Koneellisen annosjakelupalvelun aloittaminen - lääkehoidon tarkistus ja sen vaikutus potilaan lääkehoitoon

Farmaseuttisilla palveluilla tarkoitetaan apteekkien palveluita, joissa hyödynnetään apteekin farmaseuttisen henkilökunnan tietoja ja taitoja. Farmaseuttiset palvelut voidaan jakaa farmaseuttisiin perus- ja erityispalveluihin. Farmaseuttiset peruspalvelut kattavat apteekkien lakisääteiset tehtävät, kun taas farmaseuttisilla erityispalveluilla pyritään ottamaan aktiivisempi rooli asiakkaan terveyden edistämisessä. Koneellinen annosjakelupalvelu on farmaseuttinen erityispalvelu. Koneellisessa annosjakelupalvelussa lääkkeet jaetaan kerta-annospusseihin annostusajankohdan mukaan. Kun uusi asiakas aloittaa koneellinen annosjakelupalvelun, tarkistetaan asiakkaan lääkitys yhteensopimattomien ja turhien lääkkeiden osalta. Palvelun aloitushetkellä huomioidaan myös lääkevalmisteiden sopivuus koneelliseen annosjakeluun sekä tarkistetaan valmisteiden annosteluajankohdat. Koneellisessa annosjakelupalvelussa asiakkaan lääkehoidosta muodostetaan lääkityskortti, josta kokonaislääkehoito on helppo tarkistaa. Erikoistyön tavoitteena oli selvittää millainen lääkehoidon arviointi tai tarkistus koneellisen annosjakelupalvelun aloittamisen yhteydessä tehdään ja miten palvelun aloittavien asiakkaiden kokonaislääkehoitotieto saadaan selvitettyä. Lisäksi selvitettiin millaisia muutoksia lääkehoitoihin tehdään palvelun aloittamisen yhteydessä, mitkä ovat muutosten syyt sekä millainen on asiakkaan kokonaislääkehoito. Kyselylomake lähetettiin kaikkiin apteekkeihin, jotka tilasivat koneellista annosjakelua sopimusvalmistuksena Espoonlahden apteekilta syyskuussa 2010. Tutkimus suoritettiin semistrukturoidulla kirjallisella kyselyllä, joka sisälsi sekä avoimia kysymyksiä että monivalintakysymyksiä. Kyselyyn saatiin 147 vastausta ja vastausprosentiksi muodostui 45. Vastauksia kyselyyn saatiin koko Mannersuomen alueelta ja kaikkien kokoluokkien apteekeilta. Koneellisen annosjakelupalvelun aloittavat henkilöt ovat pääasiassa iäkkäitä, jotka ovat kotihoidon piirissä, asuvat hoitokodissa tai palveluasumisen yksikössä. Asiakkaiden lääkitystietojen keräämisessä hyödynnetään lääkityskorttia, mutta lääkityskortin tietoja päivitetään myös muista lähteistä. Asiakkaiden lääkityksille tehdään useimmiten lääkehoidon tarkistus moniammatillisena yhteistyönä. Lääkehoidolle tehdyt muutokset johtuvat pääasiassa lääkevaihdosta, annosjakelukoneen lääkevalikoimasta tai puolittamisen välttämisestä. Lääkehoidoissa on vain vähän yhteisvaikutuksia, jotka johtavat lääkevalmisteen käytön lopettamiseen. Lääkehoidon tarkistuksella ei ollut suurta vaikutusta asiakkaiden käyttämien lääkevalmisteiden määrään. Palvelun aloittamisen jälkeen asiakkaalla on käytössään keskimäärin 11 lääkevalmistetta, joista seitsemää jaellaan koneellisesti. Lääkeaineryhmistä eniten käytettyjä ovat hermostoon vaikuttavat sekä sydän- ja verisuonisairauksien lääkkeet, joita kumpaakin on käytössä keskimäärin kolme jokaisella uudella koneellisen annosjakelupalvelun asiakkaalla sekä palvelun aloittamista ennen että sen jälkeen.

