Skolsköterskan som är verksam inom elevhälsan har i uppdrag att arbeta hälsofrämjande på skolan. Tobaksfria nikotinprodukter såsom elektroniska cigaretter och vitt snus har ökat bland ungdomar. Det är angeläget att utforska hur skolsköterskor arbetar med nikotinprevention för att kunna förbättra det hälsofrämjande arbetet för att förhindra att en ny generation blir beroende utav nikotin. Syfte: Syftet med studien var att utforska skolsköterskors erfarenheter av att arbeta med prevention av tobaksfria nikotinprodukter bland ungdomar på högstadiet. Metod: Kvalitativ intervjustudie baserad på tio semistrukturerade intervjuer med skolsköterskor i Halland i Sverige. Manifest kvalitativ innehållsanalys med induktiv ansats. Resultat: Fem kategorier: Skolsköterskans undervisning och information ute i klasserna, skolsköterskans relation till eleverna, skolsköterskans relation till vårdnadshavarna, skolsköterskans hälsofrämjande arbete genom hälsosamtal, skolsköterskans stöd från ledningen samt 11 underkategorier och citat från informanter vilket bekräftar resultatet. Konklusion: Det saknas tydliga riktlinjer för hur skolsköterskorna ska arbeta med nikotinprevention på skolan. Ungdomar bör få kunskap hur skadligt nikotin är för hälsan och vad ett nikotinberoende kan leda till i framtiden. / The school nurse, active in student health services, is required to promote the health of the students at school. Use of tobacco-free nicotine products, such as e-cigarettes and white snuff, has increased among adolescents. In order to promote better health education and work towards the prevention of nicotine addiction in the next generation, it is important to explore the adverse effects of addiction. Aim: The aim of this study was to explore the experiences of various school nurses in working towards the prevention of tobacco-free nicotine product usage among adolescents in secondary school. Method: This is a qualitative study based on ten semi-structured interviews with school nurses in Halland, Sweden, manifesting the analysis using an inductive approach. Results: Results were classified into five categories: Teaching and information, relationship to the students, relationship to the guardians, health promotion through health talks, support from management, as well as 11 subcategories and quotes from participants confirming the result. Conclusion: There are no clear guidelines as to how school nurses currently work with nicotine prevention. However, it should be required that the next generation be taught the harmful effects of nicotine to their health and what nicotine addiction can lead to in the future.

Nicotine replacement therapy (NRT) is a pharmacotherapy used commonly to help tobacco smokers quit smoking. All forms of NRT are demonstrably efficacious for this indication, and several forms, including transdermal nicotine (TN) are available over-the-counter in the United States. NRT is less efficacious in women than in men, although the specific reasons for this gender difference are unknown. NRT generally, and TN specifically, is thought to work, at least in part, by suppressing withdrawal symptoms in abstinent smokers. While TN-induced withdrawal suppression has been demonstrated, the degree to which this withdrawal suppression is influenced by smokers' gender is uncertain. The purpose of this acute laboratory study is to determine if TN-induced withdrawal suppression is influenced by smokers' gender.One hundred twenty eight overnight-abstinent smokers completed four, double-blind, randomized, 6.5-hour laboratory sessions in which further cigarette abstinence was required. Sessions differed by TN dose (0, 7, 21, or 42 mg). All sessions were double-blind and randomly ordered. Each session included regular assessment of subjective symptoms of nicotine/tobacco withdrawal, subjective effects of transdermal nicotine dose, psychomotor performance, heart rate and plasma nicotine level. Results from this laboratory study revealed clear nicotine dose-related effects for plasma nicotine and heart rate, symptoms of nicotine intoxication (e.g. Nausea, Lightheaded) and suppression of Urges to smoke and Craving. Many DSM IV nicotine/tobacco withdrawal symptoms did not show dose-related suppression (e.g. Irritability/frustration/anger, Anxious, Difficulty concentrating). Importantly, results from this study indicated that there were very few differences between men and women in nicotine-induced suppression of the nicotine/tobacco withdrawal syndrome. Future research addressing this important issue may benefit from focusing on a potential interaction between gender and other effects of TN (i.e., blunting the effects of a concurrently administered cigarette) and/or on other triggers for relapse (i.e., smoking-related stimuli).

