bluuebunny/crossref_metadata_2025_split huggingface dataset:
Illicit drug‐related harm during the Sydney 2000 Olympic Games: implications for public health surveillance and action
Authors: Indig Devon , Thackway Sarah , Jorm Louisa , Salmon Allison , Owen Tim 
Published: March 2003

ABSTRACTAims  To describe presentations to emergency departments during the Sydney 2000 Olympic Games for conditions related to the use of illicit drugs; to discuss the implications of such presentations for surveillance and public health action at similar events in the future.Design  Identification of target presentations in sentinel emergency departments; entry of data into a purpose‐built database; and daily electronic transfer of data for central collation and analysis.Setting  Fifteen sentinel emergency departments in the greater Sydney metropolitan area for a 38‐day period spanning the Sydney 2000 Olympic Games.Participants  Four hundred and twenty‐four presentations to sentinel emergency departments with conditions related to illicit drug use.Measurements  Patient's age, sex, country and region of residence, location of emergency department, types of illicit drugs involved and departure status.Findings  The mean daily number of presentations for adverse events due to illicit drug use was significantly higher (13.3 versus 8.8 presentations, t = 2.2, P = 0.04) in the 2‐week Olympic Games period than in the lead‐up to the Games, culminating in a large peak following the closing ceremony. There was also a significant increase (5.1 versus 1.7 presentations, t = 2.8, P = 0.007) in the mean daily number of presentations related to use of ecstasy or amphetamines, whereas no change was noted in presentations related to heroin use. Over half (52%) of presentations occurred at two emergency departments in areas known as being ‘hot‐spots’ for illicit drug use.Conclusions  Enhanced surveillance of adverse events following illicit drug use, possibly targeting known ‘hot‐spots’, should be considered for future mass events. Advance preparation of preventive strategies, such as ‘party‐safe’ messages, will enable rapid response to unusual patterns of illicit drug‐related harm during future mass events.
Neonatal outcome following buprenorphine maintenance during conception and throughout pregnancy
Authors: Schindler Shird Dieter , Eder Harald , Ortner Romana , Rohrmeister Klaudia , Langer Martin , Fischer Gabriele 
Published: March 2003

ABSTRACTAims  To assess the effects of maternal buprenorphine treatment at conception and during pregnancy on neonates in terms of birth outcomes and neonatal abstinence syndrome (NAS).Design and setting  Prospective, open‐label, out‐patient maintenance, case report study, conducted at the drug addiction out‐patient clinic at the University Hospital Vienna.Participants  Two buprenorphine‐maintained pregnant women who had conceived during buprenorphine treatment. Both patients had previously given birth to healthy neonates following induction on to buprenorphine maintenance therapy in the second trimester.Measurements  Mothers: urinalysis. Neonates: gestational age at delivery, Apgar scores, birth weight, length and NAS (Finnegan Scale).Findings  Urinalyses were negative for both women for 25 and 38 months, respectively, during the pregnancy period. There were no complications during the course of the pregnancy. The newborns delivered by both women were healthy, birth outcomes were within normal ranges and there were no NAS symptoms requiring treatment.Conclusions  To our knowledge this is the first report detailing the pregnancies of women treated with buprenorphine at the time of conception and investigated in a prospective study. The NAS noted in neonates born to buprenorphine‐maintained mothers appears to be less severe than the NAS observed in neonates born to methadone‐maintained mothers. These preliminary data indicate that, in our patient cohort, buprenorphine maintenance at the time of conception and during pregnancy did not seem to affect birth outcome measurements such as pregnancy complications, week of delivery, birth weight, length, umbilical pH or neurodevelopmental progress. Future prospective studies with larger study populations are warranted.
A randomized controlled trial of a brief intervention after alcohol‐related facial injury
Authors: Smith A. J. , Hodgson R. J. , Bridgeman K. , Shepherd J. P. 
Published: March 2003

