Side Effect Information and the Influence on Patient Medicine-Taking Behaviour

Lack of patient adherence with medication results in health care costs and adverse clinical outcomes. Although fear of side effects can contribute to non-adherence, being informed about them can actually improve matters. Nonetheless, questions persist as to the most efficient way to convey that type of information to patients for a given medication. Information on side effects is largely limited to a simple list in medication leaflets, often without frequency data (that is, lacking detail as to how often they might occur). The decision-making literature suggests that the interpretation of information varies depending on the presentation format or the frame used. This study examined the impact of providing numerical information for side effect frequency, levels of illness severity, and side effect framing on the likelihood of taking an OTC medicine. Participants received a headache scenario with three drug options (X, Y and Z) to consider for use. These painkillers had three levels of potency (defined as 50, 75, and 100% effective) and were accompanied with three levels of side effects (two, four, and six items). When considering their drug choice for the headaches, participants received drug information written without side effect frequency data, then again with side effect frequency data. Subjects rated their likelihood of taking Drug X, Y and Z on a scale of 1 (very unlikely) to 100 (very likely). Participants were also asked to show their likelihood of taking a different set of two medications for headaches (coined Drug N and P) based on positively-slanted or negatively-slanted wording in relation to chances of experiencing a side effect (heartburn). Thirty subjects from Saskatoon over 50 years of age participated. The average age was 66.6 years and 63.3 percent of participants were female. Less than half of participants (n=11) had previous experience with side effects. Most participants were using at least one medicine (whether OTC or prescribed) and described themselves as knowledgeable or somewhat knowledgeable. Participants were more likely to take the hypothetical drugs in the situations described when they received frequency data for side effects (

The Effect of Transformational Leadership on Employees' Attitude by Considering the Mediating Role of Psychological Empowerment (Case Study: Municipality of Karaj, Region 1)

This research was conducted to investigate the relation between transformational leadership and staff's attitudes with consideration of the mediating role in psychological empowerment. The purpose was applied type and the method used in this research was descriptive-survey. To collect the relevant data in this study, Sung's staff attitude standard questionnaire (2006), Bass & Alluvium's Transformational Leadership Questionnaire (2000) and Spreitzer's Psychological Capital Questionnaire (1998) were used. The reliability of each questionnaire was 0.786.0.802 and 0.799, respectively. The population studied was the staff and managers of the municipality in Region 1, Karaj with 280 persons. Regarding to their limited number, 162 individuals were selected randomly to determine the sample size using the Morgan table and the questionnaire was distributed among these individuals. To collect the information and data required to evaluate the research's hypotheses, a questionnaire and statistical analysis software as SPSS and LISREL were evaluated. At the inferential level, inferential techniques such as Kolmogorov-Smirnov's normal test, Pearson correlation test, and structural equation modeling were used to test the hypotheses. Based on the results, the studied hypotheses were accepted

Idiopathic Uveitis and Familial Mediterranean Fever: Is There Any Relationship?

Introduction. Familial Mediterranean fever (FMF) is an auto-inflammatory disease characterized by attacks of fever and polyserositis. FMF is often associated with other autoimmune diseases such as rheumatoid arthritis, polyarteritis nodosa (PAN), and Behcet. Uveitis is an inflammatory process caused by underlying infectious and inflammatory disorders. This study investigates the probable relationship between idiopathic uveitis and FMF. Methods. Patients with idiopathic uveitis were analyzed for the 12 most common MEFV mutations (P369S, F479L, M680I(G/C), M680I(G/A), I692del, M694V, M694I, K695R, V726A, A744S, R761H, E148Q) by a reverse hybridization assay (FMF StripAssay,Vienna lab,Vienna, Austria). Results. 12 patients with idiopathic uveitis were enrolled in this study. 10 of them were female. The youngest patient was a 7-year-old child and the oldest was 57. The most common complaints of patients were blurred vision and then eye redness. One patient was heterozygous for R761H. Genetic analysis of the 12 most common MEFV mutations in the patients with idiopathic uveitis didnot have any positive results. Conclusion. According to the analysis of the 12 most common MEFV gene mutations, FMF is not an underlying cause of idiopathic uveitis. On the other hand, uveitis merely could not be the first presentation of FMF

