Medication adherence among Turkish type-2 diabetics in Belgium: results from a qualitative study

Abstract title: Medication adherence among Turkish type-2 diabetics in Belgium: results from a qualitative study. Aim: Prevalence of diabetes in Belgium is 2 to 3 times higher among people from Turkish descent. Medication adherence, an essential element of the diabetic regimen, appears to be lower among nonwhite ethnic groups. This study identifies factors influencing medication adherence among Turkish type-2 diabetics living in Belgium. Methods: Since this topic hasn’t been studied before we conducted an explorative, qualitative study using semi-structured in-depth interviews with the aid of an interpreter. The topicslist was based on insights from the literature and conversations with Turkish diabetics and health care workers and was slightly adjusted after the first interviews. 21 Turkish type-2 diabetics living in Belgium were selected using theoretical sampling. Respondent’s most recent HbA1c-values were also collected. Interviews lasted between 2 and 5 hours, were audio-taped, fully transcribed and translated. Thematic analysis was conducted by the first two authors with different educational backgrounds (sociologist/pharmacist). The first phase was a detailed, thematic analysis of the individual cases, in the second phase an analysis across cases, distinguishing adherers from non-adherers, identified factors influencing medication adherence. NVivo 8 was used for managing, coding and analysing the qualitative data. Results: Factors influencing medication adherence among type-2 diabetics from Turkish descent include knowledge of and attitudes towards diabetes and antidiabetics, health and medication beliefs, social support from health care providers and family members, the nature of the patient-provider relationship, perceptions of health care worker’s expertise and social roles in daily life. A typology was constructed identifying different constellations of factors that distinguish adherers from non-adherers. Implications for clinical practice are discussed. Conclusion: This qualitative study identifies factors influencing medication adherence among type-2 Turkish diabetics living in Belgium and provides a typology, distinguishing adherers from non-adherers, that may guide clinical practice. Results from this qualitative study will be tested in a future, quantitative study

Medication adherence among Turkish type-2 diabetics in Belgium: results from a qualitative study

Abstract title: Medication adherence among Turkish type-2 diabetics in Belgium: results from a qualitative study. Aim: Prevalence of diabetes in Belgium is 2 to 3 times higher among people from Turkish descent. Medication adherence, an essential element of the diabetic regimen, appears to be lower among nonwhite ethnic groups. This study identifies factors influencing medication adherence among Turkish type-2 diabetics living in Belgium. Methods: Since this topic hasn’t been studied before we conducted an explorative, qualitative study using semi-structured in-depth interviews with the aid of an interpreter. The topicslist was based on insights from the literature and conversations with Turkish diabetics and health care workers and was slightly adjusted after the first interviews. 21 Turkish type-2 diabetics living in Belgium were selected using theoretical sampling. Respondent’s most recent HbA1c-values were also collected. Interviews lasted between 2 and 5 hours, were audio-taped, fully transcribed and translated. Thematic analysis was conducted by the first two authors with different educational backgrounds (sociologist/pharmacist). The first phase was a detailed, thematic analysis of the individual cases, in the second phase an analysis across cases, distinguishing adherers from non-adherers, identified factors influencing medication adherence. NVivo 8 was used for managing, coding and analysing the qualitative data. Results: Factors influencing medication adherence among type-2 diabetics from Turkish descent include knowledge of and attitudes towards diabetes and antidiabetics, health and medication beliefs, social support from health care providers and family members, the nature of the patient-provider relationship, perceptions of health care worker’s expertise and social roles in daily life. A typology was constructed identifying different constellations of factors that distinguish adherers from non-adherers. Implications for clinical practice are discussed. Conclusion: This qualitative study identifies factors influencing medication adherence among type-2 Turkish diabetics living in Belgium and provides a typology, distinguishing adherers from non-adherers, that may guide clinical practice. Results from this qualitative study will be tested in a future, quantitative study

Multicomponent Electron-Hole Superfluidity and the BCS-BEC Crossover in Double Bilayer Graphene

Superfluidity in coupled electron-hole sheets of bilayer graphene is predicted here to be multicomponent because of the conduction and valence bands. We investigate the superfluid crossover properties as functions of the tunable carrier densities and the tunable energy band gap E_g. For small band gaps there is a significant boost in the two superfluid gaps, but the interaction-driven excitations from the valence to the conduction band can weaken the superfluidity, even blocking the system from entering the Bose-Einstein condensate (BEC) regime at low densities. At a given larger density, a band gap E_g∼80-120  meV can carry the system into the strong-pairing multiband BCS-BEC crossover regime, the optimal range for realization of high-T_c superfluidity

