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The realization and discovery of quantum spin liquid (QSL) candidate materials are crucial for exploring exotic quantum phenomena and applications associated with QSLs. Most existing metal-organic two-dimensional (2D) quantum spin liquid candidates have structures with spins arranged on the triangular or kagome lattices, whereas honeycomb-structured metal-organic compounds with QSL characteristics are rare. Here, we report the use of 2,5-dihydroxy-1,4-benzoquinone (X2dhbq, X = Cl, Br, H) as the linkers to construct cobalt(II) honeycomb lattices (NEt4)2[Co2(X2dhbq)3] as promising Kitaev-type QSL candidate materials. The high-spin d7 Co2+ has pseudospin-1/2 ground-state doublets, and benzoquinone-based linkers not only provide two separate superexchange pathways that create bond-dependent frustrated interactions but also allow for chemical tunability to mediate magnetic coupling. Our magnetization data show antiferromagnetic interactions between neighboring metal centers with Weiss constants from -5.1 to -8.5 K depending on the X functional group in X2dhbq linkers (X = Cl, Br, H). No magnetic transition or spin freezing could be observed down to 2 K. Low-temperature susceptibility (down to 0.3 K) and specific heat (down to 0.055 K) of (NEt4)2[Co2(H2dhbq)3] were further analyzed. Heat capacity measurements confirmed no long-range order down to 0.055 K, evidenced by the broad peak instead of the λ-like anomaly. Our results indicate that these 2D cobalt benzoquinone frameworks are promising Kitaev QSL candidates with chemical tunability through ligands that can vary the magnetic coupling and frustration.
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An electrochemical direct selective C-H chalcogenocyanation approach for indolizine derivatives under mild conditions has been described. Cyclic enone-fused, chromone-fused and 2-substituted indolizines possessing EDGs (electron donating groups) and EWGs (electron withdrawing groups) were successfully reacted with NH4SCN and KSeCN under electrochemical conditions to provide a wide array of mono and bis-chalcogenocyanate-indolizines in 75-94% yields. In addition, 1-substituted imidazo[1,5-a]quinolines were also successfully chalcogenocyanated under the optimized reaction conditions providing a platform for the synthesis of pharmaceutically privileged molecules. By switching the reaction conditions, the developed protocol offers selective synthesis of C-3 thiocyanate and 1,3 bis-thiocyanate indolizines in good to excellent yields under catalyst-free conditions. On the basis of control experiments and cyclic voltammetry data, a plausible reaction pathway is also presented.
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Introduction: Telehealth in India is growing rapidly and represents a strategy to promote affordable, inclusive, timely and safe access to healthcare. Yet there is a risk that telehealth increases inequity due to the digital divide and existing poor health literacy. Methods: A scoping review was conducted to explore use of telehealth in India during and following the COVID-19 pandemic by people with disabilities to inform strategies to increase equity of telehealth for people with disabilities. Of 1966 studies from the initial search in four databases and three specific telehealth journals, 20 sources met the inclusion criteria, limited to a focus on physical disability in India. Results: Findings showed examples of how people with disabilities can exercise increased control in the timing of appointments, convenience of receiving services from home and not having to travel to clinics or hospitals, and platform preference through tools and applications already familiar to them. Carers and families of people with disabilities were described as highly valued stakeholders with important roles in the uptake and effectiveness of telehealth for people with disabilities. The identified benefits of telehealth resulted in high levels of user satisfaction due to increased control and convenience, however, systemic barriers for accessibility remain. Conclusion: This review suggested that if telehealth is not designed intentionally to change the status quo for people with disabilities and prioritize equity, then the benefits may not be sustainable. Recommendations for telehealth India are provided, based on both findings from the literature and analysis of results.
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COVID-19 , Pessoas com Deficiência , Equidade em Saúde , Acessibilidade aos Serviços de Saúde , SARS-CoV-2 , Telemedicina , Humanos , COVID-19/epidemiologia , Índia/epidemiologia , Telemedicina/organização & administração , Acessibilidade aos Serviços de Saúde/organização & administração , PandemiasRESUMO
We disclose a mild, scalable, electricity-promoted cross coupling protocol between allylic iodides and disulfides/diselenides for the formation of C-S/Se bonds in the absence of transition metals, bases, and oxidants. The stereochemically different densely functionalized allylic iodides gave regio- and stereoselective diverse thioethers in good yields. This strategy demonstrates a sustainable promising approach for the synthesis of allylic thioethers in 38-80% yields. This protocol also provides a synthetic platform for the synthesis of allylic selenoethers. A single-electron transfer radical pathway was also validated with radical scavenger experiments and cyclic voltammetry data.
