Description of a multifaceted strategy for recruiting general practitioners and community pharmacists to talk about medication errors

Objective: To describe the use of a multifaceted strategy for recruiting general practitioners (GPs) and community pharmacists to talk about medication errors which have resulted in preventable drug-related admissions to hospital. This is a potentially sensitive subject with medicolegal implications. Setting: Four primary care trusts and one teaching hospital in the UK. Method: Letters were mailed to community pharmacists and general practitioners asking for provisional consent to be interviewed and permission to contact them again should a patient be admitted to hospital as a result of a medication error. In addition, GPs were asked for permission to approach their patients should they be admitted to hospital. A multifaceted approach to recruitment was used including gaining support for the study from professional defence agencies and local champions. Key findings: Eighty-five percent (310/385) of GPs and 62% (93/149) of community pharmacists responded to the letters. Eighty-five percent (266/310) of GPs who responded and 81% (75/93) of community pharmacists who responded gave provisional consent to participate in interviews. All GPs (14 out of 14) and community pharmacists (10 out of 10) who were subsequently asked to participate, when patients were admitted to hospital, agreed to be interviewed. Conclusion: The multifaceted approach to recruitment was associated with an impressive response when asking healthcare professionals to be interviewed about medication errors which have resulted in preventable drug-related morbidity.

Easing transition and promoting a positive student experience within an international partnership scheme for British and Chinese teachers

This article investigates the needs and challenges of a group of Chinese secondary school teachers in their transition to postgraduate studies in the UK in the context of a British-Chinese partnership. The strategies and efforts of the host institution, local community and the Chinese students themselves to help ease the transition and promote a positive student experience are discussed. The article highlights the sociological processes of international postgraduate student transition and contributes to our understanding of issues of student support pertinent to international partnership arrangements.

The potential for community groups to promote sustainable living

In recent times there has been a growing recognition amongst policy-makers of the role for community-based action in contributing to the broader aims of energy policy and climate change. In this paper, we will examine the potential for existing community groups to use their influence and elements of internal cohesion to encourage more widespread understanding and adoption of sustainable lifestyle habits; both amongst their members and within the broader communities of which they are a part. Findings are presented from recent empirical work with a range of well-established community groups for whom environmental issues are not their main priority. A central aspect of the research was to explore both the current status and potential role of groups that may have the capacity to reach and influence a broader sphere of the public than energy/environment specific initiatives of recent times have been able to achieve. Representing a diversity of interests, age groups and functionality, the results suggest that the potential for more effective ‘bottom-up’ engagement on climate change and sustainable living might be given fresh impetus by these types of established community groups and their networks. An assessment of what motivates participation and membership in the groups highlights a series of factors common to all groups and a smaller number that are significant for particular groups individually. It is argued that an appreciation of motivating factors can be useful in understanding more clearly how such groups are able to survive and maintain cohesion over time. The findings also suggest that climate change action means different things for different groups, with the diversity of the groups bringing with it the challenge of making sustainable living relevant to a range of interests and different shared values.

Legal outlier, again? U.S. felon suffrage: comparative and international human rights perspectives

The judiciousness of American felon suffrage policies has long been the subject of scholarly debate, not least due to the large number of affected Americans: an estimated 5.3 million citizens are ineligible to vote as a result of a criminal conviction. This article offers comparative law and international human rights perspectives and aims to make two main contributions to the American and global discourse. After an introduction in Part I, Part II offers comparative law perspectives on challenges to disenfranchisement legislation, juxtaposing U.S. case law against recent judgments rendered by courts in Canada, South Africa, Australia, and by the European Court of Human Rights. The article submits that owing to its unique constitutional stipulations, as well as to a general reluctance to engage foreign legal sources, U.S. jurisprudence lags behind an emerging global jurisprudential trend that increasingly views convicts’ disenfranchisement as a suspect practice and subjects it to judicial review. This transnational judicial discourse follows a democratic paradigm and adopts a “residual liberty” approach to criminal justice that considers convicts to be rights-holders. The discourse rejects regulatory justifications for convicts’ disenfranchisement, and instead sees disenfranchisement as a penal measure. In order to determine its suitability as a punishment, the adverse effects of disenfranchisement are weighed against its purported social benefits, using balancing or proportionality review. Part III analyzes the international human rights treaty regime. It assesses, in particular, Article 25 of the International Covenant on Civil and Political Rights (“ICCPR”), which proclaims that “every citizen” has a right to vote without “unreasonable restrictions.” The analysis concludes that the phrase “unreasonable restrictions” is generally interpreted in a manner which tolerates certain forms of disenfranchisement, whereas other forms (such as life disenfranchisement) may be incompatible with treaty obligations. This article submits that disenfranchisement is a normatively flawed punishment. It fails to treat convicts as politically-equal community members, degrades them, and causes them grave harms both as individuals and as members of social groups. These adverse effects outweigh the purported social benefits of disenfranchisement. Furthermore, as a core component of the right to vote, voter eligibility should cease to be subjected to balancing or proportionality review. The presumed facilitative nature of the right to vote makes suffrage less susceptible to deference-based objections regarding the judicial review of legislation, as well as to cultural relativity objections to further the international standardization of human rights obligations. In view of this, this article proposes the adoption of a new optional protocol to the ICCPR proscribing convicts’ disenfranchisement. The article draws analogies between the proposed protocol and the ICCPR’s “Optional Protocol Aiming at the Abolition of the Death Penalty.” If adopted, the proposed protocol would strengthen the current trajectory towards expanding convicts’ suffrage that emanates from the invigorated transnational judicial discourse.

