A conceptual framework of patient satisfaction with a pharmacy adherence service

Background Patients do not adhere to their medicines for a host of reasons which can include their underlying beliefs as well as the quality of their interactions with healthcare professionals. One way of measuring the outcome of pharmacy adherence services is to assess patient satisfaction but no questionnaire exists that truly captures patients' experiences with these relatively new services. Objective Our objective was to develop a conceptual framework specific to patient satisfaction with a community pharmacy adherence service based on criteria used by patients themselves. Setting The study was based in community pharmacies in one large geographical area of the UK (Surrey). All the work was conducted between October 2008 and September 2010. Methods This study involved qualitative non-participant observation and semi-structured interviewing. We observed the recruitment of patients to the Medicines Use Review (MUR) service and also actual MUR consultations (7). We also interviewed patients (15). Data collection continued until no new themes were identified during analysis. We analysed interviews to firstly create a comprehensive account of themes which had significance within the transcripts, then created sub-themes within super-ordinate categories. We used a structure-process-outcome approach to develop a conceptual framework relating to patient satisfaction with the MUR. Favourable ethical opinion for this study was received from the NHS Surrey Research Ethics Committee on 2nd June 2008. Results Five super-ordinate themes linked to patient satisfaction with the MUR service were identified, including relationships with healthcare providers; attitudes towards healthcare providers; patients' experience of health, healthcare and medicines; patients' views of the MUR service; the logistics of the MUR service. In the conceptual framework, structure was conceptualised as existing relationships, environment, and time; process was conceptualised as related to recruitment and consultation stages; and outcome as two concepts of immediate patient outcomes and satisfaction on reflection. Conclusion We identified and highlighted factors that can influence patient satisfaction with the MUR service and this led to the development of a conceptual framework of patient satisfaction with the MUR service. This can form the basis for developing a questionnaire for measuring patient satisfaction with this and similar pharmacy adherence services. Impact of findings on practice * Pharmacists and researchers can access the relevant ideas presented here in relation to patient satisfaction with pharmacy adherence services. * Researcher can use the conceptual framework as a basis for measuring the quality of pharmacy adherence services. * Community pharmacists can improve the quality of healthcare they provide by realizing concepts relevant to patient satisfaction with adherence services.

CASCADE: An Agent Based Framework For Modeling The Dynamics Of Smart Electricity Systems

The Complex Adaptive Systems, Cognitive Agents and Distributed Energy (CASCADE) project is developing a framework based on Agent Based Modelling (ABM). The CASCADE Framework can be used both to gain policy and industry relevant insights into the smart grid concept itself and as a platform to design and test distributed ICT solutions for smart grid based business entities. ABM is used to capture the behaviors of diff erent social, economic and technical actors, which may be defi ned at various levels of abstraction. It is applied to understanding their interactions and can be adapted to include learning processes and emergent patterns. CASCADE models ‘prosumer’ agents (i.e., producers and/or consumers of energy) and ‘aggregator’ agents (e.g., traders of energy in both wholesale and retail markets) at various scales, from large generators and Energy Service Companies down to individual people and devices. The CASCADE Framework is formed of three main subdivisions that link models of electricity supply and demand, the electricity market and power fl ow. It can also model the variability of renewable energy generation caused by the weather, which is an important issue for grid balancing and the profi tability of energy suppliers. The development of CASCADE has already yielded some interesting early fi ndings, demonstrating that it is possible for a mediating agent (aggregator) to achieve stable demandfl attening across groups of domestic households fi tted with smart energy control and communication devices, where direct wholesale price signals had previously been found to produce characteristic complex system instability. In another example, it has demonstrated how large changes in supply mix can be caused even by small changes in demand profi le. Ongoing and planned refi nements to the Framework will support investigation of demand response at various scales, the integration of the power sector with transport and heat sectors, novel technology adoption and diffusion work, evolution of new smart grid business models, and complex power grid engineering and market interactions.

Spiritual capital: the co-evolution of an ethical framework based on Abrahamic religious values in the Islamic tradition

Purpose – The aim of this paper is to investigate how values from within Abrahamic religions could be adopted to improve liberal market economies’ (LMEs’) corporate governance business practices. Design/methodology/approach – The concept of spiritual capitalism is explained from an Islamic perspective by adopting three universal Abrahamic values to critically analyse LMEs and offer an ethical alternative to current capitalism concerns. Findings – It is found that LMEs can be improved by considering all stakeholders, putting ethics before economics, and introducing shared risk/reward plus lower debt. Originality/value – The paper compares LMEs/Co-ordinated market economies (CMEs)/Islamic countries economies (ICEs) within an ethical framework for LMEs.

