Using a problem detection study (PDS) to identify and compare health care provider and consumer views of antihypertensive therapy

The objectives of this study were to ascertain consumer knowledge and behaviour about hypertension and treatment and to compare these with health care providers' perceptions (of 'most' consumers). The design for the study was a problem detection study (PDS): focus groups and then survey. Focus groups and survey participants were convenience samples of consumers, doctors, nurses and pharmacists. The main outcome measures were agreement on a 5-point Likert scale with statements about consumers' knowledge and behaviour about high blood pressure and medication. The survey identified areas of consensus and disagreement between consumers and health providers. While general knowledge and concordance with antihypertensive therapy among consumers was good, consequences such as eye and kidney disease, interactions with herbal medicines, and how to deal with missing a dose were less well known. Side effects were a problem for over one-quarter of participants, and cost was a problem in continuing therapy. Half the consumers had not received sufficient written information. Providers overall disagreed that most consumers have an adequate understanding of the condition. They agreed that most consumers adhere to therapy and can manage medicines; and about their own profession's role in information provision and condition management. Consumers confirmed positive provider behaviour, suggesting opportunities for greater communication between providers about actions taken with their consumers. In conclusion, the PDS methodology was useful in identifying consumer opinions. Differences between consumer and provider responses were marked, with consumers generally rating their knowledge and behaviour above providers' ratings of 'most' consumers. There are clear gaps to be targeted to improve the outcomes of hypertension therapy.

Attachment insecurity, depression, and the transition to parenthood

In a longitudinal study of adult attachment and depression during the transition to parenthood, 76 couples completed questionnaires on three occasions: during the second trimester of pregnancy, and six weeks and six months postbirth. On the first and second occasions, the couples were also interviewed about their experiences of pregnancy and parenthood, respectively. Measures were also completed at similar time intervals by a comparison group of 74 childless couples. Attachment security was assessed in terms of the dimensions of discomfort with closeness and relationship anxiety. Relationship anxiety was less stable for transition wives than for other participants. Relationship anxiety also predicted increases in new mothers' depressive symptoms, after controlling for a broad range of other risk factors. However, the association between relationship anxiety and maternal depression was moderated by husbands' caregiving style. Maternal depression was linked to increases in husbands' and wives' attachment insecurity and marital dissatisfaction. Results are discussed in terms of the impact of depression and negative working models of attachment on couple interaction.

Reclaiming Community? From Welfare Society to Welfare State in Australian Catholic Social Thought

Influenced by both conservative and left wing communitarian thinking, current debate about welfare governance in Australia reflects an inflated evaluation of the potential role of the third sector or civil society organisations in the production fo welfare. This paper gives an overview of twentieth century Australian Catholics social thinking about state, market and civil society relations in the production of welfare. It highlights the neglected, historical role of the Catholic Church in promoting a 'welfare society' over a 'welfare state' in Australia. It points to the reasons for the Church's later embrace of the welfare state and suggests that these reasons should make us deeply sceptical of the current communitarian fad.

A switched-beam antenna of monopoles housed in a radial guide with transition to free space

The design of a switched-beam antenna formed by a circular array of monopoles housed inside a radial guide with a transition to free space is presented. Two alternative types of transitions to free space, one using a truncated conducting cone and the other created by a tapered dielectric material at the edge of the radial guide, are described. The use of the radial guide with transition increases the return-loss bandwidth of the array and enables shaping its beam in elevation. (C) 2004 Wiley Periodicals, Inc.

Entanglement under restricted operations: Analogy to mixed-state entanglement

We show that the classification of bipartite pure entangled states when local quantum operations are restricted yields a structure that is analogous in many respects to that of mixed-state entanglement. Specifically, we develop this analogy by restricting operations through local superselection rules, and show that such exotic phenomena as bound entanglement and activation arise using pure states in this setting. This analogy aids in resolving several conceptual puzzles in the study of entanglement under restricted operations. In particular, we demonstrate that several types of quantum optical states that possess confusing entanglement properties are analogous to bound entangled states. Also, the classification of pure-state entanglement under restricted operations can be much simpler than for mixed-state entanglement. For instance, in the case of local Abelian superselection rules all questions concerning distillability can be resolved.