Acidification of In-Storage Psychrophilic Anaerobic Digestion (ISPAD) Content to Reduce Ammonia Volatilization

In-storage-psychrophilic-anaerobic-digestion (ISPAD) is a treatment system applicable to wastewaters stored for a period of over 100 days, such as livestock wastes and municipal sludge. The ISPAD system consists of a storage tank covered by an airtight geo-membrane, filled as a sequentially batch fed system and emptied when full except for a 0.3 m depth to inoculate the next batch. Thus, ISPAD operates at a temperature fluctuating with ambient, and its microbial community is acclimated to low temperatures. Taking advantage of existing structures and requiring little technical supervision because of its low operating temperatures, ISPAD is an anaerobic digestion (AD) system feasibly accessible to operations producing limited amount of organic wastewaters. Since ISPAD operates under conditions which are totally different as compared to conventional AD reactors, optimal management practices need to be developed through microbial kinetic estimation and process modelling. The first objective was to evaluate the microbial behaviour of the ISPAD system by estimating its kinetic coefficients. The second and third objectives were to develop and validate a mathematical model to simulate the ISPAD process, such as the volatile fatty acid (VFA) concentration and pH of its content and its CH4 production, based on its specific microbial kinetics. The final project objective was to predict and experimentally test conditions which lead to ISPAD content acidification to limit ammonia (NH3) volatilization from the digestate. The first part of the project consisted of determining microbial kinetic values by fitting the Monod model to results obtained from laboratory substrate activity test (SAT) using ISPAD inoculum and for temperatures of 8, 18 and 35 ºC. The fitting process consisted of: applying the decomposition principle to prioritize the determination of kinetic parameters, and then using the statistical least square error procedure to minimize the sum of squared errors between the measured ISPAD experimental data and the Monod model results. The results produce microbial kinetic values specific to the ISPAD system and associated with two groups of microbial population, one acclimated to cold and another to the mesophilic conditions. The second part of the project consisted of developing a mathematical model based on that of Keshtkar et al. (2001). Simulation of ISPAD was achieved using the Simulink/Matlab software to predict glucose, VFAs degradation, pH and CH4 production. To predict the pH of the ISPAD content, a function was introduced based on optimized dissociation constants () for the major ions found in organic wastewaters under AD. Finally, a temperature function was added for most kinetic values to simulate the ISPAD process for temperatures ranging from 4 to 35 ºC. For this purpose, the Arrhenius and Square-Root Equations were compared. For the maximum microbial growth rate (), the Square Root Equation better represented acidogens and propionate degrading acetogens, while the Arrhenius Equation better represented the methanogens and butyrate degrading acetogens. The model was calibrated using experimental data, where ISPAD content and glucose was used as inoculum and substrate, respectively. The proposed model showed good agreement with the experimental data in predicting biogas generation, substrate consumption and pH at a temperature range of 4 to 35 ºC. Although microbial activity at 4 °C was much less than that at 18 and 35 ºC, it showed acclimation to lower temperature. The third part of the project validated the ISPAD model using condition, which differed from those used for calibration, such as a different concentration of substrate. The model accuracy was checked mathematically by determining the coefficient of determination. The ISPAD model was able to predict glucose degradation, VFAs, pH, and methane. However, the model weakly predicts CO2 production for the first 2 days likely because of its water solubility. The final portion of the method dealt with ISPAD content acidification, to reduce NH3 volatilization from the digestate upon removal from the system. Acidification was based on quickly increasing the sequential organic load (OL), under specific temperatures to favour acidogen growth and VFA accumulation. A mathematical equation was applied to the ISPAD model to optimize different OL strategies, where glucose was fed to simulate the hydrolysis of sugar rich wastes. By comparing with laboratory experiments, ISPAD model prediction was found adequate in selecting optimal acidification OL strategies, but did not predict accumulation of intermediate substrates, which produced a lag in pH drop, and generates a pH drop below 6.0, because of set values for its pH inhibition function. Nevertheless, sequentially feeding 13 kg glucose/m3 of ISPAD content over 4 days was found to drop the pH of the ISPAD content to 6.0 by day 7. Such OL competes favorably against present acidification techniques such as that using concentrated sulfuric acid. The contribution to knowledge of this work was introducing the decomposition method to determine AD microbial kinetics; for ISPAD, establishing microbial kinetics, ion dissociation constants for pH prediction, and parameter variation with temperature producing an accurate model to predict and optimize the ISPAD process, and determination of sequential OL strategies to feasibly acidify the ISPAD content to lower NH3 volatilization from its digestate upon system removal

