A systematic review of interventions to enhance medication adherence in children and adolescents with chronic illness

Introduction Poor medication adherence is common in children and adolescents with chronic illness, but there is uncertainty about the best way to enhance medication adherence in this group. The authors conducted a systematic review of controlled trials examining interventions that aim to improve medication adherence. Method A comprehensive literature search was undertaken to locate controlled trials that described specific interventions aiming to improve adherence to long-term medication, where participants were aged 18 years and under, medication adherence was reported as an outcome measure, and which could be implemented by individual health practitioners. Studies were reviewed for quality and outcome. Results 17 studies met inclusion criteria: seven studies examined educational strategies, seven studies examined behavioural interventions and three studies examined educational intervention combined with other forms of psychological therapies. Only two of seven studies reported a clear benefit for education on medication adherence, whereas four of seven trials indicated a benefit of behavioural approaches on medication adherence. One trial reported that combining education with behavioural management may be more effective than education alone. Studies which combined education with other non-medication specific psychological interventions failed to demonstrate a beneficial effect on medication adherence. Only two studies examined adherence-promoting interventions in young people with established adherence problems. Conclusion These findings suggest that education interventions alone are insufficient to promote adherence in children and adolescents, and that incorporating a behavioural component to adherence interventions may increase potential efficacy. Future research should examine interventions in high-risk groups.

Nutritional impact of antipseudomonas intravenous antibiotic courses in cystic fibrosis

Editor,—In their study of cystic fibrosis patients who were nutritionally assessed at the start and end of a 14 day period of home intravenous antibiotic treatment for chest disease, Vicet al concluded that increased weight was a result of increased fat storage.1 While this may in part be true, their methodology dictates caution in drawing conclusions....

The atmospheric extinction of light

An experiment is described that enables students to understand the properties of atmospheric extinction due to Rayleigh scattering. The experiment requires the use of red, green and blue lasers attached to a traveling microscope or similar device. The laser beams are passed through an artificial atmosphere, made from milky water, at varying depths, before impinging on either a light meter or a photodiode integral to a Picotech Dr. DAQ ADC. A plot of measured spectral intensity verses depth reveals the contribution Rayleigh scattering has to the extinction coefficient. For the experiment with the light meter, the extinction coefficient for red, green and blue light in the milky sample of water were 0.27, 0.36 and 0.47 cm-1 respectively and 0.032, 0.037 and 0.092 cm-1 for the Picotech Dr. DAQ ADC.

A non-linear analogue-to-digital converter for linearization of transducer input-output relationships

Analogue and digital techniques for linearization of non-linear input-output relationship of transducers are briefly reviewed. The condition required for linearizing a non-linear function y = f(x) using a non-linear analogue-to-digital converter, is explained. A simple technique to construct a non-linear digital-to-analogue converter, based on ' segments of equal digital interval ' is described. The technique was used to build an N-DAC which can be employed in a successive approximation or counter-ramp type ADC to linearize the non-linear transfer function of a thermistor-resistor combination. The possibility of achieving an order of magnitude higher accuracy in the measurement of temperature is shown.

Neonatal screening for cystic fibrosis

Two groups of patients with cystic fibrosis were compared. The screened group, detected with an improved neonatal screening assay for immunoreactive trypsin, developed fewer chest infections requiring treatment and gained more weight than the unscreened group. Early diagnosis by screening seems to affect early morbidity.

Apparent digestibility of some nutrient sources by juvenile mud crab, Scylla serrata (Forskal 1775)

As part of preliminary work aimed at the development of a formulated diet for the mud crab, Scylla serrata, an experiment was conducted with juvenile mud crabs (95.65±2.17 g) to determine apparent digestibility coefficients (ADC) for cellulose, fish meal, shrimp meal, blood meal, soybean meal, wheat flour and cod liver oil. Apparent digestibility coefficients for dry matter (ADCdm), energy (ADCenergy) and protein (ADC protein) were in the ranges 70.0-95.7%, 77.4-97.1% and 57.7-97.9% respectively. Soybean meal had the highest ADCdm and wheat flour had the lowest value (P<0.05), while the ADCdm for fish meal, blood meal and shrimp meal were not different (P?0.05). Similarly, soybean meal had the same ADCenergy as that of fish meal, but higher than those of cod liver oil, blood meal and shrimp meal (P<0.05). Moreover, the ADC protein for blood meal or shrimp meal were not significantly different from fish meal (P?0.05); nevertheless, they were lower than that of soybean meal and higher than that of wheat flour (P<0.05). Of significant interest was the ADCdm (78.0%) and ADCenergy (77.4%) for cellulose, which indicates that plant-based nutrient sources may well be a useful component of formulated diets for mud crabs.

Modulation of arginine decarboxylase activity in cucumber (Cucumis sativus) cotyledons in short-term organ culture

Among the various amines administered to excisedCucumis sativus cotyledons in short-term organ culture, agmatine (AGM) inhibited arginine decarboxylase (ADC) activity to around 50%, and putrescine was the most potent entity in this regard. Homoarginine (HARG) dramatically stimulated (3- to 4-fold) the enzyme activity. Both AGM inhibition and HARG stimulation of ADC were transient, the maximum response being elicited at 12 h of culture. Mixing experiments ruled out involvement of a macromolecular effector in the observed modulation of ADC. HARG-stimulated ADC activity was completely abolished by cycloheximide, whereas AGM-mediated inhibition was unaffected. Half-life of the enzyme did not alter on treatment with either HARG or AGM. The observed alterations in ADC activity are accompanied by change in Km of the enzyme. HARG-stimulated ADC activity is additive to that induced by benzyladenine (BA) whereas in presence of KCl, HARG failed to enhance ADC activity, thus demonstrating the overriding influence of K+ on amine metabolism.

