Social Construction of Target Populations: A Theoretical Framework for Understanding Policy Approaches to Perinatal Illicit Substance Screening

Perinatal illicit substance use is a nursing and public health issue. Current screening policies have significant consequences for birthing individuals and their families. Racial disparities exist in spite of targeted and universal screening policies and practices. Thus, new theoretical approaches are needed to investigate perinatal illicit substance use screening in hospital settings. The purpose of this analysis is to evaluate the social construction of target populations theory in the context of perinatal illicit substance use screening. Using the theoretical insights of this theory to interrogate the approaches taken by policy makers to address perinatal illicit substance use and screening provides the contextual framework needed to understand why specific policy tools were selected when designing public policy to address these issues. The analysis and evaluation of this theory was conducted using the theory description and critical reflection model.

Emotional reactivity and difficulties in emotional regulation in drug users: a study in adolescents undergoing treatment in a therapeutic community

Purpose The purpose of this study is to investigate which emotions and difficulties in the emotional regulation of adolescents with illicit substance consumption. Design/methodology/approach In total, 41 adolescents undergoing treatment for the use of alcohol and drugs were recruited. The instruments used were the emotional rating scale and the difficulties in the regulation of emotions scale. Findings Emotional reactivity showed significant differences in the sadness dimension in relation to the number of cannabis cigarettes smoked daily and length of stay, and in the surprise dimension in relation to the number of cannabis cigarettes smoked daily. There was a significant correlation between happiness and age, surprise and number of siblings, sadness and school absenteeism and fear, school absenteeism and number of substances consumed. In regard to difficulties in emotional regulation, there were significant differences between the groups, in strategies regarding the gender of the participants and the number of substances consumed, in non-acceptance and impulses and in the number of substances consumed and in the awareness of the type and number of substances consumed. There was a significant correlation between strategies, non-acceptance, awareness and impulses and the number of substances consumed. Originality/value This study demonstrated that the emotional problems of adolescents admitted to a therapeutic community are predictors of illicit substance use.

Recreational Drug Using Behaviour and Legal Benzylpiperazine Party Pills

<p>Benzylpiperazine (BZP) is a stimulant drug that produces effects similar to amphetamines (Campbell, Cline, Evans, Lloyd, & Peck, 1973). It has been sold legally in New Zealand in the form of 'party pills' since 2000. The legal status of BZP party pills has been debated in New Zealand as the media reported cases of apparent overdoses and adverse reactions leading to hospitalization (Brogden, 2005; Crewdson, 2007; Reiber, 2005; Rankin, 2006). Representatives of the BZP party pill industry publicly defended their product claiming that BZP party pills were reducing substance related harm by reducing illicit substance use (Bowden, 2007b, p.1). They also claimed that banning BZP would result in an increase in use of illicit substances, especially methamphetamine or 'P' (Barnett, 2007). The overall aim of this thesis is to test the claims that BZP party pills reduce substance related harm by reducing illicit substance use, and to identify potential outcomes of a BZP party pill ban. In addition, the perceived risks of party pill and other drug use will be examined. In chapter one I review key concepts relating to BZP party pill use: recreational drug use, harm reduction, and risk perception. In chapter two the history and New Zealand context of BZP party pills are reviewed. In chapter three, study one qualitatively analyzes BZP party pill marketing material in an attempt to describe the culture and discourse promoted by the BZP party pill industry. This analysis demonstrated that BZP party pills were primarily marketed as part of a recreational drug using culture. In chapter four, study two quantitatively investigated whether BZP party pill use was associated with reduced levels of illicit substance use in a sample (N=796) of first year university students. This study also examined the relationship between risk perception and frequency of substance use. Study two demonstrated that BZP party pill users are generally recreational poly-drug users who used illicit substances equally as often as illicit users who did not use BZP party pills. BZP party pills did not appear to reduce illicit substance use, and therefore harm. For the majority of substances there was no significant relationship between risk and use behaviour. The legal status of substances appeared to be important when participants rated the risks of use. Legal substances (including BZP) tended to be rated as safer than illegal substances. In chapter five, study three qualitatively analyzed 60 interviews with regular BZP party pill users to identify potential outcomes of a BZP party pill ban. A combination of alternatives were likely to be used by BZP party pill users, primarily illicit substances, especially ecstasy, as well as alcohol, and black market BZP. However methamphetamine (P) was an unpopular alternative. Study three also analyzed how BZP party pill users assess the costs and benefits of BZP party pill use. Decisions to use BZP party pills relied heavily on the benefits of use, rather than the costs. In chapter six, the general discussion describes the implications, ethical considerations, limitations, and outcomes of the research.</p>

