The development of multiple drug use among anabolic-androgenic steroid users: six subjective case reports.

PubMed

Skårberg, Kurt; Nyberg, Fred; Engström, Ingemar

2008-11-28

The inappropriate use of anabolic androgenic steroids (AAS) was originally a problem among athletes but AAS are now often used in nonsport situations and by patients attending regular addiction clinics. The aim of this study was to improve understanding of the development of multiple drug use in patients seeking treatment at an addiction clinic for AAS-related problems. We interviewed six patients (four men and two women) with experience of AAS use who were attending an addiction clinic for what they believed were AAS-related problems. The patients were interviewed in-depth about their life stories, with special emphasis on social background, substance use, the development of total drug use and subjective experienced psychological and physical side effects. There was significant variation in the development of drug use in relation to social background, onset of drug use, relationship to AAS use and experience of AAS effects. All patients had initially experienced positive effects from AAS but, over time, the negative experiences had outweighed the positive effects. All patients were dedicated to excess training and took AAS in combination with gym training, indicating that the use of these drugs is closely related to this form of training. Use of multiple drugs was common either in parallel with AAS use or serially. The study shows the importance of understanding how AAS use can develop either with or without the concomitant use of other drugs of abuse. The use of AAS can, however, progress to the use of other drugs. The study also indicates the importance of obtaining accurate, comprehensive information about the development of AAS use in designing treatment programmes and prevention strategies in this area.

Direct‐to‐consumer advertising of pharmaceuticals: developed countries experiences and Turkey

PubMed Central

Semin, Semih; Aras, Şahbal; Guldal, Dilek

2006-01-01

Abstract While several major problems concerning drugs occur in the world, the attempts to direct‐to‐consumer advertising (DTCA) has gained a considerable impetus lately in both developed and developing countries. DTCA has increasingly become an appealing advertising alternative for the pharmaceutical industry as drug companies have come to wrestle with such problems as the expansion of the drug market; the decline of the medical representatives’ work efficiency; drug reimbursement restrictions; and the escalating role of the Internet in the consumer market. Some of the main disadvantages of the DTCA are: increasing drug expenditures, unnecessary drug consumption and adverse effect risks. Even though the influence of pharmaceuticals on health services and the economy hold the same importance in the developed and developing countries, its negative consequences have increased by encompassing developing countries in its grip. Therefore, in this review, using Turkey as an example, the situation of direct‐to‐consumer advertisements in developing countries is analysed in relation with developed countries. PMID:17324191

Direct-to-consumer advertising of pharmaceuticals: developed countries experiences and Turkey.

PubMed

Semin, Semih; Aras, Sahbal; Guldal, Dilek

2007-03-01

While several major problems concerning drugs occur in the world, the attempts to direct-to-consumer advertising (DTCA) has gained a considerable impetus lately in both developed and developing countries. DTCA has increasingly become an appealing advertising alternative for the pharmaceutical industry as drug companies have come to wrestle with such problems as the expansion of the drug market; the decline of the medical representatives' work efficiency; drug reimbursement restrictions; and the escalating role of the Internet in the consumer market. Some of the main disadvantages of the DTCA are: increasing drug expenditures, unnecessary drug consumption and adverse effect risks. Even though the influence of pharmaceuticals on health services and the economy hold the same importance in the developed and developing countries, its negative consequences have increased by encompassing developing countries in its grip. Therefore, in this review, using Turkey as an example, the situation of direct-to-consumer advertisements in developing countries is analysed in relation with developed countries.

Problem based review: a patient with Parkinson's disease.

PubMed

Arora, A; Fletcher, P

2013-01-01

Parkinson's disease (PD) is a chronic, progressive neurodegenerative disease characterized by bradykinesia, tremor and/ or rigidity, often with gait disturbance and postural instability. In addition to these typical features, patients with PD may experience further problems related to the disease itself or to the medications used to treat it. These comorbid problems include neuropsychiatric conditions (including psychosis, hallucinations, excessive daytime sleepiness, anxiety, depression, fatigue and dementia) as well as problems associated with autonomic nervous system function such as bowel and bladder function. PD can also present in emergency situations with a 'neuroleptic malignant like picture' and acute psychosis. It is not uncommon to see motor fluctuations due to drug interactions and 'withdrawal' symptoms following dose reduction of dopamine agonists. In patients with PD, disturbances of mental state constitute some of the most difficult treatment challenges of advanced disease, often limiting effective treatment of motor symptoms and leading to increased disability and poor quality of life. While some of these symptoms may be alleviated by antiparkinsonian medication, especially if they are 'off-period' related, treatment-related phenomena are usually exacerbated by increasing the number or dosage of antiparkinsonian drugs. Elimination of exacerbating factors and simplification of drug regimens are the first and most important steps in improvement of such symptoms.

A community stakeholder analysis of drug resistance strategies of rural native Hawaiian youth.

PubMed

Okamoto, Scott K; Helm, Susana; Delp, Justin A; Stone, Kristina; Dinson, Ay-Laina; Stetkiewicz, Jennifer

2011-08-01

This study examines and validates the drug resistance strategies identified by rural Hawaiian youth from prior research with a sample of community stakeholders on the Island of Hawai'i. One hundred thirty-eight stakeholders with a vested interest in reducing youth substance use (i.e., teachers, principals, social service agency providers, and older youth) completed a web-based survey comprised of 15 drug-related problem situations and 413 responses developed by Hawaiian youth. The findings corroborated the youth-focused findings from prior research. Differences in the endorsement of different strategies were examined based on gender, ethnicity, and age of the stakeholders. Implications for culturally grounded drug prevention in rural Hawaiian communities are discussed.

Framing effects in choices between multioutcome life-expectancy lotteries.

PubMed

Bernstein, L M; Chapman, G B; Elstein, A S

1999-01-01

To explore framing or editing effects and a method to debias framing in a clinical context. Clinical scenarios using multioutcome life-expectancy lotteries of equal value required choices between two supplementary drugs that either prolonged or shortened life from the 20-year beneficial effect of a baseline drug. The effects of these supplementary drugs were presented in two conditions, using a between-subjects design. In segregated editing (n = 116) the effects were presented separately from the effects of the baseline drug. In integrated editing (n = 100), effects of supplementary and baseline drugs were combined in the lottery presentation. Each subject responded to 30 problems. To explore one method of debiasing, another 100 subjects made choices after viewing both segregated and integrated editings of 20 problems (dual framing). Statistically significant preference reversals between segregated and integrated editing of pure lotteries occurred only when one framing placed outcomes in the gain domain, and the other framing placed them in the loss domain. When both editings resulted in gain-domain outcomes only, there was no framing effect. There was a related relationship of framing-effect shifts from losses to gains in mixed-lottery-choice problems. Responses to the dual framing condition did not consistently coincide with responses to either single framing. In some situations, dual framing eliminated or lessened framing effects. The results support two components of prospect theory, coding outcomes as gains or losses from a reference point, and an s-shaped utility function (concave in gain, convex in loss domains). Presenting both alternative editings of a complex situation prior to choice more fully informs the decision maker and may help to reduce framing effects. Given the extent to which preferences shift in response to alternative presentations, it is unclear which choice represents the subject's "true preferences."

Methadone maintenance therapy as evidence based drug abuse planning in developed countries: can developing countries afford and learn from this experience?

PubMed

Nsimba, Stephen E D

2010-03-01

Use of illicit substances of abuse is a major public health problem in developed countries like the US. However, this problem of illicit substance use has spread like a tumor to include currently developing countries where most of its youths and adolescents are actively engaged in this illegal practice. This problem is even more worse in poor resource countries, as use of these substances is accompanied with a lot of HIV- risk behaviours, and for cocaine and heroin drug injectors often share injecting equipments hence increasing the chances of contracting and spreading HIV infection. Apart from HIV infection, other infections include hepatitis B, C, abscesses and other ill-health problems such as drug dependence manifested with complex set of behaviours related to mental illnesses. For non-drug injectors, the chances of contracting and spreading HIV through their unsafe/unprotected sexual behaviours especially those having multiple partners is there. Use of these illicit substances have other consequences like compromising the dosing schedule or adherence / poor compliance to ARTs/ARVs among those enrolled. Furthermore, use of illicit substances may be accompanied with domestic sexual violence which is done without using any protective (condoms) measures) leading to HIV/AIDS and unplanned pregnancies. However, various studies and preventive approaches have been tried in the US on drug abusers in order to prevent the associated adverse health outcomes. There are many reasons why people use drugs. In many situations, drugs are being used as artificial problem-solvers such as frustrations, stress or tiredness. Drugs can often make a problem disappear for a short time but not usually the answer for solving the problem. They just help to remove it temporarily. Other people choose to use drugs to enjoy the feelings or for recreational purposes which many drugs produce. For example, many people, especially young people, experiment with using drugs to find out more about the sensations they produce. Drug use is a problem to users when it begins to cause some damage to their physical health, mental health and social well-being. These include mental illness, diseases caused by or related to use of drugs e.g. practice of sharing needles or syringes among drug injectors and also non-drug injectors may acquire HIV/AIDS and Hepatitis, crimes and violence. However, the number of harm associated with the use of drugs is increasing in Tanzania and other developing countries in Sub-Saharan Africa and globally in developed nations like the US and many others.

[Survey on drug-related problems in Lithuania's pharmacies].

PubMed

Kubiliene, Loreta; Liukenskyte, Simona; Savickas, Arūnas; Jureniene, Kristina

2006-01-01

to survey the most common and the most important drug-related problems in Lithuania, to explore their solution and factors influencing it, to formulate recommendations for solving drug-related problems. Pharmacists from community pharmacies participated in a random survey. They filled in questionnaires about drug-related problems and their solutions. It was the first survey on drug-related problems ever carried out in Lithuania. For the first time, it was found out that in Lithuania pharmacists most commonly encountered drug-related problem--additional drug therapy (52.03% of respondents)--and most rarely encountered drug-related problem--dosage too high (3% of respondents). Pharmacists stated that all categories of drug-related problems were of equal importance. It was established that pharmacists commonly solved drug-related problems associated with noncompliance with instructions (72.5% of respondents) and rarely met the problem when improper drug was selected (39.56% of respondents). Patients taking prescription medicines commonly encounter additional drug therapy problem, and patients taking nonprescription medications commonly encounter problems related to noncompliance with instructions.

[Comprehensive drug safety plan in a health department].

PubMed

Bujaldón-Querejeta, N; Aznar-Saliente, T; Esplá-González, S; Ruíz-Darbonnéns, S; Pons-Martínez, L; Talens-Bolos, A; Martínez-Ramírez, M; Camacho-Romera, D; Aranaz-Andrés, J M

2014-01-01

To develop and implement a comprehensive drug safety plan in a hospital for the years 2009-2011. Applying the Strengths Weaknesses/Limitations Opportunities Threats (SWOT) methodology, the baseline situation was analyzed and a broad strategy or plan was subsequently developed, defining the scope, responsibilities, objectives and strategic actions and indicators in order to measure the achievement of the results. A comprehensive drug safety plan with the main objective of identifying and reducing the medication-related problems in patients treated in the Hospital de San Juan in Alicante has been developed. The plan contains five strategic objectives, twenty strategic actions and the indicators to assess its outcomes. It also contains a timetable for its establishment and evaluation. Developing a comprehensive strategic plan allows the current situation relating to drug safety to be determined. The results obtained after its introduction will define its applicability. Due to the lack of publications of similar plans and results, the evaluation of this plan will be useful whether it is favorable or not. As a side benefit of the development, the multidisciplinary team continues to work on improving patient safety in the care process, and the safety culture continues to grow among the professionals. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

Drug Talk in Context: The Relationship between Situation and Performance in the Expression and Reception of Drug-Related Knowledge.

ERIC Educational Resources Information Center

Jones, Lynn

1996-01-01

Maintains that the ways in which students react, absorb, and communicate new information are defined by their perception of the requirements and expectations of their surrounding situation. This information is particularly relevant in designing and implementing school-based drug prevention programs. Provides examples of various situational-based…

Importance of stability of early living arrangements on behavior outcomes of children with and without prenatal drug exposure.

PubMed

Bada, Henrietta S; Langer, John; Twomey, Jean; Bursi, Charlotte; Lagasse, Linda; Bauer, Charles R; Shankaran, Seetha; Lester, Barry M; Higgins, Rosemary; Maza, Penelope L

2008-06-01

We evaluated whether living arrangements of children with or without prenatal drug exposure would be associated with their behavior outcomes and adaptive functioning. A total of 1388 children with or without prenatal cocaine or opiate exposure were enrolled in a longitudinal cohort study at 1 month of age, were seen at intervals, tracked over time for their living situation, and evaluated for behavior problems and adaptive functioning at 3 years of age. The Child Behavior Checklist and Vineland Adaptive Behavior Scales were administered. Using multiple regression models, we determined the factors that would predict behavior problems and adaptive functioning. Of the children enrolled, 1092 children were evaluated. Total and externalizing behavior problems T scores of children in relative care were lower (better) than those in parental care; externalizing behavior scores were lower than those in nonrelative care (p < .05). Total behavior problem scores increased 2.3 and 1.3 points, respectively, with each move per year and each year of Child Protective Services involvement. Compared to children in nonrelative care, those in parental or relative care had higher (better) scores in the Vineland Adaptive Behavior Scales total composite (p < .023), communication (p < .045), and daily living (p < .001). Each caretaker change was associated with a decrease of 2.65 and 2.19 points, respectively, in communication and daily living scores. Children's living arrangements were significantly associated with childhood behavior problems and adaptive functioning. The instability of living situation was also a significant predictor of these outcomes. While family preservation continues to be the goal of the child welfare system, expediting decision toward permanency remains paramount once children are placed in foster care.

Psychometric evaluation of the parent situation inventory: a role-play measure of coping in parents of substance-using adolescents.

PubMed

McGillicuddy, Neil B; Rychtarik, Robert G; Morsheimer, Elizabeth T

2004-12-01

This article reports on the generalizability, reliability, and construct validity of the Parent Situation Inventory (PSI), a role-play measure of coping skills in parents experiencing problems from an adolescent's drug and alcohol use. Generalizability was robust (.80) and alternate form and test-retest reliability were satisfactory. PSI skillfulness was negatively related to the parent's own substance use and to the adolescent's alcohol use. The PSI shows promise as a reliable and potentially valid measure of coping in this population and has direct implications for developing and evaluating skill-based parent training programs. Copyright 2004 APA.

Drug supply indicators: Pitfalls and possibilities for improvements to assist comparative analysis.

PubMed

Singleton, Nicola; Cunningham, Andrew; Groshkova, Teodora; Royuela, Luis; Sedefov, Roumen

2018-06-01

Interventions to tackle the supply of drugs are seen as standard components of illicit drug policies. Therefore drug market-related administrative data, such as seizures, price, purity and drug-related offending, are used in most countries for policy monitoring and assessment of the drug situation. International agencies, such as the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) and the UN Office of Drugs and Crime, also monitor and report on the drug situation cross-nationally and therefore seek to collect and make available key data in a uniform manner from the countries they cover. However, these data are not primarily collected for this purpose, which makes interpretation and comparative analysis difficult. Examples of limitations of these data sources include: the extent to which they reflect operational priorities rather than market changes; question marks over the robustness of and consistency in data collection methods, and issues around the timeliness of data availability. Such problems are compounded by cultural, social and contextual differences between countries. Making sense of such data is therefore challenging and extreme care needs to be taken using it. Nevertheless, these data provide an important window on a hidden area, so improving the quality of the data collected and expanding its scope should be a priority for those seeking to understand or monitor drug markets and supply reduction. In addition to highlighting some of the potential pitfalls in using supply indicators for comparative analysis, this paper presents a selection of options for improvements based on the current EMCDDA programme of work to improve their supply-related monitoring and analysis. The conceptual framework developed to steer this work may have wider application. Adopting this approach has the potential to provide a richer picture of drug markets, at both national and international levels, and make it easier to compare data between countries. Copyright © 2018 Elsevier B.V. All rights reserved.

Pharmacogenetics: A strategy for personalized medicine for autoimmune diseases.

PubMed

Tavakolpour, S; Darvishi, M; Ghasemiadl, M

2018-03-01

For many years, a considerable number of patients with autoimmune diseases (ADs) have suffered from a lack of drug response and drug-related toxicity. Despite the emergence of new therapeutic options such as biological agents, patients continue to struggle with these problems. Unfortunately, new challenges, including the paradoxical effects of biological drugs, have complicated the situation. In recent decades, efforts have been made to predict drug response as well as drug-related side effects. Thanks to the many advances in genetics, evaluation of markers to predict drug response/toxicity before the initiation of treatment may be an avenue toward personalizing treatments. Implementing pharmacogenetics and pharmacogenomics in the clinic could improve clinical care; however, obstacles remain to effective personalized medicine for ADs. The present study attempted to clarify the concept of pharmacogenetics/pharmacogenomics for ADs. After an overview on the pathogenesis of the most common types of treatments, this paper focuses on pharmacogenetic studies related to the selected ADs. Bridging the gap between pharmacogenetics and personalized medicine is also discussed. Moreover, the advantages, disadvantages and recommendations related to making personalized medicine practical for ADs have been addressed. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Housing First or no housing? Housing and homelessness at the end of alcohol and drug treatment.

PubMed

Dyb, Evelyn

2016-10-01

The rate of alcohol and drug dependency is high among homeless persons in Norway as well as in other Western societies. National homeless surveys also show a certain correlation between discharge from institutions and homelessness. However, the rate of homelessness versus the rate with fixed abode at the end of specialised alcohol and drug treatment has not been examined using quantitative methods. A cross-sectional survey was conducted in alcohol and drug treatment units in the national health services and private clinics. The survey investigates the housing outcome at the end of treatment compared to the situation at the start of treatment using an individual questionnaire for patients ending treatment in a specific time window. Housing outcome is measured by the odds ratio of having a fixed abode at the end of treatment in relation to main intoxicating substance, type of treatment (in- and outpatient), completing versus cutting short the treatment, housing situation at the start of treatment, socioeconomic capital, mental health problems, individual plan, medical assisted treatment, and a set of background variables. The housing versus homeless situation hardly changes during the treatment period. In both a bivariate analysis and a simple multivariate model, principal intoxicating substance is the strongest predictor of having a fixed abode both before and after treatment. However, a more sophisticated analysis indicates that socioeconomic resources and social capital play along with the preferred intoxicating substance as predictors of having permanent housing. After more than a decade of a housing-led national homeless policy, and wide embracement of Housing First approaches in the European Union, homeless persons entering specialised alcohol and drug treatment are likely to return to the streets and hostels at the end of treatment. Access to housing after treatment is very limited for those lacking resources to solve their housing problem without assistance. Copyright © 2016 Elsevier B.V. All rights reserved.

Environment and drug trafficking.

PubMed

Bryson, L O

1992-01-01

Illicit drug trafficking is a very complex matter, not only because it causes serious and pernicious problems in the socio-economic sphere, but because drug-taking can lead to personal degradation. To this situation, lamentable enough in itself, must be added the immense ecological and environmental damage, which presents grave and serious dangers for the planet.

Sexual Violence and Alcohol and Other Drug Use on Campus. Infofacts/Resources

ERIC Educational Resources Information Center

Higher Education Center for Alcohol and Other Drug Abuse and Violence Prevention, 2008

2008-01-01

This "Infofacts/Resources" describes the scope of the problem of sexual assault on campus, perpetrator characteristics and situational circumstances that may make assaults more likely to happen, and the role alcohol and other drugs, including rape-facilitating drugs, play in sexual assault. This publication also provides an overview of sexual…

Parallel satellite orbital situational problems solver for space missions design and control

NASA Astrophysics Data System (ADS)

Atanassov, Atanas Marinov

2016-11-01

Solving different scientific problems for space applications demands implementation of observations, measurements or realization of active experiments during time intervals in which specific geometric and physical conditions are fulfilled. The solving of situational problems for determination of these time intervals when the satellite instruments work optimally is a very important part of all activities on every stage of preparation and realization of space missions. The elaboration of universal, flexible and robust approach for situation analysis, which is easily portable toward new satellite missions, is significant for reduction of missions' preparation times and costs. Every situation problem could be based on one or more situation conditions. Simultaneously solving different kinds of situation problems based on different number and types of situational conditions, each one of them satisfied on different segments of satellite orbit requires irregular calculations. Three formal approaches are presented. First one is related to situation problems description that allows achieving flexibility in situation problem assembling and presentation in computer memory. The second formal approach is connected with developing of situation problem solver organized as processor that executes specific code for every particular situational condition. The third formal approach is related to solver parallelization utilizing threads and dynamic scheduling based on "pool of threads" abstraction and ensures a good load balance. The developed situation problems solver is intended for incorporation in the frames of multi-physics multi-satellite space mission's design and simulation tools.

Injection drug use and HIV/AIDS in China: Review of current situation, prevention and policy implications

PubMed Central

Qian, Han-Zhu; Schumacher, Joseph E; Chen, Huey T; Ruan, Yu-Hua

2006-01-01

Illicit drug abuse and HIV/AIDS have increased rapidly in the past 10 to 20 years in China. This paper reviews drug abuse in China, the HIV/AIDS epidemic and its association with injection drug use (IDU), and Chinese policies on illicit drug abuse and prevention of HIV/AIDS based on published literature and unpublished official data. As a major drug trans-shipment country with source drugs from the "Golden Triangle" and "Gold Crescent" areas in Asia, China has also become an increasingly important drug consuming market. About half of China's 1.14 million documented drug users inject, and many share needles. IDU has contributed to 42% of cumulatively reported HIV/AIDS cases thus far. Drug trafficking is illegal in China and can lead to the death penalty. The public security departments adopt "zero tolerance" approach to drug use, which conflict with harm reduction policies of the public health departments. Past experience in China suggests that cracking down on drug smuggling and prohibiting drug use alone can not prevent or solve all illicit drug related problems in the era of globalization. In recent years, the central government has outlined a series of pragmatic policies to encourage harm reduction programs; meanwhile, some local governments have not fully mobilized to deal with drug abuse and HIV/AIDS problems seriously. Strengthening government leadership at both central and local levels; scaling up methadone substitution and needle exchange programs; making HIV voluntary counseling and testing available and affordable to both urban and rural drug users; and increasing utilization of outreach and nongovernmental organizations are offered as additional strategies to help cope with China's HIV and drug abuse problem. PMID:16451717

Prosecution's Power, Procedural Rights, and Pleading Guilty: The Problem of Coercion in Plea Bargaining Drug Cases.

ERIC Educational Resources Information Center

Cloyd, Jerald W.

1979-01-01

The forms of psychological pressure placed on the defendant's pleading in drug cases are examined, with emphasis on the interplay between rational and emotional aspects of such situations. Three stages in plea bargaining negotiations are outlined. (Author/MC)

Affordably priced new drugs for poor populations: Approaches for a global solution.

PubMed

Mossialos, E; Dukes, G

2001-01-01

A very large proportion of the world's population, particularly the poor in developing countries, still have insufficient access or none at all to treatment with essential drugs. This situation can arise with any drug and for various reasons, but it exists in extreme form where the drug is irreplaceable yet entirely unaffordable. That is the case with new or relatively recent drugs which could save lives or eradicate endemic disease, but which (particularly during their period of patent protection) are usually sold at prices higher than patients or their community can afford to pay. The consequences of this situation in terms of persistent illness, suffering and large-scale mortality are felt most immediately in the developing world, but because today disease travels so rapidly it represents a threat to the world as a whole. As of late 2001, only a number of limited ad hoc solutions to these problems have emerged. They have provided relief in a number of specific situations but they offer no guarantee of permanence, are applied mainly at the discretion of multinational companies or aid agencies and leave the bulk of the global problem unchanged. The problem must be capable of a broad and lasting solution since the basic costs of manufacturing and distributing most of the drugs in question are not in themselves prohibitive. High prices are primarily a consequence of the need to provide an adequate return on investment, to finance research and development, and to pay the very high costs of promotion in intensively competitive markets. At present, however, these secondary costs are almost entirely covered by the sales income from industrialized countries, and that is unlikely to change. In the developing world, where the sales of such drugs has been negligible, it must be possible to supply them in more adequate quantities, at a fair and affordable prices which are very close to the basic manufacturing and distribution costs. This will require an innovative commercial approach but it may not demand a sacrifice; in many instances it will be the key to opening new emergent markets where low profit margins can be outweighed by high unit sales. The feasibility of sharply differential pricing for drugs has indeed been demonstrated already in various countries and regions where specific agreements for low-cost supply have operated successfully, for example, for vaccines and contraceptives but also for some therapeutic drugs still protected by patent. If this type of approach can be extended so that important new drugs are as a matter of routine made available to developing countries at highly preferential prices it would contribute greatly to the solution of major health problems. Naturally a number of safeguards are necessary. The most important of these is that drugs sold at "minimal" prices to a developing country must not leak across its borders to be re-sold at a profit elsewhere. Experience with vaccine and contraceptive agreements shows that this risk can be virtually eliminated, although the parallels with therapeutic drugs are not exact and the possibility of theft and "leakage" might be greater with such items, especially where they have a high potential market value. Nor must a drug, which enters a developing country at a preferential price then be burdened by taxes, customs duties or excessive wholesale or retail profit margins that might again put it out of reach of those who need it. Again, one would not wish to discourage the further evolution of good-quality drug manufacturing in developing countries, which is already making an important contribution to health and to the national economy. Safeguards on these and other matters could well be incorporated into a global working agreement between all parties, seeking to define and promote the use of minimum-level pricing for vital new drugs. That agreement would be implemented through specific arrangements and unilateral initiatives of an already familiar type; these would be centrally registered and monitored, as would situations of ongoing need. In this way, activities could be better attuned to need, progress assessed and the entire situation rendered transparent.

Impact of residential schooling and of child abuse on substance use problem in Indigenous Peoples.

PubMed

Ross, Amélie; Dion, Jacinthe; Cantinotti, Michael; Collin-Vézina, Delphine; Paquette, Linda

2015-12-01

Residential schools were the institutions, in operation from the 19th century to the late 20th century, which Indigenous children in Canada were forced to attend. The literature shows that many young people who attended these institutions were victims of neglect and abuse. Negative psychological effects resulting from child abuse have been amply documented. However, very few studies on this subject have been carried out among Canada's Indigenous Peoples. The objective of this study is to evaluate, for an Indigenous population in Quebec (Canada), the impact of residential schooling as well as self-reported experiences of sexual and physical abuse during childhood on the development of alcohol and drug use problems in adulthood. A total of 358 Indigenous participants were interviewed (164 men [45.8%] and 194 women [54.2%]). Alcoholism was evaluated using the Michigan Alcoholism Screening Test (MAST). Drug abuse was assessed with the Drug Abuse Screening Test-20 (DAST). Child abuse and residential schooling were assessed with dichotomous questions (yes/no). Among the participants, 28.5% (n=102) had attended residential schools, 35.2% (n=121) reported having experienced sexual abuse, and 34.1% (n=117) reported having experienced physical abuse before adulthood. Results of the exact logistic regression analyses indicated that residential school attendance was linked to alcohol problems, while child abuse was related to drug use problems. The results of this study highlight the importance of considering the consequences of historical traumas related to residential schools to better understand the current situation of Indigenous Peoples in Canada. Copyright © 2015 Elsevier Ltd. All rights reserved.

Relations between Behavior Problems in Classroom Social and Learning Situations and Peer Social Competence in Head Start and Kindergarten

ERIC Educational Resources Information Center

Bulotsky-Shearer, Rebecca J.; Dominguez, Ximena; Bell, Elizabeth R.; Rouse, Heather L.; Fantuzzo, John W.

2010-01-01

The relations between early emotional and behavioral problems in classroom situations and peer social competence were examined for a representative sample of urban Head Start children. Behavior problems were assessed within the context of routine peer, teacher, and structured learning classroom situations early in the preschool year. Two path…

Norwegian elderly patients' need for drug information and attitudes towards medication use reviews in community pharmacies.

PubMed

Mamen, Anette Vik; Håkonsen, Helle; Kjome, Reidun L S; Gustavsen-Krabbesund, Bjørn; Toverud, Else-Lydia

2015-12-01

Medication use review (MUR) is a community pharmacy service in several countries. Knowledge about what patients want from such a service is limited. The aim of this study was therefore to investigate Norwegian elderly patients' need for drug information and their attitudes towards MURs. In Norway's two largest cities, 162 patients (72% women; mean age: 78.9 years) who used at least one prescription drug were recruited from 18 senior centres. They were interviewed personally with a structured questionnaire (29 closed and 4 open-ended questions). The average number of prescription drugs used was 4.4. Seventy per cent also used over-the-counter drugs. The main source of drug information was the general practitioner (GP) followed by package inserts and pharmacy staff. For drug-related problems, 62% would contact the GP compared with 24% who preferred the pharmacist. Fifty per cent remembered no information when collecting prescriptions. However, 56% wanted to know more about their medication and 55% were interested in a MUR. The main topics they wished to address were effect/side effects and interactions. Lack of privacy was reported to be a major obstacle in the current situation. This study shows that community pharmacies in Norway play a minor role regarding drug information to elderly polypharmacy patients. The GP is both their main information source and whom they contact for drug-related problems. However, half of the patients would like to know more about their medication. More than half were positive towards taking part in a MUR. © 2015 Royal Pharmaceutical Society.

Liking and wanting of drug and nondrug rewards in active cocaine users: the STRAP-R questionnaire

DOE Office of Scientific and Technical Information (OSTI.GOV)

Goldstein, R.Z.; Goldstein, R.Z.; Woicik, P.A..

Few studies have examined the subjective value attributed to drug rewards specifically as it compares with the value attributed to primary non-drug rewards in addicted individuals. The objective of this study is to assess liking and wanting of expected drug rewards as compared to food and sex while respondents report about three different situations (current, and hypothetical in general, and under drug influence). In all, 20 cocaine-addicted individuals (mean abstinence = 2 days) and 20 healthy control subjects were administered the STRAP-R (Sensitivity To Reinforcement of Addictive and other Primary Rewards) questionnaire after receiving an oral dose of the dopaminemore » agonist methylphenidate (20 mg) or placebo. The reinforcers relative value changed within the addicted sample when reporting about the under drug influence situation (drug > food; otherwise, drug < food). This change was highest in the addicted individuals with the youngest age of cocaine use onset. Moreover, drug wanting exceeded drug liking in the addicted subjects when reporting about this situation during methylphenidate. Thus, cocaine-addicted individuals assign the highest subjective valence to drug rewards but only when recalling cue-related situations. When recalling this situation, they also report higher drug wanting than hedonic liking, a motivational shift that was only significant during methylphenidate. Together, these valence shifts may underlie compulsive stimulant abuse upon pharmacological or behavioural cue exposure in addicted individuals. Additional studies are required to assess the reliability of the STRAP-R in larger samples and to examine its validity in measuring the subjective value attributed to experienced reinforcers or in predicting behaviour.« less

Drugs & the Brain: Case-based Instruction for an Undergraduate Neuropharmacology Course.

PubMed

Nagel, Anastasia; Nicholas, Andrea

2017-01-01

In order to transform a traditional large non-majors general education (GE) neurobiology lecture (Drugs & the Brain) into an active learning course, we developed a series of directed mini-cases targeting major drug classes. Humorous and captivating case-based situations were used to better engage and motivate students to solve problems related to neuropharmacology and physiology. Here we provide directed cases, questions and learning outcomes for our opiates mini-cases. In addition, we describe how case studies were incorporated into our course and assessed using peer review and online quizzing. An in-depth analysis of the overall course transformation on student exam performance, opinions and instructor evaluations can be found in the JUNE article Don't Believe the Gripe! Increasing Course Structure in a Large Non-majors Neuroscience Course.

Current situation and future usage of anticancer drug databases.

PubMed

Wang, Hongzhi; Yin, Yuanyuan; Wang, Peiqi; Xiong, Chenyu; Huang, Lingyu; Li, Sijia; Li, Xinyi; Fu, Leilei

2016-07-01

Cancer is a deadly disease with increasing incidence and mortality rates and affects the life quality of millions of people per year. The past 15 years have witnessed the rapid development of targeted therapy for cancer treatment, with numerous anticancer drugs, drug targets and related gene mutations been identified. The demand for better anticancer drugs and the advances in database technologies have propelled the development of databases related to anticancer drugs. These databases provide systematic collections of integrative information either directly on anticancer drugs or on a specific type of anticancer drugs with their own emphases on different aspects, such as drug-target interactions, the relationship between mutations in drug targets and drug resistance/sensitivity, drug-drug interactions, natural products with anticancer activity, anticancer peptides, synthetic lethality pairs and histone deacetylase inhibitors. We focus on a holistic view of the current situation and future usage of databases related to anticancer drugs and further discuss their strengths and weaknesses, in the hope of facilitating the discovery of new anticancer drugs with better clinical outcomes.

The Narcotics Situation in Russia as a Social Pedagogical Problem

ERIC Educational Resources Information Center

Popov, V. A.

2012-01-01

The increase in the use of narcotics in Russia has been complicated by the spread of new kinds of drugs that are less visible than more traditional kinds. A worsening of the situation must be prevented. This requires studying the accumulation of world experience, searching for up-to-date approaches to prevention, combining the efforts of science…

To Think, To Choose, To Act.

ERIC Educational Resources Information Center

Collins, LeRoy

Social, political, and business moral issues that impede solving public problems, and the situation in higher education, specifically in Florida, are considered. Problems in society that have a moral impact include the high rate of crime and an ineffective rehabilitation system for convicted criminals, illicit drug traffic, and the strength of…

[Animal drugs quality status and reason analysis].

PubMed

Ding, Qing; Qiu, Ya-jing; Fang, Ke-hui; Hu, Hao-bin; Wu, Yue

2015-11-01

In order to reaction the quality present situation, problems on the current quality of animal sources of drugs are summed up by using test data analysis, literature search and marketing research. This paper can also help the improvement of the quality management, the revision of the relevant department policy system and the improvement of standards.

Improving drug addiction treatment in China.

PubMed

Tang, Yi-Lang; Hao, Wei

2007-07-01

To illustrate the current situation and problems of drug addiction in treatment China and propose suggestions. A descriptive study based on literature searched from Medline and the China National Knowledge Infrastructure database (1996-2007) and hand-picked references. Since the re-emergence of drug addiction in China in the early 1990s, there has been tremendous progress in drug addiction treatments in China, especially treatments for opiate addiction. However, many problems and challenges remain for improvement, including widespread negative attitudes towards drug abuse and drug-dependent individuals, the lack of evidence-based data on the efficacy of Chinese traditional medicine and the lack of a comprehensive and integrated system to organize all treatment resources and monitor treatment progress. The authors discuss the challenges that impede effective treatments of drug addiction and some suggestions are proposed. Implementing these suggestions can improve the outcome of treatment of drug-dependent individuals and benefit the whole society. China faces substantial drug addiction problems that appear to be worsening with time. Although much progress in drug addiction treatment has been made, improvement in many aspects is needed urgently.

Healthcare professionals' agreement on clinical relevance of drug-related problems among elderly patients.

PubMed

Bech, Christine Flagstad; Frederiksen, Tine; Villesen, Christine Tilsted; Højsted, Jette; Nielsen, Per Rotbøll; Kjeldsen, Lene Juel; Nørgaard, Lotte Stig; Christrup, Lona Louring

2018-02-01

Background Disagreement among healthcare professionals on the clinical relevance of drug-related problems can lead to suboptimal treatment and increased healthcare costs. Elderly patients with chronic non-cancer pain and comorbidity are at increased risk of drug related problems compared to other patient groups due to complex medication regimes and transition of care. Objective To investigate the agreement among healthcare professionals on their classification of clinical relevance of drug-related problems in elderly patients with chronic non-cancer pain and comorbidity. Setting Multidisciplinary Pain Centre, Rigshospitalet, Copenhagen, Denmark. Method A pharmacist performed medication review on elderly patients with chronic non-cancer pain and comorbidity, identified their drug-related problems and classified these problems in accordance with an existing categorization system. A five-member clinical panel rated the drug-related problems' clinical relevance in accordance with a five-level rating scale, and their agreement was compared using Fleiss' κ. Main outcome measure Healthcare professionals' agreement on clinical relevance of drug related problems, using Fleiss' κ. Results Thirty patients were included in the study. A total of 162 drug related problems were identified, out of which 54% were of lower clinical relevance (level 0-2) and 46% of higher clinical relevance (level 3-4). Only slight agreement (κ = 0.12) was found between the panellists' classifications of clinical relevance using a five-level rating scale. Conclusion The clinical pharmacist identified drug related problems of lower and higher clinical relevance. Poor overall agreement on the severity of the drug related problems was found among the panelists.

Improving medication safety and diabetes management in Hong Kong: a multidisciplinary approach.

PubMed

Chung, A Ys; Anand, S; Wong, I Ck; Tan, K Cb; Wong, C Ff; Chui, W Cm; Chan, E W

2017-04-01

Patients with diabetes often require complex medication regimens. The positive impact of pharmacists on improving diabetes management or its co-morbidities has been recognised worldwide. This study aimed to characterise drug-related problems among diabetic patients in Hong Kong and their clinical significance, and to explore the role of pharmacists in the multidisciplinary diabetes management team by evaluating the outcome of their clinical interventions. An observational study was conducted at the Diabetes Clinic of a public hospital in Hong Kong from October 2012 to March 2014. Following weekly screening, and prior to the doctor's consultation, selected high-risk patients were interviewed by a pharmacist for medication reconciliation and review. Drug-related problems were identified and documented by the pharmacist who presented clinical recommendations to doctors to optimise a patient's drug regimen and resolve or prevent potential drug-related problems. A total of 522 patients were analysed and 417 drug-related problems were identified. The incidence of patients with drug-related problems was 62.8% with a mean of 0.9 (standard deviation, 0.6) drug-related problems per patient. The most common categories of drug-related problems were associated with dosing (43.9%), drug choice (17.3%), and non-allergic adverse reactions (15.6%). Drugs most frequently involved targeted the endocrine or cardiovascular system. The majority (71.9%) of drug-related problems were of moderate clinical significance and 28.1% were considered minor problems. Drug-related problems were totally solved (50.1%) and partially solved (11.0%) by doctors' acceptance of pharmacist recommendations, or received acknowledgement from doctors (5.5%). Pharmacists, in collaboration with the multidisciplinary team, demonstrated a positive impact by identifying, resolving, and preventing drug-related problems in patients with diabetes. Further plans for sustaining pharmacy service in the Diabetes Clinic would enable further studies to explore the long-term impact of pharmacists in improving patients' clinical outcomes in diabetes management.

[Pharmacist as gatekeeper: combating medication abuse and dependence].

PubMed

Shimane, Takuya

2013-01-01

  The nonmedical use of medications, including psychotropic drugs, is a growing health problem in Japan. According to a nationwide survey of mental hospitals, the proportion of patients with sedative (mainly benzodiazepine)-related disorders has more than doubled over the last decade. An association between psychotropic drug overdose and suicide risk has also been reported. Furthermore, over-the-counter drug abuse is still a serious problem in Japan. In recent years, pharmacists have been expected to act as gatekeepers, making timely identifications of suicide risk or substance abuse and directing these individuals to appropriate medical care facilities. In August 2012, the revised Comprehensive Suicide Measures Act identified pharmacists as one professional group that should act as gatekeepers. This article begins by reviewing the fundamental terms involved in understanding the nonmedical use of medications, including abuse, dependence, and intoxication. The current situation of substance abuse and dependence is then introduced through a summary of several epidemiological surveys conducted in Japan. Finally, the role of pharmacists as gatekeepers in preventing substance abuse and dependence on medications is discussed.

Obesity and Pediatric Drug Development.

PubMed

Vaughns, Janelle D; Conklin, Laurie S; Long, Ying; Zheng, Panli; Faruque, Fahim; Green, Dionna J; van den Anker, John N; Burckart, Gilbert J

2018-05-01

There is a lack of dosing guidelines for use in obese children. Moreover, the impact of obesity on drug safety and clinical outcomes is poorly defined. The paucity of information needed for the safe and effective use of drugs in obese patients remains a problem, even after drug approval. To assess the current incorporation of obesity as a covariate in pediatric drug development, the pediatric medical and clinical pharmacology reviews under the Food and Drug Administration (FDA) Amendments Act of 2007 and the FDA Safety and Innovation Act (FDASIA) of 2012 were reviewed for obesity studies. FDA labels were also reviewed for statements addressing obesity in pediatric patients. Forty-five drugs studied in pediatric patients under the FDA Amendments Act were found to have statements and key words in the medical and clinical pharmacology reviews and labels related to obesity. Forty-four products were identified similarly with pediatric studies under FDASIA. Of the 89 product labels identified, none provided dosing information related to obesity. The effect of body mass index on drug pharmacokinetics was mentioned in only 4 labels. We conclude that there is little information presently available to provide guidance related to dosing in obese pediatric patients. Moving forward, regulators, clinicians, and the pharmaceutical industry should consider situations in drug development in which the inclusion of obese patients in pediatric trials is necessary to facilitate the safe and effective use of new drug products in the obese pediatric population. © 2018, The American College of Clinical Pharmacology.

Vocational Training of Young Migrants in Denmark.

ERIC Educational Resources Information Center

Koefoed, Else

A study looked at the overall situation of the immigrant population, and young immigrants in particular, and analyzed such problem areas as the transition from school to working life and the inadequacies of initial training with relation to the situation in Denmark. The study identified the following problem areas: (1) problems relating to the…

Effects of transnational migration on drug use: an ethnographic study of Nepali female heroin users in Hong Kong.

PubMed

Tang, Wai-Man

2015-01-01

Past studies of female drug users in South Asia tend to focus on their plights, for instance, how they have been driven to drug use and encounter more problems than their male counterparts, such as HIV/AIDS and sexual abuse. Few studies focus on their active role--how they actively make use of resources in the external environment to construct their desired femininity through drug consumption. Furthermore, little is known about the situation of female South Asian drug users who are living overseas. This paper is a study of transnational migration, drug use and gender--how transnational migration influences the drug use of female transnational migrants. An 18-month ethnography has been carried out in a Nepali community in Hong Kong and 13 informants were interviewed. Data were coded and analyzed by using the grounded-theory approach. Themes related to the drug use of the female Nepali heroin users were identified. The findings show that there are three important themes that significantly affect the drug use of female Nepali heroin users, which include (1) their relationships with intimate partners, (2) their means of support, and (3) their legal status in migration. The findings are consistent with the concept of post-structuralism in gender and transnationalism theories. Female Nepali heroin users in Hong Kong are neither active agents nor passive victims; their active/passive role is largely dependent on their reconfigured opportunities and constraints in transnational migration. Thus, transnationalism should be taken as an important perspective to study the situation of female drug users in a globalized context. Copyright © 2014 Elsevier B.V. All rights reserved.

Testing posttraumatic stress as a mediator of physical, sexual, and psychological intimate partner violence and substance problems among women.

PubMed

Sullivan, Tami P; Cavanaugh, Courtenay E; Buckner, Julia D; Edmondson, Donald

2009-12-01

This study examined whether posttraumatic stress specifically resulting from intimate partner violence (IPV-related posttraumatic stress) mediated relationships between types of IPV and drug and alcohol problems among 212 women currently experiencing IPV. Six-month prevalence was high for drug use (48%) and alcohol use (59%). Structural equation modeling revealed that the frequency of physical, sexual, and psychological IPV were significantly and positively related to greater IPV-related posttraumatic stress, and IPV-related posttraumatic stress was significantly and positively related to drug problems. Further, IPV-related posttraumatic stress mediated the relationships between physical IPV and drug problems and psychological IPV and drug problems. Findings suggest that prevention and intervention efforts targeting posttraumatic stress among IPV-exposed women may reduce drug problems in this population.

Ethical aspects on rare diseases.

PubMed

Barrera, Luis A; Galindo, Gilberto Cely

2010-01-01

In this chapter we discuss several of the most relevant subjects related to ethics on Rare Diseases. Some general aspects are discussed such as the socio-psychological problems that confront the patients and their families that finally lead to marginalization and exclusion of patients affected by these diseases from the health programs, even in wealthy countries. Then we address problems related to diagnosis and some ethical aspects of newborn screening, prenatal, pre-implantation diagnosis and reference centers, as well as some conditions that should be met by the persons and institutions performing such tasks. Alternatives of solutions for the most critical situations are proposed. Subsequently the orphan drugs subject is discussed not only from the availability point of view, prizes, industrial practices, and purchasing power in developed and developing societies. The research related to rare disease in children and other especially vulnerable conditions, the need for informed consent, review boards or ethics comities, confidentiality of the information, biobanks and pharmacogenetics are discussed.

Earning, Spending, and Drug Use in a Therapeutic Workplace

PubMed Central

Subramaniam, Shrinidhi; DeFulio, Anthony; Jarvis, Brantley P.; Holtyn, August F.; Silverman, Kenneth

2017-01-01

Drug addiction is a chronic, relapsing health problem that is associated with the degree to which individuals choose small, immediate monetary outcomes over larger, delayed outcomes. This study was a secondary analysis exploring the relation between financial choices and drug use in opioid-dependent adults in a therapeutic workplace intervention. Sixty-seven participants were randomly assigned to a condition in which access to paid job training was contingent upon naltrexone adherence (N = 35) or independent of naltrexone adherence (N = 32). Participants could earn approximately $10 per hour for 4 hours every weekday and could exchange earnings for gift cards or bill payments each weekday. Urine was collected and tested for opiates and cocaine thrice weekly. Participants’ earning, spending, and drug use were not related to measures of delay discounting obtained prior to the intervention. When financial choices were categorized based on drug use during the intervention, however, those with less frequent drug use or frequent use of one drug spent a smaller proportion of their daily earnings and maintained a higher daily balance than those who frequently tested positive for both drugs (i.e., opiates and cocaine). Several patterns described the relation between cumulative earning and spending including no saving, periods of saving, and sustained saving. One destructive effect of drug use may be that it creates a perpetual zero-balance situation in the lives of users, which in turn prevents them from gaining materials that could help to break the cycle of addiction. PMID:29104320

Earning, Spending, and Drug Use in a Therapeutic Workplace.

PubMed

Subramaniam, Shrinidhi; DeFulio, Anthony; Jarvis, Brantley P; Holtyn, August F; Silverman, Kenneth

2017-06-01

Drug addiction is a chronic, relapsing health problem that is associated with the degree to which individuals choose small, immediate monetary outcomes over larger, delayed outcomes. This study was a secondary analysis exploring the relation between financial choices and drug use in opioid-dependent adults in a therapeutic workplace intervention. Sixty-seven participants were randomly assigned to a condition in which access to paid job training was contingent upon naltrexone adherence (N = 35) or independent of naltrexone adherence (N = 32). Participants could earn approximately $10 per hour for 4 hours every weekday and could exchange earnings for gift cards or bill payments each weekday. Urine was collected and tested for opiates and cocaine thrice weekly. Participants' earning, spending, and drug use were not related to measures of delay discounting obtained prior to the intervention. When financial choices were categorized based on drug use during the intervention, however, those with less frequent drug use or frequent use of one drug spent a smaller proportion of their daily earnings and maintained a higher daily balance than those who frequently tested positive for both drugs (i.e., opiates and cocaine). Several patterns described the relation between cumulative earning and spending including no saving, periods of saving, and sustained saving. One destructive effect of drug use may be that it creates a perpetual zero-balance situation in the lives of users, which in turn prevents them from gaining materials that could help to break the cycle of addiction.

A typology and analysis of drug resistance strategies of rural Native Hawaiian youth.

PubMed

Okamoto, Scott K; Helm, Susana; Giroux, Danielle; Kaliades, Alexis; Kawano, Kaycee Nahe; Kulis, Stephen

2010-12-01

This study examines the drug resistance strategies described by Native Hawaiian youth residing in rural communities. Sixty-four youth from 7 middle and intermediate schools on the Island of Hawai'i participated in a series of gender-specific focus groups. Youth responded to 15 drug-related problem situations developed and validated from prior research. A total of 509 responses reflecting primary or secondary drug resistance strategies were identified by the youth, which were qualitatively collapsed into 16 different categories. Primary drug resistance strategies were those that participants listed as a single response, or the first part of a two-part response, while secondary drug resistance strategies were those that were used in tandem with primary drug resistance strategies. Over half of the responses reflecting primary drug resistance strategies fell into three different categories ("refuse," "explain," or "angry refusal"), whereas over half of the responses reflecting secondary drug resistance strategies represented one category ("explain"). Significant gender differences were found in the frequency of using different strategies as well as variations in the frequency of using different strategies based on the type of drug offerer (family versus friends/peers). Implications for prevention practice are discussed.

Solid dispersion of poorly water-soluble drugs: early promises, subsequent problems, and recent breakthroughs.

PubMed

Serajuddin, A T

1999-10-01

Although there was a great interest in solid dispersion systems during the past four decades to increase dissolution rate and bioavailability of poorly water-soluble drugs, their commercial use has been very limited, primarily because of manufacturing difficulties and stability problems. Solid dispersions of drugs were generally produced by melt or solvent evaporation methods. The materials, which were usually semisolid and waxy in nature, were hardened by cooling to very low temperatures. They were then pulverized, sieved, mixed with relatively large amounts of excipients, and encapsulated into hard gelatin capsules or compressed into tablets. These operations were difficult to scale up for the manufacture of dosage forms. The situation has, however, been changing in recent years because of the availability of surface-active and self-emulsifying carriers and the development of technologies to encapsulate solid dispersions directly into hard gelatin capsules as melts. Solid plugs are formed inside the capsules when the melts are cooled to room temperature. Because of surface activity of carriers used, complete dissolution of drug from such solid dispersions can be obtained without the need for pulverization, sieving, mixing with excipients, etc. Equipment is available for large-scale manufacturing of such capsules. Some practical limitations of dosage form development might be the inadequate solubility of drugs in carriers and the instability of drugs and carriers at elevated temperatures necessary to manufacture capsules.

Drug-related visits to the emergency department: how big is the problem?

PubMed

Patel, Payal; Zed, Peter J

2002-07-01

To review the literature concerning drug-related problems that result in emergency department visits, estimate the frequency of these problems and the rates of hospital admissions, and identify patient risk factors and drugs that are associated with the greatest risk. A systematic search of MEDLINE (January 1966-December 2001), EMBASE (January 1980-December 2001), and PubMed (January 1966-December 2001) databases for full reports published in English was performed. The Ottawa Valley Regional Drug Information Service database of nonindexed pharmacy journals also was searched. Data from eight retrospective and four prospective trials retrieved indicated that as many as 28% of all emergency department visits were drug related. Of these, 70% were preventable, and as many as 24% resulted in hospital admission. Drug classes often implicated in drug-related visits to an emergency department were nonsteroidal antiinflammatory drugs, anticonvulsants, antidiabetic drugs, antibiotics, respiratory drugs, hormones, central nervous system drugs, and cardiovascular drugs. Common drug-related problems resulting in emergency department visits were adverse drug reactions, noncompliance, and inappropriate prescribing. Drug-related problems are a significant cause of emergency department visits and subsequent resource use. Primary caregivers, such as family physicians and pharmacists, should collaborate more closely to provide and reinforce care plans and monitor patients to prevent drug-related visits to the emergency department and subsequent morbidity and mortality.

Internalized Homophobia and Drug Use in a National Cohort of Gay and Bisexual Men: Examining Depression, Sexual Anxiety, and Gay Community Attachment as Mediating Factors.

PubMed

Moody, Raymond L; Starks, Tyrel J; Grov, Christian; Parsons, Jeffrey T

2018-05-01

The minority stress process of internalized homophobia (IH) has been associated with a range of adverse health outcomes among gay and bisexual men (GBM). However, evidence is mixed regarding the effect of IH on drug use, suggesting the potential role of multiple mediated pathways. Researchers have linked depression, sexual anxiety, and gay community attachment with IH. Depression, sexual anxiety, and gay community attachment have also been linked with drug use and drug-related problems suggesting potential mediating roles. A U.S. national sample of 1071 HIV-negative GBM completed at-home surveys, including measures of sociodemographic characteristics, IH, depression, sexual anxiety, gay community attachment, and drug use and associated problems. Adjusting for sociodemographic characteristics, depression mediated the association between IH and recent drug use. IH was positively associated with depression, and depression was positively associated with recent drug use. Gay community attachment partially mediated drug-related problems. IH had a positive direct association with drug-related problems and a negative direct association with gay community attachment. Gay community attachment had a positive association with drug-related problems. IH was positively associated with sexual anxiety, but sexual anxiety was not associated with either drug outcome. Efforts to reduce IH among HIV-negative GBM are likely to have a positive impact on mental health problems, as well as reduce risk for drug use and drug-related problems. Gay communities could provide the social support necessary for reducing IH; however, emphasis on community level interventions that address factors that increase risk for drug-related problems remains important.

Quite a lot of smoke but very limited fire--the use of methamphetamine in Europe.

PubMed

Griffiths, Paul; Mravcik, Viktor; Lopez, Dominique; Klempova, Danica

2008-05-01

This paper provides an overview of the historical development, current situation and potential future diffusion of methamphetamine (MA) use in Europe. The analysis is based on a review of published and grey literature, as well as data collected as part of the ongoing monitoring of the drug situation in Europe. Some qualitative surveys among high-risk populations do exist, but overall the general low prevalence of methamphetamine use in most of Europe means that the data available to explore patterns of use are limited. In many parts of Europe, amphetamine use is well established and the injecting of amphetamines has historically constituted an important component of the drug problem in many Nordic countries. Methamphetamine problems are long documented in the Czech and Slovak republics, but there is no current evidence of widespread use of MA elsewhere in Europe. Concern that MA use is spreading in Europe is prompted by some reports of use among high-risk groups. However, the evidence available suggests that even in high-risk populations, the use of MA currently remains uncommon. Europe accounted for less than 1% of worldwide MA seizures in 2005, and over the period 2004-05 European ephedrine seizures amounted for 6% of the global figure. The spread of MA use is limited and no strong evidence exists that significant diffusion is occurring. It appears likely that methamphetamine diffusion in Europe is impeded by a strong market for other stimulant drugs [cocaine, amphetamine and methylenedioxymethamphetamine (MDMA)]. The future potential for the diffusion of MA may be influenced by factors such as: the relative availability and popularity of other drugs; possible 'leakage' from areas of historical high prevalence; travel by young Europeans to areas of high prevalence; and how users perceive MA as a desirable, suitable and cost-effective alternative to other stimulants available on the European illicit drug market.

[Recommendations for initial antiretroviral treatment in HIV-infected children. Update 2003].

PubMed

2004-03-01

Highly active antiretroviral therapy in HIV-infected children has been associated with a dramatic decrease in progression to AIDS and HIV-related deaths, and infected children currently have an excellent quality of life. Antiretroviral drugs cannot eradicate the virus, although they can achieve a situation of latent infection. However, chronic use of these drugs has multiple adverse effects, the most important of which are metabolic complications. The large number of drugs required and patient characteristics such as age, tolerance to drugs, adherence, and social problems make unifying the criteria for initial therapy in HIV-infected children difficult. A balance should be sought between not delaying the start of treatment, to avoid immunologic deterioration, and minimizing the long-term adverse effects of the therapy. The present treatment recommendations are adapted from international guidelines and are based on a literature review and on our own experience. Our group previously published recommendations on the treatment of HIV-infected children and the aim of the present article is to provide an update.

MDMA in humans: factors which affect the neuropsychobiological profiles of recreational ecstasy users, the integrative role of bioenergetic stress.

PubMed

Parrott, Andy C

2006-03-01

Many recreational ecstasy/MDMA users display neuropsychobiological deficits, whereas others remain problem free. This review will investigate some of the drug and non-drug factors which influence the occurrence of these deficits. Acute and chronic MDMA usage are both important. Intensive use within a session is often associated with more problems. In term of lifetime usage, novice users generally remain unimpaired, whereas most heavy users report memory or other psychobiological problems which they attribute to ecstasy. These complaints are confirmed by objective deficits in working memory, attention, frontal-executive, and episodic memory tasks. Psychobiological deficits include disturbed sleep, sexual dysfunction, reduced immuno-competence, and increased oxidative stress. Further MDMA-related factors which may contribute to these changes, include acute and chronic tolerance, and drug dependence. Around 90ñ95% of ecstasy/MDMA users also take cannabis, and this can independently contribute to the adverse neuropsychobiological pro.les; although in some situations the acute co-use of these two drugs may be interactive rather than additive, since cannabis has relaxant and hypothermic properties. Alcohol, nicotine, amphetamine, and other drugs, can also affect the psychobiological pro.les of ecstasy polydrug users in complex ways. Pure MDMA users are rare but they have been shown to display significant neurocognitive deficits. Psychiatric aspects are debated in the context of the diathesis-stress model. Here the stressor of ecstasy polydrug drug use, interacts with various predisposition factors (genetic, neurochemical, personality), to determine the psychiatric outcome. Recreational MDMA is typically taken in hot and crowded dances/raves. Prolonged dancing, feeling hot, and raised body temperature, can also be associated with more psychobiological problems. This is consistent with the animal literature, where high ambient temperature and other metabolic stimulants boost the acute effects of MDMA, and cause greater serotonergic neurotoxicity. In conclusion, the neuropsychobiological effects of MDMA are modulated by a wide range of drug and non-drug factors. These multiple influences are integrated within a bioenergetic stress model, where factors which heighten acute metabolic distress lead to more neuropsychobiological problems.

Oral Health of Drug Abusers: A Review of Health Effects and Care

PubMed Central

SHEKARCHIZADEH, Hajar; KHAMI, Mohammad R.; MOHEBBI, Simin Z.; EKHTIARI, Hamed; VIRTANEN, Jorma I.

2013-01-01

Abstract Oral health problems, among the most prevalent comorbidities related to addiction, require more attention by both clinicians and policy-makers. Our aims were to review oral complications associated with drugs, oral health care in addiction rehabilitation, health services available, and barriers against oral health promotion among addicts. Drug abuse is associated with serious oral health problems including generalized dental caries, periodontal diseases, mucosal dysplasia, xerostomia, bruxism, tooth wear, and tooth loss. Oral health care has positive effects in recovery from drug abuse: patients’ need for pain control, destigmatization, and HIV transmission. Health care systems worldwide deliver services for addicts, but most lack oral health care programs. Barriers against oral health promotion among addicts include difficulty in accessing addicts as a target population, lack of appropriate settings and of valid assessment protocols for conducting oral health studies, and poor collaboration between dental and general health care sectors serving addicts. These interfere with an accurate picture of the situation. Moreover, lack of appropriate policies to improve access to dental services, lack of comprehensive knowledge of and interest among dental professionals in treating addicts, and low demand for non-emergency dental care affect provision of effective interventions. Management of drug addiction as a multi-organ disease requires a multidisciplinary approach. Health care programs usually lack oral health care elements. Published evidence on oral complications related to addiction emphasizes that regardless of these barriers, oral health care at various levels including education, prevention, and treatment should be integrated into general care services for addicts. PMID:26060654

Heroin overdose deaths and heroin purity between 1990 and 2000 in Istanbul, Turkey*.

PubMed

Toprak, Sadik; Cetin, Ilhan

2009-09-01

Turkey has continuously experienced problems with abuse of, and addiction to, opium derivatives. In this study, we analyzed the relationship between heroin overdose deaths and the characteristics of seized opium derivatives. Data were gathered from the Council of Forensic Medicine of the Ministry of Justice in Istanbul from 1990 to 2000. There were 636 heroin-related deaths during this period, 595 of which were classified as heroin overdose deaths. Mean crude and weighted heroin purities remained relatively constant and were calculated to be 46% (57-34%) and 51% (39-59%), respectively. The weight of heroin and the number of heroin seizures, but not the heroin purity, were significantly associated with the number of heroin-related deaths. Prevention strategies are needed to reduce the number of deaths caused by overdoses in countries situated on drug trafficking routes. These strategies should focus on drug trafficking, by providing increased levels of, and support for, law enforcement, stopping the supply of precursor chemicals, and combating corruption among border officials.

Drug related problems with Antiparkinsonian agents: consumer Internet reports versus published data.

PubMed

Schröder, Sabrina; Zöllner, York Francis; Schaefer, Marion

2007-10-01

There is currently a lack of detailed information concerning drug related problems in the outpatient treatment of Parkinson's disease. Problems associated with drug treatment communicated anonymously in Parkinson's disease online forums were therefore retrospectively searched and documented for 1 year. Based on postings concerning 12 drugs for the treatment of Parkinson's disease, a total of 238 drug related problems were identified and categorised using the Problem Intervention Documentation (PI-Doc). Of these, 153 were adverse drug reactions. Adverse drug reactions associated with the skin were relatively common, but central effects such as cognitive or psychiatric changes, effects on the sleep/waking system and other problems like headache and dizziness accounted for the highest percentage of adverse events. A comparison with data from scientific literature revealed a number of differences. This means that an analysis of online forums detected a number of drug related problems that were otherwise largely invisible. These were mainly associated with the qualitative aspects of treatment such as medication handling, dosage and individual problems concerning adverse events. In addition, the described method of identifying and classifying drug related problems in Internet forums may also be seen as a contribution to the international discussion about consumer reports and pharmacovigilance. The information about adverse drug reactions given by Internet users can be seen as a valuable adjunct to clinical trial data and as being very timely with regard to the event itself. Online forums may be considered as a suitable source of observational information to complement data from randomised clinical trials.

Offenders with mental health problems and problematic substance use: affective psychopathic personality traits as potential barriers to participation in substance abuse interventions.

PubMed

Durbeej, Natalie; Palmstierna, Tom; Berman, Anne H; Kristiansson, Marianne; Gumpert, Clara Hellner

2014-01-01

Substance abuse is related to re-offending, and treatment of substance abuse may reduce criminal recidivism. Offender characteristics including problem severity, violence risk and psychopathic personality traits may be positively or negatively associated with participation in substance abuse treatment. We explored the relationships between such characteristics and participation in substance abuse interventions among Swedish offenders with mental health problems and problematic substance use. Our analyses revealed that problem severity regarding drugs, employment, and family/social situations predicted intervention participation, and that affective psychopathic personality traits were negatively associated with such participation. Thus, affective psychopathic personality traits could be considered as potential barriers to participation in substance abuse interventions. Among offenders with mental health problems and problematic substance use, such personality traits should be taken into account in order to optimize treatment participation and treatment outcome. Approaches used in cognitive-behavioral therapy (CBT) and dialectical behavioral therapy (DBT) could be applicable for these patients. Copyright © 2014 Elsevier Inc. All rights reserved.

Post-Soviet Central Asia: a summary of the drug situation.

PubMed

Zabransky, Tomas; Mravcik, Viktor; Talu, Ave; Jasaitis, Ernestas

2014-11-01

The paper aims to provide a snapshot of the drug situation in Kazakhstan, Kyrgyzstan, Tajikistan, and Uzbekistan using the EU methodology of "harmonised indicators of drug epidemiology." Most of the data reported here were gathered and analysed within the framework of the EU-funded CADAP project in 2012. Together with members of CADAP national teams, we conducted extraction from the databases of national institutions in the field of (public) health and law enforcement, issued formal requests for the provision of specific information to national governmental authorities, and obtained national grey literature in Russian. In specific cases, we leaned on the expert opinions of the national experts, gathered by means of simple online questionnaires or focus group. In the rather scarce cases where peer-reviewed sources on the specific topics exist, it is used for comparisons and discussion. All the post-Soviet Central Asian countries lack information on drug use in the general population. School surveys are relatively well developed in Kazakhstan, and Kyrgyzstan benefited from an international survey project on health in schools organised by private donors in 2009. For Tajikistan and Uzbekistan, the most recent available data on drug use in the school population are from 2006 and as such are of little relevance. Problem drug use is widespread in Central Asia and estimates of its prevalence are available for all four countries. All the post-Soviet Central Asian countries use a rather outdated system of narcological registers as the only source of data on drug users who are treated (and those investigated by the police), which was inherited from Soviet times. The availability of treatment is very low in all the countries reported on here except Kyrgyzstan; opioid substitution treatment (OST) was introduced first in Kyrgyzstan; Kazakhstan and Tajikistan are piloting their OST programmes but the coverage is extremely low, and in Uzbekistan the OST pilot programme has been abolished. HIV and hepatitis C virus (HCV) infections are concentrated in injecting drug users (IDUs) in Central Asia, with the situation in Kazakhstan having stabilised; HIV is on the increase among Kyrgyz IDUs. The sharp decrease in HIV and VHC seroprevalence among IDUs in Uzbekistan and Tajikistan still awaits an explanation. The system for monitoring of fatal drug overdoses needs substantial improvement in all the countries reported on here. Overall mortality studies of drug users registered in the narcological registers were performed in Uzbekistan, Kazakhstan, and Tajikistan; the highest excess mortality among registered drug users was found in Uzbekistan, and in all three countries, it was substantially higher for women than men. The seizures of illegal drugs are by far the highest in Kazakhstan; however, wild-growing cannabis represents 90% of these seizures. Uzbekistan was the country with the highest number of drug arrests. In Kazakhstan, after the decriminalisation of drug use in 2011, the number of reported drug-related offences dropped to below 50% of the figure for the previous year. The drug situation monitoring system in the four post-Soviet countries of Central Asia still needs substantial improvement. However, in its current state it is already able to generate evidence that is useful for the planning of effective national and regional drug policies, which would be of the utmost importance in the forthcoming years of the withdrawal of the International Security Assistance Force from Afghanistan. Copyright © 2014 Elsevier B.V. All rights reserved.

Reasons for misuse of prescription medication among physicians undergoing monitoring by a physician health program.

