Knowledge, attitude, and practices on disposal methods of expired and unused medicines among students in public academic institutions in Lusaka, Zambia

Background: Unsafe disposal of unused and expired household medicines is a public health problem and mostly occur because of a lack of knowledge towards suitable medicine disposal methods. Thus, we aimed to assess the knowledge, attitude, and practices on the disposal methods of unused and expired medicines among students in public academic institutions in Lusaka, Zambia.Methods: This was a cross-sectional study in which 385 students from three higher learning academic institutions were interviewed face to face using a structured questionnaire from 10th May to 24th June 2019. The cleaned data was then transferred to statistical package for social science (SPSS) version 25.0 for analysis.Results: The mean age of the participants was 23 (SD±2.9). Out of the 385 participants, 215 (55.8%) did not know much about medical waste and 345 (89.6%) of them did not have any previous information regarding proper and safe disposal of unused and expired medicine. However, 351 (91.4%) of the participants appropriately responded that unsafe disposal of unused and expired medicine poses a threat to human health and can harm the environment. Throwing unused and expired medicine in household garbage/bin was the most frequently used disposal practice followed by flushing them in toilet/sink as responded by 231 (60.0%) and 128 (33.3%) of participants respectively. Only 17 (4.42%) reported returning unused and expired medicines to the nearest pharmacy.  Conclusions: The majority of the study participants used unsafe methods to dispose of unused and expired medicine. However, most of the participants acknowledged that unsafe disposal of unused and expired medicines is a public health problem and proposed the need to introduce drug take-back programs in the communities. 

Neural Network Alterations Across Eating Disorders: A Narrative Review of fMRI Studies

Background: Functional magnetic resonance imaging (fMRI) has provided insight on how neural abnormalities are related to the symptomatology of the eating disorders (EDs): anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). More specifically, an increasingly growing number of brain imaging studies has shed light on how functionally connected brain networks contribute not only to disturbed eating behavior, but also to transdiagnostic alterations in body/interoceptive perception, reward processing and executive functioning. Methods: This narrative review aims to summarize recent advances in fMRI studies of patients with EDs by highlighting studies investigating network alterations that are shared across EDs. Results and Conclusion: Findings on reward processing in both AN and BN patients point to the presence of altered sensitivity to salient food stimuli in striatal regions and to the possibility of hypothalamic inputs being overridden by top-down emotional-cognitive control regions. Additionally, innovative new lines of research suggest that increased activations in fronto-striatal circuits are strongly associated with the maintenance of restrictive eating habits in AN patients. Although significantly fewer studies have been carried out in patients with BN and BED, aberrant neural responses to both food cues and anticipated food receipt appear to occur in these populations. These altered responses, coupled with diminished recruitment of prefrontal cognitive control circuitry, are believed to contribute to the binge eating of palatable foods. Results from functional network connectivity studies are diverse, but findings tend to converge on indicating disrupted resting-state connectivity in executive networks, the default-mode network and the salience network across EDs

頭部外傷の治療(交通事故による脳障害,第48回千葉医学会学術大会,第17回千葉県医師会学術大会,第10回日医医学講座,連合大会)

BACKGROUND:The negative consequences of energy dense foods are well known, yet people increasingly make unhealthy food choices leading to obesity (i.e., risky decisions). The aims of this study were: [1] to compare performance in decision-making tasks under risk and under ambiguity between individuals with obesity, overweight and normal weight; [2] to examine the associations between body mass index (BMI) and decision-making, and the degree to which these associations are modulated by reward sensitivity. METHODS:Seventy-nine adults were recruited and classified in three groups according to their BMI: obesity, overweight and normal-weight. Groups were similar in terms of age, education and socio-economic status, and were screened for comorbid medical and mental health conditions. Decision-making under risk was measured via the Wheel of Fortune Task (WoFT) and decision-making under ambiguity via the Iowa Gambling Task (IGT). Reward sensitivity was indicated by the Sensitivity to Punishment and Sensitivity to Reward Questionnaire (SPSRQ). RESULTS:Individuals with obesity made riskier choices in the WoFT, specifically in choices with an expected value close to zero and in the propensity to risk index. No differences were found in IGT performance or SPSRQ scores. BMI was associated with risk-taking (WoFT performance), independently of reward sensitivity. CONCLUSIONS:Obesity is linked to a propensity to make risky decisions in experimental conditions analogous to everyday food choices

