No description available.

No description available.

Over the past decade, the illicit drug market has experienced an explosion of designer drugs being produced by clandestine laboratories that include modifications of illicit drugs that dominated drug markets for long periods of time (e.g. cathinones and MDMA). These designer drugs, which are commonly known as “legal highs”, are popular due to that fact that they are legally obtainable and not currently controlled. Examples of these include the phenylalkylamine analogues 5-iodo-2-aminoindane (5-IAI) and 5, 6-methylenedixoy-2-amonindane (MDAI), which have similar biological effects to MDMA. In spite of the unknown risk factors associated with these substances, it is believed that “legal highs” continue to have high levels of interest among recreational users. As such, the potential for abuse is high, and 5-IAI and MDAI are under consideration in numerous jurisdictions for regulation. Many of these novel compounds have never been analyzed previously within a forensic setting. The chemical and physical properties of 5-IAI and MDAI are not fully understood. As a result, the analytical analysis of “legal highs” can be challenging. Color test kits provide a quick screening method for law enforcement officials looking to presumptively identify a substance in the field. The difficulty with this form of analysis is that most of the active ingredients present in “legal highs” are not detected by standard presumptive tests, or the results when the tests are used are ambiguous. Gas chromatography-mass spectrometry (GC-MS) is one of the most utilized analytical instruments in forensic laboratories for the identification of drugs of abuse. However, due to the rapid development and commercialization of “legal highs,” the limited availability of certified reference standards and mass spectral data make the confirmatory analysis of “legal highs” challenging. The primary aims of this research were two-fold. The first was to evaluate selected commercially available Narcotics Analysis Reagent Kits (NARK® II) and color reagent formulations recommended by the National Institute of Justice (Color Tests Reagents/ Kits for Preliminary Identification of Drugs of Abuse) to determine if the phenylalkylamine analogues 5-IAI and MDAI generate a color development. If a color was generated using a particular reagent, further testing was conducted to establish if the observed color would be detectable in the presence of various adulterants. The second aim of this research was to develop a rapid GC-MS method for the detection of 5-IAI and MDAI in contrived multi-component mixtures of selected adulterants. Standard color tests provided consistent results for 5-IAI and MDAI pure samples as well as mixtures with adulterants. 5-IAI produced a light brown color with both the Marquis and the methylenedioxypyrovalerone (MDPV) color reagent tests. The Mandelin reagent from the NARK® II test kit produced a greenish brown color and a light green color with the In-House preparations of the same reagent when tested with MDAI. Confirmatory analysis was performed using GC-MS with a temperature gradient. The analysis was performed on a non- polar (5% phenyl) methylpolysiloxane column with a total run time of 10 minutes. 5-IAI and MDAI were chromatographically separated and distinguishable from various adulterants based on retention time and mass to charge ratio.

The quantitative analysis of environmental and toxicological samples must be reliable, rapid, and in some cases field portable. In the United States, the employment of chemical weapons by rogue states and/or terrorist organizations is an ongoing concern. Nerve agent degradative products (methylphosphonic acid) as well as surrogates (glyphosate) must be detected at low quantities in various water matrices. Current methods involve tedious and time-consuming derivatizations for gas chromatography-mass spectrometry and liquid chromatography in tandem with mass spectrometry. Two solid phase extraction (SPE) techniques for the analysis of glyphosate and methylphosphonic acid are described with the utilization of isotopically enriched analytes for quantitation using atmospheric pressure chemical ionization-quadrupole-time of flight-mass spectrometry (APCI-Q-TOF-MS) that does not require derivatization. <br>The use of illicit drugs is also an increasing problem in the United States. Toxicological analysis of illicit drugs is important for death investigation as well as in the treatment of individuals who abuse and misuse drugs. This dissertation describes a newly developed analytical method for the simultaneous quantitative analysis of heroin, 6-acetylmorphine, morphine, cocaine, codeine, methadone, and fentanyl in synthetic urine. The resolution of an electrospray ionization-time of flight-mass spectrometer (ESI-TOF-MS) was utilized for simultaneous analysis of the drugs after extraction from urine using two newly developed SPE procedures. <br>The first SPE technique described in this dissertation is solid phase extraction-isotope dilution mass spectrometry (SPE-IDMS). It involves applying EPA Method 6800 in which a naturally occurring sample is pre-equilibrated with an isotopically enriched standard prior to SPE. The second extraction method, i-Spike, involves loading an isotopically enriched standard onto a SPE column independently from the naturally occurring sample. The sample and the spike are then co-eluted from the column enabling precise and accurate quantitation by molecular IDMS calculations. The SPE methods, in conjunction with IDMS, eliminate concerns of incomplete elution, matrix and sorbent effects, and MS drift. For accurate quantitation with IDMS, the isotopic contribution of all atoms in the target molecule must be statistically taken into account. This dissertation describes two newly developed sample preparation techniques for the analysis of environmental and toxicological samples as well as statistical probability analysis for accurate molecular IDMS. / Bayer School of Natural and Environmental Sciences / Chemistry and Biochemistry / PhD / Dissertation