PubMed

Merlo, Lisa J; Singhakant, Supachoke; Cummings, Simone M; Cottler, Linda B

2013-01-01

Substance-related impairment of physicians is a small but serious problem, with significant consequences for patient safety and public health. The purpose of this study was to identify reasons for prescription drug misuse among physicians referred to a physician health program for monitoring because of substance-related impairment, to develop better mechanisms for prevention and intervention. A total of 55 physicians (94.5% male) who were being monitored by their State physician health program because of substance-related impairment participated in guided focus group discussions. Participation was anonymous. Discussions were transcribed from 9 separate focus groups, lasting 60 to 90 minutes each. Qualitative analyses were conducted to examine themes. All participants were diagnosed with substance dependence, and 69.1% of them endorsed a history of misusing prescription drugs. Participants documented the following 5 primary reasons for prescription drug misuse: (1) to manage physical pain, (2) to manage emotional/psychiatric distress, (3) to manage stressful situations, (4) to serve recreational purposes, and (5) to avoid withdrawal symptoms. Our results emphasize the importance of self-medication as a leading reason for misusing prescription medications, although recreational use was also an important factor. Prevention efforts targeting prescription drug misuse among physicians should be initiated during medical training, with continuing education requirements throughout the physicians' careers.

[Adverse reactions and other drug-related problems in an emergency service department].

PubMed

Güemes Artiles, M; Sanz Alvarez, E; Garcia Sánchez-Colomer, M

1999-01-01

Adverse Drug Reactions (ADR) and Drug-Related Problems (DRP's) are a frequency cause of hospital emergency room visits and require better assessment. An analysis was made of 1097 consecutive admission to the emergency room at the Nuestra Senora de los Volcanes, Hospital (currently the General Hospital of Lanzarote) in Arrecife de Lanzarote (Canary Islands) over a three-month period in order to detect any possible DAR or any other drug-related problems. Nineteen (19) of the 1097 admissions were due to Adverse Drug Reactions (ADR) (1.73%; 95% IC:0.96%-2.5%). Some of the most outstanding of the other "Drug-Related Problems" (DRP's) were medication overdose, which was diagnosed in 5 (0.45%) of the patients; the worsening of the symptoms due to ceasing to take the medication was involved in 8 (0.72%), and incorrect treatments which involved medical care at the emergency room totaled 11 (1.0%). The number of drug-related problems (DRP's) in the sample totaled 43 (3.9%). The drug-related problems (DRP's) led to hospitalization in 1.9% of the cases seen in the emergency room and led to hospitalization in 9.6% of all of hospital admission through the emergency room for the period of time under study. The ADR led to 4.1% of the hospital admissions. Drug-related problems are a frequent, major problem which has not been well-analyzed in the emergency rooms. Additionally, emergency rooms can function as the first point of detection of a ADR among an outpatient population.

Criminal career-related factors among female robbers in the state of São Paulo, Brazil, and a presumed 'revolving-door' situation.

PubMed

Mauá, Fernando Henrique Nadalini; Baltieri, Danilo Antonio

2012-06-01

Risk-taking behaviors, family criminality, poverty, and poor parenting have been frequently associated with an earlier onset of criminal activities and a longer criminal career among male convicts. This study aims to identify factors related to the onset and recurrence of criminal behavior among female robbers in the State of São Paulo - Brazil. It was a cross-sectional study carried out inside a feminine penitentiary in São Paulo. From June 2006 to June 2010, 175 inmates convicted only for robbery were recruited to be evaluated about family antecedents of criminal conviction, alcohol and drug misuse, impulsiveness, depressive symptoms, and psychosocial features. RESULTS Having family antecedents of criminal conviction consistently predicted an earlier onset of criminal activities and a longer criminal career among female robbers. Drug use in youth and the severity of drug misuse were significantly related to the initiation and recurrence of criminal behavior, respectively. Prisons must systematically screen detainees and provide treatments for those with health problems in general. Children of inmates should obtain help to modify the negative consequences of their parents' incarceration in order to mitigate the negative consequences of pursuing this 'static' factor.

Labor analgesia for the drug abusing parturient: is there cause for concern?

PubMed

Kuczkowski, Krzysztof M

2003-09-01

Drug abuse has crossed geographic, economic and social borders, and it remains one of the major problems facing our society today. The prevalence of recreational drug abuse among young adults (including women) has increased markedly over the past two decades. Nearly 90% of drug abusing women are of childbearing age. Consequently, it is not surprising to find pregnant women with a history of drug addiction. Obstetricians and obstetric anesthesiologists become involved in the care of drug abusing patients either in emergency situations, such as placental abruption, uterine rupture or fetal distress, or in more controlled situations, such as request for labor analgesia. The diverse clinical manifestations of maternal substance abuse may result in life-threatening complications and significantly impact the peripartum care of these patients. Obstetricians & Gynecologists, Family Physicians. After completion of this article, the reader will be able to list the most commonly abused substances during pregnancy, to describe the various effects of particular substances on pregnancy including the mechanism of desired effect for various substances, and to outline the obstetric anesthesia recommendations for the various substances abused during pregnancy.

Prenatal drug exposure, behavioral problems and drug experimentation among African American urban adolescents

PubMed Central

Wang, Yan; Buckingham-Howes, Stacy; Nair, Prasanna; Zhu, Shijun; Magder, Larry; Black, Maureen M.

2014-01-01

Purpose To examine how prenatal heroin/cocaine exposure (PDE) and behavioral problems relate to adolescent drug experimentation. Methods The sample included African American adolescents (mean age=14.2 yr, SD=1.2) with PDE (n=73) and a non-exposed community comparison (n=61). PDE status was determined at delivery through toxicology analysis and maternal-report. Internalizing/externalizing problems were assessed during adolescence with the Behavior Assessment System for Children, Second Edition. Drug experimentation was assessed by adolescent-report and urine analysis. Logistic regression evaluated the likelihood of drug experimentation related to PDE and behavioral problems, adjusting for age, gender, prenatal tobacco/alcohol exposure, perceived peer drug use and caregiver drug use. Interaction terms examined gender modification. Results 67 (50%) used drugs. 25 (19%) used tobacco/alcohol only and 42 (31%) used marijuana/illegal drugs. 94 (70%) perceived peer drug use. PDE significantly increased the risk of tobacco/alcohol experimentation (OR=3.07, 95% CI: 1.09–8.66, p=0.034), but not after covariate adjustment (aOR=1.31, 95% CI: 0.39–4.36, p>0.05). PDE was not related to overall or marijuana/illegal drug experimentation. The likelihood of overall drug experimentation was doubled per Standard Deviation (SD) increase in externalizing problems (aOR=2.28, 95% CI: 1.33–3.91, p=0.003) and, among girls, 2.82 times greater (aOR=2.82, 95% CI: 1.34–5.94, p=0.006) per SD increase in internalizing problems. Age and perceived peer drug use were significant covariates. Conclusions Drug experimentation was relatively common (50%), especially in the context of externalizing problems, internalizing problems (girls only), age, and perceived peer drug use. Findings support Problem Behavior Theory and suggest that adolescent drug prevention address behavioral problems and promote prosocial peer groups. PMID:24768161

Bitzer's Model Reconstructed.

ERIC Educational Resources Information Center

Lybarger, Scott; Smith, Craig R.

1996-01-01

Reconstructs Lloyd Bitzer's situational model to serve as a guide for the generation of multiperspectival critical assessments of rhetorical discourse. Uses two of President Bush's speeches on the drug crisis to illustrate how the reconstructed model can account for such modern problems as multiple audiences, perceptions, and exigencies. (PA)

[Analysis of drug-related problems in a tertiary university hospital in Barcelona (Spain)].

PubMed

Ferrández, Olivia; Casañ, Borja; Grau, Santiago; Louro, Javier; Salas, Esther; Castells, Xavier; Sala, Maria

2018-05-07

To describe drug-related problems identified in hospitalized patients and to assess physicians' acceptance rate of pharmacists' recommendations. Retrospective observational study that included all drug-related problems detected in hospitalized patients during 2014-2015. Statistical analysis included a descriptive analysis of the data and a multivariate logistic regression to evaluate the association between pharmacists' recommendation acceptance rate and the variable of interest. During the study period 4587 drug-related problems were identified in 44,870 hospitalized patients. Main drug-related problems were prescription errors due to incorrect use of the computerized physician order entry (18.1%), inappropriate drug-drug combination (13.3%) and dose adjustment by renal and/or hepatic function (11.5%). Acceptance rate of pharmacist therapy advice in evaluable cases was 81.0%. Medical versus surgical admitting department, specific types of intervention (addition of a new drug, drug discontinuation and correction of a prescription error) and oral communication of the recommendation were associated with a higher acceptance rate. The results of this study allow areas to be identified on which to implement optimization strategies. These include training courses for physicians on the computerized physician order entry, on drugs that need dose adjustment with renal impairment, and on relevant drug interactions. Copyright © 2018 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Preschoolers' Problem-Solving in Sexually Abusive and Non-Sexual Situations.

ERIC Educational Resources Information Center

Grober, Jacqueline S.; And Others

This study examined the relation of social situation variables and children's gender to children's social problem solving ability in potentially unsafe situations. A total of 62 preschoolers (mean age 4.4 years) were shown a series of four vignettes. In two vignettes, an adult or a child asked a second child to cross a street. In two other…

Managing drugs safely.

PubMed

van den Anker, John N

2005-02-01

There is hard data to show that newborn infants are more likely than adults to experience adverse reactions to drugs. Paradoxically, drug-related legislation to ensure safe and effective drug use in humans neglected neonates until 2002, when the Best Pharmaceuticals Act for Children was signed into law in the USA. The situation for neonates should now catch up with that for adults and neonates will be prescribed more licensed drugs in the near future. If we are to be able to analyze the underlying system errors to improve the safe use of drugs in the studied patient population, reporting of adverse drug events and reactions needs to happen in a blame free environment. In addition, computerized physician order entry will certainly further improve the current situation by preventing errors in ordering, transcribing, verifying, and transmitting medication orders.

Policy Issues and the Drug Abuse Problem in America: Overview, Critique, and Recommendations.

ERIC Educational Resources Information Center

Johnston, Lloyd D.

The so-called "drug abuse problem" in America is really a constellation of separate but related problems; since a variety of drugs are illicitly used, and drug abuse leads to many derivative problems, both within and outside the United States. This monograph begins by assessing the current state of the drug abuse problem in America, and analyzing…

The history of the development of buprenorphine as an addiction therapeutic.

PubMed

Campbell, Nancy D; Lovell, Anne M

2012-02-01

This paper traces the early 21st century success of the agonist-antagonist buprenorphine and the combination drug buprenorphine with naloxone within the broader quest to develop addiction therapeutics that began in the 1920s as the search for a nonaddictive analgesic. Drawing on archival research, document analysis, and interviews with contemporary actors, this paper situates the social organization of laboratory-based and clinical research within the domestic and international confluence of several issues, including research ethics, drug regulation, public attitudes, tensions around definitions of drug addiction, and the evolving roles of the pharmaceutical industry. The fervor that drove the champions of buprenorphine must be understood in relation to (1) the material work of research and pharmaceutical manufacturing; (2) the symbolic role of buprenorphine as a solution to numerous problems with addiction treatment evident by the mid-1970s; the destigmatization and individualization of addicts as patients; and (3) the complex configurations of public and private partnerships. © 2012 New York Academy of Sciences.

New genetic findings lead the way to a better understanding of fundamental mechanisms of drug hypersensitivity

PubMed Central

Pirmohamed, Munir; Ostrov, David A.; Park, B. Kevin

2015-01-01

Drug hypersensitivity reactions are an important clinical problem for both health care and industry. Recent advances in genetics have identified a number of HLA alleles associated with a range of these adverse reactions predominantly affecting the skin but also other organs, such as the liver. The associations between abacavir hypersensitivity and HLA-B*57:01 and carbamazepine-induced Stevens-Johnson syndrome and HLA-B*15:02 have been implemented in clinical practice. There are many different mechanisms proposed in the pathogenesis of drug hypersensitivity reactions, including the hapten hypothesis, direct binding to T-cell receptors (the pharmacologic interaction hypothesis), and peptide-binding displacement. A problem with all the hypotheses is that they are largely based on in vitro findings, with little direct in vivo evidence. Although most studies have focused on individual mechanisms, it is perhaps more important to consider them all as being complementary, potentially occurring at the same time with the same drug in the same patient. This might at least partly account for the heterogeneity of the immune response seen in different patients. There is a need to develop novel methodologies to evaluate how the in vitro mechanisms relate to the in vivo situation and how the highly consistent genetic findings with different HLA alleles can be more consistently used for both prediction and prevention of these serious adverse reactions. PMID:26254050

Current Status of Malaria and Potential for Control

PubMed Central

Phillips, R. S.

2001-01-01

Malaria remains one of the world's worst health problems with 1.5 to 2.7 million deaths annually; these deaths are primarily among children under 5 years of age and pregnant women in sub-Saharan Africa. Of significance, more people are dying from malaria today than 30 years ago. This review considers the factors which have contributed to this gloomy picture, including those which relate to the vector, the female anopheline mosquito; to human activity such as creating new mosquito breeding sites, the impact of increased numbers of people, and how their migratory behavior can increase the incidence and spread of malaria; and the problems of drug resistance by the parasites to almost all currently available antimalarial drugs. In a selective manner, this review describes what is being done to ameliorate this situation both in terms of applying existing methods in a useful or even crucial role in control and prevention and in terms of new additions to the antimalarial armory that are being developed. Topics covered include biological control of mosquitoes, the use of insecticide-impregnated bed nets, transgenic mosquitoes manipulated for resistance to malaria parasites, old and new antimalarial drugs, drug resistance and how best to maintain the useful life of antimalarials, immunity to malaria and the search for antimalarial vaccines, and the malaria genome project and the potential benefits to accrue from it. PMID:11148010

Ambivalence about supervised injection facilities among community stakeholders.

PubMed

Strike, Carol; Watson, Tara Marie; Kolla, Gillian; Penn, Rebecca; Bayoumi, Ahmed M

2015-08-21

Community stakeholders express a range of opinions about supervised injection facilities (SIFs). We sought to identify reasons for ambivalence about SIFs amongst community stakeholders in two Canadian cities. We used purposive sampling methods to recruit various stakeholder representatives (n = 141) for key informant interviews or focus group discussions. Data were analyzed using a thematic process. We identified seven reasons for ambivalence about SIFs: lack of personal knowledge of evidence about SIFs; concern that SIF goals are too narrow and the need for a comprehensive response to drug use; uncertainty that the community drug problem is large enough to warrant a SIF(s); the need to know more about the "right" places to locate a SIF(s) to avoid damaging communities or businesses; worry that a SIF(s) will renew problems that existed prior to gentrification; concern that resources for drug use prevention and treatment efforts will be diverted to pay for a SIF(s); and concern that SIF implementation must include evaluation, community consultation, and an explicit commitment to discontinue a SIF(s) in the event of adverse outcomes. Stakeholders desire evidence about potential SIF impacts relevant to local contexts and that addresses perceived potential harms. Stakeholders would also like to see SIFs situated within a comprehensive response to drug use. Future research should determine the relative importance of these concerns and optimal approaches to address them to help guide decision-making about SIFs.

Ashtawarga plants - Suffering a triple standardization syndrome.

PubMed

Virk, Jaswinder Kaur; Gupta, Vikas; Kumar, Sanjiv; Singh, Ranjit; Bansal, Parveen

2017-10-01

Ayurveda is one of the oldest known holistic health care systems recommending diverse medicinal uses of plants for prevention and cure of diseases and illness. World Health Organization (WHO) estimates that the holistic system is gaining more popularity due to its easy availability, low cost, congeniality, better accessibility and higher safety than allopathic medicine. Demand of herbal drugs is increasing day-by-day because of increasing popularity of herbal drugs; however market fails to meet this supply due to numerous factors, one of the important factors being the extinction of these plants from local flora. About 560 herbal species of India have been included in the Red List of Threatened species. Hence to overcome problem of non-availability of endangered species, Department of AYUSH, Govt. of India has permitted the substitution of rare herbal drugs with available substitutes on the basis of Ayurvedic concepts. Due to this, herbal drug industry has started exploiting the situation and now Ayurvedic products are suffering from a serious problem of adulteration with addition of spoiled, inferior, spurious drugs that are inferior in therapeutic/chemical properties and used to enhance profits. Adulteration with other plants degrades the quality and credibility of Ayurvedic medicine. Ashtawarga plants being an important part of many Ayurvedic formulations are also available in a very limited amount and likely to be substituted by cheap adulterants. Keeping in view the above situation, a metadata analysis has been conducted to find out types of adulteration/substitutions malpractices going on for Ashtawarga plants.

Antimicrobial drug-related problems in a neonatal intensive care unit

PubMed Central

Nunes, Bruna Meirelly; Xavier, Tatiana Costa; Martins, Rand Randall

2017-01-01

Objective The goal was to determine the main drug-related problems in neonates who were using antimicrobials. Method This was an observational, prospective and longitudinal study. Drug-related problems were classified according to version 6.2 of the Pharmaceutical Care Network Europe Foundation classification. A descriptive analysis was performed, in which the clinical and therapeutic variables were presented as absolute and relative frequencies or as the mean and standard deviation, as appropriate. Results In total, 152 neonates with a predominance of males (58.5%), gestational age of 32.7 ± 4.2 weeks and weight of 1,903.1 ± 846.9g were included. The main diagnostic hypothesis of infection was early sepsis (66.5%), and 71.7% of the neonates had some risk factor for infection. Among the neonates, 33.6% had at least one drug-related problem. Of these, 84.8% were related to treatment effectiveness and 15.2% to adverse reactions. The main cause of drug-related problems was the selected dose, particularly for aminoglycosides and cephalosporins. Conclusion The use of antimicrobials in the neonatal intensive care is mainly associated with problems related to medication effectiveness, predominantly the prescription of subdoses of antimicrobials, especially aminoglycosides. PMID:28876403

Impact of Drug Shortages on Health System Pharmacies in the Southeastern United States

PubMed Central

Mehta, Brenna; Bookstaver, P. Brandon; Sims, LaVetra D.; Stevenson, Bill

2015-01-01

Background: Drug shortages have become all too common and affect all aspects of the health care delivery system. The increased number of drug shortages has had a negative impact on patient care as well as costly financial implications. Objectives: This article identifies the current problems and negative outcomes drug shortages have caused and provides a framework for how to best prepare for and combat future shortages. It highlights specific problems faced by health care system pharmacies in the Southeastern United States and the managerial responses to address these shortage situations. Methods: A 34-question, multiple-choice survey was distributed to pharmacy directors in North Carolina, South Carolina, Georgia, and Florida. Results: Of 549 surveys distributed, 219 (40%) responses were received. Respondents reported that drug shortages cause 1% to 5% error rates in hospitals and that 60% of the time drug shortages create unsafe conditions for patients and staff. Many of the respondents reported a 300% to 500% markup on medications on the shortage list. Seventy-six percent of institutions have autosubstitutions for drug shortages that have been preapproved by Pharmacy & Therapeutics Committees. Conclusions: The causes of drug shortages are multifaceted, and the safety and financial implications can be costly. In the short term, health care institutions can utilize pharmacists to assist in circumventing the drug shortage problem. The combined efforts of all health care professionals, the US government, manufacturers, and the lay public are necessary to bring awareness and plausible solutions to the drug shortage problems in the long term. PMID:26448658

Policing, massive street drug testing and poly-substance use chaos in Georgia - a policy case study.

PubMed

Otiashvili, David; Tabatadze, Mzia; Balanchivadze, Nino; Kirtadze, Irma

2016-01-16

Since early 2000, intensive policing, wide scale street drug testing, and actions aimed at limiting the availability of specific drugs have been implemented in Georgia. Supporters of this approach argue that fear of drug testing and resulting punishment compels drug users to stop using and prevents youth from initiating drug use. It has been also stated that reduction in the availability of specific drugs should be seen as an indication of the overall success of counter-drug efforts. The aim of the current review is to describe the drug-related law enforcement response in Georgia and its impact on illicit drug consumption and drug-related harm. We reviewed relevant literature that included peer-reviewed scientific articles, stand-alone research reports, annual drug situation reports, technical reports and program data. This was also supplemented by the review of relevant legislation and judicial practices for the twelve year period between 2002 and 2014. Every episode of reduced availability of any "traditional" injection drug was followed by the discovery/introduction of a new injection preparation. The pattern of drug consumption was normally driven by users' attempts to substitute their drug of choice through mixing together available alternative substances. Chaotic poly-substance use and extensive utilization of home-made injection drugs, prepared from toxic precursors, became common. Massive random street drug testing had little or no effect on the prevalence of problem drug use. Intensive harassment of drug users and exclusive focus on reducing the availability of specific drugs did not result in reduction of the prevalence of injecting drug use. Repressive response of Georgian anti-drug authorities relied heavily on consumer sanctions, which led to shifts in drug users' behavior. In most cases, these shifts were associated with the introduction and use of new toxic preparations and subsequent harm to the physical and mental health of drug consumers.

Information on actual medication use and drug-related problems in older patients: questionnaire or interview?

PubMed

Willeboordse, Floor; Grundeken, Lucienne H; van den Eijkel, Lisanne P; Schellevis, François G; Elders, Petra J M; Hugtenburg, Jacqueline G

2016-04-01

Information on medication use and drug-related problems is important in the preparation of clinical medication reviews. Critical information can only be provided by patients themselves, but interviewing patients is time-consuming. Alternatively, patient information could be obtained with a questionnaire. In this study the agreement between patient information on medication use and drug-related problems in older patients obtained with a questionnaire was compared with information obtained during an interview. General practice in The Netherlands. A questionnaire was developed to obtain information on actual medication use and drug-related problems. Two patient groups ≥65 years were selected based on general practitioner electronic medical records in nine practices; I. polypharmacy and II. ≥1 predefined general geriatric problems. Eligible patients were asked to complete the questionnaire and were interviewed afterwards. Agreement on information on medication use and drug-related problems collected with the questionnaire and interview was calculated. Ninety-seven patients participated. Of all medications used, 87.6 % (95 % CI 84.7-90.5) was reported identically in the questionnaire and interview. Agreement for the complete medication list was found for 45.4 % (95 % CI 35.8-55.3) of the patients. On drug-related problem level, agreement between questionnaire and interview was 75 %. Agreement tended to be lower in vulnerable patients characterized by ≥4 chronic diseases, ≥10 medications used and low health literacy. Information from a questionnaire showed reasonable agreement compared with interviewing. The patients reported more medications and drug-related problems in the interview than the questionnaire. Taking the limitations into account, a questionnaire seems a suitable tool for medication reviews that may replace an interview for most patients.

Culture as an explanation for substance-related problems: a cross-national study among French and Dutch adolescents.

PubMed

Knibbe, Ronald Arnold; Joosten, Jan; Choquet, Marie; Derickx, Mieke; Morin, Delphine; Monshouwer, Karin

2007-02-01

Our main goal was to establish whether French and Dutch adolescents differ in rates of substance-related adverse events (e.g. fights, robbery), problems with peers or socializing agents even when controlling for pattern of substance use. For problems with peers and socializing agents due to alcohol we hypothesized that, because of stronger informal control of drinking in France, French adolescents are more likely to report problems with peers and socializing agents. For adverse events due to alcohol no difference was expected after controlling for consumption patterns. For drug-related problems, the hypothesis was that, due to the more restrictive drug policy in France, French adolescents are more likely to report problems with peers, socializing agents and adverse events. Comparable surveys based on samples of adolescent schoolchildren in France (n=9646) and the Netherlands (n=4291) were used. Data were analysed using multilevel logistic regression in which school, age and gender, indicators of substance use and country were used as predictors of substance-related problems. The outcomes show that French adolescents are more likely to report problems with peers and socializing agents due to alcohol even when consumption pattern is controlled for. For adverse events due to alcohol no difference was found between French and Dutch adolescents. For drug-related problems the expected differences were found; i.e. French adolescents are more likely to report problems with peers, socializing agents and adverse events even when controlling for pattern of drug use. It is concluded that there are culturally embedded differences in the rates of some types of problems due to alcohol or drug use. With respect to alcohol use, these differences are most likely due to culturally embedded differences in the informal social control of alcohol use. The differences in rates of drug-related problems are interpreted in the context of national differences in drug policy.

Relative motion of orbiting satellites

NASA Technical Reports Server (NTRS)

Eades, J. B., Jr.

1972-01-01

The relative motion problem is analyzed, as a linearized case, and as a numerically determined solution to provide a time history of the geometries representing the motion state. The displacement history and the hodographs for families of solutions are provided, analytically and graphically, to serve as an aid to understanding this problem area. Linearized solutions to relative motion problems of orbiting particles are presented for the impulsive and fixed thrust cases. Second order solutions are described to enhance the accuracy of prediction. A method was developed to obtain accurate, numerical solutions to the intercept and rendezvous problem; and, special situations are examined. A particular problem related to relative motions, where the motion traces develop a cusp, is examined in detail. This phenomenon is found to be dependent on a particular relationship between orbital eccentricity and the inclination between orbital planes. These conditions are determined, and, example situations are presented and discussed.

Observations on ethical problems and terminal care.

PubMed Central

Fischer, D. S.

1992-01-01

Progress in medical diagnosis and therapy has raised new problems with far-reaching ethical implications. Medicine must remain a profession and not become a business. Textbooks must address ethical problems in the context of health care decisions and not restrict themselves to pathophysiology and practical therapeutics alone. The relative roles of the principles of autonomy, non-maleficence, beneficence, and justice must be balanced and appropriately applied to individual situations in biomedical ethics. When therapy becomes futile and the suffering of the patient does not justify any anticipated benefit, the patient (and/or patient surrogate) may request withholding or even withdrawing life-prolonging interventions. In the persistent vegetative state, even nutritional support by an unnatural (tube) route may ethically be denied at the patient's (or surrogate's) informed decision. New areas of ethical evaluation have been raised by the desire of some individuals to prolongation of their lives at high expense to the society such that other individuals are denied services because of limitation of available resources. There has been a long-standing conflict of interest between the acceptance by physicians and/or medical institutions of money or gifts from pharmaceutical companies whose drugs they prescribe, stock, or sell. This practice increases the cost of the drugs and is, in effect, a "sick tax," which is morally wrong. PMID:1519374

Observations on ethical problems and terminal care.

PubMed

Fischer, D S

1992-01-01

Progress in medical diagnosis and therapy has raised new problems with far-reaching ethical implications. Medicine must remain a profession and not become a business. Textbooks must address ethical problems in the context of health care decisions and not restrict themselves to pathophysiology and practical therapeutics alone. The relative roles of the principles of autonomy, non-maleficence, beneficence, and justice must be balanced and appropriately applied to individual situations in biomedical ethics. When therapy becomes futile and the suffering of the patient does not justify any anticipated benefit, the patient (and/or patient surrogate) may request withholding or even withdrawing life-prolonging interventions. In the persistent vegetative state, even nutritional support by an unnatural (tube) route may ethically be denied at the patient's (or surrogate's) informed decision. New areas of ethical evaluation have been raised by the desire of some individuals to prolongation of their lives at high expense to the society such that other individuals are denied services because of limitation of available resources. There has been a long-standing conflict of interest between the acceptance by physicians and/or medical institutions of money or gifts from pharmaceutical companies whose drugs they prescribe, stock, or sell. This practice increases the cost of the drugs and is, in effect, a "sick tax," which is morally wrong.

Housing stability over two years and HIV risk among newly homeless youth.

PubMed

Rosenthal, Doreen; Rotheram-Borus, Mary Jane; Batterham, Philip; Mallett, Shelley; Rice, Eric; Milburn, Norweeta G

2007-11-01

The stability of living situation was examined as a predictor of young people's HIV-related sexual and drug use acts two years after leaving home for the first time. Newly homeless youth aged 12-20 years were recruited in Los Angeles County, California, U.S.A. (n = 261) and Melbourne, Australia (n = 165) and followed longitudinally at 3, 6, 12, 18, and 24 months. Their family history of moves and the type and frequency of moves over the two years following becoming newly homeless were examined. Regression analyses indicated that recent sexual risk two years after becoming newly homeless was not related to the instability of youths' living situations; condom use was higher among youth with more placements in institutional settings and among males. Drug use was significantly related to having moved more often over two years and Melbourne youth used drugs significantly more than youth in Los Angeles.

The importance of family factors to protect against substance use related problems among Mexican heritage and White youth.

PubMed

Kopak, Albert M; Chen, Angela Chia-Chen; Haas, Steven A; Gillmore, Mary Rogers

2012-07-01

This study examined the ability of family cohesion, parental control, and parent-child attachment to prevent adolescents with a history of drug or alcohol use from experiencing subsequent problems related to their use. Data came from Wave I and Wave II of the National Longitudinal Study of Adolescent Health and included Mexican heritage and White adolescents who reported alcohol use (n = 4894, 25% prevalence) or any other drug use (n = 2875, 14% prevalence) in their lifetime. Logistic regression results indicate greater parent-child attachment predicted lower risk of experiencing drug use problems (OR = 0.87, 95% CI = 0.77-0.98) while stronger family cohesion predicted lower odds of experiencing drug- (OR = 0.82, 95% CI = 0.70-0.97) or alcohol-related (OR = 0.74, 95% CI = 0.65-0.84) problems. Parental control was also negatively associated with odds of problems related to drug use (OR = 0.93, 95% CI = 0.86-0.99) or alcohol use (OR = 0.94, 95% CI = 0.90-0.99). Results also indicated family cohesion was the only protective factor for Mexican heritage youth while family cohesion and parent-child attachment were protective among White youth. Parental control protected White female adolescents from drug use problems more than males. Mexican heritage male adolescents experienced more protection from drug problems compared to females. Findings highlight the need for prevention interventions to emphasize parent-child attachment for White youth and family cohesion for both Mexican-heritage and White youth to decrease adolescent substance users' drug- and alcohol-related problems. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

The Importance of Family Factors to Protect Against Substance Use Related Problems among Mexican Heritage and White Youth*

PubMed Central

Kopak, Albert M.; Chen, Angela Chia-Chen; Haas, Steven A.; Gillmore, Mary Rogers

2012-01-01

INTRODUCTION This study examined the ability of family cohesion, parental control, and parent-child attachment to prevent adolescents with a history of drug or alcohol use from experiencing subsequent problems related to their use. METHODS Data came from Wave I and Wave II of the National Longitudinal Study of Adolescent Health and included Mexican heritage and White adolescents who reported alcohol use (n = 4,894, 25% prevalence) or any other drug use (n = 2,875, 14% prevalence) in their lifetime. RESULTS Logistic regression results indicate greater parent-child attachment predicted lower risk of experiencing drug use problems (OR = 0.87, 95% CI = 0.77 – 0.98) while stronger family cohesion predicted lower odds of experiencing drug- (OR = 0.82, 95% CI = 0.70 – 0.97) or alcohol-related (OR = 0.74, 95% CI = 0.65 – 0.84) problems. Parental control was also negatively associated with odds of problems related to drug use (OR = 0.93, 95% CI = 0.86 – 0.99) or alcohol use (OR = 0.94, 95% CI = 0.90 – 0.99). Results also indicated family cohesion was the only protective factor for Mexican heritage youth while family cohesion and parent-child attachment were protective among White youth. Parental control protected White female adolescents from drug use problems more than males. Mexican heritage male adolescents experienced more protection from drug problems compared to females. CONCLUSION Findings highlight the need for prevention interventions to emphasize parent-child attachment for White youth and family cohesion for both Mexican-heritage and White youth to decrease adolescent substance users’ drug- and alcohol-related problems. PMID:22222253

Mental Models in Expert Physics Reasoning.

ERIC Educational Resources Information Center

Roschelle, Jeremy; Greeno, James G.

Proposed is a relational framework for characterizing experienced physicists' representations of physics problem situations and the process of constructing these representations. A representation includes a coherent set of relations among: (1) a mental model of the objects in the situation, along with their relevant properties and relations; (2) a…

Prenatal cocaine exposure and neonatal/infant outcomes.

PubMed

Cambell, Shelly

2003-01-01

Illegal drug use throughout the nation is a problem of epidemic proportion. Of particular concern is drug use among pregnant women. In most cases, these women have little hope of achieving a better life for themselves or their children. Illegal drugs, cocaine in particular, can have devastating effects on the neonate. These effects can last well into childhood and can exhibit themselves in academic, social, and family situations. Challenges for the neonatal nurse include early identification of these infants and use of available resources. This article addresses prenatal cocaine use and support services for drug-dependent women, effects of cocaine during the neonatal period, possible neonatal and infant outcomes, and implications for nursing practice.

Vocational Training of Young Migrants in the United Kingdom.

ERIC Educational Resources Information Center

Cross, Malcolm

This study looked at the overall situation of the immigrant population, and young immigrants in particular, and analyzed such problem areas as the transition from school to working life and the inadequacies of initial training with relation to the situation in the United Kingdom. The study identified the following problem areas: (1) problems…

21 CFR 290.10 - Definition of emergency situation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Definition of emergency situation. 290.10 Section...) DRUGS: GENERAL CONTROLLED DRUGS General Provisions § 290.10 Definition of emergency situation. For the... Controlled Substances Act, the term emergency situation means those situations in which the prescribing...

New genetic findings lead the way to a better understanding of fundamental mechanisms of drug hypersensitivity.

PubMed

Pirmohamed, Munir; Ostrov, David A; Park, B Kevin

2015-08-01

Drug hypersensitivity reactions are an important clinical problem for both health care and industry. Recent advances in genetics have identified a number of HLA alleles associated with a range of these adverse reactions predominantly affecting the skin but also other organs, such as the liver. The associations between abacavir hypersensitivity and HLA-B*57:01 and carbamazepine-induced Stevens-Johnson syndrome and HLA-B*15:02 have been implemented in clinical practice. There are many different mechanisms proposed in the pathogenesis of drug hypersensitivity reactions, including the hapten hypothesis, direct binding to T-cell receptors (the pharmacologic interaction hypothesis), and peptide-binding displacement. A problem with all the hypotheses is that they are largely based on in vitro findings, with little direct in vivo evidence. Although most studies have focused on individual mechanisms, it is perhaps more important to consider them all as being complementary, potentially occurring at the same time with the same drug in the same patient. This might at least partly account for the heterogeneity of the immune response seen in different patients. There is a need to develop novel methodologies to evaluate how the in vitro mechanisms relate to the in vivo situation and how the highly consistent genetic findings with different HLA alleles can be more consistently used for both prediction and prevention of these serious adverse reactions. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Drug use disorders and post-traumatic stress disorder over 25 adult years: role of psychopathology in relational networks.

PubMed

Balan, Sundari; Widner, Greg; Shroff, Manan; van den Berk-Clark, Carissa; Scherrer, Jeffrey; Price, Rumi Kato

2013-11-01

In traumatized populations, drug use disorders and post-traumatic stress disorder (PTSD) persist for many years. Relational factors that mediate this persistence have rarely been systematically examined. Our aim is to examine the relative effects of psychopathology in familial and non-familial networks on the persistence of both disorders over adulthood. We utilized longitudinal data from an epidemiologically ascertained sample of male Vietnam veterans (n=642). Measures included DSM-IV drug use disorders, other psychiatric disorders, network problem history and time-varying marital and employment characteristics. Longitudinal measures of veterans' psychopathology and social functioning were retrospectively obtained for each year over a 25 year period. We used generalized estimating equations (GEE) to estimate the relative effects of network problems on veteran's drug use disorders and PTSD after adjusting for covariates. Veterans' mean age was 47 years in 1996. Prevalence of illicit drug disorders declined from 29.8% in 1972 to 8.3% in 1996, but PTSD remained at 11.7% from 13.2% in 1972. While 17.0% of veterans reported a familial drug use problem, 24.9% reported a non-familial drug use problem. In full GEE models, a non-familial drug problem was a significant predictor of illicit drug use disorders over 25 years (OR=2.21, CI=1.59-3.09), while both familial depression (OR=1.69, CI=1.07-2.68) and non-familial drinking problem (OR=1.66, CI=1.08-2.54) were significant predictors of PTSD over 25 years. Familial and non-familial problems in networks differentially affect the persistence of drug use disorders and PTSD in traumatized male adults. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Child maltreatment, parent alcohol and drug-related problems, polydrug problems, and parenting practices: a test of gender differences and four theoretical perspectives.

PubMed

Locke, Thomas F; Newcomb, Michael

2004-03-01

The authors tested how adverse childhood experiences (child maltreatment and parent alcohol- and drug-related problems) and adult polydrug use (as a mediator) predict poor parenting in a community sample (237 mothers and 81 fathers). These relationships were framed within several theoretical perspectives, including observational learning, impaired functioning, self-medication, and parentification-pseudomaturity. Structural models revealed that child maltreatment predicted poor parenting practices among mothers. Parent alcohol- and drug-related problems had an indirect detrimental influence on mothers' parenting and practices through self-drug problems. Among fathers, emotional neglect experienced as a child predicted lack of parental warmth more parental neglect, and sexual abuse experienced as a child predicted a rejecting style of parenting.

Comparison of illegal drug use pattern in Taiwan and Korea from 2006 to 2014.

PubMed

Feng, Ling-Yi; Yu, Wen-Jing; Chang, Wei-Ting; Han, Eunyoung; Chung, Heesun; Li, Jih-Heng

2016-09-23

Illegal drug use has long been a global concern. Taiwan and Korea are geographically adjacent and both countries have experienced the illegal use problems of methamphetamine, a predominant prototype of New Psychoactive Substances (NPS). NPS, a term coined by the United Nations Office on Drugs and Crime (UNODC) in recent years, have not been scrutinized for their safety and may become a new threat to public health and security worldwide. To conduct evidence-based drug policy, it is imperative to estimate the trend and pattern of illegal drug use. Therefore, this study aims to analyze and compare the current status of drug-related seizures, arrests and illegal drug use, with a focus on methamphetamine and NPS, between Taiwan and Korea. Data of illegal drug (including NPS)-related seizures and arrests were collected via anti-drug related agencies of both countries from 2006 through 2014.Since listing of NPS as controlled substances was a result of NPS abuse liability through official evaluation, the items of controlled NPS were used as an indicator of emerging use. These data obtained from Taiwan and Korea was then compared. The results showed that while methamphetamine remained as a predominant drug in both Taiwan and Korea for decades, different illegal drug use patterns have been observed in these two countries. In Taiwan, the major illegal drugs were methamphetamine, heroin, and ketamine, whereas in Korea those were methamphetamine and cannabis. By comparison of per capita illicit drug seizures, the illegal drug use situation in Taiwan was at a higher stake than that in Korea. In terms of NPS use, ketamine has been a major drug in Taiwan, but it was seldom found in Korea. Besides ketamine, the major type of NPS was synthetic cathinones in Taiwan whereas it was synthetic cannabinoids and phenethylamines in Korea. The difference in the numbers of controlled NPS items between Taiwan (23) and Korea (93) may be due to the implementation of temporary control on NPS in Korea since 2011. While the problem of methamphetamine still lingers, NPS have emerged as a new issue in both countries. However, the NPS pattern was different between Taiwan and Korea. Although the controlled NPS items in Taiwan were far less than those in Korea, the quantity of total NPS seizures, especially with ketamine, was much larger in Taiwan than in Korea. Different NPS pattern may also imply they were from different sources. Factors other than geographical proximity, such as drug policy and availability and accessibility to drugs, should be taken into account for the current status of illegal drug use in Korea and Taiwan.

Ethical and legal framework and regulation for off-label use: European perspective.

PubMed

Lenk, Christian; Duttge, Gunnar

2014-01-01

For more than 20 years the off-label use of drugs has been an essential part of the ethical and legal considerations regarding the international regulation of drug licensing. Despite a number of regulatory initiatives in the European Union, there seems to remain a largely unsatisfactory situation following a number of critical descriptions and statements from actors in the field. The present article gives an overview of the ethical and legal framework and developments in European countries and identifies existing problems and possible pathways for solutions in this important regulatory area. In addition to the presentation of the ethical and legal foundations, some attention is given to criticisms from medical practitioners to the current handling of off-label drug use. The review also focuses on the situation confronted by patients and physicians when off-label prescriptions are necessary. Through legal descriptions from a number of countries, possible solutions for future discussion of European health care policy are selected and explained.

Development of recommendations for the protection of short-stay travellers to malaria endemic areas: Memorandum from two WHO Meetings*

PubMed Central

1988-01-01

In the past, since malaria chemoprophylaxis was assumed to be of benefit and with no serious complications, it was recommended to all travellers who were at risk of acquiring the disease. The current epidemiological situation of malaria is marked by the increasing spread of Plasmodium falciparum resistance to chloroquine and by problems due to the toxicity of other drugs. Recommendations for malaria prophylaxis should therefore be based on an epidemiological approach which takes into account the risk of acquiring the infection, the toxicity and effectiveness of the available antimalarial drugs, the traveller's perception of these risks, and the human factors that influence the use of all possible protective measures against malaria. This Memorandum describes the epidemiological approach and the data bases required for the development of recommendations on prophylaxis for short-stay visitors in malaria endemic areas, and gives guidelines on the protective measures and drugs that may be used in defined situations. PMID:3293826

Drug-related problems and pharmacist interventions in a cohort of patients with asthma and chronic obstructive pulmonary disease.

PubMed

Apikoglu-Rabus, Sule; Yesilyaprak, Gozde; Izzettin, Fikret Vehbi

2016-11-01

Asthma and chronic obstructive pulmonary disease are preventable and treatable chronic airway diseases with high incidence and prevalence. Pharmacists and clinical pharmacy based pharmaceutical care services have positive impact on therapy outcomes. The aim of this study is to describe drug related problems in a cohort of patients with asthma and chronic obstructive pulmonary disease and to assess interventions provided by the pharmacist to address these problems in a community pharmacy. Study population consisted of patients with asthma and chronic obstructive pulmonary disease older than 18 years who visited the study pharmacy during the pre-determined six-month period. The patients whose disease control states were "not fully controlled" were included in our study for further steps. On the first interview, present and potential drug related problems were addressed, interventions were provided. Follow-up interviews were held one month and two months later than the first interview. For the 44 patients with asthma, 59 drug-related problems and 134 causes for these problems were identified. Eighty-four interventions were made to resolve the problems; and 54.2% of the problems were resolved. For the 37 patients with chronic obstructive pulmonary disease, 60 drug-related problems and 128 causes for these problems were identified. Ninety-five interventions were made to resolve the problems; and 63.3% of the problems were resolved. Pharmacists taking part in therapy and management of asthma and chronic obstructive pulmonary disease can help patients be more educated about their disease and medications; and improve disease control and therapy outcomes. Copyright © 2016 Elsevier Ltd. All rights reserved.

Development and validation of a Client Problem Profile and Index for drug treatment.

PubMed

Joe, George W; Simpson, D Dwayne; Greener, Jack M; Rowan-Szal, Grace A

2004-08-01

The development of the Client Problem Profile and Index are described, and initial concurrent and predictive validity data are presented for a sample of 547 patients in outpatient methadone treatment. Derived from the TCU Brief Intake for drug treatment admissions, the profile covers 14 problem areas related to drug use (particularly cocaine, heroin/opiate, marijuana, other illegal drugs, and multiple drug use), HIV risks, psychosocial-functioning, health, employment, and criminality. Analyses of predictive validity show the profile and its index (number of problem areas) were significantly related to therapeutic engagement, during-treatment performance, and posttreatment follow-up outcomes. Low moderate to high moderate effect sizes were observed in analyses of the index's discrimination.

Best possible medication history for hemodialysis patients obtained by a pharmacy technician.

PubMed

Leung, Marianna; Jung, Joanne; Lau, Wynnie; Kiaii, Mercedeh; Jung, Beverly

2009-09-01

Outpatients undergoing hemodialysis are at high risk for adverse drug events. Limited resources make it challenging for pharmacists to routinely obtain a best possible medication history (BPMH). The primary objective was to determine whether, for patients undergoing hemodialysis, a pharmacy technician has the skills to obtain a BPMH that would allow a pharmacist to identify drug-related problems. The secondary objectives were to determine the number and types of medication discrepancies and drug-related problems identified and the time required by the technician to complete the BPMH. All patients treated in the hemodialysis unit during the study period were included, except for those who required an interpreter or were unable to participate in an in-person interview. A single technician was taught how to interview patients according to a structured format. For each patient, the technician's BMPH was verified by a pharmacist. The agreement rate between technician and pharmacists was determined, along with the number and types of discrepancies and drug-related problems identified. The technician interviewed 99 patients. Of the 1334 medication orders reviewed, the technician and pharmacists agreed on all but 15 (agreement rate 98.9%). A total of 358 medication discrepancies were noted for 93 patients (3.8 discrepancies per patient). Of these, 210 (59%) were undocumented intentional discrepancies, and 148 (41%) were unintentional discrepancies (most commonly errors of commission). Of the 135 drug-related problems identified, the majority involved dosing problems or nonadherence. The technician required an average of 17 min for each interview. An adequately trained technician was capable of interviewing patients to create a BPMH. A variety of medication discrepancies and drug-related problems were identified. Generation of a BPMH by a technician is a useful approach allowing pharmacists to identify drug-related problems.

Best Possible Medication History for Hemodialysis Patients Obtained by a Pharmacy Technician

PubMed Central

Leung, Marianna; Jung, Joanne; Lau, Wynnie; Kiaii, Mercedeh; Jung, Beverly

2009-01-01

Background: Outpatients undergoing hemodialysis are at high risk for adverse drug events. Limited resources make it challenging for pharmacists to routinely obtain a best possible medication history (BPMH). Objectives: The primary objective was to determine whether, for patients undergoing hemodialysis, a pharmacy technician has the skills to obtain a BPMH that would allow a pharmacist to identify drug-related problems. The secondary objectives were to determine the number and types of medication discrepancies and drug-related problems identified and the time required by the technician to complete the BPMH. Methods: All patients treated in the hemodialysis unit during the study period were included, except for those who required an interpreter or were unable to participate in an in-person interview. A single technician was taught how to interview patients according to a structured format. For each patient, the technician’s BMPH was verified by a pharmacist. The agreement rate between technician and pharmacists was determined, along with the number and types of discrepancies and drug-related problems identified. Results: The technician interviewed 99 patients. Of the 1334 medication orders reviewed, the technician and pharmacists agreed on all but 15 (agreement rate 98.9%). A total of 358 medication discrepancies were noted for 93 patients (3.8 discrepancies per patient). Of these, 210 (59%) were undocumented intentional discrepancies, and 148 (41%) were unintentional discrepancies (most commonly errors of commission). Of the 135 drug-related problems identified, the majority involved dosing problems or nonadherence. The technician required an average of 17 min for each interview. Conclusion: An adequately trained technician was capable of interviewing patients to create a BPMH. A variety of medication discrepancies and drug-related problems were identified. Generation of a BPMH by a technician is a useful approach allowing pharmacists to identify drug-related problems. PMID:22478921

Asymmetric bagging and feature selection for activities prediction of drug molecules.

PubMed

Li, Guo-Zheng; Meng, Hao-Hua; Lu, Wen-Cong; Yang, Jack Y; Yang, Mary Qu

2008-05-28

Activities of drug molecules can be predicted by QSAR (quantitative structure activity relationship) models, which overcomes the disadvantages of high cost and long cycle by employing the traditional experimental method. With the fact that the number of drug molecules with positive activity is rather fewer than that of negatives, it is important to predict molecular activities considering such an unbalanced situation. Here, asymmetric bagging and feature selection are introduced into the problem and asymmetric bagging of support vector machines (asBagging) is proposed on predicting drug activities to treat the unbalanced problem. At the same time, the features extracted from the structures of drug molecules affect prediction accuracy of QSAR models. Therefore, a novel algorithm named PRIFEAB is proposed, which applies an embedded feature selection method to remove redundant and irrelevant features for asBagging. Numerical experimental results on a data set of molecular activities show that asBagging improve the AUC and sensitivity values of molecular activities and PRIFEAB with feature selection further helps to improve the prediction ability. Asymmetric bagging can help to improve prediction accuracy of activities of drug molecules, which can be furthermore improved by performing feature selection to select relevant features from the drug molecules data sets.

A Systems Dynamic Model for Drug Abuse and Drug-Related Crime in the Western Cape Province of South Africa

PubMed Central

Coetzee, Lezanie

2017-01-01

The complex problem of drug abuse and drug-related crimes in communities in the Western Cape province cannot be studied in isolation but through the system they are embedded in. In this paper, a theoretical model to evaluate the syndemic of substance abuse and drug-related crimes within the Western Cape province of South Africa is constructed and explored. The dynamics of drug abuse and drug-related crimes within the Western Cape are simulated using STELLA software. The simulation results are consistent with the data from SACENDU and CrimeStats SA, highlighting the usefulness of such a model in designing and planning interventions to combat substance abuse and its related problems. PMID:28555161

Noncompliance and drug toxicity in black, poor, and aged patients.

PubMed

Miller, R L; Algee, J

1978-10-01

Drug toxicity is a common medical problem. Continued increases in drug toxicity are related to the extensive, indiscriminate use of drugs. This is a national health problem which is caused partly by gaps in pharmacology as a basic and clinical science and partly by the rapid proliferation of drugs (the drug explosion) in the past 30 years. Socioeconomically disadvantaged (black, poor, and aged) patients are particularly vulnerable to compliance problems and drug toxicity. In this presentation we discuss the basis for this increased vulnerability and suggest strategies that practicing physicians can use to minimize both compliance problems and drug toxicity.

Characteristics and comorbidity of drug and alcohol-related emergency department presentations detected by nursing triage text.

PubMed

Indig, Devon; Copeland, Jan; Conigrave, Katherine M; Arcuri, Anthony

2010-05-01

This study used nursing triage text to detect drug- and alcohol-related emergency department (ED) presentations and describe their patient and service delivery characteristics. Data were reviewed for all ED presentations from 2004 to 2006 (n = 263 937) from two hospitals in Sydney, Australia. Each record included two nursing triage free-text fields, which were searched for more than 100 drug-related and more than 60 alcohol-related terms. Adjusted odds ratios were used to compare the characteristics of drug and alcohol-related ED presentations with all other ED presentation types. Just over 5% of ED presentations were identified as alcohol-related and 2% as drug-related. The most prevalent drug-related ED presentations specified were related to amphetamines (18%), heroin (14%), cannabis (14%) and ecstasy (12%), while nearly half (43%) were drug unspecified. Polydrug use was mentioned in 25% of drug-related and 9% of alcohol-related ED presentations, with the highest rate of polydrug use among ecstasy-related (68%) presentations. Drug- and alcohol-related ED presentations were significantly more likely than other ED presentations to have a mental health diagnosis, with the highest rates found among cannabis-related (OR = 7.6) or amphetamine-related (OR = 7.5) presentations. The ED provides an opportunity for early intervention for patients presenting with comorbid drug and alcohol and mental health problems. Further research is needed to assess the prevalence of drug and alcohol problems in ED patients with mental health problems and to develop effective interventions in that setting.

Current Situation, Determinants, and Solutions to Drug Shortages in Shaanxi Province, China: A Qualitative Study.

PubMed

Yang, Caijun; Wu, Lina; Cai, Wenfang; Zhu, Wenwen; Shen, Qian; Li, Zongjie; Fang, Yu

2016-01-01

Drug shortages were a complex global problem. The aim of this study was to analyze, characterize, and assess the drug shortages, and identify possible solutions in Shaanxi Province, western China. A qualitative methodological approach was conducted during May-June 2015 and December 2015-January 2016. Semi-structured interviews were performed to gather information from representatives of hospital pharmacists, wholesalers, pharmaceutical producers, and local health authorities. Thirty participants took part in the study. Eight traditional Chinese medicines and 87 types of biologicals and chemicals were reported to be in short supply. Most were essential medicines. Five main determinants of drug shortages were detected: too low prices, too low market demands, Good Manufacturing Practice (GMP) issues, materials issues, and approval issues for imported drugs. Five different solutions were proposed by the participants: 1) let the market decide the drug price; 2) establish an information platform; 3) establish a reserve system; 4) enhance the communication among the three parties in the supply chain; and 5) improve hospital inventory management. Western China was currently experiencing a serious drug shortage. Numerous reasons for the shortage were identified. Most drug shortages in China were currently because of "too low prices." To solve this problem, all of the stakeholders, especially the government, needed to participate in managing the drug shortages.

Nanocarriers as pulmonary drug delivery systems to treat and to diagnose respiratory and non respiratory diseases

PubMed Central

Smola, Malgorzata; Vandamme, Thierry; Sokolowski, Adam

2008-01-01

The purpose of this review is to discuss the impact of nanocarriers administered by pulmonary route to treat and to diagnose respiratory and non respiratory diseases. Indeed, during the past 10 years, the removal of chlorofluorocarbon propellants from industrial and household products intended for the pulmonary route has lead to the developments of new alternative products. Amongst these ones, on one hand, a lot of attention has been focused to improve the bioavailability of marketed drugs intended for respiratory diseases and to develop new concepts for pulmonary administration of drugs and, on the other hand, to use the pulmonary route to administer drugs for systemic diseases. This has led to some marketed products through the last decade. Although the introduction of nanotechnology permitted to step over numerous problems and to improve the bioavailability of drugs, there are, however, unresolved delivery problems to be still addressed. These scientific and industrial innovations and challenges are discussed along this review together with an analysis of the current situation concerning the industrial developments. PMID:18488412

Shallow discounting of delayed cocaine by male rhesus monkeys when immediate food is the choice alternative.

PubMed

Huskinson, Sally L; Myerson, Joel; Green, Leonard; Rowlett, James K; Woolverton, William L; Freeman, Kevin B

2016-12-01

Huskinson et al. (2015) recently examined delay discounting in monkeys choosing between an immediate drug (cocaine) reinforcer and a delayed nondrug (food) reinforcer. The present experiment examined the reverse situation: choice between immediate nondrug (food) and delayed drug (cocaine) reinforcers. Whereas the former choice situation exemplifies drug abuse from a delay-discounting perspective, our interest in the latter choice situation is derived from the observation that drug abusers, who characteristically are associated with impulsive choice, typically must devote considerable time to procuring drugs, often at the expense of immediate nondrug alternatives. Accordingly, we analyzed 3 male rhesus monkeys' choices between immediate food and delayed cocaine (0.1 and 0.2 mg/kg/injection) using a hyperbolic model that allowed us to compare discounting rates between qualitatively different reinforcers. Choice of immediate food increased with food amount, and choice functions generally shifted leftward as delay to cocaine increased, indicating a decrease in the subjective value of cocaine. Compared with our previous delay-discounting experiment with immediate cocaine versus delayed food, both doses of delayed cocaine were discounted at a shallow rate. The present results demonstrate that rhesus monkeys will tolerate relatively long delays in an immediate-food versus delayed-drug situation, suggesting that in intertemporal choices between cocaine and food, the subjective value of cocaine is less affected by the delay until reinforcement than is the subjective value of delayed food. More generally, the present findings suggest that although drug abusers may choose impulsively when immediate drug reinforcement is available, they exercise self-control in the acquisition of a highly preferred, delayed drug reinforcer. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Situational Interest, Cognitive Engagement, and Achievement in Physical Education

ERIC Educational Resources Information Center

Zhu, Xihe; Chen, Ang; Ennis, Catherine; Sun, Haichun; Hopple, Christine; Bonello, Marina; Bae, Mihae; Kim, Sangmin

2009-01-01

Students' learning has been the center of schooling. This study examined the contribution of situational interest motivation and cognitive engagement in workbooks to student achievement in learning health-related fitness knowledge. Situational interest, performance on solving workbook problems, and knowledge gain in cardio-respiratory fitness and…

Outreach pharmacy service in old age homes: a Hong Kong experience.

PubMed

Lau, Wai-Man; Chan, Kit; Yung, Tsz-Ho; Lee, Anna See-Wing

2003-06-01

To explore drug-related problems in old age homes in Hong Kong through outreach pharmacy service. A standard form was used by outreach pharmacists to identify drug-related problems at old age homes. Homes were selected through random sampling, voluntary participation or adverse selection. Initial observation and assessment were performed in the first and second weeks. Appropriate advice and recommendations were given upon assessment and supplemented by a written report. Educational talks were provided to staff of the homes in addition to other drug information materials. At week 7 to 9, evaluations were carried out. Eighty-five homes were assessed and identified to have problems in the drug management system. These problems could generally be classified into physical storage (8.8%), quality of storage (19.2%), drug administration system (13.3%), documentation (16.4%), and drug knowledge of staff of homes (42.2%). Quality of drug storage was the most common problem found, followed by documentation and drug knowledge (73%, 50% and 44% of points assessed with problems, respectively). Apart from lack of drug knowledge and unawareness of potential risks by staff, minimal professional standards unmet may be fundamentally related to lack of professional input and inadequacy in legislation. Most homes demonstrated significant improvements upon simple interventions, from a majority of homes with more than 10 problems to a majority with less than 5 problems. Diverse problems in drug management are common in old age homes, which warrants attention and professional inputs. Simple interventions and education by pharmacists are shown to be effective in improving the quality of drug management and hence care to residents. While future financing of old age home service can be reviewed within the social context to provide incentives for improvement, review of regulatory policy with enforcement may be more fundamental and effective in upholding the service standard.

Annual Report on the State of the Drugs Problem in the European Union, 2000.

ERIC Educational Resources Information Center

European Monitoring Centre for Drugs and Drug Addiction, Lisbon (Portugal).

This report presents an overview of the drug phenomenon in Europe at the start of the new millennium. The first chapter begins with a discussion of overall drug trends. Specifically, it examines trends in drug use and the consequences including multiple drug use; problem drug use and demand for treatment; drug-related deaths; drug-related…

Noncompliance and Drug Toxicity in Black, Poor, and Aged Patients

PubMed Central

Miller, Russell L.; Algee, John

1978-01-01

Drug toxicity is a common medical problem. Continued increases in drug toxicity are related to the extensive, indiscriminate use of drugs. This is a national health problem which is caused partly by gaps in pharmacology as a basic and clinical science and partly by the rapid proliferation of drugs (the drug explosion) in the past 30 years. Socioeconomically disadvantaged (black, poor, and aged) patients are particularly vulnerable to compliance problems and drug toxicity. In this presentation we discuss the basis for this increased vulnerability and suggest strategies that practicing physicians can use to minimize both compliance problems and drug toxicity. PMID:712862

Problem drug use the public health imperative: what some of the literature says.

PubMed

Bevan, Gez

2009-12-16

With more than 200,000 problem drug users is contact with structured treatment services in England the public health imperative behind drug treatment is great. Problem drug use for many is a chronic and relapsing condition, where "cure" is often neither a reasonable or appropriate expectation and it can further be argued that in these circumstances problem drug use is no different from any number of chronic and enduring health conditions that are managed in the health care system and therefore should be conceptualised as such. A public health approach to drug treatment emphasises the need for drug users in or accessing treatment, to reduce their harmful drug use, reduce drug use related risks such as sepsis and overdose and stay alive for longer. However a public health perspective in relation to problem drug use isn't always either apparent or readily understood and to that end there is still a significant need to continue the arguments and debate that treatment and interventions for problem and dependent drug users need to extend beyond an individualistic approach. For the purposes of discussion in this article public and population health will be used interchangeably. A recognition and acceptance that a public and population health approach to the management of problem drug users is sound public health policy also then requires a long term commitment in terms of staffing and resources where service delivery mirrors that of chronic condition management.

Anecdotal therapies.

PubMed

Millikan, L E

1999-01-01

Traditionally, many advances in medicine have been serendipitous. Are serendipitous and anecdotal synonymous? Many of our materia medica today relate to initial probes and anecdotal reports that matured to full investigation and therapeutic indications. The recent situation regarding Skin Cap is one that highlights the downside of this scenario. Several drugs in the US continue usage largely related to anecdotal indications, and anecdotal extension of legend indications is a standard for American Dermatology. The situation with systemic drugs, such as Trental, zinc preparations, imidazoles for extended indications, lysine and melatonin, all will be discussed. Topical preparations such as skin cap, cantharone, Vioform, all also are included in this category. It is important to place this topic in perspective in regards to geographic variation and therapeutic need. Many diseases lacking specific therapy are important targets for anecdotal therapy, and this will foster continued approaches in this area. The growing standardization of medicine and pharmaceutical regulation, threatens the anecdotal approach, but it provides still an important link to the future for some forms of therapy in diseases that are difficult to treat. Traditionally, the anecdote has been the first step in the therapeutic chain. Withering discovery of the benefits of the common fox glove in dropsy, was followed by many other anecdotes arriving via folk-medicine in the New World. This approach of utilizing folk medicine has now reached new heights, with very active searches by major pharmaceutical companies throughout the third world for remedies that may have potential. Couched with this is the history of anecdotal "snake-oil" remedies, that clearly had no benefit to anyone except the huckster marketing same. The excesses in this area of unproven and false therapies, led to the gradual organization of therapeutic trials and the Food and Drug Administration in the US as we know it today. The biggest shot in the arm for enhancing FDA protocols was the thalidomide situation, an outgrowth of an ethically studied and used medication that perhaps had been released too soon, prior to sufficient trials to determine the total patient risk. As in many situations, the pendulum swings in both directions, and after thalidomide, the acceptance of new treatments required more and more rigorous studies, and studies from other countries often were not acceptable unless a small part of a larger, whole proposal. The AIDS crisis has prompted a swing back, away from such expensive and rigorous pre-marketing review, to more expedited processes for the relief of patients with this fatal disease. This has streamlined the FDA, and hopefully the swing of the pendulum will not go too far, to result in problems in the future. Anecdotal therapies and medications are the first step in many parts of the world to therapeutic trials. The most widely used aspects of anecdotal therapies, again, remains in the situation with diseases without good therapies at the present time. The so-called orphan drugs and orphan diseases, while a serious medical problem, do not present a significant volume for effective drug screening in many instances, and the FDA has developed some new approaches to circumvent this very expensive development process for patients suffering from these rare and unusual disorders. The most recent example of anecdotal therapy catching the public fancy in dermatology was the Skin-Cap Spray. This product, over the period of twelve months, got rave reviews in the lay press in the non-peer reviewed dermatologic periodicals, and amassed impressive sales figures in this period of time. It was extremely effective, and most dermatologists who used it have patients who consider it the most effective therapy in the last year. The formulation of a low concentration of zinc pyrithione seemed unusual, and this truly was an anecdotal approach, using a homeopathic dosage of a commonly used p

JPRS Report, Environmental Issues

DTIC Science & Technology

1990-06-27

multilateral cooperation in addition to military -political and international legal problems. Special attention was paid to discussing measures to protect the...Aleksandr Kanishchev] [Text] Moscow June 20 TASS—Problems related to the ecological situation around Soviet military bases in Czechoslovakia have...selves—a situation in which they make little or no provision for pollution control facilities. The regulations, expected to be based on the outcome

The Relationship between Relapse Prevention Treatment Outcome and Self-Efficacy.

ERIC Educational Resources Information Center

Cantrell, Peggy J.; And Others

The majority of alcoholics and drug addicts relapse after treatment, with many substance abusers developing a chronic relapse pattern. For this study, 43 patients, who went through a 3-week inpatient relapse prevention program, answered the Situational Confidence Questionnaire (a measure of self-efficacy for alcohol-related, high-risk situations)…

Stressful situations and coping strategies in relation to age.

PubMed

Richaud de Minzi, María Cristina; Sacchi, Carla

2005-10-01

Whether people cope differently with negative events at different ages was assessed by relation to age by type of situation perceived as potentially stressful and by type of coping strategy used, and also whether the kind of coping strategy used to reduce the potential stressor was related to type of stressor. To do this the factor structure of the Spanish version of the Ways of Coping Checklist of Lazarus and Folkman was examined in an Argentine sample of 153. The factor analysis of checklist scores identified five factors: Cognitive redefinition, Problem focus, Seeking social support, Wishful thinking, and Avoidance. For two groups, ages 20 to 24 and 40 to 45 years, analysis indicated a significant association of type of situation perceived as potentially stressful with age. The middle-age group (40-45 yr.) chose a way of coping in problem solution but the young adult group (20-24 yr.) seemed more often to elude problems. It appears that the type of stressor influences type of coping.

Relationships of Social Context and Identity to Problem Behavior among High-Risk Hispanic Adolescents

PubMed Central

Schwartz, Seth J.; Mason, Craig A.; Pantin, Hilda; Wang, Wei; Brown, C. Hendricks; Campo, Ana; Szapocznik, José

2008-01-01

The present study was designed to examine the extent to which (a) family and school functioning and (b) personal and ethnic identity is associated with conduct problems, drug use, and sexual risk taking in a sample of 227 high-risk Hispanic adolescents. Adolescents participated in the study with their primary parents, who were mostly mothers. Adolescents completed measures of family and school functioning, personal and ethnic identity, conduct problems, and drug use. Parents completed measures of family functioning and adolescent conduct problems. Results indicated that school functioning and personal identity confusion were related to alcohol use, illicit drug use, and sexual risk taking indirectly through adolescent reports of conduct problems. Adolescent reports of family functioning were related to alcohol use, illicit drug use, and sexual risk taking through school functioning and conduct problems. Results are discussed in terms of the problem behavior syndrome and in terms of the finding of relative independence of contextual and identity variables vis-à-vis conduct problems, substance use, and sexual risk taking. PMID:19412356

Attitudes and practices of primary healthcare center patients about drug use in Turkey.

PubMed

Arslan, Leyla Sündüs; Semin, Semih

2006-08-01

Noncompliance is considered as a widespread but often neglected problem all over the world. In order to promote compliance, it is essential to first know the current drug use situation. Therefore, this study aims to investigate the level of drug compliance in patients of a primary healthcare centre and identify factors which affect the patients' drug compliance in Turkey. The cross-sectional study was executed in 2003 in Ilica Health Centre; a total of 280 patients took part in the study. The patients were visited at home and a questionnaire was applied in order to obtain information on compliance. Overall 204 (72.8%) of patients were compliant and 76 (27.2%) were noncompliant. According to patients, the main reason for primary noncompliance was poverty. Compliance with prescription is needed to get favourable results in treatments. The results show that even in urban areas drug compliance is still an important problem in Turkey. The findings of this study may contribute to develop programmes to improve patient compliance in Turkey. The aims of these programs should include reducing the barriers, such as lack of social security, which prevent access to the prescribed drugs.

