Self-reported medical, medication and laboratory error in eight countries: risk factors for chronically ill adults.

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Scobie, Andrea

2011-04-01

To identify risk factors associated with self-reported medical, medication and laboratory error in eight countries. The Commonwealth Fund's 2008 International Health Policy Survey of chronically ill patients in eight countries. None. A multi-country telephone survey was conducted between 3 March and 30 May 2008 with patients in Australia, Canada, France, Germany, the Netherlands, New Zealand, the UK and the USA who self-reported being chronically ill. A bivariate analysis was performed to determine significant explanatory variables of medical, medication and laboratory error (P error: age 65 and under, education level of some college or less, presence of two or more chronic conditions, high prescription drug use (four+ drugs), four or more doctors seen within 2 years, a care coordination problem, poor doctor-patient communication and use of an emergency department. Risk factors with the greatest ability to predict experiencing an error encompassed issues with coordination of care and provider knowledge of a patient's medical history. The identification of these risk factors could help policymakers and organizations to proactively reduce the likelihood of error through greater examination of system- and organization-level practices.

Conceptualisations of masculinity and self-reported medication adherence among HIV-positive Latino men in Los Angeles, California, USA.

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Galvan, Frank H; Bogart, Laura M; Wagner, Glenn J; Klein, David J; Chen, Ying-Tung

2014-06-01

HIV-positive Latino men have been found to have poorer medication adherence compared to Whites. This study sought to identify how cultural conceptualisations of masculinity are associated with self-reported medication adherence among Latino men. A total of 208 HIV-positive men reported the number of doses of antiretroviral medication missed in the previous seven days (dichotomised at 100% adherence versus less). Conceptualisations of masculinity consisted of traditional machismo (e.g., power and aggressive attitudes, which are normally associated with negative stereotypes of machismo) and caballerismo (e.g., fairness, respect for elders and the importance of family). Multivariate logistic regression was used to identify factors associated with adherence. The mean adherence was 97% (SD = 6.5%; range = 57-100%). In all, 77% of the participants reported 100% adherence in the previous seven days. Caballerismo was associated with a greater likelihood (OR = 1.77; 95% CI: 1.08-2.92; p = 0.03) and machismo with a lower likelihood (OR = 0.60; 95% CI: 0.38-0.95; p = 0.03) of medication adherence. In addition, higher medication side-effects were found to be associated with a lower likelihood (OR = 0.59; 95% CI: 0.43-0.81; p = 0.001) of medication adherence. These findings reinforce the importance of identifying cultural factors that may affect medication adherence among HIV-positive Latino men resident in the USA.

Efficient replication of over 180 genetic associations with self-reported medical data.

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Joyce Y Tung

Full Text Available While the cost and speed of generating genomic data have come down dramatically in recent years, the slow pace of collecting medical data for large cohorts continues to hamper genetic research. Here we evaluate a novel online framework for obtaining large amounts of medical information from a recontactable cohort by assessing our ability to replicate genetic associations using these data. Using web-based questionnaires, we gathered self-reported data on 50 medical phenotypes from a generally unselected cohort of over 20,000 genotyped individuals. Of a list of genetic associations curated by NHGRI, we successfully replicated about 75% of the associations that we expected to (based on the number of cases in our cohort and reported odds ratios, and excluding a set of associations with contradictory published evidence. Altogether we replicated over 180 previously reported associations, including many for type 2 diabetes, prostate cancer, cholesterol levels, and multiple sclerosis. We found significant variation across categories of conditions in the percentage of expected associations that we were able to replicate, which may reflect systematic inflation of the effects in some initial reports, or differences across diseases in the likelihood of misdiagnosis or misreport. We also demonstrated that we could improve replication success by taking advantage of our recontactable cohort, offering more in-depth questions to refine self-reported diagnoses. Our data suggest that online collection of self-reported data from a recontactable cohort may be a viable method for both broad and deep phenotyping in large populations.

Predictors of self-reported academic performance among undergraduate medical students of Hawassa University, Ethiopia.

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Gedefaw, Abel; Tilahun, Birkneh; Asefa, Anteneh

2015-01-01

This study was conducted to identify predictors of self-reported academic performance in undergraduate medical students at Hawassa University. An analytical cross-sectional study involving 592 undergraduate medical students was conducted in November 2012. The academic performance of the study subjects was measured by self-reported cumulative grade point average (GPA) using a self-administered questionnaire. Data were entered and analyzed using Statistical Package for the Social Sciences version 16 software. Pearson's bivariate correlations, multiple linear regression, and multiple logistic regression were used to identify predictors of academic performance. The self-reported academic performance of students had been decreasing as the academic years progressed, with the highest and lowest performance being in the premedicine (mean GPA 3.47) and clinical I (mean GPA 2.71) years, respectively. One hundred and fifty-eight (26.7%) of the participants had ever been delayed, 37 (6.2%) had ever re-sat for examination, and two (0.3%) had ever been warned due to academic failure. The overall variation in self-reported academic performance of the students was 32.8%. Participant age alone explained 21.9% of the variation. On the other hand, university entrance examination results, substance use at university, and medicine as first choice by students were identified as predictors of variation in self-reported academic performance, accounting for 6.9%, 2.7%, and academic performance was explained by the studied variables. Hence, efficacious mechanisms should be designed to combat the intervenable determinants of self-reported academic performance, like substance use and a low medical school entrance examination result. Further studies should also be undertaken to gain a better understanding of other unstudied determinants, like personality, learning style, cognitive ability, and the system used for academic evaluation.

Predictors of self-reported academic performance among undergraduate medical students of Hawassa University, Ethiopia

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Gedefaw A

2015-04-01

Full Text Available Abel Gedefaw,1 Birkneh Tilahun,2 Anteneh Asefa3 1Department of Gynecology and Obstetrics, 2Department of Pediatrics and Child Health, 3School of Public and Environmental Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia Background: This study was conducted to identify predictors of self-reported academic performance in undergraduate medical students at Hawassa University. Methods: An analytical cross-sectional study involving 592 undergraduate medical students was conducted in November 2012. The academic performance of the study subjects was measured by self-reported cumulative grade point average (GPA using a self-administered questionnaire. Data were entered and analyzed using Statistical Package for the Social Sciences version 16 software. Pearson's bivariate correlations, multiple linear regression, and multiple logistic regression were used to identify predictors of academic performance. Results: The self-reported academic performance of students had been decreasing as the academic years progressed, with the highest and lowest performance being in the premedicine (mean GPA 3.47 and clinical I (mean GPA 2.71 years, respectively. One hundred and fifty-eight (26.7% of the participants had ever been delayed, 37 (6.2% had ever re-sat for examination, and two (0.3% had ever been warned due to academic failure. The overall variation in self-reported academic performance of the students was 32.8%. Participant age alone explained 21.9% of the variation. On the other hand, university entrance examination results, substance use at university, and medicine as first choice by students were identified as predictors of variation in self-reported academic performance, accounting for 6.9%, 2.7%, and <1% of the variation, respectively. Students who had never used tobacco, alcohol, or khat after starting university were twice as likely to score a self-reported cumulative GPA above 3.0 (adjusted odds ratio 1.95, 95

Self-reported attitudes and behaviours of medical students in Pakistan regarding academic misconduct: a cross-sectional study.

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Ghias, Kulsoom; Lakho, Ghulam Rehmani; Asim, Hamna; Azam, Iqbal Syed; Saeed, Sheikh Abdul

2014-05-29

Honesty and integrity are key attributes of an ethically competent physician. However, academic misconduct, which includes but is not limited to plagiarism, cheating, and falsifying documentation, is common in medical colleges across the world. The purpose of this study is to describe differences in the self-reported attitudes and behaviours of medical students regarding academic misconduct depending on gender, year of study and type of medical institution in Pakistan. A cross sectional study was conducted with medical students from one private and one public sector medical college. A pre-coded questionnaire about attitudes and behaviours regarding plagiarism, lying, cheating and falsifying documentation was completed anonymously by the students. A total of 465 medical students filled the questionnaire. 53% of private medical college students reported that they recognize copying an assignment verbatim and listing sources as references as wrong compared to 35% of public medical college students. 26% of private medical college students self-report this behaviour as compared to 42% of public medical college students. 22% of private versus 15% of public medical college students and 21% of students in clinical years compared to 17% in basic science years admit to submitting a fake medical certificate to justify an absence. 87% of students at a private medical college believe that cheating in an examination is wrong as compared to 66% of public medical college students and 24% self-report this behaviour in the former group as compared to 41% in the latter. 63% of clinical year students identify cheating as wrong compared to 89% of their junior colleagues. 71% of male versus 84% of female respondents believe that cheating is wrong and 42% of males compared to 23% of females admit to cheating. There are significant differences in medical students' attitudes and behaviours towards plagiarism, lying, cheating and stealing by gender, seniority status and type of institution

Increasing diabetic patient engagement and self-reported medication adherence using a web-based multimedia program.

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Elsabrout, Kerri

2018-05-01

Evidence-based, multimedia applications to supplement clinical care can improve patient engagement and clinical outcomes. Patients with diabetes with potentially devastating complication of foot ulcers present a substantial opportunity to improve engagement. This project examines how providing an online, multimedia self-management program affects patient engagement and self-reported medication adherence scores within 4-6 weeks compared with preprogram scores. Participants included 14 adult, diabetic outpatients receiving care at a Wound Care Center in suburban New York. Participants watched a Type 2 diabetes Emmi educational module on an electronic tablet during a routine wound treatment visit. Self-reported medication adherence was measured immediately before and at 4-6 weeks after the educational intervention. Patient engagement was measured immediately before, immediately after, and at 4-6 weeks postintervention. Self-reported medication adherence results demonstrated a modest increase at the delayed postintervention time. In addition, there was a large increase in engagement scores at the delayed postintervention time. The direction of change for both measures was consistent with the intervention being effective. Incorporating this type of novel, multimedia patient education resource may provide opportunities to enhance diabetes care.

Assessing the Perceptions and Practice of Self-Medication among Bangladeshi Undergraduate Pharmacy Students

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Md. Omar Reza Seam

2018-01-01

Full Text Available Objectives: To evaluate the perceptions and extent of practicing self-medication among undergraduate pharmacy students. Methods: This cross-sectional, questionnaire-based study was conducted over a six month period (January to June 2016 among undergraduate pharmacy students in five reputable public universities of Bangladesh. It involved face-to-face interviews regarding self-medication of 250 respondents selected by simple random sampling. Results: Self-medication was reported by 88.0% of students. Antipyretics (58.40% were mostly preferred for the treatment of fever and headaches. The major cause for self-medication was minor illness (59.60%, p = 0.73 while previous prescriptions were the main source of knowledge as well as the major factor (52.80%, p = 0.94 dominating the self-medication practice. The results also demonstrated 88.80% of students had previous knowledge on self-medication and 83.60% of students always checked the information on the label; mainly the expiry date before use (85.60%. A significant (p < 0.05 portion of the students (51% male and 43% female perceived it was an acceptable practice as they considered self-medication to be a segment of self-care. Furthermore, students demonstrated differences in their response level towards the adverse effect of drugs, the health hazard by a higher dose of drug, a physician’s help in case of side effects, taking medicine without proper knowledge, and stopping selling medicine without prescription. Conclusions: Self-medication was commonly used among pharmacy students primarily for minor illnesses using over-the-counter medications. Although it is an inevitable practice for them it should be considered an important public health problem as this practice may increase the misuse or irrational use of medicines.

CHRONIC MEDICAL CONDITIONS AND REPRODUCIBILITY OF SELF-REPORTED AGE AT MENOPAUSE AMONG COMMUNITY DWELLING WOMEN

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de Vries, Heather F.; Northington, Gina M.; Kaye, Elise M.; Bogner, Hillary R.

2011-01-01

OBJECTIVE To examine the association between chronic medical conditions and reproducibility of self-reported age at menopause among community-dwelling women. METHOD Age at menopause was assessed in a population-based longitudinal survey of 240 women twice, in 1993 and 2004. Women who recalled age at menopause in 2004 within one year or less of the age at menopause recalled in 1993 (concordant) were compared with women who did not recall of age at menopause in 2004 within 1 year of age at menopause recalled in 1993 (discordant). Type of menopause (surgical or natural) and chronic medical conditions were assessed by self-report. RESULTS One hundred and forty three women (59.6%) reported surgical menopause and 97 (40.4%) reported natural menopause. In all, 130 (54.2%) of women recalled age at menopause in 2004 within one year or less of recalled age at menopause in 1994 while 110 (45.8%) women did not recall age at menopause in 2004 within one year or less of recalled age at menopause in 1994. Among women with surgical menopause, women with three or more medical conditions were less likely to have concordant recall of age at menopause than women with less than three chronic medical conditions (adjusted odds ratio (OR) = 0.36, 95% confidence interval (CI) [0.15, 0.91]) in multivariate models controlling for potentially influential characteristics including cognition and years from menopause. CONCLUSIONS Among women who underwent surgical menopause, the presence of three or more medical conditions is associated with decreased reproducibility of self-reported age at menopause. PMID:21971208

Chronic medical conditions and reproducibility of self-reported age at menopause among community-dwelling women.

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de Vries, Heather F; Northington, Gina M; Kaye, Elise M; Bogner, Hillary R

2011-12-01

The aim of this study was to examine the association between chronic medical conditions and reproducibility of self-reported age at menopause among community-dwelling women. Age at menopause was assessed in a population-based longitudinal survey of 240 women twice, in 1993 and 2004. Women who recalled age at menopause in 2004 within 1 year or less of age at menopause recalled in 1993 (concordant) were compared with women who did not recall age at menopause in 2004 within 1 year of age at menopause recalled in 1993 (discordant). Type of menopause (surgical or natural) and chronic medical conditions were assessed by self-report. One hundred forty-three women (59.6%) reported surgical menopause, and 97 (40.4%) reported natural menopause. In all, 130 (54.2%) women recalled age at menopause in 2004 within 1 year or less of recalled age at menopause in 1994, whereas 110 (45.8%) women did not recall age at menopause in 2004 within 1 year or less of recalled age at menopause in 1994. Among the women with surgical menopause, the women with three or more medical conditions were less likely to have concordant recall of age at menopause than the women with less than three chronic medical conditions (adjusted odds ratio, 0.36; 95% CI, 0.15-0.91) in multivariate models controlling for potentially influential characteristics including cognition and years since menopause. Among women who underwent surgical menopause, the presence of three or more medical conditions is associated with decreased reproducibility of self-reported age at menopause.

Self-medication practices and predictors for self-medication with ...

African Journals Online (AJOL)

Background: Self-medication with antimalarials and antibiotics is highly practiced worldwide particularly in developing countries including Tanzania. This study was carried out to determine self-medication practices with antimalarials and antibiotics, and as well as predictors for self-medication among urban communities of ...

Assessment of Nature, Reasons, and Consequences of Self-medication Practice among General Population of Ras Al-Khaimah, UAE.

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Sridhar, Sathvik B; Shariff, Atiqulla; Dallah, Lana; Anas, Doaa; Ayman, Maryam; Rao, Padma Gm

2018-01-01

The aim of this study is to assess the nature, reasons, and consequences of self-medication practice among the general population of Ras Al-Khaimah, UAE. This was a prospective, cross-sectional, survey-based study. Data with respect to knowledge, awareness, and practices regarding self-medication were collected through an interviewer-assisted questionnaire answered by the study participants. Thus, collected data from 413 survey respondents were analyzed using SPSS version 24.0. The prevalence of self-medication practices among our study respondents was 52.1%. A headache (155 [37.5%]) was the most common clinical condition treated through self-medication practice. Familiarity with the treatment/medication (198 [48%]) was the most common cited reasons, whereas the advertisement and friend's advice were the most (182 [44%]) cited sources of information for self-medication usage. The majority (265 [64.1%]) of the respondents were considered self-medication practice as safe. However, 19 respondents reported side-effects or complications during the due course of self-medication. It was observed that there is a statistically significant association ( P employment status of this study participants with self-medication practices. The data from this study show that the self-medication practice is very common among the study population. Variables such as younger age group and occupation status were significantly associated with self-medication practice. We emphasize the role of pharmacist in educating the community regarding safe medication practices such as harmful effects of self-medicating and inappropriate practices such as sharing the medications among family members and friends.

Medical advice and diabetes self-management reported by Mexican-American, Black- and White-non-Hispanic adults across the United States

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Vaccaro Joan A

2012-03-01

Full Text Available Abstract Background Diabetes has reached epidemic proportions in the United States, particularly among minorities, and if improperly managed can lead to medical complications and death. Healthcare providers play vital roles in communicating standards of care, which include guidance on diabetes self-management. The background of the client may play a role in the patient-provider communication process. The aim of this study was to determine the association between medical advice and diabetes self care management behaviors for a nationally representative sample of adults with diabetes. Moreover, we sought to establish whether or not race/ethnicity was a modifier for reported medical advice received and diabetes self-management behaviors. Methods We analyzed data from 654 adults aged 21 years and over with diagnosed diabetes [130 Mexican-Americans; 224 Black non-Hispanics; and, 300 White non-Hispanics] and an additional 161 with 'undiagnosed diabetes' [N = 815(171 MA, 281 BNH and 364 WNH] who participated in the National Health and Nutrition Examination Survey (NHANES 2007-2008. Logistic regression models were used to evaluate whether medical advice to engage in particular self-management behaviors (reduce fat or calories, increase physical activity or exercise, and control or lose weight predicted actually engaging in the particular behavior and whether the impact of medical advice on engaging in the behavior differed by race/ethnicity. Additional analyses examined whether these relationships were maintained when other factors potentially related to engaging in diabetes self management such as participants' diabetes education, sociodemographics and physical characteristics were controlled. Sample weights were used to account for the complex sample design. Results Although medical advice to the patient is considered a standard of care for diabetes, approximately one-third of the sample reported not receiving dietary, weight management, or physical

Self-Medication

African Journals Online (AJOL)

2012-09-19

Sep 19, 2012 ... Key words: Self-medication, hazards, pregnant women, Nigeria ... these substances range from protection from witches and witchcrafts, preventing ... is common among pregnant women in our environment. .... Although earlier studies have association self-medication with factors such as self-employment, ...

Accuracy of Professional Self-Reports: Medical Student Self-Report and the Scoring of Professional Competence

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Richter Lagha, Regina Anne

2014-01-01

Self-report is currently used as an indicator of professional practice in a variety of fields, including medicine and education. Important to consider, therefore, is the ability of self-report to accurately capture professional practice. This study investigated how well professionals' self-reports of behavior agreed with an expert observer's…

Self-medication practice among undergraduate medical students in a tertiary care medical college, West Bengal.

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Banerjee, I; Bhadury, T

2012-01-01

Self-medication is a widely prevalent practice in India. It assumes a special significance among medical students as they are the future medical practitioners. To assess the pattern of self-medication practice among undergraduate medical students. Tertiary care medical college in West Bengal, India. A cross-sectional questionnaire-based study was conducted among the undergraduate medical students. Out of 500 students of the institute, 482 consented for the study and filled in the supplied questionnaire. Fourteen incomplete questionnaires were excluded and the remaining 468 analyzed. It was found that 267 (57.05%) respondents practiced self-medication. The principal morbidities for seeking self-medication included cough and common cold as reported by 94 students (35.21%) followed by diarrhea (68 students) (25.47%), fever (42 students) (15.73%), headache (40 students) (14.98%) and pain abdomen due to heartburn/ peptic ulcer (23 students) (8.61%). Drugs/ drug groups commonly used for self-medication included antibiotics (31.09%) followed by analgesics (23.21%), antipyretics (17.98%), antiulcer agents (8.99%), cough suppressant (7.87%), multivitamins (6.37%) and antihelminthics (4.49%). Among reasons for seeking self-medication, 126 students (47.19%) felt that their illness was mild while 76 (28.46%) preferred as it is time-saving. About 42 students (15.73%) cited cost-effectiveness as the primary reason while 23 (8.62%) preferred because of urgency. Our study shows that self-medication is widely practiced among students of the institute. In this situation, faculties should create awareness and educate their students regarding advantages and disadvantages of self-medication.

Which Depressive Symptoms and Medication Side Effects Are Perceived by Patients as Interfering Most with Occupational Functioning?

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Raymond W. Lam

2012-01-01

Full Text Available Background. Major depressive disorder (MDD is associated with significant impairment in occupational functioning. This study sought to determine which depressive symptoms and medication side effects were perceived by patients with MDD to have the greatest interference on work functioning. Methods. 164 consecutive patients with MDD by DSM-IV criteria completed a standard assessment that included a self-rated questionnaire about the degree to which symptoms and side effects interfered with work functioning. Results. The symptoms perceived by patients as interfering most with work functioning were fatigue and low energy, insomnia, concentration and memory problems, anxiety, and irritability. The medication side effects rated as interfering most with work functioning were daytime sedation, insomnia, headache, and agitation/anxiety. There were no differences between men and women in symptoms or side effects that were perceived as interfering with work functioning. Limitations. This was a cross-sectional study; only subjective assessments of work functioning were obtained; the fact that patients were using varied medications acts as a potential confound. Conclusions. Specific depressive symptoms and medication side effects were perceived by patients as interfering more with occupational functioning than others. These factors should be considered in treatment selection (e.g., in the choice of antidepressant in working patients with MDD.

Bullying and Victimization Trends in Undergraduate Medical Students - A Self-Reported Cross-Sectional Observational Survey.

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Kapoor, Shrea; Ajinkya, Shaunak; Jadhav, Pradeep R

2016-02-01

Bullying is a form of behaviour that can negatively impact a person. It can lead to several deleterious consequences like low self-confidence, drop in academic performance and depression. Studies have shown that bullying behaviour exists amongst medical students also. In the medical field, it is known to negatively impact dispensing of health care and attitudes of medical students towards becoming doctors. It is very difficult for medical students to cope with such a menace as they are already burdened with a vast curriculum and rigorous schedules. There exists paucity of studies regarding bullying amongst undergraduate medical students in Indian context. To study prevalence of peer-based bullying and victimization along with their associated factors in undergraduate medical students. Four hundred randomly chosen undergraduate medical students were included in the study. Socio-demographic and personal details including history of substance use were recorded in a self-designed case record form. Illinois Bullying Scale was used to assess bullying behaviours. Out of total 400 students, 383 completed the survey and this data was analysed. In this study, 98.69% participants self-reported to having indulged in bullying while 88.77% reported feeling victimized. Physical (pbullying was found to be of significantly greater severity in males as compared to females. Students of the third year of medical school indulged in significantly (p=0.034) greater severity of physical bullying than those of other years. Alcohol consumption (p=0.001) and cigarette smoking (pbullying. Peer-based bullying and victimization was found to be highly prevalent amongst undergraduate medical students. There is an urgent need for more detailed studies on bullying in medical students so that remedial measures can be initiated and steps to limit such behaviours can be looked at seriously.

Factors Associated With Self-reported and Medically Diagnosed Urinary Incontinence Among Community-Dwelling Older Women In Korea

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Jeongok Park

2015-06-01

Full Text Available Purpose: The purpose of this study was to examine the prevalence of urinary incontinence (UI in community-dwelling Korean women 60 years or older, and to identify factors associated with self-reported and medically diagnosed UI. Methods: This study was a secondary analysis of data from the 2008 Actual Living Condition of the Elderly and Welfare Need Survey, which used a stratified two-stage cluster sampling method to select a representative sample of 8,961 elderly Korean women. Results: Of the 8,961 women in this study, 579 (6.5% had self-reported UI, and 209 (2.3% were medically diagnosed with UI. As patient age and exercise ability of the upper extremities increased, risk for self-reported UI decreased (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.96–0.99; OR, 0.99; 95% CI, 0.98–0.99, respectively. In contrast, as the number of limited instrumental activities of daily living (IADL increased, the risk for self-reported UI increased (OR, 1.30; 95% CI, 1.24–1.35. Overweight women were 1.94 times more likely to have self-reported UI compared to underweight women. Women with a history of stroke or asthma were more likely to have self-reported UI compared to women with no history. Also, women who reported being in good health were less likely to have UI, compared to women who reported being in poor health (OR, 0.47; 95% CI, 0.31–0.70. Medically diagnosed UI was negatively associated with the number of limited IADL and exercise ability scores for the lower extremities (OR, 0.86; 95% CI, 0.80–0.92; OR, 0.98; 95% CI, 0.97–0.99, respectively. In contrast, as the exercise ability score for the upper extremities increased, so did the risk for medically diagnosed UI (OR, 1.02; 95% CI, 1.01–1.03. Conclusions: An interventional program for home visit health services is needed for incontinent women who are highly dependent on others for IADL.

Self-medication practice among undergraduate medical students in a tertiary care medical college, West Bengal

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I Banerjee

2012-01-01

Full Text Available Background: Self-medication is a widely prevalent practice in India. It assumes a special significance among medical students as they are the future medical practitioners. Aim: To assess the pattern of self-medication practice among undergraduate medical students. Settings and Design: Tertiary care medical college in West Bengal, India. Material and Methods: A cross-sectional questionnaire-based study was conducted among the undergraduate medical students. Results: Out of 500 students of the institute, 482 consented for the study and filled in the supplied questionnaire. Fourteen incomplete questionnaires were excluded and the remaining 468 analyzed. It was found that 267 (57.05% respondents practiced self-medication. The principal morbidities for seeking self-medication included cough and common cold as reported by 94 students (35.21% followed by diarrhea (68 students (25.47%, fever (42 students (15.73%, headache (40 students (14.98% and pain abdomen due to heartburn/ peptic ulcer (23 students (8.61%. Drugs/ drug groups commonly used for self-medication included antibiotics (31.09% followed by analgesics (23.21%, antipyretics (17.98%, antiulcer agents (8.99%, cough suppressant (7.87%, multivitamins (6.37% and antihelminthics (4.49%. Among reasons for seeking self-medication, 126 students (47.19% felt that their illness was mild while 76 (28.46% preferred as it is time-saving. About 42 students (15.73% cited cost-effectiveness as the primary reason while 23 (8.62% preferred because of urgency. Conclusion: Our study shows that self-medication is widely practiced among students of the institute. In this situation, faculties should create awareness and educate their students regarding advantages and disadvantages of self-medication.

Inappropriate self-medication among adolescents and its association with lower medication literacy and substance use.

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Chun-Hsien Lee

Full Text Available While self-medication is common, inappropriate self-medication has potential risks. This study assesses inappropriate self-medication among adolescents and examines the relationships among medication literacy, substance use, and inappropriate self-medication.In 2016, a national representative sample of 6,226 students from 99 primary, middle, and high schools completed an online self-administered questionnaire. Multiple logistic regression analysis was used to examine factors related to inappropriate self-medication.The prevalence of self-medication in the past year among the adolescents surveyed was 45.8%, and the most frequently reported drugs for self-medication included nonsteroidal anti-inflammatory drugs or pain relievers (prevalence = 31.1%, cold or cough medicines (prevalence = 21.6%, analgesics (prevalence = 19.3%, and antacids (prevalence = 17.3%. Of the participants who practiced self-medication, the prevalence of inappropriate self-medication behaviors included not reading drug labels or instructions (10.1%, using excessive dosages (21.6%, and using prescription and nonprescription medicine simultaneously without advice from a health provider (polypharmacy (30.3%. The results of multiple logistic regression analysis showed that after controlling for school level, gender, and chronic diseases, the participants with lower medication knowledge, lower self-efficacy, lower medication literacy, and who consumed tobacco or alcohol were more likely to engage in inappropriate self-medication.Lower medication literacy and substance use were associated with inappropriate self-medication among adolescents.

Antibiotic Self-Medication among Non-Medical University Students in Punjab, Pakistan: A Cross-Sectional Survey

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Ali Hassan Gillani

2017-09-01

Full Text Available Background: Antibiotic resistance is a global threat. Scarce knowledge about safe and appropriate antibiotic use is coupled with frequent self-administration, e.g., in China. This repeated self-medication poses potential risk in terms of antibiotic resistance. Low-resource countries are facing an elevated burden of antibiotic self-medication as compared to developed ones. Thus, this study focused on evaluating the pervasiveness of antibiotic self-medication in 3 universities of Southern Punjab, Pakistan. Methods: We conducted a descriptive cross-sectional survey in three government sector universities of Southern Punjab, Pakistan. The study was carried out with self-administered paper-based questionnaires. Data was analyzed using SPSS version 18.0 (IBM, Chicago, IL, USA. Results: Seven hundred twenty-seven students out of 750 (response rate 97% with a mean age ± SD of 23.0 ± 3.4 years agreed to participate in the study. The proportion of females was slightly greater (52% compared with males (48%, and almost one-third of the respondents (36% were in their 2nd year of university. Out of the total, 58.3% practiced self-medication in the preceding six months, and 326 (45% confirmed the use of antibiotics. Metronidazole was the most frequently self-medicated antibiotic (48%. Out of the total, 72% demonstrated awareness regarding the side effects of antibiotics. Diarrhea was the well-known adverse effect (38%. Forty-three percent affirmed having antibiotic resistance knowledge, and 30% knew that the irregular use of antibiotics would lead to increased antibiotic resistance. Conclusion: Despite having ample awareness of the adverse antibiotic reactions, self-medication among the university students was high and antibiotic resistance was a fairly unknown term.

Antibiotic Self-Medication among Non-Medical University Students in Punjab, Pakistan: A Cross-Sectional Survey.

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Gillani, Ali Hassan; Ji, Wenjing; Hussain, Waqar; Imran, Ali; Chang, Jie; Yang, Caijun; Fang, Yu

2017-09-29

Background : Antibiotic resistance is a global threat. Scarce knowledge about safe and appropriate antibiotic use is coupled with frequent self-administration, e.g., in China. This repeated self-medication poses potential risk in terms of antibiotic resistance. Low-resource countries are facing an elevated burden of antibiotic self-medication as compared to developed ones. Thus, this study focused on evaluating the pervasiveness of antibiotic self-medication in 3 universities of Southern Punjab, Pakistan. Methods : We conducted a descriptive cross-sectional survey in three government sector universities of Southern Punjab, Pakistan. The study was carried out with self-administered paper-based questionnaires. Data was analyzed using SPSS version 18.0 (IBM, Chicago, IL, USA). Results : Seven hundred twenty-seven students out of 750 (response rate 97%) with a mean age ± SD of 23.0 ± 3.4 years agreed to participate in the study. The proportion of females was slightly greater (52%) compared with males (48%), and almost one-third of the respondents (36%) were in their 2nd year of university. Out of the total, 58.3% practiced self-medication in the preceding six months, and 326 (45%) confirmed the use of antibiotics. Metronidazole was the most frequently self-medicated antibiotic (48%). Out of the total, 72% demonstrated awareness regarding the side effects of antibiotics. Diarrhea was the well-known adverse effect (38%). Forty-three percent affirmed having antibiotic resistance knowledge, and 30% knew that the irregular use of antibiotics would lead to increased antibiotic resistance. Conclusion : Despite having ample awareness of the adverse antibiotic reactions, self-medication among the university students was high and antibiotic resistance was a fairly unknown term.

Seroepidemiology of Varicella and value of self-reported history of Varicella infection in Iranian medical students.

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Allami, Abbas; Mohammadi, Navid; Najar, Azade

2014-04-01

We conducted this study to assess the seroprevalence of Varicella zoster virus (VZV) antibodies in a group of Iranian medical sciences students that were at risk of Varicella and the value of self-reported history as a predictor of immunity. 255 medical, nursing and obstetrics students who had not entered as a student or worked in a hospital from 3 different schools were enrolled in the study in 2012 (Qazvin province, Iran). Demographics and other information as well as the history of Varicella were obtained through a self-administered questionnaire. Blood samples were collected to determine the Varicella IgG levels via an enzyme-linked immunosorbent assay. A statistical analysis was performed by calculating prevalences and their 95% confidence intervals. Sensitivity, specificity, positive and negative predictive values, Cohen's kappa and positive and negative likelihood ratios of recalled history were determined. p history with immunity against the virus were statistically significant. The overall rate of reported history was 57%. The positive and negative predictive values of self-reported history of Varicella were 91% and 47.3%, respectively. Immunization of students of Iranian medical sciences seems logical in the near future. Also, they should be tested for Varicella immunity regardless of the history of previous infection.

Assessment of patient knowledge of diabetic goals, self-reported medication adherence, and goal attainment

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Whitley HP

2006-12-01

Full Text Available Background: Medication adherence is an integral aspect of disease state management for patients with chronic illnesses, including diabetes mellitus. It has been hypothesized that patients with diabetes who have poor medication adherence may have less knowledge of overall therapeutic goals and may be less likely to attain these goals. Objective: The purpose of this study was to assess self-reported medication adherence, knowledge of therapeutic goals (hemoglobin A1C [A1C], low density lipoprotein cholesterol [LDL-C] and blood pressure [BP], and goal attainment in adult patients with diabetes. Methods: A survey was created to assess medication adherence, knowledge of therapeutic goals, and goal attainment for adult patients with diabetes followed at an internal medicine or a family medicine clinic. Surveys were self-administered prior to office visits. Additional data were collected from the electronic medical record. Statistical analysis was performed. Results: A total of 149 patients were enrolled. Knowledge of therapeutic goals was reported by 14%, 34%, and 18% of survived patients for LDL-C, BP, and A1C, respectively. Forty-six percent, 37%, and 40% of patients achieved LDL-C, BP, and A1C goals, respectively. Low prescribing of cholesterol-lowering medications was an interesting secondary finding; 36% of patients not at LDL-C goal had not been prescribed a medication targeted to lower cholesterol. Forty-eight percent of patients were medication non-adherent; most frequently reported reasons for non-adherence were forgot (34% and too expensive (14%. Patients at A1C goal were more adherent than patients not at goal (p=0.025. Conclusion: The majority did not reach goals and were unknowledgeable of goals; however, most were provided prescriptions to treat these parameters. Goal parameters should be revisited often amongst multidisciplinary team members with frequent and open communications. Additionally, it is imperative that practitioners discuss

Self-reported non-adherence and beliefs about medication in a Swedish kidney transplant population.

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Lennerling, Annette; Forsberg, Anna

2012-01-01

Patients' non-adherence to immunosuppressant treatment after organ transplantation may lead to organ failure, graft loss and death. Non-adherence among Swedish kidney transplant recipients has not previously been studied. Hence the aim of this study was to explore non-adherence among Swedish kidney transplant recipients by using self-report instruments as well as testing the hypothesis that there is a difference in self-reported symptoms, beliefs about medicine and social support between respondents with or without self reported non-adherence. In the present cross sectional study 250 renal transplant recipients participated by replying to a questionnaire. Two validated instruments were included, one on beliefs about medicine (the BMQ©), the other on nonadherence (the BAASIS©). Only 46 % never failed to follow the medical treatment with respect to taking the drugs, dosage or timing (>2 hrs from prescribed time). Timing was the most frequently reported deviation (48 %). Forty-seven patients (16 %) had failed taking at least one dose of the prescribed immunosuppressants during the past four weeks. Four individuals had reduced the prescribed doses. Only one reported taking a 'drug holiday'. Nine participants reported stronger concerns than necessities for immunosuppressive medication. For the BMQ the necessity scores were extremely high while the scores for concern were low. Risk behaviour identified by the BAASIS had no association in risk attitudes as identified in the BMQ. The only factor relating to non-adherence was lack of social support (p=0.022). In general adherence was high. Identification of the exceptions remains a challenge.

Self-reported Improvement in Side Effects and Quality of Life With Integrative Medicine in Breast Cancer Patients.

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Hack, Carolin C; Hackl, Janina; Hüttner, Nina B M; Langemann, Hanna; Schwitulla, Judith; Dietzel-Drentwett, Svenja; Fasching, Peter A; Beckmann, Matthias W; Theuser, Anna-Katharin

2018-05-01

Although the demand from patients for integrative medicine is increasing, complementary medicine services are still quite heterogeneous and have not been incorporated into clinical routine. The aim of this study was to systematically evaluate improvements in side effects and quality of life associated with a hospital-based integrative medicine program in the modern breast cancer patient care setting. In a cross-sectional study, integrative health counseling and treatment were evaluated in women with breast cancer. Over a 15-month period, data for 75 patients from an integrative medicine consultancy service with standardized operating procedures were collected at the University Breast Center for Franconia. At baseline, the patients answered a questionnaire on their medical history, symptoms, and the treatment goals they were hoping to achieve with integrative medicine. In the follow-up, patient-reported outcomes related to side effects of conventional cancer treatment and patients' quality of life were analyzed. Among 60 patients with the therapy goal of reducing the side effects of conventional treatment, 46 (76.7%) were successful. Among 57 patients hoping to improve disease-related quality of life, 46 (82%) reported success. Whereas patients with metastatic disease achieved a reduction in the side effects of conventional therapy, quality-of-life improvements were predominantly achieved by patients with a good treatment prognosis. Breast cancer patients benefit from the counseling and treatment provided with integrative medicine in all phases of tumor disease. Integrative treatment services should be included as part of patient care in clinical routine work to offer patients the maximum quality of care and safety with complementary therapies.

Self-medication practice and associated factors among adult household members in Meket district, Northeast Ethiopia, 2017.

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Kassie, Aster Desalew; Bifftu, Berhanu Boru; Mekonnen, Habtamu Sewunet

2018-04-10

Self-medication practice (SMP) is the use of medication without the prescription of health care professionals. The major problems associated with self-medication practice have been drug resistance, drug side effects, wastage of resources, and serious health hazards including death. Thus, the main purpose of this study was to assess the prevalence of self-medication practice and its associated factors among adult household members in Meket District, Northeast Ethiopia. A community based cross-sectional study was conducted among 722 adult household members in Meket District, from April 5 to May 5, 2017. The systematic random sampling method was used to select study participants. A pre-tested, structured questionnaire was used for data collection using an interviewer-administered technique. Epi-info version and SPSS version 22 were utilized for data entry and analysis, respectively. Univariate and multivariate logistic regression was used to identify association factors. The overall prevalence of self-medication was found to be 35.9%. Unmarried status (AOR = 2.17, 95% CI = 1.18, 4.01), previous experience of self-medication (AOR = 1.78, 95% CI = 1.22, 2.61), accessibility of pharmacies (AOR = 3.71, 95% CI = 1.31, 10.51), peer/family pressure (AOR = 2.88, 95% CI = 1.98, 4.18) and presence of medication at home (AOR = 1.80, 95% CI = 1.11, 2.92) were factors associated with self-medication practices. More than one-third of the study participants practiced self-medication. Thus, strengthening communities awareness on drug side effects and integrated efforts of individuals, communities, health facilities, and regulatory bodies are highly necessary.

Website design: technical, social and medical issues for self-reporting by elderly patients.

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Taylor, Mark J; Stables, Rod; Matata, Bashir; Lisboa, Paulo J G; Laws, Andy; Almond, Peter

2014-06-01

There is growing interest in the use of the Internet for interacting with patients, both in terms of healthcare information provision and information gathering. In this article, we examine the issues in designing healthcare websites for elderly users. In particular, this article uses a year-long case study of the development of a web-based system for self-reporting of symptoms and quality of life with a view to examine the issues relating to website design for elderly users. The issues identified included the technical, social and medical aspects of website design for elderly users. The web-based system developed was based on the European Quality of Life 5-Dimensions health-status questionnaire, a commonly used tool for patient self-reporting of quality of life, and the more specific coronary revascularisation outcome questionnaire. Currently, self-reporting is generally administered in the form of paper-based questionnaires to be completed in the outpatient clinic or at home. There are a variety of issues relating to elderly users, which imply that websites for elderly patients may involve different design considerations to other types of websites.

Using evidence to improve satisfaction with medication side-effects education on a neuro-medical surgical unit.

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Ahrens, Susan L; Wirges, Ashley M

2013-10-01

Patient satisfaction is viewed as a significant indicator of quality of care. More specifically, improving patient satisfaction related to communication about medications and potential side effects can improve healthcare outcomes. Patient satisfaction scores related to medication side effects on a neuro-medical surgical unit were monitored following a quality improvement program. These patients frequently experience cognitive impairment and functional difficulties that can affect the way they understand and handle medications. The purpose of this quality improvement practice change was to (a) develop an educational approach for post acute neurosurgical patients and (b) evaluate whether the use of the approach is successful in improving patient satisfaction scores related to medication education on side effects. The quality improvement program interventions included (a) patient informational handouts inserted into admission folders, (b) nurse education about the importance of providing education on side effects to patient and discussion of their involvement with the program, (c) unit flyers with nurse education, and (d) various communications with bedside nurses through personal work mail and emails. The primary focus was for nurses to employ the "teach back" method to review and reinforce the medication side-effect teaching with patients. Evaluation of the data showed an increase in patient satisfaction after the implementation of the "Always Ask" program.

High prevalence of self-medication practices among medical and pharmacy students: a study from Jordan.

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Alkhatatbeh, Mohammad J; Alefan, Qais; Alqudah, Mohammad A Y

2016-05-01

To assess self-medication practices and to evaluate the impact of obtaining medical knowledge on self-medication among medical and pharmacy students at Jordan University of Science and Technology. This was a cross-sectional study. A well-validated questionnaire that included 3 sections about self-medication was administered to the subjects after introducing the term "self-medication" verbally. 1,317 students had participated in the study and were subgrouped according to their academic level into seniors and juniors. Compared to the general population rate of 42.5%, self-medication practice was reported by (1,034, 78.5%) of the students and most common amongst pharmacy students (n = 369, 82.9%) compared to Pharm.D. (n = 357, 77.9%) and medical students (n = 308, 74.4%) (p = 0.009). There was no significant difference between juniors and seniors (557, 79.1% vs. 477, 77.8%, p = 0.59, respectively). Headache (71.2%) and common cold (56.5%) were frequent ailments that provoked self-medication. Analgesics (79.9%) and antibiotics (59.8%) were frequently used to self-treat these aliments. Reasons for self-medication included previous disease experience (55.7%); minor aliments (55.3%); and having enough medical knowledge (32.1%). Medicines were used according to instructions obtained mainly from the leaflet (28.8%); pharmacist (20.7%); and university courses (19.7%). Senior students were more aware of the risk of self-medication than junior students. The majority of students frequently advise other people about self-medication (83.6%). Self-medication was common among students irrespective to their level of medical knowledge. Obtaining medical knowledge increased the students' awareness of the risk of self-medication which may result in practicing responsible self-medication. However, medical teaching institutions need to educate students about the proper use of medicines as a therapeutic tool.

Patterns and predictors of self-medication in northern Uganda.

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Moses Ocan

Full Text Available Self-medication with antimicrobial agents is a common form of self-care among patients globally with the prevalence and nature differing from country to country. Here we assessed the prevalence and predictors of antimicrobial self-medication in post-conflict northern Uganda. A cross-sectional study was carried out using structured interviews on 892 adult (≥18 years participants. Information on drug name, prescriber, source, cost, quantity of drug obtained, and drug use was collected. Households were randomly selected using multistage cluster sampling method. One respondent who reported having an illness within three months in each household was recruited. In each household, information was obtained from only one adult individual. Data was analyzed using STATA at 95% level of significance. The study found that a high proportion (75.7% of the respondents practiced antimicrobial self-medication. Fever, headache, lack of appetite and body weakness were the disease symptoms most treated through self-medication (30.3%. The commonly self-medicated antimicrobials were coartem (27.3%, amoxicillin (21.7%, metronidazole (12.3%, and cotrimoxazole (11.6%. Drug use among respondents was mainly initiated by self-prescription (46.5% and drug shop attendants (57.6%. On average, participants obtained 13.9±8.8 (95%CI: 12.6-13.8 tablets/capsules of antimicrobial drugs from drug shops and drugs were used for an average of 3.7±2.8 days (95%CI: 3.3-3.5. Over half (68.2% of the respondents would recommend self-medication to another sick person. A high proportion (76% of respondents reported that antimicrobial self-medication had associated risks such as wastage of money (42.1%, drug resistance (33.2%, and masking symptoms of underlying disease (15.5%. Predictors of self-medication with antimicrobial agents included gender, drug knowledge, drug leaflets, advice from friends, previous experience, long waiting time, and distance to the health facility. Despite

Attitudes and self-reported behavior of patients, doctors, and pharmacists in New Zealand and Belgium toward direct-to-consumer advertising of medication.

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Dens, Nathalie; Eagle, Lynne C; De Pelsmacker, Patrick

2008-01-01

Patients', doctors', and pharmacists' attitudes toward direct-to-consumer advertising (DTCA) for medication and their perceptions of its impact on patient self-reported behavior in terms of request for, and consumption of, advertised medication were investigated. Data were obtained in New Zealand, 1 of only 2 countries that allow mass-media DTCA for prescription medication, and in Belgium, which does not. Attitudes were relatively negative in both countries, but significantly more positive in New Zealand than in Belgium. The impact of DTCA (both in a positive and a negative sense) on self-reported patient behavior and patient interaction with doctors and pharmacists was limited in both countries. Although -- as already established in previous work -- the informativeness and reliability of DTCA can be much improved, and the attitude of medical professionals toward DTCA is negative in both countries, from the point of view of medical professionals and patients, DTCA does not harm the self-reported relationship between doctors, pharmacists, and patients.

Self-reported difficulty in conceiving as a measure of infertility.

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Dick, M-L B; Bain, C J; Purdie, D M; Siskind, V; Molloy, D; Green, A C

2003-12-01

This study aimed to explore the meaning and potential use of women's self-reported difficulties in conceiving as a measure of infertility in epidemiological studies, and to compare women's stated reasons for infertility with information in their medical records. Data were available from a population-based case-control study of ovarian cancer involving 1638 women. The sensitivity and specificity of women's self-reported infertility were calculated against their estimated fertility status based on detailed reproductive histories. Self-reported reasons for infertility were compared with diagnoses documented in women's medical records. The sensitivity of women's self-reported difficulty in conceiving was 66 and 69% respectively when compared with calendar-derived and self-reported times taken trying to conceive; its specificity was 95%. Forty-one (23%) of the 179 women for whom medical records were available had their self-reported fertility problem confirmed. Self-reported infertility causes could be compared with diagnoses in medical records for only 22 of these women. Self-reported difficulty conceiving is a useful measure of infertility for quantifying the burden of fertility problems experienced in the community. Validation of reasons for infertility is unlikely to be feasible through examination of medical records. Improved education of the public regarding the availability and success rates of infertility treatments is proposed.

Self-medication among healthcare and non-healthcare students at University of Ljubljana, Slovenia.

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Klemenc-Ketis, Zalika; Hladnik, Ziga; Kersnik, Janko

2010-01-01

To determine the incidence of self-medication among University of Ljubljana students and the effect of the type of curriculum on the pattern of self-medication. The study included a sample of 1,294 students who freely accessed a self-administered web-based questionnaire in the Slovene language that consisted of a preliminary letter introducing the term 'self-treatment' and 2 sections about self-medication. The preliminary letter asked participants to report the practice of self-treatment during the past year. The main outcome measures were percentages of those reporting self-medication during the past year, which were then used to compare healthcare and non-healthcare students. A majority of students (1,195, 92.3%), both healthcare and non-healthcare, reported the use of some sort of self-medication during the study period. More healthcare students in their senior year (353, 94.1%) than those in their junior year (245, 89.4%) used self-medication (p = 0.04). Healthcare students (p = 0.05) thought that self-medication without improvement of the symptoms should last for 1 week or less. They acquired the drugs for self-medication from pharmacies; thought that previous doctors' advice in a similar situation was a more important reason for self-medication; would seek the advice of a physician or pharmacist for different ways of self-treatment, and quite interestingly thought that self-medication was not very safe. On the other hand, non-healthcare students acquired the drugs from healers and friends. The study showed that self-medication was common among all University of Ljubljana students, but that healthcare-related education in students and young adults led to more responsible use of self-medication. Copyright 2010 S. Karger AG, Basel.

Psychotropic medication in the French child and adolescent population: prevalence estimation from health insurance data and national self-report survey data

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Legleye Stéphane

2009-11-01

Full Text Available Abstract Background The aim of this work is to estimate the French frequencies of dispensed psychotropic prescriptions in children and adolescents. Prevalence estimations of dispensed prescriptions are compared to the frequencies of use of psychotropic reported by 17 year-old adolescents. Methods Prescription data is derived from national health insurance databases. Frequencies of dispensed prescriptions are extrapolated to estimate a range for the 2004 national rates. Self-report data is derived from the 2003 and 2005 ESCAPAD study, an epidemiological study based on a questionnaire focused on health and drug consumption. Results The prevalence estimation shows that the prevalence of prescription of a psychotropic medication to young persons between 3 and 18 years is about 2.2%. In 2005, the self-report study (ESCAPAD shows that 14.9% of 17 year-old adolescents took medication for "nerves" or "to sleep" during the previous 12 months. The same study in 2003 also shows that 62.3% of adolescents aged 17 and 18 reporting psychotropic use, took the medication for anxiety and 56.8% to sleep. Only 49.7% of these medications are suggested by a doctor. Conclusion This study underlines a similar range of prevalence of psychotropic prescriptions in France to that observed in other European countries. Nevertheless, the proportion of antipsychotics and benzodiazepines seems to be higher, whereas the proportion of methylphenidate is lower. Secondly, a disparity between the prevalence of dispensed prescriptions and the self-report of actual use of psychotropics has been highlighted by the ESCAPAD study which shows that these treatments are widely used as "self-medication".

Relationship between medication beliefs, self-reported and refill adherence, and symptoms in patients with asthma using inhaled corticosteroids

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Van Steenis MNA

2014-01-01

Full Text Available MNA Van Steenis,1 JA Driesenaar,2 JM Bensing,2,3 R Van Hulten,4 PC Souverein,4 L Van Dijk,2,4 PAGM De Smet,5 AM Van Dulmen2,6,71Department of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands; 2NIVEL (Netherlands institute for health services research, Utrecht, The Netherlands; 3Department of Psychology, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, The Netherlands; 4Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, The Netherlands; 5IQ Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; 6Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; 7Department of Health Sciences, Buskerud University College, Drammen, NorwayBackground: Beliefs play a crucial role in medication adherence. Interestingly, the relationship between beliefs and adherence varies when different adherence measures are used. How adherence, in turn, is related to asthma symptoms is still unclear. Our aim was to investigate the relationship between beliefs (ie, necessities and concerns about inhaled corticosteroids (ICS and subjectively as well as objectively measure adherence and the agreement between these measures. Further, the relationship between adherence and asthma symptoms was examined.Methods: A total of 280 patients aged 18–80 years who filled at least two ICS prescriptions in the preceding year were recruited to complete a questionnaire. The questionnaire included the Beliefs about Medicines Questionnaire to assess necessity beliefs and concerns about ICS, four questions about ICS use to measure self-reported adherence, and the Asthma Control Questionnaire to assess asthma symptoms. Proportion of days covered was used to determine pharmacy refill adherence.Results: Data from 93 patients with asthma were analyzed. Necessities were positively related to self-reported adherence (P = 0.01. No other

Self reported outcomes and adverse events after medical abortion through online telemedicine: population based study in the Republic of Ireland and Northern Ireland.

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Aiken, Abigail R A; Digol, Irena; Trussell, James; Gomperts, Rebecca

2017-05-16

Objectives  To assess self reported outcomes and adverse events after self sourced medical abortion through online telemedicine. Design  Population based study. Setting  Republic of Ireland and Northern Ireland, where abortion is unavailable through the formal healthcare system except in a few restricted circumstances. Population  1000 women who underwent self sourced medical abortion through Women on Web (WoW), an online telemedicine service, between 1 January 2010 and 31 December 2012. Main outcome measures  Successful medical abortion: the proportion of women who reported ending their pregnancy without surgical intervention. Rates of adverse events: the proportion who reported treatment for adverse events, including receipt of antibiotics and blood transfusion, and deaths reported by family members, friends, or the authorities. Care seeking for symptoms of potential complications: the frequency with which women reported experiencing symptoms of a potentially serious complication and the proportion who reported seeking medical attention as advised. Results  In 2010-12, abortion medications (mifepristone and misoprostol) were sent to 1636 women and follow-up information was obtained for 1158 (71%). Among these, 1023 women confirmed use of the medications, and follow-up information was available for 1000. At the time women requested help from WoW, 781 (78%) were <7 weeks pregnant and 219 (22%) were 7-9 weeks pregnant. Overall, 94.7% (95% confidence interval 93.1% to 96.0%) reported successfully ending their pregnancy without surgical intervention. Seven women (0.7%, 0.3% to 1.5%) reported receiving a blood transfusion, and 26 (2.6%, 1.7% to 3.8%) reported receiving antibiotics (route of administration (IV or oral) could not be determined). No deaths resulting from the intervention were reported by family, friends, the authorities, or the media. Ninety three women (9.3%, 7.6% to 11.3%) reported experiencing any symptom for which they were advised to seek

Impact of brand or generic labeling on medication effectiveness and side effects.

