Assessing the reasons for increase in self‑medication and control measures among student nurses in University of Benin Teaching Hospital, Edo State, Nigeria

Background:Self‑medication among student nurses is the use of medicines without doctor’s prescription.This practice is a global phenomenon and potential contributor to human resistance to most drugs,associated with different types of health challenges.Despite the high knowledge on the complication of self‑medication,studies showed that most student nurses still practice self‑medication.Aims:The aim of this study was to assess the reasons for increase in self‑medication and and find ways on how to curbing the menace among student nurses in the School of Nursing,University of Benin Teaching Hospital,Edo State,Nigeria.Materials and Methods:A descriptive cross‑sectional survey was conducted with stratified simple random sampling technique to select ninety student nurses from three different levels in the School of Nursing,University of Benin Teaching Hospital in Benin City,Edo State.A self‑structured questionnaire with open‑type and Likert‑type scale questions used as instrument to assess the reasons for increase in self‑medication and the possible control measures.Data collected were analyzed using tables,percentages,means,standard deviation,and t‑test for inferential statistics at 0.05 level of significance,through Statistical Package for the Social Sciences software.Results:The result showed the reasons for increase in self‑medication and how to reduce its occurrence.It also showed that the gender of the student nurses is statistically related to the reasons why they practice self‑medication(t=6.82,P≤0.001).Conclusion:Self‑medication can be reduced among student nurses by empowering the law enforcement agencies against self‑medication,improving the availability of essential and quality drugs in school clinics,and inclusion of all student nurses in National Health Insurance Scheme(NHIS)program,where they can enjoy the benefit of paying only 10%of the treatment charges.

A cross-sectional study to assess medication safety,knowledge,attitude,and practices regarding nutrition and medication among pregnant women

Objective:To assess pregnant women's knowledge,attitude,and practice regarding nutrition and medication usage,analyse the prescribing pattern,and categorize them based on the Food and Drug Administration(FDA)guidelines.Methods:A cross-sectional study was conducted with 264 pregnant women in the obstetrics and gynaecology department of a tertiary care hospital from October 2022 to August 2023.A knowledge,attitude,and practice(KAP)questionnaire was prepared in English language by the researchers and validated by an expert panel consisting of 12 members.The validated questionnaire was then translated into regional languages,Kannada and Malayalam.The reliability of the questionnaire was assessed with test-retest method with a representative sample population of 30 subjects(10 subjects for each language).The subjects'knowledge,attitude,and practice were evaluated using the validated KAP questionnaire.The safety of the medication was assessed using the FDA drug safety classification for pregnancy.Results:The mean scores for nutritional and medication usage knowledge,attitude,and practice were 4.14±1.15,4.50±1.09,and 3.00±1.47,respectively.Among 30 prescribed medications,3 belong to category A(no risk in human studies),8 belong to category B(no risk in animal studies),18 belong to category C(risk cannot be ruled out)and 1 drug is not classified.A significant association was observed between medication knowledge and practice(r=0.159,P=0.010).Conclusions:Most of the study population knows the need to maintain good dietary and medication practices during pregnancy.Counselling pregnant women regarding diet and medication usage is crucial in maternal care.

Mediating role of inner strength in the relationship between medication literacy and medication adherence among kidney transplant patients

