Introdução. A profissão farmacêutica está em uma fase de transição na qual se tenta resgatar ao farmacêutico o papel de responsável pela farmacoterapia. Nesse sentido, a dispensação de medicamentos e a realização da Atenção Farmacêutica emergem como ferramentas eficazes para viabilizar o sucesso do tratamento medicamentoso. Entretanto, para que os resultados sejam favoráveis à saúde do usuário de medicamentos, é fundamental que o profissional possua o conhecimento necessário para a realização dos serviços farmacêuticos citados e demonstre condutas adequadas frente aos mesmos. Além disso, o tempo despendido pelos farmacêuticos com atividades não relacionadas à profissão e os interesses comerciais sobre a venda dos medicamentos podem limitar a realização adequada desses serviços. Objetivo. Avaliar o conhecimento dos farmacêuticos para a prática da dispensação de medicamentos e da Atenção Farmacêutica em drogarias, verificando suas condutas para executá-las. Casuística e Métodos. Durante o desenvolvimento deste estudo descritivo, todas as drogarias de quatro municípios brasileiros foram visitadas entre outubro e dezembro de 2012 e os farmacêuticos que atuavam nesses estabelecimentos foram convidados a responder um questionário estruturado e validado contendo 47 perguntas relacionadas aos profissionais e às drogarias onde trabalhavam. Os dados coletados foram tabulados em duplicata por dois pesquisadores independentes, sendo posteriormente analisados. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da Faculdade de Ciências Farmacêuticas de Ribeirão Preto. Resultados e Discussão. Durante a coleta de dados foram visitadas 486 drogarias e apenas 112 farmacêuticos aceitaram participar do estudo. A maioria deles era do gênero feminino (72,3%), tinha entre 20 e 30 anos de idade (48,2%), havia se formado em instituições privadas (72,8%) e trabalhava na mesma drogaria entre um e cinco anos (49,1%). Mais da metade dos participantes ocupava a função de responsável técnico (55,4%), sendo que 38,7% deles trabalhavam mais que 44h/semana e 40,3% recebiam menos que o piso salarial como remuneração. Com relação à dispensação de medicamentos, 78,6% dos farmacêuticos não apresentaram conhecimento satisfatório para realizar esse serviço, o que revela possíveis lacunas na formação e na educação continuada dos profissionais. Inversamente ao que ocorre em países mais desenvolvidos, verificou-se que as atividades gerenciais são realizadas com frequência pelos profissionais, restando um curto período de tempo para a dispensação. Fatores como o comissionamento sobre a venda de medicamentos e a comercialização de produtos alheios a saúde representam obstáculos para que as drogarias sejam compreendidas como estabelecimentos de saúde. Os participantes demonstraram não possuir conhecimento satisfatório também com relação a Atenção Farmacêutica, havendo participantes que delegam a funcionários leigos em Farmácia a responsabilidade pela execução desse serviço. Setenta e nove farmacêuticos alegaram realizar a Atenção Farmacêutica, mas apenas quatro parecem desempenhar as atividades relacionadas a essa prática conforme determina a legislação sanitária. Conclusão. Os farmacêuticos não possuem conhecimento suficiente para realizar a dispensação de medicamentos e a Atenção Farmacêutica em drogarias, além de apresentarem condutas inadequadas à promoção do uso racional de medicamentos durante a dispensação. / Introduction. The pharmacy profession is in a transition phase in which it tries to rescue the role of pharmacists as professionals responsible for the pharmacotherapy. In this way, dispensing of drugs and Pharmaceutical Care practice emerge as effective tools to enable the success of drug treatment. However, it is essential that the professional acquire the necessary knowledge and demonstrate adequate behavior to perform the pharmaceutical services mentioned above in order to provide results that improve the health of patients. Furthermore, the time spent by pharmacists with activities not related to the profession and the commercial interests on the sale of drugs may limit the proper performance of those services. Objective. To evaluate the knowledge of pharmacists to the practice of dispensing of drugs and Pharmaceutical Care in pharmacies, verifying their behavior to accomplish these services. Patients and Methods. During the development of this descriptive study, all pharmacies of four Brazilian municipalities were visited between October and December 2012. The pharmacists who worked in these establishments were invited to answer a structured and validated questionnaire containing 47 questions related to the professionals and the pharmacies where they worked. The collected data were tabulated in duplicate by two independent researchers for later analysis. The study was approved by the Research Ethics Committee of the School of Pharmaceutical Sciences of Ribeirão Preto. Results and Discussion. During data collection, 486 pharmacies were visited but only 112 pharmacists agreed to participate on the study. Most