-purchase behaviour. A longitudinal survey was conducted in the context of the restaurant industry, and the data were analysed using structural equation modelling. The results provided evidence to support the main research hypotheses. However, the effect of "Normative Expectations" on "Encounter Quality" was insignificant, and "Perceived Value" had a direct effect on "Behavioural Intentions" despite expectations that such an effect would be mediated through "Customer Satisfaction". It was also found that "Normative Expectations" were relatively more stable than "Predictive Expectations". It is argued that the present research significantly contributes to the marketing literature, and in particular the role of perceived value in the formation of customers' post-purchase behaviour. Further research efforts in this area are warranted.

Influencing water consumption at South Staffordshire Water PLC : a disaggregated behavioural analysis of contributory factors

This research identifies factors which influence the consumption of potable water supplied to customers' property. A complete spectrum of the customer base is examined including household, commercial and industrial properties. The research considers information from around the world, particularly demand management and tariff related projects from North America. A device termed the Flow Moderator was developed and proven, with extensive trials, to conserve water at a rate equivalent to 40 litres/property/day whilst maintaining standards-of-service considerably in excess of Regulatory requirements. A detailed appraisal of the Moderator underlines the costs and benefits available to the industry through deliberate application of even mild demand management. More radically the concept of a charging policy utilising the Moderator is developed and appraised. Advantages include the lower costs of conventional fixed-price charging systems coupled with the conservation and equitability aspects associated with metering. Explanatory models were developed linking consumption to a range of variables demonstrated that households served by a communal water service-pipe (known in the UK as a shared supply) are subject to associated restrictions equivalent to -180 litres/property/day. The research confirmed that occupancy levels were a significant predictive element for household, commercial and industrial customers. The occurrence of on-property leakage was also demonstrated to be a significant factor recorded as an event which offers considerable scope for demand management in its own right.