Pre-diagnostic circulating resistin concentrations and mortality among individuals with colorectal cancer: Results from the European Prospective Investigation into Cancer and Nutrition study.

Resistin is a protein involved in inflammation and angiogenesis processes and may play a role in the progression of colorectal cancer (CRC). However, it remains unclear whether resistin is associated with increased mortality after CRC diagnosis. We examined pre-diagnostic serum resistin concentrations in relation to CRC-specific and all-cause mortality among 1343 incident CRC cases from the European Prospective Investigation into Cancer and Nutrition cohort. For CRC-specific mortality as the primary outcome, hazard ratios (HRs) and 95% confidence intervals (95% CI) were estimated from competing risk analyses based on cause-specific Cox proportional hazards models and further in sensitivity analyses using Fine-Gray proportional subdistribution hazards models. For all-cause mortality as the secondary outcome, Cox proportional hazards models were used. Subgroup analyses were performed by sex, tumor subsite, tumor stage, body mass index and time to CRC diagnosis. Resistin was measured on a median of 4.8 years before CRC diagnosis. During a median follow-up of 8.2 years, 474 deaths from CRC and 147 deaths from other causes were observed. Resistin concentrations were not associated with CRC-specific mortality (HRQ4vsQ1 = 0.95, 95% CI: 0.73-1.23; Ptrend = .97; and HRper doubling of resistin concentration = 1.00; 95% CI: 0.84-1.19; P = .98) or all-cause mortality. Results from competing risk (sensitivity) analysis were similar. No associations were found in any subgroup analyses. These findings suggest no association between pre-diagnostic circulating resistin concentrations and CRC-specific or all-cause mortality among persons with CRC, and the potential insignificance of resistin in CRC progression.

Impact of cumulative body mass index and cardiometabolic diseases on survival among patients with colorectal and breast cancer: a multi-centre cohort study.

BACKGROUND: Body mass index (BMI) and cardiometabolic comorbidities such as cardiovascular disease and type 2 diabetes have been studied as negative prognostic factors in cancer survival, but possible dependencies in the mechanisms underlying these associations remain largely unexplored. We analysed these associations in colorectal and breast cancer patients. METHODS: Based on repeated BMI assessments of cancer-free participants from four European countries in the European Prospective Investigation into Cancer and nutrition (EPIC) study, individual BMI-trajectories reflecting predicted mean BMI between ages 20 to 50 years were estimated using a growth curve model. Participants with incident colorectal or breast cancer after the age of 50 years were included in the survival analysis to study the prognostic effect of mean BMI and cardiometabolic diseases (CMD) prior to cancer. CMD were defined as one or more chronic conditions among stroke, myocardial infarction, and type 2 diabetes. Hazard ratios (HRs) and confidence intervals (CIs) of mean BMI and CMD were derived using multivariable-adjusted Cox proportional hazard regression for mean BMI and CMD separately and both exposures combined, in subgroups of localised and advanced disease. RESULTS: In the total cohort of 159,045 participants, there were 1,045 and 1,620 eligible patients of colorectal and breast cancer. In colorectal cancer patients, a higher BMI (by 1 kg/m2) was associated with a 6% increase in risk of death (95% CI of HR: 1.02-1.10). The HR for CMD was 1.25 (95% CI: 0.97-1.61). The associations for both exposures were stronger in patients with localised colorectal cancer. In breast cancer patients, a higher BMI was associated with a 4% increase in risk of death (95% CI: 1.00-1.08). CMDs were associated with a 46% increase in risk of death (95% CI: 1.01-2.09). The estimates and CIs for BMI remained similar after adjustment for CMD and vice versa. CONCLUSIONS: Our results suggest that cumulative exposure to higher BMI during early to mid-adulthood was associated with poorer survival in patients with breast and colorectal cancer, independent of CMD prior to cancer diagnosis. The association between a CMD diagnosis prior to cancer and survival in patients with breast and colorectal cancer was independent of BMI.

