Service quality, outpatient satisfaction and loyalty in community pharmacies in Turkey: A structural equation modeling approach.

Background: The sustainability of community pharmacy services is dependent on service quality, patient satisfaction, and patient loyalty. While community pharmacies are perceived as medical units in terms of drug dispensing, they are also businesses that engage in social interaction with patients. Objectives: To propose a certain model to evaluate the impact of different service factors on the level of satisfaction and to reveal the relationship between satisfaction and loyalty. Methods: This cross-sectional study was conducted in the province of Afyonkarahisar, Turkey, between March 20, 2022, and December 30, 2022. The research data were collected with a questionnaire that included demographic information, selected service factors, satisfaction, and loyalty. The data obtained from 402 participants were analyzed using structural equation modeling (SEM). Result: The mean age of the participants was 32.02 ± 11.81, 53.9% were female, 58.7% were employed, 54.1% had a bachelor's degree, 11.7% had a chronic disease, and 16.1% were taking medication regularly. The findings of the study showed that communication and attitude (ß = 0.22; t = 3.90), medicine supply (ß = 0.43; t = 7.62), and pharmacy environment (ß = 0.26; t = 4.23) positively affected patient satisfaction in community pharmacies. Service promptness did not have a significant effect on patient satisfaction (ß = 0.07; t = 1.18). The most effective service factor on patient satisfaction was medicine supply (ß = 0.43). In addition, the research results determined that patient satisfaction strongly affects patient loyalty in community pharmacies (ß = 0.72, t = 11.24). Conclusions: While community pharmacies can increase patient satisfaction through service factors, they can increase patient loyalty by improving patient satisfaction. Community pharmacies that want to have satisfied and loyal patients should focus more on service factors. Community pharmacies should not only meet the medical expectations of patients but also meet their social expectations.

Conjunctival Impression Cytology and Tear Film Changes in Sarcoidosis: A Subjective and Objective Diagnosis Study.

Objectives: To evaluate sarcoidosis-induced tear film changes using subjective and objective diagnostic tests, particularly conjunctival impression cytology (IC), and to compare the results with healthy individuals. Materials and Methods: This study evaluated clinical data collected between January 2019 and January 2021 from 57 right eyes of 57 sarcoidosis patients without ocular involvement (Group 1) and 33 right eyes of 33 healthy individuals with similar demographic characteristics (Group 2). The Schirmer I test, tear break-up time (TBUT), fluorescein staining, and conjunctival IC were all performed as part of the conjunctival and corneal examinations following a thorough ophthalmological examination. The Ocular Surface Disease Index (OSDI) was used to assess subjective ocular symptoms. Results: The mean ages in Groups 1 and 2 were 49.26±3.18 and 51.91±2.89 years, respectively (p=0.720). The mean Schirmer I test, TBUT, and OSDI scores differed significantly (p<0.05 for all), with Group 1 having a significantly higher percentage of dry eyes than Group 2. Group 1 had significantly higher Nelson's grading system grades than Group 2 based on conjunctival IC analysis (p=0.001). There were no significant differences in visual acuity (p=0.17) or intraocular pressure (p=0.14) between groups. Conclusion: Sarcoidosis patients had significantly higher Nelson grades in conjunctival IC, as well as significantly higher percentages of dry eye as determined by the Schirmer I test, TBUT, and OSDI. Reduced tear quantity and quality may destabilize the tear film layer, resulting in a variety of ocular symptoms.

Sonoelastographic Assessment of the Achilles Tendon in Familial Mediterranean Fever Patients: Comparison With Healthy Subjects.

INTRODUCTION AND OBJECTIVE: This study aims at using sonoelastography as a novel technique to evaluate the stiffness and thickness of Achilles tendons in familial Mediterranean fever (FMF) patients. METHODS: Achilles tendons of 26 FMF patients and 23 control subjects were assessed with ultrasound and real-time sonoelastography. The Achilles tendons were divided into the distal, middle, and proximal thirds for elastographic image evaluation. Tendons were classified into three main types according to their elasticity features: grade 1 blue (hardest tissue) to green (hard tissue); grade 2, yellow (soft tissue); and grade 3, red (softest tissue). Tendons of the groups were compared in terms of thickness and stiffness. RESULTS: There were no significant differences in thickness and stiffness of the Achilles tendon between FMF patients and controls (p>0.05). Sonoelastography of Achilles tendons of FMF patients displayed no relationship between FMF and tendinopathy.  Conclusion: This issue should be explored in prospective studies in larger groups.

The investigation of sportsmanship behaviors of university students / La investigación de los comportamientos deportivos de los estudiantes universitarios / A investigação do comportamento esportivo de estudantes universitários

The aim of the present study was to examine the effective facors on sportsmanship behaviors of university students. With this purpose, students' attitudes for rules, injurious acts, opponent game perspective and sportsmanship behaviors were examined, and the effects of these factors were modeled via structural equation modeling. To measure the effective factors on students sportsmanship behaviors, a likert scale type questionnaire, ranging from 1 'strongly disagree' to 5 'strongly agree' was applied on a face-to-face basis. The sportsmanship questionnaire about sportsmanship was composed of 45 questions. In the statistical analysis obtained data, SPSS and LISREL software were used. The results of the analyses indicate that while "game perspective" is the most effective factor on students' sportsmanship behavior, the factors; "opponent", "rules", and "injurious acts" are also statistically significant

El objetivo del presente estudio fue examinar los factores efectivos sobre el comportamiento deportivo de los estudiantes universitarios. Con este propósito, se examinaron las actitudes de los estudiantes respecto a las reglas, los actos perjudiciales, la perspectiva del juego del oponente y los comportamientos de deportividad, y los efectos de estos factores se modelaron mediante el modelado de ecuaciones estructurales. Para medir los factores efectivos en los comportamientos de deportividad de los estudiantes, se aplicó un cuestionario tipo escala tipo Likert, que varía de 1 "totalmente en desacuerdo" a 5 "totalmente de acuerdo" en persona. El cuestionario de deportividad sobre deportividad estaba compuesto por 45 preguntas. En el análisis estadístico de los datos obtenidos, se utilizaron el software SPSS y LISREL. Los resultados de los análisis indican que si bien la "perspectiva del juego" es el factor más efectivo en el comportamiento deportivo de los estudiantes, los factores; "Oponente", "reglas" y "actos nocivos" también son estadísticamente significativos

O objetivo do presente estudo foi examinar os fatores efetivos no comportamento esportivo de universitários. Para tanto, foram examinadas as atitudes dos alunos em relação a regras, atos prejudiciais, a perspectiva de jogo do adversário e o comportamento esportivo, e os efeitos desses fatores foram modelados através da modelagem de equações estruturais. Para medir os fatores efetivos no comportamento esportivo dos alunos, foi aplicado um questionário da escala do tipo Likert, que varia de 1 "discordo totalmente" a 5 "concordo totalmente" pessoalmente. O questionário de espírito esportivo foi composto por 45 perguntas. Na análise estatística dos dados obtidos, foram utilizados os softwares SPSS e LISREL. Os resultados das análises indicam que, embora a "perspectiva do jogo" seja o fator mais eficaz no comportamento esportivo dos estudantes, os fatores; "Oponente", "regras" e "atos prejudiciais" também são estatisticamente significativos