Deal or no-deal? Using administrative data to explore buyer motivation in online drug purchases and its association with community risk factors in Scotland

Background The expansion of online drugs markets has widened opportunities to purchase drugs, for both personal use and wider distribution, thus creating new potential public health risks. However, there is little research on the motivation of online drug purchasers or the level of risk that such transactions pose to different communities. Greater insights into the intended use of drug parcels arriving by post, and how this varies across communities could help law enforcement and health services develop more effective policies and better allocate resources to reduce drug-related harms. Methods We use Scottish administrative data about illegal drug parcels seized by the UK Border Force to create a new classification of ‘buyer motivation’ (based on type of drug, estimated number of doses purchased, and patterns of drug consumption). We identify three potential types of buyer motivation: personal consumption, heavy use or social dealing, and wholesale dealing; and examine the extent to which each type is associated with a range of drug-related community risk factors, thereby identifying potential variation in levels of public health risk. Results Communities to which drug parcels were destined differed significantly from the Scottish average across a range of factors; however, this varied by buyer motivation. Parcels thought to be purchased for heavy use or social dealing appeared to pose a greater risk within communities characterised by general deprivation, but especially health-related deprivation, with a high youth population but low unemployment rates; whereas those purchased for wholesale dealing appear most likely to pose a risk in communities with higher crime and unemployment rates. Conclusions Administrative data about intercepted drug parcels could be helpful in classifying the motivation of online drug purchasers and monitoring patterns of variation in potential public health risks at a community level. This could support law enforcement and public health agencies to develop more targeted drug-harm reduction strategies

Altered functional brain network connectivity and glutamate system function in transgenic mice expressing truncated Disrupted-in-Schizophrenia 1

Considerable evidence implicates DISC1 as a susceptibility gene for multiple psychiatric diseases. DISC1 has been intensively studied at the molecular, cellular and behavioral level, but its role in regulating brain connectivity and brain network function remains unknown. Here, we utilize a set of complementary approaches to assess the functional brain network abnormalities present in mice expressing a truncated Disc1 gene (Disc1tr Hemi mice). Disc1tr Hemi mice exhibited hypometabolism in the prefrontal cortex (PFC) and reticular thalamus along with a reorganization of functional brain network connectivity that included compromised hippocampal–PFC connectivity. Altered hippocampal–PFC connectivity in Disc1tr Hemi mice was confirmed by electrophysiological analysis, with Disc1tr Hemi mice showing a reduced probability of presynaptic neurotransmitter release in the monosynaptic glutamatergic hippocampal CA1–PFC projection. Glutamate system dysfunction in Disc1tr Hemi mice was further supported by the attenuated cerebral metabolic response to the NMDA receptor (NMDAR) antagonist ketamine and decreased hippocampal expression of NMDAR subunits 2A and 2B in these animals. These data show that the Disc1 truncation in Disc1tr Hemi mice induces a range of translationally relevant endophenotypes underpinned by glutamate system dysfunction and altered brain connectivity

p-Medicine: From data sharing and integration via VPH models to personalized medicine

The Worldwide innovative Networking in personalized cancer medicine (WIN) initiated by the Institute Gustave Roussy (France) and The University of Texas MD Anderson Cancer Center (USA) has dedicated its 3rd symposium (Paris, 6–8 July 2011) to discussion on gateways to increase the efficacy of cancer diagnostics and therapeutics (http://www.winconsortium.org/symposium.html)

Development and psychometric testing of a breast cancer patient-profiling questionnaire

Introduction: The advent of \u201cpersonalized medicine\u201d has been driven by technological advances in genomics. Concentration at the subcellular level of a patient\u2019s cancer cells has meant inevitably that the \u201cperson\u201d has been overlooked. For this reason, we think there is an urgent need to develop a truly personalized approach focusing on each patient as an individual, assessing his/her unique mental dimensions and tailoring interventions to his/her individual needs and preferences. The aim of this study was to develop and test the psychometric properties of the ALGA-Breast Cancer (ALGA-BC), a new multidimensional questionnaire that assesses the breast cancer patient\u2019s physical and mental characteristics in order to provide physicians, prior to the consultation, with a patient\u2019s profile that is supposed to facilitate subsequent communication, interaction, and information delivery between the doctor and the patient. Methods: The specific validation processes used were: content and face validity, construct validity using factor analysis, reliability and internal consistency using test\u2013retest reliability, and Cronbach\u2019s alpha correlation coefficient. The exploratory analysis included 100 primary breast cancer patients and 730 healthy subjects. Results: The exploratory factor analysis revealed eight key factors: global self-rated health, perceived physical health, anxiety, self-efficacy, cognitive closure, memory, body image, and sexual life. Test\u2013retest reliability and internal consistency were good. Comparing patients with a sample of healthy subjects, we also observed a general ability of the ALGA-BC questionnaire to discriminate between the two. Conclusion: The ALGA-BC questionnaire with 29 items is a valid instrument with which to obtain a patient\u2019s profile that is supposed to help physicians achieve meaningful personalized care which supplements biological and genetic analyse

Procedural justice, compliance with the law and police stop-and-search: a study of young people in England and Scotland

