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PubMed1998

Brain dopamine transporter messenger RNA and binding sites in cocaine users: a postmortem study.

BACKGROUND: Results of recent radioligand binding experiments suggest that chronic cocaine exposure increases dopamine transporter (DAT) synthesis throughout the striatum of humans. However, detection of cocaine binding site increases in animals and humans has varied depending on the radioligand used. The present experiment tested the hypothesis in cocaine-using humans that synthesis of midbrain DAT messenger RNA increases parallel with increased striatal DAT binding sites. METHODS: Striatal and midbrain samples were collected during autopsy examination from human cocaine users (n = 34) and from age-, sex-, and race-matched control subjects (n = 36). Levels of DAT messenger RNA were quantified in the medial and lateral midbrain regions using in situ hybridization, and striatal DAT binding sites were assessed by quantitative autoradiography using the DAT-specific radioligand [3H]WIN 35428. RESULTS: Striatal DAT binding sites were markedly increased in cocaine users, but, paradoxically, medial DAT messenger RNA levels were decreased. CONCLUSION: Cocaine exposure has a marked effect on DAT function, but the mechanisms involved may be complex.

Adult↗

PubMed2003

Cognitive function in relation to hearing aid use.

Two experiments were conducted to investigate possible relationships between cognitive function and hearing aid use. In Experiment 1, 72 first-time hearing aid users were tested for speech recognition in noise (Hagerman sentence test) with and without hearing aids. Cognitive function was assessed by tests of working memory (reading span test) and verbal information-processing speed. The results indicate that, after controlling for age and hearing loss, significant correlations exist between the measures of cognitive performance and speech recognition in noise, both with and without hearing aids. High cognitive performance was associated with high performance in the speech recognition task. In Experiment 2, 17 first-time hearing aid users with either high or low working-memory capacity tested an experimental hearing aid which processed the sound differently depending on whether or not speech was detected. The results revealed that those with high working-memory capacity were better than those with low capacity at identifying and reporting the specific processing effects of the aid. This may have implications for how reported results should be interpreted in a research context, how a person's rehabilitation needs are formulated, and how hearing aid controls should be supervised. In conclusion, careful attention should be paid to the cognitive status of listeners, as it can have a significant influence on their ability to utilize their hearing aids.

Adult↗

PubMed1997

Cessation related perceptions and behavior of former and current smokeless tobacco users.

Four hundred fourteen former and 73 current users of smokeless tobacco were questioned about their experiences in giving up smokeless tobacco. Their responses were compared with those of 463 ex-smokers to determine whether former smokeless tobacco users differed from former smokers in using specific cessation techniques. Of the smokeless tobacco users, 77% were interested in quitting, but only 7% wanted to quit "now." Seven percent of the daily users reported that a college-based health or fitness professional had advised them to quit. Former smokeless tobacco users were significantly more likely than former smokers to report that smoking cigarettes was related to their efforts to give up smokeless tobacco than former smokers were to report using smokeless tobacco as a strategy to stop smoking, Former smokeless tobacco users were also significantly more likely than former smokers to report current tobacco use. Smokeless tobacco cessation programs based on the transtheoretical approach to behavior change are recommended.

Adult↗

PubMed2003

A Q-methodological study of hearing voices: a preliminary exploration of voice hearers' understanding of their experiences.

Using Q-methodology and structured interviews, this preliminary study set out to explore how a diverse range of voice hearers construed their experience of hearing voices. Following factor analysis of 20 completed Q-sorts, six factors emerged. Pejorative media stereotypes about voice hearers were rejected, and despite the dominance of the biomedical model in our culture, on no factor did participants adhere to all of the biomedical concepts. All six factors endorsed some elements of psychological discourse on voice-hearing experiences. It is argued that attempting to understand voice hearers within a single theoretical framework may limit or adversely affect engagement and understanding of an individual. Consistent with previous research, users of mental-health services were more likely to find voices frightening and perceive them as negative experiences than non-users. However, some non-users found managing some of their voices difficult despite having seemingly positive beliefs about the experience of hearing voices. Comment is made on the potential therapeutic implications of this study along with some acknowledgement of its limitations.

Adult↗

PubMed2004

Smokeless tobacco: an emerging addiction.