Bridging the gap between hospital and primary care: the pharmacist home visit.

PubMed

Ensing, Hendrik T; Koster, Ellen S; Stuijt, Clementine C M; van Dooren, Ad A; Bouvy, Marcel L

2015-06-01

Bridging the gap between hospital and primary care is important as transition from one healthcare setting to another increases the risk on drug-related problems and consequent readmissions. To reduce those risks, pharmacist interventions during and after hospitalization have been frequently studied, albeit with variable effects. Therefore, in this manuscript we propose a three phase approach to structurally address post-discharge drug-related problems. First, hospitals need to transfer up-todate medication information to community pharmacists. Second, the key phase of this approach consists of adequate follow-up at the patients' home. Pharmacists need to apply their clinical and communication skills to identify and analyze drug-related problems. Finally, to prevent and solve identified drug related problems a close collaboration within the primary care setting between pharmacists and general practitioners is of utmost importance. It is expected that such an approach results in improved quality of care and improved patient safety.

[Use of hypertext as information and training tools in the prevention of occupational risk].

PubMed

Franco, G

1998-01-01

Modern medical education is based on a variety of teaching techniques, by means of which individuals learn most effectively. The availability of the new technologies together with the diffusion of personal computers is favouring the spreading of the use of hypertexts through the World Wide Web. This contribution describes 2 hypertexts ("Human Activities and Health Risk"; "Occupation, Risk and Disease. A Problem-Oriented Hypertext-Tool to Learn Occupational Medicine") and the prototype "Virtual Hospital". Assuming that prevention of health risks is based upon their knowledge, they have been created with the aim of providing users with problem-oriented tools, whose retorical aspects (content, information organization, user interface) are analysed. The "Human Activities and Health Risk" deals with the description of working activities and allows user to recognize health risks. The "Occupation, Risk and Disease. A Problem-Oriented Hypertext-Tool to Learn Occupational Medicine" embodies a case report containing the clustered information about the patient and the library including educational material (risk factors, symptoms and signs, organ system diseases, jobs, occupational risk factors, environment related diseases. The "Virtual Hospital" has been conceived assuming that an appropriate information can change workers' behaviour in hospital, where health risks can be often underevaluated. It consists of a variety of structured and unstructured information, which can be browsed by users, allowing the discovery of links and providing the awareness of the semantic relationship between related information elements (including environment, instruments, drugs, job analysis, situations at risk for health, preventive means). The "Virtual Hospital" aims making the understanding of the working situations at risk easier and more interesting, stimulating the awareness of the relationship between jobs and risks.

Standing Genetic Variation and the Evolution of Drug Resistance in HIV

PubMed Central

Pennings, Pleuni Simone

2012-01-01

Drug resistance remains a major problem for the treatment of HIV. Resistance can occur due to mutations that were present before treatment starts or due to mutations that occur during treatment. The relative importance of these two sources is unknown. Resistance can also be transmitted between patients, but this process is not considered in the current study. We study three different situations in which HIV drug resistance may evolve: starting triple-drug therapy, treatment with a single dose of nevirapine and interruption of treatment. For each of these three cases good data are available from literature, which allows us to estimate the probability that resistance evolves from standing genetic variation. Depending on the treatment we find probabilities of the evolution of drug resistance due to standing genetic variation between and . For patients who start triple-drug combination therapy, we find that drug resistance evolves from standing genetic variation in approximately 6% of the patients. We use a population-dynamic and population-genetic model to understand the observations and to estimate important evolutionary parameters under the assumption that treatment failure is caused by the fixation of a single drug resistance mutation. We find that both the effective population size of the virus before treatment, and the fitness of the resistant mutant during treatment, are key-parameters which determine the probability that resistance evolves from standing genetic variation. Importantly, clinical data indicate that both of these parameters can be manipulated by the kind of treatment that is used. PMID:22685388

Medical problems related to recreational drug use at nocturnal dance parties.

PubMed

Van Sassenbroeck, Diederik K; Calle, Paul A; Rousseau, Filip M; Verstraete, Alain G; Belpaire, Frans M; Monsieurs, Koenraad G; Haentjens, Raoul; Allonsius, Jacques; Van Brantegem, Jean; Haenen, Wim; Buylaert, Walter A

2003-12-01

During 'I love techno' (edition 2001), an indoor rave party attended by 37 000 people, data about medical problems (especially drug-related problems) were collected. To place these data in a wider perspective, a similar registration was done during 'De Nacht', a traditional New Year's Eve dance party held at the same location and attended by 12 000 people. Furthermore, a prospective study on the time course of the level of consciousness (Glasgow Coma Score) and blood concentrations of illicit drugs, especially gamma-hydroxybutyrate was set up. The results revealed that during 'I love techno' the incidence of medical problems was high (66.5/10 000 attendees), but not higher than during 'De Nacht' (70.0/10 000 attendees). At 'I love techno', however, mainly illicit drugs were used, more frequently leading to severe drug-related medical problems. The observations in patients with a drug-related medical problem who had taken gamma-hydroxybutyrate showed that for a given level of consciousness the gamma-hydroxybutyrate concentrations may show important differences, that the transition from coma (Glasgow Coma Score < or =7) to full recovery (Glasgow Coma Score 15) takes only 30-60 min (and only a small decrease in gamma-hydroxybutyrate concentrations), and that the time it takes before a comatose patient reaches the above-mentioned 'transition area' may be a few hours.

Factors related to perceived health among elderly people: the Albertina Project.

PubMed

Lindgren, A M; Svärdsudd, K; Tibblin, G

1994-07-01

The Albertina Project is an epidemiological study of the medical, social and economic situation among people aged 75 years or older in Uppsala, Sweden. In this report, health conditions, quality-of-life measures and housing problems affecting it are presented. A postal questionnaire was sent to an 11% random sample (n = 959) of the eligible population out of which 706 (74%) persons responded. Nearly one-third of the elderly people could not read a newspaper with or without glasses, more than one-third had impaired hearing, 47% had some sort of mobility problem and 66% reported some form of sleeping problem. Forty-two per cent felt lonely sometimes or often and 65% were worried, in most cases about the risk of falling. In spite of this, 87% rated their health as good and 79% were content or rather content with their situation. Even though eyesight and hearing problems were common in this study, they did not affect perceived health to any large extent. Mobility problems and sleeping problems had a greater impact. The most important factors related to perceived health were activity score, contentment and mobility problems. Contentment was affected by activity score and loneliness and the latter was in turn affected by age and type of dwelling. The practical implication of these findings is that perhaps more attention should be focused on efforts to improve old people's satisfaction with their life situation rather than on marginal improvements of their medical situation.

Solving Drug-Related Problems in the Professional Experience Program.

ERIC Educational Resources Information Center

Kane, Michael P.; And Others

1993-01-01

A study investigated the effectiveness of using the Pharmacist's Work-up of Drug Therapy (PWDT) in teaching 91 pharmacy students in a clinical clerkship program to identify and solve drug-related problems. Because the instructional technique was recently implemented, the study looked at effects of 3 different quantities of training (0, 1, and 3…

[Interdisciplinary strategies versus doping].

PubMed

Vitzthum, Karin; Mache, Stefanie; Quarcoo, David; Groneberg, David A; Schöffel, Norman

2010-06-01

Doping is a phenomenon which in the past years through the various incidences in professional cycling has come more and more into the focus of the public interest. Whilst in the young past the problems were to define the term "doping" exactly, today's problem is to prevent adolescents and children of doping. This shall be achieved by carrying out controls and serious sanctions for doping violations. Scientific research proved that doping usage can be avoided by broad specific prevention measures. In general, the earlier the athletes dope the higher the risk to become addicted later on in life to other legal or illegal drugs. The aim of this review is to analyse the prevalence of doping regarding youth-, competitive-, high performance and recreational sports and to examine further aspects of doping abuse, risks of addiction, the legal situation, current strategies in the fight against doping and to enhance chances of further doping prevention opportunities. By means of this data an all-embracing view should be given over the current situation, problems and prospects in German-speaking countries.

Early Initiation of Substance Use as an Indicator of Problematic Substance Use Among Young Men Who Have Sex with Men (YMSM).

PubMed

Kecojevic, Aleksandar; Basch, Corey H; Lankenau, Stephen E

2018-01-02

Much research has documented that young men who have sex with men (YMSM) are at higher risk for substance use-related problems. This study examined the age of substance use initiation and it's relationship to current substance use-related problems among substance-using YMSM. A cross-sectional survey of 191 YMSM (aged 18 to 29) with recent histories of prescription drug misuse was conducted in Philadelphia in 2012-13. Participants were surveyed about age of initiation of cigarette smoking, alcohol use to the point of intoxication, marijuana, prescription, and illicit drugs, and about alternate modes of prescription drug administration. The severity of participants' current substance use related problems was measured using the Drug Abuse Screening Test (DAST-10). Mean age of initiation was 14.6 years for cigarette smoking, 15.3 years for alcohol use to the point of intoxication, 15.2 years for marijuana, 16.8 years for prescription drugs, and 17.9 years for illicit drugs. Use of 2 or more substances by the age of 15 was reported by 56% of the participants. Odds of substance-related problems were significantly greater among those who reported earlier initiation of alcohol, prescription drugs, or polysubstance use. Odds of prescription drug misuse via altered routes of administration were significantly greater among participants with earlier onset of alcohol, marijuana, prescription, illicit drugs, or polysubstance use. This study demonstrates that earlier initiation of substance use is associated with higher risk of substance-related problems among substance-using YMSM. Early interventions addressing substance use initiation could benefit this population.

What do we know about the situation of women living with HIV in Europe?

PubMed

Miralles, Celia; Mardarescu, Mariana; Sherr, Lorraine

2013-01-01

At present, women represent approximately one-third of new diagnoses of HIV in Europe - most are infected by heterosexual transmission. Some specific populations of women, such as migrants, sex workers and those who are intravenous drug users, may be at increased risk of HIV infection. Women living with HIV face a range of intersecting situations and challenges distinct from those faced by men. The most familiar of these is pregnancy and motherhood; however, family and social situations will also be different for women compared with men, and can affect how individuals access care and manage their disease. The stigma of HIV can be a particular problem for women in many communities. Improved surveillance of HIV and increased study of the situations facing women living with HIV will help to identify improved strategies to support the care of this patient population.

Evaluation of nootropic potential of Ocimum sanctum Linn. in mice.

PubMed

Joshi, Hanumanthachar; Parle, Milind

2006-02-01

Dementia is one of the age related mental problems and a characteristic symptom of various neurodegenerative disorders including Alzheimer's disease. Certain drugs like diazepam, barbiturates and alcohol disrupt learning and memory in animals and man. However, a new class of drugs known as nootropic agents is now used in situations where there is organic disorder in learning abilities. The present work was undertaken to assess the potential of O. sanctum extract as a nootropic and anti-amnesic agent in mice. Aqueous extract of dried whole plant of O. sanctum ameliorated the amnesic effect of scopolamine (0.4 mg/kg), diazepam (1 mg/kg) and aging induced memory deficits in mice. Elevated plus maze and passive avoidance paradigm served as the exteroceptive behavioral models. O. sanctum extract decreased transfer latency and increased step down latency, when compared to control (piracetam treated), scopolamine and aged groups of mice significantly. O. sanctum preparations could of beneficial in the treatment of cognitive disorders such as dementia and Alzheimer's disease.

Who copes well? Obesity-related coping and its associations with shame, guilt, and weight loss.

PubMed

Conradt, Matthias; Dierk, Jan-Michael; Schlumberger, Pia; Rauh, Elisabeth; Hebebrand, Johannes; Rief, Winfried

2008-10-01

The relationship among weight-related coping, guilt, and shame was investigated in a sample of 98 obese German individuals over a 6-month period. In terms of the objectives, the study explored the kind and frequency of typical coping situations in which obese individuals become aware of being obese. Furthermore, the study sought to determine the predictive utility of weight-related shame and guilt concerning coping responses, and to establish whether there is an association between coping responses and weight change. A longitudinal examination over a 6-month period was chosen with two measurement points. As typical distressing coping situations, individuals reported mostly negative evaluations through others/self, physical exercise situations, or environmental hazards (mainly shopping for clothes). Weight-related shame at baseline was a significant negative predictor for problem-focused engagement coping, whereas weight-related guilt was a significant positive predictor for problem-focused engagement strategies and dietary restraint at follow-up. Although Body Mass Index showed no substantial association with the coping measures, weight loss was accompanied by a substantial drop in problem-focused disengagement coping (wishful thinking, problem avoidance). Discussion of these findings focuses on the issue of possible effects of weight-related feelings of guilt and shame on coping behavior, the link between weight loss and disengaging coping strategies, and the possible use of the findings for cognitive-behavioral therapy for obesity. Copyright 2008 Wiley Periodicals, Inc.

Extending the market exclusivity of therapeutic antibodies through dosage patents

PubMed Central

Storz, Ulrich

2016-01-01

ABSTRACT Dosage patents are one way to extend the market exclusivity of an approved drug beyond the lifetime of the patent that protects the drug as such. Dosage patents may help to compensate the applicant for the long period where the active pharmaceutical ingredient as such is already under patent prosecution, but not on the market yet, due to lengthy development and approval procedures. This situation erodes part of the time the drug is marketed under patent protection. Dosage patents filed at a later date can provide remedy for this problem. Examples of successful and unsuccesful attempts, and the reasons for the respective outcomes, are provided in this article. PMID:27115842

Neighbourhood Socio-Economic Factors in Relation to Student Drug Use and Programs.

ERIC Educational Resources Information Center

Smart, Reginald G.; And Others

1994-01-01

Examines relationships between drug use problems and socioeconomic status of neighborhoods where students in grades 11 and 13 reside. Found largest number of alcohol and drug problems in areas with lowest socioeconomic characteristics, characterized by low-cost substandard housing, social and racial problems, and delinquency. Includes 13…

A Cross-Lagged Evaluation of Eating Disorder Symptomatology and Substance-Use Problems*

PubMed Central

Dunn, Erin C.; Neighbors, Clayton; Fossos, Nicole; Larimer, Mary E.

2009-01-01

Objective: The purpose of this study was to conduct a temporal examination of the associations among disordered eating behaviors, substance use, and use-related negative consequences in female college students—a population at high risk for developing eating and substance-use disorders. Method: Participants completed assessments of disordered eating behaviors, alcohol and drug use, and use-related negative consequences. Results: Results support previous research suggesting that disordered eating behaviors are more strongly associated with alcohol- and substance-related problems rather than use per se. With respect to temporal precedence, results indicated that binge eating preceded alcohol-use problems, but a bidirectional relationship was found for vomiting. With regard to drug problems, laxatives use preceded drug problems, whereas drug problems preceded fasting. These associations were not better accounted for by pre-existing eating or substance-use problems or psychiatric distress (e.g., depression, anxiety). Conclusions: This study further supports the importance of assessing consequences, in addition to use patterns, when examining substance use in individuals demonstrating threshold and subthreshold eating-disordered behaviors. PMID:19118399

Clinical implications of fixed-dose coformulations of antiretrovirals on the outcome of HIV-1 therapy.

PubMed

Llibre, Josep M; Arribas, José R; Domingo, Pere; Gatell, Josep M; Lozano, Fernando; Santos, José R; Rivero, Antonio; Moreno, Santiago; Clotet, Bonaventura

2011-09-10

The substitution by generic equivalents of some of the drugs included in fixed-dose antiretroviral coformulations (FDACs) poses the potential risk of disrupting these combinations and administering the components separately in order to incorporate the new generic drug, which offers a more competitive sales price. This may represent a step backwards in the advances achieved in simplicity and adherence to therapy, posing an increased risk of selective noncompliance of some of the separately administered drug substances. Available antiretroviral drugs must be administered for life in the affected individuals - both children and adults. The FDACs represent a significant advance in the simplification of antiretroviral therapy, facilitating adherence to complex and chronic treatments, and contributing to a quantifiable improvement in patient quality of life. These drug coformulations reduce the risk of treatment error, are associated with a lower risk of hospitalization, and can lessen the possibility of covert monotherapy in situations of selective noncompliance. Thus, FDACs can reduce the risk of selection of HIV-1 resistances, which not only adversely affect the treatment options of the individual patient but also constitute a public health problem, and further increase the cost and complexity of therapy. With the exception of those cases requiring dose adjustments, the preferential use of FDACs should be recommended for the treatment of HIV-1 infection in those situations when the agents included in the coformulation are drugs of choice.

Serving women who use drugs in Delhi, India: challenges and achievements.

PubMed

Sarin, Enisha; Selhore, Elizabeth

2008-04-01

Sharan and Sahara, two NGOs working in Delhi, India, in the field of drug use and HIV/AIDS, present some key challenges as well as lessons learned in working with women who use drugs. Although there is no official estimate of the number of women drug users in Delhi, outreach reports indicate a hidden population of women users in the slums and streets of Delhi. A rapid situation assessment (RSA) conducted in 2000 by Sharan found urban poor women using drugs in Delhi with multiple issues related to their health, livelihoods, and relationships that put them at risk of severe health problems including HIV. The findings of the RSA led to intensified and focused intervention for women users by Sahara and Sharan. This is a discussion on a gender specific intervention ongoing in Delhi by delineating the particular achievements and challenges faced in working with women who use drugs. The article also looks at broader challenges that are outside the scope of this particular intervention but which nevertheless affect the well being of women who use drugs. Out of the 3700 women who have been rehabilitated in Sahara, 40% have found employment, while another 10% have been reintegrated into their families. There is however, an overdependence on its services that impedes their successful transition to mainstream life. One of the biggest limitations in the design of drug treatment interventions in Delhi is that there is a lack of diverse treatment options for women users. Only indoor detoxification and rehabilitation facilities are available for women; even these not offering a quality of care commensurate with the needs of the women. Lack of mental health care in drug treatment centres is felt to be a huge gap in services. Finally, NGOs like Sharan and Sahara are obliged to take up the entire continuum of care services which limits their ability to provide optimal care and services to women who use drugs. Lack of funds and lack of understanding among funding agencies about issues of women users are additional limitations in service provision. A multi-sectoral response is a viable response to the multi-dimensional problem of women drug use.

Drug use, mental health and problems related to crime and violence: cross-sectional study1

PubMed Central

Claro, Heloísa Garcia; de Oliveira, Márcia Aparecida Ferreira; Bourdreaux, Janet Titus; Fernandes, Ivan Filipe de Almeida Lopes; Pinho, Paula Hayasi; Tarifa, Rosana Ribeiro

2015-01-01

Objective: to investigate the correlation between disorders related to the use of alcohol and other drugs and symptoms of mental disorders, problems related to crime and violence and to age and gender. Methods: cross-sectional descriptive study carried out with 128 users of a Psychosocial Care Center for Alcohol and other Drugs, in the city of São Paulo, interviewed by means of the instrument entitled Global Appraisal of Individual Needs - Short Screener. Univariate and multiple linear regression models were used to verify the correlation between the variables. Results: using univariate regression models, internalizing and externalizing symptoms and problems related to crime/violence proved significant and were included in the multiple model, in which only the internalizing symptoms and problems related to crime and violence remained significant. Conclusions: there is a correlation between the severity of problems related to alcohol use and severity of mental health symptoms and crime and violence in the study sample. The results emphasize the need for an interdisciplinary and intersectional character of attention to users of alcohol and other drugs, since they live in a socially vulnerable environment. PMID:26626010

National Clearinghouse for Drug Abuse Information Report Series, Series 22, No. 1. Community Action Programs.

ERIC Educational Resources Information Center

National Inst. on Drug Abuse (DHEW/PHS), Rockville, MD. National Clearinghouse for Drug Abuse Information.

Based on the principle that drug abuse is no longer a problem restricted to certain economic, social, educational, or intellectual levels or ethnic groups, this pamphlet relates some examples of on-going community action programs and projects. Essentially, these programs are striving to solve some of the drug related problems in their immediate…

Current Situation, Determinants, and Solutions to Drug Shortages in Shaanxi Province, China: A Qualitative Study

PubMed Central

Yang, Caijun; Wu, Lina; Cai, Wenfang; Zhu, Wenwen; Shen, Qian; Li, Zongjie; Fang, Yu

2016-01-01

Objective Drug shortages were a complex global problem. The aim of this study was to analyze, characterize, and assess the drug shortages, and identify possible solutions in Shaanxi Province, western China. Methods A qualitative methodological approach was conducted during May–June 2015 and December 2015–January 2016. Semi-structured interviews were performed to gather information from representatives of hospital pharmacists, wholesalers, pharmaceutical producers, and local health authorities. Results Thirty participants took part in the study. Eight traditional Chinese medicines and 87 types of biologicals and chemicals were reported to be in short supply. Most were essential medicines. Five main determinants of drug shortages were detected: too low prices, too low market demands, Good Manufacturing Practice (GMP) issues, materials issues, and approval issues for imported drugs. Five different solutions were proposed by the participants: 1) let the market decide the drug price; 2) establish an information platform; 3) establish a reserve system; 4) enhance the communication among the three parties in the supply chain; and 5) improve hospital inventory management. Conclusions Western China was currently experiencing a serious drug shortage. Numerous reasons for the shortage were identified. Most drug shortages in China were currently because of “too low prices.” To solve this problem, all of the stakeholders, especially the government, needed to participate in managing the drug shortages. PMID:27780218

Family Problems and Youth Unemployment.

ERIC Educational Resources Information Center

de Goede, Martijn; Spruijt, Ed; Maas, Cora; Duindam, Vincent

2000-01-01

Examines how family and personal characteristics relate to the employment situation of adolescents (N=995) in Denmark. Results show that parental divorce, parental unemployment (only for males), low parental affective involvement, and adolescent relationship problems were related to youth unemployment, but educational career and work commitment…

Diabetes mellitus: a prothrombotic state Implications for outcomes after coronary revascularization

PubMed Central

Cola, Clarissa; Brugaletta, Salvatore; Yuste, Victoria Martín; Campos, Bieito; Angiolillo, Dominick J; Sabaté, Manel

2009-01-01

Coronary stent thrombosis is a serious problem in the drug-eluting stent era. Despite aggressive antiplatelet therapy during and after percutaneous coronary intervention (PCI), the incidence of sub-acute stent thrombosis remains approximately 0.5%–2%, which may represent a catastrophic clinical situation. Both procedural factors and discontinuation of antiplatelet therapy are normally associated with this event. We report on simultaneous stent thromboses of two drug-eluting stents implanted in two different vessels, which resulted in a life-threatening clinical condition. Possible contributing factors that led to synergistic thrombotic effects are discussed. PMID:19436654

Antinauseants in Pregnancy: Teratogens or Not?

PubMed Central

Biringer, Anne

1984-01-01

Nausea and/or vomiting affect 50% of all pregnant women. For most women, this is a self-limited problem which responds well to conservative management. However, there are some situations where the risk to the mother and fetus posed by the illness are greater than the possible risks of teratogenicity of antinauseant drugs. Antihistamines have had the widest testing, and to date, there has been no evidence linking doxylamine, dimenhydrinate or promethazine to congenital malformations. Since no available drugs have official approval for use in nausea and vomiting of pregnancy the physician is left alone to make this difficult decision. PMID:21279128

Influence of gender and race/ethnicity on perceived barriers to help-seeking for alcohol or drug problems.

PubMed

Verissimo, Angie Denisse Otiniano; Grella, Christine E

2017-04-01

This study examines reasons why people do not seek help for alcohol or drug problems by gender and race/ethnicity using data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a nationally representative survey. Multivariate models were fit for 3 barriers to seeking help (structural, attitudinal, and readiness for change) for either alcohol or drug problems, controlling for socio-demographic characteristics and problem severity. Predicted probabilities were generated to evaluate gender differences by racial/ethnic subgroups. Over three quarters of the samples endorsed attitudinal barriers related to either alcohol or drug use. Generally, women were less likely to endorse attitudinal barriers for alcohol problems. African Americans and Latina/os were less likely than Whites to endorse attitudinal barriers for alcohol problems, Latina/os were less likely than Whites to endorse readiness for change barriers for alcohol and drug problems, however, African Americans were more likely to endorse structural barriers for alcohol problems. Comparisons within racial/ethnic subgroups by gender revealed more complex findings, although across all racial/ethnic groups women endorsed attitudinal barriers for alcohol problems more than men. Study findings suggest the need to tailor interventions to increase access to help for alcohol and drug problems that take into consideration both attitudinal and structural barriers and how these vary across groups. Copyright © 2017 Elsevier Inc. All rights reserved.

Influence of Gender and Race/Ethnicity on Perceived Barriers to Help-Seeking for Alcohol or Drug Problems

PubMed Central

Verissimo, Angie Denisse Otiniano

2017-01-01

This study examines reasons why people do not seek help for alcohol or drug problems by gender and race/ethnicity using data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a nationally representative survey. Multivariate models were fit for 3 barriers to seeking help (structural, attitudinal, and readiness for change) for either alcohol or drug problems, controlling for socio-demographic characteristics and problem severity. Predicted probabilities were generated to evaluate gender differences by racial/ethnic subgroups. Over three quarters of the samples endorsed attitudinal barriers related to either alcohol or drug use. Generally, women were less likely to endorse attitudinal barriers for alcohol problems. African Americans and Latina/os were less likely than Whites to endorse attitudinal barriers for alcohol problems, Latina/os were less likely than Whites to endorse readiness for change barriers for alcohol and drug problems, however, African Americans were more likely to endorse structural barriers for alcohol problems. Comparisons within racial/ethnic subgroups by gender revealed more complex findings, although across all racial/ethnic groups women endorsed attitudinal barriers for alcohol problems more than men. Study findings suggest the need to tailor interventions to increase access to help for alcohol and drug problems that take into consideration both attitudinal and structural barriers and how these vary across groups. PMID:28237055

Obstacles Related to Structuring for Mathematization Encountered by Students When Solving Physics Problems

ERIC Educational Resources Information Center

Niss, Martin

2017-01-01

This paper studies the cognitive obstacles related to one aspect of mathematization in physics problem-solving, namely, what might be called "structuring for mathematization," where the problem situation is structured in such a way that a translation to a mathematical universe can be done. We report the results of an analysis of four…

Preventing Alcohol-Related Problems on Campus: Methods for Assessing Student Use of Alcohol and Other Drugs. A Guide for Program Coordinators.

ERIC Educational Resources Information Center

DeJong, William; Wechsler, Henry

Under the Drug-Free Schools and Campuses Act, institutions of higher education are required to review the effectiveness of their alcohol and drug prevention programs biannually. This guide offers a method for gathering and interpreting student survey data on alcohol-related problems based on the methodology of the College Alcohol Survey developed…

A Case for Developing Community Drug Indicators

ERIC Educational Resources Information Center

Loughran, Hilda; McCann, Mary Ellen

2011-01-01

The EU Action Plan on Drugs (2005-2008) calls for member states of the European Union to provide information on five key epidemiological indicators. These are: general population surveys, prevalence and patterns of problem drug use, drug related infectious diseases, drug related deaths and mortality of drug users, and demand for drug treatment.…

Potential of Complementary and Alternative Medicine in Preventive Management of Novel H1N1 Flu (Swine Flu) Pandemic: Thwarting Potential Disasters in the Bud

PubMed Central

Arora, Rajesh; Chawla, R.; Marwah, Rohit; Arora, P.; Sharma, R. K.; Kaushik, Vinod; Goel, R.; Kaur, A.; Silambarasan, M.; Tripathi, R. P.; Bhardwaj, J. R.

2011-01-01

The emergence of novel H1N1 has posed a situation that warrants urgent global attention. Though antiviral drugs are available in mainstream medicine for treating symptoms of swine flu, currently there is no preventive medicine available. Even when available, they would be in short supply and ineffective in a pandemic situation, for treating the masses worldwide. Besides the development of drug resistance, emergence of mutant strains of the virus, emergence of a more virulent strain, prohibitive costs of available drugs, time lag between vaccine developments, and mass casualties would pose difficult problems. In view of this, complementary and alternative medicine (CAM) offers a plethora of interesting preventive possibilities in patients. Herbs exhibit a diverse array of biological activities and can be effectively harnessed for managing pandemic flu. Potentially active herbs can serve as effective anti influenza agents. The role of CAM for managing novel H1N1 flu and the mode of action of these botanicals is presented here in an evidence-based approach that can be followed to establish their potential use in the management of influenza pandemics. The complementary and alternative medicine approach deliberated in the paper should also be useful in treating the patients with serious influenza in non pandemic situations. PMID:20976081

Situational Interest and Academic Achievement in the Active-Learning Classroom

ERIC Educational Resources Information Center

Rotgans, Jerome I.; Schmidt, Henk G.

2011-01-01

The aim of the present study was to investigate how situational interest develops over time and how it is related to academic achievement in an active-learning classroom. Five measures of situational interest were administered at critical points in time to 69 polytechnic students during a one-day, problem-based learning session. Results revealed…

PTSD Symptom Severities, Interpersonal Traumas, and Benzodiazepines Are Associated with Substance-Related Problems in Trauma Patients

PubMed Central

Guina, Jeffrey; Nahhas, Ramzi W.; Goldberg, Adam J.; Farnsworth, Seth

2016-01-01

Background: Trauma is commonly associated with substance-related problems, yet associations between specific substances and specific posttraumatic stress disorder symptoms (PTSSs) are understudied. We hypothesized that substance-related problems are associated with PTSS severities, interpersonal traumas, and benzodiazepine prescriptions. Methods: Using a cross-sectional survey methodology in a consecutive sample of adult outpatients with trauma histories (n = 472), we used logistic regression to examine substance-related problems in general (primary, confirmatory analysis), as well as alcohol, tobacco, and illicit drug problems specifically (secondary, exploratory analyses) in relation to demographics, trauma type, PTSSs, and benzodiazepine prescriptions. Results: After adjusting for multiple testing, several factors were significantly associated with substance-related problems, particularly benzodiazepines (AOR = 2.78; 1.99 for alcohol, 2.42 for tobacco, 8.02 for illicit drugs), DSM-5 PTSD diagnosis (AOR = 1.92; 2.38 for alcohol, 2.00 for tobacco, 2.14 for illicit drugs), most PTSSs (especially negative beliefs, recklessness, and avoidance), and interpersonal traumas (e.g., assaults and child abuse). Conclusion: In this clinical sample, there were consistent and strong associations between several trauma-related variables and substance-related problems, consistent with our hypotheses. We discuss possible explanations and implications of these findings, which we hope will stimulate further research, and improve screening and treatment. PMID:27517964

Psychosocial and contextual correlates of opioid overdose risk among drug users in St. Petersburg, Russia.

PubMed

Grau, Lauretta E; Green, Traci C; Torban, Mikhail; Blinnikova, Ksenia; Krupitsky, Evgeny; Ilyuk, Ruslan; Kozlov, Andrei P; Heimer, Robert

2009-07-24

Opioid overdose in Russia is a problem that has grown more severe as heroin abuse expanded over the past decade, yet few studies have explored it in detail. In order to gain a clearer understanding of the situation, 60 drug users, both in and out of drug treatment in St. Petersburg, were interviewed concerning their overdose experience and knowledge about overdose recognition and prevention. Using a semi-structured interview, we sought to identify and describe local attitudes, knowledge and experience (both self-sustained and witnessed) of opioid overdose. Bi-variate and multiple logistic regressions were performed in order to identify the relationship between overdose experience and sociodemographic factors, risk behaviors, and clinical psychiatric measures. We found that having experienced or witnessed an opioid overdose within the previous year was common, overdose knowledge was generally high, but nearly half the participants reported low self-efficacy for effectively intervening in an overdose situation. In bivariate analyses, self-reported family problems (i.e., perceived problematic family interactions) were positively associated with both experiencing (t56 = 2.49; p < 0.05) and with witnessing a greater number of overdoses in the previous year (rhos = 0.31; p < 0.05). Having previously overdosed [Adjusted Risk Ratio (ARR) 1.7, 95% Confidence Interval (CI) 1.1-2.6] and higher SCL-90-R somatization scores (ARR 1.2, 95% CI 0.96 - 1.5) were independently associated in multivariable analyses with self-sustained overdose experience in the past year. Greater perceived likelihood of experiencing a future overdose and concern about medical problems were independently associated with witnessing a higher number of overdoses within the previous year. Over two thirds of the participants expressed interest in receiving training in overdose prevention and response. Opioid overdose experience is very common among drug users in St. Petersburg, Russia, and interest in receiving training for overdose recognition and prevention was high. Future research should target the development of effective overdose recognition and prevention interventions, especially ones that include naloxone distribution and involve drug users' families.

Psychosocial and contextual correlates of opioid overdose risk among drug users in St. Petersburg, Russia

PubMed Central

Grau, Lauretta E; Green, Traci C; Torban, Mikhail; Blinnikova, Ksenia; Krupitsky, Evgeny; Ilyuk, Ruslan; Kozlov, Andrei P; Heimer, Robert

2009-01-01

Background Opioid overdose in Russia is a problem that has grown more severe as heroin abuse expanded over the past decade, yet few studies have explored it in detail. In order to gain a clearer understanding of the situation, 60 drug users, both in and out of drug treatment in St. Petersburg, were interviewed concerning their overdose experience and knowledge about overdose recognition and prevention. Methods Using a semi-structured interview, we sought to identify and describe local attitudes, knowledge and experience (both self-sustained and witnessed) of opioid overdose. Bi-variate and multiple logistic regressions were performed in order to identify the relationship between overdose experience and sociodemographic factors, risk behaviors, and clinical psychiatric measures. Results We found that having experienced or witnessed an opioid overdose within the previous year was common, overdose knowledge was generally high, but nearly half the participants reported low self-efficacy for effectively intervening in an overdose situation. In bivariate analyses, self-reported family problems (i.e., perceived problematic family interactions) were positively associated with both experiencing (t56 = 2.49; p < 0.05) and with witnessing a greater number of overdoses in the previous year (rhos = 0.31; p < 0.05). Having previously overdosed [Adjusted Risk Ratio (ARR) 1.7, 95% Confidence Interval (CI) 1.1–2.6] and higher SCL-90-R somatization scores (ARR 1.2, 95% CI 0.96 – 1.5) were independently associated in multivariable analyses with self-sustained overdose experience in the past year. Greater perceived likelihood of experiencing a future overdose and concern about medical problems were independently associated with witnessing a higher number of overdoses within the previous year. Over two thirds of the participants expressed interest in receiving training in overdose prevention and response. Conclusion Opioid overdose experience is very common among drug users in St. Petersburg, Russia, and interest in receiving training for overdose recognition and prevention was high. Future research should target the development of effective overdose recognition and prevention interventions, especially ones that include naloxone distribution and involve drug users' families. PMID:19630963

Induced abortion and anxiety, mood, and substance abuse disorders: isolating the effects of abortion in the national comorbidity survey.

PubMed

Coleman, Priscilla K; Coyle, Catherine T; Shuping, Martha; Rue, Vincent M

2009-05-01

The purpose of this study was to examine associations between abortion history and a wide range of anxiety (panic disorder, panic attacks, PTSD, Agoraphobia), mood (bipolar disorder, mania, major depression), and substance abuse disorders (alcohol and drug abuse and dependence) using a nationally representative US sample, the national comorbidity survey. Abortion was found to be related to an increased risk for a variety of mental health problems (panic attacks, panic disorder, agoraphobia, PTSD, bipolar disorder, major depression with and without hierarchy), and substance abuse disorders after statistical controls were instituted for a wide range of personal, situational, and demographic variables. Calculation of population attributable risks indicated that abortion was implicated in between 4.3% and 16.6% of the incidence of these disorders. Future research is needed to identify mediating mechanisms linking abortion to various disorders and to understand individual difference factors associated with vulnerability to developing a particular mental health problem after abortion.

Does distraction facilitate problem-focused coping with job stress? A 1 year longitudinal study.

PubMed

Shimazu, Akihito; Schaufeli, Wilmar B

2007-10-01

This study examined the sole and combined effects of problem-focused coping and distraction on employee well-being (i.e., stress responses and job performance) using two-wave panel survey data with a 1-year time lag. Participants were 488 male employees, who worked for a construction machinery company in western Japan. Hierarchical multiple regression analyses were conducted to examine whether distraction moderates the relationship of problem-focused coping with well-being. More use of problem-focused coping was negatively related to subsequent stress responses among those high in distraction. The combination of high problem-focused coping and high distraction was positively related to subsequent job performance, although it was limited only to the high job stress situation. Results suggest that the combination of high problem-focused coping and high distraction may lead to lower stress responses and better performance (but only in high job stress situations for performance) than the combination of high problem-focused coping and low distraction, at least for male blue-collar workers.

Program Administrator's Handbook. Strategies for Preventing Alcohol and Other Drug Problems. The College Series.

ERIC Educational Resources Information Center

CSR, Inc., Washington, DC.

This handbook is for administrators of programs in higher education settings which deal with alcohol and other drug (AOD) related problems. Chapter 1, "Defining the Problem, Issues, and Trends" examines the problem from various perspectives and presents the latest statistics on the extent of AOD use on campuses, specific problems affecting…

Latent profiles of problem behavior within learning, peer, and teacher contexts: identifying subgroups of children at academic risk across the preschool year.

PubMed

Bulotsky-Shearer, Rebecca J; Bell, Elizabeth R; Domínguez, Ximena

2012-12-01

Employing a developmental and ecological model, the study identified initial levels and rates of change in academic skills for subgroups of preschool children exhibiting problem behavior within routine classroom situations. Six distinct latent profile types of emotional and behavioral adjustment were identified for a cohort of low-income children early in the preschool year (N=4417). Profile types provided a descriptive picture of patterns of classroom externalizing, internalizing, and situational adjustment problems common to subgroups of children early in the preschool year. The largest profile type included children who exhibited low problem behavior and were characterized as well-adjusted to the preschool classroom early in the year. The other profile types were characterized by distinct combinations of elevated internalizing, externalizing, and situational problem behavior. Multinomial logistic regression identified younger children and boys at increased risk for classification in problem types, relative to the well-adjusted type. Latent growth models indicated that children classified within the extremely socially and academically disengaged profile type, started and ended the year with the lowest academic skills, relative to all other types. Implications for future research, policy, and practice are discussed. Copyright © 2012 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

Implicit and Explicit Drug-Related Cognitions during Detoxification Treatment Are Associated with Drug Relapse: An Ecological Momentary Assessment Study

ERIC Educational Resources Information Center

Marhe, Reshmi; Waters, Andrew J.; van de Wetering, Ben J. M.; Franken, Ingmar H. A.

2013-01-01

Objective: Relapse is a major problem in drug addiction treatment. Both drug craving and drug-related cognitions (e.g., attentional bias and implicit attitudes to drugs) may contribute to relapse. Using ecological momentary assessments, we examined whether craving and cognitions assessed during drug detoxification treatment were associated with…

The joint effects of person and situation factors on stress in spaceflight.

PubMed

Endler, Norman S

2004-07-01

Psychologists can play an important role in spaceflight and exploration. Indeed, their input at four specific stages in spaceflight can help to ensure successful missions. Psychologists have a role to play in: 1) Selection; 2) Training; 3) Real or Simulated Space Missions; and 4) Post-Flight Problems. During selection, psychologists can provide guidelines as to the appropriate coping styles for reacting to mission-related stressors. During training, psychologists can help astronauts to plan for, and cope with, problems (e.g., group conflict). Training in social sensitivity, or in specific coping styles (i.e., to be high in task-oriented coping), would be beneficial so that astronauts are able to deal with unforeseen problems. Task-oriented coping is related to control and efficiency, and reduces stress and anxiety. Emotion-oriented coping relates to anxiety for controllable situations, and task-oriented coping is most efficacious. A primary role for psychologists would be the investigation of what problems could arise from living with others in a limited space and for long periods of times. As such, investigations into group dynamics, physical and psychological stress caused by such an environment, and the lack of normal ways to deal with these problems should all be considered. It is also clear that the impact of spaceflight on an individual does not end with physical re-entry. On the contrary, the astronaut will also have to make a psychological post-flight "re-entry" readjustment to life on Earth. Psychologists have an important role to play during all four stages of the space program, especially in regards to person by situation interactions. That is, space is a novel environment for human beings, and we need to investigate how we can better improve the fit between astronauts and space situational stressors. Not only are person by situation interactions relevant for each of the four stages discussed above, but each of the stages interacts with one another bidirectionally and even multidirectionally.

Current Rural Drug Use in the US Midwest

PubMed Central

Dombrowski, Kirk; Crawford, Devan; Khan, Bilal; Tyler, Kimberly

2016-01-01

The nature and challenge of illicit drug use in the United States continues to change rapidly, evolving in reaction to myriad social, economic, and local forces. While the use of illicit drugs affects every region of the country, most of our current information about drug use comes from large urban areas. Data on rural drug use and its harms justify greater attention. Record overdose rates, unexpected outbreaks of HIV, and a dearth of treatment facilities point to a rapidly worsening health situation. While health sciences have made considerable progress in understanding the etiology of drug use and uncovering the link between drug use and its myriad associated harms, this promising scientific news has not always translated to better health outcomes. The scope of the problem in the Central Plains of the US is growing, and can be estimated from available sources. Clear remedies for this rising level of abuse are available, but few have been implemented. Suggestions for short-term policy remedies are discussed. PMID:27885362

The Tentative Drug Use Scale: A Quick and Relatively Problem Free Outcome Measure for Drug Abuse Prevention Projects

ERIC Educational Resources Information Center

Horan, John J.; Williams, John M.

1975-01-01

Difficulties involved with the evaluation of drug abuse prevention programs are numerous. Tentative Drug Use Scale (TDUS) was designed in response to a number of specific problems associated with obtaining behavioral data. Advantages of this scale over others are discussed. Reliability and validity information are provided. (Author)

Social anxiety and alcohol-related impairment: The mediational impact of solitary drinking.

PubMed

Buckner, Julia D; Terlecki, Meredith A

2016-07-01

Social anxiety disorder more than quadruples the risk of developing an alcohol use disorder, yet it is inconsistently linked to drinking frequency. Inconsistent findings may be at least partially due to lack of attention to drinking context - it may be that socially anxious individuals are especially vulnerable to drinking more often in specific contexts that increase their risk for alcohol-related problems. For instance, socially anxious persons may drink more often while alone, before social situations for "liquid courage" and/or after social situations to manage negative thoughts about their performance. Among current (past-month) drinkers (N=776), social anxiety was significantly, positively related to solitary drinking frequency and was negatively related to social drinking frequency. Social anxiety was indirectly (via solitary drinking frequency) related to greater past-month drinking frequency and more drinking-related problems. Social anxiety was also indirectly (via social drinking frequency) negatively related to past-month drinking frequency and drinking-related problems. Findings suggest that socially anxious persons may be vulnerable to more frequent drinking in particular contexts (in this case alone) and that this context-specific drinking may play an important role in drinking problems among these high-risk individuals. Copyright © 2016 Elsevier Ltd. All rights reserved.

Stage III Community-based Efficacy Trial for Mothering From the Inside Out

ClinicalTrials.gov

2018-01-05

Addiction; Substance Abuse Drug Chronic; Child Neglect; Child Neglect Emotional; Child Abuse; Parenting; Parent-Child Problem; Parent-Child Relations; Parent / Child Problem; Parenteral Drug Abuse; Parents

Alcohol-Related Problems among Younger Drinkers Who Misuse Prescription Drugs: Results from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC)

ERIC Educational Resources Information Center

Hermos, J.; Winter, M.; Heeren, T.; Hingson, R.

2009-01-01

The authors determined whether lifetime prescription drug misuse (PDM) associated with increased risks for alcohol-related problems among 18- to 34-year-old, NESARC respondents. Among 8222 "ever-drinkers," 15.4% reported ever "misusing sedatives, tranquilizers, painkillers or stimulants ... as prescriptions or from indirect sources." Outcomes were…

Emergency Victim Care. A Training Manual for Emergency Medical Technicians. Module 8--Crisis Intervention, Drug-Related Problems. Revised.

ERIC Educational Resources Information Center

Ohio State Dept. of Education, Columbus. Div. of Vocational Education.

This training manual for emergency medical technicians, one of 14 modules that comprise the Emergency Victim Care textbook, covers crisis intervention and drug related problems. Objectives stated for the two chapters are for the student to be able to describe: treating common mental disturbances, relating to those suffering a crisis in a…

Relationship of drug-addicted patients' personality disorders to social problem-solving changes during the rehabilitation process.

PubMed

Kolesnikova, Jelena; Miezitis, Solveiga; Osis, Guntars

2013-08-01

Drug-addicted patients exhibit various personality disorders that interfere with their adaptation to society, as well as their ability to participate in the rehabilitation process. The Latvian Rehabilitation Programme for drug addicts includes social problem-solving training to help patients reintegrate into society. However, the role of personality disorders has not been investigated in relation to this process. The aim of the study is to assess whether personality disorders predict changes in dimensions of social problem-solving after 6 months of rehabilitation for drug-addicted patients. The sample of this study consists of 31 drug-addicted patients from the Latvian rehabilitation centres aged 21-35 (females 21%, males 79%). Two inventories are used: the Social Problem-Solving Inventory--Revised (SPSI-R) and Millon(TM) Clinical Multiaxial Inventory--III (MCMI-III) adapted into Russian. Results of the study indicated that some MCMI-III personality disorders (Schizoid and Histrionic) negatively predicted SPSI-R Positive problem orientation, and narcissistic disorder positively predicted SPSI-R Avoidance style after 6 months in the Latvian Rehabilitation Programme. The other personality disorders did not predict social problem-solving dimensions. The results of the study suggest that some personality disorders are related to changes in social problem-solving dimensions for drug-addicted patients. Hence, it is important to consider the implications of particular personality disorders to facilitate the implementation of social problem-solving rehabilitation programmes.

Assessment of computer-related health problems among post-graduate nursing students.

PubMed

Khan, Shaheen Akhtar; Sharma, Veena

2013-01-01

The study was conducted to assess computer-related health problems among post-graduate nursing students and to develop a Self Instructional Module for prevention of computer-related health problems in a selected university situated in Delhi. A descriptive survey with co-relational design was adopted. A total of 97 samples were selected from different faculties of Jamia Hamdard by multi stage sampling with systematic random sampling technique. Among post-graduate students, majority of sample subjects had average compliance with computer-related ergonomics principles. As regards computer related health problems, majority of post graduate students had moderate computer-related health problems, Self Instructional Module developed for prevention of computer-related health problems was found to be acceptable by the post-graduate students.

A Qualitative Examination of Situational Risk Recognition Among Female Victims of Physical Intimate Partner Violence.

PubMed

Sherrill, Andrew M; Bell, Kathryn M; Wyngarden, Nicole

2016-07-01

Little is known about intimate partner violence (IPV) victims' situational risk recognition, defined as the ability to identify situational factors that signal imminent risk of victimization. Using semi-structured interviews, qualitative data were collected from a community sample of 31 female victims of IPV episodes involving substance use. Thirteen themes were identified, the most prevalent being related to the partner's verbal behavior, tone of voice, motor behavior, alcohol or drug use, and facial expression. Participants reporting at least some anticipation of physical aggression (61.3% of the sample) tended to identify multiple factors (M = 3.47), suggesting numerous situational features often contribute to situational risk recognition. © The Author(s) 2015.

Addressing policy needs for prevention and control of type 2 diabetes in India.

PubMed

Atre, Sachin

2015-09-01

India carries nearly one-fifth of the global burden of diabetes cases, the majority of which are of type 2 diabetes. Recognising the need for controlling diabetes, the Government of India has initiated a national level programme for prevention and control of diabetes along with other non-communicable diseases in 2008. Despite being piloted and implemented, there is hardly any published literature about the national level situation of diabetes and its control efforts. The present article is written with the aim to fill this gap to some extent and to provide a situational analysis of the diabetes problem in India in a holistic way, addressing policy needs for the national programme. It focuses on three main areas, namely, awareness of diabetes, costs of drugs for its treatment and healthcare-system related issues. It argues that poor coverage and weak implementation of the national level programme are major forces that push patients to seek help in the weakly regulated private sector. Approaching the private sector is likely to increase the cost of care, which in turn can lead to an increased financial burden for patients and their families due to factors such as patients' lack of awareness about diabetes, poor drug price regulation and prescriptions including combinations and/or patented products of medicines used for treating diabetes by the private sector. This article addresses several needs such as strengthening the national programme and increasing its reach to unreached districts, exerting drug price regulation and implementing community-based participatory programmes for prevention and management of type 2 diabetes. It also underscores a need for piloting and implementing a robust national level electronic reporting system for diabetes programmes. © Royal Society for Public Health 2015.

Alcohol and other drug problems in Australia: the urgent need for nurse education.

PubMed

de Crespigny, C

1996-07-01

The economic, social and health costs associated with alcohol and other drug use, including medicines, impact on the Australian community profoundly. Many Australians use alcohol and other drugs (AODs) on a regular basis and a significant number experience problems at some time. There are about 25,000 drug-related deaths annually, the majority of which are related to alcohol and tobacco use. Many young people die or are injured as a direct result of alcohol intoxication, accidental overdose and related problems, and significant numbers of elderly people are hospitalised, permanently incapacitated or suffer avoidable trauma through adverse drug reactions and side-effects of medications. It is estimated that at least 25 per cent of acute hospital beds hold patients with alcohol-related problems directly associated with the medical diagnosis, and there are comparable numbers of people needing social and other forms of assistance at some time. Despite the preventative nature of many AOD problems and the call for harm reduction, timely intervention and support for the thousands of Australians attending hospitals, community health and mental health services, nurses are yet to effectively assist the community in preventing and responding to the range of AOD problems. Nursing policy, guidelines and clinical expertise are required to assist the community in addressing this issue. Undergraduate, postgraduate and continuing education have a vital role to play in providing the profession with the knowledge, skills and research base to meet this challenge.

Procedural versus Content-Related Hints for Word Problem Solving: An Exploratory Study

ERIC Educational Resources Information Center

Kock, W. D.; Harskamp, E. G.

2016-01-01

For primary school students, mathematical word problems are often more difficult to solve than straightforward number problems. Word problems require reading and analysis skills, and in order to explain their situational contexts, the proper mathematical knowledge and number operations have to be selected. To improve students' ability in solving…

[Design of a conceptual model on the transference of public health research results in Honduras].

PubMed

Macías-Chapula, César A

2012-01-01

To design a conceptual model on the transference of public health research results at the local, context level. Using systems thinking concepts, a soft systems approach (SSM) was used to analyse and solve what was perceived as a problem situation related to the transference of research results within Honduras public health system. A bibliometric analysis was also conducted to enrich the problem situation. Six root definitions were defined and modeled as relevant to the expressed problem situation. This led to the development of the conceptual model. The model obtained identified four levels of resolution as derived from the human activities involved in the transference of research results: 1) those of the researchers; 2) the information/documentation professionals; 3) health staff; and 4) the population/society. These actors/ clients and their activities were essential to the functioning of the model since they represent what the model is and does. SSM helped to design the conceptual model. The bibliometric analysis was relevant to construct the rich image of the problem situation.

[Coping with everyday stress in different problem areas- comparison of clinically referred and healthy adolescents].

PubMed

Escher, Fabian; Seiffge-Krenke, Inge

2013-09-01

Studies are lacking that analyze how clinically referred adolescents and healthy adolescents cope with everyday stressors. Clinically referred adolescents from three problematic domains (diverse disorders including delinquency, drug abuse, and depression) were compared to healthy adolescents using the Coping Across Situations Questionnaire (Seiffge-Krenke, 1995) and a short version of the Youth Self-Report (Achenbach, 1991). The different clinical groups (n = 469) showed unique patterns concerning their coping styles. The group of depressed youth altogether showed lower coping activities. The youth from institutions for drug abusive youth used more dysfunctional coping. The adolescents from youth welfare services (diverse disorders including delinquency) were more active in both dysfunctional and functional coping than the other two clinically referred groups. The control group showed more functional and less dysfunctional coping. The clinically referred adolescents did not differentiate in their coping behavior, depending on the type of stressor. Gender effects were apparent, albeit negligible. Clinically referred youth are unable to adapt their coping behavior according to the given situation.

[Therapeutical itineraries in poverty situations: diversity and plurality].

PubMed

Gerhardt, Tatiana Engel

2006-11-01

The low-income population's practices and strategies for coping with daily problems, especially in relation to the search for health care, are analyzed by means of therapeutic itineraries. To unveil this population's coping strategies in relation to their health-disease process means identifying the individual and collective strategies and the meaning of these social dynamics related directly or indirectly to health. The search for treatment is described and analyzed here in relation to socio-cultural practices in terms of the paths chosen by individuals in the attempt to solve their health problems. The study thus indicates an interdisciplinary and multi-methodological and conceptual approach relating concepts of practices, strategies, and health and life situations. The point of departure is that ways of coping with health problems require an understanding of the strategies developed in a process of (re)appropriation and (re)construction of knowledge. It is equally important to identify social support networks and individual capacity to mobilize such resources. The recognition of these practices allows (re)directing actions in collective health.

Epidemiological, clinical and sleep laboratory evaluations of insomnia

NASA Technical Reports Server (NTRS)

Bixler, E. O.; Kales, A.; Kales, J. D.

1975-01-01

Epidemiological studies have contributed to the understanding of the total scope of the insomnia problem, both in terms of the incidence of sleep difficulties, and the extent and frequency of hypnotic drug use. Clinical studies - at the Sleep Research and Treatment Center - have been used to evaluate the medical, psychological, pharmacological and situational factors contributing to insomnia, and to evaluate the psychotherapy and chemotherapy best suited to treatment of insomnia. The sleep laboratory studies were of two types: (1) the study of sleep induction, sleep maintenance, and sleep stages, and (2) the use of hypnotic drugs, emphasizing their effectiveness in inducing and maintaining sleep, and the duration of this effectiveness.

An Inside Look at Homeless Youths’ Social Networks: Perceptions of Substance Use Norms1

PubMed Central

Melander, Lisa A.; Tyler, Kimberly A.; Schmitz, Rachel M.

2016-01-01

Substance use among homeless young people is a pervasive problem, and there have been many efforts to understand more about the dynamics of this health compromising behavior. The current study examined perceived substance use norms within homeless youths’ social networks utilizing in-depth interviews. The sample included 19 homeless individuals aged 16 to 21. Four elements of substance use within networks emerged: substance use choices, drug use safety issues, encouragement and/or discouragement, and appropriate situations in which substance use is condoned. These findings provide unique insight into the norms associated with drug and alcohol use within homeless youths’ social networks. PMID:26989340

Multidrug-resistant tuberculosis: The problem and some priorities in controlling it.

PubMed

Hoffner, Sven

2016-12-01

Multidrug-resistant tuberculosis (MDR-TB), and even more severe forms of drug resistance, cause significant problems and costs for national TB control programs and constitutes an increasing public health concern globally. In parts of the former Soviet Union, the prevalence of MDR-TB is as high as 50% and one third of all newly detected TB patients are infected with MDR strains. Such strains transmit and certain MDR-TB clones constitute an important part of the problem, especially in high MDR-TB burden areas. There are several actions that should be given priority to control this situation. A first important step is timely detection of all patients infected with resistant strains, which makes possible prompt change of standard TB chemotherapy to more effective combinations of drugs. This is important both from the public health and clinical perspectives, since it renders the individual patient noninfectious and subsequently cured. Early detection of MDR-TB also allows infection control to be focused where it is most needed. Strengthened infection control measures are crucial for limiting the ongoing spread of resistant TB in hospitals and elsewhere. In addition, a sustainable drug supply must be ensured to guarantee that all patients are initiated on effective treatment and can avoid interruptions due to drug shortages. An extra focus should be put on vulnerable cases, such as immunosuppressed individuals, prisoners, drug addicts, and migrants, in whom TB is generally more frequent and difficult to control than in the normal population. Finally, political support is needed to ensure necessary infrastructures, human and financial resources to effectively control drug resistant TB. Copyright © 2016.

Safety of non-prescription medicines: knowledge and attitudes of Italian pharmacy customers.

PubMed

Cuzzolin, Laura; Benoni, Giuseppina

2010-02-01

A survey was designed to investigate customers attitudes and knowledge toward non-prescription medicines taken on a self-medication basis but not devoid of risks. Community pharmacies in Italy. Forty-four pharmacies participated in the project. On the basis of an anonymous questionnaire, face-to-face interviews were made to customers buying a non-prescription medicine over a 2-month period. The questionnaire included information about socio-demographic characteristics of the interviewed subjects and 18 items designed to elicit information about the kind of medicine purchased and reason of use, general product knowledge in relation to quality and risks, attitudes toward this kind of drugs, concurrent prescription drug use and the quality of relationship with the pharmacist. During the study period, 613 interviews were collected. The most frequently non-prescription medicines purchased by customers were non-steroidal anti-inflammatory drugs, paracetamol and medicines for gastrointestinal problems. The most of interviewees referred to read carefully the package inserts or to ask information to pharmacists. Moreover, they reported to consider non-prescription medicines easy to manage and to be used only for minor ailments and for short periods. 55.3% of customers reported to have been taking at least a prescription drug, mostly antihypertensives or other cardiovascular medicines, in association with non-prescription medicines. In this situation, interviewees often did not inform pharmacists about chronic therapies. Our interviews demonstrate that, in general, Italian customers have a cautious approach toward non-prescription medicines and are informed on their use. However, in case of a long-term use, interviewees underestimate risks related to possible physiological/pathological changes in their organism or to interactions with other drugs.

Pretest Differences in Drug-Related Variables among Intact College Classes: Implications for Outcome Evaluation in Drug Education.

ERIC Educational Resources Information Center

Gonzalez, Gerardo M.; Haney, Michael L.

1992-01-01

Identified significant pretest differences in drug-related variables in college students from alcohol and drug education class (n=99), stress management class (n=44), and social problems class (n=80). Higher levels of alcohol and drug abuse among students in drug abuse course suggests student users are possibly being attracted to course as means…

Are You in Recovery from Alcohol or Drug Problems? Know Your Rights

MedlinePlus

... drug-related criminal ac- tivity (including possession or sale). This bar ordinarily lasts for 3 years after ... of a drug-related felony (including possession or sale) after August 22, 1996. However, States may “opt ...

[Current situation and developmental trend of anthelmintics by bibliometrics].

PubMed

Zheng, Qi; Chen, Ying; Tian, Li-Guang; Zhou, Xiao-Nong

2009-08-01

To understand the current situation and developmental trend of anthelmintics in English journals through a bibliometric analysis. The literature was searched in Pubmed Database (1997-2007) using the following key words: "drug therapy", "anthelmintics", "humans", "pharmacology", and "parasitology". Access Database was constructed by relative literature through proper data admission method. The relative articles in the database were sorted by different categories, such as "research categories", "publishing year" and "research drug". Data were analyzed by using SPSS software. The annual number of anthelmintics articles increased steadily from year 1997 to 2007. The average number of annual increase was about 6. The major research category was applied research. The major diseases were schistosomiasis, filariasis, ascariasis, echinococcosis and hookworm disease. The number of articles on schistosomiasis was higher than that of other four diseases (P<0.05). The major drugs involved were albendazole, praziquantel, mebendazole, ivermectin and diethylcarbamazine. Articles on the anthelmintics were published mostly in medical journals. From the total database, articles published at the top five journals occupied 5.52%, 4.39%, 3.76%, 3.26%, and 3.26%, respectively. Increasingly importance has been attached to anthelmintics in the last decade. Meanwhile, the researchers focused on a few anthelmintics, and it is inevitable to develop new drugs.

5 Tips for Using Your Microwave Oven Safely

MedlinePlus

... not being emitted in this situation.” How to Report Problems In the FDA’s experience, most microwave ovens ... FDA’s page on microwave ovens .) You also can report any suspected radiation-related problems or injuries directly ...

Qualitative analysis of high-risk drug and alcohol use situations among severely mentally ill substance abusers.

PubMed

Bradizza, Clara M; Stasiewicz, Paul R

2003-01-01

Situational factors have been found to influence relapse to alcohol and drug use in general samples of substance abusers. However, little research exists examining the influence of interpersonal and intrapersonal determinants in samples of individuals dually diagnosed with a severe mental illness (SMI) and a substance use disorder (SUD). This study assessed high-risk alcohol and drug use situations in dually diagnosed individuals using focus group methodology. Qualitative data analysis yielded 10 themes that encompassed 33 high-risk situations: Psychological symptoms, positive and negative affect, reminders of substance use, being around people who use drugs and alcohol, interpersonal conflict, offers of drugs or alcohol, experiencing loss, receiving money, loss of appetite, and being abstinent. These results suggest that individuals with an SMI and SUD experience a number of unique high-risk situations that differ from those reported by non-SMI substance abusers. This study provides the basis for future quantitative studies assessing the prevalence of these situations in representative samples of SMI alcohol and drug abusers. This information allows for the development of relapse assessment instruments and treatment strategies appropriate for this population. Copyright 2002 Elsevier Science Ltd.

Consumption of tobacco, alcohol and recreational drugs in university students in Belgium and the Netherlands: the role of living situation.

PubMed

Boot, Cécile R L; Rosiers, Johan F M; Meijman, Frans J; Van Hal, Guido F G

2010-01-01

Studying at university/college is associated with consumption of tobacco, alcohol and recreational drugs. This lifestyle may be associated with moving outside parental control. The aim of this study was to investigate differences between students living with their parents and students living alone or with peers regarding substance use in Belgium (Antwerp) and The Netherlands (Amsterdam). The results of two separate surveys, one in Amsterdam (8,258 students) and one in Antwerp (27,210 students) were compared. Both questionnaires contained items about consumption of tobacco, alcohol and recreational drugs, and whether students considered their consumption as a problem and relevant confounders. Students living with their parents were compared with students living alone or with peers, using multivariate logistic regression analyses, separate for Antwerp and Amsterdam. Consumption of tobacco was associated with living with peers. Similar patterns were shown for consumption of alcohol and recreational drugs. Living with peers rather than living with family or alone was a determinant of problematic substance use as well. Patterns were similar for both universities in two different countries. Students living alone or with peers in Amsterdam and Antwerp may be at risk for problems concerning their consumption of recreational drugs. These findings may have implications for targeted prevention programs.

Drug Use in a Rural Secondary School in Kenya

ERIC Educational Resources Information Center

Ndetei, David M.; Khasakhala, Lincoln I.; Mutiso, Victoria; Ongecha-Owuor, Francisca A.; Kokonya, Donald A.

2010-01-01

Alcohol abuse and alcohol-related use problems among adolescents are highly prevalent and are a major concern worldwide. This study estimated the prevalence of drug abuse, knowledge about drug abuse and its effect on psychosocial well-being and induced behavioral problems among students of a public rural secondary school that admitted both girls…

Handbook for the Prevention and Control of Drug Problems.

ERIC Educational Resources Information Center

Parsippany - Troy Hills Board of Education, Parsippany, NJ.

Guidelines for teachers relative to drug abuse are developed in this handbook offering special steps necessary in attempting to prevent and/or guide students with a drug problem. Stress is placed on helping each student individually understand the forces affecting him, and in helping him form the necessary positive attitudes to cope with each…

[Current situation of and the political measures for drug abuse/dependence].

PubMed

Wada, Kiyoshi; Ozaki, Shigeru; Kondo, Ayumi

2008-04-01

More than 10 years has passed since 1995 when the third epidemic of methamphetamine abuse started in Japan. We are now still in the third epidemic of methamphetamine abuse, thought the current situation of drug abuse/dependence has obviously changed from previously. Considering several kinds of nationwide surveys and censuses, the authors summarized the change as follows: a) obvious decrease in solvent abuse/dependence, b) stabilization of methamphetamine abuse/dependence, c) increase in abuse of such drugs as cannabis or MDMA which don't have high potential to cause drug-induced psychosis, and d) emergence of non-regulatory drugs represented by designer drugs. These imply the change a) from "hard drugs" to "soft drugs", b) from Japanese unique situation which is symbolized by solvent abuse to Western situation which is symbolized by cannabis abuse, and c) from "illicit drugs" to "non-regulatory drugs". These characteristics reveal that there is the limitation to the Japanese Government policy which has tried to control the drug issue mainly as criminal cases for many years and that it is time now to change its policy. The authors stress the necessities of development of medical treatment targeting drug dependence and of its social support system.

Medication review using a Systematic Tool to Reduce Inappropriate Prescribing (STRIP) in adults with an intellectual disability: A pilot study.

PubMed

Zaal, Rianne J; Ebbers, Susan; Borms, Mirka; Koning, Bart de; Mombarg, Erna; Ooms, Piet; Vollaard, Hans; van den Bemt, Patricia M L A; Evenhuis, Heleen M

2016-08-01

A Systematic Tool to Reduce Inappropriate Prescribing (STRIP), which includes the Screening Tool to Alert doctors to Right Treatment (START) and the Screening Tool of Older Peoples' Prescriptions (STOPP), has recently been developed in the Netherlands for older patients with polypharmacy in the general population. Active involvement of the patient is part of this systematic multidisciplinary medication review. Although annual review of pharmacotherapy is recommended for people with an intellectual disability (ID), a specific tool for this population is not yet available. Besides, active involvement can be compromised by ID. Therefore, the objective of this observational pilot study was to evaluate the process of medication review using STRIP in adults with an ID living in a centralized or dependent setting and the identification of drug-related problems using this tool. The study was performed in three residential care organizations for ID. In each organization nine clients with polypharmacy were selected by an investigator (a physician in training to become a specialized physician for individuals with an ID) for a review using STRIP. Clients as well as their legal representatives (usually a family member) and professional caregivers were invited to participate. Reviews were performed by an investigator together with a pharmacist. First, to evaluate the process time-investments of the investigator and the pharmacist were described. Besides, the proportion of reviews in which a client and/or his legal representative participated was calculated as well as the proportion of professional caregivers that participated. Second, to evaluate the identification of drug-related problems using STRIP, the proportion of clients with at least one drug-related problem was calculated. Mean time investment was 130minutes for the investigator and 90minutes for the pharmacist. The client and/or a legal representatives were present during 25 of 27 reviews (93%). All 27 professional caregivers (100%) were involved. For every client included at least one drug-related problem was identified. In total 127 drug-related problems were detected, mainly potentially inappropriate or unnecessary drugs. After six months, 15.7% of the interventions were actually implemented. Medication review using STRIP seems feasible in adults with an ID and identifies drug-related problems. However, in this pilot study the implementation rate of suggested interventions was low. To improve the implementation rate, the treating physician should be involved in the review process. Besides, specific adaptations to STRIP to address drug-related problems specific for this population are required. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Pharmacotherapy in nursing homes].

