bluuebunny/crossref_metadata_2025 huggingface dataset:
First Human Case of Co-Infection with Two Different Subtypes of Hepatitis E Virus
Authors: Moal Valérie , Gerolami René , Colson Philippe
Published: March 2012

Hepatitis E virus (HEV), the main etiologic agent of enterically transmitted acute hepatitis in developing countries, is now recognized as an emerging agent of autochthonous disease and chronic hepatitis E in immunocompromised patients in Europe where HEV infection is probably zoonotically acquired. We describe the first human case of acute HEV infection with two genotype 3 viruses in a French kidney transplant recipient, probably acquired through consumption of uncooked pig liver sausage (figatellu). The patient presented two viral sequences nearly identical to sequences recovered from figatelli. Autochthonous co-infections with different genotype 3 HEV strains can occur in our geographical area.
Long-Term Outcome of Duplex Kidney with Ectopic Ureter Treated by Antireflux Ureterocystic Reimplantation
Authors: Gu Baojun , Wang Xiaolu , Xu Yuemin
Published: March 2012

Introduction: We present our 35 years’ experience of managing duplex kidneys with ectopic ureter by simple antireflux ureterocystic reimplantation. Patients and Methods: From December 1974 to April 2009, 36 female children, aged 10 months to 13 years, were treated. Hutch’s antireflux ureterocystic reimplantation was performed after preoperative location and intraoperative identification of the unilateral or bilateral ectopic ureters. Results: Thirty-one patients had follow-up data (range 11 months to 25 years). Postoperatively, there were no reports of dribbling incontinence, urinary frequency, lumbago or recurrent fever with the exception of urinary incontinence in 2 patients. Cystography and intravenous pyelography performed in 27 cases showed no or minimal bladder-ureter reflux. Superior kidney hydronephrosis improved in 12 cases and showed no change in the remaining patients. Conclusions: Antireflux ureterocystic reimplantation is a simple method to treat the duplex kidney with ectopic ureter with minimal induced trauma.
Long Waiting Period to Enter Methadone Maintenance Treatment: Relation to Patient Characteristics and Outcome
Authors: Peles Einat , Schreiber Shaul , Sason Anat , Adelson Miriam
Published: March 2012

Methadone maintenance treatment is a chronic treatment for opiate addicts. After having reached full capacity, new admissions to our clinic were delayed (through a waiting list) for all but opiate addicts with HIV and pregnant women. We compared characteristics and outcomes between patients admitted without delay (1993–2002) and those admitted through a waiting list (2003–2009). All 704 patients admitted between June 1993 and June 2009 were followed up until June 2010. There were 470 patients in the early period and 234 in the late period (56 patients were admitted immediately and 178 after 1.1 ± 0.8 years of waiting). Predictors for 1-year retention in treatment (logistic regression model) were if a patient self-referred during the late period, on a waiting list. The waiting list patient group was characterized by older age and self-referral – two known independent predictors of better retention that were attributed to their superior retention rate.
Dietary Fat and Heart Failure: Moving From Lipotoxicity to Lipoprotection
Authors: Stanley William C. , Dabkowski Erinne R. , Ribeiro Rogerio F. , O'Connell Kelly A.
Published: March 2012

There is growing evidence suggesting that dietary fat intake affects the development and progression of heart failure. Studies in rodents show that in the absence of obesity, replacing refined carbohydrate with fat can attenuate or prevent ventricular expansion and contractile dysfunction in response to hypertension, infarction, or genetic cardiomyopathy. Relatively low intake of n-3 polyunsaturated fatty acids from marine sources alters cardiac membrane phospholipid fatty acid composition, decreases the onset of new heart failure, and slows the progression of established heart failure. This effect is associated with decreased inflammation and improved resistance to mitochondrial permeability transition. High intake of saturated, monounsaturated, or n-6 polyunsaturated fatty acids has also shown beneficial effects in rodent studies. The underlying mechanisms are complex, and a more thorough understanding is needed of the effects on cardiac phospholipids, lipid metabolites, and metabolic flux in the normal and failing heart. In summary, manipulation of dietary fat intake shows promise in the prevention and treatment of heart failure. Clinical studies generally support high intake of n-3 polyunsaturated fatty acids from marine sources to prevent and treat heart failure. Additional clinical and animals studies are needed to determine the optimal diet in terms of saturated, monounsaturated, and n-6 polyunsaturated fatty acids intake for this vulnerable patient population.
Lectin-Like Oxidized Low-Density Lipoprotein 1 Receptor in a Reduced Uteroplacental Perfusion Pressure Rat Model of Preeclampsia
Authors: Morton Jude S. , Abdalvand Ali , Jiang Yanyan , Sawamura Tatsuya , Uwiera Richard R.E. , Davidge Sandra T.
Published: March 2012

