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In recent years health care personnel have seen changes to their roles and responsibilities. A number of reports both from within the occupation and from government have recommended changes in the roles of community pharmacists so that they become more active in the provision of health care. The new roles and services suggested have become known as "extended roles" and include health promotion, treatment of minor ailments, provision of advice on prescribed medicines to the public and to other health care personnel. The aim of this study was to investigate the factors affecting the extended roles of the community pharmacist. The investigation initially took an exploratory approach and used unstructured interviews with pharmacists to ascertain influences on every day practice which could have implications on implementation of extended roles. The findings from the initial qualitative stage were incorporated into a national survey of community pharmacists. A number of interrelated factors were found to be important including work practices, financial considerations, people's expectations, relationships with GPs and pharmacists' own definitions of their roles. These findings are explained in terms of the progressive division of labour in the market for the provision of health care. Recommendations are made for extending the role of the community pharmacist

Unhealthy eating and physical activity behaviours are common among nurses. As nurses spend a substantial proportion of their waking hours at work, interest in delivering interventions in the workplace to improve this populations' eating and physical activity behaviours is growing. This programme of research aimed to systematically develop evidence-based and theory-informed recommendations for a workplace intervention to change nurses' eating and physical activity behaviours. Methods: A systematic literature review of published randomised controlled trials was undertaken. Factors that behavioural theories suggest may influence nurses' eating and physical activity behaviours were identified through theoretical domains framework-informed qualitative interviews and a survey of nurses. Intervention recommendations were specified in terms of (i) intervention functions and policy categories using a Behaviour Change Wheel and (ii) theory-informed behaviour change techniques using a behaviour change technique taxonomy. Evidence related to the parameters of effectiveness for each technique was also taken into account during this intervention specification process. The selected techniques were then combined into a conceptual overview of a potential workplace intervention. Results: Data from 13 randomised controlled trials indicate workplace-based behaviour change interventions targeted to this population are effective in decreasing body weight. The evidence base is, however, limited in quantity and quality. Nurses' beliefs about important determinants of eating and physical activity behaviour change were identifed across 16 qualitative interviews and 245 survey responses and key determinants included: environmental context and resources; behavioural regulation; emotion; beliefs about consequences; knowledge and optimism. Based on this behavioural diagnosis, 24 behaviour change techniques suitable for targeting the identified determinants were chosen and combined into a potential workplace intervention. Conclusions: This thesis illustrates the utility of the Theoretical Domains Framework, the Behaviour Change Wheel and the behaviour change technique taxonomy for developing workplace intervention recommendations. The proposed recommendations address a gap in the current evidence base. Such an intervention, if implemented, has the potential to improve nurses' eating and physical activity behaviours and in turn, the health of nurses and the quality of healthcare delivery.

