Measurement of Head Circumference Using a Smartphone: Feasibility Cohort Study.

BACKGROUND: Accurate head circumference (HC) measurement is essential when assessing neonates and infants. Tape measure HC measurements are prone to errors, particularly when performed by parents/guardians, due to individual differences in head shape, hair style and texture, subject cooperation, and examiner techniques, including tape measure placement and tautness. There is, therefore, the need for a more reliable method. OBJECTIVE: The primary objective of this study was to evaluate the validity, reliability, and consistency of HC app measurement compared to the current standard of practice, serving as a proof-of-concept for use by health care professionals. METHODS: We recruited infants attending the neurosurgery clinic, and parents/guardians were approached and consented to participate in the study. Along with the standard head circumference measurement, measurements were taken with the head circumference app (HC app) developed in-house, and we also collected baseline medical history and characteristics. For the statistical analysis, we used RStudio (version 4.1.1). In summary, we analyzed covariance and intraclass correlation coefficient (ICC) to compare the measurement's within-rater and interrater reliability. The F test was used to analyze the variance between measurements and the Bland-Altman agreement, t test, and correlation coefficients were used to compare the tape measurement to the measures taken by the HC app. We also used nonvalidated questionnaires to explore parental or guardians' experiences, assess their views on app utility, and collect feedback. RESULTS: The total number of recruited patients was 37. Comparison between the app measurements and the measurements with a tape measure showed poor reliability (ICC=0.177) and wide within-app variations (ICC=0.341). The agreement between the measurements done by parents/guardians and the tape measurements done by the researcher was good (ICC=0.901). Parental/guardian feedback was overall very positive, with most of the parents/guardians reporting that the app was easy to use (n=31, 84%) and that they are happy to use the app in an unsupervised setting, provided that they are assured of the measurement quality. CONCLUSIONS: We developed this project as a proof-of-concept study, and as such, the app has shown great potential to be used both in a clinical setting and by parents/guardians in their own homes.

A Systematic Review and Meta-analysis of Face-to-face Medication Adherence Interventions for Patients with Long Term Health Conditions.

BACKGROUND: Although previous reviews demonstrated effectiveness related to medication adherence interventions, they incorporated various digital platforms and other multiple delivery modes, which makes difficult to distinguish what aspects of the interventions led to effectiveness. PURPOSE: This review aimed to (i) estimate the efficacy of face-to-face medication adherence interventions on adherence outcomes, in adults with Long Term Health Conditions (LTHCs) and (ii) identify the Behaviour Change Techniques (BCTs) used in the interventions and examine their potential impact on efficacy. METHODS: Cochrane Controlled Register of Trials, Embase, MEDLINE (Ovid), PsycINFO, Web of Science, PubMed, and Scopus databases were searched. Randomized controlled trials were included if they described an intervention to improve medication adherence, delivered via face-to-face only, and included patients with LTHCs. Studies were excluded if they used additional delivery modes, involved family members or used a group format. In addition, use of BCTs was coded. RESULTS: 20 studies were included (n = 3667). Statistically significant pooled effects were found favoring the intervention than control, for the following MEMS (electronic monitoring) measures: percentage of prescribed doses taken on time over a period of 3 weeks to 2 months (MD 9.34, 95% CI 4.36-14.33, p = .0002; I2 =0%); percentage of prescribed doses taken for a period of 1 week to 2 months (MD 5.63, 95% CI 1.62-9.64, p = .006; I2 = 51%) and for 1 month (OR = 2.51, 95% CI 1.37-4.57, p = .003; I2 = 0%); percentage of days correct doses taken for 1 month to 14 weeks (MD 6.59, 95% CI 0.74-13.15, p = .03; I2 = 68%). Studies using the Morisky scale showed a significant between group difference for 1-3 months (MD 0.86, 95% CI 0.59-1.13, p < .00001; I2 = 0%). Overall, more BCTs were identified in intervention conditions than in comparison conditions (22 vs. 10). The impact of BCTs on intervention effectiveness could not be established as the analyses were underpowered. CONCLUSIONS: Face-to-face interventions increased adherence to medication among adult patients with LTHCs. Although we were able to identify BCTs among interventions, data were insufficient to determine the impact of particular BCTs on intervention effectiveness.

Integrating care: the work of diabetes care technicians in an integrated care initiative.

BACKGROUND: As diabetes prevalence rises world-wide, the arrangement of clinics and care packages is increasingly debated by health care professionals (HCPs), health service researchers, patient groups and policy makers. 'Integrated care', while representing a range of approaches, has been positioned as a promising solution with potential to benefit patients and health systems. This is particularly the case in rural populations which are often removed from centres of specialist care. The social arrangements within diabetes integrated care initiatives are understudied but are of particular importance to those implementing such initiatives. In this paper we explore the 'work' of integration through an analysis of the role played by Health Care Assistants (HCAs) who were specially trained in aspects of diabetes care and given the title 'Diabetes Care Technician' (DCT). METHODS: Using thematic analysis of interview (n = 55) and observation data (n = 40), we look at: how the role of DCTs was understood by patients and other HCPs, as well as the DCTs; and explore what DCTs did within the integrated care initiative. RESULTS: Our findings suggested that the DCTs saw their role as part of a hierarchy, providing links between members of the integrated team, and explaining and validating clinical decisions. Patients characterised DCTs as friends and advisors who provided continuity. Other HCPs perceived the DCTs as supportive, providing long-term monitoring and doing a different job to conventional HCAs. We found that DCTs had to navigate local terrain (social, ethical and physical), engage in significant conversation and negotiate treatment plans created through integrated care. The analysis suggests that relationships between patients and the DCTs were strong, had the quality of friendship and mitigated loneliness. CONCLUSIONS: DCTs played multidimensional roles in the integrated care initiative that required great social and emotional skill. Building friendships with patients was central to their work, which mitigated loneliness and facilitated the care they provided.

