FC27-01 - Youth matters in London: Mental health, addiction and homelessness

This project will work closely with existing service partners involved in street level services and focus on testing and evaluating three approaches for street level interventions for youth who are homeless and who have severe or moderate mentally illness. Youth will be asked to choose their preferred service approach:

Housing First related initiatives focused on interventions designed to move youth to appropriate and available housing and ongoing housing supports.

Treatment First initiatives to provide Mental Health/Addiction supports and treatment solutions, and; Simultaneous attention to both Housing and Treatment Together

Our primary objective is to understand the service delivery preferences of homeless youth and understand the outcomes of these choices. Our research questions include:1.

Focus groups with staff and family members will occur to assist in understanding the nature of each of service approach, changes that evolve within services, & facilitators and barriers to service delivery. This work will be important in determining which approach is chosen by youth and why. Evaluating the outcomes with each choice will provide valuable information about outcomes for the service options chosen by youth. This assist in better identifying weaknesses in the services offered and inform further development of treatment options that youth will accept.

Limits on the spin-dependent WIMP-nucleon cross sections from the first science run of the ZEPLIN-III experiment

We present new experimental constraints on the WIMP-nucleon spin-dependent elastic cross sections using data from the first science run of ZEPLIN-III, a two-phase xenon experiment searching for galactic dark matter weakly interacting massive particles based at the Boulby mine. Analysis of approximately 450 kg x days fiducial exposure allow us to place a 90%-confidence upper limit on the pure WIMP-neutron cross section of sigma(n)=1.9x10(-2) pb at 55 GeV/c(2) WIMP mass. Recent calculations of the nuclear spin structure based on the Bonn charge-dependent nucleon-nucleon potential were used for the odd-neutron isotopes 129Xe and 131Xe. These indicate that the sensitivity of xenon targets to the spin-dependent WIMP-proton interaction could be much lower than implied by previous calculations, whereas the WIMP-neutron sensitivity is impaired only by a factor of approximately 2.

Measurement of, and Some Reasons for, Differences in Eating Habits Between Night and Day Workers

A questionnaire was designed to assess the following: why working people chose to eat or not to eat at a particular time of day; the factors that influenced the type of food eaten; and subjective responses to the meal (hunger before, enjoyment during, satiety afterward). Self-assessments were done every 3 h during a typical week containing work and rest days, by one group of 50 day workers and another group of 43 night workers. During the night work hours compared to rest days, night workers evidenced a significantly altered food intake, with a greater frequency of cold rather than hot food (p < 0.001). The type and frequency of meals were influenced significantly more (p < 0.05) by habit and time availability and less by appetite. This pattern continued into the hours immediately after the night shift had ended. In day workers food intake during work hours, compared to rest days, was also influenced significantly more often (p < 0.05) by time availability than hunger, but less so than with night workers. Moreover, day workers were less dependent than night workers upon snacks (p = 0.01), and any significant differences from rest days did not continue beyond work hours. Not only did night workers change their eating habits during work days more than did day workers but also they looked forward to their meals significantly less (p < 0.001) and felt more bloated after consuming them (p < 0.05), such effects being present to some extent during their rest days also. These findings have clear implications for measures designed to ease eating problems that are commonly problematic in night workers.

Relationships between leisure-time energy expenditure and individual coping strategies for shift-work