Preeclampsia is a major cause of maternal and fetal morbidity and mortality that has been associated with endothelial dysfunction attributed, in part, to dyslipidemia, an imbalance in angiogenic factors and oxidative stress. One of the many factors that have been shown to be elevated in women with preeclampsia is low-density lipoprotein (LDL) and the more oxidizable, small dense LDL, which can lead to increased vascular oxidative stress and decreased bioavailability of NO. Lectin-like oxidized LDL-1 receptor (LOX-1) is a specific receptor for oxidized LDL. We hypothesized that a reduction of placental perfusion using a rat model of reduced uteroplacental perfusion pressure would result in enhanced LOX-1 expression in the maternal vasculature causing impaired vascular endothelial function through the actions of increased superoxide production and decreased NO-mediated vasodilation. We demonstrated a significant increase in the expression of the LOX-1 receptor (4.3-fold;
P
=0.002), endothelial NO synthase (2.7-fold;
P
=0.001), and superoxide (
P
=0.02) in thoracic aorta of the reduced uteroplacental perfusion pressure model, whereas maximal vasodilator function was modestly decreased (
P
<0.05). Endothelial-dependent vasodilator function was unaffected by either oxidized LDL or an LOX-1 receptor inhibitor in controls but was modestly increased in the presence of both oxidized LDL and the LOX-1 receptor inhibitor in reduced uteroplacental perfusion pressure (
P
=0.03). In summary, we have shown that, in a rat model of preeclampsia, there is a dramatic increase in the expression levels of both the LOX-1 receptor and the endothelial NO synthase enzyme, along with evidence of increased superoxide production and subsequent modestly decreased endothelial function.
Human Rights in the EU Return Policy: The Case of the EU-Albania Relations
Authors: Dedja Sokol
Published: March 2012

Abstract

The examination of the approach of the EU return policy to Albania – a country to which the EU returns about one fifth of the total number of the third country nationals removed – demonstrates that the predominant focus of the EU return policy on the effectiveness and efficiency of returns has left little room for safeguarding the human rights of the returnees. The article finds that the return procedures of the readmission agreement that should guarantee the protection of human rights in the return process are not observed by the EU member states. There are insufficient guarantees that the reception and possible detention of returnees in Albania will offer a dignified treatment. Moreover, the readmission agreement opens the way for the return of asylum seekers to Albania in line with the ‘safe third country’ practice in the absence of conditions that ensure effective access to fair and efficient asylum procedures and protection in the country.
Post-Colonial Public Law: Are Current Legal Establishments Democratically Illegitimate?
Authors: Gagnon Jean-Paul
Published: March 2012

Abstract

The extant literature covering indigenous peoples resident on the African continent targets colonial law as an obstacle to the recognition of indigenous rights. Whereas colonial law is argued by a wide body of literature to be archaic and in need of review, this article takes a different route and argues the perspective that colonial law is democratically illegitimate for ordering the population it presides over – specifically in Africa. It is seen, in five case studies, that post-colonial public law structures have not considered the legitimacy of colonial law and have rather modified a variety of constitutional statutes as country contexts dictated. However, the modified statutes are based on an alien theoretical legality, something laden with connotations that hark to older and backward times. It is ultimately argued that the legal structures which underpin ex-colonies in Africa need considerable revision so as to base statutes on African theoretical legality, rather than imperialistic European ones, so as to maximise the law’s democratic legitimacy for both indigenous and non-indigenous Africans.
Gendering the Arab Spring
Authors: Al-Ali Nadje
Published: March 2012

The article discusses the gendered implications of recent political developments in the region. It argues that women and gender are key to both revolutionary and counter-revolutionary processes and developments and not marginal to them. It explores the significance of women’s involvement, the historical context of women’s political participation and marginalization in political transition. Theoretically, developments in the region point to the centrality of women and gender when it comes to constructing and controlling communities, be they ethnic, religious or political; the significance of the state in reproducing, maintaining and challenging prevailing gender regimes, ideologies, discourses and relations; the instrumentalization of women’s bodies and sexualities in regulating and controlling citizens and members of communities; the prevalence of gender-based violence; the historically and cross-culturally predominant construction of women as second-class citizens; the relationship between militarization and a militarized masculinity that privileges authoritarianism, social hierarchies and tries to marginalize and control not only women but also non-normative men.
The Revolutionary Body Politic: Preliminary Thoughts on a Neglected Medium in the Arab Uprisings
Authors: Kraidy Marwan M.
Published: March 2012