The primary motivation behind this thesis was to examine how illicit drugs represent a multidimensional threat to the security of Pacific island states and the region as a whole. However, this research was presented with significant challenges before it began, which included the illegality of the subject matter, the confidentiality of law enforcement intelligence and the fact that there was a near total absence of academic research and statistics concerning drugs within the region. In order to overcome these challenges, this thesis blends a synthesis of conflict and security literature, reports from international and non-governmental organisations and the concepts of securitisation developed by Barry Buzan, Ole Waever & Jaap de Wilde in Security: A Framework for Analysis (1998). The domestic environment of the states that form the case studies are examined, the negative influences of drugs are presented and the perceptions and responses of the governments are discussed. Furthermore, the comparative aspect of this thesis, where two case studies are drawn from the Caribbean, Jamaica and Haiti, and two from the Pacific, Papua New Guinea and Fiji, ensures a thorough understanding of the complex challenges posed to state security, and provides a window for examining how states with similar characteristic and weaknesses are threatened by drugs. For example, throughout Papua New Guinea, marijuana has facilitated the acquisition of small arms and light weapons by both criminal groups and villages involved in conflict. In Fiji, there is the potential for the trafficking of drugs to destabilise the state by providing support to criminal groups and those currently involved with transnational criminal activities. This thesis concludes that the cultivation, production and trafficking of illicit drugs present an immediate and long-term threat to the Pacific, and that the security architecture for the region must be enhance to combat this formidable threat.

Approximately 200 million people, 5% aged 15-64 worldwide are illicit drug or substance abusers (World Drug Report, 2006). Between 2002 and 2005, an average of 8.2% of 12 year olds and older in the Miami, Fort Lauderdale metropolitan areas used illicit drugs (SAMHSA, 2007). Eight percent of pregnant women, aged 15 to 25, were more likely to have used illicit drugs during pregnancy than pregnant women aged 26 to 44. Alcohol use was 9.8% and cigarette use was 18% for pregnant women aged 15 to 44 (SAMHSA, 2005). Approximately a quarter of annual birth defects are attributed to the exposure of drugs or substance abuse in utero (General Accounting Office, 1991). Physical, psychological and emotional challenges may be present for the illicit drug/substance abuse (ID/SA) mother and infant placing them at a disadvantage early in their relationship (Shonkoff & Marshall, 1990). Mothers with low self efficacy have insecurely attached infants (Donovan, Leavitt, & Walsh, 1987). As the ID/SA mother struggles with wanting to be a good parent, education is needed to help her care for her infant. In this experimental study residential rehabilitating ID/SA mothers peer taught infant massage. Massage builds bonding/attachment between mother and infant (Reese & Storm, 2008) and peer teaching is effective because participants have faced similar challenges and speak the same language (Boud, Cohen, & Sampson 2001). Quantitative data were collected using the General Self-Efficacy and Maternal Attachment Inventory-Revised Scale before and after the 4-week intervention program. A reported result of this study was that empowering ID/SA mothers increased their self-efficacy, which in turn allowed the mothers to tackle challenges encountered and created feelings of being a fit mother to their infants. This research contributes to the existing database promoting evidence-based practice in drug rehabilitation centers. Healthcare personnel, such as nurse educators and maternal-child health practitioners, can develop programs in drug rehabilitation centers that cultivate an environment where the ID/SA rehabilitating mothers can peer teach each other, while creating a support system. Using infant massage as a therapeutic tool can develop a healthy infant and nurture a more positive relationship between mother and infant.

