Adherence to Tyrosine Kinase Inhibitor (TKI) Therapy in Patients with Chronic Myeloid Leukemia (CML)

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4431-4431 ◽  
Author(s):  
Paul Jacobsen ◽  
Kendra L. Sweet ◽  
Yun-Hsiang Lee ◽  
Sara Tinsley ◽  
Jeffrey E Lancet ◽  
...  
Keyword(s):  
Conflicts Of Interest ◽  
Intervention Strategy ◽  
South Florida ◽  
Self Report ◽  
Background Information ◽  
Molecular Response ◽  
Major Advance ◽  
The Past ◽  
Treatment Interruptions ◽  
Treatment Type

Abstract Abstract 4431 Introduction: The use of TKIs represents a major advance in the treatment of CML over previous therapies in terms of both disease response and treatment-related morbidity. Therapeutic responses to TKIs in CML are, however, rarely equivalent to cures. In most patients, residual disease remains and treatment interruptions are often followed by recurrence. Consequently, TKI therapy will be life long for most patients. The necessity of taking an oral medication daily for life, combined with the potential for treatment interruptions to result in recurrence, points strongly to the importance of studying medication adherence in CML patients prescribed TKIs. Toward this end, the present study evaluated adherence and reasons for nonadherence among CML patients who had been receiving TKI therapy for at least six months. Method: Patients were eligible for the study if they were diagnosed with CML in the chronic phase, treated with the same TKI (imatinib, nilotinib or dasatinib) for at least six months, on the same TKI dose for the past two months, and in complete cytogenic response. They were identified by reviewing clinic records and approached to participate either via mail or during a routine clinic visit. Those who provided informed consent completed a background information form assessing demographic characteristics and a self-report questionnaire assessing rates of adherence and reasons for nonadherence in the past 30 days adapted from research on adherence to tamoxifen. Clinical data were obtained through review of medical records. Descriptive statistics were used to summarize adherence information. Chi-square tests and t-tests were performed to examine relationships between indices of adherence and demographic and clinical characteristics. The study was approved by the University of South Florida Institutional Review Board. Result: Of 68 patients asked to participate, 62 (91.2%) agreed and provided complete data. These patients (53.2% male, 46.8% female) were an average of 55 years old (range = 18 to 81). They had been diagnosed with CML an average of 4.6 years previously (range = 0.6 to 12.8 years) and had been taking imatinib (56.5%), nilotinib (30.6%), or dasatinib (12.9%) for an average of 3.1 years (range = 0.5 to 8.3 years). These patients were prescribed 1 (50%), 2 (20.7%), 3 (12.1%), 4 (15.5%), and 6 (1.7%) TKI pills per day. In the past 30 days, 4 patients (6.4%) reported taking more TKIs pills per day than prescribed and 23 patients (37.1%) reported taking fewer TKI pills per day than prescribed. Among all patients, the number of days one or more doses were missed were 1 day (12.9%), 2 to 3 days (12.9%), 4 to 6 days (6.6%) and 6 or more days (4.7%). Patients who missed a dose reported that they did so because they forgot (34.8%), chose to (47.8%), or both (17.4%). Among patients who chose to miss a dose, the most common reason was “because of how the medication makes me feel” (58.3%). Whether or not patients missed a dose in the past 30 days was not significantly related to demographic variables (i.e., age, gender, education, race, marital status, employment status, or income) or clinical variables (time since diagnosis, time on current treatment, type of TKI therapy, number of TKIs pills per day, or achievement of a complete molecular response). Conclusion: The results indicate that nonadherence to prescribed TKI therapy is common and suggest the need to develop and evaluate interventions to promote continued high adherence over time. Findings further suggest that use of reminders and routine symptom assessment and management should be included as components of a comprehensive intervention strategy. Disclosures: No relevant conflicts of interest to declare.