When Aliaa al-Mahdy, a 20-year old student in communication at the American University in Cairo, posted nude photographs of herself on a blog she called “A Rebel’s Diary,” she unleashed one of the most heated polemics to come out of the Egyptian revolution that began on January 25, 2011 and deposed Hosni Mubarak less than one month later. This essay, written in the days after the scandal broke in November 2011, raises preliminary questions about what responses to Aliaa’s defiant act might reveal about revolutionary politics. In the essay I argue that the polemic surrounding Aliaa can be understood in the contexts of other incidents of the Arab uprisings, beginning with Bouazizi’s self-immolation, that invite us to consider, explore and theorize the human body as a vital medium in the Arab uprisings.
Convection–Climate Feedbacks in the ECHAM5 General Circulation Model: Evaluation of Cirrus Cloud Life Cycles with ISCCP Satellite Data from a Lagrangian Trajectory Perspective
Authors: Gehlot Swati , Quaas Johannes
Published: March 2012

A process-oriented climate model evaluation is presented, applying the International Satellite Cloud Climatology Project (ISCCP) simulator to pinpoint deficiencies related to the cloud processes in the ECHAM5 general circulation model. A Lagrangian trajectory analysis is performed to track the transitions of anvil cirrus originating from deep convective detrainment to cirrostratus and thin cirrus, comparing ISCCP observations and the ECHAM5 model. Trajectories of cloudy air parcels originating from deep convection are computed for both, the ISCCP observations and the model, over which the ISCCP joint histograms are used for analyzing the cirrus life cycle over 5 days. The cirrostratus and cirrus clouds originate from detrainment from deep convection decay and gradually thin out after the convective event over 3–4 days.

The effect of the convection–cirrus transitions in a warmer climate is analyzed in order to understand the climate feedbacks due to deep convective cloud transitions. An idealized climate change simulation is performed using a +2-K sea surface temperature (SST) perturbation. The Lagrangian trajectory analysis over perturbed climate suggests that more and thicker cirrostratus and cirrus clouds occur in the warmer climate compared to the present-day climate. Stronger convection is noticed in the perturbed climate, which leads to an increased precipitation, especially on day−2 and −3 after the individual convective events. The shortwave and the longwave cloud forcings both increase in the warmer climate, with an increase of net cloud radiative forcing (NCRF), leading to an overall positive feedback of the increased cirrostratus and cirrus clouds from a Lagrangian transition perspective.
Probabilistic Projections of Anthropogenic Climate Change Impacts on Precipitation for the Mid-Atlantic Region of the United States*
Authors: Ning Liang , Mann Michael E. , Crane Robert , Wagener Thorsten , Najjar Raymond G. , Singh Riddhi
Published: March 2012

This study uses an empirical downscaling method based on self-organizing maps (SOMs) to produce high-resolution, downscaled precipitation projections over the state of Pennsylvania in the mid-Atlantic region of the United States for the future period 2046–65. To examine the sensitivity of precipitation change to the water vapor increase brought by global warming, the authors test the following two approaches to downscaling: one uses the specific humidity in the downscaling algorithm and the other does not. Application of the downscaling procedure to the general circulation model (GCM) projections reveals changes in the relative occupancy, but not the fundamental nature, of the simulated synoptic circulation states. Both downscaling approaches predict increases in annual and winter precipitation, consistent in sign with the “raw” output from the GCMs but considerably smaller in magnitude. For summer precipitation, larger discrepancies are seen between raw and downscaled GCM projections, with a substantial dependence on the downscaling version used (downscaled precipitation changes employing specific humidity are smaller than those without it). Application of downscaling generally reduces the inter-GCM uncertainties, suggesting that some of the spread among models in the raw projected precipitation may result from differences in precipitation parameterization schemes rather than fundamentally different climate responses. Projected changes in the North Atlantic Oscillation (NAO) are found to be significantly related to changes in winter precipitation in the downscaled results, but not for the raw GCM results, suggesting that the downscaling more effectively captures the influence of climate dynamics on projected changes in winter precipitation.
Estimation of Climate Change Impact on Mean Annual Runoff across Continental Australia Using Budyko and Fu Equations and Hydrological Models
Authors: Teng J. , Chiew F. H. S. , Vaze J. , Marvanek S. , Kirono D. G. C.
Published: March 2012

This paper presents the climate change impact on mean annual runoff across continental Australia estimated using the Budyko and Fu equations informed by projections from 15 global climate models and compares the estimates with those from extensive hydrological modeling. The results show runoff decline in southeast and far southwest Australia, but elsewhere across the continent there is no clear agreement between the global climate models in the direction of future precipitation and runoff change. Averaged across large regions, the estimates from the Budyko and Fu equations are reasonably similar to those from the hydrological models. The simplicity of the Budyko equation, the similarity in the results, and the large uncertainty in global climate model projections of future precipitation suggest that the Budyko equation is suitable for estimating climate change impact on mean annual runoff across large regions. The Budyko equation is particularly useful for data-limited regions, for studies where only estimates of climate change impact on long-term water availability are needed, and for investigative assessments prior to a detailed hydrological modeling study. The Budyko and Fu equations are, however, limited to estimating the change in mean annual runoff for a given change in mean annual precipitation and potential evaporation. The hydrological models, on the other hand, can also take into account potential changes in the subannual and other climate characteristics as well as provide a continuous simulation of daily and monthly runoff, which is important for many water availability studies.
Critical leadership studies: The case for critical performativity
Authors: Alvesson Mats , Spicer André
Published: March 2012