Registering scents as community trade marks

While the registrability of scents as Community trade marks has become source of much controversy, the possibility of trademarking scents represents a great potential for the industry. In the aftermath of the Sieckmann case, which has raised the threshold of registrability for scent marks, companies have refrained from submitting new smell-mark applications. Despite the difficulties in registering scents as trademarks, however, it is not impossible to meet the Sieckmann criteria and file successful scent mark applications. This article explains how this could be possible; it reviews all objections in registering scents as trademarks and brings new light into this topic by way of a comprehensive analysis of the conditions under which scents can be registered as Community trade marks.

IMILAST: a community effort to intercompare extratropical cyclone detection and tracking algorithms

The variability of results from different automated methods of detection and tracking of extratropical cyclones is assessed in order to identify uncertainties related to the choice of method. Fifteen international teams applied their own algorithms to the same dataset—the period 1989–2009 of interim European Centre for Medium-Range Weather Forecasts (ECMWF) Re-Analysis (ERAInterim) data. This experiment is part of the community project Intercomparison of Mid Latitude Storm Diagnostics (IMILAST; see www.proclim.ch/imilast/index.html). The spread of results for cyclone frequency, intensity, life cycle, and track location is presented to illustrate the impact of using different methods. Globally, methods agree well for geographical distribution in large oceanic regions, interannual variability of cyclone numbers, geographical patterns of strong trends, and distribution shape for many life cycle characteristics. In contrast, the largest disparities exist for the total numbers of cyclones, the detection of weak cyclones, and distribution in some densely populated regions. Consistency between methods is better for strong cyclones than for shallow ones. Two case studies of relatively large, intense cyclones reveal that the identification of the most intense part of the life cycle of these events is robust between methods, but considerable differences exist during the development and the dissolution phases.

Doing more harm than good? Community based natural resource management and the neglect of local institutions in policy development

Approaches to natural resource management emphasise the importance of involving local people and institutions in order to build capacity, limit costs, and achieve environmental sustainability. Governments worldwide, often encouraged by international donors, have formulated devolution policies and legal instruments that provide an enabling environment for devolved natural resource management. However, implementation of these policies reveals serious challenges. This article explores the effects of limited involvement of local people and institutions in policy development and implementation. An in-depth study of the Forest Policy of Malawi and Village Forest Areas in the Lilongwe district provides an example of externally driven policy development which seeks to promote local management of natural resources. The article argues that policy which has weak ownership by national government and does not adequately consider the complexity of local institutions, together with the effects of previous initiatives on them, can create a cumulative legacy through which destructive resource use practices and social conflict may be reinforced. In short, poorly developed and implemented community based natural resource management policies can do considerably more harm than good. Approaches are needed that enable the policy development process to embed an in-depth understanding of local institutions whilst incorporating flexibility to account for their location-specific nature. This demands further research on policy design to enable rigorous identification of positive and negative institutions and ex-ante exploration of the likely effects of different policy interventions.

Knowledge dissemination in the global service marketing community

Purpose– The evolution of the service marketing field was marked by the emergence of a global, vigorous and tolerant community of service marketing researchers. This paper seeks to examine the history of the service marketing community and argues that it may be an archetype for building the emergent global service research community. Design/methodology/approach– The study combines qualitative and quantitative approaches. The authors interviewed four pioneering service scholars and also collected descriptive data (e.g. Authorship, Affiliation, Title, Keywords) of all service related articles published in 13 top peer‐reviewed marketing and service journals over the last 30 years (5,432 articles; 6,450 authors). In a dynamic analysis the authors mapped global collaboration between countries over time and detected clusters of international collaboration. Findings– Findings suggest a growing international collaboration for the USA and the UK, while for other countries like Israel the global collaboration started from a high level and decreases now. Further, the service marketing community never became polarized and there were always contributions from researchers all over the world. Research limitations/implications– As the global service research community is developing, service marketing becomes a research neighborhood within the broader service research community. Simultaneously, other research neighborhoods are emerging within this new community (e.g. service arts, service management, service engineering, service science). Originality/value– Anchored on the social evolution and biological evolution metaphors, this study explains the evolution of the service marketing field from both qualitative and quantitative perspectives. Furthermore, it explains the development of the service marketing community as an archetype for building the global service research community.

