scholarly journals «One prick and then it´s done»: a mixed-methods exploratory study on intramuscular injection in heroin-assisted treatment

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Maximilian Meyer ◽  
Ramón Eichenberger ◽  
Johannes Strasser ◽  
Kenneth M. Dürsteler ◽  
Marc Vogel
Keyword(s):  
Subjective Effects ◽  
Venous Access ◽  
Route Of Administration ◽  
Time Saving ◽  
Routes Of Administration ◽  
Vein Access ◽  
Treatment Centre ◽  
Alternative Routes ◽  
Depth Interviews

Abstract Background Intramuscular (IM) injection of drugs is associated with high rates of injecting-related injuries and diseases. However, little is known about the role of this route of administration in heroin-assisted treatment. The aim of this study was to determine the prevalence of IM diacetylmorphine administration and associated complications as well as to explore patients’ views and opinions on the topic and the underlying reasons for this practice. Methods The research site was a Swiss outpatient treatment centre specialised in heroin-assisted treatment. We conducted in-depth interviews with two patients who intramuscularly inject diacetylmorphine. Interviews were analysed qualitatively, and emerging themes were used to develop a 38-item questionnaire on IM injections. We then offered this questionnaire to all patients in the treatment centre. Results Five main themes emerged from the in-depth interviews: poor venous access, side effects, subjective effects, procedure for IM injection, and consideration of alternatives to IM. These themes covered the rationale for using this route of administration, complications, subjective effects of IM diacetylmorphine, hygiene and safety measures as well as alternative routes of administration. Fifty-three patients filled in the questionnaire. The lifetime prevalence of IM injections was 60.4% (n = 32) and 34.4% (n = 11) of the patients stated that IM injection was their primary route of administration. No participant reported using the IM route for street drugs. The main reason for IM injections was poor vein access. Other reasons given were time saving and less risk of injuries. Complications included induration of muscle tissue and pain, whereas more severe complications like thrombosis and infections of the injection site were reported much less often. Conclusion As the population of opioid-dependent individuals is aging and the deterioration of access veins is likely to increase, the frequency of IM injecting will equally increase. Even though our data show that the IM injection of diacetylmorphine in a clinical setting is a common practice and appears to be relatively safe, research on alternative routes of administration is needed to provide potentially less harmful alternative routes of administration in heroin-assisted treatment.

Are Three Items Sufficient to Measure Sense of Coherence?

2018 ◽  
Vol 34 (4) ◽  
pp. 229-237 ◽  
Author(s):  
Francesca Chiesi ◽  
Andrea Bonacchi ◽  
Caterina Primi ◽  
Alessandro Toccafondi ◽  
Guido Miccinesi
Keyword(s):  
Sense Of Coherence ◽  
Convergent Validity ◽  
Clinical Sample ◽  
Clinical Samples ◽  
Depression Symptoms ◽  
Time Saving ◽  
Positive Role ◽  
Patients With Cancer ◽  
Measure Sense

Abstract. The present study aimed at evaluating if the three-item sense of coherence (SOC) scale developed by Lundberg and Nystrom Peck (1995) can be effectively used for research purpose in both nonclinical and clinical samples. To provide evidence that it represents adequately the measured construct we tested its validity in a nonclinical (N = 658) and clinical sample (N = 764 patients with cancer). Results obtained in the nonclinical sample attested a positive relation of SOC – as measured by the three-item SOC scale – with Antonovsky’s 13-item and 29-item SOC scales (convergent validity), and with dispositional optimism, sense of mastery, anxiety, and depression symptoms (concurrent validity). Results obtained in the clinical sample confirmed the criterion validity of the scale attesting the positive role of SOC – as measured by the three-item SOC scale – on the person’s capacity to respond to illness and treatment. The current study provides evidence that the three-item SOC scale is a valid, low-loading, and time-saving instrument for research purposes on large sample.

