Medicines optimisation for young people with juvenile arthritis and other long-term conditions:system-level barriers to engagement

To explore the views of pharmacy and rheumatology stakeholders about system-related barriers to medicines optimisation activities with young people with long-term conditions. A three-phase consensus-building study comprising (1) focus groups with community and hospital pharmacists; (2) semi-structured telephone interviews with lay and professional adolescent rheumatology stakeholders and pharmacy policymakers, and (3) multidisciplinary discussion groups with community and hospital pharmacists and rheumatology staff. Qualitative verbatim transcripts from phases 1 and 2 were subjected to framework analysis. Themes from phase 1 underpinned a briefing for phase 2 interviewees. Themes from phases 1 and 2 generated elements of good pharmacy practice and current/future pharmacy roles for ranking in phase 3. Results from phase 3 prioritisation and ranking exercises were captured on self-completion data collection forms, entered into an Excel spreadsheet and subjected to descriptive statistical analysis. Institutional ethical approval was given by Aston University Health and Life Sciences Research Ethics Committee. Four focus groups were conducted with 18 pharmacists across England, Scotland and Wales (7 hospital, 10 community and 1 community/public health). Fifteen stakeholders took part in telephone interviews (3 pharmacist commissioners; 2 pharmacist policymakers; 2 pharmacy staff members (1 community and 1 hospital); 4 rheumatologists; 1 specialist nurse, and 3 lay juvenile arthritis advocates). Twenty-five participants took part in three discussion groups in adolescent rheumatology centres across England and Scotland (9 community pharmacists; 4 hospital pharmacists; 6 rheumatologists; 5 specialist nurses, and 1 physiotherapist). In all phases of the study, system-level issues were acknowledged as barriers to more engagement with young people and families. Community pharmacists in the focus groups reported that opportunities for engaging with young people were low if parents collected prescriptions alone, which was agreed by other stakeholders. Moreover, institutional/company prescription collection policies – an activity largely disallowed for a young person under 16 without an accompanying parent - were identified by hospital and community pharmacists as barriers to open discussion and engagement. Few community pharmacists reported using Medicines Use Review (England/Wales) or Chronic Medication Service (Scotland) as a medicines optimisation activity with young people; many were unsure about consent procedures. Despite these limitations, rheumatology stakeholders ranked highly the potential of pharmacists empowering young people with general health care skills, such as repeat prescription ordering. The pharmacy profession lacks vision for its role in the care of young people with long-term conditions. Pharmacists and rheumatology stakeholders identified system-level barriers to more engagement with young people who take medicines regularly. We acknowledge that the modest number of participants may have had a specific interest and thus bias for the topic, but this underscores their frank admission of the challenges. Professional guidance and policy, practice frameworks and institutional/company policies must promote flexibility for pharmacy staff to recognise and empower young people who are able to give consent and take responsibility for medicines activities. This will increase mutual confidence and trust, and foster pharmacy’s role in teaching general health care skills. In this way, pharmacists will be able to build long-term relationships with young people and families.

A rendszerváltás után alapított és nemzetközileg sikeressé vált magyar vállalatok versenyképessége = The competitiveness of Hungarian companies that were founded and became successful internationally after the change of the economic system

A műhelytanulmány annak a kutatási munkának az első eredménye, amelyben a rendszerváltás után nemzetközileg sikeressé vált magyar vállalatok sikertényezőinek elemzését tűztük ki célul. A kérdés jelentőségét abban látjuk, hogy a magyar piac korlátozott belső nagysága miatt a sikeres magyar vállalatok számára a külföldön való terjeszkedés megkerülhetetlen stratégiai követelmény. A mélyinterjúkon alapuló kutatáshoz szakirodalmi áttekintést végeztünk, összeállítottuk kutatási propozíciónkat, kidolgoztuk a mélyinterjúknál használandó kérdéslistát. Ez a műhelytanulmány az első két mélyinterjú anyagát tartalmazza, de kidolgozás és előkészítés alatt vannak további vállalati esettanulmányok is. ----- This working paper presents the first results of our research project aiming to analyze the success factors of Hungarian companies that became successful internationally after the change in the economic system in Hungary. We believe this is a significant topic as international expansion for successful Hungarian companies is a strategic requirement, due to the limited size of domestic markets. Our research is methodologically based on in-depth interviews, backed by literature review. We have developed propositions and an outline for semi-structured interviews. This working paper covers the recorded material of two in-depth interviews of executives from two different companies, while additional case studies are still being prepared.

