Gender and general practice: the single-handed woman General Practitioner

This research examines women GPs' careers, how they run their practices and how they reconcile professional and domestic lives. It looks at the particular experiences of women GPs who practise alone, and at the pressures in past practice experience which have led them to do so. It is argued that many of the problems of group practice which can be identified are attributable to gender. For example, one reason given for entering general practice is a desire to be able to provide the full range of medical care and not to specialise. Women GPs, however, may find themselves seeing more women patients for "women's problems" and children than they would freely choose. Women have not entered general practice in order to specialise in these areas of medicine. Indeed, if they had wanted to specialise in obstetrics, gynaecology or paediatrics they would have had difficulty advancing very far in these male-dominated areas of hospital hierarchy. Other gender related problems exist for women in general practice and practising single-handedly is one strategy that women GPs have used to counter the problems of working in male-dominated practices and partnerships. However, the twenty-four hour commitment of single-handed practice may bring further pressures in reconciling this with responsibility for home life. Out-of-hours cover, which can be viewed as the link between professional and domestic life, where the one intrudes into the other, is also examined in terms of the gender issues it raises. The interaction of gender and ethnicity is also considered for the 11 Asian women GPs in the study. Interviews were conducted with 29 single-handed women GPs in the Midlands. In addition, some cases were studied in greater depth by being observed in their surgeries and on home visits for a day each. A qualitative/feminist approach to analysis has been employed.

Influences on general practitioner prescribing with particular reference to community pharmacy

Influences on general practitioner prescribing of drugs continue to be of interest and importance as cost containment becomes central to Government health policy. This thesis employs a plurality of research methods including quantitative and qualitative survey techniques for example, questionnaires, interviews and prescription analyses to investigate some of the factors which may influence GP prescribing such as information sources, hospital consultants and in particular the community pharmacist. When the use and influence of drug information sources by GPs was examined, the community pharmacist was given a relatively low rating as a source but a high rating, similar to that of the consultant, for helpfulness. Influences are needed to improve prescribing and reduce the incidence of iatrogenic disease for the benefit of the patient. The education and expertise of pharmacists and their familiarity with local prescribing habits places them in a unique position to meet the needs of local GPs. As 96.5% of the public always or nearly always take their prescriptions to the same pharmacy, patient medication records, now kept by 77.5% of pharmacies, provide a valuable check on the appropriateness and safety of patients' medication. The barriers to the pharmacist's greater involvement were shown to be suspicion by GPs of pharmacists' motivation, isolation of many community pharmacists, difficulties in leaving the pharmacy for domiciliary visits, residential home care and GP practice meetings. These barriers must be lowered if the pharmacist is to have a greater influence and involvement. It was concluded that changes are necessary in pharmaceutical education, staff training, organisation and remuneration. Some changes in the targeting of remuneration to the pharmaceutical care services provided and registration of patients with pharmacies would contribute greatly to these aims.

Role, function and responsibilities of the safety practitioner in the United Kingdom

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A comparison of the provision of the My Choice Weight Management Programme via general practitioner practices and community pharmacies in the United Kingdom

This study aimed to assess the effectiveness of a novel, community-based weight management programme delivered through general practitioner (GP) practices and community pharmacies in one city in the United Kingdom. This study used a non-randomized, retrospective, observational comparison of clinical data collected by participating GP practices and community pharmacies. Subjects were 451 overweight or obese men and women resident in areas of high socioeconomic deprivation (82% from black and minority ethnic groups, 86% women, mean age: 41.1 years, mean body mass index [BMI]: 34.5 kg m−2). Weight, waist circumference and BMI at baseline, after 12 weeks and after 9 months were measured. Costs of delivery were also analysed. Sixty-four per cent of participants lost weight after the first 12 weeks of the My Choice Weight Management Programme. There was considerable dropout. Mean percentage weight loss (last observation carried forward) was 1.9% at 12 weeks and 1.9% at final follow-up (9 months). There was no significant difference in weight loss between participants attending GP practices and those attending pharmacies at both 12 weeks and at final follow-up. Costs per participant were higher via community pharmacy which was attributable to better attendance at sessions among community pharmacy participants than among GP participants. The My Choice Weight Management Programme produced modest reductions in weight at 12 weeks and 9 months. Such programmes may not be sufficient to tackle the obesity epidemic.

