Medicines adherence: Involving patients in decisions about prescribed medicines and supporting adherence

It is thought that between a third and a half of all medicines1 There are many causes of non-adherence but they fall into two overlapping categories: intentional and unintentional. Unintentional non-adherence occurs when the patient wants to follow the agreed treatment but is prevented from doing so by barriers that are beyond their control. Examples include poor recall or difficulties in understanding the instructions, problems with using the treatment, inability to pay for the treatment, or simply forgetting to take it. prescribed for long-term conditions are not taken as recommended. If the prescription is appropriate, then this may represent a loss to patients, the healthcare system and society. The costs are both personal and economic. Adherence presumes an agreement between prescriber and patient about the prescriber’s recommendations. Adherence to medicines is defined as the extent to which the patient’s action matches the agreed recommendations. Non-adherence may limit the benefits of medicines, resulting in lack of improvement, or deterioration, in health. The economic costs are not limited to wasted medicines but also include the knock-on costs arising from increased demands for healthcare if health deteriorates. Non-adherence should not be seen as the patient’s problem. It represents a fundamental limitation in the delivery of healthcare, often because of a failure to fully agree the prescription in the first place or to identify and provide the support that patients need later on. Addressing non-adherence is not about getting patients to take more medicines per se. Rather, it starts with an exploration of patients’ perspectives of medicines and the reasons why they may not want or are unable to use them. Healthcare professionals have a duty to help patients make informed decisions about treatment and use appropriately prescribed medicines to best effec

ifo Konjunkturprognose 2005/2006: Nur zögerliche Erholung

Die Weltwirtschaft hat im laufenden Jahr merklich an Dynamik eingebüßt, nachdem sie 2004 außerordentlich stark gewachsen war. In Deutschland fehlen die binnenwirtschaftlichen Auftriebskräfte immer noch fast vollständig. Die gesamtwirtschaftliche Produktion kommt sofort aus dem Tritt, sobald vom Ausland geringere Impulse ausgehen. Für die deutsche Wirtschaft ist eine fundamentale Wachstumsschwäche zu diagnostizieren; das Produktionspotential steigt derzeit nur um 1%, das ist halb so hoch wie im restlichen Euroraum. Die Entwicklung dieses und des kommenden Jahres wird ungefähr dem Trend folgen. Das reale Bruttoinlandsprodukt dürfte im Jahresdurchschnitt 2005 um 0,8% expandieren, nach 1,6% im Jahr 2004. Im nächsten Jahr dürfte sich das Expansionstempo der gesamtwirtschaftlichen Produktion parallel zur Besserung der Weltkonjunktur wieder leicht beschleunigen; die Zuwachsrate des realen Bruttoinlandsprodukts dürfte sich dann auf 1,2% belaufen. Damit wird die gesamtwirtschaftliche Auslastung der Produktionskapazitäten wieder zunehmen. Die Inflationsrate dürfte trotz des Ölpreisschubs im Durchschnitt des Prognosezeitraums unter der 2-Prozentmarke liegen. Auf dem deutschen Arbeitsmarkt ist bisher keine Wende eingetreten. Im Mai dieses Jahres gab es 4,81 Mill. registrierte Arbeitslose; das entspricht einem Anstieg von 510 000 gegenüber dem vergleichbaren Vorjahresmonat. Der überwiegende Teil dieser Zunahme (ca. 360 000) ist auf die im Zuge der Hartz-IV-Gesetzgebung erfolgte Zusammenlegung von Arbeitslosen- und Sozialhilfe zurückzuführen. Rechnet man dagegen, dass inzwischen rund 155 000 Zusatzjobs die Statistik entlasten, so dürfte die rein konjunkturelle Zunahme der Arbeitslosigkeit rund 300 000 betragen haben. Erst im nächsten Jahr ist eine leichte Besserung auf dem Arbeitsmarkt zu erwarten. Unter der Annahme, dass bis zum Jahresende 2006 etwa 300 000 Zusatzjobs geschaffen werden, dürfte sich die Zahl der registrierten Arbeitslosen in diesem Jahr auf 4,86 Millionen belaufeWeltkonjunktur, Konjunkturprognose, Wirtschafstwachstum, Konjunkturumfrage, Geschäftsklima, Deutschland, Welt

