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Holden, Greg, Steve Marty, Jared Thigpen, Dennis Turcotte, and Tol Dean Van. "Supply Chain Management at the National Naval Medical Center Pharmacy." Thesis, Monterey, California. Naval Postgraduate School, 2010. http://hdl.handle.net/10945/7061.
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EMBA Project ReportEXECUTIVE SUMMARY: Supply Chain Management at the National Naval Medical Center Pharmacy The National Naval Medical Center (NNMC) in Bethesda, Maryland is the U.S. Navy’s flagship of medical centers and is the Navy’s third-largest medical center.1 NNMC provides medical services to approximately 46,000 patients annually,2 and its pharmacy has an annual budget of $46M for drugs dispensed to NNMC patients.3 This consulting project, completed with the support of the NNMC Pharmacy Department Head and facilitated through the Naval Postgraduate School Executive MBA Program, applied operations management and supply chain management principles to the processes used by the NNMC pharmacy to find potential efficiency improvements. Specifically, the consultant team evaluated drug purchasing data from the Defense Medical Logistics Supply System (DMLSS) and dispensing data from the Composite Healthcare System (CHCS) for specific high-cost and high-volume drugs to identify optimal inventory levels and order points. The NNMC Pharmacy Staff selected the following six drugs for analysis: _ Arimedex (anastrozole) – a breast cancer prevention drug. _ Intelence (extravirine) – an HIV treatment drug. _ Procrit (epoetin alfa) – an anemia treatment drug. _ Seroquel (quetiapine) – depressive disorder (bipolar & schizophrenia) treatment drug. _ Topamax (topiramate) – an anti-seizure/epilepsy medication. _ Vfend (voriconazole) – fungus and yeast infection treatment drug. 1 NNMC Public Affairs Document “National Naval Medical Center at a Glance,” www.bethesda.med.navy.mil 2 Ibid. 3 Personal Interview with LT Bradley Gotto, 29 July 2010 After analyzing historical ordering and dispensing data for these drugs and touring the NNMC drug storage facilities, the consultant team’s primary recommendation is that NNMC pharmacy should adjust re-order points, re-order quantities, and safety stock for the subject drugs to reduce high levels of inventory and unnecessary safety stock. Since the NNMC pharmacy can obtain drugs at low cost with minimal (1 day) lead time, NNMC can reduce the average inventory of these drugs and shift the burden of inventory management to the drug suppliers. This has potential to simplify the restocking process at the NNMC pharmacy and reduce the manpower required to fill new orders. Other secondary recommendations to improve the NNMC Pharmacy operations include: _ Perform a full inventory of drugs held at the NNMC Pharmacy to develop a full accounting of all drugs on hand. _ Expand analysis to determine required safety stock for other drugs. _ Promote adoption of a consolidated system to replace DMLSS and CHCS to coordinate ordering and dispensing operations.
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Calhoun, McKenzie L. "Medical Marijuana, CBD and THC." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/6880.
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Queiruga, Caryn, and Rebecca Roush. "Medication Error Identification Rates of Pharmacy, Medical, and Nursing Students: A Simulation." The University of Arizona, 2009. http://hdl.handle.net/10150/623966.
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Class of 2009 AbstractOBJECTIVES: To assess the ability of pharmacy, medicine, and nursing students to identify prescribing errors METHODS: Pharmacy, medicine, and nursing students from the University of Arizona were asked to participate in this prospective, descriptive study. Pharmacy and medical students in the last didactic year of their program and traditional bachelor of nursing students in the fourth semester of their program were eligible to participate. Subjects were asked to assess a questionnaire containing three sample prescriptions, evaluate if each was correct and indicate the type of error found, if any. The primary outcome measure was the number of correctly identified prescribing errors. The secondary outcome measure was the number of correct types of error found. Error identification rates for each group were calculated. Comparisons in these rates were made between pharmacy, medicine and nursing students. Chi square tests were used to analyze the nominal data gathered from various groups. RESULTS: Pharmacy students were significantly better able to identify errors than medical and nursing students (p<0.001). Pharmacy students were significantly better able to determine the type of error (p<0.001). CONCLUSIONS: Overall, pharmacy students had higher prescribing error identification rates than medical and nursing students. More studies need to be done to determine the most appropriate way to increase prescribing error identification rates.
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Coon, Scott D. "The MHS pharmacy benefit efficacy of civilian cost saving strategies." Thesis, Monterey, Calif. : Naval Postgraduate School, 2006. http://bosun.nps.edu/uhtbin/hyperion.exe/06Dec%5FCoon.pdf.
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Hess, Rick, Nicholas E. Hagemeier, Reid B. Blackwelder, Daniel Rose, Nasar Ansari, and Tandy Branham. "Teaching Communication Skills to Medical and Pharmacy Students Using a Blended Learning Course." Digital Commons @ East Tennessee State University, 2016. https://doi.org/10.5688/ajpe80464.
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Objective. To evaluate the impact of an interprofessional blended learning course on medical and pharmacy students’ patient-centered interpersonal communication skills and to compare precourse and postcourse communication skills across first-year medical and second-year pharmacy student cohorts.
Methods. Students completed ten 1-hour online modules and participated in five 3-hour group sessions over one semester. Objective structured clinical examinations (OSCEs) were administered before and after the course and were evaluated using the validated Common Ground Instrument. Nonparametric statistical tests were used to examine pre/postcourse domain scores within and across professions.
Results. Performance in all communication skill domains increased significantly for all students. No additional significant pre/postcourse differences were noted across disciplines.
Conclusion. Students’ patient-centered interpersonal communication skills improved across multiple domains using a blended learning educational platform. Interview abilities were embodied similarly between medical and pharmacy students postcourse, suggesting both groups respond well to this form of instruction.
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Hess, Rick, Nicholas E. Hagemeier, Reid Blackwelder, Daniel Rose, Nasar Ansari, and Tandy Branham. "Teaching Communication Skills to Medical and Pharmacy Students Through a Blended Learning Course." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/1478.
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Objective. To evaluate the impact of an interprofessional blended learning course on medical and pharmacy students’ patient-centered interpersonal communication skills and to compare precourse and postcourse communication skills across first-year medical and second-year pharmacy student cohorts.
Methods. Students completed ten 1-hour online modules and participated in five 3-hour group sessions over one semester. Objective structured clinical examinations (OSCEs) were administered before and after the course and were evaluated using the validated Common Ground Instrument. Nonparametric statistical tests were used to examine pre/postcourse domain scores within and across professions.
Results. Performance in all communication skill domains increased significantly for all students. No additional significant pre/postcourse differences were noted across disciplines.
Conclusion. Students’ patient-centered interpersonal communication skills improved across multiple domains using a blended learning educational platform. Interview abilities were embodied similarly between medical and pharmacy students postcourse, suggesting both groups respond well to this form of instruction.
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Mospan, Courtney M., Rick Hess, Reid Blackwelder, Susan Glover, and Chris Dula. "A Two-Year Review of Suicide Ideation Assessments Among Medical, Nursing and Pharmacy Students." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/6931.
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Thomas, C. M., and John B. Bossaer. "Patient Use of Herbal Supplements in an Outpatient Hematology/Oncology Medical Clinic." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/2356.
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Primary Objective: According to the National Center for Health Statistics, many Americans use some type of vitamin or supplement. A recent study of cancer patients in the VA medical system found that a significant number of cancer patients do not mention the use of supplements to their healthcare providers. Many of these supplements were also found to interact with or compound side effects of chemotherapy regimens. The purpose of this study is to determine the incidence of cancer patients taking supplements and to determine the completeness of home medication lists in regard to vitamins or herbal supplements.
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Mospan, Courtney M., Rick Hess, Reid B. Blackwelder, Susan Glover, and Chris Dula. "A Two-Year Review of Suicide Ideation Assessments Among Medical, Nursing, and Pharmacy Students." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/6904.
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Suicide is the 10th leading cause of death in the U.S. and has increased in prevalence during the past 15 years. Patients who attempt suicide are more likely to have contact with their primary care provider than a mental health provider in the month before attempting suicide, highlighting the need for competency in suicide ideation (SI) assessment. The Communications Skills for Health Professionals is an interprofessional course involving first-year medical, nursing, and pharmacy students. Specific instruction regarding assessment of SI was delivered through an online module and later practiced by students with standardized patients (SP). A final Objective Structured Clinical Examination featured an SP with depression, but without SI, though an assessment of SI was indicated. Three hundred fifty six interviews were reviewed and 55.1% (196/356) of students assessed for SI. Across professions, 65.5% (93/142) of medical students, 52.5% (32/61) of nursing students, and 46.4% (71/153) of pharmacy students performed an assessment. Medical students’ SI assessment was highest across the groups (p = 0.001), while pharmacy students’ SI assessment was lowest (p = 0.004). Results suggest that additional educational strategies should be developed and implemented to increase SI assessment performance in all professions, but especially in pharmacy students.
