A Distribution Services Approach for Developing Effective Competitive Strategies Against Big Box Retailers

According to one theoretical approach, the primary economic function of retailers is to deliver products together with distribution services. We use this framework to identify competitive niches for smaller retailers competing against big box stores. We compare the distribution services offered by the Home Depot versus smaller retailers using both in-store measures and consumer perception data, and the relative importance of distribution services as determinants of store choice. The results show that the Home Depot’s superiority in pricing and assortment attracts a significant market, but smaller retailers can secure niche markets by delivering higher levels of ambiance and information

A New Look at Industrial Sales and its Requisite Competencies

Although industrial sales is widely discussed in both practitioner and academic circles, no clear definition of “industrial” has been established. We present a definition of industrial sales that distinguishes it from other sales domains, and we draw from a panel of industrial sales executives and a random sample of industrial sales managers to generate and evaluate the importance of a comprehensive list of knowledge, skills, and value competencies that are required for success in industrial sales. Technical competencies, while important, were rated relatively less so than selling- and customer-related competencies. Among other recommendations, we implore industrial sales executives to incorporate a global mindset into their sales organization, and we challenge academics to extend personal selling beyond the business school to engineering, computer science, and other technical disciplines from where industrial salespeople often recruit

Medication adherence and community pharmacy: A review of education, policy and research in England

Objective: The objective of this narrative review was to identify and describe the current policy, education and research related to community pharmacy and medication adherence in England. Methods: Medline, Embase, International Pharmaceutical Abstracts and Pharmline were used to search for relevant research articles. Current policy documents were identified via the websites of the Department of Health in England, the Royal Pharmaceutical Society of Great Britain, the National Pharmacy Association, the Pharmaceutical Services Negotiating Committee and NHS Employers. All pharmacy schools in England were contacted to obtain information about the adherence-related courses they provide to undergraduate and postgraduate pharmacy students. Results: National policies and guidelines in England are conducive to an increasing role for community pharmacists to support patients with medication adherence. Many pharmacy schools cover the issue of adherence in their undergraduate and postgraduate courses. Research in this area has tested the effectiveness of pharmacists providing adherence support in the form of compliance aids, education, involvement in discharge planning, and tailored interventions. Conclusion: In community pharmacy in England, current policy and funding arrangements suggest there is great scope for pharmacists to support patients with medication adherence. Further research is necessary to identify the most useful, cost-effective and sustainable approach in practice

Developing the Diagnostic Adherence to Medication Scale (the DAMS) for use in clinical practice

There is a need for an adherence measure, to monitor adherence services in clinical practice, which can distinguish between different types of non-adherence and measure changes over time. In order to be inclusive of all patients it needs to be able to be administered to both patients and carers and to be suitable for patients taking multiple medications for a range of clinical conditions. A systematic review found that no adherence measure met all these criteria. We therefore wished to develop a theory based adherence scale (the DAMS) and establish its content, face and preliminary construct validity in a primary care population

Strong peak in Tc of Sr2RuO4 under uniaxial pressure

Sr2RuO4 is an unconventional superconductor that has attracted widespread study because of its high purity and the possibility that its superconducting order parameter has odd parity. We study the dependence of its superconductivity on anisotropic strain. Applying uniaxial pressures of up to ~1 gigapascals along a 〈100〉 direction (a axis) of the crystal lattice results in the transition temperature (Tc) increasing from 1.5 kelvin in the unstrained material to 3.4 kelvin at compression by ≈0.6%, and then falling steeply. Calculations give evidence that the observed maximum Tc occurs at or near a Lifshitz transition when the Fermi level passes through a Van Hove singularity, and open the possibility that the highly strained, Tc = 3.4 K Sr2RuO4 has an even-parity, rather than an odd-parity, order parameter.PostprintPeer reviewe

Contextual Effects of Class Mobility on Voting Behaviour in 16 Western Countries: 1956-1990

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Cost effectiveness of support for people starting a new medication for a long term condition through community pharmacies: an economic evaluation of the New Medicine Service (NMS) compared with normal practice

Background: The English community pharmacy New Medicine Service (NMS) significantly increases patient adherence to medicines, compared with normal practice. We examined the cost-effectiveness of NMS compared with normal practice by combining adherence improvement and intervention costs with the effect of increased adherence on patient outcomes and healthcare costs. Methods: We developed Markov models for diseases targeted by the NMS (hypertension, type 2 diabetes, chronic obstructive pulmonary disease, asthma and antiplatelet regimens) to assess the impact of patients’ non-adherence. Clinical event probability, treatment pathway, resource-use and costs were extracted from literature and costing tariffs. Incremental costs and outcomes associated with each disease were incorporated additively into a composite probabilistic model and combined with adherence rates and intervention costs from the trial. Costs per extra quality-adjusted-life-year(QALY) were calculated from the perspective of NHS England, using a lifetime horizon. Results: NMS generated a mean of 0.05 (95%CI: 0.00, 0.13) more QALYs per patient, at a mean reduced cost of -£144 (95%CI: -769, 73). The NMS dominates normal practice with probability of 0.78 (ICER: - £3166 per QALY). NMS has a 96.7% probability of cost-effectiveness compared with normal practice at a willingness-to-pay of £20000 per QALY. Sensitivity analysis demonstrated that targeting each disease with NMS has a probability over 0.90 of cost-effectiveness compared with normal practice at a willingness-to-pay of £20000 per QALY. Conclusions: Our study suggests that the New Medicine Service increased patient medicine adherence compared with normal practice, which translated into increased health gain at reduced overall cost