Sudden gains among women receiving treatment for alcohol use disorders

Understanding the timing and types of change during treatment for mental health disorders is an important step toward elucidating possible mechanisms of behaviour change in response to therapeutic interventions, yet these issues have not been adequately addressed in the alcohol dependence treatment literature. The current study applied sudden gains (SGs) methodology, an approach originally developed in depression treatment studies, to a sample of women receiving treatment for alcohol use disorders. SGs are drastic improvements in symptoms that occur between two psychotherapy sessions and are hypothesised to be the result of what occurred in the first of those two sessions. SGs can happen at any time during the course of treatment, can happen more than once, and are individualised, as opposed to aggregated for a sample. For the current study, SGs were examined across three variables: percent drinking days (PDD), urge frequency (UF), and urge intensity (UI) in a sample of 102 women receiving either individual or couple cognitive-behavioural therapy for alcohol use disorders. Results indicated the presence of SGs; one-third of the sample experienced at least one SG in either alcohol use or urges to drink; the most common SGs were in frequency of urges to drink. SGs in urge frequency during treatment predicted better post-treatment drinking outcome.     

Inhibitory neuropeptides and intrinsic inhibitory innervation of descending human colon

The effects of aging on inhibitory neuropeptide concentrations and intrinsic inhibitory innervation of circular muscle were investigated using normal descending colon obtained at surgery. Immunoreactive vasoactive intestinal peptide, peptide histidine-methionine, met⁵-enkephalin, neuropeptide Y, and somatostatin were extracted from specimens of muscularis externa (patient ages: 19–84 years) and measured by radioimmunoassay. Intracellular electrical activity was recorded from strips of circular muscle (patients ages: 49–84 years) using glass microelectrodes; inhibitory junction potentials were evoked by electrical field stimulation. There were no significant differences (t tests:P>0.05) between neuropeptide concentrations in patients<70 years old (N=28) compared to patients70 years old (N=12). However, the amplitude of inhibitory junction potentials declined with increasing patient age (r=–0.58,P=0.02,N=16), with no change in resting membrane potentials (r=0.22;P>0.05). The decline in amplitude in women (r=–0.68,P=0.03,N=9) preceded the decline in men (r=–0.62,P=0.10,N=7). Age-related decline in inhibitory junction potentials could be related to decreased: density of inhibitory nerves, release of inhibitory neurotransmitter, density of binding sites for inhibitory neurotransmitter on smooth muscle, or a combination thereof. Alternatively, this decline might represent a change in interaction of inhibitory neurotransmitter with the smooth muscle membrane, such as a change in coupling of binding site with the potassium channel, decreased number of potassium channels, or altered permeability of the potassium channel.This study was supported in part by the National Institutes of Health (DK 17238 and DK 34988), and by VA Medical Research funds.     

Paths to sustainable wood supply to the pulp and paper industry in Indonesia after diseases have forced a change of species from acacia to eucalypts

In Sumatra and Kalimantan in Indonesia and Sabah in Malaysia, the spread of two diseases, aggravated by damage by fauna, and by the humid tropical environment, has forced a change of planted species from Acacia mangium to Eucalyptus pellita and related interspecific hybrids, at a scale unprecedented in the history of plantation forestry. This experience highlights the risks of relying on any single species for large contiguous plantation estates in environments with endemic biotic and abiotic stresses. There is a need to transition to multiple-species plantation forestry, adopting the opportunities for changeover of species and varieties in short-rotation systems. Industry’s responses for coping with this rapid change have been helped by earlier collaborative research on acacia which promoted management practices that conserved site resources and avoided site degradation during the critical harvesting and inter-rotation phase. The current growth rates of E. pellita and its hybrids are lower than that of A. mangium. Estimates of production from plantations and expanding capacity of the pulp and paper mills highlight a risk of significant shortfalls in wood production. Improving the quality and consistency of forest operations and revision and refocussing of research and development are critical to set and achieve realistic targets for stable, incremental improvements in productivity. Each company should consider investing systematically in contemporary adaptive research for developing and applying integrated management practices that are efficient and feasible on large scales and suitable for their circumstances. There is also a critical need for research to understand the dynamics of local human capital and its relationships with the forestry sector, with focus on improving access to a stable labour force.     

