Examining community pharmacists’ intention to provide pharmacist-driven vaccination services: A structural equation modelling

BackgroundThe evidence of pharmacists' current involvement in vaccination services in low- and middle-income countries (LMICs) is uncertain. This study would be a first step to develop vaccination services by investigating community pharmacists’ intention to be involved in PDV services not just during COVID-19 pandemic but also during standard service provision in Turkey which can be taken as an example across LMICs.ObjectiveConsidering the efforts to empower community pharmacists in service provision, the goal of the present study was to develop a structural equation model to explain the “Pharmacist-Driven Vaccination Service Intention Model (PDV-SIM)” by using the theory of planned behavior (TPB).MethodsBased on the constructs of TPB, a measurement tool was developed. Sub-factors of PDV service intention was determined by conducting exploratory factor analysis (EFA). In the second step, confirmatory factor analysis (CFA) was conducted to prove the theoretical structure of the tool. Finally, a model explaining the relationship between observed variables, latent constructs from TPB was developed by SEM analysis.ResultsIn the proposed PDV-SIM, patient related attitude toward PDV services, attitude toward negative consequences of PDV services, and subjective norm about PDV services had an impact on the behavioral intention of community pharmacists. Nevertheless, professional development attitude toward PDV services and perceived behavioral control were not evaluated as determinants of the behavioral intention.ConclusionResults of this study revealed that TPB is appropriate for modelling PDV service intention of community pharmacists. This model can be utilized as a guide to potential pharmacy regulatory bodies and policy makers in their efforts to enable community pharmacists as vaccinators across LMICs.     

强化预防战略意识 深化医学教育改革

在临床医学专业的学生中进行预防医学实践,是医学教育史上的一项改革.我们打破了传统的医学教育模式,建立了以服务为前提的服务教学科研相结合的农村教学基地,改变了过去那种“只治不防”的被动局面.这种改革符合我国“预防为主”的战略思想,是实现世界卫生组织提出的“2000年人人享有卫生保健”这一目标的有力措施.     

Bromazepam in generalized anxiety

Bromazepam was compared with placebo and with chlorprothixene in a randomized, double-blind group-comparative multicenter trial in general practice. Two hundred and forty-five patients with generalized anxiety disorder (DSM-III 1980) were treated for 2 weeks with two daily doses of bromazepam, 3 mg or chlorprothixene, 15 mg or placebo. Median reductions in Hamilton Anxiety rating were 12 (bromazepam), 10.3 (chlorprothixene) and 7.3 (placebo). The study revealed significant superiority of bromazepam over placebo (median differences 3.3, 95% confidence limits: 0.3 and 6.1) but not over chlorprothixene (median difference 1.4, 95% confidence limits –0.8 and +3.5). Significantly higher rates of tiredness, sedation and hypersomnia were found on bromazepam and chlorprothixene compared to placebo. Tolerance was rated as at least good in 85.6% on bromazepam, in 86% on chlorprothixene and in 87.8% on placebo. Neither previous psychopharmacological treatment nor presence of psychosocial stress were of perceptible influence. Bromazepam and chlorprothixene are both superior to placebo in generalized anxiety states treated in general practice, but spontaneous improvements/placebo effects are substantial.General practice The following general practitioners are gratefully acknowledged for their excellent co-operation: K. Andreasen (Grenaa), T. Andreasen (Helsingoer), C. Bjerre-Christensen (Viby J), J. Brix (Aabenraa), N.B. Caning (Stokkemarke), N. Christensen (Odense), P. Dehn-Jensen (Lyngby), J. Eggert (Langebaek), H. Fuglsang-Damgaard (Havndal), I. Fraemohs (Allingaabro), J. Gylling (Nykoebing Sjaelland), E. Halkjaer-Soerensen (Roedding), B. Hansson (Frederiksvaerk), C. Hauge (Espergaerde), S. Hede (Aalborg), G. Jensen (Copenhagen S), T. Knudsen (Arden), P. Kofod (Vejle), K. Kraen (Varde), V. Lade (Hjoerring), S. Mehlsen (Auning), J. Meyer-Christensen (Hobro), R. Michael (Langebaek), J. Munch (Oersted), L. Moeller-Hansen (Alleroed), U. Moeller (Graasten), K. Nielsen (Malling), S. Kjaerem Nielsen (Copenhagen), P.V. Nielsen (Odense), J. Peulicke (Espergaerde), O. Ravn (Roedding), C.U. Rosenberg (Aarhus), J. Rude (Goerlev), S. Spangsberg (Holbaek), H. Soegaard (Oelgod), O. Tang (Hoersholm)     

