This chapter is divided into four sections. The first section introduces the concept of person-centred care within pharmaceutical care delivery and provides a historical context. The second section focuses on the professionals and explores the role of person-centred pharmaceutical care as part of multi-disciplinary health services delivery teams. The third section focuses on the patient and describes the role of health literacy in the implementation of person-centred pharmaceutical care. The last section examines E-pharmacy services and the implementation of telepharmacy with implications for person-centred care.
Hospital pharmacy is a specialized field within pharmacy and an integral part of healthcare provided to hospitalized patients in a healthcare institution, striving to maintain and continuously improve medication management and pharmaceutical care for patients in line with the highest standards in a hospital environment. Purpose of the study was to monitor pharmaceutical healthcare quality indicators for in-hospital pharmacies, to explain the concept of quality and provide recommendations for the provision of pharmaceutical healthcare in secondary and tertiary healthcare institutions through pharmaceutical healthcare quality indicators. We used the case study method as an in-depth, intense and precisely focused method of descriptive research to present our three-case series. To analyse case studies, we selected hospital pharmacies in three healthcare institutions, the Clinical-Hospital Center (CHC) Zvezdara, University Clinical Center (UCC) Kragujevac and Special Hospital for Addiction Diseases (SHAD). Reference framework was established according to pharmaceutical healthcare quality indicators taken from a pilot project on quality indicators in hospital pharmacies entitled "Indicators of quality and patient safety in pharmaceutical healthcare - hospital pharmacy" from 2012. Data was collected from questionnaires that were filled in directly by pharmacists from pharmacy databases and records from regular everyday work activities. For the purposes of achieving second and third objectives of this study, we performed a literature search for the quality of pharmaceutical healthcare and quality indicators. Comparison of the calculated indicators from the 3 health care institutions presented in our case series provided insight into indicators that are monitored in all three healthcare institutions (6 indicators) as well as in the distribution of indicators by institutions encompassed by our research. Comparative analysis of the calculated indicators by healthcare institutions indicates that I1 is monitoring 12 indicators, I2 9 indicators and I3 8 indicators. Only 1 indicator from the pilot project is being monitored in line with the new "Rule-book on healthcare quality indicators and on the evaluation of the quality of professional work" in the observed institutions (adverse reactions to the medicines/medical devices). The same Rule-book imposes monitoring of another 4 indicators, pointing to improvement of the healthcare system and modernization of pharmaceutical healthcare. It can hence be concluded that the implementation of new indicators requires recommendations and that further research is necessary to determine how to assess pharmaceutical healthcare efficiency and quality that are to be improved through indicators introduced in the pharmaceutical healthcare practice.
The number of software - mobile applications intended for use in the field of people's health and well-being is constantly increasing. The aim of this review is to compare regulations on software - mobile applications as medical devices in the United States of America (USA), European Union (EU) and Serbia, with reference on the efforts for international harmonization of the regulations. The goal is to increase awareness of the broader healthcare professionals' (HCPs) audience about this topic. Publicly available information from official regulatory bodies websites was analyzed and synthesized for two regions and one country of interest. The results show differences in regulatory approaches in this area between two biggest medical device markets - the USA and the EU, while regulations in Serbia are being harmonized with the EU. Regulations clearly define criteria that software - mobile application needs to meet to be assessed as a medical device; on the other hand, they leave a number of applications that provide health-related services out of the regulated scope. Based on the increased awareness of regulations, recommendations for future research can be directed towards greater involvement of HCPs in patient counseling and decision making regarding the selection of mobile applications, to prevent the use of inadequate mobile applications and ensure that their patients are correctly using the right applications with positive effects on health and well-being.
The principal role of biochemical laboratories is responsibility for reliable, reproducible, accurate, timely, and accurately interpreted analysis results that help in making clinical decisions, while ensuring the desired clinical outcomes. To achieve this goal, the laboratory should introduce and maintain quality control in all phases of work. The importance of applying the Six SIGMA quality model has been analyzed in a large number of scientific studies. The purpose of this review is to highlight the importance of using six SIGMA metrics in biochemical laboratories and the current application of six SIGMA metrics in all laboratory work procedures. It has been shown that the six SIGMA model can be very useful in improving all phases of laboratory work, as well as that a detailed assessment of all procedures of the phases of work and improvement of the laboratory's quality control system is crucial for the laboratory to have the highest level of six SIGMA. Clinical laboratories should use SIGMA metrics to monitor their performance, as it makes it easier to identify gaps in their performance, thereby improving their efficiency and patient safety. Medical laboratory quality managers should provide a systematic methodology for analyzing and correcting quality assurance systems to achieve Six SIGMA quality-level standards.
S ciljem zaštite tradicionalne „Visočke pečene janjetine“ oznakom geografskog porijekla pro-vedena su istraživanja na nacionalnom nivou. Po prvi put je detaljno praćen cjelokupni tehnološki po-stupak proizvodnje, od faze iskrvarenja životinje, primarne obrade trupa i konfekcioniranja mesa, do termičke obrade. Osnovni motiv istraživanja bio je ustanoviti autentičnost ovog specifičnog načina ter-mičke obrade janjećeg mesa i njegovu vezu sa ispitivanim područjem (Visoko). Uz navedeno, jedan od ciljeva je bio laboratorijskim ispitivanjima kvantificirati osnovne kvalitativne parametre. Ustanovlje-ni indikatori kvalitete „Visočke pečene janjetine“ poslužit će kao referentni pokazatelji u predstojećim aktivnostima, prilikom utvrđivanja proizvođačke specifikacije. U radu su utvrđivani senzorni, kemijski i mikrobiološki parametri kvalitete „Visočke pečene janjetine“. Senzorna ocjena pokazala je da je kva-liteta Visočke pečene janjetine ekstra visoka, pri čemu je boja najbolje ocijenjeno svojstvo. Srednje vri-jednosti kemijskih parametara iznosile su kako slijedi: 54,18 % vode, masti 19,44 %, proteina 25,28 %, pepela 1,10 %, NaCl 0,20 %. Prosječna pH vrijednost iznosila je 6,47, a aw 0,958.