of them were female (72.3%), from 20 to 30 years old (48.2%), graduated in private institutions (72.8%) and worked in the same pharmacy between one and five years (49.1%). More than half of the participants were pharmacist supervisors (55.4%), while 38.7% of them worked more than 44h/week and 40.3% earned less than the minimum salary recommended. Considering the dispensing of drugs, 78.6% of the pharmacists did not present enough knowledge to perform this service, which reveals possible gaps in training and continuous education of this professionals. In contrast to what occurs in more developed countries, the management activities are performed frequently by this professionals remaining a short period of time to perform dispensing of drugs. Factors such as the commissioning of drug sales and marketing of products unrelated to health represent obstacles to make the pharmacies recognized as health establishment. The participants demonstrated a lack of satisfactory knowledge even in relation to Pharmaceutical Care, since they delegate the responsibility of this service to lay employees. Seventy-nine pharmacists claimed to perform pharmaceutical care, but only four appear to perform activities related to this practice according to what is stated by the sanitary legislation. Conclusion. The pharmacists lack sufficient knowledge to perform dispensing of drugs and pharmaceutical care in pharmacies, moreover they present some inadequate behavior to promote the rational use of drugs.

Introdução. A profissão farmacêutica está em uma fase de transição na qual se tenta resgatar ao farmacêutico o papel de responsável pela farmacoterapia. Nesse sentido, a dispensação de medicamentos e a realização da Atenção Farmacêutica emergem como ferramentas eficazes para viabilizar o sucesso do tratamento medicamentoso. Entretanto, para que os resultados sejam favoráveis à saúde do usuário de medicamentos, é fundamental que o profissional possua o conhecimento necessário para a realização dos serviços farmacêuticos citados e demonstre condutas adequadas frente aos mesmos. Além disso, o tempo despendido pelos farmacêuticos com atividades não relacionadas à profissão e os interesses comerciais sobre a venda dos medicamentos podem limitar a realização adequada desses serviços. Objetivo. Avaliar o conhecimento dos farmacêuticos para a prática da dispensação de medicamentos e da Atenção Farmacêutica em drogarias, verificando suas condutas para executá-las. Casuística e Métodos. Durante o desenvolvimento deste estudo descritivo, todas as drogarias de quatro municípios brasileiros foram visitadas entre outubro e dezembro de 2012 e os farmacêuticos que atuavam nesses estabelecimentos foram convidados a responder um questionário estruturado e validado contendo 47 perguntas relacionadas aos profissionais e às drogarias onde trabalhavam. Os dados coletados foram tabulados em duplicata por dois pesquisadores independentes, sendo posteriormente analisados. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da Faculdade de Ciências Farmacêuticas de Ribeirão Preto. Resultados e Discussão. Durante a coleta de dados foram visitadas 486 drogarias e apenas 112 farmacêuticos aceitaram participar do estudo. A maioria deles era do gênero feminino (72,3%), tinha entre 20 e 30 anos de idade (48,2%), havia se formado em instituições privadas (72,8%) e trabalhava na mesma drogaria entre um e cinco anos (49,1%). Mais da metade dos participantes ocupava a função de responsável técnico (55,4%), sendo que 38,7% deles trabalhavam mais que 44h/semana e 40,3% recebiam menos que o piso salarial como remuneração. Com relação à dispensação de medicamentos, 78,6% dos farmacêuticos não apresentaram conhecimento satisfatório para realizar esse serviço, o que revela possíveis lacunas na formação e na educação continuada dos profissionais. Inversamente ao que ocorre em países mais desenvolvidos, verificou-se que as atividades gerenciais são realizadas com frequência pelos profissionais, restando um curto período de tempo para a dispensação. Fatores como o comissionamento sobre a venda de medicamentos e a comercialização de produtos alheios a saúde representam obstáculos para que as drogarias sejam compreendidas como estabelecimentos de saúde. Os participantes demonstraram não possuir conhecimento satisfatório também com relação a Atenção Farmacêutica, havendo participantes que delegam a funcionários leigos em Farmácia a responsabilidade pela execução desse serviço. Setenta e nove farmacêuticos alegaram realizar a Atenção Farmacêutica, mas apenas quatro parecem desempenhar as atividades relacionadas a essa prática conforme determina a legislação sanitária. Conclusão. Os farmacêuticos não possuem conhecimento suficiente para realizar a dispensação de medicamentos e a Atenção Farmacêutica em drogarias, além de apresentarem condutas inadequadas à promoção do uso racional de medicamentos durante a dispensação. / Introduction. The pharmacy profession is in a transition phase in which it tries to rescue the role of pharmacists as professionals