Egységes kockázatkezelési módszertan kialakítása a villamosenergia-ipari átviteli rendszerirányító társaságnál (Development of an integrated risk management methodology for an electricity transmission system operator (TSO) company)

A felelős vállalatirányítás egyik stratégiai jelentőségű tényezője a vállalati szintű kockázatkezelés, mely napjaink egyik legnagyobb kihívást jelentő területe a vállalatvezetés számára. A hatékony vállalati kockázatkezelés nem valósulhat meg kizárólag az általános, nemzetközi és hazai szakirodalomban megfogalmazott kockázatkezelési alapelvek követése mentén, a kockázatkezelési rendszer kialakítása során figyelembe kell venni mind az iparági, mind az adott vállalatra jellemző sajátosságokat. Mindez különösen fontos egy olyan speciális tevékenységet folytató vállalatnál, mint a villamosenergia-ipari átviteli rendszerirányító társaság (transmission system operator, TSO). A cikkben a magyar villamosenergia-ipari átviteli rendszerirányító társasággal együttműködésben készített kutatás keretében előálló olyan komplex elméleti és gyakorlati keretrendszert mutatnak be a szerzők, mely alapján az átviteli rendszerirányító társaság számára kialakítottak egy új, területenként egységes kockázatkezelési módszertant (fókuszban a kockázatok azonosításának és számszerűsítésének módszertani lépéseivel), mely alkalmas a vállalati szintű kockázati kitettség meghatározására. _______ This study handles one of today’s most challenging areas of enterprise management: the development and introduction of an integrated and efficient risk management system. For companies operating in specific network industries with a dominant market share and a key role in the national economy, such as electricity TSO’s, risk management is of stressed importance. The study introduces an innovative, mathematically and statistically grounded as well as economically reasoned management approach for the identification, individual effect calculation and summation of risk factors. Every building block is customized for the organizational structure and operating environment of the TSO. While the identification phase guarantees all-inclusivity, the calculation phase incorporates expert techniques and Monte Carlo simulation and the summation phase presents an expected combined distribution and value effect of risks on the company’s profit lines based on the previously undiscovered correlations between individual risk factors.

Adatbányászati alkalmazások lehetőségei egy multinacionális vállalat magyarországi leányvállalatának információs rendszerében (Opportunities of datamining applications in the information system of a multinational company’s Hungarian subsidiary)

A tanulmány Magyarország egyik legnagyobb foglalkoztatójának megrendelésére készült abból a célból, hogy milyen megoldásokkal lehetne a vállalati működést hatékonyabbá tenni. Ennek keretében a szerzők megvizsgálták, hol tart ma a HR adatbányászati kutatás a világban. Milyen eszközök állnak rendelkezésre ahhoz, hogy a munkavállalói elmenetelt előre jelezzék, illetve figyeljék, valamint milyen lehetőség van a hálózati kutatások felhasználására a biztonság területén. Szerencsés, hogy a vállalkozói kérdések és erőforrások találkozhattak a kutatói szféra aktuális kutatási területeivel. A tanulmány szerzői úgy gondolják, hogy a cikkben megfogalmazott állítások, következtetések, eredmények a jövőben hasznosíthatók lesznek a vállalat és más cégek számára is. _____ The authors were pleased to take part in this research project initiated by one of Hungary’s largest employer. The goal of the project was to work out BI solutions to improve upon their business process. In the framework of the project first the authors made a survey on the current trends in the world of HR datamining. They reviewed the available tools for the prediction of employee promotion and investigated the question on how to utilize results achieved in social network analysis in the field of enterprise security. When real business problems and resources meet the mainstream research of the scientific community it is always a fortunate and it is rather fruitful. The authors are certain that the results published in this document will be beneficial for Foxconn in the near future. Of course, they are not done. There are continually new research perspectives opening up and huge amount of information is accumulating in the enterprises just waiting for getting discovered and analysed. Also the environment in which an enterprise operates is dynamically changing and thus the company faces new challenges and new type of business problems arise. The authors are in the hope that their research experience will help decision makers also in the future to solve real world business problems.

