292 research outputs found
Evidence-based guidelines and decision support services: a discussion and evaluation in triple assessment of suspected breast cancer
No full textWidespread health service goals to improve consistency and safety in patient care have prompted considerable investment in the development of evidence-based clinical guidelines. Computerised decision support (CDS) systems have been proposed as a means to implement guidelines in practice. This paper discusses the general concept in oncology and presents an evaluation of a CDS system to support triple assessment (TA) in breast cancer care. Balanced-block crossover experiment and questionnaire study. One stop clinic for symptomatic breast patients. Twenty-four practising breast clinicians from United Kingdom National Health Service hospitals. A web-based CDS system. Clinicians made significantly more deviations from guideline recommendations without decision support (60 out of 120 errors without CDS; 16 out of 120 errors with CDS, P < 0.001). Ignoring minor deviations, 16 potentially critical errors arose in the no-decision-support arm of the trial compared with just one (P = 0.001) when decision support was available. Opinions of participating clinicians towards the CDS tool became more positive after they had used it (P < 0.025). The use of decision support capabilities in TA may yield significant measurable benefits for quality and safety of patient care. This is an important option for improving compliance with evidence-based practice guidelines
Photographic capture-recapture sampling for assessing populations of the Indian Gliding Lizard Draco dussumieri
No full textThe usage of invasive tagging methods to assess lizard populations has often been criticised, due to the potential negative effects of marking, which possibly cause increased mortality or altered behaviour. The development of safe, less invasive techniques is essential for improved ecological study and conservation of lizard populations. In this study, we describe a photographic capture-recapture (CR) technique for estimating Draco dussumieri (Agamidae) populations. We used photographs of the ventral surface of the patagium to identify individuals. To establish that the naturally occurring blotches remained constant through time, we compared capture and recapture photographs of 45 pen-marked individuals after a 30 day interval. No changes in blotches were observed and individual lizards could be identified with 100% accuracy. The population density of D. dussumieri in a two hectare areca-nut plantation was estimated using the CR technique with ten sampling occasions over a ten day period. The resulting recapture histories for 24 individuals were analysed using population models in the program CAPTURE. All models indicated that nearly all individuals were captured. The estimated probability for capturing D. dussumieri on at least one occasion was 0.92 and the estimated population density was 13±1.65 lizards/ha. Our results demonstrate the potential for applying CR to population studies in gliding lizards (Draco spp.) and other species with distinctive markings.Rachakonda Sreekar, Chetana B. Purushotham, Katya Saini, Shyam N. Rao, Simon Pelletier, Saniya Chaplo
Thermoresponsive magnetic composite nanofor multimodal cancer therapy. Acta Biomater 2009
No full texta b s t r a c t The synthesis, characterization and property evaluation of drug-loaded polymer-coated magnetic nanoparticles (MNPs) relevant to multimodal cancer therapy has been studied. The hyperthermia and controlled drug release characteristics of these particles was examined. Magnetite (Fe 3 O 4 )-poly-n-(isopropylacrylamide) (PNIPAM) composite MNPs were synthesized in a core-shell morphology by dispersion polymerization of n-(isopropylacrylamide) chains in the presence of a magnetite ferrofluid. These core-shell composite particles, with a core diameter of $13 nm, were loaded with the anti-cancer drug doxorubicin (dox), and the resulting composite nanoparticles (CNPs) exhibit thermoresponsive properties. The magnetic properties of the composite particles are close to those of the uncoated magnetic particles. In an alternating magnetic field (AMF), composite particles loaded with 4.15 wt.% dox exhibit excellent heating properties as well as simultaneous drug release. Drug release testing confirmed that release was much higher above the lower critical solution temperature (LCST) of the CNP, with a release of up to 78.1% of bound dox in 29 h. Controlled drug release testing of the particles reveals that the thermoresponsive property can act as an on/off switch by blocking drug release below the LCST. Our work suggests that these dox-loaded polymer-coated MNPs show excellent in vitro hyperthermia and drug release behavior, with the ability to release drugs in the presence of AMF, and the potential to act as agents for combined targeting, hyperthermia and controlled drug release treatment of cancer
Protein R number versus time (in hours).
No full text<p>The data were calculated using the stochastic simulation method. The R protein degradation rate with gene copy number = 24. Compare with <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0034536#pone-0034536-g005" target="_blank">Fig. 5</a> where gene copy = 1.</p
Correlates of MPOWER policies and tobacco smoking - an analysis of WHO South East Asia regional countries
No full textBackground
One of the greatest threat to global health is the epidemic of tobacco. One third of world's population use tobacco and almost half of whom die prematurely. The WHO Framework Convention on Tobacco Control (WHO FCTC) brought out MPOWER package of interventions country-level implementation of effective measures to reduce the tobacco demand.
