EFFECTS OF STIMULANT MEDICATION UNDER VARIED MOTIVATIONAL OPERATIONS

We evaluated the evocative effects of four conditions (high‐ and low‐preference activities, low and divided attention) and stimulant medication on the behavior of a 16‐year‐old boy with attention deficit hyperactivity disorder and moderate mental retardation. All behavior (activity engagement, activity changes, inappropriate touching, rude behaviors, and physical aggression) improved with stimulant medication in most conditions, but undesirable behaviors were not reduced to acceptable levels in all conditions. This finding suggests that stimulant medication may be a valuable adjunct to function‐based interventions.     

初治肺结核患者服药依从性的相关因素分析

为了了解初治肺结核患者服药依从性状况及影响因素,采用分层整群随机抽样方法抽取样本,利用自制调查表和Morisky依从性量表获取数据信息,并用SPSS 16.0软件进行统计分析.参与调查的578例初治肺结核患者中,依从性低组为194例,占33.6％,依从性正常组为384例,占66.4％.影响服药依从性的主要因素为职业、治疗时期、生活满意度、病情严重程度等（P＜0.05）.可见初治肺结核患者不规则服药受多方面因素影响,应加强各方督导,提高服药依从性.     

Patterns of use,knowledge, and perceived effects of sedating medication on driving: A questionnaire survey of Japanese drivers who use sedating medication

ObjectiveThis study was designed to investigate patterns of medication use among drivers using pharmaceutical drugs, the subjective impact of medication use on driving, and knowledge about the effects of medication use on driving.MethodsAn online survey was administered to a sample of Japanese drivers (n = 1424, age range 21–79 years) to investigate the use pattern of major sedating medications such as cold/sinus drugs, anxiolytics, hypnotics, and antidepressants. The strength of association between variables pertaining to the use of sedating medications and self-reported at-fault crash involvement was explored using a series of multivariate logistic regression models.ResultsOn average, respondents reported using 2.7 sedating medications over the past two years (standard deviation = 1.8; range = 0–11). The pattern of psychotropic medication use was diverse, and the use of multiple psychotropic medications was common. Respondents could be grouped into four subgroups in terms of multiple medication use. Irrespective of the type of medication taken, respondents noticed few adverse side effects of medication on driving and generally did not adhere to driving-related product warnings; some respondents were unaware of important facts such as the exacerbation of the effects of medication effects when combining medications. Multivariate logistic regression analyses showed that the presence of a higher number of sedating agents in the medication taken was positively associated with reporting an at-fault crash in the last two years, having longer driving distance, being a commercial driver, receiving more traffic tickets, and having a higher tendency for rules violations.ConclusionsThe present study showed that medication use by drivers is diverse and complex, that most drivers are not sufficiently informed of the potentially impairing effects of medication, and that poly-medication use appeared prevalent among those who use psychotropic medications. In line with previous studies, the current study reveals a need for better communication between health experts and patients and for education of all stakeholders. The results also highlighted the need for systematic investigation into cause of crash in light of potential contribution of sedating medication used by the driver, given the low autopsy rate for fatally injured drivers in Japan.     

Assessing theoretical predictors of long-term medication adherence: Patients’ treatment-related beliefs,experiential feedback and habit development

Patient non-adherence to medication is a pervasive problem that contributes to poor patient health and high healthcare costs. Basic research and interventions have focused thus far on behaviour initiation factors, such as patients’ illness and treatment beliefs. This paper proposes two processes that occur after behaviour initiation that are theorised to contribute to prediction of long-term medication adherence: ‘coherence’ of patients’ beliefs from experiences with treatment and habit development. Seventy-one hypertensive patients reported their treatment-related beliefs, experiences related to treatment efficacy and medication-taking habit strength in a baseline interview. Patients then used an electronic monitoring pill bottle for approximately one month. Patients’ medication habit-strength was the strongest predictor of all adherence measures, explaining 6–27% incremental variance in adherence to that explained by patients’ treatment-related beliefs. Patients’ beliefs and experiences did not predict overall adherence, even for patients with ‘weaker’ habits. However, patients’ experiences were found to predict intentional non-adherence and habit strength was found to predict unintentional adherence. Practitioners may assess patients’ medication-taking habits to get an initial view of their likely adherence to long-term medications. Future research should assess the current theoretical predictions in a hypertension inception sample and in populations with symptomatic conditions.     

