Publications by authors named "R Z Thomas"

7,100 Publications

3D Printed Hollow Microneedles Array using Stereolithography for Efficient Transdermal Delivery of Rifampicin.

Int J Pharm 2021 Jun 18:120815. Epub 2021 Jun 18.

Department of Pharmaceutics, National Institute of Pharmaceutical Education & Research (NIPER)-Guwahati, Changsari, Assam, India; National Centre for Pharmacoengineering, NIPER-Guwahati, Changsari, Assam, India. Electronic address:

A 3D printed assembly of hollow microneedles (HMNs) array, conjoined with a reservoir void, was designed and additively manufactured using stereolithography (SLA) technology utilizing a proprietary class-I resin. The HMNs array was utilized for transdermal delivery of high molecular weight antibiotics, i.e., rifampicin (M 822.94 g/mol), which suffers from gastric chemical instability, low bioavailability, and severe hepatotoxicity. HMNs morphology was designed with sub-apical holes present in a quarter of the needle tip to improve its mechanical strength and integrity of the HMNs array. The HMNs array was characterized by optical microscopy and electron microscopy to ascertain the print quality and uniformity across the array. The system was also subjected to mechanical characterization for failure and penetration analyses. The ex vivo permeation and consequent transport of rifampicin across porcine skin were systematically evaluated. Finally, in vivo examinations of rifampicin administration through the microneedle reservoir system in SD rats revealed efficient penetration and desired bioavailability.
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http://dx.doi.org/10.1016/j.ijpharm.2021.120815DOI Listing
June 2021

A Community Jury on initiating weight management conversations in primary care.

Health Expect 2021 Jun 21. Epub 2021 Jun 21.

Centre for Research in Evidence-Based Practice, Bond University, Gold Coast, Qld, Australia.

Background: Current guidelines recommend that patients attending general practice should be screened for excess weight, and provided with weight management advice.

Objective: This study sought to elicit the views of people with overweight and obesity about the role of GPs in initiating conversations about weight management.

Methods: Participants with a body mass index ≥25 were recruited from a region in Australia to take part in a Community Jury. Over 2 days, participants (n = 11) deliberated on two interconnected questions: 'Should GPs initiate discussions about weight management?' And 'if so, when: (a) opportunistically, (b) in the context of disease prevention, (c) in the context of disease management or (d) other?' The jury deliberations were analysed qualitatively to elicit their views and recommendations.

Results: The jury concluded GPs should be discussing weight management, but within the broader context of general health. The jury were divided about the utility of screening. Jurors felt GPs should initiate the conversation if directly relevant for disease prevention or management, otherwise GPs should provide opportunities for patients to consent to the issue being raised.

Conclusion: The jury's verdict suggests informed people affected by overweight and obesity believe GPs should discuss weight management with their patients. GPs should feel reassured that discussions are likely to be welcomed by patients, particularly if embedded within a more holistic focus on person-centred care.

Public Contribution: Members of the public took part in the conduct of this study as jurors, but were not involved in the design, analysis or write-up.
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http://dx.doi.org/10.1111/hex.13286DOI Listing
June 2021

Using the performance arts to address a "methods gap" in dementia research.

Arts Health 2021 Jun 21:1-14. Epub 2021 Jun 21.

School of Social Work, Carleton University, Ottawa, Canada.

: Traditional methods of research have frequently failed to accommodate the communication difficulties experienced by a significant proportion of residents living in long-term care. In dementia research, specifically, there is cause for more collaborative, creative ways of working.: The Linking Lives Through Care study is a performance-based narrative inquiry that will take place in a long-term care setting and will bring together all three members of the care triad - residents who are living with dementia, family members and personal support workers - to explore relational care from multiple positions and perspectives.: In this article, we discuss the design choices and creative measures taken to ensure a more inclusive research environment, specifically for those participants who are cognitively frail and/or may find it difficult to express their views using just words.
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http://dx.doi.org/10.1080/17533015.2021.1942093DOI Listing
June 2021

Lesions in sheep elbows: Insights from a large-scale study.

Int J Paleopathol 2021 Jun 17;34:50-62. Epub 2021 Jun 17.

School of Archaeology, University of Oxford, 1 South Parks Rd, Oxford OX1 3TG, United Kingdom.

Objectives: Enthesophytes on sheep elbow joints are commonly reported in archaeological material. Although these lesions are often described as 'penning elbow', little is known of their aetiology. In this study, a new method for recording these lesions is presented, and the effect of age, sex and body size is explored to understand their potential for informing upon past human-animal interactions.

Materials: 1133 distal humerii and proximal radii from 16 archaeological sites.

Methods: The presence and severity of enthesophytes were recorded and findings compared with modern data from a group of 17 complete Soay sheep skeletons.

Results: Significant, positive correlations between age and body size and the presence of enthesophytes were demonstrated. Environmental factors and trauma may also play a role in their formation.

Conclusion: The aetiology of enthesophytes on sheep elbows is complex and varied, affected by age, body size and environment.

Significance: This is the first study of enthesophytes on sheep elbows to combine archaeological data with modern animals of known age and sex. Blanket explanations of husbandry methods for the cause of these lesions are dispelled, and use of the term 'penning elbow' is redundant.

Limitations: The sample of modern specimens is relatively small and would benefit from the inclusion of older individuals and those raised in different environments.

Future Research: The method developed here can be adopted in future studies. Interpretations should take age, size and environmental factors into consideration, and only when these variables are established can the role of husbandry be evaluated.
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http://dx.doi.org/10.1016/j.ijpp.2021.05.007DOI Listing
June 2021

Implementing Palliative Care Training in the Caribbean: Development and Assessment of a Basic Palliative Care Training Course in Jamaica.

J Pain Symptom Manage 2021 Jun 16. Epub 2021 Jun 16.

Harvard Medical School, Boston, MA, USA; Jamaica Cancer Care and Research Institute, Kingston, Jamaica; Harvard/Massachusetts General Hospital Center on Genomics, Vulnerable Populations and Health Disparities, Mongan Institute Health Policy Research Center, Massachusetts General Hospital, Boston, MA, USA; The Faculty of Medical Sciences, The University of the West Indies (Mona), Kingston, Jamaica.

Context: The majority of people in need of palliative care (PC) in low- and middle-income countries lack access to it and suffer unnecessarily as a consequence. This unmet need is due, in part, to the lack of trained PC providers.

Objectives: This study aims to assess the effects of regional training in PC for doctors, nurses, and pharmacists in the Caribbean through assessment of participant satisfaction, anticipated course impact on participants' clinical practice, barriers to changing practice, and perceived course impact on achievement of key PC milestones.

Methods: We created and taught a course in basic PC for clinicians from the Caribbean region and collected and analyzed post-course quantitative and qualitative data on satisfaction and expected impact.

Results: Eighty-three clinicians from 5 Caribbean countries participated in this workshop. Thirty participants completed the post-course survey. One hundred percent of these participants ranked the quality of the course as "very high quality" or "high quality." The majority of participants anticipated changing their practice as a result of this course. Several barriers were reported, including lack of formal PC training in participants' home countries. Results of participants' retrospective pre- and post-course self-assessment for achievement of key PC milestones showed a statistically significant mean increase of at least 1 point on the 7-point Likert scale for each milestone.

Conclusion: Overall satisfaction with the course was high, and self-assessed competency in PC improved. These data suggest that an intensive training over several days is an effective format for increasing providers' perceived efficacy in delivering PC.
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http://dx.doi.org/10.1016/j.jpainsymman.2021.06.007DOI Listing
June 2021