PubMed

Kersten, Hege; Ruths, Sabine; Wyller, Torgeir Bruun

2009-09-10

There is a high risk of drug-related problems in nursing homes due to polypharmacy, multi-morbidity and age-related changes. We describe the drug use and compare the pharmacotherapy in two nursing homes with different staffing of physicians. We included 48 long-term patients from two nursing homes in Oslo; i.e. nursing home A (24 patients) and nursing home B (24 patients). A pharmacist recorded information on patients' drug use, identified and classified drug-related problems, and classified the drugs used according to their anticholinergic burden. Two physicians (with experience in geriatrics and nursing home medicine) assessed the clinical importance of the drug-related problems independently from each other. The physicians were blinded with respect to which nursing home the patients came from. Patients in nursing home A used a median (interquartile range [IQR]) of 7.0 (5.3-11.0) drugs, and those in nursing home B used 9.5 (8.0-12.8); the median difference was 2.0, 95% CI 1.0-4.0, p = 0.006). Patients also had lower anticholinergic drug scores in nursing home A (1.0 [0.0-2.0]) than in nursing home B (2.0 [2.0-3.8]); median difference 1.0, 95% CI 0.0-2.0, p = 0.009). Patients in home A also had lower numbers of drug-related problems (3.0 [2.0-4.0]) than those in home B (5.5 [3.3-8.0]); median difference 1.0, 85% CI 0.0-3.0, p = 0.007. No significant differences were found between the nursing homes with regard to patients' age, co-morbidity, kidney function, or dementia state, but nursing home A had a better staffing of physicians. The number of drugs used as well as the quality indicators varied considerably between the nursing homes assessed. Differences in physician staffing might be one reasonable explanation. Our study highlights the importance of systematic multidisciplinary medication reviews for quality improvement in nursing homes.

[Self-medication, self-prescription and medicating «by proxy» in paediatrics].

PubMed

Valenzuela Ortiz, María; Sánchez Ruiz-Cabello, Francisco Javier; Uberos, José; Checa Ros, Ana Fátima; Valenzuela Ortiz, Cristina; Augustín Morales, María Carmen; Muñoz Hoyos, Antonio

2017-05-01

Self-prescribing or medicating 'by proxy' is not an autonomous, free and voluntary decision in the case of children. On the contrary, in this case it is based on the subjective interpretation of symptoms made by the mother or by a third person who is legally responsible for the minor. In our opinion, to analyse this situation is of great importance in order to know the determining factors, perceptions, and realities related to this problem. Our proposal is to perform a prospective observational study for analysing maternal and familiar determinant factors related to self-prescribing and self-medicating 'by proxy' in paediatrics. A validated survey was developed to be applied to mothers of children aged 0 to 14 who are users of the Paediatric Emergency Department in a hospital. A total of 1,714 mothers were recruited in a random period of time. This sample included 345 mothers who exclusively self-medicated their children (case group), and 1,369 mothers (control group) who did not meet this requirement. The overall percentage of medicating 'by proxy' was 32.8%. There is a significant association between self-medicating and educational level of the mother, the number of children, and the birth order among siblings. Neither maternal age nor social-occupational level are related to this problem. Most frequently used drugs include antipyretics and 'anticatharrals', usually administered as a monotherapy. Our results seem to indicate that the educational level and the parental experience acquired with previous children could generate the required confidence in parents to choose the medication by themselves. Almost 85% of these drugs come from the 'home first-aid kit.' Copyright © 2016 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

Posttraumatic distress in security guards and the various effects of social support.

PubMed

Declercq, Frédéric; Vanheule, Stijn; Markey, Samuel; Willemsen, Jochem

2007-12-01

This study investigates the effects of six types of social support on distress and posttraumatic stress disorders in security guards who did and did not encounter a critical incident. Three types of social support were significantly related to distress and posttraumatic stress disorder: emotional support in problem situations, instrumental support, and social companionship. Emotional support in problem situations paradoxically appeared to have an aggravating effect on distress and posttraumatic stress, whereas instrumental support and social companionship had a mitigating outcome.

Problems with drugs in Croatia.

PubMed

Vrhovac, B

1997-01-01

Croatia has 4.8 million inhabitants, 11,800 physicians, 2000 pharmacists, two now shareholding, pharmaceutical companies (about 6500 employees, total sales of about 350 million US dollars). There are a number of problems due to the war (GNP fell from 3800 to about 1500 US dollars), occupation of 25% of its territory, 0.5 million refugees and lack of resources (139 US dollars/capita for health, about 40 US dollars i.e. 30%!! for drugs)--about three times less than before the aggression. The drug situation is controlled with the help of: (1) donations (approximate value of 600 million US dollars since 1991 from Europe and US), (2) (essential) drug formularies--250 for outpatients, and 580 generic names for various levels of hospital use, (3) special efforts to purchase drugs of good quality at a reasonable price (a kind of tender), (4) control of prescribing (prescriptions, specialists referral) especially by GPs. A new Medicines Act is in preparation and about 1000 generic names are on the market. DRUG EDUCATION: Pharmaca: the Croatian journal of pharmacotherapy has been published since 1962, there are several Drug bulletins (one published since 1975); special chapters on clinical pharmacology in textbooks, translation of three editions of Laurence's textbook with special commentary and adaptation to local needs; ADR spontaneous and intensive monitoring (WHO programme) with a personal feedback to the reporters and regular articles on drug use in a number of periodicals. Data on drug consumption indicates that there is room for improvement of prescribing. There is an enthusiasm for 'vasoactive drugs'--after dipirydamole came oxpentifylline and antimicrobials are always overprescribed. All these problems will hopefully decrease when the war finally stops and when industry (especially tourism) starts being fruitful again. In any case the importance of teaching of pharmacotherapy at the under- and postgraduate level should be recognized. Copyright 1997 by John Wiley & Sons, Ltd.

Tantrums, Emotion Reactions and Their EEG Correlates in Childhood Benign Rolandic Epilepsy vs. Complex Partial Seizures: Exploratory Observations.

PubMed

Potegal, Michael; Drewel, Elena H; MacDonald, John T

2018-01-01

We explored associations between EEG pathophysiology and emotional/behavioral (E/B) problems of children with two types of epilepsy using standard parent questionnaires and two new indicators: tantrums recorded by parents at home and brief, emotion-eliciting situations in the laboratory. Children with Benign Rolandic epilepsy (BRE, N = 6) reportedly had shorter, more angry tantrums from which they recovered quickly. Children with Complex Partial Seizures (CPS, N = 13) had longer, sadder tantrums often followed by bad moods. More generally, BRE correlated with anger and aggression; CPS with sadness and withdrawal. Scores of a composite group of siblings ( N = 11) were generally intermediate between the BRE and CPS groups. Across all children, high voltage theta and/or interictal epileptiform discharges (IEDs) correlated with negative emotional reactions. Such EEG abnormalities in left hemisphere correlated with greater social fear, right hemisphere EEG abnormalities with greater anger. Right hemisphere localization in CPS was also associated with parent-reported problems at home. If epilepsy alters neural circuitry thereby increasing negative emotions, additional assessment of anti-epileptic drug treatment of epilepsy-related E/B problems would be warranted.

[The Swiss population and drug problems: perception of the problems and proposals for solutions].

PubMed

Leuthold, A; Cattaneo, M; Dubois-Arber, F

1993-01-01

The aim of this study is to investigate which problems in relation with drug abuse are considered to be the most important by the Swiss population and which measures do they support to reduce them. Base for this study are the results of a representative telephone survey realized in october 1991 with 1004 Swiss residents. People are mostly concerned with problems related to the danger for youth and those concerning public order but also with the human condition of addicts. Drug addicts are considered as people who have lost the sense of live, as sick but also as dangerous and less truthful. Supported are overall prevention, offers for therapies, the repression of trafficking and money-laundering but not of drug users as well as measures going in the direction of harm-minimisation (shooting rooms, medical prescription of drugs). Younger people, those with higher education and the german-speaking population have a more positive view of drug addicts and support measures in the sense of harm-minimisation. Elder people and the french-speaking population have a rather negative view of drug addicts and don't favour measures for harm-minimisation.

The Sami Languages(s), Maintenance and Intellectualistion.

ERIC Educational Resources Information Center

Bull, Tove

2002-01-01

Gives an overview of the current socioliniguistic situation of the Sami language in Northern Scandinavia, focusing on the situation in North Norway in particular. Describes the historical development and discusses issues, problems, and practices relating to Sami language politics and planning in reaction to the use of this language in…

A prospective study to evaluate a new residential community reintegration programme for severe chronic brain injury: the Brain Integration Programme.

PubMed

Geurtsen, G J; Martina, J D; Van Heugten, C M; Geurts, A C H

2008-07-01

To assess the effectiveness of a residential community reintegration programme for participants with chronic sequelae of severe acquired brain injury that hamper community functioning. Prospective cohort study. Twenty-four participants with acquired brain injury (traumatic n = 18; stroke n = 3, tumour n = 2, encephalitis n = 1). Participants had impaired illness awareness, alcohol and drug problems and/or behavioural problems. A skills-oriented programme with modules related to independent living, work, social and emotional well-being. The Community Integration Questionnaire, CES-Depression, EuroQOL, Employability Rating Scale, living situation and work status were scored at the start (T0), end of treatment (T1) and 1-year follow-up (T2). Significant effects on the majority of outcome measures were present at T1. Employability significantly improved at T2 and living independently rose from 42% to over 70%. Participants working increased from 38% to 58% and the hours of work per week increased from 8 to 15. The Brain Integration Programme led to a sustained reduction in experienced problems and improved community integration. It is concluded that even participants with complex problems due to severe brain injury who got stuck in life could improve their social participation and emotional well-being through a residential community reintegration programme.

Inadequate prescription-drug coverage for Medicare enrollees--a call to action.

PubMed

Soumerai, S B; Ross-Degnan, D

1999-03-04

In summary, most low-income elderly and disabled persons lack coverage for important medications, resulting in avoidable deterioration of health among those with chronic illnesses and use of expensive institutional services. Rapidly escalating drug costs, more restrictive drug-coverage policies, and a dramatic increase in the population of elderly and disabled persons will exacerbate these problems. With the current budget surplus, as well as bipartisan concern about health care needs and public concern about drug costs and coverage, it is time to act responsibly and aggressively. We recommend a national replication of the best features of state pharmacy-assistance programs in a federal-state insurance program for low-income Medicare enrollees, either alone or in combination with expanded Medicare coverage. Such a program will reduce the current inequitable situation in which the most vulnerable patients have the least access to medications, with serious medical and economic consequences.

Prenatal Drug Exposure and Adolescent Cortisol Reactivity: Association with Behavioral Concerns.

PubMed

Buckingham-Howes, Stacy; Mazza, Dayna; Wang, Yan; Granger, Douglas A; Black, Maureen M

2016-09-01

To examine stress reactivity in a sample of adolescents with prenatal drug exposure (PDE) by examining the consequences of PDE on stress-related adrenocortical reactivity, behavioral problems, and drug experimentation during adolescence. Participants (76 PDE, 61 non-drug exposed [NE]; 99% African-American; 50% male; mean age = 14.17 yr, SD = 1.17) provided a urine sample, completed a drug use questionnaire, and provided saliva samples (later assayed for cortisol) before and after a mild laboratory stress task. Caregivers completed the Behavior Assessment System for Children, Second Edition (BASC II) and reported their relationship to the adolescent. The NE group was more likely to exhibit task-related cortisol reactivity compared to the PDE group. Overall behavior problems and drug experimentation were comparable across groups with no differences between PDE and NE groups. In unadjusted mediation analyses, cortisol reactivity mediated the association between PDE and BASC II aggression scores (95% bootstrap confidence interval [CI], 0.04-4.28), externalizing problems scores (95% bootstrap CI, 0.03-4.50), and drug experimentation (95% bootstrap CI, 0.001-0.54). The associations remain with the inclusion of gender as a covariate but not when age is included. Findings support and expand current research in cortisol reactivity and PDE by demonstrating that cortisol reactivity attenuates the association between PDE and behavioral problems (aggression) and drug experimentation. If replicated, PDE may have long-lasting effects on stress-sensitive physiological mechanisms associated with behavioral problems (aggression) and drug experimentation in adolescence.

Prescription drug abuse: problem, policies, and implications.

PubMed

Phillips, Janice

2013-01-01

This article provides an overview on prescription drug abuse and highlights a number of related legislative bills introduced during the 112th Congress in response to this growing epidemic. Prescription drug abuse has emerged as the nation's fastest growing drug problem. Although prescription drugs have been used effectively and appropriately for decades, deaths from prescription pain medicine in particular have reached epidemic proportions. Bills related to prescription drug abuse introduced during the 112th Congress focus on strengthening provider and consumer education, tracking and monitoring prescription drug abuse, improving data collection on drug overdose fatalities, combating fraud and abuse in Medicare and Medicaid programs, reclassifying drugs to make them more difficult to prescribe and obtain, and enforcing stricter penalties for individuals who operate scam pain clinics and sell pain pills illegitimately. This article underscores the importance of a multifaceted approach to combating prescription drug abuse and concludes with implications for nursing. Copyright © 2013. Published by Mosby, Inc.

Educational Policy and the Drug Problem--A Redistributive Politics Issue

ERIC Educational Resources Information Center

Caliguri, Joseph P.

1975-01-01

The drug problem exists as a cluster of problems affecting broad interests or groups. The issues are redistributive in that everything relates to everything else. It seems apparent that a cluster of policies and programs need development as well as genuine citizen participation in the formulation of these policies. (Author)

Relationship between stress symptoms and drug use among secondary students.

PubMed

Frade, Iracema Francisco; De Micheli, Denise; Monezi Andrade, André Luiz; de Souza-Formigoni, Maria Lucia Oliveira

2013-01-01

The aim of this study was to evaluate the relationship between drug use and four kinds of stress symptoms in 954 Brazilian students from the 6th to the 11th grades, in 4 public and 5 private schools in the city of Sao Paulo. Based on their answers to the Drug Use Screening Inventory (DUSI-R) and to the Stress Scale for Adolescents (SSA), we compared regular drug users with non/occasional drug users regarding the frequency of four kinds of stress symptoms (psychological, cognitive, physiological, interpersonal), and the period in which it happened. When compared to non/occasional drug users, regular drug users presented higher levels of psychological, cognitive and physiological symptoms of stress and these symptoms were in the most severe spectrum of severity (near to exhaustion and exhaustion). The association between drug use and stress was even stronger in the youngest age group (11 to 13 years old). Most of the regular drug users were 16 years old and over, from upper-middle class families, had poor family relationships and more academic problems. These results confirm the association between drug use and stress in adolescents and highlight the need for early screening and intervention in both drug use and stressful situations.

Chemsex: are we prepared?

PubMed

Redondo Domínguez, David; Picazo, Luis; Docavo Barrenechea-Moxo, María Luisa; González Del Castillo, Juan

2018-04-15

It was with great interest that we read the article published by Dolengevich-Segal (Dolengevich-Segal et al., 2017), which provides an interesting review of the emerging phenomenon known as chemsex and the different drugs used in this type of practice.We would like to highlight the importance and usefulness of this paper, given the progressive increase in the prevalence of drug use in the context of sexual activity among men who have sex with men (MSM) in Western Europe (Fernández-Dávila et al,. 2016). This situation raises the need to launch epidemiological studies to assess the phenomenon - not only, however, from the point of view of mental health, but also from the field of infectious diseases and toxicology. We must not forget that this type of practice involves an increase in the risk of infection by sexually transmitted diseases and the problems that drug use can cause from the toxicological point of view. Both are causes of emergency room (ER) consultation, and more training in how to tackle the problems arising from chemsex should be provided.

Professional vs. Personal Factors Related to Physicians' Attitudes toward Drug Testing.

ERIC Educational Resources Information Center

Linn, Lawrence S.; And Others

1990-01-01

Examined attitudes toward alcohol and drug testing in workplace in relation to practice characteristics, religious and political ideology, personal use experiences, views of drug problems, and other characteristics of 303 physicians. Found that drug testing was most favored by those who more strongly believed in efficacy of treatment for abusers,…

Effectiveness of a drug dosing service provided by community pharmacists in polymedicated elderly patients with renal impairment — a comparative study

PubMed Central

2013-01-01

Background Drug dosing errors are common in renal-impaired patients. Appropriate dosing adjustment and drug selection is important to ensure patients’ safety and to avoid adverse drug effects and poor outcomes. There are few studies on this issue in community pharmacies. The aims of this study were, firstly, to determine the prevalence of dosing inadequacy as a consequence of renal impairment in patients over 65 taking 3 or more drug products who were being attended in community pharmacies and, secondly, to evaluate the effectiveness of the community pharmacist’s intervention in improving dosing inadequacy in these patients when compared with usual care. Methods The study was carried out in 40 Spanish community pharmacies. The study had two phases: the first, with an observational, multicentre, cross sectional design, served to determine the dosing inadequacy, the drug-related problems per patient and to obtain the control group. The second phase, with a controlled study with historical control group, was the intervention phase. When dosing adjustments were needed, the pharmacists made recommendations to the physicians. A comparison was made between the control and the intervention group regarding the prevalence of drug dosing inadequacy and the mean number of drug-related problems per patient. Results The mean of the prevalence of drug dosing inadequacy was 17.5% [95% CI 14.6-21.5] in phase 1 and 15.5% [95% CI 14.5-16.6] in phase 2. The mean number of drug-related problems per patient was 0.7 [95% CI 0.5-0.8] in phase 1 and 0.50 [95% CI 0.4-0.6] in phase 2. The difference in the prevalence of dosing inadequacy between the control and intervention group before the pharmacists’ intervention was 0.73% [95% CI (−6.0) - 7.5] and after the pharmacists’ intervention it was 13.5% [95% CI 8.0 - 19.5] (p < 0.001) while the difference in the mean of drug-related problems per patient before the pharmacists’ intervention was 0.05 [95% CI( -0.2) - 0.3] and following the intervention it was 0.5 [95% CI 0.3 - 0.7] (p < 0.001). Conclusion A drug dosing adjustment service for elderly patients with renal impairment in community pharmacies can increase the proportion of adequate drug dosing, and improve the drug-related problems per patient. Collaborative practice with physicians can improve these results. PMID:23849005

Inverse scattering for an exterior Dirichlet program

NASA Technical Reports Server (NTRS)

Hariharan, S. I.

1981-01-01

Scattering due to a metallic cylinder which is in the field of a wire carrying a periodic current is considered. The location and shape of the cylinder is obtained with a far field measurement in between the wire and the cylinder. The same analysis is applicable in acoustics in the situation that the cylinder is a soft wall body and the wire is a line source. The associated direct problem in this situation is an exterior Dirichlet problem for the Helmholtz equation in two dimensions. An improved low frequency estimate for the solution of this problem using integral equation methods is presented. The far field measurements are related to the solutions of boundary integral equations in the low frequency situation. These solutions are expressed in terms of mapping function which maps the exterior of the unknown curve onto the exterior of a unit disk. The coefficients of the Laurent expansion of the conformal transformations are related to the far field coefficients. The first far field coefficient leads to the calculation of the distance between the source and the cylinder.

Dope, Fiends, and Myths.

ERIC Educational Resources Information Center

Reasons, Charles E.

Since the social reality of the drug problem has largely emanated from the diffuse conceptions of the drug user, an analysis of the history of the "dope fiend" mythology is presented in this paper in an attempt to assess the manner in which certain publics are informed about the problem. A content analysis of drug-related imagery was made from…

Gender Differences among Israeli Adolescents in Residential Drug Treatment

ERIC Educational Resources Information Center

Isralowitz, Richard; Reznik, Alex

2007-01-01

Aims: The use of licit and illicit drugs is considered to be primarily a male problem. Numerous studies, however, question the extent of gender differences. This article reports on last 30 day drug use and related problem behaviour among male and female youth prior to residential treatment. Methods: Self-report data were collected from 95 male and…

Prospects for Vascular Access Education in Developing Countries: Current Situation in Cambodia.

PubMed

Naganuma, Toshihide; Takemoto, Yoshiaki

2017-01-01

We report our activities training doctors on vascular access procedures at International University (IU) Hospital in Cambodia through a program facilitated by Ubiquitous Blood Purification International, a nonprofit organization that provides medical support to developing countries in the field of dialysis medicine. Six doctors from Japan have been involved in the education of medical personnel at IU, and we have collectively visited Cambodia about 15 times from 2010 to 2016. In these visits, we have performed many operations, including 42 for arteriovenous fistula, 1 arteriovenous graft, and 1 percutaneous transluminal angioplasty. Stable development and management of vascular access is increasingly required in Cambodia due to increased use of dialysis therapy, and training of doctors in this technique is urgently required. However, we have encountered several difficulties that need to be addressed, including (1) the situation of personnel receiving this training, (2) problems with facilities, including medical equipment and drugs, (3) financial limitations, and (4) problems with management of vascular access. © 2017 S. Karger AG, Basel.

Pharmacist Web-Based Training Program on Medication Use in Chronic Kidney Disease Patients: Impact on Knowledge, Skills, and Satisfaction

ERIC Educational Resources Information Center

Legris, Marie-eve; Seguin, Noemie Charbonneau; Desforges, Katherine; Sauve, Patricia; Lord, Anne; Bell, Robert; Berbiche, Djamal; Desrochers, Jean-Francois; Lemieux, Jean-Philippe; Morin-Belanger, Claudia; Paradis, Francois Ste-Marie; Lalonde, Lyne

2011-01-01

Introduction: Chronic kidney disease (CKD) patients are multimorbid elderly at high risk of drug-related problems. A Web-based training program was developed based on a list of significant drug-related problems in CKD patients requiring a pharmaceutical intervention. The objectives were to evaluate the impact of the program on community…

Relations between Young Students' Strategic Behaviours, Domain-Specific Self-Concept, and Performance in a Problem-Solving Situation

ERIC Educational Resources Information Center

Dermitzaki, Irini; Leondari, Angeliki; Goudas, Marios

2009-01-01

This study aimed at investigating the relations between students' strategic behaviour during problem solving, task performance and domain-specific self-concept. A total of 167 first- and second-graders were individually examined in tasks involving cubes assembly and in academic self-concept in mathematics. Students' cognitive, metacognitive, and…

Using a Problem-Solving Strategy to Prevent Work-Related Accidents Due to Unsafe Worker Behavior.

ERIC Educational Resources Information Center

Martella, Ronald C.; And Others

1992-01-01

A two-stage problem-solving strategy involving cue cards and their gradual withdrawal was used to teach nine sheltered workshop employees how to prevent work-related accidents. Results indicated that participants used the strategy appropriately and generalized their skills to similar and dissimilar situations up to eight weeks after training.…

Understanding and shifting drug-related decisions: Contributions of automatic decision-making processes

PubMed Central

Carpenter, Kenneth M.; Bedi, Gillinder; Vadhan, Nehal P.

2015-01-01

While substance use is common, only a minority of individuals who use drugs or alcohol develop problematic use. An understanding of the factors underlying the transition from substance use to misuse may improve prevention and intervention efforts. A key feature of substance misuse is ongoing decisions to use drugs or alcohol despite escalating negative consequences. Research findings highlight the importance of both relatively automatic, associative cognitive processes and relatively controlled, deliberative, and rational-analytic cognitive processes, for understanding situational decisions to use drugs. In this review, we discuss several cognitive component processes that may contribute to decision-making that promotes substance use and misuse, with a focus on more automatic processes. A growing body of evidence indicates that relative differences in the strength of these component processes can account for individual differences in the transition from substance use to misuse, and may offer important avenues for developing novel intervention strategies. PMID:26084667

Understanding and shifting drug-related decisions: contributions of automatic decision-making processes.

PubMed

Carpenter, Kenneth M; Bedi, Gillinder; Vadhan, Nehal P

2015-08-01

While substance use is common, only a minority of individuals who use drugs or alcohol develop problematic use. An understanding of the factors underlying the transition from substance use to misuse may improve prevention and intervention efforts. A key feature of substance misuse is ongoing decisions to use drugs or alcohol despite escalating negative consequences. Research findings highlight the importance of both relatively automatic, associative cognitive processes and relatively controlled, deliberative, and rational-analytic cognitive processes, for understanding situational decisions to use drugs. In this review, we discuss several cognitive component processes that may contribute to decision-making that promotes substance use and misuse, with a focus on more automatic processes. A growing body of evidence indicates that relative differences in the strength of these component processes can account for individual differences in the transition from substance use to misuse and may offer important avenues for developing novel intervention strategies.

A unified framework for addiction: Vulnerabilities in the decision process

PubMed Central

Redish, A. David; Jensen, Steve; Johnson, Adam

2013-01-01

The understanding of decision-making systems has come together in recent years to form a unified theory of decision-making in the mammalian brain as arising from multiple, interacting systems (a planning system, a habit system, and a situation-recognition system). This unified decision-making system has multiple potential access points through which it can be driven to make maladaptive choices, particularly choices that entail seeking of certain drugs or behaviors. We identify 10 key vulnerabilities in the system: (1) moving away from homeostasis, (2) changing allostatic set points, (3) euphorigenic “reward-like” signals, (4) overvaluation in the planning system, (5) incorrect search of situation-action-outcome relationships, (6) misclassification of situations, (7) overvaluation in the habit system, (8) a mismatch in the balance of the two decision systems, (9) over-fast discounting processes, and (10) changed learning rates. These vulnerabilities provide a taxonomy of potential problems with decision-making systems. Although each vulnerability can drive an agent to return to the addictive choice, each vulnerability also implies a characteristic symptomology. Different drugs, different behaviors, and different individuals are likely to access different vulnerabilities. This has implications for an individual’s susceptibility to addiction and the transition to addiction, for the potential for relapse, and for the potential for treatment. PMID:18662461

Conceptual carpentry as problem handling: the case of drugs and coercive treatment in social democratic welfare regimes.

PubMed

Edman, Johan; Stenius, Kerstin

2014-03-01

The drug and alcohol fields are characterised by continuous contestations of key concepts and the competing uses of concepts by various actors, in different geographies and over time. This study investigates the political processes leading to legislation enabling coercive treatment of (non-psychotic) drug users in Finland and Sweden from the 1950s until the early 1980s. The drug treatment policies are analysed through conceptual changes and innovations. The article analyses conceptual discussions in public reports in Finland and Sweden, focusing on the work preceding the first legislations where both alcohol and drug treatment were included (in Finland 1961, in Sweden 1982). Theories from conceptual history are applied. The Finnish and Swedish discussions carry arguments from two periods of the Nordic welfare state: in an early development stage and a fragile situation in Finland, and in a more mature and affluent time in Sweden. The paternalistic arguments vary over time and between countries. Still, in both countries and time periods, the view of the drug problem as a youth issue, as particularly enslaving and on society's obligation to protect drug using individuals from damaging their future give enough motivation for coercive treatment. The conceptual work included avoidance of certain terms but in other cases, a broadening of their meaning, to adopt them to the political goals. Close analyses of conceptual history can reveal new features of drug policy struggles and show how central concepts in drugs and alcohol field are continuously contested. Copyright © 2013 Elsevier B.V. All rights reserved.

Conflict Management in "Ad Hoc" Problem-Solving Groups: A Preliminary Investigation.

ERIC Educational Resources Information Center

Wallace, Les; Baxter, Leslie

Full study of small group communication must include consideration of task and socio-emotional dimensions, especially in relation to group problem solving. Thirty small groups were tested for their reactions in various "ad hoc" conflict resolution situations. Instructions to the groups were (1) no problem-solving instructions (control),…

Prescription of Sedative Drugs During Hospital Stay: A Swiss Prospective Study.

PubMed

Schumacher, Laurence; Dobrinas, Maria; Tagan, Damien; Sautebin, Annelore; Blanc, Anne-Laure; Widmer, Nicolas

2017-12-01

In recent years, the number of prescriptions for sedative drugs has increased significantly, as has their long-term use. Moreover, sedative use is frequently initiated during hospital stays. This study aimed to describe new prescriptions of sedative drugs during hospital stays and evaluate their maintenance as discharge medication. This observational prospective study took place in an internal medicine ward of a Swiss hospital over a period of 3 months in 2014. Demographic (age, sex, diagnosis, comorbidities) and medication data [long-term use of sedative drugs, new regular or pro re nata ('as needed') prescriptions of sedative drugs, drug-related problems] were collected. Sedative medications included: benzodiazepines, Z-drugs, antihistamines, antidepressants, neuroleptics, herbal drugs, and clomethiazole. McNemar's test was used for comparison. Of 290 patients included, 212 (73%) were over 65 years old and 169 (58%) were women; 34% (n = 98) were using sedative drugs long term before their hospital stay, and 44% (n = 128) had a prescription for sedative drugs at discharge-a 10% increase (p < 0.05). Sedative drugs were newly prescribed to 37% (n = 108) of patients during their stay. Among these, 37% (n = 40) received a repeat prescription at discharge. Over half of the sedative drugs were prescribed within 24 h of admission. Drug-related problems were detected in 76% of new prescriptions, of which 90% were drug-drug interactions. This study showed that hospital stays increased the proportion of patients who were prescribed a sedative drug at discharge by 10% (absolute increase). These prescriptions may generate long-term use and expose patients to drug-related problems. Promoting alternative approaches for managing insomnia are recommended.

Drug problems among homeless individuals in Toronto, Canada: prevalence, drugs of choice, and relation to health status

PubMed Central

2010-01-01

Background Drug use is believed to be an important factor contributing to the poor health and increased mortality risk that has been widely observed among homeless individuals. The objective of this study was to determine the prevalence and characteristics of drug use among a representative sample of homeless individuals and to examine the association between drug problems and physical and mental health status. Methods Recruitment of 603 single men, 304 single women, and 284 adults with dependent children occurred at homeless shelters and meal programs in Toronto, Canada. Information was collected on demographic characteristics and patterns of drug use. The Addiction Severity Index was used to assess whether participants suffered from drug problems. Associations of drug problems with physical and mental health status (measured by the SF-12 scale) were examined using regression analyses. Results Forty percent of the study sample had drug problems in the last 30 days. These individuals were more likely to be single men and less educated than those without drug problems. They were also more likely to have become homeless at a younger age (mean 24.8 vs. 30.9 years) and for a longer duration (mean 4.8 vs. 2.9 years). Marijuana and cocaine were the most frequently used drugs in the past two years (40% and 27%, respectively). Drug problems within the last 30 days were associated with significantly poorer mental health status (-4.9 points, 95% CI -6.5 to -3.2) but not with poorer physical health status (-0.03 points, 95% CI -1.3 to 1.3)). Conclusions Drug use is common among homeless individuals in Toronto. Current drug problems are associated with poorer mental health status but not with poorer physical health status. PMID:20181248

Intervention Strategies with Adolescents: The Newton Model.

ERIC Educational Resources Information Center

Green, Matt

The problem of adolescent drug/alcohol abuse seems to have once again intensified during the 1980s. When the school is the only constant in an adolescent's life and when those same teenagers bring drugs and alcohol-related problems to school, the school has an obligation to implement change. The first step is identification of the problem. Beyond…

On the importance of distinguishing shame from guilt: Relations to problematic alcohol and drug use

PubMed Central

Dearing, Ronda L.; Stuewig, Jeffrey; Tangney, June Price

2011-01-01

Previous research has demonstrated that shame-proneness (the tendency to feel bad about the self) relates to a variety of life problems, whereas guilt-proneness (the tendency to feel bad about a specific behavior) is more likely to be adaptive. The current analyses sought to clarify the relations of shame-proneness and guilt-proneness to substance use problems in three samples with differing levels of alcohol and drug problem severity: college undergraduates (Study 1 N =235, Study 2 N =249) and jail inmates (Study 3 N =332). Across samples, shame-proneness was generally positively correlated with substance use problems, whereas guilt-proneness was inversely related (or unrelated) to substance use problems. Results suggest that shame and guilt should be considered separately in the prevention and treatment of substance misuse. PMID:16022935

[A strategy of constructing the technological system for quality control of Chinese medicine based on process control and management].

PubMed

Cheng, Yi-Yu; Qian, Zhong-Zhi; Zhang, Bo-Li

2017-01-01

The current situation, bottleneck problems and severe challenges in quality control technology of Chinese Medicine (CM) are briefly described. It is presented to change the phenomenon related to the post-test as the main means and contempt for process control in drug regulation, reverse the situation of neglecting the development of process control and management technology for pharmaceutical manufacture and reconstruct the technological system for quality control of CM products. The regulation and technology system based on process control and management for controlling CM quality should be established to solve weighty realistic problems of CM industry from the root causes, including backwardness of quality control technology, weakness of quality risk control measures, poor reputation of product quality and so on. By this way, the obstacles from poor controllability of CM product quality could be broken. Concentrating on those difficult problems and weak links in the technical field of CM quality control, it is proposed to build CMC (Chemistry, Manufacturing and Controls) regulation for CM products with Chinese characteristics and promote the regulation international recognition as soon as possible. The CMC technical framework, which is clinical efficacy-oriented, manufacturing manner-centered and process control-focused, was designed. To address the clinical characteristics of traditional Chinese medicine (TCM) and the production feature of CM manufacture, it is suggested to establish quality control engineering for CM manufacturing by integrating pharmaceutical analysis, TCM chemistry, TCM pharmacology, pharmaceutical engineering, control engineering, management engineering and other disciplines. Further, a theoretical model of quality control engineering for CM manufacturing and the methodology of digital pharmaceutical engineering are proposed. A technology pathway for promoting CM standard and realizing the strategic goal of CM internationalization is elaborated. Copyright© by the Chinese Pharmaceutical Association.

Childhood maltreatment histories, alcohol and other drug use symptoms, and sexual risk behavior in a treatment sample of adolescents.

PubMed

Oshri, Assaf; Tubman, Jonathan G; Burnette, Mandi L

2012-05-01

We tested a structural model of relations among self-reported childhood maltreatment, alcohol and other drug abuse and dependence symptoms, and sexual risk behavior in a sample of adolescents receiving outpatient treatment of substance use problems. Structured interviews were administered to an ethnically diverse sample of 394 adolescents (114 girls, 280 boys; mean = 16.30 years; SD = 1.15 years; 44.9% Hispanic, 20.6% African American, 25.4% White non-Hispanic, and 9.1% other) in 2 outpatient treatment settings. Path analyses yielded findings consistent with a mediation model. Alcohol abuse and dependence symptoms mediated (1) relations between emotional neglect scores and sex with co-occurring alcohol use and (2) relations between sexual abuse scores and sex with co-occurring alcohol use. Drug abuse and dependence symptoms mediated relations between (1) neglect scores and (2) sexual intercourse with co-occurring alcohol or drug use, as well as unprotected sexual intercourse. Efforts to treat alcohol or drug use problems among adolescents or to prevent transmission of HIV or other sexually transmitted infections among youths with substance use problems may require tailoring treatment or prevention protocols to address client histories of maltreatment.

In search of salience: phenomenological analysis of moral distress.

PubMed

Manara, Duilio F; Villa, Giulia; Moranda, Dina

2014-07-01

The nurse's moral competences in the management of situations which present ethical implications are less investigated in literature than other ethical problems related to clinical nursing. Phenomenology affirms that emotional warmth is the first fundamental attitude as well as the premise of any ethical reasoning. Nevertheless, it is not clear how and when this could be confirmed in situations where the effect of emotions on the nurse's decisional process is undiscovered. To explore the processes through which situations of moral distress are determined for the nurses involved in nursing situations, a phenomenological-hermeneutic analysis of a nurse's report of an experience lived by her as a moral distress situation has been conducted. Nursing emerges as a relational doctrine that requires the nurse to have different degrees of personal involvement, the integration between logical-formal thinking and narrative thinking, the perception of the salience of the given situation also through the interpretation and management of one's own emotions, and the capacity to undergo a process of co-construction of shared meanings that the others might consider adequate for the resolution of her problem. Moral action requires the nurse to think constantly about the important things that are happening in a nursing situation. Commitment towards practical situations is directed to training in order to promote the nurse's reflective ability towards finding salience in nursing situations, but it is also directed to the management of nursing assistance and human resources for the initial impact that this reflexive ability has on patients' and their families' lives and on their need to be heard and assisted. The only case analysed does not allow generalizations. Further research is needed to investigate how feelings generated by emotional acceptance influence ethical decision making and moral distress in nursing situations. © 2014 John Wiley & Sons Ltd.

Sex Offenders.

ERIC Educational Resources Information Center

Hayes, Susan

1991-01-01

This paper on the problem of sex offending among individuals with intellectual disabilities examines the incidence of this problem, characteristics of intellectually disabled sex offenders, determination of whether the behavior is a paraphilia or functional age-related behavior, and treatment options, with emphasis on the situation in New South…

Poor Response Inhibition as a Predictor of Problem Drinking and Illicit Drug Use in Adolescents at Risk for Alcoholism and Other Substance Use Disorders

ERIC Educational Resources Information Center

Nigg, Joel T.; Wong, Maria M.; Martel, Michelle M.; Jester, Jennifer M.; Puttler, Leon I.; Glass, Jennifer M.; Adams, Kenneth M.; Fitzgerald, Hiram E.; Zucker, Robert A.

2006-01-01

Objective: To evaluate the predictive power of executive functions, in particular, response inhibition, in relation to alcohol-related problems and illicit drug use in adolescence. Method: A total of 498 children from 275 families from a longitudinal high-risk study completed executive function measures in early and late adolescence and lifetime…

The pharmacology and toxicology of “ecstasy” (MDMA) and related drugs

PubMed Central

Kalant, Harold

2001-01-01

Abtract "Ecstasy" (MDMA) and related drugs are amphetamine derivatives that also have some of the pharmacological properties of mescaline. They have become popular with participants in "raves," because they enhance energy, endurance, sociability and sexual arousal. This vogue among teenagers and young adults, together with the widespread belief that "ecstasy" is a safe drug, has led to a thriving illicit traffic in it. But these drugs also have serious toxic effects, both acute and chronic, that resemble those previously seen with other amphetamines and are caused by an excess of the same sympathomimetic actions for which the drugs are valued by the users. Neurotoxicity to the serotonergic system in the brain can also cause permanent physical and psychiatric problems. A detailed review of the literature has revealed over 87 "ecstasy"-related fatalities, caused by hyperpyrexia, rhabdomyolysis, intravascular coagulopathy, hepatic necrosis, cardiac arrhythmias, cerebrovascular accidents, and drug-related accidents or suicide. The toxic or even fatal dose range overlaps the range of recreational dosage. The available evidence does not yet permit an accurate assessment of the size of the problem presented by the use of these drugs. PMID:11599334

Predicting aberrant drug behavior in patients treated for chronic pain: importance of abuse history.

PubMed

Michna, Edward; Ross, Edgar L; Hynes, Wilfred L; Nedeljkovic, Srdjan S; Soumekh, Sharonah; Janfaza, David; Palombi, Diane; Jamison, Robert N

2004-09-01

Physicians can encounter problems in prescribing opioids for some patients with chronic pain such as multiple unsanctioned dose escalations, episodes of lost or stolen prescriptions, and positive urine drug screenings for illicit substances. This study explored the usefulness of questions on abuse history in predicting problems with prescribing opioids for patients at a hospital-based pain management program. One hundred forty-five (145) patients who were taking long- and short-acting opioids for their pain were classified as high or low risk on the basis of their responses to interview questions about 1) substance abuse history in their family, 2) past problems with drug or alcohol abuse, and 3) history of legal problems. The treating physicians completed a questionnaire about problems that they had encountered with their patients. Problem behaviors were verified through chart review. No differences in demographic characteristics were found between those classified as high and low risk. Patients who admitted to a family history of substance abuse, a history of legal problems, and drug or alcohol abuse were prone to more aberrant drug-related behaviors, including a higher incidence of lost or stolen prescriptions and the presence of illicit substances in their urine (P < 0.05). Patients classified as high risk also had a significantly higher frequency of reported mental health problems and motor vehicle accidents. More of these patients smoked cigarettes, tended to need a cigarette within the first hour of the day, took higher doses of opioids, and reported fewer adverse effects from the medications than did those without such a history (P < 0.05). This study demonstrates that questions about abuse history and legal problems can be useful in predicting aberrant drug-related behavior with opioid use in persons with chronic noncancer pain.

The syndemic of HIV, HIV-related risk and multiple co-morbidities among women who use drugs in Malaysia: Important targets for intervention.

PubMed

Loeliger, Kelsey B; Marcus, Ruthanne; Wickersham, Jeffrey A; Pillai, Veena; Kamarulzaman, Adeeba; Altice, Frederick L

2016-02-01

Substance use and HIV are syndemic public health problems in Malaysia. Harm reduction efforts to reduce HIV transmission have primarily focused on men with substance use disorders. To explore HIV risk behaviors, substance use, and social factors associated with poor health outcomes among women who use drugs in Malaysia. A cross-sectional survey of 103 drug-using women in Kuala Lumpur, Malaysia were recruited to assess their medical, psychiatric and social comorbidity as well as their engagement in nationally recommended HIV testing and monitoring activities. One-third reported having ever injected drugs, with most (68.2%) having recently shared injection paraphernalia. Sex work (44.7%) and infrequent condom use (42.4%) were common as was underlying psychiatric illness and physical and sexual violence during childhood and adulthood. Most women (62.1%) had unstable living situations and suffered from an unmet need for social support and health services. HIV prevalence was high (20%) with only two thirds of women eligible for antiretroviral therapy having received it. Suboptimal HIV testing and/or monitoring was positively associated with interpersonal violence (AOR 2.73; 95% CI 1.04-7.14) and negatively associated with drug injection (AOR 0.28; 95% CI 0.10-0.77). Women who use drugs in Malaysia demonstrate considerable medical, psychiatric and social co-morbidity, which negatively contributes to optimal and crucial engagement in HIV treatment-as-prevention strategies. Mental health and social support may be key targets for future public health interventions aimed at drug-using women in Malaysia. Copyright © 2015 Elsevier Ltd. All rights reserved.

Abuse of prescription drugs.

PubMed Central

Wilford, B B

1990-01-01

An estimated 3% of the United States population deliberately misuse or abuse psychoactive medications, with severe consequences. According to the National Institute on Drug Abuse, more than half of patients who sought treatment or died of drug-related medical problems in 1989 were abusing prescription drugs. Physicians who contribute to this problem have been described by the American Medical Association as dishonest--willfully misprescribing for purposes of abuse, usually for profit; disabled by personal problems with drugs or alcohol; dated in their knowledge of current pharmacology or therapeutics; or deceived by various patient-initiated fraudulent approaches. Even physicians who do not meet any of these descriptions must guard against contributing to prescription drug abuse through injudicious prescribing, inadequate safeguarding of prescription forms or drug supplies, or acquiescing to the demands or ruses used to obtain drugs for other than medical purposes. PMID:2349801

Drug Bioavailability Data: (Un)Available.

ERIC Educational Resources Information Center

Capomacchia, Anthony C.; And Others

1979-01-01

The obtainability of drug bioavailability data from both brand-name and generic-drug manufacturers was studied to document the relative change in availability to pharmacy students of drug bioavailability data between 1978 and 1976 for drugs exhibiting bioavailability problems. The results indicate no major change. (JMD)

Effectiveness of Culturally Appropriate Initiative on Drug-Related Harm Reduction for Sex Workers on the Thai/Malaysian Border.

PubMed

Nunun, Worapol; Kanato, Manop

2015-07-01

Drug use can harm to sex workers. Abstinence intervention, however, may not be appropriate since drug use fosters their career performance. The objective was to develop the culturally appropriate model for sex workers participation on drug demand reduction at the Thailand/Malaysian border This study was a pre-post quasi-experimental design. Tripartite participation was used to develop the model aiming to reduce harm regarding drug use. The study carried out during June 2010-May 2011. Data were collected from 150 key informant interviews, 56 focus group discussions, 22 participant observations in various situations, and numerous related materials. Descriptive statistics, survival analysis and 95% confidence interval were utilizedfor quantitative data. Qualitative data were analyzed by content analysis. Drug related harm reduction was evaluated at two-week time along implementation period of 12 months. 89.5% of all sessions introduced could decrease drug related harm. Of all sex workers participated in the study, intended to treat analysis showed 86.9% success rate (95% CI; 77.1, 96.7). Of these, 32.6% became abstinence, 39.1% reduced most of drug related harm. 13.0% reduced partial drug related harm either lessfrequency, less quantity, less concentration, decrease types of drugs/switch to safe drugs or safer method of administration. 2.2% was infancy stage, which needed further support. Key success ofthe model was tripartite participation. With active leaders and strong support, sex workers were continually motivated to reduce harm regarding drug use.

Unpredictable drug shortages: an ethical framework for short-term rationing in hospitals.

PubMed

Rosoff, Philip M

2012-01-01

Periodic and unexpected shortages of drugs, biologics, and even medical devices have become commonplace in the United States. When shortages occur, hospitals and clinics need to decide how to ration their available stock. When such situations arise, institutions can choose from several different allocation schemes, such as first-come, first-served, a lottery, or a more rational and calculated approach. While the first two approaches sound reasonable at first glance, there are a number of problems associated with them, including the inability to make fine, individual patient-centered decisions. They also do not discriminate between what kinds of patients and what types of uses may be more deserving or reasonable than others. In this article I outline an ethically acceptable procedure for rationing drugs during a shortage in which demand outstrips supply.

Effects of psychosocial and situational variables on substance abuse among homeless adults.

PubMed

Stein, Judith A; Dixon, Elizabeth L; Nyamathi, Adeline M

2008-09-01

Finding direct and indirect influences of salient psychosocial and situational variables on problem substance use among homeless people is important in designing evidence-based, effective, and relevant interventions for this special population. A stress-coping paradigm in conjunction with situational items specialized for homeless people was used to explore predictive relationships in a sample of homeless adults (N = 664) among (a) psychosocial variables of self-esteem, social support, positive and negative coping, and emotional distress, (b) situational variables of homelessness history and quality of recent housing, and (c) outcomes of alcohol use, injection drug use (IDU), and non-IDU. Lower self-esteem predicted greater emotional distress, lower positive coping, greater negative coping, and more alcohol use. Social support predicted less emotional distress and more positive coping. Chronic homelessness predicted more emotional distress, less positive coping, greater alcohol use, and IDU. Poor housing was associated with more alcohol use and IDU. Substance abuse interventions among the homeless should have a dual focus that includes attention to psychological issues and negative coping patterns while also addressing situational, environmental factors, including encouraging provision of permanent supportive housing. (c) 2008 APA, all rights reserved.

The impact of two pharmaceutical risk-sharing agreements on pricing, promotion, and net health benefits.

PubMed

Zaric, Gregory S; Xie, Bin

2009-01-01

Health insurers are increasingly making use of risk-sharing agreements with drug manufacturers to manage uncertainties regarding the costs and effectiveness of new drugs. Several risk-sharing models exist including those based on sales volume, achievement of clinical thresholds, and achievement of cost-effectiveness thresholds. The objective of this article is to compare two risk-sharing arrangements and to investigate conditions under which each is preferable from the perspective of the payer and the manufacturer. We develop two two-period models to compare two risk-sharing arrangements between a payer and a drug manufacturer in which there is uncertainty about the effectiveness of the new drug. In the first risk-sharing agreement, the drug is listed on a formulary in the first period but delisted in the second period if the net monetary benefit in the first period is negative. In the second risk-sharing agreement, the manufacturer pays a rebate in each period if the net monetary benefit in that period is negative. We show that the relative performance of the two arrangements depends on several factors and that neither arrangement is always preferred. Additionally, we are able to identify situations in which a payer and a manufacturer would prefer the same plan and other situations in which the two parties would disagree on which plan was most desirable. Because neither risk-sharing arrangement is always preferred, payers and manufacturers must carefully consider the characteristics of their individual situation when entering into such contracts.

Congestive heart failure, spouses' support and the couple's sleep situation: a critical incident technique analysis.

PubMed

Broström, Anders; Strömberg, Anna; Dahlström, Ulf; Fridlund, Bengt

2003-03-01

Sleep related breathing disorders are common as well as a poor prognostic sign associated with higher mortality in patients with congestive heart failure (CHF). These patients often have a shorter total duration of sleep, disturbed sleep structure and increased daytime sleepiness, which can negatively affect all dimensions of the life situation. The spouse has an important role in supporting the patient in relation to sleep disorders, but this role may be adversely affected by the sleep situation of the couple. The aim of this study was to describe decisive situations that influence spouses' support to patients with CHF in relation to the couple's sleep situation. A qualitative descriptive design using critical incident technique was employed. Incidents were collected by means of interviews with 25 spouses of patients with CHF, strategically selected from two hospital-based specialist clinics in southern Sweden. Two main areas emerged in the analysis: support stimulating situations and support inhibiting situations. Support stimulating situations described how spouses' support was positively affected by their own adaptation in psychosocial or practical situations, and receiving help from others. Support inhibiting situations described how the spouses' support was negatively affected by sleep disturbances as a result of the patient's symptoms, anxiety in relation to the disease, limitations as a result of the sleeping habits, dissatisfaction with care related to the sleep situation, and being left to cope alone with the problems. An increased understanding of the stimulating and inhibiting situations influencing spouses' support for patients with CHF can guide health care personnel in deciding if an intervention is needed to improve the sleep situation for patient and spouse.

Community pharmacist intervention in patients with renal impairment.

PubMed

Pourrat, Xavier; Sipert, Anne-Sophie; Gatault, Philippe; Sautenet, Bénédicte; Hay, Nicolas; Guinard, Francis; Guegan, Françoise; Halimi, Jean-Michel

2015-12-01

In France, community pharmacists do not have free access to patients' lab results, and it is therefore impossible for them to identify patients with renal impairment. (1) to evaluate the ability of community pharmacists (CPs) to identify drug related problems (DRP) in patients at risk for or suffering from renal impairment; (2) to evaluate the proportions of recommendations by CPs that lead to a modification by GP. A prospective and observational study involving 24 community pharmacists in France. Following special training, community pharmacists were asked to select 52 patients with the following characteristics: ≥65 years of age; prescribed at least two diabetic and/or antihypertensive drugs. Serum creatinine value was obtained for each patient and glomerular filtration rate estimated (eGFR) with the aMDRD formula. Those with a eGFR 60 ml/min/1.73 m² were considered having chronic kidney disease (CKD). Data was collected concerning whether the community pharmacists identified drug related problems and tried to inform the GP who prescribed the medications. Identified DRP were reviewed by a team of nephrologists and hospital clinical pharmacists. The proportion of CKD patients and those without serum creatinine monitoring, the number of drug related problems identified by community pharmacists, and the proportion of drug related problems resolved by the community pharmacists intervention to the GP. Of the total 791 patients identified, 180 (22.8 %) exhibited CKD, and 57 (7.2 %) had not undergone serum creatinine monitoring. Among the 1297 drugs prescribed, 260 had to be adapted to eGFR. The proportion of DRP was 21.5 % (56/260), of which 40 % (20) were identified by community pharmacists. Once the GP was informed, 33.3 % (6/18) of DRP were resolved. Community pharmacists identified 40 % of DRP related to CKD prescriptions, leading to prescription modification by GPs in a third of the cases. These interventions are likely to decrease drug-related morbidity and mortality.

The Documentation of Health Problems in Relation to Prescribed Medication in People with Profound Intellectual and Multiple Disabilities

ERIC Educational Resources Information Center

van der Heide, D. C.; van der Putten, A. A. J.; van den Berg, P. B.; Taxis, K.; Vlaskamp, C.

2009-01-01

Background: Persons with profound intellectual and multiple disabilities (PIMD) suffer from a wide range of health problems and use a wide range of different drugs. This study investigated for frequently used medication whether there was a health problem documented in the medical notes for the drug prescribed. Method: Persons with PIMD with an…

Fitness for work in health care workers: state of the art and possible operational recommendations for its formulation and management in relationship to alcohol and drug addiction.

PubMed

Riboldi, L; Bordini, L; Ferrario, M M

2012-01-01

Both chronic and acute alcohol or drug consumption have severe health consequences, alter the subject's cognitive functions and work performance and increase the risk of work-related accidents, for the worker and for third parties (e.g., co-workers and other people subject to negative impact of worker's actions). Limited scientific evidence has suggested that some working conditions present in the health care sector (e.g., high levels of responsibility, competitiveness, burnout, shiftwork, work-related stress) may favour alcohol and drug abuse. The aim of the present report is to describe the problem of alcohol and drug consumption among health care professionals and to evaluate the problem of related fitness for work. The magnitude of this problem remains unclear; recent estimates have reported alcohol abuse and addiction problems in 1-14% and psychotropic, illicit and non-illicit, substance abuse in 6-15% of health care workers. The prevalence of tranquilizer and sedative/hypnotic drug use is high, particularly among physicians. However, it remains unclear whether the incidence of workplace accidents and injuries is higher among drug abusers, and whether the statutory introduction of prevention programmes has led to actual control of this problem in the workplace. Italian legislation identifies the occupational physician as a key figure to prevent psychotropic substance abuse in some work activities, but some difficulties in its application remain. Legislators should issue simple norms that clearly define the responsibilities and skills of each actor involved in safeguarding workplace health and safety, as well as clearly outlining workplace monitoring procedures.

Social Capital and Bystander Behavior in Bullying: Internalizing Problems as a Barrier to Prosocial Intervention.

PubMed

Jenkins, Lyndsay N; Fredrick, Stephanie Secord

2017-04-01

Theory and research suggests that individuals with greater social capital (i.e., resources and benefits gained from relationships, experiences, and social interactions) may be more likely to be active, prosocial bystanders in bullying situations. Therefore, the goal of the current study was to examine the association of social capital (social support and social skills) with prosocial bystander behavior, and the role of internalizing problems as a potential barrier to this relation among 299 students (45.8% girls, 95% White) in sixth, seventh, and eighth grades. Results indicate a positive relation between social capital and prosocial bystander behavior. In addition, internalizing problems were a significant risk factor that may hinder youth-particularly girls-from engaging in defending behavior. Prosocial bystanders are an essential component to prevent and reduce bullying and further research is needed to better understand how to foster prosocial behavior in bullying situations, perhaps by utilizing social capital, related to school bullying.

Drug Crisis: Schools Fight Back with Innovative Programs. Education U.S.A. Special Report.

ERIC Educational Resources Information Center

Jones, J. William

An indepth study of the drug issue and problem in American schools is presented in this Education U.S.A. Special Report by the National School Public Relations Association. Dealing with what is and what is not being accomplished, the report probes the extent of the drug problem; reasons for its existence; the scare tactics of overkill versus the…

The risks for late adolescence of early adolescent marijuana use.

PubMed Central

Brook, J S; Balka, E B; Whiteman, M

1999-01-01

OBJECTIVES: The purpose of this study was to assess the relation of early adolescent marijuana use to late adolescent problem behaviors, drug-related attitudes, drug problems, and sibling and peer problem behavior. METHODS: African American (n = 627) and Puerto Rican (n = 555) youths completed questionnaires in their classrooms initially and were individually interviewed 5 years later. Logistic regression analysis estimated increases in the risk of behaviors or attitudes in late adolescence associated with more frequent marijuana use in early adolescence. RESULTS: Early adolescent marijuana use increased the risk in late adolescence of not graduating from high school; delinquency; having multiple sexual partners; not always using condoms; perceiving drugs as not harmful; having problems with cigarettes, alcohol, and marijuana; and having more friends who exhibit deviant behavior. These relations were maintained with controls for age, sex, ethnicity, and, when available, earlier psychosocial measures. CONCLUSIONS: Early adolescent marijuana use is related to later adolescent problems that limit the acquisition of skills necessary for employment and heighten the risks of contracting HIV and abusing legal and illegal substances. Hence, assessments of and treatments for adolescent marijuana use need to be incorporated in clinical practice. PMID:10511838

Ligand Residence Time at G-protein-Coupled Receptors-Why We Should Take Our Time To Study It.

PubMed

Hoffmann, C; Castro, M; Rinken, A; Leurs, R; Hill, S J; Vischer, H F

2015-09-01

Over the past decade the kinetics of ligand binding to a receptor have received increasing interest. The concept of drug-target residence time is becoming an invaluable parameter for drug optimization. It holds great promise for drug development, and its optimization is thought to reduce off-target effects. The success of long-acting drugs like tiotropium support this hypothesis. Nonetheless, we know surprisingly little about the dynamics and the molecular detail of the drug binding process. Because protein dynamics and adaptation during the binding event will change the conformation of the protein, ligand binding will not be the static process that is often described. This can cause problems because simple mathematical models often fail to adequately describe the dynamics of the binding process. In this minireview we will discuss the current situation with an emphasis on G-protein-coupled receptors. These are important membrane protein drug targets that undergo conformational changes upon agonist binding to communicate signaling information across the plasma membrane of cells. Copyright © 2015 by The American Society for Pharmacology and Experimental Therapeutics.

Resilience and Impairment: An Exploratory Study of Resilience Factors and Situational Impairment

ERIC Educational Resources Information Center

Naglieri, Jack A.; Goldstein, Sam; LeBuffe, Paul

2010-01-01

The purpose of this study was to begin to examine the relationships between social emotional factors related to resilience as measured by the Devereux Student Strengths Assessment (DESSA) and the degree of impairment as reflected in problem behaviors reported by parents according to the Home Situations Questionnaire (HSQ). A second goal was to…

An Exploration of the Burnout Situation on Teachers in Two Schools in Macau

ERIC Educational Resources Information Center

Luk, Andrew L.; Chan, Bessie P. S.; Cheong, Selwyne W.; Ko, Stanley K. K.

2010-01-01

To explore the burnout situation of teachers in two schools in Macau and to investigate any differences made of demographic characteristics. The relation of burnout on social problem solving and holistic health of teachers is also studied. A self reported questionnaire with the Chinese Maslach Burnout Inventory (C-MBI), Chinese Social Problem…

Helping Students with Disabilities Better Address Teasing and Bullying Situations: A MASNRN Study

ERIC Educational Resources Information Center

Vessey, Judith A.; O'Neill, Katherine M.

2011-01-01

Students with disabilities are more likely to be chronically teased or bullied and develop related psychosocial problems. Proactive interventions help these youths develop coping skills and become more resilient in handling such situations. The specific aims of this study were to (a) identify children with disabilities, who are at risk for being…

Drug driving and the management of risk: the perspectives and practices of a sample of problem drug users.

PubMed

McIntosh, James; O'Brien, Tommy; McKeganey, Neil

2008-06-01

This paper reports on a qualitative study of the attitudes and risk management strategies of a sample of problem drug users in relation to driving while under the influence of drugs. Interviews were conducted with 26 individuals (21 men and 5 women) all of whom had been addicted to heroin and had admitted to driving while under the influence of illegal drugs. The drug users reported four main strategies for managing the risks associated with drug driving: attempting to limit their drug intake to their tolerance level; delaying driving after taking a drug until they felt safe; stopping driving if they felt unsafe while behind the wheel; and avoiding driving altogether under the influence of certain drugs. However, the interviewees' accounts of their drug driving behaviour suggest that these strategies are not only far from reliable, they may also act to encourage drug driving by creating a false sense of security. The reassurance they provide may also undermine any educational messages targeting drug driving. There was little in the problem users' accounts to suggest that media campaigns or a more effective method of detection would have much influence upon their behaviour. The paper concludes that the most realistic approach to the problem may be to incorporate drug driving interventions within drug treatment programmes.

Exploring the Etiologic Factors and Dynamics of Prescription Drug Abuse in Southwest Virginia

PubMed Central

Redican, Kerry J; Marek, Lydia I; Brock, Donna JP; McCance-Katz, Elinore F

2012-01-01

Background: Prescription drug abuse in Southwest Virginia is a serious problem affecting indi-viduals, families, and communities. The aim of this study was to characterize and understand the extent of the prescription drug abuse problem in Southwest, Virginia as well as the dynamics that surround that abuse. More specifically, the study focused on learning the extent of the problem along with which prescription drugs are typically used prior to entering treatment, reasons for prescription drug and methadone abuse, and the sources for prescription drug use, misuse and abuse. Methods: Mixed methodology was employed which included surveying methadone clinic con-sumers at two treatment clinics in Southwest, Virginia and seven focus field interviews of key community stakeholders. Results: The extent of prescription drug abuse is high and that the demographics of prescription drug users are getting younger and now involve more males than females. Oxycodone, hydroco¬done, methadone, and morphine were the most commonly used drugs prior to enrollment in the clinics with over one-half of methadone-maintained consumers reporting that they had abused benzodiazepines along with opioids. Focus groups and clinic consumer data highlighted the key etiological factors in prescription drug abuse: use (due to workforce related injuries) turning to abuse, wanting to get high, overprescribing and physician issues, lack of information, and cultural acceptance of drug taking as problem solving behavior. The two most common sources for the abused prescription drugs were physicians and street dealers. Conclusions: A constellation of conditions have led to the epidemic of prescription drug abuse in Southwest Virginia, including poverty, unemployment and work-related injuries, besides, public health education programs on the dangers of prescription opiate misuse and abuse are urgently needed. PMID:24688929

Drug use and highway safety : a review of the literature

DOT National Transportation Integrated Search

1971-07-01

This report reviews the research literature concerning several aspects of drug use as it relates to traffic safety. Some of the topics covered include the effects of drugs, types of drug users; research problems in assessing risk; laboratory findings...

Delinquency and family problems in incarcerated adolescents with and without a history of inhalant use.

PubMed

McGarvey, E L; Canterbury, R J; Waite, D

1996-01-01

In this retrospective study of incarcerated adolescents, inhalants were used by significantly more nonminority than minority youth. Among both minority and nonminority groups, family problems and delinquent behaviors were higher among those youth with a history of inhalant use than those who reported no use. Family problems included history of running away from home, breaking rules, fighting with parents, and having relatives who had attempted suicide. Delinquent behavior included earlier personal use of drugs, selling illegal drugs, buying drugs from dealers, committing crimes while under the influence, committing crimes to get money to buy drugs, and threatening to hurt people.

Reasons behind Greek problem drug users’ decisions to quit using drugs and engage in treatment of their own volition: sense of self and the Greek filotimo.

PubMed

Fotopoulou, Maria

2014-04-01

The aim of this study was to explore Greek problem drug users’ perceptions of the reasons that led them to quit using drugs and engage in treatment of their own volition. Qualitative semi-structured in-depth interviews. Two state drug agencies in Thessaloniki, Greece. A total of 40 adult problem drug-using men and women participated in the study. Participants were asked to reflect on their decisions to wean themselves from drugs and enter treatment. Findings Participants reported that their decisions centred on the re-conceptualization of the drug-using community and their membership in it, the desire to restore aspects of identities thatwere deemed to be spoiled, and finally memories of their drug-free selves. The importance of the distinctively Greek notion of filotimo in this discussion is highlighted. Primarily in relation to filotimo (a concept that represents a complex array of virtues that regulates behaviour towards one’s family), the desire to restore one’s spoiled identity plays a pivotal role in Greek problem drug users’ decisions to cease drug use and engage in treatment.

Self-Reported Alcohol and Drug Problems Among Internal Medicine Outpatients: Relationships With Criminal Behavior

PubMed Central

Lam, Charlene; Wiederman, Michael W.

2011-01-01

Objective: Previous research indicates relationships between alcohol/substance misuse and criminal behavior, but past studies have restricted investigations to atypical samples and/or utilized limited assessments of illegal behavior. In the present study, we explored relationships between alcohol/drug problems and charges for 27 criminal behaviors in a primary care sample. Method: Participants were a cross-sectional sample of 376 consecutive men and women, aged 18 years or older, being seen for nonemergent medical care at an outpatient internal medicine clinic staffed predominantly by residents and located in a midsized, midwestern city in October 2010. Using a self-report survey methodology, we examined relationships between alcohol and drug problems (“Have you ever had a problem with alcohol?” and “Have you ever had a problem with drugs?”) and 27 illegal behaviors as delineated by the categories used by the US Federal Bureau of Investigation. Results: Men with alcohol or drug problems statistically exhibited the greatest number of charges for different forms of illegal behavior (P < .001). These charges were directly related to alcohol/drug misuse (eg, driving under the influence of alcohol or drugs) and otherwise (eg, aggravated assault, simple assault, gambling, larceny-theft). Conclusions: In primary care settings, men with alcohol/drug problems may also have a history of illegal behaviors—a finding that is relevant in terms of social and legal implications. PMID:22454803

Schooling and Disadvantage in Sri Lankan and Other Rural Situations.

ERIC Educational Resources Information Center

Baker, Victoria J.

1988-01-01

Discusses author's observations of poverty-related problems within rural Sri Lankan schools. Juxtaposes literature on Third World education problems at national, district, school, and individual levels. Concludes high educational expectations in developing world are tightly constrained by poverty, negative attitudes, and weaknesses of systems.…

[Trends in drug-induced liver injury based on reports of adverse reactions to PMDA in Japan].

