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.

Decoherence of charge qubit coupled to interacting background charges

The major contribution to decoherence of a double quantum dot or a Josephson-junction charge qubit comes from the electrostatic coupling to fluctuating background charges hybridized with the conduction electrons in the reservoir. However, estimations according to previously developed theories show that finding a sufficient number of effective fluctuators in a realistic experimental layout is quite improbable. We show that this paradox is resolved by allowing for a short-range Coulomb interaction of the fluctuators with the electrons in the reservoir. This dramatically enhances both the number of effective fluctuators and their contribution to decoherence, resulting in the most dangerous decoherence mechanism for charge qubits.

Institutional work taken literally: How logics shift as banking lawyers 'get the deal done'

The role of interest and agency in the creation and transformation of institutions, in particular the “paradox of embedded agency” (Seo & Creed, 2002) have long puzzled institutional scholars. Most recently, Lawrence and Suddaby (2006) coined the term “institutional work” to describe various strategies for creating, maintaining and disrupting institutions. This label, while useful to integrate existing research, highlights institutionalists’ lack of attention to work as actors’ everyday occupational tasks and activities. Thus, the objective of this study is to take institutional work literally and ask: How does practical work come to constitute institutional work? Drawing on concepts of “situated change” (Orlikowski, 1996) I supplement existing macro-level perspectives of change with a microscopic, practice-based alternative. I examine the everyday work of English and German banking lawyers in a global law firm. Located at the intersection of local laws, international financial markets, commercial logics and professional norms, banking lawyers’ work regularly bridges different normative settings. Hence, they must constructively negotiate contradictory meanings, practices and logics to develop shared routines that resonate with different normative frameworks and facilitate task accomplishment. Based on observation and interview data, the paper distils a process model of banking transac-tions that highlights the critical interfaces forcing English and German banking lawyers into cross-border sensemaking. It distinguishes two accounts of cross-border sensemaking: the “old story” in which contradictory practices and norms collide and the “new story” of a synthetic set of practices for collaboratively “editing” (Sahlin-Andersson, 1996) legal documentation. Data show how new practices gain shape and legitimacy over a series of dialectic contests unfolding at work and how, in turn, these contests shift institutional logics as lawyers ‘get the deal done’. These micro-mechanisms suggest that as practical and institutional work blend, everyday work-ing practices come to constitute a form of institutional agency that is situated, emergent, dialectic and, therefore, embedded.

Managers' perceptual errors revisited:the role of knowledge calibration

Insights from the stream of research on knowledge calibration, which refers to the correspondence between accuracy and confidence in knowledge, enable a better understanding of consequences of inaccurate perceptions of managers. This paper examines the consequences of inaccurate managerial knowledge through the lens of knowledge calibration. Specifically, the paper examines the antecedent role of miscalibration of knowledge in strategy formation. It is postulated that miscalibrated managers who overestimate external factors and display a high level of confidence in their estimates are likely to enact strategies that are relatively more evolutionary and incremental in nature, whereas miscalibrated managers who overestimate internal factors and display a high level of confidence in their estimates are likely to enact strategies that are relatively more discontinuous and disruptive in nature. Perspectives from social cognitive theory provide support for the underlying processes. The paper, in part, explains the paradox of the prevalence of inaccurate managerial perceptions and efficacious performance. It also advances the literature on strategy formation through the application of the construct of knowledge calibration.

How checking breeds doubt:reduced performance in a simple working memory task

A paradox of memory research is that repeated checking results in a decrease in memory certainty, memory vividness and confidence [van den Hout, M. A., & Kindt, M. (2003a). Phenomenological validity of an OCD-memory model and the remember/know distinction. Behaviour Research and Therapy, 41, 369–378; van den Hout, M. A., & Kindt, M. (2003b). Repeated checking causes memory distrust. Behaviour Research and Therapy, 41, 301–316]. Although these findings have been mainly attributed to changes in episodic long-term memory, it has been suggested [Shimamura, A. P. (2000). Toward a cognitive neuroscience of metacognition. Consciousness and Cognition, 9, 313–323] that representations in working memory could already suffer from detrimental checking. In two experiments we set out to test this hypothesis by employing a delayed-match-to-sample working memory task. Letters had to be remembered in their correct locations, a task that was designed to engage the episodic short-term buffer of working memory [Baddeley, A. D. (2000). The episodic buffer: a new component in working memory? Trends in Cognitive Sciences, 4, 417–423]. Of most importance, we introduced an intermediate distractor question that was prone to induce frustrating and unnecessary checking on trials where no correct answer was possible. Reaction times and confidence ratings on the actual memory test of these trials confirmed the success of this manipulation. Most importantly, high checkers [cf. VOCI; Thordarson, D. S., Radomsky, A. S., Rachman, S., Shafran, R, Sawchuk, C. N., & Hakstian, A. R. (2004). The Vancouver obsessional compulsive inventory (VOCI). Behaviour Research and Therapy, 42(11), 1289–1314] were less accurate than low checkers when frustrating checking was induced, especially if the experimental context actually emphasized the irrelevance of the misleading question. The clinical relevance of this result was substantiated by means of an extreme groups comparison across the two studies. The findings are discussed in the context of detrimental checking and lack of distractor inhibition as a way of weakening fragile bindings within the episodic short-term buffer of Baddeley's (2000) model. Clinical implications, limitations and future research are considered.

