MENTAL HEALTH SERVICES FOR PERSONS WITH MENTAL RETARDATION: ROLE OF THE ADVANCED PRACTICE PSYCHIATRIC NURSE

The term dual diagnosis is frequently used by mental health professionals to refer to people who have mental illness complicated by substance abuse. A less commonly recognized population are those individuals who have the dual diagnosis of mental retardation and mental illness. In this paper the author discusses (1) the mental health needs of persons with mental retardation and (2) the current state of services for them. There is a significant lack of appropriately trained professionals to help address the needs of this population. Traditionally, nurses have primarily been identified as providers of physical care. Advanced practice psychiatric nurses, however, are an underutilized group of professionals who have the capacity to assume a leadership role in clinical care, service coordination, and advocacy for individuals and families affected by mental illness and mental retardation.     

Probiotic and enterohemorrhagic Escherichia coli: An effective strategy against a deadly enemy?

Enterohemorrhagic Escherichia coli (EHEC) are major food-borne pathogens that constitute a serious public health threat. Currently, there is no specific treatment available for EHEC infections in human creating an urgent need for the development of alternative therapeutic strategies. Among them, one of the most promising approaches is the use of probiotic microorganisms. Even if many studies have shown the antagonistic effects of probiotic bacteria or yeast on EHEC survival, virulence, adhesion on intestinal epithelium or pathogen-induced inflammatory responses, mechanisms mediating their beneficial effects remain unclear. This review describes EHEC pathogenesis and novel therapeutic strategies, with a particular emphasis on probiotics. The interests and limits of a probiotic-based approach and the way it might be incorporated into global health strategies against EHEC infections will be discussed.     

Commercial ‘ready‐to‐feed’ infant foods in the UK: macro‐nutrient content and composition

Quantitative analyses of the macronutrient content of eight popular commercial ‘ready‐to‐feed’ baby meals for 6–9‐month old infants in the UK market have been undertaken in order to ascertain their nutritional suitability in relation to the total daily dietary intake as well as nutritional profiling of the products. The chemical analyses conducted included Kjeldhal for protein, acid hydrolysis and extraction for fat, phenol sulphuric acid for carbohydrate and Association of Official Analytical Chemists 985.29 for fibre. The only difference found between different varieties (meat‐ and vegetable‐based) was with respect to the protein content (P = 0.04) per 100 g of food. The experimentally determined concentrations of macronutrients (g/100 kcal) were compared with the declared values provided by the manufacturers on the product labels and, despite some variations, the values obtained comply with regulatory requirements (Commission Directive 2006/125/EC). The total daily intake of fat (27.0 g per day) – based on the menu composed from commercial complementary food – is suggested to exceed the daily recommended values for fat (31%), if the intake of snacks and desserts are incorporated. These findings imply that the formulation of recipes, based on a standard commercial menu, is an important consideration in relation to the nutritional quality of the diet of infants.     

Correction: Click chemistry approaches to expand the repertoire of PEG-based fluorinated surfactants for droplet microfluidics

Correction for ‘Click chemistry approaches to expand the repertoire of PEG-based fluorinated surfactants for droplet microfluidics’ by Randall Scanga et al., RSC Adv., 2018, 8, 12960–12974.

The authors regret that during production of the published version of their article the bold formatting in the NMR data to indicate the nuclei of interest was lost. The correctly formatted Synthesis section of the Materials and methods is presented below.     

Young carers in South Africa: tasks undertaken by children in households affected by HIV infection and other illness

‘Young carers’ are children who take on adult responsibility in response to familial illness. South Africa’s high disease burden, limited health care capacity and cultural notions of children’s familial duty suggest a large population of ‘young carers’ in this country. This study aims to explore the nature of responsibility among children affected by illness in deprived South African communities. A total of 349 children and adolescents aged 10–18 years in illness-affected households in the Western Cape province were recruited via community- and school-based convenience sampling. Data about their daily life, responsibilities and the impact of familial illness were collected via semi-structured interviews. Caring tasks involving intimate contact and medical treatments were relatively common among children in the sample, and nearly all children were engaged in some type of responsibility, from caring tasks to housework, childcare and earning money. Children frequently indicated their responsibilities constituted a substantial burden. Responses suggested a tension between duty to care and appropriateness of intimate contact between parents and children required for some caring responsibilities. Children often linked their tasks burden to familial illness, though further quantitative research is needed to identify the drivers of child responsibility.     

