A pilot study of a text messaging intervention to modify illness and medication beliefs amongst patients diagnosed with inflammatory bowel disease

Intentional and unintentional medication non-adherence is a particular challenge for patients with inflammatory bowel disease (IBD). Non-adherence can affect patients’ quality of life, which can result in unfavorable treatment outcomes, more hospitalizations, and higher healthcare-related costs. The purpose of this study was to assess whether a tailored text message intervention designed to modify illness and medication adherence beliefs in patients with IBD would increase treatment compliance and change patients’ illness perceptions and medication concerns. This pilot study utilized a pre-test-post-test non-randomized design. A sample of 32 IBD patients was recruited within the UK. Participants’ medication beliefs and illness perception scores determined the set of tailored daily text messages, which were sent to patients over duration of 12 weeks. Medication adherence increased post-intervention, as “forgetting to take medication” decreased while “never” forgetting to take medication increased over time. A significant increase in treatment control and coherence and a decreased level of concern surrounding their condition was evident. Participants’ level of concern towards their medications changed during the 12 weeks, with a baseline mean concern score of 3.08 (.57) in comparison to the 12 weeks mean concern score of 2.89 (.59), which is statistically different, t (31) = 2.16, p < .038, r = .36 (medium effect). Sixty-six percent of participants from the baseline were aware of the necessity of their medication: “without my medication I would become ill.” The results have direct implications for improving medication adherence and changing illness and medication beliefs. This study validated the benefits of text messages and highlighted the importance of addressing these beliefs in order to understand the reasons for non-adherence fully

Screening for anti-methicillin resistant Staphylococcus aureus (MRSA) bacteriocin producing bacteria

Methicillin resistant bacterial infections give a tough challenge in the selection of antibiotics. Traditional use of antibiotics is worsening the problem day by day. So, it is essential to sort out other strategies which can replace antibiotic therapy successfully. Bacteriocins are the proteinaceous compounds with a narrower spectrum of antimicrobial activity but its use as antibiotic is not common. No one has ever tried to use it for the treatment of infections. Presently, we have isolated bacteriocin producing bacteria effective against methicillin resistant bacteria. It will help in controlling MRSA infections as well as provide a new strategy to treat reemerging infections

Episodic accretion in binary protostars emerging from self-gravitating solar mass cores

Observations show a large spread in the luminosities of young protostars, which are frequently explained in the context of episodic accretion. We here test this scenario using numerical simulations following the collapse of a solar mass molecular cloud using the GRADSPH code, varying the strength of the initial perturbations and the temperature of the cores. A specific emphasis of this paper is to investigate the role of binaries and multiple systems in the context of episodic accretion, and to compare their evolution to the evolution in isolated fragments. Our models form a variety of low mass protostellar objects including single, binary and triple systems with binaries more active in exhibiting episodic accretion than isolated protostars. We also find a general decreasing trend for the average mass accretion rate over time, suggesting that the majority of the protostellar mass is accreted within the first 10^5 years. This result can potentially help to explain the surprisingly low average luminosities in the majority of the protostellar population.Comment: 16 pages, 13 figures, 4 tables. Accepted for publication with A&

Value Focused Thinking for Nation Building in Afghanistan: A Regional Perspective

This thesis is an effort to mathematically model the nation building effort that is underway in Afghanistan. The thesis examines this nation building effort from the perspective of a local person who understands Afghan culture better than a foreigner. The thesis employs value-focused thinking to categorize the factors that we need to focus on for nation building in descending order of priority. This research adds a new dimension to the models already available in the literature and is likely to be more readily embraced by the local people who are sometimes in conflict with American priorities

