Shake ‘N Bake: the Migration of ‘Pervitin’ to Ireland

Home manufactured methamphetamine known as ‘Pervitin’ has historically dominated the drug market in the Czech and Slovak Republics. Seizures and surveillance data indicate some displacement of ‘Pervitin’ across Europe to areas of low reported prevalence (Nordic countries, Germany, Cyprus, Greece and Portugal). We present the first single case study of clandestine production of ‘Pervitin’ to Ireland, a country with low reporting history of methamphetamine. Content analysis yielded three descriptive themes; ‘Pervitin’ use, Decisions to Use and Effects; Legality and Hazards; and ‘Clandestine Manufacture.’ The study yielded unique insight into migration of this culturally specific drug, and how continued cultural contexts for use and ‘cooking’ remain intact when residing in the host country. Given its unique cultural nature and national characteristics, continued migration of Eastern European citizens across Europe, diffusion of clandestine production warrants continued surveillance. Appropriate service responses require culturally appropriate information and outreach services to Eastern European service users. © 2016 Springer Science+Business Media New Yor

Community pharmacist experiences of providing needle and syringe programmes in Ireland

Background: Community pharmacists are increasingly acknowledged as under-utilized, important and accessible health providers in providing harm reduction support to drug users via needle and syringe programmes (NSP), provision of advice, HIV/Hepatitis testing and as referral mechanism to social, medical and treatment services. We report here on qualitative findings as part of the evaluation of the pilot Pharmacy Needle Exchange (PNEX) programme in Ireland. Objectives: The aim was to understand and illustrate pharmacist experiences of providing NSP. Methods: Of the 107 eligible pharmacies, a total of 70 participated in the national evaluation. Telephone interviews (n=17) and one to-one interviews (n=13) using a semi-structured guide were conducted with 30 pharmacists. Analysis of data was conducted using the Empirical Phenomenological Psychological (EPP) five step protocol. Results: Pharmacist experiences illustrated the largely positive nature of providing NSP, and highlighted needs to develop harm reduction training for pharmacists and appropriate strategies to raise awareness, provide exchange packs to meet the specific needs of the diverse populations of people who inject drugs and ensure the development of trusting relationships and opportunities to engage within a confidential service. Conclusions: Further enhancement of NSP coverage and targeted service delivery within national care pathways for drug and alcohol services is warranted

Change point models for cognitive tests using semi-parametric maximum likelihood

Random-effects change point models are formulated for longitudinal data obtained from cognitive tests. The conditional distribution of the response variable in a change point model is often assumed to be normal even if the response variable is discrete and shows ceiling effects. For the sum score of a cognitive test, the binomial and the beta-binomial distributions are presented as alternatives to the normal distribution. Smooth shapes for the change point models are imposed. Estimation is by marginal maximum likelihood where a parametric population distribution for the random change point is combined with a non-parametric mixing distribution for other random effects. An extension to latent class modelling is possible in case some individuals do not experience a change in cognitive ability. The approach is illustrated using data from a longitudinal study of Swedish octogenarians and nonagenarians that began in 1991. Change point models are applied to investigate cognitive change in the years before deat

The role of self-concept content, certainty and stability in academic procrastination

Academic procrastination has been associated with a variety of negative outcomes. While theorists have proposed that those with an unstable self-concept engage in procrastination due to the fear that they will be unable to meet the required standard, a systematic review conducted as part of the present study (Chapter 2) revealed that all research pertaining to the self-concept in academic procrastination has been correlational, thereby limiting the validity of such theories. As such, the present study employed an experimental design to investigate the self-concept of academic procrastinators (Chapter 3). Ninety-nine undergraduate students completed trait, symptom and academic procrastination inventories as well as measures of state-based affect and cognition, and self-concept content, certainty and stability before and after receiving feedback for a writing task. Compared to low procrastinators, high procrastinators described a self-concept characterised by a greater number of negative and procrastination-related attributes, higher levels of fear of negative evaluation, lower levels of self-concept clarity, self-efficacy and self-esteem and more severe symptoms of depression, anxiety and stress. Furthermore, both the content and certainty associated with procrastinators’ self-concept descriptions changed significantly as a result of receiving randomly allocated feedback for a writing task. While high procrastinators reported significant improvements to their self-concept after receiving a positive evaluation, low procrastinators showed a more positive self-concept which did not change after feedback. These results provide the first empirical evidence for the presence of an unstable self-concept in academic procrastinators, providing support for the aforementioned theory and emphasising the importance of addressing self-concept stability in the psychological treatment of academic procrastination. Further research may investigate mindfulness-based interventions

Prevalence and risk factors for hepatitis C viral infection amongst a cohort of irish drug users attending a drug treatment centre for agonist opioid treatment (AOT)

Background: Injecting drug use (IDU) is a major driver of the European hepatitis C virus (HCV) epidemic. National data on prevalence of HCV amongst Irish drug users remains confined to certain treatment sites and prison settings. Aim: To examine the prevalence of HCV infection and risk factors associated with infection among the 228 patients attending agonist opioid treatment (AOT) in a clinic in Dublin. Methods: A retrospective cross-sectional study was conducted using data collected from Health Research Board (HRB) forms and standardised written and electronic assessment forms routinely completed on treatment initiation. Results: The prevalence of HCV infection was 63.6% (n= 145) with no significant gender difference (p=0.717). Patients who were infected with HCV were older than those uninfected (41.1 ± 7.5 years versus 37.5 ± 8.5 years; p = 0.001), with prevalence significantly lower in younger adults (p=0.002). Multivariate analysis identified age of first drug use (p=0.002) and first injection (p=0.001), type of first drug used; cannabis (p=0.015), heroin (p=0.014) and cocaine (p=0.018) and early age of AOT entry (p=0.001) as the most significant risk factors for HCV infection in this cohort. Those with no IDU had decreased odds of being HCV positive by 91.1%. Conclusion: Data for this Irish sample indicates high prevalence of HCV infection, and the need to consider age of first drug onset and injecting use, particular drug types and earlier commencement of AOT to inform targeted HCV treatment and prevention interventions in Ireland. © Icro Maremmani

"codeine Is My Helper": Misuse of and Dependence on Codeine-Containing Medicines in South Africa

Misuse of codeine-containing medicines is an emerging global public health concern. The majority of research has been conducted in developed countries (European Members States, Australia, the United States). This study aimed to gain an understanding of unique individual and collective experiences of trajectories of codeine misuse and dependence in South Africa. In-depth interviews were conducted with a purposive sample of adult codeine misusers and dependents (n = 25). Narratives were analyzed using the empirical phenomenological psychological five-step method. Nine themes with 63 categories emerged, with two additional high levels of abstraction. Findings are illustrated: participant profile and product preferences, motives for use, transitioning to misuse and dependence, pharmacy purchasing and alternative sourcing routes, effects and withdrawal experiences, help-seeking and treatment experiences, and strategies for prevention. The study underscores the need for continued support for enhanced patient awareness of risk of habit forming use and related health consequences and professional pharmacovigilance. © SAGE Publications