泰州市城区零售药店员工药学服务现状调查分析

目的随着我国零售药店规模和数量的飞速发展,零售药店的工作核心及差异化竞争逐步转向为顾客提供必要的"药学服务","药学服务"已经成为零售药店的一种社会责任和经营策略。本研究对泰州市城区零售药店员工药学服务现状进行调查分析,旨在为促进零售药房药学服务的发展提供参考。方法 2017-10-15-2017-10-30对泰州市海陵区20个不同规模的药店员工发放调查问卷表,问卷内容包括受访者基本信息、对实施药学服务的态度、药品专业知识的掌握和对药学服务发展的意见等,采用描述性分析方法对其进行分析。结果共发放200份问卷,有效回收195份,回收率为97.5%。剔除信息不全或不符合要求的问卷,有效问卷为185份。目前泰州城区零售药店店员学历结构以初中以上和大专以上为主,分别占59.5%和35.1%。药学专业出身的员工较少,占18.9%,药学相关专业占53.0%,其他均为不相关专业。工作年限以5～10年居多,占36.8%;10年仅占11.9%。药店店员获取药品知识的途径主要来源于药品说明书,为168人次(90.8%);其次为医药代表介绍,为66人次(35.6%)。54.6%的药店店员表示能掌握店内药品的作用和不良反应,41.6%表示能掌握一些,3.7%表示不能掌握。6家(30.0%)药店店员表示经常培训,12家(60.0%)表示偶尔培训,2家(10.0%)表示没有过培训。118名(63.7%)受访店员表示对药学服务了解,57名(30.8%)表示有点了解。所有药店店员均会主动给予顾客用药指导,其中65.4%表示经常指导,34.6%表示偶尔指导。96名(52.0%)店员表示欢迎大力开展药学服务,89名(48.1%)表示能接受开展药学服务。结论泰州市城区药店店员认可药学服务对提高药店业绩及保障人民用药安全有效的重要性。现阶段零售药店药学服务不足,零售药店的药学服务有待进一步加强。     

天津药店员工指导消费者合理用药的调查分析

目的了解天津市药店员工指导消费者合理用药现状以及存在问题,提高消费者的合理用药水平。方法 2014年12月-2015年3月对天津市215人药店店员随机进行问卷调查,运用描述性分析的方法,分析店员指导消费者合理用药的情况。结果零售药店店员女性占86.1%,非医药类中专及以上学历的店员占59.3%,而医药大专及以上学历仅占总数9.09%,24.3%的店员同时接受了三种以上内容的培训;94.7%的受访店员可以顺利回答消费者提出的关于用药的问题;9.5%的受访店员表示不清楚妊娠期和哺乳期用药安全;执业药师每天在岗比例为34.0%。结论受访零售药店店员学历偏低、从业年限较短,合理用药专业知识水平较低,专业知识培训缺乏系统规范,执业药师每天在岗比例低。因此,零售药店应通过多种途径提高店员学历和专业水平,提高店员指导合理用药的能力,并应根据条件建立药历,关注特殊人群用药和常见疾病的用药配伍禁忌。     

浙江省杭州市计划生育药具服务需求的现状研究

目的:了解杭州市育龄群众计划生育药具服务需求现状,为完善相关政策提供科学依据。方法:由经统一培训的调查人员,使用自制的计划生育药具服务需求调查问卷,对杭州市的1610名育龄群众开展问卷调查。结果:74.6%受访者知晓国家计划生育药具领取政策;76.0%受访者知道可以到社区领取免费避孕药具;避孕套、口服避孕药、宫内节育器、皮下埋植知晓率分别为93.2%、93.2%、53.2%、17.2%。67.7%受访者遇到避孕节育困惑选择去医院;53.9%是在专业人员推荐下选择目前避孕方法;60.6%受访者目前使用免费避孕药具;免费避孕药具咨询服务满意度为59.4%。34.5%受访者希望得到个性化咨询服务;≤25岁对象对性知识教育、避孕方法和避孕药具知识介绍需求最多;文化程度在初中及以下者对各项需求最大;65.6%的受访者希望开通"避孕药具公共服务"微信公众号。结论:新时期应加强避孕知识的宣传,提高计划生育公共服务知晓率;提升药具服务人员的服务能力,保障避孕节育措施落实;推进互联网药具服务,满足群众对计划生育公共服务需求。     