A total of 13 to 14% of European and North American workers are involved in shift work. The present aim is to explore the relationships between coping strategies adopted by shift workers and their leisure-time energy expenditure. Twenty-four female and 71 male shift workers (mean +/- SD age: 37 +/- 9 years) completed an adapted version of the Standard Shift-work Index (SSI), together with a leisure-time physical activity questionnaire. Predictors of age, time spent in shift work, gender, marital status and the various shift-work coping indices were explored with step-wise multiple regression. Leisure-time energy expenditure over a 14-d period was entered as the outcome variable. Gender (beta = 7168.9 kJ/week, p = 0.023) and time spent in shift work (beta = 26.36 kJ/week, p = 0.051) were found to be predictors of energy expenditure, with the most experienced, male shift workers expending the most energy during leisure-time. Overall 'disengagement' coping scores from the SSI were positively related to leisure-time energy expenditure (beta = 956.27 kJ/week, p = 0.054). In males, disengagement of sleep problems (beta = -1078.1 kJ/week, p = 0.086) was found to be negatively correlated to energy expenditure, whereas disengagement of domestic-related problems was found to be positively related to energy expenditure (beta = 1961.92 kJ/week, p = 0.001). These relations were not found in female shift workers (p = 0.762). These data suggest that experienced male shift workers participate in the most leisure-time physical activity. These people 'disengage' more from their domestic-related problems, but less from their sleep-related problems. It is recommended that physical activity interventions for shift workers should be designed with careful consideration of individual domestic responsibilities and perceived disruption to sleep.

A review on some of the problems associated with long-distance journeys

Long-distance travel, for business or pleasure, is becoming increasingly common. Any long journey, whether by plane, road or rail, will be associated with "travel fatigue", the combined effects of a changed routine (particularly sleep loss and altered meals) and the general disruption caused by travel. Planning any trip well in advance will minimise many of these problems, but some factors are less easy to guard against; these include sitting in cramped and uncomfortable conditions and, with flights, the hypoxic environment in the cabin. After arrival at a destination in another country, there can be problems with language, altered food and different customs. If the flight has crossed the equator, then there is also likely to be a change in season and natural lighting, and if the flight has, additionally or alternatively, crossed several time zones, then there will also be the problem of "jet lag", caused by a transient dyssynchrony between the "body clock" and the new local time. The new environment might differ from the place of departure with regard to ambient temperature and humidity, altitude, natural lighting (and hence exposure to ultra-violet radiation) and pollution. In all cases, the traveller needs to be aware of these changes before setting off, so that appropriate preparations (different clothing, for example) can be made.

The role of a short post-lunch nap in improving cognitive, motor, and sprint performance in participants with partial sleep deprivation

The aim of this study was to determine the effects of a post-lunch nap on subjective alertness and performance following partial sleep loss. Ten healthy males (mean age 23.3 years, s = 3.4) either napped or sat quietly from 13:00 to 13:30 h after a night of shortened sleep (sleep 23:00-03:00 h only). Thirty minutes after the afternoon nap or control (no-nap) condition, alertness, short-term memory, intra-aural temperature, heart rate, choice reaction time, grip strength, and times for 2-m and 20-m sprints were recorded. The afternoon nap lowered heart rate and intra-aural temperature. Alertness, sleepiness, short-term memory, and accuracy at the 8-choice reaction time test were improved by napping (P < 0.05), but mean reaction times and grip strength were not affected (P > 0.05). Sprint times were improved. Mean time for the 2-m sprints fell from 1.060 s (s(x) = 0.018) to 1.019 s (s(x) = 0.019) (P = 0.031 paired t-test); mean time for the 20-m sprints fell from 3.971 s (s(x) = 0.054) to 3.878 s (s(x) = 0.047) (P = 0.013). These results indicate that a post-lunch nap improves alertness and aspects of mental and physical performance following partial sleep loss, and have implications for athletes with restricted sleep during training or before competition.