Existing accounts of leadership are underpinned by two dominant approaches: functionalist studies, which have tried to identify correlations between variables associated with leadership; and interpretive studies, which have tried to trace out the meaning-making process associated with leadership. Eschewing these approaches, we turn to an emerging strand of literature that develops a critical approach to leadership. This literature draws our attention to the dialectics of control and resistance and the ideological aspect of leadership. However, it largely posits a negative critique of leadership. We think this is legitimate and important, but extend this agenda. We posit a performative critique of leadership that emphasizes tactics of circumspect care, progressive pragmatism and searching for present potentialities. We use these tactics to sketch out a practice of deliberated leadership that involves collective reflection on when, what kind and if leadership is appropriate.
Drug Courts: A Conceptual Framework
Authors: Longshore Douglas , Turner Susan , Wenzel Suzanne , Morral Andrew , Harrell Adele , McBride Duane , Deschenes Elizabeth , Iguchi Martin
Published: March 2012

Structural and process characteristics of drug courts may have a major influence on offender outcomes. However, despite the existence of dozens of outcome evaluations in the drug court literature, it is impossible to draw clear conclusions regarding variability in outcomes in relation to drug court characteristics. We describe existing approaches to the description of drug court structure and process and argue that a new approach is needed. To address that need, we propose a conceptual framework of five drug court dimensions: leverage, population severity, program intensity, predictability, and rehabilitation emphasis. These dimensions, each scorable on a range from low to high, lend themselves to a systematic set of hypotheses regarding the effects of structure and process on drug court outcomes. Finally, we propose quantitative and qualitative methods for identifying such effects.
Drug Courts and Contingency Management
Authors: Burdon William M. , Roll John M. , Prendergast Michael L. , Rawson Richard A.
Published: March 2012

Drug courts have become an increasingly popular response to the increased burden placed on the criminal justice system by substance abuse. However, evaluation findings have been less than consistent with respect to the ability of drug courts to have the desired impact on drug use and criminal behavior. This paper reviews the literature describing the growth, operations, and evaluations of drug courts. It concludes that, contrary to most “models,” drug courts emphasize punishment (e.g., graduated sanctions) and make limited positive, or at least inconsistent, use of reinforcement to promote behavior change and abstinence from drug use. Contingency management techniques that involve the systematic application of reinforcement based on the performance of specified behaviors are presented and reviewed. The success of this model in promoting pro-social behavior and abstinence from illicit drug use suggests that drug courts could benefit substantially from the integration of contingency management-based interventions.
Considering the Need for Empirically Grounded Drug Court Screening Mechanisms
Authors: Miller J. Mitchell , Shutt J. Eagle
Published: March 2012

A primary threat to the operative effectiveness of drug courts is high failure rates. Empirically supported screening devices could aid drug court administrators in maximizing resources, either through client selection or by helping to target problem clients in need of specialized assistance. Drawing from South Carolina county-level drug court records, success rates for participants with particular background characteristics were examined to identify correlations contributing to drug court success. Risk factors for drug court members were identified using chi-square and discriminant function analysis. Recidivism, crack as drug of choice, existence of criminality before drug use, and prior drug treatment were significantly related to drug court failure. These variables, as well as social stability variables, are argued to be vital elements in screening mechanisms.
Reducing Drug Use and Crime among Offenders: The Impact of Graduated Sanctions
Authors: Harrell Adele , Roman John
Published: March 2012

The evaluation of the Washington, D.C., Superior Court Drug Intervention Program (SCDIP) compared drug felony defendants randomly assigned to either a docket offering structured graduated sanctions in combination with drug testing and judicial monitoring, or a docket using drug tests and judicial monitoring only. Assignment to the graduated sanctions docket was found to reduce drug use prior to sentencing. Program participants were significantly less likely to use drugs prior to sentencing, and, in the year after sentencing, were significantly less likely to be arrested and and had significantly fewer arrests. This paper describes characteristics of the sanctioning program that appear highly correlated with positive outcomes.
Minority and Non-Minority Perceptions of Drug Court Program Severity and Effectiveness
Authors: Cresswell Laura Sian , Deschenes Elizabeth Piper
Published: March 2012

In order for intermediate sanctions, such as drug court, to be considered effective alternatives to traditional punishments of probation and prison, offenders and policy makers must view them similarly. This article examines variation in participants' perceptions of the severity and effectiveness of the drug court program in Orange County California. In addition, the study examined perceptions of the severity of the graduated sanctions that are an integral part of the drug court program. This article focuses on differences between minority and non-minority participants. Although the severity of various sentences was rated differently by the two groups, we found few differences in perceived program effectiveness. Therefore, the drug court program can be used as an intermediate sanction for adequately supervising and rehabilitating drug offenders, protecting the public, conserving criminal justice resources, and deterring criminal activity.
Current Methods of Assessing Substance Use: A Review of Strengths, Problems, and Developments
Authors: Richter Linda , Johnson Patrick B.
Published: March 2012

