338 research outputs found
Understanding recruitment and retention in the NHS community pharmacy stop smoking service: perceptions of smoking cessation advisers
No full textNIHR Programme Grants for Applied Research Programme
(RP-PG-0609-10181
"Test me and treat me" - attitudes to vitamin D deficiency and supplementation: a qualitative study
No full text© 2015 BMJ Open, "Test me and treat me"-attitudes to vitamin D deficiency and supplementation: a qualitative study. This manuscript version is made available under the Creative Commons Attribution Licens
Modifikasi Desain Struktur Jembatan Ratna dengan Menggunakan Struktur Baja Komposit Jalan Ratna – Darmokali Kota Surabaya, Jawa Timur
No full textJembatan Ratna terletak di Kota Surabaya yang melewati Sungai Kalimas yang masuk dalam Proyek Pemerintah Kota Surabaya dengan dana CSR dari PT Bumiputera. Jembatan ini memiliki panjang 29,4 m dengan lebar 19,40 m didesain dengan 5 lajur kendaraan dan pedestrian di sisi kanan dan kiri jembatan. Jembatan ini melintasi sungai Kalimas yang menghubungkan Jalan Ratna dengan Jalan Bengawan Surabaya dengan kedalaman ± 2,97 meter dari mukai air sungai terhadap elevasi dasar sungai. Jembatan ini awalnya menggunakan balok pratekan pada struktur girder. Penulis memodifikasi desain girder jembatan menjadi balok komposit baja pada struktur girder. Jembatan Ratna digunakan sebagai objek tugas akhir untuk memodifikasi desain struktur jembatan meliputi bangunan atas meliputi: pelat lantai dan bangunan pengaman lainya menggunakan SNI 1726-2016. Perencanaan sambungan mengacu pada AISC-LRFD.
Perencanaan bangunan bawah meliputi : pilar, abutment, pondasi, tiang pancang, dan elastomer mengacu pada RSNI 2T-12-2004 serta SNI 2833:2013 Standar Perencaanaan Ketahanan Gempa untuk Jembatan. Jembatan Ratna didesain ulang menggunakan struktur baja komposit dengan bentang jembatan 29,4 meter. Jembatan didesain menggunakan profil gelagar memanjang W 900 x 300 x 16 x 28 dan profil diafragma W 300 x 300 x 10 x 15. Ditengah jembatan juga didesain pilar menggunakan beton yang kuat terhadap aliran air dan benda hanyut aliran sungai. Pada bagian pondasi juga didesain menggunakan spun pile diameter 500 mm sebanyak 16 buah pada abutment dan 20 buah pada pilar.
Dari perhitungan desain yang dimodifikasi dari struktur Jembatan Ratna diperoleh bentuk tiang sandaran dengan dimensi 200mm x 200mm dengan tinggi 1,25 m, pelat lantai kendaraan dengan tebal 250 mm. Jembatan ini juga akan dipasang elastomer berdimensi 300 x 500 x 73 mm.
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Ratna Bridge is located in Surabaya City passing through Kalimas River which is included in Surabaya City Government Project with CSR fund from PT Bumiputera. This Bridge has 29,4 meters of length, and 19,40 meters of width designed with 5 lanes of vehicles and pedestrian on the right and left side of the bridge. This bridge across Kalimas River connects Ratna Street with Bengawan Street Surabaya with ± 2.97 meters above the river water level to the riverbed. This bridge initially used prestressed beams on the girder structure. The author modified the bridge girder design to steel composite beam in the girder structure. Ratna Bridge is used as the final task object to modify the design of the bridge structure covering the upper building includes: floor plates and other security buildings using SNI 1726-2016. Connection planning refers to AISC-LRFD. Bottom structure planning includes : pillar,abutment,fondation,pile, and elastomers are refer to RSNI 2T-12-2004 and SNI 2833:2013 "Standar Perencanan Ketahanan Gempa untuk Jembatan" (Earthquake Resilience Planning Standards for Bridges). Ratna Bridge is being redesigned using composite stell structure with bridge width of 29,4 meters. Bridge Class being redesigned using extend girder profile of W 900 x 300 x 16 x 28 and diaphragm W 300 x 300 x 10 x 15. In the middle of the bridge also designed using concrete pillar which could hold the waterflow and float off objects. On the foundation part also designed using spun pile with 500mm of diameters,16 piles for abutment and 20 piles for pillars. From the calculation of the modified stucture of Ratna Bridge,the obtained shape of the support pole is 200mm x 200mm with 1,25 m of height, vehicles floor plate with 250mm of thickness. Elastomer with dimension of 300 x 400 x 73 mm will also installed on this bridge
Understanding the reasons for non participation in self-manegement intervemtions amongst aptienrs with chronic conditions: addressing and increasing opportunities for patients with advanced chronic obstructive pulmonary disease to access self-management
No full textBackground
In chronic obstructive pulmonary disease (COPD), understanding the problem of poor patient participation in evidence-based self-management (SM) and pulmonary rehabilitation (PR) programmes (together referred to as SM support programmes) is critical. This thesis aimed to improve understanding of poor patient participation and retention in these programmes; how participation might be improved; and how might patients be better supported with their SM.
