Role of neuronal nicotinic receptors in the effects of nicotine and ethanol on contextual fear conditioning.

Nicotine can enhance contextual learning while ethanol impairs some forms of learning. Nicotine can overcome some of the impairing effects of ethanol when the two drugs are co-administered. The specific brain nicotinic acetylcholine receptors (nAChRs) that mediate nicotine's effects on contextual learning and whether any of ethanol's actions are mediated by nAChRs are unknown. The potential roles of nAChRs in contextual and cued fear conditioning as well as the effects of nicotine, ethanol, or co-administration of nicotine and ethanol were examined in wild type and homozygous null mutant mice from alpha7, beta2, beta3, and beta4 mouse lines at 24 h after training. Nicotine was given prior to training and testing, whereas ethanol was given only before training. Nicotine enhanced contextual learning in both alpha7 wild types and mutants when mice were trained at 0.17 mA, but not 0.35 mA. Mutants lacking the alpha7 subunit were less sensitive to the memory impairing effects of ethanol trained at 0.35 mA. beta2 Null mutants receiving saline showed a small, but significant, impairment in contextual learning compared with wild type littermates when the shock stimulus was 0.35 mA. Beta2 Null mutant mice also did not respond to the cognitive enhancing effects of nicotine alone, or after ethanol administration. beta3 and beta4 null mutants did not differ from wild types either after saline or any of drug treatments. These results show that beta2-containing nAChRs, but not beta3- or beta4-containing receptors, mediate the enhancing effects of nicotine on contextual learning and confirm previous studies implicating beta2 in other forms of learning. A new role for alpha7 nAChRs in regulating sensitivity to the cognitive disrupting effects of ethanol is proposed.

Individual psychotherapy and persons with serious mental illness: the clients' perspective.

The perspectives of persons with serious mental illness about their experiences with individual psychotherapy were obtained from a stratified random sample of 12 psychosocial rehabilitation centers from all centers in Maryland. Response and completion rates, test-retest reliability, and generalization data were positive. Eight areas were explored: (1) Utilization and duration: of the 212 respondents, 90 percent had been in therapy for a median of 12 months (mean = 3 years); only a third expected to end their therapy within 5 years. (2) Therapeutic effectiveness: most of the respondents (72%) reported that individual psychotherapy had brought positive changes to their lives, 14 percent reported negative changes, and 14 percent reported that therapy had had no effect. (3) Preferred interventions and parameters: sixteen percent felt that medication was most useful, 25 percent felt that talking therapy was most useful, and 60 percent endorsed a combination of the two. With respect to diagnosis and psychotherapy, 84 percent of respondents with schizophrenia preferred brief, less frequent sessions of reality-oriented therapy over longer, more frequent sessions of insight therapy. Respondents with bipolar and major depression were equally split between the two. (4) Therapeutic issues: human concerns were more frequently rated as important and were rated higher in importance than illness-specific symptoms. (5) Clients' view of illness: Only 8 percent thought their illness was a brain disease, a third thought it was a psychological problem, and a quarter thought it was a combination of both; a third answered, open quote I don't know closed quote. Almost half did not know what their therapists thought. (6) Therapeutic relationship: Friendliness was the quality most desired in a therapist. (7) Confidentiality: Most felt that therapists generally kept the clients' confidences. (8) Empowerment: Persons who felt empowered in therapy spent less time in hospitals, expected a shorter stay in therapy, and knew more about their problems. Suggestions are made about a more client-responsive model of individual psychotherapy for persons with serious mental illness.

[The family planning program of the Secretaría de Salubridad y Asitencia in the border states]. / El Programa de Planificación Familiar de la Secretaría de Salubridad y Asistencia en los estados fronterizos.

