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At least 271 records · Page 15Linked to original sources
PubMed2005

Expected impacts of the Cannabis Infringement Notice scheme in Western Australia on regular users and their involvement in the cannabis market.

The effect on the cannabis market is one area of interest in the evaluation of the new 'prohibition with civil penalties' scheme for minor cannabis offences in WA. One goal of the scheme is to reduce the proportion of cannabis consumed that is supplied by large-scale suppliers that may also supply other drugs. As part of the pre-change phase of the evaluation, 100 regular (at least weekly) cannabis users were given a qualitative and quantitative interview covering knowledge and attitudes towards cannabis law, personal cannabis use, market factors, experience with the justice system and impact of legislative change. Some 85% of those who commented identified the changes as having little impact on their cannabis use. Some 89% of the 70 who intended to cultivate cannabis once the CIN scheme was introduced suggested they would grow cannabis within the two non-hydroponic plant-limit eligible for an infringement notice under the new law. Only 15% believed an increase in self-supply would undermine the large scale suppliers of cannabis in the market and allow some cannabis users to distance themselves from its unsavoury aspects. Only 11% said they would enter, or re-enter, the cannabis market as sellers as a result of the scheme introduction. Most respondents who commented believed that the impact of the legislative changes on the cannabis market would be negligible. The extent to which this happens will be addressed in the post-change phase of this research. Part of the challenge in assessing the impact of the CIN scheme on the cannabis market is that it is distinctly heterogeneous.

Adolescent↗
PubMedDate not supplied

Involving NHS service users in teaching advanced clinical skills.

With the development of advanced practice roles in nursing, innovative ways of delivering programmes are continually sought by academic staff working within higher education. This study explores the ways in which NHS service users can be included in education programmes to develop clinical examination skills for nurses. Although small scale and exploratory, this study concluded that NHS service users benefit from making a contribution towards the education of healthcare staff and feel empowered in the process.

Adult↗
PubMed1979

Changing orientations among cocaine users: consequences of involvement in community distribution networks.

A study of 44 participants in a rural community cocaine network was conducted to determine the factors associated with increased expenditures for cocaine and the consequences of such involvement. Through correlational analysis techniques, four major categories of variables were shown to be strongly related to extent of involvement: demographic, purchasing ability, supply opportunities, and cost-reduction efforts. The major effects of increased involvement were an increase in egocentrism in relations with drug-using friends, a decline in self-control over administration, heightened concerns about possession, and strengthened justifications regarding drug use.

Adult↗
PubMed2003

Personal, temporal and spatial characteristics of seriously injured crash-involved seat belt non-users in Hawaii.

The characteristics of crash-involved seat belt non-users in a high use state (Hawaii) are examined in order to better design enforcement and education programs. Using police crash report data over a 10-year period (1986-1995), we compare belted and unbelted drivers and front seat occupants, who were seriously injured in crashes, in terms of personal (age, gender, alcohol involvement, etc.) and crash characteristics (time, location, roadway factors, etc.). A logistic regression model combined with the spline method is used to analyze and categorize the salient differences between users and non-users. We find that unbelted occupants are more likely to be male, younger, unlicensed, intoxicated and driving pickup trucks versus other vehicles. Moreover, non-users are more likely than users to be involved in speed-related crashes in rural areas during the nighttime. Passengers are 70 times more likely to be unbelted if the driver is also unbelted than passengers of vehicles with belted drivers. While our general findings are similar to other seat belt studies, the contribution of this paper is in terms of a deeper understanding of the relative importance of various factors associated with non-use among seriously injured occupants as well as demonstrating a powerful methodology for analyzing safety problems entailing the categorization of various groups. While the former has implication for seat belt enforcement and education programs, the latter is relevant to a host of other research questions.

Accidents, Traffic↗
PubMed1988

Return to fertility after discontinuation of copper IUD use: a study of 55 pregnancies involving Multiload Cu-250 users among private patients in Indonesia.