nÃo hà / A AvaliaÃÃo Multidimensional RÃpida da Pessoa Idosa (AMRPI) à um instrumento que pode ser utilizado para identificar problemas de saÃde condicionantes de declÃnio funcional em pessoas idosas. Indica, quando necessÃrio, a utilizaÃÃo de outros instrumentos mais complexos: cartÃo de Jaeger; Escala de AvaliaÃÃo de Medida de IndependÃncia Funcional; Escala de Katz; Escala de Lawton; APGAR; Escala de DepressÃo GeriÃtrica; ECOMAPA; Mini exame do estado mental; e Escala de AvaliaÃÃo do EquilÃbrio e da Marcha de Tinneti. Este estudo objetivou avaliar a aplicabilidade do instrumento AvaliaÃÃo multidimensional rÃpida da pessoa idosa, na consulta de Enfermagem no contexto da EstratÃgia SaÃde da FamÃlia; e como objetivos especÃficos, verificar a concordÃncia dos especialistas acerca da aplicabilidade do instrumento AMPI na atenÃÃo bÃsica e considerar os aspectos do instrumento que foram consensuais entre os especialistas para propor as adequaÃÃes necessÃrias. Pesquisa metodolÃgica do tipo intencional. A populaÃÃo do estudo constituiu-se de enfermeiros, experts ou especialistas, do Brasil que possuÃsse conhecimento na Ãrea da saÃde do idoso com no mÃnimo cinco anos de experiÃncia. A coleta de dados foi realizada de fevereiro a abril de 2012, via correio eletrÃnico, utilizando o mÃtodo "Delphi" com duas rodadas. Para avaliaÃÃo do instrumento, foram utilizados os critÃrios da psicometria propostos por Pasquali (1999): comportamental, simplicidade, clareza e relevÃncia atribuido uma nota (-1,0 e +1). A concordÃncia esperada foi de 80%. Os dados foram agrupados e analisados estatisticamente, por meio do programa Statistical Package for the Social Sciences, versÃo 18.0, e software Excel. A pesquisa foi aprovada pelo Comità de Ãtica em Pesquisa da Universidade Federal do CearÃ, conforme protocolo n.302/11. Os participantes foram do sexo feminino e a mÃdia de idade de 45 anos. Atuava na regiÃo Nordeste (36,3%), seguidas da regiÃo Sudeste (22,7%). Quanto à Ãrea de especialidade, 72,7% tinham formaÃÃo em gerantologia. Referente à titulaÃÃo mÃxima, 54,5 % concluÃram doutorado e 36,3% mestrado; com tempo de atuaÃÃo na Ãrea de 5 a 15 anos (50%) e mais de 16 anos (49,9 %), com mÃdia do tempo de 21,13 anos. Na Ãrea de atuaÃÃo profissional, atuavam no ensino (45,4%) e na assistÃncia na EstratÃgia SaÃde da FamÃlia (36,3%). Na primeira rodada, com exceÃÃo do item atividade sexual, todos alcanÃaram concordÃncia, com proporÃÃes estatisticamente significativas. Na segunda rodada, apÃs revisÃo do item âatividade sexualâ, obteve-se concordÃncia estatisticamente significativa. Conforme os resultados apresentados, o instrumento AvaliaÃÃo multidimensional rÃpida da pessoa idosa constitui ferramenta importante na consulta de Enfermagem no contexto da EstratÃgia SaÃde da FamÃlia, na busca pelo envelhecimento ativo.

CoordenaÃÃo de AperfeiÃoamento de NÃvel Superior / O presente estudo apresenta como temÃtica o luto vivido por famÃlias cujos entes queridos foram doadores de ÃrgÃos. Discute-se a necessidade de os profissionais de saÃde conhecer as etapas do luto e a sutileza em percebÃ-las nos momentos de aproximaÃÃo com a famÃlia, instrumento valioso no processo de cuidar, em especial no enfrentamento da morte. Teve como objetivos, assistir a famÃlia no processo do luto apÃs doaÃÃo de ÃrgÃos; descrever as histÃrias das famÃlias de doadores de ÃrgÃos, focando nas experiÃncias de perda e no processo de doaÃÃo, analisar o processo de enfrentamento do luto da famÃlia apÃs doaÃÃo de ÃrgÃos e analisar a visita domiciliÃria como estratÃgia de promoÃÃo da saÃde de famÃlias em luto. Pesquisa qualitativa, utilizou a HistÃria TÃpica de vida. O local do estudo foi a Zona norte do estado do CearÃ, Brasil, onde foram identificados 39 doadores de mÃltiplos ÃrgÃos no perÃodo de 2009 a 2011, sendo a visita domiciliar a estratÃgia de cuidado e coleta de dados com oito famÃlias. Foram descritas as HistÃrias tÃpicas das famÃlias e analisados os seus lutos: identificou-se a estrutura familiar, o desenvolvimento e a sua funcionalidade, pelo Modelo Calgary de AvaliaÃÃo Familiar. Este estudo fornece contribuiÃÃes para os profissionais da saÃde, principalmente para enfermeiros, em relaÃÃo à importÃncia do cuidado à pessoa em processo de luto, sendo necessÃria a revisÃo de prÃticas que inibem a exposiÃÃo dos sentimentos, as polÃticas de acolhimento familiar em InstituiÃÃes e a prÃtica efetiva de visitas domiciliarias como metodologia de cuidado familiar. AlÃm disso, essa aproximaÃÃo entre famÃlia e equipe à uma oportunidade de os profissionais reverem suas prÃticas, nas suas fragilidades e possibilidades terapÃuticas. Esse processo proporcionaria a elaboraÃÃo constante do cuidado compartilhado. Essa pesquisa evidencia a necessidade, ainda, de estudos para sistematizaÃÃo de prÃticas de profissionais em especial de enfermeiros com a visÃo da promoÃÃo da saÃde mental de familiares em luto, visto que para o sofrimento da perda, o abraÃo cuidador à o ponto de partida. / The present study has as its central theme of discussion grief experienced by families whose loved ones were organ donors. It discusses the need for health professionals to know the stages of grief and subtlety to perceive them approaching in moments with family, valuable tool in the care process, especially in the face of death. This research aimed to assist the family in the grieving process after organ donation. Specifically, the objective is also to describe the stories of the families of organ donors, focusing on the experiences of loss and the donation process, analyze the coping process of grieving family after organ donation and analyze how the home visit strategy to promote the health of families in mourning. It is a qualitative research and used the Topical History of life. The site was the area north of the state of CearÃ, where 39 were identified multiple organ donors in the period from 2009 to 2011, being the home visit strategy and careful data collection with eight families who agreed to participate. Were described topical stories of families and analyzed their grief: identified the family structure, development and its functionality at Calgary Family Assessment Model. This study provides contributions for health professionals, mainly nurses about the importance of care for the person grieving process, necessitating a revision of practices that inhibit the exposure of feelings, policies foster care in institutions and effective practice home visits as a method of family care. Moreover, this approach between family and staff is an opportunity for professionals to review their practices, their weaknesses and therapeutic possibilities. This process would provide the constant construction of shared care. In this sense, it signals the need also to work with the vision of promoting the mental health of families in mourning, as for the pain of loss, the embrace caregiver is the starting point.