The protective effect and mechanism of rapamycin in the rat model of IgA nephropathy.

BACKGROUND: The pathogenesis of the development of IgA nephropathy has not been clear up to now. At present, some studies revealed that the mTOR pathway may participate in IgA nephropathy; however, the mechanism has not been systematically studied. In this study, we established an IgAN rat model to investigate the protective effects of rapamycin as a new type of immunosuppressant, as well as its therapeutic mechanisms. METHODS: After the establishment of IgA nephropathy model, rats were treated with different concentrations of rapamycin, and the protective effect of different concentrations of rapamycin on renal function of the rats was observed. The deposition of IgA was observed by immunofluorescence. The kidney expression of Akt and p70S6k proteins in mTOR pathway was examined using the western blot assay after rapamycin treatment. RESULTS: Morphology and immunofluorescence confirmed that the rat model of IgA nephropathy was successfully established. In particular, the level of proteinuria decreased with the increase of the dose of rapamycin, as well as the deposition of IgA in glomeruli. Moreover, the western blot analysis indicated that the expression of p70S6K in the downstream of mTOR pathway decreased and the upstream protein AKT of the mTOR pathway was overexpressed in the rats model. CONCLUSION: We found that rapamycin has protective effects in the IgA nephropathy rat model in a dose-dependent manner. In addition, the result of western blot assay suggested that rapamycin may display its therapeutic effects through interfering the AKT-mTOR-p70S6K signaling pathway.

Knowledge and practice in cardiovascular disease prevention among hospital registered nurses: a cross-sectional study.

AIMS AND OBJECTIVES: To investigate the knowledge and clinical practices of cardiovascular disease prevention among registered nurses who worked on three major clinical units in Beijing hospitals. BACKGROUND: Health education on cardiovascular disease prevention is an important component of nursing practice; however, Chinese registered nurses' knowledge and practice patterns have been poorly explored in previous studies. DESIGN: A cross-sectional study. METHODS: A stratified random sample of three hundred registered nurses was recruited from two tertiary hospitals in Beijing, China. A validated questionnaire was used to examine nurses' knowledge of cardiovascular disease risk factors, their practices and perceived barriers to cardiovascular disease prevention-related patient education. The differences in knowledge of cardiovascular disease risk factors and the practice pattern associated with cardiovascular disease prevention were compared among nurses who worked on three major clinical units. RESULTS: Questionnaires were completed by 273 registered nurses with a response rate of 91%. More than 75% of the registered nurses knew the cardiovascular disease risk factors; however, less than half knew the right target goals for cardiovascular disease risk factors. Notably, fewer than 70% of registered nurses routinely provided health education for cardiovascular disease prevention during their practice. There was inconsistency between registered nurses' knowledge of target goals for cardiovascular disease risk reduction and their education practices on cardiovascular disease prevention. The three major barriers to providing cardiovascular disease risk factor preventive education were lack of time, patients' reluctance to change lifestyle and lack of physicians' support. CONCLUSIONS: Not all of the registered nurses were motivated to educate and encourage patients to engage healthy lifestyle changes, even though most of them were knowledgeable about cardiovascular disease risk factors. A gap between the knowledge and practice for the prevention of cardiovascular disease was identified. RELEVANCE TO CLINICAL PRACTICE: The findings highlight the need to advocate for knowledge application and address knowledge deficits in the area of cardiovascular disease prevention among registered nurses.

Current Status of Cardiovascular Disease-Related Smartphone Apps Downloadable in China.

