Pharmaceutical care of patients with congestive heart failure: Interventions and outcomes

We evaluated a structured pharmaceutical care program for elderly patients (> 65 yrs) with congestive heart failure (CHF) based on objective measures of disease control, quality of life, and use of health care facilities in a randomized, controlled, longitudinal, prospective clinical trial. The 42 patients in group A received education from a pharmacist on the disease and its treatment, and lifestyle changes that could help control symptoms. Patients also were encouraged to monitor their symptoms and comply with prescribed drug therapy. If necessary, dosage regimens were simplified in liaison with hospital physicians. The 41 control patients (group B) received standard care. The following outcome measures were assessed in all patients at baseline (before the start of the trial) and at 3, 6, 9, and 12 months: 2-minute walk test, blood pressure, body weight, pulse, forced vital capacity, quality of life [disease-specific (Minnesota Living with Heart Failure questionnaire) and generic (SF-36)], knowledge of symptoms and drugs, compliance with therapy, and use of health care facilities (hospital admissions, visits to emergency room, emergency calls). Patients in group A showed improved compliance with drug therapy, which in turn improved their exercise capacity compared with those in group B; education on management of symptoms, lifestyle changes, and dietary recommendations were also of benefit. Group A patients significantly improved knowledge of their drug therapy over the 12-month study and had fewer hospital admissions compared with group B patients. They also had improved outcomes compared with group B, despite the small samples. An extension of this trial to other sites with pooling of results would provide additional evidence of the value of this structured program in elderly patients with CHF.

Spanish Golden Age Poetry in Motion: The Dynamics of Creation and Conversation.

The fourteen essays of this volume engage in distinct ways with the matter of motion in early modern Spanish poetics, without limiting the dialectic of stasis and movement to any single sphere or manifestation. Interrogation of the interdependence of tradition and innovation, poetry, power and politics, shifting signifiers, the intersection of topography and deviant temporalities, the movement between the secular and the sacred, tensions between centres and peripheries, issues of manuscript circulation and reception, poetic calls and echoes across continents and centuries, and between creative writing and reading subjects, all demonstrate that Helgerson's central notion of conspicuous movement is relevant beyond early sixteenth-century secular poetics, By opening it up we approximate a better understanding of poetry's flexible spatio-temporal co-ordinates in a period of extraordinary historical circumstances and conterminous radical cultural transformation

Highly accurate and efficient evaluation of randomising set index functions

Randomising set index functions can reduce the number of conflict misses in data caches by spreading the cache blocks uniformly over all sets. Typically, the randomisation functions compute the exclusive ors of several address bits. Not all randomising set index functions perform equally well, which calls for the evaluation of many set index functions. This paper discusses and improves a technique that tackles this problem by predicting the miss rate incurred by a randomisation function, based on profiling information. A new way of looking at randomisation functions is used, namely the null space of the randomisation function. The members of the null space describe pairs of cache blocks that are mapped to the same set. This paper presents an analytical model of the error made by the technique and uses this to propose several optimisations to the technique. The technique is then applied to generate a conflict-free randomisation function for the SPEC benchmarks. (C) 2003 Elsevier Science B.V. All rights reserved.

Marine Spatial Planning: A New Frontier? (Editorial to a special issue on Marine Spatial Planning)

Marine spatial planning is taking on greater international significance as a response to increased perceived threats to the marine environment and the need for more systematic maritime governance. It also expands the horizons of spatial planning and leads to calls for interdisciplinary research to support its development. This special issue brings together papers focusing on the need for a more active engagement of natural and social science perspectives in the formation of spatial strategies concerned with the future well-being of the seas and oceans.

