Validation and Feasibility of the Medication Acceptability Questionnaire to Investigate Tablet and Liquid Alendronic Acid with Older Hospital Patients

The effects of formulation characteristics on acceptability are poorly understood. This study evaluated the validity and feasibility of using the Medication Acceptability Questionnaire (MAQ) to investigate factors influencing acceptability of tablet compared with liquid alendronic acid. Written consent was obtained from eligible patients on Older People’s Medicine wards. MAQ face and content validity were evaluated through cognitive interviews while internal consistency and criterion validity were investigated by calculating Cronbach’s alpha and correlation of MAQ items with visual analogue scale (VAS) responses. MAQ data were obtained from 33 and 25 participants for tablet and liquid formulations respectively. Cognitive interviews indicated MAQ face and content validity. The domains of appearance, efficacy, and tolerability demonstrated adequate internal consistency and suitable refinements were identified for the domains of convenience and taste with Cronbach’s alpha <0.7. Significant positive correlations were identified between all MAQ domains and VAS. The liquid trended towards performing better for taste, appearance and tolerability and the tablet for convenience and efficacy. It is feasible to capture patient acceptability of a medication by questionnaire. Interpatient variation in acceptability for two formulations indicates that medication characteristics should be considered during prescribing and medication reviews to match patient preference with the appropriate formulation

Evaluation and Clinical Validity of a New Questionnaire for Mikulicz's Disease

Objectives. The characteristic features of Mikulicz's disease (MD) are diffuse enlargement of the lacrimal and submandibular glands, elevated levels of serum immunoglobulin (Ig)G4, and abundant infiltration of IgG4-positive plasmacytes into both glands. No disease index is available to properly evaluate MD, so we developed a functional assessment of MD, the Mikulicz's disease activity questionnaire (MAQ), and evaluated its clinical efficacy. Methods. We selected 18 patients who were either being treated for MD or who had presented with recurrence. The patients completed a self-assessment and were scored according to the MAQ sheet during each visit between December 2009 and August 2011. Assessment items were in regard to increases or decreases in lacrimal and salivary gland enlargement and severity of sicca symptoms. Results. On the first visits, MAQ scores were high, but scores decreased rapidly as treatment progressed. When doses of glucocorticoid were reduced, some patients showed increased scores. Dry-symptom scores increased initially. MAQ scores for patients with recurrent MD gradually increased over several months before relapse. However, some patients displayed no elevation in MAQ scores due to relapses at other sites. Conclusion. MAQ score can be used to quantify flares and treatment response and is useful for functional assessment of MD

Concepts of mental disorders in the United Kingdom : Similarities and differences between the lay public and psychiatrists

BACKGROUND: The lay public often conceptualise mental disorders in a different way to mental health professionals, and this can negatively impact on outcomes when in treatment. AIMS: This study explored which disorders the lay public are familiar with, which theoretical models they understand, which they endorse and how they compared to a sample of psychiatrists. METHODS: The Maudsley Attitude Questionnaire (MAQ), typically used to assess mental health professional's concepts of mental disorders, was adapted for use by a lay community sample (N = 160). The results were compared with a sample of psychiatrists (N = 76). RESULTS: The MAQ appeared to be accessible to the lay public, providing some interesting preliminary findings: in order, the lay sample reported having the best understanding of depression followed by generalised anxiety, schizophrenia and finally antisocial personality disorder. They best understood spiritualist, nihilist and social realist theoretical models of these disorders, but were most likely to endorse biological, behavioural and cognitive models. The lay public were significantly more likely to endorse some models for certain disorders suggesting a nuanced understanding of the cause and likely cure, of various disorders. Ratings often differed significantly from the sample of psychiatrists who were relatively steadfast in their endorsement of the biological model. CONCLUSION: The adapted MAQ appeared accessible to the lay sample. Results suggest that the lay public are generally aligned with evidence-driven concepts of common disorders, but may not always understand or agree with how mental health professionals conceptualise them. The possible causes of these differences, future avenues for research and the implications for more collaborative, patient-clinician conceptualisations are discussed.Peer reviewedFinal Accepted Versio

Primaquine-Induced Hemolytic Anemia: Formation and Mechanism of Action of the Hemotoxic Metabolite 6-Methoxy-8-Hudroxylamoniquinoline (MAQ-NOH)

Primaquine is an important antimalarial drug that is often dose-limited in therapy by the onset of hemolytic anemia. It is well accepted that this toxicity is due to the action of its metabolites and not the parent compound. However, the toxic species have not been identified and little is known about the mechanism underlying primaquine-induced red cell injury. Previous studies to identify the hemotoxic metabolites have focused on the redox active phenolic derivatives of primaquine and have shown that a number of these compounds are capable of decreasing red cell GSH levels and oxidizing oxyhemoglobin to methemoglobin. However, these derivatives have not been detected in humans following primaquine administration. Since N-hydroxy metabolites are known to mediate the hemotoxicity of several other arylamines, this dissertation addresses the possibility that an N hydroxy metabolite of primaquine may play a role in the hemotoxicity of the parent compound. Metabolic studies in rat and human microsomes determined that the known human primaquine metabolite, 6-methoxy-8-aminoquinoline (6-MAQ) is N-hydroxylated to 6-methoxy-8-hydroxylaminoquinoline (MAQ-NOH). MAQ-NOH was shown to be hemolytic in vivo in rats, and directly hemotoxic in rat erythrocytes. These observations suggest that primaquine can be metabolized to MAQ-NOH and that this metabolite has the requisite properties to play a role in the hemotoxicity of the parent compound. In regard to the mechanism underlying MAQ-NOH hemolytic activity, it was demonstrated that under hemolytic conditions, MAQ-NOH induced an oxidative stress within red cells, but the pattern of responses was quite different than other N-hydroxylamines previously shown to have direct hemolytic activity. In this dissertation, data is presented to suggest that MAQ-NOH may induce hemolytic injury in the red cell by more than one mechanism; one that involves lipid peroxidation in the presence of normal amounts of erythrocytic GSH, and one that involves protein oxidation in red cells with low levels of GSH, as seen in individuals with glucose-6-phosphate dehydrogenase deficiency. The relative contribution of MAQ-NOH versus the phenolic type derivatives in mediating this toxicity remains to be assessed