A niche-based framework to assess current monitoring of European forest birds and guide indicator species' selection

Concern that European forest biodiversity is depleted and declining has provoked widespread efforts to improve management practices. To gauge the success of these actions, appropriate monitoring of forest ecosystems is paramount. Multi-species indicators are frequently used to assess the state of biodiversity and its response to implemented management, but generally applicable and objective methodologies for species' selection are lacking. Here we use a niche-based approach, underpinned by coarse quantification of species' resource use, to objectively select species for inclusion in a pan-European forest bird indicator. We identify both the minimum number of species required to deliver full resource coverage and the most sensitive species' combination, and explore the trade-off between two key characteristics, sensitivity and redundancy, associated with indicators comprising different numbers of species. We compare our indicator to an existing forest bird indicator selected on the basis of expert opinion and show it is more representative of the wider community. We also present alternative indicators for regional and forest type specific monitoring and show that species' choice can have a significant impact on the indicator and consequent projections about the state of the biodiversity it represents. Furthermore, by comparing indicator sets drawn from currently monitored species and the full forest bird community, we identify gaps in the coverage of the current monitoring scheme. We believe that adopting this niche-based framework for species' selection supports the objective development of multi-species indicators and that it has good potential to be extended to a range of habitats and taxa.

Drawing from development: towards unifying theory and development of ICT4D

Within the literature, many authors have argued that the rapid growth of the field of Information and Communication Technologies for Development (ICT4D) has resulted in an emphasis on the applications rather than on theory. However, it is clear that it is not theories, rather the integration of theory and practice, that is often lacking. To address this gap, the authors begin by exploring some of the popular theoretical approaches to ICT4D with a view to identifying those theories relevant to shared impacts: development, delivery and communication. To unify practice and theory, we offer a framework to directly assess the impact of ICT4D on development.

Planning for development or decline? Education policy for Chinese language in Singapore

This article examines how political discourse, language ideologies, recent Chinese curriculum reforms, and their representations in the media are inextricably related. Using the Speak Mandarin Campaign as background for the inquiry, I focus on textual features of the various media sources, TV advertisements, campaign slogans, official speeches, and newspaper excerpts to illuminate the status and changing role of the Chinese language in Singapore’s sociocultural, economic, and political development. Using critical discourse analysis as an analytical framework, I examine the contradictory ideologies that underpin the government’s language policies and planning activities. On the one hand, the government emphasizes the cultural and economic values of the Chinese language; on the other hand, government schools teach Chinese as a subject. In particular, the recent reforms in Chinese language curriculum have arguably further diluted the content of teaching. In addition I point out how conflicting ideologies behind language policies can lead to cultural confusion and educational uncertainty. These mixed messages make it difficult for schools to offer a consistent language education curriculum that will help students appreciate the value, be it economic, cultural or educational, of the Chinese language.

The persistence of distance: a gravity model of European cross-border real estate development flows

Purpose – This paper aims to investigate the scale and drivers of cross-border real estate development in Western Europe and Central and Eastern Europe. Design/methodology/approach – Placing cross-border real estate development within the framework of foreign direct investment (FDI), conceptual complexities in characterizing the notional real estate developer are emphasized. Drawing upon a transaction database, this paper proxies cross-border real estate development flows with asset sales by developers. Findings – Much higher levels of market penetration by international real estate developers are found in the less mature markets of Central and Eastern Europe. Analysis suggests a complex range of determinants with physical distance remaining a consistent barrier to cross-border development flows. Originality/value – This analysis adds significant value in terms of understanding cross-border real estate development flows. In this study, a detailed examination of the issues based on a rigorous empirical analysis through gravity modelling is offered. The gravity framework is one of the most confirmed empirical regularities in international economics and commonly applied to trade, FDI, migration, foreign portfolio investment inter alia. This paper assesses the extent to which it provides useful insights into the pattern of cross-border real estate development flows.

An investigation of the role of business analysts in IS development

Business analysis has developed since the early 1990s as an IS discipline that is concerned with understanding business problems, defining requirements and evaluating relevant solutions. However, this discipline has had limited recognition within the academic community and little research has been conducted into the practices and standards employed by business analysts. This paper reports on a study into business analysis that considered the activities conducted and the outcomes experienced on IS projects. Senior business analysts were interviewed in order to gain insights into the business analyst role and the techniques and approaches applied when conducting this work. The Context, Content, Process, Outcomes framework was adopted as a basis for developing the interview questions. The data collected was analysed using the template analysis technique and the template was based upon this framework. Additional themes concerning aspects of business analysis that may contribute to IS success emerged during data analysis. These included the key business analysis activities and the skills business analysts require to perform these activities. The organisational attitude was also identified as a key factor in enabling the use and contribution of business analysis.