responsible for the pharmacotherapy. In this way, dispensing of drugs and Pharmaceutical Care practice emerge as effective tools to enable the success of drug treatment. However, it is essential that the professional acquire the necessary knowledge and demonstrate adequate behavior to perform the pharmaceutical services mentioned above in order to provide results that improve the health of patients. Furthermore, the time spent by pharmacists with activities not related to the profession and the commercial interests on the sale of drugs may limit the proper performance of those services. Objective. To evaluate the knowledge of pharmacists to the practice of dispensing of drugs and Pharmaceutical Care in pharmacies, verifying their behavior to accomplish these services. Patients and Methods. During the development of this descriptive study, all pharmacies of four Brazilian municipalities were visited between October and December 2012. The pharmacists who worked in these establishments were invited to answer a structured and validated questionnaire containing 47 questions related to the professionals and the pharmacies where they worked. The collected data were tabulated in duplicate by two independent researchers for later analysis. The study was approved by the Research Ethics Committee of the School of Pharmaceutical Sciences of Ribeirão Preto. Results and Discussion. During data collection, 486 pharmacies were visited but only 112 pharmacists agreed to participate on the study. Most of them were female (72.3%), from 20 to 30 years old (48.2%), graduated in private institutions (72.8%) and worked in the same pharmacy between one and five years (49.1%). More than half of the participants were pharmacist supervisors (55.4%), while 38.7% of them worked more than 44h/week and 40.3% earned less than the minimum salary recommended. Considering the dispensing of drugs, 78.6% of the pharmacists did not present enough knowledge to perform this service, which reveals possible gaps in training and continuous education of this professionals. In contrast to what occurs in more developed countries, the management activities are performed frequently by this professionals remaining a short period of time to perform dispensing of drugs. Factors such as the commissioning of drug sales and marketing of products unrelated to health represent obstacles to make the pharmacies recognized as health establishment. The participants demonstrated a lack of satisfactory knowledge even in relation to Pharmaceutical Care, since they delegate the responsibility of this service to lay employees. Seventy-nine pharmacists claimed to perform pharmaceutical care, but only four appear to perform activities related to this practice according to what is stated by the sanitary legislation. Conclusion. The pharmacists lack sufficient knowledge to perform dispensing of drugs and pharmaceutical care in pharmacies, moreover they present some inadequate behavior to promote the rational use of drugs.

Introdução. A profissão farmacêutica está em uma fase de transição na qual se tenta resgatar ao farmacêutico o papel de responsável pela farmacoterapia. Nesse sentido, a dispensação de medicamentos e a realização da Atenção Farmacêutica emergem como ferramentas eficazes para viabilizar o sucesso do tratamento medicamentoso. Entretanto, para que os resultados sejam favoráveis à saúde do usuário de medicamentos, é fundamental que o profissional possua o conhecimento necessário para a realização dos serviços farmacêuticos citados e demonstre condutas adequadas frente aos mesmos. Além disso, o tempo despendido pelos farmacêuticos com atividades não relacionadas à profissão e os interesses comerciais sobre a venda dos medicamentos podem limitar a realização adequada desses serviços. Objetivo. Avaliar o conhecimento dos farmacêuticos para a prática da dispensação de medicamentos e da Atenção Farmacêutica em drogarias, verificando suas condutas para executá-las. Casuística e Métodos. Durante o desenvolvimento deste estudo descritivo, todas as drogarias de quatro municípios brasileiros foram visitadas entre outubro e dezembro de 2012 e os farmacêuticos que atuavam nesses estabelecimentos foram convidados a responder um questionário estruturado e validado contendo 47 perguntas relacionadas aos profissionais e às drogarias onde trabalhavam. Os dados coletados foram tabulados em duplicata por dois pesquisadores independentes, sendo posteriormente analisados. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da Faculdade de Ciências Farmacêuticas de Ribeirão Preto. Resultados e Discussão. Durante a coleta de dados foram visitadas 486 drogarias e apenas 112 farmacêuticos aceitaram participar do estudo. A maioria deles era do gênero feminino (72,3%), tinha entre 20 e 30 anos de idade (48,2%), havia se formado em instituições privadas (72,8%) e trabalhava na mesma drogaria entre um e cinco anos (49,1%). Mais da metade dos participantes ocupava a função de responsável técnico (55,4%), sendo que 38,7% deles trabalhavam mais que 44h/semana e 40,3% recebiam menos que o piso salarial como remuneração. Com relação à dispensação de medicamentos, 78,6% dos farmacêuticos não apresentaram conhecimento satisfatório para realizar esse serviço, o que revela possíveis lacunas na formação e na educação continuada dos profissionais. Inversamente ao que ocorre em países mais desenvolvidos, verificou-se que as atividades gerenciais são realizadas com frequência pelos profissionais, restando um curto período de tempo para a dispensação. Fatores como o comissionamento sobre a venda de medicamentos e a comercialização de produtos alheios a saúde representam obstáculos para que as drogarias sejam compreendidas como estabelecimentos de saúde. Os participantes demonstraram não possuir conhecimento satisfatório também com relação a Atenção Farmacêutica, havendo participantes que delegam a funcionários leigos em Farmácia a responsabilidade pela execução desse serviço. Setenta e nove farmacêuticos alegaram realizar a Atenção Farmacêutica, mas apenas quatro parecem desempenhar as atividades relacionadas a essa prática conforme determina a legislação sanitária. Conclusão. Os farmacêuticos não possuem conhecimento suficiente para realizar a dispensação de medicamentos e a Atenção Farmacêutica em drogarias, além de apresentarem condutas inadequadas à promoção do uso racional de medicamentos durante a dispensação. / Introduction. The pharmacy profession is in a transition phase in which it tries to rescue the role of pharmacists as professionals responsible for the pharmacotherapy. In this way, dispensing of drugs and Pharmaceutical Care practice emerge as effective tools to enable the success of drug treatment. However, it is essential that the professional acquire the necessary knowledge and demonstrate adequate behavior to perform the pharmaceutical services mentioned above in order to provide results that improve the health of patients. Furthermore, the time spent by pharmacists with activities not related to the profession and the commercial interests on the sale of drugs may limit the proper performance of those services. Objective. To evaluate the knowledge of pharmacists to the practice of dispensing of drugs and Pharmaceutical Care in pharmacies, verifying their behavior to accomplish these services. Patients and Methods. During the development of this descriptive study, all pharmacies of four Brazilian municipalities were visited between October and December 2012. The pharmacists who worked in these establishments were invited to answer a structured and validated questionnaire containing 47 questions related to the professionals and the pharmacies where they worked. The collected data were tabulated in duplicate by two independent researchers for later analysis. The study was approved by the Research Ethics Committee of the School of Pharmaceutical Sciences of Ribeirão Preto. Results and Discussion. During data collection, 486 pharmacies were visited but only 112 pharmacists agreed to participate on the study. Most of them were female (72.3%), from 20 to 30 years old (48.2%), graduated in private institutions (72.8%) and worked in the same pharmacy between one and five years (49.1%). More than half of the participants were pharmacist supervisors (55.4%), while 38.7% of them worked more than 44h/week and 40.3% earned less than the minimum salary recommended. Considering the dispensing of drugs, 78.6% of the pharmacists did not present enough knowledge to perform this service, which reveals possible gaps in training and continuous education of this professionals. In contrast to what occurs in more developed countries, the management activities are performed frequently by this professionals remaining a short period of time to perform dispensing of drugs. Factors such as the commissioning of drug sales and marketing of products unrelated to health represent obstacles to make the pharmacies recognized as health establishment. The participants demonstrated a lack of satisfactory knowledge even in relation to Pharmaceutical Care, since they delegate the responsibility of this service to lay employees. Seventy-nine pharmacists claimed to perform pharmaceutical care, but only four appear to perform activities related to this practice according to what is stated by the sanitary legislation. Conclusion. The pharmacists lack sufficient knowledge to perform dispensing of drugs and pharmaceutical care in pharmacies, moreover they present some inadequate behavior to promote the rational use of drugs.