Return to fertility after discontinuation of use of the Multiload Cu-250 intrauterine device was found to be excellent. This was the conclusion of a seven-year study of 55 pregnancies involving 53 MLCu250 users who had their devices removed because they wanted another child. Average age was 25.02 years and average parity 1.25. Length of IUD use ranged between 1.00 and 66.42 months, averaging 27.28 months. Interval between time of removal and first day of the last menstrual period (REM-LMP) prior to conception ranged from -0.51 to 49.03 months, with an average of 5.90 months. In four cases removal was not followed by any further periods. Thirty-five (63.64%) pregnancies occurred within six months and seven (12.72%) between six and twelve months after removal. Of the 55 conceptions, 46 (83.63%) took place within one year and a total of 52 (94.54%) within two years after IUD discontinuation. The length of IUD use appeared not to affect negatively either the return to fertility or the outcome of pregnancy and offspring. In the 14 cases involving extended use of the MLCu250 beyond three years, the average REM-LMP interval was 4.15 months. Outcome of pregnancy and offspring was generally good. Except for two spontaneous abortions, one premature and two post-mature births, one case of atonic postpartum hemorrhage and one neonatal death due to respiratory distress involving a child with Down's syndrome, all other pregnancies progressed to term, with the birth weights of the newborns in 43 cases averaging 3387 grams. Of the 42 newborns with known gender, 26 (61.90%) were male and 16 (38.10%) were female. Whether this decidedly above-normal male to female ratio at birth of 162.50 (against a norm of 105-106) was a consequence of previous copper IUD use merits further study.

Adult↗
PubMed2000

Drug-involved women as potential users of vaginal microbicides for HIV and STD prevention: a three-city survey.

We wished to obtain potential users' perspectives on vaginal microbicides from a population of women at high risk for HIV. We conducted a face-to-face survey of convenience samples (total n = 743) of drug-using women and female sexual partners of male injection drug users in Bridgeport, Connecticut, Providence, Rhode Island, and San Juan, Puerto Rico. Ninety percent of respondents said that they would be very likely to use microbicides with paying partners and 78% with primary partners (p = 0.001). High hypothetical likelihood of use was expressed even after several potential product characteristics (e.g., causes minor vaginal irritation or burning) were rated as unacceptable. Latinas had significantly higher predicted likelihood of use with primary (p = 0. 001) and paying partners (p = 0.018) than blacks and whites. Eighty percent of respondents preferred products that enhance sexual pleasure by providing additional lubrication or "wetness." More than 80% of respondents said that they would want their primary partners to know of their microbicide use, and 42% (p = 0.001) said that they would want their paying partners to know. Women's concern about a paying partner's violent response to suggested use of risk reduction measures was inversely related to predicted likelihood of microbicide use (p = 0.045). Microbicides should be assessed in the context of the potential users' actual relationships and cultures. Achieving broad acceptability among drug-involved women will require a range of products.

Administration, Intravaginal↗
PubMed2001

Involving patients in research: setting up a service users' advisory group.

Looks at some of the issues raised by patients' involvment in the research process. Uses the example of a service users' advisory group established as part of a diabetes service evaluation in the north of England. Key conclusions were: a precise role for the group should be specified at the outset; genuine user involvement is needed; wide and accurate representation of all relevant groups in society is essential; and, researchers must approach users with open minds with a view to shared decision making rather than control.

Asia, Southeastern↗
PubMed2002

A service users' research advisory group from the perspectives of both service users and researchers.

Much has been written about the importance of involving service users in the research process. Far less is available about the experience of involvement from the perspective of service users themselves. The present paper is a joint account by service users and researchers of a service users' advisory group set up to support and advise a project to evaluate diabetes services in Bradford, UK. The establishment of a separate advisory group for service users is, to our knowledge, an innovative approach to lay involvement within mainstream National Health Service (NHS)-based research. Factors that contributed to the group's success included personal contact, continuity of membership and integration into the management structure of the project. Also valued were the confidence in numbers which membership of the group gave, and the opportunity to meet and discuss issues away from the formal and somewhat intimidating atmosphere of the project's steering group. Aside from the personal value to participants and any impact on the quality of research outcomes, wider benefits included the ability to share knowledge with others and gain greater intercultural understanding.

