A good quality of life under the influence of methadone: a qualitative study among opiate-dependent individuals

Background

Attention from researchers and health care workers to the quality of life (QoL) of opiate users is growing, but most studies are quantitative, giving limited attention to the consumer's perspective. No information is available on how opiate-dependent individuals themselves perceive QoL and what they see as the important components that contribute to a good QoL.

Objectives

This qualitative study aims to expand our knowledge concerning opiate-dependent individuals’ perceptions of a good QoL and the impact of methadone on components of a good QoL.

Methods

In-depth interviews were conducted with 25 opiate-dependent individuals aged between 26 and 46 years old who started a methadone maintenance treatment at least 5 years ago. Purposive sampling was used to recruit participants with different socio-demographic characteristics and drug use profiles. The interviews were audio-tape recorded, transcribed verbatim and analysed thematically.

Results

Thematic analyses revealed five key themes contributing to a good QoL for opiate-dependent individuals: (1) having social relationships, (2) holding an occupation, (3) feeling good about one's self, (4) being independent and (5) having a meaningful life. Opiate-dependent individuals valued methadone's ability to help them function normally, overcome their psychological problems and dependence on illicit opiates, and support them in achieving certain life goals. On the other hand, stigmatisation, discrimination, dependence on methadone and the drug's paralysing effects on their emotions were mentioned as common negative consequences.

Conclusions

The findings of this study highlight the importance of supporting opiate-dependent individuals in their daily life by means of practical, social and environmental support (alongside pharmacological treatment) in order to improve their QoL. This study further illustrates the ambivalent influence of methadone on opiate-dependent individuals’ QoL, and demonstrates how something commonly perceived as a ‘good’ can also be a ‘bad’ for some people. Efforts should be made to limit the negative consequences of methadone on opiate-dependent individuals’ QoL, while increasing its potential benefits.     

海口市消费者对虚假违法药品广告的认知度调查分析

目的:调查海口市消费者对虚假违法药品广告的认知度,为监督管理虚假违法药品广告提供参考。方法:对海口市消费者进行随机抽样问卷调查,采用频数分析、单因素方差分析和LSD-t检验等方法进行统计学处理。结果与结论:消费者对违法药品广告总的认知度较低,对不同变量的知晓度不一致,职业、文化程度对消费者知晓度存在显著影响。建议从加强药品广告监管和普及药品广告知识两方面改进。     

Ease of suturing surgical fabrics. A quantitative evaluation

Based on the definition that suturability is the amount of force required to puncture a graft using a surgical needle, a simple testing procedure was devised, using an Instron testing machine to measure the suturability of a number of vascular graft materials. The grafts tested, in order of preference were Cooley double velour, Weavenit, Sauvage filamentous, Cooley knitted, DeBakey woven, and Cooley woven. It has been shown that the suturability of a graft is directly related to its water porosity and the size of the needle used.     

Maximum principles applied to a model of consumer brand choice

This paper presents an application of the maximum principle and the generalized maximum principle (a recent extension of that principle) to a discrete-time model of consumer choice behaviour. The model includes two brands in a market and uses a non-stationary first-order Markov chain. The optimization is carried out by algorithms based on the above mentioned principles. These algorithms are described, and their performances are discussed and compared both with and without fulfilment of the directional convexity property.     

Course in massage therapy for medical students

Massage courses for medical students have been held at Frankfurt University Medical School since 1987. To evaluate the motives for participation and to record possible changes in the attitude towards massage therapy, the students were asked to fill out a standardized questionnaire in 1990, 1993 and 1995/96. The results show that the motive for participation and the attitude towards massage therapy remained widely unchanged during these years. Summarizing all data (n = 199) the motives for participation were: (1) to practise massage therapy (86%), (2) to be better able to (later) prescribe massage therapy (66%), (3) to improve palpation skills (75%), (4) to do 'something practical' (56%), and (5) to (later) practise massage therapy as a medical doctor (23%). On average, the proportion of theory and practical instruction of 1:3.2 was considered suitable.     

Healthy Web Sites

Abstract

Consumers are increasingly looking to the Internet to find answers to their medical questions. In an effort to help consumers find the most reliable information, Healthnet: Connecticut Consumer Health Information Network, at the University of Connecticut Health Center Library, launched a program called “Healthy Web Sites.” The program has three main content areas: (1) evaluating Web sites for quality and reliability; (2) how to find current research information on a disease or disorder; and (3) locating information on the credentials of physicians and other health care providers.     

Variations in Consumer Self-determination within US Psychiatric Advance Directives

Advance directives are legal documents that formalize consumer psychiatric care preferences. This article examines the statutes and goals of US psychiatric advance directives within the framework of consumer self-determination, a priority in national mental health reform. It seeks to distinguish between state models based on the degree that consumer rights are integrated into advance directive statutes and goals. The data set contains information from legislative statutes and goals from the 24 US states that enacted explicit psychiatric advance directive regulations prior to 2006. Researchers grouped the data into categories based on the similarities in consumer self-determination. The findings include an examination of the spectrum of consumer self-determination in US advance directive statutes along with a comparison of the gaps between intent and policy in state statutes.     

瑞丽市农村妇女生殖道感染状况定性研究

采用面谈和深入小组访谈技术，与妇幼保健服务提供者和利用者（包括已婚妇女和她们的丈夫及未婚男女青年）开展讨论，从不同角度了解农村妇女生殖道感染性疾病以及对妇女生殖道感染疾病的认识程度和就诊情况，并对今后如何减少农村妇女生殖道感染提出了建议。     

How reactions to cigarette packet health warnings influence quitting: findings from the ITC Four-Country survey

Objectives To examine prospectively the impact of health warnings on quitting activity. Design Five waves (2002–06) of a cohort survey where reactions to health warnings at one survey wave are used to predict cessation activity at the next wave, controlling for country (proxy for warning differences) and other factors. These analyses were replicated on four wave‐to‐wave transitions. Setting and participants Smokers from Australia, Canada, the United Kingdom and the United States. Samples were waves 1–2: n = 6525; waves 2–3: n = 5257; waves 3–4: n = 4439; and waves 4–5: n = 3993. Measures Warning salience, cognitive responses (thoughts of harm and of quitting), forgoing of cigarettes and avoidance of warnings were examined as predictors of quit attempts, and of quitting success among those who tried (1 month sustained abstinence), replicated across four wave‐to‐wave transitions. Results All four responses to warnings were independently predictive of quitting activity in bivariate analyses. In multivariate analyses, both forgoing cigarettes and cognitive responses to the warnings predicted prospectively making quit attempts in all replications. However, avoiding warnings did not add predictive value consistently, and there was no consistent pattern for warning salience. There were no interactions by country. Some, but not all, the effects were mediated by quitting intentions. There were no consistent effects on quit success. Conclusions This study adds to the evidence that forgoing cigarettes as a result of noticing warnings and quit‐related cognitive reactions to warnings are consistent prospective predictors of making quit attempts. This work strengthens the evidence base for governments to go beyond the Framework Convention on Tobacco Control to mandate health warnings on tobacco products that stimulate the highest possible levels of these reactions.