Crystallisation of Aspirin via Simulated Pulmonary Surfactant Monolayers and Lung-Specific Additives

Pain is a prevalent condition that can have a serious impact upon the socioeconomic function of a population. Numerous methods exist to administer analgesic medication (e.g. aspirin) to the body however inherent drawbacks limit patient acceptability. The inhaled route offers promise to facilitate the administration of medication to the body. Here, we consider the crystallisation behaviour of aspirin, our model therapeutic agent, when in contact with material of relevance to the lung. Thus, our approach aims to better understand the interaction between drug substances and the respiratory tract. Langmuir monolayers composed of a mixed surfactant system were supported on an aqueous subphase containing aspirin (7.5mg/ml). The surfactant film was compressed to either 5mN/m (i.e. inhalation end point) or 50mN/m (i.e. exhalation end point), whilst located within a humid environment for 16 hours. Standard cooling crystallisation procedures were employed to produce control samples. Antisolvent crystallisation in the presence or absence of lung-specific additives was conducted. All samples were analysed via scanning electron microscopy (SEM) and X-ray diffraction (XRD). Drug-surfactant interactions were confirmed via condensed Langmuir isotherms. SEM analysis revealed plate-like morphology. The crystallisation route dictated both the crystal habit and particle size distribution. Dominant reflections were the (100) and (200) aspects. The main modes of interaction were hydrogen bonding, hydrophobic associations and van der Waals forces. Here, we have demonstrated the potential of antisolvent crystallisation with lung-specific additives to achieve control over drug crystal morphology. The approach taken can be applied in respirable formulation engineering

Impacts of yeast metabolic network structure on enzyme evolution

Vitkup et al. recently presented an analysis of the influence of yeast metabolic network structure on enzyme evolution; different conclusions are reached when modularity is properly accounted for

A national cross-sectional survey of the attitudes, skills and use of evidence-based practice amongst Spanish osteopaths

Background Although evidence-based practice (EBP) is largely supported across healthcare professions, its implementation in manual therapy professions such as osteopathy remains limited and debated. There is currently little knowledge of how Spanish osteopaths relate to EBP. Objectives The main aim of this study was to investigate the attitudes, skills and use of EBP among Spanish osteopaths. A secondary aim was to identify barriers and facilitators for the adoption of EBP in the Spanish osteopathic context. Methods National cross-sectional survey of Spanish osteopaths registered and non-registered to an osteopathic association in Spain. Eligible participants were invited by a range of recruitment strategies including email and social media campaigns to complete the Spanish-translated Evidence-Based practice Attitude and utilization Survey (EBASE) anonymously online. Results A total of 567 osteopaths completed the survey which represents an approximate response rate of 9%. Participant’s attitudes toward EBP were largely positive. Most respondents agreed or strongly agreed that EBP was necessary in the practice of osteopathy (89.6%) and that professional literature and research findings were useful to their day-to-day practice (88.9%). Levels of perceived skill in EBP were reported as low to moderate with lowest levels for items related to ‘research conduct’. Except reading/reviewing professional literature and using online search engines to find practice-related literature, participant engagement in all other EBP-related activities was generally infrequent. The perceived proportion of clinical practice that was based on clinical research evidence was reported to be very small. Main barriers to EBP uptake included a lack of clinical evidence in osteopathy and insufficient skills for applying research findings. Main facilitators of EBP uptake included access to full-text articles, internet at the workplace and online databases. Conclusions Spanish osteopaths were largely supportive of evidence-based practice, had low to moderate skills in EBP and engaged in EBP activities infrequently. Formal regulation of the profession in Spain and the inclusion of osteopathic programs into the university sector would potentially improve EBP skills and use

Spin-orbit hybrid entanglement of photons and quantum contextuality

We demonstrate electromagnetic quantum states of single photons and of correlated photon pairs exhibiting "hybrid" entanglement between spin and orbital angular momentum. These states are obtained from entangled photon pairs emitted by spontaneous parametric down conversion, by employing a $q$-plate for coupling the spin and orbital degrees of freedom of a photon. Entanglement and contextual quantum behavior (that is also non-local, in the case of photon pairs) is demonstrated by the reported violation of the Clauser-Horne-Shimony-Holt inequality. In addition a classical analog of the hybrid spin-orbit photonic entanglement is reported and discussed.Comment: 5 pages, 3 figure

Conventional and complementary health care use and out-of-pocket expenses among Australians with a self-reported mental health diagnosis: a cross-sectional survey.