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Kurowsky, John D. "A Survey of Pharmacy and Medical School Students’ Ability to Recognize Drug-Drug Interactions." The University of Arizona, 2007. http://hdl.handle.net/10150/624404.
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Class of 2007 AbstractObjectives: The purpose of this study was to determine if there is a difference between both graduating medical and pharmacy students in their capabilities to appropriately recognize drug-drug interactions that have led or can lead to serious toxicological consequences in humans. The hypothesis of this study was that there would be no difference between the ability of medical and pharmacy students to recognize potential drug-drug interactions. Methods: A two-page questionnaire was giving during the last semester before both the medical and pharmacy students graduate. The first page requested information about demographics, such as: gender, age, current educational program, previous education in healthcare, other degrees held, and average hours worked in healthcare per week for the past year. The second page contained 22 questions on potential drug-drug interactions. Also, there will be some questions that do not contain any drug-drug interactions. The students had four choices, in which they could answer. The choices were (1) The two drugs should not be used together (contraindicated), (2) The two drugs may be used safely together with monitoring, (3) The two drugs may be used safely together without monitoring, and (4) Not sure if the drugs can be used together. Results: Of the 168 questionnaires distributed, 51 were completed and returned. Forty-seven pharmacy students responded, while only 4 medical students responded. Pharmacy students correctly identified 38.4% + 11.7% of the interactions. The minimum correct responses was 13.6% and the maximum was 68.2% Pharmacy students without a bachelor of science (BS) performed slightly better than the students having a BS with a mean score of 40.0% + 3.0% and 37.1% + 9.0%, respectively. There was no significant difference between the groups (p = 0.42). Males had a mean score of 39.1% + 8.2%, while females had a mean score of 38.1% + 13.1%. There was no significant difference between the groups (p = 0.78). Also, there was no significant difference between the student’s age or how many hours they worked per week regarding the percent of correct responses.
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Alshammari, Adel H. N. A. "Improving community pharmacy consultations for people with depression." Thesis, University of Bradford, 2015. http://hdl.handle.net/10454/14480.
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Aims The aims of this study were to increase community pharmacists’ willingness and confidence to provide consultations for people with depression, and to enhance patients’ awareness of the pharmacists’ developing role. Research Design To observe pharmacist-patient consultations, the researcher developed a patient scenario. Pharmacist knowledge and attitude questionnaires were adapted, and a skills observation checklist was developed. Assessments of patient satisfaction levels took place before and after pharmacist training, which included a simulated consultation and action planning. The consultations were both video recorded and observed. Participants undertook a short interview with the researcher and each pharmacist developed his/her own plan for continuing professional development (CPD). An exploration of the interview transcripts was undertaken qualitatively. A University Ethics Panel approved the project. Results There were twenty-two pharmacists who took part in the study, comprising eighteen males and four females. MPharm students comprised one female and two males, and community pharmacists made up three females and sixteen males. The quantitative results: It was found that pharmacists possessed appropriate knowledge (the mean score was 75%, which showed that the pharmacists were aware of the safety and action of anti-depressants). The mean score for attitude was 54%, which tends towards the positive. When observing the simulated consultations, the mean score for initiating a consultation session was recorded at 28%. This indicates that the pharmacists were not very interested in initiating rapport with patients. However, the highest mean score calculated was 61%, which corresponded with closing a consultation. For data collection and action, the mean scores were 42% and 35%, respectively, and this indicates the need for improvement in these areas. The qualitative findings: The pharmacists demonstrated good knowledge about anti-depressants and held positive attitudes towards people with depression. However, the pharmacists were not very willing to exercise the responsibilities of their extended role or provide additional services for patients. The pharmacists lacked certain skills and opportunities to be able to enhance the patients’ satisfaction. The pharmacists in this study needed to improve their soft skills in some areas and engage in mutual discussion with patients in order to enhance patients’ expectations with the service provided. Conclusion/discussion The knowledge and attitude of pharmacists were good, but their consultation skills could be improved. Although simulated consultation allowed pharmacists to review their skills and practice the apparent impact on patient care was limited. This study has enable greater understanding of pharmacist strategies when consulting people with depression, and the findings could be used by those developing training programmes for enhancing pharmacists skills.
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Duong, Phuc Lam Nate Hongkrailert. "Smoking behavior and status among medical doctors in Cantho University of Medicine and Pharmacy, Vietnam /." Abstract, 2005. http://mulinet3.li.mahidol.ac.th/thesis/2548/cd375/4737967.pdf.
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Bossaer, John B. "The Elephant in the Room: Use and Misuse of Cognitive Enhancers by Students at an Academic Health Sciences Center." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/2335.
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Khoza, Augustine. "Pharmacy Stores Profitability and Sustainability in Bulawayo, Zimbabwe." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/3251.
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Zimbabwe's catastrophic economic decline resulted in a high unemployment rate (95%), declining socioeconomic indicators, pharmacy stores' unprofitability and lower sustainability. Profitable pharmacy stores play a fundamental role in ensuring public access to medication. Lack of pharmacy profitability leads to poor healthcare delivery, resulting in increased morbidity and mortality. A healthy population is panacea to economic growth and prosperity and enhances human dignity, social cohesion, and the quality of life. In this qualitative, descriptive multicase study design, using Porter's business strategies theory and the Deming process of quality assurance as conceptual frameworks, data from 11 pharmacy stores leaders in Bulawayo, Zimbabwe were collected during interviews with open-ended questions. Participants were assumed to have influence, knowledge, and a personal stake in the pharmacy sector and that their views and experiences could address the research question of lack of pharmacy profitability and sustainability. Data were explored, categorized, and tabulated to assist drawing empirical findings and conclusions that could answer the research question. Using software the data were analyzed and themes such as the centrality of strategy in running profitable pharmacies, customer care, reimbursements by medical insurance firms, the role of the legal and regulatory frameworks on pharmacies, and mergers of single-owner pharmacies emerged. Findings from the results might provide strategies for those in the pharmacy retail sector and individuals who intend to explore the sector. Individuals who read results of the study might be influenced to lobby government on behalf of the sector to relax prohibitive regulations.
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Hagemeier, Nicholas E., Nasar Ansari, Tandy Branham, Daniel L. Rose, Richard Hess, and Reid B. Blackwelder. "Teaching Patient-Centered Communication Skills to Medical and Pharmacy Students Using an Interprofessional Blended Learning Course." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/1448.
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Objectives: 1) To evaluate the impact of an interprofessional blended learning course on pharmacy and medical students’ communication skills; 2) To compare pre- and post-course communication skills across cohorts. Method: Pharmacy (N = 57) and medical (N = 67) students enrolled in a required Communication Skills for Health Professionals course completed asynchronous online modules and face-to-face standardized patient interview sessions over the course of 1 semester. Students completed pre- and post-course objective structured clinical examinations with standardized patients and were evaluated by trained faculty using the validated Common Ground Instrument. Communication skill domains evaluated on a 1 to 5 scale included: rapport building, agenda setting, information management, active listening, addressing feelings, and establishing common ground. Nonparametric statistical tests were used to examine paired pre-/post-course domain scores within professions and pre- and post-course scores across professions. Results: Performance in all communication skill domains increased significantly for pharmacy and medical students (p valuesImplications: The blended learning Communication Skills for Health Professionals course improved students’ interpersonal communication skills across multiple domains. Fostering communication skill development in medical and pharmacy students could improve the extent to which future health care professionals engage in patient-centered communication.
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Dathe, René. "Process and efficacy of applying the TRIZ methodology to medical device innovations." Thesis, University of Gloucestershire, 2015. http://eprints.glos.ac.uk/4884/.
