202 research outputs found

    The estimation of preweaning energy intake from litter mass in rats

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    Optimising medication management for polymedicated home-dwelling older adults with multiple chronic conditions: a mixed-methods study protocol.

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    Optimal medication management is one of the basic conditions necessary for home-dwelling older adults living with multiple chronic conditions (OAMCC) to be able to remain at home and preserve their quality of life. Currently, the reasons for such high numbers of emergency department visits and the very significant rate of hospitalisations for OAMCC, due to medication-related problems (MRPs), is poorly explored. This study aims to reveal the current state of the medication management practices of polymedicated, home-dwelling OAMCC and to make proposals for improving clinical and medication pathways through an innovative and integrated model for supporting medication management and preventing adverse health outcomes. A mixed-methods study will address the medication management of polymedicated, home-dwelling OAMCC. Its explanatory sequential design will involve two major phases conducted sequentially over time. The quantitative phase will consist of retrospectively exploiting the last 5 years of electronic patient records from a local hospital (N ≈ 50 000) in order to identify the different profiles-made up of patient-related, medication-related and environment-related factors-of the polymedicated, home-dwelling OAMCC at risk of hospitalisation, emergency department visits, hospital readmission (notably for MRPs), institutionalisation or early death. The qualitative study will involve: (a) obtaining and understanding the medication management practices and experiences of the identified profiles extracted from the hospital data of OAMCC who will be interviewed at home (N ≈ 30); (b) collecting and analysing the perspectives of the formal and informal caregivers involved in medication management at home in order to cross-reference perspectives about this important dimension of care at home. Finally, the mixed-methods findings will enable the development of an innovative, integrated model of medication management based on the Agency for Clinical Innovation framework and Bodenheimer and Sinsky's quadruple aim. Ethical approval has been obtained from the Human Research Ethics Committee of the Canton Vaud (2018-02196). Findings will be disseminated in peer-reviewed journals, professional conferences and other knowledge transfer activities with primary healthcare providers, hospital care units, informal caregivers' and patients' associations

    Shear-banding in a lyotropic lamellar phase, Part 1: Time-averaged velocity profiles

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    Using velocity profile measurements based on dynamic light scattering and coupled to structural and rheological measurements in a Couette cell, we present evidences for a shear-banding scenario in the shear flow of the onion texture of a lyotropic lamellar phase. Time-averaged measurements clearly show the presence of structural shear-banding in the vicinity of a shear-induced transition, associated to the nucleation and growth of a highly sheared band in the flow. Our experiments also reveal the presence of slip at the walls of the Couette cell. Using a simple mechanical approach, we demonstrate that our data confirms the classical assumption of the shear-banding picture, in which the interface between bands lies at a given stress σ\sigma^\star. We also outline the presence of large temporal fluctuations of the flow field, which are the subject of the second part of this paper [Salmon {\it et al.}, submitted to Phys. Rev. E]

    Medication Management Models for Polymedicated Home-Dwelling Older Adults With Multiple Chronic Conditions: Protocol of a Systematic Review.

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    Older adults with multiple chronic diseases commonly require complex medication regimes. When combined with frailty, cognitive impairment, and changing pharmacological prescriptions, older adults' polymedication regimes increase the risk of medication-related problems (MRPs) and hospitalization. Effective, well-organized medication management could avoid MRPs and their clinical outcomes. Identify medication management models and analyze their impact on managing and preventing MRPs for polymedicated, home-dwelling older adults. We will conduct a systematic review of published articles in relevant professional scientific journals from inception until March 31, 2019, in the following electronic databases,: Embase; Medline OvidSP; PubMed (NOT Medline[sb]); Cumulative Index to Nursing and Allied Health Literature (CINAHL) EBSCO; PsycINFO OvidSP; Cochrane Library, Wiley; and Web of Science. We will also hand search the bibliographies of all the relevant articles found and search for unpublished studies. We will consider publications in English, French, German, Spanish, Italian, and Portuguese. Retrieved articles will be screened for eligibility. Statistical analyses will be conducted following the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and Meta-analysis Of Observational Studies in Epidemiology (MOOSE) statements. Data will be analyzed using SPSS Statistics for Windows, version 25.0 (IBM Corp), and Review Manager, version 5.5 (The Nordic Cochrane Centre, The Cochrane Collaboration). A preliminary search in Embase delivered 3272 references. This preliminary search allows us to complete our research strategy with equation development and to search the other databases. Relevant articles identified will allow for searching the reference lists for unpublished studies. The inclusion and exclusion criteria will be rigorously respected in the study selection. The entire study is expected to be completed by January 2020. This review will provide an exhaustive view of medication management models that could be effective for polymedicated, home-dwelling older adults and will allow us to analyze their impact on managing and preventing MRPs. PROSPERO CRD42018117287; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=117287 (Archived by WebCite at http://www.webcitation.org/77fCfbCjT). DERR1-10.2196/13582

    Shear-banding in a lyotropic lamellar phase, Part 2: Temporal fluctuations

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    We analyze the temporal fluctuations of the flow field associated to a shear-induced transition in a lyotropic lamellar phase: the layering transition of the onion texture. In the first part of this work [Salmon et al., submitted to Phys. Rev. E], we have evidenced banded flows at the onset of this shear-induced transition which are well accounted for by the classical picture of shear-banding. In the present paper, we focus on the temporal fluctuations of the flow field recorded in the coexistence domain. These striking dynamics are very slow (100--1000s) and cannot be due to external mechanical noise. Using velocimetry coupled to structural measurements, we show that these fluctuations are due to a motion of the interface separating the two differently sheared bands. Such a motion seems to be governed by the fluctuations of σ\sigma^\star, the local stress at the interface between the two bands. Our results thus provide more evidence for the relevance of the classical mechanical approach of shear-banding even if the mechanism leading to the fluctuations of σ\sigma^\star remains unclear

    Phase Separation of Rigid-Rod Suspensions in Shear Flow

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    We analyze the behavior of a suspension of rigid rod-like particles in shear flow using a modified version of the Doi model, and construct diagrams for phase coexistence under conditions of constant imposed stress and constant imposed strain rate, among paranematic, flow-aligning nematic, and log-rolling nematic states. We calculate the effective constitutive relations that would be measured through the regime of phase separation into shear bands. We calculate phase coexistence by examining the stability of interfacial steady states and find a wide range of possible ``phase'' behaviors.Comment: 23 pages 19 figures, revised version to be published in Physical Review
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