Adherence to prophylaxis in adolescents and young adults with severe haemophilia, A qualitative study with patients

© 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.Abstract Introduction: Reported levels of adherence to prophylaxis among young people with haemophilia (YPH) vary widely and are predominately based on estimations made by healthcare professionals and parents. Reasons for (non)adherence among YPH in particular have not been evidenced. Aim: to examine experiences in relation to prophylaxis with YPH themselves, and barriers and facilitators to their adherence. Methods: 11 Participants were recruited in five haemophilia centres across England and Wales. All patients who met the inclusion criteria (aged 12-25, diagnosed with haemophilia, on prophylaxis) were approached during a routine check-up appointment, and all participants who agreed to take part were interviewed. Interviews were audio recorded, transcribed and analysed using Interpretative Phenomenological Analysis. Results: Self-reported adherence to prophylaxis was good. Few participants admitted to intentionally skipping injections although they reported sometimes forgetting. However, due to the increasingly personalised and flexible approach to prophylaxis, adherence is not straightforward to define. Barriers to adherence included a busy lifestyle, dislike of the intravenous injection, venous access issues, anxiety or stress and being out of one’s normal routine. Support was an important facilitator to adherence, including support from health professionals at the haemophilia centre as well as friends. Parents appear to be very involved with their sons’ haemophilia management, even after their sons leave home. Conclusion: What this study adds is that the increasingly flexible and personalized approach to managing prophylaxis in haemophilia may sometimes lead to confusion around treatment frequency and dosing. This may lead to accidental non-adherence, which is distinct from both skipping and forgetting. Advice from haemophilia teams may not always be consistent, and is likely to be interpreted differently by different individuals. Some additional training and education of patients and their families to increase their knowledge and skills around prophylaxis may reduce this confusion and therefore is likely to improve adherence further.Peer reviewedFinal Published versio

Observation of the Kohn anomaly near the K point of bilayer graphene

The dispersion of electrons and phonons near the K point of bilayer graphene was investigated in a resonant Raman study using different laser excitation energies in the near infrared and visible range. The electronic structure was analyzed within the tight-binding approximation, and the Slonczewski-Weiss-McClure (SWM) parameters were obtained from the analysis of the dispersive behavior of the Raman features. A softening of the phonon branches was observed near the K point, and results evidence the Kohn anomaly and the importance of considering electron-phonon and electron-electron interactions to correctly describe the phonon dispersion in graphene systems.Comment: 4 pages, 4 figure

Multiwavelength observation from radio through very-high-energy Gamma-ray of OJ 287 during the 12-year cycle flare in 2007

We performed simultaneous multiwavelength observations of OJ 287 with the Nobeyama Millimeter Array for radio, the KANATA telescope and the KVA telescope for optical, the Suzaku satellite for X-ray and the MAGIC telescope for very high energy (VHE) gamma-ray in 2007. The observations were conducted for a quiescent state in April and in a flaring state in November-December. We clearly observed increase of fluxes from radio to X-ray bands during the flaring state while MAGIC could not detect significant VHE gamma-ray emission from the source. We could derive an upper limit (95% confidence level) of 1.7% of the Crab Nebula flux above 150 GeV from about 41.2 hours of the MAGIC observation. A simple SSC model suggests that the observed flaring activity could be caused by evolutions in the distribution of the electron population rather than changes of the magnetic field strength or Doppler beaming factor in the jet.Comment: Contribution to the 31st ICRC, Lodz, Poland, July 200

Formation of p-n junction in polymer electrolyte-top gated bilayer graphene transistor

We show simultaneous p and n type carrier injection in bilayer graphene channel by varying the longitudinal bias across the channel and the top gate voltage. The top gate is applied electrochemically using solid polymer electrolyte and the gate capacitance is measured to be 1.5 $\mu F/cm^2$, a value about 125 times higher than the conventional SiO$_2$ back gate capacitance. Unlike the single layer graphene, the drain-source current does not saturate on varying the drain-source bias voltage. The energy gap opened between the valence and conduction bands using top and back gate geometry is estimated.Comment: 16 pages, 6 figure

Opportunity lost: Mystification, elite politics and financial reform in the UK

The first phase of the crisis in Britain – from the 2007 failure of Northern Rock to the post Lehman systemic crisis of autumn 2008 – was a demystifying moment, when finance sector alibis, technocratic expertise and the assumptions of the political classes were tested and found wanting under pressure of unanticipated events. The banking rescue of 2007-8 amounted to the socialization of banking losses at a cost to the UK taxpayer of up to £1,000 billion or more (if we include contingent liabilities and exclude quantitative easing). British taxpayers got very little in return. The challenge of a brief democratic moment was met by the restatement of old pre-crisis narratives about the importance of ‘flexible’, market responsive regulation, and about the social value of finance. The result so far is marginalisation of left and radical forces (or no change on the past twenty-five years). Against this background, this essay has two interlinked aims. First, it presents an analysis of political obstacles to democratic control and reform of the finance sector that caused the financial crisis of 2007-8; a crisis that, after extreme intervention to save banks and support markets, has by 2010-11 become a fiscal crisis for individual states and a sovereign debt crisis for the eurozone. Second, it addresses (in this context) the role of ‘ideology’ within the socio-political process by examining how discourses format the world through what is now called ‘performativity’. And it shows how this new kind of discursive description can be developed and integrated with more established kinds of institutional analysis so as to generate new insights into the political obstacles to reform. The argument below is illustrated with UK evidence and our aim is to provide an analysis of national peculiarities, but the issues raised are relevant to other jurisdictions (national and supra national). We hope to raise broad questions about the mechanisms of elite power in present day capitalism where the importance of narrative has intensified since Reagan and Thatcher. We also aim to encourage reflection on how narrative power could be challenged so as to deliver a more democratic reform of finance

On the dependence between UV luminosity and Lyman-alpha equivalent width in high redshift galaxies

We show that with the simple assumption of no correlation between the Ly-alpha equivalent width and the UV luminosity of a galaxy, the observed distribution of high redshift galaxies in an equivalent width - absolute UV magnitude plane can be reproduced. We further show that there is no dependence between Ly-alpha equivalent width and Ly-alpha luminosity in a sample of Ly-alpha emitters. The test was expanded to Lyman-break galaxies and again no dependence was found. Simultaneously, we show that a recently proposed lack of large equivalent width, UV bright galaxies (Ando et al. 2006) can be explained by a simple observational effect, based on too small survey volumes.Comment: 7 pages, 3 figures, 2 tables, accepted in MNRA

Transmission through a biased graphene bilayer barrier

We study the electronic transmission through a graphene bilayer in the presence of an applied bias between layers. We consider different geometries involving interfaces between both a monolayer and a bilayer and between two bilayers. The applied bias opens a sizable gap in the spectrum inside the bilayer barrier region, thus leading to large changes in the transmission probability and electronic conductance that are controlled by the applied bias.Comment: 10 pages, 8 figures, extended versio