Altered decision-making under risk in obesity

Background: The negative consequences of energy dense foods are well known, yet people increasingly make unhealthy food choices leading to obesity (i.e., risky decisions). The aims of this study were: [1] to compare performance in decision-making tasks under risk and under ambiguity between individuals with obesity, overweight and normal weight; [2] to examine the associations between body mass index (BMI) and decision-making, and the degree to which these associations are modulated by reward sensitivity. Methods: Seventy-nine adults were recruited and classified in three groups according to their BMI: obesity, overweight and normal-weight. Groups were similar in terms of age, education and socio-economic status, and were screened for comorbid medical and mental health conditions. Decision-making under risk was measured via the Wheel of Fortune Task (WoFT) and decision-making under ambiguity via the Iowa Gambling Task (IGT). Reward sensitivity was indicated by the Sensitivity to Punishment and Sensitivity to Reward Questionnaire (SPSRQ). Results: Individuals with obesity made riskier choices in the WoFT, specifically in choices with an expected value close to zero and in the propensity to risk index. No differences were found in IGT performance or SPSRQ scores. BMI was associated with risk-taking (WoFT performance), independently of reward sensitivity. Conclusions: Obesity is linked to a propensity to make risky decisions in experimental conditions analogous to everyday food choices

Non-suicidal self-injury in eating disordered patients: associations with heart rate variability and state-trait anxiety

Background: non-suicidal self-injury (NSSI) is commonly present in individuals with eating disorders (EDs) and is often employed as a maladaptive emotion regulation strategy to avoid or abate negative emotions. One of the most prevalent negative emotions experienced by self-injurers is anxiety; however, this emotion has not been extensively studied in this population. Thus, the aim of our study was to investigate the influence of anxiety on NSSI in patients with ED from two different dimensions: state anxiety and trait anxiety. Methods: the study comprised a total of 66 females: 12 ED patients with NSSI, 32 ED patients without a history of NSSI, and 22 healthy controls. State and trait anxiety were assessed by means of State-Trait Anxiety Inventory (STAI-S-T) and physiological data [i.e., heart rate variability (HRV)] were collected. Results: STAI-trait scores were significantly higher in ED patients with NSSI than ED patients without NSSI. Furthermore, when conducting logistic regression analyses higher STAI-trait scores were associated with NSSI in ED patients. However, no differences in STAI-state scores and HRV were found between ED patients with and without NSSI. Discussion: the present findings suggest that anxiety as a trait is associated with the use of maladaptive strategies (i.e., NSSI) in ED patients. These results uphold the need to target trait anxiety in ED treatment in order to prevent possible NSSI behaviors

Correlates of Non-suicidal Self-Injury and Suicide Attempts in Bulimic Spectrum Disorders

Objective: The aim of this study was to examine the implication of personality, impulsivity, and emotion regulation difficulties in patients with a bulimic-spectrum disorder (BSD) and suicide attempts (SA), BSD patients with non-suicidal self-injury (NSSI), and BSD patients without these behaviors. Method: One hundred and twenty-two female adult BSD patients were assessed using self-report questionnaires. Patients were clustered post-hoc into three groups depending on whether they presented BSD without NSSI or SA (BSD), BSD with lifetime NSSI (BSD + NSSI) or BSD with lifetime SA (BSD + SA). Results: The BSD + NSSI and BSD + SA groups presented more emotion regulation difficulties, more eating and general psychopathology, and increased reward dependence in comparison with the BSD group. In addition, BSD + SA patients specifically showed problems with impulse control, while also presenting higher impulsivity than both the BSD and BSD + NSSI groups. No differences in impulsivity between the BSD and BSD + NSSI groups were found. Conclusions: The results show that BSD + NSSI and BSD + SA share a common profile characterized by difficulties in emotion regulation and low reward dependence, but differ in impulsivity and cooperativeness. This suggests that self-injury, in patients without a history of suicide attempts (i.e., BSD + NSSI), may have a regulatory role rather than being due to impulsivity

The role of affect-driven impulsivity in gambling cognitions: A convenience-sample study with a Spanish version of the Gambling-Related Cognitions Scale