Determinants and Impact of Treatment Interruptions and Nonadherence to Imatinib Therapy in Patients with Chronic Myeloid Leukemia in a South Brazilian Cohort

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4425-4425
Author(s):  
Marcelo Capra ◽  
Laura Fogliatto ◽  
Mariza Shaan ◽  
Mayde Seadi Torriani ◽  
Tito Vanelli Costa ◽  
...  
Keyword(s):  
Conflicts Of Interest ◽  
Late Onset ◽  
Treatment Interruption ◽  
Self Report ◽  
Imatinib Therapy ◽  
Adherence Rate ◽  
Molecular Response ◽  
Imatinib Treatment ◽  
Treatment Interruptions ◽  
Significant Difference

Abstract Abstract 4425 Adherence to imatinib therapy has proven to be a major determinant of treatment results, but the degree of impact and the determinants of nonadherence are still contradictory. There is no information regarding adherence to imatinib therapy in the Brazilian public health system. The aims of this study were to identify the characteristics related to treatment interruptions and nonadherence and to examine how these interruptions affect treatment responses and survival. Materials and Methods We conducted a retrospective study in a cohort of patients (pts) with CP-CML enrolled in 14 Hematology centers in South Brazil. All pts received imatinib 400mg as first or second-line therapy. Early-imatinib treatment was considered when imatinib started before 12 months (mo) from diagnosis. Patient evaluation and response criteria followed the ELN recommendations. The ACE-27 (Adult Comorbidity Evaluation-27) is a 27 item comorbidity index for patients with cancer and assign weights from 1 to 3 based on the dysfunction grade of each condition (mild, moderate and severe, respectively). An ACE-27 score was applied to each patient. Imatinib suspensions were considered if superior to 20 days at any point during therapy. Two levels of analysis were performed: all kinds of interruptions (nonadherence and toxicity) and only nonadherence ones. Information for nonadherence was taken from medical and pharmacy registers (pt self-report, missing scheduled appointments and pill counts). Results We analyzed data from 185 pts with CP-CML diagnosed since 1990. The median age at diagnosis was 48 yr (4 – 85) and 55% were male. The median time from diagnosis to imatinib was 7 mo (0 – 178) and 71% pts were early-imatinib treated. Prior therapy with interferon was used in 70% pts. The median of follow-up was 47 mo. Treatment interruption was observed in 63/185 patients (34%) and was related to toxicities in 35/63 pts (55%) and to nonadherence in 28/63 pts (45%). The adherence rate was 85%. In a multivariate analysis, only late-onset imatinib treatment (Odds Ratio [OR]=36,05; p<0,001) and severe comorbidity (OR=27,05; p=0,03) were associated with higher risk of interrupting imatinib for any reason. The only variable associated with nonadherence was late-onset imatinib treatment (OR=14,76; p<0,001). Although not statistical significant, male and comorbidity showed a tendency to be linked with nonadherence (Table 1). Nonadherent pts, compared with adherent ones, had lower complete cytogenetic response (CCyR) rates at 12 mo (39% and 65%; p=0,004, respectively; Figure 1) and lower major molecular response (MMR) rates at 18 mo (9,5% and 35%; p=0,002, respectively; Figure 2). Finally, treatment interruption had a relevant negative impact on EFS in 4 yr. In the group that had treatment interruption, EFS was 52%, compared with 78,5% in the group without interruptions (p=0,002; Figure 3). Analysis performed only on nonadherence treatment interruption groups showed no significant difference (53% and 71%; p=0,15, respectively). Conclusions In this cohort, a substantial proportion of pts failed to take imatinib properly, decreasing the chances of disease control. The late onset of imatinib therapy correlates with lower adherence, so front-line imatinib therapy should be started as soon as possible. Special attention should be given to pts with severe comorbidities, as they are more prone to suffer side effects or to lack adherence. Finally, pts who interrupted treatment had lower CCyR, MMR and EFS. Clinical and patient characteristics related to nonadherence Disclosures: No relevant conflicts of interest to declare.

scholarly journals BCR-ABL Fluctuation Analysis in Chronic Phase Chronic Myeloid Leukemia (CP-CML) Patients with MR 4.5

