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Objective. The objective of this study was to examine practices and policies in place for the provision of targeted prevention and treatment of cocaine and Amphetamine Type Stimulant (ATS) users in prison in nine European countries. Methodology. Across nine European member states (Belgium, the Netherlands, Czech Republic, Lithuania, Slovenia, Sweden, Malta, Ireland and Portugal), interviews were conducted with ministerial representatives and professionals (i.e. service providers and security officials) working in prisons and a total of 16 focus groups with a total of 125 prisoners. Results. The use of stimulants in prison is associated with aggression and violence, financial problems, and psychological and physical problems in prisoners (depression, anxiety and psychological craving). Both security and healthcare staff in prison often feel ill‐equipped to deal with stimulant‐related problems, leading to a lack of equivalence of care for stimulant users in prison, therefore the variety and quality of drug services outside is not reflected sufficiently inside prison. There is a need for more specific product information and harm reduction material on stimulants, for clear guidelines for the management of acute stimulant intoxication and stimulant withdrawal, for structural adjustments to improve potential diagnosis of personality and psychiatric disorders, for more non‐pharmacological treatment strategies and more opportunities for prisoners to engage in purposeful activities.

This paper identifies the theoretical stimulants and impediments associated with the implementation of PFI/PPP (Private Finance Initiative/Public Private Partnership)projects. A current defect of this procurement approach is the unintentional constraint upon the innovations incorporated into the development of PFI projects. A critical evaluation of the published literature has been utilized to synthesize a theoretical model. The paper proposes a theoretical model for the identification of potential innovation stimulants and impediments within this type of procurement. This theoretical model is then utilised to evaluate four previously completed PFI projects. These project case‐studies have been examined in detail. The evaluation demonstrates how ineffective current procedures are. The application of this model before project letting could eliminate unintentional constraints and stimulate improved innovation within the process.The implementation of the model could improve the successful delivery of innovation within the entire PFI/PPP procurement process.

European studies have shown lower prevalence rates of prescription stimulant use for cognitive enhancement, especially among student populations, compared to North America. This difference requires more cross-country research of the various factors involved. To find out whether other parts of the globe are witnessing similar increases in extra-medical stimulant use, and how this might relate to cognitive enhancement, requires empirical study of local contexts. This paper aims to argue that the academic and public discussion on cognitive enhancement should consider the specific country context of drug policy and research and rethink which drugs are included under the term cognitive enhancement drugs.

This paper offers a general review and a sociological country comparison between the Netherlands and Finland, focusing not only on prescription stimulants used to treat attention deficit hyperactivity disorder but also illicit amphetamines among young adults and methylphenidate use among Dutch and Finnish participants of the Global Drug Survey. This paper emphasises sociocultural perspectives and the importance of context in cognitive enhancement in general as the line between therapeutic and enhancement use can often be blurred. Data is drawn from global, European and national sources, including the International Narcotics Control Board, European Monitoring Centre for Drugs and Drug Addiction and Global Drug Survey.

There are hardly any national empirical studies done on cognitive enhancement drug use in Finland. On the other hand, there have been studies in the Netherlands showcasing that the use of prescription stimulants and other drugs for enhancement purposes is something that is happening among young people, albeit yet in a relatively small scale. Illicit and licit stimulant use and drug policy action in relation to cognitive enhancement drugs in the two countries varies, emphasising the importance of country context.

Given that cross-country research is scarce, this general review provides one of the first glimpses into cognitive enhancement drug use by comparing the country context and research in Finland, where the phenomenon has not been studied, with the Netherlands, where the topic has received more research and public attention. Further research areas are suggested.