Abnormal cognitions are among the most salient domain-specific features of gambling disorder. The aims of this study were: (a) to examine and validate a Spanish version of the Gambling-Related Cognitions Scale (GRCS; Raylu & Oei, 2004) and (b) to examine associations between cognitive distortion levels, impulsivity, and gambling behavior. Methods This study first recruited a convenience sample of 500 adults who had gambled during the previous year. Participants were assessed using the Spanish version of GRCS (GRCS-S) questionnaire, the UPPS-P impulsivity questionnaire, measures of gambling behavior, and potentially relevant confounders. Robust confirmatory factor analysis methods on half the sample were used to select the best models from a hypothesis-driven set. The best solutions were validated on the other half, and the resulting factors were later correlated with impulsivity dimensions (in the whole n = 500 factor analysis sample) and clinically relevant gambling indices (in a separate convenience sample of 137 disordered and non-disordered gamblers; validity sample). Results This study supports the original five-factor model, suggests an alternative four-factor solution, and confirms the psychometric soundness of the GRCS-S. Importantly, cognitive distortions consistently correlated with affect- or motivation-driven aspects of impulsivity (urgency and sensation seeking), but not with cognitive impulsivity (lack of premeditation and lack of perseverance). Discussion and conclusions Our findings suggest that the GRCS-S is a valid and reliable instrument to identify gambling cognitions in Spanish samples. Our results expand upon previous research signaling specific associations between gambling-related distortions and affect-driven impulsivity in line with models of motivated reasoning

The role of affect-driven impulsivity in gambling cognitions: a convenience-sample study with a Spanish version of the Gambling-Related Cognitions Scale

Background and aims: abnormal cognitions are among the most salient domain-specific features of gambling disorder. The aims of this study were: (a) to examine and validate a Spanish version of the Gambling-Related Cognitions Scale (GRCS; Raylu & Oei, 2004) and (b) to examine associations between cognitive distortion levels, impulsivity, and gambling behavior. Methods: this study first recruited a convenience sample of 500 adults who had gambled during the previous year. Participants were assessed using the Spanish version of GRCS (GRCS-S) questionnaire, the UPPS-P impulsivity questionnaire, measures of gambling behavior, and potentially relevant confounders. Robust confirmatory factor analysis methods on half the sample were used to select the best models from a hypothesis-driven set. The best solutions were validated on the other half, and the resulting factors were later correlated with impulsivity dimensions (in the whole n = 500 factor analysis sample) and clinically relevant gambling indices (in a separate convenience sample of 137 disordered and non-disordered gamblers; validity sample). Results: this study supports the original five-factor model, suggests an alternative four-factor solution, and confirms the psychometric soundness of the GRCS-S. Importantly, cognitive distortions consistently correlated with affect-or motivation-driven aspects of impulsivity (urgency and sensation seeking), but not with cognitive impulsivity (lack of premeditation and lack of perseverance). Discussion and conclusions: our findings suggest that the GRCS-S is a valid and reliable instrument to identify gambling cognitions in Spanish samples. Our results expand upon previous research signaling specific associations between gambling-related distortions and affect-driven impulsivity in line with models of motivated reasoning

Gender-related patterns of emotion regulation among patients with eating disorders

Difficulties in emotion regulation (ER) are common in females with eating disorders (ED). However, no study to date has analyzed ER in males with ED. In the study at hand, we assessed ER in males with ED and compared results to both females with ED and healthy controls (HC). We also examined associations between ER difficulties, personality, and psychopathology. A total of 62 males with ED were compared with 656 females with ED, as well as 78 male and 286 female HC. ER was assessed by means of the Difficulties in Emotion Regulation Scale (DERS). We found that males and females with ED showed greater ER difficulties compared to HC. Pronounced general psychopathology was a shared factor associated with higher ER difficulties in both males and females with ED. However, whereas higher novelty seeking, higher cooperativeness, lower reward dependence, and lower self-directedness were related to higher ER difficulties in females with ED, lower persistence was associated with ER difficulties in males with ED. In sum, males and females with ED show similar ER difficulties, yet they are distinct in how ER deficits relate to specific personality traits. Research on strategies promoting ER in the treatment of males with ED is warranted

Associations of food addiction and nonsuicidal selfâ injury among women with an eating disorder: A common strategy for regulating emotions?

ObjectiveWe examined the association between lifetime nonsuicidal selfâ injury (NSSI), emotion regulation, and food addiction (FA) in women (n = 220) with eating disorders (ED) compared with (n = 121) healthy controls (HC).MethodParticipants were assessed via faceâ toâ face interviews for ED diagnosis and lifetime NSSI. FA was assessed with Yale Food Addiction Scale 2.0 and emotion regulation using the Difficulty in Emotion Regulation Scale (DERS).ResultsThe prevalence of FA was significantly higher among women with an ED when compared with HC (75.9% vs. 4.1%, p < 0.001). Similarly, subjects presenting FA showed a high prevalence of lifetime NSSI, in both ED and HC (40.7% and 60.0%, respectively). Our predictive model revealed FA and DERS total scores as indicators of the presence of lifetime NSSI independent of group assignment, ED diagnosis, and age.ConclusionsThese findings suggest a shared aetiology between ED, NSSI, and FA, explained possibly in part by emotionâ regulation deficits.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146570/1/erv2646.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146570/2/erv2646_am.pd