Sexing up the city in the international beauty contest: the performative nature of spatial planning and the fictive spectacle of place branding

This paper responds to recent calls for more academic research and critical discussion on the relationship between spatial planning and city branding. Through the lens of Liverpool, the article analyses how key planning projects have delivered major transformations in the city's built environment and cultural landscape. More specifically, in concentrating on the performative nature of spatial planning it reveals the physical, symbolic and discursive re-imaging of Liverpool into a 'world class city'. Another aspect of the paper presents important socioeconomic datasets and offers a critical reading of the re-branding in showing how it presents an inaccurate representation of Liverpool. The evidence provided indicates that a more accurate label for Liverpool is a polarised and divided city, thereby questioning the fictive spectacle of city branding. Finally, the paper ends with some critical commentary on the role of spatial planning as an accessory to the sophistry of city branding.

Change in the use of and attitude to peak flow measurement among general practitioners in Northern Ireland between 1989 and 1994

In 1994 we repeated a study first performed in 1989 to assess the change in general practitioners' use of and attitudes to peak flow measurement. Of 232 general practitioners surveyed, 199 (86%) and 192 (83%) responded in 1989 and 1994 respectively. The percentage who reported having patients using domiciliary peak flow monitoring rose form 58.3 (95% confidence limits 51.4 to 65.2)% to 97.9 (95.9 to 99.9)%. The percentage who reported 'usually' using peak flow measurements for the diagnosis and management of asthma rose from 81.9 (76.5 to 87.3)% to 93.2 (89.6 to 96.8)% and from 83.3 (78.1 to 88.5)% to 95.8 (92.9 to 98.7)% respectively. An unchanged proportion took peak flow meters on house calls. General practitioners have become more aware of the potential of peak flow measurements but are still unlikely to have a meter available to assess patients seen at home. They are therefore likely to be ill-equipped to manage acute exacerbations of asthma in this setting.

Justice as Improvisation:The Law of the Extempore

Justice as Improvisation: The Law of the Extempore theorises the relationship between justice and improvisation through the case of the New York City cabaret laws. Discourses around improvisation often imprison it in a quasi-ethical relationship with the authentic, singular ‘other’. The same can be said of justice. This book interrogates this relationship by highlighting the parallels between the aporetic conception of justice advanced by the late French philosopher Jacques Derrida and the nuanced approach to improvisation pursued by musicians and theorists alike in the new and emerging interdisciplinary field of Critical Studies in Improvisation (CSI). Justice as Improvisation re-imagines justice as a species of improvisation through the formal structure of the most basic of legal mechanisms, judicial decision-making, offering law and legal theory a richer, more concrete, understanding of justice. Not further mystery or mystique, but a negotiation between abstract notions of justice and the everyday practice of judging. Improvisation in judgment calls for ongoing, practical decision-making as the constant negotiation between the freedom of the judge to take account of the otherness or singularity of the case and the existing laws or rules that both allow for and constrain that freedom. Yes, it is necessary to judge, yes, it is necessary to decide, but to judge well, to decide justly, that is a music lesson perhaps best taught by critical improvisation scholars.

Reciprocal value propositions in practice: Constraints in digital markets

The value proposition concept, while forming a central foundational premise of service-dominant (S-D) logic, has nevertheless been treated somewhat ambiguously. Recent work in attempting to address this has focused through a S-D logic lens on the reciprocal nature of value propositions. Important to this work has been a focus on communicative interactions and resource integration between network suppliers and customers. Overall, value proposition thinking has not studied in detail their adoption and use in practice. Considering the compelling notion of reciprocity, there have been recent calls for research to consider reciprocal value propositions in practice. The overall aim of this paper, therefore, was to explore how reciprocal value propositions are developed (or not) in practice at the network level. The study was set in the mobile television (TV) sector, which, as an internet-driven sector, is viewed as particularly pertinent. To conduct the study an S-D logic and Industrial Marketing and Purchasing (IMP) Group framework are integrated for the first time. A key finding is that while the reciprocal value proposition concept is theoretically intuitive, it is by no means inevitable in practice. Reciprocal value propositions were found to be simultaneously constrained, and, potentially enabled by these constraints in practice. At an overall level this paper contributes to the ongoing collaborative process, which aims to move S-D logic from a framework to a theory. More specifically, we provide new insights into the development of reciprocal value propositions in practice.

