Biomedical subjects

Jacques Tremblay

Publications and source records attributed to Jacques Tremblay.

7 recordsLinked to original sources

PubMed2007

Neurocognitive characteristics of DUI recidivists.

Individuals who drive under the influence (DUI) of alcohol may be at greater risk for neurocognitive impairment because of their exposure to multiple sources of neurological risk. This could contribute to the persistence of DUI behaviour and influence the effectiveness of remedial interventions. The objectives of this study were to clarify the neurocognitive characteristics of DUI recidivists and the nature of potential impairments, and to explore relationships between these characteristics and the frequency of past DUI convictions. One hundred male recidivists were evaluated for visuospatial constructional abilities and visual memory, verbal fluency, attention skills, cognitive flexibility, spatial planning, and verbal and movement inhibition. Results indicated that a majority of recidivists showed signs of neurocognitive impairment on several dimensions. Impairment was most marked on visuospatial constructional abilities and visual memory. In contrast to previous studies, no participants were found to have impulse control problems. Measures of memory and cognitive efficiency were significantly associated with the frequency of past convictions. Finally, exploratory analyses of two potential sources of impairment, alcohol exposure and head trauma, suggested the role of excessive alcohol use as the most obvious associated factor. Overall, the findings indicate that neurocognitive impairments are a common feature in recidivists and may contribute to DUI persistence. Development of a DUI-specific neurocognitive assessment and greater understanding of how neurocognitive status influences DUI risk could lead to remediation strategies better adapted to the individual characteristics of recidivists.

Adult↗

PubMed2006

[Clinical ethics in psychiatry: the experience at Douglas Hospital].

The authors present a brief overview of the clinical ethics committee within their mental health university institute as well as its evolving mandates over the past few decades. The main functions include case consultation, input on elaboration of institutional policy, and staff education as well as public information on issues of ethics and mental illness. With examples and questions brought to the committee's attention, the authors demonstrate how these functions are intertwined. The authors conclude that ethical questioning helps examine clinical practices and serves ultimately in guiding towards best practices in mental health.

Ethics Committees↗

PubMed2005

Salivary cortisol: a predictor of convictions for driving under the influence of alcohol?

AIMS: To examine the relationship between salivary cortisol and frequency of past driving under the influence of alcohol (DUI) convictions. METHODS: A total of 104 males with previous DUI convictions (from one to eight) and mean age of 44.7 years were assessed on measures characterizing repeat DUI offenders, including sociodemographic information, alcohol use behaviours, biological indices of the organic consequences of chronic abuse, negative consequences of excessive drinking, past DUI conviction history, impulse control, and antisocial behaviour tendencies. Saliva samples were taken approximately every 30 min over a 6 h period during an exhaustive multidimensional assessment protocol, and were then assayed to obtain cortisol responses. RESULTS: Blunted cortisol response, typically observed in alcoholics and in high-risk non-alcoholics, was associated with increased number of past DUI convictions. This association was particularly pronounced in multiple DUI offenders, and was stronger than, and independent of, other measures of alcohol use severity and chronicity commonly used for DUI assessment. CONCLUSIONS: Cortisol response may be useful in understanding the mediators underlying repeat DUI offending and the frequent failure of intervention efforts in curbing DUI behaviour.

Accidents, Traffic↗

PubMed2003

Randomization in a substance abuse treatment study: participants who consent vs those who do not.

OBJECTIVE: A mixed research design study compared patients who consented to treatment randomization with patients who opted for usual care. METHODS: Patients in substance abuse rehabilitation who consented to randomization (that is, consenting group [CG]) were compared with those unwilling to undergo randomization (that is, nonconsenting group [NG]) but who, nevertheless, underwent the experimental assessment sessions, which spanned from intake to 6-month follow-up. RESULTS: Patients in the CG exhibited a longer history of drug abuse, less occupational stability at intake, and following intensive treatment, tended not to do as well in terms of recovery, compared with those in the NG. CONCLUSION: Inclusion of data from partial participants in research protocols may offer a viable strategy to better appraise data generalizability.

