An investigation of medicines returned to general practitioners and community pharmacies

Focal points: All returned medicines were monitored in eight community pharmacies and five general medical practices over a four-week period Returns were analysed for the type, quantity, absolute cost of the medicines, original quantity and date dispensed together with the reason for return A total of 298 items was returned to pharmacists and the reason for the return was a change or stop of therapy in 56 per cent of cases; 66 per cent of these were prescribed in a quantity of one month or greater A total of 42 items was returned to GPs and the reason for the return involved a change or stop of the therapy in 54 per cent of cases; 69 per cent of these were prescribed in a quantity of one month or greater Measures to implement a procedure to limit prescribed quantities upon initiation of therapy should help to reduce medicines wastage

Leadership and the negotiation of order in small groups

This thesis is focussed on the role differentiationhypothesis as it relates to small groups (Bales, 1958). The hypothesis is systematically examined, both conceptually and empirically, in the light of the Equilibrium Hypothesis (Bales, 1953) and the Negotiated Order Theory of leadership (e.g. Hosking, 1988). Chapter 1 sketches in a context for the research,which was stimulated by attempts during the 60s and 70s to organise small groups without leaders (the leaderless group, based on isocratic principles). Chapter 2 gives a conceptual and developmental overview of Bales' work, concentrating on the Equilibrium Hypothesis. It is argued that Bales' conceptual approach, if developed, can potentially integrate the disparate small groups and leadership literatures. Chapters 3 and 4 examine the concepts `group', `leader' and `leadership' in terms of the Negotiated Order perspective. In chapter 3 it is argued that two aspects of the concept group need to be taken separately into account; physical attributes and social psychological aspects (the metaphysical glue). It is further argued that a collection of people becomes a group only when they begin to establish a shared sense of social order. In chapter 4 it is argued that leadership is best viewed as a process of negotiation between those who influence and those who are influenced, in the context of shared values about means and ends. It is further argued that leadership is the process by which a shared sense of social order is established and maintained, thus linking the concepts `leadership' and `group' in a single formulation. The correspondences with Bales' approach are discussed at the end of the chapter. Chapters 5 to 8 present a detailed critical description and evaluation of the empirical work which claims to show role differentiation or test the hypothesis, both Bales original work and subsequent studies. It is argued here, that the measurement and analytical procedures adopted by Bales and others, in particular the use of simple means as summaries of group structures, are fundamentally flawed, and that role differentiation in relation to particular identifiable groups has not been demonstrated clearly anywhere in the literature. Chapters 9 to 13 present the empirical work conducted for the thesis. 18 small groups are examined systematically for evidence of role differentiation using an approach based on early sociometry (Moreno, 1934). The results suggest that role differentiation, as described by Bales, does not occur as often as is implied in the literature, and not equivocally in any case. In particular structures derived from Liking are typically distributed or weak. This suggests that one of Bales' principal findings, that Liking varies independently of his other main dimensions, is the product of statistical artifact. Chapter 14 presents a general summary of results and presents some considerations about future research.

Community involvement in urban nature conservation : case studies of the Urban Wildlife Group 1980-85

The effectiveness of the strategies employed by the Urban Wildlife Group (a voluntary conservation organisation) to provide and manage three urban nature parks has been evaluated, using a multiple methods methodology. Where the level of community interest and commitment to a project is high, the utilisation of the community nature park strategy (to maximise benefits to UWG and the community) is warranted. Where the level of interest and commitment of the local community is low, a strategy designed to encourage limited involvement of the community is most effective and efficient. The campaign strategy, whereby the community and UWG take direct action to oppose a threat of undesirable development on a nature park, is assessed to be a sub-strategy, rather than a strategy in its own right. Questionnaire surveys and observations studies have revealed that urban people appreciate and indeed demand access to nature parks in urban areas, which have similar amenity value to that provided by countryside recreation sites. Urban nature parks are valued for their natural character, natural features (trees, wild flowers) peace and quiet, wildlife and openness. People use these sites for a mixture of informal and mainly passive activities, such as walking and dog walking. They appear to be of particular value to children for physical and imaginative play. The exact input of time and resources that UWG has committed to the projects has depended on the level of input of the local authority. The evidence indicates that the necessary technical expertise needed to produce and manage urban nature parks, using a user-oriented approach is not adequately provided by local authorities. The methods used in this research are presented as an `evaluation kit' that may be used by practitioners and researchers to evaluate the effectiveness of a wide range of different open spaces and the strategies employed to provide and manage them.