Accurate band mapping via photoemission from thin films

Electron bands in solids can be determined in angle-resolved photoemission experiments from thin films, where the perpendicular wave vector (k⊥) uncertainty that characterizes photoemission from bulk crystals is removed. However, the comparison with state-of-the-art quasiparticle band-structure calculations has never been done. In this work we have mapped both initial-state (occupied) and final-state (empty) E(k⊥) bands along the A axis of aluminum, from photon-energy- and thickness-dependent quantum-well spectra of aluminum films. For final states the best fit is obtained with inverse low-energy electron diffraction band structure calculations. For initial-state bands of Cu and Al, thin-film data display excellent agreement with bulk quasiparticle theory, suggesting the use of thin films as model systems to investigate fine effects in the crystal band structure.This work has been supported in part by the Universidad del País Vasco (A.Mu. and J.E.O. under Contract No. 00057.240-EA-13668/2001, and A.Ma., A.R., and F.J.G.A. under Contract No. 00206.215-13639/2001), the European Community (EC) research training network NANOPHASE [A.Ma. and A.R. (Grant No. HPRN-CT-2000-00167)], and the Spanish Ministerio de Ciencia y Tecnología [A.Ma., A.R., and F.J.G.A. (Grant No. MAT2001-0946), and J.L. and E.G.M. (BFM2001-0244)].Peer Reviewe

Building an Assessment Use Argument for sign language: the BSL Nonsense Sign Repetition Test

In this article, we adapt a concept designed to structure language testing more effectively, the Assessment Use Argument (AUA), as a framework for the development and/or use of sign language assessments for deaf children who are taught in a sign bilingual education setting. By drawing on data from a recent investigation of deaf children's nonsense sign repetition skills in British Sign Language, we demonstrate the steps of implementing the AUA in practical test design, development and use. This approach provides us with a framework which clearly states the competing values and which stakeholders hold these values. As such, it offers a useful foundation for test-designers, as well as for practitioners in sign bilingual education, for the interpretation of test scores and the consequences of their use

The genera Melanothamnus Bornet & Falkenberg and Vertebrata S.F. Gray constitute well-defined clades of the red algal tribe Polysiphonieae (Rhodomelaceae, Ceramiales).

Polysiphonia is the largest genus of red algae, and several schemes subdividing it into smaller taxa have been proposed since its original description. Most of these proposals were not generally accepted, and currently the tribe Polysiphonieae consists of the large genus Polysiphonia (190 species), the segregate genus Neosiphonia (43 species), and 13 smaller genera (< 10 species each). In this paper, phylogenetic relationships of the tribe Polysiphonieae are analysed, with particular emphasis on the genera Carradoriella, Fernandosiphonia, Melanothamnus, Neosiphonia, Polysiphonia sensu stricto, Streblocladia and Vertebrata. We evaluated the consistency of 14 selected morphological characters in the identified clades. Based on molecular phylogenetic (rbcL and 18S genes) and morphological evidence, two speciose genera are recognized: Vertebrata (including the type species of the genera Ctenosiphonia, Enelittosiphonia, Boergeseniella and Brongniartella) and Melanothamnus (including the type species of the genera Fernandosiphonia and Neosiphonia). Both genera are distinguished from other members of the Polysiphonieae by synapomorphic characters, the emergence of which could have provided evolutionarily selective advantages for these two lineages. In Vertebrata trichoblast cells are multinucleate, possibly associated with the development of extraordinarily long, photoprotective, trichoblasts. Melanothamnus has 3-celled carpogonial branches and plastids lying exclusively on radial walls of the pericentral cells, which similarly may improve resistance to damage caused by excessive light. Other relevant characters that are constant in each genus are also shared with other clades. The evolutionary origin of the genera Melanothamnus and Vertebrata is estimated as 75.7-95.78 and 90.7-138.66 Ma, respectively. Despite arising in the Cretaceous, before the closure of the Tethys Seaway, Melanothamnus is a predominantly Indo-Pacific genus and its near-absence from the northeastern Atlantic is enigmatic. The nomenclatural implications of this work are that 46 species are here transferred to Melanothamnus, six species are transferred to Vertebrata and 13 names are resurrected for Vertebrata