The research includes a comparative analysis of the structure and floristic composition of different types of lawns along Belgrade roads (grass areas of roundabouts, dividing strips, areas near roads and grass areas of first order roads), their floristic composition, as well as determining changes over a period of 17 years. The analyses are based on the results of floristic research from 2002, as well as the results of field research conducted during 2019. A total of 114 plant species were recorded on the studied lawns along Belgrade roads, among which the highest proportion belongs to the category of weed species. The taxonomic analysis has shown a reduction in the recorded number of families and genera over the study period of 17 years Both studies indicate the absolute dominance of plants from the group of hemicryptophytes. The results of the research are used to provide guidelines and recommendations for improving the condition and structure of lawns along Belgrade roads. Also, they provide the basis for the future selection of adequate types of grass for the establishment of new lawns, as well as the repair of the existing ones, i.e. for the sustainable management of green spaces along city roads.
During 2019, 28 grave constructions were excavated at cemetery Metaljica (Hadzici municipality, Bosnia and Herzegovina)
Vector-borne diseases occur in the chain pathogen-vector-host, with vectors playing the most prominent role. Vectors transmit pathogens between humans, and more often, from animals to humans so that many vector-borne diseases are categorized as zoonoses. Vector-borne diseases have become more important worldwide, and not exclusively in the tropics as in the past, by causing high morbidity and mortality every year. Out of all infectious diseases, more than 17% are vector-borne. The most significant and widespread vectors are mosquitoes and ticks, and the most significant diseases are West Nile fever, yellow fever, Zika virus fever, tick encephalitis, Lyme borreliosis, Crimean-Congo hemorrhagic fever and rickettsioses. Life and preservation of the vectors, and breakouts and spread of vector-borne diseases are profoundly affected by climate change (rise in temperature and humidity, downfalls, extreme weather conditions), urbanization, deforestation, inadequate waste management, international travel, international commerce and social conditions, with poverty being the most important and directly linked to the rising incidence. In recent years, all factors mentioned above have favoured a rising number of the vectors and their spread, so that vector-borne diseases have become emergent or reemergent, meaning their high incidence have been registered in the countries with no previous breakouts; or they reoccurred in the areas where they had earlier been eradicated. Some extra reasons contributing to the increasing incidence are lowered investments and limited resources for monitoring vector-borne diseases. Most vector-borne diseases are zoonoses, making "One Health" the only appropriate approach, which implies integrated monitoring of the diseases in the sectors of both animal and human health. Prevention of vector-borne diseases should be aimed at raising public awareness on the importance of the vectors, education of the professionals and active involvement of the community as a whole.
Introduction/Objective Patient safety is defined as the prevention of errors and adverse effects aimed at patients and associated with health care. Patient safety culture (PSC) is "the product of individual and group values, attitudes, perceptions, competencies and patterns of behaviour that determine the commitment to, and the style and proficiency of, an organization's health and safety management." Improving the perception of the PSC within the healthcare sector plays a key role in improving its overall quality, efficacy and productivity. This article aims to point out the importance of the inexhaustible and very interesting topic of safety culture as a basis for further research and strategy creation. Methods This is a qualitative research paper, based on a scientific review of the literature. Relevant articles for this review have been identified by searching digital databases: PubMed, Medline and Google Scholar. The research was retrospective and covered a timeframe of five years. Articles were selected by introducing keywords relevant to the subject. Results The results are based on the analysis and review of 12 published scientific articles from 2017 to 2021. Conclusion Patient safety must be the priority of the healthcare provider. Theoretical foundations should be combined with educational experiences following the development of knowledge, skills and attitudes for effective patient safety. Adverse event reporting should include learning from mistakes, supporting an environment that encourages reporting without blame or fear of punishment. The healthcare system needs to be made as safe as possible for both the patients and all those providing healthcare. Improving and developing the quality of healthcare requires knowledge, selection and application of specific methods and tools tailored to the capabilities of individual healthcare institutions.
Introduction. The most common form of leishmaniasis is cutaneous leishmaniasis. It presents with cutaneous lesions of the unprotected parts of the skin which leave scars later on. The causative agents are protozoae from the Leishmania species , and there are more than 20 of them. Clinical presentation and therapy depend on the type of leishmaniasis. The vectors of leishmaniosis are flies from the Phlebotomus species, and the source of infection is people and animals. Case report. A patient used to work in Iraq. Due to skin lesions that persisted for three months and suspicion of cutaneous leishmaniosis, he was sent by an infectious disease specialist from General hospital, Pancevo to the Public Health Institute of Serbia - PHIS. Lesions were localized on the hands, in the form of plaques with central ulcerations. There were similar cases among his colleagues. Microscopic examination of the skin samples, Giemza stained, showed intracellular amastigote Leishmania. The patient spent two months in the Clinic for infectious and tropical diseases. He was treated with fluconazole and liposomal amphotericin B and discharged with crusts on his hands. Clinical presentation, epidemiologic data, and microbiological diagnosis are very important for the diagnosis of cutaneous leishmaniasis.
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