Seasonal influenza vaccination of healthcare workers : Systematic review of qualitative evidence

Background Most countries recommend that healthcare workers (HCWs) are vaccinated seasonally against influenza in order to protect themselves and patients. However, in many cases coverage remains low. A range of strategies have been implemented to increase uptake. Qualitative evidence can help in understanding the context of interventions, including why interventions may fail to achieve the desired effect. This study aimed to synthesise evidence on HCWs’ perceptions and experiences of vaccination for seasonal influenza. Methods Systematic review of qualitative evidence. We searched MEDLINE, EMBASE and CINAHL and included English-language studies which reported substantive qualitative data on the vaccination of HCWs for seasonal influenza. Findings were synthesised thematically. Results Twenty-five studies were included in the review. HCWs may be motivated to accept vaccination to protect themselves and their patients against infection. However, a range of beliefs may act as barriers to vaccine uptake, including concerns about side-effects, scepticism about vaccine effectiveness, and the belief that influenza is not a serious illness. HCWs value their autonomy and professional responsibility in making decisions about vaccination. The implementation of interventions to promote vaccination uptake may face barriers both from HCWs’ personal beliefs and from the relationships between management and employees within the targeted organisations. Conclusions HCWs’ vaccination behaviour needs to be understood in the context of HCWs’ relationships with each other, with management and with patients. Interventions to promote vaccination should take into account both the individual beliefs of targeted HCWs and the organisational context within which they are implemented

A New Species Of Freshwater Crab (Brachyura : Potamoidea : Potamonautidae) From The Ruwenzori Region Of Western Uganda, East Africa

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Omega-3 fatty acid and antioxidant enriched liposomes for nasal administration of anti-Alzheimer drugs

The purpose of this work was the formulation of liposomes for nasal administration of tacrine\ub7HCl. This route has many advantages, in fact it is possible to convey the drug directly to the CNS, through the olfactory bulb. Part of tacrine administered can also be absorbed into the systemic circulation avoiding hepatic first pass effect. Liposomes were formulated with ingredients that have a beneficial effect against the disease. In particular, the cholesterol was replaced with α-tocopherol, and phospholipids were enriched with polyunsaturated fatty acids (DHA, EPA α-linolenic acid). This formulative approach allowed us to obtain 100% active liposomes against symptoms of Alzheimer's disease

Eudragit-coated albumin nanospheres carrying inclusion complexes for oral administration of indomethacin

Oral administration of indomethacin as well as drugs with low aqueous solubility usually results in poor absorption and bioavailability. The aim of this study was to prepare enteric-coated bovine serum albumin nanospheres carrying cyclodextrin complex for indomethacin delivery. Inclusion complex composed of indomethacin and β-cyclodextrin was prepared by spray-drying. Indomethacin alone and its inclusion complex were incorporated into albumin nanospheres using a coacervation method followed by thermal cross-linking. Then nanosphere suspensions were spray-dried. The inclusion complex and the nanospheres were characterized by FT-IR spectroscopy and DSC analysis. Phase-solubility diagrams and stability constants were determined at pH 2.0 and 7.4 and at different temperatures (10, 25 and 37\ub0C). Swelling ability of nanospheres were evaluated as well as the in vitro release behaviour at pH 2.0 and 7.4. The nanospheres were coated with Eudragit L-100 or S-100 using spray-drying to give protection in the stomach. The results showed that indomethacin solubility can be increased by complexation with β-cyclodextrin or protein/drug interaction with albumin nanospheres. The inclusion complex loaded into BSA nanospheres provided a zero order drug release kinetic. The coating process with EudL and EudS allowed to obtain a negligible release at acidic pH without limit drug availability at pH 7.4

Thermal analysis of systems containing theophylline and three types of Compritol

The use of fluid-bed or spray-drying processing in the development and production of solid dosage forms is increasing. These processes are traditionally used for granulation and the drying and coating of powders, granules, tablets, beads. Generally speaking, the coating material is dissolved in a solvent (water or organic) prior to spraying. During and after coating the solvent must be evaporated. The use of solvents nowadays is under constraint due to the problems of trace levels, while recovering a solvent often proves expensive. Moreover also long evaporation time of the solvent (especially water) could be a problem. In order to avoid such problems and to reduce costs, it is appealing to use meltable materials, such as waxes or derivatives or other different low-melting lipid materials – as coating agents. The aim of the present study was to analyse the ability of different types of Compritol, namely Compritol 888 ATO (glyceryl di-behenate), Compritol E ATO (mixture of mono-, di- e tri-glycerides of behenic acid: mp 67-80°C) and Compritol HD5 ATO (mixture of glyceril di-behenate and PEG -mp. 60-67°C) to sustain the release of theophylline, used as tracer model drugs incorporated into a solid dispersion prepared by the melting method using the three lipid materials. Formulations with drug:Compritol 10, 20 and 30 % w/w were evaluated: physical mixtures were heat treated at 80°C for 10 min to prepare the solid dispersions. The material thus obtained was maintained at -20° for 2 days and then milled and sieved. Samples of each formulation were analyzed by DSC and HSM, revealing the different solvent ability of the molten phase of each Compritol. In fact at HSM, after the melting of the carrier, undissolved theophylline particles are clearly evident at all the compositions examined that demonstrated to dissolve into the molten carrier at increasing temperature. This event was not documented by DSC thermograms that therefore did not offer important information. HSM technique revealed also suitable to examine the effects of aging. After 6 months comparison of similar situations (composition, temperature, and nature of the carrier) revealed the presence of a larger amount of crystallized material. Increased particle amount was due to crystallization of previously dissolved drug, during the preparation of the solid dispersion that, in the presence of the solid carrier was only delayed. This fact was also confirmed by dissolution profiles: a control of the release was obtained only at the lowest concentration, while at higher concentrations no difference could be observed with respect to pure theophylline: this was hypothesized as due to better coating of the drug particles by the lipid carrier, suggesting at the same time that the concentration range, useful to obtain a control of the release of theophylline, is quite restricted. Better results, in terms of control of the release, were obtained if the molten phase was spray-congealed using an ultrasound assisted device. In this case the process allowed obtaining spherically shaped microparticles: SEM and HSM observation indicated that single theophylline particles were coated by the lipid material that could slow down dissolution of the drug with respect to pure drug. On the contrary in the final dispersion, after solidification, the milling could have acted along fracture lines that made free the drug particle surface, hindering any control to the release by the lipid material