Globally, approximately 208 million people aged 15 and older used illicit drugs at least once in the last 12 months; 2 billion consumed alcohol and tobacco consumption affected 25% (World Drug Report, 2008). In the United States, 20.1 million (8.0%) people aged 12 and older were illicit drug users, 129 million (51.6%) abused alcohol and 70.9 million (28.4%) used tobacco (SAMHSA/OAS, 2008).Usually considered a problem specific to men (Lynch, 2002), 5.2% of pregnant women aged 15 to 44 are also illicit drug and substance abusers (SAMHSA/OAS, 2007). During pregnancy, illicit drugs and substance abuse (ID/SA) can significantly affect a woman and her infant contributing to developmental and communication delays for the infant and influencing parenting abilities (Budden, 1996; March of Dimes, 2006b; Rossetti, 2000). Feelings of guilt and shame and stressful experiences influence approaches to parenting (Ashley, Marsden, & Brady, 2003; Brazelton, & Greenspan, 2000; Ehrmin, 2000; Johnson, & Rosen, 1990; Kelley, 1998; Rossetti, 2000; Velez et al., 2004; Zickler, 1999). Parenthood is an expanded role that can be a trying time for those lacking a sense of self-efficacy and creates a high vulnerability to stress (Bandura, 1994). Residential treatment programs for ID/SA mothers and their children provide an excellent opportunity for effective interventions (Finkelstein, 1994; Social Care Institute for Excellence, 2005). This experimental study evaluated whether teaching American Sign Language (ASL) to mothers living with their infants/children at an ID/SA residential treatment program increased the mothers’ self-efficacy and decreased their anxiety. Quantitative data were collected using the General Self-Efficacy Scale and the State-Trait Anxiety Inventory showing there was both a significant increase in self efficacy and decrease in anxiety for the mothers. This research adds to the knowledge base concerning ID/SA mothers’ caring for their infants/children. By providing a simple low cost program, easily incorporated into existing rehabilitation curricula, the study helps educators and healthcare providers better understand the needs of the ID/SA mothers. This study supports Bandura’s theory that parents who are secure in their efficacy can navigate through the various phases of their child’s development and are less vulnerable to stress (Bandura, 1994).

In this experiment, more than one hundred volatile organic compounds were analyzed with the gas chromatograph. Six capillary columns ZB wax plus, ZB 35, TR1MS, TR5, TG5MS and TG1301MS with different polarities have been used for separation of compounds and illicit drugs. The Abraham solvation model has five solute descriptors. The solute descriptors are E, S, A, B, L (or V). Based on the six stationary phases, six equations were constructed as a training set for each of the six columns. The six equations served to calculate the solute descriptors for a set of illicit drugs. Drugs studied are nicotine (S= 0.870, A= 0.000, B= 1.073), oxycodone(S= 2.564. A= 0.286, B= 1.706), methamphetamine (S= 0.297, A= 1.570, B= 1.009), heroin (S=2.224, A= 0.000, B= 2.136) and ketamine (S= 1.005, A= 0.000, B= 1.126). The solute property of Abraham solvation model is represented as a logarithm of retention time, thus the logarithm of experimental and calculated retention times is compared.