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The pharmaceutical business is driven by innovation and new technologies. In order to improve the overall efficiency, the modern R&D organisations nowadays have integrated problem-solving techniques in their innovation process. This thesis aims to explore and analyse the application of TRIZ technique in the problem-solving process in the medical device sector of the pharmaceutical industry. The findings of the literature review indicate that TRIZ can effectively guide the problem-finding process with a tool kit that can recognise patterns and regularities based on the past solutions in a knowledgebase. The results suggest that such systematic approach is more effective than the conventional methods of trial-and-error. This study conducted a survey amongst the innovative medical device departments of various pharmaceutical companies in the Rhine-Main region in Germany and provided contemporary data on the application of problem-solving tools, especially TRIZ, in those institutions. As a result, the survey data also delivered some possible criteria for technical solutions of medical devices which were subsequently discussed and finalised with a group of experienced experts (expert panel). The next step of the study was organised as a 2x2 experiment. During the experiments, two groups of experienced practitioners were asked to improve the design of two sample medical devices, alternatively using TRIZ and brainstorming. The efficacy of TRIZ application was analysed both in terms of the quality of the technical solutions and that of the group work. The SYMLOG Adjective Rating Form method initiated by Bales was used for the assessment of the group work. The results of the experiment indicate that the impact of the problem-solving tools is influenced by the type of innovation problem. For the analysis of such influences, this research makes a contribution to knowledge by proposing a 2-dimensional framework to capture the problem types. In addition, a TRIZ procedure for the technical innovations of medical devices was developed based on the model of Su et al. Due to the sensitive protection of intellectual property in the pharmaceutical industry, field studies of R&D processes in large pharmaceutical firms are limited in the public literature. This work provides valuable insights into this business sector, especially in respect of application of problem-solving tools and how those tools may potentially improve the outcomes of the R&D activities in the pharmaceutical industry.
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Hagemeier, Nicholas E., Rick Hess, Kyle S. Hagen, and Emily L. Sorah. "Impact of an Interprofessional Communication Course on Nursing, Medical, and Pharmacy Students’ Communication Skill Self-Efficacy Beliefs." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/1475.
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Objective. To describe an interprofessional communication course in an academic health sciences center and to evaluate and compare interpersonal and interprofessional communication self-efficacy beliefs of medical, nursing, and pharmacy students before and after course participation, using Bandura’s self-efficacy theory as a guiding framework.
Design. First-year nursing (n=36), first-year medical (n=73), and second-year pharmacy students (n=83) enrolled in an interprofessional communication skills development course voluntarily completed a 33-item survey instrument based on Interprofessional Education Collaborative (IPEC) core competencies prior to and upon completion of the course during the fall semester of 2012.
Assessment. Nursing students entered the course with higher interpersonal and interprofessional communication self-efficacy beliefs compared to medical and pharmacy students. Pharmacy students, in particular, noted significant improvements in communication self-efficacy beliefs across multiple domains postcourse.
Conclusion. Completion of an interprofessional communications course was associated with a positive impact on health professions students’ interpersonal and interprofessional communication self-efficacy beliefs.
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Byrt, Sarah. "Social, medical and geographical aspects of the provision of community pharmacy services in rural West Wales." Thesis, University of Wales Trinity Saint David, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.683168.
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Bossaer, John B., and M. Decoske. "What’s Next? Options After Residency Training." Digital Commons @ East Tennessee State University, 2011. https://www.amzn.com/1449604838.
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Securing and Excelling in a Pharmacy Residency is a practical guide and handbook for pharmacy students seeking a residency, residents currently enrolled in a program, and residency program leadership. This user-friendly text encourages high-quality pharmacy residency training, which elevates the individual, the profession, and ultimately patient care.
Answering the need for residency training and improvement raised by the ASHP/ACCP joint 2020 initiative, Securing and Excelling in a Pharmacy Residency uniquely prepares students for the increasingly competitive pharmacy residency market. This one-of-a-kind resource is also helpful to guide individuals currently enrolled in a residency and their mentors. This valuable resource also addresses options after residency training, priceless guidance for both current residents and faculty advisers.
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Diepeveen, Benjamin. "Second Opinions: Why Canadian Doctors Do Not Always Defend Medical Dominance." Thesis, Université d'Ottawa / University of Ottawa, 2019. http://hdl.handle.net/10393/39662.
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Organized medicine is a uniquely powerful political force in Canada, with physician
colleges and associations exerting extensive influence over healthcare provision. Their
influence has contributed to what social scientists describe as medical dominance, or the exceptional power of the medical profession within the healthcare system and wider
society. However, Canadian medical organizations do not consistently defend this
dominance; rather, they have occasionally lent support to policy changes that, on their
face, would appear incompatible with traditional conceptions of medical power and
authority.
Typically, these instances are explained as a simple matter of strategic retreat: medicine
conceding defeat on a particular issue in an effort to save face or conserve resources,
without any change in underlying beliefs. This dissertation questions that assumption,
asking if at times organized medicine’s support for threats to medical dominance is
instead a function of more fundamental shifts in core policy beliefs. Through a series of
interviews exploring how organized medicine responded to the re-emergence of
midwifery and expansions of pharmacy scope in four provinces (Alberta, Ontario,
Quebec and Nova Scotia), the analysis determines that, while medicine only supported
expanded pharmacy scope out of strategic retreat, there are signs of more substantive
shifts in belief with respect to midwifery. This suggests that the relationship between
organized medicine and traditional medical dominance is more flexible and dynamic than has been assumed.
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Sävlind, Canan. "Customers’ perceptions of the re-regulated pharmacy market : A qualitative study of the views of Stockholm customers five years after the re-regulation process." Thesis, Umeå universitet, Kemiska institutionen, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-101889.
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Moen, Kjetil. "Fra monopol til konkurranse EØS, norsk legemiddelpolitikk og Norsk Medisinaldepot /." Universitetet i Oslo Institutt for statsvitenskap, 1999. http://www.ub.uio.no/ubit/hopp/publ/moen/.
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Clayton-Smith, Bevan, and n/a. "He ratonga hauora Maori me nga ratonga rarau rongoa o Aotearoa e tirohanga, he tataritanga i nga mohio o tenei wa, i nga tumanako me etahi huarahi atu = Maori health providers and pharmacy services in New Zealand : a survey and analysis of current awareness, expectations and options." University of Otago. School of Pharmacy, 2005. http://adt.otago.ac.nz./public/adt-NZDU20070501.142338.
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This research aims to assess the existing relationship and characteristics between Maori health providers (MHPs) and pharmacy services in New Zealand and to provide future direction, pathways and strategies for collaboration, planning and improving health outcomes for Maori within the primary health care environment.
The characteristics of the relationship were identified and discussed before exploring strategies to strengthen the relationship and to improve Māori health outcomes. The assessment and analysis of the characteristics required an exploration of MHPs current knowledge of pharmacy services, the expectations of MHPs of pharmacy services and the current knowledge of pharmacists of MHP services and Maori health.
Themes identified that characterised the relationship were related to knowledge, health philosophies, interaction, service and capacity issues.
Knowledge issues incorporated themes of group dynamics, historical context, participant knowledge, pharmacy participant knowledge, MHP participant knowledge, solutions/ outcome knowledge, consideration of Maori.
Health philosophies related to themes of paradigms/worldviews, kaupapa Maori, capacity, culture and delivery of services, Treaty of Waitangi, knowledge of culture, communication and te reo, rongoa Maori, environmental culture, access, tino rangatiratanga.
Interaction issues discussed the themes of collaboration and communication, extent of collaboration, contact with Maori, community relationships, cost, benefits and opportunities.
The pharmacy environment, cost and health service delivery were identified as themes relating to service issues.
Capacity issues included themes of mana, direct workforce development (education, employment, promotion), indirect workforce development (education, environment, relationship building, funding), and the Maori Pharmacists Association.
This research attempted to follow kaupapa Maori qualitative research methodology, methods and the epistemology of kaupapa Maori throughout the research and design process. One to one semi-structured interviews were conducted with participants from each group. The sample size was established based on the purposeful sampling strategy of maximum variation sampling (7 MHP participants, 8 pharmacy participants.
Responses were directly related to differences in world-views and the historical context of the two health provider groups with respect to their roles in health. Variations within each group were related to knowledge, location and previous experience working with their counterparts.
Recommendations were associated with themes/issues of environment, knowledge, communication, cultural awareness, collaboration, services and the increased awareness of the roles and responsibilities with respect to each health provider group.
This dissertation also highlighted a number of key components that formed a collaborative, empowerment model of health created between organisations with different world-views, which can be adapted to a number of environments where there are different or opposing world-views within the overall same patient population.
It is anticipated that the results and outcomes from this research will help develop Maori responsive pharmacy services based on health promotion and wellness to Maori locally, regionally, nationally and have a positive impact on Maori health in collaboration with MHPs. Areas of pharmaceutical care are highlighted which may encourage projects or initiatives in collaboration with MHPs to enhance health gains for Maori, while increasing professional practice roles and scope for pharmacy.
