Analyzing Pain Medication Use and Adherence in Patients with Myotonic Dystrophy and Facioscapulohumeral Dystrophy

Objectives: Myotonic dystrophy (DM) and facioscapulohumeral dystrophy (FSHD) are two of the most common muscular dystrophies in adults. It has been reported that patients with these two disorders may suffer from pain and inadequate pain management. The purpose of this study is to analyze the current use of pain medications and develop a survey to assess pain medication use and adherence in this patient population. Methods: Patients registered in the National Registry for DM and FSHD at the University of Rochester were surveyed on pain medication use and the most significant problem of their disease. After analysis of these surveys, an additional survey was created that contained questions specifically on pain medication use, adherence, and general questions about the patients’ pain. Questions for the survey were devised from previous studies on medication adherence, questionnaires on medication adherence and beliefs, and questions from the Brief Pain Inventory. Results: In the first survey, pain medication was used by 34% of the survey respondents (n=519/1527). Specifically, NSAIDs were used by 23.5% and opioids were used by 4% of survey respondents. In a separate survey, pain was reported as the most burdensome problem by 8% of patients (n= 27/355). This was greater than problems related with balance (n=10/355), fatigue (n=20/355), or gastrointestinal distress (n=8/355). Conclusion: Despite the low reported response that pain was the most significant problem associated with their disease, the prevalence of pain medication use indicates that further study into the impact of pain and pain medication use in this patient population is warranted. Specifically, investigating questions about adherence, use, and beliefs toward pain medication will lead to an increased understanding of pain and its treatment in this patient population. This knowledge can lead to the ability of pharmacists to optimize pain management and to reduce adverse reactions to pain medications

ANALISIS PERENCANAAN JARINGAN HSPA+ OUTDOOR SITE DAN INDOOR BUILDING COVERAGE DI KAWASAN BUDAYA SABILULUNGAN KECAMATAN SOREANG

Kawasan Budaya Sabilulungan adalah kawasan yang terdiri dari tiga gedung yaitu Gedung Auditorium Budaya Sabilulungan, Gedung Science Center dan Bale Rame Sabilulungan. Terletak di pusat Kecamatan Soreang, kawasan ini dapat digunakan untuk berbagai kegiatan, sehingga kapasitas pengunjung yang disediakan di lokasi ini sangat besar. Kawasan Budaya Sabilulungan hingga saat ini belum memiliki infrastruktur jaringan telekomunikasi yang baik untuk mencakup coverage indoor maupun outdoor, padahal kawasan tersebut sering digunakan untuk berbagai acara besar seperti festival, wisata edukasi, konser hingga Pekan Olahraga Nasional. Hal tersebut melatar belakangi penulisan tugas akhir ini. Perencanaan jaringan HSPA+ meliputi coverage planning dan capacity planning. Terdapat dua macam perencanaan jaringan yang dilakukan yaitu indoor planning untuk IBC di ketiga gedung dan outdoor planning untuk menentukan lokasi site baru agar dapat melayani pelanggan di area outdoor. Coverage planning dan capacity planning dilakukan dengan perhitungan matematis yang selanjutnya dilakukan simulasi menggunakan software Atoll 3.3 untuk simulasi outdoor dan Radiowave Propagation Simulator 5.4 untuk simulasi indoor. Perencanaan outdoor menghasilkan satu sel HSPA+ agar dapat memenuhi kebutuhan baik dari segi capacity dan coverage, dengan nilai distribusi signal strength diatas -75 dBm sebesar 91.3%, distribusi signal quality diatas -9 dB sebesar 94.88% dan distribusi throughput diatas 1.4 Mbps sebesar 96.29%. Sedangkan hasil perencanaan untuk ketiga gedung masing-masing membutuhkan total 12 antena untuk Gedung Budaya Sabilulungan dengan distribusi signal strength diatas -75 dBm sebesar 100% (lantai 1) dan 99.36% (lantai 2), 6 antena untuk Gedung Science Center dengan signal strength diatas -75 dBm sebesar 96.58% (lantai 1) dan 100% (lantai 2 dan 3) dan 1 antena untuk Bale Rame Sabilulungan dengan signal strength diatas -75 dBm sebesar 90.52%. Kata kunci : HSPA+, coverage planning, capacity planning, indoor building coverag

