Medication safety, privacy, and stigma: A qualitative study of pharmacy opioid agonist treatment disruptions and adaptations in the 2022 Northern Rivers floods, Australia

Background: Opioid agonist treatment (OAT) involves the daily consumption of long-acting opioid medications to assist in managing health and wellbeing issues related to illicit or high-strength opioid drug use. Flooding events disrupted OAT service systems in the Northern Rivers region (Australia) in 2022. This study describes the experiences of OAT consumers and pharmacists during this time, including how structural stigma may have limited clinician behaviours and influenced consumer experiences. Methods: Interview transcripts from eleven pharmacists and thirteen consumers were collated and thematically analysed. Results: Opioid agonist treatment consumers experienced disruptions when their prescribing and pharmacy treatment sites were destroyed by flood or where roads were cut off, and faced long delays if they attended the primary public clinic for emergency dosing or prescription re-issuing. Absent prescriptions were the main barrier to enabling emergency dosing. Pharmacists’ efforts in providing advance takeaways or discretionary doses reduced consumer hardships and distress. The treatment access difficulties that consumers experienced were found to be constrained by stigma, and this intensified risks related to medication safety and privacy. Conclusions: Treatment access was enabled when pharmacists operated outside of the restrictive medication safety protocols that opioid agonist treatment is uniquely subject to, and that is informed by structural stigma towards OAT consumers. Potential distress was averted where pharmacists took responsive approaches to protecting and maintaining OAT access. Future emergency planning should aim to protect and transmit OAT dose authorisation records more effectively, while striving to minimise adverse impacts including decreased privacy and accessibility

Opioid agonist treatment and trust in the community pharmacy setting: a qualitative study of perceptions and experiences

Background: Opioid agonist treatment (OAT) in New South Wales Australia involves prescribed consumption of methadone or buprenorphine formulations and is commonly accessed through community pharmacies. People with a history of drug use often feel mistrusted and this can deter them from starting or staying in treatment. This study sought pharmacist and consumer perspectives to understand how treatment engagement can be best supported. Objective: To explore consumer and pharmacist experiences of OAT services, identifying the social and structural elements that enhance or impair treatment and professional satisfaction and analyzing how these are influenced by trust. Methods: Semi-structured interviews were conducted in 2021–2022 with 10 pharmacists and 15 consumers. Transcripts were analyzed using a realist thematic approach. Results: Burdensome fees, pharmacy service problems, and system opportunities were generated as themes of subjection, and socially inclusive care and person-centered approaches as themes of connection. OAT consumers felt more inclusion when pharmacy practices did not differentiate or demean them and when pharmacists communicated in a personable and caring manner, and pharmacists recognized these aspects as contributing to greater professional fulfillment and less service problems. Conclusion: OAT delivery in community pharmacies provides opportunities for greater social inclusion, particularly when trust and fairness are demonstrated

Strategic human resource effectiveness, internal marketing and performance in the public sector

Internal marketing (IM) focuses on acquiring and retaining customer-oriented employees and is seen as particularly relevant to service organisations. Critics of internal marketing claim that the term is simply a synonym for good human resources management. The concepts of Internal Marketing and Strategic Human Resource Effectiveness (SHRE) are considered and suitable measures are identified Data is collected from the Australian public sector and a regression analysis is used to investigate the hypothesised relationships. The study provides empirical evidence of a demarcation between IM and SHRE; that SHRE is an important antecedent to IM and that SHRE has both a direct and indirect effect on performance, Management implications are considered and directions for future research offered.peer-reviewe

Very low complexity convolutional neural network for quadtree structures

© 2018 Australasian Robotics and Automation Association. All rights reserved. In this paper, we present a Very Low Complexity Convolutional Neural Network (VLC-CNN) for the purpose of generating quadtree data structures for image segmentation. The use of quadtrees to encode images has applications including video encoding and robotic perception, with examples including the Coding Tree Unit in the High Efficiency Video Coding (HEVC) standard and Occupancy Grid Maps (OGM) as environment representations with variable grid-size. While some methods for determining quadtree structures include brute-force algorithms or heuristics, this paper describes the use of a Convolutional Neural Network (CNN) to predict the quadtree structure. CNNs traditionally require substantial computational and memory resources to operate, however, VLC-CNN exploits downsampling and integer-only quantised arithmetic to achieve minimal complexity. Therefore, VLC-CNN's minimal design makes it feasible for implementation in realtime or memory-constrained processing applications

