ABSTRACT
INTRODUCTION: Circadian rhythms are associated with bipolar disorder (BD). This cross-sectional study aimed at investigating ARNTL and MAOA gene expression differences (1) between individuals with BD and controls, (2) between affective episodes, and (3) the relationship between ARNTL and MAOA expression. METHODS: ARNTL and MAOA gene expression in peripheral mononuclear blood cells were analysed from fasting blood samples (BD n = 81, controls n = 54) with quantitative real-time PCR operating on TaqMan® assays (normalised to 18S RNA expression). ANCOVAs corrected for age, sex, body mass index, and medication was used to evaluate expression differences and correlation analyses for the relation between ARNTL and MAOA expression. RESULTS: ARNTL gene expression differed between affective episodes (F(2,78) = 3.198, p = 0.047, Partial Eta2= 0.083), but not between BD and controls (n.s.). ARNTL and MAOA expression correlated positively in BD (r = 0.704, p < 0.001) and in controls (r = 0.932, p < 0.001). MAOA expression differed neither between BD and controls nor between affective episodes (n.s.). DISCUSSION: Clock gene expression changes were observed in different affective states of BD. More precisely, ARNTL gene expression was significantly higher in euthymia than in depression. ARNTL and MAOA gene expression correlated significantly in BD and in controls, which emphasises the strong concatenation between circadian rhythms and neurotransmitter breakdown.
Subject(s)
ARNTL Transcription Factors , Bipolar Disorder , Monoamine Oxidase , Humans , ARNTL Transcription Factors/genetics , Bipolar Disorder/genetics , Circadian Rhythm/genetics , Cross-Sectional Studies , Gene Expression , Monoamine Oxidase/geneticsSubject(s)
Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy , Muscle, Skeletal/drug effects , Protein Kinase Inhibitors/adverse effects , Protein-Tyrosine Kinases/antagonists & inhibitors , Adult , Aged , Female , Humans , Male , Middle Aged , Mitochondria, Muscle/drug effects , Mitochondria, Muscle/physiology , Muscle, Skeletal/physiopathologyABSTRACT
Antiviral therapy for hepatitis B is effective and reduces the risk of progression to cirrhosis and liver cancer but is often required for an indefinite duration. Treatment adherence is important to prevent the development of resistance and optimize outcomes. Pharmacy adherence measures can be used to assess treatment adherence, with the medication possession ratio being less susceptible to bias than physician- or self-reported adherence. The aim of this study was to measure adherence in public hospital outpatients over a 3-year period and to examine factors associated with nonadherence. A retrospective study of pharmacy records of patients dispensed antiviral therapy for hepatitis B from four major hospitals in Melbourne between 2010 and 2013. Hospital record numbers were linked with and de-identified demographic information including age, sex, Indigenous status, country of birth, interpreter requirement, spoken language and postcode of residence. The medication possession ratio was the outcome measure with poor adherence defined <.90. Univariate logistic regression and multivariate logistic regression were performed to examine associations with nonadherence. Records of 1026 patients were included in the analysis. Twenty per cent of all participants met the definition of poor adherence. Significant factors affecting adherence included age <35 years (P=.002), hospital site and treatment by multiple doctors within shorter time periods. This is the largest study examining detailed factors associated with adherence to hepatitis B treatment. Understanding poor adherence in clinical settings, and the factors associated with lower adherence, is important to inform efforts towards promoting treatment adherence for hepatitis B.
Subject(s)
Antiviral Agents/therapeutic use , Hepatitis B/drug therapy , Medication Adherence , Adult , Aged , Aged, 80 and over , Australia , Female , Hospitals, Public , Humans , Male , Middle Aged , Outpatients , Retrospective Studies , Young AdultABSTRACT
Wishing to increase awareness of the work of Martha Rogers (nurse, scientist and visionary), Nicole Allard, who teaches at the Université de Rimouski and is studying towards a doctorate at the University of Toronto, and Serge Landry, who teaches at the cégep de Granby, have produced an analysis of the theoretician's conceptual model. The Science of Unitary Human Beings. Rogers envisions the human being as a system of energy in motion within other such systems, themselves forming more complex systems. Each human being is said to be "unitary" and he or she can not be considered in isolation, separate from his or her environment. In "rogerian" perspective, nurses' work is to be done with unitary human beings in a state of continuous mutual exchange with their environment. And nursing's goal is to participate in this process of change in order to maximise each client's health potential. The model application accompanying the article illustrates the concepts and theoretical principles described.