Dry sliding wear behavior of Al2O3 fiber reinforced aluminum composites

Dry sliding wear behavior of die-cast ADC12 aluminum alloy composites reinforced with short alumina fibers were investigated by using a pin-on-disk wear tester. The Al2O3 fibers were 4 mu m in diameter and were present in volume fractions (T-f)ranging from 0.03 to 0.26, The length of the fiber varied from 40 to 200 mu m. Disks of aluminum-alumina composites were rubbed against a pin of nitrided stainless steel SUS440B with a load of 10 N at a sliding velocity of 0.1 m/s. The unreinforced ADC 12 aluminum alloy and their composites containing low volume fractions of alumina (V-f approximate to 0.05) showed a sliding-distance-dependent transition from severe to mild wear. However, composites containing high volume fractions of alumina ( V-f > 0.05) exhibited only mild wear for all sliding distances. The duration of occurrence of the severe wear regime and the wear rate both decrease with increasing volume fraction. In MMCs the wear rate in the mild wear regime decreases with increase in volume fraction: reaching a minimum value at V-f = 0.09 Beyond V-f = 0.09 the wear rate increasesmarginally. On the other hand, the wear rate of the counterface (steel pin) was found to increase moderately with increase in V-f. From the analysis of wear data and detailed examination of (a) worn surfaces, (b) their cross-sections and (c) wear debris, two modes of wear mechanisms have been identified to be operative, in these materials and these are: (i) adhesive wear in the case of unreinforced matrix material and in MMCs with low Vf and (ii) abrasive wear in the case of MMCs with high V-f. (C) 2000 Elsevier Science Ltd. All rights reserved.

A new quinone from Maesa indica (Roxb)A DC, (Myrsinaceae)

Isolation and structure elucidation of kiritiquinone, a new benzoquinone 2 5 dihydroxy-6-methyl 3 (hemeos 16-enyl)-1 4 benzoquinone from the frutis of Masca indica (Roxb) A DC is described

Optimal Power and Noise for Analog and Digital Sections of a Low Power Radio Receiver

We determine the optimal allocation of power between the analog and digital sections of an RF receiver while meeting the BER constraint. Unlike conventional RF receiver designs, we treat the SNR at the output of the analog front end (SNRAD) as a design parameter rather than a specification to arrive at this optimal allocation. We first determine the relationship of the SNRAD to the resolution and operating frequency of the digital section. We then use power models for the analog and digital sections to solve the power minimization problem. As an example, we consider a 802.15.4 compliant low-IF receiver operating at 2.4 GHz in 0.13 μm technology with 1.2 V power supply. We find that the overall receiver power is minimized by having the analog front end provide an SNR of 1.3dB and the ADC and the digital section operate at 1-bit resolution with 18MHz sampling frequency while achieving a power dissipation of 7mW.

Optimizing resolution of signals in a low-IF receiver

The resolution of the digital signal path has a crucial impact on the design, performance and the power dissipation of the radio receiver data path, downstream from the ADC. The ADC quantization noise has been traditionally included with the Front End receiver noise in calculating the SNR as well as BER for the receiver. Using the IEEE 802.15.4 as an example, we show that this approach leads to an over-design for the ADC and the digital signal path, resulting in larger power. More accurate specifications for the front-end design can be obtained by making SNRreg a function of signal resolutions. We show that lower resolution signals provide adequate performance and quantization noise alone does not produce any bit-error. We find that a tight bandpass filter preceding the ADC can relax the resolution requirement and a 1-bit ADC degrades SNR by only 1.35 dB compared to 8-bit ADC. Signal resolution has a larger impact on the synchronization and a 1-bit ADC costs about 5 dB in SNR to maintain the same level of performance as a 8-bit ADC.

Continous Time Sigma-Delta Modulator Employing a Novel Comparator Architecture

A novel comparator architecture is proposed for speed operation in low voltage environment. Performance comparison with a conventional regenerative comparator shows a speed-up of 41%. The proposed comparator is embedded in a continuous time sigma-delta ADC so as to reduce the quantizer delay and hence minimizes the excess loop delay problem. A performance enhancement of 1dB in the dynamic range of the ADC is achieved with this new comparator. We have implemented this ADC in a standard single-poly 8-Metal 0.13 mum UMC process. The entire system operates at 1.2 V supply providing a dynamic range of 32 dB consuming 720 muW of power and occupies an area of 0.1 mm2.

A power-scalable RF CMOS receiver for 2.4 GHz Wireless Sensor Network applications

A power scalable receiver architecture is presented for low data rate Wireless Sensor Network (WSN) applications in 130nm RF-CMOS technology. Power scalable receiver is motivated by the ability to leverage lower run-time performance requirement to save power. The proposed receiver is able to switch power settings based on available signal and interference levels while maintaining requisite BER. The Low-IF receiver consists of Variable Noise and Linearity LNA, IQ Mixers, VGA, Variable Order Complex Bandpass Filter and Variable Gain and Bandwidth Amplifier (VGBWA) capable of driving variable sampling rate ADC. Various blocks have independent power scaling controls depending on their noise, gain and interference rejection (IR) requirements. The receiver is designed for constant envelope QPSK-type modulation with 2.4GHz RF input, 3MHz IF and 2MHz bandwidth. The chip operates at 1V Vdd with current scalable from 4.5mA to 1.3mA and chip area of 0.65mm2.

GSPS photonic analogue to digital conversion system using broadband continuous wave source

An 80 GSPS photonic ADC system is demonstrated, using broadband MLL and dispersive fibre to form a continuous waveform with time-wavelength mapping, and AWG to channelise. Tests are carried out for RF signals up to 10GHz. © 2005 Optical Society of America.