Altering the physicochemical characteristics of the formulated plasmids can vary the distribution of plasmid to the bronchial tree buy discount aceon 4 mg online blood pressure journal pdf. Immunohistochemical studies of lung tissues after intratracheal administration of plasmid/lipid complexes have shown gene expression mainly within the epithelial cell layer lining the bronchus buy aceon 8 mg cheap arrhythmia blood pressure. Depending on the site of expression and the nature of antigen order aceon in india blood pressure medication recall 2015, in vivo expression of plasmids encoding antigen can provide superior cellular, humoral and mucosal immunity. The efficacy of genetic vaccines could be enhanced or modulated through the use of formulations that increase nucleic acid stability or distribution in the tissue, the coexpression of immune molecules that affect the processing of antigens, or through the use of adjuvants that affect the immune response. Genetic vaccines have been applied to several systems, including immune responses against cancer antigens, mycoplasma, tuberculosis, malaria, parasites, and viral infections. Two types of immunity may be induced in response to an antigen, namely humoral immunity mediated by antigen-specific antibodies produced by B lymphocytes, and cell-mediated immunity produced by activated macrophages and cytotoxic T lymphocytes. Antibodies may neutralize pathogens, whereas 355 cytotoxic T lymphocytes can destroy infected cells or control infection by noncytolytic means. Antibody- mediated immunity effectively prevents infection by binding to the infectious organisms and then eliminating either directly or via phagocytic ingestion by neutrophils and/or monocytes. Antibodies also bind to the surface of infected cells expressing the specific antigen. Several routes, including intramuscular, subcutaneous, intravenous, intradermal, nasal, and oral administration, have been investigated for the administration of genetic vaccines. Of these routes, intramuscular injection of genetic vaccines generated the best response. Mature myotube has been shown to be the target for the uptake of plasmid after intramuscular administration. Plasmid can enter the bloodstream and lymphatic system after intramuscular administration and traffic to the spleen, liver, kidney, lymph nodes and bone marrow. It is not clear whether the production of antigens in muscle has unique properties with respect to the elicitation of a prolonged immune response or whether expression in any tissue in the periphery is sufficient for the induction of an antigen-specific immune response. Single injection provides for a full humoral and T cell response for 60–70 weeks, with the antibody titer being higher than that achieved by intramuscular injection. Skin is rich in dendritic cells, which are potent initiators of immune responses and possess the co- stimulatory and adhesion molecules required for T cell activation. Thus, transfection of plasmids into these cells is likely to elicit both cellular and humoral responses. Specific targeting of dendritic cells residing in the lymph nodes will likely represent an attractive strategy for providing a robust immune response with nucleic acid vaccines. Plasmid-based (or non-viral) gene therapy has generated considerable research interest because of many inherent advantages over the viral vectors in terms of safety, immunogenicity and ease of manufacture. Gene therapy offers unique opportunities in the development of novel products that produce intracellular proteins. Several plasmid-based approaches are already in clinical trials and offer the potential of safe and effective gene therapy. To enhance the therapeutic efficacy of 356 proteins using plasmid-based expression systems, many fundamental questions related to their pharmaceutical formulation, biodistribution and intracellular trafficking still need to be addressed. Describe the pharmacodynamic and pharmacokinetic barriers to effective plasmid-based gene delivery. Outline the various approaches to cancer gene therapy presently being investigated. Traditionally new chemical entities have been identified by the screening of natural products and chemical libraries to identify potential lead compounds. These lead compounds have then been optimized through an iterative lead-optimization process involving the synthesis of analogs, the development of quantitative-structure-activity relationships and the use of molecular modeling to obtain new chemical entities with high specificity and affinity for the therapeutic target for pharmaceutical development. The development of combinatorial chemistry has led to the ability to produce vast libraries of compounds for initial screening. The evaluation of combinatorial libraries using high-throughput screening technologies allows the rapid screening of potential lead compounds with a wider molecular diversity against a broad range of therapeutic targets. Until recently, therapeutic targets were identified through the application of basic pharmacology and biochemistry with both receptor and enzyme targets being identified and isolated from specific tissues. The identification of potential therapeutic targets has been further enhanced through the recent development of genomics and proteomics. These techniques provide mechanisms to identify upregulated gene and protein expression in diseased tissue providing pointers towards potential