The link between market orientation and performance in the Australian public sector

Marketing academics and practitioners assume a direct link between market orientation and performance and argue that this applies to both business and non-business organisations. While this aspect has been studied in the business sector, this paper discusses the concepts of market orientation and performance and investigates this relationship in the Australian public sector. The conceptualization of market orientation used is that by Jaworski and Kohli (1993) on which basis MARKOR was developed. This instrument together with an instrument to measure the perceptions of performance of senior managers in the Australian public sector are used to investigate the hypothesized link. The findings confirm a positive relationship between market orientation and performance. The size and type of public sector organisation involved are also found to affect the levels of market orientation together with its components and performance. From the findings, implication are drawn and directions for future research discussed.peer-reviewe

Market orientation and performance in the public sector : the role of organizational commitment

Increased calls for transparency and accountability in government organizations underscores the need for a market orientation even in the public sector. The degree of market orientation and its effect on performance and on organizational commitment in government departments in three Australian states is considered. Results provide empirical support for a direct relationship between market orientation and performance and evidence of the mediating role of organizational commitment. Implications are drawn and directions for future research are discussed.peer-reviewe

Effects of some environmental challenges and centralization on the entrepreneurial orientation and performance of public sector entities

The relevance of entrepreneurship in the public sector is considered. In investigating relationships a review of the literature is undertaken and a model is proposed to examine the effects of certain environmental variables and centralisation on entrepreneurship and ultimately, performance. The proposed model is based on work conducted by Covin and Slevin [1991], reconsidered within a public sector context. Research is conducted among Australian public sector entities. A structural equation model is used to examine the hypothesised linkages. Implications of the findings are discussed, limitations are noted and directions for future research are outlined.peer-reviewe

Expectations about management consultancy services : testing the assumption of equivalence across Australian and Singaporean firms

Consultancy firms have adopted a higher international profile as they follow the increased global presence of many businesses. The provision of a quality offering by providers of consultancy services necessitates a clear understanding of customer expectations across countries. The expectations items in SERVQUAL have been applied to samples of firms in Australia and Singapore to test for the equivalence of the expectations construct. Multiple sample LISREL analysis is carried out on data from the two countries. The results indicate an absence of construct equivalence. Implications and suggestions for future research are provided.peer-reviewe

Differences in stigma reduction related to injection drug use between people expressing conservative, moderate and progressive values following an online intervention

Introduction: Contact interventions have shown short-term effectiveness in reducing stigmatising attitudes and behaviours of the public towards marginalised population groups, including people who inject drugs. We theorised that the effectiveness of an intervention differs according to peoples' underlying social values and undertook a study to test this. Methods: We recruited participants from the Australian public by social media and measured their attitudes, desire to maintain personal distance, and support for structural stigma towards people who inject drugs before and after a brief online video intervention (n = 314). We divided participants into tertile groups according to their responses to a conservatism scale and compared group differences in post-intervention stigma scores (n = 242–244), controlling for pre-intervention scores and demographic variables. Results: Adjusting for baseline levels, the post-intervention scores in all measures showed significant improvement but scores of the moderate group were consistently most improved. Stigmatising attitudes in the moderate group were significantly reduced when compared with the conservative and progressive groups. However, reductions in desire for personal distance and support for structural stigma did not significantly differ by conservatism group. Discussion and Conclusions: A brief online contact intervention showed immediate effectiveness in reducing stigma towards people who inject drugs. As people with moderate values were found to be more amenable to changing their perspectives, audience social values may need consideration when designing and evaluating stigma interventions. More research is needed to understand how to influence people with more conservative values, and how to increase public support for policies and practices that reduce stigma

Problematising international placements as a site of intercultural learning

This paper theorises some of the learning outcomes of a three-year project concerning student learning in international social work placements in Malaysia. The problematic issue of promoting cultural and intercultural competence through such placements is examined, where overlapping hegemonies are discussed in terms of isomorphism of social work models, that of the nation state, together with those relating to professional values and knowledge, and the tyrannies of received ideas. A critical discussion of cultural competence as the rationale for international placements is discussed in terms of the development of the graduating social worker as a self-reflexive practitioner. The development of sustainable international partnerships able to support student placement and the issue of non-symmetrical reciprocation, typical of wide socio-economic differentials across global regions, is additionally discussed