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

A model for the fluid dynamic behavior of a film coating suspension during tablet coating

This work models the behavior of a liquid-particle suspension on the surface of a tablet during the pharmaceutical film-coating process. The model uses the “mixture modeling” approach and the lubrication approximation method to simulate how the suspension moves and dries on the surface of a tablet, considering how important physical properties of the suspension, such as the density and viscosity, change when the carrier fluid evaporates.The model also accounts for the absorption of the coating suspension inside the core of the porous tablet, yielding the tablet water content, a key quantity characterizing the coating process. The numerical results, obtained with the gPROMS Modelbuilder platform, agree with experimental data taken from the literature and Volume-Of-Fluid CFD simulations

The Use of Earthworms and Household Organic Waste Composting Length of TIME

Composting with earthworms is composting process by involving earthmacroorganism. Cooperation between earthworms and microorganisms may impact on decomposition process done by the microorganisms as assisted by the existence of earthworms. Because any materials to be decomposed by microorganisms had been decomposed by earthworms earlier, microorganisms would work more effectively and quickly. This study aimed to determine effects of using earthworms toward household organic waste composting length of time by using experimental design of study. The object of study was all organic waste taken randomly from one household. Variable of study was composting length of time measured after addition of earthworms and composting process completed. Tools used in this study were measuring tape, calendar, hygrometer and smelling sensory (organoleptic). Statistical analysis used differ test. Results of study showed data was normally distributed, equality of variance and no difference found between composting length of time with or without using earthworms. In conclusion, there is no relation found between the use of earthworms and the household organic waste length of time

Pengembangan LKPD Literasi Sains Berbasis Lesson Study for Learning Community (LSLC)

Penelitian ini bertujuan untuk menghasilkan LKPD literasi sains berbasis lesson study for learning community yang valid. Lembar kerja peserta didik (LKPD) yang dikembangkan ini merupakan LKPD yang spefisik untuk menfasilitasi siswa mengenal literasi sains. Adapun pola pengembangan LKPD literasi sains ini sendiri mengacu pada lesson study for learning community (LSLC) yang terdiri dari perencanaan, pelaksanaan, dan refleksi. Penelitian ini merupakan penelitian Research and Development (R & D) dengan model 4D (define, design, develop, dan disseminate). Data dikumpulkan dengan menggunakan lembar validasi. Analisis data dilakukan dengan metode deskriptif kuantitatif terhadap validitas LKPD literasi sains berbasis lesson study for learning community. Hasil penelitian menunjukkan bahwa: 1) LKPD literasi sains berbasis lesson study for learning community dinyatakan valid dengan skor rata-rata 3.60, 2) kepraktisan terhadap LKPD yang dikembangkan berada pada kriteria 3.80 oleh guru dan 3.50 oleh peserta didik. Berdasarkan hasil penelitian dapat disimpulkan bahwa LKPD literasi sains berbasis lesson study for learning community sangat valid dan praktis

Multi-site analysis of dopamine uptake in the somatosensory cortex

Poster presented at Biomedical Technology Showcase 2006, Philadelphia, PA. Retrieved 18 Aug 2006 from http://www.biomed.drexel.edu/new04/Content/Biomed_Tech_Showcase/Poster_Presentations/Moxon_2.pdf.Voltammetry has been used as a method to measure the concentration of monoaminergic neurotransmitters in-vivo. Studies have shown that the concentration of neurotransmitters, such as dopamine, varies across small regions of the brain (less than 1mm). To study the varying concentration of dopamine, a multi-site electrode would be beneficial. Therefore, the recording sites of our ceramic-based multi-site electrode were coated with carbon and deployed in the somatosensory cortex of a rat. Known concentrations of dopamine were pressure injected and the diffusion curve, which is the change in concentration over time, was recorded. The results show that the in-vivo data does not follow the prediction of the model providing an interesting insight to the uptake of monoamines across the different layers of the somatosensory cortex

Application of random amplified polymorphic DNA (RAPD) analysis and plasmid profiles to the differentiation of Vibrio parahaemolyticus isolated from coastal waters

Plasmid profiles and random amplified polymorphic DNA (RAPD) techniques were used to analyse the genetic differentiation of 57 isolates of Vibrio parahaemolyticus isolated from coastal water. Among the isolates, 16 plasmid patterns were observed, with plasmid sizes ranging from 1.5 to 7.6 megadalton. The two primers (Gen1-50-01, 5'-GTGCAATGAG-3' and Gen1-50-02, 5'-CAATGCGTCT-3') generated reproducible profiles of genomic DNA fingerprints producing bands ranging from 0.25 to 5.0 kb. The RAPD types profiles revealed a high level of DNA sequence diversity within the Vibrio parahaemolyticus isolates tested, as 48 RAPD types were observed for each primer respectively. Hence, plasmid profiles and RAPD-PCR analysis proved useful in discriminating the isolates. The later method proved to be more sensitive. Our data show that Vibrio parahaemolyticus isolates can be divided into at least 56 epidemiological subgroups on the basis of the plasmid profiles and RAPD-PCR results