means of therapeutic intervention. The advances in molecular biology have also led to the ability to clone receptors into various cell types to facilitate screening of potential ligands against such targets. The parallel development of cell biology has led to the ability to utilize cell-based assays rather than tissue-based assays for drug screening and the advances in robotics have led to the development of high-throughput screening technologies. The development of genomics, proteomics, high-throughput screening and combinatorial chemistry has led to an information explosion within pharmaceutical companies requiring better mechanisms for the storage and manipulation of biological and chemical data. This has driven the development of the field of bioinformatics which serves to provide searchable databases allowing comparison of molecular and biological information to potentially identify other therapeutic targets and lead compounds. This chapter aims to provide a brief overview of these different technologies to provide a basis for the reader to develop their understanding of this field in order to appreciate how these technologies will underpin the future of drug delivery and targeting. The majority of combinatorial approaches utilize polymeric solid supports as a base onto which the compounds are synthesized. However, there are also approaches which utilize solution- based chemistries to generate combinatorial libraries. Such supports are traditionally composed of polymeric resin beads on to which the synthesis of a peptide is undertaken in a stepwise fashion with each amino acid being added sequentially to the peptide chain (Figure 15. After coupling the amino acid to the peptide chain, the protecting group is removed from the terminal amino acid exposing a reactive site to which another amino acid may subsequently be coupled. This technique relies on the clean coupling of amino acids in peptide synthesis, the ability to easily remove reactants and solvents and wash the products between each stage of the synthesis and the ability to protect and deprotect reactive groups on the solid support as necessary. An example of a 3×3×3 combinatorial split and mix combinatorial synthesis is shown in Figure 15. The technique involves three initial batches of resin beads to which are initially coupled, for example, a different amino acid. These batches are then combined, mixed and split again into three batches; each batch now containing a mixture of beads containing different amino acids. A different amino acid is then coupled to each of these batches of beads, the beads mixed, split and the process repeated a third time. This simple 360 3×3×3 combinatorial split and mix approach generates a library of beads containing 27 different compounds in only 6 coupling reactions. A10×10×10×10×10 split and mix reaction scheme will produce 10,000 compounds in only 50 reactions. It is therefore clear that these strategies can produce large libraries of compounds of wide molecular diversity. As each resin bead contains only a single molecule the beads can be screened individually for bioactivity by either screening for activity of bound peptide in the biological assay or by cleaving the resultant peptide from the bead before undertaking the bioanalysis. The identity of any active compounds can then be determined by using mass spectrometry to sequence the active peptide. These involve the synthesis of a large number of combinatorial libraries making it possible to identify the sequence of the active agent from the identification of the libraries containing the active agent. For example, if we were interested in a 5 amino acid peptide we could use an indexed library approach.
It may be given in cases of abscess where there is a slow and poor reparative process cheap aceon 8mg without a prescription arrhythmia low blood pressure, or no inclination to repair; in nasal catarrh proven aceon 8 mg pulse pressure widening causes, with obstruction buy 8mg aceon mastercard blood pressure medication lower testosterone, the mucous membrane being pale, with watery secretion; perverted nutrition, disease of the epithelial covering of skin, deformity of nails, dry and harsh hair, etc. The tincture of the root may be employed in some cases of cough, but is not so good as from the plant. The Rosin Weed exerts a direct influence upon the respiratory tract, especially upon the nerve centers controlling the function. Its principal use thus far has been in the treatment of asthma, in some cases of which its action has been very decided. I think the cases in which it has proven most beneficial, are those in which there is a spasmodic dry cough, with sensations of dryness and constriction in the throat. I have not found it beneficial in lymphatic persons, or where there was congestion of mucous membranes, or profuse secretion. I have employed it in the treatment of cough, with some advantage, but can not specify the cases in which it was useful or those in which it failed. The tincture of the root has been furnished the profession by druggists, and the want of success with it is no evidence that the preparation from the plant is not anti- asthmatic. The action of this variety of Silphium, if we are to believe the reports of the few who use it, is very direct and certain upon the chylopoietic viscera. It is claimed that it is one of the best remedies in the treatment of ague-cake, and congestion of