Cellular and molecular mechanisms involved in the neurotoxicity of opioid and psychostimulant drugs

Substance abuse and addiction are the most costly of all the neuropsychiatric disorders. In the last decades, much progress has been achieved in understanding the effects of the drugs of abuse in the brain. However, efficient treatments that prevent relapse have not been developed. Drug addiction is now considered a brain disease, because the abuse of drugs affects several brain functions. Neurological impairments observed in drug addicts may reflect drug-induced neuronal dysfunction and neurotoxicity. The drugs of abuse directly or indirectly affect neurotransmitter systems, particularly dopaminergic and glutamatergic neurons. This review explores the literature reporting cellular and molecular alterations reflecting the cytotoxicity induced by amphetamines, cocaine and opiates in neuronal systems. The neurotoxic effects of drugs of abuse are often associated with oxidative stress, mitochondrial dysfunction, apoptosis and inhibition of neurogenesis, among other mechanisms. Understanding the mechanisms that underlie brain dysfunction observed in drug-addicted individuals may contribute to improve the treatment of drug addiction, which may have social and economic consequences.http://www.sciencedirect.com/science/article/B6SYS-4S50K2J-1/1/7d11c902193bfa3f1f57030572f7034

Patient-Reported Outcome Measures for Abdominal Aortic Aneurysm: A systematic review and qualitative evidence synthesis

Background: The aim was to identify and evaluate existing patient reported outcome measures (PROMs) for use in patients with an abdominal aortic aneurysm (AAA) to inform the selection for use in surgical practice. Methods: Two systematic reviews were conducted: a systematic review to identify valid, reliable and acceptable PROMs for patients with AAA and a qualitative evidence synthesis to assess the relevance to patients of the identified PROMs items. PROMs studies were evaluated for their psychometric properties using established assessment criteria and their methodological quality using the COSMIN checklist. Qualitative studies were synthesised using framework analysis and identified concepts were then triangulated using a triangulation protocol with the item concepts of the identified PROMs. Results: Four PROMs from three studies were identified in the first review; the SF-36, the Australian Vascular Quality of Life Index, the AneurysmDQoL and AneurysmSRQ. None of the identified PROMs had undergone a rigorous psychometric evaluation within the AAA population. Four studies were included in the qualitative synthesis, from which 28 concepts important to patients with an AAA were identified. The AneurysmDQoL and the AneurysmSRQ together provided the most comprehensive assessment of these concepts. Fear of rupture, control, ability to forget about the condition and size of aneurysm were all concepts identified in the qualitative studies but not covered by items on the identified PROMs. Conclusion: Further research is needed to develop PROMs that are reliable, valid and acceptable to patients for use in surgical practice for AAA

Support needs of adolescents' post-cancer treatment: A systematic review.

INTRODUCTION: The study aimed to investigate the support needs for adolescents' post-cancer treatment. MATERIALS AND METHODS: A systematic literature review was conducted, articles were obtained from the following databases, Science Direct, PubMed and SCOPUS. Additional studies were identified from the reference lists of articles included in the review. RESULTS: 119 articles were identified as potentially relevant, of these, a total of 16 articles were nominated to be included in the review for analysis. CONCLUSION: The role of relationships and key workers were important to enabling survivors to self-manage. Studies have commended the role of friendships during the cancer treatment process but also as a means to coping with issues relating to survivorship. Using a coping mechanism thought to be beneficial by the survivor often improves their overall wellbeing. The eagerness to continue a normal successful life post-cancer treatment seems to be over-shadowed by the fear of not being able to conceive offspring. This, in turn, can impact the psychological wellbeing of survivors, thus signifying the need to develop ways in supporting these individuals. With research into quality of life (QoL) and survivorship issues continuing to progress and reach new heights, there is still much to be done

Physical activity interventions in children and young people with Type 1 diabetes mellitus: a systematic review with meta-analysis

