The frequency of illicit use of prescription stimulants (IUPS) was examined in relation to known risk factors. A hierarchical linear regression (N = 903) was used to evaluate self-reported past-year IUPS and demographic variables. Gender (p < .05), race (p < .05), and GPA (p < .01) were significantly associated with the frequency of past-year illicit use. However, Greek organization membership status, perceived ADHD symptoms and access to prescription stimulant medication were not significant individual correlates of past-year IUPS. Additional analyses were conducted on the user subgroup (n = 101) to determine whether these relationships were similar compared to the general sample. Among users, ASRS Inattention and Hyperactivity-Impulsivity Subscale scores were significantly associated with the frequency of past-year IUPS (p < .05), even after accounting for gender, race, and GPA. Interpretations of these findings and implications for future research are discussed.

Latter-day Saints are recognized throughout the world by their peculiar dietary code known as the Word of Wisdom. It is accepted by the Church as revelation and contains both proscriptions and prescriptions. Different levels of interpretation, understanding and observance of the principles in the Word of Wisdom make it a unique Latter-day Saint religious health code. The study population consists of college-aged male and female members of The Church of Jesus Christ of Latter-day Saints from Brigham Young University and a Latter-day Saint student stake affiliated with Utah Valley University. A questionnaire was conceptualized, designed and validated over a one year rigorous process. The responses of 720 participants were evaluated using frequency distributions and measures of central tendency. The t statistic was used for testing the null hypothesis of equality of means between independent groups and computed using approximate degrees of freedom from Satterhwaite's approximation when the variances between the two groups are unequal. Logistic regression was used with the stepwise option to identify demographic variables associated with selected interpretation variables. Two-sided tests of significance were based on the 0.05 level against a null hypothesis of no association. Participants generally interpret and comply with the proscriptions in the Word of Wisdom. Participants can identify the prescriptions, but actual behaviors are far below scientific and government recommended minimums. The interpretations and behaviors of this sample provide valuable insights for those interested in the Word of Wisdom and its connection to the standards of the Church.

Bakgrund: Regeringens 11 huvudmål från 2001 för att förbättra folkhälsan innefattar fysisk aktivitet genom att förutsättningarna för en ökad fysisk aktivitet hos befolkningen möjliggörs. Därav är det hälso- och sjukvårdens ansvar att främja fysisk aktivitet. En metod som idag används i Sverige är Fysisk aktivitet på recept (FaR). FaR bryter skadligt stillasittande och är bevisat en effektiv behandlingsform mot en rad. Det som är av intresse för förskrivaren är hur vårdtagaren ser på behandlingsmodellen och hur vårdtagaren upplever de olika aspekterna i behandlingen. Syftet med denna studie var att undersöka patienters upplevelser av fysisk aktivitet på recept samt deras upplevelser av stöd och uppföljning. Metoden som användes hade en kvalitativ ansats och intervjuer genomfördes som datainsamlingsmetod med hjälp av en semistrukturerad intervjuguide. Data analyserades med en kvalitativ innehållsanalys varvid tre kategorier och tio subkategorier identifierades. Resultatet visade att det var många faktorer som påverkade för en lyckad behandling. Informanterna upplevde att få fysisk aktivitet på recept som en sporre och en hjälp att komma igång med någonting de ville. Informanterna tyckte också att de fick en individanpassad vård där deras behov och önskemål togs tillvara. Det uttrycktes även att informanterna hade en allt växande ansvarskänsla för sin egen hälsa och fysisk aktivitet. Stödet de fick genom samtal gjorde att de kunde öppna sig och kände att någon annan brydde sig om deras hälsa. Att följas upp och att få rådgivning sågs av informanterna som oumbärligt för behandlingen. Slutsats: Kategorierna som utgjorde studiens resultat mynnade alla ut i en påverkan på informanternas motivation och detta identifierades följaktligen som temat för studien. För en lyckad FaR-behandling bör sjuksköterskan vid förskrivning och pågående behandling beakta en rad faktorer som identifierats utifrån informanternas utsagor. / Background: The governments 11 goals from 2001to improve general health includes physical activity in the sense that the prospects of higher physical activity among the population is made possible. Therefore it is the responsibility of the health care to promote physical activity. A method that is used in Sweden today is Physical activity on prescription (PaP). PaP breaks harmful sedentary lifestyle and is proven to be an effective treatment against many endemic diseases. What is of interest to the prescriber is how the patient perceives the treatment model and how the patient experiences the different aspects of the treatment. The aim this study was to examine the patient’s experiences of Physical activity on prescription as well as their experiences of support and follow-up. The method that was used had a qualitative approach and interviews were conducted as data collection method using a semi-structured interview guide. Data was analyzed using a qualitative content analysis. Three main categories and six subcategories were identified. The results showed that there were many factors that had an influence on a successful treatment. The informants experienced that getting physical activity on prescription was a spur and helped them get started with something they wanted to do. The informants felt that they received an individualized care where their needs were given consideration. The informants also expressed that they had a growing sense of responsibility for their own health. The support they received through discussions allowed them to open up and feel that someone else cared about their health. To be followed-up and to receive advice was seen by informants as crucial to the treatment.The conclusion was that the categories that formed this study resulted in an impact on the informants' motivation and thus was identified as the theme for the study. For a successful treatment, the nurse should to consider a number of factors identified by the informants' statements when prescribing and during ongoing treatment.

