Dispensing activity in a community pharmacy-based repeat dispensing pilot project

Objective: To measure changes in dispensing activity in a UK repeat dispensing pilot study and to estimate any associated cost savings. Method: Patients were provided with two successive three-monthly repeat prescriptions containing all of the items on their "repeat medicines list" and valid at a study pharmacy. Pharmacists consulted with patients at the time of supply and completed a patient-monitoring form. Prescriptions with pricing data were returned by the UK Prescription Pricing Authority. These data were used to calculate dispensing activity, the cost of dispensed items and an estimate of cost savings on non-dispensed items. A retrospective identification of items prescribed during the six months prior to the project was used to provide a comparison with those dispensed during the project and thus a more realistic estimate of changes. Setting: 350 patients from two medical practices in a large English City, with inner city and suburban locations, and served by seven pharmacies. Key findings: There were methodological challenges in establishing a robust framework for calculating changes. Based on all of the items that patients could have obtained from their repeat list, 23.8% were not dispensed during the intervention period. A correction was then made to allow for a comparison with usage in the six months prior to the study. Based on the corrected data, there was an estimated 11.3% savings in drug costs compared with the pre-intervention period. There was a marked difference in changes between the two practices, the pharmacies and individual patients. The capitation-based remuneration method was acceptable to all but one of the community pharmacists. Conclusion: The repeat dispensing system reduced dispensing volume in comparison with the control period. A repeat dispensing system with a focus on patients' needs and their use of medicines might be cost neutral.

Managing people and performance:An evidence based framework applied to health service organizations

People and their performance are key to an organization's effectiveness. This review describes an evidence-based framework of the links between some key organizational influences and staff performance, health and well-being. This preliminary framework integrates management and psychological approaches, with the aim of assisting future explanation, prediction and organizational change. Health care is taken as the focus of this review, as there are concerns internationally about health care effectiveness. The framework considers empirical evidence for links between the following organizational levels: 1. Context (organizational culture and inter-group relations; resources, including staffing; physical environment) 2. People management (HRM practices and strategies; job design, workload and teamwork; employee involvement and control over work; leadership and support) 3. Psychological consequences for employees (health and stress; satisfaction and commitment; knowledge, skills and motivation) 4. Employee behaviour (absenteeism and turnover; task and contextual performance; errors and near misses) 5. Organizational performance; patient care. This review contributes to an evidence base for policies and practices of people management and performance management. Its usefulness will depend on future empirical research, using appropriate research designs, sufficient study power and measures that are reliable and valid.

Computer based monitoring in U.K. service organizations : a comparative study

The majority of the literature about CBM is American in origin, and (inter alia) notes that there were differing uses of similar technology, indicating that context has an important role to play in the use of CBM. The literature maps the psychological effects of CBM in considerable detail, but only two published studies examine the context of CBM. These grounded results provide scant support for any systematic, quantitative, large scale analysis of computer based monitoring in the UK context. This thesis thus aims to systemically examine the context of CBM using discourse analysis. Forty four interviewees were theoretically sampled using a structured sample technique in four organizations. All were national or multinational enterprises. The interviews were semi structured in nature and divided into three sections. The first addressed the respondents' thoughts and perceptions about CBM, the second elicited talk about the departmental context (focusing the management - worker relationship), and the final section addressed the organizational context. The cases demonstrated variation in the use of CBM, measured according to the criteria of Westin (1987, 1988) and according to the interpretive repertoires used by the respondents in each case. Seven analytical categories of talk emerged from the data: three at the organizational level and four at the departmental level of analysis. Discourse analysis revealed two discrete interpretive repertories - the procedural and the substantive repertoires - in respondents' talk whose main variation occurred at the departmental level of analysis. Furthermore, patterns were found in the use of these repertories within cases and between categories. Between the cases, variation in the use of the repertories matched the between case variation according to the criteria of Westin. It would thus appear that the source of variation in the use of CBM lies in its context, more specifically in the relative emphasis of humanistic, interpersonal and idiosyncratic values within the management worker relationship.