PubMed

Sudo, Chie; Maekawa, Keiko; Segawa, Katsunori; Hanatani, Tadaaki; Sai, Kimie; Saito, Yoshiro

2012-01-01

Reports on drug-related adverse reactions from manufacturing/distributing pharmaceutical companies or medical institutions/pharmacies are regulated under the Pharmaceutical Affairs Law of Japan, and this system is important for post-marketing safety measures. Although association between the medicine and the adverse event has not been clearly evaluated, and an incidence may be redundantly reported, this information would be useful to roughly grasp the current status of drug-related adverse reactions. In the present study, we analyzed the incidence of drug-induced liver injury by screening the open-source data publicized by the homepage of Pharmaceutical and Medical Devices Agency from 2005 to 2011 fiscal years. Major drug-classes suspected to cause general drug-induced liver injury were antineoplastics, anti-inflammatory agents/common cold drugs, chemotherapeutics including antituberculous drugs, antidiabetics, antiulcers and antiepileptics. In addition, reported cases for fulminant hepatitis were also summarized. We found that antituberculous isoniazid and antineoplastic tegafur-uracil were the top two suspected drugs. These results might deepen understanding of current situations for the drug-induced liver injury in Japan.

Social Anxiety and Heavy Situational Drinking: Coping and Conformity Motives as Multiple Mediators

PubMed Central

Terlecki, Meredith A.; Buckner, Julia D.

2014-01-01

Individuals with clinically elevated social anxiety are at greater risk for alcohol use disorder, and the relation between social anxiety and drinking problems is at least partially accounted for by drinking more in negative emotional (e.g., feeling sad or angry) and personal/intimate (e.g., before sexual intercourse) situations. Identification of cognitive/motivational factors related to drinking in these high-risk situations could inform the development of treatment and prevention interventions for these high-risk drinkers. The current study examined the mediating effect of drinking motives on the relationship between social anxiety and drinking these high-risk situations amongst undergraduates (N = 232). Clinically elevated social anxiety was associated with greater coping and conformity motives. Both coping and conformity motives mediated the relation between social anxiety and heavier alcohol consumption in negative emotional and personal/intimate contexts. Multiple mediation analyses indicated that these motives work additively to mediate the social anxiety-drinking situations relationship, such that that heavy situational drinking amongst undergraduates with clinically elevated social anxiety can be jointly attributed to desire to cope with negative affect and to avoid social scrutiny. PMID:25233446

Drug-related problems in type 2 diabetes mellitus patients with dyslipidemia

PubMed Central

2013-01-01

Background Drug-Related Problems (DRPs) commonly occur among type 2 diabetes mellitus (T2DM) patients. However, few studies have been performed on T2DM patients with dyslipidemia. This purpose of this study was to assess drug-related problems (DRPs) and factors associated with its occurrence. Methods The retrospective study involved 208 T2DM in-patients and out-patients with dyslipidemia, and was conducted at a tertiary hospital in Malaysia from January 2009 to December 2011. The identification and assessment of DRPs were based on the Pharmaceutical Care Network Europe (PCNE) tool version 5.01. The potentially inappropriate medication use in older adults was assessed based on the American Geriatrics Society updated Beers Criteria. Results A total of 406 DRPs were identified. Among these patients, 91.8% had at least one DRP, averaging 1.94 ± 1.10 problems per patient. The majority of T2DM patients with dyslipidemia (91.8%) had at least one DRP. The most frequent types of DRP were potential drug-drug interaction (18.0%), drug not taken or administered (14.3%) and insufficient awareness of health and diseases (11.8%). Anti-hypertensive, lipid-modifying and anti-diabetic agents were the drug classes that were most likely to be associated with DRPs. Male gender, renal impairment, polypharmacy and poor lipid control were factors that were significantly associated with DRP in diabetic dyslipidemia patients. Conclusion Early identification of DRPs and factors associated with them are essential to prevent and resolve DRPs in T2DM patients with dyslipidemia. PMID:24341672

Pharmacokinetic variations in cancer patients with liver dysfunction: applications and challenges of pharmacometabolomics.

PubMed

Aboel Dahab, Ali; El-Hag, Dhia; Moutamed, Gamal M; Aboel Dahab, Sarah; Abuknesha, Ramadan; Smith, Norman W

2016-09-01

In cancer patients, pharmacokinetic variations between individuals and within individuals due to impairments in organs' function and other reasons such as genetic polymorphisms represent a major problem in disease management, which can result in unpredictable toxicity and variable antineoplastic effects. Addressing pharmacokinetic variations in cancer patients with liver dysfunction and their implications on anticancer and analgesic drugs, in addition to the use of advanced analytical techniques such as metabolomics and pharmacometabolomics, to monitor altered kinetic and discover metabolic biomarkers during therapeutic intervention will help in understanding and reducing pharmacokinetic variations of drugs in cancer patients as a step forward towards personalised medicine. Reviewing published literature addressing and/or related to complications resulting from altered pharmacokinetics (PKs) in cancer patients with liver dysfunction, anticancer and analgesic drugs, evaluating recent advances of pharmacokinetic detection using metabolomics/pharmacometabolomics and the challenges that are currently facing these techniques. The current situation presents a pressing need to reduce pharmacokinetic variations of drugs in cancer patients. Although most of the omics technologies are not entirely focussed on the study of pharmacokinetic variations and some studies are met with uncertainty, the use of pharmacometabolomics combined with other omics technology such as pharmacogenomics can provide clues to personalised cancer treatments by providing useful information about the cancer patient's response to medical interventions via identification of patients' dependent variables, understanding of correlations between individuals and population PKs, and therapy outcomes to achieve optimum therapeutic effects with minimum toxicity. We also propose an approach for PKs' evaluation using pharmacometabolomics.

[Legalization of drugs--pro and con].

PubMed

Marjanović-Cengić, S

2001-01-01

This article deals with various opinions and assertions regarding drug legalization. Societal and clinical implication regarding the effect of decrease or increase in the use of psyhoactive substances, on public health, violence and criminal activities have been pointed out. The relation between legal and illegal drugs has been considered. Special attention has been paid to arguments on legalization and decriminalization of marihuana and possible consequences on the risk group-children and adolescents. Experiences from USA and some European countries have been presented. Having in mind the specific situation in BiH, the author of article gives her own view and suggest the introduction of harm reduction strategy into BiH drug policy, without changing the legal drug status.

Fever with Rashes.

PubMed

Soman, Letha

2018-07-01

Fever with rashes is one of the commonest clinical problems a general practitioner or pediatrician has to face in day-to-day clinical practice. It can be a mild viral illness or a life-threatening illness like meningococcemia or Dengue hemorrhagic fever or it can be one with a lifelong consequence like Kawasaki disease. It is very important to arrive at a clinical diagnosis as early as possible with the minimum investigational facilities. The common causes associated with fever and rashes are infections, viral followed by other infections. There can be so many non-infectious causes also for fever and rashes like auto immune diseases, drug allergies etc. The type of rashes, their appearance in relation to the fever and pattern of spread to different parts of body and the disappearance, all will help in making a diagnosis. Often the diagnosis is clinical. In certain situations laboratory work up becomes essential.

Who works in the sex industry? A profile of female prostitutes in Victoria.

PubMed

Pyett, P M; Haste, B R; Snow, J D

1996-08-01

A large-scale survey was conducted to obtain a comprehensive picture of the range of women involved in prostitution in Victoria and to document their concerns about health in relation to sex work. There was considerable diversity in the ages, education levels, family situations and attitudes to sex work among women working mainly in the legal brothels in Victoria. While their practices in client-worker interactions were low-risk for human immunodeficiency virus and other sexually transmitted diseases, many of the women were more at risk from unprotected sex with private partners and some were more at risk from injecting drug use. Most women reported economic reasons for entering the sex industry and cited problems associated with male clients as the worst aspects. Effective health interventions should be devised and aimed at specific sub-populations of these (and other) sex workers.

Drug Resistance Strategies and Substance Use among Adolescents in Monterrey, Mexico

PubMed Central

Marsiglia, Flavio Francisco; Castillo, Jason; Becerra, David; Nieri, Tanya

2011-01-01

This study examined drug resistance strategies and substance use among adolescents from Monterrey, Mexico. The focus was strategies that U.S. adolescents use most often to resist using substances, including refuse (saying no), explain (declining with an explanation), avoid (staying away from situations where drugs are offered), and leave (exiting situations where drugs are offered). Using self-administered questionnaire data from a convenience sample of 327 Mexican students enrolled at two secondary schools (preparatorias), we tested whether frequent use of particular drug resistance strategies predicted actual substance use. Multiple regression results showed that different strategies were effective for different substances, that some effects were mediated by number of offers received, and that certain effects were stronger for females than for males. Students using the refuse strategy reported less cigarette use and less binge drinking; those using the avoid strategy reported less alcohol and cigarette use; and those using the leave strategy reported less binge drinking and, for females only, less marijuana use. Use of the explain strategy was not significantly related to substance use after controlling for use of other strategies. Findings are discussed in terms of Mexican cultural values and their implications for the design of prevention programs for Mexican youth. PMID:18365314

Self-medication: from European regulatory directives to therapeutic strategy.

PubMed

Bergmann, Jean-François

2003-06-01

Self medications are drugs which can be used without a physician's advice or supervision. There is a clear emerging patient demand for efficient drugs available without prescription. This review summarizes the regulatory rules regarding the status of self-medication drugs in Europe and describes some situations where specific clinical trials are needed for a new drug to be registered as a self medication. These drugs not only have to offer a very positive safety profile but also a well-established level of efficacy. A nonprescription drug can only be proposed in situations where the patient himself can make a self-assessment of the medical condition and its follow-up. These products must be safe even in the event of incorrect use and must offer clear and complete information contributing to a proper use, i.e. a definition of situations where a physician's advice is necessary. For registration as an 'over-the-counter' drug, specific efficacy trials may be conducted in real self-medication situation especially when the target populations, the dosage or the indications in self medication are not the same as those evaluated previously when the drug in question had prescription status. Specific pharmacovigilance is needed and the patient, pharmacist and physician encouraged to report any adverse events. A safety survey may be necessary in some situations such as insomnia or emergency contraception. It is important for the patient, pharmacist and public health in general to distinguish the efficient and safe self medications from the nonvalidated, nonevaluated alternative medicines.

The assessment on impact of essential drugs policy on primary health care system in rural areas of Shandong Province policy and regulation division of the Health Department of Shandong Province.

PubMed

Li, Zhuge; Shu, Defeng; Xia, Mei; Gao, Dehai; Lu, Dan; Huang, Ning; Tian, Xiaoqing; An, Limei; Li, Shixue; Li, Sheng

2015-01-01

At present, China has achieved an initial establishment and gradual implementation of a framework for national essential drugs policy. With the further implementation of the national essential drugs policy, it is not clear how the policy works, whether it achieves the original intention of essential drugs policy, and what impact essential drugs policy exerts on the primary health care system. In view of it, we conducted a field research on sample areas of Shandong Province to understand the conditions of the implementation of the essential drugs policy in Shandong Province. From three perspectives of medical institutions, patients and medical staff, this thesis analyzes the impact of essential drugs policy on village-level and township-level health service system, summarizes the effectiveness of implementing essential drugs policy, discovers the problems of various aspects and conducts an in-depth analysis of the causes, and puts forward feasible suggestions to provide reference for improving the essential drugs policy. The assessment results show that the implementation of essential drugs policy in Shandong Province has played a positive role in promoting the sound development of the primary health care system, changed the situation of covering hospital expenses with medicine revenue in the past, contributed to the return of medical institutions to public welfare, and reduced the patient's economic burden of disease. But there emerge many problems as follows: impact on the doctor's diagnosis and treatment due to incompleteness of drug types, and distribution not in place, patient loss and operational difficulty of village clinic. Thus, this thesis makes recommendations of drugs catalog formulation, drug procurement, sales and use, and meanwhile points out that the supporting financial compensation policy and performance appraisal policy and other measures in place are a prerequisite for a positive role of essential drugs policy.

Childhood Maltreatment Histories, Alcohol and Other Drug Use Symptoms, and Sexual Risk Behavior in a Treatment Sample of Adolescents

PubMed Central

Tubman, Jonathan G.; Burnette, Mandi L.

2012-01-01

Objectives. We tested a structural model of relations among self-reported childhood maltreatment, alcohol and other drug abuse and dependence symptoms, and sexual risk behavior in a sample of adolescents receiving outpatient treatment of substance use problems. Methods. Structured interviews were administered to an ethnically diverse sample of 394 adolescents (114 girls, 280 boys; mean = 16.30 years; SD = 1.15 years; 44.9% Hispanic, 20.6% African American, 25.4% White non-Hispanic, and 9.1% other) in 2 outpatient treatment settings. Results. Path analyses yielded findings consistent with a mediation model. Alcohol abuse and dependence symptoms mediated (1) relations between emotional neglect scores and sex with co-occurring alcohol use and (2) relations between sexual abuse scores and sex with co-occurring alcohol use. Drug abuse and dependence symptoms mediated relations between (1) neglect scores and (2) sexual intercourse with co-occurring alcohol or drug use, as well as unprotected sexual intercourse. Conclusions. Efforts to treat alcohol or drug use problems among adolescents or to prevent transmission of HIV or other sexually transmitted infections among youths with substance use problems may require tailoring treatment or prevention protocols to address client histories of maltreatment. PMID:22401530

Toward a Practical Model of Cognitive/Information Task Analysis and Schema Acquisition for Complex Problem-Solving Situations.

ERIC Educational Resources Information Center

Braune, Rolf; Foshay, Wellesley R.

1983-01-01

The proposed three-step strategy for research on human information processing--concept hierarchy analysis, analysis of example sets to teach relations among concepts, and analysis of problem sets to build a progressively larger schema for the problem space--may lead to practical procedures for instructional design and task analysis. Sixty-four…

Do Children Do What They Say? Responses to Hypothetical and Real-Life Social Problems in Children with Mild Intellectual Disabilities and Behaviour Problems

ERIC Educational Resources Information Center

van Nieuwenhuijzen, M.; Bijman, E. R.; Lamberix, I. C. W.; Wijnroks, L.; de Castro, B. Orobio; Vermeer, A.; Matthys, W.

2005-01-01

Abstract: Background Most research on children's social problem-solving skills is based on responses to hypothetical vignettes. Just how these responses relate to actual behaviour in real-life social situations is, however, unclear, particularly for children with mild intellectual disabilities (MID). Method: In the present study, the spontaneous…

Improving physician and medical student education in substance use disorders.

PubMed

Wyatt, Stephen A; Dekker, Michael A

2007-09-01

Medical and psychosocial problems related to substance use disorders (SUDs) remain a major source of national morbidity and mortality. This situation exists despite greater understanding of genetic, neurobiologic, and social underpinnings of the development of these illnesses that has resulted in many advances in addiction medicine. The value of assessment and brief intervention of this disease is well documented. Patients need to be identified and engaged in order for them to be treated. A variety of evidence-based pharmacologic and psychotherapeutic treatments are now available. Strong evidence exists that treatment of patients for SUDs produces results similar to or better than those obtained from treatment for other chronic illnesses. It is also clear that physicians can play a pivotal role in helping to reduce the burden of disease related to SUDs However, to do this, physicians need to be better educated. Through such education comes greater confidence in identification and providing treatment. Also, the discomfort and stigma often associated with this disease are reduced. The federal government-through the Office of National Drug Control Policy, the Surgeon General, the Center for Substance Abuse Treatment, the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism, and the National Highway Traffic Safety Administration of the Department of Transportation (DOT)-is expending concerted efforts to improve physician education in addiction medicine. These efforts culminated in the Second Leadership Conference on Medical Education in Substance Abuse in December 2006. The osteopathic medical profession was represented at this conference. This article reviews not only the recommendations from this meeting, but also the nature of the problem, how members of the osteopathic medical profession are currently addressing it, and a strategy for improvement endorsed by the American Osteopathic Academy of Addiction Medicine.

Gendered Pathways: Violent Childhood Maltreatment, Sex Exchange, and Drug Use.

PubMed

Verona, Edelyn; Murphy, Brett; Javdani, Shabnam

2015-04-20

Recent work has emphasized the role of violent victimization, along with risky contexts like sex exchange, in pathways to problems of externalizing and substance use in women. Nonetheless, few studies have empirically tested gender differences involving the roles of adversity factors (e.g., childhood violent maltreatment, sex exchange) in drug use patterns. The present study tested a model of gender differences in relationships between childhood physical and sexual abuse, sex exchange, and two indicators of drug use: engagement and symptoms of disorder. We recruited an ethnically-diverse sample of 304 (130 women) adults with recent histories of violence and/or drug use, who completed a substance use diagnostic interview, the Childhood Trauma Questionnaire, and a sex exchange questionnaire. First, structural equation modeling revealed that childhood sexual and physical abuse were related to increased drug engagement in women and men, respectively, above the influence of early childhood contextual variables (e.g., neighborhood, family) and age. Second, sexual abuse was related to sex exchange, which in turn was related to drug use symptoms in women but not men. These data provide empirical support for distinct trauma-related pathways to drug use problems in men and women, which has implications for gendered explanations and prevention approaches.

Inappropriate drug donations: what has happened since the 1999 WHO guidelines?

PubMed

van Dijk, D P; Dinant, G; Jacobs, J A

2011-08-01

Drug donations to developing countries may be part of medical relief operations in acute emergencies, development aid in non-emergency situations, or a corporate donations programme. After a number of documented inappropriate drug donations, the World Health Organization developed the 'Guidelines for Drug Donations', with the second and final version published in 1999. We reviewed the medical literature on drug donations since the Guidelines publication in 1999. Literature was retrieved from PubMed and other on-line databases as well as from relevant websites providing medical literature for use in developing countries. We considered the following donations to be inappropriate: (i) essential drugs in excessive quantities; (ii) mixed unused drugs (unsorted medicines and free samples); and (iii) drug dumping (large quantities of useless medicines). We retrieved 25 publications dated after 1999, including 20 and 5 from the scientific literature and 'grey' literature (technical reports, working papers), respectively. New information concerned emergencies in East Timor, Mozambique, El Salvador, Gujarat State (India), Aceh (Indonesia) and Sri Lanka. Except for East Timor and Gujarat, inappropriate donations still occurred, accounting for 85%, 37%, 70% and 80% of donations in Mozambique, El Salvador, Aceh and Sri Lanka, respectively. Very little information was found on drug donations in non-emergency situations. There are few recent reports on the compliance of drug donations with the World Health Organization guidelines. For emergency situations, there is still room for improvement. Drug donations in non-emergency situations need to be evaluated. A reform of drug donations policy is needed.

Using snowball sampling method with nurses to understand medication administration errors.

PubMed

Sheu, Shuh-Jen; Wei, Ien-Lan; Chen, Ching-Huey; Yu, Shu; Tang, Fu-In

2009-02-01

We aimed to encourage nurses to release information about drug administration errors to increase understanding of error-related circumstances and to identify high-alert situations. Drug administration errors represent the majority of medication errors, but errors are underreported. Effective ways are lacking to encourage nurses to actively report errors. Snowball sampling was conducted to recruit participants. A semi-structured questionnaire was used to record types of error, hospital and nurse backgrounds, patient consequences, error discovery mechanisms and reporting rates. Eighty-five nurses participated, reporting 328 administration errors (259 actual, 69 near misses). Most errors occurred in medical surgical wards of teaching hospitals, during day shifts, committed by nurses working fewer than two years. Leading errors were wrong drugs and doses, each accounting for about one-third of total errors. Among 259 actual errors, 83.8% resulted in no adverse effects; among remaining 16.2%, 6.6% had mild consequences and 9.6% had serious consequences (severe reaction, coma, death). Actual errors and near misses were discovered mainly through double-check procedures by colleagues and nurses responsible for errors; reporting rates were 62.5% (162/259) vs. 50.7% (35/69) and only 3.5% (9/259) vs. 0% (0/69) were disclosed to patients and families. High-alert situations included administration of 15% KCl, insulin and Pitocin; using intravenous pumps; and implementation of cardiopulmonary resuscitation (CPR). Snowball sampling proved to be an effective way to encourage nurses to release details concerning medication errors. Using empirical data, we identified high-alert situations. Strategies for reducing drug administration errors by nurses are suggested. Survey results suggest that nurses should double check medication administration in known high-alert situations. Nursing management can use snowball sampling to gather error details from nurses in a non-reprimanding atmosphere, helping to establish standard operational procedures for known high-alert situations.

Public health nurses' perception of their roles in relation to psychotropic drug use by adolescents: a phenomenographic study.

PubMed

Steffenak, Anne Kjersti Myhrene; Nordström, Gun; Hartz, Ingeborg; Wilde-Larsson, Bodil

2015-04-01

The purpose of the paper was to describe the perceptions of public health nurses' roles in relation to psychotropic drug use by adolescents. Mental health problems among adolescents are documented with studies indicating an increased use of psychotropic drugs. In Norway, care for such adolescents may fall naturally into the remit of public health nurses. A phenomenographic approach was used to analyse the data. A qualitative interview study was made of 20 Norwegian public health nurses, strategically chosen using phenomenographic methodology. The public health nurses described three categories: discovering public health nurses who become aware of psychotropic drug use in the health dialogue with adolescents and choose to either act or not act in relation to psychotropic drug use. Those public health nurses who take action are cooperating public health nurses, who cooperate with adolescents, their families, schools and others. If cooperation has been established, supporting public health nurses teach and support the adolescent in relation to psychotropic drug use. The public health nurses who do not act can hinder or delay further treatment. Public health nurses need to acquire knowledge about psychotropic drugs, to fulfil their role in nursing mental health problems among adolescents and the increasing use of psychotropic drugs. The results demonstrated that public health nurses, working in health centres and schools, have the responsibility and the opportunity to identify young people struggling with mental health problems and psychotropic drug use as well as teach and support significant others, e.g. parents and siblings. Intervention studies are needed with regard to health promotion programmes aimed at fortifying young people's mental health. © 2014 The Authors. Journal of Clinical Nursing Published by John Wiley & Sons Ltd.

Accelerated Hydrolysis of Aspirin Using Alternating Magnetic Fields

NASA Astrophysics Data System (ADS)

Reinscheid, Uwe M.

2009-08-01

The major problem of current drug-based therapy is selectivity. As in other areas of science, a combined approach might improve the situation decisively. The idea is to use the pro-drug principle together with an alternating magnetic field as physical stimulus, which can be applied in a spatially and temporarily controlled manner. As a proof of principle, the neutral hydrolysis of aspirin in physiological phosphate buffer of pH 7.5 at 40 °C was chosen. The sensor and actuator system is a commercially available gold nanoparticle (NP) suspension which is approved for animal usage, stable in high concentrations and reproducibly available. Applying the alternating magnetic field of a conventional NMR magnet system accelerated the hydrolysis of aspirin in solution.

Reform in Mathematics Education: "What Do We Teach for and Against?"

ERIC Educational Resources Information Center

Petric, Marius

2011-01-01

This study examines the implementation of a problem-based math curriculum that uses problem situations related to global warming and pollution to involve students in modeling polynomial, exponential, and logarithmic functions. Each instructional module includes activities that engage students in investigating current social justice and…

Aerospace Mechanisms and Tribology Technology: Case Study

NASA Technical Reports Server (NTRS)

Miyoshi, K.

1999-01-01

This paper focuses attention on tribology technology practice related to vacuum tribology. A case study describes an aspect of a real problem in sufficient detail for the engineer and scientist to understand the tribological situation and the failure. The nature of the problem is analyzed and the tribological properties are examined.

[Antipsychotics for schizophrenia: the paradigm of psychiatric drugs].

PubMed

Pol Yanguas, Emilio

2015-03-01

Antipsychotic drugs do not appear to reverse the causes of schizophrenia, and although they can relieve symptoms in the short to medium term, in the long term they may not be beneficial and could even be counterproductive. Their use should be limited to acute situations in which agitation and tension is disabling. The drugs have significant adverse effects, and given the refusal of a person to continue taking them, a harm reduction strategy to support and monitor the withdrawal may be preferable to coercion. There are alternatives to neuroleptics. Prescribers should be more vigilant and consider the assessments of users regarding the drugs' effects. Adherence to treatment guidelines is low, probably because the guidelines are based on clinical trials of deficient quality which consequently should be improved and extended over a greater period of time. The root of the problem is likely the tautology on the etiology and biological nature of what is known as schizophrenia, which in fact does not seem to be more than a commercial and ideological construct.

Are clinical impressions of adolescent substance use accurate?

PubMed

Wilson, Celeste R; Sherritt, Lon; Gates, Erin; Knight, John R

2004-11-01

To compare providers' impressions of adolescents' level of substance use with diagnostic classifications from a structured diagnostic interview. Secondary analysis of data was conducted from a validation study of the CRAFFT substance abuse screening test of 14- to 18-year-old medical clinic patients (n = 533) and their corresponding medical care providers (n = 109) at an adolescent clinic affiliated with a large tertiary care pediatric hospital. Medical care providers completed a form that recorded their clinical impressions of patients' level of alcohol and drug involvement (none, minimal, problem, abuse, dependence) and demographic characteristics. The form included brief diagnostic descriptions for each level of use. After the medical visit, patients completed the Adolescent Diagnostic Interview (ADI), a structured diagnostic interview that yields diagnoses of abuse and dependence according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). On the basis of their past 12 months of alcohol and drug use on the ADI interview, adolescents were classified into 5 mutually exclusive diagnostic groups. "None" was defined by no reported use of alcohol or drugs during the past year. "Minimal use" was defined as use of alcohol or drugs but no report of any substance-related problems. "Problem use" was defined as reporting 1 or more substance-related problems but no diagnosis of abuse or dependence. "Abuse" was defined by meeting any 1 of 4 DSM-IV diagnostic criteria for either alcohol or drug abuse but no diagnosis of dependence. "Dependence" was defined by meeting any 3 of 7 diagnostic criteria for either alcohol or drug dependence, with or without a diagnosis of abuse. Proportions were compared using Fisher exact test. Agreement was assessed with the weighted kappa, and these analyses were stratified by substance used (ie, alcohol vs drug) and demographic characteristics. Sensitivity, specificity, and positive and negative predictive values were calculated from 2 x 2 tables. Compared with the criterion standard interview, providers identified significantly fewer patients with problem use and abuse and no patients with dependence. Of >100 patients whom the ADI classified with substance problem use, providers correctly identified 18. Of 50 patients who were classified with a diagnosis of alcohol or drug abuse, providers correctly identified 10. Of 36 patients who were classified with a diagnosis of alcohol or drug dependence, providers correctly identified none. For the 86 adolescents who were classified with a substance-related disorder (ie, abuse or dependence), providers' impressions were "none" (24.4%), "minimal use" (50%), "problem use" (15.1%), "abuse" (10.5%), and "dependence" (0%). There was only marginal agreement between providers' impressions and diagnoses related to alcohol use (kappa = .29), drug use (kappa = .31), and any substance use (kappa = .30). Kappa was not significantly affected by the patient's age, but it was by gender. Among boys, kappa was significantly higher for impressions of drug use versus alcohol use (kappa = .48 vs kappa = .27); and, among drug users, kappa was significantly higher among boys compared with girls (kappa = .48 vs kappa = .24). Kappa did not differ significantly across race/ethnicity subgroups, although there is a suggestive trend toward higher agreement for black non-Hispanic compared with white non-Hispanic adolescents (kappa = .35 vs kappa = .21). Kappa did not differ significantly on the basis of the visit type, but the size of this difference (kappa = .36 vs kappa = .24) suggests that the longer well-child visit yielded greater identification of substance-related pathology. Providers' impressions had a sensitivity of .63 for identifying use of alcohol or drugs. However, sensitivity was poor for identification of problem use (.14), abuse (.10), and dependence (0), whereas specificity and positive predictive values were high. Of the 86 adolescents with a diagnosis of abuse or dependence, 75.6% were correctly identified by providers as using substances; however, the level of use in 50% of these adolescents was reported by providers as minimal. In this study, clinical impressions of adolescents' alcohol/drug involvement underestimated substance-related pathology. When providers thought that use was present, there was a very high likelihood that a problem or disorder existed. The use of structured screening devices would likely improve identification of adolescents with substance-related pathology in primary care settings and should be considered for use with all adolescent patients, rather than only those who are perceived to be at higher risk.

The U.S. Hardwood Situation Related to Exports

Treesearch

Philip A. Araman; John Tansey

1990-01-01

The U.S. grows more hardwood timber each year than is being used for domestic and export markets. However, we do have some problems. In this paper, the authors present a quick look at our hardwood resource situation (species, quality, availability). They also describe where the timber is growing for several species, talk about availability in the Southeast region, and...

Training and Appointing Processes of School Leaders in Developed and Developing Countries: How Is the Situation in Turkey?

ERIC Educational Resources Information Center

Saglam, Aycan Çiçek; Geçer, Ali; Bag, Derya

2017-01-01

Goal of the study is to compare training and appointing processes of education administrators in developed and developing countries to see similarities and differences and also the situation in Turkey so as to give some suggestion thought to have some positive impacts on training and appointing-related problems of Turkish Education. Within the…

Children's Approaches to Tasks, Self-Perceptions, and Use of Relevant External Cues.

ERIC Educational Resources Information Center

Ruble, Diane N.

A proposed study of the differences in the way children perceive, approach, and behave in problem-solving situations is described. The behavioral measure to be used is "glancing," which has been related to outerdirectedness. Children will be given two sets of two puzzles to put together. On the basis of the number of glances and the situation in…

From offender to situation: the 'cold' approach to sexual violence prevention?

PubMed

Hebenton, Bill

2011-01-01

Many commentators have pointed to the monstrous nature of sexual violence, with its related sense of pollution and disgust. In response, post-release regulation has a 'hot' quality: in the USA, sexually violent predator statutes, residency requirements, GPS satellite monitoring, and variations on the theme of community notification all speak of the expressiveness of the response. 'Hot' signifies and has embedded within it an 'individualist' rather than 'structural' account of action, emphasises a dramaturgical reading of the social world, and privileges the political rather than the problem-solving sphere. What has been far less explored, until recently, is research and prevention policy related specifically to the sexual violence itself, or the situation in which the offense occurs. By contrast to the 'hot' response, elision from offender to situation appears to betoken a 'cold' quality. This paper analyses the conceptual and empirical underpinnings of such a 'cold' situational approach, evaluates existing studies across settings, and assesses the implications of this problem-solving process for prevention policy and practice. It concludes by embedding the analysis within a broader precautionary politics of 'hot' and 'cold' control. Copyright © 2011 Elsevier Ltd. All rights reserved.

Selective attention and drug related attention bias in methadone maintenance patients.

PubMed

Nejati, Majid; Nejati, Vahid; Mohammadi, Mohammad Reza

2011-01-01

One of the main problems of the drug abusers is drug related attention bias, which causes craving, and as a result drive the drug abusers to take narcotics. Methadone is used as a maintenance treatment for drug abusers. The purpose of this study is evaluation of the effect of Methadone maintenance therapy (MMT) on selective attention and drug related attention bias. This study investigated drug cue-related attention bias and selective attention in 16 methadone-maintained patients before and 45 days after methadone therapy period. Stroop color-word test and addiction Stroop test were used as measurement methods. Results show less reaction time and higher accuracy in Color-Word Stroop Test after MMT and less delay for addict related word in addiction Stroop test. It is concluded that methadone can improve selective attention capability and reduce drug related attention bias.

The role of typography in differentiating look-alike/sound-alike drug names.

PubMed

Gabriele, Sandra

2006-01-01

Until recently, when errors occurred in the course of caring for patients, blame was assigned to the healthcare professionals closest to the incident rather than examining the larger system and the actions that led up to the event. Now, the medical profession is embracing expertise and methodologies used in other fields to improve its own systems in relation to patient safety issues. This exploratory study, part of a Master's of Design thesis project, was a response to the problem of errors that occur due to confusion between look-alike/sound-alike drug names (medication names that have orthographic and/or phonetic similarities). The study attempts to provide a visual means to help differentiate problematic names using formal typographic and graphic cues. The FDA's Name Differentiation Project recommendations and other typographic alternatives were considered to address issues of attention and cognition. Eleven acute care nurses participated in testing that consisted of word-recognition tasks and questions intended to elicit opinions regarding the visual treatment of look-alike/sound-alike names in the context of a label prototype. Though limited in sample size, testing provided insight into the kinds of typographic differentiation that might be effective in a high-risk situation.

[Conflict of rights in the decision of nursing care].

PubMed

Deodato, Sérgio

2008-01-01

Nursing care relations require an ethical decision, for an identified problem or a dilemma. To solve these requires a search for good solutions, respecting involved people and their rights. Care decision may come across situations where two rights of the person can oppose each other. Starting from the concept that there are no absolute rights, nurses take over, as their duty, the search for the best ethical resolution conciliating both, in each particular situation. As a reply to this problem, we shall analyze the principle of practical agreementfor the conflict resolution of the persons'rights and assume for ourselves to plan the best solutions for the dilemmatic situations in the nursing profession. Along with the reflection around this principle, we shall approach some examples that will help to clarify those ideas.

Vocalizations associated with anxiety and fear in the common marmoset (Callithrix jacchus).

PubMed

Kato, Yoko; Gokan, Hayato; Oh-Nishi, Arata; Suhara, Tetsuya; Watanabe, Shigeru; Minamimoto, Takafumi

2014-12-15

Vocalizations of common marmoset (Callithrix jacchus) were examined under experimental situations related to fear or anxiety. When marmosets were isolated in an unfamiliar environment, they frequently vocalized "tsik-egg" calls, which were the combination calls of 'tsik' followed by several 'egg'. Tsik-egg calls were also observed after treatment with the anxiogenic drug FG-7142 (20mg/kg, sc). In contrast, when marmosets were exposed to predatory stimuli as fear-evoking situations, they frequently vocalized tsik solo calls as well as tsik-egg calls. These results suggest that marmosets dissociate the vocalization of tsik-egg and tsik calls under conditions related to fear/anxiety; tsik-egg solo vocalizations were emitted under anxiety-related conditions (e.g., isolation and anxiogenic drug treatment), whereas a mixed vocalization of tsik-egg and tsik was emitted when confronted with fear-provoking stimuli (i.e., threatening predatory stimuli). Tsik-egg call with/without tsik can be used as a specific vocal index of fear/anxiety in marmosets, which allows us to understand the neural mechanism of negative emotions in primate. Copyright © 2014 Elsevier B.V. All rights reserved.

Consumers devise drug cost-cutting measures: medical and legal issues to consider.

PubMed

Ganguli, Gouranga

2003-01-01

Health care costs in general, and prescription drug costs in particular, are rapidly rising. Between 1996 and 2007 the average annual per capita health care cost is projected to increase from dollar 3,781 to dollar 7,100. [AQ1] The single leading component of health care cost is the cost of prescription drugs (currently 10% of total health care spending, projected to become 18% in 2008). The average cost per drug increased 40% during the 1993-1998 period. Forty-one million Americans have no health insurance, and those who have, have inadequate prescription drug coverage. [AQ2] To cope with this situation, many consumers are trying to economize by doing without the prescriptions or the appropriate doses, buying generics or medicines from Canada or Mexico, or splitting pills of higher doses to take advantage of the pricing policy of drug manufacturers. Some of these approaches are medically and/or legally acceptable, while some are dubious. Most adversely affected are the seniors and poor; for certain groups of seniors prescription drugs account for 30% of their health care spending. The problem must receive prompt concerted attention from consumers, insurers, pharmaceutical companies, and lawmakers before it gets out of hand.

OpenVigil FDA - Inspection of U.S. American Adverse Drug Events Pharmacovigilance Data and Novel Clinical Applications.

PubMed

Böhm, Ruwen; von Hehn, Leocadie; Herdegen, Thomas; Klein, Hans-Joachim; Bruhn, Oliver; Petri, Holger; Höcker, Jan

2016-01-01

Pharmacovigilance contributes to health care. However, direct access to the underlying data for academic institutions and individual physicians or pharmacists is intricate, and easily employable analysis modes for everyday clinical situations are missing. This underlines the need for a tool to bring pharmacovigilance to the clinics. To address these issues, we have developed OpenVigil FDA, a novel web-based pharmacovigilance analysis tool which uses the openFDA online interface of the Food and Drug Administration (FDA) to access U.S. American and international pharmacovigilance data from the Adverse Event Reporting System (AERS). OpenVigil FDA provides disproportionality analyses to (i) identify the drug most likely evoking a new adverse event, (ii) compare two drugs concerning their safety profile, (iii) check arbitrary combinations of two drugs for unknown drug-drug interactions and (iv) enhance the relevance of results by identifying confounding factors and eliminating them using background correction. We present examples for these applications and discuss the promises and limits of pharmacovigilance, openFDA and OpenVigil FDA. OpenVigil FDA is the first public available tool to apply pharmacovigilance findings directly to real-life clinical problems. OpenVigil FDA does not require special licenses or statistical programs.

Determining the Performances of Pre-Service Primary School Teachers in Problem Posing Situations

ERIC Educational Resources Information Center

Kilic, Cigdem

2013-01-01

This study examined the problem posing strategies of pre-service primary school teachers in different problem posing situations (PPSs) and analysed the issues they encounter while posing problems. A problem posing task consisting of six PPSs (two free, two structured, and two semi-structured situations) was delivered to 40 participants.…

HIV Sexual Risk Behavior Among Low-Income Women Experiencing Intimate Partner Violence: The Role of Posttraumatic Stress Disorder

PubMed Central

Cavanaugh, Courtenay E.; Hansen, Nathan B.; Sullivan, Tami P.

2010-01-01

Posttraumatic stress disorder resulting from intimate partner violence (IPV-related PTSD), drug problems, and alcohol problems were tested as correlates of women’s sexual risk behavior. Participants were 136 low-income women experiencing physical violence by a male partner during the past 6 months. Sexual risk behavior was assessed by whether women had unprotected sex with a risky primary partner (i.e., HIV-positive, injection drug user, and/or nonmonogamous), unprotected sex with a risky nonprimary partner (i.e. HIV-positive or unknown status), or traded sex during the past 6 months. Nearly one in five women engaged in these recent sexual risk behaviors. Simultaneous logistic regression results revealed IPV-related PTSD, but not drug or alcohol problems, was significantly associated with sexual risk behavior while controlling for childhood abuse and demographic covariates. Women with IPV-related PTSD had four times greater odds of recent sexual risk behavior compared to women without IPV-related PTSD. Implications for HIV prevention interventions are discussed. PMID:19856093

Can Food be Addictive? Public Health and Policy Implications

PubMed Central

Gearhardt, Ashley N.; Grilo, Carlos M.; DiLeone, Ralph J.; Brownell, Kelly D.; Potenza, Marc N.

2011-01-01

Aims Data suggest that hyperpalatable foods may be capable of triggering an addictive process. Although the addictive potential of foods continues to be debated, important lessons learned in reducing the health and economic consequences of drug addiction may be especially useful in combating food-related problems. Methods In the current paper, we review the potential application of policy and public health approaches that have been effective in reducing the impact of addictive substances to food-related problems. Results Corporate responsibility, public health approaches, environmental change, and global efforts all warrant strong consideration in reducing obesity and diet-related disease. Conclusions Although there exist important differences between foods and addictive drugs, ignoring analogous neural and behavioral effects of foods and drugs of abuse may result in increased food-related disease and associated social and economic burdens. Public health interventions that have been effective in reducing the impact of addictive drugs may have a role in targeting obesity and related diseases. PMID:21635588

Can food be addictive? Public health and policy implications.

PubMed

Gearhardt, Ashley N; Grilo, Carlos M; DiLeone, Ralph J; Brownell, Kelly D; Potenza, Marc N

2011-07-01

Data suggest that hyperpalatable foods may be capable of triggering an addictive process. Although the addictive potential of foods continues to be debated, important lessons learned in reducing the health and economic consequences of drug addiction may be especially useful in combating food-related problems. In the current paper, we review the potential application of policy and public health approaches that have been effective in reducing the impact of addictive substances to food-related problems. Corporate responsibility, public health approaches, environmental change and global efforts all warrant strong consideration in reducing obesity and diet-related disease. Although there exist important differences between foods and addictive drugs, ignoring analogous neural and behavioral effects of foods and drugs of abuse may result in increased food-related disease and associated social and economic burdens. Public health interventions that have been effective in reducing the impact of addictive drugs may have a role in targeting obesity and related diseases. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

Facts about Alcohol and Other Drug Use during Pregnancy. ARC Facts.

ERIC Educational Resources Information Center

Association for Retarded Citizens, Arlington, TX.

The fact sheet provides basic information about how alcohol and drug use during pregnancy can lead to Fetal Alcohol Syndrome (FAS) and Alcohol Related Birth Defects (ARBD), resulting in such problems as mental retardation, sleep disturbances, learning disabilities, muscle problems, heart defects, and small head size. The question and answer format…

Employee Drug Testing Policies in Police Departments. Research in Brief.

ERIC Educational Resources Information Center

McEwen, J. Thomas; And Others

1986-01-01

The development of drug testing policies and the implementation of drug testing procedures involve legal, ethical, medical, and labor relations issues. To learn how police departments are addressing the problem of drug use and drug testing of police officers, the National Institute of Justice sponsored a telephone survey of 33 major police…

Microbiological testing of Skylab foods.

NASA Technical Reports Server (NTRS)

Heidelbaugh, N. D.; Mcqueen, J. L.; Rowley, D. B.; Powers , E. M.; Bourland, C. T.

1973-01-01

Review of some of the unique food microbiology problems and problem-generating circumstances the Skylab manned space flight program involves. The situations these problems arise from include: extended storage times, variations in storage temperatures, no opportunity to resupply or change foods after launch of the Skylab Workshop, first use of frozen foods in space, first use of a food-warming device in weightlessness, relatively small size of production lots requiring statistically valid sampling plans, and use of food as an accurately controlled part in a set of sophisticated life science experiments. Consideration of all of these situations produced the need for definite microbiological tests and test limits. These tests are described along with the rationale for their selection. Reported test results show good compliance with the test limits.

Patients in palliative care-Development of a predictive model for anxiety using routine data.

PubMed

Hofmann, Sonja; Hess, Stephanie; Klein, Carsten; Lindena, Gabriele; Radbruch, Lukas; Ostgathe, Christoph

2017-01-01

Anxiety is one of the most common psychological symptoms in patients in a palliative care situation. This study aims to develop a predictive model for anxiety using data from the standard documentation routine. Data sets of palliative care patients collected by the German quality management benchmarking system called Hospice and Palliative Care Evaluation (HOPE) from 2007 to 2011 were randomly divided into a training set containing two-thirds of the data and a test set with the remaining one-third. We dichotomized anxiety levels, proxy rated by medical staff using the validated HOPE Symptom and Problem Checklist, into two groups with no or mild anxiety versus moderate or severe anxiety. Using the training set, a multivariable logistic regression model was developed by backward stepwise selection. Predictive accuracy was evaluated by the area under the receiver operating characteristic curve (AUC) based on the test set. An analysis of 9924 data sets suggests a predictive model for anxiety in patients receiving palliative care which contains gender, age, ECOG, living situation, pain, nausea, dyspnea, loss of appetite, tiredness, need for assistance with activities of daily living, problems with organization of care, medication with sedatives/anxiolytics, antidepressants, antihypertensive drugs, laxatives, and antibiotics. It results in a fair predictive value (AUC = 0.72). Routinely collected data providing individual-, disease- and therapy-related information contain valuable information that is useful for the prediction of anxiety risks in patients receiving palliative care. These findings could thus be advantageous for providing appropriate support for patients in palliative care settings and should receive special attention in future research.

Detection of Drug-Resistant Mycobacterium tuberculosis.

PubMed

Engström, Anna; Juréen, Pontus

2015-01-01

Tuberculosis (TB) remains a global health problem. The increasing prevalence of drug-resistant Mycobacterium tuberculosis, the causative agent of TB, demands new measures to combat the situation. Rapid and accurate diagnosis of the pathogen and its drug susceptibility pattern is essential for timely initiation of optimal treatment, and, ultimately, control of the disease. We have developed a molecular method for detection of first- and second-line drug resistance in M. tuberculosis by Pyrosequencing(®). The method consists of seven Pyrosequencing assays for the detection of mutations in the genes or promoter regions, which are most commonly responsible for resistance to the drugs rifampicin, isoniazid, ethambutol, amikacin, kanamycin, capreomycin, and fluoroquinolones. The method was validated on clinical isolates and it was shown that the sensitivity and specificity of the method were comparable to those of Sanger sequencing. In the protocol in this chapter we describe the steps necessary for setting up and performing Pyrosequencing for M. tuberculosis. The first part of the protocol describes the assay development and the second part of the protocol describes utilization of the method.

Factors Related to Drug Abuse in the Submarine Service. IV. Correlates of Permissiveness of Attitudes Toward Drug Abuse

DTIC Science & Technology

1974-07-23

man’s home situation, the family composition and birth order similarly were unrelated; but, (5) there was some tendency for less permissive...criterion. The sociological literature contains numerous examples of correlation be- tween birth order and the presence or absence of a range of...recalled that an earlier NSMRL Report, presented 15 TABLE X. Relationship of Birth Order , Number and Sex of Siblings, and Size of Hometown to

[Management of agitated, violent or psychotic patients in the emergency department: an overdue protocol for an increasing problem].

PubMed

Jiménez Busselo, M T; Aragó Domingo, J; Nuño Ballesteros, A; Loño Capote, J; Ochando Perales, G

2005-12-01

Patients with extreme agitation, delirium, violent behavior or acute psychosis are frequently evaluated in the emergency departments of general hospitals. However, the traditional infrequency of this type of situation in pediatric emergency services can lead to a certain lack of foresight and efficiency in the initial management of these patients. Because of the current known increase of psychosocial disorders in pediatric emergencies, new pharmacological treatments for juvenile psychotic processes, and particularly the lack of compliance with these treatments, as well as the earlier consumption of ever more varied illicit drugs among young people, the frequency and diversity of this kind of disorder is on the increase. The treatment of agitation, aggression and violence begins with successful management of the acute episode, followed by strategies designed to reduce the intensity and frequency of subsequent episodes. The key to safety is early intervention to prevent progression from agitation to aggression and violence. Consequently, urgent measures designed to inhibit agitation should be adopted without delay by the staff initially dealing with the patient, usually in the emergency unit. Patients with psychomotor agitation disorder (PMAD) may require emergency physical and/or chemical restraints for their own safety and that of the healthcare provider in order to prevent harmful clinical sequelae and to expedite medical evaluation to determine the cause. However, the risks of restraint measures must be weighed against the benefits in each case. This review aims to present the emergency measures to be taken in children with PMAD. The distinct etiological situations and criteria for the choice of drugs for chemical restraint in each situation, as well as the complications associated with certain drugs, are discussed. It is advisable, therefore, that health professionals become familiar with the distinct pharmacological options.

[Basic policy towards patient's violation of drug control law].

PubMed

Hirai, Shinji

2003-12-01

All medical workers have a duty to protect a patient's privacy by law. Civil servants have a duty to prosecute anyone if a crime has been committed and others have the right to prosecute. When medical workers find their patient using illegal drugs, they are in a situation where any possible action they take is either a breach of one of the duties or an abandonment of the right to prosecute. Any worker in this situation should choose to do what will greater benefit society. Medical workers should avoid prosecuting a patient for illegal drug use, so that drug users can seek help. At the same time medical workers should try to put the patient in a situation where the patient's drug use in the future can be treated by the criminal justice system.

Knowledge Integration and Use-Case Analysis for a Customized Drug-Drug Interaction CDS Service

NASA Astrophysics Data System (ADS)

Kam, Hye Jin; Park, Man Young; Kim, Woojae; Yoon, Duk Yong; Ahn, Eun Kyoung; Park, Rae Woong

Clinical decision support systems (CDSSs) are thought to reduce adverse drug events (ADEs) by monitoring drug-drug interactions(DDIs). However, clinically improper or excessive alerts can result in high alert overrides. A tailored CDS service, which is appropriate for clinicians and their ordering situations, is required to increase alert acceptance. In this study, we conducted a 12-week pilot project adopting a tailed CDSS at an emergency department. The new CDSS was conducted via a stepwise integration of additional new rules. The alert status with changes in acceptance rate was analyzed. The most frequent DDI alerts were related to prescriptions of anti-inflammatory drugs. The percentages of alert overrides for each stage were 98.0%, 96.0%, 96.9%, and 98.1%, respectively. 91.5% of overridden alerts were related to discharge medications. To reduce the potential hazards of ADEs, the development of an effective customized DDI CDSS is required, via in-depth analysis on alert patterns and overridden reasons.

Malaria remains a military medical problem.

PubMed

World, M J

2001-10-01

To bring military medical problems concerning malaria to the attention of the Defence Medical Services. Seven military medical problems related to malaria are illustrated by cases referred for secondary assessment over the past five years. Each is discussed in relation to published data. The cases of failure of various kinds of chemoprophylaxis, diagnosis and treatment of malaria may represent just a fraction of the magnitude of the overall problem but in the absence of reliable published military medical statistics concerning malaria cases, the situation is unclear. Present experience suggests there are a number of persisting problems affecting the military population in relation to malaria. Only publication of reliable statistics will define their magnitude. Interim remedies are proposed whose cost-effectiveness remains to be established.

Using "The West Wing" for Problem-Based Learning in Public Relations Courses

ERIC Educational Resources Information Center

Smudde, Peter M.; Luecke, John R.

2005-01-01

Integrating "The West Wing" in public relations courses can effectively dramatize the concrete and abstract dimensions of public relations. In turn, students see public relations in action (albeit fictionally so) and learn much about it through structured lessons. From individual writing assignments about situations in "The West Wing," to the…

The Context of Ethnicity: Peer Victimization and Adjustment Problems in Early Adolescence

ERIC Educational Resources Information Center

Hoglund, Wendy L. G.; Hosan, Naheed E.

2013-01-01

The current study bridges research on peer relational and physical victimization with research on ethnic victimization and situates this research in the context of ethnic diversity. Specifically, the authors investigate how ethnic, relational, and physical victimization relate to concurrent levels of depression/anxiety and physical aggression and…

A randomized clinical trial of behavioral couples therapy versus individually-based treatment for drug-abusing women.

PubMed

O'Farrell, Timothy J; Schumm, Jeremiah A; Murphy, Marie M; Muchowski, Patrice M

2017-04-01

Behavioral couples therapy (BCT) is more efficacious than individually-based therapy (IBT) for substance and relationship outcomes among substance use disorder patients. This study compared BCT with IBT for drug-abusing women. Sixty-one women, mostly White, late 30s, with primary substance use disorder other than alcohol (74% opioid), and male partners were randomized to 26 sessions over 13 weeks of BCT plus 12-step-oriented IBT (i.e., BCT + IBT) or IBT. Substance-related outcomes were percentage days abstinent (PDA), percentage days drug use (PDDU), Inventory of Drug Use Consequences. Relationship outcomes were Dyadic Adjustment Scale (DAS), days separated. Data were collected at baseline, posttreatment, and quarterly for 1-year follow-up. On PDA, PDDU, and substance-related problems, both BCT + IBT and IBT patients showed significant (p < .01) large effect size improvements throughout 1-year follow-up (d > .8 for most time periods). BCT + IBT showed a significant (p < .001) large effect size (d = -.85) advantage versus IBT on fewer substance-related problems, while BCT + IBT and IBT did not differ on PDA or PDDU (ps > .47). On relationship outcomes, compared to IBT, BCT + IBT had significantly higher male-reported Dyadic Adjustment Scale (p < .001, d = .57) and fewer days separated (p = .01, d = -.47) throughout 1-year follow-up. BCT + IBT for drug-abusing women was more efficacious than IBT in improving relationship satisfaction and preventing relationship breakup. On substance use and substance-related problems, women receiving both treatments substantially improved, and women receiving BCT + IBT had fewer substance-related problems than IBT. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

A Randomized Clinical Trial of Behavioral Couples Therapy versus Individually-Based Treatment for Drug Abusing Women

PubMed Central

O’Farrell, Timothy J.; Schumm, Jeremiah A.; Murphy, Marie M.; Muchowski, Patrice M.

2017-01-01

Objective Behavioral couples therapy (BCT) is more efficacious than individually-based therapy (IBT) for substance and relationship outcomes among patients with substance use disorder (SUD). This study compared BCT with IBT for drug-abusing women. Method Sixty-one women, mostly White, late thirties, with primary SUD other than alcohol (74% opioid diagnosis), and male partners were randomized to 26 sessions over 13-weeks of BCT plus 12-step-oriented IBT (i.e. BCT+IBT) or IBT. Substance-related outcomes: percentage days abstinent (PDA), percentage days drug use (PDDU), Inventory of Drug Use Consequences. Relationship outcomes: Dyadic Adjustment Scale (DAS) and days separated. Data were collected at baseline, post-treatment, and quarterly for 1-yr follow-up. Results On PDA, PDDU, and substance-related problems, both BCT+IBT and IBT patients showed significant (p < .01) large effect size improvements throughout the 1-yr follow-up (d > .8 for most time periods). BCT+IBT showed a significant (p < .001) large effect size (d = −.85) advantage versus IBT on fewer substance-related problems, while BCT+IBT and IBT did not differ on PDA or PDDU (p’s > .47). On relationship outcomes, compared to IBT, BCT+IBT had significantly higher male-reported DAS (p < .001, d = .57) and fewer days separated (p = .01, d = −.47) throughout the 1-yr follow-up. Conclusion BCT+IBT for drug-abusing women was more efficacious than IBT in improving relationship satisfaction and preventing relationship break-up. On substance use and substance-related problems, women receiving both treatments substantially improved, and women receiving BCT+IBT had fewer substance-related problems than IBT. PMID:28333533

School Dropouts in Perspective.

ERIC Educational Resources Information Center

Sherraden, Michael W.

1986-01-01

Discusses aspects of the school dropout problem: figures and trends, related youth problems (unemployment, crime and vandalism, drug and alcohol abuse, political alienation, teen pregnancy and childbirth, homicide and suicide), and suggestions for solving the problem. (CT)

A Qualitative Study of Individual and Peer Factors Related to Effective Nonviolent versus Aggressive Responses to Problem Situations among Adolescents with High Incidence Disabilities

ERIC Educational Resources Information Center

Sullivan, Terri N.; Helms, Sarah W.; Bettencourt, Amie F.; Sutherland, Kevin; Lotze, Geri M.; Mays, Sally; Wright, Stephen; Farrell, Albert D.

2012-01-01

To enhance the positive adjustment of youths with high incidence disabilities, a better understanding of the factors that influence their use of effective responses in challenging situations is needed. In this qualitative study, adolescents described individual and peer factors that would influence their use of effective nonviolent or aggressive…

Does trauma exposure predict prescription drug problems beyond the contribution of post-traumatic stress disorder and depression? An analysis of the Mind Your Heart cohort study.

PubMed

Kalapatapu, Raj K; Dannenbaum, Tatiana P; Harbison, John D; Cohen, Beth E

2017-01-01

It is not clear from prior studies whether trauma exposure predicts substance use problems independent of psychiatric comorbidities. Most prior studies were cross-sectional in nature, and none focused on prescription drug problems. To address this gap in the literature, the current article is a secondary analysis of veterans from the Mind Your Heart prospective cohort study. The primary research question is whether trauma exposure predicts prescription drug problems even after controlling for major psychiatric symptoms, such as post-traumatic stress disorder and depression. Multinomial logistic regression was used to assess whether the 10-item lifetime Brief Trauma Questionnaire (e.g., serious car accidents, war traumas, life-threatening illness, natural disasters, physical, or sexual abuse) predicts prescription drug problems as determined by a self-report categorical question (three answer choices) over a 4-year follow-up time period (n = 661 [100%] at year 1; 83.4% at year 2; 85.9% at year 3; and 78.2% at year 4). Trauma exposure was positively associated with prescription drug problems in unadjusted and age-, sex-, and race-adjusted analyses at follow-up. After accounting for post-traumatic stress disorder (PTSD Checklist-17 Civilian Version) and depression (Patient Health Questionnaire-9) symptoms, trauma exposure was no longer associated with prescription drug problems at all time points (relative risk ratios range 0.91-1.47). These results were robust to different missing data strategies. Trauma exposure was not associated with prescription drug problems over a 4-year follow-up in a prospective cohort study of veterans. Future directions include detailed measures of prescription drug problems and recruitment from community sites.

Importance of target-mediated drug disposition for small molecules.

PubMed

Smith, Dennis A; van Waterschoot, Robert A B; Parrott, Neil J; Olivares-Morales, Andrés; Lavé, Thierry; Rowland, Malcolm

2018-06-18

Target concentration is typically not considered in drug discovery. However, if targets are expressed at relatively high concentrations and compounds have high affinity, such that most of the drug is bound to its target, in vitro screens can give unreliable information on compound affinity. In vivo, a similar situation will generate pharmacokinetic (PK) profiles that deviate greatly from those normally expected, owing to target binding affecting drug distribution and clearance. Such target-mediated drug disposition (TMDD) effects on small molecules have received little attention and might only become apparent during clinical trials, with the potential for data misinterpretation. TMDD also confounds human microdosing approaches by providing therapeutically unrepresentative PK profiles. Being aware of these phenomena will improve the likelihood of successful drug discovery and development. Copyright © 2018. Published by Elsevier Ltd.

Virtual Reality: An Experiential Tool for Clinical Psychology

ERIC Educational Resources Information Center

Riva, Giuseppe

2009-01-01

Several Virtual Reality (VR) applications for the understanding, assessment and treatment of mental health problems have been developed in the last 15 years. Typically, in VR the patient learns to manipulate problematic situations related to his/her problem. In fact, VR can be described as an advanced form of human-computer interface that is able…

Developing Creative Materials for Teaching the Culturally Different Child.

ERIC Educational Resources Information Center

Lindberg, Dormalee H.; Swick, Kevin J.

A persistent problem confronting the teacher of the culturally different child is the need for finding learning materials that the child can relate to and utilize in his learning situation. The increasing availability of mass-produced learning materials for these children, although helpful, has not solved the problem of providing socioeconomically…

Social Relationships and Interpersonal Skills: A Guide for People with Sensory and Physical Limitations.

ERIC Educational Resources Information Center

Institute for Information Studies, Falls Church, VA.

Intended for individuals with physical or sensory handicaps, the guide explores the social and interpersonal implication of disability and suggests alternative ways of dealing with related problems. Chapter 1 looks at the social environment that people with disabilities encounter. Potential social problems and types of situations the disabled may…

An Adaptive Display to Treat Stress-Related Disorders: EMMA's World

ERIC Educational Resources Information Center

Banos, R. M.; Botella, C.; Guillen, V.; Garcia-Palacios, A.; Quero, S.; Breton-Lopez, J.; Alcaniz, M.

2009-01-01

Most of the virtual environments currently available in the field of psychological treatments were designed to solve a specific problem. Our research group has developed a versatile virtual reality system (an adaptive display) called "EMMA's world", which can address a wide range of problems. It was designed to assist in clinical situations where…

Problem Solving in All Seasons: Prekindergarten-Grade 2

ERIC Educational Resources Information Center

Markworth, Kim; McCool, Jenni; Kosiak, Jennifer

2015-01-01

Holidays and seasonal activities provide excitement and a change of pace for teachers and students alike. They also offer perfect backdrops for mathematical tasks that can be related to other topics and themes in the classroom. "Problem Solving in All Seasons, Prekindergarten-Grade 2" delivers thirty-two appealing, real-world situations,…

First-Year Students' Beliefs about Context Problems in Mathematics in University Science Programmes

ERIC Educational Resources Information Center

Drobnic Vidic, Andreja

2015-01-01

Mathematics-related beliefs play an important role in the willingness to engage in academic activities in mathematics education. Such beliefs might not be consistent with the beliefs students hold about context problems that require sufficient mathematical knowledge and the application of such knowledge to various real-life situations. This study…

AIDS: An Employer's Dilemma.

ERIC Educational Resources Information Center

Letchinger, Robert S.

1986-01-01

How should employers respond to applicants and employees with AIDS-related conditions, and how do they resolve employment problems arising from those situations? This article provides some guidance for employers who are currently facing these questions. Discusses legal ramifications, employee attitudes, cost-related considerations, and health…

Online Chat Dependency: The Influence of Social Anxiety

NASA Astrophysics Data System (ADS)

Wang, Chih-Chien; Chang, Shu-Chen

Recent developments in information technology have made it easy for people to “chat” online with others in real time, and many do so regularly. “Virtual” relationships can be attractive, especially for people with social interaction problems in the “real world”. This study examines the influence on online chat dependency of three dimensions of social anxiety: general social situation fear, negative evaluation fear, and novel social situation fear. Participants of this study were 454 college students. The survey results show that negative evaluation fear and general social situation fear are relative to online chat dependency, while novel social situation fear does not seem to be a relevant factor.

Problem Drinking among transnational mexican migrants: Exploring migrant Status and Situational Factors

PubMed Central

Garcia, Victor

2011-01-01

We present research finding son problem drinking among transnational Mexican migrants employed in the mushroom industry of southeastern Pennsylvania. Our research explored the relationship between situational factors—living arrangements, social isolation, and peer pressure to drink—and problem drinking. Individual characteristics of the migrants, such as age, education level, migration history, and work experience in the mushroom industry are also considered. The premise of our study is that the migrants’ judicial status in the country—as foreign solo men and, at times, undocumented or illegal migrants—places them at a high risk to binge drink. The men mainly live without their families in relatively isolated, grower-provided housing or overcrowded apartment units for months, if not years, away from traditional community and kin deterrents to heavy drinking. We employed the ethnographic method in two complementary field studies: a community ethnography, designed to identify the community context of problem drinking, and a series of case studies of migrant drinkers, designed to identify the relationships between situational factors and problem drinking. Focus groups were used to explore and verify the findings being generated in the two studies. Our findings reveal that there is an alcohol abuse problem among the migrants as a consequence of situational and other factors, such as festive occasions, bad news from home, and a long workweek. Their binge drinking does not always result in negative behavior because the migrants follow drinking norms, and violators of these norms are dealt with accordingly. Nonetheless, binge drinking does place them at a high risk for negative behavior, which results in problems in their housing units and in local communities. PMID:21990944

Assessment of Alcohol and Other Drug Use Behaviors in Health Professions Students

ERIC Educational Resources Information Center

Baldwin, Jeffrey N.; Scott, David M.; Agrawal, Sangeeta; Bartek, Jean K.; Davis-Hall, R. Ellen; Reardon, Thomas P.; DeSimone, Edward M., II

2006-01-01

Alcohol and other drug (AOD) use behaviors of health professions students (HPS) were assessed by surveying both university-based HPS and other nursing programs in a Midwestern state in 1999. Response was 2,646 (56.4%) of surveyed students. Family history of alcohol-related and drug-related problems were reported by 39.8% and 13.9%, respectively,…

Medication errors: the role of the patient.

PubMed

Britten, Nicky

2009-06-01

1. Patients and their carers will usually be the first to notice any observable problems resulting from medication errors. They will probably be unable to distinguish between medication errors, adverse drug reactions, or 'side effects'. 2. Little is known about how patients understand drug related problems or how they make attributions of adverse effects. Some research suggests that patients' cognitive models of adverse drug reactions bear a close relationship to models of illness perception. 3. Attributions of adverse drug reactions are related to people's previous experiences and to their level of education. The evidence suggests that on the whole patients' reports of adverse drug reactions are accurate. However, patients do not report all the problems they perceive and are more likely to report those that they do perceive as severe. Patients may not report problems attributed to their medications if they are fearful of doctors' reactions. Doctors may respond inappropriately to patients' concerns, for example by ignoring them. Some authors have proposed the use of a symptom checklist to elicit patients' reports of suspected adverse drug reactions. 4. Many patients want information about adverse drug effects, and the challenge for the professional is to judge how much information to provide and the best way of doing so. Professionals' inappropriate emphasis on adherence may be dangerous when a medication error has occurred. 5. Recent NICE guidelines recommend that professionals should ask patients if they have any concerns about their medicines, and this approach is likely to yield information conducive to the identification of medication errors.

Social anxiety and heavy situational drinking: coping and conformity motives as multiple mediators.

PubMed

Terlecki, Meredith A; Buckner, Julia D

2015-01-01

Individuals with clinically elevated social anxiety are at greater risk for alcohol use disorder, and the relation between social anxiety and drinking problems is at least partially accounted for by drinking more in negative emotional (e.g., feeling sad or angry) and personal/intimate (e.g., before sexual intercourse) situations. Identification of cognitive/motivational factors related to drinking in these high-risk situations could inform the development of treatment and prevention interventions for these high-risk drinkers. The current cross-sectional study examined the mediating effect of drinking motives on the relationship between social anxiety and drinking these high-risk situations among undergraduates (N=232). Clinically elevated social anxiety was associated with greater coping and conformity motives. Both coping and conformity motives mediated the relation between social anxiety and heavier alcohol consumption in negative emotional and personal/intimate contexts. Multiple mediation analyses indicated that these motives work additively to mediate the social anxiety-drinking situations relationship, such that heavy situational drinking among undergraduates with clinically elevated social anxiety can be jointly attributed to desire to cope with negative affect and to avoid social scrutiny. Copyright © 2014 Elsevier Ltd. All rights reserved.

Links between Alcohol and Other Drug Problems and Maltreatment among Adolescent Girls: Perceived Discrimination, Ethnic Identity, and Ethnic Orientation as Moderators

ERIC Educational Resources Information Center

Gray, Calonie M. K.; Montgomery, Marilyn J.

2012-01-01

Objectives: This study examined the links between maltreatment, posttraumatic stress symptoms, ethnicity-specific factors (i.e., perceived discrimination, ethnic identity, and ethnic orientation), and alcohol and/or other drug (AOD) problems among adolescent girls. Methods: These relations were examined using archived data from a community sample…

Adolescents' sense-making of alcohol-related risks: The role of drinking situations and social settings.

