A conceptual framework of patient satisfaction with a pharmacy adherence service

Background Patients do not adhere to their medicines for a host of reasons which can include their underlying beliefs as well as the quality of their interactions with healthcare professionals. One way of measuring the outcome of pharmacy adherence services is to assess patient satisfaction but no questionnaire exists that truly captures patients' experiences with these relatively new services. Objective Our objective was to develop a conceptual framework specific to patient satisfaction with a community pharmacy adherence service based on criteria used by patients themselves. Setting The study was based in community pharmacies in one large geographical area of the UK (Surrey). All the work was conducted between October 2008 and September 2010. Methods This study involved qualitative non-participant observation and semi-structured interviewing. We observed the recruitment of patients to the Medicines Use Review (MUR) service and also actual MUR consultations (7). We also interviewed patients (15). Data collection continued until no new themes were identified during analysis. We analysed interviews to firstly create a comprehensive account of themes which had significance within the transcripts, then created sub-themes within super-ordinate categories. We used a structure-process-outcome approach to develop a conceptual framework relating to patient satisfaction with the MUR. Favourable ethical opinion for this study was received from the NHS Surrey Research Ethics Committee on 2nd June 2008. Results Five super-ordinate themes linked to patient satisfaction with the MUR service were identified, including relationships with healthcare providers; attitudes towards healthcare providers; patients' experience of health, healthcare and medicines; patients' views of the MUR service; the logistics of the MUR service. In the conceptual framework, structure was conceptualised as existing relationships, environment, and time; process was conceptualised as related to recruitment and consultation stages; and outcome as two concepts of immediate patient outcomes and satisfaction on reflection. Conclusion We identified and highlighted factors that can influence patient satisfaction with the MUR service and this led to the development of a conceptual framework of patient satisfaction with the MUR service. This can form the basis for developing a questionnaire for measuring patient satisfaction with this and similar pharmacy adherence services. Impact of findings on practice * Pharmacists and researchers can access the relevant ideas presented here in relation to patient satisfaction with pharmacy adherence services. * Researcher can use the conceptual framework as a basis for measuring the quality of pharmacy adherence services. * Community pharmacists can improve the quality of healthcare they provide by realizing concepts relevant to patient satisfaction with adherence services.

3D roll-forming of hat-profile with variable depth and width

The use of roll-formed products in automotive, furniture, buildings etc. increases every year due to the low part-production cost and the complicated cross-sections that can be produced. The limitation with roll-forming until recent years is that one could only produce profiles with a constant cross-section in the longitudinal direction. About eight years ago ORTIC AB [1] developed a machine in which it was possible to produce profiles with a variable width (“3D roll-forming”) for the building industry. Experimental equipment was recently built for research and prototyping of profiles with variable cross-section in both width and depth for the automotive industry. The objective with the current study is to investigate the new tooling concept that makes it possible to roll-form hat-profiles, made of ultra high strength steel, with variable cross-section in depth and width. The result shows that it is possible to produce 3D roll-formed profiles with close tolerances.

Compositional Model Repositories via Dynamic Constraint Satisfaction with Order-of-Magnitude Preferences

The predominant knowledge-based approach to automated model construction, compositional modelling, employs a set of models of particular functional components. Its inference mechanism takes a scenario describing the constituent interacting components of a system and translates it into a useful mathematical model. This paper presents a novel compositional modelling approach aimed at building model repositories. It furthers the field in two respects. Firstly, it expands the application domain of compositional modelling to systems that can not be easily described in terms of interacting functional components, such as ecological systems. Secondly, it enables the incorporation of user preferences into the model selection process. These features are achieved by casting the compositional modelling problem as an activity-based dynamic preference constraint satisfaction problem, where the dynamic constraints describe the restrictions imposed over the composition of partial models and the preferences correspond to those of the user of the automated modeller. In addition, the preference levels are represented through the use of symbolic values that differ in orders of magnitude.

Two-branes with variable tension model and the effective Newtonian constant

It is shown that, in the two brane time variation model framework, if the hidden brane tension varies according to the phenomenological Eotvos law, the visible brane tension behavior is such that its time derivative is negative in the past and positive after a specific time of cosmological evolution. This behavior is interpreted in terms of a useful mechanical system analog and its relation with the variation of the Newtonian (effective) gravitational constant is explored.

Patient satisfaction with maxillofacial prosthesis. Literature review

Obturators and facial prostheses are important not only in rehabilitation and aesthetics, but also in patient re-socialisation. The level of reintegration is directly related to the degree of satisfaction with rehabilitation. So, the maxillofacial prosthetics must provide patient satisfaction during treatment. This study aimed to search information in database and conduct a literature review on patient satisfaction with maxillofacial prosthesis. The problems experienced by these patients may decrease when specialists keep the patient on regular inspection. Rehabilitation through alloplasty or prosthetic restoration provides satisfactory conditions in aesthetics and well-being and reinstates individuals in familial and social environment. (C) 2008 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

LEAST ACTION PRINCIPLE and THE INCOMPRESSIBLE EULER EQUATIONS WITH VARIABLE DENSITY

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Notes on the two-brane model with variable tension

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Joint (X)over-bar and R charts with variable sample sizes and sampling intervals

Recent studies have shown that the (X) over bar chart with variable sampling intervals (VSI) and/or with variable sample sizes (VSS) detects process shifts faster than the traditional (X) over bar chart. This article extends these studies for processes that are monitored by both the (X) over bar and R charts. A Markov chain model is used to determine the properties of the joint (X) over bar and R charts with variable sample sizes and sampling intervals (VSSI). The VSSI scheme improves the joint (X) over bar and R control chart performance in terms of the speed with which shifts in the process mean and/or variance are detected.

AATS for the (X)over-bar chart with variable parameters

A Fortran computer program is given for the computation of the adjusted average time to signal, or AATS, for adaptive (X) over bar charts with one, two, or all three design parameters variable: the sample size, n, the sampling interval, h, and the factor k used in determining the width of the action limits. The program calculates the threshold limit to switch the adaptive design parameters and also provides the in-control average time to signal, or ATS.

(X)over-bar charts with variable parameters

Varying the parameters of the (X) over bar chart has been explored extensively in recent years. In this paper, we extend the study of the (X) over bar chart with variable parameters to include variable action limits. The action limits establish whether the control should be relaxed or not. When the (X) over bar falls near the target, the control is relaxed so that there will be more time before the next sample and/or the next sample will be smaller than usual. When the (X) over bar falls far from the target but not in the action region, the control is tightened so that there is less time before the next sample and/or the next sample will be larger than usual. The goal is to draw the action limits wider than usual when the control is relaxed and narrower than usual when the control is tightened. This new feature then makes the (X) over bar chart more powerful than the CUSUM scheme in detecting shifts in the process mean.

(X)OVER-BAR CHARTS WITH VARIABLE SAMPLE-SIZE

The usual practice in using a control chart to monitor a process is to take samples of size n from the process every h hours This article considers the properties of the XBAR chart when the size of each sample depends on what is observed in the preceding sample. The idea is that the sample should be large if the sample point of the preceding sample is close to but not actually outside the control limits and small if the sample point is close to the target. The properties of the variable sample size (VSS) XBAR chart are obtained using Markov chains. The VSS XBAR chart is substantially quicker than the traditional XBAR chart in detecting moderate shifts in the process.