When is it appropriate to address patients' alcohol consumption in health care--national survey of views of the general population in Sweden

The aim of this study was to investigate the Swedish population's beliefs and attitudes on when it is appropriate to address patients' alcohol in health care services and to identify the characteristics of those who are most supportive of this alcohol-preventive work. A cross-sectional study of 5981 nationally representative individuals (18-64 years) was done using confidential mail questionnaires. Alcohol consumption was assessed with AUDIT-C and respondents were classified into four levels of drinking status. Sociodemographic data were also collected. Thirty-four percent completely agreed that health care providers should routinely ask patients about their alcohol habits and 33% completely agreed that providers should ask but only if patients have consulted them with alcohol-related symptoms. There was limited support for a statement that alcohol conversations should be premised on the patient bringing up the issue and even less support for the notion that alcohol habits are people's own business and not something that health care providers should address. Thirty-four percent believed that people did not answer honestly when asked about their alcohol habits in health care. There appears to be considerable support in the general population for alcohol prevention in Swedish health care services that involves questions being asked routinely about alcohol. This should be helpful in ongoing efforts to improve the implementation of alcohol screening and brief interventions in Sweden. Further studies on the views of hazardous and excessive drinkers appear particularly important.     

Astrocyte‐derived interleukin‐6 promotes specific neuronal differentiation of neural progenitor cells from adult hippocampus

The purpose of this study was to investigate the ability of astrocyte‐derived factors to influence neural progenitor cell differentiation. We previously demonstrated that rat adult hippocampal progenitor cells (AHPCs) immunoreactive for the neuronal marker class III β‐tubulin (TUJ1) were significantly increased in the presence of astrocyte‐derived soluble factors under noncontact coculture conditions. Using whole‐cell patch‐clamp analysis, we observed that the cocultured AHPCs displayed two prominent voltage‐gated conductances, tetraethyl ammonium (TEA)‐sensitive outward currents and fast transient inward currents. The outward and inward current densities of the cocultured AHPCs were approximately 2.5‐fold and 1.7‐fold greater, respectively, than those of cells cultured alone. These results suggest that astrocyte‐derived soluble factors induce neuronal commitment of AHPCs. To investigate further the activity of a candidate neurogenic factor on AHPC differentiation, we cultured AHPCs in the presence or absence of purified rat recombinant interleukin‐6 (IL‐6). We also confirmed that the astrocytes used in this study produced IL‐6 by ELISA and RT‐qPCR. When AHPCs were cultured with IL‐6 for 6–7 days, the TUJ1‐immunoreactive AHPCs and the average length of TUJ1‐immunoreactive neurites were significantly increased compared with the cells cultured without IL‐6. Moreover, IL‐6 increased the inward current density to an extent comparable to that of coculture with astrocytes, with no significant differences in theoutward current density, apparent resting potential, or cell capacitance. These results suggest that astrocyte‐derived IL‐6 may facilitate AHPC neuronal differentiation. Our findings have important implications for understanding injury‐induced neurogenesis and developing cell‐based therapeutic strategies using neural progenitors. © 2010 Wiley‐Liss, Inc.     

Psychometric properties of the Ethos Brief Index (EBI) using factorial structure and Rasch Analysis among patients with obstructive sleep apnea before and after CPAP treatment is initiated

Sleep and Breathing - Continuous positive airway treatment (CPAP) is the recommended treatment for patients with obstructive sleep apnea (OSA). Outcome measures often focus on clinical and/or...     

Special issues in injury prevention research: Developing the science of program implementation

IntroductionDespite widespread application of the public health approach to injury prevention, there is an acknowledged limitation in the extent to which it facilitates translation of research evidence to injury prevention practice.AimIn this paper we clarify the ecoepidemiological principles that underpin the public health approach to injury control in order to support explicit efforts to address the multilevel component causes and improve the evidence base on which effective program implementation depends.KeypointsIf injury causation is understood in terms of the ecoepidemiological model rather than the proximal risk factor model, then quantification of the context in which the event occurs is evidently as important as quantification of the energy exchange event itself. The ecoepidemiological model of injury causation recognises barriers and facilitators to injury prevention as component causes of population burden of injury and thus delineates these factors as legitimate targets for intervention. Injury prevention programs that are designed to specifically address the factors causally related to the program's implementation, as well as the contextual factors that determine the characteristics of the energy exchange event, are more likely to be implemented and more likely to result in effective uptake of recommended energy exchange countermeasures.ConclusionInterventions to reduce the burden of injury in the population should address the individual level factors that increase the risk of injury, but also the upstream factors that influence the extent to which there is widespread adoption by individuals of the recommended countermeasures.