Fracture Resistance of Premolars Restored by Various Types and Placement Techniques of Resin Composites

To verify the fracture resistance of premolars with mesioocclusodistal preparations restored by different resin composites and placement techniques. Sixty premolars were randomly divided into two groups based on type of composite resin: Filtek P60 or Nulite F, and then each group was separated into three subgroups: bulk, centripetal, and fiber insert according to the type of placement method (n = 10). Single-bond adhesive system was used as composite bonding according to the manufacturer's instructions. Specimens were restored in Groups 1, 2, and 3 with Filtek P60 and in Groups 4, 5, and 6 with Nulite F. After being stored 24 hours at 37°C, a 4 mm diameter steel sphere in a universal testing machine was applied on tooth buccal and lingual cusps at a cross-head speed of 5 mm/min until fracture occurred. Groups 3 and 6 showed higher fracture resistance than Groups 1, 2, 4, and 5. Among the placement techniques, the fiber insert method had a significant effect, but the type of composite was ineffective. The insertion technique in contrast to the type of material had a significant influence on the fracture resistance of premolar teeth

Men's Health Week in Iran; the Discrepancy between Experts and the General Population for Educational Priorities

Introduction: With the obsoletion of the paternalistic model of the doctor-patient relationship, considering public opinion regarding healthcare policymaking seems to be of great necessity. The present study was conducted to determine the educational priorities of male urology specialists and the general male population concerning urological diseases. Materials and methods: In this cross-sectional survey study, 400 male urologists and 400 men from the general population were assessed. Our investigation was carried out using a seven-item questionnaire covering the most important urological conditions. Respondents gathered from all over Iran through the 22nd Congress of Iranian Urological Association (IUA) and street surveys. Results: The mean age of the participants was 40.69 ± 13.23. The mean age for the general population and urologists was 35.8 ± 13.7 and 45.6 ± 10.6 years, respectively (P=0.0001). 56.8% of the respondents from the general population had a university degree. Overall, erectile dysfunction and sexually transmitted diseases (STDs) were the most mentioned diseases as an educational priority (40.1%). Chronic prostatitis was also the least mentioned condition as an educational priority in both groups and overall among all the participants ‎ (20.9%). A significant difference was observed between the general population and urologists in all the examined conditions (P<0.05).  Conclusion: This study indicated the differences among the educational priorities of the general male population and male urologists, and the necessity to make these two points of view closer and to involve the opinion of general population in decision making for men’s health week educational topics. &nbsp

SVR Algorithm as a Tool for More Optimal Intergalactic Medium Simulation in the Epoch of Reionization

All kinds of simulations of the intergalactic medium, such as hydrodynamic simulation, N-body simulation, numerical and semi-numerical simulation, etc., have been used to realize the history of this medium. One of these simulations is 21SSD, which is specifically focused on the epoch of reionization. This simulation deepens our understanding of the physics behind the intergalactic medium by considering the free parameters related to the Wouthuysen-Field coupling fluctuations and X-ray and Lyman line transfers in the intergalactic medium, and by presenting the plots of the power spectrum, brightness temperature, etc. in different redshifts. However, due to many physical phenomena that play significant roles in this epoch, simulations of the intergalactic medium are usually extremely complex, time-consuming, and require very powerful hardware. In this work, by using the Support Vector Regression algorithm and based on the 21SSD simulation datasets, we have tried to make the machine fully understand the brightness temperature changes in terms of redshift for different astrophysical free parameters values. At first, we trained the machine with the results of the 21SSD simulation. Then, the machine was able to predict the brightness temperature in terms of redshift with very high accuracy for other interval coefficients. Although we have used this algorithm to estimate the brightness temperature, it seems that this algorithm can be easily used for other parts of cosmology and astrophysics. With its help, it is possible to save time and obtain results with extraordinary accuracy similar to complex simulations, even with normal hardware