A brief review of exercise, bipolar disorder, and mechanistic pathways.

Despite evidence that exercise has been found to be effective in the treatment of depression, it is unclear whether these data can be extrapolated to bipolar disorder. Available evidence for bipolar disorder is scant, with no existing randomized controlled trials having tested the impact of exercise on depressive, manic or hypomanic symptomatology. Although exercise is often recommended in bipolar disorder, this is based on extrapolation from the unipolar literature, theory and clinical expertise and not empirical evidence. In addition, there are currently no available empirical data on program variables, with practical implications on frequency, intensity and type of exercise derived from unipolar depression studies. The aim of the current paper is to explore the relationship between exercise and bipolar disorder and potential mechanistic pathways. Given the high rate of medical co-morbidities experienced by people with bipolar disorder, it is possible that exercise is a potentially useful and important intervention with regard to general health benefits; however, further research is required to elucidate the impact of exercise on mood symptomology.

Motivational interviewing to explore culturally and linguistically diverse people's comorbidity medication self-efficacy

Aims and objectives: To examine the perceptions of a group of culturally and linguistically diverse participants with the comorbidities of diabetes, chronic kidney disease and cardiovascular disease to determine factors that influence their medication self-efficacy through the use of motivational interviewing. Background: These comorbidities are a global public health problem and their self-management is more difficult for culturally and linguistically diverse populations living in English-speaking communities. Few interventions have been tested in culturally and linguistically diverse people to improve their medication self-efficacy. Design: A series of motivational interviewing telephone calls were conducted in the intervention arm of a randomised controlled trial using interpreter services. Methods: Patients with these comorbidities aged ≥18 years of age whose preference it was to speak Greek, Italian or Vietnamese were recruited from nephrology outpatient clinics of two Australian metropolitan hospitals in 2009. Results: The average age of the 26 participants was 73·5 years. The fortnightly calls averaged 9·5 minutes. Thematic analysis revealed three core themes which were attitudes towards medication, having to take medication and impediments to chronic illness medication self-efficacy. A lack of knowledge about medications impeded confidence necessary for optimal disease self-management. Participants had limited access to resources to help them understand their medications. Conclusion: This work has highlighted communication gaps and barriers affecting medication self-efficacy in this group. Culturally sensitive interventions are required to ensure people of culturally and linguistically diverse backgrounds have the appropriate skills to self-manage their complex medical conditions. Relevance to clinical practice: Helping people to take their medications as prescribed is a key role for nurses to serve and protect the well-being of our increasingly multicultural communities. The use of interpreters in motivational interviewing requires careful planning and adequate resources for optimal outcomes.

Jurors' consideration of inadmissible evidence: A motivational explanation

Procedural justice research suggests that, as decision makers in a trial, jurors may be unwilling to disregard inadmissible evidence if they believe it will lead to a just outcome. In an experimental study, three hypotheses were tested: participants reading trial evidence while assuming the role of a juror (rather than observer) would report stronger motivations to protect the community; motivations to protect the community would be associated with higher conviction rates; and participants would be more likely to follow judicial instructions to disregard inadmissible evidence when they assumed an observer (rather than juror) role. Findings indicated that participants were more likely to convict the defendant when they experienced higher motivations to protect the community, reinforcing the importance of studying juror motivations. However, results revealed a complex pattern of factors affecting juror motivations as well as verdict decisions. Results are discussed in terms of the effectiveness of the curative instruction, and key directions for future research.

