Criteria in consultant selection: public procurement of architectural and engineering services

The competence, commitment and attitudes of design consultants strongly influence the quality and costs of built facilities. However, in the selection of professional services it is often difficult to specify and assess non-price criteria related to both firms and individual consultants. Therefore, clients traditionally rely on long term relations or recommendations from clients or colleagues. Public procurement regulation, however, restricts the use of such informal data. This study seeks to understand how procurers act to reconcile these conflicting demands.An explorative questionnaire survey distributed to Swedish municipalities investigates which selection criteria and information sources are used, as well as perceived difficulties and shortcomings related to consultancy procurement. Results show a high focus on price or more easily measured non-price criteria. This might limit the ability of municipal officials to evaluate consultant competence, especially aspects related to design and execution of projects. Furthermore, personal information sources are widely used, indicating a conflict between procurement practice and existing regulation. Unexpectedly, procurement officials were generally satisfied with their procurement practice. However, managers and more experienced procurers tend to be more satisfied than other officials. Satisfaction also appears to be connected to the existence of a procurement policy and more advanced selection methods. Keywords: public procurement, selection, consultants, Swede

Criteria in consultant selection: Public procurement of architectural and engineering services

The competence, commitment and attitudes of design consultants strongly influence the quality and costs of built facilities. However, in the selection of professional services it is often difficult to specify and assess non-price criteria related to both firms and individual consultants. Therefore, clients traditionally rely on long term relations or recommendations from clients or colleagues. Public procurement regulation, however, restricts the use of such informal data. This study seeks to understand how procurers act to reconcile these conflicting demands.An explorative questionnaire survey distributed to Swedish municipalities investigates which selection criteria and information sources are used, as well as perceived difficulties and shortcomings related to consultancy procurement. Results show a high focus on price or more easily measured non-price criteria. This might limit the ability of municipal officials to evaluate consultant competence, especially aspects related to design and execution of projects. Furthermore, personal information sources are widely used, indicating a conflict between procurement practice and existing regulation. Unexpectedly, procurement officials were generally satisfied with their procurement practice. However, managers and more experienced procurers tend to be more satisfied than other officials. Satisfaction also appears to be connected to the existence of a procurement policy and more advanced selection methods.&nbsp;Keywords: public procurement, selection, consultants, Sweden</span

Managing Complexity: Exploring Decision Making on Medication by Young Adults with ADHD

Attention-deficit hyperactivity disorder (ADHD) causes difficulties with hyperactivity, impulsivity and inattention. Treatment of ADHD includes both medication and non-pharmacological options. Knowledge of treatment preferences by young adults with ADHD is sparse. The objective of this study was to explore the beliefs and experiences of young adults with ADHD related to their medication treatment decisions. Data were collected in Denmark in 2016 through a focus group and individual in-depth interviews. Conventional content analysis was used. Ten young adults with ADHD (22-to 29-year-old) participated. Three major themes were identified: (1) the patient&rsquo;s right to choose concerning ADHD medicine; (2) the patient&rsquo;s decision of whether or not to treat ADHD with medication; and (3) factors affecting the patient&rsquo;s decision on whether to take ADHD medication or not. The latter theme contained 15 factors, which were distributed across three levels: individual, between-individuals, and societal. The dominant factors were increasing quality of life and improving oneself e.g., improving social skills. For counselling at the pharmacy and by prescribers, it is important to be aware of the different factors that affect young adult patients&rsquo; decisions on whether to take ADHD medication or not. This knowledge will aid to understand reasons for non-adherence and to determine appropriate treatment for the individual patient

Introducing Pharmaceutical Care to Primary Care in Iceland—An Action Research Study

Even though pharmaceutical care is not a new concept in pharmacy, its introduction and development has proved to be challenging. In Iceland, general practitioners are not familiar with pharmaceutical care and additionally no such service is offered in pharmacies or primary care settings. Introducing pharmaceutical care in primary care in Iceland is making great efforts to follow other countries, which are bringing the pharmacist more into patient care. General practitioners are key stakeholders in this endeavor. The aim of this study was to introduce pharmacist-led pharmaceutical care into primary care clinics in Iceland in collaboration with general practitioners by presenting different setting structures. Action research provided the framework for this research. Data was collected from pharmaceutical care interventions, whereby the pharmaceutical care practitioner ensures that each of a patient’s medications is assessed to determine if it is appropriate, effective, safe, and that the patient can take medicine as expected. Sources of data included pharmaceutical care notes on patients, researcher’s notes, meetings, and interviews with general practitioners over the period of the study. The study ran from September 2013 to October 2015. Three separate semi-structured in-depth interviews were conducted with five general practitioners from one primary health care clinic in Iceland at different time points throughout the study. Pharmaceutical care was provided to elderly patients (n = 125) before and between general practitioners’ interviews. The study setting was a primary care clinic in the Reykjavik area and the patients’ homes. Results showed that the GPs’ knowledge about pharmacist competencies as healthcare providers and their potential in patient care increased. GPs would now like to have access to a pharmacist on a daily basis. Direct contact between the pharmacist and GPs is better when working in the same physical space. Pharmacist’s access to medical records is necessary for optimal service. Pharmacist-led clinical service was deemed most needed in dose dispensing polypharmacy patients. This research indicated that it was essential to introduce Icelandic GPs to the potential contribution of pharmacists in patient care and that action research was a useful methodology to promote and develop a relationship between those two health care providers in primary care in Iceland.Peer Reviewe

Response of Nongame Birds and Terrestrial Invertebrates to High-Diverstiy and Low-Diversity Restoration Plantings on Upland Grasslands in the Rainwater Basin Region, Nebraska

Department of Natural Resource Ecology and Managemen

Estimating environmental exposure to analgesic drugs: A cross-sectional study of drug utilization patterns in the area surrounding Sweden’s largest drinking water source

Use of pharmaceuticals is continuously increasing globally and their residues are recognized as a risk for the environment. The aim of this study was to investigate drug utilization patterns of analgesics in relation to environmental hazard in the region surrounding Sweden's largest drinking water source, Lake Mälaren. This was examined using sales data on pharmaceuticals from the Swedish E-health Agency. The total sales of analgesics (non-steroidal anti-inflammatory drugs, paracetamol, other non-opioid analgesics, and opioids) for both human and veterinary use in the region were analyzed for the years 2016 to 2020, in relation to the inherent environmental hazard for each active pharmaceutical ingredient (API). We found that a total of 454 tons of analgesics were sold in the region during these 5 years. Classifications of environmental hazard were available for 16 out of the 45 studied APIs, accounting for 98.8% of the total mass in kilograms. Paracetamol, ibuprofen, and acetylsalicylic acid, which are all classified as low-hazard compounds, were the most commonly sold APIs. Diclofenac, the only pharmaceutical classified as high-hazard, was the fifth most commonly sold API, with a total sold mass of 2321 kg. The majority of the total sold mass of analgesics originated from dispensed prescriptions for human use in urban areas. Visualization of drug sales for humans and animals in different settings can be used to identify the environmental burden of pharmaceuticals. Based on our study, we suggest that additional measures to reduce the impacts of pharmaceuticals on the environment should primarily be directed to prescribing physicians in urban areas and campaigns targeted at the high over-the-counter sales of diclofenac. Moreover, it is important to address the fact that many pharmaceuticals currently have limited data on environmental hazard