Drug trafficking and addiction among low-income urban youths: An ecological perspective

Drug addiction and drug trafficking continue to be a major problem during adolescence and a primary cause of significant problems in adulthood. For low-income, urban, African American youths, these problems are compounded by environmental factors-such as communities that are depleted of resources, schools that are inadequately funded, family members who are unemployed-and other physical, legal, spiritual, social and psychological factors. These ecological factors have the potential to impinge significantly on the lives of those who become involved with drug use and sales. The problems resulting from these issues not only affect the individual but also family members, communities and the nation.

This paper examines the patterns of drug addiction and trafficking among African American youths in poverty, with an eye toward answering the following questions: What is drug trafficking? What is the youths perception of drug addiction? What role does drug trafficking play in subsequent drug use? What is the nature and role of ecological factors, such as poverty, in the interaction between drug addiction and drug trafficking? How do these issues reflect on developmental theories of addiction?     

Land of the Free,Home of the Brave: Voting Accommodations for Older Adults

Voting is a fundamental right for all United States citizens, one that usually continues for elderly people as long as they are alive. As adults age, certain issues regarding voting warrant deeper consideration than in previous years, especially those presenting as a result of impaired sight, hearing difficulty, dementia, or other special needs. What will happen to millions of men and women who have taken the right to vote for granted, but who gradually become immobile or physically impaired? What are states doing to help secure the enfranchisement of an increasing number of older adult voters? The purpose of this article is to address these issues by focusing on the following questions: What has been the historical nature of polling place accommodations for elderly people? What are states doing in terms of accommodating older voters at the polls while ensuring the integrity of the voting process? What effect has recent Help America Vote Act legislation had with regard to polling place accommodations? Our results indicate that accommodations for older voters are being made but are not yet at a level required to serve a rapidly aging population.     

Potential for the Abuse of Medication for the Elderly in Residential and Nursing Homes in the UK

ABSTRACT

Abuse of the medication prescribed to the elderly living in long-stay care homes may be perpetrated by a minority of unscrupulous doctors, pharmacists, or home staff caring for the residents. Disorganised practices and homes, poor communications, and sloppy professional practices may create opportunities for over-dosing, errors, fraud, or theft. This article describes the circumstances leading to the potential abuse of elderly residents' medication, and the measures that may be taken to avoid or minimise such abuse from occurring.     

MODERNIZATION IN THE PEOPLE'S REPUBLIC OF CHINA: THE POLITICIZATION OF THE ELDERLY

The rapid modernization in the People's Republic of China (PRC) allows us to identify some of the principles that underlie the changes in State-managed economies and their affects on the elderly. Modernization theory predicts that traditionally high status of the elderly declines with industrialization. This theory's difficulties can be overcome by using the variables of the "state" and the political economy by developing a model of "bureaucratic politics" and the "state" which explains "how" the status of the elderly changes through the interplay of competing interests within the society and thus may "increase" or "decrease" as the society modernizes. This research is based on data collected in the PRC between 1981–1986. Since 1978 there have been three major reform efforts; each has consequences for the elderly: (1) economic, (2) bureaucratic, and (3) population. In order to achieve them, programming for elderly is occurring: (1) retirement pensions and medical care, (2) homes for the aged, and (3) special activities to use the "left over energy" of the elderly. The future importance of the elderly in China will depend on their consequences for (1) the developing economy, (2) the bureaucratic politics of the Party and the State, and (3) other agendas of the State the implicate the elderly.     

Constructing deservingness: federal welfare reform,supplemental security income,and elderly immigrants

On August 22, 1996, President Clinton signed the welfare reform law that ended eligibility for all immigrants to federal means tested entitlements. Poor elderly immigrants on Supplemental Security Income were specifically targeted. This article documents how the print media responded to these policy changes. The following are the major research questions: (1) How were older immigrants on Supplemental Security Income portrayed in the print media before and after federal welfare reform? (2) Who was involved in the print media coverage of older immigrants on Supplemental Security Income before and after federal welfare reform? (3) What types of statements were made by those involved in the print media coverage of older immigrants on Supplemental Security Income, before and after federal welfare reform? The approach used was an in-depth content analysis of newspaper articles from major U.S. newspapers. The findings demonstrate that older immigrants were constructed as "undeserving" in news articles prior to the passage of the federal welfare reform bill. However, after the passage of the federal welfare reform bill the coverage of older immigrants on Supplemental Security Income started to change, and older immigrants were portrayed as "deserving." In advancing aging policy for poor, vulnerable elderly, such as elderly immigrants, advocates, health and social service providers can play an influential role in bringing their voices to the print media.     

A Judicial Menu:

An "incapacitated" elderly person may be brought to probate court in proceedings to impose adult protective services, involuntary commitment for mental illness, or guardianship. If the person or agency bringing the petition has chosen a remedy the criteria of which do not fit the respondent, the case is likely to be dismissed without assuring assistance to the elderly person. Suggesting that judges take a global view, the article encourages them to ask, "What remedy is appropriate for this person, in this situation?" Key to choosing the remedy is comprehensive, functional evaluation of the respondent by a qualified human services professional. The article discusses content of the evaluation, available resources, and implications of the judicial menu approach for the respondent and the court.     

