Negative experiences of non-drinking college students in Great Britain: an interpretative phenomenological analysis

Research relating to alcohol use amongst university students primarily examines the effects of binge drinking. Researchers rarely focus on a range of drinking styles including light or non-drinking. This study was designed to gain an in-depth understanding of the lived experiences of female, first year UK undergraduates, who do not drink alcohol. Semi-structured interviews were conducted with eight participants. Narratives were analysed using interpretative phenomenological analysis (IPA; by Smith and Osborn (Sage 51-80, 2003). Three superordinate themes were identified: managing the feeling that you don’t belong^ highlights the importance of managing social interactions as a non-drinker; experiencing social exclusion recognises the impact on social bonding as a result of insufficient socialising opportunities; and experiencing peer pressure and social stigma highlights the scrutiny and labelling participants endured. These findings provide an understanding of some of the difficulties experienced by these undergraduates as a result of their non-drinking status. Implications of this research are discussed and areas for future research are outlined

The state of methamphetamine ('tik') use among youth in the Western Cape, South Africa

BACKGROUND Methamphetamine use among youth in the Western Cape Province of South Africa has increased at alarming rates over the past decade. Although current estimates of youth use exist, they range from 2% to 12%. OBJECTIVES To identify (i) the prevalence of methamphetamine use in Western Cape youth and (ii) the association between use and known risk factors for methamphetamine use. METHODS Data were obtained from 10 000 Western Cape Province Grade 8 learners in 54 secondary schools (mean age 14.0 years). Prevalence was descriptively reported while risk factors for past-month use were modelled in a hierarchical logistic regression with demographic, socioeconomic status, substance use, sexual activity and relationship predictors. RESULTS Approximately 5% (n=496) of learners had used methamphetamine within their lifetime. Of these users, 65% (n=322) had used in the past month or week. Compared to never users, past-month users were more likely to be male, less likely to have a present or partially present mother, less likely to live in an apartment/flat/brick house, more likely to have used alcohol and tobacco and more likely to report having a same-sex partner. CONCLUSION Results replicate previously known methamphetamine risk factors and highlight the need to address methamphetamine use in comprehensive prevention initiatives.DHE

An Exploratory Study of Lecturers' Views of Out-of-class Academic Collaboration Among Students

This article reports an exploratory study of lecturers' perceptions of out-of-class academic collaboration (OCAC) among students at a large Singapore university. Two types of OCAC were investigated: collaboration initiated by students, e.g., groups decide on their own to meet to prepare for exams, and collaboration required by teachers, e.g., teachers assign students to do projects in groups. Data were collected via one-on-one interviews with 18 faculty members from four faculties at the university. Findings suggest that OCAC, especially of a teacher-required kind, is fairly common at the university. Faculty members' views on factors affecting the success of OCAC are discussed for the light they might shed on practices to enhance the effectiveness of OCAC

Everyday Legal Problems and the Cost of Justice in Canada: Overview Report

Law and legal problems are part of everyday life. If you have ever been harassed at work, unfairly fired or evicted, divorced, not received support payments, disputed a will or a cell phone contract, or had your credit rating challenged, you may have already experienced one of these types of everyday legal problems. If so, you are not alone. Almost half (48.4%) of Canadians over 18 will experience at least one civil or family justice problem over any given three-year period. Even though many Canadians do not understand, feel connected to or welcomed by the justice system, essentially all of us will experience at least one everyday legal problem over the course of our lifetime

Everyday Legal Problems and the Cost of Justice in Canada: Overview Report

Law and legal problems are part of everyday life. If you have ever been harassed at work, unfairly fired or evicted, divorced, not received support payments, disputed a will or a cell phone contract, or had your credit rating challenged, you may have already experienced one of these types of everyday legal problems. If so, you are not alone. Almost half (48.4%) of Canadians over 18 will experience at least one civil or family justice problem over any given three-year period. Even though many Canadians do not understand, feel connected to or welcomed by the justice system,2 essentially all of us will experience at least one everyday legal problem over the course of our lifetime

Can Electronic Health Records Systems Support New Payment Methods for Health Centers?

This study assessed the feasibility and usefulness of combining electronic health record (EHR) data with federal cost report data for the purposes of: 1) quantifying the provision of enabling services; and 2) for use as the basis of community health center payment rate-setting. The study used EHR data derived from the Center for Primary Care Informatics to isolate enabling services and perform the end-to-end analysis that might be required to develop or evaluate reimbursement rates. The study revealed that data extracted from federal cost reports combined with data from the EHR fall short of providing the information required to reasonably develop new rate setting approaches or evaluate existing rates as they might be applied to community health centers. Specifically, key findings include: Use of internal, center-specific codes (for example, in CPT fields) complicates the translation into relative value units (RVUs) and the aggregation of comparable data across health centers. Enabling services are difficult to quantify. Vague and inconsistent position titles lead to potential inaccuracies in the allocation of expenses. The current funding environment deters capture of new information. This study raises fundamental questions about how to quantify (let alone how to reimburse) the true value associated with the community health center model of care. The study recommends tailoring EHR products to better capture the unique services provided by health centers and their effective management of high-risk patients. Fully moving to value-based reimbursement models will likely require that health centers adapt workflow to ensure that additional critical information (e.g., social determinants of health) is properly entered as structured data and not merely as scanned notes and other documentatio

