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    What people think about medicines : the relationship between medication beliefs and adherence to antidepressant therapy : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Psychology at Massey University
    (Massey University, 2006) Russell, Judith Catherine
    Major depressive disorder is a common mental disorder seen in primary care and treatment with antidepressant medication has been shown to be an effective treatment. Non-adherence to treatment regimens is considered by many to be the most serious challenge facing medical practice today. Research on medication adherence has more recently shifted its focus to the cognitive factors (i.e., patient beliefs) that determine adherence. Prior research has shown that pre-treatment perception of benefits and barriers to medication predict initial medication adherence. To contribute to this emerging literature, the present study assessed 85 depressed primary care patients about their beliefs in the necessity for and concerns about antidepressant therapy, and reported adherence using validated questionnaires (BMQ, Home, Weinman, & Hankins, 1999; MARS. Home & Weinman, 2002). The results of the present study showed no relationship between patient beliefs about the necessity of antidepressant therapy for their health and reported adherence. As predicted, participants holding stronger concerns about the potential adverse effects of the medication and stronger necessity beliefs, compared to concerns beliefs, reported increased rates of adherence. Depression severity was found to be associated with reported adherence, but was independent of the relationship between medication concerns and adherence. The present study replicated previous research and added further support for the theoretical basis of medication adherence by showing that there are similar theoretically based, determinants of adherence among patients with chronic physical health issues and those with mental health issues.
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    The lived experience of adult patients commencing radiotherapy and/or cytotoxic chemotherapy : thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Nursing at Massey University
    (Massey University, 1995) Wilson, Alan William
    A Phenomenological Study Of The Lived Experience Of Adult Patients Commencing Radiotherapy And/Or Cytotoxic Chemotherapy This study describes the lived experience of seven adult patients commencing radiotherapy and/or cytotoxic chemotherapy as outpatients at a regional cancer centre. Due to the long distances between their homes and the centre, six of the patients stayed in an oncology hostel during their treatment. A phenomenological research method was used to describe the lived experience of these participants. Data analysis involved the development of themes from thematic statements, and a description of the central phenomena. The central phenomena identified is the concept of "walking alongside" one's normal lifeworld. There is a strong theme in the lifeworld of lived time through "counting up, down or through" treatments and this provides a basic measurement of the "distance of the trip" of radiotherapy or cytotoxic chemotherapy treatment. Links to normality are sought by patients and are important if the patients are to return to their pre-treatment lifeworld. By improving health professionals understanding of the experience of having radiotherapy or chemotherapy, they will be better able to support patients through the experience of having these treatments. Patients stand to benefit from health professionals understanding the experience of patients commencing radiotherapy and/or cytotoxic chemotherapy and assisting patients through facilitating this trip.
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    The disposition of gentamicin in equine plasma, synovial fluid and lymph : a thesis presented in partial fulfilment of the requirements for the degree of Master of Veterinary Science at Massey University
    (Massey University, 1993) Anderson, Brian
    Although it is easy to monitor blood concentrations of antimicrobials most bacterial infections occur in extravascular sites, more specifically within the interstitial fluid. It is very difficult to sample interstitial fluid and many different methods have been used. Reports of the relationship between blood and interstitial concentrations of antibiotics have varied depending on the tissue/tissue fluid sampling technique used. The sampling of tissue fluid for antimicrobial studies in horses has been limited. Most studies have measured antibiotic concentrations in readily accessible body fluids such as urine, peritoneal fluid and synovial fluid. The relationship between these fluids and interstitial fluid in the horse is not known. The disposition of gentamicin in equine plasma, synovial fluid and in peripheral lymph was studied. A lymph vessel (dorsal digital lymph trunk) on the medial aspect of the distal hindlimb was selected for the disposition study. To better define the relationship between synovial fluid and tissue concentrations of an antimicrobial it was