Perinatal Health and School Trajectories

Perinatal Health and School Trajectorie

Medication adherence in patients with myotonic dystrophy and facioscapulohumeral muscular dystrophy

Myotonic dystrophy (DM) and facioscapulohumeral muscular dystrophy (FSHD) are the two most common adult muscular dystrophies and have progressive and often disabling manifestations. Higher levels of medication adherence lead to better health outcomes, especially important to patients with DM and FSHD because of their multisystem manifestations and complexity of care. However, medication adherence has not previously been studied in a large cohort of DM type 1 (DM1), DM type 2 (DM2), and FSHD patients. The purpose of our study was to survey medication adherence and disease manifestations in patients enrolled in the NIH-supported National DM and FSHD Registry. The study was completed by 110 DM1, 49 DM2, and 193 FSHD patients. Notable comorbidities were hypertension in FSHD (44 %) and DM2 (37 %), gastroesophageal reflux disease in DM1 (24 %) and DM2 (31 %) and arrhythmias (29 %) and thyroid disease (20 %) in DM1. Each group reported high levels of adherence based on regimen complexity, medication costs, health literacy, side effect profile, and their beliefs about treatment. Only dysphagia in DM1 was reported to significantly impact medication adherence. Approximately 35 % of study patients reported polypharmacy (taking 6 or more medications). Of the patients with polypharmacy, the DM1 cohort was significantly younger (mean 55.0 years) compared to DM2 (59.0 years) and FSHD (63.2 years), and had shorter disease duration (mean 26 years) compared to FSHD (26.8 years) and DM2 (34.8 years). Future research is needed to assess techniques to ease pill swallowing in DM1 and to monitor polypharmacy and potential drug interactions in DM and FSHD

Animal models of atherosclerosis.

Atherosclerosis is a significant cause of morbidity and mortality globally. Many animal models have been developed to study atherosclerosis, and permit experimental conditions, diet and environmental risk factors to be carefully controlled. Pathophysiological changes can be produced using genetic or pharmacological means to study the harmful consequences of different interventions. Experiments using such models have elucidated its molecular and pathophysiological mechanisms, and provided platforms for pharmacological development. Different models have their own advantages and disadvantages, and can be used to answer different research questions. In the present review article, different species of atherosclerosis models are outlined, with discussions on the practicality of their use for experimentation.GT was supported by a BBSRC Doctoral Training Award and thanks the Croucher Foundation of Hong Kong for the generous support of his clinical assistant professorship. YC is supported by the ESRC

Evolutionary and functional analysis of coagulase-positivity among the Staphylococci

The ability of some species of staphylococci to promote coagulation of plasma is a key pathogenic and diagnostic trait. Here, we provide a comprehensive analysis of the coagulase positivity of the staphylococci and its evolutionary genetic basis

Animal models of atherosclerosis.

Atherosclerosis is a significant cause of morbidity and mortality globally. Many animal models have been developed to study atherosclerosis, and permit experimental conditions, diet and environmental risk factors to be carefully controlled. Pathophysiological changes can be produced using genetic or pharmacological means to study the harmful consequences of different interventions. Experiments using such models have elucidated its molecular and pathophysiological mechanisms, and provided platforms for pharmacological development. Different models have their own advantages and disadvantages, and can be used to answer different research questions. In the present review article, different species of atherosclerosis models are outlined, with discussions on the practicality of their use for experimentation.GT was supported by a BBSRC Doctoral Training Award and thanks the Croucher Foundation of Hong Kong for the generous support of his clinical assistant professorship. YC is supported by the ESRC