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.

Globalization and new policy concerns: the WTO and the EU's sustainability criteria for biofuels

The transfer of some decision-making authority from the domestic to the supranational arena as a result of the establishment of the World Trade Organization (WTO) in 1995 potentially changed domestic policy dynamics. The WTO agreements reflect the trade policy concerns addressed in the Uruguay Round in the late 1980s and early 1990s. This article applies and adapts historical institutionalism to explain how international organizations may constrain and facilitate certain domestic policy options. It demonstrates that, while the WTO legal framework has become more receptive of environmental sustainability concerns, the social sustainability concerns that were increasingly entering the debate over biofuel policies were not easily accommodated, and this was seen as a constraint on the content of the European Union’s (EU) policy adopted in 2009. Only the environmental dimension of a broader concept of sustainability was included in the policy design.

The 'veil' of control: exploring the attitudes and perceptions of UK design controllers

In the UK, architectural design is regulated through a system of design control for the public interest, which aims to secure and promote ‘quality’ in the built environment. Design control is primarily implemented by locally employed planning professionals with political oversight, and independent design review panels, staffed predominantly by design professionals. Design control has a lengthy and complex history, with the concept of ‘design’ offering a range of challenges for a regulatory system of governance. A simultaneously creative and emotive discipline, architectural design is a difficult issue to regulate objectively or consistently, often leading to policy that is regarded highly discretionary and flexible. This makes regulatory outcomes difficult to predict, as approaches undertaken by the ‘agents of control’ can vary according to the individual. The role of the design controller is therefore central, tasked with the responsibility of interpreting design policy and guidance, appraising design quality and passing professional judgment. However, little is really known about what influences the way design controllers approach their task, providing a ‘veil’ over design control, shrouding the basis of their decisions. This research engaged directly with the attitudes and perceptions of design controllers in the UK, lifting this ‘veil’. Using in-depth interviews and Q-Methodology, the thesis explores this hidden element of control, revealing a number of key differences in how controllers approach and implement policy and guidance, conceptualise design quality, and rationalise their evaluations and judgments. The research develops a conceptual framework for agency in design control – this consists of six variables (Regulation; Discretion; Skills; Design Quality; Aesthetics; and Evaluation) and it is suggested that this could act as a ‘heuristic’ instrument for UK controllers, prompting more reflexivity in relation to evaluating their own position, approaches, and attitudes, leading to better practice and increased transparency of control decisions.

International experiential diversity and performance at project organizations: The case of national football teams

Purpose– The purpose of this paper is to shed new light on the link between diversity in project teams and team performance by examining the effects of players’ international career diversity on the performance of national football teams. Design/methodology/approach– The paper draws upon the literature on project organizations and experiential diversity in teams. Using data on players’ international career backgrounds and team performance from the FIFA World Cup 2006, the authors test two hypotheses linking experiential diversity in teams and a measure of relative team performance. The dataset includes detailed individual background profiles of the 736 participating players and performance data from the 64 games played at the tournament. Findings– The findings suggest that different types of experiential diversity have contrasting effects on team performance in a time‐limited project team setting. Research limitations/implications– These findings encourage team diversity researchers to further examine the impact of experiential diversity in teams on team process and performance outcomes in future research. Practical implications– The findings particularly highlight the need to carefully manage experiential diversity in project team settings in order to benefit from access to diverse tacit resources, while at the same time avoiding that the integrative capacities of teams becoming overstretched. Originality/value– The paper is a step towards a better understanding of how diversity of individual career backgrounds affects team performance outcomes in project teams.

Adjustments in the forcing-feedback framework for understanding climate change

The traditional forcing-feedback framework has provided an indispensable basis for discussing global climate changes. However, as analysis of model behavior has become more detailed, shortcomings and ambiguities in the framework have become more evident and physical effects unaccounted for by the traditional framework have become interesting. In particular, the new concept of adjustments, which are responses to forcings that are not mediated by the global mean temperature, has emerged. This concept, related to the older ones of climate efficacy and stratospheric adjustment, is a more physical way of capturing unique responses to specific forcings. We present a pedagogical review of the adjustment concept, why it is important, and how it can be used. The concept is particularly useful for aerosols, where it helps to organize what has become a complex array of forcing mechanisms. It also helps clarify issues around cloud and hydrological response, transient vs. equilibrium climate change, and geoengineering.