Extravascular Administration of Factor IX: Potential for Replacement Therapy of Canine and Human Hemophilia B

1997 ◽  
Vol 77 (05) ◽  
pp. 0944-0948 ◽  
Author(s):  
Darla Liles ◽  
Charles N Landen ◽  
Dougald M Monroe ◽  
Celeste M Lindley ◽  
Marjorie s Read ◽  
...  
Keyword(s):  
Gene Therapy ◽  
Vitamin K ◽  
Absorption Rate ◽  
Venous Access ◽  
Factor Ix ◽  
Hemophilia B ◽  
Current Therapy ◽  
Home Therapy ◽  
Routes Of Administration ◽  
Plasma Compartment

SummaryCurrent therapy for hemophilia B requires large intravenous doses of factor IX (F.IX) given in the clinic or at home. Although home therapy is possible for many patients, it is often complicated by factors such as the lack of good venous access. Very little is known about extravascular routes for administering proteins like F.IX (57 kD) or other vitamin K-dependent procoagulant factors into the circulation. Questions about the absorption rate from extravascular administration as well as plasma recovery and bioavailability have arisen recently with the growing availibility of highly purified procoagulant proteins and increased interest in gene therapy of hemophilia B. Therefore, a group of studies were undertaken to determine the absorption rate, plasma recovery, and bioavailability of high purity, human plasma-derived F.IX concentrates administered via extravascular routes in hemophilia B dogs and in one human hemophilia B subject. Five hemophilia B dogs were given human F.IX via either a subcutaneous (SC), intramuscular (IM), intra- peritoneal (IP) or intravenous (IV) route. In a subsequent study, a single SC administration of human F.IX was compared to an identical IV dose of F.IX in the human hemophilia B subject. All extravascular routes of F.IX administration in both the canine and human gave lower levels of circulating plasma F.IX than the IV route, however all routes resulted in measurable F.IX activity. Of the extravascular routes, the IM injection in the canine resulted in a bioavailibility of 82.8%, while the SC injection resulted in a bioavailability of 63.5%. F.IX reached the plasma compartment by all extravascular routes used, confirming that F.IX can be absorbed extravascularly. The duration of measurable F.IX activity following extravascular administration is prolonged beyond that typically seen with IV administration. These data show that significant levels of F.IX may be obtained via SC injection in canine and ‘ human hemophilia B subjects and further highlight the potential of extravascular routes of administration for future experimental and clinical uses of F.IX and other procoagulant proteins.

Sasak People’s Resistance Against Mataram-Karangasem and Dutch Colonial Rulers: The Role of Tuan Guru Umar Kelayu

2020 ◽  
Vol 2 (1) ◽  
pp. 73-90
Author(s):  
Ahmad Tohri ◽  
H. Habibuddin ◽  
Abdul Rasyad
Keyword(s):  
Data Analysis ◽  
19Th Century ◽  
Economic Factors ◽  
Historical Method ◽  
The 19Th Century ◽  
Historical Methods ◽  
Depth Interviews ◽  
Dutch Colonial ◽  
Dutch Colonialism

This article discusses the Sasak people’s resistance against MataramKarangasem and Dutch colonial rulers in the 19th century in Lombok, Indonesia. It particularly focuses on Tuan Guru Umar Kelayu and his central role in the emergence of Sasak people’s resistance which transformed into Sasak physical revolution local and global imperialismcolonialism. Using the historical method, this article collected data through observation, in-depth interviews, and documentation. The data analysis involved the historical methods of heuristics, verification or criticism, interpretation, and historiography. The findings show that Sasak people’s resistance was not only caused by economic factors but also related to other factors such as social, cultural, and religious ones. Tuan Guru Umar Kelayu played a key role in the Sasak people’s resistance in that it was under his leadership and influence that the resistance transformed into a physical struggle against MataramKarangasem and Dutch colonialism as seen in Sakra War and Praya War which were led by his students and friends.

Mereka yang Tidak Dibayar Tinggi: Ibuisme, Taman Kanak-kanak, dan Kampung di Indramayu

2018 ◽  
Vol 3 (2) ◽  
pp. 121
Author(s):  
Mochammad Arief Wicaksono
Keyword(s):  
Kindergarten Teachers ◽  
New Order ◽  
The Family ◽  
Role Of Women ◽  
Community Pressure ◽  
The Village ◽  
Depth Interviews ◽  
The Ideal

The ideology of state-ibuism has always been interwoven with how the New Order regime until nowadays government constructing the “ideal” role of women in the family and community through the PKK (Pembinaan Kesejahteraan Keluarga) organization. However, in Cangkring Village, Indramayu, the ideology of ibuism works not because of the massive government regulating the role of women through the PKK organization, but it is possible because of the structure of the kampung community itself. Through involved observations and in-depth interviews about a kindergarten in the village, a group of housewives who dedicated themselves to teaching in kindergarten were met without getting paid high. From these socio-cultural phenomenons, this paper will describe descriptively and analytically that housewives in the Cangkring village are willing to become kindergarten teachers because of their moral burden as part of the warga kampung and also from community pressure from people who want their children to be able to read and write.

