33 research outputs found
Qualitative study on the implementation of professional pharmacy services in Australian community pharmacies using framework analysis
Abbreviations: BCT, Behavioural change techniques taxonomy; BCW, Behavioural change wheel; CFIR, Consolidated
framework for implementation research; EPOC, Cochrane effective practice and organisation of care; FISpH, Framework
for the implementation of services in pharmacy; GIF, Generic implementation framework; KPI, Key performance
indicator; TDF, Theoretical domains frameworkBackground: Multiple studies have explored the implementation process and influences, however it appears there
is no study investigating these influences across the stages of implementation. Community pharmacy is attempting
to implement professional services (pharmaceutical care and other health services). The use of implementation
theory may assist the achievement of widespread provision, support and integration. The objective was to investigate
professional service implementation in community pharmacy to contextualise and advance the concepts of a generic
implementation framework previously published.
Methods: Purposeful sampling was used to investigate implementation across a range of levels of implementation in
community pharmacies in Australia. Twenty-five semi-structured interviews were conducted and analysed using a
framework methodology. Data was charted using implementation stages as overarching themes and each stage
was thematically analysed, to investigate the implementation process, the influences and their relationships. Secondary
analyses were performed of the factors (barriers and facilitators) using an adapted version of the Consolidated
Framework for Implementation Research (CFIR), and implementation strategies and interventions, using the
Expert Recommendations for Implementing Change (ERIC) discrete implementation strategy compilation.
Results: Six stages emerged, labelled as development or discovery, exploration, preparation, testing, operation
and sustainability. Within the stages, a range of implementation activities/steps and five overarching influences
(pharmacys' direction and impetus, internal communication, staffing, community fit and support) were identified.
The stages and activities were not applied strictly in a linear fashion. There was a trend towards the greater the
number of activities considered, the greater the apparent integration into the pharmacy organization. Implementation
factors varied over the implementation stages, and additional factors were added to the CFIR list and definitions
modified/contextualised for pharmacy. Implementation strategies employed by pharmacies varied widely.
Evaluations were lacking. Conclusions: The process of implementation and five overarching influences of professional services implementation
in community pharmacy have been outlined. Framework analysis revealed, outside of the five overarching influences,
factors influencing implementation varied across the implementation stages. It is proposed at each stage, for
each domain, the factors, strategies and evaluations should be considered. The Framework for the Implementation of
Services in Pharmacy incorporates the contextualisation of implementation science for pharmacy.The study was funded as part of a University of Technology Sydney (UTS)
Research Excellence Scholarship (RES), comprising of an Australian Postgraduate
Award (APA) Scholarship funded by the Australian Government, plus a Top-up
funded by the University of Technology Sydney, received from the primary
author (JCM)
Who Eats Whom in a Pool? A Comparative Study of Prey Selectivity by Predatory Aquatic Insects
Predatory aquatic insects are a diverse group comprising top predators in small fishless water bodies. Knowledge of their diet composition is fragmentary, which hinders the understanding of mechanisms maintaining their high local diversity and of their impacts on local food web structure and dynamics. We conducted multiple-choice predation experiments using nine common species of predatory aquatic insects, including adult and larval Coleoptera, adult Heteroptera and larval Odonata, and complemented them with literature survey of similar experiments. All predators in our experiments fed selectively on the seven prey species offered, and vulnerability to predation varied strongly between the prey. The predators most often preferred dipteran larvae; previous studies further reported preferences for cladocerans. Diet overlaps between all predator pairs and predator overlaps between all prey pairs were non-zero. Modularity analysis separated all primarily nectonic predator and prey species from two groups of large and small benthic predators and their prey. These results, together with limited evidence from the literature, suggest a highly interconnected food web with several modules, in which similarly sized predators from the same microhabitat are likely to compete strongly for resources in the field (observed Pianka’s diet overlap indices >0.85). Our experiments further imply that ontogenetic diet shifts are common in predatory aquatic insects, although we observed higher diet overlaps than previously reported. Hence, individuals may or may not shift between food web modules during ontogeny