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Sample records for risky drug practices

  1. Reducing substance use and risky sexual behaviour among drug ...

    African Journals Online (AJOL)

    2017-10-02

    Oct 2, 2017 ... journalCode=rsah20. SAHARA-J: Journal of Social Aspects of HIV/AIDS ... use and risky sexual behaviour among drug users in Durban, South Africa: Assessing the impact ..... borative experiences between different role players can facilitate ..... between participants meaning that for some there was more of.

  2. [Drug use and involvement in risky driving styles in a sample of university students. The uniHcos project].

    Science.gov (United States)

    Jiménez-Mejías, Eladio; Medina-García, Miguel Ángel; Martínez-Ruiz, Virginia; Pulido-Manzanero, José; Fernández-Villa, Tania

    2015-09-01

    Drug and alcohol use are known to increase the risk of traffic accidents, especially among youth. However, the association between habitual drug use and the adoption of risky driving behavior is not well known. The aim of this study was to identify and quantify the association between habitual drug use and involvement in risky driving practices overall and by gender among university students. A cross sectional study was conducted. The study population was composed of 559 car drivers younger than 31 years who completed an online questionnaire during the 2011-2012 academic year. Among other factors, the questionnaire assessed the following items: habitual drug consumption (20 or more days) during the last year and involvement in other risky driving practices during the last month. A total of 27.7% of students reported they had used drugs regularly during the last year. Drug use was associated with a higher frequency of involvement in risky driving practices. In men, the factors most strongly associated with drug consumption were speeding, driving under influence of alcohol, and feeling drowsy while driving. In women, drug consumption was mainly associated with smoking while driving, drunk driving, and driving without rest. The results of our study support the hypothesis that habitual drug use is associated with an increased frequency of risky driving behavior. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  3. Dopaminergic Drug Effects on Probability Weighting during Risky Decision Making.

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    Ojala, Karita E; Janssen, Lieneke K; Hashemi, Mahur M; Timmer, Monique H M; Geurts, Dirk E M; Ter Huurne, Niels P; Cools, Roshan; Sescousse, Guillaume

    2018-01-01

    Dopamine has been associated with risky decision-making, as well as with pathological gambling, a behavioral addiction characterized by excessive risk-taking behavior. However, the specific mechanisms through which dopamine might act to foster risk-taking and pathological gambling remain elusive. Here we test the hypothesis that this might be achieved, in part, via modulation of subjective probability weighting during decision making. Human healthy controls ( n = 21) and pathological gamblers ( n = 16) played a decision-making task involving choices between sure monetary options and risky gambles both in the gain and loss domains. Each participant played the task twice, either under placebo or the dopamine D 2 /D 3 receptor antagonist sulpiride, in a double-blind counterbalanced design. A prospect theory modelling approach was used to estimate subjective probability weighting and sensitivity to monetary outcomes. Consistent with prospect theory, we found that participants presented a distortion in the subjective weighting of probabilities, i.e., they overweighted low probabilities and underweighted moderate to high probabilities, both in the gain and loss domains. Compared with placebo, sulpiride attenuated this distortion in the gain domain. Across drugs, the groups did not differ in their probability weighting, although gamblers consistently underweighted losing probabilities in the placebo condition. Overall, our results reveal that dopamine D 2 /D 3 receptor antagonism modulates the subjective weighting of probabilities in the gain domain, in the direction of more objective, economically rational decision making.

  4. Dopaminergic Drug Effects on Probability Weighting during Risky Decision Making

    Science.gov (United States)

    Timmer, Monique H. M.; ter Huurne, Niels P.

    2018-01-01

    Abstract Dopamine has been associated with risky decision-making, as well as with pathological gambling, a behavioral addiction characterized by excessive risk-taking behavior. However, the specific mechanisms through which dopamine might act to foster risk-taking and pathological gambling remain elusive. Here we test the hypothesis that this might be achieved, in part, via modulation of subjective probability weighting during decision making. Human healthy controls (n = 21) and pathological gamblers (n = 16) played a decision-making task involving choices between sure monetary options and risky gambles both in the gain and loss domains. Each participant played the task twice, either under placebo or the dopamine D2/D3 receptor antagonist sulpiride, in a double-blind counterbalanced design. A prospect theory modelling approach was used to estimate subjective probability weighting and sensitivity to monetary outcomes. Consistent with prospect theory, we found that participants presented a distortion in the subjective weighting of probabilities, i.e., they overweighted low probabilities and underweighted moderate to high probabilities, both in the gain and loss domains. Compared with placebo, sulpiride attenuated this distortion in the gain domain. Across drugs, the groups did not differ in their probability weighting, although gamblers consistently underweighted losing probabilities in the placebo condition. Overall, our results reveal that dopamine D2/D3 receptor antagonism modulates the subjective weighting of probabilities in the gain domain, in the direction of more objective, economically rational decision making. PMID:29632870

  5. Reducing substance use and risky sexual behaviour among drug ...

    African Journals Online (AJOL)

    There were no decreases in drug use practices such as use of cannabis, heroin, cocaine and Ecstasy after the intervention with drug users; however, there was a significant reduction in alcohol use following the intervention. While there was a substantial increase in the proportion of participants using drugs daily as ...

  6. Reported risky sexual practices amongst female undergraduate students in KwaZulu-Natal, South Africa

    Directory of Open Access Journals (Sweden)

    Muhammad E. Hoque

    2011-11-01

    Objective: This study was designed to establish risky sexual practices amongst female undergraduate students. Method: This was a descriptive cross-sectional study carried out in September 2009 amongst full-time female undergraduate students. A multi-stage sampling method was used to recruit 391 students for the study. Results: The mean age of the students was 21.4 ± 3.2 years (range 17–45 years. More than half (52.4% of the students were sexually active. The median age at first sexual intercourse was 19.0 years (range 12–24 years. Participants who had multiple sexual partners had a median of 2 (range, 2–4 sexual partners. The majority (89.3% of the students used contraceptives. Almost half (41.5%, sometimes or rarely, used contraceptives during sex. With regard to substance use, 57.5% and 6.9% respectively drank alcohol and used drugs. Sexually active students had 1.5 times (OR = 1.5, p = 0.04, (OR = Odds Ratio, more chances of consuming alcohol than those who were not sexually active. Students with multiple sexual partners were 7 times more likely to consume alcohol compared to those who did not have multiple partners (OR = 6.9, p = 0.004. Students with multiple sexual partners had 3.5 times more chances of taking drugs compared to students with one steady partner (OR = 3.5, p = 0.038. Conclusion: A large number of female university students are engaging in risky sexual practices. University Management should concentrate on developing and implementing policies to promote safer sexual practices, in particular targeting consequences of STIs and HIV and methods to minimise the risk.

  7. Prevalence and determinants of risky sexual practice in Ethiopia: Systematic review and Meta-analysis.

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    Muche, Achenef Asmamaw; Kassa, Getachew Mullu; Berhe, Abadi Kidanemariam; Fekadu, Gedefaw Abeje

    2017-09-06

    Risky sexual practice is a major public health problem in Ethiopia. There are various studies on the prevalence and determinants of risky sexual practice in different regions of the country but there is no study which shows the national estimate of risky sexual practices in Ethiopia. Therefore, this review was conducted to estimate the national pooled prevalence of risky sexual practice and its risk factors in Ethiopia. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was followed to review published and unpublished studies in Ethiopia. The databases used were; PubMed, Google Scholar, CINAHL and African Journals Online. Search terms were; risky sexual behavior, risky sexual practice, unprotected sex, multiple sexual partner, early sexual initiation, and/or Ethiopia. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument was used for critical appraisal. The meta-analysis was conducted using Review Manager software. Descriptive information of studies was presented in narrative form and quantitative results were presented in forest plots. The Cochran Q test and I 2 test statistics were used to test heterogeneity across studies. The pooled estimate prevalence and the odd ratios with 95% confidence intervals were computed by a random effect model. A total of 31 studies with 43,695 participants were included in the meta-analysis. The pooled prevalence of risky sexual practice was 42.80% (95% CI: 35.64%, 49.96%). Being male (OR: 1.69; 95% CI: 1.21, 2.37), substance use (OR: 3.42; 95% CI: 1.41, 8.31), peer pressure (OR: 3.41; 95% CI: 1.69, 6.87) and watching pornography (OR: 3.6; 95% CI: 2.21, 5.86) were factors associated with an increase in risky sexual practices. The prevalence of risky sexual practices is high in Ethiopia. Being male, substance use, peer pressure and viewing pornographic materials were found to be associated with risky sexual practices. Therefore, life skills training is recommended to

  8. Risky Decisions Despite Counter Evidence: Modeling a Culture of Safer Sexual Practices

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    Patel, Vimla L.; Yoskowitz, Nicole A.; Kaufman, David R.; Gutnik, Lily A.; Shortliffe, Edward H.

    2005-01-01

    To create a culture of safe practices, we need to understand how and under what conditions the public makes risky decisions about their health. Because risky sexual behaviors are known to be common in young adults, we investigated their decision making regarding sexual activities that could incur a high risk of HIV infection. Sixty young urban adults maintained journals for two weeks and were interviewed regarding condom use and sexual history. We characterized four patterns...

  9. Risky Behaviors of Injecting Drug Users (IDUs Referred to Addiction Rehabilitation Centers in Khuzestan Province in 2014

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    Farkhondeh Jamshidi

    2017-07-01

    Full Text Available Aim: In the last decade, the prevalence of injecting drugs has been increasing rapidly. Injecting drug use puts one at the risk of risky behaviors that affect the health of individual and society. The present study aims at evaluating and comparing risky behaviors of injecting and non-injecting drug users. Methods: In this cross-sectional descriptive study, 4400 addicts referred to public, private and drop-in-centers (DICs in 2014 were enrolled. The addicts were divided into injecting and non-injecting drug users. A researcher-made questionnaire was used to collect demographic data and the pattern of drug use and risky behavior. Data were analyzed by SPSSV21, chi-square test and ANOVA. A significance level of less than 0.05 was considered. Results: Among the addicts, 4% were injecting drug users (IDUs and 96% non-injecting drug addicts (non-IDUs. The age of the first injection was 24.68 ± 6.45 years old. The age of onset of drug use in IDUs was significantly lower than in non-IDUs (P<0.001. Risky behaviors including the use of shared needles, risky sexual relations, a history of sexually transmitted infections and a history of imprisonment and suicide were significantly higher in IDUs. Addiction relapse and slip during treatment were higher in IDUs (P<0.001. Conclusion: Injecting drug addiction significantly increases the risk of relapse and risky behaviors. Priority should be given to risky behavior prevention programs.

  10. Mechanisms That Link Parenting Practices to Adolescents' Risky Sexual Behavior: A Test of Six Competing Theories.

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    Simons, Leslie Gordon; Sutton, Tara E; Simons, Ronald L; Gibbons, Frederick X; Murry, Velma McBride

    2016-02-01

    Risky sexual behavior, particularly among adolescents, continues to be a major source of concern. In order to develop effective education and prevention programs, there is a need for research that identifies the antecedents of such behavior. This study investigated the mediators that link parenting experiences during early adolescence to subsequent risky sexual behaviors among a diverse sample of African American youth (N = 629, 55 % female). While there is ample evidence that parenting practices (e.g., supportive parenting, harsh parenting, parental management) are antecedent to risky sexual behavior, few studies have examined whether one approach to parenting is more strongly related to risky sex than others. Using a developmental approach, the current study focused on factors associated with six theories of risky sexual behavior. While past research has provided support for all of the theories, few studies have assessed the relative contribution of each while controlling for the processes proposed by the others. The current study addresses these gaps in the literature and reports results separately by gender. Longitudinal analyses using structural equation modeling revealed that the mediating mechanisms associated with social learning and attachment theories were significantly related to the risky sexual behavior of males and females. Additionally, there was support for social control and self-control theories only for females and for life history theory only for males. We did not find support for problem behavior theory, a perspective that dominates the risky sex literature, after controlling for the factors associated with the other theories. Finally, supportive parenting emerged as the parenting behavior most influential with regard to adolescents' risky sexual behavior. These results provide insight regarding efficacious approaches to education and preventative programs designed to reduce risky sexual behaviors among adolescents.

  11. Risky sexual practices and related factors among ART attendees in Addis Ababa Public Hospitals, Ethiopia: a cross-sectional study.

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    Dessie, Yadeta; Gerbaba, Mulusew; Bedru, Abdo; Davey, Gail

    2011-06-01

    Many HIV-positive persons avoid risky sexual practices after testing HIV sero-positive. However, a substantial number continue to engage in risky sexual practices that may further transmit the virus, put them at risk of contracting secondary sexually transmitted infections and lead to problems with drug resistance. Thus, this study was intended to assess risky sexual practices and related factors among HIV- positive ART attendees in public hospitals of Addis Ababa. A cross-sectional study was conducted among ART attendees from February to March, 2009. Questionnaire-based face-to-face interviews were used to gather data. SPSS software was used to perform descriptive and logistic regression analyses. Six hundred and one ART attendees who fulfilled the inclusion criteria was included in the study and interviewed. More than one-third (36.9%) had a history of risky sexual practices in the three months prior to the study. The major reasons given for not using condoms were: partner's dislike of them, both partners being positive for HIV and the desire to have a child. Factors associated with risky sexual practices included: lack of discussion about condom use (Adjusted Odds Ratio (AOR = 7.23, 95% CI: 4.14, 12.63); lack of self-efficacy in using condoms (AOR = 3.29, 95% CI: 2.07, 5.23); lack of sexual pleasure when using a condom (AOR = 2.39, 95% CI: 1.52, 3.76); and multiple sexual partners (AOR = 2.67, 95% CI: 1.09, 6.57). Being with a negative sero-status partner (AOR = 0.33, 95% CI: 0.14, 0.80), or partners of unknown sero-status (AOR = 0.19, 95% CI: 0.09, 0.39) were associated with less risky practice. A considerable proportion (36.9%) of respondents engaged in unprotected sexual intercourse, potentially resulting in re-infection by a new virus strain, other sexually transmitted infections and onward transmission of the HIV virus. Health education and counseling which focuses on the identified factors has to be provided. The health education and counseling can be

  12. Risky sexual practices and related factors among ART attendees in Addis Ababa Public Hospitals, Ethiopia: A cross-sectional study

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    Bedru Abdo

    2011-06-01

    Full Text Available Abstract Background Many HIV-positive persons avoid risky sexual practices after testing HIV sero-positive. However, a substantial number continue to engage in risky sexual practices that may further transmit the virus, put them at risk of contracting secondary sexually transmitted infections and lead to problems with drug resistance. Thus, this study was intended to assess risky sexual practices and related factors among HIV- positive ART attendees in public hospitals of Addis Ababa. Methods A cross-sectional study was conducted among ART attendees from February to March, 2009. Questionnaire-based face-to-face interviews were used to gather data. SPSS software was used to perform descriptive and logistic regression analyses. Results Six hundred and one ART attendees who fulfilled the inclusion criteria was included in the study and interviewed. More than one-third (36.9% had a history of risky sexual practices in the three months prior to the study. The major reasons given for not using condoms were: partner's dislike of them, both partners being positive for HIV and the desire to have a child. Factors associated with risky sexual practices included: lack of discussion about condom use (Adjusted Odds Ratio (AOR = 7.23, 95% CI: 4.14, 12.63; lack of self-efficacy in using condoms (AOR = 3.29, 95% CI: 2.07, 5.23; lack of sexual pleasure when using a condom (AOR = 2.39, 95% CI: 1.52, 3.76; and multiple sexual partners (AOR = 2.67, 95% CI: 1.09, 6.57. Being with a negative sero-status partner (AOR = 0.33, 95% CI: 0.14, 0.80, or partners of unknown sero-status (AOR = 0.19, 95% CI: 0.09, 0.39 were associated with less risky practice. Conclusions A considerable proportion (36.9% of respondents engaged in unprotected sexual intercourse, potentially resulting in re-infection by a new virus strain, other sexually transmitted infections and onward transmission of the HIV virus. Health education and counseling which focuses on the identified factors has to

  13. Response inhibition moderates the association between drug use and risky sexual behavior.

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    Nydegger, Liesl A; Ames, Susan L; Stacy, Alan W; Grenard, Jerry L

    2014-09-01

    HIV infection is problematic among all drug users, not only injection drug users. Drug users are at risk for contracting HIV by engaging in risky sexual behaviors. The present study sought to determine whether inhibitory processes moderate the relationship between problematic drug use and HIV-risk behaviors (unprotected sex and multiple sex partners). One hundred ninety-six drug offenders enrolled in drug education programs were administered a battery of computer-based assessments. Measures included a cued go/no-go assessment of inhibitory processes, the Drug Abuse Screening Test (DAST) assessment of problematic drug use, and self-report assessment of condom use and multiple sex partners. Findings revealed that response inhibition assessed by the proportion of false alarms on the cued go/no-go moderated the relationship between problematic drug use and an important measure of HIV risk (condom nonuse) among drug offenders. However, response inhibition did not moderate the relationship between problematic drug use and another measure of HIV risk: multiple sex partners. Among this sample of drug offenders, we have found a relationship between problematic drug use and condom nonuse, which is exacerbated by poor control of inhibition. These findings have implications for the development of HIV intervention components among high-risk populations.

  14. Risky health seeking practice among pregnant women in rural Congo

    DEFF Research Database (Denmark)

    Hørby, Laila

    2007-01-01

    the clinics at M’shi., and to analyze the practice and logic of the untrained helpers, in the villages and the professional staff at M’shi. To do that I have done a fieldwork study in the area around M’shi., using qualitative methods such as Interviews, Focus Group Discussions and observations. I have used...... they are part of the tradition and the culture. The women make a perfectly normal choice when they choose the TBAs for care as they are part of the folk sector. The TBA’s are there, culturally sensitive, trusted and respected. They have certain knowledge and skills. The professional, medical system may as well...

  15. Risky decisions despite counter evidence: modeling a culture of safer sexual practices.

    Science.gov (United States)

    Patel, Vimla L; Yoskowitz, Nicole A; Kaufman, David R; Gutnik, Lily A; Shortliffe, Edward H

    2005-01-01

    To create a culture of safe practices, we need to understand how and under what conditions the public makes risky decisions about their health. Because risky sexual behaviors are known to be common in young adults, we investigated their decision making regarding sexual activities that could incur a high risk of HIV infection. Sixty young urban adults maintained journals for two weeks and were interviewed regarding condom use and sexual history. We characterized four patterns of condom use behavior: consistent (35.0%), inconsistent (16.7%), consistent to inconsistent (35.0%), and inconsistent to consistent (13.3%). Directionality of reasoning was analyzed in the explanations provided for condom use decisions. The consistent and inconsistent patterns were associated with data-driven heuristic reasoning, where behavior becomes automated and is associated with a high level of confidence in one's judgment. In the other two patterns, the shift in behavior was due to a significant event that influenced a change in directionality to explanation-based reasoning. We discuss these results within the framework of identifying potentially high-risk groups for whom customized intervention strategies (such as computer-based educational programs) can be used to reduce risk, thereby creating a culture of safer sexual practices.

  16. Erectile dysfunction drug receipt, risky sexual behavior and sexually transmitted diseases in HIV-infected and HIV-uninfected men.

    Science.gov (United States)

    Cook, Robert L; McGinnis, Kathleen A; Samet, Jeffrey H; Fiellin, David A; Rodriguez-Barradas, Maria C; Rodriquez-Barradas, Maria C; Kraemer, Kevin L; Gibert, Cynthia L; Braithwaite, R Scott; Goulet, Joseph L; Mattocks, Kristin; Crystal, Stephen; Gordon, Adam J; Oursler, Krisann K; Justice, Amy C

    2010-02-01

    Health care providers may be concerned that prescribing erectile dysfunction drugs (EDD) will contribute to risky sexual behavior. To identify characteristics of men who received EDD prescriptions, determine whether EDD receipt is associated with risky sexual behavior and sexually transmitted diseases (STDs), and determine whether these relationships vary for certain sub-groups. Cross-sectional study. Two thousand seven hundred and eighty-seven sexually-active, HIV-infected and HIV-uninfected men recruited from eight Veterans Health Affairs outpatient clinics. Data were obtained from participant surveys, electronic medical records, and administrative pharmacy data. EDD receipt was defined as two or more prescriptions for an EDD, risky sex as having unprotected sex with a partner of serodiscordant or unknown HIV status, and STDs, according to self-report. Overall, 28% of men received EDD in the previous year. Eleven percent of men reported unprotected sex with a serodiscordant/unknown partner in the past year (HIV-infected 15%, HIV-uninfected 6%, P sexual behavior (11% vs. 10%, p = 0.9) and STDs (7% vs 7%, p = 0.7). In multivariate analyses, EDD receipt was not significantly associated with risky sexual behavior or STDs in the entire sample or in subgroups of substance users or men who had sex with men. EDD receipt was common but not associated with risky sexual behavior or STDs in this sample of HIV-infected and uninfected men. However, risky sexual behaviors persist in a minority of HIV-infected men, indicating ongoing need for prevention interventions.

  17. Drug promotion practices: A review.

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    Jacob, Nilan T

    2018-01-18

    Over the years, the pharmaceutical industry has been at the forefront of research and innovation in drug discovery and development. The process of drug discovery extending from preclinical studies to multicentric clinical trials and postmarketing phase is a costly affair running into billions of dollars. On the flip side, not all investigational molecules clear the trial phases and get approved, which puts pressure on the manufacturers to maximize the profit from approved drugs. It is in this key area that the practice of drug promotion plays its role. The World Health Organization defines drug promotion as "all informational and persuasive activities by manufacturers and distributors, the effect of which is to influence the prescription, supply, purchase or use of medicinal drugs". With its humble intent of creating awareness among healthcare professionals and updating their knowledge on recent advances in treatment options, drug promotion has been an important tool, but gradually it has evolved to embrace aggressive marketing strategies and sometimes unethical business and scientific practices where the need for profit-making eclipses commitment to patient care and scientific exploration. In this review, we discuss the evolution of drug promotion practices, the various types, its merits and demerits, the influence of drug promotion on physician prescribing behaviour, the role of regulatory bodies, unethical promotional practices and finally summarize with future directions. © 2018 The British Pharmacological Society.

  18. Risky sexual practices among youth attending a sexually transmitted infection clinic in Dar es Salaam, Tanzania

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    Mhalu F

    2008-11-01

    Full Text Available Abstract Background Youth have been reported to be at a higher risk of acquiring STIs with significant adverse health and social consequences. Knowledge on the prevailing risky practices is an essential tool to guide preventive strategies. Methods Youth aged between 18 and 25 years attending an STI clinic were recruited. Social, sexual and demographic characteristics were elicited using a structured standard questionnaire. Blood samples were tested for syphilis and HIV infections. Urethral, high vaginal and cervical swabs were screened for common STI agents. Results A total of 304 youth were studied with mean age of 21.5 and 20.3 years for males and females respectively. 63.5% of youth were seeking STI care. The mean age of coitache was 16.4 and 16.2 years for males and females respectively. The first sexual partner was significantly older in females compared to male youth (23.0 vs 16.8 years (p Conclusion Most female youth seen at the STI clinic had their first sexual intercourse with older males. Youth were engaging in high risk unprotected sexual practices which were predisposing them to STIs and unplanned pregnancies. There is a great need to establish more youth-friendly reproductive health clinics, encourage consistent and correct use of condoms, delay in sexual debut and avoid older sexual partners in females.

  19. Risky driving and lifestyles in adolescence.

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    Bina, Manuela; Graziano, Federica; Bonino, Silvia

    2006-05-01

    Several studies have shown that risky driving is especially prevalent among young drivers and recent research has pointed out that driving in adolescence should be investigated in the more general context of adolescent development. The first aim of this contribution was to analyze involvement in risky driving in a normative sample of 645 Italian adolescents, boys and girls, aged 14-17, through a self-report questionnaire. A second aim was to evaluate the association between risky driving and lifestyle, defined as involvement in other health risk behaviors and leisure activities. The main results showed that many adolescents drove cars and motorcycles without the required driving license and the most frequent offences were speeding and failure to maintain a safe braking distance. Gender and age differences were also investigated. Results concerning the association between risky driving and lifestyle showed that risky driving was not an isolated behavior. Boys who displayed risky driving practices were more likely to adopt a lifestyle characterized by high involvement in antisocial behaviors, tobacco smoking, comfort eating and time spent in non-organized activities with friends. Girls involved in risky driving were more likely to be involved in other risk-taking behaviors, antisocial behaviors and drug use.

  20. Stress Mediates the Relationship Between Past Drug Addiction and Current Risky Sexual Behaviour Among Low-income Women.

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    Wu, Z Helen; Tennen, Howard; Hosain, G M Monawar; Coman, Emil; Cullum, Jerry; Berenson, Abbey B

    2016-04-01

    This study examined the role of stress as a mediator of the relationship between prior drug addiction and current high-risk sexual behaviour. Eight hundred twenty women aged 18 to 30 years, who received care at community-based family planning clinics, were interviewed using the Composite International Diagnostic Interview and the Sexual Risk Behavior Assessment Schedule. They also completed the brief version of the Self-Control Scale as a measure of problem-solving strategies and measures of recent stressful events, daily hassles and ongoing chronic stress. Regardless of addiction history, stress exposure during the previous 12 months was associated with risky sexual behaviour during the previous 12 months. Structural equation modelling revealed that 12-month stress levels mediated the relationship between past drug addiction and 12-month high-risk sexual behaviours, as well as the negative relationship between problem-solving strategies and high-risk sexual behaviours. Problem-solving strategies did not moderate the relationship between drug addiction and high-risk sexual behaviours. These findings suggest that stress management training may help reduce risky behaviour among young, low-income women. Copyright © 2014 John Wiley & Sons, Ltd.

  1. Physiological correlates of neurobehavioral disinhibition that relate to drug use and risky sexual behavior in adolescents with prenatal substance exposure.

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    Conradt, Elisabeth; Lagasse, Linda L; Shankaran, Seetha; Bada, Henrietta; Bauer, Charles R; Whitaker, Toni M; Hammond, Jane A; Lester, Barry M

    2014-01-01

    Physiological correlates of behavioral and emotional problems, substance use onset and initiation of risky sexual behavior have not been studied in adolescents with prenatal drug exposure. We studied the concordance between baseline respiratory sinus arrhythmia (RSA) at age 3 and baseline cortisol levels at age 11. We hypothesized that children who showed concordance between RSA and cortisol would have lower neurobehavioral disinhibition scores which would in turn predict age of substance use onset and first sexual intercourse. The sample included 860 children aged 16 years participating in the Maternal Lifestyle Study, a multisite longitudinal study of children with prenatal exposure to cocaine and other substances. Structural equation modeling was used to test pathways between prenatal substance exposure, early adversity, baseline RSA, baseline cortisol, neurobehavioral disinhibition, drug use, and sexual behavior outcomes. Concordance was studied by examining separate male and female models in which there were statistically significant interactions between baseline RSA and cortisol. Prenatal substance exposure was operationalized as the number of substances to which the child was exposed. An adversity score was computed based on caregiver postnatal substance use, depression and psychological distress, number of caregiver changes, socioeconomic and poverty status, quality of the home environment, and child history of protective service involvement, abuse and neglect. RSA and cortisol were measured during a baseline period prior to the beginning of a task. Neurobehavioral disinhibition, based on composite scores of behavioral dysregulation and executive dysfunction, substance use and sexual behavior were derived from questionnaires and cognitive tests administered to the child. Findings were sex specific. In females, those with discordance between RSA and cortisol (high RSA and low cortisol or low RSA and high cortisol) had the most executive dysfunction which, in

  2. Attitudes, knowledge and risky practices facing with the human inmunodeficiency virus between the university population of Chontales (Nicaragua

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    Fernando López-Noguero

    2013-12-01

    Full Text Available In this article a study between the university population of Centro Regional Chontales in Universidad Nacional Autónoma of Nicaragua is presented. The attitudes facing with the HIV are analyzed and the knowledge that the lecturers and students have about this topic, also the risky practices that they usually realize.Method:Only one ad hoc questionnaire was used with questions about sexual orientation, sexual habits and birth control, knowledge about HIV, other sexually transmitted diseases, attitudes, perceptions and risky practices. A proportional stratified sampling was used to select the samples. Descriptive analysis (percentage, correlation analysis (correlation coefficient and contrast of the non-parametric hypothesis bymeans of the correlation coefficient test. Results: Fromthe analysis realized we can deduce that there is still a lack of awareness about the transmission routes of the disease (just the 14,57 % of the students and the 8,43 % of the lecturers knows that the spread is possible by blood transfusion in certain conditions. There are problems by means of attitudes and risky practices (almost the 59 % of the students states that they do not use any type of birth control in their sexual relations also the persistency of social discrimination elements (almost the 42%of the students states that theywould not livewith a person with AIDS or they say that they do not know if they would do it or not due to fear of transmission.Conclusions: It has been considered necessary to develop social and educational initiatives of healthy promotion in this environment, a multisectorial questions approach facing with the HIV, where the social and educational has a prevailing place

  3. HANDLING OF RISK-BEARING DRUGS DURING PREGNANCY - DO WE CHOOSE LESS RISKY ALTERNATIVES

    NARCIS (Netherlands)

    DEJONGVANDENBERG, LTW; VANDENBERG, PB; HAAIJER-RUSKAMP, FM; DUKES, MNG; WESSELING, H

    1992-01-01

    The drug use of nearly 2,000 pregnant women was evaluated at the level of the individual patient for the drugs belonging to the Australian risk categories B3, C and D. The pattern of changes in the use of these drugs is studied in terms of women who discontinue (d), continue (c) or begin (b) using

  4. Assessment of risky sexual behavior and practice among Aksum University students, Shire Campus, Shire Town, Tigray, Ethiopia, 2017.

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    Kebede, Awoke; Molla, Bogale; Gerensea, Hadgu

    2018-01-31

    Having sex at early age, having multiple sexual partners, having sex while under the influence of alcohol or drugs and unprotected sexual behaviors are the common characteristics of risky sexual behavior which increases risk of individuals to sexuality and reproductive health problems. Risky sexual behavior is the most common problem in adolescents and young adults which may expose individuals for permanent social, economical, psychological and physical problem. So that this study focus on assessment of risk sexual behavior using institution based cross-sectional study design on 287 randomly selected subjects among Aksum University students. Almost 60% students reported to have ever had sexual activity. Of which 86 (83.5%) and 112 (64.4%) reported having inconsistent condom use and multiple sexual partners respectively. Even though more than half of first sexual intercourse (61.5%) starts due to their desire but still peer pressure and alcohol have significant effect. Similarly the study indicated that a significant segment of students have risk sexual behaviors which increase individuals' risk of acquiring HIV/AIDS. Unless appropriate age and institutional targeted interventions exist, certain behaviors can place the university students at greater risk of HIV infection and sexually transmitted disease.

  5. Reducing substance use and risky sexual behaviour among drug users in Durban, South Africa: Assessing the impact of community-level risk-reduction interventions.

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    Parry, C D H; Carney, T; Petersen Williams, P

    2017-12-01

    Alcohol and other drug (AOD) use is increasingly recognised as having a direct and indirect effect on the transmission of human immunodeficiency virus (HIV). However, there is evidence to suggest that drug- and sex-related HIV risk-reduction interventions targeted at drug users within drug treatment centres or via community outreach efforts can lead to positive health outcomes. This study aimed to test whether a community-level intervention aimed at AOD users has an impact on risky AOD use and sexual risk behaviour. In 2007, in collaboration with a local non-governmental organisation (NGO) in Durban, an initiative was begun to implement a number of harm reduction strategies for injection and non-injection drug users. The NGO recruited peer outreach workers who received intensive initial training, which was followed by six-monthly monitoring and evaluation of their performance. Participants had to be 16 years of age or older, and self-reported alcohol and/or drug users. Peer outreach workers completed a face-to-face baseline questionnaire with participants which recorded risk behaviours and a risk-reduction plan was developed with participants which consisted of reducing injection (if applicable) and non-injection drug use and sex-related risks. Other components of the intervention included distribution of condoms, risk-reduction counselling, expanded access to HIV Testing Services, HIV/sexually transmitted infection care and treatment, and referrals to substance abuse treatment and social services. At follow-up, the baseline questionnaire was completed again and participants were also asked the frequency of reducing identified risk behaviours. Baseline information was collected from 138 drug users recruited into the study through community-based outreach, and who were subsequently followed up between 2010 and 2012. No injection drug users were reached. The data presented here are for first contact (baseline) and the final follow-up contact with the participants

  6. HIV Risk Perception and Risky Behavior Among People Who Inject Drugs in Kermanshah, Western Iran.

    Science.gov (United States)

    Noroozi, Mehdi; Ahounbar, Elahe; Karimi, Salah Eddin; Ahmadi, Sina; Najafi, Mohammad; Bazrafshan, Ali; Shushtari, Zahra Jorjoran; Farhadi, Mohammad Hassan; Higgs, Peter; Rezaei, Fatemeh; Ghiasvand, Hesam; Sharhani, Asaad; Armoon, Bahram; Waye, Katherine

    2017-08-01

    Understanding and increasing awareness on individual risk for HIV infection as well as HIV risk perception's effects on different behavioral outcomes for people who inject drugs (PWID) is important for policymaking and planning purposes. The objectives of the present study were to determine whether HIV risk perception was associated with greater injection and sexual risk-taking behaviors among PWIDs. We surveyed 460 PWID in Kermanshah regarding their demographic characteristics, sexual risk behaviors, HIV risk perception, and drug-related risk behaviors in the month prior to the study. Three classes of HIV risk perception were identified using ordinal regression to determine factors associated with HIV risk perception. Study participants were categorized as follows: "low" (n = 100, 22%), "moderate" (n = 150, 32%), and "high" (n = 210, 46%) risk perception for becoming infected with HIV. The odds of categorizing as "high" risk for HIV was significantly greater in PWID that reported unprotected sex (adjusted odds ratio (AOR) 2.4, p value 0.02), receptive syringe sharing (AOR 1.8, p value 0.01), and multiple sex partners (AOR 1.4, p value 0.03). PWID who reported unprotected sex had 2.7 times the odds of "high" risk perception when compared to PWID with "low" risk perception. Findings show that PWID could rate their HIV risk with acceptable accuracy. Additionally, perceived HIV risk was associated with many risk factors for transmission of HIV, emphasizing the importance of developing targeted prevention and harm reduction programs for all domains of risk behaviors, both sexual and drug-related use.

  7. "Shotgunning" as an illicit drug smoking practice.

    Science.gov (United States)

    Perlman, D C; Perkins, M P; Paone, D; Kochems, L; Salomon, N; Friedmann, P; Des Jarlais, D C

    1997-01-01

    There has been a rise in illicit drug smoking in the United States. "Shotgunning" drugs (or "doing a shotgun") refers to the practice of inhaling smoke and then exhaling it into another individual's mouth, a practice with the potential for the efficient transmission of respiratory pathogens. Three hundred fifty-four drug users (239 from a syringe exchange and 115 from a drug detoxification program) were interviewed about shotgunning and screened for tuberculosis (TB). Fifty-nine (17%; 95% CI 12.9%-20.9%) reported shotgunning while smoking crack cocaine (68%), marijuana (41%), or heroin (2%). In multivariate analysis, age alcohol to intoxication (OR 2.2, 95% CI 1.1-4.3), having engaged in high-risk sex (OR 2.6, 95% CI 1.04-6.7), and crack use (OR 6.0, 95% CI 3.0-12) were independently associated with shotgunning. Shotgunning is a frequent drug smoking practice with the potential to transmit respiratory pathogens, underscoring the need for education of drug users about the risks of specific drug use practices, and the ongoing need for TB control among active drug users.

  8. Prevalence of Sexual Violence and its Association with Depression among Male and Female Patients with Risky Drug Use in Urban Federally Qualified Health Centers.

    Science.gov (United States)

    Bone, Curtis W; Goodfellow, Amelia M; Vahidi, Mani; Gelberg, Lillian

    2018-02-01

    Sexual violence (SV) is common; however, the prevalence of SV and its long term sequela vary geographically and among subpopulations within the USA. As such, the aims of this study are the following: (1) to determine the prevalence of SV, (2) to identify correlates of SV, and (3) to determine if SV is associated with depression among male and female risky drug users in urban Federally Qualified Health Centers (FQHCs) in Los Angeles. This study includes adult patients of five urban FQHCs who self-reported risky drug use. We identified survivors of SV and those experiencing depression through survey questions that queried, before or after age 18, "Were you ever sexually assaulted, molested or raped?" and with the RAND Mental Health Index (MHI-5). We utilized Pearson's chi-square tests to assess predictors of SV and logistic regression to assess for an association between SV and depression. Data collection took place from February 2011 to November 2012. Of the 334 study patients, 49% of females and 25% of males reported surviving SV. Exposure to SV, (both before 18 years of age and after 18 years of age) was the strongest predictor of depression among men and women in this study (OR 4.7, p < 0.05). These data demonstrate that sexual violence is prevalent in this urban FQHC population and is strongly associated with depression. Providers should consider screening both men and women with risky drug use for SV while health systems should continue to align mental health and primary care services to appropriately care for these extremely vulnerable patients. Trial Registration Clinical Trials. gov ID NCT01942876, Protocol ID DESPR DA022445, http://www.clinicaltrials.gov.

  9. [Drug regulation: theory and practice].

    Science.gov (United States)

    Zara Yahni, C; Segú Tolsa, L; Font Pous, M; Rovira, J

    1998-01-01

    Regulation of drugs from the public administration is an activity which is produced in different countries independently from the sanitary model they own. In the field of public financing of drugs there have been several measures to improve the efficiency of their use. However, the analysis of the impact of these measures is complex and this may justify the shortage of objectivable results, especially at long term. The objective of this study is to perform a systematic review of such measures due to the need to have information about the different alternatives before making a decision. The introduction of an isolated measure is in many cases compensated by other changes in other regulating or aiding fields which suggests the creation of an integral strategy which affects different fields (supply/demand of drugs and prescribers). It seems necessary to suggest a social debate taking as a basis the scientific information available at the moment and promote the taking of decisions which lead to a rational use of the available pharmacological resources.

  10. Raising Backyard Poultry in Rural Bangladesh: Financial and Nutritional Benefits, but Persistent Risky Practices

    DEFF Research Database (Denmark)

    Shanta, I. S.; Hasnat, Md A.; Zeidner, N.

    2016-01-01

    Poultry is commonly raised by households in rural Bangladesh. In 2007, the Government of Bangladesh began a mass media campaign to disseminate 10 recommended precautions to prevent transmission of H5N1 from poultry to humans. This longitudinal study explored the contribution of backyard poultry...... interviewed the raisers to collect data on poultry-raising practices. They followed the raisers for 2–12 months to collect data on household income and nutrition from poultry. Income from backyard poultry flocks accounted for 2.8% of monthly household income. Return on annual investment (ROI) per flock...... handling poultry. Only 3% reported poultry illness and deaths to local authorities. These reported practices did not improve during the study period. Raising backyard poultry in rural Bangladesh provides important income and nutrition with an excellent ROI. Government recommendations to reduce the risk...

  11. Raising Backyard Poultry in Rural Bangladesh: Financial and Nutritional Benefits, but Persistent Risky Practices.

    Science.gov (United States)

    Shanta, I S; Hasnat, Md A; Zeidner, N; Gurley, E S; Azziz-Baumgartner, E; Sharker, M A Y; Hossain, K; Khan, S U; Haider, N; Bhuyan, A A; Hossain, Md A; Luby, S P

    2017-10-01

    Poultry is commonly raised by households in rural Bangladesh. In 2007, the Government of Bangladesh began a mass media campaign to disseminate 10 recommended precautions to prevent transmission of H5N1 from poultry to humans. This longitudinal study explored the contribution of backyard poultry on household economy and nutrition and compared poultry-raising practices to government recommendations. From 2009 to 2012, we enrolled a nationally representative sample of 2489 primary backyard poultry raisers from 115 rural villages selected by probability proportional to population size. Researchers interviewed the raisers to collect data on poultry-raising practices. They followed the raisers for 2-12 months to collect data on household income and nutrition from poultry. Income from backyard poultry flocks accounted for 2.8% of monthly household income. Return on annual investment (ROI) per flock was 480%. Yearly, median family consumption of eggs was one-fifth of the total produced eggs and three poultry from their own flock. Respondents' reported practices conflicted with government recommendations. Sixty per cent of raisers had never heard of avian influenza or 'bird flu'. Among the respondents, 85% handled sick poultry or poultry that died due to illness, and 49% slaughtered or defeathered sick poultry. In 37% of households, children touched poultry. Fifty-eight per cent never washed their hands with soap after handling poultry, while poultry. Only 3% reported poultry illness and deaths to local authorities. These reported practices did not improve during the study period. Raising backyard poultry in rural Bangladesh provides important income and nutrition with an excellent ROI. Government recommendations to reduce the risk of avian influenza transmission did not impact the behaviour of poultry producers. Further research should prioritize developing interventions that simultaneously reduce the risk of avian influenza transmission and increase productivity of

  12. Cardiovascular drugs in anaesthetic practice

    NARCIS (Netherlands)

    Schwarte, Lothar A.; Loer, S.A.; Wietasch, Johann; Scheeren, TWL

    This two-volume work of 91 chapters covers all aspects of practice in anaesthesia. Volume 1 addresses the underpinning sciences of anaesthesia including physiology, pharmacology, physics, anaesthetic equipment, statistics, and evidence-based anaesthesia. Volume 1 also outlines the fundamental

  13. Australia's evolving food practices: a risky mix of continuity and change.

    Science.gov (United States)

    Venn, Danielle; Banwell, Cathy; Dixon, Jane

    2017-10-01

    To investigate trends in five key aspects of Australian food practice which have been implicated in diet-related health risks, specifically energy intake. They are: the replacement of home-prepared foods by commercially prepared foods; consumer reliance on ultra-processed foods; de-structured dining; increased pace of eating; and a decline in commensal eating. Data were from repeated cross-sections from the national Household Expenditure and Time Use Surveys. Trends in food practice aspects were examined using indicators of food expenditure across different food groups and time spent eating and cooking, including where, when and with whom eating activities took place. Australia, 1989-2010. Nationally representative samples of Australian households. The share of the total food budget spent on food away from home rose steadily from 22·8 % in 1989 to 26·5 % in 2010, while spending on ultra-processed foods increased. The basic patterning of meals and the pace of eating changed little, although people spent more time eating alone and at restaurants. Cooking time declined considerably, particularly for women. These changes have occurred over the same time that obesity and diet-related, non-communicable diseases have increased rapidly in Australia. Some aspects are implicated more than others: particularly the shift from domestic cooking to use of pre-prepared and ultra-processed foods, a reduction in time spent in food preparation and cooking, as well as an upsurge in time and money devoted to eating away from home. These are all likely to operate through the higher energy content of commercially prepared, compared with unprocessed or lightly processed, foods.

  14. Discontinuation of Preventive Drugs in General Practice

    DEFF Research Database (Denmark)

    Andersen, John Sahl; Lindberg, Laura Maria Glahder; Nixon, Michael Simon

    Introduction: In Denmark about 600,000 persons are treated for hypertension and more than 300,000 people are receiving cholesterol lowering drugs. The prevalence of hypertension in people aged 80 years is 70%. For antidepressants the defined daily doses/1000 aged >80 years/day exceed 200. By far...... the most preventive drugs are prescribed in general practice. Special considerations exist in relation to medication of elderly patients. The prevalence of polypharmacy and the subsequent increased risk of side effects and drug interactions is high. Drug-related problems represent the fifth leading cause...... of death in the United States. The public expenses to drug treatment are constantly increasing. The possibility to withdraw the medication must be taken into account but the decision to discontinue drugs is complex and poorly understood. Planned studies: 1. Patients’ views upon discontinuation...

  15. Strategies for a risky business: How drug dealers manage customers, suppliers and competitors in Italy, Slovenia and Germany.

    Science.gov (United States)

    Tzvetkova, Marina; Pardal, Mafalda; Disley, Emma; Rena, Alice; Talic, Sanela; Forberger, Sarah

    2016-05-01

    the day-to-day operational concerns and modes of relationship management. Interviewees' arrangements for securing supplies of drugs provide support to the notion that drug markets are resilient and flexible. Our findings correspond with other empirical research in relation to the centrality of trust in the practical operation of supply and sale of drugs. The research highlights some differences, but important similarities between dealers who were part of organised crime groups and those who were not; dealers all faced some common challenges and adopted some common responses to these. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. Association of Indoor Tanning Frequency With Risky Sun Protection Practices and Skin Cancer Screening.

    Science.gov (United States)

    Fischer, Alexander H; Wang, Timothy S; Yenokyan, Gayane; Kang, Sewon; Chien, Anna L

    2016-10-12

    Indoor tanning is prevalent among young adults and women and is associated with increased risk of melanoma. Evidence suggests that indoor tanners may be more inclined to adopt poor photoprotective practices that further increase their risk of skin cancer; however, gaps in the literature exist in young adults and by indoor tanning frequency. To examine the association between indoor tanning frequency and behaviors related to skin cancer prevention and to investigate whether these associations vary by age group or sex. Cross-sectional population-based study of US 2015 National Health Interview Survey data including 10 262 non-Hispanic white adults aged 18 to 60 years without a history of skin cancer. Rare/never use of sunscreen, protective clothing, shade; multiple sunburns within the past year; previous full-body skin examination. Of the 10 262 individuals in our study population (49% female; median age, 39 y), 787 (7.0%) reported having tanned indoors in the past year. Among individuals aged 18 to 34 years, frequent indoor tanners (≥10 times in the past year) were more likely to report never/rare use of protective clothing (adjusted prevalence ratio [aPR], 1.28; 95% CI, 1.10-1.49) and shade (aPR, 1.32; 95% CI, 1.03-1.70), compared with individuals who did not tan indoors. Among women aged 18 to 60 years, those who frequently tanned indoors were more likely to rarely/never use sunscreen (aPR, 1.34; 95% CI, 1.11-1.62), protective clothing (aPR, 1.27; 95% CI, 1.15-1.42), and shade (aPR, 1.54; 95% CI, 1.25-1.90) on a warm sunny day, as well as more likely to report multiple sunburns in the past year (aPR, 1.21; 95% CI, 1.00-1.45) compared with those who did not tan indoors. Individuals who tanned indoors in the past year were not significantly more likely to have undergone a previous full-body skin examination in any subpopulation examined. Individuals who tan indoors often exhibited a concurrent tendency to sunburn, avoid sun protection, and avoid skin cancer

  17. Risky markets

    International Nuclear Information System (INIS)

    Hammond, G.

    1998-01-01

    The Export Development Corporation (EDC) supports Canadian exporters and investors in international projects by providing export credit insurance for commodities and by providing financing for projects ranging from chemical plants to pipeline projects. EDC has been an active participant in financing projects in 'risky markets' in China, Columbia, India, Indonesia, Mexico, Russia and Venezuela. This presentation reviewed the origins and dimensions of the Asian crisis and how the spillover effects are showing up in most regions of the world. It was suggested that the factors which contributed to the crisis were: (1) growing macroeconomic imbalances, (2) excessive private capital inflows financing risky and low-profitability ventures, (3) financial sector mismanagement, (4) political uncertainty, and (5) decline in investor confidence. The Asian financial crisis will affect other developing countries in the following ways: (1) shrinking foreign private capital flows, (2) widening spreads for foreign and private borrowers, (3) reduced trade volumes due to import compression, (4) lower prices for traded goods, (5) depressed international interest rates. As a result of the Asian crisis, banks in Japan, Korea, Singapore, Europe and North America have cancelled or restructured several billion dollars in loans. Several projects are now under review, have been delayed or cancelled. It was suggested that significant changes in risk management strategies must be made in order for the countries of Asia to restructure their economies. Putting an end to 'cronyism' establishing well-supervised banking, legal and court systems that are up-to-date and transparent, are also essential ingredients of recovery

  18. Recreational Drug Use among Chinese Men Who Have Sex with Men: A Risky Combination with Unprotected Sex for Acquiring HIV Infection

    Directory of Open Access Journals (Sweden)

    Jun-Jie Xu

    2014-01-01

    Full Text Available Objective. To investigate the prevalence of recreational drug use and its relationship with HIV infection among Chinese MSM. Methods. A cross-sectional study of 625 MSM was conducted in Shenyang, China. Questionnaires were administered to collect information on recreational drug use and sexual behaviors. Blood specimens were collected to test for HIV and syphilis antibodies. Results. Nearly a quarter (23.2%, 145/625 of participants reported ever using recreational drugs, among which alkyl nitrites (poppers was the most frequently used drug (19.2%, followed by methylmorphine phosphate (5.1%, methamphetamine (4.0%, and ketamine (0.8%. The overall prevalence of HIV and syphilis was 9.6% and 10.4%, respectively. Multivariate logistic analysis showed that recreational drug use was significantly correlated with age ≤25 year (adjusted odds ratio [aOR] = 1.6, 95% CI, 1.1–2.9, single marital status (aOR = 2.1, 95% CI, 1.2–3.6, and seeking male sexual partners mainly through Internet (aOR = 1.8, 95% CI, 1.8–2.8. Recreational drug use was independently associated with an increased risk of HIV infection (aOR = 3.5, 95% CI, 2.0–6.2. Conclusions. Our study suggests that recreational drug use is popular among Chinese MSM and is associated with significantly increased HIV infection risk. HIV prevention intervention programs should reduce both drug use and risky sexual behaviors in this population.

  19. Recreational Drug Use among Chinese Men Who Have Sex with Men: A Risky Combination with Unprotected Sex for Acquiring HIV Infection

    Science.gov (United States)

    Xu, Jun-Jie; Qian, Han-Zhu; Chu, Zhen-Xing; Zhang, Jing; Hu, Qing-Hai; Jiang, Yong-Jun; Geng, Wen-Qing; Zhang, Christiana Meng; Shang, Hong

    2014-01-01

    Objective. To investigate the prevalence of recreational drug use and its relationship with HIV infection among Chinese MSM. Methods. A cross-sectional study of 625 MSM was conducted in Shenyang, China. Questionnaires were administered to collect information on recreational drug use and sexual behaviors. Blood specimens were collected to test for HIV and syphilis antibodies. Results. Nearly a quarter (23.2%, 145/625) of participants reported ever using recreational drugs, among which alkyl nitrites (poppers) was the most frequently used drug (19.2%), followed by methylmorphine phosphate (5.1%), methamphetamine (4.0%), and ketamine (0.8%). The overall prevalence of HIV and syphilis was 9.6% and 10.4%, respectively. Multivariate logistic analysis showed that recreational drug use was significantly correlated with age ≤25 year (adjusted odds ratio [aOR] = 1.6, 95% CI, 1.1–2.9), single marital status (aOR = 2.1, 95% CI, 1.2–3.6), and seeking male sexual partners mainly through Internet (aOR = 1.8, 95% CI, 1.8–2.8). Recreational drug use was independently associated with an increased risk of HIV infection (aOR = 3.5, 95% CI, 2.0–6.2). Conclusions. Our study suggests that recreational drug use is popular among Chinese MSM and is associated with significantly increased HIV infection risk. HIV prevention intervention programs should reduce both drug use and risky sexual behaviors in this population. PMID:24829916

  20. Drug users in contact with general practice.

    Science.gov (United States)

    Robertson, J R

    1985-01-05

    A group of heroin users who are in contact with a general practice in north west Edinburgh are described. The study group was younger and included more women than previous studies. These people used a large variety of drugs and mainly purchased them locally. Frequent and often prolonged abstinent periods occurred with no prescribed opiate treatment. The group had experienced a high rate of drug related medical disorders. All these points raise the possibility that opiate users who are known to general practitioners may be a distinctly different population from those who attend drug dependency clinics. The frequency of remission and the prevalence of polydrug use have profound implications for planning and evaluating an effective medical response.

  1. Assessing the Knowledge Level, Attitudes, Risky Behaviors and Preventive Practices on Sexually Transmitted Diseases among University Students as Future Healthcare Providers in the Central Zone of Malaysia: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Adigun Temiloluwa Folasayo

    2017-02-01

    Full Text Available This study was done to assess the knowledge, attitudes, risky behaviors and preventive practices related to sexually-transmitted diseases (STDs among health and non-health sciences university students as future healthcare providers in Malaysia. A total of 700 health and non-health sciences university students (255 male; 445 female aged between 17 and 30 years were surveyed by using a self-administered questionnaire. The majority (86.6% had heard of STDs, and 50.4% knew STDs could present without symptoms. HIV remains the best known STD (83.6% by the students, while chlamydia (26% and trichomoniasis (21.0% were rarely known. Gender, age group, educational level and faculty type were strongly associated with knowledge level (p-values < 0.05. Most of them (88.8% were aware that STD screening was important while use of condoms was protective (63.8%. The majority of them strongly felt that treatment should be sought immediately if they (85.5% and their partners (87.4% have symptoms. Among the sexually-active students, 66.7% and 18% had sexual intercourse with multiple partners and commercial sex workers, while 17.4% and 9.4% took alcohol and drugs before having sex, respectively. By logistic regression analysis, students aged 24–30 years old (an odds ratio (AOR = 0.57, 95% confidence interval (CI = 0.377–0.859 and faculty type (AOR = 5.69, 95% CI = 4.019–8.057 were the significant predictors for the knowledge level. Knowledge on the non-HIV causes of STDs is still lacking, and the risky behavior practiced by the sexually-active students in this study is alarming. There is a need to revisit the existing STD education curriculum in both schools and universities so that appropriate intervention on STDs can be implemented.

  2. Assessing the Knowledge Level, Attitudes, Risky Behaviors and Preventive Practices on Sexually Transmitted Diseases among University Students as Future Healthcare Providers in the Central Zone of Malaysia: A Cross-Sectional Study.

    Science.gov (United States)

    Folasayo, Adigun Temiloluwa; Oluwasegun, Afolayan John; Samsudin, Suhailah; Saudi, Siti Nor Sakinah; Osman, Malina; Hamat, Rukman Awang

    2017-02-08

    This study was done to assess the knowledge, attitudes, risky behaviors and preventive practices related to sexually-transmitted diseases (STDs) among health and non-health sciences university students as future healthcare providers in Malaysia. A total of 700 health and non-health sciences university students (255 male; 445 female) aged between 17 and 30 years were surveyed by using a self-administered questionnaire. The majority (86.6%) had heard of STDs, and 50.4% knew STDs could present without symptoms. HIV remains the best known STD (83.6%) by the students, while chlamydia (26%) and trichomoniasis (21.0%) were rarely known. Gender, age group, educational level and faculty type were strongly associated with knowledge level ( p -values students, 66.7% and 18% had sexual intercourse with multiple partners and commercial sex workers, while 17.4% and 9.4% took alcohol and drugs before having sex, respectively. By logistic regression analysis, students aged 24-30 years old (an odds ratio (AOR) = 0.57, 95% confidence interval (CI) = 0.377-0.859) and faculty type (AOR = 5.69, 95% CI = 4.019-8.057) were the significant predictors for the knowledge level. Knowledge on the non-HIV causes of STDs is still lacking, and the risky behavior practiced by the sexually-active students in this study is alarming. There is a need to revisit the existing STD education curriculum in both schools and universities so that appropriate intervention on STDs can be implemented.

  3. Drugs + HIV, Learn the Link

    Medline Plus

    Full Text Available ... related risk behaviors, including drug injection and unsafe sexual practices. Drug use disorder treatment programs also serve an important role in ... increasingly at risk for HIV infection through risky sexual behaviors. NIDA ... of the disease. Since the epidemic began, injection drug use has ...

  4. Risky business: focus-group analysis of sexual behaviors, drug use and victimization among incarcerated women in St. Louis.

    Science.gov (United States)

    Millay, Tamara A; Satyanarayana, Veena A; O'Leary, Catina C; Crecelius, Robert; Cottler, Linda B

    2009-09-01

    Incarcerated women report multiple vulnerabilities and, yet, are under-represented in research. This study used focus-group methodology to explore high-risk sexual behaviors, drug use, and victimization among female offenders in St. Louis. Inmates of the St. Louis Medium Security Institution (MSI) were invited to participate in one of five focus groups between May and September 2005 in preparation for an NIH/NINR HIV-prevention intervention study among female offenders in Drug Court. The focus group sample of 30 women was 70% African-American, with a mean age of 36 years. Results indicated that oral sex was the most common sex trade activity. Consistent with the literature, condom usage was described as irregular. In terms of drug use, participants reported that crack was most commonly used, with binges often lasting for several days. Regarding victimization, women frequently reported sexual abuse in childhood, and some described abusive relationships as adults. Participants also reported being beaten and raped by customers, which led to their concealing knives in purses and razors under the tongue. Consequently, perpetrated violence, including murder, was reported as protection against further violence. These findings confirm the vulnerability of this population of women who are at high risk for HIV. Effective HIV-prevention interventions are needed to assist these incarcerated women in making lifestyle changes during incarceration and sustaining them after release.

  5. Drug choice in medical practice : rationales, routines and remedies

    NARCIS (Netherlands)

    Denig, Petra

    1994-01-01

    The aim of the studies presented in this dissertation is to describe and analyse drug choice in medical practice, and provide a better understanding of the possible shortcomings and the role of biomedical knowledge in the drug choice process.

  6. Off-Label Drug Use in Pediatric Practice: Unsolved Problems

    Directory of Open Access Journals (Sweden)

    A. R. Titova

    2015-01-01

    Full Text Available The widespread «off-label» drug use and the prescribing of unlicensed medicines in pediatric practice is a major health problem. The authors discuss actual regulatory and legal issues of «off-label» drug use in children in the US, Europe and Russia. The results of different population-based studies from many countries, showing the structure and frequency of «off-label» drug use in children, are summarized in this article. It is shown that such practice increases the risk of adverse drug reactions. The authors offer practical recommendations for a safer use of drugs in pediatric practice. The priority issue is conducting high quality clinical trials with the participation of children, improving national pharmacovigilance and the monitoring of off-label drug use, developing pediatric formularies, improving doctors’ knowledge and awareness of safety and efficacy of medicines in pediatric population.

  7. Clinical practice - Drug desensitization in children

    NARCIS (Netherlands)

    de Groot, H.; Mulder, W.M.C.

    2010-01-01

    Immediate type allergic reactions to medication are potentially life threatening and can hamper drug therapy of several medical conditions. Exact incidence and prevalence data for these reactions in children are lacking. If no alternative drug treatment is available, a desensitization procedure may

  8. Risk factors for potential drug interactions in general practice

    DEFF Research Database (Denmark)

    Bjerrum, Lars; Gonzalez Lopez-Valcarcel, Beatriz; Petersen, Gert

    2008-01-01

    interactions during 1 year. Patient factors associated with increased risk of potential drug interactions were high age, a high number of concurrently used drugs, and a high number of prescribers. Practice factors associated with potential drug interactions were a high percentage of elderly patients and a low......Objective: To identify patient- and practice-related factors associated with potential drug interactions. Methods: A register analysis study in general practices in the county of Funen, Denmark. Prescription data were retrieved from a population-based prescription database (Odense University......, depending on the severity of outcome and the quality of documentation. A two-level random coefficient logistic regression model was used to investigate factors related to potential drug interactions. Results: One-third of the population was exposed to polypharmacy, and 6% were exposed to potential drug...

  9. Implicit attitudes towards risky and safe driving

    DEFF Research Database (Denmark)

    Martinussen, Laila Marianne; Sømhovd, Mikael Julius; Møller, Mette

    ; further, self-reports of the intention to drive safely (or not) are socially sensitive. Therefore, we examined automatic preferences towards safe and risky driving with a Go/No-go Association Task (GNAT). The results suggest that (1) implicit attitudes towards driving behavior can be measured reliably...... with the GNAT; (2) implicit attitudes towards safe driving versus towards risky driving may be separable constructs. We propose that research on driving behavior may benefit from routinely including measures of implicit cognition. A practical advantage is a lesser susceptibility to social desirability biases......, compared to self-report methods. Pending replication in future research, the apparent dissociation between implicit attitudes towards safe versus risky driving that we observed may contribute to a greater theoretical understanding of the causes of unsafe and risky driving behavior....

  10. The Effectiveness of the Harm Reduction Group Therapy Based on Bandura's Self-Efficacy Theory on Risky Behaviors of Drug-Dependent Sex Worker Women.

    Science.gov (United States)

    Rabani-Bavojdan, Marjan; Rabani-Bavojdan, Mozhgan; Rajabizadeh, Ghodratollah; Kaviani, Nahid; Bahramnejad, Ali; Ghaffari, Zohreh; Shafiei-Bafti, Mehdi

    2017-07-01

    The aim of this study was to investigate the effectiveness of the harm reduction group therapy based on Bandura's self-efficacy theory on risky behaviors of sex workers in Kerman, Iran. A quasi-experimental two-group design (a random selection with pre-test and post-test) was used. A risky behaviors questionnaire was used to collect. The sample was selected among sex workers referring to drop-in centers in Kerman. Subjects were allocated to two groups and were randomly classified into two experimental and control groups. The sample group consisted of 56 subjects. The experimental design was carried out during 12 sessions, and the post-test was performed one month and two weeks after the completion of the sessions. The results were analyzed statistically. By reducing harm based on Bandura's self-efficacy theory, the risky behaviors of the experimental group, including injection behavior, sexual behavior, violence, and damage to the skin, were significantly reduced in the pre-test compared to the post-test (P group therapy based on Bandura's self-efficacy theory can reduce the risky behaviors of sex workers.

  11. `Risky fun' or `Authentic science'? How teachers' beliefs influence their practice during a professional development programme on outdoor learning

    Science.gov (United States)

    Glackin, Melissa

    2016-02-01

    Teaching outdoors has been established as an important pedagogical strategy; however, science classes rarely take place outside. Previous research has identified characteristics of teachers who have integrated out-of-classroom opportunities into their teaching repertoire; yet little is understood as to why teachers make these different pedagogical decisions. This paper explores the relationship between secondary science teachers' beliefs and their pedagogical practice during a two-year professional development programme associated with the 'Thinking Beyond the Classroom' project. Using data from lesson observations, interviews, session questionnaires and field notes, six teacher case studies were developed from participants completing the programme. Data analysis reveals that teachers who successfully taught outside generally held social constructivist beliefs about learning and valued 'authentic' science opportunities. Conversely, teachers who were less successful in teaching outside generally held traditional learning beliefs and simply valued the outdoors for the novelty and potential for fun. All the case study teachers were concerned about managing student learning outside, and for the majority, their concerns influenced their subsequent pedagogical practice. The findings are discussed in detail, as are the implications for pre-service and in-service professional development programmes related to outdoor science learning.

  12. Improving drug treatment in general practice

    NARCIS (Netherlands)

    Veninga, CCM; Denig, P; Zwaagstra, R; Haaijer-Ruskamp, FM

    In the international Drug Education Project, an educational program involving auditing and feedback in peer groups to improve the treatment of asthma and urinary tract infections (UTI) was developed and tested in primary care. Individualized feedback was provided and discussed in 24 Dutch peer

  13. Knowledge, Attitude and Practice of Adverse Drug Reaction ...

    African Journals Online (AJOL)

    Erah

    . Keywords: Adverse drug reactions; Knowledge, attitude and practice; Health care workers; Yellow card reporting scheme. Received: 24 August 2010. Revised accepted: 22 April 2011. *Corresponding author: E-mail: jofadare@gmail.com ...

  14. Patterns of drug use among a sample of drug users and injecting drug users attending a General Practice in Iran

    Directory of Open Access Journals (Sweden)

    Shakeshaft Anthony

    2006-01-01

    Full Text Available Abstract Aim This study aimed to examine drug use, drug treatment history and risk behaviour among a sample of Iranian drug users seeking treatment through a general practice clinic in Iran. Methods Review of medical records and an intake questionnaire at a large general practice in Marvdasht, Iran, with a special interest in drug dependence treatment. Records from a random sample of injecting drug users (IDU, non-injecting drug users (DU and non-drug using patients were examined. Results 292 records were reviewed (34% IDU, 31% DU and 35% non-drug users. Eighty-three percent were males; all females were non-drug users. The mean age of the sample was 30 years. Of the IDU sample, 67% reported sharing a needle or syringe, 19% of these had done so in prison. Of those who had ever used drugs, being 'tired' of drug use was the most common reason for seeking help (34%. Mean age of first drug use was 20 years. The first drugs most commonly used were opium (72%, heroin (13% and hashish/ other cannabinoids (13%. Three quarters reported having previously attempted to cease their drug use. IDU were more likely than DU to report having ever been imprisoned (41% vs 7% and 41% to have used drugs in prison. Conclusion This study has shown that there is a need for general practice clinics in Iran to treat drug users including those who inject and that a substantial proportion of those who inject have shared needles and syringes, placing them at risk of BBVI such as HIV and hepatitis C. The expansion of services for drug users in Iran such as needle and syringe programs and pharmacotherapies are likely to be effective in reducing the harms associated with opium use and heroin injection.

  15. Frequent Nonprescription Stimulant Use and Risky Behaviors in College Students: The Role of Effortful Control

    Science.gov (United States)

    Reid, Adam M.; Graziano, Paulo A.; Balkhi, Amanda M.; McNamara, Joseph P. H.; Cottler, Linda B.; Meneses, Evander; Geffken, Gary R.

    2015-01-01

    Objective: The goal of this study was to (a) investigate the association between nonprescription stimulant use (NPSU) and risky behaviors, including risky sex, driving, financial behaviors, and drug use and (b) collect preliminary evidence on mechanisms that may link NPSU to risky behaviors. Participants: A sample of 555 college students was…

  16. "A'ole" Drugs! Cultural Practices and Drug Resistance of Rural Hawai'ian Youths

    Science.gov (United States)

    Po'A-Kekuawela, Ka'Ohinani; Okamoto, Scott K.; Nebre, La Risa H.; Helm, Susana; Chin, Coralee I. H.

    2009-01-01

    This qualitative study examined how Native Hawai'ian youths from rural communities utilized cultural practices to promote drug resistance and/or abstinence. Forty-seven students from five different middle schools participated in gender-specific focus groups that focused on the cultural and environmental contexts of drug use for Native Hawai'ian…

  17. Risky behaviours among university students in Italy

    Directory of Open Access Journals (Sweden)

    Andrea Poscia

    2015-06-01

    Full Text Available BACKGROUND: The use of psychoactive substances is one of the most important public health issues. Tobacco, alcohol and illicit drugs are among the top risk factors for ill-health defined by World Health Organisation. The risky behaviours acquired in teenage can be magnified or decreased during university when a person starts having more awareness about the importance of own wellness. This paper describes the results of the project "Sportello Salute Giovani" ("Youth Health Information Desk" with respect to risky behaviours in a large sample of Italian university students. MATERIALS AND METHODS: 18 questions of the survey "Sportello Salute Giovani" dealing with risky behaviors, the use of psychoactive substances such as tobacco, alcohol and illicit drugs were included. Absolute and relative frequencies were calculated. Besides, chi square test were used to test the differences in sex, age class and socio-economic status. RESULTS: About 24% of the interviewed students currently smokes. 89% and 42.2% respectively drinks at least rarely or weekly beer, wine or spirits. About 40% of students smoked at least a joint and about 2% used other drugs (mostly cocaine. CONCLUSION: The "Sportello Salute Giovani" survey suggests that the frequency of risky behaviours in Italian university students is not reassuring, although they should be aware about the negative consequences on their and others health because of their educational level.

  18. Resiliency as a factor protecting youths from risky behaviour: Moderating effects of gender and sport.

    Science.gov (United States)

    Lipowski, Mariusz; Lipowska, Małgorzata; Jochimek, Magdalena; Krokosz, Daniel

    2016-01-01

    We hypothesised that resiliency may protect adolescents against risky behaviours, and that both the practicing of sports, and gender are moderating variables in relationships between resiliency and risky behaviours. The study included 18-year-old pupils from a selection of secondary schools (n = 556). A total of 188 individuals practiced competitive sports and the remaining 368 participants were non-athletes. The participants were examined with the Resiliency Assessment Scale for Children and Adolescents (SPP-18) and with a survey containing questions and statements related to high-risk "experiments with adulthood". Adolescent athletes showed higher levels of resiliency than their peers. The power of the "Determination and Persistence in Action" effect on "Alcohol" scale differed significantly between male athletes and male non-athletes. Only in the athletes groups were higher scores on this scale reflected by lower values on the "Drugs" scale. Moreover, it is possible to observe differences in undertaking risky behaviour between male and female athletes. The analysis of risky sexual behaviour suggests that sport is a risk factor for men, and a protective factor for women. These data suggest that consistent prophylactic and psycho-educative activities, with a special attention to differences between genders, should be provided to all the adolescents, irrespective of their sport performance levels.

  19. Prescribing in prison: minimizing psychotropic drug diversion in correctional practice.

    Science.gov (United States)

    Pilkinton, Patricia D; Pilkinton, James C

    2014-04-01

    Correctional facilities are a major provider of mental health care throughout the United States. In spite of the numerous benefits of providing care in this setting, clinicians are sometimes concerned about entering into correctional care because of uncertainty in prescribing practices. This article provides an introduction to prescription drug use, abuse, and diversion in the correctional setting, including systems issues in prescribing, commonly abused prescription medications, motivation for and detection of prescription drug abuse, and the use of laboratory monitoring. By understanding the personal and systemic factors that affect prescribing habits, the clinician can develop a more rewarding correctional practice and improve care for inmates with mental illness.

