Coping with information style and family burden:Possible roles of self-stigma and hope among parents of children in a psychiatric inpatient unit

Objective: Parents of children who are hospitalized in inpatient psychiatric units must cope with significant challenges. One of these challenges relates to the way in which they cope with illness-related information. The current study examined the relationship between two such coping styles - monitoring and blunting - and family burden among parents of children in a psychiatric inpatient unit. Moreover, the possible moderating roles.played by hope and self-stigma in these associations were also examined. Methods: Questionnaires regarding coping with information style, self-stigma, hope and family burden were administered to 70 parents. Results: A main positive effect of hope and a main negative effect of self-stigma were uncovered. An interaction between self-stigma and monitoring was also revealed, suggesting that for parents with high self-stigma, compared to those with low self-stigma, more monitoring was related to more burden. Conclusions: Tailoring family interventions according to coping style and self-stigma is highly recommended as a mean to reduce the family burden of parents whose child is hospitalized in a psychiatric inpatient unit. (C) 2016 Elsevier Masson SAS. All rights reserved

Nonlinear Model-Based Control of Unstable Wells

This paper illustrates the potential of nonlinear model-based control applied for stabilization of unstable flow in oil wells. A simple empirical model is developed that describes the qualitative behavior of the downhole pressure during severe riser slugging. A nonlinear controller is designed by an integrator backstepping approach, and stabilization for open-loop unstable pressure setpoints is demonstrated. The proposed backstepping controller is shown in simulations to perform better than PI and PD controllers for low pressure setpoints, and is in addition easier to tune. Operation at a low pressure setpoint is desirable since it corresponds to a high production flow rate. The simulation results are presented to illustrate the effectiveness of proposed control scheme

Experimental study of the hydrodynamic behaviour of slug flow in a horizontal pipe

This paper investigates the unsteady hydrodynamic behaviour of slug flow occurring within an air–silicone oil mixture, within a horizontal 67 mm internal diameter pipe. A series of slug flow regime experiments were performed for a range of injected air superficial velocities (0.29–1.4 m s−1) and for liquid flows with superficial velocities of between 0.05–0.47 m s−1. A pair of Electrical Capacitance Tomography (ECT) probes was used to determine: the slug translational velocities of the elongated bubbles and liquid slugs, the slug frequencies, the lengths of elongated bubbles and the liquid slugs, the void fractions within the elongated bubbles and liquid slugs. The pressure drop experienced along the pipe was measured using a differential pressure transducer cell (DP cell). A comparative analysis of the current experimental data and that previously published experimental confirms good agreement

Women’s beliefs about medicines and adherence to pharmacotherapy in pregnancy: Opportunities for community pharmacists?

Background During pregnancy women might weigh benefits of treatment against potential risks to the unborn child. However, non-adherence to necessary treatment can adversely affect both mother and child. To optimize pregnant women’s beliefs and medication adherence, community pharmacists are ideally positioned to play an important role in primary care. Objective This narrative review aimed to summarize the evidence on 1) pregnant women’s beliefs, 2) medication adherence in pregnancy, and 3) community pharmacists’ counselling during pregnancy. Method Three search strategies were used in Medline and Embase to find original studies evaluating women’s beliefs, medication adherence and community pharmacists’ counselling during pregnancy. All original descriptive and analytic epidemiological studies performed in Europe, North America and Australia, written in English and published from 2000 onwards were included. Results We included 14 studies reporting on women’s beliefs, 11 studies on medication adherence and 9 on community pharmacists’ counselling during pregnancy. Women are more reluctant to use medicines during pregnancy and tend to overestimate the teratogenic risk of medicines. Risk perception varies with type of medicine, level of health literacy, education level and occupation. Furthermore, low medication adherence during pregnancy is common. Finally, limited evidence showed current community pharmacists’ counselling is insufficient. Barriers hindering pharmacists are insufficient knowledge and limited access to reliable information. Conclusion Concerns about medication use and non-adherence are widespread among pregnant women. Community pharmacists’ counselling during pregnancy is insufficient. Further education, training and research are required to support community pharmacists in fulfilling all the opportunities they have when counselling pregnant women

Long-Term Costs and Health Consequences of Issuing Shorter Duration Prescriptions for Patients with Chronic Health Conditions in the English NHS.

BACKGROUND: The National Health Service (NHS) in England spends over £9 billion on prescription medicines dispensed in primary care, of which over two-thirds is accounted for by repeat prescriptions. Recently, GPs in England have been urged to limit the duration of repeat prescriptions, where clinically appropriate, to 28 days to reduce wastage and hence contain costs. However, shorter prescriptions will increase transaction costs and thus may not be cost saving. Furthermore, there is evidence to suggest that shorter prescriptions are associated with lower adherence, which would be expected to lead to lower clinical benefit. The objective of this study is to estimate the cost-effectiveness of 3-month versus 28-day repeat prescriptions from the perspective of the NHS. METHODS: We adapted three previously developed UK policy-relevant models, incorporating transaction (dispensing fees, prescriber time) and drug wastage costs associated with 3-month and 28-day prescriptions in three case studies: antihypertensive medications for prevention of cardiovascular events; drugs to improve glycaemic control in patients with type 2 diabetes; and treatments for depression. RESULTS: In all cases, 3-month prescriptions were associated with lower costs and higher QALYs than 28-day prescriptions. This is driven by assumptions that higher adherence leads to improved disease control, lower costs and improved QALYs. CONCLUSION: Longer repeat prescriptions may be cost-effective compared with shorter ones. However, the quality of the evidence base on which this modelling is based is poor. Any policy rollout should be within the context of a trial such as a stepped-wedge cluster design

Population Trends???Prologue to Library Development

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