Paliperidone extended-release tablets: a new atypical antipsychotic

This article reviews the use of the new atypical antipsychotic drug paliperidone extended-release (Pal-ER). Pal-ER is a delayed-release formulation that provides continual drug delivery over 24 hours and reduces fluctuations in serum drug concentrations. This delayed release minimizes side effects related to high serum levels that occur with immediate-release formulations. Pal-ER is effective, safe, and relatively well tolerated. Although Pal-ER does not have any major advantages or disadvantages compared with other antipsychotic drugs, it has unique pharmacological properties and may be a beneficial alternative medication for some patients.     

Maintaining an Illusion: Abuse, Somatization, and the Elaboration of Meaning

Many clinicians who have treated adult survivors of abuse have known for some time what is now confirmed by the empirical literature: these clients often suffer from a host of physical complaints for which their doctors tell them there is no physical cause. The symptoms as well as the response of the doctors are frequently quite disturbing to the client. Both aspects of the clients' experiences are also very difficult to treat. Relational theory may provide a perspective that will enhance the understanding of somatization in survivors of abuse. The resulting thesis is that somatization may be the result of deficits in meaning, which are in turn due to conflicts between distinct levels of meaning. This theory weds two previously opposed perspectives: the deficit and conflict models of psychopathology. While the hypothesis may be interesting on the level of pure theory, the ultimate aim of the paper is to apply the theory to the treatment of somatic symptoms among adult survivors of abuse, expanding upon existing interventions. First, the clinician must assess for deficits in the levels of meaning, then utilize interventions appropriate to specific levels. To safeguard that no new conflicts arise, the clinician must ensure that the meanings elaborated in treatment support an integration of meaning on all three levels. To this end, he or she must target interpretations to the client's zone of proximal meaning. These principles are illustrated in a case example.     

The Use of Psychiatric Medication,Human Capital,and the Amplification of Mistrust

This research investigates the relationships among willingness to utilize psychiatric medication, education, and three forms of mistrust—generalized mistrust, mistrust in physicians, and mistrust in psychiatric medication. Utilizing human capital theory and two waves of the U.S. General Social Survey (N = 2,671), our findings show a curvilinear relationship between willingness to use psychiatric drugs and education, such that individuals with less than a high school diploma and those with a college or advanced degree are more willing to use psychiatric drugs compared to those with a high school degree. Also, the effects of all three forms of mistrust are amplified and have significant, negative effects on the use of psychiatric medication among college graduates. Mistrust in physicians and mistrust in psychiatric drugs matters for high school graduates, while only mistrust in psychiatric medication impacts the use of psychotropics for those with less than a high school degree.     

Dietary intake and the risk of hyperuricemia,gout and chronic kidney disease in elderly Taiwanese men

Introduction.?This study was conducted to examine the relationship between dietary intake and the risk of chronic kidney disease (CKD), treated hyperuricemia (or gout) without CKD, and untreated hyperuricemia without CKD in elderly men.

Methods.?The study population comprised 752 men aged 65 or older who had been included in the Elderly Nutrition and Health Survey (1999–2000) (Elderly NAHSIT).

Results.?Statistical analysis using a polychotomous logistic regression model revealed that compared with the individuals in the normouricemic group, the individuals in the other groups exhibited a significant association between a higher prevalence of CKD and the following factors: advanced age, drug use for hypertension, egg and shellfish consumption and consumption of poultry with the skin and meat with fat. The significant risk factors for the patients who did not have CKD and were undergoing treatment for hyperuricemia were as follows: BMI?≥?25 kg/m²; drug use for hypertension; intake of poultry with skin; increased daily consumption of shellfish, fried food, sugar and juice.

Conclusions.?Men who use anti-hypertensive drugs and who consume fewer soy products and more shellfish may be at a higher risk of developing hyperuricemia or CKD.     

Physical activity is inversely related to drug consumption in elderly patients with cardiovascular events

Elderly patients with cardiovascular events are characterized by high drug consumptions. Whether high drug consumptions are related to physical activity is not known. In order to examine whether physical activity is related to drug consumption in the elderly, patients older than 65 years (n?=?250) with a recent cardiovascular event were studied. Physical activity was analyzed according to the Physical Activity Scale for the Elderly (PASE) score and related to drug consumption. PASE score was 72.4?±?45.0 and drug consumption was 8.3?±?2.2. Elderly patients with greater comorbidity took more drugs (8.7?±?2.1) and are less active (PASE?=?64.4?±?50.6) than patients with Cumulative Illness Rating Scale severity score higher than 1.8 than those with a score lower than 1.8 (76.3?±?41.4, p?<?0.05, and 8.0?±?2.0, p?=?0.006, respectively). Multivariate analysis correlation confirmed that PASE score is negatively associated with drug consumption (β?=??0.149, p?=?0.031), independently of several variables including comorbidity. Thus, physical activity is inversely related to drug consumption in elderly patients with cardiovascular events. This inverse relationship may be attributable to the high degree of comorbidity observed in elderly patients in whom poor level of physical activity and high drug consumption are predominant.     