liver and spleen, so frequently associated with chronic intermittents. It is often forgotten that, in our civilized life, at least, common salt is necessary to health. It also seems to be forgotten that common salt is necessary to the well-being of the sick, though it would seem that at least this should not be overlooked. A person with protracted disease, like typhoid fever, will be allowed to go days, and even weeks, without salt in his food, especially if he is having a milk diet. This should be carefully looked after, for it may be the difference between a good recovery and death. I have seen a marked improvement within twenty four hours, from the giving of salt with food, or in the drink. In the infantile dyspepsia of children nursing the bottle, marked benefit will sometimes follow the addition of a small portion of salt to the milk, and the child will make flesh and become plump, and much to the mother’s satisfaction, good tempered. Some years since common salt was used very successfully in our South-western country to cure ague. It was given in doses of from ten to thirty grains every three hours, and if the stomach was loaded it was first used as an emetic. I have used it successfully in a few cases, the tongue being broad and pallid, or simply broad (natural color) but pitting where it came in contact with the teeth. It is certainly one of the best remedies we have for disease of the canaliculi and lachrymal sac. In this way we obtain the effects of some of the best mineral waters (laxative sulphur waters. A solution of sulphate of soda is also one of the best remedies for lead poisoning, and may be used by workers in lead as a prophylactic. Whilst the iodide of potash would be preferred in severe cases, the sulphate of soda is borne for a much longer time. The first is in the form of large colorless transparent crystals, freely soluble in water, the second in white prismatic crystals soluble in four parts of cold water: a want of solubility should cause the preparation to be rejected. In the first part of this work (Alkalies), will be found the general indications for the use of alkaline salts. We employ the Sulphite and Hyposulphite of Soda as antizymotics, where there are the indications for the use of an alkaline salt as above. As a general rule, the indications for these salts will be - pallidity of mucous membranes, with a thick, pasty, white or dirty-white fur upon the tongue. The influence of zymotic causes of disease on the fluids and solids is not well understood, but we know that it impairs their life, even if it does not cause more rapid sepsis In some cases this impairment of vital power is all the change that can be noted, retrograde metamorphosis progressing more slowly than in health or ordinary disease. But the remedies we are studying are more than antiseptics - they antagonize the zymotic cause whether it produces sepsis or not. In local diseases from a zymotic cause, as diphtheria, cynanche maligna, some forms of catarrh and influenza, erysipelas, surgical fever, etc. The indications, however, must be as named above - pallidity, with pasty exudates upon tongue. Their action in arresting the growth of microscopic fungi, and during diseases arising from this cause, is specific. In yeasty vomiting, presenting sarcina ventriculi, the disease is speedily cheeked by the Sulphites. In some forms of apthous sore mouth and throat, speedy relief is given by their local application. Some chronic skin diseases are rendered very stubborn by these minute growths, and here also the Sulphites will prove valuable. We consider the Sulphurous Acid here, rather than under the head of Acids, from its relations to the Sulphites just noticed. The Sulphurous Acid, like the alkaline sulphites, specifically antagonizes zymotic causes of disease. It is well to keep in mind the fact that this is something more than simply arresting or modifying the septic process, for we have already seen that the zymotic influence frequently destroys the life of the fluids and solids without producing putrescency. We prescribe sulphurous acid as an anti-zymotic in cases which present reddened mucous membranes, with brownish coatings of tongue and sordes. Given, the indications for the use of an anti-zymotic, with the indications for the use of an acid, and we select the sulphurous acid. Sulphurous acid may be employed in yeasty vomiting, in apthous mouth and throat, or wherever the presence of microscopic fungi is suspected, with the same certainty as the sulphite of soda. We also use it in porrigo, trichosis of scalp, and ptyriasis versicolor, with excellent results. I wish to call especial attention to its use in some diseases of the throat, by the spray or atomizing apparatus. In diphtheria, with dark redness of mucous membranes, and fullness with relaxation, there is no local remedy equal to sulphurous acid spray. It is equally beneficial in those cases of cynanche maligna, with dark redness of mucous membranes. Whilst in ordinary sore throat from cold, with dusky discoloration, it offers one of the best local applications in the materia medica. The Bittersweet has the reputation of being a good alterative, in cutaneous diseases, syphilis, scrofula, and inflammatory deposits, and we conclude that it increases waste and excretion. It exerts a marked influence upon the cerebro-spinal centers, when used in large doses, but this has not been studied. I would advise the employment of the remedy in small doses in those cases of chronic disease in which the circulation is feeble, the hands and feet cold and purplish, with fullness of tissues and tendency to œdema.
