The Role of Social Capital in African Americans' Attempts to Reduce and Quit Cocaine Use

BACKGROUND:

Research examining substance users' recovery has focused on individual-level outcomes while paying limited attention to the contexts within which individuals are embedded, and the social processes involved in recovery.

OBJECTIVES:

This paper examines factors underlying African American cocaine users' decisions to reduce or quit cocaine use and uses practice theory to understand how lifestyle changes and shifts in social networks facilitate access to the capital needed to change cocaine use patterns.

METHODS:

The study, an in-depth analysis of substance-use life history interviews carried out from 2010 to 2012, included 51 currently not-in-treatment African American cocaine users in the Arkansas Mississippi Delta region. A blended inductive and deductive approach to data analysis was used to examine the socio-cultural and economic processes shaping cocaine use and recovery.

RESULTS:

The majority of participants reported at least one lifetime attempt to reduce or quit cocaine use; motivations to reduce use or quit included desires to meet social role expectations, being tired of using, and incarceration. Abstinence-supporting networks, participation in conventional activities, and religious and spiritual practices afforded access to capital, facilitating cocaine use reduction and sobriety.

CONCLUSIONS:

Interventions designed to increase connection to and support from nondrug using family and friends with access to recovery capital (e.g., employment, faith community, and education) might be ideal methods to reduce substance use among minorities in low-income, resource-poor communities.

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By:  Cheney AM¹, Booth BM², Borders TF³, Curran GM⁴.

¹ Center for Healthy Communities , University of California Riverside , Riverside , California , USA.

² Division of Health Services Research , University of Arkansas for Medical Sciences , Little Rock , Arkansas , USA.

³ Department of Health Management and Policy , University of Kentucky , Lexington , Kentucky , USA.

⁴ Department of Pharmacy Practice , University of Arkansas for Medical Sciences , Little Rock , Arkansas , USA.

Subst Use Misuse. 2016 Apr 20:1-11.

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"A Day's Work" - How the $100 billion temporary staffing industry is putting millions of American workers at risk

"A Day's Work" (Documentary, 2015) from A Day's Work on Vimeo.


Heard through:  http://goo.gl/DKjrYB

Trajectories of Recovery among Formerly Homeless Adults with Serious Mental Illness

OBJECTIVE:

Recovery from mental illness is possible, but individuals with co-occurring disorders and homelessness face challenges. Although a nonlinear recovery course is assumed, few studies have analyzed recovery over time. This mixed-methods study examined recovery trajectories over 18 months after enrollment in supportive housing programs of 38 participants with DSM axis I diagnoses.

METHODS:

Qualitative interview data were quantified through consensual ratings to generate a recovery score for four waves of data collection based on eight recovery domains culled from the literature. Case study analyses were conducted of participants whose scores varied by one standard deviation or more between baseline and 18 months to identify which domains were important.

RESULTS:

Most of the 38 participants (N=23) had no significant change in recovery; seven had a negative trajectory, and eight had a positive trajectory. Case studies of these 15 participants indicated domains that contributed to change: significant-other relationships (N=9), engagement in meaningful activities (N=9), mental health (N=7), family relationships (N=6), general medical health (N=5), housing satisfaction (N=5), employment (N=2), and substance use (N=1). Except for mental health and substance use (which contributed only to negative trajectories), the influence of domains was both positive and negative. Domains were intertwined; for example, variation in relationships was linked to changes in meaningful activities.

CONCLUSIONS:

This study showed little change in recovery over time for most participants and a decline in mental health for a small minority. Findings underscore the importance of social relationships and meaningful activities among individuals with serious mental illness, who experience complex challenges.

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By:  Padgett DK1, Smith BT1, Choy-Brown M1, Tiderington E1, Mercado M1.

• 1Dr. Padgett, Ms. Choy-Brown, and Dr. Mercado are with the Silver School of Social Work, New York University, New York City (e-mail: dkp1@nyu.edu ). Ms. Smith is with the School of Social Service Administration, University of Chicago, Chicago, Illinois. Dr. Tiderington is with the School of Social Work, Rutgers University, New Brunswick, New Jersey. 
• Psychiatr Serv. 2016 Feb 14:appips201500126. 

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Post-Release Employment of Desisting Inmates

Recent research has questioned the causal effect of employment on desistance from crime. 