Transnational logic of gratitude: Marriage migrants’ narratives on marital satisfaction in South Korea

2021 ◽  
pp. 026858092199469
Author(s):  
Gowoon Jung
Keyword(s):  
Marital Satisfaction ◽  
Cognitive Processes ◽  
Gender Ideology ◽  
Marriage Migrants ◽  
Sociology Of Emotion ◽  
Micro Level ◽  
And Gender ◽  
The Impact ◽  
Depth Interviews

Scholarship on marriage migrants has examined the impact of class and gender ideology of receiving countries on their marital satisfaction. However, little is known about the role of transnational background in explaining women’s feelings of gratitude for husbands. Drawing on qualitative in-depth interviews with marriage migrant women residing in the eastern side of Seoul, Korea, this article explores the micro-level cognitive processes in understanding women’s gratitude for their husbands. Categorizing marriage migrants into two groups, ‘gratified’ and ‘ungratified’ wives, the author demonstrates how the gratified wives’ feelings of contentment is mediated by their active comparison of Korean husbands with local men in their homelands, and how these viewpoints conversely affect their aspirations for return. Bringing the sociology of emotion into an explanation of marriage migrants’ marital satisfaction, this study aims to develop a transnational frame of reference as an underlying dynamic for comprehending marriage migrants’ (in)gratitude.

scholarly journals Towards Sustainable Mobility? The Influence of the COVID-19 Pandemic on Romanian Mobile Citizens in Spain

2021 ◽  
Vol 13 (7) ◽  
pp. 4023
Author(s):  
Silvia Marcu
Keyword(s):  
Sustainable Development Goals ◽  
Human Mobility ◽  
Sustainable Mobility ◽  
The Sustainable Development ◽  
New Models ◽  
Challenges And Opportunities ◽  
Development Goals ◽  
Depth Interviews

Using the case study of Romanians in Spain, this article highlights how the COVID-19 crisis presents both challenges and opportunities when it comes to human mobility and sustainability. Drawing on in-depth interviews with mobile people during the period of lockdown and circulation restrictions, and in accordance with the objectives of the Sustainable Development Goals (SDGs), the paper advances and contributes to the relevance of sustainability and its impact on people’s mobility in the context of the COVID-19 pandemic. I argue that even in the midst of the crisis, sustainable ways may be found to promote and protect human mobility. The paper raises the way sustainability acts as a driver, gains relevance and influence, and contributes to the creation of new models of resilient mobility in times of crisis. The conclusions defend the respect for the SDGs regarding human mobility and emphasise the role of people on the move as sustainable actors learning to overcome distance and the barriers to their mobility during the pandemic.

scholarly journals Peripheral Inotropes in Critically Ill Children: Is It Safe?

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110222
Author(s):  
Ravi K. Mooli ◽  
Kalaimaran Sadasivam
Keyword(s):  
Central Venous Access ◽  
Pediatric Intensive Care ◽  
Venous Access ◽  
Critically Ill Children ◽  
Middle Income ◽  
Central Lines ◽  
Middle Income Countries ◽  
Peripheral Venous Access ◽  
Vasoactive Medications

Many children needing pediatric intensive care units care require inotropes, which are started peripherally prior to securing a central venous access. However, many hospitals in low- and middle-income countries (LMIC) may not have access to central lines and the vasoactive medications are frequently given through a peripheral venous access. Aim: The aim of our study was to describe the role of peripheral vasoactive inotropes in children. Methods: Children requiring peripheral vasoactive medications were included in this study. We retrospectively collected data at 2 time points on use and complications of peripheral vasoactive medications. Results: Eighty-four children (51 pre-COVID era and 33 COVID pandemic) received peripheral vasoactive medications. Only 3% of children (3/84) developed extravasation injury, all of whom recovered completely. Conclusions: Results from our study suggest that extravasation injury due to peripheral inotrope infusion is very low (3%) and it may be safely administered in children at a diluted concentration.