M.B.A. / Increased environmental pressure in a firms' local market are forcing many companies to consider markets outside of their own to do maximize their profitability. According to Henisz (2000) when expanding internationally, a firm's management often must contend with a new culture, a new language, a new social system, new market structures, and a new political system. Titan, a premier brand in the Indian sub-continent aspires to assess the Gulf Cooperation Countries (GCC) market for watches. Despite global market recessionary trends, the luxury watch market in the GCC reflects a constant thirty percent increase in business over the previous year, as measured on a monthly comparative basis. The research will indicate that Titan cannot simply apply the local strategies used in India, as this global market possesses different characteristics to those experienced in the GCC, the importance if brand utility may provide a distinct differential over the major competitors in this market. Though the model that is derived will be based on the Titan experience, it will also be applicable to other items in the luxury goods market, and may be utilised to facilitate market entry for all luxury goods which will be categorised in the same band as watches, examples of these include fashion accessories, sunglasses, perfumes and jewellery. The aim of the study was to develop a model to guide the market entry process for new watch brands under the Titan umbrella into the GCC market.

Over the past decade there has been a shift in marketing spend from above the line advertising, to below the line advertising commonly referred to as promotions. This has been brought about by recessionary economic conditions, increased competition, rising media costs and long term profitability prospects. Many fast moving consumer goods’ (FMCG) companies are shifting a large portion of their marketing spend from advertising to sales promotion. This has occurred because of consumers becoming more prone to deals, declining brand loyalty and the growing power of major retail chains. Sales promotion spend can comprise of as much as 50% of the marketing budget in certain industries and the majority of the marketing budget for most FMCG companies. This has been heightened further by the global financial recession which has both direct and indirect effects on South Africa. Approximately 70% of purchasing decisions are made in store by understanding how these decisions are made and how to influence them is essential in developing an effective marketing strategy. Besides product characteristics, promotional techniques are among the most popular instruments used by marketers to influence this process. Global trends show that 83% of all senior marketers increase or maintain spend on promotional merchandise year on year. However, they had limited insight into how to best spend the funds or if they even achieved their intended purpose. Despite the rise in promotional activity, especially in the FMCG sector, limited research has been conducted on the influence and effectiveness in South Africa. The purpose of this treatise, then, is to examine addresses the paucity in research with regard to consumer sales promotions in the non-alcoholic ready to drink (NARTD) market, particularly within South Africa. By developing a relationship model to measure the influence and effectiveness of selected sales promotion techniques on consumer off-take and attitude. That can be used by organisations to retain consumers, grow market share, improve brand equity and achieve higher profitability. Equipping marketers with an improved understanding of the impact of sales promotion techniques and consumer buying patterns within the South African NARTD market and delivering value to consumers through targeted promotions. In order to achieve this goal a thorough literature review was performed which drew on both academic- and industry-based research. This led to the development of a conceptual relationship model which was tested using rigorous measures incorporating questionnaire-style, quantitative data collection and statistical analysis. The research revealed that sales promotion techniques are an important element of a successful marketing strategy and when correctly executed deliver positive business results. FMCG companies operating within the NARTD market need to ensure that they incorporate sampling and premiums into their marketing mix even if this requires them to reduce their spend on above the line marketing activities. Ultimately, sampling and premiums were found to be effective sales promotion techniques within the South African NARTD market and have the ability to positively influence consumer off-take, brand love and buying behaviour.