Bakgrund: Många människor är fördomsfulla mot patienter som har ett narkotikamissbruk. Patienter med narkotikamissbruk uttrycker att de blir behandlade annorlunda av sjuksköterskor inom vården -att de blir placerade i fack, bortprioriterade, ignorerade samt får sämre vård. Sjuksköterkors förhållningssätt beskrivs innehålla en drivkraft och ett gediget engagemang för patienter som missbrukar narkotika.  Syfte: Att beskrivasjuksköterskors erfarenheter av att vårda patienter med narkotikamissbruk.  Metod: I litteraturöversikten användes totalt 10 vårdvetenskapliga artiklar. Artiklarna hämtades från databaserna Academic Search Complete, CINAHL Complete och PsycInfo där sökorden som använts bland annat var ”nurse” ”substance abuse” och ”experiences”.Fribergs (2012) analysmetod har använts för att analysera de vårdvetenskapliga artiklarna.Den teoretiska referensramen som använts är Katie Erikssons caritativa vårdteori. Resultat: Resultatet visade sig i tre huvudteman och tre subteman. I det första temat ”Hur sjuksköterskor förhåller sig till vårdandet av narkotikamissbrukare” uppkom tre subteman; ”Sjuksköterskors attityder och fördomar” samt ”Stress & manipulation som hinder i vårdandet”. Under det huvudtemat beskrivs hur sjuksköterskors attityder och fördomar kan påverka den vården de ger till narkotikamissbrukare. I det andra temat ”Vad utbildning och kunskap har för betydelse i vårdandet” beskrivs det hur sjuksköterskor erfarit att deras brist på utbildning påverkat vårdandet och även varför god kompetens är betydelsefull. I det sista huvudtemat ”Oro, rädsla och ångest” belyses bland annat sjuksköterskors oro/rädsla för att vårda dessa patienter av olika anledningar. Diskussion: I diskussionsdelen belyser författarna de mest framträdande delarna i resultatdelen tillsammans med Katie Erikssons caritativa vårdteori. Sjuksköterkornas attityder/fördomar, misstro/manipulation samt utbildning diskuteras i förhållande till författarnas tankar, litteraturöversiktens bakgrund / Background: People are often prejudiced towards people with a substance abuse. Patients with a substance abuse express that nurses seems to care for them differently than with other patients –they feel like they’re being stigmatized, not being prioritized, ignored and that they receive less care than others. Commitment and urge are two components that should be contained in the nurses’ approach towards patients with substance abuse.   Aim: The aim of this study was to describenurses’ experiences of caring for patients with substance abuse.  Method: This litterature review was based on ten scientific articles. The articles were obtained from the databases Academic Search Complete, CINAHL Complete and PsycInfo. Some of the keywords that were used in the research were “nurse”, “substance abuse” and “experiences”.To analyse the articles we have used Fribergs (2012) method.The theoretical framework that was used in this literature review was Katie Erikssons caritative theory.  Results: The results of this litterature review show three main themes and two subthemes. The first theme “How nurses treat the substance abusers while they care for them”, include two subthemes “Nurses’ attitudes and prejudiced actions” and “How stress and manpulation can affect the care”. The theme highlights how nurses’ attitudes and prejudices affect the care they’re giving. The secondtheme, “The importance of education and knowledge in the care of patients who suffers from substance abuse”, describes nurses’ experiences of how their lack of education affects the care they’re giving and why it’s important to have good competence. The last theme “Worries, fears and anxiety” illuminates different reasons to why the nurses have these types of feelings when they’re caring for patients with a substance disorder.  Discussion: The discussion highlights the most outstanding parts of the result in association with Katie Erikssons caritative theory. Nurses’ attitudes/prejudices, distrust/manipulation and the importance of education are discussed in relation the authors’ thoughts, the background of the literature review and the theoretical frame.

Background: The adverse effects of mechanical ventilation (MV) are a major health concern associated with poor outcomes and economic burden. Some populations, such as those requiring more than one attempt at the gradual removal of MV (weaning), are at risk for longer duration of MV and associated complications. Traumatically injured patients have a higher prevalence of positive illicit drug toxicology then the general population. The traumatically injured, positive for illicit drugs who requires MV, may experience the sequelae of withdrawal syndrome and violate the thresholds that allow weaning, leading to longer durations MV. Methods: A retrospective descriptive analysis of a convenience sample of 52 adult trauma patients from SJHMC admitted between January 1 to December 31, 2014 who presented positive for illicit drugs and required mechanical ventilation. This sample was analyzed to: 1) describe the characteristics of this specific sample, 2) determine the prevalence of a difficult-to-wean subsample, 3) describe the characteristics of this sample during weaning attempts, and 4) determine if the existing weaning protocol necessitates amending. Results: Samples ability to wean; 78.8% (n=41) simple weaning; 15.38% (n=8) difficult weaning; and 5.77% (n=3) prolonged. Zero cases of adverse effects of MV or withdrawal syndrome detected. There was no correlation between stimulant and/or depressant and ability to wean (p=0.662). There was no relationship between injury severity score (ISS) and weaning group (p=0.762). Characteristics identified included; male to female ratio 4:1 and majority with ISS score>24. Variables within weaning protocol were missing 25-84% of data. Conclusion: The ability to wean MV in this sample is similar to what is reported in the general population, suggesting that they are not at risk for difficult weaning or prolonged MV. This sample’s majority was comprised of more traumatically complex, young males than found in the general trauma population. Investigators were unable to analyze or amend the current protocol because of the large amounts of missing data indicating possible gaps in adherence and/or documentation. To our knowledge, this is the first project that describes ability to wean in the traumatically injured positive for illicit drug.