ABSTRACTAim  To evaluate the effectiveness of a brief motivational intervention on alcohol consumption and misuse in young males with alcohol‐related face injury.Design  Randomized controlled trial.Setting  Oral and maxillofacial surgery out‐patient clinic in an urban teaching hospital.Participants  One hundred and fifty‐one participants were randomized to motivational intervention and control conditions.Interventions  Control was treatment as usual. The intervention was treatment as usual plus a one‐session brief motivational intervention administered by a nurse.Measurements  Three sets of measurements were taken at baseline, 3‐month and 1‐year follow‐up. Collateral measurements were also taken at 1‐year follow‐up. Primary outcome measures were total alcohol consumption, typical weeks consumption and days abstinent in preceding 3 months. Other outcome measures included the Alcohol Use Disorders Identification Test, a short form of the Alcohol Problems Questionnaire, and a measure of satisfaction with social relationships.Results  There was a significant decrease in 84‐day total alcohol consumption across the year (P < 0.006) and further, a significant effect for the motivational intervention was demonstrated (P < 0.029). This pattern was repeated for days abstinent and alcohol consumption in a typical week as well as alcohol‐related problems. There was a significantly greater reduction in the percentage of hazardous drinkers in the motivational intervention group (from 60% to 27%, P < 0.009) compared to the control group (from 54% to 51%, NS).Conclusion  A proportion of young men change their alcohol consumption following alcohol‐related injury. A nurse‐led psychological intervention adds significantly to the proportion and magnitude of response.
General practice management of illicit drug users in Scotland: a national survey
Authors: Matheson C. , Pitcairn J. , Bond C. M. , Van Teijlingen E. , Ryan M. 
Published: March 2003

ABSTRACTAims  To describe the level of involvement of general practitioners (GPs) in the management of illicit drug dependency; nature of current practice in the management of illicit drug dependency; influence of guidelines on practice; GP training experience and needs; and to consider the policy implications of the findings.Design  A cross‐sectional postal questionnaire survey.Setting  General practice in Scotland.Participants  A 1 : 4 randomized sample (n = 926) of general practice principals, stratified according to age, gender and number of practice partners.Measurements  A structured postal questionnaire.Findings  A 63% response rate was achieved after two reminders (n = 583). Sixty per cent of respondents treated drug users, 51.5% provided methadone maintenance but only 58% used doses in the recommended range. Maintenance prescribing of dihydrocodeine and benzodiazepines was provided by 24% and 44.8% of respondents, respectively. While 79.3% had received the national clinical guidelines only 22.5% believed this had influenced their practice. Only a third of respondents had received drug dependency training. Beliefs about whether prescribing for drug misusers is part of a GPs professional remit was split.Conclusions  There was relatively high involvement with drug users, with methadone maintenance being the most common treatment provided. Maintenance prescribing of dihydrocodeine and benzodiazepines were common despite a lack of clinical evidence supporting the effectiveness of these treatments. This may reflect the nature of the presenting drug problems and highlights the difficulties some GPs may face in managing multiple drug dependencies within current guidelines. Further local training to implement guidelines along with trials of alternative treatments currently outwith guidelines should be considered.
Gender and ethnic differences in smoking, drinking and illicit drug use among American 8th, 10th and 12th grade students, 1976–2000
Authors: Wallace John M. , Bachman Jerald G. , O'Malley Patrick M. , Schulenberg John E. , Cooper Shauna M. , Johnston Lloyd D. 
Published: March 2003

ABSTRACTAims  This paper examines ethnic differences in licit and illicit drug use among American 8th, 10th and 12th grade students, with a particular focus on girls.Design  The study uses cross‐sectional data from large, ethnically diverse, nationally representative samples of 8th, 10th and 12th grade girls.Setting  Data were collected through questionnaires administered in schools.Participants  A total of 40 416 8th grade girls and 37 977 8th grade boys, 35 451 10th grade girls and 33 188 10th grade boys, and 33 588 12th grade girls and 31 014 12th grade boys took part in the study.Findings  Across ethnic groups, drug use is highest among Native American girls and lowest among black and Asian American girls. Trend data suggest that there have been important changes in girls’ drug use over time and that girls’ and boys’ drug use patterns are converging.Conclusions  Drug use is widespread among American adolescent girls. Future research should examine further girls’ drug use and seek to identify whether risk and protective factors identified in past research, based on predominantly white samples, are also important predictors for drug use among non‐white girls.
A prospective study of the association between smoking and later alcohol drinking in the general population
Authors: Jensen Majken K. , Sørensen Thorkild I. A. , Andersen Anne T. , Thorsen Thorkil , Tolstrup Janne S. , Godtfredsen Nina S. , Grønbæk Morten 
Published: March 2003