BACKGROUND: Mental health disorders are a global health concern. In Australia, numerous national reports have found that the current mental healthcare system does not adequately meet the needs of Australians with mental illness. Consequently, a greater understanding of how people with a mental health disorder are using the broader healthcare system is needed. The aim of this paper is to explore conventional and complementary health care use and expenditure among Australian adults reporting a mental health disorder diagnosis. METHODS: A cross-sectional online survey of 2,019 Australian adults examined socio-demographic characteristics, complementary and conventional health care use and the health status of participants. RESULTS: 32 % (n = 641) of the total sample (N = 2019) reported a mental health disorder in the previous 3 years. Of these, 96 % reported consulting a general practitioner, 90.6 % reported using prescription medicines, 42.4 % consulted a complementary medicine practitioner, 56.9 % used a complementary medicine product and 23 % used a complementary medicine practice. The estimated 12-month out-of-pocket health care expenditure among Australians with a mental health disorder was AUD$4,568,267,421 (US$ 3,398,293,672) for conventional health care practitioners and medicines, and AUD$1,183,752,486 (US$ 880,729,891) for complementary medicine practitioners, products and practices. Older people (50-59 and 60 and over) were less likely to consult a CM practitioner (OR = 0.538, 95% CI [0.373, 0.775]; OR = 0.398, 95% CI [0.273, 0.581] respectively) or a psychologist/counsellor (OR = 0.394, 95% CI [0.243, 0.639]; OR = 0.267, 95% CI [0.160, 0.447] respectively). People either looking for work or not in the workforce were less likely to visit a CM practitioner (OR = 0.298, 95% CI [0.194, 0.458]; OR = 0.476, 95% CI [0.353, 0.642], respectively). CONCLUSIONS: A substantial proportion of Australian adults living with a mental health disorder pay for both complementary and conventional health care directly out-of-pocket. This finding suggests improved coordination of healthcare services is needed for individuals living with a mental health disorder. Research examining the redesign of primary health care provision should also consider whether complementary medicine practitioners and/or integrative health care service delivery models could play a role in addressing risks associated with complementary medicine use and the unmet needs of people living with a mental health disorder

Attitudes, skills and use of evidence-based practice among UK osteopaths: A national cross-sectional survey

© 2018 The Author(s). Background: Evidence-based practice (EBP) is a clinical decision-making framework that supports quality improvement in healthcare. While osteopaths are key providers of musculoskeletal healthcare, the extent to which osteopaths engage in EBP is unclear. Thus, the aim of this cross-sectional study was to investigate UK osteopaths' attitudes, skills and use of EBP, and perceived barriers and facilitators of EBP uptake. Methods: UK-registered osteopaths were invited to complete the Evidence-Based Practice Attitude and Utilisation Survey (EBASE) online. Results: Of the 5200 registered osteopaths in the UK, 9.9% (517/5200) responded to the invitation, and 7.2% (375/5200) completed the EBASE (< 20% incomplete answers). The demographic characteristics of the survey sample were largely similar to those of the UK osteopathy workforce. The osteopaths reported overall positive attitudes towards EBP, with most agreeing that EBP improves the quality of patient care (69.3%) and is necessary for osteopathy practice (76.5%). The majority reported moderate-level skills in EBP, and most (80.8%) were interested in improving these skills. Participating osteopaths typically engaged in EBP activities 1-5 times over the last month. Barriers to EBP uptake included a lack of time and clinical evidence in osteopathy. Main facilitators of EBP included having access to online databases, internet at work, full-text articles, and EBP education materials. Conclusions: UK osteopaths were generally supportive of evidence-based practice, had moderate-level skills in EBP and engaged in EBP activities infrequently. The development of effective interventions that improve osteopaths' skills and the incorporation of EBP into clinical practice should be the focus of future research

Transitioning to practice: a qualitative investigation of Australian graduate naturopath's experiences of being in practice.

