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PubMed1997

Prescribing for the moderate-to-advanced ametropic presbyopic VDT user. A comparison of the Technica Progressive and Datalite CRT trifocal.

BACKGROUND: Use of video display terminals (VDTs) is expected to dramatically increase. This clinical study was performed to examine the moderate-to-advanced ametropic presbyopic VDT user to determine the most prevalent visual or physical symptoms incurred while working at a VDT, and to develop a comparative benefit analysis of two currently available occupational lens designs. METHODS: Twenty-four symptomatic VDT users who were currently wearing a non-occupational lens design were selected from a pool of 100 applicants. The non-occupational lens distribution included 17 bifocals, 3 trifocals and 4 progressives lenses. The subjects compared two occupational lens designs. RESULTS: Statistical analyses indicated that the frequency and severity of seven of 10 symptoms reported were significantly reduced by wearing the occupational lenses, including the three most frequently reported pre-existing symptoms of neck/shoulder aches, eyestrain, and blurred intermediate vision. CONCLUSION: Study results suggest that symptomatic moderate-to-advanced ametropic presbyopic VDT users may benefit from an occupational progressive lens when work involves prolonged or exclusive viewing of a VDT screen. An occupational trifocal may benefit VDT users also required to perform other viewing tasks.

Aged↗

PubMed1998

Effect of fenfluramine challenge on cocaine craving in addicted male users.

The authors studied the effects of a challenging dose of the serotonin (5-HT)-releaser/reuptake inhibitor d,l-fenfluramine (FEN) on spontaneous cocaine craving in a group of cocaine-addicted users in order to evaluate the involvement of serotonergic pathways in the modulation of craving for cocaine. Nineteen cocaine-dependent male inpatients received 60 mg of FEN or placebo (double-blind). Data were compared with those obtained in a previous study of another serotonergic probe, the partial postsynaptic agonist meta-chlorophenyl-piperazine (m-CPP). FEN significantly reduced cocaine craving and increased cortisol and prolactin when compared with placebo. When the responses to the two drugs were compared, there were no differences in the cortisol and prolactin rises, but m-CPP was a more potent inhibitor of cocaine craving than FEN. These data suggest that 5-HT releasers/reuptake inhibitors and serotonergic agents with greater postsynaptic activity should be further examined.

Adult↗

PubMed2003

Estimating the size of an illicit-drug-using population.

This paper describes a new method for estimating the size of an illicit-drug-using population. It is designed to overcome certain limitations of registry-based techniques that require both comprehensive site coverage and unique case identifiers, and which do not typically provide estimates of the number of drug users who are currently active. The approach involves collecting retrospective self-report data on the careers of individuals who appear at drug treatment programmes. A model is developed that corrects for the selection bias introduced by the sampling plan, and which allows us to estimate the rate at which drug users generate treatment admission events during spells of use. The size of the drug-using population is estimated by dividing the estimated total number of treatment admissions that are generated during some fixed interval of time by the estimated rate at which individuals generate such events. The technique is tested in a series of simulation studies which demonstrate that accurate estimates of the size of the drug using population can be obtained in this manner. Analytical expressions for confidence intervals about the population estimates are derived as part of the exercise. Limitations of the approach and other potential applications are discussed.

Bias↗

PubMedDate not supplied

[Abuse of licit and illicit psychoactive substances in children and teenagers in the PACA Region (Southeastern France)].

INTRODUCTION: The abuse of licit and illicit psychoactive substances in children and teenagers represents a public health problem. MATERIALS AND METHODS: The aim of this study was to evaluate the extent of this phenomenon and its growth in the PACA (Provence-Alpes-Côte d'Azur) region (Southeastern France). The cases identified during the 10-year period 1992-2002 by the CEIP (Centre d'Evaluation et d'Information sur la Pharmacodépendance) were studied retrospectively. RESULTS: One hundred and ninety-one cases were identified. In most instances, abuse involved a first experience or was sporadic. The users were often boys (70%). The substances were solvents (48.7%) used collectively (33%) during recreational activities (74%). Illicit drugs accounted for 28.2% of the cases involving a first experience (89%), with polyconsumption accounting for 50%, cannabis 57.6%, ecstasy 25.9%, and LSD (lysergic acid diethylamide) 12.1% of cases. Medicines were also used (16%), the most frequent being benzodiazepines (51.6%). CONCLUSION: The study confirms the abuse of licit and illicit psychoactive substances in children and teenagers and provides information regarding the substances available in this region of France.

