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Experiences of Disengagement from Mental Health Services: an Interpretative Study
EXPERIENCES OF DISENGAGEMENT FROM MENTAL HEALTH SERVICES: AN INTERPRETATIVE STUDY by CHRISTOPHER WAGSTAFF A thesis submitted to the University of Birmingham for the degree of DOCTOR OF PHILOSOPHY Nursing, Health & Population Sciences College of Medical & Dental Sciences University of Birmingham 2015 University of Birmingham Research Archive e-theses repository This unpublished thesis/dissertation is copyright of the author and/or third parties. The intellectual property rights of the author or third parties in respect of this work are as defined by The Copyright Designs and Patents Act 1988 or as modified by any successor legislation. Any use made of information contained in this thesis/dissertation must be in accordance with that legislation and must be properly acknowledged. Further distribution or reproduction in any format is prohibited without the permission of the copyright holder. ABSTRACT Whilst there is evidence of a range of effective treatments available for people with severe mental health problems (SMHP), people frequently disengage from mental health services (MHS). This thesis investigates experiences of disengagement of people with SMHP and comprises two studies: 1) semi-structured interviews to elicit the experiences of people with SMHP and a history of disengagement from MHS; and 2) building on those findings, focus groups with staff from assertive outreach teams (specialising in providing care for people with SMHP and a history of disengagement). The participants were those perceived as the most disengaged from MHS yet they were willing to engage with the research. Interpretative phenomenological analysis was used to develop themes for individual participants and then across the participants. Disengagement from MHS was part of a wider experience of a limited connection to social structures, including an ambivalent and complex relationship with MHS. -
Hallucinogens - LSD, Peyote, Psilocybin, and PCP
Hallucinogens - LSD, Peyote, Psilocybin, and PCP Hallucinogenic compounds found in some • Psilocybin (4-phosphoryloxy-N,N- plants and mushrooms (or their extracts) dimethyltryptamine) is obtained from have been used—mostly during religious certain types of mushrooms that are rituals—for centuries. Almost all indigenous to tropical and subtropical hallucinogens contain nitrogen and are regions of South America, Mexico, and classified as alkaloids. Many hallucinogens the United States. These mushrooms have chemical structures similar to those of typically contain less than 0.5 percent natural neurotransmitters (e.g., psilocybin plus trace amounts of acetylcholine-, serotonin-, or catecholamine- psilocin, another hallucinogenic like). While the exact mechanisms by which substance. hallucinogens exert their effects remain • PCP (phencyclidine) was developed in unclear, research suggests that these drugs the 1950s as an intravenous anesthetic. work, at least partially, by temporarily Its use has since been discontinued due interfering with neurotransmitter action or to serious adverse effects. by binding to their receptor sites. This DrugFacts will discuss four common types of How Are Hallucinogens Abused? hallucinogens: The very same characteristics that led to • LSD (d-lysergic acid diethylamide) is the incorporation of hallucinogens into one of the most potent mood-changing ritualistic or spiritual traditions have also chemicals. It was discovered in 1938 led to their propagation as drugs of abuse. and is manufactured from lysergic acid, Importantly, and unlike most other drugs, which is found in ergot, a fungus that the effects of hallucinogens are highly grows on rye and other grains. variable and unreliable, producing different • Peyote is a small, spineless cactus in effects in different people at different times. -
Anaesthesia and Past Use Of
177 Correspondence were using LSD. It is more popular than other commonly Anaesthesia and past use of used hallucinogens whose quoted incidence of clients are: LSD ketamine 0.1% (super-K/vitamin K.I), psilocybin and psilocin 0.6% (the active alkaloids in the Mexican "magic To the Editor: mushroom"), and 3,4 methylenedioxymethamphetamine We report the case of a 43-yr-old lady who was admitted ~MDMA" 1% (ecstasy). The effects of the concurrent to the Day Surgery Unit for release of her carpal tunnel ingestion of LSD on anaesthesia are well described. 2-4 retinaculum. During the preoperative visit, she reported The long-term effects of the past use of LSD are largely no intercurrent illnesses, drug therapy or allergies. She unknown. We wonder if the hallucinations experienced did say, however, that she was frightened of general anaes- by our patient during anaesthesia were due to her LSD thesia, since she had experienced terrifying dreams during intake many years before. We would be interested to surgery under general anaesthesia on three occasions dur- know if others have had experience anaesthetising patients ing the previous ten years. On further questioning, she who are past users of phencyclidine-derived drugs. admitted that she had used lysergic acid diethylamide (LSD) during the late 1960's, the last occasion being 1968 Geoffrey N. Morris MRCGPFRCA when she had experienced characterstic hallucinations. Patrick T. Magee MSe FRCA She had not experienced hallucinations in the ensuing Anaesthetic Department years, except on the surgical occasions mentioned. Royal United Hospital One of the three previous operations had been per- Combe Park formed at our hospital and the anaesthetic record was Bath BA1 3NG checked. -