Eredményes projektszervezet kialakítása funkcionális, hierarchikus szervezetek esetén: egy példa az államigazgatásból (Development of effective project organization in functional, hierarchical organizations: an example from public administration)

Az államigazgatásban – itthon és külföldön is – a projektek jelentős százaléka időben csúszik, nem azt eredményezi, amit eredetileg elvártak, a szakmai résztvevők szerint túladminisztrált, a munkatársak tevékenysége nem áttekinthető. Ezeknek a problémáknak a nagy része a projektszervezet és a hierarchikusfunkcionális- hivatali szervezet egymás mellett éléséből és a nehezen szinkronizálható együttműködésből fakad. A cikkben egy, a gyakorlatban bevált módszertant mutat be a szerző, amely adott feltételrendszer mellett nagymértékben kiküszöböli a fent említett hiányosságokat és a szervezet napi működésébe illeszkedő tevékenységek sorozatára vezeti vissza a projekttevékenységeket. A módszer egy gyakorlati problémából – a volt APEH-es és VP-s rendszerek integrálása a NAV-ba – indult ki, azonban a szerző véleménye szerint alkalmazható más, funkcionális alapokon felépülő szervezetnél is. _____ The high percentage of public sector projects slips in time, the result is not that what was expected initially, those are overadministrated by according to the professional participants’ opinion, and the activity of staff does not clear. In this article the author describes a best practice methodology, which led the project activities to series of activities which fit to the organization’s daily operations. The method started from a practical problem, but according to the author’s opinion it can be applied to other structured functional basis organizations.

Social network structure as a critical success condition for open source software project communities

In recent years, a surprising new phenomenon has emerged in which globally-distributed online communities collaborate to create useful and sophisticated computer software. These open source software groups are comprised of generally unaffiliated individuals and organizations who work in a seemingly chaotic fashion and who participate on a voluntary basis without direct financial incentive. ^ The purpose of this research is to investigate the relationship between the social network structure of these intriguing groups and their level of output and activity, where social network structure is defined as (1) closure or connectedness within the group, (2) bridging ties which extend outside of the group, and (3) leader centrality within the group. Based on well-tested theories of social capital and centrality in teams, propositions were formulated which suggest that social network structures associated with successful open source software project communities will exhibit high levels of bridging and moderate levels of closure and leader centrality. ^ The research setting was the SourceForge hosting organization and a study population of 143 project communities was identified. Independent variables included measures of closure and leader centrality defined over conversational ties, along with measures of bridging defined over membership ties. Dependent variables included source code commits and software releases for community output, and software downloads and project site page views for community activity. A cross-sectional study design was used and archival data were extracted and aggregated for the two-year period following the first release of project software. The resulting compiled variables were analyzed using multiple linear and quadratic regressions, controlling for group size and conversational volume. ^ Contrary to theory-based expectations, the surprising results showed that successful project groups exhibited low levels of closure and that the levels of bridging and leader centrality were not important factors of success. These findings suggest that the creation and use of open source software may represent a fundamentally new socio-technical development process which disrupts the team paradigm and which triggers the need for building new theories of collaborative development. These new theories could point towards the broader application of open source methods for the creation of knowledge-based products other than software. ^

Investigating positive identity development in a school-based youth development project

Adolescence is a pivotal period offering both opportunities and constraints on individual development. It is during this important time that one decides upon and commits to the values, goals, and beliefs which will form one's identity and guide one throughout the lifespan. Positive youth development programs, such as the Miami Youth Development Project's Changing Lives Program, target the formation of a positive sense of identity as a critical intervention point. Through developing a coherent and positive sense of self, adolescents take control of and responsibility for their lives and their decisions. Furthermore, a positive identity has been found to be a developmental asset and is linked to lower risk behaviors and positive outcomes including increased self-esteem, sense of purpose, and a positive view of the future. Positive youth development programs, which promote positive identity development, have been found to be more strongly tied to positive outcomes including skills, values, and competencies than have contextual opportunities. As such, it is critical to determine what leads to positive identity development. ^ The current study used structural equation modeling to evaluate three potential mediators of identity development. Findings indicated good model fit where change in identity commitment and change in identity exploration were mediated by informational identity style, personal expressiveness, and identity distress. There were also significant differences found between the control and intervention groups indicative of intervention effects. The findings of the current study suggest potential areas of intervention as well as the need for further research including longitudinal study and the use of qualitative methodology. ^