BACKGROUND: The transition from student to practitioner can be challenging, resulting in stress, burnout and attrition. While there has been ample research examining graduate medical and allied health practitioner experiences of transitioning to practice, there is a paucity of research exploring such experiences in newly qualified naturopathic medicine practitioners. In light of this knowledge gap, the objective of this study was to ascertain the experiences of practicing as a naturopath in Australia within the first 5 years post-graduation. METHODS: Using a qualitative descriptive approach, recent graduates of an Australian Bachelor of Naturopathy (or equivalent) program were invited to participate in a semi-structured telephone interview to address the study objective. Data were analysed utilising a framework approach. RESULTS: A total of 19 new graduates (94.7% female; 57.9% aged 40-59 years) undertook an interview. Five inter-related themes emerged from the data: practitioner, practice, proprietorship, professions, and perceptions. Connected with these themes were contrasting feelings, multiplicity of duties, small business challenges, professional collaboration, and professional identity, respectively. CONCLUSIONS: Participants were generally content with their decision to become a naturopath. However, most were confronted by a range of challenges as they transitioned from graduate to practitioner, for which many felt ill-prepared. In light of the complexity of the issue, and the potential impact on the sustainability of the profession, it is evident that a multi-pronged, multi-stakeholder approach would be needed to better support graduate naturopath transition to practice

Development of a facial expression scale using footrot and mastitis as models of pain in sheep

Management of pain in sheep is limited by the challenges of recognising and accurately quantifying pain in this species. The use of facial expression scoring to assess pain is a well-utilised, practical tool in both humans and non-human animals. The objective of this study was to develop a standardised facial expression pain scale for adult sheep, that could be used reliably and accurately to detect pain associated with naturally occurring painful diseases, such as footrot and mastitis. We also investigated whether the scale could be reliably and accurately utilised by observers after training, enabling the development of an on-farm pain assessment tool. The Sheep Pain Facial Expression Scale (SPFES) was able to correctly identify sheep suffering from disease with a high degree of accuracy (AUC; Footrot: 0.81, Mastitis: 0.80). Diseased sheep scored higher on the scale than controls on the day of disease identification (P<0.05) and diseased sheep showed changes in their facial expression after treatment (P<0.001). The abnormal facial expressions of diseased sheep reduced over time, and at recovery were in line with control sheep. Control sheep did not change their facial expression over time. Five scorers who were trained to use the developed scale also assessed the facial expressions of sheep. The scorers were blind to treatment and session. Scorers reliably (ICC: 0.86) and accurately (α = 0.86) identified changes in the facial expression of sheep with footrot over time (P<0.05), and scored control sheep consistently low over time. The SPFES offers a reliable and effective method of assessing pain in sheep after minimal training.We would like to thank the EU VII Framework Program (FP7-KBBE-2010-4) for funding this study as part of the AWIN project. Boehringer Imgelheim Ltd are thanked for providing the meloxicam used in this study.This is the author accepted manuscript. The final version is available from Elsevier via http://dx.doi.org/10.1016/j.applanim.2016.01.00

Evidence-Based Practice Attitudes, Skills, and Usage Among Canadian Naturopathic Doctors: A Summary of the Evidence and Directions for the Future

Evidence-based practice (EBP) is a framework aimed at facilitating the delivery of best practice care. Despite documented benefits, many health professionals have expressed concerns about EBP. Naturopathic medicine has been cited as being in opposition to EBP; however, this is not supported by the evidence. In a recent cross-sectional Canadian survey of naturopathic doctors, respondents self-reported a moderate to high use of EBP and use of a range of sources of evidence to guide clinical decisions. Evidence-based practice skill was reported to be moderately high, and attitudes were predominantly positive. These findings are consistent with other research undertaken on the topic which has identified a shift towards embracing EBP. Canadian naturopathic doctors have indicated a high level of interest in improving their EBP skills, and we present an upcoming opportunity for skill development.</jats:p

Differences between male and female consumers of complementary and alternative medicine in a national US population: A secondary analysis of 2012 NIHS data

© 2015 Yan Zhang et al. We examined the National Health Interview Survey (NHIS) 2012 to explore how US adult consumers of CAM differ by gender in terms of their sociodemographic characteristics, current health conditions, and perceived benefits of CAM. All individuals who completed the adults core interviews (N = 34,525) were included. CAM use, major sociodemographic variables, perceived benefits of using CAM, and top ten reported health conditions for which CAM was used were selected and analyzed by Stata. Findings revealed that 29.6% (n = 10,181) reported having used at least one form of CAM in the previous 12 months. Compared to male CAM users, female CAM users were more likely to have a bachelor degree, to be divorced/separated or widowed, and less likely to earn $75,000 or more. Back pain/problem was the most common problem reported by both male and female CAM users (32.2% and 22.6%, resp.). A higher proportion of female CAM users reported using CAM for perceived benefits such as general wellness or general disease prevention. This paper provides foundation information regarding gender differences in CAM use and is a platform for further in-depth examination into how and why males and females differ in their reasons for CAM use