Beliefs about medications: measurement and relationship to adherence in patients with severe mental disorders.

Objective: To determine if the Beliefs about Medicines Questionnaire (BMQ) has satisfactory psychometric properties in patients with severe mental disorders and if their scores differ from those of patients with severe medical disorders. To investigate if the scores are related to medication adherence.

Method: Two hundred and eighty psychiatric patients completed the BMQ and reported how much of their medication they had taken the past week.

Initiation of therapy with a subcutaneously administered antiretroviral in treatment-experienced HIV-infected patients: understanding physician and patient perspectives.

Enfuvirtide (Fuzeon) is the first self-injectable antiretroviral (ARV) therapy approved for the treatment of HIV. This study was undertaken to explore the perceptions of injectable ARVs among physicians and treatment-experienced HIV-infected patients and identify potential motivators or barriers to the initiation of injectable ARV therapies. This empirical study was conducted based on qualitative field research conducted in multiple centres in five European countries and the US.

Achieving asthma control in practice: understanding the reasons for poor control.

Achieving asthma control remains an elusive goal for the majority of patients worldwide. Ensuring a correct diagnosis of asthma is the first step in assessing poor symptom control; this requires returning to the basics of history taking and physical examination, in conjunction with lung function measurement when appropriate. A number of factors may contribute to sub-optimal asthma control.

Attachment and growth of human embryonic stem cells on microcarriers.

The use of human embryonic stem cells (hESCs) for cell-based therapies will require large quantities of genetically stable pluripotent cells and their differentiated progeny. Traditional hESC propagation entails adherent culture and is sensitive to enzymatic dissociation. These constraints hamper modifying method from 2-dimensional flat-bed culture, which is expensive and impractical for bulk cell production.

Validation of actigraphy for determining sleep and wake in preterm infants.

Background: Actigraphy has been widely used in adults and children for the determination of sleep and wake. However, there have been limited studies in infants and to date there have been no studies to validate the reliability of actigraphy in preterm infants.

Aim: To evaluate the usefulness of actigraphy in preterm infants in a neonatal unit setting for determining sleep-wake by comparing results with those recorded from behavioural observations.

Prone sleeping impairs circulatory control during sleep in healthy term infants: implications for SIDS.

Study Objectives: To determine the effects of sleeping position on development of circulatory control in infants over the first 6 months of postnatal age (PNA).

Design: Effects of sleeping position, sleep state and PNA on beat-beat heart rate (HR) and mean arterial pressure (MAP) responses to a head-up tilt (HUT) were assessed during sleep in infants at 2-4 wks, 2-3 mo and 5-6 mo PNA.

Measurements: Daytime polysomnography was performed on 20 full-term infants (12 F/8 M) and MAP was recorded continuously and noninvasively (Finometer).

Effect of pimobendan on case fatality rate in Doberman Pinschers with congestive heart failure caused by dilated cardiomyopathy.

Background: Despite traditional therapy of a diuretic, angiotensin converting enzyme inhibitor, digoxin, or a combination of these drugs, survival of dogs with dilated cardiomyopathy (DCM) is low. Pimobendan, an inodilator, has both inotropic and balanced peripheral vasodilatory properties.

Hypothesis: Pimobendan when added to conventional therapy will improve morbidity and reduce case fatality rate in Doberman Pinschers with congestive heart failure (CHF) caused by DCM.

Arousal and ventilatory responses to mild hypoxia in sleeping preterm infants.

A failure to adequately respond to hypoxia has been implicated in the Sudden Infant Death Syndrome (SIDS). Preterm infants are at increased risk for SIDS, thus we compared ventilatory and arousal responses to mild hypoxia [15% oxygen (O2)] in preterm and term infants. Eight preterm and 15 term infants were serially studied with daytime polysomnography during which nasal airflow was monitored by pneumotachograph at 2-5 weeks, 2-3 and 5-6 months.

Effects of sleeping position on development of infant cardiovascular control.

Objective: Sudden Infant Death Syndrome (SIDS) is associated with prone sleeping, and circulatory failure has been hypothesised to be a factor in the fatal event. We aimed to determine the effect of prone sleeping on heart rate (HR) and blood pressure (BP) control over the first 6 months of life.

Subjects: Term infants (n = 20) were studied longitudinally at 2-4 weeks, 2-3 months and 5-6 months with daytime polysomnography.

Beliefs about medicines in patients with rheumatoid arthritis and systemic lupus erythematosus: a comparison between patients of South Asian and White British origin.

Objective: To assess whether patients with RA and SLE who are of South Asian origin have different beliefs about medicines in general, and about DMARDs in particular, compared with patients of White British/Irish origin.

Methods: One hundred patients of South Asian origin (50 RA; 50 SLE) and 100 patients of White British/Irish origin (50 RA; 50 SLE) were recruited. Demographic and disease-related details and responses to the Beliefs about Medicines Questionnaire (BMQ), the SF-36 and the HAQ were collected.

Illness perceptions of low back pain patients in primary care: what are they, do they change and are they associated with outcome?

We describe the illness perceptions of patients with low back pain, how they change over 6 months, and their associations with clinical outcome. Consecutive patients consulting eight general practices were eligible to take part in a prospective cohort study, providing data within 3 weeks of consultation and 6 months later. Illness perceptions were measured using the Revised Illness Perception Questionnaire (IPQ-R).

Improving haemodialysis patients' understanding of phosphate-binding medication: a pilot study of a psycho-educational intervention designed to change patients' perceptions of the problem and treatment.

Objectives: To evaluate a psycho-educational intervention aimed to improve understanding of the need for phosphate control, provide a rationale for phosphate-binding medication (PBM) and explain its mode of action.