Smokeless tobacco (ST) use is an important health issue in the United States, and chronic use leads to significant morbidity. ST users are exposed to levels of nicotine comparable with smokers and experience symptoms of nicotine withdrawal when attempting to stop. Clinical treatment of ST users requires an understanding of the unique characteristics of ST. This article reviews ST products, epidemiology, pharmacology, health risks, and treatment approaches.

Humans↗

PubMedDate not supplied

Developing the theoretical basis for service user/survivor-led research and equal involvement in research.

AIMS AND METHODS: This article, written from a service user/survivor perspective, explores a hypothesis which seeks to offer a more systematic basis for the full and equal involvement of mental health service users/survivors in both the research process and research structures more generally. The hypothesis challenges traditional emphasis on positivist assumptions about the priority of values of 'distance', 'neutrality' and 'objectivity' (which it argues discriminate against service users and their experiential knowledge). It explores instead the idea that 'the shorter the distance between direct experience and its interpretation, then the less likely resulting knowledge is to be inaccurate, unreliable and distorted.' RESULTS AND CONCLUSIONS: The proposal discusses ways in which such (objective and subjective) distance may be reduced, to improve the quality of research, to enable more equal involvement of service users and their direct experience and to make it possible for non-service user researchers to work alongside service users on more equal terms.

Attitude to Health↗

PubMed2005

The intimate mediator: a carer's experience of Alzheimer's.

This research arose out of a collaboration between a service user (M) and two researchers. Following M's invitation to us to explore issues surrounding a carer's experience of Alzheimer's, we jointly agreed a research strategy in which we would engage in a series of interviews with M, with the aim of developing insight into how the intimate carer's complex journey can support and benefit other family caregivers faced with similar challenges. Using a broadly hermeneutic-phenomenological method, three essential themes emerged to describe the carer's journey: (i) something is wrong; (ii) the challenging shared journey: being the carer; (iii) coping through meaning-making: advocacy. We arrive at a position which considers the unique role of an intimate carer as a 'liminal' figure between the private world of an Alzheimer's sufferer and the public world of health and social care systems. The paper concludes with a consideration of how the unique role of the intimate carer as mediator could be more respectfully involved as an ongoing knowledge source for care planning and treatment decisions. Specific areas of consideration in this regard include mechanisms for such user involvement in policy making, day-to-day care delivery, and developments in the support of other carers. We hope to highlight the 'intimacy' of this position and the distinctive benefits and challenges of such intimacy in providing a crucial level of user knowledge and 'evidence' for ongoing treatment decisions. We also hope to highlight the value and power of single-case study in generating useful insights for practice.

Alzheimer Disease↗

PubMed2003

Perceptions and attitudes of clinical oncologists on complementary and alternative medicine: a nationwide survey in Japan.

BACKGROUND: The prevalence of complementary and alternative medicine (CAM) is increasing worldwide because of the growing public interest in natural or holistic therapies and because of the flow of information through the Internet. However, there is a lack of communication between cancer patients and their physicians on topics relating to CAM. The authors performed a cross-sectional survey to evaluate the perceptions and attitudes of Japanese clinical oncologists toward cancer CAM. METHODS: The CAM questionnaires were sent to 2118 clinical oncologists. The questionnaires gathered data on background (age, gender, years in practice, specialty, and knowledge of cancer CAM), perception (effectiveness/ineffectiveness, scientific evidence, and drug interactions), and attitude (experience with and response to CAM users). Questions about oncologists' perceptions and attitudes to CAM were limited to herbs and other natural products that were sold over the counter. RESULTS: One hundred sixty-six questionnaires were returned as undeliverable. Of the remaining questionnaires, 751 were returned (a response rate of 39%). Two-thirds of the responders were surgical oncologists and most of the remaining responders were medical oncologists. The majority of oncologists (82%) believed that CAM products were ineffective against cancer. The main reason for this belief was a lack of reliable information (as cited by 85% of oncologists). Only 13% of oncologists had experienced CAM-associated disease improvement in their cancer patients. Of all the oncologists, 84% considered the possibility of drug interactions between anticancer drugs and CAM products. The majority of oncologists (80%) replied that they could neither promote the use of CAM products nor recommend quitting the products, when they were asked about the use of CAM products by cancer patients. CONCLUSIONS: Negative perceptions of CAM products persist among clinical oncologists. A lack of proven effectiveness of CAM products and concerns about drug interactions with anticancer treatment suggest a need for both accurate information on CAM products and clinical trials.

