What affected UK adults' adherence to medicines during the COVID-19 pandemic? Cross-sectional survey in a representative sample of people with long-term conditions.

Aim: Medicines non-adherence is associated with poorer outcomes and higher costs. COVID-19 affected access to healthcare, with increased reliance on remote methods, including medicines supply. This study aimed to identify what affected people's adherence to medicines for long-term conditions (LTCs) during the pandemic. Subject and methods: Cross-sectional online survey of UK adults prescribed medicines for LTCs assessing self-reported medicines adherence, reasons for non-adherence (using the capability, opportunity and motivation model of behaviour [COM-B]), medicines access and COVID-19-related behaviours. Results: The 1746 respondents reported a mean (SD) of 2.5 (1.9) LTCs, for which they were taking 2.4 (1.9) prescribed medicines, 525 (30.1%) reported using digital tools to support ordering or taking medicines and 22.6% reported medicines non-adherence. No access to at least one medicine was reported by 182 (10.4%) respondents; 1048 (60.0%) reported taking at least one non-prescription medicine as a substitute; 409 (23.4%) requested emergency supply from pharmacy for at least one medicine. Problems accessing medicines, being younger, male, in the highest socioeconomic group and working were linked to poorer adherence. Access problems were mostly directly or indirectly related to the COVID-19 pandemic. Respondents were generally lacking in capabilities and opportunities, but disruptions to habits (automatic motivation) was the major reason for non-adherence. Conclusion: Navigating changes in how medicines were accessed, and disruption of habits during the COVID-19 pandemic, was associated with suboptimal adherence. People were resourceful in overcoming barriers to access. Solutions to support medicines-taking need to take account of the multiple ways that medicines are prescribed and supplied remotely. Supplementary Information: The online version contains supplementary material available at 10.1007/s10389-022-01813-0.

The causes of organizational citizenship behavior: a motivational analysis.

This study addressed the role of motives in organizational citizenship behavior (OCB). Three motives were identified through factor analyses: prosocial values, organizational concern, and impression management. Scales that measured these motives and other variables known to covary with OCB were administered to 141 municipal employees and were correlated with self-, peer, and supervisor ratings of 5 aspects of OCB. Relative to the other motives, prosocial values motives were most strongly associated with OCB directed at individuals, and organizational concern motives were most strongly associated with OCB directed toward the organization. Each of the motives accounted for unique amounts of variance in OCB. The results suggest that motives may play an important role in OCB.

Individual differences in intraperson variability in mood.

The experience sampling method and palm-top computers were used to obtain 75-100 randomly timed in situ assessments of 11 mood-related items from 54 Ss over 12-14 days. The variability in the distribution of an S's responses to each item was used as an estimate of intrasubject mood variability. Mood variability was stable across time (average r > .58) and across situations (average r = .51). The intercorrelations among the individual item variabilities were also substantial (average r = .41); when the items were combined into a mood variability scale, the coefficient alpha was .84. The stability and internal consistency of mood variability could not be reasonably attributed to similarity in item valences, differences among the Ss in the situations they encountered, response biases, or response errors. It was concluded that mood variability is a stable personal characteristic, but additional analyses suggested that it may be independent from other kinds of intraperson variability.

Functional expression of a human C5a receptor clone in Xenopus oocytes requires additional RNA.

cRNA from a PCR-generated C5aR clone was prepared by in vitro transcription and microinjected into Xenopus laevis oocytes. Ligand-induced whole cell current could be detected after co-injection of cRNA for the C5aR with total RNA of the unstimulated U937 cell line, but not with either of the components injected alone. These data clearly demonstrate an absolute requirement of the C5aR for an additional human factor to become functionally expressed in Xenopus oocytes.

Size overestimation among anorexics: much ado about very little?

