4,953 research outputs found

    Suppression of spatially periodic patterns by dc voltage

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    The effect of superposed dc and ac applied voltages on two types of spatially periodic instabilities in nematic liquid crystals, flexoelectric domains (FD) and electroconvection (EC), was studied. The onset characteristics, threshold voltages and critical wave vectors, were determined. We found that in general the superposition of driving with different time symmetries inhibits the pattern forming mechanisms for FD and EC as well. As a consequence the onset extends to much higher voltages than the individual dc or ac thresholds. A dc bias induced reduction of the crossover frequency from the conductive to the dielectric EC regimes and a peculiar transition between two types of flexodomains with different wavelengths were detected. Direct measurements of the change of the electrical conductivity and its anisotropy, induced by the applied dc voltage component, showed that the dc bias substantially affects both parameters. Taking into account the experimentally detected variations of the conductivity in the linear stability analysis of the underlying nemato-hydrodynamic equations, a qualitative agreement with the experimental findings on the onset behaviour of spatially periodic instabilities was obtained

    Suppression of spatially periodic patterns by dc voltage

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    The effect of superposed dc and ac applied voltages on two types of spatially periodic instabilities in nematic liquid crystals, flexoelectric domains (FD) and electroconvection (EC), was studied. The onset characteristics, threshold voltages and critical wave vectors, were determined. We found that in general the superposition of driving with different time symmetries inhibits the pattern forming mechanisms for FD and EC as well. As a consequence the onset extends to much higher voltages than the individual dc or ac thresholds. A dc bias induced reduction of the crossover frequency from the conductive to the dielectric EC regimes and a peculiar transition between two types of flexodomains with different wavelengths were detected. Direct measurements of the change of the electrical conductivity and its anisotropy, induced by the applied dc voltage component, showed that the dc bias substantially affects both parameters. Taking into account the experimentally detected variations of the conductivity in the linear stability analysis of the underlying nemato-hydrodynamic equations, a qualitative agreement with the experimental findings on the onset behaviour of spatially periodic instabilities was obtained

    The effect of a transitional pharmaceutical care program on the occurrence of ADEs after discharge from hospital in patients with polypharmacy

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    Introduction: Transitional care programs (i.e. interventions delivered both in hospital and in primary care), could increase continuity and consequently quality of care. However, limited studies on the effect of these programs on Adverse Drug Events (ADEs) post-discharge are available. Therefore, the aim of this study was to investigate the effect of a transitional pharmaceutical care program on the occurrence of ADEs 4 weeks post-discharge. Methods: A multicentre prospective before-after study was performed in a general teaching hospital, a university hospital and 49 community pharmacies. The transitional pharmaceutical care program consisted of: teach-back to the patient at discharge, a pharmaceutical discharge letter, a home visit by a community pharmacist and a clinical medication review by both the community and the clinical pharmacist, on top of usual care. Usual care consisted of medication reconciliation at admission and discharge by pharmacy teams. The primary outcome was the proportion of patients who reported at least 1 ADE 4 weeks post-discharge. Multivariable logistic regression was used to adjust for potential confounders. Results: In total, 369 patients were included (control: n = 195, intervention: n = 174). The proportion of patients with at least 1 ADE did not statistically significant differ between the intervention and control group (general teaching hospital: 59% vs. 67%, ORadj 0.70 [95% CI 0.38–1.31], university hospital: 63% vs 50%, OR adj 1.76 [95% CI 0.75–4.13]). Conclusion: The transitional pharmaceutical care program did not decrease the proportion of patients with ADEs after discharge. ADEs after discharge were common and more than 50% of patients reported at least 1 ADE. A process evaluation is needed to gain insight into how a transitional pharmaceutical care program could diminish those ADEs

    Application of intervention mapping to develop and evaluate a pharmaceutical discharge letter to improve information transfer between hospital and community pharmacists

