The public health role of community pharmacies

This article describes the experience of developing an enhanced public health role for a community pharmacy in the Castle Vale estate in Birmingham. It shows that the neighbourhood-based regeneration context of Castle Vale has created a stimulating setting for an ambitious and innovative pharmacy company to demonstrate what might be possible on a much wider scale in the UK. A core ethos of the Castle Vale regeneration initiative has been public-private partnership and this project reveals some 'critical success factors' for on-the-ground achievement.

Patterns of phonological errors as a function of a phonological versus an articulatory locus of impairment

WWe present the case of two aphasic patients: one with fluent speech, MM, and one with dysfluent speech, DB. Both patients make similar proportions of phonological errors in speech production and the errors have similar characteristics. A closer analysis, however, shows a number of differences. DB's phonological errors involve, for the most part, simplifications of syllabic structure; they affect consonants more than vowels; and, among vowels, they show effects of sonority/complexity. This error pattern may reflect articulatory difficulties. MM's errors, instead, show little effect of syllable structure, affect vowels at least as much as consonants and, and affect all different vowels to a similar extent. This pattern is consistent with a more central impairment involving the selection of the right phoneme among competing alternatives. We propose that, at this level, vowel selection may be more difficult than consonant selection because vowels belong to a smaller set of repeatedly activated units.

Egg quality and fecundity in rainbow trout: the determining factors and mechanisms of control

This thesis considers the factors involved in the determination of egg quality and fecundity in farmed stocks of rainbow trout ( Salmo gairdneri R) • Measurements of egg quality, ie. percentage survivals of eggs and fry, from the production batches of eggs of seven fish farms, showed mean survivals of 70% to eying but levels of only 35% to 4.5g fry (approx. 130 days post-fertilisation). Under optimum conditions survivals may reach 85% suggesting that husbandry methods exert significant influences on egg quality. Chemical analyses of the protein, fat, vitellogenin, ash, amino acids, free fatty acid and mineral levels of eggs of varying quality and from parents of different strains showed compositional differences even between individuals of the same stock. However, none of these differences were correlated with egg quality. Egg size showed similar variations but, again under hatchery conditions there was no correlation with differences in egg quality. The only factor which has been shown to exert a significant influence on egg quality is the time of stripping after ovulation. At 1 0°C eggs should be removed from gravid females within ten days of ovulation to achieve optimum egg and fry survival. Studies of egg production from approximately 10,000 broodstock revealed that total fecundity and egg size increased and relative fecundity decreased with increasing fish size. In general, most fish appeared to produce a constant volume of eggs. This is consistent with a hypothesis that egg size can only be increased by parallel reductions in fecundity. Feeding broodstock at half-ration (0.35% body weight day- 1 ) did not affect egg quality but reduced total fecundity and egg size and increased relative fecundity when compared with eggs produced by fish on full-ration. Comparisons of regressions of total fecundity against fish weight for three strains using ANOCO revealed that one strain was significantly more fecund than two other strains considered. Trout of the same strain maintained on different farms behaved similarly suggesting there was some reproducibility of strain characteristics.

Determinants of sales performance in insurance industry:a cross-cultural comparison between the UK and Malaysia

This thesis is concerned with an empirical investigation of the factors that predict a successful salesperson, using a cross-cultural comparison of two countries: the UK and Malaysia. Besides collecting quantitative data, qualitative data on organisational, environmental and cultural factors were also collected through interviews, personal and case observations. The quantitative data consist of sixteen independent factors and three dependent factors. The independent variables include self-efficacy, self-esteem, locus of control, self-monitoring, extrinsic motivation, intrinsic motivation, experience, training perception, role ambiguity, role conflict, role inaccuracy, gender, age, education, race and religion. The dependent variables are performance target achieved, performance earnings and performance ratings. Questionnaires were distributed to about 500 salespersons in each country, from three insurance companies in the UK and two insurance companies in Malaysia. Response rates were 75 and 50 percent from the UK and Malaysia respectively. The survey results indicated that a salesperson's performance in the UK is predicted by self-efficacy, internal locus of control, self-esteem, extrinsic motivation, experience, training perceptions, role conflict and gender. In Malaysia, a salesperson's performance is predicted by self-efficacy, self-monitoring, experience, role conflict, role ambiguity, education, gender, race and religion. Self-efficacy, experience, role conflict and gender are common predictors of salespersons' performance in both cultures. The likely explanation for these results is culture differences, i.e. UK has a homogeneous culture, while Malaysia has a heterogeneous one. Results from the case observations, such as organisational and environmental factors, give supporting evidence in explaining the empirical results. Implications from the findings are discussed from two aspects: (1) theoretical implications for divergence/convergence theory, Hofstede's model, Churchill's model, and (2) managerial implications for selection, training, motivation and appraisal.

