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Patient education constitutes a relevant strategy to improve pain management. In the field of therapeutic patient education (TPE), we aimed 1) to assess pain impact in cancer patients, 2) to identify patients' educative needs in pain management, and 3) to refine research criteria for its future evaluation. Pain intensity, relief and interference were assessed in 75 cancer patients with unbalanced background pain. Self-assessment questionnaire evaluated i) patients' pain management and ii) their knowledge and needs in TPE. Most patients experienced pain for more than 6 months and 41.6% reported adequate pain relief. Understanding pain and pain management were major patients' preferences (>58%). Most patients declared they knew their pain treatments, but fewer than half of them were able to name them. However, education concerning pain treatment was considered as essential in <30% of patients. Almost all patients (97.1%) stated pain education as beneficial, with a preference for individualized sessions (41.2%). In addition, the assessment criteria for its future evaluation were refined. Targeted population mainly concerned patients with persistent pain. Only half of patients reported pain relief despite antalgics. Patient education was declared as beneficial for almost all participants. Tailoring a pain TPE on patients' needs has the potential to help them to optimally manage their pain daily.

Locteron™, a newly developed controlled-release formulation of Lemna-derived free (unpegylated) recombinant interferon-α2b (IFN-α2b, Biolex Therapeutics, Pittsboro, NC) in poly(ether-ester) microspheres (PolyActive, OctoPlus N.V., Leiden, the Netherlands), was evaluated in 27 volunteers injected with either 20, 80, or 320 μg Locteron (equivalent to 6.25, 25, or 100 × 106 IU, respectively), 80 μg pegylated IFN-α2b (PEG-IFN-α2b), microspheres not containing IFN-α2b, or placebo. Serum free or PEG-IFN-α2b and two biomarkers of IFN activity, neopterin and 2′,5′-oligoadenylate synthetase (2′,5′-OAS), were measured. After injection of 320 μg Locteron, serum IFN-α2b remained elevated through 14 days. The elimination half-life of Locteron was more than 2-fold that of PEG-IFN-α2b. The effects of 80 μg Locteron and 80 μg PEG-IFN-α2b on both neopterin and 2′,5′-OAS were in a comparable range. Serum persistence of both these biomarkers was similar at 14 days after 320 μg Locteron compared with 7 days after 80 μg PEG-IFN-α2b. Mild, moderate, or severe influenza-like symptoms developed in all 6 subjects receiving 80 μg PEG-IFN-α2b. No such symptoms occurred after 20 or 80 μg Locteron doses. Among the 4 recipients of 320 μg Locteron, 1 experienced mild and 2 experienced moderate influenza-like symptoms. Locteron merits further clinical investigation as a hepatitis C therapy suitable for dosing once per 2 weeks.

Locteron, a newly developed controlled-release formulation of Lemna-derived free (unpegylated) recombinant interferon- alpha 2b (IFN- alpha 2b, Biolex Therapeutics, Pittsboro, NC) in poly(ether-ester) microspheres (Poly-Active, OctoPlus N.V., Leiden, the Netherlands), was evaluated in 27 volunteers injected with either 20, 80, or 320 mu g Locteron (equivalent to 6.25, 25, or 100 X 10 super(6) IU, respectively), 80 mu g pegylated IFN- alpha 2b (PEG-IFN- alpha 2b), microspheres not containing IFN- alpha 2b, or placebo. Serum free or PEG-IFN- alpha 2b and two biomarkers of IFN activity, neopterin and 2',5'-oligoadenylate synthetase (2',5'-OAS), were measured. After injection of 320 mu g Locteron, serum IFN- alpha 2b remained elevated through 14 days. The elimination half-life of Locteron was more than 2-fold that of PEG-IFN- alpha 2b. The effects of 80 mu g Locteron and 80 mu g PEG-IFN- alpha 2b on both neopterin and 2',5'-OAS were in a comparable range. Serum persistence of both these biomarkers was similar at 14 days after 320 mu g Locteron compared with 7 days after 80 mu g PEG-IFN- alpha 2b. Mild, moderate, or severe influenza-like symptoms developed in all 6 subjects receiving 80 mu g PEG-IFN- alpha 2b. No such symptoms occurred after 20 or 80 mu g Locteron doses. Among the 4 recipients of 320 mu g Locteron, 1 experienced mild and 2 experienced moderate influenza-like symptoms. Locteron merits further clinical investigation as a hepatitis C therapy suitable for dosing once per 2 weeks.

