Development of pharmaceutical care services in nursing homes: practice and research in a Swiss canton.

OBJECTIVE: The aim of this study was to assess the implementation process and economic impact of a new pharmaceutical care service provided since 2002 by pharmacists in Swiss nursing homes. SETTING: The setting was 42 nursing homes located in the canton of Fribourg, Switzerland under the responsibility of 22 pharmacists. METHOD: We developed different facilitators, such as a monitoring system, a coaching program, and a research project, to help pharmacists change their practice and to improve implementation of this new service. We evaluated the implementation rate of the service delivered in nursing homes. We assessed the economic impact of the service since its start in 2002 using statistical evaluation (Chow test) with retrospective analysis of the annual drug costs per resident over an 8-year period (1998-2005). MAIN OUTCOME MEASURES: The description of the facilitators and their implications in implementation of the service; the economic impact of the service since its start in 2002. RESULTS: In 2005, after a 4-year implementation period supported by the introduction of facilitators of practice change, all 42 nursing homes (2,214 residents) had implemented the pharmaceutical care service. The annual drug costs per resident decreased by about 16.4% between 2002 and 2005; this change proved to be highly significant. The performance of the pharmacists continuously improved using a specific coaching program including an annual expert comparative report, working groups, interdisciplinary continuing education symposia, and individual feedback. This research project also determined priorities to develop practice guidelines to prevent drug-related problems in nursing homes, especially in relation to the use of psychotropic drugs. CONCLUSION: The pharmaceutical care service was fully and successfully implemented in Fribourg's nursing homes within a period of 4 years. These findings highlight the importance of facilitators designed to assist pharmacists in the implementation of practice changes. The economic impact was confirmed on a large scale, and priorities for clinical and pharmacoeconomic research were identified in order to continue to improve the quality of integrated care for the elderly.

Promotion of learning skills in the study of economics. pilot project in the subject area of

This communication is part of a larger teaching innovation project financed by the University ofBarcelona, whose objective is to develop and evaluate transversal competences of the UB, learningability and responsibility. The competence is divided into several sub-competencies being the ability toanalyze and synthesis the most intensely worked in the first year. The work presented here part fromthe results obtained in phase 1 and 2 previously implemented in other subjects (Mathematics andHistory) in the first year of the degree of Business Administration Degree. In these subjects’ previousexperiences there were deficiencies in the acquisition of learning skills by the students. The work inthe subject of Mathematics facilitated that students become aware of the deficit. The work on thesubject of History insisted on developing readings schemes and with the practical exercises wassought to go deeply in the development of this competence.The third phase presented here is developed in the framework of the second year degree, in the WorldEconomy subject. The objective of this phase is the development and evaluation of the same crosscompetence of the previous phases, from a practice that includes both, quantitative analysis andcritical reflection. Specifically the practice focuses on the study of the dynamic relationship betweeneconomic growth and the dynamics in the distribution of wealth. The activity design as well as theselection of materials to make it, has been directed to address gaps in the ability to analyze andsynthesize detected in the subjects of the first year in the previous phases of the project.The realization of the practical case is considered adequate methodology to improve the acquisition ofcompetence of the students, then it is also proposed how to evaluate the acquisition of suchcompetence. The practice is evaluated based on a rubric developed in the framework of the projectobjectives. Thus at the end of phase 3 we can analyze the process that have followed the students,detect where they have had major difficulties and identify those aspects of teaching that can help toimprove the acquisition of skills by the students. The interest of this phase resides in the possibility tovalue whether tracing of learning through competences, organized in a collaborative way, is a goodtool to develop the acquisition of these skills and facilitate their evaluation.

Evaluation of Implementation of BSc IT Curriculum at Tumaini University

In Tanzania computer knowledge is vital to supplement the pace fast growing economic and development activities, which demands high and reliable level of expertise in com- puting field. In 2006, a research carried out at Tumaini University with purpose to design and implement a contextualized curriculum that can supplement for such needs hence facilitate development in Tanzanian context. A contextualized curriculum took advantage of six principles namely curriculum contex- tualization, projects, practical, interdisciplinary orientation, international recognition and continuous research for the program’s formative and development. Implementation of the curriculum followed the CATI (Contextualize, Apply, Transfer, and Import) model with emphasis on students to identify societal expectations at the early stage in learning process, in which case the graduates will potentially cater for societal expertise needs on ICT. This study adopts an emergent exploratory cross-section research design, while employ- ing a qualitative approach. This study was conducted at Tumaini University in Iringa where by purposeful sampling was used to obtain participants such as students, teach- ers, administrators and employers who participated in several focus group discussions, in-depth interviews and participant observation. The study reveals that six principles are satisfactorily met,despite of bottlenecks such as incompatibility in pedagogical thinking and technology availability for e-learning, learning attitudes, insufficient experts with actual skills and experience,in academic field among the others. The study recommends that iterative longitudinal study should be car- ried out to design for proper intervention in response to these problems which will help in improving and stabilize the curriculum.