“课堂理论教学与临床实践教学相结合”的两步教学法理论与实践

阐述了山东大学医学院医学伦理学课程“课程理论教学与临床实践教学相结合”教学模式改革的设想提出过程,具体实施办法和实施效果。实践证明,这一教学法,对于培养医学生的医德信念和医学伦理决策能力是切实有效的,值得在实践中进一步完善和推广。     

医学生艾滋病知识的调查及其健康教育

①目的 调查医学生对艾滋病知识的了解情况,探讨健康教育的有效措施。②方法 参考WHO关于艾滋病的知识、态度、信念、行为问卷,根据医学生实际情况编制调查问卷,以无记名选择答案的方式,对558名医学生进行了有关艾滋病知识的调查。③结果 100％的医学生知道艾滋病,但只有67.6%的学生知道艾滋病的病原体是HIV,62.2%的被调查者能正确回答出艾滋病的传播途径,92.0%的学生对艾滋病病人和HIV感染者表示不歧视,72.4%的学生较关心艾滋病的流行趋势,84.2%的学生认为我国现在广泛地开展艾滋病的健康教育十分必要。④结论 在医学生中加强艾滋病的健康教育势在必行。     

医学文献检索虚拟课堂

本文就《医学文献检索》虚拟课堂的建设提出了构想,包括实现技术、硬软件需求和课堂内容组织等。并提供了建设实例。     

创新思维与医学写作教学

创新思维对创造性人才至关重要。我校医学写作课程采用灵活的教学方法,重启发,善引导,常激励,将创新思维的培养贯穿于教学活动始终,积极探索培养医科大学生创新能力的新途径。     

关于社区卫生服务人力资源开发的思考与探讨

基于北京市朝阳区大力发展社区卫生服务３年多的实践,就发展社区卫生服务的关键所在－人力资源开发,在配置卫生资源,实施全科医学培训工程,制定相应政策保障,充分展示社区卫生服务功能等方面的现状及其对策进行了充分的论述和有益的探讨。     

组织学实验课教学方法的探讨

目的　 探讨组织学实验课的教学方法 ,提高教学质量。方法　 在组织学实验课上 ,分别采用幻灯讲解、放映电视录像等方法对学生进行辅导 ;要求学生分别做绘镜下实像图、模式图、填图作业 ,在此基础上 ,组织学生进行讨论 ,并列表调查学生对上述 3种作业和 2种辅导的反映。结果　 赞成幻灯讲解辅导的人数 ( 71 % )显著地多于赞成放电视录像辅导的人数 ( 2 9% ) ,具有显著性差异 ( P<0 .0 0 1 )。 61 %的学生认为 ,在节约时间、检查发现学习的薄弱环节、增加复习面、调动学习积极性等方面 ,填图优于绘图。赞成做填图作业的人数 ( 94% )显著地多于赞成做绘图作业的人数 ( 4 % ) ,差异显著 ( P <0 .0 0 1 )。结论　 在目前的条件下 ,作为组织学实验课上的集体辅导 ,电视录像并不能完全代替幻灯讲解 ;让学生做填图作业 ,在节约时间、调动学习积极性、发现学习的薄弱环节、加深学习印象、增加复习的广度等方面明显地优于做绘图作业 ,值得在教学中推广。     

Factors Influencing the Growth in Knowledge of Trainees in General Practice

Objectives: The relation between the content of postgraduate training for general practice and the outcome in terms of the growth in knowledge of trainees was investigated. The training variables included were: (1) the number of patients seen per day, (2) the trainer, (3) the practice and (4) the theoretical curriculum.Methods: Subjects were 58 trainee-trainer pairs. Growth in knowledge was assessed by two written tests administered with eight months interval. Training variables were evaluated by means of questionnaires and logbook-registration. The correlation was explored between each of the training variables and the knowledge tests scores. To correct for interactional effects, a step-wise multiple regression analysis was performed with the second test as dependent variable and the first test as well as the training variables as independent variables.Results: Significant growth in knowledge was demonstrated. Non of all training variables investigated explained the variance in scores on the second test equally good or better than the scores on the entry test.Conclusions: The impact of the separate training-components on the growth in knowledge, remains unclear. We may speculate, that the sort of knowledge assessed with the written literature based true/false test is different from the sort of knowledge transferred during every day training: evidence based knowledge versus experience based knowledge. Equally valid is the conclusion that these findings fit into the theory that in adult learning the outcome is more learner than teacher dependent.This revised version was published online in September 2005 with corrections to the Cover Date.