Large Proportion Of Participants Research Articles

The neuropsychological correlates of cannabis use in schizophrenia: Lifetime abuse/dependence, frequency of use, and recency of use

This study examined the relationship between neuropsychological performance and three different indices of cannabis use in schizophrenia. These indices were DSM-IV lifetime abuse/dependence, frequency of use, and recency of use. Sixty males with schizophrenia/schizoaffective disorder and 17 healthy males were recruited. The two groups were matched for age, years of education, and premorbid IQ. Medical history, substance use, and psychiatric symptoms were assessed. A neuropsychological battery was also administered to assess attention/processing speed, executive functions, memory, and perceptual organisation. Substance use within 24 hours of cognitive assessment was screened by urine analysis, and a range of confounds were controlled. In the schizophrenia group, 44 participants met DSM-IV criteria for lifetime cannabis abuse/dependence. In addition, there were three mutually exclusive frequency-of-cannabis-use subgroups comprising “high” frequency users ( n = 11), “medium” frequency users ( n = 7), and “low” frequency users ( n = 34) over the preceding year. There were also four mutually exclusive recency-of-cannabis-use categories comprising “cannabis abuse/dependence in the past week” ( n = 11 users), “non-dependent cannabis use in the past week” ( n = 7 users), “non-dependent cannabis use in the past month, but prior to the past week” ( n = 7 users), and “non-dependent cannabis use prior to the past month” ( n = 9 users). The control group performed better than the schizophrenia group in all cognitive domains. Within the schizophrenia group, a larger proportion of participants with lifetime cannabis abuse/dependence demonstrated better performance than those without lifetime abuse/dependence on a component of psychomotor speed. Frequency and recency of cannabis use were also associated with better neuropsychological performance, predominantly in the domains of attention/processing speed and executive functions. In conclusion, cannabis use is associated with enhanced cognitive functioning in schizophrenia. Implications of the results, limitations of the study, and directions for future research are discussed.

Contingency Management for the Treatment of Methamphetamine Use Disorders

Theory and some preliminary evidence suggest that contingency management may be an effective treatment strategy or adjunct to psychosocial treatment for methamphetamine use disorders. An experimentally rigorous investigation on the topic was provided by a large multisite trial conducted under the auspices of the Clinical Trials Network of the National Institute on Drug Abuse. The authors report data on 113 participants who were diagnosed with methamphetamine abuse or dependence. They were randomly assigned to receive 12 weeks of either treatment as usual or treatment as usual plus contingency management. Urine samples were tested for illicit drugs, and breath samples were tested for alcohol. The reinforcers for drug-negative samples were plastic chips, some of which could be exchanged for prizes. The number of plastic chips drawn increased with each week of negative samples but was reset to one after a missed or positive sample. The participants in both groups remained in treatment for equivalent times, but those receiving contingency management in addition to usual treatment submitted significantly more negative samples, and they were abstinent for a longer period of time (5 versus 3 weeks). These results suggest that contingency management has promise as a component in treatment strategies for methamphetamine use disorder.

Breast cancer-developing clinical guidellines for England and Wales

Gagnon C, Mathieu J, Jean S, Laberge L, Perron M, Veillette S, Richer L, Noreau L. Predictors of disrupted social participation in myotonic dystrophy type 1.To identify personal and environmental predictors of the most disrupted participation domains in people with myotonic dystrophy type 1 (DM1).Cross-sectional study.Outpatient neuromuscular clinic.Adults (n=200; 121 women), age 18 years or older (mean age, 47y), with a confirmed diagnosis of DM1 were selected from the registry of a neuromuscular clinic (N=416). Fifty-two participants had the mild phenotype and 148 the adult phenotype.Not applicable.Social participation in mobility, housing, employment, and recreation was assessed with the Life Habits Measure. Disrupted participation was based on whether help was needed in performing most life habits because of incapacities or environmental barriers. Environmental factors were assessed by using the Measure of the Quality of the Environment. Personal factors were assessed with standardized instruments including the Berg Balance Scale, the Krupp Fatigue Severity Scale, and manual muscle testing.A large proportion of participants (45%–61%) reported disrupted participation in all 4 domains. Lower-extremity strength (odd ratios [OR], 15.0–5.5; P<.050) and higher fatigue (OR, 6.0–2.6; P<.05) were present in participants with disrupted participation. With regard to environmental factors, family support (OR, 3.6–2.5; P<.05) and public services (OR, 2.8–2.2; P<.05) were perceived as barriers for participants with disrupted participation in most domains.This study identified personal and environmental factors that may influence the trajectory toward disrupted participation in individuals with DM1. Fatigue, strength, family support, and public services were found to be independent predictors of disrupted participation.