Objective:Compared with long-term renal replacement therapy,kidney transplantation is the ideal treatment for end-stage renal disease(ESRD),significantly extending patient life and improving quality of life.Kidney transplant patients need to adhere to lifelong immunosuppressive medication regimens,but their medication adherence is generally poor compared with other organ transplant recipients.Medication adherence is closely related to medication literacy and psychological status,yet related studies are limited.This study aims to investigate the current status of medication adherence,inner strength,and medication literacy in kidney transplant patients,analyze the relationships among these 3 factors,and explore the mediating role of inner strength in the relationship between medication literacy and medication adherence.Methods:A cross-sectional survey was conducted from March to October 2023 involving 421 patients aged≥18 years who visited kidney transplantation outpatient clinics at 4 tertiary hospitals in Hunan Province.The inner strength,medication literacy,and medication adherence of kidney transplant patients were investigated using the Inner Strength Scale(ISS),the Chinese version of the Medication Literacy Assessment in Spanish and English(MedLitRxSE),and the Chinese version of the Morisky Medication Adherence Scale-8(C-MMAS-8),respectively.Univariate analysis was performed to examine the effects of demographic and clinical data on medication adherence.Correlation analysis was conducted to explore the relationships among medication literacy,medication adherence,and inner strength.Significant variables from univariate and correlation analyses were further analyzed using multiple linear regression,and the mediating effect of inner strength was explored.Results:Among the 421 questionnaires collected,408 were valid,with an effective rate of 96.91%.The scores of C-MMAS-8,MedLitRxSE,and ISS were 6.64±1.16,100.63±14.67,and 8.47±4.03,respectively.Among the 408 patients,only 86(21.08%)patients had a high level of medication adherence,whereas 230(56.37%)patients had a medium level of medication adherence,and 92(22.55%)patients had poor medication adherence.Univariate analysis indicated that the kidney transplant patients’age,marital status,education levels,years since their kidney transplant operation,number of hospitalizations after the kidney transplant,and adverse drug reactions showed significant differences in medication adherence(all P<0.05).Correlation analysis showed that inner strength positively correlated with both medication literacy(r=0.183,P<0.001)and medication adherence(r=0.201,P<0.001).Additionally,there was a positive correlation between medication adherence and medication literacy(r=0.236,P<0.001).Inner strength accounted for 13.22%of the total effect in the mediating role between medication literacy and medication adherence.Conclusion:The level of medication adherence among kidney transplant patients needs improvement,and targeted intervention measures are essential.Inner strength mediates the relationship between medication literacy and medication adherence in these patients.Healthcare professionals should focus on enhancing medication literacy and supporting patients’inner strength to improve medication adherence.

Informing policy makers in developing countries:Practices and limitations of geriatric home medication review in Malaysia-A qualitative inquiry

Objective:To explore existing practices and challenges in the delivery of geriatric home medication review(HMR).The study was part of a larger study aimed to offer solution to expand the range of geriatric HMR.Methods:This study employed qualitative exploratory design through semi-structured individual in-depth interviews with the public pharmacists involved in the delivery of geriatric HMR at public hospitals.The purpose of the interviews was to explore challenges faced by them in the delivery of geriatric HMR.Results:Based on the emerging themes from the qualitative data,the study reveals that geriatric HMR in Malaysia is integrated as part of multidisciplinary home care visits,encompassing a diverse patient population with various healthcare needs.However,it faces challenges such as the lack of outcome monitoring,formal training,and workforce constraints.Despite these hurdles,there is a pressing need for the expansion of this service to better serve the community,and collaboration with community pharmacists holds potential to broaden its scope.Ultimately,the findings suggest that pharmacist-led HMR is both warranted and feasible within the Malaysian healthcare context.In order to optimize medicine-use among older people living in the community,approaches for expanding geriatric HMR services in Malaysia must be developed.Conclusions:This study holds profound implications as it attempts to illuminate policy makers in developing countries,enabling them to formulate effective HMR plans.By considering the challenges highlighted within this research,policy makers can design a comprehensive HMR service that caters adeptly to the healthcare needs of the mass population.

Advancements in Medication Rule for Pulmonary Nodules: A Review of Current Research Progress

This paper reviewed the literature on medication rule of pulmonary nodules in recent years. It is found that contemporary doctors pay more attention to regulating Qi, clearing heat and detoxifying, eliminating phlegm, dissolving phlegm and dissipating masses. They use mild drugs, cold and warm treatments in parallel, combining the tastes of pungent, bitterness, and sweetness at the same time. The treatment focuses on the five viscera with emphasis on the lung meridian while also considering the spleen and stomach functions as well as soothing liver stagnation. This information aims to provide some reference for clinical treatment of pulmonary nodules.

Research Progress of Measuring Tools for Patient Medication Compliance

This paper introduced the content, compilation process, reliability and validity, scoring method of the evaluation tool for patients’ medication compliance at home and abroad, and reviewed the research progress of the tool. The evaluation method, dimension, scoring method, evaluation content and application scope of the tool were compared, so as to provide reference for nurses to comprehensively and accurately evaluate patients’ medication status.

Exploring the limited use of transdermal medications in psychiatry:Challenges and potential solutions

Transdermal medications are an useful yet underutilized tool in the field of psychiatry.Despite numerous advantages of using this route of medication delivery,transdermal medications remain less popular compared to other routes of medication administration such as oral and intramuscular routes in the management of various psychiatric conditions.In this editorial,we examine the advantages of transdermal medications with a brief overview of transdermal being used in psychiatry and other medical specialties.We discuss the factors that play a role in their limited usage in psychiatry.We highlight certain patient categories who can specifically benefit from them and discuss potential solutions that can broaden the perspective of treating clinicians making this an intriguing avenue in the field of psychiatry.

Adaptive Modeling of Monthly Depression Levels in Terms of Daily Assessments of Opioid Medications Taken and Pain Levels for Cancer Patients

A research study collected intensive longitudinal data from cancer patients on a daily basis as well as non-intensive longitudinal survey data on a monthly basis. Although the daily data need separate analysis, those data can also be utilized to generate predictors of monthly outcomes. Alternatives for generating daily data predictors of monthly outcomes are addressed in this work. Analyses are reported of depression measured by the Patient Health Questionnaire 8 as the monthly survey outcome. Daily measures include numbers of opioid medications taken, numbers of pain flares, least pain levels, and worst pain levels. Predictors are averages of recent non-missing values for each daily measure recorded on or prior to survey dates for depression values. Weights for recent non-missing values are based on days between measurement of a recent value and a survey date. Five alternative averages are considered: averages with unit weights, averages with reciprocal weights, weighted averages with reciprocal weights, averages with exponential weights, and weighted averages with exponential weights. Adaptive regression methods based on likelihood cross-validation (LCV) scores are used to generate fractional polynomial models for possible nonlinear dependence of depression on each average. For all four daily measures, the best LCV score over averages of all types is generated using the average of recent non-missing values with reciprocal weights. Generated models are nonlinear and monotonic. Results indicate that an appropriate choice would be to assume three recent non-missing values and use the average with reciprocal weights of the first three recent non-missing values.

Clinical effects of detailed nursing management interventions on medication adherence and disease perception in patients with drugresistant tuberculosis

BACKGROUND Tuberculosis(TB)is a chronic respiratory infectious disease that considerably jeopardizes human health,and there is no effective vaccine suitable for its prevention in the entire population.AIM To investigate the promotion of medication adherence and disease cognition in patients with drug-resistant(DR-)TB using detailed nursing management.METHODS In total,114 patients with DR-TB who were diagnosed and treated at our hospital between January 2019 and January 2023 were included in this study.Patients in the control group(n=57)were managed with conventional nursing care,while those in the observation group(n=57)were managed with detailed nursing care.Medication adherence,disease awareness scores,medication safety,and nursing satisfaction were compared between the two groups after the intervention.RESULTS The post-intervention medication compliance rate was 91.23%in the observation group and 75.44%in the control group,with the former being 15.79%higher than the latter(P<0.05).There was no statistically significant difference in the disease awareness scores between the two groups before the intervention;the disease awareness scores of the observation group were significantly higher than those of the control group after the intervention(P<0.05).The incidence of gastrointestinal reactions,joint swelling and pain,hearing loss,electrolyte disorders,and liver and kidney function abnormalities were lower in the observation group than those in the control group.The total nursing satisfaction of the observation group was higher than that of the control group(P<0.05).CONCLUSION Implementation of detailed nursing management for patients with DR-TB can effectively improve medication adherence,enhance awareness of the disease,ensure safety of medication,and improve satisfaction with nursing care.