This article discusses various means of assessing and measuring substance use behaviors and describes the relative advantages and disadvantages of each of the measurement tools. Self-report instruments are the most convenient and widely used forms of substance use assessment. Self-report measures can be obtained through various modes of administration, including self-administration via paper-and-pencil questionnaires, computer assisted self-interviews or interactive voice recording, and through personal (interviewer-administered) interviews. The advantages and disadvantages of each of these modes of administration are discussed. Alternative assessment techniques, such as biological measurements, are also frequently used to measure substance use or to validate self-report measures of substance use. This article reviews the various available methods for validating self-report measures, highlighting self-report and biological testing techniques currently in use. It concludes by suggesting future avenues of research for improving upon current substance use measurement techniques.
The Relationship between Interviewer Characteristics and Physical and Sexual Abuse Disclosures among Substance Users: A Multilevel Analysis
Authors: Dailey René M. , Claus Ronald E.
Published: March 2012

Data were collected at assessment for substance abuse treatment from 22 interviewers and 8,276 clients to assess the relationship between interviewer characteristics and disclosure of physical and sexual abuse. Characteristics examined were client and interviewer gender, race/ethnicity, and age. Multilevel regressions that adjusted for the clustering of clients within interviewers were compared to unadjusted logistic regressions to determine the effect of response similarity within clusters. Clustering accounted for only 2–5% of the unexplained variance; however, ignoring the clustering effect generated several misleading results. Adjusted models indicated that clients were more likely to disclose physical abuse to Caucasian interviewers than to African American interviewers and more likely to disclose sexual abuse to female interviewers than to male interviewers. Matching clients and interviewers on gender, race, and age did not increase disclosures of either physical or sexual abuse.
Self-Initiated Cessation from Substance Use: A Longitudinal Study of the Relationship between Postulated Mediators and Quitting
Authors: Hansen William B. , McNeal Ralph B.
Published: March 2012

This study examines psychosocial predictors of self-initiated substance use cessation among youths who have had recent substance use experience. Variables included those that are the focus of many primary prevention programs. Middle school and high school students who used either alcohol, cigarettes, smokeless tobacco, marijuana, or inhalants were surveyed on two occasions, one year separating the pretest and posttest. Pretest differences distinguished those who would quit versus those who would continue using alcohol, tobacco, and marijuana, but not inhalants. The largest pretest differences were youths' normative beliefs, manifest commitments to not use substances, and perceived incongruence between drug use and their desired lifestyles. Those who continued to use had scale values for most mediators that continued to worsen in programmatic terms, whereas measures among those who quit significantly improved. School-aged users may benefit from programs that target some of the same mediators currently promoted as effective in primary prevention programs.
Estimating the Prevalence of Substance Abuse with Social Indicators
Authors: McRae James A. , Beebe Timothy J. , Harrison Patricia A.
Published: March 2012

Governments are increasingly interested in estimating the prevalence of substance abuse with social indicators, largely because of the high cost of estimating prevalence with surveys of random samples of the population. With both the individual and county as the unit, we regress measures of the use of alcohol, marijuana, and other drugs on social indicators that fall into three categories: demographics, measures of social disorganization, and measures more directly related to the use of substances. The measures of explained variance are fairly low, but even more troubling is that the effects of several social indicators are in the “wrong” direction. Reliance on social indicator data to supplant survey estimates of the prevalence of substance abuse requires further validation, attention to sources of bias in the indicator data, and replication of the models over time.
The Experience and Acceptability of Drug Testing: Poll Trends
Authors: Fendrich Michael , Kim Julia Yun Soo
Published: March 2012

With a growing interest in using drug testing as part of standard survey procedures for drug use prevalence estimation, we undertook an examination of national surveys of attitudes towards and experience with employment-related drug testing. After identifying 102 questions from 20 different surveys administered from the mid 1980s to the late 1990s, we found a trend suggesting that the population has become increasingly favorable toward drug testing. Although drug-testing policies are highly prevalent, personal experience with drug testing is not normative. Personal experience also varies with race, gender, age, and occupational group. Implications for epidemiological research incorporating testing are addressed.
Does ADAM Need a Haircut? A Pilot Study of Self-Reported Drug Use and Hair Analysis in an Arrestee Sample
Authors: Mieczkowski Tom
Published: March 2012

