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Despite efforts to increase the number of students from socio-economically marginalised communities in higher education (HE) they remain under-represented, a situation likely to perpetuate economic and social inequality. University is a form of HE that is especially vulnerable to decreased representation of students from marginalised communities. This study draws on the perspectives of multiple stakeholders in HE access to identify contemporary barriers to attending university in the Republic of Ireland. It highlights the perspectives of stakeholder groups connected with a university peer mentoring access initiative, including secondary education students and their parents, HE students and graduates, and university and secondary school staff. Findings suggest that contemporary barriers to accessing universities are manifold and include socio-cultural, financial and structural factors involved in applying for, and attending, university. Stakeholders identified supports that would address these factors, with a strong emphasis on the need for relational supports provided through the peer mentoring programme to ensure students feel included in, and prepared to succeed at university. Differences in perspectives by stakeholder group were evident. Secondary education students frequently highlighted socio-cultural and structural barriers to university, for example the low expectations of themselves or others and the 'points' entry system. In contrast, university students and graduates emphasised the need for relational support, knowledge and preparedness in applying for and attending university. The series of barriers identified in this study begin in secondary education and continue throughout HE indicating a need for ongoing responsive supports at various stages throughout students' educational journey.

Previous studies suggest that individuals with substance use disorder have abnormally large responses to unexpected outcomes (reward prediction errors [RPEs]). However, there is much less information on RPE in individuals at risk of alcohol misuse, prior to neurobiological adaptations that might result from sustained alcohol use. Here, participants (mean age 23.77 years, range 18-32 years) performed the electrophysiological monetary incentive delay task. This task involved responding to a target stimulus following reward incentive cues to win, or avoid losing, the cued reward while brain activity was recorded under 64-channel EEG. The Alcohol Use Disorders Identification Test (AUDIT) was used to quantify at-risk alcohol use, with high (n = 22, mean AUDIT score: 13.82) and low (n = 22, mean AUDIT score: 5.77) alcohol use groups. Trial-by-trial RPEs were estimated using a Rescorla-Wagner reinforcement model based on behavioral data. A single-trial analysis revealed that the feedback-related negativity (FRN) and feedback P3 (fb-P3) event-related potential components were significantly modulated by RPEs. There was increased RPE-related fb-P3 amplitude for those in the high alcohol use group. Next, the mean amplitude of ERPs elicited by positive and negative RPEs were compared between groups. We found that high alcohol use participants had attenuated FRN amplitude in contrast with low alcohol use participants for both positive and negative RPEs but enhanced fb-P3 for both positive and negative RPE. These results, with differences in RPE in an at-risk group, suggest that RPE a potential vulnerability marker for alcohol use disorder. [ABSTRACT FROM AUTHOR]

Background and Aims Dysfunction in brain regions underlying impulse control, reward processing and executive function have been associated previously with adolescent alcohol misuse. However, identifying pre-existing neurobiological risk factors, as distinct from changes arising from early alcohol-use, is difficult. Here, we outline how neuroimaging data can identify the neural predictors of adolescent alcohol-use initiation and misuse by using prospective longitudinal studies to follow initially alcohol-naive individuals over time and by neuroimaging adolescents with inherited risk factors for alcohol misuse. Method A comprehensive narrative of the literature regarding neuroimaging studies published between 2010 and 2016 focusing on predictors of adolescent alcohol use initiation and misuse. Findings Prospective, longitudinal neuroimaging studies have identified pre-existing differences between adolescents who remained alcohol-naive and those who transitioned subsequently to alcohol use. Both functional and structural grey matter differences were observed in temporal and frontal regions, including reduced brain activity in the superior frontal gyrus and temporal lobe, and thinner temporal cortices of future alcohol users. Interactions between brain function and genetic predispositions have been identified, including significant association found between the Ras protein-specific guanine nucleotide releasing factor 2 ( RASGRF2) gene and reward-related striatal functioning. Conclusions Neuroimaging predictors of alcohol use have shown modest utility to date. Future research should use out-of-sample performance as a quantitative measure of a predictor's utility. Neuroimaging data should be combined across multiple modalities, including structural information such as volumetrics and cortical thickness, in conjunction with white-matter tractography. A number of relevant neurocognitive systems should be assayed; particularly, inhibitory control, reward processing and executive functioning. Combining a rich magnetic resonance imaging data set could permit the generation of neuroimaging risk scores, which could potentially yield targeted interventions. [ABSTRACT FROM AUTHOR]

Impulsivity is a multidimensional construct that is related to different aspects of alcohol use, abuse, and dependence. Inhibitory control, one facet of impulsivity, can be assayed using the stop-signal task (SST) and quantified behaviorally via the stop-signal reaction time (SSRT) and electrophysiologically using event-related potentials (ERPs). Research on the relationship between alcohol use and SSRTs, and between alcohol use and inhibitory-control ERPs, is mixed. Here, adult alcohol users (n = 79), with a wide range of scores on the Alcohol Use Disorders Identification Test (AUDIT), completed the SST under electroencephalography (EEG) (70% of participants had AUDIT total scores greater than or equal to 8). Other measures, including demographic, self-report, and task-based measures of impulsivity, personality, and psychological factors, were also recorded. A machine-learning method with penalized linear regression was used to correlate individual differences in alcohol use with impulsivity measures. Four separate models were tested, with out-of-sample validation used to quantify performance. ERPs alone statistically predicted alcohol use (cross-validated r = 0.28), with both early and late ERP components contributing to the model (larger N2, but smaller P3, amplitude). Behavioral data from a wide range of impulsivity measures were also associated with alcohol use (r = 0.37). SSRT was a relatively weak statistical predictor, whereas the Stroop interference effect was relatively strong. The addition of nonimpulsivity behavioral measures did not improve the correlation (r = 0.34) and was similar when ERPs were combined with non-ERP data (r = 0.29). These findings show that inhibitory control ERPs are robustly correlated individual differences in alcohol use. [ABSTRACT FROM AUTHOR]

Background: Sweet's syndrome, originally described as an acute febrile neutrophilic dermatosis, belongs to a class of skin lesions that histologically have intense epidermal and/or dermal inflammatory infiltrate of neutrophils without evidence of infection or vasculitis. Skin lesions of Sweet's syndrome most commonly present on the face, trunk, upper extremities, and hands. The presenting lesions are often confused with infections because of their clinical appearance., Methods: A retrospective search of the electronic medical record was performed to identify patients with Sweet's syndrome from 1996 to the present. These records were then reviewed to identify those patients who had Sweet's syndrome that involved the hands., Results: A total of 103 patients with Sweet's syndrome have been seen and treated at Scott and White Memorial Hospital since 1996. Of these, 49 patients had lesions on the hands. The presentation, treatment, and outcomes of several of these patients are presented., Conclusions: As physicians responsible for the treatment of hand lesions, it is important to consider the diagnosis of Sweet's syndrome because these wounds are unresponsive to antibiotics, do not benefit from débridement, and instead, require treatment with steroids.