PubMed

Katainen, Anu; Lehto, Anna-Sofia; Maunu, Antti

2015-09-01

The article explores how young people understand the risks of alcohol use and how these understandings are associated with differing drinking situations and social settings. By taking account of situational factors, the aim is to demonstrate how young people have highly nuanced notions of drinking styles that suit different drinking situations and of associated risks. The data for the research were gathered in 18 group interviews with Finnish ninth graders aged 14-15 years. Short film clips portraying young people in different drinking situations were used as stimulus material for the interviews. Data analysis focussed on the risk factors related to the social situations illustrated in the film clips. The results show that young people's risk assessments are not based on alcohol itself, but the magnitude of risk is estimated in relation to the social setting of the drinking situation. What is relevant for young people is whether the social situation allows them to make choices with which they feel comfortable. At the opposite pole of problem drinking was social drinking for the purpose of having fun together with other people in such a way that one remains in control of the drinking situation. From a prevention point of view, a key implication is that awareness of the risks is closely associated with situational and social factors. However, the awareness of those risks does not necessarily prevent young people from drinking because they may be accepted as part of the drinking experience. © The Author(s) 2014.

A Qualitative Approach to a Better Understanding of the Problems Underlying Drug Shortages, as Viewed from Belgian, French and the European Union’s Perspectives

PubMed Central

Prokop, Anna; Pilc, Andrzej

2015-01-01

The problem of drug shortages has been reported worldwide, gaining prominence in multiple domains and several countries in recent years. The aim of the study was to analyze, characterise and assess this problem in Belgium and France, while also adopting a wider perspective from the European Union. A qualitative methodological approach was employed, including semi-structured interviews with the representatives of respective national health authorities, pharmaceutical companies and wholesalers, as well as hospital and community pharmacists. The research was conducted in early 2014. Four themes, which were identified through the interviews, were addressed in the paper, i.e. a) defining drug shortages, b) their dynamics and perception, c) their determinants, d) the role of the European and national institutions in coping with the problem. Three groups of determinants of drug shortages were identified throughout this study: manufacturing problems, distribution and supply problems, and problems related to economic aspects. Currently, the Member States of the European Union are striving to resolve the problem very much on their own, although a far more focused and dedicated collaboration may well prove instrumental in coping with drug shortages throughout Europe more effectively. To the best of the authors’ knowledge, this is the first qualitative study to investigate the characteristics, key determinants, and the problem drivers of drug shortages, focusing on this particular group of countries, while also adopting the European Union’s perspective. PMID:25942432

PubMed

Ríos, Pedro Rizo; Rivera, Aurora González; Oropeza, Itzel Rivas; Rivas Bocanegra, Ruth E

2013-12-01

The high costs generated by the current epidemiological profile and the introduction of new technologies, impact on public health systems, this situation is complicated when the health budget is low and causes the drug to be paid by the patient's pocket. In this situation it is necessary to design strategies that strengthen the approval of drugs that will be used in public health institutions in Mexico. To describe the results of the drug approval process for use in public health institutions to ensure the efficacy, safety, and efficiency of health technologies used in public health institutions in Mexico. We conducted a cross-sectional drug approval process, from September 2011 to December 2012, with a descriptive analysis for each stage in the process considered. Of the 394 applications received for approval of health technology, 244 (62%) were for drugs; of these, 151 (62%) met the requirements for evaluation (32% and 68% were modifications inclusions), finally was approved of 42% (61% of the changes and 33% of inclusions). The 73% of the applications were for consensus approval, 12% were conditioned at low price and 6% were approved by majority vote. The main reasons for refusal were lack of clinical evidence (31%) and methodological problems in the economic evaluation (27%). The strengthening of the process was conducted with methodological rigor based on critical analysis of scientific evidence, with transparency and legitimacy under a legal framework to promote resource optimization. The highest percentage of requests was for drugs which are the most commonly used therapeutic technology; for this reason it requires a proper selection process to ensure greater health benefit that ensures efficient use of economic resources. The economic evaluation was a support tool to consider in addition to price, the value of health determined by the quality of evidence, establishing a GDP per capita as a threshold to define a drug as an efficient alternative. © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Published by International Society for Pharmacoeconomics and Outcomes Research (ISPOR) All rights reserved.

From Abstinence to Relapse: A Preliminary Qualitative Study of Drug Users in a Compulsory Drug Rehabilitation Center in Changsha, China

PubMed Central

Yang, Mei; Mamy, Jules; Gao, Pengcheng; Xiao, Shuiyuan

2015-01-01

Background Relapse among abstinent drug users is normal. Several factors are related to relapse, but it remains unclear what individuals’ actual life circumstances are during periods of abstinence, and how these circumstances facilitate or prevent relapse. Objective To illuminate drug users’ experiences during abstinence periods and explore the real-life catalysts and inhibitors contributing to drug use relapse. Method Qualitative in-depth interviews were conducted with 20 drug users recruited from a compulsory isolated drug rehabilitation center in Changsha. The interviews were guided by open-ended questions on individuals’ experiences in drug use initiation, getting addicted, treatment history, social environment, abstinence, and relapse. Participants were also encouraged to share their own stories. Interviews were digitally recorded and fully transcribed. The data of 18 participants who reported abstinence experiences before admission were included in the analyses. The data were analyzed using a thematic analysis with inductive hand coding to derive themes. Results Most drug users were able to successfully abstain from drugs. During abstinence, their lives were congested with challenges, such as adverse socioeconomic conditions, poor family/social support, interpersonal conflicts, and stigma and discrimination, all of which kept them excluded from mainstream society. Furthermore, the police’s system of ID card registration, which identifies individuals as drug users, worsened already grave situations. Relapse triggers reported by the participants focused mainly on negative feelings, interpersonal conflicts, and stressful events. Craving was experienced but not perceived as a relapse trigger by most participants. Conclusions This study of in-depth interview with drug users found evidence of situations and environments they live during abstinence appear rather disadvantaged, making it extremely difficult for them to remain abstinent. Comprehensive programs on relapse prevention that acknowledge these disadvantages are implicated. PMID:26107639

Application of the Pareto principle to identify and address drug-therapy safety issues.

PubMed

Müller, Fabian; Dormann, Harald; Pfistermeister, Barbara; Sonst, Anja; Patapovas, Andrius; Vogler, Renate; Hartmann, Nina; Plank-Kiegele, Bettina; Kirchner, Melanie; Bürkle, Thomas; Maas, Renke

2014-06-01

Adverse drug events (ADE) and medication errors (ME) are common causes of morbidity in patients presenting at emergency departments (ED). Recognition of ADE as being drug related and prevention of ME are key to enhancing pharmacotherapy safety in ED. We assessed the applicability of the Pareto principle (~80 % of effects result from 20 % of causes) to address locally relevant problems of drug therapy. In 752 cases consecutively admitted to the nontraumatic ED of a major regional hospital, ADE, ME, contributing drugs, preventability, and detection rates of ADE by ED staff were investigated. Symptoms, errors, and drugs were sorted by frequency in order to apply the Pareto principle. In total, 242 ADE were observed, and 148 (61.2 %) were assessed as preventable. ADE contributed to 110 inpatient hospitalizations. The ten most frequent symptoms were causally involved in 88 (80.0 %) inpatient hospitalizations. Only 45 (18.6 %) ADE were recognized as drug-related problems until discharge from the ED. A limited set of 33 drugs accounted for 184 (76.0 %) ADE; ME contributed to 57 ADE. Frequency-based listing of ADE, ME, and drugs involved allowed identification of the most relevant problems and development of easily to implement safety measures, such as wall and pocket charts. The Pareto principle provides a method for identifying the locally most relevant ADE, ME, and involved drugs. This permits subsequent development of interventions to increase patient safety in the ED admission process that best suit local needs.

"Not just eliminating the mosquito but draining the swamp": A critical geopolitics of Turkish Monitoring Center for Drugs and Drug Addiction and Turkey's approach to illicit drugs.

PubMed

Evered, Kyle T; Evered, Emine Ö

2016-07-01

In the 1970s, Turkey ceased to be a significant producer state of illicit drugs, but it continued to serve as a key route for the trade of drugs between East and West. Over the past decade, however, authorities identified two concerns beyond its continued transit state status. These reported problems entail both new modes of production and a rising incidence of drug abuse within the nation-state - particularly among its youth. Amid these developments, new law enforcement institutions emerged and acquired European sponsorship, leading to the establishment of TUBİM (the Turkish Monitoring Center for Drugs and Drug Addiction). Coordinating with and reporting to the European Union agency EMCDDA (the European Monitoring Center for Drugs and Drug Addiction), TUBİM's primary assigned duties entail the collection and analysis of data on drug abuse, trafficking, and prevention, the geographic identification of sites of concern (e.g. consumption, drug-related crimes, and peoples undergoing treatment), and the production of annual national reports. In this article, we examine the geopolitical origins of TUBİM as Turkey's central apparatus for confronting drug problems and its role as a vehicle for policy development, interpretation, and enforcement. In doing so, we emphasize the political and spatial dimensions inherent to the country's institutional and policy-driven approaches to contend with drug-related problems, and we assess how this line of attack reveals particular ambiguities in mission when evaluated from scales at world regional, national, and local levels. In sum, we assess how Turkey's new institutional and legislative landscapes condition the state's engagements with drug use, matters of user's health, and policy implementation at local scales and amid ongoing political developments. Copyright © 2016 Elsevier B.V. All rights reserved.

[The good PBL tutor--to be or not to be: instructional films for tutors].

PubMed

Skelin, Silvia; Huwendiek, Sören; Nikendei, Christoph; Dieter, Peter; Kirschfink, Michael; Bosse, Hans-Martin

2008-01-01

Many faculties worldwide apply the method of problem-based learning (PBL) in their curricula as a form of instruction by which students in small groups develop problem-solving strategies on the basis of a specific case. This approach fosters self-responsible and context-dependent learning, which aims at providing an improved anchoring of knowledge. For this reason, the previous decades have seen a distribution of the method to medical schools across the world. The role of the tutor assumes particular importance since, in contrast to the traditional university system, he or she serves as a facilitator who fosters and structures content-related and group-dynamic learning processes. In some cases, this requires an intervention by the tutor. The major challenge is to intervene at the right time and in an appropriate manner. This paper presents examples of difficult PBL situations using short film sequences to demonstrate and comments on potential approaches of the tutor in attempting to resolve the problem. Standard problem situations within a PBL tutorial were defined and produced in a film. A collection of seven frequent critical PBL situations are presented in short film sequences. Potential instruments of intervention are demonstrated in the videos and discussed. The film sequences may be downloaded in the supplementary of the electronic version of this article (www.sciencedirect.com). Within the framework of a tutor-training programme, the problematic situations and interventions presented in this article will help to sensitise tutors to potentially critical PBL tutorial situations and aid the development of individual resolution approaches.

Adjunctive antiepileptic drugs in adult epilepsy: how the first add-on could be the last.

PubMed

Cretin, Benjamin; Hirsch, Edouard

2010-05-01

In adult epilepsies, incomplete seizure control under monotherapy affects approximately 20-25% of patients with idiopathic generalized epilepsies (IGE) and approximately 20-40% of patients with epilepsies with focal seizures (FE). The choice of an adjunctive therapy is therefore a common event. Efficacy studies of add-on anti-epileptic drugs for adult epilepsies--approved since the early 1990s until 2008--were reviewed. An exception was made for valproate. Efficacy studies give important clues for add-on drug choice but--beyond this--we encourage physicians to consider other parameters, especially co-morbidity(ies) and special situation(s). According to clinical and pharmacological data, an original, practical approach is proposed, by which decisions are based on three main criteria, which aim to optimize patients' seizure control and quality of life. The need for drugs that act not only on 'ictogenesis' but also on 'epileptogenesis' is also discussed briefly. Given the increasing disposal of anti-epileptic drugs, the choice of an add-on therapy appears to be partly based on subjective criteria (physician opinions and preferences). In fact, the selection criteria can be clarified as: treatment decisions rely not only on seizure type, efficacy and tolerability profiles but also on patient-related factors.

Approaches to Drug Abuse Prevention

ERIC Educational Resources Information Center

Gordon, Paula D.

1971-01-01

This article concerns the drug abuse related definitions of the words education" and prevention" as they have come to be used today. The writer infers that the changing uses of these words reflects an increasingly more enlightened approach to ameliorating the problem of drug abuse. (Author)

Prevalence and characteristics of psychotropic drug use in institutionalized children and adolescents with mild intellectual disability.

PubMed

Scheifes, Arlette; de Jong, Daniël; Stolker, Joost Jan; Nijman, Henk L I; Egberts, Toine C G; Heerdink, Eibert R

2013-10-01

Psychotropic drugs are a cornerstone in the treatment of psychopathology and/or behavioral problems in children with intellectual disability (ID), despite concerns about efficacy and safety. Studies on the prevalence of psychotropic drug use have mainly been focused on adults with ID or children without ID. Therefore the aim of this cross sectional study was to assess the prevalence and characteristics of psychotropic drug use in children with mild ID who were institutionalized in specialized inpatient treatment facilities in The Netherlands. Demographic data, psychiatric diagnoses, the nature of the behavioral problems, level of intellectual functioning, and medication data were extracted from medical records using a standardized data collection form. Adjusted relative risks (ARR) for the association between patient characteristics and psychotropic drug use were estimated with Cox regression analysis. Of the 472 included children, 29.4% (n=139) used any psychotropic drug, of which 15.3% (n=72) used antipsychotics (mainly risperidone), and 14.8% (n=70) used psychostimulants (mainly methylphenidate). Age, sex, and behavioral problems were associated with psychotropic drug use. Boys had a 1.7 (95%CI 1.1-2.4) higher probability of using psychotropic drugs, compared to girls adjusted for age and behavioral problems. Having any behavioral problem was associated with psychotropic drug use with an ARR of 2.1 (95%CI 1.3-3.3), adjusted for sex and age. The high prevalence of psychotropic drug use in children with ID is worrisome because of the lack of evidence of effectiveness (especially for behavioral problems) at this young age, and the potential of adverse drug reactions. Copyright © 2013 Elsevier Ltd. All rights reserved.

[Psychopharmacology and metabolic syndrome].

PubMed

Telles-Correia, Diogo; Guerreiro, Diogo F; Coentre, Ricardo; Coentre, Rui; Góis, C; Figueira, Luísa

2008-01-01

Metabolic Syndrome consists in a group of metabolic changes, being the most important problem insulin resistence. Other important components of this syndrome are abdominal obesity, hypertension and hyperlipidemia /hypercholestrolemia. It was demonstrated that psychiatric patients have a greater risk to develop metabolic syndrome with a prevalence of 41%. Prevalence of this syndrome in psychiatric male patients is 138% higher than in general population and in female patients 251% higher. Some of the factors that can explain this increase of metabolic risk in psychiatric patients are psychiatric drugs. We preformed a systematic review of literature published until June, 2007, by means of MEDLINE. Studies reviewed include clinical cases, reviews, analytic and observational studies. We selected 72 articles. Authors pretend to understand the mechanisms, by which, different psychiatric drugs can influence metabolic syndrome, and strategies for prevention of this situation.

Links between alcohol and other drug problems and maltreatment among adolescent girls: Perceived discrimination, ethnic identity, and ethnic orientation as moderators

PubMed Central

Gray, Calonie M. K.; Montgomery, Marilyn J.

2012-01-01

Objectives This study examined the links between maltreatment, posttraumatic stress symptoms, ethnicity-specific factors (i.e., perceived discrimination, ethnic identity, and ethnic orientation), and alcohol and/or other drug (AOD) problems among adolescent girls. Methods These relations were examined using archived data from a community sample of 168 Black and Hispanic adolescent girls who participated in a school-based substance use intervention. Results The results revealed that maltreatment was linked to AOD problems, but only through its relation with posttraumatic stress symptoms; maltreatment was positively related to posttraumatic stress symptoms, which were positively related to AOD problems. Both perceived discrimination and ethnic orientation were significant moderators. Specifically, greater perceived discrimination was associated with an increased effect of maltreatment on posttraumatic stress symptoms. Ethnic orientation demonstrated protective properties in the relation between maltreatment and AOD problem severity, such that the effect of maltreatment on AOD problem severity was less for girls with average to high ethnic orientation compared to girls with low ethnic orientation. Conclusions The findings of this study underscore the importance of developing interventions for Black and Hispanic girls that target maltreatment and AOD use concurrently and address ethnicity-specific factors. PMID:22608406

Analyses related to the development of DSM-5 criteria for substance use related disorders: 1. Toward amphetamine, cocaine and prescription drug use disorder continua using Item Response Theory.

PubMed

Saha, Tulshi D; Compton, Wilson M; Chou, S Patricia; Smith, Sharon; Ruan, W June; Huang, Boji; Pickering, Roger P; Grant, Bridget F

2012-04-01

Prior research has demonstrated the dimensionality of alcohol, nicotine and cannabis use disorders criteria. The purpose of this study was to examine the unidimensionality of DSM-IV cocaine, amphetamine and prescription drug abuse and dependence criteria and to determine the impact of elimination of the legal problems criterion on the information value of the aggregate criteria. Factor analyses and Item Response Theory (IRT) analyses were used to explore the unidimensionality and psychometric properties of the illicit drug use criteria using a large representative sample of the U.S. population. All illicit drug abuse and dependence criteria formed unidimensional latent traits. For amphetamines, cocaine, sedatives, tranquilizers and opioids, IRT models fit better for models without legal problems criterion than models with legal problems criterion and there were no differences in the information value of the IRT models with and without the legal problems criterion, supporting the elimination of that criterion. Consistent with findings for alcohol, nicotine and cannabis, amphetamine, cocaine, sedative, tranquilizer and opioid abuse and dependence criteria reflect underlying unitary dimensions of severity. The legal problems criterion associated with each of these substance use disorders can be eliminated with no loss in informational value and an advantage of parsimony. Taken together, these findings support the changes to substance use disorder diagnoses recommended by the American Psychiatric Association's DSM-5 Substance and Related Disorders Workgroup. Published by Elsevier Ireland Ltd.

Family, Religiosity, and the Risk of Adolescent Drug Use.

ERIC Educational Resources Information Center

Bahr, Stephen J.; Maughan, Suzanne L.; Marcos, Anastasios C.; Li, Bingdao

1998-01-01

Uses data from a random sample of 13,250 adolescents. Results show that mother/adolescent bonding and family drug problems have modest, indirect effects on the likelihood of adolescent drug use; father/adolescent bonding, parental monitoring, and family aggression have relatively weak effects on adolescent drug use; and religious students do not…

Interlocked Problem Posing and Children's Problem Posing Performance in Free Structured Situations

ERIC Educational Resources Information Center

Cankoy, Osman

2014-01-01

The aim of this study is to explore the mathematical problem posing performance of students in free structured situations. Two classes of fifth grade students (N = 30) were randomly assigned to experimental and control groups. The categories of the problems posed in free structured situations by the 2 groups of students were studied through…

The financial burden of prescription drugs for neurological conditions in Canada: Results from the National Population Health Study of Neurological Conditions.

PubMed

Guilcher, Sara; Munce, Sarah; Conklin, James; Packer, Tanya; Verrier, Molly; Marras, Connie; Bereket, Tarik; Versnel, Joan; Riopelle, Richard; Jaglal, Susan

2017-04-01

This paper describes the current situation in Canada concerning the availability and use of prescription drugs for neurological conditions. We conducted semi-structured qualitative interviews with health care providers, administrators, community organization representatives, opinion leaders and policy makers. The analysis revealed three primary themes related to the availability of and access to prescription drugs to treat neurological conditions. First, we learned that across Canada there is significant vulnerability and a need for advocacy on behalf of people living with these conditions. Second, we learned that the heightened level of vulnerability and need for advocacy stems in part from the significant differences in the drug coverage available in the different provinces and territories. As a result, there are significant inequities across Canada. Third, we determined that the existing situation is also due to the current approach to health governance (i.e., accountability, transparency). Our study provides evidence for the urgent need for a formal discourse on national pharmacare in Canada, with representatives of neurological conditions having a voice at the table. Copyright © 2017 Elsevier B.V. All rights reserved.

Medicating Relational Trauma in Youth

ERIC Educational Resources Information Center

Foltz, Robert

2008-01-01

Children who have experienced relational trauma present a host of problems and are often diagnosed with psychiatric disorders and then medicated. But there is evidence that commonly used drugs interfere with oxytocin or vasopressin, the human trust and bonding hormones. Thus, psychotropic drugs may impair interpersonal relationships and impede…

PTSD-Related Behavioral Traits in a Rat Model of Blast-Induced mTBI Are Reversed by the mGluR2/3 Receptor Antagonist BCI-838.

PubMed

Perez-Garcia, Georgina; De Gasperi, Rita; Gama Sosa, Miguel A; Perez, Gissel M; Otero-Pagan, Alena; Tschiffely, Anna; McCarron, Richard M; Ahlers, Stephen T; Elder, Gregory A; Gandy, Sam

2018-01-01

Battlefield blast exposure related to improvised explosive devices (IEDs) has become the most common cause of traumatic brain injury (TBI) in the recent conflicts in Iraq and Afghanistan. Mental health problems are common after TBI. A striking feature in the most recent veterans has been the frequency with which mild TBI (mTBI) and posttraumatic stress disorder (PTSD) have appeared together, in contrast to the classical situations in which the presence of mTBI has excluded the diagnosis of PTSD. However, treatment of PTSD-related symptoms that follow blast injury has become a significant problem. BCI-838 (MGS0210) is a Group II metabotropic glutamate receptor (mGluR2/3) antagonist prodrug, and its active metabolite BCI-632 (MGS0039) has proneurogenic, procognitive, and antidepressant activities in animal models. In humans, BCI-838 is currently in clinical trials for refractory depression and suicidality. The aim of the current study was to determine whether BCI-838 could modify the anxiety response and reverse PTSD-related behaviors in rats exposed to a series of low-level blast exposures designed to mimic a human mTBI or subclinical blast exposure. BCI-838 treatment reversed PTSD-related behavioral traits improving anxiety and fear-related behaviors as well as long-term recognition memory. Treatment with BCI-838 also increased neurogenesis in the dentate gyrus (DG) of blast-exposed rats. The safety profile of BCI-838 together with the therapeutic activities reported here, make BCI-838 a promising drug for the treatment of former battlefield Warfighters suffering from PTSD-related symptoms following blast-induced mTBI.

PTSD-Related Behavioral Traits in a Rat Model of Blast-Induced mTBI Are Reversed by the mGluR2/3 Receptor Antagonist BCI-838

PubMed Central

Perez-Garcia, Georgina; De Gasperi, Rita; Gama Sosa, Miguel A.; Perez, Gissel M.; Otero-Pagan, Alena; Tschiffely, Anna; McCarron, Richard M.; Ahlers, Stephen T.

2018-01-01

Battlefield blast exposure related to improvised explosive devices (IEDs) has become the most common cause of traumatic brain injury (TBI) in the recent conflicts in Iraq and Afghanistan. Mental health problems are common after TBI. A striking feature in the most recent veterans has been the frequency with which mild TBI (mTBI) and posttraumatic stress disorder (PTSD) have appeared together, in contrast to the classical situations in which the presence of mTBI has excluded the diagnosis of PTSD. However, treatment of PTSD-related symptoms that follow blast injury has become a significant problem. BCI-838 (MGS0210) is a Group II metabotropic glutamate receptor (mGluR2/3) antagonist prodrug, and its active metabolite BCI-632 (MGS0039) has proneurogenic, procognitive, and antidepressant activities in animal models. In humans, BCI-838 is currently in clinical trials for refractory depression and suicidality. The aim of the current study was to determine whether BCI-838 could modify the anxiety response and reverse PTSD-related behaviors in rats exposed to a series of low-level blast exposures designed to mimic a human mTBI or subclinical blast exposure. BCI-838 treatment reversed PTSD-related behavioral traits improving anxiety and fear-related behaviors as well as long-term recognition memory. Treatment with BCI-838 also increased neurogenesis in the dentate gyrus (DG) of blast-exposed rats. The safety profile of BCI-838 together with the therapeutic activities reported here, make BCI-838 a promising drug for the treatment of former battlefield Warfighters suffering from PTSD-related symptoms following blast-induced mTBI. PMID:29387781

[Analysis on the current use and trend of drugs for digestive system through comprehensive statistics index, in Hangzhou].

PubMed

Chen, Xin-yu; Zhang, Chun-quan; Zhang, Hong; Liu, Wei; Wang, Jun-yan

2010-05-01

To investigate the use and trend of drugs on digestive system in Hangzhou area, under the comprehensive statistics index (CSI). Using the analytical method related to the sum of consumption and CSI, the application of digestive system drugs of different manufacturers in Hangzhou from 2005 to 2007 was analyzed. Other than H2 receptor antagonist, the total consumption of digestive system drugs increased yearly, in terms of the total consumption, the first 4 leading ones were proton pump inhibitors, micro ecology medicines, antiemetic drugs and gastroprokinetic agents. The Laspeyres index of drugs on digestive system increased to different extent. The Laspeyres indices of proton pump inhibitors, probiotics, antiemetic drugs and gastroprokinetic agents were 1.396 50, 1.020 42, 1.728 90, 1.148 50 in 2006 while 2.081 10, 1.217 55, 2.223 50, 1.156 60 in 2007, respectively. Through CSI, the results showed the situation of use and trend of digestive system related drugs in Hangzhou. Factors as rationality, efficiency and costs of the drugs as well as the etiology of the disease were also explored to some degree.

On the Role of Situational Stressors in the Disruption of Global Neural Network Stability during Problem Solving.

PubMed

Liu, Mengting; Amey, Rachel C; Forbes, Chad E

2017-12-01

When individuals are placed in stressful situations, they are likely to exhibit deficits in cognitive capacity over and above situational demands. Despite this, individuals may still persevere and ultimately succeed in these situations. Little is known, however, about neural network properties that instantiate success or failure in both neutral and stressful situations, particularly with respect to regions integral for problem-solving processes that are necessary for optimal performance on more complex tasks. In this study, we outline how hidden Markov modeling based on multivoxel pattern analysis can be used to quantify unique brain states underlying complex network interactions that yield either successful or unsuccessful problem solving in more neutral or stressful situations. We provide evidence that brain network stability and states underlying synchronous interactions in regions integral for problem-solving processes are key predictors of whether individuals succeed or fail in stressful situations. Findings also suggested that individuals utilize discriminate neural patterns in successfully solving problems in stressful or neutral situations. Findings overall highlight how hidden Markov modeling can provide myriad possibilities for quantifying and better understanding the role of global network interactions in the problem-solving process and how the said interactions predict success or failure in different contexts.

The extent of problematic alcohol and other drug use within selected South African workplaces.

PubMed

Harker Burnhams, Nadine; Dada, Siphokazi; Linda, Betty; Myers, Bronwyn; Parry, Charles

2013-09-30

The use of alcohol and other drugs (AODs) in the workplace has a major impact on the health and productivity of the workforce globally. Yet information on this issue is limited in South Africa (SA). To describe the nature and extent of AOD problems in selected workplace settings in SA. Secondary data analysis was conducted on a large dataset compiled by an Employee Assistance Programme (EAP) service provider in SA. As part of an EAP risk audit, assessments for AOD-related problems were completed for each employee accessing EAP services (n=10 428) between 2005 and 2011. Data on the socio-demographic profiles, AOD use and impact of AOD use on the work performance of employees were analysed. Findings indicate that employed men are more likely to experience alcohol-related problems than women, the latter demonstrating a higher percentage of drug-related problems. The majority of referrals to the EAPs emanate from the public, industrial and financial sectors. AOD-related problems were also found to significantly impact on employee work performance. The study begins to address the knowledge gap on the extent of AOD use in SA workplaces and points to the need for further investigations into the exact nature of AOD use. In addition, the study highlights the need for intervention programmes and policies suited to the workplace.

Linking Family Characteristics with Poor Peer Relations: The Mediating Role of Conduct Problems

PubMed Central

Bierman, Karen Linn; Smoot, David L.

2012-01-01

Parent, teacher, and peer ratings were collected for 75 grade school boys to test the hypothesis that certain family interaction patterns would be associated with poor peer relations. Path analyses provided support for a mediational model, in which punitive and ineffective discipline was related to child conduct problems in home and school settings which, in turn, predicted poor peer relations. Further analyses suggested that distinct subgroups of boys could be identified who exhibited conduct problems at home only, at school only, in both settings, or in neither setting. Boys who exhibited cross-situational conduct problems were more likely to experience multiple concurrent problems (e.g., in both home and school settings) and were more likely than any other group to experience poor peer relations. However, only about one-third of the boys with poor peer relations in this sample exhibited problem profiles consistent with the proposed model (e.g., experienced high rates of punitive/ineffective home discipline and exhibited conduct problems in home and school settings), suggesting that the proposed model reflects one common (but not exclusive) pathway to poor peer relations. PMID:1865049

The Effects of Group Monitoring on Fatigue-Related Einstellung during Mathematical Problem Solving

ERIC Educational Resources Information Center

Frings, Daniel

2011-01-01

Fatigue resulting from sleep deficit can lead to decreased performance in a variety of cognitive domains and can result in potentially serious accidents. The present study aimed to test whether fatigue leads to increased Einstellung (low levels of cognitive flexibility) in a series of mathematical problem-solving tasks. Many situations involving…

Aerospace Mechanisms and Tribology Technology: Case Studies

NASA Technical Reports Server (NTRS)

Miyoshi, Kazuhisa

1999-01-01

This chapter focuses attention on tribology technology practice related to vacuum tribology and space tribology. Two case studies describe aspects of real problems in sufficient detail for the engineer and the scientist to understand the tribological situations and the failures. The nature of the problems is analyzed and the range of potential solutions is evaluated. Courses of action are recommended.

Learning to Solve a Business Problem: "Hands-On" Can Get Results

ERIC Educational Resources Information Center

Neeson, Robyn; Billington, Leo; Barrett, Rowena

2007-01-01

Small business training can facilitate business growth. The authors show that a "hands-on" approach can have a direct impact on a business owner's current situation. They consider this in relation to the problem of being unable to find the right staff, demonstrating that a program such as the one they describe enables learning and…

PUPIL-TEACHER RELATIONSHIPS--MAJOR FACTORS IN DEVELOPING LANGUAGE ARTS IN SLOW LEARNERS.

ERIC Educational Resources Information Center

PRINDIVILLE, SISTER FRANCIS DE SALES

TEACHERS INCREASE THEIR STUDENTS' DISCOURAGEMENT AND CONFUSION BY IGNORING THEIR PERSONAL GROWTH AND BY NOT RELATING SCHOOL SITUATIONS TO LIFE PROBLEMS. FOR SLOW LEARNERS, THIS MAY LEAD TO FAILURE, FRUSTRATION, AND BEHAVIOR PROBLEMS. IF THE TEACHER IS TO HELP SLOW LEARNERS, HE MUST BE ABLE TO IDENTIFY THEM, KNOW WHAT THEY EXPECT FROM EDUCATION,…

Describing and Predicting Developmental Profiles of Externalizing Problems from Childhood to Adulthood

PubMed Central

Petersen, Isaac T.; Bates, John E.; Dodge, Kenneth A.; Lansford, Jennifer E.; Pettit, Gregory S.

2014-01-01

This longitudinal study considers externalizing behavior problems from ages 5 to 27 (N = 585). Externalizing problem ratings by mothers, fathers, teachers, peers, and self-report were modeled with growth curves. Risk and protective factors across many different domains and time frames were included as predictors of the trajectories. A major contribution of the study is in demonstrating how heterotypic continuity and changing measures can be handled in modeling changes in externalizing behavior over long developmental periods. On average, externalizing problems decreased from early childhood to preadolescence, increased during adolescence, and decreased from late adolescence to adulthood. There was strong nonlinear continuity in externalizing problems over time. Family process, peer process, stress, and individual characteristics predicted externalizing problems beyond the strong continuity of externalizing problems. The model accounted for 70% of the variability in the development of externalizing problems. The model’s predicted values showed moderate sensitivity and specificity in prediction of arrests, illegal drug use, and drunk driving. Overall, the study showed that by using changing, developmentally-relevant measures and simultaneously taking into account numerous characteristics of children and their living situations, research can model lengthy spans of development and improve predictions of the development of later, severe externalizing problems. PMID:25166430

[Consideration about chemistry, manufacture and control (CMC) key problems in simplified registration of classical traditional Chinese medicine excellent prescriptions].

PubMed

Wang, Zhi-Min; Liu, Ju-Yan; Liu, Xiao-Qian; Wang, De-Qin; Yan, Li-Hua; Zhu, Jin-Jin; Gao, Hui-Min; Li, Chun; Wang, Jin-Yu; Li, Chu-Yuan; Ni, Qing-Chun; Huang, Ji-Sheng; Lin, Juan

2017-05-01

As an outstanding representative of traditional Chinese medicine(TCM) prescriptions accumulated from famous TCM doctors' clinical experiences in past dynasties, classical TCM excellent prescriptions (cTCMeP) are the most valuable part of TCM system. To support the research and development of cTCMeP, a series of regulations and measures were issued to encourage its simplified registration. There is still a long-way to go because many key problems and puzzles about technology, registration and administration in cTCMeP R&D process are not resolved. Based on the analysis of registration and management regulations of botanical drug products in FDA of USA and Japan, and EMA of Europe, the possible key problems and countermeasures in chemistry, manufacture and control (CMC) of simplified registration of cTCMeP were analyzed on the consideration of its actual situation. The method of "reference decoction extract by traditional prescription" (RDETP) was firstly proposed as standard to evaluate the quality and preparation uniformity between the new developing product under simplified registration and traditional original usages of cTCMeP, instead of Standard Decoction method in Japan. "Totality of the evidence" approach, mass balance and bioassay/biological assay of cTCMeP were emphatically suggested to introduce to the quality uniformity evaluation system in the raw drug material, drug substance and final product between the modern product and traditional decoction. Copyright© by the Chinese Pharmaceutical Association.

Stimulating neuroregeneration as a therapeutic drug approach for traumatic brain injury

PubMed Central

Mueller, Bernhard K; Mueller, Reinhold; Schoemaker, Hans

2009-01-01

Traumatic brain injury, a silent epidemic of modern societies, is a largely neglected area in drug development and no drug is currently available for the treatment of patients suffering from brain trauma. Despite this grim situation, much progress has been made over the last two decades in closely related medical indications, such as spinal cord injury, giving rise to a more optimistic approach to drug development in brain trauma. Fundamental insights have been gained with animal models of central nervous system (CNS) trauma and spinal cord injury. Neuroregenerative drug candidates have been identified and two of these have progressed to clinical development for spinal cord injury patients. If successful, these drug candidates may be used to treat brain trauma patients. Significant progress has also been made in understanding the fundamental molecular mechanism underlying irreversible axonal growth arrest in the injured CNS of higher mammals. From these studies, we have learned that the axonal retraction bulb, previously regarded as a marker for failure of regenerative growth, is not static but dynamic and, therefore, amenable to pharmacotherapeutic approaches. With the development of modified magnetic resonance imaging methods, fibre tracts can be visualised in the living human brain and such imaging methods will soon be used to evaluate the neuroregenerative potential of drug candidates. These significant advances are expected to fundamentally change the often hopeless situation of brain trauma patients and will be the first step towards overcoming the silent epidemic of brain injury. PMID:19422372

A new approach to identify, classify and count drugrelated events

PubMed Central

Bürkle, Thomas; Müller, Fabian; Patapovas, Andrius; Sonst, Anja; Pfistermeister, Barbara; Plank-Kiegele, Bettina; Dormann, Harald; Maas, Renke

2013-01-01

Aims The incidence of clinical events related to medication errors and/or adverse drug reactions reported in the literature varies by a degree that cannot solely be explained by the clinical setting, the varying scrutiny of investigators or varying definitions of drug-related events. Our hypothesis was that the individual complexity of many clinical cases may pose relevant limitations for current definitions and algorithms used to identify, classify and count adverse drug-related events. Methods Based on clinical cases derived from an observational study we identified and classified common clinical problems that cannot be adequately characterized by the currently used definitions and algorithms. Results It appears that some key models currently used to describe the relation of medication errors (MEs), adverse drug reactions (ADRs) and adverse drug events (ADEs) can easily be misinterpreted or contain logical inconsistencies that limit their accurate use to all but the simplest clinical cases. A key limitation of current models is the inability to deal with complex interactions such as one drug causing two clinically distinct side effects or multiple drugs contributing to a single clinical event. Using a large set of clinical cases we developed a revised model of the interdependence between MEs, ADEs and ADRs and extended current event definitions when multiple medications cause multiple types of problems. We propose algorithms that may help to improve the identification, classification and counting of drug-related events. Conclusions The new model may help to overcome some of the limitations that complex clinical cases pose to current paper- or software-based drug therapy safety. PMID:24007453

Family-Based Intervention Program for Parents of Substance-Abusing Youth and Adolescents

PubMed Central

Bisetto Pons, David; González Barrón, Remedios

2016-01-01

The use of drugs among adolescents/youth often results in a high degree of distress for the family members who live with them. This in turn can lead to a deterioration of mental (psychological) health, hindering any attempt to successfully cope with the situation. The goal of our research was to study the effect of the Community Reinforcement and Family Training (CRAFT) program on parents of adolescents/young adult drug users. Study volunteers (n = 50) were parents from Valencia (Spain) that were divided into two groups. The experimental group (n = 25) was made up of parents whose sons and daughters exhibited problems with drug use and the constructed noncausal baseline group (n = 25) was made up of parents whose sons and daughters did not show any substance abuse problems. For both groups, self-esteem (Rosenberg Self-Esteem Scale), depression (BDI-II), anxiety (STAI), and anger (STAXI-II) were evaluated before and after the application of the CRAFT program. Results show a significant improvement in the experimental group's self-esteem, depression, and anger state and a decrease in negative moods. These changes in parents produce a positive effect on their substance-using sons and daughters: of the 25 participants, 15 contacted specialized addiction treatment resources for the first time. PMID:27800208

Urban African American Pre-Adolescent Social Problem Solving Skills: Family Influences and Association with Exposure to Situations of Sexual Possibility

PubMed Central

Traube, Dorian E.; Chasse, Kelly Taber; McKay, Mary M.; Bhorade, Anjali M.; Paikoff, Roberta; Young, Stacie D.

2010-01-01

SUMMARY The results of two studies focusing on the social problem solving skills of African American preadolescent youth are detailed. In the first study data from a sample of 150 African American children, ages 9 to 11 years, was used to examine the association between type of youth social problem solving approaches applied to hypothetical risk situations and time spent in unsupervised peer situations of sexual possibility. Findings revealed that children with more exposure to sexual possibility situations generated a wider range of social problem solving strategies, but these approaches tended to be unrealistic and ambiguous. Further, there was a positive association between the amount of time spent unsupervised and youth difficulty formulating a definitive response to hypothetical peer pressure situations. Children with less exposure to sexual possibility situations tended to be more aggressive when approaching situations of peer pressure. In the second study, data from a non-overlapping sample of 164 urban, African American adult caregivers and their 9 to 11 year old children was examined in order to explore the associations between child gender, family-level factors including family communication frequency and intensity, time spent in situations of sexual possibility, and youth social problem solving approaches. Results revealed that children were frequently using constructive problem solving and help seeking behaviors when confronted by difficult social situations and that there was a significant relationship between the frequency and intensity of parent child communication and youth help seeking social problem solving approaches. Implications for research and family-based interventions are highlighted. PMID:20871790

Cocaine problems in the coca-growing countries of South America.

PubMed

Negrete, J C

1992-01-01

The problems of cocaine present a rather particular profile in the Central Andes region from which this drug originates. On the one hand there is a relatively harmless pattern of use (coca leaf chewing) in the countries concerned which minimizes the drug's most hazardous properties. On the other hand the region suffers from some of the most severe cocaine-related problems to be observed anywhere: (a) easy access to the newer, highly toxic preparations of the drug (such as coca paste) and a rapid growth in the number of new users; (b) the abandonment of certain traditional and essential agricultural activities in favour of the more profitable coca leaf production; (c) the severe ecological damage being caused in the coca growing areas; and (d) the establishment of a powerful coca trade economy which is subverting the very fabric of society and is creating corruption, lawless violence and political anarchy.

Interpersonal Problem-Solving Skills, Executive Function and Learning Potential in Preadolescents with High/Low Family Risk.

PubMed

Mata, Sara; Gómez-Pérez, M Mar; Molinero, Clara; Calero, M Dolores

2017-10-30

Situations generated by high family risk have a negative effect on personal development, especially during preadolescence. Growing up in the presence of risk factors can lead to negative consequences on mental health or on school performance. The objective of this study focuses on individual factors related to this phenomenon during preadolescence. Specifically, we seek to establish whether level of family risk (high vs. low risk) is related to interpersonal problem-solving skills, executive function and learning potential in a sample of preadolescents controlling age, sex, total IQ, verbal comprehension ability and the classroom influences. The participants were 40 children, 23 boys and 17 girls between the ages of 7 and 12, twenty of which had a record on file with the Social and Childhood Protection Services of Information deleted to maintain the integrity of the review process, and therefore, a high family risk situation. The other 20 participants had a low family risk situation. Results show that the preadolescents from high family risk performed worse on interpersonal solving-problem skills and executive function (p < .05, b from -119,201.81 to 132,199.43, confidence interval from -162,589.78/-75,813.8 to 84,403.05/179,995.8). Nevertheless, they showed the same ability to learn as the participants from low family risk. These results highlight the negative effects of high family risk situation in preadolescents and give value of taking into account protective factors such as learning potential when assessing preadolescents from high family risk.

Medical and psychosocial experiences of family caregivers with children fed enterally at home.

PubMed

Enrione, Evelyn B; Thomlison, Barbara; Rubin, Aviva

2005-01-01

Pediatric home enteral nutrition (HEN) studies that evaluate the psychosocial aspects of caregiving are limited. Overlooking the psychosocial needs of the caregiver may result in negative outcomes such as lack of adherence to the HEN regimen. This study determined whether caregivers report psychosocial situations more frequent and difficult to manage than medical situations. A questionnaire, which identified 10 psychosocial and 10 medical issues related to pediatric HEN, was mailed to 150 caregivers (37 responded), who rated the statements for frequency and difficulty. Each statement was ranked from most frequent/difficult to least frequent/difficult by mean cross-product score (frequency x difficulty). To indicate overall burden, a medical total composite score (MTCS) and a psychosocial total composite score (PTCS) were calculated by summing the cross-products of the respective problems. Paired t tests compared MTCS to PTCS and also the psychosocial frequency means and difficulty means to the same for the medical problems. Of the top 10 problems, 7 were psychosocial, whereas 3 were medical. Caregivers reported incidences of psychosocial problems more frequently (p < .003) than medical problems, and they had more difficulty (p < .001) with the psychosocial situations than with the medical ones. The PTCS was significantly higher (p < .001) than the MTCS. The psychosocial situations were perceived as causing a greater burden and greater difficulty in coping with everyday life. Health professionals need to understand and address the psychosocial difficulties of the caregiver in order to provide support for the caregiver and promote positive growth and development of the child.

Sexual life and sexual wellness in individuals with complete androgen insensitivity syndrome (CAIS) and Mayer-Rokitansky-Küster-Hauser Syndrome (MRKHS).

PubMed

Fliegner, Maike; Krupp, Kerstin; Brunner, Franziska; Rall, Katharina; Brucker, Sara Y; Briken, Peer; Richter-Appelt, Hertha

2014-03-01

Sexual wellness depends on a person's physical and psychological constitution. Complete Androgen Insensitivity Syndrome (CAIS) and Mayer-Rokitansky-Küster-Hauser Syndrome (MRKHS) can compromise sexual well-being. To compare sexual well-being in CAIS and MRKHS using multiple measures: To assess sexual problems and perceived distress. To gain insight into participants' feelings of inadequacy in social and sexual situations, level of self-esteem and depression. To determine how these psychological factors relate to sexual (dys)function. To uncover what participants see as the source of their sexual problems. Data were collected using a paper-and-pencil questionnaire. Eleven individuals with CAIS and 49 with MRKHS with/without neovagina treatment were included. Rates of sexual dysfunctions, overall sexual function, feelings of inadequacy in social and sexual situations, self-esteem and depression scores were calculated. Categorizations were used to identify critical cases. Correlations between psychological variables and sexual function were computed. Sexually active subjects were compared with sexually not active participants. A qualitative content analysis was carried out to explore causes of sexual problems. An extended list of sexual problems based on the Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text revision, by the American Psychiatric Association and related distress. Female Sexual Function Index (FSFI), German Questionnaire on Feelings of Inadequacy in Social and Sexual Situations (FUSS social scale, FUSS sexual scale), Rosenberg Self-Esteem Scale (RSE), Brief Symptom Inventory (BSI) subscale depression. Open question on alleged causes of sexual problems. The results point to a far-reaching lack of sexual confidence and sexual satisfaction in CAIS. In MRKHS apprehension in sexual situations is a source of distress, but sexual problems seem to be more focused on issues of vaginal functioning. MRKHS women report being satisfied with their sex life. Different conditions can affect individuals in diagnosis-specific ways despite some shared clinical features. Professionals should adopt an interdisciplinary approach and provide custom-made care in order to promote sexual well-being in patients. © 2013 International Society for Sexual Medicine.

How do drug users define their progress in harm reduction programs? Qualitative research to develop user-generated outcomes

PubMed Central

Ruefli, Terry; Rogers, Susan J

2004-01-01

Background Harm reduction is a relatively new and controversial model for treating drug users, with little formal research on its operation and effectiveness. In order to advance the study of harm reduction programs and our understanding of how drug users define their progress, qualitative research was conducted to develop outcomes of harm reduction programming that are culturally relevant, incremental, (i.e., capable of measuring change), and hierarchical (i.e., capable of showing how clients improve over time). Methods The study used nominal group technique (NGT) to develop the outcomes (phase 1) and focus group interviews to help validate the findings (phase 2). Study participants were recruited from a large harm-reduction program in New York City and involved approximately 120 clients in 10 groups in phase 1 and 120 clients in 10 focus groups in phase 2. Results Outcomes of 10 life areas important to drug users were developed that included between 10 to 15 incremental measures per outcome. The outcomes included ways of 1) making money; 2) getting something good to eat; 3) being housed/homeless; 4) relating to families; 5) getting needed programs/benefits/services; 6) handling health problems; 7) handling negative emotions; 8) handling legal problems; 9) improving oneself; and 10) handling drug-use problems. Findings also provided insights into drug users' lives and values, as well as a window into understanding how this population envisions a better quality of life. Results challenged traditional ways of measuring drug users based solely on quantity used and frequency of use. They suggest that more appropriate measures are based on the extent to which drug users organize their lives around drug use and how much drug use is integrated into their lives and negatively impacts other aspects of their lives. Conclusions Harm reduction and other programs serving active drug users and other marginalized people should not rely on institutionalized, provider-defined solutions to problems in living faced by their clients. PMID:15333130

Reflective Questions, Self-Questioning and Managing Professionally Situated Practice

ERIC Educational Resources Information Center

Malthouse, Richard; Watts, Mike; Roffey-Barentsen, Jodi

2015-01-01

Reflective self-questioning arises within the workplace when people are confronted with professional problems and situations. This paper focuses on reflective and "situated reflective" questions in terms of self-questioning and professional workplace problem solving. In our view, the situational context, entailed by the setting, social…

The impact of childhood emotional abuse and experiential avoidance on maladaptive problem solving and intimate partner violence.

PubMed

Bell, Kathryn M; Higgins, Lorrin

2015-04-16

The purpose of the current study was to examine the joint influences of experiential avoidance and social problem solving on the link between childhood emotional abuse (CEA) and intimate partner violence (IPV). Experiential avoidance following CEA may interfere with a person's ability to effectively problem solve in social situations, increasing risk for conflict and interpersonal violence. As part of a larger study, 232 women recruited from the community completed measures assessing childhood emotional, physical, and sexual abuse, experiential avoidance, maladaptive social problem solving, and IPV perpetration and victimization. Final trimmed models indicated that CEA was indirectly associated with IPV victimization and perpetration via experiential avoidance and Negative Problem Orientation (NPO) and Impulsivity/Carelessness Style (ICS) social problem solving strategies. Though CEA was related to an Avoidance Style (AS) social problem solving strategy, this strategy was not significantly associated with IPV victimization or perpetration. Experiential avoidance had both a direct and indirect effect, via NPO and ICS social problem solving, on IPV victimization and perpetration. Findings suggest that CEA may lead some women to avoid unwanted internal experiences, which may adversely impact their ability to effectively problem solve in social situations and increase IPV risk.

The Impact of Childhood Emotional Abuse and Experiential Avoidance on Maladaptive Problem Solving and Intimate Partner Violence

PubMed Central

Bell, Kathryn M.; Higgins, Lorrin

2015-01-01

The purpose of the current study was to examine the joint influences of experiential avoidance and social problem solving on the link between childhood emotional abuse (CEA) and intimate partner violence (IPV). Experiential avoidance following CEA may interfere with a person’s ability to effectively problem solve in social situations, increasing risk for conflict and interpersonal violence. As part of a larger study, 232 women recruited from the community completed measures assessing childhood emotional, physical, and sexual abuse, experiential avoidance, maladaptive social problem solving, and IPV perpetration and victimization. Final trimmed models indicated that CEA was indirectly associated with IPV victimization and perpetration via experiential avoidance and Negative Problem Orientation (NPO) and Impulsivity/Carelessness Style (ICS) social problem solving strategies. Though CEA was related to an Avoidance Style (AS) social problem solving strategy, this strategy was not significantly associated with IPV victimization or perpetration. Experiential avoidance had both a direct and indirect effect, via NPO and ICS social problem solving, on IPV victimization and perpetration. Findings suggest that CEA may lead some women to avoid unwanted internal experiences, which may adversely impact their ability to effectively problem solve in social situations and increase IPV risk. PMID:25893570

Understanding physicians' professional knowledge and practice in research on skilled migration.

PubMed

Weiß, Anja

2016-08-01

Research on the integration of migrant professionals into high-skilled labor markets either focuses on differences between nation states which may be exacerbated by national closure or it celebrates the global versatility of professional knowledge, especially in the natural and health sciences. Building on a pragmatist approach to professional knowledge, the article argues that professional knowledge should not be seen as either universal or local, but both the institutionalized and the incorporated aspects of cultural capital are characterized by 'local universality'. Professionals recreate professional knowledge in specific 'local' situations by relating to universal standards and to internalized 'libraries' of situated expert experience. While the more common notion of knowledge as a socially contested resource continues to be relevant for research on skilled migration, professional knowledge should also be seen as emerging in situations in response to socio-material problems. These problems can be structured by the nation-state, but they can also be transnational in nature.

Drug choice as a self-handicapping strategy in response to noncontingent success.

PubMed

Berglas, S; Jones, E E

1978-04-01

In two closely related experiments, college student subjects were instructed to choose between a drug that allegedly interfered with performance and a drug that allegedly enhanced performance. This choice was the main dependent measure of the experiment. The drug choice intervened between work on soluble or insoluble problems and a promised retest on similar problems. In Experiment 1, all subjects received success feedback after their initial problem-solving attempts, thus creating one condition in which the success appeared to be accidental (noncontingent on performance) and one in which the success appeared to be contingent on appropriate knowledge. Males in the noncontingent-success condition were alone in preferring the performance-inhibiting drug, presumably because they wished to externalize probable failure on the retest. The predicted effect, however, did not hold for female subjects. Experiment 2 replicated the unique preference shown by males after noncontingent success and showed the critical importance of success feedback.

Characteristics of older adult problem gamblers calling a gambling helpline.

PubMed

Potenza, Marc N; Steinberg, Marvin A; Wu, Ran; Rounsaville, Bruce J; O'malley, Stephanie S

2006-06-01

Few investigations have characterized groups of older adults with gambling problems, and published reports are currently limited by small samples of older adult problem gamblers. Gambling helplines represent a widespread mechanism for assisting problem gamblers to move into treatment settings. Given data from older adult problem gamblers in treatment, we hypothesized that older as compared with younger adult problem gamblers calling a gambling helpline would be less likely to report gambling-related problems. Logistic regression analyses were performed on data obtained from January 1, 2000 to December 31, 2001, inclusive, from callers with gambling problems (N = 1,084) contacting the Connecticut Council on Problem Gambling Helpline. Of the 1,018 phone calls used in the logistic regression analyses, 168 (16.5%) were from older adults and 850 (83.5%) from younger adults. Age-related differences were observed in demographic features, types and patterns of gambling reported as problematic, gambling-related problems and psychiatric symptoms, substance use problems, patterns of indebtedness, and family histories of addictive disorders. Older as compared with younger adult problem gamblers were more likely to report having lower incomes, longer durations of gambling, fewer types of problematic gambling, and problems with casino slot machine gambling and less likely to report gambling-related anxiety, family problems, illegal behaviors and arrests, drug problems, indebtedness to bookies or acquaintances, family histories of drug abuse, and problems with casino table gambling. Older as compared with younger adult problem gamblers calling a gambling helpline differ on many clinically relevant features. The findings suggest the need for improved and unique prevention and treatment strategies for older adults with gambling problems.

Options in Education Transcript: Program No. 152: "Kids and Drugs, One."

ERIC Educational Resources Information Center

George Washington Univ., Washington, DC. Inst. for Educational Leadership.

This radio transcript includes six parts of a series "Kids and Drugs." Part one describes high school students' experience with alcohol and drugs. Part two deals with law enforcement in relations to marihuana and other drugs. Part three deals with students and their drinking habits. Liquor dealers explain the problem of sales to minors in part…

Adolescent tramadol use and abuse in Egypt.

PubMed

Bassiony, Medhat M; Salah El-Deen, Ghada M; Yousef, Usama; Raya, Yasser; Abdel-Ghani, Mohamed M; El-Gohari, Hayam; Atwa, Samar A

2015-05-01

Tramadol abuse liability is underestimated and the evidence of abuse and dependence is emerging. It has many health and social consequences especially in adolescents. Tramadol abuse has not been well studied in Egypt. The aim of this study was to estimate the prevalence and associated correlates of tramadol use and abuse among school students in Egypt. A total of 204 students, aged 13-18 years, from six schools in Zagazig, Egypt, were screened for tramadol use using The Drug Use Disorders Identification Test and a urine screen for tramadol. The prevalence of tramadol use was 8.8% among school students and the average age at onset of tramadol use was 16.5 ± 1.1. Some 83% of the users were using tramadol alone while the rest (17%) were using a combination of tramadol, alcohol, and cannabis. Two-thirds of these students started with tramadol as the first drug after the onset of tobacco smoking. Over one third of tramadol users had drug-related problems and 6% had dependence. There was a significant association between tramadol use and older age, male gender, and smoking. Drug-related problems were negatively correlated with age at onset of tramadol use. Tramadol use was common among adolescents and over one third of tramadol users had drug-related problems. Population-based longitudinal studies are needed to investigate tramadol use and the possible role of tramadol as a gateway drug in the development of substance abuse in Egypt.

Irrational Beliefs and Abuse in University Students' Romantic Relations

ERIC Educational Resources Information Center

Kaygusuz, Canani

2013-01-01

Problem Statement: The complex nature of romantic relationships, in general, makes the continuation of these relationships a challenge. This situation is even more problematic in traditional societies, as social norms for these relations are more strict and more disciplinarian. University students want to be in romantic relationships due to their…

Parental grief after a child's drug death compared to other death causes: investigating a greatly neglected bereavement population.

PubMed

Feigelman, William; Jordan, John R; Gorman, Bernard S

2011-01-01

This comparative survey contrasted 571 parents who lost children to various death causes: 48 to drug-related deaths and overdoses, 462 to suicide, 24 to natural death cases, and 37 to mostly accidental death cases. Groups were compared in terms of grief difficulties, mental health problems, posttraumatic stress, and stigmatization. Results did not show any appreciable differences in these respects between the suicide bereaved parents and those losing children to drug-related deaths. However, when the suicide and drug-related death survivors were specifically contrasted against accidental and natural death loss cases, a consistent pattern emerged showing the former group was consistently more troubled by grief and mental health problems than the latter two sub-groups. These differences remained when controls of time since the loss and gender differences were employed as covariates. These findings suggest that the powerful and intense stigma against drug use and mental illness, shared among the public-at-large, imposes challenges in healing of immense proportion for these parents as they find less compassionate responses from their significant others, following their losses.

Linear and nonlinear acoustic wave propagation in the atmosphere

NASA Technical Reports Server (NTRS)

Hariharan, S. I.; Yu, Ping

1988-01-01

The investigation of the acoustic wave propagation theory and numerical implementation for the situation of an isothermal atmosphere is described. A one-dimensional model to validate an asymptotic theory and a 3-D situation to relate to a realistic situation are considered. In addition, nonlinear wave propagation and the numerical treatment are included. It is known that the gravitational effects play a crucial role in the low frequency acoustic wave propagation. They propagate large distances and, as such, the numerical treatment of those problems become difficult in terms of posing boundary conditions which are valid for all frequencies.

Computerized pharmacy surveillance and alert system for drug-related problems.

PubMed

Ferrández, O; Urbina, O; Grau, S; Mateu-de-Antonio, J; Marin-Casino, M; Portabella, J; Mojal, S; Riu, M; Salas, E

2017-04-01

Because of the impact of drug-related problems (DRPs) on morbidity and mortality, there is a need for computerized strategies to increase drug safety. The detection and identification of the causes of potential DRPs can be facilitated by the incorporation of a pharmacy warning system (PWS) in the computerized prescriber order entry (CPOE) and its application in the routine validation of inpatient drug therapy. A limited number of studies have evaluated a clinical decision support system to monitor drug treatment. Most of these applications have utilized a small range of drugs with alerts and/or types of alert. The objective of this study was to describe the implementation of a PWS integrated in the electronic medical record (EMR). The PWS was developed in 2003-2004. Pharmacological information to generate drug alerts was entered on demographic data, drug dosage, laboratory tests related to the prescribed drug and drug combinations (interactions, duplications and necessary combinations). The PWS was applied in the prescription reviews conducted in patients admitted to the hospital in 2012. Information on 83% of the drugs included in the pharmacopeia was introduced into the PWS, allowing detection of 2808 potential DRPs, representing 79·1% of all potential DRPs detected during the study period. Twenty per cent of PWS DRPs were clinically relevant, requiring pharmacist intervention. The PWS detected most potential DRPs, thus increasing inpatient safety. The detection ability of the PWS was higher than that reported for other tools described in the literature. © 2017 John Wiley & Sons Ltd.

Heterogeneous Costs of Alcohol and Drug Problems Across Cities and Counties in California

PubMed Central

Miller, Ted R.; Nygaard, Peter; Gaidus, Andrew; Grube, Joel W.; Ponicki, William R.; Lawrence, Bruce A.; Gruenewald, Paul J.

2017-01-01

Background Estimates of economic and social costs related to alcohol and other drug (AOD) use and abuse are usually made at state and national levels. Ecological analyses demonstrate, however, that substantial variations exist in the incidence and prevalence of AOD use and problems including impaired driving, violence, and chronic disease between smaller geopolitical units like counties and cities. This study examines the ranges of these costs across counties and cities in California. Methods We used estimates of the incidence and prevalence of AOD use, abuse and related problems to calculate costs in 2010 dollars for all 58 counties and an ecological sample of 50 cities with populations between 50,000 and 500,000 persons in California. The estimates were built from archival and public-use survey data collected at state, county and city-levels over the years from 2009 to 2010. Results Costs related to alcohol use and related problems exceeded those related to illegal drugs across all counties and most cities in the study. Substantial heterogeneities in costs were observed between cities within counties. Conclusions AOD costs are heterogeneously distributed across counties and cities, reflecting the degree to which different populations are engaged in use and abuse across the state. These findings provide a strong argument for the distribution of treatment and prevention resources proportional to need. PMID:28208210

Traffic risk behaviors at nightlife: drinking, taking drugs, driving, and use of public transport by young people.

PubMed

Calafat, A; Blay, N; Juan, M; Adrover, D; Bellis, M A; Hughes, K; Stocco, P; Siamou, I; Mendes, F; Bohrn, K

2009-04-01

Road traffic crashes associated with nightlife alcohol and recreational drug use are a major health problem for young people. This study explores use of different forms of transport to and from nightlife environments and the relationships between traffic risk behaviors, drunkenness, and drug consumption. 1363 regular nightlife users from nine European cities in 2006 completed a self-administered and anonymous questionnaire. Sampling utilized a variation of respondent-driven sampling. Private car was the most frequent form of transport used when going out, especially by males and older individuals. Drug use was related to crashes and traffic risk behaviors, including having a lift from someone drunk or driving drunk or driving having taken drugs; drunkenness was related to risk behaviors but not to crashes (possibly because drunk people tend to use the private car less). Males showed higher levels of drunkenness and drug consumption, traffic risk behaviors, and traffic crashes. Age is not related to the traffic risk behaviors, but older individuals had less crashes. There are serious health problems related to transport and recreational nightlife activities. It is necessary to improve later public transport services, complemented by actions that deter the use of private cars. The relationships of both drunkenness and cannabis/cocaine use with traffic risk behaviors should be addressed and programs implemented to change risk perceptions on the effects of illegal drugs on driving.

[Bioavailability, proof of efficacy and their consequences for drug legislation (author's transl)].

PubMed

Schnieders, B

1976-01-01

Drugs should be effective for the indicatons stated, they should not involve risks which would not be justified in relation to their benefit and they should be of the necessary quality. It is the objective of drug legislation to warrant these requirements in its area of jurisdiction. It has become a necessity to revise current legislation; it is going to be replaced by a new law. A corresponding bill is being considered by Parliament at present. The present and the future legal situation with regards to proof and safeguarding of the bioavailability of pharmacologically active substances and the necessary prerequisites and rules for the procedure of clinical testing of drugs to prove their efficacy and safety is described.

Metaphor and analogy in everyday problem solving.

PubMed

Keefer, Lucas A; Landau, Mark J

2016-11-01

Early accounts of problem solving focused on the ways people represent information directly related to target problems and possible solutions. Subsequent theory and research point to the role of peripheral influences such as heuristics and bodily states. We discuss how metaphor and analogy similarly influence stages of everyday problem solving: Both processes mentally map features of a target problem onto the structure of a relatively more familiar concept. When individuals apply this structure, they use a well-known concept as a framework for reasoning about real world problems and candidate solutions. Early studies found that analogy use helped people gain insight into novel problems. More recent research on metaphor goes further to show that activating mappings has subtle, sometimes surprising effects on judgment and reasoning in everyday problem solving. These findings highlight situations in which mappings can help or hinder efforts to solve problems. WIREs Cogn Sci 2016, 7:394-405. doi: 10.1002/wcs.1407 For further resources related to this article, please visit the WIREs website. © 2016 Wiley Periodicals, Inc.

Governing through problems: the formulation of policy on amphetamine-type stimulants (ATS) in Australia.

PubMed

Fraser, Suzanne; Moore, David

2011-11-01

Producing and implementing credible and effective policies on illicit drug use is generally seen as an important aspect of health governance in the West. Yet the controversy surrounding illicit drug use means this is no easy task. With public opinion perceived by policy makers to be set against illicit drug use, and understandings of its effects tending towards generalisation and pathologisation, the need for timely and rational responses is considered self evident. These responses are, however, regularly criticised as driven as much by electoral politics and expedience as by research findings or expert opinion. Destined to receive close critical scrutiny from all sides, these policies, and the processes undertaken to develop them, are obliged to negotiate a complex political domain. Despite this scrutiny, and the pressure it brings to bear on the policy-making process, little scholarly attention has been paid to the area to date. In this article, we examine in detail one important area of illicit drug policy - the use of amphetamine-type stimulants (ATS) in Australia. We draw on the international critical literature on the ATS problem to situate our analysis. We note that ideas of 'panic', including Cohen's notion of moral panic, have been used here to good effect, but, aiming to acknowledge the complexities of policy, we turn to poststructuralist methods of policy analysis to pursue a different approach. Following Bacchi's observation that 'we are governed through problematisations rather than policies' (2009, p. xi), we ask how the problem of ATS use has been formulated in policy. We examine key state and national policy documents, and two central themes found in them - causation and evidence - to identify the specific strategies used to authorise the recommendations and measures presented as following from the problem of ATS use. In doing so, we clarify important ways in which policy may at times work to obscure the limits of its legitimacy. Copyright © 2011 Elsevier B.V. All rights reserved.

An Interactive Videodisc Program To Evaluate and Train Job-Related Math Skills for Transition. Final Report.

ERIC Educational Resources Information Center

Harris, Carolyn DeMeyer; And Others

The project designed and developed a videodisc package that provides both assessment and related instruction programs for job-related mathematics problem solving, using simulations to provide direct access to vocational situations. The materials are intended to meet the needs of youth and young adults with mild mental handicaps in transition from…

Re-Inventing Infectious Disease: Antibiotic Resistance and Drug Development at the Bayer Company 1945-80.

PubMed

Gradmann, Christoph

2016-04-01

This paper analyses how research on antibiotic resistance has been a driving force in the development of new antibiotics. Drug resistance, while being a problem for physicians and patients, offers attractive perspectives for those who research and develop new medicines. It imposes limits on the usability of older medicines and simultaneously modifies pathologies in a way that opens markets for new treatments. Studying resistance can thus be an important part of developing and marketing antibiotics. The chosen example is that of the German pharmaceutical company Bayer. Before World War Two, Bayer had pioneered the development of anti-infective chemotherapy, sulpha drugs in particular, but had missed the boat when it came to fungal antibiotics. Exacerbated by the effects of war, Bayer's world market presence, which had been considerable prior to the war, had plummeted. In this critical situation, the company opted for a development strategy that tried to capitalise on the problems created by the use of first-generation antibiotics. Part and parcel of this strategy was monitoring what can be called the structural change of infectious disease. In practice, this meant to focus on pathologies resulting from resistance and hospital infections. In addition, Bayer also focused on lifestyle pathologies such as athlete's foot. This paper will follow drug development and marketing at Bayer from 1945 to about 1980. In this period, Bayer managed to regain some of its previous standing in markets but could not escape from the overall crisis of anti-infective drug development from the 1970s on.