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Faasse, Kate; Martin, Leslie R; Grey, Andrew; Gamble, Greg; Petrie, Keith J

2016-02-01

Branding medication with a known pharmaceutical company name or product name bestows on the drug an added assurance of authenticity and effectiveness compared to a generic preparation. This study examined the impact of brand name and generic labeling on medication effectiveness and side effects. 87 undergraduate students with frequent headaches took part in the study. Using a within-subjects counterbalanced design, each participant took tablets labeled either as brand name "Nurofen" or "Generic Ibuprofen" to treat each of 4 headaches. In reality, half of the tablets were placebos, and half were active ibuprofen (400 mg). Participants recorded their headache pain on a verbal descriptor and visual analogue scale prior to taking the tablets, and again 1 hour afterward. Medication side effects were also reported. Pain reduction following the use of brand name labeled tablets was similar in active ibuprofen or a placebo. However, if the tablets had a generic label, placebo tablets were significantly less effective compared to active ibuprofen. Fewer side effects were attributed to placebo tablets with brand name labeling compared to the same placebo tablets with a generic label. Branding of a tablet appears to have conferred a treatment benefit in the absence of an active ingredient, while generic labeled tablets were substantially less effective if they contained no active ingredient. Branding is also associated with reduced attribution of side effects to placebo tablets. Future interventions to improve perceptions of generics may have utility in improving treatment outcomes from generic drugs. (c) 2016 APA, all rights reserved).

A single-item self-report medication adherence question predicts hospitalisation and death in patients with heart failure.

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Wu, Jia-Rong; DeWalt, Darren A; Baker, David W; Schillinger, Dean; Ruo, Bernice; Bibbins-Domingo, Kristen; Macabasco-O'Connell, Aurelia; Holmes, George M; Broucksou, Kimberly A; Erman, Brian; Hawk, Victoria; Cene, Crystal W; Jones, Christine DeLong; Pignone, Michael

2014-09-01

To determine whether a single-item self-report medication adherence question predicts hospitalisation and death in patients with heart failure. Poor medication adherence is associated with increased morbidity and mortality. Having a simple means of identifying suboptimal medication adherence could help identify at-risk patients for interventions. We performed a prospective cohort study in 592 participants with heart failure within a four-site randomised trial. Self-report medication adherence was assessed at baseline using a single-item question: 'Over the past seven days, how many times did you miss a dose of any of your heart medication?' Participants who reported no missing doses were defined as fully adherent, and those missing more than one dose were considered less than fully adherent. The primary outcome was combined all-cause hospitalisation or death over one year and the secondary endpoint was heart failure hospitalisation. Outcomes were assessed with blinded chart reviews, and heart failure outcomes were determined by a blinded adjudication committee. We used negative binomial regression to examine the relationship between medication adherence and outcomes. Fifty-two percent of participants were 52% male, mean age was 61 years, and 31% were of New York Heart Association class III/IV at enrolment; 72% of participants reported full adherence to their heart medicine at baseline. Participants with full medication adherence had a lower rate of all-cause hospitalisation and death (0·71 events/year) compared with those with any nonadherence (0·86 events/year): adjusted-for-site incidence rate ratio was 0·83, fully adjusted incidence rate ratio 0·68. Incidence rate ratios were similar for heart failure hospitalisations. A single medication adherence question at baseline predicts hospitalisation and death over one year in heart failure patients. Medication adherence is associated with all-cause and heart failure-related hospitalisation and death in heart

Pattern of medication selling and self-medication practices: A study from Punjab, Pakistan.

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Aziz, Muhammad Majid; Masood, Imran; Yousaf, Mahreen; Saleem, Hammad; Ye, Dan; Fang, Yu

2018-01-01

Access to medicines without prescription is a major contributing factor for self-medication practices. This study was designed to examine the ratio of non-prescribed medicines sales and self-medication practices in Punjab, Pakistan. This study also evaluates the reasons for self-medication within its communities. An observational study was conducted in 272 systemically selected pharmacies to analyze medicines-related sales, with or without prescription. A cross-sectional survey was performed between June 2015 and November 2016. Consumers were interviewed about their self-medication practices. Of the pharmacies surveyed, 65.3% participated in the study. A total of 4348 medicines were purchased for self-medication by 3037 consumers (15.2% of all study participants), of which 873 (28.7%) participated in an interview. Majority (81.2%) medicine purchaser, (90.9%) interview participants, and (59.4%) drug users were male. On average, each community pharmacy sold 7.9 medicines without prescription each day, to an average of 5.5 customers. Many participants (28.9%) had matriculation in their formal education. The medicines most often sold for self-medication were analgesics and antipyretics(39.4%). More than 25% of participants reported fever symptoms and 47.8% assumed their illness was too trivial to consult a doctor. Media advertisements were the most common source of information for participants (46.7%). Many types of medicines were often sold without prescription from community pharmacies. Self-medication was common practice for a wide range of illnesses. Pakistan also needs effective implementation of policies to monitor medication sales. Public education about rational medication and limits to advertising medicine are very necessary.

A Dynamic Combinatorial Approach for Identifying Side Groups that Stabilize DNA-Templated Supramolecular Self-Assemblies

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Delphine Paolantoni

2015-02-01

Full Text Available DNA-templated self-assembly is an emerging strategy for generating functional supramolecular systems, which requires the identification of potent multi-point binding ligands. In this line, we recently showed that bis-functionalized guanidinium compounds can interact with ssDNA and generate a supramolecular complex through the recognition of the phosphodiester backbone of DNA. In order to probe the importance of secondary interactions and to identify side groups that stabilize these DNA-templated self-assemblies, we report herein the implementation of a dynamic combinatorial approach. We used an in situ fragment assembly process based on reductive amination and tested various side groups, including amino acids. The results reveal that aromatic and cationic side groups participate in secondary supramolecular interactions that stabilize the complexes formed with ssDNA.

Osteopathic manipulative treatment for self-reported fatigue, stress, and depression in first-year osteopathic medical students.

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Wiegand, Sarah; Bianchi, William; Quinn, Thomas A; Best, Mark; Fotopoulos, Thomas

2015-02-01

During medical education, many students experience psychological distress, including symptoms such as fatigue, stress, and depression. To evaluate the effect of osteopathic manipulative treatment (OMT) on self-perceived fatigue, stress, and depression in first-year osteopathic medical students. This randomized controlled pilot study with repeated measures was conducted at the Lake Erie College of Osteopathic Medicine-Bradenton in Florida during the fall 2012 semester. First-year osteopathic medical students voluntarily enrolled in the study and were randomly assigned to directed OMT (D-OMT), nondirected OMT (ND-OMT), or control groups. The D-OMT and ND-OMT groups received treatment by osteopathic physicians weekly for 4 weeks. The control group received no treatment. All groups completed the Epworth Sleepiness Scale (ESS), the Self-Perceived Stress Scale (SPSS), and the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire 9 (PHQ-9) depression scale before treatment (pretest), after 2 treatments (midtest), and after 4 treatments (posttest). All participants self-reported as white and single, with both sexes equally represented, and had an mean age of 24 years. Analysis of ESS scores revealed a statistically significant decrease in the D-OMT group from pretest and posttest scores and a statistically significant increase in the ND-OMT group from pretest to midtest but not from pretest to posttest scores. No statistically significant differences were noted in the control group scores on this measure. No statistically significant differences were seen in the SPSS or PHQ-9 scores from pretest to midtest or pretest to posttest in any of the 3 groups. The D-OMT regimen used in the current study produced a statistically significant decrease in self-perceived fatigue in first-year osteopathic medical students. Osteopathic manipulative treatment represents a potential modality to reduce self-perceived distress in medical students. Further research is

Knowledge and Practice of Self-medication among Undergraduate Medical Students

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Anishma Karmacharya

2018-05-01

Full Text Available Introduction: Self-medication is an important aspect of self-care. It is a common practice in society and medical students are no exception. The aim of this study was to explore the knowledge and practice of self-medication among students of a medical school in Western Nepal. Methods: A cross sectional study was conducted among basic science and clinical students after obtaining prior consent from those willing to participate. Respondents’ degree of agreement with a set of 25 statements was noted using Likert scale to assess their knowledge. The practice of self-medication was studied by asking about the use of selected groups of medicines during the past one-year period and noting the pattern of use. Results: Three hundred and thirty of the 356 students (92.6% participated in the study. Mean knowledge score was 93.2 (SD = 8.1. Self-medication was practiced by 83.3% (n = 275 of respondents. Knowledge about self-medication differed among respondents according to gender (p = 0.03 and nationality (p = 0.04 but not other variables. Practice of self-medication was associated with father’s profession (p = 0.03 and nationality of the respondents (p = 0.04. Conclusions: Students’ knowledge about self-medication was good and they commonly practiced self-medication. Pain-killers were the most commonly used drug.

Swallowing difficulties with medication intake assessed with a novel self-report questionnaire in patients with systemic sclerosis – a cross-sectional population study

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Messerli M

2017-09-01

Full Text Available Markus Messerli,1,2 Rebecca Aschwanden,1 Michael Buslau,2 Kurt E Hersberger,1 Isabelle Arnet1 1Pharmaceutical Care Research Group, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland; 2European Centre for the Rehabilitation of Scleroderma, Reha Rheinfelden, Rheinfelden, Switzerland Objectives: To assess subjective swallowing difficulties (SD with medication intake and their practical consequences in patients suffering from systemic sclerosis (SSc with a novel self-report questionnaire.Design and setting: Based on a systematic literature review, we developed a self-report questionnaire and got it approved by an expert panel. Subsequently, we sent the questionnaire by post mail to SSc patients of the European Center for the Rehabilitation of Scleroderma Rheinfelden, Switzerland.Participants: Patients were eligible if they were diagnosed with SSc, treated at the center, and were of age ≥18 years at the study start.Main outcome measures: Prevalence and pattern of SD with oral medication intake, including localization and intensity of complaints.Results: The questionnaire consisted of 30 items divided into five sections Complaints, Intensity, Localization, Coping strategies, and Adherence. Of the 64 SSc patients eligible in 2014, 43 (67% returned the questionnaire. Twenty patients reported SD with medication intake (prevalence 47%, either currently (11; 26% or in the past that had been overcome (9; 21%. Self-reported SD were localized mostly in the larynx (43% and esophagus (34%. They were of moderate (45% or strong to unbearable intensity (25%. Modification of the dosage form was reported in 40% of cases with SD. Adherence was poor for 20 (47% patients and was not associated with SD (p=0.148.Conclusion: Our novel self-report questionnaire is able to assess the pattern of complaints linked to medication intake, that is, localization and intensity. It may serve as a guide for health care professionals in selecting the most

Self-regulated learning and academic performance in medical education.

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Lucieer, Susanna M; Jonker, Laura; Visscher, Chris; Rikers, Remy M J P; Themmen, Axel P N

2016-06-01

Medical schools aim to graduate medical doctors who are able to self-regulate their learning. It is therefore important to investigate whether medical students' self-regulated learning skills change during medical school. In addition, since these skills are expected to be helpful to learn more effectively, it is of interest to investigate whether these skills are related to academic performance. In a cross-sectional design, the Self-Regulation of Learning Self-Report Scale (SRL-SRS) was used to investigate the change in students' self-regulated learning skills. First and third-year students (N = 949, 81.7%) SRL-SRS scores were compared with ANOVA. The relation with academic performance was investigated with multinomial regression analysis. Only one of the six skills, reflection, significantly, but positively, changed during medical school. In addition, a small, but positive relation of monitoring, reflection, and effort with first-year GPA was found, while only effort was related to third-year GPA. The change in self-regulated learning skills is minor as only the level of reflection differs between the first and third year. In addition, the relation between self-regulated learning skills and academic performance is limited. Medical schools are therefore encouraged to re-examine the curriculum and methods they use to enhance their students' self-regulated learning skills. Future research is required to understand the limited impact on performance.

Are patients reliable when self-reporting medication use? Validation of structured drug interviews and home visits by drug analysis and prescription data in acutely hospitalized patients

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Glintborg, Bente; Hillestrøm, Peter René; Olsen, Lenette Holm

2007-01-01

were compared to the patients' self-reported medication history. Information on prescribed drugs dispensed from any Danish pharmacy was collected from nationwide real-time pharmacy records. The authors performed home visits in a subgroup of 115 patients 4 weeks after their discharge. Stored drugs were......The medication history among hospitalized patients often relies on patients' self-reports due to insufficient communication between health care professionals. The aim of the present study was to estimate the reliability of patients' self-reported medication use. Five hundred patients admitted...... to an acute medical department at a Danish university hospital were interviewed on the day of admission about their recent medication use. Blood samples drawn immediately after admission were screened for contents of 5 drugs (digoxin, bendroflumethiazide, amlodipine, simvastatin, glimepiride), and the results...

Relationship of work-family conflict, self-reported social support and job satisfaction to burnout syndrome among medical workers in southwest China: A cross-sectional study.

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Yang, Shujuan; Liu, Danping; Liu, Hongbo; Zhang, Juying; Duan, Zhanqi

2017-01-01

Burnout is a psychosomatic syndrome widely observed in Chinese medical workers due to the increasing cost of medical treatment, excessive workload, and excessive prescribing behavior. No studies have evaluated the interrelationship among occupational burnout, work-family conflict, social support, and job satisfaction in medical workers. The aim of this study was to evaluate these relationships among medical workers in southwest China. This cross-sectional study was conducted between March 2013 and December 2013, and was based on the fifth National Health Service Survey (NHSS). A total of 1382 medical workers were enrolled in the study. Pearson correlation analysis and general linear model univariate analysis were used to evaluate the relationship of work-family conflict, self-reported social support, and job satisfaction with burnout syndrome in medical workers. We observed that five dimensions of job satisfaction and self-reported social support were negatively associated with burnout syndrome, whereas three dimensions of work-family conflict showed a positive correlation. In a four-stage general linear model analysis, we found that demographic factors accounted for 5.4% of individual variance in burnout syndrome (F = 4.720, Pfamily conflict, self-reported social support, and job satisfaction accounted for 2.6% (F = 5.93, Pfamily conflict and self-reported social support slightly affect the level of burnout syndrome, and that job satisfaction is a much stronger influence on burnout syndrome in medical workers of southwest China.

The value of self-medication: summary of existing evidence.

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Noone, Joshua; Blanchette, Christopher M

2018-02-01

The aim of this review was to identify the international evidence that is currently available on the economic value of self-care through responsible self-medication, in terms of the measures related to access to treatment, time, and productivity. A targeted literature search was conducted for 1990-2016, including data gathered from members of the World Self-Medication Industry and searches on PubMed, EBSCOHost, and Google Scholar. Specific searches of individual drug classes known to be switched to non-prescription status in this period were also conducted. A total of 71 articles were identified, of which 17 (11 modeling studies, six retrospective analyses) were included in the review. Evidence from modeling studies and retrospective analyses of grouped data across a range of common conditions for which non-prescription medications are available in different countries/regions showed that the use of non-prescription products for the treatment of common conditions or for symptom management (e.g. allergies, chronic pain, migraine, vaginitis, gastrointestinal symptoms, or common cold symptoms) had considerable value to patients, payers, and employers alike in terms of cost savings and improved productivity. Potential benefits of self-medication were also identified in preventative healthcare strategies, such as those for cardiovascular health and osteoporosis. This review was limited by a targeted, but non-systematic approach to literature retrieval, as well as the inclusion of unpublished reports/white papers and patient self-reported data. The evidence identified in this literature review shows that responsible, appropriate self-medication with non-prescription products can provide significant economic benefits for patients, employers, and healthcare systems worldwide.

Residents' Ratings of Their Clinical Supervision and Their Self-Reported Medical Errors: Analysis of Data From 2009.

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Baldwin, DeWitt C; Daugherty, Steven R; Ryan, Patrick M; Yaghmour, Nicholas A; Philibert, Ingrid

2018-04-01

Medical errors and patient safety are major concerns for the medical and medical education communities. Improving clinical supervision for residents is important in avoiding errors, yet little is known about how residents perceive the adequacy of their supervision and how this relates to medical errors and other education outcomes, such as learning and satisfaction. We analyzed data from a 2009 survey of residents in 4 large specialties regarding the adequacy and quality of supervision they receive as well as associations with self-reported data on medical errors and residents' perceptions of their learning environment. Residents' reports of working without adequate supervision were lower than data from a 1999 survey for all 4 specialties, and residents were least likely to rate "lack of supervision" as a problem. While few residents reported that they received inadequate supervision, problems with supervision were negatively correlated with sufficient time for clinical activities, overall ratings of the residency experience, and attending physicians as a source of learning. Problems with supervision were positively correlated with resident reports that they had made a significant medical error, had been belittled or humiliated, or had observed others falsifying medical records. Although working without supervision was not a pervasive problem in 2009, when it happened, it appeared to have negative consequences. The association between inadequate supervision and medical errors is of particular concern.

Barriers to medical error reporting

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Jalal Poorolajal

2015-01-01

Full Text Available Background: This study was conducted to explore the prevalence of medical error underreporting and associated barriers. Methods: This cross-sectional study was performed from September to December 2012. Five hospitals, affiliated with Hamadan University of Medical Sciences, in Hamedan,Iran were investigated. A self-administered questionnaire was used for data collection. Participants consisted of physicians, nurses, midwives, residents, interns, and staffs of radiology and laboratory departments. Results: Overall, 50.26% of subjects had committed but not reported medical errors. The main reasons mentioned for underreporting were lack of effective medical error reporting system (60.0%, lack of proper reporting form (51.8%, lack of peer supporting a person who has committed an error (56.0%, and lack of personal attention to the importance of medical errors (62.9%. The rate of committing medical errors was higher in men (71.4%, age of 50-40 years (67.6%, less-experienced personnel (58.7%, educational level of MSc (87.5%, and staff of radiology department (88.9%. Conclusions: This study outlined the main barriers to reporting medical errors and associated factors that may be helpful for healthcare organizations in improving medical error reporting as an essential component for patient safety enhancement.

Self-medication of mood and anxiety disorders with marijuana: Higher in states with medical marijuana laws.

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Sarvet, Aaron L; Wall, Melanie M; Keyes, Katherine M; Olfson, Mark; Cerdá, Magdalena; Hasin, Deborah S

2018-05-01

Self-medication with drugs or alcohol is commonly reported among adults with mood or anxiety disorders, and increases the risk of developing substance use disorders. Medical marijuana laws (MML) may be associated with greater acceptance of the therapeutic value of marijuana, leading individuals to self-medicate. The study utilized data from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (2004-2005). Participants were sampled from households in the general population and included adults with a mood or anxiety disorder in the past 12 months (n = 7418), and the subset of those who used marijuana and no other drug (n = 314). Weighted logistic regression models predicted the prevalence of self-medication with drugs in U.S. states with and without MML, adjusting for individual and state-level covariates. As a negative control, analyses were repeated for self-medication with alcohol. Overall, self-medication with drugs was 3.73 percentage points higher (95% confidence interval [CI]: 0.93-6.53) among those living in MML states (p = 0.01). For the subpopulation that only used marijuana, self-medication with drugs was 21.22 percentage points higher (95% CI: 3.91-38.53) among those living in MML states (p = 0.02). In contrast, self-medication with alcohol had nearly identical prevalence in MML and non-MML states, overall and for drinkers. Among adults with mood or anxiety disorders, living in a medical marijuana law state is associated with self-medication with marijuana. While additional research is needed to determine the reasons for this association, clinical screening for self-medication with marijuana may be particularly important in states with medical marijuana laws. Copyright © 2018 Elsevier B.V. All rights reserved.

Perceptions of health status, medication side effects and depression after successful renal transplantation

International Nuclear Information System (INIS)

Kamran, F.; Masood, A.

2017-01-01

Objective: To investigate the perceptions of health status and depression among Renal Transplant Recipients (RTRs). Stydy Design: A longitudinal research design was used. Methods: Recipients’ perceived health status (PHS) was measured by a self-developed questionnaire that reflected the symptom severity and frequency of common immunosuppressant side effects. Depression levels were assessed using Beck Depression Inventory B.D.I II) .The sample population comprised of RTRs with a successful and healthy renal transplant recruited from private and government sector renal units in Lahore, Pakistan. Results: Recipients with poorer perceptions of health status tend to be more depressed as indicated by significant negative correlations between PHS and depression. However, further regression analysis found both constructs as significant predictors of each other, raising a question of causal direction. A cross lagged correlation analysis indicated that PHS appears to be a stronger predictor of depression comparatively. Most recipients tend to have positive perceptions of their health status (M = 30.84, S.D = 3.64) with minimum to moderate level of depression (M = 9.50, S.D = 4.00), It is found that a positive perception of health status is associated with lowered depression. Conclusion: Most recipients’ with a healthy kidney transplant tend to report a positive perception of their health status despite adverse medication side effects. However, the perceived health status is significantly associated with consequent feeling of depression. The study confirms the efficacy and positive health outcomes of renal transplantation in Pakistan. (author)

Concordance of Adherence Measurement Using Self-Reported Adherence Questionnaires and Medication Monitoring Devices: An Updated Review.

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Monnette, Alisha; Zhang, Yichen; Shao, Hui; Shi, Lizheng

2018-01-01

As medication adherence continues to be a prevalent issue in today's society, the methods used to monitor medication-taking behaviors are constantly being re-evaluated and compared in search of the 'gold standard' measure. Our review aimed to assess the current literature surrounding the correlation between self-reported questionnaires (SRQs) and electronic monitoring devices to determine if these measures produce similar results. We performed a literature search from 2009 to 2017 using PubMed, PubMed In-Process and Non-Indexed, EMBASE, Ovid MEDLINE, and Ovid MEDLINE In-Process. A keyword search using the terms 'patient compliance', 'treatment compliance', 'medication adherence', 'drug monitoring', 'drug therapy', 'electronic', 'digital', 'computer', 'monitor', 'monitoring', 'drug', 'pharmaceutical preparations', 'compliance', and 'medications' was done to capture all articles. We included articles measuring adherence using both monitoring devices and SRQs. Thirty-five articles were included in this review. The average difference in measured adherence rates between the two measures was 9.2% (range -66.3 to 61.5). A majority (62.7%) of articles reported moderate (n = 12; 27.9%), high (n = 5, 11.6%), or significant (n = 10, 23.3%) correlations between SRQs and monitoring devices. Results from our review are consistent with previous studies, as we found that many of our studies produced moderate to high correlation between both SRQs and monitoring devices [Farmer, Clin Ther 21(6):1074-90 (1999), IMS Institute for Healthcare Informatics. Avoidable costs in US health care (2012), Patel et al., Respirology 18(3):546-52 (2013), Siracusa et al., J Cyst Fibros 14(5):621-6 (2015), Smith et al., Int J Cardiol 145(1):122-3 (2010)]. Our findings demonstrate that self-reported adherence produces comparable results to electronic monitoring devices. As there is not yet a 'gold standard' measure for monitoring patient adherence, SRQs and Medication Event Monitoring Systems

Prevalence & Practice of Self-Medication in Ernakulum District, southern India

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Nimitha Paul

2017-09-01

Full Text Available Introduction Self-medication can lead to many problems and has many concerns associated with it including development of drug resistance. The objectives of the current study were to assess the prevalence of self-medication practices among people residing in selected urban and rural areas of Ernakulam district, to assess the pattern of use of self-medications and to determine the differences, if any, between the rural, urban and slum population in the prevalence and pattern of use of self-medications Methods A community based cross-sectional study was conducted and 539 individuals from urban, rural and urban slums of Ernakulam district, Kerala were interviewed using a structured questionnaire. Data was tabulated in MS Excel and analysed using IBM Statistical Package for Social Science (SPSS version 15. Descriptive statistics such as frequency and percentage was used to summarize the data. Univariate and multivariate analysis was done to assess the factors associated with self-medication Results In the study, 21.5% (114/539 reported that they practised self-medication within last three months. Major indications for self-medication were aches and pain (28.9%, fever (22.8% and chronic diseases (13.7%. Among those who practised self-medication, 6.1% (7/114 used antibiotics. In the final logistic regression model, being in urban area [urban areas (OR 5.8, 95% CI 3.2-10.4, urban slums (OR 2.9, 95% CI 1.5-5.4] and increasing age groups [18-59 years (OR 2.1 95% CI 1.1-3.8 and more than 60 years (OR 3.2 95% CI 1.6-6.5] were associated with self-medication practices. Conclusion Holistic approach should be taken to prevent the problem of self-medications, which includes proper awareness and education to public, improving access to care and regulation of pharmacies regarding sale of drugs.

[Treatment of postherpetic neuralgia on the right side of nose: a case report].

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Tang, Jiyuan; Tang, Qiao

2015-11-01

Postherpetic neuralgia (PHN) is a difficult medical issue and symptomatic treatment with medication is common. One case of PHN was cured by nerve avulsion and microtherm plasma nerve block. The male patient was 48-year-old with PHN on the right side of the nose, suffering recurrent pains within one year. The symptoms occurred irregularly and lasted for several minutes to hours every time. Electroacupuncture and Chinese medicine treatments in other hospitals made little efficacy. Physical examination showed skin of right side of the nose and nasal mucosa was normal and all laboratory reports confirmed negative. After microtherm plasma treatment in nasal cavity and corresponding area of nasal septum, the pain disappeared.

Perception of self-medication among university students in Saudi Arabia

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Mustafa S Saeed

2014-01-01

Full Text Available The aim of this study is to assess self-medication practice among university students in the Al-Qassim Province of Saudi Arabia. A cross-sectional community-based survey was conducted by distributing a self-administered 18-item questionnaire among university students in the Al-Qassim Province of Saudi Arabia in the period between October and December 2012. The participants were selected using a convenience sampling technique. Data were collected from the questionnaire and analyzed using SPSS version 19. A total of 354 male students with an average age of 21.95 (SD ± 3.43 participated in this study. Our study showed that self-medication among male students was high (86.6% compared to results shown in other studies in the same region. Headache (59.9%, cough/cold (41% and fever (24.6% were the most common symptoms associated with self-medication. Congruent with the medical conditions reported, the most widely used medications without prescriptions were paracetamol (34.7%, followed by antibiotics (31.4% and nonsteroidal anti-inflammatory drugs (28.7%. Our study shows that antibiotics were sometimes irrationally used for self-treatment of cough and fever. Self-medication was highly frequent among the students. Influence of TV advertisements, high accessibility of pharmacies and convenience stores, as well as good buying power were found to be leading factors for self-medication among male university students.

Self-medication behaviors among Japanese consumers: sex, age, and SES differences and caregivers’ attitudes toward their children’s health management

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Aoyama Ikuko

2012-09-01

Full Text Available Abstract Background Since 2009, when the revised Pharmaceutical Affairs Act was enacted in Japan, self-medication practices have increased. Because the concept of self-medication was recently introduced in Japan, few studies exist on this topic. Therefore, it is necessary to explore how self-medication is practiced. This study examined Japanese consumers’ self-medication practices and attitudes toward over-the-counter (OTC medicines based on their sex, age, and socioeconomic status (SES. Methods The participants were 403 adults (Mage = 41.1 years, SD = 16.22. A quota sampling method was employed based on age group, and participants completed an online questionnaire. Results Participants in the 20–29 age group reported medical costs as an obstacle in seeing a doctor; in contrast, transportation was a mitigating factor for elderly people. Regarding SES, people at lower SES levels chose to rest instead of seeing a doctor or purchasing over-the-counter (OTC medicines when sick. They also placed more value on national brand OTC medicines than private brands (likely due to advertisements. This finding suggests individuals with a low SES do not select OTC medicines based on their effects or ingredients. Regarding attitudes toward OTC medicines, Japanese participants seemed to be unaware of the potential for abuse and side effects associated with OTC medicines. Finally, in relation to caregivers’ self-medication practices for their children, the majority of participants reported taking their children to the hospital since children tend to receive free medical care. Furthermore, caregivers with a high educational background are more confident in being able to help manage their children’s health. Conclusions Our results suggest that health and medical discrepancies among Japanese consumers pose new social problems. In Japan, universal health care is available, but the cost of receiving medical care is not completely free of charge. Thus

Psychosomatic symptoms in medical outpatients: an investigation of self-handicapping theory.

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Organista, P B; Miranda, J

1991-01-01

Investigated self-handicapping theory as it relates to somatization in medical patients. We predicted that medical outpatients (N = 113) would report psychosomatic symptoms in response to events that threaten their self-esteem. As predicted, results of hierarchical multiple regression indicated that high-perfectionism patients reported somatic symptoms positively related to the number of events that jeopardize their sense of accomplishment, whereas low-perfectionism patients' somatic symptoms were not related to these events (p = .005). Contrary to prediction, high-dependency patients did not differ significantly from low-dependency patients in the relationship of somatic symptoms and events that threatened their interpersonal relationships (p = .115). Implications of these findings and the utility of self-handicapping theory for predicting somatization in medical patients are discussed.

The accuracy of self-reported medical history: a preliminary analysis of the promise of internet-based research in Inflammatory Bowel Diseases.

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Kelstrup, Anne Mette; Juillerat, Pascal; Korzenik, Joshua

2014-05-01

Internet-based surveys provide a potentially important tool for Inflammatory Bowel Disease (IBD) research. The advantages include low cost, large numbers of participants, rapid study completion and less extensive infrastructure than traditional methods. The aim was to determine the accuracy of patient self-reporting in internet-based IBD research and identify predictors of greater reliability. 197 patients from a tertiary care center answered an online survey concerning personal medical history and an evaluation of disease specific knowledge. Self-reported medical details were compared with data abstracted from medical records. Agreement was assessed by kappa (κ) statistics. Participants responded correctly with excellent agreement (κ=0.96-0.97) on subtype of IBD and history of surgery. The agreement was also excellent for colectomy (κ=0.88) and small bowel resection (κ=0.91), moderate for abscesses and fistulas (κ=0.60 and 0.63), but poor regarding partial colectomy (κ=0.39). Time since last colonoscopy was self-reported with better agreement (κ=0.84) than disease activity. For disease location/extent, moderate agreements at κ=69% and 64% were observed for patients with Crohn's disease and ulcerative colitis, respectively. Subjects who scored higher than the average in the IBD knowledge assessment were significantly more accurate about disease location than their complementary group (74% vs. 59%, p=0.02). This study demonstrates that IBD patients accurately report their medical history regarding type of disease and surgical procedures. More detailed medical information is less reliably reported. Disease knowledge assessment may help in identifying the most accurate individuals and could therefore serve as validity criteria. Internet-based surveys are feasible with high reliability about basic disease features only. However, the participants in this study were engaged at a tertiary center, which potentially leads to a bias and compromises generalization to

Self-medication practice among undergraduate medical students of ...

African Journals Online (AJOL)

1Department of Family and Community Medicine, Faculty of Medicine, 2Faculty of Medicine, Jazan University, Jazan, Kingdom ... Results: Self-medication practice was highly prevalent among the medical students, with 87 % ... as part of self-care to improve the health care ..... No conflict of interest associated with this work.

Perceptions and practices of self-medication among medical students in coastal South India.

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Nithin Kumar

Full Text Available Self-medication is a common practice worldwide and the irrational use of drugs is a cause of concern. This study assessed the prevalence of self-medication among the medical students in South India. The data was analysed using SPSS version 11.5. A total of 440 students were included in the study. The prevalence of self-medication was 78.6%. A larger number of females were self-medicating (81.2% than males (75.3%. The majority of the students self-medicated because of the illness being too trivial for consultation (70.5%. Antipyretics were most commonly self-medicated by the participants (74.8%. Only 47% of the participants opined that self-medication was a part of self-care and it needs to be encouraged. 39.3% of the participants perceived that the supply of medicine without prescription by the pharmacist can prevent the growing trend of self-medication. Easy availability and accessibility to health care facilities remains the cornerstone for reducing the practice of self-medication.

Non-Medical Prescription Stimulant Use in Graduate Students: Relationship With Academic Self-Efficacy and Psychological Variables.

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Verdi, Genevieve; Weyandt, Lisa L; Zavras, Brynheld Martinez

2016-09-01

The objective of this study was to examine graduate students' non-medical use of prescription stimulant medication, and the relationship between non-medical use of prescription stimulants with academic self-efficacy, psychological factors (i.e., anxiety, depression, and stress), and internal restlessness. The sample consisted of 807 graduate students from universities located in five geographic regions of the United States. Past-year rates of self-reported non-medical use were determined to be 5.9%, with overall lifetime prevalence of 17.5%. Observed self-reported non-medical use of prescription stimulant medications was significantly correlated with self-reported levels of anxiety and stress, various aspects of internal restlessness, and perceived safety of the medications. Findings support graduate students' motivations of non-medical prescription stimulant use to be both academic and social in nature. Effective prevention and education efforts are needed to help address the non-medical use of prescription stimulants by graduate students on university campuses. © The Author(s) 2014.

Dental patients' self-reports of xerostomia and associated risk factors.

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Villa, Alessandro; Polimeni, Antonella; Strohmenger, Laura; Cicciù, Domenico; Gherlone, Enrico; Abati, Silvio

2011-07-01

Most studies regarding xerostomia focus on elderly people. Therefore, the authors conducted a study of dental patients 18 years or older to determine the prevalence of self-reported xerostomia and associated risk factors. The authors sent a total of 2,200 questionnaires to four dental clinics to assess patients' self-reported xerostomia. They also collected sociodemographic data and information regarding personal behavior. They used logistic regression models to estimate odds ratios (OR) and 95 percent confidence intervals (CI) to explore the relationship between self-reported xerostomia and risk factors that reasonably might be expected to be associated with self-reported xerostomia. The overall prevalence of xerostomia in participants was 7 percent. Participants with burning-mouth sensations were associated with having higher odds of experiencing dry mouth (OR, 2.1; 95 percent CI, 0.9-5.2). Participants 51 years or older were significantly more likely to report having dry mouth than were younger participants (P xerostomia increased with increasing numbers of medications patients reported using. The authors found that medication use and age were highly significant risk factors for dental patients reporting xerostomia. Clinicians should interview their patients carefully regarding their use of medications and provide proper oral health care to improve xerostomia resulting from medication use.

Self-care and adherence to medication: a survey in the hypertension outpatient clinic

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Lip Gregory YH

2008-02-01

Full Text Available Abstract Background Self-care practices for patients with hypertension include adherence to medication, use of blood pressure self-monitoring and use of complementary and alternative therapies (CAM The prevalence of CAM use and blood pressure self-monitoring have not been described in a UK secondary care population of patients with hypertension and their impact on adherence to medication has not been described. Adherence to medication is important for blood pressure control, but poor adherence is common. The study aimed to determine the prevalence of self-care behaviours in patients attending a secondary care hypertension clinic. Methods Cross-sectional questionnaire survey. 196 patients attending a secondary care hypertension clinic in a teaching hospital serving a multiethnic population, Birmingham, UK. Main outcome measures: Prevalence of use of CAM, home monitors, adherence to anti-hypertensive medication. Results CAM use in previous 12 months was reported by 66 (43.1% respondents. CAM users did not differ statistically from non-CAM users by age, gender, marital status or education. Vitamins, prayer a dietary supplements were the most commonly used CAM. Nine (12.7% women reported using herbal CAM compared to one man (1.2%, (p = 0.006. Ten (6.7% respondents reported ever being asked by a doctor about CAM use. Perfect adherence to anti-hypertensive medication was reported by 26 (44.8% CAM-users and 46 (60.5% non-CAM users (p = 0.07. Being female and a CAM user was significantly associated with imperfect adherence to anti-hypertensive medication. Older and white British respondents were significantly more likely to report perfect adherence. Blood pressure monitors were used by 67 (43.8% respondents, which was not associated with gender, CAM use or adherence to medication. Conclusion Hypertensive patients use a variety of self-care methods, including CAM, home blood pressure monitors, and adherence to prescribed medication. This study found the

Prevalence and Side Effects of Energy Drink Consumption among Medical Students at Umm Al-Qura University, Saudi Arabia

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Naif A. Bawazeer

2013-12-01

Full Text Available Background: Energy drinks are freely available at markets and shops on the university campus without regulation or proper education regarding its side effects. The caffeine amount within energy drinks is high and could become an addictive substance or cause intoxication. Therefore, this study aims to assess the prevalence of energy drink consumption and its reported side effects among medical students. Methods:A total number of 257 medical students from Umm Al-Qura University completed a questionnaire about energy drinks that was administrated electronically from September through November, 2012. Results:Out of the 257 participants, 27.2% (n=70 reported consuming at least one energy drink per month, with 61.5% (n=48 being males. Males consume significantly more energy drinks than females (p=0.0001. The students consumed energy drinks to get energy in general (32.8% and while studying for exams or finishing a project (31.4%. Other reasons given include, lack of sleep (12.8%, just to be like friends (11.4%, or driving (8.5%. Heart palpitations are the most common side effect in our sample (20%, followed by insomnia (10%, headache and tremors (5.7%, nausea and vomiting (4.2% and nervousness (2.8%. Conclusion: Energy drinks consumption is common practice among medical students and the main reason cited for consumption is the need for energy during general activities. Approximately one-third of the consumers manifested some side effect after consumption. We recommend the need to create public awareness about energy drinks. Further studies are recommended to assess the educational level of students consuming energy drinks, about the dangerous side effects.

Emergency Medical Services Perspectives on Identifying and Reporting Victims of Elder Abuse, Neglect, and Self-Neglect.

Science.gov (United States)

Rosen, Tony; Lien, Cynthia; Stern, Michael E; Bloemen, Elizabeth M; Mysliwiec, Regina; McCarthy, Thomas J; Clark, Sunday; Mulcare, Mary R; Ribaudo, Daniel S; Lachs, Mark S; Pillemer, Karl; Flomenbaum, Neal E

2017-10-01

Emergency Medical Services (EMS) providers, who perform initial assessments of ill and injured patients, often in a patient's home, are uniquely positioned to identify potential victims of elder abuse, neglect, or self-neglect. Despite this, few organized programs exist to ensure that EMS concerns are communicated to or further investigated by other health care providers, social workers, or the authorities. To explore attitudes and self-reported practices of EMS providers surrounding identification and reporting of elder mistreatment. Five semi-structured focus groups with 27 EMS providers. Participants reported believing they frequently encountered and were able to identify potential elder mistreatment victims. Many reported infrequently discussing their concerns with other health care providers or social workers and not reporting them to the authorities due to barriers: 1) lack of EMS protocols or training specific to vulnerable elders; 2) challenges in communication with emergency department providers, including social workers, who are often unavailable or not receptive; 3) time limitations; and 4) lack of follow-up when EMS providers do report concerns. Many participants reported interest in adopting protocols to assist in elder protection. Additional strategies included photographically documenting the home environment, additional training, improved direct communication with social workers, a dedicated location on existing forms or new form to document concerns, a reporting hotline, a system to provide feedback to EMS, and community paramedicine. EMS providers frequently identify potential victims of elder abuse, neglect, and self-neglect, but significant barriers to reporting exist. Strategies to empower EMS providers and improve reporting were identified. Copyright © 2017 Elsevier Inc. All rights reserved.

Self-medication practice in Ethiopia: a systematic review

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Ayalew MB

2017-03-01

Full Text Available Mohammed Biset Ayalew Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia Background: Self-medication patterns vary among different populations, and are influenced by many factors. No review has been done that comprehensively expresses self-medication practice in Ethiopia. The aim of this study was to provide an overview of the literature on self-medication practice in Ethiopia.Materials and methods: Databases (PubMed, Google Scholar, ResearchGate, and Hinari were searched for published studies on the practice of self-medication in Ethiopia without restriction in the year of publication or methodology. Some studies were also identified through manual Google search. Primary search terms were “self medication”, “Ethiopia”, “self care”, “non-prescription”, “OTC drug use”, “drug utilization”, and “drug hoarding”. Studies that measured knowledge only or attitude only or beliefs only and did not determine the practice of self-medication were excluded.Results: The database search produced a total of 450 papers. After adjustment for duplicates and inclusion and exclusion criteria, 21 articles were found suitable for the review. All studies were cross-sectional in nature. The prevalence of self-medication varied from 12.8% to 77.1%, with an average of 36.8%. Fever/headache, gastrointestinal tract diseases, and respiratory diseases were the commonest illnesses/symptoms for which self-medication was taken. The major reasons for practicing self-medication were previous experience of treating a similar illness and feeling that the illness was mild. Analgesics/antipyretics, antimicrobials, gastrointestinal drugs, and respiratory drugs were the common drug classes used in self-medication. Mainly, these drugs were obtained from drug-retail outlets. The use of self-medication was commonly suggested by pharmacy professionals and friends

Association of Maternal Self-Medication and Over-the-Counter Analgesics for Children

DEFF Research Database (Denmark)

Jensen, Janne Fangel; Gottschau, Mathilde; Siersma, Volkert Dirk

2014-01-01

Self-medication with over-the-counter (OTC) analgesics, such as paracetamol (PCM), among children and adolescents is increasing and constitutes an important public health issue internationally. Reasons for this development are unclear; parental influence is suggested. Our objective was to examine...... whether self-medication with OTC analgesics among school-aged children is influenced by maternal self-reported health and medicine use, taking the child's frequency of pain into account....

Prevalence of Self-prescribing Propranolol Among Medical and Dental Students in Riyadh, Saudi Arabia: A Cross-sectional Study

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Omar A. Al-Mohrej

2018-03-01

Conclusions: The overall results showed a slightly high rate of propanol misuse among medical and dental students. The majority of users are aware of the risks and potential side effects of self-prescribing medications, however; the anxiety relieving effect of propranolol increased its use prior to oral exams and presentations. Educational activity targeting students must be implemented.

Multidimensional Inventory of Hypochondriacal Traits: An Examination of a Bifactor Model and Measurement Invariance Between Those With and Without a Self-Reported Medical Condition.

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Bardeen, Joseph R; Fergus, Thomas A

2017-08-01

The Multidimensional Inventory of Hypochondriacal Traits (MIHT) is a self-report measure that assesses four interrelated domains of health anxiety (i.e., Cognitive, Behavioral, Perceptual, Affective). Prior research has supported a correlated four-factor model, as well as a hierarchical model, in which each of the four factors load onto the higher order health anxiety construct. However, a bifactor modeling approach has yet to be used to examine the factor structure of the MIHT. Results supported a bifactor model of the MIHT in three different samples (i.e., unselected based on current medical status [ n = 824], and those with [ n = 348] and without [ n = 354] a self-reported medical condition). The MIHT appears to be strongly multidimensional, with three of the four subscales providing substantive value. Confirmatory factor analysis supported the configural and metric/scalar invariance of the bifactor model between those with and without a self-reported medical condition. Results provide support for a bifactor conceptualization of the MIHT and the invariance of that model across levels of current health status.

[Self-medication with antibiotics in Poland

NARCIS (Netherlands)

Olczak, A.; Grzesiowski, P.; Hryniewicz, W.; Haaijer-Ruskamp, F.M.

2006-01-01

Antibiotic resistance, the important public health threat, depends on antibiotic overuse/misuse. Self-medication with antibiotics is of serious medical concern. The aim of the study, as a part of SAR project (Self-medication with antibiotic in Europe) was to survey the incidence of this phenomenon.

Patient-provider communication and hormonal therapy side effects in breast cancer survivors.

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Lin, Jenny J; Chao, Jennifer; Bickell, Nina A; Wisnivesky, Juan P

2017-09-01

Side effects from hormonal therapy (HT) for breast cancer treatment occur frequently and are associated with worse quality of life and HT non-adherence. Whether improved patient-physician communication is associated with patients' reporting of side effects is unknown. We undertook this study to assess factors associated with women's reports of HT side effects. Between December 2012 and April 2013, we conducted a cross-sectional survey of breast cancer patients undergoing HT in an urban medical center. Descriptive statistics, univariate analyses, and multivariate analyses were used to evaluate associations. Of the 100 participants, 67% reported having HT side effects. However, when prompted, an additional 9% reported experiencing specific HT-related symptoms. Despite very high communication scores, one-third of participants reported they had not discussed side effects with providers. Multivariate analysis showed that after controlling for age, education, race, and medication beliefs, women who had difficulty asking providers for more information were more likely to report side effects (odds ratio 8.27, 95% confidence interval 1.01-69.88). Although HT side effects often occur and are bothersome, patient-provider discussions about side effects remain suboptimal. Providers should actively ask patients about medication side effects so that they can be addressed to improve quality of life and potentially, medication adherence.

Relationship of work-family conflict, self-reported social support and job satisfaction to burnout syndrome among medical workers in southwest China: A cross-sectional study.

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Shujuan Yang

Full Text Available Burnout is a psychosomatic syndrome widely observed in Chinese medical workers due to the increasing cost of medical treatment, excessive workload, and excessive prescribing behavior. No studies have evaluated the interrelationship among occupational burnout, work-family conflict, social support, and job satisfaction in medical workers. The aim of this study was to evaluate these relationships among medical workers in southwest China.This cross-sectional study was conducted between March 2013 and December 2013, and was based on the fifth National Health Service Survey (NHSS. A total of 1382 medical workers were enrolled in the study. Pearson correlation analysis and general linear model univariate analysis were used to evaluate the relationship of work-family conflict, self-reported social support, and job satisfaction with burnout syndrome in medical workers.We observed that five dimensions of job satisfaction and self-reported social support were negatively associated with burnout syndrome, whereas three dimensions of work-family conflict showed a positive correlation. In a four-stage general linear model analysis, we found that demographic factors accounted for 5.4% of individual variance in burnout syndrome (F = 4.720, P<0.001, R2 = 0.054, and that work-family conflict, self-reported social support, and job satisfaction accounted for 2.6% (F = 5.93, P<0.001, R2 = 0.080, 5.7% (F = 9.532, P<0.001, R2 = 0.137 and 17.8% (F = 21.608, P<0.001, R2 = 0.315 of the variance, respectively. In the fourth stage of analysis, female gender and a lower technical title correlated to a higher level of burnout syndrome, and medical workers without administrative duties had more serious burnout syndrome than those with administrative duties.In conclusion, the present study suggests that work-family conflict and self-reported social support slightly affect the level of burnout syndrome, and that job satisfaction is a much stronger influence on burnout syndrome

Acute liver failure and self-medication.

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de Oliveira, André Vitorio Câmara; Rocha, Frederico Theobaldo Ramos; Abreu, Sílvio Romero de Oliveira

2014-01-01

Not responsible self-medication refers to drug use in high doses without rational indication and often associated with alcohol abuse. It can lead to liver damage and drug interactions, and may cause liver failure. To warn about how the practice of self-medication can be responsible for acute liver failure. Were used the Medline via PubMed, Cochrane Library, SciELO and Lilacs, and additional information on institutional sites of interest crossing the headings acute liver failure [tiab] AND acetaminophen [tiab]; self-medication [tiab] AND acetaminophen [tiab]; acute liver failure [tiab] AND dietary supplements [tiab]; self-medication [tiab] AND liver failure [tiab] and self-medication [tiab] AND green tea [tiab]. In Lilacs and SciELO used the descriptor self medication in Portuguese and Spanish. From total surveyed were selected 27 articles and five sites specifically related to the purpose of this review. Legislation and supervision disabled and information inaccessible to people, favors the emergence of cases of liver failure drug in many countries. In the list of released drugs that deserve more attention and care, are some herbal medicines used for the purpose of weight loss, and acetaminophen. It is recommended that institutes of health intensify supervision and better orient their populations on drug seemingly harmless, limiting the sale of products or requiring a prescription for release them.

SelfMED: Self-Administration of Medication in Hospital: A Prevalence Study in Flanders, Belgium.

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Vanwesemael, Toke; Van Rompaey, Bart; Petrovic, Mirko; Boussery, Koen; Dilles, Tinne

2017-05-01

Self-management is a key element in regaining and maintaining health. However, during hospitalization it becomes less obvious. Patient self-administration of medication during hospitalization is suggested to be beneficial to patient satisfaction, adherence to pharmacotherapy, and self-care competence. This study aimed to examine the prevalence of self-administration of medication during hospitalization, and possible contributing factors. A cross-sectional observational study was conducted in 12 Belgian hospitals from February 2015 until June 2015. Data were collected on all hospitalized patients at 57 wards, based in 12 hospitals. A structured questionnaire at ward level and patient level on medication management, self-administration of medication, and rationale for prohibiting or allowing patients to self-administer their medication was conducted in consultation with the head nurse. Of the 1,269 patients participating in this study, 22% self-administered at least one medicine during hospitalization and 13.8% self-administered at least 50% of their total amount of medication. In the opinion of the head nurse, 40.9% of the hospitalized patients would have been able to self-administer their medication during hospitalization. Only a few wards had an available procedure and screening tool to assess the competence of the patients to self-administer their medication. This did not affect the prevalence of self-administration. Self-administration occurred significantly more at surgical short-stay wards, compared to other wards. The self-administering patients were on average younger and female and had a lower number of different medications per day before and during hospitalization. These patients had a good health status and were independent to mildly dependent on nurses on the ward. Related factors were used to provide a multivariate logistic regression model. Sometimes self-administration of medication was allowed. According to the surveyed nurses, however, more

Self-medication practices in patients attending a Tertiary Care Teaching Hospital in Urban North-West India

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Shilpa Patrick

2018-01-01

Full Text Available Background: This study was designed to determine the frequency, reasons, and the association of self-medication with demographic and other factors reported by participants. Materials and Methods: This study was conducted in 500 patients visiting a tertiary hospital in Ludhiana, North Western India. Participants were interviewed with a preset questionnaire. Data were entered into Microsoft Excel and analysis was performed using SPSS software version 16. Frequencies and proportions were calculated. Results: Of 500 study participants, 93.8% reported self-medication with no gender difference. The participants who took self-medication were of the opinion that self-medication resulted in quick cure of illness 50.75%, saved their time 17.46%, and gave them a sense of independence in 17.06%, respectively. The common reasons self-medication 45.84% for fever, 18.34% for pain, and 10.87% for headache with nonsteroidal anti-inflammatory drugs 49.4% followed by antibiotics (11.6% be the common medication. The most common source of information is local chemists/pharmacy 39%. Conclusions: Self-medication is described as a double-edged sword in India, and regulation of over-the-counter sale of antibiotics prescription medication is necessary to safeguard the populace.

The prevalence of self-reported deliberate self harm in Irish adolescents.

LENUS (Irish Health Repository)

Morey, Carolyn

2008-01-01

BACKGROUND: Deliberate self harm is major public health problem, in particular among young people. Although several studies have addressed the prevalence of deliberate self harm among young people in the community, little is known about the extent to which deliberate self harm comes to the attention of medical services, the self harm methods used and the underlying motives. The aim of this study was to determine the prevalence of deliberate self harm in adolescents and the methods, motives and help seeking behaviour associated with this behaviour. METHODS: A cross-sectional survey using an anonymous self-report questionnaire was administered in 39 schools in the Southern area of the Health Service Executive, Ireland. Of the 4,583 adolescents aged 15-17 years who were invited to participate in the survey, 3,881 adolescents took part (response: 85%). RESULTS: A lifetime history of DSH was reported by 9.1% (n = 333) of the adolescents. DSH was more common among females (13.9%) than males (4.3%). Self cutting (66.0%) and overdose (35.2%) were the most common DSH methods. A minority of participants accessed medical services after engaging in DSH (15.3%). CONCLUSION: DSH is a significant problem in Irish adolescents and the vast majority do not come to the attention of health services. Innovative solutions for prevention and intervention are required to tackle DSH in adolescents.

KNOWLEDGE, ATTITUDE AND PRACTICE OF SELF-MEDICATION AMONG MEDICAL COLLEGE STUDENTS IN KERALA

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Messaline

2016-05-01

Full Text Available BACKGROUND & RATIONALE Self-medication is defined as the selection and use of medicines by individuals to treat self-recognised illness or symptoms. Practice of self-medication, especially by medical students can cause wastage of resources, bacterial resistance, drug addiction and serious adverse drug reactions. The objective of our study is to evaluate the knowledge, attitude and practice of selfmedication among medical college students in Kerala. METHODS AND MATERIAL MBBS students of a private medical college were included in the study. The students filled a structured pretested questionnaire and descriptive statistics was applied to the data with SPSS version 20. RESULTS Out of 300, 264 (88% students had taken self-medication over the past 1 year. Past exposure with the same drug was the significant source of information for the drugs (49.2% and the drugs frequently self-medicated were analgesics 34.4% (91 and antipyretics 30.3% (80. More than half of the students, 66% (198 students had expressed positive and 34% (102 students had expressed negative attitude towards self-medication. Around 66% students declared that they were not aware of the dose, frequency and adverse effects of the drugs. CONCLUSION The pattern of self-medication practice from our study was similar to other studies done in various parts of India. Similar studies in future will provide adequate information to regulatory authorities to implement these results on strict drug dispensing and drug advertising policies. KEYWORDS Self-medication, Medical College Students, Kerala.

Gastrointestinal Side Effects of Antiarrhythmic Medications: A Review of Current Literature.

Science.gov (United States)

Amjad, Waseem; Qureshi, Waqas; Farooq, Ali; Sohail, Umair; Khatoon, Salma; Pervaiz, Sarah; Narra, Pratyusha; Hasan, Syeda M; Ali, Farman; Ullah, Aman; Guttmann, Steven

2017-09-03

Antiarrhythmic drugs are commonly prescribed cardiac drugs. Due to their receptor mimicry with several of the gastrointestinal tract receptors, they can frequently lead to gastrointestinal side effects. These side effects are the most common reasons for discontinuation of these drugs by the patients. Knowledge of these side effects is important for clinicians that manage antiarrhythmic drugs. This review focuses on the gastrointestinal side effects of these drugs and provides a detailed up-to-date literature review of the side effects of these drugs. The review provides case reports reported in the literature as well as possible mechanisms that lead to gastrointestinal side effects.