  20. Assessing the Knowledge Level, Attitudes, Risky Behaviors and Preventive Practices on Sexually Transmitted Diseases among University Students as Future Healthcare Providers in the Central Zone of Malaysia: A Cross-Sectional Study

    OpenAIRE

    Folasayo, Adigun Temiloluwa; Oluwasegun, Afolayan John; Samsudin, Suhailah; Saudi, Siti Nor Sakinah; Osman, Malina; Hamat, Rukman Awang

    2017-01-01

    This study was done to assess the knowledge, attitudes, risky behaviors and preventive practices related to sexually-transmitted diseases (STDs) among health and non-health sciences university students as future healthcare providers in Malaysia. A total of 700 health and non-health sciences university students (255 male; 445 female) aged between 17 and 30 years were surveyed by using a self-administered questionnaire. The majority (86.6%) had heard of STDs, and 50.4% knew STDs could present w...

  1. Not so risky business?

    DEFF Research Database (Denmark)

    Rapp, Carolin; Shore, Jennifer; Tosun, Jale

    2017-01-01

    This article addresses ongoing debates about whether the welfare state hinders or fosters self-employment. Starting a business can be an inherently risky undertaking and is thus not a feasible option for all people. Policies that have the potential to shoulder some of this risk can be particularly...

  2. Promising Practices in Drug Treatment: Findings from Southeast Asia

    Science.gov (United States)

    Libretto, Salvatore; Nemes, Susanna; Namur, Jenny; Garrett, Gerald; Hess, Lauren; Kaplan, Linda

    2005-01-01

    In a study to evaluate the drug treatment and aftercare efforts sponsored by the State Department's International Narcotics and Law Enforcement Affairs Bureau, residential Therapeutic Community (TC) treatment programs in three countries in Southeast Asia--Malaysia, Singapore, and Thailand--were examined to identify promising practices and to…

  3. Frequent nonprescription stimulant use and risky behaviors in college students: the role of effortful control.

    Science.gov (United States)

    Reid, Adam M; Graziano, Paulo A; Balkhi, Amanda M; McNamara, Joseph P H; Cottler, Linda B; Meneses, Evander; Geffken, Gary R

    2015-01-01

    The goal of this study was to (a) investigate the association between nonprescription stimulant use (NPSU) and risky behaviors, including risky sex, driving, financial behaviors, and drug use and (b) collect preliminary evidence on mechanisms that may link NPSU to risky behaviors. A sample of 555 college students was collected between August 2010 and February 2012. Students completed several self-report measures assessing their drug use history, attention-deficit and hyperactivity symptoms, temperament, and risky behaviors beyond drug use. Those who reported more frequent NPSU were more likely to engage in high-risk behavior across all 4 domains studied. Further, effortful control abilities partially mediated the link between NPSU and risky behaviors. These results highlight the associated risks of frequent NPSU for college students as well as provide future directions for examining effortful control as a potentially important mechanism linking NPSU to other risky behaviors.

  4. Young Risk Takers: Alcohol, Illicit Drugs, and Sexual Practices among a Sample of Music Festival Attendees

    Science.gov (United States)

    Jenkinson, Rebecca; Bowring, Anna; Dietze, Paul; Hellard, Margaret; Lim, Megan S. C.

    2014-01-01

    Background. Alcohol and other drug use and sexual risk behaviour are increasing among young Australians, with associated preventable health outcomes such as sexually transmissible infections (STIs) on the rise. Methods. A cross-sectional study of young people's health behaviours conducted at a music festival in Melbourne, Australia, in 2011. Results. 1365 young people aged 16–29 completed the survey; 62% were female with a mean age of 20 years. The majority (94%, n = 1287) reported drinking alcohol during the previous 12 months; among those, 32% reported “binge” drinking (6+ drinks) at least weekly. Half (52%) reported ever using illicit drugs and 25% reported past month use. One-quarter (27%) were identified as being at risk of STIs through unprotected sex with new or casual partners during the previous 12 months. Multivariable analyses found that risky sexual behaviour was associated with younger age (≤19 years), younger age of sexual debut (≤15 years), having discussed sexual health/contraception with a doctor, regular binge drinking, and recent illicit drug use. Conclusion. Substance use correlated strongly with risky sexual behaviour. Further research should explore young people's knowledge of alcohol/drug-related impairment and associated risk-taking behaviours, and campaigns should encourage appropriate STI testing among music festival attendees. PMID:26316974

  5. Are Drinkers Prone to Engage in Risky Sexual Behaviors?

    OpenAIRE

    Ana I. Gil Lacruz; Marta Gil Lacruz; Juan Oliva

    2009-01-01

    Sexually transmitted diseases pose an important public health problem around the world. Although many studies have explored the link between alcohol use and risky sexual practices, the unobserved differences among individuals make it difficult to assess whether the associations are casual in nature. In order to overcome these difficulties, we have obtained data from the Spanish Health and Sexual Behavior Survey (2003) in order to analyze risky sexual behaviors using four alternative methodolo...

  6. 21 CFR 212.2 - What is current good manufacturing practice for PET drugs?

    Science.gov (United States)

    2010-04-01

    ..., holding, or distribution of PET drugs intended for human use. Current good manufacturing practice is... 21 Food and Drugs 4 2010-04-01 2010-04-01 false What is current good manufacturing practice for... HUMAN SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR POSITRON EMISSION...

  7. Risky Behavior, Ecstasy, and Education

    Science.gov (United States)

    Callier, Heather H.

    2011-01-01

    Ecstasy is a risky behavior that continues to be a concern in the education system today. The review of the Ecstasy literature focused on the definition of risky behavior, prevalence, and other basis aspects of Ecstasy; discovering life events that are associated with Ecstasy use, the function of this behavior, interventions for substance abuse,…

  8. Does the theory-driven program affect the risky behavior of drug injecting users in a healthy city? A quasi-experimental study.

    Science.gov (United States)

    Karimy, Mahmood; Abedi, Ahmad Reza; Abredari, Hamid; Taher, Mohammad; Zarei, Fatemeh; Rezaie Shahsavarloo, Zahra

    2016-01-01

    The horror of HIV/AIDS as a non-curable, grueling disease is a destructive issue for every country. Drug use, shared needles and unsafe sex are closely linked to the transmission of HIV/AIDS. Modification or changing unhealthy behavior through educational programs can lead to HIV prevention. The aim of this study was to evaluate the efficiency of theory-based education intervention on HIV prevention transmission in drug addicts. In this quasi-experimental study, 69 male drug injecting users were entered in to the theory- based educational intervention. Data were collected using a questionnaire, before and 3 months after four sessions (group discussions, lecture, film displaying and role play) of educational intervention. The findings signified that the mean scores of constructs (self-efficacy, susceptibility, severity and benefit) significantly increased after the educational intervention, and the perceived barriers decreased (phistory of HIV testing was reported to be 9% before the intervention, while the rate increased to 88% after the intervention. The present research offers a primary founding for planning and implementing a theory based educational program to prevent HIV/AIDS transmission in drug injecting addicts. This research revealed that health educational intervention improved preventive behaviors and the knowledge of HIV/AIDS participants.

  9. Risky business: rhesus monkeys exhibit persistent preferences for risky options.

    Science.gov (United States)

    Xu, Eric R; Kralik, Jerald D

    2014-01-01

    Rhesus monkeys have been shown to prefer risky over safe options in experiential decision-making tasks. These findings might be due, however, to specific contextual factors, such as small amounts of fluid reward and minimal costs for risk-taking. To better understand the factors affecting decision-making under risk in rhesus monkeys, we tested multiple factors designed to increase the stakes including larger reward amounts, distinct food items rather than fluid reward, a smaller number of trials per session, and risky options with greater variation that also included non-rewarded outcomes. We found a consistent preference for risky options, except when the expected value of the safe option was greater than the risky option. Thus, with equivalent mean utilities between the safe and risky options, rhesus monkeys appear to have a robust preference for the risky options in a broad range of circumstances, akin to the preferences found in human children and some adults in similar tasks. One account for this result is that monkeys make their choices based on the salience of the largest payoff, without integrating likelihood and value across trials. A related idea is that they fail to override an impulsive tendency to select the option with the potential to obtain the highest possible outcome. Our results rule out strict versions of both accounts and contribute to an understanding of the diversity of risky decision-making among primates.

  10. Knowledge, attitude and practice of drug abuse among public ...

    African Journals Online (AJOL)

    Highland Medical Research Journal ... More than 50% knew the meaning of drug abuse, the dangers in using drugs wrongly and the legal status of drug abuse. ... Drug and alcohol education should therefore be strengthened in schools ...

  11. Drug Interactions in Clinical Practice | Ohaju-Obodo | Nigerian ...

    African Journals Online (AJOL)

    The existence of numerous drugs available today for clinical management of patients require consideration of their potential interactions - alteration of the effects of one drug by the concurrent or prior administration of one or more drugs (drug-drug interactions). There could also be alteration of the effects of a drug by food ...

  12. Drugs + HIV, Learn the Link

    Medline Plus

    Full Text Available ... influence of drugs and alcohol engaged in risky sexual behavior that resulted in HIV infection. Watch the "After ... poor decision making, which can result in risky sexual behaviors and HIV infection. Although the characters are fictional, ...

  13. Injectable-antineoplastic-drug practices in Michigan hospitals.

    Science.gov (United States)

    Cohen, I A; Newland, S J; Kirking, D M

    1987-05-01

    Practices related to parenteral (injectable) antineoplastic drugs (PADs) in Michigan hospitals were surveyed. All hospitals in Michigan were surveyed to assess compliance with American Society of Hospital Pharmacists (ASHP) and Occupational Safety and Health Administration (OSHA) recommendations related to PADs. Other PAD-related practice issues not covered within those guidelines were also studied. Surveys were mailed to the pharmacy directors of the state's 192 acute-care hospitals. Included were questions concerning policies and procedures for ordering, storing, preparing, handling, labeling, transporting, administering, and disposing of PADs. Questions concerning staff education, spill cleanup, and personnel issues were also included. A total of 169 questionnaires were returned, yielding a response rate of 88%. Of those respondents, 132 indicated that they prepare PAD doses for inpatients. Adherence rates were high for several of the PAD-preparation recommendations, including handwashing (97%) and gloving (98.5%). Rates for gowning (71.2%), labeling of PAD doses as biohazards (chemical hazards) (73.5%), and use of Class II biological-safety cabinets (71.2%) were less favorable. Practice areas with relatively poor adherence rates included use of plastic-backed absorbent pads under PAD preparation areas (53.8%), storing PADs separately from other drugs (48.5%), informing prospective employees of potential risks of handling PADs (36.4%), availability of spill kits (36.4%), and attaching and priming i.v. tubing before adding PADs to i.v. containers (5.4%). Many pharmacy departments in Michigan hospitals can substantially improve their adherence to ASHP and OSHA recommendations related to PADs.

  14. Forward-Thinking Teens: The Effects of College Costs on Adolescent Risky Behavior

    Science.gov (United States)

    Cowan, Benjamin W.

    2011-01-01

    This paper analyzes the effect of college costs on teenagers' engagement in risky behaviors before they are old enough to attend college. Individuals with brighter prospects for future schooling attainment may engage in less drug and alcohol use and risky sexual activity because they have more to lose if such behaviors have harmful effects in…

  15. Risky behavior and correlates of HIV and Hepatitis C Virus infection among people who inject drugs in three cities in Afghanistan.

    Science.gov (United States)

    Ruiseñor-Escudero, Horacio; Wirtz, Andrea L; Berry, Mark; Mfochive-Njindan, Iliassou; Paikan, Feda; Yousufi, Hussain A; Yadav, Rajpal S; Burnham, Gilbert; Vu, Alexander

    2014-10-01

    Injecting drug use is the primary mode of HIV transmission and acquisition in Afghanistan. People who inject drugs (PWID) in the country have been characterized by high risk injecting behavior and a high burden of HCV infection. We aimed to estimate the burden of HIV, HCV, and other infectious diseases and to identify the correlates of HIV and HCV infection among PWID living in three major Afghan cities in 2009. Epidemiologic data was collected among PWID for the integrated biological and behavioral surveillance (IBBS) survey between May and August, 2009 in three Afghan cities. Data were collected using a structured questionnaire and biologic specimens to screen for HIV, HBV, HCV, syphilis, and HSV-2 using rapid testing kits. Multiple logistic regression models were constructed to identify correlates of infection. Among 548 participants, pooled HIV prevalence was 7.1% (Mazar-i-Sharif: 1.0%, Kabul: 3.1%, Herat: 18.4%) and HCV prevalence was 40.3%. Almost all participants with HIV infection were co-infected with HCV (94.9%). Pooled prevalence estimates for other diseases included 7.1% for HBV, 5.5% for syphilis; and 9.3% for HSV-2. Living in Herat, ever in prison and time injecting were independently associated with HIV infection. Living in Kabul, Herat and time injecting were independently associated with HCV infection. There is a high and heterogeneous burden of HIV and HCV among PWID in Afghan cities. Provision of comprehensive harm reduction services to PWID in Afghanistan is warranted to reduce exposures associated with HIV and HCV infection, especially in the city of Herat. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  16. A Prospective Research on Self-medication Practices of Drug ...

    African Journals Online (AJOL)

    Preferred Customer

    METHODS: A multi-stage stratified sampling of drug retail outlets in Addis Ababa was employed. ... the drug. Two-thirds of the drug consumers requested drugs by specifically mentioning the name of the drug or category to which it belongs and 20.7% by telling their illness or .... city, and further classified as private, public.

  17. A practical drug discovery project at the undergraduate level.

    Science.gov (United States)

    Fray, M Jonathan; Macdonald, Simon J F; Baldwin, Ian R; Barton, Nick; Brown, Jack; Campbell, Ian B; Churcher, Ian; Coe, Diane M; Cooper, Anthony W J; Craven, Andrew P; Fisher, Gail; Inglis, Graham G A; Kelly, Henry A; Liddle, John; Maxwell, Aoife C; Patel, Vipulkumar K; Swanson, Stephen; Wellaway, Natalie

    2013-12-01

    In this article, we describe a practical drug discovery project for third-year undergraduates. No previous knowledge of medicinal chemistry is assumed. Initial lecture workshops cover the basic principles; then students, in teams, seek to improve the profile of a weakly potent, insoluble phosphatidylinositide 3-kinase delta (PI3Kδ) inhibitor (1) through compound array design, molecular modelling, screening data analysis and the synthesis of target compounds in the laboratory. The project benefits from significant industrial support, including lectures, student mentoring and consumables. The aim is to make the learning experience as close as possible to real-life industrial situations. In total, 48 target compounds were prepared, the best of which (5b, 5j, 6b and 6ap) improved the potency and aqueous solubility of the lead compound (1) by 100-1000 fold and ≥tenfold, respectively. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. Open source drug discovery in practice: a case study.

    Science.gov (United States)

    Årdal, Christine; Røttingen, John-Arne

    2012-01-01

    Open source drug discovery offers potential for developing new and inexpensive drugs to combat diseases that disproportionally affect the poor. The concept borrows two principle aspects from open source computing (i.e., collaboration and open access) and applies them to pharmaceutical innovation. By opening a project to external contributors, its research capacity may increase significantly. To date there are only a handful of open source R&D projects focusing on neglected diseases. We wanted to learn from these first movers, their successes and failures, in order to generate a better understanding of how a much-discussed theoretical concept works in practice and may be implemented. A descriptive case study was performed, evaluating two specific R&D projects focused on neglected diseases. CSIR Team India Consortium's Open Source Drug Discovery project (CSIR OSDD) and The Synaptic Leap's Schistosomiasis project (TSLS). Data were gathered from four sources: interviews of participating members (n = 14), a survey of potential members (n = 61), an analysis of the websites and a literature review. Both cases have made significant achievements; however, they have done so in very different ways. CSIR OSDD encourages international collaboration, but its process facilitates contributions from mostly Indian researchers and students. Its processes are formal with each task being reviewed by a mentor (almost always offline) before a result is made public. TSLS, on the other hand, has attracted contributors internationally, albeit significantly fewer than CSIR OSDD. Both have obtained funding used to pay for access to facilities, physical resources and, at times, labor costs. TSLS releases its results into the public domain, whereas CSIR OSDD asserts ownership over its results. Technically TSLS is an open source project, whereas CSIR OSDD is a crowdsourced project. However, both have enabled high quality research at low cost. The critical success factors appear to be clearly

  19. Open Source Drug Discovery in Practice: A Case Study

    Science.gov (United States)

    Årdal, Christine; Røttingen, John-Arne

    2012-01-01

    Background Open source drug discovery offers potential for developing new and inexpensive drugs to combat diseases that disproportionally affect the poor. The concept borrows two principle aspects from open source computing (i.e., collaboration and open access) and applies them to pharmaceutical innovation. By opening a project to external contributors, its research capacity may increase significantly. To date there are only a handful of open source R&D projects focusing on neglected diseases. We wanted to learn from these first movers, their successes and failures, in order to generate a better understanding of how a much-discussed theoretical concept works in practice and may be implemented. Methodology/Principal Findings A descriptive case study was performed, evaluating two specific R&D projects focused on neglected diseases. CSIR Team India Consortium's Open Source Drug Discovery project (CSIR OSDD) and The Synaptic Leap's Schistosomiasis project (TSLS). Data were gathered from four sources: interviews of participating members (n = 14), a survey of potential members (n = 61), an analysis of the websites and a literature review. Both cases have made significant achievements; however, they have done so in very different ways. CSIR OSDD encourages international collaboration, but its process facilitates contributions from mostly Indian researchers and students. Its processes are formal with each task being reviewed by a mentor (almost always offline) before a result is made public. TSLS, on the other hand, has attracted contributors internationally, albeit significantly fewer than CSIR OSDD. Both have obtained funding used to pay for access to facilities, physical resources and, at times, labor costs. TSLS releases its results into the public domain, whereas CSIR OSDD asserts ownership over its results. Conclusions/Significance Technically TSLS is an open source project, whereas CSIR OSDD is a crowdsourced project. However, both have enabled high quality

  20. Three essays in risky behaviors

    OpenAIRE

    Sampaio, Mafalda

    2012-01-01

    A PhD Dissertation, presented as part of the requirements for the Degree of Doctor of Philosophy from the NOVA - School of Business and Economics This dissertation consists of three essays on the relationship between risky behaviors and social environment, including the strategic construction of conversational networks to discuss HIV related issues, the impact of social stigma on risky behaviors, and how subjective expectations from parents can influence childhood obesity. Underst...

  1. Divorce as risky behavior.

    Science.gov (United States)

    Light, Audrey; Ahn, Taehyun

    2010-11-01

    Given that divorce often represents a high-stakes income gamble, we ask how individual levels of risk tolerance affect the decision to divorce. We extend the orthodox divorce model by assuming that individuals are risk averse, that marriage is risky, and that divorce is even riskier. The model predicts that conditional on the expected gains to marriage and divorce, the probability of divorce increases with relative risk tolerance because risk averse individuals require compensation for the additional risk that is inherent in divorce. To implement the model empirically, we use data for first-married women and men from the 1979 National Longitudinal Survey of Youth to estimate a probit model of divorce in which a measure of risk tolerance is among the covariates. The estimates reveal that a 1-point increase in risk tolerance raises the predicted probability of divorce by 4.3% for a representative man and by 11.4% for a representative woman. These findings are consistent with the notion that divorce entails a greater income gamble for women than for men.

  2. Drugs and devices: audit and accreditation the Malaysian Practice

    International Nuclear Information System (INIS)

    Eisha Abdul Rahman; Anis Ahmad

    1999-01-01

    The Malaysian Drugs Control Authority (DCA) implemented the licensing scheme in April 1992 under the Control of Drugs and Cosmetics Regulations 1984. Premises that need be licensed are those involved in any part of the process of production products or bringing the products to their final state, including storage, processing, assembling, sterilising, packaging, testing, labelling and releasing for sale. A total of 64 manufacturers producing prescription medicines, over-the-counter (OTC) drugs and cosmetics products, and another 61 for traditional medicines, have been licensed. Compliance to Good Manufacturing Practice (GMP) which focuses on product safety, purity, efficacy and identity, is a pre-requisite for licensing. The GMP guidelines for pharmaceuticals lay down several pertinent elements such as quality management, personnel, premises and equipment, documentation, production, quality control, contract manufacture, complaints and product recall, and self-inspection. Audits are regularly carried out for the purposes of licensing, certification, surveillance, investigations, and verification. Medical devices, encompassing an enormous range of technologies and application, are however not covered by the above mentioned Regulation. A separate new Bill for Medical Devices will be introduced, as targeted under 7th Malaysia Plan. Although currently not regulated, medical device manufacturers are committed towards quality system management in order to penetrate the international market. Hence, the need to establish quality system standards that comply with EN 46001/2, similar to that ISO 9001/2 requirements. Unlike GMP, which is a regulatory standard, ISO 9001/2 is merely a voluntary certification. The key elements dwell mainly on process management, process improvement, customer interfaces and system administration or control. There are significant similarities between GMP requirements for pharmaceutical and quality system for medical devices. However there are also

  3. "Current Good Manufacturing Practices" and the Federal Food, Drug and Cosmetic Act

    OpenAIRE

    Goldstein, Beth F.

    1995-01-01

    The Food and Drug Administration (hereinafter, FDA) regulates food, drugs, and cosmetics in order to ensure that these products are safe and truthfully labelled. As part of its responsibilities under the Federal Food, Drug, and Cosmetic Act (hereinafter, Act), the FDA monitors the manufacturing practices of companies involved in the production of food, drugs, and medical devices. The manufacturing practices used by these companies must comply with certain standards, identified in the Act as "...

  4. Dopaminergic Modulation of Risky Decision-Making

    Science.gov (United States)

    Simon, Nicholas W.; Montgomery, Karienn S.; Beas, Blanca S.; Mitchell, Marci R.; LaSarge, Candi L.; Mendez, Ian A.; Bañuelos, Cristina; Vokes, Colin M.; Taylor, Aaron B.; Haberman, Rebecca P.; Bizon, Jennifer L.; Setlow, Barry

    2012-01-01

    Many psychiatric disorders are characterized by abnormal risky decision-making and dysregulated dopamine receptor expression. The current study was designed to determine how different dopamine receptor subtypes modulate risk-taking in young adult rats, using a “Risky Decision-making Task” that involves choices between small “safe” rewards and large “risky” rewards accompanied by adverse consequences. Rats showed considerable, stable individual differences in risk preference in the task, which were not related to multiple measures of reward motivation, anxiety, or pain sensitivity. Systemic activation of D2-like receptors robustly attenuated risk-taking, whereas drugs acting on D1-like receptors had no effect. Systemic amphetamine also reduced risk-taking, an effect which was attenuated by D2-like (but not D1-like) receptor blockade. Dopamine receptor mRNA expression was evaluated in a separate cohort of drug-naive rats characterized in the task. D1 mRNA expression in both nucleus accumbens shell and insular cortex was positively associated with risk-taking, while D2 mRNA expression in orbitofrontal and medial prefrontal cortex predicted risk preference in opposing nonlinear patterns. Additionally, lower levels of D2 mRNA in dorsal striatum were associated with greater risk-taking. These data strongly implicate dopamine signaling in prefrontal corticalstriatal circuitry in modulating decision-making processes involving integration of reward information with risks of adverse consequences. PMID:22131407

  5. Effects of combat deployment on risky and self-destructive behavior among active duty military personnel.

    Science.gov (United States)

    Thomsen, Cynthia J; Stander, Valerie A; McWhorter, Stephanie K; Rabenhorst, Mandy M; Milner, Joel S

    2011-10-01

    Although research has documented negative effects of combat deployment on mental health, few studies have examined whether deployment increases risky or self-destructive behavior. The present study addressed this issue. In addition, we examined whether deployment effects on risky behavior varied depending on history of pre-deployment risky behavior, and assessed whether psychiatric conditions mediated effects of deployment on risky behavior. In an anonymous survey, active duty members of the U.S. Marine Corps and U.S. Navy (N = 2116) described their deployment experiences and their participation in risky recreational activities, unprotected sex, illegal drug use, self-injurious behavior, and suicide attempts during three time frames (civilian, military pre-deployment, and military post-deployment). Respondents also reported whether they had problems with depression, anxiety, or PTSD during the same three time frames. Results revealed that risky behavior was much more common in civilian than in military life, with personnel who had not deployed, compared to those who had deployed, reporting more risky behavior and more psychiatric problems as civilians. For the current time period, in contrast, personnel who had deployed (versus never deployed) were significantly more likely to report both risky behavior and psychiatric problems. Importantly, deployment was associated with increases in risky behavior only for personnel with a pre-deployment history of engaging in risky behavior. Although psychiatric conditions were associated with higher levels of risky behavior, psychiatric problems did not mediate associations between deployment and risky behavior. Implications for understanding effects of combat deployment on active duty personnel and directions for future research are discussed. Published by Elsevier Ltd.

  6. Topical and transdermal drug delivery: principles and practice

    National Research Council Canada - National Science Library

    Benson, Heather A. E; Watkinson, Adam C

    2012-01-01

    .... Providing an overview of the current science in drug and cosmetic application to and through the skin, Topical and Transdermal Drug Delivery includes treatment of skin conditions, skin permeation...

  7. Successful schools and risky behaviors among low-income adolescents.

    Science.gov (United States)

    Wong, Mitchell D; Coller, Karen M; Dudovitz, Rebecca N; Kennedy, David P; Buddin, Richard; Shapiro, Martin F; Kataoka, Sheryl H; Brown, Arleen F; Tseng, Chi-Hong; Bergman, Peter; Chung, Paul J

    2014-08-01

    We examined whether exposure to high-performing schools reduces the rates of risky health behaviors among low-income minority adolescents and whether this is due to better academic performance, peer influence, or other factors. By using a natural experimental study design, we used the random admissions lottery into high-performing public charter high schools in low-income Los Angeles neighborhoods to determine whether exposure to successful school environments leads to fewer risky (eg, alcohol, tobacco, drug use, unprotected sex) and very risky health behaviors (e.g., binge drinking, substance use at school, risky sex, gang participation). We surveyed 521 ninth- through twelfth-grade students who were offered admission through a random lottery (intervention group) and 409 students who were not offered admission (control group) about their health behaviors and obtained their state-standardized test scores. The intervention and control groups had similar demographic characteristics and eighth-grade test scores. Being offered admission to a high-performing school (intervention effect) led to improved math (P performance of public schools in low-income communities may be a powerful mechanism to decrease very risky health behaviors among low-income adolescents and to decrease health disparities across the life span. Copyright © 2014 by the American Academy of Pediatrics.

  8. I Did What Last Night? Adolescent Risky Sexual Behaviors and Substance Abuse

    OpenAIRE

    Michael Grossman; Sarah Markowitz

    2005-01-01

    Risky sexual behaviors by teenagers have shown to be strongly correlated with drug and alcohol consumption. The purpose of this study is to examine the question of whether alcohol and drug use increases the likelihood that teenagers will engage in four risky sexual behaviors: having sex, sex with multiple partners, sex without a condom, and sex without birth control. Two-stage least squares and a reduced form model are used to account for the potential endogeneity of substance use. The findin...

  9. Regulatory aspects of oncology drug safety evaluation: Past practice, current issues, and the challenge of new drugs

    International Nuclear Information System (INIS)

    Rosenfeldt, Hans; Kropp, Timothy; Benson, Kimberly; Ricci, M. Stacey; McGuinn, W. David; Verbois, S. Leigh

    2010-01-01

    The drug development of new anti-cancer agents is streamlined in response to the urgency of bringing effective drugs to market for patients with limited life expectancy. FDA's regulation of oncology drugs has evolved from the practices set forth in Arnold Lehman's seminal work published in the 1950s through the current drafting of a new International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH) safety guidance for anti-cancer drug nonclinical evaluations. The ICH combines the efforts of the regulatory authorities of Europe, Japan, and the United States and the pharmaceutical industry from these three regions to streamline the scientific and technical aspects of drug development. The recent development of new oncology drug classes with novel mechanisms of action has improved survival rates for some cancers but also brings new challenges for safety evaluation. Here we present the legacy of Lehman and colleagues in the context of past and present oncology drug development practices and focus on some of the current issues at the center of an evolving harmonization process that will generate a new safety guidance for oncology drugs, ICH S9. The purpose of this new guidance will be to facilitate oncology drug development on a global scale by standardizing regional safety requirements.

  10. What is the Relationship between Risky Outdoor Play and Health in Children? A Systematic Review

    Directory of Open Access Journals (Sweden)

    Mariana Brussoni

    2015-06-01

    Full Text Available Risky outdoor play has been associated with promoting children’s health and development, but also with injury and death. Risky outdoor play has diminished over time, concurrent with increasing concerns regarding child safety and emphasis on injury prevention. We sought to conduct a systematic review to examine the relationship between risky outdoor play and health in children, in order to inform the debate regarding its benefits and harms. We identified and evaluated 21 relevant papers for quality using the GRADE framework. Included articles addressed the effect on health indicators and behaviours from three types of risky play, as well as risky play supportive environments. The systematic review revealed overall positive effects of risky outdoor play on a variety of health indicators and behaviours, most commonly physical activity, but also social health and behaviours, injuries, and aggression. The review indicated the need for additional “good quality” studies; however, we note that even in the face of the generally exclusionary systematic review process, our findings support the promotion of risky outdoor play for healthy child development. These positive results with the marked reduction in risky outdoor play opportunities in recent generations indicate the need to encourage action to support children’s risky outdoor play opportunities. Policy and practice precedents and recommendations for action are discussed.

  11. What is the Relationship between Risky Outdoor Play and Health in Children? A Systematic Review

    Science.gov (United States)

    Brussoni, Mariana; Gibbons, Rebecca; Gray, Casey; Ishikawa, Takuro; Sandseter, Ellen Beate Hansen; Bienenstock, Adam; Chabot, Guylaine; Fuselli, Pamela; Herrington, Susan; Janssen, Ian; Pickett, William; Power, Marlene; Stanger, Nick; Sampson, Margaret; Tremblay, Mark S.

    2015-01-01

    Risky outdoor play has been associated with promoting children’s health and development, but also with injury and death. Risky outdoor play has diminished over time, concurrent with increasing concerns regarding child safety and emphasis on injury prevention. We sought to conduct a systematic review to examine the relationship between risky outdoor play and health in children, in order to inform the debate regarding its benefits and harms. We identified and evaluated 21 relevant papers for quality using the GRADE framework. Included articles addressed the effect on health indicators and behaviours from three types of risky play, as well as risky play supportive environments. The systematic review revealed overall positive effects of risky outdoor play on a variety of health indicators and behaviours, most commonly physical activity, but also social health and behaviours, injuries, and aggression. The review indicated the need for additional “good quality” studies; however, we note that even in the face of the generally exclusionary systematic review process, our findings support the promotion of risky outdoor play for healthy child development. These positive results with the marked reduction in risky outdoor play opportunities in recent generations indicate the need to encourage action to support children’s risky outdoor play opportunities. Policy and practice precedents and recommendations for action are discussed. PMID:26062038

  12. Impact of Spacing of Practice on Learning Brand Name and Generic Drugs.

    Science.gov (United States)

    Terenyi, James; Anksorus, Heidi; Persky, Adam M

    2018-02-01

    Objective. To test the impact of schedules of retrieval practice on learning brand and generic name drug information in a self-paced course. Methods. Students completed weekly quizzes on brand and generic name conversions for 100 commonly prescribed drugs. Each student completed part of the drug list on a schedule of equal, expanding, or contracting spacing, one practice (massed) or study only in a partial block design. Results. On measures of long-term retention, the contracting spacing schedule led to superior retention (67%) compared to the massed practice (50%) and study-only condition (46%); contracting practice also was significantly higher than expanding practice (58%,) or equal practice (59%). Overall performance decreased by almost 50% (final exam 95%, long-term retention 55%) over a 6-week period. Conclusion. A contracting spacing schedule was the most effective schedule of practice, and all spacing schedules were superior to massed practice or study-only conditions.

  13. Safe models for risky decisions

    NARCIS (Netherlands)

    Steingröver, H.M.

    2017-01-01

    In everyday life, we often have to decide between options that differ in their immediate and long-term consequences. Would you, for example, opt for a delicious piece of cake or rather eat a healthy apple? To investigate how people make risky decisions, this thesis focuses on the Iowa gambling task

  14. Prevalence and predictors of problematic alcohol use, risky sexual practices and other negative consequences associated with alcohol use among safety and security employees in the Western Cape, South Africa.

    Science.gov (United States)

    Harker Burnhams, Nadine; Parry, Charles; Laubscher, Ria; London, Leslie

    2014-03-04

    Harmful alcohol use can compromise worker health and productivity. Persons employed in safety-sensitive occupations are particularly vulnerable to hazardous alcohol use and its associated risks. This study describes the patterns of harmful alcohol use, related HIV risks and risk factors for the harmful use of alcohol among a sample of employees in South Africa working in the safety and security sector. A cross-sectional study that formed the baseline for a clustered randomized control trial was undertaken in 2011. A random sample of 325 employees employed within a safety and security sector of a local municipality in the Western Cape Province of South Africa participated in the study. Data were collected by means of an 18-page self-administered structured questionnaire and analyzed using SAS/STAT software version 9.2. For all significance testing, the F-statistic and p-values are reported. Three hundred and twenty-five employees were surveyed. Findings suggest that more than half (76.1%) of the 78.9% of participants who consumed alcohol engaged in binge drinking, with close to a quarter reporting a CAGE score greater than the cut-off of 2, indicating potentially hazardous drinking patterns. The study further found that employees who use alcohol are more likely to engage in risky sexual practices when under the influence. A favorable drinking climate (p safety-sensitive occupations at the workplace. It suggests that persons employed within such positions are at high risk for developing alcohol-related disorders and for contracting HIV. This study highlights the need for testing a comprehensive package of services designed to prevent hazardous alcohol use among safety and security employees.

  15. [Drug use and sexual practices of teenagers in the city of Medellin (Colombia)].

    Science.gov (United States)

    Castaño Pérez, Guillermo A; Arango Tobon, Eduardo; Morales Mesa, Santiago; Rodríguez Bustamante, Alexander; Montoya Montoya, Carolina

    2012-01-01

    The purpose of this research project was to study the relationship between drug consumption and sexual practices in teenagers in the city of Medellin, Colombia. A transversal studied was designed in order to identify the variables related to having had sexual intercourse under the effects of drugs or alcohol. The sample was made up of 955 teenagers between 14 and 17, who were in 9th, 10th and 11th grades in public and private schools in the city of Medellin. The results show that the prevalence of drug and alcohol influence in sexual intercourse is 43,67%. The most common drugs used for sexual practices are alcohol, marihuana, popper, cocaine and ecstasy. Consuming alcohol or drugs and having sexual practices shows an associated meaningful statistic (p= .001). The more common sexual practices under psychoactive substances are the exploratory ones (caresses and touching) (71%), vaginal penetration (63.67%), oral sex (45.30%) and masturbation (19.59%). Regarding the protection methods during sexual intercourse under drug or alcohol influence 55,9% always use a condom, 37,3% sometimes use it, and 6,8% never do it. This study proves what had been previously established by other research projects that show a high statistic association between drug consumption and sexual practices, but realizes that there is no statistically significant association between sexual practices under the influence of alcohol or drugs and the use or non-use of protective methods, which is the most important finding.

  16. The Effective Business Practices of Mexican Drug Trafficking Organizations (DTOs)

    Science.gov (United States)

    2013-06-01

    today, customers have easy access to information, products, and services from numerous companies simply by using the Internet or a smartphone , so...customers in the smartphone 81 Campbell, Drug War Zone, 245. 82 Paul Gootenberg, “Talking About The...Drug addictions bring people back once they become hooked. Cartels have been known to allow contractors to use the “bait and hook” technique, a method

  17. Practices, patients and (imperfect data - feasibility of a randomised controlled clinical drug trial in German general practices

    Directory of Open Access Journals (Sweden)

    Hummers-Pradier Eva

    2011-04-01

    Full Text Available Abstract Background Randomised controlled clinical (drug trials supply high quality evidence for therapeutic strategies in primary care. Until now, experience with drug trials in German general practice has been sparse. In 2007/2008, the authors conducted an investigator-initiated, non-commercial, double-blind, randomised controlled pilot trial (HWI-01 to assess the clinical equivalence of ibuprofen and ciprofloxacin in the treatment of uncomplicated urinary tract infection (UTI. Here, we report the feasibility of this trial in German general practices and the implementation of Good Clinical Practice (GCP standards as defined by the International Conference on Harmonisation (ICH in mainly inexperienced general practices. Methods This report is based on the experience of the HWI-01 study conducted in 29 German general practices. Feasibility was defined by 1 successful practice recruitment, 2 sufficient patient recruitment, 3 complete and accurate data collection and 4 appropriate protection of patient safety. Results The final practice recruitment rate was 18%. In these practices, 79 of 195 screened UTI patients were enrolled. Recruitment differed strongly between practices (range 0-12, mean 2.8 patients per practice and was below the recruitment goal of approximately 100 patients. As anticipated, practice nurses became the key figures in the screening und recruitment of patients. Clinical trial demands, in particular for completing symptom questionnaires, documentation of source data and reporting of adverse events, did not agree well with GPs' documentation habits and required support from study nurses. In many cases, GPs and practice staff seemed to be overwhelmed by the amount of information and regulations. No sudden unexpected serious adverse reactions (SUSARs were observed during the trial. Conclusions To enable drug trials in general practice, it is necessary to adapt the setup of clinical research infrastructure to the needs of GPs and

  18. Predictors of risky sexual behaviour among young people in the era ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    people's practicing risky sexual behaviour in the era of HIV/AIDS. Data used in ... pregnancies, unsafe induced abortion and HIV .... additional selection criteria. ...... India. International. Family. Planning. Perspectives 1999; 25(3): 139-146. 18.

  19. Risky Decision Making in a Laboratory Driving Task Is Associated with Health Risk Behaviors during Late Adolescence but Not Adulthood

    Science.gov (United States)

    Kim-Spoon, Jungmeen; Kahn, Rachel; Deater-Deckard, Kirby; Chiu, Pearl; Steinberg, Laurence; King-Casas, Brooks

    2016-01-01

    Adolescence is characterized by increasing incidence of health risk behaviors, including experimentation with drugs and alcohol. To fill the gap in our understanding of the associations between risky decision-making and health risk behaviors, we investigated associations between laboratory-based risky decision-making using the Stoplight task and…

  20. Drug-related problems and pharmacy interventions in community practice

    DEFF Research Database (Denmark)

    Westerlund, Tommy; Almarsdóttir, Anna Birna; Melander, Arne

    1999-01-01

    Objectives. (1) To document types and number of drug-related problems identified by community pharmacy personnel in Sweden; (2) to determine relationships among the types and number of problems identified and the gender, age and number of prescribed drugs in patients; and (3) to document the inte......Objectives. (1) To document types and number of drug-related problems identified by community pharmacy personnel in Sweden; (2) to determine relationships among the types and number of problems identified and the gender, age and number of prescribed drugs in patients; and (3) to document...... the interventions made by pharmacy personnel with patients and prescribers. Method. Random samples of pharmacists, prescriptionists and pharmacy technicians were drawn nationwide in Sweden; 144 (63 per cent) of the employees fulfilling the inclusion criteria agreed to take part. The participants documented drug......-related problems, interventions and patient variables on a data collection form, and tallied the number of patients they served on another form. Setting. One hundred and sixteen community pharmacies and 12 outpatient hospital pharmacies. Key findings. One problem or more was identified among 2.5 per cent...

  1. Adulteration Practices of Psychoactive Illicit Drugs: An Updated Review.

    Science.gov (United States)

    Solimini, Renata; Rotolo, Maria C; Pellegrini, Manuela; Minutillo, Adele; Pacifici, Roberta; Busardò, Francesco P; Zaami, Simona

    2017-01-01

    Powdery drugs such as cocaine and heroin are frequently adulterated or diluted predominantly to obtain more doses and to increase the drug dealer's profits, but also to enhance, to modify or to oppose drug effects. The aim of this report is to provide an overview of the recent scientific literature on medicines as well as on new psychoactive substances, used as cutting agents (i.e. pharmacologically active adulterants) and on the related adverse health effects on consumers, possibly due to the synergistic effect of the adulterants laced with substances of abuse. A literature search up to January 2017 was performed on MEDLINE, Scopus and Web of Science and reports and documents of international agencies or institutions were also searched. Pharmacologically active substances such as: paracetamol, caffeine, dextromethorphan, clenbuterol for heroin; levamisole, phenacetine, lidocaine, hydroxyzine and diltiazem for cocaine; caffeine and phentermine for amphetamine, have been identified over the years. Furthermore, since cocaine and morphine (this latter as a precursor of heroin) are both extracted from natural products, some impurities and minor alkaloids can be present in the final preparation. In this context, it is worth considering that new psychoactive substances are also used as cutting agents. The wide availability of illicit psychotropic drugs is the most serious hazard threatening consumers. Indeed emergency departments are often responsible in evaluating damages caused not only by the base substance, but also by other eventual compounds added to mimic or antagonize drug effects or simply dilute the drug amount, with a possible harmful synergic toxic action. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  2. Improvement of Pediatric Drug Development: Regulatory and Practical Frameworks.

    Science.gov (United States)

    Tsukamoto, Katusra; Carroll, Kelly A; Onishi, Taku; Matsumaru, Naoki; Brasseur, Daniel; Nakamura, Hidefumi

    2016-03-01

    A dearth in pediatric drug development often leaves pediatricians with no alternative but to prescribe unlicensed or off-label drugs with a resultant increased risk of adverse events. We present the current status of pediatric drug development and, based on our data analysis, clarify the problems in this area. Further action is proposed to improve the drug development that has pediatric therapeutic orphan status. We analyzed all Phase II/III and Phase III trials in ClinicalTrials.gov that only included pediatric participants (Performance index, an indicator of pediatric drug development, was calculated by dividing the annual number of pediatric clinical trials by million pediatric populations acquired from Census.gov. Effects of the 2 Japanese premiums introduced in 2010, for the enhancement of pediatric drug development, were analyzed by comparing mean performance index prepremiums (2006-2009) and postpremiums (2010-2014) among Japan, the European Union, and the United States. The European Union Clinical Trials Register and published reports from the European Medicines Agency were also surveyed to investigate the Paediatric Committee effect on pediatric clinical trials in the European Union. Mean difference of the performance index in prepremiums and postpremiums between Japan and the European Union were 0.296 (P 15% after 2008. Recruitment and ethical obstacles make conducting pediatric clinical trials challenging. An improved operational framework for conducting clinical trials should mirror the ever-improving regulatory framework that incentivizes investment in pediatric clinical trials. Technological approaches, enhancements in electronic medical record systems, and community approaches that actively incorporate input from physicians, researchers, and patients could offer a sustainable solution to recruitment of pediatric study participants. The key therefore is to improve pediatric pharmacotherapy collaboration among industry, government, academia, and

  3. Does substance use moderate the effects of parents and peers on risky sexual behaviour?

    Science.gov (United States)

    Donenberg, Geri R; Emerson, Erin; Bryant, Fred B; King, Scott

    2006-04-01

    We investigated the moderating effects of drug/alcohol use in the past 3 months on the relationships of peer influence, parental permissiveness, and teen disposition (i.e., achievement motivation, attitude toward school, and value placed on health) with adolescent risky sexual behaviour. Participants were 207 adolescents receiving psychiatric care. Substance use did not moderate the relationship between adolescent disposition and risky sex. By contrast, peer influence and parental permissiveness were linked to risky sex but only for teens who reported using drugs/alcohol. Controlling for other predictors in the model, negative peer influence explained 21% and parental permissiveness explained 13% of the variance in risky sex among substance users, but less than half of 1% of the variance among non-substance users. The disinhibiting effects of substance use on decision-making and the need for effective parental monitoring to reduce opportunities for risk behaviour are discussed.

  4. Measuring risky adolescent cycling behaviour.

    Science.gov (United States)

    Feenstra, Hans; Ruiter, Robert A C; Schepers, Jan; Peters, Gjalt-Jorn; Kok, Gerjo

    2011-09-01

    Adolescents are at a greater risk of being involved in traffic accidents than most other age groups, even before they start driving cars. This article aims to determine the factor structure of a self-report questionnaire measuring adolescent risky cycling behaviour, the ACBQ (Adolescent Cycling Behaviour Questionnaire). The questionnaire's structure was based on the widely used Driver Behaviour Questionnaire (DBQ). A sample of secondary school students (N = 1749; age range: 13-18 years) filled out the questionnaire. Factor analysis revealed a three-factor structure underlying the questionnaire, which was confirmed on two equally large portions of the entire sample. These three underlying factors were identified as errors, common violations and exceptional violations. The ACBQ is a useful instrument for measuring adolescents' risky cycling behaviour.

  5. Alcohol consumption and risky drinking patterns in Malaysia: findings from NHMS 2011.

    Science.gov (United States)

    Mutalip, Mohd Hatta B Abdul; Kamarudin, Rozanim Bt; Manickam, Mala; Abd Hamid, Hamizatul Akmal Bt; Saari, Riyanti Bt

    2014-01-01

    To identify the characteristics of current drinker and risky alcohol-drinking pattern by profiles in Malaysia. We analyzed data from the National Health and Morbidity Survey 2011. It was a cross-sectional population-based with two stages stratified random sampling design. A validated Alcohol Use Disorder Identification Test Malay questionnaire was used to assess the alcohol consumption and its alcohol related harms. Analysis of complex survey data using Stata Version 12 was done for descriptive analysis on alcohol use and risky drinking by socio-demography profiles. Logistic regression analysis was used to measure the association of risky drinking status with the socio-demography characteristics. The prevalence of current alcohol use was 11.6% [95% confidence interval (CI): 10.5, 12.7], among them 23.6% (95% CI: 21.0, 26.4) practiced risky drinking. The onset for alcohol drinking was 21 years old (standard deviation 7.44) and majority preferred Beer. Males significantly consumed more alcohol and practiced risky drinking. Current alcohol use was more prevalent among urbanites, Chinese, those with high household income, and high education. Conversely, risky drinking was more prevalent among rural drinkers, Bumiputera Sabah and Sarawak, low education and low household income. The estimated odds of risky drinking increased by a factor of 3.5 among Males while a factor of 2.7 among Bumiputera Sabah and Sarawak. Education status and household income was not a significant predictor to risky drinking. There was an inverse drinking pattern between current drinker and risky drinking by the socio-demography profiles. Initiating early screening and focused intervention might avert further alcohol related harms and dependence among the risky drinkers. © The Author 2014. Medical Council on Alcohol and Oxford University Press. All rights reserved.

  6. Drug-drug interactions as a determinant of elevated lithium serum levels in daily clinical practice

    NARCIS (Netherlands)

    Wilting, [No Value; Movig, KL; Moolenaar, M; Hekster, YA; Brouwers, [No Value; Heerdink, ER; Nolen, WA; Egberts, AC

    Objective: Lithium is a drug with a narrow therapeutic window. Concomitantly used medication is a potentially influencing factor of lithium serum concentrations. We conducted a multicentre retrospective case-control study with the aim of investigating lithium-related drug interactions as

  7. Knowledge and Practice of Drug Retailers in Malaria Management ...

    African Journals Online (AJOL)

    The aim of the study was to evaluate what drug sellers know about malaria and how they can manage their clients. ... All respondent knew that malaria was caused by the bite of an infected mosquito,but malaria was also attributed to various other causes such as:other infected people 7 (11.7%) eating too many mangoes ...

  8. Drugs in Aviation - A Review | Muntingh | South African Family Practice

    African Journals Online (AJOL)

    in 1994 by the FAA revealed that an estimated 14 000 US pilots flew while using prohibited medications or illegal substances or flew with significant unreported medical conditions.1. Greater understanding of the effects of medication in humans, and advances in drug development have now made possible the use of various ...

  9. Drugs in Aviation - A Review | Muntingh | South African Family Practice

    African Journals Online (AJOL)

    examiners, pilots, cabin crew and air traffic services personnel) to consider the effects that medicine or drugs may have on performance. Studies confirm that some pilots, and other crew members while on duty, used prohibited medications or illegal substances or performed duties while suffering significant unreported

  10. New drugs in general practice: prescribing patterns and external influences

    NARCIS (Netherlands)

    Florentinus, S.R.

    2006-01-01

    In this thesis several studies are presented with the objective to detect and elucidate the patterns by which new drugs are prescribed by general practitioners (GPs). Furthermore, we studied the influences of medical specialists and community pharmacists as important factors on the GP's decision to

  11. On illicit drug policies; methods of evaluation and comments on recent practices.

    Science.gov (United States)

    Trovato, Giovanni; Vezzani, Antonio

    2013-06-01

    This contribution provides an overview of different approaches used to analyse drug policies within and across countries. Besides the great number of cost of illness studies which have contributed to the assessment of health harms and risks associated to the drug use, most of the recent efforts have focused on the creation of synthetic indices to classify countries around the world or to evaluate particular law enforcement policies in some countries. This is probably due to a general lack of comparable data across countries. The wide variety of budgetary practices in the drugs field in Europe contributes to the problems that exist in estimating drug-related public expenditure. These heterogeneous accounting practices, together with the complexity of the drug phenomenon and the multiplicity of perspectives on the issue, strongly constrains the possibility of economically evaluate and compare drug laws across countries.

  12. Does substance use moderate the effects of parents and peers on risky sexual behaviour?

    OpenAIRE

    DONENBERG, GERI R.; EMERSON, ERIN; BRYANT, FRED B.; KING, SCOTT

    2006-01-01

    We investigated the moderating effects of drug/alcohol use in the past 3 months on the relationships of peer influence, parental permissiveness, and teen disposition (i.e., achievement motivation, attitude toward school, and value placed on health) with adolescent risky sexual behaviour. Participants were 207 adolescents receiving psychiatric care. Substance use did not moderate the relationship between adolescent disposition and risky sex. By contrast, peer influence and parental permissiven...

  13. Topical and transdermal drug delivery: principles and practice

    National Research Council Canada - National Science Library

    Benson, Heather A. E; Watkinson, Adam C

    2012-01-01

    ..., and enhancement and measurement of skin permeation. The book provides pharmaceutical scientists, skin product development experts, and those in the cosmetic and personal care industry with practical knowledge and insight into future product...

  14. A baseline study of drug prescribing practices in a Nigerian military ...

    African Journals Online (AJOL)

    Military facilities provide health care services to an important segment of both themilitary and civil population. Methods: The aim of this study was to evaluate drug prescribing practices at a Nigerian military hospital (MilitaryHospital, Ikoyi, Lagos) and tomake recommendations for its improvement.UsingWHOrational drug use ...

  15. Which drug or drug delivery system can change clinical practice for brain tumor therapy?

    OpenAIRE

    Siegal, Tali

    2013-01-01

    The prognosis and treatment outcome for primary brain tumors have remained unchanged despite advances in anticancer drug discovery and development. In clinical trials, the majority of promising experimental agents for brain tumors have had limited impact on survival or time to recurrence. These disappointing results are partially explained by the inadequacy of effective drug delivery to the CNS. The impediments posed by the various specialized physiological barriers and active efflux mechanis...

  16. Risky movies, risky behaviors, and ethnic identity among Black adolescents.

    Science.gov (United States)

    Bleakley, Amy; Ellithorpe, Morgan E; Hennessy, Michael; Jamieson, Patrick E; Khurana, Atika; Weitz, Ilana

    2017-12-01

    To investigate how exposure to sex, alcohol and violent content in mainstream and Black-oriented movies relates to corresponding adolescent behavior among Black youth from the United States and whether those relationships are moderated by ethnic identity. The present study uses survey data from an online sample of 1000 Black adolescents and content analysis ratings on top-grossing 2014 films and 2013/2014 Black-oriented films. Content-specific exposure measures for alcohol, sexual activity, and violence were calculated from self-reported exposure data and content analysis ratings. Regression analyses estimated the associations among exposures to risky health content in mainstream and Black-oriented films and adolescent behaviors as well as moderation by ethnic group identity. Black adolescents were mostly unaffected by exposure to risk portrayals in mainstream films, but exposure to risk in Black-oriented films was related to their behavior in all three domains. Strong group identity strengthened the relationship between exposure to sex in Black-oriented and mainstream films depending on the sexual outcome. The type of movie (i.e., mainstream or Black-oriented) through which Black adolescents are exposed to risky health portrayals is important for understanding its relationship to their behavior, and variations by ethnic identity were limited to sex content. Future research should identify the mechanisms through which risk content in Black-oriented films is associated with Black adolescents' risky behaviors to determine how media influence contributes to behavioral disparities among youth. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Drug-Induced QTc Interval Prolongation: A Multicenter Study to Detect Drugs and Clinical Factors Involved in Every Day Practice.

    Science.gov (United States)

    Keller, Guillermo A; Alvarez, Paulino A; Ponte, Marcelo L; Belloso, Waldo H; Bagnes, Claudia; Sparanochia, Cecilia; Gonzalez, Claudio D; Villa Etchegoyen, M Cecilia; Diez, Roberto A; Di Girolamo, Guillermo

    2016-01-01

    The actual prevalence of drug induced QTc prolongation in clinical practice is unknown. Our objective was to determine the occurrence and characteristics of drug-induced QT prolongation in several common clinical practices. Additionally, a subgroup of patients treated with dextropropoxyphene of particular interest for the regulatory authority was analysed. Medical history and comorbidities predisposing to QT interval prolongation were registered for 1270 patient requiring medical assistance that involved drug administration. Three ionograms and ECGs were performed: baseline, intra- and after treatment; QT interval was corrected with Bazzet formula. Among patients, 9.9% presented QTc >450/470 ms, 3% QTc > 500 ms, 12.7% ΔQTc >30 ms and 5.2% ΔQTc >60 ms. QTc prolongation associated with congestive heart failure, ischemic cardiopathy, diabetes, renal failure, arrhythmias, hypothyroidism, and bradycardia. At univariate analysis, clarithromycin, haloperidol, tramadol, amiodarone, glyceryl trinitrate, amoxicillin + clavulanic acid, amoxicillin + sulbactam, ampicillin + sulbactam, fentanyl, piperacillin + tazobactam, and diazepam prolonged QTc. Prolongation remained significantly associated with furosemide, clarithromycin, glyceryl trinitrate and betalactamase inhibitors after multivariate analysis. QT interval prolongation in everyday practice is frequent, in association to clinical factors and drugs that can be easily identified for monitoring and prevention strategies.

  18. ETHICAL PRACTICES IN DRUG PRESCRIBING. A COMPARATIVE STUDY BETWEEN DOCTORS’ AND PHARMACISTS’ OPINION ABOUT DRUG PRESCRIBING IN ROMANIA

    Directory of Open Access Journals (Sweden)

    LASZLO-ZOLTAN SZTANKOVSZKY

    2015-11-01

    Full Text Available The prescription of drugs is influenced by a number of factors with a great impact upon the health of the main beneficiaries of health services. The purpose of the study is to identify the perception of doctors and pharmacists on drug prescription practices adopted by doctors. Material and Methods: a number of 349 subjects (149 pharmacists and 200 doctors answered a survey about the perception of drug dispensing in Romania. Variables like age, work environment (urban, rural, length of employment were taken into account. Results: When prescribing a treatment, 93% of doctors follow the standard treatment protocol for the given diagnosis and 93,5% of them are declaring that personal resources are the main source for training while the percent appreciated by pharmacists is evaluated to 65,78%. A total of 50% of doctors are considering other criteria than the treatment when prescribing a drug (financial contribution for the patient or National Health Insurance House. A total of 59% of doctors are recommending overthe-counter products while pharmacists consider that is happening in more than 70% of the cases. Conclusions: There are differences of opinion between doctors and pharmacists regarding doctor’s practices of prescribing drugs to their patients, like: kinds of sponsorship for the continuing education, the relationship with the pharmaceutical representative or the frequency of prescribing over-the-counter products or supplements when they are recommending a certain treatment.

  19. [Explanation of risky sexual behaviors in men who have sex with men].

    Science.gov (United States)

    Jacques Aviñó, Constanza; García de Olalla, Patricia; Díez, Elia; Martín, Silvia; Caylà, Joan A

    2015-01-01

    To explore views about risky sexual behaviors and perceptions of HIV, and to propose interventions for preventing HIV infections in a group of men who have sex with men. We performed a qualitative study in a sample of 13 men who have sex with men, who were participating in an HIV-seronegative cohort, and who we contacted via saunas for the gay community in Barcelona (Spain). We performed in-depth semi-structured interviews, followed by content analysis. Risky sexual behaviors were associated with masculinity related to strong sexual needs, certain sexual exchange venues (such as saunas, private parties and clubs), drug use, and a desire to experiment with risk and one's own sexuality. HIV infection was perceived as a normalized disease, although becoming infected was still associated with shame and guilt. Proposed interventions included raising awareness of what it is like to live with HIV, generating greater social alarm, incorporating new technologies in prevention, and intensifying activity at gay venues. The concept of masculinity plays a fundamental role in sexual practices among men who have sex with men. We suggest renewed innovation in preventive programs and incorporating the perception of risk and HIV infection from a gender perspective. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  20. Knowledge and Practices about HIV/AIDS among Injecting Drug ...

    African Journals Online (AJOL)

    This is a descriptive cross-sectional study on 200 IDUs of Dhaka city was conducted to evaluate their knowledge. ... Regarding practice majority (94.5%) of the IDUs shared needle, 69% had multiple sex partners, out of which only 2.5% used new disposable syringe and only 4.8% always used condom during intercourse.

  1. Knowledge, Attitude and Practice of Adverse Drug Reaction ...

    African Journals Online (AJOL)

    Erah

    Purpose: To determine the knowledge, attitude and practice of ADR monitoring and ... of nurses in pharmacovigilance will go a long way in improving reporting of ADRs. .... Know. None. Suspected ADR. Medical practitioner. Pharmacy. Nursing. 31. 01 .... patients, especially patients on hospital .... international experience.

  2. Translating data on antihypertensive drugs into clinical practice.

    Science.gov (United States)

    Weber, M A

    1998-06-01

    Two problems in the treatment of hypertension continue to be largely unsolved. The first, and more simple, is our inability to adequately control blood pressure in the majority of hypertensive patients. This not only reflects the difficulty of retaining patients in effective treatment programs, but also of convincing physicians to strive for optimal blood pressure levels. There is a continuing need for new antihypertensive drugs and combinations to help accomplish these goals. The second major problem is that the major clinical endpoints, including coronary events and renal failure, have not been adequately reduced by traditional therapies. Standard regimens, particularly those including diuretics, have protected against strokes and heart failure. Our improved understanding of vascular biology in hypertension has directed interest to the mechanisms in hypertensive patients that might accelerate atherosclerosis and vascular events in these individuals. This involves addressing the concomitant metabolic risk factors that comprise the "Hypertension Syndrome," and, perhaps of equal importance, finding therapies that directly inhibit unwanted types of growth and proliferative activities within the walls of critical arteries. Many substances within the endothelium and the vascular wall may participate as initiators or mediators of pathology, but most information thus far has focused on the renin-angiotensin system. Angiotensin converting enzyme inhibitors (and potentially angiotensin receptor blockers) have provided coronary and renal protection in various cardiovascular conditions, though not yet in formal hypertension trials. Calcium channel blockers have also shown promise, including recent stroke and cardiovascular benefits in patients with isolated systolic hypertension, but, again, definitive coronary data in hypertension are awaited. Unless concomitant conditions mandate the selection of a particular antihypertensive drug class, physicians currently have a dilemma

  3. Dating Violence and Substance Use as Longitudinal Predictors of Adolescents’ Risky Sexual Behavior

    Science.gov (United States)

    Shorey, Ryan C.; Fite, Paula J.; Choi, HyeJeong; Cohen, Joseph R.; Stuart, Gregory L.; Temple, Jeff R.

    2015-01-01

    Objective To examine dating violence perpetration and victimization (physical, psychological, and sexual) and lifetime substance use (alcohol, marijuana, and hard drugs) as longitudinal predictors of adolescents’ risky sexual behavior across one year, and to determine whether predictors varied across adolescents’ gender and ethnicity. Methods A sample of Caucasian, African American, and Hispanic male and female adolescents from 7 public high schools in Texas (N = 882) participated. Adolescents completed self-report measures of dating violence, lifetime substance use, and risky sexual behavior at baseline and, 1-year later, completed a second assessment of their risky sexual behavior. Results Path analysis demonstrated that greater physical dating violence victimization, lifetime alcohol use, lifetime marijuana use, and age (being older) were all significant predictors of risky sexual behavior at the 1-year follow-up. These results did not vary across gender or the three ethnic groups (Caucasian, African American, and Hispanic). Conclusions Overall, substance use was a longitudinal predictor of risky sexual behavior across the three ethnic groups, with physical dating violence victimization being the only type of dating violence longitudinally predicting risky sexual behavior. Prevention efforts should consider the roles of physical dating violence and substance use in preventing risky sexual behavior. PMID:25797949

  4. Dating Violence and Substance Use as Longitudinal Predictors of Adolescents' Risky Sexual Behavior.

    Science.gov (United States)

    Shorey, Ryan C; Fite, Paula J; Choi, HyeJeong; Cohen, Joseph R; Stuart, Gregory L; Temple, Jeff R

    2015-08-01

    The objectives of this study is to examine dating violence perpetration and victimization (physical, psychological, and sexual) and lifetime substance use (alcohol, marijuana, and hard drugs) as longitudinal predictors of adolescents' risky sexual behavior across 1 year and to determine whether predictors varied across adolescents' gender and ethnicity. A sample of Caucasian, African American, and Hispanic male and female adolescents from seven public high schools in Texas (N = 882) participated. Adolescents completed self-report measures of dating violence, lifetime substance use, and risky sexual behavior at baseline and, 1-year later, completed a second assessment of their risky sexual behavior. Path analysis demonstrated that greater physical dating violence victimization, lifetime alcohol use, lifetime marijuana use, and age (being older) were all significant predictors of risky sexual behavior at the 1-year follow-up. These results did not vary across gender or the three ethnic groups (Caucasian, African American, and Hispanic). Overall, substance use was a longitudinal predictor of risky sexual behavior across the three ethnic groups, with physical dating violence victimization being the only type of dating violence longitudinally predicting risky sexual behavior. Prevention efforts should consider the roles of physical dating violence and substance use in preventing risky sexual behavior.

  5. Inhaled Drug Delivery: A Practical Guide to Prescribing Inhaler Devices

    Directory of Open Access Journals (Sweden)

    Pierre Ernst

    1998-01-01

    Full Text Available Direct delivery of medication to the target organ results in a high ratio of local to systemic bioavailability and has made aerosol delivery of respiratory medication the route of choice for the treatment of obstructive lung diseases. The most commonly prescribed device is the pressurized metered dose inhaler (pMDI; its major drawback is the requirement that inspiration and actuation of the device be well coordinated. Other requirements for effective drug delivery include an optimal inspiratory flow, a full inspiration from functional residual capacity and a breath hold of at least 6 s. Available pMDIs are to be gradually phased out due to their use of atmospheric ozone-depleting chlorofluorocarbons (CFCs as propellants. Newer pMDI devices using non-CFC propellants are available; preliminary experience suggests these devices greatly increase systemic bioavailability of inhaled corticosteroids. The newer multidose dry powder inhalation devices (DPIs are breath actuated, thus facilitating coordination with inspiration, and contain fewer ingredients. Furthermore, drug delivery is adequate even at low inspired flows, making their use appropriate in almost all situations. Equivalence of dosing among different devices for inhaled corticosteroids will remain imprecise, requiring the physician to adjust the dose of medication to the lowest dose that provides adequate control of asthma. Asthma education will be needed to instruct patients on the effective use of the numerous inhalation devices available.

  6. Evaluation of new drugs in daily clinical practice: anti-TNF alpha in rheumatoid arthritis patients.

    OpenAIRE

    Kievit, W.

    2008-01-01

    The objective of this thesis was to explore the value and the validity of data collected in daily clinical practice for drug evaluation and cost-effectiveness studies, using data collected on TNFa blocking agents in rheumatoid arthritis. First, the need for and value of information from daily clinical practice was researched. Together, the results of Chapters 3, 4 and 5 illustrated that treatment of RA patients with anti-TNFa blocking agents in daily clinical practice was different from what ...

  7. 'It's risky to walk in the city with syringes': understanding access to HIV/AIDS services for injecting drug users in the former Soviet Union countries of Ukraine and Kyrgyzstan

    Directory of Open Access Journals (Sweden)

    Harmer Andrew

    2011-07-01

    Full Text Available Abstract Background Despite massive scale up of funds from global health initiatives including the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund and other donors, the ambitious target agreed by G8 leaders in 2005 in Gleneagles to achieve universal access to HIV/AIDS treatment by 2010 has not been reached. Significant barriers to access remain in former Soviet Union (FSU countries, a region now recognised as a priority area by policymakers. There have been few empirical studies of access to HIV/AIDS services in FSU countries, resulting in limited understanding and implementation of accessible HIV/AIDS interventions. This paper explores the multiple access barriers to HIV/AIDS services experienced by a key risk group-injecting drug users (IDUs. Methods Semi-structured interviews were conducted in two FSU countries-Ukraine and Kyrgyzstan-with clients receiving Global Fund-supported services (Ukraine n = 118, Kyrgyzstan n = 84, service providers (Ukraine n = 138, Kyrgyzstan n = 58 and a purposive sample of national and subnational stakeholders (Ukraine n = 135, Kyrgyzstan n = 86. Systematic thematic analysis of these qualitative data was conducted by country teams, and a comparative synthesis of findings undertaken by the authors. Results Stigmatisation of HIV/AIDS and drug use was an important barrier to IDUs accessing HIV/AIDS services in both countries. Other connected barriers included: criminalisation of drug use; discriminatory practices among government service providers; limited knowledge of HIV/AIDS, services and entitlements; shortages of commodities and human resources; and organisational, economic and geographical barriers. Conclusions Approaches to thinking about universal access frequently assume increased availability of services means increased accessibility of services. Our study demonstrates that while there is greater availability of HIV/AIDS services in Ukraine and Kyrgyzstan, this does not equate with greater

  8. 'It's risky to walk in the city with syringes': understanding access to HIV/AIDS services for injecting drug users in the former Soviet Union countries of Ukraine and Kyrgyzstan

    LENUS (Irish Health Repository)

    Spicer, Neil

    2011-07-13

    Abstract Background Despite massive scale up of funds from global health initiatives including the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) and other donors, the ambitious target agreed by G8 leaders in 2005 in Gleneagles to achieve universal access to HIV\\/AIDS treatment by 2010 has not been reached. Significant barriers to access remain in former Soviet Union (FSU) countries, a region now recognised as a priority area by policymakers. There have been few empirical studies of access to HIV\\/AIDS services in FSU countries, resulting in limited understanding and implementation of accessible HIV\\/AIDS interventions. This paper explores the multiple access barriers to HIV\\/AIDS services experienced by a key risk group-injecting drug users (IDUs). Methods Semi-structured interviews were conducted in two FSU countries-Ukraine and Kyrgyzstan-with clients receiving Global Fund-supported services (Ukraine n = 118, Kyrgyzstan n = 84), service providers (Ukraine n = 138, Kyrgyzstan n = 58) and a purposive sample of national and subnational stakeholders (Ukraine n = 135, Kyrgyzstan n = 86). Systematic thematic analysis of these qualitative data was conducted by country teams, and a comparative synthesis of findings undertaken by the authors. Results Stigmatisation of HIV\\/AIDS and drug use was an important barrier to IDUs accessing HIV\\/AIDS services in both countries. Other connected barriers included: criminalisation of drug use; discriminatory practices among government service providers; limited knowledge of HIV\\/AIDS, services and entitlements; shortages of commodities and human resources; and organisational, economic and geographical barriers. Conclusions Approaches to thinking about universal access frequently assume increased availability of services means increased accessibility of services. Our study demonstrates that while there is greater availability of HIV\\/AIDS services in Ukraine and Kyrgyzstan, this does not equate with

  9. Prevalence of illicit drug use in pregnant women in a Wisconsin private practice setting.

    Science.gov (United States)

    Schauberger, Charles W; Newbury, Emily J; Colburn, Jean M; Al-Hamadani, Mohammed

    2014-09-01

    We sought to measure the prevalence of illicit drug use in our obstetric population, to identify the drugs being used, and to determine whether a modified version of the 4Ps Plus screening tool could serve as an initial screen. In this prospective study, urine samples of 200 unselected patients presenting for initiation of prenatal care in a Wisconsin private practice were analyzed for evidence of the use of illicit drugs. Of 200 patients, 26 (13%) had evidence of drugs of abuse in their urine samples. Marijuana (7%) and opioids (6.5%) were the most commonly identified drugs. Adding 5 questions about drug or alcohol use to the obstetric intake questionnaire proved sensitive in identifying patients with high risks of having a positive drug screen. The rate of drug use in our low-risk population was higher than expected and may reflect increasing rates of drug use across the United States. Enhanced screening should be performed to identify patients using illicit drugs in pregnancy to improve their care. Medical centers and communities may benefit from periodic testing of their community prevalence rates to aid in appropriate care planning. Copyright © 2014 Mosby, Inc. All rights reserved.

  10. Serotonin shapes risky decision making in monkeys

    OpenAIRE

    Long, Arwen B.; Kuhn, Cynthia M.; Platt, Michael L.

    2009-01-01

    Some people love taking risks, while others avoid gambles at all costs. The neural mechanisms underlying individual variation in preference for risky or certain outcomes, however, remain poorly understood. Although behavioral pathologies associated with compulsive gambling, addiction and other psychiatric disorders implicate deficient serotonin signaling in pathological decision making, there is little experimental evidence demonstrating a link between serotonin and risky decision making, in ...

  11. Assessment of the prevalence of nootropic drugs by elderly patients in geriatric practice

    Directory of Open Access Journals (Sweden)

    Emilia Główczewska-Siedlecka

    2017-08-01

    Full Text Available So-called nootropics include a diverse group of drugs whose idea is to improve brain function. They are quite commonly accepted among the elderly. Although currently available data from the literature do not show unequivocally the efficacy of these drugs, in practice a large number of patients are in practice. These drugs are prescribed to patients fairly commonly and the range of indications for their use is wide and non-specific. This publication presents the mechanism of action of these nootropic drugs, historical outline of their use and epidemiological data on their use in elderly patients on the basis of patients treated in the Department of Geriatrics of Medical University in Bydgoszcz.