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 5162-5162 ◽  
Author(s):  
Mariana Pinto Pereira ◽  
Tito Vanelli ◽  
Eduardo Gomes da Silva ◽  
André Dias Américo ◽  
Mariana M Burin ◽  
...  
Keyword(s):  
Kinase Inhibitor ◽  
Conflicts Of Interest ◽  
Chronic Phase ◽  
Treatment Interruption ◽  
The Other ◽  
Fluctuation Analysis ◽  
Molecular Response ◽  
Log Reduction ◽  
Treatment Interruptions ◽  
History Of

Abstract Introduction: Imatinibe, a target tyrosine kinase inhibitor, have revolutionized CP-CML treatment. Considering that it is being discussed imatinibe treatment interruption in patients with MR ≥ 4.5 lasting two years or more, we believe to be important to establish predictors of major molecular response (MMR) loss. Fluctuations in BCR-ABL transcripts are being advocated to be able to predict MMR loss, although the real impact of small fluctuations among patients with in MR ≥ 4.5 is uncertain. Objective: Correlate BCR-ABL fluctuations and MMR loss in patients considered to be in MR ≥ 4.5, as well as to recognize possible factors associated with these small fluctuations. Methods: We conducted a retrospective analysis in CP-CML patients receiving imatinibe (as first or second treatment line) that achieved MR ≥ 4.5 (defined as a 4.5 log reduction on an international scale) and surveyed for BCR-ABL fluctuations. We considered a fluctuation to be a rise of at least 0.5 log of BCR-ABL transcripts. Treatment interruptions were considered only when imatinibe was not taken for 15 or more consecutive days. The presence of comorbities was evaluated by applying the Charlson Index. Results: Fifty-eight patients were evaluated between with a median follow-up 7 years. Fifty-five percent were men and 28 were women, with a median age of 46 (18 - 93) years-old, most of the patients were older than 60 yo (75,9%). Among 32 patients evaluated by the Sokal risk score 97,5% were estimated to be low or intermediate. Twenty six patients presented at least one fluctuation. Regarding the number of fluctuations per patient, 18 presented only 1 fluctuation, 5 presented 2 fluctuations and 3 patients presented 3 fluctuations. Among those patients with at least one fluctuation 3 (11%) presented MMR loss, while there was none among patients without documented fluctuations (p=0,15). Among these three patients considered to have MMR loss, two presented fluctuations that reached MR 3.0, while the other patient presented a history of long treatment suspension. More patients that interrupted treatment presented BCR-ABL fluctuations, although this difference was not statically significant (78% vs 50% p=0,11). Conclusion: Small fluctuations among patients with MR ≥ 4.5 didn't seem to correlate with MMR loss, however we do believe that our population is underpowered to rule out this difference. We considered that it very interesting that patients which reached MR 3.0 presented MMR loss (considering that the other patient had to abandon treatment during pregnancy). Disclosures No relevant conflicts of interest to declare.

scholarly journals Shopping Centres, Cycling Accessibility and Planning—The Case of Nova Lund in Sweden

Urban Science ◽  
2020 ◽  
Vol 4 (4) ◽  
pp. 70
Author(s):  
Till Koglin ◽  
Lucas Glasare
Keyword(s):  
Conflicts Of Interest ◽  
Current Situation ◽  
Decision Makers ◽  
Power Structures ◽  
Literature Study ◽  
Shopping Centre ◽  
The Past ◽  
Whole Process ◽  
The Subject

This paper evaluates the history and cycling accessibility of Nova, a shopping centre established in Lund, Sweden, in 2002. The current situation was also analysed through observation and a literature review. Moreover, the study conducted a closer analysis of the history and role of the municipality based on further literature study and interviews with officials. The conclusion of the analysis indicates poor and unsafe bikeways caused by conflicts of interest between politicians, officials, landowners and the general public. It also depicts a situation in which the municipality’s master plan has been ignored, and, in contrast to the local goals, cycling accessibility at Nova has seen no significant improvement since the shopping centre was first established. The reasons for this, arguably, are a relatively low budget for bikeway improvements in the municipality, as well as a situation in which decision-makers have stopped approaching the subject, as a result of the long and often boisterous conflicts it has created in the past. Lastly, it must be noted that it is easy to regard the whole process of Nova, from its establishment to the current situation, as being symptomatic of the power structures between drivers and cyclists that still affect decision-makers at all levels.

