ABSTRACT
Patients with Down syndrome have significant specialized health care needs. Our objective was to understand the needs, satisfaction, and online habits of caregivers as they care for persons with Down syndrome. A mixed-method survey was distributed through REDCap from April 2022 to June 2022 in the United States; a Spanish-translated version was distributed through SurveyMonkey from August 2022 to March 2023 in Mexico. We received 290 completed responses from the United States and 58 from caregivers in Mexico. We found that current health care options are not meeting the needs of many individuals with DS in both the United States (39.7%) and Mexico (46.6%). Caregivers expressed frustrations with the inaccessibility and inapplicability of health care information. In particular, they often found the volume of information overwhelming, given their limited medical background. Additionally, health care recommendations were not customized and lacked practical recommendations. Most caregivers in both the United States (72.1%) and Mexico (82.8%) believe it is not easy to find answers to medical questions about their loved ones with DS. Online platforms with customized, specific health information related to DS could offer innovative solutions to these unmet needs for families and primary care providers.
Subject(s)
Caregivers , Down Syndrome , Humans , United States , Literacy , Delivery of Health Care , Personal SatisfactionABSTRACT
This paper presents the findings of our fourth annual horizon-scanning exercise, which aims to identify topics that increasingly may affect conservation of biological diversity. The 15 issues were identified via an iterative, transferable process by a team of professional horizon scanners, researchers, practitioners, and a journalist. The 15 topics include the commercial use of antimicrobial peptides, thorium-fuelled nuclear power, and undersea oil production.
Subject(s)
Conservation of Natural Resources/trends , Animals , Antimicrobial Cationic Peptides , Aquaculture/trends , Aquatic Organisms , Autoimmune Diseases/etiology , Biodiversity , Cocos , Coral Reefs , DNA/analysis , Extinction, Biological , Extraction and Processing Industry/trends , Forestry/trends , Humans , Hypersensitivity/etiology , Nuclear Power Plants/statistics & numerical data , Nucleic Acids/chemical synthesis , Printing/trends , Solar Energy/statistics & numerical data , Thorium , Water CycleABSTRACT
Our aim in conducting annual horizon scans is to identify issues that, although currently receiving little attention, may be of increasing importance to the conservation of biological diversity in the future. The 15 issues presented here were identified by a diverse team of 22 experts in horizon scanning, and conservation science and its application. Methods for identifying and refining issues were the same as in two previous annual scans and are widely transferable to other disciplines. The issues highlight potential changes in climate, technology and human behaviour. Examples include warming of the deep sea, increased cultivation of perennial grains, burning of Arctic tundra, and the development of nuclear batteries and hydrokinetic in-stream turbines.
Subject(s)
Conservation of Natural Resources , BiodiversityABSTRACT
Liquid mixing scale-up in pharmaceutical industry has often been based on empirical approach in spite of tremendous understanding of liquid mixing scale-up in engineering fields. In this work, we attempt to provide a model-based approach to scale-up dissolution process from a 2 l lab-scale vessel to a 4,000 l scale vessel used in manufacturing. Propylparaben was used as a model compound to verify the model predictions for operating conditions at commercial scale that would result in similar dissolution profile as observed in lab scale. Geometric similarity was maintained between both of the scales to ensure similar mixing characteristics. We utilized computational fluid dynamics (CFD) to ensure that the operating conditions at laboratory and commercial scale will result in similar power per unit volume (P/V). Utilizing this simple scale-up criterion of similar P/V across different scales, results obtained indicate fairly good reproducibility of the dissolution profiles between the two scales. Utilization of concepts of design of experiments enabled summarizing scale-up results in statistically meaningful parameters, for example -90% dissolution in lab scale at a given time under certain operating conditions will result in 75-88% at commercial scale with 95% confidence interval when P/V is maintained constant across the two scales. In this work, we have successfully demonstrated that scale-up of solid dissolution can be done using a systematic process of lab-scale experiments followed by simple CFD modeling to predict commercial-scale experimental conditions.