Care in the community? Interpretations of a fractured goat bone from Neolithic Jarmo, Iraq

A case study of a goat metatarsal exhibiting a complex diaphyseal fracture from Pottery Neolithic Jarmo in the Central Zagros region of the eastern Fertile Crescent is here described and analysed. The Central Zagros is one of the areas with the earliest evidence for goat domestication. The significance of the pathology may be viewed within the context of domestic goat ecology in the landscape of Jarmo, potentially impacting browsing behaviour (goats raise themselves on their hind limbs to browse) and movement with the herd in the landscape (the terrain around Jarmo is very steep in places, which would be difficult for an animal to navigate on three legs). In the light of this, possible levels of care that the Neolithic human community may have afforded this animal are discussed – from a situation where therapeutic intervention may have occurred, to one of stall confinement of the animal to allow the pathology to heal, to a position of simple awareness of the condition – and how this impacts on our understanding of changes in attitudes towards animals through the process of domestication.

Prevalence and risk factors of radiographic vertebral fracture in Brazilian community-dwelling elderly

The prevalence and risk factors of radiographic vertebral fracture were determined among Brazilian community-dwelling elderly. Vertebral fractures were a common condition in this elderly population, and lower hip bone mineral density was a significant risk factor for vertebral fractures in both genders. The aim of the study was to estimate the prevalence of radiographic vertebral fracture and investigate factors associated with this condition in Brazilian community-dwelling elderly. This cross-sectional study included 943 elderly subjects (561 women and 382 men) living in So Paulo, Brazil. Thoracic and lumbar spine radiographs were obtained, and vertebral fractures were evaluated using Genant`s semiquantitative method. Bone mineral density (BMD) was measured by dual X-ray absorptiometry, and bone biochemical markers were also evaluated. Female and male subjects were analyzed independently, and each gender was divided into two groups based on whether vertebral fractures were present. The prevalence of vertebral fracture was 27.5% (95% CI 23.8-31.1) in women and 31.8% in men (95% CI 27.1-36.5) (P = 0.116). Cox regression analyses using variables that were significant in the univariate analysis showed that age (prevalence ratio = 1.03, 95% CI 1.01-1.06; p = 0.019) and total femur BMD (PR = 0.27, 95% CI 0.08-0.98; p = 0.048) were independent factors in predicting vertebral fracture for the female group. In the male group, Cox regression analyses demonstrated that femoral neck BMD (PR = 0.26, 95% CI 0.07-0.98; p = 0.046) was an independent parameter in predicting vertebral fractures. Our results suggest that radiographic vertebral fractures are common in Brazilian community-dwelling elderly and that a low hip BMD was an important risk factor for this condition in both genders. Age was also significantly correlated with the presence of vertebral fractures in women.

Shared decision-making in mental health care : a user perspective on decisional needs in community-based services

BACKGROUND: Shared decision-making (SDM) is an emergent research topic in the field of mental health care and is considered to be a central component of a recovery-oriented system. Despite the evidence suggesting the benefits of this change in the power relationship between users and practitioners, the method has not been widely implemented in clinical practice. OBJECTIVE: The objective of this study was to investigate decisional and information needs among users with mental illness as a prerequisite for the development of a decision support tool aimed at supporting SDM in community-based mental health services in Sweden. METHODS: Three semi-structured focus group interviews were conducted with 22 adult users with mental illness. The transcribed interviews were analyzed using a directed content analysis. This method was used to develop an in-depth understanding of the decisional process as well as to validate and conceptually extend Elwyn et al.'s model of SDM. RESULTS: The model Elwyn et al. have created for SDM in somatic care fits well for mental health services, both in terms of process and content. However, the results also suggest an extension of the model because decisions related to mental illness are often complex and involve a number of life domains. Issues related to social context and individual recovery point to the need for a preparation phase focused on establishing cooperation and mutual understanding as well as a clear follow-up phase that allows for feedback and adjustments to the decision-making process. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: The current study contributes to a deeper understanding of decisional and information needs among users of community-based mental health services that may reduce barriers to participation in decision-making. The results also shed light on attitudinal, relationship-based, and cognitive factors that are important to consider in adapting SDM in the mental health system.