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    Background: Insufficient information transfer is a major barrier in the transition from hospital to home. This study describes the systematic development and evaluation of an intervention to improve medication information transfer between hospital and community pharmacists. Objective: To develop and evaluate an intervention to improve the medication information transfer between hospital and community pharmacists based on patients', community and hospital pharmacists’ needs. Methods: The intervention development and evaluation was guided by the six-step Intervention Mapping (IM) approach: (1) needs assessment to identify determinants of the problem, with a scoping review and focus groups with patients and healthcare providers, (2) formulation of intervention objectives with an expert group, (3) inventory of communication models to design the intervention, (4) using literature review and qualitative research with pharmacists and patients to develop the intervention (5) pilot-testing of the intervention in two hospitals, and (6) a qualitative evaluation of the intervention as part of a multicenter before-after study with hospital and community pharmacists. Results: Barriers in the information transfer are mainly time and content related. The intervention was designed to target a complete, accurate and timely medication information transfer between hospital and community pharmacists. A pharmaceutical discharge letter was developed to improve medication information transfer. Hospital and community pharmacists were positive about the usability, content, and comprehensiveness of the pharmaceutical discharge letter, which gave community pharmacists sufficient knowledge about in-hospital medication changes. However, hospital pharmacists reported that it was time-consuming to draft the discharge letter and not always feasible to send it on time. The intervention showed that pharmacists are positive about the usability, content and comprehensiveness. Conclusion: This study developed an intervention systematically to improve medication information transfer, consisting of a discharge letter to be used by hospital and community pharmacists supporting continuity of care

    Fixed point theorems for cyclic self-maps involving weaker Meir-Keelerfunctions in complete metric spaces and applications

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    We obtain fixed point theorems for cyclic self-maps on complete metric spaces involving Meir-Keeler and weaker Meir-Keeler functions, respectively. In this way, we extend several well-known fixed point theorems and, in particular, improve some very recent results on weaker Meir-Keeler functions. Fixed point results for well-posed property and for limit shadowing property are also deduced. Finally, an application to the study of existence and uniqueness of solutions for a class of nonlinear integral equations is presented.The second author thanks for the support of the Ministry of Economy and Competitiveness of Spain under grant MTM2012-37894-C02-01, and the Universitat Politecnica de Valencia, grant PAID-06-12-SP20120471.Nashine, HK.; Romaguera Bonilla, S. (2013). Fixed point theorems for cyclic self-maps involving weaker Meir-Keelerfunctions in complete metric spaces and applications. Fixed Point Theory and Applications. 2013(224):1-15. https://doi.org/10.1186/1687-1812-2013-224S1152013224Kirk WA, Srinavasan PS, Veeramani P: Fixed points for mapping satisfying cyclical contractive conditions. Fixed Point Theory 2003, 4: 79–89.Banach S: Sur les operations dans les ensembles abstraits et leur application aux equations integerales. Fundam. Math. 1922, 3: 133–181.Boyd DW, Wong SW: On nonlinear contractions. Proc. Am. Math. Soc. 1969, 20: 458–464. 10.1090/S0002-9939-1969-0239559-9Caristi J: Fixed point theorems for mappings satisfying inwardness conditions. Trans. Am. Math. Soc. 1976, 215: 241–251.Di Bari C, Suzuki T, Vetro C: Best proximity points for cyclic Meir-Keeler contractions. Nonlinear Anal. 2008, 69: 3790–3794. 10.1016/j.na.2007.10.014Karapinar E: Fixed point theory for cyclic weaker ϕ -contraction. Appl. Math. Lett. 2011, 24: 822–825. 10.1016/j.aml.2010.12.016Karapinar E, Sadarangani K: Corrigendum to “Fixed point theory for cyclic weaker ϕ -contraction” [Appl. Math. Lett. Vol. 24(6), 822–825.]. Appl. Math. Lett. 2012, 25: 1582–1584. 10.1016/j.aml.2011.11.001Karapinar E, Sadarangani K:Fixed point theory for cyclic ( ϕ − φ ) -contractions. Fixed Point Theory Appl. 2011., 2011: Article ID 69Nahsine HK: Cyclic generalized ψ -weakly contractive mappings and fixed point results with applications to integral equations. Nonlinear Anal. 2012, 75: 6160–6169. 10.1016/j.na.2012.06.021Păcurar M: Fixed point theory for cyclic Berinde operators. Fixed Point Theory 2011, 12: 419–428.Păcurar M, Rus IA: Fixed point theory for cyclic φ -contractions. Nonlinear Anal. 2010, 72: 2683–2693.Piatek B: On cyclic Meir-Keeler contractions in metric spaces. Nonlinear Anal. 2011, 74: 35–40. 10.1016/j.na.2010.08.010Rus IA: Cyclic representations and fixed points. Ann. “Tiberiu Popoviciu” Sem. Funct. Equ. Approx. Convexity 2005, 3: 171–178.Chen CM: Fixed point theory for the cyclic weaker Meir-Keeler function in complete metric spaces. Fixed Point Theory Appl. 2012., 2012: Article ID 17Chen CM: Fixed point theorems for cyclic Meir-Keeler type mappings in complete metric spaces. Fixed Point Theory Appl. 2012., 2012: Article ID 41Meir A, Keeler E: A theorem on contraction mappings. J. Math. Anal. Appl. 1969, 28: 326–329. 10.1016/0022-247X(69)90031-6Matkowski J: Integrable solutions of functional equations. Diss. Math. 1975, 127: 1–68.Karapinar E, Romaguera S, Tas K: Fixed points for cyclic orbital generalized contractions on complete metric spaces. Cent. Eur. J. Math. 2013, 11: 552–560. 10.2478/s11533-012-0145-0De Blasi FS, Myjak J: Sur la porositĂ© des contractions sans point fixed. C. R. Math. Acad. Sci. Paris 1989, 308: 51–54.Lahiri BK, Das P: Well-posedness and porosity of certain classes of operators. Demonstr. Math. 2005, 38: 170–176.Popa V: Well-posedness of fixed point problems in orbitally complete metric spaces. Stud. Cercet. ƟtiinĆŁ. - Univ. Bacău, Ser. Mat. 2006, 16: 209–214. Supplement. Proceedings of ICMI 45, Bacau, Sept. 18–20 (2006)Popa VV: Well-posedness of fixed point problems in compact metric spaces. Bul. Univ. Petrol-Gaze, Ploiesti, Sec. Mat. Inform. Fiz. 2008, 60: 1–4

