Search

The use of computers in the National Health Service (UK) as a workplace is fundamental to its future. However, there is evidence of a paucity of information technology skills within the workforce and therefore, information technology skill training is essential. The National Health Service in Wales has been using the European Computer Driving Licence qualification to educate its staff in order to cover this skill gap. This paper reports on an evaluation of the perceived benefits to staff, both clinical and non-clinical, working for the National Health Service in Wales of information technology training through the European Computer Driving Licence qualification. Results show that there is an increase in confidence in terms of tasks undertaken but also towards other general life skills. Additionally, for those respondents with clinical contact, there is a perceived increase both in the time available with and the quality of care, given to patients. As the continued move towards a computer orientated healthcare system occurs, the information technology skills obtained through but not limited to training schemes such as European Computer Driving Licence will become of paramount importance, particularly as the single most important failure for technology-related projects in healthcare is a lack of readiness. [ABSTRACT FROM AUTHOR]

BACKGROUND: Several hypotheses exist to account for the higher than normal rate of alcoholism in individuals with high trait anxiety (or anxiety disorders). Most of these suggest that the practice of drinking alcohol to reduce anxiety leads to an increased risk of alcoholism in vulnerable individuals. The first assumption of the hypothesis is that anxious individuals use alcohol to cope with their anxiety. Few studies have examined this issue systematically, and none have used a nonanxious matched control group. METHODS: Twenty-three individuals with high social anxiety and 23 nonsocially anxious matched controls were included in the study. Groups were similar on demographic variables and alcohol use. All participants were queried regarding the use of alcohol to cope, the practice of avoiding social situations if alcohol was not available, and the degree of relief attained by alcohol. Participants also were asked about using alcohol in 11 specific situations. RESULTS: The socially anxious group was significantly more likely than controls to report using alcohol to feel more comfortable in social situations and to avoid social situations if alcohol was unavailable. They also reported a greater degree of relief of anxiety from alcohol. Exploratory analyses revealed that socially anxious individuals reported using alcohol more to cope with social interactions than with social performance situations. CONCLUSIONS: Individuals high in social anxiety deliberately drink alcohol to cope with their social fears. They report that alcohol is moderately effective at reducing their anxiety, which is seemingly sufficient to allow them to endure social situations. The data support the first assumption of the self-medication hypothesis-that alcohol is used to reduce social discomfort in socially anxious individuals; however, the study was not designed to address the veracity of the self-medication hypothesis as a whole. Results can help guide future studies that examine the relationship between social anxiety and alcohol. [ABSTRACT FROM AUTHOR]

Regular heavy alcohol use can cause or worsen several oral health disorders and is associated with complications during and after dental procedures. Dental student education should provide detailed knowledge of these issues together with skills needed to detect and counsel patients with unhealthy drinking patterns. This project was designed to develop and evaluate a five-module, online program to teach dental students about alcohol and oral health, systemic and oral biological effects of heavy drinking, required changes to treatment protocols for heavy drinkers, reliable methods of alcohol screening, and ways to provide heavy drinkers with brief interventions. Results indicated that the online program resulted in significant changes in knowledge, attitudes, and behavior. This online format could easily be incorporated into an already crowded dental school curriculum, with students learning the material at their own pace and in their own available time.

Background: Relapse risk factors, such as psychological stress and alcohol cues, are often encountered together. Understanding how they interact has the potential to improve alcoholism treatments. This study was conducted to examine whether an acute psychosocial stressor enhanced alcohol cue reactivity in non-treatment-seeking alcoholics., Methods: Seventy-nine alcohol-dependent individuals (39 women) randomly received either the Trier Social Stress Test or a no-stress control condition. Stress reactivity was measured with serum adrenocorticotropic hormone and cortisol, mean arterial blood pressure, and subjective distress. Immediately following the stress manipulation, participants held and sniffed a neutral cue then their preferred alcoholic beverage. Cue reactivity was measured by 2 subjective measures of craving following each cue. Additionally, general craving was assessed with the Alcohol Urge Questionnaire at the beginning and end of the laboratory procedure., Results: The stress manipulation showed internal validity on all measures of stress reactivity. There was not a main effect of stress nor a stress × cue interaction on either cue reactivity measure. As expected, there was a main effect of cue (alcohol > neutral cue) on both measures of cue reactivity. General craving increased during the challenge, but not differently by stress group. Magnitude of stress reactivity was not associated with magnitude of cue reactivity, and all results were independent of gender., Conclusion: In this well-controlled clinical laboratory study of non-treatment-seeking alcoholics, an acute psychological stressor did not make an alcohol cue a more potent urge-inducing stimulus, and stress had no effect on general alcohol craving., (Copyright © 2010 by the Research Society on Alcoholism.)