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Apte, Uday M., and Keebom Kang. "Lean Six Sigma in healthcare: combating the military's escalating pharmacy costs." Monterey, California: Naval Postgraduate School, 2009. http://hdl.handle.net/10945/11064.
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Approved for public release, distribution unlimitedApproved for public release; distribution unlimited.
Healthcare costs throughout the United States are on the rise, drawing increased scrutiny from government officials and Congress. The cost of pharmacy operations and pharmaceuticals is growing at a rate that is alarmingly higher than that of the total cost of military healthcare itself. Recent congressional legislation has essentially given the Department of Defense the ultimatum to cut costs for beneficiaries wherever possible, or risk having benefits arbitrarily cut by Congress. In the face of this possibility, cutting costs through better business practices must be explored, particularly within the area of pharmacy operations. This project explores the potential cost savings that can be realized by implementing Lean Six Sigma (LSS) methodology in the pharmacy operations of the DoD Medical Treatment Facilities (MTF). This research proves that implementing Lean Six Sigma methodology will improve military pharmacy operations, often at little cost, while realizing significant savings and increased customer satisfaction.
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Ubeid, Zeineb. "Hur framtidens apoteksverksamhet kan komma att se ut år 2030." Thesis, Malmö universitet, Fakulteten för hälsa och samhälle (HS), 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-25928.
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Bakgrund: Apoteksverksamheten är en verksamhet som genomgår en ständig förändring. Sedan omregleringen av apoteksmarknaden 2009 har det svenska apoteket genomgått flera förändringar som varit oförutsägbara tidigare. E-handeln har ökat, apotekens tillgänglighet har ökat och likaså har behoven. Hur framtiden kommer att se ut för apotekens del är något vi saknar kunskap kring till skillnad från omvärlden där forskning kring ämnet pågått sedan en lång tid tillbaka. Därav är det av stor vikt att undersöka hur personer på berörda myndigheter och organisationer tror att Sveriges apoteksverksamhet kan komma att se ut år 2030. Metod: Frågeställningen besvarades genom en kvantitativ enkätundersökning som besvarades av olika apoteksaktörer samt myndigheter och organisationer. Enkätfrågorna bestod utav olika påståenden om hur framtidens apoteksverksamhet kan komma att se ut, som de sedan fick instämma i olika grad Resultat : Apoteksaktörerna respektive myndigheter och organisationer hade likadana åsikter inom majoriteten av frågorna. Båda parterna ansåg att e-handeln kommer att öka, apoteket i framtiden kommer att bli en del av sjukvården och att hälsotjänsterna apotek i apotek kommer att öka i omfattning. Diskussion: I vissa frågor var dock åsikterna motsägelsefulla vilket indikerar att det finns ett behov av vidare studier som reder ut frågan djupare samt preciserar innebörden av resultatet för samhället i stort. Slutsats: apoteksverksamheten utveckling i framtiden kommer att resultera i fler hälsotjänster på apotek samtidigt som samarbetet mellan apotek och hälso- och sjukvården i Sverige förbättras är 2030.Background: The pharmacy business is a business that is undergoing constant change. Since the re-regulation of the pharmacy market in 2009, the Swedish pharmacy has undergone several changes that have been unpredictable. E-commerce has increased, the pharmacy's availability has increased and also has the needs. How the future will look for the pharmacy's part is something we lack knowledge about unlike the rest of the world where research on the subject has been ongoing. Hence the great importance to investigate how people at the relevant authorities and organizations believe that Sweden's pharmacy business may look like in 2030. Method: The question was answered by a quantitative questionnaire which various pharmacy actors and authorities/organizations answered. The questions consisted of statements about how the future pharmacy business might look year 2030, which they had to agree to different degrees.Results: The pharmacy actors and authorities /organizations had similar opinions in the majority of the questions. Both parties felt that e-commerce will increase, the pharmacy in the future will become a part of the healthcare system and that the health services in pharmacies will increase in the future. Discussion: In some questions, however, the views were contradictory, which indicates that there is a need for further studies that outweigh the question and clarify the meaning of the result for society as a whole. Conclusion: The pharmacy business development in the future will result in more health services at pharmacies, while the collaboration between pharmacies and healthcare in Sweden will improve by 2030.
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Song, Mi Chi, and Austin Gessay. "Medical, Nursing, and Pharmacy Students’ Ability to Recognize Potential Drug-Drug Interactions: A Comparison of Healthcare Professional Students." The University of Arizona, 2009. http://hdl.handle.net/10150/623967.
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Class of 2009 AbstractOBJECTIVES: The purpose of this study is to evaluate and compare the DDI knowledge of pharmacy, medical, and nurse practitioner students who are beginning clinical clerkships. METHODS: This study utilized a prospective evaluation of DDI knowledge among healthcare professional students who were currently enrolled in their final didactic year at the University of Arizona College of Medicine, College of Pharmacy, or College of Nursing’s nurse practitioner course. Students were provided with 15 possible DDI pairs, and asked to select an appropriate management strategy for each pair. Management options included: “Avoid Combination,” “Usually Avoid Combination,” “Take Precaution,” “No Special Precaution,” and “Not Sure.” The primary outcome measure was the ability to correctly categorize each DDI pair into one of the five management responses. The secondary outcome measure was the number of clinically significant DDIs recognized. Analysis of variance was used to evaluate differences between groups. An alpha of 0.05 was set a-priori. RESULTS: Response rates were 61% for medical students (72 of 119), 82% for pharmacy students (64 of 78) and 100% for nurse practitioner students (29 of 29). The mean number correct for management strategies was comparable in the medical students (2.5, SD= 1.9) and nurse practitioner students (3.0, SD= 1.9), while the pharmacy students had a mean score of 6.1 (SD= 2.2) correct answers. There was a significant difference between the groups in correct responses (p< 0.001). In regards to student ability to identify interactions, the mean number correct was 10.1 (SD= 2.6), 5.0 (SD= 3.3), and 4.4 (SD= 3.0) for pharmacy, medicine, and nursing respectively (F= 60.6; p< 0.001). Post hoc analysis demonstrated that pharmacy students performed significantly better than medical and nurse practitioner students in regards to their ability to: 1) select management strategies for DDI pairs; and 2) identify a DDI interaction. No significant differences were found between the medical and nurse practitioner students. CONCLUSIONS: Pharmacy students demonstrated better knowledge than medical and nurse practitioner students with respect to identifying and selecting management strategies for possible DDIs. However, there is much room for improvement for all groups.
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Peters, David C. II. "Qualitative reports of Michigan medical marijuana patients and caregivers including reduced opiate use, dispensary operations, legal concerns, and marijuana strains." Thesis, Wayne State University, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3602589.
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After hundreds of years of use the medical properties of Marijuana have been marginalized in our society. Qualitative interview data was collected from medical marijuana patients and knowledgeable producers and activists in Michigan about their perceptions and observations on the medical use of marijuana. Patients consistently reported using marijuana to substitute or wean off prescription drugs. All patients and producers who were taking opiate narcotics claimed they reduced overall drug use, especially opiates, by using medical marijuana. Patients and caregivers also claimed medical marijuana was preferred over opiates, eased withdrawal from opiates, and in some cases was perceived as more effective at relieving pain. Other issues explored included the operation of the Michigan Medical Marijuana Act, the formation and operation of medical marijuana centers in the face of countervailing State and federal, opposition, and the varieties and effects of different strains of medical marijuana.
Keywords: Medical Marijuana, State and Federal Marijuana Laws, Michigan Marijuana, Controlled Substances, Drugs, Qualitative Interviews
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Flores, Emily K., and Linsey A. Courtney. "Development of a Partnership for International Rural Advanced Pharmacy Practice Experiences." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/ijhse/vol2/iss1/5.
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Objective. To design a faculty-guided international elective Advanced Pharmacy Practice Expereince (APPE) in partnership with a medical relief organization. To expose students to pharmacy-related opportunities in non-traditional settings focused on an indigent population, while obtaining a global perspective on healthcare.
Methods. The College of Pharmacy partnered with an international medical relief organization utilizing their resources for trip planning and in-country logistics to provide a framework for a pharmacy student rotation. The international trip is a portion of the calendar month rotation, while the balance is faculty-guided discussion groups, involvement in formulary planning, developing educational materials, and local medical relief work. Student course evaluations, exit interviews, and post-trip debriefing were used to evaluate the rotation experience.
