Triangulating Horizontal Inequality: Towards Improved Conflict Analysis.

Does economic inequality cause civil war? Deviating from individualist measures of inequality such as the Gini coefficient, recent studies have found a statistical link between group-level inequalities and conflict onset. Yet, this connection remains controversial, not least because of the difficulties associated with conceptualizing and measuring group-level differences in development. In an effort to overcome weaknesses afflicting specific methods of measurement, we introduce a new composite indicator that exploits the strengths of three sources of data. The first step of our method combines geocoded data from the G-Econ project with night lights emissions data from satellites. In a second step, we bring together the combined spatial values with survey estimates in order to arrive at an improved measure of group-level inequality that is both more accurate and robust than any one of the component measures. We evaluate the effect of the combined indicator and its components on the onset of civil violence. As expected, the combined index yields stronger results as more information becomes available, thus confirming the initial hypothesis that horizontal economic inequality does drive conflict in the case of groups that are relatively poorer compared to the country average. Furthermore, these findings appear to be considerably more robust than those relying on a single data source.Swiss National Science FoundationAlexander von Humboldt Foundatio

It is the future. Clinical pharmaceutical care simply has to be a matter of course: community pharmacy clinical service providers' and service developers' views on complex implementation factors.

Background: While there is a lot of documented evidence about the clinical and cost effectiveness of pharmacists' role extensions there is an inherent gap between service development and implementation. Objective(s): This study aims to better understand the complex factors that influence the implementation of clinical pharmacy services from both the perspective of the community pharmacy service providers and service developers. Methods: A prospective qualitative interview study using purposive sampling of twelve service developers and twelve community pharmacy service providers from across all nine Federal States of Austria. The validated and piloted interview guide contained questions and prompts on role perceptions, attitudes, experience, implementation barriers, training needs and measures identified to strengthen clinical pharmacy provision in community pharmacy. Verbatim quotes were independently mapped to the Framework for the Implementation of Services in Pharmacy (FISpH) by two researchers. Results: 24 Interviews were carried out. Data saturation was achieved. There is a great deal of enthusiasm to develop the remit of clinical pharmacy services. It is seen as important to ensure the future survival of the profession. Service developers are more positive and confident in the implementation success and pharmacists' skills than providers. Clear mandates for politics, academia and individual pharmacists have been discussed to affect change. Conclusions: Austrian pharmacists are facing the same well documented challenges as many other healthcare systems only with more urgency. The development of a clinical pharmacy service framework; education accreditation standard and a well-supported continuous professional development system are considered key to bring about the necessary culture shift

Un curieux microfossile de la Molasse oligocène de Suisse occidentale et de Haute-Savoie (France)

Nouvelle description de l’incertae sedis Calcicarpinum? fallax. Détermination de son âge oligocène supérieur et de sa répartition biogéographique. Il s’agit d’un nucule de Boraginaceae désormais nommé Boraginocarpus fallax (Taugourdeau-Lantz & Rosset 1966) comb. novA re-analysis and new description of the incertae sedis Calcicarpinum? fallax is presented, and its Late Oligocene age and paleobiogeographical distribution is ascertained. It is identified as a nutlet of a Boraginaceae and is named Boraginocarpus fallax (Taugourdeau-Lantz & Rosset 1966) comb. nov

Interprofessional student-run primary health clinics: implications for pharmacy education in Scotland.

Introduction Interprofessional student run primary health care clinics have been a flagship model of health professional education in Canada for many years. The purpose of this study was to determine if there is support for implementing this educational model in the United Kingdom and to highlight the implications for pharmacy education in Scotland. Method A cross-sectional postal survey of 3000 randomly selected citizens of Aberdeen city and shire, Scotland, aged 18 years and over. Results Out of the 824 questionnaires that were returned (response rate 27.5%) over half of respondents (62.4%; n=514) would consider accessing healthcare from a student led, walk in service. The range of services they expect to see include general health checks (60%; n=494); help for sexually transmitted diseases (57.5%; n=474); weight management (56.8%; n=468); smoking cessation (54.4%; n=448) and drug misuse services (47.2%; n=387). Concerns raised pertained to student ability; suitability for children and accessibility. Many comments pertained to the improvement of the current system by offering after-hours care. Discussion The positive response from the general public towards an interprofessional student run primary health care clinic in Aberdeen, suggest that this Canadian model of interdisciplinary health professional education would likely be a successful addition to the pharmacy curriculum in Scotland

nlGis: A use case in linked historic geodata

While existing Linked Datasets provide detailed representations of Cultural Heritage objects, the locations where the objects originate from is often not accurately represented. Countries, municipalities, and excavation sites are commonly represented by geospatial points, and the fact that countries and municipalities change their geometry over time is not reflected in the data. We present nlGis, a collection of existing geo-historic datasets that are now published as Linked Open Data. The datasets in nlGis contain detailed geographic information about historic regions, with an emphasis on the Netherlands. We describe the creation of this Linked Geodataset and how it can be used to enrich Cultural Heritage data. We also distill several 'lessons learned' that can guide future attempts at publishing detailed Linked Geodata in the Cultural Heritage domain

On Information Theory, Spectral Geometry and Quantum Gravity

We show that there exists a deep link between the two disciplines of information theory and spectral geometry. This allows us to obtain new results on a well known quantum gravity motivated natural ultraviolet cutoff which describes an upper bound on the spatial density of information. Concretely, we show that, together with an infrared cutoff, this natural ultraviolet cutoff beautifully reduces the path integral of quantum field theory on curved space to a finite number of ordinary integrations. We then show, in particular, that the subsequent removal of the infrared cutoff is safe.Comment: 4 page

Facilitating implementation of medication reviews in the community pharmacy setting: an application of the implementation research logic model.