Two-stage photoquenching in semi-insulating GaAs:EL2

The photoquenching of EL2 in semi‐insulating gallium arsenide is seen to be a complex process, where at low temperatures the initial slow quenching is followed by a switch to fast quenching. A possible explanation involving lattice strain mediated cooperative structural relaxation arising out of transition to the metastable state is proposed.

A Hybrid Multilevel Inverter Topology for an Open-End Winding Induction-Motor Drive Using Two-Level Inverters in Series With a Capacitor-Fed H-Bridge Cell

In this paper, a new five-level inverter topology for open-end winding induction-motor (IM) drive is proposed. The open-end winding IM is fed from one end with a two-level inverter in series with a capacitor-fed H-bridge cell, while the other end is connected to a conventional two-level inverter. The combined inverter system produces voltage space-vector locations identical to that of a conventional five-level inverter. A total of 2744 space-vector combinations are distributed over 61 space-vector locations in the proposed scheme. With such a high number of switching state redundancies, it is possible to balance the H-bridge capacitor voltages under all operating conditions including overmodulation region. In addition to that, the proposed topology eliminates 18 clamping diodes having different voltage ratings compared with the neutral point clamped inverter. On the other hand, it requires only one capacitor bank per phase, whereas the flying-capacitor scheme for a five-level topology requires more than one capacitor bank per phase. The proposed inverter topology can be operated as a three-level inverter for full modulation range, in case of any switch failure in the capacitor-fed H-bridge cell. This will increase the reliability of the system. The proposed scheme is experimentally verified on a four-pole 5-hp IM drive.

Open-circuit potential—time transients of alkaline porous iron electrodes at various states-of-charge

Open-circuit potential—time transients during the discharge of alkaline porous iron electrodes at various states-of-charge have been studied. From this, it has been possible to arrive at a correlation between the parameters of self-discharge kinetics of the electrode and observed open-circuit potential—recovery time constants. The study provides a method of estimate the state-of-charge of the rechargeable iron electrodes. As a hydrogen evolution reaction inevitably occurs on alkaline iron electrodes, the kinetics of the reaction have also been investigated.

Semi-Supervised Classification Using Sparse Gaussian Process Regression

Gaussian Processes (GPs) are promising Bayesian methods for classification and regression problems. They have also been used for semi-supervised learning tasks. In this paper, we propose a new algorithm for solving semi-supervised binary classification problem using sparse GP regression (GPR) models. It is closely related to semi-supervised learning based on support vector regression (SVR) and maximum margin clustering. The proposed algorithm is simple and easy to implement. It gives a sparse solution directly unlike the SVR based algorithm. Also, the hyperparameters are estimated easily without resorting to expensive cross-validation technique. Use of sparse GPR model helps in making the proposed algorithm scalable. Preliminary results on synthetic and real-world data sets demonstrate the efficacy of the new algorithm.

Structure and superconducting properties of Tl1?yPbyY1?xCaxSr2Cu2O7star, open: Dependence of Tc on hole concentration

Structure and superconducting properties of Tl1?yPbyY1?xCaxSr2Cu2O7 (y=0.0, 0.1, 0.25 and 0.5) , derived from the parent insulator TlYSr2Cu2O7, have been investigated for different values of x. XANES studies show Pb to be in the 4+ state while Tl is in the 3+ state, suggesting thereby that in this series, (x?y) approximately corresponds to the hole concentration. The in-plane Cu---O distance decreases with increase in x for all values of y. The apical Cu---O distance as well as the Tl(Pb)---O(2) distance show anomalies at x=0.5 in the series with y=0.25; at this composition, Tc also reaches a maximum. In general, the composition (value of x) at which the Tc of Tl1?yPbyY1?xCaxSr2Cu2O7 reaches a maximum depends on the Pb content and the maximum Tc itself increases with increase in y, reaching a value of 105 K at y=0.5. More interestingly, a maximum Tc occurs at an (x?y) value of not, vert, similar0.25, which is close to the hole concentration at maximum Tc in other cuprate superconductors containing two CuO2 layers.