The aim of the current study was to examine the post-release employment trajectories of Finnish inmates convicted to prison in 2004–05 (n = 1,998) who are desisting from crime, using varying criteria. 

While a majority of the inmates received some salary from work during the four-year follow-up, the results show that only one tenth of them were able to sustain a continued streak of employment. Instead, the proportion outside of the labour force garew with time from release. 

The results suggest that employment plays a limited role in the desistance processes in the current Finnish context. The potential causes for this finding are discussed, and avenues for future research are proposed.

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By:  Mikko Aaltonen

Mikko Aaltonen, University of Helsinki/Institute of Criminology and Legal Policy, PO Box 10 (Pitkänsillanranta 3 a), 00014 University of Helsinki, Finland; mikko.aaltonen@helsinki.fi.

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Transgender Works: Creating a Transgender-Inclusive Work Place - Video

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Desistance for a Long-Term Drug-Involved Sample of Adult Offenders: The Importance of Identity Transformation

Using a mixed-race sample of male and female drug-involved offenders who were released from prison in the early 1990s and re-interviewed in 2009 through 2011, this article represents perhaps the first attempt to determine the utility of the identity theory of desistance (ITD) in explaining desistance in a contemporary cohort of adult drug-involved offenders. 

Supporting the ITD, interview narratives revealed that the vast majority of offenders who successfully desisted from crime and substance misuse had first transformed their offender identity into a non-offender identity. 

Although partnership and employment did not appear to be significant turning points per se for the majority of our respondents, rekindling relationships with extended family and finding living-wage employment did serve to solidify new prosocial identities once the transformation had occurred.

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By:  Ronet Bachman, University of Delaware

1. Erin Kerrison, University of Pennsylvania
2. Raymond Paternoster, University of Maryland
3. Daniel O’Connell, Lionel Smith, University of Delaware

1. Ronet Bachman, Department of Sociology and Criminal Justice, University of Delaware, Newark, DE 19716; e-mail: ronet@udel.edu.

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Medicaid Expansion Did Not Result In Significant Employment Changes or Job Reductions in 2014

Medicaid expansion undertaken through the Affordable Care Act (ACA) is already producing major changes in insurance coverage and access to care, but its potential impacts on the labor market are also important policy considerations. 

Economic theory suggests that receipt of Medicaid might benefit workers who would no longer be tied to specific jobs to receive health insurance (known as job lock), giving them more flexibility in their choice of employment, or might encourage low-income workers to reduce their hours or stop working if they no longer need employment-based insurance. Evidence on labor changes after previous Medicaid expansions is mixed. 

To view the impact of the ACA on current labor market participation, we analyzed labor-market participation among adults with incomes below 138 percent of the federal poverty level, comparing Medicaid expansion and nonexpansion states and Medicaid-eligible and -ineligible groups, for the pre-ACA period (2005-13) and the first fifteen months of the expansion (January 2014-March 2015). Medicaid expansion did not result in significant changes in employment, job switching, or full- versus part-time status. 

While we cannot exclude the possibility of small changes in these outcomes, our findings rule out the large change found in one influential pre-ACA study; furthermore, they suggest that the Medicaid expansion has had limited impact on labor-market outcomes thus far.

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By:  Gooptu A1, Moriya AS2, Simon KI3, Sommers BD4.

• 1Angshuman Gooptu is a doctoral student in the School of Public and Environmental Affairs at Indiana University, in Bloomington.
• 2Asako S. Moriya (Asako.Moriya@ahrq.hhs.gov) is a service fellow economist in the Center for Financing, Access and Cost Trends at the Agency for Healthcare Research and Quality, in Rockville, Maryland.
• 3Kosali I. Simon is a professor in the School of Public and Environmental Affairs at Indiana University and a research associate at the National Bureau of Economic Research in Cambridge, Massachusetts.
• 4Benjamin D. Sommers is an assistant professor in the Department of Health Policy and Management at the Harvard T.H. Chan School of Public Health and in the Department of Medicine at Brigham and Women's Hospital, in Boston, Massachusetts.
• Health Aff (Millwood). 2016 Jan 1;35(1):111-8. doi: 10.1377/hlthaff.2015.0747. 

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Navigating Barriers to Vocational Rehabilitation for HIV-Positive Persons

This study documented the outcomes of 108 HIV-positive persons receiving vocational rehabilitation services. 