  12. Motives for and against injecting drug use among young adults in Amsterdam: qualitative findings and considerations for disease prevention

    NARCIS (Netherlands)

    Witteveen, Ewald; van Ameijden, Erik J. C.; Schippers, Gerard M.

    2006-01-01

    To elucidate injection initiation and risky injection practices among young drug users (YDUs) in Amsterdam, this study identifies self-reported motives for injecting and not injecting to inform interventions to be targeted at issues personally relevant for this population. A qualitative study was

  13. 76 FR 9027 - Draft Guidance for Industry and Food and Drug Administration Staff on Best Practices for...

    Science.gov (United States)

    2011-02-16

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-D-0057] Draft Guidance for Industry and Food and Drug Administration Staff on Best Practices for Conducting and...: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is...

  14. Impaired-driving prevalence among US high school students: associations with substance use and risky driving behaviors.

    Science.gov (United States)

    Li, Kaigang; Simons-Morton, Bruce G; Hingson, Ralph

    2013-11-01

    We examined the prevalence of impaired driving among US high school students and associations with substance use and risky driving behavior. We assessed driving while alcohol or drug impaired (DWI) and riding with alcohol- or drug-impaired drivers (RWI) in a nationally representative sample of 11th-grade US high school students (n = 2431). We examined associations with drinking and binge drinking, illicit drug use, risky driving, and demographic factors using multivariate sequential logistic regression analysis. Thirteen percent of 11th-grade students reported DWI at least 1 of the past 30 days, and 24% reported RWI at least once in the past year. Risky driving was positively associated with DWI (odds ratio [OR] = 1.25; P phone calls (OR = 3.2) while driving. Our findings suggest the need for comprehensive approaches to the prevention of DWI, RWI, and other risky driving behavior.

  15. Drugs + HIV, Learn the Link

    Medline Plus

    Full Text Available ... she went to a party and under the influence of drugs and alcohol engaged in risky sexual ... the message to young people and to parents, teachers, and the media about the link between drug ...

  16. Drugs + HIV, Learn the Link

    Medline Plus

    Full Text Available ... night she went to a party and under the influence of drugs and alcohol engaged in risky sexual behavior that resulted in HIV infection. Watch the "After the Party" Video Behaviors associated with drug ...

  17. Current good manufacturing practice and investigational new drugs intended for use in clinical trials. Final rule.

    Science.gov (United States)

    2008-07-15

    The Food and Drug Administration (FDA) is amending the current good manufacturing practice (CGMP) regulations for human drugs, including biological products, to exempt most phase 1 investigational drugs from complying with the regulatory CGMP requirements. FDA will continue to exercise oversight of the manufacture of these drugs under FDA's general statutory CGMP authority and through review of the investigational new drug applications (IND). In addition, elsewhere in this issue of the Federal Register, FDA is announcing the availability of a guidance document entitled "Guidance for Industry: CGMP for Phase 1 Investigational Drugs" dated November 2007 (the companion guidance). This guidance document sets forth recommendations on approaches to compliance with statutory CGMP for the exempted phase 1 investigational drugs. FDA is taking this action to focus a manufacturer's effort on applying CGMP that is appropriate and meaningful for the manufacture of the earliest stage investigational drug products intended for use in phase 1 clinical trials while ensuring safety and quality. This action will also streamline and promote the drug development process.

  18. Indicators of club management practices and biological measurements of patrons' drug and alcohol use.

    Science.gov (United States)

    Byrnes, Hilary F; Miller, Brenda A; Johnson, Mark B; Voas, Robert B

    2014-12-01

    Electronic music and dance events in nightclubs attract patrons with heavy alcohol/drug use. Public health concerns are raised from risks related to these behaviors. Practices associated with increased risk in these club settings need to be identified. The relationship between club management practices and biological measures of patrons' alcohol/drug use is examined. Observational data from 25 events across six urban clubs were integrated with survey data (N = 738 patrons, 42.8% female) from patrons exiting these events, 2010-2012. Five indicators of club management practices were examined using mixed model regressions: club security, bar crowding, safety signs, serving intoxicated patrons, and isolation. Analyses revealed that serving intoxicated patrons and safety signs were related to substance use. Specifically, serving intoxicated patrons was related to heavy alcohol and drug use at exit, while safety signs were marginally related to less exit drug use. CONCLUSIONS/IMPORTANCE: Findings indicate observable measures in nightclubs provide important indicators for alcohol/drug use, suggesting practices to target. Study strengths include the use of biological measures of substance use on a relatively large scale. Limitations and future directions are discussed.

  19. Turning theory into practice: the development of modern transdermal drug delivery systems and future trends.

    Science.gov (United States)

    Perumal, O; Murthy, S N; Kalia, Y N

    2013-01-01

    Despite its remarkable barrier function, the skin remains an attractive site for systemic drug delivery given its easy accessibility, large surface area and the possibility to bypass the gastrointestinal tract and the liver and so modify drug absorption kinetics. The pioneering work of Scheuplein, Higuchi and others in the 1960s helped to explain the processes involved in passive percutaneous absorption and led to the development of mathematical models to describe transdermal drug delivery. The intervening years have seen these theories turned to practice and a significant number of transdermal systems are now available including some that employ active drug delivery. This review briefly discusses the evolution of transdermal therapeutic systems over the years and the potential of newer transdermal technologies to deliver hydrophilic drugs and macromolecules through the skin. © 2013 S. Karger AG, Basel.

  20. Authoritative parenting and drug-prevention practices: implications for antidrug ads for parents.

    Science.gov (United States)

    Stephenson, Michael T; Quick, Brian L; Atkinson, Joshua; Tschida, David A

    2005-01-01

    This research employed the theory of reasoned action to investigate the role of authoritative parenting in 3 drug-prevention behaviors: (a) parental monitoring, (b) parent-child discussions, and (c) awareness of the child's environment. A phone survey of 158 parents of adolescents in 7th, 9th, and 11th grades revealed that authoritative parenting was correlated with parenting practices that reduce the likelihood of adolescent drug use, including discussing family rules about drugs, discussing strategies to avoid drugs, discussing those in trouble with drugs, parental monitoring, knowing the child's plans for the coming day, and personally knowing the child's friends well. Additionally, authoritative parenting moderated the attitude-behavioral intention relation for parental monitoring and awareness of the child's environment, with the weakest relation detected for low-authoritative parents. The utility of these findings in helping design and target antidrug messages for parents more effectively is discussed.

  1. Best practice strategies to safeguard drug prescribing and drug administration: an anthology of expert views and opinions.

    Science.gov (United States)

    Seidling, Hanna M; Stützle, Marion; Hoppe-Tichy, Torsten; Allenet, Benoît; Bedouch, Pierrick; Bonnabry, Pascal; Coleman, Jamie J; Fernandez-Llimos, Fernando; Lovis, Christian; Rei, Maria Jose; Störzinger, Dominic; Taylor, Lenka A; Pontefract, Sarah K; van den Bemt, Patricia M L A; van der Sijs, Heleen; Haefeli, Walter E

    2016-04-01

    While evidence on implementation of medication safety strategies is increasing, reasons for selecting and relinquishing distinct strategies and details on implementation are typically not shared in published literature. We aimed to collect and structure expert information resulting from implementing medication safety strategies to provide advice for decision-makers. Medication safety experts with clinical expertise from thirteen hospitals throughout twelve European and North American countries shared their experience in workshop meetings, on-site-visits and remote structured interviews. We performed an expert-based, in-depth assessment of implementation of best-practice strategies to improve drug prescribing and drug administration. Workflow, variability and recommended medication safety strategies in drug prescribing and drug administration processes. According to the experts, institutions chose strategies that targeted process steps known to be particularly error-prone in the respective setting. Often, the selection was channeled by local constraints such as the e-health equipment and critically modulated by national context factors. In our study, the experts favored electronic prescribing with clinical decision support and medication reconciliation as most promising interventions. They agreed that self-assessment and introduction of medication safety boards were crucial to satisfy the setting-specific differences and foster successful implementation. While general evidence for implementation of strategies to improve medication safety exists, successful selection and adaptation of a distinct strategy requires a thorough knowledge of the institute-specific constraints and an ongoing monitoring and adjustment of the implemented measures.

  2. Implicit attitudes towards risky and safe driving in a Danish sample

    DEFF Research Database (Denmark)

    Martinussen, Laila Marianne

    ; further, self-reports of the intention to drive safely (or not) are socially sensitive. Therefore, we examined automatic preferences towards safe and risky driving with a Go/No-go Association Task (GNAT). The results suggest that (1) implicit attitudes towards driving behavior can be measured reliably...... with the GNAT; (2) implicit attitudes towards safe driving versus towards risky driving may be separable constructs. We propose that research on driving behavior may benefit from routinely including measures of implicit cognition. A practical advantage is a lesser susceptibility to social desirability biases......, compared to self-report methods. Pending replication in future research, the apparent dissociation between implicit attitudes towards safe versus risky driving that we observed may contribute to a greater theoretical understanding of the causes of unsafe and risky driving behavior....

  3. Go Play Outside! Effects of a risk-reframing tool on mothers' tolerance for, and parenting practices associated with, children's risky play: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Brussoni, Mariana; Ishikawa, Takuro; Han, Christina; Pike, Ian; Bundy, Anita; Faulkner, Guy; Mâsse, Louise C

    2018-03-07

    Children's risky play is associated with a variety of positive developmental, physical and mental health outcomes, including greater physical activity, self-confidence and risk-management skills. Children's opportunities for risky play have eroded over time, limited by parents' fears and beliefs about risk, particularly among mothers. We developed a digital tool and in-person Risk-reframing (RR) workshop to reframe parents' perceptions of risk and change parenting behaviours. The purpose of this paper is to describe our RR intervention, rationale and protocol for a randomised controlled trial to examine whether it leads to increases in mothers' tolerance of risk in play and goal attainment relating to promoting their child's opportunities for risky play. We use a randomised controlled trial design and will recruit a total of 501 mothers of children aged 6-12 years. The RR digital tool is designed for a one-time visit and includes three chapters of self-reflection and experiential learning tasks. The RR in-person tool is a 2-h facilitated workshop in which participants are guided through discussion of the same tasks contained within the digital tool. The control condition consists of reading the Position Statement on Active Outdoor Play. Primary outcome is increased tolerance of risk in play, as measured by the Tolerance of Risk in Play Scale. Secondary outcome is self-reported attainment of a behaviour-change goal that participants set for themselves. We will test the hypothesis that there will be differences between the experimental and control conditions with respect to tolerance of risk in play using mixed-effects models. We will test the hypothesis that there will be differences between the experimental and control conditions with respect to goal attainment using logistic regression. The results of this trial will have important implications for facilitating the widespread change in parents' risk perception that is necessary for promoting broad societal

  4. A Mixture IRT Analysis of Risky Youth Behavior

    Directory of Open Access Journals (Sweden)

    Holmes eFinch

    2011-05-01

    Full Text Available The study reported in this manuscript used a mixture item response model with data from the Youth Risk Behavior Survey 2009 (N = 16,410 to identify subtypes of adolescents at-risk for engaging in unhealthy behaviors, and to find individual survey items that were most effective at identifying such students within each subtype. The goal of the manuscript is twofold: 1 To demonstrate the utility of the mixture item response theory model for identifying subgroups in the population and for highlighting the use of group specific item response parameters and 2 To identify typologies of adolescents based on their propensity for engaging in sexually and substance use risky behaviors. Results indicate that 4 classes of youth exist in the population, with differences in risky sexual behaviors and substance use. The first group had a greater propensity to engage in risky sexual behavior, while group 2 was more likely to smoke tobacco and drink alcohol. Group 3 was the most likely to use other substances, such as marijuana, methamphetamine, and other mind altering drugs, and group 4 had the lowest propensity for engaging in any of the sexual or substance use behaviors included in the survey. Finally, individual items were identified for each group that can be most effective at identifying individuals at greatest risk. Further proposed directions of research and the contribution of this analysis to the existing literature are discussed.

  5. Randomized clinical trial on the use of antispasmodic drugs in barium enema: impact on radiological practice

    International Nuclear Information System (INIS)

    Goei, Reginald; Kessels, Alphons H.; Nix, Maarten; Knipschild, Paul G.

    2000-01-01

    Purpose: To assess the willingness of radiologists to change their practice when the results of a randomized clinical trial (RCT) on the use of antispasmodic drugs in barium enema are presented. Materials and Methods: During the years 1994 and 1995 two postal questionnaires were sent to 481 practicing radiologists who were all members of the Netherlands Society of Radiology. In the first questionnaire the respondents were asked to give the characteristics of their practices in performing daily barium enema. The data from this questionnaire was used as a reference. The second questionnaire was sent to the respondents together with an abstract on the randomized clinical trial supporting the use of antispasmodic drugs in barium enema. We also indicated a preference for Buscopan over Glucagon as the antispasmodic drug. The willingness to change prescription habits was measured by comparing the data of the two questionnaires. Results: Of 481 practicing radiologists, 312 responded to the first questionnaire and gave information of their prescription habits (response rate 64%). These 312 responders were sent an abstract of the RCT and were asked to fill out a second questionnaire to determine their willingness to change their practice. Two hundred and sixty-seven radiologists responded (response rate 86%). A significant number of 119 (51%) were willing to increase the use of antispasmodic drugs. A significant number of 128 (55%) chose to increase the use of Buscopan, while a significant number of 81 (32%) were willing to decrease the use of Glucagon. Conclusion: Direct exposure to the results of an RCT recommending the use of antispasmodic drugs in barium enema, especially Buscopan, is likely to increase its use by practicing radiologists

  6. Risky sexual practices among men who have sex with men in Northeast Brazil: results from four sequential surveys Práticas sexuais de risco de homens que fazem sexo com homens no Nordeste do Brasil: resultados de quatro inquéritos seqüenciais

    Directory of Open Access Journals (Sweden)

    Rogério Costa Gondim

    2009-06-01

    Full Text Available This paper focuses on recent trends in risky sexual practices for HIV/AIDS among men who have sex with men (MSM in Fortaleza, Ceará State, Brazil. Four cross-sectional surveys were conducted (1995, 1998, 2002, and 2005 among MSM 14 years or older who reported oral or anal sex in the previous 12 months. Sexual practices were considered risky whenever the respondent reported unprotected receptive or insertive anal intercourse in the six months preceding the interview. Different selection techniques were used to recruit the study population: snowball (1995, 1998, 2002 - 32%; time-space sampling (2002 - 68%; and respondent-driven sampling (2005. Analyses were based on the comparison between proportions. High rates of risky sexual practices were reported in 1995 (49.9%, decreasing in 1998 (32.6%, increasing again in 2002 (51.3%, and showing the lowest level in 2005 (31.4%. Participants with more schooling increased their risky practices from 1998 to 2002, decreasing in 2005. Among individuals with medium or low schooling, risky behavior declined from 2002 to 2005. The article highlights the need for behavioral surveillance to properly address STD/HIV prevention.Estudaram-se as tendências recentes das práticas sexuais de risco para DST/AIDS entre homens que fazem sexo com homens (HSH em Fortaleza, Ceará, Brasil. Realizaram-se quatro estudos seccionais (1995, 1998, 2002 e 2005 em HSH, com 14 anos ou mais, que tenham referido prática sexual oral ou anal com homens nos últimos 12 meses. Definiu-se prática sexual de risco uma relação anal insertiva ou receptiva sem uso de preservativo nos seis meses que antecederam a entrevista. Utilizaram-se técnicas de recrutamento do tipo snow ball (1995, 1998, 2002 - 32%; time space sampling (2002 - 68% e respondent driven sampling (2005. Análises basearam-se nas comparações entre proporções. Elevados percentuais de práticas sexuais de risco foram referidos em 1995 (49,9%, decrescendo em 1998 (32

  7. 77 FR 49449 - Food and Drug Administration Clinical Trial Requirements, Compliance, and Good Clinical Practice...

    Science.gov (United States)

    2012-08-16

    ... investigator initiated research. Topics for discussion include the following: (1) What FDA Expects in a...] Food and Drug Administration Clinical Trial Requirements, Compliance, and Good Clinical Practice...-sponsorship with the Society of Clinical Research Associates (SoCRA) is announcing a public workshop. The...

  8. Evaluation of new drugs in daily clinical practice: anti-TNF alpha in rheumatoid arthritis patients.

    NARCIS (Netherlands)

    Kievit, W.

    2008-01-01

    The objective of this thesis was to explore the value and the validity of data collected in daily clinical practice for drug evaluation and cost-effectiveness studies, using data collected on TNFa blocking agents in rheumatoid arthritis. First, the need for and value of information from daily

  9. [Prescribed drug use for bipolar disorder type I and II in clinical practice].

    Science.gov (United States)

    Persson, Charlotte; Kardell, Mathias; Karanti, Alina; Isgren, Anniella; Annerbrink, Kristina; Landen, Mikael

    2017-01-10

    Prescribed drug use for bipolar disorder type I and II in clinical practice Practice guidelines based on available evidence and clinical consensus are available for the treatment of bipolar disorder. We surveyed to which extent those guidelines are implemented in clinical practice in Sweden. We analysed pharmacological treatment in patients with bipolar disorder in 2015 using the national quality register for bipolar disorder (BipoläR). We compared bipolar disorder type I (BDI) with type bipolar disorder type II (BDII). The vast majority of patients were prescribed a mood stabilizer either as monotherapy or as a part of combination therapy (BDI 87%, BDII 83%, pbipolar disorder.

  10. Safety risks with investigational drugs: Pharmacy practices and perceptions in the veterans affairs health system.

    Science.gov (United States)

    Cruz, Jennifer L; Brown, Jamie N

    2015-06-01

    Rigorous practices for safe dispensing of investigational drugs are not standardized. This investigation sought to identify error-prevention processes utilized in the provision of investigational drug services (IDS) and to characterize pharmacists' perceptions about safety risks posed by investigational drugs. An electronic questionnaire was distributed to an audience of IDS pharmacists within the Veteran Affairs Health System. Multiple facets were examined including demographics, perceptions of medication safety, and standard processes used to support investigational drug protocols. Twenty-one respondents (32.8% response rate) from the Northeast, Midwest, South, West, and Non-contiguous United States participated. The mean number of pharmacist full-time equivalents (FTEs) dedicated to the IDS was 0.77 per site with 0.2 technician FTEs. The mean number of active protocols was 22. Seventeen respondents (81%) indicated some level of concern for safety risks. Concerns related to the packaging of medications were expressed, most notably lack of product differentiation, expiration dating, barcodes, and choice of font size or color. Regarding medication safety practices, the majority of sites had specific procedures in place for storing and securing drug supply, temperature monitoring, and prescription labeling. Repackaging bulk items and proactive error-identification strategies were less common. Sixty-seven percent of respondents reported that an independent double check was not routinely performed. Medication safety concerns exist among pharmacists in an investigational drug service; however, a variety of measures have been employed to improve medication safety practices. Best practices for the safe dispensing of investigational medications should be developed in order to standardize these error-prevention strategies.

  11. Human factors in cybersecurity; examining the link between Internet addiction, impulsivity, attitudes towards cybersecurity, and risky cybersecurity behaviours.

    Science.gov (United States)

    Hadlington, Lee

    2017-07-01

    The present study explored the relationship between risky cybersecurity behaviours, attitudes towards cybersecurity in a business environment, Internet addiction, and impulsivity. 538 participants in part-time or full-time employment in the UK completed an online questionnaire, with responses from 515 being used in the data analysis. The survey included an attitude towards cybercrime and cybersecurity in business scale, a measure of impulsivity, Internet addiction and a 'risky' cybersecurity behaviours scale. The results demonstrated that Internet addiction was a significant predictor for risky cybersecurity behaviours. A positive attitude towards cybersecurity in business was negatively related to risky cybersecurity behaviours. Finally, the measure of impulsivity revealed that both attentional and motor impulsivity were both significant positive predictors of risky cybersecurity behaviours, with non-planning being a significant negative predictor. The results present a further step in understanding the individual differences that may govern good cybersecurity practices, highlighting the need to focus directly on more effective training and awareness mechanisms.

  12. Pharmacokinetic drug-drug interaction between erlotinib and paracetamol: A potential risk for clinical practice.

    Science.gov (United States)

    Karbownik, Agnieszka; Szałek, Edyta; Sobańska, Katarzyna; Grabowski, Tomasz; Wolc, Anna; Grześkowiak, Edmund

    2017-05-01

    Erlotinib is a tyrosine kinase inhibitor available for the treatment of non-small cell lung cancer. Paracetamol is an analgesic agent, commonly used in cancer patients. Because these drugs are often co-administered, there is an increasing issue of interaction between them. The aim of the study was to investigate the effect of paracetamol on the pharmacokinetic parameters of erlotinib, as well as the influence of erlotinib on the pharmacokinetics of paracetamol. The rabbits were divided into three groups: the rabbits receiving erlotinib (I ER ), the group receiving paracetamol (II PR ), and the rabbits receiving erlotinib+paracetamol (III ER+PR ). A single dose of erlotinib was administered orally (25mg) and was administered intravenously (35mg/kg). Plasma concentrations of erlotinib, its metabolite (OSI420), paracetamol and its metabolites - glucuronide and sulphate were measured with the validated method. During paracetamol co-administration we observed increased erlotinib maximum concentration (C max ) and area under the plasma concentration-time curve from time zero to infinity (AUC 0-∞ ) by 87.7% and 31.1%, respectively. In turn, erlotinib lead to decreased paracetamol AUC 0-∞ by 35.5% and C max by 18.9%. The mean values of paracetamol glucuronide/paracetamol ratios for C max were 32.2% higher, whereas paracetamol sulphate/paracetamol ratios for C max and AUC 0-∞ were 37.1% and 57.1% lower in the II PR group, when compared to the III ER+PR group. Paracetamol had significant effect on the enhanced plasma exposure of erlotinib. Additionally, erlotinib contributed to the lower concentrations of paracetamol. Decreased glucuronidation and increased sulphation of paracetamol after co-administration of erlotinib were also observed. Copyright © 2017. Published by Elsevier B.V.

  13. An audit of prescribing practices for benzodiazepines and Z-drugs.

    LENUS (Irish Health Repository)

    Cadogan, C

    2015-03-01

    Concerns persist over the use of benzodiazepines and Z-drugs in Ireland. A prospective prescription audit was conducted in 81 community pharmacies across Ireland over a four week period. The study sought to assess the level of prescription compliance with key components of benzodiazepine and Z-drug prescribing guidelines. 28% of audit booklets issued were returned, yielding data on 4,418 prescriptions. The findings suggest that little progress has been made in improving the prescribing of benzodiazepines and Z-drugs in Ireland in the decade since publication of the Benzodiazepine Committee\\'s report. Fewer than one fifth of prescriptions (18.8%) were fully compliant with the assessment criteria and the majority (53.7%) had multiple discrepancies. This study highlights the importance of monitoring and auditing benzodiazepine and Z-drug prescribing practices. Interventions involving patients, prescribers and pharmacists are required to improve the prescribing and use of these medications in Ireland.

  14. Evidence behind FDA alerts for drugs with adverse cardiovascular effects: implications for clinical practice.

    Science.gov (United States)

    Rackham, Daniel M; C Herink, Megan; Stevens, Ian G; Cardoza, Natalie M; Singh, Harleen

    2014-01-01

    The U.S. Food and Drug Administration (FDA) periodically publishes Drug Safety Communications and Drug Alerts notifying health care practitioners and the general public of important information regarding drug therapies following FDA approval. These alerts can result in both positive and negative effects on patient care. Most clinical trials are not designed to detect long-term safety end points, and postmarketing surveillance along with patient reported events are often instrumental in signaling the potential harmful effect of a drug. Recently, many cardiovascular (CV) safety announcements have been released for FDA-approved drugs. Because a premature warning could discourage a much needed treatment or prompt a sudden discontinuation, it is essential to evaluate the evidence supporting these FDA alerts to provide effective patient care and to avoid unwarranted changes in therapy. Conversely, paying attention to these warnings in cases involving high-risk patients can prevent adverse effects and litigation. This article reviews the evidence behind recent FDA alerts for drugs with adverse CV effects and discusses the clinical practice implications. © 2013 Pharmacotherapy Publications, Inc.

  15. Mixed Frames and Risky Decision-Making.

    Science.gov (United States)

    Peng, Jiaxi; Zhang, Jiaxi; Sun, Hao; Zeng, Zhicong; Mai, Yuexia; Miao, Danmin

    2017-01-01

    By applying unitive vocabulary, "die" or "save," to respective frames of the Asian disease problem, Tversky and Kahneman were able to define framing effect. In this study, we preliminarily explored the effect of mixed frames, which are characterized by the use of different vocabulary in one frame. In study 1, we found that only the sure option description had significant effect on decision-making, while the effects of risky option descriptions were not significant, nor were interactions between descriptions. In study 2, the results suggested that after controlling the effects of the hedonic tone of the sure options, risky option description did not significantly predict decision-making. In study 3, we found that neither the sure-to-risky option presentation order nor presentation order within risky options had significant effect on decision-making. We thus concluded that sure option description can serve as the decision-making foundation (reference point) for decision-makers in mixed frames.

  16. Risky Business: Dealing with Your Teen's Behavior

    Science.gov (United States)

    ... Issues Subscribe September 2011 Print this issue Risky Business Dealing With Your Teen’s Behavior Send us your ... go it alone. You can find helpful resources online and in community and school programs (See our ...

  17. Clinical practice guidelines for translating pharmacogenomic knowledge to bedside. Focus on anticancer drugs.

    Directory of Open Access Journals (Sweden)

    José A G Agúndez

    2014-08-01

    Full Text Available The development of clinical practice recommendations or guidelines for the clinical use of pharmacogenomics data is an essential issue for improving drug therapy, particularly for drugs with high toxicity and/or narrow therapeutic index such as anticancer drugs. Although pharmacogenomic-based recommendations have been formulated for over 40 anticancer drugs, the number of clinical practice guidelines available is very low. The guidelines already published indicate that pharmacogenomic testing is useful for patient selection, but final dosing adjustment should be carried out on the basis of clinical or analytical parameters rather than on pharmacogenomic information.Patient selection may seem a modest objective, but it constitutes a crucial improvement with regard to the pre-pharmacogenomics situation and it saves patients’ lives. However we should not overstate the current power of pharmacogenomics. At present the pharmacogenomics of anticancer drugs is not sufficiently developed for dose adjustments based on pharmacogenomics only, and no current guidelines recommend such adjustments without considering clinical and/or analytical parameters.

  18. Hiponatremia in the practice of a psychiatrist. Part 1: SIADH syndrome and drug-induced hyponatremia.

    Directory of Open Access Journals (Sweden)

    Stelmach Ewa

    2017-06-01

    Full Text Available Introduction. Hyponatremia is an important part of psychiatric practice. In order to analyze its causes and symptoms, the literature on hyponatremia in psychiatric patients has been reviewed. The work has been divided into two separate manuscripts. In the first one the authors discuss the syndrome of inappropriate antidiuretic hormone secretion (SIADH and hyponatremia occurring with the use of psychotropic drugs (antidepressants, antipsychotics, normotimics, while the second paper discusses research on psychogenic polydipsia. The causes of hyponatremia in patients treated in psychiatric wards include: water intoxication associated with polydipsia, somatic comorbidities, side effect of internal medicine and psychiatric drugs. The most common mechanism leading in these cases to hyponatremia is the syndrome of inappropriate secretion of vasopressin (SIADH. The SIADH syndrome is a group of symptoms, first described in 1967 by Schwartz and Bartter in The American Journal of Medicine, which results from the hypersecretion of antidiuretic hormone, also called vasopressin, which causes patients to develop normovolemic hyponatremia. The phenomenon of drug-induced hyponatremia in psychiatric practice is generally observed with the use of antidepressants, antipsychotics and anti-epileptic drugs (used in psychiatry as normotimic drugs.

  19. Modifying Evaluations and Decisions in Risky Situations.

    Science.gov (United States)

    Maldonado, Antonio; Serra, Sara; Catena, Andrés; Cándido, Antonio; Megías, Alberto

    2016-09-20

    The main aim of this research was to investigate the decision making process in risky situations. We studied how different types of feedback on risky driving behaviors modulate risk evaluation and risk-taking. For a set of risky traffic situations, participants had to make evaluative judgments (judge the situation as risky or not) and urgent decisions (brake or not). In Experiment 1, participants received feedback with and without negative emotional content when they made risky behaviors. In Experiment 2 we investigated the independent effects of feedback and negative emotional stimuli. The results showed three important findings: First, urgent decisions were faster [F(1, 92) = 6.76, p = .01] and more cautious [F(1, 92) = 17.16, p towards more cautious responses [F(1, 111) = 14.09, p emotional stimuli had an effect only when they were presented as feedback. The results of this research increase our understanding of the processes involved in risky driving behavior and suggest efficient ways to control risk taking through the use of feedback.

  20. Drug evaluation and the permissive principle: continuities and contradictions between standards and practices in antidepressant regulation.

    Science.gov (United States)

    Abraham, John; Davis, Courtney

    2009-08-01

    Pharmaceuticals are not permitted on to the market unless they are granted regulatory approval. The regulatory process is, therefore, crucial in whether or not a drug is widely prescribed. Regulatory agencies have developed standards of performance that pharmaceuticals are supposed to meet before entering the market. Regulation of technologies is often discussed by reference to the precautionary principle. In contrast, this paper develops the concept of the 'permissive principle' as a way of understanding the departure of regulators' practices from standards of drug efficacy to which regulatory agencies themselves subscribe. By taking a case study of antidepressant regulation in the UK and the USA, the mechanisms of permissive regulatory practices are examined. An STS methodology of both spatial (international) and temporal comparisons of regulatory practices with regulatory standards is employed to identify the nature and extent of the permissive regulation. It is found that the permissive principle was adopted by drug regulators in the UK and the USA, but more so by the former than the latter. Evidently, permissive regulation, which favours the commercial interests of the drug manufacturer, but is contrary to the interests of patients, may penetrate to the heart of regulatory science. On the other hand, permissive regulation of specific drugs should not be regarded as an inevitable result of marketing strategies and concomitant networks deployed by powerful pharmaceutical companies, because the extent of permissive regulation may vary according to the intra-institutional normative commitments of regulators to uphold their technical standards against the commercial interests of the manufacturer. Likely sociological factors that can account for such permissive regulatory practices are 'corporate bias', secrecy and excessive regulatory trust in the pharmaceutical industry in the UK, political expediency and ideological capture in the USA, combined in both countries

  1. Treatment practices and quantification of antimicrobial drug usage in conventional and organic dairy farms in Wisconsin.

    Science.gov (United States)

    Pol, M; Ruegg, P L

    2007-01-01

    The objective of this study was to develop a method to quantify antimicrobial drug usage and treatment practices on conventional and organic dairy farms that had been recruited to represent a broad spectrum of potential exposure to antimicrobial drugs. Data on disease prevalence and treatment practices of organic (n = 20) and conventional (n = 20) farms were obtained during a farm visit using a survey instrument. A standardized estimate of antimicrobial drug usage was developed using a defined daily dose (DDD) of selected compounds. Density of antimicrobial drug usage was expressed as the number of DDD per adult cow per year. Differences in prevalence and management of selected diseases between conventional and organic farms were identified. The overall estimated prevalence of selected diseases was greater for conventional farms compared with organic farms. Organic farmers reported use of a variety of nonantimicrobial compounds for treatment and prevention of disease. Conventional farmers reported that penicillin was the compound most commonly used for dry cow therapy and cephapirin was most commonly used for treatment of clinical mastitis. On conventional farms, the estimated overall exposure to antimicrobial drugs was 5.43 DDD per cow per year composed of 3.58 and 1.85 DDD of intramammary and parenteral antimicrobial drugs, respectively. Of total intramammary antimicrobial drug usage, treatment of clinical mastitis contributed 2.02 DDD compared with 1.56 DDD attributed to the use of dry cow therapy. Of total parenteral treatments, the distribution of exposure was 0.52 (dry cow therapy), 1.43 (clinical mastitis treatment), 0.39 (treatment of foot disease), 0.14 (treatment of respiratory disease), and 0.32 (treatment of metritis) DDD. For treatments of foot infections (0.33 DDD), respiratory infections (0.07 DDD), and metritis (0.19 DDD), the mean density of ceftiofur usage was significantly greater compared with other compounds.

  2. Drugs + HIV, Learn the Link

    Medline Plus

    Full Text Available ... the influence of drugs and alcohol engaged in risky sexual behavior that resulted in HIV infection. Watch the "After ... to poor decision making, which can result in risky sexual behaviors and HIV infection. Although the characters are fictional, ...

  3. A Practical Methodology for Disaggregating the Drivers of Drug Costs Using Administrative Data.

    Science.gov (United States)

    Lungu, Elena R; Manti, Orlando J; Levine, Mitchell A H; Clark, Douglas A; Potashnik, Tanya M; McKinley, Carol I

    2017-09-01

    Prescription drug expenditures represent a significant component of health care costs in Canada, with estimates of $28.8 billion spent in 2014. Identifying the major cost drivers and the effect they have on prescription drug expenditures allows policy makers and researchers to interpret current cost pressures and anticipate future expenditure levels. To identify the major drivers of prescription drug costs and to develop a methodology to disaggregate the impact of each of the individual drivers. The methodology proposed in this study uses the Laspeyres approach for cost decomposition. This approach isolates the effect of the change in a specific factor (e.g., price) by holding the other factor(s) (e.g., quantity) constant at the base-period value. The Laspeyres approach is expanded to a multi-factorial framework to isolate and quantify several factors that drive prescription drug cost. Three broad categories of effects are considered: volume, price and drug-mix effects. For each category, important sub-effects are quantified. This study presents a new and comprehensive methodology for decomposing the change in prescription drug costs over time including step-by-step demonstrations of how the formulas were derived. This methodology has practical applications for health policy decision makers and can aid researchers in conducting cost driver analyses. The methodology can be adjusted depending on the purpose and analytical depth of the research and data availability. © 2017 Journal of Population Therapeutics and Clinical Pharmacology. All rights reserved.

  4. Adverse drug reaction and toxicity caused by commonly used antimicrobials in canine practice

    Directory of Open Access Journals (Sweden)

    K. Arunvikram

    2014-05-01

    Full Text Available An adverse drug reaction (ADR is a serious concern for practicing veterinarians and other health professionals, and refers to an unintended, undesired and unexpected response to a drug that negatively affects the patient's health. It may be iatrogenic or genetically induced, and may result in death of the affected animal. The ADRs are often complicated and unexpected due to myriad clinical symptoms and multiple mechanisms of drug-host interaction. Toxicity due to commonly used drugs is not uncommon when they are used injudiciously or for a prolonged period. Licosamides, exclusively prescribed against anaerobic pyoderma, often ends with diarrhoea and vomiting in canines. Treatment with Penicillin and β-lactam antibiotics induces onset of pemphigious vulgare, drug allergy or hypersensitivity. Chloroamphenicol and aminoglycosides causes Gray's baby syndrome and ototoxicity in puppies, respectively. Aminoglycosides are very often associated with nephrotoxicity, ototoxicity and neuromuscular blockage. Injudicious use of fluroquinones induces the onset of arthropathy in pups at the weight bearing joints. The most effective therapeutic measure in managing ADR is to treat the causative mediators, followed by supportive and symptomatic treatment. So, in this prospective review, we attempt to bring forth the commonly occurring adverse drug reactions, their classification, underlying mechanism, epidemiology, treatment and management as gleaned from the literature available till date and the different clinical cases observed by the authors.

  5. Effectiveness of an educational feedback intervention on drug prescribing in dental practice.

    Science.gov (United States)

    Rauniar, G P; Das, B P; Manandhar, T R; Bhattacharya, S K

    2012-01-01

    Irrational use of drugs as well as inappropriate and over drug prescribing leads to unnecessary expenditures and emergence of resistant bacterial strains. Feedback intervention on drug prescribing habits and face to face educational intervention of prescription audit would be effective in rationalizing prescribing practices. To measure the impact of educational feedback intervention on the prescribing behavior of dental surgeons. Prospective audit of twelve hundred outpatients prescriptions in dental OPD at BPKIHS of those dental surgeon who attended the educational intervention session was collected randomly by trained persons on customized data collection sheet before and after educational intervention. A total 1200 prescription were collected, 300 before and 300 after intervention period at the internal of one month, three months and six months. Majority of the prescriptions (39.33%) contained four drugs but after intervention, prescriptions contained mostly one drug, 73% in first month, 78.67% in third month and 65.34% in six month. Mean number of drugs per prescription after intervention were decreased. There was increased number of generic names of drugs after intervention. Amoxicillin, Metronidazole, Chlorhexidine, Povidone iodine gargle, Nimesulide, Ibuprofen, Ibuprofen + paracetamol, and Paracetamol were most commonly prescribed by dental prescribers before and after intervention. Selection of antimicrobial was done on empirical basis which was correct because Amoxicillin concentration reaches effectively in gingival crevicular fluid and Metronidazole covered effectively against anaerobic bacteria were found in orodental infection. The uses of topical anti-infective preparation as irrigants of choice that can kill majority of micro-organisms found is root canal and dental tubules and minimize systemic use of antimicrobials. Nimesulide prescribing needs to be rationalized. Feedback educational intervention of prescription audit is effective to improve their

  6. Recommendations to bridge rural/urban drug-use(r) research and practice.

    Science.gov (United States)

    Leukefeld, C G; Edwards, R W

    1999-01-01

    This article presents recommendations developed by a group of United States drug-use(r) researchers interested in rural and urban research and practice who met in Lexington, Kentucky, in October 1996. Overall, there was consensus about the importance of better understanding the urban/rural drug and alcohol use/dependency continuum. It was emphasized that drug and alcohol use/dependency are chronic and relapsing disorders. Definitions of rural and urban are most important, and different definitions may be associated with factors that are masked by population density. Specific recommendations are presented in the following areas: Rural Factors, Epidemiology, HIV/AIDS, Treatment and Other Services, Migration, Youth, Protective Factors, Systems Perspective, Measurement, Confidentiality, Criminal Justice, Research, Policy Research, Economic Factors, Service Providers, and Managed Care.

  7. Approaches to Increasing Ethical Compliance in China with Drug Trial Standards of Practice

    DEFF Research Database (Denmark)

    Rosenberg, Jacob

    2016-01-01

    . With recent reports of scientific misconduct from China, there is an urgent need to find approaches to compel researchers to adhere to ethical research practices. This problem does not call for a simple solution, but if forces are joined with governmental regulations, education in ethics issues for medical......Zeng et al.'s Ethics Review highlights some of the challenges associated with clinical research in China. They found that only a minority of published clinical trials of anti-dementia drugs reported that they fulfilled the basic ethical principles as outlined in the Declaration of Helsinki...... researchers, and strong reinforcement by Chinese journal editors not to publish studies with these flaws, then research ethics and publication standards will probably improve. Other solutions to foster ethical practice of drug trials are discussed including Chinese initiatives directed at managing conflict...

  8. [Students' practice in the construction of knowledge about the phenomenon of drug abuse].

    Science.gov (United States)

    dos Santos, Vanessa Oliveira Guimarães; Vargens, Octavio Muniz da Costa

    2010-03-01

    This is a qualitative descriptive research, carried out with nursing undergraduates from Rio de Janeiro State University, Brazil. The purpose is to discuss students' experiences and their social practice in assisting drugs uses. Data were collected from December 2008 to January, 2009, with the use of focal groups composed by 19 undergraduates from the last three semesters of the course. The project was approved by the Ethics Research Commission. All participants signed the Informed Consent. The results evidenced students' difficulty in facing reality, due to the contrast between theory and practice. Such difficulty came out as a consequence of an inapropriate educational approach. We concluded that the academic institutions should optimize the use of teaching process. Professional formation related to the phenomenon of drug abuse is considered essential as it becomes more and more frequent in nurses' daily routines.

  9. Zolpidem prescribing practices before and after Food and Drug Administration required product labeling changes

    OpenAIRE

    Norman, Jessica L; Fixen, Danielle R; Saseen, Joseph J; Saba, Laura M; Linnebur, Sunny A

    2017-01-01

    Background: Women have higher morning serum zolpidem concentrations than men after taking an evening dose, potentially leading to increased risk of harm. On 19 April 2013, the United States Food and Drug Administration required labeling changes for zolpidem, recommending an initial dose of no greater than 5 mg (immediate release) or 6.25 mg (controlled release) per night in women. Objectives: The primary objective of this study was to compare prescribing practices before and after the 2013 zo...

  10. General anesthesia in cardiac surgery: a review of drugs and practices.

    Science.gov (United States)

    Alwardt, Cory M; Redford, Daniel; Larson, Douglas F

    2005-06-01

    General anesthesia is defined as complete anesthesia affecting the entire body with loss of consciousness, analgesia, amnesia, and muscle relaxation. There is a wide spectrum of agents able to partially or completely induce general anesthesia. Presently, there is not a single universally accepted technique for anesthetic management during cardiac surgery. Instead, the drugs and combinations of drugs used are derived from the pathophysiologic state of the patient and individual preference and experience of the anesthesiologist. According to the definition of general anesthesia, current practices consist of four main components: hypnosis, analgesia, amnesia, and muscle relaxation. Although many of the agents highlighted in this review are capable of producing more than one of these effects, it is logical that drugs producing these effects are given in combination to achieve the most beneficial effect. This review features a discussion of currently used anesthetic drugs and clinical practices of general anesthesia during cardiac surgery. The information in this particular review is derived from textbooks, current literature, and personal experience, and is designed as a general overview of anesthesia during cardiac surgery.

  11. Evolution of health technology assessment: best practices of the pan-Canadian Oncology Drug Review

    Directory of Open Access Journals (Sweden)

    Rocchi A

    2015-06-01

    Full Text Available Angela Rocchi,1 Isabelle Chabot,2 Judith Glennie3 1Athena Research Inc., Burlington, ON, 2EvAccess Inc., Vaudreuil-Dorion, QC, 3JL Glennie Consulting Inc., Aurora, ON, Canada Background: In 2007, Canada chose to develop a separate and distinct path for oncology drug health technology assessment (HTA. In 2013, the decision was made to transfer the pan-Canadian Oncology Drug Review (pCODR to the Canadian Agency for Drugs and Technologies in Health (CADTH, to align the pCODR and CADTH Common Drug Review processes while building on the best practices of both. The objective of this research was to conduct an examination of the best practices established by the pCODR. Methods: A qualitative research approach was taken to assess the policies, processes, and practices of the pCODR, based on internationally accepted best practice “principles” in HTA, with a particular focus on stakeholder engagement. Publicly available information regarding the approach of the pCODR was used to gauge the agency's performance against these principles. In addition, stakeholder observations and real-world experiences were gathered through key informant interviews to be inclusive of perspectives from patient advocacy groups, provincial and/or cancer agency decision-makers, community and academic oncologists, industry, expert committee members, and health economists. Results: This analysis indicated that, through the pCODR, oncology stakeholders have had a voice in and have come to trust the quality and relevance of oncology HTA as a vital tool to ensure the best decisions for Canadians with cancer and their health care system. It could be expected that adoption of the principles and processes of the pCODR would bring a similar level of engagement and trust to other HTA organizations in Canada and elsewhere. Conclusion: The results of this research led to recommendations for improvement and potential extrapolation of these best practices to other HTA organizations

  12. Risky behavior regarding drug use and HIV infection: an Internet questionnaire coupled with short education texts for Portuguese speakers Comportamento de risco para uso de drogas e infecção pelo HIV: questionário na internet acoplado com textos educacionais para língua portuguesa

    Directory of Open Access Journals (Sweden)

    Leila Strazza

    2007-08-01

    Full Text Available Surveys of risky behavior relating to HIV/AIDS are generally made for groups at risk of infection, for which HIV/AIDS prevalence is usually expected to be higher than in the general population. Therefore, an educational homepage in Portuguese was created on the Internet to inform/ask internauts regarding knowledge and behavior. The internauts were classified as adolescents (13 to 25 years and adults (>25 years. The number of STDs was reported as 1. 8 ± 2. 6 infections (range: 1 to 20 infections; 43% used condoms during sexual intercourse. Alcohol consumption was reported by 63% and illicit drug use by 32% (marijuana 24% and inhalants 15%. Among the adolescents, 31% did not classified alcohol as a drug. The adults more frequently reported homosexuality, anal intercourse and STDs, although the adolescents also presented high rates of risky behavior. These results show the need to reach out to internauts through better control strategies. Different types of strategies must be encouraged, in order to reach people that use this means of communication and entertainment.Levantamentos de comportamento de risco para HIV/AIDS são geralmente feitos para grupos de risco onde a prevalência é normalmente esperada ser maior que na população geral. Assim, foi criada uma homepage educacional em português para informar/perguntar sobre conhecimento e comportamento aos internautas. Os internautas foram classificados em grupos: adolescentes (13 a 25a e adultos (>25a. DST foi relatada como 1,8 ± 2,6 infecções (intervalo de 1 a 20 infecções; 43% usaram preservativo durante ralação sexual. Álcool foi referido por 63%, droga ilícita por 32% (maconha 24% e inalantes 15%. Trinta e um por cento dos jovens não classificaram álcool como droga. Adultos referiram maior freqüência em homossexualismo, sexo anal e DST, embora jovens apresentem altas taxas no comportamento de risco. Os resultados mostram necessidade de atingir internautas com melhores estrat

  13. Risky drinking patterns are being continued into pregnancy: a prospective cohort study.

    Science.gov (United States)

    Anderson, Amy E; Hure, Alexis J; Forder, Peta M; Powers, Jennifer; Kay-Lambkin, Frances J; Loxton, Deborah J

    2014-01-01

    Risky patterns of alcohol use prior to pregnancy increase the risk of alcohol-exposed pregnancies and subsequent adverse outcomes. It is important to understand how consumption changes once women become pregnant. The aim of this study was to describe the characteristics of women that partake in risky drinking patterns before pregnancy and to examine how these patterns change once they become pregnant. A sample of 1577 women from the 1973-78 cohort of the Australian Longitudinal Study on Women's Health were included if they first reported being pregnant in 2000, 2003, 2006, 2009 and reported risky drinking patterns prior to that pregnancy. Multinomial logistic regression was used to determine which risky drinking patterns were most likely to continue into pregnancy. When reporting risky drinking patterns prior to pregnancy only 6% of women reported weekly drinking only, whereas 46% reported binge drinking only and 48% reported both. Women in both binge categories were more likely to have experienced financial stress, not been partnered, smoked, used drugs, been nulliparous, experienced a violent relationship, and were less educated. Most women (46%) continued these risky drinking patterns into pregnancy, with 40% reducing these behaviors, and 14% completely ceasing alcohol consumption. Once pregnant, women who binged only prior to pregnancy were more likely to continue (55%) rather than reduce drinking (29%). Of the combined drinking group 61% continued to binge and 47% continued weekly drinking. Compared with the combined drinking group, binge only drinkers prior to pregnancy were less likely to reduce rather than continue their drinking once pregnant (OR = 0.37, 95% CI  =  0.29, 0.47). Over a third of women continued risky drinking into pregnancy, especially binge drinking, suggesting a need to address alcohol consumption prior to pregnancy.

  14. Risky drinking patterns are being continued into pregnancy: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Amy E Anderson

    Full Text Available BACKGROUND: Risky patterns of alcohol use prior to pregnancy increase the risk of alcohol-exposed pregnancies and subsequent adverse outcomes. It is important to understand how consumption changes once women become pregnant. OBJECTIVE: The aim of this study was to describe the characteristics of women that partake in risky drinking patterns before pregnancy and to examine how these patterns change once they become pregnant. METHODS: A sample of 1577 women from the 1973-78 cohort of the Australian Longitudinal Study on Women's Health were included if they first reported being pregnant in 2000, 2003, 2006, 2009 and reported risky drinking patterns prior to that pregnancy. Multinomial logistic regression was used to determine which risky drinking patterns were most likely to continue into pregnancy. RESULTS: When reporting risky drinking patterns prior to pregnancy only 6% of women reported weekly drinking only, whereas 46% reported binge drinking only and 48% reported both. Women in both binge categories were more likely to have experienced financial stress, not been partnered, smoked, used drugs, been nulliparous, experienced a violent relationship, and were less educated. Most women (46% continued these risky drinking patterns into pregnancy, with 40% reducing these behaviors, and 14% completely ceasing alcohol consumption. Once pregnant, women who binged only prior to pregnancy were more likely to continue (55% rather than reduce drinking (29%. Of the combined drinking group 61% continued to binge and 47% continued weekly drinking. Compared with the combined drinking group, binge only drinkers prior to pregnancy were less likely to reduce rather than continue their drinking once pregnant (OR = 0.37, 95% CI  =  0.29, 0.47. CONCLUSIONS: Over a third of women continued risky drinking into pregnancy, especially binge drinking, suggesting a need to address alcohol consumption prior to pregnancy.

  15. Food and Drug Administration upscheduling of hydrocodone and the effects on nurse practitioner pain management practices.

    Science.gov (United States)

    Mack, Rachel

    2018-06-01

    In 2013, the Advisory Committee of the Food and Drug Administration determined hydrocodone combination medications (HCMs) needed tighter regulation due to high abuse potential; they recommended upscheduling HCMs from Schedule III to II. The purpose of this study was to examine the effect of upscheduling of HCMs on pain management practices of advanced practiced registered nurses (APRNs) in Oklahoma. In this qualitative study, 25 participants described their primary care experiences after the upscheduling. A thematic analysis was used to understand the effects on APRN pain management practices. The upscheduling of HCMs has greatly affected the pain management practices of APRNs in a state where Schedule II narcotic prescribing is forbidden. Findings will assist APRNs with improving patient access to care, implementing practice regulations, and exploring options for alternative pain therapies in primary care. Upscheduling of HCMs has had a severe impact on APRNs, affecting their prescribing practices and leading to increased referrals. They noted limited treatment options, increased health care costs, and decreased access to care. The APRNs understand the problem of prescription opioid abuse, diversion, and misuse. A consensus model could standardize the regulatory process for APRNs, increase interstate mobility for practice, and increase access to APRN care nationwide.

  16. Practical considerations and patient selection for intrathecal drug delivery in the management of chronic pain

    Directory of Open Access Journals (Sweden)

    Saulino M

    2014-11-01

    Full Text Available Michael Saulino,1,2 Philip S Kim,3,4 Erik Shaw5 1MossRehab, Elkins Park, PA, USA; 2Department of Rehabilitation Medicine, Jefferson Medical College, Philadelphia, PA, USA; 3Helen F Graham Cancer Center, Christiana Care Health System, Newark, DE, USA; 4Center for Interventional Pain Spine, LLC., Bryn Mawr, PA, USA; 5Shepherd Pain Institute, Shepherd Center, Atlanta, GA, USA Abstract: Chronic pain continues to pose substantial and growing challenges for patients, caregivers, health care professionals, and health care systems. By the time a patient with severe refractory pain sees a pain specialist for evaluation and management, that patient has likely tried and failed several nonpharmacologic and pharmacologic approaches to pain treatment. Although relegated to one of the interventions of “last resort”, intrathecal drug delivery can be useful for improving pain control, optimizing patient functionality, and minimizing the use of systemic pain medications in appropriately selected patients. Due to its clinical and logistical requirements, however, intrathecal drug delivery may fit poorly into the classic pain clinic/interventional model and may be perceived as a "critical mass" intervention that is feasible only for large practices that have specialized staff and appropriate office resources. Potentially, intrathecal drug delivery may be more readily adopted into larger practices that can commit the necessary staff and resources to support patients' needs through the trialing, initiation, monitoring, maintenance, and troubleshooting phases of this therapy. Currently, two agents – morphine and ziconotide – are approved by the United States Food and Drug Administration for long-term intrathecal delivery. The efficacy and safety profiles of morphine have been assessed in long-term, open-label, and retrospective studies of >400 patients with chronic cancer and noncancer pain types. The efficacy and safety profiles of ziconotide have been

  17. Risky driving behaviors in Tehran, Iran.

    Science.gov (United States)

    Shams, Mohsen; Rahimi-Movaghar, Vafa

    2009-03-01

    Iran has one of the highest fatality rates due to road traffic crashes (RTC) in the world. The disability adjusted life years (DALYs) for RTC in Iran is more than 1,300,000 years, which is more than that for any other disease such as cardiovascular or cancer. We evaluated risky driving behaviors in Tehran, the capital of Iran. A retrospective analysis was conducted based on the data obtained from the Tehran Police Safety Driving Department. Offenses and crashes were studied in different municipal districts in Tehran from March 2006 to March 2007. The inclusion criteria were risky driving behaviors fined by the police. Nonbehavioral offences were excluded. There were 3,821,798 offenses in Tehran. Not wearing a seat belt was the most common (59%) example of risky driving behavior, followed by tailgating, not wearing motorcycle helmets, talking on the cell phone while driving, overtaking from the wrong side, speeding, not driving between the lanes, weaving in and out of traffic, left deviation, and changing lanes without signals. The most common causes of RTC in Tehran are speeding, overtaking from the wrong side, and the rapid changing of driving lanes. The study factors effective in preventing risky driving behaviors in Tehran is recommended. The consideration of specific characteristics of the municipal districts is necessary to reduce risky driving behaviors.

  18. ASSESSMENT OF PRACTICE AT RETAIL PHARMACIES IN PAKISTAN: EXTENT OF COMPLIANCE WITH THE PREVAILING DRUG LAW OF PAKISTAN.

    Science.gov (United States)

    Ullah, Hanif; Zada, Wahid; Khan, Muhammad Sona; Iqbal, Muhammad; Chohan, Osaam; Raza, Naeem; Khawaja, Naeem Raza; Abid, Syed Mobasher Ali; Murtazai, Ghulam

    2016-01-01

    The main objective of this study was to assess the practice at retail pharmacies in Pakistan and to compare the same in rural and urban areas. The maintenance of pharmacy and drug inspectors' visit was also assessed. This cross sectional study was conducted in Abbottabad, Pakistan during October-November, 2012. A sample of 215 drug sellers or drug stores was selected by employing convenient sampling method. With a response rate of 91.6%, 197 drug sellers participated in this study. All the drug sellers were male. Overall, 35% (n = 197) of the drug sellers did not have any professional qualification. A majority of the drug sellers were involved in various malpractices like selling of medicines without prescription (80.7%), prescribing practice (60.9%), prescription intervention (62.4%) and selling of controlled substances (66%) without a license for selling it. These malpractices were significantly higher in rural area than that in urban area.

  19. Risky music-listening behaviors and associated health-risk behaviors.

    Science.gov (United States)

    Vogel, Ineke; van de Looij-Jansen, Petra M; Mieloo, Cathelijne L; Burdorf, Alex; de Waart, Frouwkje

    2012-06-01

    To examine, among adolescents and emerging adults attending inner-city lower education, associations between risky music-listening behaviors (from MP3 players and in discotheques and at pop concerts) and more traditional health-risk behaviors: substance use (cigarettes, alcohol, cannabis, and hard drugs) and unsafe sexual intercourse. A total of 944 students in Dutch inner-city senior-secondary vocational schools completed questionnaires about their music-listening and traditional health-risk behaviors. Multiple logistic regression analyses were used to examine associations between music-listening and traditional health-risk behaviors. Risky MP3-player listeners used cannabis more often during the past 4 weeks. Students exposed to risky sound levels during discotheque and pop concert attendance used cannabis less often during the past 4 weeks, were more often binge drinkers, and reported inconsistent condom use during sexual intercourse. The coexistence of risky music-listening behaviors with other health-risk behaviors provides evidence in support of the integration of risky music-listening behaviors within research on and programs aimed at reducing more traditional health-risk behaviors, such as substance abuse and unsafe sexual intercourse.

  20. Relative Binding Free Energy Calculations in Drug Discovery: Recent Advances and Practical Considerations.

    Science.gov (United States)

    Cournia, Zoe; Allen, Bryce; Sherman, Woody

    2017-12-26

    Accurate in silico prediction of protein-ligand binding affinities has been a primary objective of structure-based drug design for decades due to the putative value it would bring to the drug discovery process. However, computational methods have historically failed to deliver value in real-world drug discovery applications due to a variety of scientific, technical, and practical challenges. Recently, a family of approaches commonly referred to as relative binding free energy (RBFE) calculations, which rely on physics-based molecular simulations and statistical mechanics, have shown promise in reliably generating accurate predictions in the context of drug discovery projects. This advance arises from accumulating developments in the underlying scientific methods (decades of research on force fields and sampling algorithms) coupled with vast increases in computational resources (graphics processing units and cloud infrastructures). Mounting evidence from retrospective validation studies, blind challenge predictions, and prospective applications suggests that RBFE simulations can now predict the affinity differences for congeneric ligands with sufficient accuracy and throughput to deliver considerable value in hit-to-lead and lead optimization efforts. Here, we present an overview of current RBFE implementations, highlighting recent advances and remaining challenges, along with examples that emphasize practical considerations for obtaining reliable RBFE results. We focus specifically on relative binding free energies because the calculations are less computationally intensive than absolute binding free energy (ABFE) calculations and map directly onto the hit-to-lead and lead optimization processes, where the prediction of relative binding energies between a reference molecule and new ideas (virtual molecules) can be used to prioritize molecules for synthesis. We describe the critical aspects of running RBFE calculations, from both theoretical and applied perspectives

  1. [Drug advertising to the general public: conceptual parameters of a risk producer practice].

    Science.gov (United States)

    Nascimento, Alvaro César

    2010-11-01

    This article analyzes some concepts relating to marketing, advertising, medications, regulation and manipulation. It discusses ethical and health surveillance parameters of drugs advertising for the general public. The focus of this work is the analysis of contradictions from a conceptual point of view between the practice of pharmaceutical advertising as a tool for the increase of sales and the conquest of markets versus the policy of rational use of medicines. Academic studies and monitoring of drugs advertising conducted by the National Health Surveillance Agency show that the contents of the advertising pieces oriented towards the general public overestimate the - sometimes dubious - qualities of their medication, focusing almost exclusively on the benefits and put them in a central position in the therapeutic process. They also fail to mention the risks inherent in their use. Rather than focusing on regulatory proposals aimed at creating constraints to this practice, this article discusses the impossibility, considering the interests of public health, of the coexistence of marketing with the policies for the correct, rational and safe use of drugs.

  2. The practice of pre-marketing safety assessment in drug development.

    Science.gov (United States)

    Chuang-Stein, Christy; Xia, H Amy

    2013-01-01

    The last 15 years have seen a substantial increase in efforts devoted to safety assessment by statisticians in the pharmaceutical industry. While some of these efforts were driven by regulations and public demand for safer products, much of the motivation came from the realization that there is a strong need for a systematic approach to safety planning, evaluation, and reporting at the program level throughout the drug development life cycle. An efficient process can help us identify safety signals early and afford us the opportunity to develop effective risk minimization plan early in the development cycle. This awareness has led many pharmaceutical sponsors to set up internal systems and structures to effectively conduct safety assessment at all levels (patient, study, and program). In addition to process, tools have emerged that are designed to enhance data review and pattern recognition. In this paper, we describe advancements in the practice of safety assessment during the premarketing phase of drug development. In particular, we share examples of safety assessment practice at our respective companies, some of which are based on recommendations from industry-initiated working groups on best practice in recent years.

  3. [Professional practice evaluation of injectable drug preparation and administration in neonatology].

    Science.gov (United States)

    Morin, P; Guillois, B; Gloanec, L; Chatelier, N; Saint-Lorant, G

    2017-09-01

    Adverse drug events are a daily concern in neonatology departments. The aim of this study was to assess the professional practices of preparation and administration of injectable forms of medications in neonatology. A professional practice evaluation with regard to the preparation and administration of various injectable forms of medications in different neonatology units within a given department was conducted by a pharmacy intern based on an assessment grid comprising ten criteria. Following an initial assessment, the results were presented to the care team, which validated the corrective measures put forward by a multiprofessional work group. A second assessment was conducted following the same methodology. Fifty of the department's 76 pediatric nurses were assessed during the first round of the audit and 21 during the second round. Two improvement priorities were identified: taking account of the dead volume of medication in needles and syringe hubs, together with complete identification of syringes used to administer medication. During the second round, these two aspects were improved, progressing from 38% to 100% and from 59% to 89%, respectively. To improve drug administration in neonatology and consequently, to improve patient safety, professional practice evaluation is an essential tool that requires close collaboration between the paramedical team, physicians and pharmacists. Its main value lies in the mobilization of the entire team around the subject in question, hence generating improved understanding and application of corrective measures. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  4. Engagement in Risky Sexual Behavior: Adolescents' Perceptions of Self and the Parent-Child Relationship Matter

    Science.gov (United States)

    Kerpelman, Jennifer L.; McElwain, Alyssa D.; Pittman, Joe F.; Adler-Baeder, Francesca M.

    2016-01-01

    The current study examined associations among parenting practices, adolescents' self-esteem and dating identity exploration, and adolescents' sexual behaviors. Participants were 680 African American and European American sexually experienced adolescents attending public high schools in the southeast. Results indicated that risky sexual behavior…

  5. Drugs + HIV, Learn the Link

    Medline Plus

    Full Text Available ... she went to a party and under the influence of drugs and alcohol engaged in risky sexual ... encourages them to share this information with their peers to prevent the spread of this disease. NIDA's ...

  6. Drugs + HIV, Learn the Link

    Medline Plus

    Full Text Available ... she went to a party and under the influence of drugs and alcohol engaged in risky sexual ... this information with their peers to prevent the spread of this disease. NIDA's ...

  7. Drugs + HIV, Learn the Link

    Medline Plus

    Full Text Available ... risky behavior. Drug misuse by any route (not just injection) can put a person at risk for ... The Learn the Link public service campaign is just one example of how NIDA continues to respond ...

  8. Drugs + HIV, Learn the Link

    Medline Plus

    Full Text Available ... she went to a party and under the influence of drugs and alcohol engaged in risky sexual ... the discussion between friends, and the importance of family. For more information, read a message from the ...

  9. Self - care strategies among risky profession workers

    Directory of Open Access Journals (Sweden)

    Katarína Vasková

    2015-01-01

    Full Text Available Taking care of oneself is crucial for maintaining one´s psychical and physical health. In the context of risky profession this topic can play an even more important role, because it can be the source of necessary information for improvement of coping capacity when one is confronted with crisis situations. The aim of the present study is to identify the most common forms of self-care among selected risky professions. In the second part is the attention focused on the comparison of the specificities of risky to non-risky professions in self-care. Methods: For data collection Self-regulation Self-care Questionnaire by authors Hricová and Lovaš (in press is used. The sample consists of two groups. In the first one participated 156 respondents, who worked in risky professions - namely police officers (60 at the age between 22 to 55 years (average age is 36.88, SD=9.49, fire fighters (46 at the age between 22 to 62 years (average age is 35.13, SD=8.31 and paramedics (50 at the age between 25 to 55 years (average age is 40.3, SD=6.62. 76.2% of the sample are men, 19.0% are women and 4,8% didn´t state their gender. The second sample consists of 161 participants who work in administrative, industry production or IT sphere. They were at the age between 23 to 61 years (average age is 38.01, SD=10.45. 74% of the sample are men and 21.7% are women. Results and discussion: Results confirmed the dominance of psychological self-care above physical among risky professions. To the forefront gets the need to live meaningful life, to fully use one´s skills and to be satisfied with one´s life and decisions. All this needs can be assigned to the necessity of sense, which could be seen as a result of everyday contact with critical and life threaten situations. Equally important sphere of self-care is the necessity of high-quality relationships, which doesn´t mean only relationships with family or friends. It is important to highlight also relationships with

  10. Smoking and Bone Healing - A Risky Surgical Combination

    Science.gov (United States)

    ... Risky Surgical Combination A A A | Print | Share Smoking and Bone Healing – A Risky Surgical Combination Imagine ... saying that they'd prefer patients to quit smoking. There hasn't been a great deal of ...

  11. A survey of attitudes, practices, and knowledge regarding drug-drug interactions among medical residents in Iran

    NARCIS (Netherlands)

    Nabovati, Ehsan; Vakili-Arki, Hasan; Taherzadeh, Zhila; Saberi, Mohammad Reza; Abu-Hanna, Ameen; Eslami, Saeid

    2017-01-01

    Background When prescribing medications, physicians should recognize clinically relevant potential drug-drug interactions (DDIs). To improve medication safety, it is important to understand prescribers' knowledge and opinions pertaining to DDIs. Objective To determine the current DDI information

  12. Malaria treatment in the retail sector: Knowledge and practices of drug sellers in rural Tanzania

    Directory of Open Access Journals (Sweden)

    Makemba Ahmed M

    2008-05-01

    Full Text Available Abstract Background Throughout Africa, the private retail sector has been recognised as an important source of antimalarial treatment, complementing formal health services. However, the quality of advice and treatment at private outlets is a widespread concern, especially with the introduction of artemisinin-based combination therapies (ACTs. As a result, ACTs are often deployed exclusively through public health facilities, potentially leading to poorer access among parts of the population. This research aimed at assessing the performance of the retail sector in rural Tanzania. Such information is urgently required to improve and broaden delivery channels for life-saving drugs. Methods During a comprehensive shop census in the districts of Kilombero and Ulanga, Tanzania, we interviewed 489 shopkeepers about their knowledge of malaria and malaria treatment. A complementary mystery shoppers study was conducted in 118 retail outlets in order to assess the vendors' drug selling practices. Both studies included drug stores as well as general shops. Results Shopkeepers in drug stores were able to name more malaria symptoms and were more knowledgeable about malaria treatment than their peers in general shops. In drug stores, 52% mentioned the correct child-dosage of sulphadoxine-pyrimethamine (SP compared to only 3% in general shops. In drug stores, mystery shoppers were more likely to receive an appropriate treatment (OR = 9.6, but at an approximately seven times higher price. Overall, adults were more often sold an antimalarial than children (OR = 11.3. On the other hand, general shopkeepers were often ready to refer especially children to a higher level if they felt unable to manage the case. Conclusion The quality of malaria case-management in the retail sector is not satisfactory. Drug stores should be supported and empowered to provide correct malaria-treatment with drugs they are allowed to dispense. At the same time, the role of general shops

  13. Using classification tree modelling to investigate drug prescription practices at health facilities in rural Tanzania

    Directory of Open Access Journals (Sweden)

    Kajungu Dan K

    2012-09-01

    Full Text Available Abstract Background Drug prescription practices depend on several factors related to the patient, health worker and health facilities. A better understanding of the factors influencing prescription patterns is essential to develop strategies to mitigate the negative consequences associated with poor practices in both the public and private sectors. Methods A cross-sectional study was conducted in rural Tanzania among patients attending health facilities, and health workers. Patients, health workers and health facilities-related factors with the potential to influence drug prescription patterns were used to build a model of key predictors. Standard data mining methodology of classification tree analysis was used to define the importance of the different factors on prescription patterns. Results This analysis included 1,470 patients and 71 health workers practicing in 30 health facilities. Patients were mostly treated in dispensaries. Twenty two variables were used to construct two classification tree models: one for polypharmacy (prescription of ≥3 drugs on a single clinic visit and one for co-prescription of artemether-lumefantrine (AL with antibiotics. The most important predictor of polypharmacy was the diagnosis of several illnesses. Polypharmacy was also associated with little or no supervision of the health workers, administration of AL and private facilities. Co-prescription of AL with antibiotics was more frequent in children under five years of age and the other important predictors were transmission season, mode of diagnosis and the location of the health facility. Conclusion Standard data mining methodology is an easy-to-implement analytical approach that can be useful for decision-making. Polypharmacy is mainly due to the diagnosis of multiple illnesses.

  14. Malaria treatment-seeking behaviour and drug prescription practices in an area of low transmission in Uganda

    DEFF Research Database (Denmark)

    Ndyomugyenyi, Richard; Magnussen, Pascal; Clarke, Siân

    2007-01-01

    actually using insecticide-treated nets. Many patients (25%) had received treatment prior to visiting a health facility, with drug shops and general stores being the main sources of treatment. Some shops dispensed quinine, a second-line drug recommended for complicated malaria. Prescription practices...

  15. Drug-resistant tuberculosis: Study of clinical practices of chest physicians, Maharashtra, India

    Directory of Open Access Journals (Sweden)

    Yatin Dholakia

    2012-01-01

    Full Text Available Background: Patients suffering from drug-resistant tuberculosis (DR TB avail of private care since Programmatic Management of DR TB (PMDT is not universally available in India. Management of DR TB is challenging and involves great expertise. Chest physicians (CPs play a major role in this area. The study was undertaken with the objective to see whether the practices of CPs comply with current guidelines and to identify areas where they could be involved to improve access to PMDT. Materials and Methods : For this cross-sectional study, CPs from Mumbai and Nagpur, Maharashtra, India, were given pretested questionnaires to be filled in and returned. Observations : Of 70 enlisted CPs, 29 (41% responded. Twenty-six (89% respondents used the drug susceptibility test (DST for diagnosis: private labs and hospitals were preferred; 9 (31% used standard treatment, 15 (51% switched to individual treatment after starting standard therapy and 12 (41% started empirical treatment later switched to individual treatment as per the WHO guidelines. Seven consultants (10% used in addition drugs from alternative systems of medicine for immune modulation and adverse drug effects. Eighty-six per cent CPs monitored treatment by smear examination, 51% by culture and 93% used X-rays. Reported case holding in the form of regular follow-up consultation visits was around 70%, treatment success estimated to be between 30% and 70%, and deaths around 30%. Adverse drug reactions were reported in around 30% cases. Conclusion : This study shows that most private CPs generally comply with current guidelines for management of DR TB. Accreditation of private labs for DST, involving CPs in diagnosis, treatment and monitoring of patients through public private partnerships can improve access to PMDT.