A Dissipative-Particle-Dynamics Model for Simulating Dynamics of Charged Colloid

A mesoscopic colloid model is developed in which a spherical colloid is represented by many interacting sites on its surface. The hydrodynamic interactions with thermal fluctuations are taken accounts in full using Dissipative Particle Dynamics, and the electrostatic interactions are simulated using Particle-Particle-Particle Mesh method. This new model is applied to investigate the electrophoretic mobility of a charged colloid under an external electric field, and the influence of salt concentration and colloid charge are systematically studied. The simulation results show good agreement with predictions from the electrokinetic theory.Comment: 17 pages, 8 figures, submitted to the proceedings of High Performance Computing in Science & Engineering '1

Efficacy and safety of telithromycin 800 mg once daily for 7 days in community-acquired pneumonia: an open-label, multicenter study

BACKGROUND: Community-acquired pneumonia (CAP) remains a major cause of morbidity and mortality throughout the world. Telithromycin (a new ketolide) has shown good in vitro activity against the key causative pathogens of CAP, including S pneumoniae resistant to penicillin and/or macrolides. METHODS: The efficacy and safety of telithromycin 800 mg orally once daily for 7 days in the treatment of CAP were assessed in an open-label, multicenter study of 442 adults. RESULTS: Of 149 microbiologically evaluable patients, 57 (9 bacteremic) had Streptococcus pneumoniae. Of the 57 S pneumoniae pathogens isolated in these patients, 9 (2 bacteremic) were penicillin- or erythromycin-resistant; all 57 were susceptible to telithromycin and were eradicated. Other pathogens and their eradication rates were: Haemophilus influenzae (96%), Moraxella catarrhalis (100%), Staphylococcus aureus (80%), and Legionella spp. (100%). The overall bacteriologic eradication rate was 91.9%. Of the 357 clinically evaluable patients, clinical cure was achieved in 332 (93%). In the 430 patients evaluable for safety, the most common drug-related adverse events were diarrhea (8.1%) and nausea (5.8%). CONCLUSION: Telithromycin 800 mg once daily for 7 days is an effective and well-tolerated oral monotherapy and offers a new treatment option for CAP patients, including those with resistant S pneumoniae

Klinische Bedeutung der Bestimmung der Bindung von Trijodthyronin an Serumproteine mittels Dextran-Gel-Filtration

Neben den bewährten älteren Verfahren zur Bestimmung des proteingebundenen127Jods und des Radiojodumsatzes hat sich die gleichzeitige Bestimmung des sog. freien und des proteingebundenen Anteils an in vitro mit Serum inkubiertem L-Trijodthyronin-131Jod mittels Dextran-Gel-Filtration klinisch zur Differentialdiagnose von Hyperthyreose und Euthyreose bewährt. Bei Ausnützung der Verdrängung von proteingebundenem L-Trijodthyronin-131Jod durch nichtmarkiertes Hormon und bei Variation der Dextran-Gel-Menge in der Säule bietet die Methode gute Differenzierungsmöglichkeiten auch für die Schilddrüsenfunktionszustände Euthyreose und Hypothyreose. Bei dem Verfahren wird der Patient nicht mit radioaktivem Jod belastet, ein für die Kinderklinik wichtiger Gesichtspunkt. Manche Störfaktoren, die den131Jodspeicherungstest und die Bestimmung des proteingebundenen Jods (PB127I) verfälschen, haben keinen Einfluß auf die mit der Dextran-Gel-Filtration untersuchten Proteinbindungsverhältnisse für L-Trijodthyronin-131Jod. So hat sich das Verfahren für die Untersuchung von Patienten mit operativ oder durch131Jodbehandlung verkleinerten Schilddrüsen, mit endokrinem Exophthalmus und in Fällen mit vorausgegangener Jodgabe, z. B. in Form von Kontrastmitteln, besonders bewährt. Mit der Bestimmung des sog. freien L-Trijodthyronin-131Jods wird ein physiologisch und pathogenetisch wichtiger Parameter der Schilddrüsenfunktion ermittelt. Die klinische Bedeutung der Bestimmung der Bindungs-und Transportverhältnisse für Trijodthyronin mittels Dextran-Gel-Filtration wird diskutiert.In addition to conventional methods of assay of protein bound iodine (PB127I) and of131iodine turnover in the thyroid, the simultaneous determination of socalled free and protein bound 1-triiodothyronine-131I, added in vitro to serum, using dextran gel filtration was found to be clinically helpful for diagnosis of euthyroidism and hyperthyroidism. Employing discharge effects of non-labelled triiodothyronine on protein bound 1-triiodothyronine-131I and varying the amount of dextran gel in the columns, the method provides reasonably good differentiation of euthyroid and hypothyroid states. No radioactive iodine is given to patients during this procedure, a fact of importance for pediatriciens. Some factors, that influence131iodine uptake or PB127I levels, do not disturb protein binding of 1-triiodothyronine-131I as determined by dextran gel filtration. The latter method was found to be especially useful for the examination of patients with surgically, or by therapy with131iodine dissected thyroid glands, with endocrine exophthalmos, and in cases of previous iodine administration (e.g. X-ray procedures). Determination of socalled free 1-triiodothyronine-131I provides information about a factor of physiological and pathogenetical significance, its clinical meaning is discussed