The corporatization of community pharmacy:implications for service provision, the public health function, and pharmacy's claims to professional status in the United Kingdom

Background Pharmacy has experienced both incomplete professionalization and deprofessionalization. Since the late 1970s, a concerted attempt has been made to re-professionalize pharmacy in the United Kingdom (UK) through role extension—a key feature of which has been a drive for greater pharmacy involvement in public health. However, the continual corporatization of the UK community pharmacy sector may reduce the professional autonomy of pharmacists and may threaten to constrain attempts at reprofessionalization. Objectives The objectives of the research: to examine the public health activities of community pharmacists in the UK; to explore the attitudes of community pharmacists toward recent relevant UK policy and barriers to the development of their public health function; and, to investigate associations between activity, attitudes, and the type of community pharmacy worked in (eg, supermarket, chain, independent). Methods A self-completion postal questionnaire was sent to a random sample of practicing community pharmacists, stratified for country and sex, within Great Britain (n = 1998), with a follow-up to nonresponders 4 weeks later. Data were analyzed using SPSS (SPSS Inc., Chicago, IL, USA) (v12.0). A final response rate of 51% (n = 1023/1998) was achieved. Results The level of provision of emergency hormonal contraception on a patient group direction, supervised administration of medicines, and needle-exchange schemes was lower in supermarket pharmacies than in the other types of pharmacy. Respondents believed that supermarkets and the major multiple pharmacy chains held an advantageous position in terms of attracting financing for service development despite suggesting that the premises of such pharmacies may not be the most suitable for the provision of such services. Conclusions A mixed market in community pharmacy may be required to maintain a comprehensive range of pharmacy-based public health services and provide maximum benefit to all patients. Longitudinal monitoring is recommended to ensure that service provision is adequate across the pharmacy network.

Community pharmacists' engagement with public health in Great Britain

Objective - The objective of the research was to examine to what extent community pharmacists in Great Britain believed that their job was concerned with local public health issues. Methods - The project (Pharmacy and Public Health)received ethical approval from the Research Ethics Committee of the School of Life and Health Sciences at Aston University. After piloting, in August 2006 a self-completion postal questionnaire was sent to practicing community pharmacists in Great Britain (n=1998), with a follow-up to non-responders 4 weeks later. A final response rate of 51% (n=1023/1998) was achieved. Results - Respondents were asked to indicate their answer to the question “to what extent is your present job concerned with local public health issues?” on a three-point scale – “highly”, “slightly” or “not at all” concerned with public health. They were also asked to indicate whether they were pharmacy owners, employee pharmacists or self-employed locum pharmacists. Less than half (43%,n=384/898) of respondents answering both questions believed that their job was highly concerned with public health. A relationship was observed between employment status and the level to which a respondent believed that their job was concerned with public health (chi-square test with P=0.001). Over half of pharmacy owners (51%, n=68/134) considered that their job was highly concerned with public health compared to44% (n=193/443) of employee pharmacists and38% (n=123/321) of locum pharmacists. Conclusion - This research suggests that community pharmacists in Great Britain are not ‘fully engaged’ with public health. Pharmacy owners may feel more enfranchised in the public health movement than their employees and locums. Indeed, one-in-ten locums reported that their job was not at all concerned with public health which, as locum pharmacists constitute over a third of actively employed community pharmacists, could be limiting factor in any drive to strengthen the public health function of community pharmacists.

Developing the public health function of locum pharmacists under the auspices of the new pharmacy contract

Focal Point - There are reduced opportunities for locum pharmacists to access training and education that meets their needs and enables them to play a full role under the new pharmacy contract - Eighty-six per cent of locums consider themselves to be more health professional than business person, compared to just 48% of pharmacy owners - Forty per cent of locums believe that a lack of access to training is a major barrier to the development of their public health function - While locum pharmacists are arguably more likely to embrace 'professionalising', patient-care-based roles, they are also the group least likely to be able to access the necessary training to fulfill such roles Introduction It has been suggested that locum pharmacists do not want the business-based responsibilities (e.g. staff management, meeting targets, etc) that come with pharmacy management.1 Research also suggests that locums derive great satisfaction from the health-professional aspects of the pharmacists’ role (e.g. patient contact, the provision of advice, etc).1 However, upon the introduction of the new pharmacy contract (April 2005), concerns were expressed that it was becoming increasingly difficult for locum pharmacists to access training and education that would meet their needs and enable them to play a full role under the new framework.2,3 Method After piloting, in August 2006 a self-completion postal questionnaire was sent to a random sample of practising community pharmacists, stratified for country and sex, within Great Britain (n = 1998), with a follow-up to non-responders 4 weeks later. Data were analysed using SPSS (v12.0). A final response rate of 51% (n = 1023/1998) was achieved. Respondents were asked ‘indicate how you view yourself as a pharmacist’ – in terms of their relative focus on the health-professional and business aspects of their role. Respondents were also asked ‘do you consider a lack of training opportunities to be a barrier to the development of the public health role of community pharmacists?’. Results Locums were significantly more likely than owners or employees to consider each factor a major barrier. Discussion Four in 10 locums consider a lack of training opportunities to constitute a major barrier to the development of their public health function. Pharmacy may not be able to provide the services required of it by the policy agenda if pharmacists are unable to be involved in extended role activities through a lack of training opportunities. Therefore, the paradox that needs to be addressed is that while locum pharmacists are arguably more likely to embrace ‘professionalising’, patient-care-based roles, they are also the group least likely to be able to access training to fulfil such roles. The training needs of this large subset of the pharmacist population need to be assessed and met if the whole community pharmacy workforce is going to maximise its contribution to public health under the new contractual framework. References 1 Shann P, Hassell K. An exploration of the diversity and complexity of the pharmacy locum workforce. London: Royal Pharmaceutical Society of Great Britain; 2004. 2 Almond M. Locums – key players in workforce – cast adrift as contract launched. Pharm J 2005;274:420. 3 Bishop DH. A lack of appreciation of what really happens. Pharm J 2005;274:451.

