Measuring adherence to inhaled control medication in patients with asthma: Comparison among an asthma app, patient self‐report and physician assessment

Background Previous studies have demonstrated the feasibility of using an asthma app to support medication management and adherence but failed to compare with other measures currently used in clinical practice. However, in a clinical setting, any additional adherence measurement must be evaluated in the context of both the patient and physician perspectives so that it can also help improve the process of shared decision making. Thus, we aimed to compare different measures of adherence to asthma control inhalers in clinical practice, namely through an app, patient self-report and physician assessment. Methods This study is a secondary analysis of three prospective multicentre observational studies with patients (≥13 years old) with persistent asthma recruited from 61 primary and secondary care centres in Portugal. Patients were invited to use the InspirerMundi app and register their inhaled medication. Adherence was measured by the app as the number of doses taken divided by the number of doses scheduled each day and two time points were considered for analysis: 1-week and 1-month. At baseline, patients and physicians independently assessed adherence to asthma control inhalers during the previous week using a Visual Analogue Scale (VAS 0–100). Results A total of 193 patients (72% female; median [P25–P75] age 28 [19–41] years old) were included in the analysis. Adherence measured by the app was lower (1 week: 31 [0–71]%; 1 month: 18 [0–48]%) than patient self-report (80 [60–95]) and physician assessment (82 [51–94]) (p 0.05). There was a moderate correlation between patient self-report and physician assessment (ρ = 0.596, p < 0.001). Conclusions Adherence measured by the app was lower than that reported by the patient or the physician. This was expected as objective measurements are commonly lower than subjective evaluations, which tend to overestimate adherence. Nevertheless, the low adherence measured by the app may also be influenced by the use of the app itself and this needs to be considered in future studies.info:eu-repo/semantics/publishedVersio

Molecule – colloidal particle interactions: raman spectroscopic studies

SEIÇA, Ana Filipa Santos - Molecule – colloidal particle interactions: raman spectroscopic studies. Coimbra : [s.n.], 2016. Dissertação de Mestrado em Bioquiínica,This thesis aims to analyze the behaviour of natural cyclodextrins and methylate cyclodextrins with colloidal particles - micelles of sodium decanoate and silver nanoparticles using Raman Spectroscopy and Surface Enhanced Raman Spectroscopy. We held the first part in the Molecular Physics Chemistry Department at the University of Coimbra and the second part in the Physics and Chemistry Department at University of Malaga. In the first part, we deal with sodium decanoate aqueous solutions, above and below the critical micellar concentration, that contain trimethyl--cyclodextrin or -cyclodextrin. A method for calibrating Raman intensities of diluted aqueous solutions, based on the integrated intensity of the OH stretching bands of liquid water as an external intensity standard, is described and used to obtain a difference spectrum that reveals intensity changes mainly due the intermolecular interaction between two solutes. This method was applied to trimethyl--cyclodextrin in sodium decanoate aqueous solutions. The difference between the interaction spectra above and below the critical micellar contribution of sodium decanoate, in the CH stretching region between 2700 and 3100 cm-1, shows an intensity increase of the CH stretching bands for trimethyl--cyclodextrin above the critical micellar concentration of sodium decanoate, whereas -cyclodextrin is relatively insensitive to the presence of decanoate ion micelles in aqueous solution. This part of the thesis led to a publication entitled "Raman spectroscopic evidence for the inclusion of decanoate ion in trimethyl--cyclodextrin" [Annex 2]. In Part II, we observed the interaction of native and methylate cyclodextrins with trans-cinnamic acid and silver colloidal particles using Surface Enhanced Raman Spectroscopy. Native cyclodextrins are adsorbed on the surface of silver colloidal particles via chemisorption through rim hydroxyl groups, stabilizing the colloidal solution during 45 minutes, whereas TRIMEB stabilizes silver nanoparticles during 90 minutes. TRIMEB acts as a better surface stabilizer than CD, improving the stability of colloidal solution and preventing aggregation. Finally, native and methylated cyclodextrins exhibit different behaviours in presence of colloidal particles. TRIMEB is adsorbed on the surface of sodium decanoatemicelles , contrasting with CD which is not adsorbed by these micelles,. In presence of silver nanoparticles natural cyclodextrin is adsrobed on the surface of silver colloidal particles while methylate cyclodextrin is not adsorbedO presente trabalho visa analisar o comportamento das ciclodextrinas naturais e metiladas nas suas interações com partículas coloidais - micelas de decanoato de sódio e nanopartículas de prata e foi realizado no Departamento de Química-Física Molecular da Universidade de Coimbra durante três semestres, se onde utilizou a Espectroscopia de Raman, e no Departamento de Química-Física da Universidade de Málaga (um semestre), onde se recorreu à Espectroscopia de Raman com Intensificação à Superfície. A primeira parte deste estudo envolveu o estudo de soluções aquosas de decanoato de sódio, acima e abaixo da concentração micelar crítica, contendo trimetil-ciclodextrina-β ou ciclodextrina-β. Um método para calibrar intensidades Raman de soluções aquosas, com base nas bandas de elongação OH da água líquida, como padrão de intensidade externa, é descrito e utilizado para obter um espetro de diferença que revela alterações de intensidade devido a interações intermoleculares entre dois solutos. Este método é aplicado à trimetil-ciclodextrina-β em soluções aquosas de decanoato de sódio. A diferença entre os espectros de interação acima e abaixo da concentração micelar crítica de decanoato de sódio, na região de CH entre 2700 e 3100 cm-1, mostra um aumento de intensidade nas bandas de elongação CH de trimetil-ciclodextrina-β acima da concentração micelar crítica de decanoato de sódio, ao passo que a ciclodextrina-β é relativamente insensível à presença de micelas de decanoato em solução aquosa. Este trabalho originou uma publicação intitulada "Raman spectroscopic evidence for the inclusion of decanoate ion in trimethyl--cyclodextrin" [Anexo 2]. Na segunda parte deste estudo, observámos a interação das ciclodextrinas nativas e metiladas com ácido trans-cinâmico e as particulas coloidais de prata, por Espectroscopia Raman com Intensificação à Superfície. As ciclodextrinas nativas são adsorvidas quimicamente à superfície de partículas coloidais de prata através dos grupos hidroxilo presentes na cavidade externa da ciclodextrina estabilizando a solução durante 45 minutos, enquanto a TRIMEB estabiliza a solução durante 90 minutos. Relativamente à βCD, a ciclodextrina metilada age como melhor estabilizador das nanopartículas, melhorando a estabilidade da solução coloidal e prevenindo agregação. Da análise dos dois estudos efectuados, concluímos que as ciclodextrinas naturais e as ciclodextrinas metiladas apresentam comportamentos diferentes na presença de partículas coloidais.A TRIMEB é absorbida à superfície das micelas de decanoato de sódio, enquanto a CD não é adsorbida pelas micelas. Na presença de nanopartículas de prata, a ciclodextrina natural é adsorbida à superficie das particulas coloidais de prata, contrastando com a ciclodextrina metilada que não é adsorbid

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved