The investigation of exercise as an adjunct to the treatment and rehabilitation of the problem drinker

The effects of undertaking a three week supervised exercise programme followed by a twelve week home based exercise programme, were investigated with adults in an abstinence treatment programme within four alcohol problem clinics. A randomised experimental design was used with physiological and psychological variables being measured at baseline, on entry to the programme, at 1 month, following the intervention programme and then at time points from baseline at 2 months and 5 months. Recruitment to the study of 165 subjects exceeded expectation. Of these 117 completed the first stage with 61 in the exercise group (n-46 male: n=15 female) and 56 in the placebo control group (n=43 male n=13 female). The findings of this study indicate that the inclusion of a three week programme of exercise in an abstinence rehabilitation programme improves fitness, strength, physical activity and physical self-perceptions and that these improvements are maintained for a further month by undertaking a home based exercise programme. At five months however, only improved fitness is maintained. There is no evidence that exercise can be linked to maintaining abstinence levels. Under reporting of drinking behaviour was high. At two months 27% and at 5 months 35% of those identified by the CDT blood test as drinking, at levels associated with relapse, self reported abstinence or low levels of alcohol intake. These findings have clinical relevance to physiotherapists and other health care professionals, as they indicate that problem drinkers have low aerobic fitness and low self perceptions. Inclusion of a three week programme designed to improve fitness and strength, followed by a home based programme, may be beneficial in improving these parameters with the possibility of increasing physical activity

Descriptors and accounts of alcohol consumption:methodological issues piloted with female undergraduate drinkers in Scotland

Excessive drinking among young women continues to attract adverse media attention and is the target of UK government-led initiatives. Reliable research on alcohol consumption is needed to inform/evaluate public health interventions. This pilot study, investigating descriptors of alcohol drinking in female Scottish undergraduate students, comprised: (i) self-completed questionnaire survey (n=95); (ii) interview plus test pouring of a ‘drink’ (n=19). Self-reports by 70% of drinkers (n=90) indicated alcohol consumption for the ‘week past’ meriting classification as ‘binge’ drinking, and 83% of this group reported drinking in this fashion at least fortnightly. However, binge-drinking may be under-estimated, since poured drinks were measured to be on average double the alcohol content for a standard drink, drinking often occurred outwith licensed premises, and respondents preferred to quantify consumption in (fractions of) bottles, rather than glasses. Qualitative analysis showed that interviewees oriented to drinking as an accountable practice but were unaware of the clinical definition of binge drinking. They defined it in terms of the effect of alcohol consumed on individual behaviour, not in absolute quantities. Given the unreliability of self-reported consumption, future health surveys and initiatives should consider ‘quantifying’ alcohol in a way more meaningful to the population of interest, in terms of effect

A protocol for the development of professional competencies: the SPA Project

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Report submitted to ScotMid Co-operative Society 'Recall, understanding and responses to the 'Sensible Drinking message' among supermarket shoppers in Scotland'.

EdinburghThis study was conducted with the following general aims; - To investigate the feasibility of carrying out a questionnaire-based study dealing with issues relating to alcohol drinking within the supermarket setting. - To document awareness and recall of the UK 'Sensible Drinking' message among shoppers. - To investigate the perceived usefulness of the message and the ability to apply knowledge to personal drinking. - To monitor awareness of, and response to, the initiative by the Co-operative Society to promote the 'Sensible Drinking' message on wine labels. - To distribute and monitor reaction to 'Sensible Drinking 'guidance literature.sch_diesubmitted506submitte

White matter abnormalities in methcathinone abusers with an extrapyramidal syndrome

Funding Information: National Institute for Health Research Oxford Biomedical Research Centre (to H.J.B. and C.J.S.); the Wellcome Trust (to H.J.B.) and the European Social Fund (to A.S.). Copyright: Copyright 2017 Elsevier B.V., All rights reserved.We examined white matter abnormalities in patients with a distinctive extrapyramidal syndrome due to intravenous methcathinone (ephedrone) abuse. We performed diffusion tensor imaging in 10 patients and 15 age-matched controls to assess white matter structure across the whole brain. Diffuse significant decreases in white matter fractional anisotropy, a diffusion tensor imaging metric reflecting microstructural integrity, occurred in patients compared with controls. In addition, we identified two foci of severe white matter abnormality underlying the right ventral premotor cortex and the medial frontal cortex, two cortical regions involved in higher-level executive control of motor function. Paths connecting different cortical regions with the globus pallidus, the nucleus previously shown to be abnormal on structural imaging in these patients, were generated using probabilistic tractography. The fractional anisotropy within all these tracts was lower in the patient group than in controls. Finally, we tested for a relationship between white matter integrity and clinical outcome. We identified a region within the left corticospinal tract in which lower fractional anisotropy was associated with greater functional deficit, but this region did not show reduced fractional anisotropy in the overall patient group compared to controls. These patients have widespread white matter damage with greatest severity of damage underlying executive motor areas.Peer reviewe

An Individual-specific heart rate monitoring method of determining daily physical activity pattern in minutes.

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The development of a Scottish Physical Activity Questionnaire for Students: a tool for use in population studies.

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HIV/SIV Infection Primes Monocytes and Dendritic Cells for Apoptosis

Subversion or exacerbation of antigen-presenting cells (APC) death modulates host/pathogen equilibrium. We demonstrated during in vitro differentiation of monocyte-derived macrophages and monocyte-derived dendritic cells (DCs) that HIV sensitizes the cells to undergo apoptosis in response to TRAIL and FasL, respectively. In addition, we found that HIV-1 increased the levels of pro-apoptotic Bax and Bak molecules and decreased the levels of anti-apoptotic Mcl-1 and FLIP proteins. To assess the relevance of these observations in the context of an experimental model of HIV infection, we investigated the death of APC during pathogenic SIV-infection in rhesus macaques (RMs). We demonstrated increased apoptosis, during the acute phase, of both peripheral blood DCs and monocytes (CD14+) from SIV+RMs, associated with a dysregulation in the balance of pro- and anti-apoptotic molecules. Caspase-inhibitor and death receptors antagonists prevented apoptosis of APCs from SIV+RMs. Furthermore, increased levels of FasL in the sera of pathogenic SIV+RMs were detected, compared to non-pathogenic SIV infection of African green monkey. We suggest that inappropriate apoptosis of antigen-presenting cells may contribute to dysregulation of cellular immunity early in the process of HIV/SIV infection