Comorbidity between depression and inflammatory bowel disease explained by immune-inflammatory, oxidative, and nitrosative stress; tryptophan catabolite; and gut–brain pathways

The nature of depression has recently been reconceptualized, being conceived as the clinical expression of activated immune-inflammatory, oxidative, and nitrosative stress (IO&NS) pathways, including tryptophan catabolite (TRYCAT), autoimmune, and gut–brain pathways. IO&NS pathways are similarly integral to the pathogenesis of inflammatory bowel disease (IBD). The increased depression prevalence in IBD associates with a lower quality of life and increased morbidity in IBD, highlighting the role of depression in modulating the pathophysiology of IBD.This review covers data within such a wider conceptualization that better explains the heightened co-occurrence of IBD and depression. Common IO&NS underpinning between both disorders is evidenced by increased pro-inflammatory cytokine levels, eg, interleukin-1 (IL-1) and tumor necrosis factor-α, IL-6 trans-signalling; Th-1- and Th-17-like responses; neopterin and soluble IL-2 receptor levels; positive acute phase reactants (haptoglobin and C-reactive protein); lowered levels of negative acute phase reactants (albumin, transferrin, zinc) and anti-inflammatory cytokines (IL-10 and transforming growth factor-β); increased O&NS with damage to lipids, proteinsm and DNA; increased production of nitric oxide (NO) and inducible NO synthase; lowered plasma tryptophan but increased TRYCAT levels; autoimmune responses; and increased bacterial translocation. As such, heightened IO&NS processes in depression overlap with the biological underpinnings of IBD, potentially explaining their increased co-occurrence. This supports the perspective that there is a spectrum of IO&NS disorders that includes depression, both as an emergent comorbidity and as a contributor to IO&NS processes. Such a frame of reference has treatment implications for IBD when “comorbid” with depression.

Pavements and pathways

A one-day interdisciplinary collaborative performance event exploring Mobility and the city. A Deakin-Monash collaboration in which project participants will engage in the interactive remapping of the City in a creative place-making event.

Shaping pathways to gambling consumption? An analysis of the promotion of gambling and non-gambling activities from gambling venues

Background: In Australia, venues which provide gambling activities also provide activities that are utilised by families and children. However, there has been limited theoretical or empirical discussion about whether engagement with non-gambling activities may play a role in shaping pathways to current or future engagement in gambling within these environments. We examined marketing tactics for non-gambling and gambling activities in Clubs. Using this data, we propose a conceptual model to test the role of non-gambling activities within gambling environments in shaping gambling attitudes and consumption intentions.

Methods: This study used a mixed method interpretive content analysis to review the marketing activities on the websites of a sample of 65 registered Clubs in New South Wales, Australia. We identified the extent and nature of techniques used to market gambling and non-gambling activities, particularly non-gambling activities directed towards families and children.

Results: Clubs use various marketing tactics to appeal to families and encourage parents to bring their children into venues. We hypothesise that marketing aimed at bringing children and families into gambling environments may play a role in shaping children’s and adults perceptions of these environments and may be influential in the development of a pathway that increases the likelihood that children will continue to visit these environments as adults, and subsequently the extent to which they engage in gambling later in life.

Conclusions: Future research should explore how the presence of family-friendly activities in Clubs and other venues with gambling activities may play a role in shaping future gambling attitudes and behaviours.

Translating person-centered care into practice: a comparative analysis of motivational interviewing, illness-integration support, and guided self-determination

OBJECTIVE: Person-centred care [PCC] can engage people in living well with a chronic condition. However, translating PCC into practice is challenging. We aimed to compare the translational potentials of three approaches: motivational interviewing [MI], illness integration support [IIS] and guided self-determination [GSD]. METHODS: Comparative analysis included eight components: (1) philosophical origin; (2) development in original clinical setting; (3) theoretical underpinnings; (4) overarching goal and supportive processes; (5) general principles, strategies or tools for engaging peoples; (6) health care professionals' background and training; (7) fidelity assessment; (8) reported effects. RESULTS: Although all approaches promoted autonomous motivation, they differed in other ways. Their original settings explain why IIS and GSD strive for life-illness integration, whereas MI focuses on managing ambivalence. IIS and GSD were based on grounded theories, and MI was intuitively developed. All apply processes and strategies to advance professionals' communication skills and engagement; GSD includes context-specific reflection sheets. All offer training programs; MI and GSD include fidelity tools. CONCLUSION: Each approach has a primary application: MI, when ambivalence threatens positive change; IIS, when integrating newly diagnosed chronic conditions; and GSD, when problem solving is difficult, or deadlocked. PRACTICE IMPLICATIONS: Professionals must critically consider the context in their choice of approach.

