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Objective To identify the defining features of the quality of community pharmacy (CP) services and synthesise these into an evidence-based quality framework.Design Systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Data sources International research evidence (2005 onwards) identified from six electronic databases (Embase, PubMed, Scopus, CINAHL, Web of Science and PsycINFO) was reviewed systematically from October 2022 to January 2023. Search terms related to ‘community pharmacy’ and ‘quality’.Eligibility criteria for selecting studies Titles and abstracts were screened against inclusion or exclusion criteria, followed by full-text screening by at least two authors. Qualitative, quantitative and mixed-method studies relevant to quality in CP were included.Data extraction and synthesis A narrative synthesis was undertaken. Following narrative synthesis, a patient and public involvement event was held to further refine the quality framework.Results Following the title and abstract screening of 11 493 papers, a total of 81 studies (qualitative and quantitative) were included. Of the 81 included studies, 43 investigated quality dimensions and/or factors influencing CP service quality; 21 studies assessed patient satisfaction with and/or preferences for CP, and 17 studies reported the development and assessment of quality indicators, standards and guidelines for CPs, which can help define quality.The quality framework emerging from the global literature consisted of six dimensions: person-centred care, access, environment, safety, competence and integration within local healthcare systems. Quality was defined as having timely and physical access to personalised care in a suitable environment that is safe and effective, with staff competent in the dispensing process and pharmacy professionals possessing clinical knowledge and diagnostic skills to assess and advise patients relative to pharmacists’ increasingly clinical roles.Conclusion The emerging framework could be used to measure and improve the quality of CP services. Further research and feasibility testing are needed to validate the framework according to the local healthcare context.

Background and Aim: Theileriosis, caused by tick-borne hemoprotozoans of the genus Theileria, severely impacts the economics of the livestock industry in most tropical and subtropical countries. The aim of the present study was to detect Theileria spp. in domesticated animals (camels, cows, sheep, and goats) using direct microscopy and to determine the infection rate in geographically distinct regions in the northern emirates of the UAE. Materials and Methods: Blood samples (n = 536) were collected from clinically symptomatic and asymptomatic domesticated animals and subjected to Giemsa staining and examined microscopically for the identification of Theileria. Results: Smears showed an overall rate of positivity for Theileria spp. in 325/536 (60.6%) animals. Different infection rates were recorded across the various animal groups in the different study areas (Middle region 215/386 [55.7%], East region 100/139 [71.9%]). Of the 11 goat samples collected from the North region, 10 (90%) were positive. Infection rates per animal group based on microscopy were as follows: camels, 3/35 (8.5%); cows, 19/36 (52.7%); goats, 200/303 (66%); and sheep, 103/162 (63.5%). Reverse transcription polymerase chain reaction confirmation of all microscopy-positive samples identified 23/325 (7.1%) results as false-positive. Conclusion: This study clarified that Theileria spp. is present in the Middle (Sharjah, Umm Al Quwain, and Ajman), East, and North regions. This report also confirmed the use of direct microscopy with Giemsa-stained blood films as the method of choice for diagnosing acute infections. Further work is needed to molecularly determine the prevalence and species of Theileria spp. circulating in the different parts of the UAE.

Abstract Background Since 2015, the National Health Service (NHS) has funded pharmacists to work in general practice (GP practice) to ease workload pressures. This requires pharmacists to work in new roles and be integrated effectively in GPs. Independent prescribing is a key part of the GP pharmacist role, but little is known about pharmacists’ integration into GP practice as well as patients’ perceptions and experiences of the care provided by GP pharmacists. This study aims to explore the perceptions of pharmacist independent prescribers (PIPs) about their integration into GP practice and gain insight into patients’ perceptions about the care provided to them by pharmacists. Methods A mixed-methods study comprising semi-structured interviews with PIPs (n = 13) followed by questionnaire-based assessment of patients’ (n = 77) evaluation of pharmacists’ care was conducted between December 2019 and March 2020. Quantitative data were analysed using descriptive statistics. Interviews and open comments of the survey were thematically analysed. Results Pharmacist independent prescribers reported undertaking a range of patient-facing and non-clinical roles. Lack of understanding about PIPs’ clinical role and working beyond their clinical area of competence were some of the barriers to their integration into GP practice. Most patients were satisfied with the consultations they received from pharmacists and reported confidence in the pharmacist’s recommendations about their health conditions. However, a few patients (14%) felt they would still need to consult a general practitioner after their appointment and 11% were not sure if a further consultation was needed. Conclusions Pharmacist independent prescribers provide a range of clinical services for the management of long-term conditions which appear to be recognised by patients. However, there is a need to address the barriers to PIPs’ integration into GP practice to optimise their skill-mix and patient-centred care.