ABSTRACTAims  To address the possible prospective association between smoking habits and risk of later heavy drinking in the adult population.Design  Pooled population‐based long‐term cohort studies with repeated assessments of smoking and alcohol habits.Setting  Copenhagen, Denmark.Participants  A total of 14 130 non‐ to moderate drinkers at baseline, who attended re‐examination.Measurements  Among the non‐ to moderate drinkers we addressed the relation between smoking habits at first examination and the risk of becoming a heavy and excessive drinker at follow‐up.Findings  Level of tobacco consumption at first examination predicted an increased risk of becoming a heavy and excessive drinker in a dose‐dependent manner. Men who smoked more than 25 g of tobacco per day had adjusted odds ratios of 2.12 (95% confidence interval (CI): 1.44–3.11) and 3.95 (95% CI: 1.93–8.95) for becoming heavy and excessive drinkers, compared to participants who had never smoked. Equivalent estimates among women were 1.76 (95% CI: 1.02–3.04) and 2.21 (95% CI: 1.00–4.58), respectively.Conclusions  This study suggests that tobacco use is associated quantitatively with later risk of heavier drinking.
Prison‐based syringe exchange programmes: a review of international research and development
Authors: Dolan Kate , Rutter Scott , Wodak Alex D. 
Published: March 2003

ABSTRACTJournal publications and conference presentations on prison‐based syringe exchange (PSE) programmes were identified by a comprehensive search of electronic databases. Experts involved with development and evaluation of current PSE programmes or policy were contacted for reports, documents and unpublished material. Spanish information on PSE was translated for this review. We identified 14 papers specifically on PSE programmes in Switzerland (six papers), Germany (four) and Spain (four). The first PSE programme started in 1992 in Switzerland. As of December 2000, seven PSEs were operating in Switzerland, seven in Germany and five in Spain. There have been six evaluations of prison syringe exchange programmes and all have been favourable. Reports of drug use decreased or remained stable over time. Reports of syringe sharing declined dramatically. No new cases of HIV, hepatitis B or hepatitis C transmission were reported. The evaluations found no reports of serious unintended negative events, such as initiation of injection or of the use of needles as weapons. Staff attitudes were generally positive but response rates to these surveys varied. Overall, this review indicated that prison syringe exchange programmes are feasible and do provide benefit in the reduction of risk behaviour and the transmission of blood‐borne infection without any unintended negative consequences.
Measuring outcome in cocaine clinical trials: a comparison of sweat patches with urine toxicology and participant self‐report
Authors: Winhusen Theresa M. , Somoza Eugene C. , Singal Bonita , Kim Sunme , Horn Paul S. , Rotrosen John 
Published: March 2003

ABSTRACTAims  To evaluate the advantages of using a sweat patch (PharmCheck™) for detecting cocaine abuse in cocaine‐dependent patients participating in a clinical trial. The utility of the sweat patch was assessed from the following perspectives: the reliability and validity of quantitative sweat patch results, the possible degradation of cocaine to benzoylecgonine (BE) as a function of the length of time that a patch is worn, the completeness of the dataset yielded by thrice‐weekly urine toxicology compared with thrice‐weekly and weekly sweat patches, and the relative costs associated with sweat patch versus urine measures.Design  Data were collected during a 10‐week out‐patient clinical trial in which participants wore two sweat patches, one applied every visit and one applied weekly. Urine samples were collected thrice weekly, as were self‐reports of substance use.Setting  A multi‐site clinical trial conducted in Boston, Cincinnati and New York, USA.Participants  Twenty‐seven participants with comorbid diagnoses of cocaine dependence and adult attention deficit disorder completed the study.Measurements  Sweat patch and urine samples were analyzed by standard methods for cocaine and cocaine metabolites.Findings  Quantitative sweat patch measures had good reliability in that the correlation between the weekly and per‐visit patches was 0.96 (P < 0.0001). The concurrent validity, as judged by the correlation between quantitative urine BE levels and either weekly (0.76, P < 0.0001) or per‐visit (0.73, P < 0.0001) cocaine sweat patch levels was reasonable. The correlation between the self‐report of cocaine use and these same two patches, however, was lower (0.40, P < 0.05 and 0.30, P < 0.05, respectively). The results revealed no significant degradation of cocaine to BE associated with wearing the patch for a longer time. Finally, the per‐visit patch provided cocaine use data on 80.5% of all study days (a total of 70), while urine toxicology and the weekly patch provided 77.4% and 76.1%, respectively.Conclusions  The present findings suggest that the PharmCheck™ patch might be an attractive alternative to urine toxicology for use as an outcome measure in cocaine clinical trials.
The Israel Society for the Prevention of Alcoholism
Authors: Weiss Shoshana , Gefen Lia 
Published: March 2003