Mental health of youth orphaned due to AIDS in South Africa: biological and supportive links to caregivers

This research explored the biological and social support relationship between youth orphaned due to AIDS and his/her caregiver to identify protective factors that are related to positive mental health outcomes. These youth have significantly higher levels of depression, anxiety, and post-traumatic stress (PTS) symptoms compared to those orphaned due to other causes and non-orphans. Using a 2009 cross-sectional data-set from South Africa, 254 youth orphaned due to AIDS were purposively selected from the overall sample of 732 to further examine this caregiver relationship. Caregiver relation was analyzed in several combinations to determine if it was significantly related to mental health outcomes, with only anxiety showing significance. Those living with a biological parent had significantly higher anxiety symptoms than those living with a grandparent, other kin, or non-kin. Anxiety was also significantly related to an increased age, lower levels of emotional support, and lower levels of instrumental/financial support (R² = .153). Age was the only significant variable from the model that was related to depression symptoms (R² = .111). PTS symptoms were related to increases in age, lower levels of emotional support, instrumental/financial support, and satisfaction with the caregiver (R² = .194). Gender and age were related to suicidal tendencies, specifically boys were 2.26 times more likely to exhibit suicidal tendencies compared to girls, and every yearly increase in age results in the youth being 1.22 times more likely to exhibit suicidal tendencies. Strengthening the caregiver’s ability to provide social support for the child is critical, irrespective of any biological kin relationship.     

Acute morphine affects the rat circadian clock via rhythms of phosphorylated ERK1/2 and GSK3β kinases and Per1 expression in the rat suprachiasmatic nucleus

Background and Purpose

Opioids affect the circadian clock and may change the timing of many physiological processes. This study was undertaken to investigate the daily changes in sensitivity of the circadian pacemaker to an analgesic dose of morphine, and to uncover a possible interplay between circadian and opioid signalling.

Experimental Approach

A time-dependent effect of morphine (1 mg·kg⁻¹, i.p.) applied either during the day or during the early night was followed, and the levels of phosphorylated ERK1/2, GSK3β, c-Fos and Per genes were assessed by immunohistochemistry and in situ hybridization. The effect of morphine pretreatment on light-induced pERK and c-Fos was examined, and day/night difference in activity of opioid receptors was evaluated by [³⁵S]-GTPγS binding assay.

Key Results

Morphine stimulated a rise in pERK1/2 and pGSK3β levels in the suprachiasmatic nucleus (SCN) when applied during the day but significantly reduced both kinases when applied during the night. Morphine at night transiently induced Period1 but not Period2 in the SCN and did not attenuate the light-induced level of pERK1/2 and c-Fos in the SCN. The activity of all three principal opioid receptors was high during the day but decreased significantly at night, except for the δ receptor. Finally, we demonstrated daily profiles of pERK1/2 and pGSK3β levels in the rat ventrolateral and dorsomedial SCN.

Conclusions and Implications

Our data suggest that the phase-shifting effect of opioids may be mediated via post-translational modification of clock proteins by means of activated ERK1/2 and GSK3β.Tables of Links

Molybdenum(0) tricarbonyl and tetracarbonyl complexes with a cationic pyrazolylpyridine ligand: synthesis,crystal structures and catalytic performance in olefin epoxidation

