Optical and Electrical Properties of TTF-MPcs (M = Cu, Zn) Interfaces for Optoelectronic Applications.

Sandwich structures were fabricated by a vacuum deposition method using MPc (M = Cu, Zn), with a Tetrathiafulvalene (TTF) derivative, and Indium Tin Oxide (ITO) and aluminum electrodes. The structure and morphology of the deposited films were studied by IR spectroscopy, scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS). The absorption spectra of TTF derivative-MPc (M = Cu, Zn) thin films deposited at room temperature were recorded in the spectral range 200-1000 nm. The optical band gap of the thin films was determined from the (αhν)(1/2) vs. hν plot. The direct-current (DC) electrical properties of the glass/ITO/TTFderiv-MPc (M = Cu, Zn)/Al structures were also investigated. Changes in conductivity of the derivative-TTF-enriched Pc compounds suggest the formation of alternative paths for carrier conduction. At low voltages, forward current density obeys an ohmic I-V relationship; at higher voltages, conduction is mostly due to a space-charge-limited conduction (SCLC) mechanism.

Randomized Trial of Reduced-Nicotine Standards for Cigarettes.

BACKGROUND: The Food and Drug Administration can set standards that reduce the nicotine content of cigarettes. METHODS: We conducted a double-blind, parallel, randomized clinical trial between June 2013 and July 2014 at 10 sites. Eligibility criteria included an age of 18 years or older, smoking of five or more cigarettes per day, and no current interest in quitting smoking. Participants were randomly assigned to smoke for 6 weeks either their usual brand of cigarettes or one of six types of investigational cigarettes, provided free. The investigational cigarettes had nicotine content ranging from 15.8 mg per gram of tobacco (typical of commercial brands) to 0.4 mg per gram. The primary outcome was the number of cigarettes smoked per day during week 6. RESULTS: A total of 840 participants underwent randomization, and 780 completed the 6-week study. During week 6, the average number of cigarettes smoked per day was lower for participants randomly assigned to cigarettes containing 2.4, 1.3, or 0.4 mg of nicotine per gram of tobacco (16.5, 16.3, and 14.9 cigarettes, respectively) than for participants randomly assigned to their usual brand or to cigarettes containing 15.8 mg per gram (22.2 and 21.3 cigarettes, respectively; P<0.001). Participants assigned to cigarettes with 5.2 mg per gram smoked an average of 20.8 cigarettes per day, which did not differ significantly from the average number among those who smoked control cigarettes. Cigarettes with lower nicotine content, as compared with control cigarettes, reduced exposure to and dependence on nicotine, as well as craving during abstinence from smoking, without significantly increasing the expired carbon monoxide level or total puff volume, suggesting minimal compensation. Adverse events were generally mild and similar among groups. CONCLUSIONS: In this 6-week study, reduced-nicotine cigarettes versus standard-nicotine cigarettes reduced nicotine exposure and dependence and the number of cigarettes smoked. (Funded by the National Institute on Drug Abuse and the Food and Drug Administration Center for Tobacco Products; ClinicalTrials.gov number, NCT01681875.).

Selegiline transdermal system (STS) as an aid for smoking cessation.

INTRODUCTION: This study examined the efficacy and safety of selegiline transdermal system (STS) and brief repeated behavioral intervention (BRBI) for smoking cessation in heavy smokers. We hypothesized that the quit rate of subjects who received STS and BRBI would be significantly greater than that of those who received placebo patch and BRBI. METHODS: This was a double-blind, placebo-controlled parallel-group study in which 246 men and women were randomized to receive either STS (n = 121) or placebo patch (n =125) for 9 weeks. Recruitment targeted heavy smokers, defined as individuals with self-reported use of ≥15 cigarettes/day in the 30 days prior to enrollment, who had smoked cigarettes for the past 5 years, and had an expired CO level ≥9 ppm during screening. RESULTS: Although STS was well tolerated, the overall results indicated that STS with BRBI was not more effective than placebo plus BRBI for smoking cessation (p = .58). CONCLUSIONS: The results are discussed in relation to interventions for heavy smokers. Although 2 trials using oral selegiline both showed trends toward improved abstinence, these results indicate that STS with BRBI was not an effective aid for smoking cessation at the end of treatment (10 weeks), 14, or 26 weeks.

