The impacts and service responses to injecting cathinones and novel opioids amongst marginalized drug using populations – a scoping review

Background: A growing body of literature reports on the injection of synthetic cathinones (SC) and novel synthetic opioids (NSO) in marginalized drug-using (MDU) populations. This review seeks to establish what is known about the injection of SCs and NSOs impacts on MDUs. Method: A six-stage iterative scoping literature review was conducted in relation to SCs, NSOs, MDU impacts and service responses. Searches were conducted through Pubmed™ and Google Scholar™. Results: Two Thousand and Ninety-Nine search items were retrieved. After duplicates were removed (n = 880), articles were screened for injecting drug use by MDUs leading to the removal of a further 1102 articles. Three articles were identified through a hand search, yielding a total of 22 articles for appraisal. Conclusions: SC injection has largely dissipated in many regions due to service and policy responses and changes in the drug market. Responses to NSO have been less effective, with extensive use and opioid overdosing due to contamination and adulteration within the illicit drug market. These impacts have stimulated innovative responses such as fentanyl test strips and housing-based consumption sites. The evidence for their effectiveness is not established. In this context, the underlying environmental and structural factors shaping the risk of these populations should be addressed.info:eu-repo/semantics/acceptedVersio

Descripción de una nueva especie del género Arganiella Giusti y Pezzoli, 1980 (Mollusca, Gastropoda, Hydrobiidae) en la Península Ibérica

10 pages, 4 figures, 5 tables.[EN] A new species of Arganiella Giusti & Pezzoli, 1980, up to now a monotypic genus, thought to be endemic to the Italian Central Apennines, is described from the Iberian Peninsula. This new species, named Arganiella tartessica, is located in southwestern Spain, provinces of Huelva and Badajoz. In this paper, a detailed description of its morphological characters is given and new data of nervous system and ciliated areas in the cephalic region are provided.[ES] Se describe una especie ibérica de Arganiella Giusti y Pezzoli, 1980, un género que hasta ahora se consideraba monotípico y endémico de los Apeninos centrales italianos. Esta nueva especie, denominada Arganiella tartessica, ha sido localizada en el sureste español, en las provincias de Huelva y Badajoz. En este artículo se describen en detalle sus caracteres morfológicos y se presentan datos, hasta la fecha desconocidos en el género Arganiella, del sistema nervioso y de áreas ciliadas en la región cefálica.This work was funded by the “Fauna Ibérica” Project (DGES PB95–0235).Peer reviewe

The Dynamic Landscape of Novel Psychoactive Substance (NPS) Use in Ireland: Results from an Expert Consultation

In Ireland, legislators encountered a new phenomenon in 2005 onwards with the advent of ‘legal highs’ sold in headshops. Use of ‘legal highs’ containing herbal and synthetic new psychoactive substances (NPS) was not confined to problematic drug users, and included social recreational users. Legislative controls were enacted in 2010, 2011 and 2015. The study aimed to investigate expert perspectives on the NPS situation with regard to changing and emergent trends in use, health and social consequences and service implications. This brief report presents descriptive findings from a national consultation using a structured guide with experts in 2016. Four themes emerged and centred on; ‘Definitions of NPS used within Professional Roles’; ‘Professional Experiences of NPS‘; ‘Types of NPS Users, Sourcing and Consequences of Use’; and ‘Service Response.’ Findings underscored the mental health and addiction related consequences of NPS use, with prevention, clinical and treatment services ill- equipped to deal with the particular characteristics of this form of drug abuse. Enhanced strategies, services and clinical responses are warranted to address the challenges encountered. © 2016 Springer Science+Business Media New Yor

Long-term effectiveness and prediction of treatment outcome in cognitive behavioral therapy and sertraline for late-life anxiety disorders

Background: Although anxiety disorders are prevalent in older adults, randomized controlled trials of treatment effectiveness for late-life anxiety are scarce and have focused primarily on the effectiveness of psychotherapeutic interventions. However, recent findings suggest that in some cases, pharmacological treatment may be more beneficial for late-life anxiety disorders. As yet, there have been no systematic studies investigating prognostic factors for the outcome of cognitive behavioral therapy (CBT) and pharmacotherapy for late-life anxiety. The objective of the present study was to study long-term treatment outcomes and to explore differential predictors for both short-term and long-term treatment outcomes of sertraline and CBT for late-life anxiety disorders. Methods: Participants of a randomized controlled trial (RCT) comparing sertraline and CBT for the treatment of late-life anxiety were contacted one year after completing their treatment, so that predictors for both short-term and long-term treatment outcome could be established. Results: Sertraline showed a greater reduction of symptoms than CBT on anxiety (Hamilton Anxiety Rating Scale; HARS) and worry (Worry Domain Questionnaire) ratings at one-year follow-up. The strongest predictor for short-term CBT outcome was poor perceived health, explaining 40% of the variance in post-treatment residual gain scores on the HARS. The strongest predictor for long-term CBT outcome was neuroticism, explaining 20% of the variance in residual gain scores at one-year follow-up. Analyses revealed no significant predictors for treatment outcome in sertraline participants. Conclusions: Our study suggests that long-term use of sertraline might be more beneficial for late-life anxiety than a 15-week CBT program. Poor perceived health and neuroticism are predictive of less improvement after CBT in anxious older adults. Implications of these findings are discussed

Wishing for deburdening through a sustainable control after bariatric surgery

The aim of this study was an in-depth investigation of the change process experienced by patients undergoing bariatric surgery. A prospective interview study was performed prior to as well as 1 and 2 years after surgery. Data analyses of the transcribed interviews were performed by means of the Grounded Theory method. A core category was identified: Wishing for deburdening through a sustainable control over eating and weight, comprising three related categories: hoping for deburdening and control through surgery, feeling deburdened and practising control through physical restriction, and feeling deburdened and trying to maintain control by own willpower. Before surgery, the participants experienced little or no control in relation to food and eating and hoped that the bariatric procedure would be the first brick in the building of a foundation that would lead to control in this area. The control thus achieved in turn affected the participants' relationship to themselves, their roles in society, and the family as well as to health care. One year after surgery they reported established routines regarding eating as well as higher self-esteem due to weight loss. In family and society they set limits and in relation to health care staff they felt their concern and reported satisfaction with the surgery. After 2 years, fear of weight gain resurfaced and their self-image was modified to be more realistic. They were no longer totally self-confident about their condition, but realised that maintaining control was a matter of struggle to obtaining a foundation of sustainable control. Between 1 and 2 years after surgery, the physical control mechanism over eating habits started to more or less fade for all participants. An implication is that when this occurs, health care professionals need to provide interventions that help to maintain the weight loss in order to achieve a good long-term outcome