Does trust in health care influence the use of complementary and alternative medicine by chronically ill people?

BACKGROUND: People's trust in health care and health care professionals is essential for the effectiveness of health care, especially for chronically ill people, since chronic diseases are by definition (partly) incurable. Therefore, it may be understandable that chronically ill people turn to complementary and alternative medicine (CAM), often in addition to regular care. Chronically ill people use CAM two to five times more often than non-chronically ill people. The trust of chronically ill people in health care and health care professionals and the relationship of this with CAM use have not been reported until now. In this study, we examine the influence of chronically ill people's trust in health care and health care professionals on CAM use. METHODS: The present sample comprises respondents of the 'Panel of Patients with Chronic Diseases' (PPCD). Patients (≥25 years) were selected by GPs. A total of 1,625 chronically ill people were included. Trust and CAM use was measured by a written questionnaire. Statistical analyses were t tests for independent samples, Chi-square and one-way analysis of variance, and logistic regression analysis. RESULTS: Chronically ill people have a relatively low level of trust in future health care. They trust certified alternative practitioners less than regular health care professionals, and non-certified alternative practitioners less still. The less trust patients have in future health care, the more they will be inclined to use CAM, when controlling for socio-demographic and disease characteristics. CONCLUSION: Trust in future health care is a significant predictor of CAM use. Chronically ill people's use of CAM may increase in the near future. Health policy makers should, therefore, be alert to the quality of practising alternative practitioners, for example by insisting on professional certification. Equally, good quality may increase people's trust in public health care

Composable and predictable dynamic loading for time-critical partitioned systems

In time-critical systems such as in avionics, for safety and timing guarantees, applications are isolated from each other. Resources are partitioned in time and space creating a partition per application. Such isolation allows fault containment and independent development, testing and verification of applications. Current partitioned systems do not allow dynamically adding applications. Applications are statically loaded in their respective partitions. However dynamic loading can be useful or even necessary for scenarios such as on-board software updates, dynamic reconfiguration or re-loading applications in case of a fault. In this paper we propose a software architecture to dynamically create and manage partitions and a method for compostable dynamic loading which ensures that loading applications do not affect the running applications and vice versa. Furthermore the loading time is also predictable i.e. the loading time can be bounded a priori. We achieve this by splitting the loading process into parts, wherein only a small part which reserves minimum required resources is executed in the system partition and the other parts are executed in the allocated application partition which ensures isolation from other applications. We implement the software architecture for a SoC prototype on an FPGA board and demonstrate its composability and predictability properties