In this study, the authors identify how well self-care agents function in the self-administration of medication. The sample population included 60 adults who were evaluated on their ability to read three prescription labels and perform the tasks necessary to administer medications correctly. Age, gender, number of medications taken, and type of chronic disease did not contribute significantly to the ability to self-medicate correctly. Complexity of the medication regime and educational level were highly significant. Reading scores improved as educational levels increased; however, all educational groups had consistently lower performance scores compared with reading scores.

Adult↗

PubMedDate not supplied

Theoretical accounts of Gulf War Syndrome: from environmental toxins to psychoneuroimmunology and neurodegeneration.

Non-specific illness includes a wide variety of symptoms: behavioural (e.g., reduced food and water intake), cognitive (e.g., memory and concentration problems) and physiological (e.g., fever). This paper reviews evidence suggesting that such symptoms can be explained more parsimoniously as a single symptom cluster than as a set of separate illnesses such as Gulf War Syndrome (GWS) and chronic fatigue syndrome (CFS). This superordinate syndrome could have its biological basis in the activity of pro-inflammatory cytokines (in particular interleukin-1: IL-1), that give rise to what has become known as the 'sickness response'. It is further argued that the persistence of non-specific illness in chronic conditions like GWS may be (in part) attributable to a bio-associative mechanism (Ferguson and Cassaday, 1999). In the case of GWS, physiological challenges could have produced a non-specific sickness response that became associated with smells (e.g., petrol), coincidentally experienced in the Persian Gulf. On returning to the home environment, these same smells would act as associative triggers for the maintenance of (conditioned) sickness responses. Such associative mechanisms could be mediated through the hypothalamus and limbic system via vagal nerve innervation and would provide an explanation for the persistence of a set of symptoms (e.g., fever) that should normally be short lived and self-limiting. We also present evidence that the pattern of symptoms produced by the pro-inflammatory cytokines reflects a shift in immune system functioning towards a (T-helper-1) Th1 profile. This position contrasts with other immunological accounts of GWS that suggest that the immune system demonstrates a shift to a Th2 (allergy) profile. Evidence pertaining to these two contrasting positions is reviewed.

Association↗

PubMedDate not supplied

Intellect and somatic health: associations with hypochondriacal concerns, perceived threat and fainting.

BACKGROUND: : Compared to the other domains of the Big 5, intellect has been relatively underresearched with regard to somatic health outcomes. It is argued that this, in part, is because specific hypotheses concerning intellect and somatic health have not been formulated. It is argued that intellect is related to both alexithymia and hypnotic ability. As such the High Risk Model of Threat Perception forms one useful theoretical framework for generating hypotheses about intellect and somatic health. On this basis it is hypothesised that intellect should show a U-shaped relationship to hypochondriacal concerns, a positive association with appraisals of threat and loss, and a negative association with levels of self-reported vasovagal syncope (feelings of faintness). METHODS: Two cross-sectional studies, using student samples (n = 205, 179), examined the relationships between intellect and hypochondriacal concerns as well as intellect and appraisals of threat and loss. A third prospective study, using a sample of blood donors (n = 373), examined the relationship between levels of self-reported vasovagal syncope and intellect. RESULTS: Compared to the other domains of the Big 5, intellect demonstrated a U-shaped association with hypochondriacal concerns, a positive association with perceived threat and loss and a negative association with fainting. The negative association with fainting remained once incidence of previous fainting, the number of previous blood donations and emotional stability were held as covariates. CONCLUSIONS: Intellect is associated in a number of important ways with a variety of psychosomatic variables.

Adolescent↗

PubMedDate not supplied

Managing health and safety in hospitals.

This article is set against the background of recent changes in health and safety legislation which directly affect hospital staff. Research into the central concepts of hazard, risk and harm is contributing to a broader understanding of the management of health and safety. Both occupational medicine and safety practice must recognise the role of psychosocial and organisational processes in managing workplace hazards.

Humans↗

PubMedDate not supplied

Comparison of measured and predicted creatinine excretion is an unreliable index of compliance in PD patients.

OBJECTIVE: To evaluate the use of the ratio of measured to predicted creatinine excretion as an index of compliance in peritoneal dialysis (PD) patients. DESIGN: A prospective analysis. SETTING: Academic teaching hospital dialysis unit. PATIENTS: Forty-three patients on PD. MEASUREMENTS: Creatinine excretion in daily dialysate and urine collections was measured on one occasion in 10 patients and on two occasions in 33 patients, and, after adding an estimate for extrarenal creatinine degradation, was divided by predicted creatinine excretion to give a creatinine excretion ratio, which has been proposed as an index of compliance with exchanges in PD patients. Values above 1.24 have been suggested to indicate noncompliance. Lean body mass was also estimated from creatinine excretion. RESULTS: The mean creatinine excretion ratio was 1.12, and 30% of patients had a value above 1.3. Only one patient admitted noncompliance. Studies on four consecutive days of guaranteed compliance in 7 patients with high ratios showed that creatinine excretion remained constant, suggesting that the patients were high creatinine producers rather than noncompliant. Creatinine excretion was stable when measured at intervals of days, but over months it tended to change markedly in many patients. Lean body mass estimations using creatinine excretion were low in most patients. CONCLUSION: Comparison of measured and predicted creatinine excretion is not a reliable indicator of noncompliance because many compliant patients consistently excrete more creatinine than predicted. The standard formulas were not validated in dialysis patients and underestimate creatinine excretion significantly in many PD patients. Existing estimates in the literature of noncompliance, using this methodology, may not be accurate. Better methods of detecting this problem are required.

Adolescent↗

PubMedDate not supplied

Environmental pulmonary edema: an update.

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Disasters↗