The mental health experiences and needs of methamphetamine users in Cape Town: A mixed-methods study

Background. South Africa (SA) has a burgeoning problem of methamphetamine use, particularly in the Western Cape Province. Although methamphetamine has been associated with elevated psychological distress, there has been little examination of the mental health needs of out-of-treatment methamphetamine users in SA.Objective. To describe the mental health experiences and needs of out-of-treatment methamphetamine users in Cape Town.Methods. Active methamphetamine users were recruited using respondent-driven sampling techniques. Eligible participants (N=360) completed a computer-assisted assessment and clinical interview, where they provided data on mental health symptoms and treatmentseeking behaviour. A subset of 30 participants completed qualitative in-depth interviews in which they provided narrative accounts of their mental health experiences and needs. Analysis of the mixed-methods data was conducted using a concurrent triangulation strategy whereby both methods contributed equally to the analysis and were used for cross-validation.Results. About half of the participants met screening criteria for depression and traumatic stress, and there were some indications of paranoia. Using substances to cope with psychological distress was common, with participants talking about using methamphetamine to numb their feelings or forget stressful memories. One-third of women and 13% of men had previously tried to commit suicide. Despite the huge mental health burden in this population, very few had ever received mental health treatment.Conclusion. The data indicate a need for integrated care that addresses both substance use and psychiatric needs in this population. Mental health and drug treatment services targeting methamphetamine users should include a concerted focus on suicide prevention

Implementation of a School-Based HIV Prevention Curriculum Following National Dissemination in Nyanza Province, Kenya

Background: Primary School Action for Better Health (PSABH) became the national HIV prevention curriculum of Kenya in 2005.Objective: To examined implementation of PSABH and student risk behaviours.Setting: Muhuru, a rural division of Nyanza Province.Subjects: One thousand one hundred and forty six students aged 9-21 years from six primary schools in Muhuru.Outcome measures: Anonymous surveys were administered to assess students’ exposure to PSABH curriculum components, sexual activity, condom use, and self-efficacy related to engaging in lower risk behaviours.Results: The six schools implementing PSABH were not implementing the full curriculum. Fifty-five percent of males and 44% of females reported a history of sexual activity. For females, condom self-efficacy was related to lower risk behaviour , while HIV education during pastoral instruction was associated with higher risk. Boys who reported higher self-efficacy and learning about abstinence strategies engaged in lower risk behaviour , while exposure to HIV education in assemblies and communication with relatives about HIV was associated with higher risk.Conclusion: Previous studies documented benefits of PSABH. However, it is unclear how effective the curriculum is after national scale-up. In this community, PSABH was implemented at a low level, with some curriculum components associated with higher risk behaviour , calling into question how PSABH is being delivered. Future studies should examine effective strategies for ongoing support, monitoring, and evaluation. Successfully disseminating evidence-based prevention strategies could reduce HIV incidence and the burden on healthcare providers struggling to care forpeople living with HIV/AIDS

Trade regimes and GATT: resource-intensive vs. knowledge intensive growth

Trading blocks can help or hinder the liberalization of world trade. A determining factor is whether trade within the block is organized around traditional comparative advantages, or around economies of scale. Regional free trade agreements such as NAFTA can be a substitutes for global free trade when they are based on traditional comparative advantages; then each regional market develops market power and incentives to impose tariffs on the rest of the word. Alternatively, regional trade agreements can be complementary to global free trade. This occurs when the blocks are organized around the exploitation of economies of scale and based on knowledge-intensive sectors. I establish that external economies of scale produce incentives for expanded trade; they can defeat the standard argument for "optimal tariffs" and mitigate another negative feature of trading blocks: their tendency to divert trade from efficient to inefficient sources. The emergence of regional blocks organized around economies of scale can therefore lead to increasingly open international markets. I discuss policy implications for the EU and for free trade in the Americas

Decaying Dark Matter in the Supersymmetric Standard Model with Freeze-in and Seesaw mechanims

