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Protection from exercise-induced oxidative damage by vitamin E supplementation was examined. Experiments involved the determination of plasma vitamins E and C, uric acid, muscle vitamin E, conjugated diens, fatty acids and reactive substances of urinary thrombotic acid from 21 male volunteers supplemented with 800 IU of vitamin E daily and performing a bout of eccentric exercises. The utility of vitamin E supplementation for diminishing free radical-mediated oxidative damage induced by exercise was demonstrated.

Background: Concern exists that involving vulnerable individuals as participants in research into suicide and self-harm may cause distress and increase suicidal feelings. Actual understanding of participants' experiences is however limited, especially in relation to in-depth qualitative research.Methods: Data were collected from four separate studies focused on self-harm or suicide. These included people with varying levels of past distress, including some who had made nearly lethal suicide attempts. Each involved semi-structured qualitative interviewing. Participants (n=63) were asked to complete a visual analogue scale measuring current emotional state before and after their interview and then comment on how they had experienced the interview, reflecting on any score change.Results: Most participants experienced a change in well-being. Between 50% and 70% across studies reported improvement, many describing the cathartic value of talking. A much smaller group in each study (18-27%) reported lowering of mood as they were reminded of difficult times or forced to focus on current issues. However, most anticipated that their distress would be transient and it was outweighed by a desire to contribute to research. An increase in distress did not therefore necessarily indicate a negative experience.Limitations: There was no follow-up so the long-term effects of participation are unknown. Scores and post interview reflections were collected from participants by the researcher who had conducted the interview, which may have inhibited reporting of negative effects.Conclusions: These findings suggest individuals are more likely to derive benefit from participation than experience harm. Overprotective gate-keeping could prevent some individuals from gaining these benefits. [ABSTRACT FROM AUTHOR]

Background:Few young adults with mental disorder seek help from a GP.Aim:To explore young adults' perceptions of GPs as a source of help for mental distress.Design of study:Qualitative interviews.Setting:Bristol and surrounding areas, UK.Method:Males and females aged 16-24 years screened as 'cases' with probable mental disorder (GHQ [General Health Questionnaire]-12 score>/=4) or describing past episodes of mental disorder (n = 23) were sampled purposively according to help-seeking behaviour. Semi-structured interviews explored help-seeking choices. Transcripts were analysed using thematic, constant comparison and case study analysis.Results:Most young adults did not value or recognise GPs as a source of help for mental disorder or distress. They thought that GPs deal exclusively with physical illness, lack training in mental health, are unable to provide 'talking' therapy, and may be dismissive of those consulting with mental distress. A prescription for antidepressants was seen as the most likely outcome of a consultation, but young adults wished to avoid this and so rarely consulted. Encounters with GPs could challenge or reinforce these perceptions.Conclusion:Negative perceptions about the value of consulting a GP for mental distress may explain low rates of help-seeking among young adults, including those with severe distress. Young people require a better understanding of GPs' role. It is also necessary to address evidence reported elsewhere that some GPs also experience uncertainties about what they can offer within the constraints of primary care. [ABSTRACT FROM AUTHOR]

