Brands are recognised as one of the most valuable assets that a company can possess and therefore brands are key role-players in the business strategies of organisations. The rivalry amongst competitors in the pharmaceutical industry is fierce and companies should design their strategies in such a way in order to achieve competitive advantage. Brand loyalty is regarded as a powerful tool in the development of pharmaceutical brands. The main aim of this study was to measure brand loyalty in the pharmaceutical industry of South Africa and to establish whether patients are brand loyal to original pharmaceutical brands and the influence of generics on pharmaceutical brand loyalty. The measurement of brand loyalty in the pharmaceutical industry is based on Moolla’s brand loyalty framework for the FMCG (fast moving consumer goods) industry. This study also aimed to determine whether Moolla’s FMCG brand loyalty framework is applicable to the pharmaceutical industry. The twelve brand loyalty influences identified by Moolla are: Customer satisfaction; Switching costs; Brand trust; Repeat purchase; Involvement; Perceived value; Commitment; Relationship proneness; Brand affect; Brand relevance; Brand performance and Culture. The empirical study was conducted among 250 over-the-counter medicine consumers with different demographic profiles. The methodology included the sampling procedure, data collection, questionnaire development and statistical techniques used. Results were analysed with regards to Factor analysis; the Kaiser- Meyer-Olkin measure of sampling adequacy; Cronbach Alpha coefficients; Bartlett’s test of sphericity, mean values and effect sizes. The Empirical results through quantitative analysis included the validity of the research instruments, the calculation of the reliability coefficients which reported on the significance of the research variables. The results were presented in a conceptual framework to measure pharmaceutical brand loyalty. The results of this study concluded that the brand loyalty influences as identified by Moolla are important for measuring pharmaceutical brand loyalty. The results of this study also concluded that patients are indeed brand loyal and do prefer branded pharmaceuticals to generic pharmaceuticals in the over-the-counter medicine industry of South Africa. The importance of this study is the contribution of a brand loyalty framework to measure pharmaceutical brand loyalty which will aid pharmaceutical companies in the strategic management thereof. / Thesis (MBA)--North-West University, Potchefstroom Campus, 2013

Brands are recognised as one of the most valuable assets that a company can possess and therefore brands are key role-players in the business strategies of organisations. The rivalry amongst competitors in the pharmaceutical industry is fierce and companies should design their strategies in such a way in order to achieve competitive advantage. Brand loyalty is regarded as a powerful tool in the development of pharmaceutical brands. The main aim of this study was to measure brand loyalty in the pharmaceutical industry of South Africa and to establish whether patients are brand loyal to original pharmaceutical brands and the influence of generics on pharmaceutical brand loyalty. The measurement of brand loyalty in the pharmaceutical industry is based on Moolla’s brand loyalty framework for the FMCG (fast moving consumer goods) industry. This study also aimed to determine whether Moolla’s FMCG brand loyalty framework is applicable to the pharmaceutical industry. The twelve brand loyalty influences identified by Moolla are: Customer satisfaction; Switching costs; Brand trust; Repeat purchase; Involvement; Perceived value; Commitment; Relationship proneness; Brand affect; Brand relevance; Brand performance and Culture. The empirical study was conducted among 250 over-the-counter medicine consumers with different demographic profiles. The methodology included the sampling procedure, data collection, questionnaire development and statistical techniques used. Results were analysed with regards to Factor analysis; the Kaiser- Meyer-Olkin measure of sampling adequacy; Cronbach Alpha coefficients; Bartlett’s test of sphericity, mean values and effect sizes. The Empirical results through quantitative analysis included the validity of the research instruments, the calculation of the reliability coefficients which reported on the significance of the research variables. The results were presented in a conceptual framework to measure pharmaceutical brand loyalty. The results of this study concluded that the brand loyalty influences as identified by Moolla are important for measuring pharmaceutical brand loyalty. The results of this study also concluded that patients are indeed brand loyal and do prefer branded pharmaceuticals to generic pharmaceuticals in the over-the-counter medicine industry of South Africa. The importance of this study is the contribution of a brand loyalty framework to measure pharmaceutical brand loyalty which will aid pharmaceutical companies in the strategic management thereof. / Thesis (MBA)--North-West University, Potchefstroom Campus, 2013

No description available.