A doping-dependent switch from one- to two-component superfluidity at temperature above 100K in coupled electron-hole Van der Waals heterostructures

The hunt for high temperature superfluidity has received new impetus from the discovery of atomically thin stable materials. Electron-hole superfluidity in coupled MoSe2-WSe2 monolayers is investigated using a mean-field multiband model that includes the band splitting caused by the strong spin-orbit coupling. The splitting leads to a large energy misalignment of the electron and hole bands which can be markedly changed by interchanging the doping of the monolayers. The choice of doping determines if the superfluidity is tuneable from one- to two-components. The electron-hole pairing is strong, with high transition temperatures in excess of 100 K

Chester supersolid of spatially indirect excitons in double-layer semiconductor heterostructures

A supersolid, a counter-intuitive quantum state in which a rigid lattice of particles flows without resistance, has to date not been unambiguously realised. Here we reveal a supersolid ground state of excitons in a double-layer semiconductor heterostructure over a wide range of layer separations outside the focus of recent experiments. This supersolid conforms to the original Chester supersolid with one exciton per supersolid site, as distinct from the alternative version reported in cold-atom systems of a periodic modulation of the superfluid density. We provide the phase diagram augmented by the supersolid. This new phase appears at layer separations much smaller than the predicted exciton normal solid, and it persists up to a solid--solid transition where the quantum phase coherence collapses. The ranges of layer separations and exciton densities in our phase diagram are well within reach of the current experimental capabilities

Flattening conduction and valence bands for interlayer excitons in a moir\'e MoS2_2/WSe2_2 heterobilayer

We explore the flatness of conduction and valence bands of interlayer excitons in MoS$_2$/WSe$_2$ van der Waals heterobilayers, tuned by interlayer twist angle, pressure, and external electric field. We employ an efficient continuum model where the moir\'e pattern from lattice mismatch and/or twisting is represented by an equivalent mesoscopic periodic potential. We demonstrate that the mismatch moir\'e potential is too weak to produce significant flattening. Moreover, we draw attention to the fact that the quasi-particle effective masses around the $\Gamma$-point and the band flattening are \textit{reduced} with twisting. As an alternative approach, we show (i) that reducing the interlayer distance by uniform vertical pressure can significantly increase the effective mass of the moir\'e hole, and (ii) that the moir\'e depth and its band flattening effects are strongly enhanced by accessible electric gating fields perpendicular to the heterobilayer, with resulting electron and hole effective masses increased by more than an order of magnitude leading to record-flat bands. These findings impose boundaries on the commonly generalized benefits of moir\'e twistronics, while also revealing alternate feasible routes to achieve truly flat electron and hole bands to carry us to strongly correlated excitonic phenomena on demand

Experimental conditions for observation of electron-hole superfluidity in GaAs heterostructures

The experimental parameter ranges needed to generate superfluidity in optical and drag experiments in GaAs double quantum wells are determined, using a formalism that includes self-consistent screening of the Coulomb pairing interaction in the presence of the superfluid. The very different electron and hole masses in GaAs make this a particularly interesting system for superfluidity, with exotic superfluid phases predicted in the BCS-BEC crossover regime. We find that the density and temperature ranges for superfluidity cover the range for which optical experiments have observed indications of superfluidity, but that existing drag experiments lie outside the superfluid range. However we also show that for samples with low mobility with no macroscopically connected superfluidity, if the superfluidity survived in randomly distributed localized pockets, standard quantum capacitance measurements could detect these pockets.Comment: 7 pages, 4 figure

Real-time clinical clutter reduction in combined epi-optoacoustic and ultrasound imaging

Flexible imaging of the human body, a requirement for broad clinical application, is obtained by direct integration of optoacoustic (OA) imaging with echo ultrasound (US) in a multimodal epi-illumination system. Up to date, successful deep epi-OA imaging is difficult to achieve owing to clutter. Clutter signals arise from optical absorption in the region of tissue irradiation and strongly reduce contrast and imaging depth. Recently, we developed a displacement-compensated averaging (DCA) technique for clutter reduction based on the clutter decorrelation that occurs when palpating the tissue. To gain first clinical experience on the practical value of DCA, we implemented this technique in a combined clinical OA and US imaging system. Our experience with freehand scanning of human volunteers reveals that real-time feedback on the clutter-reduction outcome is a key factor for achieving superior contrast and imaging dept