Adolescent intermittent ethanol exposure enhances adult stress effects in male rats.

Binge patterns of alcohol use, prevalent among adolescents, are associated with a higher probability of developing alcohol use disorders (AUD) and other psychiatric disorders, like anxiety and depression. Additionally, adverse life events strongly predict AUD and other psychiatric disorders. As such, the combined fields of stress and AUD have been well established, and animal models indicate that both binge-like alcohol exposure and stress exposure elevate anxiety-like behaviors. However, few have investigated the interaction of adolescent intermittent ethanol (AIE) and adult stressors. We hypothesized that AIE would increase vulnerability to restraint-induced stress (RS), manifested as increased anxiety-like behavior. After AIE exposure, in adulthood, animals were tested on forced swim (FST) and saccharin preference (SP) and then exposed to either RS (90 min/5 days) or home-cage control. Twenty-four hours after the last RS session, animals began testing on the elevated plus maze (EPM), and were re-tested on FST and SP. A separate group of animals were sacrificed in adulthood after AIE and RS, and brains were harvested for immunoblot analysis of dorsal and ventral hippocampus. Consistent with previous reports, AIE had no significant effect on closed arm time in the EPM (anxiety-like behavior). However, in male rats the interaction of AIE and adult RS increased time spent in the closed arms. No effect was observed among female animals. AIE and RS-specific alterations were found in glial and synaptic markers (GLT-1, FMRP and PSD-95) in male animals. These findings indicate AIE has sex-specific effects on both SP and the interaction of AIE and adult RS, which induces a propensity toward anxiety-like behavior in males. Also, AIE produces persistent hippocampal deficits that may interact with adult RS to cause increased anxiety-like behaviors. Understanding the mechanisms behind this AIE-induced increase in stress vulnerability may provide insight into treatment and prevention strategies for alcohol use disorders.

Sex differences in the effects of adolescent intermittent ethanol exposure on exploratory and anxiety-like behavior in adult rats.

Adolescent intermittent ethanol (AIE) exposure in rodents has been shown to alter adult behavior in several domains, including learning and memory, social interaction, affective behavior, and ethanol self-administration. AIE has also been shown to produce non-specific behavioral changes that compromise behavioral efficiency. Many studies of these types rely on measuring behavior in mazes and other enclosures that can be influenced by animals' activity levels and exploratory behavior, and relatively few such studies have assessed sex as a biological variable. To address the effects of AIE and its interaction with sex on these types of behavioral assays, male and female adolescent rats (Sprague Dawley) were exposed to 10 doses of AIE (5 g/kg, intra-gastrically [i.g.]), or control vehicle, over 16 days (postnatal day [PND] 30-46), and then tested for exploratory and anxiety-like behaviors on the novelty-induced hypophagia (NIH) task in an open field, the elevated plus (EPM) maze, and the Figure 8 maze. AIE reduced activity/exploratory behaviors in males on the anxiety-producing NIH and EPM tasks, but reduced activity in both males and females in the Figure 8 maze, a task designed to create a safe environment and reduce anxiety. Independent of AIE, females engaged in more rearing behavior than males during the NIH task but less in the EPM, in which they were also less active than males. AIE also increased EPM open arm time in females but not in males. These findings demonstrate previously unrecognized sex differences in the effects of AIE on activity, exploratory behavior, and anxiety-like behavior; additionally, they underscore the need to design future behavioral studies of AIE using sex as a variable and with rigorous attention to how AIE alters these behaviors.

Adolescent intermittent ethanol exposure reduces astrocyte-synaptic proximity in the adult medial prefrontal cortex in rats: Reversal by gabapentin.

Alcohol consumption in adolescence causes multiple acute negative changes in neural and behavioral function that persist well into adulthood and possibly throughout life. The medial prefrontal cortex (mPFC) and dorsal hippocampus are critical for executive function and memory and are especially vulnerable to adolescent ethanol exposure. We have reported that astrocytes, particularly in the mPFC, change both in morphology and synaptic proximity during adolescence. Moreover, adolescent intermittent ethanol (AIE) exposure produces enduring effects on both astrocyte function and synaptic proximity in the adult hippocampal formation, and the latter effect was reversed by the clinically used agent gabapentin (Neurontin), an anticonvulsant and analgesic that is an inhibitor of the VGCC α2δ1 subunit. These findings underscore the importance of investigating AIE effects on astrocytes in the mPFC, a region that undergoes marked changes in structure and connectivity during adolescence. Using astrocyte-specific viral labeling and immunohistochemistry, mPFC astrocytic morphology and colocalization with AMPA-(α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid) glutamate receptor 1 (GluA1), an AMPA receptor subunit and established neuronal marker of excitatory synapses, were assessed to quantify the proximity of astrocyte processes with glutamatergic synaptic puncta. AIE exposure significantly reduced astrocyte-synaptic proximity in adulthood, an effect that was reversed by sub-chronic gabapentin treatment in adulthood. There was no effect of AIE on astrocytic glutamate homeostasis machinery or neuronal synaptic proteins in the mPFC. These findings indicate a possible glial-neuronal mechanism underlying the effects of AIE on frontal lobe-mediated behaviors and suggest a specific therapeutic approach for the amelioration of those effects.

Effects of adolescent intermittent ethanol on hippocampal expression of glutamate homeostasis and astrocyte-neuronal tethering proteins in male and female rats.