Relationship of work-family conflict, self-reported social support and job satisfaction to burnout syndrome among medical workers in southwest China: A cross-sectional study

Science.gov (United States)

Yang, Shujuan; Liu, Danping; Liu, Hongbo; Zhang, Juying; Duan, Zhanqi

2017-01-01

Background Burnout is a psychosomatic syndrome widely observed in Chinese medical workers due to the increasing cost of medical treatment, excessive workload, and excessive prescribing behavior. No studies have evaluated the interrelationship among occupational burnout, work-family conflict, social support, and job satisfaction in medical workers. The aim of this study was to evaluate these relationships among medical workers in southwest China. Methods This cross-sectional study was conducted between March 2013 and December 2013, and was based on the fifth National Health Service Survey (NHSS). A total of 1382 medical workers were enrolled in the study. Pearson correlation analysis and general linear model univariate analysis were used to evaluate the relationship of work-family conflict, self-reported social support, and job satisfaction with burnout syndrome in medical workers. Results We observed that five dimensions of job satisfaction and self-reported social support were negatively associated with burnout syndrome, whereas three dimensions of work-family conflict showed a positive correlation. In a four-stage general linear model analysis, we found that demographic factors accounted for 5.4% of individual variance in burnout syndrome (F = 4.720, Pjob satisfaction accounted for 2.6% (F = 5.93, Pburnout syndrome, and medical workers without administrative duties had more serious burnout syndrome than those with administrative duties. Conclusions In conclusion, the present study suggests that work-family conflict and self-reported social support slightly affect the level of burnout syndrome, and that job satisfaction is a much stronger influence on burnout syndrome in medical workers of southwest China. PMID:28207821

Self-reported patient safety competence among Canadian medical students and postgraduate trainees: a cross-sectional survey.

Science.gov (United States)

Doyle, Patricia; VanDenKerkhof, Elizabeth G; Edge, Dana S; Ginsburg, Liane; Goldstein, David H

2015-02-01

Quality and patient safety (PS) are critical components of medical education. This study reports on the self-reported PS competence of medical students and postgraduate trainees. The Health Professional Education in Patient Safety Survey was administered to medical students and postgraduate trainees in January 2012. PS dimension scores were compared across learning settings (classroom and clinical) and year in programme. Sixty-three percent (255/406) of medical students and 32% (141/436) of postgraduate trainees responded. In general, both groups were most confident in their learning of clinical safety skills (eg, hand hygiene) and least confident in learning about sociocultural aspects of safety (eg, understanding human factors). Medical students' confidence in most aspects of safety improved with years of training. For some of the more intangible dimensions (teamwork and culture), medical students in their final year had lower scores than students in earlier years. Thirty-eight percent of medical students felt they could approach someone engaging in unsafe practice, and the majority of medical students (85%) and postgraduate trainees (78%) agreed it was difficult to question authority. Our results suggest the need to improve the overall content, structure and integration of PS concepts in both classroom and clinical learning environments. Decreased confidence in sociocultural aspects of PS among medical students in the final year of training may indicate that culture in clinical settings negatively affects students' perceived PS competence. Alternatively, as medical students spend more time in the clinical setting, they may develop a clearer sense of what they do not know. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Validating self-reported mobile phone use in adults using a newly developed smartphone application.

Science.gov (United States)

Goedhart, Geertje; Kromhout, Hans; Wiart, Joe; Vermeulen, Roel

2015-11-01

Interpretation of epidemiological studies on health effects from mobile phone use is hindered by uncertainties in the exposure assessment. We used a newly developed smartphone application (app) to validate self-reported mobile phone use and behaviour among adults. 107 participants (mean age 41.4 years) in the Netherlands either downloaded the software app on their smartphone or were provided with a study smartphone for 4 weeks. The app recorded the number and duration of calls, text messages, data transfer, laterality and hands-free use. Self-reported mobile phone use was collected before using the app and after 6 months through an interviewer-administered questionnaire. The geometric mean ratios (GMR, 95% CI) and Spearman correlations (r) of self-reported (after 6 months) versus recorded number and duration of calls were: GMR=0.65 (0.53 to 0.80), r=0.53; and GMR=1.11 (0.86 to 1.42), r=0.57 respectively. Participants held the phone on average for 86% of the total call time near the head. Self-reported right side users held the phone for 70.7% of the total call time on the right side of the head, and left side users for 66.2% on the left side of the head. The percentage of total call time that the use of hands-free devices (headset, speaker mode, Bluetooth) was recorded increased with increasing frequency of reported hands-free device usage. The observed recall errors and precision of reported laterality and hands-free use can be used to quantify and improve radiofrequency exposure models based on self-reported mobile phone use. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Self-Medication Practice with Nonprescription Medication among University Students: a review of the literature

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Dedy Almasdy

2011-09-01

Full Text Available Objective: To review the literature relating to self-medicationpractice with nonprescription medication among universitystudents.Methods: A narrative review of studies on self-medicationpractice with nonprescription medication among universitystudent was performed. An extensive literature search wasundertaken using indexing services available at UniversitiSains Malaysia (USM library. The following keywords wereused for the search: self-care, self-medication, over-thecountermedicine, nonprescription medicine, minor illnesses,minor ailment, university population and communitypharmacy. Electronic databases searched were Science Direct,Medline, ISI Web of Knowledge, Inside Web, JSTOR, SpringerLink, Proquest, Ebsco Host and Google Scholar. Theseelectronic databases were searched for full text paperspublished in English.Results: Eleven studies were identified. In general, the reviewhas shown that self-medication practice with nonprescriptionmedication highly prevalence among university students. Thereasons for self-medication are vary among this populationand the main symptoms leading to self-medication areheadache or minor pain; fever, flu, cough, or cold; anddiarrhoea.The common medication is analgesic, antipyreticproducts, cough and cold remedies, anti allergy andvitamins or minerals. The sources of the medicines arepharmacy, home medicine cabinet, supermarket/shopand other person such as family, friend, neighbours andclassmates. The sources of drug information are familymember, previous experience, pharmacy salesman,doctor or nurse, advertisement and others. The reviewalso has shown that the self-medication practice couldhave many problems.Conclusions: The review provides insights about theself-medication practices among the university students.These practices were highly prevalence among universitystudents. The symptoms leading to self-medication arevary, thus the medication used and the medicationsources. It needs an adequate drug information

Self-efficacy reduces the impact of social isolation on medical student's rural career intent.

Science.gov (United States)

Isaac, Vivian; Pit, Sabrina Winona; McLachlan, Craig S

2018-03-20

Social isolation in medical students is a subjective experience that may influence medical career decision making. Rural self-efficacy has been shown to influence rural career intentions following a rural clinical placement, however its impact on social isolation during a rural clinical placement has not been previously modeled. The objective of this study is to explore whether self-perception of social isolation is associated with rural career intent in rural medical students. Secondly, to determine whether self-efficacy influences the association between social isolation and rural career intent. 2015 data, from a cross-sectional survey of the National Federation of Rural Australian Medical Educators (FRAME) study. Among 619 medical students attending rural clinical schools (RCS), rural career intent was assessed. This included intended rural location for either postgraduate medical specialist or generalist training or completion of that training. Self-efficacy beliefs in rural medical practice were based on a validated scale consisting of six questions. Social isolation was measured asking students whether they felt socially isolated during their RCS placement. 31.3% of surveyed students self-reported feeling socially isolated during their rural placement. Social isolation was associated with reduced rural career intent after controlling for gender, rural background, RCS preference, RCS support and wellbeing. In step-wise logistic regression the association between social isolation and rural intent disappeared with the inclusion of rural self-efficacy. Social isolation during a rural clinical placement is commonly reported and is shown to reduce rural career intent. High levels of rural clinical self-efficacy reduce the effects of social isolation on future rural workforce intentions.

Reasons for self-medication and perceptions of risk among Mexican migrant farm workers.

Science.gov (United States)

Horton, Sarah; Stewart, Analisia

2012-08-01

Although the frequency of self-medication among Mexican migrants has been well-documented in the public health literature, the multiple reasons for this practice are poorly understood. Most studies point to migrants' cultural preferences for Mexican medications, their prior experiences in countries where antibiotics are loosely regulated, and their lack of access to health care as the primary factors behind their self-medication. Based on participant observation and in-depth interviews with 23 Mexican migrants in a farm working community in the interior of California, we argue that occupational vulnerability is an equally important factor that encourages self-medication. All 23 of our interviewees reported having engaged in some degree of self-medication, notable in this location 8 h from the US-Mexico border. Among interviewees, occupational vulnerability represented an even more important factor influencing self-medication than lack of health insurance or lack of legal documentation. While interviewees did express a preference for Mexican medications as more potent and effective, this did not necessarily translate to a preference for using them without a doctor's supervision. Finally, we show that rather than remaining unaware of the risks of following this custom "transported from Latin America", Mexican migrants devised an elaborate hierarchy of resort of the safest self-medication practices to follow.

Accurate assessment of adherence: self-report and clinician report vs electronic monitoring of nebulizers.

Science.gov (United States)

Daniels, Tracey; Goodacre, Lynne; Sutton, Chris; Pollard, Kim; Conway, Steven; Peckham, Daniel

2011-08-01

People with cystic fibrosis have a high treatment burden. While uncertainty remains about individual patient level of adherence to medication, treatment regimens are difficult to tailor, and interventions are difficult to evaluate. Self- and clinician-reported measures are routinely used despite criticism that they overestimate adherence. This study assessed agreement between rates of adherence to prescribed nebulizer treatments when measured by self-report, clinician report, and electronic monitoring suitable for long-term use. Seventy-eight adults with cystic fibrosis were questioned about their adherence to prescribed nebulizer treatments over the previous 3 months. Self-report was compared with clinician report and stored adherence data downloaded from the I-Neb nebulizer system. Adherence measures were expressed as a percentage of the prescribed regimen, bias was estimated by the paired difference in mean (95% CI) patient and clinician reported and actual adherence. Agreement between adherence measures was calculated using intraclass correlation coefficients (95% CI), and disagreements for individuals were displayed using Bland-Altman plots. Patient-identified prescriptions matched the medical record prescription. Median self-reported adherence was 80% (interquartile range, 60%-95%), whereas median adherence measured by nebulizer download was 36% (interquartile range, 5%-84.5%). Nine participants overmedicated and underreported adherence. Median clinician report ranged from 50% to 60%, depending on profession. Extensive discrepancies between self-report and clinician report compared with nebulizer download were identified for individuals. Self- and clinician-reporting of adherence does not provide accurate measurement of adherence when compared with electronic monitoring. Using inaccurate measures has implications for treatment burden, clinician prescribing practices, cost, and accuracy of trial data.

Validity and reliability of self-reported diabetes in the Atherosclerosis Risk in Communities Study.

Science.gov (United States)

Schneider, Andrea L C; Pankow, James S; Heiss, Gerardo; Selvin, Elizabeth

2012-10-15

The objective of this study was to assess the validity of prevalent and incident self-reported diabetes compared with multiple reference definitions and to assess the reliability (repeatability) of a self-reported diagnosis of diabetes. Data from 10,321 participants in the Atherosclerosis Risk in Communities (ARIC) Study who attended visit 4 (1996-1998) were analyzed. Prevalent self-reported diabetes was compared with reference definitions defined by fasting glucose and medication use obtained at visit 4. Incident self-reported diabetes was assessed during annual follow-up telephone calls and was compared with reference definitions defined by fasting glucose, hemoglobin A1c, and medication use obtained during an in-person visit attended by a subsample of participants (n = 1,738) in 2004-2005. The sensitivity of prevalent self-reported diabetes ranged from 58.5% to 70.8%, and specificity ranged from 95.6% to 96.8%, depending on the reference definition. Similarly, the sensitivity of incident self-reported diabetes ranged from 55.9% to 80.4%, and specificity ranged from 84.5% to 90.6%. Percent positive agreement of self-reported diabetes during 9 years of repeat assessments ranged from 92.7% to 95.4%. Both prevalent self-reported diabetes and incident self-reported diabetes were 84%-97% specific and 55%-80% sensitive as compared with reference definitions using glucose and medication criteria. Self-reported diabetes was >92% reliable over time.

The prevalence of self-reported underuse of medications due to cost for the elderly: results from seven European urban communities.

Science.gov (United States)

Stankuniene, Aurima; Stankunas, Mindaugas; Avery, Mark; Lindert, Jutta; Mikalauskiene, Rita; Melchiorre, Maria Gabriella; Torres-Gonzalez, Francisco; Ioannidi-Kapolou, Elisabeth; Barros, Henrique; Savickas, Arūnas; Radziunas, Raimondas; Soares, Joaquim J F

2015-09-26

The aim of this study was to evaluate the prevalence of self-reported underuse of medications due to procurement costs amongst older persons from seven European urban communities. The data were collected in a cross-sectional study ("ABUEL, Elder abuse: A multinational prevalence survey") in 2009. Randomly selected people aged 60-84 years (n = 4,467) from seven urban communities: Stuttgart (Germany), Athens (Greece), Ancona (Italy), Kaunas (Lithuania), Porto (Portugal), Granada (Spain) and Stockholm (Sweden) were interviewed. Response rate - 45.2%. Ethical permission was received in each country. The results indicate that 3.6% (n = 162) of the respondents self-reported refraining from buying prescribed medications due to cost. The highest prevalence of this problem was identified in Lithuania (15.7%, n = 99) and Portugal (4.3%, n = 28). Other countries reported lower percentages of refraining from buying medications (Germany - 2.0%, Italy - 1.6%, Sweden - 1.0%, Greece - 0.6%, Spain - 0.3%). Females refrained more often from buying medications than males (2.6% vs. 4.4%, p < 0.0001). The prevalence of this refraining tended to increase with economic hardship. These differences between countries can be only partly described by the financing of health-care systems. In spite of the presence of cost reimbursement mechanisms, patients need to make co-payments (or in some cases to pay the full price) for prescribed medications. This indicates that the purchasing power of people in 10.1186/s12913-015-1089-4 the particular country can play a major role and be related with the economic situation in the country. Lithuania, which has reported the highest refrain rates, had the lowest gross domestic product (at the time of conducting this study) of all participating countries in the study. Refraining from buying the prescribed medications due to cost is a problem for women and men in respect to ageing people in Europe. Prevalence varies by country, sex, and

Prevalence of Self-Medication among Students of Pharmacy and Medicine Colleges of a Public Sector University in Dammam City, Saudi Arabia

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Fatimah Ali Albusalih

2017-09-01

Full Text Available Pharmacy and medical students are expected to be more knowledgeable regarding rational use of medications as compared to the general public. A cross-sectional study was conducted among students of pharmacy and medicine colleges of Imam Abdulrahman Bin Faisal University in Dammam, Saudi Arabia using a survey questionnaire. The duration of the study was six months. The aim was to report self-medication prevalence of prescription and non-prescription drugs among pharmacy and medical students. The prevalence of self-medication in the pharmacy college was reported at 19.61%. Prevalence of self-medication at the medical college was documented at 49.3%. The prevalence of multivitamin use was reported at 30.53%, analgesics; 72.35%, antihistamines; 39.16%, and antibiotic use at 16.59%. The prevalence of anti-diarrheal medicines and antacids use among students was found to be 8.63% and 6.64%, respectively. The variable of college and study year was statistically associated with the nature of the medicines. The most common justifications given by students indulging in self-medication were ‘mild problems’ and ‘previous experience with medicines’. Our study reported that prevalence of self-medication in the College of Clinical Pharmacy was low, i.e., 19.61%. The figure has been reported for the first time. Students were mostly observed self-medicating with OTC drugs, however, some reported using corticosteroids and isotretenoin, which are quite dangerous if self-medicated. Students have a positive outlook towards pharmacists as drug information experts.

Understanding Healthcare Workers Self-Reported Practices, Knowledge and Attitude about Hand Hygiene in a Medical Setting in Rural India.

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Diwan, Vishal; Gustafsson, Charlotte; Rosales Klintz, Senia; Joshi, Sudhir Chandra; Joshi, Rita; Sharma, Megha; Shah, Harshada; Pathak, Ashish; Tamhankar, Ashok J; Stålsby Lundborg, Cecilia

2016-01-01

To describe self-reported practices and assess knowledge and attitudes regarding hand hygiene among healthcare workers in a rural Indian teaching hospital. A rural teaching hospital and its associated medical and nursing colleges in the district of Ujjain, India. The study population consisted of physicians, nurses, teaching staff, clinical instructors and nursing students. Self-administered questionnaires based on the World Health Organization Guidelines on Hand Hygiene in Healthcare were used. Out of 489 healthcare workers, 259 participated in the study (response rate = 53%). The proportion of healthcare workers that reported to 'always' practice hand hygiene in the selected situations varied from 40-96% amongst categories. Reported barriers to maintaining good hand hygiene were mainly related to high workload, scarcity of resources, lack of scientific information and the perception that priority is not given to hand hygiene, either on an individual or institutional level. Previous training on the topic had a statistically significant association with self-reported practice (p = 0.001). Ninety three per cent of the respondents were willing to attend training on hand hygiene in the near future. Self-reported knowledge and adherence varied between situations, but hand hygiene practices have the potential to improve if the identified constraints could be reduced. Future training should focus on enhancing healthcare workers' knowledge and understanding regarding the importance of persistent practice in all situations.

Self-medication: frequent practice in adolescence? Study on a sample of high school students in Sorocaba

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Inês Maria Crespo Gutierres Pardo

2013-06-01

bjectives: self-medication is a practice that has been widely discussed around the world, becoming the target of several studies, including Brazil. Self-medication can cause harm. Children and adolescents are the group most inclined to irrational use of medications. The present study aims to evaluate the behavior of high school students about self-medication. Methods: a cross-sectional sample of 79 high school teenagers, aged 14 - 18 years old of both genders. The questionnaire included the following variables: age, gender, grade, frequency of use of medications, who guided the consumption and self-medication, which were evaluated using dichotomous questions, specifying the(s drug(s used and their purpose. Results: the self-medication occurred in 96.2% of the sample, with no difference between genders (p = 0.19 or age (p = 0.61. Among those who self-medicated on their own, 55.88% based on old prescriptions. The most consumed pharmacological groups were analgesics, followed by medicines for colds or flu. Almost half (48.1% participants reported using nonprescription medicines. There was association between adolescents' self-medication and maternal self-medication (p = 0.02. Conclusion: it is extremely worrying the large percentage of adolescents who engage in self-medication, in view of the potential health risks. The consumption of drugs without medical advice by mothers proved to be an influencing factor in adolescents' self-medication.

A survey of mindset theories of intelligence and medical error self-reporting among pediatric housestaff and faculty.

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Jegathesan, Mithila; Vitberg, Yaffa M; Pusic, Martin V

2016-02-11

Intelligence theory research has illustrated that people hold either "fixed" (intelligence is immutable) or "growth" (intelligence can be improved) mindsets and that these views may affect how people learn throughout their lifetime. Little is known about the mindsets of physicians, and how mindset may affect their lifetime learning and integration of feedback. Our objective was to determine if pediatric physicians are of the "fixed" or "growth" mindset and whether individual mindset affects perception of medical error reporting.  We sent an anonymous electronic survey to pediatric residents and attending pediatricians at a tertiary care pediatric hospital. Respondents completed the "Theories of Intelligence Inventory" which classifies individuals on a 6-point scale ranging from 1 (Fixed Mindset) to 6 (Growth Mindset). Subsequent questions collected data on respondents' recall of medical errors by self or others. We received 176/349 responses (50 %). Participants were equally distributed between mindsets with 84 (49 %) classified as "fixed" and 86 (51 %) as "growth". Residents, fellows and attendings did not differ in terms of mindset. Mindset did not correlate with the small number of reported medical errors. There is no dominant theory of intelligence (mindset) amongst pediatric physicians. The distribution is similar to that seen in the general population. Mindset did not correlate with error reports.

Parental social support as a moderator of self-medication in adolescents.

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Reimuller, Alison; Shadur, Julia; Hussong, Andrea M

2011-03-01

We examined the moderating effects of parenting on the temporal relationship between negative affect and subsequent alcohol use in adolescents as an indicator of self-medication. Specifically, we tested whether youth are more likely to self-medicate if they receive less parental social support. We used a multi-method, multi-reporter strategy and an experience sampling paradigm to examine these mechanisms in an elevated-risk sample preparing for the transition to high school. Seventy-one adolescents and their parents completed home-based interviews and adolescents completed a 21-day experience sampling protocol in which they reported their alcohol use daily and their affect thrice daily. Parent-reported family communication, though no other parental support indicators, moderated the relation between daily negative affect and alcohol use. Plotting of interactions showed a greater likelihood of drinking on days characterized by greater negative affect only in adolescents with higher levels of parent-reported family communication. This study offers tentative support for parental support as a moderator of the relation between daily negative affect and alcohol use. Parental support may be a response to alcohol use and self-medication in teens such that parents become more involved and open in talking with their teens when they notice these patterns of behavior. Copyright © 2010 Elsevier Ltd. All rights reserved.

Factors associated with self-medication in Spain: a cross-sectional study in different age groups.

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Niclós, Gracia; Olivar, Teresa; Rodilla, Vicent

2018-06-01

The identification of factors which may influence a patient's decision to self-medicate. Descriptive, cross-sectional study of the adult population (at least 16 years old), using data from the 2009 European Health Interview Survey in Spain, which included 22 188 subjects. Logistic regression models enabled us to estimate the effect of each analysed variable on self-medication. In total, 14 863 (67%) individuals reported using medication (prescribed and non-prescribed) and 3274 (22.0%) of them self-medicated. Using logistic regression and stratifying by age, four different models have been constructed. Our results include different variables in each of the models to explain self-medication, but the one that appears on all four models is education level. Age is the other important factor which influences self-medication. Self-medication is strongly associated with factors related to socio-demographic, such as sex, educational level or age, as well as several health factors such as long-standing illness or physical activity. When our data are compared to those from previous Spanish surveys carried out in 2003 and 2006, we can conclude that self-medication is increasing in Spain. © 2017 Royal Pharmaceutical Society.

Self-reported adverse effects as barriers to adherence to ...

African Journals Online (AJOL)

Conclusions: In conclusion, self-reported barriers to optimal adherence included the use of non-prescribed drugs, and the presence of side effects such as insomnia, headaches and abdominal pain; while eating well was a facilitator. These findings emphasise the need for better communication between patients and ...

Self-reported financial barriers to care among patients with cardiovascular-related chronic conditions.

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Campbell, David J T; King-Shier, Kathryn; Hemmelgarn, Brenda R; Sanmartin, Claudia; Ronksley, Paul E; Weaver, Robert G; Tonelli, Marcello; Hennessy, Deirdre; Manns, Braden J

2014-05-01

People with chronic conditions who do not achieve therapeutic targets have a higher risk of adverse health outcomes. Failure to meet these targets may be due to a variety of barriers. This article examines self-reported financial barriers to health care among people with cardiovascular-related chronic conditions. A population-based survey was administered to western Canadians with cardiovascular-related chronic conditions (n = 1,849). Associations between self-reported financial barriers and statin use, the likelihood of stopping use of prescribed medications, and emergency department visits or hospitalizations were assessed. More than 10% respondents reported general financial barriers (12%) and lack of drug insurance (14%); 4% reported financial barriers to accessing medications. Emergency department visits or hospitalizations were 70% more likely among those reporting a general financial barrier. Those reporting a financial barrier to medications were 50% less likely to take statins and three times more likely to stop using prescribed medications. Individuals without drug insurance were nearly 30% less likely to take statins. In this population, self-reported financial barriers were associated with lower medication use and increased likelihood of emergency department visits or hospitalization.

Comparing antibiotic self-medication in two socio-economic groups in Guatemala City: a descriptive cross-sectional study.

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Ramay, Brooke M; Lambour, Paola; Cerón, Alejandro

2015-04-27

Self-medication with antibiotics may result in antimicrobial resistance and its high prevalence is of particular concern in Low to Middle Income Countries (LMIC) like Guatemala. A better understanding of self-medication with antibiotics may represent an opportunity to develop interventions guiding the rational use of antibiotics. We aimed to compare the magnitude of antibiotic self-medication and the characteristics of those who self-medicate in two pharmacies serving disparate socio-economic communities in Guatemala City. We conducted a descriptive, cross-sectional study in one Suburban pharmacy and one City Center pharmacy in Guatemala City. We used a questionnaire to gather information about frequency of self-medication, income and education of those who self-medicate. We compared proportions between the two pharmacies, using two-sample z-test as appropriate. Four hundred and eighteen respondents completed the survey (221 in the Suburban pharmacy and 197 in the City Center pharmacy). Most respondents in both pharmacies were female (70%). The reported monthly income in the suburban pharmacy was between $1,250.00-$2,500.00, the city-center pharmacy reported a monthly income between $125.00- $625.00 (p Guatemala City. Additionally, self-medicating respondents were most often women and most commonly self-medicated with amoxicillin. Our findings support future public health interventions centered on the regulation of antibiotic sales and on the potential role of the pharmacist in guiding prescription with antibiotics in Guatemala.

Self-medication with antibiotics in a Swedish general population

NARCIS (Netherlands)

Svensson, E; Haaijer-Ruskamp, FM; Lundborg, CS

To assess the extent of antibiotic self-medication in a Swedish population, a postal questionnaire was distributed to 1000 randomly selected subjects. The antibiotics used were in all but 3 cases reported to have been obtained with a prescription. Thus, prescribers are the primary target for

Inaccuracy in self-report of fractures may underestimate association with health outcomes when compared with medical record based fracture registry

International Nuclear Information System (INIS)

Siggeirsdottir, Kristin; Aspelund, Thor; Sigurdsson, Gunnar; Mogensen, Brynjolfur; Chang, Milan; Jonsdottir, Birna; Eiriksdottir, Gudny; Launer, Lenore J.; Harris, Tamara B.; Jonsson, Brynjolfur Y.; Gudnason, Vilmundur

2007-01-01

Introduction and objective Misreporting fractures in questionnaires is known. However, the effect of misreporting on the association of fractures with subsequent health outcomes has not been examined. Methods Data from a fracture registry (FR) developed from an extensive review of radiographic and medical records were related to self-report of fracture for 2,255 participants from the AGES Reykjavik Study. This data was used to determine false negative and false positive rates of self-reported fractures, correlates of misreporting, and the potential effect of the misreporting on estimates of health outcomes following fractures. Results In women, the false positive rate decreased with age as the false negative rate increased with no clear trend with age in men. Kappa values for agreement between FR and self-report were generally higher in women than men with the best agreement for forearm fracture (men 0.64 and women 0.82) and the least for rib (men 0.28 and women 0.25). Impaired cognition was a major factor associated with discordant answers between FR and self-report, OR 1.7 (95% CI: 1.3-2.1) (P < 0.0001). We estimated the effect of misreporting on health after fracture by comparison of the association of the self-report of fracture and fracture from the FR, adjusting for those factors associated with discordance. The weighted attenuation factor measured by mobility and muscle strength was 11% (95% CI: 0-24%) when adjusted for age and sex but reduced to 6% (95% CI: -10-22%) when adjusted for cognitive impairment. Conclusion Studies of hip fractures should include an independent ascertainment of fracture but for other fractures this study supports the use of self-report

Financial hardship, unmet medical need, and health self-efficacy among African American men.

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Tucker-Seeley, Reginald D; Mitchell, Jamie A; Shires, Deirdre A; Modlin, Charles S

2015-06-01

Health self-efficacy (the confidence to take care of one's health) is a key component in ensuring that individuals are active partners in their health and health care. The purpose of this study was to determine the association between financial hardship and health self-efficacy among African American men and to determine if unmet medical need due to cost potentially mediates this association. Cross-sectional analysis was conducted using data from a convenience sample of African American men who attended a 1-day annual community health fair in Northeast Ohio (N = 279). Modified Poisson regression models were estimated to obtain the relative risk of reporting low health self-efficacy. After adjusting for sociodemographic characteristics, those reporting financial hardship were 2.91 times, RR = 2.91 (confidence interval [1.24, 6.83]; p financial hardship and low health self-efficacy was no longer statistically significant. Our results suggest that the association between financial hardship and health self-efficacy can be explained by unmet medical need due to cost. Possible intervention efforts among African American men with low financial resources should consider expanding clinical and community-based health assessments to capture financial hardship and unmet medical need due to cost as potential contributors to low health self-efficacy. © 2014 Society for Public Health Education.

Medical students’ perception of lesbian, gay, bisexual, and transgender (LGBT) discrimination in their learning environment and their self-reported comfort level for caring for LGBT patients: a survey study

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Nama, Nassr; MacPherson, Paul; Sampson, Margaret; McMillan, Hugh J.

2017-01-01

ABSTRACT Background: Historically, medical students who are lesbian, gay, bisexual or transgendered (LGBT) report higher rates of social stress, depression, and anxiety, while LGBT patients have reported discrimination and poorer access to healthcare. Objective: The objectives of this study were: (1) to assess if medical students have perceived discrimination in their learning environment and; (2) to determine self-reported comfort level for caring for LGBT patients. Design: Medical students ...

Depression and medication adherence among older Korean patients with hypertension: Mediating role of self-efficacy.

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Son, Youn-Jung; Won, Mi Hwa

2017-06-01

Many studies have reported the negative effects of depression on adherence to antihypertensive medication. However, little is known about the mechanism underlying this relationship in elderly patients with hypertension. The aim of this cross-sectional study is to examine the mediating role of self-efficacy in the relationship between depression and medication adherence among older patients with hypertension. The data were collected from October to December 2014. A total of 255 older patients with hypertension were assessed using the Geriatric Depression Scale, the Self-efficacy for Appropriate Medication Use Scale, and the Morisky Medication Adherence Scale. Hierarchical linear regression analysis and the Sobel test were used to examine the mediating role of self-efficacy in the relationship between depression and medication adherence. Depression and self-efficacy were statistically significant predictors of medication adherence in older patients with hypertension. Self-efficacy partially mediated the relationship between depression and medication adherence. Interventions targeting self-efficacy could increase the confidence of patients in their ability to actively take their medicines. Moreover, health care providers should be aware of the importance of early detection of depression in older patients with hypertension. Future studies with longitudinal data are warranted to clarify the multidirectional relationships between depression, self-efficacy, and medication adherence. © 2017 John Wiley & Sons Australia, Ltd.

Delayed Diagnosis of Acromegaly in the Context of Post-Traumatic Stress Disorder due to Symptoms Mimicking Known Psychotropic Medication Side Effects.

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Portier, Ray-Bernard; Afarin, Afshin; Pope, Sara

2017-07-01

, physical examination, laboratory data, and the pituitary lesion, this patient was diagnosed with acromegaly. He was referred to neurosurgery for further evaluation and management. This case shows that side effects of medications can easily mimic some medical conditions. The possibility of unrecognized disease should not be overlooked simply because a patient's symptoms that develop after starting a medication correspond well the side effect profile of the prescribed medications. This is especially true if side effects do not stop with alteration of medication dose, cessation of the medication, or changing to another medication. Pituitary adenomas are rare in patients treated for PTSD. However, attribution of PTSD patient's symptoms to the side effects of selective serotonin reuptake inhibitors therapy without considering a broader differential may lead to a missed diagnosis of an endocrine disease. In this case, the presence of an undiagnosed pituitary lesion resulted in ineffective medical management of PTSD in the patient. Mental health providers should remain allied with their primary care counterparts and consider directing patients to primary care for periodic physical re-evaluation to provide the most effective approach to symptom evaluation and management. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

Self-reported responsiveness to direct-to-consumer drug advertising and medication use: results of a national survey

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Somes Grant W

2011-09-01

Full Text Available Abstract Background Direct-to-consumer (DTC marketing of pharmaceuticals is controversial, yet effective. Little is known relating patterns of medication use to patient responsiveness to DTC. Methods We conducted a secondary analysis of data collected in national telephone survey on knowledge of and attitudes toward DTC advertisements. The survey of 1081 U.S. adults (response rate = 65% was conducted by the Food and Drug Administration (FDA. Responsiveness to DTC was defined as an affirmative response to the item: "Has an advertisement for a prescription drug ever caused you to ask a doctor about a medical condition or illness of your own that you had not talked to a doctor about before?" Patients reported number of prescription and over-the-counter (OTC medicines taken as well as demographic and personal health information. Results Of 771 respondents who met study criteria, 195 (25% were responsive to DTC. Only 7% respondents taking no prescription were responsive, whereas 45% of respondents taking 5 or more prescription medications were responsive. This trend remained significant (p trend .0009 even when controlling for age, gender, race, educational attainment, income, self-reported health status, and whether respondents "liked" DTC advertising. There was no relationship between the number of OTC medications taken and the propensity to discuss health-related problems in response to DTC advertisements (p = .4. Conclusion There is a strong cross-sectional relationship between the number of prescription, but not OTC, drugs used and responsiveness to DTC advertising. Although this relationship could be explained by physician compliance with patient requests for medications, it is also plausible that DTC advertisements have a particular appeal to patients prone to taking multiple medications. Outpatients motivated to discuss medical conditions based on their exposure to DTC advertising may require a careful medication history to evaluate for

Self-reported responsiveness to direct-to-consumer drug advertising and medication use: results of a national survey.

Science.gov (United States)

Dieringer, Nicholas J; Kukkamma, Lisa; Somes, Grant W; Shorr, Ronald I

2011-09-23

ABSTRACT: BACKGROUND: Direct-to-consumer (DTC) marketing of pharmaceuticals is controversial, yet effective. Little is known relating patterns of medication use to patient responsiveness to DTC. METHODS: We conducted a secondary analysis of data collected in national telephone survey on knowledge of and attitudes toward DTC advertisements. The survey of 1081 U.S. adults (response rate = 65%) was conducted by the Food and Drug Administration (FDA). Responsiveness to DTC was defined as an affirmative response to the item: "Has an advertisement for a prescription drug ever caused you to ask a doctor about a medical condition or illness of your own that you had not talked to a doctor about before?" Patients reported number of prescription and over-the-counter (OTC) medicines taken as well as demographic and personal health information. RESULTS: Of 771 respondents who met study criteria, 195 (25%) were responsive to DTC. Only 7% respondents taking no prescription were responsive, whereas 45% of respondents taking 5 or more prescription medications were responsive. This trend remained significant (p trend .0009) even when controlling for age, gender, race, educational attainment, income, self-reported health status, and whether respondents "liked" DTC advertising. There was no relationship between the number of OTC medications taken and the propensity to discuss health-related problems in response to DTC advertisements (p = .4). CONCLUSION: There is a strong cross-sectional relationship between the number of prescription, but not OTC, drugs used and responsiveness to DTC advertising. Although this relationship could be explained by physician compliance with patient requests for medications, it is also plausible that DTC advertisements have a particular appeal to patients prone to taking multiple medications. Outpatients motivated to discuss medical conditions based on their exposure to DTC advertising may require a careful medication history to evaluate for therapeutic

Pattern of self-medication with analgesics among Iranian University students in central Iran

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Shadi Sarahroodi

2012-01-01

Full Text Available Background: Self-medication is defined as the use of drugs for the treatment of self-diagnosed disorders. It is influenced by factors such as education, family, society, law, availability of drugs and exposure to advertisements. This study was performed to evaluate self-medication with analgesics and its pattern among different groups of Iranian University Students. Materials and Methods: A randomized, cross-sectional, multicenter study was conducted from December 2009 to February 2010. The target population of this study was 564 students out of 10,000 students attending four medical and non-medical science universities in Qom state. Data was analyzed using SPSS version 16, and analysis was conducted with descriptive analysis procedures. Results: 76.6% of the students had used analgesics in self-medication in the previous 3 months. The frequency of analgesic use in the study period was once in 19.2% of the participants, twice in 22.2%, three times in 16.3% and more than three times in 35.5% of the participants, although 6.8% of them were not sure when they were used. Of all the respondents, 49.8% reported headache as the problem. This was the most common problem, after which came Dysmenorrhea,headache and stomach ache. Bone and joint pains were other problems that led to the use of analgesics. The most commonly used source of information for self-medication with analgesics was advice from friends and family (54.7%, previously prescribed medications (30.1%, their medical knowledge (13.3% and recommendation of a pharmacist (1.9%. Conclusion: Self-medication with analgesics is very high among Iranian students in Qom city. This could be an index for other parts of the Iranian community. Because the source of information about analgesics is inappropriate, we would recommend education courses about analgesics and self-medication on the radio and television for the entire population.

Faculty self-reported experience with racial and ethnic discrimination in academic medicine.

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Peterson, Neeraja B; Friedman, Robert H; Ash, Arlene S; Franco, Shakira; Carr, Phyllis L

2004-03-01

Despite the need to recruit and retain minority faculty in academic medicine, little is known about the experiences of minority faculty, in particular their self-reported experience of racial and ethnic discrimination at their institutions. To determine the frequency of self-reported experience of racial/ethnic discrimination among faculty of U.S. medical schools, as well as associations with outcomes, such as career satisfaction, academic rank, and number of peer-reviewed publications. A 177-item self-administered mailed survey of U.S. medical school faculty. Twenty-four randomly selected medical schools in the contiguous United States. A random sample of 1,979 full-time faculty, stratified by medical school, specialty, graduation cohort, and gender. Frequency of self-reported experiences of racial/ethnic bias and discrimination. The response rate was 60%. Of 1,833 faculty eligible, 82% were non-Hispanic white, 10% underrepresented minority (URM), and 8% non-underrepresented minority (NURM). URM and NURM faculty were substantially more likely than majority faculty to perceive racial/ethnic bias in their academic environment (odds ratio [OR], 5.4; P discrimination by a superior or colleague. Faculty with such reported experiences had lower career satisfaction scores than other faculty (P discrimination achieved academic productivity similar to that of other faculty.

Self medication amongst general outpatients in a nigerian community hospital.

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Omolase, C O; Adeleke, O E; Afolabi, A O; Afolabi, O T

2007-12-01

This study was designed to determine the proportion of general out patients who practice self medication, the drugs employed and the reasons for resorting to self medication. This study was conducted between June and December, 2007 at the General Outpatient Clinic of the Federal Medical Centre, Owo, Ondo State, Nigeria. Two hundred consenting respondents were selected by simple random sampling and interviewed with the aid of semi structured questionnaire by the authors with three assistants. Information regarding their bio-data, history of self medication, drugs used and the reasons for resorting to self medication were obtained. Majority of the respondents (85%) admitted to self medication while the remaining proportion (15%) did not practice it. Drugs utilized could be single, usually analgesics (26.5%) and anti-malaria (15.9%) or in combinations, usually antimalaria-analgesics (22.4%), antimalariaanalgesic- antibiotic (15.3%) and antibiotic-analgesic (10.0%). The reasons cited by respondents for self medication were their perception of their complaints been minor enough to be amenable to self medication (54.7%) and financial constraint (22.4%). Majority of the respondents practiced self medication using an array of drugs like analgesics, anti-malaria and antibiotics used either singly or in combination. The main reasons identified for self medication were that the ailments were minor and financial constraint.

Nurses' reported thinking during medication administration.

Science.gov (United States)

Eisenhauer, Laurel A; Hurley, Ann C; Dolan, Nancy

2007-01-01

To document nurses' reported thinking processes during medication administration before and after implementation of point-of-care technology. Semistructured interviews and real-time tape recordings were used to document the thinking processes of 40 nurses practicing in inpatient care units in a large tertiary care teaching hospital in the northeastern US. Content analysis resulted in identification of 10 descriptive categories of nurses' thinking: communication, dose-time, checking, assessment, evaluation, teaching, side effects, work arounds, anticipating problem solving, and drug administration. Situations requiring judgment in dosage, timing, or selection of specific medications (e.g., pain management, titration of antihypertensives) provided the most explicit data about nurses' use of critical thinking and clinical judgment. A key element was nurses' constant professional vigilance to ensure that patients received their appropriate medications. Nurses' thinking processes extended beyond rules and procedures and were based on patient data and interdisciplinary professional knowledge to provide safe and effective care. Identification of thinking processes can help nurses to explain the professional expertise inherent in medication administration beyond the technical application of the "5 rights."

Self-medication with antibiotics in rural population in Greece: a cross-sectional multicenter study

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Skliros Eystathios

2010-08-01

Full Text Available Abstract Background Self-medication is an important driver of antimicrobial overuse as well as a worldwide problem. The aim of the present study was to estimate the use of antibiotics, without medical prescription, in a sample of rural population presenting in primary care in southern Greece. Methods The study included data from 1,139 randomly selected adults (545 men/594 women, mean age ± SD: 56.2 ± 19.8 years, who visited the 6 rural Health Centres of southern Greece, between November 2009 and January 2010. The eligible participants were sought out on a one-to-one basis and asked to answer an anonymous questionnaire. Results Use of antibiotics within the past 12 months was reported by 888 participants (77.9%. 508 individuals (44.6% reported that they had received antibiotics without medical prescription at least one time. The major source of self-medication was the pharmacy without prescription (76.2%. The antibiotics most frequently used for self-medication were amoxicillin (18.3%, amoxicillin/clavulanic acid (15.4%, cefaclor (9.7%, cefuroxim (7.9%, cefprozil (4.7% and ciprofloxacin (2.3%. Fever (41.2%, common cold (32.0% and sore throat (20.6% were the most frequent indications for the use of self-medicated antibiotics. Conclusion In Greece, despite the open and rapid access to primary care services, it appears that a high proportion of rural adult population use antibiotics without medical prescription preferably for fever and common cold.

Self-medication with antibiotics in rural population in Greece: a cross-sectional multicenter study

Science.gov (United States)

2010-01-01

Background Self-medication is an important driver of antimicrobial overuse as well as a worldwide problem. The aim of the present study was to estimate the use of antibiotics, without medical prescription, in a sample of rural population presenting in primary care in southern Greece. Methods The study included data from 1,139 randomly selected adults (545 men/594 women, mean age ± SD: 56.2 ± 19.8 years), who visited the 6 rural Health Centres of southern Greece, between November 2009 and January 2010. The eligible participants were sought out on a one-to-one basis and asked to answer an anonymous questionnaire. Results Use of antibiotics within the past 12 months was reported by 888 participants (77.9%). 508 individuals (44.6%) reported that they had received antibiotics without medical prescription at least one time. The major source of self-medication was the pharmacy without prescription (76.2%). The antibiotics most frequently used for self-medication were amoxicillin (18.3%), amoxicillin/clavulanic acid (15.4%), cefaclor (9.7%), cefuroxim (7.9%), cefprozil (4.7%) and ciprofloxacin (2.3%). Fever (41.2%), common cold (32.0%) and sore throat (20.6%) were the most frequent indications for the use of self-medicated antibiotics. Conclusion In Greece, despite the open and rapid access to primary care services, it appears that a high proportion of rural adult population use antibiotics without medical prescription preferably for fever and common cold. PMID:20691111

Implementation of a web-based tool for patient medication self-management: the Medication Self-titration Evaluation Programme (Med-STEP for blood pressure control

Directory of Open Access Journals (Sweden)

Richard W Grant

2013-12-01

Full Text Available Background Informatics tools may help support hypertension management.Objective To design, implement and evaluate a web-based system for patient anti-hypertensive medication self-titration.Methods Study stages included: six focus groups (50 patients to identify barriers/facilitators to patient medication self-titration, software design informed by qualitative analysis of focus group responses and a six-month single-arm pilot study (20 patients to assess implementation feasibility.Results Focus groups emphasised patient need to feel confident that their own primary care providers were directly involved and approved of the titration protocol. Physicians required 3.3 ± 2.8 minutes/patient to create individualised six-step medication pathways for once-monthly blood pressure evaluations. Pilot participants (mean age of 51.5 ± 11 years, 45% women, mean baseline blood pressure 139/84 ± 12.2/7.5 mmHg had five medication increases, two non-adherence self-reports, 52months not requiring medication changes, 24 skipped months and 17 months with no evaluations due to technical issues. Four pilot patients dropped out before study completion. From baseline to study completion, blood pressure decreased among the 16 patients remaining in the study (8.0/4.7 mmHg, p = 0.03 for both systolic and diastolic pressures.Conclusions Lessons learned included the benefit of qualitative patient analysis prior to system development and the feasibility of physicians designing individual treatment pathways. Any potential clinical benefits were offset by technical problems, the tendency for patients to skip their monthly self-evaluations and drop outs. To be more widely adopted such systems must effectively generalise to a wider range of patients and be integrated into clinical workflow.

Self-medication with antimicrobial drugs in Europe

NARCIS (Netherlands)

Grigoryan, L; Haaijer-Ruskamp, FM; Burgerhof, JGM; Mechtler, R; Deschepper, R; Tambic-Andrasevic, A; Andrajati, R; Monnet, DL; Cunney, R; Di Matteo, A; Edelstein, H; Valinteliene, R; Alkerwi, A; Scicluna, EA; Grzesiowski, P; Bara, AC; Tesar, T; Cizman, M; Campos, J; Lundborg, CS; Birkin, J

We surveyed the populations of 19 European countries to compare the prevalence of antimicrobial drug self-medication in the previous 12 months and intended self-medication and storage and to identify the associated demographic characteristics. By using a multistage sampling design, 1,000-3,000

Attention deficit hyperactivity disorder symptom self-report among ...

African Journals Online (AJOL)

Objective: To determine the prevalence of self-reported attention deficit hyperactivity disorder (ADHD) symptoms among medical students in Eldoret ... divided into two parts. ... representatives prior to the start of whole-class activities and.

Relationships between self-reported unfair treatment and prescription medication use, illicit drug use, and alcohol dependence among Filipino Americans.

Science.gov (United States)

Gee, Gilbert C; Delva, Jorge; Takeuchi, David T

2007-05-01

We examined associations between self-reported unfair treatment and prescription medication use, illicit drug use, and alcohol dependence. We used data from the Filipino American Community Epidemiological Survey, a cross-sectional investigation involving 2217 Filipino Americans interviewed in 1998-1999. Multinomial logistic and negative binomial regression analyses were used in assessing associations between unfair treatment and the substance use categories. Reports of unfair treatment were associated with prescription drug use, illicit drug use, and alcohol dependence after control for age, gender, location of residence, employment status, educational level, ethnic identity level, nativity, language spoken, marital status, and several health conditions. Unfair treatment may contribute to illness and subsequent use of prescription medications. Furthermore, some individuals may use illicit drugs and alcohol to cope with the stress associated with such treatment. Addressing the antecedents of unfair treatment may be a potential intervention route.

Sleep Characteristics of Self-Reported Long Sleepers

Science.gov (United States)

Patel, Sanjay R.; Blackwell, Terri; Ancoli-Israel, Sonia; Stone, Katie L.

2012-01-01

Background: Self-reported long habitual sleep durations (≥ 9 h per night) consistently predict increased mortality. We compared objective sleep parameters of self-reported long versus normal duration sleepers to determine whether long sleepers truly sleep more or have an underlying sleep abnormality. Methods: Older men participating in the Osteoporotic Fractures in Men Study (MrOS) were recruited for a comprehensive sleep assessment, which included wrist actigraphy, overnight polysomnography (PSG), and a question about usual nocturnal sleep duration. Results: Of the 3134 participants (mean age 76.4 ± 5.6; 89.9% Caucasian), 1888 (60.2%) reported sleeping 7-8 h (normal sleepers) and 174 (5.6%) reported ≥ 9 h (long sleepers). On actigraphy, long sleepers spent on average 63.0 min more per night in bed (P sleep stage distribution did not differ. After adjusting for differences in demographics, comorbidities, and medication usage, self-reported long sleepers continued to spend more time in bed and sleep more, based on both actigraphy and PSG. Each additional 30 min in bed or asleep as measured by actigraphy increased the odds of being a self-reported long-sleeper 1.74-fold and 1.33-fold, respectively (P sleep disorders. Citation: Patel SR; Blackwell T; Ancoli-Israel S; Stone KL. Sleep characteristics of self-reported long sleepers. SLEEP 2012;35(5):641-648. PMID:22547890

Beliefs about medications predict adherence to antidepressants in older adults.

Science.gov (United States)

Fawzi, Waleed; Abdel Mohsen, Mohamed Yousry; Hashem, Abdel Hamid; Moussa, Suaad; Coker, Elizabeth; Wilson, Kenneth C M

2012-01-01

Adherence to treatment is a complex and poorly understood phenomenon. This study investigates the relationship between older depressed patients' adherence to antidepressants and their beliefs about and knowledge of the medication. Assessment was undertaken of 108 outpatients over the age of 55 years diagnosed with depressive disorder and treated for at least four weeks with antidepressants. Adherence was assessed using two self-report measures: the Medication Adherence Rating Scale (MARS) and a Global Adherence Measure (GAM). Potential predictors of adherence investigated included sociodemographic, medication and illness variables. In addition, 33 carers were interviewed regarding general medication beliefs. 56% of patients reported 80% or higher adherence on the GAM. Sociodemographic variables were not associated with adherence on the MARS. Specific beliefs about medicines, such as "my health depends on antidepressants" (necessity) and being less worried about becoming dependant on antidepressants (concern) were highly correlated with adherence. General beliefs about medicines causing harm or being overprescribed, experiencing medication side-effects and severity of depression also correlated with poor adherence. Linear regression with the MARS as the dependent variable explained 44.3% of the variance and showed adherence to be higher in subjects with healthy specific beliefs who received more information about antidepressants and worse with depression severity and autonomic side-effects. Our findings strongly support a role for specific beliefs about medicines in adherence. Challenging patients' beliefs, providing information about treatment and discussing side-effects could improve adherence. Poor response to treatment and medication side-effects can indicate poor adherence and should be considered before switching medications.

Attention deficit hyperactivity disorder symptom self-report among ...

African Journals Online (AJOL)

Attention deficit hyperactivity disorder symptom self-report among medical students in Eldoret, Kenya. ... checklist to approximate a Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR) ADHD diagnosis ...

Exposure to Direct-to-Consumer Pharmaceutical Advertising and Medication Nonadherence Among Patients With Serious Mental Illness.

Science.gov (United States)

Green, Charee E; Mojtabai, Ramin; Cullen, Bernadette A; Spivak, Amethyst; Mitchell, Melissa; Spivak, Stanislav

2017-12-01

This study explored the association of exposure to direct-to-consumer advertising (DTCA) with medication nonadherence among individuals with serious mental disorders. Results of an anonymous survey administered at an inner-city mental health clinic were examined by using logistic regression. Nonadherence was defined as not taking prescribed medications for at least two out of seven days. Of 246 respondents, 48% reported DTCA exposure and 43% reported nonadherence. Sixty-one percent of those exposed to DTCA reported nonadherence, compared with 26% of those not exposed (adjusted odds ratio=4.96, 95% confidence interval=2.64-9.33, preporting nonadherence, 59% reported changing medication-taking behaviors or stopping prescribed medications because of side effect information in advertisements. Only a minority communicated with providers before becoming nonadherent. This study found an association between self-report of DTCA exposure and self-reported nonadherence. These results support further research on DTCA as a possible risk factor for nonadherence.

Nurses' attitude and intention of medication administration error reporting.

Science.gov (United States)

Hung, Chang-Chiao; Chu, Tsui-Ping; Lee, Bih-O; Hsiao, Chia-Chi

2016-02-01

The Aims of this study were to explore the effects of nurses' attitudes and intentions regarding medication administration error reporting on actual reporting behaviours. Underreporting of medication errors is still a common occurrence. Whether attitude and intention towards medication administration error reporting connect to actual reporting behaviours remain unclear. This study used a cross-sectional design with self-administered questionnaires, and the theory of planned behaviour was used as the framework for this study. A total of 596 staff nurses who worked in general wards and intensive care units in a hospital were invited to participate in this study. The researchers used the instruments measuring nurses' attitude, nurse managers' and co-workers' attitude, report control, and nurses' intention to predict nurses' actual reporting behaviours. Data were collected from September-November 2013. Path analyses were used to examine the hypothesized model. Of the 596 nurses invited to participate, 548 (92%) completed and returned a valid questionnaire. The findings indicated that nurse managers' and co-workers' attitudes are predictors for nurses' attitudes towards medication administration error reporting. Nurses' attitudes also influenced their intention to report medication administration errors; however, no connection was found between intention and actual reporting behaviour. The findings reflected links among colleague perspectives, nurses' attitudes, and intention to report medication administration errors. The researchers suggest that hospitals should increase nurses' awareness and recognition of error occurrence. Regardless of nurse managers' and co-workers' attitudes towards medication administration error reporting, nurses are likely to report medication administration errors if they detect them. Management of medication administration errors should focus on increasing nurses' awareness and recognition of error occurrence. © 2015 John Wiley & Sons Ltd.

Breaching confidentiality: medical mandatory reporting laws in Iran.

Science.gov (United States)

Milanifar, Alireza; Larijani, Bagher; Paykarzadeh, Parvaneh; Ashtari, Golanna; Mehdi Akhondi, Mohammad

2014-01-01

Medical ethics is a realm where four important subjects of philosophy, medicine, theology and law are covered. Physicians and philosophers cooperation in this area will have great efficiency in the respective ethical rules formation. In addition to respect the autonomy of the patient, physician's obligation is to ensure that the medical intervention has benefit for the patient and the harm is minimal. There is an obvious conflict between duty of confidentiality and duty of mandatory reporting. Professional confidentiality is one of the basic components in building a constant physician-patient relationship which nowadays, beside the novelty, it is the subject of discussion. Legal obligation of confidentiality is not absolute. In physician-patient relationship, keeping patient's secrets and maintaining confidentiality is a legal and ethical duty, and disclosure of such secrets is mainly through specific statutes. Thus, there are a number of situations where breach of confidentiality is permitted in different legal systems. One of the situations where breaching confidentiality is permitted is the medical mandatory reporting to the relevant authority which is in accordance with many countries' legal systems. Some situations are considered in many countries legal systems' such as notification of births and deaths, infectious diseases, child abuse, sport and relevant events, medical errors, drug side effects and dangerous pregnancies. In this paper, we will examine and discuss medical mandatory reporting and its ethical and legal aspects in the judicial and legal system of Iran and few other countries. Finally we will suggest making Medical Mandatory Reporting Law in Iran.