ABSTRACTThis paper describes the profile of the Israel Society for the Prevention of Alcoholism (ISPA), which is a nation‐wide, public, non‐profit association. It portrays various aspects of ISPA treatment and rehabilitation facilities—the residential treatment center, the rehabilitative hostel and the ‘warm home’ for homeless alcoholics. It depicts ISPA prevention activities, prevention materials and its usage of the media, and deals with ISPA involvement in policy issues. The paper also addresses the research reality of ISPA and its scientific journal, and refers to the society's structure and its future.
Long‐term influence of duration and intensity of treatment on previously untreated individuals with alcohol use disorders
Authors: Moos Rudolf H. , Moos Bernice S. 
Published: March 2003

ABSTRACTAims  This study examined the influence of the duration and intensity of the first episode of treatment for previously untreated individuals with alcohol use disorders on short‐term and long‐term outcomes, and the effect of additional treatment and delayed treatment on outcomes.Design, setting, participants  A sample of alcoholic individuals (n = 473) was recruited at alcoholism information and referral centers and detoxification units and was surveyed at baseline and 1 year, 3 years and 8 years later.Measurements  At each contact point, participants completed an inventory that assessed their treatment utilization since the last assessment and their current alcohol‐related, psychological and social problems.Findings  Compared with individuals who remained untreated, individuals who entered treatment relatively quickly and who obtained a longer duration of treatment had better short‐ and long‐term alcohol‐related outcomes and better short‐term social functioning. Individuals who obtained a longer duration of additional treatment had better alcohol‐related outcomes than individuals who obtained no additional treatment but, among individuals who delayed treatment entry, the duration of treatment was not associated with treatment outcomes. In general, the intensity of treatment was not related to better outcomes.Conclusions  Rapid entry into treatment and the duration of treatment for alcohol use disorders may be more important than the intensity of treatment. Treatment providers should consider structuring their programs to emphasize continuity, rather than intensity of care.
Changing the focus: the case for recognizing and treating cannabis use disorders
Authors: Dennis Michael , Babor Thomas F. , Roebuck M. Christopher , Donaldson Jean 
Published: March 2003

AbstractDuring the late 1960s, cannabis emerged from relative obscurity to become the most common illicit drug used in the United States, and has remained so ever since. From an epidemiological perspective, three major waves of successively younger new users can be identified during the past 40 years. Contrary to popular opinion, cannabis use can be problematic for many people (particularly adolescents). Moreover, the drug has become increasingly more potent. Cannabis is currently one of the leading substances reported in arrests, emergency room admissions, autopsies and treatment admissions. Like alcohol and tobacco, the need for effective approaches to treating cannabis use disorders transcends debates about whether it should be legal. Moreover, the costs to society are continuing to mount from past neglect of this continuing public health problem. This paper provides background on the need to develop effective models for treating cannabis use disorders.
Moving from research to practice just in time: the treatment of cannabis use disorders comes of age
Authors: Westley Clark H. , MacNeill Horton Arthur , Dennis Michael , Babor Thomas F. 
Published: March 2003

