Medium-term prognosis of an incident cohort of parkinsonian patients compared to controls

Funding This work was supported by Parkinson's UK (grant numbers G0502, G0914), BMA Doris Hillier Award, the BUPA Foundation, NHS Grampian Endowments, RS MacDonald Trust.

Motivação para a Mudança em Doentes Alcoólicos

Este estudo tem como objectivo identificar os estádios de motivação em que se encontram os indivíduos com problemas relacionados com o álcool, quando se encontram internados para tratamento. Pretende-se ainda verificar se existe correlação entre o grau de dependência e o estádio em que se encontra o indivíduo. A população em estudo é composta por 40 indivíduos do sexo masculino, encontrando-se todos na primeira semana de tratamento. Para analisar a amostra, os instrumentos utilizados foram um questionário sóciodemográfico, o questionário AUDIT que avalia o grau de dependência alcoólica, e os questionários RCQ e o EEM que avalia os estádios de motivação para a mudança. Este é um estudo quantitativo descritivo correlacional. Os resultados obtidos foram de que os indivíduos se encontravam no estádio de contemplação e que o grau dependência influenciava o estádio de mudança dos mesmos. / The main goal of this study is to identify the motivation stage in which the individuals with alcohol related problems are, while they were hospitalized. We also aim to verify if there is a correlation between the dependency level and the individual’s stage. Our sample has 40 male individuals that were in the first week of treatment. In order to analyze this sample, we have used a socio-demographic questionnaire, the AUDIT, as a tool that assesses the level of alcohol dependency, the RCQ e o EEM that evaluates the motivation stages to change. This is a quantitative descriptive correlational study. As results were obtained that individuals were in the contemplation stage and the dependence level influenced the stage of change of the individuals.

Child Safety Signal Learning in the Context of Parental Worry, Overprotection, PTSD, and Depression

Thesis (Ph.D.)--University of Washington, 2016-08

Percepções de adolescentes usuários de drogas acerca da dependência química

Este estudo objetivou conhecer a percepção de adolescentes usuários de drogas atendidos no CAPS ad no município do Rio Grande acerca da dependência química.Tratou-se de uma pesquisa com abordagem qualitativa realizada no primeiro semestre de 2012 no CAPS ad do município do Rio Grande/ RS, com oito adolescentes usuários de drogas. Os dados foram coletados através de entrevistas semiestruturadas e analisados pelo método de Discurso do Sujeito Coletivo. Os dados do estudo mostraram que as principais causas apontadas pelos adolescentes para o início do uso de drogas foram à curiosidade, a imaturidade e a ingenuidade; a influência dos amigos e a vontade de pertencer a um grupo, de não ser diferente de seus pares; acharem que se muitos às utilizam estas devem ser boas; conviver com usuários de drogas no seu ambiente de consumo e a dificuldade de enfrentar perdas e a desestruturação familiar. Evidenciou-se que a droga apresenta-se como fonte de alívio para a tristeza e o desamparo sentido. As principais consequências do uso de drogas foram desgraça, tristeza e muitas coisas ruins; alguns se sentem fortes, poderosos e rebeldes, desestruturação familiar, interrupção do processo de escolarização e marginalização. Os principais fatores de risco para o uso de drogas na adolescência são a falta de informações, o não acreditar nos malefícios das drogas e nas consequências negativas destas em suas vidas, ver outro usuário falando ou consumindo a droga e conviver com usuários de drogas no seu ambiente de consumo, ser assediado por traficantes que lhes oferecem a droga e insistem para que a consumam, morar com uma família em que o uso de drogas está naturalizado, perceber a droga como uma coisa boa e fonte de alívio e vivenciar situações de raiva extrema e de perda de controle. Verificou-se como fatores de proteção a vontade de parar de usar drogas, a busca de ajuda por parte dos familiares, a existência dos Serviços de Atenção aos usuários, do Conselho Tutelar e do Juizado da Infância e da Adolescência. Verificou-se como Influência do vínculo familiar para o uso de drogas na adolescência a falta de atitude dos pais ao saberem do uso de drogas de seus filhos. Os familiares percebem que o adolescente está fazendo uso de drogas por seu aspecto físico e diante de suas atitudes agressivas. Muitos adolescentes convivem com o uso de drogas por seus familiares desde a infância. Possuem como expectativas e projetos de vida: retomar os estudos, arrumar um emprego e ter uma profissão, construir uma família, tornar-se motivo de orgulho para seus pais, mudar sua história de vida, realizar um tratamento e parar de usar drogas, se desintoxicar e se reinserir na sociedade, reconquistando a confiança e respeito das pessoas com quem convive, viver pelo menos até passar dos 18 anos de idade. concluiu-se que adolescência é uma etapa vulnerável, em que o jovem enfrenta mudanças pessoais, familiares e sociais. Dessa forma a família, professores e profissionais da saúde precisam saber como lidar com os conflitos vividos pelos adolescentes de forma a fornecer suporte com vistas a minimizá-los. O conhecimento construído com este estudo poderá nos possibilitar um novo olhar para os transtornos relacionados ao uso de drogas na adolescência, auxiliando na elaboração de estratégias de prevenção e tratamento mais efetivo.