After 30 years of dissemination, have we achieved sustained practice change in motivational interviewing?

AIMS: Motivational interviewing (MI) is the most successfully disseminated evidence-based practice in the substance use disorder (SUD) treatment field. This systematic review considers two questions relevant to policymakers and service providers: (1) does training in MI achieve sustained practice change in clinicians delivering SUD treatment; and (2) do clinicians achieve a level of competence after training in MI that impacts upon client outcomes? METHODS: A systematic review was conducted and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, examining training outcomes for MI in the SUD treatment sector, and for clinicians working in a SUD treatment role. We determined a training method to have resulted in sustained practice change when over 75% of participants met beginning proficiency in MI spirit at a follow-up time-point. RESULTS: Of the 20 studies identified, 15 measured training at a follow-up time-point using standard fidelity measures. The proportion of clinicians who reached beginning proficiency was either reported or calculated for 11 of these studies. Only two studies met our criterion of 75% of clinicians achieving beginning proficiency in MI spirit after training. Of the 20 studies identified, two measured client substance use outcomes with mixed results. CONCLUSIONS: A broad range of training studies failed to achieve sustained practice change in MI according to our criteria. It is unlikely that 75% of clinicians can achieve beginning proficiency in MI spirit after training unless competency is benchmarked and monitored and training is ongoing. The impact of training on client outcomes requires future examination.

Considering the chemical energy requirements of the tri-n-propylamine co-reactant pathways for the judicious design of new electrogenerated chemiluminescence detection systems

The introduction of a 'co-reactant' was a critical step in the evolution of electrogenerated chemiluminescence (ECL) from a laboratory curiosity to a widely utilised detection system. In conjunction with a suitable electrochemiluminophore, the co-reactant enables generation of both the oxidised and reduced precursors to the emitting species at a single electrode potential, under the aqueous conditions required for most analytical applications. The most commonly used co-reactant is tri-n-propylamine (TPrA), which was developed for the classic tris(2,2'-bipyridine)ruthenium(ii) ECL reagent. New electrochemiluminophores such as cyclometalated iridium(iii) complexes are also evaluated with this co-reactant. However, attaining the excited states in these systems can require much greater energy than that of tris(2,2'-bipyridine)ruthenium(ii), which has implications for the co-reactant reaction pathways. In this tutorial review, we describe a simple graphical approach to characterise the energetically feasible ECL pathways with TPrA, as a useful tool for the development of new ECL detection systems.

It’s not all about language ability: motivational cultural intelligence matters in call center performance

his study focuses on the role of motivational cultural intelligence (CQ) in call center performance. Call centers mainly rely on verbal communication with language ability playing a significant role in delivery of tasks. This study argues that motivational CQ, or the interest and efficacy when interacting with individuals from culturally diverse backgrounds, plays a significant role in call center performance. This study was conducted in the Philippines, one of the top destinations for offshore services like call centers. Studies were conducted at two time points to determine the relationship between language ability, motivational CQ, and task performance. At Time 1, the language ability of 125 call center agent applicants was determined and assessed. At Time 2 which was conducted six months later, performance data were obtained and the level of the motivational CQ of the respondents measured. Results show that language ability is positively and significantly related to task performance. However, when motivational CQ was included, the relationship between language ability and task performance became non-significant, which conveys the full mediating role of motivational CQ in that relationship.