BACKGROUND: Smartphone apps present a great opportunity for the management of cardiovascular disease (CVD) as the adoption of apps becomes increasingly popular in China. Yet, little is known about the status of CVD-related Smartphone apps in the country. The aim of this study was to examine the current status of CVD-related smartphone apps available for download in China. MATERIALS AND METHODS: Using CVD-related keywords written either in Chinese or English, the top 6 most popular smartphone app online stores in China were searched in September 2015. The information accountability of the selected apps was assessed with the Silberg scale. The key topic areas identified from the European Guidelines on cardiovascular disease prevention served to determine information coverage of the top 5 downloaded apps. RESULTS: The average Silberg score of 151 apps was 2.87 (out of 9) with most apps not revealing authors' qualifications and information references. There was also a lack of sponsorship disclosure and information update. Moreover, none of the top 5 downloaded apps covered all key areas of CVD management as recommended by the European Guidelines on cardiovascular disease prevention. There was little evidence of health professionals' involvement in the formation of the CVD-related apps. CONCLUSION: This study identified areas for improvement concerning information accountability and the scope of coverage of CVD-related apps downloadable in China. The findings may guide the future advancement of CVD-related apps and benefit CVD management in China.

The quality of life of patients developed delirium after coronary artery bypass grafting is determined by cognitive function after discharge: A cross-sectional study.

AIMS: Postoperative delirium (POD) and declined cognitive function were common in patients (especially elderly patients) who underwent coronary artery bypass grafting (CABG), which may affect quality of life (QoL). The aim of this study was to determine the relationships among age, POD, declined cognitive function, and QoL in patients who underwent CABG. METHODS: Consecutive patients who underwent first time elective CABG and assessed for POD using Confusion Assessment Method for intensive care unit for 5 postoperative days from November 2013 to March 2015 were recruited. A cross-sectional study was conducted during April 2015 to assess their cognitive function and QoL, using the Telephone Interview for Cognitive Status Scale and Medical Outcomes Study 36-Item Short Form Health Survey. The relationships among age, POD, declined cognitive function, and QoL were tested using path analysis. RESULTS: Declined cognitive function was associated with poorer QoL. POD was associated with declined cognitive function but was not associated with poorer QoL. Ageing was not associated with QoL but was associated with POD and declined cognitive function. CONCLUSION: The QoL of patients developed delirium after CABG is determined by cognitive function after discharge. Necessary strategies should be implemented to prevent POD and declined cognitive function, especially in elderly patients.

Nursing-sensitive indicators: a concept analysis.

AIM: To report a concept analysis of nursing-sensitive indicators within the applied context of the acute care setting. BACKGROUND: The concept of 'nursing sensitive indicators' is valuable to elaborate nursing care performance. The conceptual foundation, theoretical role, meaning, use and interpretation of the concept tend to differ. The elusiveness of the concept and the ambiguity of its attributes may have hindered research efforts to advance its application in practice. DESIGN: Concept analysis. DATA SOURCES: Using 'clinical indicators' or 'quality of nursing care' as subject headings and incorporating keyword combinations of 'acute care' and 'nurs*', CINAHL and MEDLINE with full text in EBSCOhost databases were searched for English language journal articles published between 2000-2012. Only primary research articles were selected. METHODS: A hybrid approach was undertaken, incorporating traditional strategies as per Walker and Avant and a conceptual matrix based on Holzemer's Outcomes Model for Health Care Research. RESULTS: The analysis revealed two main attributes of nursing-sensitive indicators. Structural attributes related to health service operation included: hours of nursing care per patient day, nurse staffing. Outcome attributes related to patient care included: the prevalence of pressure ulcer, falls and falls with injury, nosocomial selective infection and patient/family satisfaction with nursing care. CONCLUSION: This concept analysis may be used as a basis to advance understandings of the theoretical structures that underpin both research and practical application of quality dimensions of nursing care performance.

Bedside nursing handover: patients' opinions.

