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Biocompatible and biodegradable ingredients of natural origin are widely used in the design of foam and emulsion systems with various technological applications in the food, cosmetics and pharmaceutical industries. The determination of the precise composition of aqueous solution formulations is a key issue for the achievement of environmentally-friendly disperse systems with controllable properties and reasonable stability. The present work is focused on the investigation of synergistic interactions in aqueous systems containing Quillaja saponins and Apple pectins. Profile analysis tensiometer (PAT-1) is applied to study the surface tension and surface dilational rheology of the adsorption layers at the air/solution interface. The properties and the foam films (drainage kinetics, film thickness, disjoining pressure isotherm, critical pressure of rupture) are investigated using the thin-liquid-film (TLF) microinterferometric method of Scheludko–Exerowa and the TLF-pressure-balance technique (TLF-PBT). The results demonstrate that the structure and stability performance of the complex aqueous solutions can be finely tuned by changing the ratio of the bioactive ingredients. The attained experimental data evidence that the most pronounced synergy effect is registered at a specific saponin:pectin ratio. The obtained information is essential for the further development of aqueous solution formulations intended to achieve stable foams based on mixtures of Quillaja saponins and Apple pectins in view of future industrial, pharmaceutical and biomedical applications. [ABSTRACT FROM AUTHOR]

Background: Evidence suggests specialist eating disorders services for children and adolescents with anorexia nervosa have the potential to improve outcomes and reduce costs through reduced hospital admissions. This study aimed to evaluate the cost-effectiveness of assessment and diagnosis in community-based specialist child and adolescent mental health services (CAMHS) compared to generic CAMHS for children and adolescents with anorexia nervosa. Method: Observational, surveillance study of children and adolescents aged 8 to 17, in contact with community-based CAMHS in the UK or Republic of Ireland for a first episode of anorexia nervosa. Data were reported by clinicians at baseline, 6 and 12-months follow-up. Outcomes included the Children's Global Assessment Scale (CGAS) and percentage of median expected body mass for age and sex (%mBMI). Service use data included paediatric and psychiatric inpatient admissions, outpatient and day-patient attendances. A joint distribution of incremental mean costs and effects for each group was generated using bootstrapping to explore the probability that each service is the optimal choice, subject to a range of values a decision-maker might be willing to pay for outcome improvements. Uncertainty was explored using cost-effectiveness acceptability curves. Results: Two hundred ninety-eight children and adolescents met inclusion criteria. At 12-month follow-up, there were no significant differences in total costs or outcomes between specialist eating disorders services and generic CAMHS. However, adjustment for pre-specified baseline covariates resulted in observed differences favouring specialist services, due to significantly poorer clinical status of the specialist group at baseline. Cost-effectiveness analysis using CGAS suggests that the probability of assessment in a specialist service being cost-effective compared to generic CAMHS ranges from 90 to 50%, dependent on willingness to pay for improvements in outcome. Conclusions: Assessment in a specialist eating disorders service for children and adolescents with anorexia nervosa may have a higher probability of being cost-effective than assessment in generic CAMHS. Trial registration: ISRCTN12676087. Date of registration 07/01/2014. Plain English summary: Specialist eating disorders services may improve outcomes and reduce hospitalisations for children and adolescents with anorexia nervosa. Reductions in hospitalisation could save money for the NHS and are better for young people because hospitalisation disrupts their home life, social life and education. This study evaluated outcomes and costs of specialist eating disorders services compared to general child and adolescent mental health services (CAMHS) for children and adolescents with anorexia nervosa. Children and adolescents were identified by contacting child and adolescent psychiatrists in the UK and Ireland and asking them to report any new cases of anorexia nervosa. These psychiatrists identified 298 young people aged 8 to 17 with an anorexia nervosa diagnosis for the first time. The psychiatrists provided information on the health services these young people used and how they were doing when they were first diagnosed and 6 months and 1 year later. Children and adolescents in specialist services were more severely ill than those in CAMHS when they were first diagnosed. Despite this, care for the young people in specialist services cost about the same as for those diagnosed in CAMHS, and their outcomes after 1 year were similar. This work showed that specialist services may be better value for money than CAMHS. [ABSTRACT FROM AUTHOR]