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Herein, we disclosed a sustainable electrochemical approach for site-selective C-H mono and bis-chalcogenation (sulfenylation or selenylation) of indolizine frameworks. Diversely functionalized disulfides and diselenides possessing EDGs and EWGs were successfully reacted with a variety of indolizines to directly access sulfenylated/selenylated indolizines in 40-96% yields. A mechanistic radical pathway was also validated with control experiments and cyclic voltammogram data.
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BACKGROUND: Informal carers (ICs) of residents living in nursing homes (NH) have a key role in the care of residents, including making decisions about and providing care. As radiology has a role in decision making about care, it is important to understand IC's perspectives about resident's use of mobile X-ray services (MXS). The aim was to explore the perspectives of ICs of residents living in nursing homes about the use of MXS. METHODS: From November 2020 to February 2021, twenty ICs of residents living in four nursing homes in different areas of one Australian city participated. Their perspectives of MXS, including benefits and barriers, were explored in semi-structured interviews. Data were analysed using thematic analysis. RESULTS: ICs were resident's children (80%) and spouses (20%). One resident had received a MXS. Four themes were developed: (1) a priority for resident well-being, where ICs were positive about using MXS, because residents could receive healthcare without transfer; (2) MXS could reduce carer burden; (3) economic considerations, where MXS could reduce health system burden but the MXS call-out fee could result in health inequities; and (4) pathways to translation, including the need to improve consumer awareness of MXS, ensure effective processes to using MXS,, consider nursing home staff levels to manage MXS and ICs expectations about quality and availability of MXS. CONCLUSIONS: ICs consider MXS can benefit resident well-being by potentially reducing transfers to hospital or radiology facilities and advocated equitable access. ICs cautioned that the quality and safety of healthcare delivered in nursing homes should equal what they would receive in hospitals.
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Cuidadores , Radiologia , Humanos , Raios X , Austrália , Casas de Saúde , Atenção à Saúde , Pesquisa QualitativaRESUMO
A novel series of nitrostyrene-based spirooxindoles were synthesized via the reaction of substituted isatins 1a-b, a number of α-amino acids 2a-e and (E)-2-aryl-1-nitroethenes 3a-e in a chemo/regio-selective manner using [3+2] cycloaddition (Huisgen) reaction under microwave irradiation conditions. The structure elucidation of all the synthesized spirooxindoles were done using 1H and 13C NMR and HRMS spectral analysis. The single crystal X-ray crystallographic study of compound 4l was used to assign the stereochemical arrangements of the groups around the pyrrolidine ring in spiro[pyrrolidine-2,3'-oxindoles] skeleton. The in vitro anticancer activity of spiro[pyrrolidine-2,3'-oxindoles] analogs 4a-w against human lung (A549) and liver (HepG2) cancer cell lines along with immortalized normal lung (BEAS-2B) and liver (LO2) cell lines shows promising results. Out of the 23 synthesized spiro[pyrrolidine-2,3'-oxindoles], while five compounds (4c, 4f, 4m, 4q, 4t) (IC50 = 34.99-47.92 µM; SI = 0.96-2.43) displayed significant in vitro anticancer activity against human lung (A549) cancer cell lines, six compounds (4c, 4f, 4k, 4m, 4q, 4t) (IC50 = 41.56-86.53 µM; SI = 0.49-0.99) displayed promising in vitro anticancer activity against human liver (HepG2) cancer cell lines. In the case of lung (A549) cancer cell lines, these compounds were recognized to be more efficient and selective than standard reference artemisinin (IC50 = 100 µM) and chloroquine (IC50 = 100 µM; SI: 0.03). However, none of them were found to be active as compared to artesunic acid [IC50 = 9.85 µM; SI = 0.76 against lung (A549) cancer cell line and IC50 = 4.09 µM; SI = 2.01 against liver (HepG2) cancer cell line].