Adult↗

PubMed2003

Telomerase can extend the proliferative capacity of human myoblasts, but does not lead to their immortalization.

Normal cells in culture display a limited capacity to divide and reach a non-proliferative state called cellular senescence. Spontaneous escape from senescence resulting in an indefinite life span is an exceptionally rare event for normal human cells and viral oncoproteins have been shown to extend the replicative life span but not to immortalize them. Telomere shortening has been proposed as a mitotic clock that regulates cellular senescence. Telomerase is capable of synthesizing telomere repeats onto chromosome ends to block telomere shortening and to maintain human fibroblasts in proliferation beyond their usual life span. However, the consequence of telomerase expression on the life span of human myoblasts and on their differentiation is unknown. In this study, the telomerase gene and the puromycin resistance gene were introduced into human satellite cells, which are the natural muscle precursors (myoblasts) in the adult and therefore, a target for cell-mediated gene therapy. Satellite cells expressing telomerase were selected, and the effects of the expression of the telomerase gene on proliferation, telomere length, and differentiation were investigated. Our results show that the telomerase-expressing cells are able to differentiate and to form multinucleated myotubes expressing mature muscle markers and do not form tumors in vivo. We also demonstrated that the expression of hTERT can extend the replicative life of muscle cells although these failed to undergo immortalization.

Cell Differentiation↗

PubMed2002

Process and outcome changes with relapse prevention versus 12-Step aftercare programs for substance abusers.

AIMS: Presumptive support was sought for mechanisms of action whereby two conceptually distinct aftercare programs, relapse prevention (RP) and 12-Step facilitation (TSF), impact upon substance abusers. PATIENTS AND DESIGN: Adults who had just completed intensive treatment were assigned randomly to either RP (n=61) or TSF (n=70) aftercare programs. SETTING: Three residential treatment facilities. INTERVENTIONS: Trained counselors delivered to small groups a manualized aftercare program which focused either upon the utilization of cognitive-behavioral processes to orchestrate change through an individualized treatment plan (i.e. RP) or which sought to facilitate utilization of AA's 12 Steps (i.e. TSF). MEASUREMENTS: Process measures developed specifically to quantify either: (a) the changes in self-efficacy process in RP or (b) the utilization of AA's principles in TSF, as well as psychosocial and substance abuse indices were administered to all patients pre- and post-aftercare and at 6-month follow-up. FINDINGS: A significant relationship between changes in measures of self- efficacy for RP participants as well as a trend for a relationship between process-specific change for TSF participants partially satisfied the first condition for presumptive support. The fact that the intervention-specific mediators covaried with several outcome indices, and that removal of such mediators attenuated prediction of outcome met, respectively, the second and third conditions for presumptive support. CONCLUSION: Carefully orchestrated RP and TSF aftercare programs yield process changes that are related positively to improved outcome.

Adult↗

PubMedDate not supplied

Matching substance abuse aftercare treatments to client characteristics.

This study investigated matching client attributes to different aftercare treatments. A naturalistic sample of adults entering substance abuse treatment was randomized into either Structured Relapse Prevention (RP, n=61) or a 12-Step Facilitation (TSF, n=72) aftercare program. Four patient attributes were matched to treatment: age, gender, substance abuse profile, and psychological status. Substance use outcomes were assessed 3 and 6 months posttreatment. At 6 months, four significant matches were uncovered. Females and individuals with a multiple substance abuse profile reported better alcohol outcomes with TSF aftercare than their cohorts exposed to RP aftercare. Individuals with high psychological distress at treatment entry were able to maintain longer periods of posttreatment abstinence with TSF aftercare compared to their cohorts exposed to RP. Inversely, RP was found to maintain abstinence significantly longer for individuals reporting low distress compared to those with high distress. Finally, better outcomes were achieved when random assignment to aftercare was consistent with participant preference. Overall, an Alcoholics Anonymous approach to aftercare appears to provide the most favorable substance use outcomes for most groups of substance abusers. RP may be most suitable for clients whose psychological distress is low, especially where maintenance of abstinence is targeted. Where choice in aftercare program is possible, matching client preference with type of aftercare program can improve outcome.

Adult↗