Reconciliation, Restoration and Reconstruction of a Conflict Ridden Country

Conflict has sadly been a constant part of history. Winning a conflict and making a lasting peace are often not the same thing. While a peace treaty ends a conflict and often dictates terms from the winners’ perspective, it may not create a lasting peace. Short of unconditional surrender, modern conflict ends with a negotiated cessation of hostilities. Such accords may have some initial reconstruction agreements, but Reconciliation, Restoration and Reconstruction (RRR) is a long term process. This study maintains that to achieve a lasting peace: 1) The culture and beliefs of the conflict nation must be continuously considered and 2) RRR is a long term effort which will occur over years not just in the immediate wake of signing a treaty or agreement. To assure the inclusion of all stakeholders and gain the best results in dealing with this “wicked problem”, an array of Operations Research techniques can be used to support the long term planning and execution of a RRR effort. The final decisions will always be political, but the analysis provided by an OR support team will guide the decision makers to better execute consensus decisions that consider all stakeholder needs. The development of the value hierarchy framework in this dissertation is a keystone of building a rational OR supported long term plan for a successful RRR. The primary aim of the research is to propose a framework and associated set of guidelines derived from appropriate techniques of OR, Decision Analysis and Project Management (right from development of a consensus based value hierarchy to its implementation, feedback and steering corrections) that may be applied to help RRR efforts in any conflict ridden country across the globe. The framework is applicable to any conflict ridden country after incorporating changes particular to any country witnessing a prolonged conflict

Phenotypic and Molecular Characterization of Plasmid- Encoded Extended Spectrum Beta-Lactamases Produced by Escherichia coli and Klebsiella spp from Lahore, Pakistan

Purpose: To investigate the distribution of plasmid-encoded extended spectrum beta-lacatamases (ESBLs) in Lahore, Pakistan using different phenotypic and molecular methods.Methods: Escherichia coli and Klebsiella spp were obtained over a period of nineteen months (June 2007 to December 2008). Both were tested by the double disk synergy test, combined disk test and  Epsiometer-test (E-test) to evaluate their ability to detect ESBLs. The genotypes of ESBLs were analyzed by monoplex polymerase chain reaction (PCR), multiplex PCR, DNA sequencing and isoelectric focusing.Results: 662 E. coli and 153 Klebsiella spp were analyzed. Among these isolates, 39.3 % E. coli and 26.1 % Klebsiella spp were positive for extended spectrum beta-lactamases (ESBLs).71.9 % E. coli and 79.6 % Klebsiella spp showed minimum inhibitory concentration (MIC) in the range &gt; 32/0.064 = 500 μl/mL for cetatzidime/cetatzidime + clavulanic acid, while 66.5 % E. coli and 69.1 % Klebsiella spp revealed MIC in the range of &gt; 16/0.016 = 1000 μl/mL for cefotaxime/cefotaxime + clavulanic acid. Antibiotic susceptibility testing revealed that imipemem, meropenem and tazocine were the most effective in the management of such infections. The most frequent genotype of ESBL was OXA (19.2 %) for E. coli and SHV (92.5 %) for Klebsiella spp. The highest genotypic combination found was the combination of TEM/OXA (44.2 %) for E. coli.Conclusion: The resistance of E. coli and Klebsiella spp-producing ESBLs in Pakistan is a serious issue, and TEM, OXA and SHV type ESBL were the most common genotypes. Some isolates produced two or three genotypes at a time. Multiplex PCR of ESBL may help in early detection as well as phenotypic antibiotic therapy of these infections.Keywords: Beta-lactamases, Escherichia coli, Klebsiella spp, Antibiotic susceptibility,  Plasmidencoded, Structural genes, Imipemem, Meropenem, Tazocin

Antibiotic susceptibility pattern and multiple antibiotic resistances (MAR) calculation of extended spectrum β- lactamase (ESBL) producing Escherichia coli and Klebsiella species in Pakistan

The aim of this study was to check for the antibiotic susceptibility pattern and multiple antibiotic resistances (MAR) of extended spectrum β-lactamase (ESBL) producing Escherichia coli and Klebsiella species. All methods used in this study were according to the standard criteria of NCCLs. It was shown that there was high rate of resistance, which was alarming for health practitioners of Pakistan.Key words: Antibiotics, multiple antibiotic resistances (MAR), extended spectrum β-lactamase (ESBL)