scholarly journals 106 Self-Reported Sleep and Resilience

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A43-A44
Author(s):  
Michelle Persich ◽  
Sara Cloonan ◽  
Michael Grandner ◽  
William Killgore
Keyword(s):  
Sleep Quality ◽  
Sleep Time ◽  
Self Report ◽  
Subjective Perception ◽  
Psychological Resilience ◽  
Cross Sectional ◽  
Sleep Quantity ◽  
The Past ◽  
Resilience Scale ◽  
Longitudinal Effects

Abstract Introduction Psychological resilience is the ability to withstand setbacks, adapt positively to challenges, and bounce back from the adversities of life. While the construct of resilience is broadly understood, the specific individual factors that contribute to the ability to be resilient and persevere in the face of difficulties remain poorly understood. We recently showed that psychological resilience during the COVID-19 pandemic was associated with a number of factors, including fewer complaints of insomnia, and others have suggested that sleep is an important contributor. We therefore tested the hypothesis that sleep quality and acute sleep quantity would combine to predict measures of psychological resilience and perseverance (i.e. “grit”). Methods We asked 447 adults (18–40 yrs; 72% female) to report the number of hours of sleep obtained the night before their assessment session (SLEEP), and complete several questionnaires, including the Pittsburgh Sleep Quality Index (PSQI), the Connor-Davidson Resilience Scale (CD-RISC), Bartone Dispositional Resilience Scale (Hardiness), and the Grit Scale. Sleep metrics were used to predict resilience, hardiness, and grit using multiple linear regression. Results For resilience, PSQI (β=-.201, p&lt;.00003) and SLEEP (β=.155, p&lt;.001) each contributed uniquely to prediction of CD-RISC (R2=.08, p&lt;.00001). Hardiness was also predicted (R2=.08, p&lt;.00001) by a combination of PSQI (β=-.218, p&lt;.00001) and SLEEP (β=.128, p=.007). Interestingly, worse sleep quality over the past month on the PSQI (β=.13, p=.008) in combination with more SLEEP the night before the assessment (β=.137, p=.005) each contributed uniquely to higher Grit (i.e., perseverance; R2=.03, p=.003). Conclusion Self-reported sleep quality and quantity were both independently associated with greater self-reported resilience, hardiness, and grit. While better sleep quality and more sleep the night before testing each uniquely predicted greater resilience and hardiness, a different pattern emerged for Grit. The combination of lower quality sleep over the past month followed by greater recent sleep duration was associated with increased perseverance. Whereas sleep quality appears to be more important for general resilience/hardiness, recent sleep time appears more important for the subjective perception of perseverance. Because these data are purely self-report and cross sectional, future work will need to determine the longitudinal effects on behavior. Support (if any):

scholarly journals THink: Inferring Cognitive Status from Subtle Behaviors

AI Magazine ◽  
2015 ◽  
Vol 36 (3) ◽  
pp. 49-60 ◽  
Author(s):  
Randall Davis ◽  
David Libon ◽  
Roda Au ◽  
David Pitman ◽  
Dana Penney
Keyword(s):  
Neuropsychological Testing ◽  
Cognitive Status ◽  
Major Advance ◽  
Test Results ◽  
Clock Drawing Test ◽  
The Past ◽  
Drawing Test ◽  
Testing Technology ◽  
Opening Up

The digital clock drawing test is a fielded application that provides a major advance over existing neuropsychological testing technology. It captures and analyzes high precision information about both outcome and process, opening up the possibility of detecting subtle cognitive impairment even when test results appear superficially normal. We describe the design and development of the test, document the role of AI in its capabilities, and report on its use over the past seven years. We outline its potential implications for earlier detection and treatment of neurological disorders. We set the work in the larger context of the THink project, which is exploring multiple approaches to determining cognitive status through the detection and analysis of subtle behaviors.