Adolescent alcohol drinking is widely recognized as a significant public health problem, and evidence is accumulating that sufficient levels of consumption during this critical period of brain development have an enduring impact on neural and behavioral function. Recent studies have indicated that adolescent intermittent ethanol (AIE) exposure alters astrocyte function, astrocyte-neuronal interactions, and related synaptic regulation and activity. However, few of those studies have included female animals, and a broader assessment of AIE effects on the proteins mediating astrocyte-mediated glutamate dynamics and synaptic function is needed. We measured synaptic membrane expression of several such proteins in the dorsal and ventral regions of the hippocampal formation (DH, VH) from male and female rats exposed to AIE or adolescent intermittent water. In the DH, AIE caused elevated expression of glutamate transporter 1 (GLT-1) in both males and females, elevated postsynaptic density 95 expression in females only, and diminished NMDA receptor subunit 2A expression in males only. AIE and sex interactively altered ephrin receptor A4 (EphA4) expression in the DH. In the VH, AIE elevated expression of the cystine/glutamate antiporter and the glutamate aspartate transporter 1 (GLAST) in males only. Compared to males, female animals expressed lower levels of GLT-1 in the DH and greater levels of ephrin receptor B6 (EphB6) in the VH, in the absence of AIE effects. These results support the growing literature indicating that adolescent alcohol exposure produces long-lasting effects on astrocyte function and astrocyte-neuronal interactions. The sex and subregion specificity of these effects have mechanistic implications for our understanding of AIE effects generally.

Evaluating the delivery, impact, costs and benefits of an active lives programme for older people living in the community.

Aim Age UK Lancashire received Big Lottery funding to deliver an active lives programme from January 2012 to December 2014 to the population of West Lancashire aged over 50 years. The overall aims of the associated evaluation were to measure older people's experiences of participating in the programme, identify the impacts on their health and well-being and their suggestions for services development, and establish the costs and benefits of the programme. BACKGROUND: The World Health Organisation recommends older people should be able to achieve physical, social and mental well-being throughout their lives, and that international, national and local policies should be developed to support older adults, promote their independence and well-being, and encourage physical exercise. Consequently, the West Lancashire programme was to establish preventative community support for older people to assist in improving their well-being and physical and mental health, particularly those isolated due to age-related illness or disability. It was to provide interventions not available from local social care providers. METHODS: A mixed methods approach was adopted, with the qualitative evaluation utilising focus groups to establish people's experiences, identify impacts on their health and well-being, and suggestions for services development. This paper describes the quantitative evaluation, which involved three surveys and a costs analysis. The surveys were scheduled to give timely feedback to management about programme delivery and content, and overall benefits of participation. Findings The active lives programme and groups offered a wide range of flexible and local activities that provided benefits for older people in terms of health and well-being, social well-being and quality of life, and reducing social isolation. There was interconnectivity between these benefits. The programme was delivered in an affordable and flexible manner. Such programmes should be made more widely available.

The knowledge and attitudes of student nurses towards patients with sexually transmitted infections: exploring changes to the curriculum.

Evidence suggests that nurses can struggle to care for patients with sexually transmitted infections in a non-judgemental way. It is unknown how targeted education can influence the knowledge and attitudes of student nurses towards caring for patients with sexually transmitted infections. This study aimed to investigate how a change in curriculum influenced the reported sexual health knowledge and attitudes of pre-registration adult student nurses in a University in the UK. A two phase mixed methods study, using a sequential explanatory strategy, collected quantitative questionnaire data (n = 117) followed by qualitative group data (n = 12). Data were collected from one cohort of students before a curriculum change and then from a subsequent cohort of students. Those students who had increased educational input in relation to sexual health reported higher degrees of knowledge and demonstrated a more positive attitude towards patients with a sexually transmitted infection. Both cohorts of students identified that education in this subject area was essential to challenge negative attitudes and positively influence patient care. Active learning approaches in the curriculum such as small group debates and service user involvement have the ability to allow students to express and challenge their beliefs in a safe and supportive environment.

Peer learning partnerships: exploring the experience of pre-registration nursing students.

AIMS AND OBJECTIVES: This paper explores the impact of a peer learning initiative developed to facilitate, purposefully, mutually supportive learning relationships between student nurses in the practice setting. BACKGROUND: Finding effective strategies to support learning in the practice setting has been the focus of professional concern for a considerable time. In the UK clinical mentorship is seen as pivotal to ensuring fitness to practice; however, recent debate on the nature of learning has revealed the clinical workplace as a rich learning environment where learning occurs not only through hierarchical relationships, but also from a network of peer relationships. Formalising peer relationships through peer assisted learning is increasingly suggested as a strategy to support workplace learning and support novice students' transition to the clinical setting. Despite the developing literature in this field there is limited understanding about how students experience facilitated peer relationships. DESIGN: An interpretive qualitative design. METHODS: Focus group interviews were used to collect interactive and situated discourse from nursing students who had recently participated in peer learning partnerships (n = 54). Narrative data were analysed thematically. RESULTS: Findings suggest that active support from a fellow student reduced the feelings of social isolation experienced by novice students in initial clinical placements, helping them to deal more effectively with the challenges faced and reducing the factors that have an impact on attrition. In addition, the reciprocity of the peer learning partnerships facilitated understanding of mentorship and created a heightened sense of readiness for registration and professional practice. CONCLUSIONS: Peer learning partnerships facilitated by mentors in clinical practice can support the transition to nursing for first year students and can help more experienced students gain a confidence and a heightened readiness for mentorship and registered practice. RELEVANCE TO PRACTICE: Facilitated peer learning partnerships can enhance the student experience in the practice setting and can help maximise opportunities for learning and support. This suggests that peer assisted learning is a legitimate area for innovation and further research.