Estudio de caso: la gestión de la alimentación escolar en Santiago de Cali y Bogotá D.C. / Case study: school meals' management in Santiago de Cali and Bogota

Objetivo La preocupación de esta investigación giró alrededor del papel del Estado frente a la problemática del hambre y la manera como gestiona en aras de combatirla, para ello se evaluó la gestión de una medida en seguridad alimentaria y nutricional en dos ciudades colombianas: la alimentación escolar en Santiago de Cali y Bogotá D.C. Métodos Se partió de un enfoque cualitativo, utilizando como técnicas de recolección de información el análisis documental, la observación participante y entrevistas a profundidad con diversos actores para ambos casos seleccionados. Resultados No todas las medidas en la materia se encuentran bajo unos principios normativos orientados a todas las dimensiones que abarca la seguridad alimentaria y nutricional. En Santiago de Cali hay serias debilidades en la gestión que se asocian con un contexto débil en la lucha contra el hambre. Bogotá presenta una gestión encaminada a la realización del derecho a la alimentación que ha contado con un proceso institucional, donde el tema de reducir el hambre se ha vuelto un propósito. Discusión La gestión de la medida se asocia con las características de su producto, lo cual incide en la intervención y finalmente en el estado alimentario y nutricional de la población. De esta forma, la gestión del Estado se vuelve otra dimensión de la seguridad alimentaria y nutricional.

Objective This research was aimed at ascertaining the state's role regarding hunger and how it manages to combat this matter; a food security program in two Colombian cities was thus assessed (i.e. school meals' provision in Cali and Bogota). Methods A qualitative approach was adopted; documentary analysis, participant observation and in-depth interviews with various actors for both selected cases were used as data collection techniques. Results It was found that several measures taken in this area were not covered by regulatory principles aimed at covering all the dimensions of food security. Serious weaknesses in school meals' management in Cali were associated with a weak environment regarding the fight against hunger. School meals' management in Bogotá was aimed at recognizing the right to food as being supported by an institutional process where the issue of reducing hunger has become a firm purpose. Discussion School meals' program management was associated with the characteristics of its product, thereby affecting the program and the population's food and nutritional status; state management thus becomes another dimension of food security.

Generalizability of clinical trials for cannabis dependence to community samples.

There is growing concern that results of tightly controlled clinical trials may not generalize to broader community samples. To assess the proportion of community dwelling adults with cannabis dependence who would have been eligible for a typical cannabis dependence treatment study, we applied a standard set of eligibility criteria commonly used in cannabis outcome studies to a large (N=43,093) representative US adult sample interviewed face-to-face, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Approximately 80% of the community sample of adults with a diagnosis of cannabis dependence (N=133) would be excluded from participating in clinical trials by one or more of the common eligibility criteria. Individual study criteria excluded from 0% to 41.0% of the community sample. Legal problems, other illicit drug use disorders, and current use of fewer than 5 joints/week excluded the largest percentage of individuals. These results extend to cannabis dependence concerns that typical clinical trials likely exclude most community dwelling adults with the disorder. The results also support the notion that clinical trials tend to recruit highly selective samples, rather than adults who are representative of typical patients. Clinical trials should carefully evaluate the effects of eligibility criteria on the generalizability of their results. Even in efficacy trials, stringent exclusionary criteria could limit the representativeness of study results.

Avances en la investigación de inmunoterapias contra las drogas de abuso / Research advances in the immunotherapies of addictions

Introducción: Las terapias inmunológicas, ya sea con vacunas (inmunización activa) o con anticuerpos (inmunización pasiva), se están investigando activamente para el manejo de las complicaciones del consumo de drogas de abuso. Objetivo: Revisar el estado actual del desarrollo en la investigación de inmunoterapias contra nicotina, cocaína, heroína, metanfetamina y fenciclidina (PCP), con énfasis en los aspectos clínicos de cada una de ellas. Método: Revisión de la literatura sobre el tema. Resultados: Hasta el momento, las inmunoterapias evaluadas en humanos parecen ser seguras desde el punto de vista médico y con eficacia esperanzadora. Por este mecanismo se previene la activación de los mecanismos de refuerzo cerebral asociados con los efectos adictivos de la droga y, eventualmente, la extinción de la adicción. Conclusión: En teoría, las vacunas también podrían ser útiles en la prevención del desarrollo de la adicción al igual que para prevenir las recaídas del uso de drogas. Los anticuerpos monoclonales parecen ser útiles en el tratamiento de las sobredosis de drogas, porque pueden prevenir los efectos neurotóxicos de las drogas al bloquear su acceso al cerebro. Actualmente, se están investigando vacunas contra la cocaína, heroína, metanfetamina y nicotina. Igualmente se están investigando anticuerpos monoclonales contra la cocaína, metanfetamina, nicotina y PCP...