Aims To synthesize evidence from randomized and non‐randomized studies of physical activity interventions in children and young people with Type 1 diabetes so as to explore clinically relevant health outcomes and inform the promotion of physical activity. Method We conducted a search of CINAHL Plus, the Cochrane Library, EMBASE, MEDLINE, PsycINFO, SCOPUS, SportDiscus and Web of Science between October and December 2012. Eligible articles included subjects aged ≤18 years with Type 1 diabetes and a physical activity intervention that was more than a one‐off activity session. Physiological, psychological, behavioural or social outcomes were those of interest. Results A total of 26 articles (10 randomized and 16 non‐randomized studies), published in the period 1964–2012, were reviewed. Although there was heterogeneity in study design, methods and reporting, 23 articles reported at least one significant beneficial health outcome at follow‐up. Meta‐analyses of these studies showed potential benefits of physical activity on HbA1c (11 studies, 345 participants, standardized mean difference ‐0.52, 95% CI ‐0.97 to ‐0.07; P = 0.02), BMI (four studies, 195 participants, standardized mean difference ‐0.41, 95% CI ‐0.70 to ‐0.12; P = 0.006) and triglycerides (five studies, 206 participants, standardized mean difference ‐0.70, 95% CI ‐1.25 to ‐0.14; P = 0.01).The largest effect size was for total cholesterol (five studies, 206 participants, standardized mean difference ‐0.91, 95% CI ‐1.66 to ‐0.17; P = 0.02). Conclusions Physical activity is important for diabetes management and has the potential to delay cardiovascular disease, but there is a lack of studies that are underpinned by psychological behaviour change theory, promoting sustained physical activity and exploring psychological outcomes. There remains a lack of knowledge of how to promote physical activity in people with Type 1 diabetes

Die implizite Sprachauffassung in ausgewählten Werken Hölderlins.

