This paper discusses the concept of anhedonia defined as the inability to experience pleasure. Many authors have noted the presence of anhedonia as a personality feature in patients with schizophrenia and other disorders. Anhedonia apparently begins early in life in relation to pathological reactions within the core family. Many authors feel that anhedonia is closely associated with poor premorbid adjustment, interpersonal incompetence and chronicity, and mediates towards poor prognosis. The authors feel that interpretive forms of psychotherapy and psychoactive medication are not particularly effective in the treatment of anhedonic patients. They propose a selection of intellectual, physical and social activities as a more direct attack on this problem of anhedonia. Through these activities the patients are able to gain a tangible experience of pleasure while developing more effective interpersonal skills. The response of patients to activities also provides material for structured forms of psychotherapy and the combination and interaction of activity therapy and traditional psychotherapy is considered to be effective in many anhedonic patients.

Adult↗

PubMedDate not supplied

Pupil-led sex education in England (RIPPLE study): cluster-randomised intervention trial.

BACKGROUND: Improvement of sex education in schools is a key part of the UK government's strategy to reduce teenage pregnancy in England. We examined the effectiveness of one form of peer-led sex education in a school-based randomised trial of over 8000 pupils. METHODS: 29 schools were randomised to either peer-led sex education (intervention) or to continue their usual teacher-led sex education (control). In intervention schools, peer educators aged 16-17 years delivered three sessions of sex education to 13-14 year-old pupils from the same schools. Primary outcome was unprotected (without condom) first heterosexual intercourse by age 16 years. Analysis was by intention to treat. FINDINGS: By age 16 years, significantly fewer girls reported intercourse in the peer-led arm than in the control arm, but proportions were similar for boys. The proportions of pupils reporting unprotected first sex did not differ for girls (8.4% intervention vs 8.3% control) or for boys (6.2% vs 4.7%). Stratified estimates of the difference between arms were -0.4% (95% CI -3.7% to 2.8%, p=0.79) for girls and -1.4% (-4.4% to 1.6%, p=0.36) for boys. At follow-up (mean age 16.0 years [SD 0.32]), girls in the intervention arm reported fewer unintended pregnancies, although the difference was borderline (2.3% vs 3.3%, p=0.07). Girls and boys were more satisfied with peer-led than teacher-led sex education, but 57% of girls and 32% of boys wanted sex education in single-sex groups. INTERPRETATION: Peer-led sex education was effective in some ways, but broader strategies are needed to improve young people's sexual health. The role of single-sex sessions should be investigated further.

Adolescent↗

PubMedDate not supplied

Women, health, and knowledge: travels through and beyond foreign parts.

The meanings of health for women as a social group are discussed. It is argued that women's perspectives on health give central importance to the concepts of self-determination, coping, power, and control. Health for women is bound up with their experiences in everyday life. Women are also primary health care providers. Medicine, however, dominates women's bodies in ways that conflict with women's own perspectives on their health: In "developed" societies, medical intervention now poses a major threat to women's health. By concentrating on quantitative methodology, most researchers studying women's health have ignored these important meanings of health to women.

Adaptation, Psychological↗

PubMedDate not supplied

Neuritogenic-neurotoxic effects of membrane-associated forms of amyloid precursor protein.

The membrane-bound glycoprotein, amyloid precursor protein (APP), plays a central role in Alzheimer's disease (AD). The present paper investigates the neuritogenic-neurotoxic properties of this protein and relates them to possible aetiopathological mechanisms in AD. Marked differences in neuritic differentiation were detected when comparing untransfected tetraploid mouse neuroblastoma cells (or vector only cells) with transfected cells overexpressing APP(751). Transfected cells developed neurites quicker, and whereas all transfected cells differentiated, the degree of differentiation of untransfected cells was more variable. Fully differentiated transfected and untransfected cells had marked differences in neuritic morphology. Transfected cells had more neurites per cell, these being shorter and more branched than neurites on untransfected cells. The precocious differentiation of transfected cells was not maintained with neuritic process disintegration and cell death occurring from the seventh day onwards. Untransfected cells continued to extend their neuritic processes for up to five weeks. Membrane-associated forms of APP were responsible for these effects, rather than secreted APP or the beta/A4-peptide. Combined data from Western blot and immunocytochemical procedures showed a prominent accumulation of APP-C-terminal fragments in the perinuclear region, neuritic varicosities and growth cones of transfected cells, suggesting their involvement in the neuritogenic-neurotoxic process. Similar neuritogenic-neurotoxic mechanisms occurring in vivo, in association with compensatory synaptoplastic responses in the aged brain, may be part of the pathological process in AD.

Alzheimer Disease↗

PubMedDate not supplied

What price professionalism? The importance of being a nurse.

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Female↗