This article evaluates the potential impact that the use of hair analysis may have on the drug prevalence estimations derived from survey research that has relied upon urinalysis as an indicator of the accuracy of self-reported drug use. The paper reviews the history and nature of the DUF and ADAM programs, the relationship between self-report drug use and urinalysis results for arrestee populations, and the outcome of a pilot study employing hair assays in lieu of urinalysis. The author concludes that hair analysis may have a significant impact on the estimations of drug use for cocaine, heroin, and amphetamines and is less likely to have an effect on estimations of marijuana use. The author recommends consideration of periodic use of hair analysis within the ADAM system to more accurately and effectively monitor drug use.
Social Factors Associated with Pharmacists' Unauthorized Use of Mind-Altering Prescription Medications
Authors: Hollinger Richard C. , Dabney Dean A.
Published: March 2012

A “medical model” ideology dominates the study of drug abuse among health care professionals. This perspective defines and approaches drug abuse as a disease. While this disease is said to have bio-psycho-social origins, scholars have principally focused on possible biological and psychological factors that produce a “predisposition” to drug abuse. Pertinent social factors have been largely overlooked. Drawing upon the membership list (N=50,000+) of the American Pharmaceutical Association, a random sample of 2,036 practicing pharmacists were queried to investigate the relationship between pharmacists' educational, occupational, and professional socialization and their involvement in illicit prescription drug use. A total of 1,016 (50.2%) questionnaires were returned. The data show that 40.1% of the respondents self-reported illegally using some form of potentially addictive, mind-altering prescription drug. Further, 21% reported 5 or more lifetime use episodes and 6.6% reported more than 10. Multivariate analysis reveals significant relationships between numerous social factors and pharmacists' levels of self reported drug use. The existence of these relationships raises the possibility that certain aspects of the professional socialization process may also play a role in the etiology of pharmacists' drug abuse. We conclude that there exists a need to revisit current theoretical and policy approaches to this social problem.
Program Retention and Perceived Coercion in Three Models of Mandatory Drug Treatment
Authors: Young Douglas , Belenko Steven
Published: March 2012

Despite the proliferation of drug courts and other mandatory treatment models, few studies have compared the impact of different program features comprising these models. This study compared three groups of clients (N = 330) mandated to the same long-term residential treatment facilities. Study participants were referred from two highly structured programs or from more conventional legal sources, such as probation or parole agents. Analyses showed that these clients varied substantially in their perceptions of legal pressure, and these perceptions generally corresponded to the programs' different coercive policies and practices. Retention analyses confirmed that the odds of staying in treatment for six months or more was nearly three times greater for clients in the most coercive program compared to clients in the third group. Results support the use of structured protocols for informing clients about legal contingencies of participation and how that participation will be monitored, and developing the capacity to enforce threatened consequences for failure.
Exclusion and Extinction — The Fight against Narcotics in the Third Reich
Authors: Mach Holger
Published: March 2012

Social exclusion — currently defined as an undesired phenomenon that governments and societies at large are supposed to be battling against – used to be held in high regard during the fascist reign in Germany. This article shows how stigmatization and exclusion policies towards drug dealers and users during the Third Reich prepared the policy of extermination and anticipated the anti-drug discourse in contemporary Germany.
Crack Cocaine in Germany — Current State of Affairs
Authors: Stoever Heino
Published: March 2012

Crack cocaine first appeared in German drug markets during the mid-1990s. For several years the drug could only be found in Frankfurt and Hamburg, major cities with large open drug scenes and well-established transportation infrastructures (these cities contain the largest airport and the biggest harbor in Germany). More recently, however, crack cocaine has been found in other cities as well. Police and drug treatment service data suggest that there has been a continuous, although not dramatic, increase in its use. Crack use is typically part of a poly-drug use pattern (used in combination with heroin, benzodiazepines, methadone and alcohol) in metropolitan areas. Most users are well known to the institutions providing counseling and basic care (contact and sleeping houses and methadone treatment centers), and to the police. In addition to well-known members of the visible/open drug scene, three other groups are using crack: marginalized juveniles, young male and female prostitutes and young migrants. At present there is no research data indicating whether these groups have established a stable pattern of use or if they are drifting into a poly-drug use pattern. This paper provides epidemiological data on crack use in Germany, an assessment of future prevalence estimates and speculation about the impact increasing crack use is likely to have on local drug treatment services.
Socio-Cultural and Psychological Aspects of Contemporary LSD use in Germany
Authors: Prepeliczay Susanna
Published: March 2012