US Screening and Evaluation System of Inventions Utilized in Hungary

The commercialization of inventions is very complex and challenging therefore it requires the collaboration of several actors in an economy. Even when an invention possesses significant added value, its successful commercialization could only be executed in a stable macroeconomic and innovation environment and also if proper innovation management expertise is provided. ValDeal Innovations Zrt. was established to foster the commercialization of Hungarian, high business potential inventions by providing its business expertise. The company used an – already in various markets and countries probed – US innovation management method consisting of the tasks of technology evaluation as well as the commercialization of inventions. There were major changes necessary while probing the US method residing in the different macroeconomic circumstances and the attitudes for innovation in Hungary. The article details the above mentioned issues together with the conclusions the members of ValDeal have drawn during the innovation management process.

Ecosystems as climate controllers – biotic feedbacks (a review)

There is good evidence that higher global temperature will promote a rise of green house gas levels, implying a positive feedback which will increase the effect of the anthropogenic emissions on global temperatures. Here we present a review about the results which deal with the possible feedbacks between ecosystems and the climate system. There are a lot of types of feedback which are classified. Some circulation models are compared to each other regarding their role in interactive carbon cycle.

Az egyéni teljesítményértékelési rendszer működésének tapasztalatai a magyar közigazgatásban (Operating experiences of the individual performance appraisal system in the Hungarian public sector)

A tanulmány – egy 2005 végén lefolytatott, országosan reprezentatív kérdőíves felmérés empirikus bázisán – a magyar közigazgatási dolgozók körében 2002-től bevezetett egyéni teljesítményértékelési rendszert vizsgálja. A rendszer egészét tekintve a vizsgálat végkövetkeztetései nem túl rózsásak: az eredmények arra utalnak, hogy a rendszer mint egész nem képes kitűzött fő célját, a munkateljesítmények javítását elérni. Az egyes részrendszerek, szervezettípusok szintjén differenciáltabb eredményeket kapunk, míg a minisztériumokban a rendszer egésze a szándékolttól alapvetően különböző célokat látszik szolgálni, addig a többi szervezettípusnál inkább „csak” a rendszer tökéletlen működéséről beszélhetünk. ____ On the basis of a questionnaire survey of a nationally representative sample of Hungarian civil servants, the study attempts to give a preliminary evaluation of the individual performance assessment system introduced in 2002 throughout the Hungarian civil service. The general conclusion of the analysis is that the performance assessment system is unlikely to reach its goals: its central element, the performance related pay incentives are overly dispersed and, on the average, insignificant in size, meanwhile the objectivity of performance assessments is also questionable. Moreover, comparative analysis of responses from different administrative branches reveals an interesting idiosyncrasy characteristic for central government ministries. Here, the main function of the incentive system seems to be ensuring the labor market competitiveness of the ministries as employers by enabling them to pay higher-than-usual salaries for employees having certain types of expertise.