Advisory Committees↗
PubMed1994

The effect of hormone replacement therapy on prognostic indices in women with breast cancer.

OBJECTIVE: To examine the effect of hormone replacement therapy (HRT) on breast cancer biology. PATIENTS: Four hundred and sixty Western Australian women with breast cancer who were 40 years or over at the time of their breast cancer surgery. DESIGN AND SETTING: A questionnaire was sent to women seeking information on the use of HRT before breast cancer surgery. To qualify as HRT users, HRT had to have been used continuously for six months or more up to within two weeks of surgery. MAIN OUTCOME MEASURES: Biochemical indices of oestrogen receptor, progesterone receptor, cathepsin D and protein levels, and pathological indices of tumour size, tumour differentiation and lymph node involvement for users and nonusers of HRT. RESULTS: Eighty-seven per cent of questionnaires were recovered and 39 HRT users and 258 non-users were analysed. Twenty-five HRT users used a combination of oestrogen and progestogen and 14 used oestrogen only. Twenty-six had used HRT for more than two years and 13 for two years or less at the time of breast cancer diagnosis. There were no significant differences in the tumour indices between these two groups. The mean level of oestrogen receptors appeared to be lower in oestrogen-only users than in combination HRT users and non-users. The mean cathepsin D level was significantly higher in oestrogen-only users than in non-users. The percentage of all HRT users with involved lymph nodes (23%) was significantly lower than the percentage of non-users (44%). CONCLUSION: Oestrogen-only HRT may have a detrimental effect on tumour biology. The use of a progestogen in combination with oestrogen may offer some protection. On the other hand, HRT users had less lymph node involvement with tumour. This may reflect early detection with increased surveillance in women using HRT.

Adult↗
PubMed2006

Mothers in substance abuse treatment: differences in characteristics based on involvement with child welfare services.

PROBLEM: Greater awareness of the role of parental substance abuse in child maltreatment makes it imperative that the substance abuse treatment and child welfare systems coordinate services for these parents. Yet little is known about the characteristics of child-welfare involved parents (primarily mothers) who enter into substance abuse treatment. This paper compares the characteristics of mothers in substance abuse treatment who were and were not involved with child welfare services, and discusses the treatment implications of these differences. METHOD: Data were obtained from a statewide treatment outcome monitoring project in California. Clients were assessed at treatment admission using the Addiction Severity Index. Bivariate analyses and multivariate logistic regression were conducted comparing mothers who were (N=1,939) and were not (N=2,217) involved with child welfare. RESULTS: Mothers who were involved with child welfare were younger, had more children, and had more economic problems. They were more likely to be referred by the criminal justice system or other service providers, to have a history of physical abuse, and to be treated in outpatient programs. They had lower levels of alcohol severity, but did not differ with regard to psychiatric severity or criminal involvement. Primary users of methamphetamine were disproportionately represented among this group and had a distinct profile from primary alcohol- and opiate-users. CONCLUSION: Study findings suggest that mothers involved with child welfare enter substance abuse treatment through different avenues and present a clinical profile of treatment needs related to exposure to physical abuse, economic instability, and criminal justice involvement.

Adolescent↗
PubMed2005

BioSense: implementation of a National Early Event Detection and Situational Awareness System.

BioSense is a CDC initiative to support enhanced early detection, quantification, and localization of possible biologic terrorism attacks and other events of public health concern on a national level. The goals of the BioSense initiative are to advance early detection by providing the standards, infrastructure, and data acquisition for near real-time reporting, analytic evaluation and implementation, and early event detection support for state and local public health officials. BioSense collects and analyzes Department of Defense and Department of Veterans Affairs ambulatory clinical diagnoses and procedures and Laboratory Corporation of America laboratory-test orders. The application summarizes and presents analytical results and data visualizations by source, day, and syndrome for each ZIP code, state, and metropolitan area through maps, graphs, and tables. An initial proof of a concept evaluation project was conducted before the system was made available to state and local users in April 2004. User recruitment involved identifying and training BioSense administrators and users from state and local health departments. User support has been an essential component of the implementation and enhancement process. CDC initiated the BioIntelligence Center (BIC) in June 2004 to conduct internal monitoring of BioSense national data daily. BIC staff have supported state and local system monitoring, conducted data anomaly inquiries, and communicated with state and local public health officials. Substantial investments will be made in providing regional, state, and local data for early event detection and situational awareness, test beds for data and algorithm evaluation, detection algorithm development, and data management technologies, while maintaining the focus on state and local public health needs.