Metabolic complications of psychotropic medications in psychiatric disorders:Emerging role of de novo lipogenesis and therapeutic consideration

Although significant advances have been made in understanding the pathophysiology of psychiatric disorders(PDs),therapeutic advances have not been very convincing.While psychotropic medications can reduce classical symptoms in patients with PDs,their long-term use has been reported to induce or exaggerate various pre-existing metabolic abnormalities including diabetes,obesity and non-alcoholic fatty liver disease(NAFLD).The mechanism(s)underlying these metabolic abnormalities is not clear;however,lipid/fatty acid accumulation due to enhanced de novo lipogenesis(DNL)has been shown to reduce membrane fluidity,increase oxidative stress and inflammation leading to the development of the aforementioned metabolic abnormalities.Intriguingly,emerging evidence suggest that DNL dysregulation and fatty acid accumulation could be the major mechanisms associated with the development of obesity,diabetes and NAFLD after long-term treatment with psychotropic medications in patients with PDs.In support of this,several adjunctive drugs comprising of anti-oxidants and antiinflammatory agents,that are used in treating PDs in combination with psychotropic medications,have been shown to reduce insulin resistance and development of NAFLD.In conclusion,the above evidence suggests that DNL could be a potential pathological factor associated with various metabolic abnormalities,and a new avenue for translational research and therapeutic drug designing in PDs.

Analysis of the Effect of Family-Centered Empowerment Model(FCEM)Health Education Through WeChat on Medication Compliance and Blood Pressure of Elderly Hypertensive Patients in Rural Areas

Objective: To validate the effectiveness of a Family-Centered Empowerment Model (FCEM) health education through WeChat on medication compliance and blood pressure among elderly hypertensive patients in rural areas. Methods: One hundred and two rural elderly hypertensive patients aged 65-80 years were selected and randomly divided into an experimental and control group of 51 each. The control group implemented conventional health education, and the experimental group implemented FCEM health education through WeChat platform for 4 consecutive weeks. The Therapeutic Adherence Scale for Hypertensive Patients (TASHP) scores and blood pressure measurements were compared between and within the two groups. Results: After the intervention, there were significant differences in medication compliance and blood pressure between the two groups (P < 0.001). In the control group, before and after the intervention, there was a significant difference in medication compliance (P < 0.001), but no significant difference in blood pressure (P > 0.05). In the experimental group, there were significant differences in medication compliance and blood pressure before and after the intervention (P < 0.001). Conclusion: The FCEM health education through an online social platform significantly improved medication compliance and led to effective blood pressure control in rural elderly hypertensive patients. Therefore, as an effective, safe, and economical model, it is also necessary to explore its effectiveness in improving health problems in other chronic diseases and other age groups.

Evaluation of the Effectiveness of Community Pharmacy Services on Rational Medication Use in Elderly Patients with Hypertension and Diabetes

Objective:To explore the effect of community pharmacy services on rational medication use in elderly patients with hypertension and diabetes.Methods:Between November 2022 and December 2023,80 elderly patients with hypertension and diabetes were selected and randomly divided into a control group(routine medication guidance)and an observation group(community pharmacy services),with 40 subjects each.The medication effect scores,blood pressure,blood sugar levels,and quality of life scores before and after intervention were compared between the two groups.Results:Comparison of pharmaceutical knowledge,medication compliance,and safe medication behavior scores showed that the observation group had higher scores as compared to the control group(P<0.05);blood pressure(systolic blood pressure,diastolic blood pressure,heart rate)and blood sugar(fasting blood glucose,2 h postprandial blood glucose,glycated hemoglobin)index levels were compared,and the observation group’s index levels were lower than those of the control group(P<0.05);the scores of physical health,mental health,social relationships,and environment in the observation group were higher than those in the control group(P<0.05).Conclusion:Community pharmacy services improved the rational medication effect of elderly patients with hypertension and diabetes,and improved their blood pressure,blood sugar control levels,and quality of life.