Within the context of contemporary nursing practice, bedside handover has been advocated as a potentially more suitable mode for achieving patient-centred care. Given that patients can play an important role in the process, better understanding of patients' perspectives of bedside handover could be a critical determinate for successful implementation of the practice. Using a phenomenological approach, this study attempted to explore patients' perceptions of bedside nursing handover. Four key themes emerged from the patient interviews: 'a more effective and personalised approach', 'being empowered and contributing to error minimization', 'privacy, confidentiality and sensitive topics', and 'training need and avoidance of using technical jargon'. Patients welcome bedside handover as they can be empowered through participation in the process. Nevertheless, attention is needed to ensure that adequate training is provided to nurses and to minimize the use of technical jargon so that handover is delivered with a professional and consistent approach.

Towards patient-centred care: perspectives of nurses and midwives regarding shift-to-shift bedside handover.

The aim of this descriptive qualitative study was to explore perspectives of nurses and midwives towards the introduction of shift-to-shift bedside handover. Semistructured interviews with nurses (n = 20) and midwives (n = 10) occurred 12 months after the introduction of bedside handover. Data were analyzed using thematic content analysis. Two main themes were identified: enhanced individual patient care and documentation, along with improved patient-clinician partnerships; and protection of confidentiality and privacy. The newly introduced bedside handover model improved efficiency and accuracy of the handover process and led to the provision of safe, high-quality care. Development of ward-specific tools and relevant educational resources, along with clinical support, are identified as the facilitators to ensure the new model can be successfully integrated into normal clinical practice.

Orthodontic decompensation and correction of skeletal Class III malocclusion with gradual dentoalveolar remodeling in a growing patient.

An 8-year-old girl with a skeletal Class III malocclusion was treated in 2 phases. Maxillary expansion and protraction were carried out as the early intervention. However, her maxillary hypoplasia and mandibular hyperplasia deteriorated with age. The phase 2 comprehensive treatment began with proper mechanics when she was 12 years old with growth potential. In the maxillary arch, an auxiliary rectangular wire was used with a round main wire and an opening spring to create space for the impacted teeth and to bodily move the anterior teeth forward. Decompensation of mandibular incisors and correction of the Class III malocclusion were achieved by short Class III elastics with light forces and a gentle interaction between the rectangular wires and the lingual root-torque slots. The phase 2 active treatment period was 4 years 8 months. The 2-year follow-up indicated that our treatment results were quite stable.

Bedside handover enhances completion of nursing care and documentation.

Bedside handover has been proposed as a patient-focused nursing practice model with the potential to reduce adverse events and improve standards of care. This pre-/postintervention study examined changes in completion of nursing care tasks and documentation after the implementation of bedside handover. Analysis of 754 cases revealed significant improvements in several nursing care tasks and documentation, whereas there was no variation in handover duration. Implementing bedside handover may enhance nursing care for hospitalized patients.

Prediagnostic Prescription Antibiotics Use and Survival in Patients with Colorectal Cancer: A Swedish National Register-Based Study.

BACKGROUND: Antibiotics use is associated with higher colorectal cancer risk, but little is known regarding any potential effects on survival. METHODS: We conducted a nationwide cohort study, using complete-population data from Swedish national registers between 2005 and 2020, to investigate prediagnostic prescription antibiotics use in relation to survival in colorectal cancer patients. RESULTS: We identified 36,061 stage I-III and 11,242 stage IV colorectal cancer cases diagnosed between 2010 and 2019. For stage I-III, any antibiotics use (binary yes/no variable) was not associated with overall or cancer-specific survival. Compared with no use, moderate antibiotics use (total 11-60 days) was associated with slightly better cancer-specific survival [adjusted HR (aHR) = 0.93; 95% confidence interval (CI), 0.86-0.99)], whereas very high use (>180 days) was associated with worse survival [overall survival (OS) aHR = 1.42; 95% CI, 1.26-1.60, cancer-specific survival aHR = 1.31; 95% CI, 1.10-1.55]. In analyses by different antibiotic types, although not statistically significant, worse survival outcomes were generally observed across several antibiotics, particularly macrolides and/or lincosamides. In stage IV colorectal cancer, inverse relationships between antibiotics use and survival were noted. CONCLUSIONS: Overall, our findings do not support any substantial detrimental effects of prediagnostic prescription antibiotics use on cancer-specific survival after colorectal cancer diagnosis, with the possible exception of very high use in stage I-III colorectal cancer. Further investigation is warranted to confirm and understand these results. IMPACT: Although the study findings require confirmation, physicians probably do not need to factor in prediagnostic prescription antibiotics use in prognosticating patients with colorectal cancer.

