Assessment of neuropsychological impairments in regular cannabis users

BackgroundCannabis is the most widely used illicit drug in the world. It is responsible for cognitive dysfunction of memory, speed of information processing, attention, and executive functions. Cognitive performance depends on the level of study, tolerance, and duration of abstinence from cannabis use. This study analyses cognitive function in a large population of regular cannabis consumers taking into account level of education.MethodsA battery of neuropsychological tests using the Cambridge Neuropsychological Test Automated Battery was performed on a population of 58 cannabis users categorized into two groups according to their level of education with a threshold of 12 years of study, and 25 non-users.ResultsIn Attention Switching Task percent correct trials, significant differences were found between the group of cannabis smokers with less than 12 years of study and the non-smoker group (P = 0.022), and between the cannabis users with more than 12 years of study and the non-smoker group (P = 0.008). A significantly lower performance in the Rapid Visual Information Processing (Mean latency, Probability of hit, Total hits, Total misses, Correct rejections) was found in the cannabis users with less than 12 years of study compared with the non-user group.ConclusionIn our population, chronic cannabis users presented divided and sustained attention and working memory disorders. Rapid Visual Information Processing performance may be influenced by education level in cannabis smokers.     

Preferences for professional versus informal care at end of life amongst African-American drug users with HIV/AIDS

With the advent of antiretroviral therapies, persons living with HIV/AIDS (PLHIVs) are living longer but with increased impairment and care needs. The purpose of this study was to assess whether a vulnerable population of PLHIVs preferred informal versus professional care when unable to care for themselves, and individual and support network factors associated with preference for informal care. The findings have potential implications for facilitating the population's informal care at end of life. Data were from the BEACON study, which examined social factors associated with health outcomes among former or current drug-using PLHIVs in Baltimore, MD. Structural equation modeling was used to identify individual and support network characteristics associated with PLHIVs' preference for informal (family or friends) compared to professional care. The structural equation model indicated preference for informal care was associated with female sex, greater informal care receipt, reporting one's main partner (i.e., boy/girlfriend or spouse) as the primary source of informal care, and a support network comprised greater numbers of female kin and persons supportive of the participant's HIV treatment adherence. Not asking for needed help to avoid owing favors was associated with preferring professional care. Findings suggest that interventions to promote informal end of life care should bolster supportive others' resources and skills for care provision and treatment adherence support, and should address perceived norms of reciprocity. Such intervention will help ensure community caregiving in a population with high needs for long-term care.     

Challenges facing HIV-positive persons who use drugs and their families in Vietnam

It is hypothesized that persons who use drugs (PWUD) in Vietnam who are also HIV-positive may face additional challenges in psychosocial outcomes, and these challenges may extend to their family members. In this study, we examined depressive symptoms, stigma, social support, and caregiver burden of HIV-positive PWUD and their family members, compared to the outcomes of HIV-negative PWUD and their family members. Baseline, 3-month, and 6-month assessment data were gathered from 83 PWUD and 83 family members recruited from four communes in Phú Th? Province, Vietnam. For PWUD, although we observed a general decline in overall stigma over time for both groups, HIV-positive PWUD consistently reported significantly higher overall stigma for all three periods. Depressive symptoms among family members in both groups declined over time; however, family members of HIV-positive PWUD reported higher depressive symptoms across all three periods. In addition, family members of HIV-positive PWUD reported lower levels of tangible support across all three periods. Caregiver burden among family members of HIV-positive PWUD increased significantly over time, whereas the reported burden among family members of HIV-negative PWUD remained relatively unchanged. The findings highlight the need for future interventions for PWUD and family members, with targeted and culturally specific strategies to focus on the importance of addressing additional stigma experienced by PWUD who are HIV-positive. Such challenges may have direct negative impact on their family members' depressive symptoms, tangible support, and caregiver burden.     

An institutional ethnography of prevention and treatment services for substance use disorders in the Dominican Republic

ABSTRACT

The Dominican Republic is thought to have significant epidemics of illicit drug use but lacks surveillance and formal analyses of the policy context of drug prevention and treatment services. We conducted an institutional ethnography of 15 drug service organisations in Santo Domingo and Boca Chica, Dominican Republic, to explore barriers and resources for drug abuse prevention and treatment. Here, we present a typology of drug service organisations based on their services, methods, and approach. We then draw on interviews with representatives of drug service institutions to describe the primary barriers to drug treatment and prevention services for drug users. We conclude with a focus on the policy priorities that could improve the conditions of health care for marginalised drug users in the Dominican Republic.     

Potential users’ preferences towards cardiac telemedicine: A discrete choice experiment investigation in Sardinia

Background

Potential users’ preferences for telemedicine services directed to cardio-vascular diseases are investigated applying a discrete choice experiment (DCE). Given the potential of telemedicine to minimize costs without reducing overall efficiency, assessing preferences for these types of services represents a priority for policy makers. This is especially true for those pathologies that absorb a relatively high quota of total health expenditure. The empirical setting is Sardinia (Italy) because of its insularity and the underdeveloped internal transport network. Telemedicine is likely to mitigate distance between healthcare providers and final users.

吸毒者肺谷物性肉芽肿尸检2例光镜及电镜观察

目的 报告2例吸毒致死者肺谷物性肉芽肿。方法 应用光镜、电镜及组织化学方法，对肺谷物性肉芽肿的形态学及组织化学特征进行分析，并结合文献复习对肺谷物性肉芽肿的形成机制进行初步讨论。结果 肺谷物性肉芽肿甲基紫、刚果红强阳性，光镜及电镜下具有特征性的马尔他十字结构。结论 吸毒者肺谷物性肉芽肿形成与非静脉注射性毒品中的添加剂有关，该肉芽肿诊断需与肺部其他肉芽肿性病变进行鉴别。     

利用提名法和乘数法对云南省大理州吸毒人群规模进行调查研究

目的 通过对大理州吸毒人群规模调查及近年吸毒人群血清学、行为学监测资料,掌握吸毒人群HIV感染现状,为全面开展高危行为综合干预提供科学依据.方法 在12个县(市)利用提名-乘数法对吸毒人群进行规模调查;用估计结果及近年相关监测资料,用Workbook 2007版估计软件估计静脉吸毒人群中艾滋病病毒(HIV)感染数.结果 大理州目前有11 092名吸毒者,其中静脉吸毒8049人,占所有吸毒人员的72.57%.现存HIV感染者中5587人有静脉吸毒史.结论 提名法和乘数法是艾滋病流行相关高危人群规模估计较实用的方法,但应注意调查时间、指定机构在辖区的代表性、目标人群的识别及调查员培训和调查方法的标准化等因素,以减少评估结果的偏差.