Factors determining patients’ intentions to use point-of-care testing medical devices for self-monitoring: The case of international normalised ratio self-testing

This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited. - Copyright @ 2012 Dove Medical Press LtdThis article has been made available through the Brunel Open Access Publishing Fund.Purpose: To identify factors that determine patients' intentions to use point-of-care medical devices, ie, portable coagulometer devices for self-testing of the international normalized ratio (INR) required for ongoing monitoring of blood-coagulation intensity among patients on long-term oral anticoagulation therapy with vitamin K antagonists, eg, warfarin. Methods: A cross-sectional study that applied the technology-acceptance model through a self-completed questionnaire, which was administered to a convenience sample of 125 outpatients attending outpatient anticoagulation services at a district general hospital in London, UK. Data were analyzed using descriptive statistics, factor analyses, and structural equation modeling. Results: The participants were mainly male (64%) and aged ≥ 71 years (60%). All these patients were attending the hospital outpatient anticoagulation clinic for INR testing; only two patients were currently using INR self-testing, 84% of patients had no knowledge about INR self-testing using a portable coagulometer device, and 96% of patients were never offered the option of the INR self-testing. A significant structural equation model explaining 79% of the variance in patients’ intentions to use INR self-testing was observed. The significant predictors that directly affected patients' intention to use INR self-testing were the perception of technology (β = 0.92, P < 0.001), trust in doctor (β = −0.24, P = 0.028), and affordability (β = 0.15, P = 0.016). In addition, the perception of technology was significantly affected by trust in doctor (β = 0.43, P = 0.002), age (β = −0.32, P < 0.001), and affordability (β = 0.23, P = 0.013); thereby, the intention to use INR self-testing was indirectly affected by trust in doctor (β = 0.40), age (β = −0.29), and affordability (β = 0.21) via the perception of technology. Conclusion: Patients’ intentions to use portable coagulometers for INR self-testing are affected by patients' perceptions about the INR testing device, the cost of device, trust in doctors/clinicians, and the age of the patient, which need to be considered prior to any intervention involving INR self-testing by patients. Manufacturers should focus on increasing the affordability of INR testing devices for patients’ self-testing and on the potential role of medical practitioners in supporting use of these medical devices as patients move from hospital to home testing.This study is funded by the Multidisciplinary Assessment of Technology Centre for Healthcare (MATCH) program (EPSRC grant EP/GO12393/1)

Putting a Face on Hunger: A Community-Academic Research Project

Food insecurity is a growing concern for Eau Claire County residents in Western Wisconsin. A community-academic partnership studied food insecurity through the voices of families struggling to access food and institutions that assist with hunger related problems. Data were collected through focus groups held in urban and rural parts of the county. Participants reported that food insecurity affected all aspects of daily life, increasing stress and reducing coping abilities. Results indicate that when Extension and campus-based staff partner with community groups, they can increase community awareness of and find innovative solutions to pressing community needs, such as food insecurity

Phase Equilibria in Triacylglycerols – Ethanol – Oleic Acid – Athyl Oleate Quasi-Quaternary System

In order to use waste vegetable oils to produce biodiesel a possibility of reagents (sunflower oil and ethanol) mixture homogenization under the simultaneous effect of two cosolvents (oleic acid and ethyl oleate) was investigated. The possibility of action of oleic acid and ethyl oleate as cosolvents was analyzed with GSP model. For qualitative assessment of the intermolecular interaction parameter ξ was used. This parameter is a measure of the ratio between cross-association (solvation) energy A–B and self-association (association) energies A–A and B–B. It was shown that most important role at intermolecular interactions of oleic acid and ethyl oleate with triglycerides belonged to dispersion forces. Predominant contribution of hydrogen bonds in the interaction of oleic acid and ethyl oleate with ethanol was shown. The prediction of improving the effect of the cosolvents with temperature increasing was done, and it was confirmed by experimental results. The effect of oleic acid and ethyl oleate as cosolvents for homogenization of mixtures of sunflower oil and ethanol was investigated experimentally by studying the phase equilibria in the quasi-quaternary system triacylglycerols (sunflower oil) – ethanol – oleic acid – ethyl oleate at 30, 40, 50, 60 and 70 °C. The results of the experiments are presented in the form of phase diagrams of quasi-ternary boundary systems: triacylglycerols – oleic acid – ethanol and triacylglycerols – ethyl oleate – ethanol, and the phase diagrams of composition tetrahedron sections with five different ratios of components oleic acid: ethyl oleate. Generalization of the research results is presented in the form of polythermal phase diagram for the system triacylglycerols – ethanol – oleic acid – ethyl oleate. Solubility polytherms (from 30 to 70 °C) for the system triacylglycerols – ethanol – mixed cosolvent with different ratios of oleic acid and ethyl oleate were plotted