Self-Medication in University Students from the City of Mansoura, Egypt.

Science.gov (United States)

Helal, R M; Abou-ElWafa, H S

2017-01-01

Background . Self-medication is a common practice in developed and developing countries. Objectives . To explore the prevalence of self-medication practices among university students, probable reasons, symptoms requiring self-medication, and sources of advice. Methods . A descriptive cross-sectional study was carried out in Mansoura University, Egypt, and included 1st and last year students of both medical and nonmedical faculties. Results . Prevalence of self-medication was 62.9%. Younger age, female, medical, and ever-married students and those having home pharmacy tended to self-medicate more than their peers with significant difference between them. Being medical student, being from urban area, having good current health condition, being careless about health, and having drugs stored at home pharmacy were independently associated with the likelihood of self-medicating. Conclusion . Prevalence of self-medication among university students is high which constitutes a health problem that needs intervention.

The evaluation-mediation hypothesis: does the specification of potential side effects influence the perceived risk of medication?

International Nuclear Information System (INIS)

Reimer, T.

1998-01-01

Full text of publication follows: starting from the assumptions of support theory, this project analyzed the extent to which the specification of potential side effects influences the perceived risk associated, with a particular medication. Respondents were presented with an instruction leaflet for a medication which indicated (a) the overall probability that a side effect will occur or (b) the probability of occurrence of several specific side effects. Support theory predicts that the cognitive availability of potential side effects and therefore the perceived risk increases as a function of the specificity with which the side effects are presented. In contrast the evaluation-mediation hypothesis predicts that a more detailed presentation of potential side effects enhances the perceived quality of the information leaflet and thereby leads to a reduction of perceived risk. Support for the evaluation-mediation hypothesis was found in a series of studies which included the editing hypothesis and the elaboration likelihood model as additional explanations: the more detailed the information about potential side effects, the lower the estimated risk of suffering a side effect on taking the medication. As predicted, the influence of presentation specificity on perceived risk was mediated almost exclusively by the perceived quality of the information leaflet. A current series of studies seeks to support the evaluation-mediation hypothesis in a completely different domain, the perceived risk of environmental pollution by motor vehicles. (author)

Self-regulated learning and academic performance in medical education

NARCIS (Netherlands)

Lucieer, Susanna M.; Jonker, Laura; Visscher, Chris; Rikers, Remy M. J. P.; Themmen, Axel P. N.

Content: Medical schools aim to graduate medical doctors who are able to self-regulate their learning. It is therefore important to investigate whether medical students' self-regulated learning skills change during medical school. In addition, since these skills are expected to be helpful to learn

More, more, more: the dark side of self-expansion motivation.

Science.gov (United States)

Burris, Christopher T; Rempel, John K; Munteanu, Armand R; Therrien, Patrick A

2013-05-01

Self-expansion without regard for others' well-being may represent the dark side of an otherwise healthy motive. Guided by Amoebic Self-Theory (AST), we developed the Engulfing Self Scale (ESS) to measure acquisitive tendencies across AST's three domains of the self. Four studies revealed that bodily engulfment appeared generally benign, and that the problematic aspects of social engulfment were generally restricted to interpersonal contexts. Spatial-symbolic engulfment motivation was linked to a breadth of problematic indices such as psychopathy, Machiavellianism, narcissism, psychological entitlement, social dominance orientation, economic system justification, greed, and valuation of power. It also predicted reluctance to expose a cheating group leader when doing so would threaten one's own positive outcomes, greater justification of a looter's behavior when prompted take his or her perspective, and greater justification of self-serving reward allocations after defeating an ostensible competitor. Spatial-symbolic engulfment may be a motivational fountainhead for behaviors that negate others' well-being.

Self-Medication: potential risks and hazards among pregnant ...

African Journals Online (AJOL)

Self-Medication: potential risks and hazards among pregnant women in Uyo, ... Reasons for using these substances range from protection from witches and ... shows that self-medication is common among pregnant women in our environment.

Synthesis and solution self-assembly of side-chain cobaltocenium-containing block copolymers.

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Ren, Lixia; Hardy, Christopher G; Tang, Chuanbing

2010-07-07

The synthesis of side-chain cobaltocenium-containing block copolymers and their self-assembly in solution was studied. Highly pure monocarboxycobaltocenium was prepared and subsequently attached to side chains of poly(tert-butyl acrylate)-block-poly(2-hydroxyethyl acrylate), yielding poly(tert-butyl acrylate)-block-poly(2-acryloyloxyethyl cobaltoceniumcarboxylate). The cobaltocenium block copolymers exhibited vesicle morphology in the mixture of acetone and water, while micelles of nanotubes were formed in the mixture of acetone and chloroform.

The self-regulated learning of medical students in the clinical environment - a scoping review.

Science.gov (United States)

Cho, Kenneth K; Marjadi, Brahm; Langendyk, Vicki; Hu, Wendy

2017-07-10

Self-regulated learning is the individual's ability to effectively use various strategies to reach their learning goals. We conducted this scoping review to explore what has been found regarding self-regulated learning in the clinical environment and how this was measured. Using Arksey and O'Malley's five-stage framework, we searched three medical and educational databases as well as Google Scholar for literature on the self-regulated learning of medical students in the clinical environment published between 1966 and February 2017. After results were screened and relevant studies were identified, the data was summarised and discursively reported. The search resulted in 911 articles, with 14 articles included in the scoping review after the inclusion criteria was applied. Self-regulated learning was explored in these studies in various ways including qualitative, quantitative and mixed methods. Three major findings were found: 1) levels of self-regulated learning change in the clinical environment, 2) self-regulated learning is associated with academic achievement, success in clinical skills and mental health and 3) various factors can support self-regulated learning levels in medical students. Most of articles exploring the self-regulated learning of medical students during the clinical years have been published in the last 5 years, suggesting a growing interest in the area. Future research could explore the self-regulated learning levels of medical students during the clinical years using a longitudinal approach or through the use of novel qualitative approaches.

Shining the light on the dark side of medical leadership - a qualitative study in Australia.

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Loh, Erwin; Morris, Jennifer; Thomas, Laura; Bismark, Marie Magdaleen; Phelps, Grant; Dickinson, Helen

2016-07-04

Purpose The paper aims to explore the beliefs of doctors in leadership roles of the concept of "the dark side", using data collected from interviews carried out with 45 doctors in medical leadership roles across Australia. The paper looks at the beliefs from the perspectives of doctors who are already in leadership roles themselves; to identify potential barriers they might have encountered and to arrive at better-informed strategies to engage more doctors in the leadership of the Australian health system. The research question is: "What are the beliefs of medical leaders that form the key themes or dimensions of the negative perception of the 'dark side'?". Design/methodology/approach The paper analysed data from two similar qualitative studies examining medical leadership and engagement in Australia by the same author, in collaboration with other researchers, which used in-depth semi-structured interviews with 45 purposively sampled senior medical leaders in leadership roles across Australia in health services, private and public hospitals, professional associations and health departments. The data were analysed using deductive and inductive approaches through a coding framework based on the interview data and literature review, with all sections of coded data grouped into themes. Findings Medical leaders had four key beliefs about the "dark side" as perceived through the eyes of their own past clinical experience and/or their clinical colleagues. These four beliefs or dimensions of the negative perception colloquially known as "the dark side" are the belief that they lack both managerial and clinical credibility, they have confused identities, they may be in conflict with clinicians, their clinical colleagues lack insight into the complexities of medical leadership and, as a result, doctors are actively discouraged from making the transition from clinical practice to medical leadership roles in the first place. Research limitations/implications This research was

Acute liver failure and self-medication

OpenAIRE

OLIVEIRA, André Vitorio Câmara de; ROCHA, Frederico Theobaldo Ramos; ABREU, Sílvio Romero de Oliveira

2014-01-01

INTRODUCTION: Not responsible self-medication refers to drug use in high doses without rational indication and often associated with alcohol abuse. It can lead to liver damage and drug interactions, and may cause liver failure. AIM: To warn about how the practice of self-medication can be responsible for acute liver failure. METHOD: Were used the Medline via PubMed, Cochrane Library, SciELO and Lilacs, and additional information on institutional sites of interest crossing the headings acute l...

Self-Limited Kleptomania Symptoms as a Side Effect of Duloxetine

Directory of Open Access Journals (Sweden)

Christopher W. T. Miller

2016-01-01

Full Text Available Introduction. Impulse control disorders (ICDs have been described as a side effect of dopamine agonists, frequently used in neurodegenerative conditions affecting the nigrostriatal pathway. Serotonin-norepinephrine reuptake inhibitors (e.g., duloxetine have dose-dependent differential affinity for monoaminergic transporters, inhibiting the dopamine transporter at higher doses, thus increasing availability of synaptic dopamine, with the potential for similar impulse control side effects. Case Presentation. A 19-year-old Asian-American female with a history of depression developed new-onset stealing behaviors after an increase in her dose of duloxetine from 60 mg to 90 mg; she described these actions as “compulsive” and irresistible, later experiencing either relief or guilt, features compatible with an ICD. Her symptoms eventually subsided with continued use of 90 mg of duloxetine. Discussion. To the knowledge of the authors, this is the first report of a patient developing new-onset ICD behaviors after being placed on a higher dose of duloxetine, which can inhibit the dopamine transporter and cause difficulty with impulse control. The self-resolving nature of the symptoms may result from compensatory upregulation of dopamine transporters, increasing reuptake of dopamine. Asian populations may be at a higher risk due to the frequent occurrence of CYP2D6 polymorphisms, which decrease the conversion of duloxetine to its inactive metabolites.

Medical students' health behaviour and self-reported mental health status by their country of origin: a cross-sectional study.

Science.gov (United States)

Terebessy, András; Czeglédi, Edit; Balla, Bettina Claudia; Horváth, Ferenc; Balázs, Péter

2016-05-28

Numerous previous studies have investigated the lifestyle and self-perceived health status of medical students. This study examined whether students' country of origin contributed to their mental health and health risk behaviour. We conducted our cross-sectional questionnaire survey over four consecutive years (2009-2012). The target population was fourth-year English- and Hungarian-language course medical students at Semmelweis University, Hungary. We gathered data on medical students' health behaviour (tobacco smoking, alcohol consumption, dietary habits and exercise) and mental health status and used analysis of variance (ANOVA) to examine the association between country of origin and mental health. The response rate was 76.1 % for the Hungarian and 63.4 % for the English course students. The mean age of our sample was 24.1 years (SD = 2.42). Only 15.3 % of students reported following dietary recommendations, but 75.0 % reported engaging in vigorous and regular physical exercise. The prevalence of tobacco smoking was 18.6 % and 13.8 % overconsumed alcoholic beverages. Hungarian and Iranian students reported lower mental well-being than Mediterranean, Israeli and Scandinavian students (F(4) = 18.943, p mental health: vigorous exercise was associated with better mental health status (F(1) = 5.505, p = 0.019). Medical students' mental health and health behaviour are associated with multiple factors. One of these is country of origin but exercise may also influence mental health. Health promotion programmes organised for medical students should take their country of origin into consideration and should include physical activity.

The prevalence and characterization of self-medication for obtaining pain relief among undergraduate nursing students.

Science.gov (United States)

Souza, Layz Alves Ferreira; da Silva, Camila Damázio; Ferraz, Gisely Carvalho; Sousa, Fátima Aparecida Emm Faleiros; Pereira, Lílian Varanda

2011-01-01

This study investigates the prevalence of self-medication among undergraduate nursing students seeking to relieve pain and characterizes the pain and relief obtained through the used medication. This epidemiological and cross-sectional study was carried out with 211 nursing students from a public university in Goiás, GO, Brazil. A numerical scale (0-10) measured pain intensity and relief. The prevalence of self-medication was 38.8%. The source and main determining factor of this practice were the student him/herself (54.1%) and lack of time to go to a doctor (50%), respectively. The most frequently used analgesic was dipyrone (59.8%) and pain relief was classified as good (Md=8.5;Max=10;Min=0). The prevalence of self-medication was higher than that observed in similar studies. Many students reported that relief obtained through self-medication was good, a fact that can delay the clarification of a diagnosis and its appropriate treatment.

Household storage of medicines and self-medication practices in south-east Islamic Republic of Iran.

Science.gov (United States)

Foroutan, B; Foroutan, R

2014-10-12

Self-medication and inappropriate storage of medicines at home are potential health risks. This crosssectional study in south-east Islamic Republic of Iran in 2010 aimed to determine where householders kept their medicines and to assess the frequency and determinants of self-medication. Householders from different parts of Birjand city (n = 500) were visited and completed a semi-structured questionnaire. Analgesics were the most common medicines stored at home, followed by adult cold remedies and antibiotics. The refrigerator was the most common place for storing medicines (50.6%). Most householders did not consult the package inserts. Many householders (53.6%) reported that they practised self-medication, and the frequency of reuse of physicianprescribed antibiotics was high. There was a significant association between self-medication and educational level but not with age, sex, martial status, occupation and type of insurance. Better public knowledge and information about storage and risks of reuse of prescription medications is needed.

Medical students' clerkship experiences and self-perceived competence in clinical skills.

Science.gov (United States)

Katowa-Mukwato, P; Andrews, B; Maimbolwa, M; Lakhi, S; Michelo, C; Mulla, Y; Banda, S S

2014-01-01

In a traditional curriculum, medical students are expected to acquire clinical competence through the apprenticeship model using the Halstedian "see one, do one, and teach one, approach". The University of Zambia School of Medicine used a traditional curriculum model from 1966 until 2011 when a competence-based curriculum was implemented. To explore medical students' clerkships experiences and self-perceived competence in clinical skills. A cross-sectional survey was conducted on 5th, 6 th , and 7 th year medical students of the University of Zambia, School of Medicine two months prior to final examinations. Students were asked to rate their clerkship experiences with respect to specific skills on a scale of 1 to 4 and their level of self-perceived competence on a scale of 1 to 3. Skills evaluated were in four main domains: history taking and communication, physical examination, procedural, and professionalism, team work and medical decision making. Using Statistical Package for Social Scientist (SPSS), correlations were performed between experiences and self-perceived competence on specific skills, within domains and overall. Out of 197 clinical students 138 (70%) participated in the survey. The results showed significant increase in the proportion of students performing different skills and reporting feeling very competent with each additional clinical year. Overall correlations between experience and self-perceived competence were moderate (0.55). On individual skills, the highest correlation between experience and self-perceived competence were observed on mainly medical and surgical related procedural skills with the highest at 0.82 for nasal gastric tube insertion and 0.76 for endotracheal intubation. Despite the general improvement in skills experiences and self-perceived competence, some deficiencies were noted as significant numbers of final year students had never attempted common important procedures especially those performed in emergency situations

Self-reported cannabis use characteristics, patterns and helpfulness among medical cannabis users.

Science.gov (United States)

Bonn-Miller, Marcel O; Boden, Matthew Tyler; Bucossi, Meggan M; Babson, Kimberly A

2014-01-01

Little research has investigated the demographic and symptom profile of medical cannabis users in states in the USA that have legalized cannabis use. In the present cross-sectional study, we investigated the demographic profile of 217 adults currently receiving medical cannabis, as well as differences in problematic use and perceived helpfulness in terms of (i) symptoms of psychological disorders and pain, and (ii) motives for use. Findings indicated that medical cannabis users (i) use and perceive cannabis to be beneficial for multiple conditions, some for which cannabis is not specifically prescribed or allowed at the state level; and (ii) report similar rates of disordered use as compared with population estimates among regular users. Furthermore, problematic cannabis use was predicted by several symptoms of psychological disorders (e.g. depression) and a variety of use motives (e.g. coping), while cannabis was reported as particularly helpful among those with several psychological symptoms (e.g. traumatic intrusions), as well as those reporting use for social anxiety reasons. Results are discussed in terms of future directions for research given the current debates regarding legalization of cannabis for medical purposes and, more generally, the lack of empirical data to inform such debates.

Association between chronic urticaria and self-reported penicillin allergy.

Science.gov (United States)

Silverman, Susanna; Localio, Russell; Apter, Andrea J

2016-04-01

Penicillin allergy is the most commonly reported drug allergy and often presents with cutaneous symptoms. Other common diagnoses, such as chronic urticaria, may be falsely attributed to penicillin allergy. Because chronic urticaria is fairly common in the general population, evaluation of its prevalence in patients with self-reported penicillin allergy was of interest. Similarly, the prevalence of self-reported penicillin allergy in patients with chronic urticaria is not well known and also becomes interesting in light of the high prevalence of self-reported penicillin allergy in the general population. To determine the prevalence of self-reported penicillin allergy in patients with chronic urticaria and the prevalence of chronic urticaria in patients with self-reported penicillin allergy. This was a retrospective medical record review of 11,143 patients completed using the electronic health record of the University of Pennsylvania Allergy and Immunology clinic. The prevalence of self-reported penicillin allergy in patients with chronic urticaria was found to be approximately 3 times greater than in the general population. The prevalence of chronic urticaria in patients with self-reported penicillin allergy was also found to be approximately 3 times greater than in the population. This link between chronic urticaria and self-reported penicillin allergy highlights the need for clinicians to inquire about self-reported penicillin allergy in patients with chronic urticaria and to consider penicillin skin testing. Furthermore, patients who report penicillin allergy might actually have chronic urticaria, indicating the importance of inquiring about chronic urticaria symptoms in patients with self-reported penicillin allergy. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Medication Errors in a Swiss Cardiovascular Surgery Department: A Cross-Sectional Study Based on a Novel Medication Error Report Method

Directory of Open Access Journals (Sweden)

Kaspar Küng

2013-01-01

Full Text Available The purpose of this study was (1 to determine frequency and type of medication errors (MEs, (2 to assess the number of MEs prevented by registered nurses, (3 to assess the consequences of ME for patients, and (4 to compare the number of MEs reported by a newly developed medication error self-reporting tool to the number reported by the traditional incident reporting system. We conducted a cross-sectional study on ME in the Cardiovascular Surgery Department of Bern University Hospital in Switzerland. Eligible registered nurses ( involving in the medication process were included. Data on ME were collected using an investigator-developed medication error self reporting tool (MESRT that asked about the occurrence and characteristics of ME. Registered nurses were instructed to complete a MESRT at the end of each shift even if there was no ME. All MESRTs were completed anonymously. During the one-month study period, a total of 987 MESRTs were returned. Of the 987 completed MESRTs, 288 (29% indicated that there had been an ME. Registered nurses reported preventing 49 (5% MEs. Overall, eight (2.8% MEs had patient consequences. The high response rate suggests that this new method may be a very effective approach to detect, report, and describe ME in hospitals.

Self-medication in university students from the city of Rio Grande, Brazil

Science.gov (United States)

2012-01-01

Background Self-medication is the use of medication without prescription, orientation, or supervision of a physician or dentist. Self-medication might become a serious health problem. The purpose of this study was to identify the prevalence and factors associated with self-medication among first and last-year students enrolled in healthcare and non-healthcare programs. Methods A cross-sectional study was conducted at Universidade Federal do Rio Grande (FURG), state of Rio Grande do Sul, Brazil. Of 830 students in the sample, 95% answered the questionnaire – 789 students enrolled in 10 undergraduate programs. Mean age was 22 ± 6.17 years. The students answered a questionnaire covering socio-economic and demographic variables, use of medication, and medication knowledge. Information was collected on the conditions treated with medication, the medications used, and attitude towards self-medication. Results Of 789 students, 86.4% self-medicated (88.5% of 446 healthcare students). There were no significant differences in self-medication between healthcare and non-healthcare students, nor between first and last-year students. Bivariate and multivariate analyses showed a significant association between self-medication and having children (p = 0.01), having a home pharmacy (p Illicit drug use was significantly associated with self-medication in the multivariate analysis. Conclusion The fact that being a healthcare student was associated with higher medication knowledge, but not with less self-medication, suggests that medication knowledge might contribute to increase self-medication. This should be taken into account when designing educational interventions relating to self-medication. PMID:22568959

CONSUMER EXPECTATION ON SERVICE QUALITY PROVIDE BY PHARMACIST IN SELF MEDICATION PRACTICES AND ITS ASSOCIATED FACTORS IN BANDUNG, INDONESIA.

Science.gov (United States)

Alfian, Sofa D; Sinuraya, Rano K; Kautsar, Angga P; Abdulah, Rizky

2016-11-01

Self-medication is the use of medicines for therapeutic intent without a clinician’s advice or prescription. The National Socioeconomic Survey for Indonesia in 2009 found the percentage of the Indonesians engaging in self-medication is increasing. The objectives of this study were to assess consumers’ expectations regarding service quality provide by pharmacist in self-medication practices and determine the factors associated with self-medication in Bandung, Indonesia. We conduct a cross-sectional survey at eight randomly selected community pharmacies during July-November 2012 and purposely sampled 1,200 costumers purchasing medication at those sites. Subjects reported they understood the information about the medicines given by the pharmacist but still wanted more information and time to consult with the pharmacist about their medicines. Factors associated with self-medication were younger age, male gender, greater education and lower income. The intervention is needed to improve appropriate self-medication.

Changes in medical students' motivation and self-regulated learning: a preliminary study.

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Kim, Kyong-Jee; Jang, Hye W

2015-12-28

To investigate whether medical students' motivation and Self-Regulated Learning (SRL) change over time to enhance our understanding of these constructs as dependent variables in medical education. A cohort of first-year students (n=43) at a medical school in South Korea completed a self-report questionnaire on motivation and SRL--the Motivated Strategies for Learning Questionnaire (MSLQ). The same questionnaire was administered to the same cohort in the beginning of Year 2. A Wilcoxon signed-rank test was conducted to determine if changes in participants' MSLQ scores occurred between in Years 1 and 2. Forty-one students completed the questionnaires in both years (95% response rate). Participants' motivation scores significantly increased, whereas their SRL scores decreased significantly after they went through Year 1. The most notable change in participants' MLSQ scores was in the increase in their test anxiety. There was a positive association between the participants' test anxiety and their cognitive strategies use in Year 1, which changed to a negative one in Year 2. Meanwhile, participants' test anxiety scores and their self-regulation scores became more negatively associated over time. Our study shows that even as medical students become more motivated, they actually use fewer self-regulated strategies over time. Our findings highlight the need for change in the medical school's learning environment to lessen students' test anxiety to facilitate their use of cognitive and meta-cognitive strategies.

Medical students' self-efficacy in problem-based learning and its relationship with self-regulated learning.

Science.gov (United States)

Demirören, Meral; Turan, Sevgi; Öztuna, Derya

2016-01-01

Problem-based learning (PBL) is most commonly used in medical education to enhance self-regulated learning (SRL) skills. Self-efficacy beliefs affect students' motivation through self-regulatory processes. The purpose of this study is to examine the relationship between medical students' self-reported SRL skills and their self-efficacy in PBL. A cross-sectional study was conducted with second (286; 83.1%) and third (275; 80.2%) year students at the Ankara University School of Medicine. The SRL perception (SRLP) scale and self-efficacy for problem-based learning (SPBL) scale were used in the study. The SRLP subscales were positively correlated with the SPBL subscales. There was a weak but meaningful correlation between the subscales of SRLP (with the exception of the lack of self-directedness scale) and the subscales of SPBL and the students' views on benefiting from PBL. The female students' mean score was higher for the 'planning and goal setting' subscale of SRLP (p=0.017), and the second-year students' mean score was higher than that of the third-year students for the 'lack of self-directedness' subscale of SRLP (p=0.001) with small effect sizes (Cohen's d is 0.17 and 0.27). There was no statistically significant difference between the year and subscales of SPBL. With regard to gender, the female students had higher scores than the male students on the 'responsibility' subscale of SPBL (p=0.003; Cohen's d=0.26). The study showed that medical students used SRL skills and believed in their ability to learn effectively in the PBL context and demonstrated the relationship between SRL skills and self-efficacy beliefs. Monitoring students' development in these skills and giving them feedback could be beneficial for the cognitive achievement of students with learning difficulties and insufficient study skills. Further studies need to be undertaken to investigate issues such as the curriculum, learning environment, individual differences, and how these can affect the

Medical students’ self-efficacy in problem-based learning and its relationship with self-regulated learning

Science.gov (United States)

Demirören, Meral; Turan, Sevgi; Öztuna, Derya

2016-01-01

Background Problem-based learning (PBL) is most commonly used in medical education to enhance self-regulated learning (SRL) skills. Self-efficacy beliefs affect students’ motivation through self-regulatory processes. The purpose of this study is to examine the relationship between medical students’ self-reported SRL skills and their self-efficacy in PBL. Methods A cross-sectional study was conducted with second (286; 83.1%) and third (275; 80.2%) year students at the Ankara University School of Medicine. The SRL perception (SRLP) scale and self-efficacy for problem-based learning (SPBL) scale were used in the study. Results The SRLP subscales were positively correlated with the SPBL subscales. There was a weak but meaningful correlation between the subscales of SRLP (with the exception of the lack of self-directedness scale) and the subscales of SPBL and the students’ views on benefiting from PBL. The female students’ mean score was higher for the ‘planning and goal setting’ subscale of SRLP (p=0.017), and the second-year students’ mean score was higher than that of the third-year students for the ‘lack of self-directedness’ subscale of SRLP (p=0.001) with small effect sizes (Cohen's d is 0.17 and 0.27). There was no statistically significant difference between the year and subscales of SPBL. With regard to gender, the female students had higher scores than the male students on the ‘responsibility’ subscale of SPBL (p=0.003; Cohen's d=0.26). Conclusions The study showed that medical students used SRL skills and believed in their ability to learn effectively in the PBL context and demonstrated the relationship between SRL skills and self-efficacy beliefs. Monitoring students’ development in these skills and giving them feedback could be beneficial for the cognitive achievement of students with learning difficulties and insufficient study skills. Further studies need to be undertaken to investigate issues such as the curriculum, learning

Medical students’ self-efficacy in problem-based learning and its relationship with self-regulated learning

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Meral Demirören

2016-03-01

Full Text Available Background: Problem-based learning (PBL is most commonly used in medical education to enhance self-regulated learning (SRL skills. Self-efficacy beliefs affect students’ motivation through self-regulatory processes. The purpose of this study is to examine the relationship between medical students’ self-reported SRL skills and their self-efficacy in PBL. Methods: A cross-sectional study was conducted with second (286; 83.1% and third (275; 80.2% year students at the Ankara University School of Medicine. The SRL perception (SRLP scale and self-efficacy for problem-based learning (SPBL scale were used in the study. Results: The SRLP subscales were positively correlated with the SPBL subscales. There was a weak but meaningful correlation between the subscales of SRLP (with the exception of the lack of self-directedness scale and the subscales of SPBL and the students’ views on benefiting from PBL. The female students’ mean score was higher for the ‘planning and goal setting’ subscale of SRLP (p=0.017, and the second-year students’ mean score was higher than that of the third-year students for the ‘lack of self-directedness’ subscale of SRLP (p=0.001 with small effect sizes (Cohen's d is 0.17 and 0.27. There was no statistically significant difference between the year and subscales of SPBL. With regard to gender, the female students had higher scores than the male students on the ‘responsibility’ subscale of SPBL (p=0.003; Cohen's d=0.26. Conclusions: The study showed that medical students used SRL skills and believed in their ability to learn effectively in the PBL context and demonstrated the relationship between SRL skills and self-efficacy beliefs. Monitoring students’ development in these skills and giving them feedback could be beneficial for the cognitive achievement of students with learning difficulties and insufficient study skills. Further studies need to be undertaken to investigate issues such as the curriculum

Self-reported use of evidence-based medicine and smoking ...

African Journals Online (AJOL)

Self-reported use of evidence-based medicine and smoking cessation 6 - 9 months after acute coronary syndrome: A single-centre perspective. ... questionnaire detailing current medication use, reasons for non-adherence and smoking status.

Prevalence of Self-Medication of Psychoactive Stimulants and ...

African Journals Online (AJOL)

Purpose: To evaluate the prevalence of self-medication of psychoactive stimulants and antidepressants among pharmacy students of Pakistan. Methods: A cross-sectional survey on self-medication of psychoactive stimulants and antidepressants among pharmacy students was conducted with a structured and validated ...

[Factors associated with self-directed learning among medical students].

Science.gov (United States)

Spormann R, Camila; Pérez V, Cristhian; Fasce H, Eduardo; Ortega B, Javiera; Bastías V, Nancy; Bustamante D, Carolina; Ibáñez G, Pilar

2015-03-01

Self-directed learning is a skill that must be taught and evaluated in future physicians. To analyze the association between self-directed learning, self-esteem, self-efficacy, time management and academic commitment among medical students. The self-directed learning, Rosemberg self-esteem, general self- efficacy, time management and Utrecht work engagement scales were applied to 297 first year medical students. A multiple regression analysis showed a significant association between self-efficacy, time management and academic commitment with self-directed learning. Self-esteem and satisfaction with studies did not enter in the model. self-esteem, academic commitment and a good time management were associated with self-directed learning in these students.

Self-Medication Practice and Associated Factors among Residents in Wuhan, China

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Xiaosheng Lei

2018-01-01

Full Text Available Background: This study aims to examine the prevalence and predictors associated with self-medication, and related consequences in Wuhan, China. Methods: Two-hundred-sixty residents were interviewed from randomly selected four districts of Wuhan, China. A modified version of Anderson’s health behavioral model was used in the survey to collect information of self-medication behavior. Multivariable logistic regression analyses were used to measure correlates of the prevalence of self-medication. Results: Nearly half of the respondents would select self-medication, and 39.1% would see a doctor if they felt sick. The most common self-medicated illnesses were cold and cough, cardiovascular disease and gastrointestinal disease. The main reasons for self-medication were that the illness was not severe (enough to see the doctor (45%; the patient did not think that the trouble of seeing a doctor was worth the effort (23%; the patient had no time to see the doctor (12%, and the patient did not want to pay high medical costs (15%. Logistic regression results suggested that respondents tended to select self-medication if the illness was minor or short-term (less than seven days. Conclusions: Our findings suggest that more strict regulation on over-the-counter medicines may be required to reduce health risks related to self-medication. Targeted health education on the risks of self-medication should be considered.

Self-medication in university students from the city of Rio Grande, Brazil

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Corrêa da Silva Marília

2012-05-01

Full Text Available Abstract Background Self-medication is the use of medication without prescription, orientation, or supervision of a physician or dentist. Self-medication might become a serious health problem. The purpose of this study was to identify the prevalence and factors associated with self-medication among first and last-year students enrolled in healthcare and non-healthcare programs. Methods A cross-sectional study was conducted at Universidade Federal do Rio Grande (FURG, state of Rio Grande do Sul, Brazil. Of 830 students in the sample, 95% answered the questionnaire – 789 students enrolled in 10 undergraduate programs. Mean age was 22 ± 6.17 years. The students answered a questionnaire covering socio-economic and demographic variables, use of medication, and medication knowledge. Information was collected on the conditions treated with medication, the medications used, and attitude towards self-medication. Results Of 789 students, 86.4% self-medicated (88.5% of 446 healthcare students. There were no significant differences in self-medication between healthcare and non-healthcare students, nor between first and last-year students. Bivariate and multivariate analyses showed a significant association between self-medication and having children (p = 0.01, having a home pharmacy (p p = 0.01. The most frequently used active ingredients were acetaminophen (paracetamol, dipyrone, aspirin, phytotherapic compounds, and tea. Illicit drug use was significantly associated with self-medication in the multivariate analysis. Conclusion The fact that being a healthcare student was associated with higher medication knowledge, but not with less self-medication, suggests that medication knowledge might contribute to increase self-medication. This should be taken into account when designing educational interventions relating to self-medication.

Self-medication for infants with colic in Lagos, Nigeria

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Oshikoya Kazeem A

2009-02-01

Full Text Available Abstract Background Infantile colic is a self-limiting condition that is distributed worldwide. It is often misdiagnosed as an organic disease for which an infant is admitted to the hospital. Many studies have described the aetiopathogenesis, pharmacologic and non-pharmacologic management of colic but none has evaluated self-medication for infants with colic. The aim of this study was therefore to determine the knowledge of Nigerian mothers about colic, their home-based management, extent of self-medication for the infants with colic and the types of medicines involved. Methods It is a prospective study conducted at the vaccination clinics of 20 primary health care centres, each from different Local Government Areas in Lagos, Nigeria. Eight hundred mothers that brought their infants for vaccination between April and September, 2006 were interviewed with open-and close-ended questionnaire. Results Six hundred and eighty three (85.4% mothers claimed they had a good knowledge of colic. Incessant and excessive cry was the main clinical feature of colic identified by 430(62.9% mothers. Three hundred and seventy eight (67.7% infants were treated by self-medication, 157 (28.1% sought medical intervention and 17 (3.1% were treated at a traditional birth attendant home. Herbal medicines constituted 51.8% of the self-medicated medicines, of which 48 (26.2% were "Ororo Ogiri". Nospamin® (49.5% and Gripe water® (43.0% were the two frequently prescribed and self-medicated medicines for infants with colic. Conclusion Nigerian mothers are deficient in their knowledge of colic. Self-medication was the most frequently used home-based intervention. Health education would appear necessary to improve parental management of this self-limiting condition.

The relationship between self-reported oral health, self-regulation, proactive coping, procrastination and proactive attitude.

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Dumitrescu, A L; Dogaru, B C; Dogaru, C D; Manolescu, B

2011-06-01

This cross-sectional study investigated the relationship between self-regulation, proactive coping, procrastination and proactive attitude, perceived oral health and self-reported oral-health behaviours. The study sample consisted of 198 first year medical students. The questionnaire included information about socio-demographic factors, behavioural variables, self-reported oral health status, proactive coping (proactive coping subscale of the Proactive Coping Inventory), procrastination (Procrastination Scale) and proactive attitude (Proactive Attitude Scale). Significant differences were found on self-regulation, proactive coping, procrastination and proactive attitude scales between participants who rated their gingival condition as very good/excellent and those who evaluated it as being poor, very poor or normal (p procrastination level among individuals who never visit their dentist and those who visit their dentist for check-up or for tooth cleaning and scaling (p = 0.001) or when treatment is needed or when in pain (p procrastination and proactive coping are important determinants of perceived oral health and self-reported oral-health behaviours.

Diode-side-pumped continuous wave Nd³⁺ : YVO₄ self-Raman laser at 1176 nm.

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Kores, Cristine Calil; Jakutis-Neto, Jonas; Geskus, Dimitri; Pask, Helen M; Wetter, Niklaus U

2015-08-01

Here we report, to the best of our knowledge, the first diode-side-pumped continuous wave (cw) Nd3+:YVO4 self-Raman laser operating at 1176 nm. The compact cavity design is based on the total internal reflection of the laser beam at the pumped side of the Nd3+:YVO4 crystal. Configurations with a single bounce and a double bounce of the laser beam at the pumped faced have been characterized, providing a quasi-cw peak output power of more than 8 W (multimode) with an optical conversion efficiency of 11.5% and 3.7 W (TEM00) having an optical conversion efficiency of 5.4%, respectively. Cw output power of 1.8 W has been demonstrated.

Medication storage and self-medication behaviour amongst female students in Malaysia

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Ali SE

2010-12-01

Full Text Available Objectives: The aims of this study are to determine the prevalence, attitudes and behaviours of medication storage and self-medication amongst female students at Universiti Sains Malaysia (USM. Methods: A cross-sectional survey was conducted and cluster random sampling technique was used for respondent selection. A pre-piloted questionnaire was administered to female respondents so as to collect the data. Data was analyzed using SPSS version 12 and analysis was conducted using descriptive analysis procedures.Results: Of the 481 participants (mean age; SD was 22.1; 3.3, 93.1% (n=448 students stated that they stored medicine in their rooms, while 70.7% (n=340 stated that they stopped taking a prescribed medicine without consulting a doctor. The prevalence of self-medication was 80.9% (n=389. The most common reasons for self-medication were related to their knowledge of their ailment and its treatment (58.0%, 14.4% thought it saved time and 8.5% mentioned that medication given by provider was not effective. The most common symptoms were otorhinolaryngology problems (22.5%, followed by respiratory disease (19.6%, Gastro Intestinal Tract (GIT disease (18.1% and headache/fever (16.8%. Commonly used medicines were analgesics & antipyretics (30.2%, ear, nose & throat drugs (10.8%, vitamins & minerals (10.8%, GIT drugs (8.5%, anti-infections (7.3% and herbal medicines (3.5%. Prevalence of medicine storage and self-medication practice is high among educated female students in USM.Conclusions: There is a need to educate the students to ensure safe practice by increasing their awareness. Strict policies need to be implemented on the unrestricted availability of medicines so as to prevent the wastage of medicines.

Self-medication in Central Saudi Arabia. Community pharmacy consumers' perspectives.

Science.gov (United States)

Aljadhey, Hisham; Assiri, Ghada A; Mahmoud, Mansour A; Al-Aqeel, Sinaa; Murray, Michael

2015-03-01

To determine the prevalence of self-medication and assess the knowledge, attitudes, and perception of consumers toward self-medication. This cross-sectional survey was conducted over 4 weeks in May 2011 in Riyadh city, Kingdom of Saudi Arabia. Community pharmacies within 5 areas of the city (North, South, West, East, and Middle) were randomly selected for the study. All consumers were approached to participate in the study, with the exception of those buying cosmetic and medicinal equipments. A validated self-administered questionnaire was used to collect the data. A total of 538 out of 707 consumers attending community pharmacies in Riyadh city, agreed to participate in the study. Most responders were male (73%), 23-33 years old (35%), and college graduates (42%). A total of 285 medications were bought without a prescription. Of these, 149 (49%) medications should be dispensed by prescription only, and 155 (51%) were over the counter medications. The most common prescription medications dispensed without prescriptions were antibiotics (22%) and analgesics/antipyretics (19%). The most common reasons for buying medications without a prescription were that the symptoms were too minor to visit a doctor (54%), time saving (40%), and minor illnesses for which the participants knew the required treatment (40%). Overall, most participants had poor knowledge, and negative perceptions regarding self-medication. More than 68% of participants did not know whether the medicine they bought is a prescription-only or over the counter medication. Irresponsible self-medication is common in Saudi Arabia. Future studies should focus on improving the consumers' awareness of self-medication and the proper use of medications.

Parental Expectation of Side Effects Following Vaccination Is Self-fulfilling: A Prospective Cohort Study.

Science.gov (United States)

Smith, Louise E; Weinman, John; Amlôt, Richard; Yiend, Jenny; Rubin, G James

2018-06-02

One of the major factors contributing to parental refusal of vaccinations is the perception that vaccines cause side effects. Although symptoms are commonly reported following vaccinations, their causes are not always straightforward. Although some may be directly attributable to the vaccine itself, others may reflect pre-existing or coincidental symptoms that are misattributed to the vaccine. To investigate psychological factors associated with parental report of side effects following vaccination with the child influenza vaccine, and parental intention to re-vaccinate one's child the following year. A prospective cohort study was run in primary care practices in London in the 2016-2017 influenza season (ClinicalTrials.gov number NCT02909855). Two hundred seventy parents from 14 practices completed a questionnaire before their child's vaccination. Follow-up questionnaires were completed 3 days after vaccination and one month after vaccination. Parental report of side effects and vaccination intention for the subsequent year were measured. Parental report of side effects was strongly associated with pre-vaccination expectation of side effects. Suggestions received from the media, National Health Service (NHS) vaccination leaflet, and health care workers, as well as uncertainty-related beliefs, perceived sensitivity of the child to medicines, pessimism, and anxiety were also associated with reporting side effects. Side effect report was associated with lower vaccination intention for the following influenza season. Side effect perception following vaccination is influenced by psychological factors, in particular expectations. Perceiving side effects reduces future vaccination intention. Future public health communications should aim to decrease unrealistic expectations of side effects to increase vaccine uptake.

Self-citation of Medical and Non-medical Universities in Northern Iran.

Science.gov (United States)

Jahani, Mohammad Ali; Yaminfirooz, Mousa

2016-12-01

Self-citation is one of the main challenges in the evaluation of researchers' scientific output. This study aimed at comparing the institutional self-citation among the universities located in Northern Iran. This study was conducted as a scientometric study. Research population included all scientific productions of 16 Northern Iran Universities with at least 100 indexed documents indexed in the Web of Science (WoS) by 2 June 2015. The citation analysis section of WoS was used for data collection. SPSS was applied for data analysis. Study hypotheses were tested with two independent sample t-test and paired sample t-test. Producing 16,399 papers, northern Iran universities had 5.33% of contribution in Iran's scientific production. They received 84,058 citations with 17% and 12% of self-citations belonged to the non-medical and medical universities, respectively. Testing hypotheses revealed that increase in received citations significantly increases the rate of self-citation and increase in scientific production does not necessarily increase the rate of self-citation. The rate of self-citation in the studied universities was not relatively high. However, investigating into the factors affecting the rate of and motives for self-citation needs further research.

Self-medication and related health complaints among expatriate high school students in the United Arab Emirates

Science.gov (United States)

Shehnaz, Syed Ilyas; Khan, Nelofer; Sreedharan, Jayadevan; Issa, Khaled Jamal; Arifulla, Mohamed

Background Self-medication, often without adult guidance, has been reported to be a common practice during adolescence. Similar to other preventable health-risk behaviors initiated in early adolescence, it has become a cause for concern universally. Objective This study examines the prevalence of self-medication with both prescribed and non-prescribed (OTC) medications, related health complaints, sources of drugs, and sources of drug recommendation, and gender differences related to self-medication among expatriate high school students in the United Arab Emirates (UAE). Methods A cross-sectional survey was conducted among 324 expatriate students through a validated, self-administered questionnaire and data was analyzed using SPSS 19 version. Means and proportions were calculated and Pearson Chi-square test of significance was used to analyze association among variables. Results Majority of the participating students, almost equally distributed by gender, was aged 16 to 17 years. The period prevalence rate of self-medication with prescribed and OTC medications were 89.2%, which did not vary with age, gender, ethnicity or parents’ educational level. The most common sources of drug and drug recommendation were community pharmacies and parents respectively. Headache and fever were the common self-medicated conditions and consequently, analgesics and antipyretics were most commonly used both in the previous two weeks and the previous year prior to the survey. A high prevalence of self-medication with antibiotics (53%) and sedative/hypnotics (27%) was also observed. A female excess emerged for certain health complaints and use of medicines except for the use of anti-allergic and herbal/homeopathic drugs. Conclusions This is the first study to explore self-medication practices among high school students in UAE and provides baseline data critical in creating awareness about the risks and benefits of self-medication. Health care providers, educators and parents should be

Facilitated Nurse Medication-Related Event Reporting to Improve Medication Management Quality and Safety in Intensive Care Units.

Science.gov (United States)

Xu, Jie; Reale, Carrie; Slagle, Jason M; Anders, Shilo; Shotwell, Matthew S; Dresselhaus, Timothy; Weinger, Matthew B

Medication safety presents an ongoing challenge for nurses working in complex, fast-paced, intensive care unit (ICU) environments. Studying ICU nurse's medication management-especially medication-related events (MREs)-provides an approach to analyze and improve medication safety and quality. The goal of this study was to explore the utility of facilitated MRE reporting in identifying system deficiencies and the relationship between MREs and nurses' work in the ICUs. We conducted 124 structured 4-hour observations of nurses in three different ICUs. Each observation included measurement of nurse's moment-to-moment activity and self-reports of workload and negative mood. The observer then obtained MRE reports from the nurse using a structured tool. The MREs were analyzed by three experts. MREs were reported in 35% of observations. The 60 total MREs included four medication errors and seven adverse drug events. Of the 49 remaining MREs, 65% were associated with negative patient impact. Task/process deficiencies were the most common contributory factor for MREs. MRE occurrence was correlated with increased total task volume. MREs also correlated with increased workload, especially during night shifts. Most of these MREs would not be captured by traditional event reporting systems. Facilitated MRE reporting provides a robust information source about potential breakdowns in medication management safety and opportunities for system improvement.

Adolescent Self-Reported and Peer-Reported Self-Esteem.

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O'Donnell, William James

1979-01-01

The study is an examination of the relationship between adolescents' self-reported and peer-reported self-esteem and how this relationship is affected by sex, race, and age variables. Significant sex and race variations interacted with age. Explanatory hypotheses for these findings are given. (Author/KC)

Statin Use and Self-Reported Hindering Muscle Complaints in Older Persons: A Population Based Study.

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Milly A van der Ploeg

Full Text Available Statins are widely used by older persons in primary and secondary prevention of cardiovascular disease. Although serious adverse events are rare, many statin users report mild muscle pain and/or muscle weakness. It's unclear what impact statins exert on a patient's daily life. Research on statin related side effects in older persons is relatively scarce. We therefore investigated the relation between statin use and self-reported hindering muscle complaints in older persons in the general population.The present research was performed within the Integrated Systematic Care for Older Persons (ISCOPE study in the Netherlands (Netherlands trial register, NTR1946. All registered adults aged ≥ 75 years from 59 participating practices (n = 12,066 were targeted. Information about the medical history and statin use at baseline and after 9 months was available for 4355 participants from the Electronic Patient Records of the general practitioners. In the screening questionnaire at baseline we asked participants: 'At the moment, which health complaints limit you the most in your day-to-day life?' Answers indicating muscle or musculoskeletal complaints were coded as such. No specific questions about muscle complaints were asked.The participants had a median age of 80.3 (IQR 77.6-84.4 years, 60.8% were female and 28.5% had a history of CVD. At baseline 29% used a statin. At follow-up, no difference was found in the prevalence of self-reported hindering muscle complaints in statin users compared to non-statin users (3.3% vs. 2.5%, OR 1.39, 95% CI 0.94-2.05; P = 0.98. Discontinuation of statin use during follow-up was independent of self-reported hindering muscle complaints.Based on the present findings, prevalent statin use in this community-dwelling older population is not associated with self-reported hindering muscle complaints; however, the results might be different for incident users.

Statin Use and Self-Reported Hindering Muscle Complaints in Older Persons: A Population Based Study.

Science.gov (United States)

van der Ploeg, Milly A; Poortvliet, Rosalinde K E; van Blijswijk, Sophie C E; den Elzen, Wendy P J; van Peet, Petra G; de Ruijter, Wouter; Blom, Jeanet W; Gussekloo, Jacobijn

2016-01-01

Statins are widely used by older persons in primary and secondary prevention of cardiovascular disease. Although serious adverse events are rare, many statin users report mild muscle pain and/or muscle weakness. It's unclear what impact statins exert on a patient's daily life. Research on statin related side effects in older persons is relatively scarce. We therefore investigated the relation between statin use and self-reported hindering muscle complaints in older persons in the general population. The present research was performed within the Integrated Systematic Care for Older Persons (ISCOPE) study in the Netherlands (Netherlands trial register, NTR1946). All registered adults aged ≥ 75 years from 59 participating practices (n = 12,066) were targeted. Information about the medical history and statin use at baseline and after 9 months was available for 4355 participants from the Electronic Patient Records of the general practitioners. In the screening questionnaire at baseline we asked participants: 'At the moment, which health complaints limit you the most in your day-to-day life?' Answers indicating muscle or musculoskeletal complaints were coded as such. No specific questions about muscle complaints were asked. The participants had a median age of 80.3 (IQR 77.6-84.4) years, 60.8% were female and 28.5% had a history of CVD. At baseline 29% used a statin. At follow-up, no difference was found in the prevalence of self-reported hindering muscle complaints in statin users compared to non-statin users (3.3% vs. 2.5%, OR 1.39, 95% CI 0.94-2.05; P = 0.98). Discontinuation of statin use during follow-up was independent of self-reported hindering muscle complaints. Based on the present findings, prevalent statin use in this community-dwelling older population is not associated with self-reported hindering muscle complaints; however, the results might be different for incident users.

Assessing the Accuracy of Self-Reported Self-Talk

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Thomas M. Brinthaupt

2015-05-01

Full Text Available Self-Talk Scale (STS; Brinthaupt, Hein, & Kramer, 2009 is a self-report measure of self-talk frequency that has been shown to possess acceptable reliability and validity. However, no research using the STS has examined the accuracy of respondents’ self-reports. In the present paper, we report a series of studies directly examining the measurement of self-talk frequency and functions using the STS. The studies examine ways to validate self-reported self-talk by (1 comparing STS responses from 6 weeks earlier to recent experiences that might precipitate self-talk, (2 using experience sampling methods to determine whether STS scores are related to recent reports of self-talk over a period of a week, and (3 comparing self-reported STS scores to those provided by a significant other who rated the target on the STS. Results showed that (1 overall self-talk scores, particularly self-critical and self-reinforcing self-talk, were significantly related to reports of context-specific self-talk; (2 high STS scorers reported talking to themselves significantly more often during recent events compared to low STS scorers, and, contrary to expectations, (3 friends reported less agreement than strangers in their self-other self-talk ratings. Implications of the results for the validity of the STS and for measuring self-talk are presented.

A social media self-evaluation checklist for medical practitioners.

Science.gov (United States)

Visser, Benjamin J; Huiskes, Florian; Korevaar, Daniel A

2012-01-01

Increasing numbers of medical practitioners and medical students are using online social and business-related networking websites such as Facebook, Doc2doc and LinkedIn. These rapidly evolving and growing social media have potential to promote public health by providing powerful instruments for communication and education. However, evidence is emerging from studies, legal cases, and media reports that the use of these new technologies is creating several ethical problems for medical practitioners as well as medical students. Improper online activities may harm not only individual reputations and careers, but also the medical profession as a whole, for example by breach of patient confidentiality, defamation of colleagues and employers, undisclosed conflict of interests that bias the medical practitioner's medical advice, posting of advice/information without an evidence base, and infringement of copyright. We developed a self-evaluation checklist for medical practitioners using social media. The checklist addresses three key elements in the use of social media: personal information and accessibility, connections, and postings. It contains questions specifically formulated to evaluate a medical practitioner's social media profile, to prevent unintended, improper online activities and to promote professional online behaviour.

Are patients reliable when self-reporting medication use? Validation of structured drug interviews and home visits by drug analysis and prescription data in acutely hospitalized patients

DEFF Research Database (Denmark)

Glintborg, Bente; Hillestrøm, Peter René; Olsen, Lenette Holm

2007-01-01

inspected, and patients were interviewed about their drug use. Additional blood samples were drawn for drug analysis. The median age of included patients was 72 years, and 298 patients (60%) were women. Patients reported use of 3 (median) prescription-only medications (range, 0-14) during the structured...... interview. The congruence between self-report and drug analysis was high for all 5 drugs measured (all kappa >0.8). However, 9 patients (2%) reported use of drugs that were not detected in their blood samples. In 29 patients (6%), the blood samples contained drugs not reported during the structured...... to an acute medical department at a Danish university hospital were interviewed on the day of admission about their recent medication use. Blood samples drawn immediately after admission were screened for contents of 5 drugs (digoxin, bendroflumethiazide, amlodipine, simvastatin, glimepiride), and the results...

Impact of an undergraduate course on medical students’ self-perceived nutrition intake and self-efficacy to improve their health behaviours and counselling practices

Directory of Open Access Journals (Sweden)

Crowley J

2014-06-01

Full Text Available INTRODUCTION: Doctors are increasingly involved in the management of chronic disease and counsel patients about their lifestyle behaviours, including nutrition, to improve their health outcomes. AIM: This study aimed to assess the impact of a medical undergraduate course containing nutrition content on medical students’ self-perceived nutrition intake and self-efficacy to improve their health behaviours and counselling practices. METHODS: A total of 239 medical students enrolled in a 12-week nutrition-related course at The University of Auckland were invited to complete an anonymous questionnaire before and after the course. The questionnaire was adapted from a previous evaluation of a preventive medicine and nutrition course at Harvard Medical School. RESULTS: Sixty-one medical students completed both pre- and post-course questionnaires (25.5%. At baseline, medical students described their eating habits to be more healthy than non-medical students (p=0.0261. Post-course, medical students reported a higher frequency of wholegrain food intake (p=0.0229. Medical students also reported being less comfortable making nutrition recommendations to family and friends post-course (p=0.008. Most medical students (63.9% perceived increased awareness of their own dietary choices, and some (15.3% reported an increased likelihood to counsel patients on lifestyle behaviour post-course. DISCUSSION: Students can increase awareness of their own nutrition behaviour after undertaking a course that includes nutrition in the initial phase of their medical degree. Further investigation of how medical students’ confidence to provide nutrition advice evolves throughout their training and in future practice is required.

[The Results of Self-Assessment by Medical Organizations Their Correspondence to Proposals (Practical Recommendations) of the Roszdravnadzor Concerning Organization of Internal Control of Quality and Safety of Medical Activity].

Science.gov (United States)

Ivanov, I V; Shvabsky, O R; Minulin, I B

2017-11-01

The article presents the analysis of the results of internal audits (self-rating) in medical organizations implemented on the basis of Proposals (practical guidelines) of the Roszdravnadzor concerning organization of inner control of quality and safety of medical activities in medical organization (hospital). The self-rating was implemented by the medical organizations themselves according the common criteria of the Proposals as provided the following plan: planning of self-rating, collection and processing of data, application of self-rating, analysis of obtained results, preparation of report. The article uses the results of self-rating of medical organizations corresponding to following criteria: profile of activity-multi-field hospital-number of beds more than 350-state property. The self-rating was implemented according to 11 basic parts of the Proposals. The criteria were developed for every part. The evaluation lists developed on the basis of the given Proposals permitted to medical organizations to independently establish problems in their activities. Within the framework of implemented self-rating medical organizations mentioned the directions of activity related to personnel management, identification of personality of patient, support of epidemiological and surgical safety as having significant discrepancies with the Proposals and requiring implementation of improvement measures.