This study is on thermodynamics of crystalline nanoparticles of materials. It provides measurements of the equilibrium melting point of nanocrystals of zinc in a size distribution of 30 - 120 nm, as observed by using Philips CM 12 TEM and JEOL 2010F TEM/STEM, and of the heat capacity, and melting enthalpy by using Perkin-Elmer Pyris-Diamond and TA Q100 Calorimeters. The observed melting point of zinc nanoparticles is lower than that of the bulk zinc, but their heat capacity increases and enthalpy of melting decreases. During heating, the nanoparticles oxidizes and forms zinc oxide surface layer reducing the amount and size of zinc nanocrystals. Calculations based upon the Debye theory for heat capacity show that the surface atoms on the zinc nanoparticles have ~ 55 % larger vibrational amplitude and therefore increase the entropy of the surface layer over that of the interior of the particles. During cooling, the crystallization of zinc oxide encaged zinc nanodroplets occurs in two stages, which are heterogeneous and homogeneous nucleations. As the amount of zinc nanocrystals decreases and the liquid-zinc oxide interface increases, homogeneous nucleation becomes less dominant and the two-stage crystallization merges. Nano-pharmaceuticals were produced by incorporating them in a nanoporous amorphous polymer matrix by using a technique based on diffusion method. The presence of embedded nano-pharmaceuticals is shown by their lower melting point relative to the bulk pharmaceuticals and by peak-broadening of x-ray diffraction, which shows that their size lies in 70 - 100 nm range. Although no phase inversion between allotropic forms of the pharmaceutical was observed, a sample calculation for polymorphs of tin shows that such phase inversion should occur at a smaller particle size at a lower temperature. In general, these findings show the effects of the increase in the surface energy relative to bulk energy of nanoparticles, and the consequent differences between the properties of their surface atoms relative to the interior atoms. / Thesis / Master of Applied Science (MASc)

ABSTRAKT Bakgrund: De mest sjuka/sköra äldre är en ökande grupp patienter som ofta hamnar i kläm då missförstånd uppstår vid övergång mellan slutenvård och kommunal sjukvård. Tidigare forskning har visat att bland annat bristande informationsöverföring mellan instanser är en av de mest förekommande orsakerna till vårdskador. Att samarbetet mellan dessa två primära vårdinstanser fungerar är av största vikt för god patientsäkerhet. Syfte: att undersöka sjuksköterskors erfarenheter av samarbetet mellan slutenvården och kommunal sjukvård kring den äldre patienten. Metod: En kvalitativ metod valdes för att undersöka sjuksköterskors erfarenheter av samarbetet mellan slutenvård och kommunal sjukvård. Sammanlagt 27 sjuksköterskor från både kommunal sjukvård och slutenvård svarade på en elektronisk enkät via e-post. Deras svar analyserades med en kvalitativ innehållsanalys. Resultat: Sjuksköterskor från både slutenvården och den kommunala sjukvården anser att ett bättre samarbete måste till för att öka patientsäkerheten. Brister finns i samarbetet framför allt kring läkemedelshantering, kommunikation och informationsöverföring. De upplever även att förståelsen för varandras verksamheter bör öka. Som förbättringsförslag ges utbildning och hospitering för att öka sjuksköterskornas kompetens för det gemensamma kommunikationsverktyget och bättre förståelse för de olika verksamheterna. Slutsats: Samarbetet mellan kommunal sjukvård och slutenvård kan bli bättre och patientsäkerheten öka om läkemedelshanteringen säkras, bra planer görs upp med och för patienten och om informationsöverföringen sker korrekt. Då möjliggörs ett gott samarbetet och vårdens övergångar blir inte lika märkbara för patienten. Det befintliga kommunikationsverktyget, om det används till fullo, är ett bra stöd i detta. / ABSTRACT Background: The frail and/or sick elderly are a growing group of patients who are often caught in between healthcare instances when misunderstandings occur in transition between inpatient and municipal healthcare providers. Previous research has shown that, among other things, lack of information between instances are one of the most common causes of preventable harm. Improved cooperation between these two primary health facilities work is of paramount importance for patient safety. Aim: The aim of the study was to examine nurses experiences of cooperation between inpatient care and municipal healthcare concerning geriatric patients. Method: A qualitative method was chosen to investigate the nurses' experience of cooperation between inpatient care and municipal healthcare. A total of 27 nurses from both municipal and inpatient answered an electronic questionnaire via e-mail. Their answers were analyzed using qualitative content analysis. Results: Nurses from both inpatient care and municipal healthcare believes that the cooperation is in need of improvement in order to increase patient safety. Shortcomings occur in cooperation, especially regarding medicinal management, communication and information transfer. They are also under the impression that an increased understanding of each other's work situations are crucial. Suggestions of improvement are increased education within the common communicational tool and also visits to each other’s workplaces to increase the understanding of the different work situations. Conclusion: An increased and improved cooperation between municipal healthcare and inpatient care can improve patient safety if medicinal management and transference is secured, better care plans are set up with and for the patient, and also that information transfer is conducted properly. These things will enable a good cooperation and transition of caregiver will not be as noticeable to the patient. The existing tool for communication, if used to its full extent, is a great support in doing this.