Catalytic Ozonation of 4-Nitrophenol in the Presence of Magnetically Separable Titanium Dioxide – Magnetite Composite

This paper deals with determining catalytic activities of titania (TiO2) with various crystalline structures and magnetite (Fe3O4) during mineralization of 4-nitrophenol in aqueous media by ozonation. Among the titania samples under study, amorphized TiO2 was shown to have the highest catalytic activity, while magnetite was characterized by the lowest catalytic activity. A procedure is proposed to synthesize a magnetically separable composite (TiO2/Fe3O4) including amorphized titania and magnetite phases, which involves deposition of a catalytically active titania phase on preformed magnetite particles. We also studied the effect of mass ratio of titania and magnetite phases in the composite on its catalytic activity during 4-nitrophenol mineralization by ozonation. It was found that catalytic activity of composite increased as the amorphized titania phase was doped with magnetite phase up to 30% wt but as the magnetite portion in the composite catalyst was further increased, its activity decreased. According to Fourier transform infrared (FTIR) spectroscopy, content of catalytically active sites (hydroxyl groups of titania) in the composite catalyst decreases as compared to the pure phase of amorphized titania. Increase in catalytic activity of the composite as its magnetite content increases to 30% wt can be attributed to increase of accessibility of catalytically active sites (OH groups) for ozone, because specific surface area and total pore volume of the composite catalyst as determined by BET increase as compared to amorphized TiO2 and catalytically active titania phase is located mostly on surface of magnetite particles which is indicated by scanning electron microscopy (SEM) results and electrophoretic light scattering (ELS) data. It was shown that the obtained composite catalyst of optimized composition, in spite of its fine particles, can be easily recovered from aqueous phase by magnetic field and used repeatedly in ozonation in order to promote water purification process

Copolymer-induced stabilizing effect of highly swollen hexagonal mesophases

We show quantitatively that tiny amounts of copolymer that decorate a oil/water interfaces can greatly enhance the stability of swollen surfactant hexagonal phases, comprising oil tubes regularly arranged in a water matrix. Such soft composite materials, whose both radius of the tubes and water channel between the tubes can be controlled independently over large ranges, offer a potential interest for the synthesis of mesoporous materials

Hydrophilic interaction liquid chromatography (HILIC)—a powerful separation technique

Hydrophilic interaction liquid chromatography (HILIC) provides an alternative approach to effectively separate small polar compounds on polar stationary phases. The purpose of this work was to review the options for the characterization of HILIC stationary phases and their applications for separations of polar compounds in complex matrices. The characteristics of the hydrophilic stationary phase may affect and in some cases limit the choices of mobile phase composition, ion strength or buffer pH value available, since mechanisms other than hydrophilic partitioning could potentially occur. Enhancing our understanding of retention behavior in HILIC increases the scope of possible applications of liquid chromatography. One interesting option may also be to use HILIC in orthogonal and/or two-dimensional separations. Bioapplications of HILIC systems are also presented

Circulating microRNAs in sera correlate with soluble biomarkers of immune activation but do not predict mortality in ART treated individuals with HIV-1 infection: A case control study

Introduction: The use of anti-retroviral therapy (ART) has dramatically reduced HIV-1 associated morbidity and mortality. However, HIV-1 infected individuals have increased rates of morbidity and mortality compared to the non-HIV-1 infected population and this appears to be related to end-organ diseases collectively referred to as Serious Non-AIDS Events (SNAEs). Circulating miRNAs are reported as promising biomarkers for a number of human disease conditions including those that constitute SNAEs. Our study sought to investigate the potential of selected miRNAs in predicting mortality in HIV-1 infected ART treated individuals. Materials and Methods: A set of miRNAs was chosen based on published associations with human disease conditions that constitute SNAEs. This case: control study compared 126 cases (individuals who died whilst on therapy), and 247 matched controls (individuals who remained alive). Cases and controls were ART treated participants of two pivotal HIV-1 trials. The relative abundance of each miRNA in serum was measured, by RTqPCR. Associations with mortality (all-cause, cardiovascular and malignancy) were assessed by logistic regression analysis. Correlations between miRNAs and CD4+ T cell count, hs-CRP, IL-6 and D-dimer were also assessed. Results: None of the selected miRNAs was associated with all-cause, cardiovascular or malignancy mortality. The levels of three miRNAs (miRs -21, -122 and -200a) correlated with IL-6 while miR-21 also correlated with D-dimer. Additionally, the abundance of miRs -31, -150 and -223, correlated with baseline CD4+ T cell count while the same three miRNAs plus miR- 145 correlated with nadir CD4+ T cell count. Discussion: No associations with mortality were found with any circulating miRNA studied. These results cast doubt onto the effectiveness of circulating miRNA as early predictors of mortality or the major underlying diseases that contribute to mortality in participants treated for HIV-1 infection