Hospital pharmacists' awareness of a new antibiotic guideline in the UK:implications for practice

Objectives: Pharmacists play an important role in the review of local hospital guidelines. British Thoracic Society (BTS) guidelines for the management of patients with community-acquired pneumonia (CAP) were updated in 2001, and it is important that individual hospital recommendations are based upon this national guidance. The aim of this study was to identify UK Chief Pharmacists' awareness of these updated guidelines one year after their publication. Secondary aims were to identify whether pharmacists had subsequently initiated revision of institutional CAP guidelines, and what roles different professional staff had performed in this process. Method: A self-completion postal questionnaire was sent to the Chief Pharmacist (or their nominated staff) in 253 UK NHS hospitals in November 2002. This aimed to identify issues relating to their awareness of the 2001 BTS guidelines and subsequent revision of their hospital's guidelines. Results:188 questionnaires were returned (a response rate of 74%), of which 164 hospitals had local antibiotic prescribing guidelines. Respondents in 29% of these hospitals were unaware of the 2001 BTS publication and institutional guidelines had been revised in only 51% of hospitals where the Chief Pharmacist was purportedly aware of the new BTS guidance. Generally, more staff types were involved in revising guidelines than initiating revision. Conclusions:Variability existed in both Chief Pharmacists' awareness of new national guidance and subsequent review processes operating in individual hospitals. A lack of proactive reaction to new national guidance was identified in some hospitals, and it is hoped that the establishment of specialist "infectious diseases pharmacists" will facilitate the review of institutional antibiotic prescribing guidelines in the future. © Springer 2005.

The impact of drug information on the prescribing of drugs

Using prescription analyses and questionnaires, the way drug information was used by general medical practitioners during the drug adoption process was studied. Three new drugs were considered; an innovation and two 'me-too' products. The innovation was accepted by general practitioners via a contagion process, information passing among doctors. The 'me-too' preparations were accepted more slowly and by a process which did not include the contagion effect. 'Industrial' information such as direct mail was used more at the 'awareness' stage of the adoption process while 'professional' sources of information such as articles in medical journals were used more to evaluate a new product. It was shown that 'industrial' information was preferred by older single practice doctors who did not specialise, had a first degree only and who did not dispense their own prescriptions. Doctors were divided into early and late-prescribers by using the date they first prescribed the innovatory drug. Their approach to drug information sources was further studied and it was shown that the early-prescriber issued slightly more prescriptions per month, had a larger list size, read fewer journals and generally rated industrial sources of information more highly than late-prescribers. The prescribing habits of three consultant rheumatologists were analysed and compared with those of the general practitioners in the community which they served. Very little association was noted and the influence of the consultant on the prescribing habits of general practitioners was concluded to be low. The consultants influence was suggested to be of two components, active and passive; the active component being the most influential. Journal advertising and advertisement placement were studied for one of the 'me-too' drugs. It was concluded that advertisement placement should be based on the reading patterns of general practitioners and not on ad-hoc data gathered by representatives as was the present practice. A model was proposed relating the 'time to prescribe' a new drug to the variables suggested throughout this work. Four of these variables were shown to be significant. These were, the list size, the medical age of the prescriber, the number of new preparations prescribed in a given time and the number of partners in the practice.

Pre-conception care : current practice and methods of provision

This thesis examines the present provisions for pre-conception care and the views of the providers of services. Pre-conception care is seen by some clinicians and health educators as a means of making any necessary changes in life style, corrections to imbalances in the nutritional status of the prospective mother (and father) and the assessment of any medical problems, thus maximizing the likelihood of the normal development of the baby. Pre-conception care may be described as a service to bridge the gap between the family planning clinic and the first ante-natal booking appointment. There were three separate foci for the empirical research - the Foresight organisation (a charity which has pioneered pre-conception care in Britain); the pre-conception care clinic at the West London Hospital, Hammersmith; and the West Midlands Regional Health Authority. The six main sources of data were: twenty five clinicians operating Foresight pre-conception clinics, couples attending pre-conception clinics, committee members of the Foresight organisation, staff of the West London Hospital pre-conception clinic, Hammersmith, District Health Education Officers working in the West Midlands Regional Health Authority and the members of the Ante-Natal Care Action Group, a sub-group of the Regional Health Advisory Group on Health Promotion and Preventive Medicine. A range of research methods were adopted. These were as follows: questionnaires and report forms used in co-operation with the Foresight clinicians, interviews, participant observation discussions and informal meetings and, finally, literature and official documentation. The research findings illustrated that pre-conception care services provided at the predominantly private Foresight clinics were of a rather `ad hoc' nature. The type of provision varied considerably and clearly reflected the views held by its providers. The protocol which had been developed to assist in the standardization of results was not followed by the clinicians. The pre-conception service provided at the West London Hospital shared some similarities in its approach with the Foresight provision; a major difference was that it did not advocate the use of routine hair trace metal analysis. Interviews with District Health Education Officers and with members of the Ante Natal Care Action Group revealed a tentative and cautious approach to pre-conception care generally and to the Foresight approach in particular. The thesis concludes with a consideration of the future of pre-conception care and the prospects for the establishment of a comprehensive pre-conception care service.