Methods
This study has en undertaken to determine the
correlation between prevalence of tobacco smoking and existing tobacco control
policy initiatives of selected South East Asia Regional Countries.A secondary data based correlation study where data on tobacco smoking prevalence and nations' compliance to tobacco control policies during the year 2013 were obtained from Tobacco Atlas 2013, 5th Edition. Data were analyzed using Pearson´s Correlation Coefficient on SPSS version 16. Results were considered significant at 95% level of significance.
Results
The study represented eleven countries of the WHO - South East Asia Region. Current smoking prevalence ranged between 2.8% and 39.8% with a mean prevalence of 20.5% (± 9.67). As smoking prevalence among boys increased in these eleven countries, prevalence increased among adult males as well with a positive moderate correlation (r= 0.67; P≤0.05). Advertisement ban compliance negatively correlated with the prevalence of male smoking in the region (r= - 0.69; P≤0.05). Total advertisement ban compliance correlated strongly with the indirect advertisement ban (r= 0.78; P≤0.01). Protection from smoke policies had a reduced effect on the male smoking prevalence (r= -0.67; P≤0.05) in the region. [Tobacco Smoking Prevalence and MPOWER Policies]
Conclusions
In this study, prevalence of tobacco smoking had a relationship with the major MPOWER policies such as total ban on tobacco advertisements and protection from smoke helps in reducing the prevalence. Hence, MPOWER policies contribute to reduce smoking prevalence in the WHO SEAR region
Burden of Disease in Patients with Mild or Mild-to-Moderate Chronic Obstructive Pulmonary Disease (Global Initiative for Chronic Obstructive Lung Disease Group A or B): A Systematic Literature Review
No full textAlexandrosz Czira,1 Sneha Purushotham,2 Ike Iheanacho,2 Kieran J Rothnie,1 Chris Compton,3 Afisi S Ismaila4,5 1Value Evidence and Outcomes, R&D Global Medical, GSK, Brentford, UK; 2Evidera, London, UK; 3Global Medical, GSK, London, UK; 4Value Evidence and Outcomes, GSK, Collegeville, PA, USA; 5Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, CanadaCorrespondence: Alexandrosz Czira, Value Evidence and Outcomes, R&D Global Medical, GSK, 980 Great West Road, Brentford, Middlesex, TW8 9GS, UK, Tel +44 7788 351610, Email [email protected]: Patients with mild or mild-to-moderate chronic obstructive pulmonary disease (COPD), defined as Global Initiative for Chronic Obstructive Lung Disease (GOLD) group A/B, are regarded as having a lower risk of experiencing multiple or severe exacerbations compared with patients classified as GOLD group C/D. Current guidelines suggest that patients in GOLD A/B should commence treatment with a bronchodilator; however, some patients within this population who have a higher disease burden may benefit from earlier introduction of dual bronchodilator or inhaled corticosteroid-containing therapies. This study aimed to provide research-based insights into the burden of disease experienced by patients classified as GOLD A/B, and to identify characteristics associated with poorer outcomes.Methods: A systematic literature review (SLR) was conducted to identify evidence (burden of disease and prevalence data) relating to the population of interest (patients with COPD classified as GOLD A/B).Results: A total of 79 full-text publications and four conference abstracts were included. In general, the rates of moderate and severe exacerbations were higher among patients in GOLD group B than among those in group A. Among patients classified as GOLD A/B, the risk of exacerbation was higher in those with more symptoms (modified Medical Research Council or COPD Assessment Test scales) and more severe airflow limitation (forced expiratory volume in 1 second % predicted).Conclusion: Data from this SLR provide clear evidence of a heavier burden of disease for patients in GOLD B, compared with those in GOLD A, and highlight factors associated with worse outcomes for patients in GOLD A/B.Keywords: COPD Assessment Test, COPD, disease burden, GOLD A/B, modified Medical Research Council, systematic revie
ChemInform Abstract: Chemoenzymatic Synthesis of (S)‐ and (R)‐Mappicines and Their Analogues.
No full textR protein number as a function of time (in hours).
No full text<p>Upper panel: R protein degradation rate (and other parameters as described in the text) with the dynamics simulated using the stochastic algorithm (Gillespie model). Gene copy = 1. The corresponding rate equation model predicts perfectly periodic oscillations, as shown in the lower panel, for this set of parameters.</p
R protein number as as a function of time (in hours).
No full text<p>The R protein degradation rate with the dynamics calculated with the stochastic algorithm. The rate equation model predicts a time-independent steady-state (after transients die away) for this set of parameter values. Gene copy number = 1.</p
Avoiding the zero sum game in global cancer policy: Beyond 2011 UN high level summit
No full textIn September 2011 a unique high level summit on non-communicable diseases will be held in New York. For cancer as for many of the other chronic diseases this marks their first high level recognition. However, the reality of cancer control in middle and low income countries is and will be very different from the trajectory experienced by developed countries. This perspective seeks to critically examine the approach being taken, mapping pitfalls and presenting alternative solutions for an international cancer control policy. (C) 2011 Published by Elsevier Ltd.</p
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