The status and use of tree biomass in a semi-arid village ecosystem

The status of the tree biomass resource was investigated in Ungra, a semi-arid village ecosystem in South India. There were 57 tree species with 12 trees capita−1 and 35 trees ha−1. Multiple benefit yielding local tree species dominated the village ecosystem, while fuel only or single end use trees accounted for a small proportion of trees. The standing tree biomass is adequate to meet the requirement of biomass fuels for cooking only for about two years. Village tree biomass is presently being depleted largely for export to urban areas. Tree regeneration is now characterized by transformation from multiple-use local tree species to a few single-use species. A large potential exists for tree biomass production along field boundaries (bunds), stream banks and roadsides. Biomass estimation equations were developed for 10 species.

Constructing a Community : Myths and Realities of the Open Development Model

The open development model of software production has been characterized as the future model of knowledge production and distributed work. Open development model refers to publicly available source code ensured by an open source license, and the extensive and varied distributed participation of volunteers enabled by the Internet. Contemporary spokesmen of open source communities and academics view open source development as a new form of volunteer work activity characterized by hacker ethic and bazaar governance . The development of the Linux operating system is perhaps the best know example of such an open source project. It started as an effort by a user-developer and grew quickly into a large project with hundreds of user-developer as contributors. However, in hybrids , in which firms participate in open source projects oriented towards end-users, it seems that most users do not write code. The OpenOffice.org project, initiated by Sun Microsystems, in this study represents such a project. In addition, the Finnish public sector ICT decision-making concerning open source use is studied. The purpose is to explore the assumptions, theories and myths related to the open development model by analysing the discursive construction of the OpenOffice.org community: its developers, users and management. The qualitative study aims at shedding light on the dynamics and challenges of community construction and maintenance, and related power relations in hybrid open source, by asking two main research questions: How is the structure and membership constellation of the community, specifically the relation between developers and users linguistically constructed in hybrid open development? What characterizes Internet-mediated virtual communities and how can they be defined? How do they differ from hierarchical forms of knowledge production on one hand and from traditional volunteer communities on the other? The study utilizes sociological, psychological and anthropological concepts of community for understanding the connection between the real and the imaginary in so-called virtual open source communities. Intermediary methodological and analytical concepts are borrowed from discourse and rhetorical theories. A discursive-rhetorical approach is offered as a methodological toolkit for studying texts and writing in Internet communities. The empirical chapters approach the problem of community and its membership from four complementary points of views. The data comprises mailing list discussion, personal interviews, web page writings, email exchanges, field notes and other historical documents. The four viewpoints are: 1) the community as conceived by volunteers 2) the individual contributor s attachment to the project 3) public sector organizations as users of open source 4) the community as articulated by the community manager. I arrive at four conclusions concerning my empirical studies (1-4) and two general conclusions (5-6). 1) Sun Microsystems and OpenOffice.org Groupware volunteers failed in developing necessary and sufficient open code and open dialogue to ensure collaboration thus splitting the Groupware community into volunteers we and the firm them . 2) Instead of separating intrinsic and extrinsic motivations, I find that volunteers unique patterns of motivations are tied to changing objects and personal histories prior and during participation in the OpenOffice.org Lingucomponent project. Rather than seeing volunteers as a unified community, they can be better understood as independent entrepreneurs in search of a collaborative community . The boundaries between work and hobby are blurred and shifting, thus questioning the usefulness of the concept of volunteer . 3) The public sector ICT discourse portrays a dilemma and tension between the freedom to choose, use and develop one s desktop in the spirit of open source on one hand and the striving for better desktop control and maintenance by IT staff and user advocates, on the other. The link between the global OpenOffice.org community and the local end-user practices are weak and mediated by the problematic IT staff-(end)user relationship. 4) Authoring community can be seen as a new hybrid open source community-type of managerial practice. The ambiguous concept of community is a powerful strategic tool for orienting towards multiple real and imaginary audiences as evidenced in the global membership rhetoric. 5) The changing and contradictory discourses of this study show a change in the conceptual system and developer-user relationship of the open development model. This change is characterized as a movement from hacker ethic and bazaar governance to more professionally and strategically regulated community. 6) Community is simultaneously real and imagined, and can be characterized as a runaway community . Discursive-action can be seen as a specific type of online open source engagement. Hierarchies and structures are created through discursive acts. Key words: Open Source Software, open development model, community, motivation, discourse, rhetoric, developer, user, end-user

