Class of 2010 Abstract / OBJECTIVES: The objective of this study is to compare the number of medication refill errors that occur between the Pyxis Medstation 3500 and the Pyxis PARx automated dispensing systems. The accuracy of refilling Pyxis Medstation 3500 automated dispensing machines by pharmacy technicians at the University Medical Center (UMC) was assessed during six days in July 2009. The accuracy was then reassessed over the course of five days in September 2009, one month after implementation of the new Pyxis PARx barcode technology in August. All medications in both the morning and afternoon Pyxis refill reports generated by the UMC inpatient pharmacy were audited during the chosen days. METHODS: The accuracy of refilling Pyxis Medstation 3500 automated dispensing machines by pharmacy technicians at a 350-bed, tertiary-care, teaching hospital with a total of 50 automated dispensing systems was assessed during five days in July 2009. The accuracy was then reassessed over the course of five days in September 2009, one month after implementation of the new Pyxis PARx barcode technology in August. It was assumed that the following types of medication refill errors would be reduced: 1)Wrong drug, Wrong strength 2) Wrong drug, Right strength 3) Right drug, Wrong strength 4) Filling error/Wrong pocket 5) Overfill of pocket 6) Expired medication 7) Right drug, Wrong form. This study was a prospective evaluation of medication refill errors between an older automated dispensing system (Pyxis Medstation) and a newer system (Pyxis PARx). The addition of PARx barcode technology automates the pick and delivery method in order to enhance security during the medication refill process. When the appropriate drawer is opened, the medication must be scanned using the handheld scanner to make sure the correct medication is being refilled. All medications from each Pyxis refill report on the chosen days were audited during pre and post implementation of the new Pyxis PARx barcode technology. Medications to be audited were identified by collecting data from each automated dispensing system listed on the refill reports for the previous day. Audits were performed on the following day (i.e., Monday’s refill reports was audited on Tuesday) by study investigators. Each completed refill was audited for the above medication errors and a brief description of any errors found was noted. RESULTS: A total of 825 refilled items were audited prior to PARx installation (from dates 7/14/09-7/19/09) and a total of five errors were found. Post PARx installation, 959 items were audited (from dates 9/24/09-9/29/09) and a total of two errors were found. Overall, the types of errors encountered were Right Drug/Wrong Form (1/7, 14.3%), Filling Error/Wrong Pocket (2/7, 28.6%), Overfill (1/7, 14.3%), Expired Medication (2/7, 28.6%) and Right Drug/Wrong Strength (1/7, 14.3%). A Chi-square analysis was done to compare pre and post-PARx implementation errors found. The Chi square value was found to be 1.79 with a p-value of 0.18, meaning that there is an 18% probability that any deviation from expected is due to chance. Thus, per our investigation the installation of PARx did not significantly decrease refill error rates. CONCLUSIONS: In Progress

Master of Public Health - MPH / Background: The irrational use of medicines is a global public health challenge, particularly in developing countries like Nigeria. One of the consequences of irrational medicine use is rising antimicrobial resistance, which continues to contribute to the increase in morbidity, mortality, and high cost of care, despite breakthroughs in medicine and new treatment options. Community pharmacists have been identified as contributors to antimicrobial resistance through their antibiotic dispensing practices. However, there is little research on community pharmacists who provide private healthcare in Nigeria. Aim: This study described the antibiotic dispensing practices of community pharmacists and factors associated with such dispensing practices in Jos, Nigeria. Methodology: The study used a cross-sectional descriptive design. Simple random sampling was used to select a sample of 84 community pharmacies out of a total of approximately 107 community pharmacies in Jos, and one community pharmacist from each community pharmacy. A research assistant was trained to administer the questionnaire along with the researcher and collect information on community pharmacists’ demographics, antibiotic dispensing practices, and the factors associated with those dispensing practices. The socio-demographic data was analysed via descriptive analytical tools such as simple percentages and crosstabulations. These tools were used to generate a descriptive picture of the data, patterns and associations using SPSS version 25. Quantitative content analysis was done on responses to scenario-based questions, and recommendations made as to how the dispensing of antibiotics could be improved. Ethical clearance was obtained from the University of the Western Cape Biomedical Research Ethics Committee and Jos University Teaching Hospital, while informed consent was obtained from all community pharmacists before the commencement of the study. Results: The majority of the community pharmacists (87%) indicated that patients could purchase antibiotics without prescription from their pharmacies, and most pharmacists (98%) asked for reasons why antibiotics were demanded for without prescriptions. While 58% indicated that patients could purchase partial quantities of prescribed antibiotics at their pharmacies, 96% investigated the reasons for partial requests, and 94% counselled on the right dosage and frequency of the prescribed antibiotics. Sixty-seven percent of the pharmacists indicated that one of the major reasons for dispensing antibiotics without prescription was self-medication by patients, while most (87%) indicated that financial constraint was a major reason why patients requested for partial quantities of prescribed antibiotics. Conclusion: The dispensing of non-prescribed and part-prescribed antibiotics is a common practice amongst community pharmacists in Jos, Nigeria. Enhancing the financial status of Nigerians, as well as ensuring stricter regulatory measures on antibiotic use, would help promote rational use of antibiotics and reduce rising antimicrobial resistance rates.

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Reproduction de : Thèse d'exercice : Pharmacie : Nantes : 2008. / Bibliogr.

