Retrovirus Drugs-Loaded PEGylated PAMAM for Prolonging Drug Release and Enhancing Efficiency in HIV Treatment

Polyamidoamine dendrimer (PAMAM) with its unique characteristics emerges as a potential drug delivery system which can prolong releasing time, reduce the side effects but still retaining treatment efficiency. In this study, methoxy polyethylene glycol modified PAMAM generation 3.0 (G3.0@mPEG) is prepared and characterized via 1H-NMR, FT-IR, and TEM. Subsequently, two antiretroviral agents (ARV) including lamivudine (3TC) and zidovudine (AZT) are individually encapsulated into G3.0@mPEG. The drug-loading efficiency, drug release profile, cytotoxicity and anti-HIV activity are then evaluated. The results illustrate that G3.0@mPEG particles are spherical with a size of 34.5 ± 0.2 nm and a drug loading content of about 9%. Both G3.0@mPEG and [email protected]@mPEG show no cytotoxicity on BJ cells, and G3.0@mPEG loading 3TC and AZT performs sustained drug release behavior which is best fitted with the Korsmeyer–Peppas model. Finally, the anti-HIV activity of ARV via Enzymatic Assay of Pepsin is retained after being loaded into the G3.0@mPEG, in which about 36% of pepsin activity was inhibited by AZT at the concentration of 0.226 mM. Overall, PAMAM G3.0@mPEG is a promising nanocarrier system for loading ARV in HIV treatment and prevention.

Evaluation of the impact of an augmented model of The Productive Ward: Releasing Time to Care on staff and patient outcomes: a naturalistic stepped-wedge trial

BackgroundImproving the quality and efficiency of healthcare is an international priority. A range of complex ward based quality initiatives have been developed over recent years, perhaps the most influential programme has been Productive Ward: Releasing Time to Care. The programme aims to improve work processes and team efficiency with the aim of ‘releasing time’, which would be used to increase time with patients ultimately improving patient care, although this does not form a specific part of the programme. This study aimed to address this and evaluate the impact using recent methodological advances in complex intervention evaluation design.MethodThe objective of this study was to assess the impact of an augmented version of The Productive Ward: Releasing Time to Care on staff and patient outcomes. The design was a naturalistic stepped-wedge trial. The setting included fifteen wards in two acute hospitals in a Scottish health board region. The intervention was the Productive Ward: Releasing Time to Care augmented with practice development transformational change methods that focused on staff caring behaviours, teamwork and patient feedback. The primary outcomes included nurses’ shared philosophy of care, nurse emotional exhaustion, and patient experience of nurse communication. Secondary outcomes covered additional key dimensions of staff and patient experience and outcomes and frequency of emergency admissions for same diagnosis within 6 months of discharge.ResultsWe recruited 691 patients, 177 nurses and 14 senior charge nurses. We found statistically significant improvements in two of the study’s three primary outcomes: patients’ experiences of nurse communication (Effect size=0.15, 95% CI; 0.05 to 0.24), and nurses’ shared philosophy of care (Effect size =0.42, 95% CI; 0.14 to 0.70). There were also significant improvements in secondary outcomes: patients’ overall rating of ward quality; nurses’ positive affect; and items relating to nursing team climate. We found no change in frequency of emergency admissions within six months of discharge.ConclusionsWe found evidence that the augmented version of The Productive Ward: Releasing Time to Care Intervention was successful in improving a number of dimensions of nurse experience and ward culture, in addition to improved patient experience and evaluations of the quality of care received. Despite these positive summary findings across all wards, intervention implementation appeared to vary between wards. By addressing the contextual factors, which may influence these variations, and tailoring some elements of the intervention, it is likely that greater improvements could be achieved.Trial registration numberUKCRN 14195.

A Facile Synthesis of Core-Shell SiO2@Cu-LBMS Nano-Microspheres for Drug Sustained Release Systems

A well-dispersed SiO2@Layered hydroxide cupric benzoate (SiO2@Cu-LBMS) with a hierarchical structure have been synthesized by a facile method. The layered hydroxide cupric benzoate with a structure of layered basic metal salt (Cu-LBMS) was directly deposited on the surface of silica spheres without any blinder. The morphology of the SiO2@Cu-LBMS nano-microsphere was observed by SEM, and the reaction conditions was also discussed. In addition, the XRD patterns and FTIR spectra provide consistent evidence to the formation of SiO2@Cu-LBMS nano-microspheres. The release behavior and drug loading capability of SiO2@Cu-LBMS microspheres were also investigated by using ibuprofen, aspirin and salicylic acid as model drugs. The results indicated that the drug loading capability of SiO2@Cu-LBMS nano-microspheres was much larger than layered hydroxide cupric benzoate, and the releasing time was significantly prolonged than layered hydroxide cupric benzoate and their physical mixture.