Endoplasmic reticulum (ER) stress is an integral part of life for all professional secretory cells, but it has been studied to greatest depth in the pancreatic β-cell. This reflects both the crucial role played by ER stress in the pathogenesis of diabetes and also the exquisite vulnerability of these cells to ER dysfunction. The adaptive cellular response to ER stress, the unfolded protein response, comprises mechanisms to both regulate new protein translation and a transcriptional program to allow adaptation to the stress. The core of this response is a triad of stress-sensing proteins: protein kinase R-like endoplasmic reticulum kinase (PERK), inositol-requiring enzyme 1 (IRE1) and activating transcription factor 6. All three regulate portions of the transcriptional unfolded protein response, while PERK also attenuates protein synthesis during ER stress and IRE1 interacts directly with the c-Jun amino-terminal kinase stress kinase pathway. In this review we shall discuss these processes in detail, with emphasis given to their impact on diabetes and how recent findings indicate that ER stress may be responsible for the loss of β-cell mass in the disease., (Copyright © 2010 John Wiley & Sons, Ltd.)

Background: Despite the relative success of opiate antagonist medication within controlled clinical trials for alcoholism, laboratory studies have not fully examined potential mechanisms for their efficacy in alcohol-dependent persons. The present study evaluated the impact of naltrexone and nalmefene on craving and subjective effects after a moderate alcohol dose among non-treatment-seeking alcoholics (n = 125) and social drinkers (n = 90)., Methods: Participants were randomly assigned to receive placebo, naltrexone (titrated to 50 mg/day), or nalmefene (titrated to 40 mg/day) for seven days before an alcohol challenge clinical laboratory session. During the clinical laboratory session, a drink of alcohol (0.4 mg/kg for men, 0.34 mg/kg for women) was provided in a bar-like setting. The effects of the alcohol dose on subjective craving, stimulation, and sedation were measured before having free access to alcohol., Results: Alcoholics reported higher levels of craving than social drinkers before and after the drink as well as higher levels of alcohol-induced stimulation. Both opiate antagonist medications suppressed initial increases in craving and stimulation., Conclusions: These findings demonstrate that both naltrexone and nalmefene are associated with reduced alcohol-induced craving and stimulation among alcoholics who are not actively attempting to reduce drinking. These data provide insights into potential mechanisms that may underlie opiate antagonists' effects in the context of treatment.

Although several treatments for adolescents with substance use disorders are available, there are few well-controlled studies in the extant literature that compare these treatments for efficacy. This paper provides an overview of controlled treatment studies for adolescents with substance use disorders. It focuses specifically on five main treatment modalities: family-based and multi-systemic interventions, behavioral therapy, cognitive behavioral therapy, pharmacotherapy, and twelve step approaches. Examples of adolescent-specific standardized assessment instruments are also provided, the inclusion of which may improve future treatment comparison studies. While the results look especially promising for cognitive behavioral therapy and family-based/multi-systemic therapies for adolescents with SUDs, most of the relevant studies fail to utilize validated outcome measures, making it difficult to conclude that one treatment approach is more effective than another.

The present study compares male and female alcoholics with concurrent social phobia (N = 110) enrolled in an alcohol treatment study. Groups were compared using demographics, social phobia symptoms and severity, and psychiatric variables. Results showed that females reported higher fear ratings than males on some social phobia measures, although for the most part, the genders were more similar than different on social phobia symptoms and severity. There was a high occurrence of psychiatric comorbidity, especially for females. Females also reported more distress than males in family and social functioning. The results are discussed in terms of their implications for treatment for individuals with concurrent alcoholism and social phobia.

Children diagnosed with fetal alcohol syndrome (FAS) were assessed with items from the social skills domain of the Vineland Adaptive Behavior Scales (VABS) via interviews with their caregivers. Their scores were compared with scores from children in two control groups. The control groups included children matched for IQ to the FAS group (specifically on verbal IQ, henceforth, the VIQ group) and children with IQ scores in the average to above-average range (normal control group). Forty-five children (age range, 5 years 7 months to 12 years 11 months) were assessed (n/group = 15). All groups differed with regard to social ability, as measured by the VABS (NC > VIQ > FAS), even when the effects of socioeconomic status were held constant. The three subdomains of the VABS social scale (interpersonal relationship skills, use of play and leisure time, and coping skills) were assessed, and results showed that the children with FAS were most impaired on the subdomain that assessed interpersonal relationship skills. An additional measure was constructed by obtaining an age-equivalent score for the VABS social scale and calculating a difference score by subtracting the child's chronological age from his/her age-equivalent score. There was a significant correlation between chronological age and difference scores for children in the FAS group but not for children in the two control groups. Specifically, in older children with FAS, there was an increased discrepancy between their ages and their age-equivalent scores, a discrepancy that was not present in children in the control groups. These results suggest that social deficits in children with FAS are beyond what can be explained by low IQ scores and indicate that there may be arrested, and not simply delayed, development of social abilities in children with FAS.