Malaria self-medication among students of a Nigerian Tertiary ...

African Journals Online (AJOL)

67%) practice self medication. One hundred and fifty students (60%) believe self medication should be discouraged and most of them 98(55.4%) believe it encourages drug abuse. Conclusion: The students treat themselves when they believe ...

Prevalence of self-medication in Brazil and associated factors.

Science.gov (United States)

Arrais, Paulo Sérgio Dourado; Fernandes, Maria Eneida Porto; Pizzol, Tatiane da Silva Dal; Ramos, Luiz Roberto; Mengue, Sotero Serrate; Luiza, Vera Lucia; Tavares, Noemia Urruth Leão; Farias, Mareni Rocha; Oliveira, Maria Auxiliadora; Bertoldi, Andréa Dâmaso

2016-12-01

To analyze the prevalence and associated factors regarding the use of medicines by self-medication in Brazil. This cross-sectional population-based study was conducted using data from the PNAUM (National Survey on Access, Use and Promotion of Rational Use of Medicines), collected between September 2013 and February 2014 by interviews at the homes of the respondents. All people who reported using any medicines not prescribed by a doctor or dentist were classified as self-medication practitioners. Crude and adjusted prevalence ratios (Poisson regression) and their respective 95% confidence intervals were calculated in order to investigate the factors associated with the use of self-medication by medicines. The independent variables were: sociodemographic characteristics, health conditions and access to and use of health services. In addition, the most commonly consumed medicines by self-medication were individually identified. The self-medication prevalence in Brazil was 16.1% (95%CI 15.0-17.5), with it being highest in the Northeast region (23.8%; 95%CI 21.6-26.2). Following the adjusted analysis, self-medication was observed to be associated with females, inhabitants from the North, Northeast and Midwest regions and individuals that have had one, or two or more chronic diseases. Analgesics and muscle relaxants were the therapeutic groups most used for self-medication, with dipyrone being the most consumed medicines. In general, most of the medicines used for self-medication were classified as non-prescriptive (65.5%). Self-medication is common practice in Brazil and mainly involves the use of non-prescription medicines; therefore, the users of such should be made aware of the possible risks. Analisar a prevalência e os fatores associados à utilização de medicamentos por automedicação no Brasil. Este estudo transversal de base populacional foi realizado com dados da Pesquisa Nacional de Acesso, Utilização e Promoção do Uso Racional de medicamentos (PNAUM

Self-reported adherence rates in glaucoma patients in Southwest Nigeria

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Adeola Olukorede Onakoya

2016-01-01

Full Text Available Context: Nigerian glaucoma patients have an aversion to surgery and often rely on medical therapy to prevent disease progression. For medical therapy to be effective, the drugs have to be used as prescribed. Compliance has been reported to be low in the previous Nigerian studies. Aims: To evaluate the adherence rates of primary open angle glaucoma (POAG patients on medical therapy using patient self-report. Settings and Design: A hospital-based cross-sectional design was used to assess consecutive POAG patients attending a glaucoma clinic in a Tertiary Hospital in Lagos, Nigeria. Subjects and Methods: Self-reported adherence was evaluated by trained interviewers. Comprehensive clinical assessment including intraocular pressure, gonioscopy, visual field assessment, and dilated binocular funduscopy using the slit lamp and + 78D fundus lens was done. Statistical Analysis Used: Data analysis was done using MedCalc Statistical Software. Results: One hundred and fourteen patients reported adherence rates ranging from 10% to 100% with a mean adherence rate of 82.33% ± 19.25%. Only 31 respondents (27.2% reported 100% adherence. Duration of the disease was the only significant factor on multiple regression analysis. Conclusions: The development of strategies to improve compliance and persistence in glaucoma patients is crucial for the reduction of disease progression and blindness.

Ruminant self-medication against gastrointestinal nematodes: evidence, mechanism, and origins☆

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Villalba, Juan J.; Miller, James; Ungar, Eugene D.; Landau, Serge Y.; Glendinning, John

2014-01-01

Gastrointestinal helminths challenge ruminants in ways that reduce their fitness. In turn, ruminants have evolved physiological and behavioral adaptations that counteract this challenge. Ruminants display anorexia and avoidance behaviors, which tend to reduce the incidence of parasitism. In addition, ruminants appear to learn to self-medicate against gastrointestinal parasites by increasing consumption of plant secondary compounds with antiparasitic actions. This selective feeding improves health and fitness. Here, we review the evidence for self-medication in ruminants, propose a hypothesis to explain self-medicative behaviors (based on post-ingestive consequences), and discuss mechanisms (e.g., enhanced neophilia, social transmission) that may underlie the ontogeny and spread of self-medicative behaviors in social groups. A better understanding of the mechanisms that underlie and trigger self-medication in parasitized animals will help scientists devise innovative and more sustainable management strategies for improving ruminant health and well-being. PMID:24971486

Prevalence of self-medication practices and its associated factors in Urban Puducherry, India

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Kalaiselvi Selvaraj

2014-01-01

Full Text Available Background and Objectives: Self medication is an important concern for health authorities at global level. This study was aimed to find the prevalence of self medication for allopathic drugs and associated factors among households of urban community. This study was also aimed at assessing the attitude of respondents who had experienced self-medication. Materials and Methods: This cross-sectional study was done in field practice area attached to a medical institution in urban Puducherry. A total of 352 subjects from 124 households were selected by random sampling. With pretested interview schedule, information regarding self-medication use in the past three months and associated sociodemographic factors, purpose, source of drug procurement, attitude toward self-medication use were collected. Results: Prevalence of self-medication was found to be 11.9%. Males, age >40 years and involving in moderate level activity of occupation, were found to be significantly associated with higher self-medication usage (P < 0.05. Fever (31%, headache (19%, and abdominal pain (16.7% are most common illnesses where self-medication is being used. Telling the symptoms to pharmacist (38.1% was the commonest method adopted to procure drugs by the users. Majority of the self-medication users expressed that self-medication is harmless (66.6% and they are going to use (90% and advice others also (73.8% to use self-medication drugs. Conclusion: Self-medication is an important health issue in this area. Health education of the public and regulation of pharmacies may help in limiting the self-medication practices.

Cancer Screening Among Patients Who Self-Identify as Muslim: Combining Self-Reported Data with Medical Records in a Family Practice Setting.

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Lofters, A K; Slater, M; Vahabi, M

2018-02-01

Cancer screening is a core component of family medicine but screening inequalities are well documented in Canada for foreign-born persons. Although people of Muslim faith and culture are the fastest growing immigrant population in Canada, there is little information in the literature about their cancer screening practices. Determining screening gaps could inform practice-based quality improvement initiatives. We conducted a retrospective chart review combining patient-level medical record data with self-reported religious affiliation to examine the relationship between religion and cancer screening in a large multi-site urban family practice. Religious affiliation was classified as Muslim, other affiliation, or atheist/no religious affiliation. 5311 patients were included in the study sample. Muslim patients were significantly less likely to prefer English for spoken communication than the other two groups, less likely to be Canadian-born, more likely to have a female family physician, and were over-represented in the lowest income quintile. Muslim women were most likely to be up-to-date on breast cancer screening (85.2 vs. 77.5 % for those with other religions vs. 69.5 % for those with no religious affiliation). There were no significant differences in cancer screening by physician sex. In this pilot study conducted within a primary care practice, we used self-reported data on religious affiliation to examine possible inequities in cancer screening and observed intriguing variations in screening by self-identified religious affiliation. Future efforts to collect and use similar patient-level data should incorporate non-official languages and intensively outreach to patients with less health system contact. Regardless, the family medicine context may be the ideal setting to collect and act on patient-level sociodemographic data such as religious affiliation.

Side-chain-controlled self-assembly of polystyrene-polypeptide miktoarm star copolymers

KAUST Repository

Junnila, Susanna

2012-03-27

We show how the self-assembly of miktoarm star copolymers can be controlled by modifying the side chains of their polypeptide arms, using A 2B and A 2B 2 type polymer/polypeptide hybrids (macromolecular chimeras). Initially synthesized PS 2PBLL and PS 2PBLL 2 (PS, polystyrene; PBLL, poly(ε-tert-butyloxycarbonyl-l-lysine) ) miktoarms were first deprotected to PS 2PLLHCl and PS 2PLLHCl 2 miktoarms (PLLHCl, poly(l-lysine hydrochloride)) and then complexed ionically with sodium dodecyl sulfonate (DS) to give the supramolecular complexes PS 2PLL(DS) and PS 2(PLL(DS)) 2. The solid-state self-assemblies of these six miktoarm systems were studied by transmission electron microscopy (TEM), Fourier transform infrared spectroscopy (FTIR), and small- and wide-angle X-ray scattering (SAXS, WAXS). The side chains of the polypeptide arms were observed to have a large effect on the solubility, polypeptide conformation, and self-assembly of the miktoarms. Three main categories were observed: (i) lamellar self-assemblies at the block copolymer length scale with packed layers of α-helices in PS 2PBLL and PS 2PBLL 2; (ii) charge-clustered polypeptide micelles with less-defined conformations in a nonordered lattice within a PS matrix in PS 2PLLHCl and PS 2PLLHCl 2; (iii) lamellar polypeptide-surfactant self-assemblies with β-sheet conformation in PS 2PLL(DS) and PS 2(PLL(DS)) 2 which dominate over the formation of block copolymer scale structures. Differences between the 3- and 4-arm systems illustrate how packing frustration between the coil-like PS arms and rigid polypeptide conformations can be relieved by the right number of arms, leading to differences in the extent of order. © 2012 American Chemical Society.

Self-medication with antibiotics among undergraduate nursing students of a government medical college in Eastern India

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suvadip biswas

2015-10-01

Full Text Available Antibiotics serve very useful therapeutic purpose in eradicating pathogens. Unfortunately excessive and inappropriate use of antibiotics results in antibiotic resistance. The consequences of inappropriate self-medication with antibiotics among healthcare professionals have severe implications which might be legal issues, ethical issues, negative impacts on patient and poor quality of health care delivery. The present study was conducted on self-medication by undergraduate nursing students in a government medical college of West Bengal, India. A pre designed questionnaire was used to collect the relevant information pertaining to the study variables. Among the participants 54.2% had self-medicated in the last six months. The antibiotics most commonly used being metronidazole (67.4%, azithromycin (32.6% and norfloxacin (16.8%. Regarding the source of the antibiotics used for self-medication 41.6% participants went for leftover medicines at home, 34.8% participants obtained the drug from community pharmacies or drug stores. Hospital pharmacies and medicine samples were the source of the drugs for 19.2% and 4.4% participants respectively for this purpose. This study has shown that self-medication with antibiotics is common among undergraduate nursing students. There is a need for a rigorous mass enlightenment campaign to educate the population, including the health care professional about the disadvantages and possible complications of antibiotic self-medication. 

Study of Self Medication In Patients With Diabetes Using Path Analysis

Directory of Open Access Journals (Sweden)

M Rezaei

2015-01-01

Full Text Available Self-medication is a behavior in which one tries to solve his/her health condition or problem without professional help. With regard to mortality and severe complications of diabetes, inappropriate self- medication can have severe consequences but proper planning can control this behavior to improve the patient′s health. In this study, the effect of each factor on self-medication in patients with diabetes is determined using path analysis technique. This cross-sectional study was conducted in the Kermanshah diabetes center. The number of patients with diabetes interviewed were 500. Each patient′s score of self-medication were determined according to a questionnaire, with a higher score showing greater self-medication. Demographic information and scores of trust to doctors, medical expenses, others′ recommendations and busy work environment as predictor variables were measured and analyzed using SPSS 16.0. Based on the questionnaire scores, two patients (0.4% largely, 191 (38.7% moderately and 300 (60.9% slightly were on self-medication. The variable; mistrust of doctors only directly, variables; age, the duration of diabetes and family history of heart disease only indirectly and variables; busy work environment, medical expenses, others′ recommendations and family history of hypertension directly and indirectly were related to self-medication. The results of this study showed that more than 60% of patients with diabetes had low self-medication, which represents the success of education principles and methods. Extracting causal relationships among the complexity of factors influencing a disease requires powerful statistical tools such as path analysis.

Adverse Side Effects of Psychotropic Medication and Challenging Behavior: Pilot Work Assessing Impact.

Science.gov (United States)

Valdovinos, Maria G; Schieber, Elizabeth; McMahon, Meara; Beard, Lisa; Wilkinson, Alyssa; Carpenter, Jaimie

2017-12-01

Psychotropic medications are often prescribed to reduce challenging behavior in individuals with intellectual and developmental disabilities (IDD). Functional analyses (FAs) have demonstrated utility in assessing medication impact on behavior; however, the impact of adverse side effects (ASE) on challenging behavior is under-assessed. The purpose of this study was to develop a methodology, similar to FAs, to explore potential medication ASE impact on challenging behavior in seven individuals with IDD. Results revealed response rate differences in designed ASE conditions for most participants. Outcomes support further development and use of this methodology to assess the presence and impact of ASEs.

Left-sided gall bladder: Report of two cases

Directory of Open Access Journals (Sweden)

Chrungoo R

2007-01-01

Full Text Available Left-sided gall bladder without situs inversus viscerum is a rare albeit recognized clinical entity. We report our experience of two cases of left-sided gall bladder in two women aged 36 and 48 who underwent laparoscopic cholecystectomy for chronic calculous cholecystitis. Left-sided gall bladder may provide an unusual surprise to the surgeons during laparoscopy as routine pre-operative studies may not always detect the anomaly. Awareness of the unpredictable confluence of the cystic duct into the common bile duct (CBD and selective use of intraoperative cholangiography aid in the safe laparoscopic management of this unusual entity.

A program of symptom management for improving self-care for patients with HIV/AIDS.

Science.gov (United States)

Chiou, Piao-Yi; Kuo, Benjamin Ing-Tiau; Chen, Yi-Ming; Wu, Shiow-Ing; Lin, Li-Chan

2004-09-01

The purpose of this study was to investigate the effect of a symptom management program on self-care of medication side effects among AIDS/HIV-positive patients. Sixty-seven patients from a sexually transmitted disease control center, a medical center, and a Catholic AIDS support group in Taipei were randomly assigned to three groups: one-on-one teaching, group teaching, and a control group. All subjects in each teaching group attended a 60- or 90-minute program on highly active antiretroviral therapy (HAART) side effect self-care education and skill training once per week for 3 weeks; subjects also underwent counseling by telephone. A medication side effect self-care knowledge questionnaire, Rosenberg's Self-Esteem Scale (RSES), and unscheduled hospital visits were used to evaluate the effectiveness of the symptom management program. The results revealed there were significant differences in mean difference of knowledge and unscheduled hospital visits between baseline and post-testing at 3 months for symptom management in the two groups. The mean difference of the self-esteem scale was not significant between the two groups. In summary, the symptom management program effectively increased the ability of AIDS/HIV-positive patients to self-care for medication side effects. We recommend that this program be applied in the clinical nursing practice.

Self-medication with antibiotics in Europe and its determinants

NARCIS (Netherlands)

Grigoryan, Larissa

2007-01-01

A postal survey was conducted to determine and compare the prevalence of self-medication with antibiotics in 19 European countries. Face to face interviews were conducted with the respondents of the postal survey to study the determinants of self-medication.

Medical students’ perception of lesbian, gay, bisexual, and transgender (LGBT) discrimination in their learning environment and their self-reported comfort level for caring for LGBT patients: a survey study

Science.gov (United States)

Nama, Nassr; MacPherson, Paul; Sampson, Margaret; McMillan, Hugh J.

2017-01-01

ABSTRACT Background: Historically, medical students who are lesbian, gay, bisexual or transgendered (LGBT) report higher rates of social stress, depression, and anxiety, while LGBT patients have reported discrimination and poorer access to healthcare. Objective: The objectives of this study were: (1) to assess if medical students have perceived discrimination in their learning environment and; (2) to determine self-reported comfort level for caring for LGBT patients. Design: Medical students at the University of Ottawa (N = 671) were contacted via email and invited to complete a confidential web-based survey. Results: Response rate was 15.4% (103/671). This included 66 cis-gender heterosexuals (64.1%) and 37 LGBT students (35.9%). Anti-LGBT discrimination had been witnessed by 14.6% and heterosexism by 31.1% of respondents. Anti-LGBT discrimination most often originated from fellow medical students. Respondents who self-identified as LGBT were more likely to have perceived heterosexism (favoring opposite-sex relationships) (OR = 8.2, p LGBT discrimination (OR = 6.6, p = 0.002). While half of LGBT students shared their status with all classmates (51.4%), they were more likely to conceal this from staff physicians (OR = 27.2, p = 0.002). Almost half of medical students (41.7%) reported anti-LGBT jokes, rumors, and/or bullying by fellow medical students and/or other members of the healthcare team. Still, most respondents indicated that they felt comfortable with and capable of providing medical care to LGBT patients (≥83.5%), and were interested in further education around LGBT health issues (84.5%). Conclusion: Anti-LGBT discrimination and heterosexism are noted by medical students, indicating a suboptimal learning environment for LGBT students. Nonetheless, students report a high level of comfort and confidence providing health care to LGBT patients. PMID:28853327

Medical students' perception of lesbian, gay, bisexual, and transgender (LGBT) discrimination in their learning environment and their self-reported comfort level for caring for LGBT patients: a survey study.

Science.gov (United States)

Nama, Nassr; MacPherson, Paul; Sampson, Margaret; McMillan, Hugh J

2017-01-01

Historically, medical students who are lesbian, gay, bisexual or transgendered (LGBT) report higher rates of social stress, depression, and anxiety, while LGBT patients have reported discrimination and poorer access to healthcare. The objectives of this study were: (1) to assess if medical students have perceived discrimination in their learning environment and; (2) to determine self-reported comfort level for caring for LGBT patients. Medical students at the University of Ottawa (N = 671) were contacted via email and invited to complete a confidential web-based survey. Response rate was 15.4% (103/671). This included 66 cis-gender heterosexuals (64.1%) and 37 LGBT students (35.9%). Anti-LGBT discrimination had been witnessed by 14.6% and heterosexism by 31.1% of respondents. Anti-LGBT discrimination most often originated from fellow medical students. Respondents who self-identified as LGBT were more likely to have perceived heterosexism (favoring opposite-sex relationships) (OR = 8.2, p LGBT discrimination (OR = 6.6, p = 0.002). While half of LGBT students shared their status with all classmates (51.4%), they were more likely to conceal this from staff physicians (OR = 27.2, p = 0.002). Almost half of medical students (41.7%) reported anti-LGBT jokes, rumors, and/or bullying by fellow medical students and/or other members of the healthcare team. Still, most respondents indicated that they felt comfortable with and capable of providing medical care to LGBT patients (≥83.5%), and were interested in further education around LGBT health issues (84.5%). Anti-LGBT discrimination and heterosexism are noted by medical students, indicating a suboptimal learning environment for LGBT students. Nonetheless, students report a high level of comfort and confidence providing health care to LGBT patients.

Supplementing the Braden scale for pressure ulcer risk among medical inpatients: the contribution of self-reported symptoms and standard laboratory tests.

Science.gov (United States)

Skogestad, Ingrid Johansen; Martinsen, Liv; Børsting, Tove Elisabet; Granheim, Tove Irene; Ludvigsen, Eirin Sigurdssøn; Gay, Caryl L; Lerdal, Anners

2017-01-01

To evaluate medical inpatients' symptom experience and selected laboratory blood results as indicators of their pressure ulcer risk as measured by the Braden scale. Pressure ulcers reduce quality of life and increase treatment costs. The prevalence of pressure ulcers is 6-23% in hospital populations, but literature suggests that most pressure ulcers are avoidable. Prospective, cross-sectional survey. Three hundred and twenty-eight patients admitted to medical wards in an acute hospital in Oslo, Norway consented to participate. Data were collected on 10 days between 2012-2014 by registered nurses and nursing students. Pressure ulcer risk was assessed using the Braden scale, and scores indicated pressure ulcer risk. Skin examinations were categorised as normal or stages I-IV using established definitions. Comorbidities were collected by self-report. Self-reported symptom occurrence and distress were measured with 15 items from the Memorial Symptom Assessment Scale, and pain was assessed using two numeric rating scales. Admission laboratory data were collected from medical records. Prevalence of pressure ulcers was 11·9, and 20·4% of patients were identified as being at risk for developing pressure ulcers. Multivariable analysis showed that pressure ulcer risk was positively associated with age ≥80 years, vomiting, severe pain at rest, urination problems, shortness of breath and low albumin and was negatively associated with nervousness. Our study indicates that using patient-reported symptoms and standard laboratory results as supplemental indicators of pressure ulcer risk may improve identification of vulnerable patients, but replication of these findings in other study samples is needed. Nurses play a key role in preventing pressure ulcers during hospitalisation. A better understanding of the underlying mechanisms may improve the quality of care. Knowledge about symptoms associated with pressure ulcer risk may contribute to a faster clinical judgment of

Correlation between self-reported gestational age and ultrasound measurements

DEFF Research Database (Denmark)

Olesen, Annette Wind; Westergaard, Jes Grabow; Thomsen, Sten Grove

2004-01-01

BACKGROUND: We studied the agreement between different measurements of gestational age, i.e. self-reported gestational age in the Danish National Birth Cohort Study, ultrasound-estimated gestational age from the medical records in one Danish county and gestational age from the Danish National...

Self-Reported Presence and Experience of Pain in Adults with Down Syndrome.

Science.gov (United States)

de Knegt, Nanda C; Lobbezoo, Frank; Schuengel, Carlo; Evenhuis, Heleen M; Scherder, Erik J A

2017-07-01

The aim was to examine whether the presence of pain (based on physical conditions and participants' report) and self-reported pain experience in adults with Down syndrome (DS) differ from general population controls. Cross-sectional study of 224 adults with DS (mean age = 38.1 years, mild-severe intellectual disabilities) and 142 age-matched controls (median age = 40.5 years, mean estimated IQ = 105.7) in the Netherlands. File-based medical information was evaluated. Self-reported presence and experience of pain were assessed in rest and after movement during a test session (affect with facial affective scale (FAS: 0.04-0.97), intensity assessed with numeric rating scale (NRS: 0-10). Compared with controls, more DS participants had physical conditions that may cause pain and/or discomfort ( p  = .004, 50% vs 35%), but fewer DS participants reported pain during the test session ( p  = .003, 58% vs 73%). Of the participants who indicated pain and comprehended self-reporting scales ( n  = 198 FAS, n  = 161 NRS), the DS group reported a higher pain affect and intensity than the controls ( p  painful/discomforting physical conditions reported pain. Those who did indicated a higher pain experience than adults from the general population. Research into spontaneous self-report of pain, repeated pain assessment, and acute pain is needed in people with DS for more insight into pain experience and mismatches between self-report and medical information. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Dispositional optimism, self-framing and medical decision-making.

Science.gov (United States)

Zhao, Xu; Huang, Chunlei; Li, Xuesong; Zhao, Xin; Peng, Jiaxi

2015-03-01

Self-framing is an important but underinvestigated area in risk communication and behavioural decision-making, especially in medical settings. The present study aimed to investigate the relationship among dispositional optimism, self-frame and decision-making. Participants (N = 500) responded to the Life Orientation Test-Revised and self-framing test of medical decision-making problem. The participants whose scores were higher than the middle value were regarded as highly optimistic individuals. The rest were regarded as low optimistic individuals. The results showed that compared to the high dispositional optimism group, participants from the low dispositional optimism group showed a greater tendency to use negative vocabulary to construct their self-frame, and tended to choose the radiation therapy with high treatment survival rate, but low 5-year survival rate. Based on the current findings, it can be concluded that self-framing effect still exists in medical situation and individual differences in dispositional optimism can influence the processing of information in a framed decision task, as well as risky decision-making. © 2014 International Union of Psychological Science.

Two sides of the coin. Part 1. Lipid and surfactant self-assembly revisited.

Science.gov (United States)

Ninham, Barry W; Larsson, Kåre; Lo Nostro, Pierandrea

2017-04-01

Hofmeister, specific ion effects, hydration and van der Waals forces at and between interfaces are factors that determine curvature and microstructure in self assembled aggregates of surfactants and lipids; and in microemulsions. Lipid and surfactant head group interactions and between aggregates vary enormously and are highly specific. They act on the hydrophilic side of a bilayer, micelle or other self assembled aggregate. It is only over the last three decades that the origin of Hofmeister effects has become generally understood. Knowledge of their systematics now provides much flexibility in designing nanostructured fluids. The other side of the coin involves equally specific forces. These (opposing) forces work on the hydrophobic side of amphiphilic interfaces. They are due to the interaction of hydrocarbons and other "oils" with hydrophobic tails of surfactants and lipids. The specificity of oleophilic solutes in microemulsions and lipid membranes provides a counterpoint to Hofmeister effects and hydration. Together with global packing constraints these effects determine microstructure. Another factor that has hardly been recognised is the role of dissolved gas. This introduces further, qualitative changes in forces that prescribe microstructure. The systematics of these effects and their interplay are elucidated. Awareness of these competing factors facilitates formulation of self assembled nanostructured fluids. New and predictable geometries that emerge naturally provide insights into a variety of biological phenomena like anaesthetic and pheromone action and transmission of the nervous impulse (see Part 2). Copyright © 2017 Elsevier B.V. All rights reserved.

Behavioral Studies Peptic Ulcer Patients Self-Medication by Visiting Pharmacy in Pontianak

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Eka K. Untari

2013-09-01

Full Text Available Self-medication practices is now considered as a component of self-care. Gastric ulcer is one of minor symptom that can be treated by self-medication. The aim of this study was to determine the prevalence, behavior, and appropriateness of self-medication practice for gastric ulcer or its related symptom amongst population. The population of this study attended community pharmacies in Pontianak of West Borneo province. This study was a cross sectional survey involving 98 adults who did self-medication on peptic ulcer or its related symptom. This study was conducted in 2010. The result of showed that 67.3% of gastric ulcer self-medication practice was appropriate; 66.3% subject used antacida class to treat the symptom; 6.1% participant however, still used antibiotic; and only 27% subject satisfied with the information given during self-medication process. Although self-medication practice for gastric ulcer was often done, some practice might be harmful. Thus, there is a need to educate the community to ensure its safe practices.

Left Sided Amyand's Hernia, A Rare Occurance: A Case Report.

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Ravishankaran, Praveen; Mohan, G; Srinivasan, A; Ravindran, G; Ramalingam, A

2013-06-01

This is a case report about a 35 year old man admitted with complains of obstructed left sided inguinal hernia. On exploration of the left inguinal canal to our surprise a normal appendix was found in addition to a gangrenous omentum. Resection of the gangrenous omentum was done. Appendectomy was done. This case is reported for its rare occurance as only three such cases of left sided amyand's hernia has been reported so far in literature[4-6].

Self-transcendence and medication adherence in older adults with hypertension.

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Thomas, Nezbile F; Dunn, Karen S

2014-12-01

The purpose of this study was to examine the relationship between self-transcendence and medication adherence among older adults prescribed antihypertensive medication. Descriptive, correlational research design. Forty-six older adults who were prescribed antihypertensive medications from an independent living facility participated in this study. Participants were given a survey that included a demographic questionnaire, the Morisky Medication Adherence Scale, and Reed's Self-Transcendence Scale. No significant relationship was found between medication adherence and self-transcendence (r = -.20, p = .18). Ninety percent of the participants however, admitted to cutting back or stopping their medication without notifying their providers. Continued investigation is needed to identify reasons why older adults fail to adhere to taking prescribed hypertension medications in order to improve health outcomes in this population. © The Author(s) 2014.

Burnout syndrome among non-consultant hospital doctors in Ireland: relationship with self-reported patient care.

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Sulaiman, Che Fatehah Che; Henn, Patrick; Smith, Simon; O'Tuathaigh, Colm M P

2017-10-01

Intensive workload and limited training opportunities for Irish non-consultant hospital doctors (NCHDs) has a negative effect on their health and well-being, and can result in burnout. Burnout affects physician performance and can lead to medical errors. This study examined the prevalence of burnout syndrome among Irish NCHDs and its association with self-reported medical error and poor quality of patient care. A cross-sectional quantitative survey-based design. All teaching hospitals affiliated with University College Cork. NCHDs of all grades and specialties. The following instruments were completed by all participants: Maslach Burnout Inventory-Human Service Survey (MBI-HSS), assessing three categories of burnout syndrome: Emotional exhaustion (EE), Personal Achievement (PA) and Depersonalization (DP); questions related to self-reported medical errors/poor patient care quality and socio-demographic information. Self-reported measures of burnout and poor quality of patient care. Prevalence of burnout among physicians (n = 265) was 26.4%. There was a significant gender difference for EE and DP, but none for PA. A positive weak correlation was observed between EE and DP with medical error or poor patient care. A negative association was reported between PA and medical error and reduced quality of patient care. Burnout is prevalent among NCHDs in Ireland. Burnout syndrome is associated with self-reported medical error and quality of care in this sample population. Measures need to be taken to address this issue, with a view to protecting health of NCHDs and maintaining quality of patient care. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Self-medication practices and rational drug use habits among university students: a cross-sectional study from Kahramanmaraş, Turkey

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Ramazan Azim Okyay

2017-11-01

Full Text Available Background Self-medication refers to the use of medicines to treat self-diagnosed diseases without consulting any healthcare professionals. Irrational drug use and self-medication have serious negative consequences both on health and economy. Therefore, the aim of this study is to assess the habits related to rational use of drugs (RUD and to estimate the prevalence of self-medication practices among university students. Methods This cross-sectional study was conducted on university students in Kahramanmaraş. From May 2017 to June 2017 a total of 960 students filled a “Rational Use of Drugs Questionnaire”. Results The prevalence of practicing self-medication in students was 63.4%. The most common medicines that the students had consumed without prescription were analgesics by 39.5%, antibiotics by 36.9% and cold remedies by 24.0%. The rate of students who declared that they were familiar with RUD and “rational use of antibiotics” (RUA was 45.9%. Reading/checking the instructions in the prospectus (OR = 1.529, 95% CI [1.176–1.990], understanding the context of the prospectus (OR = 1.893, 95% CI [1.387–2.584], compliance with the duration of antibiotic treatment (OR = 1.597, 95% CI [1.231–2.071] and consulting a physician in case of a side effect (OR = 1.350, 95% CI [1.037–1.757] were significantly higher among students who were familiar with RUD as compared to who were not. Discussion Since the awareness of RUD among university students was found to be inadequate, it has critical importance to hold educational activities with the cooperation of physicians, health organizations, universities, non-governmental organizations and media to avoid negative consequences of irrational drug use and self-medication.

An internet survey on self-reported food allergy in Greece: clinical aspects and lack of appropriate medical consultation.

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Kalogeromitros, D; Makris, M P; Chliva, C; Sergentanis, T N; Church, M K; Maurer, M; Psaltopoulou, T

2013-05-01

Food allergy (FA) represents a common and worldwide disorder but in publications referring to FA the reported diagnosis is rarely confirmed. Consequently, the subjectively assessed FA may negatively affect the quality of life of patients and their families. We have conducted this internet survey in order to estimate the self-reported perception of FA in Greece. A standard anonymous questionnaire was posted for a 3-month period on http://www.in.gr, a Greek popular Internet portal. Each individual could participate only once. Participants were screened for the presence or history of FA by a key question and were then asked to provide information on symptoms, course and management. A total of 3673 adult subjects (mean age 34.2 years, range 18-74, females 61.3%), reporting FA were included in analysis. Most reported reactions were related to fruits (14.9%), seafood (10.7%) and nuts (9.2%). The first episode occurred principally during the second (29.2%) and third (30.9%) decade within 3 h from consumption (82.2%). Predominant symptoms were urticaria and oral allergy syndrome (almost 25% each one). Nearly half of the participants sought no medical advice, while 31.4% asked for an allergist's consultation. Almost 21% of reactors were hospitalized; nuts, severity of symptoms (lower respiratory and/or cardiovascular), onset in lower age, previous exercise and concomitant alcohol and/or aspirin intake were positively associated with hospitalization. Although FA causes severe anaphylactic episodes, almost 50% of individuals who experience symptoms perceived as FA do not seek medical advice. Awareness programmes must be carried out in order to increase consciousness about this potentially fatal medical condition. © 2012 The Authors. Journal of the European Academy of Dermatology and Venereology © 2012 European Academy of Dermatology and Venereology.

Self-medication as adaptive plasticity: increased ingestion of plant toxins by parasitized caterpillars.

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Michael S Singer

Full Text Available Self-medication is a specific therapeutic behavioral change in response to disease or parasitism. The empirical literature on self-medication has so far focused entirely on identifying cases of self-medication in which particular behaviors are linked to therapeutic outcomes. In this study, we frame self-medication in the broader realm of adaptive plasticity, which provides several testable predictions for verifying self-medication and advancing its conceptual significance. First, self-medication behavior should improve the fitness of animals infected by parasites or pathogens. Second, self-medication behavior in the absence of infection should decrease fitness. Third, infection should induce self-medication behavior. The few rigorous studies of self-medication in non-human animals have not used this theoretical framework and thus have not tested fitness costs of self-medication in the absence of disease or parasitism. Here we use manipulative experiments to test these predictions with the foraging behavior of woolly bear caterpillars (Grammia incorrupta; Lepidoptera: Arctiidae in response to their lethal endoparasites (tachinid flies. Our experiments show that the ingestion of plant toxins called pyrrolizidine alkaloids improves the survival of parasitized caterpillars by conferring resistance against tachinid flies. Consistent with theoretical prediction, excessive ingestion of these toxins reduces the survival of unparasitized caterpillars. Parasitized caterpillars are more likely than unparasitized caterpillars to specifically ingest large amounts of pyrrolizidine alkaloids. This case challenges the conventional view that self-medication behavior is restricted to animals with advanced cognitive abilities, such as primates, and empowers the science of self-medication by placing it in the domain of adaptive plasticity theory.

Knowledge that people with intellectual disabilities have of their inhaled asthma medications: messages for pharmacists.

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Davis, Sharon R; Durvasula, Seeta; Merhi, Diana; Young, Paul M; Traini, Daniela; Bosnic Anticevich, Sinthia Z

2016-02-01

Fifteen percent of Australians with intellectual disability (ID) are reported to have asthma. People with ID are at risk of poor health knowledge due to deficits in intellectual and adaptive functioning, but their medication knowledge has largely been ignored in research to date. To explore the level of understanding of asthma medication use of people with ID who self-administer their inhaled medications, in order to inform future educational support. Setting The research was conducted in NSW, Australia, at the participants' homes, the point of health care access, or the offices of relevant support organisations. In this qualitative study face-to-face interviews were conducted with people with ID using a semi-structured interview guide. The interviews were recorded, transcribed and thematically analysed. Main outcome Identification of barriers to asthma medication self-management by people with ID. Seventeen people with ID who self-administer their asthma medications were interviewed. Factors influencing their asthma medication knowledge and use included understanding of their illness and the need for medication; aspects of self-management and autonomy versus dependence. This sample of people with ID had a good understanding of the importance of using their inhaled asthma medications, as well as asthma triggers, and the difference between use of preventer and reliever medications. Both enablers and barriers to asthma medication self-management were identified in the domains of managing attacks, adherence, knowledge of side effects and sources of information on correct use of inhalers. The level of autonomy for medication use varied, with motivation to self-manage asthma influenced by the level of support that was practically available to individual participants. This research investigated aspects of asthma medication self-management of people with ID. Based on the barriers identified, pharmacists should promote use of spacers and written asthma action plans as well

Finasteride and sexual side effects

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Venkataram Mysore

2012-01-01

Full Text Available Finasteride, a 5-alpha reductase inhibitor, widely used in the medical management of male pattern hairloss, has been reported to cause sexual side effects. This article critically examines the evidence available and makes recommendations as to how a physician should counsel a patient while prescribing the drug.

Oral health impacts of medications used to treat mental illness.

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Cockburn, N; Pradhan, A; Taing, M W; Kisely, S; Ford, P J

2017-12-01

Many psychotropic medications affect oral health. This review identified oral side effects for antidepressant, antipsychotic, anticonvulsant, antianxiety and sedative drugs that are recommended in Australia for the management of common mental illnesses and provides recommendations to manage these side-effects. The Australian Therapeutic Guidelines and the Australian Medicines Handbook were searched for medications used to treat common mental health conditions. For each medication, the generic name, class, and drug company reported side-effects were extracted from the online Monthly Index of Medical Specialties (eMIMs) and UpToDate databases. Meyler's Side Effect of Drugs Encyclopaedia was used to identify additional oral adverse reactions to these medications. Fifty-seven drugs were identified: 23 antidepressants, 22 antipsychotics or mood stabilisers, and 12 anxiolytic or sedative medications. Xerostomia (91%) the most commonly reported side effect among all classes of medications of the 28 identified symptoms. Other commonly reported adverse effects included dysguesia (65%) for antidepressants, and tardive dyskinesia (94%) or increased salivation (78%) for antipsychotic medications. While xerostomia has often been reported as a common adverse effect of psychotropic drugs, this review has identified additional side effects including dysguesia from antidepressants and tardive dyskinesia and increased salivation from antipsychotics. Clinicians should consider oral consequences of psychotropic medication in addition to other side-effects when prescribing. For antidepressants, this would mean choosing duloxetine, agomelatine and any of the serotonin re-uptake inhibitors except sertraline. In the case of antipsychotics and mood stabilisers, atypical agents have less oral side effects than older alternatives. Copyright © 2017 Elsevier B.V. All rights reserved.

Psychiatric side effects of ketamine in hospitalized medical patients administered subanesthetic doses for pain control.

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Rasmussen, Keith G

2014-08-01

To assess the psychiatric side effects of ketamine when administered in subanesthetic doses to hospitalized patients. It is hypothesized that such effects occur frequently. In this retrospective study, the medical records of 50 patients hospitalized on medical and surgical units at our facility who had continuous intravenous infusions of ketamine for pain or mild sedation were reviewed. Patient progress in the days following the start of ketamine infusion was reviewed and response to ketamine was noted. Twenty-two percent of the patients were noted to have some type of psychiatric reaction to ketamine, including agitation, confusion, and hallucinations. These reactions were relatively short lived, namely, occurring during or shortly after the infusions. No association was found between patient response to ketamine and gender, age, or infusion rate. Awareness of the psychiatric side effects of ketamine is an important consideration for clinicians administering this medication either for pain control or for depressive illness.

Predictors of medication non-adherence for vasculitis patients

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Hogan, Susan L.; DeVellis, Robert F.

2013-01-01

The primary purpose of this article is to document whether demographic, clinical, regimen-related, intrapersonal, and interpersonal factors predict medication non-adherence for vasculitis patients. A secondary purpose is to explore whether adherence varies by medication type and whether patients experienced drug-related side effects. Vasculitis patients (n=228) completed online baseline and 3-month follow-up surveys. Demographic (age, gender, education, race, marital status, and insurance status), clinical (perceived vasculitis severity, disease duration, vasculitis type, and relapse/remission status), regimen-related (experience of side effects), intrapersonal (depressive symptoms), and interpersonal (adherence-related support from family and friends) factors were measured at baseline. Medication non-adherence was assessed at follow-up using the Vasculitis Self-Management Survey medication adherence sub-scale (α=0.89). Variables that significantly correlated (pvasculitis medication types, patients who experienced side effects were less adherent than patients who did not experience side effects. Multiple factors are associated with medication non-adherence for vasculitis patients. Providers should discuss medication adherence and drug-related side effects with vasculitis patients. Providers may want to particularly target younger patients and patients with clinical signs of depression. PMID:23314654

Self-Reflected Well-Being via a Smartphone App in Clinical Medical Students: Feasibility Study.

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Berryman, Elizabeth K; Leonard, Daniel J; Gray, Andrew R; Pinnock, Ralph; Taylor, Barry

2018-03-07

Well-being in medical students has become an area of concern, with a number of studies reporting high rates of clinical depression, anxiety, burnout, and suicidal ideation in this population. The aim of this study was to increase awareness of well-being in medical students by using a smartphone app. The primary objective of this study was to determine the validity and feasibility of the Particip8 app for student self-reflected well-being data collection. Undergraduate medical students of the Dunedin School of Medicine were recruited into the study. They were asked to self-reflect daily on their well-being and to note what experiences they had encountered during that day. Qualitative data were also collected both before and after the study in the form of focus groups and "free-text" email surveys. All participants consented for the data collected to be anonymously reported to the medical faculty. A total of 29 participants (69%, 20/29 female; 31%, 9/29 male; aged 21-30 years) were enrolled, with overall median compliance of 71% at the study day level. The self-reflected well-being scores were associated with both positive and negative experiences described by the participants, with most negative experiences associated with around 20% lower well-being scores for that day; the largest effect being "receiving feedback that was not constructive or helpful," and the most positive experiences associated with around 20% higher scores for that day. The study of daily data collection via the Particip8 app was found to be feasible, and the self-reflected well-being scores showed validity against participant's reflections of experiences during that day. ©Elizabeth K Berryman, Daniel J Leonard, Andrew R Gray, Ralph Pinnock, Barry Taylor. Originally published in JMIR Medical Education (http://mededu.jmir.org), 07.03.2018.

Framing effects on expectations, decisions, and side effects experienced: the case of influenza immunization.

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O'Connor, A M; Pennie, R A; Dales, R E

1996-11-01

To examine the effects of using positive or negative frames to describe influenza vaccine benefits and side effects on patients' expectations, decisions, decisional conflict, and reported side effects. 292 previously unimmunized patients with chronic respiratory or cardiac disease were randomly assigned to receive benefit/risk information that was framed: (1) positively as the percentage who remain free of influenza and have no vaccine side effects, or (2) negatively as the percentage who acquire influenza and have vaccine side effects. Questionnaires elicited expectations, decisions, and decisional conflict. Vaccines were telephoned 3 days later for a self-report of local and systemic side effects and work absenteeism. Both groups had similar immunization rates and decisional conflict scores. The positive frame group had lower and more realistic expectations of vaccine side effects, fewer systemic side effects, and less work absenteeism (p framing did not influence patients' decisions, possibly due to the patients' awareness of their higher risk of influenza complications and greater desire to follow recommendations. The common practice of using negative frames when describing probabilities of side effects may need to be reexamined, considering its deleterious influence on self-reported side effects and work absenteeism.

A clinical nurse specialist-led intervention to enhance medication adherence using the plan-do-check-act cycle for continuous self-improvement.

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Russell, Cynthia L

2010-01-01

A clinical nurse specialist-led intervention to improve medication adherence in chronically ill adults using renal transplant recipients as an exemplar population is proposed. Meta-analyses and systematic reviews of chronically ill and transplant patients indicate that patient-specific characteristics not only are poor and inconsistent predictors for medication nonadherence but also are not amenable to intervention. Adherence has not meaningfully improved, despite meta-analyses and systematic narrative reviews of randomized controlled trials (RCTs) dealing with medication nonadherence in acutely and chronically ill persons and RCTs dealing with transplant patients. Interventions with a superior potential to enhance medication adherence must be developed. Use of a clinical nurse specialist-led continuous self-improvement intervention with adult renal transplant recipients is proposed. Continuous self-improvement focuses on improving personal systems thinking and behavior using the plan-do-check-act process. Electronic medication monitoring reports, one of several objective measures of medication adherence, are used by the clinician to provide patient feedback during the check process on medication-taking patterns. Continuous self-improvement as an intervention holds promise in supporting patient self-management and diminishing the blame that clinicians place on patients for medication nonadherence. Using an objective measure of medication adherence such as an electronic monitoring report fosters collaborative patient-clinician discussions of daily medication-taking patterns. Through collaboration, ideas for improving medication taking can be explored. Changes can be followed and evaluated for effectiveness through the continuous self-improvement process. Future studies should include RCTs comparing educational and/or behavioral interventions to improve medication adherence.

Association of learning styles with research self-efficacy: study of short-term research training program for medical students.

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Dumbauld, Jill; Black, Michelle; Depp, Colin A; Daly, Rebecca; Curran, Maureen A; Winegarden, Babbi; Jeste, Dilip V

2014-12-01

With a growing need for developing future physician scientists, identifying characteristics of medical students who are likely to benefit from research training programs is important. This study assessed if specific learning styles of medical students, participating in federally funded short-term research training programs, were associated with research self-efficacy, a potential predictor of research career success. Seventy-five first-year medical students from 28 medical schools, selected to participate in two competitive NIH-supported summer programs for research training in aging, completed rating scales to evaluate learning styles at baseline, and research self-efficacy before and after training. We examined associations of individual learning styles (visual-verbal, sequential-global, sensing-intuitive, and active-reflective) with students' gender, ranking of medical school, and research self-efficacy. Research self-efficacy improved significantly following the training programs. Students with a verbal learning style reported significantly greater research self-efficacy at baseline, while visual, sequential, and intuitive learners demonstrated significantly greater increases in research self-efficacy from baseline to posttraining. No significant relationships were found between learning styles and students' gender or ranking of their medical school. Assessments of learning styles may provide useful information to guide future training endeavors aimed at developing the next generation of physician-scientists. © 2014 Wiley Periodicals, Inc.

Reversible global aphasia as a side effect of quetiapine: a case report and literature review

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Chien CF

2017-08-01

Full Text Available Ching-Fang Chien,1 Poyin Huang,1,2 Sun-Wung Hsieh1,2 1Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; 2Department of Neurology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan Abstract: Quetiapine is an atypical antipsychotic agent which is also prescribed for delirium due to its anti-dopaminergic effects; aphasia is an unusual side effect associated with the drug. Here, we report the case of an 83-year-old woman who was prescribed quetiapine (50 mg per day for delirium. Unexpected, global aphasia occurred 3 days after treatment began. Complete recovery occurred following discontinuation of the drug. A brain computed tomography scan excluded intracranial hemorrhage and the laboratory results confirmed that no exacerbation of infection or electrolyte imbalances were present. During the aphasic episode, the patient’s condition did not deteriorate and no new neurological symptoms occurred. We suspect that the occurrence of aphasia was directly due to an adverse reaction to quetiapine. To our knowledge, this is the first case report of reversible, global aphasia as a side effect of quetiapine. We propose that this occurrence of aphasia may be due to the action of quetiapine as a dopamine receptor antagonist. Clinicians should use quetiapine with caution, especially in elderly patients. On observation of aphasia, a review of the patient’s medical history is required to assess for the usage of quetiapine. Keywords: aphasia, quetiapine, insomnia, delirium

Self-Medication Practices with Antibiotics among Tertiary Level Students in Accra, Ghana: A Cross-Sectional Study

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Patrick Nartey

2012-10-01

Full Text Available The study was carried out to estimate the prevalence of self-medication with antibiotics among tertiary level students in Accra (Ghana and evaluate factors associated with the practice. This was a descriptive cross-sectional study and involved face-to-face interviews of 600 respondents selected by convenient sampling. Prevalence of self medication was 70% (95% CI: 66.3–73.7, and the practice was significantly lower among medically inclined students (OR: 0.2, 95% CI: 0.1–0.4, p < 0.001. Among the respondents who practiced self medication, the most common frequency of antibiotic usage was at intervals of one month (30%, 95% CI: 25.6–34.4%, and the most common antibiotic used was amoxacillin (23.9%, 95% CI: 21.0–26.8%. Treatment failure were reported by 35% (95% CI: 30.5–39.6% of the respondents, and the main reasons cited for self medication were that, it was less expensive compared to medical care in the hospital and  secondly, medical care in hospitals were associated with long delays. Forty nine percent (95% CI: 44.2–53.8% of the respondents had poor knowledge about the health implications of irrational use of antibiotics, and 46% (95% CI: 41.2–50.8% did not comply with the completion of the full course of antibiotics. Self medication among tertiary students in Accra is an important public health problem and this may reflect the situation among tertiary students in the whole of Ghana.

The impact of cognitive insight, self-stigma, and medication compliance on the quality of life in patients with schizophrenia.

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Lien, Yin-Ju; Chang, Hsin-An; Kao, Yu-Chen; Tzeng, Nian-Sheng; Lu, Chien-Wen; Loh, Ching-Hui

2018-02-01

Impaired quality of life (QoL) is a common and clinically relevant feature of schizophrenia. In the present study, we attempted to formulate a model of QoL in the chronic stage of schizophrenia by including key variables-namely cognitive insight, self-stigma, insight into treatment, and medication compliance-that were proposed as its significant predictors in previous studies. We employed structural equation modeling (SEM) to simultaneously test the associations between these variables. A total of 170 community-dwelling patients with schizophrenia participated in this study. Cognitive insight, self-stigma, insight into treatment, medication compliance, and QoL were assessed through self-reporting. Symptoms were rated by interviewers. The influences of cognitive insight, stigma, insight into treatment, and medication compliance on QoL were supported using SEM. Our findings indicated that cognitive insight had a significant, positive, and direct effect on both self-stigma and insight into treatment; in contrast, it had a negative and direct effect on medication compliance. Notably, no evidence indicated a direct effect of cognitive insight on QoL. Thus, individuals with high cognitive insight reported low QoL because of stigma, low medication compliance, and their increased insight into treatment. In contrast, cognitive insight might indirectly ameliorate QoL mediated by the effect of insight into treatment on medication compliance. The findings provide additional support of the links between cognitive and clinical insight, self-stigma, medication compliance, and QoL in those with schizophrenia and suggest the need for screening and intervention services appropriate for this high-risk population.

A Comparison of the Mental Health and Well-Being of Sexual Minority and Heterosexual First-Year Medical Students: A Report From the Medical Student CHANGE Study.

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Przedworski, Julia M; Dovidio, John F; Hardeman, Rachel R; Phelan, Sean M; Burke, Sara E; Ruben, Mollie A; Perry, Sylvia P; Burgess, Diana J; Nelson, David B; Yeazel, Mark W; Knudsen, John M; van Ryn, Michelle

2015-05-01

Research is lacking on psychological distress and disorder among sexual minority medical students (students who identify as nonheterosexual). If left unaddressed, distress may result in academic and professional difficulties and undermine workforce diversity goals. The authors compared depression, anxiety, and self-rated health among sexual minority and heterosexual medical students. This study included 4,673 first-year students who self-reported sexual orientation in the fall 2010 baseline survey of the Medical Student Cognitive Habits and Growth Evaluation Study, a national longitudinal cohort study. The authors used items from published scales to measure depression, anxiety, self-rated health, and social stressors. They conducted bivariate and multivariate analyses to estimate the association between sexual identity and depression, anxiety, and self-rated health. Of 4,673 students, 232 (5.0%) identified as a sexual minority. Compared with heterosexual students, after adjusting for relevant covariates, sexual minority students had greater risk of depressive symptoms (adjusted relative risk [ARR] = 1.59 [95% confidence interval, 1.24-2.04]), anxiety symptoms (ARR = 1.64 [1.08-2.49]), and low self-rated health (ARR = 1.77 [1.15-2.60]). Sexual minority students were more likely to report social stressors, including harassment (22.7% versus 12.7%, P sexual identity and mental and self-reported health measures. First-year sexual minority students experience significantly greater risk of depression, anxiety, and low self-rated health than heterosexual students. Targeted interventions are needed to improve mental health and well-being.

The Perceived Medical Condition Self-Management Scale can be applied to patients with chronic kidney disease.

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Wild, Marcus G; Wallston, Kenneth A; Green, Jamie A; Beach, Lauren B; Umeukeje, Ebele; Wright Nunes, Julie A; Ikizler, T Alp; Steed, Julia; Cavanaugh, Kerri L

2017-10-01

Chronic Kidney Disease (CKD) is a major burden on patients and the health care system. Treatment of CKD requires dedicated involvement from both caretakers and patients. Self-efficacy, also known as perceived competence, contributes to successful maintenance of patient's CKD self-management behaviors such as medication adherence and dietary regulations. Despite a clear association between self-efficacy and improved CKD outcomes, there remains a lack of validated self-report measures of CKD self-efficacy. To address this gap, the Perceived Kidney/Dialysis Self-Management Scale (PKDSMS) was adapted from the previously validated Perceived Medical Condition Self-Management Scale. We then sought to validate this using data from two separate cohorts: a cross-sectional investigation of 146 patients with end-stage renal disease receiving maintenance hemodialysis and a longitudinal study of 237 patients with CKD not receiving dialysis. The PKDSMS was found to be positively and significantly correlated with self-management behaviors and medication adherence in both patient cohorts. The PKDSMS had acceptable reliability, was internally consistent, and exhibited predictive validity between baseline PKDSMS scores and self-management behaviors across multiple time points. Thus, the PKDSMS is a valid and reliable measure of CKD patient self-efficacy and supports the development of interventions enhancing perceived competence to improve CKD self-management. Copyright © 2017 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

Self-reported needs for improving the supervision competence of PhD supervisors from the medical sciences in Denmark.