The unsatisfactory conditions which are created by the total lack of official standards, or indeed of any figures or definitions relating to food and some drug products is well illustrated in the report of a prosecution which appeared in last month's issue of the Journal. This case in question was dismissed by the Bench. The Bench was tendered some highly technical and very conflicting evidence. In view of this the defendants received the benefit of the doubt ; and they received this benefit because in the absence of any standard the Bench were unable to decide what was “ the nature, substance and quality demanded by the purchaser ” of the invalid wine—non‐alcoholic meat and malt wine—which was the subject of the prosecution. Wine may be defined as the juice of the grape which has been fermented under control conditions. The term has been extended in meaning and is now applied to a variety of substances which have had nothing to do with the grape and frequently contain very little or no alcohol, but may, as in this case, contain substances entirely foreign to the idea of wine, if the term be used in its original and restricted sense. A well known variety of ginger wine has an alcohol content of about 26 per cent. of proof spirit. So far as the alcohol content goes this liquid may be correctly described as a wine. It has, within its limits, the stimulating properties that are usually associated with an alcoholic drink and its value as an aid to digestion or a warm drink in winter cold has never been questioned. It appears that non‐alcoholic meat and malt wine also has virtues peculiar to itself dependent not on alcohol, but on other substances whose nature and quantity determine its characteristics. The term “ demand ” as used in the Act connotes the idea of a purchaser who well knows what he ought to get and furthermore will vigorously insist on getting it. The fact is, as everyone knows, that the purchaser is in a state of profound ignorance as to “ the nature, substance and quality ” of what he wishes to buy, and as a result he is in a sufficiently humble state of mind to accept without hesitation almost anything that may be told him about his prospective purchase from the other side of the shop counter. It is this state of mind on the part of the average purchaser and the desire to profit by it on the part of some food vendors that led to the passing of the Food and Drugs Act. The underlying idea being to protect the ordinary man and woman in health and pocket against the result of their purchasing adulterated material or inferior material described as being of superior quality. To enable the Act to be satisfactorily administered certain officers were appointed, known as Public Analysts. They were the officials of the old Local Government Board. They are the officials of the Ministry of Health. Their wide experience, special knowledge, and impartiality combine to make their services of peculiar value to the community so that they may, without unduly stretching language, be described as part trustees for the public health. Everyone will readily admit that there is scarcely anything, if anything, more complex than any one of our ordinary and unsophisticated food products. This complexity is, so to speak, raised to the second power by the variations that naturally occur in the essential constituents of these. The process of administering the acts directed against adulteration and similar offences has been frequently enlivened by the lively controversies to which this fact has given rise in the past and which it will no doubt do in the future. Another consideration must be taken into account. It is this. Since the year 1875 when the Food and Drugs Act became law the knowledge of food chemistry, in common with other kinds of knowledge, has increased rapidly in kind and in amount. This knowledge is now freely drawn on by those whose financial and business interests are bound up with food manufacture. As a result of this all kinds of more or less elaborately processed foods in immense variety and in many cases of a kind unthought of or impossible of manufacture sixty years ago have been put on the market. Among these processed products may be counted in considerable variety foods for the use of invalids or those convalescing from illness. Very large claims are made for these by the manufacturers, and it is only fair to say that these claims are to a considerable degree substantiated in the case of the better class of these substances prepared by reputable firms. All will agree that foods and stimulants which are said to have been specially prepared for the relief and more rapid recovery of a patient during the critical period of convalescence should be in every respect of such a nature as to be above suspicion and entirely beyond challenge by reasonable and expert opinion. This is unfortunately not always the case. Trade competition is acute. Official standards are non‐existent. Practically no official definitions exist, and no official figures to declare what shall be the minimum quantity of an essential constituent. The result is that nature is “ improved ”—to borrow a term which is in frequent and objectionable use among certain manufacturers—and the variation in the proportions of essential constituents depends on the taste and fancy of the manufacturer rather than on the needs of the consumer. Hence it comes about that to obtain a footing in a lucrative branch of trade a cheap product may be put on the market. It is cheap because it is made of inferior or adulterated materials, or what may be described as a vanishing quantity of an essential constituent is introduced. The quality of this constituent need not be in question. It is probably perfectly wholesome, but almost useless in such microscopic doses. For example, a mixture called “ chicory and coffee ” may be sold. The maker may please himself as to how much or how little coffee he uses, but as long as the coffee is not a purely subjective phenomenon he is on the right side of the law if he describes it as a mixture. Cheaper jams, it has been said, may be filled up with apple pulp. We may even suggest spent apple pulp which is certainly cheap and very filling at the price. As to the amount of essential constituent in the somewhat grandiloquently named “ Full Fruit Standard ” jams we may refer readers to the back numbers of this Journal. “ In bismuth tablets the amount of bismuth may become almost negligible because the law does not demand that there should be a fixed minimum present.” Many other instances could be given, and they would be found to relate to nearly every food and drink. In every case where the prosecution alleges that the nature or the substance, which is the basis of the prosecution, is