Results. The APPE rotation met all pre-selected objectives outlined by the American Association of Colleges of Pharmacy. This is evidenced by complete submersion into a developing country’s culture and healthcare system as well as student course evaluation responses. Students evaluated seven rotation objectives with the College of Pharmacy’s Likert scale. The average score was 4.8 of 5, which demonstrated the student’s either agreed or strongly agreed that each objective was met. Additionally, the response to the exit interview and group de-briefing questions confirmed that the students successfully met the goals and objectives of the APPE rotation.
Conclusions. Partnering with an international medical organization can provide a framework for a faculty-guided international elective APPE experience, requiring minimal resources from the College of Pharmacy while providing a quality international experience.
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Bossaer, John B. "Opioid Patient Education: What You Don’t Know Could Kill." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/2334.
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Kakde, Deepak. "Synthesis, characterisation and applications of new polyesters for drug delivery." Thesis, University of Nottingham, 2016. http://eprints.nottingham.ac.uk/37381/.
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In recent years, a number of reports have focused on the use of polyesters in drug delivery due to their intrinsic biocompatibility and biodegradability. In this thesis, aliphatic polyesters were synthesized by polycondensation reaction and ring opening polymerization reactions. The properties of the polymers and drug delivery potential of the resultant materials were evaluated. In the polycondensation reactions, a series of aliphatic polyesters of similar molecular weight were synthesized by reacting 1,10-decanediol with different ratios of succinic acid/phenylsuccinic acid and the effects of phenyl group side-chain substitution on polymer properties was investigated. A solvent-free melt polycondensation method using scandium (III) triflate as catalyst at an industrially relevant temperature (120 °C) was used. As the phenyl content increased, the polymers changed from semicrystalline to amorphous in state. The loading capability of polymers was checked by formulating nanoparticles containing coumarin 6 as a fluorescent dye analogue of active drugs. A polymer with a 70/30 ratio of succinic acid and phenylsuccinic acid showed the highest dye loading among the set of materials synthesised. This polymer was found to be degradable over time under selected experimental conditions. Amphiphilic block co-polymers from the PluronicTM class were used to stabilize, in PBS, nanoparticles formed from these polyesters by nanoprecipitation routes. The metabolic activity, cell membrane integrity and lysosomal functions of C3A cells dosed with the polymers were determined to observe the cytocompatibility of the highest dye-loaded nanoparticles. Activity relative to undosed C3A cells was retained at more than 80% in the all of the assays. Imaging of Pluronic coated and uncoated nanoparticles in C3A cells suggested that both types of the nanoparticles were endocytosed in the early stage of the study (within 10 min). The internalization of nanoparticles was increased progressively over the study time. These results indicated the possible utility of the selected polymers in diagnostic and delivery applications. Ring opening polymerization (ROP) reactions were used for the synthesis of a diblock (mPEG-b-PεDL) and a triblock (PεDL-b-PEG-b-PεDL) copolymer from a seven membered ε-decalactone (ε-DL) monomer obtained from renewable sources. A diblock (mPEG-b-PεDL) copolymer was compared with structurally similar mPEG-b-PCL copolymer synthesized via ROP of ε-caprolactone (ε-CL) monomer, which can be considered as a non-renewable monomer. A six membered δ-decalactone (δ-DL) was also used for the synthesis of a diblock copolymer (mPEG-b-PδDL) to compare the reaction kinetics and properties of the copolymers. The copolymers were prepared via bulk polymerisation using 1,5,7-Triazabicyclo[4.4.0]dec-5-ene (TBD) as a metal-free catalyst to replace the conventionally used stannous octoate [Sn(Oct)2]. A higher polymerization efficiency was achived with TBD compared to Sn(Oct)2 catalyst. However, a notable difference in the reaction temperature required for ε-DL and δ-DL polymerization was observed. The comparison with a structural analogue, i.e. ε-CL, demonstrated that the ε-DL polymerization was inhibited due to the presence of the alkyl chain of ε-DL monomer. However, a higher reaction time (12 h for TBD and 24 h for Sn(Oct)2) in CROP of ε-DL was addressed by using microwave based ring opening polymerization (MROP) reaction. The MROP was adopted as a ‘green’ and cheap heating method alternative to conventional heating (CROP) for the synthesis of mPEG-b-PεDL diblock copolymers using TBD as a catalyst. All the reactions were conducted in bulk. The MROP was designed based on the dielectric properties of all the reacting materials, as it was found that ε-DL monomers showed good absorption of MW radiation (tanδ>0.5). Accordingly, MROP resulted in a higher rate of ε-DL polymerization compared to CROP but comparison of the synthesis of mPEG-b-PCL copolymer by MROP indicated that the presence of the alkyl chain in ε-DL monomer significantly reduced the rate of polymerization. The synthesized mPEG-b-PεDL copolymer was investigated as a potential drug delivery vehicle for solubilization and controlled delivery of indomethacin. The indomethacin loading and release from mPEG-b-PεDL micelles (amorphous core) was compared against well-established mPEG-b-PCL micelles (semicrystalline core). The drug-polymer compatibility was also determined through a predictive computational approach to access the drug solubilisation (or drug loading) into hydrated micelles. The micelles were prepared by solvent evaporation method and characterized for size, morphology, indomethacin (IND) loading and release. Both of the micelle formulations showed a uniform distribution of spherical micelles with size <60 nm. However, a significantly higher size of empty mPEG-b- PεDL micelle was observed compared to mPEG-b-PCL micelles. A higher compatibility of the drug was predicted with PCL core as determined by modified Flory-Huggins interaction parameters (sp) using the Hanson solubility parameter (HSP) approach. The compatibility of the drug was determined for both of the segments (hydrophilic and hydrophobic) of the copolymers and found to be in the order of sp (PεDL)> sp (mPEG)> sp (PCL). The predictions suggested that more IND should encapsulate within the micelles with PCL core compared to PDL core, but the IND loading experiments revealed an overall higher loading in PεDL core (6.55 wt%) compared to PCL core (5.39 wt%) (P < 0.05, unpaired student’s t-test). However, consideration of the IND loading per unit volume of the micelles revealed that the PCL cored micelles was able to load 1.5 times more compared to the PεDL cored micelles. This result illustrated the higher compatibility of the IND with PCL core in accordance with the solubility parameter calculations. These data also suggested that the overall higher IND loading in PεDL core was attributable to the amorphous nature of the core which increased the core volume by 1.81 times compared to the PCL core. Drug release studies showed the sustained release pattern from both of the micelle systems although the semicrystalline PCL core (80% drug release in 110 h) was able to release the drug for a longer period compared to PεDL core (80% drug release in 72 h). Cell viability tests demonstrated the cytocompatibility of the mPEG-b-PεDL polymer. The micelles were internalized effectively in the early stages of the study and progressively increased with time. The results of the present thesis suggested that novel aliphatic polyester can be good candidates for the drug delivery applications and further studies can explore the possible applications of these polymers in the biomedical field.
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Raisch, Dennis William 1952. "ANALYSIS OF ANTIBIOTIC THERAPY IN SELECTED DIAGNOSIS RELATED GROUPS (CLINICAL PHARMACY, PATIENT CARE, LENGTH OF STAY, TREATMENT, CHARGES)." Thesis, The University of Arizona, 1986. http://hdl.handle.net/10150/276371.
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Shaker, Nuha. "Examining the Influence and Role of Pharmacogenetics among Children with Autism Spectrum Disorder." TopSCHOLAR®, 2017. https://digitalcommons.wku.edu/theses/2037.
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Pharmacogenetics is the study of genomic-guided individualized drug prescription that plays an important role in preventing the severe adverse effects of drugs, decreasing the time and cost of therapeutic choices, and directing healthcare professionals to choose medications that are effective and safe. It is noteworthy that this approach becomes highly beneficial in patients suffering from chronic diseases or disorders, since these conditions may require multiple and long term pharmacological therapies, as in children with autism spectrum disorder (ASD). However, public acceptance is a major challenge when implementation of pharmacogenetics merges into clinical practice. The purpose of this study is a) to investigate, among small cohort group of children with ASD, several genetic variants of enzymes that influence the metabolism of commonly prescribed drugs to treat ASD and b) to inspect the knowledge of, attitude towards and future expectations with regards to pharmacogenetics among parents of children with ASD. A group of 15 school-aged participants with ASD were recruited for the study. Approximately 5 ml of venous blood was drawn for each participant to analyze the genotype of enzymes implicated in drug metabolism via pharmacogenetics testing. Thereafter, the parents of these children attended a training session to help them gain a better understanding of the pharmacogenetics results depicted in the drug panel results. A pre-training and post-training survey was conducted to assess the knowledge of, attitude towards and future expectations of pharmacogenetics among the children’s parents.