Introduction: Immunological therapies, either with vaccines (active immunization) or with antibodies (passive immunization), are being actively investigated in the management of complications of drug abuse. Objetive: To review the current state of research development of immunotherapies against nicotine, cocaine, heroin, methamphetamine and phencyclidine (PCP) with an emphasis on the clinical aspects. Method: Review the literature about the topic. Results: So far, immunotherapies evaluated in humans appear to be safe from a medical standpoint and effective. This mechanism prevents the activation of brain reinforcement mechanisms associated with the addictive effects of drugs and, eventually, the extinction of the drug addiction. Conclusion: In theory, vaccines could also be useful in preventing the development of addiction as well as to prevent the relapse of drug use. Currently, vaccines are being investigated against cocaine, heroin, methamphetamine and nicotine. Likewise, monoclonal antibodies are being investigated against cocaine, methamphetamine, nicotine and phencyclidine (PCP)...

Treatment of tobacco dependence in mental health and addictive disorders.

People with mental health and addictive (MHA) disorders smoke at high rates and require tobacco treatment as a part of their comprehensive psychiatric care. Psychiatric care providers often do not address tobacco use among people with mental illness, possibly owing to the belief that their patients will not be able to quit successfully or that even short-term abstinence will adversely influence psychiatric status. Progress in the development of treatments has been slow in part because smokers with current MHA disorders have been excluded from most smoking cessation trials. There are several smoking cessation treatment options, including psychological and pharmacological interventions, that should be offered to people with an MHA disorder who smoke. Building motivation and readiness to quit smoking is a major challenge, and therefore motivational interventions are essential. We review the treatment options for people with tobacco dependence and MHA disorders, offer recommendations on tobacco assessment and tailored treatment strategies, and provide suggestions for future research. Treatment efficacy could be enhanced through promoting smoking reduction as an initial treatment goal, extending duration of treatment, and delivering it within an integrated care model that also aims to reduce the availability of tobacco in MHA treatment settings and in the community.

Genome-wide association for nicotine dependence and smoking cessation success in NIH research volunteers.

Phenotypes related to both nicotine dependence and ability to successfully quit smoking display substantial heritabilities in classical and molecular genetic studies. Twin studies suggest that some genetic components for dependence overlap with genetic components of ability to quit, but that many components do not overlap. Initial genome-wide association (GWA) studies have demonstrated haplotypes that distinguish nicotine-dependent from nondependent smokers. These haplotypes overlap partially with those that distinguish individuals who successfully quit smoking from those who were not able to quit smoking in clinical trials for smoking cessation. We now report novel genome-wide association results from National Institutes of Health research volunteers who reported smoking histories, symptoms of nicotine dependence, and ability to successfully quit smoking outside the context of a clinical trial. These results buttress data from several prior GWA studies. The data from these volunteers support the idea that previously reported studies of genes associated with smoking cessation success in clinical trial participants may also apply to smokers who are more or less able to initiate and sustain abstinence outside of clinical trial settings.

Medications Development for the Treatment of Nicotine Dependence in Individuals with Schizophrenia.