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Raffing, Rie; Jensen, Thor Bern; Tønnesen, Hanne

2017-10-23

Quality of supervision is a major predictor for successful PhD projects. A survey showed that almost all PhD students in the Health Sciences in Denmark indicated that good supervision was important for the completion of their PhD study. Interestingly, approximately half of the students who withdrew from their program had experienced insufficient supervision. This led the Research Education Committee at the University of Copenhagen to recommend that supervisors further develop their supervision competence. The aim of this study was to explore PhD supervisors' self-reported needs and wishes regarding the content of a new program in supervision, with a special focus on the supervision of PhD students in medical fields. A semi-structured interview guide was developed, and 20 PhD supervisors from the Graduate School of Health and Medical Sciences at the Faculty of Health and Medical Sciences at the University of Copenhagen were interviewed. Empirical data were analysed using qualitative methods of analysis. Overall, the results indicated a general interest in improved competence and development of a new supervision programme. Those who were not interested argued that, due to their extensive experience with supervision, they had no need to participate in such a programme. The analysis revealed seven overall themes to be included in the course. The clinical context offers PhD supervisors additional challenges that include the following sub-themes: patient recruitment, writing the first article, agreements and scheduled appointments and two main groups of students, in addition to the main themes. The PhD supervisors reported the clear need and desire for a competence enhancement programme targeting the supervision of PhD students at the Faculty of Health and Medical Sciences. Supervision in the clinical context appeared to require additional competence. The Scientific Ethical Committee for the Capital Region of Denmark. Number: H-3-2010-101, date: 2010.09.29.

Central nervous system side effects associated with zolpidem treatment.

Science.gov (United States)

Toner, L C; Tsambiras, B M; Catalano, G; Catalano, M C; Cooper, D S

2000-01-01

Zolpidem is one of the newer medications developed for the treatment of insomnia. It is an imidazopyridine agent that is an alternative to the typical sedative-hypnotic agents. Zolpidem use is gaining favor because of its efficacy and its side effect profile, which is milder and less problematic than that of the benzodiazepines and barbiturates used to treat insomnia. Still, side effects are not uncommon with zolpidem use. We report a series of cases in which the patients developed delirium, nightmares and hallucinations during treatment with zolpidem. We will review its pharmacology, discuss previous reports of central nervous system side effects, examine the impact of drug interactions with concurrent use of antidepressants, examine gender differences in susceptibility to side effects, and explore the significance of protein binding in producing side effects.

Patients Who Attend the Emergency Department Following Medication Overdose: Self-Reported Mental Health History and Intended Outcomes of Overdose

Science.gov (United States)

Buykx, Penny; Ritter, Alison; Loxley, Wendy; Dietze, Paul

2012-01-01

Medication overdose is a common method of non-fatal self-harm. Previous studies have established which mental health disorders are commonly associated with the behaviour (affective, substance use, anxiety and personality disorders) and which medications are most frequently implicated (benzodiazepines, antidepressants, antipsychotics and non-opioid…

Self-medication with antibiotics by a population in northern Israel

NARCIS (Netherlands)

Raz, R; Edelstein, H; Grigoryan, L; Haaijer-Ruskamp, FM

2005-01-01

Background: The current study is part of a larger study - Self-Medication with Antibiotics and Resistance Levels in Europe (SAR project) - coordinated by the University of Groningen in the Netherlands and run in 19 European countries and Israel. Objectives: To estimate self-medication with

A Study of the Prevalence of Self-Medication Practice among ...

African Journals Online (AJOL)

Purpose: To estimate the prevalence of self-medication with antibiotics and antimalarials among university students in southwestern Nigeria and evaluate the factors associated with self-medication. Methods: A pre-tested questionnaire was used to collect data from 2000 university students using a convenient sampling ...

Self-medication with antibiotics by a population in northern Israel

NARCIS (Netherlands)

Raz, R; Edelstein, H; Grigoryan, L; Haaijer-Ruskamp, FM

Background: The current study is part of a larger study - Self-Medication with Antibiotics and Resistance Levels in Europe (SAR project) - coordinated by the University of Groningen in the Netherlands and run in 19 European countries and Israel. Objectives: To estimate self-medication with

Are psychophysiological arousal and self-reported emotional stress during an oncological consultation related to memory of medical information? An experimental study.

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Visser, Leonie N C; Tollenaar, Marieke S; Bosch, Jos A; van Doornen, Lorenz J P; de Haes, Hanneke C J M; Smets, Ellen M A

2017-01-01

Patients forget 20-80% of information provided during medical consultations. The emotional stress often experienced by patients during consultations could be one of the mechanisms that lead to limited recall. The current experimental study therefore investigated the associations between (analog) patients' psychophysiological arousal, self-reported emotional stress and their (long term) memory of information provided by the physician. One hundred and eighty one cancer-naïve individuals acted as so-called analog patients (APs), i.e. they were instructed to watch a scripted video-recoding of an oncological bad news consultation while imagining themselves being in the patient's situation. Electrodermal and cardiovascular activity (e.g. skin conductance level and heart rate) were recorded during watching. Self-reported emotional stress was assessed before and after watching, using the STAI-State and seven Visual Analog Scales. Memory, both free recall and recognition, was assessed after 24-28 h. Watching the consultation evoked significant psychophysiological and self-reported stress responses. However, investigating the associations between 24 psychophysiological arousal measures, eight self-reported stress measures and free recall and recognition of information resulted in one significant, small (partial) correlation (r = 0.19). Considering multiple testing, this significant result was probably due to chance. Alternative analytical methods yielded identical results, strengthening our conclusion that no evidence was found for relationships between variables of interest. These null-findings are highly relevant, as they may be considered to refute the long-standing, but yet untested assumption that a relationship between stress and memory exists within this context. Moreover, these findings suggest that lowering patients' stress levels during the consultation would probably not be sufficient to raise memory of information to an optimal level. Alternative

Might ART Adherence Estimates Be Improved by Combining Biomarker and Self-Report Data?

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Rhead, Rebecca; Masimirembwa, Collen; Cooke, Graham; Takaruza, Albert; Nyamukapa, Constance; Mutsimhi, Cosmas; Gregson, Simon

2016-01-01

As we endeavour to examine rates of viral suppression in PLHIV, reliable data on ART adherence are needed to distinguish between the respective contributions of poor adherence and treatment failure on high viral load. Self-reported data are susceptible to response bias and although biomarker data on drug presence and concentration can provide a superior, alternative method of measurement, complications due to drug-drug interactions and genetic variations can cause some inaccuracies. We investigate the feasibility of combining both biomarker and self-report data to produce a potentially more accurate measure of ART adherence. Data were taken from a large general-population survey in the Manicaland province, Zimbabwe, conducted in 2009-2011. HIV-infected adults who had initiated ART (N = 560) provided self-report data on adherence and dried blood spot samples that were analysed for traces of ART medication. A new three-category measure of ART adherence was constructed, based on biomarker data but using self-report data to adjust for cases with abnormally low and high drug concentrations due to possible drug-drug interactions and genetic factors, and was assessed for plausibility using survey data on socio-demographic correlates. 94.3% (528/560) and 92.7% (519/560) of the sample reported faithful adherence to their medication and had traces of ART medication, respectively. The combined measure estimated good evidence of ART adherence at 69% and excellent evidence of adherence at 53%. The regression analysis results showed plausible patterns of ART adherence by socio-demographic status with men and younger participants being more likely to adhere poorly to medication, and higher socio-economic status individuals and those living in more urban locations being more likely to adhere well. Biomarker and self-reported measures of adherence can be combined in a meaningful way to produce a potentially more accurate measure of ART adherence. Results indicate that ART adherence

Might ART Adherence Estimates Be Improved by Combining Biomarker and Self-Report Data?

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Rebecca Rhead

Full Text Available As we endeavour to examine rates of viral suppression in PLHIV, reliable data on ART adherence are needed to distinguish between the respective contributions of poor adherence and treatment failure on high viral load. Self-reported data are susceptible to response bias and although biomarker data on drug presence and concentration can provide a superior, alternative method of measurement, complications due to drug-drug interactions and genetic variations can cause some inaccuracies. We investigate the feasibility of combining both biomarker and self-report data to produce a potentially more accurate measure of ART adherence.Data were taken from a large general-population survey in the Manicaland province, Zimbabwe, conducted in 2009-2011. HIV-infected adults who had initiated ART (N = 560 provided self-report data on adherence and dried blood spot samples that were analysed for traces of ART medication. A new three-category measure of ART adherence was constructed, based on biomarker data but using self-report data to adjust for cases with abnormally low and high drug concentrations due to possible drug-drug interactions and genetic factors, and was assessed for plausibility using survey data on socio-demographic correlates.94.3% (528/560 and 92.7% (519/560 of the sample reported faithful adherence to their medication and had traces of ART medication, respectively. The combined measure estimated good evidence of ART adherence at 69% and excellent evidence of adherence at 53%. The regression analysis results showed plausible patterns of ART adherence by socio-demographic status with men and younger participants being more likely to adhere poorly to medication, and higher socio-economic status individuals and those living in more urban locations being more likely to adhere well.Biomarker and self-reported measures of adherence can be combined in a meaningful way to produce a potentially more accurate measure of ART adherence. Results indicate that

Medication incidents reported to an online incident reporting system.

LENUS (Irish Health Repository)

Alrwisan, Adel

2011-01-15

AIMS: Approximately 20% of deaths from adverse events are related to medication incidents, costing the NHS an additional £500 million annually. Less than 5% of adverse events are reported. This study aims to assess the reporting rate of medication incidents in NHS facilities in the north east of Scotland, and to describe the types and outcomes of reported incidents among different services. Furthermore, we wished to quantify the proportion of reported incidents according to the reporters\\' profession. METHODS: A retrospective description was made of medication incidents reported to an online reporting system (DATIX) over a 46-month-period (July 2005 to April 2009). Reports originated from acute and community hospitals, mental health, and primary care facilities. RESULTS: Over the study period there were 2,666 incidents reported with a mean monthly reporting rate of 78.2\\/month (SD±16.9). 6.1% of all incidents resulted in harm, with insulin being the most commonly implicated medication. Nearly three-quarters (74.2%, n=1,978) of total incidents originated from acute hospitals. Administration incidents were implicated in the majority of the reported medication incidents (59%), followed by prescribing (10.8%) and dispensing (9.9%), while the nondescript "other medication incidents" accounted for 20.3% of total incidents. The majority of reports were made by nursing and midwifery staff (80%), with medical and dental professionals reporting the lowest number of incidents (n=56, 2%). CONCLUSIONS: The majority of medication incidents in this study were reported by nursing and midwifery staff, and were due to administration incidents. There is a clear need to elucidate the reasons for the limited contribution of the medical and dental professionals to reporting medication incidents.

Engagement with Health Care Providers Affects Self- Efficacy, Self-Esteem, Medication Adherence and Quality of Life in People Living with HIV.

Science.gov (United States)

Chen, Wei-Ti; Wantland, Dean; Reid, Paula; Corless, Inge B; Eller, Lucille S; Iipinge, Scholastika; Holzemer, William L; Nokes, Kathleen; Sefcik, Elizbeth; Rivero-Mendez, Marta; Voss, Joachim; Nicholas, Patrice; Phillips, J Craig; Brion, John M; Rose, Caro Dawson; Portillo, Carmen J; Kirksey, Kenn; Sullivan, Kathleen M; Johnson, Mallory O; Tyer-Viola, Lynda; Webel, Allison R

2013-11-01

The engagement of patients with their health care providers (HCP) improves patients' quality of life (QOL), adherence to antiretroviral therapy, and life satisfaction. Engagement with HCP includes access to HCP as needed, information sharing, involvement of client in decision making and self-care activities, respect and support of the HCP for the client's choices, and management of client concerns. This study compares country-level differences in patients' engagement with HCP and assesses statistical associations relative to adherence rates, self-efficacy, self-esteem, QOL, and symptom self-reporting by people living with HIV (PLHIV). A convenience sample of 2,182 PLHIV was enrolled in the United States, Canada, Puerto Rico, Namibia, and China. Cross-sectional data were collected between September 2009 and January 2011. Inclusion criteria were being at least 18 years of age, diagnosed with HIV, able to provide informed consent, and able to communicate in the local language with site researchers. In the HCP scale, a low score indicated greater provider engagement. Country comparisons showed that PLHIV in Namibia had the most HCP engagement (OR 2.80, p Western countries. Individuals having better HCP engagement showed better self-efficacy for adherence (t = -5.22, p < 0.0001), missed fewer medication doses (t = 1.92, p ≤ 0.05), had lower self-esteem ratings (t = 2.67, p < 0.01), fewer self-reported symptoms (t = 3.25, p < 0.0001), and better overall QOL physical condition (t = -3.39, p < 0.001). This study suggests that promoting engagement with the HCP is necessary to facilitate skills that help PLHIV manage their HIV. To improve ART adherence, HCPs should work on strategies to enhance self-efficacy and self-esteem, therefore, exhibiting fewer HIV-related symptoms and missing less medication doses to achieve better QOL.

STRUCTURE OF READINESS OF MEDICAL COLLEGE STUDENTS FOR PROFESSIONAL SELF-DEVELOPMENT

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Кирило Соцький

2014-04-01

Full Text Available The article reflects the analysis of the existing approaches to interpretation of the notion of selfdevelopment in psychological and pedagogical literature. It has been determined, that professional and personal self-development is carried out with the help of mechanisms of self-knowledge, self-organization, self-education, self-esteem, self-control. The research also presents the clarified essence and structure of the readiness of medical college students for professional self-development. Value, motivational, cognitive, operating, and volitional components have been singled out. Factors and stages of intending medical employees’ selfdevelopment have been substantiated in the article.

Patient perceptions about illness self-management in ANCA-associated small vessel vasculitis.

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Thorpe, C T; DeVellis, R F; Blalock, S J; Hogan, S L; Lewis, M A; DeVellis, B M

2008-06-01

To characterize patient perceptions, related to eight self-management behaviours relevant for adults with ANCA-associated small vessel vasculitis (ANCA-SVV), and to determine if these perceptions were associated with performance of each behaviour. Adults with ANCA-SVV (n = 202) completed a self-administered questionnaire that assessed eight self-management behaviours (adherence to recommendations for medication, health service use, diet, exercise, infection avoidance and symptom monitoring; prompt reporting of symptoms and side effects; and adjusting activities in response to symptoms), perceptions about these behaviours, socio-demographics, clinical factors and social desirability bias. Descriptive statistics were generated to characterize patients' perceptions about difficulty of, importance of, and specific barriers to performing each behaviour. Regression analyses explored whether these variables were associated with performing each behaviour, controlling for potential confounders. With few exceptions, higher perceived importance and lower perceived difficulty of each behaviour were associated with more frequent performance of the behaviour. For each behaviour, several specific barriers were frequently endorsed by patients and a number of these were associated with lower levels of self-management. This study reveals that patient perceptions about the illness and its treatment influence ANCA-SVV self-management. Perceived barriers to medication, health services, diet and exercise adherence were similar to those in other illnesses. This study also provides insight into barriers experienced by patients in performing behaviours (infection avoidance, symptom monitoring, reporting symptoms and side-effects and adjusting activities) not often previously studied. How the identification of these barriers can help inform future interventions for ANCA-SVV patients is to be discussed.

Phytotherapy in Germany : Its Role in Self-Medication and in Medical Prescribing

OpenAIRE

LUTZ, HEIDE; Pharmaceutical Biology, Pharmaceutical Institute, University of Tuebingen

1996-01-01

This paper gives a review of the present state of herbal medicine in Germany. Phytotherapeutic drugs (herbal remedies) are of considerable importance in Germany, both in self-medication and in medical prescriptions. They represent approx. 5.4% of the prescriptions by medical doctors, and 10% of the entire domestic drug market. The Federal Health Office of the German Ministry of Health has officially evaluated the efficacy and safety of approx. 300 medicinal plants used in Germany; their evalu...

Role of Side Chains in β-Sheet Self-Assembly into Peptide Fibrils. IR and VCD Spectroscopic Studies of Glutamic Acid-Containing Peptides.

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Tobias, Fernando; Keiderling, Timothy A

2016-05-10

Poly(glutamic acid) at low pH self-assembles after incubation at higher temperature into fibrils composed of antiparallel sheets that are stacked in a β2-type structure whose amide carbonyls have bifurcated H-bonds involving the side chains from the next sheet. Oligomers of Glu can also form such structures, and isotope labeling has provided insight into their out-of-register antiparallel structure [ Biomacromolecules 2013 , 14 , 3880 - 3891 ]. In this paper we report IR and VCD spectra and transmission electron micrograph (TEM) images for a series of alternately sequenced oligomers, Lys-(Aaa-Glu)5-Lys-NH2, where Aaa was varied over a variety of polar, aliphatic, or aromatic residues. Their spectral and TEM data show that these oligopeptides self-assemble into different structures, both local and morphological, that are dependent on both the nature of the Aaa side chains and growth conditions employed. Such alternate peptides substituted with small or polar residues, Ala and Thr, do not yield fibrils; but with β-branched aliphatic residues, Val and Ile, that could potentially pack with Glu side chains, these oligopeptides do show evidence of β2-stacking. By contrast, for Leu, with longer side chains, only β1-stacking is seen while with even larger Phe side chains, either β-form can be detected separately, depending on preparation conditions. These structures are dependent on high temperature incubation after reducing the pH and in some cases after sonication of initial fibril forms and reincubation. Some of these fibrillar peptides, but not all, show enhanced VCD, which can offer evidence for formation of long, multistrand, often twisted structures. Substitution of Glu with residues having selected side chains yields a variety of morphologies, leading to both β1- and β2-structures, that overall suggests two different packing modes for the hydrophobic side chains depending on size and type.

A case report of over-the-counter codeine dependence as consequence of self-medication for premature ejaculation

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Sethulakshmi Sreevalsam Anil

2017-01-01

Full Text Available Over-the-counter (OTC opioid abuse, including codeine, has been a growing problem around the world. Although the majority of the abusers use it for recreational purposes, many become dependent on it after having used it a medication for pain or cough. We present a case of codeine dependence where the initial prescribed use had been as a cough medication, but the subsequent abuse of it occurred the following self-medication for premature ejaculation. There is growing need for awareness among doctors and pharmacists of OTC abuse of opioids and for preventive interventions such as restricting supply, audit of pharmacies, training pharmacists, and counter staff and dispensing knowledge about proper use of opioid-containing medications to patients.

Medical students and stigma of depression. Part 2. Self-stigma.

Science.gov (United States)

Suwalska, Julia; Suwalska, Aleksandra; Szczygieł, Marta; Łojko, Dorota

2017-06-18

Up to 30% of medical students suffer from depression. They have better access to healthcare, but still receive appropriate treatment less frequently than people with depression in the general population. Most of them do not seek medical help as depression is perceived as a stigmatizing disorder, which leads to self-stigma and hampers early diagnosis and treatment. Thus, self-stigma means less effective therapy, unfavorable prognosis and relapses. According to the literature, self-stigma results in lowered self-esteem and is a major obstacle in the performance of social roles at work and in personal life. Stigmatization and self-stigma of depression among medical students are also associated with effects in their later professional life: they can lead to long-term consequences in the process of treating their patients in the future. Currently there are no unequivocal research results indicating the most effective ways of reducing stigmatization and self-stigma. It is necessary to educate about the symptoms and treatment of depression and to implement diverse intervention techniques to change behaviors and attitudes as early as possible.

Self-reported efficacy of complementary and alternative medicine: the Akershus study of chronic headache.

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Kristoffersen, Espen Saxhaug; Aaseth, Kjersti; Grande, Ragnhild Berling; Lundqvist, Christofer; Russell, Michael Bjørn

2013-04-18

Chronic headache is associated with disability and high utilisation of health care including complementary and alternative medicine (CAM). We investigated self-reported efficacy of CAM in people with chronic headache from the general population. Respondents with possible self-reported chronic headache were interviewed by physicians experienced in headache diagnostics. CAM queried included acupuncture, chiropractic, homeopathy, naprapathy, physiotherapy, psychological treatment, and psychomotor physiotherapy. Sixty-two % and 73% of those with primary and secondary chronic headache had used CAM.Self-reported efficacy of CAM ranged from 0-43% without significant differences between gender, headache diagnoses, co-occurrence of migraine, medication use or physician contact. CAM is widely used, despite self-reported efficacy of different CAM modalities is modest in the management of chronic headache.

Beliefs about medicines and self-reported adherence among pharmacy clients.

Science.gov (United States)

Mårdby, Ann-Charlotte; Akerlind, Ingemar; Jörgensen, Tove

2007-12-01

To analyse any association between general beliefs about medicines and self-reported adherence among pharmacy clients. Further, to examine general beliefs about medicines by background variables. The data were collected by questionnaires including the general section of the Beliefs about Medicines Questionnaire (BMQ), the self-reporting Medication Adherence Report Scale (MARS) and the following background variables: gender, age, education, country of birth and medicine use. The General BMQ measures beliefs about medicines as something harmful (General-Harm), beneficial (General-Benefit) and beliefs about how doctors prescribe medicines (General-Overuse). Of the 324 participating pharmacy clients, 54% were considered non-adherent. An association was found between General-Harm and adherence. Adherent behaviour and higher level of education were associated respectively with more beneficial and less harmful beliefs about medicines. Those born in the Nordic countries regarded medicines as more beneficial. Current users of herbal medicines and non-users of medicines were more likely to believe that doctors overprescribed medicines. General-Harm was associated with adherence to medication among Swedish pharmacy clients. Country of birth, education and medicine use influenced beliefs about medicines. Increased awareness of the patient's beliefs about medicines is needed among healthcare providers. We should encourage patients to express their views about medicines in order to optimize and personalize the information process. This can stimulate concordance and adherence to medication.

Experiential Education Builds Student Self-Confidence in Delivering Medication Therapy Management

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Wendy M. Parker

2017-07-01

Full Text Available To determine the impact of advanced pharmacy practice experiences (APPE on student self-confidence related to medication therapy management (MTM, fourth-year pharmacy students were surveyed pre/post APPE to: identify exposure to MTM learning opportunities, assess knowledge of the MTM core components, and assess self-confidence performing MTM services. An anonymous electronic questionnaire administered pre/post APPE captured demographics, factors predicted to impact student self-confidence (Grade point average (GPA, work experience, exposure to MTM learning opportunities, MTM knowledge and self-confidence conducting MTM using a 5-point Likert scale (1 = Not at all Confident; 5 = Extremely Confident. Sixty-two students (26% response rate responded to the pre-APPE questionnaire and n = 44 (18% to the post-APPE. Over 90% demonstrated MTM knowledge and 68.2% completed MTM learning activities. APPE experiences significantly improved students’ overall self-confidence (pre-APPE = 3.27 (0.85 SD, post-APPE = 4.02 (0.88, p < 0.001. Students engaging in MTM learning opportunities had higher self-confidence post-APPE (4.20 (0.71 vs. those not reporting MTM learning opportunities (3.64 (1.08, p = 0.05. Post-APPE, fewer students reported MTM was patient-centric or anticipated engaging in MTM post-graduation. APPE learning opportunities increased student self-confidence to provide MTM services. However, the reduction in anticipated engagement in MTM post-graduation and reduction in sensing the patient-centric nature of MTM practice, may reveal a gap between practice expectations and reality.

Self-Access Learning in Medical English (ME

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Pop Anişoara

2017-12-01

Full Text Available Individual learning is a pre-requisite of formal ME credit allocation in higher education (HE, albeit this may be hard to document and quantify. Edmodo-enhanced self-access learning can be customized to accommodate different learning styles, form basic learning skills and field-specific subskills, extend and expand the students’ medical language use, while also meeting the desiderata of independent curriculum-stipulated learning that can thus be exploited and demonstrated. The paper will reflect on the design of ME multimedia assignments as well as the quantitative and qualitative results, motivation and attitude of a group of medical students working on Edmodo self-access ME learning as part of a class research project for two years.

Privacy-Preserving Self-Helped Medical Diagnosis Scheme Based on Secure Two-Party Computation in Wireless Sensor Networks

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Yi Sun

2014-01-01

Full Text Available With the continuing growth of wireless sensor networks in pervasive medical care, people pay more and more attention to privacy in medical monitoring, diagnosis, treatment, and patient care. On one hand, we expect the public health institutions to provide us with better service. On the other hand, we would not like to leak our personal health information to them. In order to balance this contradiction, in this paper we design a privacy-preserving self-helped medical diagnosis scheme based on secure two-party computation in wireless sensor networks so that patients can privately diagnose themselves by inputting a health card into a self-helped medical diagnosis ATM to obtain a diagnostic report just like drawing money from a bank ATM without revealing patients’ health information and doctors’ diagnostic skill. It makes secure self-helped disease diagnosis feasible and greatly benefits patients as well as relieving the heavy pressure of public health institutions.

[Assessment of two applications of medication self-management in older patients. Qualitative study].

Science.gov (United States)

Carrillo, I; Guilabert, M; Pérez-Jover, V; Mira, J J

2015-01-01

The aging population and the growing use of technology are two realities of modern society. Developing tools to support medication self-management to polymedicated elderly may contribute to increase their safety. To know how patients polymedicated and older than 64 years manage dose their medication and assessment the utility of two medication self-management applications, specifically analyzing management systems, medication errors and positive and improvable aspects of each of the tools presented. Seven focal groups with 59 patients from associations and health departments were conducted. In such meetings, they received the applications and they were encouraged to use it. Then, a several group questions were asked them about their health status, how they managed their medication and their assessment about the applications. Most participants reported to use memory strategies to take correctly their medication. They assessed positively the applications although some of them showed resistance to incorporate it in their daily routine. The simple interface and ease of use were the characteristics of the applications most appreciated by patients. Is possible to foster among elderly patients the use of technological tools to support the proper administration of medications with purpose is to decrease errors and increase safety. When designing health applications is necessary to take into account the preferences of those who are targeted. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

Prevalence and pattern of self-medication practices in an urban area of Delhi, India

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Varun Kumar

2015-01-01

Full Text Available Background: Self-medication is one of the major health concerns worldwide and World Health Organization has laid emphasis on correctly investigating and controlling it. There is much public and professional concern regarding self-medication practices, which has dramatically increased in the last few decades, especially in the developing countries. Hence, this study was designed to study the prevalence and practice of self-medication practices in an urban area of Delhi, India. Materials and Methods: A cross-sectional study was conducted in March 2013 and data were collected by personal interviews using pretested questionnaires. An urban colony in the south district of Delhi was chosen and the eldest member of the family, present at the time of the visit was interviewed. Data were collected from 236 persons and analyzed using SPSS version 21. Results: The prevalence of self-medication was 92.8% (95 confidence interval: 66.5-79.4. 74.9% preferred allopathic medicines. Self-medication was found to be practiced more among younger persons than older age group persons (P = 0.000. Graduates and postgraduates practiced self-medication more than others (P = 0.002. Common cold (61.6% and fever (51.8% were the most common ailments for which self-medication were practiced. Paracetamol and cough syrups were the most commonly used class of drugs. Conclusion: The prevalence of self-medication in this study was high. Drugs especially antimicrobials were not taken for the proper length of time. Awareness regarding self-medication practices to help patients decide on the appropriateness of self-medication is required.

Self-regulation theory: applications to medical education: AMEE Guide No. 58.

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Sandars, John; Cleary, Timothy J

2011-01-01

Self-regulation theory, as applied to medical education, describes the cyclical control of academic and clinical performance through several key processes that include goal-directed behaviour, use of specific strategies to attain goals, and the adaptation and modification to behaviours or strategies to optimise learning and performance. Extensive research across a variety of non-medical disciplines has highlighted differences in key self-regulation processes between high- and low-achieving learners and performers. Structured identification of key self-regulation processes can be used to develop specific remediation approaches that can improve performance in academic and complex psycho-motor skills. General teaching approaches that are guided by a self-regulation perspective can also enhance academic performance. Self-regulation theory offers an exciting potential for improving academic and clinical performance in medical education.

Self-regulated learning processes of medical students during an academic learning task.

Science.gov (United States)

Gandomkar, Roghayeh; Mirzazadeh, Azim; Jalili, Mohammad; Yazdani, Kamran; Fata, Ladan; Sandars, John

2016-10-01

This study was designed to identify the self-regulated learning (SRL) processes of medical students during a biomedical science learning task and to examine the associations of the SRL processes with previous performance in biomedical science examinations and subsequent performance on a learning task. A sample of 76 Year 1 medical students were recruited based on their performance in biomedical science examinations and stratified into previous high and low performers. Participants were asked to complete a biomedical science learning task. Participants' SRL processes were assessed before (self-efficacy, goal setting and strategic planning), during (metacognitive monitoring) and after (causal attributions and adaptive inferences) their completion of the task using an SRL microanalytic interview. Descriptive statistics were used to analyse the means and frequencies of SRL processes. Univariate and multiple logistic regression analyses were conducted to examine the associations of SRL processes with previous examination performance and the learning task performance. Most participants (from 88.2% to 43.4%) reported task-specific processes for SRL measures. Students who exhibited higher self-efficacy (odds ratio [OR] 1.44, 95% confidence interval [CI] 1.09-1.90) and reported task-specific processes for metacognitive monitoring (OR 6.61, 95% CI 1.68-25.93) and causal attributions (OR 6.75, 95% CI 2.05-22.25) measures were more likely to be high previous performers. Multiple analysis revealed that similar SRL measures were associated with previous performance. The use of task-specific processes for causal attributions (OR 23.00, 95% CI 4.57-115.76) and adaptive inferences (OR 27.00, 95% CI 3.39-214.95) measures were associated with being a high learning task performer. In multiple analysis, only the causal attributions measure was associated with high learning task performance. Self-efficacy, metacognitive monitoring and causal attributions measures were associated

Use of Over-the-Counter Medication among Pregnant Women in Sharjah, United Arab Emirates

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Abduelmula R. Abduelkarem

2017-01-01

Full Text Available Background. Over-the-counter medications are widely available in pharmacies Their safety profile, however, does not extend to pregnant women. Accordingly, there should be educational programs developed for pregnant women to protect them from the harms of the side effects. Aim. This study was planned and designed with the aim of exploring the awareness and assessing the usage of OTC medications among pregnant women in Sharjah, UAE. Method. A cross-sectional survey using a self-administered questionnaire. Results. More than three-quarters (75.7% reported that they are familiar with the term “over-the-counter drugs.” Interestingly, 40% of the respondents reported that they took OTC drugs during pregnancy, and the majority (94.2% agreed with the survey statement “not all OTC medications are safe to be taken during pregnancy.” Constipation was the most frequent side effect that most of the participants reported during the study period. Folic acid (36%, calcium (28.6%, and iron (35.1% were the most common supplements used by the pregnant women responding. Conclusion. The reported 40% usage of OTC medications among pregnant women in this study is worrisome and calls for the need to educate, counsel, and increase awareness among pregnant women regarding the dangers of OTC drugs usage while pregnant in Sharjah, UAE.

A validation analysis of two self-reported HAM-D6 versions

DEFF Research Database (Denmark)

Bech, P; Wilson, P; Wessel, T

2009-01-01

the unidimensionality of this administration form in patients with mild-to-moderate depression. METHOD: The item response theory analysis of Mokken was used to test the unidimensionality of both the Interactive Voice Recording System (IVRS) version of the HAM-D(6) and a paper-and-pencil self-reported version (S-HAM-D(6......OBJECTIVE: The six items of the clinician-administrated Hamilton Depression Scale (HAM-D(6)) cover the core items of depressive states reflecting the antidepressive effect of medication. In this study, the two self-reported versions of the HAM-D(6) have been psychometrically validated to ensure...

Using Self-reports or Claims to Assess Disease Prevalence: It's Complicated.

Science.gov (United States)

St Clair, Patricia; Gaudette, Étienne; Zhao, Henu; Tysinger, Bryan; Seyedin, Roxanna; Goldman, Dana P

2017-08-01

Two common ways of measuring disease prevalence include: (1) using self-reported disease diagnosis from survey responses; and (2) using disease-specific diagnosis codes found in administrative data. Because they do not suffer from self-report biases, claims are often assumed to be more objective. However, it is not clear that claims always produce better prevalence estimates. Conduct an assessment of discrepancies between self-report and claims-based measures for 2 diseases in the US elderly to investigate definition, selection, and measurement error issues which may help explain divergence between claims and self-report estimates of prevalence. Self-reported data from 3 sources are included: the Health and Retirement Study, the Medicare Current Beneficiary Survey, and the National Health and Nutrition Examination Survey. Claims-based disease measurements are provided from Medicare claims linked to Health and Retirement Study and Medicare Current Beneficiary Survey participants, comprehensive claims data from a 20% random sample of Medicare enrollees, and private health insurance claims from Humana Inc. Prevalence of diagnosed disease in the US elderly are computed and compared across sources. Two medical conditions are considered: diabetes and heart attack. Comparisons of diagnosed diabetes and heart attack prevalence show similar trends by source, but claims differ from self-reports with regard to levels. Selection into insurance plans, disease definitions, and the reference period used by algorithms are identified as sources contributing to differences. Claims and self-reports both have strengths and weaknesses, which researchers need to consider when interpreting estimates of prevalence from these 2 sources.

Evaluation of Self Medication Amongst Nursing Students of Bastar Region: A Questionnaire Based Study

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Syed Sajid Ali

2015-07-01

Full Text Available  Self-medication provides low cost alternative for expensive medical management but inappropriate use can cause problems. For Nursing undergraduates such practice has special significance since they have medical knowledge but very superficial and also its application is limited.  Hence the present study was planned to evaluate the status of students studying in different years of B.Sc. Nursing.To determine the prevalence, attitude and knowledge of self medication amongst the students of Government Nursing College, Jagdalpur(ChhatisgarhThis questionnaire based study was performed on 142 Nursing students of 1st, 2nd and 3rd year aged between17-24 years. Mean age was found to be 20.5 years (±2.5years. A prevalidated questionnaire was distributed amongst the participants after explaining the purpose of the study and taking informed consent. The results obtained from this study showed that out of 142 students 120 (84.50 % students used self medicationCommonest source of information for self medication were seniors and colleagues 40(33.33%, and the most common indication for self medication was common cold 41(34.16 %.D’cold Total 49(40.83% was the most common medication used as self medication .Only 16 (13.33% students were having the knowledge about content, dose, duration of therapy and adverse drug reaction of the medication that they used. The most common source to obtain medicines for self medication was pharmaceutical store 80 (66.67 %.The findings from this study highlights the striking prevalence of self medication among nursing students, the lack of knowledge and the risks associated with them. We recommend that a global approach must be taken to prevent this problem from escalating which would involve awareness and education regarding the implications of self medication, strategies to prevent the supply of medicines without prescription by pharmacies and strict rules regarding pharmaceutical advertising.

Proportion of medication error reporting and associated factors among nurses: a cross sectional study.

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Jember, Abebaw; Hailu, Mignote; Messele, Anteneh; Demeke, Tesfaye; Hassen, Mohammed

2018-01-01

A medication error (ME) is any preventable event that may cause or lead to inappropriate medication use or patient harm. Voluntary reporting has a principal role in appreciating the extent and impact of medication errors. Thus, exploration of the proportion of medication error reporting and associated factors among nurses is important to inform service providers and program implementers so as to improve the quality of the healthcare services. Institution based quantitative cross-sectional study was conducted among 397 nurses from March 6 to May 10, 2015. Stratified sampling followed by simple random sampling technique was used to select the study participants. The data were collected using structured self-administered questionnaire which was adopted from studies conducted in Australia and Jordan. A pilot study was carried out to validate the questionnaire before data collection for this study. Bivariate and multivariate logistic regression models were fitted to identify factors associated with the proportion of medication error reporting among nurses. An adjusted odds ratio with 95% confidence interval was computed to determine the level of significance. The proportion of medication error reporting among nurses was found to be 57.4%. Regression analysis showed that sex, marital status, having made a medication error and medication error experience were significantly associated with medication error reporting. The proportion of medication error reporting among nurses in this study was found to be higher than other studies.

Child and caregiver reported problems in using asthma medications and question-asking during paediatric asthma visits.

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Sleath, Betsy; Carpenter, Delesha M; Beard, Ashley; Gillette, Christopher; Williams, Dennis; Tudor, Gail; Ayala, Guadalupe X

2014-02-01

The objectives of the study were to describe the extent to which lay caregivers and children who reported asthma medication problems asked medication questions during their medical visits. Children with asthma ages 8 through 16 years and their caregivers were recruited at five paediatric practices and their medical visits were audiotape recorded. Children were interviewed after their medical visits and caregivers completed questionnaires. A home visit was conducted 1 month later. Generalized estimating equations were used to analyse the data. Two hundred and ninety six families participated. Among those caregivers who reported asthma medication problems, only 35% had asked at least one medication question during the visit. Among children who reported asthma medication problems, only 11% had asked at least one medication question during their consultation. Caregivers and children who reported a problem with their asthma medications were significantly more likely to have asked medication questions if providers had asked more questions about control medications. Children who reported higher asthma management self-efficacy were significantly more likely to have asked an asthma medication question. Only one in three caregivers and one in 10 children who reported an asthma medication problem asked a question during their medical visits and many still reported these problems 1 month later. Pharmacists should encourage caregivers and children to report problems they may be having using their asthma medications. © 2013 Royal Pharmaceutical Society.

Self-reported hair loss in patients with chronic spontaneous urticaria treated with omalizumab: an under-reported, transient side effect?

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Konstantinou, G N; Chioti, A G; Daniilidis, M

2016-09-01

Omalizumab has been recently approved for treating patients with refractory to H1- antihistamines chronic spontaneous urticaria (CSU). Although hair loss is listed among omalizumab side effects, there are no available data to estimate its frequency. We describe for the first time hair loss as a side effect associated with omalizumab administration in three women, 38, 62 and 70 years old, suffering from refractory to H1-antihistamines CSU. This information was retrieved from their Chronic Urticaria Quality of Life Questionnaires. Despite this side effect, all patients agreed to continue omalizumab regular administration. Hair loss appeared to be transient, lasting up to four months. All cases finally benefited from omalizumab continuation.

Characteristics of self-medication for pain relief among first-year health care students in Zagreb, Croatia.

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Brlić, Kristina Čuljak; Janev Holcer, Nataša; Sović, Slavica; Štimac, Danijela

2014-12-01

Taking over the responsibility for one's own health and active participation in eliminating the existing health problems is ever more widespread in the world. Self-medication in the form of using any kind of therapy without previous consultation with medical professionals has been ever more common among student populations in many countries. The aim of this study was to determine the attitudes about self-medication for pain relief and features of self-medication in first-year students of the University of Applied Health Studies in Zagreb. The study was conducted using an anonymous questionnaire, which was completed by 389 respondents. Taking painkillers in the past year was reported by 74.6% of respondents, significantly more by female students (80.8%); 62.6% of female students used painkillers once a month versus 45.7% of male students taking analgesics once a year. Ibuprofen was preferred by female students and acetylsalicylic acid by male students. Headache was the most common indication for taking painkillers (76.6%), followed by menstrual discomforts in female students (66.2%) and toothache (28.6%). Significant sex differences were recorded in the choice of drugs, indications for self-medication, and frequency of drug use. There were no differences between study courses. Appropriate student education and improved information transfer between professionals and students are the key elements to ensure judicious, quality and knowledge based use of drugs among students.

Evaluation of self-medication amongst university students in Abbottabad, Pakistan; prevalence, attitude and causes.

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Ullah, Hanif; Khan, Shujaat A; Ali, Sayyad; Karim, Sabiha; Baseer, Abdul; Chohan, Ossam; Hassan, Syed M F; Khan, Kashif M; Murtaza, Ghulam

2013-01-01

Self-medication is a serious issue in most parts of the world. This study aims to evaluate self-medication among university students of Abbottabad, Pakistan. This cross-sectional survey study was carried out in COMSATS Institute of Information Technology, Abbottabad during December 1 - December 31,2011. A sample of 275 students was selected for the study using convenience method of sampling. Data were managed and analyzed via SPSS version 16.0. Inferences were drawn using Z-test Out of 268 respondents (male = 61.6%, female = 38.6%), 138 were non-health professional students whereas 130 were health professional students. The prevalence of self-medication was 95.5%. Most common factor (45.7%) responsible for self-medication was "low severity of disease". Most common symptom (50.8%) that caused self-medication and stocking of medicines was "storage of medicines for multi purposes". Some respondents (22.7%) got addicted due to self-medication. Most of the students trust in allopathic medicines system. High prevalence of self-medication can be controlled through regulatory authorities, mass education and availability of health facilities.

Revisiting the 'self-medication' hypothesis in light of the new data linking low striatal dopamine to comorbid addictive behavior.

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Awad, A George; Voruganti, Lakshmi L N P

2015-06-01

Persons with schizophrenia are at a high risk, almost 4.6 times more likely, of having drug abuse problems than persons without psychiatric illness. Among the influential proposals to explain such a high comorbidity rate, the 'self-medication hypothesis' proposed that persons with schizophrenia take to drugs in an effort to cope with the illness and medication side effects. In support of the self-medication hypothesis, data from our earlier clinical study confirmed the strong association between neuroleptic dysphoria and negative subjective responses and comorbid drug abuse. Though dopamine has been consistently suspected as one of the major culprits for the development of neuroleptic dysphoria, it is only recently our neuroimaging studies correlated the emergence of neuroleptic dysphoria to the low level of striatal dopamine functioning. Similarly, more evidence has recently emerged linking low striatal dopamine with the development of vulnerability for drug addictive states in schizophrenia. The convergence of evidence from both the dysphoria and comorbidity research, implicating the role of low striatal dopamine in both conditions, has led us to propose that the person with schizophrenia who develops dysphoria and comorbid addictive disorder is likely to be one and the same.

Self-reported needs for improving the supervision competence of PhD supervisors from the medical sciences in Denmark

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Rie Raffing

2017-10-01

Full Text Available Abstract Background Quality of supervision is a major predictor for successful PhD projects. A survey showed that almost all PhD students in the Health Sciences in Denmark indicated that good supervision was important for the completion of their PhD study. Interestingly, approximately half of the students who withdrew from their program had experienced insufficient supervision. This led the Research Education Committee at the University of Copenhagen to recommend that supervisors further develop their supervision competence. The aim of this study was to explore PhD supervisors’ self-reported needs and wishes regarding the content of a new program in supervision, with a special focus on the supervision of PhD students in medical fields. Methods A semi-structured interview guide was developed, and 20 PhD supervisors from the Graduate School of Health and Medical Sciences at the Faculty of Health and Medical Sciences at the University of Copenhagen were interviewed. Empirical data were analysed using qualitative methods of analysis. Results Overall, the results indicated a general interest in improved competence and development of a new supervision programme. Those who were not interested argued that, due to their extensive experience with supervision, they had no need to participate in such a programme. The analysis revealed seven overall themes to be included in the course. The clinical context offers PhD supervisors additional challenges that include the following sub-themes: patient recruitment, writing the first article, agreements and scheduled appointments and two main groups of students, in addition to the main themes. Conclusions The PhD supervisors reported the clear need and desire for a competence enhancement programme targeting the supervision of PhD students at the Faculty of Health and Medical Sciences. Supervision in the clinical context appeared to require additional competence. Trial registration The Scientific Ethical Committee

Medical student self-efficacy, knowledge and communication in adolescent medicine.

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Woods, Jennifer L; Pasold, Tracie L; Boateng, Beatrice A; Hense, Devon J

2014-08-20

To evaluate student self-efficacy, knowledge and communication with teen issues and learning activities. Data were collected during the 8-week pediatric rotation for third-year medical students at a local children's hospital. Students completed a self-efficacy instrument at the beginning and end of the rotation; knowledge and communication skills were evaluated during standardized patient cases as part of the objective structured clinical examination. Self-efficacy, knowledge and communication frequencies were described with descriptive statistics; differences between groups were also evaluated utilizing two-sample t-tests. Self-efficacy levels of both groups increased by the end of the pediatric rotation, but students in the two-lecture group displayed significantly higher self-efficacy in confidentiality with adolescents (t(35)=-2.543, p=0.02); interviewing adolescents, assessing risk, sexually transmitted infection risk and prevention counseling, contraception counseling were higher with marginal significance. No significant differences were found between groups for communication; assessing sexually transmitted infection risk was marginally significant for knowledge application during the clinical exam. Medical student self-efficacy appears to change over time with effects from different learning methods; this higher self-efficacy may increase future comfort and willingness to work with this high-risk, high-needs group throughout a medical career.

Prevalence of depression and low self-esteem among medical ...

African Journals Online (AJOL)

Prevalence of depression and low self-esteem among medical students in the ... and predisposes students to a range of negative psychological reactions. ... Anxiety and Stress Scale and Rosenberg Self-Esteem Scale, to investigate the ...

The Role of Self-Concept in Medical Education

Science.gov (United States)

Yeung, Alexander Seeshing; Li, Bingyi; Wilson, Ian; Craven, Rhonda G.

2014-01-01

Much research has acknowledged the importance of self-concept for adolescents' academic behaviour, motivation and aspiration, but little is known about the role of self-concept underpinning the motivation and aspiration of higher education students in a specialised field such as medical education. This article draws upon a programme of research…

Relationships between self-reported physical and mental health and intelligence performance across adulthood.

Science.gov (United States)

Perlmutter, M; Nyquist, L

1990-07-01

One hundred and twenty-seven adults between 20 and 90 years of age were tested on the Wechsler Adult Intelligence Scale for their digit span memory (forward and backward), fluid intelligence (block design and digit symbol), and crystallized intelligence (vocabulary and information), as well as assessed for self-reported health (Cornell Medical Index, Zung Depression Scale, health habits, and self-ratings of physical and mental health). As expected, across the entire age range there was no correlation between age and digit span memory (r = .03), a strong negative correlation between age and fluid intelligence (r = -.78), and a modest positive correlation between age and crystallized intelligence (r = .27). In addition, older adults reported more physical (r = .36) and mental (r = .32) health problems than did younger adults. Of special interest was the finding that both self-reported physical and mental health accounted for significant variance in intelligence performance, particularly in older adults. Moreover, self-reported health accounted for a considerable portion of observed variance, even when age differences in self-reported health were statistically controlled.

Self-medication with antibiotics among undergraduate nursing students of a government medical college in Eastern India

OpenAIRE

suvadip biswas; aritra ghosh; Krishnendu Mondal; Saikat Kumar Dalui; Mithilesh Haldar; Supreeti Biswas

2015-01-01

Antibiotics serve very useful therapeutic purpose in eradicating pathogens. Unfortunately excessive and inappropriate use of antibiotics results in antibiotic resistance. The consequences of inappropriate self-medication with antibiotics among healthcare professionals have severe implications which might be legal issues, ethical issues, negative impacts on patient and poor quality of health care delivery. The present study was conducted on self-medication by undergraduate nursing students in ...

Validation of an abbreviated Treatment Satisfaction Questionnaire for Medication (TSQM-9 among patients on antihypertensive medications

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Desrosiers Marie-Pierre

2009-04-01

Full Text Available Abstract Background The 14-item Treatment Satisfaction Questionnaire for Medication (TSQM Version 1.4 is a reliable and valid instrument to assess patients' satisfaction with medication, providing scores on four scales – side effects, effectiveness, convenience and global satisfaction. In naturalistic studies, administering the TSQM with the side effects domain could provoke the physician to assess the presence or absence of adverse events in a way that is clinically atypical, carrying the potential to interfere with routine medical care. As a result, an abbreviated 9-item TSQM (TSQM-9, derived from the TSQM Version 1.4 but without the five items of the side effects domain was created. In this study, an interactive voice response system (IVRS-administered TSQM-9 was psychometrically evaluated among patients taking antihypertensive medication. Methods A total of 3,387 subjects were invited to participate in the study from an online panel who self-reported taking a prescribed antihypertensive medication. The subjects were asked to complete the IVRS-administered TSQM-9 at the start of the study, along with the modified Morisky scale, and again within 7 to 14 days. Standard psychometric analyses were conducted; including Cronbach's alpha, intraclass correlation coefficients, structural equation modeling, Spearman correlation coefficients and analysis of covariance (ANCOVA. Results A total of 396 subjects completed all the study procedures. Approximately 50% subjects were male with a good racial/ethnic mix: 58.3% white, 18.9% black, 17.7% Hispanic and 5.1% either Asian or other. There was evidence of construct validity of the TSQM-9 based on the structural equation modeling findings of the observed data fitting the Decisional Balance Model of Treatment Satisfaction even without the side effects domain. TSQM-9 domains had high internal consistency as evident from Cronbach's alpha values of 0.84 and greater. TSQM-9 domains also demonstrated good test

Self‐medication patterns among medical students in South India

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Nitasha Bhat

2012-04-01

Full Text Available BackgroundSelf-medication results in wastage of resources, increases resistance of pathogens and generally causes serious health hazards such as adverse drug reactions, prolonged suffering and drug dependence. This study was undertaken to determine the reasons for self-medication and the pattern of self-medication among medical students.MethodThis cross-sectional descriptive study was conducted at the K.S. Hegde Medical Academy, Mangalore. The participants were medical students from first to final year. Medical students were selected through convenience sampling. The data was collected using a pre-tested semi-structured questionnaire. The data was analysed using SPSS version 16 and the results expressed as proportions.ResultsA total of 200 students, 121 (60.5% female and 79 (39.5% male, were included in the study. Of the medical students surveyed, self-medication was reported among 92%. The respondents who used self-medication found it to be time-saving in providing relief from minor ailments. The most common ailments for which self-medication were used were: the common cold (69%, fever (63% and headache (60%. The students consulted their textbooks (39% and seniors or classmates (38% for the medications. Antipyretics (71%, analgesics (65%, antihistamines (37% and antibiotics (34% were the most common self-medicated drugs. Of the respondents, 33% were unaware of the adverse effects of the medication and 5% had experienced adverse reactions. The majority (64% of students advised medications to others, more often to family and friends.ConclusionThe prevalence of self-medication among medical students is high, facilitated by the easy availability of drugs and information from textbooks or seniors. A significant number of students are unaware of the adverse effects of the medication that they themselves take and suggest to others. Therefore, potential problems of self-medication should be emphasised to the students.

Comparing the Self-Report and Measured Smartphone Usage of College Students: A Pilot Study.

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Lee, Heyoung; Ahn, Heejune; Nguyen, Trung Giang; Choi, Sam-Wook; Kim, Dae Jin

2017-03-01

Nowadays smartphone overuse has become a social and medical concern. For the diagnosis and treatment, clinicians use the self-report information, but the report data often does not match actual usage pattern. The paper examines the similarity and variance in smartphone usage patterns between the measured data and self-reported data. Together with the self-reported data, the real usage log data is collected from 35 college students in a metropolitan region of Northeast Asia, using Android smartphone monitoring application developed by the authors. The unconscious users underestimate their usage time by 40%, in spite of 15% more use in the actual usage. Messengers are most-used application regardless of their self-report, and significant preference to SNS applications was observed in addict group. The actual hourly pattern is consistent with the reported one. College students use more in the afternoon, when they have more free time and cannot use PCs. No significant difference in hourly pattern is observed between the measured and self-report. The result shows there are significant cognitive bias in actual usage patterns exists in self report of smartphone addictions. Clinicians are recommended to utilize measurement tools in diagnosis and treatment of smartphone overusing subjects.

Reported Sildenafil Side Effects in Pediatric Pulmonary Hypertension Patients

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Stephanie Leigh Siehr

2015-03-01

Full Text Available Background: Sildenafil, a phosphodiestase type 5 inhibitor, was approved in 2005 for the treatment of pulmonary arterial hypertension (PAH in adults, and is commonly used off-label for pediatric patients. Little is known, however, about sildenafil’s side effects in this population.Methods: Single institution, longitudinal survey-based study performed in an outpatient pediatric cardiology clinic. Pediatric patients on sildenafil (alone or in combination with other PH therapies completed questionnaires regarding frequency of vascular, gastrointestinal, neurologic and hematologic side effects. Results: Between January 2011 and May 2014, 66 pediatric patients with PH on sildenafil filled out 214 surveys, 32 patients (96 surveys on monotherapy, and 43 patients (118 surveys on sildenafil plus an endothelin receptor antagonist (bosentan or ambrisentan and/or a prostacyclin (epoprostenol or treprostinil. Overall, 30% of respondents identified at least one side effect. For all patients on sildenafil, incidence of side effects by system was 37% gastrointestinal, 35% vascular and 22% neurologic. For patients on sildenafil monotherapy, incidence of side effects by system was 24% gastrointestinal, 21% vascular and 18% neurologic compared to patients on combination therapy who reported an incidence of 48% gastrointestinal, 45% vascular and 25% neurologic.Conclusion: Incidence of vascular, gastrointestinal and neurologic side effect in pediatric patients on sildenafil therapy for pulmonary arterial hypertension was 30%. Side effects were more common in patients on combination therapy with an endothelin receptor antagonist and/or prostacyclin than in patients on sildenafil monotherapy.

Self Medication: Predictors and Practices among Rural Population of Nellikuppam Village, Kancheepuram District, Tamil Nadu

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Kalaivani Annadurai

2017-01-01

Full Text Available Background: Inappropriate self medication is one of the leading causes of growing antibiotic resistance in developing nations which poses a major public health threat worldwide and assessment of self medication practices is essential for better understanding of the problem. Aim and Objectives: To find out the predictors of self medication use among the residents of Nellikuppam village, Kancheepuram District, Tamil Nadu. To assess the self medication practices among the residents of Nellikuppam village, Kancheepuram District, Tamil Nadu. Material and Methods: This was a descriptive cross sectional study conducted among 335 adult households with six months recall period in Nellikuppam village of Tamil Nadu during May to October, 2014 using a pretested semi-structured questionnaire. Results: Prevalence of self medication among adult rural population was 53.43% and only half of the study population opined that it was harmful. Pharmacists (72.06% were the major source of drug information on self medication. Paracetomol (84.91% was the commonest drug used for self medication. Major predictors were perception of illness as minor ailment and unavailability of doctors in their locality. Nearly half of the current self medication users (47.49% were in the idea of practicing self medication in the future. Conclusion: This study results implies the need for proper enforcement of legal measures towards the restriction of over the counter medicine and creating awareness among general population on adverse reaction of self medication.