Adolescent↗

PubMedDate not supplied

Visual signatures in video visualization.

Video visualization is a computation process that extracts meaningful information from original video data sets and conveys the extracted information to users in appropriate visual representations. This paper presents a broad treatment of the subject, following a typical research pipeline involving concept formulation, system development, a path-finding user study, and a field trial with real application data. In particular, we have conducted a fundamental study on the visualization of motion events in videos. We have, for the first time, deployed flow visualization techniques in video visualization. We have compared the effectiveness of different abstract visual representations of videos. We have conducted a user study to examine whether users are able to learn to recognize visual signatures of motions, and to assist in the evaluation of different visualization techniques. We have applied our understanding and the developed techniques to a set of application video clips. Our study has demonstrated that video visualization is both technically feasible and cost-effective. It has provided the first set of evidence confirming that ordinary users can be accustomed to the visual features depicted in video visualizations, and can learn to recognize visual signatures of a variety of motion events.

Algorithms↗

PubMed1996

Smoking and cycle control among oral contraceptive users.

OBJECTIVE: Because cigarette smoking has a variety of antiestrogenic actions, we investigated the possibility that smoking may adversely affect spotting and bleeding among women using oral contraceptives. STUDY DESIGN: Three open-label, randomized clinical trials involving 16,506 cycles among 2956 oral contraceptive users were performed. RESULTS: Smokers reported a consistently higher frequency of spotting or bleeding than did nonsmokers. After recency and consistency of oral contraceptive use and progestin component were controlled for, smokers were, on average, 47% more likely to have spotting or bleeding than nonsmokers were over six cycles of oral contraceptive use, with higher levels of smoking associated with a greater frequency of spotting or bleeding. By the sixth cycle women who smoked > or = 16 cigarettes per day were almost three times more likely to have spotting or bleeding than were nonsmokers. CONCLUSION: Cigarette smoking adversely affects cycle control among oral contraceptive users, possibly by increasing estrogen catabolism. Although these findings also raise the possibility that oral contraceptive efficacy may also be impaired in smokers, an immediate concern is that oral contraceptive users who have spotting and bleeding are more likely to discontinue their use, placing them at risk of unintended pregnancy.

Adolescent↗

PubMed2006

Differences in orbitofrontal activation during decision-making between methadone-maintained opiate users, heroin users and healthy volunteers.

OBJECTIVE: Previously, we reported that opiate users enrolled in methadone treatment made 'risky' choices on a decision-making task following a loss of points compared with heroin users and healthy volunteers. One possible explanation for this behaviour is that methadone users were less sensitive to punishment on immediately preceding unsuccessful trials. METHODS: We sought to explore this finding from a neural perspective by performing a post hoc analysis of data from a previous [see text] positron emission tomography study. We restricted the analysis to the opiate groups and controls, assessing differences between opiate users on methadone and those on heroin. RESULTS: We found significant over-activation in the lateral orbitofrontal cortex (OFC) in methadone users compared with both heroin users and controls concomitant with the greatest overall tendency to 'play risky'. Heroin users showed significant under-activation in this area compared with the other two groups whilst exhibiting the greatest overall tendency to 'play safe'. Correlational analysis revealed that abnormal task-related activation of the left OFC was associated with the dose of methadone in methadone users and with the duration of intravenous heroin use in heroin users. 'Playing safe' following a loss of points was also negatively correlated with the activation of pregenual anterior cingulate and insula cortex in controls, but not in opiate users. CONCLUSION: Our findings suggest that the interplay between processes involved in integrating penalty information for the purpose of response selection may be altered in opiate users. This change was reflected differentially in task-related pattern of OFC activation depending on the opiate used.