流产后提供避孕服务者对提供避孕服务态度的调查

目的:了解提供避孕服务者包括计划生育专业技术人员和干部对提供流产后服务的态度、意愿及知识知晓情况,提出落实流产后计划生育咨询和技术服务的建议。方法:选择河北省丰宁满族自治县、黄骅市、阜城县和邯郸市丛台区4个县(区)市,采用问卷调查方式按照统一标准对计划生育专业技术人员和干部进行面对面问卷调查。结果:共调查提供流产后避孕服务者435人,包括计划生育专业技术人员257人,计划生育干部178人,发放调查问卷435份,收回435份。调查显示:提供流产后避孕服务的人员没有经过避孕知识系统培训的213人,认为流产后避孕重要的192人,非常重要的243人;认为提供流产后避孕服务的途径位居前三位的是由妇科和计划生育医生提供的服务、进行面对面咨询和发放宣传资料;愿意为流产后妇女提供的避孕方法位居前三位的是避孕套、宫内节育器及避孕药;认为提供流产后避孕服务目前存在的最大困难是流产后妇女不愿接受和提供避孕服务的人员不足。结论:加强提供流产后避孕服务人员的专题培训,提高提供避孕服务人员对流产后避孕重要性的认识,让提供者具备流产后避孕服务意识,更好地为广大流产后妇女提供流产后服务。     

贵州省骨病类内服中成药医院使用与药店销售现状调查研究

目的对贵州省骨病类内服中成药医院使用情况和零售连锁药店销售情况进行分析并提出对策建议。方法在贵州省分层随机抽样37家二甲及以上医院、骨科专科医院相关科室主任医师、主任药师和210家零售连锁药店销售人员,开展实地问卷调查,对调查结果进行统计分析。结果开具风湿类疾病内服首选药最多的是盐酸氨基葡萄糖,占42.4%;开具骨质疏松类疾病首选药大多数的是仙灵骨葆胶囊,占51.5%。79.3%的药店采取指导型或半指导购买型的经营模式,74.2%的销售人员在顾客购买风湿类药物时偏向介绍麝香壮骨膏,61.3%偏向介绍万通筋骨片;84.3%的销售人员在为顾客介绍骨质疏松类药物时偏向推荐仙灵骨宝胶囊;其次是碳酸钙D3片,占62.2%。57.6%的药店近半年对风湿或骨质疏松类疾病内服药的销售采取了促销手段,21.2%的零售药店表示无骨病类内服中成药的医药代表来访,而有到药店来访的则以仙灵骨宝胶囊的医药代表为首,占61.5%。结论贵州省骨病类内服中成药市场前景良好,但当前营销存在知名度不高、市场占有率低和产品宣传不到位等问题。因此,提出拓宽贵州省二甲及以上医院市场、定期开展相关疾病学术讲座、要求零售药店摆放简单显眼的POP广告牌和建立健全售后服务体系等对策建议。     

执业药师在零售药店中现状和培养的探讨

目的:分析零售药店中执业药师的服务现状与培养情况,提出建议.方法:分析执业药师在岗位设置、社会角色、继续教育培养等方面的现状及问题.结果:零售药店执业药师的岗位多有虚化状态,服务水平一般,社会地位不高,继续教育欠缺等状态.结论:需要尽快提高执业药师的服务水平,完善继续教育培养政策,充分发挥零售药店中执业药师的作用.     