Attitude of Health Personnel↗

PubMed2005

Misconceptions and realities about teaching online.

This article is intended to guide online course developers and teachers. A brief review of the literature on the misconceptions of beginning online teachers reveals that most accept the notion that putting one's lecture notes online produces effective learning, or that technology will make education more convenient and cost-effective for all concerned. Effective online learning requires a high level of responsibility for learning on the part of students and a reduction of the teacher-student power differential. This, in turn, has major implications for faculty and course development, student selection criteria, the cost of instruction, and the outcomes of education. Effective online teaching focuses on processes of learning rather than outcomes, and is consistent with modern principles of learning that emphasize focusing on issues of high interest to learners, teaching students to use skills of active and effective learning, providing prompt feedback, and enabling students to establish learning goals and employ alternative paths to achieving those goals. Multiple ways of operationalizing these goals online are presented. Tips are offered concerning selection of students who are capable of benefiting from the online experience, developing curriculum that is user-friendly, using resources that stimulate good writing and critical thinking, and limiting class size to a manageable number.

Computer-Assisted Instruction↗

PubMed1996

An evaluation of road crash injury severity measures.

Reliable and consistent measures of injury severity are necessary for the study of environmental, crash and personal factors involved in road traffic crashes. This study was designed to evaluate measures of injury severity derived from computerized hospital discharge records, using 3609 road crash casualties admitted to hospital in Western Australia in 1988. External cause of injury codes were used to identify injuries from road traffic crashes. The ICDMAP software was used to convert the diagnosis codes into Abbreviated Injury Scale (AIS) scores for each body region. The maximum AIS values were derived using (1) all 12 diagnosis codes; (2) the first six diagnosis codes; and (3) the principal diagnosis code alone. Other measures of injury severity evaluated were the number of body regions with at least one injury; the number of regions with Abbreviated Injury Severity score of three or more; and total number of days spent in hospital. Discriminant analysis suggested that the AIS could be separated into minor and major injuries at a score of three and the Injury Severity Score at a score of nine. The measures derived from the AIS were all strongly correlated with each other and with the length of hospital stay and the dichotomized values gave similar results to the other scores when used in regression analyses of the injury experience of different types of road users. It was concluded that measures incorporating elements of both severity and number of injuries were preferable but length of hospital stay would be a suitable proxy if no other injury information was available.

Accidents, Traffic↗

PubMed1983

Five years' experience of intrauterine contraception with the Nova-T and the Copper-T-200.

A randomized study was performed for the comparison of two copper-releasing intrauterine contraceptive devices (IUDs), the Nova-T and the Copper-T-200, simultaneously in Denmark, Finland, and Sweden. Five years' experience demonstrated that Nova-T users had a significantly lower pregnancy rate than Copper-T-200 users. The Pearl index over 5 years was 0.8 for Nova-T users and 2.0 for Copper-T users. The performance and tolerance of the Nova-T were less affected by parity and age than was the performance of the Copper-T. Infections were treated by removal of the device and with antibiotics. The cumulative rate of removals because of infections and suspected infections was below 5 with both devices over 5 years. The copper wire in the Nova-T has a silver core which prevents corrosion-induced fragmentation of the wire. Hence, the effective lifetime of this device is more than 5 years. The results indicate that the Nova-T, which is easy to insert and remove and is associated with a low pregnancy rate and a low medical termination rate, is a real improvement over other IUDs.

Adult↗

PubMed1995

Human posture in microgravity: an experiment on EUROMIR '95 to verify and improve a simulation tool.

An anthropometric mannequin implemented in robotic modelling software has proved very useful in the simulation of static and semi-dynamic reachability envelopes. Its prediction of working postures has been verified to some extent during neutral buoyancy trials. While a robotic solution is useful for static analyses or rough estimates of simple movements, more realistic movement strategies need to be identified directly measuring astronauts' in-orbit behaviour. A set of experiments is to be performed as part of the EUROMIR '95 mission to the MIR orbiting station in which dynamic posture (i.e. posture and movement) measurements will be taken using the ELITE system. The data and analyses of the data will be used to animate the Alenia anthropometric mannequin and to develop movement algorithms more similar to those of a person in microgravity than the robotic solutions currently employed. This paper presents the experiments to be performed and the changes to Alenia's mannequin that will allow the model to effect movements according to the experimental results. It is aimed at expanding the dialog between the biomechanical and human factors disciplines started in this experiment to other potential end-users of the experimental results.