Exploring the sustainability of quality improvement interventions in healthcare organisations: a multiple methods study of the 10-year impact of the ‘Productive Ward: Releasing Time to Care’ programme in English acute hospitals

BackgroundThe ‘Productive Ward: Releasing Time to Care’ programme is a quality improvement (QI) intervention introduced in English acute hospitals a decade ago to: (1) Increase time nurses spend in direct patient care. (2) Improve safety and reliability of care. (3) Improve experience for staff and patients. (4) Make changes to physical environments to improve efficiency.ObjectiveTo explore how timing of adoption, local implementation strategies and processes of assimilation into day-to-day practice relate to one another and shape any sustained impact and wider legacies of a large-scale QI intervention.DesignMultiple methods within six hospitals including 88 interviews (with Productive Ward leads, ward staff, Patient and Public Involvement representatives and senior managers), 10 ward manager questionnaires and structured observations on 12 randomly selected wards.ResultsResource constraints and a managerial desire for standardisation meant that, over time, there was a shift away from the original vision of empowering ward staff to take ownership of Productive Ward towards a range of implementation ‘short cuts’. Nonetheless, material legacies (eg, displaying metrics data; storage systems) have remained in place for up to a decade after initial implementation as have some specific practices (eg, protected mealtimes). Variations in timing of adoption, local implementation strategies and contextual changes influenced assimilation into routine practice and subsequent legacies. Productive Ward has informed wider organisational QI strategies that remain in place today and developed lasting QI capabilities among those meaningfully involved in its implementation.ConclusionsAs an ongoing QI approach Productive Ward has not been sustained but has informed contemporary organisational QI practices and strategies. Judgements about the long-term sustainability of QI interventions should consider the evolutionary and adaptive nature of change processes.

Introducing Ximenia americana Seedling Stage Potential and Technique to Communities at Sarang and Mecan Islands, Batam, Indonesia

The activity was carried out with “Kompang” Conservation group members on Sarang and Mecan islands, Sekanak Raya sub-district, Belakang Padang district, Batam, Indonesia. The Activity was started from May to October 2018. Implemented methods were counseling, training, seedling practice, direct observation, and Participatory Action Research. (1) Coordination and Seeking for Ximenia americana seedlings (Results: timing and scheduling Agreement stages; knowing the Ximenia americana fruiting season cycle; getting Ximenia americana seed for seedling). (2). Ximenia americana seedling Experiments in Polybag (Results: Ximenia americana Seed known having shell which wrapped its bean; The duration of germination depends on fruit maturity and its pulp releasing time. The result showed germination taking 2-3 months; a necessary soil for growing Ximenia americana sandy soil; during the experiment, mice and ants were identified as Pests). (3). training materials about Mangroves and Ximenia americana (Results: There were three training materials which can help the community to understand mangrove and Ximenia americana ecosystems and their benefits for ecosystems, economics and food sources). (4). Mangrove and Ximenia americana introducing Training for community (Results: Increasing community understanding and skills for natural coastal resources potentialization, especially mangroves and Ximenia americana; target community knows and understands the other benefits of mangroves and Ximenia Americana as healthy food source; environmental awareness on conservation and friendly environment). (5). Planting Ximenia americana in partner plantation (Results: There were sources of seeds to disseminate mangrove and Ximenia americana as sustainable supplier for syrup; Ensuring the sustainability of future partner community businesses).

HIPNOBREASFEEDING DAN PIJAT OKSITOSIN BERPENGARUH TERHADAP PENGELUARAN KOLOSTRUM PADA IBU POST PARTUM

Woman are blessed by The Almight God to conceive, give birth, and breastfeed. The nature given to the woman is characterized by the existence of its reproductive organs, such as uterus where the fetus grows and develops in the womb, breasts which breastfeed milk is produced so that the mother can breastfeed her baby at the beginning of childbirth. It means that all women have the potential to breastfeed their babies, just as their potential to conceive and deliver (Perinesia, 2010). At the early labor many post-partum mothers complain that their breastfeed milk cannot or not yet to be released that they cannot give colostrums to their baby at the beginning of their birth. One effort that can be done to help release the colostrum is by doing hypnobreasfeeding, oxytocin massage to the post-partum mothers 2-6 hours.This study discusses the effect of hypnobreastfeeding, the oxytocin massage on the releasing time of colostrum to the post-partum mothers 2-6 hours. This research used quantitative method. Respondents are post-partum mothers who performed hypnobreasfeeding, massage of oxytocin. The research design was Quasi Experiment. Sampling was done by purposive sampling of 70 respondents. The research results showed that parity was related to colostrum release at 4 hours post partum (p value = 0.020). Multivariate analysis proved that the most dominant factor that influenced colostrum release was multi-gravid parity by hypnobreastfeeding and oxytocin massage at 4 hours of post partum.