Clinical pharmacist in oncology palliative medicine: drug compliance and patient adherence.

OBJECTIVES: Most patients in palliative oncology care are polymorbid and thus treated with multiple drugs. The therapeutic effect and safety of these drugs can be compromised by drug/drug interactions, but also by wider problems such as polypharmacy and compliance. The clinical pharmacist is, therefore, responsible for risk analysis and prevention. Our prospective open label non-randomised clinical study evaluated the importance of a clinical pharmacist in the palliative care team. METHODS: A total of 250 outpatients were included in the clinical study: 126 women (50.4%) and 124 men (49.6%), with a mean age of 71 years (range 21-94 years; SD 11.9). The patients had the performance status scale 0-3 [Formula: see text]. Clinical examinations were performed on a monthly basis (n=509 check-up visits). The clinical pharmacist prepared an educational chart for all medications used after each visit and evaluated any drug-related problems. Follow-up was 6 months. RESULTS: This study found a significant association between drug related-problems and polypharmacy (p<0.001). A low risk of drug-rfelated problems was observed during the initial visit, that is, 68 female (27.2%) and 25 male (10.4%) patients. A greater clinical-pharmaceutical risk was observed among the patients taking antihypertensive drugs (p=0.003) and/or beta blockers (p=0.048). CONCLUSION: This study confirms the essential role of a clinical pharmacist in oncology palliative care. The feedback obtained from the patients showed a notable improvement in their quality of life. Further, this clinical study confirmed the need for a personalised approach in palliative oncology care.

Acoustic Emission Signal Entropy as a Means to Estimate Loads in Fiber Reinforced Polymer Rods.

Fibre reinforced polymer (FRP) rods are widely used as corrosion-resistant reinforcing in civil structures. However, developing a method to determine the loads on in-service FRP rods remains a challenge. In this study, the entropy of acoustic emission (AE) emanating from FRP rods is used to estimate the applied loads. As loads increased, the fraction of AE hits with higher entropy also increased. High entropy AE hits are defined using the one-sided Chebyshev's inequality with parameter k = 2 where the histogram of AE entropy up to 10-15% of ultimate load was used as a baseline. According to the one-sided Chebyshev's inequality, when more than 20% (k = 2) of AE hits that fall further than two standard deviations away from the mean are classified as high entropy events, a new distribution of high entropy AE hits is assumed to exist. We have found that the fraction of high AE hits. In glass FRP and carbon FRP rods, a high entropy AE hit fraction of 20% was exceeded at approximately 40% and 50% of the ultimate load, respectively. This work demonstrates that monitoring high entropy AE hits may provide a useful means to estimate the loads on FRP rods.

Semi-Automated Air-Coupled Impact-Echo Method for Large-Scale Parkade Structure.

Structural Health Monitoring (SHM) has moved to data-dense systems, utilizing numerous sensor types to monitor infrastructure, such as bridges and dams, more regularly. One of the issues faced in this endeavour is the scale of the inspected structures and the time it takes to carry out testing. Installing automated systems that can provide measurements in a timely manner is one way of overcoming these obstacles. This study proposes an Artificial Neural Network (ANN) application that determines intact and damaged locations from a small training sample of impact-echo data, using air-coupled microphones from a reinforced concrete beam in lab conditions and data collected from a field experiment in a parking garage. The impact-echo testing in the field is carried out in a semi-autonomous manner to expedite the front end of the in situ damage detection testing. The use of an ANN removes the need for a user-defined cutoff value for the classification of intact and damaged locations when a least-square distance approach is used. It is postulated that this may contribute significantly to testing time reduction when monitoring large-scale civil Reinforced Concrete (RC) structures.

[Outpatient clinic of palliative care in oncology]. / Ambulance paliativní onkologické péce.

Palliative treatment and related nursing care are currently a major problem in the organization of health care. Outpatient palliative cancer care (OPCC) helps to verify the clinical status of cancer patients and helps to choose the best treatment options and their completion. The OPCC has to be able to provide all treatment possibilities of cancer related symptoms such as cancer pain or symptoms related with cancer therapy. During tracking period in the OPCC, 446 patients were treated--288 women, mean age 61 years (age range 20-81 years) and 158 men, mean age 56 years (age range 18-96 years). According to the assessment of performance status (PS) there was following stratification: PS-0 (8%), PS-1 (54%), PS-2 (33%) and PS-3 (5%). The OPCC uses a uniform system of medical records, uniform system for assessing the quality and quantity of health care--and determination of "minimal health care". Here we present our results, which reflect the need of cooperation of all, who are involved in health care of cancer patient--collaboration between the general practitioner (GP), oncology departments, including hospice and home care agencies.