Patient-focused interventions to support vulnerable people using oral anticoagulants: a narrative review.

The aim of this review was to identify patient-focused interventions that have been trialed to support vulnerable patient populations taking oral anticoagulants (warfarin and the direct-acting oral anticoagulants (DOACs)) such as older persons (65 years and over), those with limited health literacy, and those from culturally and linguistically diverse (CALD) backgrounds. This review also aimed to report on the effects of these interventions on outcomes relevant to the use of anticoagulant therapy. Original articles published between 1 January 1995 and 30 June 2017 were identified using several electronic databases such as Medline, Ovid, Embase, Scopus, Cochrane, and Google Scholar. The following terms were used for the three-tiered search: Tier 1, elderly, aged, older adult, geriatrics; Tier 2, health literacy, literacy, low health literacy, low English proficiency, patient literacy; and Tier 3, ethnicity, ethnic, ethnic groups, CALD, culturally and linguistically diverse, NESB, non-English speaking background, race, racial groups, religion, religious groups, and minority groups. The terms for each tier were combined with the following terms: anticoagulants, anticoagulation, warfarin, apixaban, dabigatran, rivaroxaban, DOACS, new oral anticoagulants, novel oral anticoagulants, patient care, patient knowledge, comprehension, patient education, patient participation, and communication. A total of 41 studies were identified. Most of the interventions identified included older persons taking warfarin who were monitored using the international normalized ratio (INR) and who received patient education. Many interventions reported a significant positive impact on patients' knowledge, reduction in the number of adverse events caused by hemorrhage, and better INR control. More research on patient-focused interventions is needed that includes patients with limited health literacy, those from CALD backgrounds, and family members and caregivers of patients taking oral anticoagulants

Identification of structural defects using a simplified algorithm of thermal tomography

Abstract This paper concerns modification of the thermal tomography reconstruction algorithm to improve the speed of calculations for faster reconstruction of thermal and geometrical parameters inside a tested structure. We propose to solve the inverse problem in the two step procedure. First, initial rough reconstruction of a tested structure based on the one dimensional (1-D) thermal model. Second, execution of the full 3-D reconstruction procedure, with the first step result as the initial condition for further calculations. To verify value of the proposed method some simulation results of the phantom structure developed for testing the method as well as real reconstruction of this phantom are presented

Electronic Structure and X-Ray Photoemission Spectra of MPtSn (M = Ti, Zr, Hf)

The electronic structures of the half-Heusler isostructural compounds TiPtSn, ZrPtSn and HfPtSn were calculated and measured applying the X-ray photoemission spectroscopy. The (Ti, Zr, Hf)PtSn compounds have gaps between the occupied valence band and the empty conduction band, calculated as about 0.75, 1.12, and 1.09 eV, respectively. The calculations were done by the full-potential local orbitals method in the framework of the local spin-density approximation and partly also by the full-potential linear mu±n-tin orbitals method by the LmtART code. Experimental X-ray photoemission spectra were measured using photons of en- ergy of 1486.6 eV. The experimental and calculated spectra match quite well except a small shift in the energy scale

Magnetite thin films

A low temperature process for converting hematite (α-Fe_2O_3) thin films into magnetite (Fe_3O_4) is described. The films produced are unambiguously identified as magnetite by several complementary methods of analysis. These include α-backscattering spectrography, X-ray powder diffractometry, and observations of electrical, magnetic, and optical properties

The Electronic and Magnetic Properties of YbxGd1-xNi5 Systems

The intermetallic compounds YbxGd1¡xNi5 crystallize in the hexagonal CaCu5-type structure. Based on wide ranging SQUID-type magnetometer, it was shown that the saturation magnetization decreases with growing concentration of ytterbium. The opposite tendency was observed for the Sommerfeld coefficient obtained in the heat capacity measurements. These results are confirmed using ab initio band structure calculations

Understanding the reasons behind the low utilisation of thrombolysis in stroke

Background Thrombolysis remains the only approved therapy for acute ischaemic stroke (AIS); however, its utilisation is reported to be low. Aims This study aimed to determine the reasons for the low utilisation of thrombolysis in clinical practice. Method Five metropolitan hospitals comprising two tertiary referral centres and three district hospitals conducted a retrospective, cross-sectional study. Researchers identified patients discharged with a principal diagnosis of AIS over a 12-month time period (July 2009-July 2010), and reviewed the medical record of systematically chosen samples. Results The research team reviewed a total of 521 records (48.8% females, mean age 74.4 ±14 years, age range 5-102 years) from the 1261 AIS patients. Sixty-nine per cent of AIS patients failed to meet eligibility criteria to receive thrombolysis because individuals arrived at the hospital later than 4.5 hours after the onset of symptoms. The factors found to be positively associated with late arrival included confusion at onset, absence of a witness at onset and waiting for improvement of symptoms. However, factors negatively associated with late arrival encompassed facial droop, slurred speech and immediately calling an ambulance. Only 14.7% of the patients arriving within 4.5 hours received thrombolysis. The main reasons for exclusion included such factors as rapidly improving symptoms (28.2%), minor symptoms (17.2%), patient receiving therapeutic anticoagulation (6.7%) and severe stroke (5.5%). Conclusion A late patient presentation represents the most significant barrier to utilising thrombolysis in the acute stroke setting. Thrombolysis continues to be currently underutilised in potentially eligible patients, and additional research is needed to identify more precise criteria for selecting patients for thrombolysis

Microstructural and magnetic characterization of Ni0.5Zn0.5Fe2O4 ferrite nanoparticles

International audienc

Preferential Oxidation of Fe in Permalloy Films

On the basis of He-ion backscattering, x-ray fluorescence, and complementary measurements, it is unambiguously established for the first time that the oxide layer on the surface of oxidized 81% Ni-19% Fe evaporated films is predominantly Fe-oxide. Extrapolation of results for pure iron films indicates that the oxide is most likely antiferromagnetic alpha-Fe2O3. On the basis of ferromagnetic resonance measurements, it is concluded that the oxide negligibly affects the pinning of the bulk spins at the film-oxide interface