Over a 12-month follow-up, participants reported significantly decreased odds of any unstable housing and increased odds of being employed at least part-time. However, reductions in perceived barriers to employment and increases in income were more pronounced among those not receiving disability benefits at baseline. This was consistent with findings from baseline qualitative interviews with 22 participants where those not on disability were subject to bureaucratic hurdles to rapidly accessing benefits and anticipated stigma of being on disability that propelled them to rejoin the workforce. 

Vocational rehabilitation could address key structural barriers to optimizing HIV treatment as prevention, and novel approaches are needed to improve outcomes among individuals receiving disability benefits.

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By:   Gómez W¹, Flentje A¹, Schustack A², Ramirez-Forcier J², Andrews B², Dilworth SE³, Riley ED⁴, Curotto A³, Carrico AW^5,6.

¹School of Nursing, University of California, San Francisco (https://nursing.ucsf.edu/), 2 Koret Way, N511M, San Francisco, CA, 94143, USA.

²Positive Resource Center, San Francisco, CA, USA.

³Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA, USA.

⁴HIV/AIDS Division, San Francisco General Hospital, University of California, San Francisco, San Francisco, CA, USA.

⁵School of Nursing, University of California, San Francisco, 2 Koret Way, N511M, San Francisco, CA, 94143, USA. adam.carrico@ucsf.edu.

⁶Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA, USA. adam.carrico@ucsf.edu.

AIDS Behav. 2015 Dec 22. [Epub ahead of print]

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A Cross Sectional Study: Knowledge, Attitude, Perception, Misconception & Views (KAPMV) of Adult Family Members of People Living with HIV/AIDS

We intended to assess knowledge, attitude, perception, misconception and views (KAP-MV) of family members of PLWHA. 

A cross-sectional retrospective study conducted in Anti-retroviral centre of Mahatma Gandhi Memorial—MGM hospital, Warangal, Telangana, South-India from July to September 2014. A questionnaire containing 41 items was distributed among adult family members accompanying patients living with HIV/AIDS-PLWHA. Level of KAP-MV was categorized into poor (0–28), average (29–55) and good (56–82). Analysis was performed by Pearson’s Chi square, analysis of variance and Spearman’s correlation test on 41 variables using SPSS version 21 and p < 0.01. 538 questionnaires were distributed, response rate was (96 %). 

On knowledge scale, respondents had a mean score of 8.0 ± 1.7, attitude 5.8 ± 3.4, perception 23.4 ± 4.1, misconceptions 8.0 ± 2.1 and views 8.0 ± 3.9. The respondents mean score was 53.2 ± 9.1 (64.9 %). 

Overall, level of education, marital status, religious beliefs, and employment status has significant (p < 0.001) associations with KAP-MV. Knowledge was significantly correlated with respondents’ attitude (r = −0.15, p < 0.001), perception (0.39; p < 0.001), and views (0.381; p < 0.001). Family members of PLWHA with less knowledge score had more negative attitude, perception and views. Level of education, marital status, religious beliefs and employment status were identified as key barriers. Interventions targeting family members of PLWHA are warranted.

Table 2

Respondents knowledge and attitude about HIV/AIDS in Warangal, South India (n = 515)