Towards a framework for managing IT-enabled change, sourcing and governance

In the resource-based view, organisations are represented by the sum of their physical, human and organisational assets, resources and capabilities. Operational capabilities maintain the status quo and allow an organisation to execute their existing business. Dynamic capabilities, otherwise, allow an organisation to change this status quo including a change of the operational ones. Competitive advantage, in this context, is an effect of continuously developing and reconfiguring these firm-specific assets through dynamic capabilities. Deciding where and how to source the core operational capabilities is a key success factor. Furthermore, developing its dynamic capabilities allows an organisation to effectively manage change its operational capabilities. Many organisations are asserted to have a high dependency on - as well as a high benefit from - the use of information technology (IT), making it a crucial and overarching resource. Furthermore, the IT function is assigned the role as a change enabler and so IT sourcing affects the capability of managing business change. IT sourcing means that organisations need to decide how to source their IT capabilities. Outsourcing of parts of the IT function will also outsource some of the IT capabilities and therefore some of the business capabilities. As a result, IT sourcing has an impact on the organisation's capabilities and consequently on the business success. And finally, a turbulent and fast moving business environment challenges organisations to effectively and efficiently managing business change. Our research builds on the existing theory of dynamic and operational capabilities by considering the interdependencies between the dynamic capabilities of business change and IT sourcing. Further it examines the decision-making oversight of these areas as implemented through IT governance. We introduce a new conceptual framework derived from the existing theory and extended through an illustrative case study conducted in a German bank. Under a philosophical paradigm of constructivism, we collected data from eight semi-structured interviews and used additional sources of evidence in form of annual accounts, strategy papers and IT benchmark reports. We applied an Interpretative Phenomenological Analysis (IPA), which emerged the superordinate themes for our tentative capabilities framework. An understanding of these interdependencies enables scholars and professionals to improve business success through effectively managing business change and evaluating the impact of IT sourcing decisions on the organisation's operational and dynamic capabilities.

The adoption of the materiality concept in social and environmental reporting assurance: a field study approach

This study investigates the logics or values that shape the social and environmental reporting (SER) and SER assurance (SERA) process. The influence of logics is observed through a study of the conceptualisation and operationalisation of the materiality concept by accounting and non-accounting assurors and their assurance statements. We gathered qualitative data from interviews with both accounting and non-accounting assurors. We analysed the interplay between old and new logics that are shaping materiality as a reporting concept in SER. SER is a rich field in which to study the dynamics of change because it is a voluntary, unregulated, qualitative reporting arena. It has a broad, stakeholder audience, where accounting and non-accounting organisations are in competition. There are three key findings. First, the introduction of a new, stakeholder logic has significantly changed the meaning and role of materiality. Second, a more versatile, performative, social understanding of materiality was portrayed by assurors, with a forward-looking rather than a historic focus. Third, competing logics have encouraged different beliefs about materiality, and practices, to develop. This influenced the way assurors theorised the concept and interpreted outcomes. A patchwork of localised understandings of materiality is developing. Policy implications both in SERA and also in financial audit are explored.

Governing calculative practices: An investigation of development viability modelling in the English planning system

Over the last decade the English planning system has placed greater emphasis on the financial viability of development. ‘Calculative’ practices have been used to quantify and capture land value uplifts. Development viability appraisal (DVA) has become a key part of the evidence base used in planning decision-making and informs both ‘site-specific’ negotiations about the level of land value capture for individual schemes and ‘area-wide’ planning policy formation. This paper investigates how implementation of DVA is governed in planning policy formation. It is argued that the increased use of DVA raises important questions about how planning decisions are made and operationalised, not least because DVA is often poorly understood by some key stakeholders. The paper uses the concept of governance to thematically analyse semi-structured interviews conducted with the producers of DVAs and considers key procedural issues including (in)consistencies in appraisal practices, levels of stakeholder consultation and the potential for client and producer bias. Whilst stakeholder consultation is shown to be integral to the appraisal process in order to improve the quality of the appraisals and to legitimise the outputs, participation is restricted to industry experts and excludes some interest groups, including local communities. It is concluded that, largely because of its recent adoption and knowledge asymmetries between local planning authorities and appraisers, DVA is a weakly governed process characterised by emerging and contested guidance and is therefore ‘up for grabs’.

Legal and regulatory barriers to effective public-private partnership governance in Kazakhstan

Purpose – The purpose of this paper is to provide a critical assessment of legal and regulatory impediments to effective governance of public-private partnerships (PPPs) in Kazakhstan. Design/methodology/approach – The qualitative study develops propositions from the PPP literature and then tests them against findings from in-depth interviews. Interviewees have been selected by a purposeful sampling from PPP projects in Kazakhstan as well as from national and regional PPP centres. Findings – The identified barriers to effective PPP management include irregularities in the PPP legal framework, such as lack of legal definition of a PPP and controversy with the government guarantee’s legal status for its long-term payments to partnerships; bureaucratic tariff setting for partnership services; non-existent opportunity for private asset ownership; and excessive government regulation of PPP workers’ wage rates. Practical implications – The partners’ opposing perspectives on a number of PPP issues show that management needs to identify and carefully reconcile stakeholder values in a partnership in order to achieve more effective PPP governance. Practitioners, particularly those in the public agencies, have to be concerned with ways to reduce the government overregulation of the private operators, which is likely to result in greater PPP flexibility in management and, ultimately, higher efficiency in delivering the public services. Originality/value – By elucidating multiple examples of overregulation and PPPs’ inefficiency, the paper demonstrates that the government dominance in PPP management is conceptually inappropriate. Instead, the government should adopt the concept of co-production and manage its relations with the private sector partner in a collaborative fashion.