Building a Social Education curriculum based on Professional Competences : the experience of University of Girona

This article describes the process of adapting Social Education studies to the European Higher Education Area undertaken by a team of the teaching staff at the University of Girona (Spain). The aim of the experience is to build a curriculum based on thecompetencies recognized as such by professionals in the field of social education in our region. The article specifies the development of the various phases, each involving the active participation of professionals and teaching staff from the universities. To conclude, main characteristics of the curriculum are highlighted

Outsourcing process in pharmaceutical product development

The aim of this study was to create an outsourcing process for pharmaceutical product development. This study focuses on two main questions. The first question is “What is the outsourcing process model?” In the second phase key success factors of the outsourcing process are identified. As a result of the literature reviews, a general outsourcing process was created. Transaction cost economics and resource based view were used to derived a theoretical framework to the process by combining the existing processes presented in the literature. The model of process is considered used to the outsourcing broadly. The general outsourcing process was then developed further with the key factors that affect the success of pharmaceutical product development and the interviews of pharmaceutical outsourcing experts. The result of the research was the process consists of seven phases with key activities and expected outputs for each of the phases. In addition, the strategic decision-making framework for outsourcing decision in pharmaceutical product development is giving as well as the tools for selecting supplier and preparing structured contract. This study also gives some recommendations for managing the outsourcing process.

Economics of combined power plant and pyrolysis bio-oil production

There are reasons of necessity in bio-fuel use and bio-energy fast development. It includes the material about bio-energy technologies, applications and methods. There are basic thermodynamics and economic theories. The economic calculation presents the comparison between two combinations. There are boiler plant below 20 MW in combination with ablative pyrolysis plant for bio-oil production and CHP plant below 100 MW in combination with the RTP pyrolysis bio-oil production technology. It provides a material about wood chips and bio-oil characteristics and explains it nature, presents the situation around the bio-fuel market or bio-fuel trade. There is a description of pyrolysis technologies such as ablative and RTP. The liquid product of the pyrolysis processes is bio-oil. The bio-oil could be different even of the same production process, because of the raw material nature and characteristics. The calculation shows advantages and weaknesses of combinations and obtained a proof of suppositions. The next thing, proven by this work is the fact that to get more efficiency from energy project it is good possibility to built plants in combinations.

Network effects: Scale development and implications for new product performance

More and more innovations currently being commercialized exhibit network effects, in other words, the value of using the product increases as more and more people use the same or compatible products. Although this phenomenon has been the subject of much theoretical debate in economics, marketing researchers have been slow to respond to the growing importance of network effects in new product success. Despite an increase in interest in recent years, there is no comprehensive view on the phenomenon and, therefore, there is currently incomplete understanding of the dimensions it incorporates. Furthermore, there is wide dispersion in operationalization, in other words, the measurement of network effects, and currently available approaches have various shortcomings that limit their applicability, especially in marketing research. Consequently, little is known today about how these products fare on the marketplace and how they should be introduced in order to maximize their chances of success. Hence, the motivation for this study was driven by the need to increase our knowledge and understanding of the nature of network effects as a phenomenon, and of their role in the commercial success of new products. This thesis consists of two parts. The first part comprises a theoretical overview of the relevant literature, and presents the conclusions of the entire study. The second part comprises five complementary, empirical research publications. Quantitative research methods and two sets of quantitative data are utilized. The results of the study suggest that there is a need to update both the conceptualization and the operationalization of the phenomenon of network effects. Furthermore, there is a need for an augmented view on customers’ perceived value in the context of network effects, given that the nature of value composition has major implications for the viability of such products in the marketplace. The role of network effects in new product performance is not as straightforward as suggested in the existing theoretical literature. The overwhelming result of this study is that network effects do not directly influence product success, but rather enhance or suppress the influence of product introduction strategies. The major contribution of this study is in conceptualizing the phenomenon of network effects more comprehensively than has been attempted thus far. The study gives an augmented view of the nature of customer value in network markets, which helps in explaining why some products thrive on these markets whereas others never catch on. Second, the study discusses shortcomings in prior literature in the way it has operationalized network effects, suggesting that these limitations can be overcome in the research design. Third, the study provides some much-needed empirical evidence on how network effects, product introduction strategies, and new product performance are associated. In general terms, this thesis adds to our knowledge of how firms can successfully leverage network effects in product commercialization in order to improve market performance.