Recreational Drug Using Behaviour and Legal Benzylpiperazine Party Pills

<p>Benzylpiperazine (BZP) is a stimulant drug that produces effects similar to amphetamines (Campbell, Cline, Evans, Lloyd, & Peck, 1973). It has been sold legally in New Zealand in the form of 'party pills' since 2000. The legal status of BZP party pills has been debated in New Zealand as the media reported cases of apparent overdoses and adverse reactions leading to hospitalization (Brogden, 2005; Crewdson, 2007; Reiber, 2005; Rankin, 2006). Representatives of the BZP party pill industry publicly defended their product claiming that BZP party pills were reducing substance related harm by reducing illicit substance use (Bowden, 2007b, p.1). They also claimed that banning BZP would result in an increase in use of illicit substances, especially methamphetamine or 'P' (Barnett, 2007). The overall aim of this thesis is to test the claims that BZP party pills reduce substance related harm by reducing illicit substance use, and to identify potential outcomes of a BZP party pill ban. In addition, the perceived risks of party pill and other drug use will be examined. In chapter one I review key concepts relating to BZP party pill use: recreational drug use, harm reduction, and risk perception. In chapter two the history and New Zealand context of BZP party pills are reviewed. In chapter three, study one qualitatively analyzes BZP party pill marketing material in an attempt to describe the culture and discourse promoted by the BZP party pill industry. This analysis demonstrated that BZP party pills were primarily marketed as part of a recreational drug using culture. In chapter four, study two quantitatively investigated whether BZP party pill use was associated with reduced levels of illicit substance use in a sample (N=796) of first year university students. This study also examined the relationship between risk perception and frequency of substance use. Study two demonstrated that BZP party pill users are generally recreational poly-drug users who used illicit substances equally as often as illicit users who did not use BZP party pills. BZP party pills did not appear to reduce illicit substance use, and therefore harm. For the majority of substances there was no significant relationship between risk and use behaviour. The legal status of substances appeared to be important when participants rated the risks of use. Legal substances (including BZP) tended to be rated as safer than illegal substances. In chapter five, study three qualitatively analyzed 60 interviews with regular BZP party pill users to identify potential outcomes of a BZP party pill ban. A combination of alternatives were likely to be used by BZP party pill users, primarily illicit substances, especially ecstasy, as well as alcohol, and black market BZP. However methamphetamine (P) was an unpopular alternative. Study three also analyzed how BZP party pill users assess the costs and benefits of BZP party pill use. Decisions to use BZP party pills relied heavily on the benefits of use, rather than the costs. In chapter six, the general discussion describes the implications, ethical considerations, limitations, and outcomes of the research.</p>

Intervenciones de cambio de comportamiento para la reducción del consumo de alcohol durante el embarazo.

INTRODUCCIÓN: A nivel mundial, se estima que más del 20% de las mujeres embarazadas consumen alcohol. La investigación actual sugiere que la ingesta de alcohol durante el embarazo pone en riesgo al recién nacido de sufrir discapacidades cognitivas y del desarrollo graves de por vida. Las intervenciones de cambio de comportamiento pueden ayudar a las mujeres a reducir su consumo de alcohol durante el embarazo. OBJETIVO: El objetivo de este análisis crítico es comprobar la validez y aplicabilidad de los resultados con respecto a la efectividad de intervenciones de cambio de comportamiento para reducir el consumo de alcohol en mujeres embarazadas, y responder a la interrogante: ¿Son efectivas las intervenciones de cambio de comportamiento en la reducción del consumo de alcohol en mujeres embarazadas?. MÉTODOS: Se realizó una búsqueda de evidencia proveniente de revisiones sistemáticas, sobre Intervenciones de cambio de comportamiento para la reducción del consumo de alcohol durante el embarazo. Se especificó para cada revisión los componentes PICO de la pregunta y, del listado de revisiones relevantes, se seleccionó la que pudiese responder mejor a la pregunta. RESULTADOS: Identificamos seis revisiones sistemáticas y dos revisiones panorámicas. Se analizó críticamente el artículo “Identifying effective behavior change techniques for alcohol and illicit substance use during pregnancy: a systematic review.” CONCLUSIÓN: Existe evidencia para decir que algunas técnicas de cambio de comportamiento podrían ser útiles para lograr la reducción del consumo de alcohol durante el embarazo. Sin embargo, estos resultados se deben tomar con precaución dado algunas limitaciones metodológicas en la evidencia disponible.

Prevalence of Depression in Pre-Organ Transplantation Patients at King Chulalongkorn Memorial Hospital

Objective: To study the prevalence of depression in pre-organ transplantation patients at the King Chulalongkorn Memorial Hospital. Materials and Methods: The present study was a cross-sectional descriptive study. The data were collected from the pre-organ transplantation patients of heart, liver, kidney, and lungs, at the King Chulalongkorn Memorial Hospital. The demographic and clinical data questionnaire, the Patient Health Questionnaire-9 in Thai version (PHQ-9-T), the Generalized Anxiety Disorder-7 in Thai version (GAD-7-T), the Thai Mental State Exam (TMSE), and the Thai Alcohol Use Disorders Identification Test (AUDIT-T) were used. The prevalence of depression and other psychiatric problems in pre-organ transplantation patients were assessed. The relationship was then analyzed using chi-square and Pearson’s correlation. Results: One hundred ten pre-organ transplant patients participated in the present study. The mean age was 50.32±12.2 years old, with 73.6% male participants. Types of organ failure composed of liver (50.9%), heart (31.8%), kidney (16.4%), and lungs (0.9%). The prevalence of depression was 23.6% with mean PHQ-9 score of 5.56. Anxiety, cognitive impairment, alcohol, nicotine or other illicit substance use disorder appeared to be less prevalent in the present study cohort. Conclusion: One in every five pre-organ transplantation patients were found to have depression. Suicide, anxiety, cognitive impairment, alcohol, and other illicit substance problems were also observed within the present study population but to a lesser extent. Therefore, the systematic pre-transplant psychiatric and psychosocial assessment are strongly recommended in Thai pre-organ transplantation patients. Keywords: Depression; Psychiatric prevalence; Pre-organ transplantation patients