Barriers and Facilitators of Addiction Treatment: a Qualitative Study

International Journal of Mental Health and Addiction - Addictive disorders affect a considerable proportion of the population worldwide and in India. Treatment-related barriers and facilitators...     

Received social support, self-efficacy, and finding benefits in disease as predictors of physical functioning and adherence to antiretroviral therapy

OBJECTIVE: The study investigated whether received social support, self-efficacy, and finding benefits in disease are related to physical functioning and adherence to antiretroviral medication among men and women infected with HIV. METHODS: Data were collected among 104 patients of three HIV clinics in India. The measures included general self-efficacy scale, Berlin social support scales, questionnaire on taking antiretroviral medication, and SF-20 (physical functioning). RESULTS: The results of path analysis and mediation analysis revealed that finding benefits and self-efficacy were directly related to both adherence and physical functioning. Additionally, finding benefits mediated the relation between patients' self-efficacy and adherence as well as physical functioning. Although received support was unrelated to adherence directly, effects of received support on adherence were mediated by self-efficacy. CONCLUSIONS: Besides personal and social resources, benefit finding was related to better adherence to antiretroviral medication. PRACTICE IMPLICATIONS: Identifying patients receiving low social support, with weak general self-efficacy and finding no benefits in being diagnosed with HIV may help to elicit those people who are at risk for poorer adherence and physical functioning.     

Letter to the editor concerning “A systematic review and meta-analysis on the management of accidental dural tears in spinal surgery: drowning in information but thirsty for a clear message” by Alshameeri ZAF,et al. [Eur Spine J (2020); DOI 10.1007/s00586-020-06401-y]

European Spine Journal -     

Intrathoracic migration of an unbent Steinmann pin

Steinmann pins are known to be used as a shoulder stabilisation device in recurrent dislocation. Although rare, their potential to migrate within the thorax has been reported. We present the case of an 87-year-old man who was treated for recurrent left shoulder dislocation with pinning using a Steinmann pin. He presented eight days postoperatively with the pin impaling the aortic adventitia. To our knowledge, this is only the fifth case report of such an event. Awareness of this complication and attempts to prevent its occurrence are critical as the outcome can be fatal.     

Association between initial morphine intake and body weight change,acoustic startle reflex and drug seeking in rats

Rationale

Although chronic use of opiates can induce physical dependence and addiction, individual differences contributing to these symptoms are largely unknown.

Objectives

Using intravenous morphine self-administration (MSA), we investigated whether individual differences in drug intake are associated with weight change, acoustic startle reflex (ASR), pre-pulse inhibition (PPI), and drug seeking during spontaneous withdrawal.

Methods

Male Sprague-Dawley rats self-administered morphine (0.5 mg/kg/infusion) or saline for 3 weeks (4–6 h/day, 5 days/week) and drug intake and body weight were monitored daily. The ASR and the PPI (baseline, 1 day and 1 week) and drug seeking (1 week) were measured during spontaneous withdrawal.

Results

Morphine animals did not gain weight (101 %?±?0.69), while the control animals did (115 %?±?1.06) after 3 weeks of self-administration. The ASR and the PPI were not significantly different between morphine and saline animals in 1-day or 1-week withdrawal. However, individual differences in initial (first 10 min), but not total (4–6 h), morphine intake of the daily sessions were positively correlated with weight change (r?=?0.437, p?=?0.037) and drug seeking (r?=?0.424, p?=?0.035) while inversely correlated with the ASR (r?=??0.544, p?=?0.005) in 1-week withdrawal from chronic morphine.

Conclusions

A subgroup of animals that self-administered a larger amount of morphine at the beginning of the daily sessions exhibited subsequent weight gain, reduced ASR, and enhanced drug seeking in morphine withdrawal. Thus, individual differences in initial morphine intake may reveal a novel behavioral phenotype in opioid addiction.