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Antifibrinolíticos , Micro-Ondas , Humanos , Oxindóis , Fígado , AminoácidosRESUMO
An interesting electrochemical direct bisarylation of carbonyls with indole derivatives to afford the corresponding bis(indolyl)methane (BIM) derivatives is described. The developed protocol is suitable for aliphatic, aromatic, and heteroaromatic aldehydes, which react with various electron-rich and electron-poor indoles to afford the corresponding BIMs in good to excellent yields. Isatin derivatives also underwent bisarylation with various indole derivatives under the influence of current to afford the corresponding BIMs in excellent yields.
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BACKGROUND: There is interest in reducing avoidable emergency department presentations from residential aged care facilities (RACF). Mobile x-ray services may enable the delivery of healthcare in residential aged care facilities. Accordingly, the Australian Government in November 2019 introduced a Medicare Benefit Schedule rebate providing for a 'call-out' fee payable to radiology service providers. This study aims to understand stakeholder perspectives on the benefits of mobile x-ray services and the factors influencing their adoption by RACFs. DESIGN, SETTING, PARTICIPANTS: Twenty-two semi-structured interviews were conducted between October 2020 and February 2021 with a range of stakeholders involved in healthcare delivery to residents: a) general practitioners; b) emergency department clinicians; c) paramedic clinicians; d) a hospital avoidance clinician; e) radiology clinicians and managers; and f) aged care clinicians and managers. Thematic analysis was conducted. RESULTS: Mobile x-ray services were considered valuable for RACF residents. Lack of timely general practitioner in-person assessment and referral, as well as staffing deficits in residential aged care facilities, reduces optimal use of mobile x-ray services and results in potentially unnecessary hospital transfers. CONCLUSIONS: The use of mobile x-ray services, as a hospital avoidance strategy, depends on the capacity of RACFs to provide more complex healthcare-in-place. However, this requires greater access to general practitioners for in-person assessment and referral, adequate staffing numbers and appropriately skilled nursing staff within residential aged care facilities.
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Instituição de Longa Permanência para Idosos , Radiologia , Idoso , Austrália , Atenção à Saúde , Humanos , Programas Nacionais de Saúde , Casas de Saúde , Raios XRESUMO
BACKGROUND: Mobile X-ray services (MXS) could be used to investigate clinical issues in aged care residents within familiar surroundings, reducing transfers to and from emergency departments and enabling healthcare to be delivered in residential aged care facilities. There is however little research exploring consumer perspectives about such services. The objective of this research was to explore the perspectives and preferences of residents about the provision of MXS in residential aged care facilities, including their knowledge about the service, perceived benefits, and factors that require consideration for effective implementation. METHODS: A qualitative study design was used. The setting for the study included four residential aged care facilities of different sizes from different parts of a South Australian city. Purposive sampling was used to recruit participants. 16 residents participated in semi-structured interviews that were audio-recorded and transcribed verbatim. Data were inductively derived using thematic analysis. RESULTS: Participants had a mean age of 85 years, 56% were female, 25% had dementia and 25% had had a mobile X-ray in the last 12 months. Four themes were developed. Participants preferred mobile X-rays, provided as healthcare-in-place, to improve accessibility to them and minimize physical and psychological discomfort. Participants had expectations about the processes for receiving mobile X-rays. Costs of X-rays to people, family and society were a consideration. Decision making required residents be informed about mobile X-rays. CONCLUSIONS: Residents have positive views of MXS as they can receive healthcare-in-place, with familiar people and surroundings. They emphasised that MXS delivered in residential aged care facilities need to be of equivalent quality to those found in other settings. Increased awareness of mobile X-ray services is required.