Fast and accurate short read alignment with Burrows–Wheeler transform

Motivation: The enormous amount of short reads generated by the new DNA sequencing technologies call for the development of fast and accurate read alignment programs. A first generation of hash table-based methods has been developed, including MAQ, which is accurate, feature rich and fast enough to align short reads from a single individual. However, MAQ does not support gapped alignment for single-end reads, which makes it unsuitable for alignment of longer reads where indels may occur frequently. The speed of MAQ is also a concern when the alignment is scaled up to the resequencing of hundreds of individuals

The taberna structures of Roman Britain

The aim of this thesis is to explain how the shops (tabernae) of Roman Britain related to society. The buildings of a more humble nature, including tabernae, have been frequently overlooked at the expense of the more ornate public buildings and villas. This thesis proposes to redress this imbalance, as it is believed that retailing and manufacture were one of the most crucial features of Roman society. Varied sources have been used to aid this hypothetical reconstruction and these included the excavated archaeological remains, the extant remains from other parts of the empire and the ancient literary sources. Although these provided a wealth of information they are by themselves limited in what they can reveal about their society. Anthropological and geographical studies have proved an immensely useful tool to illuminate other aspects of society. These were approached with great circumspection and examined in relation to the archaeological evidence. Using all this information the thesis attempts to describe and explain the major factors that helped to create the form and geographical pattern of retail establishments in Roman Britain. It is argued that the tabernae were more responsive to and give a more accurate picture of the social and economic climate of Roman Britain than any other building type. It appears that the Romano-British community was well catered for in life's necessities with a wide variety of merchandise supplied by tabernae. The development of tabernae is difficult to summarise, as more than any other building type they were subject to a multitude of varied and individual circumstances, but it can be demonstrated that a thriving and competitive retailing community existed in the major settlements of Roman Britain

Excited scalar mesons in a chiral quark model

First radial excitations of the isoscalar and isovector scalar mesons f_0(400-1200), f_0(980) and a_0(980) are investigated in the framework of a nonlocal version of a chiral quark model of the Nambu--Jona-Lasinio type. It is shown that f_0(1370), f_J(1710) and a_0(1450) are the first radially excited states of f_0(400-1200), f_0(980) and a_0(980) which are ground states of the scalar meson nonet. The mesons' masses and strong decay widths are calculated. The scalar resonance f_0(1500) is supposed to be a glueball. The status of K_0^*(1430) is discussed.Comment: LaTeX, 1 figure, minor misprints eradicate

A quantitative assessment of marital quality among couples in Kerala, India

The increasing number of divorces and domestic violence in Kerala, India points out the need to assess marital quality among couples in Kerala. The lack of assessment tools in the native language prevents evaluating Malayali couples\u27 marital relationships. The purpose of the proposed study was to examine couples\u27 marital quality in Kerala and validate the translated Marital Adjustment Questionnaire (MAQ) and Marital Quality Scale (MQS), the M-MAQ and the M-MQS, respectively. The instruments were translated into Malayalam through a forward and backward translation. A quantitative survey research design collected data from a criterion[1]based sample of 260 couples in Kerala using the M-MAQ and M-MQS, along with the demographic questions and the three items of the Kansas Marital Satisfaction Scale. The results showed that the respondents with no children, higher education and fewer years of marriage indicated higher levels of marital satisfaction. An exploratory factor analysis suggested a higher internal reliability score for M-MQS and M-MAQ than the non-translated versions. Future research should assess the psychometric properties of these instruments with particular attention to determine the factor structure of the translation

Uniform Suspension of the Clustered Triamcinolone Acetonide Particle

Purpose. MaQaid (MaQ) is a new triamcinolone acetonide commercialised in Japan to visualize the vitreous. Because MaQ is preservative-free, it has a lower risk of ocular toxicities. However, since MaQ is only available as a powder, it needs suspenssion. Suspension does not always result uniformally, which causes poor visibility. This study reports a new MaQ suspension for better visibility. Methods. After medium addition to a MaQ vial, various methods were used. These included the use of (1) vortex mixer, (2) two syringes and a three-way stopcock, and (3) ultrasonic washer. We calculated suspended MaQ concentration (). To evaluate the reproducibility, we estimated the coefficient of variance (CV, ). We used this MaQ for pig eyes, and vitreous visualization was simulated. Subsequently, we used this MaQ suspension for humans. Results. MaQ suspensions were sucessfull, and the concentrations of single particles increased significantly (). The CV was 36.1% for the routine method and 9.03% ffor the new method. Administration of a suspended MaQ made it possible to clearly visualize the vitreous in both pig and human eyes. Conclusions. We devised new techniques for uniformal MaQ suspension. These new methods can compensate for the MaQ disadvantages and ensure a safety surgery