The Effect of Contradictory Information on Recently Acquired Knowledge

When individuals encounter information contradicting their beliefs, they may briefly retain the contradiction, but are likely to revert to their original beliefs over time. Past research has focused on the effects of prior knowledge and consistency of information when prior knowledge was well-established. This study investigated the effects of prior knowledge and information consistency for recently acquired knowledge. By learning whether the same reverting effect holds for recently acquired information, interventions can be sought to enhance recall of important information. Participants in this study were given two information packages about a fictional animal and their recall on various facts tested. Although a large proportion of participants recalled the updated information, overall recall of contradicted information after two weeks was reduced compared to when information was consistent. Recall of the original information was shown to resurface.

Informed consent in China: quality of information provided to participants in a research project

A study was carried out of informed consent strategies in an epidemiological project approved by the regional research ethics committees in Sweden and China and conducted in three areas south-west of Shanghai. All participants in the epidemiological project (EP) were included in the research ethical study (RES), which was conducted as a questionnaire-based interview survey in the three areas. Answers were collected by five field interviewers. All participants included answered the questionnaire. Almost all perceived the information provided as rather good or quite good. However, a majority (on average 76%) had the impression that the EP was part of routine healthcare measures, and not a research project. Almost all participants felt free to abstain from participation although 38% in area II stated that they had not been informed about freedom to abstain from participation. A large proportion of participants did not fully understand the nature of the EP. However, almost all participants stated that they would agree to participate in a similar study in the future. Although informed consent procedures are supposed to be internationally applicable our study illustrates that it is not always easy to convey information and obtain consent in the present study setting.

The importance of assessing the readiness to change sun-protection behaviours: a population-based study

The purpose of this study was to collect information that may be valuable in developing successful skin cancer prevention programmes. A random sample of 6000 adolescents and 4000 adults answered a questionnaire about sun-related issues. The response rate was 68%. Using sunscreen was the main sun-protection behaviour measured. Approximately 40% of adolescents and 30% of adults did not use any sun-protection strategy other than sunscreen. Readiness to change sun-protection behaviour was measured by assessing the stages of change modified from the Transtheoretical Model (TTM). Half of the participants were in the precontemplation stage of giving up sunbathing and avoiding the sun between 11 a.m. and 3 p.m. Attitude had the strongest association with being in the action/maintenance stages for all sun protection behaviours. A large proportion of participants were not ready to change their sun-protection behaviours, which highlights the importance of including motivational strategies when attempting to change sun-protection behaviours.

Prospective Memory in Pediatric Traumatic Brain Injury: A Preliminary Study

Prospective memory (PM) performance was investigated in a preliminary study of children and adolescents ages 10-19 in 3 groups: individuals with orthopedic injuries (not involving the head) requiring hospitalization (Ortho, N = 15), mild traumatic brain injury (TBI, N = 17), and severe TBI (N = 15). All participants with TBI were at least 5 years postinjury and participants in the Ortho group were at least 3 years postinjury. The PM task involved reporting words presented in blue during a category decision task in which words were presented in several different colors and participants were to determine which of two categories the word belonged. Participants were asked to make their choices as quickly as possible. After a 10- to 15-min intervening computer task in which all words were presented in black letters, a large proportion of participants with mild or severe TBI failed to indicate any blue words when they appeared. After a reminder to perform the PM task was given to all at the same point in the task, PM performance increased in the Ortho and Mild TBI groups, but remained comparably impaired in the Severe TBI group. Reaction time (RT) data indicated that mean RT was slower with increasing TBI severity. Further, there was a significant cost in RT for performing the PM task during the ongoing category decision task for all groups. The cost in terms of slowed RT increased with greater TBI severity.

Effective warnings in the Deese-Roediger-McDermott false-memory paradigm: The role of identifiability.

These experiments document that warnings can substantially reduce false memories in the Deese-Roediger-McDermott (DRM) paradigm when the critical items are easily identifiable. Participants in a norming study identified the critical item after hearing a list of words. The lists with critical items that could be identified by the largest proportion of participants (high identifiable [HI] lists) and the smallest proportion of participants (low identifiable [LI] lists) were used in the experiment. Participants heard lists of words (e.g., bed, rest, doze) related to a critical item (e.g., sleep) and were warned about the nature of the lists before the study phase. The results indicated that warnings reduced false recognition of critical items for HI lists but not LI lists.