Synthesis and characterization of cationic surfactants and their interactions with drug and metal complexes.

Two new cationic surfactants, n-hexadecyl-3-methylpyridinium bromide and n-heptadecyl-3-methylpyridinium bromide have been synthesized and characterized in solid state by FT-IR, and in solution by 1H- and 13C-NMR spectroscopy. The values of critical micelle concentration (CMC) were determined by UV-visible spectroscopy and conductometry. Interaction of synthesized surfactants with two anionic drugs, i.e., diclofenac sodium {[2-(2, 6-Dichloroanilino) phenyl] acetic acid} and ketoprofen [(RS)-2-(3-benzoylphenyl) propionic acid] was studied by UV-visible spectroscopy. Binding constant (K), Gibb's free energy (ΔG) and number of drug molecules (n) per micelle were also calculated. These synthesized surfactants were proved to be efficient in increasing the solubility and bioavailability of drug molecules. In order to check the carrier efficiency of synthesized surfactants against bioactive coordinate, on complexes, interaction of recently reported bioactive zinc complexes was tested with synthesized cationic surfactants by conductometric measurements. Mole fractions (Xcmc) and Gibbs free energy (ΔGcmc) values were also calculated. Both surfactants were further screened for anti-fungal and anti-bacterial activities.

Combined application of compost and Bacillus sp. CIK-512 ameliorated the lead toxicity in radish by regulating the homeostasis of antioxidants and lead.

Lead (Pb) contamination is ubiquitous and usually causes toxicity to plants. Nevertheless, application of compost and plant growth promoting rhizobacteria synergistically may ameliorate the Pb toxicity in radish. The present study assessed the effects of compost and Bacillus sp. CIK-512 on growth, physiology, antioxidants and uptake of Pb in contaminated soil and explored the possible mechanism for Pb phytotoxicity amelioration. Treatments comprised of un-inoculated control, compost, CIK-512, and compost + CIK-512; plants were grown in soil contaminated with Pb (500mgkg-1) and without Pb in pot culture. Lead caused reduction in shoot dry biomass, photosynthetic rate, stomatal conductance, relative water contents, whereas enhanced root dry biomass, ascorbate peroxidase, catalase, malondialdehyde and electrolyte leakage in comparison with non-contaminated control. Plants inoculated with strain CIK-512 and compost produced significantly higher dry biomass, photosynthetic rate and stomatal conductance in normal and contaminated soils. Bacterial strain CIK-512 and compost synergy improved growth and physiology of radish in contaminated soil possibly through homeostasis of antioxidant activities, reduced membrane leakage and Pb accumulation in shoot. Possibly, Pb-induced production of reactive oxygen species resulted in increased electrolyte leakage and malondialdehyde contents (r = 0.88-0.92), which led to reduction in growth (r = -0.97) and physiology (r = -0.38 to -0.80), however, such negative effects were ameliorated by the regulation of antioxidants (r = 0.78-0.87). The decreased activity of antioxidants coupled with Pb accumulation in aerial part of the radish indicates the Pb-phytotoxicity amelioration through synergistic application of compost and Bacillus sp. CIK-512.

Phytochemical Screening, Alpha-Glucosidase Inhibition, Antibacterial and Antioxidant Potential of Ajuga bracteosa Extracts.

BACKGROUND: Ajuga bracteosa, a medicinal herb, is used by local community to cure a number of diseases such as inflammation, jaundice bronchial asthma, cancer and diabetes. OBJECTIVES: The aim of present work was to evaluate the antioxidant potential, in vitro antidiabetic and antimicrobial effects of A. bracteosa. METHODS: n-hexane, ethyl acetate, chloroform, acetone, methanol and aqueous extracts of Ajuga bracteosa roots, were prepared via maceration. Antibacterial activity was carried out by agar well diffusion method. Quantitative and qualitative phytochemical screening was done. The antioxidant activity was determined by iron (II) chelating activity, iron reducing power, DPPH, and ABTS free radical scavenging methods, Antidiabetic activity was evaluated through inhibition of α-glucosidase assay. RESULTS: Phytochemical analysis showed the presence of phenols, flavonoids, tannins, saponins, quinines, terpenoids, xanthoproteins, glycosides, carbohydrates, steroids, phytosterols and amino acids. DPPH and ABTS potential values were recorded as 61.92% to 88.84% and 0.11% to 38.82%, respectively. Total phenolic and total flavonoid contents were expressed as gallic acid and rutin equivalents. Total iron content was expressed as FeSO4 equivalents. Chloroform and n-hexane extracts showed significant enzyme inhibition potential with IC50 values of 29.92 µg/ml and 131.7 µg/ml respectively. Aqueous extract showed maximum inhibition of E. coli, S. typhimurium, E. amnigenus, S. pyogenes, and S. aureus, (18.0±1.0 mm, 12.5±0.7 mm, 17.0±0.0 mm, 11.0±0.0 mm and 15.3±2.0 mm mm), respectively. Similarly, n-hexane extract showed maximum inhibition of E. coli, E. amnigenus, S. aureus (11.6±1.5 mm; 11.3±1.5 mm; 13.3±0.5 mm). This study also shows that n-hexane, chloroform, ethyl acetate and aqueous extracts of A. bracteosa root possess α-glucosidase inhibitory activities and therefore it may be used as hypoglycemic agents in the management of postprandial hyperglycemia. CONCLUSION: Ajuga bracteosa root extracts may provide a basis for development of antioxidant, antimicrobial and antidiabetic drugs.