Open Content Licenses

The EU Directive harmonising copyright, Directive 2001/29/EC, has been implemented in all META-NORD countries. The licensing schemas of open content/open source and META-SHARE as well as CLARIN are discussed shortly. The status of the licensing of tools and resources available at the consortium partners are outlined. The aim of the article is to compare a set of open content and open source license and provide some guidance on the optimal use of licenses provided by META-NET and CLARIN for licensing the tools and resources for the benefit of the language technology community.

Bile acid based semi-rigid molecular tweezers

The easily constructed bile acid-based semi-rigid molecular tweezer 2 binds guest 8 in chloroform with an association constant of 83 dm(3) mol(-1).

Five-level inverter scheme for an open-end winding induction machine with less number of switches

Higher level of inversion is achieved with a less number of switches in the proposed scheme. The scheme proposes a five-level inverter for an open-end winding induction motor which uses only two DC-link rectifiers of voltage rating of Vdc/4, a neutral-point clamped (NPC) three-level inverter and a two-level inverter. Even though the two-level inverter is connected to the high-voltage side, it is always in square-wave operation. Since the two-level inverter is not switching in a pulse width modulated fashion and the magnitude of switching transient is only half compared to the convention three-level NPC inverter, the switching losses and electromagnetic interference is not so high. The scheme is experimentally verified on a 2.5 kW induction machine.

Robust Semi-Blind Estimation for Beamforming Based MIMO Wireless Communication

In this paper, we present robust semi-blind (SB) algorithms for the estimation of beamforming vectors for multiple-input multiple-output wireless communication. The transmitted symbol block is assumed to comprise of a known sequence of training (pilot) symbols followed by information bearing blind (unknown) data symbols. Analytical expressions are derived for the robust SB estimators of the MIMO receive and transmit beamforming vectors. These robust SB estimators employ a preliminary estimate obtained from the pilot symbol sequence and leverage the second-order statistical information from the blind data symbols. We employ the theory of Lagrangian duality to derive the robust estimate of the receive beamforming vector by maximizing an inner product, while constraining the channel estimate to lie in a confidence sphere centered at the initial pilot estimate. Two different schemes are then proposed for computing the robust estimate of the MIMO transmit beamforming vector. Simulation results presented in the end illustrate the superior performance of the robust SB estimators.

Characterization of aerosol black carbon over a tropical semi-arid region of Anantapur, India

Black carbon (BC) aerosol mass concentrations measured using an aethalometer at Anantapur, a semi-arid tropical station in the southern part of peninsular India, from August 2006 to July 2007 are analyzed. Seasonal and diurnal variations of BC in relation to changes in the regional meteorological conditions have been studied along with the mass fraction of BC to the total aerosol mass concentration (M-t) and fine particle mass (FPM) concentration in different months. The data collected during the study period shows that the annual average BC mass concentration at Anantapur is 1.97 +/- 0.12 mu g m(-3). Seasonal variations of BC aerosol mass concentration showed high during the dry (winter and summer) seasons and low during the post-monsoon followed by the monsoon seasons. Diurnal variations of BC aerosols attain a gradual build up in BC concentration from morning and a sharp peak occurs between 07:00 and 09:00 h almost an hour after local sunrise and a broad nocturnal peak from 19:00 to 21:00 h with a minimum in noon hours. The ratio of BC to the fine particle mass concentration was high during the dry season and low during the monsoon season. The regression analysis between BC mass concentration and wind speed indicates that, with increase in wind speeds the BC mass concentrations would decrease and vice-versa. Aerosol BC mass concentration shows a significant positive correlation with total mass concentration (M-t) and aerosol optical depth (ACID, tau(p)) at 500 nm. (C) 2010 Elsevier B.V. All rights reserved.