Introduction
Previous research confirmed high rates (20-89%) of non-adherence to medication among psychotic and bipolar patients. Results suggests that positive attitude to treatment has the highest ...influence on patients’ adherence and significant differences between treatment related attitudes and treatment adherence of psychotic and bipolar patients were found.
Objectives
The aims were to compare treatment related attitudes and treatment adherence between psychotic (schizophrenia spectrum) and bipolar patients; to evaluate the relationship between treatment related attitudes, illness perceptions and health locus of control in psychotic and bipolar populations.
Methods
Treatment attitude was evaluated with the Drug Attitude Scale (DAI). Treatment adherence was rated by doctors on Clinical Global Impression (CGI) Scale. Illness perceptions were evaluated with the Illness Perception Questionnaire for Schizophrenia (IPQS) and health locus of control with the Multidimensional of Health Locus of Control Scale –Form C (MHLC) at the end of inpatient care.
Results
Number of participants was 51. Data indicated more positive treatment attitude in bipolar patients than in psychotic patients. MHLC scores indicated significant role in symptoms control for chance (p=0,042) and „powerful” persons (p=0,011) in psychotic patients. IPQS scores indicated that bipolar patients rather have perceptions about treatment influencing symptoms than psychotic patients. Treatment related attitudes were strongly influenced by perceptions about controllability of symptoms by treatment.
Conclusions
Bipolar patients had more positive treatment attitude and perceptions about effectiveness of treatment on symptoms. This illness perception about controllability of symptoms by treatment was the strongest determinant of positive treatment attitude in this study.
Disclosure
No significant relationships.
Dose-response dependencies of the radiochromic Turnbull blue (TB), modified Fricke gel (FXO), polymer gel VIPET, and solid-state Presage® dosimeters were investigated, in high-dose-rate radiation ...fields, using spectrophotometry. A sealed radionuclide source (60Co) with a dose rate up to 9 Gy s−1 was used for irradiation. Standard liquid Fricke solution was used as a reference dosimeter. It was found that the properties of different types of gel dosimeters are affected by the dose rate. The results were compared with the predictions derived from the physical-chemical irradiation response principles. Considerable dose-rate dependencies were observed for all investigated 3D dosimeters. Dose responses of TB, VIPET, and FXO were decreased by 30–40% while the Presage® response were decreased by approximately 20% for dose rates from 7.2 × 10−3 to 9.01 Gy s−1. Presented results could have practical impact on some clinical applications, and therefore proper corrections might be needed.
•Dose-rate dependences of TB, FXO, VIPET, and Presage® dosimeters were investigated.•60Co dose rates between 7.2 × 10−3 and 9.01 Gy s−1 were applied.•Dose responses of gels is decreased by 30–40% over the studied dose-rate range.•The dose response of Presage® is decreased by 20% over the studied dose-rate range.
•DDPM generating treatment planning data was developed and verified (FID < 50).•Synthetic data helped to improve performance of SBRT outcome model by > 10 %.•Other techniques for imbalanced training ...improved performance by less than 4%.•DDPM model can diminish the negative effect of event imbalance in outcome models.•Introduced approach can help in clinical translation of radiotherapy outcome models.
Radiotherapy outcome modelling often suffers from class imbalance in the modelled endpoints. One of the main options to address this issue is by introducing new synthetically generated datapoints, using generative models, such as Denoising Diffusion Probabilistic Models (DDPM). In this study, we implemented DDPM to improve performance of a tumor local control model, trained on imbalanced dataset, and compare this approach with other common techniques.
A dataset of 535 NSCLC patients treated with SBRT (50 Gy/5 fractions) was used to train a deep learning outcome model for tumor local control prediction. The dataset included complete treatment planning data (planning CT images, 3D planning dose distribution and patient demographics) with sparsely distributed endpoints (6–7 % experiencing local failure). Consequently, we trained a novel conditional 3D DDPM model to generate synthetic treatment planning data. Synthetically generated treatment planning datapoints were used to supplement the real training dataset and the improvement in the model’s performance was studied. Obtained results were also compared to other common techniques for class imbalanced training, such as Oversampling, Undersampling, Augmentation, Class Weights, SMOTE and ADASYN.
Synthetic DDPM-generated data were visually trustworthy, with Fréchet inception distance (FID) below 50. Extending the training dataset with the synthetic data improved the model’s performance by more than 10%, while other techniques exhibited only about 4% improvement.
DDPM introduces a novel approach to class-imbalanced outcome modelling problems. The model generates realistic synthetic radiotherapy planning data, with a strong potential to increase performance and robustness of outcome models.
To examine the prevalence of and survival rates for coinfection with human immunodeficiency virus (HIV) and hepatitis C virus (HCV), data were analyzed from all HIV-infected patients tested for HCV ...antibody from January 1992 until May 1997. The prevalence of HCV infection among 350 HIV-infected patients was 33%. By univariate analysis, HCV-positive (HCV+) patients were more likely to be older (P = .003), be positive for hepatitis B core antibody (P = .006), be black (P = .001), be intravenous drug users (P = .001), and have an abnormal level of aspartate aminotransferase (AST) (P = .001). In a logistic regression model, only intravenous drug abuse and abnormal AST level remained independently associated with HCV positivity. Length of survival, as determined by the Cox proportional hazards model, was similar for HCV+ vs. HCV− patients when analyzed for three different endpoints: time from diagnosis of HIV to diagnosis of AIDS, time from diagnosis of HIV to death, and time from diagnosis of AIDS to death. The prevalence of HCV infection in this population is high but does not appear to affect HIV progression or survival.
Chronic spontaneous urticaria is challenging to manage and substantially affects quality of life. This US, non-interventional qualitative study examined patients' clinical journeys and emotional ...burden from symptom onset through disease management. Chronic spontaneous urticaria patients participated in interviews and completed diaries focusing on disease and treatment history/perspectives, impact on personal/family life, and relationships with physicians/other healthcare providers. Physicians were interviewed about their views on disease management and patient care. Twenty-five patients, previously or currently receiving chronic spontaneous urticaria treatment(s), and 12 physicians participated. Key stages following symptom onset were identified: Crisis (associated with feelings of torment/disorientation/shock); Searching for answers (puzzlement/frustration/anxiety); Diagnosis (relief/satisfaction/fear/isolation); and Disease management (frustration/hope/powerlessness). Findings revealed patients' perceptions and experiences of chronic spontaneous urticaria, including living with a 'skinemy', experiencing their 'own personal hell' and feeling 'like an experiment'. Awareness of unmet needs in patient care/management identified in this study may ultimately improve patient support and enhance physicians' understanding of disease burden.
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