Assessing medical students' self-regulation as aptitude in computer-based learning.

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Song, Hyuksoon S; Kalet, Adina L; Plass, Jan L

2011-03-01

We developed a Self-Regulation Measure for Computer-based learning (SRMC) tailored toward medical students, by modifying Zimmerman's Self-Regulated Learning Interview Schedule (SRLIS) for K-12 learners. The SRMC's reliability and validity were examined in 2 studies. In Study 1, 109 first-year medical students were asked to complete the SRMC. Bivariate correlation analysis results indicated that the SRMC scores had a moderate degree of correlation with student achievement in a teacher-developed test. In Study 2, 58 third-year clerkship students completed the SRMC. Regression analysis results indicated that the frequency of medical students' usage of self-regulation strategies was associated with their general clinical knowledge measured by a nationally standardized licensing exam. These two studies provided evidence for the reliability and concurrent validity of the SRMC to assess medical students' self-regulation as aptitude. Future work should provide evidence to guide and improve instructional design as well as inform educational policy.

Self-Care Strategies among Chinese Adolescent Girls with Dysmenorrhea: A Qualitative Study.

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Wong, Cho Lee; Ip, Wan Yim; Lam, Lai Wah

2016-08-01

Little is known about how Chinese adolescent girls manage dysmenorrhea. This study aims to explore self-care strategies among Chinese adolescent girls with dysmenorrhea. The study uses a mixed methods design with two phases: a cross-sectional survey in phase I and semistructured interviews in phase II. This paper reports phase II. In line with the phase I findings, 28 adolescent girls with different characteristics (high or low levels of self-care behavior and pain intensity, who did or did not self-medicate, and who had or had not received menstrual education) were recruited for interviews. Content analysis was used for data analysis. Four categories emerged from the data: lifestyle changes, symptom management, communicating dysmenorrhea with others, and seeking medical advice. Girls selected their diets carefully and reduced physical activity during menstruation to avoid aggravating symptoms. Heat therapy commonly was employed for symptom management. A few girls self-medicated to obtain immediate relief from pain, but the majority expressed reservations about using medication because they worried about dependence and side effects. Some girls communicated dysmenorrhea with their family and friends, but the majority did not seek medical advice. The present study showed that girls employed various self-care strategies for dysmenorrhea, including some strategies stemming from traditional Chinese medicine. The findings revealed menstrual etiquette among Chinese adolescent girls with dysmenorrhea, and demonstrated that self-medication was not part of most girls' self-care. Understanding the self-care strategies of these girls is important, as it can help nurses develop a culturally-specific intervention to promote self-care among adolescent girls with dysmenorrhea. Copyright © 2016 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Use of traditional eye medicine and self-medication in rural India: A population-based study.

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Gupta, Noopur; Vashist, Praveen; Tandon, Radhika; Gupta, Sanjeev K; Kalaivani, Mani; Dwivedi, S N

2017-01-01

To determine the type and nature of traditional eye medicine (TEM), their sources and use and practices related to self-medication for ophthalmic diseases in a rural Indian population. A population-based, cross-sectional study was conducted in 25 randomly selected clusters of Rural Gurgaon, Haryana, India as part of CORE (Cornea Opacity Rural Epidemiological) study. In addition to comprehensive ophthalmic examination, health-seeking behavior and use of self-medication and TEM was assessed in the adult population using a semi-structured questionnaire. Physical verification of available ophthalmic medications in the enumerated households was conducted by the study team. Descriptive statistics were computed along with multivariable logistic regression analysis to determine associated factors for use of self-medication and TEM. Of the 2160 participants interviewed, 396 (18.2%) reported using ophthalmic medications without consulting an ophthalmologist, mainly for symptoms like watering (37.1%), redness (27.7%), itching (19.2%) and infection (13.6%). On physical verification of available eye drops that were being used without prescription, 26.4% participants were practicing self-medication. Steroid, expired/unlabeled and indigenous eye drops were being used by 151(26.5%), 120(21.1%) and 75 (13.2%) participants respectively. Additionally, 25.7% (529) participants resorted to home remedies like 'kajal'(61.4%), honey (31.4%), ghee (11.7%) and rose water (9.1%). Use of TEM is prevalent in this population. The rampant use of steroid eye drops without prescription along with use of expired or unlabelled eye drops warrants greater emphasis on safe eye care practices in this population. Public awareness and regulatory legislations must be implemented to decrease harmful effects arising due to such practices.

Medical doctors as the captain of a ship: an analysis of medical students' book reports on Joseph Conrad's "Lord Jim".

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Hwang, Kun; Lee, Seung Jae; Kim, Seong Yeon; Hwang, Se Won; Kim, Ae Yang

2014-01-01

In South Korean ferry disaster in 2014, the captain abandoned the ship with passengers including high school students still aboard. We noticed the resemblance of abandoning the ship with passengers still aboard the ferry (named the Sewol) and the ship Patna, which was full of pilgrims, in Joseph Conrad's novel "Lord Jim." The aim of this study is to see how medical students think about the role of a medical doctor as a captain of a ship by analyzing book reports on Conrad's "Lord Jim." Participants included 49 third-year medical students. Their book reports were analyzed. If placed in the same situation as the character of Jim, 24 students of the 49 respondents answered that they would stay with the passengers, while 18 students indicated they would escape from the ship with the crew. Most of the students thought the role of a doctor in the medical field was like that of a 'captain.' The medical students reported that they wanted to be a doctor who is responsible for his or her patients, highly moral, warm-hearted, honest, and with high self-esteem. In conclusion, we found that "Lord Jim" induced the virtue of 'responsibility' from the medical students. Consequently, "Lord Jim" could be good teaching material for medical humanities.

[Relationship between self-directed learning with learning styles and strategies in medical students].

Science.gov (United States)

Márquez U, Carolina; Fasce H, Eduardo; Pérez V, Cristhian; Ortega B, Javiera; Parra P, Paula; Ortiz M, Liliana; Matus B, Olga; Ibáñez G, Pilar

2014-11-01

Self-directed learning (SDL) skills are particularly important in medical education, considering that physicians should be able to regulate their own learning experiences. To evaluate the relationship between learning styles and strategies and self-directed learning in medical students. One hundred ninety nine first year medical students (120 males) participated in the study. Preparation for Independent Learning (EPAI) scale was used to assess self-direction. Schmeck learning strategies scale and Honey and Alonso (CHAEA) scales were used to evaluate learning styles and strategies. Theoretical learning style and deep processing learning strategy had positive correlations with self-direct learning. Medical students with theoretical styles and low retention of facts are those with greater ability to self-direct their learning. Further studies are required to determine the relationship between learning styles and strategies with SDL in medical students. The acquired knowledge will allow the adjustment of teaching strategies to encourage SDL.

The development of self-regulated learning during the pre-clinical stage of medical school: a comparison between a lecture-based and a problem-based curriculum.

Science.gov (United States)

Lucieer, Susanna M; van der Geest, Jos N; Elói-Santos, Silvana M; de Faria, Rosa M Delbone; Jonker, Laura; Visscher, Chris; Rikers, Remy M J P; Themmen, Axel P N

2016-03-01

Society expects physicians to always improve their competencies and to be up to date with developments in their field. Therefore, an important aim of medical schools is to educate future medical doctors to become self-regulated, lifelong learners. However, it is unclear if medical students become better self-regulated learners during the pre-clinical stage of medical school, and whether students develop self-regulated learning skills differently, dependent on the educational approach of their medical school. In a cross-sectional design, we investigated the development of 384 medical students' self-regulated learning skills with the use of the Self-Regulation of Learning Self-Report Scale. Next, we compared this development in students who enrolled in two distinct medical curricula: a problem-based curriculum and a lectured-based curriculum. Analysis showed that more skills decreased than increased during the pre-clinical stage of medical school, and that the difference between the curricula was mainly caused by a decrease in the skill evaluation in the lecture-based curriculum. These findings seem to suggest that, irrespective of the curriculum, self-regulated learning skills do not develop during medical school.

Side effects of AAS abuse: an overview.

Science.gov (United States)

Turillazzi, E; Perilli, G; Di Paolo, M; Neri, M; Riezzo, I; Fineschi, V

2011-05-01

Anabolic - androgenic steroids (AAS) were originally developed to promote growth of skeletal muscle. AAS abuse is commonly associated with bodybuilders, weightlifters, and other athletes. The issue of AAS toxicity is not yet completely understood since the adverse effects outline a varied scenario with side effects reported affecting many organs and systems in humans. The true incidence of AAS related medical problems is not known, due to several drawbacks in human studies. The entity of side effects depends on the sex, the dose, the duration of treatment, whether they are taken during exercise training or under sedentary conditions, and the susceptibility of the individuals themselves to androgen exposure partly depending on genetic factors. Both the acute and the chronic effects can lead to toxicity, but generally the serious and even fatal effects depend on the time and the duration of AAS administration. A limitation of human studies is represented by the fact that information about the intake of steroids are, generally, self reported and it is hardly possible to assess the exact dosage. AAS are often used in combination with other dugs or substances, so it is difficult to separate their toxic effects from those caused by the other drugs abused. Hence experimental studies conducted on animal models are mandatory to investigate the mechanisms underlying to AAS toxicity and the organ alterations due to these substances. Finally, clinicians should be aware of the complex and varied pattern of toxicity so as to be able to perform correct diagnoses and treatments.

Engagement with Health Care Providers Affects Self- Efficacy, Self-Esteem, Medication Adherence and Quality of Life in People Living with HIV

Science.gov (United States)

Chen, Wei-Ti; Wantland, Dean; Reid, Paula; Corless, Inge B; Eller, Lucille S.; Iipinge, Scholastika; Holzemer, William L; Nokes, Kathleen; Sefcik, Elizbeth; Rivero-Mendez, Marta; Voss, Joachim; Nicholas, Patrice; Phillips, J. Craig; Brion, John M.; Rose, Caro Dawson; Portillo, Carmen J; Kirksey, Kenn; Sullivan, Kathleen M; Johnson, Mallory O; Tyer-Viola, Lynda; Webel, Allison R

2014-01-01

The engagement of patients with their health care providers (HCP) improves patients’ quality of life (QOL), adherence to antiretroviral therapy, and life satisfaction. Engagement with HCP includes access to HCP as needed, information sharing, involvement of client in decision making and self-care activities, respect and support of the HCP for the client’s choices, and management of client concerns. This study compares country-level differences in patients’ engagement with HCP and assesses statistical associations relative to adherence rates, self-efficacy, self-esteem, QOL, and symptom self-reporting by people living with HIV (PLHIV). A convenience sample of 2,182 PLHIV was enrolled in the United States, Canada, Puerto Rico, Namibia, and China. Cross-sectional data were collected between September 2009 and January 2011. Inclusion criteria were being at least 18 years of age, diagnosed with HIV, able to provide informed consent, and able to communicate in the local language with site researchers. In the HCP scale, a low score indicated greater provider engagement. Country comparisons showed that PLHIV in Namibia had the most HCP engagement (OR 2.80, p < 0.001) and that PLHIV in China had the least engagement (OR −7.03, p < 0.0001) compared to the PLHIV in the Western countries. Individuals having better HCP engagement showed better self-efficacy for adherence (t = −5.22, p < 0.0001), missed fewer medication doses (t = 1.92, p ≤ 0.05), had lower self-esteem ratings (t = 2.67, p < 0.01), fewer self-reported symptoms (t = 3.25, p < 0.0001), and better overall QOL physical condition (t = −3.39, p < 0.001). This study suggests that promoting engagement with the HCP is necessary to facilitate skills that help PLHIV manage their HIV. To improve ART adherence, HCPs should work on strategies to enhance self-efficacy and self-esteem, therefore, exhibiting fewer HIV-related symptoms and missing less medication doses to achieve better QOL. PMID:24575329

Association of Type D personality to perceived side effects and adherence in CPAP-treated patients with OSAS.

Science.gov (United States)

Broström, Anders; Strömberg, Anna; Mårtensson, Jan; Ulander, Martin; Harder, Lena; Svanborg, Eva

2007-12-01

Continuous positive airway pressure (CPAP) is the treatment of choice for obstructive sleep apnoea syndrome (OSAS), but side effects are common and long-term adherence low. The Type D (distressed) personality is defined as a combination of negative affectivity and social inhibition. The association of Type D personality with adherence has not been studied in CPAP-treated patients with OSAS. This study aimed to describe the prevalence of Type D personality in OSAS patients with CPAP treatment longer than 6 months and the association with self-reported side effects and adherence. A cross-sectional descriptive design was used. A total of 247 OSAS patients with a mean use of CPAP treatment for 55 months (6-182 months) were included. Data collection was achieved by two questionnaires; the Type D scale 14 (DS14) (Type D personality), SECI (side effects of CPAP), as well as from medical records (clinical variables and objective adherence to CPAP treatment). Type D personality occurred in 30% of the patients with OSAS and significantly (P < 0.05-0.001) increased the perceived frequency and severity of a broad range of side effects. The objective adherence was significantly lower (P < 0.001) for OSAS patients with Type D compared to OSAS patients without Type D, both with regard to a mean use of 4 h per night and 85% of the self-rated sleep time per night. The additional effect of a Type D personality on perceived side effects and adherence to CPAP treatment found in this study could be used by healthcare personnel when evaluating patients waiting for treatment.

Left-sided incarcerated Amyand’s hernia with cecum and terminal ileum: a case report

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Bekele K

2017-10-01

Full Text Available Kebebe Bekele,1 Desalegn Markos2 1Department of Surgery, School of Medicine, Madda Walabu University, Bale Robe, Ethiopia; 2Unit of Neonatology Nursing, St Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia Background: Amyand’s hernia, which is the presence of a normal or pathological appendix as a part of an inguinal hernia, is a rare clinical entity. We are reporting a very rare case of left-sided incarcerated Amyand’s hernia with cecum and terminal ileum involvement. Case presentation: A 4-year-old male child with left inguinal swelling of 2-year duration presented to Goba Referral Hospital. Two days before the patient visited our hospital, the swelling had become irreducible and caused severe groin pain. He had abdominal cramps, bilious vomiting, and mild abdominal distention, but passed feces. With the diagnosis of left-sided incarcerated inguinal hernia, the patient was investigated and prepared for surgical management. During the operative procedure, we identified the presence of appendix, cecum, and terminal ileum in the scrotum as the herniated component. After the sack was dissected, since there was also appendicitis, an appendectomy was performed. Then, high ligation of sack was done after cecum and ileum were reduced. After 3 uneventful postoperative days in the hospital, the patient was discharged. The patient was followed-up for 6 months, and he did not develop any complications. Conclusion: Left-sided incarcerated Amyand’s hernia with cecum and terminal ileum involvement is a rare clinical entity. Even though it is not common, appendicitis is one of the comorbidities that can be seen in patients with left-sided incarcerated Amyand’s hernia with cecum and terminal ileum. Surgeons should have a high index of clinical suspicion and be aware of the potential involvement of appendix, cecum, and ileum as part of an incarcerated hernia during surgery, even in the left inguinal region. In this case, left-sided

Self-medication among non-healthcare students of the University of Sharjah, United Arab Emirates

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Suleiman Ibrahim Sharif

2014-01-01

Full Text Available Objectives: The objective of the following study is to estimate the prevalence of self-medication among university students and evaluate factors associated with the practice. Materials and Methods: This study was conducted during May, 2012 using a pre-validated questionnaire distributed to 250 students of the 4 years of study at the college of business administration. Data were analyzed using PASW Statistics for Windows, Version 18.0. Chicago: SPSS Inc and results are expressed as counts and percentages. Chi-square test was used to evaluate significant association among the study variables and P < 0.05 were considered to be statistically significant. Results: The response rate was 80% and all respondents were Arabs with 114 (57% females and 86 (43% males. Self-medication was practiced by 118 (59% students and most (88.1% of them obtained medications from pharmacies. About 21 (11% respondents self-medicated with antibiotics. Only 34 (17% and 16 (8% of respondents were aware of bacterial resistance and rational drug use respectively. The most common reasons for self-medication were seeking quick relief (134, 67%, physician′s advice of self-management (100, 50%, illness is minor (91, 45.5%. Common reasons against self-medication include risk of misdiagnosis of illness (160, 80%, risk of using the wrong medication (154, 77%, risk of adverse effects (140, 70%. Self-medication was practiced for headache or mild pain, eye and ear symptoms, gastric problems, cold, fever and allergy. Conclusion: Self-medication among non-healthcare students is common with high prevalence. Knowledge of students of reasons for and against self-medication was adequate, but awareness of respondents of rational drug use and risk of bacterial resistance in response to misuse was poor. Orientation courses/workshops directed to university students would be beneficial.

Self-medication in three Orange Free State communities

African Journals Online (AJOL)

lates of non-compliance were explored, but self- medication was not found to be a substitute for formal medical care. S Air Med J 1993; 83: 345·346. Medicines. None. 1-3 types ... availability and accessibility of professional health care;. (iv) the perceived health .... tent manner in which cultural differences, education, health ...

Self-management of chronic illness: the role of 'habit' versus reflective factors in exercise and medication adherence.

Science.gov (United States)

Phillips, L Alison; Cohen, Joshua; Burns, Edith; Abrams, Jessica; Renninger, Steffi

2016-12-01

Non-adherence to health behaviors required for chronic illness self-management is pervasive. Advancing health-behavior theory to include behavioral initiation and maintenance factors, including reflective (e.g., belief- and feedback-based) and automatic (e.g., habit-based) mechanisms of adherence to different treatment-related behaviors could improve non-adherence prediction and intervention efforts. To test behavioral initiation and maintenance factors from an extended common sense self-regulation theoretical framework for predicting medication adherence and physical activity among patients with Type 2 diabetes. Patients (n = 133) in an in-person (n = 80) or online (n = 53) version of the study reported treatment-related (1) barriers, (2) beliefs and experiential feedback (reflective mechanisms of treatment-initiation and short-term repetition), and (3) habit strength (automatic mechanism of treatment-maintenance) for taking medication and engaging in regular physical activity at baseline. Behaviors were assessed via self-reports (n = 133) and objectively (electronic monitoring pill bottles, accelerometers; n = 80) in the subsequent month. Treatment-specific barriers and habit strength predicted self-reported and objective adherence for both behaviors. Beliefs were inconsistently related to behavior, even when habits were "weak". Experiential feedback from behavior was not related to adherence. Among patients with Type 2 diabetes diagnosis, medication and physical activity adherence were better predicted by their degree of automatic behavioral repetition than their beliefs/experiences with the treatment-actions. Habit strength should be an intervention target for chronic illness self-management; assessing it in practice settings may effectively detect non-adherence to existing treatment-regimens. However, future research and further refining of CS-SRM theory regarding the processes required for such habit development are needed.

Relationship between self-directed learning with learning styles and strategies in medical students

OpenAIRE

Márquez U, Carolina; Fasce H, Eduardo; Pérez V, Cristhian; Ortega B, Javiera; Parra P, Paula; Ortiz M, Liliana; Matus B, Olga; Ibáñez G, Pilar

2014-01-01

Background: Self-directed learning (SDL) skills are particularly important in medical education, considering that physicians should be able to regulate their own learning experiences. Aim: To evaluate the relationship between learning styles and strategies and self-directed learning in medical students. Material and Methods: One hundred ninety nine first year medical students (120 males) participated in the study. Preparation for Independent Learning (EPAI) scale was used to assess self-direc...

The relationship among self-efficacy, perfectionism and academic burnout in medical school students.

Science.gov (United States)

Yu, Ji Hye; Chae, Su Jin; Chang, Ki Hong

2016-03-01

The purpose of this study was to examine the relationship among academic self-efficacy, socially-prescribed perfectionism, and academic burnout in medical school students and to determine whether academic self-efficacy had a mediating role in the relationship between perfectionism and academic burnout. A total of 244 first-year and second-year premed medical students and first- to fourth-year medical students were enrolled in this study. As study tools, socially-prescribed perfectionism, academic self-efficacy, and academic burnout scales were utilized. For data analysis, correlation analysis, multiple regression analysis, and hierarchical multiple regression analyses were conducted. Academic burnout had correlation with socially-prescribed perfectionism. It had negative correlation with academic self-efficacy. Socially-prescribed perfectionism and academic self-efficacy had 54% explanatory power for academic burnout. When socially-prescribed perfectionism and academic self-efficacy were simultaneously used as input, academic self-efficacy partially mediated the relationship between socially-prescribed perfectionism and academic burnout. Socially-prescribed perfectionism had a negative effect on academic self-efficacy, ultimately triggering academic burnout. This suggests that it is important to have educational and counseling interventions to improve academic self-efficacy by relieving academic burnout of medical school students.

[Self-reporting of road traffic accidents in a national survey of urban population in Peru].

Science.gov (United States)

Wong, Paolo; Gutiérrez, César; Romaní, Franco

2010-06-01

To estimate the frequency of self-reporting of road traffic accidents in the previous year in the general population and to determine the associated factors. We conducted a secondary analysis of the data of the III National Survey of Drug Use in the General Population of Peru, 2006. We measured socio-demographical variables: age, gender, place of origin, educational level and marital status. We also evaluated the use of legal, illegal and medical drugs. The independent variable was the self-reporting of a road traffic accident. We performed the descriptive, bivariate and multivariate analysis of the socio-demographical variables and the drug use (legal and illegal), together with the self-reporting of the traffic accident. The frequency of reporting of road traffic accidents in the last year according to the survey was 2.93% (95%CI: 2.92-2.94). The associated factors for self-reporting of a road traffic accident were: to live in the jungle areas (OR: 2.03; 95%CI:1.55-2.65), male gender (OR: 1.79; 95%CI: 1.46-2.22), legal drugs use in the last year (OR: 1.98, 95%CI: 1.53-2.55), alcohol consumption in the last year (OR: 1.82; 95%CI: 1.44-2.32) and medical drugs use in the last year (OR: 2.45, 95%CI 1.63-3.68). The prevalence of self-reporting of road traffic accidents in the last year was very high compared to similar studies and other reporting sources. The variables associated with having had a traffic accident were: living in the jungle area, being male, legal drug use in the last month, especially alcohol and medical drug use in the last month. It is necessary to think carefully about the information system of the road traffic accidents in order to achieve a better picture of the problem putting emphasis in the legal drugs use.

Self-Explanation, An Instructional Strategy to Foster Clinical Reasoning in Medical Students

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Martine Chamberland

2015-12-01

Full Text Available Clinical reasoning is a critical and complex skill that medical students have to develop in the course of their training. Although research on medical expertise has successfully examined the different components of that skill, designing educational interventions that support the development of clinical reasoning in students remains a challenge for medical educators. The theory of medical expertise describes how students׳ medical knowledge develops and is progressively restructured during their training and in particular through clinical exposure to patient problems. Instructional strategies to foster students’ learning from practice with clinical cases are scarce. This article describes the use of self-explanation as such a strategy. Self-explanation is an active learning technique of proven effectiveness in other domains which consists of having students explaining to themselves information on to-be-learned materials. The mechanisms through which self-explanation fosters learning are described. Self-explanation promotes knowledge development and revision of mental representations through elaboration on new information, organisation and integration of new knowledge into existing cognitive structures and monitoring of the learning process. Subsequently, the article shows how self-explanation has recently been investigated in medicine as an instructional strategy to support students׳ clinical reasoning. Available studies have demonstrated that students׳ diagnostic performance improves when they use self-explanation while solving clinical problems of a less familiar clinical topic. Unfamiliarity seems to trigger more self-explanations and to stimulate students to reactivate relevant biomedical knowledge, which could lead to the development of more coherent representations of diseases. The benefit of students׳ self-explanation is increased when it is combined with listening to residents׳ self-explanation examples and with prompts. The

Patient and regimen characteristics associated with self-reported nonadherence to antiretroviral therapy.

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Patrick S Sullivan

Full Text Available BACKGROUND: Nonadherence to antiretroviral therapy (ARVT is an important behavioral determinant of the success of ARVT. Nonadherence may lead to virological failure, and increases the risk of development of drug resistance. Understanding the prevalence of nonadherence and associated factors is important to inform secondary HIV prevention efforts. METHODOLOGY/PRINCIPAL FINDINGS: We used data from a cross-sectional interview study of persons with HIV conducted in 18 U.S. states from 2000-2004. We calculated the proportion of nonadherent respondents (took or=4 medications; living in a shelter or on the street; and feeling "blue" >or=14 of the past 30 days. We found weaker associations with having both male-male sex and injection drug use risks for HIV acquisition; being prescribed ARVT for >or=21 months; and being prescribed a protease inhibitor (PI-based regimen not boosted with ritonavir. The median proportion of doses missed was 50%. The most common reasons for missing doses were forgetting and side effects. CONCLUSIONS/SIGNIFICANCE: Self-reported recent nonadherence was high in our study. Our data support increased emphasis on adherence in clinical settings, and additional research on how providers and patients can overcome barriers to adherence.

Translation failure and medical reversal: Two sides to the same coin.

Science.gov (United States)

Prasad, Vinay

2016-01-01

Translation failure occurs when the results of preclinical, observational and/or early phase studies fail to predict the results of well done (i.e. appropriately controlled, adequately powered, and properly conducted) phase III or randomised clinical trials. Some failures occur when promising basic science findings fail to replicate in human studies, while others happen when promising uncontrolled trial data show an exaggerated effect that vanishes in the setting of a randomised trial. Medical reversals occur when the results of preclinical, observational and/or early phase studies fail to predict the results of subsequent randomized clinical trials, but the practice has already gained widespread acceptance. Oncologic examples include bevacizumab and the use of autologous stem cell transplant in metastatic breast cancer. In a well-intentioned effort to reduce the rate of translation failure, oncologists must be careful that changes to regulatory processes and clinical trial design do not actually work to increase the approval of ineffective compounds. By trying to cure translation failure, we should be careful to avoid medical reversal. The rise of surrogate end-points and role of hard-wired bias in oncology trials suggest that we may be currently ignoring the simple fact that translation failure and medical reversal are two sides to the same coin. Published by Elsevier Ltd.

The relationship between assessment methods and self-directed learning readiness in medical education.

Science.gov (United States)

Monroe, Katherine S

2016-03-11

This research explored the assessment of self-directed learning readiness within the comprehensive evaluation of medical students' knowledge and skills and the extent to which several variables predicted participants' self-directed learning readiness prior to their graduation. Five metrics for evaluating medical students were considered in a multiple regression analysis. Fourth-year medical students at a competitive US medical school received an informed consent and an online survey. Participants voluntarily completed a self-directed learning readiness scale that assessed four subsets of self-directed learning readiness and consented to the release of their academic records. The assortment of metrics considered in this study only vaguely captured students' self-directedness. The strongest predictors were faculty evaluations of students' performance on clerkship rotations. Specific clerkship grades were mildly predictive of three subscales. The Pediatrics clerkship modestly predicted critical self-evaluation (r=-.30, p=.01) and the Psychiatry clerkship mildly predicted learning self-efficacy (r =-.30, p=.01), while the Junior Surgery clerkship nominally correlated with participants' effective organization for learning (r=.21, p=.05). Other metrics examined did not contribute to predicting participants' readiness for self-directed learning. Given individual differences among participants for the variables considered, no combination of students' grades and/or test scores overwhelmingly predicted their aptitude for self-directed learning. Considering the importance of fostering medical students' self-directed learning skills, schools need a reliable and pragmatic approach to measure them. This data analysis, however, offered no clear-cut way of documenting students' self-directed learning readiness based on the evaluation metrics included.

Self-reported accidents

DEFF Research Database (Denmark)

Møller, Katrine Meltofte; Andersen, Camilla Sloth

2016-01-01

The main idea behind the self-reporting of accidents is to ask people about their traffic accidents and gain knowledge on these accidents without relying on the official records kept by police and/or hospitals.......The main idea behind the self-reporting of accidents is to ask people about their traffic accidents and gain knowledge on these accidents without relying on the official records kept by police and/or hospitals....

Self-perceived versus objectively measured competence in performing clinical practical procedures by final year medical students.

Science.gov (United States)

Katowa-Mukwato, Patricia; Banda, Sekelani

2016-04-30

To determine and compare the self-perceived and objectively measured competence in performing 14 core-clinical practical procedures by Final Year Medical Students of the University of Zambia. The study included 56 out of 60 graduating University of Zambia Medical Students of the 2012/2013 academic year. Self-perceived competence: students rated their competence on 14 core- clinical practical procedures using a self-administered questionnaire on a 5-point Likert scale. Objective competence: it was measured by Objective Structured Clinical Examination (OSCE) by faculty using predetermined rating scales. Rank order correlation test was performed for self-perceived and objectively measured competence. Two thirds 36 (66.7%) of the participants perceived themselves as moderately competent, 15 (27.8%) rated themselves as highly competent while 3 (5.6%) had low self-perception. With objective competence, the majority 52 (92.8%) were barely competent while 4 (7.2%) were absolutely competent. When overall self-perception was compared to objectively measured competence, there was a discordance which was demonstrated by a negative correlation (Spearman rho -.123). Significant numbers of students reported low self-competence in performing procedures such as endotracheal intubation, gastric lavage and cardiopulmonary resuscitation which most never performed during the clinical years of medical education. In addition, the negative correlation between self-perceived and objectively measured competence demonstrated the inability of students to assess and rate themselves objectively due to fear that others may know their weaknesses and realize that they are not as competent as expected at a specific level of training.

Marijuana Use and Self-reported Quality of Eyesight.

Science.gov (United States)

Akano, Obinna F

2017-05-01

There is increasing use of marijuana among young adults and more states in the United States are legalizing medical marijuana use. A number of studies have revealed both the beneficial and harmful effects of marijuana to the human system. Despite some beneficial effects, studies have shown marijuana to have a lot of deleterious effects on the visual system, which subsequently reduces the quality of eyesight. The aim of this study was to investigate if heavy marijuana smoking is associated with a poor quality of eyesight compared with light/no use of marijuana. The National Longitudinal Survey of Youths (NLSY79), a nationally representative sample of 12,686 young men and women surveyed in 1979 to 2010 was used for this study. The quality of eyesight of 1304 heavy marijuana users was compared with 1304 respondents with light or no marijuana use. The t test, multivariate and weighted logistic regression were used in the data analysis. There was no statistically significant difference in the self-reported quality of eyesight among heavy marijuana smokers compared with youths who never used marijuana or are light marijuana users. Among heavy marijuana smokers, males and high school graduates have decreased odds of reporting a poor quality of eyesight, whereas blacks have increased odds of reporting a poor quality of eyesight. The self-reported quality of eyesight among marijuana users can aid clinicians and other health practitioners facilitate the development of sex-, racial/ethnic-, and educational level-informed prevention and early intervention programs and also help characterize public opinions regarding cannabis, which are particularly relevant given the ongoing debate concerning the medicalization and legalization of cannabis in the United States.

Assessing medication adherence in inflammatory bowel diseases. A comparison between a self-administered scale and a pharmacy refill index.

Science.gov (United States)

de Castro, María Luisa; Sanromán, Luciano; Martín, Alicia; Figueira, Montserrat; Martínez, Noemi; Hernández, Vicent; Del Campo, Victor; Pineda, Juan R; Martínez-Cadilla, Jesús; Pereira, Santos; Rodríguez Prada, José Ignacio

2017-08-01

Medication non-adherence in inflammatory bowel disease (IBD) has a negative impact on disease outcome. Different tools have been proposed to assess non-adherence. We aimed to compare a self-administered scale and a pharmacy refill index as a reliable measure of medication adherence and to determine what factors are related to adherence. Consecutive non-active IBD outpatients were asked to fill in the self-reported Morisky Medication Adherence Scale (MMAS-8) and the Beliefs about Medication Questionnaire (BMQ). Pharmacy refill data were reviewed from the previous three or six months and the medication possession ratio (MPR) was calculated. Non-adherence was defined as MMAS-8 scores harm of medication were significantly associated with MPR non-adherence (p = 0.01). The accuracy of MMAS-8 to identify medication non-adherence in inactive IBD outpatients in our setting is poor due to a low specificity and a negative predictive value. Psychosocial factors such as beliefs about medication seem to be related to IBD non-adherence.

Prevalence of self-reported medical conditions among dental patients

Directory of Open Access Journals (Sweden)

Mukhatar A Javali

2017-01-01

Conclusion: The results of our study found a high prevalence of medical conditions among patients seeking periodontal treatment, thereby highlighting the need to record patients' medical and dental care history in detail.

Predicting acute side effects of stimulant medication in pediatric attention deficit/hyperactivity disorder: data from quantitative electroencephalography, event-related potentials, and a continuous-performance test

Directory of Open Access Journals (Sweden)

Ogrim G

2013-09-01

Full Text Available Geir Ogrim,1–3 Knut A Hestad,3,4 Jan Ferenc Brunner,3,5,6 Juri Kropotov3,7,8 1Neuropsychiatric Unit, Østfold Hospital Trust, Fredrikstad, Norway; 2National Resource Center for ADHD, Tourettes' Syndrome and Narcolepsy, Oslo, Norway; 3Institute of Psychology, Norwegian University of Science and Technology (NTNU, Trondheim, Norway; 4Division of Mental Health, Innlandet Hospital Trust, Brumunddal, Norway; 5Department of Physical Medicine and Rehabilitation, St Olav's Hospital, Trondheim, Norway; 6Department of Neuroscience, NTNU, Trondheim, Norway; 7Institute of the Human Brain, Russian Academy of Sciences, Saint Petersburg, Russia; 8Department of Neuropsychology, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland Background: The aim of this study was to search for predictors of acute side effects of stimulant medication in pediatric attention deficit/hyperactivity disorder (ADHD, emphasizing variables from quantitative electroencephalography (QEEG, event-related potentials (ERPs, and behavior data from a visual continuous-performance test (VCPT. Methods: Seventy medication-naïve ADHD patients aged 7–16 years were tested with QEEG, including a go/no-go task condition (VCPT from which behavior data and ERPs were extracted, followed by a systematic trial on stimulant medication lasting at least 4 weeks. Based on data from rating scales and interviews, two psychologists who were blind to the QEEG/ERP test results independently rated the patients as having no or small side effects (n = 37 or troublesome side effects (n = 33. We determined if the side effects were related to sex, age, IQ, ADHD subtype, comorbidities, clinical outcome, and variables in QEEG, ERPs, and VCPT. Results: There was a moderate negative correlation between clinical outcome and side effects. Three variables were significantly associated with side effects in a multivariate logistic regression analysis. In the ERP independent component – contingent negative variation

The Relationship of Vocabulary Learning Strategies and Self-Efficacy with Medical English and Terminology.

Science.gov (United States)

Wang, Ya-Huei; Kao, Pan-Fu; Liao, Hung-Chang

2016-02-01

This study examined the relationship between the use of vocabulary learning strategies and self-efficacy in medical English learning, and whether after an initial six-week course to master the basics of medical terminology, those with higher use of vocabulary learning strategies and those with a higher degree of self-efficacy would have significant score improvements in the medical English proficiency. Second-year medical students (N = 115; M age = 19.6, SD = 0.5; 82 men, 33 women) participated in the study. A one-group pretest-posttest design was used. Measures included medical English tests, the English Vocabulary Learning Strategies Survey (EVLSS), and the English Learning Self-Efficacy Scale (ELSES). Results showed that there was no significant correlation between vocabulary learning strategies and English learning self-efficacy. In addition, as a whole, vocabulary learning strategies and self-efficacy significantly predicted students' score improvements in medical English proficiency. © The Author(s) 2016.

Factors affecting self-regulated learning in medical students: a qualitative study.

Science.gov (United States)

Jouhari, Zahra; Haghani, Fariba; Changiz, Tahereh

2015-01-01

Clinical courses are required of all medical students and means that they must develop the key skill of self-regulation during learning. The ability to self-regulate learning strategies is affected by different factors. This study determined the views of medical students on the factors affecting self-regulated learning (SRL). This study uses a qualitative approach and the content analysis method. Nineteen medical students in their fourth, fifth, and sixth years of study at Isfahan University of Medical Science participated in semi-structured, in-depth interviews. The students were selected using purposive sampling based on their overall grade point average (GPA). Five main themes were found to affect SRL. These themes included family with the two subthemes of family supervisory and supportive roles; peers with the two subthemes of facilitating and inhibiting roles; instructors with the two subthemes of personal and educational instructor's characteristics; educational environment with the two subthemes of facilitator and inhibitor roles; and student with the two subthemes of facilitating and inhibiting personal factors. The outcomes of student understanding of the factors affecting self-regulation indicate that facilitating factors should be used on an individual basis to reduce the effect of inhibiting factors to improve self-regulation in students.

Type D personality, self-efficacy, and medication adherence in patients with heart failure-A mediation analysis.

Science.gov (United States)

Wu, Jia-Rong; Song, Eun Kyeung; Moser, Debra K

2015-01-01

Type D personality is associated with medication non-adherence. Both Type D personality and non-adherence are predictors of poor outcomes. Self-efficacy, which is modifiable, is also associated with medication adherence. To determine the relationships among Type D personality, self-efficacy, and medication adherence in 84 heart failure patients. Self-efficacy, Type D personality, medication adherence, demographic and clinical data were collected. Hierarchical linear regression was used. Type D patients were more likely to have lower self-efficacy (p = .023) and medication non-adherence (p = .027) than non-Type D patients. Low self-efficacy was associated with medication non-adherence (p mediation. Self-efficacy mediates the relationship between Type D personality and medication adherence. Developing and applying interventions to enhance self-efficacy may help to sever the link between Type D personality and poor outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

Guidelines for Reporting Medical Research

DEFF Research Database (Denmark)

Johansen, Mathilde; Thomsen, Simon Francis

2016-01-01

As a response to a low quality of reporting of medical research, guidelines for several different types of study design have been developed to secure accurate reporting and transparency for reviewers and readers from the scientific community. Herein, we review and discuss the six most widely...... accepted and used guidelines: PRISMA, CONSORT, STROBE, MOOSE, STARD, and SPIRIT. It is concluded that the implementation of these guidelines has led to only a moderate improvement in the quality of the reporting of medical research. There is still much work to be done to achieve accurate and transparent...... reporting of medical research findings....

The relationship among self-efficacy, perfectionism and academic burnout in medical school students

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Ji Hye Yu

2016-03-01

Full Text Available Purpose: The purpose of this study was to examine the relationship among academic self-efficacy, socially-prescribed perfectionism, and academic burnout in medical school students and to determine whether academic self-efficacy had a mediating role in the relationship between perfectionism and academic burnout. Methods: A total of 244 first-year and second-year premed medical students and first- to fourth-year medical students were enrolled in this study. As study tools, socially-prescribed perfectionism, academic self-efficacy, and academic burnout scales were utilized. For data analysis, correlation analysis, multiple regression analysis, and hierarchical multiple regression analyses were conducted. Results: Academic burnout had correlation with socially-prescribed perfectionism. It had negative correlation with academic self-efficacy. Socially-prescribed perfectionism and academic self-efficacy had 54% explanatory power for academic burnout. When socially-prescribed perfectionism and academic self-efficacy were simultaneously used as input, academic self-efficacy partially mediated the relationship between socially-prescribed perfectionism and academic burnout. Conclusion: Socially-prescribed perfectionism had a negative effect on academic self-efficacy, ultimately triggering academic burnout. This suggests that it is important to have educational and counseling interventions to improve academic self-efficacy by relieving academic burnout of medical school students.

Determinants of academic stress and stress-related self- medication ...

African Journals Online (AJOL)

of self-medication was 31.58 and 29.20 % among pharmacy and medical students, ... Conclusion: Academic stress in undergraduate students in health disciplines is ... reproduction in any medium, provided the original work is properly credited. Tropical .... students stayed with family (N = 136, 63.8 %). ..... Conflict of interest.

Determinants of self medication practices among pregnant women in Ibadan, Nigeria.

Science.gov (United States)

Yusuff, Kazeem B; Omarusehe, Louis-Domeih

2011-10-01

To assess the frequency and evaluate the factors underlining self-medication with orthodox and herbal medicines among pregnant women in Ibadan, Nigeria. Setting Antenatal clinics at the major antenatal care facility in Ibadan, south-western Nigeria. A prospective cross-sectional study with a pre-tested 15-item structured questionnaire over a 12 week period among 1,650 pregnant women who attended antenatal clinics at a major antenatal care facility in Ibadan, south-western Nigeria. Data analysis was done with Chi-square, multivariate logistic regression and summary statistics. Frequency and major factors associated with self-medication in pregnancy. The response and completion rate was 96.6% (1,594) [mean age ± SD 27 ± 5.3 years]. The majority of the respondents were literate (92.6%), self-employed (61.5%) and in the third trimester (49.5%). A significant majority (63.8%) used self-medication (orthodox and herbal medicines) as their first response to perceived ill-health (P patent medicine stores (55%). Mothers-in-law and relatives (41.3%) were the most frequently cited sources of advice during self-medication. Miscarriage/bleeding (44.3%) was the most frequently cited potential adverse effect that could occur with the use of certain medicines during pregnancy. Only 32% of respondents could identify medicines that are potentially harmful in pregnancy. Poorly guided self-medication with prescription, over-the-counter and herbal medicines is pervasive and significantly associated with gestational age and occupational pattern among pregnant women in Ibadan, south-western. A majority lacked the knowledge of potential adverse outcomes associated with the use of certain medicines, and the potentially harmful medicines to avoid during pregnancy.

Self-report disability in an international primary care study of psychological illness

NARCIS (Netherlands)

VonKorff, M; Ustun, TB; Ormel, J; Kaplan, [No Value; Simon, GE

We assessed the replicability of reliability and validity of a brief self-report disability scale, adapted from the Medical Outcomes Survey (short form), in a 15-center, cross-national, multilingual study of psychological illness among primary care patients (n = 5438). Across all 15 centers in the

Evaluation of antibiotic self-medication among outpatients of the state university hospital of Port-Au-Prince, Haiti: a cross-sectional study.

Science.gov (United States)

Moise, Kenny; Bernard, Joseph Junior; Henrys, Jean Hugues

2017-01-01

In Haiti, where all drugs are available over the counter, self-medication with antibiotics appears as a common practice. Inappropriate use of beta-lactams and macrolides is likely to contribute to the development of antimicrobial resistance. This study aimed to (i) assess the extent of self-medication with antibiotics, (ii) explore the contributing factors (age, gender and educational background) and (iii) identify specific antibiotic drug classes used among patients attending the outpatient clinic of the State University Hospital of Port-au-Prince. A cross-sectional survey among 200 outpatients of the State University Hospital of Port-au-Prince was conducted in December 2014. Face-to-face interviews were conducted using a standardized questionnaire. Parents of pediatric patients were allowed to answer to questions on their behalf. Among the study sample, 45.5% practiced self-medication with antibiotics. It was less prevalent among patients with the highest education level (23.1%; OR: 0.89 (0.5-1.75), p = 0.001). Mild symptoms (28.6%) and vaginal itching (44.4%) were the main reasons for self-medication with antibiotics. Self-medication using amoxicillin was reported by 67.0%. Self-medication with antibiotics is a common practice among Haitian patients and is more common among the less educated. Amoxicillin for urinary tract infections is the most commonly used medication. It is crucial to raise awareness on the dangers of the practice in the population and inforce the current law regarding the use of over the counter antibiotics.

Can Individualized Learning Plans in an advanced clinical experience course for fourth year medical students foster Self-Directed Learning?

Science.gov (United States)

Chitkara, Maribeth B; Satnick, Daniel; Lu, Wei-Hsin; Fleit, Howard; Go, Roderick A; Chandran, Latha

2016-09-01

Residency programs have utilized Individualized Learning Plans (ILPs) to customize resident education while undergraduate medical education has not done so in a meaningful way. We discuss the use of ILPs within a fourth year medical school course to facilitate self-directed learning (SDL). At Stony Brook University School of Medicine, an ILP component was added to the Advanced Clinical Experience (ACE) course for fourth year students. Each completed an ILP outlining personal learning goals and strategies to achieve them. An adaptation of the Motivated Strategies for Learning Questionnaire (MSLQ) (Duncan T and McKeachie W, Educ Psych 40(2):117-128, 2005 and Cook DA et al., Med Ed 45:1230-1240, 2011) was used to measure success of ILPs in improving SDL. Qualitative data analysis was conducted on the ILPs and self-reflections. Forty-eight students participated. Two of the four SDL sub-domains identified on the MSLQ showed improvement; self-efficacy (p = .001) and self-regulation (p = .002). 'Medical Knowledge' was the competency most frequently identified as an area of concentration (90 %) and professionalism was selected least frequently (4 %). A higher percentage (83 %) of students who reported complete achievement of their ILP goals also reported feeling better prepared for entering residency. ILPs improve SDL strategies among medical students and may serve as useful tools to help shape future learning goals as they transition to residency training.

Self-Reported Non-Celiac Wheat Sensitivity in High School Students: Demographic and Clinical Characteristics

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Antonio Carroccio

2017-07-01

Full Text Available Background: Non-Celiac Wheat Sensitivity (NCWS has recently been included among the gluten-related disorders. As no biomarkers of this disease exist, its frequency has been estimated based on self-reported symptoms, but to date no data are available about self-reported NCWS in teenagers. Aim: To explore the prevalence of self-reported NCWS in a group of high school students and to study their demographic and clinical characteristics. Methods: The study was performed between April 2015 and January 2016 in two high schools of a coastal town in the south of Sicily (Italy. A total of 555 students (mean age 17 years, 191 male, 364 female completed a modified validated questionnaire for self-reported NCWS. The subjects who self-reported NCWS were then compared with all the others. Results: Seven individuals (1.26% had an established diagnosis of CD. The prevalence of self-reported NCWS was 12.2%, and 2.9% were following a gluten-free diet (GFD. Only 15 out of 68 (23% NCWS self-reporters had consulted a doctor for this problem and only nine (14% had undergone serological tests for celiac disease. The NCWS self-reporters very often had IBS symptoms (44%. Conclusions: Self-reported NCWS was found to be common in teenagers, with a frequency of 12.2%; the frequency of GFD use was 2.9%, which was much higher than the percentage of known CD in the same population (1.26%. A greater awareness of the possible implications on the part of the subjects involved, and a more thorough medical approach to the study of self-reported wheat-induced symptoms are required.

STS-3 medical report

Science.gov (United States)

Pool, S. L. (Editor); Johnson, P. C., Jr. (Editor); Mason, J. A. (Editor)

1982-01-01

The medical operations report for STS-3, which includes a review of the health of the crew before, during, and immediately after the third Shuttle orbital flight is presented. Areas reviewed include: health evaluation, medical debriefing of crewmembers, health stabilization program, medical training, medical 'kit' carried in flight, tests and countermeasures for space motion sickness, cardiovascular profile, biochemistry and endocrinology results, hematology and immunology analyses, medical microbiology, food and nutrition, potable water, shuttle toxicology, radiological health, and cabin acoustic noise. Environmental effects of shuttle launch and landing medical information management, and management, planning, and implementation of the medical program are also dicussed.

Industrial demand side management: A status report

Energy Technology Data Exchange (ETDEWEB)

Hopkins, M.F.; Conger, R.L.; Foley, T.J. [and others

1995-05-01

This report provides an overview of and rationale for industrial demand side management (DSM) programs. Benefits and barriers are described, and data from the Manufacturing Energy Consumption Survey are used to estimate potential energy savings in kilowatt hours. The report presents types and examples of programs and explores elements of successful programs. Two in-depth case studies (from Boise Cascade and Eli Lilly and Company) illustrate two types of effective DSM programs. Interviews with staff from state public utility commissions indicate the current thinking about the status and future of industrial DSM programs. A comprehensive bibliography is included, technical assistance programs are listed and described, and a methodology for evaluating potential or actual savings from projects is delineated.

[Motivation and self-directed learning among medical students].

Science.gov (United States)

Fasce H, Eduardo; Ortega B, Javiera; Ibáñez G, Pilar; Márquez U, Carolina; Pérez V, Cristhian; Bustamante D, Carolina; Ortiz M, Liliana; Matus B, Olga; Bastías V, Nancy; Espinoza P, Camila

2016-05-01

Motivation is an essential aspect in the training process of medical students. The association that motivation can have with learning self-regulation is of utmost importance for the design of curriculum, teaching methods and evaluation. To describe the motivational aspects of self-directed learning among medical students from a traditional Chilean University. A qualitative, descriptive study based on grounded theory of Strauss and Corbin. Twenty 4th and 5th year medical students were selected using a maximum variation sampling technique. After obtaining an informed consent, semi-structured interviews and field notes were carried out. Data were analyzed to the level of open coding through Atlas-ti 7.5.2. From the student point of view, personal motivational aspects are linked to the search for information, constant updating, the perception of the physician-patient relationship and interest in subject matters. From the scope of teachers, a main issue is related to their ability to motivate students to develop independent study skills. Personal motivational aspects facilitate the development of independent study skills, specifically in the search of information. The role of teachers is crucial in promoting these skills and the perception of medical students from their learning process.

Self-reported quality of ADL task performance among patients with COPD exacerbations.

Science.gov (United States)

Bendixen, Hans Jørgen; Wæhrens, Eva Ejlersen; Wilcke, Jon Torgny; Sørensen, Lisbeth Villemoes

2014-07-01

Patients suffering from chronic obstructive pulmonary disease (COPD) experience problems in the performance of activities of daily living (ADL) tasks. The objective was to examine the self-reported quality of ADL task performance among COPD patients, and to investigate whether age, gender, and routine COPD characteristics correlate with the self-reported ADL ability. Eighty patients admitted to hospital with COPD exacerbations participated. In a cross-sectional study, the patients' self-reported ADL ability was assessed using the ADL-Interview (ADL-I) instrument. Data concerning age, gender, and routine COPD characteristics were drawn from the patients' medical records. The patients reported being inefficient to markedly inefficient when performing ADL tasks within the personal hygiene, toileting, dressing, household, mobility, and transportation domains. While more than 90% of the participants reported increased effort and/or fatigue when performing the ADL tasks, up to 88% of the participants relied on help from others in the performance of general household chores like cooking and shopping. Self-reported ADL ability did not correlate with age, gender, or routine COPD characteristics. Decreased quality of ADL task performance seemed to be extremely common among COPD patients. Therefore, addressing the problems in individually tailored pulmonary rehabilitation programmes may be advantageous.

Organizational safety culture and medical error reporting by Israeli nurses.

Science.gov (United States)

Kagan, Ilya; Barnoy, Sivia

2013-09-01

To investigate the association between patient safety culture (PSC) and the incidence and reporting rate of medical errors by Israeli nurses. Self-administered structured questionnaires were distributed to a convenience sample of 247 registered nurses enrolled in training programs at Tel Aviv University (response rate = 91%). The questionnaire's three sections examined the incidence of medication mistakes in clinical practice, the reporting rate for these errors, and the participants' views and perceptions of the safety culture in their workplace at three levels (organizational, departmental, and individual performance). Pearson correlation coefficients, t tests, and multiple regression analysis were used to analyze the data. Most nurses encountered medical errors from a daily to a weekly basis. Six percent of the sample never reported their own errors, while half reported their own errors "rarely or sometimes." The level of PSC was positively and significantly correlated with the error reporting rate. PSC, place of birth, error incidence, and not having an academic nursing degree were significant predictors of error reporting, together explaining 28% of variance. This study confirms the influence of an organizational safety climate on readiness to report errors. Senior healthcare executives and managers can make a major impact on safety culture development by creating and promoting a vision and strategy for quality and safety and fostering their employees' motivation to implement improvement programs at the departmental and individual level. A positive, carefully designed organizational safety culture can encourage error reporting by staff and so improve patient safety. © 2013 Sigma Theta Tau International.

Self-medication in academic course graduate of health in a private university of the state of Rio Grande do Sul

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Thricy Dhamer

2012-10-01

Full Text Available Rationale and Objectives: The World Health Organization defi nes self-medication as the selection and use of medicines by individuals to treat their illnesses or symptoms. It is considered a public health problem that deserves special attention, since it presents risks, because of adverse drug reactions, bringing serious consequences and may lead to the death. To determine the prevalence and characteristics of self-medication realized by undergraduate students enrolled in health courses in a community college, as well the symptoms that led to this practice. Methods: This study was an observational and quantitative research, where it was used structured and pre-coded questionnaires to obtains the data, among students enrolled at 5th and 6th semesters of Biology, Physical Education, Nursing, Pharmacy, Physiotherapy, Medicine, Nutrition, Dentistry and Psychology at the University of Santa Cruz do Sul. Results: 342 students were evaluated, 74% female, aged between 18 and 50, which was the most prevalent age group of 21-30 years, which were 71.4% of students. The prevalence of medicines used among those surveyed was 68.7% last month, with an average of 2 medications per student. The medications were distributed by medical prescription in 282 cases (59.1%, under self-medication in 139 cases (29.1%, oriented by a pharmaceutical in 25 cases (5.2% and no response in 31 cases (6.6%. The classes of drugs most used were analgesics/antipyretics (48.2%, NSAIDs (14.2% and antacids (9.9%. The main purpose of motivating self medication were headache (14.4%, digestive disorders (13.2%, contraception (7.2% and general pain (6.0%. Conclusion: Self medication is a common practice among students in the health area, where about a third reported conduct such practice. KEYWORDS Self-medication. Student Health Occupations. Drugs.