Quality of life outcomes in sarcoma patients receiving care at a tertiary center.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e23557-e23557
Author(s):  
Jonathan R. Day ◽  
Benjamin Miller ◽  
Sarah L. Mott ◽  
Bradley T. Loeffler ◽  
Munir Tanas ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Radiation Treatment ◽  
Soft Tissue Sarcomas ◽  
Well Being ◽  
Self Report ◽  
University Of Iowa ◽  
Treatment Type ◽  
Tertiary Center ◽  
Multiple Domains

e23557 Background: Sarcomas are a diverse group of neoplasms that vary greatly in clinical presentation and responsiveness to treatment. Given the differences in the sites of involvement, rarity, and treatment modality, a multidisciplinary approach is required. Previous literature suggests patients with sarcoma suffer from poorer quality of life (QoL) especially physical and functional well-being. This study aims to understand if there is an association between treatment at a tertiary sarcoma center and a difference in QoL. Methods: De-identified data was obtained from the Sarcoma Tissue Repository at University of Iowa. Mixed effects regression models were utilized to evaluate the association between disease and treatment characteristics and QoL. QoL was assessed using the self-report FACT-G questionnaire at 12-, 24-, and 36-months post-diagnosis; overall scores and the 4 well-being subscales (Physical, Emotional, Social, Functional) were calculated. Results: 443 patients were identified. Soft tissue sarcomas were more prevalent (87.6%) than bone (12.4%). 53% of patients received chemotherapy and 38.6% got radiation therapy. Sarcomas were most frequently located in the lower extremities(ext.) (33.1%), followed by abdomen (20.9%), pelvic (13.6%), upper ext. (13.1%), thorax (11.3%), head & neck (7.8%). For ext. sarcoma; lower ext: 144 (71.3%), Upper ext: 58 (28.7%). Patients with extremity sarcoma; 133 had limb sparing and 48 had amputations. FACT-G Scores did not appreciably vary between 12, 24-, and 36-month for any QoL responses. Overall well-being had a mean score reported of 87.7 (sd = 15.7). Social well-being sores averaged 23.5 (5.0). Emotional well-being (EWB) 19.2 (4.1) and functional well-being (FWB) 21.3 (6.1), and physical well-being (PWB) 23.7 (4.6). There was no association between overall, PWB, EWB, or FWB with the histological subtype, radiation treatment, type of limb surgery, or any location in the same patients over time. Chemotherapy treatments were associated with lower well-being in multiple domains; PWB scores being 2.01 points lower, (p < 0.01), EWB scores being 1.27 points lower (p = 0.01) and FWB scores being 1.72 (p = 0.03), and 4.44 points lower overall (p = 0.03), on average, after adjusting for overall changes across time. Patients with ext. sarcoma only overall FACT-G scores differed 6.72 points higher for upper ext. than lower ext (p = 0.04). Conclusions: Overall QoL areas were similar to normative FACT-G scores both overall and specific areas. Having received chemotherapy was associated with lower well-being scores physically, emotionally, functionally, and overall. There were no clinically relevant differences reported in QoL scores between 12-,24-, and 36-months in the same patients. Further work is needed to describe QoL differences among patients with sarcoma at tertiary centers and examine what protective factors may influence patient well-being.