Integrating service user and practitioner expertise within a web-based system for collaborative mental-health risk and safety management

Objectives: To develop a decision support system (DSS), myGRaCE, that integrates service user (SU) and practitioner expertise about mental health and associated risks of suicide, self-harm, harm to others, self-neglect, and vulnerability. The intention is to help SUs assess and manage their own mental health collaboratively with practitioners. Methods: An iterative process involving interviews, focus groups, and agile software development with 115 SUs, to elicit and implement myGRaCE requirements. Results: Findings highlight shared understanding of mental health risk between SUs and practitioners that can be integrated within a single model. However, important differences were revealed in SUs' preferred process of assessing risks and safety, which are reflected in the distinctive interface, navigation, tool functionality and language developed for myGRaCE. A challenge was how to provide flexible access without overwhelming and confusing users. Conclusion: The methods show that practitioner expertise can be reformulated in a format that simultaneously captures SU expertise, to provide a tool highly valued by SUs. A stepped process adds necessary structure to the assessment, each step with its own feedback and guidance. Practice Implications: The GRiST web-based DSS (www.egrist.org) links and integrates myGRaCE self-assessments with GRiST practitioner assessments for supporting collaborative and self-managed healthcare.

What can practitioner perceptions tell us about our subject?

Part of the challenge of fostering learning is to open up learner minds to new possibilities or ways of thinking but is what we are encouraging learners to think really that different from the current practitioner conceptions? Having been uncomfortable with the focus of textbooks for the teaching of the core concept, the nature of a program, in the teaching of object-­oriented programming, we sought to discover how practitioner’s conceived the concept. Our findings provide a framework for understanding the different ways of conceiving the concept and the features that distinguish these conceptions. How could these conceptions and their critical features influence the focus in teaching especially in relation to computational thinking?

Practitioner perspectives on supply chain management and logistics:a study from the United Kingdom

Purpose: The focus of this paper is the evolution of supply chain management (SCM) and logistics, as well as of the relationship between them. Its purpose is to generate deep insights into practice, particularly in relation to the fundamental issue of how practitioners define these key terms and phrases. Research approach: A largely qualitative study which involved in depth interviews with managers from two third party logistics providers (3PLs)/distributors, two retailers and two manufacturers from the United Kingdom. This interview protocol is based on the template used in a previous study published over a decade ago. Findings and originality: The data collected during the focussed interviews in the United Kingdom is contrasted with results from the earlier study. The findings suggest that there is variation between practitioners particularly in relation to what SCM is specifically concerned with. This variation mirrors to a large extent the differing orientations and emphases evident in the many theoretical definitions of SCM that have been proposed in recent decades. Research impact: The authors introduced the concept of refined replication in SCM research. This allows previous research to be built upon in order to test understanding of SCM theory and its practical implementation among SCM professionals in the United Kingdom. Practical impact: A profile of SCM understanding and adoption by firms in the United Kingdom is presented .

How do practitioners understand? Practitioner perceptions of an object-oriented programming.

In the computer science community, there is considerable debate about the appropriate sequence for introducing object-oriented concepts to novice programmers. Research into novice programming has struggled to identify the critical aspects that would provide a consistently successful approach to teaching introductory object-oriented programming. Starting from the premise that the conceptions of a task determine the type of output from the task, assisting novice programmers to become aware of what the required output should be, may lay a foundation for improving learning. This study adopted a phenomenographic approach. Thirty one practitioners were interviewed about the ways in which they experience object-oriented programming and categories of description and critical aspects were identified. These critical aspects were then used to examine the spaces of learning provided in twenty introductory textbooks. The study uncovered critical aspects that related to the way that practitioners expressed their understanding of an object-oriented program and the influences on their approach to designing programs. The study of the textbooks revealed a large variability in the cover of these critical aspects.

Knowledge acquisition and research evidence in autism:researcher and practitioner perspectives and engagement

Background: Government policy and national practice guidelines have created an increasing need for autism services to adopt an evidence-based practice approach. However, a gap continues to exist between research evidence and its application. This study investigated the difference between autism researchers and practitioners in their methods of acquiring knowledge. Methods: In a questionnaire study, 261 practitioners and 422 researchers reported on the methods they use and perceive to be beneficial for increasing research access and knowledge. They also reported on their level of engagement with members of the other professional community. Results: Researchers and practitioners reported different methods used to access information. Each group, however, had similar overall priorities regarding access to research information. While researchers endorsed the use of academic journals significantly more often than practitioners, both groups included academic journals in their top three choices. The groups differed in the levels of engagement they reported; researchers indicated they were more engaged with practitioners than vice versa. Conclusions: Comparison of researcher and practitioner preferences led to several recommendations to improve knowledge sharing and translation, including enhancing access to original research publications, facilitating informal networking opportunities and the development of proposals for the inclusion of practitioners throughout the research process.

Organizations driving positive social change:a review and an integrative framework of change processes

Academic and practitioner interest in how market-based organizations can drive positive social change (PSC) is steadily growing. This paper helps to recast how organizations relate to society. It integrates research on projects stimulating PSC – the transformational processes to advance societal well-being – which is fragmented across different streams of research in management and related disciplines. Focusing on the mechanisms at play in how organizations and their projects affect change in targets outside of organizational boundaries, we 1) clarify the nature of PSC as a process, 2) develop an integrative framework that specifies two distinct PSC strategies, 3) take stock of and offer a categorization scheme for change mechanisms and enabling organizational practices, and 4) outline opportunities for future research. Our conceptual framework differentiates between surface- and deep-level PSC strategies understood as distinct combinations of change mechanisms and enabling organizational practices. These strategies differ in the nature and speed of transformation experienced by the targets of change projects and the resulting quality (pervasiveness and durability), timing, and reach of social impact. Our findings provide a solid base for integrating and advancing knowledge across the largely disparate streams of management research on Corporate Social Responsibility, Social Entrepreneurship, and Base of the Pyramid, and open up important new avenues for future research on organizing for PSC and on unpacking PSC processes.

