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The purpose of this review was to analyze the literature for potential next-day residual effects of zolpidem, a non-benzodiazepine hypnotic, following nighttime administration. Based on more than 30 international clinical trials involving more than 2,600 subjects/patients, it can be concluded that at the recommended doses of zolpidem 10 mg for adults and zolpidem 5 mg for the elderly, at single or repeated dosing, in healthy subjects or insomniac patients, zolpidem appears to induce minimal next-day residual effects. As for all sedative hypnotics, zolpidem is indicated for the short-term treatment of insomnia and is recommended to be taken only when the patient is able to get a full night's sleep before resuming usual activities.
Mental health and wellbeing, including addressing impacts of historical trauma and substance use among young people, has been identified as a key priority by Indigenous communities and leaders across Canada and globally. Yet, research to understand mental health among young Indigenous people who have used drugs is limited.
To examine longitudinal risk and strengths-based factors associated with psychological distress among young Indigenous people who use drugs.
The Cedar Project is an ongoing cohort study involving young Indigenous people who use drugs in Vancouver, Prince George, and Chase, British Columbia, Canada. This study included participants who completed the Symptom Checklist-90-Revised, returned for follow-up between 2010 and 2012, and completed the Childhood Trauma Questionnaire. Adjusted linear mixed-effects models estimated effects of study variables on changes in area T-scores of psychological distress.
Of 202 eligible participants, 53% were women and the mean age was 28 years. Among men, childhood maltreatment (emotional abuse, physical abuse, sexual abuse, physical neglect), any drug use, blackouts from drinking, and sex work were associated with increased distress. Among women, childhood maltreatment (emotional abuse, physical abuse, physical neglect), blackouts from drinking, and sexual assault were associated with increased distress, while having attempted to quit using drugs was associated with reduced distress. Marginal associations were observed between speaking their traditional language and living by traditional culture with lower distress among men.
Culturally safe mental wellness interventions are urgently needed to address childhood trauma and harmful coping strategies that exacerbate distress among young Indigenous people who use drugs.
We argue that the stellar velocity dispersion observed in an elliptical galaxy is a good proxy for the halo velocity dispersion. As dark matter halos are almost completely characterized by a single scale parameter, the stellar velocity dispersion tells us the virial radius of the halo and the mass contained within. This permits non-dimensionalizing of the stellar mass and effective radius axes of the stellar mass fundamental plane by the virial radius and halo mass, respectively.
Post-traumatic stress disorder (PTSD) in response to the World Trade Center (WTC) disaster of 11 September 2001 (9/11) is one of the most prevalent and persistent health conditions among both professional (e.g. police) and non-traditional (e.g. construction worker) WTC responders, even several years after 9/11. However, little is known about the dimensionality and natural course of WTC-related PTSD symptomatology in these populations.
Data were analysed from 10 835 WTC responders, including 4035 police and 6800 non-traditional responders who were evaluated as part of the WTC Health Program, a clinic network in the New York area established by the National Institute for Occupational Safety and Health. Confirmatory factor analyses (CFAs) were used to evaluate structural models of PTSD symptom dimensionality; and autoregressive cross-lagged (ARCL) panel regressions were used to examine the prospective interrelationships among PTSD symptom clusters at 3, 6 and 8 years after 9/11.
CFAs suggested that five stable symptom clusters best represent PTSD symptom dimensionality in both police and non-traditional WTC responders. This five-factor model was also invariant over time with respect to factor loadings and structural parameters, thereby demonstrating its longitudinal stability. ARCL panel regression analyses revealed that hyperarousal symptoms had a prominent role in predicting other symptom clusters of PTSD, with anxious arousal symptoms primarily driving re-experiencing symptoms, and dysphoric arousal symptoms primarily driving emotional numbing symptoms over time.