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Objective: To describe the studies on the working process during the practice of pharmacist dispensing. Methods: Three systematic reviews the following steps were performed accordingly: (1) identification of studies in the following databases: PubMed / Medline, Web of Science, Scopus, and Lilacs, using the descriptors ''counseling'', ''dispensing'', ''community pharmacy services'',' ''pharmacies'' and ''pharmacists'' and its synonyms with different combinations; (2) evaluation studies, in which the title and summary were eligible, according to the following inclusion criteria: studies were conducted in community pharmacies, studies on the working process in the practice of pharmaceutical dispensing and articles published in English, Portuguese or Spanish. (3) Full Text evaluation according to the following inclusion criteria: - 1st Systematic Review: The aim of this review was to understand the process of work and the quality indicators used in the Dispensation. Thus, we had the following inclusion criteria: studies with quality indicators in the dispensing work process; - 2nd Systematic Review: this review aimed to identify the questions and instructions given by the pharmacist and propose a model of practice for dispensing. Therefore, he presented as specific inclusion criteria: studies that have questions and/ or guidelines in the work process in the practice of pharmaceutical dispensing; - 3rd Systematic Review: whose objective was to evaluate the studies documenting the work process in the practice of pharmaceutical dispensing. Therefore, we had the specific inclusion criteria: studies that addressed the documentation of the work process in the practice of pharmaceutical dispensing. When there were differences between the two evaluators, a third evaluator examined and judged discrepancies in each systematic review. The databases were reviewed until September 02, 2015. Results: - In the first systematic review included 60 articles. The studies showed high heterogeneity indicating the lack of standardization of the practice of pharmaceutical dispensing work process. It was found that the quality of the tools used to evaluate the dispensing work process was not often assessed. Nine quality indicators in practice dispensing work process were found. - In the second systematic review articles 65 were included, with most studies used the method of Simulated patient, with most patients showing a passive behavior. by were listed and quantified the most common questions and instructions given pharmacists as: identification and clinical condition of the patient, indication, dose and effect of the drug, allergy, duration of treatment, adverse effects, drug interactions, non-pharmacological treatments and referral to the doctor. - In the third systematic review were included 26 articles. Few studies have addressed the documentation as part of the dispensing work process and most documented by non-computerized instruments. Conclusion: Studies on pharmaceutical dispensing should be standardized, which will facilitate the comparison of results and measure the working process of this service. Protocols, algorithms and practical documentation are needed to guide, standardize the work process of dispensing and measuring the impact of interventions by community pharmacists in patient care. / Objetivo: descrever os estudos publicados sobre o processo de trabalho durante a prática da dispensação farmacêutica. Métodos: Três revisões sistemáticas foram realizadas de acordo as seguintes etapas: (1) identificação de estudos nas seguintes bases de dados: PubMed/ Medline, Web of Science, Scopus e Lilacs, usando os descritores ‘‘counseling”, ‘‘dispensing”, ‘‘community pharmacy services’’, ‘‘pharmacies’’ and ‘‘pharmacists’’ e seus sinônimos com diferentes combinações; (2) avaliação de estudos, no qual o título e resumo foram elegíveis, de acordo com as seguintes critérios de inclusão: estudos serem conduzidos em farmácias comunitárias, estudos sobre o processo de trabalho na prática da dispensação farmacêutica e artigos publicados em inglês, português ou espanhol. (3) avaliação do texto completo de acordo com os critérios de inclusão a seguir: - 1ª Revisão Sistemática: o objetivo desta revisão foi conhecer o processo de trabalho e os indicadores de qualidade utilizados na Dispensação. Assim, teve-se como critérios de inclusão: estudos com indicadores de qualidade no processo de trabalho da Dispensação; - 2ª Revisão Sistemática: esta revisão visou Identificar as perguntas e orientações realizadas pelo farmacêutico e propor um modelo de prática para a dispensação. Logo, apresentou-se como critérios de inclusão específicos: estudos que tiveram perguntas e/ou orientações no processo de trabalho na prática da dispensação farmacêutica; - 3ª Revisão Sistemática: cujo objetivo foi avaliar os estudos que documentaram o processo de trabalho na prática da dispensação farmacêutica. Portanto, teve-se como critério de inclusão específico: estudos que abordaram a documentação no processo de trabalho na prática da dispensação farmacêutica. Quando ocorreram divergências entre os dois avaliadores, um terceiro avaliador analisou e julgou as discrepâncias em cada revisão sistemática. As bases de dados foram revisadas até 02 de setembro de 2015. Resultados: - Na primeira revisão sistemática foram incluídos 60 artigos. Os estudos apresentaram alta heterogeneidade indicando a falta de padronização do processo de trabalho da prática da dispensação farmacêutica. Foi detectado que a qualidade dos instrumentos utilizados