Adaptation, Physiological↗

PubMed1996

Psychoactive constituents of the genus Sceletium N.E.Br. and other Mesembryanthemaceae: a review.

The use by the Khoisan of South Africa of Sceletium plants in psychoactive preparations has often been alluded to in the literature. However, much of it is fragmentary and contradictory. The current review reassembles the historical data recorded over a 300-year period, describes techniques for the preparation and use of "kougoed' from plants of Sceletium and documents the subjective experiences of a number of contemporary users. Apart from chewing the dried product, after "fermentation', there are reports of uses as tinctures for sedation and analgesia, chewing the material directly and smoking the residue after chewing. The symbolic connections of Sceletium with eland antelopes, the "trance animals' par excellence of the San hunter-gatherers is noted. Observations by Paterson (1789) and reports of contemporary users indicate a synergism and potentiation with smoked Cannabis. There is no evidence to support the view that "kougoed' or Sceletium alkaloids are hallucinogenic. The alkaloid distribution in Sceletium and other members of the family Mesembryanthemaceae are considered. Chemical studies have indicated as many as nine alkaloids in Sceletium which fall into three distinct structural categories. Mesembrine, the alkaloid first isolated and named is not the dominant constituent of plants and is weakly narcotic. Evidence is assembled to suggest that traditional and contemporary methods of preparation serve to reduce levels of potentially harmful oxalates, which are found in Sceletium and other Mesembryanthemaceae. It is concluded that there is a need for further pharmacological studies on these alkaloids, based on their narcotic-anxiolytic properties, strong synergism with other psychomimetics, moderate toxicity and anti-cancer activity.

Alkaloids↗

PubMed2004

Defining a never-smoker: results from the nonsmokers survey.

The U.S. Centers for Disease Control defines a never-smoker as someone who has smoked < 100 cigarettes per lifetime. In an attempt to explore differences among nonsmokers and to validate this cutpoint, we surveyed 69 nonsmokers who had smoked between 1 and 200 cigarettes in their lifetime on their experiences during the time they smoked. Of the 7 who classified themselves as ex-smokers, 2 met DSM-IV criteria for nicotine dependence, compared with none who classified themselves as never-smokers. No respondents provided data permitting the computation of a Fagerstrom Test for Nicotine Dependence (FTND) score. Withdrawal effects were minimal, but craving, tolerance, and subjective effects showed a pattern of significant differences that were most prominent between those who smoked only 1 cigarette and those who smoked at least a pack. Our data indicate a graded effect but also suggest that 19 cigarettes per lifetime is a more conservative cutpoint than 99 for defining the never-smoker phenotype. Further investigation of the smoking trajectory and characteristics associated with development of signs of dependence in never- vs. ever-smokers may help refine this cutpoint and shed light on what protects some people who experiment with smoking from becoming chronic users.

Adult↗

PubMed2006

Deposition of cannabinoids in hair after long-term use of cannabis.

Hair analysis has shown great potential in the detection and control of drug use. Whether an assay is of quantitative value roughly corresponding to the amount of drug consumed, is still a matter of debate. The present investigation was aimed at a possible relationship between the cannabinoid concentration in hair and the cumulative dose in regular users of cannabis. Hair samples from the vertex region of the scalp were obtained from 12 male regular users of cannabis, and 10 male subjects with no experience of cannabis served as controls. None of the subjects had his hair permed, bleached or colored. Cannabis users provided information on drug use such as the current cannabis dose per day, the cumulative cannabis dose of the last 3 months, as well as the frequency of cannabis use during the last year. The concentration of delta-9-tetrahydrocannabinol (THC), cannabinol (CBN) and cannabidiol (CBD) in hair was determined using gas chromatography-mass spectrometry. Cannabinoids were present in any hair sample of cannabis users, but were not detectable in control specimens. An increase in the amount of cannabinoids in hair with increasing dose was evident. The concentration of major cannabinoids (sum of THC, CBD and CBN) was significantly correlated to either the reported cumulative cannabis dose during the last 3 months or to the cannabis use during the last 3 months estimated from the daily dose and the frequency per year (r=0.68 or 0.71, p=0.023 or 0.014). A significant relationship between THC and the amount of cannabis used could not be established. As a conclusion, the sum of major cannabinoids in hair of regular users may provide a better measure of drug use than THC.