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Han, Ling 1955. "Use of anticholinergic medications predicts symptom severity of delirium in older medical impatients : a prospective cohort study with repeated measurements." Thesis, McGill University, 2000. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=33406.
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Background. Anticholinergic (ACH) medications are among biologically plausible and potentially modifiable risk factors of delirium. But the epidemiological findings on its role in hospitalized elderly patients are conflicting. Objectives. To evaluate the association between use of ACH medications and delirium severity and the potential effect-modification on this association by dementia. Methods. A cohort of 278 medical inpatients aged 65 years and over with diagnosed delirium was prospectively followed up with the Delirium Index (DI) every 2--7 days up to 3 weeks in a primary acute care hospital. Their DI scores were associated with measures of ACH medication exposure in the previous day using the mixed linear regression model adjusting for potential confounders or effect modifiers. Results . A total of 47 potential ACH medications were used in the cohort (mean: 1.4 per patient per day). An increase in daily ACH medication exposure of one such medication was on average associated with a subsequent increase in delirium severity of 0.52 DI points (95% CI: 0.3--0.8) after adjusting for dementia, baseline DI score, length of follow-up and concurrent use of non-ACH medications. Dementia did not modify the association. Sensitivity analyses using alternative definitions of ACH medications or excluding antipsychotics did not change the results. Conclusions. Exposure to ACH medications is independently and specifically associated with a subsequent increase in symptom severity of delirium among elderly medical inpatients.
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Yao, Wei-yen Rosa. "An evaluation of the reform and quality of pharmacy service in Hospital Authority : a case study at Princess Margaret Hospital /." Hong Kong : University of Hong Kong, 1995. http://sunzi.lib.hku.hk/hkuto/record.jsp?B14035534.
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Maahs, Michael Keith. "Medical Academia Conflict of Interest Policy and Potential Impact on Research Funding." ScholarWorks, 2015. http://scholarworks.waldenu.edu/dissertations/1317.
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Medical Academia Conflict of Interest Policy and Potential Impact on Research Funding
by
Michael K. Maahs
MPA, Troy University, 1993
BA, Ripon College, 1990
Dissertation Submitted in Partial Fulfillment
of the Requirements for the Degree of
Doctor of Philosophy
Public Policy and Administration
Walden University
July 2015
The partnership between medical academia and the pharmaceutical industry has been scrutinized for issues associated with research bias. As a result of this scrutiny, the Institute of Medicine (IOM) issued policy recommendations in 2009 directing academia to adopt comprehensive conflict of interest (COI) policies. During the same time, a slowdown of funded research into academia occurred, and it is not clear whether the IOM recommendations contributed to this problem. The purpose of this case study was to determine the extent to which compliance with the IOM policy resulted in a reduction in funded research. The Advocacy Coalition Framework (ACF) was the theoretical lens used for study. COI policy statements (n = 15) were analyzed from American Association of Medical Colleges member schools that engage in medical research. In addition, in-depth interviews were conducted with 4 medical academic researchers. Data were inductively coded and organized around key themes. Key findings indicated that medical academia is compliant with IOM recommendations and COI policies did not appear to have a direct effect on research placement by industry. Interestingly, a possible explanation for reductions in industry funding relate to inefficient institutional review board processes. Additionally, the ACF construct was validated via an observed complex and slowly evolving COI policy process. The positive social change implications of this study include recommendations to academia to continue to monitor and report on COI and explore efficiency improvements related to IRB oversight in order to support important pharmaceutical research that ultimately improves the health and wellbeing of people.
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Hall, Scott Thomas, Ferena Salek, Edina Hall, and Jon Glover. "Description of a Pharmacy Technician and Student Intern-Driven Medication Reconciliation Process and Evaluation of Medical Provider Acceptance of Recommendations to Reorder Critical Medications." The University of Arizona, 2011. http://hdl.handle.net/10150/614604.
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Class of 2011 AbsrtactOBJECTIVES: To describe a pharmacy technician and student intern-driven medication reconciliation process and to evaluate medical provider acceptance of recommendations to reorder critical medications. METHODS: Patients admitted to Northwest Medical Center had medication histories taken on admission. A specially trained pharmacy technician or student intern reviewed these histories, with emphasis placed on critical medications as defined by the Pharmacy and Therapeutics Committee. Recommendations to re-order these critical medications were made to medical providers. All patients, excluding those under 18 years of age or current enrollment in the prison system, admitted during the months of May-June 2010 were reviewed for acceptance of critical medication recommendations through information recorded in the pharmacy electronic medical record system. RESULTS: One hundred seventy-eight (178) recommendations were made on 132 patients requiring recommendations. All medical providers accepted 102 (57%, p-value=0.008) of the recommendations made. Hospitalists were more likely than physician specialists or surgeons to accept recommendations made (62.5%, p-value<0.001). Recommendations made regarding thyroid products were accepted the greatest majority of the time (82.1%, p-value<0.001); antidepressants (54.8%, p-value=0.321), anticonvulsants (63.2%, p-value=0.194), and medications classified as other (55.6%, p-value=0.480) were also accepted a majority of the time. Vitamin K antagonists did not have recommendations accepted a majority of the time (31.8%, p-value=0.034). CONCLUSION: Medical providers accepted a majority of recommendations to reorder critical medications made by pharmacy technicians or student interns.
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Kim, Myo-Kyoung. "PEER-REPORTING OF ACADEMIC DISHONESTY IN CLASSROOM AND ONLINE EXAMINATIONS: PREVALENCE, EXPERIENCES, PERCEPTIONS, AND BELIEFS OF PHARMACY STUDENTS." Scholarly Commons, 2020. https://scholarlycommons.pacific.edu/uop_etds/3723.
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The purpose of this study was to investigate pharmacy students’ experiences, perceptions, and beliefs regarding peer-reporting of academic dishonesty by adopting a cross-sectional anonymous survey to pharmacy students in the United States. In addition, this study identified factors that may affect pharmacy students’ likelihood of reporting peers’ academic dishonesty including the relationship between the cheater and their observer, the severity of the punishment on the reported cheating, and the reporting systems. Fifty-six out of 271 respondents (20.7%) reported their engagement of academic dishonesty. One hundred forty-four respondents (53.1%) reported that they directly observed someone else’s cheating behavior. One hundred eighty-nine respondents (69.7%) reported that they indirectly heard about someone else’s cheating behavior from others who directly observed cheating; yet, only 25 respondents (9.2%) peer-reported their classmates’ cheating.The current study shows that although the majority of participants believe that peer-reporting is ethical, they have not reported the cheating they observed due in part to fear of retaliation and no information (or clear direction) on who they should report to or how to report. Additionally, the current study shows that if an innovative system to anonymously report cheating (e.g., a specific peer-reporting website or hotline to protect confidentiality) is adopted, the likelihood to report in the innovative system is higher than in the current system across all types of student-student relationships and all levels of punishment. The current study also demonstrated a statistically significant inverse relationship between likelihood to report and punishment severity. Peer-reporting can be an effective method when well-established polices protect peer-reporters from retaliation and when transparent and reasonable punishments are assigned to those who engage in academic dishonesty. It is imperative that pharmacy schools consider these findings, review their policies regarding academic integrity and its peer-reporting, and modify practices so that professionalism is encouraged and expected.
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Van, Sickle John David. "The rise of asthma and allergy in South India: How representations of illness influence medical practice and the marketing of medicine." Diss., The University of Arizona, 2004. http://hdl.handle.net/10150/290053.
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Asthma has become one of the most commonly talked about and politically charged health topics in India. Yet, less than a decade ago, international studies reported that rates of the disease in the country were among the lowest in the world. This dissertation examines how asthma rapidly became a preeminent health concern in Tamil Nadu. I document and critically examine factors that have led to the phenomenon of asthma, from the multiple perspectives of its sufferers, the practitioners who diagnose and treat the disease, and the pharmaceutical companies that develop and market products for its management. I examine how popular representations of asthma and allergy--which view the disease as the result of an increasingly toxic environment, a more susceptible population, and new, modern ways of life--have influenced the social meaning and medical management of asthma. Using a variety of data, I describe patterns of health care seeking, the therapeutic regimens prescribed for asthma, and the important role played by factors such as the affordability of medications, and the perceptions of the activity and potential harm of medications, such as steroids. I look at increasing coverage of asthma in the Indian print media, and the efforts of the private health care industry and Indian environmental organizations, to draw further attention to the disease. Through detailed clinical observations and interviews with a wide range of allopathic and traditional Indian medical practitioners, I outline the variety of professional understandings and therapeutic approaches toward asthma, describe important differences in the interpretations of its symptoms, and examine the medical and social factors contributing to misdiagnoses, underdiagnosis, and undertreatment. In addition to medical knowledge about asthma, practice patterns are determined by a variety of practical logics, including economic competition in the pluralistic marketplace, the social relations of disease labels, and the pressures to forge a stable relationship between practitioner and patient. Finally, I describe the variety of techniques through which some of the leading drug companies in India have actively promoted asthma and allergy, and provide an ethnographic account of the introduction of new asthma drugs--the leukotriene receptor antagonists--to the Indian market.