Why organizational and community diversity matter:the emergence of incivility and organizational outcomes

Integrating sociological and psychological perspectives, this research considers the value of organizational ethnic diversity as a function of community diversity. Employee and patient surveys, census data, and performance indexes relevant to 142 hospitals in the United Kingdom suggest that intraorganizational ethnic diversity is associated with reduced civility toward patients. However, the degree to which organizational demography was representative of community demography was positively related to civility experienced by patients and ultimately enhanced organizational performance. These findings underscore the understudied effects of community context and imply that intergroup biases manifested in incivility toward out-group members hinder organizational performance.

Evaluating authentic behaviour change in leadership development programmes

The global economic crisis that hit the western countries strongly has emphasised the need to abandon the economic-performance significance of leadership and return to a meaning-making significance. While a lot of research has been done in the field of leadership and management disciplines, little has been done on how to develop leadership. This study evaluated the degree in which leadership training in the market-place today was effective at developing authentic leadership and, therefore, at changing individual behaviour. Since none of the leadership theories address how behavioural change is actually achieved, theories of change were integrated in the current study. A conceptual model combining Authentic Leadership Development (ALD) theory and the Theory of Planned Behaviour (TPB) was proposed. Furthermore, this study explored the relationship between a positive contemplation of change and the actual change observed in individuals after the leadership intervention. In order to test this conceptualisation, a longitudinal quasi-experimental study was conducted. Leaders were surveyed in this study one month before and one month after the programme. Three complementary questionnaires were distributed to participants in one of four leadership development programmes (two corporate initiatives and two business-school programmes). Analyses showed that leaders who attended a leadership intervention (as compared to a control group) developed higher levels of authentic leadership, as rated by them-selves and others in their working environment and controlling for baseline scores. The results also indicated that intentions were developed through the interventions and that the development of such intentions translated into changes in authentic behaviour. Intentions mediated the relationship between attitude and authentic leader-ship. In addition, when contemplation of change was high and attitudes towards authentic leadership were positive, the development of intentions was stronger. The implications of these findings for the theory and practice of leadership development programmes and the impact on organisational performance are discussed.

A study into the effectiveness of quality management training:a focus on tools and critical success factors

Purpose ��� The purpose of this paper is to investigate the effectiveness of quality management training by reviewing commonly used critical success factors and tools rather than the overall methodological approach. Design/methodology/approach ��� The methodology used a web-based questionnaire. It consisted of 238 questions covering 77 tools and 30 critical success factors selected from leading academic and practitioner sources. The survey had 79 usable responses and the data were analysed using relevant statistical quality management tools. The results were validated in a series of structured workshops with quality management experts. Findings ��� Findings show that in general most of the critical success factor statements for quality management are agreed with, although not all are implemented well. The findings also show that many quality tools are not known or understood well; and that training has an important role in raising their awareness and making sure they are used correctly. Research limitations/implications ��� Generalisations are limited by the UK-centric nature of the sample. Practical implications ��� The practical implications are discussed for organisations implementing quality management initiatives, training organisations revising their quality management syllabi and academic institutions teaching quality management. Originality/value ��� Most recent surveys have been aimed at methodological levels (i.e. ���lean���, ���Six Sigma���, ���total quality management��� etc.); this research proposes that this has limited value as many of the tools and critical success factors are common to most of the methodologies. Therefore, quite uniquely, this research focuses on the tools and critical success factors. Additionally, other recent comparable surveys have been less comprehensive and not focused on training issues.

The French fifth Republic as an opportunity structure:a neo-institutional and cultural approach to the study of leadership politics

The Gaullist settlement of 1958 reconfigured the political institutions of France, introducing into the republican mainstream a new form of leadership politics. Adapting the literature on political opportunity structure (POS) theory, and using the French left as a case study, can help us understand how political parties, ideology and leadership adapt to political institutions and norms. It also illuminates what the consequences are of such adaptation in the contemporary period, particularly as regards the institutionally bound roles of political 'character', protocol and discourse. The paper appraises the relevance and appropriateness of POS theory to leadership politics in France.

Congenital prosopagnosia in a child:neuropsychological assessment, eye movement recordings and training

Here we report the assessment and treatment of a 6-year-old boy (L.G.) who was referred to us for congenital prosopagnosia (CP). We investigated his performance using a test battery and eye movement recordings pre- and post-training. L.G. showed deficits in recognising relatives and learning new faces, and misrecognition of unfamiliar people. Eye movement recordings showed that L.G. focused on the lower part of stimuli in naming tasks based on familiar or unfamiliar incomplete or complete faces. The training focused on improving his ability to explore internal features of faces, to discriminate specific facial features of familiar and unfamiliar faces, and to provide his family with strategies to use in the future. At the end of the training programme L.G. no longer failed to recognise close and distant relatives and classmates and did not falsely recognise unknown people.