Cations can be formed by various Chemistry/Select instruments to perform test/Drugs of methods order generic aceon canada arteria femoralis profunda, the most common of which is electron abuse/2 bombardment (electron ionization) 2 mg aceon with mastercard hypertension pregnancy. Cations caused by electron loss or proton a nitrogen laser causes transfer of a proton from the attachment matrix (an acid) to the protein buy line aceon arteria princeps pollicis. Chemistry/Deﬁne fundamental characteristics/ Instrumentation/1 186 Chapter 5 | Clinical Chemistry 68. Electrospray ionization uses a small-bore tube that forms a 1–4 μ nozzle at the mass Chemistry/Identify basic principle(s)/Mass spectroscopy/1 ﬁlter inlet and which is charged by several kilovolts. In mass spectroscopy, the term base peak typically The sample enters the tube along with inert drying refers to: gas. A natural isotope of the molecular ion reaches the nozzle, it becomes highly charged. Te ﬁrst peak to reach the mass detector size of the droplet is decreased owing to evaporation. Chemistry/Deﬁne fundamental characteristics/ This causes the charge density to become excessive, Instrumentation/1 and the droplets break apart. These particles are drawn into the for errors of amino and organic acid metabolism? Electrospray ionization tandem-mass parent or “molecular” ion, a process called soft spectroscopy ionization. B The base peak is typically the “molecular ion” or Chemistry/Select instruments to perform test/Newborn parent ion, meaning that it is the initial fragment screening/2 made by releasing an electron. The cation thus formed has a charge of +1, and therefore, its m/z ratio is equal to its mass. It is the most abundant and most stable ion, and gives the best sensitivity for quantitative analysis. C While two-dimensional thin-layer chromatography can separate both amino and organic acids, it is not suﬃciently sensitive for newborn screening. Electrospray ionization allows a small alcohol-extracted whole-blood sample to be analyzed by two mass spectrometers without prior separation by liquid or gas chromatography. Disorders of both organic and fatty acid metabolism are identiﬁed by the speciﬁc pattern of acylcarnitine ions produced. Amino acids are detected as amino species that have lost a carboxyl group during ionization, a process called neutral loss. In tandem-mass spectroscopy, the ﬁrst mass ﬁlter Answers to Questions 71–73 performs the same function as: A. Te vacuum system molecular or parent ions of interest by excluding ions outside a speciﬁed size range. Therefore, it eﬀectively Chemistry/Apply principles of special procedures/ separates the analyte(s) of interest from unwanted Instrumentation/1 compounds. Results of an Autotune test are drawn into a second mass ﬁlter where they are showed the appearance of a base peak at 16 with bombarded by argon atoms. Te carrier gas is contaminated The process can be repeated in a third mass ﬁlter C. Why is vacuum necessary in the mass ﬁlter of a acid, amino acid, and organic acid metabolism. It removes electrons from the ion source atmosphere also contains small quantities of two D. It prevents contamination isotopes with molecular weights of 17 and 18 owing to one and two extra neutrons, respectively. What method is used to introduce the sample into Answers to Questions 74–76 a mass spectrometer for analysis of a trace element? This is done by introducing the sample into a very hot plasma (6,000–10,000°K) called a torch. The Chemistry/Apply principles of special procedures/ torch is made by circulating argon through inner and Instrumentation/2 outer quartz tubes. Which component is needed for a thermal cycler coil of wire that receives a radio frequency. Sealed airtight constant-temperature chamber argon is ignited by a spark, it forms the plasma. Temperature-controlled ionization chamber sample is mixed with argon at the other end to create Chemistry/Deﬁne fundamental characteristics/ an aerosol. When it reaches the torch, the solvent is Instrumentation/1 evaporated and the energy from the torch and collisions with argon ions cause ejection of outer- 76. Annealing requires a Instrumentation/1 temperature between 40°C–65°C and allows the primers to bind to the target base sequence. Extension requires a temperature of 72°C and allows the heat-stable polymerase to add complementary bases to the primer in the 5’ to 3’ direction. Rapid heating and cooling is usually achieved using a thermoelectric block that is cooled by forced air ﬂow. They are used to correct the measurements from each well so that the same concentration of ﬂuorescent dye gives the same signal intensity regardless of the well. A line is drawn from the threshold value on the y-axis through the curve, and a perpendicular dropped to the x-axis. A The relative centrifugal force (number times the force of gravity) is proportional to the square of the rotor speed in revolutions per minute and the radius in centimeters of the head (distance from the shaft to A. B Electronic balances do not use substitution weights needed to calculate the relative centrifugal force or knife edges to balance the weight on the pan. Diameter of the centrifuge tube type of balance used, all need to be