Adult↗

PubMed2004

Soft-tissue abscess involving Actinomyces odontolyticus and two Prevotella species in an intravenous drug abuser.

Skin and soft-tissue infections in intravenous users comprise a variety of microorganisms and anaerobic bacteria are frequently involved in these suppurative infections. A case of subcutaneous abscess into anterior femoral muscles involving Actinomyces odontolyticus and two Prevotella species (Prevotella buccae and Prevotella melaninogenica) in an intravenous drug abuser is presented. This combination of microorganisms has not previously been described in soft-tissue infections. The patient volunteering that he licked his hypodermic needle prior to cocaine injection supports that the implicating bacteria originated from the oral cavity. Eventually, the patient recovered and at a 6-month follow-up a gradual improvement of his subcutaneous infection was noticed.

Abscess↗

PubMed2006

Substance abuse among rural and very rural drug users at treatment entry.

Historically, researchers and policymakers concerned with the problems of substance abuse have focused their attention almost exclusively on urban America. However, this focus now includes the special needs of rural areas. In the past, rural areas were more sheltered from the problems of mainstream America, but now, mass communication has decreased the isolation of rural areas. The purpose of this study is to examine rural and very rural drug users; including: (a) demographic and other selected background characteristics of rural and very rural drug users admitted to substance abuse treatment, (b) lifetime drug use patterns, (c) current drug use, (d) age of first drug use, (e) recognition of drug abuse as a problem, and (f) correlates of drug use behavior to identify potential predisposing factors. It was hypothesized that drug users from very rural areas would be more sheltered and the severity of their involvement with drug use would be less than that of drug users from rural areas. Between November 15, 1999 and January 31, 2001, face-to-face interviews were conducted in three geographic regions of Kentucky (N=604); eastern Kentucky (n=206), south central Kentucky (n= 165)--both frequently are considered rural (n=371)--and Western Kentucky, which is considered more urban (N=233). Over half of the participants were admitted to outpatient treatment (57%). The majority of participants were male (75%), White (94%), had no religious preference (51%), had been referred to by the criminal justice system (64%), and had a history of prior substance abuse treatment (55%). Findings indicate that being from very rural areas may be somewhat protective with lower current drug use and older age at drug use initiation. While alcohol remains the most used substance in terms of lifetime and current use, cocaine use was three times higher in rural areas than in very rural areas. Implications are discussed and recommendations are presented for substance abuse treatment providers and policymakers.

Adult↗

PubMed2003

Retinoids and drugs of abuse: implications for neurological disease risk in human immunodeficiency virus type 1 infection.

Among injection drug users, human immunodeficiency virus (HIV) type 1 infection may be associated with an increased risk of nervous system disease. For HIV-infected drug users with vitamin A deficiency, the overall risk of HIV-related morbidity and mortality may also be higher. In previous studies, levels of retinol, retinol-binding protein, and transthyretin in samples from such individuals were examined and found to be lower than such levels in seronegative control subjects. Also, in studies using an activated mononuclear cell line, all-trans retinoic acid and 9-cis retinoic acid suppressed production of the tumor necrosis factor (TNF)-alpha and interferon (IFN)-gamma. However, simultaneous exposure of the cells to morphine at a concentration similar to that to which drug users are exposed resulted in increased production of these cytokines. Therefore, morphine may alter the immunomodulatory effects of retinoids, thereby potentially affecting the clinical outcome of studies involving retinoid administration to HIV-infected drug users and increasing the risk for the development of HIV-related complications, including neurological disease.

AIDS Dementia Complex↗

PubMed1994

Case management to enhance HIV risk reduction among users of injection drugs and crack cocaine.

Case management is being applied to increasingly diverse client populations. This article describes the application of a field-based, service-broker model of case management with a population of injection drug users and crack cocaine users within the context of an AIDS risk-reduction program. The major problem encountered involved client engagement. The feasibility of implementing an effective case management program with active users of injection drugs and crack is questionable so long as involvement with such drugs is cast primarily as a criminal justice problem.