The development of medications for the treatment of nicotine dependence in patients with schizophrenia is a public health priority due to its high prevalence rates, devastating medical consequences, and difficulty to treat. It has been hypothesized that the high prevalence of nicotine dependence among patients with schizophrenia may be due to a shared neurobiological vulnerability. This shared vulnerability has been evidenced in reports showing that nicotine improves neuropsychological deficits associated with schizophrenia such as in the P50 evoked auditory potentials, spatial working memory, and attention. The common pathophysiologic pathways of smoking and schizophrenia may serve as the basis for the pharmacological evaluation of medications for the treatment of these concurrent disorders. Currently, little research of medications for the treatment of this comorbidity has been conducted. Studies have evaluated the efficacy of smoking cessation medications in patients with schizophrenia. These include the nicotine replacement therapy (patch, nasal spray) and sustained release bupropion. Others have evaluated the anti-smoking effect of medications (e.g., clozapine, haloperidol) used for the treatment of schizophrenia. In both cases, the results have not been conclusive. Newer smoking cessation approaches such as varenicline, selegiline, rimonabant, and nicotine vaccine, among others, have yet to be tested in this population. The purpose of this article is to review the results of the studies conducted to date and propose some potential pharmacotherapies based on the current knowledge of the pathophysiology of both disorders.

Identification and treatment of patients with nicotine problems in routine clinical psychiatry practice.

The aim of this study is to assess the rates of nicotine problems diagnosed by psychiatrists, the characteristics of psychiatric patients who smoke, and the services provided to them in routine psychiatric practice. Data were obtained by asking psychiatrists participating in the American Psychiatric Institute for Psychiatric Research and Education's Practice Research Network to complete a self-administered questionnaire to provide detailed sociodemographic, clinical, and health plan information on three of their patients seen during routine clinical practice. A total of 615 psychiatrists provided information on 1,843 patients, of which 280 (16.6%) were reported to have a current nicotine problem. Of these, 9.1% were reported to receive treatment for nicotine dependence. Patients with nicotine problems were significantly more likely to be males, divorced or separated, disabled, and uninsured, and have fewer years of education. They also had significantly more co-morbid psychiatric disorders, particularly schizophrenia or alcohol/substance use disorders; a lower Global Assessment Functioning score; and poorer treatment compliance than their counterparts. The results suggest a very low rate of identification and treatment of nicotine problems among patients treated by psychiatrists, even though psychiatric patients who smoke seem to have more clinical and psychosocial stressors and more severe psychiatric problems than those who do not smoke. Programs should be developed to raise the awareness and ability of psychiatrists to diagnose and treat patients with nicotine problems, with a particular emphasis on the increased medical and psychosocial needs of psychiatric patients who smoke.

Improving the care of individuals with schizophrenia and substance use disorders: consensus recommendations.

National attention continues to focus on the need to improve care for individuals with co-occurring mental illnesses and substance use disorders, as emphasized in the 2003 President's New Freedom Commission Report on Mental Health and recent publications from the Substance Abuse and Mental Health Services Administration (SAMHSA). These reports document the need for best practice recommendations that can be translated into routine clinical care. Although efforts are underway to synthesize literature in this area, few focused recommendations are available that include expert opinion and evidence-based findings on the management of specific co-occurring disorders, such as schizophrenia and addiction. In response to the need for user-friendly recommendations on the treatment of schizophrenia and addiction, a consensus conference of experts from academic institutions and state mental health systems was organized to 1) frame the problem from clinical and systems-level perspectives; 2) identify effective and problematic psychosocial, pharmacological, and systems practices; and 3) develop a summary publication with recommendations for improving current practice. The results of the consensus meeting served as the foundation for this publication, which presents a broad set of recommendations for clinicians who treat individuals with schizophrenia. "Integrated treatment" is the new standard for evidence-based treatment for this population and recommendations are given to help clinicians implement such integrated treatment. Specific recommendations are provided concerning screening for substance use disorders in patients with schizophrenia, assessing motivation for change, managing medical conditions that commonly occur in patients with dual diagnoses (e.g., cardiovascular disease, liver complications, lung cancer, HIV, and hepatitis B or C infections) and selecting the most appropriate medications for such patients to maximize safety and minimize drug interactions, use of evidence-based psychosocial interventions for patients with dual diagnoses (e.g., Dual Recovery Therapy, modified cognitive-behavioral therapy, modified motivational enhancement therapy, and the Substance Abuse Management Module), and key pharmacotherapy principles for treating schizophrenia, substance use disorders, and comorbid anxiety, depression, and sleep problems in this population. Finally the article reviews programmatic and systemic changes needed to overcome treatment barriers and promote the best outcomes for this patient population. An algorithm summarizing the consensus recommendations is provided in an appendix.

Parenting knowledge among substance abusing women in treatment.