Organising the business processes of a product servitised supply chain:a value perspective

This paper develops a structured method from the perspective of value to organise and optimise the business processes of a product servitised supply chain (PSSC). This method integrates the modelling tool of e3value with the associated value measurement, evaluation and analysis techniques. It enables visualisation, modelling and optimisation of the business processes of a PSSC. At the same time, the value co-creation and potential contribution to an organisation’s profitability can also be enhanced. The findings not only facilitate organisations that are attempting to adopt servitisation by helping avert any paradox, but also help a servitised organisation to identify the key business processes and clarify their influences to supply chain operations.

The use of maturity models in improving project management performance:an empirical investigation

Purpose – The purpose of the paper was to conduct an empirical investigation to explore the impact of project management maturity models (PMMMs) on improving project performance. Design/methodology/approach – The investigation used a cross-case analysis involving over 90 individuals in seven organisations. Findings – The findings of the empirical investigation indicate that PMMMs demonstrate very high levels of variability in individual's assessment of project management maturity. Furthermore, at higher levels of maturity, the type of performance improvement adopted following their application is related to the type of PMMM used in the assessment. The paradox of the unreliability of PMMMs and their widespread acceptance is resolved by calling upon the “wisdom of crowds” phenomenon which has implications for the use of maturity model assessments in other arena. Research limitations/implications – The investigation does have the usual issues associated with case research, but the steps that have been taken in the cross-case construction and analysis have improved the overall robustness and extendibility of the findings. Practical implications – The tendency for PMMMs to shape improvements based on their own inherent structure needs further understanding. Originality/value – The use of empirical methods to investigate the link between project maturity models and extant changes in project management performance is highly novel and the findings that result from this have added resonance.

Translating Nietzsche, mediating literature: Alexander Tille and the limits of Anglo-German intercultural transfer

Dr. Alexander Tille (1866–1912) was one of the key-figures in Anglo-German intercultural transfer towards the end of the 19th century. As a lecturer in German at Glasgow University he was the first to translate and edit Nietzsche’s work into English. Writers such as W. B. Yeats were influenced by Nietzsche and used Tille’s translations. Tille’s social Darwinist reading of the philosopher’s oeuvre, however, had a narrowing impact on the reception of Nietzsche in the Anglo-Saxon world for decades. Through numerous publications Tille disseminated knowledge about British authors (e.g., Robert Louis Stevenson, William Wordsworth) in Germany and about German authors (e.g., Johann Wolfgang von Goethe) in Britain. His role as mediator also extended into areas such as history, religion, and industry. During the Boer war, however, Tille’s outspoken pro-German nationalism brought him in conflict with his British host society. After being physically attacked by his students he returned to Germany and published a highly anglophobic monograph. Tille personifies the paradox of Anglo-German relations in the pre-war years, which deteriorated despite an increase in intercultural transfer and knowledge about the respective Other.

Constitutional patriotism, migration and the post-national dilemma

This article addresses the challenges of justifying restrictions on migration given a rejection of nationalism as a defensible mode of political integration. Specifically, it focuses on constitutional patriotism, which is proposed as a means of making robust democratic practice possible in diverse contexts. Given that constitutional patriotism represents a commitment to universal principles as a source of attachment rather than the binding sentiment of nationalism, can we continue to rely on nationally defined and controlled migration practices? This article argues that, appropriately understood, constitutional patriotism implies a commitment to much freer movement of individuals across political boundaries than theorists have previously acknowledged. Applying such an approach, however, provokes some challenges to the sustainability of shared rule informed by principles rather than identity. This seeming paradox may mean that constitutional patriotism is more difficult to implement, and highlights practical challenges surrounding the liberalisation of border controls that are pertinent to theorists concerned with post-national citizenship more broadly conceived.

Did they ‘Read before burning’? The Coalition and quangos

Attitudes to quangos are paradoxical. On the one hand they are perceived to be undemocratic, unaccountable organisations, while on the other they are seen to improve effectiveness, limit political interference and increase public confidence in government. This paradox is reflected in the behaviour of political parties, which generally adopt a harsh line towards quangos in opposition, but come to rely on these bodies in office. Ahead of the 2010 general election it was, however, noticeable that the Conservative party rejected this dynamic by promising to pursue ‘a more sophisticated approach’. This article explores the Coalition government's subsequent ‘public bodies reform programme’, assessing its progress against recommendations contained within the Institute for Government's Read before Burning report of July 2010. It concludes that while the Coalition has addressed long-standing concerns about the day-to-day governance of public bodies, it has failed to resolve a set of broader and strategic (metagovernance) issues.