Adult↗

PubMedDate not supplied

"The rock always comes first": drug users' accounts about using formal health care.

Illicit drug use remains a significant public health threat. The issues surrounding drug use are recognized by public health professionals as important for several reasons. The incidence and prevalence of drug use persists in spite of the extensive societal, interpersonal, and individual consequences. In addition, the chronic health issues and health care costs associated with drug use continue to spiral. A wide variety of quantitative studies have examined the extent of health care problems, access, cost, and health care satisfaction among illicit drug users. While these studies offer important information through survey formats, fewer studies focus on subjective constructions of health care management from the users' perspective. This article examines the elements of the decision-making process involved in accessing formal health care among chronic and injecting street drug users. Twenty-eight in-depth interviews provide the data for this analysis, which is part of a large quantitative study of 1,479 injecting and chronic drug users and nondrug users in Miami, Florida. By exploring the elements of health care access through the eyes of the drug users, researchers and treatment professionals may gain insights into new ways to improve health care access for this at-risk population.

Delivery of Health Care↗

PubMed1990

Perceived family relationships in drug abusing adolescents.

A group of 15- to 16-year-old adolescents were asked to report on their perception of their own family relationships, previous family experiences and their perceptions of their relationships with their fathers and with their mothers. They were also asked to report on their use of psychoactive drugs. Drug users were more likely than non-users to perceive their families as distant and less involved, with poor communications, mistrusting and punitive. Fathers were more likely perceived to be ineffective, and less significant than mothers. Drug users reported more parental separation, divorce, re-marriage and bereavement.

Adolescent↗

PubMed2004

We are the experts: people with asthma talk about their medicine information needs.

People with chronic illness are being encouraged to become more involved in their care. For this, they need to be well informed about their medicines, and more written medicines information is becoming available. However, there is little data about its effectiveness and impact. This study examined the patient perspective of medicines information through focus groups of people with asthma. Most participants actively sought medicines information from a variety of professional and lay sources. There were some positive experiences but many examples of partial or total information failure. Individualised information was valued and medicine leaflets were generally seen as less helpful than face-to-face advice. Some felt strongly that patients with long experience should be involved in the development of medicine information leaflets. We conclude that medicine information leaflets do not currently meet the needs of users and that people who take medicines should be involved in their development and testing.

Adolescent↗

PubMedDate not supplied

Control of virtual environments for young people with learning difficulties.

PURPOSE: The objective of this research is to identify the requirements for the selection or development of usable virtual environment (VE) interface devices for young people with learning disabilities. METHOD: A user-centred design methodology was employed, to produce a design specification for usable VE interface devices. Details of the users' cognitive, physical and perceptual abilities were obtained through observation and normative assessment tests. CONCLUSIONS: A review of computer interface technology, including virtual reality and assistive devices, was conducted. As there were no devices identified that met all the requirements of the design specification, it was concluded that there is a need for the design and development of new concepts. Future research will involve concept and prototype development and user-based evaluation of the prototypes.

Adolescent↗

PubMedDate not supplied

Patterns of antihypertensive use among patients in the US Department of Defense database initially prescribed an angiotensin-converting enzyme inhibitor or calcium channel blocker.