Background: The intention to more effectively mobilise and integrate the capabilities of the community pharmacy workforce within primary care is clearly stated within National Health Service (NHS) England policy. The Pharmacy Integration Fund (PhIF) was established in 2016 to support the development of clinical pharmacy practice in a range of primary care settings, including community pharmacy. Objective: This study sought to determine how PhIF funded learning pathways for post-registration pharmacists and accuracy checking pharmacy technicians enabled community pharmacy workforce transformation, in what circumstances, and why. Methods: Realist evaluation. We identified two main programme theories underpinning the PhIF programme and tested these theories against data collected through 41 semi-structured qualitative interviews with community pharmacist and pharmacy technician learners, educational supervisors, and community pharmacy employers. Results: The data supported the initial programme theories and indicated that the learning pathway for post-registration pharmacists had also provided opportunity for pharmacists to develop and consolidate their clinical skills before pursuing an independent prescribing qualification. Employer support was a key factor influencing learner participation, whilst employer engagement was mediated by perceptions of value expectancy and clarity of purpose. The study also highlights the influence of contextual factors within the community pharmacy setting on opportunities for the application of learning in practice. Conclusions: When designing and implementing workforce transformation plans and funded service opportunities that require the engagement of a diverse range of private, for-profit businesses within a mixed economy setting, policymakers should consider the contextual factors and mechanisms influencing participation of all stakeholder groups. [ABSTRACT FROM AUTHOR]

The fast advancements in technology have generated significant interest in optoelectronic materials. Nevertheless, the difficulty of creating affordable materials with exceptional optical characteristics is an ongoing challenge. Therefore, the objective of this work was to tune the optical properties of poly(methyl methacrylate) (PMMA) by embedding silver vanadate (SV) in the polymer matrix. Moreover, the wettability test of the fabricated composite membranes showed a hydrophobic behavior, with the PMMA film containing 0.6 wt.% SV showed a contact angle of 86.75 ± 0.7°. Furthermore, SV showed high thermal stability with a maximum weight loss of 0.74% at 830°C, which is very high thermal stability at high temperatures. In addition, the 0.6 wt.% SV@PMMA film exhibited a maximum weight loss of 96.7% at 785°C. Moreover, the 0.6 wt.% SV@PMMA film showed the lowest indirect band gap energy (2.02 eV) compared to the other films and pure SV NPs. The findings demonstrate the potential of the synthesized films for optoelectronic applications. [ABSTRACT FROM AUTHOR]

Abstract Background Currently, there is little experiential learning in general practice (GP) during UK undergraduate and postgraduate pharmacy education and training. Aim To apply educational theories to explore pharmacy stakeholders’ perceptions of placements in general practice and contribute to the development of a model of experiential learning for pharmacy. Methods Qualitative, semi-structured interviews, conducted as part of two studies exploring experiential learning in general practice, with learners and their GP based supervisors. Interviews explored experiences of learning and practice, and what aided or hindered this. An abductive approach to analysis combined inductive coding with deductive, theory-driven interpretation using Lave and Wenger’s concept of “Communities of Practice”. Results Forty-four interviews were conducted, with learners and placement supervisors. Participants valued placements for providing authentic patient-facing learning experiences in the workplace, facilitated through legitimate peripheral participation by supervisors and supported by the use of pre- and de-briefing. Learners benefitted from support from their supervisor(s) and other staff during their day-to-day learning (informal learning), whilst also having protected time with their supervisors to discuss learning needs or go through workplace-based assessments (formal learning). Lack of clarity regarding which and how competencies should be assessed / demonstrated in general practice challenged monitoring progress from peripheral to full participation. Findings suggest that GP placements provide opportunities for learning about the patient journey between care settings; to work effectively with multidisciplinary teams; and consolidation and application of consultation / communication skills learning. Conclusions The learning culture of GP supports learners’ development, providing time and opportunities for meaningful and authentic workplace learning, with healthcare professionals acting as supervisors and mentors. These findings can usefully inform implementation of meaningful learning opportunities in primary and secondary care for those involved in pharmacy education and training.