The families and friends of heavy drinkers: Caught in the cross-fire of policy change?

INTRODUCTION AND AIMS: Research highlights the need to better understand the impact of alcohol-related harm on families and communities. Scottish policy initiatives to reduce alcohol consumption and alcohol-related harm include the planned introduction of a minimum unit price for alcohol. We aimed to explore existing and proposed changes in alcohol policy, from the standpoint of heavy drinkers, through accounts of their involvement and repercussions for family and friends. DESIGN AND METHODS: Interviews were conducted with 20 heavy drinkers, recruited from hospital alcohol treatment centres in Scotland's two largest cities. Participants were part of a larger longitudinal mixed methods study. Interviews explored experiences of alcohol-related harm and the impact, or potential impact, of alcohol policy changes on drinking patterns, risk-taking, consumption and wellbeing. Data coded for 'family and friends' were thematically analysed using a constant comparison method. RESULTS: Family and friends were portrayed as important for aiding moderation and abstinence, but more often for sustaining continued heavy drinking. Heavy drinkers with complex needs and those living in deprived communities suggested that increased alcohol prices could exacerbate the detrimental effect on their health and social circumstances, and that of their family, should their consumption remain excessive. DISCUSSION AND CONCLUSIONS: Population level policy initiatives to reduce alcohol consumption, such as minimum unit pricing, will impact on the families and social networks of heavy drinkers in addition to the drinker. The most vulnerable may be affected disproportionately. Alcohol policy changes and evaluations need to consider consequences for drinkers, families and communities. [O'May F, Whittaker A, Black H, Gill J. The families and friends of heavy drinkers: Caught in the cross-fire of policy change?

Alcoholism and coping strategies among IPB students

This study aimed to assess the alcohol consumption habits and the different coping strategies of a group of students from the Instituto Politécnico de Bragança - IPB (Polytechnic Institute of Bragança) with a sample made out of 126 of its students (n=126). For this study, which is descriptive-correlational and transversal, a socio-demographic questionnaire, the AUDIT (Alcohol Use Disorders Identification Test, Cunha 2002) and the Brief COPE questionnaire (Pais-Ribeiro, J. and Rodrigues, A. 2004) were used as evaluation instruments. Findings were that the majority of young students stated they do not have significant life problems, that they have good social supports and they do not consume alcohol in an inadequate way. Similarly, the coping strategies that they indicate as most frequent seem also to be the most adaptive, which may help to explain the fact that most do not perceive significant current problems and do not resort to alcohol in an inadequate way.

Avaliação das atividades anti-inflamatória, anticoagulante e antiproliferativa do inibidor de quimotripsina das sementes de erythrina velutina (EvCI)

Studies indicate that several components were isolated from medicinal plants, which have antibacterial, antifungal, antitumor and anti-inflammatory properties. Sepsis is characterized by a systemic inflammation which leads to the production of inflammatory mediators exacerbated by excessive activation of inflammatory cells and disseminated intravascular coagulation (DIC), in which the human neutrophil elastase plays an important role in its pathogenesis. Several epidemiological studies suggest that components of plants, especially legumes, can play a beneficial role in reducing the incidence of different cancers. A chymotrypsin inhibitor of Kunitz (Varela, 2010) was purified from seeds of Erythrina velutina (Mulungu) by fractionation with ammonium sulfate, affinity chromatography on Trypsin-Sepharose, Chymotrypsin-Sepharose and ion exchange chromatography on Resource Q 1 ml (GE Healthcare) in system FPLC / AKTA. The inhibitor, called EvCI, had a molecular mass of 17 kDa determined by SDS-PAGE. The purified protein was able to inhibit human neutrophil elastase (HNE), with an IC50 of 3.12 nM. The EvCI was able to inhibit both pathways of HNE release stimulated by PAF and fMLP (75.6% and 65% respectively). The inhibitor also inhibited leukocyte migration in septic mice about 87% and prolonged the time of coagulation and inhibition factor Xa. EvCI showed neither hemolytic activity nor cytotoxicity. EvCI showed a selective antiproliferative effect to HepG2 cell lines with IC50 of 0.5 micrograms per milliliter. These results suggest EvCI as a molecule antagonist of PAF / fMLP and a potential use in fighting inflammation related disorders, disseminated intravascular coagulation (DIC) and cancer