Background: Research on healthcare for asylum seekers and refugees (ASR) has focused strongly on accessibility and legal entitlements, with quality of care receiving little attention. This study aimed to assess responsiveness - the non-medical quality of care - as perceived by recently arrived ASR in Germany. Methods: 31 ASR with existing medical conditions were recruited in six refugee clinics and three psychosocial counselling centres. Semi-structured, qualitative interviews were conducted, reconstructing the patient journeys after arrival. Interviews were recorded, transcribed and analysed thematically. Results: Responsive care is important in evaluations of the German health system. Trust in providers and their expertise as well as accounts of a ‘‘caring’’ attitude, respectful treatment - e.g. taking afflictions and the situation of ASR seriously - and clear communication resurfaced frequently in ASR narratives. Their evaluation of care was affected by related expectations being exceeded or disappointed. Other responsiveness dimensions, like cleanliness of facilities, autonomy of decision-making and choice of provider were mentioned seldom. Participants voiced a high overall satisfaction with German healthcare. We observed that positive experiences were often set in contrast to negative experiences in countries of origin or during transit and many participants evaluated their healthcare experience initially in terms of the perceived technical quality and outcome of care rather than referring to responsiveness. Conclusions: Aspects of respectful treatment, clear communication and trust are important to ASR. To further strengthen the provision of high quality and responsive care to a diverse patient population, policy action is needed: expansion of professional interpreting services, provision of professional training to increase the reflective and structural competence of healthcare staff and alignment between the healthcare and asylum processes to promote continuity of care. Key messages: • Health systems need to pay attention to the responsiveness dimensions deemed important by asylum seekers to better address needs and concerns of this patient population. • Aspects of trust, respectful treatment and clear communication in healthcare encounters are particularly important to provide high-quality care to asylum seekers and should be strengthened. Background: Research on healthcare for asylum seekers and refugees (ASR) has focused strongly on accessibility and legal entitlements, with quality of care receiving little attention. This study aimed to assess responsiveness - the non-medical quality of care - as perceived by recently arrived ASR in Germany. Methods: 31 ASR with existing medical conditions were recruited in six refugee clinics and three psychosocial counselling centres. Semi-structured, qualitative interviews were conducted, reconstructing the patient journeys after arrival. Interviews were recorded, transcribed and analysed thematically. Results: Responsive care is important in evaluations of the German health system. Trust in providers and their expertise as well as accounts of a ‘‘caring’’ attitude, respectful treatment - e.g. taking afflictions and the situation of ASR seriously - and clear communication resurfaced frequently in ASR narratives. Their evaluation of care was affected by related expectations being exceeded or disappointed. Other responsiveness dimensions, like cleanliness of facilities, autonomy of decision-making and choice of provider were mentioned seldom. Participants voiced a high overall satisfaction with German healthcare. We observed that positive experiences were often set in contrast to negative experiences in countries of origin or during transit and many participants evaluated their healthcare experience initially in terms of the perceived technical quality and outcome of care rather than referring to responsiveness. Conclusions: Aspects of respectful treatment, clear communication and trust are important to ASR. To further strengthen the provision of high quality and responsive care to a diverse patient population, policy action is needed: expansion of professional interpreting services, provision of professional training to increase the reflective and structural competence of healthcare staff and alignment between the healthcare and asylum processes to promote continuity of care. Key messages: • Health systems need to pay attention to the responsiveness dimensions deemed important by asylum seekers to better address needs and concerns of this patient population. • Aspects of trust, respectful treatment and clear communication in healthcare encounters are particularly important to provide high-quality care to asylum seekers and should be strengthened. [ABSTRACT FROM AUTHOR]

Growth failure in zinc-deficient animals is associated with decreased DNA synthesis; zinc deprivation of 3T3 cells, by use of diethylenetrinitrilopentaacetate (DTPA), impairs thymidine incorporation when the cells are stimulated with fetal bovine serum (FBS). The purpose of this study was to determine the step of cell cycle progression that is affected by zinc deprivation. Swiss murine 3T3 cells were cultured for 3 d in complete media and then for 2 d in low serum media. Cells were then placed in serum-free media and stimulated in sequence with platelet-derived growth factor (PDGF; 3 h), epidermal growth factor (EGF; 0.5 h) and insulin-like growth factor-I (IGF-I; 16 h). The combination of growth factors stimulated thymidine incorporation to the same extent as 10% FBS, and DTPA or EDTA (0.6 mmol/L) inhibited thymidine incorporation. Inhibition was prevented by addition of zinc, but not calcium, iron or cadmium (0.4 mmol/L). When DTPA was present during all stages with no addition of zinc, or zinc added during the competency-priming (PDGF and EGF) step, the IGF-I step, or both steps, the zinc effect occurred at the IGF-I step. Zinc addition 4 h before the measurement of thymidine incorporation had no ameliorative effect, but the presence of zinc during the prior 12 h increased incorporation. Thus zinc exerts its major effect on DNA synthesis during the IGF-I stimulatory phase of the cell cycle. The total zinc concentration of 3T3 cells treated with DTPA for 16 h was not different from that of untreated cells; hence only a small compartment of the cell is affected by DTPA. [ABSTRACT FROM AUTHOR]