Antibiotics Use and Subsequent Risk of Colorectal Cancer: A Swedish Nationwide Population-Based Study.

BACKGROUND: Antibiotics use may increase colorectal cancer (CRC) risk by altering the gut microbiota, with suggestive evidence reported. Our study aims to investigate antibiotics use in relation to subsequent CRC risk. METHODS: This is a nationwide, population-based study with a matched case-control design (first primary CRC cases and 5 matched, cancer-free controls). Complete-population data, extracted from Swedish national registers for the period 2005-2016, were used to calculate odds ratios and 95% confidence intervals. RESULTS: We included 40 545 CRC cases and 202 720 controls. Using the full dataset, we found a positive association between more frequent antibiotics use and CRC, excluding antibiotics prescribed within 2 years of diagnosis attenuated results toward the null. In site-specific analyses, excluding the 2-year washout, the positive association was confined to the proximal colon (adjusted odds ratio for very high use vs no use = 1.17, 95% confidence interval = 1.05 to 1.31). For rectal cancer, an inverse association, which appears to be driven by women, was observed. Quinolones and sulfonamides and/or trimethoprims were positively associated with proximal colon cancer, whereas a more general inverse association, across antibiotics classes, was observed for rectal cancer. We found no association between methenamine hippurate, a urinary tract antiseptic not affecting the gut microbiota, and CRC risk. CONCLUSIONS: This register-based study covering the entire population of Sweden found a robust association between antibiotics use and higher risk of proximal colon cancer and an inverse association with rectal cancer in women. This study strengthens the evidence from previous investigations and adds important insight into site-specific colorectal carcinogenesis.

Examination of current handover practice: evidence to support changing the ritual.

Examining systems of nursing handover provides the opportunity to identify areas in need of improvement and modification. The aim of this study was to describe nursing handover practices for one organization and explore clinical nurses' opinions regarding the quality of the current shift-to-shift handover style. One hundred and fifty-three registered nurses employed in 23 wards in an acute tertiary hospital in Australia completed a survey. The survey collected information about demographic data, current methods and preferences for style of handover and opinions about the quality of nursing handover. This study found that existing handover practice is time-consuming, lacks patient involvement and essential information, and is varied in style. Only one ward (4.3%) conducted handover at the bedside. The majority (82%) expressed reluctance to change their current handover style. Modification of existing nursing handover is needed but might be challenging in view of the reluctance to change this ritual.

Immediate Prone Positioning After Massive Gastric Aspiration Reduces Lung Injury Possibly by Attenuating Interleukin-6-Mediated Lung-Tissue Inflammation in Pigs.

Gastric aspiration, which can cause acute, diffuse, inflammatory lung injury, is of particular concern in critically ill patients. This study aimed to determine the effects of immediate prone positioning on the degree of lung injury and inflammatory response induced by gastric aspiration. Following induction of gastric aspiration by injection of gastric fluid, 16 healthy pigs were randomized to one of two groups: supine position (SP) or prone position (PP). After ventilation and monitoring for 6 hr, all pigs were euthanized. The ratio of the partial pressure of arterial oxygen/fraction of inspired oxygen (PaO2/FIO2) and the partial pressure of arterial carbon dioxide (PaCO2) were recorded during the 6-hr study period. Serum levels of interleukin (IL)-6 were measured every 2 hr, and the mean optical density (MOD) of IL-6 in lung tissues and lung-injury scores were measured at the end of the experiment. The PP group showed a significantly higher PaO2/FIO2 ratio, lower serum IL-6 concentration (p = .015), lower lung-injury scores (p = .012), and lower IL-6 concentration and MOD of IL-6 in lung tissue, especially in dorsal (p = .001, p = .021, respectively) and nondependent regions (p = .005, p = .035, respectively) than the SP group. There were no statistically significant differences in PaCO2 between the groups. Lung-injury severity was positively correlated with the IL-6 concentration and MOD of IL-6 in lung tissues (p < .05). These results suggest that immediate prone positioning alleviated the degree of aspiration-induced lung injury, possibly through mitigating IL-6-mediated lung inflammation.