Abstract Background This study aimed to use marketing theory to examine the views of patients, pharmacists and general practitioners (GPs) on how community pharmacies are currently used and to identify how community pharmacy services may be better integrated within the primary care pathway for people with long-term conditions (LTCs). Methods A qualitative research design was used. Two focus groups were conducted with respiratory patients (n = 6, 5) and two with type 2 diabetes patients (both n = 5). Two focus groups were held with pharmacists (n = 7, 5) and two with GPs (both n = 5). The “7Ps marketing mix” (“product”, “price”, “place”, “promotion”, “people”, “process”, “physical evidence”) was used to frame data collection and analysis. Data was analysed using thematic analysis. Results Due to the access and convenience of community pharmacies (“place”), all stakeholder groups recommended using community pharmacies over GP practices for services such as management of minor ailments, medication reviews and routine check-ups for well managed LTCs (“product”). All stakeholder groups preferred pharmacy services with clear specifications which focused on specific interventions to reduce variability in service delivery and quality (“process”). However, all stressed the importance of having an appropriate system to share relevant information, allowing pharmacists and GPs two-way flow (“process”). Pharmacists and GPs mentioned difficulties in collaborating with each other due to inter-professional tensions arising from funding conflicts, which leads to duplication of services and inefficient workflow within the primary care pathway (“people”). Patients and GPs were sometimes doubtful of community pharmacies’ potential to expand services due to limited space, size and poor quality consultation rooms (“physical evidence”). However, all stakeholder groups recommended promoting community pharmacy services locally and nationally (“promotion”). Patients felt the most effective form of promotion was first-hand experience of high quality pharmacy services and peer word-of-mouth. The added value of using pharmacy services was faster access and convenience for patients, and freeing up GPs’ time to focus on more complex patients (“value”). Conclusions Using the 7Ps marketing mix highlighted factors which could influence utilisation and integration of community pharmacy services within the primary care pathway for patients with LTCs. Further research is needed to identify their relative importance.

Generally, Advanced Parking Management Systems (APMS) use VariableMessage Signs (VMS) to provide drivers with updated information on the number ofopen spaces at selected off-street parking facility to minimize or avoid parking searchtraffic within a full car park facility, and reduce the delay times at the entrance and exitgates of a parking facility. The simulation model STARSIM-VMS is developed, in thepresent study, to simulate the operation of a designed parking garage with theimplementation of the VMS technology. The simulation results show that the delayvalues is smallest than that predicted without using the VMS technique, especially atthe high proportions of vehicles waiting to park. These results reflect the importance ofusing the VMS in the transportation systems.

A common problem in regression analysis using ordinary least squares (OLS) is the effect of outliers or contaminated data on the estimates of the parameters. A robust method that is not sensitive to outliers and can handle contaminated data is needed. In this study, the objective is to determine the significant parameters that determine the moisture content of the seaweed after drying and develop a hybrid model to reduce the outliers. The data were collected with sensors from the v-Groove Hybrid Solar Drier (v-GHSD) at Semporna, South-Eastern Coast of Sabah, Malaysia. After the second order interaction, we have 435 drying parameters, each parameter has 1914 observations. First, we used four machine learning algorithms, such as random forest, support vector machine, bagging and boosting to determine the significant parameters by selecting 15, 25, 35 and 45 parameters. Second, we developed the hybrid model using robust methods such as M. Bi-Square, M. Hampel and M. Huber. The results show that there is a significant improvement in the reduction of the number of outliers and better prediction using hybrid model for the contaminated seaweed big data. For the highest variable importance of 45 significant drying parameters of seaweed, the hybrid model bagging M Bi-square performs better because it has the lowest percentage of outliers of 4.08 %. [ABSTRACT FROM AUTHOR]