Practitioners are from Mars; academics are from Venus? An investigation of the research-practice gap in management accounting

Purpose: The aim of this paper is to identify and gain insights into the significance of barriers contributing to the purported "gap" between academic management accounting research and practice. Design/methodology/approach: Drawing on diffusion of innovations theory, this study collects and analyses data from a questionnaire survey and follow-up interviews with 19 representatives of the four principal professional accounting bodies in Australia. Findings: Professional accounting bodies perceive the gap between academic research and practice in management accounting to be of limited concern to practitioners. The two most significant barriers to research utilisation by practitioners are identified as: difficulties in understanding academic research papers; and limited access to research findings. In acting as a conduit between the worlds of academia and practice, professional bodies have an important role to play by demonstrating the mutual value to both academics and practitioners resulting from a closer engagement between MA research and practice. Research limitations/implications: As one of the few empirically-based, theoretically informed investigations exploring the research-practice gap in management accounting, this study provides insights rather than "answers". Its findings therefore serve as a foundational basis for further empirical and theoretical enquiry. Originality/value: This study contributes to the conversation about the "research-practice gap" in management accounting by adopting a distinct theoretical vantage point to organize, analyse and interpret empirical evidence obtained from Australian professional accounting bodies about management accounting practice. © Emerald Group Publishing Limited.

The implementation of supply chain management theory in practice:an empirical investigation

Purpose: The purpose of the research described in this paper is to disentangle the rhetoric from the reality in relation to supply chain management (SCM) adoption in practice. There is significant evidence of a divergence between theory and practice in the field of SCM. Design/methodology/approach: Based on a review of extant theory, the authors posit a new definitional construct for SCM – the Four Fundamentals – and investigated four research questions (RQs) that emerged from the theoretical review. The empirical work comprised three main phases: focussed interviews, focus groups and a questionnaire survey. Each phase used the authors’ definitional construct as its basis. While the context of the paper’s empirical work is Ireland, the insights and results are generalisable to other geographical contexts. Findings: The data collected during the various stages of the empirical research supported the essence of the definitional construct and allowed it to be further developed and refined. In addition, the findings suggest that, while levels of SCM understanding are generally quite high, there is room for improvement in relation to how this understanding is translated into practice. Research limitations/implications: Expansion of the research design to incorporate case studies, grounded theory and action research has the potential to generate new SCM theory that builds on the Four Fundamentals construct, thus facilitating a deeper and richer understanding of SCM phenomena. The use of longitudinal studies would enable a barometer of progress to be developed over time. Practical implications: The authors’ definitional construct supports improvement in the cohesion of SCM practices, thereby promoting the effective implementation of supply chain strategies. A number of critical success factors and/or barriers to implementation of SCM theory in practice are identified, as are a number of practical measures that could be implemented at policy/supply chain/firm level to improve the level of effective SCM adoption. Originality/value: The authors’ robust definitional construct supports a more cohesive approach to the development of a unified theory of SCM. In addition to a profile of SCM understanding and adoption by firms in Ireland, the related critical success factors and/or inhibitors to success, as well as possible interventions, are identified.

Logisztikai folyamatok informatikai támogatottsága Magyarországon – Fókuszban a disztribúciós logisztika (Supporting logistics processes by information technology – current practice and improvement possibilities at Hungarian companies)