Precursors and Chemicals Frequently Used in the Illicit Manufacture of Narcotic Drugs and Psychotropic Substances 2017
INTERNATIONAL NARCOTICS CONTROL BOARD Precursors and chemicals frequently used in the illicit manufacture of narcotic drugs and psychotropic substances 2017 EMBARGO Observe release date: Not to be published or broadcast before Thursday, 1 March 2018, at 1100 hours (CET) UNITED NATIONS CAUTION Reports published by the International Narcotics Control Board in 2017 The Report of the International Narcotics Control Board for 2017 (E/INCB/2017/1) is supplemented by the following reports: Narcotic Drugs: Estimated World Requirements for 2018—Statistics for 2016 (E/INCB/2017/2) Psychotropic Substances: Statistics for 2016—Assessments of Annual Medical and Scientific Requirements for Substances in Schedules II, III and IV of the Convention on Psychotropic Substances of 1971 (E/INCB/2017/3) Precursors and Chemicals Frequently Used in the Illicit Manufacture of Narcotic Drugs and Psychotropic Substances: Report of the International Narcotics Control Board for 2017 on the Implementation of Article 12 of the United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances of 1988 (E/INCB/2017/4) The updated lists of substances under international control, comprising narcotic drugs, psychotropic substances and substances frequently used in the illicit manufacture of narcotic drugs and psychotropic substances, are contained in the latest editions of the annexes to the statistical forms (“Yellow List”, “Green List” and “Red List”), which are also issued by the Board. Contacting the International Narcotics Control Board The secretariat of the Board may be reached at the following address: Vienna International Centre Room E-1339 P.O. Box 500 1400 Vienna Austria In addition, the following may be used to contact the secretariat: Telephone: (+43-1) 26060 Fax: (+43-1) 26060-5867 or 26060-5868 Email: [email protected] The text of the present report is also available on the website of the Board (www.incb.org). -
Substance Abuse: the Pharmacy Educator’S Role in Prevention and Recovery
Substance Abuse: The Pharmacy Educator’s Role in Prevention and Recovery Curricular Guidelines for Pharmacy: Substance Abuse and Addictive Disease i Curricular Guidelines for Pharmacy: Substance Abuse and Addictive Disease1,2 BACKGROUND OF THE CURRICULUM DEVELOPMENT PROJECT In 1988, the AACP Special Interest Group (SIG) on Pharmacy Student and Faculty Impairment (renamed Substance Abuse Education and Assistance) undertook the development of curricular guidelines for colleges/schools of pharmacy to facilitate the growth of educational opportunities for student pharmacists. These Curricular Guidelines for Pharmacy Education: Substance Abuse and Addictive Disease were published in 1991 (AJPE. 55:311-16. Winter 1991.) One of the charges of the Special Committee on Substance Abuse and Pharmacy Education was to review and revise the 1991 curricular guidelines. Overall, the didactic and experiential components in the suggested curriculum should prepare the student pharmacist to competently problem-solve issues concerning alcohol and other drug abuse and addictive diseases affecting patients, families, colleagues, themselves, and society. The guidelines provide ten educational goals, while describing four major content areas including: psychosocial aspects of alcohol and other drug use; pharmacology and toxicology of abused substances; identification, intervention, and treatment of people with addictive diseases; and legal/ethical issues. The required curriculum suggested by these guidelines addresses the 1 These guidelines were revised by the AACP Special Committee on Substance Abuse and Pharmacy Education. Members drafting the revised guidelines were Edward M. DeSimone (Creighton University), Julie C. Kissack (Harding University), David M. Scott (North Dakota State University), and Brandon J. Patterson (University of Iowa). Other Committee members were Paul W. Jungnickel, Chair (Auburn University), Lisa A. -
Substance Abuse and Dependence