How does knowledge relate to political action?

In this paper we investigate the relation between knowledge and political action, focusing on knowledge claims stemming from science that at the same time have relevance in a policy context. In so doing, we will revisit some well-known and some lesser known approaches, such as C.P. Snow's thesis of the two cultures and Mannheim's conceptualization of theory and practice. We arrive at a distinction between knowledge for practice and practical knowledge, which we briefly apply to the case of climate change science and policy. We state as our thesis that policy is ever more reliant on knowledge, but science can deliver ever less certainty. Political decisions and programs have to recognize this fact, either implicitly or explicitly. This creates a paradox that is normally resolved through the political decision and not the dissemination of "truth" in the sense of uncontested knowledge. We use the case of the Intergovernmental Panel on Climate Change as an example. © 2012 Copyright ICCR Foundation.

A dual definition for the factor content of trade and its effect on factor rewards in US manufacturing sector

We introduce a dual definition of the Factor Content of Trade (FCT) using the concept of the Equivalent Autarky Equilibrium. Estimating a symmetric normalized quadratic revenue function for the U.S. manufacturing sector between 1965 and 1991, we find that the FCT for capital is positive, while the FCT for skilled and unskilled labor is negative, suggesting that the Leontief Paradox is not present. Then the growth rate of the factor rewards is decomposed to the FCT, endowments, and technological change effects. We find that technological change is the most important determinant in explaining wage inequality between skilled and unskilled labor.

The governance of justice and internal security in Scotland:between the Scottish independence referendum and British decisions on the EU

This article examines how the governance of justice and internal security in Scotland could be affected by the outcome of the Scottish independence referendum in September 2014. The article argues that it is currently impossible to equate a specific result in the referendum with a given outcome for the governance of justice and internal security in Scotland. This is because of the complexities of the current arrangements in that policy area and the existence of several changes that presently affect them and are outside the control of the government and of the people of Scotland. This article also identifies an important paradox. In the policy domain of justice and internal security, a ‘no’ vote could, in a specific set of circumstances, actually lead to more changes than a victory of the ‘yes’ camp.

Do women earn less even as social entrepreneurs? The gender pay gap among UK social enterprise directors

Based upon unique survey data collected using respondent driven sampling methods, we investigate whether there is a gender pay gap among social entrepreneurs in the UK. We find that women as social entrepreneurs earn 29% less than their male colleagues, above the average UK gender pay gap of 19%. We estimate the adjusted pay gap to be about 23% after controlling for a range of demographic, human capital and job characteristics, as well as personal preferences and values. These differences are hard to explain by discrimination since these CEOs set their own pay. Income may not be the only aim in an entrepreneurial career, so we also look at job satisfaction to proxy for non-monetary returns. We find female social entrepreneurs to be more satisfied with their job as a CEO of a social enterprise than their male counterparts. This result holds even when we control for the salary generated through the social enterprise. Our results extend research in labour economics on the gender pay gap as well as entrepreneurship research on women’s entrepreneurship to the novel context of social enterprise. It provides the first evidence for a “contented female social entrepreneur” paradox.

Szennyezéselhárítás és technológiai fejlődés a környezetgazdaságtanban – mikroökonómiai elemzés

A cikk újszerű módon csoportosítja a vállalat szennyezéselhárítási költségeit, s bemutatja, hogy az elhárítás során miként maximalizálhatja egy vállalat a profitját, valamint hogy a környezetvédelmi hatóságnak milyen mértékű emissziócsökkentés megvalósítására célszerű törekednie, ha a társadalmi szinten megjelenő hasznok lehető legmagasabb szintjét kívánja elérni. A tanulmány elemzi az extenzív, az intenzív és a nem környezetvédelmet szolgáló technológiai fejlődés optimális szennyezéskibocsátásra vonatkozó dinamikus hatását. Megismertet az intenzív környezetvédelem paradoxonával: egyes környezetbarát technológiák elterjedésével – bizonyos körülmények között – romlik az optimális szennyezettségi állapot. /===/ The article groups the enterprise costs of preventing pollution and shows how a firm can maximize its profit, as well as the volume of emission reduction the environmental conservation authority should purposefully strive after if it wants to attain the highest possible level of benefit appearing on societal level. The study analyses the dynamic impact of techological progress serving extensive and intensive conservation of the environment and of that not serving conservation on the optimum emission of pollution. It makes readers acquainted with the paradox of intensive conservation of the environment: the spreading of some environmentfriendly technologies impairs – under certain conditions – the optimum state of pollution.