Research on size overestimation among anorexics has failed to control for the effects of actual body size on estimated size. We obtained estimates of the size of 3 body sites from 3 groups: 13 anorexic women; 13 non-eating disordered women matched with the anorexics on actual body size; and 13 non-eating disordered women of average size. The anorexic and size-matched normal subjects did not differ in the extent to which they overestimated their body size, but both displayed significantly greater overestimation than did the subjects of average size. Both groups also estimated the actual size of their body sites to be larger than did average-size normal subjects. These findings illustrate the need for appropriate control procedures when considering body image disturbances among persons with eating disorders, and they raise questions about the psychological significance of disturbances in the perceptual component of body image.

Death certificate categorization of malignant pleural and peritoneal mesothelioma in a cohort of asbestos insulation workers.

Accuracy of diagnosis of malignant mesothelioma (pleural and peritoneal) was studied in a cohort of asbestos insulation workers in the United States and Canada. Initial clinical diagnosis, clinical diagnosis at death and death certificate diagnosis were compared with the diagnosis of malignant mesothelioma ascertained by full data review at the Division of Environmental and Occupational Medicine, Mount Sinai Medical Center, New York ('best evidence'). In both groups the death certificate diagnosis was somewhat less frequently accurate than clinical diagnosis at death. Knowledge of the patients' occupational history by the attending physician and its relation to accuracy of diagnosis of malignant mesothelioma is considered.

The human intracellular Mx-homologous protein is specifically induced by type I interferons.

The murine Mx-1 protein is one of the best biochemically and functionally characterized interferon (IFN)-induced proteins that is necessary, and sufficient, for providing resistance to murine cells against viral influenza infection. Recently an intracellular human protein homologous to the murine Mx-1 protein has been identified by means of a specific monoclonal antibody. The restricted induction of this intracellular protein in human mononuclear cells (MNC) by various cytokines was investigated. MNC from 26 of 28 healthy people and 35 of 36 cancer patients before IFN-alpha therapy had no detectable Mx-homologous protein. Incubation of human MNC with IFN-alpha and IFN-beta for 24 h at different concentrations led to a dose-dependent induction of the Mx-homologous protein. All IFN-alpha or IFN-beta preparations tested were equally effective in eliciting this intracellular protein. IFN-gamma induced only 1% of the Mx amount elicited by type-1 IFN compared on a weight basis. Neither interleukin (IL) 1 nor IL3, IL4, IL5, IL6, tumor necrosis factor-alpha/beta, granulocyte colony-stimulating factor (CSF) or granulocyte macrophage-CSF at any of the concentrations tested were capable of eliciting any detectable amount of the Mx homolog, while IL2 was a poor Mx-homologous protein inducer. In the presence of high-titered IFN-alpha antisera both IL2 and IFN-gamma were unable to stimulate this protein, proving that IFN-gamma and IL2 indirectly induce the Mx homolog via IFN-alpha. Therefore, the human Mx-homologous protein is a strictly by type I IFN-regulated protein in human peripheral blood lymphocytes.

Malignant mesothelioma in a cohort of asbestos insulation workers: clinical presentation, diagnosis, and causes of death.

Malignant mesothelioma has been rare in the general population. In recent decades its incidence has risen dramatically, parallel to the increasing use of asbestos in industry since 1930. Altogether 17,800 asbestos insulation workers, members of the International Association of Heat and Frost Insulators and Asbestos Workers (AFL-CIO-CLC) in the United States and Canada, were enrolled for prospective study on 1 January 1967 and followed up to the present. Every death that occurs is investigated by our laboratory. One hundred and seventy five deaths from mesothelioma occurred among the 2221 men who died in 1967-76 and 181 more such deaths in the next eight years. Altogether, 356 workers had died of malignant mesothelioma (pleural or peritoneal) by 1984. Diagnosis of mesothelioma was accepted only after all available clinical, radiological, and pathological material was reviewed by our laboratory and histopathological confirmation by the pathology unit made in each case. One hundred and thirty four workers died of pleural and 222 of peritoneal mesothelioma. Age at onset of exposure, age at onset of the disease, and age at death were similar in both groups of patients. Significant difference was noted only in the time elapsed from onset of exposure to the development of first symptoms, which was longer in the group with peritoneal mesothelioma. Shortness of breath, either new or recently increased, and chest pain were the most frequent presenting symptoms in the group with pleural mesothelioma; abdominal pain and distension were frequent in the patients with peritoneal mesothelioma. Pleural effusion or ascites were found in most patients. The most effective approach to the diagnosis of malignant pleural mesothelioma in these cases was by open lung biopsy; exploratory laparotomy was best for diagnosing peritoneal mesothelioma. Patients with pleural mesothelioma died principally from pulmonary insufficiency whereas those with peritoneal mesothelioma succumbed after a period of pronounced wasting.