Keyhole Foraminotomy via a Percutaneous Posterior Full-endoscopic Approach for Cervical Radiculopathy: An Advanced Procedure and Clinical Study.

Endoscopic cervical foraminotomy is increasingly used for cervical spondylotic radiculopathy (CSR), but there is great concern about radiation exposure because of the heavy dependence of this surgical method on fluoroscopy. The objective of this study was to introduce in detail an advanced surgical technique of keyhole foraminotomy via a percutaneous posterior full-endoscopic approach as a treatment for CSR and investigate its clinical outcomes. We retrospectively reviewed 33 consecutive patients with CSR who underwent keyhole foraminotomy via a percutaneous posterior full-endoscopic approach from October 2015 to April 2017. The patients' general characteristics, including operative time, blood loss, hospital stay, complications, and recurrence, were obtained. Clinical outcomes were evaluated using the visual analogue scale (VAS) for radicular pain, the neck disability index (NDI) for functional assessment, and the modified MacNab criteria for patient satisfaction. All operations were successfully performed (mean operation time, 62 min), with no measurable blood loss or severe related complications. The mean follow-up was 25 months. The VAS and NDI scores were significantly improved as compared with those in the preoperative period (preoperative vs. final follow-up: 7.6±1.6 vs. 3.83±7.34 for VAS, P<0.01; 69.5%±10.5% vs. 17.54%±13.40% for NDI, P<0.01). Of the 33 patients, 32 (97.0%) had good-to-excellent global outcomes and all patients obtained symptomatic improvement. In conclusion, keyhole foraminotomy via a percutaneous posterior full-endoscopic approach is an efficient, safe, and feasible procedure for the treatment of CSR. Its simplified single-step blunt incision for localization appears to decrease radiation exposure risks.

Multi-functional self-assembled nanoparticles for pVEGF-shRNA loading and anti-tumor targeted therapy.

Although RNA interference (RNAi) technology shows great potential in cancer treatment, the tumor target delivery and sufficient cytosolic transport of RNAi agents are still the main obstacles for its clinical applications. Herein, we report a functional supramolecular self-assembled nanoparticle vector for RNAi agent loading and tumor target therapy. Molecular block adamantane-grafted poly(ethylene glycol) (Ad-PEG) was modified with epidermal growth factor receptor (EGFR)-specific binding ligand GE11 or pH-sensitive fusogenic peptide GALA and then used for self-assembly with cyclodextrin-grafted branched polyethylenimine (CD-PEI), adamantane-grafted polyamidoamine dendrimer (Ad-PAMAM), and plasmid DNA containing a small hairpin RNA expression cassette against vascular endothelial growth factor (VEGF) into functional DNA-loaded supramolecular nanoparticles (GE11&GALA-pshVEGF@SNPs) based on molecular recognition and charge interaction. These functional peptides facilitated the target cell binding, internalization, and endosomal escape of GE11&GALA-pshVEGF@SNPs, resulting in increased reporter gene expression and efficient targeted gene silencing. The systemic delivery of the GE11&GALA-pshVEGF@SNPs can efficiently downregulate the intratumoral VEGF protein levels, reduce blood vessel formation, and significantly inhibit A549 xenograft tumor growth. These results reveal the potential of these multifunctional self-assembled nanoparticles as a nucleic acid drug delivery system for the treatment of lung cancer.

