This study examined the behaviors relating to the utilization of prescription and over-the-counter medications in a small group of elderly subjects in the 65 years and over age range. This group was attending an Elderhostel at Western Oregon State College during the summer of 1991, when the information was obtained. The objectives of this study were to ascertain specific medication taking behaviors, and whether or not directions were adhered to as prescribed by physicians for this highly educated group, or if their behaviors were similar to those referred to in the literature for all elderly. A sample of 38 elderly was obtained during an Elderhostel Wellness Vacation at Western Oregon State College in Monmouth, Oregon during July, 1991. Subjects completed questionnaires regarding medication-taking behaviors as part of a wellness class session regarding the safe use of medications. Questionnaires were filled out prior to the class discussion. Data were assembled using one survey instrument with questions relating to medication usage. Descriptive statistics using histograms showing frequency distributions were used for data analysis. Sixty-five percent of this group were taking prescription medications and sixty-eight percent of this group were taking over-the-counter medications. Medications were being obtained from more than one physician and more than one pharmacy. The subjects took fewer doses of medications per day and less medication per dose than prescribed. Medications were discontinued prematurely if feeling better or worse. Leftover medications from previous prescriptions were being taken. Outdated or expired medications were being taken. Alcoholic beverages were being used in conjunction with the use of prescription medications. In some cases, prescriptions were not filled because they were considered to be unnecessary. Recommendations for education and future research in the problematic area of drug use in the elderly include: 1) More time spent by health care professionals to educate the elderly in the correct and safe use of medications; 2) Community health promotion programs targeted at the well elderly; 3) Personalized "brown bag" medication counselling sessions; 4) Medication education programs at Elderhostels throughout the country; 5) Education programs through the American Association of Retired Persons; and 6) Further studies of larger groups of well-educated, healthy and active elderly. / Graduation date: 1993

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The present study described the daily moods of male bodybuilders who self-administered large doses of anabolic-androgenic steroids (AS) through a full cycle of steroid use. Male bodybuilders (N = 13) who had been self-administering AS for 2.5 to 12 years served as subjects and participated in a 14 to 16 week experience sampling procedure wherein brief mood questionnaires were filled out twice daily. / Findings revealed that 11 of the 13 subjects experienced self-reported mood changes in association with AS use. In particular, 2 subjects (subjects 4 & 11) experienced quite dramatic changes in mood. It is concluded that there is much variability with regards to the psychological effects that humans may display in association with AS use. / Data are discussed in terms of the effects that AS use may have on mental health.

Background Stroke is a serious condition that can have significant impact on an individual’s health and is a significant burden on public health and public finances. Secondary preventive drug treatment after stroke is important for decreasing the risk of recurrent strokes. Non-adherence to drug treatment hampers the treatment effect, especially in long-term preventive treatments. The aim of this thesis was to study the use of secondary preventive drugs after stroke among Swedish stroke patients in terms of inequalities in implementation in clinical practice and patient adherence to treatment over time. Methods Riks-Stroke, the Swedish stroke register, was used to sample stroke patients and as a source of information on background characteristics and medical and health care-related information including information on prescribed preventive drugs. The patients that were included had a stroke between 2004 and 2012. Individual patient data on prescriptions filled in Swedish pharmacies were retrieved from the Swedish Prescribed Drug Register and used to estimate patient adherence to drug treatment. Data on education, income, and country of birth were included from the LISA database at Statistics Sweden. A questionnaire survey was used to collect information about patients’ perceptions about stroke, beliefs about medicines, and self-reported adherence. Results Results showed that a larger proportion of men than women were prescribed statins and warfarin after stroke. There was also a social stratification in the prescribing of statins. Patients with higher income and a higher level of education were more likely to be prescribed a statin compared to patients with low income and low level of education. Statins were also more often prescribed to patients born in Nordic countries, Europe, or outside of Europe compared to patients born in Sweden. Primary non-adherence (not continuing treatment at all within 4 months of discharge from hospital) was low for preventive drug treatment after stroke. Data on filled prescriptions, however, indicated that the proportion of patients who continued to use the drugs declined during the first 2 years after stroke. For most drugs, refill adherence in drug treatment was associated with female sex, good self-rated health, and living in institutions and (for antihypertensive drugs and statins) having used the drug before the stroke. For statins and warfarin, a first-ever stroke was also associated with continuous drug use. Self-reported adherence 3 months after stroke also showed associations with patients’ personal beliefs about medicines; non-adherent patients scored higher on negative beliefs and lower on positive beliefs about medicines. Conclusion Inequalities between men and women and between different socioeconomic groups were found in the prescribing of secondary preventive drugs after stroke. Only a small proportion of Swedish stroke patients did not continue treatment after discharge from hospital, but the proportion of non-adherent patients increased over time. Poor adherence to preventive drug treatment after stroke is a public health problem, and improving adherence to drug treatment requires consideration of patients’ personal beliefs and perceptions about drugs.