below any reasonable standard the prosecuting authority finds itself heavily penalised by having no official standards to quote. The defence, on the other hand, gains what the prosecution has lost. It finds itself in a much stronger position if the case should be dismissed than when the proceedings commenced. The local authority has been put to great and perhaps useless expense in their endeavours to protect the public. The particular case of the meat and malt wine referred to appears to be an excellent instance of this kind of practice. The Public Analyst affirmed that a wine‐glassful of this “ wine ” contained 8¾ grains of meat extract, 52½ grains of malt extract, 150 grains of sugars (invert, etc.). The concoction was diastatically inactive. It contained no vitamins. It is further pointed out that the total cost of the contents of a pint bottle would be about three half‐pence. It is sold for four shillings and sixpence ! The report of the proceedings says that this “ wine ” was declared by the vendors to contain the juice of the finest grapes. The Public Analyst, however, certified that there was no grape juice in it. These facts and figures have not been called in question, and it is really somewhat difficult to speak with restraint of a transaction of this nature, especially when it is remembered that this, and other such “ wines ” and stimulants have been compounded for the alleged benefit of convalescents and of invalids. It is regrettable that experts can be found willing to support the doubtful claims of the manufacturers so far as it appears that they relate to the proportion of meat and malt extract in the “ wine.” The Public Analyst for the prosecuting authority stated that in his opinion such an article should contain a minimum of 4 per cent. of meat extract and 25 per cent. of malt extract. Another Public Analyst, called for the defence, said that in his opinion the proportions of these ingredients should be one and four respectively. Here are huge discrepancies in the ratio of about four to one in the essential constituents of an invalid food or stimulant. It is impossible, in the face of such wide differences of opinion among experts, to avoid drawing a comparison between the make up of the medical prescriptions which determine the nature of the drugs administered during illness and the nature of the stimulants, such as this “ wine,” which is to be taken during the period of convalescence. In the one case the prescription is drawn up by a medical man and the medicine compounded by a qualified pharmacist from drugs whose “ nature, substance and quality ” are rigidly defined in the pharmacopoeia. In the other case the stimulants which are presumably intended to help the patient on his road to recovery are, it appears, primarily made to sell, and have been compounded by the manufacturers to enable them to put money into their pockets. We can only say that if the same differences in composition existed in the same medicine and the same differences of opinion existed among medical men as to the efficacy of such medicine the patient would in all probability not reach the stage of convalescence at all. The only thing that might conceivably give trouble under the circumstances would be the wording of the death certificate. If medical men and analysts in official positions are to be regarded as joint trustees of the public health let them play the part. What would be thought of a trustee in the ordinary sense of the term who would recommend investment in a concern as to whose soundness there was considerable doubt? His good faith need not be called in question, but his judgment might certainly be described as faulty. It would be worse than a crime, it would be a mistake. A remedy for this unsatisfactory state may, in our opinion, be found in the setting up of standards for foods and drugs. The difficulties, of course, are great and a serious objection, or one of the objections, would be the inevitable lowering of the quality of most foods to the level of the minimum requirements of the law. There really seems to be no other way out of the difficulty, and if a beginning is to be made there seem to be very good reasons to begin with some of these invalid foods and stimulants. It is as much a matter for the medical man in cases of this kind as it is for the public analyst. If the medical man has succeeded in putting his patient after a serious illness on the high road to recovery he does not want to see him made to “ stand and deliver ” at the demand of anyone who has the necessary assurance to play such a part. With regard to standards in general a well known public analyst has recently observed : “ The Public Analyst should be umpire certainly, but if he is he should take into consideration the whole question of standards for any particular article ; long custom of the trade ; and also give weight to the needs and desires of the public.” He adds, “ The whole question of standards requires the attention of a small, but very competent, body—not a crowd.” This seems to be a complete statement of the case in few words. Some of the difficulties are suggested by the phrases “ custom of the trade ” and “ needs of the public.” It is the first of these that presents by far the most difficulty. The manufacturer well knows what “ custom ” would be of most benefit to him. He will fight for this by every means in his power. The fact that the public is extremely hazy as to its needs operates powerfully in favour of the manufacturer. It may also be added that while the manufacturers are almost always a well organised community, the members of the public are not, nor are they ever likely to be. It has been suggested that the public should be made “ food conscious.” It should “ take an interest in what it is buying ” and ask “ what do I expect to get when I buy this article? ” The meat and malt “ wine ” case is a sufficient answer. The purchaser paid four shillings and sixpence for what was stated to be “ three ha'porth of stuff ” made up to half a pint, and he was unconscious of the fact. This may be taken as a measure of the interest and knowledge shown by him when he was content to let the manufacturers make a profit of some three thousand per cent. on material that the Public Analyst is reported to have said was “ comparatively worthless.” While the magistrates were unable to accept the Public Analyst's standards as proved in view of the conflicting evidence, they added that the case had been most properly instigated by the West Riding County Council, and the defence was made to pay its own costs ! The whole case affords a clear demonstration of the urgent necessity of a small Standing Committee which could act and put its views into force without delay.

