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Very long chain fatty acids (VLCFA) have a chain length ≥24 carbons. Fish contain low levels of these fatty acids. A commercial oil called EPAX® Evolve 05 with an up-concentration of VLCFAs of approximately 10 times, has been developed as a dietary supplement by Epax Norway AS. A series of toxicological studies were performed using mice and rats to determine the safety and toxicity of repeat dosing with a gavage administered VLCFA formulation. The results suggest transient lipid accumulation in kidneys and liver. Lipid accumulation was seen with the test item and with the soya control but was not dose related. Liver and kidney lipid accumulation, whilst present in 14- day repeat dose study, was absent in a 90-day rat study. No treatment-effect was seen in urine analysis in any of the studies. No treatment-related effects were seen with a functional observation battery, ophthalmological examination, haematology, urine analysis, oestrus cycle, thyroid hormones, organ weight, or histopathology. In the 90-day study the liver enzymes ALP, AST and ALT were statistically significantly increased with test item but within control values. There were no associated histological findings in the liver suggesting there was no toxic effect and the normalisation of values for all liver enzymes in the recovery groups suggests an adaptive response rather than a prevailing toxic response. The no-observed-adverse-effect level (NOAEL) was determined as 1200 mg VLCFA/kg b.w./day. • An oil (EPAX EVOLVE 05) containing Very Long Chain Fatty Acids (VLCFA) was tested. • Toxicity was assessed with 14, 28, and 90-day repeat dose studies. • No adverse effects were noted up to a dose of 1200 mg/kg bw/day in a 90-day rat study. • NOAEL was defined as 1200 mg VLCFA/kg bw/day in Sprague Dawley rats. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to explore the attitudes of staff working within mental health settings toward cannabis in general and cannabis use in individuals with severe mental-health problems. Method: Twenty members of staff working within community mental health teams in Birmingham, UK, were interviewed using qualitative research methods. The overarching themes within the staff accounts are described and the interrelationship between themes explored. Findings: Staff use an 'individualized' approach when working with cannabis-using clients dependent on a number of key components, including the positive and negative effects of use, wider evidence base, client vulnerability, engagement, professional and personal views and harm reduction. It is suggested that any approach staff may take toward cannabis use at any one time is greatly dependent upon the above factors and these factors are highly client specific. Conclusions: The findings may help to explain why interventions aimed at reducing substance use in people with psychosis might prove less successful when targeting cannabis use. [ABSTRACT FROM AUTHOR]

Background: Cocaine/crack-cocaine use is associated with a number of negative outcomes in people with mental health problems. Aims: To explore the extent of use in individuals with severe mental health problems and impact of client use on mental health service staff. Method: Following Graham et al. (2001), care coordinators within community mental health teams in Birmingham, UK completed a prevalence survey of cocaine/crack-cocaine use in clients on their current caseload to determine the extent of use. Findings were compared to those of Graham et al. Interviews with staff explored the impact of cocaine/crack-cocaine on client outcome and effects on staff within the teams under study. Results: An increase in cocaine/crack-cocaine use is reported (from 5.6% to 11.5% over 8 years). Interview data indicate that despite this increase, staff declare themselves more competent and confident in dealing with cocaine/crack-cocaine use. Conclusions: We propose that the integration of substance use treatment within mainstream mental health services is, in part, responsible for this finding. [ABSTRACT FROM AUTHOR]

Presents information on a study providing bio-chemical evidence that exposure of keratinocytes to ultraviolet radiation (UVB) causes rapid association of tumor necrosis factor (TNF). Materials and methods used; Identification of membrane receptors belonging to the TNF family of receptors; Indication that exposure of mammalian skin to ultraviolet light results in induced gene transcription; Results and discussion of the study.

The present study was carried out to examine the role of reactive oxygen species in mediating the melanogenic effects of UVR. B 16 mouse melanoma cells responded to a single dose of UVR by showing increases in their melanin content. Although there was a small increase in melanin at 48 72 hours, which was associated with a rise in tyrosinase activity at 48 h, the greatest change occurred at 3 h and this was not associated with an increase in tyrosinase activity. This short-term response, unlike the more delayed melanogenic response, was reduced by superoxide dismutase (SOD). Xanthine oxidase (XO), which generates the superoxide anion (O[SUB2]), also increased the melanin content of B 16 melanoma cells with effects at 3 h and 48 h. As with UVR, the delayed response was ac- companied by an increase in tyrosinase activity but no such association was evident at 3 h. In addition, the short-term effect, like that seen with UVR, was reduced with SOD and to a lesser extent with catalase. In contrast to the effects found with XO, glucose oxidase, which generates hydrogen peroxide, had no effect on the melanin content or tyrosinase activity of the B16 cells. These results confirm previous observations that UVR is able to act directly on cells to bring about delayed increases in melanogenesis. They further demonstrate that UVR also stimulates melanogenesis through a more rapid action that is not associated with an activation of tyrosinase. This effect could be mediated by the O[SUB2] which, rather than activating tyrosinase, could act by serving as a substrate for for the enzyme. [ABSTRACT FROM AUTHOR]

