Tramadol abuse and value for life among young persons: moderating effects of moral identity

Burgeoning research has begun to question what the actual value for life is among drug using individuals. Why do they engage in acts they know undermine the quality and length of their lives? Can the use of drugs be directly linked to lack of value for their lives? Or does the repeated use of drugs make them value less their lives? What if, regardless of their drug abuse, they had high levels of moral self and integrity? Would the pattern of results still be the same? Interested in finding this out, we employed the snowball technique to recruit young persons (n= 158, 75.95% males, Mage= 23 years) with differing levels of tramadol abuse, and obtained data regarding their self-reported value for life and moral identity. Results revealed significant associations between tramadol use, dimensions of moral identity and value for life such that as the level of tramadol abuse increased, value for life decreased; while as moral integrity and moral self increased, value for life also increased. Moderation analysis further showed a buffering effect of moral self and integrity on the relationship of tramadol use and value for life. These findings question our already existing drug use policies, anti-drug use campaigns and intervention strategies. Will our efforts at combatting drug use become more effective if we dwell more on building moral identities in individuals rather than incarcerating them? We suggest in-depth investigation to further explore the roles of morality in the non-medical use of prescription drugs. Keywords: Criminalization, Morality, Non-medical, Policy, Tramadol, Value for lif

Parents\u27 Knowledge, Attitudes and Beliefs of Childhood Fever Management in Jordan: a Cross-Sectional Study

Background: Studies have demonstrated that some parents have limited knowledge and several false beliefs regarding fever, its management and role in illness. Objective: The aims of this study were to investigate parents\u27 knowledge, attitudes and beliefs regarding childhood fever management in Jordan in comparison to current National Institute for Health and Care Excellence (NICE) and Italian fever management guidelines. Methods: An observational, survey-based cross-sectional study design was carried out with a convenience sample of 419 Jordanian adult parents in Irbid governorate area, Jordan. The survey consisted of four major categories with 32 ‘yes/no’ and multiple-choice questions. Descriptive statistics were presented, and chi-square test/ Fisher exact test and a t-test were performed to compare the demographics in this study to the frequencies of oral vs. rectal drug administration and beliefs about the usefulness of alternating drugs. SAS 9.3 was used to conduct all the statistical analysis at a significance level of 0.05. Results: Our results indicated that a high proportion of parents use rectal route for temperature measurement (37%) and medication administration (50%). Approximately half the parents administer treatment when temperature is above 38°C (48%)and only 10% based their calculation of dose on weight. Approximately half the parents reported deciding the right antipyretic medication (59%) and the right dose (48%) to administer to their un-well child using previous advice they have had from their pediatrician. The chi-square test showed no significant differences with any of the demographics with beliefs regarding the usefulness of alternating drugs, while a significant association between the site used in administering the drugs and sex (p=0.003), age category (p=0.03) and number of kids (p=0.029) were documented. Conclusion: Our results indicate that parents often misuse the antipyretics medications, incorrectly manage their child’s fever, follow inappropriate practices to reduce fever, and generally have poor knowledge of basic information regarding fever. As the data suggest that a high proportion of parents use the rectal route for temperature measurement and medication administration, educational programs may be necessary to ensure the process of taking rectal temperature readings is safe and sanitary, especially among female parents, younger age groups and those with 3 or less kids. Findings from this study underscore the need to develop and evaluate programs that educate parents and provide them with the knowledge base required to better manage their children’s fevers

Primary source of income is associated with differences in HIV risk behaviors in street-recruited samples