The current study uses a qualitative methodology to investigate socio-cultural and psychological aspects involved in the use of LSD and comparable psychedelic substances. To date, 26 narrative interviews have been conducted with 12 female and 14 male users aged 19 to 53 years. The resulting data were subjected to content analysis in several thematic areas. Subjective reports of LSD use and experiences are considered among the complex interrelationship of drug effects, individual and environmental factors, as well as in comparison to the results reported in earlier research. Preliminary results suggest the use of LSD is largely independent of the “party drugs” scene, although its users do embrace elements of alternative lifestyles and subcultures. The majority of participants report their LSD experiences to be of great importance and to have intellectual relevance for their individuation process and personality development. Exploration of the self and the desire to experience profound changes in their perception of the world are reported as primary motives for LSD use, in addition to its hedonistic value. Individual backgrounds, knowledge and patterns of reaction are found to strongly influence the character of the drug effects that are experienced. Next to a wide range of extra-pharmacological factors, various methods for actively modifying LSD induced states were discovered to determine the general character of LSD experiences. These are discussed with regard to their implications for the development of suitable harm reduction concepts.
Primary Drug Prevention: Developments in Germany since the 1970s
Authors: Franzkowiak Peter
Published: March 2012

Primary drug prevention in Germany has been in a constant state of transition since the early 1970s. Five consecutive phases can be identified: (1) drug deterrence and repression; (2) drug education and drug information; (3) primary drug prevention through alternatives to risk-taking, and the strengthening of personal resources; (4) primary drug prevention through strengthening of personal and social resources, promotion of resistance and life skills; (5) primary drug prevention through strengthening of personal and social resources, promotion of resistance and life skills, the promotion of harm reduction and competence in risk-taking with young people who may already consume legal or illegal drugs. During the last decade, the concept of health promotion, with its integration of individual, contextual and structural prevention has served as a guide. Beginning in the mid-1990s, secondary and tertiary prevention efforts have attracted growing interest. The integrative concept of “risk-taking competence,” which introduces harm reduction approaches into primary prevention strategies, is favored in contemporary discussion and practice.
Heroin-Based Treatment
Authors: Michels Ingo Ilja
Published: March 2012

This article describes the history of the heated legal controversy in Germany about prescribing medicinal narcotics. The professional corporations of medical doctors have claimed a right to govern the interpretation and definition of legal terms and for a long time resisted the clinical insights and practical experience about maintenance treatment that had been gathered from abroad. The next logical step was to prescribe heroin – also formerly a licensed medication – in cases where methadone was not accepted or physically tolerated by patients. Slowly the social and political taboos against providing narcotic maintenance to addicts have been removed. The author addresses the question of whether prescribing heroin to addicts can reduce health and social problems and improve the client's quality of life.
The Efficacy of Forced Treatment
Authors: Koerner Harald Hans
Published: March 2012

The author describes the German drug policy approach of “Therapy instead of punishment” and its legal ramifications. The substantive and formal requirements of the pertinent laws and their interpretations are identified. Four options are considered: (1) deferral of prison detention in favor of in-patient drug treatment; (2) deferral of prison detention in favor of both drug-free and drug maintenance outpatient treatment; (3) refraining from prosecution and sentencing; and (4) deferral of prison detention in favor of outpatient treatment.
The Influence of Drug Policy on Transportation Policy Decisions
Authors: Neumeyer Juergen
Published: March 2012

Since about 1994, when the German Federal Constitutional Court effectively decriminalized the possession of small amounts of cannabis, a functional equivalent to criminal law has evolved in the form of traffic laws providing for the revocation of driving licenses in cases of cannabis possession. The historical and legal interpretations of this regulation are described, and its consequences are analyzed. It is postulated that, under the veil of traffic safety, harsh and repressive drug policies are being utilized to counteract legalization tendencies.
Consumption Rooms — A Middle Ground between Health and Public Order Concerns
Authors: Stoever Heino
Published: March 2012

After working in a juridical gray field for nearly a decade, drug consumption rooms were legalized by the German government in February 2000, with certain legal and professional stipulations. At present, 16 such facilities are being operated in 5 large German cities. This study describes the effects of the drug consumption rooms and summarizes the available scientific data associated with their evaluation. Finally, problematic aspects of drug consumption rooms are discussed.
The Medical use of Cannabis in Germany
Authors: Grotenhermen Franjo
Published: March 2012

The author first describes the history of medical use of cannabis and its revival in the 1990s. He then provides an overview of the legal situation and how this affects doctors and patients if cannabis is prescribed or recommended as treatment. Subsequently, the state of the art of cannabis medication research is described and analyzed. Finally, the public and political discourse that arose in reaction to legal and political efforts to legalize cannabis for medical purposes is described.
Controlled Drinking as a Treatment Goal in Germany
Authors: Koerkel Joachim
Published: March 2012

In Germany public health is impaired by high alcohol consumption and alcohol related damage. Yet very few people who participate in excessive forms of alcohol consumption obtain any alcohol specific treatment. The present German controversy surrounding Controlled Drinking (CD) as an appropriate treatment goal and a means to improve the range and effectiveness of the existing health care system is discussed. In this article the author provides an overview of the German CD trials. The German behavioral self-control programs (the “AkT” group program and the bibliotherapeutic “10 Steps Program”) that triggered the present debate on CD are discussed as well. It is concluded that with regard to public health, ethical, therapeutic, and effectiveness concerns, CD approaches should become adjunct to the traditional German abstinence oriented treatment system for alcohol and drug addicts.
Integrating Cultural Variables into Drug Abuse Prevention and Treatment with Racial/Ethnic Minorities
Authors: Castro Felipe González , Alarcón Eduardo Hernández
Published: March 2012