	Variables	Correct answer	Correct answers (%)	Wrong answers (%)	Mean ± standard deviation
	General knowledge
1.	AIDS abbreviation	Acquired Immunodeficiency Virus	316 (61.4)a	199 (38.6)	8.01 ± 1.76
2.	AIDS a transmittable disease	Yes	485 (94.2)	30 (5.8)
3.	AIDS a hereditary disease	No	449 (87.2)	66 (12.8)
4.	AIDS cured at this moment	No	454 (88.2)	61 (11.8)
5.	There is a vaccine for AIDS	No	475 (92.2)	40 (7.8)
	Attitudes
6.	Feel comfortable talking with AIDS patients	Yes	277 (53.8)	238 (46.2)	5.80 ± 3.47
7.	Feel comfortable working with AIDS patients	Yes	275 (53.4)	240 (46.6)
8.	Living with AIDS patients in same house	Yes	266 (51.7)a	249 (48.3)
9.	Feel empathy towards AIDS patients	Yes	282 (54.8)	233 (45.2)
10.	AIDS patients deserve free treatment	Yes	394 (76.5)	121 (23.5)
	Perception
11.	Sexual intercourse without a condom with HIV-infected person	Yes	469 (91.1)	46 (8.9)	23.44 ± 4.19
12.	Sharing needle with HIV-infected organ	Yes	499 (96.9)	16 (3.1)
13.	Transfusion of HIV-infected blood or receiving HIV-infected organ	Yes	498 (96.7)	17 (3.3)
14.	Having sex with multiple sexual partners with unknown HIV status	Yes	484 (94.0)	31 (6.0)
15.	From an HIV positive mother to her fetus	Yes	479 (93.0)	36 (7.0)
16.	Sharing personal items such as shaving blades	Yes	438 (85.0)	77 (15.0)
17.	Breast Feeding from a HIV-infected mother	Yes	410 (79.6)	105 (20.4)
18.	Having tattoo or body piercing	No	337 (65.4)	178 (34.6)
19.	Kissing can transmit HIV-infection	No	147 (28.5)a	368 (71.5)
20.	Mosquito bites	No	460 (89.3)	55 (10.7)
21.	Sharing/eating a meal with an HIV-infected person	No	452 (87.8)	63 (12.2)
22.	Sharing water or drinks with an HIV-infected person	No	465 (90.3)	50 (9.7)
23.	Using Public toilets	No	470 (91.3)	45 (8.7)
24.	Casual contacts (hugging or touching) with an HIV-infected person	No	427 (82.9)a	88 (17.1)

aMost wrongly answered

Table 3

Respondents views and misconceptions about HIV/AIDS (n = 515)

	Variables	Correct answer	Correct answers (%)	Wrong answers (%)	Mean ± standard deviation
	Respondents views
25.	Avoid taking illicit drugs/use of intravenous drugs	Yes	477 (92.6)	38 (7.4)	21.00 ± 3.98
26.	By avoiding sharing needles and syringes	Yes	501 (97.3)	14 (2.7)
27.	Having sex with only one faithful, uninfected partner	Yes	494 (95.9)	21 (4.1)
28.	Using condoms during sexual intercourse	Yes	491 (95.3)	24 (4.7)
29.	Treating STDs promptly	Yes	480 (93.2)	35 (6.8)
30.	Screening donated blood before transfusion	Yes	463 (89.9)	52 (10.1)
31.	Not sharing toilets with an infected person	No	411 (79.8)	104 (20.2)
32.	Not sharing food with an infected person	No	431 (83.7)	84 (16.3)
33.	Isolating people living with HIV/AIDS	No	367 (71.3)a	149 (28.7)
34.	Do not stay with infected person on same house	No	448 (87.0)	67 (13.0)
35.	Do not have casual contact with infected person	No	439 (85.2)	76 (14.8)
36.	Avoid mosquito bites for HIV transmission	No	406 (78.8)	109 (21.2)
	Misconceptions
37.	Love is a reason for HIV/AIDS	No	337 (65.4)a	178 (34.6)	8.03 ± 2.19
38.	AIDS is a punishment of God	No	373 (72.4)	142 (27.6)
39.	AIDS can treat by holy water	No	442 (85.8)	73 (14.2)
40.	AIDS do not come after marriage	No	454 (88.2)	61 (11.8)
41.	AIDS can be transmitted by the cough	No	461 (89.5)	54 (10.5)

aMost wrongly answered

Below:

Full article at:   http://goo.gl/ltmOcj

By:   Akshaya Srikanth Bhagavathula, Deepak Kumar Bandari, Asim Ahmad Elnour, Akram Ahmad, Muhammad Umair Khan, Mohamed Baraka, Farah Hamad, and Abdulla Shehab

Department of Clinical Pharmacy, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia

Department of Clinical Pharmacy, Vagdevi College of Pharmacy, Warangal, Telangana India

Pharmacology Department, College of Medicine and Health Sciences, UAE University, Dubai, UAE

Department of Clinical Pharmacy, UCSI University, Cheras, Kuala Lumpur, Malaysia

Department of Clinical Pharmacy, College of Clinical Pharmacy, University of Dammam Eastern Province, Dammam, Kingdom of Saudi Arabia

Department of Pharmaceutics, College of Pharmacy, Ajman University of Sciences and Technology, Ajman, UAE

Internal Medicine Department, College of Medicine and Health Sciences (CMHS), UAE University, Al Ain, UAE

Akshaya Srikanth Bhagavathula, Email: moc.liamg@dmrahpyahska.

  

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