Inspired by the decaying dark matter (DM) which can explain cosmic ray anomalies naturally, we consider the supersymmetric Standard Model with three right-handed neutrinos (RHNs) and R-parity, and introduce a TeV-scale DM sector with two fields \phi_{1,2} and a $Z_3$ discrete symmetry. The DM sector only interacts with the RHNs via a very heavy field exchange and then we can explain the cosmic ray anomalies. With the second right-handed neutrino N_2 dominant seesaw mechanism at the low scale around 10^4 GeV, we show that \phi_{1,2} can obtain the vacuum expectation values around the TeV scale, and then the lightest state from \phi_{1,2} is the decay DM with lifetime around \sim 10^{26}s. In particular, the DM very long lifetime is related to the tiny neutrino masses, and the dominant DM decay channels to \mu and \tau are related to the approximate \mu-\tau symmetry. Furthermore, the correct DM relic density can be obtained via the freeze-in mechanism, the small-scale problem for power spectrum can be solved due to the decays of the R-parity odd meta-stable states in the DM sector, and the baryon asymmetry can be generated via the soft leptogensis.Comment: 24 pages,3 figure

Determination of an optimal dosing regimen for aspirin chemoprevention of 1,2-dimethylhydrazine-induced colon tumours in rats

In order to establish an optimal timing and duration of aspirin treatment in the chemoprevention of 1,2-dimethylhydrazine (DMH)-induced colon cancer in rats, colon tumours were induced using an established protocol and aspirin was given in the diet at 500 p.p.m. during various stages of colon carcinogenesis. Results indicate that only aspirin treatment throughout the entire carcinogenic period significantly reduced tumour incidence and volume whereas intermittent aspirin dosing increased tumour number and/or volume, suggesting that aspirin must be used for an extended period in order to gain any chemopreventive benefit. © 1999 Cancer Research Campaig

The chemopreventive polyphenol Curcumin prevents hematogenous breast cancer metastases in immunodeficient mice

Dissemination of metastatic cells probably occurs long before diagnosis of the primary tumor. Metastasis during early phases of carcinogenesis in high risk patients is therefore a potential prevention target. The plant polyphenol Curcumin has been proposed for dietary prevention of cancer. We therefore examined its effects on the human breast cancer cell line MDA-MB-231 in vitro and in a mouse metastasis model. Curcumin strongly induces apoptosis in MDA- MB- 231 cells in correlation with reduced activation of the survival pathway NF kappa B, as a consequence of diminished I kappa B and p65 phosphorylation. Curcumin also reduces the expression of major matrix metalloproteinases (MMPs) due to reduced NF kappa B activity and transcriptional downregulation of AP-1. NF kappa B/p65 silencing is sufficient to downregulate c-jun and MMP expression. Reduced NF kappa B/AP-1 activity and MMP expression lead to diminished invasion through a reconstituted basement membrane and to a significantly lower number of lung metastases in immunodeficient mice after intercardiac injection of 231 cells (p=0.0035). 68% of Curcumin treated but only 17% of untreated animals showed no or very few lung metastases, most likely as a consequence of down-regulation of NF kappa B/AP-1 dependent MMP expression and direct apoptotic effects on circulating tumor cells but not on established metastases. Dietary chemoprevention of metastases appears therefore feasible. Copyright (c) 2007 S. Karger AG, Basel

Electrophysiological dynamics of Chinese phonology during visual word recognition in Chinese-English bilinguals

Silent word reading leads to the activation of orthographic (spelling), meaning, as well as phonological (sound) information. For bilinguals, native language information can also be activated automatically when they read words in their second language. For example, when Chinese-English bilinguals read words in their second language (English), the phonology of the Chinese translations is automatically activated. Chinese phonology, however, consists of consonants and vowels (segmental) and tonal information. To what extent these two aspects of Chinese phonology are activated is yet unclear. Here, we used behavioural measures, event-related potentials and oscillatory EEG to investigate Chinese segmental and tonal activation during word recognition. Evidence of Chinese segmental activation was found when bilinguals read English words (faster responses, reduced N400, gamma-band power reduction) and when they read Chinese words (increased LPC, gamma-band power reduction). In contrast, evidence for Chinese tonal activation was only found when bilinguals read Chinese words (gamma-band power increase). Together, our converging behavioural and electrophysiological evidence indicates that Chinese segmental information is activated during English word reading, whereas both segmental and tonal information are activated during Chinese word reading. Importantly, gamma-band oscillations are modulated differently by tonal and segmental activation, suggesting independent processing of Chinese tones and segments