Methods
Using the Medical Research Council guidance on complex interventions this thesis (1) quantified the ‘actual’ patient participation and completion rates; (2) explained, using theory, the factors that influenced participation in studies of SM support including the programmes among chronic disease and COPD patients; and (3) explored patient and expert stakeholders’ perspectives on the reasons for non-participation in SM support programmes, how participation might be improved, how might patients be supported with their SM.
Results
(1) Among 56 studies, high study participation rates and completion rates were seen however, the incomplete reporting of participant flow confused the problem of participation. (2) Among 31 studies, participation among patients with chronic disease including COPD was shown to be influenced by their ‘attitude’ and ‘perceived social influence/subjective norms’; ‘illness’ and ‘intervention perceptions’. (3) From 38 interviewees, besides patients’ beliefs, non-participation was also influenced by resignation and denial of the illness; health systems; and programme organisational factors. Professionals building relationships and supporting patients with their SM alongside programme organisational improvements might encourage patient participation in SM and the programmes.
Conclusions
Patient participation is a complex behaviour, besides socio-behavioural factors, participation behaviour can by influenced by a mix of several health system and programme organisational factors. Changing the behaviour of health professionals and indeed the wider health system, towards normalising a patient partnership approach, with implementation of SM support in routine care might help more patients to consider participation in their care and improve patient participation in COPD SM support programmes.The National Institute for Health Researc
Reporting participation rates in studies of non-pharmacological interventions for patients with chronic obstructive pulmonary disease: a systematic review
No full textAbstract Background Pulmonary rehabilitation (PR) and self-management (SM) support programmes are effective in the management of patients with chronic obstructive pulmonary disease (COPD), but these interventions are not widely implemented in routine care. One reason may be poor patient participation and retention. We conducted a systematic review to determine a true estimate of participation and dropout rates in research studies of these interventions. Methods Studies were identified from eight electronic databases including MEDLINE, UK Clinical Trial Register, Cochrane library, and reference lists of identified studies. Controlled clinical trial studies of structured SM, PR and health education (HE) programmes for COPD were included. Data extraction included ‘participant flow’ data using the Consolidated Standards of Reporting Trials (CONSORT) statement and its extension to pragmatic trials. Patient ‘participation rates’ (study participation rate (SPR), study dropout rate (SDR) and intervention dropout rate (IDR)) were calculated using prior participation definitions consistent with CONSORT. Random effects logistic regression analysis was conducted to examine effects of four key study characteristics (group vs. individual treatment, year of publication, study quality and exercise vs. non-exercise) on participation rates. Results Fifty-six quantitative studies (51 randomised controlled trials, three quasi-experimental and two before-after studies) evaluated PR (n = 31), SM (n = 21) and HE (n = 4). Reports of participant flow were generally incomplete; ‘numbers of potential participants identified’ were only available for 16%, and ‘numbers assessed for eligibility’ for only 39% of studies. Although ‘numbers eligible’ were better reported (77%), we were unable to calculate SPR for 23% of studies. Overall we found ‘participation rates’ for studies (n = 43) were higher than previous reports; only 19% of studies had less than 50% SPR and just over one-third (34%) had a SPR of 100%; SDR and IDR were less than or equal to 30% for around 93% of studies. There was no evidence of effects of study characteristics on participation rates. Conclusion Unlike previous reports, we found high participation and low dropout rates in studies of PR or SM support for COPD. Previous studies adopted different participation definitions; some reported proportions without stating definitions clearly, obscuring whether proportions referred to the study or the intervention. Clear, uniform definitions of patient participation in studies are needed to better inform the wider implementation of effective interventions.</p
First record of Celaenorrhinus ratna daphne Evans,1949 from Himachal Pradesh and its first photographic record from the Western Himalayas (Lepidoptera: Hesperiidae, Pyrginae)
No full textThe daphne subspecies of Celaenorrhinus ratna Fruhstorfer, [1908] reported first by Evans (1949) from Uttarakhand and has not been reported in the past from the neighbor state Himachal Pradesh. In July 2017, Author recorded and photographed about eight specimens of Celaenorrhinus ratna daphne Evans, 1949 for the first time near McLeodganj town of Himachal Pradesh.La subespecie daphne de Celaenorrhinus ratna Fruhstorfer, [1908] citada por primera vez por Evans (1949) de Uttarakhand y no ha sido citada en el pasado del estado vecino Himachal Pradesh. En julio de 2017, el autor registró y fotografió unos ocho ejemplares de Celaenorrhinus ratna daphne Evans, 1949 por primera vez cerca de la ciudad de McLeodganj de Himachal Pradesh
Critical Analysis of Rasa Ratna Samuchhaya with Respect to its Applied Aspects on Ayurvedic Pharmaceutical Process