  16. How Mental Health Interviews Conducted Alone, in the Presence of an Adult, a Child or Both Affects Adolescents' Reporting of Psychological Symptoms and Risky Behaviors.

    Science.gov (United States)

    Herrera, Aubrey V; Benjet, Corina; Méndez, Enrique; Casanova, Leticia; Medina-Mora, Maria Elena

    2017-02-01

    The normative process of autonomy development in adolescence involves changes in adolescents' information management typically characterized by decreasing disclosure and increasing concealment. These changes may have an important impact on the early detection and timely treatment of mental health conditions and risky behavior. Therefore, the objective was to extend our understanding of how these developmental changes in adolescent disclosure might impact adolescent mental health interviews. Specifically, we estimated the effects of third party presence and type of third party presence (adult, child, or both) on adolescents' reports of psychiatric symptoms, substance use, suicidal behavior, and childhood adversity. In this representative sample of 3005 adolescents from Mexico City (52.1 % female), administered the World Mental Health Composite International Diagnostic Interview (WMH-CIDI-A), adult presence influenced reporting the most; in their presence, adolescents reported more ADHD, parental mental illness and economic adversity, but less panic disorder, PTSD, drug use and disorder, and suicidal behavior. The presence of children was associated with increased odds of reporting conduct disorder, opportunity for drug use, parental criminal behavior, neglect, and the death of a parent. While adolescent information management strategies are normative and even desirable as a means of gaining emotional autonomy, they may also interfere with timely detection and treatment or intervention for mental health conditions and risky behaviors. Research and practical implications of these findings are discussed.

  17. Serotonin shapes risky decision making in monkeys.

    Science.gov (United States)

    Long, Arwen B; Kuhn, Cynthia M; Platt, Michael L

    2009-12-01

    Some people love taking risks, while others avoid gambles at all costs. The neural mechanisms underlying individual variation in preference for risky or certain outcomes, however, remain poorly understood. Although behavioral pathologies associated with compulsive gambling, addiction and other psychiatric disorders implicate deficient serotonin signaling in pathological decision making, there is little experimental evidence demonstrating a link between serotonin and risky decision making, in part due to the lack of a good animal model. We used dietary rapid tryptophan depletion (RTD) to acutely lower brain serotonin in three macaques performing a simple gambling task for fluid rewards. To confirm the efficacy of RTD experiments, we measured total plasma tryptophan using high-performance liquid chromatography (HPLC) with electrochemical detection. Reducing brain serotonin synthesis decreased preference for the safe option in a gambling task. Moreover, lowering brain serotonin function significantly decreased the premium required for monkeys to switch their preference to the risky option, suggesting that diminished serotonin signaling enhances the relative subjective value of the risky option. These results implicate serotonin in risk-sensitive decision making and, further, suggest pharmacological therapies for treating pathological risk preferences in disorders such as problem gambling and addiction.

  18. Tempus fugit : Time pressure in risky decisions

    NARCIS (Netherlands)

    Kocher, M.G.; Pahlke, J.; Trautmann, S.T.

    2013-01-01

    We study the effects of time pressure on risky decisions for pure gain prospects, pure loss prospects, and mixed prospects involving both gains and losses. In two experiments we find that time pressure has no effect on risk attitudes for gains, but increases risk aversion for losses. For mixed

  19. New Paradoxes of Risky Decision Making

    Science.gov (United States)

    Birnbaum, Michael H.

    2008-01-01

    During the last 25 years, prospect theory and its successor, cumulative prospect theory, replaced expected utility as the dominant descriptive theories of risky decision making. Although these models account for the original Allais paradoxes, 11 new paradoxes show where prospect theories lead to self-contradiction or systematic false predictions.…

  20. Risky decision making in adults with ADHD.

    Science.gov (United States)

    Matthies, S; Philipsen, A; Svaldi, J

    2012-09-01

    Risky decision making and disadvantageous choices constitute core characteristics of patients with attention-deficit/hyperactivity disorder (ADHD). Consequences include negative psychosocial and health-related outcomes. However, risky decision making and its interrelations with emotional states in ADHD are poorly understood. Therefore, the authors investigated risky decision making without and after boredom induction in adults with and without ADHD. In study 1, ADHD patients (n = 15) and age/education matched controls (CG; n = 16) were compared on the Game of Dice Task (GDT), an established task measuring decision making in unambiguous situations. In study 2, ADHD patients (n = 14) and CG (n = 13) underwent boredom induction prior to the GDT. In study 1, ADHD patients selected the disadvantageous alternatives significantly more often than CG. In study 2, no significant group differences were found due to an increase in risky decision making in CG following the boredom induction. Even if severity of depression did not affect our results, it may be necessary to compare GDT responses in ADHD patients with and without current depression. Risk as a motor of disadvantageous decision making needs to be taken into account in therapeutic contexts as a maintenance factor of dysfunctional behaviour. The findings of study 2 are in line with postulated alterations of emotional state adjustment in ADHD. The link between decisions making and emotional regulation in ADHD needs further attention in research. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. Paternal Influences and Adolescents' Sexual Risky Behaviours ...

    African Journals Online (AJOL)

    05) and adolescents' sexual risky behaviour. The results further showed the significant position between Parents adolescent disclosure (X2 cal = 32.856) is the most potent factor followed Parental autonomy (X2 cal = 24.642); Parent adolescent relationship (X2 cal = 18.986); Positive adolescent behaviour (X2 cal = 11.626); ...

  2. Valuation of risky and uncertain choices

    NARCIS (Netherlands)

    Tobler, P.N.; Weber, E.U.; Glimcher, P.W.; Fehr, E.

    2013-01-01

    In this chapter, we describe how risk and ambiguity impact the value of choice options, how this impact can be modelled formally and how it is implemented in the brain. In particular, we give an overview of two distinct ways of how risky choice options can be decomposed – either into outcomes and

  3. Is Utilitarianism Risky? How the Same Antecedents and Mechanism Produce Both Utilitarian and Risky Choices.

    Science.gov (United States)

    Lucas, Brian J; Galinsky, Adam D

    2015-07-01

    Philosophers and psychologists have long been interested in identifying factors that influence moral judgment. In the current analysis, we compare the literatures on moral psychology and decision making under uncertainty to propose that utilitarian choices are driven by the same forces that lead to risky choices. Spanning from neurocognitive to hormonal to interpersonal levels of analysis, we identify six antecedents that increase both utilitarian and risky choices (ventromedial prefrontal cortex brain lesions, psychopathology, testosterone, incidental positive affect, power, and social connection) and one antecedent that reduces these choices (serotonin activity). We identify the regulation of negative affect as a common mechanism through which the effects of each antecedent on utilitarian and risky choices are explained. By demonstrating that the same forces and the same underlying mechanism that produce risky choices also promote utilitarian choices, we offer a deeper understanding of how basic psychological systems underlie moral judgment. © The Author(s) 2015.

  4. Are ECG monitoring recommendations before prescription of QT-prolonging drugs applied in daily practice?

    DEFF Research Database (Denmark)

    Warnier, Miriam Jacoba; Rutten, Frans Hendrik; Souverein, Patrick Cyriel

    2015-01-01

    PURPOSE: Monitoring of the QT duration by electrocardiography (ECG) prior to treatment is frequently recommended in the label of QT-prolonging drugs. It is, however, unknown how often general practitioners in daily clinical practice are adhering to these risk-minimization measures. We assessed...... the frequency of ECG measurements in patients where haloperidol was initiated in primary care. METHODS: Patients (≥18 years) with a first prescription of haloperidol in the UK Clinical Practice Research Datalink (2009-2013) were included. The proportion of ECGs made was determined in two blocks of 4 weeks......: during the exposure period when haloperidol was initiated, and during the control period, 1 year before. Conditional logistic regression analysis was applied to calculate the relative risk of having an ECG in the exposure period compared with the control period. Subgroup analyses were performed to assess...

  5. Prescription practice of anti-tuberculosis drugs in Yunnan, China: A clinical audit.

    Directory of Open Access Journals (Sweden)

    Lin Xu

    Full Text Available China has a high burden of drug-resistant tuberculosis (TB. As irrational use and inadequate dosing of anti-TB drugs may contribute to the epidemic of drug-resistant TB, we assessed the drug types and dosages prescribed in the treatment of TB cases in a representative sample of health care facilities in Yunnan.We applied multistage cluster sampling using probability proportion to size to select 28 counties in Yunnan. Consecutive pulmonary TB patients were enrolled from either the TB centers of Yunnan Center of Disease Control or designated TB hospitals. Outcomes of interest included the regimen used in the treatment of new and retreatment TB patients; and the proportion of patients treated with adequate dosing of anti-TB drugs. Furthermore, we assess whether there has been reduction in the use of fluoroquinolone and second line injectables in Tuberculosis Clinical Centre (TCC after the training activity in late 2012.Of 2390 TB patients enrolled, 582 (24.4% were prescribed second line anti-TB drugs (18.0% in new cases and 60.9% in retreatment cases; 363(15.2% prescribed a fluoroquinolone. General hospitals (adjusted odds ratio (adjOR 1.97, 95% confidence interval (CI 1.47-2.66, retreatment TB cases (adjOR 4.75, 95% CI 3.59-6.27, smear positive cases (adjOR 1.69, 95% CI 1.22-2.33, and extrapulmonary TB (adjOR 2.59, 95% CI 1.66-4.03 were significantly associated with the use of fluoroquinolones. The proportion of patients treated with fluoroquinolones decreased from 41.4% before 2013 to 13.5% after 2013 (adjOR 0.19, 95% CI 0.12-0.28 in TCC. The proportion of patients with correct, under and over dosages of isoniazid was 88.2%, 1.5%, and 10.4%, respectively; of rifampicin was 50.2%, 46.8%, and 2.9%; of pyrazinamide was 67.6%, 31.7% and 0.7%; and of ethambutol was 41.4%, 57.5%, and 1.0%.The prescribing practice of anti-TB drugs was not standardized, findings with significant programmatic implication.

  6. Sociocultural Determinants of Risky Sexual Behaviors among Adult Latinas: A Longitudinal Study of a Community-Based Sample.

    Science.gov (United States)

    Rojas, Patria; Huang, Hui; Li, Tan; Ravelo, Gira J; Sanchez, Mariana; Dawson, Christyl; Brook, Judith; Kanamori, Mariano; De La Rosa, Mario

    2016-11-23

    Few studies have examined the sociocultural determinants of risky sexual behavior trajectories among adult Latinas. To longitudinally examine the link between sociocultural determinants of risky sexual behaviors, we followed a sample of adult Latina mother-daughter dyads ( n = 267) across a 10-year span through four waves of data collection. The present study investigates how risky sexual behavior (operationalized as sex under the influence of alcohol or other drugs, sex without a condom, or multiple sex partners) is affected by: (a) socioeconomic conditions; (b) mental health; (c) medical health; (d) acculturation to U.S. culture; (e) interpersonal support; (f) relationship stress; (g) mother-daughter attachment; (h) intimate partner violence; (i) religious involvement; and (j) criminal justice involvement. Results indicate the following factors are negatively associated with risky sexual behavior: drug and alcohol use, treating a physical problem with prescription drugs, religious involvement, and mother-daughter attachment. The following factors are positively associated with risky sexual behavior: higher number of mental health symptoms, being U.S.-born, and criminal justice involvement. We discuss implications for the future development of culturally relevant interventions based on the study findings.

  7. A practical approach to risk-benefit estimation in pediatric drug research.

    Science.gov (United States)

    Koren, Gideon

    2015-02-01

    One of the most difficult challenges in pediatric drug research is in exposing children to risk, often without a balanced chance of benefits. While the concept of risk is similar in adult research, the adult patient can decide for himself/herself on an acceptable level of risk, whereas children have to accept the decisions of their guardians. This paper attempts to put the complexities of estimating risk in pediatric drug research into their practical perspective, and to familiarize the reader with the way such processes are conducted in different parts of the world. Although there are regional differences, all authorities typically quantify risks of pediatric research in general, and drug research in particular, in three levels: those experienced in day-to-day life; risks slightly above this 'baseline' risk; and risks substantially above 'baseline risk'. Proportionally, the diligence of the ethics process depends on these levels, as well as on the potential benefits (or lack of) to the child involved in the research. Importantly, risk is context dependent, and a particular intervention may be effective or safe in one setting but not in another, based on local experience, staffing levels, and similar variabilities.

  8. Pharmacist's knowledge, practice and attitudes toward pharmacovigilance and adverse drug reactions reporting process.

    Science.gov (United States)

    Suyagh, Maysa; Farah, Doaa; Abu Farha, Rana

    2015-04-01

    Adverse drug reactions (ADRs) are a major cause of drug related morbidity and mortality. Pharmacovigilance is the science that plays an essential role in the reduction of ADRs, thus the evolution and growth of this science are critical for effective and safe clinical practice. This study is considered the first study in the region to evaluate pharmacist's knowledge, practice and attitudes toward ADRs reporting after establishing the national ADRs reporting center in Jordan. A cross sectional study was used to evaluate pharmacist knowledge and attitude toward ADRs reporting. A structured validated questionnaire was developed for this purpose and a total of 208 pharmacists were recruited to participate in this study. The majority of pharmacists have insufficient awareness and lack of knowledge about pharmacovigilance and ADRs reporting. Also the rate of reporting of ADRs was extremely poor. Several factors were found to discourage pharmacists from reporting ADRs, which include inadequate information available from the patient, unavailability of pharmacist ADRs form when needed, unawareness of the existence of the national ADRs reporting system. Also pharmacists think that ADRs are unimportant or they did not know how to report them. The results of this study suggest that pharmacists have insufficient knowledge about the concept of pharmacovigilance and spontaneous ADRs reporting. On the other hand, pharmacists had positive attitudes toward pharmacovigilance, despite their little experience with ADRs reporting. Educational programs are needed to increase pharmacist's role in the reporting process, and thus to have a positive impact on the overall patient caring process.

  9. Innovating Chinese Herbal Medicine: From Traditional Health Practice to Scientific Drug Discovery

    Directory of Open Access Journals (Sweden)

    Shuo Gu

    2017-06-01

    Full Text Available As one of the major contemporary alternative medicines, traditional Chinese medicine (TCM continues its influence in Chinese communities and has begun to attract the academic attention in the world of western medicine. This paper aims to examine Chinese herbal medicine (CHM, the essential branch of TCM, from both narrative and scientific perspectives. CHM is a traditional health practice originated from Chinese philosophy and religion, holding the belief of holism and balance in the body. With the development of orthodox medicine and science during the last centuries, CHM also seized the opportunity to change from traditional health practice to scientific drug discovery illustrated in the famous story of the herb-derived drug artemisinin. However, hindered by its culture and founding principles, CHM faces the questions of the research paradigm posed by the convention of science. To address these questions, we discussed two essential questions concerning the relationship of CHM and science, and then upheld the paradigm of methodological reductionism in scientific research. Finally, the contemporary narrative of CHM in the 21st century was discussed in the hope to preserve this medical tradition in tandem with scientific research.

  10. Innovating Chinese Herbal Medicine: From Traditional Health Practice to Scientific Drug Discovery.

    Science.gov (United States)

    Gu, Shuo; Pei, Jianfeng

    2017-01-01

    As one of the major contemporary alternative medicines, traditional Chinese medicine (TCM) continues its influence in Chinese communities and has begun to attract the academic attention in the world of western medicine. This paper aims to examine Chinese herbal medicine (CHM), the essential branch of TCM, from both narrative and scientific perspectives. CHM is a traditional health practice originated from Chinese philosophy and religion, holding the belief of holism and balance in the body. With the development of orthodox medicine and science during the last centuries, CHM also seized the opportunity to change from traditional health practice to scientific drug discovery illustrated in the famous story of the herb-derived drug artemisinin. However, hindered by its culture and founding principles, CHM faces the questions of the research paradigm posed by the convention of science. To address these questions, we discussed two essential questions concerning the relationship of CHM and science, and then upheld the paradigm of methodological reductionism in scientific research. Finally, the contemporary narrative of CHM in the 21st century was discussed in the hope to preserve this medical tradition in tandem with scientific research.

  11. Alcohol, drugs, and risky sexual behavior are related to HIV infection in female adolescents Álcool, drogas e comportamento sexual de risco estão relacionados à infecção por HIV em mulheres adolescentes

    Directory of Open Access Journals (Sweden)

    Ana Margareth Siqueira Bassols

    2010-12-01

    Full Text Available OBJECTIVE: To examine associations between risk factors for HIV infection in a sample of young women who sought HIV testing in a city of southern Brazil. METHOD: Cross-sectional study with a consecutive convenience sample of 258 female adolescents aged 13 to 20 years evaluated in an anonymous testing site for HIV and sexually transmitted diseases in Brazil. Risk behavior for HIV was assessed with the Brazilian version of the Risk Assessment Battery and HIV status was assessed through ELISA (Enzyme Linked Immunosorbent Assay. RESULTS: Overall seropositivity rate was 7.4%. HIV-seropositive patients had significantly more sexual intercourse in exchange for money, higher rates of pregnancy and abortion, as well as earlier sexual debut. In multiple analyses with the inclusion of two composite variables (sex risk and drug risk, only drug risk was associated with positive HIV status (OR = 4.178; IC 95% = 1.476-11.827. CONCLUSION: Our findings suggest that high HIV seropositivity among female adolescents seeking HIV testing in Brazil directly reflects the need for effective interventions specifically designed to prevent risk behaviors in order to halt the spread of HIV infection.OBJETIVO: Descrever fatores de risco para infecção pelo HIV numa amostra de adolescentes do sexo feminino que procurou fazer o teste HIV em uma cidade do sul do país. MÉTODO: Num estudo transversal, 258 adolescentes do sexo feminino foram avaliadas em relação ao seu estado sorológico para o vírus HIV e comportamentos de risco utilizando-se a versão brasileira da escala Risk Assessment Battery. RESULTADOS: A taxa geral de soropositividade foi de 7,4%. As jovens soropositivas tiveram significativamente mais relações sexuais em troca de dinheiro, história de gravidez e aborto prévio, bem como iniciação sexual mais precoce do que as adolescentes soronegativas. Nas análises multivariadas, com a inclusão de duas variáveis compostas ("risco sexual" e "risco por drogas

  12. Patterns of Alcohol and Other Drug Use Associated with Major Depression among Gay Men Attending General Practices in Australia

    Science.gov (United States)

    Holt, Martin; Bryant, Joanne; Newman, Christy E.; Paquette, Dana M.; Mao, Limin; Kidd, Michael R.; Saltman, Deborah C.; Kippax, Susan C.

    2012-01-01

    Our aim was to clarify the role of alcohol and other drug (AOD) use in major depression among gay men attending general medical practices. A secondary analysis was conducted on survey data collected from 531 gay men attending high-HIV-caseload general practices in Adelaide and Sydney, Australia. The survey contained demographic, social,…

  13. Impacts of generic competition and benefit management practices on spending for prescription drugs: evidence from Medicare's Part D benefit.

    Science.gov (United States)

    Sheingold, Steven; Nguyen, Nguyen Xuan

    2014-01-01

    This study estimates the effects of generic competition, increased cost-sharing, and benefit practices on utilization and spending for prescription drugs. We examined changes in Medicare price and utilization from 2007 to 2009 of all drugs in 28 therapeutic classes. The classes accounted for 80% of Medicare Part D spending in 2009 and included the 6 protected classes and 6 classes with practically no generic competition. All variables were constructed to measure each drug relative to its class at a specific plan sponsor. We estimated that the shift toward generic utilization had cut in half the rate of increase in the price of a prescription during 2007-2009. Specifically, the results showed that (1) rapid generic penetration had significantly held down costs per prescription, (2) copayment and other benefit practices shifted utilization to generics and favored brands, and (3) price increases were generally greater in less competitive classes of drugs. In many ways, Part D was implemented at a fortuitous time; since 2006, there have been relatively few new blockbuster drugs introduced, and many existing high-volume drugs used by beneficiaries were in therapeutic classes with multiple brands and generic alternatives. Under these conditions, our paper showed that plan sponsors have been able to contain costs by encouraging use of generics or drugs offering greater value within therapeutic classes. It is less clear what will happen to future Part D costs if a number of new and effective drugs for beneficiaries enter the market with no real competitors.

  14. Risky substance exposure during pregnancy: a pilot study from Lebanese mothers

    Directory of Open Access Journals (Sweden)

    Rachidi S

    2013-05-01

    Full Text Available Samar Rachidi,1 Sanaa Awada,1 Amal Al-Hajje,1 Wafaa Bawab,1 Salam Zein,1 Nadine Saleh,1,2 Pascale Salameh1,21Laboratory of Epidemiological and Clinical Research, Lebanese University, Beirut, Lebanon; 2Faculty of Public Health Labanese University, Beirut, LebanonBackground: The harmful effects of medication and licit substance use during pregnancy may potentially constitute a major public health concern. Our study aims to assess risky exposure of Lebanese pregnant women to drugs, tobacco, caffeine, and alcohol, and to determine their effect on postnatal outcomes.Methods: Women at term were addressed after delivery in five university hospitals of Beirut and Mount Lebanon between February and June 2012. A standardized questionnaire was administered to them. Moreover, medical files of both mothers and their respective newborns were checked to confirm information given by mothers, and to assess the health outcome of the babies.Results: Among the interviewed 350 women, active and passive smoking of tobacco (cigarette or water pipe, and consumption of category C, D, and X drugs were common during pregnancy in Lebanon; they were shown to negatively affect the neonatal outcome in multivariate analyses: they significantly decreased Apgar scores and increased the risk of underweight and medical complications of babies (P < 0.05.Conclusion: Our study demonstrated that Lebanese women were exposed during pregnancy to multiple medications and licit substances that affected the neonates' health. Our findings have implications for clinical obstetric practice and prevention programs in Lebanon. Efforts should be made to decrease exposure to harmful substances during pregnancy.Keywords: pregnancy, smoking, cigarette, water pipe, caffeine, alcohol, drugs, Apgar score

  15. Triangular relationship among risky sexual behavior, addiction, and aggression: A systematic review.

    Science.gov (United States)

    Ahmadi, Khodabakhsh; Javadinia, Seyed Alireza; Saadat, Seyed Hassan; Ramezani, Mohammad Arash; Sedghijalal, Homa

    2017-08-01

    Risky sexual behavior (RSB), addiction, and aggression are three important personal and social factors which influence each other. To overview the potential relationship among RSB, addiction, and aggression to conduct an interactive model for the pathology and management of human behavior. This review article was carried out by searching studies in PubMed, Medline, Web of Science, Ebsco, IEEE, Scopus, Springer, MagIran, and IranMedex databases from the year 1993 to 2013. The search terms were violence, aggression, drug abuse, substance abuse, illicit drug, psychoactive drug, intravenous drug users, addiction and high-risk sexual relationships, unprotected sex, high risk sexual behavior, and sexual risk-taking. In this study, forty-nine studies were accepted for further screening, and met all our inclusion criteria (in English or Persian, full text, and included the search terms). Forty-nine articles were included; 17 out of 26 studies showed a significant correlation between addiction and risky sexual behavior, 15 out of 19 articles indicated a statistically significant correlation between aggression and addiction, and 9 out of 10 articles reported significant correlation between aggression and risky sexual behavior. According to the results, the triangle hypothesis of sex, addiction, and aggression led to the definition of the relationship among the variables of the hypothetical triangle based on the reviewed studies; and the proposed dual and triple relationship based on the conducted literature review was confirmed. This is not a meta-analysis, and there is no analysis of publication bias.

  16. Risky sexual behavior among patients in Turkey with bipolar disorder, schizophrenia, and heroin addiction.

    Science.gov (United States)

    Hariri, Aytul Gursu; Karadag, Figen; Gokalp, Peykan; Essizoglu, Altan

    2011-08-01

    Risky sexual behavior associated with such sexually transmitted infections (STIs) as hepatitis B and C, herpes, Treponema pallidum, and Neisseria gonorrhoeae, is more frequent among psychiatric patients and parenteral drug abusers than the general population. The aim of this study was to investigate risky sexual behavior in psychiatric outpatients diagnosed with schizophrenia (SCH), bipolar disorder, and heroin addiction (HA), and to compare them with those observed in healthy controls. The study group (N = 485; 234 females and 251 males) consisted of patients that consecutively presented to Bakırkoy State and Training Hospital for Psychiatric and Neurological Diseases in Istanbul and normal healthy controls. The chi-squared test was used for comparisons between groups and categorical variables. One-way analysis of variance (post-hoc Bonferroni test) was used for demographic data. A 22-item questionnaire for collecting demographic, illness history, and sexual activity data, and a structured 23-item form for collecting data on risky sexually behavior were administered to the participants. In all, 10% of the participants had a positive history for STIs. The majority of risky sexual behaviors was observed among the HA patients. The frequency of being sexually assaulted and having homosexual acts among the SCH group were higher. None of the patients had a positive human immunodeficiency virus (HIV) test result. The frequency of positivity for hepatitis B and C markers was highest among the HA patients. The provision of information and training about all STIs and risky sexual behavior should become routine in the treatment of mentally ill patients, especially those that abuse drugs. © 2011 International Society for Sexual Medicine.

  17. Chiral drug analysis using mass spectrometric detection relevant to research and practice in clinical and forensic toxicology.

    Science.gov (United States)

    Schwaninger, Andrea E; Meyer, Markus R; Maurer, Hans H

    2012-12-21

    This paper reviews analytical approaches published in 2002-2012 for chiral drug analysis and their relevance in research and practice in the field of clinical and forensic toxicology. Separation systems such as gas chromatography, high performance liquid chromatography, capillary electromigration, and supercritical fluid chromatography, all coupled to mass spectrometry, are discussed. Typical applications are reviewed for relevant chiral analytes such as amphetamines and amphetamine-derived designer drugs, methadone, tramadol, psychotropic and other CNS acting drugs, anticoagulants, cardiovascular drugs, and some other drugs. Usefulness of chiral drug analysis in the interpretation of analytical results in clinical and forensic toxicology is discussed as well. Copyright © 2012 Elsevier B.V. All rights reserved.

  18. Good research practices for measuring drug costs in cost-effectiveness analyses: a societal perspective: the ISPOR Drug Cost Task Force report--Part II.

    Science.gov (United States)

    Garrison, Louis P; Mansley, Edward C; Abbott, Thomas A; Bresnahan, Brian W; Hay, Joel W; Smeeding, James

    2010-01-01

    Major guidelines regarding the application of cost-effectiveness analysis (CEA) have recommended the common and widespread use of the "societal perspective" for purposes of consistency and comparability. The objective of this Task Force subgroup report (one of six reports from the International Society for Pharmacoeconomics and Outcomes Research [ISPOR] Task Force on Good Research Practices-Use of Drug Costs for Cost Effectiveness Analysis [Drug Cost Task Force (DCTF)]) was to review the definition of this perspective, assess its specific application in measuring drug costs, identify any limitations in theory or practice, and make recommendations regarding potential improvements. Key articles, books, and reports in the methodological literature were reviewed, summarized, and integrated into a draft review and report. This draft report was posted for review and comment by ISPOR membership. Numerous comments and suggestions were received, and the report was revised in response to them. The societal perspective can be defined by three conditions: 1) the inclusion of time costs, 2) the use of opportunity costs, and 3) the use of community preferences. In practice, very few, if any, published CEAs have met all of these conditions, though many claim to have taken a societal perspective. Branded drug costs have typically used actual acquisition cost rather than the much lower social opportunity costs that would reflect only short-run manufacturing and distribution costs. This practice is understandable, pragmatic, and useful to current decision-makers. Nevertheless, this use of CEA focuses on static rather than dynamic efficacy and overlooks the related incentives for innovation. Our key recommendation is that current CEA practice acknowledge and embrace this limitation by adopting a new standard for the reference case as one of a "limited societal" or "health systems" perspective, using acquisition drug prices while including indirect costs and community preferences. The

  19. The relationship between future time perspective, self-efficacy and risky sexual behaviour in the Black youth of central South Africa.

    Science.gov (United States)

    Abousselam, Nikki; Naudé, Luzelle; Lens, Willy; Esterhuyse, Karel

    2016-01-01

    An interest exists in understanding why adolescents partake in risky sexual behaviours, as well as the risk and protective practices associated with risky sexual behaviour. The aim of this study was to investigate the moderator effect of future time perspective in the relationship between self-efficacy and risky sexual behaviour. A random cluster consisting of 467 learners from English medium high schools of central South Africa participated in this study. The participants' risky sexual behaviour, self-efficacy and future time perspective were measured with the Perceptions of HIV/AIDS Risk Survey, Generalised Perceived Self-efficacy Scale and the Zimbardo Time Perspective Inventory, respectively. Product term regression analysis was performed. It was found that both self-efficacy and future time perspective were negatively related to risky sexual behaviour. No moderating effect was found for future time perspective in the relationship between self-efficacy and risky sexual behaviour. Self-efficacy and future time perspective were identified as qualities that protect adolescents from engaging in risky sexual behaviours. This finding can be useful in developing prevention programmes. Intervention programmes aimed at the youth should foster a sense of hope and possibility about the future and the development of goals and aspirations to prevent risky behaviour.

  20. The rotationally improved Skyrmion, or RISKY

    International Nuclear Information System (INIS)

    Dorey, N.

    1995-01-01

    The perceived inability of the Skyrme model to reproduce pseudovector pion-baryon coupling has come to be known as the ''Yukawa problem.'' In this talk, we review the complete solution to this problem. The solution involves a new configuration known as the rotationally improved Skyrmion, or ''RISKY,'' in which the hedgehog structure is modified by a small quadrupole distortion. We illustrate our ideas both in the Skyrme model and in a simpler model with a global U(l) symmetry

  1. Is international exploration really more risky

    International Nuclear Information System (INIS)

    Chua, J.; Woodward, R.

    1992-01-01

    Over the past few years many Canadian oil producers have shifted their exploration efforts to finding larger reserves outside of Canada. Evaluation of such international projects requires the same type of economic analysis as is carried out for domestic projects, essentially discounted cash flow or net present value analysis. Applying this evaluation methodology requires two types of data: a series of forecasted cash flows and an appropriate hurdle rate. Conventional wisdom states that foreign projects should be evaluated at a higher discount rate than domestic projects. This wisdom is called into question. While some overseas projects may indeed be of higher risk, especially unconventional projects or those located in politically unstable areas, it is not obvious that overseas projects located in politically stable economies and comparable technologically to domestic projects are indeed more risky. In addition to evaluating the market riskiness of overseas projects, the extent to which on-going globalization of world financial markets might impact the riskiness of both domestic and overseas investments in the energy industry is assessed. It is indicated that it may be appropriate for Canadian oil and gas companies to revisit the methods used to measure their corporate hurdle rates in light of this globalization process. 3 tabs

  2. Risky Decision Making in Juvenile Myoclonic Epilepsy

    Directory of Open Access Journals (Sweden)

    Iris Unterberger

    2018-03-01

    Full Text Available It is not known whether patients with juvenile myoclonic epilepsy (JME differ from healthy people in decision making under risk, i.e., when the decision-making context offers explicit information about options, probabilities, and consequences already from the beginning. In this study, we adopted the Game of Dice Task-Double to investigate decision making under risk in a group of 36 patients with JME (mean age 25.25/SD 5.29 years and a group of 38 healthy controls (mean age 26.03/SD 4.84 years. Participants also underwent a comprehensive neuropsychological assessment focused on frontal executive functions. Significant group differences were found in tests of psychomotor speed and divided attention, with the patients scoring lower than the controls. Importantly, patients made risky decisions more frequently than controls. In the patient group, poor decision making was associated with poor executive control, poor response inhibition, and a short interval since the last seizure episode. Executive control and response inhibition could predict 42% of variance in the frequency of risky decisions. This study indicates that patients with JME with poorer executive functions are more likely to make risky decisions than healthy controls. Decision making under risk is of major importance in every-day life, especially with regard to treatment decisions and adherence to long-term medical therapy. Since even a single disadvantageous decision may have long-lasting consequences, this finding is of high relevance.

  3. Risky Decision Making in Juvenile Myoclonic Epilepsy.

    Science.gov (United States)

    Unterberger, Iris; Zamarian, Laura; Prieschl, Manuela; Bergmann, Melanie; Walser, Gerald; Luef, Gerhard; Javor, Andrija; Ransmayr, Gerhard; Delazer, Margarete

    2018-01-01

    It is not known whether patients with juvenile myoclonic epilepsy (JME) differ from healthy people in decision making under risk, i.e., when the decision-making context offers explicit information about options, probabilities, and consequences already from the beginning. In this study, we adopted the Game of Dice Task-Double to investigate decision making under risk in a group of 36 patients with JME (mean age 25.25/SD 5.29 years) and a group of 38 healthy controls (mean age 26.03/SD 4.84 years). Participants also underwent a comprehensive neuropsychological assessment focused on frontal executive functions. Significant group differences were found in tests of psychomotor speed and divided attention, with the patients scoring lower than the controls. Importantly, patients made risky decisions more frequently than controls. In the patient group, poor decision making was associated with poor executive control, poor response inhibition, and a short interval since the last seizure episode. Executive control and response inhibition could predict 42% of variance in the frequency of risky decisions. This study indicates that patients with JME with poorer executive functions are more likely to make risky decisions than healthy controls. Decision making under risk is of major importance in every-day life, especially with regard to treatment decisions and adherence to long-term medical therapy. Since even a single disadvantageous decision may have long-lasting consequences, this finding is of high relevance.

  4. Dissecting the risky-choice framing effect

    Directory of Open Access Journals (Sweden)

    Ellen Peters

    2008-08-01

    Full Text Available Using five variants of the Asian Disease Problem, we dissected the risky-choice framing effect by requiring each participant to provide preference ratings for the full decision problem and also to provide attractiveness ratings for each of the component parts, i.e., the sure-thing option and the risky option. Consistent with previous research, more risky choices were made by respondents receiving negatively framed versions of the decision problems than by those receiving positively framed versions. However, different processes were evident for those scoring high and low on numeracy. Whereas the choices of the less numerate showed a large effect of frame above and beyond any influence of their evaluations of the separate options, the choices of the highly numerate were almost completely accounted for by their attractiveness ratings of the separate options. These results are consistent with an increased tendency of the highly numerate to integrate complex numeric information in the construction of their preferences and a tendency for the less numerate to respond more superficially to non-numeric sources of information.

  5. Risky decisions in a lottery task are associated with an increase of cocaine use

    Directory of Open Access Journals (Sweden)

    Amrei eWittwer

    2016-05-01

    Full Text Available Cocaine use disorder is associated with maladaptive decision-making behaviour, which strongly contributes to the harmful consequences of chronic drug use. Prior research has shown that cocaine users exhibit impaired neuropsychological test performances, particularly with regard to attention, learning, and memory but also in executive functions such as decision-making and impulse control. However, to what extent cocaine users show impaired decision-making under risk without feedback has not yet been investigated systematically. Therefore, to examine risk-taking behaviour, 31 chronic cocaine users and 26 stimulant-naïve healthy controls, who were part of the Zurich Cocaine Cognition Study, performed the Randomized Lottery Task (RALT with winning lotteries consisting of an uncertain and a certain prospect. Results revealed that risky decisions were associated with male sex, increased cocaine use in the past year, higher cocaine concentrations in the hair, and younger age. In addition, higher levels of cocaine in the hair and cumulative lifetime consumption were associated with risky decisions, whereas potentially confounding factors including cognition and psychiatric symptoms had no significant effect. Taken together, our results indicate that cocaine users who increased their consumption over a period of one year show deficits in the processing of risky information accompanied with increased risk-taking. Future research should analyse whether risky decisions could potentially serve as a prognostic marker for cocaine use disorder.

  6. Cloud Infrastructures for In Silico Drug Discovery: Economic and Practical Aspects

    Science.gov (United States)

    Clematis, Andrea; Quarati, Alfonso; Cesini, Daniele; Milanesi, Luciano; Merelli, Ivan

    2013-01-01

    Cloud computing opens new perspectives for small-medium biotechnology laboratories that need to perform bioinformatics analysis in a flexible and effective way. This seems particularly true for hybrid clouds that couple the scalability offered by general-purpose public clouds with the greater control and ad hoc customizations supplied by the private ones. A hybrid cloud broker, acting as an intermediary between users and public providers, can support customers in the selection of the most suitable offers, optionally adding the provisioning of dedicated services with higher levels of quality. This paper analyses some economic and practical aspects of exploiting cloud computing in a real research scenario for the in silico drug discovery in terms of requirements, costs, and computational load based on the number of expected users. In particular, our work is aimed at supporting both the researchers and the cloud broker delivering an IaaS cloud infrastructure for biotechnology laboratories exposing different levels of nonfunctional requirements. PMID:24106693

  7. Reconceptualising the Gender of Fitness Doping: Performing and Negotiating Masculinity through Drug-Use Practices

    Directory of Open Access Journals (Sweden)

    Jesper Andreasson

    2015-08-01

    Full Text Available This article analyses self-portrayals and gender constructions among Swedish male bodybuilders who are engaged in fitness doping. The empirical material comes from a larger ethnographic investigation into gym culture. The results show that there is a strong propensity to conform with particular gender fantasies that rests heavily on a binary understanding of gendered, doped bodies. However, this storyline does not apprehend the entire self-presentation of the analysed drug users. Negotiations and inclusive subversions of traditional gender norms are also expressed. For example, the narratives show how the use of performance-enhancing substances makes it possible for (heterosexual men to approach, touch and express feelings of desire towards other men and their bodies. As such, this practice can be viewed as a contestation of hegemonic gender values, in which masculinity and fitness doping are detached from a quite heterosexist understanding, and turned into a symbolic world of homoerotic pleasure.

  8. Cloud Infrastructures for In Silico Drug Discovery: Economic and Practical Aspects

    Directory of Open Access Journals (Sweden)

    Daniele D'Agostino

    2013-01-01

    Full Text Available Cloud computing opens new perspectives for small-medium biotechnology laboratories that need to perform bioinformatics analysis in a flexible and effective way. This seems particularly true for hybrid clouds that couple the scalability offered by general-purpose public clouds with the greater control and ad hoc customizations supplied by the private ones. A hybrid cloud broker, acting as an intermediary between users and public providers, can support customers in the selection of the most suitable offers, optionally adding the provisioning of dedicated services with higher levels of quality. This paper analyses some economic and practical aspects of exploiting cloud computing in a real research scenario for the in silico drug discovery in terms of requirements, costs, and computational load based on the number of expected users. In particular, our work is aimed at supporting both the researchers and the cloud broker delivering an IaaS cloud infrastructure for biotechnology laboratories exposing different levels of nonfunctional requirements.

  9. Risky substance exposure during pregnancy: a pilot study from Lebanese mothers

    OpenAIRE

    Rachidi, Samar; Awada, Sanaa; Al-Hajje, Amal; Bawab, Wafaa; Zein, Salam; Saleh, Nadine; Salameh, Pascale

    2013-01-01

    Samar Rachidi,1 Sanaa Awada,1 Amal Al-Hajje,1 Wafaa Bawab,1 Salam Zein,1 Nadine Saleh,1,2 Pascale Salameh1,21Laboratory of Epidemiological and Clinical Research, Lebanese University, Beirut, Lebanon; 2Faculty of Public Health Labanese University, Beirut, LebanonBackground: The harmful effects of medication and licit substance use during pregnancy may potentially constitute a major public health concern. Our study aims to assess risky exposure of Lebanese pregnant women to drugs, tobacco, caff...

  10. Immunosuppressive Drug Discontinuation in Noninfectious Uveitis From Real-Life Clinical Practice: A Survival Analysis.

    Science.gov (United States)

    Abásolo, Lydia; Rosales, Zulema; Díaz-Valle, David; Gómez-Gómez, Alejandro; Peña-Blanco, Rayma C; Prieto-García, Ángela; Benítez-Del-Castillo, José Manuel; Pato, Esperanza; García-Feijoo, Julián; Fernández-Gutiérrez, Benjamín; Rodriguez-Rodriguez, Luis

    2016-09-01

    To assess in uveitis patients the rate of immunosuppressive drug (ISD) discontinuation in real-life clinical practice, comparing this rate among ISDs. Longitudinal retrospective cohort study. We included uveitis patients attending a tertiary eye referral center from Madrid (Spain) between 1989 and 2015, prescribed any ISDs (cyclosporine, methotrexate, azathioprine, anti-TNF drugs, or others). Our main outcome was discontinuation of all ISDs owing to clinical efficacy, inefficacy, adverse drug reaction (ADR), and other medical causes. Discontinuation rates (DRs) per 100 patient-years were estimated. Variables associated with specific-cause discontinuations were analyzed using Cox bivariate and multivariate models. We analyzed 110 patients with 263 treatment courses and 665.2 patient-years of observation. Cyclosporine (66.4%), methotrexate (47.3%), azathioprine (30.9%), and anti-TNFs (30.9%) were the most frequently used ISDs. Treatment was suspended in 136 cases (mostly owing to clinical efficacy [38.2%], inefficacy [26.5%], and ADRs [22.8%]). All-cause DR with 95% confidence interval was 20.4 [17.3-24.2]. Retention rates at 1 and 10 years were 74% and 16%, respectively. In the multivariate analysis, combined treatment exhibited higher DRs owing to clinical efficacy than other ISDs in monotherapy. Conversely, nonbiologic combination therapy with azathioprine exhibited the highest DR owing to ADRs. Clinical efficacy was the most frequent cause for ISD discontinuation, followed by inefficacy and ADRs. DR owing to efficacy was higher for combination therapy. Furthermore, nonbiologic combination therapy with azathioprine was associated with a higher DR owing to ADRs. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. [Consensus clinical practice guidelines of the Andalusian Epilepsy Society on prescribing generic antiepileptic drugs].

    Science.gov (United States)

    Cañadillas-Hidalgo, F M; Sánchez-Alvarez, J C; Serrano-Castro, P J; Mercadé-Cerdá, J M

    Pharmaceutical spending in Spain accounts for 1.2-1.4% of the gross domestic product and is increasing by 5-12% per year. One of the measures adopted by the government to cut this spending is the possible substitution of original prescribed drugs by generics. In the case of antiepileptic drugs (AED), which are characterised by a scant therapeutic margin, these steps have sparked a scientific debate about their repercussion on the control of epileptic patients. We propose to draw up a set of implicit evidence-based consensus practice guidelines concerning issues related with this topic. A selective search for quality scientific information on the subject was conducted on PubMed-Medline, Tripdatabase and the Biblioteca Cochrane Plus. The selected references were analysed and discussed by the authors, and the recommendations deriving from them were collected. A total of 21 primary documents and 16 practice guidelines, protocols or experts' recommendations were identified. Our recommendations were explicitly included at the end of the text. The Andalusian Epilepsy Society makes the following recommendations: 1) not replacing an innovative AED by its generic in a controlled patient; 2) beginning treatment with a generic AED in monotherapy or in association is acceptable; 3) not exchanging generic AED from different pharmaceutical companies; 4) explaining to the patient the rules governing the authorization of generics and the importance of avoiding exchanges between different generic AED; and 5) if there is some worsening of the clinical condition or side effects appear following the introduction of a generic, the causes must be investigated and communicated to the bodies responsible for pharmacovigilance.

  12. Local tolerance testing of parenteral drugs: how to put into practice.

    Science.gov (United States)

    Jochims, Karin; Kemkowski, Joerg; Nolte, Thomas; Bartels, Thomas; Heusener, Alexander

    2003-10-01

    Notwithstanding that there are national and international guidelines about local tolerance testing of parenteral drugs in animals, in particular to mention CPMP/SWP/2145/00 (Note for Guidance on Non-Clinical Local Tolerance Testing of Medicinal Products), very heterogeneous study designs have been established in the past. A working group including experts of the leading pharmaceutical industry from German-language countries, named "Arbeitskreis Lokale Verträglichkeit," has been intensively discussing the experimental procedures in detail for a period of six years and has been considering their pros and cons. This team of experts now feels confident to give some recommendations for study conduct besides describing different materials and methods for this type of toxicological study. Special knowledge from toxicologists as well as pathologists from our working group has been taken into account. This paper deals with choice of species, number of animals used, controls, administration sites, volumes, rate and frequency, length of observation period, termination, clinical, macroscopic and histopathological examinations and, finally, overall assessment criteria and conclusion. Our purpose is that this paper may be of value for: *The study director who is inexperienced in the conduction of local tolerance testing and who may need a standard design as his first step into this new field. *The well-versed study director who would like to know how others have done in the past, who may examine self-critically his own practice and who is open to our team's recommendations, tips and tricks from practice. *The specialist at a regulatory authority who, finally, reviews study reports, assesses their format and content and, above all, decides on the approval of a drug product.

  13. The Effects of Early Sexual Abuse on Adult Risky Sexual Behaviors among Persons with Severe Mental Illness

    Science.gov (United States)

    Van Dorn, Richard A.; Mustillo, Sarah; Elbogen, Eric B.; Dorsey, Shannon; Swanson, Jeffrey W.; Swartz, Marvin S.

    2005-01-01

    Objective: There were two aims: first, to examine the relationship between prior sexual abuse and three types of adult risky sexual behaviors [(1) ever traded sex for drugs or money, (2) had unprotected sex in the past 6 months, and (3) frequency of unprotected sex in the past 6 months] among persons with severe mental illness (SMI), and second,…

  14. Reducing Risky Security Behaviours: Utilising Affective Feedback to Educate Users

    Directory of Open Access Journals (Sweden)

    Lynsay A. Shepherd

    2014-11-01

    Full Text Available Despite the number of tools created to help end-users reduce risky security behaviours, users are still falling victim to online attacks. This paper proposes a browser extension utilising affective feedback to provide warnings on detection of risky behaviour. The paper provides an overview of behaviour considered to be risky, explaining potential threats users may face online. Existing tools developed to reduce risky security behaviours in end-users have been compared, discussing the success rates of various methodologies. Ongoing research is described which attempts to educate users regarding the risks and consequences of poor security behaviour by providing the appropriate feedback on the automatic recognition of risky behaviour. The paper concludes that a solution utilising a browser extension is a suitable method of monitoring potentially risky security behaviour. Ultimately, future work seeks to implement an affective feedback mechanism within the browser extension with the aim of improving security awareness.

  15. Substance abuse and pharmacy practice: what the community pharmacist needs to know about drug abuse and dependence

    Directory of Open Access Journals (Sweden)

    Tommasello Anthony C

    2004-04-01

    Full Text Available Abstract Pharmacists, the most accessible of health care professionals, are well positioned to help prevent and treat substance use disorders and should prepare themselves to perform these functions. New research improves our knowledge about the pharmacological and behavioral risks of drug abuse, supports the clinical impression that drug dependence is associated with long-lasting neurochemical changes, and demonstrates effective pharmacological treatments for certain kinds of drug dependencies. The profession is evolving. Pharmacists are engaging in new practice behaviors such as helping patients manage their disease states. Collaborative practice agreements and new federal policies set the stage for pharmacists to assist in the clinical management of opioid and other drug dependencies. Pharmacists need to be well informed about issues related to addiction and prepared not only to screen, assess, and refer individual cases and to collaborate with physicians caring for chemically dependent patients, but also to be agents of change in their communities in the fight against drug abuse. At the end of this article the pharmacist will be better able to: 1. Explain the disease concept of chemical dependence 2. Gather the information necessary to conduct a screen for chemical dependence 3. Inform patients about the treatment options for chemical dependence 4. Locate resources needed to answer questions about the effects of common drugs of abuse (alcohol, marijuana, narcotics, "ecstasy", and cocaine 5. Develop a list of local resources for drug abuse treatment 6. Counsel parents who are concerned about drug use by their children 7. Counsel individuals who are concerned about drug use by a loved one. 8. Counsel individuals who are concerned about their own drug use

  16. Risky decisions and their consequences: neural processing by boys with Antisocial Substance Disorder.

    Directory of Open Access Journals (Sweden)

    Thomas J Crowley

    2010-09-01

    Full Text Available Adolescents with conduct and substance problems ("Antisocial Substance Disorder" (ASD repeatedly engage in risky antisocial and drug-using behaviors. We hypothesized that, during processing of risky decisions and resulting rewards and punishments, brain activation would differ between abstinent ASD boys and comparison boys.We compared 20 abstinent adolescent male patients in treatment for ASD with 20 community controls, examining rapid event-related blood-oxygen-level-dependent (BOLD responses during functional magnetic resonance imaging. In 90 decision trials participants chose to make either a cautious response that earned one cent, or a risky response that would either gain 5 cents or lose 10 cents; odds of losing increased as the game progressed. We also examined those times when subjects experienced wins, or separately losses, from their risky choices. We contrasted decision trials against very similar comparison trials requiring no decisions, using whole-brain BOLD-response analyses of group differences, corrected for multiple comparisons. During decision-making ASD boys showed hypoactivation in numerous brain regions robustly activated by controls, including orbitofrontal and dorsolateral prefrontal cortices, anterior cingulate, basal ganglia, insula, amygdala, hippocampus, and cerebellum. While experiencing wins, ASD boys had significantly less activity than controls in anterior cingulate, temporal regions, and cerebellum, with more activity nowhere. During losses ASD boys had significantly more activity than controls in orbitofrontal cortex, dorsolateral prefrontal cortex, brain stem, and cerebellum, with less activity nowhere.Adolescent boys with ASD had extensive neural hypoactivity during risky decision-making, coupled with decreased activity during reward and increased activity during loss. These neural patterns may underlie the dangerous, excessive, sustained risk-taking of such boys. The findings suggest that the dysphoria, reward

  17. Modelling system development of risky industry on world experience base

    Directory of Open Access Journals (Sweden)

    O.T. Polishchuk

    2017-12-01

    Full Text Available The paper researches the tendencies and dynamic characteristics of risky business. The means of development stimulation in risky business in the USA are examined. The factors for insurance companies, banks, retirement funds of their investors’ function inability are explained. The multichoice model of economy structure transformation according to the innovative changes and regulatory policy is developed. The authors systematize the factors, which determine the branch attraction for risky investment. Four scenarios for the development of risky industry in Ukraine are studied and the matrix of their development is formed.

  18. Optimising translational oncology in clinical practice: strategies to accelerate progress in drug development.

    Science.gov (United States)

    Stahel, R; Bogaerts, J; Ciardiello, F; de Ruysscher, D; Dubsky, P; Ducreux, M; Finn, S; Laurent-Puig, P; Peters, S; Piccart, M; Smit, E; Sotiriou, C; Tejpar, S; Van Cutsem, E; Tabernero, J

    2015-02-01

    Despite intense efforts, the socioeconomic burden of cancer remains unacceptably high and treatment advances for many common cancers have been limited, suggesting a need for a new approach to drug development. One issue central to this lack of progress is the heterogeneity and genetic complexity of many tumours. This results in considerable variability in therapeutic response and requires knowledge of the molecular profile of the tumour to guide appropriate treatment selection for individual patients. While recent advances in the molecular characterisation of different cancer types have the potential to transform cancer treatment through precision medicine, such an approach presents a major economic challenge for drug development, since novel targeted agents may only be suitable for a small cohort of patients. Identifying the patients who would benefit from individual therapies and recruiting sufficient numbers of patients with particular cancer subtypes into clinical trials is challenging, and will require collaborative efforts from research groups and industry in order to accelerate progress. A number of molecular screening platforms have already been initiated across Europe, and it is hoped that these networks, along with future collaborations, will benefit not only patients but also society through cost reductions as a result of more efficient use of resources. This review discusses how current developments in translational oncology may be applied in clinical practice in the future, assesses current programmes for the molecular characterisation of cancer and describes possible collaborative approaches designed to maximise the benefits of translational science for patients with cancer. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  19. Zolpidem prescribing practices before and after Food and Drug Administration required product labeling changes.

    Science.gov (United States)

    Norman, Jessica L; Fixen, Danielle R; Saseen, Joseph J; Saba, Laura M; Linnebur, Sunny A

    2017-01-01

    Women have higher morning serum zolpidem concentrations than men after taking an evening dose, potentially leading to increased risk of harm. On 19 April 2013, the United States Food and Drug Administration required labeling changes for zolpidem, recommending an initial dose of no greater than 5 mg (immediate release) or 6.25 mg (controlled release) per night in women. The primary objective of this study was to compare prescribing practices before and after the 2013 zolpidem labeling change. A secondary objective was to evaluate serious adverse events potentially related to zolpidem. Electronic medical records of adults receiving care through the University of Colorado Health system were accessed for study inclusion if patients were provided a first-time prescription for zolpidem either prior to or after the Food and Drug Administration labeling change. Patients were randomly chosen from eight strata based on age, gender, and date of zolpidem initiation (before/after the labeling change). Demographic and zolpidem prescribing data were collected. Low-dose zolpidem was considered 5 mg (immediate release) or 6.25 mg (controlled release) daily or less. Documentation of potentially related serious adverse events within the patients' records was also evaluated. A total of 400 patients were included in the study. The overall percentage of patients prescribed low-dose zolpidem increased from 44% to 58% after the labeling change (p = 0.0020). In a pre-specified subgroup analysis, the percentage of patients prescribed low-dose zolpidem increased in all groups, including young men (38%-50%, p = 0.23), elderly men (34%-40%, p = 0.53), and elderly women (60%-74%, p = 0.14), but the change was only significant in young women (42%-70%, p = 0.0045). After Food and Drug Administration-mandated labeling changes for zolpidem in 2013, the percentage of overall patients in our health system, and specifically young women, with initial prescriptions for low

  20. Zolpidem prescribing practices before and after Food and Drug Administration required product labeling changes

    Directory of Open Access Journals (Sweden)

    Jessica L Norman

    2017-05-01

    Full Text Available Background: Women have higher morning serum zolpidem concentrations than men after taking an evening dose, potentially leading to increased risk of harm. On 19 April 2013, the United States Food and Drug Administration required labeling changes for zolpidem, recommending an initial dose of no greater than 5 mg (immediate release or 6.25 mg (controlled release per night in women. Objectives: The primary objective of this study was to compare prescribing practices before and after the 2013 zolpidem labeling change. A secondary objective was to evaluate serious adverse events potentially related to zolpidem. Methods: Electronic medical records of adults receiving care through the University of Colorado Health system were accessed for study inclusion if patients were provided a first-time prescription for zolpidem either prior to or after the Food and Drug Administration labeling change. Patients were randomly chosen from eight strata based on age, gender, and date of zolpidem initiation (before/after the labeling change. Demographic and zolpidem prescribing data were collected. Low-dose zolpidem was considered 5 mg (immediate release or 6.25 mg (controlled release daily or less. Documentation of potentially related serious adverse events within the patients’ records was also evaluated. Results: A total of 400 patients were included in the study. The overall percentage of patients prescribed low-dose zolpidem increased from 44% to 58% after the labeling change (p = 0.0020. In a pre-specified subgroup analysis, the percentage of patients prescribed low-dose zolpidem increased in all groups, including young men (38%–50%, p = 0.23, elderly men (34%–40%, p = 0.53, and elderly women (60%–74%, p = 0.14, but the change was only significant in young women (42%–70%, p = 0.0045. Conclusion: After Food and Drug Administration–mandated labeling changes for zolpidem in 2013, the percentage of overall patients in our health

  1. Risky business: human factors in critical care.

    Science.gov (United States)

    Laussen, Peter C; Allan, Catherine K; Larovere, Joan M

    2011-07-01

    Remarkable achievements have occurred in pediatric cardiac critical care over the past two decades. The specialty has become well defined and extremely resource intense. A great deal of focus has been centered on optimizing patient outcomes, particularly mortality and early morbidity, and this has been achieved through a focused and multidisciplinary approach to management. Delivering high-quality and safe care is our goal, and during the Risky Business symposium and simulation sessions at the Eighth International Conference of the Pediatric Cardiac Intensive Care Society in Miami, December 2010, human factors, systems analysis, team training, and lessons learned from malpractice claims were presented.

  2. Applying a perceptions and practicalities approach to understanding nonadherence to antiepileptic drugs.

    Science.gov (United States)

    Chapman, Sarah C E; Horne, Rob; Eade, Rona; Balestrini, Simona; Rush, Jennifer; Sisodiya, Sanjay M

    2015-09-01

    Nonadherence to antiepileptic drugs (AEDs) is a common cause of poor seizure control. This study examines whether reported adherence to AEDs is related to variables identified in the National Institute for Health and Clinical Excellence (NICE) Medicines Adherence Guidelines as being important to adherence: perceptual factors (AED necessity beliefs and concerns), practical factors (limitations in capability and resources), and perceptions of involvement in treatment decisions. This was a cross-sectional study of people with epilepsy receiving AEDs. Participants completed an online survey hosted by the Epilepsy Society (n = 1,010), or as an audit during inpatient admission (n = 118). Validated questionnaires, adapted for epilepsy, assessed reported adherence to AEDs (Medication Adherence Report Scale [MARS]), perceptions of AEDs (Beliefs about Medicines Questionnaire [BMQ]), and patient perceptions of involvement in treatment decisions (Treatment Empowerment Scale [TES]). Low adherence was related to AED beliefs (doubts about necessity: t(577) = 3.90, p < 0.001; and concerns: t(995) = 3.45, p = 0.001), reported limitations in capability and resources (t(589) = 7.78, p < 0.001), and to perceptions of a lack of involvement in treatment decisions (t(623) = 4.48, p < 0.001). In multiple logistic regression analyses, these factors significantly (p < 0.001) increased variance in reported adherence, above that which could be explained by age and clinical variables (seizure frequency, type, epilepsy duration, number of AEDs prescribed). Variables identified in the NICE Medicines Adherence Guidelines as potentially important factors for adherence were found to be related to adherence to AEDs. These factors are potentially modifiable. Interventions to support optimal adherence to AEDs should be tailored to address doubts about AED necessity and concerns about harm, and to overcome practical difficulties, while engaging patients in treatment decisions. Wiley Periodicals, Inc.

  3. Publication and non-publication of drug trial results: a 10-year cohort of trials in Norwegian general practice.

    Science.gov (United States)

    Brænd, Anja Maria; Straand, Jørund; Jakobsen, Rune Bruhn; Klovning, Atle

    2016-04-11

    Previously, we identified a 10-year cohort of protocols from applications to the Norwegian Medicines Agency 1998-2007, consisting of 196 drug trials in general practice. The aim of this study was to examine whether trial results were published and whether trial funding and conflicts of interest were reported. Cohort study of trials with systematic searches for published results. Clinical drug trials in Norwegian general practice. We performed systematic literature searches of MEDLINE, Embase and CENTRAL to identify publications originating from each trial using characteristics such as test drug, comparator and patient groups as search terms. When no publication was identified, we contacted trial sponsors for information regarding trial completion and reference to any publications. We determined the frequency of publication of trial results and trial characteristics associated with publication of results. Of the 196 trials, 5 were never started. Of the remaining 191 trials, 71% had results published in a journal, 11% had results publicly available elsewhere and 18% of trials had no results available. Publication was more common among trials with an active comparator drug (χ(2) test, p=0.040), with a larger number of patients (total sample size≥median, p=0.010) and with a longer trial period (duration≥median, p=0.025). Trial funding was reported in 85% of publications and increased over time, as did reporting of conflicts of interest among authors. Among the 134 main journal articles from the trials, 60% presented statistically significant results for the investigational drug, and the conclusion of the article was favourable towards the test drug in 78% of papers. We did not identify any journal publication of results for 29% of the general practice drug trials. Trials with an active comparator, larger and longer trials were more likely to be published. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a

  4. Gender Differences in the Association between Conduct Disorder and Risky Sexual Behavior

    Science.gov (United States)

    Brooks Holliday, Stephanie; Ewing, Brett A.; Storholm, Erik D.; Parast, Layla; D’Amico, Elizabeth J.

    2017-01-01

    Despite suggestions that there are gender differences in the association between conduct disorder (CD) and risky sexual behavior, limited empirical research has examined this question. Youth (N = 616) were recruited from four primary care clinics and completed questions related to risky sexual behavior, alcohol and marijuana use, and CD. Results of stratified multivariate models indicated that the association between CD and having four or more lifetime partners, having two or more partners in the last 3 months, and engaging in condomless sex was stronger among female youth. However, association between CD and alcohol and other drug use before sex was stronger in male youth. This is an important contribution to our understanding of gender-specific manifestations of conduct disorder, and has the potential to inform screening and brief intervention efforts for this population. PMID:28182979

  5. Gender differences in the association between conduct disorder and risky sexual behavior.

    Science.gov (United States)

    Brooks Holliday, Stephanie; Ewing, Brett A; Storholm, Erik D; Parast, Layla; D'Amico, Elizabeth J

    2017-04-01

    Despite suggestions that there are gender differences in the association between conduct disorder (CD) and risky sexual behavior, limited empirical research has examined this question. Youth (N = 616) were recruited from four primary care clinics and completed questions related to risky sexual behavior, alcohol and marijuana use, and CD. Results of stratified multivariate models indicated that the association between CD and having four or more lifetime partners, having two or more partners in the last 3 months, and engaging in condomless sex was stronger among female youth. However, the association between CD and alcohol and other drug use before sex was stronger in male youth. This is an important contribution to our understanding of gender-specific manifestations of conduct disorder, and has the potential to inform screening and brief intervention efforts for this population. Copyright © 2017 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  6. “It's Sweet Without Condom”: Understanding Risky Sexual Behaviour Among Nigerian Female University Students

    Directory of Open Access Journals (Sweden)

    Anthony Idowu Ajayi

    2018-01-01

    Full Text Available Background: Over a million people globally acquire sexually transmitted infections (STI every day mainly through unprotected sexual contact. While the consequences of risky sexual behaviour are well documented, the literature on young educated women's perceptions of, and narratives about risky sexual behaviour is limited, and thus, it is difficult to fathom from available sources why such behaviour persists. This study examined the prevalence of sexual risk-taking and assessed female University students' knowledge of the consequences of unprotected sex and reasons why such behaviour persists. Paradoxes between their narratives and risky sexual behaviour were discussed. Methods: The study adopted a mixed study design involving a survey of 420 students selected using cluster random sampling, 20 in-depth interviews and 5 focus group discussions. The analysis of the quantitative data involves the use of descriptive and inferential statistics, while thematic content analysis was used to analyse the qualitative data. Results: High prevalence of unprotected sexual intercourse was reported and was not associated with age, year of study, place of residence and religion. The narratives of participants indicate that female university students were aware of the risks associated with unprotected sex. Participants generally condemned sexual risk-taking and asserted that freedom, peer influence, poverty, ignorance, lack of sex education, civilisation, promiscuity, and satisfying sexual urge were the reasons for the persistent risky sexual behaviour among female university students. Also, perceived reduced fun associated with condom use, nourishment of marital expectations, and equivalence of unprotected sex with trust are among the reasons for persistent sexual risk-taking among female university students. Conclusion: Our findings show that female students practice risky sexual behaviour despite having knowledge of its consequences. Change in sexual behaviour

  7. Age differences in the effect of framing on risky choice: A meta-analysis

    Science.gov (United States)

    Best, Ryan; Charness, Neil

    2015-01-01

    The framing of decision scenarios in terms of potential gains versus losses has been shown to influence choice preferences between sure and risky options. Normative cognitive changes associated with aging have been known to affect decision-making, which has led to a number of studies investigating the influence of aging on the effect of framing. Mata, Josef, Samanez-Larkin, and Hertwig (2011) systematically reviewed the available literature using a meta-analytic approach, but did not include tests of homogeneity nor subsequent moderator variable analyses. The current review serves to extend the previous analysis to include such tests as well as update the pool of studies available for analysis. Results for both positively and negatively framed conditions were reviewed using two meta-analyses encompassing data collected from 3,232 subjects across 18 studies. Deviating from the previous results, the current analysis finds a tendency for younger adults to choose the risky option more often than older adults for positively framed items. Moderator variable analyses find this effect to likely be driven by the specific decision scenario, showing a significant effect with younger adults choosing the risky option more often in small-amount financial and large-amount mortality-based scenarios. For negatively framed items, the current review found no overall age difference in risky decision making, confirming the results from the prior meta-analysis. Moderator variable analyses conducted to address heterogeneity found younger adults to be more likely than older adults to choose the risky option for negatively framed high-amount mortality-based decision scenarios. Practical implications for older adults are discussed. PMID:26098168

  8. Age differences in the effect of framing on risky choice: A meta-analysis.

    Science.gov (United States)

    Best, Ryan; Charness, Neil

    2015-09-01

    The framing of decision scenarios in terms of potential gains versus losses has been shown to influence choice preferences between sure and risky options. Normative cognitive changes associated with aging have been known to affect decision making, which has led to a number of studies investigating the influence of aging on the effect of framing. Mata, Josef, Samanez-Larkin, and Hertwig (2011) systematically reviewed the available literature using a meta-analytic approach, but did not include tests of homogeneity or subsequent moderator variable analyses. The current review serves to extend the previous analysis to include such tests as well as update the pool of studies available for analysis. Results for both positively and negatively framed conditions were reviewed using 2 meta-analyses encompassing data collected from 3,232 subjects across 18 studies. Deviating from the previous results, the current analysis found a tendency for younger adults to choose the risky option more often than older adults for positively framed items. Moderator variable analyses found this effect likely to be driven by the specific decision scenario, showing a significant effect, with younger adults choosing the risky option more often in small-amount financial and large-amount mortality-based scenarios. For negatively framed items, the current review found no overall age difference in risky decision making, confirming the results from the prior meta-analysis. Moderator variable analyses conducted to address heterogeneity found younger adults to be more likely than older adults to choose the risky option for negatively framed high-amount mortality-based decision scenarios. Practical implications for older adults are discussed. (c) 2015 APA, all rights reserved).

  9. Determinants of the range of drugs prescribed in general practice: a cross-sectional analysis.

    NARCIS (Netherlands)

    Bakker, D.H. de; Coffie, D.S.V.; Heerdink, E.R.; Dijk, L. van; Groenewegen, P.P.

    2007-01-01

    BACKGROUND: Current health policies assume that prescribing is more efficient and rational when general practitioners (GPs) work with a formulary or restricted drugs lists and thus with a limited range of drugs. Therefore we studied determinants of the range of drugs prescribed by general

  10. [Prescribed and dispensed in the third trimester of pregnancy drugs: What practices and risks?].

    Science.gov (United States)

    Parent, G; Mottet, N; Mairot, P; Baudier, F; Carel, D; Goguey, M; Riethmuller, D; Limat, S

    2016-09-01

    The aim of the study was to describe the prescribing of drugs to pregnant women during the third trimester of pregnancy. The retrospective analysis is interested by pregnant women from August 2009 to April 2011, living in Franche-Comté. The used data are recorded in the database of the French Health Insurance Service. Drugs prescribing were analyzed and classified according to three categories: drugs that are contraindicated, not recommended drugs and drugs that are used. This classification is based on two databases: the Summaries of Product Characteristics of Vidal 2010 and data from the National Security Agency of Medicines. The potential exposure of patients was pointed out. On 15,027 patients, 80% had a prescription. Six percent of prescriptions containing drugs not recommended and 1% drugs that contraindicated. Therapeutic classes identified are analgesics, anti-infective drugs and medicines supplementing with vitamins and minerals. Contraindicated drugs (10%) are NSAIDs, rubella vaccine, cyclins and ACE inhibitors and ARBs. Approximately 2.7% of women were potentially exposed to these drugs. Despite the recommendations of the ANSM, some drugs that are contraindicated are prescribed for pregnant women in their third trimester of pregnancy. In the absence of studies, the decision must be made on a case by case basis by assessing the risk-benefit ratio. Particular care is to bring about the drugs taken in self-medication. Information and advice are key steps to avoid incidents. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  11. Drugs, alcohol and sexual health: opportunities to influence risk behaviour

    Directory of Open Access Journals (Sweden)

    Keaney Francis

    2008-06-01

    Full Text Available Abstract Background Alcohol and drug consumption can affect judgment and may contribute towards an increased likelihood of engaging in risky sexual behaviour. In this cross sectional survey of clients attending STI services levels of drug and alcohol use were assessed using two standardised drug and alcohol screening instruments (the PAT and the SDS. Findings The rates of hazardous alcohol consumption were similar to those found among patients attending A&E departments. Approximately 15% of clients indicated possible dependence on alcohol or other drugs, and these clients were likely to cite their substance use as related to their attendance, and to accept the offer of help or advice. Conclusion The use of brief screening instruments as part of routine clinical practice is recommended. The STI clinic is well placed to identify substance use and to offer advice and/or onward referral to specialist services.

  12. Non-medical use of prescription drugs among illicit drug users: A case study on an online drug forum.

    Science.gov (United States)

    Rönkä, Sanna; Katainen, Anu

    2017-01-01

    The non-medical use of prescription drugs is a growing phenomenon associated with increasing health-related harms. However, little is known about the drivers of this process among illicit drug users. Our aim is to show how the qualities of pharmaceutical drugs, pharmaceutical related knowledge, online communities sharing this knowledge and medical professionals mediate and transform the consumption behaviour related to pharmaceutical drugs. The data consist of discussion threads from an online drug use forum. Using actor network theory (ANT), we analysed translations that mediate the online user community's relationship with pharmaceutical drugs. Differences in experienced drug effects are explained both as a process of 'learning' and as differences in brain chemistry at the receptor level. Both science- and experience-based information are shared on best practices to optimise use, avoid adverse health effects and maximise the experience of intoxication. The expanded context of doctors' practices places stress on the medical framework for drug use. Our analysis shows how the non-medical use of psychoactive pharmaceuticals relates to joint, medicalised ideas of bodies as sites of medical experimentation, as well as to the collective process of constructing 'pharmaceutical competences' in user networks. Understandings of intoxication have increasingly been permeated with the pharmacological and scientific logic of knowledge. The forum works as a platform for harm reduction inspired exchange of knowledge. However, the user community's knowledge sharing practices can generate a shared perception of a sufficient or even superior drug use experience and knowledge. This may lead to overdoses and other risky behaviour, and thereby contribute to increased harms related to non-medical use of prescription drugs. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. Risky sexual behavior and predisposing factors among students of ...