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Graden, Suzanne. "National Estimate of Cost of Illness for Hypertension and Non-Persistence with Drug Therapy Using the Medical Expenditure Panel Survey." The Ohio State University, 2003. http://rave.ohiolink.edu/etdc/view?acc_num=osu1046972930.
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Chang, Vicki, and Stephanie Campbell. "An Evaluation of Student Pharmacist Admission Medication Histories at a Level 1 Trauma, Academic Medical Center: A Descriptive Study." The University of Arizona, 2017. http://hdl.handle.net/10150/624163.
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Class of 2017 AbstractObjectives: The purpose of this study is to demonstrate the effect of using advanced pharmacy practice experience (APPE) students in the collection of admission medication history at an academic teaching hospital prior to pharmacist review. Methods: The study is a retrospective, descriptive study. Using electronic medical records, the study looked at patients admitted to specific floors during a two-month period. The primary outcome was number of discrepancies found by the APPE students. The secondary outcome was the type of discrepancy found (omission, duplication, wrong dose, wrong frequency, wrong dosage form, and medications the subject no longer takes). Results: Over eight weeks, the APPE students identified 2,666 discrepancies, which equates to approximately 4.71 ± 4.76 discrepancies per patient. The majority of these discrepancies were identified as omissions of therapy (39.1%), followed by medications the patients were no longer taking (29.8%), and wrong dosing frequencies (18.1%). Conclusions: APPE students assisted the medication reconciliation process by identifying numerous medication discrepancies which may have prevented patient harm. APPE students are an underutilized resource and prove to be an asset to the healthcare team.
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Hanna, Bishoy. "DEVELOPMENT AND VALIDATION OF A SEMI-PHYSIOLOGICAL PHARMACOKINETIC (PBPK) MODEL TO PREDICT SYSTEMIC AND PULMONARY EXPOSURES AFTER INTRAVENOUS, ORAL ADMINISTRATION AND PULMONARY INHALATION OF SELECTED DRUGS, BUDESONIDE, TOBRAMYCIN AND CIPROFLOXACIN, IN HUMANS." VCU Scholars Compass, 2018. https://scholarscompass.vcu.edu/etd/5470.
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Using a semi-PBPK modeling/quantitative meta-analysis approach, this project investigated what factors affect pulmonary and systemic exposures of Budesonide (BUD), Tobramycin (TOB), and Ciprofloxacin (CIP) after inhalation:
Three structurally different pulmonary disposition models were developed for each drug, including pulmonary absorption (all three), excretion (TOB and CIP) and sequestration (TOB) in a peripheral and central lung compartment. Systemic disposition parameters were estimated using available human mean plasma (cp(t)) and sputum (cs(t)) concentration profiles after IV administration, and GI absorption parameters were estimated from these profiles after oral administration. Pulmonary disposition parameters were estimated from cp(t) and cs(t) profiles after inhalation using various devices along with their published pulmonary deposition characteristics. Appropriate covariate models accounted for effects of Cystic Fibrosis on the systemic disposition/GI absorption for TOB and CIP. Monte Carlo Simulations (MCS) were used to optimize parameters and validate the final models and parameter spaces against published data.
Despite limited available data, especially cs(t) for BUD and CIP (after IV administration), the point estimates for the final model parameters were mechanistically plausible for all three drugs and consistent with their known differences in physicochemical and ADME properties. Model predictions adequately described the observed cp(t) and cs(t) profiles as well as exposure metrics across studies.
As the most lipophilic drug, BUD showed the fastest pulmonary absorption rates and highest Fpul (83%). TOB, a very hydrophilic drug, exhibited (intracellular) pulmonary sequestration, resulting in slow pulmonary absorption and excretion and low Fpul (10%). CIP - as zwitterion - showed relatively slow pulmonary absorption and excretion, leading to low Fpul (8%); pulmonary excretion accounted for 27% of CIP overall elimination.
Results of a formal parameter sensitivity analysis demonstrated that, for all three drugs, after inhalation, (1) their systemic exposures (cp(t)) depend primarily on CLtot along with Fpul/sequestration combined with Foral; (2) increasing pulmonary exposures (cs(t)) can be accomplished by slowing down pulmonary absorption rates (kca) and/or slowing down mucociliary clearance from the lungs into the GI tract (kcm) – affirming the overall hypothesis guiding the project.
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Walls, Zachary, John B. Bossaer, and David Cluck. "Using Scientific Inquiry to Increase Knowledge of Vaccine Theory and Infectious Diseases." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/2326.
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Background: The aim of this study was to design and evaluate a laboratory activity based on scientific inquiry to educate first-year pharmacy students in the U.S. about vaccination theory and the attributes of common pathogens. Methods: The laboratory activity had two principal sections. The first consisted of an interactive game during which students rolled a die to determine outcomes based on a set of pre-determined criteria. In the second section, students generated and tested hypotheses about vaccine theory using a computer simulation that modeled disease transmission within a large population. In each section students were asked to evaluate epidemiological data and make inferences pertinent to vaccination effectiveness. Results: Mean scores on a knowledge-based assessment given immediately before and immediately after the activity increased from 46% to 71%. Discussion: A laboratory activity designed to stimulate scientific inquiry within pharmacy students enabled them to increase their knowledge of common vaccines and infectious diseases.
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Yao, Wei-yen Rosa, and 姚惠穎. "An evaluation of the reform and quality of pharmacy service in Hospital Authority: a case study at PrincessMargaret Hospital." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1995. http://hub.hku.hk/bib/B31964874.
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Ababneh, Mera. "Predictors of Carbapenem Resistant Gram-negative Bacteria in a Consortium of Academic Medical Center Hospitals." VCU Scholars Compass, 2012. http://scholarscompass.vcu.edu/etd/302.
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Background: Gram-negative resistance is a growing problem worldwide. It is generally believed that rates of resistant bacteria within a hospital are a function of antibiotic use, resistant organisms brought into the hospital, infection control efforts, and underlying severity of patient illness. The relative contribution of each to a particular resistance phenotype is unclear. P. aeruginosa is responsible for many hospital acquired infections and it may become resistant to carbapenems. In addition, newer threats to the future utility of the carbapenems are carbapenemase-producing K. pneumoniae Purpose: To determine if there is an association between the volume and composition of antibiotic use, geography, severity of illness and rates of carbapenem-resistant P. aeruginosa and K. pneumoniae. Methods: This is a retrospective ecological longitudinal investigation within the University HealthSystem Consortium affiliated academic medical centers. Antibiotic use data between January 1, 2006 and December 31, 2009 were obtained from billing records and reported as days of therapy per 1000 patient days (DOT/1000 PD), in addition to hospital characteristics (e.g. geographical location, bed size, case mix index). “Whole house” antibiograms were obtained to determine rates and proportions of carbapenem-resistant P. aeruginosa (CR-PA) and carbapenem resistant K. pneumoniae (CR-KP). Also, CR-KP isolation was generated as a binary outcome. Generalized estimating equations (GEE) were used to model CR-KP and CR-PA. Results: CR-KP rates (1000PDs) increased from 0.07 in 2006 to 0.15 in 2009 (P= 0.0118) and CR-KP proportions increased from 1.3% in 2006 to 3.1% in 2009 (0.0003) within 40 hospitals over 2006-2009. However, CR-PA rates and proportions were stable over the same period. Geographical location, carbapenems use, and antipseudomonal penicillins use were significantly associated with CR-KP isolation. Thus, for every ten DOT/1000 PDs increase in carbapenem use, the odds of CR-KP isolation increased by 42% (P=0.0149). In contrast, for every ten DOT/1000 PDs increase in antipseudomonal penicillin use, the odds of CR-KP isolation decreased by 14%. However, there was no significant model to explain CR-PA rates and proportions. Conclusion: Carbapenems, antipseudomonal penicillins, and geographical location were identified as risk factors associated with CR-KP isolation. These findings emphasize the challenges associated with the treatment of multidrug- gram-negative bacteria.