para avaliar o processo de trabalho da dispensação não foi, muitas vezes, avaliada. Nove indicadores de qualidade no processo de trabalho da dispensação prática foram encontrados. – Na segunda revisão sistemática foram incluídos 65 artigos, sendo que a maior parte dos estudos utilizou o método do Paciente Simulado, com a maioria dos pacientes apresentando comportamento passivo. Foram listadas e quantificadas as perguntas e orientações mais comuns realizadas pelos farmacêuticos como: identificação e condição clínica do paciente, indicação, dose e ação do medicamento, alergia, duração do tratamento, efeitos adversos, interações medicamentosas, tratamentos não farmacológicos e encaminhamento ao médico. – Na terceira revisão sistemática foram incluídos 26 artigos. Poucos estudos abordaram a documentação como parte do processo de trabalho da dispensação e a maioria documentou por meio de instrumentos não informatizados. Conclusão: Estudos e a prática da dispensação farmacêutica devem ser padronizados, o que irá facilitar a comparação dos resultados e medir o processo de trabalho desse serviço. Protocolos, algoritmos e documentação da prática são necessários para guiar, padronizar o processo de trabalho da dispensação e medir o impacto das intervenções dos farmacêuticos comunitários no cuidado ao paciente.

Magister Public Health - MPH / Background: Optimal management of Type 2 diabetes requires that patients have a convenient method of collecting chronic medication. In the Western Cape Province, Type 2 diabetes patients can collect chronic medication from primary health care facilities including community health centres. The Chronic Dispensing Unit (CDU) was established to facilitate the dispensing of chronic medication by making medication collection more convenient for patients and was expected to improve medication collection. However, it has been observed that some Type 2 diabetes patients fail to collect pre-packed CDU parcels on the prescribed date and time which could result in poor treatment outcomes and secondary complications. This study therefore aims to explore the factors that influence collection of CDU chronic medication parcels by Type 2 diabetes patients from the Elsies River Community Health Centre (CHC), a primary health care facility in the Western Cape Province. Methodology: An exploratory qualitative research design was used to explore the personal-, social-, health system-related factors that affect collection of pre-packed CDU parcels. Semistructured interviews were conducted in English or Afrikaans with 18 purposefully selected Type 2 diabetes patients who are registered to collect pre-packed CDU parcels from the Elsies River CHC, and three key-informants from the Elsies River CHC. Data was recorded using a digital recorder. Interviews were transcribed and analysed using inductive content analysis. Results: The main factors that facilitate collection of pre-packed CDU parcels were support from family and social support. On the other hand, social factors that were reported as barriers to collection were the safety of the patients and collectors failing to collect on behalf of the patient. Patients' recognition of the value of their treatment and value of the service were the main personal factors which facilitated collection. Personal factors that were reported as a barrier to collection included forgetfulness, laziness and tiredness. Other personal factors that were reported by participants as barriers to collection were illness, transport problems, financial constraints and anticipating non-collection. Health service related factors reported as facilitating factors were reduced waiting time and mistrust of the off-site collection system. In addition, participation in the diabetes chronic club and pharmacy support were also reported as facilitating factors. Negative staff attitude and a limited collection time for pre-packed CDU parcels were reported as barriers to collection by Conclusion: Various personal-, social and health service related factors affect the collection of pre-packed CDU parcels by Type 2 diabetes patients from the Elsies River CHC. To improve collection among patients who fail to collect on their appointment date, the factors that have been found to facilitate collection should be extended to more patients. Recommendations: It is recommended that patients surround themselves with support structures including family, friends and community organisations to assist and motivate them in displaying adherent behaviour. Patients who make use of independent collectors should ensure that these individuals are reliable to avoid an undersupply of medication. Counselling and health promotion should be provided to patients by health service staff as a means of encouragement and empowerment. The diabetes club which serves as a source of information and support should be accessed by more patients. Open communications channels between health service staff and patients should be constructed to ensure that staff are aware of the barriers patients face.