The Birth of Shakespeare's Birthplace

"There is, indeed, little doubt,” the formidable scholar James Orchard Halliwell-Phillipps confidently explained to the Victorian readers of his Outlines of the Life of Shakespeare, “that the Birth-place did not become one of the incentives for pilgrimage until public attention had been specially directed to it at the time of the Jubilee.” That's broadly true. The earliest reference to the three-gabled, half-timbered house (two houses, originally) on Henley Street in Stratford-upon-Avon as the birthplace of William Shakespeare dates only from the late 1750s, when it was so named in Samuel Winter's town map. During the Stratford Jubilee, which David Garrick organized in 1769, the “small old house,” as the actor's first biographer called it, was fully recognized and promoted as the place where Shakespeare was born. Even so, Halliwell-Phillipps's observation conceals more than it reveals, because there is also little doubt that the dwelling that tradition calls Shakespeare's birthplace did not suddenly acquire that status during the first week of September 1769. The process by which the unremarkable piece of real estate that John Shakespeare purchased sometime in the late sixteenth century was transformed into what Barbara Hodgdon has rightly called the “controlling ideological center” of Shakespeare biography was long, slow, and far from inevitable. That process is the subject of this essay.

A Life Course Perspective on Urban–Rural Migration: the Importance of the Local Context

The relationship between migration and age has long been established, and most recently, there have been calls for the inclusion of a life course perspective to migration research. In this paper, we explore Northern Ireland’s internal migration patterns, and in particular, we test for the importance of urban to rural migration at different stages of the life course. Data from the Northern Ireland Longitudinal Study are used for the first time to analyse urban–rural migration patterns. The resulting modelling demonstrates unique aspects of urban to rural migration within Northern Ireland, which up until now have gone largely
unreported. Results from logistic regression modelling suggest that there is an age selectivity to urban– rural mobility but not necessarily at the life course stages predicted from a review of the life course migration literature. Individuals in younger age groups (at the household and family formation stages of the life course) are most likely to make an urban to rural move in Northern Ireland, with a decline in the likelihood of this move type with age. Possible explanations are offered linked to Northern Ireland’s settlement hierarchy, rural planning policy, and family farming traditions. The findings challenge researchers to pay due attention to how migration processes may play out differently in varying geographical, social, and planning contexts and emphasise the importance of structural factors to explain migration patterns.

Large Scale Verification of MPI Programs Using Lamport Clocks with Lazy Update

We propose a dynamic verification approach for large-scale message passing programs to locate correctness bugs caused by unforeseen nondeterministic interactions. This approach hinges on an efficient protocol to track the causality between nondeterministic message receive operations and potentially matching send operations. We show that causality tracking protocols that rely solely on logical clocks fail to capture all nuances of MPI program behavior, including the variety of ways in which nonblocking calls can complete. Our approach is hinged on formally defining the matches-before relation underlying the MPI standard, and devising lazy update logical clock based algorithms that can correctly discover all potential outcomes of nondeterministic receives in practice. can achieve the same coverage as a vector clock based algorithm while maintaining good scalability. LLCP allows us to analyze realistic MPI programs involving a thousand MPI processes, incurring only modest overheads in terms of communication bandwidth, latency, and memory consumption. © 2011 IEEE.

