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The applicant's research has led to a substantial body of published work and 17 pieces from this work are submitted here. Of these, eight are in peer refereed journals testifying to the importance of the body of work submitted. The work has attracted external funding of £73,000 from North West Thames Regional Health Authority which attests further to the quality of the work undertaken. In addition the applicant's expertise in the area has been recognised internationally by her appointments as World Health Organisation Advisor (Guidelines on Counselling of HIV Infected and AIDS Patients; Intravenous Drug Use and Risk of HIV Infection) and as UK representative to the Commission of the European Communities (Prevention of AIDS for Intravenous Drug Users) and she has presented evidence to a Home Office Working Party (Advisory Council on the Misuse of Drugs) and acted as academic referee for several academic journals including AIDS, AIDS Care, and Addiction. The submitted research publications are based upon five studies drawing upon 623 injecting drug users (idus) surveyed between 1985 and October 1992. The demographic characteristics of the clients included in each of the studies did not vary substantially between studies. Three of the studies involved evaluation of interventions for harm minimisation and two of those included designs of innovative interventions. The remaining two were aimed at identifying trends in risk - related behaviours and risk reduction. The body of work with its regular data collection over a seven year period from one location in the UK charts the behavioural changes and service responses from a point in time when AIDS awareness among idus was virtually non-existent through the response to the awareness of risks of sharing injecting equipment, followed by the introduction of needle exchange schemes and their evaluation, awareness of sexual transmission risks and need for sexual counselling, provides a unique perspective. The first and the final study had longitudinal components but the over all behavioural and attitudinal trends are identified from cross-sectional data. The approach taken by the research was to place risk-related behaviours within a context of the idus' social lifestyles rather than isolating behaviours from the contexts in which they occur. This approach contrasts with the individualistic social-cognitive models that have been used by others rather unsuccessfully to try to account for health related risk behaviours. The aims of the research were to obtain accurate information about the behaviours of idus with specific reference to HIV transmission related behaviours especially injecting practices and sexual behaviours by (1) identifying the characteristics of idus attending a drug dependency unit and/or syringe exchange unit in Central London (2) examining the sexual and drug-related behaviours of clients attending those services and their risks for HIV infections.

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Approximately 10% of women use cocaine and 20% smoke cigarettes during pregnancy. Animal studies indicate that both cocaine and nicotine are neuroteratogenic agents, although findings with humans are inconsistent. Studies with human infants have been plagued by unreliable subject identification procedures, poor control over confounding factors, and invalid measures of CNS integrity. The literature on prenatal cocaine and nicotine use is reviewed and two studies are presented along with an intriguing case report. The effects of maternal prenatal cocaine use (Study 1) and two levels of cigarette smoking (Study 2) on newborn information processing ability were examined using an auditory habituation-recovery paradigm. Case-control designs were employed in which subjects were individually matched on a number of maternal and infant factors. Cocaine exposure was determined by newborn meconium analysis, urine analysis, and maternal self-report. Maternal smoking was determined by self-report and a variation of the bogus pipeline method. Fetal cocaine- and nicotine-exposure were associated with differential impairments in neonatal information processing. Cocaine-exposed newborns exhibited deficits on measures of habituation and recovery to novelty. Dose-response effects of nicotine-exposure were evident on measures of orientation and habituation, but recovery to novelty was not consistently affected. The results imply that fetal cocaine-exposure severely impairs neonatal auditory information processing ability, whereas fetal tobacco-exposure is associated with deficits in information-processing which may be secondary to impairments in arousal regulation. These auditory processing deficits may be related to the later language impairments reported in follow-up studies with cocaine-and tobacco-exposed infants. Following the two studies, a case is presented of an infant born to a woman who reported using large amounts of cocaine throughout pregnancy, although the infant's meco

<p>This study presents a discursive journey with regard to the risk and protective factors confronting individuals who engage in methamphetamine use within the Manenberg area. Given that this journey requires a cautious and sensitive approach to the meaning making of the lived experiences of the six (6) individual users (the informant base) / the study adopted an analysis process that would allow for a guided &ldquo / tour&rdquo / of these experiences. In doing so, the study made use of the grounded theory method that allowed for this guided &ldquo / tour&rdquo / to be fully anchored in the collected data. External to this data, and once the data emerged as engageable themes, the study introduced, relevantly so, Bronfenbrenner&rsquo / s social-ecological model of human development, so to multiply and deepen the meanings embedded within the data. The merging of this external frame, provided by Bronfenbrenner&rsquo / s model, and the rich data provided by the six (6) informants, uncovered critical themes in understanding the risk and protective factors at play within Manenberg. These themes relate to the historical identity of Manenberg, given the history of Apartheid, the role of the local community and its perceived tolerance of the practice of drug use, which is further echoed in the identity of the family and its limited ability to support drug users in the face of ever-growing poverty. The themes also uncovered the bipolarity in the practice of drug trade and gangsterism as serving a subsistence function, at one level, and an exploitative function at another. Furthermore, the study solidified traditional views that the peer collective is, indeed, a critical actor on the stage of drug use and that the individual (as an actor) continues to be confronted by a script of poverty and disillusionment. This script, as will be illustrated, is also active in preconceived notions of gender stratification.</p>

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

The purpose of the study was to gather and analyze data concerning the implementation of drug education programs in fourteen selected Indiana senior high schools. The study focused on several aspects of the drug education programs including the description of the type of program; the determination of need for the program; school policies related to student drug abusers; in-service training programs for teachers; school-community drug programs; evaluation techniques; and the role of the high school principal in planning, implementing, and evaluating drug education programs.

Rationale and objectives: Alcohol and nicotine are the most commonly abused drugs and they are often taken together. To help address some of clinical issues regarding nicotine and alcohol co-dependence, a procedure in which rats self-administer nicotine intravenously and alcohol orally during the same operant session has been developed. Methods: Male Wistar rats were trained to self-administer alcohol (12%, w/v; 0.19 ml/delivery) or implanted with jugular catheters and trained to self-administer nicotine (30 μg/kg IV/infusion) by pressing a lever or were trained to self-administer both drugs, some with alcohol first, and others with nicotine first. Results: Animals readily coadministered alcohol and nicotine concurrently. Access to alcohol reduced nicotine selfadministration significantly. Conclusions: These results show that rats will self-administer relevant amounts of intravenous nicotine and oral alcohol concurrently. They also provide further support for the important relationship between nicotine and alcohol.

Rationale and objectives: Alcohol and nicotine are the most commonly abused drugs and they are often taken together. To help address some of clinical issues regarding nicotine and alcohol co-dependence, a procedure in which rats self-administer nicotine intravenously and alcohol orally during the same operant session has been developed. Methods: Male Wistar rats were trained to self-administer alcohol (12%, w/v; 0.19 ml/delivery) or implanted with jugular catheters and trained to self-administer nicotine (30 μg/kg IV/infusion) by pressing a lever or were trained to self-administer both drugs, some with alcohol first, and others with nicotine first. Results: Animals readily coadministered alcohol and nicotine concurrently. Access to alcohol reduced nicotine selfadministration significantly. Conclusions: These results show that rats will self-administer relevant amounts of intravenous nicotine and oral alcohol concurrently. They also provide further support for the important relationship between nicotine and alcohol.

Thesis (MPsy(Clinical))--University of South Australia, 1999.