The effects of participation in an Internet -based project on the development of global knowledge, global mindedness, and global pedagogy among preservice social studies teachers

In order to prepare younger generations to live in a world characterized by interconnectedness, developing global and international perspectives for future teachers has been recommended by the National Council for the Social Studies and the National Council for the Accreditation of Teacher Education. The purpose of this study was to investigate the effects that participation in the International Communication and Negotiation Simulation (ICONS), an Internet-based communication project has on preservice social studies teachers' global knowledge, global mindedness, and global teaching strategies. ^ The study was conducted at a public university in South Florida. A combination of quantitative and qualitative approaches was employed. Two groups of preservice social studies teachers were chosen as participants: a control group composed of 14 preservice teachers who enrolled in a global education class in the summer semester of 1998 and an experimental group that included nine preservice teachers who took the same class in the fall semester of 1998. The summer class was conducted in a traditional format, which included lectures, classroom discussions, and student presentations. The fall class incorporated a five-week Internet-based communication project. The Global Mindedness Scale (Hett, 1993) and an adapted Test of Global Knowledge (ETS, 1981) were administered upon the completion of the class. ^ Contrasting case studies were utilized to investigate the impact of participation in the ICONS on the development of preservice teachers' global pedagogy. Four preservice teachers, two selected from each group were observed and interviewed to explore how they were infusing global perspectives into social studies curriculum and instruction during a 10-week student teaching internship in the spring semester of 1999. ^ This study had three major findings. First, preservice social studies teachers from the experimental group on average scored significantly higher than those from the control group on the global knowledge test. Second, no significant difference was found between the two groups in their mean scores on the Global Mindedness Scale. Third, all four selected preservice social studies teachers were infusing global perspectives into United States and world history curriculum and instruction during their student teaching internship. Using multiple resources was the common pedagogy. The two who participated in the ICONS were more aware of using the communication feature of the Internet and the web sites that reflect more international perspectives to facilitate teaching about the world. ^ Recommendations were made for further research and for preservice studies teacher education program development. ^

Social Network Structure as a Critical Success Condition for Open Source Software Project Communities

In recent years, a surprising new phenomenon has emerged in which globally-distributed online communities collaborate to create useful and sophisticated computer software. These open source software groups are comprised of generally unaffiliated individuals and organizations who work in a seemingly chaotic fashion and who participate on a voluntary basis without direct financial incentive. The purpose of this research is to investigate the relationship between the social network structure of these intriguing groups and their level of output and activity, where social network structure is defined as 1) closure or connectedness within the group, 2) bridging ties which extend outside of the group, and 3) leader centrality within the group. Based on well-tested theories of social capital and centrality in teams, propositions were formulated which suggest that social network structures associated with successful open source software project communities will exhibit high levels of bridging and moderate levels of closure and leader centrality. The research setting was the SourceForge hosting organization and a study population of 143 project communities was identified. Independent variables included measures of closure and leader centrality defined over conversational ties, along with measures of bridging defined over membership ties. Dependent variables included source code commits and software releases for community output, and software downloads and project site page views for community activity. A cross-sectional study design was used and archival data were extracted and aggregated for the two-year period following the first release of project software. The resulting compiled variables were analyzed using multiple linear and quadratic regressions, controlling for group size and conversational volume. Contrary to theory-based expectations, the surprising results showed that successful project groups exhibited low levels of closure and that the levels of bridging and leader centrality were not important factors of success. These findings suggest that the creation and use of open source software may represent a fundamentally new socio-technical development process which disrupts the team paradigm and which triggers the need for building new theories of collaborative development. These new theories could point towards the broader application of open source methods for the creation of knowledge-based products other than software.

The Antibiotic Resistance and Prescribing in European Children Project: A Neonatal and Pediatric Antimicrobial Web-based Point Prevalence Survey in 73 Hospitals Worldwide

BACKGROUND: The neonatal and pediatric antimicrobial point prevalence survey (PPS) of the Antibiotic Resistance and Prescribing in European Children project (http://www.arpecproject.eu/) aims to standardize a method for surveillance of antimicrobial use in children and neonates admitted to the hospital within Europe. This article describes the audit criteria used and reports overall country-specific proportions of antimicrobial use. An analytical review presents methodologies on antimicrobial use.