Previous research has identified both determinants and potential strategies to facilitate implementation of medication reviews (MR). A conceptual model which links determinants, strategies to support implementation and mechanisms of change to execute implementation, with projected outcomes is helpful to plan the approach and facilitate MR-implementation. The aim of this research was to apply the Implementation Research Logic Model (ILRM) for the implementation of medication reviews in the German community pharmacy setting, and thus illustrate the links between determinants, strategies, and implementation outcomes. The resulting map is meant to inform and facilitate MR-implementation. The IRLM was populated with determinants (barriers and facilitators structured using the Framework for Implementation of Services in Pharmacy, FISpH), proposed strategies (according to the Expert Recommendations for Implementing Change, ERIC) and mechanisms of change which were identified in an interview study with 21 German pharmacy owners. The research team linked these with 8 implementation outcomes derived from Proctor: acceptability, adoption, appropriateness, cost, feasibility, fidelity, penetration, sustainability. Twenty strategies from the interview study were mapped against 32 determinants. All strategies were hypothesised to impact on one or several of the 8 implementation outcomes. Depending on pharmacies' implementation stage (exploration, preparation, implementation, and sustainment) the importance of strategies was expected to vary. Strategies such as educational meetings and learning collaboratives can increase perceived appropriateness and boost adoption of MRs which is particularly important for pharmacies in the early exploration stage. Strategies such as receiving support from external implementation advisors as well as recruiting and training internal implementation leaders were deemed particularly important for pharmacies at the preparation stage to strengthen feasibility and fidelity. In later stages (implementation and sustainment) pharmacies were thought to benefit from provision of clinical feedback, obtaining and using patient feedback and re-examining implementation to achieve high fidelity, penetration, and sustainability of MR-provision. Some strategies such as fixed payment and stable delivery contracts were deemed pre-requisites for implementation irrespective of the stage the pharmacy was at. The application of the Implementation Research Logic Model illustrated the relations between determinants, strategies, mechanisms, and implementation outcomes. Future research is needed to ascertain that strategies work as planned and achieve the projected implementation outcomes

Just a 'romantic idea'? A theory-based interview study on medication review implementation with pharmacy owners.

Recent legal changes in Germany entitle patients on multiple medications to receive a medication review (MR). However, the provision of MRs is not mandatory and pharmacy owners decide whether to implement this service in their pharmacies. The aim of this study was to determine pharmacy owners' attitudes towards MRs, explore their experiences with MR implementation and examine their perceptions of barriers and facilitators towards implementation of MRs in community pharmacies. Pharmacy owners were invited to participate in semi-structured interviews. Purposive sampling was used with selection criteria being MR-implementation stage, and geographical location of the pharmacy. The topic guide was based on a systematic review and the Framework for Implementation of Services in Pharmacy (FISpH). Interviews were recorded, transcribed verbatim and coded directly against the FISpH. Twenty-one pharmacy owners were interviewed. Despite participants' consistent positive attitude towards MRs, most believed that providing MRs on an economically viable basis would be challenging. Several practical suggestions emerged which would enable community pharmacies a smoother implementation of MRs. Suggestions included employing ‘change facilitators', who visit and support implementing pharmacies; national awareness campaigns targeting patients and health professionals; reducing bureaucracy; continuing professional development; involving technicians in some MR-tasks; and offering an additional incentive to lower the initial implementation threshold. This research identified numerous factors that are likely to increase owners' and managers' support to the idea of MRs. This may be of interest to any country planning implementation of MRs

Implementation of medication reviews in community pharmacy: reaching consensus on stakeholders' recommendations for mechanisms of change using the nominal group technique.

Since 2022, patients with five or more medicines are eligible for a medication review (MR) in a community pharmacy remunerated by the German health system. However, implementation has been slow, with few pharmacies providing MRs. Stakeholders' input is necessary to detail how implementation strategies can be executed effectively on a national level. Prior research identified "external facilitation" and "altering incentives" as crucial strategies to achieve implementation outcomes. To gather stakeholders’ recommendations for, and obtain consensus on, mechanisms of change that allow implementation strategies to work in practice. The consensus method used was the nominal group technique (NGT) with NGT-discussions held separately with pharmacy owners and pharmacy chambers employees. Votes were summed and the relative importance (rI) calculated, defined as (score achieved for a mechanism)/(maximum possible score) × 100. Content analysis provided context for the highest ranked mechanisms and allowed linking to implementation outcomes. Four NGT-discussions were held in 2023 (n = 2 owners; n = 2 chamber employees) with a total of 17 participants. The overall highest ranked mechanisms were fit-for-purpose software (rI = 154.7) detailed process support (rI = 104.9) and an expert support line (rI = 77.7). These together with financial viability (rI = 40.0) were prioritised by both participant groups. Three mechanisms were favoured for both implementation strategies, namely software, process support and materials (rI = 34.3). This study identified stakeholders' priorities for mechanisms of change to implement MRs in community pharmacies. Focusing efforts on the prioritised mechanisms is likely to significantly advance a national implementation plan for countries which are at an early implementation stage