The US Department of Defense recently assembled electronic records of outpatient prescriptions dispensed through the Uniformed Services Prescription Database Project (USPDP) going back to 1990. The objectives of this portion of a larger study were: (1) to examine longitudinally the patterns of antihypertensive drug use during the first year of therapy in patients whose initial therapy was with an angiotensin-converting enzyme (ACE) inhibitor or a calcium channel blocker (CCB); (2) to determine continuous and noncontinuous users of antihypertensive drugs; and (3) to estimate the direct medication costs for each pattern of medication use. Filtering criteria for patient and prescription identification were developed, because the USPDP contains no records of confirmatory diagnoses of hypertension. Once data filters were implemented, information for 771 patients was analyzed. An ACE inhibitor was the initial therapy for 328 patients, accounting for 1935 antihypertensive medication prescription fills, and a CCB was the initial therapy for 443 patients, accounting for 2459 fills (including refills). Slightly more than half of the patients (n = 401, 52.0%) were classified as continuous users (> or = 80% medication-possession ratio [supply of medication in days divided by the number of days in the 12-month study period]). In the first year, 177 of these continuous users (44.1%) had no change in therapy in the first year, 49 (12.2%) had an increase in dose, 8 (2.0%) had a decrease in dose, 15 (3.7%) had a change to a different therapeutic class of antihypertensive medication, 14 (3.5%) were changed to a different medication in the same therapeutic class, 20 (5.0%) had a new medication added to the regimen, and 118 (29.4%) had complex regimens involving more than one change. For continuous users, the mean medication supply in days was 354.6, and the average time before a medication change was 152.1 days for those continuous users who had one change in therapy. The overall average wholesale price (AWP) and average manufacturer price (AMP) for continuous users during 1 year of therapy were $471.31 and $378.51, respectively. For those patients whose therapy was changed to an ACE inhibitor/CCB combination and who were continuous users, the average AWP was $598.47 per year ($492.05 AMP). Once the change from monotherapy to an ACE inhibitor/CCB combination occurred in continuous users, AWP costs per member per month increased by approximately $22.00 ($18.00 AMP). Over half of the patients whose initial therapy was an ACE inhibitor or CCB had at least one change in their first year of therapy. Research into the reasons for these changes and their outcomes is needed.

Angiotensin-Converting Enzyme Inhibitors↗

PubMed2006

Recent-onset ecstasy use: association with deviant behaviors and psychiatric comorbidity.

BACKGROUND: Despite increases in ecstasy (MDMA) use in the United States, little is known about characteristics linked with recent-onset ecstasy use, especially psychiatric symptoms and deviant behaviors. AIMS: To test whether individuals with high levels of other drug use are more likely to be recent-onset ecstasy users; to test whether psychiatric symptoms in adults are associated with recent-onset ecstasy use; to explore the association between recent-onset ecstasy use and concomitant deviant behaviors in adolescents and adults. METHODS: Data from the 2001 National Survey on Drug Use and Health. FINDINGS: Recent-onset ecstasy use was significantly more likely to occur among adolescents and adults (18-34 years old) who engaged in deviant behaviors during the past year as compared with those who did not engage in deviant behaviors during the past year. Higher levels of deviancy indicated a higher likelihood of being a recent-onset ecstasy user, and associations were strongest with nonviolent deviant behaviors such as selling illegal drugs and stealing. Associations between deviant behaviors and recent-onset ecstasy use were similar in strength to associations between deviant behaviors and recent-onset cocaine and marijuana use, respectively. Adults who had past-year psychiatric symptoms (both depressive and panic symptoms) were twice as likely to be recent-onset ecstasy users as compared with those without past-year psychiatric symptoms. Greater levels of drug involvement increased the odds of being a recent-onset ecstasy user. CONCLUSION: Recent-onset ecstasy use seems to be associated with a range of other behavioral problems and may reflect one aspect of a larger problem behavior syndrome.

Adolescent↗

PubMed1994

Family involvement in illicit drug treatment?

Support now exists for the practice of including the family in attempts to alter individual problems related to alcohol use. The present paper extends discussion of family involvement in treatment to include programmes addressing illicit drug use. In contrast to programmes focusing on alcohol use where the cohabitating family has been the focus, developmental issues arising within the family of origin tend to be of most interest in illicit drug treatment. Treatment process descriptions, in a range of programmes, refer to the need to redress developmental failures originating in the family. More commonly the family is seen as a method of obtaining practical support for recovery. There are differences, however, both in the developmental deficits targeted for intervention and the approaches utilized to involve families in treatment. The frequent reference to illicit drug-users' families as high-risk groups for harmful behaviours, together with demonstrations of family involvement as a successful strategy, recommends the potential of these approaches as a practical prevention initiative. Broader assessment of potential benefits for the wider family network is suggested as a useful way to encourage such developments.

Journal Article↗