The Entrepreneurship Educator: Understanding Role Identity

2020 ◽  
pp. 251512742097966
Author(s):  
Birgitte Wraae ◽  
Candida Brush ◽  
Shahrokh Nikou
Keyword(s):  
Role Identity ◽  
Future Research ◽  
Analysis Tool ◽  
Perceptions Of Students ◽  
Significant Research ◽  
Future Research Directions ◽  
The Relationship ◽  
Role Identity Theory ◽  
Depth Interviews

Significant research explores effectiveness of entrepreneurial curriculum, teaching innovations and programs, but less often studied is the role of entrepreneurship educators. The way that the educator sees his or her role relative to the students is of critical importance because this directly influences pedagogy choices, expectations for students and learning outcomes, as well as job satisfaction. While recent studies propose typologies characterizing pedagogical approaches of educators, few of these are based on the data from entrepreneurship educators. Framed within role identity theory, we conducted 13 in–depth interviews to examine how entrepreneurship educators perceive their role. Using the qualitative data analysis tool (NVivo), we analyzed how the relationship between their perceptions of their role and core value orientation is connected to teaching approaches. Results show that these educators view their roles as teacher-focused, network-focused, or student-focused and that these perspectives are associated with different perceptions of students’ role and learning objectives. Further, we find different levels of emphasis on roles and that personal core values are differentially linked to these roles. Implications and future research directions are discussed.

The Costs of Seeking Shelter for Renters With Discrediting Background Records

2021 ◽  
pp. 153568412110124
Author(s):  
Anna Reosti
Keyword(s):  
Financial Burden ◽  
Rental Housing ◽  
Application Process ◽  
Direct Role ◽  
Screening Process ◽  
Housing Search ◽  
Housing Options ◽  
Depth Interviews ◽  
Rental Housing Market

This study illuminates an understudied pathway through which disadvantage is reproduced in the rental housing market: the housing search, application, and tenant screening process. Using in-depth interviews with 25 housing-seekers with criminal conviction records, past evictions, and damaged credit histories, this article examines the direct role of the rental housing search and application process in reproducing economic precarity and social disadvantage among renters with discrediting background records, beyond delimiting their housing options. Its findings suggest that navigating the housing search from a position of acute market disadvantage comes with significant costs for this population, including the financial burden of repeated application fees and the psychological strains associated with the specter of indefinite housing insecurity. The findings also demonstrate how the housing search process may undermine the willingness of stigmatized renters to contest exploitative or unlawful rental practices by reinforcing awareness of their degraded status in the rental market.

scholarly journals Towards the Development of Sustainable Tourism in Pakistan: A Study of the Role of Tour Operators

2021 ◽  
Vol 13 (9) ◽  
pp. 4902
Author(s):  
Zia Ullah ◽  
Rana Tahir Naveed ◽  
Atta Ur Rehman ◽  
Naveed Ahmad ◽  
Miklas Scholz ◽  
...  
Keyword(s):  
Sustainable Tourism ◽  
Developed Countries ◽  
Least Developed Countries ◽  
Face To Face ◽  
Phone Calls ◽  
The Government ◽  
Social Environmental ◽  
Sole Criterion ◽  
Depth Interviews

The literature on sustainable tourism is scant, particularly in the least developed countries. Very few studies touch upon the concept and no holistic theoretical or conceptual frameworks around the idea of sustainable tourism have been formulated. This study aims at exploring the role of tour operators in developing sustainable tourism in Pakistan and how the tour operators (TOs) conceive their role in this regard. TOs were reached through phone calls, emails, and virtual sources as face-to-face interviews were not possible due to COVID-19 pandemic and restrictions on travel by the government. In-depth interviews were conducted to gather data. Results suggest that the TOs although realize the importance of social, environmental, and economic dimensions of tourism on the communities but have no management systems in place to cater accordingly. There are no incentives in place by the government facilitate TOs to design and implement such systems. The TOs do not select a destination based on Global Sustainable Tourism Council criterion, but rather the selection of destination is mostly demand-based and profit-oriented. The study suggests that corporate profit motive is the sole criterion for decision making and is one of the major causes impeding sustainable tourism in Pakistan. The role of TOs in developing sustainable tourism is vague as the TOs do not have any systems in place to implement sustainable models. The study recommends that efforts need to be put in place to incentivize sustainable tourism in Pakistan and proper laws should be set forth by the authorities to comply by the TOs. The role of TOs is important and understood, however, there is a need to put proper systems in place.

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