An exploration of consultation skills in community pharmacists

Abstract An exploration of consultation skills in community pharmacists By: Ahmed Al-Nagar Keywords Community pharmacy, consultation skills, pharmacist consultations, pharmacist consultation skills, training of pharmacist Background The role of the community pharmacist has evolved from compounding and dispensing to providing patient focused services which require more patient interaction. Previous research has described pharmacist consultation skills as not optimal or patient centred. The aim of the thesis was to add an in depth understanding about the possible reasons behind this. Method The thesis comprises three studies; the first study used focus groups to investigate community pharmacists’ experiences and perceptions of their consultations with patients. The second study was the first nationwide questionnaire based study to investigate consultation skills training received by community pharmacists. The final study was a feasibility study to investigate the use of an innovative interactional-analysis methodology known as the Roter Interactional Analysis to audio recorded community pharmacy consultations. Results The results showed while community pharmacists enjoy speaking to patients, a number of factors limit the quality of these interactions. The nationwide questionnaire results indicates that a large number of community pharmacists have not had any formal consultation skills training and seek more advanced consultation skills training. Analysis showed consultation skills training could influence confidence and had a positive impact on the delivery of more patient facing services. The use of an interactional analysis system is a useful tool to develop future consultation skills training in community pharmacy. Conclusion The thesis has provided a more in depth understanding of the consultation based challenges facing community pharmacists, community pharmacy as a profession and researchers investigating pharmacist-patient interaction. It has also identified many areas which require further development if community pharmacists are going to undertake high quality consultations. It will be important for these to be fully considered if any future proposed changes to community pharmacy roles are to be successful

Developing a mode choice model for New Zealand freight transportation.

The aim of this research was to construct a freight mode choice model, from the perspective of New Zealand freight shippers, identifying the possibility of mode substitution effects. Shipper’s freight modal choice depends on freight demand and infrastructure as well as the quality of service characteristics of alternative modes, such as transport cost, delivery time, reliability, damage and loss and frequency of service. Freight logistics characteristics, such as the attributes of the shipper, the attributes of the commodities to be transported, and the spatial attributes of shipments, strongly influence modal choice. In New Zealand, due to the heterogeneity of firms and issues of confidentiality and reliability of data, relatively little research has been done on modelling freight mode choice. This research involved revealed preference (RP) and stated preference (SP) surveys of representative freight shippers and agents. User-specific data make it possible to better identify the dependence between shipper’s mode shift behaviour and freight logistics in New Zealand circumstances. Moreover, by applying a discrete choice approach, the possibility of mode substitution effects was investigated. This research approach was prompted by substantial changes in New Zealand’s freight transport patterns due to the increasing use of logistic processes, and previously developed models using a four-stage approach fail to model elements of firms’ characteristics (i.e. size of shipments, delivery distance, export volume, product shelf-life, size and location of firm, number of road fleets, and relationship with contracted carriers). The outcomes of this research have shown that many of the operational and logistical influences that affect mode choice vary with the shipper and the industry. As a result, public policy makers should recognize that effective policy must consider both the needs of the transportation service provider and user. In particular, the public policy maker should recognize that freight transport mode choice results from an array of interactions among transportation characteristics, logistics characteristics and product characteristics

Cloud computing and context-awareness: A study of the adapted user experience

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.Today, mobile technology is part of everyday life and activities and the mobile ecosystems are blossoming, with smartphones and tablets being the major growth drivers. The mobile phones are no longer just another device, we rely on their capabilities in work and in private. We look to our mobile phones for timely and updated information and we rely on this being provided any time of any day at any place. Nevertheless, no matter how much you trust and love your mobile phone the quality of the information and the user experience is directly associated with the sources and presentation of information. In this perspective, our activities, interactions and preferences help shape the quality of service, content and products we use. Context-aware systems use such information about end-users as input mechanisms for producing applications based on mobile, location, social, cloud and customized content services. This represents new possibilities for extracting aggregated user-centric information and includes novel sources for context-aware applications. Accordingly, a Design Research based approach has been taken to further investigate the creation, presentation and tailoring of user-centric information. Through user evaluated experiments findings show how multi-dimensional context-aware information can be used to create adaptive solutions tailoring the user experience to the users’ needs. Research findings in this work; highlight possible architectures for integration of cloud computing services in a heterogeneous mobile environment in future context-aware solutions. When it comes to combining context-aware results from local computations with those of cloud based services, the results provide findings that give users tailored and adapted experiences based on the collective efforts of the two