METHODS: A 1-day PPS on antimicrobial use in hospitalized children was organized in September 2011, using a previously validated and standardized method. The survey included all inpatient pediatric and neonatal beds and identified all children receiving an antimicrobial treatment on the day of survey. Mandatory data were age, gender, (birth) weight, underlying diagnosis, antimicrobial agent, dose and indication for treatment. Data were entered through a web-based system for data-entry and reporting, based on the WebPPS program developed for the European Surveillance of Antimicrobial Consumption project.

RESULTS: There were 2760 and 1565 pediatric versus 1154 and 589 neonatal inpatients reported among 50 European (n = 14 countries) and 23 non-European hospitals (n = 9 countries), respectively. Overall, antibiotic pediatric and neonatal use was significantly higher in non-European (43.8%; 95% confidence interval [CI]: 41.3-46.3% and 39.4%; 95% CI: 35.5-43.4%) compared with that in European hospitals (35.4; 95% CI: 33.6-37.2% and 21.8%; 95% CI: 19.4-24.2%). Proportions of antibiotic use were highest in hematology/oncology wards (61.3%; 95% CI: 56.2-66.4%) and pediatric intensive care units (55.8%; 95% CI: 50.3-61.3%).

CONCLUSIONS: An Antibiotic Resistance and Prescribing in European Children standardized web-based method for a 1-day PPS was successfully developed and conducted in 73 hospitals worldwide. It offers a simple, feasible and sustainable way of data collection that can be used globally.

Project Pró-Natal: population-based study of perinatal and infant mortality in Natal, Northeast Brazil

RAMOS, Ana Maria de Oliveira et al. Project Pró-Natal: population-based study of perinatal and infant mortality in Natal, Northeast Brazil. Pediatric and Developmental Pathology, v.3, n.1, p.29-35, 2000

Exploring Alternative Terrain in the Rehabilitation and Treatment of Offenders: Findings from a Prison-based Music Project

The arts in prison settings have provided an alternative or complimentary component to rehabilitation. Despite increased interest, studies capturing the voice of offenders participating in projects and the long-term impact are limited. Data from semistructured interviews with 18 men who had taken part in a music-based project while incarcerated, including one group of five participants who were tracked for 18 months with supplemented data from correctional staff and official documentation, is presented. Participants of the art-based projects comment on changes they believe to have derived from participating in the project, particularly relating to emotions, self-esteem, self-confidence, communication and social skills. An exoffender sample of participants reported that participation in art projects provide experiences that promote beneficial skills that have been useful for post prison life.

A DST-based Approach for Construction Project Risk Analysis

Despite its huge potential in risk analysis, the Dempster–Shafer Theory of Evidence (DST) has not received enough attention in construction management. This paper presents a DST-based approach for structuring personal experience and professional judgment when assessing construction project risk. DST was innovatively used to tackle the problem of lacking sufficient information through enabling analysts to provide incomplete assessments. Risk cost is used as a common scale for measuring risk impact on the various project objectives, and the Evidential Reasoning algorithm is suggested as a novel alternative for aggregating individual assessments. A spreadsheet-based decision support system (DSS) was devised to facilitate the proposed approach. Four case studies were conducted to examine the approach's viability. Senior managers in four British construction companies tried the DSS and gave very promising feedback. The paper concludes that the proposed methodology may contribute to bridging the gap between theory and practice of construction risk assessment.

Science-based entrepreneur project development process for pre-service science teachers: difficulties faced*

This study used a phenomenological research design to determine the difficulties faced in the science-based entrepreneur project development process for pre-service science teachers.. Qualitative data were obtained through interviews conducted with ten pre-service science teachers. The data were analysed using an inductive thematic analysis. The results indicated that pre-service science teachers have most difficulty ‘making decisions on one of the innovative ideas’ and ‘making predictions about unexpected situations’. They also have difficulties ‘calculating the cost as a result of design or work analysis’, ‘identifying if the idea already existed (similarity analysis)’ and ‘making decisions on the required materials, tools, services’. These results show the need for pre-service science teachers to communicate with other institutions and organisations.

Integrating a mobile accessible electronic system into dockside monitoring: How can small-scale fisheries data collection programs transition from paper-based to digital data collection?

Thesis (Master's)--University of Washington, 2016-06