Purpose: The purpose of this research was to estimate the impact of Medicare Part D on prescription and medical utilization among Arizona's senior dual eligible population.Methods: Generalized estimating equations were used to analyze changes in utilization among dual eligibles (Arizona Health Care Cost Containment (AHCCCS) beneficiaries between the ages of 66 and 80 as of January 1, 2006) relative to a "comparison" group ineligible for Part D (AHCCCS beneficiaries between the ages of 50 and 62 as of January 1, 2006) for the first two years following the implementation of Part D. Medical and pharmacy claims from AHCCCS from January 1, 2005 to December 31, 2007 were used in this analysis.Results: The dual eligibles and Part D ineligible comparison group were similar in their level and trend of utilization of over-the-counter (OTC) medications and benzodiazepines in the pre-Part D period. Following implementation of Part D, there was an immediate decline in utilization of both OTC medications and benzodiazepines in the dual eligibles relative to the comparison group (p<0.001).Increasing trends for both the dual eligible and comparison group were observed during the pre-Part D period for total prescription utilization, generic medication utilization and antidepressant use. After the implementation of Medicare Part D, utilization of these drug classes was significantly lower among the dual eligibles relative to the comparison group.Trends in physician office visits were similar between the dual eligible group and comparison group for the entire study period. During the first month of Part D, the dual eligibles had a statistically significantly larger increase in physician visits over the previous month relative to the comparison group (p=0.001). The trend in hospitalizations between the two groups significantly differed during the pre-period, precluding meaningful comparisons between the groups for this particular outcome.Conclusion: This study supports the belief that medication use for dual eligible Medicare beneficiaries was disrupted by the transition of outpatient drug benefits from Medicaid to Medicare Part D.

Human pharmaceuticals have been shown to be entering the aquatic environment in quantities sufficient to produce adverse effects to aquatic organisms, particularly fish. The impacts of synthetic oestrogens have been well documented, but other groups of steroidal pharmaceuticals have not yet been studied. Hence, the present research was designed to study synthetic glucocorticoids (GCs), which are used in large amounts as immunosuppressive and anti-inflammatory drugs. This study involved different approaches, including in silico, in vitro, in vivo and genomics, to assess the effects of GCs on fish. Using reliable data on consumption of GCs in the UK and the LF2000-WQX hydrological model, mean concentrations of GCs in the river Thames were predicted to be in the range from 30 ng/L to 850 ng/L. Mammalian cell lines were transiently transfected with trout corticosteroid receptors (GR1, GR2 and MR) and the transactivation abilities of ten of the most prescribed GCs in the UK were measured in vitro. All tested GCs showed significantly higher activity with GR2 than with GR1. In order to assess the impact of low concentrations of GCs in vivo, two chronic exposure experiments were conducted with adult fathead minnows (Pimephales promelas). Both experiments showed potency-related and concentration-related impacts on various endpoints. There was a concentration-related increase in plasma glucose concentrations and a decrease in blood lymphocyte count. Induction of secondary sexual characters in females suggests a concentration-related masculinisation of fathead minnows. There was a decreasing trend in plasma vitellogenin concentrations in female fish with increasing exposure concentration of GCs. Expression profiles of selected genes (PEPCK, GR and Vtg) in liver also demonstrated concentration-related effects at all three tested concentrations. Hence, it was not possible to define a no effect concentration for the tested GCs. This study probably provides reliable estimates of the likely range of concentrations of GCs in a typical river, impacted by effluent from many sewage treatment plants. The in vitro results indicate that all tested GCs bind to fish GR in a similar manner to that reported for mammalian receptors. The in vivo results suggest that GCs could cause effects at very low (as low as 100 ng/L) concentrations that could be environmentally-relevant. The immunosuppresive effects could make fish susceptible to disease and the reproductive effects may have population-level impacts. It is very likely that the effects of different GCs will be additive, as has been shown for oestrogenic chemicals. Therefore, this study warrants further environmental risk assessment of GCs, especially in mixture scenarios.