Developing the public health function of locum pharmacists under the auspices of the new pharmacy contract

Focal Point - There are reduced opportunities for locum pharmacists to access training and education that meets their needs and enables them to play a full role under the new pharmacy contract - Eighty-six per cent of locums consider themselves to be more health professional than business person, compared to just 48% of pharmacy owners - Forty per cent of locums believe that a lack of access to training is a major barrier to the development of their public health function - While locum pharmacists are arguably more likely to embrace 'professionalising', patient-care-based roles, they are also the group least likely to be able to access the necessary training to fulfill such roles Introduction It has been suggested that locum pharmacists do not want the business-based responsibilities (e.g. staff management, meeting targets, etc) that come with pharmacy management.1 Research also suggests that locums derive great satisfaction from the health-professional aspects of the pharmacists’ role (e.g. patient contact, the provision of advice, etc).1 However, upon the introduction of the new pharmacy contract (April 2005), concerns were expressed that it was becoming increasingly difficult for locum pharmacists to access training and education that would meet their needs and enable them to play a full role under the new framework.2,3 Method After piloting, in August 2006 a self-completion postal questionnaire was sent to a random sample of practising community pharmacists, stratified for country and sex, within Great Britain (n = 1998), with a follow-up to non-responders 4 weeks later. Data were analysed using SPSS (v12.0). A final response rate of 51% (n = 1023/1998) was achieved. Respondents were asked ‘indicate how you view yourself as a pharmacist’ – in terms of their relative focus on the health-professional and business aspects of their role. Respondents were also asked ‘do you consider a lack of training opportunities to be a barrier to the development of the public health role of community pharmacists?’. Results Locums were significantly more likely than owners or employees to consider each factor a major barrier. Discussion Four in 10 locums consider a lack of training opportunities to constitute a major barrier to the development of their public health function. Pharmacy may not be able to provide the services required of it by the policy agenda if pharmacists are unable to be involved in extended role activities through a lack of training opportunities. Therefore, the paradox that needs to be addressed is that while locum pharmacists are arguably more likely to embrace ‘professionalising’, patient-care-based roles, they are also the group least likely to be able to access training to fulfil such roles. The training needs of this large subset of the pharmacist population need to be assessed and met if the whole community pharmacy workforce is going to maximise its contribution to public health under the new contractual framework. References 1 Shann P, Hassell K. An exploration of the diversity and complexity of the pharmacy locum workforce. London: Royal Pharmaceutical Society of Great Britain; 2004. 2 Almond M. Locums – key players in workforce – cast adrift as contract launched. Pharm J 2005;274:420. 3 Bishop DH. A lack of appreciation of what really happens. Pharm J 2005;274:451.

Ownership concentration:'Private benefits of control' and debt financing

Building on the ‘law and economics’ literature, this paper analyses corporate governance implications of debt financing in an environment where a dominant owner is able to extract ex ante ‘private benefits of control’. Ownership concentration may result in lower efficiency, measured as a ratio of a firm’s debt to investment, and this effect depends on the identity of the largest shareholder. Moreover, entrenched dominant shareholder(s) may be colluding with fixed-claim holders in extracting ‘control premium’. One of possible outcomes is a ‘crowding out’ of entrepreneurial firms from the debt market, and this is supported by evidence from the transition economies.

Governance of open content creation:a conceptualization and analysis of control and guiding mechanisms in the open content domain

The open content creation process has proven itself to be a powerful and influential way of developing text-based content, as demonstrated by the success of Wikipedia and related sites. Distributed individuals independently edit, revise, or refine content, thereby creating knowledge artifacts of considerable breadth and quality. Our study explores the mechanisms that control and guide the content creation process and develops an understanding of open content governance. The repertory grid method is employed to systematically capture the experiences of individuals involved in the open content creation process and to determine the relative importance of the diverse control and guiding mechanisms. Our findings illustrate the important control and guiding mechanisms and highlight the multifaceted nature of open content governance. A range of governance mechanisms is discussed with regard to the varied levels of formality, the different loci of authority, and the diverse interaction environments involved. Limitations and opportunities for future research are provided.

Equimultiple Locus of Embedded Algebroid Surfaces and Blowing–up in Characteristic Zero

2000 Mathematics Subject Classification: 14B05, 32S25.

The effect of vision congruence on employee empowerment, commitment, satisfaction, and performance

Five models delineating the person-situation fit controversy were developed and tested. Hypotheses were tested to determine the linkages between vision congruence, empowerment, locus of control, job satisfaction, organizational commitment, and employee performance. Vision was defined as a mental image of a possible and desirable future state of the organization.^ Data were collected from 213 employees in a major flower import company. Participants were from various organizational levels and ethnic backgrounds. The data collection procedure consisted of three parts. First, a profile analysis instrument was used which was developed employing a Q-sort based technique, to measure the vision congruence between the CEO and each employee. Second, employees completed a survey instrument which included scales measuring empowerment, locus of control, job satisfaction, organizational commitment, and social desirability. Third, supervisor performance ratings were gathered from employee files. Data analysis consisted of using Kendall's tau to measure the correlation between CEO's and each employee's vision. Path analyses were conducted using the EQS structural equation program to test five theoretical models for goodness-of-fit. Regression analysis was employed to test whether locus of control acted as a moderator variable.^ The results showed that vision congruence is significantly related to job satisfaction and employee commitment, and perceived empowerment acts as an intervening variable affecting employee outcomes. The study also found that people with an internal locus of control were more likely to feel empowered than were those with external beliefs. Implications of these findings for both researchers and practitioners are discussed and suggestions for future research directions are provided. ^