Re-Inventing Infectious Disease: Antibiotic Resistance and Drug Development at the Bayer Company 1945–80

PubMed Central

Gradmann, Christoph

2016-01-01

This paper analyses how research on antibiotic resistance has been a driving force in the development of new antibiotics. Drug resistance, while being a problem for physicians and patients, offers attractive perspectives for those who research and develop new medicines. It imposes limits on the usability of older medicines and simultaneously modifies pathologies in a way that opens markets for new treatments. Studying resistance can thus be an important part of developing and marketing antibiotics. The chosen example is that of the German pharmaceutical company Bayer. Before World War Two, Bayer had pioneered the development of anti-infective chemotherapy, sulpha drugs in particular, but had missed the boat when it came to fungal antibiotics. Exacerbated by the effects of war, Bayer’s world market presence, which had been considerable prior to the war, had plummeted. In this critical situation, the company opted for a development strategy that tried to capitalise on the problems created by the use of first-generation antibiotics. Part and parcel of this strategy was monitoring what can be called the structural change of infectious disease. In practice, this meant to focus on pathologies resulting from resistance and hospital infections. In addition, Bayer also focused on lifestyle pathologies such as athlete’s foot. This paper will follow drug development and marketing at Bayer from 1945 to about 1980. In this period, Bayer managed to regain some of its previous standing in markets but could not escape from the overall crisis of anti-infective drug development from the 1970s on. PMID:26971595

New psychoactive substances: catalysing a shift in forensic science practice?

PubMed

Tettey, Justice; Crean, Conor

2015-08-05

The analysis of substances of abuse remains one of the most matured areas in forensic science with a strong scientific basis, namely analytical chemistry. The current evolving drug markets, characterized by the global emergence of new psychoactive substances (NPS) and the need for forensic scientists to identify an unprecedented and ever-increasing number of NPS, presents a unique challenge to this discipline. This article looks at the current situation with NPS at the global level, and the challenges posed to the otherwise technically robust forensic science discipline of analysis of substances of abuse. It discusses the preparedness of forensic science to deal with the current situation and identifies the need for a shift in forensic science practice, especially one which embraces research and looks beyond normal casework in order to provide the much needed data for developing effective policy responses to the NPS problem. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

Non-opioid anesthetic drug abuse among anesthesia care providers: a narrative review.

PubMed

Zuleta-Alarcón, Alix; Coffman, John C; Soghomonyan, Suren; Papadimos, Thomas J; Bergese, Sergio D; Moran, Kenneth R

2017-02-01

The objective of this narrative review is to provide an overview of the problem of non-opioid anesthetic drug abuse among anesthesia care providers (ACPs) and to describe current approaches to screening, therapy, and rehabilitation of ACPs suffering from non-opioid anesthetic drug abuse. We first performed a search of all literature available on PubMed prior to April 11, 2016. The search was limited to articles published in Spanish and English, and the following key words were used: anesthesiology, anesthesia personnel, AND substance-related disorders. We also searched Ovid MEDLINE ® databases from 1946-April 11, 2016 using the following search terms: anesthesiology OR anesthesia, OR nurse anesthetist OR anesthesia care provider OR perioperative nursing AND substance-related disorders. Despite an increased awareness of drug abuse among ACPs and improvements in preventive measures, the problem of non-opioid anesthetic drug abuse remains significant. While opioids are the most commonly abused anesthesia medications among ACPs, the abuse of non-opioid anesthetics is a significant cause of morbidity, mortality, and professional demise. Early detection, effective therapy, and long-term follow-up help ACPs cope more effectively with the problem and, when possible, resume their professional activities. There is insufficient evidence to determine the ability of ACPs to return safely to anesthesia practice after rehabilitation, though awareness of the issue and ongoing treatment are necessary to minimize patient risk from potentially related clinical errors.

[Attitude of patients and customers toward on-line purchase of drugs--a Hungarian survey by community pharmacies].

PubMed

Fittler, András; Bosze, Gergely; Botz, Lajos

2010-11-28

As internet is now available to nearly everyone in Hungary, the accessibility of websites offering pharmaceutical products is also increasing. The national and international regulation of these sites is currently an unsolved problem worldwide, thus potentially harmful, counterfeit and prescription only medicines are easily accessible on the market. We aimed to measure and estimate the current situation of the ordering of online medicines. In 5 Hungarian cities 434 self-administered questionnaires were collected in community pharmacies. Our results show that 6.2% of the respondents have already ordered drugs or dietary supplements online and approximately same amount of people are considering this option in the near future. Based on our survey mostly the educated, the 30-49 year old people and women are likely to buy drugs online. Every fifth respondent reported willingness to buy drugs online from abroad if lower prices were offered. Most people do not know that the quality of medicines purchased online could be different from the ones purchased from community pharmacies. We would like to draw attention of healthcare professionals to the rising popularity and potential risks of drugs available online.

Gender Comparisons Among Asian American and Pacific Islander Patients in Drug Dependency Treatment.

PubMed

Han, Yun; Lin, Veronique; Wu, Fei; Hser, Yih-Ing

2016-05-11

Few studies have focused on Asian Americans and Pacific Islanders (AAPIs), despite indications of increasing substance abuse among AAPIs in recent years. This prospective longitudinal study examined gender differences among AAPIs in treatment. The study included 567 (177 women, 390 men) AAPI patients drawn from two prior studies, one with 32 community treatment programs in 13 California counties (CalTOP, 3, 9 months), and another project including 36 treatment sites in 5 California counties (TSI, 3, 12 months). Baseline and follow-up assessments utilized the Addiction Severity Index(ASI). A subset of patients was assessed at 3 and 9/12 months (n = 106). Significant gender-related differences were observed at baseline: fewer women than men were employed or never married. More women were living with someone having alcohol and drug problems. Methamphetamine was the primary drug for women and men, followed by alcohol and heroin. Compared to AAPI men, AAPI women reported greater problem severity in family/social relationships (0.18 vs. 0.11, p <.001), employment (0.68 vs. 0.56, p <.001), and mental health (0.19 vs. 0.14, p <.01). Relative to women, AAPI men reported greater treatment satisfaction at the 3-month follow-up. Significant improvements at follow-up were observed in family, alcohol, drug, and legal domains for both genders, and in mental health for men only. Compared to AAPI men, AAPI women demonstrated significantly greater improvements in drug problems (ΔASI = 0.07, p <.05). Gender differences revealed in this study suggest a need for a greater treatment focus on psychiatric problems for AAPI women and drug use problems for AAPI men.

Social adversities in first-time and repeat prisoners.

PubMed

Kjelsberg, Ellen; Friestad, Christine

2008-11-01

To explore possible systematic differences between prison inmates serving their first sentence and inmates having experienced previous incarcerations. It is hoped that a better knowledge of these issues will make us better equipped to meet the rehabilitation needs of our prisoners and decrease their risk of reoffending and reincarceration. In this cross-sectional study a randomly selected and nationally representative sample of 260 Norwegian prisoners, 100 serving their first sentence and 160 recidivists, was interviewed with special focus on childhood circumstances, education, work experience, and present social and economic situation. In addition their criminal records were collected from the National Crime Registry. In males multivariate analyses identified a number of variables independently and significantly associated with being a repeat offender. The odds for reincarceration increased significantly if the person fulfilled any one of the following criteria: having experienced the incarceration of a family member during childhood (OR = 3.6); having experienced childcare interventions during childhood (OR = 3.2); current drug abuse (OR = 2.6); current housing problems (OR = 2.3). In females only one strong correlation emerged: if the person had current drug problems the odds for being a recidivist increased substantially (OR = 10.9). While criminal reoffending and reincarceration seemed to be primarily associated with drug abuse in females, the childhood problems of male repeat offenders, compared with males serving their first sentence, indicate that these individuals' current multiple social and economic disadvantages were complex in origin and of long standing. Interventions aimed at preventing reoffending must take into account the gender differences demonstrated. ing at primary prevention, the negative effects associated with parental incarceration are crucial: how can one prevent the perpetuation of these problems from one generation to the next?

Investigating Ongoing Strategic Behaviour of Students with Mild Mental Retardation: Implementation and Relations to Performance in a Problem-Solving Situation

ERIC Educational Resources Information Center

Dermitzaki, Irini; Stavroussi, Panayiota; Bandi, Maria; Nisiotou, Ioulia

2008-01-01

The aim of this study was to investigate to what extent students with mild mental retardation exhibit strategic behaviour during problem solving and to investigate the relationships between the ongoing behaviours examined and the students' respective performance. Eleven students with non-organic mild mental retardation participated in the study.…

Some Considerations When Using A Domain-Referenced System of Achievement Tests in Instructional Situations.

ERIC Educational Resources Information Center

Nitko, Anthony J.

The problem of using a domain-referenced system of achievement tests is discussed as it relates to the design of instruction. Testing problems are discussed from the point of view that the teacher, pupil, and/or automation needs certain kinds of information in order to make instructional decisions that are adaptive to the individual learner. The…

Transitions in illicit drug use status over 3 years: a prospective analysis of a general population sample.

PubMed

Compton, Wilson M; Dawson, Deborah A; Conway, Kevin P; Brodsky, Marc; Grant, Bridget F

2013-06-01

The authors examined 3-year transitions among nonuse, asymptomatic use, and problem use of illicit drugs for U.S. adults in the general household population. Data were from the nationally representative National Epidemiologic Survey on Alcohol and Related Conditions, a study of 34,653 adults interviewed twice, 3 years apart. Respondents were categorized on three mutually exclusive categories of baseline drug status: past-year nonusers (N=32,675), past-year asymptomatic drug users (N=861), and past-year symptomatic drug users (N=1,117). Symptomatic drug use, or problem use, was defined as presence of one or more symptoms that operationalize DSM-IV drug abuse and dependence criteria. The authors assessed sociodemographic, health, substance use, and psychiatric covariates for association with 3-year transitions to different status categories. Among baseline nonusers, 95.4% continued to be nonusers at follow-up, 2.1% became asymptomatic users, and 2.5% developed problem use. Among baseline asymptomatic users, 66.6% had stopped using drugs at follow-up, 14.3% continued to be asymptomatic users, and 19.1% had developed problem use. Nearly half (49.0%) of those with problem use at baseline had stopped using drugs at follow-up, 10.9% had transitioned to asymptomatic use, and 40.1% continued to have problem use. Younger age, male sex, white race, and not being married were associated with progression from nonuse to use or problem use, as were alcohol and tobacco use and disorders, major depression, and schizotypal, borderline, and narcissistic personality disorders. Panic disorder and avoidant personality disorder were associated with less progression. Transitions in drug use status are common. The finding that alcohol and tobacco variables and co-occurring psychopathology are important correlates of transitions suggests the value of addressing all co-occurring disorders and substance use in patient assessments and treatment planning, both to prevent adverse transitions and to promote positive transitions.

Is money laundering a true problem in China?

PubMed

Ping, He

2006-02-01

Money laundering was stipulated as an offense by Chinese criminal law more than 10 years ago. However, the judicial situation is such that no one has yet been prosecuted for it. This article describes the phenomena that are closely related to money laundering, namely the current situation of the predicate offences and other factors conducive to money laundering such as corruption, underground bank shops, and shell companies. Based on these facts, the article infers that money laundering is a real problem in China. Then it explores the reasons why case examples of money laundering are not available. Finally, this article presents some of the factors necessary in the investigation of money laundering.

Effects of occupational future time perspective on managing stressful work situations.

PubMed

Ho, Henry C Y; Yeung, Dannii Y

2016-08-01

According to the socioemotional selectivity theory (SST; Carstensen, 2006), older adults perceive their future time as increasingly limited, which motivates them to focus more on emotional goals and prefer passive emotion-focused strategies. This study aims to investigate the effect of occupational future time perspective (OFTP) on the use of problem-solving strategies in stressful work situations and to examine the effectiveness of these strategies on psychological well-being. A sample of 199 Chinese clerical workers responded to a structured questionnaire on problem-solving strategy use in relation to hypothetical work scenarios. Results revealed that relative to those with limited OFTP, workers with expansive OFTP preferred problem-focused and proactive strategies in both low- and high-emotionally salient scenarios. Workers with limited OFTP consistently preferred passive strategies irrespective of emotional salience. OFTP moderated the effect of problem-focused strategies on psychological distress. In particular, there was a significant negative relationship between problem-focused strategies and psychological distress among workers with expansive OFTP, but such pattern of relationship was not observed among workers with limited OFTP. Findings of this study inform the training strategies employed by practitioners to fit the developmental goals of workers in order to maximise their strengths at work. © 2015 International Union of Psychological Science.

Family Dysfunction Differentially Affects Alcohol and Methamphetamine Dependence: A View from the Addiction Severity Index in Japan

PubMed Central

Sugaya, Nagisa; Haraguchi, Ayako; Ogai, Yasukazu; Senoo, Eiichi; Higuchi, Susumu; Umeno, Mitsuru; Aikawa, Yuzo; Ikeda, Kazutaka

2011-01-01

We investigated the differential influence of family dysfunction on alcohol and methamphetamine dependence in Japan using the Addiction Severity Index (ASI), a useful instrument that multilaterally measures the severity of substance dependence. The participants in this study were 321 male patients with alcohol dependence and 68 male patients with methamphetamine dependence. We conducted semi-structured interviews with each patient using the ASI, which is designed to assess problem severity in seven functional domains: Medical, Employment/Support, Alcohol use, Drug use, Legal, Family/Social relationships, and Psychiatric. In patients with alcohol dependence, bad relationships with parents, brothers and sisters, and friends in their lives were related to current severe psychiatric problems. Bad relationships with brothers and sisters and partners in their lives were related to current severe employment/support problems, and bad relationships with partners in their lives were related to current severe family/social problems. The current severity of psychiatric problems was related to the current severity of drug use and family/social problems in patients with alcohol dependence. Patients with methamphetamine dependence had difficulty developing good relationships with their father. Furthermore, the current severity of psychiatric problems was related to the current severity of medical, employment/support, and family/social problems in patients with methamphetamine dependence. The results of this study suggest that family dysfunction differentially affects alcohol and methamphetamine dependence. Additionally, family relationships may be particularly related to psychiatric problems in these patients, although the ASI was developed to independently evaluate each of seven problem areas. PMID:22073020

Family dysfunction differentially affects alcohol and methamphetamine dependence: a view from the Addiction Severity Index in Japan.

PubMed

Sugaya, Nagisa; Haraguchi, Ayako; Ogai, Yasukazu; Senoo, Eiichi; Higuchi, Susumu; Umeno, Mitsuru; Aikawa, Yuzo; Ikeda, Kazutaka

2011-10-01

We investigated the differential influence of family dysfunction on alcohol and methamphetamine dependence in Japan using the Addiction Severity Index (ASI), a useful instrument that multilaterally measures the severity of substance dependence. The participants in this study were 321 male patients with alcohol dependence and 68 male patients with methamphetamine dependence. We conducted semi-structured interviews with each patient using the ASI, which is designed to assess problem severity in seven functional domains: Medical, Employment/Support, Alcohol use, Drug use, Legal, Family/Social relationships, and Psychiatric. In patients with alcohol dependence, bad relationships with parents, brothers and sisters, and friends in their lives were related to current severe psychiatric problems. Bad relationships with brothers and sisters and partners in their lives were related to current severe employment/support problems, and bad relationships with partners in their lives were related to current severe family/social problems. The current severity of psychiatric problems was related to the current severity of drug use and family/social problems in patients with alcohol dependence. Patients with methamphetamine dependence had difficulty developing good relationships with their father. Furthermore, the current severity of psychiatric problems was related to the current severity of medical, employment/support, and family/social problems in patients with methamphetamine dependence. The results of this study suggest that family dysfunction differentially affects alcohol and methamphetamine dependence. Additionally, family relationships may be particularly related to psychiatric problems in these patients, although the ASI was developed to independently evaluate each of seven problem areas.

Compassion fatigue and substance use among nurses.

PubMed

Jarrad, Reem; Hammad, Sawsan; Shawashi, Tagreed; Mahmoud, Naser

2018-01-01

This study aimed to detect if there were differences in compassion fatigue (CF) among nurses based on substance use and demographic variables of gender, marital status, type of health institution and income. Compassion fatigue is considered an outcome of poorly handled stressful situations in which nurses may respond with self-harming behaviours like substance use. Evidence in this area is critically lacking. This study used a descriptive design to survey differences in CF of 282 nurses. The participants completed a demographic survey and indicated whether they consume any of the following substances on a frequent basis: cigarettes, sleeping pills, power drinks, anti-depressant drugs, anti-anxiety drugs, coffee, analgesics, amphetamines and alcohol. Compassion Fatigue scores were surveyed using CF self-test 66 items developed by Stamm and Figely (Compassion satisfaction and fatigue test. http://www.isu.edu/~bhstamm/tests.htm, 1996). There were significant differences in CF scores in favour of nurses who used cigarettes, sleeping pills, power drinks, anti-depressants and anti-anxiety drugs. While no significant differences in CF were found between nurses who used coffee, analgesics, amphetamines and alcohol, significant differences in nurses' CF were found in relation to type of institution, gender and marital status. But nurses' income did not bring differences to CF scores. Nurses who might be lacking resilience cope negatively with CF using maladaptive negative behaviours such as substance use. Nursing management should be aware of the substance use drive among nurses and build organizational solutions to overcome compassion fatigue and potential substance use problems.

The role of expressive writing in math anxiety.

PubMed

Park, Daeun; Ramirez, Gerardo; Beilock, Sian L

2014-06-01

Math anxiety is a negative affective reaction to situations involving math. Previous work demonstrates that math anxiety can negatively impact math problem solving by creating performance-related worries that disrupt the working memory needed for the task at hand. By leveraging knowledge about the mechanism underlying the math anxiety-performance relationship, we tested the effectiveness of a short expressive writing intervention that has been shown to reduce intrusive thoughts and improve working memory availability. Students (N = 80) varying in math anxiety were asked to sit quietly (control group) prior to completing difficulty-matched math and word problems or to write about their thoughts and feelings regarding the exam they were about to take (expressive writing group). For the control group, high math-anxious individuals (HMAs) performed significantly worse on the math problems than low math-anxious students (LMAs). In the expressive writing group, however, this difference in math performance across HMAs and LMAs was significantly reduced. Among HMAs, the use of words related to anxiety, cause, and insight in their writing was positively related to math performance. Expressive writing boosts the performance of anxious students in math-testing situations. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Schema Knowledge Structures for Representing and Understanding Arithmetic Story Problems.

DTIC Science & Technology

1987-03-01

do so on a common unit of measure. Implicit in the CP relation is the concept of one-to- one matching of one element in the problem with the other. As...engages in one-to-one matching , removing one member from each set and setting them apart as a matched pair. The smaller of the two sets is the one...to be critical. As we pointed out earlier, some of the semantic * relations can be present in situations that demand any of * the four arithmetic

The relationship between alcohol consumption, perceived stress, and CRHR1 genotype on the hypothalamic–pituitary–adrenal axis in rural African Americans

PubMed Central

Obasi, Ezemenari M.; Shirtcliff, Elizabeth A.; Brody, Gene H.; MacKillop, James; Pittman, Delishia M.; Cavanagh, Lucia; Philibert, Robert A.

2015-01-01

Objective: Rurally situated African Americans suffer from stress and drug-related health disparities. Unfortunately, research on potential mechanisms that underlie this public health problem have received limited focus in the scientific literature. This study investigated the effects of perceived stress, alcohol consumption, and genotype on the hypothalamic–pituitary–adrenal (HPA) Axis. Methods: A rural sample of African American emerging adults (n = 84) completed a battery of assessments and provided six samples of salivary cortisol at wakeup, 30 min post wakeup, 90 min post wakeup, 3:00 PM, 3:30 PM, and 4:30 PM. Results: Participants with a TT genotype of the CRHR1 (rs4792887) gene tended to produce the most basal cortisol throughout the day while participants with a CC genotype produced the least amount. Increased levels of perceived stress or alcohol consumption were associated with a blunted cortisol awakening response (CAR). Moreover, the CAR was obliterated for participants who reported both higher stress and alcohol consumption. Conclusion: Perceived stress and alcohol consumption had a deleterious effect on the HPA-Axis. Furthermore, genotype predicted level of cortisol production throughout the day. These findings support the need to further investigate the relationship between stress dysregulation, drug-use vulnerability, and associated health disparities that affect this community. PMID:26150798

The predictive power of family history measures of alcohol and drug problems and internalizing disorders in a college population.

PubMed

Kendler, Kenneth S; Edwards, Alexis; Myers, John; Cho, Seung Bin; Adkins, Amy; Dick, Danielle

2015-07-01

A family history (FH) of psychiatric and substance use problems is a potent risk factor for common internalizing and externalizing disorders. In a large web-based assessment of mental health in college students, we developed a brief set of screening questions for a FH of alcohol problems (AP), drug problems (DP) and depression-anxiety in four classes of relatives (father, mother, aunts/uncles/grandparents, and siblings) as reported by the student. Positive reports of a history of AP, DP, and depression-anxiety were substantially correlated within relatives. These FH measures predicted in the student, in an expected pattern, dimensions of personality and impulsivity, alcohol consumption and problems, smoking and nicotine dependence, use of illicit drugs, and symptoms of depression and anxiety. Using the mean score from the four classes of relatives was more predictive than using a familial/sporadic dichotomy. Interactions were seen between the FH of AP, DP, and depression-anxiety and peer deviance in predicting symptoms of alcohol and tobacco dependence. As the students aged, the FH of AP became a stronger predictor of alcohol problems. While we cannot directly assess the validity of these FH reports, the pattern of findings suggest that our brief screening items were able to assess, with some accuracy, the FH of substance misuse and internalizing psychiatric disorders in relatives. If correct, these measures can play an important role in the creation of developmental etiologic models for substance and internalizing psychiatric disorders which constitute one of the central goals of the overall project. © 2015 Wiley Periodicals, Inc.

Links between alcohol and other drug problems and maltreatment among adolescent girls: perceived discrimination, ethnic identity, and ethnic orientation as moderators.

PubMed

Gray, Calonie M K; Montgomery, Marilyn J

2012-05-01

This study examined the links between maltreatment, posttraumatic stress symptoms, ethnicity-specific factors (i.e., perceived discrimination, ethnic identity, and ethnic orientation), and alcohol and/or other drug (AOD) problems among adolescent girls. These relations were examined using archived data from a community sample of 168 Black and Hispanic adolescent girls who participated in a school-based substance use intervention. The results revealed that maltreatment was linked to AOD problems, but only through its relation with posttraumatic stress symptoms; maltreatment was positively related to posttraumatic stress symptoms, which were positively related to AOD problems. Both perceived discrimination and ethnic orientation were significant moderators. Specifically, greater perceived discrimination was associated with an increased effect of maltreatment on posttraumatic stress symptoms. Ethnic orientation demonstrated protective properties in the relation between maltreatment and AOD problem severity, such that the effect of maltreatment on AOD problem severity was less for girls with average to high ethnic orientation compared to girls with low ethnic orientation. The findings of this study underscore the importance of developing interventions for Black and Hispanic girls that target maltreatment and AOD use concurrently and address ethnicity-specific factors. Copyright © 2012 Elsevier Ltd. All rights reserved.

Organization of professional practices against intrafamily violence against children and adolescents in the institutional context 1

PubMed Central

Schek, Gabriele; da Silva, Mara Regina Santos; Lacharité, Carl; Bueno, Maria Emília Nunes

2017-01-01

ABSTRACT Objective: to analyze based on the practitioners' discourse, the way they organize their practices confronting situations of intra-family violence against children and adolescents. Method: qualitative research carried out with 15 professionals who work in social and health services located in the southernmost of Brazil. Data were collected through semi-structured interviews, performed at the participants' workplace. We used a theoretical matrix to analyze the data, based on Institutional Ethnography and the technique of discursive textual analysis. Results: the practitioners' practices developed in situations of intra-family violence against children and adolescents are organized on the basis of: power relations that take place in services that respond to violence situations; routines instituted to meet the demands of care in services; and the interplay between the conception of violence as a public health problem and the conception of violence as a social problem. Conclusion: the way these practices are organized is reflected in actions that are not protective against situations of intra-family violence against children and adolescents. PMID:28591297

Testing the effects of brief intervention in primary care for problem drug use in a randomized controlled trial: rationale, design, and methods.

PubMed

Krupski, Antoinette; Joesch, Jutta M; Dunn, Chris; Donovan, Dennis; Bumgardner, Kristin; Lord, Sarah Peregrine; Ries, Richard; Roy-Byrne, Peter

2012-12-14

A substantial body of research has established the effectiveness of brief interventions for problem alcohol use. Following these studies, national dissemination projects of screening, brief intervention (BI), and referral to treatment (SBIRT) for alcohol and drugs have been implemented on a widespread scale in multiple states despite little existing evidence for the impact of BI on drug use for non-treatment seekers. This article describes the design of a study testing the impact of SBIRT on individuals with drug problems, its contributions to the existing literature, and its potential to inform drug policy. The study is a randomized controlled trial of an SBIRT intervention carried out in a primary care setting within a safety net system of care. Approximately 1,000 individuals presenting for scheduled medical care at one of seven designated primary care clinics who endorse problematic drug use when screened are randomized in a 1:1 ratio to BI versus enhanced care as usual (ECAU). Individuals in both groups are reassessed at 3, 6, 9, and 12 months after baseline. Self-reported drug use and other psychosocial measures collected at each data point are supplemented by urine analysis and public health-related data from administrative databases. This study will contribute to the existing literature by providing evidence for the impact of BI on problem drug use based on a broad range of measures including self-reported drug use, urine analysis, admission to drug abuse treatment, and changes in utilization and costs of health care services, arrests, and death with the intent of informing policy and program planning for problem drug use at the local, state, and national levels. ClinicalTrials.gov NCT00877331.

The Association between Parent Early Adult Drug Use Disorder and Later Observed Parenting Practices and Child Behavior Problems: Testing Alternate Models

PubMed Central

Bailey, Jennifer A.; Hill, Karl G.; Guttmannova, Katarina; Oesterle, Sabrina; Hawkins, J. David; Catalano, Richard F.; McMahon, Robert J.

2012-01-01

This study tested the association between parent illicit drug use disorder (DUD) in early adulthood and observed parenting practices at ages 27 – 28 and examined the following three, theoretically-derived models explaining this link: a) a disrupted parent adult functioning model, b) a pre-existing parent personality factor model, c) a disrupted adolescent family process model. Associations between study variables and child externalizing problems also were examined. Longitudinal data linking two generations were drawn from the Seattle Social Development Project (SSDP) and The SSDP Intergenerational Project (TIP), and included 167 parents and their 2- to 8-year-old child. Path modeling revealed that parent DUD in early adulthood predicted later observed low-skilled parenting, which was related to child externalizing problems. The pre-existing parent personality factor model was supported. Parent negative emotionality accounted for the association between parent early adult DUD and later parenting practices. Parent negative emotionality also was related directly to child externalizing behavior. Limited support for the disrupted transition to adulthood model was found. The disrupted adolescent family process model was not supported. Results suggest that problem drug use that occurs early in adulthood may affect later parenting skills, independent of subsequent parent drug use. Findings highlight the importance of parent negative emotionality in influencing their own problem behavior, their interactions with their child, and their child’s problem behavior. Prevention and treatment programs targeting young adult substance use, poor parenting practices, and child behavior problems should address parent personality factors that may contribute to these behaviors. PMID:22799581

The association between parent early adult drug use disorder and later observed parenting practices and child behavior problems: testing alternate models.

PubMed

Bailey, Jennifer A; Hill, Karl G; Guttmannova, Katarina; Oesterle, Sabrina; Hawkins, J David; Catalano, Richard F; McMahon, Robert J

2013-05-01

This study tested the association between parent illicit drug use disorder (DUD) in early adulthood and observed parenting practices at ages 27-28 and examined the following 3 theoretically derived models explaining this link: (a) a disrupted parent adult functioning model,(b) a preexisting parent personality factor model, and (c) a disrupted adolescent family process model. Associations between study variables and child externalizing problems also were examined. Longitudinal data linking 2 generations were drawn from the Seattle Social Development Project (SSDP) and The SSDP Intergenerational Project (TIP), and included 167 parents and their 2- to 8-year-old child. Path modeling revealed that parent DUD in early adulthood predicted later observed low-skilled parenting, which was related to child externalizing problems. The preexisting parent personality factor model was supported. Parent negative emotionality accounted for the association between parent early adult DUD and later parenting practices. Parent negative emotionality also was related directly to child externalizing behavior. Limited support for the disrupted transition to adulthood model was found. The disrupted adolescent family process model was not supported. Results suggest that problem drug use that occurs early in adulthood may affect later parenting skills, independent of subsequent parent drug use. Findings highlight the importance of parent negative emotionality in influencing his or her own problem behavior, interactions with his or her child, and his or her child's problem behavior. Prevention and treatment programs targeting young adult substance use, poor parenting practices, and child behavior problems should address parent personality factors that may contribute to these behaviors.

A situational picture of HIV/AIDS and injection drug use in Vinnitsya, Ukraine

PubMed Central

Barcal, Katerina; Schumacher, Joseph E; Dumchev, Kostyantyn; Moroz, Larisa Vasiliyevna

2005-01-01

Background New and explosive HIV epidemics are being witnessed in certain countries of Eastern Europe, including Ukraine, as well as a rapid and dramatic increase in the supply, use, and negative public health consequences of illicit drugs. A majority of registered HIV cases in Ukraine occur among injection drug users (IDUs), large numbers of whom report HIV risk behaviors such as needle sharing. The purpose of this study was to apply the World Health Organization's Rapid Assessment and Response on Injection Drug Use (IDU-RAR) guide to create a situational picture in the Vinnitsya Oblast, Ukraine, a region with very scarce information about the HIV/AIDS and injection drug use (IDU) epidemics. Methods The IDU-RAR uses a combination of qualitative data collection techniques commonly employed in social science and evaluation research to quickly depict the extent and nature of the given health problem and propose locally relevant recommendations for improvement. The investigators focused their assessment on the contextual factors, drug use, and intervention and policy components of the IDU-RAR. A combination of network and block sampling techniques was used. Data collection methods included direct observation, review of existing data, structured and unstructured interviews, and focus group discussions. Key informants and locations were visited until no new information was being generated. Results The number of registered HIV cases in Vinnitsya has increased from 3 (1987–1995) to 860 (1999–10/2004), 57 of whom have already died. Ten percent of annual admissions to the area's Regional Narcological Dispensary were for opiate disorders, and the number of registered IDUs rose by 20% from 1999 to 2000. The level of HIV/AIDS awareness is generally poor among the general population but high among high-risk populations. Both HIV/AIDS and injection drug use carry a strong stigma in the community, even among medical professionals. There was very little evidence of primary HIV/AIDS prevention efforts, and IDU prevention efforts focused on promotion of anti-drug messages in the schools. Conclusion Given that Ukraine has sparse resources to be devoted to this problem, action recommendations should be prioritized, realistic, and initially targeted to persons in greatest need. The following action recommendations are prioritized by the following categories: First priority: Voluntary Counseling and Testing; Second Priority: Prevention and Education; and Third Priority: Harm Reduction and Treatment. They are provided in this sequence based on what response can realistically be implemented first with limited additional resources and can make the greatest immediate impact. The persons at greatest risk, HIV positive persons and IDUs, should be attended to first. PMID:16164758

Socially indiscriminate attachment behavior in the Strange Situation: convergent and discriminant validity in relation to caregiving risk, later behavior problems, and attachment insecurity.

PubMed

Lyons-Ruth, Karlen; Bureau, Jean-François; Riley, Caitlin D; Atlas-Corbett, Alisha F

2009-01-01

Socially indiscriminate attachment behavior has been repeatedly observed among institutionally reared children. Socially indiscriminate behavior has also been associated with aggression and hyperactivity. However, available data rely heavily on caregiver report of indiscriminate behavior. In addition, few studies have been conducted with samples of home-reared infants exposed to inadequate care. The current study aimed to develop a reliable laboratory measure of socially indiscriminate forms of attachment behavior based on direct observation and to validate the measure against assessments of early care and later behavior problems among home-reared infants. Strange Situation episodes of 75 socially at-risk mother-infant dyads were coded for infant indiscriminate attachment behavior on the newly developed Rating for Infant-Stranger Engagement. After controlling for infant insecure-organized and disorganized behavior in all analyses, extent of infant-stranger engagement at 18 months was significantly related to serious caregiving risk (maltreatment or maternal psychiatric hospitalization), observed quality of disrupted maternal affective communication, and aggressive and hyperactive behavior problems at age 5. Results are discussed in relation to the convergent and discriminant validity of the new measure and to the potential utility of a standardized observational measure of indiscriminate attachment behavior. Further validation is needed in relation to caregiver report measures of indiscriminate behavior.

The Progress of Therapeutic Vaccination with Regard to Tuberculosis.

PubMed

Cardona, Pere-Joan

2016-01-01

A major problem with tuberculosis (TB) control is the long duration of drug therapy-both for latent and for active TB. Therapeutic vaccination has been postulated to improve this situation, and to this end there are several candidates already in clinical phases of development. These candidates follow two main designs, namely bacilli-directed therapy based on inactivated -whole or -fragmented bacillus ( Mycobacterium w and RUTI) or fusion proteins that integrate non-replicating bacilli -related antigens (H56 vaccine), and host-directed therapy to reduce the tissue destruction. The administration of inactivated Mycobacterium vaccae prevents the "Koch phenomenon" response, and oral administration of heat-killed Mycobacterium manresensis prevents excessive neutrophilic infiltration of the lesions. This review also tries to explain the success of Mycobacterium tuberculosis by reviewing its evolution from infection to disease, and highlights the lack of a definitive understanding of the natural history of TB pathology and the need to improve our knowledge on TB immunology and pathogenesis.

The Progress of Therapeutic Vaccination with Regard to Tuberculosis

PubMed Central

Cardona, Pere-Joan

2016-01-01

A major problem with tuberculosis (TB) control is the long duration of drug therapy–both for latent and for active TB. Therapeutic vaccination has been postulated to improve this situation, and to this end there are several candidates already in clinical phases of development. These candidates follow two main designs, namely bacilli-directed therapy based on inactivated -whole or -fragmented bacillus (Mycobacterium w and RUTI) or fusion proteins that integrate non-replicating bacilli -related antigens (H56 vaccine), and host-directed therapy to reduce the tissue destruction. The administration of inactivated Mycobacterium vaccae prevents the “Koch phenomenon” response, and oral administration of heat-killed Mycobacterium manresensis prevents excessive neutrophilic infiltration of the lesions. This review also tries to explain the success of Mycobacterium tuberculosis by reviewing its evolution from infection to disease, and highlights the lack of a definitive understanding of the natural history of TB pathology and the need to improve our knowledge on TB immunology and pathogenesis. PMID:27733848

Preparing Nursing and Social Work Students to Care for Patients in Acute Alcohol Withdrawal.

PubMed

Gates, Sharon A; Brown, James R

Alcohol and other drug abuse has become a national crisis with approximately 26% of general medical patients having alcohol-related problems. New nurses and social workers are often not prepared to care for patients with severe alcohol withdrawal symptoms because they lack experience in actual crisis situations. The purpose of this study was to prepare nursing and social work students to care for a patient undergoing an acute alcohol withdrawal process. Nine groups of 8-10 students participated in a 2.5-hour simulation event that included an alcohol withdrawal seizure, team meeting, and discharge of the patient. Students recognized the importance of all the professional roles and how each professional benefits patient care. Before the simulation, students thought they were prepared to care for patients experiencing alcohol withdrawal; however, the crisis of an alcohol seizure decreased the student's ability to perform skills and communicate effectively. These findings suggest that new nurses and social workers may not be prepared to care for the acute alcohol withdrawal patient.

Pharmacists' role in handling problems with prescriptions for antithrombotic medication in Belgian community pharmacies.

PubMed

Desmaele, S; De Wulf, I; Dupont, A G; Steurbaut, S

2015-08-01

Community pharmacists have an important task in the follow-up of patients treated with antithrombotics. When delivering these medicines, pharmacists can encounter drug-related problems (DRPs) with substantial clinical and economic impact. To investigate the amount and type of antithrombotic related DRPs as well as how community pharmacists handled these DRPs. Belgian community pharmacies. MSc pharmacy students of six Belgian universities collected data about all DRPs encountered by a pharmacist during ten half days of their pharmacy internship. Data were registered about DRPs detected at delivery and in an a posteriori setting, when consulting the medical history of the patient. Classification of the DRP, cause of the DRP, intervention and result of the intervention were registered. Amount and type of antotrombitocs related DRPs occurring in community pharmacies, as well as how community pharmacists handled these DRPs. 3.1 % of the 15,952 registered DRPs concerned antithrombotics. 79.3 % of these DRPs were detected at delivery and 20.7 % were detected a posteriori. Most antithrombotic-related DRPs concerned problems with the choice of the drug (mainly because of drug-drug interactions) or concerned logistic problems. Almost 80 % of the antithrombotic-related DRPs were followed by an intervention of the pharmacist, mainly at the patient's level, resulting in 90.1 % of these DRPs partially or totally solved. Different DRPs with antithrombotic medication occurred in Belgian community pharmacies. About 20 % was detected in an a posteriori setting, showing the benefit of medication review. Many of the encountered DRPs were of technical nature (60.7 %). These DRPs were time-consuming for the pharmacist to resolve and should be prevented. Most of the DRPs could be solved, demonstrating the added value of the community pharmacist as first line healthcare provider.

The Multi-Player Performance-Enhancing Drug Game

PubMed Central

Haugen, Kjetil K.; Nepusz, Tamás; Petróczi, Andrea

2013-01-01

This paper extends classical work on economics of doping into a multi-player game setting. Apart from being among the first papers formally formulating and analysing a multi-player doping situation, we find interesting results related to different types of Nash-equilibria (NE). Based mainly on analytic results, we claim at least two different NE structures linked to the choice of prize functions. Linear prize functions provide NEs characterised by either everyone or nobody taking drugs, while non-linear prize functions lead to qualitatively different NEs with significantly more complex predictive characteristics. PMID:23691018

Medical Emergencies Related to Ethanol and Illicit Drugs at an Annual, Nocturnal, Indoor, Electronic Dance Music Event.

PubMed

Calle, Paul; Sundahl, Nora; Maudens, Kristof; Wille, Sarah Mr; Van Sassenbroeck, Diederik; De Graeve, Koen; Gogaert, Stefan; De Paepe, Peter; Devriese, Dieter; Arno, Geert; Blanckaert, Peter

2018-02-01

Introduction Medical problems are frequently encountered during electronic dance music (EDM) events. Problem There are uncertainties about the frequencies and severity of intoxications with different types of recreational drugs: ethanol, "classical" illicit party drugs, and new psychoactive substances (NPS). Statistical data on the medical problems encountered during two editions of an indoor electronic dance event with around 30,000 attendants were retrieved from the Belgian Red Cross (Mechelen, Belgium) database. Data on drug use were prospectively collected from the patient (or a bystander), the clinical presentation, and/or toxicological screening. In the on-site medical station, 487 patients were treated (265 in 2013 and 222 in 2014). The most frequent reasons were trauma (n=171), headache (n=36), gastro-intestinal problems (n=44), and intoxication (n=160). Sixty-nine patients were transferred to a hospital, including 53 with severe drug-related symptoms. Analysis of blood samples from 106 intoxicated patients detected ethanol in 91.5%, 3,4-methylenedioxymethamphetamine (MDMA) in 34.0%, cannabis in 30.2%, cocaine in 7.5%, amphetamine in 2.8%, and gamma-hydroxybutyric acid (GHB) in 0.9% of patients (alone or in combination). In only six of the MDMA-positive cases, MDMA was the sole substance found. In 2014, the neuroleptic drug clozapine was found in three cases and ketamine in one. Additional analyses for NPS were performed in 20 cases. Only in one agitated patient, the psychedelic phenethylamines 25B-NBOMe and 25C-NBOMe were found. At this particular event, recreational drug abuse necessitated on-site medical treatment in one out of 350 attendants and a hospital transfer in one out of 1,000. Ethanol remains the most frequently abused (legal) drug, yet classical illicit recreational drugs are also frequently (co-) ingested. The most worrying observation was high-risk poly-drug use, especially among MDMA users. Regarding NPS, the number of cases was low and the clinical presentations were rather mild. It should be stressed that these observations only apply to this particular event and cannot be generalized to other EDM events. Calle P , Sundahl N , Maudens K , Wille SMR , Van Sassenbroeck D , De Graeve K , Gogaert S , De Paepe P , Devriese D , Arno G , Blanckaert P . Medical emergencies related to ethanol and illicit drugs at an annual, nocturnal, indoor, electronic dance music event. Prehosp Disaster Med. 2018;33(1):71-76.

Physical Symptoms and Psychological Distress among Inhalant Users.

ERIC Educational Resources Information Center

Joe, George W.; And Others

1991-01-01

Among 110 Mexican-American adolescents with varying drug use histories, self-reported physical health problems were not related to inhalant use history, but blood analyses indicated a relationship between extensive inhalant use and liver problems. Psychological distress symptoms were related to inhalant use and physical symptoms. Contains 23…

The intimate relationship as a site of social protection: Partnerships between people who inject drugs.

PubMed

Rhodes, Tim; Rance, Jake; Fraser, Suzanne; Treloar, Carla

2017-05-01

Public health research treats intimate partnerships as sites of risk management, including in the management of HIV and hepatitis C transmission. This risk-infused biomedical approach tends to undermine appreciation of the emotional and socially situated meanings of care in intimate partnerships. In this article we explore qualitative interview accounts of the care enacted in partnerships between people who inject drugs, drawing on a 2014 study of 34 couples and 12 individuals living in two locations of Australia. A thematic analysis highlights 'best friend relationships', 'doing everything together', 'co-dependency', and 'doing normalcy' as core to narratives of care. As we will argue, the accounts position the care undertaken by couples as at once shaped by day-to-day practices of drug use and by social situation, with the partnership enacting care as a form of social protection, including protection from stigma and other environmental hostilities. The intimacy of doing everything together offers insulation against stigma, yet also reproduces its isolating effects. While the care produced in drug-using partnerships is presented as double-edged, we note how interview accounts are used to deflect the charge that these relationships represent harmful co-dependency. Taken together, the interview accounts negotiate a 'counter-care' in relation to normalcy, presenting the intimate partnership between people who use drugs as a legitimate embodiment of care. Copyright © 2017. Published by Elsevier Ltd.

Drug policy, intravenous drug use, and heroin addiction in the UK.

PubMed

Geraghty, Jemell

In order to fully understand and appreciate today's drug problem in the UK, the foundations of drug legislation and the history of drug evolution require exploration. This paper critically examines the history of drug policy and the growth of heroin addiction from the perspective of a novice researcher who works closely with intravenous drug users in relation to leg ulceration and wound care in the acute setting. Today's drug policy has come a long way in understanding the problems of heroin addiction and establishing services to meet intravenous drug users' needs and the needs of society. This paper highlights the early warning signs of drug addiction and growth within the UK from an early stage with key areas such as who the early users were and how addiction grew so rapidly between 1920 and 1960. Current policy and decision makers as well as clinicians and researchers in this field must understand the impacts of past policy and embed it within their decisions surrounding drug policy today.

HIV+ and HIV- youth living in group homes in South Africa need more psychosocial support.

PubMed

Nestadt, D F; Alicea, S; Petersen, I; John, S; Myeza, N P; Nicholas, S W; Cohen, L G; Holst, H; Bhana, A; McKay, M M; Abrams, E J; Mellins, C A

2013-07-01

Orphans and vulnerable youth who live in group homes are at risk of poor mental health and sexual and drug-using behaviors that increase the risk of HIV transmission. This study explores factors related to this risk among youth living in group homes ("children's homes") for orphans and vulnerable children in South Africa, a country afflicted by high levels of parental loss due to HIV. The study explores 1) knowledge and attitudes about HIV, 2) social support, 3) communication with group home caregivers, and 4) the relevance of an existing evidence-based HIV prevention and mental health promotion program to situations where sexual and drug risk behaviors can occur. In-depth qualitative individual interviews were conducted with 20 youth (age 10 to 16 years) residing in two children's homes in Durban, South Africa. Content analysis focused on critical themes related to coping and prevention of risk activities. Respondents exhibited inconsistent and incomplete knowledge of HIV transmission and prevention. They displayed positive attitudes toward people living with HIV, but reported experiencing or witnessing HIV-related stigma. Participants witnessed substance use and romantic/sexual relationships among their peers; few admitted to their own involvement. While relationships with childcare workers were central to their lives, youth reported communication barriers related to substance use, sex, HIV, and personal history (including parental loss, abuse, and other trauma). In conclusion, these qualitative data suggest that evidence-based HIV prevention programs that bring caregivers and youth together to improve communication, HIV knowledge, social support, youth self-esteem, and health care, reduce sexual and drug risk behaviors, and strengthen skills related to negotiating situations of sexual and substance use possibility could benefit youth and childcare workers in children's homes.

HIV+ and HIV− youth living in group homes in South Africa need more psychosocial support

PubMed Central

Nestadt, D.F.; Alicea, S.; Petersen, I.; John, S.; Myeza, N.P.; Nicholas, S.W.; Cohen, L.G.; Holst, H.; Bhana, A.; McKay, M.M.; Abrams, E.J.; Mellins, C.A.

2013-01-01

Orphans and vulnerable youth who live in group homes are at risk of poor mental health and sexual and drug-using behaviors that increase the risk of HIV transmission. This study explores factors related to this risk among youth living in group homes (“children’s homes”) for orphans and vulnerable children in South Africa, a country afflicted by high levels of parental loss due to HIV. The study explores 1) knowledge and attitudes about HIV, 2) social support, 3) communication with group home caregivers, and 4) the relevance of an existing evidence-based HIV prevention and mental health promotion program to situations where sexual and drug risk behaviors can occur. In-depth qualitative individual interviews were conducted with 20 youth (age 10 to 16 years) residing in two children’s homes in Durban, South Africa. Content analysis focused on critical themes related to coping and prevention of risk activities. Respondents exhibited inconsistent and incomplete knowledge of HIV transmission and prevention. They displayed positive attitudes toward people living with HIV, but reported experiencing or witnessing HIV-related stigma. Participants witnessed substance use and romantic/sexual relationships among their peers; few admitted to their own involvement. While relationships with childcare workers were central to their lives, youth reported communication barriers related to substance use, sex, HIV, and personal history (including parental loss, abuse, and other trauma). In conclusion, these qualitative data suggest that evidence-based HIV prevention programs that bring caregivers and youth together to improve communication, HIV knowledge, social support, youth self-esteem, and health care, reduce sexual and drug risk behaviors, and strengthen skills related to negotiating situations of sexual and substance use possibility could benefit youth and childcare workers in children’s homes. PMID:24039626

Legislative Norms to Control Cannabis Use in the Light of Its Prevalence in Czech Republic, Poland, Slovakia, and Hungary.

PubMed

Čecho, Róbert; Baška, Tibor; Švihrová, Viera; Hudečková, Henrieta

2017-12-01

Cannabis control legislation ranks among key measures to prevent social-health impacts of its use. The article qualitatively analyses respective legislation in the Czech Republic, Poland, Slovakia, and Hungary (Visegrad Four, V4) considering level of decriminalisation of cannabis use in relation to current epidemiological situation. Qualitative analysis of the cannabis control legislation in V4 countries from 1995 to 2016 focusing on criminal liability, differentiation of cannabis from other illicit substances, definition of a small amount intended for personal use, sentences for possessing and dealership of the drug. Results: Slovakia, Hungary and Poland share similar restrictive legislative approach throughout the studied period. In the Czech Republic, the situation has been different and since 2010 cannabis has been further decriminalised: possession of defined small amount of drug not being under prosecution and milder sentences for cannabis than for other illicit psychoactive substances. Slovakia, Hungary and Poland share similar restrictive legislative approach throughout the studied period. In the Czech Republic, the situation has been different and since 2010 cannabis has been further decriminalised: possession of defined small amount of drug not being under prosecution and milder sentences for cannabis than for other illicit psychoactive substances. Although the prevalence of cannabis use among adolescents is the highest in the Czech Republic, partial decriminalisation did not show further increase. Slovakia, Hungary and Poland show different trends in epidemiological situation despite of similar legislative approach. Results indicate that beside legislation other social factors play a role and measures to change attitudes and decrease social tolerance are important. Copyright© by the National Institute of Public Health, Prague 2017

Validity of the Addiction Severity Index (adapted version) in a Costa Rican population group.

PubMed

Sandí Esquivel, L E; Avila Corrales, K

1990-01-01

Until recently, no adapted and validated instrument was available for assessing the alcohol and drug problems of individuals in Costa Rica. This article reports the results of a study performed by Costa Rica's Institute on Alcoholism and Drug Dependence in order to test an adapted version of one such instrument, the Addiction Severity Index (ASI), in a Costa Rican setting. The instrument was used to interview 100 male subjects 18 to 64 years old (51 with diagnosed alcohol or drug problems and 49 controls). In general, the subjects with previously diagnosed alcohol or drug problems were assigned substantially higher scores. More specifically, statistical analysis indicated highly significant correlations (p less than 0.001) between the type of subject (test subject or control) and the likelihood that noteworthy problems would be found in the areas of alcohol use, family/social relations, work/finances, and psychological status. Overall, the study demonstrated that the instrument was capable of distinguishing between the affected and unaffected populations, and also of gauging the severity of the problems involved and the patients' treatment needs.

Person/Situation Selection Research: The Problem of Identifying Salient Situational Dimensions. Research Report No. 13.

ERIC Educational Resources Information Center

Schneider, Benjamin

The study was concerned with the persistent problem in conducting person/situation research--the identification of relevant dimensions or features of the situation. Since the usual strategy for discovering relevant perceptual dimension of organizational life is to ask organizational employees to respond to a set of predetermined questions, this…

Towards the Ethical or the Unethical Side?: An Explorative Research of Greek Business Students' Attitudes

ERIC Educational Resources Information Center

Karassavidou, Eleonora; Glaveli, Niki

2006-01-01

Purpose: The purpose of this research is to investigate the ethical orientations of undergraduate business students in Greece by exploring the relations among students' internalized code of ethics, anomia and students' judgment related to ethical problem situations within classroom as well as business context. Design/methodology/approach: A…

Infant-Mother Attachment Classification: Risk and Protection in Relation to Changing Maternal Caregiving Quality

ERIC Educational Resources Information Center

Developmental Psychology, 2006

2006-01-01

The relations between early infant-mother attachment and children's social competence and behavior problems during the preschool and early school-age period were examined in more than 1,000 children under conditions of decreasing, stable, and increasing maternal parenting quality. Infants' Strange Situation attachment classifications predicted…

Transitions in Illicit Drug Use Status over 3 Years: A Prospective Analysis of a General Population Sample

PubMed Central

Compton, Wilson M.; Dawson, Deborah A.; Conway, Kevin P.; Brodsky, Marc; Grant, Bridget F.

2015-01-01

Objective To examine 3-year transitions among nonuse, asymptomatic use and problem use of illicit drugs for US adults in the general household population. Method Data from the nationally representative NESARC study of 34,653 adults interviewed twice, 3 years apart. Three mutually exclusive categories of baseline drug status comprised past year non-users (n=32,675), past-year asymptomatic drug users (n=861), and past-year symptomatic drug users (n=1,117). Symptomatic drug use was defined as presence of one or more symptoms that operationalize DSM-IV drug abuse and dependence criteria. Variables tested for association with 3-year transitions to different status categories included sociodemographic, health, substance use and psychiatric covariates. Results Among baseline nonusers, 95.4% continued to be nonusers at follow-up, 2.1% became asymptomatic users, and 2.5% developed drug problems. Among baseline asymptomatic users, 66.6% had stopped using drugs at follow-up, 14.3% continued to be asymptomatic users and 19.1% had developed drug problems. Nearly half (49.0%) of those with drug problems at baseline had stopped using drugs at follow-up, 10.9% had transitioned to asymptomatic use and 40.1% continued to have drug problems. Younger age, male gender, white race, and not being married were associated with progression from non-use to use or problematic use, as were alcohol and tobacco categories, major depression and schizotypal, borderline and narcissistic personality disorders. Panic disorder and avoidant personality disorder were associated with less progression. Conclusions Transitions in drug use status are common. The finding that alcohol and tobacco-related variables and co-occurring psychopathology are important correlates of transitions suggests the value of addressing all co-occurring disorders and substance use in patient assessments and treatment planning, both for preventing adverse transitions and promoting positive transitions. PMID:23511653

Prevalence of skin problems and leg ulceration in a sample of young injecting drug users.

PubMed

Coull, Alison F; Atherton, Iain; Taylor, Avril; Watterson, Andrew E

2014-08-13

Drug users suffer harm from the injecting process, and clinical services are reporting increasing numbers presenting with skin-related problems such as abscesses and leg ulcers. Skin breakdown can lead to long-term health problems and increased service costs and is often the first indication of serious systemic ill health. The extent of skin problems in injecting drug users has not previously been quantified empirically, and there is a dearth of robust topical literature. Where skin problems have been reported, this is often without clear definition and generic terms such as 'soft tissue infection' are used which lack specificity. The aim of this study was to identify the range and extent of skin problems including leg ulceration in a sample of injecting drug users. Definitions of skin problems were developed and applied to descriptions from drug users to improve rigour. Data were collected in needle exchanges and methadone clinics across Glasgow, Scotland, from both current and former drug injectors using face-to-face interviews. Two hundred participants were recruited, of which 74% (n = 148) were males and 26% (n = 52) were females. The age range was 21-44 years (mean 35 years). Just under two thirds (64%, n = 127) were currently injecting or had injected within the last 6 months, and 36% (n = 73) had previously injected and had not injected for more than 6 months.Sixty per cent (n = 120) of the sample had experienced a skin problem, and the majority reported more than one problem. Most common were abscesses, lumps, track marks and leg ulcers. Fifteen per cent (n = 30) of all participants reported having had a leg ulcer. This is an original empirical study which demonstrated unique findings of a high prevalence of skin disease (60%) and surprisingly high rates of leg ulceration (15%). Skin disease in injecting drug users is clearly widespread. Leg ulceration in particular is a chronic recurring condition that is costly to treat and has long-term implications for drug users and services caring for current or former injectors long after illicit drug use has ceased.

Childhood or adolescent parental divorce/separation, parental history of alcohol problems, and offspring lifetime alcohol dependence.

PubMed

Thompson, Ronald G; Lizardi, Dana; Keyes, Katherine M; Hasin, Deborah S

2008-12-01

This study examined whether the experiences of childhood or adolescent parental divorce/separation and parental alcohol problems affected the likelihood of offspring DSM-IV lifetime alcohol dependence, controlling for parental history of drug, depression, and antisocial behavior problems. Data were drawn from the 2001-2002 National Epidemiological Survey on Alcohol and Related Conditions (NESARC), a nationally representative United States survey of 43,093 civilian non-institutionalized participants aged 18 and older, interviewed in person. Logistic regression models were used to calculate the main and interaction effects of childhood or adolescent parental divorce/separation and parental history of alcohol problems on offspring lifetime alcohol dependence, after adjusting for parental history of drug, depression, and antisocial behavior problems. Childhood or adolescent parental divorce/separation and parental history of alcohol problems were significantly related to offspring lifetime alcohol dependence, after adjusting for parental history of drug, depression, and antisocial behavior problems. Experiencing parental divorce/separation during childhood, even in the absence of parental history of alcohol problems, remained a significant predictor of lifetime alcohol dependence. Experiencing both childhood or adolescent parental divorce/separation and parental alcohol problems had a significantly stronger impact on the risk for DSM-IV alcohol dependence than the risk incurred by either parental risk factor alone. Further research is needed to better identify the factors that increase the risk for lifetime alcohol dependence among those who experience childhood or adolescent parental divorce/separation.

Childhood or Adolescent Parental Divorce/Separation, Parental History of Alcohol Problems, and Offspring Lifetime Alcohol Dependence

PubMed Central

Thompson, Ronald G.; Lizardi, Dana; Keyes, Katherine M.; Hasin, Deborah S.

2013-01-01

Background This study examined whether the experiences of childhood or adolescent parental divorce/separation and parental alcohol problems affected the likelihood of offspring DSM-IV lifetime alcohol dependence, controlling for parental history of drug, depression, and antisocial behavior problems. Method Data were drawn from the 2001–2002 National Epidemiological Survey on Alcohol and Related Conditions (NESARC), a nationally representative United States survey of 43,093 civilian non-institutionalized participants aged 18 and older, interviewed in person. Logistic regression models were used to calculate the main and interaction effects of childhood or adolescent parental divorce/separation and parental history of alcohol problems on offspring lifetime alcohol dependence, after adjusting for parental history of drug, depression, and antisocial behavior problems. Results Childhood or adolescent parental divorce/separation and parental history of alcohol problems were significantly related to offspring lifetime alcohol dependence, after adjusting for parental history of drug, depression, and antisocial behavior problems. Experiencing parental divorce/separation during childhood, even in the absence of parental history of alcohol problems, remained a significant predictor of lifetime alcohol dependence. Experiencing both childhood or adolescent parental divorce/separation and parental alcohol problems had a significantly stronger impact on the risk for DSM-IV alcohol dependence than the risk incurred by either parental risk factor alone. Conclusions Further research is needed to better identify the factors that increase the risk for lifetime alcohol dependence among those who experience childhood or adolescent parental divorce/separation. PMID:18757141

Fluorescent blue lights, injecting drug use and related health risk in public conveniences: findings from a qualitative study of micro-injecting environments.

PubMed

Parkin, Stephen; Coomber, Ross

2010-07-01

This paper presents findings relating to injecting drug users' experiences and opinions of public toilets illuminated with fluorescent blue lights and presents an empirical assessment of the intended deterrent effect of such installations. Data analysis identified that blue lights deterred less than half the sample interviewed. Furthermore over half (18/31) of the sample were prepared to inject in conditions specifically designed to deter injecting practice. Of these, 11 respondents were completely undeterred and 7 individuals were only partially deterred by blue light environments. These findings are discussed within the interpretative frameworks of Pierre Bourdieu's theory of habitus and symbolic violence. The authors conclude that fluorescent blue lights contribute towards the development of situated resistance by injecting drug users within a public injecting habitus; a resistance that produces and reproduces drug-related harm and is a behaviour that opposes the symbolic violence of harm reduction intervention. The paper concludes with suggestions for theory-driven practical intervention that may seek to disrupt the harmful elements of the public injecting habitus. 2010 Elsevier Ltd. All rights reserved.

Amphetamine primes motivation to gamble and gambling-related semantic networks in problem gamblers.

PubMed

Zack, Martin; Poulos, Constantine X

2004-01-01

Previous research suggests that gambling can induce effects that closely resemble a psychostimulant drug effect. Modest doses of addictive drugs can prime motivation for drugs with similar properties. Together, these findings imply that a dose of a psychostimulant drug could prime motivation to gamble in problem gamblers. This study assessed priming effects of oral D-amphetamine (AMPH) (30 mg) in a within-subject, counter-balanced, placebo-controlled design in problem gamblers (n=10), comorbid gamblerdrinkers (n=6), problem drinkers (n=8), and healthy controls (n=12). Modified visual analog scales assessed addictive motivation and subjective effects. A modified rapid reading task assessed pharmacological activation of words from motivationally relevant and irrelevant semantic domains (Gambling, Alcohol, Positive Affect, Negative Affect, Neutral). AMPH increased self-reported motivation for gambling in problem gamblers. Severity of problem gambling predicted positive subjective effects of AMPH and motivation to gamble under the drug. There was little evidence that AMPH directly primed motivation for alcohol in problem drinkers. On the reading task, AMPH produced undifferentiated improvement in reading speed to all word classes in Nongamblers. By contrast, in the two problem gambler groups, AMPH improved reading speed to Gambling words while profoundly slowing reading speed to motivationally irrelevant Neutral words. The latter finding was interpreted as directly congruent with models, which contend that priming of addictive motivation involves a linked suppression of motivationally irrelevant stimuli. This study provides experimental evidence that psychostimulant-like neurochemical activation is an important component of gambling addiction.

Drug-Related-Problem Outcomes and Program Satisfaction from a Comprehensive Brown Bag Medication Review.

PubMed

O'Connell, Mary Beth; Chang, Feng; Tocco, Ashley; Mills, Megan E; Hwang, Jamie M; Garwood, Candice L; Khreizat, Hanan S; Gupta, Nishi S

2015-09-01

To classify and quantify drug-related problems (DRPs), determine acceptance of DRP recommendations, and assess medication review satisfaction. Comprehensive brown bag medication reviews. Six senior centers and three senior high-rises. Individuals aged 60 and older (mean age 75.9 ± 8.5) taking five or more medications (n = 85). Two investigators independently classified DRPs using modified Pharmaceutical Care Network Europe classification scheme and severity of medication error and value of service scales. Two other investigators adjudicated classification differences. Satisfaction surveys were administered immediately and 3 months after review. A DRP recommendation implementation survey was completed at least 3 months after the review. Participants had a mean of 4.3 ± 2.8 DRPs (range 0-10). DRPs were classified as adverse reactions (30%), treatment effectiveness (28%), treatment costs (13%), information need (8%), and other (21%). Causes included drug selection (40%), wrong dosage (23%), participant problems (e.g., adherence, lack of medication knowledge, 16%), drug use process problems (12%), drug formulation (0.5%), treatment duration (0.5%), and other (7%). Interventions required drug changes (44%), prescriber input (37%), individual counseling (18%), or other (1%). DRP severities were significant (59%) or minor (35%). Participants expressed satisfaction with the program because they were able to ask questions, trusted the answers, and knew more about their medications. After 3 months, they had implemented 63% of the DRP recommendations. Older adults found the medication review helpful and implemented 63% of the DRP recommendations. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

The Fight against Drugs. Sozial-Report.

ERIC Educational Resources Information Center

Loeper, Ellen; Hirschfeld, Gerhard

For the past 20 years West Germany has actively combatted its country's drug-related problems, and has been a leader in international narcotics' coordination and control efforts. Part 1 of this document describes West Germany's attempts to contain and eradicate addiction and to assist persons who are addicted to legal drugs, such as alcohol,…

Alcohol and Other Drugs: Prevention Challenges at Community Colleges.

ERIC Educational Resources Information Center

Ryan, Barbara E.

In this document, The Higher Education Center for Alcohol and Other Drug Prevention focuses on prevention challenges at community colleges. Students at community colleges differ from those at four-year institutions in a number of areas, including social demographics as well as alcohol and other drug-related problems. Community college students are…

Does Polyvictimization Affect Incarcerated and Non-Incarcerated Adult Women Differently? An Exploration Into Internalizing Problems.

PubMed

Radatz, Dana L; Wright, Emily M

2015-06-10

In this study, we used data from life histories of 424 non-incarcerated (n = 266) and incarcerated (n = 158) women to examine the extent to which women are exposed to multiple forms of victimization, including child abuse, intimate partner violence, sexual assault, and traumatic life events. We assessed the effects of polyvictimization (e.g., multiple victimizations) on women's health-related outcomes (e.g., attempted suicide, drug and alcohol problems) as well as whether the prevalence rates and effects of victimization were significantly different between the subsamples of women. Results indicate that incarcerated women experience significantly more victimization than non-incarcerated women, and while polyvictimization was associated with a higher likelihood of alcohol problems, drug problems, and attempted suicide among non-incarcerated women, it was only marginally associated with an increased likelihood of alcohol problems among incarcerated women. Finally, low levels of polyvictimization affected alcohol and drug problems among incarcerated and non-incarcerated women differently. © The Author(s) 2015.

HIV in Indian prisons: risk behaviour, prevalence, prevention & treatment.

PubMed

Dolan, Kate; Larney, Sarah

2010-12-01

HIV is a major health challenge for prison authorities. HIV in prisons has implications for HIV in the general community. The aim of this paper was to gather information on HIV risk, prevalence, prevention and treatment in prisons in India. Relevant published and unpublished reports and information were sought in order to provide a coherent picture of the current situation relating to HIV prevention, treatment and care in prisons in India. Information covered prison management and population statistics, general conditions in prisons, provision of general medical care and the HIV situation in prison. No data on drug injection in prison were identified. Sex between men was reported to be common in some Indian prisons. A national study found that 1.7 per cent of inmates were HIV positive. Some prisons provided HIV education. Condom provision was considered illegal. A few prisoners received drug treatment for drug use, HIV infection or co-infection with sexually transmitted infections (STIs). HIV prevalence in prisons in India was higher than that in the general community. Regular monitoring of information on HIV risk behaviours and prevalence in Indian prisons is strongly recommended. Evidence based treatment for drug injectors and nation-wide provision of HIV prevention strategies are urgently required. Voluntary counselling, testing and treatment for HIV and STIs should be provided.

Treating the Illness: The School Practitioner's Response to Health-Related Student Death and Children's Grief

ERIC Educational Resources Information Center

Jimerson, Shane R.; Miller, David N.

2008-01-01

Although childhood death from health-related disorders has decreased dramatically in the United States due largely to advances in medical technology, it is an unfortunate fact of life that children can and do die from medical and health-related problems. A possible role for school psychologists in dealing with this situation is providing direct…

Affective dysregulation predicts incident nonmedical prescription analgesic use among college students.