    African Journals Online (AJOL)

    BACKGROUND: Students of higher institutions are assumed to be exposed to many risky sexual behaviors. However, little has been explored about the magnitude of risky behavior and predisposing factors in the context of higher education institutions in Ethiopia. Thus, the objective of this study was to assess the pattern of ...

  14. Pubertal Development and Peer Influence on Risky Decision Making

    Science.gov (United States)

    Kretsch, Natalie; Harden, Kathryn Paige

    2014-01-01

    Adolescents engage in more risky behavior when they are with peers and show, on average, heightened susceptibility to peer influence relative to children and adults. However, individual differences in susceptibility to peer influence are not well understood. The current study examined whether the effect of peers on adolescents' risky decision…

  15. Social-cognitive correlates of risky adolescent cycling behavior

    Directory of Open Access Journals (Sweden)

    Ruiter Robert AC

    2010-07-01

    Full Text Available Abstract Background Bicycle use entails high safety and health risks especially for adolescents. Most safety education programs aimed at adolescents focus on accident statistics and risk perceptions. This paper proposes the investigation of the social-cognitive correlates of risky cycling behaviors of adolescents prior to developing safety education programs. Method Secondary school students aged 13 to 18 years (n = 1446 filled out questionnaires regarding bicycle behavior, risky intentions, accident experience, and social-cognitive determinants as suggested by the theory of planned behavior. Results Regression analysis revealed that the proximal variables (i.e., self-efficacy, attitudes towards drunk driving, personal norm regarding safekeeping of self and others, and compared risk were able to predict 17% of the variance of risky behavior and 23% of the variance of risky intentions. The full model explained respectively 29% and 37% of the variance in risky behavior and risky intentions. Adolescents with positive attitudes towards risky behavior and low sense of responsibility report risky behavior, even when having been (close to an accident. Conclusions Adolescents realize whether they are risk takers or not. This implies that the focus of education programs should not be on risk perceptions, but on decreasing positive attitudes towards alcohol in traffic and increasing sense of responsibility instead. Cognitions regarding near accidents should be studied, the role of safe cycling self-efficacy is unclear.

  16. Personality psychopathology differentiates risky behaviors among women with bulimia nervosa.

    Science.gov (United States)

    Pearson, Carolyn M; Pisetsky, Emily M; Goldschmidt, Andrea B; Lavender, Jason M; Wonderlich, Stephen A; Crosby, Ross D; Engel, Scott G; Mitchell, James E; Crow, Scott J; Peterson, Carol B

    2016-07-01

    Individuals with bulimia nervosa (BN) frequently endorse risky behaviors such as self-harm and substance use. However, no studies of BN to date have examined factors associated with engaging in individual or co-occurring risky behaviors. Given that individuals with BN often have personality psychopathology, which has been linked to symptoms and course of illness, this study sought to examine how personality may differentiate engagement in risky behaviors among BN individuals. A sample of 133 women with BN completed self-report measures of personality psychopathology at baseline, and then reported on bulimic and risky behaviors (e.g., substance misuse, self-harm) over 2 weeks using ecological momentary assessment. A series of hierarchical multiple regression analyses were conducted to examine the unique associations between state-level predictor variables (each risky behavior, e.g., substance misuse, and combination of risky behaviors, e.g., substance misuse plus self-harm) and trait-level personality constructs. Substance misuse behavior, above and beyond all other risky behaviors, was significantly associated with higher scores on trait dissocial behavior (P = 0.004). Substance misuse in BN has a unique association with dissocial behavior, a personality trait characterized by hostility, impulsivity, and entitlement. These results suggest that targeting personality variables may help facilitate more effective treatment of risky behaviors, including substance use in BN. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:681-688). © 2016 Wiley Periodicals, Inc.

  17. Acceptance of and Engagement in Risky Driving Behaviors by Teenagers

    Science.gov (United States)

    Sarkar, Sheila; Andreas, Marie

    2004-01-01

    Data gathered from 1,430 teenage student drivers and 880 teenage traffic violators were used to examine the levels of exposure to risky driving behaviors and perceptions concerning the level of danger of such behaviors. For student drivers, 55% reported exposure to risky driving by being in a car with a driver engaging in such activities as drunk…

  18. The role of general parenting and cannabis-specific parenting practices in adolescent cannabis and other illicit drug use.

    Science.gov (United States)

    Vermeulen-Smit, E; Verdurmen, J E E; Engels, R C M E; Vollebergh, W A M

    2015-02-01

    To investigate general and cannabis-specific parenting practices in relation to adolescent cannabis and other illicit drug use. Data were derived from the Dutch National School Survey on Substance Use among students (N=3209; aged 12-16 years) and one of their parents in 2011. Logistic regression analyses revealed that 1) parental cannabis use was significantly related to more adolescent lifetime and recent cannabis use, and 2) restrictive cannabis-specific parental rules were associated with less adolescent recent cannabis and lifetime use of other illicit drugs, even when controlled for sociodemographic factors, general parenting, adolescent tobacco use, and tobacco-specific parenting. In addition, no significant interaction was observed between parental cannabis use and cannabis-specific rules in their relation to adolescent cannabis and other illicit drug use, indicating that cannabis rules are evenly associated with adolescent drug use for families with and without parental cannabis experience. In addition to general parenting practices, restrictive cannabis-specific rules are related to lower adolescent cannabis and other illicit drug rates. Parents who ever used cannabis have children with a higher prevalence of cannabis use. However, their restrictive cannabis-specific rules are equally related to a lower chance of adolescent cannabis use. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. Risky Behaviors of University Students: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Hilal Ozcebe

    2012-04-01

    Full Text Available Objective: This study aimed to identify certain risky behavior patterns (unsafe sex, tobacco and drug use, and binge drinking and the factors affecting these behaviors among first- and third-year students in a university. Method: The study included a total of 8407 students enrolled as first- (4392 and third- (4015 year students. A self-administered questionnaire was used for data collection. In data analysis, respecting sampling weights, models were formed by logistic regression method to determine factors that affect the risky behaviors. Results: 731 male–1114 female students from the first year and 560 male–1096 female students from the third year were interviewed. Male students were found to be engaged in risky behaviors more frequently than females. Logistic models of the study indicated that gender, place of residence, relationship with parents, and socialization with friends have profound effects on risky behaviors. Conclusion: After leaving home, young people develop their own lifestyles, and this study demonstrates that lifestyle is the main effective factor for risky behaviors in this group. Universities need to assume more responsibility to guide students’ lives and to provide the facilities and opportunities that encourage and facilitate their adoption of a healthy lifestyle.   Key Words: University students, risky behaviours Bir Üniversitede Öğrencilerin Riskli Davranışları: Kesitsel Bir Çalışma Amaç: Bu çalışmanın amacı, bir üniversitenin birinci ve üçüncü sınıf öğrencileri arasında bazı riskli davranış modellerini (güvensiz seks, tütün ve uyuşturucu kullanımı ve aşırı alkol ve bu davranışları etkileyen faktörleri saptamaktır. Yöntem: Araştırmanın evrenini birinci (4392 ve üçüncü (4015 sınıflarda kayıtlı 8407 öğrenci oluşturmaktadır. Veri öğrencilerin gözlem altında doldurdukları anket aracılığı ile toplanmıştır. Riskli davranışları etkileyen fakt

  20. Risky Driving Behaviours among Medical Students in Erbil, Iraq

    Directory of Open Access Journals (Sweden)

    Nazar P. Shabila

    2015-08-01

    Full Text Available Objectives: This study aimed to assess risky driving behaviours among medical students in Erbil, Iraq, and to explore the relationship between risky driving behaviours and perceptions of risky driving. Methods: This self-administered questionnaire-based survey was conducted from January to May 2014 among a random sample of 400 medical students at Hawler Medical University in Erbil. The questionnaire was designed to assess the frequency of engagement in 21 risky driving behaviours, the perceived risk of each behaviour and the preference for each behaviour as ranked on a 5-point scale. Results: A total of 386 students responded to the survey (response rate: 96.5%. Of these, 211 reported that they currently drove a vehicle (54.7%. Drivers most frequently engaged in the following behaviours: playing loud music (35.9%, speeding (30.4%, allowing front seat passengers to not wear seat belts (27.9% and using mobile phones (27.7%. Least frequent driving behaviours included not stopping at a red light (3.9%, driving while sleepy (4.4%, driving after a mild to moderate intake of alcohol (4.5% and drunk driving (6.4%. Mean risky driving behaviour scores were significantly higher among males (P 20-year-olds (P = 0.028. There was a significant positive relationship between the preference for risky behaviours and risky driving behaviours (beta = 0.44; P <0.001. Conclusion: Medical students in Erbil reported high frequencies of several serious risky driving behaviours. The preference for risky behaviours was found to be an important predictor of risky driving behaviours among medical students in Erbil.

  1. Maternal and Paternal Psychological Control as Moderators of the Link between Peer Attitudes and Adolescents' Risky Sexual Behavior.

    Science.gov (United States)

    Oudekerk, Barbara A; Allen, Joseph P; Hafen, Christopher A; Hessel, Elenda T; Szwedo, David E; Spilker, Ann

    2014-05-01

    Maternal and paternal psychological control, peer attitudes, and the interaction of psychological control and peer attitudes at age 13 were examined as predictors of risky sexual behavior before age 16 in a community sample of 181 youth followed from age 13 to 16. Maternal psychological control moderated the link between peer attitudes and sexual behavior. Peer acceptance of early sex predicted greater risky sexual behaviors, but only for teens whose mothers engaged in high levels of psychological control. Paternal psychological control demonstrated the same moderating effect for girls; for boys, however, high levels of paternal control predicted risky sex regardless of peer attitudes. Results are consistent with the theory that peer influences do not replace parental influences with regard to adolescent sexual behavior; rather, parental practices continue to serve an important role either directly forecasting sexual behavior or moderating the link between peer attitudes and sexual behavior.

  2. Maternal and Paternal Psychological Control as Moderators of the Link between Peer Attitudes and Adolescents’ Risky Sexual Behavior

    Science.gov (United States)

    Oudekerk, Barbara A.; Allen, Joseph P.; Hafen, Christopher A.; Hessel, Elenda T.; Szwedo, David E.; Spilker, Ann

    2013-01-01

    Maternal and paternal psychological control, peer attitudes, and the interaction of psychological control and peer attitudes at age 13 were examined as predictors of risky sexual behavior before age 16 in a community sample of 181 youth followed from age 13 to 16. Maternal psychological control moderated the link between peer attitudes and sexual behavior. Peer acceptance of early sex predicted greater risky sexual behaviors, but only for teens whose mothers engaged in high levels of psychological control. Paternal psychological control demonstrated the same moderating effect for girls; for boys, however, high levels of paternal control predicted risky sex regardless of peer attitudes. Results are consistent with the theory that peer influences do not replace parental influences with regard to adolescent sexual behavior; rather, parental practices continue to serve an important role either directly forecasting sexual behavior or moderating the link between peer attitudes and sexual behavior. PMID:25328265

  3. Drugs + HIV, Learn the Link

    Medline Plus

    Full Text Available ... she went to a party and under the influence of drugs and alcohol engaged in risky sexual ... learn-link-drugs-hiv . 120x90 460x80 486x60 Social Media Send the message to young people and to ...

  4. Drugs + HIV, Learn the Link

    Medline Plus

    Full Text Available ... she went to a party and under the influence of drugs and alcohol engaged in risky sexual behavior that resulted in HIV infection. Watch the "After the Party" Video Behaviors associated with drug misuse are among the main factors in the spread of HIV infection in the ...

  5. Drugs + HIV, Learn the Link

    Medline Plus

    Full Text Available ... the influence of drugs and alcohol engaged in risky sexual behavior that resulted in HIV infection. Watch the "After the Party" Video Behaviors associated with drug misuse are among the main factors in the spread of HIV infection in the ...

  6. Drugs + HIV, Learn the Link

    Medline Plus

    Full Text Available ... can be transmitted between users. Other infections, such as hepatitis C, can also be spread this way. Hepatitis C can cause liver disease and permanent liver damage. Poor judgment and risky behavior. Drug misuse by any route (not just injection) can put a person at risk for getting HIV. Drug and ...

  7. Predicting pharmacy syringe sales to people who inject drugs: Policy, practice and perceptions.

    Science.gov (United States)

    Meyerson, Beth E; Davis, Alissa; Agley, Jon D; Shannon, David J; Lawrence, Carrie A; Ryder, Priscilla T; Ritchie, Karleen; Gassman, Ruth

    2018-06-01

    Pharmacies have much to contribute to the health of people who inject drugs (PWID) and to community efforts in HIV and hepatitis C (HCV) prevention through syringe access. However, little is known about what predicts pharmacy syringe sales without a prescription. To identify factors predicting pharmacy syringes sales to PWID. A hybrid staggered online survey of 298 Indiana community pharmacists occurred from July-September 2016 measuring pharmacy policy, practice, and pharmacist perceptions about syringe sales to PWID. Separate bivariate logistical regressions were followed by multivariable logistic regression to predict pharmacy syringe sales and pharmacist comfort dispensing syringes to PWID. Half (50.5%) of Indiana pharmacies sold syringes without a prescription to PWID. Pharmacy syringe sales was strongly associated with pharmacist supportive beliefs about syringe access by PWID and their comfort level selling syringes to PWID. Notably, pharmacies located in communities with high rates of opioid overdose mortality were 56% less likely to sell syringes without a prescription than those in communities with lower rates. Pharmacist comfort dispensing syringes was associated with being male, working at a pharmacy that sold syringes to PWID and one that stocked naloxone, having been asked about syringe access by medical providers, and agreement that PWID should be able to buy syringes without a prescription. As communities with high rates of opioid overdose mortality were less likely to have pharmacies that dispensed syringes to PWID, a concerted effort with these communities and their pharmacies should be made to understand opportunities to increase syringe access. Future studies should explore nuances between theoretical support for syringe access by PWID without a prescription and actual dispensing behaviors. Addressing potential policy conflicts and offering continuing education on non-prescription syringe distribution for pharmacists may improve comfort

  8. Community intervention to improve knowledge and practices on commonly used drugs.

    Science.gov (United States)

    Kafle, K K; Karkee, S B; Shrestha, N; Prasad, R R; Bhuju, G B; Das, P L; Chataut, B D

    2010-01-01

    action. The key messages have effectively reached the households, and the knowledge and practices of the community members in drug use have improved.

  9. On-site management of investigational products and drug delivery systems in conformity with Good Clinical Practices (GCPs).

    Science.gov (United States)

    Méthot, Julie; Brisson, Diane; Gaudet, Daniel

    2012-04-01

    Investigators and research teams participating in clinical trials have to deal with complex investigational products, study designs, and research environments. The emergence of new drug delivery systems and investigational products combining more than one drug and the development of biodrugs such as monoclonal antibodies, peptides, siRNA, and gene therapy to treat orphan or common diseases constitute a new challenge for investigators and clinical sites. We describe the requirements and challenges of drug management in conformity with Good Clinical Practices (GCPs) for investigators and sites participating in clinical trials. Review At all sites participating in clinical trials, standard operating procedures (SOPs) covering the critical path of drug and drug delivery systems management are required. All steps should be auditable, including reception, validation, storage, access, preparation, distribution, techniques of administration, use, return, and destruction of research products. Biodrugs require traceability and specific SOPs on the management of potential immune reactions. Investigational products must be stored under standard auditable conditions. The traceability of storage conditions (including temperature) requires these conditions to be monitored on a continuous basis. A dedicated space with restricted access limited to authorized qualified personnel facilitates the monitoring. The development of standardized, auditable settings and the application of dedicated, site-specific SOPs for the management of investigational products and drug delivery systems contribute to guarantee the compliance to GCP requirements.

  10. Hormonal and antimicrobial therapy in theriogenology practice: currently approved drugs in the USA and possible future directions.

    Science.gov (United States)

    Modric, T; Momcilovic, D; Gwin, W E; Peter, A T

    2011-08-01

    Hormonal and antimicrobial therapies are essential to regulate and maintain healthy reproduction in domestic animals. The appropriate and legal use of these compounds is ultimately the responsibility of the veterinarian and other users, with a primary mission to directly protect and promote the health of animals, and indirectly the health of people. The appropriate use of these products is defined by the Federal Food, Drug, and Cosmetic Act, 21 United States of America § 301 et seq and implementing regulations in the Code of Federal Regulations. In the past, use of a drug in an animal for an unapproved use violated this Act. However, passage of the Animal Medicinal Drug Use Clarification Act 1994 legalized the extra-label use of certain animal and human drugs in veterinary practice for treating diseases. This manuscript reviews currently approved hormonal and antimicrobial drugs for use in theriogenology. Considering the ever increasing knowledge in the area of veterinary reproduction, particularly in the treatment and control of reproduction using antimicrobials and hormones, it would be beneficial to widen the therapeutic options in these categories. The potential for widening the therapeutic options is also discussed in this review, by providing a non-exhaustive but essential list of potential new drugs for use in clinical animal reproduction (theriogenology). Copyright © 2011 Elsevier Inc. All rights reserved.

  11. The Neuropsychology of Risky Sexual Behavior.

    Science.gov (United States)

    Ross, J Megan; Duperrouzel, Jacqueline; Vega, Melanie; Gonzalez, Raul

    2016-07-01

    Engagement in risky sexual behavior (RSB) is a significant public health concern. A growing body of literature is elucidating the role of brain systems and neuropsychological constructs implicated in RSB, which may pave the way for novel insights and prevention efforts. In this article, we review studies incorporating neuropsychology into the study of RSB across the lifespan. The review of the literature on the neuropsychology of RSB is separated into three different sections by age of participants. Background is presented on research associating RSB with neurocognitive processes and the brain systems involved. Given the overlap between RSBs and substance use, studies addressing these problems in tandem are also discussed. Neurocognitive constructs are implicated in RSB, including impulsivity, decision-making, and working memory. Thus far, evidence suggest that neuropsychological factors are associated with engagement in RSB. More research on the influence of neuropsychological factors on engagement in RSB is necessary and may help inform future prevention efforts. (JINS, 2016, 22, 586-594).

  12. The World of WarsRisky systems

    DEFF Research Database (Denmark)

    Harste, Gorm

      The world of the future will not be one without wars. The many hopes we have about a future peace governed by a more or less confederal state will not make wars obsolete. Regular wars and irregular wars will continue and probably on different subjects than we are used to. The paper proposes...... that the form of war will be more about temporalities, i.e. fast interchanges or, rather, more risky protracted wars of attrition and exhaustion and less on tactical well defined territories. The West can neither dominate such wars nor establish one world that is ruled or even governed. The risk is that we have....... The "extreme 20th century" will have another history and another impact. Its extremes will be more extreme and its temporal bindings easier to observe. The much celebrated revolutions in military affairs will not dominate future war systems. Unipolarity is fading away. Kantian convergences may appear....

  13. Strategic insight and age-related goal-neglect influence risky decision-making.

    Science.gov (United States)

    Westbrook, Andrew; Martins, Bruna S; Yarkoni, Tal; Braver, Todd S

    2012-01-01

    Maximizing long-run gains often requires taking on some degree of risk, yet decision-makers often exhibit risk aversion (RA), rejecting risky prospects even when these have higher expected value (EV) than safer alternatives. We investigated whether explicit strategy instruction and practice can decrease prepotent RA, and whether aging impacts the efficacy of such an intervention. Participants performed a paired lottery task with options varying in risk and magnitude, both before and after practice with a similar task that encouraged maximization of EV and instruction to use this strategy in risky decisions. In both younger and older adults (OAs), strategy training reduced RA. Although RA was age-equivalent at baseline, larger training effects were observed in younger adults (YAs). These effects were not explained by risk-related (i.e., affective) interference effects or computation ability, but were consistent with a progressive, age-related neglect of the strategy across trials. Our findings suggest that strategy training can diminish RA, but that training efficacy is reduced among OAs, potentially due to goal neglect. We discuss implications for neural mechanisms that may distinguish older and YAs' risky decision-making.

  14. Transferable and non-transferable drug resistance in enteric bacteria from hospital and from general practice

    DEFF Research Database (Denmark)

    Møller, JK; Bak, AL; Bülow, P

    1976-01-01

    Drug resistance to 8 different antibiotics in Enterobacteriaceae isolated from different hospitals and two groups of general practitioners was studied. Escherichia coli dominated among the 632 strains investigated. Drug resistance was found in 62% of the 512 hospital strains and in 38% of the 120...

  15. Conformational Analysis of Drug Molecules: A Practical Exercise in the Medicinal Chemistry Course

    Science.gov (United States)

    Yuriev, Elizabeth; Chalmers, David; Capuano, Ben

    2009-01-01

    Medicinal chemistry is a specialized, scientific discipline. Computational chemistry and structure-based drug design constitute important themes in the education of medicinal chemists. This problem-based task is associated with structure-based drug design lectures. It requires students to use computational techniques to investigate conformational…

  16. Risky drinking among community pharmacy customers in New Zealand and their attitudes towards pharmacist screening and brief interventions.

    Science.gov (United States)

    Sheridan, Janie; Stewart, Joanna; Smart, Ros; McCormick, Ross

    2012-01-01

    To estimate the prevalence of risky drinking among customers in community pharmacies and to explore customer attitudes towards screening and brief intervention (SBI). Cross-sectional, anonymous survey, using random selection of community pharmacies in New Zealand to collect data using self-completion questionnaires and an opportunity to enter a prize draw. Participants were customers/patients attending the community pharmacy on a specific, randomly selected day (Monday to Friday) in one set week. Alcohol Use Disorder Identification Test (AUDIT)-C using a cut-off score of 5 was used to measure risky drinking. Attitudes towards pharmacists engaging in SBI for risky drinkers were measured. 2384 completed customer/patient questionnaires from 43 participating pharmacies. Almost 84% ever drank alcohol and using a score of 5 or more as a cut-off, 30% of the sample would be considered as risky drinkers. Attitudes were generally positive to pharmacists undertaking SBI. Logistic regression with AUDIT-C positive or negative as the dependent variable found those taking medicines for mental health and liver disease being more likely to score negative on the AUDIT-C, and smokers and those purchasing hangover cures were more likely than average to have a positive AUDIT-C screen. This study indicates there is scope for community pharmacists to undertake SBI for risky drinking, and that customers find this to be acceptable. Targeted screening may well be useful, in particular for smokers. Further research is required to explore the effectiveness of SBI for risky drinkers in this setting. © 2011 Australasian Professional Society on Alcohol and other Drugs.

  17. Chemotherapy drug handling in first opinion small animal veterinary practices in the United Kingdom: results of a questionnaire survey.

    Science.gov (United States)

    Edery, E G

    2017-05-27

    To investigate how first opinion small animal veterinary surgeons in the UK handled chemotherapeutic agents, a questionnaire was distributed at the 2014 British Small Animal Veterinary Association congress and by internet. Chemotherapy was regularly offered by 70.4 per cent of the respondents. Gold standards defined according to available guidelines for safe handling of antineoplastic drugs were poorly followed by general practitioners with only 2 per cent of respondents complying with all of them. Dedicated facilities for preparation and administration of cytotoxic drugs were variably available among participants. The level of training of staff indirectly involved in handling chemotherapy was appropriate in less than 50 per cent of practices. No association was found between demographic characteristics of the sampled population and the decision to perform chemotherapy. The results of this study raise concerns about the safety of the veterinary staff in first opinion practices involved in handling chemotherapy. British Veterinary Association.

  18. [Health care models for users of alcohol and other drugs: political discourse, knowledge, and practices].

    Science.gov (United States)

    Alves, Vânia Sampaio

    2009-11-01

    This article aims to characterize health care models for users of alcohol and other drugs in the Brazilian context. Discourse analysis was performed on public drug policy in Brazil from the 1970s. This analysis was contextualized by a brief digression on the main political positions identified in several countries of the world in relation to drug use problems. Beginning in the current decade, drug policies in Brazil have been receptive to harm reduction approaches, resulting in reorientation of the health care model. In conclusion, the structuring and strengthening of a network of care for users of alcohol and other drugs and their families, based on community care and the harm reduction approach and combined with other social and health services, is now a key public health challenge for the country.

  19. Pattern and practice of psychoactive substance abuse and risky ...

    African Journals Online (AJOL)

    risks and are more likely to face physical, emotional and sexual abuse, especially at night. ... They often fall sick owing to the harsh cold weather, poor hygiene and sanitation ..... streets. Other studies in Nigeria and India also reported that >70% of street ... behaviours by street children can lead to health and social problems.

  20. Therapy of anxiety disorders – the problem of choosing a drug in the primary health care physician’s practice

    Directory of Open Access Journals (Sweden)

    Łukasz Święcicki

    2015-03-01

    Full Text Available Anxiety disorders are the most prevalent mental disorders. A vast majority of patients with such problems are treated by the primary health care physicians. In practice, the most available form of treatment at this level of health care is pharmacotherapy. The most frequently chosen drugs belong to the group of benzodiazepines. Benzodiazepine anxiolytics exhibit the commonly known advantages: they are effective in the short run and very well tolerated. A bit less attention is paid to their severe disadvantages. These disadvantages comprise first of all: inclination to induce dependence which is often connected with the need to increase the dose of the drug to obtain a comparable effect, adverse impact on cognitive functions, and the risk of a significant increase in the dose of the drug after discontinuation of benzodiazepine (rebound phenomena. The article presents disadvantages and advantages of benzodiazepines and benefits connected with the use of the underestimated though effective anxiolytic – hydroxyzine. The results of controlled studies point to the efficacy of this drug in therapy of generalized anxiety disorder. Hydroxyzine may be also effectively used during discontinuation of benzodiazepines. This drug does not exhibit any addictive properties and its administration does not cause disturbances in cognitive functions. Psychotherapy continues to be the basic form of treatment of anxiety disorders, but its use in everyday medical practice conditions is often very difficult. In pharmacotherapy of anxiety the use of hydroxyzine is safer than the use of benzodiazepines, and it is often equally effective. Also other drugs, which are not discussed extensively in this article, such as antidepressants in the group of selective serotonin reuptake inhibitors, buspirone and pregabalin, exhibit significant anti-anxiety effects.

  1. Leachables and extractables handbook: safety evaluation, qualification, and best practices applied to inhalation drug products

    National Research Council Canada - National Science Library

    Ball, Douglas J

    2012-01-01

    ...). It discusses best practices for evaluation and management of leachables and extractables throughout the pharma product lifecycle by providing practical knowledge about how and why safety thresholds were developed...

  2. Did the dependent coverage expansion increase risky substance use among young adults?

    Science.gov (United States)

    Breslau, Joshua; Yu, Hao; Han, Bing; Pacula, Rosalie L; Burns, Rachel M; Stein, Bradley D

    2017-09-01

    The dependent coverage expansion (DCE) enacted through the Affordable Care Act increased health insurance coverage among young adults. Increasing insurance coverage in this age group has the potential for unintended consequences on risky substance use. Repeated cross-sectional surveys were used to compare change in substance use during the period the DCE was implemented in the 19-25year old target age group (Pre-DCE n=15,772, Post-DCE n=22,719) with contemporaneous change in a slightly older age group that was not targeted by the policy (Pre-DCE=19,851, Post-DCE n=28,157). Outcomes include 11 measures of alcohol, illicit drug and cigarette use. Statistical controls were included for demographic and socioeconomic factors and for early initiation of substance use to adjust for historical trends in developmental trajectories. Risky substance use decreased in young adults relative to the older age group over the period that the DCE was implemented. However, statistical adjustment for initiation of substance use prior to age 18, which is prior to exposure to the DCE, accounted for the differences between the age groups. In adjusted models, associations between the DCE and substance use outcomes range from 0.96 to 1.08 with p-values ranging from 0.330 to 0.963. Historical trends in initiation of substance use prior to age 18, not the DCE, account for change in risky substance use among 19-25year olds relative to 26-34year olds. The evidence does not support the suggestion that health insurance coverage would increase risky substance use among young adults. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. How Drug Control Policy and Practice Undermine Access to Controlled Medicines.

    Science.gov (United States)

    Burke-Shyne, Naomi; Csete, Joanne; Wilson, Duncan; Fox, Edward; Wolfe, Daniel; Rasanathan, Jennifer J K

    2017-06-01

    Drug conventions serve as the cornerstone for domestic drug laws and impose a dual obligation upon states to prevent the misuse of controlled substances while ensuring their adequate availability for medical and scientific purposes. Despite the mandate that these obligations be enforced equally, the dominant paradigm enshrined in the drug conventions is an enforcement-heavy criminal justice response to controlled substances that prohibits and penalizes their misuse. Prioritizing restrictive control is to the detriment of ensuring adequate availability of and access to controlled medicines, thereby violating the rights of people who need them. This paper argues that the drug conventions' prioritization of criminal justice measures-including efforts to prevent non-medical use of controlled substances-undermines access to medicines and infringes upon the right to health and the right to enjoy the benefits of scientific progress. While the effects of criminalization under drug policy limit the right to health in multiple ways, we draw on research and documented examples to highlight the impact of drug control and criminalization on access to medicines. The prioritization and protection of human rights-specifically the right to health and the right to enjoy the benefits of scientific progress-are critical to rebalancing drug policy.

  4. 77 FR 16158 - Current Good Manufacturing Practice in Manufacturing, Processing, Packing, or Holding of Drugs...

    Science.gov (United States)

    2012-03-20

    .... FDA-1997-N-0518] (formerly 97N-0300) Current Good Manufacturing Practice in Manufacturing, Processing... labeling control provisions of the current good manufacturing practice (CGMP) regulations for human and... GOOD MANUFACTURING PRACTICE FOR FINISHED PHARMACEUTICALS 0 1. The authority citation for 21 CFR part...

  5. Zachowania ryzykowne młodzieży = Risky behaviors of teenagers

    Directory of Open Access Journals (Sweden)

    Aneta Baranowska

    2016-06-01

          Streszczenie W artykule została podjęta problematyka zachowań ryzykownych przejawianych przez współczesną młodzież. Autorka tekstu dokonała zwięzłej charakterystyki najczęściej występujących wśród młodych ludzi zachowań problemowych, takich jak: palenie papierosów, nadużywanie alkoholu, narkotyków i dopalaczy; ryzykowna aktywność seksualna; okaleczanie własnego ciała (autoagresja; nadmierne opalanie się. Następnie, odwołując się do teorii czynników ryzyka i czynników chroniących, koncepcji resilience, modelu ekologicznego Bronfenbrennera oraz Teorii Zachowań Problemowych, zwróciła uwagę na czynniki, które intensyfikują prawdopodobieństwo występowania zachowań ryzykownych u adolescentów oraz na czynniki, które wzmacniają ogólny potencjał zdrowotny człowieka i tym samym jego odporność na działanie tych pierwszych. Opracowanie kończy ilustracja zadań, jakie stoją przed osobami prowadzącymi działania profilaktyczne, w związku z rozpowszechnianiem się wśród nastolatków zachowań problemowych.   Słowa klucze: zachowanie ryzykowne, adolescenci, czynniki ryzyka, czynniki chroniące, profilaktyka.   Summary The article touches upon risky behaviors manifested by contemporary teenagers. The article characterizes the most frequent types of risky behaviors among young people, such as: smoking cigarettes, alcohol, drugs and designer drugs abuse, risky sexual contacts, self-mutilation (self-injury and excessive sunbathing. The author also appeals to the theory of risk and protective factors, notion of resilience, ecologic model of Bronfenbrenner, and the theory of problem behavior in order to point out to the factors which intensify the probability of risky behaviors of adolescents as well as the factors which enhance the overall health potential of a person and thus his resistance to such factors. The research ends with a list of tasks that people responsible for preventive actions are facing due to the

  6. Does anti-malarial drug knowledge predict anti-malarial dispensing practice in drug outlets? A survey of medicine retailers in western Kenya

    Directory of Open Access Journals (Sweden)

    Rusk Andria

    2012-08-01

    Full Text Available Abstract Background Malaria is a major cause of morbidity and mortality in Kenya, where it is the fifth leading cause of death in both children and adults. Effectively managing malaria is dependent upon appropriate treatment. In Kenya, between 17 to 83 percent of febrile individuals first seek treatment for febrile illness over the counter from medicine retailers. Understanding medicine retailer knowledge and behaviour in treating suspected malaria and dispensing anti-malarials is crucial. Methods To investigate medicine retailer knowledge about anti-malarials and their dispensing practices, a survey was conducted of all retail drug outlets that sell anti-malarial medications and serve residents of the Webuye Health and Demographic Surveillance Site in the Bungoma East District of western Kenya. Results Most of the medicine retailers surveyed (65% were able to identify artemether-lumefantrine (AL as the Kenyan Ministry of Health recommended first-line anti-malarial therapy for uncomplicated malaria. Retailers who correctly identified this treatment were also more likely to recommend AL to adult and paediatric customers. However, the proportion of medicine retailers who recommend the correct treatment is disappointingly low. Only 48% would recommend AL to adults, and 37% would recommend it to children. It was discovered that customer demand has an influence on retailer behaviour. Retailer training and education were found to be correlated with anti-malarial drug knowledge, which in turn is correlated with dispensing practices. Medicine retailer behaviour, including patient referral practice and dispensing practices, are also correlated with knowledge of the first-line anti-malarial medication. The Kenya Ministry of Health guidelines were found to influence retailer drug stocking and dispensing behaviours. Conclusion Most medicine retailers could identify the recommended first-line treatment for uncomplicated malaria, but the percentage that could

  7. EFFICACY OF RUFINAMIDE IN THE TREATMENT OF DRUG-RESISTANT FOCAL EPILEPSIES IN PAEDIATRIC PRACTICE

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    I. O. Shchederkina

    2016-01-01

    Full Text Available Among drug-resistant epilepsies, epileptic syndromes, characterized by combination of several types of seizures, are considered to be the most difficult in terms of treatment. Lennox–Gastaut syndrome is one of them. It manifests with polymorphic seizures (tonic axial, myatonic, atypical absence seizures, status epilepticus of minor motor seizures, myoclonic, generalized convulsive, and focal seizures. This is a heterogeneous disease, represented by a complex of clinical and electroencephalographic manifestations with various etiology. Current review is devoted to a novel antiepileptic drug rufinamide, which has a new mechanism of action. The drug has been registered in Russia in 2015. The authors also describe their own experience of rufinamide usage in the treatment of drug-resistant focal epilepsy as a part of multicomponent therapy for polymorphic seizures. One patient achieved clinical remission for 16 months; the second one had more than 50 % decrease in seizures frequency with a remission of drop-attacks.

  8. "Academic drug-detailing": from project to practice in a Swedish urban area.

    Science.gov (United States)

    Lundborg, C S; Hensjö, L O; Gustafsson, L L

    1997-01-01

    To develop and test the long-term feasibility of an interdisciplinary independent drug information service providing both written and oral drug information to physicians in an urban area of Sweden (> 400,000 inhabitants). A drug information service was developed encouraging a cooperative approach between a department of clinical pharmacology, general practitioners (GPs), pharmacists, and Drug and Therapeutic Committees. Scientifically-based drug information was condensed and interpreted by a team and presented in both written and oral form. In one part of the area, both oral and written information was provided, while in another part of the area, only written information was distributed. Questionnaires and one prescription survey were performed to elucidate the knowledge and attitudes of the GPs regarding drug treatment of one condition (urinary tract infection, UTI, and norfloxacin were used as examples), as well as their opinion of our services. Over a period of 10 years, 75 issues of a drug bulletin (2000 copies) were distributed. Oral producer-independent drug information, provided jointly by a GP and a pharmacist, was given on 16 occasions in each of 30 health centres (150 GPs). Around 80% of the GPs participated in the meetings. Of these GPs, 75% found the service important for their daily work. A majority of the GPs had prescribed the test drug, norfloxacin, not a first-line drug according to local recommendations, 1 year after approval. A significantly lower proportion of prescribers were observed in the area where the GPs had been provided with both written and oral information regarding recommended treatment (including first-line drugs) for uncomplicated cystitis. The approximate cost for this service in 1995 was SEK 0.685 million (USD 0.1 million); the prescribing costs of the 150 GPs were estimated at SEK 255 million per year. This means that the cost of the service per GP is only around 0.3% of normal prescribing costs. Over a period of 10 years the

  9. General Anesthesia in Cardiac Surgery: A Review of Drugs and Practices

    OpenAIRE

    Alwardt, Cory M.; Redford, Daniel; Larson, Douglas F.

    2005-01-01

    General anesthesia is defined as complete anesthesia affecting the entire body with loss of consciousness, analgesia, amnesia, and muscle relaxation. There is a wide spectrum of agents able to partially or completely induce general anesthesia. Presently, there is not a single universally accepted technique for anesthetic management during cardiac surgery. Instead, the drugs and combinations of drugs used are derived from the pathophysiologic state of the patient and individual preference and ...

  10. General public knowledge, perceptions and practice towards pharmaceutical drug advertisements in the Western region of KSA.

    Science.gov (United States)

    Al-Haddad, Mahmoud S; Hamam, Fayez; Al-Shakhshir, Sami M

    2014-04-01

    This study aims to examine general public knowledge and behavior toward pharmaceutical advertisements in the Western part of KSA. A cross sectional convenience sampling technique was used in this study. A total of 1445 valid questionnaires were received and analyzed using SPSS version 16 at alpha value of 0.05. Majority of respondents were aware of different types of drugs to be advertised and drug advertisements should seek approval from the health authorities. Television and Internet showed the highest effect on consumers. Almost half of the participants preferred an advertised drug over non-advertised one. Most of the respondents indicated that the quality of frequently advertised drugs is not better than those prescribed by the doctors. Majority of participants had positive beliefs toward advertised drugs concerning their role in education and spreading of awareness among the public. Pharmaceutical advertisements harm the doctor-patient relationship as evidenced by one-third of the investigated sample. Moreover, majority of the participants mentioned that they would consult another doctor or even change the current doctor if he/she refused to prescribe an advertised medication. Results of this study could be used to develop awareness programs for the general public and try to enforce the regulations and policies to protect the general public and patients from the business oriented pharmaceutical companies and drug suppliers.

  11. Higher Trait Psychopathy Is Associated with Increased Risky Decision-Making and Less Coincident Insula and Striatal Activity

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    Matthew T. Sutherland

    2017-12-01

    Full Text Available Higher trait levels of psychopathy have been associated with both a tendency to maintain disadvantageous decision-making strategies and aberrant cortico-limbic neural activity. To explore the neural mechanisms associated with the psychopathy-related propensity to continue selecting risky choices, a non-forensic sample of participants completed a self-report psychopathy questionnaire and two runs of a risky decision-making task during H215O positron emission tomography (PET scanning. In this secondary data analysis study, we leveraged data previously collected to examine the impact of previous drug use on risky decision-making to explore the relations between self-reported psychopathy and behavioral and brain metrics during performance of the Cambridge Decision-Making Task (CDMT, in which volunteers chose between small/likely or large/unlikely potential reward outcomes. Behaviorally, we observed that psychopathy scores were differentially correlated with the percent of risky decisions made in run 1 vs. run 2 of the task. Specifically, higher levels of psychopathy, above and beyond that attributable to drug use or sex, were associated with greater tendencies to make risky selections only in the second half (run 2 of the task. In parallel, psychopathy scores negatively correlated with regional cerebral blood flow (rCBF in the right insula and right ventral striatum during run 2 of the CDMT. These exploratory outcomes suggest that greater levels of psychopathy may be associated with an inability to translate experience with negative outcomes into behavioral adaptations possibly due to decreased neural efficiency in regions related to somatic and/or reward feedback processes.

  12. The role of family conflict on risky sexual behavior in adolescents aged 15 to 21.

    Science.gov (United States)

    Lyerly, Jordan E; Brunner Huber, Larissa R

    2013-04-01

    Family conflict is related to numerous risky behavioral outcomes during adolescence; however, few studies have examined how family conflict is associated with risky sexual behavior during adolescence. Data from 1104 adolescents aged 15 to 21 who completed the 2008 National Longitudinal Survey of Youth were analyzed. Information on family conflict (family fighting and family criticizing) and sexual behavior (number of sexual partners in past year and use of contraception at last intercourse) was self-reported. Logistic regression was used to obtain odds ratios (ORs) and 95% confidence intervals (CIs). After adjustment, adolescents whose family members often fought had increased odds of not using contraception at last intercourse and having two or more sexual partners in the past year (OR, 1.40 [95% CI, 1.04-1.88] and OR, 1.62 [95% CI, 1.23-2.14], respectively). Adolescents whose family members often criticized each other also had increased odds of not using contraception at last intercourse and having two or more sexual partners in the past year (OR, 1.46 [95% CI, 1.12-1.90] and OR, 1.22 [95% CI, 0.96-1.55], respectively). Family conflict was associated with risky sexual behaviors in this racially/ethnically diverse sample of adolescents. If confirmed in other studies, adolescents who experience family conflict may be an important population to target with information regarding safer sex practices. Copyright © 2013 Elsevier Inc. All rights reserved.

  13. A Meta-Analysis of Risky Sexual Behaviour among Male Youth in Developing Countries

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    Yifru Berhan

    2015-01-01

    Full Text Available The purpose of this meta-analysis was to assess the association between risky sexual behaviour and level of education and economic status in male youth. Previous tests of the association of risky sexual behaviour with levels of education and economic status have yielded inconsistent results. Using data from 26 countries, from both within and outside Africa, we performed a meta-analysis with a specific focus on male youths’ risky sexual behaviour. We applied a random effects analytic model and calculated a pooled odds ratio. Out of 19,148 males aged 15–24 years who reported having sexual intercourse in the 12 months preceding the survey, 75% engaged in higher-risk sex. The proportion of higher-risk sex among male youth aged 15–19 years was nearly 90% in 21 of the 26 countries. The pooled odds ratio showed a statistically significant association of higher-risk sex with male youth younger than 20 years, living in urban centers, well educated, and of a high economic status. The overall proportion of condom use during youths’ most recent higher-risk sexual encounter was 40% and 51% among 15–19-year-olds and 20–24-year-olds, respectively. Our findings suggest that male youth’s socioeconomic status is directly related to the likelihood that they practice higher-risk sex. The relationship between income and sexual behaviour should be explored further.

  14. The dark and bright sides of self-efficacy in predicting learning, innovative and risky performances.

    Science.gov (United States)

    Salanova, Marisa; Lorente, Laura; Martínez, Isabel M

    2012-11-01

    The objective of this study is to analyze the different role that efficacy beliefs play in the prediction of learning, innovative and risky performances. We hypothesize that high levels of efficacy beliefs in learning and innovative performances have positive consequences (i.e., better academic and innovative performance, respectively), whereas in risky performances they have negative consequences (i.e., less safety performance). To achieve this objective, three studies were conducted, 1) a two-wave longitudinal field study among 527 undergraduate students (learning setting), 2) a three-wave longitudinal lab study among 165 participants performing innovative group tasks (innovative setting), and 3) a field study among 228 construction workers (risky setting). As expected, high levels of efficacy beliefs have positive or negative consequences on performance depending on the specific settings. Unexpectedly, however, we found no time x self-efficacy interaction effect over time in learning and innovative settings. Theoretical and practical implications within the social cognitive theory of A. Bandura framework are discussed.

  15. Risky Drinking Can Put a Chill on Your Summer Fun

    Science.gov (United States)

    ... on Your Summer Fun Print version Risky Drinking Can Put a Chill on Your Summer Fun Summer ... adults involve the use of alcohol. 1 Swimmers can get in over their heads. Alcohol impairs judgment ...

  16. Risky sexual behaviour and associated factors among students of ...

    African Journals Online (AJOL)

    kim

    Key words: Risky sexual behaviours, University students, Debre Tabor. Introduction .... Missionary/religious school. 2. 0.6. Others. 1 ..... Abebe A, Mitikie G. Perception of high school students towards voluntary HIV counseling and testing, using ...

  17. Distress tolerance as a predictor of risky and aggressive driving.

    Science.gov (United States)

    Beck, Kenneth H; Ali, Bina; Daughters, Stacey B

    2014-01-01

    The purpose of this investigation was to determine the relationship between distress tolerance and risky and aggressive driving. Distress tolerance, defined as an individual's capability to experience and endure negative emotional states, was hypothesized to be related negatively to aggressive driving and risky driving. An anonymous, web-based survey of 769 college students was conducted at a large East Coast university. After controlling for age, gender, race, ethnicity, year in school, grade point average, and driving frequency, distress tolerance was significantly inversely related to reported risky driving and aggressive driving. College drivers who have a diminished capacity to endure frustration without experiencing negative emotional states (i.e., low distress tolerance) tend to drive aggressively and in a risky manner. Traditional deterrence-based approaches to highway safety may benefit from inclusion of a wider array of prevention strategies that focus on emotion regulation while driving.

  18. The Role of Sexual Health Professionals in Developing a Shared Concept of Risky Sexual Behavior as it Relates to HIV Transmission.

    Science.gov (United States)

    Brawner, Bridgette M; Alexander, Kamila A; Fannin, Ehriel F; Baker, Jillian L; Davis, Zupenda M

    2016-01-01

    "Risky sexual behavior" accounts for the majority of new HIV infections regardless of gender, age, geographic location, or ethnicity. The phrase, however, refers to a relatively nebulous concept that hampers development of effective sexual health communication strategies. The purpose of this paper was to propose development of a shared conceptual understanding of "risky sexual behavior." We reviewed multidisciplinary HIV/AIDS literature to identify definitions of risky sexual behavior. Both the linguistic components and the social mechanisms that contribute to the concept of risky sexual behaviors were noted. Risky sexual behavior was often defined in a subjective manner in the literature, even in the scientific research. We urge a paradigm shift to focus on explicit behaviors and the social context of those behaviors in determining HIV risk. We also propose a new definition that reduces individual biases and promotes a broader discussion of the degree of sexual risk across a diversity of behavioral contexts. Sexual health professionals can strengthen practice and research initiatives by operating from a concise working definition of risky sexual behavior that is broadly transferable and expands beyond a traditional focus on identity-based groups. © 2015 Wiley Periodicals, Inc.

  19. Factors Affecting Adverse Drug Reaction Reporting of Healthcare Professionals and Their Knowledge, Attitude, and Practice towards ADR Reporting in Nekemte Town, West Ethiopia

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    Lense Temesgen Gurmesa

    2016-01-01

    Full Text Available Background. Adverse drug reactions are global problems of major concern. Adverse drug reaction reporting helps the drug monitoring system to detect the unwanted effects of those drugs which are already in the market. Aims. To assess the knowledge, attitude, and practice of health care professionals working in Nekemte town towards adverse drug reaction reporting. Methods and Materials. A cross-sectional study design was conducted on a total of 133 health care professionals by interview to assess their knowledge, attitude, and practice using structured questionnaire. Results. Of the total respondents, only 64 (48.2%, 56 (42.1%, and 13 (9.8% health care professionals have correctly answered the knowledge, attitude, and practice assessment questions, respectively. Lack of awareness and knowledge on what, when, and to whom to report adverse drug reactions and lack of commitments of health care professionals were identified as the major discouraging factors against adverse drug reaction reporting. Conclusion. This study has revealed that the knowledge, attitude, and practice of the health care professionals working in Nekemte town towards spontaneous adverse drug reaction reporting were low that we would like to recommend the concerned bodies to strive on the improvement of the knowledge, attitude, and practice status of health care professionals.

  20. Cosmetic surgery in Australia: a risky business?

    Science.gov (United States)

    Parker, Rhian

    2007-08-01

    Cosmetic surgery is increasing in popularity in Australia and New Zealand, as it is across other Western countries. However, there is no systematic mechanism for gathering data about cosmetic surgery, nor about the outcomes of that surgery. This column argues that the business of cosmetic surgery in Australia has questionable marketing standards, is conducted with little scrutiny or accountability and offers patients imperfect knowledge about cosmetic procedures. It also argues that while medical practitioners debate among themselves over who should carry out cosmetic procedures, little attention has been paid to questionable advertising in the industry and even less to highlighting the real risks of undergoing cosmetic surgery. While consumers are led to believe that cosmetic surgery is accessible, affordable and safe, they are sheltered from the reality of invasive and risky surgery and from the ability to clearly discern that all cosmetic procedures carry risk. While doctors continue to undertake advertising and engage in a territorial war, they fail to address the really important issues in cosmetic surgery. These are: providing real evidence about what happens in the industry, developing stringent regulations under which the industry should operate and ensuring that all patients considering cosmetic surgery are fully informed as to the risks of that surgery.

  1. The association between problematic cellular phone use and risky behaviors and low self-esteem among Taiwanese adolescents.

    Science.gov (United States)

    Yang, Yuan-Sheng; Yen, Ju-Yu; Ko, Chih-Hung; Cheng, Chung-Ping; Yen, Cheng-Fang

    2010-04-28

    Cellular phone use (CPU) is an important part of life for many adolescents. However, problematic CPU may complicate physiological and psychological problems. The aim of our study was to examine the associations between problematic CPU and a series of risky behaviors and low self-esteem in Taiwanese adolescents. A total of 11,111 adolescent students in Southern Taiwan were randomly selected into this study. We used the Problematic Cellular Phone Use Questionnaire to identify the adolescents with problematic CPU. Meanwhile, a series of risky behaviors and self-esteem were evaluated. Multilevel logistic regression analyses were employed to examine the associations between problematic CPU and risky behaviors and low self-esteem regarding gender and age. The results indicated that positive associations were found between problematic CPU and aggression, insomnia, smoking cigarettes, suicidal tendencies, and low self-esteem in all groups with different sexes and ages. However, gender and age differences existed in the associations between problematic CPU and suspension from school, criminal records, tattooing, short nocturnal sleep duration, unprotected sex, illicit drugs use, drinking alcohol and chewing betel nuts. There were positive associations between problematic CPU and a series of risky behaviors and low self-esteem in Taiwanese adolescents. It is worthy for parents and mental health professionals to pay attention to adolescents' problematic CPU.

  2. The association between problematic cellular phone use and risky behaviors and low self-esteem among Taiwanese adolescents

    Directory of Open Access Journals (Sweden)

    Ko Chih-Hung

    2010-04-01

    Full Text Available Abstract Background Cellular phone use (CPU is an important part of life for many adolescents. However, problematic CPU may complicate physiological and psychological problems. The aim of our study was to examine the associations between problematic CPU and a series of risky behaviors and low self-esteem in Taiwanese adolescents. Methods A total of 11,111 adolescent students in Southern Taiwan were randomly selected into this study. We used the Problematic Cellular Phone Use Questionnaire to identify the adolescents with problematic CPU. Meanwhile, a series of risky behaviors and self-esteem were evaluated. Multilevel logistic regression analyses were employed to examine the associations between problematic CPU and risky behaviors and low self-esteem regarding gender and age. Results The results indicated that positive associations were found between problematic CPU and aggression, insomnia, smoking cigarettes, suicidal tendencies, and low self-esteem in all groups with different sexes and ages. However, gender and age differences existed in the associations between problematic CPU and suspension from school, criminal records, tattooing, short nocturnal sleep duration, unprotected sex, illicit drugs use, drinking alcohol and chewing betel nuts. Conclusions There were positive associations between problematic CPU and a series of risky behaviors and low self-esteem in Taiwanese adolescents. It is worthy for parents and mental health professionals to pay attention to adolescents' problematic CPU.

  3. Trajectories of psychopathology and risky behaviors associated with childhood abuse and neglect in low-income urban African American girls.

    Science.gov (United States)

    Wilson, Helen W; Samuelson, Sarah L; Staudenmeyer, Anna H; Widom, Cathy Spatz

    2015-07-01

    The current study examined patterns of psychopathology, drug and alcohol use, and sexual behavior associated with childhood abuse and neglect in a high-risk sample of low-income African American girls seeking mental health treatment. Participants (N=177) were African American girls recruited from mental health clinics serving low-income communities in Chicago, IL and followed over six waves of data collection (T1-T6) reflecting early (mean age 14) to late (mean age 17) adolescence. Child abuse and neglect history was determined from adolescent and caregiver reports. Latent curve modeling examined patterns of internalizing and externalizing psychopathology, drug and alcohol use, sexual experience, and risky sexual behavior reported by girls and associations with reported child abuse and neglect. Overall, these trajectories indicated a decrease in internalizing and externalizing symptoms, stability of drug and alcohol use, and an increase in sexual experience and risky sexual behaviors over time. Child abuse and neglect was associated with increased internalizing symptoms and sexual experience at baseline and with externalizing symptoms and risky sexual behavior both at baseline and the final point. Child abuse and neglect was not significantly associated with alcohol or drug use. This study adds to the literature on the long-term consequences of child abuse and neglect by demonstrating patterns of psychopathology and risky behavior that persist over time in a high-risk group of girls with self or parent reported histories of abuse and neglect. Interventions that address externalizing problems and health risk behaviors may be of particular importance for this population. Copyright © 2015. Published by Elsevier Ltd.

  4. Mother-infant consultation during drug treatment: Research and innovative clinical practice

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    Lester Barry M

    2008-02-01

    Full Text Available Abstract Background This paper details a model for consulting with mothers and infants, and drug treatment staff used in a residential drug treatment program and relevant to other treatment settings. The role of parent-infant consultation based on the Neonatal Network Neurobehavioral Scale (NNNS was evaluated. Methods A sequential cohort model was used to assign participants to 1. NNNS consultation versus 2. standard care. The effects of NNNS consultation were evaluated using the Parenting Stress Index and NNNS summary scores. Results Participants in the NNNS consultation condition had significantly less stress overall, and less stress related to infant behavior than participants in standard care. There were no differences in infant behavior on the NNNS Summary scores. Conclusion The implications for NNNS consultation in drug treatment programs is outlined. The importance of prevention/intervention to establish satisfactory mother-infant interaction in recovery programs which include a central parenting component is indicated.

  5. Sexual and injection-related risks in Puerto Rican-born injection drug users living in New York City: A mixed-methods analysis

    Directory of Open Access Journals (Sweden)

    Gelpí-Acosta Camila

    2011-10-01

    Full Text Available Abstract Background These data were collected as part of the National HIV Behavioral Surveillance (NHBS study. NHBS is a cross-sectional study to investigate HIV behavioral risks among core risk groups in 21 U.S. cities with the highest HIV/AIDS prevalence. This analysis examines data from the NHBS data collection cycle with IDU conducted in New York City in 2009. We explored how the recency of migration from Puerto Rico (PR to New York City (NYC impacts both syringe sharing and unprotected sex among injection drug users (IDU currently living in NYC. Methods We used a mixed-methods approach to examine differences in risk between US-born IDU, PR IDU who migrated to NYC more than three years ago (non-recent migrants, and PR IDU who migrated in the last three years (recent migrants. Respondent-driven sampling (RDS was used to recruit the sample (n = 514. In addition, qualitative individual and group interviews with recent PR migrants (n = 12 and community experts (n = 2 allowed for an in-depth exploration of the IDU migration process and the material and cultural factors behind continued risk behaviors in NYC. Results In multiple logistic regression controlling for confounding factors, recent migrants were significantly more likely to report unprotected sexual intercourse with casual or exchange partners (adjusted odds ratio [AOR]: 2.81; 95% confidence intervals [CI]: 1.37-5.76 and receptive syringe sharing (AOR = 2.44; 95% CI: 1.20-4.97 in the past year, compared to US-born IDU. HIV and HCV seroprevalence were highest among non-recent migrants. Qualitative results showed that risky injection practices are partly based on cultural norms acquired while injecting drugs in Puerto Rico. These same results also illustrate how homelessness influences risky sexual practices. Conclusions Poor material conditions (especially homelessness may be key in triggering risky sexual practices. Cultural norms (ingrained while using drugs in PR around injection drug

  6. Role of scanning electron microscopy in identifying drugs used in medical practice.

    Science.gov (United States)

    Fazil Marickar, Y M; Sylaja, N; Koshy, Peter

    2009-10-01

    Several plant preparations are administered for treatment of stone disease without scientific basis. This paper presents the results of in vitro and animal experimental studies using scanning electron microscopy (SEM) in the identification of the therapeutic properties of trial drugs in medicine. In the first set of the study, urinary crystals namely calcium oxalate monohydrate and calcium oxalate dehydrate were grown in six sets of Hane's tubes in silica gel medium. Trial drugs namely scoparia dulcis Lynn, musa sapiens and dolicos biflorus were incorporated in the gel medium to identify the dopant effect of the trial drugs on the size and extent of crystal column growth. The changes in morphology of crystals were studied using SEM. In the second set, six male Wistar rats each were calculogenised by administering sodium oxalate and ethylene glycol and diabetised using streptozotocin. The SEM changes of calculogenisation were studied. The rats were administered trial drugs before calculogenisation or after. The kidneys of the rats studied under the scanning electron microscope showed changes in tissue morphology and crystal deposition produced by calculogenisation and alterations produced by addition of trial drugs. The trial drugs produced changes in the pattern of crystal growth and in the crystal morphology of both calcium oxalate monohydrate and calcium oxalate dihydrate grown in vitro. Elemental distribution analysis showed that the crystal purity was not altered by the trial drugs. Scoparia dulcis Lynn was found to be the most effective anticalculogenic agent. Musa sapiens and dolicos biflorus were found to have no significant effect in inhibiting crystal growth. The kidneys of rats on calculogenisation showed different grades of crystals in the glomerulus and interstitial tissues, extrusion of the crystals into the tubular lumen, collodisation and tissue inflammatory cell infiltration. Scoparia dulcis Lynn exhibited maximum protector effect against the

  7. Establishing a compulsory drug treatment prison: Therapeutic policy, principles, and practices in addressing offender rights and rehabilitation.

    Science.gov (United States)

    Birgden, Astrid; Grant, Luke

    2010-01-01

    A Compulsory Drug Treatment Correctional Center (CDTCC) was established in Australia in 2006 for repeat drug-related male offenders. Compulsory treatment law is inconsistent with a therapeutic jurisprudence approach. Despite the compulsory law, a normative offender rehabilitation framework has been established based on offender moral rights. Within moral rights, the offender rehabilitation framework addresses the core values of freedom (supporting autonomous decision-making) and well-being (supporting support physical, social, and psychological needs). Moral rights are underpinned by a theory or principle which, in this instance, is a humane approach to offender rehabilitation. While a law that permits offenders to choose drug treatment and rehabilitation is preferable, the article discusses the establishment of a prison based on therapeutic policy, principles, and practices that respond to participants as both rights-violators and rights-holders. The opportunity for accelerated community access and a therapeutic alliance with staff has resulted in offenders actively seeking to be ordered into compulsory drug treatment and rehabilitation. Crown Copyright © 2010. Published by Elsevier Ltd. All rights reserved.

  8. Current good manufacturing practice in manufacturing, processing, packing, or holding of drugs; revision of certain labeling controls. Final rule.

    Science.gov (United States)

    2012-03-20

    The Food and Drug Administration (FDA) is amending the packaging and labeling control provisions of the current good manufacturing practice (CGMP) regulations for human and veterinary drug products by limiting the application of special control procedures for the use of cut labeling to immediate container labels, individual unit cartons, or multiunit cartons containing immediate containers that are not packaged in individual unit cartons. FDA is also permitting the use of any automated technique, including differentiation by labeling size and shape, that physically prevents incorrect labeling from being processed by labeling and packaging equipment when cut labeling is used. This action is intended to protect consumers from labeling errors more likely to cause adverse health consequences, while eliminating the regulatory burden of applying the rule to labeling unlikely to reach or adversely affect consumers. This action is also intended to permit manufacturers to use a broader range of error prevention and labeling control techniques than permitted by current CGMPs.

  9. A practical and convenient method for the synthesis of anesthetic drug thiopental: using thiourea and sodium ethoxide

    Directory of Open Access Journals (Sweden)

    Hojat Narimani

    2014-02-01

    Full Text Available A general, simple, practical and convenient method has been described for the synthesis of anesthetic drug thiopental using thiourea in the presence of sodium ethoxide. Anesthetic drug of thiopental was prepared in two stages; during the first stage, the alkylation of mthyl cyanoacetate was performed which was then to be followed by cyclization. Alkylation of methyl cyanoacetate which was performed by 2-iodopentane in the presence of sodium ethoxide reacts with thiourea and then the process was followed by thiopental prepration in excellent yield. Some important aspects of this methodology are the high reactivity of the substrates, avoidance of the use of hazardous solvents, simplicity of the product separation, low cost of the substrates and reagents and high yield of product. This is a applicable and efficient method for the preparation of thiopental anesthesia in high yield and in an appropriate time.

  10. Tile relations between subjective or objective risky driving and motives for risky driving or attitudes towards road safety

    OpenAIRE

    Žardeckaitė-Matulaitienė, Kristina; Markšaitytė, Rasa; Endriulaitienė, Auksė; Šeibokaitė, Laura; Pranckevičienė, Aistė

    2012-01-01

    The study aims to evaluate how the factors of motivation and attitudes about traffic safety are related to risky driving evaluated by young drivers both subjectively and objectively. Risky driving was evaluated in three ways: self-knowledge, driving in a simulation environment, and recalled violations of road traffic regulations as well as accidents caused. 226 respondents aged 18–29 answered the questions from the self-knowledge questionnaire, 40 of them participated in the experiment of dri...

  11. [Potential antimicrobial drug interactions in clinical practice: consequences of polypharmacy and multidrug resistance].

    Science.gov (United States)

    Martínez-Múgica, Cristina

    2015-12-01

    Polypharmacy is a growing problem nowadays, which can increase the risk of potential drug interactions, and result in a loss of effectiveness. This is particularly relevant to the anti-infective therapy, especially when infection is produced by resistant bacteria, because therapeutic options are limited and interactions can cause treatment failure. All antimicrobial prescriptions were retrospectively reviewed during a week in the Pharmacy Department, in order to detect potential drug-interactions and analysing their clinical significance. A total of 314 antimicrobial prescriptions from 151 patients were checked. There was at least one potential interaction detected in 40% of patients, being more frequent and severe in those infected with multidrug-resistant microorganisms. Drugs most commonly involved were quinolones, azoles, linezolid and vancomycin. Potential drug interactions with antimicrobial agents are a frequent problem that can result in a loss of effectiveness. This is why they should be detected and avoided when possible, in order to optimize antimicrobial therapy, especially in case of multidrug resistant infections.

  12. Highly deformable and highly fluid vesicles as potential drug delivery systems: theoretical and practical considerations

    Directory of Open Access Journals (Sweden)

    Romero EL

    2013-08-01

    Full Text Available Eder Lilia Romero, Maria Jose Morilla Nanomedicine Research Program, Department of Science and Technology, National University of Quilmes, Bernal, Buenos Aires, Argentina Abstract: Vesicles that are specifically designed to overcome the stratum corneum barrier in intact skin provide an efficient transdermal (systemic or local drug delivery system. They can be classified into two main groups according to the mechanisms underlying their skin interaction. The first group comprises those possessing highly deformable bilayers, achieved by incorporating edge activators to the bilayers or by mixing with certain hydrophilic solutes. The vesicles of this group act as drug carriers that penetrate across hydrophilic pathways of the intact skin. The second group comprises those possessing highly fluid bilayers, owing to the presence of permeation enhancers. The vesicles of this group can act as carriers of drugs that permeate the skin after the barrier of the stratum corneum is altered because of synergistic action with the permeation enhancers contained in the vesicle structure. We have included a detailed overview of the different mechanisms of skin interaction and discussed the most promising preclinical applications of the last five years of Transfersomes® (IDEA AG, Munich, Germany, ethosomes, and invasomes as carriers of antitumoral and anti-inflammatory drugs applied by the topical route. Keywords: Transfersomes, ethosomes, antitumoral, anti-inflammatory, topical delivery

  13. A Threat to the Environment from Practice of Drug Disposal in Thailand

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    Wiwat Arkaravichien

    2014-01-01

    Full Text Available Medicine contains active pharmaceutical ingredients which may do harm to the environment when dispersed into the environment. Once people have leftover medicines, if they discard them incorrectly, these medicines will contaminate the environment. This study determined how Thai villagers stored and disposed their medicines. A survey study of 331 subjects was conducted in 4 villages of Khon Kaen suburb by interviewing about what medications they stored, how they stored and how they managed their leftover medicines. The study showed that 89.4% of people kept some kind of drugs in their houses. Neuromuscular drugs were the most common group. The study revealed that there were leftover medicines at homes and they discarded them when unwanted. The most common method of discard was trashing in to rubbish bin. This method accounted for 81.4%, 64.6% and 66.6% of solid dosage form, liquid dosage form and external use drugs respectively. Liquid dosage forms were also put into the drainage system (7.4%. These disposal methods are discussed as non environmental friendly methods as the active pharmaceutical ingredients could eventually get into surface water and then may unconsciously get back to people through tap water and drinking water. This study alerts the concern for more appropriate means of drug disposal in Thailand.

  14. "The first shot": the context of first injection of illicit drugs, ongoing injecting practices, and hepatitis C infection in Rio de Janeiro, Brazil.

    Science.gov (United States)

    Oliveira, Maria de Lourdes Aguiar; Hacker, Mariana A; Oliveira, Sabrina Alberti Nóbrega de; Telles, Paulo Roberto; O, Kycia Maria Rodrigues do; Yoshida, Clara Fumiko Tachibana; Bastos, Francisco I

    2006-04-01

    The context of first drug injection and its association with ongoing injecting practices and HCV (hepatitis C virus) infection were investigated. Injection drug users (IDUs) (N = 606) were recruited in "drug scenes" (public places, bars) in Rio de Janeiro, Brazil, interviewed, and tested for HCV. Sharing of needles/syringes was more prevalent at the first injection (51.3%) than at the baseline interview (36.8%). Those who shared syringes/needles at first injection were more likely to be currently engaged in direct/indirect sharing practices. Among young injectors (drug injection were identified as independent predictors of HCV infection. To effectively curb HCV transmission among IDUs and minimize harms associated with risk behaviors, preventive strategies should target individuals initiating drug injection beginning with their very first injection and discourage the transition from non-injecting use to the self-injection of illicit drugs.

  15. Knowledge, perception, practices and barriers of healthcare professionals in Bosnia and Herzegovina towards adverse drug reaction reporting and pharmacovigilance

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    Maša Amrain

    2014-09-01

    Full Text Available Introduction: Pharmacovigilance is an arm of patient care. No one wants to harm patients, but unfortunately any medicine will sometimes do just this. Underreporting of adverse drug reactions by healthcare professionals is a major problem in many countries. In order to determine whether our pharmacovigilance system could be improved, and identify reasons for under-reporting, a study to investigate the role of health care professionals in adverse drug reaction (ADR reporting was performed.Methods: A pretested questionnaire comprising of 20 questions was designed for assessment of knowledge, perceptions, practice and barriers toward ADR reporting on a random sample of 1000 healthcare professionals in Bosnia and Herzegovina.Results: Of the 1000 respondents, 870 (87% completed the questionnaire. The survey showed that 62.9% health care professionals would report ADR to the Agency for Medicinal Products and Medical Device of Bosnia and Herzegovina (ALMBIH. Most of surveyed respondents has a positive perception towards ADR reporting, and believes that this is part of their professional and legal obligation, and they also recognize the importance of reporting adverse drug reactions. Only small percent (15.4% of surveyed health care professionals reported adverse drug reaction.Conclusions: The knowledge of ADRs and how to report them is inadequate among health care professionals. Perception toward ADR reporting was positive, but it is not reflected in the actual practice of ADRs, probably because of little experience and knowledge regarding pharmacovigilance. Interventions such as education and training, focusing on the aims of pharmacovigilance, completing the ADR form and clarifying the reporting criteria are strongly recommended.

  16. Clinical guidelines «Rational use of nonsteroidal anti-inflammatory drugs (NSAIDs in clinical practice»

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    A. E. Karateev

    2015-01-01

    Full Text Available The paper presents the new version of the clinical guidelines «Rational use of nonsteroidal anti-inflammatory drugs (NSAIDs in clinical practice » prepared by the Association of Rheumatologists of Russia, the Russian Pain Society, the Russian Gastroenterological Association, the Russian Society of Cardiology, the Association of Traumatologists and Orthopedists of Russia, the Association of Interdisciplinary Medicine, and the Russian Association of Palliative Medicine.In our country, NSAIDs are the most important and most popular class of analgesics. Unlike global practice, Russian physicians rather rarely recommend paracetamol as a first-line drug to relieve moderate or severe pain, by giving preference to NSAIDs; the use of opioid analgesics for noncancers is minimized because of tight legal restrictions.NSAIDs are effective and easy-to-use; however, they are far from safe; the administration of these medications may lead to serious gastrointestinal, cardiovascular, renal, and other complications in a number of cases. So the use of NSAIDs should be compulsorily monitored for adverse reactions and the choice of a specific drug for each clinical case should be based on the objective estimation of a ratio of its efficacy to safety.In recent years, there have been fresh data on the use of NSAIDs for different diseases and a few novel representatives of this drug group have appeared on the Russian pharmacological market.This all has necessitated a new version of the guidelines on the rational use of NSAIDs. These are based on the provisions that have high validity and have been confirmed by the results of well-organized clinical and large-scale population-based studies, as well as by their meta-analysis.The guidelines are intended for physicians of all specialties. 

  17. Prática de parapente e comportamentos de risco: uma análise a partir do conceito de redoma sensorial Practica del paraglider y comportamientos de riesgo: un análisis a partir del concepto de redoma sensorial Practice of paraglider and risky behaviors: an analysis starting from the concept of sensorial dome

    Directory of Open Access Journals (Sweden)

    Jairo Antonio Paixão

    2010-09-01

    was possible to verify through a descriptive and exploratory search, that the mastery of technique and the use of appropriate equipment, though essential, does not guarantee the success of these actors. Many times, the risky situations experienced in the adventure sport, join at a first moment a true outline of extraordinary sensorial elements, but the daily living observed in a given modality can lead to the banalization of those elements by the practitioner, becoming ordinary sensory elements. This transformation can present implications when practicing adventure sports, for instance, in maintaining the physical and emotional integrity of the practitioner.