A nurse-administered 3-Minute diagnostic interview for CAM-defined Delirium (3D-CAM Chinese version) in hospitalized elderly patients: A validation study.

BACKGROUND: Delirium is a common complication in hospitalized elderly patients, yet often remains unrecognized in the clinical care unit. The newly developed 3-Minute Diagnostic Interview for CAM-Defined Delirium (3D-CAM) has high sensitivity and specificity when administered by trained researchers. However, diagnostic characteristics of the 3D-CAM as performed in routine practice are unclear. OBJECTIVE: To determine the diagnostic characteristics of a Chinese version of the 3D-CAM administered to hospitalized elderly patients by bedside nurses. DESIGN: A prospective cohort study. SETTING: A tertiary geriatric hospital in China. PARTICIPANTS: 323 patients and 49 bedside nurses. METHODS: This prospective cohort study was conducted at a tertiary geriatric hospital in China. A Chinese version of 3D-CAM was administered by trained bedside nurses and compared against the reference standard performed by experienced neurologists using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria. All assessors were blinded to each other's assessment results. Sensitivity and specificity of the 3D-CAM among bedside nurses were analysed by comparing with the reference standard to test the ability of 3D-CAM in detecting delirium. RESULTS: A total of 323 patients were included in the study, of whom 64 were classified as delirium positive by the neurologists. The 3D-CAM had a sensitivity of 92% (95% confidence interval, 82-97%), specificity of 89% (95% confidence interval, 84-92%), respectively. CONCLUSION: The Chinese version of 3D-CAM demonstrated good performance as a bedside nurse-administered screening tool for delirium detection among hospitalized Chinese geriatric patients. Registration number: ChiCTR-IOR-17,010,368.

Subjective side effects of antipsychotics and medication adherence in people with schizophrenia.

AIM: This paper is a report of a study conducted to describe the prevalence of antipsychotic medication side effects in individuals with schizophrenia, and to assess if a relationship existed between side effects and medication-taking. BACKGROUND: Non-adherence to antipsychotics is common in people with schizophrenia. There is a direct relationship between non-adherence and relapse, but it is unclear if an association exists between side effects and non-adherence. METHOD: The Liverpool University Neuroleptic Side-effect Rating Scale was used with a convenience sample of 81 mental health service users with schizophrenia. Participants were recruited from one urban and one rural area in Australia in 2004. Data were analysed using Statistical Package for Social Science and nonparametric statistical methods based on the nature of data. FINDINGS: Around 20% of participants had missed taking their medication at least once in the week before data collection. About half experienced one or more side effects, but the level of accumulated side effects was not associated with medication omission. Older participants were more likely to experience anticholinergic and allergic side effects than their younger counterparts. Younger women were more likely to experience hormone-related side effects than older women. Overall, medication omission was not statistically significantly correlated with any of the seven Liverpool University Neuroleptic Side-effect Rating Scale subscales. CONCLUSION: Greater attention needs to be paid to age- and gender-specific side effects and to monitoring side effects in people prescribed atypical medication antipsychotics. Service users, case managers and prescribers may need additional training to assist them to identify side effects and to take steps to ameliorate or at least minimize their effects.

Medication adherence and significant others' support of consumers with schizophrenia in Australia.

Medication adherence is problematic in people with chronic illness. The purpose of this exploratory study was to examine the effects of the perceived support from significant others on the oral antipsychotic medication taking of consumers with schizophrenia. A convenience sample of 81 consumers took part in the study. The consumers were recruited by case managers from the community in the western region of Melbourne and in regional and rural Victoria, Australia. No difference was found in self-reported medication adherence between the consumers with significant others' support and those without significant others' support. The perceived effect of having a supportive relationship with significant others was not associated with increased medication adherence. The findings indicated that the significant others' support did not influence the self-reported medication adherence of the consumers with schizophrenia. The results highlighted the importance of considering medication adherence as a multidimensional concept.