Application of the Artificial Intelligence Algorithms for System Analysis of Multi Dimension Physiological Data for Developing Polyparametric Information System of Public Health Diagnostics

The polyparametric intelligence information system for diagnostics human functional state in medicine and public health is developed. The essence of the system consists in polyparametric describing of human functional state with the unified set of physiological parameters and using the polyparametric cognitive model developed as the tool for a system analysis of multitude data and diagnostics of a human functional state. The model is developed on the basis of general principles geometry and symmetry by algorithms of artificial intelligence systems. The architecture of the system is represented. The model allows analyzing traditional signs - absolute values of electrophysiological parameters and new signs generated by the model – relationships of ones. The classification of physiological multidimensional data is made with a transformer of the model. The results are presented to a physician in a form of visual graph – a pattern individual functional state. This graph allows performing clinical syndrome analysis. A level of human functional state is defined in the case of the developed standard (“ideal”) functional state. The complete formalization of results makes it possible to accumulate physiological data and to analyze them by mathematics methods.

Forging professional public health nursing in a southern state: Florida's public health nurses, 1889-1934

From 1889 to 1934, Florida's nurses belonging to a new group of professional women ushered in a pioneering phase of public health nursing in Florida. During this era, the nurses' ability to confront health and professional issues varied a great deal but in quiet and forceful ways they tackled cultural and environmental problems to assist people who were ill or help prevent people from becoming ill. This dissertation places the development of professional public health nursing in its social context by uncovering the relationships public health nurses formed with clubwomen, the medical profession, city leaders, midwives, and others. In 1888, there were few graduate nurses in the state, no state board of health and no organized nursing service to respond to Jacksonville's great yellow fever epidemic. By 1934, national and state leaders of public health nursing had built up the profession to become an essential part of the State Board of Health's service to the community. Between these milestones, in the era of white supremacy and Jim Crow, public health nurses combined their professional training with a pioneer spirit of innovation and risk-taking. In the predominately rural state, the public health nurses' resolve to overcome environmental hazards and cultural obstacles stands out as they attempted to reach those who were unserved or underserved by modern medicine.

The Public Health of Cubans and Cuban Americans: A Symposium [Program]

This is the program for "The Public Health of Cubans and Cuban Americans: A Symposium".

Relational conceptions of paternalism : a way to rebut nanny-state accusations and evaluate public health interventions

This work is funded by NHMRC grant 1023197. Stacy Carter is funded by an NHMRC Career Development Fellowship 1032963.

Healthy Food, Healthy Iowans, Healthy Communities Public Health Tools to Advance Healthy, Sustainable Food Systems, June 2014

The purposes of the Healthy Food, Healthy Iowans, Healthy communities Series are to demonstrate the interconnectedness of the food system to public health issues (Part 1) and to provide tools to local public health agencies for assessing, planning, implementing and evaluating food system initiatives (Part 2).

Iowa Department of Public Health Regulatory Plan FY 2016, August 1, 2015

The Department’s vision and mission statements broadly describe the obligations imposed on the Department of Public Health by statute. This plan was approved by Gerd Clabaugh, MPA, Director of the Iowa Department of Public Health. The following table, arranged by Department Divisions, summarizes the administrative rules currently under active consideration or development for fiscal year 2016.

Iowa Department of Public Health, Occupational Health & Safety Surveillance Program Annual Report, July 1, 2013- June 30, 2014, August 1, 2014

The mission of the Iowa OHSSP is to promote and protect the health and safety of Iowans in the workplace. The fundamental or core program provides administrative coordination and continuity across all IDPH OHSSP projects, explores options to improve the surveillance and data translation capacity of the entire program, and provides outreach, dissemination, and evaluation functions to support each project. The core program is also responsible for the Occupational Health Indicators project and Adult Blood Lead Epidemiology and Surveillance (ABLES), as well as working with external partner projects and reports.

Iowa Department of Public Health Maternal and Child Health Administrative Manual 4th Edition, October 23, 2012

The MCH Administrative Manual provides the basis for the development of business practices and programming for maternal and child health services made available through an Iowa Department of Public Health (IDPH) competitive bid process every five years. For each five year project period, policies in the manual provide the basis for the competitive Request for Proposal (RFP). During intervening years, policies provide the basis for the RFP and the Request for Application (RFA) covering the applicable contract year.