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Instituição de Longa Permanência para Idosos , Casas de Saúde , Idoso , Idoso de 80 Anos ou mais , Austrália , Atenção à Saúde , Feminino , Humanos , Masculino , Pesquisa Qualitativa , Instituições Residenciais , Raios XRESUMO
BACKGROUND: Most older people after a hip fracture injury never return to their prefracture status, and some are admitted to residential aged care facilities. Advancement of digital technology has helped in optimizing health care including self-management and telerehabilitation. OBJECTIVE: This study aims to understand the perspectives of older patients with hip fracture and their family members and residential aged caregivers on the feasibility of developing a model of care using a personalized digital health hub. METHODS: We conducted a mixed methods study in South Australia involving patients aged 50 years and older, their family members, and residential aged caregivers. Quantitative data analysis included basic demographic characteristics, and access to digital devices was analyzed using descriptive statistics. Spearman rank-order correlation was used to examine correlations between the perceived role of a personalized digital health hub in improving health and the likelihood of subsequent use. Findings from qualitative analysis were interpreted using constructs of capability, opportunity, and motivation to help understand the factors influencing the likelihood of potential personalized digital health hub use. RESULTS: This study recruited 100 participants-55 patients, 13 family members, and 32 residential aged caregivers. The mean age of the patients was 76.4 (SD 8.4, range 54-88) years, and 60% (33/55) of the patients were female. Approximately 50% (34/68) of the patients and their family members had access to digital devices, despite less than one-third using computers as part of their occupation. Approximately 72% (72/100) of the respondents thought that personalized digital health hub could improve health outcomes in patients. However, a moderate negative correlation existed with increasing age and likelihood of personalized digital health hub use (Spearman ρ=-0.50; P<.001), and the perceived role of the personalized digital health hub in improving health had a strong positive correlation with the likelihood of personalized digital health hub use by self (Spearman ρ=0.71; P<.001) and by society, including friends and family members (Spearman ρ=0.75; P<.001). Most patients (54/55, 98%) believed they had a family member, friend, or caregiver who would be able to help them use a personalized digital health hub. Qualitative analysis explored capability by understanding aspects of existing knowledge, including willingness to advance digital navigation skills. Access could be improved through supporting opportunities, and factors influencing intrinsic motivation were considered crucial for designing a personalized digital health hub-enabled model of care. CONCLUSIONS: This study emphasized the complex relationship between capabilities, motivation, and opportunities for patients, their family members, and formal caregivers as a patient networked unit. The next stage of research will continue to involve a cocreation approach followed by iterative processes and understand the factors influencing the development and successful integration of complex digital health care interventions in real-world scenarios.
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Fraturas do Quadril , Telerreabilitação , Idoso , Idoso de 80 Anos ou mais , Cuidadores , Família , Feminino , Fraturas do Quadril/terapia , Humanos , Pessoa de Meia-Idade , MotivaçãoRESUMO
Multimorbidity is the presence of more than one chronic disease condition in an individual. Health-related, socioeconomic, cultural and environmental factors, as well as patient behaviour, all influence the outcomes of multimorbidity. Addressing these complex and often interacting biopsychosocial factors therefore requires a shift in treatment from a physical damage model towards person-centred integrated care with increased patient agency. Education influences behaviour and can be used to empower patients and their carers with greater agency, thus allowing greater responsibility for and control over the management of patient care. In this paper we reflect on our own learning as a community of health practitioners from different disciplines. Recognizing the increasing importance of patient agency in driving the evolution of health care, we describe the concept of a web-based personal digital health hub for integrated patient care. Informed by collaboration between patient, health and education communities, we share our early experience in the implementation of a health hub around a cohort of patients with hip fractures. We also describe a vision for future health care based on the co-creation of digital health hubs centred on patients' and carers' needs. The health hub could allow important advances and efficiencies to be achieved in workforce practice and education; patient and carer engagement in self-care; and the collection of patient-reported health data required for ongoing research and improvements in health care.
La multimorbidité est la présence de plus d'une maladie chronique chez un individu. L'aboutissement de la multimorbidité est influencé par des facteurs sanitaires, socio-économiques, culturels et environnementaux. Aborder ces facteurs biopsychosociaux complexes et souvent interdépendants requiert donc un changement de traitement, qui consiste à s'éloigner d'un modèle axé sur les dommages physiques pour se rapprocher d'un modèle de soins intégré et centré sur la personne, allié à une meilleure implication du patient. L'éducation a un impact sur le comportement et peut être utilisée pour renforcer la capacité d'agir des patients et de leurs soignants, ce qui permettra de conférer plus de responsabilités et un meilleur contrôle de la gestion des soins aux patients. Dans ce document, nous réfléchissons à notre propre apprentissage en tant que communauté de professionnels de la santé issus de différentes disciplines. Nous reconnaissons l'importance croissante de l'implication du patient pour stimuler l'évolution des soins de santé, et imaginons un concept de centre de santé numérique et personnalisé via site Web pour la prise en charge intégrée des patients. Grâce à la collaboration entre patients, professionnels de la santé et structures pédagogiques, nous partageons nos premières expériences en matière de mise en Åuvre d'un centre de santé regroupant des patients présentant des fractures de la hanche. Nous dévoilons également notre vision d'avenir pour les soins de santé, qui repose sur la cocréation de centres de santé numériques adaptés aussi bien aux besoins des patients qu'à ceux des soignants. Ce concept pourrait faire progresser l'enseignement et la pratique pour les professionnels du secteur, mais aussi améliorer leur efficacité; favoriser la participation des patients et soignants dans les soins auto-administrés; et enfin, permettre la collecte des données fournies par les patients, et nécessaires à la poursuite des recherches et améliorations dans le domaine des soins de santé.