  18. Socio-demographic and sexual practices associated with HIV infection in Kenyan injection and non-injection drug users.

    Science.gov (United States)

    Budambula, Valentine; Matoka, Charles; Ouma, James; Ahmed, Aabid A; Otieno, Michael F; Were, Tom

    2018-01-30

    Substance use is increasingly becoming prevalent on the African continent, fueling the spread of HIV infection. Although socio-demographic factors influence substance consumption and risk of HIV infection, the association of these factors with HIV infection is poorly understood among substance users on the African continent. The objective of the study was to assess socio-demographic and sexual practices that are associated with HIV infection among injection drug users (IDUs), non-IDUs, and non-drug users (DUs) at an urban setting of coastal Kenya. A cross-sectional descriptive study was conducted among 451 adults comprising HIV-infected and -uninfected IDUs (n = 157 and 39); non-IDUs (n = 17 and 48); and non-DUs (n = 55 and 135); respectively at coastal, Kenya. Respondent driven sampling, snowball and makeshift methods were used to enroll IDUs and non-IDUs. Convenience and purposive sampling were used to enroll non-DUs from the hospital's voluntary HIV testing unit. Participant assisted questionnaire was used in collecting socio-demographic data and sexual practices. Binary logistic regression analysis indicated that higher likelihood of HIV infection was associated with sex for police protection (OR, 9.526; 95% CI, 1.156-78.528; P = 0.036) and history of sexually transmitted infection (OR, 5.117; 95% CI, 1.924-13.485; P = 0.001) in IDUs; divorced, separated or widowed marital status (OR, 6.315; 95% CI, 1.334-29.898; P = 0.020) in non-IDUs; and unemployment (OR, 2.724; 95% CI, 1.049-7.070; P = 0.040) in non-drug users. However, never married (single) marital status (OR, 0.140; 95% CI, 0.030-0.649; P = 0.012) was associated with lower odds for HIV infection in non-drug users. Altogether, these results suggest that socio-demographic and sexual risk factors for HIV transmission differ with drug use status, suggesting targeted preventive measures for drug users.

  19. Nonsteroidal antiinflammatory drugs and dyspepsia in general practice – a prospective, controlled study

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    Marija Skok

    2005-01-01

    Full Text Available Background: Treatment of dyspeptic patients is a diagnostic and therapeutic problem frequently encountered by general and family practitioners, by internists and gastroenterologists.Aims: In our study we attempted to assess the prevalence of dyspeptic symptoms in patients over 60 who are regular users of nonsteroidal antiinflammatory drugs.Patients and methods: This is a prospective cohort study based on an interview during examination in the OPC, the results obtained by the diagnostic procedures and follow-up. It was carried out between 1999 and 2003 at a family practitioner’s and a gastroenterologic OPC. In patients who were regular users of nonsteroidal antiinflammatory drugs, we established the prevalence of dyspeptic symptoms, the most often used drugs and the type of diagnostic procedure applied to define the cause of dyspepsia. The control group was composed of patients over 60 who were also exhibiting dyspeptic symptoms but not using any NSAID.Results: The study comprised 50 patients, 27 women and 23 men, the mean age was 67.3 years, the range 60–80 years. The control group comprised 50 patients, 28 women and 22 men, the mean age was 66.6 years, the range 61–80 years. All patients of the study group had used NSAR or preparations of acetylsalicylic acid during the past 3 months. There were no statistically significant differences between the patients of both groups as regards the number and use of other drugs, p = 0.65. The average score of dyspeptic complaints in our study group was 3.02, SD ± 0.6, and 70% of patients wished to use H2 antagonists or proton pump inhibitors for these complaints. In patients of the control group, the average score of complaints was 2.72, SD ± 0.7, and they also took drugs for the alleviation of their complaints more rarely.Conclusions: Nonsteroidal antiinflammatory drugs belong among the important causes of dyspepsia in the elderly. When making decisions about the various diagnostic procedures for

  20. Social network correlates of risky sexual behavior among adolescents in Bahir Dar and Mecha Districts, North West Ethiopia: an institution-based study.

    Science.gov (United States)

    Asrese, Kerebih; Mekonnen, Alemtsehay

    2018-04-11

    Behaviors established during adolescence such as risky sexual behaviors have negative effects on future health and well-being. Extant literature indicated that individual attributes such as peer pressure and substance use have impacts on healthy development of young peoples' sexual behavior. The patterns of relationships (social network structure) and the social network content (members' norm regarding sexual practice) established by adolescents' network on adolescents' risky sexual behaviors are not well investigated. This cross-sectional study assessed the roles of social networks on sexual behavior of high school adolescents in Bahir Dar and Mecha district, North West Ethiopia. Data were collected from 806 high school adolescents using a pretested anonymously self administered questionnaire. Hierarchical logistic regression model was used for analysis. The results indicated that more than 13% had risky sexual behavior. Taking social networks into account improved the explanation of risky sexual behavior over individual attributes. Adolescents embedded within increasing sexual practice approving norm (AOR 1.61; 95%CI: 1.04 - 2.50), increasing network tie strength (AOR 1.12; 95% CI: 1.06 - 1.19), and homogeneous networks (AOR 1.58; 95% CI: .98 - 2.55) were more likely to had risky sexual behavior. Engaging within increasing number of sexuality discussion networks was found protective of risky sexual behavior (AOR .84; 95% CI: .72 - .97). Social networks better predict adolescent's risky sexual behavior than individual attributes. The findings indicated the circumstances or contexts that social networks exert risks or protective effects on adolescents' sexual behavior. Programs designed to reduce school adolescents' sexual risk behavior should consider their patterns of social relationships.

  1. How Phenotypic Screening Influenced Drug Discovery: Lessons from Five Years of Practice.

    Science.gov (United States)

    Haasen, Dorothea; Schopfer, Ulrich; Antczak, Christophe; Guy, Chantale; Fuchs, Florian; Selzer, Paul

    Since 2011, phenotypic screening has been a trend in the pharmaceutical industry as well as in academia. This renaissance was triggered by analyses that suggested that phenotypic screening is a superior strategy to discover first-in-class drugs. Despite these promises and considerable investments, pharmaceutical research organizations have encountered considerable challenges with the approach. Few success stories have emerged in the past 5 years and companies are questioning their investment in this area. In this contribution, we outline what we have learned about success factors and challenges of phenotypic screening. We then describe how our efforts in phenotypic screening have influenced our approach to drug discovery in general. We predict that concepts from phenotypic screening will be incorporated into target-based approaches and will thus remain influential beyond the current trend.

  2. Software Infrastructure for Computer-aided Drug Discovery and Development, a Practical Example with Guidelines.

    Science.gov (United States)

    Moretti, Loris; Sartori, Luca

    2016-09-01

    In the field of Computer-Aided Drug Discovery and Development (CADDD) the proper software infrastructure is essential for everyday investigations. The creation of such an environment should be carefully planned and implemented with certain features in order to be productive and efficient. Here we describe a solution to integrate standard computational services into a functional unit that empowers modelling applications for drug discovery. This system allows users with various level of expertise to run in silico experiments automatically and without the burden of file formatting for different software, managing the actual computation, keeping track of the activities and graphical rendering of the structural outcomes. To showcase the potential of this approach, performances of five different docking programs on an Hiv-1 protease test set are presented. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  3. Antimicrobial drug use and related management practices among Ontario swine producers.

    OpenAIRE

    Dunlop, R H; McEwen, S A; Meek, A H; Friendship, R A; Clarke, R C; Black, W D

    1998-01-01

    A mail survey of swine producers in Ontario was undertaken during 1991 to describe the types, frequency, and motives for antimicrobial use. Two hundred operations that marketed fewer than 350 hogs per year, and 800 that marketed more than 350 per year were sent questionnaires, 63% of which were completed and returned. Most operations (86%) added antimicrobials to starter (weanling pig) rations, while fewer (29%) added these drugs to finisher pig rations. The most commonly used antimicrobials ...

  4. NMR screening in fragment-based drug design: a practical guide.

    Science.gov (United States)

    Kim, Hai-Young; Wyss, Daniel F

    2015-01-01

    Fragment-based drug design (FBDD) comprises both fragment-based screening (FBS) to find hits and elaboration of these hits to lead compounds. Typical fragment hits have lower molecular weight (FBDD since it identifies and localizes the binding site of weakly interacting hits on the target protein. Here we describe ligand-based NMR methods for hit identification from fragment libraries and for functional cross-validation of primary hits.

  5. Parasite control in the age of drug resistance and changing agricultural practices.

    Science.gov (United States)

    Molento, Marcelo Beltrão

    2009-08-07

    The benefits of using antiparasitic drugs in farm animals are unquestionable. However, despite anthelmintic use as the predominant control strategy, extreme parasite infection cases are appearing in sheep and goat production; these impact productivity and have show mortality rates reaching pre-drug use levels. This was a predictable situation resulting from the loss of efficacy by all available products, particularly when some products were used as the sole intervention. The concepts of agroecology and holistic agriculture, which advocate the use of integrated management strategies, such as target selected treatment, herbal medicine, and the application of other parasite control alternatives, are not completely new, but are undergoing a resurgence because of their more sustainable appeal. The objective of this review article is to examine the problem of parasite control in the face of parasite drug resistance and to outline some strategies that may be used in parasite control programmes. Before they are accepted and recommended by the WAAVP, agroecological methods such as those listed above and described in detail herein should be validated based on scientific evidence of their efficacy for parasite control and should be tested for both host and environmental safety.

  6. Human factors in cybersecurity; examining the link between Internet addiction, impulsivity, attitudes towards cybersecurity, and risky cybersecurity behaviours

    Directory of Open Access Journals (Sweden)

    Lee Hadlington

    2017-07-01

    Full Text Available The present study explored the relationship between risky cybersecurity behaviours, attitudes towards cybersecurity in a business environment, Internet addiction, and impulsivity. 538 participants in part-time or full-time employment in the UK completed an online questionnaire, with responses from 515 being used in the data analysis. The survey included an attitude towards cybercrime and cybersecurity in business scale, a measure of impulsivity, Internet addiction and a ‘risky’ cybersecurity behaviours scale. The results demonstrated that Internet addiction was a significant predictor for risky cybersecurity behaviours. A positive attitude towards cybersecurity in business was negatively related to risky cybersecurity behaviours. Finally, the measure of impulsivity revealed that both attentional and motor impulsivity were both significant positive predictors of risky cybersecurity behaviours, with non-planning being a significant negative predictor. The results present a further step in understanding the individual differences that may govern good cybersecurity practices, highlighting the need to focus directly on more effective training and awareness mechanisms.

  7. The dopamine transporter gene, a spectrum of most common risky behaviors, and the legal status of the behaviors.

    Directory of Open Access Journals (Sweden)

    Guang Guo

    2010-02-01

    Full Text Available This study tests the specific hypothesis that the 9R/9R genotype in the VNTR of the dopamine transporter gene (DAT1 exerts a general protective effect against a spectrum of risky behaviors in comparison to the 10R/9R and 10R/10R genotypes, drawing on three-time repeated measures of risky behaviors in adolescence and young adulthood on about 822 non-Hispanic white males from the Add Health study. Our data have established two empirical findings. The first is a protective main effect in the DAT1 gene against risky behaviors. The second finding is that the protective effect varies over age, with the effect prominent at ages when a behavior is illegal and the effect largely vanished at ages when the behavior becomes legal or more socially tolerated. Both the protective main effect and the gene-lifecourse interaction effect are replicated across a spectrum of most common risky behaviors: delinquency, variety of sexual partners, binge drinking, drinking quantity, smoking quantity, smoking frequency, marijuana use, cocaine use, other illegal drug use, and seatbelt non-wearing. We also compared individuals with the protective genotype and individuals without it in terms of age, physical maturity, verbal IQ, GPA, received popularity, sent popularity, church attendance, two biological parents, and parental education. These comparisons indicate that the protective effect of DAT1*9R/9R cannot be explained away by these background characteristics. Our work demonstrates how legal/social contexts can enhance or reduce a genetic effect on risky behaviors.

  8. A comparison of cardiovascular risk factors for ten antipsychotic drugs in clinical practice

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    Bodén R

    2013-03-01

    Full Text Available Robert Bodén,1,2 Gunnar Edman,3,4 Johan Reutfors,2 Claes-Göran Östenson,3 Urban Ösby3,4 1Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden; 2Department of Medicine Solna, Centre for Pharmacoepidemiology, Karolinska Institutet, Stockholm, Sweden; 3Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; 4Department of Psychiatry, Tiohundra AB, Norrtälje, Sweden Abstract: It is well known that abdominal obesity, dyslipidemia, and insulin resistance are highly prevalent in patients receiving maintenance treatment with antipsychotics, but there is limited knowledge about the association between cardiovascular risk factors and treatment with antipsychotic drugs. In this naturalistic study we investigated a sample of 809 antipsychotic-treated patients from Swedish psychosis outpatient teams. Cardiovascular risk factors (eg, metabolic syndrome, homeostasis model assessment of insulin resistance, and low-density lipoprotein values were measured, and their associations to current antipsychotic pharmacotherapy were studied. Ten antipsychotic drugs were compared in a stepwise logistic regression model. For the patients, the presence of the components of metabolic syndrome ranged from 35% for hyperglycemia to 64% for elevated waist circumference. Hypertriglyceridemia was associated with clozapine (odds ratio [OR] = 1.81, 95% confidence interval [CI] 1.08–3.04, reduced high-density lipoprotein with both clozapine and olanzapine (OR = 1.73, 95% CI 1.01–2.97; and OR = 2.03, 95% CI 1.32–3.13, hypertension with perphenazine (OR = 2.00, 95% CI 1.21–3.59, and hyperglycemia inversely with ziprasidone (OR = 0.21, 95% CI 0.05–0.89 and positively with haloperidol (OR = 2.02, 95% CI 1.18–3.48. There were no significant relationships between any of the antipsychotic drugs and increased waist circumference, homeostasis model assessment of insulin resistance, or low-density lipoprotein levels. In

  9. Best practices: an electronic drug alert program to improve safety in an accountable care environment.

    Science.gov (United States)

    Griesbach, Sara; Lustig, Adam; Malsin, Luanne; Carley, Blake; Westrich, Kimberly D; Dubois, Robert W

    2015-04-01

    The accountable care organization (ACO), one of the most promising and talked about new models of care, focuses on improving communication and care transitions by tying potential shared savings to specific clinical and financial benchmarks. An important factor in meeting these benchmarks is an ACO's ability to manage medications in an environment where medical and pharmacy care has been integrated. The program described in this article highlights the critical components of Marshfield Clinic's Drug Safety Alert Program (DSAP), which focuses on prioritizing and communicating safety issues related to medications with the goal of reducing potential adverse drug events. Once the medication safety concern is identified, it is reviewed to evaluate whether an alert warrants sending prescribers a communication that identifies individual patients or a general communication to all physicians describing the safety concern. Instead of basing its decisions regarding clinician notification about drug alerts on subjective criteria, the Marshfield Clinic's DSAP uses an internally developed scoring system. The scoring system includes criteria developed from previous drug alerts, such as level of evidence, size of population affected, severity of adverse event identified or targeted, litigation risk, available alternatives, and potential for duration of medication use. Each of the 6 criteria is assigned a weight and is scored based upon the content and severity of the alert received.  In its first 12 months, the program targeted 6 medication safety concerns involving the following medications: topiramate, glyburide, simvastatin, citalopram, pioglitazone, and lovastatin. Baseline and follow-up prescribing data were gathered on the targeted medications. Follow-up review of prescribing data demonstrated that the DSAP provided quality up-to-date safety information that led to changes in drug therapy and to decreases in potential adverse drug events. In aggregate, nearly 10,000 total

  10. Practical Management of Patients with a History of Immediate Hypersensitivity to Common non-Beta-Lactam Drugs.

    Science.gov (United States)

    Macy, Eric

    2016-01-01

    Immediate hypersensitivity reactions to medications are among the most feared adverse drug reactions, because of their close association with anaphylaxis. This review discusses a practical management approach for patients with a history of an immediate hypersensitivity to a non-beta-lactam medication, where reexposure to the implicated, or similar, medication is clinically necessary. Mechanisms associated with severe immediate hypersensitivity reactions include IgE-mediated mast cell activation, complement-mediated mast cell activation, and direct mast cell activation. Immediate hypersensitivity reactions may also be mediated by vasodilators, other pharmacologic mechanisms, or be secondary to underlying patient-specific biochemical abnormalities such as endocrine tumors or chronic spontaneous urticaria. The key features in the reaction history and the biochemistry of the implicated medication are discussed. Most individuals with a history of immediate hypersensitivity to a medication, who require reuse of that drug, can be safely retreated with a therapeutic course of the implicated drug after a full-dose challenge, graded challenge, or desensitization, with or without premedication and/or any preliminary diagnostic testing, depending on the specific situation.

  11. Practical guidelines for the characterization and quality control of pure drug nanoparticles and nano-cocrystals in the pharmaceutical industry.

    Science.gov (United States)

    Peltonen, Leena

    2018-06-16

    The number of poorly soluble drug candidates is increasing, and this is also seen in the research interest towards drug nanoparticles and (nano-)cocrystals; improved solubility is the most important application of these nanosystems. In order to confirm the functionality of these nanoparticles throughout their lifecycle, repeatability of the formulation processes, functional performance of the formed systems in pre-determined way and system stability, a thorough physicochemical understanding with the aid of necessary analytical techniques is needed. Even very minor deviations in for example particle size or size deviation in nanoscale can alter the product bioavailability, and the effect is even more dramatic with the smallest particle size fractions. Also, small particle size sets special requirements for the analytical techniques. In this review most important physicochemical properties of drug nanocrystals and nano-cocrystals are presented, suitable analytical techniques, their pros and cons, are described with the extra input on practical point of view. Copyright © 2018. Published by Elsevier B.V.

  12. Practical considerations in clinical strategy to support the development of injectable drug-device combination products for biologics.

    Science.gov (United States)

    Li, Zhaoyang; Easton, Rachael

    2018-01-01

    The development of an injectable drug-device combination (DDC) product for biologics is an intricate and evolving process that requires substantial investments of time and money. Consequently, the commercial dosage form(s) or presentation(s) are often not ready when pivotal trials commence, and it is common to have drug product changes (manufacturing process or presentation) during clinical development. A scientifically sound and robust bridging strategy is required in order to introduce these changes into the clinic safely. There is currently no single developmental paradigm, but a risk-based hierarchical approach has been well accepted. The rigor required of a bridging package depends on the level of risk associated with the changes. Clinical pharmacokinetic/pharmacodynamic comparability or outcome studies are only required when important changes occur at a late stage. Moreover, an injectable DDC needs to be user-centric, and usability assessment in real-world clinical settings may be required to support the approval of a DDC. In this review, we discuss the common issues during the manufacturing process and presentation development of an injectable DDC and practical considerations in establishing a clinical strategy to address these issues, including key elements of clinical studies. We also analyze the current practice in the industry and review relevant and status of regulatory guidance in the DDC field.

  13. Practical considerations in clinical strategy to support the development of injectable drug-device combination products for biologics

    Science.gov (United States)

    Easton, Rachael

    2018-01-01

    ABSTRACT The development of an injectable drug-device combination (DDC) product for biologics is an intricate and evolving process that requires substantial investments of time and money. Consequently, the commercial dosage form(s) or presentation(s) are often not ready when pivotal trials commence, and it is common to have drug product changes (manufacturing process or presentation) during clinical development. A scientifically sound and robust bridging strategy is required in order to introduce these changes into the clinic safely. There is currently no single developmental paradigm, but a risk-based hierarchical approach has been well accepted. The rigor required of a bridging package depends on the level of risk associated with the changes. Clinical pharmacokinetic/pharmacodynamic comparability or outcome studies are only required when important changes occur at a late stage. Moreover, an injectable DDC needs to be user-centric, and usability assessment in real-world clinical settings may be required to support the approval of a DDC. In this review, we discuss the common issues during the manufacturing process and presentation development of an injectable DDC and practical considerations in establishing a clinical strategy to address these issues, including key elements of clinical studies. We also analyze the current practice in the industry and review relevant and status of regulatory guidance in the DDC field. PMID:29035675

  14. The typological approach to the risky behavior of adolescents

    Directory of Open Access Journals (Sweden)

    Mitrović D.

    2006-01-01

    Full Text Available The main research problem is focused on the following question: Is it possible to identify specific patterns of interaction between precipitating and protective factors for the risky behavior among adolescents. The research was conducted on the sample of 204 adolescents of both genders (18 to 20 years old. Specific personality traits and socio-demographic characteristics are manifested as the most important precipitating and/or protective factors for the risky behavior. The frame of reference for personality assessment was the alternative five-factor model (Zuckerman, 2002, specified in the ZKPQ-50-CC questionnaire, and consisted of the five biologically determined personality traits: activity, aggressiveness/hostility, impulsive sensation seeking, neuroticism/anxiety and sociability. Latent dimensions of the risky behavior: risky activities and life - conditions, were extracted by applying the homogeneity analyses (HOMALS. The matrix of squared Euclidean distances (in the common space of factor scores on the principal components of ZKPQ questionnaire, scores on HOMALS dimensions and school grades was a subject of the Ward hierarchical cluster analysis method, extracting three clusters. According to the discriminant functions: risk proneness and pro-social activity, the clusters were identified: the group of pro-social oriented adolescents, the aloof group and the group of adolescents prone to risky behavior. The results have considerable implications for the prevention programs’ development and implementation.

  15. Acute stress does not affect risky monetary decision-making

    Directory of Open Access Journals (Sweden)

    Peter Sokol-Hessner

    2016-12-01

    Full Text Available The ubiquitous and intense nature of stress responses necessitate that we understand how they affect decision-making. Despite a number of studies examining risky decision-making under stress, it is as yet unclear whether and in what way stress alters the underlying processes that shape our choices. This is in part because previous studies have not separated and quantified dissociable valuation and decision-making processes that can affect choices of risky options, including risk attitudes, loss aversion, and choice consistency, among others. Here, in a large, fully-crossed two-day within-subjects design, we examined how acute stress alters risky decision-making. On each day, 120 participants completed either the cold pressor test or a control manipulation with equal probability, followed by a risky decision-making task. Stress responses were assessed with salivary cortisol. We fit an econometric model to choices that dissociated risk attitudes, loss aversion, and choice consistency using hierarchical Bayesian techniques to both pool data and allow heterogeneity in decision-making. Acute stress was found to have no effect on risk attitudes, loss aversion, or choice consistency, though participants did become more loss averse and more consistent on the second day relative to the first. In the context of an inconsistent previous literature on risk and acute stress, our findings provide strong and specific evidence that acute stress does not affect risk attitudes, loss aversion, or consistency in risky monetary decision-making.

  16. New Drugs and Devices from 2011 – 2012 That Might Change Your Practice

    Directory of Open Access Journals (Sweden)

    Lex, Joe

    2013-11-01

    Full Text Available To be honest, I thought this would be a lost cause. Even after skipping a New Drugs and Devices essay in 2012, I figured that I would have to search long and hard to find ten new things that emergency practitioners needed to know about. Although there were no true blockbuster medications for emergency physicians, I nonetheless found ten medicines that we probably should know, along with a new device that may change the way we work up patients with palpitations, and a clever new delivery system for subcutaneous epinephrine. [West J Emerg Med. 2013;14(6:619–628.

  17. Drug dispensing practices at pharmacies in Bengaluru: A cross-sectional study

    OpenAIRE

    R Soumya; Vijayalakshmi Devarashetty; C R Jayanthi; M Sushma

    2016-01-01

    Objectives: Pharmacists are one of the crucial focal points for health care in the community. They have tremendous outreach to the public as pharmacies are often the first-port-of-call. With the increase of ready-to-use drugs, the main health-related activity of a pharmacist today is to assure the quality of dispensing, a key element to promote rational medicine use. Materials and Methods: A cross-sectional study of 200 pharmacies, 100 each in various residential (R) and commercial (C) areas ...

  18. Application of basic pharmacology and dispensing practice of antibiotics in accredited drug-dispensing outlets in Tanzania

    Directory of Open Access Journals (Sweden)

    Minzi OM

    2013-01-01

    Full Text Available OM Minzi,1 VS Manyilizu21Unit of Pharmacology and Therapeutics, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, 2Logistics System Strengthening Unit, John Snow Inc, Dar es Salaam, TanzaniaBackground: Provision of pharmaceutical services in accredited drug-dispensing outlets (ADDOs in Tanzania has not been reported. This study compared the antibiotics dispensing practice between ADDOs and part II shops, or duka la dawa baridi (DLDBs, in Tanzania.Methodology: This was a cross-sectional study that was conducted in ADDOs and DLDBs. A simulated client method for data collection was used, and a total of 85 ADDOs, located in Mvomero, Kilombero, and Morogoro rural districts, were compared with 60 DLDBs located in Kibaha district. The research assistants posed as simulated clients and requested to buy antibiotics from ADDOs and DLDBs after presenting a case scenario or disease condition. Among the diseases presented were those requiring antibiotics and those usually managed only by oral rehydration salt or analgesics. The simulated clients wanted to know the antibiotics that were available at the shop. The posed questions set a convincing ground to the dispenser either to dispense the antibiotic directly, request a prescription, or refer the patient to a health facility. Proportions were used to summarize categorical variables between ADDOs and DLDBs, and the chi-square test was used to test for statistical difference between the two drug-outlet types in terms of antibiotic-dispensing practice.Results: As many as 40% of trained ADDO dispensers no longer worked at the ADDO shops, so some of the shops employed untrained staff. A larger proportion of ADDOs than DLDBs dispensed antibiotics without prescriptions (P = 0.004. The overall results indicate that there was no difference between the two types of shops in terms of adhering to regulations for dispensing antibiotics. However, in some circumstances, eg

  19. Adolescent Brain Development and Drugs

    Science.gov (United States)

    Winters, Ken C.; Arria, Amelia

    2011-01-01

    Research now suggests that the human brain is still maturing during adolescence. The developing brain may help explain why adolescents sometimes make decisions that are risky and can lead to safety or health concerns, including unique vulnerabilities to drug abuse. This article explores how this new science may be put to use in our prevention and…

  20. Drugs + HIV, Learn the Link

    Medline Plus

    Full Text Available ... HIV > Learn the Link campaign. This campaign shows teens and young adults that non-injection drug use and alcohol use can lead to poor decision making, which can result in risky sexual behaviors and HIV infection. Although the characters are fictional, ...

  1. Knowledge regarding antibiotic drug action and prescription practices among dentist in Jaipur city, Rajasthan

    Directory of Open Access Journals (Sweden)

    Dushyant Pal Singh

    2015-01-01

    Full Text Available Introduction: Dentists prescribe antibiotics routinely to manage oral and dental infections. Unscrupulous antibiotic prescriptions can be associated with unfavorable side effects and the development of resistance. Thus, the aim of this study was to assess the level of knowledge regarding antibiotic prescription use among dentists in Jaipur City, Rajasthan. Materials and Methods: A questionnaire survey was conducted among 300 dentists in Jaipur city. A validated, self-designed, 21-item, closed-ended questionnaire was used to collect data on knowledge regarding antibiotic prescription. Descriptive statistics were calculated. Results: A total of 300 dental practitioners were included in the study. The majority of the respondents seem to prescribe antibiotics that are broad spectrum or the ones that are commonly used. A considerable percentage of the respondents were not aware of the pregnancy drug risk categories by Food and Drug Administration. The most of the respondents said that they prescribe antibiotics on the basis of the diagnosis, whereas more than two-thirds of the respondents said that they never advise culture sensitivity test before prescribing the antibiotics. Conclusion: Our findings suggest the knowledge of dentists regarding antibiotic prescription is inadequate and more focus should be given to the ongoing training regarding the pharmacological aspects, pertinent medical conditions, and prophylactic use of antibiotics in dentistry.

  2. Culture and context: buffering the relationship between stressful life events and risky behaviors in American Indian youth.

    Science.gov (United States)

    Baldwin, Julie A; Brown, Betty G; Wayment, Heidi A; Nez, Ramona Antone; Brelsford, Kathleen M

    2011-01-01

    The Sacred Mountain Youth Project was conducted to investigate risk and protective factors related to alcohol and drug use among American Indian youth. Findings indicated that stressful life events were positively associated with depressed mood, substance use, and risky behavior; cultural identity had no direct effects, but a secondary model showed that social support and protective family and peer influences were related to cultural identity. These findings suggest that the relationships between stressors and their negative sequelae are complex. Emphasis on protective processes that are culturally specific to American Indian youth may lead to effective alcohol and drug use prevention programs.

  3. Innovating Chinese Herbal Medicine: From Traditional Health Practice to Scientific Drug Discovery

    OpenAIRE

    Gu, Shuo; Pei, Jianfeng

    2017-01-01

    As one of the major contemporary alternative medicines, traditional Chinese medicine (TCM) continues its influence in Chinese communities and has begun to attract the academic attention in the world of western medicine. This paper aims to examine Chinese herbal medicine (CHM), the essential branch of TCM, from both narrative and scientific perspectives. CHM is a traditional health practice originated from Chinese philosophy and religion, holding the belief of holism and balance in the body. W...

  4. An evaluation of knowledge, attitude and practice of Indian pharmacists towards adverse drug reaction reporting: A pilot study

    Directory of Open Access Journals (Sweden)

    Akram Ahmad

    2013-01-01

    Full Text Available Background: Pharmacovigilance is a useful to assure the safety of medicines and protect consumers from their harmful effects. Healthcare professionals should consider Adverse Drug Reaction (ADR reporting as part of their professional obligation and participate in the existent pharmacovigilance programs in their countries. In India, the National PV Program was re-launched in July 2010. Objectives: This survey was conducted in order to assess the knowledge, attitude and practice of Indian pharmacists with the aim of exploring the pharmacists′ participation in ADR reporting system, identifying the reasons of under reporting and determining the steps that could be adopted to increase reporting rates. Materials and Methods: A cross-sectional survey was carried out among the pharmacists in India using a pretested questionnaire with 33 questions (10 questions on knowledge, 6 on attitude, 7 on practice, 7 on future of ADR reporting in India and 3 on benefits of reporting ADRs.. The study was conducted, over a period of 3 months from May 2012 to July 2012. Results: Out of the 600 participants to whom the survey was administered, a total of 400 were filled. The response rate of the survey was 67%. 95% responders were knowledgeable about ADRs. 90% participants had a positive attitude towards making ADRs reporting mandatory for practicing pharmacists. 87.5% participants were interested in participating in the National Pharmacovigilance program, in India. 47.5% respondents had observed ADRs in their practice, and 37% had reported it to the national pharmacovigilance center. 92% pharmacists believed reporting ADRs immensely helped in providing quality care to patients. Conclusion : The Indian pharmacists have poor knowledge, attitude, and practice (KAP towards ADR reporting and pharmacovigilance. Pharmacists with higher qualifications such as the pharmacists with a PharmD have better KAP. With additional training on Pharmacovigilance, the Indian Pharmacists

  5. Ethical conflicts in public health research and practice: antimicrobial resistance and the ethics of drug development.

    Science.gov (United States)

    Aiello, Allison E; King, Nicholas B; Foxman, B

    2006-11-01

    Since the 1960s, scientists and pharmaceutical representatives have called for the advancement and development of new antimicrobial drugs to combat infectious diseases. In January 2005, Senate Majority Leader Bill Frist (R-TN), MD, introduced a biopreparedness bill that included provisions for patent extensions and tax incentives to stimulate industry research on new antimicrobials. Although government stimulus for private development of new antimicrobials is important, it does not resolve long-standing conflicts of interest between private entities and society. Rising rates of antimicrobial resistance have only exacerbated these conflicts. We used methicillin-resistant Staphylococcus aureus as a case study for reviewing these problems, and we have suggested alternative approaches that may halt the vicious cycle of resistance and obsolescence generated by the current model of antimicrobial production.

  6. A national drug related problems database: evaluation of use in practice, reliability and reproducibility

    DEFF Research Database (Denmark)

    Kjeldsen, Lene Juel; Birkholm, Trine; Fischer, Hanne Lis

    2014-01-01

    Background A drug related problems database (DRP-database) was developed on request by clinical pharmacists. The information from the DRP-database has only been used locally e.g. to identify focus areas and to communicate identified DRPs to the hospital wards. Hence the quality of the data...... by clinical pharmacists with categorization performed by the project group. Reproducibility was explored by re-categorization of a sample of existing records in the DRP-database by two project group members individually. Main outcome measures Observed proportion of agreement and Fleiss' kappa as measures...... reliability study of 34 clinical pharmacists showed high inter-rater reliability with the project group (Fleiss' kappa = 0.79 with 95 % CI (0.70; 0.88)), and the reproducibility study also documented high inter-rater reliability of a sample of 379 records from the DRP-database re-categorized by two project...

  7. Predictors of Retention in an Alcohol and Risky Sex Prevention Program for Homeless Young Adults.

    Science.gov (United States)

    Pedersen, Eric R; Ewing, Brett A; D'Amico, Elizabeth J; Miles, Jeremy N V; Haas, Ann C; Tucker, Joan S

    2018-05-01

    Homeless young adults are at risk for alcohol and other drug (AOD) use and risky sexual behavior. Interventions are needed to help these young people reduce their risky behavior, but this population is often difficult to engage and retain in services. We offered a four-session AOD and risky sex reduction program to 100 participants and examined if retention in the program was predicted by a number of factors: demographics, homelessness severity, other service use, AOD behaviors, mental health symptoms, sexual risk behaviors, and readiness to change AOD and condom use. Nearly half (48%) of participants completed all sessions. In bivariate analyses, participants were significantly less likely to be retained in the program if they had slept outdoors in the past month, engaged in more alcohol and marijuana use, experienced more alcohol-related consequences, and received the program in an urban drop-in center (as opposed to a drop-in center near the beach). When controlling for all significant bivariate relationships, only sleeping outdoors and receipt of the program in the urban setting predicted fewer sessions completed. The most endorsed reasons for program non-completion were being too busy to attend and inconvenient day/time of the program. Findings can help outreach staff and researchers better prepare methods to engage higher risk homeless youth and retain them in services. Finding unique ways to help youth overcome barriers related to location of services appears especially necessary, perhaps by bringing services to youth where they temporarily reside or offering meaningful incentives for program attendance.

  8. Cortisol boosts risky decision-making behavior in men but not in women.

    Science.gov (United States)

    Kluen, Lisa Marieke; Agorastos, Agorastos; Wiedemann, Klaus; Schwabe, Lars

    2017-10-01

    Acute stress may escalate risky decision-making in men, while there is no such effect in women. Although first evidence links these gender-specific effects of stress to stress-induced changes in cortisol, whether elevated cortisol is indeed sufficient to boost risk-taking, whether a potential cortisol effect depends on simultaneous noradrenergic activation, and whether cortisol and noradrenergic activation exert distinct effects on risk-taking in men and women is unknown. In this experiment, we therefore set out to elucidate the impact of cortisol and noradrenergic stimulation on risky decision-making in men and women. In a fully-crossed, placebo-controlled, double-blind design, male and female participants received orally either a placebo, hydrocortisone, yohimbine, an alpha-2-adrenoceptor-antagonist leading to increased noradrenergic stimulation, or both drugs before completing the balloon analogue risk task, a validated measure of risk-taking. Overall, participants' choice was risk-sensitive as reflected in reduced responding in high- compared to moderate- and low-risk conditions. Cortisol, however, led to a striking increase in risk-taking in men, whereas it had no effect on risk-taking behavior in women. Yohimbine had no such effect and the gender-specific effect of cortisol was not modulated by yohimbine. Our data show that cortisol boosts risk-taking behavior in men but not in women. This differential effect of cortisol on risk-taking may drive gender differences in risky decision-making under stress. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Affective and cognitive mechanisms of risky decision making.

    Science.gov (United States)

    Shimp, Kristy G; Mitchell, Marci R; Beas, B Sofia; Bizon, Jennifer L; Setlow, Barry

    2015-01-01

    The ability to make advantageous decisions under circumstances in which there is a risk of adverse consequences is an important component of adaptive behavior; however, extremes in risk taking (either high or low) can be maladaptive and are characteristic of a number of neuropsychiatric disorders. To better understand the contributions of various affective and cognitive factors to risky decision making, cohorts of male Long-Evans rats were trained in a "Risky Decision making Task" (RDT), in which they made discrete trial choices between a small, "safe" food reward and a large, "risky" food reward accompanied by varying probabilities of footshock. Experiment 1 evaluated the relative contributions of the affective stimuli (i.e., punishment vs. reward) to RDT performance by parametrically varying the magnitudes of the footshock and large reward. Varying the shock magnitude had a significant impact on choice of the large, "risky" reward, such that greater magnitudes were associated with reduced choice of the large reward. In contrast, varying the large, "risky" reward magnitude had minimal influence on reward choice. Experiment 2 compared individual variability in RDT performance with performance in an attentional set shifting task (assessing cognitive flexibility), a delayed response task (assessing working memory), and a delay discounting task (assessing impulsive choice). Rats characterized as risk averse in the RDT made more perseverative errors on the set shifting task than did their risk taking counterparts, whereas RDT performance was not related to working memory abilities or impulsive choice. In addition, rats that showed greater delay discounting (greater impulsive choice) showed corresponding poorer performance in the working memory task. Together, these results suggest that reward-related decision making under risk of punishment is more strongly influenced by the punishment than by the reward, and that risky and impulsive decision making are associated with

  10. Difficulties in emotion regulation and risky driving among Lithuanian drivers.

    Science.gov (United States)

    Šeibokaitė, Laura; Endriulaitienė, Auksė; Sullman, Mark J M; Markšaitytė, Rasa; Žardeckaitė-Matulaitienė, Kristina

    2017-10-03

    Risky driving is a common cause of traffic accidents and injuries. However, there is no clear evidence of how difficulties in emotion regulation contribute to risky driving behavior, particularly in small post-Soviet countries. The present study aimed to investigate the relationship between difficulties in emotion regulation and self-reported risky driving behavior in a sample of Lithuanian drivers. A total of 246 nonprofessional Lithuanian drivers participated in a cross-sectional survey. Difficulties in emotion regulation were assessed using the Difficulties in Emotion Regulation Scale (DERS; Gratz and Roemer 2004), and risky driving behavior was assessed using the Manchester Driver Behaviour Questionnaire (DBQ; Lajunen et al. 2004). Males scored higher than females in aggressive violations and ordinary violations. Females scored higher for the nonacceptance of emotional responses, whereas males had more difficulties with emotional awareness than females. More difficulties in emotion regulation were positively correlated with driving errors, lapses, aggressive violations, and ordinary violations for both males and females. Structural equation modeling showed that difficulties in emotion regulation explained aggressive and ordinary violations more clearly than lapses and errors. When controlling for interactions among the distinct regulation difficulties, difficulties with impulse control and difficulties engaging in goal-directed behavior predicted risky driving. Furthermore, nonacceptance of emotional responses and limited access to emotion regulation strategies were related to less violations and more driving errors. Emotion regulation difficulties were associated with the self-reported risky driving behaviors of Lithuanian drivers. This provides useful hints for improving driver training programs in order to prevent traffic injuries.

  11. Sexual Orientation, Drug Use Preference during Sex, and HIV Risk Practices and Preferences among Men Who Specifically Seek Unprotected Sex Partners via the Internet

    Directory of Open Access Journals (Sweden)

    Hugh Klein

    2009-05-01

    Full Text Available The present study entailed conducting a content analysis of 1,434 ads/profiles posted on one of the most popular “Men who have Sex with Men” (MSM websites that specifically fosters unprotected sex. Ads/profiles were selected randomly based on the American ZIP code of residence (n = 1,316, with a randomly-drawn oversampling of profiles of men who self-identified as heterosexual or ���curious” rather than gay or bisexual (n = 118. Data were collected between September 2006 and September 2007. The purpose of the present paper is to examine the conjoint effects of self-identified sexual orientation and preference for having/not having sex while high, on men’s sought-after sexual risk. Analytical comparisons of the four groups showed that, on most measures, the combination of sexual orientation and drug use preference during sex differentiated the men. Generally speaking, gay/bisexual men who advertised online for partners with whom they could have sex while high expressed the greatest interest in risky sexual behaviors (e.g., felching, unprotected oral sex, unprotected anal sex and various risk-related preferences (e.g., multiple partner sex, anonymous sex, eroticizing ejaculatory fluids. This is especially true when they are compared to their heterosexual/“curious” counterparts whose online profiles were not as likely to indicate a desire for having sex while high.

  12. The policy-practice gap: describing discordances between regulation on paper and real-life practices among specialized drug shops in Kenya.

    Science.gov (United States)

    Wafula, Francis; Abuya, Timothy; Amin, Abdinasir; Goodman, Catherine

    2014-09-16

    Specialized drug shops (SDSs) are popular in Sub-Saharan Africa because they provide convenient access to medicines. There is increasing interest in how policymakers can work with them, but little knowledge on how their operation relates to regulatory frameworks. This study sought to describe characteristics and predictors of regulatory practices among SDSs in Kenya. The regulatory framework governing the Kenya pharmaceutical sector was mapped, and a list of regulations selected for inclusion in a survey questionnaire. An SDS census was conducted, and survey data collected from 213 SDSs from two districts in Western Kenya. The majority of SDSs did not comply with regulations, with only 12% having a refrigerator and 22% having a separate dispensing area for instance. Additionally, less than half had at least one staff with pharmacy qualification (46%), with less than a third of all interviewed operators knowing the name of the law governing pharmacy.Regulatory infringement was more common among SDSs in rural locations; those that did not have staff with pharmacy qualifications; and those whose operator did not know the name of the pharmacy law. Compliance was not significantly associated with the frequency of inspections, with over 80% of both rural and urban SDSs reporting an inspection in the past year. While compliance was low overall, it was particularly poor among SDSs operating in rural locations, and those that did not have staff with pharmacy qualification. This suggested the need for policy to introduce levels of practice in recognition of the variations in resource availability. Under such a system, rural SDSs operating in low-resource setting, and selling a limited range of medicines, may be exempted from certain regulatory requirements, as long as their scope of practice is limited to certain essential services only. Future research should also explore why regulatory compliance is poor despite regular inspections.

  13. High-risk sexual behavior among drug-using men.

    Science.gov (United States)

    Seidman, S N; Sterk-Elifson, C; Aral, S O

    1994-01-01

    Drug-using men are at high risk for acquisition and transmission of STD, presumably due to the risky behaviors practiced in environments of drug use. To study behaviors associated with STD transmission among drug-using men. Drug outreach workers distributed vouchers to self-identified drug-using men in urban Atlanta. Vouchers could be redeemed for cash at a storefront clinic where subjects provided urine for a urethritis screening test (leukocyte esterase test) and a drug screen, and were interviewed. Of 382 voucher recipients, 252 (66%) came to the clinic. Subjects were predominantly black (92%), homeless (70%), and aged 20 to 40 (88%). All used illicit drugs; none were currently receiving drug abuse treatment. Urine drug screen confirmed recent cocaine use in 63%, and recent opiate use in 4%. Three-fourths reported a history of STD, mostly gonorrhea. In the preceding 3 months, 14% had not had sex, 80% had sex exclusively with women, 4% had sex with both men and women, and 2% had sex exclusively with men. Of the heterosexually active men, 29% had 5 or more recent partners. Compared to other heterosexually active men, these men were more likely to always use alcohol or crack before having sex (prevalence ratio [PR] = 2.0, 95% CI = 1.3-2.5) and to drink alcohol every day (PR = 2.0, 95% CI = 1.2-3.3). Daily crack use was associated with choosing partners at elevated STD risk; daily alcohol use with having more partners. Positive drug screen for cocaine was associated with self-reported crack use. Urethritis, detected in 16%, was not correlated with behavior. A substantial number of drug-using men practice high-risk sexual behavior and should be targeted for intervention. Monetary and other incentives should be considered for recruitment. Further study is needed to clarify the relationship between sexual behavior, cocaine use, and STD.

  14. Risky sexual behaviour among young men in Nepal

    OpenAIRE

    Dahal, Govinda P.; Hennink, Monique; Hinde, Andrew

    2005-01-01

    We use the Nepal Adolescents and Young Adults (NAYA) Survey of 2000 to analyse the prevalence of sexual activity and risky sexual behaviour among Nepalese males aged 14-22 years. Risky sexual behaviour is considered to be characterised by having multiple partners, or having one non-regular partner with whom a condom was not used, in the 12 months before the survey. About 9 per cent of the sexually active married men aged 14-22 years, and about 20 per cent of sexually active single men in the ...

  15. Searches for Randomized Controlled Trials of Drugs in MEDLINE and EMBASE Using Only Generic Drug Names Compared with Searches Applied in Current Practice in Systematic Reviews

    Science.gov (United States)

    Waffenschmidt, Siw; Guddat, Charlotte

    2015-01-01

    Background: It is unclear which terms should be included in bibliographic searches for randomized controlled trials (RCTs) of drugs, and identifying relevant drug terms can be extremely laborious. The aim of our analysis was to determine whether a bibliographic search using only the generic drug name produces sufficient results for the generation…

  16. Self-reported injection practices among people who use drugs in French prisons: Public health implications (ANRS-Coquelicot survey 2011-2013).

    Science.gov (United States)

    Michel, Laurent; Trouiller, Philippe; Chollet, Aude; Molinier, Marie; Duchesne, Lucie; Jauffret-Roustide, Marie

    2018-04-01

    The aims of this study were to describe the prevalences of injection practices and needle/syringe sharing in people who use drugs in French prisons, and to investigate associated factors. Using the ANRS-Coquelicot survey (2011-2013), a random sample of 1718 people who used drugs in free society was included. Information regarding a history of incarceration, drug-injection practices inside prison and needle/syringe sharing was collected during interviews. In our sample, 65.5% reported a history of injection and 57.4% had been incarcerated at least once. Among those who reported both of these conditions, 14% reported injection practices inside prison, 40.5% of whom had shared needles/syringes. In the multivariable model, the following variables were associated with injection practices inside prison: being a Russian-speaking detainee, having spent more time in prison, and having started to inject before 1996 and especially before 1987. Being Russian speaking was also associated with needle/syringe sharing in prison. The prevalences of injection practices and needle/syringe sharing in prisons are alarmingly high. Effective interventions to prevent the transmission of infectious diseases among people who use drugs in the prison setting are essential. The implementation of international recommendations on the principle of equivalence between prisons and the community is still very limited in most countries, and should be complemented with tailored interventions for the most vulnerable prison populations, especially Russian-speaking detainees. © 2017 Australasian Professional Society on Alcohol and other Drugs.

  17. Risky business: is pubic hair removal by women associated with body image and sexual health?

    Science.gov (United States)

    Grossman, Stephanie L; Annunziato, Rachel A

    2018-04-30

    Background: Body hair removal is a behaviour that has become normative among women in Westernised cultures, and is presented by the media as the feminine ideal, despite being painful and a potential cause of infection. Of concern, removal may be part of a more global pattern of appearance dissatisfaction and risky sexual behaviour. The aim of the present study was to examine the relationships among pubic hair removal, body image and sexual health indicators. Methods: Women (n=264; Mage=33.82, s.d.=11.13, range=18-66) completed self-report questionnaires assessing these constructs, including an assessment of body hair removal practices. Results: Greater appearance concerns (as measured by thin-ideal internalisation, appearance investment and self-objectification) and sexual health indicators (i.e. less condom use self-efficacy when a partner disapproves of condom use) all predicted greater importance of reasons for pubic hair removal (R2=0.315, F(8184)=9.97, Pwomen who removed a greater amount of hair reported more thin-ideal internalisation and appearance investment than those who removed less hair. Conclusions: Women who express stronger reasoning for pubic hair removal, and remove a larger amount of it, may endorse problematic beliefs and behaviours particularly related to appearance concerns. It is important for practitioners to consider this practice as distinct from grooming and to be aware of its association with a broader array of risky beliefs and behaviours that can compromise women's well-being.

  18. Antimicrobial drug use and related management practices among Ontario swine producers.

    Science.gov (United States)

    Dunlop, R H; McEwen, S A; Meek, A H; Friendship, R A; Clarke, R C; Black, W D

    1998-02-01

    A mail survey of swine producers in Ontario was undertaken during 1991 to describe the types, frequency, and motives for antimicrobial use. Two hundred operations that marketed fewer than 350 hogs per year, and 800 that marketed more than 350 per year were sent questionnaires, 63% of which were completed and returned. Most operations (86%) added antimicrobials to starter (weanling pig) rations, while fewer (29%) added these drugs to finisher pig rations. The most commonly used antimicrobials were tylosin, carbadox, and furazolidone in weanling pigs, and tylosin, lincomycin, and tetracycline in finishers. Water medication of grower-finisher pigs was practised on 25% of farms; 80% of farms had injected at least some grower-finisher pigs with antimicrobials in the 12 mo preceding the survey. Approximately 20% of operations that added antimicrobials to finisher rations did so for growth promotion purposes only, while others used them for disease treatment, prevention, control, or a combination of reasons. Among those not using antimicrobials in finisher rations, 83% did not believe they were necessary and 37% were concerned about the potential for residues in marketed hogs.

  19. Fragment based drug discovery: practical implementation based on ¹⁹F NMR spectroscopy.

    Science.gov (United States)

    Jordan, John B; Poppe, Leszek; Xia, Xiaoyang; Cheng, Alan C; Sun, Yax; Michelsen, Klaus; Eastwood, Heather; Schnier, Paul D; Nixey, Thomas; Zhong, Wenge

    2012-01-26

    Fragment based drug discovery (FBDD) is a widely used tool for discovering novel therapeutics. NMR is a powerful means for implementing FBDD, and several approaches have been proposed utilizing (1)H-(15)N heteronuclear single quantum coherence (HSQC) as well as one-dimensional (1)H and (19)F NMR to screen compound mixtures against a target of interest. While proton-based NMR methods of fragment screening (FBS) have been well documented and are widely used, the use of (19)F detection in FBS has been only recently introduced (Vulpetti et al. J. Am. Chem. Soc.2009, 131 (36), 12949-12959) with the aim of targeting "fluorophilic" sites in proteins. Here, we demonstrate a more general use of (19)F NMR-based fragment screening in several areas: as a key tool for rapid and sensitive detection of fragment hits, as a method for the rapid development of structure-activity relationship (SAR) on the hit-to-lead path using in-house libraries and/or commercially available compounds, and as a quick and efficient means of assessing target druggability.

  20. Health-damaging policing practices among persons who inject drugs in Mexico: Are deported migrants at greater risk?

    Science.gov (United States)

    Pinedo, Miguel; Beletsky, Leo; Alamillo, Nathan; Ojeda, Victoria D

    2017-08-01

    Evidence-based public health and criminal justice policies aimed at addressing the structurally vulnerable population of persons who inject drugs (PWID) and who are involved in the immigrant enforcement and deportation system are lacking. Policing practices are critical structural determinants of HIV among PWID. PWID in Mexico who have been deported from the US are at elevated risk of HIV. From 2011 to 2013, 733 PWID were recruited to complete structured questionnaires, including past 6-month experiences with police. Eligible PWID were 18 years or older, had injected in the past month, and resided in Tijuana, Mexico with no intentions of moving. To determine if deportation status was associated with experiences of arrests and problematic policing practices, we conducted separate multivariate logistic regression models for independent policing variables. In multivariate analyses, deportation status was independently associated with higher odds of being arrested (Adjusted Odds Ratio (AOR): 1.45; 95% Confidence Interval (CI): 1.02-2.05), being asked for a bribe (AOR: 1.39; 95% CI: 1.05-2.04), and being forced to leave a place of residence (AOR: 2.00; 95% CI: 1.08-3.70) in the past 6 months. Results highlight a previously poorly understood elements of the US-deportation experience: migrants' experiences with law enforcement post-deportation and the role of deportation policies and practices as structural drivers of public health risk in destination countries. We provide policy recommendations for Mexico and the US based on our findings, which have potential application in other countries seeking to improve enforcement and related policing practices from a public health perspective. Copyright © 2017. Published by Elsevier B.V.

  1. Moving evidence-based drug abuse prevention programs from basic science to practice: "bridging the efficacy-effectiveness interface".

    Science.gov (United States)

    August, Gerald J; Winters, Ken C; Realmuto, George M; Tarter, Ralph; Perry, Cheryl; Hektner, Joel M

    2004-01-01

    This article examines the challenges faced by developers of youth drug abuse prevention programs in transporting scientifically proven or evidence-based programs into natural community practice systems. Models for research on the transfer of prevention technology are described with specific emphasis given to the relationship between efficacy and effectiveness studies. Barriers that impede the successful integration of efficacy methods within effectiveness studies (e.g., client factors, practitioner factors, intervention structure characteristics, and environmental and organizational factors) are discussed. We present a modified model for program development and evaluation that includes a new type of research design, the hybrid efficacy-effectiveness study that addresses program transportability. The utility of the hybrid study is illustrated in the evaluation of the Early Risers "Skills for Success" prevention program.

  2. Hepatitis C virus (HCV genotype 1 subtype identification in new HCV drug development and future clinical practice.

    Directory of Open Access Journals (Sweden)

    Stéphane Chevaliez

    Full Text Available BACKGROUND: With the development of new specific inhibitors of hepatitis C virus (HCV enzymes and functions that may yield different antiviral responses and resistance profiles according to the HCV subtype, correct HCV genotype 1 subtype identification is mandatory in clinical trials for stratification and interpretation purposes and will likely become necessary in future clinical practice. The goal of this study was to identify the appropriate molecular tool(s for accurate HCV genotype 1 subtype determination. METHODOLOGY/PRINCIPAL FINDINGS: A large cohort of 500 treatment-naïve patients eligible for HCV drug trials and infected with either subtype 1a or 1b was studied. Methods based on the sole analysis of the 5' non-coding region (5'NCR by sequence analysis or reverse hybridization failed to correctly identify HCV subtype 1a in 22.8%-29.5% of cases, and HCV subtype 1b in 9.5%-8.7% of cases. Natural polymorphisms at positions 107, 204 and/or 243 were responsible for mis-subtyping with these methods. A real-time PCR method using genotype- and subtype-specific primers and probes located in both the 5'NCR and the NS5B-coding region failed to correctly identify HCV genotype 1 subtype in approximately 10% of cases. The second-generation line probe assay, a reverse hybridization assay that uses probes targeting both the 5'NCR and core-coding region, correctly identified HCV subtypes 1a and 1b in more than 99% of cases. CONCLUSIONS/SIGNIFICANCE: In the context of new HCV drug development, HCV genotyping methods based on the exclusive analysis of the 5'NCR should be avoided. The second-generation line probe assay is currently the best commercial assay for determination of HCV genotype 1 subtypes 1a and 1b in clinical trials and practice.

  3. Moral Stress, Moral Practice, and Ethical Climate in Community-Based Drug-Use Research: Views From the Front Line.

    Science.gov (United States)

    Fisher, Celia B; True, Gala; Alexander, Leslie; Fried, Adam L

    2013-01-01

    The role of front-line researchers, those whose responsibilities include face-to-face contact with participants, is critical to ensuring the responsible conduct of community-based drug use research. To date, there has been little empirical examination of how front-line researchers perceive the effectiveness of ethical procedures in their real-world application and the moral stress they may experience when adherence to scientific procedures appears to conflict with participant protections. This study represents a first step in applying psychological science to examine the work-related attitudes, ethics climate, and moral dilemmas experienced by a national sample of 275 front-line staff members whose responsibilities include face-to-face interaction with participants in community-based drug-use research. Using an anonymous Web-based survey we psychometrically evaluated and examined relationships among six new scales tapping moral stress (frustration in response to perceived barriers to conducting research in a morally appropriate manner); organizational ethics climate; staff support; moral practice dilemmas (perceived conflicts between scientific integrity and participant welfare); research commitment; and research mistrust. As predicted, front-line researchers who evidence a strong commitment to their role in the research process and who perceive their organizations as committed to research ethics and staff support experienced lower levels of moral stress. Front-line researchers who were distrustful of the research enterprise and frequently grappled with moral practice dilemmas reported higher levels of moral stress. Applying psychometrically reliable scales to empirically examine research ethics challenges can illuminate specific threats to scientific integrity and human subjects protections encountered by front-line staff and suggest organizational strategies for reducing moral stress and enhancing the responsible conduct of research.

  4. Adolescents risky MP3-player listening and its psychosocial correlates

    NARCIS (Netherlands)

    Vogel, I.; Brug, J.; Ploeg, C.P.B. van der; Raat, H.

    2011-01-01

    Analogue to occupational noise-induced hearing loss, MP3-induced hearing loss may be evolving into a significant social and public health problem. To inform prevention strategies and interventions, this study investigated correlates of adolescents' risky MP3-player listening behavior primarily

  5. Adolescents Risky MP3-Player Listening and Its Psychosocial Correlates

    Science.gov (United States)

    Vogel, Ineke; Brug, Johannes; Van Der Ploeg, Catharina P. B.; Raat, Hein

    2011-01-01

    Analogue to occupational noise-induced hearing loss, MP3-induced hearing loss may be evolving into a significant social and public health problem. To inform prevention strategies and interventions, this study investigated correlates of adolescents' risky MP3-player listening behavior primarily informed by protection motivation theory. We invited…

  6. Pessimism, Trauma, Risky Sex: Covariates of Depression in College Students

    Science.gov (United States)

    Swanholm, Eric; Vosvick, Mark; Chng, Chwee-Lye

    2009-01-01

    Objective: To explain variance in depression in students (N = 648) using a model incorporating sexual trauma, pessimism, and risky sex. Method: Survey data collected from undergraduate students receiving credit for participation. Results: Controlling for demographics, a hierarchical linear regression analysis [Adjusted R[superscript 2] = 0.34,…

  7. Is Poverty a Driver for Risky Sexual Behaviour? Evidence from ...

    African Journals Online (AJOL)

    This paper contributes to conflicting evidence on the link between poverty and risky sexual behaviour by examining the effect of wealth status on age at first sex, condom use, and multiple partners using nationally representative adolescents\\' data from Burkina Faso, Ghana, Malawi, and Uganda. The results show that the ...

  8. Living with parents and risky sexual behaviors among preparatory ...

    African Journals Online (AJOL)

    EB

    Keywords: Risky sexual behavior, living with parents, family environment. African Halth ... increases the probability of negative consequences ... greater the gender imbalance in rates of HIV infection, with ... communication and family support) (22 Items with. 5-point ... students relationship and school-students relationship).

  9. Relationship Between Methamphetamine Use and Risky Sexual Behavior in Adolescents

    Directory of Open Access Journals (Sweden)

    Cheng-Fang Yen

    2004-04-01

    Full Text Available Substance abuse and risky sexual behavior have been identified as behaviors that can endanger adolescent psychosocial development. This study examined the relationship between methamphetamine (MAMP use and risky sexual behavior in adolescents. Risky sexual behavior was compared not only between MAMP users and non-users, but also between high-frequency and low-frequency MAMP users. We compared the sexual intercourse histories of 85 adolescents formally charged as MAMP users with those of 170 gender-matched adolescents with no record of MAMP use. MAMP usage characteristics were compared between users who had and those who had not experienced sexual intercourse. Previous sexual experience was more likely in MAMP users than in non-users. MAMP users were also more likely to have had a greater total number of sexual partners and were more likely to have had unplanned sex under the influence of alcohol. High-frequency MAMP use was associated with increased tendencies to engage in unprotected sex and to use MAMP before sexual intercourse. In general, the chance of sexual intercourse increased in proportion to frequency of MAMP use. Given the clear link between MAMP use and risky sexual behavior, risk-reduction programs directed at teen MAMP users are urgently needed.

  10. Risky sexual behaviours among HIV Sero-discordant individuals ...

    African Journals Online (AJOL)

    Backgound: HIV/AIDS pandemic is a great public health concern hence the need to identify interventions to prevent new infections among risk groups. Objective: To determine risky sexual behaviours among HIV sero-discordant individuals attending Defence Forces Memorial Hospital (DFMH). Design: A descriptive ...

  11. A comparison of risky sexual behaviours between circumcised and ...

    African Journals Online (AJOL)

    though male circumcision coupled with preventive behaviour reduces this risk. Objective: To compare the factors associated with risky sexual behaviour among circumcised and uncircumcised men in Bo- tswana. Methods: Nationally representative data from the Botswana AIDS Impact Survey III were used. A sample of 313 ...

  12. Traditional Gender Roles As Precursors Of Risky Sexual Behaviour ...

    African Journals Online (AJOL)

    ... it was recommended that those in the helping professions should take cognizance of those variables that have been found to influence risky sexual behaviours and decisions among couples. The result also recommends intervention strategy to help couples achieve a better reproductive health behaviour, relationship and ...

  13. Distortion of Probability and Outcome Information in Risky Decisions

    Science.gov (United States)

    DeKay, Michael L.; Patino-Echeverri, Dalia; Fischbeck, Paul S.

    2009-01-01

    Substantial evidence indicates that information is distorted during decision making, but very few studies have assessed the distortion of probability and outcome information in risky decisions. In two studies involving six binary decisions (e.g., banning blood donations from people who have visited England, because of "mad cow disease"),…

  14. Risky Sexual Behaviour Associated with Alcohol Consumption among

    African Journals Online (AJOL)

    Zamzar

    ABSTRACT: BACKGROUND: The consumption of alcoholic beverages has been known to be responsible for several negative forms, of behavior, actions, attitudes and social ills. The link between alcohol consumption and risky sexual behavior has also been established. As the scorge of HIV ravages the population, the ...

  15. Age Differences in Risky Decisions: The Role of Anticipated Emotions

    Science.gov (United States)

    Chen, Yiwei; Ma, Xiaodong

    2009-01-01

    The present study investigated the role of anticipated emotions in risky decisions of young and older adults. Young and older adults were asked to make a choice between an alternative that may have either a very positive or a very negative consequence and an alternative that was relatively safe. Meanwhile, they rated their anticipated emotions if…

  16. Knowledge Of Hiv, Sexua Behagior And Correlates Of Risky Sex ...

    African Journals Online (AJOL)

    , sexual activity, exposure to HIV-prevention services, and to identify correlates of risky sexual behaviour (not having used a condom at first or last sexual encounter and/or having multiple sexual partners over a 12-month period) among street ...

  17. Living with parents and risky sexual behaviors among preparatory ...

    African Journals Online (AJOL)

    Background: Risky sexual behavior is any behavior that increases the probability of negative consequences associated with sexual contact. Family environment, peer influence, community factors and school attachment seem an important factor affecting sexual risk behavior and decision of in-school youths. Objective: To ...

  18. Locus of control and investment in risky assets

    NARCIS (Netherlands)

    Salamanca Acosta, N.; de Grip, A.; Fouarge, D.; Montizaan, R.M.

    2013-01-01

    Using representative household panel data, we show that the investment behavior of households is related to the economic locus of control of household heads. A household’s internal locus of control in economic issues is positively related to its decision to hold risky assets as well as its share of

  19. Locus of control and investment in risky assets

    NARCIS (Netherlands)

    Salamanca, N.; de Grip, A.; Fouarge, D.; Montizaan, R.M.

    2013-01-01

    Using representative household panel data, we show that the investment behavior of households is related to the economic locus of control of household heads. A household's internal locus of control in economic issues is positively related to its decision to hold risky assets as well as its share of

  20. Risky sexual behaviour and associated factors among students of ...

    African Journals Online (AJOL)

    Descriptive and stepwise logistic regression model was carried out using SPSS version 21. ... (STI) were 16 times more likely to have early sexual contact compared to those students who ... Key words: Risky sexual behaviours, University students, Debre Tabor. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT

  1. The staying safe intervention: training people who inject drugs in strategies to avoid injection-related HCV and HIV infection.

    Science.gov (United States)

    Mateu-Gelabert, Pedro; Gwadz, Marya Viorst; Guarino, Honoria; Sandoval, Milagros; Cleland, Charles M; Jordan, Ashly; Hagan, Holly; Lune, Howard; Friedman, Samuel R

    2014-04-01

    This pilot study explores the feasibility and preliminary efficacy of the Staying Safe Intervention, an innovative, strengths-based program to facilitate prevention of infection with the human immunodeficiency virus and with the hepatitis C virus among people who inject drugs (PWID). The authors explored changes in the intervention's two primary endpoints: (a) frequency and amount of drug intake, and (b) frequency of risky injection practices. We also explored changes in hypothesized mediators of intervention efficacy: planning skills, motivation/self-efficacy to inject safely, skills to avoid PWID-associated stigma, social support, drug-related withdrawal symptoms, and injection network size and risk norms. A 1-week, five-session intervention (10 hours total) was evaluated using a pre- versus 3-month posttest design. Fifty-one participants completed pre- and posttest assessments. Participants reported significant reductions in drug intake and injection-related risk behavior. Participants also reported significant increases in planning skills, motivation/self-efficacy, and stigma management strategies, while reducing their exposure to drug withdrawal episodes and risky injection networks.

  2. Non-steroidal anti-inflammatory drug related upper gastrointestinal bleeding: types of drug use and patient profiles in real clinical practice.

    Science.gov (United States)

    Sostres, Carlos; Carrera-Lasfuentes, Patrica; Lanas, Angel

    2017-10-01

    The best available evidence regarding non-steroidal anti-inflammatory drug (NSAID)-related gastrointestinal (GI) bleeding comes from randomized controlled trials including patients who use NSAIDs to manage chronic rheumatic diseases; however, patients with varying background profiles commonly take NSAIDs for many other reasons, often without prescription, and such usage has not been well studied. To define the characteristics of patients hospitalized for upper GI bleeding in clinical practice, we conducted a case-control study among patients with endoscopy-proven major upper GI bleeding due to gastroduodenal peptic lesions and control subjects. We used adjusted logistic regression models to estimate bleeding risks. Data analysis was performed using SPSS 22.0. Our analysis included 3785 cases and 6540 controls, including 1270 cases (33.55%) and 834 controls (12.75%) reporting recent use (upper GI bleeding, with an adjusted relative risk of 4.86 (95% CI, 4.32-5.46). Acute musculoskeletal pain (36.1%), chronic osteoarthritis (13.5%), and headache (13.6%) were the most common reasons for NSAID use. Among cases, only 17.31% took NSAIDs and 6.38% took high dose ASA due to chronic osteoarthritis. Demographic characteristics significantly differed between subjects with chronic vs. acute musculoskeletal pain. Proton pump inhibitor use was significantly higher in patients who used NSAIDs due to chronic osteoarthritis compared to patients with acute musculoskeletal pain. NSAID (65.15%) or high-dose ASA use (65.83%) preceding upper GI bleeding was most often short-term. In over half of cases (63.62%), the upper GI bleeding event was not preceded by dyspeptic warning symptoms. The majority of patients hospitalized due to NSAID-related upper GI bleeding reported short-term NSAID use for reasons other than chronic rheumatic disease. These findings suggest that current prevention strategies may not reach a wide population of short-term NSAID users.

  3. Risky Business? Rural Entrepreneurship in Subsistence Markets

    NARCIS (Netherlands)

    Cieslik, Katarzyna; D’Aoust, Olivia

    2017-01-01

    Present-day development theory and practice highlight the potential of micro-entrepreneurship for poverty reduction in rural Africa. At the same time, subsequent studies show that entrepreneurial propensity is not often exhibited by subsistence farmers. Basing our analysis on a cross-section

  4. The context of HIV risk behaviours among HIV-positive injection drug users in Viet Nam: Moving toward effective harm reduction

    Directory of Open Access Journals (Sweden)

    Thanh Duong

    2009-04-01

    Full Text Available Abstract Background Injection drug users represent the largest proportion of all HIV reported cases in Viet Nam. This study aimed to explore the perceptions of risk and risk behaviours among HIV-positive injection drug users, and their experiences related to safe injection and safe sex practices. Methods This study used multiple qualitative methods in data collection including in-depth interviews, focus group discussions and participant observation with HIV-positive injection drug users. Results The informants described a change in the sharing practices among injection drug users towards more precautions and what was considered 'low risk sharing', like sharing among seroconcordant partners and borrowing rather than lending. However risky practices like re-use of injection equipment and 'syringe pulling' i.e. the use of left-over drugs in particular, were frequently described and observed. Needle and syringe distribution programmes were in place but carrying needles and syringes and particularly drugs could result in being arrested and fined. Fear of rejection and of loss of intimacy made disclosure difficult and was perceived as a major obstacle for condom use among recently diagnosed HIV infected individuals. Conclusion HIV-positive injection drug users continue to practice HIV risk behaviours. The anti-drug law and the police crack-down policy appeared as critical factors hampering ongoing prevention efforts with needle and syringe distribution programmes in Viet Nam. Drastic policy measures are needed to reduce the very high HIV prevalence among injection drug users.