Hydrophobically modified polyelectrolytes, such as polyacrylic acids (PAA) are widely used as technological viscosifiers. At the same time, they are of great academic interest in view of wide possibilities for fine-tuning of their aqueous solution properties. The latter strongly depend on the quantity of added low-molecular-mass electrolytes and are sensitive to the pH-value of the solution. The present study explores the bulk and interfacial characteristics of aqueous solutions of two polyacrylic acids: PAA150C 10 (MW = 150000) and PAA150C 12 (MW = 150000), randomly grafted with 3 mol% decyl (C 10 ) and dodecyl (C 12 ) chains. Bulk viscoelastic properties of PAA150C 10 and PAA150C 12 are explored; dynamic, equilibrium and rheological properties of the adsorption layers at solution/air interface are studied, as well. For the same systems, microscopic foam films are investigated (drainage kinetics, disjoining pressure vs. film thickness isotherms, stability, etc.). The obtained results contain valuable new information which may be related to the interplay of the specific interactions in the particular formulations and to the possible conformation changes of these amphiphilic polymers. The experimental data provide additional evidences for the response of the investigated aqueous systems to well-defined changes in the experimental conditions (pH, addition of low-molecular-mass electrolytes, etc.). [ABSTRACT FROM AUTHOR]

We studied silica suspensions with chitosan and biodegradable synthetic surfactant lauroyl ethyl arginate (LAE). Hydrophilic and negatively charged silica nanoparticles were neutralised due to the coating with chitosan. That presence of LAE led to the partial hydrophobisation of their surface, which favoured their attachment to the surface of a thin foam film. It was found that the presence of small and medium-sized (6–9 nm) hydrophobic particles in the interfacial layer of lamella foam film inhibited the coalescence and coarsening processes, which prolonged the life of the foam. Furthermore, hydrophobising of 30 nm particles allowed the formation of large aggregates precipitating from the mixture under steady-state conditions. These aggregates, however, under the conditions of the dynamic froth flotation process in the foam column, were floated into the foam layer. As a result, they were trapped in the foam film and Plateau borders, effectively preventing liquid leakage out of the foam. These results demonstrate the efficiency of using chitosan-LAE mixtures to remove silica nanoparticles from aqueous phase by foaming and flotation. [ABSTRACT FROM AUTHOR]

This cross-sectional study aimed to determine the prevalence and impact of depression on health care costs in patients with complex chronic pain. The sample included 1204 patients attending a tertiary pain management service for people with chronic disabling pain, unresponsive to medical treatment. As part of routine care, patients completed a web-based questionnaire assessing mental and physical health, functioning, and service use in the preceding 3 months. Depression was assessed using the 9-item Patient Health Questionnaire. Self-report health care utilisation was measured across 4 domains: general practitioner contacts, contacts with secondary/tertiary care doctors, accident and emergency department visits, and days hospitalised. The participation rate was 89%. Seven hundred and thirty-two patients (60.8%; 95% CI 58.0-63.6) met criteria for probable depression, and 407 (33.8%) met the threshold for severe depression. Patients with depression were more likely to be unable to work because of ill health and reported greater work absence, greater pain-related interference with functioning, lower pain acceptance, and more generalised pain. Mean total health care costs per 3-month period were £731 (95% CI £646-£817) for patients with depression, compared with £448 (95% CI £366-£530) for patients without depression. A positive association between severe depression and total health care costs persisted after controlling for key demographic, functional, and clinical covariates using multiple linear regression models. These findings reveal the extent, severity, and impact of depression in patients with chronic pain and make evident a need for action. Effective treatment of depression may improve patient health and functioning and reduce the burden of chronic pain on health care services. [ABSTRACT FROM AUTHOR]

Wetting behavior of aqueous solutions of four polyoxyalkylated diethylenetriamine (DETA) polymeric surfactants (named A–D) are studied and pH effect is assessed. Surfactants A, B and C have a ‘star-like’ structure differing only by the number of polymeric branches: 4, 6 and 9 in the mentioned order while the forth one, D, is of a dendritic type with 4–6 primary and 2–3 secondary branches. Experimental data about liquid/air surface tension, contact angle θ and equilibrium wetting film thickness of the surfactant solutions in pH range of 1–12 are obtained. The liquid/solid and the air/solid surface tension are calculated using the empirical equation of state and Berthelot’s combining rule. Results from the studies indicate that pH affects polymer solution properties at liquid/solid and liquid/air interfaces, and influences parameters such as surface tension, solid surface hydrophobicity, equilibrium film thickness, etc. [ABSTRACT FROM AUTHOR]

The article discusses the randomised study on patients in hospital medical clinics who had excessive health anxiety and attended sessions of adapted cognitive behaviour therapy (CBT-HA group) delivered by hospital-based therapists or to standard care in clinics. The study found that at one year, patients in the CBT-HA group was 2.98 points greater in improvement in health anxiety compared to the standard care group, and twice the patients receiving CBT achieved health anxiety normal levels.