La multimorbilidad es la presencia de más de una enfermedad crónica en un individuo. Los factores medioambientales, culturales, socioeconómicos y los relacionados con la salud, así como el comportamiento de los pacientes, influyen en los resultados de la multimorbilidad. Por lo tanto, se requiere un cambio en el tratamiento desde el modelo de daño físico hacia una atención integrada y centrada en el individuo con una mayor participación del paciente para abordar estos factores biopsicosociales complejos y a menudo interactivos. La educación influye en el comportamiento y se puede utilizar para que los pacientes y sus cuidadores tengan más capacidad de acción, lo que permite una mayor responsabilidad y control sobre la gestión de la atención al paciente. En este documento reflexionamos sobre nuestro propio aprendizaje como comunidad de profesionales de la salud de diferentes disciplinas. Se describe el concepto de un centro de salud virtual personalizado para la atención integrada del paciente, al reconocer la creciente relevancia de la participación y la acción del paciente en el proceso de evolución de la atención médica. Gracias a la colaboración entre las comunidades de pacientes, de salud y de educación, compartimos nuestra experiencia inicial sobre el establecimiento de un centro de salud en torno a una cohorte de pacientes con fracturas de cadera. Asimismo, describimos una visión de la futura atención médica basada en la creación conjunta de centros de salud virtuales que se centran en las necesidades de los pacientes y de los cuidadores. El centro de salud permitiría alcanzar importantes avances y mejoras en la práctica y la educación de la fuerza de trabajo; en el compromiso de los pacientes y los cuidadores con el autocuidado de la salud; y en la recopilación de los datos sobre la salud que los pacientes comunican y que se requieren para la investigación y las mejoras continuas en la atención médica.
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Doença Crônica/terapia , Gerenciamento Clínico , Aplicações da Informática Médica , Assistência ao Paciente/métodos , Comorbidade , Humanos , Smartphone , SoftwareRESUMO
This article describes the identification of 1-(2-hydroxyethyl)-piperazine as a new, cost-effective, highly efficient organocatalyst, which promotes both inter- and intra-molecular direct C(sp2)-H arylations of unactivated arenes in the presence of potassium tert-butoxide. While the inter-molecular C-H arylation of unactivated benzenes with aryl halides (Ar-X; X = I, Br, Cl) toward biaryl syntheses underwent smoothly in the presence of only 10 mol % organocatalyst, the intra-molecular C-H arylation catalytic system composed of 40 mol % each of the catalyst and the additive (4-dimethylaminopyridine (DMAP)). The novel catalyst was also able to perform both inter- and intra-molecular direct arylations simultaneously in a single pot. The mechanistic studies confirmed the involvement of aryl radical anions and proceeded via a single-electron-transfer (SET) mechanism. The large substrate scope, high functional group tolerance, competition experiments, gram-scale synthesis, and kinetic studies further highlight the importance and versatile nature of the methodology as well as the compatibility of the new catalyst. To the best of our knowledge, this is the first report on any organocatalyst that reported detailed investigations of both inter- and intra-molecular direct C(sp2)-H arylations of unactivated arenes in a single representation.
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A Bu4NI-catalyzed, DTBP-promoted, regioselective C(sp2)-C(sp3) cross dehydrogenative coupling (CDC) protocol for the direct C-3 benzylation of 2H-indazoles is reported. The metal-free protocol is operationally simple and proceeds mechanistically via the generation of stable benzylic free-radicals followed by regioselective addition at the C-3 position of 2H-indazoles which afforded C-3 benzylated 2H-indazoles up to 87% yields. The methodology showed a varied array of functional group tolerance and wide substrate compatibility. The gram-scale synthesis further highlights the importance and versatile nature of this methodology.