Pesticide Residues in Food

PEDIATRICS ◽  
1985 ◽  
Vol 76 (3) ◽  
pp. 473-474
Author(s):  
RICHARD J. JACKSON ◽  
LYNN GOLDMAN
Keyword(s):  
American Academy ◽  
Environmental Health ◽  
Pesticide Residues ◽  
Background Information ◽  
Northern California ◽  
Ethylene Dibromide ◽  
The Past ◽  
American Academy Of Pediatrics ◽  
Health Committee

To the Editor.— The Environmental Health Committee of the Northern California Chapter of the American Academy of Pediatrics is concerned about the finding of pesticide residues in food, particularly the fumigant ethylene dibromide (EDB), which is a known carcinogen in animals and a mutagen in many testing systems, including mammals.1,2 Recently, Gerber Products published a statement, "Ethylene Dibromide Background Information," in their widely disseminated journal Pediatric Basics.3 Gerber rightly states that analytical testing ability has improved during the past 30 years.

Assessing Barriers to Medication Adherence in Pediatric and Adolescent and Young Adult (AYA) Patients on Anticoagulation

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 9-10
Author(s):  
Kevin E Todd ◽  
Meghan E Mcgrady ◽  
Anne Blackmore ◽  
Carrie Hennessey ◽  
Lori Luchtman-Jones
Keyword(s):  
Young Adults ◽  
Linear Regression ◽  
Medication Administration ◽  
Self Report ◽  
Adolescent And Young Adult ◽  
The Past ◽  
Children And Young Adults ◽  
The Impact ◽  
The Relationship ◽  
Lower Adherence

Background: Medication nonadherence rates as high as 50-75% have been widely reported in children and adolescents with chronic medical conditions. Anticoagulation nonadherence is associated with increased morbidity and mortality from hemorrhagic and thrombotic complications, reported mostly in older adult populations. As direct oral anticoagulant use increases, it is critical that pediatric clinicians understand the prevalence, adverse sequelae, and predictors of nonadherence for various anticoagulants prescribed for children and young adults to facilitate self-management in this population. To begin to address these critical knowledge gaps, this study explored the frequency of reported barriers to anticoagulation adherence and the relationship between reported barriers and adherence among a cohort of children and young adults who were prescribed anticoagulants through a pediatric thrombosis clinic. Methods: Data for this abstract were collected as part of a quality improvement (QI) initiative in the pediatric thrombosis clinic from May 2019 to November 2019. This QI initiative included the administration of a self-report measure which asked families to rate the presence/absence of 19 barriers to adherence and respond to two items assessing adherence ("How many anticoagulation doses did you/your child miss in the past 7 days?"; "Did you/your child miss any anticoagulation doses in the past month?"). Patients aged &gt; 10 years (yr.) and/or their caregivers (for patients 0-17 yr.) visiting the clinic for anticoagulation follow-up completed the measure. With IRB approval, results from 161 anonymous measures from 130 families (n = 37 caregivers; n = 62 patients; n = 31 patient/caregiver dyads) were analyzed. Descriptive statistics were used to summarize the most frequent barriers, rates of adherence, and concordance of barriers within patient/caregiver dyads. Linear regression was used to explore relationships between barriers and adherence after controlling for medication administration type (injections versus oral). To ensure only one measure per family was included in this analysis, the regression was run on the subset of measures completed by caregivers of children &lt; 18 yr. and patients ≥ 18 yr. (n = 105 [37 caregivers + 62 patients + 31 caregivers from patient/caregivers dyad = 130 families; 130 - 25 families with missing adherence data = 105 families]). Results: Of 161 reporters, 120 reported at least 1 barrier. The most common barriers were medication side effects (n = 44), alterations in lifestyle secondary to medication (n = 44) and forgetting to take the medications (n = 37). The distributions of barriers by reporter and medication type are illustrated in Figure 1. Of 31 dyads, 26 reported 1 or more barriers. Only 6 caregiver/child dyads reported the same set of barriers. The remaining 77% (n = 20) of caregivers endorsed different barriers than their children. On average, patients and caregivers reported 1.85 barriers (SD = 1.95, range 0 - 10) and that they/their child took 96% of prescribed doses (SD= 9%, range = 71 - 100%). The linear regression was significant (F(2, 102) = 4.19, p = 0.02, R2 = 0.08). After controlling for medication type (p = 0.06), a greater number of barriers was significantly associated with lower adherence (t = -2.63, p = 0.01). Every one unit increase in total barriers (1 additional barrier reported) was associated with a decrease of .26% in adherence. Discussion: Although self-reported adherence was high, 75% of patients and caregivers reported 1 or more barriers to adherence. A greater number of barriers is associated with lower adherence, regardless of medication route, suggesting that addressing reported barriers might improve adherence. The spectrum of reported barriers was diverse, differing even within patient and caregiver dyads. Therefore, it is important to evaluate both patients and caregivers to fully assess the burden of barriers. Future studies are needed to evaluate the impact of addressing barriers and the relationship between anticoagulation adherence, barriers, and health outcomes. Figure 1 Disclosures Luchtman-Jones: Corgenix: Other: Provided discounted kits for study; Accriva Diagnostics: Other: Provided kits for study.