Predictors of Divorcing Women's Use of Divorce Mediation

This study examined the relations between perceived usefulness of mediation, problem susceptibility, mental health conditions, availability of social support, and the likelihood of using divorce mediation service. The sample comprised 124 divorcing women in Hong Kong who sought legal aid to settle matrimonial issues. A large proportion of participants indicated their willingness to use mediation. Logistic regression showed that likely users have higher appreciation of the helpfulness of the service, have poorer mental health, and to some extent, receive lower levels of social support from informal sources. Susceptibility to housing, finance, and child-care problems is not a significant predictor. The results strongly suggest the importance of promoting mediation services to the people in need.

Sympathetic nervous system in chronic joint pain.

<h3>Introduction</h3> This study explored the pregnancy outcomes of Inflammatory Bowel Disease (IBD) patients in Bradford against the standards of the British Society of Gastroenterology (BSG) and European Crohn’s and Colitis Organisation (ECCO) Reproduction and Pregnancy Consensus and includes a patient evaluation on the quality of care they received. It is well documented that pregnant women with IBD are at risk of poor outcomes from pregnancy, but less clear if there is a need for a dedicated pregnancy service for IBD patients. <h3>Methods</h3> A qualitative retrospective analysis of the pregnancy outcomes of IBD patients in Bradford Royal Infirmary (BRI) and patient perspective on care was conducted. Data search was performed using the ‘IBD database’, ‘Evolve’ and electronic patient clinical notes. 4112 females patients were identified. Questionnaires were sent to 89 of these patients who fulfilled the inclusion criteria for the project. An initial response of 12 questionnaires were received and telephone interviews were then conducted to generate a further 11 sets of data. The final study sample was 25. Data was analysed using descriptive statistical analysis in Microsoft Excel. No ethical approval was required for this project. <h3>Results</h3> 47% of patients in our study flared during pregnancy compared to an expected rate of 30%. 4 out of 9 complications during pregnancy could be attributable to IBD. The rates of prematurity, low gestational birth weight and emergency caesarean sections were 17% in each case in our study, as opposed to 45%, 32% and 29.5% respectively in the general IBD population. 13 out of 25 participants rated the IBD helpline a 10 out of 10, and 18 out of 25 participants rated the level of support a 5 out of 5. Overall, 60% of participants were in favour of a dedicated IBD pregnancy service in Bradford. <h3>Conclusion</h3> Pregnancy outcomes in the IBD population in BRI were favourable compared to national statistics, although the sample size was small. The Bradford IBD service provision and outcomes for pregnant patients are in line with the BSG national standards and ECCO guidelines. The majority of patients wanted to discuss their pregnancy and pre-pregnancy planning in an IBD clinic. Patient information posters and leaflets will be made available in out-patient clinics to enhance patient knowledge about IBD before and during pregnancy and to actively encourage patients to discuss concerns. A large proportion of participants were content with the care they received and felt supported with improvements to the helpline accessibility being a key area for improvement. The IBD Nurse Helpline remains a vital and valued part of the service, to ensure timely management and telephone advice.

Odds in genetic counselling

<h3>Objectives</h3> Common mental disorders (CMDs) are a major cause of rising disability benefit expenditures. We urgently need evidence on programmes that can increase work participation in CMDs. The aim of this study was to evaluate the effectiveness of work-focused cognitive–behavioural therapy (CBT) and individual job support for people struggling with work participation due to CMDs. <h3>Methods</h3> A randomised controlled multicentre trial (RCT) including 1193 participants was conducted. Participants were on sick leave, at risk of going on sick leave or on long-term benefits. The intervention integrated work-focused CBT with individual job support. The control group received usual care. The main outcome was objectively ascertained work participation at 12 months follow-up, with changes in mental health and health-related quality of life as secondary outcomes. <h3>Results</h3> A larger proportion of participants in the intervention group had increased or maintained their work participation at follow-up compared to the control group (44.2% vs 37.2%, p=0.015). The difference remained significant after 18 months (difference 7.8%, p=0.018), and was even stronger for those on long-term benefits (difference 12.2%, p=0.007). The intervention also reduced depression (t=3.23, p≤0.001) and anxiety symptoms (t=2.52, p=0.012) and increased health-related quality of life (t=2.24, p=0.026) more than usual care. <h3>Conclusions</h3> A work-focused CBT and individual job support was more effective than usual care in increasing or maintaining work participation for people with CMDs. The effects were profound for people on long-term benefits. This is the first large-scale RCT to demonstrate an effect of a behavioural intervention on work participation for the large group of workers with CMDs. <h3>Trial registration number</h3> ClinicalTrials.gov, registration number: NCT01146730.