Development and initial evaluation of an instrument to assess physiotherapists’ clinical reasoning focused on clients’ behavior change

Background and Aim: A systematically developed and evaluated instrument is needed to support investigations of physiotherapists’ clinical reasoning integrated with the process of clients’ behavior change. This study’s aim was to develop an instrument to assess physiotherapy students’ and physiotherapists’ clinical reasoning focused on clients’ activity-related behavior and behavior change, and initiate its evaluation, including feasibility and content validity. Methods: The study was conducted in three phases: 1) determination of instrument structure and item generation, based on a model, guidelines for assessing clinical reasoning, and existing measures; 2) cognitive interviews with five physiotherapy students to evaluate item understanding and feasibility; and 3) a Delphi process with 18 experts to evaluate content relevance. Results: Phase 1 resulted in an instrument with four domains: Physiotherapist; Input from client; Functional behavioral analysis; and Strategies for behavior change. The instrument consists of case scenarios followed by items in which key features are identified, prioritized, or interpreted. Phase 2 resulted in revisions of problems and approval of feasibility. Phase 3 demonstrated high level of consensus regarding the instrument’s content relevance. Conclusions: This feasible and content-validated instrument shows potential for use in investigations of physiotherapy students’ and physiotherapists’ clinical reasoning, however continued development and testing are needed.     

Anterior segment changes after pharmacologic mydriasis using Pentacam and optical coherence tomography in angle closure suspects

AIM:To compare the dynamic changes of anterior segment parameters especially iris morphology induced by pharmacologic mydriasis between angle closure suspects and normal controls.METHODS:The study group comprised 19 eyes of 19 angle closure suspects and 19 eyes of 19 age- and sex-matched normal open-angle eyes. Pentacam and optical coherence tomography measurements before and 30min after instillation of compound tropicamide eye drop were performed and compared. Biometric evaluations of iris tomography and anterior chamber angle were estimated by a customized image-processing software.RESULTS:Baseline axial length, iris cross sectional area and volume did not differ significantly between angle closure suspects and normal controls. Angle closure suspects had smaller pupil size, narrower anterior segment dimension and axial length, thinner iris with greater curve in comparison with normal controls. Pharmacologic mydriasis led to significant increments in iris thickness at 750 μm, anterior chamber depth and volume, whereas significant decrements in iris curve, cross sectional area and volume in both groups. Angle opening distance at 500 μm was increased significantly in normal controls (from 0.465±0.115 mm to 0.539±0.167 mm, P=0.009), but not in angle closure suspects (from 0.125±0.100 mm to 0.145±0.131 mm, P=0.326). Iris volume change per millimeter of pupil dilation (△IV/△PD) decreased significantly less in angle closure suspects than normal controls (-2.47±1.33 mm² vs -3.63±1.58 mm², P=0.019). Linear regression analysis showed that the change of angle opening distance at 500 μm was associated most with the change of central anterior chamber depth (β=0.841, P=0.002) and △IV/△PD (β=0.028, P=0.002), followed by gender (β=0.062, P=0.032).CONCLUSION:Smaller iris volume decrement per millimeter of pupil dilation is related significantly with the less anterior angle opening in angle closure suspects after pharmacologic mydriasis. Dynamic iris change may be as a prospective indicator of iris compressibility and angle closure glaucoma.     

慢性氟中毒小鼠脊髓病理学改变

本文对120只纯系巴氏小白鼠进行了不同时间、不同浓度氟水饲养后,饮高氟水小鼠脊髓病理改变如下,神经细胞空泡变性;神经细胞Nissl氏小体溶解、减少或消失;神经细胞固缩改变;噬神经细胞现象;神经细胞及其间质水肿;神经细胞数量减少和脊髓出血。病理改变与饮高氟水浓度有关,与饮高氟水时间关系更密切。所有实验小鼠脊髓神经髓鞘均未见异常。从而论证氟中毒可造成脊髓的直接损害,而且主要是对灰质的损害。对脊髓血运的影响间接造成脊髓损害可能也是病理因素之一。