  5. Risky sexual behaviors among female youth in Tiss Abay, a semi-urban area of the Amhara Region, Ethiopia.

    Directory of Open Access Journals (Sweden)

    Gojjam Tadesse

    Full Text Available Little is known about sexual risks and associated factors about female youths in semi-urban areas of Ethiopia. This study aimed to describe the nature and magnitude of risky sexual behaviors, and the socio-demographic and behavioral determinants among female youths in Tiss Abay, a semi-urban area on the outskirts of Bahir Dar City of the Amhara Region in northern Ethiopia.A cross-sectional census type study was conducted among female youths who were unmarried and aged 15-29 years in September 2011.711 female youths participated in the study, with the mean age of initiation of sex of 78.6% being16.73±2.53 years. Only 52(9.3% used condom during the first sex. Within the last 12 months, 509(71.6% had sexual intercourse and 278(54.6% had two or more sex partners, and 316(62.1% did not use condom during their last sex. Sex under the influence of substances was reported by 350(68.8%, and a third of the recent sexes were against the will of participants. One or more risky sexual practices were reported by 503(70.3% participants, including: multiple sexual partnerships, inconsistently using or not using condoms, sex under the influence of alcohol and/or sex immediately after watching pornography. Age group, current marital status, drinking homemade alcohol, chewing 'khat', watching pornography and using any form of stimulant substances were the predictors of risky sexual behavior. Watching pornography before sex and sex for transaction were the predicators of not using condom during most recent sex.Risky sexual behaviors were very common among the female youths in Tiss Abay. Initiation of context-based interventions, such as raising awareness about the risks, safer sex practices, condom promotion and integration of gender issues in the programs are recommended.

  6. Risky sexual behaviors among female youth in Tiss Abay, a semi-urban area of the Amhara Region, Ethiopia.

    Science.gov (United States)

    Tadesse, Gojjam; Yakob, Bereket

    2015-01-01

    Little is known about sexual risks and associated factors about female youths in semi-urban areas of Ethiopia. This study aimed to describe the nature and magnitude of risky sexual behaviors, and the socio-demographic and behavioral determinants among female youths in Tiss Abay, a semi-urban area on the outskirts of Bahir Dar City of the Amhara Region in northern Ethiopia. A cross-sectional census type study was conducted among female youths who were unmarried and aged 15-29 years in September 2011. 711 female youths participated in the study, with the mean age of initiation of sex of 78.6% being16.73±2.53 years. Only 52(9.3%) used condom during the first sex. Within the last 12 months, 509(71.6%) had sexual intercourse and 278(54.6%) had two or more sex partners, and 316(62.1%) did not use condom during their last sex. Sex under the influence of substances was reported by 350(68.8%), and a third of the recent sexes were against the will of participants. One or more risky sexual practices were reported by 503(70.3%) participants, including: multiple sexual partnerships, inconsistently using or not using condoms, sex under the influence of alcohol and/or sex immediately after watching pornography. Age group, current marital status, drinking homemade alcohol, chewing 'khat', watching pornography and using any form of stimulant substances were the predictors of risky sexual behavior. Watching pornography before sex and sex for transaction were the predicators of not using condom during most recent sex. Risky sexual behaviors were very common among the female youths in Tiss Abay. Initiation of context-based interventions, such as raising awareness about the risks, safer sex practices, condom promotion and integration of gender issues in the programs are recommended.

  7. Predictive performance of three practical approaches for grapefruit juice-induced 2-fold or greater increases in AUC of concomitantly administered drugs.

    Science.gov (United States)

    Takahashi, M; Onozawa, S; Ogawa, R; Uesawa, Y; Echizen, H

    2015-02-01

    Clinical pharmacists have a challenging task when answering patients' question about whether they can take specific drugs with grapefruit juice (GFJ) without risk of drug interaction. To identify the most practicable method for predicting clinically relevant changes in plasma concentrations of orally administered drugs caused by the ingestion of GFJ, we compared the predictive performance of three methods using data obtained from the literature. We undertook a systematic search of drug interactions associated with GFJ using MEDLINE and the Metabolism & Transport Drug Interaction Database (DIDB version 4.0). We considered an elevation of the area under the plasma concentration-time curve (AUC) of 2 or greater relative to the control value [AUC ratio (AUCR) ≥ 2.0] as a clinically significant interaction. The data from 74 drugs (194 data sets) were analysed. When the reported information of CYP3A involvement in the metabolism of a drug of interest was adopted as a predictive criterion for GFJ-drug interaction, the performance assessed by positive predictive value (PPV) was low (0.26), but that assessed by negative predictive value (NPV) and sensitivity was high (1.00 for both). When the reported oral bioavailability of ≤ 0.1 was used as a criterion, the PPV improved to 0.50 with an acceptable NPV of 0.81, but sensitivity was reduced to 0.21. When the reported AUCR was ≥ 10 after co-administration of a typical CYP3A inhibitor, the corresponding values were 0.64, 0.79 and 0.19, respectively. We consider that an oral bioavailability of ≤ 0.1 or an AUCR of ≥ 10 caused by a CYP3A inhibitor of a drug of interest may be a practical prediction criterion for avoiding significant interactions with GFJ. Information about the involvement of CYP3A in their metabolism should also be taken into account for drugs with narrow therapeutic ranges. © 2014 John Wiley & Sons Ltd.

  8. Preventing Drug Abuse Among Hispanic Adolescents: Developing a Responsive Intervention Approach.

    Science.gov (United States)

    Schinke, Steven P; Schwinn, Traci M; Hursh, Hilary A

    2015-10-01

    Intervention research is essential to help Hispanic American adolescents avoid drug use. This article describes an intervention research program aimed at preventing drug use among these youths. Grounded in salient epidemiological data, the program is informed by bicultural competence, social learning, and motivational interviewing theories. The program, called Vamos, is aimed at the risk and protective factors as well as the cultural prerogatives that demark the adolescent years of Hispanic American youths. Innovative in its approach, the program is delivered through a smartphone application (app). By interacting with engaging content presented via the app, youths can acquire the cognitive-behavioral skills necessary to avoid risky situations, urges, and pressures associated with early drug use. The intervention development process is presented in detail, and an evaluation plan to determine the program's efficacy is outlined. Lessons for practice and intervention programming are discussed.

  9. An analysis of respondent-driven sampling with injecting drug users in a high HIV prevalent state of India.

    Science.gov (United States)

    Phukan, Sanjib Kumar; Medhi, Gajendra Kumar; Mahanta, Jagadish; Adhikary, Rajatashuvra; Thongamba, Gay; Paranjape, Ramesh S; Akoijam, Brogen S

    2017-07-03

    Personal networks are significant social spaces to spread of HIV or other blood-borne infections among hard-to-reach population, viz., injecting drug users, female sex workers, etc. Sharing of infected needles or syringes among drug users is one of the major routes of HIV transmission in Manipur, a high HIV prevalence state in India. This study was carried out to describe the network characteristics and recruitment patterns of injecting drug users and to assess the association of personal network with injecting risky behaviors in Manipur. A total of 821 injecting drug users were recruited into the study using respondent-driven sampling (RDS) from Bishnupur and Churachandpur districts of Manipur; data on demographic characteristics, HIV risk behaviors, and network size were collected from them. Transition probability matrices and homophily indices were used to describe the network characteristics, and recruitment patterns of injecting drug users. Univariate and multivariate binary logistic regression models were performed to analyze the association between the personal networks and sharing of needles or syringes. The average network size was similar in both the districts. Recruitment analysis indicates injecting drug users were mostly engaged in mixed age group setting for injecting practice. Ever married and new injectors showed lack of in-group ties. Younger injecting drug users had mainly recruited older injecting drug users from their personal network. In logistic regression analysis, higher personal network was found to be significantly associated with increased likelihood of injecting risky behaviors. Because of mixed personal network of new injectors and higher network density associated with HIV exposure, older injecting drug users may act as a link for HIV transmission or other blood-borne infections to new injectors and also to their sexual partners. The information from this study may be useful to understanding the network pattern of injecting drug users

  10. Percepción de padres y profesores de los factores de riesgo para el uso de drogas lícitas e ilicitas en los escolares Percepção de pais e profesores dos fatores de risco para o uso de drogas lícitas e ilícitas entre escolares Parents and teachers perception of the risky factors for legal and ilegal drugs consumption among students

    Directory of Open Access Journals (Sweden)

    Fátima Morán Sánchez

    2004-04-01

    falta de conhecimento dos pais e professores sobre o assunto das drogas. Além disso, querem obter mais informações sobre a prevenção do consumo para criar resistência entre as crianças.This work had the opportunity to know and analyze the parents and teachers' perception about the risky factors that influence in scholars for the legal and illegal consumption of drugs. The methodology focused is the qualitative one, of the descriptive explanatory type with the modality of case study. The sample consisted on 8 parents and 8 teachers from the 5th, 6th and 7th basic grades of the Fiscal Primary School, "Carmen Navarro Wither" from Guayaquil , Ecuador. To obtain the data, it was used the "focused group technique" and the observation participation. Also, the thematic containing analysis was done. During the develop of the focused group, it was showed by the parents and teachers a lot of interest and preoccupation about the topic and they perceived it as risky factors the following: The economic situation that commonly force the parents' emigration, the influence of the surroundings and the ignorance of parents and teachers about the drugs topic. Besides, they really would like to know and learn more the drugs' consumption prevention to raise, in this way, the children's rejection about it.

  11. Factors associated with drug-related harms related to policing in Tijuana, Mexico

    Science.gov (United States)

    2011-01-01

    Objective To assess factors associated with drug-related harms related to policing among injection drug users (IDUs) in Tijuana, Mexico. Methods IDUs who were over 18 years old and had injected drugs within the last six months were recruited via respondent-driven sampling and underwent questionnaires and testing for HIV (human immunodeficiency virus), syphilis and TB (tuberculosis). Random effects logistic regression was used to simultaneously model factors associated with five drug-related harms related to policing practices in the prior six months (i.e., police led them to rush injections; affected where they bought drugs; affected locations where they used drugs; feared that police will interfere with their drug use; receptive syringe sharing). Results Of 727 IDUs, 85% were male; median age was 38 years. Within the last 6 months, 231 (32%) of IDUs reported that police had led them to rush injections, affected where they bought or used drugs or were very afraid police would interfere with their drug use, or shared syringes. Factors independently associated with drug-related harms related to policing within the last six months included: recent arrest, homelessness, higher frequencies of drug injection, use of methamphetamine, using the local needle exchange program and perceiving a decrease in the purity of at least one drug. Conclusions IDUs who experienced drug-related harms related to policing were those who were most affected by other micro and macro influences in the physical risk environment. Police education programs are needed to ensure that policing practices do not exacerbate risky behaviors or discourage protective behaviors such as needle exchange program use, which undermines the right to health for people who inject drugs. PMID:21477299

  12. Factors associated with drug-related harms related to policing in Tijuana, Mexico

    Directory of Open Access Journals (Sweden)

    Patterson Thomas L

    2011-04-01

    Full Text Available Abstract Objective To assess factors associated with drug-related harms related to policing among injection drug users (IDUs in Tijuana, Mexico. Methods IDUs who were over 18 years old and had injected drugs within the last six months were recruited via respondent-driven sampling and underwent questionnaires and testing for HIV (human immunodeficiency virus, syphilis and TB (tuberculosis. Random effects logistic regression was used to simultaneously model factors associated with five drug-related harms related to policing practices in the prior six months (i.e., police led them to rush injections; affected where they bought drugs; affected locations where they used drugs; feared that police will interfere with their drug use; receptive syringe sharing. Results Of 727 IDUs, 85% were male; median age was 38 years. Within the last 6 months, 231 (32% of IDUs reported that police had led them to rush injections, affected where they bought or used drugs or were very afraid police would interfere with their drug use, or shared syringes. Factors independently associated with drug-related harms related to policing within the last six months included: recent arrest, homelessness, higher frequencies of drug injection, use of methamphetamine, using the local needle exchange program and perceiving a decrease in the purity of at least one drug. Conclusions IDUs who experienced drug-related harms related to policing were those who were most affected by other micro and macro influences in the physical risk environment. Police education programs are needed to ensure that policing practices do not exacerbate risky behaviors or discourage protective behaviors such as needle exchange program use, which undermines the right to health for people who inject drugs.

  13. Risky Sexual Behavior in HIV/AIDS

    Directory of Open Access Journals (Sweden)

    Levent Kiylioglu

    2017-06-01

    Full Text Available Sexual relations hold an important place in the life and development of the individual. However, it can cause health risks such as HIV infection without done the necessary protective measures. The purpose of this study is to review sexual behaviors which increase HIV infection and AIDS risk. This sexual behavior expressed as: anal sex, one-night stand, sex without condoms, sex with older persons, concurrent sexual relationships, using alcohol and illegal drugs before or during intercourse, and starting sex at an early age. Because HIV is likely to rise in accordance with the increase in the number of people the person had sexual intercourse, especially concurrent sexual behavior and one-night stand, the most effective way to stay away from HIV/AIDS risk is to have sexual intercourse only with stable partners who know each other's sexual history and use condoms regularly. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2017; 9(2.000: 147-162

  14. Awareness and Knowledge of Child and Adolescent Risky Behaviors: A Parent's Perspective.

    Science.gov (United States)

    Ahern, Nancy R; Kemppainen, Jeanne; Thacker, Paige

    2016-04-01

    Adolescence is a developmental stage marked by risk-taking and limited comprehension of dangers of risky behaviors. Previous research has focused on adolescents' perspective of risk with little evidence on parents' knowledge regarding risk. This qualitative study examined parental knowledge and perspectives of child/teen risk behaviors associated with salvia, sexting, inhalant use/abuse, and self/participant-assisted choking. A sample of 30 parents of children/teens aged 10-17 completed a self-administered survey based on Flanagan's critical incident technique. Data were analyzed according to Flanagan's guidelines. Two advanced practice nurses determined category reliability with 95% agreement. The survey yielded five categories of parental responses to potential risky behaviors in their child/teen including the following: talking to my children, setting up consequences, confronting the child, seeking help, and talking to others. Although the majority of the parents were aware of newer behaviors, less than one half of the participants reported discussing risks with their child/teen. One third reported that their child knew a friend who was thinking about/tried sexting. One quarter of parents reported that they were not monitoring their child/teen's media use. Study findings provide important implications for developing an evidence-based education intervention to improve parents' awareness, knowledge, and identification of risk behaviors in their children/teens. © 2016 Wiley Periodicals, Inc.

  15. Thrill and adventure seeking in risky driving at work: The moderating role of safety climate.

    Science.gov (United States)

    Wishart, Darren; Somoray, Klaire; Evenhuis, Amanda

    2017-12-01

    Introduction Within many industrialized countries, the leading cause of worker fatalities and serious injuries can be attributed to road trauma. In non-occupational research, high levels of sensation seeking personality, and specifically thrill and adventure seeking, have been associated with risky driving behaviors. In work driving literature, high organizational safety climate has been associated with reduced risky driving in work drivers. However, the extent that factors such as safety climate and thrill seeking interact in regard to work driving safety remains unclear, and the current research examined this interaction. Methods A total of 1,011 work drivers from four organizations participated in the research. Surveys were distributed online and hardcopies were sent via mail. The survey included measures of thrill and adventure seeking, safety climate and work-related driving behaviors, as well as questions relating to participant demographics and information about their work driving. Results The results demonstrated that safety climate significantly moderated the effect of thrill and adventure seeking trait on driving errors, driving violations, and driving while fatigued. Conclusion These results suggest that the development of a strong safety climate has the potential to improve work driving safety outcomes by reducing the impact of particular personality traits such as thrill seeking within an organizational context. Practical application To improve work driving safety, organizations and management need to develop strategies to encourage and foster positive work driving safety climate, particularly within work settings that may attract thrill and adventure seeking employees. Copyright © 2017. Published by Elsevier Ltd.

  16. Pills and pints: risky drinking and alcohol-related harms among regular ecstasy users in Australia.

    Science.gov (United States)

    Kinner, Stuart A; George, Jessica; Johnston, Jennifer; Dunn, Matthew; Degenhardt, Louisa

    2012-05-01

    A significant proportion of young Australians engage in risky alcohol consumption, and an increasing minority are regular ecstasy (3,4-methylenedioxymethamphetamine) users. Risky alcohol use, alone or in combination with ecstasy, is associated with a range of acute and chronic health risks. The aim of this study was to document the incidence and some health-related correlates of alcohol use, and concurrent alcohol and ecstasy use, among a large, national sample of regular ecstasy users (REU) in Australia. National, cross-sectional surveys of REU in Australia 2003-2008. Among REU in 2008 (n=678) usual alcohol use, psychological distress and health-related quality of life were measured using the Alcohol Use Disorders Identification Test, Kessler Psychological Distress Scale and Short Form-8 Survey respectively. Among REU in 2008, 36% reported high-risk patterns of usual alcohol consumption, 62% reported usually consuming more than five standard drinks with ecstasy, and 24% reported currently experiencing high or very high levels of psychological distress. Controlling for age and education, high-risk drinking among REU was associated with higher levels of psychological distress and poorer health-related functioning; however, the associations between concurrent alcohol and ecstasy use, and health outcomes, were not significant (P>0.05). A large and increasing proportion of REU in Australia engage in high-risk patterns of alcohol consumption, including in combination with ecstasy. High-risk alcohol consumption among this group is associated with adverse health-related outcomes. Prevention and harm reduction interventions for REU should incorporate messages about the risks associated with alcohol use. There is an ongoing need for youth-specific, coordinated alcohol and other drug and mental health services. © 2011 Australasian Professional Society on Alcohol and other Drugs.

  17. "The first shot": the context of first injection of illicit drugs, ongoing injecting practices, and hepatitis C infection in Rio de Janeiro, Brazil

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    Maria de Lourdes Aguiar Oliveira

    Full Text Available The context of first drug injection and its association with ongoing injecting practices and HCV (hepatitis C virus infection were investigated. Injection drug users (IDUs (N = 606 were recruited in "drug scenes" (public places, bars in Rio de Janeiro, Brazil, interviewed, and tested for HCV. Sharing of needles/syringes was more prevalent at the first injection (51.3% than at the baseline interview (36.8%. Those who shared syringes/needles at first injection were more likely to be currently engaged in direct/indirect sharing practices. Among young injectors (< 30 years, those reporting sharing of needles/ syringes at the first injection were about four times more likely to have been infected by HCV. Hepatitis C virus prevalence among active IDUs (n = 272 was 11%. Prison history and longer duration of drug injection were identified as independent predictors of HCV infection. To effectively curb HCV transmission among IDUs and minimize harms associated with risk behaviors, preventive strategies should target individuals initiating drug injection beginning with their very first injection and discourage the transition from non-injecting use to the self-injection of illicit drugs.

  18. Parenting Practices and Problem Behavior across Three Generations: Monitoring, Harsh Discipline, and Drug Use in the Intergenerational Transmission of Externalizing Behavior

    Science.gov (United States)

    Bailey, Jennifer A.; Hill, Karl G.; Oesterle, Sabrina; Hawkins, J. David

    2009-01-01

    Using data from grandparents (G1), parents (G2), and children (G3), this study examined continuity in parental monitoring, harsh discipline, and child externalizing behavior across generations, and the contribution of parenting practices and parental drug use to intergenerational continuity in child externalizing behavior. Structural equation and…

  19. Procedure of safe handling with cytostatic drugs

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    Kodžo Dragan

    2003-01-01

    Full Text Available Working group for safe handling with cytostatic drugs has been formed by the Ministry of Health, and it consists of professionals from IORS, Federal Bureau of Weights and Measures, Industrial Medicine, Institute of Hematology, Military Medical Academy, and Crown Agents. The aim of this working group is to prepare procedures for safe handling with cytostatic drugs, as well as program for educational seminar for nurses, medical technicians, and pharmaceutical technicians. The procedures will serve as a guide of good practice of oncology health care, and will refer to all actions that health care professionals carry out from the moment of drugs arrival to the pharmacy to the moment of their application. In the first segment of this procedure, general rules are given for working with cytotoxic agents, control for risky exposures, safe system of work, control of working environment, monitoring of the employees' health condition adequate protection in the working environment, protective equipment of the employees (gloves, mask, cap, eyeglasses, shoe covers, coats and chambers for vertical laminary air stream. Storing of cytostatics, procedure in case of accident, and waste handling and removal are also described in this segment. Fifty-three standard operational procedures are described in detail in the second segment. Training scheme for preparation of chemotherapy is given in the third segment - education related to various fields and practical part, which would be carried out through workshops, and at the end of the course participants would pass a test and obtain certificate. After the procedures for safe handling with cytostatics are legally regulated employer will have to provide minimum of protective equipment, special rooms for the drugs dissolving, chambers with laminar airflow, 6 hours working time, rotation of the staff working with drugs dissolving in intervals of every five years, higher efficiency, better health control. In conclusion

  20. Effects of organizational safety practices and perceived safety climate on PPE usage, engineering controls, and adverse events involving liquid antineoplastic drugs among nurses.

    Science.gov (United States)

    DeJoy, David M; Smith, Todd D; Woldu, Henok; Dyal, Mari-Amanda; Steege, Andrea L; Boiano, James M

    2017-07-01

    Antineoplastic drugs pose risks to the healthcare workers who handle them. This fact notwithstanding, adherence to safe handling guidelines remains inconsistent and often poor. This study examined the effects of pertinent organizational safety practices and perceived safety climate on the use of personal protective equipment, engineering controls, and adverse events (spill/leak or skin contact) involving liquid antineoplastic drugs. Data for this study came from the 2011 National Institute for Occupational Safety and Health (NIOSH) Health and Safety Practices Survey of Healthcare Workers which included a sample of approximately 1,800 nurses who had administered liquid antineoplastic drugs during the past seven days. Regression modeling was used to examine predictors of personal protective equipment use, engineering controls, and adverse events involving antineoplastic drugs. Approximately 14% of nurses reported experiencing an adverse event while administering antineoplastic drugs during the previous week. Usage of recommended engineering controls and personal protective equipment was quite variable. Usage of both was better in non-profit and government settings, when workers were more familiar with safe handling guidelines, and when perceived management commitment to safety was higher. Usage was poorer in the absence of specific safety handling procedures. The odds of adverse events increased with number of antineoplastic drugs treatments and when antineoplastic drugs were administered more days of the week. The odds of such events were significantly lower when the use of engineering controls and personal protective equipment was greater and when more precautionary measures were in place. Greater levels of management commitment to safety and perceived risk were also related to lower odds of adverse events. These results point to the value of implementing a comprehensive health and safety program that utilizes available hazard controls and effectively communicates

  1. Your resting brain CAREs about your risky behavior.

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    Christine L Cox

    2010-08-01

    Full Text Available Research on the neural correlates of risk-related behaviors and personality traits has provided insight into mechanisms underlying both normal and pathological decision-making. Task-based neuroimaging studies implicate a distributed network of brain regions in risky decision-making. What remains to be understood are the interactions between these regions and their relation to individual differences in personality variables associated with real-world risk-taking.We employed resting state functional magnetic resonance imaging (R-fMRI and resting state functional connectivity (RSFC methods to investigate differences in the brain's intrinsic functional architecture associated with beliefs about the consequences of risky behavior. We obtained an individual measure of expected benefit from engaging in risky behavior, indicating a risk seeking or risk-averse personality, for each of 21 participants from whom we also collected a series of R-fMRI scans. The expected benefit scores were entered in statistical models assessing the RSFC of brain regions consistently implicated in both the evaluation of risk and reward, and cognitive control (i.e., orbitofrontal cortex, nucleus accumbens, lateral prefrontal cortex, dorsal anterior cingulate. We specifically focused on significant brain-behavior relationships that were stable across R-fMRI scans collected one year apart. Two stable expected benefit-RSFC relationships were observed: decreased expected benefit (increased risk-aversion was associated with 1 stronger positive functional connectivity between right inferior frontal gyrus (IFG and right insula, and 2 weaker negative functional connectivity between left nucleus accumbens and right parieto-occipital cortex.Task-based activation in the IFG and insula has been associated with risk-aversion, while activation in the nucleus accumbens and parietal cortex has been associated with both risk seeking and risk-averse tendencies. Our results suggest that

  2. Preventing Risky Drinking in Veterans Treated with Prescription Opioids

    Science.gov (United States)

    2017-04-01

    subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. PLEASE DO NOT...pharmacy records, and the screening proce - dures to detect risky alcohol use in these individuals 15-Oct-2014 Task 3: Complete training for the two...has contributed to discussions about research design and statistical analyses, and provided updated power calculations to ad- dress reduced sample

  3. Multiattribute Risky Choice Behavior: The Editing of Complex Prospects

    OpenAIRE

    John W. Payne; Dan J. Laughhunn; Roy Crum

    1984-01-01

    This investigation draws upon concepts from prospect theory (Kahneman and Tversky [Kahneman, D., A. Tversky. 1979. Prospect theory: an analysis of decisions under risk. Econometrica 47 263--291.]) and multiattribute utility theory (Keeney and Raiffa [Keeney, R. L., H. Raiffa. 1976. Decisions with Multiple Objectives: Preferences and Value Tradeoffs. Wiley, New York.]) in an examination of the multiattribute risky choice behavior of 128 managers. The questions of how managers edit multiattribu...

  4. Influence of Social Settings on Risky Sexual Behavior

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    James B. Hittner

    2016-02-01

    Full Text Available This study investigated the relevance of social settings as predictors of risky sexual behavior. In a young adult sample (n = 324, M age = 20.2 years, we examined the association between frequency of attendance at five different settings and frequency of engaging in four risky sexual behaviors (i.e., unprotected intercourse when not drunk or high, unprotected intercourse when drunk or high, casual sex when not drunk or high, casual sex when drunk or high. Predictive associations were examined using negative binomial regression, and all analyses controlled for frequency of recent alcohol use and age at first use of alcohol. Greater attendance at fraternity/sorority parties predicted more frequent intercourse for females in the not drunk or high and drunk or high contexts, and more frequent casual sex for males in the not drunk or high context. Greater attendance at large private parties predicted more frequent intercourse for females in the not drunk or high context. Greater attendance at bars without dance floors predicted more frequent intercourse for males in the drunk or high context. These findings highlight the importance of socializing habits in understanding risky sexual behavior.

  5. Characterising and comparing drug-dispensing practices at animal health outlets in the Rift Valley, Kenya: an exploratory analysis (part II).

    Science.gov (United States)

    Higham, L E; Ongeri, W; Asena, K; Thrusfield, M V

    2016-12-01

    A mixed-method study was conducted in the Rift Valley of Kenya to characterise drug-dispensing practices amongst staff at animal health outlets and to explore perceptions of veterinary medicines amongst pastoralists and farmers. Forty structured questionnaires were administered to staff at animal health outlets, including franchise outlets of 'Sidai Africa Ltd.', and two focus group discussions were facilitated to explore the perceptions of local animal health services by a Maasai pastoralist group and a dairy farmer cooperative. Differences were detected in the characteristics of Sidai outlets, agrovets, pharmacies and dukas. A greater proportion of Sidai outlet staff selected drugs based on principles of responsible drug use than staff at other types of outlet, and technical qualifications and training were associated with responsible drug use. Across all outlet types, staff knowledge and training gaps were identified, including in the correct administration of medicines. The majority of drug sales are accompanied by verbal advice to farmers. Members of the Maasai pastoralist group were concerned about accidental self-medication, withdrawal periods, drug residues and the misuse of drugs due to a lack of quality information and advice. The dairy farmer group raised similar concerns, reporting under-dosing as a common mistake amongst farmers. This study concludes that current knowledge, attitudes and practices of many service providers and livestock owners in the sale, purchase and use of veterinary medicines present risks of drug misuse and therefore the emergence of antimicrobial resistance. There is a clear demand from livestock keepers for accessible, affordable and quality animal health services and products in Kenya, and animal health practitioners have the potential to provide increased support to livestock-based livelihoods and act as stewards of our existing portfolio of animal and human medicines.

  6. Patient factors influencing the prescribing of lipid lowering drugs for primary prevention of cardiovascular disease in UK general practice: a national retrospective cohort study.

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    Jianhua Wu

    Full Text Available Guidelines indicate eligibility for lipid lowering drugs, but it is not known to what extent GPs' follow guidelines in routine clinical practice or whether additional clinical factors systematically influence their prescribing decisions.A retrospective cohort analysis was undertaken using electronic primary care records from 421 UK general practices. At baseline (May 2008 patients were aged 30 to 74 years, free from cardiovascular disease and not taking lipid lowering drugs. The outcome was prescription of a lipid lowering drug within the next two years. The proportions of eligible and ineligible patients prescribed lipid lowering drugs were reported and multivariable logistic regression models were used to investigate associations between age, sex, cardiovascular risk factors and prescribing.Of 365,718 patients with complete data, 13.8% (50,558 were prescribed lipid lowering drugs: 28.5% (21,101/74,137 of those eligible and 10.1% (29,457/291,581 of those ineligible. Only 41.7% (21,101/50,558 of those prescribed lipid lowering drugs were eligible. In multivariable analysis prescribing was most strongly associated with increasing age (OR for age ≥ 65 years 4.21; 95% CI 4.05-4.39; diabetes (OR 4.49; 95% CI 4.35-4.64; total cholesterol level ≥ 7 mmol/L (OR 2.20; 95% CI 2.12-2.29; and ≥ 4 blood pressure measurements in the past year (OR 4.24; 95% CI 4.06-4.42. The predictors were similar in eligible and ineligible patients.Most lipid lowering drugs for primary prevention are prescribed to ineligible patients. There is underuse of lipid lowering drugs in eligible patients.

  7. Non-clinical studies in the process of new drug development - Part II: Good laboratory practice, metabolism, pharmacokinetics, safety and dose translation to clinical studies.

    Science.gov (United States)

    Andrade, E L; Bento, A F; Cavalli, J; Oliveira, S K; Schwanke, R C; Siqueira, J M; Freitas, C S; Marcon, R; Calixto, J B

    2016-12-12

    The process of drug development involves non-clinical and clinical studies. Non-clinical studies are conducted using different protocols including animal studies, which mostly follow the Good Laboratory Practice (GLP) regulations. During the early pre-clinical development process, also known as Go/No-Go decision, a drug candidate needs to pass through several steps, such as determination of drug availability (studies on pharmacokinetics), absorption, distribution, metabolism and elimination (ADME) and preliminary studies that aim to investigate the candidate safety including genotoxicity, mutagenicity, safety pharmacology and general toxicology. These preliminary studies generally do not need to comply with GLP regulations. These studies aim at investigating the drug safety to obtain the first information about its tolerability in different systems that are relevant for further decisions. There are, however, other studies that should be performed according to GLP standards and are mandatory for the safe exposure to humans, such as repeated dose toxicity, genotoxicity and safety pharmacology. These studies must be conducted before the Investigational New Drug (IND) application. The package of non-clinical studies should cover all information needed for the safe transposition of drugs from animals to humans, generally based on the non-observed adverse effect level (NOAEL) obtained from general toxicity studies. After IND approval, other GLP experiments for the evaluation of chronic toxicity, reproductive and developmental toxicity, carcinogenicity and genotoxicity, are carried out during the clinical phase of development. However, the necessity of performing such studies depends on the new drug clinical application purpose.

  8. Quantum Decision Theory in Simple Risky Choices.

    Science.gov (United States)

    Favre, Maroussia; Wittwer, Amrei; Heinimann, Hans Rudolf; Yukalov, Vyacheslav I; Sornette, Didier

    2016-01-01

    Quantum decision theory (QDT) is a recently developed theory of decision making based on the mathematics of Hilbert spaces, a framework known in physics for its application to quantum mechanics. This framework formalizes the concept of uncertainty and other effects that are particularly manifest in cognitive processes, which makes it well suited for the study of decision making. QDT describes a decision maker's choice as a stochastic event occurring with a probability that is the sum of an objective utility factor and a subjective attraction factor. QDT offers a prediction for the average effect of subjectivity on decision makers, the quarter law. We examine individual and aggregated (group) data, and find that the results are in good agreement with the quarter law at the level of groups. At the individual level, it appears that the quarter law could be refined in order to reflect individual characteristics. This article revisits the formalism of QDT along a concrete example and offers a practical guide to researchers who are interested in applying QDT to a dataset of binary lotteries in the domain of gains.

  9. Risky Bodies in the Plasma Bioeconomy

    Science.gov (United States)

    Farrell, Anne-Maree

    2015-01-01

    In 2003 the UK National Blood Service introduced a policy of ‘male donor preference’ which involved women’s plasma being discarded following blood collection. The policy was based on the view that data relating to the incidence of Transfusion-Related Acute Lung Injury (TRALI) was linked to transfusion with women’s plasma. While appearing to treat female donors as equal to male donors, exclusion criteria operate after donation at the stage of processing blood, thus perpetuating myths of universality even though only certain ‘extractions’ from women are retained for use in transfusion. Many women in the UK receive a plasma-derived product called Anti-D immunoglobulin which is manufactured from pooled male plasma. This article examines ways in which gender has significance for understanding blood relations, and how the blood economy is gendered. In our study of relations between blood donors and recipients, we explore how gendered bodies are produced through the discursive and material practices within blood services. We examine both how donation policies and the manufacturing and use of blood products produces gendered blood relations. PMID:26097401

  10. Quantum Decision Theory in Simple Risky Choices

    Science.gov (United States)

    Favre, Maroussia; Wittwer, Amrei; Heinimann, Hans Rudolf; Yukalov, Vyacheslav I.; Sornette, Didier

    2016-01-01

    Quantum decision theory (QDT) is a recently developed theory of decision making based on the mathematics of Hilbert spaces, a framework known in physics for its application to quantum mechanics. This framework formalizes the concept of uncertainty and other effects that are particularly manifest in cognitive processes, which makes it well suited for the study of decision making. QDT describes a decision maker’s choice as a stochastic event occurring with a probability that is the sum of an objective utility factor and a subjective attraction factor. QDT offers a prediction for the average effect of subjectivity on decision makers, the quarter law. We examine individual and aggregated (group) data, and find that the results are in good agreement with the quarter law at the level of groups. At the individual level, it appears that the quarter law could be refined in order to reflect individual characteristics. This article revisits the formalism of QDT along a concrete example and offers a practical guide to researchers who are interested in applying QDT to a dataset of binary lotteries in the domain of gains. PMID:27936217

  11. Examining characteristics, knowledge and regulatory practices of specialized drug shops in Sub-Saharan Africa: a systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Wafula Francis N

    2012-07-01

    Full Text Available Abstract Background Specialized drug shops such as pharmacies and drug shops are increasingly becoming important sources of treatment. However, knowledge on their regulatory performance is scarce. We set out to systematically review literature on the characteristics, knowledge and practices of specialized drug shops in Sub-Saharan Africa. Methods We searched PubMed, EMBASE, WEB of Science, CAB Abstracts, PsycINFO and websites for organizations that support medicine policies and usage. We also conducted open searches using Google Scholar, and searched manually through references of retrieved articles. Our search included studies of all designs that described characteristics, knowledge and practices of specialized drug shops. Information was abstracted on authors, publication year, country and location, study design, sample size, outcomes investigated, and primary findings using a uniform checklist. Finally, we conducted a structured narrative synthesis of the main findings. Results We obtained 61 studies, mostly from Eastern Africa, majority of which were conducted between 2006 and 2011. Outcome measures were heterogeneous and included knowledge, characteristics, and dispensing and regulatory practices. Shop location and client demand were found to strongly influence dispensing practices. Whereas shops located in urban and affluent areas were more likely to provide correct treatments, those in rural areas provided credit facilities more readily. However, the latter also charged higher prices for medicines. A vast majority of shops simply sold whatever medicines clients requested, with little history taking and counseling. Most shops also stocked popular medicines at the expense of policy recommended treatments. Treatment policies were poorly communicated overall, which partly explained why staff had poor knowledge on key aspects of treatment such as medicine dosage and side effects. Overall, very little is known on the link between regulatory

  12. Examining characteristics, knowledge and regulatory practices of specialized drug shops in Sub-Saharan Africa: a systematic review of the literature.

    Science.gov (United States)

    Wafula, Francis N; Miriti, Eric M; Goodman, Catherine A

    2012-07-27

    Specialized drug shops such as pharmacies and drug shops are increasingly becoming important sources of treatment. However, knowledge on their regulatory performance is scarce. We set out to systematically review literature on the characteristics, knowledge and practices of specialized drug shops in Sub-Saharan Africa. We searched PubMed, EMBASE, WEB of Science, CAB Abstracts, PsycINFO and websites for organizations that support medicine policies and usage. We also conducted open searches using Google Scholar, and searched manually through references of retrieved articles. Our search included studies of all designs that described characteristics, knowledge and practices of specialized drug shops. Information was abstracted on authors, publication year, country and location, study design, sample size, outcomes investigated, and primary findings using a uniform checklist. Finally, we conducted a structured narrative synthesis of the main findings. We obtained 61 studies, mostly from Eastern Africa, majority of which were conducted between 2006 and 2011. Outcome measures were heterogeneous and included knowledge, characteristics, and dispensing and regulatory practices. Shop location and client demand were found to strongly influence dispensing practices. Whereas shops located in urban and affluent areas were more likely to provide correct treatments, those in rural areas provided credit facilities more readily. However, the latter also charged higher prices for medicines. A vast majority of shops simply sold whatever medicines clients requested, with little history taking and counseling. Most shops also stocked popular medicines at the expense of policy recommended treatments. Treatment policies were poorly communicated overall, which partly explained why staff had poor knowledge on key aspects of treatment such as medicine dosage and side effects. Overall, very little is known on the link between regulatory enforcement and practices of specialized drug shops

  13. Usual care and management of fall risk increasing drugs in older dizzy patients in Dutch general practice

    Science.gov (United States)

    Stam, Hanneke; Harting, Thomas; van der Sluijs, Marjolijn; van Marum, Rob; van der Horst, Henriëtte; van der Wouden, Johannes C.; Maarsingh, Otto R.

    2016-01-01

    Objective For general practitioners (GPs) dizziness is a challenging condition to deal with. Data on the management of dizziness in older patients are mostly lacking. Furthermore, it is unknown whether GPs attempt to decrease Fall Risk Increasing Drugs (FRIDs) use in the management of dizziness in older patients. The aim of this study is to gain more insight into GP’s management of dizziness in older patients, including FRID evaluation and adjustment. Design Data were derived from electronic medical records, obtained over a 12-month period in 2013. Setting Forty-six Dutch general practices. Patients The study sample comprised of 2812 older dizzy patients of 65 years and over. Patients were identified using International Classification of Primary Care codes and free text. Main outcome measures Usual care was categorized into wait-and-see strategy (no treatment initiated); education and advice; additional testing; medication adjustment; and referral. Results Frequently applied treatments included a wait-and-see strategy (28.4%) and education and advice (28.0%). Additional testing was performed in 26.8%; 19.0% of the patients were referred. Of the patients 87.2% had at least one FRID prescription. During the observation period, GPs adjusted the use of one or more FRIDs for 11.7% of the patients. Conclusion This study revealed a wide variety in management strategies for dizziness in older adults. The referral rate for dizziness was high compared to prior research. Although many older dizzy patients use at least one FRID, FRID evaluation and adjustment is scarce. We expect that more FRID adjustments may reduce dizziness and dizziness-related impairment. Key PointsIt is important to know how general practitioners manage dizziness in older patients in order to assess potential cues for improvement.This study revealed a wide variety in management strategies for dizziness in older patients.There was a scarcity in Fall Risk Increasing Drug (FRID) evaluation and adjustment

  14. Drug Repurposing Is a New Opportunity for Developing Drugs against Neuropsychiatric Disorders

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    Hyeong-Min Lee

    2016-01-01

    Full Text Available Better the drugs you know than the drugs you do not know. Drug repurposing is a promising, fast, and cost effective method that can overcome traditional de novo drug discovery and development challenges of targeting neuropsychiatric and other disorders. Drug discovery and development targeting neuropsychiatric disorders are complicated because of the limitations in understanding pathophysiological phenomena. In addition, traditional de novo drug discovery and development are risky, expensive, and time-consuming processes. One alternative approach, drug repurposing, has emerged taking advantage of off-target effects of the existing drugs. In order to identify new opportunities for the existing drugs, it is essential for us to understand the mechanisms of action of drugs, both biologically and pharmacologically. By doing this, drug repurposing would be a more effective method to develop drugs against neuropsychiatric and other disorders. Here, we review the difficulties in drug discovery and development in neuropsychiatric disorders and the extent and perspectives of drug repurposing.

  15. Relationship between Drugs Use and Sexual Risk Behaviors among Senior High School Students

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    Yola Yuniaarti Herijanto

    2017-03-01

    Full Text Available Background: Drugs use and risky sexual behavior among teenager are some of crucial problems arising in Indonesia. Statistic showed that there is an increasing prevalence in drugs use and risky sexual behavior among teenagers. This study was conducted to analyze the relationship between drugs use and risky sexual behaviors among high school students. Methods: An analytic study involving 432 students in 5 state high schools located in Kerees region Bandung, West Java, Indonesia, was carried out in 2013. The region was chosen due the high prevalence of substance abuse. The inclusion criteria were every high school students in the Karees region. The exclusion criteria were the students who refused to participate in the study, did not come when the sample was taken, and did not fill the questionnaire completely. The instruments used for the study were questionnaires with cross-sectional technique. Furthermore, the questionnaire used for analyzing drugs use was Addiction Severity Index-Lite Version (ASI-lite questionnaire; with additional questionnaire to analyze risky sexual behaviors. Results: Out of 432 students, 23.8% students already engaged to one or more risky sexual behavior. Among all respondents, the prevalence of students who had already done kissing was 22.7%, necking 9.3%, petting 7.2% and sexual intercourse 1.2%. Illegal drugs had been used at least once by 21.8% students. According to Chi-square test, drugs use and risky sexual behavior were related. Conclusions:The prevalence of both drugs use and risky sexual behaviors are high and students who use drugs are more prone to do risky sexual behavior.

  16. California drug courts: outcomes, costs and promising practices: an overview of Phase II in a statewide study.

    Science.gov (United States)

    Carey, Shannon M; Finigan, Michael; Crumpton, Dave; Waller, Mark

    2006-11-01

    The rapid expansion of drug courts in California and the state's uncertain fiscal climate highlighted the need for definitive cost information on drug court programs. This study focused on creating a research design that can be utilized for statewide and national cost-assessment of drug courts by conducting in-depth case studies of the costs and benefits in nine adult drug courts in California. A Transactional Institutional Costs Analysis (TICA) approach was used, allowing researchers to calculate costs based on every individual's transactions within the drug court or the traditional criminal justice system. This methodology also allows the calculation of costs and benefits by agency (e.g., Public Defender's office, court, District Attorney). Results in the nine sites showed that the majority of agencies save money in processing an offender though drug court. Overall, for these nine study sites, participation in drug court saved the state over 9 million dollars in criminal justice and treatment costs due to lower recidivism in drug court participants. Based on the lessons learned in Phases I and II, Phase III of this study focuses on the creation of a web-based drug court cost self-evaluation tool (DC-CSET) that drug courts can use to determine their own costs and benefits.

  17. Substance use and risky sexual behaviours among sexually experienced Ghanaian youth

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    Doku David

    2012-07-01

    Full Text Available Abstract Background The association between risky sexual behaviours and substance uses among Ghanaian youth were investigated. Methods An in-school cross-sectional representative survey was conducted among 12-18-year- old youth in Ghana in 2008 (N = 1195, response rate =90%. Logistic regression analyses were employed to investigate the association between substance use (tobacco use, drunkenness, marijuana use and other drug uses and risky sexual behaviours (sexual debut, condom use and number of sexual partners. Results Of all youth, 25% (28% boys and 23% girls were sexually experienced. The mean age for first sexual intercourse was 14.8 years (14.4 years for boys and 15.1 years for girls. Among the sexually experienced, 31% had multiple sexual partners. Older age (OR = 3.4, 95% CI = 1.7-3.4 and rural residency (OR = 1.5, 95% CI = 1.1-2.1 were independently associated with sexual debut while only older age (OR = 2.4, 95% CI = 1.7-3.4 was associated with condom use. Additionally, smoking (OR = 3.7, 95% CI = 2.0-6.8, tawa use (OR = 2.4, 95% CI = 1.3-4.7, tobacco use (OR = 2.8, 95% CI = 1.7-4.7 drunkenness (OR = 1.7, 95% CI = 1.1-2.8 and marijuana use (OR = 3.3, 95% CI = 1.6-7.0 were independently associated with sexual debut. Furthermore, all substance uses studied were associated with having one or multiple sexual partners. Conclusion Substance use seems to be a gateway for risky sexual behaviours among Ghanaian youth. Public health interventions should take into account the likelihood of substance use among sexually experienced youth.

  18. Knowledge, attitudes, and practices related to uterotonic drugs during childbirth in Karnataka, India: a qualitative research study.

    Directory of Open Access Journals (Sweden)

    Nitya Nand Deepak

    Full Text Available BACKGROUND AND OBJECTIVES: India has the highest annual number of maternal deaths of any country. As obstetric hemorrhage is the leading cause of maternal death in India, numerous efforts are under way to promote access to skilled attendance at birth and emergency obstetric care. Current initiatives also seek to increase access to active management of the third stage of labor for postpartum hemorrhage prevention, particularly through administration of an uterotonic after delivery. However, prior research suggests widespread inappropriate use of uterotonics at facilities and in communities-for example, without adequate monitoring or referral support for complications. This qualitative study aimed to document health providers' and community members' current knowledge, attitudes, and practices regarding uterotonic use during labor and delivery in India's Karnataka state. METHODS: 140 in-depth interviews were conducted from June to August 2011 in Bagalkot and Hassan districts with physicians, nurses, recently delivered women, mothers-in-law, traditional birth attendants (dais, unlicensed village doctors, and chemists (pharmacists. RESULTS: Many respondents reported use of uterotonics, particularly oxytocin, for labor augmentation in both facility-based and home-based deliveries. The study also identified contextual factors that promote inappropriate uterotonic use, including high value placed on pain during labor; perceived pressure to provide or receive uterotonics early in labor and delivery, perhaps leading to administration of uterotonics despite awareness of risks; and lack of consistent and correct knowledge regarding safe storage, dosing, and administration of oxytocin. CONCLUSIONS: These findings have significant implications for public health programs in a context of widespread and potentially increasing availability of uterotonics. Among other responses, efforts are needed to improve communication between community members and providers

  19. Knowledge, attitudes, and practices related to uterotonic drugs during childbirth in Karnataka, India: a qualitative research study.

    Science.gov (United States)

    Deepak, Nitya Nand; Mirzabagi, Ellie; Koski, Alissa; Tripathi, Vandana

    2013-01-01

    India has the highest annual number of maternal deaths of any country. As obstetric hemorrhage is the leading cause of maternal death in India, numerous efforts are under way to promote access to skilled attendance at birth and emergency obstetric care. Current initiatives also seek to increase access to active management of the third stage of labor for postpartum hemorrhage prevention, particularly through administration of an uterotonic after delivery. However, prior research suggests widespread inappropriate use of uterotonics at facilities and in communities-for example, without adequate monitoring or referral support for complications. This qualitative study aimed to document health providers' and community members' current knowledge, attitudes, and practices regarding uterotonic use during labor and delivery in India's Karnataka state. 140 in-depth interviews were conducted from June to August 2011 in Bagalkot and Hassan districts with physicians, nurses, recently delivered women, mothers-in-law, traditional birth attendants (dais), unlicensed village doctors, and chemists (pharmacists). Many respondents reported use of uterotonics, particularly oxytocin, for labor augmentation in both facility-based and home-based deliveries. The study also identified contextual factors that promote inappropriate uterotonic use, including high value placed on pain during labor; perceived pressure to provide or receive uterotonics early in labor and delivery, perhaps leading to administration of uterotonics despite awareness of risks; and lack of consistent and correct knowledge regarding safe storage, dosing, and administration of oxytocin. These findings have significant implications for public health programs in a context of widespread and potentially increasing availability of uterotonics. Among other responses, efforts are needed to improve communication between community members and providers regarding uterotonic use during labor and delivery and to target training and

  20. Virtually 'in the heat of the moment': insula activation in safe sex negotiation among risky men.

    Science.gov (United States)

    Smith, Benjamin J; Xue, Feng; Droutman, Vita; Barkley-Levenson, Emily; Melrose, A James; Miller, Lynn C; Monterosso, John R; Bechara, Antoine; Appleby, Paul R; Christensen, John L; Godoy, Carlos G; Read, Stephen J

    2018-01-01

    HIV is most prevalent among men who have sex with men (MSM), and although most MSM use condoms consistently during casual sex, some take risks. To better understand the psychology of those risky decisions, we examined neural correlates of playing a virtual sexual 'hook up' game in an functional magnetic resonance imaging scanner in MSM who had, in the past 90 days, been sexually risky (N = 76) or safe (N = 31). We found that during potentially risky sexual choices, previously risky MSM had more right insula activity than previously safe MSM. Real-life sexual risk was related to trait positive and negative urgency. Insula activity that differentiated risky and safe MSM was related to trait positive and negative urgency. Future work should further examine if, and to what extent, insula activation during safe sex negotiation drives MSM's rash risky sexual decision-making. © The Author (2017). Published by Oxford University Press.

  1. Acute disinhibiting effects of alcohol as a factor in risky driving behavior

    Science.gov (United States)

    Fillmore, Mark T.; Blackburn, Jaime S.; Harrison, Emily L. R.

    2008-01-01

    Automobile crash reports show that up to 40% of fatal crashes in the United States involve alcohol and that younger drivers are over-represented. Alcohol use among young drivers is associated with impulsive and risky driving behaviors, such as speeding, which could contribute to their over-representation in alcohol-related crash statistics. Recent laboratory studies show that alcohol increases impulsive behaviors by impairing the drinker’s ability to inhibit inappropriate actions and that this effect can be exacerbated in conflict situations where the expression and inhibition of behavior are equally motivating. The present study tested the hypothesis that this response conflict might also intensify the disruptive effects of alcohol on driving performance. Fourteen subjects performed a simulated driving and a cued go/no-go task that measured their inhibitory control. Conflict was motivated in these tasks by providing equal monetary incentives for slow, careful behavior (e.g., slow driving, inhibiting impulses) and for quick, abrupt behavior (fast driving, disinhibition). Subjects were tested under two alcohol doses (0.65 g/kg and a placebo) that were administered twice: when conflict was present and when conflict was absent. Alcohol interacted with conflict to impair inhibitory control and to increase risky and impaired driving behavior on the drive task. Also, individuals whose inhibitory control was most impaired by alcohol displayed the poorest driving performance under the drug. The study demonstrates potentially serious disruptions to driving performance as a function of alcohol intoxication and response conflict, and points to inhibitory control as an important underlying mechanism. PMID:18325693

  2. Economic Booms and Risky Sexual Behavior: Evidence from Zambian Copper Mining Cities

    OpenAIRE

    Nicholas Wilson

    2010-01-01

    Existing studies suggest that individual and household level economic shocks affect the demand for and supply of risky sex. However, little evidence exists on the effects of an aggregate shock on equilibrium risky sexual behavior. This paper examines the effects of the early twenty-first century copper boom on risky sexual behavior in Zambian copper mining cities. The results indicate that the copper boom substantially reduced rates of transactional sex and multiple partnerships in copper min...

  3. Exploring adolescents' perceptions of risky behaviour using the mobile phone / N. Gois De Gouveia.

    OpenAIRE

    De Gouveia, Natalie Gois

    2013-01-01

    The aim of this study was to examine adolescent perceptions of risky behaviour using a mobile phone. This research may contribute to creating an awareness of risky and healthy adolescent uses of mobile phones. Anonymous sketches were collected from Grade 10 learners depicting their understanding of risky behaviour using the mobile phone. Thereafter, 12 learners agreed, through informed consent, to participate in semi-structured interviews. All participants considered the mobile phone an i...

  4. Is physician adherence to prescription guidelines a general trait of health care practices or dependent on drug type?--a multilevel logistic regression analysis in South Sweden.

    Science.gov (United States)

    Ohlsson, Henrik; Merlo, Juan

    2009-08-01

    Therapeutic traditions at health care practices (HCPs) influence physicians' adherence to prescription guidelines for specific drugs, however, it is not known if such traditions affect all kinds of prescriptions or only specific types of drug. Our goal was to determine whether adherence to prescription guidelines is a common trait of HCPs or dependent on drug type. We fitted separate multi-level logistic regression models to all patients in the Skåne region who received a prescription for a statin drug (ATC: C10AA, n = 6232), an agent acting on the renin-angiotensin system (ATC: C09, n = 7222) or a proton pump inhibitor (ATC: A02BC, n = 11 563) at 198 HCPs from July 2006 to December 2006. There was a high clustering of adherence to prescription guidelines at HCPs for the different drug types (MOR(agents acting on the renin-angiotensin system) = 4.72 [95% CI: 3.90-5.92], MOR(Statins) = 2.71 [95% CI: 2.23-3.39] and MOR(Proton pump inhibitors) = 2.16 [95% CI: 1.95-2.45]). Compared with HCPs with low adherence to guidelines in two drug types, those HCPs with the highest level of adherence for these two drug types also showed a higher probability of adherence for the third drug type. Physicians' decisions to follow prescription guidelines seem to be influenced by therapeutic traditions at the HCP. Moreover, these therapeutic traditions seem to affect all kinds of prescriptions. This information can be used as basis for interventions to support rational and cost-effective medication use. Copyright 2009 John Wiley & Sons, Ltd.

  5. From risky behaviour to sexy adventures: reconceptualising young people's online sexual activities.

    Science.gov (United States)

    Naezer, Marijke

    2018-06-01

    Western discourses about young people and sexuality centre around the concept of risk. Anxieties have been fuelled by the increasing popularity of social media and practices such as 'sexting' and watching 'sexually explicit' materials online. Research has shown however that such risk discourses mainly serve to moralise about, pathologise and police particular behaviours and children. In order to counter such paternalism, researchers advocated a reconceptualisation of youth not as passive victims, but as active agents who actively negotiate sexual experiences and discourses. In this paper, which is based on ethnographic fieldwork among young people in The Netherlands, I argue that we need a reconceptualisation not only of youth, but also of their sexual practices, especially their online sexual practices. Mobilising an interdisciplinary interaction between critical socio-cultural studies of risk, feminist theory and adventure studies, I propose to reconceptualise these practices as 'adventures' rather than 'risky behaviour'. This opens up possibilities for a more reasoned analysis that acknowledges: (1) the distinction between risks and outcomes of an activity; (2) the constructive potential of risk; and (3) the subjective, dynamic character of risk and pleasure.

  6. 78 FR 22887 - Guidance for Industry on Non-Penicillin Beta-Lactam Drugs: A Current Good Manufacturing Practices...

    Science.gov (United States)

    2013-04-17

    ... for Preventing Cross- Contamination; Availability AGENCY: Food and Drug Administration, HHS. ACTION... require separation of manufacturing facilities to avoid cross-contamination, the only class of products... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-D-0104...

  7. Racial/ethnic differences in report of drug testing practices at the workplace level in the U.S.

    Science.gov (United States)

    Becker, William C; Meghani, Salimah; Tetrault, Jeanette M; Fiellin, David A

    2014-01-01

    It is unknown whether racial/ethnic differences in report of workplace drug testing persist when analyzed within and across various occupations. We sought to examine the association between worker demographics, workplace characteristics, and report of employment in a workplace that performs drug testing. We performed a cross-sectional study of the 2008-2010 National Survey on Drug Use and Health examining the relationship between race/ethnicity and report of workplace drug testing among employed, white, black, or Hispanic respondents ≥18 years old. In logistic regression analysis, we adjusted for demographic, occupational, and other relevant variables and performed stratified analyses among three specific occupations. Among 69,163 respondents, 48.2% reported employment in a workplace that performs drug testing. On multivariable analysis, younger age, male sex, black race, income greater than $20,000, completion of high school and non-urban residence were associated with report of drug testing at one's workplace among the full sample as were non-white collar occupation, work in medium or large workplace, and absence of other substance abuse/dependence. In stratified analyses, black race was associated with report of workplace level drug testing among executive/administrative/managerial/financial workers and technicians/related support occupations; Hispanic ethnicity was associated with the outcome among technicians/related support occupations. Racial/ethnic differences in report of workplace drug testing exist within and across various occupations. These differences have important public health implications deserving further study. Increased report of drug testing where racial/ethnic minorities work highlights the potential bias that can be introduced when drug testing policies are not implemented in a universal fashion. © American Academy of Addiction Psychiatry.

  8. Risky Zoographies: The Limits of Place in Avian Flu Management

    Directory of Open Access Journals (Sweden)

    Natalie Porter

    2012-11-01

    Full Text Available Global anxieties about avian influenza stem from a growing recognition that highly-virulent, highly-mobile disease vectors infiltrate human spaces in ways that are difficult to perceive, and even more difficult to manage. This article analyses a participatory health intervention in Việt Nam to explore how avian influenza threats challenge long-held understandings of animals’ place in the environment and society. In this intervention, poultry farmers collaborated with health workers to illustrate maps of avian flu risks in their communities. Participant-observation of the risk-mapping exercises shows that health workers treated poultry as commodities, and located these animals in environments that could be transformed and dominated by humans. However, these maps did not sufficiently represent the physical and social landscapes where humans and poultry coexist in Việt Nam. As such, farmers located poultry in environments dominated by risky nonhuman forces such as winds, waterways, and other organisms. I argue that these divergent risk maps demonstrate how ecological factors, interpersonal networks, and global market dynamics combine to engender a variety of interspecies relationships, which in turn shape the location of disease risks in space. I develop the term risky zoographies to signal the emergence of competing descriptions of animals and their habitats in zoonotic disease contexts. This concept suggests that as wild animals, livestock products, and microbial pathogens continue to globalise, place-based health interventions that limit animals to particular locales are proving inadequate. Risky zoographies signal the inextricability of nonhuman animals from human spaces, and reveal interspecies interactions that transect and transcend environments.

  9. Dissociable neural processes underlying risky decisions for self versus other

    Directory of Open Access Journals (Sweden)

    Daehyun eJung

    2013-03-01

    Full Text Available Previous neuroimaging studies on decision making have mainly focused on decisions on behalf of oneself. Considering that people often make decisions on behalf of others, it is intriguing that there is little neurobiological evidence on how decisions for others differ from those for self. Thus, the present study focused on the direct comparison between risky decisions for self and those for other using functional magnetic resonance imaging (fMRI. Participants (N = 23 were asked to perform a gambling task for themselves (decision-for-self condition or for another person (decision-for-other condition while in the scanner. Their task was to choose between a low-risk option (i.e., win or lose 10 points and a high-risk option (i.e., win or lose 90 points. The winning probabilities of each option varied from 17% to 83%. Compared to choices for others, choices for self were more risk-averse at lower winning probability and more risk-seeking at higher winning probability, perhaps due to stronger affective process during risky decision for self compared to other. The brain activation pattern changed according to the target of the decision, such that reward-related regions were more active in the decision-for-self condition than in the decision-for-other condition, whereas brain regions related to the theory of mind (ToM showed greater activation in the decision-for-other condition than in the decision-for-self condition. A parametric modulation analysis reflecting each individual’s decision model revealed that activation of the amygdala and the dorsomedial prefrontal cortex (DMPFC were associated with value computation for self and for other, respectively, during a risky financial decision. The present study suggests that decisions for self and other may recruit fundamentally distinctive neural processes, which can be mainly characterized by dominant affective/impulsive and cognitive/regulatory processes, respectively.

  10. Dissociable Neural Processes Underlying Risky Decisions for Self Versus Other

    Science.gov (United States)

    Jung, Daehyun; Sul, Sunhae; Kim, Hackjin

    2013-01-01

    Previous neuroimaging studies on decision making have mainly focused on decisions on behalf of oneself. Considering that people often make decisions on behalf of others, it is intriguing that there is little neurobiological evidence on how decisions for others differ from those for oneself. The present study directly compared risky decisions for self with those for another person using functional magnetic resonance imaging (fMRI). Participants were asked to perform a gambling task on behalf of themselves (decision-for-self condition) or another person (decision-for-other condition) while in the scanner. Their task was to choose between a low-risk option (i.e., win or lose 10 points) and a high-risk option (i.e., win or lose 90 points) with variable levels of winning probability. Compared with choices regarding others, those regarding oneself were more risk-averse at lower winning probabilities and more risk-seeking at higher winning probabilities, perhaps due to stronger affective process during risky decisions for oneself compared with those for other. The brain-activation pattern changed according to the target, such that reward-related regions were more active in the decision-for-self condition than in the decision-for-other condition, whereas brain regions related to the theory of mind (ToM) showed greater activation in the decision-for-other condition than in the decision-for-self condition. Parametric modulation analysis using individual decision models revealed that activation of the amygdala and the dorsomedial prefrontal cortex (DMPFC) were associated with value computations for oneself and for another, respectively, during risky financial decisions. The results of the present study suggest that decisions for oneself and for other may recruit fundamentally distinct neural processes, which can be mainly characterized as dominant affective/impulsive and cognitive/regulatory processes, respectively. PMID:23519016

  11. Improving safety-related knowledge, attitude and practices of nurses handling cytotoxic anticancer drug: pharmacists' experience in a general hospital, Malaysia.

    Science.gov (United States)

    Keat, Chan Huan; Sooaid, Nor Suhada; Yun, Cheng Yi; Sriraman, Malathi

    2013-01-01

    An increasing trend of cytotoxic drug use, mainly in cancer treatment, has increased the occupational exposure among the nurses. This study aimed to assess the change of nurses' safety-related knowledge as well as attitude levels and subsequently to assess the change of cytotoxic drug handling practices in wards after a series of pharmacist-based interventions. This prospective interventional study with a before and after design requested a single group of 96 nurses in 15 wards actively providing chemotherapy to answer a self-administered questionnaire. A performance checklist was then used to determine the compliance of all these wards with the recommended safety measures. The first and second assessments took 2 months respectively with a 9-month intervention period. Pharmacist-based interventions included a series of technical, educational and administrative support measures consisting of the initiation of closed-system cytotoxic drug reconstitution (CDR) services, courses, training workshops and guideline updates. The mean age of nurses was 32.2∓6.19 years. Most of them were female (93.8%) and married (72.9%). The mean knowledge score of nurses was significantly increased from 45.5∓10.52 to 73.4∓8.88 out of 100 (p<0.001) at the end of the second assessment. Overall, the mean practice score among the wards was improved from 7.6∓5.51 to 15.3∓2.55 out of 20 (p<0.001). The pharmacist-based interventions improved the knowledge, attitude and safe practices of nurses in cytotoxic drug handling. Further assessment may help to confirm the sustainability of the improved practices.

  12. Parenting practices and problem behavior across three generations: Monitoring, harsh discipline, and drug use in the intergenerational transmission of externalizing behavior

    OpenAIRE

    Bailey, Jennifer A.; Hill, Karl G.; Oesterle, Sabrina; Hawkins, J. David

    2009-01-01

    Using data from grandparents (G1), parents (G2), and children (G3), this study examined continuity in parental monitoring, harsh discipline, and child externalizing behavior across generations, and the contribution of parenting practices and parental drug use to intergenerational continuity in child externalizing behavior. Structural equation and path modeling of prospective, longitudinal data from 808 G2 participants, their G1 parents, and their school-aged G3 children (n = 136) showed that ...

  13. Information Integration in Risky Choice: Identification and Stability

    OpenAIRE

    Stewart, Neil

    2011-01-01

    How is information integrated across the\\ud attributes of an option when making risky\\ud choices? In most descriptive models of\\ud decision under risk, information about\\ud risk, and reward is combined multiplicatively\\ud (e.g., expected value; expected utility\\ud theory, Bernouli, 1738/1954; subjective\\ud expected utility theory, Savage, 1954;\\ud Edwards, 1955; prospect theory, Kahneman\\ud and Tversky, 1979; rank-dependent utility,\\ud Quiggin, 1993; decision field theory,\\ud Busemeyer and To...

  14. Premeditation moderates the relation between sensation seeking and risky substance use among young adults.

    Science.gov (United States)

    McCabe, Connor J; Louie, Kristine A; King, Kevin M

    2015-09-01

    Young adulthood is a peak period for externalizing behaviors such as substance abuse and antisocial conduct. Evidence from developmental neuroscience suggests that externalizing conduct within this time period may be associated with a "developmental asymmetry" characterized by an early peak in sensation seeking combined with a relatively immature impulse control system. Trait measures of impulsivity-sensation seeking and premeditation-are psychological manifestations of these respective systems, and multiple prior studies suggest that high sensation seeking and low premeditation independently confer risk for distinct forms of externalizing behaviors. The goal of the present study was to test this developmental asymmetry hypothesis, examining whether trait premeditation moderates the effect of sensation seeking on substance use and problems, aggression, and rule-breaking behavior. Using a cross-sectional sample of college-enrolled adults (n = 491), we applied zero-inflated modeling strategies to examine the likelihood and level of risky externalizing behaviors. Results indicated that lower premeditation enhanced the effect of higher sensation seeking on higher levels of positive and negative alcohol consequences, more frequent drug use, and more problematic drug use, but was unrelated to individual differences in antisocial behaviors. Our findings indicate that the developmental asymmetry between sensation seeking and a lack of premeditation is a risk factor for individual differences in problematic substance use among young adults, and may be less applicable for antisocial behaviors among high functioning individuals. (c) 2015 APA, all rights reserved).

  15. Children’s Proneness to Shame and Guilt Predict Risky and Illegal Behaviors in Young Adulthood

    Science.gov (United States)

    Stuewig, Jeffrey; Tangney, June P.; Kendall, Stephanie; Folk, Johanna B.; Meyer, Candace Reinsmith; Dearing, Ronda L.

    2014-01-01

    Do shame and guilt help people avoid doing wrong? Although some research suggests that guilt-proneness is a protective factor while shame-proneness puts individuals at risk, most research is either cross-sectional or short-term. In this longitudinal study, 380 5th graders (ages 10–12) completed measures of proneness to shame and guilt. We re-interviewed 68% of participants after they turned 18 years old (range 18–21). Guilt-proneness assessed in childhood predicted fewer sexual partners, less use of illegal drugs and alcohol, and less involvement with the criminal justice system. Shame-proneness, in contrast, was a risk factor for later deviant behavior. Shame-prone children were more likely to have unprotected sex and use illegal drugs in young adulthood. These results held when controlling for childhood SES and teachers’ ratings of aggression. Children’s moral emotional styles appear to be well established by at least middle childhood, with distinct downstream implications for risky behavior in early adulthood. PMID:24842762

  16. Children's proneness to shame and guilt predict risky and illegal behaviors in young adulthood.

    Science.gov (United States)

    Stuewig, Jeffrey; Tangney, June P; Kendall, Stephanie; Folk, Johanna B; Meyer, Candace Reinsmith; Dearing, Ronda L

    2015-04-01

    Do shame and guilt help people avoid doing wrong? Although some research suggests that guilt-proneness is a protective factor while shame-proneness puts individuals at risk, most research is either cross-sectional or short-term. In this longitudinal study, 380 5th graders (ages 10-12) completed measures of proneness to shame and guilt. We re-interviewed 68 % of participants after they turned 18 years old (range 18-21). Guilt-proneness assessed in childhood predicted fewer sexual partners, less use of illegal drugs and alcohol, and less involvement with the criminal justice system. Shame-proneness, in contrast, was a risk factor for later deviant behavior. Shame-prone children were more likely to have unprotected sex and use illegal drugs in young adulthood. These results held when controlling for childhood SES and teachers' ratings of aggression. Children's moral emotional styles appear to be well established by at least middle childhood, with distinct downstream implications for risky behavior in early adulthood.

  17. Subgrouping of risky behaviors among Iranian college students: a latent class analysis

    Directory of Open Access Journals (Sweden)

    Safiri S

    2016-07-01

    also estimated. Three latent classes were determined: 1 low risk; 2 cigarette and hookah smoker; and 3 high risk. It is worth mentioning that 3.7% of males and 0.4% of females were in the high risk group.Conclusion: Subgrouping of college students showed that a considerable percentage of them, especially males, were classified into the high risk and cigarette and hookah smoker groups. Appropriate preventive measures that consider multiple different risky behaviors simultaneously are needed for this part of the population. Keywords: alcohol drinking, sexual behavior, latent class analysis, risk behaviors, drug abuse, substance abuse

  18. Risky behaviors and depression in conjunction with--or in the absence of--lifetime history of PTSD among sexually abused adolescents.

    Science.gov (United States)

    Danielson, Carla Kmett; Macdonald, Alexandra; Amstadter, Ananda B; Hanson, Rochelle; de Arellano, Michael A; Saunders, Benjamin E; Kilpatrick, Dean G

    2010-02-01

    Posttraumatic stress disorder (PTSD) is often considered the primary problematic outcome of child sexual abuse (CSA). However, a number of other, relatively understudied negative sequelae appear to be prevalent as well. Data from 269 adolescents with a CSA history from the National Survey of Adolescents-Replication Study were therefore used to examine the prevalence of risky behaviors (i.e., problematic alcohol and drug use, delinquent behavior) and depression in this sample. The frequencies of these problems in youth with and without a history of PTSD also were examined. Results indicated that risky behaviors and depression were reported as or more frequently than PTSD. Among youth with a history of PTSD, depression and delinquent behavior were more common than among those without a history of PTSD. However, there were no differences between adolescents with and without a history of PTSD in reported problematic substance use. Findings highlight the need for comprehensive trauma-informed interventions for CSA-exposed adolescents.

  19. SAFE USE OF DRUGS DURING PREGNANCY IN FOCUS OF INTERNATIONAL PRACTICE OF PHARMACOVIGILANCE SYSTEM AND TERATOLOGICAL INFORMATION SERVICE ORGANIZATION

    Directory of Open Access Journals (Sweden)

    K. A. Lutsevich

    2012-01-01

    Full Text Available The safe use of drugs during pregnancy is essential to optimize the health of both pregnant woman and her future child. At the same time obstetrician-gynecologists often face the lack of evidence-based information on the use of drugs and leave the issue to the woman herself — whether the treatment benefit to the mother outweighs risks to the unborn child — relying on the limited amount of scientific data. Preconception discussion of actual risks and safe treatment reduces patient fears and maximizes the emphasis on the therapy safety. At the same time, the lack of adequate information on safety for the majority of drugs used by pregnant women combined with the need to make appropriate treatment decisions and communicate drug risk information to a potentially vulnerable population is the most challenging and critical issue of pregnant women's health.

