HFE genotype modifies the influence of heme iron intake on iron status

Background: Public health policy to prevent iron deficiency through food fortification or other measures may be disadvantageous to people with hereditary hemochromatosis. Methods: From a cohort of U.K. women, 2531 women were typed for C282Y and H63D mutations in the hemochromatosis gene. These women completed food frequency questionnaires and provided blood for iron status. Results: C282Y homozygotes (n = 31) had serum ferritin concentrations 2.4 times higher (95% confidence interval = 1.9–3.1) than wild types (n = 1774), but heterozygotes (n = 726) were not different from wild types. H63D genotype had no effect on its own. The effect of heme iron intake (from meat, fish, and poultry) was 2.0 times greater (1.2–3.2) on C282Y homozygotes than other groups. Nonheme iron had little effect. Conclusions: There may be scope for dietary intervention in women homozygous for the C282Y mutation. C282Y heterozygotes and H63D homozygotes and heterozygotes have similar serum ferritin concentrations to wild type and need not reduce their meat intake other than as part of a normal healthy diet

Behavior maintained by intravenous injection of codeine, cocaine, and etorphine in the rhesus macaque and the pigtail macaque

Lever-pressing behavior of two species of macaque, the rhesus macaque ( M. mulatta ) and the pigtail macaque ( M. nemestrina ) was maintained by intravenous injection of codeine, etorphine, or cocaine. Monkeys responded under a fixed-ratio 30 timeout 600 s schedule of drug injection during two daily experimental sessions. Drug-maintained behavior was studied under two access conditions. Under the first condition, selected doses of codeine or cocaine were available for ten consecutive sessions. Under the second condition, responding was maintained by 0.32 mg/kg codeine or 0.32 mg/kg cocaine, and saline and selected doses of codeine, etorphine, and cocaine were substituted during single experimental sessions. Performance varied with drug and injection dose, access condition, and macaque species. For all three drugs, response rate increased and then decreased as injection dose increased. Maximal rates were maintained by 0.10–0.32 mg/kg codeine, 0.0003–0.001 mg/kg etorphine, and 0.10–0.32 mg/kg cocaine. A cocaine dose of 0.32 mg/kg maintained higher rates than any dose of codeine or etorphine, and maintained higher rates when available during consecutive sessions than when substituted for codeine for a single session. Codeine maintained similar rates under all access conditions. The pigtail macaques had short catheter lives, did not readily acquire codeine-maintained responding, and displayed lower rates of drug-maintained lever pressing than the rhesus macaques.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/46415/1/213_2004_Article_BF00427883.pd

The epidemiology and patterns of acute and chronic toxicity associated with recreational ketamine use

Ketamine was originally synthesised for use as a dissociative anaesthetic, and it remains widely used legitimately for this indication. However, there is increasing evidence of non-medical recreational use of ketamine, particularly in individuals who frequent the night-time economy. The population-level and sub-population (clubbers) prevalence of recreational use of ketamine is not known but is likely to be similar, or slightly lower than, that of other recreational drugs such as cocaine, MDMA, and amphetamine

Effects of fluoxetine on functional outcomes after acute stroke (FOCUS): a pragmatic, double-blind, randomised, controlled trial

Background Results of small trials indicate that fluoxetine might improve functional outcomes after stroke. The FOCUS trial aimed to provide a precise estimate of these effects. Methods FOCUS was a pragmatic, multicentre, parallel group, double-blind, randomised, placebo-controlled trial done at 103 hospitals in the UK. Patients were eligible if they were aged 18 years or older, had a clinical stroke diagnosis, were enrolled and randomly assigned between 2 days and 15 days after onset, and had focal neurological deficits. Patients were randomly allocated fluoxetine 20 mg or matching placebo orally once daily for 6 months via a web-based system by use of a minimisation algorithm. The primary outcome was functional status, measured with the modified Rankin Scale (mRS), at 6 months. Patients, carers, health-care staff, and the trial team were masked to treatment allocation. Functional status was assessed at 6 months and 12 months after randomisation. Patients were analysed according to their treatment allocation. This trial is registered with the ISRCTN registry, number ISRCTN83290762. Findings Between Sept 10, 2012, and March 31, 2017, 3127 patients were recruited. 1564 patients were allocated fluoxetine and 1563 allocated placebo. mRS data at 6 months were available for 1553 (99·3%) patients in each treatment group. The distribution across mRS categories at 6 months was similar in the fluoxetine and placebo groups (common odds ratio adjusted for minimisation variables 0·951 [95% CI 0·839–1·079]; p=0·439). Patients allocated fluoxetine were less likely than those allocated placebo to develop new depression by 6 months (210 [13·43%] patients vs 269 [17·21%]; difference 3·78% [95% CI 1·26–6·30]; p=0·0033), but they had more bone fractures (45 [2·88%] vs 23 [1·47%]; difference 1·41% [95% CI 0·38–2·43]; p=0·0070). There were no significant differences in any other event at 6 or 12 months. Interpretation Fluoxetine 20 mg given daily for 6 months after acute stroke does not seem to improve functional outcomes. Although the treatment reduced the occurrence of depression, it increased the frequency of bone fractures. These results do not support the routine use of fluoxetine either for the prevention of post-stroke depression or to promote recovery of function. Funding UK Stroke Association and NIHR Health Technology Assessment Programme

Reproducibility of systematic literature reviews on food, nutrition, physical activity and endometrial cancer.

Objective: Despite the increasing dependence on systematic reviews to summarise the literatuer and to issue public health recommendations, the formal assessment of the reliability of conclusions emerging from systematic reviews has received little attention. The main goal of the present study was to evaluate whether two independent centres, in two continents, draw similar conclusions regarding the association of food, nutrtition and physical activity and endometrial cancer, when provided with the same general instructions and with similar resources. Design: The assessment of reproducibility concentrated on four main areas: (1) paper search and selection; (2) assignment of study design; (3) inclusion of 'key' papers; and (4) individual studies selected for meta-analysis and the summary risk estimate obtained. Results: In total 310 relevant papers were identified, 166 (54%) were included by both centres. Of the remaining 144 papers, 72 (50%) were retrieved in the searches of one centre and not the other (54 in centre A, 18 in centre B) and 72 were retrieved in both searches but regarded as relevant by only one of the centres (52 in centre A, 20 in centre B). Of papers included by both centres, 80% were allocated the same study desing. Agreement for inclusion of cohort-type and case-control studies was about 63% compared with 50% or less for ecological and case series studies. The agreement for inclusion of 138 'key' papers was 87%. Summary risk estimates from meta-analyses were similar. Conclusions: Transparency of process and explicit detailed procedures are necessary parts of a systematic review and crucial for the reader to interpret its finding

Doing narrative feminist research: Intersections and challenges

This article contributes to social work methodological discussions by examining narrative feminist research in action. Our discussion considers our conceptualization and use of narrative feminist research, which is appreciative of intersectionality. We draw illustrative examples from four projects: (1) In the Name of Love, Women’s Narratives of Love, and Abuse (1998–2008), (2) Helping Alliances with Drug Treatment Clients (2010–2016), (3) In Good Company, Women, Companion Animals, and Social Work (2013–2014), and (4) Distress in Childbirth: A Social Work Perspective (in process). We also consider challenges associated with using narrative feminist research data as evidence. For all of the challenges currently facing narrative feminist researchers, we maintain that the methodology offers social workers many benefits and expansive, praxis-oriented possibilities