Muscle redox signalling pathways in exercise. Role of antioxidants

Recent research highlights the importance of redox signalling pathway activation by contraction-induced reactive oxygen species (ROS) and nitric oxide (NO) in normal exercise-related cellular and molecular adaptations in skeletal muscle. In this review, we discuss some potentially important redox signalling pathways in skeletal muscle that are involved in acute and chronic responses to contraction and exercise. Specifically, we discuss redox signalling implicated in skeletal muscle contraction force, mitochondrial biogenesis and antioxidant enzyme induction, glucose uptake and muscle hypertrophy. Furthermore, we review evidence investigating the impact of major exogenous antioxidants on these acute and chronic responses to exercise. Redox signalling pathways involved in adaptive responses in skeletal muscle to exercise are not clearly elucidated at present, and further research is required to better define important signalling pathways involved. Evidence of beneficial or detrimental effects of specific antioxidant compounds on exercise adaptations in muscle is similarly limited, particularly in human subjects. Future research is required to not only investigate effects of specific antioxidant compounds on skeletal muscle exercise adaptations, but also to better establish mechanisms of action of specific antioxidants in vivo. Although we feel it remains somewhat premature to make clear recommendations in relation to application of specific antioxidant compounds in different exercise settings, a bulk of evidence suggests that N-acetylcysteine (NAC) is ergogenic through its effects on maintenance of muscle force production during sustained fatiguing events. Nevertheless, a current lack of evidence from studies using performance tests representative of athletic competition and a potential for adverse effects with high doses (>70 mg/kg body mass) warrants caution in its use for performance enhancement. In addition, evidence implicates high dose vitamin C (1 g/day) and E (≥260 IU/day) supplementation in impairments to some skeletal muscle cellular adaptations to chronic exercise training. Thus, determining the utility of antioxidant supplementation in athletes likely requires a consideration of training and competition periodization cycles of athletes in addition to type, dose and duration of antioxidant supplementation.

Recovery pathways from small-scale disturbance in a temperate Australian seagrass

Recovery from disturbance is a key element of ecosystem persistence, and recovery can be influenced by large-scale regional differences and smaller local-scale variations in environmental conditions. Seagrass beds are an important yet threatened nearshore habitat and recover from disturbance by regrowth, vegetative extension and dispersive propagules. We described recovery pathways from small-scale disturbances in the seagrass Zostera nigricaulis in Port Phillip Bay, a large embayment in southeastern Australia, and tested whether these pathways differed between 5 regions with different hydrodynamic conditions and water quality, and between sites within those regions. Recovery pathways were broadly consistent. When aboveground biomass was removed, recovery, defined as the point at which disturbed areas converged with undisturbed controls, took from 2 to 8 mo, but when we removed above-and below-ground biomass, it took between 2 and 13 mo. There was no evidence of recovery resulting from sexual reproduction at any sites regardless of the presence of seeds in the sediment or flower production. We found no differences in recovery at the regional scale, but we found substantial differences between local sites. At some sites, rapid recovery occurred because seagrasses grew quickly, but at others, apparent recovery occurred because regrowth coincided with overall declines in cover of undisturbed areas. Recovery time was unrelated to seagrass canopy height, biomass, percentage cover, stem density, seed bank density, epiphyte cover or sediment organic matter in seagrass adjacent to disturbance experiments. This study highlights the importance of understanding fine-scale variation in local recovery mechanisms, which may override or obscure any regional signal.

Influence of base on nitro-aldol (Henry) reaction products for alternative clandestine pathways

Australian clandestine drug laboratories are constantly utilising alternative methods to produce methamphetamine, in part as restrictions are placed by Government on, for example, chemicals such as phenyl-2-propanone (P2P) (in the early 1980s), or on pseudoephedrine-containing pharmaceuticals, from the mid-2000s. This paper discusses the nitro-aldol reaction occurring between nitroethane and benzaldehyde, which can be utilised in a number of differing routes, in the presence of different bases. The resulting products, namely phenyl-2-nitropropene (P2P pathway) and 2-nitro-1-phenyl-1-propanol (ephedrine pathway) are directly dependant on which base is used; as such, the base may be used to provide an indication of a possible manufacture pathway of methamphetamine at a clandestine laboratory.