located on a D. Doors must be Chemistry/Deﬁne fundamental characteristics/ closed to prevent air currents from inﬂuencing the Instrumentation/1 weighing, and the pan and platform must be clean and free of dust and chemical residue. Which of the following situations is likely to cause an error when weighing with an electronic 80. Failure to close the doors of the balance before involves dilution, gravimetric analysis is associated reading the weight with greater certainty. Using the balance without allowing it to warm up for at least 10 minutes Chemistry/Identify sources of error/Balances/3 80. Which of the following represents the Answers to Questions 1–5 Henderson–Hasselbalch equation as applied to blood pH? Most Chemistry/Apply knowledge of fundamental biological laboratories consider less than 7. The negative logarithm of K´ is the pK´, Chemistry/Apply knowledge of fundamental biological which is 6. Alternately, bicarbonate substance contributes most to the amount of base can be measured by an enzymatic reaction using in the blood?
Following a brief account of the terminology used to describe the behaviour of medication taking buy 4 mg aceon amex blood pressure medication restless leg syndrome, the following chapter summarises research related to the impact of adherence on symptoms and relapse buy 2mg aceon fast delivery what us prehypertension. Statistics that relate to the prevalence of adherence are then provided aceon 8mg amex arterial blood gases, however, they should be interpreted with caution due to the difficulties associated with measuring adherence accurately. This is followed by a discussion of factors proposed to influence adherence in qualitative and quantitative research. An overview of the Health Belief Model, which has been proposed to explain adherence behaviour amongst consumers with schizophrenia, is then presented. By highlighting the benefits associated with adherence for consumers and providing statistics which illustrate how common non-adherence is, the present chapter supports the value of research aimed at improving adherence amongst consumers. Furthermore, the summary of quantitative and 36 qualitative research exploring factors related to adherence, in addition to explanatory models of adherence, provide a comprehensive overview of previous findings. Indeed, there is some overlap with previous findings in the analysis presented in subsequent Chapters 5, 6 and 7. The most commonly used, traditional term is compliance, which has been defined as the extent to which a consumer’s behaviour matches the prescriber’s recommendations (Horne, Weinman, Barber, Elliot, & Morgan. The use of the term compliance is declining as it implies a lack of consumer involvement and, rather, suggests a passive approach whereby the consumer faithfully (and often unquestioningly) follows the advice and directions of the healthcare provider (Horne et al. Inherent to the various definitions of compliance is the assumption that medical advice is good for the consumer and that rational consumer behaviour means following medical advice precisely (Swaminath, 2007). Adherence is defined as the extent to which the consumer’s behaviour matches agreed recommendations from the prescriber (Horne et al. It reduces attribution of greater power to the healthcare provider in the prescriber-consumer relationship and, rather, denotes some collaboration regarding health-related decisions (Swaminath, 2007). Adherence represents an attempt to emphasise that a consumer is free to decide whether to adhere to the health provider’s recommendations and that 37 failure to do so should not be a reason to blame the patient (Horne et al. According to Swaminath (2007), utilising this terminology with the consumer assists in fostering ownership and the continuation of treatment decisions by the consumer. Another new term which is predominantly used in the United Kingdom is concordance. The definition of concordance focuses on the consultation process, in which healthcare provider and consumer agree to therapeutic decisions that incorporate their respective views (Horne et al. The term ‘persistence’ has also been used recently and refers to the act of continuing treatment for the prescribed duration, or alternatively, the duration of time from initiation to discontinuation of therapy (Cramer, 2008). Despite some changes throughout the course of the present research, the term adherence was ultimately used, in line with the increased focus on consumer-centred approaches in healthcare. Interview data which will be discussed in the analysis in greater depth (in particular Chapter 7), however, suggest that the term adherence may not accurately reflect current clinical practice. That is, whilst the term adherence implies increased collaboration between the healthcare provider and the consumer, and suggests that consumers have the freedom to choose whether or not to follow a prescribed treatment regimen, in practice, many consumers perceived a lack of control over their treatment regimens. Indeed, many of the individuals with schizophrenia who were interviewed had not previously heard of the term ‘adherence’ but understood the term ‘compliance’ and used this to describe the degree to which they followed their medication prescriptions. Several studies have shown that illness symptoms are more pronounced amongst individuals with schizophrenia who are non-adherent. Extreme exacerbations in