Social ventures : the development of the theory of sustainable contributive advantage and initial empirical tests

This thesis attempts to fill gaps in both a theoretical basis and an operational and strategic understanding in the areas of social ventures, social entrepreneurship and nonprofit business models. This study also attempts to bridge the gap in strategic and economic theory between social and commercial ventures. More specifically, this thesis explores sustainable competitive advantage from a resource-based theory perspective and explores how it may be applied to the nonmarket situation of nonprofit organizations and social ventures. It is proposed that a social value-orientation of sustainable competitive advantage, called sustainable contributive advantage, provides a more realistic depiction of what is necessary in order for a social venture to perform better than its competitors over time. In addition to providing this realistic depiction, this research provides a substantial theoretical contribution in the area of economics, social ventures, and strategy research, specifically in regards to resource-based theory. The proposed model for sustainable contributive advantage uses resource-based theory and competitive advantage in order to be applicable to social ventures. This model proposes an explanation of a social venture’s ability to demonstrate consistently superior performance. In order to determine whether sustainable competitive advantage is in fact, appropriate to apply to both social and economic environments, quantitative analyses are conducted on a large sample of nonprofit organizations in a single industry and then compared to similar quantitative analyses conducted on commercial ventures. In comparing the trends and strategies between the two types of entities from a quantitative perspective, propositions are developed regarding a social venture’s resource utilization strategies and their possible impact on performance. Evidence is found to support the necessity of adjusting existing models in resource-based theory in order to apply them to social ventures. Additionally supported is the proposed theory of sustainable contributive advantage. The thesis concludes with recommendations for practitioners, researchers and policy makers as well as suggestions for future research paths.

Sustainable development: conceptualizations and measurement

The paper builds up from a review of some expected, but other quite surprising results regarding country estimates for the year 2000 of genuine saving, a sustainability indicator developed by a World Bank research team. We examine this indicator, founded on neoclassical welfare theory, and discuss one of its major problems. Theoretical developments from ecological economics are then considered, together with insights from Georgescu-Roegen's approach to the production process, in search for an alternative approach. A model with potentially fruitful contributions in this direction is reviewed; it points the course efforts could take enable sustainability evaluations based on a more realistic set of interrelated monetary and biophysical indicators.

The structuralist tradition in economics: methodological and macroeconomics aspects

This paper examines the structuralist tradition in economics, emphasizing the role that structures play in the economic growth of developing countries. Since the subject at hand is evidently too large to cover in a single article, an emphasis has been brought to bear upon the macroeconomic elements of such a tradition, while also exploring its methodological aspects. It begins by analysing some general aspects of structuralism in economics (its evolution and origins) associated with ECLAC thought, in this instance focusing on the dynamics of the center-periphery relationship. Thereafter, the macroeconomic structuralism derived from the works of Taylor (1983, 1991) is presented, followed by a presentation of neo-structuralism. Centred on the concept of systemic competitiveness, this approach defines a strategy to achieve the high road of globalization, understood here as an inevitable process in spite of its engagement being dependent on the policies adopted. The conclusions show the genuine contributions of this tradition to economic theory.

Strategies for economic development in the Commonwealth Caribbean: a comparative study of the foreign economic policy strategies adopted by the Manley government in Jamaica and the Williams government in Trinidad and Tobago