Compliance to Medication Management and Mental Health Status of Elderly Hypertensive Patients: Basis of Educational Health Program

Objective:The study aimed to assess medication management compliance and mental health in elderly patients with hypertension.Method:The study evaluated medication compliance and mental health status of elderly hypertensive patients in China using simple random sampling.Data was collected using the Morisky Medication Compliance Questionnaire,Hospital Anxiety and Depression Scale,and a checklist.Ethical practices were strictly observed.Results:A study of 100 elderly hypertensive patients found poor drug management compliance,with female patients showing worse compliance.Female patients were more vulnerable to anxiety and depression.The study also found no significant association between gender,age,education level,marital status,living standards,and medication compliance.Barriers to medication management included food and daily necessities,lack of awareness about the importance of drug treatment,and basic family needs.The lowest-ranked barriers were lack of support from government health clinics,low income,and lack of family support.Conclusion:Based on the results,the study proposes an educational plan for elderly hypertensive patients and their families,to be evaluated and implemented by the hospital and township community service center.The plan aims to improve medication management and lifestyle modification compliance,encourage active participation,and provide access to medical and mental health clinics,support groups,and counseling services.

Application and Effect Evaluation of the Integrated“5A and 3+3”Management Model in the Safe Medication Use for Chemotherapy Patients

Objective:To explore the application and effect evaluation of the integrated“5A and 3+3”management model in ensuring safe medication use for chemotherapy patients.Methods:A total of 100 intravenous chemotherapy patients admitted to the oncology department of Shaanxi Provincial People’s Hospital were randomly divided into two groups using a random number list method.Both groups received conventional nursing management during chemotherapy,while the study group additionally received the integrated“5A and 3+3”safety management model.The nursing intervention effects between the two groups were compared.Results:After the intervention,the study group showed higher levels of self-management ability,compliance,and nursing satisfaction compared to the control group.The overall incidence of adverse events during hospitalization was lower in the study group,with statistically significant differences(P<0.05).The knowledge scores of medical staff in the study group,related to the prevention and treatment of chemotherapy drug side effects,daily symptom management,and daily life management,were higher than those in the control group,with statistically significant differences(P<0.05).Conclusion:Implementing the integrated“5A and 3+3”model in the safe medication management of intravenous chemotherapy patients can effectively enhance patients’self-management abilities and compliance,improve medical staff’s ability to safely administer chemotherapy drugs,reduce adverse events caused by chemotherapy,and increase patient satisfaction.

Self-Medication during Eye Affections among Consultant Patients at Chu-Iota

Introduction: According to the World Health Organization (WHO), self-medication consists in the fact that an individual resorts to a drug, on his own initiative or that of a loved one, with the aim of treating an ailment or a symptom that he identified himself without having recourse to a health professional. Self-medication involves the use of medicinal products by the consumer to treat self-recognized disorders or symptoms, or the intermittent or continued use of a medication prescribed by a physician for chronic or recurring diseases or symptoms. The aim of this study is to determine the different characteristics of ophthalmic self-medication at the CHU-IOTA. Patients and Method: We conducted a prospective study in patients of any age who resorted to ophthalmological self-medication before the first consultation or during the ophthalmological care of consulting patients at the CHU-IOTA between January 1 and July 31, 2021. Results: Over the period, 521 cases of ophthalmological self-medication were collected out of a total of 24,512 consultations, which corresponds to a frequency of 2.12%. The average age was 37.7 years, [2 months - 78]. The sex ratio was 0.50. Economic factors were the main factor mentioned, 66.79%. Corticosteroids accounted for 45.26% of the pharmacological class with dexamethasone/neomycin eye drops being the most widely used, i.e. 22.94%. The most common complication was corticosteroid-induced ocular hypertension on ametropia, i.e. 15.54%. Our patients were 68.13% educated. Among his educated patients 53.35% had no knowledge of the products. Conclusion: Given the harm associated with this practice, awareness and information campaigns aimed at the population, caregivers and pharmacists or pharmacy vendors are necessary in order to reduce the frequency of the practice of self-medication.