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A new series of functionalized (Z)-3-(2-oxo-2-substituted ethylidene)-3,4-dihydro-2H-benzo[b][1,4]oxazin-2-ones 23-26, incorporating pharmaceutically privileged substructures such as cyclopropyl, naphthyl, biphenyl and cyclohexylphenyl were synthesized in excellent yields. All the synthesized compounds were screened for their in vitro antibacterial activity against gram-(+)ve and gram-(-)ve bacterial species i.e. S. griseus, S. aureus, B. subtillis and E. coli as well as in vitro antifungal activity against fungal species i.e. F. oxysporium, A. niger, P. funiculosum and T. reesei, respectively. In this study, compounds containing cyclopropyl and cyclohexylphenyl substructures were identified as promising antimicrobial agents than standard drugs, ampicillin and chloramphenicol as well as ketoconazole. SAR study illustrates that electron-withdrawing groups increases the antibacterial as well as antifungal activity of 2-oxo-benzo[1,4]oxazines and vice versa. Compounds 23e and 26e, the most active compounds of the series, displayed promising antibacterial activity than Ampicillin and Chloramphenicol. Moreover, compound 26d showed promising antifungal potency as compared to Ketoconazole. Cytotoxic studies of the active compounds i.e. 23c-e, 24e, 25d and 26d-e found to be non-toxic in nature in 3T3 fibroblast cell lines using MTT assay.
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Antibacterianos/farmacologia , Antifúngicos/farmacologia , Bactérias/efeitos dos fármacos , Benzoxazinas/farmacologia , Fungos/efeitos dos fármacos , Células 3T3 , Animais , Antibacterianos/síntese química , Antibacterianos/química , Antifúngicos/síntese química , Antifúngicos/química , Benzoxazinas/síntese química , Benzoxazinas/química , Sobrevivência Celular/efeitos dos fármacos , Relação Dose-Resposta a Droga , Camundongos , Estrutura Molecular , Relação Estrutura-AtividadeRESUMO
A new series of ester analogues of artemisinin 8a-f, incorporating diphenylmethyl as pharmacologically privileged substructure, and 8g-j have been prepared and evaluated for their antimalarial activity against multidrug-resistant (MDR) Plasmodium yoelii nigeriensis in Swiss mice via oral route. These diphenylmethyl-based ester analogues 8a-f were found to be 2-4 folds more active than the antimalarial drugs ß-arteether 4 and artesunic acid 5. Ester 8a, the most active compound of the series, provided complete protection to the infected mice at 24 mg/kg × 4 days as well as 12 mg/kg × 4 days, respectively. In this model ß-arteether provided 100% and 20% protection at 48 mg/kg × 4 days and 24 mg/kg × 4 days, respectively.
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Antimaláricos/síntese química , Antimaláricos/farmacologia , Artemisininas/administração & dosagem , Artemisininas/farmacologia , Resistência a Múltiplos Medicamentos , Ésteres/farmacologia , Plasmodium yoelii/efeitos dos fármacos , Administração Oral , Animais , Antimaláricos/administração & dosagem , Antimaláricos/química , Artemisininas/síntese química , Artemisininas/química , Relação Dose-Resposta a Droga , Ésteres/administração & dosagem , Ésteres/química , Camundongos , Estrutura Molecular , Testes de Sensibilidade Parasitária , Relação Estrutura-AtividadeRESUMO
BACKGROUND: The incidence of hip fractures in older adults in India is likely to increase dramatically in the coming decades as a result of an aging population and increasing life expectancy. Currently, more than 600,000 adults over 60 years of age suffer a hip fracture annually in India. This paper outlines a protocol for a qualitative study investigating the care seeking behavior of older adults with hip fractures: to determine the processes in decision making, identify causes for delay in obtaining care, and identify potential barriers and facilitators to seeking appropriate care in time. METHODS AND DESIGN: The planned study will consider Odisha, an eastern state in India with limited health care facility, as a suitable case study. It is proposed to conduct 30 in-depth interviews in two administrative districts of Odisha. The participants will be patient and their carers in seven health facilities- four public hospitals, two private hospitals and one traditional bone-setting facility. The study relies on a purposive sampling strategy. Ethics permission will be sought from each participating institution and participants. The participants will be adults aged 50 years or older of both sexes arriving at the recruiting centers with a history of fall or injury, pain in the hip region and inability to walk and X-ray confirmed diagnosis of proximal femoral fracture and their primary carer. Trained qualitative research team will conduct these interviews. A thematic framework approach will be used to analyze the data using NVivo 9 software. The data collected from the interviews will be analysed to explore the cause of the hip fracture, events following the injury, the experiences of patients from the time of sustaining the injury, pain relief measures, decision to seek care, understanding of the urgency for treatment, causes for delay in receiving treatment, funding sources, cost liabilities for the family, financing mechanisms for out of pocket expenditure and the burden for caring. DISCUSSION: The findings of this study will provide an increased understanding of the care seeking behaviors of older adults with hip fracture, and inform contextually appropriate changes in healthcare program and policy aimed at improving health outcomes.
