Evaluating the effect and user satisfaction of an adapted and translated mobile health application ASTHMAXcel© among adults with asthma in Pune, India.

OBJECTIVE: ASTHMAXcel© is a mobile application previously shown to improve asthma knowledge, control, and quality of life. In this study, we translated the application to Marathi for pilot testing in Pune, India in order to evaluate its impact on user satisfaction and asthma knowledge among adult asthma patients. METHODS: ASTHMAXcel© was adapted to Marathi with the help of asthma patients and clinicians from Bharati Hospital. 57 different asthma patients were then recruited and received the Asthma Knowledge Questionnaire (AKQ), Asthma Control Questionnaire (ACQ), and Mini Asthma Quality of Life Questionnaire (Mini-AQLQ) to complete at baseline. Study participants then completed the adapted ASTHMAXcel© application. Post-intervention, participants filled out a post-AKQ and Questionnaire for User Interface Satisfaction (QUIS). A subset of participants was also interviewed for qualitative feedback. Paired t-tests and Pearson's correlation were used for statistical analysis. RESULTS: Mean AKQ improved from 5.0+/-2.4 to 12.4+/-1.6 (p = 0.0001). QUIS results revealed that participants were highly satisfied with the application, scoring an average of 50 out of 54 maximum points. Better baseline asthma control was correlated with greater overall experience with the application (-0.110, p = 0.0417). Finally, the qualitative feedback revealed four themes for future refinement. CONCLUSION: The adapted version of ASTHMAXcel© was linked to significant improvement in patient asthma knowledge and a high level of user satisfaction. These results support the potential utility of mHealth applications in promoting guideline-based asthma care in India. However, further studies are needed to establish a causal relationship between ASTHMAXcel© and improved clinical outcomes.

Correlates of Functional Limitations in Midlife: A Cross-Sectional Study in Middle-Aged Men (45-59 Years) from Pune.

BACKGROUND AND OBJECTIVE: The present article aims to determine the correlates of functional limitation in middle-aged men (45-59 years age) in the slums of Pune, India. MATERIALS AND METHODS: A total of 553 community-dwelling middle-aged men were randomly selected from the study area. Data on demographic characteristics, health-related conditions, and social and psychological determinants of health were collected using a pretested, structured questionnaire. Functional ability was assessed using the Pune-Functional Ability Assessment Tool. Univariate analyses and bivariate logistic regression analyses were carried out to examine the associations between various correlates and functional limitations. RESULTS: A total of 55.2% of the respondents displayed functional limitations. Univariate analysis identified significant correlates of functional limitations, which were increasing age, nature of the occupation, presence of chronic diseases, self-reported aches and pains, vision problems, previous hospital admission, and stress. Binary logistic regression displayed the higher odds of having functional decline in men with age above 55 years (odds ratio [OR] = 2.592; 95% confidence interval [CI] = 1.597-4.207), unskilled occupation (OR = 1.681; 95% CI = 1.050-2.692), chronic disease (OR = 2.608; 95% CI = 1.553-4.378), and reporting aches and pains (OR = 6.605; 95% CI = 3.732-11.689) as compared to their counterparts. CONCLUSION: This study has identified the magnitude of functional decline and its risk factors for midlife men. These study findings suggest that men having several risk factors should be monitored to protect against accelerated functional loss. These findings are important because functional decline has implications on older adult's health and disease conditions. A better understanding of these factors will help to develop health promotion interventions for men in midlife.

Improving the content uniformity of a low-dose tablet formulation through roller compaction optimization.

In this investigation, the potency distribution of a low-dose drug in a granulation was optimized through a two-part study using statistically designed experiments. The purpose of this investigation was to minimize the segregation potential by improving content uniformity across the granule particle size distribution, thereby improving content uniformity in the tablet. Initial operating parameters on the Gerteis 3-W-Polygran 250/100/3 Roller Compactor resulted in a U-shaped potency function (potency vs. granule particle size) with superpotent fines and large granules. The roller compaction optimization study was carried out in two parts. Study I used a full factorial design with roll force (RF) and average gap width (GW) as independent variables and Study II used a D-optimal response surface design with four factors: RF, GW, granulating sieve size (SS), and granulator speed (GS). The planned response variables for Study I were bypass weight % and potency of bypass. Response variables for Study II included mean granulation potency with % relative standard deviation (% RSD), granulation particle size, sieve cut potency % RSD, tablet potency with % RSD, compression force at 7 kP crushing strength, and friability of 7-kP tablets. A constraint on GW was determined in Study I by statistical analysis. Bypass and observations of ribbon splitting were minimized when GW was less than 2.6 mm. In Study II, granulation potency, granulation uniformity, and sieve cut uniformity were optimized when the SS was 0.8 mm. Higher RF during dry granulation produced better sieve cut uniformity and tablets with improved uniformity throughout the run, as measured by stratified tablet samples taken during compression and assayed for potency. The recommended optimum roller compaction and milling operating parameters that simultaneously met all constraints were RF = 9 kN, GW = 2.3 mm, SS = 0.8 mm, and GS = 50 rpm. These parameters became the operating parameter set points during a model confirmation trial. The results from the confirmation trial proved that the new roller compaction and milling conditions reduced the potential for segregation by minimizing the granulation potency variability as a function of particle size as expressed by sieve cut potency % RSD, and thus improved content uniformity of stratified tablet samples.