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Master of Science / Department of Psychology / Mary E. Cain / Rats reared in an enriched condition (EC) with novel stimuli and social contact with cohorts display less sensitization to nicotine than rats reared under impoverished conditions (IC). However, it is currently unknown what effect differential rearing has on nicotine-induced conditioned hyperactivity. The present study determined whether differential rearing affects conditioning to a nicotine-associated context. In addition, this study also examined the effects of mecamylamine, an antagonist to nicotinic acetylcholine receptors, on conditioned hyperactivity and sensitization. This antagonistic drug has been shown to attenuate the locomotor effects of nicotine. In the current study, EC, IC, and social condition (SC) rats were reared from 21 to 51 days of age before training for the acquisition of conditioned hyperactivity and sensitization. Nicotine (0.4 mg/kg) was administered prior to 1-h locomotor sessions. Conditioned hyperactivity testing followed. Rats then received 5 sessions of sensitization training followed by a 16-day drug-free rest period before being tested for sensitization. Mecamylamine (1.0 mg/kg) was administered to rats prior to the conditioned hyperactivity test and sensitization test. Nicotine treatment resulted in sensitization and conditioned hyperactivity in all differential rearing groups. EC rats displayed less locomotor activity in response to nicotine than both IC and SC rats. Pretreatment with mecamylamine blocked the expression of conditioned hyperactivity in EC and SC rats and attenuated sensitization in all three rearing groups. These findings suggest that environmental enrichment may alter nAChR binding during development and may be a protective factor in the initiation and relapse of smoking behavior.

Le trouble déficitaire de l'attention avec hyperactivité (TDAH) et le tabagisme ont un lien établi. Les personnes atteintes d’un TDAH sont plus portées à développer une dépendance à la cigarette, à débuter le tabagisme plus jeune et ont plus de difficultés à cesser de fumer. Il est maintenant connu que le traitement du TDAH modifie ces interactions. Bien que les psychostimulants soient le traitement pharmacologique de choix pour le TDAH, les effets secondaires indésirables de ces substances réduisent considérablement l’utilisation par ceux qui veulent cesser de fumer, surtout s’ils utilisent déjà des substances ayant des propriétés stimulantes, tel que la nicotine, pour les aider. Cette étude a comme objectif d’évaluer l’efficacité potentielle d’un traitement de neurofeedback chez des adultes atteints d’un TDAH et qui, malgré l’utilisation d’un timbre de nicotine, n’arrivaient toujours pas à cesser de fumer. Quatre participantes qui ont rencontré les critères de recherche pour le TDAH ont reçu 12 à 14 séances de neurofeedback pendant qu’elles continuaient un traitement avec un timbre de nicotine. L’efficacité de l’intervention en neurofeedback est évaluée selon un devis de recherche à cas unique avec lignes de base multiples établies en fonction des participants. L’analyse post-intervention révèle que trois des quatre participantes ont réduit de façon significative leur dépendance sur la nicotine à la suite du traitement. Le neurofeedback déjà connu comme traitement efficace du TDAH, dans le cas de dépendance à la nicotine, peut améliorer la tolérance aux symptômes de sevrage en passant par une amélioration de l’attention.

Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Homoeopathy, Durban University of Technology, 2011. / ‘Cigarette smoking is a modern day epidemic that poses a substantial health burden’, it has been proven that smokers die on average fourteen years earlier than non smokers as a direct result of their smoking. An abundance of evidence indicates that the health risks associated with cigarette smoking can however be reversed with a sufficient period of abstinence. Thus achieving life-long abstinence must be a health priority for both developing and developed countries (Caponnetto &, Polosa, 2008). Over 80% of smokers express a desire to stop smoking and 35% of them try to stop each year. However, less than 5% are successful in un-aided attempts to quit (American Psychiatric Association, 1995). The greatest challenge facing smokers who wish to quit are nicotine withdrawal symptoms; these include dysphoric or depressed mood, insomnia, irritability, frustration, anger, anxiety, difficulty concentrating, restlessness, decreased heart rate and increased appetite or weight gain (American Psychiatric Association, 1995). The aim of this double blind placebo controlled quantitative study was to determine the effectiveness of a homoeopathic complex (Caladium seguinum 30 CH, Nux vomica 30 CH and Staphysagria delphinium 30 CH); a tautopathic preparation and the combined effect thereof, in the treatment of nicotine withdrawal syndrome as determined by the Tolerance Dependence Questionnaire, Smoking History and Perceptions of Treatment Questionnaire. Methodology Forty participants recruited by means of convenience sampling were randomly and equally divided into one of four treatment groups, namely tautopathic group, homoeopathic group, combined tautopathic and homoeopathic group and placebo group. The duration of the study was 2 weeks and two consultations with each participant were conducted. The respective interventions were administered in oral spray format; participants were asked to spray their respective preparations directly into their mouth three times daily and to repeat the dose whenever they had a craving for a cigarette. iv Measurements in the form of the Tolerance Dependence Questionnaire (Appendix D), Perceptions of Treatment Questionnaire (Appendix H), and Smoking History (Appendix G) were used to quantify response to treatment. Non-parametric statistical analysis was conducted to analyse the data. Results All four research groups experienced a statistically significant reduction in the amount of cigarettes smoked, favourable perceptions of their response to treatment and improved tolerance. Statistically however when the groups were compared with each other they were similar with respect to their tolerance to nicotine, perception of response to treatment and reduction in amount smoked. Although interventions were statistically similar in terms of effectiveness, the data does suggest that Tautopathy as an intervention warrants exploration. The Tautopathic group achieved the highest reduction in the number of cigarettes smoked when comparing medians (11 less smoked per day), achieved the highest percentage of participants who experienced reduced cravings, and the highest percentage of participants who would continue using the intervention (90% respectively) as well as improvements in 6/9 variables of the Tolerance Dependence Questionnaire. Conclusions The study concludes that each of the four subject groups (including placebo) proved to be successful in aiding the participant to cease smoking. The results showed a significantly positive perception of the participants to the interventions used. The influence of the placebo effect however was very evident in this study; in addition other factors such as the unique method of administration of the medication (oral spray format on demand) the Hawthorn effect and the participants’ desire/commitment to quit smoking may have contributed to the positive results obtained. Notwithstanding the above and although not statistically significant; positive trends within the data do suggest that the Tautopathic approach used in this study should be further investigated in future.