Preparation of gastroresistant mesalazine lipidic microcapsules

INTRODUCTION AND OBJECTIVES Mesalazine or 5-aminosalicylic (5-ASA), a typical antiinflatmmatory drug, is customarily used to maintain remission in inflammatory bowel disease (Carter, 2004). Mesalazine acts topically on the colonic mucosa: current 5-ASA delivery systems have been developed to avoid absorption of mesalazine in the small intestine, thereby delivering maximal amounts of the drug to colonic mucosa (Van den Mooter 2006). The aim of this work was to develop and characterize gastro-resistant multiparticulate system for mesalazine colon delivery in paediatric administration. MATERIAL AND METHODS Mesalazine was kindly supplied by Doppel (Cortemaggiore, Italy) and stearic acid was purchased by ACEF (Fiorenzuola, Italy). Carnauba wax (Produits Roche S.A. France) and Eudragit (Rhom Pharma, Germany) were also used. All other chemicals were of analytical grade. The 5-ASA microcapsules were manufactured in two steps through the spray-congealing technique. In the first step the mesalazine was disperded in a solution of Eudragit L in isopropyl alcohol prepared under stirring at the tempetature of 70\ub0C. The carnauba wax was added to the dispersion and the temperature was raised up until 95\ub0C to evaporate the isopropyl alcohol and io melt the lipid. The melted mass was sprayed through the WPN nozzle at 3.0 bar. In the second step the microcapsules were obtained by disperding the 5-ASA cores in a low melting point lipid as stearic acid at the temperature around 70\ub0C. At this temperature the microsphere did not melt and remained well dispersed in the liquid mass. The dispersion was sprayed with the WPN nozzle at 1.2 bar and the microcapsules were obtained. The drug loading was determined by adding the samples to a simulated intestinal fluid (SIF) at pH 7.4 and heating up to 70\ub0C or to 850C to melt the lipophilic carrier as stearic acid or carnauba wax, respectively. The process was carried out under magnetic stirring for 5 hours to extract completely the 5-ASA. The solution was filtered with microcellulose filter and then assayed by UV at 330 nm. The analysis was peformed in triplicate. The lipid microcapsules were examined both under an optical stereomicroscope (Citoval 2. Jena, Germany) connected to a video camera (JVC, Tokyo, Japan) and Scanning Electron Microscopy (SEM, JSM 6400, Jeol Ltd. Tokyo, Japan). Physical changes in microcapsules during heating were monitored by Hot Stage Microscopy (HSM). A hot plate (FP 52 Mettler, Grefensee, Switzerland) connected to a temperature controller (FP 5 Mettler) was used ..........

A Study for the Development of Mesalazine Multiparticulate Dosage Forms for Colon Delivery in Pediatric Patients

Mesalazine (5-ASA) is an anti-inflammatory drug used for ulcerative colitis or Crohn’s disease. Most of available oral 5-ASA dosage forms are modified release tablets targeting the colon. However, in paediatrics patient compliance would improve by avoiding dosage forms that cannot be swallowed by children. The aim of this work was to develop gastro-resistant multiparticulate dosage forms for mesalazine colon delivery with easier dose intake by children

Hydroxypropylmethylcellulose films for prolonged delivery of the antipsychotic drug chlorpromazine

Objectives - The aim of this study was to develop transdermal films based on hydroxypropylmethylcellulose with the purpose of improving transdermal permeation of chlorpromazine hydrochloride, an antipsychotic drug used to alleviate the symptoms and signs of psychosis. Methods - Hydroxypropylmethylcellulose films were prepared and evaluated for their drug content, film thickness, residual water content and bioadhesive properties. In-vitro permeation experiments were performed in the absence and in the presence of permeation enhancers (oleic acid, polysorbate 80, or both) with the purpose of improving drug availability. Other formulative parameters, such as drug and plasticizer concentration and hydroxypropylmethylcellulose type, were investigated. Key findings - Either oleic acid and polysorbate 80 had significant effect on drug permeation with respect to the control formulation. In particular films containing a mixture of oleic acid and polysorbate 80 provided the best enhancement activity for chlorpromazine. Moreover, a decrease in propylene glycol or chlorpromazine content or an increase of hydroxypropylmethylcellulose viscosity provided lower cumulative amounts of drug permeated. Conclusions - The results obtained confirm that chlorpromazine permeation can be easily modulated by varying the composition of hydroxypropylmethylcellulose-based films. These formulations could serve as candidates for transdermal delivery of antipsychotic drugs