深圳市育龄妇女计划生育/生殖健康咨询需求调查

目的:了解深圳市育龄妇女生殖健康与计划生育咨询需求,为进一步开展计划生育优质服务提供理论依据。方法:在深圳地区选取研究对象998名,采用定性定量的方法收集数据。结果:对避孕方法名称知晓率最低的是皮下埋植(42.83%),最高的是避孕套(91.98%);缺点知晓率最高的是紧急避孕(59.88%),最低的是避孕针剂(46.56%)。咨询服务满意度满意率较高,为97.49%。育龄群众生殖健康知识水平还需要提高,对计划生育咨询内容范围还需要扩大。结论:在今后的计划生育服务中,应加强计划生育咨询的深度和广度,根据不同需求提供不同的性和生殖健康的知识。     

悄然兴起的行业外竞争 --药店替代医院现象应予关注

(一 )卫生部组织进行的全国第二次卫生服务调查显示 :１９９８年居民患病到各级医疗机构就诊的总就诊率 ,农村仅为６７．１２ % ,城市只有５０．２４%。与１９９３年全国第一次卫生服务调查结果相比 ,农村情况差异不大 ,城市则下降了７个百分点。而患病不就医、自购药治疗的比例城市高达４３．６１ % ,农村亦有２１．５３%。近两年上述情况还呈发展趋势。药店销售药品 ,为购买医疗保健品的群众和自治小伤小病的病人提供方便 ,本无可厚非。问题是 :近几年药店增加太多 ,药品零售种类太滥 ,医药广告太虚 ,售药员缺乏指导用药的能力。同时 ,我…     

北京市西城区育龄妇女流产后综合服务现状调查

目的:了解城区育龄妇女人工流产术后接受综合服务的现状,为开展规范化流产后服务提供依据。方法:随机抽取在北京市西城区4家计划生育技术服务医疗机构中自愿要求人工流产的育龄妇女400例,进行现场问卷调查。结果:调查对象年龄28.9±6.89(18～48)岁;本次妊娠主要原因,42.6%未使用避孕方法,55.6%避孕失败,其他原因占1.8%;已婚育龄妇女重复流产率(68.05%)高于未婚育龄妇女(37.25%);既往避孕措施使用频率最高的是避孕套(68.1%),其次依次为安全期(38.7%)、体外排精(33.5%)、紧急避孕(19.4%)等;调查对象获得的宣教信息,最多的是流产后注意事项,其次是避孕方法的种类、避孕药具的使用方法等;95%能确定流产后使用哪种避孕方法,并愿意接受计划生育宣教服务;62.0%主动询问了有关避孕方法的问题,在咨询时医生介绍避孕方法占91.2%,咨询时间的中位数和众数均为10min,医生当场提供避孕药具占77.8%。结论:育龄妇女人工流产术后接受计划生育宣教和咨询服务意愿强,开展规范化流产后综合服务,有助于促进妇女生殖健康。     

银川市药店售药人员对紧急避孕知识的知晓率及影响因素分析

目的:了解银川市药店售药人员对紧急避孕知识的掌握情况,并分析其影响因素,为对药店售药人员进行紧急避孕知识宣教提供依据。方法:采用横断面调查研究,从银川市194家社会零售药店中抽取86家作为研究现场,选择研究现场中的450名售药人员作为研究对象进行问卷调查。结果:分析有效问卷438份,药店售药人员对紧急避孕的知识掌握的不够,其中对紧急避孕使用方法的2个问题的正确回答率分别为19.1%、26.5%,对服药后发生副作用处理的掌握正确的仅为41.6%;不同民族、年龄、学历和工龄的药店售药人员对于紧急避孕知识的掌握情况不同,差异有统计学意义(P<0.05);多因素Logistic回归分析显示,民族、年龄(<24)、对紧急避孕的态度及行为是影响药店售药人员掌握紧急避孕知识的因素。结论:银川市药店售药人员对紧急避孕的相关知识较欠缺,应对售药人员开展有针对性的紧急避孕宣教工作。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.