A comparison of brief and extended session duration functional analyses.

Many behavior analysts do not conduct a functional analysis (FA) prior to treatment in a clinical setting (e.g., Roscoe et al., 2015). When asked for an explanation, respondents commonly report that an FA is too time consuming. One way to address this perceived constraint is to evaluate the utility of an abbreviated FA with 5-min session durations. In the current study, 2 independent FAs, 1 with 5-min sessions and 1 with 10-min sessions, were conducted for the problem behavior of 5 individuals diagnosed with autism spectrum disorder (ASD). For all participants, the 5- and 10-min session duration FAs yielded the same identified function of problem behavior: escape from demands. A brief differential reinforcement of alternative behavior (DRA) analysis was subsequently conducted and found to be effective at decreasing problem behavior and increasing an appropriate communication response across participants. These findings demonstrate the utility of conducting an FA using briefer session durations followed by a brief DRA analysis.

Effects of Marine Phospholipids Extract on the Lipid Levels of Metastatic and Nonmetastatic Prostate Cancer Patients.

High intake of omega-3 fatty acids (n-3 FAs) from fish has shown to reduce metastatic progression of prostate cancer. This clinical trial investigated the influence of high n-3 FA intake (marine phospholipids, MPL) on the FA composition of blood lipids, lysophosphatidylcholine (LPC), and on lipoproteins in prostate cancer patients and elderly men without prostate cancer. MPL supplementation resulted in a significant increase of n-3 FAs (eicosapentaenoic and docosahexaenoic acid) in blood lipids, while arachidonic acid (n-6 FA) decreased significantly. Low density lipoprotein (LDL) and high density lipoprotein (HDL) increased significantly, but the LDL increase was observed only in subjects with an inactive tumour. Similarly, LPC plasma concentration increased significantly only in patients without tumour. The missing increase of LDL and LPC after MPL supplementation in patients with actively growing (metastasizing) prostate cancer suggests that tumour cells have an elevated demand for LDL and LPC. Due to the MPL-induced increase of n-3 FAs in these blood lipids, it can be assumed that especially actively growing and metastasizing prostate cancer cells are provided with elevated amounts of these antimetastatic n-3 FAs. A hypothetic model explaining the lower incidence of metastatic progression in prostate cancer patients with high fish consumption is presented.

Prospective use of CYP pharmacogenetics and medication analysis to facilitate improved therapy - a pilot study.

OBJECTIVES: To assess the efficacy of cytochrome P450 (CYP) pharmacogenetic testing and medication interaction analysis in a controlled environment for reduction of events, stays in hospital, extra care and required extra doctors visits to the patients. METHODS: A prospective cohort study of 28 patients in a geriatric care facility with multimedication and at least one report of an event was performed over a period of 7 months. In the first phase of the study the patients were closely monitored twice a day by the care staff, recording all potential events, regardless of association with the indication or not, requirement for extra care, requirement for an unplanned site visit from a physician and days in hospital. In a 1-month period, the patients were genotyped for the cytochromes CYP2C9, CYP2C19 and CYP2D6, and their medication analyzed for interactions, using a proprietary computer program. Recommendations for medication change based upon genetics and/or medication interaction analysis were made to the care physicians. In a second 3-month phase the patients were monitored as in Phase I. The data comparing Phase I with Phase II was analyzed using two way ANOVA. RESULTS: Of the 28 patients in the study in both phases, 16 (55%) had genetic and/or medication interaction problems that required change of medication. A total of 11 out of 16 (69%) of the patients did have their medication altered by the care physician. Of the 11 patients, five (45%) demonstrated some betterment in the number of reported events after alteration of their medication. Of these five patients, three had improvements when their medication was altered for their genetics. A further three (one patient had improvements due to both effects) had improvements when their medication was altered after a medication interaction analysis. CONCLUSION: Although an exploratory pilot study, this cohort study shows the possibilities and potential of pharmacogenetic testing for CYP alterations combined with medication interaction analysis of patients in a geriatric care facility.