The policing of young people, especially through stop-and-search, has been rigorously debated in the context of rising violence in the UK. While concepts based on procedural justice theory and perceptions of police fairness are directly relevant to these debates, these have rarely been tested on young people, nor have they taken account of the impact of stop-and-search. This paper examines young people’s experiences of stop-and-search in two Scottish and two English cities, and tests the relationship between these experiences, their trust in the police, their perceptions of police legitimacy and their compliance with the law. The study finds that Scottish adolescents, who experienced higher volume stop-and-search, had more negative attitudes to the police and perceived them to be less procedurally fair than English adolescents. Structural equation modelling confirms that principles of procedural justice theory do apply to young people in this UK sample. However, our findings suggest that stop-and-search may damage trust in the police and perceptions of police legitimacy, regardless of the volume of police stop-and-search, and this may result in increased offending behaviour. With ongoing calls to increase the use of stop-and-search in response to recent increases in knife crime in England, we argue that its use needs to be carefully balanced against the, as yet poorly evidenced, benefits of the use of the tactic

Post-treatment follow-up study of abdominal cystic echinococcosis in Tibetan communities of northwest Sichuan Province, China

Background: Human cystic echinococcosis (CE), caused by the larval stage of Echinococcus granulosus, with the liver as the most frequently affected organ, is known to be highly endemic in Tibetan communities of northwest Sichuan Province. Antiparasitic treatment with albendazole remains the primary choice for the great majority of patients in this resource-poor remote area, though surgery is the most common approach for CE therapy that has the potential to remove cysts and lead to complete cure. The current prospective study aimed to assess the effectiveness of community based use of cyclic albendazole treatment in Tibetan CE cases, and concurrently monitor the changes of serum specific antibody levels during treatment. Methodology/Principal Findings: Ultrasonography was applied for diagnosis and follow-up of CE cases after cyclic albendazole treatment in Tibetan communities of Sichuan Province during 2006 to 2008, and serum specific IgG antibody levels against Echinococcus granulosus recombinant antigen B in ELISA was concurrently monitored in these cases. A total of 196 CE cases were identified by ultrasound, of which 37 (18.9%) showed evidence of spontaneous healing/involution of hepatic cyst(s) with CE4 or CE5 presentations. Of 49 enrolled CE cases for treatment follow-up, 32.7% (16) were considered to be cured based on B-ultrasound after 6 months to 30 months regular albendazole treatment, 49.0% (24) were improved, 14.3% (7) remained unchanged, and 4.1% (2) became aggravated. In general, patients with CE2 type cysts (daughter cysts present) needed a longer treatment course for cure (26.4 months), compared to cases with CE1 (univesicular cysts) (20.4 months) or CE3 type (detached cyst membrane or partial degeneration of daughter cysts) (9 months). In addition, the curative duration was longer in patients with large (.10 cm) cysts (22.3 months), compared to cases with medium (5– 10 cm) cysts (17.3 months) or patients with small (,5 cm) cysts (6 months). At diagnosis, seven (53.8%) of 13 cases with CE1 type cysts without any previous intervention showed negative specific IgG antibody response to E. granulosus recombinant antigen B (rAgB). However, following 3 months to 18 months albendazole therapy, six of these 7 initially seronegative CE1 cases sero-converted to be specific IgG antibody positive, and concurrently ultrasound scan showed that cysts changed to CE3a from CE1 type in all the six CE cases. Two major profiles of serum specific IgG antibody dynamics during albendazole treatment were apparent in CE cases: (i) presenting as initial elevation followed by subsequent decline, or (ii) a persistent decline. Despite a decline, however, specific antibody levels remained positive in most improved or cured CE cases. Conclusions: This was the first attempt to follow up community-screened cystic echinococcosis patients after albendazole therapy using ultrasonography and serology in an endemic Tibetan region. Cyclic albendazole treatment proved to be effective in the great majority of CE cases in this resource-poor area, but periodic abdominal ultrasound examination was necessary to guide appropriate treatment. Oral albendazole for over 18 months was more likely to result in CE cure. Poor drug compliance resulted in less good outcomes. Serology with recombinant antigen B could provide additional limited information about the effectiveness of albendazole in CE cases. Post-treatment positive specific IgG antibody seroconversion, in initially seronegative, CE1 patients was considered a good indication for positive therapeutic efficacy of albendazole

The pains of desistance

Desistance is generally presented in a positive light, with themes of ‘making good’ and generativity recurring in the literature. This article reports on two qualitative studies exploring the desistance journeys of two different groups of ex-offenders, drawing attention to the pains of this process. It examines the possible consequences of these ‘pains of desistance’ and how they are linked to three spheres of desistance: act-desistance; identity desistance; and relational desistance. The attempt to achieve act-desistance often led to the pain of isolation for our interviewees, while the clash between the need to achieve identity desistance and a lack of relational desistance (especially on the meso- and macro-levels) meant that they suffered the pain of goal failure. The pains of isolation and goal failure combined to lead to the further pain of hopelessness. Those interviewed were indeed ‘going straight’, but taking this path led many to a limited and often diminished life