The synthesis of molybdenum(0) tricarbonyl and tetracarbonyl complexes of the form [Mo(CO)₃(ptapzpy)Br] (1) and cis-[Mo(CO)₄(ptapzpy)]Br (2) is reported, where ptapzpy = 2-(1-propyltrimethylammonium-3-pyrazolyl)pyridine. Preparation of these derivatives was accomplished either through thermal replacement of CO in Mo(CO)₆ (for 1) or substitution under milder conditions of piperidine ligands in the precursor cis-[Mo(CO)₄(pip)₂] (for 2). The crystal structures of the ligand [ptapzpy]Br and complexes 1 and 2 were determined. Thermal treatment of 2 at 125–150 °C leads to mono decarbonylation and formation of 1. On the other hand, oxidative decarbonylation of 1 and 2 by reaction with tert-butylhydroperoxide (TBHP, 10 equiv.) gives a molybdenum oxide hybrid material formulated as [Mo₃O₉([ptapzpy]Br)₂]·nH₂O (3), which was characterised by FT-IR and Raman spectroscopy, thermogravimetric analysis, and ¹³C{¹H} CP MAS NMR spectroscopy. Compounds 1–3 were effective (pre)catalysts for the epoxidation of cis-cyclooctene at 55 °C with aqueous H₂O₂ or TBHP (slightly better results were obtained with the former). The characterisation of the Mo-containing solids isolated after the catalytic reaction showed that poorly soluble β-octamolybdate salts, (L)_x[Mo₈O₂₆], were formed from 1–3 with TBHP and from 1 with H₂O₂, while soluble oxoperoxo species were formed from 3 with H₂O₂. These findings helped to explain the different catalytic performances obtained.

The oxidative decarbonylation and catalytic chemistry of molybdenum(0) tricarbonyl and tetracarbonyl complexes containing the same diimine ligand are compared.     

Xenobiotic-metabolizing enzymes in plants and their role in uptake and biotransformation of veterinary drugs in the environment

Many various xenobiotics permanently enter plants and represent potential danger for their organism. For that reason, plants have evolved extremely sophisticated detoxification systems including a battery of xenobiotic-metabolizing enzymes. Some of them are similar to those in humans and animals, but there are several plant-specific ones. This review briefly introduces xenobiotic-metabolizing enzymes in plants and summarizes present information about their action toward veterinary drugs. Veterinary drugs are used worldwide to treat diseases and protect animal health. However, veterinary drugs are also unwantedly introduced into environment mostly via animal excrements, they persist in the environment for a long time and may impact on the non-target organisms. Plants are able to uptake, transform the veterinary drugs to non- or less-toxic compounds and store them in the vacuoles and cell walls. This ability may protect not only plant themselves but also other organisms, predominantly invertebrates and wild herbivores. The aim of this review is to emphasize the importance of plants in detoxification of veterinary drugs in the environment. The results of studies, which dealt with transport and biotransformation of veterinary drugs in plants, are summarized and evaluated. In conclusion, the risks and consequences of veterinary drugs in the environment and the possibilities of phytoremediation technologies are considered and future perspectives are outlined.     

Implication of different cardiac troponin I levels for clinical outcomes and prognosis of acute chest pain patients

OBJECTIVES: We compared outcomes in patients with non-ST-segment elevation acute coronary syndromes (ACS) according to the degree of cardiac troponin I (cTnI) elevation. BACKGROUND: Controlled trials of high-risk patients have found that troponin elevations identify an even higher risk subset. It is unclear whether outcomes are similar among a lower risk, heterogeneous patient group. Also, few studies have reported outcomes other than myocardial infarction (MI) or death, based on the peak troponin value. METHODS: Consecutively, admitted patients without ST-segment elevation on the initial electrocardiogram underwent serial marker sampling using creatine kinase (CK), CK-MB fraction, and cTnI. Patients were grouped according to peak cTnI: negative = no detectable cTnI; low = peak greater than the lower limit of detectability but less than the optimal diagnostic value; intermediate = peak greater than or equal to the optimal diagnostic value but less than the manufacturer's suggested upper reference limit (URL); and high = peak greater than or equal to the URL. Thirty-day outcomes included cardiac death, MI based on CK-MB, revascularization, significant disease, and a reversible defect on stress testing. Six-month mortality was also determined. Negative evaluations for ischemia included nonsignificant disease, no reversible stress defect, and negative rest perfusion imaging. RESULTS: Of the 4,123 patients admitted, 893 (22%) had detectable cTnI values. Cardiac events and positive test results at 30 days and 6-month mortality increased significantly with increasing cTnI values. Negative evaluations for ischemia were significantly and inversely related to peak cTnI values. Although adverse events were significantly more common in patients with a low cTnI value than in those with negative cTnI, negative evaluations for ischemia were frequent. CONCLUSIONS: Increased cTnI values are associated with worse outcomes. Although low cTnI values are associated with adverse events, they do not have the same implication as higher cTnI values, and nonischemic evaluations are frequent.