A Matter of Substance, April 2011

A publication of the IDPH Division of Behavioral Health to find out what's happening with Substance Abuse Prevention and Treatment.

A Matter of Substance, May 2011

A publication of the IDPH Division of Behavioral Health to find out what's happening with Substance Abuse Prevention and Treatment.

A Matter of Substance, June 2011

A publication of the IDPH Division of Behavioral Health to find out what's happening with Substance Abuse Prevention and Treatment.

A Matter of Substance, July 2011

A publication of the IDPH Division of Behavioral Health to find out what's happening with Substance Abuse Prevention and Treatment.

A Matter of Substance, August 2011

A publication of the IDPH Division of Behavioral Health to find out what's happening with Substance Abuse Prevention and Treatment.

A Matter of Substance, September 2011

A publication of the IDPH Division of Behavioral Health to find out what's happening with Substance Abuse Prevention and Treatment.

A Matter of Substance, October 2011

A publication of the IDPH Division of Behavioral Health to find out what's happening with Substance Abuse Prevention and Treatment.

A Matter of Substance, November 2011

A publication of the IDPH Division of Behavioral Health to find out what's happening with Substance Abuse Prevention and Treatment.

A Matter of Substance, December 2011

A publication of the IDPH Division of Behavioral Health to find out what's happening with Substance Abuse Prevention and Treatment.

A Matter of Substance, January 2012

A publication of the IDPH Division of Behavioral Health to find out what's happening with Substance Abuse Prevention and Treatment.

A Matter of Substance, February 2012

A publication of the IDPH Division of Behavioral Health to find out what's happening with Substance Abuse Prevention and Treatment.

The experience of transplantation for patients and their significant ones: A difficult encounter of two worlds

Objectives This paper reports on a longitudinal qualitative study exploring concerns of 60 patients before and after transplantation. Methods Semi-structured interviews were conducted without time constraints in a protected space out of the hospital. Qualitative analysis was performed. Results Prior to transplantation, all patients talked freely about negative feelings, stigmatisation, being misunderstood by others, loneliness and culpability caused by increasing physical dependency or abandoned roles. They mentioned alternative ways to cope (magic, spirituality), and even expressed their right to let go. In a subset of 13 patients, significant ones allowed themselves in the interview, or were integrated on the request of the patients. In this modified setting, two illness-worlds were confronted. If common themes were mentioned (e.g., modified life plans, restricted space, physical and psychological barriers), they were experienced differently. Fear of transplantation or guilt towards the donors was overtly expressed, often for the first time. Mutual hiding of anxiety in order to protect loved ones or to prevent loss of control was disclosed. The significant ones talked about accumulated stress and exhaustion related to the physical degradation of the patient, fear of the unpredictable evolution of illness and financial problems, and stressed their difficulty to adapt adequately to the fluctuating state of the patient. After transplantation, other themes emerged, where difficulty in disclosure was observed: intensive care and near death experiences, being a transplanted person, debt to the donor and his/her family, fear of rejection. Conclusions With the self-imposed strategy of hiding concerns to protect one another, a discrepancy between two illness-worlds was created. When concerns were confronted during the interviews, a new mutual understanding emerged. Patients and their families stated the need for sharing concerns in the course of illness.

For better or worse: Associations between the experience of negative life events and positive and negative sibling relationship characteristics

Using Dutch data (N = 6630), this article examines how sibling relationships (including full biological, half- and adopted siblings) differed for persons who experienced a negative life event (divorce, physical illness, psychological problems, addiction, problems with the law, victimization of abuse or financial problems) and those who did not. Results showed that people who experienced serious negative life events in the past often had less active, less supportive and more strained sibling ties. The group that experienced a physical illness formed an exception, showing more supportive and active sibling ties, but also higher levels of conflict. Results suggest inequality between persons who have experienced negative life events and those who have not in terms of access to positive and supportive sibling relationships.

A Matter of Substance, March 2012

A publication of the IDPH Division of Behavioral Health to find out what's happening with Substance Abuse Prevention and Treatment.

Training in hypoxia fails to further enhance endurance performance and lactate clearance in well-trained men and impairs glucose metabolism during prolonged exercise.

The aim of this study was to investigate the synergistic effects of endurance training and hypoxia on endurance performance in normoxic and hypoxic conditions (approximately 3000 m above sea level) as well as on lactate and glucose metabolism during prolonged exercise. For this purpose, 14 well-trained cyclists performed 12 training sessions in conditions of normobaric hypoxia (HYP group, n = 7) or normoxia (NOR group, n = 7) over 4 weeks. Before and after training, lactate and glucose turnover rates were measured by infusion of exogenous lactate and stable isotope tracers. Endurance performance was assessed during incremental tests performed in normoxia and hypoxia and a 40 km time trial performed in normoxia. After training, performance was similarly and significantly improved in the NOR and HYP groups (training, P < 0.001) in normoxic conditions. No further effect of hypoxic training was found on markers of endurance performance in hypoxia (training x hypoxia interaction, n.s.). In addition, training and hypoxia had no significant effect on lactate turnover rate. In contrast, there was a significant interaction of training and hypoxia (P < 0.05) on glucose metabolism, as follows: plasma insulin and glucose concentrations were significantly increased; glucose metabolic clearance rate was decreased; and the insulin to glucagon ratio was increased after training in the HYP group. In conclusion, our results show that, compared with training in normoxia, training in hypoxia has no further effect on endurance performance in both normoxic and hypoxic conditions or on lactate metabolic clearance rate. Additionally, these findings suggest that training in hypoxia impairs blood glucose regulation in endurance-trained subjects during exercise.