Justice source and justice content:evaluating the fairness of organizational career management practices

This article presents part of the findings of a multi-method study into employee perceptions of fairness in relation to the organisational career management (OCM) practices of a large financial retailer. It focuses on exploring how employees construct fairness judgements of their career experiences and the role played by the organisational context and, in particular, OCM practices in forming these judgements. It concludes that individuals can, and do, separate the source and content of (in)justice when it comes to evaluating these experiences. The relative roles of the employer, line manager and career development opportunities in influencing employee fairness evaluations are discussed. Conceptual links with organisational justice theory are proposed, and it is argued that the academic and practitioner populations are provided with empirical evidence for a new theoretical framework for evaluating employee perceptions of, and reactions to, OCM practices.

A study of outcomes measures in forensic mental health

Outcomes measures, which is the measurement of effectiveness of interventions and services has been propelled onto the health service agenda since the introduction of the internal market in the 1990s. It arose as a result of the escalating cost of inpatient care, the need to identify what interventions work and in what situations, and the desire for effective information by service users enabled by the consumerist agenda introduced by Working for Patients white paper. The research reported in this thesis is an assessment of the readiness of the forensic mental health service to measure outcomes of interventions. The research examines the type, prevalence and scope of use of outcomes measures, and further seeks a consensus of views of key stakeholders on the priority areas for future development. It discusses the theoretical basis for defining health and advocates the argument that the present focus on measuring effectiveness of care is misdirected without the input of users, particularly patients in their care, drawing together the views of the many stakeholders who have an interest in the provision of care in the service. The research further draws on the theory of structuration to demonstrate the degree to which a duality of action, which is necessary for the development, and use of outcomes measures is in place within the service. Consequently, it highlights some of the hurdles that need to be surmounted before effective measurement of health gain can be developed in the field of study. It concludes by advancing the view that outcomes research can enable practitioners to better understand the relationship between the illness of the patient and the efficacy of treatment. This understanding it is argued would contribute to improving dialogue between the health care practitioner and the patient, and further providing the information necessary for moving away from untested assumptions, which are numerous in the field about the superiority of one treatment approach over another.

The precursors and impacts of BSR on AMT acquisition and implementation

This paper reports on the results of research into the connections between transaction attributes and buyer-supplier relationships (BSRs) in advanced manufacturing technology (AMT) acquisition and implementation. The investigation began by examining the impact of the different patterns of BSR on the performance of the AMT acquisition. In understanding the phenomena, the study drew upon and integrated the literature of transaction cost economics theory, BSRs, and AMT, and used this as the basis for a theoretical framework and hypotheses development. This framework was then empirically tested using data that were gathered through a questionnaire survey with 147 companies and analyzed using a structural equation modeling technique. The results of the analysis indicated that the higher the level of technological specificity and uncertainty, the more firms are likely to engage in a stronger relationship with technology suppliers. However, the complexity of the technology being implemented was associated with BSR only indirectly through its association with the level of uncertainty (which has a direct impact upon BSR). The analysis also provided strong support for the premise that developing strong BSR could lead to an improved performance in acquiring and implementing AMT. The implications of the study are offered for both the academic and practitioner audience.

Introduction to organisational behaviour

Introduction to Organisational Behaviour is the first truly integrated multimedia package for introductory OB modules. It provides a rigorous critique of the essential organisational behaviour topics in a creative, interactive and visual way. Key features include: - Practitioner case studies presenting real organisational dilemmas accompanied by video interviews online where the practitioners talk about approaches and solutions - Tailored tutor resources online, recognising that you have different needs - one area is designed for new OB lecturers; the other contains materials for more experienced OB lecturers - An underpinning focus on employability skills, with tips in the book on how each topic could be linked to different skills and professionally produced video demonstrations online - A global perspective reflecting today's market-place, integrated through global examples and theories including those from developing countries - Innovative learning features including ethical dilemmas, best and worst practice examples, taking your learning further, review and discussion questions, applying theory to practice and a glossary - Written by a team of experts at prestigious UK-based and international institutions - A foreword by Richard Atfield of the Higher Education Academy. Online resources For tutors: - Interviews with practitioners - Demonstrations of employability skills - Additional short and long case study per chapter with questions - Additional discussion and assignment questions - Tutorial activities - PowerPoint slides - Guidance notes - Figures and tables from the book For students: - Web links including YouTube links and links to seminal articles