Design: A controlled intervention study comparing the effect of a self-regulatory theory-based psycho-educational intervention versus standard care control on knowledge of phosphate control and beliefs about PBM.

Method: End-stage renal disease (ESRD) patients were assigned to either an intervention group (N=19) or control group (N=20).

A systematic review of the prevalence and determinants of nonadherence to phosphate binding medication in patients with end-stage renal disease.

Background: Cardiovascular events are the leading cause of death in end stage renal disease (ESRD). Adherence to phosphate binding medication plays a vital role in reducing serum phosphorus and associated cardiovascular risk. This poses a challenge for patients as the regimen is often complex and there may be no noticeable impact of adherence on symptoms.

Beliefs about medicines predict refill adherence to inhaled corticosteroids.

Objective: Despite the importance of the chronic use of inhaled corticosteroids (ICS) in maintaining asthma control, reported adherence varies between 40% and 60%. The Beliefs about Medicines Questionnaire (BMQ) has been shown to correlate with self-reported adherence. The aim of this study is to investigate whether beliefs about ICS (necessity and concerns), as measured by the BMQ, relate to adherence objectively measured by prescription-refill records.

Understanding different beliefs held by adherers, unintentional nonadherers, and intentional nonadherers: application of the Necessity-Concerns Framework.

Objective: The objective of this study was to explore beliefs about medicines, using the Necessity-Concerns Framework, of patients who report adherence, unintentional nonadherence, and intentional nonadherence.

Method: This study performed a cross-sectional survey of patients starting a new medication for a chronic condition. Self-reported adherence was assessed via telephone interview.

Sudden infant death syndrome.

Despite declines in prevalence during the past two decades, sudden infant death syndrome (SIDS) continues to be the leading cause of death for infants aged between 1 month and 1 year in developed countries. Behavioural risk factors identified in epidemiological studies include prone and side positions for infant sleep, smoke exposure, soft bedding and sleep surfaces, and overheating. Evidence also suggests that pacifier use at sleep time and room sharing without bed sharing are associated with decreased risk of SIDS.

Adherence to medication in bipolar disorder: a qualitative study exploring the role of patients' beliefs about the condition and its treatment.

Objectives: Patients' perceptions of illness and treatment have been found to predict adherence to medication in many chronic conditions. This has not yet been fully explored in bipolar disorder (BD). The aim was to use a qualitative methodology to explore in depth the beliefs about BD and its treatment that are associated with adherence to medication prescribed for BD.

Relationship between sleep/wake patterns, temperament and overall development in term infants over the first year of life.

Background: This study sought to assess the relationship between the development of infant sleep/wake patterns, temperament and overall mental, motor and behavioural development over the first year of life. We hypothesised that infants with more regular sleep/wake patterns and longer sleep durations would have an easier temperament and higher developmental scores.

Study Design: Sleep/wake characteristics were recorded with the use of both parental sleep diary and actigraphy (Actiwatch AW64, Mini Mitter Company Inc, Sunriver, OR, USA) in 20 healthy term infants at monthly intervals over the first year of life.

Physical symptoms, beliefs about medications, negative mood, and long-term HIV medication adherence.

Background: Near-perfect levels of HIV medication adherence are necessary for treatment to be successful. However, many patients continue to report nonadherence to HIV treatment.

Purpose: This study examines the relationship between symptoms of HIV and medication adherence and evaluates beliefs about HIV medications and negative mood states as potential mediators of this relationship.

Postnatal development of periodic breathing cycle duration in term and preterm infants.

Previous studies of the maturation of periodic breathing cycle duration (PCD) with postnatal age in infants have yielded conflicting results. PCD is reported to fall in term infants over the first 6 mo postnatally, whereas in preterm infants PCD is reported either not to change or to fall. Contrary to measured values, use of a theoretical respiratory control model predicts PCD should increase with postnatal age.

A cohort study of adherence to antidepressants in primary care: the influence of antidepressant concerns and treatment preferences.

Objective: Clinical guidelines recommend that antidepressant treatment should be continued for a minimum of 6 months following response in depression and anxiety disorders. However, adherence to antidepressants is low. This prospective cohort study investigated the influence of patients' antidepressant concerns, treatment preferences, and illness perceptions on adherence to antidepressants over a 6-month period.

The cost effectiveness of a telephone-based pharmacy advisory service to improve adherence to newly prescribed medicines.

Objective: This "proof of concept" study aimed to assess the cost effectiveness of pharmacists giving advice via telephone, to patients receiving a new medicine for a chronic condition, in England.

Methods: The self-regulatory model (SRM) theory was used to guide development of our intervention and used in training pharmacists to adopt a patient-centred approach. Non-adherence to new medicines for chronic conditions develops rapidly so we developed a study intervention in which a pharmacist telephoned patients two weeks after they had started a new medicine for a chronic condition.

Validation of actigraphy for determining sleep and wake in children with sleep disordered breathing.

There have been limited studies of the validation of actigraphy for the determination of sleep and wake in children and in this study we aimed to compare wrist actigraphy with polysomnography (PSG). We studied 45 children (29 M/16 F), aged between 1 and 12 years (5.8 +/- 2.

The use of actigraphy for assessment of the development of sleep/wake patterns in infants during the first 12 months of life.

Maturation of sleep/wake patterns is one of the most important physiological developments during the first year of life. In this study, we aimed to compare the use of actigraphy and parental sleep diaries (SD) for recording the development of sleep/wake patterns longitudinally in term infants in their own home environments over the first 12 months of life. Twenty healthy term infants (7F/13M) were studied for 3 days each month in their own homes over the first 12 months of life.