Towards improving the framework for probabilistic forecast evaluation

The evaluation of forecast performance plays a central role both in the interpretation and use of forecast systems and in their development. Different evaluation measures (scores) are available, often quantifying different characteristics of forecast performance. The properties of several proper scores for probabilistic forecast evaluation are contrasted and then used to interpret decadal probability hindcasts of global mean temperature. The Continuous Ranked Probability Score (CRPS), Proper Linear (PL) score, and IJ Good’s logarithmic score (also referred to as Ignorance) are compared; although information from all three may be useful, the logarithmic score has an immediate interpretation and is not insensitive to forecast busts. Neither CRPS nor PL is local; this is shown to produce counter intuitive evaluations by CRPS. Benchmark forecasts from empirical models like Dynamic Climatology place the scores in context. Comparing scores for forecast systems based on physical models (in this case HadCM3, from the CMIP5 decadal archive) against such benchmarks is more informative than internal comparison systems based on similar physical simulation models with each other. It is shown that a forecast system based on HadCM3 out performs Dynamic Climatology in decadal global mean temperature hindcasts; Dynamic Climatology previously outperformed a forecast system based upon HadGEM2 and reasons for these results are suggested. Forecasts of aggregate data (5-year means of global mean temperature) are, of course, narrower than forecasts of annual averages due to the suppression of variance; while the average “distance” between the forecasts and a target may be expected to decrease, little if any discernible improvement in probabilistic skill is achieved.

Entrepreneurial ecosystems in cities: establishing the framework conditions

This study focuses on regional entrepreneurial ecosystems and offers a complex model of start-ups, Regional Entrepreneurship and Development Index (REDI) and six domains of the entrepreneurial ecosystem (culture, formal institutions, infrastructure and amenities, IT, Melting Pot and demand). Altogether they capture the contextual features of socioeconomic, institutional and information environment in cities. To explain variations in entrepreneurship in a cross-section of 70 European cities, we utilize exploratory factor analysis and structural equation modelling for regional systems of entrepreneurship using individual perception surveys by Eurostat and the REDI. This study supports policymakers and scholars in development of new policies conducive to regional systems of innovation and entrepreneurship and serves as a basis for future research on urban entrepreneurial ecosystems.

Arctic Snow Microstructure Experiment for the development of snow emission modelling

The Arctic Snow Microstructure Experiment (ASMEx) took place in Sodankylä, Finland in the winters of 2013-2014 and 2014-2015. Radiometric, macro-, and microstructure measurements were made under different experimental conditions of homogenous snow slabs, extracted from the natural seasonal taiga snowpack. Traditional and modern measurement techniques were used for snow macro- and microstructure observations. Radiometric measurements of the microwave emission of snow on reflector and absorber bases were made at frequencies 18.7, 21.0, 36.5, 89.0 and 150.0 GHz, for both horizontal and vertical polarizations. Two measurement configurations were used for radiometric measurements: a reflecting surface and an absorbing base beneath the snow slabs. Simulations of brightness temperatures using two microwave emission models, Helsinki University of Technology (HUT) snow emission model and Microwave Emission Model of Layered Snowpacks (MEMLS), were compared to observed brightness temperatures. RMSE and bias were calculated; with the RMSE and bias values being smallest upon an absorbing base at vertical polarization. Simulations overestimated the brightness temperatures on absorbing base cases at horizontal polarization. With the other experimental conditions, the biases were small; with the exception of the HUT model 36.5 GHz simulation, which produced an underestimation for the reflector base cases. This experiment provides a solid framework for future research on the extinction of microwave radiation inside snow.

Advanced functionality for radio analysis in the Offline software framework of the Pierre Auger Observatory

The advent of the Auger Engineering Radio Array (AERA) necessitates the development of a powerful framework for the analysis of radio measurements of cosmic ray air showers. As AERA performs ""radio-hybrid"" measurements of air shower radio emission in coincidence with the surface particle detectors and fluorescence telescopes of the Pierre Auger Observatory, the radio analysis functionality had to be incorporated in the existing hybrid analysis solutions for fluorescence and surface detector data. This goal has been achieved in a natural way by extending the existing Auger Offline software framework with radio functionality. In this article, we lay out the design, highlights and features of the radio extension implemented in the Auger Offline framework. Its functionality has achieved a high degree of sophistication and offers advanced features such as vectorial reconstruction of the electric field, advanced signal processing algorithms, a transparent and efficient handling of FFTs, a very detailed simulation of detector effects, and the read-in of multiple data formats including data from various radio simulation codes. The source code of this radio functionality can be made available to interested parties on request. (C) 2011 Elsevier B.V. All rights reserved.