BACKGROUND: The relationship between primary source of income and HIV risk behaviors and the racial/ethnic differences in risk behavior profiles among disadvantaged populations have not been fully explored. This is unusual given that the phenomenon of higher risk in more disadvantaged populations is well-known but the mechanisms remain unclear. We examined the relationship between primary source of income and differences in HIV risk behaviors among four racial/ethnic groups in the southern United States. METHODS: Self-reported data on primary source of income and HIV risk behaviors were collected from 1494 African American, Hispanic, Asian, and White men and women in places of public congregation in Houston, Texas. Data were analyzed using calculation of percentages and by chi-square tests with Yates correction for discontinuity where appropriate. RESULTS: Data revealed that a higher proportion of whites were involved in sex for money exchanges compared to the other racial groups in this sample. The data suggest that similar street sampling approaches are likely to recruit different proportions of people by primary income source and by ethnicity. It may be that the study locations sampled are likely to preferentially attract those involved in illegal activities, specifically the white population involved in sex for drug or money exchanges. Research evidence has shown that people construct highly evolved sexual marketplaces that are localized and most unlikely to cross racial, ethnic, and socioeconomic or geographical boundaries. Thus, the areas that we sampled may have straddled a white sexual marketplace more than that of the other groups, leading to an over-representation of sex exchange in this group. Drug use was highest among those with illegal primary sources of income (sex exchange and drug dealing and theft), and they were also those most likely to have injected drugs rather than administered them by any other route (p < 0.001). In addition, bisexual or homosexual identification was reported by more respondents in the sex exchange as primary source of income category. The number of sexual partners in the last three months followed a similar pattern, with those whose primary source of income was drug dealing or theft reporting relatively high partner numbers. CONCLUSIONS: These data suggest that social disadvantage is associated with HIV risk in part by its association with drug and sex work for survival, and offers one variable that may be associated with the concentration of disease among those at greatest disadvantage by having an illegal and unstable primary income source

Strategies to prevent HIV transmission among heterosexual African-American women

BACKGROUND: African-American women are disproportionately affected by HIV, accounting for 60% of all cases among women in the United States. Although their race is not a precursor for HIV, the socioeconomic and cultural disparities associated with being African American may increase their risk of infection. Prior research has shown that interventions designed to reduce HIV infection among African-American women must address the life demands and social problems they encounter. The present study used a qualitative exploratory design to elicit information about strategies to prevent HIV transmission among young, low-income African-American women. METHODS: Twenty five low income African American women, ages 18–29, participated in five focus groups of five women each conducted at a housing project in Houston, Texas, a large demographically diverse metropolitan area that is regarded as one of the HIV/AIDS epicenters in the United States. Each group was audiotaped, transcribed, and analyzed using theme and domain analysis. RESULTS: The participants revealed that they had most frequently placed themselves at risk for HIV infection through drugs and drinking and they also reported drug and alcohol use as important barriers to practicing safer sex. The women also reported that the need for money and having sex for money to buy food or drugs had placed them at risk for HIV transmission. About one-third of the participants stated that a barrier to their practicing safe sex was their belief that there was no risk based on their being in a monogamous relationship and feeling no need to use protection, but later learning that their mate was unfaithful. Other reasons given were lack of concern, being unprepared, partner's refusal to use a condom, and lack of money to buy condoms. Finally, the women stated that they were motivated to practice safe sex because of fear of contracting sexually transmitted diseases and HIV, desire not to become pregnant, and personal experience with someone who had contracted HIV. CONCLUSION: This study offers a foundation for further research that may be used to create culturally relevant HIV prevention programs for African-American women

Composition of unfermented, unroasted, roasted cocoa beans and cocoa shells from Peninsular Malaysia

Composition of cocoa beans depends on origin and cocoa processing such as fermentation, drying and roasting. However, less research has been conducted to analyse the composition of Peninsular Malaysia cocoa bean at different processing stages. Thus, the purpose of this study was to determine the proximate, phytosterol level, antioxidant content and activity of Peninsular Malaysia unfermented, unroasted, roasted cocoa beans and cocoa shells. Analysis involved was proximate analysis, total phenolic compound (Folin–Ciocalteu reagent assay), antioxidant activity (2,2-diphenyl-1-picrylhydrazyl scavenging assay) and phytosterol composition. Results show that the crude fiber of unroasted cocoa beans and cocoa shells increased from 17.19 to 28.45% and 13.86 to 16.06% respectively after roasting process. The roasting process is suspected to increase the dietary fiber content of cocoa products due to the interaction between polysaccharides, protein, polyphenolic and Maillard products at high temperature. The total phenolic content in cocoa bean and cocoa shells ranged from 2.42 to 10.82 µg GAE/ml. The unfermented cocoa beans contain significantly (p < 0.05) higher antioxidant activity (92.3%) compared to other samples. This study shows that cholesterol, stigmasterol and β-sitosterol were present in roasted cocoa beans and cocoa shells. Hence, the information on the composition of Malaysia unfermented, unroasted, roasted cocoa beans and cocoa shells are needed to enrich the databases composition as a reference for the cocoa industry

Stigmatisation liée au VIH/SIDA et la discrimination au Nigéria: Compte-rendu des études de recherche et la direction future pour les stratégies de la prevention