Background: Dispensing medication is a chain of multiple stages, and any error during the dispensing process may cause potential or actual risk for the patient. Few research studies have investigated the nature and contributory factors associated with dispensing errors in hospital pharmacies. Aim: To determine the nature and severity of dispensing errors reported in the hospital pharmacies at King Saud Medical City (KSMC) hospital in Saudi Arabia, and at Luton and Dunstable University Hospital (L&D) NHS Foundation Trust in the UK; and to explore the pharmacy staff perceptions of contributory factors to dispensing errors and strategies to reduce these errors. Materials and Methods: A mixed method approach was used and encompassed two phases. Phase I: A retrospective review of dispensing error reports for an 18-month period at the two hospitals. The potential clinical significance of unprevented dispensing errors was assessed. Data was analysed using descriptive statistics in SPSS and A Fisher's test was used to compare the findings. Phase II: Self-administered qualitative questionnaires (open-ended questions) were distributed to the dispensary teams in KSMC and L&D hospitals. Content analysis was applied to the qualitative data using NVivo qualitative analysis software. Result: Dispensing the wrong medicine or the incorrect strength were the most common dispensing error types in both hospitals. Labelling errors were also common at the L&D pharmacy dispensary. The majority of the unprevented dispensing errors were assessed to have minor or moderate potential harm to patients. Look-alike/sound-alike medicines, high workload, lack of staff experience, fatigue and loss of concentration during work, hurrying through tasks and distraction in the dispensary were the most common contributory factors suggested. Ambiguity of the prescriptions was a specified factor in the L&D pharmacy, while poor pharmacy design and unstructured dispensing process were specified contributory factors in the KSMC pharmacy. Conclusions: Decreasing distractions and enhancing the pharmacy design and the dispensing workflow are necessary to reduce dispensing errors. Furthermore, monitoring and reporting errors and educating the dispensary team about these errors is also needed. Automation and e-prescribing systems may improve dispensing efficiency and safety. The findings of this study reemphasise the fact that dispensing errors are prevalent in hospital pharmacies. Efficient interventions need to be implemented to mitigate these errors.

If the analyses of trace components in complex organic samples are to be optimised, then these compounds must be isolated either physically or chemically from surrounding matrices. Ion mobility spectrometry (IMS) is an analytical technique used worldwide for the detection of on-site trace compounds. The technique can be optimised to isolate the target species from complex matrices through both physical separation, based on the mobility of the analyte ions at ambient pressure, and chemical discrimination through preferential ionisation of the target. Optimisation of the latter is commonly achieved through doping the spectrometer with a selective reagent gas, termed a dopant. The chemical processes required to optimise the responses of target analytes are dependent on the identity and concentration of the dopant. As such, a variety of dopants have been successfully implemented in ion mobility spectrometers. The technology for the deliverance of dopants in IMS is commonly through permeation sources, which provide a stable chemical environment in the ion mobility cell. Althoughrelatively inexpensive and durable, these devices are difficult to change and generally deliver a single dopant concentration. As a result, only one type of chemistry is possible and the responses cannot be optimised for a range of analytical applications. Such limitationsbecome increasingly significant when IMS is hyphenated to a chromatograph where a range of different dopant conditions may be sought over the course of a chromatographic run. This thesis sought to overcome these limitations through the development and implementation of piezoelectric dispensers, interfaced directly to the transport gas regions of IMS cells. The study demonstrates for the first time the ability to use piezoelectric dispensing as a dopant introduction methodology in IMS for controlling and calibrating a range of dopant chemistries. 2-butanol, acetone, dichloromethane, 1-chlorohexane, 4-heptanone and 1-bromohexane were the candidate dopants chosen for the studies, covering a wide range of physical and chemical properties. The novel technology was used to dispense the target dopants into IMS cells at concentration ranges over three orders of magnitude. Dopant chemistries were achieved within three seconds from the point of dispensing, administered in drop-ondemand formats, and could be delivered either transiently or at steady-state concentrations. The concept was validated through integrated spectral dopant responses. In transient control, dynamic linear relationships of R2 = 0.991 - 0.998 were achieved between dispensed dopant mass and peak area. Under continuous operation, the RSD of the dopant level was < 18% for all dopants. Clear out times for dopant responses were in the order of 3-5 seconds, indicating negligible hysteresis effects. The study also proved the concept of controlling monomer and dimer ion chemistries from 2-butanol actuations when interfaced to a differential mobility spectrometer at mass fluxes between 21 - 1230 ng m-3 , and the simultaneous control of dopants in negative and positive ionisation modes to RSDs <10%. This thesis describes the techniques used to optimise the piezoelectric dispensing of the full dopant range, as well as the full design protocols required to interface to mobility spectrometers. The outcomes from these studies provide a realisation for piezoelectric dispensers as a future mainstream dopant introduction technique for the analysis of complex samples.