PIP: All available data to date indicate that the Family Planning Program of the Public Health Department, together with the rest of the Health Institutions which offer this type of service are having great success at the national level and, consequently, in the border states. The Public Health Department Program and the Programs of the Institutions as a whole are enrolling approximately 15% of the eligible couples/year, this number compares very favorably with that reported internationally. The rapid progress observed in the rural areas has been particularly stimulating, especially if we consider the fact that it is this area that the greatest resistance was expected. At the present time, one of the prime activities of the Public Health Department is to extend the Program to a greater number of rural communities through an established network of community promoters. There is a clear difference in the yield, extension, etc. between the different health units within the same state. This variation includes the border states as well. The directed efforts to understand and detect these differences systematically are still being studied. Presently we can state that the coverage reached by the Program has not yet begun to stagnate or indicate negative growth, although there is some indication of this in the urban areas. Acceptor characteristics point to the necessity of extending the Program to an economically weak population and not to restrict it to the privileged people. This is supported by the results obtained in a National Contraceptive Prevalence Study done by the Coordination of the National Program for Family Planning, which shows that 60% of couples in urban areas use contraceptive methods, 20% of rural couples, and 40% at the national level. These numbers are equal or even greater in the border states. (author's modified)^ieng

[Assessment of the promotion component in the postpartum/postabortion program]. / Evaluación del componente de promoción en el programa postparto/postaborto.

PIP: To study the low acceptance rate of contraception, the authors investigated the postpartum postabortum program of family planning in 8 hospitals run by the Mexican Ministry of Health. During 1 week all patients, 502 women who were leaving the hospital were interviewed; the personnel in charge of family planning were also interviewed. The number of acceptors leaving the hospital went from 1% of patients in Hermosillo to 47% in the General Hospital, a rate of acceptance much lower than that observed with other programs. Sociocultural characteristics of patients were very similar in all hospitals, and acceptance of IUDs was much greater than acceptance of the pill. In all hospitals, promotion of contraception consisted of a talk given to groups of patients and never to individuals; in most hospitals there were no other possibilities to receive contraceptive information. Most patients, either before or after the talk, still equated family planning with better education for children and better social conditions for the family; very few mentioned the health of mothers and children. 4% of patients did not know what contraceptives were available at the hospital even after the talk; many patients stated that the type of presentation and the vocabulary used were too difficult. Only 4% left the hospital with an adequate knowledge of both oral contraception and the IUD. Duration of the talk went from 7-39 minutes, depending on the hospital. The personnel delivering the talk were not specifically prepared for that purpose, and many times failed to answer questions or to expound on important aspects of contraception, such as side effects or contraindications. No teaching materials were available and even the meeting rooms were inadequate. It is obvious that postabortum postpartum programs of family planning should be restructured and reorganized, personnel should be trained, patients should receive individual attention, husbands should be encouraged to participate, and simple, inexpensive teaching materials, such as slides and prints, should be made available.^ieng

Psychological determinants of family size in a Mexican village.

PIP: 22 couples who use contraceptives and 43 who do not, reasonably well matched for age, education, and number of living children, were selected for a study of the psychological determinants of family size. All were from an Indian village in the state of Oaxaca in southern Mexico, where a rural family planning clinic has existed for years, patronized by about 8% of the population. Hour-long interviews were conducted with each person with 6 measures in mind: feelings of efficacy, need for achievement, need for emotional contact with others, feelings about sexual relations, perceptions of the opposite sex, and impulsivity. Both male and female users obtained higher scores on feelings of efficacy and need for achievement. Female nonusers were significantly more likely than users to show a need for emotional contact. Male users scored significantly higher scores on impulsivity than nonusers; the reverse was true for women. Users generally revealed more positive attitudes toward sexual relations and expectations of the opposite sex, although the differences were not significant. The study showed that the differences between users and nonusers at the same parities did indicate a relationship between psychological factors and propensity to have large rather than small families. However, the anticipated finding that the strongest differences would be between users of low parity and nonusers of high parity and that the differences between total user and nonuser groups would be weaker was not seen. In retrospect it was felt that this was because the model was only well suited to societies in which it was unlikely that users or nonusers would reach high parity before finding out about contraceptives.^ieng