High Prevalence of Musculoskeletal Disorders and Self-Medication among Street Vendors in Bangui, Central African Republic (CAR)

Introduction: Musculoskeletal disorders (MSDs) are a set of peri-articular conditions that result mainly in pain and functional discomfort. They represent a major occupational health problem in all areas of activity. The objective of this work was to determine the prevalence of MSDs among street vendors in the city of Bangui in the Central African Republic (CAR). Methods: A cross-sectional study was conducted from September 01 to October 31, 2021 in Bangui, the capital of CAR. The study population consisted of street vendors which were included at the entrance of 4 large markets of Bangui after giving informed consent. The sample size, calculated according to the Schwartz formula, was 384. Sociodemographic data (age, gender, level of education, marital status), professional data (the duration of sale in hours, the distance traveled per day);and health data (the health problems suffered by itinerant sellers and the means of dealing with them) were collected using a pre-established self-questionnaire. This collected data was processed using Microsoft Excel 2013 and Epi-Info version 7 software. Results: Among 384 street vendors included, women represented a quarter (24.9%). The average age was 27 years;the 25-34 age group was the most represented (50%). About two-thirds (64.8%) sold for at least 12 hours and traveled more than 10 km (69.3%) per day. The main health problems reported by street vendors were musculoskeletal disorders (95.8%). Their locations concerned the upper limbs shoulder 65.36% (251), elbow 24.22% (93). Non-ergonomic postures that stress the back and joints all day long, causing pain are risk factors for MSDs. These MSDs were treated by self-medication with non-steroidal anti-inflammatory drugs (22.0%), mainly sold on the street. Conclusion: MSDs dominated the health problems of street vendors. These problems raise the need for recognition and support for these workers to optimize their performance while preserving their health through awareness and good management of MSDs whose chronicity generates a disability.

Prevalence and clinical implications of polypharmacy and potentially inappropriate medication in elderly patients with heart failure: results of six months' follow-up

OBJECTIVES To investigate the prevalence of polypharmacy and potentially inappropriate medication(PIM)in elderly patients with heart failure(HF)and their impact on readmission and mortality.METHODS We conducted a study of 274 participants aged 60 years or older with HF.The prevalence of polypharmacy(defined as the use of five or more medications)was calculated,and the 2019 American Geriatrics Society Beers criteria were applied to access PIMs.Medications and PIMs were characterized at admission and discharge,and changes in prescriptions during hospitalization were compared.The impact of polypharmacy and PIM on readmission and mortality were investigated.RESULTS The median age of this study population was 68 years old.The median number of prescribed drugs was 7 at admission and 10 at discharge.At discharge,99.27%of all patients were taking five or more drugs.The incidence of composite endpoint and cardiovascular readmission increased with the number of polypharmacy within 6 months.The use of guideline-directed medical therapy reduced the incidence of composite endpoint events and cardiovascular readmission,while the use of noncardiovascular medications increased the composite endpoint events.The frequency of PIMs was 93.79%at discharge.The incidence of composite endpoint events increased with the number of PIMs.“PIMs in older adults with caution”increased cardiovascular readmission and“PIMs based on kidney function”increased cardiovascular mortality.Several comorbidities were associated with cardiovascular mortality or non-cardiovascular readmission.CONCLUSIONS Polypharmacy and PIM were highly prevalent in elderly patients with HF,and their use was associated with an increased risk of composite endpoint events,readmission and mortality.Non-cardiovascular medications,“PIMs in older adults with caution”,“PIMs based on kidney function”and several comorbidities were important factors associated with hospital readmission and mortality.Our findings highlight the importance of medication optimization in the management of HF in elderly patients.