    Implementation of a pharmacist-led transitional pharmaceutical care programme:Process evaluation of Medication Actions to Reduce hospital admissions through a collaboration between Community and Hospital pharmacists (MARCH)

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    What is known and objective: The recently conducted Medication Actions to Reduce hospital admissions through a collaboration between Community and Hospital pharmacists (MARCH) transitional care programme, which aimed to test the effectiveness of a transitional care programme on the occurrence of ADEs post-discharge, did not show a significant effect. To clarify whether this non-significant effect was due to poor implementation or due to ineffectiveness of the intervention as such, a process evaluation was conducted. The aim of the study was to gain more insight into the implementation fidelity of MARCH. Methods: A mixed methods design and the modified Conceptual Framework for Implementation Fidelity was used. For evaluation, the implementation fidelity and moderating factors of four key MARCH intervention components (teach-back, the pharmaceutical discharge letter, the post-discharge home-visit and the transitional medication review) were assessed. Quantitative data were collected during and after the intervention. Qualitative data were collected using semi-structured interviews with MARCH healthcare professionals (community pharmacists, clinical pharmacists, pharmacy assistants and pharmaceutical consultants) and analysed using thematic analysis. Results and Discussion: Not all key intervention components were implemented as intended. Teach-back was not always performed. Moreover, 63% of the pharmaceutical discharge letters, 35% of the post-discharge home-visits and 44% of the transitional medication reviews were not conducted within their planned time frames. Training sessions, structured manuals and protocols with detailed descriptions facilitated implementation. Intervention complexity, time constraints and the multidisciplinary coordination were identified as barriers for the implementation. What is new and Conclusion: Overall, the implementation fidelity was considered to be moderate. Not all key intervention components were carried out as planned. Therefore, the non-significant results of the MARCH programme on ADEs may at least partly be explained by poor implementation of the programme. To successfully implement transitional care programmes, healthcare professionals require full integration of these programmes in the standard work-flow including IT improvements as well as compensation for the time investment
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