  20. Synthesis of sulfadiazine and silver sulfadiazine in semi-micro scale, as an experimental practice in drug synthesis

    International Nuclear Information System (INIS)

    Borges, Aurea Donizete Lanchote; Del Ponte, Gino; Federman Neto, Alberto; Carvalho, Ivone

    2005-01-01

    The total synthesis of sulfadiazine and silver sulfadiazine from readily available starting materials was adapted to semi-micro laboratory scale and is proposed as an experiment in drug synthesis for undergraduate courses. (author)

  1. [Cyclooxygenase inhibitors and antiplatelet effect of acetylsalicylic acid. selective approach to nonsteroidal anti-inflammatory drugs in cardiological practice].

    Science.gov (United States)

    Lomakin, N V; Gruzdev, A K

    2011-01-01

    Nonsteroidal anti-inflammatory drugs (NSAIDs) represent class of medicines which is wide concerning chemical structure and mechanism of action. In the light of contradictory data on efficacy and safety of NSAID in cardiovascular patients selection of most appropriate NSAID (basing on profile of efficacy and safety) in patients receiving continuous therapy with low dose aspirin appears to be a problem. In this paper we discuss peculiarities of drug interaction between cyclooxygenase inhibitors and acetylsalicylic acid, and principles of selection of adequate NSAI.

  2. Toxins and drug discovery.

    Science.gov (United States)

    Harvey, Alan L

    2014-12-15

    Components from venoms have stimulated many drug discovery projects, with some notable successes. These are briefly reviewed, from captopril to ziconotide. However, there have been many more disappointments on the road from toxin discovery to approval of a new medicine. Drug discovery and development is an inherently risky business, and the main causes of failure during development programmes are outlined in order to highlight steps that might be taken to increase the chances of success with toxin-based drug discovery. These include having a clear focus on unmet therapeutic needs, concentrating on targets that are well-validated in terms of their relevance to the disease in question, making use of phenotypic screening rather than molecular-based assays, and working with development partners with the resources required for the long and expensive development process. Copyright © 2014 The Author. Published by Elsevier Ltd.. All rights reserved.

  3. Risky module prediction for nuclear I and C software

    International Nuclear Information System (INIS)

    Kim, Young Mi; Kim, Hyeon Soo

    2012-01-01

    As software based digital I and C (Instrumentation and Control) systems are used more prevalently in nuclear plants, enhancement of software dependability has become an important issue in the area of nuclear I and C systems. Critical attributes of software dependability are safety and reliability. These attributes are tightly related to software failures caused by faults. Software testing and V and V (Verification and Validation) activities are hence important for enhancing software dependability. If the risky modules of safety-critical software can be predicted, it will be possible to focus on testing and V and V activities more efficiently and effectively. It should also make it possible to better allocate resources for regulation activities. We propose a prediction technique to estimate risky software modules by adopting machine learning models based on software complexity metrics. An empirical study with various machine learning algorithms was executed for comparing the prediction performance. Experimental results show SVMs (Support Vector Machines) perform as well or better than the other methods.

  4. Detecting Adverse Drug Events using Information Technology: Identifying Knowledge, Attitude, Practices & barriers to Adverse Drug Reaction (ADR) reporting in a Secondary Hospital.

    OpenAIRE

    Zeeshan, Hina

    2017-01-01

    Objectives:– To meet compliance of medication management system by modifying ADR reporting form.– Enhance customer satisfaction by providing safe & quality care.– Decrease prolonged length of stay ultimately increasing cost occurring from ADRs.– Improve employee knowledge, attitude & practices towards ADR process.Introduction/Background: Healthcare professional’s knowledge and attitudes to ADR and its reporting play vital role to report any cases of ADR. Positive attitudes may favor A...

  5. 75 FR 3239 - National Institute on Drug Abuse; Notice of Closed Meeting

    Science.gov (United States)

    2010-01-20

    ... unwarranted invasion of personal privacy. Name of Committee: National Institute on Drug Abuse Special Emphasis Panel; Rapid Assessment for Drug Abuse and Risky Sex (5556). Date: February 16, 2010. Time: 1:30 p.m. to..., Contract Review Specialist, Office of Extramural Affairs, National Institute on Drug Abuse, NIH, DHHS, Room...

  6. Simple heuristics in over-the-counter drug choices: a new hint for medical education and practice.

    Science.gov (United States)

    Riva, Silvia; Monti, Marco; Antonietti, Alessandro

    2011-01-01

    Over-the-counter (OTC) drugs are widely available and often purchased by consumers without advice from a health care provider. Many people rely on self-management of medications to treat common medical conditions. Although OTC medications are regulated by the National and the International Health and Drug Administration, many people are unaware of proper dosing, side effects, adverse drug reactions, and possible medication interactions. This study examined how subjects make their decisions to select an OTC drug, evaluating the role of cognitive heuristics which are simple and adaptive rules that help the decision-making process of people in everyday contexts. By analyzing 70 subjects' information-search and decision-making behavior when selecting OTC drugs, we examined the heuristics they applied in order to assess whether simple decision-making processes were also accurate and relevant. Subjects were tested with a sequence of two experimental tests based on a computerized Java system devised to analyze participants' choices in a virtual environment. We found that subjects' information-search behavior reflected the use of fast and frugal heuristics. In addition, although the heuristics which correctly predicted subjects' decisions implied significantly fewer cues on average than the subjects did in the information-search task, they were accurate in describing order of information search. A simple combination of a fast and frugal tree and a tallying rule predicted more than 78% of subjects' decisions. The current emphasis in health care is to shift some responsibility onto the consumer through expansion of self medication. To know which cognitive mechanisms are behind the choice of OTC drugs is becoming a relevant purpose of current medical education. These findings have implications both for the validity of simple heuristics describing information searches in the field of OTC drug choices and for current medical education, which has to prepare competent health

  7. Simple heuristics in over-the-counter drug choices: a new hint for medical education and practice

    Science.gov (United States)

    Riva, Silvia; Monti, Marco; Antonietti, Alessandro

    2011-01-01

    Introduction Over-the-counter (OTC) drugs are widely available and often purchased by consumers without advice from a health care provider. Many people rely on self-management of medications to treat common medical conditions. Although OTC medications are regulated by the National and the International Health and Drug Administration, many people are unaware of proper dosing, side effects, adverse drug reactions, and possible medication interactions. Purpose This study examined how subjects make their decisions to select an OTC drug, evaluating the role of cognitive heuristics which are simple and adaptive rules that help the decision-making process of people in everyday contexts. Subjects and methods By analyzing 70 subjects’ information-search and decision-making behavior when selecting OTC drugs, we examined the heuristics they applied in order to assess whether simple decision-making processes were also accurate and relevant. Subjects were tested with a sequence of two experimental tests based on a computerized Java system devised to analyze participants’ choices in a virtual environment. Results We found that subjects’ information-search behavior reflected the use of fast and frugal heuristics. In addition, although the heuristics which correctly predicted subjects’ decisions implied significantly fewer cues on average than the subjects did in the information-search task, they were accurate in describing order of information search. A simple combination of a fast and frugal tree and a tallying rule predicted more than 78% of subjects’ decisions. Conclusion The current emphasis in health care is to shift some responsibility onto the consumer through expansion of self medication. To know which cognitive mechanisms are behind the choice of OTC drugs is becoming a relevant purpose of current medical education. These findings have implications both for the validity of simple heuristics describing information searches in the field of OTC drug choices and

  8. From Racial Discrimination to Risky Sex: Prospective Relations Involving Peers and Parents

    Science.gov (United States)

    Roberts, Megan E.; Gibbons, Frederick X.; Gerrard, Meg; Weng, Chih-Yuan; Murry, Velma M.; Simons, Leslie G.; Simons, Ronald L.; Lorenz, Frederick O.

    2012-01-01

    This study investigated how early experience with racial discrimination affected the subsequent risky sexual behaviors of a diverse sample of African American youths (N = 745). The analyses focused on 3 risk-promoting factors thought to mediate the hypothesized discrimination--risky sex relation: negative affect, affiliation with deviant peers,…

  9. The Cost of Materialism in a Collectivistic Culture: Predicting Risky Behavior Engagement in Chinese Adolescents

    Science.gov (United States)

    Auerbach, Randy P.; McWhinnie, Chad M.; Goldfinger, Marc; Abela, John R. Z.; Zhu, Xiongzhao; Yao, Shuqiao

    2010-01-01

    The goals of the current study were to examine whether (a) negative events mediate the relationship between materialism and risky behavior engagement and (b) materialism moderates the relationship between stress and engagement in risky behaviors in Chinese youth. At Time 1, 406 adolescents (ages 14-19) from Yue Yang, China, completed measures…

  10. Predictors of Risky Behavior and Offending for Adolescents with Mild Intellectual Disability

    Science.gov (United States)

    Savage, Melissa N.; Bouck, Emily C.

    2017-01-01

    Adolescents with intellectual disability (ID) engage in risky behavior and offending. However, little is known on the impact school-related predictors have on engagement in risky behaviors for adolescents with ID. This study analyzed secondary data from the National Longitudinal Transition Study-2 (NLTS2) to determine levels of engagement in risky…

  11. Child Abuse, Early Maladaptive Schemas, and Risky Sexual Behavior in College Women

    Science.gov (United States)

    Roemmele, Melissa; Messman-Moore, Terri L.

    2011-01-01

    Previous research suggests that individuals abused as children are more likely to engage in risky sexual behavior during adulthood. The present study examined early maladaptive schemas as mediators of the child abuse-risky sexual behavior relationship among 653 college women. Self-report surveys assessed three forms of child abuse: Sexual,…

  12. Predictors of risky sexual behavior in African American adolescent girls: implications for prevention interventions.

    Science.gov (United States)

    Bachanas, Pamela J; Morris, Mary K; Lewis-Gess, Jennifer K; Sarett-Cuasay, Eileen J; Sirl, Kimberly; Ries, Julie K; Sawyer, Mary K

    2002-09-01

    To describe empirically the risky sexual behavior of an at-risk sample of adolescent girls, to assess psychosocial correlates of risky behavior, and to examine the utility of applying a risk and protective model to predicting teens' risky sexual behavior. Participants included 158 African American girls, ages 12 to 19, who were receiving medical care in an adolescent primary care clinic. Teens completed measures of depression, conduct problems, substance use, peer norms, social support, HIV knowledge, sexual self-efficacy, and sexual behavior. Teens in this sample reported high rates of risky sexual behaviors, including early sexual debuts and frequent unprotected sexual encounters with multiple partners. African American girls who reported high rates of substance use and who reported that their peers engaged in risky behaviors also reported engaging in high rates of risky sexual behaviors. Little support was obtained for protective factors (HIV knowledge, social support, sexual self-efficacy) moderating the relations between risk factors and adolescents' risky sexual behavior in this sample. Teens presenting in primary care settings in urban environments seem to be at high risk for HIV, STDs, and substance abuse, and risk reduction strategies should be introduced during the preteen years. An interdisciplinary model of care in primary care settings serving adolescents is clearly indicated, and prevention-oriented interventions aimed at reducing risky behaviors and preventing the development of more significant health, mental health, or substance abuse disorders are needed.

  13. Risky decision making in Attention-Deficit/Hyperactivity Disorder : A meta-regression analysis

    NARCIS (Netherlands)

    Dekkers, T.J.; Popma, A.; Agelink van Rentergem, J.A.; Bexkens, A.; Huizenga, H.M.

    ADHD has been associated with various forms of risky real life decision making, for example risky driving, unsafe sex and substance abuse. However, results from laboratory studies on decision making deficits in ADHD have been inconsistent, probably because of between study differences. We therefore

  14. Risky business: Behaviors associated with indoor tanning in US high school students

    OpenAIRE

    Chapman, Stephanie; Ashack, Kurt; Bell, Eric; Sendelweck, Myra Ann; Dellavalle, Robert

    2017-01-01

    Background: Understanding of associations between indoor tanning and risky health related behaviors such as sexual activity and substance abuse among high school students across the United States is incomplete. Objective: To identify risky health related behaviors among high school students utilizing indoor tanning and analyze differences between state specific data. Methods: Results from the Youth Risk Behavior Surveillance System (YRBSS) 2013 in...

  15. HIV/AIDS, poverty and risky sexual behaviour in South Africa | le R ...

    African Journals Online (AJOL)

    This paper employs data from the 1998 South African Demographic and Health Survey in exploring the nature of socio-economic inequalities in and determinants of risky sexual behaviour. Risky sexual behaviour was associated with poverty only in the case of multiple partnerships. Affluent women that have engaged in ...

  16. African Journal of Drug & Alcohol Studies, 12(1), 2013 Copyright ...

    African Journals Online (AJOL)

    5Witwatersrand Reproductive Health & HIV Institute (WRHI), Faculty of Health. Sciences ... were more likely to engage in risky sex practices ..... and stress management, whilst Doumas. & Hannah ...... success or failure of a study. In addition.

  17. [Socioeconomic status and risky health behaviors in Croatian adult population].

    Science.gov (United States)

    Pilić, Leta; Dzakula, Aleksandar

    2013-03-01

    Based on the previous research, there is strong association between low socioeconomic status (SES) and high morbidity and mortality rates. Even though association between SES and risky health behaviors as the main factors influencing health has been investigated in Croatian population, some questions are yet to be answered. The aim of this study was to investigate the presence of unhealthy diet, physical inactivity, smoking and excessive drinking in low, middle, and high socioeconomic group of adult Croatian population included in the cohort study on regionalism of cardiovascular health risk behaviors. We also investigated the association between SES measured by income, education and occupation, as well as single SES indicators, and risky health behaviors. We analyzed data on 1227 adult men and women (aged 19 and older at baseline) with complete data on health behaviors, SES and chronic diseases at baseline (2003) and 5-year follow up. Respondents were classified as being healthy or chronically ill. SES categories were derived from answers to questions on monthly household income, occupation and education by using two-step cluster analysis algorithm. At baseline, for the whole sample as well as for healthy respondents, SES was statistically significantly associated with unhealthy diet (whole sample/healthy respondents: p = 0.001), physical inactivity (whole sample/healthy respondents p = 0.44/ p = 0.007), and smoking (whole sample/healthy respondents p < 0.001/p = 0.002). The proportion of respondents with unhealthy diet was greatest in the lowest social class, smokers in the middle and physically inactive in the high social class. During the follow up, smoking and physical inactivity remained statistically significantly associated with SES. In chronically ill respondents, only smoking was statistically significantly associated with SES, at baseline and follow up (p = 0.001/p = 0.002). The highest share of smokers was in the middle social class. Results of our

  18. The procedure of new drug application and the philosophy of critical rationalism or the limits of quality assurance with good clinical practice.

    Science.gov (United States)

    Högel, J; Gaus, W

    1999-12-01

    K.R. Popper's philosophy of critical rationalism is concerned with the detection and removal of error. Fundamental contradictions exist between Popper's theory of knowledge and the present-day practice of the clinical investigation of new drugs. Currently, the public authorities concerned with the licensing of drugs pass judgment on trials, which are closely linked by the one-sponsor problem: the assertions made by the sponsor are not independently confirmed. This lack leads to excessive documentation and to costly monitoring and auditing, which are intended to ensure the credibility of results. In Popper's view, confirmatory trials, independent of the sponsor and supervised by the regulatory bodies, would be a better way to achieve reliable knowledge. The consequence would, among other things, be a reorganization of phase III of the clinical investigation of new drugs by dividing it into independent parts, one under the control of the sponsor and one under the control of the public authority. The implementation of this suggestion would lead to a more scientific manner of dealing with new drugs and to savings in terms of unproductive measures during the application process.

  19. Incorporating a Drug Information Consult into a Pharmacy Practice Course to Build Literature Search and Evaluation Skills Through a 3-Stage Model.

    Science.gov (United States)

    Wittman, Deborah; Kovera, Craig; Sullivan, Maureen; Rumore, Martha M

    2017-06-01

    Pharmacy students need to be equipped with skills to research and evaluate literature to effectively apply evidence-based medicine (EBM) in practice. To prepare them, a 3-stage approach to writing a drug information consult (3sDIC) was incorporated into a pharmacy course. The primary objective was to assess students' abilities to retrieve and analyze literature pursuant to a drug information consult. Secondary objectives were to examine feasibility of faculty participation and continuation of the assignment. Ninety students were given a clinical scenario about a patient. The assignment consisted of 3 stages incorporating use of the Population, Intervention, Comparison intervention, Outcome (PICO) method and modified systematic approach (MSA) for stage 1, evaluation of primary literature to write a draft for stage 2, and stage 3, the final consult. All 3 stages were reviewed and graded by faculty. All students completed the 3sDIC, with no grade failures. The rubric employed by faculty was effective, providing students the opportunity to improve the consult. The 3sDIC was found to be feasible with adequate faculty support. The 3sDIC, although not a substitute for a complete drug information course, demonstrated a streamlined approach for Pharmacy year 2 (P2) students to acquire and develop drug information skills.

  20. Young novice drivers and the risky behaviours of parents and friends during the provisional (intermediate) licence phase: a brief report.

    Science.gov (United States)

    Scott-Parker, Bridie; Watson, Barry; King, Mark J; Hyde, Melissa K

    2014-08-01

    While there is research indicating that many factors influence the young novice driver's increased risk of road crash injury during the earliest stages of their independent driving, there is a need to further understand the relationship between the perceived risky driving behaviour of parents and friends and the risky behaviour of drivers with a Provisional (intermediate) licence. As part of a larger research project, 378 drivers aged 17-25 years (M=18.22, SD=1.59, 113 males) with a Provisional licence completed an online survey exploring the perceived riskiness of their parents' and friends' driving, and the extent to which they pattern (i.e. base) their driving behaviour on the driving of their parents and friends. Young drivers who reported patterning their driving on their friends, and who reported they perceived their friends to be risky drivers, reported more risky driving. The risky driving behaviour of young male drivers was associated with the perceived riskiness of their fathers' driving, whilst for female drivers the perceived riskiness of their mothers' driving approached significance. The development and application of countermeasures targeting the risky behaviour of same-sex parents appears warranted by the robust research findings. In addition, countermeasures need to encourage young people in general to be non-risky drivers; targeting the negative influence of risky peer groups specifically. Social norms interventions may minimise the influence of potentially-overestimated riskiness. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Clinical relevance of the gap between pre-marketing trials and medical practice : the case of the cardiovascular drugs

    NARCIS (Netherlands)

    Wieringa, N F; Denig, P; de Graeff, P A; Vos, R

    OBJECTIVES/BACKGROUND: The external validity of trial results of new cardiovascular drugs is limited, because the short-term studies are performed with relatively small, highly selected populations. Using qualitative methods, we examined the clinical relevance of under-representation of subgroups of

  2. The impact of new insights and revised practice guidelines on prescribing drugs in the treatment of type 2 diabetes mellitus

    NARCIS (Netherlands)

    Lub, Rene; Denig, Petra; van den Berg, Paulus; Hoogenberg, Klaas; de Jong-van den Berg, Lolkje

    2006-01-01

    Aims. The aim of this study was to investigate the impact of new insights and revised guidelines on initial and follow-up treatment with antihyperglycaemic drugs over the period 1998-2003. Methods. The InterAction Database (IADB), which contains pharmacy dispensing data from 53 community pharmacies

  3. Assessment of knowledge, attitude and practice of adverse drug reaction reporting among healthcare professionals in secondary and tertiary hospitals in the capital of Pakistan

    Directory of Open Access Journals (Sweden)

    Zaka Un Nisa

    2018-05-01

    Full Text Available Adverse Drug Reactions (ADRs underreporting is a great challenge to pharmacovigilance. Healthcare professionals should consider ADR reporting as their professional obligation because the effective system of ADR reporting is important to improve patient care and safety. This study was designed to assess the knowledge, attitude, practice and factors associated with ADR reporting by healthcare professionals (physicians and pharmacists in secondary and tertiary hospitals of Islamabad. A pretested questionnaire comprising of 27 questions (knowledge 12, attitude 4, practice 9 and factors influencing ADR reporting 2 was administered to 384 physicians and pharmacists in public and private hospitals. Respondents were evaluated for their knowledge, attitude and practice related to ADR reporting. Additionally, the factors which encourage and discourage respondents to report ADRs were also determined. The data was analysed by using SPSS statistical software. Among 384 respondents, 367 provided responses to questionnaire, giving a response rate of 95.5%. The mean age was 28.3 (SD = 6.7. Most of the respondents indicated poor ADR reporting knowledge (83.1%. The majority of respondents (78.2% presented a positive attitude towards ADR reporting and only a few (12.3% hospitals have good ADR reporting practice. The seriousness of ADR, unusualness of reaction, new drug involvement and confidence in the diagnosis of ADR are the factors which encourage respondents to report ADR whereas lack of knowledge regarding where and how to report ADR, lack of access to ADR reporting form, managing patient is more important than reporting ADR legal liability issues were the major factors which discourage respondents to report ADR. The study reveals poor knowledge and practice regarding ADR reporting. However, most of the respondents have shown a positive attitude towards ADR reporting. There is a serious need for educational training as well as sincere and sustained

  4. Self-medication practices and rational drug use habits among university students: a cross-sectional study from Kahramanmaraş, Turkey

    Directory of Open Access Journals (Sweden)

    Ramazan Azim Okyay

    2017-11-01

    Full Text Available Background Self-medication refers to the use of medicines to treat self-diagnosed diseases without consulting any healthcare professionals. Irrational drug use and self-medication have serious negative consequences both on health and economy. Therefore, the aim of this study is to assess the habits related to rational use of drugs (RUD and to estimate the prevalence of self-medication practices among university students. Methods This cross-sectional study was conducted on university students in Kahramanmaraş. From May 2017 to June 2017 a total of 960 students filled a “Rational Use of Drugs Questionnaire”. Results The prevalence of practicing self-medication in students was 63.4%. The most common medicines that the students had consumed without prescription were analgesics by 39.5%, antibiotics by 36.9% and cold remedies by 24.0%. The rate of students who declared that they were familiar with RUD and “rational use of antibiotics” (RUA was 45.9%. Reading/checking the instructions in the prospectus (OR = 1.529, 95% CI [1.176–1.990], understanding the context of the prospectus (OR = 1.893, 95% CI [1.387–2.584], compliance with the duration of antibiotic treatment (OR = 1.597, 95% CI [1.231–2.071] and consulting a physician in case of a side effect (OR = 1.350, 95% CI [1.037–1.757] were significantly higher among students who were familiar with RUD as compared to who were not. Discussion Since the awareness of RUD among university students was found to be inadequate, it has critical importance to hold educational activities with the cooperation of physicians, health organizations, universities, non-governmental organizations and media to avoid negative consequences of irrational drug use and self-medication.

  5. Nationwide prevalence and drug treatment practices of inflammatory bowel diseases in Hungary: A population-based study based on the National Health Insurance Fund database.

    Science.gov (United States)

    Kurti, Zsuzsanna; Vegh, Zsuzsanna; Golovics, Petra A; Fadgyas-Freyler, Petra; Gecse, Krisztina B; Gonczi, Lorant; Gimesi-Orszagh, Judit; Lovasz, Barbara D; Lakatos, Peter L

    2016-11-01

    Crohn's disease (CD) and ulcerative colitis (UC) are chronic inflammatory diseases associated with a substantial healthcare utilization. Our aim was to estimate the national prevalence of inflammatory bowel disease (IBD), CD and UC and to describe current drug treatment practices in CD and UC. Patients and drug dispensing events were identified according to international classification codes for UC and CD in in-patient care, non-primary out-patient care and drug prescription databases (2011-2013) of the National Health Insurance Fund. A total of 55,039 individuals (men: 44.6%) with physician-diagnosed IBD were alive in Hungary in 2013, corresponding to a prevalence of 0.55% (95% CI, 0.55-0.56). The prevalence of CD 0.20% (95% CI, 0.19-0.20), and UC was 0.34% (95% CI, 0.33-0.34). The prevalence both in men and women was the highest in the 20-39 year-olds in CD. Current use of immunosuppressives and biological therapy was highest in the pediatric CD population (44% and 15%) followed by adult CD (33% and 9%), while their use was lowest in elderly patients. Interestingly, current use of 5-ASA (5-aminosalicylates) was high in both UC and CD irrespective of the age group. The Hungarian IBD prevalence based on nationwide database of the National Health Insurance Fund was high. We identified significant differences in the drug prescription practices according to age-groups. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  6. Risky changes: transformation of ownership in contemporary Russia

    International Nuclear Information System (INIS)

    Feofanov, K.

    1998-01-01

    Transformation of economic and political course in the last decade in Russia has evoked big changes in the main agent of techno-genic risk, companies concerned with production, storage, recycling, and transportation of chemical, biological, energetic, etc. products. The basic aspect of the changes is the 'denationalizing' transformation of ownership, from state to shareholder or private, providing instability both during and, mainly, after the process of transformation, in cases of 'refreezing' the inadequate 'new order of things'. The transformation is hindered by compressed and indefinite terms of transformation, worsening of financial level of companies due to their 'transitional' status, struggle for power within and outside the companies initiated by provocative and dangerous actions by different fighting groups and forces in the firms, factories, and industry branches. The paper is written on the basis of in-depth expert interviews and clarifies the peculiarities of the risky transformation. (author)

  7. Making business less risky : the benefits of business interrelationships

    International Nuclear Information System (INIS)

    Auchinleck, D.

    1998-01-01

    The importance of business interrelationships for the success of the capital intensive and inherently risky petroleum industry was discussed. The major types of interrelationships include: (1) joint interest/ownership, (2) joint ventures, (3) production sharing contracts, and (4) strategic alliances. The makings of a successful and unsuccessful business relationship were also described. Examples of successful joint ventures, (Syncrude with Athabasca Oil Trust), joint ownerships (Gulf Oil with IPL), strategic alliances (Northrock Resources), and production sharing contracts (Gulf Oil with Talisman and Pertamina) were outlined by way of illustration. A failed joint venture between Gulf Oil, British Gas and Komineft to revitalize production and exploration in the Komi Republic (formerly part of the USSR) was also cited as an example of a situation where unsteady operational and political environments combined to bring about the failure of the project

  8. Noisy preferences in risky choice: A cautionary note.

    Science.gov (United States)

    Bhatia, Sudeep; Loomes, Graham

    2017-10-01

    We examine the effects of multiple sources of noise in risky decision making. Noise in the parameters that characterize an individual's preferences can combine with noise in the response process to distort observed choice proportions. Thus, underlying preferences that conform to expected value maximization can appear to show systematic risk aversion or risk seeking. Similarly, core preferences that are consistent with expected utility theory, when perturbed by such noise, can appear to display nonlinear probability weighting. For this reason, modal choices cannot be used simplistically to infer underlying preferences. Quantitative model fits that do not allow for both sorts of noise can lead to wrong conclusions. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  9. Thinking Fast Increases Framing Effects in Risky Decision Making.

    Science.gov (United States)

    Guo, Lisa; Trueblood, Jennifer S; Diederich, Adele

    2017-04-01

    Every day, people face snap decisions when time is a limiting factor. In addition, the way a problem is presented can influence people's choices, which creates what are known as framing effects. In this research, we explored how time pressure interacts with framing effects in risky decision making. Specifically, does time pressure strengthen or weaken framing effects? On one hand, research has suggested that framing effects evolve through the deliberation process, growing larger with time. On the other hand, dual-process theory attributes framing effects to an intuitive, emotional system that responds automatically to stimuli. In our experiments, participants made decisions about gambles framed in terms of either gains or losses, and time pressure was manipulated across blocks. Results showed increased framing effects under time pressure in both hypothetical and incentivized choices, which supports the dual-process hypothesis that these effects arise from a fast, intuitive system.

  10. Optimal growth entails risky localization in population dynamics

    Science.gov (United States)

    Gueudré, Thomas; Martin, David G.

    2018-03-01

    Essential to each other, growth and exploration are jointly observed in alive and inanimate entities, such as animals, cells or goods. But how the environment's structural and temporal properties weights in this balance remains elusive. We analyze a model of stochastic growth with time correlations and diffusive dynamics that sheds light on the way populations grow and spread over general networks. This model suggests natural explanations of empirical facts in econo-physics or ecology, such as the risk-return trade-off and the Zipf law. We conclude that optimal growth leads to a localized population distribution, but such risky position can be mitigated through the space geometry. These results have broad applicability and are subsequently illustrated over an empirical study of financial data.

  11. Social inclusion facilitates risky mating behavior in men.

    Science.gov (United States)

    Sacco, Donald F; Brown, Christina M; Young, Steven G; Bernstein, Michael J; Hugenberg, Kurt

    2011-07-01

    Although past research has reliably established unique effects of social exclusion on human cognition and behavior, the current research focuses on the unique effects of social inclusion. Recent evidence indicates that social inclusion leads to enhanced prioritization of reproductive interests. The current study extends these findings by showing that the pursuit of these inclusion-induced reproductive goals occurs in sex-specific ways. Across three experiments, social inclusion led men, but not women, to endorse riskier, more aggressive mating strategies compared to control and socially excluded participants. Specifically, included men were more likely to endorse sexual aggression (Experiment 1), high-risk mate poaching behaviors (Experiment 2), and high-risk mate retention tactics (Experiment 3). These results demonstrate that the experience of social inclusion can affect sex-differentiated preferences for risky mating strategies. © 2011 by the Society for Personality and Social Psychology, Inc

  12. Affective imposition influences risky choice: handedness points to the hemispheres.

    Science.gov (United States)

    McElroy, Todd; Corbin, Jonathan

    2010-07-01

    The study of risk preference has become a widely investigated area of research. The current study is designed to investigate the relationship between handedness, hemispheric predominance and valence imposition in a risky-choice decision task. Research into the valence hypothesis (e.g., Ahern & Schwartz, 1985; Davidson, 1984) has shown that the left hemisphere is more active in processing positively valenced stimuli, whereas the right hemisphere is more active in processing negatively valenced stimuli. A total of 520 individuals (343 female, 117 male) participated in a self-imposed framing task and took a degree of handedness questionnaire. The results of the framing task and handedness questionnaire showed that participants' degree of handedness significantly influenced the positive/negative valence they imposed onto the framing task as well as their level of risk preference.

  13. Risky business: When humor increases and decreases status.

    Science.gov (United States)

    Bitterly, T Bradford; Brooks, Alison Wood; Schweitzer, Maurice E

    2017-03-01

    Across 8 experiments, we demonstrate that humor can influence status, but attempting to use humor is risky. The successful use of humor can increase status in both new and existing relationships, but unsuccessful humor attempts (e.g., inappropriate jokes) can harm status. The relationship between the successful use of humor and status is mediated by perceptions of confidence and competence. The successful use of humor signals confidence and competence, which in turn increases the joke teller's status. Interestingly, telling both appropriate and inappropriate jokes, regardless of the outcome, signals confidence. Although signaling confidence typically increases status and power, telling inappropriate jokes signals low competence and the combined effect of high confidence and low competence harms status. Rather than conceptualizing humor as a frivolous or ancillary behavior, we argue that humor plays a fundamental role in shaping interpersonal perceptions and hierarchies within groups. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  14. Risky choice in younger versus older adults: Affective context matters

    Directory of Open Access Journals (Sweden)

    Yumi Huang

    2013-03-01

    Full Text Available Earlier frameworks have indicated that older adults tend to experience decline in their deliberative decisional capacity, while their affective abilities tend to remain intact (Peters, Hess, Vastfjall, and Auman, 2007. The present study applied this framework to the study of risky decision-making across the lifespan. Two versions of the Columbia Card Task (CCT were used to trigger either affective decision-making (i.e., the ``warm'' CCT or deliberative decision-making (i.e., the ``cold'' CCT in a sample of 158 individuals across the lifespan. Overall there were no age differences in risk seeking. However, there was a significant interaction between age and condition, such that older adults were relatively more risk seeking in the cold condition only. In terms of everyday decision-making, context matters and risk propensity may shift within older adults depending upon the context.

  15. Determination of Risky Health Behaviors of Immigrant and Nonimmigrant Adolescents

    Directory of Open Access Journals (Sweden)

    Asli Kalkim

    2014-08-01

    Full Text Available AiM: This study was planned as a descriptive study in order to investigate risky health behaviors of immigrant and non immigrant adolescents. METHODS: The study was performed in a high school situated Izmir between the dates of October and November 2008. Sample group of this research was included 293 immigrant and 813 non immigrant adolescents. Data were collected by using Socio-demographic question form and and Health Risk Behaviors Scale. Data were collected from students with a technical pencil-paper by researcher in classroom. Frequencies, one way anova (post-hoc bonferroni and independent t test were used with Stastical Package for Social Science 13.0 program for statistical analysis of data. Written consent was taken from Izmir Directorate of Education to carry out the study. Oral consent was taken from the school manager and the students. RESULTS: Mean age of adolescents was 15.42+/-0.03. It was determined that risky health behaviors mean score (t: 2.161, p: 0.031 and physical activity (t: 2.132, p: 0.033, nutrition (t:3.030, p: 0.003, hygiene (t: 3.850, p: 0.000 sub-scales mean scores of immigrant adolescent were statistically higher than non immigrant adolescents (p<0.05. CONCLUSiONS: Consequently, this study was important to health professionals worked primary health services and school health services The study have significant data about migration affects on health behaviors of adolescent to show health professionals worked primary care and school health services and to plan health services towards adolescents. [TAF Prev Med Bull 2014; 13(4.000: 289-294

  16. A dynamic dual process model of risky decision making.

    Science.gov (United States)

    Diederich, Adele; Trueblood, Jennifer S

    2018-03-01

    Many phenomena in judgment and decision making are often attributed to the interaction of 2 systems of reasoning. Although these so-called dual process theories can explain many types of behavior, they are rarely formalized as mathematical or computational models. Rather, dual process models are typically verbal theories, which are difficult to conclusively evaluate or test. In the cases in which formal (i.e., mathematical) dual process models have been proposed, they have not been quantitatively fit to experimental data and are often silent when it comes to the timing of the 2 systems. In the current article, we present a dynamic dual process model framework of risky decision making that provides an account of the timing and interaction of the 2 systems and can explain both choice and response-time data. We outline several predictions of the model, including how changes in the timing of the 2 systems as well as time pressure can influence behavior. The framework also allows us to explore different assumptions about how preferences are constructed by the 2 systems as well as the dynamic interaction of the 2 systems. In particular, we examine 3 different possible functional forms of the 2 systems and 2 possible ways the systems can interact (simultaneously or serially). We compare these dual process models with 2 single process models using risky decision making data from Guo, Trueblood, and Diederich (2017). Using this data, we find that 1 of the dual process models significantly outperforms the other models in accounting for both choices and response times. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  17. Effect of Chronic Lead Intoxication on Risky Behavior in Mice

    Directory of Open Access Journals (Sweden)

    L Mohammadyar

    2010-08-01

    Full Text Available Introduction: With industrialization of human societies, pollutants like lead have entered in the life cycle, causing harmful effects on body organs. No sufficient studies have been done on the effects of pollutants on behavior. The aim of this study was to investigate possible effects of lead on some measurable behaviors of an animal model. Methods: Forty eight male adult mice were divided into 4 groups of 12 each. Lead acetate was added at concentrations of 0, 5, 50, or 500 ppm to the drinking water of the animals for 4 weeks (28 days. On day 29, animals were placed on an Elevated Plus maze (EPM for 5 min and the time in sec spent was measured on closed arms, open arms and the end 1/3rd of the open arms. Increased time on open arms, particularly the end 1/3rd was considered to reflect an enhanced risk-accepting behavior. Results: In this study, it was shown that lead exposure caused an increased number of entrance (P=0.006 and time spent (P=0.034 by mice on open arms of the EPM. There was a positive correlation between the concentration of lead acetate and those two effects. Conclusion: The present study demonstrated that lead poisoning may decrease normal anxiety in mice and increase risky behavior in this species. Clinical studies on human subjects with risky behavior are strongly suggested in order to find a possible relation between chronic exposures to lead as well as plasma concentration of lead with the extent of this kind of behavior.

  18. Reducing widespread pipe sharing and risky sex among crystal methamphetamine smokers in Toronto: do safer smoking kits have a potential role to play?

    Directory of Open Access Journals (Sweden)

    Hunter Charlotte

    2012-02-01

    Full Text Available Abstract Background Crystal methamphetamine smoking is associated with many negative health consequences, including the potential for transmission of hepatitis. We examined whether or not a kit for crystal methamphetamine smoking might have some potential to reduce the negative health effects of crystal methamphetamine smoking. Methods Five focus groups were conducted with crystal methamphetamine smokers recruited by community health agencies and youth shelters in Toronto, Canada. Target groups included homeless/street-involved youth, sex workers, men who have sex with men, and youth in the party scene. Participants (n = 32 were asked questions about motivations for crystal methamphetamine use, the process of smoking, health problems experienced, sharing behaviour, risky sexual practices, and the ideal contents of a harm reduction kit. Results Pipe sharing was widespread among participants and was deemed integral to the social experience of smoking crystal methamphetamine. Heated pipes were unlikely to cause direct injuries, but participants mentioned having dry, cracked lips, which may be a vector for disease transmission. Many reported having sex with multiple partners and being less likely to use condoms while on the drug. Demand for harm reduction kits was mixed. Conclusions Changing pipe sharing behaviours may be difficult because many participants considered sharing to be integral to the social experience of smoking crystal methamphetamine. Within the context of a broader health promotion and prevention program, pilot testing of safer smoking kits to initiate discussion and education on the risks associated with sharing pipes and unprotected sex for some communities (e.g., homeless/street-involved youth is worth pursuing.

  19. Risky sexual behaviors among sexually active first-year students matriculating at a historically Black college: Is a positive self-image an instigator?

    Science.gov (United States)

    Ellis, Walter L

    2016-01-01

    A sample of 498 sexually active first-year students matriculating at a historically Black college in North Carolina was used to determine correlates of risky sexual behaviors. In an Ordinary Least Squares regression, the self-esteem element "I take a positive attitude toward myself" (B = 1.12, p = .05), non-condom use because of partner issues (B = .53, p = .05) and being drunk or high (B = 1.20, p = .001), oral sex (B = 1.74, p = .001), anal sex (B = .61, p = .04), and bisexuality (B = .85, p = .03) all increased the number of these behaviors. Higher scores on the condom usage scale (B = -.38, p = .002) were found to decrease the number of risky sexual behaviors. Illicit drug use was an underpinning of the surprisingly positive relationship between positive self-image and risky sexual behaviors. It was concluded that school-based social workers, mental health care professionals, and community-based prevention providers can play a critical role in the training of peer facilitators, development, and supervision of peer-driven risk-reduction programs to address the complex interplay among self-esteem, sex, and substances.

  20. Sexual health, risky sexual behavior and condom use among adolescents young adults and older adults in Chiang Mai, Thailand: findings from a population based survey.

    Science.gov (United States)

    Pinyopornpanish, Kanokporn; Thanamee, Sanhapan; Jiraporncharoen, Wichuda; Thaikla, Kanittha; McDonald, Jessica; Aramrattana, Apinun; Angkurawaranon, Chaisiri

    2017-12-04

    Sexual health is one of the key dimensions of health across all ages. Understanding risky sexual behaviors remains an important area of public health research. This study aimed to explore sexual health, risky sexual behaviors and factors associated with recent condom use as condom use is considered a main intervention proven to reduce negative health consequences of risky sexual behaviors, specifically related to sexually transmitted infections and unintended pregnancies. A stratified two-stage cluster sampling technique survey was conducted in Chiang Mai, Thailand. Information was obtained about age of first sexual intercourse, sexual activity, condom use, number of partners and history of drug/alcohol use prior to sexual activities within the past 3 months. A weighted analysis was performed to account for data clustering. It is estimated that most men (93%) and women (86%) in Chiang Mai have engaged in sexual intercourse. More than 70% of the people in Chiang Mai over age 30 remained sexually active in the past 3 months, even for populations over age 50. Eight percent of male teenagers reported having more than one sexual partner in the past 3 months. Regular condom use was reported in less than 5% of the population (6.6% men and 3.1% women). Our study demonstrated that sexual health is an important public health issue across all age groups. Condom use has been promoted as one way to minimize and prevent unintended consequences of sexual behavior but overall use remains low.

  1. The Use of the Risky Sex Scale among Adolescents Receiving Treatment Services for Substance Use Problems: Factor Structure and Predictive Validity

    Science.gov (United States)

    Tubman, Jonathan G.; Des Rosiers, Sabrina E.; Schwartz, Seth J.; O'Hare, Thomas

    2015-01-01

    The present study evaluated the use of the Risky Sex Scale (RSS; O'Hare, 2001) among youth in outpatient treatment for substance use problems. An ethnically diverse sample of 394 adolescents (280 males; Mage = 16.33 years, SDage = 1.15) was recruited from two treatment sites. The study was guided by two aims. First, a confirmatory factor analysis was conducted on RSS item responses. Findings replicated the factor structure identified in previous studies of undergraduate students cited for campus alcohol violations. Second, structural equation modeling (SEM) was used to document associations between RSS subscales and self-reported substance use and sexual risk behaviors. The Risky Sex Expectancies (RSE) subscale was significantly associated with co-occurring alcohol use and sex, alcohol use at last intercourse, and alcohol use during the prior 30 days. The Risky Sex Behaviors (RSB) subscale was significantly associated with cooccurring drug use and sex, condom use at last intercourse and unprotected intercourse during the prior 30 days. The factor structure of the RSS was consistent across age group (12-16 and 16- 18) and across gender, and the links between the RSS subscales and health risk behaviors varied somewhat by gender but not by age group. These findings suggest that the RSS is an appropriate brief screening tool for predicting health risk behaviors among adolescents in substance abuse treatment. PMID:22425202

  2. Attention deficit hyperactivity symptoms and risky sexual behavior in young adult women.

    Science.gov (United States)

    Hosain, G M Monawar; Berenson, Abbey B; Tennen, Howard; Bauer, Lance O; Wu, Z Helen

    2012-04-01

    This study was undertaken to assess the association between adult attention deficit/hyperactivity disorder (ADHD) symptoms and high-risk sexual behavior. This cross-sectional study interviewed 462 low-income women aged 18-30 years. We used the 18-item Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist to assess ADHD symptoms. Risky sexual behaviors included sex before 15 years of age, risky sex partners in lifetime, number of sex partners in the last 12 months, condom use in the last 12 months, alcohol use before sex in the last 12 months, traded sex in lifetime, and diagnosed with sexually transmitted infection (STI) in lifetime. Mean ADHD symptom score was 19.8 (SD±12.9), and summary index of all risky sexual behavior was 1.77 (SD±1.37). Using unadjusted odds ratios (OR), women who endorsed more ADHD symptoms reported engaging in more risky sexual behaviors of all types. However, when multivariable logistic regression was applied adjusting for various sociodemographic covariates, the adjusted ORs remained significant for having risky sex partners and having ≥3 sex partners in the prior 12 months. We observed some differences in risky sexual behavior between two domains of ADHD. The ADHD symptom score appears to be associated with some risky sexual behaviors and deserves further attention. A brief ADHD screening can identify this high-risk group for timely evaluation and safe sex counseling.

  3. The effectiveness of community action in reducing risky alcohol consumption and harm: a cluster randomised controlled trial.

    Directory of Open Access Journals (Sweden)

    Anthony Shakeshaft

    2014-03-01

    Full Text Available The World Health Organization, governments, and communities agree that community action is likely to reduce risky alcohol consumption and harm. Despite this agreement, there is little rigorous evidence that community action is effective: of the six randomised trials of community action published to date, all were US-based and focused on young people (rather than the whole community, and their outcomes were limited to self-report or alcohol purchase attempts. The objective of this study was to conduct the first non-US randomised controlled trial (RCT of community action to quantify the effectiveness of this approach in reducing risky alcohol consumption and harms measured using both self-report and routinely collected data.We conducted a cluster RCT comprising 20 communities in Australia that had populations of 5,000-20,000, were at least 100 km from an urban centre (population ≥ 100,000, and were not involved in another community alcohol project. Communities were pair-matched, and one member of each pair was randomly allocated to the experimental group. Thirteen interventions were implemented in the experimental communities from 2005 to 2009: community engagement; general practitioner training in alcohol screening and brief intervention (SBI; feedback to key stakeholders; media campaign; workplace policies/practices training; school-based intervention; general practitioner feedback on their prescribing of alcohol medications; community pharmacy-based SBI; web-based SBI; Aboriginal Community Controlled Health Services support for SBI; Good Sports program for sports clubs; identifying and targeting high-risk weekends; and hospital emergency department-based SBI. Primary outcomes based on routinely collected data were alcohol-related crime, traffic crashes, and hospital inpatient admissions. Routinely collected data for the entire study period (2001-2009 were obtained in 2010. Secondary outcomes based on pre- and post-intervention surveys (n

  4. The effectiveness of community action in reducing risky alcohol consumption and harm: a cluster randomised controlled trial.

    Science.gov (United States)

    Shakeshaft, Anthony; Doran, Christopher; Petrie, Dennis; Breen, Courtney; Havard, Alys; Abudeen, Ansari; Harwood, Elissa; Clifford, Anton; D'Este, Catherine; Gilmour, Stuart; Sanson-Fisher, Rob

    2014-03-01

    The World Health Organization, governments, and communities agree that community action is likely to reduce risky alcohol consumption and harm. Despite this agreement, there is little rigorous evidence that community action is effective: of the six randomised trials of community action published to date, all were US-based and focused on young people (rather than the whole community), and their outcomes were limited to self-report or alcohol purchase attempts. The objective of this study was to conduct the first non-US randomised controlled trial (RCT) of community action to quantify the effectiveness of this approach in reducing risky alcohol consumption and harms measured using both self-report and routinely collected data. We conducted a cluster RCT comprising 20 communities in Australia that had populations of 5,000-20,000, were at least 100 km from an urban centre (population ≥ 100,000), and were not involved in another community alcohol project. Communities were pair-matched, and one member of each pair was randomly allocated to the experimental group. Thirteen interventions were implemented in the experimental communities from 2005 to 2009: community engagement; general practitioner training in alcohol screening and brief intervention (SBI); feedback to key stakeholders; media campaign; workplace policies/practices training; school-based intervention; general practitioner feedback on their prescribing of alcohol medications; community pharmacy-based SBI; web-based SBI; Aboriginal Community Controlled Health Services support for SBI; Good Sports program for sports clubs; identifying and targeting high-risk weekends; and hospital emergency department-based SBI. Primary outcomes based on routinely collected data were alcohol-related crime, traffic crashes, and hospital inpatient admissions. Routinely collected data for the entire study period (2001-2009) were obtained in 2010. Secondary outcomes based on pre- and post-intervention surveys (n = 2,977 and 2

  5. Clinical practice of analysis of anti-drug antibodies against interferon beta and natalizumab in multiple sclerosis patients in Europe

    DEFF Research Database (Denmark)

    Link, Jenny; Ramanujam, Ryan; Auer, Michael

    2017-01-01

    six countries (Sweden, Austria, Spain, Switzerland, Germany and Denmark) on 20,695 patients and on 42,555 samples were loaded into tranSMART including data points of age, gender, treatment, samples, and ADA results. The previously observed immunogenic difference among the four IFNβ preparations...... positive test. Shorter times were observed for IFNβ-1b-Extavia s.c. (0.99 and 0.94 years) and natalizumab (0.25 and 0.23 years), which were introduced on the market when ADA testing was already available, as compared to IFNβ-1a i.m. (1.41 and 2.27 years), IFNβ-1b-Betaferon s.c. (2.51 and 1.96 years....... For drugs where routine monitoring of ADA is not in place, there is a risk that some patients remain on treatment for several years despite ADA positivity. For drugs where a strategy of ADA testing is introduced with the release of the drug, there is a reduced risk of having ADA positive patients and thus...

  6. Screening and brief intervention for alcohol and other drug use in primary care: associations between organizational climate and practice.

    Science.gov (United States)

    Cruvinel, Erica; Richter, Kimber P; Bastos, Ronaldo Rocha; Ronzani, Telmo Mota

    2013-02-11

    Numerous studies have demonstrated that positive organizational climates contribute to better work performance. Screening and brief intervention (SBI) for alcohol, tobacco, and other drug use has the potential to reach a broad population of hazardous drug users but has not yet been widely adopted in Brazil's health care system. We surveyed 149 primary health care professionals in 30 clinics in Brazil who were trained to conduct SBI among their patients. We prospectively measured how often they delivered SBI to evaluate the association between organizational climate and adoption/performance of SBI. Organizational climate was measured by the 2009 Organizational Climate Scale for Health Organizations, a scale validated in Brazil that assesses leadership, professional development, team spirit, relationship with the community, safety, strategy, and remuneration. Performance of SBI was measured prospectively by weekly assessments during the three months following training. We also assessed self-reported SBI and self-efficacy for performing SBI at three months post-training. We used inferential statistics to depict and test for the significance of associations. Teams with better organizational climates implemented SBI more frequently. Organizational climate factors most closely associated with SBI implementation included professional development and relationship with the community. The dimensions of leadership and remuneration were also significantly associated with SBI. Organizational climate may influence implementation of SBI and ultimately may affect the ability of organizations to identify and address drug use.

  7. Prospective drug safety monitoring using the UK primary-care General Practice Research Database: theoretical framework, feasibility analysis and extrapolation to future scenarios.

    Science.gov (United States)

    Johansson, Saga; Wallander, Mari-Ann; de Abajo, Francisco J; García Rodríguez, Luis Alberto

    2010-03-01

    Post-launch drug safety monitoring is essential for the detection of adverse drug signals that may be missed during preclinical trials. Traditional methods of postmarketing surveillance such as spontaneous reporting have intrinsic limitations, many of which can be overcome by the additional application of structured pharmacoepidemiological approaches. However, further improvement in drug safety monitoring requires a shift towards more proactive pharmacoepidemiological methods that can detect adverse drug signals as they occur in the population. To assess the feasibility of using proactive monitoring of an electronic medical record system, in combination with an independent endpoint adjudication committee, to detect adverse events among users of selected drugs. UK General Practice Research Database (GPRD) information was used to detect acute liver disorder associated with the use of amoxicillin/clavulanic acid (hepatotoxic) or low-dose aspirin (acetylsalicylic acid [non-hepatotoxic]). Individuals newly prescribed these drugs between 1 October 2005 and 31 March 2006 were identified. Acute liver disorder cases were assessed using GPRD computer records in combination with case validation by an independent endpoint adjudication committee. Signal generation thresholds were based on the background rate of acute liver disorder in the general population. Over a 6-month period, 8148 patients newly prescribed amoxicillin/clavulanic acid and 5577 patients newly prescribed low-dose aspirin were identified. Within this cohort, searches identified 11 potential liver disorder cases from computerized records: six for amoxicillin/clavulanic acid and five for low-dose aspirin. The independent endpoint adjudication committee refined this to four potential acute liver disorder cases for whom paper-based information was requested for final case assessment. Final case assessments confirmed no cases of acute liver disorder. The time taken for this study was 18 months (6 months for

  8. The Saudi Arabia Food and Drug Authority: An Evaluation of the Registration Process and Good Review Practices in Saudi Arabia in Comparison with Australia, Canada and Singapore.

    Science.gov (United States)

    Hashan, Hajed; Aljuffali, Ibrahim; Patel, Prisha; Walker, Stuart

    This study compares the current regulatory review process and good review practices at the Saudi Food and Drug Authority (SFDA) with those of regulatory agencies in Australia, Canada, and Singapore and identifies opportunities for developing the SFDA as a Regional Centre of Excellence. A questionnaire completed by the SFDA included data regarding the organisation, key milestones, review timelines, and good review practices of the agency. Similar information was obtained within the same timeframe (2014/2015) through the same standard questionnaire regarding the processes and practices for Health Canada, Singapore's Health Sciences Authority, and Australia's Therapeutic Goods Administration. All four regulatory agencies have established target times for scientific assessment and regulatory review, examine dossier sections in parallel, and separate company response time from overall timing. Additionally, all four agencies have instituted good review practices including standard operating procedures, templates, dossier monitoring, and continuous improvement processes, and assign a high priority to transparency in their relationships with the public, healthcare professionals and industry. Of the four agencies, however, only the SFDA requires a Certificate of Pharmaceutical Product (CPP) at the time of the submission and pricing negotiations before final product approval. To assist the SFDA in its efforts to become a Regional Centre of Excellence, it is suggested that the agency explore a risk stratification approach to select dossiers for verification, abridged, or full reviews; use forms of certification other than the CPP; make pricing negotiations independent to the review process; and introduce a feedback process for the quality of the dossier.

  9. Value-based decision-making battery: A Bayesian adaptive approach to assess impulsive and risky behavior.

    Science.gov (United States)

    Pooseh, Shakoor; Bernhardt, Nadine; Guevara, Alvaro; Huys, Quentin J M; Smolka, Michael N

    2018-02-01

    Using simple mathematical models of choice behavior, we present a Bayesian adaptive algorithm to assess measures of impulsive and risky decision making. Practically, these measures are characterized by discounting rates and are used to classify individuals or population groups, to distinguish unhealthy behavior, and to predict developmental courses. However, a constant demand for improved tools to assess these constructs remains unanswered. The algorithm is based on trial-by-trial observations. At each step, a choice is made between immediate (certain) and delayed (risky) options. Then the current parameter estimates are updated by the likelihood of observing the choice, and the next offers are provided from the indifference point, so that they will acquire the most informative data based on the current parameter estimates. The procedure continues for a certain number of trials in order to reach a stable estimation. The algorithm is discussed in detail for the delay discounting case, and results from decision making under risk for gains, losses, and mixed prospects are also provided. Simulated experiments using prescribed parameter values were performed to justify the algorithm in terms of the reproducibility of its parameters for individual assessments, and to test the reliability of the estimation procedure in a group-level analysis. The algorithm was implemented as an experimental battery to measure temporal and probability discounting rates together with loss aversion, and was tested on a healthy participant sample.

  10. Is identification of smoking, risky alcohol consumption and overweight and obesity by General Practitioners improving? A comparison over time.

    Science.gov (United States)

    Bryant, Jamie; Yoong, Sze Lin; Sanson-Fisher, Rob; Mazza, Danielle; Carey, Mariko; Walsh, Justin; Bisquera, Alessandra

    2015-12-01

    Detection of lifestyle risk factors by GPs is the first step required for intervention. Despite significant investment in preventive health care in general practice, little is known about whether GP detection of lifestyle risk factors have improved over time. To examine whether sensitivity and specificity of GP detection of smoking, risky alcohol consumption and overweight and obesity has increased in patients presenting to see their GP, by comparing results from four Australian studies conducted between 1982 and 2011. Demographic characteristics of patient and GP samples and the prevalence, sensitivity and specificity of detection of each risk factor were extracted from published studies. Differences between GP and patient sample characteristics were examined. To identify trends over time in prevalence of risk factors, sensitivity and specificity of detection across studies and the Cochran-Armitage test for trend were calculated for each risk factor for the overall sample and by male and female subgroups. There were no statistically significant changes in the sensitivity of GP detection of smoking or overweight or obesity over time. Specificity of detection of smoking increased from 64.7% to 98% (P investment to increase GP detection and intervention for lifestyle risk factors, accurate detection of smoking, risky alcohol consumption and overweight and obesity occurs for less than two-thirds of all patients. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Correlates of risky sexual behaviors in recently traditionally circumcised men from initiation lodges in the Eastern Cape, South Africa.

    Science.gov (United States)

    Nyembezi, Anam; Sifunda, Sibusiso; Funani, Itumeleng; Ruiter, Robert A C; Van Den Borne, Bart; Reddy, Priscilla S

    This exploratory quantitative study examines past risky sexual behaviors among young men who were circumcised as part of a rite of passage to adulthood embedded within a cultural and traditional belief system in the Eastern Cape Province in South Africa. Following permission from the Eastern Cape House of Traditional Leaders (ECHOTL), individual face-to-face interviews using a structured questionnaire were conducted among 114 initiates. The mean age of the participants was 18.9 years, ranging from 15 to 32 years old. About 79.8% reported already having had sex with a woman prior to initiation. Of those, 89% reported that they ever used condoms when having sex, and 61% reported consistent use. Logistic regression analysis showed that consistent condom use increased with higher educational levels. Those involved in other risky health behaviors (specifically, smoking) were also more likely to report inconsistent condom use. Most participants had positive beliefs about male circumcision and STI/HIV transmission. This study provides a first look at the sexual behaviors of young men at the time of their initiation in adulthood, a process that is intended to make it socially acceptable to initiate sexual relations and highlights a major public health challenge in integrating the protective health benefits of circumcision with indigenous cultural practices.

  12. [What do adolescents and young people think about recreational drug use and sexual risks?].

    Science.gov (United States)

    Rodríguez García de Cortázar, Ainhoa; Hernán García, Mariano; Cabrera León, Andrés; García Calleja, José María; Romo Avilés, Nuria

    2007-01-01

    The objective of this article is to analyse the opinions of adolescents and young people, from gypsy and non-gypsy populations, on the relationship between recreational drug use and sexual practices that increase the risk of HIV infection. A descriptive qualitative research was undertaken. 14 focus groups were conducted with 98 adolescents and young people, and 7 semi-structured interviews with young recreational drug users. Both sort of results were triangulated. Two major discursive lines emerge in the analysis. The first one defends the notion that moderate consumption of alcohol facilitates the sexual encounter, but it does not imply risky behaviours. However, polydrug use or an elevated use of recreational drugs is related to a lack of concern for sexual risks, and in men with the loss of sexual sensitivity that sometimes justifies not using a condom. The second line argues other reasons for the non-use of condoms, such as their lack of availability, confidence in one's sexual partner, a concept of desire as something uncontrollable, infatuation and the state of mind or self-esteem. Some recommendations to prevent sexual transmission of HIV are derived from the results, such as the distribution of condoms in places where alcohol and other drugs are consumed, publicising the use of condoms and other latex barriers for oral genital sexual practices, working with young males on the optimisation of pleasure, designing preventive interventions targeting stable partners, and training adolescent girls in the social skills needed to negotiate the use of condoms.

  13. Economic booms and risky sexual behavior: evidence from Zambian copper mining cities.

    Science.gov (United States)

    Wilson, Nicholas

    2012-12-01

    Existing studies suggest that individual and household level economic shocks affect the demand for and supply of risky sex. However, little evidence exists on the effects of an aggregate shock on equilibrium risky sexual behavior. This paper examines the effects of the early twenty-first century copper boom on risky sexual behavior in Zambian copper mining cities. The results suggest that the copper boom substantially reduced rates of transactional sex and multiple partnerships in copper mining cities. These effects were partly concentrated among young adults and copper boom induced in-migration to mining cities appears to have contributed to these reductions. Copyright © 2012. Published by Elsevier B.V.

  14. Current status of therapeutic drug monitoring in Australia and New Zealand: a need for improved assay evaluation, best practice guidelines, and professional development.

    Science.gov (United States)

    Norris, Ross L; Martin, Jennifer H; Thompson, Erin; Ray, John E; Fullinfaw, Robert O; Joyce, David; Barras, Michael; Jones, Graham R; Morris, Raymond G

    2010-10-01

    The measurement of drug concentrations, for clinical purposes, occurs in many diagnostic laboratories throughout Australia and New Zealand. However, the provision of a comprehensive therapeutic drug monitoring (TDM) service requires the additional elements of pre- and postanalytical advice to ensure that concentrations reported are meaningful, interpretable, and clinically applicable to the individual patient. The aim of this project was to assess the status of TDM services in Australia and New Zealand. A range of professions involved in key aspects of TDM was surveyed by questionnaire in late 2007. Information gathered included: the list of drugs assayed; analytical methods used; interpretation services offered; interpretative methods used; and further monitoring advice provided. Fifty-seven responses were received, of which 42% were from hospitals (public and/or private); 11% a hospital (public and/or private) and pathology provider; and 47% a pathology provider only (public and/or private). Results showed that TDM is applied to a large number of different drugs. Poorly performing assay methods were used in some cases, even when published guidelines recommended alternative practices. Although there was a wide array of assays available, the evidence suggested a need for better selection of assay methods. In addition, only limited advice and/or interpretation of results was offered. Of concern, less than 50% of those providing advice on aminoglycoside dosing in adults used pharmacokinetic tools with six of 37 (16.2%) respondents using Bayesian pharmacokinetic tools, the method recommended in the Australian Therapeutic Guidelines: Antibiotic. In conclusion, the survey highlighted deficiencies in the provision of TDM services, in particular assay method selection and both quality and quantity of postanalytical advice. A range of recommendations, some of which may have international implications, are discussed. There is a need to include measures of impact on clinical

  15. Impact of the FDA warning of potential ceftriaxone and calcium interactions on drug use policy in clinical practice.

    Science.gov (United States)

    Esterly, John S; Steadman, Emily; Scheetz, Marc H

    2011-06-01

    In September 2007, the FDA issued an alert recommending that ceftriaxone and calcium-containing solutions should not be administered to any patient within 48 h of each other. Due to the widespread use of ceftriaxone, significant concern was expressed by the greater healthcare community about the warning, which the FDA eventually retracted in April of 2009. We sought to quantify the impact of the warning on healthcare institutions. A survey was administered to the membership of the Society of Infectious Diseases Pharmacists to quantify perceived changes in ceftriaxone use among healthcare institutions across the United States. A survey of Infectious Diseases experts was conducted. Participants were queried for hospital policies/drug use statistics during two times: immediately after the FDA warning and approximately 13 months post warning (preceding the FDA retraction). Related changes in formulary, drug-use policy, and the number of employee hours that were devoted to addressing the FDA warning were assessed. Ninety-four surveys representing 94 hospital systems were included in the analysis. Approximately half (n = 49, 52%) of respondent institutions enacted at least one drug-use policy change based on the warning; one institution removed ceftriaxone from a clinical protocol. Institutions' final interpretations of the warning differed slightly from initial understanding of the warning, and there was an overall minor decrease in the perceived use of ceftriaxone. The majority of those surveyed (n = 70, 74%) estimated that their respective institutions devoted between 1 and 49 employee hours to address the warning. Hospitals with ID pharmacists had minimal changes to ceftriaxone use after the 2007 FDA warning. Specialized pharmacists may be uniquely situated to help hospitals interpret global recommendations locally.

  16. [Analysis of the risky behaviors among HIV positive female sex workers].

    Science.gov (United States)

    Wang, Jue; Jia, Manhong; Luo, Hongbing; Li, Youfang; Song, Lijun; Mei, Jingyuan; Ma, Yanling; Yang, Yanling; Lu, Ran; Wang, Ling; Zhang, Renzhong; Pan, Songfeng; Li, Zhiqing; Lu, Lin

    2015-11-01

    To analyze the characteristics of risky behaviors among different age groups of HIV positive female sex workers, and to explore the strengthening of their management. From January to June 2014, 22 814 female sex workers were investigated and tested HIV in 117 sentinel surveillance sites in Yunnan Province, and 181 were confirmed to be HIV antibody positive, who accepted questionnaire surveys. According to the age, the participants were divided into the HIV/AIDS and related risk behaviors characteristics of the two groups were obtained via questionnaire surveys among 181 HIV positive female sex workers, and in-depth qualitative interviews were conducted from among 12 HIV positive sex workers. HIV antibody positive rate was 0.8% (181), the age of the 181 subjects were (35.83 ± 9.17) years old, 76 cases (42.0%) were HIV, the proportion of AIDS awareness was 95.6% (173); the proportion of drug use among ≥ 35 years old age group was 51.4% (54), which was higher than that in HIV counseling and testing in the past year. The proportion of continuing to engage in sexual services over 5 years after HIV infection was 48.5% (51/105) and the proportion of receiving antiretroviral treatment was 69.5% (73/105) in ≥ 35 years old age group, which were higher than those in the HIV positive female sex workers found that regular clients, not consistent use of condoms were the main cause of no condom use. Economic and livelihood factors are important reasons for continuing to engage in sexual services among HIV positive sex workers. HIV positive sex workers still have high risk behaviors including continuing to engage in commercial sexual service and no condom use after knowing their HIV infection status, and the proportion of using drugs in the ≥ 35 years old group was higher than that in < 35 years old group.

  17. EXPERIENCE WITH THE ROSINSULIN C IN COMBINATION WITH ORAL ANTIDIABETIC DRUGS IN PATIENTS WITH TYPE 2 DIABETES IN ROUTINE CLINICAL PRACTICE

    Directory of Open Access Journals (Sweden)

    O. D. Rymar

    2014-01-01

    Full Text Available This study aimed to estimate the efficacy and safety of intermediate-acting insulin Rosinsulin C in patients with type 2 diabetes mellitus inadequately controlled with oral antidiabetic drugs.The present study is a 6-month, prospective, uncontrolled, clinical experience evaluation study using insulin Rosinsulin С for type 2 diabetes patients in daily clinical practice. Episodes of hypoglycaemia, adverse events were recorded. The study included 28 patients with type 2 diabetes, 4 men and 24 women who treated with metformin in combination with sulfonylureas in the highest dose. Indicators of glycosylated hemoglobin (HbA1c of 8 to 14%, the median HbA1c was 11 (10; 13% of patients age 65 (57; 72 years, body mass index – 33 (30; 35 kg/m2, waist circumference – 105 (99; 111 cm, diabetes duration – 7 (2; 11 years. With the introduction of Rosinsulin С cartridges carried pen Autopen. At the start of the study and after 3 and 6 months, determined the level of HbA1c, fasting plasma glucose.After 6 months' treatment with Rosinsulin С in combination with oral antidiabetic drugs HbA1c was significantly lowered (–3% (p = 0,001, fasting plasma glucose level decreased by 5 mmol/L (p = 0,001. There was not severe hypoglycemia during the observation period.This research showed that Rosinsulin C is effective and safe in the treatment of patients with type 2 diabetes who were decompensated with oral antidiabetic drugs and can be recommended for use as the initiation of insulin therapy in routine clinical practice.

  18. Community-based management of multiple drug resistant tuberculosis in a tertiary hospital in Tanzania: a best practice implementation project.

    Science.gov (United States)

    Jelly, Isaya; Peters, Micah D J

    2017-12-01

    The World Health Organization (WHO) has prioritized collaboration with communities in its 2016 "End TB" implementation strategy. Acknowledging the difficulties that some communities face in gaining access to health facilities due to barriers such as stigma, discrimination, healthcare expenditure, transport and income loss, partnering with communities in the roll-out of community-based TB management activities is vital. The aim of this project was to make a contribution to promoting evidence-based practice with regards to the community-based management of multidrug-resistant tuberculosis (MDR-TB) at Kibong'oto National Infectious Disease Hospital, Tanzania, and thereby supporting improvements in patient outcomes and resource utilization. The project utilized the Joanna Briggs Institute Practical Application of Clinical Evidence System (JBI PACES) program to facilitate the collection of pre- and post-audit data. The Getting Research into Practice (GRiP) module was also used to analyze the potential barriers and for designing the final action plan. This project was conducted in three phases over a three-month period at the MDR-TB unit in a referral hospital in Northern Tanzania. The project showed that there were significant improvements in compliance rates in staff education and documentation of patients' suitability and preferences in receiving community-based care for MDR-TB. The compliance rate of criterion 2, which was already 100% at baseline, was slightly lower at follow-up. The project achieved significant improvements in the delivery of evidence-based practice with regards to community-based management of MDR-TB.

  19. Risky business: Correlation and causation in longitudinal studies of skill development.

    Science.gov (United States)

    Bailey, Drew H; Duncan, Greg J; Watts, Tyler; Clements, Doug H; Sarama, Julie

    2018-01-01

    Developmental theories often posit that changes in children's early psychological characteristics will affect much later psychological, social, and economic outcomes. However, tests of these theories frequently yield results that are consistent with plausible alternative theories that posit a much smaller causal role for earlier levels of these psychological characteristics. Our article explores this issue with empirical tests of skill-building theories, which predict that early boosts to simpler skills (e.g., numeracy or literacy) or behaviors (e.g., antisocial behavior or executive functions) support the long-term development of more sophisticated skills or behaviors. Substantial longitudinal associations between academic or socioemotional skills measured early and then later in childhood or adolescence are often taken as support of these skill-building processes. Using the example of skill-building in mathematics, we argue that longitudinal correlations, even if adjusted for an extensive set of baseline covariates, constitute an insufficiently risky test of skill-building theories. We first show that experimental manipulation of early math skills generates much smaller effects on later math achievement than the nonexperimental literature has suggested. We then conduct falsification tests that show puzzlingly high cross-domain associations between early math and later literacy achievement. Finally, we show that a skill-building model positing a combination of unmeasured stable factors and skill-building processes can reproduce the pattern of experimental impacts on children's mathematics achievement. Implications for developmental theories, methods, and practice are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  20. Reframing Risqué/Risky: Queer Temporalities, Teenage Sexting, and Freedom of Expression

    Directory of Open Access Journals (Sweden)

    Lara Karaian

    2015-01-01

    Full Text Available Canada recognizes young people’s constitutionally protected freedom of expression and consequently their right to engage in a narrow subset of consensual sexually expressive practices without being prosecuted as child pornographers. Nevertheless, numerous anti-sexting campaigns decry the possibility of voluntary and “safe sexting” let alone the affordances of adolescents’ self-produced and consensually shared sexual imagery. In this article, we argue that these actors have erred in their construction of youths’ risqué imagery as inherently risky and thus governable. We propose that anti-sexting frameworks—which conflate consensual and nonconsensual sexting and which equate both with negative risks that purportedly outweigh the value and benefits of the practice—rely on a calculus that is fundamentally flawed. This article consists of two main parts. In Part I, we map and trouble the ways in which responses to consensual teenage sexting emphasize the practice’s relationship to embodied, financial, intimate and legal risks. In Part II, we suggest that research examining consensual adolescent sexting and young people’s rights to freedom of expression consider alternative theoretical frameworks, such as queer theories of temporality, when calculating the risk of harm of adolescent sexual imagery.