The MG Rover closure and policy response: an evaluation of the Task Force model in the UK

In recent years there have been a number of high-profile plant closures in the UK. In several cases, the policy response has included setting up a task force to deal with the impacts of the closure. It can be hypothesised that task force involving multi-level working across territorial boundaries and tiers of government is crucial to devising a policy response tailored to people's needs and to ensuring success in dealing with the immediate impacts of a closure. This suggests that leadership, and vision, partnership working and community engagement, and delivery of high quality services are important. This paper looks at the case of the MG Rover closure in 2005, to examine the extent to which the policy response to the closure at the national, regional and local levels dealt effectively with the immediate impacts of the closure, and the lessons that can be learned from the experience. Such lessons are of particular relevance given the closure of the LDV van plant in Birmingham in 2009 and more broadly ��� such as in the case of the downsizing of the Opel operation in Europe following its takeover by Magna.

Development and Application of a Methodology to Identify Projects of Energy Community Interest

Projects of Energy Community Interest��� (PECIs) is a label attached to those projects which have the highest positive impact in the largest possible number of Contracting Parties. The assessment of one hundred projects submitted as candidates, and final selection of 35 PECIs was achieved in a collaborative process undertaken by the same Task Force that contributed to the preparation of the Energy Strategy. Chaired by the European Commission, the Task Force was facilitated by the Energy Community Secretariat and benefited from technical assistance of a Consultant sponsored from the Energy Community budget.

Haitians in Miami: An Assessment of Their Background and Potential (Dialogue #12)

EXECUTIVE SUMMARY Our research on Haitians in Miami reveals the common stereotypes to be wrong in virtually every respect. Miami Haitians are not a significant drain on community resources. They did not come to the U.S. anticipating benefits from the welfare system. They are not uneducated nor are they unskilled. To the contrary, Miami Haitians have a tremendous potential for productively contributing to U.S. society. They are well educated by Haitian standards and many come with readily employable skills. Their motivations for leaving Haiti are inseparably both political and economic. They possess a sound work ethic and are striving to improve themselves. Economic problems are severe, yet they confront and surmount them with virtually no help from the state welfare system. They rely largely upon opportunities and resources within Miami's own Haitian community. Yet, they do not isolate themselves from the large community around them. They work with, buy from, and live in the same neighborhoods as Cubans, Anglos, and American Blacks. In spite of the many personal difficulties they have encountered since arriving in the U.S., they maintain a positive view both of themselves and their experiences in U.S. society. If given sufficient opportunities, they are likely to adapt quickly and succeed economically. These findings stem from a recently completed survey of 129 Haitians enrolled in English for Speakers of Other Languages (ESOL) classes in Miami administered by the Haitian Adult Development Education Program (HADEP) of the Phelps Stokes Fund. The U.S. Department of Education funded the project to provide instruction in English communication and literacy skills, acculturation support and vocational training. The classes were free and open without restrictions to all Haitians. The Haitians neither paid nor received money to attend the classes. The classes were offered both during the day and evening and drew from all levels of the Haitian population in Miami. The survey was administered in June and July of this year and consisted of 146 questions in Creole on a broad range of subjects from background and experiences in Haiti to migration and employment history and perceptions of U.S. society.

An evaluation of child welfare inservice training: The relative effectiveness of substance abuse content in improving worker knowledge and attitudes

Given the seriousness of substance abuse as a child welfare problem, the purpose of this study was to examine the relative effectiveness of an inservice training curriculum for child welfare workers. The training was designed to improve worker knowledge and attitudes in working with substance abusing families. Seventy (70) child welfare workers from public and private agencies in two south Florida counties participated in a pretest/posttest control group design that also trained and retested the control group. The literature review supports that the general preparedness of child welfare workers for the issues presented by substance abusing families is in question. Confounding this problem is a lack of understanding of substance abuse dynamics, worker biases, and predispositions. The two research hypotheses focused on whether inservice training could increase worker knowledge and improve worker attitudes in working with this population. Training delivery was in the form of a five-day inservice focusing on an array of substance abuse knowledge and attitudinal topics. Separate knowledge and attitude instruments were developed for the research and were administered, before and after training, to a purposive sample of participants that were randomly assigned to the experimental and control groups. The data analysis supported the research hypotheses but raised a question. Specifically, the experimental group demonstrated significant improvement in posttest scores on both instruments after receiving the training; whereas the control group, with training withheld, also demonstrated a significant improvement at posttest, but only on the knowledge instrument. Although the question was unanswered, when examined at a more critical significance level, only the experimental group remained significant. The hypotheses were reconfirmed when, after training and retesting, the control group also displayed significant improvement on both instruments. The findings support the conclusion that this substance abuse inservice was effective in improving worker knowledge and attitudes regarding working with substance abusing families. As an implication for social work practice, it suggests that similar inservice training can be a viable training resource when formal substance abuse training is unavailable. Additional research is suggested regarding to what degree increased substance abuse knowledge and improved worker attitudes correlate with improved practice.