Absence of LPA1 receptor results in altered pattern of limbic activation after tail suspension test

Stress serves as an adaptive mechanism and helps organisms to cope with life-threatening situations. However, individual vulnerability to stress and dysregulation of this system may precipitate stress-related disorders such as depression. The neurobiological circuitry in charge of dealing with stressors has been widely studied in animal models. Recently our group has demonstrated a role for lysophosphatidic acid (LPA) through the LPA1 receptor in vulnerability to stress, in particular the lack of this receptor relates to robust decrease of adult hippocampal neurogenesis and induction of anxious and depressive states. Nevertheless, the specific abnormalities in the limbic circuit in reaction to stress remains unclear. The aim of this study is to examine the differences in the brain activation pattern in the presence or absence of LPA1 receptor after acute stress. For this purpose, we have studied the response of maLPA1-null male mice and normal wild type mice to an intense stressor: Tail Suspension Test. Activation induced by behaviour of brain regions involved in mood regulation was analysed by stereological quantification of c-Fos immunoreactive positive cells. We also conducted multidimensional scaling analysis in order to unravel coativation between structures. Our results revealed hyperactivity of stress-related structures such as amygdala and paraventricular nucleus of the hypothalamus in the knockout model and different patterns of coactivation in both genotypes using a multidimensional map. This data provides further evidence to the engagement of the LPA1 receptors in stress regulation and sheds light on different neural pathways under normal and vulnerability conditions that can lead to mood disorders.

Anti-apoptotic effects of phyllanthin against alcoholinduced liver cell death

Purpose: To evaluate the anti-apoptotic effect of phyllanthin on alcohol-induced liver cell death in HepG2 cells alone and in co-culture with human monocytic (THP-1) differentiated macrophage cells. Methods: Cell viability was determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The cells were pretreated with 1, 5 and 10 μM phyllanthin for 24 h followed by 1300 mM alcohol for HepG2 cells and 2000 mM alcohol for the co-cultured cells. Thereafter, intracellular reactive oxygen species (ROS), mitochondrial membrane potential (MMP) changes, apoptotic cell death and caspase-3/7 activities were assessed. Results: Alcohol exposure significantly increased intracellular ROS generation (p < 0.001), decreased MMP changes (p < 0.001), increased the number of apoptotic and necrotic cells (p < 0.001) and also induced higher caspase-3/7 activity (p < 0.001) in the co-culture with THP-1 differentiated macrophage cells than in HepG2 cells alone. Pretreatment of HepG2 cells and co-cultured cells with phyllanthin for 24 h prior to alcohol exposure significantly decreased intracellular production of ROS (p < 0.001) and also increased the change in MMP (p < 0.001) as well as caused a decrease in the number of apoptotic and necrotic cells (p < 0.001), but inhibited caspase-3/7 activity (p < 0.001). Conclusion: The results indicate that phyllanthin treatment may have a significant therapeutic effect on alcohol-related liver diseases.

Lost in translation? The potential psychobiotic Lactobacillus rhamnosus (JB-1) fails to modulate stress or cognitive performance in healthy male subjects

Background: Preclinical studies have identified certain probiotics as psychobiotics a live microorganisms with a potential mental health benefit. Lactobacillus rhamnosus (JB-1) has been shown to reduce stress-related behaviour, corticosterone release and alter central expression of GABA receptors in an anxious mouse strain. However, it is unclear if this single putative psychobiotic strain has psychotropic activity in humans. Consequently, we aimed to examine if these promising preclinical findings could be translated to healthy human volunteers. Objectives: To determine the impact of L. rhamnosus on stress-related behaviours, physiology, inflammatory response, cognitive performance and brain activity patterns in healthy male participants. An 8 week, randomized, placebo-controlled, cross-over design was employed. Twenty-nine healthy male volunteers participated. Participants completed self-report stress measures, cognitive assessments and resting electroencephalography (EEG). Plasma IL10, IL1β, IL6, IL8 and TNFα levels and whole blood Toll-like 4 (TLR-4) agonist-induced cytokine release were determined by multiplex ELISA. Salivary cortisol was determined by ELISA and subjective stress measures were assessed before, during and after a socially evaluated cold pressor test (SECPT). Results: There was no overall effect of probiotic treatment on measures of mood, anxiety, stress or sleep quality and no significant effect of probiotic over placebo on subjective stress measures, or the HPA response to the SECPT. Visuospatial memory performance, attention switching, rapid visual information processing, emotion recognition and associated EEG measures did not show improvement over placebo. No significant anti-inflammatory effects were seen as assessed by basal and stimulated cytokine levels. Conclusions: L. rhamnosus was not superior to placebo in modifying stress-related measures, HPA response, inflammation or cognitive performance in healthy male participants. These findings highlight the challenges associated with moving promising preclinical studies, conducted in an anxious mouse strain, to healthy human participants. Future interventional studies investigating the effect of this psychobiotic in populations with stress-related disorders are required.