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Wallace, Rick L., Emily C. Weyant, and Nakia J. Woodward. "Using Checklists to Rethink Library Resources and Services Training." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/8677.
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This article presents the use of the Checklist as a tool to tailor and enhance library resource instruction and the faculty response. A checklist was developed that covered the information resources of the library and the information skills needed by pharmacy faculty. Librarians learned the value of using a checklist. Better relationships were developed with the college of pharmacy faculty. Weaknesses in the library’s training of pharmacy faculty were discovered and remedied. Checklists are used in medicine to obtain quality. Checklists can be used in medical librarianship for the same purpose.
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Віжунов, Віктор Леонідович, Виктор Леонидович Вижунов, Viktor Leonidovych Vizhunov, Костянтин Костянтинович Васильєв, Константин Константинович Васильев, and Kostiantyn Kostiantynovych Vasyliev. "Вольные аптеки Лебединского уезда в конце ХІХ- начале ХХ вв." Thesis, Издательство СумГУ, 2011. http://essuir.sumdu.edu.ua/handle/123456789/14496.
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Futter, William Thomas. "An analysis of the relationship between the sources of conflict and the stages in the conflict process within the marketing channel comprising retail pharmacy managers and medical doctors." Thesis, Rhodes University, 1988. http://hdl.handle.net/10962/d1001628.
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Marketing channels have traditionally been examined as commercial conduits the sale objective of which was to facilitate the flow of goods from producer to consumer. This approach emphasized functional and structural aspects of the channel and was primarily concerned with the efficiency of the distribution system. During the last two decades, marketing channels have increasingly been viewed as social systems affected by the behavioural dimensions of power, conflict, roles and communication. The rapid growth of vertical marketing systems with greater authority and interdependence between channel members, have stimulated interest in this field. Nevertheless, research has been limited and characterized by methodological problems and conceptual differences about the definitions of behavioural variables and their relationships. Some attempts have been made to develop an integrated framework within which to conduct research into channel relationships, but the validity and relaibility of these models has not been tested. This research project examined the relationship between the sources of conflict and stages in the conflict process. The sources of conflict were subdivided into attitudinal and structural categories, the latter being concerned with goal differences, the desire for autonomy in the face of interdependence and competition for scarce resources. The conflict process model adopted by the author assumes the existence of stages of latency, feeling, perception, manifestation and aftermath in each conflict episode. The first four were treated as separate behavioural states for which different levels of conflict intensity were measured. In order to provide greater explanatory power to the results of the analysis, the perceptions of two respondent groups were identified, namely the leader group, consisting of channel members responsible for the overall strategic interests of the channel, and the affected group, consisting of channel members who had been adversly affected by the activities of their partners in the channel dyad. In addition, respondents were asked to identify separately, their perceptions of the macro and micro levels of conflict in the four conflict states. The marketing channel for prescription medicines was selected for the study. The focal dyad consisted of retail pharmacy managers and doctors with single respondent perceptual measures being obtained from the retail pharmacy managers. A mail survey of all the retail pharmacy managers in South Africa, South West Africa/Namibia, and the independent homelands conducted in July 1987 resulted in a 40% response rate (1031 returns). Tests indicated statistically significant differences between the perceptual measures representing the sources and stages of conflict, the macro and micro levels of the stages of conflict and between the leader and the non-leader groups and the affected and non-affected groups. A sequential hierarchy in the level of conflict measured in the behavioural states was indicated, with decreasing levels of conflict being identified in states of latency, perception, feeling and manifestations, respectively. An analysis of the results revealed that attitudinal sources of conflict were more important that structural sources in measures of perceptions, feelings and manifestations of conflict behaviour. In the latent conflict state, structural sources assumed greater importance than attitudinal sources. In most of the measures, the sources of conflict were more correlated with perceptions of conflict at the macro level than the micro level. The exception was manifest conflict for which micro conflict levels were more important. The major sources of conflict were differences in perceptions, differences in goals and the lack of autonomy. The leader group indicated a particular concern for attitudinal factors, particularly communication difficulties. The affected group, whilst identifying attitudinal factors as being the most important, was especially concerned with their lack of autonomy from the doctor, rather than the competition for scarce resources which could have been expected. An overall assessment of the level of conflict between retail pharmacy managers and doctors indicated that the channel dyad was relatively free from conflict. Relationships were characterized by a degree of satisfaction, some degree of harmony and little evidence of conflict behaviour.
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Blazejewski, Lucas M. "Ohio Pharmacists’ Provision of Non-Dispensing Services to Underserved Populations: Involvement, Willingness, Capabilities, and Barriers to Care." University of Toledo Health Science Campus / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=mco1342157653.
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Tejomurthula, Sravanthi. "Overexpression of Human Aryl Hydrocarbon Receptor in E.coli Using Two Different Solubility Enhancing Tags." Scholarly Commons, 2017. https://scholarlycommons.pacific.edu/uop_etds/261.
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Dioxins such as TCDD are environment pollutants whose toxic effects are mediated via aryl hydrocarbon receptor (AhR) signaling pathway. AhR is a ligand sensitive transcription factor. The unbound AhR resides in cytoplasm as a complex containing p23, Hsp90 and XAP2. Upon ligand binding, AhR undergoes conformational change and translocates into the nucleus. Once the AhR dimerizes with AhR nuclear translocator (Arnt), the chaperone proteins in the complex get dissociated followed by the activation of transcription of various genes such as CYP1A1 and CYP1A2 by AhR-ARNT heterodimer. Various cancers have altered levels of AhR in the absence of ligand. Our current knowledge is only limited in the regulation of AhR protein levels in its ligand bound state. However, the mechanism involved in the regulation of AhR protein levels in the absence of ligand is still unknown. To make the study of AhR signaling pathway possible, our lab has been working on the expression of various AhR constructs in E.coli using recombinant DNA technology. As AhR forms inclusion bodies due to its poor solubility in the cytoplasm of the host bacteria, it is tagged as a “difficult to express” protein. Therefore, it is challenging to generate functional recombinant AhR protein. My thesis documents the expression of human AhR construct amino acid 108-400 using two different solubility enhancing tags (thioredoxin and maltose binding protein). Western blot data revealed that the soluble expression of the human AhR construct by thioredoxin solubility enhancing tag has outperformed the other.
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Patlolla, Karthik Reddy. "Predicting aqueous solubility of pharmaceutical agents by solid dispersion prepared by solvent evaporation method." Scholarly Commons, 2015. https://scholarlycommons.pacific.edu/uop_etds/268.
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Solubility of active pharmaceutical agents is a crucial process that determines drug absorption and ultimately its bioavailability. Many of the new therapeutically beneficial compounds discovered are lipophilic requiring various solubility enhancement strategies to improve their solubility. Among these strategies, solubility enhancement using solid dispersions is a leading method. To obtain a desirable increase in the solubility of a poorly-soluble compound, a good understanding of the molecular descriptors influencing the enhancement of solubility is essential. Therefore, the major research objective was to determine the descriptors which significantly influence the solubility enhancement by solid dispersions. After enhancing the solubility of selected poorly-soluble model compounds, a regression analysis was performed to determine the correlation of molecular descriptors of the active agent, polymer, and solvent with solubility enhancement. The partition co-efficient, hydrogen bonding and solubility parameters of polymer and water were found to influence the aqueous solubility of the poorly-soluble compounds. Aqueous solubility of a compound had an inverse relation with difference in solubility parameters of polymer and water. Similarly partition coefficient was found to be inversely related to aqueous solubility. However for an increase in hydrogen bond acceptors present in pharmaceutical agents increased their solubility, while the higher number hydrogen bond donors resulted in lower solubility. This complexity can be attributed to the contribution of hydrogen bonding in a crystal lattice and in aqueous environment. In conclusion, the contribution of partition co-efficient, solubility parameter and hydrogen bonding were found to be significant for a given set of poorly-soluble model compounds selected with a wide range of descriptors. Several models estimating aqueous solubility of compounds have been employed as screening tool in drug development process. However, all such models were developed to estimate aqueous solubility of pure active agents. Hence, the second research objective was to develop a model that could estimate aqueous solubility of Active Pharmaceutical Ingredient (API) in solubility-enhanced solid dispersions. Using multiple linear regression, a computational model was developed using the molecular descriptors of poorly-soluble compound, polymer and water. S=(2.02*HBA)-(3.37*??)-(11.56*log?P )-(0.9*HBD)+119.66 The model showed a regression (R2) value of 0.858. Upon validation, the model estimated the aqueous solubility of 79% of the compositions evaluated with within 20% variability.