Factors associated with self-care activities among adults in the United Kingdom: a systematic review

Background: The Government has promoted self-care. Our aim was to review evidence about who uses self-tests and other self-care activities (over-the-counter medicine, private sector,complementary and alternative medicine (CAM), home blood pressure monitors). Methods: During April 2007, relevant bibliographic databases (Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, Applied Social Sciences Index and Abstracts, PsycINFO,British Nursing Index, Allied and Complementary Medicine Database, Sociological Abstracts, International Bibliography of the Social Sciences, Arthritis and Complementary Medicine Database, Complementary and Alternative Medicine and Pain Database) were searched, and potentially relevant studies were reviewed against eligibility criteria. Studies were included if they were published during the last 15 years and identified factors, reasons or characteristics associated with a relevant activity among UK adults. Two independent reviewers used proformas to assess the quality of eligible studies. Results: 206 potentially relevant papers were identified, 157 were excluded, and 49 papers related to 46 studies were included: 37 studies were, or used data from questionnaire surveys, 36 had quality scores of five or more out of 10, and 27 were about CAM. Available evidence suggests that users of CAM and over-the-counter medicine are female, middle-aged, affluent and/or educated with some measure of poor health, and that people who use the private sector are affluent and/or educated. Conclusion: People who engage in these activities are likely to be affluent. Targeted promotion may, therefore, be needed to ensure that use is equitable. People who use some activities also appear to have poorer measures of health than non-users or people attending conventional services. It is, therefore, also important to ensure that self-care is not used as a second choice for people who have not had their needs met by conventional service

Opioid [delta]-receptor involvement in supraspinal and spinal antinociception in mice

The possibility that the opioid [delta]-receptor mediates antinociception in tests where heat is the noxious stimulus was investigated using highly selective [mu]- and [delta]-agonists and -antagonists. Antinociceptive dose-response curves were constructed for [mu] ([-Ala2, NMePhe4, Gly-ol]enkephalin, DAGO; morphine) and [delta] ([-Pen2,-Pen5]enkephalin, DPDPE)-agonist in the absence, and in the presence of the [mu] non-surmountable antagonist, [beta]-funaltrexamine ([beta]-FNA) or the [delta]-antagonist ICI 174,864 (N,N-diallyl-Tyr-Aib-Aib-Phe-Leu- OH, where Aib is [alpha]-amino-isobutyric acid). Agonists and ICI 174,864 were given alone or in the same intracerebroventicular (i.c.v.) or intrathecal (i.th.) injection to mice 20 min prior to testing in the warm-water (55 [deg]C) tail-withdrawal test (+10 min for i.th. DPDPE); [beta]-FNA was given as a single i.c.v. or i.th. pretreatment dose (20 and 0.01 nM, respectively) 4 hr with [beta]-FNA resulted in a rightward displacement of the DAGO and morphine antinociceptive dose-response lines, but failed to displace the i.c.v. DPDPE curve. Similarly, i.th. pretreatment with [beta]-FNA displaced the i.th. morphine dose-response curve to the right without affecting the i.th. DPDPE antinociceptive dose-response line. ICI 174,864 (1 and 3 [mu]g) produced a dose-related antagonism of i.c.v. or i.th. DPDPE, but did not alter the antinociceptive effects of DAGO or morphine given by the same routes. Co-administration of ICI 174 864 ([mu]g) i.c.v. morphine in [beta]-FNA pretreated (but not control) mkce resulted in a further rightward displacement of the morphine dose-response line. The effective antagonism of DPDPE but not morphine or DAGO antinociception by ICI 174,864, together with the effectiveness of [beta]-FNA against morphine and DAGO but not DPDPE antinociception, provide strong and direct evidence for the involvement of cerebral and spinal [delta]-receptors in the mediation of antinociception in tests where heat is employed as the noxious stimulus. Additionally, the effectiveness of ICI 174,864 against morphine in [beta]-FNA pretreated (but not control) mice demonstrates a [delta]-effect of morphine, in vivo.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/26577/1/0000116.pd