RESUMEN Worin besteht die Sprachauffassung Hölderlins? Diese Frage ist nicht neu. Auch liegen schon lange zahlreiche Antworten vor. Neu an der vorliegenden Arbeit ist aber, dass hier die Antwort nicht in den theoretischen Arbeiten Hölderlins über Poetologie bzw. Philosophie gesucht wird, wo man sie vernünftigerweise zuerst vermuten würde, denn das hat man auch schon zur Genüge gemacht, sondern hier wird sie in Hölderlins literarischer Praxis gesucht, in der manchmal unbewussten und manchmal bewussten Anwendung der Ausdrücke, die etwas mit dem Begriff 'Sprache' zu tun haben. Dementsprechend muss die vorige Frage d.h. die zentrale Frage, welche die vorliegende Arbeit leitet eingeschränkt und umformuliert werden: Welche Bausteine der hölderlinischen Ideologie zum Thema 'Sprache' können in seinen literarischen Texten aufgespürt werden? Im Schnittpunkt von Literatur und Linguistik wird versucht, anhand einer eingehenden Korpusanalyse den Begriff 'Sprache' bei Hölderlin zu untersuchen. Der Begriff wird nicht im Sinne der strukturalistischen semantischen Wortfelder erforscht das wäre eine linguistische Perspektive , sondern eher aus einer literaturwissenschaftlichkognitivistischen Perspektive, auf der Suche nach der transzendentalen Wichtigkeit des Sprechens und Schweigens bei Hölderlin, d.h. auf der Suche nach der Rolle der Sprache beim Aufbau seiner begrifflichen Weltanschauung, die besonders bei Hölderlin eine wesentliche Grundlage der Thematik und der rhetorischen Mittel seiner literarischen Texte darstellt. Die philosophische Seite dieses Punktes wird dabei außer Acht gelassen, denn die vorliegende Arbeit beschränkt sich zunächst auf die praktische Auslegung konkreter Texte und dann auf die Klassifizierung der daraus gewonnenen Ergebnisse. Daraufhin werden Schlussfolgerungen gezogen, die etwas mehr Licht auf die literarischen Motive der Texte Hölderlins werfen und das Endergebnis der vorliegenden Arbeit darstellen werden. Zusammenfassend kann man die vorliegende Arbeit durch folgende Merkmale charakterisieren: ● wissenschaftliche Grundlegung: Die bei der Analyse berücksichtigten literaturwissenschaftlichen und linguistischen Theorien werden zunächst erläutert und problematisiert. ● methodologische Strenge: Die Kontextualisierung wird strikt von der eigentlichen Analyse getrennt. Die Einführung in das für das Verständnis nötige Hintergrundwissen gehört nicht in dasselbe Kapitel wie die Korpusanalyse. Auf diese Weise lässt sich eine weniger arbiträre Auslegung der Texte erzielen. ● Analyse der in den Texten impliziten Bedeutungen: Die Texte dürfen diesmal sozusagen selbst zu Wort kommen. Im Englischen wird dieser Vorgang close reading genannt. ● linguistisch gestützte literaturwissenschaftliche Untersuchung: u.a. spielen die Theorie der Prototypen und die der Präsuppositionen eine wichtige Rolle bei der Analyse. ● Fokussierung auf die Sprachauffassung: Alle anderen Themen, Beziehungen und Wechselwirkungen werden wo möglich beiseite gelassen. Keine dieser Eigenschaften ist an sich neu, wie weiter unten ausgeführt wird. Neuartig ist aber, dass sie alle zugleich auf ein und dieselbe Studie angewandt werden. Das Ergebnis ist ebenfalls neuartig: Aus den Texten gehen bestimmte Vorstellungen hervor, die von einer Analyse herrühren, die mit linguistischer Gründlichkeit durchgeführt wurde. Die analysierten Textstellen werden nach den aus ihnen selbst gewonnenen Vorstellungen sortiert. Dann werden die verschiedenen Vorstellungen systematisch nach ihrer eigenen Beschaffenheit angeordnet, so dass eine begriffliche Konstellation, eine Sprachideologie ersichtlich wird, die als ein reines Destillat aus den literarischen Werken Hölderlins ohne Interferenzen durch textäußere Faktoren betrachtet werden darf und somit aus einer neuen Perspektive Aufschluss über die schon vielfach untersuchte Sprachauffassung Hölderlins gibt. _________________________________________________ _________________________________________________What does Hölderlin think about language? This dissertation doesn't look for the answer in Hölderlin's theoretical essays, but in his conscious or unconscious use of expressions that have something to do with the notion of language. Thus the former question, which is the lead aim of this dissertation, can be reformulated and specified as follows: Which elements of Hölderlin's ideology about language can be found in his literary texts? On a point of contact between Literature and Linguistics, Hölderlin's notion about language is analyzed on the base of a thorough corpus analysis. This notion isn't studied as a structuralistic semantic field, because that would be just a linguistic perspective, but it is studied from a literary and cognitivistic perspective, looking for the transcendental importance of speaking or of silence for Hölderlin, i.e. looking for the role that language plays in building his way of understandig life, which is for Hölderlin a central theme in his literary texts and also one of his fundamental rhetorical resources. The philosophical aspect of this issue has been left apart, for this dissertation just makes first of all a practical interpretation of the selected texts and afterwards the results are classified. The next step are the conclusions that allow to understand Hölderlin's literary themes a little bit better. And at that point this dissertation comes to an end

Dietary assessment in minority ethnic groups: A systematic review of portion size estimation instruments relevant for the UK

This is a pre-copyedited, author-produced PDF of an article accepted for publication in Nutrition Reviews following peer review. The version of record Almiron-Roig, E., Galloway, C., Aitken, A. & Ellahi., B. (2016). Dietary assessment in minority ethnic groups: A systematic review of portion size estimation instruments relevant for the UK. Nutrition Reviews, 75(3), 188-213. DOI: 10.1093/nutrit/nuw058 is available online at: https://academic.oup.com/nutritionreviews/article-lookup/doi/10.1093/nutrit/nuw058Context: Dietary assessment in minority ethnic groups is critical for surveillance programmes and for implementing effective interventions. A major challenge is the accurate estimation of portion sizes for traditional foods/dishes. Objective: To systematically review published records up to 2014 describing a portion size estimation element (PSEE) applicable to dietary assessment of UK-residing ethnic minorities. Data sources, selection, extraction: Electronic databases, internet sites, and theses repositories were searched generating 5683 titles from which 57 eligible full-text records were reviewed. Data analysis: Forty-two publications aimed at minority ethnic groups (n=20) or autochthonous populations (n=22) were included. The most common PSEE (47%) were combination tools (e.g. food models and portion size lists); followed by portion size lists in questionnaires/guides (19%); image-based and volumetric tools (17% each). Only 17% PSEE had been validated against weighed data. Conclusions: When developing ethnic-specific dietary assessment tools it is important to consider customary portion sizes by sex and age; traditional household utensil usage and population literacy levels. Combining multiple PSEE may increase accuracy but such tools need validating