A comparison of the impact of trained media specialists and untrained media personnel in junior colleges in the Republic of China

From educational, communications, psychological, and technical points of view, the renovation of pedagogy in media education is based upon the promotion of "educational technology." The promotion of educational technology relies upon the appropriate availability and knowledge of different educational media made available by the trained media personnel.^ In the past three decades most of the junior colleges in Taiwan set up educational media centers to help students learn through the use of media which enables them to obtain optimum benefits in a short time. What are the roles the media personnel play in the media center? What responsibilities have they to bear in the center? What differences are there when a trained and untrained media personnel are presented in junior colleges media center in Taiwan? What do the trained and untrained media personnel feel toward the importance of each media service in the area of media center's administration, media production, specialized media duties, and the training of staff in media use? These are the questions addressed in this study.^ Through the study of the related literature and a survey conducted in the junior colleges in Taiwan, recommendations are offered to provide improvement of the services and training of media specialists in Taiwan that are appropriate for a changing work and environment. These recommendations are for media specialists to be formally trained to effectively serve the changing needs of school library media so as to make optimal use of media in the junior colleges. ^

The choice not to use computers: A case study of community college faculty who do not use computers in teaching

The primary purpose of this investigation is to study the motives of community college faculty who decide not to use computers in teaching. In spite of the fact that many of the environmental blocks that would otherwise inhibit the use of the computers have been eliminated at many institutions, many faculty do not use a computer beyond its word-processing function. For the purpose of the study non-adoption of computers in teaching is defined as not using computers for more than word-processing. ^ The issues in the literature focus on resistance and assume a pro-innovation and pro-adoption bias. Previous research on the questions is primarily surveys with narrowly focused assumptions. This qualitative research directly asks the participants about their feelings, beliefs, attitudes, experiences, and behaviors in regard to computers in teaching. Through the interview process a number of other correlated issues emerge. ^ The investigation was conducted at Miami-Dade Community College, a large urban multicampus institution, in Miami-Dade, Florida. It was conducted through a series of in-depth phenomenological interviews. There were nine interviews; eight within the profile; two were pilots; and one was an extreme opposite of the profile. Each participant was interviewed three times for about 45 minutes. ^ The results indicate that the computer conflicts with the participants' values in regard to their teaching and their beliefs in regard to the nature of knowledge, learning, and the relationship that they wish to maintain with students. Computers require significant changes in the values, beliefs, and consequent behaviors. These are changes that the participants are not willing to make without overwhelming evidence that they are worth the sacrifice. For the participants, this worth is only definable as it positively improves learning. For even the experts the evidence is not there. Unlike the innovator, the high end computer user, these participants are not willing to adopt the computer on faith. ^

A case study of the Ellison model's use of mentoring as an approach toward inclusive community building

The Ellison Executive Mentoring Inclusive Community Building (ICB) Model is a paradigm for initiating and implementing projects utilizing executives and professionals from a variety of fields and industries, university students, and pre-college students. The model emphasizes adherence to ethical values and promotes inclusiveness in community development. It is a hierarchical model in which actors in each succeeding level of operation serve as mentors to the next. Through a three-step process���content, process, and product���participants must be trained with this mentoring and apprenticeship paradigm in conflict resolution, and they receive sensitivity and diversity training through an interactive and dramatic exposition. ^ The content phase introduces participants to the model's philosophy, ethics, values and methods of operation. The process used to teach and reinforce its precepts is the mentoring and apprenticeship activities and projects in which the participants engage and whose end product demonstrates their knowledge and understanding of the model's concepts. This study sought to ascertain from the participants' perspectives whether the model's mentoring approach is an effective means of fostering inclusiveness, based upon their own experiences in using it. The research utilized a qualitative approach and included data from field observations, individual and group interviews, and written accounts of participants' attitudes. ^ Participants complete ICB projects utilizing The Ellison Model as a method of development and implementation. They generally perceive that the model is a viable tool for dealing with diversity issues whether at work, at school, or at home. The projects are also instructional in that whether participants are mentored or serve as apprentices, they gain useful skills and knowledge about their careers. Since the model is relatively new, there is ample room for research in a variety of areas including organizational studies to determine its effectiveness in combating problems related to various kinds of discrimination. ^