Prescription drug misuse (PDM), defined as use without a prescription or solely for the feeling or experience caused by the drug, has become a popular topic among substance use researchers. While the vast majority of studies on the topic tackle epidemiological questions surrounding PDM, there is a notable lack of studies that look specifically at risk factors rooted in sociological/criminological theories. The current research seeks to bridge this gap in the literature by examining theoretically based explanations for PDM among college students utilizing three criminological theories commonly applied to other forms of substance use: Social Learning Theory, Social Bonding/Control theory, and General Strain Theory. In addition, this study also seeks to examine differences in user types characterized by motives for misuse as they relate to predictors stemming from these theories of interest. Utilizing an independently collected sample of 841 college undergraduates from a large southern university, the findings show that nearly one in four students misused prescription drugs in the past semester. Motivations for PDM were primarily instrumental in nature, with very few respondents misusing solely for recreational purposes. Furthermore, social learning based risk factors could best account for PDM within the sample with partial and indirect supports also found for strain based risk factors as well. Implications of these findings as well as theoretical and practical applications are presented.

The production and approval process for the various labels used in clinical trials wastes significant time and resources through the need to outsource label production or rely on large reams of pre-cut label stock for each revision throughout the process. An in-house, on-demand label printing and cutting system is a potential remedy to this waste. Previous work by Cheadle et al. resulted in a functional electomechanical prototype of the label cutting aspect of this research, capable of rudimentary linear cuts. In this continued research, emphasis was placed on improved label cutting capabilities and creating PC control software for label design. Cutting operations were enhanced through the development of an algorithm for circular cuts, proportional motor control, and a prototype graphical user interface (GUI) for simple user control. The changes to cutting methods have improved linear cutting precision to an average of 0.00402-in (s = 0.00602-in, n=26) at minimum. The new method for circular cuts has an average precision of 0.04384-in (s = 0.01471-in, n=26). The target precision for cuts is 0.040-in, suggesting that linear cuts are satisfactory, but circular cuts must still be refined. The prototype user interface developed for this research is capable of driving the label cutting system through RS232 communication and exposes all functionality of the system to date. Overall, this research has enhanced the capabilities of the label cutting system significantly, but further work is required to realize a complete label production solution.

Illicit use of prescription stimulants (IUPS) has become more common in the late adolescent and emerging adulthood populations. This study examined the impact of close friend and parent disapproval/approval on IUPS in college students. A sample of 903 college students (MAge = 19.23) completed a questionnaire assessing variables including lifetime IUPS (14.59% of sample), and perceived close friend/parent disapproval/approval of either academic or recreational IUPS. A 2 X 2 chi-square test of independence was used to analyze data regarding perceived close friend/parent disapproval/approval and IUPS. There were four primary findings. First, students were significantly less likely to report having engaged in IUPS if they perceived close friend (CHI2 (1) = 55.99, p < .001) or parent disapproval (CHI2 (1) = 31.99, p < .001) of IUPS for academic purposes. Second, students were significantly less likely to report having engaged in IUPS if they perceived close friend disapproval of IUPS for recreational purposes (CHI2 (1) = 24.38, p < .001). Third, students were significantly more likely to report having engaged in IUPS if they perceived close friend approval (CHI2 (1) = 51.17, p < .001) and parent approval (CHI2 (1) = 7.87, p = .005) for academically-motivated IUPS. Fourth, students were significantly more likely to report having engaged in IUPS if they perceived close friend approval for recreationally-motivated IUPS (CHI2 (1) = 33.86, p < .001). Future researchers should focus on conducting longitudinal studies to confirm if perceived close friend and parent approval function as risk factors for IUPS and if disapproval functions as a protective factor. Future research is also needed to help identify whether student perceptions of disapproval and approval are accurate (i.e., do close friends and parents really approve or disapprove of IUPS?). Finally, investigators should work to assess whether increased perceptions of disapproval can function to reduce level of IUPS (i.e., not just lifetime prevalence) and whether increases in perceived approval function to exacerbate IUPS. Results of these kinds of research efforts would better inform whether psychoeducational interventions should target decreasing approval and increasing disapproval perceptions in order to both prevent and reduce IUPS behaviors.