Adult↗

PubMed2006

Development of a harmonised method for the profiling of amphetamines VI: Evaluation of methods for comparison of amphetamine.

Amphetamine samples were analysed by gas chromatography-mass spectrometry (GC-MS), and the peak areas of 33 target compounds were transformed by applying various pretreatment techniques. The objective was to optimise the ability of a number of distance metrics to establish links between samples of amphetamine originating from the same batch (henceforth referred to as linked distances). Furthermore, partial least squares discriminant analysis (PLS-DA) was used to evaluate the effects of various pretreatment methods on separation of amphetamine batches synthesised by the Leuckart reaction, reductive amination of benzyl methyl ketone, and the nitrostyrene route. The most efficient way to pretreat GC-MS data varied for the different distance metrics, although best results were obtained when data were normalised to the sum of peak areas, and either the fourth root or a logarithm was applied to the normalised data. When pretreating normalised data by fourth root transformation, Pearson correlation was the distance metric that was most successful at finding linked samples. Normalisation and the use of fourth root also represented the best method of pretreating data when employing PLS-DA to separate samples synthesised by different routes. To achieve a faster and more user-friendly procedure for evaluating chromatograms, experiments were performed in which the number of target compounds used to compare samples was reduced. The effect of each compound that was removed was studied by applying PLS-DA and by using Pearson correlation to calculate linked distances as well as unlinked distances (between samples from different batches of amphetamine). Considering both links between samples from the same batch and separation of samples synthesised by different routes, the best results were obtained with the data set comprising 26 compounds. Finally, it was found that the profiling method developed in this work was superior to an existing technique with respect to separating linked and unlinked distances.

Journal Article↗

PubMed2006

Herbal medicine and treatment of diabetes in Africa: an example from Guinea.

AIM: Use of medicinal plants is widespread in Africa, particularly in Guinea where oral transmission of practices is part of the social ritual. The purpose of this study was to determine the proportion of diabetic patients who use herbal medicine and identify the types of plants in use. Reasons for using herbal medicine and the formulations employed were also noted. METHODS: A questionnaire on use of herbal medicine was proposed to all diabetic patients hospitalized or consulting the Endocrinology Unit of the Conakry University Hospital between April 1 and June 30, 2003. RESULTS: A total of 397 patients responded; 33% declared they used herbal medicine. They proposed many motivations, sometimes in association: belief in its efficacy (74%), easy access to medicinal plants (70%), lower cost (48%), and search for complete cure of diabetes (37%). Hearing about a positive experience had convinced 78% of the users to use herbal medicine. The majority of the users were satisfied (85%). One or more clinical manifestations occurring concomitantly with use of herbs was observed in 23 patients (18%), particularly gastrointestinal disorders (n = 10) and skin problems (n = 8). Two cases of hypoglycaemia were noted. CONCLUSION: Herbal medicine plays an important role in anti-diabetes treatment in Guinea. This type of treatment should be based on scientific evidence but very few studies have been conducted. Conditions of use should be better defined and patients should be informed of potential adverse effects.

Adult↗

PubMed2001

Association between heroin use, needle sharing and tattoos received in prison with hepatitis B and C positivity among street-recruited injecting drug users in New Mexico, USA.

This study aimed to assess the seroprevalence and risk factors for hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV-1 infections among injecting drug users (IDU) in New Mexico. Serological and behavioural surveys were conducted in conjunction with street-based outreach, education and HIV counselling and testing. High rates of antibody positivity for HCV (82.2%) and HBV (61.1%), and a low rate for HIV (0.5%) were found. In multivariate analyses, both HBV and HCV infection were positively associated with increasing age, increasing years of injection and heroin use. Receipt of a tattoo in prison/jail was associated with HBV (odds ratio = 2.3, 95% confidence interval 1.4, 3.8) and HCV (OR = 3.4, 95% CI = 1.6, 7.5) infections. Prevention of bloodborne pathogens among IDUs should focus on young users, early in their drug use experience. Studies examining the relationship between tattooing and HBV and HCV infection are needed as are efforts to promote sterile tattooing, in prisons and elsewhere.

Adolescent↗