Effect of fixed-dose subcutaneous reslizumab on asthma exacerbations in patients with severe uncontrolled asthma and corticosteroid sparing in patients with oral corticosteroid-dependent asthma : results from two phase 3, randomised, double-blind, placebo-controlled trials

BACKGROUND: Reslizumab 3 mg/kg administered intravenously is approved for the treatment of severe eosinophilic asthma. We assessed the safety and efficacy of subcutaneous reslizumab 110 mg in two trials in patients with uncontrolled severe asthma and increased blood eosinophils. The aim was to establish whether subcutaneous reslizumab 110 mg can reduce exacerbation rates in these patients (study 1) or reduce maintenance oral corticosteroid dose in patients with corticosteroid-dependent asthma (study 2). METHODS: Both studies were randomised, double-blind, placebo-controlled, phase 3 studies. Entry criteria for study 1 were uncontrolled severe asthma, two or more asthma exacerbations in the previous year, a blood eosinophil count of 300 cells per μL or more (including no more than 30% patients with an eosinophil count <400 cells/μL), and at least a medium dose of inhaled corticosteroids with one or more additional asthma controllers. Patients in study 2 had severe asthma, a blood eosinophil count of 300 cells per μL or more, daily maintenance oral corticosteroid (prednisone 5-40 mg, or equivalent), and high-dose inhaled corticosteroids plus another controller. Patients were randomly assigned (1:1) to subcutaneous reslizumab (110 mg) or placebo once every 4 weeks for 52 weeks in study 1 and 24 weeks in study 2. Patients and investigators were masked to treatment assignment. Primary efficacy outcomes were frequency of exacerbations during 52 weeks in study 1 and categorised percentage reduction in daily oral corticosteroid dose from baseline to weeks 20-24 in study 2. Primary efficacy analyses were by intention to treat, and safety analyses included all patients who received at least one dose of study treatment. These studies are registered with ClinicalTrials.gov, NCT02452190 (study 1) and NCT02501629 (study 2). FINDINGS: Between Aug 12, 2015, and Jan 31, 2018, 468 patients in study 1 were randomly assigned to placebo (n=232) or subcutaneous reslizumab (n=236), and 177 in study 2 to placebo (n=89) or subcutaneous reslizumab (n=88). In study 1, we found no significant difference in the exacerbation rate between reslizumab and placebo in the intention-to-treat population (rate ratio 0·79, 95% CI 0·56-1·12; p=0·19). Subcutaneous reslizumab reduced exacerbation frequency compared with placebo in the subgroup of patients with blood eosinophil counts of 400 cells per μL or more (0·64, 95% CI 0·43-0·95). Greater reductions in annual exacerbation risk (p=0·0035) and longer time to first exacerbation were observed for patients with higher trough serum reslizumab concentrations. In study 2, we found no difference between placebo and fixed-dose subcutaneous reslizumab in categorised percentage reduction in daily oral corticosteroid dose (odds ratio for a lower category of oral corticosteroid use in the reslizumab group vs the placebo group, 1·23, 95% CI 0·70-2·16; p=0·47). The frequency of adverse events and serious adverse events with reslizumab were similar to those with placebo in both studies. INTERPRETATION: Fixed-dose (110 mg) subcutaneous reslizumab was not effective in reducing exacerbation frequency in patients with uncontrolled asthma and increased blood eosinophils (≥300 cells/μL), or in reducing the daily maintenance oral corticosteroid dose in patients with oral corticosteroid-dependent severe eosinophilic asthma. Higher exposures than those observed with 110 mg subcutaneous reslizumab are required to achieve maximal efficacy. FUNDING: Teva Branded Pharmaceutical Products R&D

An Immune Evasion Mechanism for Spirochetal Persistence in Lyme Borreliosis

Borrelia burgdorferi, the Lyme disease spirochete, persistently infects mammalian hosts despite the development of strong humoral responses directed against the pathogen. Here we describe a novel mechanism of immune evasion by B. burgdorferi. In immunocompetent mice, spirochetes that did not express ospC (the outer-surface protein C gene) were selected within 17 d after inoculation, concomitantly with the emergence of anti-OspC antibody. Spirochetes with no detectable OspC transcript that were isolated from immunocompetent mice reexpressed ospC after they were either cultured in vitro or transplanted to naive immunocompetent mice, but not in OspC-immunized mice. B. burgdorferi persistently expressed ospC in severe combined immune-deficient (SCID) mice. Passive immunization of B. burgdorferi–infected SCID mice with an anti-OspC monoclonal antibody selectively eliminated ospC-expressing spirochetes but did not clear the infection. OspC-expressing spirochetes reappeared in SCID mice after the anti-OspC antibody was eliminated. We submit that selection of surface-antigen nonexpressers is an immune evasion mechanism that contributes to spirochetal persistence