Introduction: Medication errors are a major cause of illness and hospitalization of patients throughout the world. This study examines the situation regarding medication errors in the Armed Forces Hospital, Kuwait since no literature exists of any such studies for this country. Several types of potential errors were studied by physicians, nurses and pharmacists. Their attitudes to the commission of errors and possible consequences were surveyed using questionnaires. Additionally, patient medical records were reviewed for possible errors arising from such actions such as the co-administration of interacting drugs. Methods: This study included direct observations of physicians during the prescribing process, pharmacists while they dispensed medications and nurses as they distributed and administered drugs to patients. Data were collected and compiled on Microsoft Excel spreadsheet and analyses were performed using SPSS. Where applicable, results were reported as counts and/ or percentages of error rates. Nurses, pharmacists and physicians survey questionnaires: From the 200 staff sent questionnaires a total of 149 respondents comprising nurses (52.3%), physicians (32.2%) and pharmacists (16.1%) returned the questionnaires a total response rate of 74.5%. All responses were analyzed and compared item-by-item to see if there were any significant differences between the three groups for each questionnaire item. All three groups were most in agreement about their perception of hospital administration as making patient safety a top priority with regard to communicating with staff and taking action when medication errors were reported (all means 3.0 and p > 0.05). Pharmacists were most assured of administration support when an error was reported whereas nurses were least likely to see the administration as being supportive ( p < 0.001), and were more afraid of the negative consequences associated with reporting of medication errors (p = 0.026). Although nurses were generally less likely to perceive themselves as being able to communicate freely regarding reporting of errors compared to pharmacists there was no significant difference between the two groups. Both however were significantly different from physicians (p< 0.001). Physicians had the most favorable response to perceiving new technology as helping to create a safer environment for patients and to the full utilization of such technologies within the institution in order to help prevent medical errors. Scenario response - Responses to two scenarios outlining possible consequences, should a staff member commit a medication error, tended to be very similar among the three groups and followed the same general trend in which the later the error was discovered and the more grievous the patient harm, the more severe would be the consequences to the staff member. Interestingly, physicians saw themselves as less likely to suffer consequences and nurses saw themselves as more likely to suffer consequences should they have committed a medication error. All three groups were more likely to see themselves as facing dismissal from their job if the patient were to die. RESULTS OF ALL THREE OBSERVATIONS: Result of Nursing observations: For 1124 doses studied, 194 resulted in some form of error. The error rate was 17.2% and the accuracy was 82.8%. The commonest errors in a descending order were: wrong time, wrong drug, omission, wrong strength/ dose, wrong route, wrong instruction and wrong technique. No wrong drug form was actually administered in the observational period. These were the total number of errors observed for the entire month period of the study. IV Result of Pharmacist observations: A total of 2472 doses were observed during the one month period. Observations were done for 3 hours per day each day that the study was carried out. The study showed that there were 118 errors detected which were in the following categories respectively: 52 no instructions, 28 wrong drug/unordered, 21 wrong strength/dose, ignored/omission 13, shortage of medication 3 and expired date 1. Result of Prescribers in Chart review for drug-drug interactions: The analysis of the drug-drug interactions showed that out of a total of 1000 prescriptions, 124 had drug-drug interactions. None were found to fall into the highest severity rating i.e. 4 (contraindicated). Only twenty-one interactions were rated 3 (major), 87 interactions were rated moderate and 15 interactions were rated minor according the modified Micromedex scale. Patient education: All health care such as physician, pharmacist, and nurses have a responsibility to educate patient about their medication use and their health conditions to protecting them from any error can occur by wrong using drugs. Conclusion This study has contributed to the field of medication errors by providing data for a Middle Eastern country for the very first time. The views and opinions of the nurses, pharmacists and physicians should be considered to enhance the systems to minimize any errors in the future.

京都大学 / 新制・課程博士 / 博士(医学) / 甲第24881号 / 医博第5015号 / 新制||医||1068(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 古川 壽亮, 教授 髙橋 良輔, 教授 阪上 優 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Researchers have argued that a reason for non-medical use of prescription psychostimulants is to self-medicate an undiagnosed case of ADHD. Therefore, this study examined neuropsychological complaints in college students with and without a history of prescription psychostimulant use. College students (N = 615) completed an Internet-based survey assessing behaviors associated with prescription psychostimulant use and symptoms of neuropsychological impairment. The results of the current study support the hypothesis that college students who non-medically use prescription psychostimulants report more symptoms of cognitive impairment (i.e., memory and attention complaints) than college students classified as non-users. Complaints about memory and attention were as common in non-medical users as medical users. Overall, the results suggest that non-medical users may use prescription psychostimulants due to perceived symptoms of ADHD.

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