Human Immunodeficiency Virus (HIV) infection and AIDS remain a major public health crisis in Nigeria which harbors more people living with HIV than any other country in the world, except South Africa and India. A significant challenge to the success of achieving universal access to HIV prevention, treatment, care and support by 2010 is HIV-AIDS stigma and discrimination. Eight studies looking at some degree of measurement of stigma and discrimination in Nigeria were reviewed in an attempt to investigate the cultural context of stigma, health seeking behavior and the role both perceived and community stigma play in HIV prevention. Results suggest that reducing stigma does increase the individual as well as community acceptance of people living with HIV-AIDS (PLWHAs), but long term studies are needed. Some suggestions are recommended for future research on culture specific stigma studies in Nigeria (Afr J Reprod Health 2009; 13[3]:21-35).L’infection du virus de l’immunodéficience humaine (VIH) et le SIDA reste une crise majeure de la santé publique au Nigéria, un pays qui abrite un plus grand nombre des gens séropositifs que les autres pays du monde, à part l’Afrique du Sud et l’Inde. La stigmatisation et la discrimination causeés par le VIH/SIDA constituent un défi important aux efforts pour l’accès universel à la prévention, au traitement, au soin et au soutien jusqu’en l’année 2010. Nous avons fait un compte-rendu de huit études qui examinaient à quelque niveau de mesures de la stigmatisation au Nigéria afin d’évaluer le contexte culturel de la stigmatisation, le comportement qui favorise la santé et le rôle que jouent à la fois la sstigmatisation perçu et la stigmatisation de la communauté dans la prévention du VIH. Les résultats ont montré que la réduction de la stigmatisation augmente, en effet, l’acceptation de l’individu ainsi que l’acceptation par la communauté des gens séropositfs: mais il faut des études à long terme. Nous avons fait quelques recommendations pour les recherches futures à l’égard des études de la stigmatisation propre à la culture au Nigéria (Afr J Reprod Health 2009; 13[3]:21-35)

Female Genital Mutilation: Potential for HIV Transmission in sub-Saharan Africa and Prospect for Epidemiologic Investigation and Intervention

Female Genital Mutilation (FGM) which involves alteration of the female genitalia for non-medical grounds is prevalent in Sub-Saharan Africa, associated with long- term genitourinary complications, and possible HIV transmission. This mini-review aims to examine FGM and the possibility of HIV transmission through this procedure. We performed an electronic search using Medline for articles published between 1966 to 2006 for evidence of FGM practice, its complications, and the nexus between this procedure and HIV sero-positivity. The results indicate ongoing FGM practice, albeit prevalence reduction, due probably to the increasing knowledge of the consequences of FGM as a result of non-sterile techniques. Secondly, the complications of FGM are well established which include Genitourinary disorders. Further, while data is limited on HIV transmission via FGM, there is biologic plausibility in suggesting that FGM may be associated with increasing prevalence of HIV in sub-Saharan Africa. This paper recommends further studies in order to assess the association between FGM and HIV transmission.Mutilation génitale féminine: Potentiel pour la transmission du VIH en Afrique subsaharienne et la perspective pour l&apos;enquête et l&apos;intervention épidémiologiques La mutilation génitale féminine (MGF) qui implique la modification des organes génitaux féminins pour des raisons non médicales est répandue en Afrique subsaharienne et elle est liée aux complications génitaux-urinaires à long terme et peut-être à la transmission du VIH. Cette mini-étude a pour objectif d&apos;examiner la MGF et la possilibité de la transmission du VIH par cette procédure. Nous avons recherché sur l&apos;internet à l&apos;aide de la medline des articles publiés entre 1966 et 2006 pour l&apos;évidence de la pratique de la MGF, ses complications et la liaison entre cette procedure et la séropositivité du VIH. Les résultats montrent que la pratique de la MGFse poursuit bien que la prévalence soit réduite dû probablement à la croissance de la connaissance des conséquences de la MGF à cause des conséquences non-stériles. Deuxièment, les complications de la MGF sont bien établies y compris les troubles génitaux-urinaires. De plus, alors que les données sont limitées par rapport à la transmission du VIH par la MGF, il y a une plausibilité biologique de suggérer que la MGF peut être liée à la prévalence croissante du VIH en Afrique subsaharienne. L&apos;article préconise encore d&apos;études pour permettre d&apos;évaluer le lien entre la MGF et la transmission du VIH