Nebraska Serious and Violent Offender Re-entry Program: An Evaluation of Participants\u27 Perception of Program Effectiveness

In response to the three-fold increase in the number of returning inmates to America\u27s communities over the last three decades, the Department of Justice\u27s Serious and Violent Offender Re-entry Initiative provides funding for development of programming to reduce recidivism rates and improve community safety. However, evaluations of these re-entry programs have not addressed the attitudes and opinions of the program participants themselves. This study examined the perceptions of the re-entry participants to help assess the effectiveness of the programming they are receiving from the Nebraska Serious and Violent Offender Re-entry Pilot Program. Data was gathered from personalized re-entry plans for offenders and through qualitative interviews of the program transition managers and program participants. The results of this research addressed the effectiveness and possible improvements of the Nebraska re-entry program, which will ultimately affect the inmates\u27 likelihood of living crime-free upon their return to the community and hence increase public safety

Correlates of illicit methadone use in New York City: A cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Despite growing concern about illicit methadone use in the US and other countries, there is little data about the prevalence and correlates of methadone use in large urban areas. We assessed the prevalence and examined correlates of lifetime and recent illicit methadone use in New York City (NYC).</p> <p>Methods</p> <p>1,415 heroin, crack, and cocaine users aged 15–40 years were recruited in NYC between 2000 and 2004 to complete interviewer-administered questionnaires.</p> <p>Results</p> <p>In multivariable logistic regression, non-injection drug users who used illicit methadone were more likely to be heroin dependent, less than daily methamphetamine users and to have a heroin using sex partner in the last two months. Injection drug users who used illicit methadone were more likely to use heroin daily, share injection paraphernalia and less likely to have been in a detoxification program and to have not used marijuana in the last six months.</p> <p>Conclusion</p> <p>The results overall suggest that illicit (or street) methadone use is likely not a primary drug of choice, but is instead more common in concert with other illicit drug use.</p

Paramedian Approach to Coccygectomy in the Treatment of Chronic Coccydynia: A Technical Note

Objective There is a growing body of clinical evidence to support coccygectomy as an effective treatment for chronic coccygodynia. To date, the authors identified no other studies that describe and evaluate the paramedian surgical approach to coccygectomy and post-operative outcomes. Methods A case report of 36 patients who underwent coccygectomy with a paramedian or midline approach. All patients had chronic coccydynia that was refractory to conservative treatment. Three patients were excluded from the study due to additional lumbar surgery (2) or missing data (1). Outcomes assessed were Visual Analog Scale (VAS), operative and post-operative complications, use of post-operative pain medication, and surgery time. Results Included in the study were 24 females and 9 males with a mean age of 46 years (range 18-74 years). The most common etiologies were trauma (26) and idiopathic (7). Twenty seven patients underwent coccygectomy with a paramedian approach and 6 had the same procedure with the midline incision. There was a significantly lower infection rate in the paramedian group (p-value=0.00871). Conclusion The paramedian and midline approach to coccygectomy are both viable treatments for coccygodynia. The two methods offer low complication rates and high patient satisfaction. Surgeon and patient preference should be taken into account when choosing a surgical approach for coccygectomy. Further examination comparing traditional midline vs. paramedian approach are needed to assess superiority

Epidemiology of human immunodeficiency virus-1 and hepatitis B virus co-infection and risk factors for acquiring these infections in the Fako division of Southwest Cameroon