Az SAP-rendszer fejlesztése egy műanyag-feldolgozó vállalatnál (Development of SAP system in a plastic manufacturing company)

Az SAP-rendszernek a kontrollingszervezetek működésére gyakorolt pozitív hatása nem titok. A visszacsatolás lehetőségének biztosításával alkalom nyílik a szervezetek tevékenységének követésére, ellenőrzésére, felülbírálására. A logisztika mint az egész vállalatot átszövő rendszer, működésének nyomon követése is létfontosságúvá vált, hiszen összetettségéből kifolyólag jellegzetességei, színvonala az egész rendszerre hatást gyakorol. A logisztikai rendszer és folyamatainak figyelemmel kísérésére a logisztikai kontrollingrendszer nyújt megoldást, visszacsatolási pontjain keresztül. A műanyag-feldolgozó vállalat esetében a szervezeti SAP-rendszer logisztikai kontrollingterületének fejlesztésétől várják a szervezeti hatékonyság emelkedését és a jobb színvonal elérését. _____ Positive effect of the SAP system on the operation of controlling organisations has not been a secret. Opportunity of the feedback will be possible to track, control, override operation of the organisations. The logistic controlling system provides a solution through feedback points for monitoring the logistic system and processes. In the case of plastics manufacturing company the increasing of organisational efficiency and achievement of a better standard is anticipated from development of logistic controlling area of the organisational SAP system.

Vágyott kultúra és reális értékítélet - Tudásmenedzsment-rendszer kiépítésének előfeltétele egy felsőoktatási intézményben (Desired culture and real value judgement – Precondition of development a knowledge management system in a higher education institution)

A tudásmenedzsment-rendszerek kiépítése és működtetése egyre népszerűbb vállalati cél. A legnagyobb igyekezet ellenére is kudarccal végződhet egy ilyen változás megvalósítása, ha a szükséges feltételek nélkül próbálkozunk ezzel a beavatkozással a szervezet életében. Az egyik legfontosabb előfeltétel a bizalomra, közös tanulásra, fejlődésre épülő, nyitott szervezeti kultúra, mely a tanulószervezeti jellemzőkkel írható le. A szerzők kutatásukban arra voltak kíváncsiak, milyen elképzeléseik, vágyaik vannak a felsőoktatásban oktató kollégáknak az ideálisnak nevezett szervezeti kultúráról. Ezeket az elképzeléseket egy külső tanácsadó cég által végzett kérdőíves felmérésen alapuló vizsgálat segítségével tudták meg, melynek kiértékelésére a circumplex-módszer szolgált. Az eredményeket összevetették a tanulószervezeti jellemzőkkel, vizsgálva azt a hipotézist, miszerint az oktató kollégák tudat alatt is olyan ideális szervezetet képzelnek el, mely a tanulószervezeti kultúra jellemzőivel azonos. _________ To create and to operate a knowledge management system is becoming a more and more popular target of the companies. Realizing the changes above can result in a failure – in spite of the biggest will – if organizations lack certain prerequisites which are necessary in companies’ lives. One of the most important prerequisites is organizational culture which can be characterized by confidence, common learning, development and open atmosphere. This is called a learning organizational culture. In their research the authors would have liked to know what kind of dreams the colleagues have about their own organizational culture. They achieve these results from an investigation with questionnaires which were realized by an advisory team. To evaluating the results of this investigation circumplex method was used. These results were compared with the characteristics of learning organization to confirm our hypothesis. According to this idea colleagues have the same images about their successful organization as the characteristics of learning organizations.

Recent Developments in the Autonomy and Governance of Higher Education Institutions in Hungary: the Introduction of the Chancellor System

After the change of regime in 1989, Hungarian higher education started to return to its Humboldtian tradition. It was widely accepted that academic freedom could be guaranteed by high degree of institutional autonomy manifested especially in structures of self-governance and avoidance of direct state supervision/interventions. Attempts to introduce boards and other supervising bodies were successfully resisted until 2011. The new government coming into power in 2010, however, introduced new mechanisms of supervision and changed institutional governance and reduced institutional autonomy considerably. Changes in the selection of rectors, the appearance of state-appointed financial inspectors and the newly appointed Chancellors responsible for the finance, maintenance and administration of institutions are important milestones in this process. In the paper I review these developments focusing especially on the analysis of the Chancellor system.