A set of variables, identified as “cultural variables,” is introduced as important descriptors of the life experiences of people from the major ethnic/racial minority groups in the United States. It is stated that most contemporary models for prevention and treatment of substance abuse are “culturally blind” to the effects of these cultural variables on the risk of substance abuse among racial/ethnic minority people. Accordingly, a viable strategy for culturally relevant research and program design is to integrate these cultural variables into extant models to create culturally rich models for research as well as for the development of prevention and treatment programs. The use of “model programs” is discussed in regard to the competing aims of maintaining program fidelity while also making cultural adaptations to these model programs to make them more culturally relevant. Strategies and recommendations are presented for integrating cultural variables into prevention and treatment programs that purport to serve racial/ethnic minority people.
Meeting the Treatment Needs of Multiply Diagnosed Consumers
Authors: Steele Lisa D. , Rechberger Elke
Published: March 2012

Recent research demonstrates that approximately 10 million people in the United States have been diagnosed with at least one co-occurring mental health disorder and substance abuse disorder in any given year (Substance Abuse & Mental Health Services Administration National Advisory Council, 1997). Emerging awareness by clinicians, substance abuse counselors, and researchers has subsequently awakened the treatment community to the needs of consumers who are afflicted with co-occurring problems. One panel of the Los Angeles County-wide conference “Common Ground, Common Language, Common Goals: Bringing Substance Abuse Research and Practice Together” (held in April 2001) focused on the prevalence and treatment of co-occurring disorders. This article outlines the discussion and findings of this panel on the numerous treatment needs of consumers with multiple diagnoses and the converging and conflicting treatment models that have been developed for them.
Los Angeles County Evaluation System (LACES): Bringing Accountability to Alcohol and Drug Abuse Treatment through a Collaboration between Providers, Payers, and Researchers
Authors: Crèvecoeur Desirée , Finnerty Beth , Rawson Richard A.
Published: March 2012

The design and early implementation stages of a large-scale, system-wide evaluation of Los Angeles County's substance abuse treatment system (Los Angeles County Evaluation System: An Outcomes Reporting Program, or LACES) will be examined. In the first stage of implementation, individuals entering treatment will provide a standardized data set using the Los Angeles County Participant Reporting System (LACPRS) admission forms and the Addiction Severity Index (ASI). At treatment program discharge, the LACPRS discharge form will be administered, and at one-year post admission the ASI will be re-administered to a stratified sample of 1,500 individuals from 31 “sentinel programs.” Additional information will be gathered on the services provided by Los Angeles County alcohol and other drug treatment/recovery programs. Data from LACES will provide the treatment providers feedback on the impact of treatment services and will create the foundation of an ongoing evaluation system for the County's substance abuse treatment clients and services.
Linking Researchers and Practitioners in the Substance Abuse Field: Perspectives of Two “Bridgers”
Authors: Spear Suzanne , Rawson Richard A.
Published: March 2012

This article presents a conceptual framework for substance abuse research and practice collaboration based on John-Steiner's (2000) seminal work on characterizing creative collaborative processes in fields such as science, art, music, and literature. Using John-Steiner's core concept of “co-construction of knowledge,” the authors provide examples of informal and formal collaborative methods for “bridging the gap” between substance abuse research and practice. An ongoing collaborative effort in Los Angeles County, California, called “L.A. County Partnerships Network,” is described and important strategies for developing collaborative relationships between substance abuse researchers and practitioners are highlighted. Informal patterns of collaboration, such as those used by the L.A. Partnerships Network, can lead to significant developments among substance abuse researchers and practitioners.
Ketamine Injection among High Risk Youth: Preliminary Findings from New York City
Authors: Lankenau Stephen E. , Clatts Michael C.
Published: March 2012

Ketamine, a synthetic drug commonly consumed by high risk youth, produces a range of experiences, including sedation, dissociation, and hallucinations. While ketamine is more typically sniffed, we describe a small sample of young ketamine injectors (n=25) in New York City and highlight risks associated with this emerging type of injection drug use. Our findings indicate that the injection practices, injection groups, and use norms surrounding ketamine often differ from other injection drug use: intramuscular injections were more common than intravenous injections; injection groups were often large; multiple injections within a single episode were common; bottles rather than cookers were shared; and the drug was often obtained for free. Our findings suggest that the drug injection practices exercised by ketamine injectors place them at risk for bloodborne pathogens, such as HIV, HBV, and HCV. We conclude that ketamine injectors represent an emerging, though often hidden, population of injection drug users, particularly among high risk, street-involved youth.