Knowledge transfer of the Western concept of ‘quality’

This paper addresses one of the issues in contemporary globalisation theory: the extent to which there is ‘one best way’ in which business can be done and organisations managed. It uses Czarniawska’s ‘Travels of Ideas’ model as an organising framework to present and understand how the concept of ‘Quality’, so important in contemporary approaches to manufacturing & services, and their management, travelled to, and impinged on, a newly opened vehicle assembly plant in Poland. The extent to which new meanings were mutually created in the process of translation is discussed, using ethnographic reporting and analysis techniques commonly used in diffusion research. Parallels between the process of translation as an idea becomes embedded into a new cultural location, and the processes which contemporary research has identified as important to organisational learning, are briefly discussed in conclusion.

The evolution of green leases: towards inter-organizational environmental governance

Improving the environmental performance of non-domestic buildings is a complex and ‘wicked’ problem due to conflicting interests and incentives. This is particularly challenging in tenanted spaces, where landlord and tenant interactions are regulated through leases that traditionally ignore environmental considerations. ‘Green leasing’ is conceptualized as a form of ‘middle-out’ inter-organizational environmental governance that operates between organizations, alongside other drivers. This paper investigates how leases are evolving to become ‘greener’ in the UK and Australia, providing evidence from five varied sources on: (1) UK office and retail leases, (2) UK retail sector energy management, (3) a major UK retailer case study; (4) office leasing in Sydney, and (5) expert interviews on Australian retail leases. With some exceptions, the evidence reveals an increasing trend towards green leases in prime offices in both countries, but not in retail or sub-prime offices. Generally introduced by landlords, adopted green leases contain a variety of ambitions and levels of enforcement. As an evolving form of private–private environmental governance, green leases form a valuable framework for further tenant–landlord cooperation within properties and across portfolios. This increased cohesion could create new opportunities for polycentric governance, particularly at the interface of cities and the property industry.

Sport and re/creation: what skateboarders can teach us about learning

This paper explores the role of digital media and creativity in the processes of learning that occur in groups of urban skateboarders. In particular, it examines how the production and consumption of amateur videos contribute to both skaters’ mastery of the techniques of the sport and their integration into the culture of the sport. The data come from an ethnographic study of skateboarders in Hong Kong, which included in-depth interviews, participant observation and the collection of texts and artifacts like magazines, blog entries and amateur skating videos. Skateboarders use video in a number of ways that significantly impact their learning and integration into their communities. They use it to analyze tricks and techniques, to document the stages of their learning and socialization into the group, to set community standards, to build a sense of belonging with their ‘crews’ and to imagine ‘idealized futures’ for themselves and their communities. Understanding the value and function of such ‘semiotic mediation’ in learning and socialization into sport cultures, I suggest, can contribute to helping physical educators design tasks that integrate training in physical skills with opportunities for students to make meaning around their experiences of sport and physical education.

Elitidrottsproblem? : En kvalitativ studie om elitidrottares karriäravslutning

This paper used a qualitative technique from a social scientific perspective, a model based on Hewitt and his theory of the self-concept. The purpose of this study was to investigate why some elite athletes experience troublesome periods after their career ending. Interviews were performed with five elite athletes with varying experiences after career ending. The length of the elite athlete careers vary between 7 to 17 years. Two groups were made based upon experiences after career ending. Group 1 had experienced problems, for example suicide tendency, and group 2 had not. The result shows that a troublesome period can come up independently of career ending. The self-concept was investigated during the career and further different kind of variables which could affect the self as training and competition, social relations both before and after termination from sport. Result indicates that an individual in group 2 who has a high complexity in the self-concept based upon significant others outside the elite sport during the career copes with the new situation after career ending much better than group 1 who have not. To build up the self based only upon significant others in the elite sport seems to give expression in a strengthen self. Intensity in training and competition did not have a connection with a troublesome period after retirement from sport but it could prevent establishing contact with others outside the elite sport and reduce a high complexity in the self-concept. The result further shows that elite athletes who practise an individual sport trains in to a greater extent than elite athletes in a seasonal sport. Result also shows that practising a sport with one day off a week, contributes to better opportunities for developing a higher complexity in the self-concept. Suspicions has also rouse that practising an elite sport on the highest level can lead to extensive focusing that further leads to social isolation from individuals outside elite sport. To build up the self upon significant others outside elite sport during the career and keep in touch with significant others from elite sport after the career seems to be the key to avoid problems after the career ending. Suggestions about further investigations are made to see if medial exposure and status can affect the self.