The aim of this thesis was to describe how a manual assembly process of polycarbonate sheets for heat exchangers can be automated with an industrial robot. The objectives were to design suitable robot cell concepts and simulate them to describe how the automated process could be done and to present which machines and equipment that could be used. Additionally, productivity rates and investment costs was to be calculated.The project started with a situation assessment and a literature review. Experts and suppliers of robotic equipment were consulted, and the results served as a basis for the concept generation process. Several concept ideas were evaluated, and three ideas using adhesive for the assembly were chosen for further studies and simulation. Existing products and machines were used in the designs when possible. By modeling and simulating the cells in simulation software, feasible cell designs was created, and cycle times were measured.The three proposed solutions all utilize an industrial robot, a vacuum gripper and adhesive as the assembly method. Two of the concepts has the robot attending different adhesive dispensing machines; one gantry and one conveyor. In the third concept, the robot applies the adhesive. The cell design that achieved the lowest cycle time in the simulations was the conveyor concept, with a cycle time of 21 seconds per sheet. The conclusion of the study is that investing in a robot cell would increase productivity. / Syftet med detta arbete var att designa en robotcell anpassad för tillverkning av värmeväxlarpaket i moduler. Målet var att besvara hur tillverkningen av värmeväxlare kan automatiseras samt vilken robot och övriga verktyg och maskiner som kan användas. Vidare skulle den möjliga produktionstakten och investeringskostnaden för designförslagen beräknas. Arbetet inleddes med en nulägesanalys och en litteraturstudie. Ett flertal experter och leverantörer inom automationsområdet konsulterades. Resultaten från detta låg till grund för en konceptgenereringsprocess i vilken ett flertal designidéer togs fram. Tre av dessa designförslag valdes ut för vidare studier och simulering. Genom att modellera och simulera robotcellerna kunde de utformas realistiskt och möjliga cykeltider beräknas. De tre designförslagen använder alla en robotarm, ett vakuumgripdon samt lim som metod för monteringen. Två av koncepten består av en medelstor robotarm som betjänar en limappliceringsmaskin. I ena konceptet är det en kartesisk robot med limbord som används för limappliceringen, i det andra är det ett transportband som för plastskivan under ett antal limpistoler. Det tredje designförslaget låter en större robot, utrustad med verktygsväxlare, utföra alla moment i processen genom att den byter verktyg mellan vakuumgripdon och limpistol. Det koncept som uppnådde den lägsta cykeltiden i simuleringarna var lösningen med rullbandet, med en cykeltid på 21 sekunder per skiva. Studiens slutsats är att en investering i en robotcell skulle leda till ökad produktivitet jämfört med manuell produktion.

The aim of this diploma thesis is to design and create a prototype of automatic pipetting head that will be useful for pipetting in laboratories after attaching it to a robotic manipulator. In the beginning, a research about various types of automatic pipetting heads was made followed by a device design and component analysis. The prototype was made using 3D printing method and it utilises a peristaltic pump, Arduino microcontroller and Bluetooth interface. A measurement of repeatability and dispensing accuracy was made on the finished device. The results are evaluated in the conclusion.

This thesis deals with rework of BGA components. There are described defects and errors in a solder joints. The current trend is focused on thin packages with fine pitch. It is assembled with smaller and smaller solder balls. It is described effect of different application of flux and solders paste for rework. The main part is focused on dipping and dispensing. These methods are suitable for repair process.