Evaluating the Impact of the Winning New Jobs Programme on the Re-employment and Mental Health of a Mixed Profile of Unemployed People

This paper reports on the evaluation of the JOBS programme (Caplan et al, 1989), an evidence-based intervention designed to promote re-employment and improve the mental health of the unemployed. While previous evaluations have examined the programme's effects on the recently unemployed, this study examines the programme with a mixed profile of participants, including those long-term unemployed. The JOBS programme was adapted as the Winning New Jobs (WNJ) programme and implemented in the Republic and North of Ireland. It employs a quasi-experimental design, and programme outcomes included re-employment, general and mental health, and job search behaviour followed up over 12 months. The programme has produced positive long-term results, particularly with regard to re-employment. Specifically, 47.7% of the intervention group were employed compared with 16.8% of the comparison group (p<0.001) at the one-year follow-up. WNJ also had a positive effect on reducing economic hardship and enhancing inoculation against setbacks.     

D-cycloserine Deters Reacquisition of Cocaine Self-Administration by Augmenting Extinction Learning

Augmentation of cue exposure (extinction) therapy with cognitive-enhancing pharmacotherapy may offer an effective strategy to combat cocaine relapse. To investigate this possibility at the preclinical level, rats and squirrel monkeys were trained to self-administer cocaine paired with a brief visual cue. Lever pressing was subsequently extinguished by withholding cocaine injections while maintaining response-contingent presentations of the cue. The glycine partial agonist D-cycloserine (DCS; 15 and 30 mg/kg in rats, 3 and 10 mg/kg in monkeys) was evaluated for its effects on the rate of extinction and subsequent reacquisition of cocaine self-administration. Compared with vehicle, pretreatment with 30 mg/kg DCS 0.5 h before extinction training reduced the number of responses and latency to reach the extinction criterion in rats, but neither dose of DCS altered these measures in monkeys. In both species, pretreatment with the higher dose of DCS before extinction training significantly attenuated reacquisition of cocaine self-administration compared with either extinction training in the absence of DCS or DCS in the absence of explicit extinction. Furthermore, treatment with 30 mg/kg DCS accompanied by brief handling (a stress induction) immediately after but not 6 h after extinction training attenuated reacquisition of cocaine self-administration in rats. No adverse effects of 10 mg/kg DCS were evident in quantitative observational studies in monkeys. The results suggest that DCS augmented consolidation of extinction learning to deter reacquisition of cocaine self-administration in rats and monkeys. The results suggest that DCS combined with exposure therapy may constitute a rational strategy for the clinical management of cocaine relapse.     

The fate of older diabetic patients on peritoneal dialysis: myths and mysteries and suggestions for further research.

The outcome of older and especially of female diabetic patients appears to be worse on peritoneal dialysis (PD) than on hemodialysis (HD). This opinion is based mostly on data coming from the USA, whereas data from other regions seem to give a more balanced picture. The questions arise whether indeed outcome is worse in this patient group, and what might be the underlying reasons for this; further research to unravel this phenomenon is warranted. This review proposes several suggestions for further exploration. The observed differences in outcome might be attributable to differences in treatment practices and experience with PD versus HD. As cardiovascular mortality is a major killer in end-stage renal disease patients, differences in fluid homeostasis and how it is achieved are potential explanations. Fluid balance is potentially more difficult to obtain in PD patients, especially as in the past it was spuriously suggested that fluid restriction was less important in PD patients. PD and HD might also have different impacts on factors related to inflammation, insulin resistance, and hormone balance. The adipocytokine network is of special interest in this respect. It is also possible that bias introduced by the way we measure body composition might have a more negative impact on PD than on HD patients. Finally, it still is not fully established that if diabetic patients are treated appropriately, their outcome on PD is worse than that on HD; further observational trials in this respect are needed. All these topics require further clarification and investigation.     

Association between tobacco control policies and smoking behaviour among adolescents in 29 European countries

Aims To investigate the associations between well‐known, cost‐effective tobacco control policies at country level and smoking prevalence among 15‐year‐old adolescents. Design Multi‐level modelling based on the 2005–06 Health Behaviour in School‐aged Children Study, a cross‐national study at individual level, and with country‐level variables from the Tobacco Control Scale and published country‐level databases. Setting Twenty‐nine European countries. Participants A total of 25 599 boys and 26 509 girls. Main outcome measures Self‐reported regular smoking defined as at least weekly smoking, including daily smoking (dichotomous). Findings Interaction effects between gender and smoking policies were identified, therefore boys and girls were analysed separately. Large cross‐national differences in smoking prevalence were documented. Intraclass correlations (ICC) of 0.038 (boys) and 0.035 (girls) were found. In the final multi‐level model for boys, besides the significance of the individual variables such as family affluence, country‐level affluence and the legality of vending machines were related significantly to regular smoking [b(country affluence) = ?0.010; b(partial restriction vending machines) = ?0.366, P < 0.05]. Price policy was of borderline significance [b(price policy) = ?0.026, P = 0.050]. All relationships were in the expected direction. The model fit is not as good for girls; only the legality of vending machines had a borderline significance in the final model [b(total ban vending machines) = ?0.372, P = 0.06]. Conclusions For boys, some of the currently recommended tobacco control policies may help to reduce smoking prevalence. However, the model is less suitable for girls, indicating gender differences in the potential efficacy of smoking policies. Future research should address this issue.     

Non-HIV sexually transmitted infections

This review covers in broad terms developments in epidemiology, diagnosis and management of sexually transmitted infections. It does not cover human immunodeficiency virus (HIV) and hepatitis because the management of these two conditions is rarely if ever undertaken by gynaecologists. Management of all sexually transmitted infections is being standardised by the British Association of Sexual Health and HIV and their protocols are heavily quoted from here.     

Cholesterol granuloma (Xanthomatous metritis) in the uterus of a cat.

A case of uterine cholesterol granuloma in a 12-year old mixed breed cat is reported. The lesions were found in the endometrium of the left uterine horn as scattered, raised nodules or foci. Histologically, mononuclear cell infiltrates were seen to surround cholesterol crystals, in both the endometrium and the smooth muscle layer, reaching the serosa. The findings support the role of haemorrhage in promoting chronic inflammatory reactions around interstitial cholesterol ester precipitates.     

Biology of aging: theories, mechanisms, and perspectives

Abstract The article reviews the major biological theories of aging, and discusses the most relevant mechanisms to explain the aging process. It begins with the evolutionary theories, explores the molecular-cellular mechanisms, and presents the perspective of the systemic theories. The complex etiology of aging is a challenge to the researchers. The knowledge on that phenomenon develops towards an integrative approach.