Knowledge, but not anxiety, predicted medication adherence [F (3,114) = 3.63, p=.015]. Results for staff-reported compliance emphasized the role of disease knowledge over anxiety in predicting adherence. The present data support the need to consider medical adherence as a multifaceted concept by demonstrating that anxiety is related to some aspects of renal disease management. Results also highlight the need for more sophisticated models to explain the influence of anxiety on adherence in patients with ESRD. Limitations of the present study, implications, and suggestions for future research are presented. Background: Recent studies of health care referrals among the under five children with high fever have indicated that incomplete treatment due unfulfilled referrals was the major reason for the children dying in the homes. Despite the Zambian government acknowledging malaria and fever as leading cause of morbidity and mortality among the under five children, the community behaviour and practices on care-giving at household level, have not been well documented. Identification of reasons that lead to an increased number of children dying in the homes is understudied. To try and understand risks and benefits of home management of fever a community qualitative study was conducted. Methods: Participants consisted of 10 caregivers whose children were 5 years and below old and had died in the community, 10 parents of children 5 years and below, who were admitted in the children's hospital with severe fever, survived and discharged from the hospital and went back home and 10 participants, whose children had fever and survived within the community 14 days prior to the commencement of the study. Questions were devoted to knowledge and attitudes about health seeking behaviour at household level. Knowledge about disease transmission, treatment and prevention, perceived risks of failure to take the child to health facility for early treatment and completion of referrals, were investigated. Results: Of the 30 key informants who participated in the study, 10 informants were of caregivers of children died before seeing the medical specialist. Majority of children (67.8%) were between 1 and 24 months old. Over 87 and 90 percent respectively were living with biological parents at the time of death. Caretakers from the three groups feared of losing their children if admitted in the children hospital (54.3% and 58.9%). Fear that their children would be exposed to other disease, lack of knowledge about the disease and referral, and lack of medicines in health facilities characterized demotivation for early access of quality care. Fees and transportation resulted in delay accessing health care outside the home and unfulfilled referrals. Medication non-adherence affects health outcomes in chronic illness. Only 50% of hypertensive patients adhere to prescribed medication (World Health Organization, 2004) . Depression has been considered one of the main psychosocial predictors of medication non-adherence (DiMatteo, Lepper & Croghan, 2000) . The psychological mechanisms that can explain this relationship remain uncertain. Objective: To evaluate the role of depression as a medication nonadherence factor in hypertensive patients and the possible psychological mechanism involved in this effect. Methods: 204 hypertensive patients (67.6 yrs old, 36.8% men) attending Primary Health Care Centers were evaluated in their regular visit to the cardiovascular program. All patients had over 1 year of pharmacological treatment for hypertension and had blood pressure over 140/90 mmHg in the last health control visit. Study variables included depression (POMSdepression scale), medication beliefs (Specific Beliefs about Medicine Questionnaire), and adherence to prescribed antihypertensive medication (Hill -Bone Medication Adherence Scale). Results: Depressive patients had a higher level of specific medication concerns than non-depressive patients (t=3,351, p<,001) . Multivariate linear regression shows that medication non-adherence is predicted by depression (B=.172, p<.01), and medication beliefs have a mediating role on this effect. Mediation effects were studied using Baron and Kenny's Criteria (1986) : depression predicted medication beliefs (B=−.304, p<.01); medication beliefs predicted non-adherence (B=−.442, p<.01) , and the predictive role of depression on non-adherence decreased when medication adherence was included in the regression equation (B=.012, p=.863). Conclusion: Our results confirm, in a sample of Chilean hypertensive patients, the effect of depression and beliefs about medicine over medication adherence and suggest that concerns about medication should be included in anti-depression psychotherapy for hypertensive patients. Background: This study compares and contrasts patient and provider perceptions of challenges and opportunities for patients on antiretroviral therapy (ART) in India. Methods: HIV patients (2 groups, n=8 women, 8 men) and HIV providers (n =18) were recruited from the Post Graduate Institute for Medical Education & Research (PGIMER) in Chandigarh, India to participate in focus group discussions (FGDs) and key informant interviews (KIIs). KIIs included HIV peers, treatment providers, NGO stakeholders and researchers. FGDs included experienced ART users, those new to ART and HIV treatment providers; interviews and groups used semi-structured stem questions. Transcriptions were coded based on conceptual relevance; codes were expanded for common themes and grouped into categories. Results: Provider interviews and groups reflected disparate perceptions regarding the relative importance of specific issues with respect to ART adherence, e.g., patient knowledge, karma, use of alternative medications. Providers agreed, in order of importance, that education, illiteracy, depression and alcohol and drug use negatively affect ART adherence; disagreed on the influence of income, gender and karma. Patients and providers agreed on the impact of HIV knowledge and alternative therapies (homeopathy, ayurveda, unani, yoga, reiki, astrology) . Patients expressed concern about food insecurity, stigma, side effects, clinic wait time, distance from clinics and the frequency of visits required. Though medications are no-cost, patients noted the hidden costs of blood tests, travel to clinics, and days missed from work at clinics. For longer term patients, discontinuing medication following remission of symptoms occurred. Enabling migrant and traveling workers to obtain ART during time away from home, social support, increased patient morale, positive attitudes about medication and patient provider communication were identified as key elements in enhancing adherence. Conclusions: Preliminary findings highlight the need for a patient -provider collaborative approach to ART provision and enhancing adherence. Future initiatives to encourage providers and stakeholders to collectively explore existing policies for ART provision will be proposed. This study is supported by NIH grant no. R21NR011131. Post-operative adherence rates among heart transplant (HT) patients remain lower than expected when considering the potential consequences, and these rates tend to decrease as more time passes following surgery. In the initial period after transplant older patients have higher rates of mortality and morbidity, but in the long-term some studies have suggested that older patients have better adjustment and quality of life compared to younger patients. The purpose of this study was: 1) to identify age differences in long-term adjustment to HT across a range of psychosocial adjustment measures, and 2) to examine other demographic and psychosocial predictors of overall adherence behavior. HT patients (n=555, mean age=54) from multiple centers were assessed 5-10 years post-surgery for adherence behaviors, psychological factors and physical symptoms. Analysis of variance results showed that older adults (age≥60) had better adjustment on measures of quality of life, satisfaction with social support, negative affect and disease-related stress compared to younger adults. Linear multiple regression demonstrated that age and several psychosocial factors, including depressive cognitions, accounted for 25.7% of the variance in self-reported difficulty with adherence. Similar variables were significant in a logistic regression analysis predicting which patients would have difficulty or no difficulty with adherence. Clinical implications are discussed in terms of tailoring interventions to age groups for optimal postoperative adjustment.