Background Past studies have demonstrated that a large population of Cameroonians are afflicted with human immunodeficiency virus (HIV) and/or hepatitis B virus (HBV) demonstrating a need for better prevention programs. We aim to describe the prevalence of HIV, HBV and HIV/HBV co-infection; examine the association between HIV and HBV; and determine risk correlates associated with HIV and HBV transmission in Southwest Cameroon. Methods A cross-sectional, community-based surveillance study was conducted among adults in five hospitals , one in each of the five health districts of the Fako division of the Southwest region of Cameroon. Participants underwent pre- and post-test counselling, a 30-question survey and blood draw for HIV and HBV serologic testing. To construct a final model, chi-squared tests and logistic regression were used to investigate associations. Results Among 761 participants, 40.32 % were male, mean age was 35.21 ± 12.42 years, and the prevalence of HIV, HBV and HIV/HBV co-infection was 10.69 % , 9.86 % , and 1.16 % , respectively. There was no association between HIV and HBV infection. However, there was a statistically significant crude associated (p-value < 0.05) between HIV and three high-risk sexual behaviour variables: condom use, number of lifetime sexual partners, and age at first sexual intercourse. After adjustment, HIV status continued to be associated with number of lifetime sexual partners (adjusted odds ratio (AOR) = 2.26; 95 % confidence interval (CI) =1.22–4.17) and age at first sexual intercourse (AOR = 2.63; 95 % CI =1.44–4.81). In contrast, none of the high-risk sexual behaviours was associated with HBV. Conclusions The prevalence of HIV and HBV was relatively high in the Southwest region of Cameroon, emphasizing the importance of intervention and treatment programs in this country. Additionally, the results from this study suggest that unlike HIV, HBV is not associated with sexual risk factors and may provide evidence that HBV is acquired through routes other than sexual transmission, warranting further investigation in this region

Needle Exchange Programs and Experience of Violence in an Inner City Neighborhood

Objective: To assess the association between proximity to a needle exchange program (NEP) and experience of violence in an inner city neighborhood. Methods: A cross-sectional survey of residents of Harlem, New York City provided data for this study. We used geocoding to obtain the distance between respondents and the nearest NEP. Respondents reported violence they were aware of or had personally experienced in their neighborhood. Multiple logistic regression analyses assessed the relation between violence and distance from the nearest NEP. Results: Among 220 respondents, 50.1% were African American, 39.0% were Latino, 44.7% were male, and the mean age was 44.5 years. In separate age-, race-, sex-, and income-adjusted logistic regression models, there was no significant association between (1) reporting a fight and distance from the nearest NEP (odds ratio [OR] = 1.05, p = .89); (2) robbery in the neighborhood in the previous 6 months and distance from the nearest NEP (OR = 1.13, p = .71); (3) ever having experienced violence and distance from the nearest NEP (OR = 0.72, p = .52); or (4) ever having been robbed by drug users and distance from the nearest NEP (OR = 1.05, p = .91). Conclusions: There was no consistent association between living close to NEPs and violence reported by residents of Harlem in this study. This study suggests that NEPs do not adversely affect rates of violence in their vicinity.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/40339/2/Galea_Needle Exchange Programs and Experience_2001.pd

Ecstasy Use Among Hispanic and Black Substance Users in New York City

Surveillance data suggests that use of ecstasy in the U.S. is predominantly among white adolescent and young adults. To investigate ecstasy use among substance users in New York City we added questions to ongoing efforts to recruit heroin and cocaine users. Of 715 participants recruited, 58.3% were injection dug users (IDUs). The median age was 32 (range 17–64), 76.4% were male, 49.0% were currently homeless, 62.4% were Hispanic, 27.3% were black, and 34.5% were born outside the United States. Overall, 23.4% used ecstasy in their lifetime and 11.9% had used in the last-6 months. In multivariate logistic regression, correlates of lifetime ecstasy use included younger age, being born in the U.S., and current homelessness. We observed a significant interaction between injection drug use and race where, compared to black non-IDUs, Hispanic non-IDUs, and white IDUs were significantly more likely to have a history of lifetime ecstasy use while black IDUs were significantly less likely. These findings are limited to persons who use other drugs, but suggest that further investigation of ecstasy use in minority populations is warranted.http://deepblue.lib.umich.edu/bitstream/2027.42/40374/2/Ompad_Ecstasy Use Among Hispanic and Black_2005.pd

The Association Between Multiple Domains of Discriminations and Self-Assessed Health: A Multilevel Analysis of Latinos and Blacks in Four Low-Income New York City Neighborhoods