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Σκοπός της έρευνάς μας είναι να διευκρινίσουμε το προφίλ των καταναλωτών με βάση την επιλογή τους για τον τόπο αγοράς των καλλυντικών, να ερευνήσουμε τους λόγους της επιλογής τους, τις ανάγκες που καλύπτουν τα φαρμακεία, τα σούπερ μάρκετ ή τα πολυκαταστήματα καλλυντικών και πώς το φαρμακείο μπορεί να προσαρμοστεί σε αυτές ούτως ώστε να καλύψει μεγαλύτερο μέρος της αγοράς. Επιπλέον επιδιώκουμε να μελετήσουμε πώς τα δημογραφικά στοιχεία, ο τρόπος ενημέρωσης αλλά και πιο συγκεκριμένα στοιχεία όπως είναι η συσκευασία του καλυντικού και ο τρόπος προώθησής του, επηρεάζει τη συμπεριφορά του καταναλωτή. Για το λόγο αυτό δημιουργήσαμε ένα ερωτηματολόγιο το οποίο μας βοηθάει να αξιολογήσουμε την αγοραστική συμπεριφορά του κοινού σε σχέση με δημογραφικούς, οικονομικούς και μορφωτικούς παράγοντες. Πριν παραθέσουμε τα αποτελέσματα της έρευνας, θα κάνουμε μία σύντομη ανασκόπηση στην παρούσα βιβλιογραφία σχετικά με το μάρκετινγκ των καλλυντικών στο φαρμακείο. Θα αναφερθούμε στις ισχύουσες τάσεις της αγοράς και της κοινωνίας που επηρεάζουν τις πωλήσεις των καλλυντικών ούτως ώστε να μπορέσουμε να τις συσχετίσουμε με τις ερωτήσεις και τις απαντήσεις που λάβαμε. Στη συνέχεια, θα αναλυθεί η μεθοδολογία της έρευνάς μας, ο τρόπος σχηματισμού του ερωτηματολογίου και η λογική πίσω από τις ερωτήσεις. Κατόπιν θα γίνει μια λεπτομερής αναφορά και ανάλυση των αποτελεσμάτων της δειγματοληπτικής έρευνας, τα οποία θα σχολιαστούν και θα συσχετιστούν με τις δεδομένες ανάγκες της αγοράς του φαρμακείου. Τέλος θα παρατεθεί η βιβλιογραφία με τη βοήθεια της οποίας συγγράφηκε η διπλωματική εργασία. / -

No description available.

This thesis considers the structural characteristics of online criminal networks from a technical and an economic perspective. Through large-scale measurements, we empirically describe some salient elements of the online criminal infrastructures, and we derive economic models characterizing the associated monetization paths enabling criminal profitability. This analysis reveals the existence of structural choke points: components of online criminal operations being limited in number, and critical for the operations’ profitability. Consequently, interventions targeting such components can reduce the opportunities and incentives to engage in online crime through an increase in criminal operational costs, and in the risk of apprehension. We define a methodology describing the process of distilling the knowledge gained from the empirical measurements on the criminal infrastructures towards identifying and evaluating appropriate countermeasures. We argue that countermeasures, as defined in the context of situational crime prevention, can be effective for a long-term reduction in the occurrence of online crime.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2002. / Härtill 5 uppsatser.

South Africa has a high prevalence of infectious diseases; the major ones being the Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome epidemic, and tuberculosis. South Africa’s burden of resistant bacteria is also increasing. Antibiotic resistance in hospitalised patients leads to an increase in morbidity and mortality, resulting in longer hospital stays, and an increase in hospital costs. In order to counteract the problem of antibiotic resistance in hospitals and other healthcare facilities and preserve the efficacy of currently available antibiotics, there is a need for serious antibiotic management. Antibiotic stewardship initiatives have thus been put in place to guide healthcare professionals on the correct use of antibiotics. Clinical pharmacists can intervene and contribute to antibiotic stewardship owing to comprehensive knowledge of antibiotics, including the properties, uses, safety and efficacy of individual agents. There is a paucity of research to support the role of the clinical pharmacist in antibiotic stewardship in public sector hospitals. The current pharmacist staffing system within public sector hospitals does not adequately support pharmacists, in particular clinical pharmacists, to participate actively in antibiotic stewardship. The primary aim of the study was to evaluate the role of the clinical pharmacist in antibiotic stewardship in a public hospital setting. A secondary aim was to contribute towards more rational inpatient use of antibiotics in the general medical ward. The hypothesis for the study was that clinical pharmacists can make a positive contribution to the correct use of antibiotics in a public hospital setting. The study showed that the introduction of a pharmacist-driven antibiotic stewardship in the ward, using a prospective audit and feedback strategy, had a positive effect on overall appropriateness of antibiotic prescribing (Chi2=7.89; df=3; p=0.04815, Cramer’s V=0.13). However, this finding did not show any reduction in the volume of antibiotic use. Positive patient outcomes were achieved and shown through a reduction in the length of hospital stay (p=0.00487; one-way ANOVA). Although patients were not followed up on discharge to assess re-admission rates, the results are relevant in order to inform the hospital staff about the implementation of antibiotic stewardship at the public hospital setting with the aims of reducing inappropriate antibiotic prescribing and improving patient outcomes. From the results of the study, it can be concluded that the hypothesis was achieved and that the clinical pharmacist did play an integral role in antibiotic prescribing at the public hospital setting. Thus, it can be concluded that the study, though limited in its scope, achieved its aims and objectives, and showed that the clinical pharmacist does play an integral role in the rational use of antibiotics in a public hospital setting.