Bioterrorism↗
PubMed2005

The autonomy of professionals and the involvement of patients and families.

PURPOSE OF REVIEW: The involvement of patients/service users and their families/caregivers in the field of mental health has been of interest for several years. It is timely to review what has been learned about involvement; to understand where and how involvement has been implemented; and to explore factors which influence the effectiveness of implementation. Recent literature on user involvement and its implications for professional practice forms the focus of this review. Material is drawn largely from Europe, North America and Australasia, since this reflects where there is most interest in this topic. Papers outside of mental health are included where they further illuminate issues under discussion. RECENT FINDINGS: The involvement of users/patients and their caregivers is an important aspect of the care and treatment of mental illness extending across health and social care. Involvement has implications for professional practice including the negotiation of treatment, the coordination of care and communication strategies. Tensions may emerge during the process of effectively implementing patient/family involvement, but the autonomy of professionals is not usually a factor. SUMMARY: There is no singular definition of involvement. There has been growth in the levels of user/caregiver involvement, particularly in community-based provision and within transition processes from hospital to community-based treatment. There is no suggestion that involvement is widespread. Implementation of involvement should be underpinned by effective communication on the part of professionals and recognition of service users and caregivers as partners in processes of treatment and recovery. Implementation is most effective when supported by appropriate organizational policies and integrated into the education of health professionals.

Journal Article↗
PubMed2005

Healthcare reform involving the introduction of user fees and drug revolving funds: influence on health workers' behavior in southeast Nigeria.

OBJECTIVES: To assess the perceptions of health workers towards the drug revolving fund (DRF) scheme and the perceptions of the community members about health workers since the introduction of the DRF. METHODS: The study was conducted in four purposively selected local government areas (LGAs) in southeast Nigeria where the Bamako initiative DRF was operational. Data was collected using in-depth interviews with randomly selected health workers and exit interviews with patients who attended the health centers. RESULTS: There were differences between the ways the DRF affected health workers in the different LGAs. In general, the motivation of the health workers to deliver health services improved significantly largely because they had basic drugs to work with and they benefited from the drug gains accruing through the operations of the DRF. However, as time went on, some got de-motivated and their attentions became more focused on revenue generation and profit making through sale of own drugs at the expense of health of the people as no incentives were paid and salaries were delayed. Curative services were provided more than promotive and preventive services and drugs are prescribed irrationally. Patients showed wide spread dissatisfaction with fees charged, waiting time before being seen, and treatment instructions given to them. CONCLUSION: Governments need to focus not only on the provision of drugs and revenue generation but also on providing strong support for in-service training, monitoring and supervisory activities to improve health workers' attitude to work. The governments also need to explore incentives such as working condition and monetary incentives to motivate health workers to improve their performance so as to serve the consumers better.

Adult↗
PubMed2003

Getting by with a little help from your friends: the impact of peer networks on criminality in a cohort of treatment-seeking drug users.

This study investigates the links between social networks of drug users and criminal activity. Opiate misusers (n=128) receiving in-patient treatment were interviewed about substance use, social networks, and crime in the month before treatment. Almost 60% of participants reported an average of more than 70 crimes each. Less than one-fifth of the subjects spent no time with other users, while just over half spent either "quite a lot" or "a lot" of time with drug users. Time with users increased the risk of crime. Spending no time with users provided a protective effect. Time with criminally involved drug users was associated with greater levels of crime. Social networks represent an important marker for integration in criminal networks in treatment-seeking drug users and a long-term barrier to rehabilitation.

Adult↗