Recombinant erythropoietin (Epo)/darbepoetin (Darb) associated venous thromboembolism (VTE) in the oncology setting: Findings from the Research on Adverse Drug Events And Reports (RADAR) project

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Background: Cancer patients are at increased risk for VTE as compared to the general population, making VTE as a sADR difficult to detect in the oncology setting. In 2004, two phase III trials identified higher mortality rates among epo-treated cancer patients who were receiving chemotherapy in “off-label” settings- with these studies identifying higher VTE rates in the treatment arms. We reviewed data on epo/darb-associated VTE in the oncology setting. Methods: Data sources were meta-analyses and the FDA’s MedWatch database. Results: Since 1996, only 259 VTE reports (darb: n=30, epo: n=229) of VTE in the setting of chemotherapy and epo/darb were reported to MedWatch. Meta-analyses findings are tabulated below: Conclusions: In 2004, package inserts for Epo/Darb were revised, identifying increased risks of VTE with these agents in the oncology setting. Identification of this adverse drug reaction thirteen years after Epo received FDA approval for this indication (and had been prescribed to > 500,000 cancer patients) illustrates difficulties inherent with current pharmacovigilance efforts.

[Table: see text]

No significant financial relationships to disclose.

The stress of travel

International travel is an essential part of the life of elite athletes, both for competition and training. It is also becoming increasingly common among recreational sportspersons. Long-distance travel is associated with a group of transient negative effects, collectively referred to as 'travel fatigue', which result from anxiety about the journey, the change to an individual's daily routine, and dehydration due to time spent in the dry air of the aircraft cabin. Travel fatigue lasts for only a day or so, but for those who fly across several time zones, there are also the longer-lasting difficulties associated with 'jet lag'. The problems of jet lag can last for over a week if the flight crosses 10 time zones or more, and they can reduce performance and the motivation to train effectively. Knowledge of the properties of the body clock enables the cause of the difficulties to be understood (an unadjusted body clock), and forms the basis of using light in the new time zone to promote adjustment of the body clock. Sleep loss and its effects are important components of jet lag, and attempts to promote sleep by the use of melatonin and other hypnotics are also relevant. Sleep loss is also found in those who undertake challenges that involve long periods where the normal consolidated sleep of 8 h length is not possible. Advice on sleep regimens in such circumstances is given.

Some chronobiological considerations related to physical exercise

Variables associated with physical activity show circadian rhythms in resting subjects; these rhythms have both exogenous (due to the individual's lifestyle and environment) and endogenous (due to the "body clock") components. During exercise, many of the rhythms persist, even though some show decreasing amplitude with increasing severity of exercise. Whilst the value of physical fitness is not disputed (for elite athletes, for individuals who just want to be physically fit, or for patients undertaking physical rehabilitation regimens), there are certain times of the day when special care is needed. These times are soon after waking--when there is the possibility of an increased risk of cardiovascular morbidity and damage to the spine--and late in the day--when there is an increased risk of respiratory difficulties. Since physical exercise is inextricably linked with thermoregulation, there are special considerations to bear in mind when exercise takes place in cold or hot environments. Further, due to the effects of the body clock, exercise and activity during night work and after time-zone transitions presents problems peculiar to these circumstances. In addition, the menstrual cycle affects physical performance, and these circatrigintan rhythms interact with the circadian ones. Bearing in mind these factors, advice that is based upon knowledge of circadian and circatrigintan rhythms can be given to all those contemplating physical activity. Chronobiologically, there is advantage in undertaking physical activity programmes towards the middle of the waking day and not at times when a sleep or nap has just been taken.

Circadian rhythms in sports performance--an update

We discuss current knowledge on the description, impact, and underlying causes of circadian rhythmicity in sports performance. We argue that there is a wealth of information from both applied and experimental work, which, when considered together, suggests that sports performance is affected by time of day in normal entrained conditions and that the variation has at least some input from endogenous mechanisms. Nevertheless, precise information on the relative importance of endogenous and exogenous factors is lacking. No single study can answer both the applied and basic research questions that are relevant to this topic, but an appropriate mixture of real-world research on rhythm disturbances and tightly controlled experiments involving forced desynchronization protocols is needed. Important issues, which should be considered by any chronobiologist interested in sports and exercise, include how representative the study sample and the selected performance tests are, test-retest reliability, as well as overall design of the experiment.