Objective. This study examines the association between discrimination due to race and other attributes (e.g., sex, age) and self-assessed mental and physical health among Latinos and blacks. Data Source. Latino and black adult participants (n5873) identified by randomdigit dialing were interviewed by telephone in four low-income neighborhoods in New York City: the South Bronx, East Harlem, Central Harlem, and Bedford-Stuyvesant. Study Design. In this cross-sectional study, generalized estimating equations were used to fit multilevelmultivariablemodels to test the association between discrimination and poor mental and physical health while controlling for socioeconomic status, access to health care, social support, smoking, and the racial and ethnic composition of each neighborhood. Principal Findings. Discrimination due to race and discrimination due to other attributes were associated with poor self-assessed mental but not physical health in separate multivariable models. Persons who experienced multiple domains of discrimination had a greater probability of reporting poor mental health than persons who experienced no discrimination. Conclusions. Discrimination due to race and other attributes was a significant correlate of mental health among Latinos and blacks independent of other accepted determinants of health.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/40298/2/Stuber_The Association Between Multiple Domains_2003.pd

Preliminary Evidence of Health Care Provider Support for Naloxone Prescription as Overdose Fatality Prevention Strategy in New York City

Preliminary research suggests that naloxone (Narcan), a short-acting opiate antagonist, could be provided by prescription or distribution to heroin users to reduce the likelihood of fatality from overdose. We conducted a random postal survey of 1,100 prescription-authorized health care providers in New York City to determine willingness to prescribe naloxone to patients at risk of an opiate overdose. Among 363 nurse practitioners, physicians, and physician assistants responding, 33.4% would consider prescribing naloxone, and 29.4% were unsure. This preliminary study suggests that a substantial number of New York City health care providers would prescribe naloxone for opiate overdose prevention.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/40255/2/Coffin_Preliminary Evidence of Health Care Provider_2003.pd

Updating the Infection Risk Reduction Hierarchy: Preventing Transition into Injection

Current approaches to prevention of blood-borne infections in injection drug users include referral to drug abuse treatment, access to sterile syringes, bleach disinfection of injection equipment, and education about not sharing equipment. However, rates of some blood-borne infections (e.g., hepatitis C virus) remain elevated among injection drug users, especially early after initiation into injection drug use. With lower infection rates in noninjectors and transition into injection drug use occurring most commonly among these noninjectors, prevention of transition into injection drug use as an additional step to reduce risk for acquisition and transmission of blood-borne infections merits closer attention.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/40275/2/Vlahov_Updating the Infection Risk Reduction Hierarchy_2004.pd

Hepatitis C Incidence- a Comparison Between Injection and Noninjection Drug Users in New York City

Hepatitis C virus (HCV) burdens injection drug users (IDUs) with prevalence estimated from 60–100% compared to around 5% among noninjection drug users (non-IDUs). We present preliminary data comparing the risk for HCV among IDUs and non-IDUs to inform new avenues of HCV prevention and intervention planning. Two cohorts, new IDUs (injecting≤ 3 years) and non-IDUs (smoke/sniff heroine, crack or cocaine≤ 10 years), ages 15–40, were street-recruited in New York City. Participants underwent risk surveys and HCV serology at baseline and 6-month follow-up visits. Person-time analysis was used to estimate annual HCV incidence. Of 683 non-IDUs, 653 were HCV seronegative, 422 returned for at least 1 follow-up visit, and 1 became HCV seropositive. Non-IDUs contributed 246.3 person-years (PY) yielding an annual incident rate of 0.4/100 PY (95% Confidence Interval [CI]=0.0-1.2). Of 260 IDUs, 114 were HCV seronegative, 62 returned for at least 1 follow-up visit, and 13 became HCV seropositive. IDUs contributed 36.3 PY yielding an annual incidence rate of 35.9/100 PY (95%CI=19.1–61.2). Among IDUs, HCV seroconverters tended to be younger (median age 25 vs. 28, respectively), and inject more frequently (61.5% vs. 34.7%, respectively) than nonseroconverters. These interim data suggest that IDUs may have engaged in high-risk practices prior to being identified for prevention services. Preventing or at least delaying transition into injection could increase opportunity to intervene. Identifying risk factors for transition into injection could inform early prevention to reduce onset of injection and risk of HCV.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/40369/2/Fuller_Hepatitis C Incidence - a Comparison Betwwen Injection_2004.pd