This thesis compares the foreign economic poUcy dimension of the development strategies adopted by the governments of two Commonwealth caribbean countries: The Hardey government In Jamaica, and the· Williams government in Trlnidad and T ooago, The foreign economic policIes adopted by these governments appeared, on the surface~ to be markedly dissimilar. The Jamakan strategv on the one hand, emphasised self-reliance and national autonomy; and featured the espousal of radical oonaHgnment together with attempts to re-deftne the terms of the Islands externaa economIc relaUoos. The Trinidadian strategy 00 the other hand, featured Uberal externaUy-oriented growth poUctes, and close relatjoos with Western governments and financial institutions. Th1s study attempts to identify the explanatory factors that account for the apparent dlssimUarUy 1n the foreign economic policies of these two govemnents. The study is based on a comparison of how the structural bases of an underdeveloped ecooomYg and the foreign penetration and vulnerabUUy to external pressures asSOCiated wUh dependence, shape and influence foreign economic poUcy strategy. The framework views fore1gn ecooom1c strategy as an adaptive response on the part of the decision makers of a state to the coostralnts and opportunities provided by a particular situation. The · situat i 00' in this case being the events, conditions, structures and processes, associated wUh dependente and underdevelopment. The results indicate that the similarities and dissimHarities in the foreign economic policies of the governments of Jamaica and Trinidad were a reflecUon of the simHarities and dissimilarities in their respective situations. The conclusion derived suggests that If the foreign pol1cy field as an arena of choice, Is indeed one of opportunities and constraints for each and every state, then poHcy makers of smaU, weak, hlghW penetrated and vulnerable states enter thlS arena with constraints outweighing opportunities. This places effective limits 00 their decisional latitude and the range of policy options avaUable. Policy makers thus have to decide critical issues with few estabUshed precedents, in the face of domestic social and political cleavages, as wen as serious foreign pressures. This is a reflection not only of the trappings of dependence, but also of the Umned capabilities arising from the sman size of the state, and the Impact of the resource-gap In an underdeveloped economy. The Trinidadian strategy 1s UlustraUve of a development strategy made viable through a combination of a fortuitous circumstance, a confluence of the interests of influential groups» and accurate perception on the part of poUcy makers. These factors enabled policy makers to minimise some of the constraints of dependence. The faUure of Manlets strategy on the other hand, 15 iHustraUve of the problems involved tn the adoption of poUcles that work against the interest of internal and external political and economic forces. It is also tUustraUve of the consequences of the faUure 00 the part of policy makers to clarify goals, and to reconcile the values of rapid economic growth with increased self-reliance and national autonomy. These values tend to be mutuany Incompatible given the existing patterns of relations in the jnternational economy.

Teachers' experiences and perceptions of voluntary committee work as a vehicle for leadership development

In response to a looming leadership shortage, leadership development for teachers has become an increasingly important area of interest around the world. A review of the literature identified the key components of educational leadership development programs as effective curriculum, leadership practice, relationship building, and reflection. A gap in the research was found regarding the use of voluntary committee work as a vehicle for leadership practice. The purpose of this study was to explore teachers' perceptions of their experiences within board-level committees to determine the key factors that contributed, positively or negatively, to their leadership,pevelopment. A qualitative research design was employed using semistructured interviews with 8 participants. The key findings included a list of factors perceived by teachers as either supporting or hindering their leadership development. The supporting factors were: (a) leadership practice, (b) mentors and role models, (c) relationships and networks, and (d) positive outcomes for students. The hindering factors were: (a) lack of follow through and support, (b) committee members with a careerist approach to the experience, (c) personal and political agendas, and (d) overcommitment leading to burnout. Recommendations for practice focused on strategies to enhanc~_ the committee experience as a tool for leadership development. Recommendations for theory and research suggested more research be done on each of the 8 key factors, perceptions associated with teachers choosing to follow a leadership path, and how school boards can structure the committee process as an effective leadership development tool. This study provides a starting point for educators to begin to intentionally design, develop, and deliver voluntary committee experiences as a tool for leadership development.

Buried Treasure: The Economics of Leak Detection and Water Loss Prevention in Ontario

On average approximately 13% of the water that is withdrawn by Canadian municipal water suppliers is lost before it reaches final users. This is an important topic for several reasons: water losses cost money, losses force water agencies to draw more water from lakes and streams thereby putting more stress on aquatic ecosystems, leaks reduce system reliability, leaks may contribute to future pipe failures, and leaks may allow contaminants to enter water systems thereby reducing water quality and threatening the health of water users. Some benefits of leak detection fall outside water agencies’ accounting purview (e.g. reduced health risks to households connected to public water supply systems) and, as a result, may not be considered adequately in water agency decision-making. Because of the regulatory environment in which Canadian water agencies operate, some of these benefits-especially those external to the agency or those that may accrue to the agency in future time periods- may not be fully counted when agencies decide on leak detection efforts. Our analysis suggests potential reforms to promote increased efforts for leak detection: adoption of a Canada-wide goal of universal water metering; development of full-cost accounting and, pricing for water supplies; and co-operation amongst the provinces to promulgate standards for leak detection efforts and provide incentives to promote improved efficiency and rational investment decision-making.