HGS-ETR1, a fully human TRAIL-receptor 1 monoclonal antibody, induces cell death in multiple tumour types in vitro and in vivo

Tumour necrosis factor-related apoptosis-inducing ligand (TRAIL) induces apoptosis in a variety of tumour cells through activation of TRAIL-R1 and TRAIL-R2 death signalling receptors. Here, we describe the characterisation and activity of HGS-ETR1, the first fully human, agonistic TRAIL-R1 mAb that is being developed as an antitumour therapeutic agent. HGS-ETR1 showed specific binding to TRAIL-R1 receptor. HGS-ETR1 reduced the viability of multiple types of tumour cells in vitro, and induced activation of caspase 8, Bid, caspase 9, caspase 3, and cleavage of PARP, indicating activation of TRAIL-R1 alone was sufficient to induce both extrinsic and intrinsic apoptotic pathways. Treatment of cell lines in vitro with HGS-ETR1 enhanced the cytotoxicity of chemotherapeutic agents (camptothecin, cisplatin, carboplatin, or 5-fluorouracil) even in tumour cell lines that were not sensitive to HGS-ETR1 alone. In vivo administration of HGS-ETR1 resulted in rapid tumour regression or repression of tumour growth in pre-established colon, non-small-cell lung, and renal tumours in xenograft models. Combination of HGS-ETR1 with chemotherapeutic agents (topotecan, 5-fluorouracil, and irinotecan) in three independent colon cancer xenograft models resulted in an enhanced antitumour efficacy compared to either agent alone. Pharmacokinetic studies in the mouse following intravenous injection showed that HGS-ETR1 serum concentrations were biphasic with a terminal half-life of 6.9–8.7 days and a steady-state volume of distribution of approximately 60 ml kg⁻¹. Clearance was 3.6–5.7 ml⁻¹ day⁻¹ kg⁻¹. These data suggest that HGS-ETR1 is a specific and potent antitumour agent with favourable pharmacokinetic characteristics and the potential to provide therapeutic benefit for a broad range of human malignancies.

Order in dense hydrogen at low temperatures

By increase in density, impelled by pressure, the electronic energy bands in dense hydrogen attain significant widths. Nevertheless, arguments can be advanced suggesting that a physically consistent description of the general consequences of this electronic structure can still be constructed from interacting but state-dependent multipoles. These reflect, in fact self-consistently, a disorder-induced localization of electron states partially manifesting the effects of proton dynamics; they retain very considerable spatial inhomogeneity (as they certainly do in the molecular limit). This description, which is valid provided that an overall energy gap has not closed, leads at a mean-field level to the expected quadrupolar coupling, but also for certain structures to the eventual emergence of dipolar terms and their coupling when a state of broken charge symmetry is developed. A simple Hamiltonian incorporating these basic features then leads to a high-density, low-temperature phase diagram that appears to be in substantial agreement with experiment. In particular, it accounts for the fact that whereas the phase I-II phase boundary has a significant isotope dependence, the phase II-III boundary has very little.

Exercise does not necessarily influence the phase of the circadian rhythm in temperature in healthy humans

Seventeen healthy adults exercised for 30 min (70% VO2max), at different times of the day and night throughout a 24 h period. The effect on the phase of core temperature rhythm was assessed by comparing the rhythms on the day immediately before and immediately after the day of exercise with the participants living normally on these 2 days. Assessments were made upon data that had been corrected for the thermogenic effects of sleep and activity. When exercise was performed in the period between 4 h before and 1 h after the temperature minimum, there was a phase delay of 1.03 +/- 0.78 h (mean +/- s; n = 6); when performed between 3 and 8 h after the temperature minimum, there was a phase advance of 1.07 +/- 1.23 h (n = 9). Both means were significantly different from zero (Student's one-sample t-tests: P < 0.05). Performed at other times, exercise had no significant effect on the phase of the temperature rhythm. The phase changes were not significantly different from those previously observed by us in sedentary individuals exposed to domestic lighting. We conclude that the amount of physical activity has very little effect on the body clock.