Diageo's 'Stop Out of Control Drinking' campaign in Ireland: an analysis

Background: It has been argued that the alcohol industry uses corporate social responsibility activities to influence policy and undermine public health, and that every opportunity should be taken to scrutinise such activities. This study analyses a controversial Diageo-funded ‘responsible drinking’ campaign (“Stop out of Control Drinking”, or SOOCD) in Ireland. The study aims to identify how the campaign and its advisory board members frame and define (i) alcohol-related harms, and their causes, and (ii) possible solutions. Methods: Documentary analysis of SOOCD campaign material. This includes newspaper articles (n = 9), media interviews (n = 11), Facebook posts (n = 92), and Tweets (n = 340) produced by the campaign and by board members. All material was coded inductively, and a thematic analysis undertaken, with codes aggregated into sub-themes. Results: The SOOCD campaign utilises vague or self-defined concepts of ‘out of control’ and ‘moderate’ drinking, tending to present alcohol problems as behavioural rather than health issues. These are also unquantified with respect to actual drinking levels. It emphasises alcohol-related antisocial behaviour among young people, particularly young women. In discussing solutions to alcohol-related problems, it focuses on public opinion rather than on scientific evidence, and on educational approaches and information provision, misrepresenting these as effective. “Moderate drinking” is presented as a behavioural issue (“negative drinking behaviours”), rather than as a health issue. Conclusions: The ‘Stop Out of Control Drinking’ campaign frames alcohol problems and solutions in ways unfavourable to public health, and closely reflects other Diageo Corporate Social Responsibility (CSR) activity, as well as alcohol and tobacco industry strategies more generally. This framing, and in particular the framing of alcohol harms as a behavioural issue, with the implication that consumption should be guided only by self-defined limits, may not have been recognised by all board members. It suggests a need for awareness-raising efforts among the public, third sector and policymakers about alcohol industry strategies

Caractérisation du potentiel de champ locale dans le cortex préfrontal médian du rat durant le stress et la prise alimentaire

Le stress joue un rôle important dans le maintien de la qualité de vie quotidienne. Une exposition à une situation stressante peut causer divers désordres neuropsychiatriques du cerveau qui sont associés avec des problèmes liés au sommeil, à la dépression, à des problèmes digestifs et à des troubles de l’alimentation. Les traitements de ces troubles liés au stress sont très coûteux à travers le monde. De nos jours, des considérations importantes ont été soulevées afin de trouver des moyens appropriés pour la prévention plutôt que de dépenser ultérieurement plus de budget sur les traitements. De cette façon, l’étude et l’expérimentation sur les animaux des troubles liés au stress sont l’un des moyens les plus fiables pour atteindre une compréhension plus profonde des problèmes liés au stress. Ce projet visait à révéler la modulation des potentiels de champ locaux (LFP) lors de la consommation de sucrose dans deux conditions englobant la condition de contrôle non-stressante et celle stressante d’un choc électrique aiguë à la patte dans le cortex préfrontal médian (CPFm) du cerveau de rat. Le CPFm est une structure importante dans la réponse au stress et à l’anxiété par l’interaction avec l’axe hypothalamique-pituitaire surrénale (HPA). Les résultats de ce projet ont révélé que la plupart des coups de langue se sont produits dans les 15 premières minutes de l’accès à une solution de sucrose autant pour la condition contrôle non-stressante que pour la condition stressante. En outre, le stress aigu d’un choc à la patte affecte de manière significative la consommation horaire de sucrose en diminuant le volume de la consommation. Les résultats ont également révélé une présence importante du rythme thêta dans le CPFm pendant la condition de base et pendant l’ingestion de sucrose dans les deux conditions. De plus, les résultats ont montré une diminution de puissance des bandes delta et thêta lors des initiations de léchage du sucrose. Ce projet conduit à des informations détaillées sur les propriétés électrophysiologiques du cortex infra-limbique (IL) du CPFm en réponse à l’exposition à des conditions de stress et de l’apport d’une solution de sucrose. Ce projet permet également de mieux comprendre les mécanismes neurophysiologiques des neurones du CPFm en réponse à l’exposition à une condition stressante suivie d’apport de sucrose. Ce projet a également permis de confirmer les effets anorexigènes du stress et suggèrent également que la synchronisation neuronale dans le cortex IL peut jouer un rôle dans le comportement de léchage et sa désynchronisation pendant le léchage après une exposition à des conditions stressantes.