Dramas,Metaphors, and Structures*

It is argued that dramaturgical sociology/social psychology must be examined as a continuation of the methods and practices of dramatism. Such an examination will reveal answers to the persistent questions regarding the work of Erving Goffman: Is he using a metaphor, simile, analogy, etc.! Is he a symbolic interactionist! Is his work a form of structuralism! What is the relationship between the sociologist and the drama of human relations! What is the relationship between interactionism and structuralism! The answers to these questions, it appears, are that drama is not used as a simple analogy in the study of human relations and that the separation of structuralism and interactionism is yet another essay in the confrontation between Heraclitus' flux and Zeno's paradox. You cannot step twice into the same river; for fresh waters are ever flowing in upon you. Heraclitus In which case, you cannot step even once into the river: there will in fact be no river. after Parmenides, Zeno etc.     

Seclusion. The nursing challenge.

The research to date shows that there is not much data to guide nursing decisions about the use of seclusion. The justification for its use is not always as clear as one might hope. Although many patients are secluded for violence against themselves or others, there are others who have not been violent who are secluded. There may be justification for secluding violent patients, but, as indicated earlier, it may reinforce the behavior it is designed to stop. There probably is no justification for secluding patients who make loud noises, refuse to take medication, or refuse to participate in activities. In addition, it is disconcerting that a large percentage of patients are secluded for "escalating agitation," that is, they have not acted violently against themselves or others. What is problematic is that staff are undoubtedly predicting violent behaviors in these patients--predictions that might be erroneous. Thus, there is ample room for injustice to occur. The potential for injustice is even greater if certain patients are singled out for seclusion or if patients are secluded longer than they or the staff think that they need to be, as is indicated in some of the studies to date. Moreover, if unit variables are associated with seclusion activity, this too, may be indicative of decision making at certain times of the day or by certain staff members that may not be in the best interest of the patient. What seems fairly clear is that secluding a patient is a distressing event for staff and is viewed extremely negatively by some patients and as a reward by others.(ABSTRACT TRUNCATED AT 250 WORDS)     

Effective medication management

The effectiveness of a drug treatment is based on its efficacy, tolerability, safety, and acceptability. Effective medication management implies that the process of selecting and managing prescribed drugs results in an optimal patient outcome. Effectively prescribing medications includes gaining a mastery of drug knowledge, learning the nuts and bolts of treatment using medication, and appreciating the fundamental importance of psychotherapeutic and psychoeducational processes in medication management. Nurses have an essential role in providing effective medication management, given their direct level of patient contact and their collaborative relationship with physicians.     

Drug War Politics: Governing Culture Through Prohibition,Intoxicants as Customary Practice and the Challenge of Drug Normalisation

This article on the American administration’s war on drugs policy uses an interdisciplinary approach to assess the assumptions of drug prohibition. It applies a historical and contemporary analysis to the issue of drugs in society. It will explore new ways of thinking about drug war politics, aiming to address drugs as a source of political state repression. American foreign policy has sought to use the war on drugs to reduce human suffering; but instead, the age of prohibition has brought financial opportunities for criminal syndicates and clandestine political operations and causes. I will seek to show that prohibition faces serious challenges as a result of changes in contemporary culture and communication. I will argue that prohibition has been concerned with more than drug control and through drug war policy, it has wider ambitions to govern culture through prohibition. The paper explores the growth of drug normalisation and questions whether drugs can be understood as a customary practice across social groups in different communities and asks to what extent the United Nations policy of ‘cultural sensitivity’ can fit alongside an aggressive war on drugs policy.     

Substance Use Among Rural African American Adolescents: Identifying Risk and Protective Factors

Substance use continues to be a significant problem among youth in our society, particularly in rural communities. The purpose of the current study was to identify the possible risk and protective factors that may be affecting the rates of alcohol and illegal drug use among a population of African American adolescents living in a rural, southern community. The following were identified as possible risk factors: (1) Being an older adolescent (15 years of age or older); (2) Spending afternoons after school with friends; (3) Having friends or family members who use alcohol or illegal drugs; (4) Being raised by non-family members; and (5) Having plans to enter military after high school. The following characteristics were associated with less alcohol and illegal drug use, and were identified as possible protective factors: (1) Being raised by parent(s) or other family members; (2) Spending afternoons after school with parents; (3) Having parents who talk to youth about dangers of drug and alcohol use; (4) Having parents who disapprove of their child using drugs or alcohol; (5) Being involved in extra-curricular church-related activities; and (6) Having plans to work, or attend college or technical school after high school. Characteristics that have been associated with drug and alcohol in previous research that were not associated with use in the current study include: (1) Being male; (2) Peer pressure to use alcohol or illegal drugs; (3) Grades in school; and (4) Involvement in extra-curricular activities. Implications for developing effective community programs aimed at reducing substance use among our youth are discussed.