This study examined how youth would mitigate non-medical use of prescription medication among their peers.

The National Monitoring of Adolescent Prescription Stimulants Study (N-MAPSS) was conducted as an interview comprising 11,048 youth of 10–18 years of age between 2008 and 2011 from entertainment venues of 10 US urban, suburban, and rural areas. Using a mixed-methods approach, participants completed a survey culminating in open-ended questions asking: (1) How should kids your age be informed about prescription drugs and their effects? (2) If you ran the world, how would you stop kids from taking other people’s prescription medicines? (3) Why do people use prescription stimulants without a prescription? Responses from a random sample of 900 children were analyzed using qualitative thematic analyses.

The random sample of 900 youth (52 percent female, 40 percent white, with a mean age of 15.1 years) believed they should be educated about prescription drugs and their negative effects at schools, at home by parents, through the media, and health professionals. Youth would stop kids from using other people’s prescription drugs through more stringent laws that restricted use, and providing education about negative consequences of use. Peer pressure was the most common reason the youth gave for using other’s pills, though some reported taking them out of curiosity.

The importance of considering youth’s opinions on non-medical use of prescription medications is often overlooked. This evidence, from a peer perspective, could end the illicit use of prescription drugs among today’s youth.

Attention disorders in people with intellectual disabilities (ID) is common. Current drug treatments are based on the literature in people without ID. The purpose of this paper is to present a review of the drug treatment of Attention Deficit Hyperactivity Disorder (ADHD) in people with ID in the German and English languages literature with the aim of exploring the current evidence base.

The paper provides a general review of the evidence base on drug treatment of ADHD in people with ID from the German and English language literature.

Studies and practice guidance on ADHD in both languages are similar with more information published in English. Much of the evidence on drug therapy to treat ADHD in people with ID is based on studies in children. The literature on ADHD in children without ID is helpful but not specific to all people with ID who have ADHD. The response rates to medication to treat ADHD in people with ID are lower than in people without ID. The occurrence of side effects from medication is more common in people with ID. Co-morbid disorders are often present in people with ADHD that could affect study findings.

Medication used to treat ADHD is effective when treating ADHD in people with ID. Prescribers should be aware of guidelines on medication and their potential drug interactions and side effects. Newer drugs could offer more effective treatments because of fewer adverse effects than current medications.

The general review offers an insight in to the literature in German and English on ADHD in ID comparing what is published in both languages.

The objectives of this study were to determine the prevalence and pattern of Kola nut use among secondary school students in Osogbo, Osun State, Nigeria. The study also aimed to determine the association of socio-demographic variables (of the students and their parents) with kola nut chewing. A questionnaire consisting of socio-demographic variables, the stimulant use section of the WHO Students Drug Use Questionnaire was administered on three hundred and eighty-five (385) randomly selected students of the two Local Government Areas of Osogbo. The prevalence rate of kola nut use was calculated and some socio demographic variables were determined. The 30-day prevalence rate of kola nut use was 11.2%. The one-year prevalence of kola nut use was 29.1 percent and the lifetime rate was 74.8 percent. Majority of users started at age 14 years or below. Kola nut use was associated with lower age group, poor school attendance, polygamous background, low education of mother, high education of father and the description of mother as being too permissive. The findings suggest the need to increase the awareness of the dangers of kolanut use among adolescents. Control program are urgently needed to prevent student wastage.

The rise in the diagnosis of attention deficit hyperactivity disorder (ADHD) and the use of stimulant medication such as Ritalin to treat it raises important questions about how childhood is conceptualised in contemporary western society today. By focusing on within‐child explanations for behaviour, the diagnosis of ADHD divorces a child from their context; real life experiences, including traumatic ones, are marginalised or excluded from clinical consideration. This paper1 explores how ADHD manages to occupy and hold on to such a dominant position despite the lack of evidence supporting its supposed medical origins, and explores what the ADHD diagnosis reveals about cultural expectations of childhood and power hierarchies in the UK and North America.

This paper examines the relationship between the dimensions of dispersed – self‐management – leadership and a number of work environment dimensions conducive to creativity and productivity.

The study involves a questionnaire‐based survey of employees from a high technology organisation operating in the United Arab Emirates (UAE). A total of 104 useable questionnaires were received from employees who are engaged in self‐managing activities. These were subjected to a series of correlational and regression analyses.

There are three major findings in this research. First, the relationship between dispersed leadership and the “stimulant” dimensions of the work environment for creativity is positive and significant. Second, the relationship between dispersed leadership, with the exception of encouraging self‐reinforcement, and the “obstacle” dimensions of the work environment for creativity is negative and significant. Finally, the findings have clearly shown that the “stimulant” dimensions of the work environment for creativity have a positive and significant impact on both creativity and productivity.

The study shows that the role of the leader is to be the provider of a context and situation for creativity and productivity. Thus, the art of leading creative organisations in the UAE is the art of handling people and the task of leadership in such organisations is to provide the people with the work – environmental – conditions under which they can exercise their creativity.

The paper clarifies which of the dispersed leadership behaviours best predict the dimensions of the work environment conducive to creativity and productivity. The paper will assist organisations in the UAE in identifying those particular leader behaviours that appear to have an impact on creativity and productivity.