Locteron, a newly developed controlled-release formulation of Lemna-derived free (unpegylated) recombinant interferon-alpha2b (IFN-alpha2b, Biolex Therapeutics, Pittsboro, NC) in poly(ether-ester) microspheres (PolyActive, OctoPlus N.V., Leiden, the Netherlands), was evaluated in 27 volunteers injected with either 20, 80, or 320 microg Locteron (equivalent to 6.25, 25, or 100 x 10(6) IU, respectively), 80 microg pegylated IFN-alpha2b (PEG-IFN-alpha2b), microspheres not containing IFN-alpha2b, or placebo. Serum free or PEG-IFN-alpha2b and two biomarkers of IFN activity, neopterin and 2',5'-oligoadenylate synthetase (2',5'-OAS), were measured. After injection of 320 microg Locteron, serum IFN-alpha2b remained elevated through 14 days. The elimination half-life of Locteron was more than 2-fold that of PEG-IFN-alpha2b. The effects of 80 microg Locteron and 80 microg PEG-IFN-alpha2b on both neopterin and 2',5'-OAS were in a comparable range. Serum persistence of both these biomarkers was similar at 14 days after 320 microg Locteron compared with 7 days after 80 microg PEG-IFN-alpha2b. Mild, moderate, or severe influenza-like symptoms developed in all 6 subjects receiving 80 microg PEG-IFN-alpha2b. No such symptoms occurred after 20 or 80 microg Locteron doses. Among the 4 recipients of 320 microg Locteron, 1 experienced mild and 2 experienced moderate influenza-like symptoms. Locteron merits further clinical investigation as a hepatitis C therapy suitable for dosing once per 2 weeks.

BackgroundQuality standards invite organisations to determine and meet customer requirements in order to continually improve customer satisfaction. However, a certification organisation stressed that customer focus was insufficiently developed in our facility. This deficiency could lead to serious repercussions as this hospital pharmacy is independent from its customers and is currently evolving in a changing environment.PurposeTo develop a self-assessment tool to evaluate the pharmacy’s functioning in relation to customer-focused quality requirements.Material and methodsRequirements of an optimal customer-focused quality management system were obtained from two quality standards (ISO 9001 and a hospital pharmacy quality reference system (RQPH)). A three-person workgroup scored these requirements according to the level of realisation, the extent of measurements performed, the suitability of the implemented answer; and its relevance to the organisation (0 pt = non-existent, 1–2 pts = intermediate, 3 pts = optimal). By adding these four scores, a total score of maturity was obtained for each requirement (≤4 pts = insufficient; 5–8 pts = intermediate; ≥9 pts = satisfactory). The requirements that scored 0 pt for any criterion, 1 pt for their degree of realisation or a total score <5 pts, were selected for improvement.Results54 requirements were identified (ISO 9001 = 14; RQPH = 14 general, 26 specific). Most of them scored more points on their level of realisation and measurement than on suitability and relevance, indicating that customer-focused activities had probably been implemented merely to answer quality requirements, without being useful, usable or put into use. A mean score of 7.25/12 pts indicated an intermediate global maturity of the customer-focused quality management system. One-third of requirements were selected for improvement (4/14 ISO 9001, 14/40 RQPH). Various practical suggestions for improving the pharmacy’s functioning were finally made based on these results, and are currently being implemented.ConclusionA quality requirement self-assessment tool was developed and tested successfully. It could be used by other organisations to assess their response to various quality requirements.References and/or acknowledgementsNo conflict of interest.

Locteron, a newly developed controlled-release formulation of Lemna-derived free (unpegylated) recombinant interferon-alpha2b (IFN-alpha2b, Biolex Therapeutics, Pittsboro, NC) in poly(ether-ester) microspheres (PolyActive, OctoPlus N.V., Leiden, the Netherlands), was evaluated in 27 volunteers injected with either 20, 80, or 320 microg Locteron (equivalent to 6.25, 25, or 100 x 10(6) IU, respectively), 80 microg pegylated IFN-alpha2b (PEG-IFN-alpha2b), microspheres not containing IFN-alpha2b, or placebo. Serum free or PEG-IFN-alpha2b and two biomarkers of IFN activity, neopterin and 2',5'-oligoadenylate synthetase (2',5'-OAS), were measured. After injection of 320 microg Locteron, serum IFN-alpha2b remained elevated through 14 days. The elimination half-life of Locteron was more than 2-fold that of PEG-IFN-alpha2b. The effects of 80 microg Locteron and 80 microg PEG-IFN-alpha2b on both neopterin and 2',5'-OAS were in a comparable range. Serum persistence of both these biomarkers was similar at 14 days after 320 microg Locteron compared with 7 days after 80 microg PEG-IFN-alpha2b. Mild, moderate, or severe influenza-like symptoms developed in all 6 subjects receiving 80 microg PEG-IFN-alpha2b. No such symptoms occurred after 20 or 80 microg Locteron doses. Among the 4 recipients of 320 microg Locteron, 1 experienced mild and 2 experienced moderate influenza-like symptoms. Locteron merits further clinical investigation as a hepatitis C therapy suitable for dosing once per 2 weeks.