Uses of expertise:Sources, quotes, and voice in the reporting of genetics in the news

Science journalists call upon experts for background and for clarification and comment on scientific findings. This paper examines how science writers choose and use experts, and it focuses on several cases of reporting about genetics and behavior. Our research included two sources of data: interviews with 15 science reporters and three print media samples of coverage of genetics and behavior - alcoholism (between 1980-1995), homosexuality (in 1993 and 1995), and mental illness (between 1970-1995). Science reporters seek relevant and specific experts for nearly every story. Good sources are knowledgeable, are connected to prestigious institutions, are direct and articulate and don't overqualify statements, and they return phone calls. The mean number of experts quoted was 2.8 per story, differing for alcoholism (3.5), homosexuality (2.8), and mental illness (2.6). Researchers and scientists predominated among experts quoted. Quotes were used to provide context, give legitimization, as explication, to provide a kind of balance, and to outline implications. For the homosexuality sample, a significantly greater percentage of activists and advocates were quoted (21 percent compared with 5 percent and 1 percent in other samples, X <0.0001). "Lay" quotes for alcoholism and mental illness were minimal. Except for homosexuality, whose advocates are organized, those "affected" do not have a voice in genetics news stories.

From theory to practice:Improving the impact of health services research

Background: While significant strides have been made in health research, the incorporation of research evidence into healthcare decision-making has been marginal. The purpose of this paper is to provide an overview of how the utility of health services research can be improved through the use of theory. Integrating theory into health services research can improve research methodology and encourage stronger collaboration with decision-makers. Discussion: Recognizing the importance of theory calls for new expectations in the practice of health services research. These include: the formation of interdisciplinary research teams; broadening the training for those who will practice health services research; and supportive organizational conditions that promote collaboration between researchers and decision makers. Further, funding bodies can provide a significant role in guiding and supporting the use of theory in the practice of health services research. Summary: Institutions and researchers should incorporate the use of theory if health services research is to fulfill its potential for improving the delivery of health care. © 2005 Brazil et al; licensee BioMed Central Ltd.

Corporate Governance in Canadian and US Credit Unions

This report, a collaborative effort between the Filene Research Institute and the Credit Union Central of Canada, with participation from the Desjardins Group, follows on two recent governance projects: Tracking the Relationship Between Credit Union Governance and Performance and a three-part series by Professor Robert Hoel about how boards can add more value. Beyond these, the academic literature of corporate governance is well developed, so this study includes an in-depth review of financial institution governance research and calls out the differences between credit unions and other firms. Also, because surveys can only go so far in teasing out insights, the authors followed up with a dozen interviews with credit unions of all sizes across all three major North American credit union systems.

Because the report is survey-based, large swaths of the findings compare major and minor details of different (and often not-so-different) approaches to governance in the three systems and among differently sized credit unions. From those comparisons, some interesting differences emerge. For example, as a federated system, Desjardins excels at some aspects of board development and system governance in ways that the more atomized US and Canadian credit union systems do not.

Reducing the psychological distress of family caregivers of home based palliative care patients: Longer term effects from a randomised controlled trial.

Background: Palliative care incorporates comprehensive support of family caregivers because many of them experience burden and distress. However, evidence-based support initiatives are few.

Purpose: We evaluated a one-to-one psychoeducational intervention aimed at mitigating the distress of caregivers of patients with advanced cancer receiving home-based palliative care. We hypothesised that caregivers would report decreased distress as assessed by the General Health Questionnaire (GHQ).

Method: A randomised controlled trial comparing two versions of the delivery of the intervention (one face-to-face home visit plus telephone calls versus two visits) plus standard care to a control group (standard care only) across four sites in Australia.

Results: Recruitment to the one visit condition was 57, the two visit condition 93, and the control 148. We previously reported non-significant changes in distress between times 1 (baseline) and 2 (1-week post-intervention) but significant gains in competence and preparedness. We report here changes in distress between times 1 and 3 (8-week post-death). There was significantly less worsening in distress between times 1 and 3 in the one visit intervention group than in the control group; however, no significant difference was found between the two visit intervention and the control group.

Conclusions: These results are consistent with the aim of the intervention, and they support existing evidence demonstrating that relatively short psychoeducational interventions can help family caregivers who are supporting a dying relative. The sustained benefit during the bereavement period may also have positive resource implications, which should be the subject of future inquiry. © 2014 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.