Background Method Results Conclusion Many young people (YP) struggle with their mental health and look online for help. To capitalise on their digital presence, we need to better understand how and where they seek information online and what they think of what they find.We recruited 24 YP (aged 13–18 years). Online interviews were co‐conducted by research team members and trained young researchers. We presented a persona with depression symptoms and asked about potential sources of information/support they might seek. They were also asked to think aloud while searching online and reviewing mental health resources (NHS, Young Minds). We used reflexive thematic analysis.Analysis generated four themes: (1) the online help‐seeking process, showcasing where YP look for information and why; (2) the mismatch between the information YP expected to find and the reality; (3) the strategies YP employed to determine a source's trust and credibility and (4) individual differences that can influence help‐seeking.Participants initiated their online search by Googling symptoms. They trusted NHS websites for basic medical information, while charities provided detailed content. Despite scepticism about content, social media offered validation. Online resources should prioritise visual appeal, user‐friendliness, age‐appropriate and personalised content and peer insights. Codesign is imperative to ensure high‐quality, impactful research. [ABSTRACT FROM AUTHOR]

Abstract Background Schools have been identified as an important place in which to support adolescent emotional health, although evidence as to which interventions are effective remains limited. Relatively little is known about student and staff views regarding current school-based emotional health provision and what they would like to see in the future, and this is what this study explored. Methods A random sample of 296 English secondary schools were surveyed to quantify current level of emotional health provision. Qualitative student focus groups (27 groups, 154 students aged 12-14) and staff interviews (12 interviews, 15 individuals) were conducted in eight schools, purposively sampled from the survey respondents to ensure a range of emotional health activity, free school meal eligibility and location. Data were analysed thematically, following a constant comparison approach. Results Emergent themes were grouped into three areas in which participants felt schools did or could intervene: emotional health in the curriculum, support for those in distress, and the physical and psychosocial environment. Little time was spent teaching about emotional health in the curriculum, and most staff and students wanted more. Opportunities to explore emotions in other curriculum subjects were valued. All schools provided some support for students experiencing emotional distress, but the type and quality varied a great deal. Students wanted an increase in school-based help sources that were confidential, available to all and sympathetic, and were concerned that accessing support should not lead to stigma. Finally, staff and students emphasised the need to consider the whole school environment in order to address sources of distress such as bullying and teacher-student relationships, but also to increase activities that enhanced emotional health. Conclusion Staff and students identified several ways in which schools can improve their support of adolescent emotional health, both within and outside the curriculum. However, such changes should be introduced as part of a wider consideration of how the whole school environment can be more supportive of students' emotional health. Clearer guidance at policy level, more rigorous evaluation of current interventions, and greater dissemination of good practice is necessary to ensure adolescents' emotional health needs are addressed effectively within schools.

Abstract Background The n-of-1 trial offers a more methodologically sound approach to determining optimum treatment for an individual patient than "trials of therapy" routinely conducted in clinical practice. However, such methodology is rarely used in the UK. This pilot study explores the acceptability of n-of-1 trials to patients in the UK. Methods Patients with osteoarthritis of the knee were recruited to their own 12-week n-of-1 trial comparing either two knee supports or an NSAID with simple analgesic. Patients were interviewed at the start and completion of their trial to explore reasons for participation, understanding of the trial design and experiences of participation. Daily diaries were completed to inform future treatment. Results Nine patients participated (5 supports, 4 drugs). Patients were keen to participate, believing that the trial may lead to personal gains such as improved symptom control and quality of life. However, recruitment to the pharmacological comparison was more difficult since this could also entail risk. All patients were eager to complete the trial, even when difficulties were encountered. Completing the daily diary provided some patients with greater insight into their condition, which allowed them to improve their self-management. The n-of-1 trial design was viewed as a 'logical' design offering an efficient method of reaching a personalised treatment decision tailored to suit individual needs and preferences. Conclusion This pilot study suggests that patients perceive the n-of-1 trial as an acceptable approach to the individualisation of treatment. In addition, further benefits over and above any gained from the interventions can be derived from involvement in such a study.