A case study of the development of the Argentinean community college system

In the 1980's and 1990's, Argentina was undergoing significant political, social and economic changes as a result of the change over from a military driven government to elected governments. A major aspect of the change was an increased emphasis on privatization, and promotion of foreign and domestic investment in Argentina. Higher education leaders were increasingly drawn into developing a national strategy for changing the educational structure to help facilitate changes in other aspects of the society. Preliminary reviews by the Argentinean higher education leaders indicated that adaptation of the American community college promised to help achieve the national goals. ^ The purpose of this study was to determine: if and how the community college concept, an American invention, could be adapted to function in Argentina, a nation with a significantly different history of political, social, cultural and economic development. Achieving this purpose involved: identifying the key leaders in the movement that developed to apply the community college concept in Argentina; the study of their perspectives regarding the movement as it developed; and tracking the assistance given by selected American community college leaders. ^ The case study method was employed in this research, using interview and historical data collection. Key leaders from higher education in the United States and Argentina were interviewed in-depth, to determine their views. An interview protocol with appropriate sub-questions was followed to ensure complete coverage. The interviewees identified several major areas of education in need of change including, the system, access to the system, new areas of study, integration into the hemisphere and, in general, decentralization. Historical review revealed a steady development of the community college concept in Argentina reflected in documentation of events, conceptual writings and legal structures. ^ It was concluded that there is a community college structure beginning to emerge that, so far, in broad outline, follows the structure developed in the United States. It is anticipated however, that future developments will include conceptual aspects to the model reflective of Argentina. ^

An assessment of computer usage within the Bahamian public school system and recommended guidelines towards the development of a strategic national computer plan

Computers have dramatically changed the way we live, conduct business, and deliver education. They have infiltrated the Bahamian public school system to the extent that many educators now feel the need for a national plan. The development of such a plan is a challenging undertaking, especially in developing countries where physical, financial, and human resources are scarce. This study assessed the situation with regard to computers within the Bahamian public school system, and provided recommended guidelines to the Bahamian government based on the results of a survey, the body of knowledge about trends in computer usage in schools, and the country's needs. ^ This was a descriptive study for which an extensive review of literature in areas of computer hardware, software, teacher training, research, curriculum, support services and local context variables was undertaken. One objective of the study was to establish what should or could be relative to the state-of-the-art in educational computing. A survey was conducted involving 201 teachers and 51 school administrators from 60 randomly selected Bahamian public schools. A random stratified cluster sampling technique was used. ^ This study used both quantitative and qualitative research methodologies. Quantitative methods were used to summarize the data about numbers and types of computers, categories of software available, peripheral equipment, and related topics through the use of forced-choice questions in a survey instrument. Results of these were displayed in tables and charts. Qualitative methods, data synthesis and content analysis, were used to analyze the non-numeric data obtained from open-ended questions on teachers' and school administrators' questionnaires, such as those regarding teachers' perceptions and attitudes about computers and their use in classrooms. Also, interpretative methodologies were used to analyze the qualitative results of several interviews conducted with senior public school system's officials. Content analysis was used to gather data from the literature on topics pertaining to the study. ^ Based on the literature review and the data gathered for this study a number of recommendations are presented. These recommendations may be used by the government of the Commonwealth of The Bahamas to establish policies with regard to the use of computers within the public school system. ^