养老机构冠心病患者服药依从性现状及影响因素

采用Morisky推荐的MAQ对锦州市养老机构中153名冠心痛患者的服药依从性进行测评,探讨冠心病患者的服药依从性现状及影响因素.结果显示,养老机构冠心病患者服药依从性差的比率为81.7％,影响服药依从性的因素为文化程度、服药种类、医疗背景、入住年限.养老机构的护理人员应对上述因素给予更多的关注,从而提高其服药依从性,进而提升其临床治疗效果.     

The effects of clinical motor variables and medication dosage on working memory in Parkinson’s disease

In this study, we investigate the interrelationship between clinical variables and working memory (WM) in Parkinson’s disease (PD). Specifically, the aim of the study was to investigate the relationship between disease duration, dopaminergic medication dosage, and motor disability (UPDRS score) with WM in individuals with PD. Accordingly, we recruited three groups of subjects: unmedicated PD patients, medicated PD patients, and healthy controls. All subjects were tested on three WM tasks: short-delay WM, long-delay WM, and the n-back task. Further, PD encompasses a spectrum that can be classified either into akinesia/rigidity or resting tremor as the predominant motor presentation of the disease. In addition to studying medication effects, we tested WM performance in tremor-dominant and akinesia-dominant patients. We further correlated WM performance with disease duration and medication dosage. We found no difference between medicated and unmedicated patients in the short-delay WM task, but medicated patients outperformed unmedicated patients in the long-delay WM and n-back tasks. Interestingly, we also found that akinesia-dominant patients were more impaired than tremor-dominant patients at various WM measures, which is in agreement with prior studies of the relationship between akinesia symptom and basal ganglia dysfunction. Moreover, the results show that disease duration inversely correlates with more demanding WM tasks (long-delay WM and n-back tasks), but medication dosage positively correlates with demanding WM performance. In sum, our results show that WM impairment in PD patients depend on cognitive domain (simple vs. demanding WM task), subtype of PD patients (tremor- vs. akinesia-dominant), as well as disease duration and medication dosage. Our results have implications for the interrelationship between motor and cognitive processes in PD, and for understanding the role of cognitive training in treating motor symptoms in PD.     

Establishing compliance with liquid medication administration in a child with autism

Children with autism often display difficulty with swallowing pills and liquid medications. In the current study, stimulus fading and positive reinforcement established compliance with liquid medication administration in a young boy with autism. The boy's mother eventually administered liquid medication on her own.     

Mature adults' attitudes to mental health service utilisation

This qualitative study examined mature adults' attitudes to mental health services, in order to improve service utilisation among members of this group. Twenty individual and 12 focus group interviews were conducted with 111 West Australians aged ≥40 years living in urban and regional areas. The findings indicate that mature individuals may be receptive to information that assists them in differentiating the symptoms of ageing and mental illness and empowers them to make appropriate help‐seeking decisions. Perceived stigma and an aversion to medication were identified as barriers preventing individuals from acknowledging and addressing mental illness. A model of mature adults' intentions to utilise mental health services is proposed.     

肿瘤个体化药物治疗研究探讨

肿瘤个体化药物治疗可提高治疗疗效,避免药物的毒副作用和医疗资源的浪费。影响肿瘤药物治疗疗效有多方面因素,主要与肿瘤本身的生物学特性和肿瘤患者个体生物学特性有关。通过对这些特性的研究,可获得用于指导肿瘤个体化药物治疗客观检测指标。