scholarly journals What’s hidden in my filedrawer and what’s in yours? Disclosing Non-published Findings in the Cognitive Science of Religion

2020 ◽  
Author(s):  
Michiel van Elk
Keyword(s):  
Peripersonal Space ◽  
Self Report ◽  
Short Report ◽  
Magical Thinking ◽  
Cognitive Science Of Religion ◽  
The Past ◽  
Superstitious Behavior ◽  
Behavior Study ◽  
Unpublished Studies ◽  
Neurocognitive Measures

In this short report I present an overview of different unpublished studies that we conducted in my lab over the past years. Across the different studies we observed consistent effects of our experimental manipulations or variables of interest on self-report measures, but less so on behavioral and neurocognitive measures. For instance, religious people said they were more prosocial but did not donate more money (Study 1 &amp; 2); participants experienced awe but this did not affect their body and self perception (Study 6 &amp; 7); participants had mystical-like experiences but this did not affect the perception of their peripersonal space (Study 8 &amp; 9); and self-reported magical thinking was unrelated to superstitious behavior (Study 11). In other studies, the hypothesized effects did not bear out as expected or were even in an unexpected direction. Participants perceived more agency in threatening pictures and scenarios, but this was not related to their supernatural beliefs (Study 3-5) and a death priming manipulation reduced rather than increased participants’ religiosity (Study 10). Opening the filedrawer through the publication of short reports like this one, will hopefully further increase transparency and will help other researchers to learn from our own trials and errors.

Patient-Controlled Analgesia: A Review of Effectiveness of Therapy and an Evaluation of Currently Available Devices

DICP ◽  
1989 ◽  
Vol 23 (11) ◽  
pp. 899-904 ◽  
Author(s):  
Robert P. Rapp ◽  
Brack A. Bivins ◽  
Robert A. Littrell ◽  
Thomas S. Foster
Keyword(s):  
Health Care ◽  
Pain Control ◽  
Health Care Personnel ◽  
Hard Copy ◽  
Major Advance ◽  
Patient Controlled Analgesia ◽  
The Past ◽  
Pca Method ◽  
Care Situation ◽  
Single Publication

Patient-controlled analgesia (PCA) is a major advance in the management of pain in postoperative and cancer patients. The success of PCA has resulted in a proliferation of marketed devices to administer small bolus doses of parenteral pain-control drugs at fixed intervals controlled by the patient with the push of a button. Because patients demonstrate marked individual variation in pain medication requirements, PCA devices should be able to accommodate rapidly changing requirements for drugs with a minimum amount of effort on behalf of health care personnel. Crude electronic devices were developed in the late 1960s and the early 1970s and usually consisted of a syringe pump connected to some sort of timing device. Most modern PCA devices marketed in the past five years are much more sophisticated devices that are microprocessor based and some newer devices even generate hard copy for a permanent record of drug administration. Although many such devices are available (including a totally disposable PCA device), few have undergone extensive clinical evaluation. A review of the literature shows many devices are available for use without a single publication to document the safety and utility of the device in the routine patient care situation. Use of the PCA method of pain control will grow, and all hospital-based health care personnel should become familiar with their use and limitations.

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