Results of this study suggest that disaster-related PTSD symptomatology in WTC responders is best represented by five symptom dimensions. Anxious arousal symptoms, which are characterized by hypervigilance and exaggerated startle, may primarily drive re-experiencing symptoms, while dysphoric arousal symptoms, which are characterized by sleep disturbance, irritability/anger and concentration difficulties, may primarily drive emotional numbing symptoms over time. These results underscore the importance of assessment, monitoring and early intervention of hyperarousal symptoms in WTC and other disaster responders.
where N ≥ 3;, ϵ is a positive parameter; V:RN → [0, ∞) satisfies some suitable assumptions. We study two cases: if f is asymptotically linear, i.e., if lim|t| → ∞f(t)/t=constant, then we get positive solutions. If f is superlinear and f(u)=|u|p−2u+|u|q−2u, 2* > p > q > 2, we obtain the existence of multiple sign-changing semi-classical bound states with information on the estimates of the energies, the Morse indices and the number of nodal domains. For this purpose, we establish a mountain cliff theorem without the compactness condition and apply a new sign-changing critical point theorem.
Longitudinal symptoms of post-traumatic stress disorder (PTSD) are often characterized by heterogeneous trajectories, which may have unique pre-, peri- and post-trauma risk and protective factors. To date, however, no study has evaluated the nature and determinants of predominant trajectories of PTSD symptoms in World Trade Center (WTC) responders.
A total of 10835 WTC responders, including 4035 professional police responders and 6800 non-traditional responders (e.g. construction workers) who participated in the WTC Health Program (WTC-HP), were evaluated an average of 3, 6 and 8 years after the WTC attacks.
Among police responders, longitudinal PTSD symptoms were best characterized by four classes, with the majority (77.8%) in a resistant/resilient trajectory and the remainder exhibiting chronic (5.3%), recovering (8.4%) or delayed-onset (8.5%) symptom trajectories. Among non-traditional responders, a six-class solution was optimal, with fewer responders in a resistant/resilient trajectory (58.0%) and the remainder exhibiting recovering (12.3%), severe chronic (9.5%), subsyndromal increasing (7.3%), delayed-onset (6.7%) and moderate chronic (6.2%) trajectories. Prior psychiatric history, Hispanic ethnicity, severity of WTC exposure and WTC-related medical conditions were most strongly associated with symptomatic trajectories of PTSD symptoms in both groups of responders, whereas greater education and family and work support while working at the WTC site were protective against several of these trajectories.
Trajectories of PTSD symptoms in WTC responders are heterogeneous and associated uniquely with pre-, peri- and post-trauma risk and protective factors. Police responders were more likely than non-traditional responders to exhibit a resistant/resilient trajectory. These results underscore the importance of prevention, screening and treatment efforts that target high-risk disaster responders, particularly those with prior psychiatric history, high levels of trauma exposure and work-related medical morbidities.
Thousands of rescue and recovery workers descended on the World Trade Center (WTC) in the wake of the terrorist attack of September 11, 2001 (9/11). Recent studies show that respiratory illness and post-traumatic stress disorder (PTSD) are the hallmark health problems, but relationships between them are poorly understood. The current study examined this link and evaluated contributions of WTC exposures.
Participants were 8508 police and 12 333 non-traditional responders examined at the WTC Medical Monitoring and Treatment Program (WTC-MMTP), a clinic network in the New York area established by the National Institute for Occupational Safety and Health (NIOSH). We used structural equation modeling (SEM) to explore patterns of association among exposures, other risk factors, probable WTC-related PTSD [based on the PTSD Checklist (PCL)], physician-assessed respiratory symptoms arising after 9/11 and present at examination, and abnormal pulmonary functioning defined by low forced vital capacity (FVC).
Fewer police than non-traditional responders had probable PTSD (5.9% v. 23.0%) and respiratory symptoms (22.5% v. 28.4%), whereas pulmonary function was similar. PTSD and respiratory symptoms were moderately correlated (r=0.28 for police and 0.27 for non-traditional responders). Exposure was more strongly associated with respiratory symptoms than with PTSD or lung function. The SEM model that best fit the data in both groups suggested that PTSD statistically mediated the association of exposure with respiratory symptoms.