AbstractThis supplement issue on the treatment of marijuana use disorders describes two large multi‐site field experiments: the Cannabis YouthTreatment (CYT) study with adolescents and the Marijuana Treatment Project (MTP) with adults. The papers cover multiple aspects ofthe treatment of cannabis users, including the rationale for studying cannabis use disorders, descriptions of the CYT and MTP studies,characteristics of adolescents and adults presenting for treatment of cannabis use disorders, court diversion issues, economic evaluationand confirmation of self‐reported cannabis use, among other topics. This Introduction provides background information and an overviewof the papers from the perspective of the funding agency.
The economic cost of outpatient marijuana treatment for adolescents: findings from a multi‐site field experiment
Authors: French Michael T. , Roebuck M. Christopher , Dennis Michael L. , Diamond Guy , Godley Susan H. , Tims Frank , Webb Charles , Herrell James M. 
Published: March 2003

AbstractAims Despite recent advances in the economic evaluation of adult substance abuse treatment, information and basic research is lacking on the cost of adolescent substance abuse treatment. The present study conducted an economic cost analysis of several outpatient adolescent treatment approaches.Design The Cannabis Youth Treatment (CYT) study evaluated five structured treatments for cannabis‐using adolescents. One of the approaches was implemented by all of the four geographically and institutionally diverse treatment facilities collaborating in CYT; each of the other four approaches was implemented in two of the sites. Using the Drug Abuse Treatment Cost Analysis Program (DATCAP), the economic cost of each site‐specific treatment was determined.Findings The average economic costs of the five types of outpatient treatments ranged from $837 to $3334 per episode, and varied by both direct factors (e.g. hours of treatment, treatment retention) and indirect factors (e.g. cost of living, staff level, case‐load variation).Conclusions These adolescent treatment cost estimates are examined in terms of their calculation, variability by condition, variability by site within condition and comparability with previous DATCAP results from outpatient drug‐free programs for adults. Future research will integrate treatment outcomes and costs to complete cost‐effectiveness and benefit–cost analyses of the five therapies.
Sexual segregation by Masai giraffes at two spatial scales
Authors: Ginnett Tim F. , Demment Montague W. 
Published: March 2003

SummaryIn this paper alternative explanations for observed patterns of sexual segregation by giraffes are examined at two spatial scales: within‐habitats and within‐landscape. Habitats are defined as recognizable plant associations and the landscape as the collection of all available habitat types. The study was conducted in Mikumi National Park, Tanzania. At the within‐landscape level, all sex and age classes of giraffes exhibited high degrees of preference for riverine habitats. Sex differences in habitat selection were mostly due to females with young, who tended to select open floodplain habitats in which their vigilance time was lowest. Males, and females without young, preferred more heavily‐wooded habitat. Habitat preferences were not related to observed habitat‐specific forage intake rates for either males or females. Within habitats, male and female giraffes selected different feeding heights, males feeding higher in the canopy than females. Females showed a strong tendency to generalize with respect to feeding height. It is suggested that a sexual dimorphism–body size hypothesis provides a parsimonious explanation for the observed feeding height selection patterns, whereas a reproductive strategy hypothesis can explain sex‐differences in habitat selection patterns within the landscape.
The abundance of large wild herbivores in a semi‐arid savanna in relation to seasons, pans and livestock
Authors: Bergström Roger , Skarpe Christina 
Published: March 2003

SummaryLarge herbivores, including livestock and ostrich, were counted along a 200‐km long track in south‐western Kalahari, Botswana. Altogether, 37 counts were made during different seasons. The number of animals seen and group size were recorded. These variables were compared with monthly and accumulated rainfall (number of animals and group size) and distance to pans (number of animals). Observations of game and livestock were also related to distance to villages. In four of the seven studied species, most animals were seen during the wet season. Group size also varied between seasons apart from the non‐gregarious steenbok and duiker. Number of animals and group size were in some cases correlated with rainfall during the month of observation or with accumulated rainfall during the preceding months. The various species were more often observed close to pans than further away from the pans. Compared to livestock, game was on average observed >10 km further away from the villages. Few observations of game were made between village centres and the livestock observations most distant from the village.