A comparison of the suitabilities of rectal, gut, and insulated axilla temperatures for measurement of the circadian rhythm of core temperature in field studies

Eight healthy males were studied for a total of 13 subject-days to assess if gut (from an ingested pill) and axilla (from a thermally insulated skin probe) temperatures would act as a substitute for rectal temperature in field studies of the circadian rhythm of core temperature. Subjects slept and went about their activities, indoors and outdoors, normally. Regular recordings (at 6 min intervals) were made of temperatures from the three sites. In addition, activity was measured (by a sensor on the nondominant wrist) so that the raw temperature data could be "purified," that is, corrected for the direct effects of sleep and activity. Inspection of the raw data indicated that there was a close parallelism between rectal and gut temperatures, but that the parallelism between rectal and insulated axilla temperatures was less reliable. This parallelism was supported by initial calculations of the correlations between rectal and gut temperatures (high and positive) and between rectal and insulated axilla (lower, though still positive) temperatures. Calculation of the limits of agreement between the parameters of the cosine curves fitted to the raw data confirmed that the rectal and gut temperatures were far closer with regard to acrophase and amplitude than were rectal and insulated axilla temperatures (-0.31 +/- 0.89 vs. +0.75 +/- 6.03 h and +0.002 +/- 0.116 vs. +0.083 +/- 0.625 degrees C, respectively). After purification of the temperature data, the limits of agreement for the cosine parameters acrophase and amplitude still indicated that there was a closer agreement between rectal and gut temperatures than between rectal and insulated axilla temperatures (-0.30 +/- 1.12 vs. +0.58 +/- 6.69 h, and +0.007 +/- 0.116 vs. +0.104 +/- 0.620 degrees C, respectively). Part of the explanation of this difference was the unreliable relationships between temperature changes in insulated axilla temperature and bursts of activity and going to bed. It is concluded that, whereas gut temperature is a viable alternativ to rectal temperature (from the viewpoints of both user acceptability and the reliability of data obtained), insulated axilla temperature, though acceptable to subjects, is unreliable from an experimental viewpoint.

Identifying some determinants of "jet lag" and its symptoms: a study of athletes and other travellers

BACKGROUND

Travelling across multiple time zones disrupts normal circadian rhythms and induces "jet lag". Possible effects of this on training and performance in athletes were concerns before the Sydney Olympic Games.

OBJECTIVE

To identify some determinants of jet lag and its symptoms.

METHODS

A mixture of athletes, their coaches, and academics attending a conference (n = 85) was studied during their flights from the United Kingdom to Australia (two flights with a one hour stopover in Singapore), and for the first six days in Australia. Subjects differed in age, sex, chronotype, flexibility of sleeping habits, feelings of languor, fitness, time of arrival in Australia, and whether or not they had previous experience of travel to Australia. These variables and whether the body clock adjusted to new local time by phase advance or delay were tested as predictors for jet lag and some of its symptoms by stepwise multiple regression analyses.

RESULTS

The amount of sleep in the first flight was significantly greater in those who had left the United Kingdom in the evening than the morning (medians of 5.5 hours and 1.5 hours respectively; p = 0.0002, Mann-Whitney), whereas there was no significant difference on the second flight (2.5 hours v 2.8 hours; p = 0.72). Only the severity of jet lag and assessments of sleep and fatigue were commonly predicted significantly (p<0.05) by regression analysis, and then by only some of the variables. Thus increasing age and a later time of arrival in Australia were associated with less jet lag and fatigue, and previous experience of travel to Australia was associated with an earlier time of getting to sleep. Subjects who had adjusted by phase advance suffered worse jet lag during the 5th and 6th days in Australia.

CONCLUSIONS

These results indicate the importance of an appropriate choice of itinerary and lifestyle for reducing the negative effects of jet lag in athletes and others who wish to perform optimally in the new time zone.