Although longitudinal data are needed to confirm the mediation hypothesis, the link between PTSD and respiratory symptoms is noteworthy and calls for further investigation. The findings also support the value of integrated medical and psychiatric treatment for disaster responders.
The genesis of this book about development itself has been a developmental process. The structure as well as the source of some of the material derive from a conference held in 2005, entitled “Four Dimensions of Childhood: Brain, Mind, Culture, and Time.” Organized and funded by the nonprofit The Foundation for Psychocultural Research (FPR), the meeting was co-sponsored by the University of California, Los Angeles, and The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD, R13HD048149). The conference itself was the product of the vision of FPR founder Robert Lemelson, of discussions by members of the foundation board, and of creative and energetic foundation staff.
The intellectual highlights of the conference drove decisions about formation of the volume. First, we found that the initial focus on advances in developmental neuroscience required expansion to include the equally compelling breakthroughs in epigenetics, genomics, neuroendocrine regulation, and behavioral and social biology. Second, we observed that the interaction among scientists and practitioners around specific cases or findings were particularly revealing. Several sessions at the meeting were organized as case studies, which were then discussed in depth by a panel of researchers from different fields. We found that the diversity of contexts, observations, and perspectives – even within academic disciplines – contributed to a richer understanding of early life experience and its defining moments. Consequently, we set out to identify a complementary set of case studies or research vignettes and then elicited commentary from key thinkers in other fields.
The authors offer a unique exploration of the formative effects of children's early life experiences, with an emphasis on interactions among neurodevelopmental, behavioural and cultural dynamics. Multidisciplinary case studies focus on specific periods of development, or windows of susceptibility, during which care giving and other cultural practices potentially have a long-lasting impact on brain and behaviour. Chapters describe in detail: how social experience interacts with neurodevelopmental disorders; how epigenetic mechanisms mediate the effects of early environment; the interaction of temperament and environmental influences; the implications of early life stress or trauma for mental health and well-being; and the cultural shaping of sexual development and gender identity. The final section translates insights from this work into a fresh appraisal of child-rearing practices, clinical interventions and global public health policy that affect the mental health and well-being of children around the world.
Biogenic amines such as norepinephrine, dopamine, and serotonin play a well-described role in the treatment of mood disorders and some types of pain. As α2A-adrenoceptors regulate the release of these neurotransmitters, we examined the therapeutic potential of BRL 44408, a potent (Ki=8.5 nm) and selective (>50-fold) α2A-adrenoceptor antagonist (KB=7.9 nm). In rats, BRL 44408 penetrated the central nervous system resulting in peak brain and plasma concentrations of 586 ng/g and 1124 ng/ml, respectively. In a pharmacodynamic assay, pretreatment with BRL 44408 to rats responding under a fixed-ratio 30 operant response paradigm resulted in a rightward shift of the clonidine dose–response curve, an effect indicative of α2-adrenoceptor antagonism in vivo. Consistent with presynaptic autoreceptor antagonism and tonic regulation of neurotransmitter release, acute administration of BRL 44408 elevated extracellular concentrations of norepinephrine and dopamine, but not serotonin, in the medial prefrontal cortex. Additionally, BRL 44408, probably by inhibiting α2A heteroceptors, produced a significant increase in cortical levels of acetylcholine. In the forced swim test and schedule-induced polydipsia assay, BRL 44408 produced an antidepressant-like response by dose-dependently decreasing immobility time and adjunctive water intake, respectively, while in a model of visceral pain, BRL 44408 exhibited analgesic activity by decreasing para-phenylquinone (PPQ)-induced abdominal stretching. Finally, BRL 44408 did not produce deficits in overall motor coordination nor alter general locomotor activity. This preclinical characterization of the neurochemical and behavioural profile of BRL 44408 suggests that selective antagonism of α2A-adrenoceptors may represent an effective treatment strategy for mood disorders and visceral pain.