Are physical symptoms among survivors of a disaster presented to the general practitioner? A comparison between self-reports and GP data

Directory of Open Access Journals (Sweden)

Stellato Rebecca K

2007-09-01

Full Text Available Abstract Background Most studies examining medically unexplained symptoms (MUS have been performed in primary or secondary care and have examined symptoms for which patients sought medical attention. Disasters are often described as precipitating factors for MUS. However, health consequences of disasters are typically measured by means of questionnaires, and it is not known whether these self-reported physical symptoms are presented to the GP. It is also not known if the self-reported symptoms are related to a medical disorder or if they remain medically unexplained. In the present study, three research questions were addressed. Firstly, were self-reported symptoms among survivors presented to the GP? Secondly, were the symptoms presented to the GP associated with a high level of functional impairment and distress? Thirdly, what was the GP's clinical judgment of the presented symptoms, i.e. were the symptoms related to a medical diagnosis or could they be labeled MUS? Methods Survivors of a man-made disaster (N = 887 completed a questionnaire 3 weeks (T1 and 18 months (T2 post-disaster. This longitudinal health survey was combined with an ongoing surveillance program of health problems registered by GPs. Results The majority of self-reported symptoms was not presented to the GP and survivors were most likely to present persistent symptoms to the GP. For example, survivors with stomachache at both T1 and T2 were more likely to report stomachache to their GP (28% than survivors with stomachache at only T1 (6% or only T2 (13%. Presentation of individual symptoms to the GP was not consistently associated with functional impairment and distress. 56 – 91% of symptoms were labeled as MUS after clinical examination. Conclusion These results indicate that the majority of self-reported symptoms among survivors of a disaster are not presented to the GP and that the decision to consult with a GP for an individual symptom is not dependent on the level of

Writing, self-reflection, and medical school performance: the Human Context of Health Care.

Science.gov (United States)

Stephens, Mark B; Reamy, Brian V; Anderson, Denise; Olsen, Cara; Hemmer, Paul A; Durning, Steven J; Auster, Simon

2012-09-01

Finding ways to improve communication and self-reflection skills is an important element of medical education and continuing professional development. This study examines the relationship between self-reflection and educational outcomes. We correlate performance in a preclinical course that focuses on self-reflection as it relates to contextual elements of patient care (Human Context of Health Care), with educational measures such as overall grade point average, clinical clerkship scores, and Medical College Admission Test (MCAT) scores. Student performance in Human Context of Health Care correlated with MCAT-Verbal scores, MCAT-writing sample scores, clerkship grades, and overall medical school grade point average (R = 0.3; p self-reflection skills are often neglected in undergraduate medical curricula. Our findings suggest that these skills are important and correlate with recognized long-term educational outcomes.

Determinants of self-medication among undergraduate students at King Saud University: Knowledge, attitude and practice

Directory of Open Access Journals (Sweden)

Khulood K AlRaddadi

2017-01-01

Conclusion: Half of the respondents practice self-medication; which demonstrates the need to raise public awareness, becoming more conscious during drug utilisation and the pharmacists' advisory role. In addition, further studies should be conducted to assess the herbals' practice in our community as their use was reported to be high in the results.

Self-determining medical leadership needs of occupational health physicians.

Science.gov (United States)

Giri, Prosenjit; Aylott, Jill; Kilner, Karen

2017-10-02

Purpose The purpose of this study was to explore which factors motivate doctors to engage in leadership roles and to frame an inquiry of self-assessment within Self-Determination Theory (SDT) to identify the extent to which a group of occupational health physicians (OHPs) was able to self-determine their leadership needs, using a National Health Service (NHS) England competency approach promoted by the NHS England Leadership Academy as a self-assessment leadership diagnostic. Medical leadership is seen as crucial to the transformation of health-care services, yet leadership programmes are often designed with a top-down and centrally commissioned "one-size-fits-all" approach. In the UK, the Smith Review (2015) concluded that more decentralised and locally designed leadership development programmes were needed to meet the health-care challenges of the future. However, there is an absence of empirical research to inform the design of effective strategies that will engage and motivate doctors to take up leadership roles, while at the same time, health-care organisations continue to develop formal leadership roles as a way to secure medical leadership engagement. The problem is further compounded by a lack of validated leadership qualities assessment instruments which support researching this problem. Design/Methodology/approach The analysis draws on a sample of about 25 per cent of the total population size of the Faculty of Occupational Medicine ( n = 1,000). The questionnaire used was the Leadership Qualities Framework tool as a form of online self-assessment ( NHS Leadership Academy, 2012 ). The data were analysed using descriptive statistics and simple inferential methods. Findings OHPs are open about reporting their leadership strengths and leadership development needs and recognise leadership learning as an ongoing development need regardless of their level of personal competence. This study found that the single most important factor to affect a doctor

Self-reported quality of ADL task performance among patients with COPD exacerbations

DEFF Research Database (Denmark)

Bendixen, Hans Jørgen; Wæhrens, Eva Elisabet Ejlersen; Wilcke, Jon Torgny

2014-01-01

OBJECTIVE: Patients suffering from chronic obstructive pulmonary disease (COPD) experience problems in the performance of activities of daily living (ADL) tasks. The objective was to examine the self-reported quality of ADL task performance among COPD patients, and to investigate whether age...... concerning age, gender, and routine COPD characteristics were drawn from the patients' medical records. RESULTS: The patients reported being inefficient to markedly inefficient when performing ADL tasks within the personal hygiene, toileting, dressing, household, mobility, and transportation domains. While...... more than 90% of the participants reported increased effort and/or fatigue when performing the ADL tasks, up to 88% of the participants relied on help from others in the performance of general household chores like cooking and shopping. Self-reported ADL ability did not correlate with age, gender...

The role of goal cognitions, illness perceptions and treatment beliefs in self-reported adherence after kidney transplantation: a cohort study.

Science.gov (United States)

Massey, Emma K; Tielen, Mirjam; Laging, Mirjam; Beck, Denise K; Khemai, Roshni; van Gelder, Teun; Weimar, Willem

2013-09-01

Nonadherence to immunosuppressive medication (IM) after kidney transplantation is related to poorer patient and graft outcomes; therefore research into modifiable factors associated with nonadherence is a priority. In this prospective cohort study we investigated whether changes in goal cognitions, illness perceptions, and treatment beliefs were related to self-reported medication adherence six months after kidney transplantation. Interviews were conducted with patients in the out-patient clinic six weeks (T1: n=113) and six months (T2: n=106) after transplantation. Self-reported adherence was measured using the Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS© Interview). The Brief Illness Perceptions Questionnaire, Beliefs about Medicines Questionnaire and questions on goal cognitions were also administered at both time points. Self-reported nonadherence increased significantly between 6 weeks and 6 months after transplantation from 17% to 27%. Importance of medication adherence as a personal goal and self-efficacy to successfully carry out this goal decreased significantly over time. Perceived necessity of immunosuppressive medication was high but significantly decreased over time. Concerns about the medicines were low. There were no significant changes in illness perceptions or concerns over time. An increase in perceived graft longevity (timeline) was related to higher likelihood of nonadherence six months post-transplant. Furthermore, younger adult patients were more likely to be nonadherent six months after transplantation. The self-reported nonadherence levels found in this study so soon after transplantation demonstrate the need for early and continued intervention after kidney transplantation in order to maximise adherence and consequently clinical outcomes. Changes in (unrealistic) beliefs regarding the longevity of the graft may offer a potential target for intervention among nonadherent patients. © 2013.

Leakage from medically-certified to self-certified workplace absence among norwegian employees

OpenAIRE

Karlsen, Geir Runar; Ytterstad, Elinor

2017-01-01

Source at https://dx.doi.org/10.1080/20021518.2017.1411119 There are two different kinds of sickness absence in Norway: self-certified absence (SCA), and medically-certified absence (MCA). In this study of 6437 Norwegian employees, we applied logistic regression models for a dichotomous SCA variable on initially 38 independent vari- ables including age and gender. Our findings showed that employees reporting long-term health issues but no record of MCA in the past 12 months (...

Evaluation of self-medication practices in acute diseases among university students in Oman

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Marwa Al Flaiti

2014-01-01

Conclusion: The prevalence of self-medication among university students was very high. There is a need for intensive education and comprehensive awareness campaign to advocate for reduction in the prevalence of self-medication practices among students.

Self-hypnosis for anxiety associated with severe asthma: a case report

Directory of Open Access Journals (Sweden)

Anbar Ran D

2003-07-01

Full Text Available Abstract Background Management of asthma can be complicated by both medical and psychiatric conditions, such as gastroesophageal reflux, chronic sinusitis, and anxiety. When symptoms of asthma are interpreted without regard to such conditions treatment may yield a suboptimal outcome. For example, anxiety-associated dyspnea, tachypnea, and chest tightness can be mistakenly interpreted as resulting from an exacerbation of asthma. Medical treatment directed only for asthma may thus lead to overuse of asthma medications and increased hospitalizations. Case Presentation The described case illustrates how a systemic steroid-dependent patient with asthma benefited from receiving care from a pediatric pulmonologist who also was well versed in the diagnosis and treatment of anxiety. By using self-hypnosis, the patient was able to reduce her dependence on bronchodilators. Following modification of her medical therapy under supervision of the pulmonologist, and regular use of hypnosis, the patient ultimately was weaned off her systemic steroid therapy. Conclusions This report emphasizes that anxiety must be considered as a comorbid condition in the treatment of asthma. Self-hypnosis can be a useful skill in the treatment of a patient with anxiety and asthma.

The PsyLOG mobile application: development of a tool for the assessment and monitoring of side effects of psychotropic medication.

Science.gov (United States)

Kuzman, Martina Rojnic; Andlauer, Olivier; Burmeister, Kai; Dvoracek, Boris; Lencer, Rebekka; Koelkebeck, Katja; Nawka, Alexander; Riese, Florian

2017-06-01

Mobile health interventions are regarded as affordable and accessible tools that can enhance standard psychiatric care. As part of the mHealth Psycho-Educational Intervention Versus Antipsychotic-Induced Side Effects (mPIVAS) project (www.psylog.eu), we developed the mobile application "PsyLOG" based on mobile "smartphone" technology to monitor antipsychotic-induced side effects. The aim of this paper is to describe the rationale and development of the PsyLOG and its clinical use. The PsyLOG application runs on smartphones with Android operating system. The application is currently available in seven languages (Croatian, Czech, English, French, German, Japanese and Serbian). It consists of several categories: "My Drug Effects", "My Life Styles", "My Charts", "My Medication", "My Strategies", "My Supporters", "Settings" and "About". The main category "My Drug Effects" includes a list of 30 side effects with the possibility to add three additional side effects. Side effects are each accompanied by an appropriate description and the possibility to rate its severity on a visual analogue scale from 0-100%. The PsyLOG application is intended to enhance the link between patients and mental health professionals, serving as a tool that more objectively monitors side-effects over certain periods of time. To the best of our knowledge, no such applications have so far been developed for patients taking antipsychotic medication or for their therapists.

[The relationship between academic self-efficacy and academic burnout in medical students].

Science.gov (United States)

Lee, Su Hyun; Jeon, Woo Taek

2015-03-01

The purpose of this study was to examine the correlation between academic burnout and academic self-efficacy in medical students. The study group comprised 446 students in years 1 to 4 of medical school. They were asked to rate their academic burnout and academic self-efficacy on a scale. The data were analyzed by multivariate analysis of variance and regression analysis. Academic self-efficacy was correlated negatively with academic burnout explaining 37% of academic burnout. Academic self-efficacy (especially self-confidence) had the greatest effect on academic burnout. The implications of these results are discussed in terms of an evaluation and support system for students.

Predictors of students' self-reported adoption of a smartphone application for medical education in general practice.

Science.gov (United States)

Sandholzer, Maximilian; Deutsch, Tobias; Frese, Thomas; Winter, Alfred

2015-05-21

Smartphones and related applications are increasingly gaining relevance in the healthcare domain. We previously assessed the demands and preferences of medical students towards an application accompanying them during a course on general practice. The current study aims to elucidate the factors associated with adoption of such a technology. Therefore we provided students with a prototype of an application specifically related to their studies in general practice. A total estimation among students participating in a general practice examination at the Leipzig Medical School was conducted in May 2014. Students were asked to answer a structured self-designed questionnaire. Univariable comparisons were made to identify significant differences between those students who reported to have used the application frequently and those who did not. Multivariable binary logistic regression was used to reveal independent predictors of frequent application usage. The response rate was 99.3 % (n = 305/307). The majority (59 %, n = 180/305) were female students. The mean age was 24.5 years and 79.9 % (n = 243/304) owned a smartphone or tablet computer. Regarding the usage of the provided application, 2.3 % (n = 7/303) did not use the app while 68.0 % (n = 206/303) replied to have used it more than five times. Frequent users significantly differed from non-frequent users with regard to being female rather than male, higher mobile device ownership, more frequent exchange about obtaining the course certificate, higher personal interest in new technologies, larger enjoyment of the technology, lower intention to not use smartphone applications in the future, better opinion towards smartphone applications for the profession of a doctor, higher perceived importance of medical applications on the job, higher compatibility of smartphone applications with personal work style, higher perceived relevance of university support and personal benefit of use. Multivariable

STS-1 medical report

Science.gov (United States)

Pool, S. L. (Editor); Johnson, P. C., Jr. (Editor); Mason, J. A. (Editor)

1981-01-01

The report includes a review of the health of the crew before, during and immediately after the first Shuttle orbital flight (April 12-14, 1981). Areas reviewed include: health evaluation, medical debriefing of crewmembers, health stabilization program, medical training, medical kit carried inflight; tests and countermeasures for space motion sickness, cardiovascular profile, biochemistry and endocrinology results; hematology and immunology analyses; medical microbiology; food and nutrition; potable water; shuttle toxicology; radiological health; cabin acoustical noise. Also included is information on: environmental effects of Shuttle launch and landing, medical information management; and management, planning and implementation of the medical program.

Accuracy of self-reported survey data on assisted reproductive technology treatment parameters and reproductive history.

Science.gov (United States)

Stern, Judy E; McLain, Alexander C; Buck Louis, Germaine M; Luke, Barbara; Yeung, Edwina H

2016-08-01

It is unknown whether data obtained from maternal self-report for assisted reproductive technology treatment parameters and reproductive history are accurate for use in research studies. We evaluated the accuracy of self-reported in assisted reproductive technology treatment and reproductive history from the Upstate KIDS study in comparison with clinical data reported to the Society for Assisted Reproductive Technology Clinic Outcome Reporting System. Upstate KIDS maternal questionnaire data from deliveries between 2008 and 2010 were linked to data reported to Society for Assisted Reproductive Technology Clinic Outcome Reporting System. The 617 index deliveries were compared as to treatment type (frozen embryo transfer and donor egg or sperm) and use of intracytoplasmic sperm injection and assisted hatching. Use of injectable medications, self-report for assisted reproductive technology, or frozen embryo transfer prior to the index deliveries were also compared. We report agreement in which both sources had yes or both no and sensitivity of maternal report using Society for Assisted Reproductive Technology Clinic Outcome Reporting System as the gold standard. Significance was determined using χ(2) at P < 0.05. Universal agreement was not reached on any parameter but was best for treatment type of frozen embryo transfer (agreement, 96%; sensitivity, 93%) and use of donor eggs (agreement, 97%; sensitivity, 82%) or sperm (agreement, 98%; sensitivity, 82%). Use of intracytoplasmic sperm injection (agreement, 78%: sensitivity, 78%) and assisted hatching (agreement, 57%; sensitivity, 38%) agreed less well with self-reported use (P < .0001). In vitro fertilization (agreement, 82%) and frozen embryo transfer (agreement, 90%) prior to the index delivery were more consistently reported than was use of injectable medication (agreement, 76%) (P < .0001). Women accurately report in vitro fertilization treatment but are less accurate about procedures handled in the

Self-reported Function, Health Resource Use, and Total Health Care Costs Among Medicare Beneficiaries With Glaucoma.

Science.gov (United States)

Prager, Alisa J; Liebmann, Jeffrey M; Cioffi, George A; Blumberg, Dana M

2016-04-01

The effect of glaucoma on nonglaucomatous medical conditions and resultant secondary health care costs is not well understood. To assess self-reported medical conditions, the use of medical services, and total health care costs among Medicare beneficiaries with glaucoma. Longitudinal observational study of 72,587 Medicare beneficiaries in the general community using the Medicare Current Beneficiary Survey (2004-2009). Coding to extract data started in January 2015, and analyses were performed between May and July 2015. Self-reported health, the use of health care services, adjusted mean annual total health care costs per person, and adjusted mean annual nonoutpatient costs per person. Participants were 72,587 Medicare beneficiaries 65 years or older with (n = 4441) and without (n = 68,146) a glaucoma diagnosis in the year before collection of survey data. Their mean age was 76.9 years, and 43.2% were male. Patients with glaucoma who responded to survey questions on visual disability were stratified into those with (n = 1748) and without (n = 2639) self-reported visual disability. Medicare beneficiaries with glaucoma had higher adjusted odds of inpatient hospitalizations (odds ratio [OR], 1.27; 95% CI, 1.17-1.39; P total health care costs and $2599 (95% CI, $1985-$3212; P total and nonoutpatient medical costs. Perception of vision loss among patients with glaucoma may be associated with depression, falls, and difficulty walking. Reducing the prevalence and severity of glaucoma may result in improvements in associated nonglaucomatous medical conditions and resultant reduction in health care costs.

Contributions of psychological needs, self-compassion, leisure-time exercise, and achievement goals to academic engagement and exhaustion in Canadian medical students.

Science.gov (United States)

Babenko, Oksana; Mosewich, Amber; Abraham, Joseph; Lai, Hollis

2018-01-01

To investigate the contributions of psychological needs (autonomy, competence, and relatedness) and coping strategies (self-compassion, leisure-time exercise, and achievement goals) to engagement and exhaustion in Canadian medical students. This was an observational study. Two hundred undergraduate medical students participated in the study: 60.4% were female, 95.4% were 20-29 years old, and 23.0% were in year 1, 30.0% in year 2, 21.0% in year 3, and 26.0% in year 4. Students completed an online survey with measures of engagement and exhaustion from the Oldenburg Burnout Inventory-student version; autonomy, competence, and relatedness from the Basic Psychological Needs Scale; self-compassion from the Self-Compassion Scale-short form; leisure-time exercise from the Godin Leisure-Time Exercise Questionnaire; and mastery approach, mastery avoidance, performance approach, and performance avoidance goals from the Achievement Goals Instrument. Descriptive and inferential analyses were performed. The need for competence was the strongest predictor of student engagement (β= 0.35, P= 0.000) and exhaustion (β= -0.33, P= 0.000). Students who endorsed mastery approach goals (β= 0.21, P= 0.005) and who were more self-compassionate (β= 0.13, P= 0.050) reported greater engagement with their medical studies. Students who were less self-compassionate (β= -0.32, P= 0.000), who exercised less (β= -0.12, P= 0.044), and who endorsed mastery avoidance goals (β= 0.22, P= 0.003) reported greater exhaustion from their studies. Students' gender (β= 0.18, P= 0.005) and year in medical school (β= -0.18, P= 0.004) were related to engagement, but not to exhaustion. Supporting students' need for competence and raising students' awareness of self-compassion, leisure-time exercise, and mastery approach goals may help protect students from burnout-related exhaustion and enhance their engagement with their medical school studies.

Azadirachtin poisoning: a case report.

Science.gov (United States)

Iyyadurai, Ramya; Surekha, V; Sathyendra, Sowmya; Paul Wilson, Benny; Gopinath, K G

2010-10-01

The use of neem-based products is widespread in the Indian Subcontinent. Neem-based pesticides obtained from neem kernels are considered natural and safe. The toxic effects of ingestion and overdose of this pesticide in adults have not been described in this literature. We report the case of a 35-year-old lady who had consumed Azadirachtin in an attempt of deliberate self-harm. The patient had features of neurotoxicity because of Azadirachtin requiring intensive medical care with mechanical ventilation. The patient survived the overdose with no long-lasting side effects of the toxin.

Self-reported versus behavioral self-handicapping: empirical evidence for a theoretical distinction.

Science.gov (United States)

Hirt, E R; Deppe, R K; Gordon, L J

1991-12-01

The present study was an investigation of how Ss would respond when given 2 self-handicapping options, 1 behavioral (withdrawal of practice effort) and 1 self-reported (reporting high levels of stress). Ss anticipating a diagnostic test of intellectual ability were given different instructions regarding the effects of stress and practice on test performance. Ss were told that (a) stress only, (b) practice only, (c) both stress and practice, or (d) neither stress nor practice affected test scores. Ss were then given the opportunity to self-report a handicap on a stress inventory and to behaviorally self-handicap by failing to practice before the test. High self-handicapping men and women showed evidence of self-reported handicapping, but only high self-handicapping men behaviorally self-handicapped. However, when both self-handicaps were viable, both high self-handicapping men and women preferred the self-reported over the behavioral self-handicap.

Indigenous Healing Practices and Self-Medication amongst ...

African Journals Online (AJOL)

Indigenous Healing Practices and Self-Medication amongst Pregnant Women in Cape Town, South Africa. Naeemah Abrahams, Rachel Jewkes, Zodumo Mvo. Abstract. This study was conducted in and around Cape Town, South Africa, at two primary obstetric facilities and in the antenatal clinics of two secondary hospitals.

Feasibility of a self-administered survey to identify primary care patients at risk of medication-related problems

Directory of Open Access Journals (Sweden)

Makowsky MJ

2014-02-01

Full Text Available Mark J Makowsky,1 Andrew J Cave,2 Scot H Simpson1 1Faculty of Pharmacy and Pharmaceutical Sciences, 2Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada Background and objectives: Pharmacists working in primary care clinics are well positioned to help optimize medication management of community-dwelling patients who are at high risk of experiencing medication-related problems. However, it is often difficult to identify these patients. Our objective was to test the feasibility of a self-administered patient survey, to facilitate identification of patients at high risk of medication-related problems in a family medicine clinic. Methods: We conducted a cross-sectional, paper-based survey at the University of Alberta Hospital Family Medicine Clinic in Edmonton, Alberta, which serves approximately 7,000 patients, with 25,000 consultations per year. Adult patients attending the clinic were invited to complete a ten-item questionnaire, adapted from previously validated surveys, while waiting to be seen by the physician. Outcomes of interest included: time to complete the questionnaire, staff feedback regarding impact on workflow, and the proportion of patients who reported three or more risk factors for medication-related problems. Results: The questionnaire took less than 5 minutes to complete, according to the patient's report on the last page of the questionnaire. The median age (and interquartile range of respondents was 57 (45–69 years; 59% were women; 47% reported being in very good or excellent health; 43 respondents of 100 had three or more risk factors, and met the definition for being at high risk of a medication-related problem. Conclusions: Distribution of a self-administered questionnaire did not disrupt patients, or the clinic workflow, and identified an important proportion of patients at high risk of medication-related problems. Keywords: screening tool, pharmacists, primary

Perceived Discrimination and Reported Delay of Pharmacy Prescriptions and Medical Tests

Science.gov (United States)

Van Houtven, Courtney Harold; Voils, Corrine I; Oddone, Eugene Z; Weinfurt, Kevin P; Friedman, Joëlle Y; Schulman, Kevin A; Bosworth, Hayden B

2005-01-01

BACKGROUND Access to health care varies according to a person's race and ethnicity. Delaying treatment is one measure of access with important health consequences. OBJECTIVE Determine whether perceptions of unfair treatment because of race or ethnicity are associated with reported treatment delays, controlling for economic constraints, self-reported health, depression, and demographics. DESIGN Cross-sectional, observational study. PARTICIPANTS A randomly selected community sample of 181 blacks, 148 Latinos, and 193 whites in Durham County, NC. MEASUREMENTS A phone survey conducted in 2002 to assess discrimination, trust in medical care, quality of care, and access to care. Treatment delays were measured by whether or not a person reported delaying or forgoing filling a prescription and delaying or forgoing having a medical test/treatment in the past 12 months. Perceived discrimination was measured as unfair treatment in health care and as racism in local health care institutions. RESULTS The odds of delaying filling prescriptions were significantly higher (odds ratio (OR)=2.02) for persons who perceived unfair treatment, whereas the odds of delaying tests or treatments were significantly higher (OR=2.42) for persons who thought racism was a problem in health care locally. People with self-reported depression and people who reported not working had greater odds of delaying both types of care. CONCLUSIONS A prospective cohort study with both personal and macro measures of discrimination, as well as more refined measures of treatment delays, would help us better understand the relationship between perceived discrimination and treatment delays. PMID:16050850

The relations between personality traits and psychopathy as measured by ratings and self-report

Directory of Open Access Journals (Sweden)

Kujačić Daliborka

2015-01-01

Full Text Available The objective of this study was to examine the relations between psychopathy - as assessed by ratings (PCL-R and by self-report (SRP3 - on one side, and The Five-Factor personality Model - expanded to include the traits Amorality and Disintegration - on the other. Both methods examined four traits of psychopathy: interpersonal, affective, lifestyle and antisocial characteristics. Data were collected on a sample of 112 male convicts. The results show the absence of congruence between the two methods - self-report and rating - in case of interpersonal and affective psychopathic dispositions. This incongruence is also reflected in their relations with personality traits. The self-report measures and the ratings of Lifestyle and Antisocial tendencies are related to amorality, aggressiveness, schizotypy, Neuroticism and impulsivity. However, the ratings of affective and interpersonal style are related to the integrated, organized, and emotionally stable aspects of personality. The results are interpreted in the light of differences between the methods of assessment and in the light of the essential characteristics of the psychopathic phenomena.

Medical Cannabis Use Is Associated With Decreased Opiate Medication Use in a Retrospective Cross-Sectional Survey of Patients With Chronic Pain.

Science.gov (United States)

Boehnke, Kevin F; Litinas, Evangelos; Clauw, Daniel J

2016-06-01

Opioids are commonly used to treat patients with chronic pain (CP), though there is little evidence that they are effective for long term CP treatment. Previous studies reported strong associations between passage of medical cannabis laws and decrease in opioid overdose statewide. Our aim was to examine whether using medical cannabis for CP changed individual patterns of opioid use. Using an online questionnaire, we conducted a cross-sectional retrospective survey of 244 medical cannabis patients with CP who patronized a medical cannabis dispensary in Michigan between November 2013 and February 2015. Data collected included demographic information, changes in opioid use, quality of life, medication classes used, and medication side effects before and after initiation of cannabis usage. Among study participants, medical cannabis use was associated with a 64% decrease in opioid use (n = 118), decreased number and side effects of medications, and an improved quality of life (45%). This study suggests that many CP patients are essentially substituting medical cannabis for opioids and other medications for CP treatment, and finding the benefit and side effect profile of cannabis to be greater than these other classes of medications. More research is needed to validate this finding. This article suggests that using medical cannabis for CP treatment may benefit some CP patients. The reported improvement in quality of life, better side effect profile, and decreased opioid use should be confirmed by rigorous, longitudinal studies that also assess how CP patients use medical cannabis for pain management. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

Medical and occupational radiation exposure reported by self-administered questionnaire

International Nuclear Information System (INIS)

Yamamoto, Osamu; Fujita, Shoichiro

1977-01-01

Affirmative response rates for diagnostic, therapeutic, and occupational ionizing radiation exposure were ascertained by surveying Hiroshima and Nagasaki aBCC-JNIH Adult Health Study subjects. Half reported diagnostic exposure since last visiting ABCC; 20%, within 3 months of interview. Rates were higher for A-bomb exposed than those not-in-city; possibly because of a higher disease rate or concern therefore among the A-bomb exposed group and/or A-bomb Survivors Medical Treatment Law handbooks' facilitating more examinations of the exposed. The rates did not differ among the A-bomb exposed groups. The respective Hiroshima and Nagasaki rates were 2.6%, and 1.6% for radiation therapy; and 0.5% and 0.2% for occupational exposure. Neither radiation therapy nor occupational exposure rates differed by A-bomb dose. (auth.)

Self-Report and Dry Blood Spot Measurement of Antiretroviral Medications as Markers of Adherence in Pregnant Women in Rural South Africa.

Science.gov (United States)

Alcaide, Maria L; Ramlagan, Shandir; Rodriguez, Violeta J; Cook, Ryan; Peltzer, Karl; Weiss, Stephen M; Sifunda, Sibusiso; Jones, Deborah L

2017-07-01

Antiretroviral (ARV) adherence is essential to prevent mother-to-child transmission of HIV. This study compared self-reported adherence versus ARV detection in dried blood spots (DBS) among N = 392 HIV-infected pregnant women in South Africa (SA). Women completed two self-reported adherence measures [visual analog scale (VAS), AIDS Clinical Trials Group Adherence (ACTG)]. Adherence was 89% (VAS), 80% (ACTG), and 74% (DBS). Self-report measures marginally agreed with DBS (VAS: Kappa = 0.101, Area under the ROC curve (AUROC) = 0.543; ACTG: Kappa  = 0.081, AUROC = 0.538). Self-reported adherence was overestimated and agreement with DBS was poor. Validation of self-reported ARV adherence among pregnant HIV+ women in SA is needed.

The life mission theory V. Theory of the anti-self (the shadow) or the evil side of man.

Science.gov (United States)

Ventegodt, Søren; Andersen, Niels Jorgen; Merrick, Joav

2003-12-11

According to the life mission theory, the essence of man is his purpose of life, which comes into existence at conception. This first purpose is always positive and in support of life. This is not in accordance with the everyday experience that man also engages in evil enterprises born out of destructive intentions. This paper presents a theory about the evil side of man, called the "anti-self" (the shadow), because it mirrors the self and its purpose of life. The core of the anti-self is an evil and destructive intention opposite to the intention behind the life mission. The evil side of man arises when, as the life mission theory proclaims, man is denying his good, basic intention to avoid existential pain. The present theory of the anti-self claims that all the negative decisions accumulated throughout the personal history, sum up to a negative or dark anti-self, as complex, multifaceted, and complete as the self. All the negative decisions taken through personal history build this solid, negative, existential structure. The anti-self, or shadow as Carl Gustav Jung used to call it, is a precise reflection of man's basically good and constructive nature. When mapped, it seems that for most or even for all the many fine talents of man, there is a corresponding evil intention and talent in the person's anti-self. As man is as evil as he is good, he can only realize his good nature and constructive talents by making ethical choices. Ethics therefore seem to be of major importance to every patient or person engaged in the noble project of personal growth. Understanding the nature and structure of the evil side of man seems mandatory to every physician or therapist offering existential therapy to his patient. The theory of anti-self makes it possible to treat patients with destructive behavioral patterns, who want to be good deep in their heart, by helping them let go of their evil intentions. The anti-self also seems to explain the enigma of why human beings often

A qualitative study about self-medication in the community among market vendors in Fuzhou, China.

Science.gov (United States)

Wen, Yi; Lieber, Eli; Wan, Dai; Hong, Yuanhao

2011-09-01

Despite government efforts to increase healthcare insurance and access in China, many individuals, regardless of insurance status, continue to engage in high levels of self-medication. To understand the factors influencing common self-medication behaviour in a community of food market vendors in Fuzhou China, a total of 30 market vendors were randomly recruited from six food markets in 2007. In-depth interviews were conducted with each participant at their market stalls by trained interviewers using a semi-structured open-ended interview protocol. Participants were asked broad questions about their health-seeking behaviours as well as their past experiences with self-medication and hospital care. ATLAS. ti was used to manage and analyse the interview data. The results showed that hospital-based healthcare services were perceived as better quality. However, self-medication was viewed as more affordable in terms of money and time. Other factors prompting self-medication, included confidence in understanding the health problem, the easy accessibility of local pharmacies and the influences of friends/peers and advertising. Three broad domains, attitude, cost and effectiveness, were all seen to determine past decisions and experiences with self-medication. Interestingly, the effective management of self-medication via pharmacy resources raised particular concern because of perceived variation in quality. In conclusion, self-medication was found to be an important and common health-seeking behaviour driven by multiple factors. A sound and comprehensive public health system should systematically attend to these behaviours and the pharmacies, where much of the behaviour occurs. © 2011 Blackwell Publishing Ltd.

How clinical medical students perceive others to influence their self-regulated learning.

Science.gov (United States)

Berkhout, Joris J; Helmich, Esther; Teunissen, Pim W; van der Vleuten, Cees P M; Jaarsma, A Debbie C

2017-03-01

Undergraduate medical students are prone to struggle with learning in clinical environments. One of the reasons may be that they are expected to self-regulate their learning, which often turns out to be difficult. Students' self-regulated learning is an interactive process between person and context, making a supportive context imperative. From a socio-cultural perspective, learning takes place in social practice, and therefore teachers and other hospital staff present are vital for students' self-regulated learning in a given context. Therefore, in this study we were interested in how others in a clinical environment influence clinical students' self-regulated learning. We conducted a qualitative study borrowing methods from grounded theory methodology, using semi-structured interviews facilitated by the visual Pictor technique. Fourteen medical students were purposively sampled based on age, gender, experience and current clerkship to ensure maximum variety in the data. The interviews were transcribed verbatim and were, together with the Pictor charts, analysed iteratively, using constant comparison and open, axial and interpretive coding. Others could influence students' self-regulated learning through role clarification, goal setting, learning opportunities, self-reflection and coping with emotions. We found large differences in students' self-regulated learning and their perceptions of the roles of peers, supervisors and other hospital staff. Novice students require others, mainly residents and peers, to actively help them to navigate and understand their new learning environment. Experienced students who feel settled in a clinical environment are less susceptible to the influence of others and are better able to use others to their advantage. Undergraduate medical students' self-regulated learning requires context-specific support. This is especially important for more novice students learning in a clinical environment. Their learning is influenced most

Quality issues of self-report of hypertension: analysis of a population representative sample of older adults in Taiwan.

Science.gov (United States)

Tsai, Alan Chung-Hong; Chang, Tsui-Lan

2012-01-01

The study was to evaluate the quality of self-report of hypertension and examine the factors associated with under- and over-reporting of hypertension in older Taiwanese. Data for this analysis were from the Social Environment and Biomarkers Study in Taiwan 2000, which involved a national sample of 1021 Taiwanese over 54 years of age. We performed binary classification tests to compare the prevalence rates of self-reported vs. clinically measured hypertension according to World Health Organization (WHO) (blood pressure ≥ 160/95 mm Hg or on hypertension medication) and JNC-6 (140/90 mm Hg or on hypertension medication) definitions. Logistic regression analysis was performed to analyze the potential factors associated with under- or over-reporting of blood pressure status. Results showed the test characteristics of self-reports were: sensitivity 73%, specificity 93%, and kappa = 0.68 (p WHO definition; and sensitivity 51%, specificity 95% and kappa = 0.43 (p definition. Old age was associated with over-reporting whereas having no health checkup during the past 12 months was associated with under-reporting. The relatively low agreement between self-reports and clinically measured hypertension (JNC-6 definition) was mainly due to the lack of a well-defined hypertension practice guideline and the failure of clinicians to clearly inform patients of their diagnoses. The consistency of hypertension practice guidelines and the effectiveness of informing the patients of their diagnoses are two main factors impacting the quality of self-report of hypertension in elderly Taiwanese. Better self-reports of health data can improve the efficiency of public health surveillance efforts. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Prevalence of self-medication among university students in Baghdad: a cross-sectional study from Iraq.

Science.gov (United States)

Al-Ameri, Rawa J K; Abd Al-Badri, Husham J; Lafta, Riyadh K

2017-03-30

The objective of this study is to find out the prevalence and determinants of self-medication among college students in Baghdad, Iraq. A cross-sectional survey was conducted in Al-Mustansiriyah and Al-Nahrain universities, Baghdad, from January to April 2015. A multistage random sampling technique was adopted to collect data from 1435 college students using a questionnaire form. The mean age of the joining students was 19.8 years. Females form 53% of the sample. Self-medications use was prevalent among 92.4% of students. Antipyretics and antibiotics were the most used medicines. Self-medication was higher among urban residents (OR= 7.99, P resilience to self-medication (OR=0.455, P = 0.001). Despite free access to healthcare institutions, nine out of ten college students from Baghdad universities have practiced self-medication. Education of students about the safe use of medications and supervision of pharmacies are effective ways to control this malpractice.

Perceived medication use challenges and coping strategies among medical outpatients in Nigeria.

Science.gov (United States)

Yusuff, Kazeem B

2013-02-01

The use of medicines is an action that involves a change in behaviour and it is a complex construct involving reciprocal interactions between social, environmental and cognitive factors. This is particularly true when a patient uses medicines for asymptomatic chronic conditions, requiring life-long use. To identify patient-perceived medication use challenges, determine the coping strategies used and investigate the relationship between patient-perceived challenges and self-initiation of coping strategies. A premier 900-bed tertiary/teaching hospital located in Ibadan, Nigeria. Ten pharmacists conducted cross-sectional medication use interviews for a random sample of 324 medical outpatients in 4 weeks (25th October-19th November 2006). Patient-perceived challenges with prescribed medications, self-initiated coping strategies used and relationship between patient-perceived challenges and self-initiation of coping strategies Eighty-one percent (324) of the random sample of 400 patients consented and completed the interview. Of these, 50.3 % were males while 49.7 % were females with mean age (SD) of 51.5 (17.6) and 52.1 (17.4) years respectively. The most frequent diagnoses were hypertension (53 %) and type-2 diabetes + hypertension (14.5 %). Two hundred and twenty-four patients reported one or more perceived challenges. Of these, 43.8 % were 65 years or older and about half reported at least 3 challenges. The majority (95.6 %) of patients who reported perceived challenges initiated one or more coping strategies without the knowledge of their physicians or pharmacists. Of 100 patients who did not report any perceived challenge, 43 % admitted initiating strategies to maintain perceived "cure" of their medical conditions. Self-initiation and use of coping strategies was far more likely among patients who reported perceived challenges (OR: 28.4, 95 % CI 26.1-30.5). The number of coping strategies reported appeared strongly related to the number of perceived challenges (r

The willingness and attitude of patients towards self-administration of medication in hospital

NARCIS (Netherlands)

Vanwesemael, T. (Toke); K. Boussery (Koen); P.M.L.A. van den Bemt (Patricia); Dilles, T. (Tinne)

2018-01-01

textabstractBackground: Literature suggests a positive impact of self-administration of medication during hospitalization on medication adherence and safety, and on patient satisfaction. However, self-administration is not a common practice in Belgian hospitals. The aim of this study was to describe

Living well: an intervention to improve self-management of medical illness for individuals with serious mental illness.

Science.gov (United States)

Goldberg, Richard W; Dickerson, Faith; Lucksted, Alicia; Brown, Clayton H; Weber, Elyssa; Tenhula, Wendy N; Kreyenbuhl, Julie; Dixon, Lisa B

2013-01-01

Individuals with serious mental illness have elevated rates of comorbid chronic general medical conditions and may benefit from interventions designed to support illness self-management. This study examined the effectiveness of a modified version of the Chronic Disease Self-Management Program called Living Well for individuals with serious mental illness. A total of 63 mental health consumers with serious mental illness and at least one concurrent chronic general medical condition were randomly assigned to receive the 13-session peer-cofacilitated Living Well intervention or usual care. Participants were evaluated on attitudinal, behavioral, and functional outcomes at baseline, at the end of the intervention, and at a two-month follow-up. Living Well participants showed significant postintervention improvements across a range of attitudinal (self-efficacy and patient activation), behavioral (illness self-management techniques), and functional (physical and emotional well-being and general health functioning) outcomes. Although attenuation of effect was observed for most outcomes at two months postintervention, evidence was found of continued improvement in general self-management behaviors (use of action planning, brainstorming, and problem-solving). Continued advantage was found for the Living Well group in other areas, such as health-related locus of control and reports of healthy eating and physical activity. Receipt of Living Well was associated with a notable decrease in use of the emergency room for medical care, although the between-group difference was not statistically significant. Living Well shows promise in helping mental health consumers more effectively manage chronic general medical conditions and experience improved functioning and well-being.

Symptoms and side effects in chronic non-cancer pain: patient report vs. systematic assessment.

Science.gov (United States)

Jonsson, T; Christrup, L L; Højsted, J; Villesen, H H; Albjerg, T H; Ravn-Nielsen, L V; Sjøgren, P

2011-01-01

relieving distressing symptoms and managing the side effects of analgesics are essential in order to improve quality of life and functional capacity in chronic non-cancer pain patients. A quick, reliable and valid tool for assessing symptoms and side effects is needed in order to optimize treatment. We aimed to investigate the symptoms reported by chronic non-cancer pain patients after open-ended questioning vs. a systematic assessment using a list of symptoms, and to assess whether the patients could distinguish between the symptoms and the side effects induced by analgesics. patients treated with either opioids and/or adjuvant analgesics were asked to report their symptoms spontaneously, followed by a 41-item investigator-developed symptom checklist. A control group also filled in the checklist. a total of 62 patients and 64 controls participated in the study. The numbers of symptoms reported by the patients (9.9 ± 5.9) were significantly higher than those reported by the controls (3.2 ± 3.9) (Pside effects due to analgesics was: (1) Dry mouth (42%); (2) Sweating (34%); (3) Weight gain (29%); (4) Memory deficits (24%); (5) Fatigue (19%); and (6) Concentration deficits (19%). the number of symptoms reported using systematic assessment was eightfold higher than those reported voluntarily. Fatigue, cognitive dysfunction, dry mouth, sweating and weight gain were the most frequently reported. The patients reported the side effects of their analgesics to contribute substantially to the reported symptoms. 2010 The Acta Anaesthesiologica Scandinavica Foundation.

Cardiovascular Side Effects of Atomoxetine and Its Interactions with Inhibitors of the Cytochrome P450 System

Directory of Open Access Journals (Sweden)

Pashtoon Murtaza Kasi

2011-01-01

Full Text Available Attention deficit hyperactivity disorder (ADHD is one of the most common neurobehavioral disorders of childhood and adolescence. Classically, stimulants have been used in the treatment of this condition. Atomoxetine (Strattera; Eli Lilly and Company is a selective norepinephrine reuptake inhibitor (SNRI, one of the first medications in the nonstimulant class of medications that has been approved by the FDA for the treatment of ADHD. Atomoxetine is a phenoxypropylamine derivative and is structurally related to the antidepressant fluoxetine. The common side effects reported with the use of atomoxetine include mainly GI disturbances. Cardiovascular side effects are less commonly reported. The increase in the noradrenergic tone may explain some of the side effects noted with the use of this medication. Here, we present a case of a patient who presented with syncope, orthostatic hypotension, and tachycardia and discuss the various clinical implications based on the pharmacokinetics and pharmacodynamics of the drug.

Do Workers Underreport Morbidity? The Accuracy of Self-reports of Chronic Conditions

DEFF Research Database (Denmark)

Datta Gupta, Nabanita; Jürges, Hendrik

2012-01-01

We use matched Danish health survey and register data to investigate discrepancies between register-based diagnoses and self-reported morbidity. We hypothesize that false negatives (medical diagnoses existing in the register but not reported in the survey) arise partly because individuals fear ca...... career repercussions of being discovered suffering a chronic or severe illness that potentially lowers productivity. We find evidence of substantial underreporting, which is indeed systematically higher for individuals in the labor market....

Development and validation of the Patient Experience with Treatment and Self-management (PETS): a patient-reported measure of treatment burden.

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Eton, David T; Yost, Kathleen J; Lai, Jin-Shei; Ridgeway, Jennifer L; Egginton, Jason S; Rosedahl, Jordan K; Linzer, Mark; Boehm, Deborah H; Thakur, Azra; Poplau, Sara; Odell, Laura; Montori, Victor M; May, Carl R; Anderson, Roger T

2017-02-01

The purpose of this study was to develop and validate a new comprehensive patient-reported measure of treatment burden-the Patient Experience with Treatment and Self-management (PETS). A conceptual framework was used to derive the PETS with items reviewed and cognitively tested with patients. A survey battery, including a pilot version of the PETS, was mailed to 838 multi-morbid patients from two healthcare institutions for validation. A total of 332 multi-morbid patients returned completed surveys. Diagnostics supported deletion and consolidation of some items and domains. Confirmatory factor analysis supported a domain model for scaling comprised of 9 factors: medical information, medications, medical appointments, monitoring health, interpersonal challenges, medical/healthcare expenses, difficulty with healthcare services, role/social activity limitations, and physical/mental exhaustion. Scales showed good internal consistency (α range 0.79-0.95). Higher PETS scores, indicative of greater treatment burden, were correlated with more distress, less satisfaction with medications, lower self-efficacy, worse physical and mental health, and lower convenience of healthcare (Ps health literacy, less adherence to medications, and more financial difficulties reported higher PETS scores (Ps < 0.01). A comprehensive patient-reported measure of treatment burden can help to better characterize the impact of treatment and self-management burden on patient well-being and guide care toward minimally disruptive medicine.

Delivering health information about self-medication to older adults: use of touchscreen-equipped notebook computers.

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Neafsey, P J; Strickler, Z; Shellman, J; Padula, A T

2001-11-01

Preventing Drug Interactions in Active Older Adults is an educational intervention to prevent prescription and over-the-counter (OTC) drug and alcohol interactions in active, community-living older adults. The objectives of the program are to increase older adults' knowledge of potential interactions of prescription medications with OTC drugs and alcohol and to increase their confidence (self-efficacy) about how to avoid such interactions. An interactive multimedia computer software program (Personal Education Program or PEP) was designed for the learning styles and psychomotor skills of older adults. Focus groups of older adults evaluated PEP components in a formative manner during development. The program content dealing with antacids, calcium supplements, and acid reducers was pilot tested with 60 older adults recruited from local senior centers. Participants used the PEP on notebook computers equipped with infrared-sensitive touchscreens. Users of PEP had greater knowledge and self-efficacy scores than controls. Participants indicated a high degree of satisfaction with the PEP and reported their intent to make specific changes in self-medication behaviors.

Factors that determine self-reported immunosuppressant adherence in kidney transplant recipients: a correlational study.

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Weng, Li-Chueh; Yang, Ya-Chen; Huang, Hsiu-Li; Chiang, Yang-Jen; Tsai, Yu-Hsia

2017-01-01

To determine the factors related to immunosuppressant therapy adherence in kidney transplant recipients in Taiwan. Adherence to immunosuppressant treatment is critical after kidney transplantation. Thus, the factors associated with self-reported medication adherence in kidney transplant recipients warrant investigation. The study used a cross-sectional and correlation design. A convenience sample of 145 kidney transplant recipients was included. Structured questionnaires were used to collect data during 2012-2013. Multivariate linear regression was used to examine the factors related to immunosuppressant therapy adherence. Over half of the participants were female (54·5%), mean age was 45·5 years, and mean year after transplant was 7·4. The mean score for medication adherence was 29·73 (possible score range 7-35). The results of the multivariate linear regression analysis showed that gender (male), low income with a high school or college education, years after transplantation and concerns about medication taking were negatively associated with adherence. Medication self-efficacy was positively associated with adherence. Therapy-related factors, partnerships with healthcare professionals and having private healthcare insurance did not significantly relate to immunosuppressant therapy adherence. Kidney transplant recipients demonstrated a high level of adherence. Strategies to enhance patients' self-efficacy and alleviate concerns about medication may promote medication adherence. Male patients, those with a lower income and those with a higher education level, should be a focus of efforts to maintain adherence to the medication regimen. © 2016 John Wiley & Sons Ltd.

Self-reported concussion history: impact of providing a definition of concussion

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Robbins CA

2014-05-01

Full Text Available Clifford A Robbins,1 Daniel H Daneshvar,1,2 John D Picano,1,3 Brandon E Gavett,1,4 Christine M Baugh,1,2 David O Riley,1 Christopher J Nowinski,1,2,5 Ann C McKee,1,2,6–8 Robert C Cantu,1,5,9,10 Robert A Stern1,2,8,91Center for the Study of Traumatic Encephalopathy, 2Department of Neurology, Boston University School of Medicine, Boston, MA, USA; 3School of Medicine and Biomedical Sciences, University of Buffalo, Buffalo, NY, USA; 4Department of Psychology, University of Colorado, Colorado Springs, CO, USA; 5Sports Legacy Institute, Waltham MA, USA; 6United States Department of Veterans Affairs, VA Boston Healthcare System, Boston, MA, USA; 7Department of Pathology, 8Alzheimer's Disease Center, 9Department of Neurosurgery, Boston University School of Medicine, Boston, MA, USA; 10Department of Neurosurgery, Emerson Hospital, Concord, MA, USABackground: In recent years, the understanding of concussion has evolved in the research and medical communities to include more subtle and transient symptoms. The accepted definition of concussion in these communities has reflected this change. However, it is unclear whether this shift is also reflected in the understanding of the athletic community.What is known about the subject: Self-reported concussion history is an inaccurate assessment of someone's lifetime exposure to concussive brain trauma. However, unfortunately, in many cases it is the only available tool.Hypothesis/purpose: We hypothesize that athletes' self-reported concussion histories will be significantly greater after reading them the current definition of concussion, relative to the reporting when no definition was provided. An increase from baseline to post-definition response will suggest that athletes are unaware of the currently accepted medical definition.Study design: Cross-sectional study of 472 current and former athletes.Methods: Investigators conducted structured telephone interviews with current and former athletes between January

The Life Mission Theory V. Theory of the Anti-Self (the Shadow or the Evil Side of Man

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Soren Ventegodt

2003-01-01

Full Text Available According to the life mission theory, the essence of man is his purpose of life, which comes into existence at conception. This first purpose is always positive and in support of life. This is not in accordance with the everyday experience that man also engages in evil enterprises born out of destructive intentions. This paper presents a theory about the evil side of man, called the �anti-self� (the shadow, because it mirrors the self and its purpose of life. The core of the anti-self is an evil and destructive intention opposite to the intention behind the life mission. The evil side of man arises when, as the life mission theory proclaims, man is denying his good, basic intention to avoid existential pain. The present theory of the anti-self claims that all the negative decisions accumulated throughout the personal history, sum up to a negative or dark anti-self, as complex, multifaceted, and complete as the self. All the negative decisions taken through personal history build this solid, negative, existential structure. The anti-self, or shadow as Carl Gustav Jung used to call it, is a precise reflection of man�s basically good and constructive nature. When mapped, it seems that for most or even for all the many fine talents of man, there is a corresponding evil intention and talent in the person�s anti-self. As man is as evil as he is good, he can only realize his good nature and constructive talents by making ethical choices. Ethics therefore seem to be of major importance to every patient or person engaged in the noble project of personal growth. Understanding the nature and structure of the evil side of man seems mandatory to every physician or therapist offering existential therapy to his patient. The theory of anti-self makes it possible to treat patients with destructive behavioral patterns, who want to be good deep in their heart, by helping them let go of their evil intentions. The anti-self also seems to explain the enigma

Antibiotictherapy and Self Medication: A Common Practice Among Students of a Biomedicine Course in a Higher Education Institution

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Isabella Leone Rossi

2014-12-01

Full Text Available Self-medication habit of antibiotics contributes to the bacterial resistance mechanism, which is a global public health problem that must be prevented. The university student, as a future health professional, is summoned to guide a conduct and report on the use of antimicrobials regarding the casual agent, the site of infection and the severity of the disease. In this study, it has been verified, through a questionnaire, the profile of freshmen and academic students who are majoring in Biomedical Science in an institution of higher education, comparing the results obtained. It is a descriptive study with quantitative data approach (relative frequency – % through a self-administered questionnaire, and containing 13 multiple choice questions stored in the database in Excel. The sample consisted of 132 undergraduate students from the Biomedical Science course from this University Center. Among the freshmen, the purchase of antibiotic is mainly influenced by previous experiences with the drug, what is not repeated by the students that are graduating and prefer to seek and follow medical advice. Thus, 91.8% of trainees believe that self-medication may be harmful to health. Regarding the use of anti-inflammatory, analgesic and antipyretic before the use of antibiotics, 67% of the entering students said that they take these medications, against 70% of the senior students that also do it. Therefore, we may conclude that information on the danger of self-medication is provided in the disciplines of microbiology and pharmacology, which have not been studied by the freshmen and is unknown by the general population, that appeals to self-medication due to the lack of knowledge. To reverse this situation, it is necessary a greater media exposure on educational practices regarding the risks, the benefits, and elucidation about multi-resistant bacteria.

Self-reported confidence and skills of general practitioners in management of mental health disorders.

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Oakley Browne, Mark; Lee, Adeline; Prabhu, Radha

2007-10-01

To identify the predictors of self-reported confidence and skills of GPs in management of patients with mental health problems. Cross-sectional survey, with questionnaire presented to 246 GPs working in 62 practices throughout Gippsland. Rural general practices in Gippsland. One hundred and thirty-four GPs across Gippsland. GPs completed a questionnaire assessing self-perception of knowledge and skills in recognition and management of common mental health problems. Of 134 GPs, 45% reported that they have a specific interest in mental health, and 39% of GPs reported that they had previous mental health training. Only 22% of GPs describe having both an interest and prior training in mental health care. Age and years since graduation are not significantly related to self-reported confidence and skills. The results of this study highlight that self-professed interest and prior training in mental health are associated. Self-professed interest in mental health care predicts confidence and self-perceived skills in recognition, assessment and management of common mental health disorders. Similarly, prior training in mental health care predicts confidence and self-perceived skills in recognition, assessment and management of common mental health problems. Self-professed interest in mental health issues is also associated with hours of participation in continuing medical education related to mental health care. Unfortunately, only a minority described having both interest and prior training in mental health care.