Az elemzés egy a Budapesti Corvinus Egyetem (BCE) Logisztika és Ellátási Lánc Menedzsment Tanszéke által végzett kérdőíves felmérés eredményeit foglalja össze. A kutatás alapvető célja, hogy felmérje és bemutassa a hazai vállalatok logisztikai, ezen belül is elsősorban disztribúciós logisztikai folyamatainak informatikai oldalról történő jelenlegi támogatottsági szintjét és a következő két-három év e téren várható fejlesztési irányait. A kutatás szisztematikusan kitért a logisztikai információs rendszer valamennyi alrendszerére, vizsgálta a különböző azonosítási megoldások elterjedtségét, a vállalatirányítási rendszer, illetve egyes moduljainak használatával kapcsolatban kialakult gyakorlatot, de a logisztika stratégiai döntéseinek informatikai támogatottságát és a használt kommunikációs technikákat is. Összességében megállapítható, hogy a logisztikai információs rendszerek fejlettségi szintje ma Magyarországon közepes, fontos megjegyezni azonban, hogy a kkv-szektor e téren is jelentősen lemaradt. Ez természetesen azt is jelenti, hogy az informatikai eszközök alkalmazásának kiterjesztésével még komoly teljesítményjavulás érhető el. ________ The essay summarizes the results of a survey carried out by Corvinus University of Budapest, Department of Logistics and Supply Chain Management. Aim of the survey was to analyze and describe the actual Hungarian company practice regarding the IT support of logistics – and particularly distribution – processes, and the plans to develop it within the next 2-3 years. Survey has systematically overviewed all fields of logistics information system, analyzed the prevalence of different identification techniques and systems. Generally the authors appoint that logistics information systems applied by Hungarian companies are on satisfactory level; however it is important to tell that SME companies are in huge lag. This means that improving logistics information system hides the possibility of considerable performance development.

A lean menedzsment és a leadership jellemzők kapcsolata a hazai vállalati gyakorlatban (Lean management and leadership attributes in the practice of Hungarian firms)

A nemzetközi szakirodalom a vezetőt a lean termelés bevezetésében és fenntartásában is kulcsszereplőként határozza meg. Ennek ellenére nagyon kevés empirikus elemzés vizsgálja a vezetőkkel kapcsolatos kérdéseket. A szerzők a kontingencialista leadership elmélet keretei között a lean termelési rendszer és a vezetési jellemzők kapcsolatát vizsgálják elméleti szempontból és empirikusan egyaránt. Bár a kérdés nem került korábbi munkák fókuszába, az elméleti és empirikus megfontolások alapján egyaránt megállapítható, hogy több vezetési jellemző is szorosan kapcsolható egy jól működő lean termelővállalat vezetőjéhez. Követendő vezetési jellemzőként jelenik meg többek között az együttműködő, a delegáló, a teljesítményorientált vagy fejlődésorientált. Azonosíthatók olyan jellemzők is, amelyek elméletileg nem egyeztethetők össze a lean termelési rendszer logikájával, pl. autokrata, diktatórikus vagy mikrovezető ______ The working paper focuses on two connected research questions: on one hand based on widely accepted literature it systematically maps the ideal leadership style and related leader attributes that help in transforming a company into a real and well-functioning lean organization. On the other hand the paper analyzes whether leaders of companies with more developed lean practice do or do not follow these leadership attributes recommended by literature. The study uses the fourth round of the Hungarian Competitiveness Research Survey from 2009. This study is limited to the analysis of questionnaires filled in by producers that have more than 50 employees (about 65 manufacturing firms). The authors analyze the leadership styles of two managers, namely the CEO and production manager. Results of the empirical analysis revealed astonishing and contradictory attitudes toward ideal leadership attributes of leaders operating in more developed lean companies.

Current Best Practice for Management of Medial Collateral Ligament Injury

Medical collateral ligament injuries are among the most common knee injuries for the athletic population. Immobilization once was the accepted course of treatment for MCL injuries but research has demonstrated the ineffectiveness of this approach.

Making the governance of public bodies work : chair-chief executive relationships in practice

The authors gratefully acknowledge a grant from the British Academy (SG10591) and an award from the University of Aberdeen Knowledge Exchange and Transfer Fund.

Developing inclusive practice in Scotland : the national framework for inclusion

Peer reviewed

'Sitting alone in the staffroom contemplating my future’ : communities of practice, legitimate peripheral participation and student teachers’ experiences of problematic school placements as guests

Peer reviewed

Making the governance of public bodies work : chair-chief executive relationships in practice

The authors gratefully acknowledge a grant from the British Academy (SG10591) and an award from the University of Aberdeen Knowledge Exchange and Transfer Fund.

Developing inclusive practice in Scotland : the national framework for inclusion

Peer reviewed

'Sitting alone in the staffroom contemplating my future’ : communities of practice, legitimate peripheral participation and student teachers’ experiences of problematic school placements as guests

Peer reviewed

The urban community in fifteenth-century Scotland : language, law and political practice

Peer reviewed