Patients� experience of tuberculosis treatment using directly observed treatment, short-course (DOTS): A qualitative study

Background: Despite effective diagnosis and treatment, prevalence of tuberculosis (TB) is still growing. The directly observed treatment, short-course (DOTS) strategy to treat TB was introduced by the World Health Organization more than a decade ago. Little is known about patients� experience of TB treatment, according to DOTS, in Iran. Objectives: This study aimed to understand the patients� experience of tuberculosis treatment according to DOTS in Iran. Patients and Methods: This study is a qualitative study, using content analysis to examine patients� experience of TB treatment and to understand their compliance during DOTS. In this study, a semi-structured interview with open questions was answered by 40 patients, who had a diagnosis of pulmonary and extrapulmonary tuberculosis, and improved during the course of their treatment. The method of sampling was purposive sample and the interview process lasted until data saturation. Results: Data analysis resulted in the extraction of six themes, which reflect the experiences of the study participants. The themes are: 1) individual factors; 2) change of the attitudes and beliefs of patients on TB treatment; 3) support terms of patients with tuberculosis; 4) the role of health care professionals; 5) social factors and 6) the financial burden. Conclusions: Successful completion of TB treatment requires an effective partnership between the patient and health care professionals, and a harmony between the cultural context, attitude of the patient, family support and health literacy. Future health policies should address these issues to improve patients� adherence to DOTS. © 2015, Iranian Red Crescent Medical Journal

Patients� experience of tuberculosis treatment using directly observed treatment, short-course (DOTS): A qualitative study

Background: Despite effective diagnosis and treatment, prevalence of tuberculosis (TB) is still growing. The directly observed treatment, short-course (DOTS) strategy to treat TB was introduced by the World Health Organization more than a decade ago. Little is known about patients� experience of TB treatment, according to DOTS, in Iran. Objectives: This study aimed to understand the patients� experience of tuberculosis treatment according to DOTS in Iran. Patients and Methods: This study is a qualitative study, using content analysis to examine patients� experience of TB treatment and to understand their compliance during DOTS. In this study, a semi-structured interview with open questions was answered by 40 patients, who had a diagnosis of pulmonary and extrapulmonary tuberculosis, and improved during the course of their treatment. The method of sampling was purposive sample and the interview process lasted until data saturation. Results: Data analysis resulted in the extraction of six themes, which reflect the experiences of the study participants. The themes are: 1) individual factors; 2) change of the attitudes and beliefs of patients on TB treatment; 3) support terms of patients with tuberculosis; 4) the role of health care professionals; 5) social factors and 6) the financial burden. Conclusions: Successful completion of TB treatment requires an effective partnership between the patient and health care professionals, and a harmony between the cultural context, attitude of the patient, family support and health literacy. Future health policies should address these issues to improve patients� adherence to DOTS. © 2015, Iranian Red Crescent Medical Journal

Passive CO₂ removal in urban soils:evidence from brownfield sites

Management of urban brownfield land can contribute to significant removal of atmospheric CO2 through the development of soil carbonate minerals. However, the potential magnitude and stability of this carbon sink is poorly quantified as previous studies address a limited range of conditions and short durations. Furthermore, the suitability of carbonate-sequestering soils for construction has not been investigated. To address these issues we measured total inorganic carbon, permeability and ground strength in the top 20 cm of soil at 20 brownfield sites in northern England, between 2015 and 2017. Across all sites accumulation occurred at a rate of 1–16 t C ha−1 yr−1, as calcite (CaCO3), corresponding to removal of approximately 4–59 t CO2 ha−1 yr−1, with the highest rate in the first 15 years after demolition. C and O stable isotope analysis of calcite confirms the atmospheric origin of the measured inorganic carbon. Statistical modelling found that pH and the content of fine materials (combined silt and clay content) were the best predictors of the total inorganic carbon content of the samples. Measurement of permeability shows that sites with carbonated soils possess a similar risk of run-off or flooding to sandy soils. Soil strength, measured as in-situ bearing capacity, increased with carbonation. These results demonstrate that the management of urban brownfield land to retain fine material derived from concrete crushing on site following demolition will promote calcite precipitation in soils, and so offers an additional CO2 removal mechanism, with no detrimental effect on drainage and possible improvements in strength. Given the large area of brownfield land that is available for development, the contribution of this process to CO2 removal by urban soils needs to be recognised in CO2 mitigation policies

Taj Mahal – An Appraisal of Foundation Performance

Because of severe restrictions placed by the National Authority, no authentic data on subsoil details below Taj Mahal - a protected monument - is available. For the first time, an attempt has been made to fill in gaps that exist in our knowledge of subsoil profile below the structure and present a plausible appraisal of foundation performance during the existence of the structure. Since details of foundations cited in literature on Taj Mahal really fall into the realms of architectural conjecture, in the present analysis, engineering intuition and judgement have gone into making certain premises regarding the probable type, dimensions and the depth of the existing foundations of Taj Mahal. These premises, complimented by borehole data and laboratory tests have enabled the assessment of the foundation performance to be made in as realistic a manner as is practically possible

On the shopfloor: exploring the impact of teacher trade unions on school-based industrial relations

Teachers are highly unionised workers and their trade unions exert an important influence on the shaping and implementation of educational policy. Despite this importance there is relatively little analysis of the impact of teacher trade unions in educational management literature. Very little empirical research has sought to establish the impact of teacher unions at school level. In an era of devolved management and quasi-markets this omission is significant. New personnel issues continue to emerge at school level and this may well generate increased trade union activity at the workplace. This article explores the extent to which devolved management is drawing school-based union representation into a more prominent role. It argues that whilst there can be significant differences between individual schools, increased school autonomy is raising the profile of trade union activity in the workplace, and this needs to be better reflected in educational management research

Predictability of Invisalign® Clear Aligners Using OrthoPulse®: A Retrospective Study

This preliminary retrospective study evaluates how effective the OrthoPulse (Biolux Technology, Austria) is in increasing the predictability of orthodontic treatment in patients treated with Invisalign (R) clear aligners (Align Technology Inc., Tempe, AZ, USA). A group of 376 patients were treated with Invisalign (R) orthodontic clear aligners in association with an OrthoPulse (R) . The OrthoPulse (R) was prescribed for 10 min a day for the entire duration of the orthodontic treatment. The OrthoPulse (R) App remotely tracked the percentage compliance of each patient. The number of aligners planned with the ClinCheck software at the beginning of the treatment and the number of total aligners (including the adjunctive aligners) used to finish the treatment were then considered. After applying inclusion/exclusion criteria, a total of 40 patients remained in the study and were compared with a control group of 40 patients with the same characteristics as the study group. A statistical analysis was carried out to investigate whether using OrthoPulse (R) led to a statistical reduction in the number of adjunctive aligners, thus leading to a more accurate prediction of the treatment. The statistical analysis showed that patients who used OrthoPulse (R) needed fewer finishing aligners and a greater predictability of the treatment was obtained. In fact, in the treated group the average number of additional aligners represented 66.5% of the initial aligners, whereas in the control group 103.4% of the initially planned aligners were needed. In conclusion, in patients treated with clear aligners, OrthoPulse (R) would appear to increase the predictability of orthodontic treatment with clear aligners, thus reducing the number of finishing phase requirements