No full textObjective:Rasa Ratna Samuchaya is one of the pioneer literature of Rasa Shastra, written during 13th Cen. AD. Acharya Rasa Vagbhat has written this book with utmost care to the practical and applied aspects of Ayurvedic pharmaceutics in the ancient language. The objective of this review article is to explore and critically analyze the trend of development and applied aspects of Ayurvedic pharmaceutics in contemporary language that may help the academicians and Ayurveda industries.Data Sources:The current manuscript is prepared collecting literature from the book Rasa Ratna Samuchhaya, different commentary on it by eminent scholars and from published papers in different journals.Review Methods:The facts and philosophies mentioned in the same book and different commentaries are thoroughly analyzed, reviewed with respect to historical edges, traditional values, and applied aspects and tried to present systematically and affirmatively.Conclusion:The concerned part of the book reviewed is the 11 chapters, of the first part of the book, where the author has tried to describe; the definition of technical terminologies, designing and uses of different types of tools and devices, identification and collection of materials, systematic pharmaceutical processings, and therapeutic uses as well, in concern with metals/minerals. This book acknowledges all the fundamental principles of Rasa Shastra systematically with approaching its future course of development. This manuscript contains all the rational and time needed descriptions with the elimination of impractical and outdated hypothetical materials (carry forwarded by many previous era authors), having no more utility, with the use of available materials and contemporary intellectuals
Equipping community pharmacy workers as agents for health behaviour change: developing and testing a theory-based intervention
No full textOBJECTIVE: To develop a complex intervention for community pharmacy staff to promote uptake of smoking cessation services and to increase quit rates. DESIGN: Following the Medical Research Council framework, we used a mixed-methods approach to develop, pilot and then refine the intervention. METHODS: Phase I: We used information from qualitative studies in pharmacies, systematic literature reviews and the Capability, Opportunity, Motivation-Behaviour framework to inform design of the initial version of the intervention. Phase II: We then tested the acceptability of this intervention with smoking cessation advisers and assessed fidelity using actors who visited pharmacies posing as smokers, in a pilot study. Phase III: We reviewed the content and associated theory underpinning our intervention, taking account of the results of the earlier studies and a realist analysis of published literature. We then confirmed a logic model describing the intended operation of the intervention and used this model to refine the intervention and associated materials. SETTING: Eight community pharmacies in three inner east London boroughs. PARTICIPANTS: 12 Stop Smoking Advisers. INTERVENTION: Two, 150 min, skills-based training sessions focused on communication and behaviour change skills with between session practice. RESULTS: The pilot study confirmed acceptability of the intervention and showed preliminary evidence of benefit; however, organisational barriers tended to limit effective operation. The pilot data and realist review pointed to additional use of Diffusion of Innovations Theory to seat the intervention in the wider organisational context. CONCLUSIONS: We have developed and refined an intervention to promote smoking cessation services in community pharmacies, which we now plan to evaluate in a randomised controlled trial. TRIAL REGISTRATION NUMBER: UKCRN ID 18446, Pilot
High resolution profiling of EGFR mutations in glioblastoma patients using an ultrasensitive digital PCR approach
No full textGlioblastoma Multiforme (GBM) is the most aggressive type of adult brain cancer. The average survival time after GBM diagnosis is 14.6 months even with current tri-modality therapy. The Epidermal Growth Factor Receptor (EGFR) is amplified in 57% of GBM. Mutations in EGFR such as EGFR variant III, A289V, and R108K lead to more aggressive tumors, and diminished survival. We are in dire need of a molecular assay that rapidly profiles these alterations in EGFR since other assays currently available clinically, like Next Generation Sequencing, may take up to 4 weeks due to the batching of samples in current workflows.
Our lab has established a very sensitive and novel digital Polymerase Chain Reaction (dPCR) assay that detects EGFRvIII in patient tumors within 24 hours of resection. This dPCR assay utilizes RNA extracted from microgram quantities of resected tumor from GBM patients, which is then converted to complementary DNA (cDNA). cDNA is then pre-amplified and subjected to the dPCR assay using specific primers and probes for EGFRvIII and EGFR WT. The assay is multiplexed with an internal reference control, RNaseP. The same starting material can be used to detect the presence or absence of two other mutations, R108K and A289V, with exquisite sensitivity and specificity.
We have utilized this assay and tested the platform on patient derived organoids and patient tumor samples. We have also validated this assay on exosomal RNA extracted from media used for culturing U87 WT and U87 vIII cell lines, as well as patient-derived glioma stem cell lines like NS039 and T4213.
This assay allows for rapid and ultrasensitive detection of EGFRvIII, EGFRWT, R108K, and A289V mutations in patient tumors and patient derived organoids. The workflow for this assay allows results within 24 hours of tumor resection, which facilitates early initiation of novel investigational therapeutic agents. It is possible that molecular characterization of tumor tissue, biofluids, microvesicles, platelets, and cfRNA would help to elucidate genomic variations that occur during disease recurrence. In the future, we plan to test this assay on RNA extracted from various microvesicles and platelets derived from blood to facilitate non-invasive tumor characterization and usefully complement conventional follow-up and imaging methods.This poster was presented at the first annual Celebration of Undergraduate Research and Creative Activity while the author was an undergraduate student at Rutgers University-Camden
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