The Development of Swedish Tourism Public Policy 1930-2010

In this article, the development and changes in Swedish public policy relating to tourism from the 1930s to 2010 is described and interpreted from a political economy perspective. A case study, compiled from mainly secondary sources, is analyzed from a theoretical framework based on regulation theory. The purpose with this study is to increase the understanding of how the macro political economy context has influenced the policy-making in tourism in Sweden, but also to make a contribution to an area which seems to be quite neglected when it comes to research. The changes are analyzed according to the three periods denoted as pre-Fordism (mid-19th century-1930s), Fordism (1930s-1970s) and post-Fordism (1970s to present). It is observed how the general changes between these periods regarding aspects such as regulation and deregulation, and the degree of state involvement, have affected tourism policy making. The tourism policy making has changed from being insignificant, to a high degree of state involvement including planning, control and supervision, to a situation where the market rather than government regulation is considered as state of the art. 

Outdoor performance of forest seedlings pre-cultivated under artificial lights : effects of the light spectra used for pre-cultivation on the future establishment and development

Forest nurseries are essential for producing good quality seedlings, thus being a key element in the reforestation process. With increasing climate change awareness, nursery managers are looking for new tools that can help reduce the effects of their operations on the environment. The ZEPHYR project, funded by the European Commission under the Seventh Framework Programme (FP7), has the objective of finding new alternatives for nurseries by developing innovative zero-impact technologies for forest plant production. Due to their direct relationship to the energy consumption of the nurseries, one of the main elements addressed are the grow lights used for the pre-cultivation. New LED luminaires with a light spectrum tailored to the seedlings’ needs are being studied and compared against the traditional fluorescent lamps. Seedlings of Picea abies and Pinus sylvestris were grown under five different light spectra (one fluorescent and 4 LED) during 5 weeks with a photoperiod of 16 hours at 100 μmol∙m-2∙s-1 and 60% humidity. In order to evaluate if these seedlings were able cope with real field stress conditions, a forest field trial was also designed. The terrain chosen was a typical planting site in mid-Sweden after clear-cutting. Two vegetation periods after the outplanting, the seedlings that were pre-cultivated under the LED lamps have performed at least as well as those that were grown under fluorescent lights. These results show that there is a good  potential for lightning substitution in forestry nurseries.

Health system context and implementation of evidence-based practices-development and validation of the Context Assessment for Community Health (COACH) tool for low- and middle-income settings

Background: The gap between what is known and what is practiced results in health service users not benefitting from advances in healthcare, and in unnecessary costs. A supportive context is considered a key element for successful implementation of evidence-based practices (EBP). There were no tools available for the systematic mapping of aspects of organizational context influencing the implementation of EBPs in low- and middle-income countries (LMICs). Thus, this project aimed to develop and psychometrically validate a tool for this purpose. Methods: The development of the Context Assessment for Community Health (COACH) tool was premised on the context dimension in the Promoting Action on Research Implementation in Health Services framework, and is a derivative product of the Alberta Context Tool. Its development was undertaken in Bangladesh, Vietnam, Uganda, South Africa and Nicaragua in six phases: (1) defining dimensions and draft tool development, (2) content validity amongst in-country expert panels, (3) content validity amongst international experts, (4) response process validity, (5) translation and (6) evaluation of psychometric properties amongst 690 health workers in the five countries. Results: The tool was validated for use amongst physicians, nurse/midwives and community health workers. The six phases of development resulted in a good fit between the theoretical dimensions of the COACH tool and its psychometric properties. The tool has 49 items measuring eight aspects of context: Resources, Community engagement, Commitment to work, Informal payment, Leadership, Work culture, Monitoring services for action and Sources of knowledge. Conclusions: Aspects of organizational context that were identified as influencing the implementation of EBPs in high-income settings were also found to be relevant in LMICs. However, there were additional aspects of context of relevance in LMICs specifically Resources, Community engagement, Commitment to work and Informal payment. Use of the COACH tool will allow for systematic description of the local healthcare context prior implementing healthcare interventions to allow for tailoring implementation strategies or as part of the evaluation of implementing healthcare interventions and thus allow for deeper insights into the process of implementing EBPs in LMICs.