shown that this vessel had a contribution to its lymph derived from the synovium of the fetlock joint. Very high concentrations of gentamicin were retrieved in the lymph collected from the cannulated vessel after intra-articular injection (150mg dose). The mean maximum lymph gentamicin concentration was approximately 50 μg/ml and the time to reach this, approximately 1.7 h after joint injection. The mean synovial fluid concentration 0.25 h following injection was 7244 ± 660 μg/ml and disappearance from the synovial fluid was consistent with first order kinetics with a mean disappearance half-life (harmonic mean) of 0.99 (0.83-1.22) h. A technique for chronic cannulation of the dorsal digital lymph trunk was developed. Two Trials were conducted and in the first (Trial A) the disposition of gentamicin in plasma and lymph was studied after intravenous injection (2.2 mg/kg). In Trial B the disposition of gentamicin in plasma, synovial fluid and lymph was studied. Kinetic parameters were similar to other reported studies. There was no significant difference in kinetic parameters between trials. The disposition curves for all three fluids were similar. Mean maximum lymph concentrations were approximately 4.6 μg/ml and were 40% of the plasma concentrations 15 minutes after injection. These were achieved approximately 1.35 h after injection. The maximum concentration of gentamicin in synovial fluid (2.86 ± 0.45 μg/ml) was significantly less than in lymph. Three hours after injection plasma, synovial fluid and lymph concentrations were very similar and it was concluded that a sample of any one would be a good index of the others at this time. The relationship between synovial fluid and tissue fluid 3-8 h after injection was less clear with marked divergence of the disposition curves. Gentamicin was more slowly eliminated from lymph than plasma but a parallel relationship between the two fluids was observed 3-8 h after injection, with a mean lymph:plasma ratio of approximately 1.6. It was concluded that plasma concentrations were a good index of tissue fluid concentrations. Maximum lymph concentrations of gentamicin after intravenous injection were 10 times less than after intra-articular injection. The presence of very high concentrations in lymph derived from the synovium of a joint after intra-articular injection suggest that subsynovial interstitial fluid concentrations are also this high and therefore that intra-articular injection may have some therapeutic advantage over systemic injection. Lymph cannulation in the horse appears to be a viable technique for antimicrobial disposition studies.
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    An investigation into the regulation of the topoisomerase IIα promoter in breast cancer cells exposed to doxorubicin : a thesis presented to Massey University in partial fulfillment of the requirement for the degree of Doctor of Philosophy in Biochemistry
    (Massey University, 2003) Allen, Kirsty Ann
    Chemotherapeutic drugs, such as doxorubicin, are some of the most effective agents for the treatment of breast cancer. Acquired resistance to these drugs often develops, however, and may preclude effective treatment. Such resistance is multifactorial in origin, but may include down-regulation of topoisomerase IIα (topo IIα) - an essential enzyme involved in normal DNA metabolism and a target for some of the anticancer drugs. A reduction in the levels of this enzyme is thought to reduce DNA damage induced by the drug-topo IIα complex and so increases the chances of survival. The mechanisms involved in this down-regulation and the development of resistance to doxorubicin are the focus of this study. Stable breast cancer cell lines, containing deletion constructs of the topo IIα promoter linked to the hGH reporter gene, were exposed to doxorubicin and both the reporter and endogenous gene expression were analysed in the surviving cells. It was shown that the reporter and endogenous topo IIα gene expression in the cell line containing the full length topo IIα promoter construct was no longer correlated in the surviving cells negating the use of this experimental system. Instead the endogenous expression of topo IIα and putative regulatory factors were investigated. Data suggest that specific cell lines show a down-regulation in the levels of the topo IIα protein. These changes were not due to changes in cellular proliferation rates, cell cycle profile or promoter sequence. Selected cell lines were analysed for changes in the relative amounts of specific transcription factors with putative roles in topo IIα gene regulation and for the expression of proteins proposed to have a role in the development of drug resistance. In specific cell lines, a reduction in topo IIα protein levels correlated with alterations in the relative amounts of NF-YA and/or Sp1. It was shown that the drug efflux pumps MDR1 and MRP1, as well as the heat shock factor Hsp70 were not involved in the survival of cells that were exposed to the drug. In vivo footprinting was attempted to detect changes in the in vivo binding of proteins to the topo IIα promoter after short term drug exposure.