Non-malignant chest x ray changes in patients with mesothelioma in a large cohort of asbestos insulation workers.

To assess the prevalence of non-malignant chest x ray abnormalities in cases of mesothelioma 184 cases of mesothelioma (72 pleural and 112 peritoneal) which had occurred in a cohort of asbestos insulation workers followed up since 1967 were studied. Chest x ray films of satisfactory quality, on which the presence or absence of non-malignant radiological changes indicating interstitial pulmonary fibrosis or pleural fibrosis or both, could be assessed with a high degree of certainty were available. In some cases (20% for pleural mesothelioma, 11.6% for peritoneal mesothelioma) non-malignant radiological changes were not radiologically detectable. Parenchymal interstitial fibrosis (small irregular opacities) only was found in a proportion of cases (25.4% of pleural mesotheliomas, 12.5% of peritoneal mesotheliomas). Pleural fibrosis only was detected in 17% of cases of pleural mesothelioma and 27% of cases of peritoneal mesothelioma. Most patients had both parenchymal and pleural fibrosis. Although these results tend to indicate that in peritoneal mesothelioma the proportion of pleural fibrosis is significantly higher, these findings might have been due to the fact that in most cases of pleural mesothelioma non-malignant changes were interpreted in one hemithorax only. In 46 cases (21 pleural, 25 peritoneal) in which sufficient lung tissue was available histopathology of lung parenchyma indicated the presence of interstitial fibrosis; in 20 (43.5%) of these the chest x ray film had been read as negative. Thus the absence of radiologically detectable small opacities on the chest x ray film does not exclude the existence of interstitial pulmonary fibrosis in cases of mesothelioma among insulation workers. With lower levels of exposure (such as in family contacts of asbestos workers) it is conceivable that mesothelioma might occur in the absence of interstitial pulmonary fibrosis.

Heterakidosis and nodular granulomas caused by Heterakis isolonche in the ceca of gallinaceous birds.

Five pheasants and two ocellated turkeys from the San Diego Zoological Garden had multiple cecal nodules. These nodules were composed mostly of granulomas and fibrous hyperplastic tissue associated with Heterakis isolonche.

Obedience as a function of experimenter competence.

The purpose of this study was to investigate obedience to an E's commands as a function of E competency. Based upon Orne's (1962, 1969) discussion of the demand characteristics inherent in the typical aggression study, it was hypothesized that E incompetence would decrease S obedience. Competence was manipulated by: (1) presenting some Ss with a nervous and inexperienced E, and (2)"accidentally" killing the victim (a rat) midway through the experiment. Thirty-two undergraduate female Ss participated in the experiment-supposedly a study on the physiological effects of stress. Obedi6nce was operationalized as the difference, in simple reaction time, between trials on which Ss were told that their response might result in shock to the rat and trials on which they were told that their response might save the rat from shock. Significant differences in obedience were obtained between competent and incompetent E conditions, and a significant "kill" effect was found in the competent E conditidn. The results of this study suggested that the extreme acts of obedience observed in the laboratory (e.g., Milgram, 1963) occur only when E is perceived as competent. This finding imposes limits on the generalizability of laboratory studies of obedience.