Intentional and unintentional medication non-adherence in hypertension: the role of health literacy, empowerment and medication beliefs

Background: Medication non-adherence is a major public health issue, creating obstacles to effective treatment of hypertension. Examining the underlying factors of deliberate and non-deliberate non-adherence is crucial to address this problem. Thus, the goal of the present study is to assess the socio-demographic, clinical and psychological determinants of intentional and unintentional non-adherence. Design and methods: A cross-sectional survey was conducted between March, 2015 and April, 2016. The sample consisted of hypertension patients holding at least one medical prescription (N=109). Measurements assessed patients’ medication adherence, health literacy, empowerment, self-efficacy, medication beliefs, and patients’ acceptance of their doctor’s advice, socio-demographic and clinical characteristics. Results: Patients who occasionally engaged in either intentional or unintentional non-adherence reported to have lower adherence selfefficacy, higher medication concern beliefs, lower meaningfulness scores and were less likely to accept the doctor’s treatment recommendations. Patients who occasionally engaged in unintentional nonadherence were younger and had experienced more side effects compared to completely adherent patients. Adherence self-efficacy was a mediator of the effect of health literacy on patients’ medication adherence and acceptance of the doctor’s advice was a covariate. Conclusions: Regarding the research implications, health literacy and adherence self-efficacy should be assessed simultaneously when investigating the factors of non-adherence. Regarding the practical implications, adherence could be increased if physicians i) doublecheck whether their patients accept the treatment advice given and ii) if they address patients’ concerns about medications. These steps could be especially important for patients characterized with lower self-efficacy, as they are more likely to engage in occasional nonadherence

„Hogy minden beteg megértse!” – Az egészségműveltség (health literacy) mérése Magyarországon

Absztrakt Bevezetés: A gyógyítás sikerességét meghatározza, hogy a beteg érti-e és megfelelően használja-e az orvosi információkat. Ezt jelentős mértékben befolyásolja az úgynevezett „health literacy” (egészségműveltség). Célkitűzés: A tanulmány az egyik legelterjedtebb funkcionális egészségműveltséget mérő eszköz, a Short-Test of Functional Health Literacy, valamint egy előszűrő teszt (Chew-kérdések) magyar adaptációját mutatja be. Módszer: 302 fős felnőttmintán vették fel a célkérdőívet egy nagyobb tesztbattéria részeként, amelyben szerepelt a számolási készségeket mérő Newest Vital Sign teszt is. Eredmények: A Short-Test of Functional Health Literacy olvasott szövegértési rész belső konzisztenciája kimagaslóan jó, a Chew-kérdéseké elfogadható, a számolási részé azonban alacsony megbízhatóságú. A célkérdőív egészségműveltségi szintjeinek magyar eloszlása illeszkedik más európai felmérések adataihoz. A problémás egészségműveltség kategóriába kerülésre a 65 év felettiek és az általános iskolai végzettségűek voltak különösen veszélyeztetettek. A krónikus betegség alacsonyabb egészségműveltséggel jár együtt, ami egybevág más európai eredményekkel. Következtetések: A szerzők által validált mérőeszközök segíthetik a problémás páciensek kiszűrését, a hatékonyabb információmegértést és -felhasználást. Orv. Hetil., 2016, 157(23), 905–915

Immunological identification of the alternative oxidase of Acanthamoeba castellanii mitochondria

AbstractMitochondria of the protozoa Acanthamoeba castellanii possess a cyanide-insensitive oxidase cross-reacting with monoclonal antibodies raised against the plant alternative oxidase. Immunoblotting revealed three monomeric forms (38, 35, and 32 kDa) and very low amounts of a single 65 kDa dimeric form. Cross-linking studies suggest that while in plants the alternative oxidase occurs as a dimer, in amoeba it functions as a monomer. Immunologically detectable protein levels change with the age of amoeba cell culture. Increased amounts of the 35 kDa protein are accompanied by an increase in the activity of cyanide-resistant respiration

Skin necrosis in smoking patients receiving partial breast irradiation: two case reports

Partial breast irradiation has become an increasingly popular mode of treatment after excisional biopsy to treat early stage invasive breast cancer. Its main advantage is that treatment can be delivered in five days rather than 30, as is standard for whole breast irradiation. Early reports suggest good to excellent cosmesis in the vast majority of subjects. Herein we report two cases of skin necrosis in women with Stage 1 breast cancer who smoked before and after partial breast irradiation

DELTEX2 C-terminal domain recognizes and recruits ADP-ribosylated proteins for ubiquitination

Cross-talk between ubiquitination and ADP-ribosylation regulates spatiotemporal recruitment of key players in many signaling pathways. The DELTEX family ubiquitin ligases (DTX1 to DTX4 and DTX3L) are characterized by a RING domain followed by a C-terminal domain (DTC) of hitherto unknown function. Here, we use two label-free mass spectrometry techniques to investigate the interactome and ubiquitinated substrates of human DTX2 and identify a large proportion of proteins associated with the DNA damage repair pathway. We show that DTX2-catalyzed ubiquitination of these interacting proteins requires PARP1/2-mediated ADP-ribosylation and depends on the DTC domain. Using a combination of structural, biochemical, and cell-based techniques, we show that the DTX2 DTC domain harbors an ADP-ribose–binding pocket and recruits poly-ADP-ribose (PAR)–modified proteins for ubiquitination. This PAR-binding property of DTC domain is conserved across the DELTEX family E3s. These findings uncover a new ADP-ribose–binding domain that facilitates PAR-dependent ubiquitination

Impairment of a model peptide by oxidative stress: Thermodynamic stabilities of asparagine diamide C(alpha)-radical foldamers

Electron structure calculations on N-acetyl asparagine N-methylamide were performed to identify the global minimum from which radicals were formed after H-abstraction by the OH radical. It was found that the radical generated by breaking the C–H bond of the alpha-carbon was thermodynamically the most stable one in the gas- and aqueous phases. The extended ((beta)L and (beta)D) backbone conformations are the most stable, but syn–syn or inverse gamma-turn ((gamma)L) and gamma-turn ((gamma)D) have substantial stability too. The highest energy conformers are the degenerate eL and eD foldamers. Clearly, the most stable beta foldamer is the most likely intermediate for racemization

A combined fMRI and DTI examination of functional language lateralization and arcuate fasciculus structure: Effects of degree versus direction of hand preference Author links open overlay panel

The present study examined the relationship between hand preference degree and direction, functional language lateralization in Broca’s and Wernicke’s areas, and structural measures of the arcuate fasciculus. Results revealed an effect of degree of hand preference on arcuate fasciculus structure, such that consistently-handed individuals, regardless of the direction of hand preference, demonstrated the most asymmetric arcuate fasciculus, with larger left versus right arcuate, as measured by DTI. Functional language lateralization in Wernicke’s area, measured via fMRI, was related to arcuate fasciculus volume in consistent-left-handers only, and only in people who were not right hemisphere lateralized for language; given the small sample size for this finding, the future investigation is warranted. Results suggest handedness degree may be an important variable to investigate in the context of neuroanatomical asymmetries