Lately, there has been a particular interest in increasing the bandwidth of the ionospheric channel in the high frequency (HF) range. Tests on the use of bandwidths of up to 24kHz have shown that under certain conditions a substantial increase in the data transfer rate in the HF range could be achieved. But the bandwidth increase is limited mainly due to the noise level. This paper approaches a preliminary experimental analysis of the noise power levels in variable bandwidth ionospheric channels under Near Vertical Incidence Skywave (NVIS) operating conditions in the 3-9 MHz band. The results show that the mean noise power increases by an average of 3.5 dB at doubling the bandwidth of the ionospheric channel, while the dispersion of noise is maintained (at maximum 9.5 dB) regardless of the bandwidth of the ionospheric channel.

SPHERE+ is a proposed upgrade of the SPHERE instrument at the VLT, which is intended to boost the current performances of detection and characterization for exoplanets and disks. SPHERE+ will also serve as a demonstrator for the future planet finder (PCS) of the European ELT. The main science drivers for SPHERE+ are 1/ to access the bulk of the young giant planet population down to the snow line (\\(3-10\\) au), to bridge the gap with complementary techniques (radial velocity, astrometry); 2/ to observe fainter and redder targets in the youngest (\\(1-10\\)\\,Myr) associations compared to those observed with SPHERE to directly study the formation of giant planets in their birth environment; 3/ to improve the level of characterization of exoplanetary atmospheres by increasing the spectral resolution in order to break degeneracies in giant planet atmosphere models. Achieving these objectives requires to increase the bandwidth of the xAO system (from \\(\\sim\\)1 to 3\\,kHz) as well as the sensitivity in the infrared (2 to 3\\,mag). These features will be brought by a second stage AO system optimized in the infrared with a pyramid wavefront sensor. As a new science instrument, a medium resolution integral field spectrograph will provide a spectral resolution from 1000 to 5000 in the J and H bands. This paper gives an overview of the science drivers, requirements and key instrumental trade-off that were done for SPHERE+ to reach the final selected baseline concept.

In ground-based high-contrast instruments, non-common path aberrations (NCPAs) limit detection performance, as they are unseen by the adaptive optics (AO) wavefront sensor but impact the astrophysical image, creating quasi-static speckles. SAXO+, the upgrade of the SAXO (SPHERE AO system) includes a second loop of AO downstream of the SAXO loop that is equipped with a near-infrared pyramid wavefront sensor whose nonlinearities, usually described with modal optical gains, might be challenging for removing quasi-static speckles. We investigated two methods of quasi-static speckle removal : NCPA compensation and a dark hole loop, behind a pyramid AO system, measuring the interest of compensating for the pyramid optical gains. We performed end-to-end numerical simulations under various astrophysical conditions. We offset the pyramid wavefront sensor operating point to apply both the speckle suppression methods, with or without optical gain calibration. We evaluated the performance by measuring the residual starlight in the coronagraph image. A by-product of our study is an on-sky calibration method of measuring the pyramid optical gains. NCPA compensation reduces the residual starlight in the coronagraph image by a factor of 20 for seeing between 0.7\" and 1\" for a bright star and a factor of 2 at 0.7\" for a faint star. Optical gains compensation enhances the performance at poor seeing and small pyramid modulation radius with a bright star, but shows a useless or even negative impact due to estimation inaccuracies at faint targets. On the other hand, the dark hole loop reduces the residual starlight by a factor of 200. The optical gain calibration enhances the dark hole performance behind a single pyramid AO system but is useless behind the SAXO+ system. Our parametric study gives baseline values for the efficient control of the dark hole loop for the SAXO+ system.