Hepatitis C (HCV) is an infectious disease of the liver which affects more than 250,000 Canadians; the majority of those living with the disease have experience with injection drug use. Treatment for HCV involves a strict protocol, has only a 50% success rate and has harsh side effects. Interest in HCV treatment among people who use drugs is high, but actual uptake of treatment remains low. The objective of this research was to explore the barriers to accessing HCV treatment for individuals who were accessing methadone. A mixed methods approach was used; a cross sectional survey and an in-depth interview were administered to clients of a methadone maintenance program. The two sets of data identified three main barriers to HCV treatment; stigma, the toxicity of treatment, and day-to-day struggles. Future research should be conducted to further explore how stigma guides decisions around HCV treatment, particularly in a methadone treatment setting.

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Henri Michaux first discovered mescaline in 1956. This encounter proved a lasting influence on the work of the writer who, for at least ten years, struggled to circumscribe, then tried to explain the nature of the terrible shock he had received from the mind-altering chemical. The event was so important for the poet that in due time, it brought about a veritable conversion, a total and uncompromising revision of his most fundamental relationships towards the function of language and thought, and towards the basic premises of existence in general. Signs had hinted, previously, at this sudden transfiguration of his vision. His relationships with other drugs (ether, opium) betrayed his hidden desire to go beyond the limits ordained by his tragically caustic and defiant mind. Yet mescaline alone, as a weapon, proved strong enough to overcome Michaux's chronic insubordination, and clear the prolific way that led him toward the realisation and acceptance of that obscure other whose presence he had hitherto only felt, and which had been asleep within him forever.

This study addressed the efficacy of a multimodal substance abuse prevention program with elite-level athletes. By utilizing components of substance abuse information and education, coping skills training, and self-esteem strategies, the study examined the effect of these variables on the subsequent alcohol and drug use behaviors and attitudes of the participants.In addition, measures of self-esteem and stress were examined to determine the effect of prevention on these variables. Gender differences were examined regarding substance use behaviors and attitudes, and change score measures were utilized to observe for behavioral changes from pretest to follow-up testing.Results indicated no differences on any of the dependent measures. Utilizing a repeated measures multivariate analysis of variance (MANOVA), no significant differences in substance use behaviors and attitudes between athletes in the treatment and control conditions were found. There were also no gender differences reported on the dependent measures. In addition, chisquare (X2) analyses demonstrated no behavioral or attitudinal differences. A significant finding indicated that control group subjects had more substance abuse changes (both positive and negative) than the treatment condition. The hypotheses of the study were unconfirmed as a result of the statistical analyses.Limitations of the present study include the small sample size (although representative of the population), the small amount of actual reported use behaviors, and the length of the program (not sufficient time). It is recommended that future research in this area maintain the multimodal approach, while lengthening the time of implementation. Future dependent measures must be able to accurately detect small fluctuations in reported substance abuse behavioral changes.The survey data suggest that athletes at the elite level do demonstrate alcohol and drug use behaviors that may be detrimental to their personal and professional potential. Substance abuse education programs are necessary components of holistic prevention for athletes at all levels of training and competition. Future programs must consider the present study in the development of more successful and practical substance abuse education for athletes. / Department of Counseling Psychology and Guidance Services