The occurrence of pharmaceuticals in aquatic environments originating from human consumption has received increased scientific attention during the last decades due to concerns regarding their combined environmental effects. This concerns stress the need of studies quantifying dissipation rates of pharmaceutical in aquatic ecosystems. The aims of this study were: i) to assess the degradation rates of trimethoprim (TPR), diphenhydramine (DPH), diclofenac (DCL), oxazepam (OXZ) and hydroxyzine (HDZ) in laboratory incubations, and ii) to compare laboratory assessment of dissipation rates with previously measured in situ half-lives of these drugs in a pond ecosystem. I hypothesized that the dissipation of these five drugs dissolved, in laboratory incubations, is affected by common environmental parameters such as temperature, UV-light, organic solutes and presences of sediments. In line with my hypothesis, all substances were affected by my treatments. Here, main parameters affecting the dissipation of the drugs were UV light and to a lesser temperature (i.e. through microbial degradation). All drugs were found to be affected by sediment sorption, especially HDZ where 95 % of the applied pharmaceutical was adsorbed. Laboratory estimate with highest environmental relevance (low TOC and 3 °C water temperature or low TOC, sediments and UV light) seemed to predict field estimates fairly well for all of the drugs beside OXZ and DCL. Given the strong adsorption for sediments seen in the laboratory incubations, it seems likely that the mismatch between laboratory inferred half-lives and the in situ half-lives for OXZ was likely caused by sediment exchange processes releasing drugs initially adsorbed to the sediments into water column over time.

Pharmaceutical contamination is increasing in the environment and the consequences this will bring are of growing concern. The highest contamination of pharmaceuticals can be found in aquatic ecosystems and the organisms of these systems are therefore of utmost importance to research in order to understand the ecological consequences of pharmaceutical contamination. This report will reveal the effect contamination can have on an important apex predator often found in temperate aquatic systems, the Northern pike (Esox lucius) when exposed to the psychiatric pharmaceutical Oxazepam. The predatory performance of pike was studied before and after Oxazepam exposure by monitoring how fast each pike caught three prey of roach (Rutilus rutilus), as well as observing the amount of failed predation attempts when hunting the roach. The exposed pike displayed more failed predation attempts after exposure as opposed to the control group. Furthermore it took the exposed pike longer to catch all three roach after exposure while the mean for the control group decreased. Hence, Oxazepam exposure seem to have an effect on predation performance of pike but no definite conclusion could be drawn about to which extent this affects the foraging success and thereby the survival of the pike considering the complex nature of aquatic systems. More studies are therefore needed in order to determine the full effect pharmaceutical contamination can have on complex aquatic ecosystems and more specifically on an apex predator.

Few studies have been conducted on the effectiveness of phytoremediation of pharmaceutical compounds, although the persistent and non-acutely toxic nature of many of these compounds in today's water bodies may yield an ideal application for this practice. To quantify the potential effectiveness of plant uptake, kinetic and proportional bioconcentration factors (BCFk, and BCFp, respectively) in nanograms (ng) carbamazepine and amiodarone per gram (g) wet weight plant tissue for Lemna spp. were determined utilizing a 14-day continuous flow-through study. Samples were analyzed using isotope dilution liquid chromatography-tandem mass spectrometry (ID-LC-MS/MS) running in positive ion mode. Kinetic BCF was estimated at 0.538, while proportional BCF was estimated at 0.485. Kinetic BCF for the amiodarone study was estimated at 23.033, whereas proportional BCF was estimated at 41.340. Possible contamination of the C18 column and peristaltic pump failure may have impacted uptake results. In light of variability and current lack of research in the field, this work should be considered exploratory rather than conclusive.