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Idoso Fragilizado , Comportamentos Relacionados com a Saúde , Acessibilidade aos Serviços de Saúde , Fraturas do Quadril/terapia , Idoso , Idoso de 80 Anos ou mais , Feminino , Fraturas do Quadril/economia , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Pesquisa QualitativaRESUMO
Objective: To introduce, describe, and demonstrate the emergence and testing of an evaluation method that combines different logics for co-designing, measuring, and optimizing innovations and solutions within complex adaptive health systems. Method: We describe the development and preliminary testing of a framework to evaluate new ways of using and implementing knowledge (innovations) and technological solutions to solve problems via co-design methods and measurable approaches such as data science. The framework is called PROLIFERATE; it is initially located within the ecological logic: complexity science, by investigating the evolving and emergent properties of systems, but also embraces the mechanistic logic of implementation science (IS) (i.e., getting evidence-based interventions into practice); and the social logic, as the study of individuals, groups, and organizations. Integral to this logic mixture is measuring person-centered parameters (i.e., comprehension, emotional responses, barriers, motivations, and optimization strategies) concerning any evaluated matter across the micro, meso, and macro levels of systems. We embrace the principles of Nilsen's taxonomy to demonstrate its adaptability by comparing and encompassing the normalization process theory, the 2 × 2 conceptual map of influence on behaviors, and PROLIFERATE. Results: Snapshots of ongoing research in different healthcare settings within Australia are offered to demonstrate how PROLIFERATE can be used for co-designing innovations, tracking their optimization process, and evaluating their impacts. The exemplification involves the evaluation of Health2Go (the design and implementation of an innovative procedure: interdisciplinary learning within an allied health service-community-based) and RAPIDx_AI (an artificial intelligence randomized clinical trial being tested to improve the cardiac care of patients within emergency departments-tertiary care). Conclusion: PROLIFERATE is one of the first frameworks to combine ecological, mechanistic, and social logic models to co-design, track, and evaluate complex interventions while operationalizing an innovative complexity science approach: the knowledge translation complexity network model (KT-cnm). It adds a novel perspective to the importance of stakeholders' agency in the system by considering their sociodemographic characteristics and experiences within different healthcare settings (e.g., procedural innovations such as "interdisciplinary learning" for Health2Go, and tech-enabled solutions such as RAPIDx_AI). Its structured facilitation processes engage stakeholders in dynamic and productive ways while measuring and optimizing innovation within the complexities of health systems.
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Herein, for the first time, we report the transition metal-free electrochemical site-selective direct C-H sulfenylation/selenylation of chromone-fused indolizine compounds (CFIs) to afford the corresponding CFIs thioethers and selenoethers in 58-96% yields. The developed protocol offers a transition metal-free, ligand-free, catalyst-free methodology and is suitable for a variety of chalcogenide molecules (S and Se) along with various electron-rich and electron-poor chromone-fused indolizine compounds. Cyclic voltammograms and control experiments also validated the plausible reaction pathway.
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Surface enhanced Raman spectroscopy (SERS) allows the ultrasensitive detection of analytes present in traces or even single molecule levels by the generation of electromagnetic fields. It is a powerful vibrational spectroscopic method that is capable to detect traces of chemical and biological analytes. SERS technique is involved in the extremely sophisticated studies of molecules with high specificity and sensitivity. In the vicinity of nanomaterials decorated surfaces, SERS can monitor extremely low concentrations of analytes in a non-destructive manner with narrow line widths. This review article is focused on some recently developed SERS-based sensors for distinct types of analytes like disease-related biomarkers, organic and inorganic molecules, various toxins, dyes, pesticides, bacteria as well as single molecules. This study aims to enlighten the arising sensing approaches based on the SERS technique. Apart from this, some basics of the SERS technique like their mechanism, detection strategy, and involvement of some specific nanomaterials are also highlighted herein. Finally, the study concluded with some discussion of applications of SERS in various fields like food and environmental analysis.