A predictive model for medication adherence in older adults with heart failure.

AIMS: Although many studies have examined the predictors of medication adherence (MA), further empirical research is required to clarify the best model for predicting MA for older adults with heart failure (HF). Thus, we hypothesized a model in which information (knowledge), motivation (social support and depressive symptoms), and behavioural skills (barriers to self-efficacy) would be associated with MA in patients with HF. METHODS AND RESULTS: Using a cross-sectional survey, 153 adults aged ≥ 65 years taking medication for HF were recruited from a university hospital in Korea. Data were collected based on the information-motivation-behavioural skills (IMB) model constructs and MA. In the hypothesized path model, self-efficacy was directly related to MA (ß = -0.335, P = 0.006), whereas social support was indirectly related to MA through self-efficacy (ß = -0.078, P = 0.027). Depressive symptoms were directly related to MA (ß = 0.359, P = 0.004) and indirectly related to MA through self-efficacy (ß = 0.141, P = 0.004). The hypothesized MA model showed a good fit for the data. Knowledge, social support, and depressive symptoms accounted for 44.3% of the variance in self-efficacy (P = 0.004). Left ventricular ejection fraction, knowledge, social support, depressive symptoms, and self-efficacy explained 64.4% of the variance in MA (P = 0.004). CONCLUSION: These results confirmed the IMB model's suitability for predicting MA in older adults with HF. These findings may guide and inform intervention programmes designed to alleviate depressive symptoms in older adults with HF and enhance their HF knowledge, social support, and self-efficacy, with the ultimate goal of improving their MA.

Characterization of biological effect of 1763 MHz radiofrequency exposure on auditory hair cells.

PURPOSE: Radiofrequency (RF) exposure at the frequency of mobile phones has been reported not to induce cellular damage in in vitro and in vivo models. We chose HEI-OC1 immortalized mouse auditory hair cells to characterize the cellular response to 1763 MHz RF exposure, because auditory cells could be exposed to mobile phone frequencies. MATERIALS AND METHODS: Cells were exposed to 1763 MHz RF at a 20 W/kg specific absorption rate (SAR) in a code division multiple access (CDMA) exposure chamber for 24 and 48 h to check for changes in cell cycle, DNA damage, stress response, and gene expression. RESULTS: Neither of cell cycle changes nor DNA damage was detected in RF-exposed cells. The expression of heat shock proteins (HSP) and the phosphorylation of mitogen-activated protein kinases (MAPK) did not change, either. We tried to identify any alteration in gene expression using microarrays. Using the Applied Biosystems 1700 full genome expression mouse microarray, we found that only 29 genes (0.09% of total genes examined) were changed by more than 1.5-fold on RF exposure. CONCLUSION: From these results, we could not find any evidence of the induction of cellular responses, including cell cycle distribution, DNA damage, stress response and gene expression, after 1763 MHz RF exposure at an SAR of 20 W/kg in HEI-OC1 auditory hair cells.

Differential gene expression profiles in spontaneously hypertensive rats induced by administration of enalapril and nifedipine.

Enalapril and nifedipine are used as antihypertensive drugs; however, the therapeutic target molecules regulated by enalapril and nifedipine have yet to be fully identified. The aim of this study was to identify novel target genes that are specifically regulated by enalapril and nifedipine in tissues from spontaneously hypertensive rats (SHR) using DNA microarray analysis. We found that administration of SHR with enalapril and nifedipine differentially regulated 33 genes involved in the pathogenesis of cardiovascular diseases. Furthermore, we identified 16 genes that have not previously been implicated in cardiovascular diseases, including interleukin-24 (IL-24). Among them, exogenous administration of IL-24 attenuated the expression of vascular inflammation and hypertension-related genes induced by H2O2 treatment in mouse vascular smooth muscle (MOVAS) cells. This study provides valuable information for the development of novel antihypertensive drugs. In addition, the genes identified may be of use as biomarkers and therapeutic targets for cardiovascular diseases, including hypertension.