RESUMEN

Little is known about which quality of life measure best captures the lived experience of people with a chronic skin condition. The purpose of this study was to explore patients' views on the Dermatology Life Quality Index (DLQI) and Skindex-29. Participants were adults (n = 28) with a diagnosis of eczema or psoriasis who completed the DLQI and the Skindex-29 before being interviewed about the content and format of these questionnaires. Interviews were analysed using content analysis. Participants were generally satisfied with length and layout of both questionnaires. However, the majority preferred the Skindex-29 for its ease of understanding, use of a longer recall period and incorporation of items on a variety of emotions. Participants reported both questionnaires failing to incorporate important aspects of their lives, for instance impact on professional relationships. Participants voiced limitations in both measures but overall felt Skindex-29 better captured their lived experience.

Asunto(s)

Eccema/psicología , Psoriasis/psicología , Calidad de Vida , Encuestas y Cuestionarios , Adolescente , Adulto , Anciano , Enfermedad Crónica , Comprensión , Emociones , Femenino , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Prioridad del Paciente , Percepción , Investigación Cualitativa , Adulto Joven

RESUMEN

BACKGROUND: Documented barriers to Medication Therapy Management (MTM) delivery, such as limited time and inefficient workflow may be overcome by utilizing support staff for administrative services. However, it is unknown how pharmacy technicians have been historically utilized to assist pharmacists in MTM-delivery. OBJECTIVE: To characterize literature describing pharmacy technicians' participation in actions commonly undertaken in the provision of MTM services. METHODS: In August 2016, a PubMed (MEDLINE) and Journal of Pharmacy Technology search was conducted using the term "pharmacy technician" with services outlined within the MTM Core Elements Version 2.0, and with terms related to administrative actions in the provision of MTM. References were searched using identified studies. Eligible articles described pharmacy technicians' performance and/or assistance in at least one MTM Core Element or related administrative action to the provision of MTM. Data was independently extracted by two researchers; any variation in extraction was reconciled via with discussion until consensus reached. A standardized data extraction template was used. RESULTS: Forty-four manuscripts were included. Manuscripts were most likely to describe pharmacy technicians' assistance with medication reconciliation (70%), documentation (41%) and medication therapy review (30%). Actions least likely to be described included personal medication record development (5%), physical assessment (5%), follow-up (2%), and medication action plan development (0%). Most articles were written in the United States (73%), or Europe (16%), while the remaining articles were Canadian (11%); no articles were found originating from Asia, Africa, Australia or the Middle East. CONCLUSION: Pharmacy technicians are utilized most often to support MTM through assistance in medication reconciliation. Standardized training for pharmacy technicians that delineates administrative support from pharmacists' role of clinical decision making could help pharmacists obtain greater efficiency in MTM delivery.

Asunto(s)

Administración del Tratamiento Farmacológico , Técnicos de Farmacia , Rol Profesional , Servicios Comunitarios de Farmacia/organización & administración , Humanos , Conciliación de Medicamentos

RESUMEN

The mechanical behaviour of thermal barrier coatings in operation holds the key to understanding durability of jet engine turbine blades. Here we report the results from experiments that monitor strains in the layers of a coating subjected to thermal gradients and mechanical loads representing extreme engine environments. Hollow cylindrical specimens, with electron beam physical vapour deposited coatings, were tested with internal cooling and external heating under various controlled conditions. High-energy synchrotron X-ray measurements captured the in situ strain response through the depth of each layer, revealing the link between these conditions and the evolution of local strains. Results of this study demonstrate that variations in these conditions create corresponding trends in depth-resolved strains with the largest effects displayed at or near the interface with the bond coat. With larger temperature drops across the coating, significant strain gradients are seen, which can contribute to failure modes occurring within the layer adjacent to the interface.

RESUMEN

Measurement techniques to obtain accurate in situ synchrotron strain measurements of thermal barrier coating systems (TBCs) applied to hollow cylindrical specimens are presented in this work. The Electron Beam Physical Vapor Deposition coated specimens with internal cooling were designed to achieve realistic temperature gradients over the TBC coated material such as that occurring in the turbine blades of aeroengines. Effects of the circular cross section on the x-ray diffraction (XRD) measurements in the various layers, including the thermally grown oxide, are investigated using high-energy synchrotron x-rays. Multiple approaches for beam penetration including collection, tangential, and normal to the layers, along with variations in collection parameters are compared for their ability to attain high-resolution XRD data from the internal layers. This study displays the ability to monitor in situ, the response of the internal layers within the TBC, while implementing a thermal gradient across the thickness of the coated sample. The thermal setup maintained coating surface temperatures in the range of operating conditions, while monitoring the substrate cooling, for a controlled thermal gradient. Through variation in measurement location and beam parameters, sufficient intensities are obtained from the internal layers which can be used for depth resolved strain measurements. Results are used to establish the various techniques for obtaining XRD measurements through multi-layered coating systems and their outcomes will pave the way towards goals in achieving realistic in situ testing of these coatings.