The current project examined the ability of nicotine to modulate dopamine transporter (DAT) function. Initial experiments determined the dose-response for nicotine to modulate dopamine (DA) clearance in rat striatum and medial prefrontal cortex (MPFC) using in vivo voltammetry and determined if this effect was mediated by nicotinic receptors (nAChRs). In both striatum and MPFC, nicotine increased DA clearance in a mecamylamine-sensitive manner, indicating nAChR-mediation. The effect of acute nornicotine on DAT function was also determined. In contrast to nicotine, nornicotine in a dose-related manner decreased striatal DA clearance in a mecamylamine-sensitive manner, indicating nAChR mediation. To determine if tolerance developed to the nicotine effect nicotine, separate groups of rats were injected once daily for 5 days with nicotine or saline. DA clearance in striatum and MPFC was determined 24 hrs after the last injection. Nicotine increased DA clearance only 10-15% in the group repeatedly administered nicotine, demonstrating that tolerance developed. To determine if nicotine altered striatal DAT efficiency, following nicotine injection, DAT density and maximal velocity of [3H]DA uptake was determined using [3H]GBR12935 binding and saturation analysis of [3H]DA uptake in rat striatum, respectively. Nicotine did not alter the Bmax or Kd of maximal binding of [3H]GBR12935 binding. However, an increase in Vmax was observed at 10 and 40 min following nicotine injection, suggesting that nicotine increases DAT efficiency. To determine if systemic nicotine enhanced DAT function via an action at nAChRs on striatal DA terminals, [3H]DA uptake was determined in striatum in vitro in the absence or presence of nicotine in the buffer. Nicotine did not alter the Vmax for [3H]DA uptake in vitro, suggesting that the nicotine-induced increase in DAT function observed in vivo is mediated by nAChRs on DA cell bodies or another site which indirectly alters DAT function. To determine if the increase in DAT efficiency was due to increased surface expression of striatal DAT, biotinylation and Western blot analyses were performed. Nicotine did not alter striatal DAT, suggesting that the nicotine-induced increase in DA clearance in vivo and DAT efficiency in vitro is not the result of increased trafficking of this protein to the cell surface.

Class of 2012 Abstract / Specific Aims: The goal of this project was to evaluate the use of a preparation of the brainstem and spinal cord of neonatal rats that has been widely used for observing and quantifying central nervous activity, as well as the response to pharmacological manipulation. To achieve this, we specifically aimed to remove the intact brainstem and spinal cord of newborn rats, and develop a preparation that would maintain physiological function and allow for recording of electrical activity. Methods: Multiple dissections were performed on neonatal rats. Conditions during the dissections were controlled to maintain physiological function. Once removed, the intact brainstem and spinal cord was placed in a preparation that allowed for manipulation and access to nerve rootlets. Finally, glass suction electrodes were used to record electrical activity directly from the nerve rootlets. Once recorded, the data were stored on a hard drive for further analysis. Main Results: We were successful in isolating the intact brainstem and spinal cord in neonatal rats while maintaining physiological conditions and nervous activity. The preparation allowed for easy access to nerve roots as well as customization for different experiments. We were also successful in recording nerve activity in the preparation and collection of data for use in future experiments Conclusions: We conclude that the brainstem spinal cord preparation described in this study is a valuable tool that allows for recording and analysis of nerve activity, and specifically for measurement of respiratory motor output. This is a preparation that can be used in a variety of experiments that attempt to observe or quantify the activity of central nerve cells and allows for pharmacological interventions that could be applied in various experiments.

Traumatic Brain Injury (TBI) and its resulting pathophysiology have been extensively examined before. However, little is known in the area of pre-injury factors that influence vulnerability to and recovery from TBI. The current study examined the effects of pre-injury chronic nicotine exposure on Morris water maze performance, following TBI in adolescent rats. Fifteen days prior to lateral fluid percussion injury (FPI), adolescent rats (30 days old) were implanted with osmotic mini-pumps filled with nicotine (4.5mg/kg/day) or saline. Half the rats received lateral fluid percussion injury and half received sham injury. Animals were assessed for cognitive recovery in the Morris water maze on post-injury days (PID) 11 through 15. The MWM results indicated no significant differences between injured animals infused with chronic nicotine and injured animals infused with saline.