The purpose of this study was to assess parenting knowledge and beliefs among drug abusing pregnant and recently postpartum women engaged in a comprehensive substance abuse treatment program. The effects of a parenting skills training program for this population were evaluated. A Parenting Skills Questionnaire was developed and administered to a sample of 73 pregnant and drug-dependent women during their first week of substance abuse treatment and again approximately 7 weeks later, following parenting skills training. The questionnaire was designed to assess whether group and individual parenting sessions changed the subjects' knowledge and beliefs in four parenting domains: newborn care, feeding practices, child development and drug abuse during pregnancy. Pre-intervention scores for all parenting domains were low. Post- vs. pre-intervention comparisons showed significant increases in all domain scores after individual and group parenting skills training. Preliminary results obtained from this clinic-based sample suggest that these substance abusing mothers lacked important parenting knowledge and that this knowledge improved after comprehensive substance abuse treatment that included parenting training.

Heroin detoxification with buprenorphine on an inpatient psychiatric unit.

The purpose of this open-label, uncontrolled study was to evaluate the feasibility of administering off-label buprenorphine in combination with ancillary medications for inpatient short-term detoxification of heroin-dependent patients at a psychiatric facility. A sample of 20 heroin-dependent patients admitted to an urban psychiatric hospital was administered buprenorphine 6, 4, and 2 mg/day during the first, second, and third day of detoxification, respectively, and then observed during the fourth and fifth day. Eighty-five percent of the subjects abused other substances, 75% reported cocaine abuse/dependence, 75% had comorbid mood disorders. All subjects completed the medication phase of the study. No clinically significant adverse events were reported. There was a significant decrease in the Clinical Investigation Narcotic Assessment (CINA) total score between baseline and days 2 through 5. The results suggest that buprenorphine is well tolerated and may be beneficial for medically supervised short-term withdrawal from heroin for hospitalized psychiatric patients.

Open-label pilot study of bupropion plus bromocriptine for treatment of cocaine dependence.

Combinations of medications are often used in neuropsychiatry to enhance treatment efficacy. This 8-week, open-label study tested the combination of bupropion (< or =300 mg) and bromocriptine (< or =7.5 mg) daily in 34 cocaine-dependent (DSM-IIIR) outpatients also receiving weekly individual counseling. The first 18 subjects spent one week at maximum dose; the next 16 spent three weeks. Both groups showed significant reductions in self-reported cocaine use, with no significant change in proportion of urine toxicology tests positive for cocaine. There were no significant differences in outcome between groups. These results suggest that the combination of bupropion and bromocriptine is safe in cocaine addicts, but provide ambiguous evidence of its efficacy.

Prevalencia de depresion clinica medida por la SDS en personas que adelantan programas de especializacion en el area de la salud en Medellin, Colombia / Prevalency of clinical depression meassure by the SDS in persons advancing programs of specialization in the health area in Medellin, Colombia

Se llevo a cabo un estudio de corte sobre la prevalencia de sintomatologia depresiva medida con la escala autoevaluativa de depresion (SDS) de Zung, en 148 hombres y 53 mujeres que cursaban programas de especializacion en salud en Medellin, Colombia en junio de 1987. Se encontro que el 25% de los hombres y el 40% de las mujeres presntaban sintomatologia depresiva clinicamente significativa (indices mayores de 50 puntos en la escala), en el momento del estudio. Los nveles mas importantes de depresion, de acuerdo con la SDS, se encontraron en las mujeres que estaban llevando a cabo residencias clinicas en la Facultad de Medicina de la Universidad de Antioquia, seguidas por los hombres de esta facultad, y luego las mujeres y los hombres de la Facultad Nacional de Sauld Publica. Los residentes de la Facultad de Medicina de la Universidad Pontificia Bolivariana mostraron menos sintomatologia depresiva que los anteriores. Se hicieron analisis de cada uno de los sintomas, encontrando con mayor frecuencia las siguientes: dimsinucion de la libido, malestar matinal, confusion, retardo psicomotor, falta de confianza en el futuro, tristeza generalizada, irritabilidad, indecision y descenso en la capacidad para disfrutar de las actividades cotidianas. Los hallazgos de esta investigacion senalan la necesidad de estudios complementarios de causalidad y posiblemente de alguna intervencion administrativa y terapeutica que sirva para mejorar la situacion a esta poblacion.