Evaluating and Selecting a Property Management System

In his study - Evaluating and Selecting a Property Management System - by Galen Collins, Assistant Professor, School of Hotel and Restaurant Management, Northern Arizona University, Assistant Professor Collins states briefly at the outset: “Computerizing a property requires a game plan. Many have selected a Property Management System without much forethought and have been unhappy with the final results. The author discusses the major factors that must be taken into consideration in the selection of a PMS, based on his personal experience.” Although, this article was written in the year 1988 and some information contained may be dated, there are many salient points to consider. “Technological advances have encouraged many hospitality operators to rethink how information should be processed, stored, retrieved, and analyzed,” offers Collins. “Research has led to the implementation of various cost-effective applications addressing almost every phase of operations,” he says in introducing the computer technology germane to many PMS functions. Professor Collins talks about the Request for Proposal, its conditions and its relevance in negotiating a PMS system. The author also wants the system buyer to be aware [not necessarily beware] of vendor recommendations, and not to rely solely on them. Exercising forethought will help in avoiding the drawback of purchasing an inadequate PMS system. Remember, the vendor is there first and foremost to sell you a system. This doesn’t necessarily mean that the adjectives unreliable and unethical are on the table, but do be advised. Professor Collins presents a graphic outline for the Weighted Average Approach to Scoring Vendor Evaluations. Among the elements to be considered in evaluating a PMS system, and there are several analyzed in this essay, Professor Collins advises that a perspective buyer not overlook the service factor when choosing a PMS system. Service is an important element to contemplate. “In a hotel environment, the special emphasis should be on service. System downtime can be costly and aggravating and will happen periodically,” Collins warns. Professor Collins also examines the topic of PMS system environment; of which the importance of such a factor should not be underestimated. “The design of the computer system should be based on the physical layout of the property and the projected workloads. The heart of the system, housed in a protected, isolated area, can support work stations strategically located throughout the property,” Professor Collins provides. A Property Profile Description is outlined in Table 1. The author would also point out that ease-of-operation is another significant factor to think about. “A user-friendly software package allows the user to easily move through the program without encountering frustrating obstacles,” says Collins. “Programs that require users to memorize abstract abbreviations, codes, and information to carry out standard routines should be avoided,” he counsels.

Application of a PERT-Type System and "Crashing" in a Food Service Operation

A pert-type system, a combination of the program evaluation and review technique (PERT) and the critical path method (CPM), might be used by the hospitality industry to improve planning and control of complex functions. The author discusses this management science technique and how it can assist.

Near Term Computer Management Strategy For Hospitality Managers and Computer System Vendors

In his dialogue - Near Term Computer Management Strategy For Hospitality Managers and Computer System Vendors - by William O'Brien, Associate Professor, School of Hospitality Management at Florida International University, Associate Professor O’Brien initially states: “The computer revolution has only just begun. Rapid improvement in hardware will continue into the foreseeable future; over the last five years it has set the stage for more significant improvements in software technology still to come. John Naisbitt's information electronics economy¹ based on the creation and distribution of information has already arrived and as computer devices improve, hospitality managers will increasingly do at least a portion of their work with software tools.” At the time of this writing Assistant Professor O’Brien will have you know, contrary to what some people might think, the computer revolution is not over, it’s just beginning; it’s just an embryo. Computer technology will only continue to develop and expand, says O’Brien with citation. “A complacent few of us who feel “we have survived the computer revolution” will miss opportunities as a new wave of technology moves through the hospitality industry,” says ‘Professor O’Brien. “Both managers who buy technology and vendors who sell it can profit from strategy based on understanding the wave of technological innovation,” is his informed opinion. Property managers who embrace rather than eschew innovation, in this case computer technology, will benefit greatly from this new science in hospitality management, O’Brien says. “The manager who is not alert to or misunderstands the nature of this wave of innovation will be the constant victim of technology,” he advises. On the vendor side of the equation, O’Brien observes, “Computer-wise hospitality managers want systems which are easier and more profitable to operate. Some view their own industry as being somewhat behind the times… They plan to pay significantly less for better computer devices. Their high expectations are fed by vendor marketing efforts…” he says. O’Brien warns against taking a gamble on a risky computer system by falling victim to un-substantiated claims and pie-in-the-sky promises. He recommends affiliating with turn-key vendors who provide hardware, software, and training, or soliciting the help of large mainstream vendors such as IBM, NCR, or Apple. Many experts agree that the computer revolution has merely and genuinely morphed into the software revolution, informs O’Brien; “…recognizing that a computer is nothing but a box in which programs run.” Yes, some of the empirical data in this article is dated by now, but the core philosophy of advancing technology, and properties continually tapping current knowledge is sound.