symptoms often lead to a relapse of psychosis for non-adherent consumers and hospitalisation. A recent study, which followed up outpatients with schizophrenia over three years found that symptom remission was more likely to occur in consumers who were adherent to their medication at follow-up (Novick et al. By contrast, Rosa, Marcolin and Elkis (2005) found that non- adherent consumers presented with an initial worsening of symptoms, which remained constant over one year follow-up. Furthermore, in their study comparing symptom severity amongst consumers who were hospitalised, Janssen et al. Non-adherence has also been associated with an increased risk of violence, outpatient treatment program dropout, housing instability and homelessness compared with adherence to treatment programs (Compton, 2007; Olfson et al. It has recently been estimated that 75% of people with schizophrenia will experience relapses and ongoing associated disability (Smith et al. Leff and Wing (1971) conducted a landmark study whereby outpatients with schizophrenia were prescribed a low daily dose of oral, typical antipsychotic medication in a double-blind trial, which was shown to lead to a 50% reduction in the risk of relapse within one year of the acute episode. In a review of relevant literature on adherence, Fenton, Blyler and Heinssen (1997) reported an unequivocal link between non-adherence and relapse and hospitalisation, citing seven studies which indicated that consumers rated as non-adherent have a six month to two year risk of relapse that is an average of 3. The magnitude of elevated risk of relapse associated with non-adherence was comparable to that reported for randomisation to placebo groups in maintenance antipsychotic medication trials (Fenton et al. More recently, in their longitudinal study involving first episode consumers with schizophrenia and schizoaffective disorder, Robinson et al. It was additionally found that consumers who 40 discontinued medication twelve months after the first episode had high rates of second and third relapses, despite careful monitoring by a dedicated research treatment team. In summary, non-adherence to antipsychotic medications following discharge from an acute hospitalisation has been described as the single, most significant risk factor for relapse (Compton, 2007). Whilst antipsychotic medication therapy does not prevent symptom relapses, it can extend the intervals between relapses and render psychotic episodes less severe. There is some evidence to suggest that the longer a patient survives without relapse, the lower the risk of relapse becomes, thus, highlighting the long-term benefits associated with adherence (Birchwood & Jackson, 2001). Additionally, if a relapse does occur, despite the beneficial effects of taking medication, it reportedly tends to be milder and can usually be effectively treated by temporarily increasing the dosage of antipsychotic medication (Mueser & Gingerich, 2006). The prevention of multiple relapses and extension of periods between episodes is critical, as not only are relapses distressing, causing significant emotional and psychological damage, but they can also lead to irreversible social consequences and increase the likelihood of symptoms persisting between episodes (Birchwood & Jackson, 2001) Non-adherence amongst people with schizophrenia has also been shown to be significantly associated with increased rate and length of rehospitalisation, increased costs of care as well as increased risk of emergency room visits (Compton, 2007; Lacro et al. In their study which examined the medical histories of 63 consumers who were regularly hospitalised, Weiden and Glazer (1997) reported that the most common reason for hospitalisation was non-adherence, which accounted for 50% of cases. Moreover, with each 41 missed day of medication, the risk of rehospitalisation increases. Rehospitalisation is reportedly four times higher among patients who miss 30 days or more over a year compared to those who take their medication as prescribed (Kozma & Grogg, 2003 cited in Masand & Narasimhan, 2006). Regarding the costs associated with non-adherence, Masand and Narasimhan (2006) point out that not only are the direct, medical costs high, particularly when there are recurrent hospitalisations and ongoing outpatient care is required, but the indirect costs related to disability and unemployment are even greater. Even partial non-adherence can lead to worsening symptoms and an increased risk of relapse and rehospitalisation. Irregular adherence has been associated with approximately a two-fold increase in hospitalisation and a four-fold increase in number of days hospitalised in another study, however (Svarstad, Shireman & Sweeney, 2001). Such data provide further support for the importance of adherence to continuous, maintenance medication schedules. Amongst people with schizophrenia, more specifically, the prevalence of non- 42 adherence with maintenance antipsychotic medications has been reported in the range of 30-50% for oral and 10-15% for depot preparations in early studies (Johnson, 1993; Kane & Borstein, 1985). A more recent French study reported that 30% of inpatients were considered to be non-adherent (Dassa et al. Such figures may be optimistic, however, in the context of several recent studies which have reported non-adherence rates between 40 and 55% (Compton, 2007; Gray, Wykes & Gournay, 2002; Lacro et al.