Impact of HIV-related stigma on treatment adherence: systematic review and meta-synthesis

Introduction: Adherence to HIV antiretroviral therapy (ART) is a critical determinant of HIV-1 RNA viral suppression and health outcomes. It is generally accepted that HIV-related stigma is correlated with factors that may undermine ART adherence, but its relationship with ART adherence itself is not well established. We therefore undertook this review to systematically assess the relationship between HIV-related stigma and ART adherence. Methods: We searched nine electronic databases for published and unpublished literature, with no language restrictions. First we screened the titles and abstracts for studies that potentially contained data on ART adherence. Then we reviewed the full text of these studies to identify articles that reported data on the relationship between ART adherence and either HIV-related stigma or serostatus disclosure. We used the method of meta-synthesis to summarize the findings from the qualitative studies. Results: Our search protocol yielded 14,854 initial records. After eliminating duplicates and screening the titles and abstracts, we retrieved the full text of 960 journal articles, dissertations and unpublished conference abstracts for review. We included 75 studies conducted among 26,715 HIV-positive persons living in 32 countries worldwide, with less representation of work from Eastern Europe and Central Asia. Among the 34 qualitative studies, our meta-synthesis identified five distinct third-order labels through an inductive process that we categorized as themes and organized in a conceptual model spanning intrapersonal, interpersonal and structural levels. HIV-related stigma undermined ART adherence by compromising general psychological processes, such as adaptive coping and social support. We also identified psychological processes specific to HIV-positive persons driven by predominant stigmatizing attitudes and which undermined adherence, such as internalized stigma and concealment. Adaptive coping and social support were critical determinants of participants’ ability to overcome the structural and economic barriers associated with poverty in order to successfully adhere to ART. Among the 41 quantitative studies, 24 of 33 cross-sectional studies (71%) reported a positive finding between HIV stigma and ART non-adherence, while 6 of 7 longitudinal studies (86%) reported a null finding (Pearson's χ 2=7.7; p=0.005). Conclusions: We found that HIV-related stigma compromised participants’ abilities to successfully adhere to ART. Interventions to reduce stigma should target multiple levels of influence (intrapersonal, interpersonal and structural) in order to have maximum effectiveness on improving ART adherence

Widening participation in nurse education; an integrative literature review

Background: Widening participation into higher education is espoused within educational policy in the UK, and internationally, as a mechanism to promote equality and social mobility. As nurse education is located within higher education it has a responsibility to promote widening participation within pre-registration educational programmes. It could also be argued that the profession has a responsibility to promote equality to ensure its’ workforce is as diverse as possible in order to best address the health needs of diverse populations. Objectives: To undertake an integrative review on published papers exploring Widening Participation in undergraduate, pre-registration nurse education in the UK Design: A six step integrative review methodology was utilised, reviewing papers 2013-2016; published in English. Data sources: Search of CINAHL, Education Source, MEDLINE, PsychINFO, SocINDEX, Science Direct, Business Scource Complete, ERIC, British Library ETOS, Teacher Reference Centre, Informit Health Collection and Informit Humanities and Social Science Collection which highlighted 449 citations; from these 14 papers met the review inclusion criteria. Review methods: Both empirical studies and editorials focusing upon widening participation in pre-registration nurse education in the UK (2013-2016) were included. Papers excluded were non UK papers or papers not focussed upon widening participation in pre-registration nursing education. Research papers included in the review were assessed for quality using appropriate critical appraisal tools Results: 14 papers were included in the review; these were analysed thematically identifying four themes; knowledge and identification of WP, pedagogy and WP, attrition and retention and career prospects. Conclusions: Whilst widening participation is a key issue for both nurse education and the wider profession there is a lack of conceptualisation and focus regarding mechanisms to both encourage and support a wider diversity of entrant. Whilst there are some studies, these focus on particular individual widening participation groups rather than a wider strategic focus across the student lifecycle