This thesis deals with the in-store marketing and its application in the supermarket Billa ltd. The work is divided into the theoretical and practical part. The theoretical part deals with sales support, which includes in-store marketing. In the practical part I describe the current trends within in-store marketing and the merchandising problems there as well. The practical work is also dedicated to the description of the actual means of in-store marketing in the supermarket Billa ltd. The actual research work is carried out on the basis of survey and field survey of the supermarket. Using the obtained results and their comparison with the supermarket Albert are defined and I evaluated current trends in in-store marketing within the supermarket Billa ltd.

The transition from hospital to home can be complicated, leaving family caregivers in stressful situations that they may not know how to handle. The burden that is placed on these individuals has led researchers to focus on the public health implications of caregiving in hopes of identifying at-risk caregivers. This quantitative analysis identified what relationships exist between caregiver compassion fatigue among family caregivers and training or education received per the Caregiver Advise Record and Enable (CARE) Act and if education influences readmission rates. A purposive sample of 385 family caregivers participated in this study. The Care Transitions Measure (CTM-15), the Caregiver Reaction Scale (CRS), and the LACE (length of stay, acuity of admission, comorbidities, and emergency department visits) index were used to explore the relationship between caregiver education received, caregiver compassion fatigue, and rates of readmission. The results of this study did not support a significant relationship between the education that caregivers receive according to the CARE Act and readmission rates of the care receiver when utilizing the CTM-15 and the LACE index but it did support a relationship between the caregiver's compassion fatigue and the amount of training the caregivers receive from the CARE Act in some areas of the CRS. While research continues to identify flaws in the caregiver transition, the CRS and CTM-15 show a significant relationship in some areas of the CRS, identifying some caregivers are better educated prior to leaving the hospital and with a potential reduction in compassion fatigue.

Obesity remains a public health concern among persons with mental illness resulting from the interaction of a combination of factors such as genetic, medication, effects of their symptoms, social, and environmental factors. Obesity complications account for increased mortality and morbidity, reduced life expectancy, and quality of life in persons with mental illness. The management of obesity is challenging and predicting the ability of mental health professionals to advise patients on weight management behavior is important to improve patients' overall well-being. The social cognitive theory constructs knowledge, expectations, situational perception, self-efficacy, and goal setting were utilized in predicting Weight Management Advice Behavior (WMAB) among psychiatry professionals. WMAB described the ability of professionals to effectively offer advice on managing weight. A cross-sectional study design was used, in which data were collected using a validated instrument. A sample size of 134 was used and the collected data were analyzed using simple and multiple linear regression, logistic regression and MANOVA. Self-efficacy, goal setting, knowledge, and situational perception were found to have a significant association with WMAB individually. Only self-efficacy (p < .001), goal setting (p < .001), knowledge (p < .001), and situational perception (p < .05) were independent predictors of WMAB among psychiatry healthcare professionals. There were significant differences among the professional groups with regards to knowledge, self-efficacy, goal setting, situational perception, and expectations. The study findings will bring about positive social change by informing the advice of professionals, reducing obesity and alleviating its burden among people with mental illness.