“Raw juicing” – an online study of the home manufacture of anabolic androgenic steroids (AAS) for injection in contemporary performance and image

Background: New evidence with regard to an under documented practice – the home manufacture of anabolic androgenic steroids (AAS) for injection, known as ‘homebrewing’ – in contemporary injecting performance and image enhancing drug (PIED) culture is the subject of this paper. Methods: Data was collected from five publicly accessible internet discussion forums and coded using NVivo software. For the purposes of this study, threads in relation to homebrewing (n = 14) were extracted from the final set of records for ethnographic content analysis. Results: Motivation to perform homebrewing was largely grounded in the circumnavigation of unreliable online sourcing routes for AAS products, financial losses and potential harms associated with contaminated and counterfeit injectables. Instructions on how to perform homebrewing were found within discussion threads. Identified areas of concern included potential for sterility and dosing issues, injecting harms, isolation from health services. Conclusion: This study provides a snapshot of online communal activity around practice of homebrewing AAS amongst individuals who inject AAS. Further research in this area is warranted, and will be of benefit to healthcare workers, treatment providers and policy makers particularly as this relates to evidence informed and targeted harm reduction policies and effective public health interventions

Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

International transformations of the capitalist state.

There has not been a retreat but a transformation of the state, involving significant changes in both the public sphere of politics and the so-called private sphere of economic activity, and in their modes of interaction, especially law. The privatization of state-owned assets and the reduction of direct state economic intervention have not led to a reduced role of the state but to changes in its form, involving new types of formalized regulation, the fragmentation of the public sphere, the decentering of the state and the emergence of multi-level governance. This has been complemented by the increased salience of “private” regulation, so that in many ways the apparently private sphere of economic activity has become more public. In fact, there has been a complex process of interaction with a blurring of the divisions between apparently private and public regulation. Despite talk of deregulation there has been extensive reregulation, or formalization of regulation, and the emergence of global regulatory networks, intermingling the public and the private. The transition from government to governance means a lack of a clear hierarchy of norms, a blurring of distinctions between hard and soft law, and a fragmentation of public functions entailing a resurgence of technocracy