PubMed

Morioka, Christine K; Howard, Donna E; Caldeira, Kimberly M; Wang, Min Qi; Arria, Amelia M

2018-01-01

This study investigated the relationship between four suspected risk factors-affective dysregulation, conduct problems, depressive symptoms, and psychological distress-and incident nonmedical prescription analgesic (NPA) use among college students. The sample was derived from 929 college students from a large, mid-Atlantic university who completed the third annual College Life Study assessment (Y 3 ) and were NPA use naïve at baseline (Y 1 ). A series of logistic regression analyses were conducted to evaluate the predictors of incident NPA use by Y 3 . Separate models were developed to evaluate the association between the suspected risk factors and (a) NPA use relative to non-use of other drugs, including nonmedical use of other drug classes, (b) NPA use relative to other drug use, and (c) other drug use relative to non-use. All models included gender, parental education level, and race/ethnicity. Affective dysregulation was significantly associated with becoming an incident NPA user relative to both drug users without NPA use as well as non-users, after statistically controlling for demographic characteristics and other factors. Conduct problems in early childhood were positively related to both incident NPA use and other drug use without NPA use relative to non-users, after statistically controlling for demographic characteristics and other factors. Depressive symptoms were associated with NPA incidence at the bivariate level only. These findings extend previous research suggesting that NPA use might be related to deficits in regulating negative emotional states, and highlight possible markers for screening and intervention to prevent NPA use. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effective policy initiatives to constrain lipid-lowering drug expenditure growth in South Korea.

PubMed

Bae, Green; Park, Chanmi; Lee, Hyejin; Han, Euna; Kim, Dong-Sook; Jang, Sunmee

2014-03-03

The rapid growth of prescription drug expenditures is a major problem in South Korea. Accordingly, the South Korean government introduced a positive listing system in 2006. They also adopted various price reduction policies. Nevertheless, the total expenditure for lipid-lowering drugs have steadily increased throughout South Korea. The present study explores the factors that have influenced the increased expenditures of lipid-lowering drugs with a particular focus on the effects of statins in this process. This paper investigates the National Health Insurance claims data for prescribed lipid-lowering drugs collected between January 1, 2005 and December 31, 2009. We specifically focused on statins and assessed the yearly variation of statin expenditure by calculating the increased rate of paired pharmaceutical expenditures over a 2 year period. Our study classified statins into three categories: new entrants, core medicines and exiting medicines. For core medicines, we further examined influencing factors such as price, amount of drugs consumed by volume, and prescription changes (substitutes for other drug). Statin expenditure showed an average annual increase of 25.7% between 2005 and 2009. Among the different statins, the expenditure of atorvastatin showed a 36.6% annual increase rate, which was the most dramatic among all statins. Also we divided expenditure for core medicines by the price factor, volume factor, and prescription change. The result showed that annual weighted average prices of individual drug decreased each year, which clearly showed that price influenced statin expenditure in a negative direction. The use of generic drugs containing the same active ingredient as name-brand drugs increased and negatively affected statin expenditure (Generic Mix effect). However, the use of relatively expensive ingredients within statin increase, Ingredient Mix effect contributed to increased statin expenditure (Ingredient Mix effect). In particular, the volume effect was found to be critical for increasing statin expenditure as the amount of statin consumed increased steadily throughout the study period. The recent rapid increase in statin expenditure can largely be attributed to an increase in consumption volume. In order to check drug expenditures effectively in our current situation, in which chronic diseases remain steadily on the rise, it is necessary to not only have supply-side initiatives such as price reduction, but also demand-side initiatives that could control drug consumption volume, for example: educational programs for rational prescription, generic drug promotional policies, and policies providing prescription targets.

Technology Education and the Elementary School.

ERIC Educational Resources Information Center

Thode, Terry

1996-01-01

In the technology education program at Hemingway School in Ketchum, Idaho, students are involved in hands-on activities that encourage the use of critical thinking skills, tools, and high-tech equipment to solve problems related to real world situations. (Author)

‘Safer Environment Interventions’: A qualitative synthesis of the experiences and perceptions of people who inject drugs

PubMed Central

McNeil, Ryan; Small, Will

2014-01-01

There is growing acknowledgment that social, structural, and environmental forces produce vulnerability to health harms among people who inject drugs (PWID), and safer environment interventions (SEI) have been identified as critical to mitigating the impacts of these contextual forces on drug-related harm. To date, however, SEIs have been under-theorized in the literature, and how they minimize drug-related risks across intervention types and settings has not been adequately examined. This article presents findings from a systematic review and meta-synthesis of qualitative studies reporting PWID’s experiences with three types of SEIs (syringe exchange programmes, supervised injection facilities and peer-based harm reduction interventions) published between 1997 and 2012. This meta-synthesis seeks to develop a comprehensive understanding of SEIs informed by the experiences of PWID. Twenty-nine papers representing twenty-one unique studies that included an aggregate of more than 800 PWID were included in this meta-synthesis. This meta- synthesis found that SEIs fostered social and physical environments that mitigated drug-related harms and increased access to social and material resources. Specifically, SEIs: (1) provided refuge from street-based drug scenes; (2) enabled safer injecting by reshaping the social and environmental contexts of injection drug use; (3) mediated access to resources and health care services; and, (4) were constrained by drug prohibition and law enforcement activities. These findings indicate that it is critical to situate SEIs in relation to the lived experiences of PWID, and in particular provide broader environmental support to PWID. Given that existing drug laws limit the effectiveness of interventions, drug policy reforms are needed to enable public health, and specifically SEIs, to occupy a more prominent role in the response to injection drug use. PMID:24561777

Issues in the Analysis of Focus Groups: Generalisability, Quantifiability, Treatment of Context and Quotations

ERIC Educational Resources Information Center

Vicsek, Lilla

2010-01-01

In this paper I discuss some concerns related to the analysis of focus groups: (a) the issue of generalisation; (b) the problems of using numbers and quantifying in the analysis; (c) how the concrete situation of the focus groups could be included in the analysis, and (d) what formats can be used when quoting from focus groups. Problems with…

Situational drinking in private and public locations: A multilevel analysis of blood alcohol level in Finnish drinking occasions.

PubMed

Mustonen, Heli; Mäkelä, Pia; Lintonen, Tomi

2016-11-01

The first aim was to estimate the extent to which the variation in alcohol use across specific drinking occasions arises from variation at the occasion level and from variation at the drinker level. The second aim was to identify characteristics of drinking situations that moderate or increase situational alcohol use beyond the influence of drinker-level characteristics. The general population aged 15-69 years in Finland was sampled randomly in 2008. The multilevel analysis was based on data from 1511 drinkers and 2933 drinking occasions that occurred in the 7 days before the interview. Alcohol use was operationalised as estimated blood alcohol level (BAL). Characteristics of drinking occasions included location, circumstance, company and timing. Drinker-level data included demographic and drinking pattern variables. Fifty-three percent of the variance in BAL was between occasions and 47% between respondents, for both women and men. With drinking patterns and demographic characteristics controlled for, the dominant characteristics of drinking occasions predisposing to greater intoxication were late-night drinking, across locations and for both genders. For private locations, predisposing characteristics included drinking on weekends for both genders and drinking with friends for men. Situational and drinker levels are equally important in determining the BAL in drinking occasions; therefore, prevention efforts should be targeted at both risky individuals and risky drinking occasions. Occasions occurring late at night, often at home and with friends, are a central challenge for targeting preventive efforts related to situational drinking.[Mustonen H, Mäkelä P, Lintonen T. Situational drinking in private and public locations: A multilevel analysis of blood alcohol level in Finnish drinking occasions. Drug Alcohol Rev 2016;35:772-784]. © 2016 Australasian Professional Society on Alcohol and other Drugs.

Interpersonal Relationship Styles in Marathon Group Therapy: A Study with Illicit Drug Users.

ERIC Educational Resources Information Center

Page, Richard C.; Bridges, Ned

1983-01-01

Assessed how illegal drug users (N=12) related to one another during a 16-hour unstructured group marathon. Interaction analysis supported the effectiveness of the marathon group. Members and facilitators were able to relate to each other by confronting significant behaviors and receiving feedback about ways to cope with personal problems. (JAC)

Science and scepticism: Drug information, young men and counterpublic health.

PubMed

Farrugia, Adrian; Fraser, Suzanne

2017-11-01

It is perhaps no surprise that young people can be sceptical of the drug-related information they receive in school-based health education, health promotion and the media. Significant societal anxiety surrounds young people's drug consumption, so it is tempting to approach this scepticism as a problem to be solved. In this article, we look closely at a group of young Australian men (n = 25), all of whom hold deeply sceptical views about the drug information they received in schools, social marketing campaigns and public speech generally. We do not approach their scepticism as a problem to be solved in itself, however. Instead, we analyse its origins and how it relates to the way knowledge is constructed in drug education, health promotion and media accounts of drug use. To conceptualise this scepticism, we draw on Irwin and Michael's analysis of the changing relationship between science and society, Warner's theorisation of publics and counterpublics, and Race's related notion of 'counterpublic health'. The article organises the data into three key themes: scepticism about the accuracy of the claims made about drug risks and dangers, scepticism about representations of drug users, and scepticism about the motivations behind the health messages and drug policy in general. We then draw these different aspects of scepticism together to argue that the young men can be seen to constitute a health 'counterpublic', and we consider the implications of this approach, arguing for what has been described as a more diplomatic engagement between science and publics.

Illicit drugs and the media: models of media effects for use in drug policy research.

PubMed

Lancaster, Kari; Hughes, Caitlin E; Spicer, Bridget; Matthew-Simmons, Francis; Dillon, Paul

2011-07-01

Illicit drugs are never far from the media gaze and although identified almost a decade ago as 'a new battleground' for the alcohol and other drug (AOD) field there has been limited research examining the role of the news media and its effects on audiences and policy. This paper draws together media theories from communication literature to examine media functions. We illustrate how each function is relevant for media and drugs research by drawing upon the existing literature examining Australian media coverage during the late 1990s of escalating heroin-related problems and proposed solutions. Media can influence audiences in four key ways: by setting the agenda and defining public interest; framing issues through selection and salience; indirectly shaping individual and community attitudes towards risk; and feeding into political debate and decision making. Each has relevance for the AOD field. For example, media coverage of the escalating heroin-related problems in Australia played a strong role in generating interest in heroin overdoses, framing public discourse in terms of a health and/or criminal issue and affecting political decisions. Implications AND CONCLUSION: Media coverage in relation to illicit drugs can have multifarious effects. Incorporating media communication theories into future research and actions is critical to facilitate understanding of the short- and long-term impacts of media coverage on illicit drugs and the avenues by which the AOD field can mitigate or inform future media debates on illicit drugs. © 2010 Australasian Professional Society on Alcohol and other Drugs.

How Strong Is the Evidence that Illicit Drug Use by Young People Is an Important Cause of Psychological or Social Harm? Methodological and Policy Implications of a Systematic Review of Longitudinal, General Population Studies

ERIC Educational Resources Information Center

MacLeod, John; Oakes, Rachel; Oppenkowski, Thomas; Stokes-Lampard, Helen; Copello, Alex; Crome, Ilana; Davey Smith, George; Egger, Matthias; Hickman, Mathew; Judd, Ali

2004-01-01

Recreational use of illicit drugs (i.e. use not associated with a diagnosed drug problem) may cause psychological and social harm. A recent systematic review found that evidence for this was equivocal. Extensive evidence was only available in relation to cannabis use. This was relatively consistently associated with lower educational attainment…

Once hurt, twice shy: Social pain contributes to social anxiety.

PubMed

Fung, Klint; Alden, Lynn E

2017-03-01

Social rejection has been consistently linked to the development of social anxiety. However, mechanisms underlying the relation have been largely unexplored, which presents an obstacle to fully understanding the origins of social anxiety and to the development of effective prevention and treatment strategies. Two studies were conducted to test the hypothesis that the emotion of social pain following rejection promotes the development of social anxiety in subsequent situations. In Study 1, undergraduate participants were exposed to 2 social situations (Cyberball) 2 days apart. Participants who were rejected in the first situation reported higher social anxiety before and during the second situation relative to those who were included. This effect was fully mediated by initial social pain intensity. In Study 2, all participants were initially rejected. Using double-blinded drug administration, participants were randomly assigned to ingest acetaminophen to alleviate the social pain from rejection, or a sugar placebo. As predicted, the acetaminophen group reported lower social anxiety before and during the second situation. Approximately half of the effect was mediated by reduction in social pain. Notably, the immediate effect of acetaminophen was specific to social pain rather than social anxiety. Results were discussed in the context of literature on the etiology of social anxiety and social pain. Future directions were suggested. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

A Criminological Perspective on the Prenatal Abuse of Substances during Pregnancy and the Link to Child Abuse in South Africa

ERIC Educational Resources Information Center

Ovens, Michelle

2009-01-01

The increase in drug abuse in South Africa has had major social implications in the country. Problems associated with drug dependency are poverty, unemployment, a heavier burden on the health care system, the disintegration of family systems and drug-related crimes. Another area of concern is the link between drug abuse and child abuse. While…

Cost-effectiveness analysis: should it be required for drug registration and beyond?

PubMed

Arnold, Renée J Goldberg

2007-11-01

Cost-effectiveness analysis (CEA) is applied in situations where trade-offs exist, typically, greater benefit for an increased cost over an alternative therapy or strategic option versus usual care. CEA is useful where a new strategy is more costly but expected to be more effective or where a new strategy is less costly but less effective. A good example for the relevance of CEA is the unanimous recommendation of a US federal vaccine advisory panel to vaccinate 11-year-old girls against cervical cancer. This recommendation was at least partly because of data showing the relative cost-effectiveness of HPV vaccine. In this era of finite budgets, CEA may facilitate drug development, drug approval, patient segmentation and pricing model development throughout the drug lifecycle continuum.

["First aid" for addictive diseases].

PubMed

Nespor, K

2009-01-01

All clinicians should perform routinely brief intervention for addictive problems. We prepared free online self-help manuals for the patients with alcohol, drugs and gambling related problems. The considerably more simplified version of these manuals is presented here.

The levels of stress, depression and anxiety of parents of disabled children in Turkey.

PubMed

Uskun, Ersin; Gundogar, Duru

2010-01-01

Parents of disabled children experience some special problems in their lives. It is reported that the parents of disabled children experience a very high level of stress. This study aims to determine the situations in which the parents experience higher levels of stress; to investigate the relation between the levels of stress, depression and anxiety. This cross-sectional study was conducted with parents whose children attend a Special Education and Rehabilitation Centre. The total number of parents was 156 and 127 (81.4%) of them voluntarily participated in this study. A questionnaire form, consisting of questions regarding the socio-demographic characteristics of disabled children and of their parents, was given to the participants. Additionally, the participants were asked to score 10 possible stressful situations (financial problems, relations with other people, having limited free time, not to be able to participate in social activities, etc.) on a scale of 0-10 points. Moreover, psychometric scales such as Beck Depression Inventory (BDI) and Spielberger State Trait Anxiety Inventory (STAI) were applied to the participants. The mean BDI (SD) score was found to be 14.9 (10.9). The mean STAI-state and STAI-trait scores were 55.1 ± 12.2 and 48.6 ± 8.8, respectively. Among the stressful experiences, the parents gave the highest points to 'attitudes of society towards disabled people', 'having limited free time' and 'financial problems' (Top three situations). In multiple analyses, it was found that by employing the BDI there was a relation between financial problems (ß: 0.32, p < 0.01), a decrease in relations with other people (ß: 0.21, p < 0.05), having limited free time (ß: -0.19, p < 0.05) and insufficiency of physical structures (ß: 0.21, p < 0.05). The relations between financial problems (ß: 0.31, p < 0.01) and being an individual who has close relations with disabled person other than his/her parents (ß: 0.27, p < 0.01) were defined employing the STAI-state as effective variables. 'Negative attitudes of society towards disabled people' (ß: 0.29; p < 0.01) were defined employing the STAI-trait as the only effective variable. Financial problems are the most important factors that affect the psychology of the parents of disabled people. Social programmes that support the parents in respect of both financial matters and home-care facilities should be set up.

Fascioliasis: a worldwide parasitic disease of importance in travel medicine.

PubMed

Ashrafi, Keyhan; Bargues, M Dolores; O'Neill, Sandra; Mas-Coma, Santiago

2014-01-01

Fascioliasis is a foodborne zoonotic disease caused by the two parasite species Fasciola hepatica and Fasciola gigantica. This trematodiasis has never been claimed special relevance for travellers and migrants. However, the situation has drastically changed in the last two decades, in a way that fascioliasis should today be included in the list of diseases to be enhanced in Travel Medicine. Different kind of travellers have been involved in human infection reports: business travellers, tourists, migrants, expatriated workers, military personnel, religious missionaries, and refugees. Europe is the continent where more imported cases have been reported in many countries. More cases would have been probably reported in Europe if fascioliasis would be a reportable disease. In the Americas, most of the reports concern cases diagnosed in USA. Relative few patients have been diagnosed in studies on travellers performed in Asia. In Africa, most cases were reported in Maghreb countries. Blood eosinophilia and the ingestion of watercress or any other suggestive freshwater plant in anamnesis are extremely useful in guiding towards a fascioliasis diagnosis in a developed country, although may not be so in human endemic areas of developing countries. Several suggestive clinical presentation aspects may be useful, although the clinical polymorphism may be misleading in many cases. Non-invasive techniques are helpful for the diagnosis, although images may lead to confusion. Laparoscopic visualization should assist and facilitate procurement of an accurately guided biopsy. Endoscopic retrograde cholangiopancreatography (ERCP) is the first choice in patients in the chronic phase. ERCP and sphincterotomy are used to extract parasites from the biliary tree. Fluke egg finding continues to be the gold standard and enables for burden quantification and establishing of the drug dose. Many serological and stool antigen detection tests have been developed. Immunological techniques present the advantages of being applicable during all periods of the disease, but fundamentally during the invasive or acute period, as well as to other situations in which coprological techniques may present problems. Triclabendazole is the drug of choice at present, although the spread of resistance to this drug is challenging. Prevention mainly concerns measures to avoid individual infection by considering the different human infection sources. Copyright © 2014 Elsevier Ltd. All rights reserved.

Life-Time Risk for Substance Use Among Offspring of Abusive Family Environment From the Community

PubMed Central

Nomura, Yoko; Hurd, Yasmin L.; Pilowsky, Daniel J.

2018-01-01

The current study examined the cumulative risk, age of initiation, and functional impairments among adults with substance use problems (N = 1748) by child abuse status. Child abuse was associated with earlier initiation of marijuana, cocaine, and heroin use, and had greater risks for all the drugs studied (hazard ratios, 1.7–3.2). Furthermore, child abuse was associated with increased medical and functional impairments, including ER visits, health problems, drug dealing, drug dependence, and drug cravings. Provision of social services and parenting education during the perinatal period may prevent the long-term impact of child abuse on substance use and related impairments. The study’s limitations are noted. PMID:22780838

Changes in psychiatric symptoms among persons with methamphetamine dependence predicts changes in severity of drug problems but not frequency of use.

PubMed

Polcin, Douglas L; Korcha, Rachael; Bond, Jason; Galloway, Gantt; Nayak, Madhabika

2016-01-01

Few studies have examined how changes in psychiatric symptoms over time are associated with changes in drug use and severity of drug problems. No studies have examined these relationships among methamphetamine (MA)-dependent persons receiving motivational interviewing within the context of standard outpatient treatment. Two hundred seventeen individuals with MA dependence were randomly assigned to a standard single session of motivational interviewing (MI) or an intensive 9-session model of MI. Both groups received standard outpatient group treatment. The Addiction Severity Index (ASI) and timeline follow-back (TLFB) for MA use were administered at treatment entry and 2-, 4-, and 6-month follow-ups. Changes in ASI psychiatric severity between baseline and 2 months predicted changes in ASI drug severity during the same time period, but not changes on measures of MA use. Item analysis of the ASI drug scale showed that psychiatric severity predicted how troubled or bothered participants were by their drug us, how important they felt it was for them to get treatment, and the number of days they experienced drug problems. However, it did not predict the number days they used drugs in the past 30 days. These associations did not differ between study conditions, and they persisted when psychiatric severity and outcomes were compared across 4- and 6-month time periods. Results are among the first to track how changes in psychiatric severity over time are associated with changes in MA use and severity of drug problems. Treatment efforts targeting reduction of psychiatric symptoms among MA-dependent persons might be helpful in reducing the level of distress and problems associated with MA use but not how often it is used. There is a need for additional research describing the circumstances under which the experiences and perceptions of drug-related problems diverge from frequency of consumption.

The Visibility of Illicit Drugs: Implications for Community-Based Drug Control Strategies

PubMed Central

Saxe, Leonard; Kadushin, Charles; Beveridge, Andrew; Livert, David; Tighe, Elizabeth; Rindskopf, David; Ford, Julie; Brodsky, Archie

2001-01-01

Objectives. This study examined differences between the visibility of drugs and drug use in more than 2100 neighborhoods, challenging an assumption about drug use in poor, minority, and urban communities. Methods. A telephone survey assessed substance use and attitudes across 41 communities in an evaluation of a national community-based demand reduction program. Three waves of data were collected from more than 42 000 respondents. Results. Measures of neighborhood disadvantage, population density, and proportion of minority residents explained more than 57% of the variance between census tracts in visibility of drug sales but less than 10% of tract-to-tract variance in drug use. Visible drug sales were 6.3 times more likely to be reported in the most disadvantaged neighborhoods than in the least disadvantaged, while illicit drug use was only 1.3 times more likely. Conclusions. The most disadvantaged neighborhoods have the most visible drug problems, but drug use is nearly equally distributed across all communities. Thus, efforts to address drug-related problems in poorer areas need to take into account the broader drug market served by these neighborhoods. PMID:11726381

Observation of children with attention-deficit hyperactivity (ADHD) problems in three natural classroom contexts.

PubMed

Lauth, G W; Heubeck, B G; Mackowiak, K

2006-06-01

Observation studies of students with attention-deficit hyperactivity disorder (ADHD) problems in natural classroom situations are costly and relatively rare. The study enquired how teacher ratings are anchored in actual student classroom behaviours, and how the behaviour of children with ADHD problems differs from their classmates. The authors attempted to broaden the usual focus on disruptive and inattentive behaviours to elucidate the role of various on-task behaviours, as well as considering differences between classroom contexts. DSM-III-R criteria were used in conjunction with a teacher rating scale to select a sample of 55 students with ADHD problems, and 55 matched controls from a population of 569 primary school students. Students were observed in their natural classrooms using the Munich Observation of Attention Inventory (MAI; Helmke, 1988). Correlations between teacher reports and observation codes were computed, and systematic differences between students with ADHD problems and controls in different classroom contexts were examined using a generalized linear mixed model (GLMM). Global teacher reports showed moderate to strong correlations with observed student behaviours. Expected on-task behaviour demonstrated the strongest relationship (r>-.70) with teacher reports. As hypothesized, the children with ADHD were more disruptive and inattentive than their matched peers. They were also less often inconspicuous on-task as expected by their teachers. However, their behaviour was assigned to two other on-task categories more often than their peers, and this raised their total on-task behaviour to over 66%. Situational differences were found for all codes as well, which mostly affected all students in a similar way, not just students with ADHD. ADHD related behaviours are pervasive across the classroom situations coded. Teachers appear to distinguish between desirable and undesirable on-task behaviours. Nevertheless, assisting students with ADHD problems requires shaping both. Future studies need to include more differentiated codes for various types of on-task behaviours and also need to code the lesson context concurrently.

Is the clinical relevance of drug-food and drug-herb interactions limited to grapefruit juice and Saint-John's Wort?

PubMed

Mouly, Stéphane; Lloret-Linares, Célia; Sellier, Pierre-Olivier; Sene, Damien; Bergmann, J-F

2017-04-01

An interaction of drug with food, herbs, and dietary supplements is usually the consequence of a physical, chemical or physiologic relationship between a drug and a product consumed as food, nutritional supplement or over-the-counter medicinal plant. The current educational review aims at reminding to the prescribing physicians that the most clinically relevant drug-food interactions may not be strictly limited to those with grapefruit juice and with the Saint John's Wort herbal extract and may be responsible for changes in drug plasma concentrations, which in turn decrease efficacy or led to sometimes life-threatening toxicity. Common situations handled in clinical practice such as aging, concomitant medications, transplant recipients, patients with cancer, malnutrition, HIV infection and those receiving enteral or parenteral feeding may be at increased risk of drug-food or drug-herb interactions. Medications with narrow therapeutic index or potential life-threatening toxicity, e.g., the non-steroidal anti-inflammatory drugs, opioid analgesics, cardiovascular medications, warfarin, anticancer drugs and immunosuppressants may be at risk of significant drug-food interactions to occur. Despite the fact that considerable effort has been achieved to increase patient' and doctor's information and ability to anticipate their occurrence and consequences in clinical practice, a thorough and detailed health history and dietary recall are essential for identifying potential problems in order to optimize patient prescriptions and drug dosing on an individual basis as well as to increase the treatment risk/benefit ratio. Copyright © 2016 Elsevier Ltd. All rights reserved.

Ethiopian Youth in Israel: Gender-Related Alcohol Use and Related Problem Behaviour

ERIC Educational Resources Information Center

Isralowitz, Richard; Shpiegel, Svetlana; Reznik, Alex; Laytin, Adam

2009-01-01

Jewish people from Ethiopia have been immigrating to Israel since 1973. Difficulties with language, unemployment; low socioeconomic status and prejudice have been common place and linked to problem behaviour including school drop out, delinquency and drug abuse among Ethiopian youth. This research examines the patterns of alcohol use and related…

Swallowing Disorders in Schizophrenia.

PubMed

Kulkarni, Deepika P; Kamath, Vandan D; Stewart, Jonathan T

2017-08-01

Disorders of swallowing are poorly characterized but quite common in schizophrenia. They are a source of considerable morbidity and mortality in this population, generally as a result of either acute asphyxia from airway obstruction or more insidious aspiration and pneumonia. The death rate from acute asphyxia may be as high as one hundred times that of the general population. Most swallowing disorders in schizophrenia seem to fall into one of two categories, changes in eating and swallowing due to the illness itself and changes related to psychotropic medications. Behavioral changes related to the illness are poorly understood and often involve eating too quickly or taking inappropriately large boluses of food. Iatrogenic problems are mostly related to drug-induced extrapyramidal side effects, including drug-induced parkinsonism, dystonia, and tardive dyskinesia, but may also include xerostomia, sialorrhea, and changes related to sedation. This paper will provide an overview of common swallowing problems encountered in patients with schizophrenia, their pathophysiology, and management. While there is a scarcity of quality evidence in the literature, a thorough history and examination will generally elucidate the predominant problem or problems, often leading to effective management strategies.

[Follow-up of alcohol and/or cocaine dependents after their discharge from a therapeutic community: a pilot study].

PubMed

Lopez-Fernandez, Olatz; Ferrer-Pérez, Xavier; Lafarga-Lebey, Sandra; Honrubia-Serrano, María Luisa; Tudela-Marí, Maite

2011-01-01

In Spain, the Therapeutic Community (TC) constitutes a common model of treatment in the field of addictions, although there hardly exists any investigation about its efficiency and the persistence of its attainments. To evaluate the short, half and long term effects of treatment of addiction to alcohol or cocaine in the TC run by "Fundacion Salud y Comunidad" (Foundation Health and Community). descriptive pilot study, with a sequential design of cohort. 91 users completed a survey specifically designed to know their evolution at different follow-up periods (1, 3, 5 or 10 years after their exit from the TC): socio-demographic, psychoactive substance use, other variables related to the stay at the TC. Changes between before the TC and the present time regarding variables such as academic, labour, drug consumption, health, family and social adaptation and their criminal behaviour are described. the cohorts showed a relatively common previous socio-demographic pattern having received a similar treatment. The users reported to have diminished the frequent consumption of the main drug, having 48.9% never relapsed even through an occasional consumption of the drug/s. Also they perceived to have improved their health and family relations, as well as their aggressive behaviour and legal problems linked with their consumption of drug/s. after their rehabilitation in a TC, the users report a global decrease of the consumption of drugs and perceive an improvement of their health, family relations, violence and other problems linked to their former drug use.

Targeted drug delivery for cancer therapy: the other side of antibodies

PubMed Central

2012-01-01

Therapeutic monoclonal antibody (TMA) based therapies for cancer have advanced significantly over the past two decades both in their molecular sophistication and clinical efficacy. Initial development efforts focused mainly on humanizing the antibody protein to overcome problems of immunogenicity and on expanding of the target antigen repertoire. In parallel to naked TMAs, antibody-drug conjugates (ADCs) have been developed for targeted delivery of potent anti-cancer drugs with the aim of bypassing the morbidity common to conventional chemotherapy. This paper first presents a review of TMAs and ADCs approved for clinical use by the FDA and those in development, focusing on hematological malignancies. Despite advances in these areas, both TMAs and ADCs still carry limitations and we highlight the more important ones including cancer cell specificity, conjugation chemistry, tumor penetration, product heterogeneity and manufacturing issues. In view of the recognized importance of targeted drug delivery strategies for cancer therapy, we discuss the advantages of alternative drug carriers and where these should be applied, focusing on peptide-drug conjugates (PDCs), particularly those discovered through combinatorial peptide libraries. By defining the advantages and disadvantages of naked TMAs, ADCs and PDCs it should be possible to develop a more rational approach to the application of targeted drug delivery strategies in different situations and ultimately, to a broader basket of more effective therapies for cancer patients. PMID:23140144

Series: The research agenda for general practice/family medicine and primary health care in Europe. Part 4. Results: specific problem solving skills.

PubMed

Hummers-Pradier, Eva; Beyer, Martin; Chevallier, Patrick; Eilat-Tsanani, Sophia; Lionis, Christos; Peremans, Lieve; Petek, Davorina; Rurik, Imre; Soler, Jean Karl; Stoffers, Henri Ejh; Topsever, Pinar; Ungan, Mehmet; van Royen, Paul

2010-09-01

The 'Research Agenda for General Practice/Family Medicine and Primary Health Care in Europe' summarizes the evidence relating to the core competencies and characteristics of the Wonca Europe definition of GP/FM, and its implications for general practitioners/family doctors, researchers and policy makers. The European Journal of General Practice publishes a series of articles based on this document. The previous articles presented background, objectives, and methodology, as well results on 'primary care management' and 'community orientation' and the person-related core competencies of GP/FM. This article reflects on the general practitioner's 'specific problem solving skills'. These include decision making on diagnosis and therapy of specific diseases, accounting for the properties of primary care, but also research questions related to quality management and resource use, shared decision making, or professional education and development. Clinical research covers most specific diseases, but often lacks pragmatism and primary care relevance. Quality management is a stronghold of GP/FM research. Educational interventions can be effective when well designed for a specific setting and situation. However, their message that 'usual care' by general practitioners is insufficient may be problematic. GP and their patients need more research into diagnostic reasoning with a step-wise approach to increase predictive values in a setting characterized by uncertainty and low prevalence of specific diseases. Pragmatic comparative effectiveness studies of new and established drugs or non-pharmaceutical therapy are needed. Multi-morbidity and complexity should be addressed. Studies on therapy, communication strategies and educational interventions should consider impact on health and sustainability of effects.

`Negative of my money, positive of her money': secondary students' ways of relating equations to a debt context

NASA Astrophysics Data System (ADS)

Whitacre, Ian; Pierson Bishop, Jessica; Lamb, Lisa L.; Philipp, Randolph A.; Bagley, Spencer; Schappelle, Bonnie P.

2015-02-01

We interviewed 40 students each in grades 7 and 11 to investigate their integer-related reasoning. In one task, the students were asked to write and interpret equations related to a story problem about borrowing money from a friend. All the students solved the story problem correctly. However, they reasoned about the problem in different ways. Many students represented the situation numerically without invoking negative numbers, whereas others wrote equations involving negative numbers. When asked to interpret equations involving negative numbers in relation to the story, students did so in two ways. Their responses reflect distinct perspectives concerning the relationship between arithmetic equations and borrowing/owing. We discuss these findings and their implications regarding the role of contexts in integer instruction.

Manipulatives and problem situations as escalators for students' geometric understanding: a semiotic analysis

NASA Astrophysics Data System (ADS)

Daher, Wajeeh M.

2014-04-01

Mathematical learning and teaching are increasingly seen as a multimodal experience involved in cultural and social semiotic registers and means, and as such social-cultural semiotic analysis is expected to shed light on learning and teaching processes occurring in the mathematics classroom. In this research, three social-cultural semiotic frameworks were utilised to analyse elementary school students' learning of a geometric relation: the semiotic bundle, the space of action, production and communication and the theoretical framework of attention, awareness and objectification. Educational mathematical situations are described, in addition to semiotic sets, registers and means emerging in the different mathematical situations and that are relevant to the three social-cultural semiotic frameworks which the current research utilizes. Further, the students, as a consequence of (1) their multimodal experience, (2) their connecting between the different mathematical situations and semiotic registers, and (3) the teacher's questions and tasks, could objectify the geometric relation between the lengths of the triangle's edges.

Design of shared unit-dose drug distribution network using multi-level particle swarm optimization.

PubMed

Chen, Linjie; Monteiro, Thibaud; Wang, Tao; Marcon, Eric

2018-03-01

Unit-dose drug distribution systems provide optimal choices in terms of medication security and efficiency for organizing the drug-use process in large hospitals. As small hospitals have to share such automatic systems for economic reasons, the structure of their logistic organization becomes a very sensitive issue. In the research reported here, we develop a generalized multi-level optimization method - multi-level particle swarm optimization (MLPSO) - to design a shared unit-dose drug distribution network. Structurally, the problem studied can be considered as a type of capacitated location-routing problem (CLRP) with new constraints related to specific production planning. This kind of problem implies that a multi-level optimization should be performed in order to minimize logistic operating costs. Our results show that with the proposed algorithm, a more suitable modeling framework, as well as computational time savings and better optimization performance are obtained than that reported in the literature on this subject.

Substance abuse and developments in harm reduction.

PubMed

Cheung, Y W

2000-06-13

A drug is a substance that produces a psychoactive, chemical or medicinal effect on the user. The psychoactive effect of mood-altering drugs is modulated by the user's perception of the risks of drug use, his or her ability to control drug use and the demographic, socioeconomic and cultural context. The ability to control drug use may vary along a continuum from compulsive use at one end to controlled use at the other. The "drug problem" has been socially constructed, and the presence of a moral panic has led to public support for the prohibitionist approach. The legalization approach has severely attacked the dominant prohibitionist approach but has failed to gain much support in society because of its extreme libertarian views. The harm reduction approach, which is based on public health principles, avoids the extremes of value-loaded judgements on drug use and focuses on the reduction of drug-related harm through pragmatic and low-threshold programs. This approach is likely to be important in tackling the drug problem in the 21st century.

Substance abuse and developments in harm reduction

PubMed Central

Cheung, Y W

2000-01-01

A drug is a substance that produces a psychoactive, chemical or medicinal effect on the user. The psychoactive effect of mood-altering drugs is modulated by the user's perception of the risks of drug use, his or her ability to control drug use and the demographic, socioeconomic and cultural context. The ability to control drug use may vary along a continuum from compulsive use at one end to controlled use at the other. The "drug problem" has been socially constructed, and the presence of a moral panic has led to public support for the prohibitionist approach. The legalization approach has severely attacked the dominant prohibitionist approach but has failed to gain much support in society because of its extreme libertarian views. The harm reduction approach, which is based on public health principles, avoids the extremes of value-loaded judgements on drug use and focuses on the reduction of drug-related harm through pragmatic and low-threshold programs. This approach is likely to be important in tackling the drug problem in the 21st century. PMID:10870502

Initiation and Retention in Couples Outpatient Treatment for Parents with Drug and Alcohol Use Disorders

PubMed Central

Braitman, Abby L.; Kelley, Michelle L.

2016-01-01

The focus of the current study was to identity mental health, relationship factors, substance use related problems, and individual factors as predictors of couples-based substance abuse treatment initiation and attendance. Heterosexual couples with children that met study criteria were invited to attend 12 sessions of outpatient behavioral couples therapy (BCT). Men were more likely to initiate treatment if they had a higher income, had greater relationship satisfaction, were initiating treatment for alcohol use disorder only, if they were younger when they first suspected a problem, and had higher depression but lower hostility or phobic anxiety. Men attended more treatment sessions if they reported less intimate partner victimization, if they sought treatment for both alcohol and drug use disorder, if they were older when they first suspected a substance use problem, and if they were more obsessive-compulsive, more phobic anxious, less hostile, and experienced less somatization and less paranoid ideation. For women, treatment initiation was associated with less cohesion in their relationships, more somatization, and being older when they first suspected an alcohol or drug use problem. Trends were observed between women’s treatment retention and being older, experiencing more somatization, and suspecting drug-related problems when they were younger; however, no predictors reached statistical significance for women. Results suggest that different factors may be associated with men and women’s willingness to initiate and attend conjoint treatment for substance abuse. PMID:27064819

Antimicrobial drug resistance in Staphylococcus aureus isolated from cattle in Brazil.

PubMed

Pereira, M S; Siqueira-Júnior, J P

1995-06-01

Isolates of Staphylococcus aureus obtained from apparently healthy cattle in the State of Paraiba, Brazil were characterized in relation to resistance to 21 antimicrobial agents. Among the 46 isolates obtained, resistance to penicillin was most frequent, followed by resistance to cadmium, streptomycin, arsenate, tetracycline, mercury, erythromycin and kanamycin/neomycin. All isolates were susceptible to fusidic acid, ethidium bromide, cetrimide, chloramphenicol, benzalkonium chloride, doxycycline, gentamicin, methicillin, minocycline, novobiocin, rifamycin, tylosin and vancomycin. Only six isolates were susceptible to all the drugs tested. With respect to the antibiotics, multi-resistant isolates were uncommon. These results are probably a consequence of the peculiarities of local drug usage pressures. In relation to metal ions, resistance to mercury was rare while resistance to arsenate was relatively frequent, which contrasts with the situation for human Staph. aureus strains. After treatment with ethidium bromide, elimination of resistance to penicillin, tetracycline, streptomycin, erythromycin and cadmium was observed, which was consistent with the genetic determinants being plasmid-borne.

Challenges and prospects for malaria elimination in the Greater Mekong Subregion

PubMed Central

Cui, Liwang; Yan, Guiyun; Sattabongkot, Jetsumon; Chen, Bin; Cao, Yaming; Fan, Qi; Parker, Daniel; Sirichaisinthop, Jeeraphat; Su, Xin-zhuan; Yang, Henglin; Yang, Zhaoqing; Wang, Baomin; Zhou, Guofa

2011-01-01

Despite significant improvement in the malaria situation of the Greater Mekong Subregion (GMS), malaria control for the region continues to face a multitude of challenges. The extremely patchy malaria distribution, especially along international borders, makes disease surveillance and targeted control difficult. The vector systems are also diverse with dramatic differences in habitat ecology, biting behavior, and vectorial capacity, and there is a lack of effective transmission surveillance and control tools. Finally, in an era of heavy deployment of artemisinin-based combination therapies, the region acts as an epicenter of drug resistance, with the emergence of artemisinin resistant P. falciparum posing a threat to both regional and global malaria elimination campaigns. This problem is further exacerbated by the circulation of counterfeit and substandard artemisinin drugs. Accordingly, this Southeast Asian Malaria Research Center, consisting of a consortium of US and regional research institutions, has proposed four interlinked projects to address these most urgent problems in malaria control. The aims of these projects will help to substantially improve our understanding of malaria epidemiology, vector systems and their roles in malaria transmission, as well as the mechanisms of drug resistance in parasites. Through the training of next-generation scientists in malaria research, this program will help build up and strengthen regional research infrastructure and capacities, which are essential for sustained malaria control in this region. PMID:21515238

Romania's drug policy from 2005 to 2012: experiences with implementation.

PubMed

Dégi, Csaba László

2014-05-01

Even with the relatively high rate of illicit drug use in Romania, drug prevention remains a relatively low political and professional priority. Policies focus primarily on the criminalization of drug use rather than on prevention and treatment. By studying official Romanian drug policies and legislative documents, as well as national and European reports on the state of the ''drug problem,'' this article focuses on the impact of policy on drug use, treatment, and prevention, with an emphasis on the criminalization of drug use and the resultant trends and practical impacts. The reported lifetime use of illicit drugs has been rising slowly but steadily over the last few years. Contraction of communicable diseases among intravenous drug users is also trending upwards. And with the emphasis on criminalization of drug use and the accompanying marginalization of users, drug-law-related offences are also likely to increase. Unmet needs in drug prevention, a declining tendency to seek drug treatment, and an increase in drug-related deaths are also indicators of the negative effects of the current policy on drug use, criminalization, infections, and the lack of effective prevention. As Romania continues to face serious financial limitations, evidence-based research on drug use is needed; best practice guidelines have to be followed in order to improve access to drug prevention, treatment, and harm-reduction services.

Parenting and Children's Externalizing Problems in Substance-Abusing Families

ERIC Educational Resources Information Center

Stanger, Catherine; Dumenci, Levent; Kamon, Jody; Burstein, Marcy

2004-01-01

This study tested associations in path models among positive and negative parenting and children's rule-breaking behavior, aggressive and oppositional behavior, and attention problems for families with a drug-dependent parent. A structural model tested relations between parenting and children's externalizing problems for 251 families with 399…

"Now drugs in Libya are much cheaper than food": A qualitative study on substance use among young Libyans in post-revolution Tripoli, Libya.

PubMed

Elamouri, Fauzi Muftah; Musumari, Patou Masika; Techasrivichien, Teeranee; Farjallah, Anwer; Elfandi, Sufian; Alsharif, Osama Fathi; Benothman, Hussein; Suguimoto, S Pilar; Ono-Kihara, Masako; Kihara, Masahiro

2018-03-01

Libya is facing a rapidly growing epidemic of illicit drug use and HIV. This situation is fueled by a complex array of factors, mainly the consequences of the political and military turmoil of the Arab Spring. Although it is extensively documented in other settings that young people are one of the most vulnerable groups to both HIV and illicit drug use, no study has explored this issue among young people in Libya. The current study addresses this research gap. This study is a qualitative study using in-depth interviews guided by a semi-structured questionnaire. We used a maximum variation, purposive sampling strategy to recruit male and female participants, aged 14-18 years, from schools, prisons, and community-based informal re-education and rehabilitation centers in Tripoli, Libya. In total, 31 participants were recruited: 6 females and 25 males. Sixteen participants were prisoners and residents of community-based informal re-education and rehabilitation centers, and 15 were recruited in schools. Risk factors for drug use included peer influence, the increased availability and affordability of drugs, disruption of social life and healthy recreational activities, and the distress and casualties of the war. Protective factors were religious beliefs and practices, good parent-child connectedness, and high self-esteem and future aspiration. Risk factors for HIV were insufficient knowledge related to HIV transmission and unsafe injection practices, such as sharing needles and syringes. We found individual, interpersonal, family, and structural-level factors that interplayed to shape the vulnerability of young people to drug use and HIV infection in Tripoli, Libya. Structural factors, including the increased availability and affordability of drugs, provided the frame within which other factors, such as peer influence, insufficient knowledge of substance use, and HIV, operated to increase the vulnerability of young people to drugs and HIV, while religious beliefs and parent-child connectedness acted as protective factors. Multisectoral efforts and studies to quantitatively evaluate the magnitude and distribution of these problems are urgently needed. Copyright © 2017 Elsevier B.V. All rights reserved.

Drug Use with Parents as a Relational Strategy for Incarcerated Female Adolescents

ERIC Educational Resources Information Center

Lopez, Vera; Katsulis, Yasmina; Robillard, Alyssa

2009-01-01

Problems associated with poor quality parent-child relationships are compounded for incarcerated girls. Using attachment theory as a framework, the present qualitative study examined how 18 incarcerated adolescent girls made meaning with regard to their parents' drug use. We found that 8 of the 18 girls used drugs with their parents as a…

Slammin' and Snortin': A Community Based Model of Intervention in Drug Cases.

ERIC Educational Resources Information Center

Boggess, Patricia A.; Reiman, Dean

This report describes a service model developed for the Division of Children and Family Services in Wenatchee, Washington that attempts to address the needs of families impacted by substance abuse. The service area is rural and has an overwhelming drug problem. Caseload trends provide evidence for a large number of drug-related referrals and an…

A randomized controlled trial of a pharmacist consultation program for family physicians and their elderly patients

PubMed Central

Sellors, John; Kaczorowski, Janusz; Sellors, Connie; Dolovich, Lisa; Woodward, Christel; Willan, Andrew; Goeree, Ron; Cosby, Roxanne; Trim, Kristina; Sebaldt, Rolf; Howard, Michelle; Hardcastle, Linda; Poston, Jeff

2003-01-01

Background Pharmacists can improve patient outcomes in institutional and pharmacy settings, but little is known about their effectiveness as consultants to primary care physicians. We examined whether an intervention by a specially trained pharmacist could reduce the number of daily medication units taken by elderly patients, as well as costs and health care use. Methods We conducted a randomized controlled trial in family practices in 24 sites in Ontario. We randomly allocated 48 randomly selected family physicians (69.6% participation rate) to the intervention or the control arm, along with 889 (69.5% participation rate) of their randomly selected community-dwelling, elderly patients who were taking 5 or more medications daily. In the intervention group, pharmacists conducted face-to-face medication reviews with the patients and then gave written recommendations to the physicians to resolve any drug-related problems. Process outcomes included the number of drug-related problems identified among the senior citizens in the intervention arm and the proportion of recommendations implemented by the physicians. Results After 5 months, seniors in the intervention and control groups were taking a mean of 12.4 and 12.2 medication units per day respectively (p = 0.50). There were no statistically significant differences in health care use or costs between groups. A mean of 2.5 drug-related problems per senior was identified in the intervention arm. Physicians implemented or attempted to implement 72.3% (790/1093) of the recommendations. Interpretation The intervention did not have a significant effect on patient outcomes. However, physicians were receptive to the recommendations to resolve drug-related problems, suggesting that collaboration between physicians and pharmacists is feasible. PMID:12847034

Lay beliefs about the efficacy of self-reliance, seeking help and external control as strategies for overcoming obesity, drug addiction, marital problems, stuttering and insomnia.

PubMed

Furnham, Adrian; McDermott, Mark R

1994-07-01

This study was concerned with peoples' beliefs about the importance of twenty-four different contributors towards overcoming five relatively common personal health problems, namely: obesity, drug addiction, marital difficulties, stuttering and insomnia. One hundred and twenty-two subjects completed a five-page questionnaire indicating how effective each of these contributors were to overcoming the problems as specified. Factor analysis revealed an interpretable structure similar to previous studies (Luk and Bond, 1992): the emerging three factors were labelled ' self-reliance", "seeking help" and "external control". Multiple regression showed that few individual difference variables as measured were related to perceived relevance of the different contributors. The results were discussed in terms of subjects' beliefs concerning the value of self-reliance as opposed to seeking help, and in relation to the importance of understanding lay beliefs about the efficacy of different forms of intervention.

HUMAN RELATIONS IN THE CLASSROOM--A CHALLENGE TO TEACHER EDUCATION.

ERIC Educational Resources Information Center

North Central Association of Colleges and Schools, Chicago, IL.

A SURVEY OF A REPRESENTATIVE SAMPLE OF 1,075 SECONDARY SCHOOL TEACHERS HAS SHOWN THAT TEACHERS ARE CONFRONTED DAILY IN THEIR CLASSROOMS WITH A WIDE RANGE OF HUMAN RELATIONS PROBLEMS AND SITUATIONS. DECIDING HOW TO DISCUSS SUCH A CONTROVERSIAL SUBJECT AS DISCRIMINATION WITH MINORITY GROUPS OR DECIDING WHETHER OR NOT TO SING SONGS SUCH AS "OLD…

Concept Map Engineering: Methods and Tools Based on the Semantic Relation Approach

ERIC Educational Resources Information Center

Kim, Minkyu

2013-01-01

The purpose of this study is to develop a better understanding of technologies that use natural language as the basis for concept map construction. In particular, this study focuses on the semantic relation (SR) approach to drawing rich and authentic concept maps that reflect students' internal representations of a problem situation. The…

Simulator: A Pilot Interactive Simulation Program for Use in Teaching Public Relations.

ERIC Educational Resources Information Center

Pavlik, John V.

An interactive simulation program was developed for use in teaching students how to handle public relations problems. The program user is placed in the role of assistant newsletter editor, facing a series of decision-making situations. Each choice the user makes affects the subsequent reality created by the program, which is designed to provide…

Education and Religion in Times of Secularization: Problems and Possibilities within the German Situation

ERIC Educational Resources Information Center

Schluss, Henning

2009-01-01

In the current climate of increasing alienation from religion, traditional concepts no longer suffice to explain the relation between education and religion. Thus, Religious Education needs to take on the task of reconceiving of this relation. This article looks specifically at Religious Education in Germany. The term religious literacy, which is…

The study of direct-to-consumer advertising for prescription drugs.

PubMed

Schommer, Jon C; Hansen, Richard A

2005-06-01

The objectives of this article are to (1) identify key methodological issues related to investigating the effects of direct-to-consumer advertising (DTCA) for prescription drugs, (2) highlight opportunities and challenges that these issues pose, and (3) provide suggestions to address these challenges and opportunities from a social and administrative pharmacy perspective. Through a review of existing literature and consultation with research colleagues, we identified 3 broad issues regarding the study of DTCA for prescription drugs: (1) the importance of problem formulation, (2) the role of health behavior and decision-making perspectives, and (3) data collection and data analysis challenges and opportunities. Based upon our findings, we developed recommendations for future research in this area. Clear problem formulation will be instructive for prioritizing research needs and for determining the role that health behavior and decision-making perspectives can serve in DTCA research. In addition, it appears that cluster bias, nonlinear relationships, mediating/moderating effects, time effects, acquiescent response, and case mix are particularly salient challenges for the DTCA research domain. We suggest that problem formulation, selection of sound theories upon which to base research, and data collection and data analysis challenges are key methodological issues related to investigating the effects of DTCA for prescription drugs.

Predictors of non-drug psychiatric/psychotherapeutic treatment in children and adolescents with mental or behavioural disorders.

PubMed

Abbas, Sascha; Ihle, Peter; Adler, Jürgen-Bernhard; Engel, Susanne; Günster, Christian; Holtmann, Martin; Kortevoss, Axel; Linder, Roland; Maier, Werner; Lehmkuhl, Gerd; Schubert, Ingrid

2017-04-01

Children and adolescents with mental health problems need effective and safe therapies to support their emotional and social development and to avoid functional impairment and progress of social deficits. Though psychotropic drugs seem to be the preferential treatment, psychotherapy and psychosocial interventions are essential in mental health care. For Germany, current data on the utilization of psychotherapy and psychosocial interventions in children with mental health problems is lacking. To analyse why certain children and adolescents with mental or behavioural disorders do and others do not receive non-drug treatment, we assessed predictors associated with specific non-drug psychiatric/psychotherapeutic treatment including psychosocial interventions, psychotherapy and other non-drug treatments. The study is based on data of two large German health insurance funds, AOK and TK, comprising 30 % of the German child and adolescent population. Predictors of non-drug psychiatric/psychotherapeutic treatment were analysed for 23,795 cases and two controls for every case of the same age and sex in children aged 0-17 years following a new diagnosis of mental or behavioural disorder in 2010. Predictors were divided according to Andersen's behavioural model into predisposing, need and enabling factors. The most prominent and significant predictors positively associated with non-drug psychiatric/psychotherapeutic treatment were the residential region as predisposing factor; specific, both ex- and internalizing, mental and behavioural disorders, psychiatric co-morbidity and psychotropic drug use as need factors; and low area deprivation and high accessibility to outpatient physicians and inpatient institutions with non-drug psychiatric/psychotherapeutic department as enabling factors. In conclusion, the present study suggests that the residential region as proxy for supply of therapist and socioeconomic situation is an influencing factor for the use of psychotherapy. The analysis sheds further light on predisposing, need and enabling factors as predictors of non-drug psychotherapeutic/psychiatric treatment in children and adolescents with mental or behavioural health disorders in Germany. More research is needed to further understand the factors promoting the gap between the need and utilization of mental health care.

Framing effects in medical situations: distinctions of attribute, goal and risky choice frames.

PubMed

Peng, Jiaxi; Jiang, Yuan; Miao, Danmin; Li, Rui; Xiao, Wei

2013-06-01

To verify whether three different framing effects (risky choice, attribute and goal) exist in simulated medical situations and to analyse any differences. Medical decision-making problems were established, relating to medical skill evaluation, patient compliance and a selection of treatment options. All problems were described in positive and negative frame conditions. Significantly more positive evaluations were made if the doctor's medical records were described as 'of 100 patients, 70 patients became better' compared with those described as 'of 100 patients, 30 patients didn't become better'. Doctor's advice described in a negative frame resulted in significantly more decisions to comply, compared with advice described in a positive frame. Treatment options described in terms of survival rates resulted in significantly more adventurous choices compared with options described in terms of mortality rates. Decision-making reversal appeared in the risky choice and attribute frames, but not the goal frame. Framing effects were shown to exist in simulated medical situations, but there were significant differences among the three kinds of such effects.

Drug use in a rural secondary school in Kenya.

PubMed

Ndetei, David M; Khasakhala, Lincoln I; Mutiso, Victoria; Ongecha-Owuor, Francisca A; Kokonya, Donald A

2010-07-01

Alcohol abuse and alcohol-related use problems among adolescents are highly prevalent and are a major concern worldwide. This study estimated the prevalence of drug abuse, knowledge about drug abuse and its effect on psychosocial well-being and induced behavioral problems among students of a public rural secondary school that admitted both girls and boys which offered both boarding and day school facilities. The students filled out a self-reporting substance use tool which measures the prevalence, frequency, and general patterns of substance use. Alcohol, tobacco, khat (catha edulis) and bhang (cannabis) were the most commonly reported substance of use, with user prevalence rates of 5.2%, 3.8%, 3.2%, and 1.7%, respectively. Tobacco use was initiated at 10 years, while cannabis, hard drugs, khat, and alcohol were initiated at 11, 12, 13, and 15 years of age, respectively. Among the students 71% were aware that their schoolmates were on drugs and it was known by 49.8%, 41.7%, 37.6%, 44.3%, and 32.4% of these students that using alcohol, tobacco, khat, cannabis, and hard drugs, respectively was a behavioral problem in the school. Three quarters of the students were aware that use of drugs was harmful to their health, with majority (78.6%) indicating that drug users need help to stop the drug use behavior. However most (73.6%) of the students suggested drug users in school should be punished. The drug use behavioral problems included school dropout, poor scholastic attainment, drunken driving, delinquency, and adolescence pregnancy which threaten the stability of the education system, family as an institution (family difficulties) and society at large. Therefore, teachers have an added burden of playing an active role in guidance and counselling the survivors of drug abuse, a pandemic facing teaching institutions apart from instilling knowledge.

Alcohol and Drug Use among Gang Members: Experiences of Adolescents Who Attend School

ERIC Educational Resources Information Center

Swahn, Monica H.; Bossarte, Robert M.; West, Bethany; Topalli, Volkan

2010-01-01

Background: Problems related to gangs have been noted in large cities and in many schools across the United States. This study examined the patterns of alcohol, drug use, and related exposures among male and female high school students who were gang members. Methods: Analyses were based on the Youth Violence Survey, conducted in 2004, and…

Drug Addiction

MedlinePlus

... harm it causes. Drug addiction can start with experimental use of a recreational drug in social situations, ... and interests K2, Spice and bath salts Two groups of synthetic drugs ... is no quality control and some ingredients may not be known. Synthetic ...

Prevalence and Psychosocial Correlates of Party-Drug Use and Associated Problems among University Students in the Netherlands.

PubMed

Kunst, Laura E; Gebhardt, Winifred A

2018-04-18

Recent developments in drug use patterns call for an investigation of current party-drug use and associated problems among college students, who appear to be an important target population for harm reduction interventions. In addition to reporting on party-drug use prevalence, we investigated whether initial use and continuation of party-drug use among students was associated with demographic, personality and psychosocial factors. An online questionnaire was administered to 446 students from a Dutch university, inquiring about party-drug use, demographic characteristics, social norms and personality (big five, impulsiveness, aggression). Univariate and multivariate bootstrapped linear regression analyses were used. Of all students, 22.9% indicated having used party-drugs at least once, with a notable sex difference (39.2% of men vs. 16.2% of women). In contrast to the reported trends in Dutch nightlife, GHB was used rarely (lifetime 1.6%) and new psychoactive substances (NPS; 6.7%) appeared almost equally popular as amphetamines (7.6%) and cocaine (7%). Mild health/psychosocial problems (e.g., doing embarrassing things, feeling unwell) were common (65%), whereas serious problems (e.g., being hospitalized) were rare. Neuroticism, extraversion, conscientiousness and impulsiveness were associated with lifetime but not regular party-drug use. Of all predictors, lifetime and regular party-drug use were most strongly related to lenient injunctive and descriptive norms in friends, and a low motivation to comply with parents. Our findings indicate that harm reduction/preventive interventions might profit from focusing on social norms, and targeting students who are highly involved in a pro-party-drug environment while experiencing less parental influence.

Drug procurement, the Global Fund and misguided competition policies

PubMed Central

2009-01-01

In an effort to increase competition and decrease price, the Global Fund to Fight AIDS, Tuberculosis and Malaria recently began asking some grant recipients to use international competitive bidding processes for certain drug purchases. Unfortunately, for countries like Kenya, this request has caused more harm than good. After awarding the tender for its annual supply of the anti-malarial artemether-lumefantrine to the lowest bidder, Ajanta Pharma, Kenya experienced wide stock-outs in part due to the company's inability to supply the order in full and on time. Similar problems could arise in Uganda. Despite Kenya's experience, Uganda has awarded its next tender for artemether-lumefantrine to Ajanta Pharma. Uganda is already facing wide stock-outs and risks exacerbating an already dire situation the longer it takes to fulfil the procurement contract. A tender process based primarily on price cannot account for a company's ability to consistently supply sufficient product in time. PMID:20028536

Human Factors in Financial Trading

PubMed Central

Leaver, Meghan; Reader, Tom W.

2016-01-01

Objective This study tests the reliability of a system (FINANS) to collect and analyze incident reports in the financial trading domain and is guided by a human factors taxonomy used to describe error in the trading domain. Background Research indicates the utility of applying human factors theory to understand error in finance, yet empirical research is lacking. We report on the development of the first system for capturing and analyzing human factors–related issues in operational trading incidents. Method In the first study, 20 incidents are analyzed by an expert user group against a referent standard to establish the reliability of FINANS. In the second study, 750 incidents are analyzed using distribution, mean, pathway, and associative analysis to describe the data. Results Kappa scores indicate that categories within FINANS can be reliably used to identify and extract data on human factors–related problems underlying trading incidents. Approximately 1% of trades (n = 750) lead to an incident. Slip/lapse (61%), situation awareness (51%), and teamwork (40%) were found to be the most common problems underlying incidents. For the most serious incidents, problems in situation awareness and teamwork were most common. Conclusion We show that (a) experts in the trading domain can reliably and accurately code human factors in incidents, (b) 1% of trades incur error, and (c) poor teamwork skills and situation awareness underpin the most critical incidents. Application This research provides data crucial for ameliorating risk within financial trading organizations, with implications for regulation and policy. PMID:27142394

Human Factors in Financial Trading: An Analysis of Trading Incidents.

PubMed

Leaver, Meghan; Reader, Tom W

2016-09-01

This study tests the reliability of a system (FINANS) to collect and analyze incident reports in the financial trading domain and is guided by a human factors taxonomy used to describe error in the trading domain. Research indicates the utility of applying human factors theory to understand error in finance, yet empirical research is lacking. We report on the development of the first system for capturing and analyzing human factors-related issues in operational trading incidents. In the first study, 20 incidents are analyzed by an expert user group against a referent standard to establish the reliability of FINANS. In the second study, 750 incidents are analyzed using distribution, mean, pathway, and associative analysis to describe the data. Kappa scores indicate that categories within FINANS can be reliably used to identify and extract data on human factors-related problems underlying trading incidents. Approximately 1% of trades (n = 750) lead to an incident. Slip/lapse (61%), situation awareness (51%), and teamwork (40%) were found to be the most common problems underlying incidents. For the most serious incidents, problems in situation awareness and teamwork were most common. We show that (a) experts in the trading domain can reliably and accurately code human factors in incidents, (b) 1% of trades incur error, and (c) poor teamwork skills and situation awareness underpin the most critical incidents. This research provides data crucial for ameliorating risk within financial trading organizations, with implications for regulation and policy. © 2016, Human Factors and Ergonomics Society.

Young children's imagination in science education and education for sustainability

NASA Astrophysics Data System (ADS)

Caiman, Cecilia; Lundegård, Iann

2017-09-01

This research is concerned with how children's processes of imagination, situated in cultural and social practices, come into play when they invent, anticipate, and explore a problem that is important to them. To enhance our understanding of young children's learning and meaning-making related to science and sustainability, research that investigates children's use of imagination is valuable. The specific aim of this paper is to empirically scrutinize how children's imaginations emerge, develop, and impact their experiences in science. We approach imagination as a situated, open, and unscripted act that emerges within transactions. This empirical study was conducted in a Swedish pre-school, and the data was collected `in between' a science inquiry activity and lunchtime. We gathered specific video-sequences wherein the children, lived through the process of imagination, invented a problem together and produced something new. Our analysis showed that imagination has a great significance when children provide different solutions which may be useful in the future to sustainability-related problems. If the purpose of an educational experience in some way supports children's imaginative flow, then practicing an open, listening approach becomes vital. Thus, by encouraging children to explore their concerns and questions related to sustainability issues more thoroughly without incautious recommendations or suggestions from adults, the process of imagination might flourish.

Decision making in Germany: is health economic evaluation as a supporting tool a sleeping beauty?

PubMed

Gerber-Grote, Andreas; Sandmann, Frank Gerd; Zhou, Min; Ten Thoren, Corinna; Schwalm, Anja; Weigel, Carolin; Balg, Christiane; Mensch, Alexander; Mostardt, Sarah; Seidl, Astrid; Lhachimi, Stefan K

2014-01-01

For many years, the legal situation within the statutory health insurance (SHI) system in Germany has allowed for health economic evaluations. There are various reasons why health economic evaluations have played virtually no role in decision making until now: to begin with, a method for the evaluation of the relation between benefits and costs which needed to be in accordance with the legal requirements had to be developed, the outcome of which was the efficiency frontier approach. Subsequent health care reforms have led to changing objectives and strategies. Currently, price negotiations of newly launched drugs are based on an early benefit assessment of dossiers submitted by pharmaceutical manufacturers. Other reasons might be the presently very comfortable financial situation of the statutory health insurance system as well as a historically grown societal fear and discomfort towards what is perceived to be a rationing of medicinal products. For the time being, it remains open how long the German health care system can afford to continue neglecting the benefits of health economic evaluations for drug and non-drug interventions, and when it will be time to wake this sleeping beauty. Copyright © 2014. Published by Elsevier GmbH.

Towards better process understanding: chemometrics and multivariate measurements in manufacturing of solid dosage forms.

PubMed

Matero, Sanni; van Den Berg, Frans; Poutiainen, Sami; Rantanen, Jukka; Pajander, Jari

2013-05-01

The manufacturing of tablets involves many unit operations that possess multivariate and complex characteristics. The interactions between the material characteristics and process related variation are presently not comprehensively analyzed due to univariate detection methods. As a consequence, current best practice to control a typical process is to not allow process-related factors to vary i.e. lock the production parameters. The problem related to the lack of sufficient process understanding is still there: the variation within process and material properties is an intrinsic feature and cannot be compensated for with constant process parameters. Instead, a more comprehensive approach based on the use of multivariate tools for investigating processes should be applied. In the pharmaceutical field these methods are referred to as Process Analytical Technology (PAT) tools that aim to achieve a thorough understanding and control over the production process. PAT includes the frames for measurement as well as data analyzes and controlling for in-depth understanding, leading to more consistent and safer drug products with less batch rejections. In the optimal situation, by applying these techniques, destructive end-product testing could be avoided. In this paper the most prominent multivariate data analysis measuring tools within tablet manufacturing and basic research on operations are reviewed. Copyright © 2013 Wiley Periodicals, Inc.

Structured Medication Review to Improve Pharmacotherapy in People with Intellectual Disability and Behavioural Problems.

PubMed

Scheifes, Arlette; Egberts, Toine C G; Stolker, Joost Jan; Nijman, Henk L I; Heerdink, Eibert R

2016-07-01

Polypharmacy and chronic drug use are common in people with intellectual disability and behavioural problems, although evidence of effectiveness and safety in this population is lacking. This study examined the effects of a structured medication review and aimed to improve pharmacotherapy in inpatients with intellectual disability. In a treatment facility for people with mild to borderline intellectual disability and severe behavioural problems, a structured medication review was performed. Prevalence and type of drug-related problems (DRPs) and of the recommended and executed actions were calculated. In a total of 55 patients with intellectual disability and behavioural problems, 284 medications were prescribed, in which a DRP was seen in 106 (34%). No indication/unclear indication was the most prevalent DRP (70). Almost 60% of the recommended actions were also executed. This high prevalence of DRPs is worrying. The structured medication review is a valuable instrument to optimize pharmacotherapy and to support psychiatrists in adequate prescribing of both psychotropic and somatic drugs. © 2015 John Wiley & Sons Ltd.

Decision-Making Styles and Problem-Solving Appraisal.

ERIC Educational Resources Information Center

Phillips, Susan D.; And Others

1984-01-01

Compared decision-making style and problem-solving appraisal in 243 undergraduates. Results suggested that individuals who employ rational decision-making strategies approach problematic situations, while individuals who endorse dependent decisional strategies approach problematic situations without confidence in their problem-solving abilities.…