Assessment of knowledge,cultural beliefs,and behavior regarding medication safety among residents in Harbin,China

BACKGROUND Medication misuse or overuse is significantly associated with poor health outcomes.Information regarding the knowledge,cultural beliefs,and behavior about medication safety in the general population is important.AIM To conduct a survey on medication habits and explored the potential factors impacting medication safety.METHODS The current survey included adults from 18 districts and counties in Harbin,China.A questionnaire on medication safety was designed based on knowledge,cultural beliefs,and behavior.Both univariate and multivariate analyses were used to explore the factors that impacted medication safety.RESULTS A total of 394 respondents completed the questionnaires on medication safety.The mean scores for knowledge,cultural beliefs,and behavior about medication safety were 59.41±19.33,40.66±9.24,and 60.97±13.69,respectively.The medication knowledge score was affected by age(P=0.044),education(P<0.001),and working status(P=0.015).Moreover,the cultural beliefs score was significantly affected by education(P<0.001).Finally,education(P=0.003)and working status(P=0.011)significantly affected the behavior score.CONCLUSION The knowledge,cultural beliefs,and behavior about medication safety among the general population was moderate.Health education should be provisioned for the elderly,individuals with a low education level,and the unemployed to improve medication safety in Harbin,China.

Initial medication adherence in newly diagnosed glaucoma patients:three adherence measures

AIM:To determine initial medication adherence in newly diagnosed glaucoma patients treated with anti-glaucoma drugs.METHODS:This retrospective and observational study included all patients diagnosed with glaucoma in the Primary Health Care units in Portugal during the years 2012 and 2013,which in consequence received a first prescription for anti-glaucoma drugs.Data was collected from electronic prescribing records of the primary care units and from pharmacy claims records.Initiation of glaucoma treatment and early discontinuation were measured,and the combination of(non)-initiation and early discontinuation accounted for initial medication(non)-adherence.RESULTS:A total of 3548 new glaucoma patients(40.1%male;59.9%female)were included.The 1133(31.9%)patients were initially classified as non-users,since there was no pharmacy claim found for their first prescription for glaucoma treatment.Additionally,277(11.5%)patients early discontinued their treatment,acquiring only their first prescription.Overall,the initial medication non-adherence rate was 39.7%since 1410 patients either didn’t initiate treatment or discontinued it early.CONCLUSION:This study,reveals a major opportunity to improve glaucoma treatment and its control,since a large proportion of patients fail to engage with their prescribed therapy,which implies that implementation of individual or group strategies that enable patients with glaucoma to correctly perform their treatment is still needed.

基于Self-Attention-BiLSTM网络的西瓜种苗叶片氮磷钾含量高光谱检测方法

元素含量无损检测技术可以为植物生长发育的环境精准调控提供关键实时数据。以西瓜苗为例,提出了一种基于图谱特征融合的氮磷钾含量深度学习检测方法。首先,使用高光谱仪拍摄西瓜苗叶片的高光谱图像,使用连续流动化学分析仪测定叶片的3种元素含量。然后,采用基线偏移校正(BOC)叠加高斯平滑滤波(GF)的光谱预处理方法和随机森林算法(RF)建立预测模型,基于竞争性自适应重加权采样(CARS)和连续投影算法(SPA)2种算法初步筛选出特征波长,再综合考虑波长数和建模精度设计了一种最优波长评价方法,将波长数进一步减少到3~4个。最后,提取使用U-Net网络分割的彩色图像颜色和纹理特征,和光谱反射率特征一起作为输入,基于自注意力机制-双向长短时记忆(Self-Attention-BiLSTM)网络构建了3种元素含量的预测模型。实验结果表明,氮磷钾含量预测的R2分别为0.961、0.954、0.958,RMSE分别为0.294%、0.262%、0.196%,实现了很好的建模效果。使用该模型对另2个品种西瓜进行测试,R2超过0.899、RMSE小于0.498%,表明该模型具有很好的泛化性。该高光谱建模方法使用少量波长光谱即实现了高精度检测,在精度和效率上达成了很好的平衡,为后续便携式高光谱检测装备开发奠定了理论基础。