APhA house of delegates considers issues from assisted suicide to collaborative practice.
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PURPOSE: U.S. and Canadian health-system pharmacists' perceptions of the importance of managerial skills and self-ratings of skills were studied. METHODS: A questionnaire asking recipients to rate the importance of 61 pharmacy management skills and to rate their own skill levels was prepared. The instrument was mailed in 2000 to pharmacy managers in Canada. Participants in the Leadership in Healthcare Administration for Pharmacists conference in Phoenix, Arizona, received the survey at the end of the 2001 and 2002 conferences. Participants in the 2002 Department of Veterans Affairs pharmacists' conference in Memphis, Tennessee, received the survey eight weeks before the conference. RESULTS: The net response rates for the Canadian, Arizona, and Tennessee surveys were 52.7%, 56.9%, and 38.4%, respectively. The five skills rated most important in each of the three surveys were all practice foundation skills and tended to be required by all health care managers. Skills rated least important were also generally similar among the surveys. Only five skills demonstrated a significant mean difference in perceived importance among the surveys. In all three surveys, demonstrating ethical conduct was rated the most important skill and was judged by participants to be their greatest strength. Using an organized system for staying current with managerial literature was cited as the greatest weakness by the Tennessee sample and the second greatest weakness by the Canadian sample. CONCLUSION: Surveys in the United States and Canada found differences and similarities in pharmacy managers' opinions of the importance of managerial skills and in self-rated managerial strengths. Also identified were gaps in training.
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We investigated the pharmacist-patient relationship, conceptualizing its interpersonal constructs and dynamics using social exchange principles. The constructs of felt indebtedness (FI), collaborative willingness (CW), interpersonal relationship quality (IRQ), medication use beliefs (MUBs), and critical interpersonal incidents (CII) between pharmacist and patient were proposed, measured, and modeled. Patient responses were collected using interviews and mail surveys in 2 pharmacist-managed anticoagulation clinics. Higher IRQ levels predicted greater FI toward and CW with pharmacists (p < .01). MUBs predicted CW with IRQ mediating the association (p < .01). Patients reporting positive CII gave higher IRQ ratings and expressed greater FI (p < .05). Findings suggested that patients' perceptions of their pharmacists, and not their therapy, may lead to increased interpersonal exchange and patient collaboration in care.
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The authors analyse the responsibility of the nurse during the administration of drugs and solutions. Three aspects are approached: the ethic aspects of professional attitudes, scientific and iatrogenic.
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The ethics must do justice to the man who can freely decide and should pose to him the proper questions that can lead to a good choice. 'Playing God' is out of the question, because the biblical God has taken the enchantment out of the creation and produced man for him to shape and keep her. The zygote is already a human being in gestation. But not all stages of gestation of man have the right to the same reverence. The end justifies the means. Reason why this growing respect should be weighed against the use and meaning of the modifying action. The goal should be human in order to have a justifiable effect. Man is not determined by his genes but conditioned by them: they are pliable. Prenatal diagnostic tests and cloning should not be allowed to lead to the moulding of an 'Ubermensch'. It is indeed not yet technologically possible. Germination technology is justifiable provided that it is safely performed. DNA-profiling for identification of criminals is allowed. If only the profile and not the DNA were kept one could consider making a profile-bank. The patenting of discoveries should not stop developing countries from getting cheap medicines (e.g. for AIDS). Not everything that is possible is also allowed. Every time the reason and the benefit should be weighed against the damage and there must be a humane authority.
The Food and Drug Administration (FDA) is amending its new drug and biological product regulations to allow appropriate studies in animals in certain cases to provide substantial evidence of the effectiveness of new drug and biological products used to reduce or prevent the toxicity of chemical, biological, radiological, or nuclear substances. This rule will apply when adequate and well-controlled clinical studies in humans cannot be ethically conducted and field efficacy studies are not feasible. In these situations, certain new drug and biological products that are intended to reduce or prevent serious or life-threatening conditions may be approved for marketing based on evidence of effectiveness derived from appropriate studies in animals and any additional supporting data.
Problems encountered in the testing for bioequivalence of reproduced drugs (generics) are discussed in the parts incompletely resolved in domestic methodological recommendations. There are special cases when such drugs significantly vary in concentration and dosage, contain endogenous substances, exhibit intensive metabolism with a genetically polymorphous component, belong to "long-lived" compounds, and are intended for local administration. Also mentioned are problems related to insufficient sensitivity of analytical methods and some ethical aspects of investigations.
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