Objective:This article reports the results of an evaluation of a consultation-liaison service for people with combined mental health and substance use problems. The service is one component of an overall integrated service framework for this group of clients developed and delivered across one of the largest Mental Health Foundation Trusts in the UK. A full description of the client group referred to consultation-liaison over a 3-year period is provided, as well as a description of different referral pathways and a preliminary evaluation of a brief intervention offered as part of the service.Methods:Service evaluation data were collected through routine practice and provided demographic and diagnostic information on the clients who were referred to the consultation-liaison service (N= 173). A sample of these clients (n= 39) received a full brief motivational intervention consisting of six sessions delivered over a 12-week period. Quantitative questionnaire data collected for clients who received this component subsequently allowed a baseline and follow-up cohort assessment of changes on various substance-related outcomes in those receiving the brief intervention.Results:The results indicated that clients referred to the service (N= 173) were typically male (69.9%), in their mid-30s (M= 36.6 years,SD= 9.98) and considered to be white British (61.8%). They often presented with psychotic (52.6%) or depressive (16.8%) disorders and were commonly using alcohol (67.1%) or cannabis (47.4%). Of the clients who completed the full brief intervention (n= 39), baseline and follow-up outcome measures were available on a subsample (nranged from 11 to 25 depending on each specific measure) and results showed significant changes in a number of areas, including increased engagement with treatment (p< .001), reduced alcohol (p= .001) and cannabis use (p= .015), fewer signs of hazardous alcohol use (p= .026), and improved confidence to change substance use (p= .006). These findings have to be considered as preliminary given the limitations of the service evaluation methodology.Conclusions:The consultation-liaison service appears to be a helpful component within an overall service framework for dual diagnosis in a number of ways, for example through the enhancement of existing services such as assessment, advice, and consultation, as well as the delivery of a brief intervention. [ABSTRACT FROM AUTHOR]

This article is a service report based on the experience of the Combined Psychosis and Substance Use Programme (COMPASS), which aims to provide integrated treatment for people who experience coexisting mental health and substance use problems. A fundamental role of the service is to deliver a structured training package based on a Cognitive-Behavioural Integrated Treatment approach to staff within mental health services. We aimed to establish whether the needs of staff prior to training were consistent across various service areas and whether our training package can enhance staff confidence and skills to work with this client group. The final aim was to consider if confidence and skills can be maintained over an extended period of time. This article is based on service evaluation data collected between the late 1990s and 2011. Data that had been collected from staff across diverse service areas within a large Mental Health Trust in the UK were analysed. There was a high degree of consistency across the service areas. Prior to training staff expressed interest in combined psychosis and substance use problems and felt that it was part of their role to work with this client group. However they also reported that their knowledge of and competence in the area could be improved. Following the receipt of training staff confidence significantly increased and remained high at our most recent follow up 10 years later. The different strands of evidence provide robust support for the aims of our work. Specifically the significant role of training and continued support and supervision in increasing the confidence and skills of mental health staff responding to combined mental health and substance use problems. [ABSTRACT FROM PUBLISHER]

Aim: This study sought to develop a methodology to measure the integration of substance use treatment within five existing assertive outreach (AO) teams in Birmingham, UK. Changes in the way teams approach and discuss drug and alcohol problems amongst clients with severe mental health problems were anticipated. This was assessed at team meetings, through clinical sessions and case notes. The impact of change in team practice was also measured at the level of service users by assessing psychiatric symptoms, engagement, amount of substance used, and conviction ratings of positive substance-related beliefs.Method: Each team were provided with training and supervision to deliver cognitive behavioural integrated treatment (C-BIT). This aimed to increase awareness of the relationship between psychosis and problem substance use and provide skills to manage these difficulties. Data was collected at intervals over a 36 month period.Results: Staff within teams increased in self reported confidence and skills to deliver C-BIT and these gains were maintained over time. Findings suggest that following training, integration was achieved to a degree and changes in teams practice were observed. Improvements in client engagement and reduction in alcohol intake and positive alcohol-related beliefs were also noted but occurred regardless of team training.Conclusions: Training and supporting AO staff to use an integrated treatment approach is well received and produces lasting changes in confidence and practice. Whether this can go on to impact upon client outcome is yet to be established. [ABSTRACT FROM AUTHOR]