9 Substance Abuse and Dependence CHAPTER CHAPTER OUTLINE CLASSIFICATION OF SUBSTANCE-RELATED THEORETICAL PERSPECTIVES 310–316 Residential Approaches DISORDERS 291–296 Biological Perspectives Psychodynamic Approaches Substance Abuse and Dependence Learning Perspectives Behavioral Approaches Addiction and Other Forms of Compulsive Cognitive Perspectives Relapse-Prevention Training Behavior Psychodynamic Perspectives SUMMING UP 325–326 Racial and Ethnic Differences in Substance Sociocultural Perspectives Use Disorders TREATMENT OF SUBSTANCE ABUSE Pathways to Drug Dependence AND DEPENDENCE 316–325 DRUGS OF ABUSE 296–310 Biological Approaches Depressants Culturally Sensitive Treatment Stimulants of Alcoholism Hallucinogens Nonprofessional Support Groups TRUTH or FICTION T❑ F❑ Heroin accounts for more deaths “Nothing and Nobody Comes Before than any other drug. (p. 291) T❑ F❑ You cannot be psychologically My Coke” dependent on a drug without also being She had just caught me with cocaine again after I had managed to convince her that physically dependent on it. (p. 295) I hadn’t used in over a month. Of course I had been tooting (snorting) almost every T❑ F❑ More teenagers and young adults die day, but I had managed to cover my tracks a little better than usual. So she said to from alcohol-related motor vehicle accidents me that I was going to have to make a choice—either cocaine or her. Before she than from any other cause. (p. 297) finished the sentence, I knew what was coming, so I told her to think carefully about what she was going to say. It was clear to me that there wasn’t a choice. I love my T❑ F❑ It is safe to let someone who has wife, but I’m not going to choose anything over cocaine. -
Aphrodisiac Herbal Therapy for Erectile Dysfunction
Original Article Aphrodisiac Herbal therapy for Erectile Dysfunction Bharti Goel1, Neelesh Kumar Maurya2* 1Research Scholar Department of Foods and Nutrition, Government Home Science College, Panjab University, Chandigarh, India. 2 Research Scholar, Department of Foods and Nutrition, Institute of Home Science, Bundelkhand University, Jhansi, Uttar Pradesh, India. Abstract Erectile dysfunction (ED) or male impotence is described as an inability to maintain penile erection primarily endothelial and neuronal dysfunction which is partly characterized by decreased production of nitric oxide (NO). Male impotence can be caused by androgen deficiency in aging men, atherosclerosis, diabetes mellitus, spinal cord injury, high level of cholesterol, hypertension, prostate surgery, prostate and heart disease, penis anatomical deformity, social and psychological conditions as unhappy marital relationship, depression, and stress. Aphrodisiac is a drink or food that arouse sexuality. It can be categorized into three groups according to their action mode as follows: increase sexual pleasure substances, increase libido substances (arousal, sexual desire), and increase sexual potency (erection effectiveness). Various extracts of medicinal plants and orally active drugs such as vardenafil, sildenafil, and tadalafil are used to increase arterial blood flow for treating (ED) in southwest Asia. Hence, this paper review focuses on medicinal plants used as aphrodisiacs for scientific validation and management of erectile dysfunction (ED). Keywords: Aphrodisiacs, herbal plants, erectile dysfunction, penile erection INTRODUCTION care providers, testosterone replacement therapy for aging men has been practiced for many years but if the patient has Erectile dysfunction (ED) is a neurovascular condition that no clinical signs of androgen deficiency then testosterone involves endothelium of the corpora cavernosal arterial blood replacement therapy will have no clinical effect [13, 14]. -
Understanding Solvents: Part I
Understanding Solvents: Part I Solvents make stains and finishes work. You will never feel really comfortable with finishing until you have an understanding of solvents. Following is an overview of each of the most commonly available solvents. For a deeper understanding that better relates all the finish solvents to each other, see Understanding Solvents, Part II. For an explanation of lacquer thinner, which is composed of about half- a-dozen individual solvents, see Lacquer Thinner. Petroleum Distillates and Turpentine Petroleum distillates are distillations of petroleum. They include mineral spirits (informally referred to as “paint thinner”), naphtha, toluene, xylene and some “turpentine substitutes” such as turpatine and T.R.P.S. Their primary use in wood finishing is for thinning waxes, oils, and varnishes, including polyurethane varnish, and for cleaning brushes. Petroleum distillates are also used to remove oil, grease and wax. Turpentine is a distillation of pine-tree sap. Before the mid-twentieth century, turpentine was widely used as a thinner and clean-up solvent for oil paint and varnish and also as an oil, grease and wax remover. With the growth of the automobile industry and its need for petroleum products, a large number of petroleum solvents were introduced and these have almost entirely replaced turpentine because they are less expensive and have less unpleasant odor. The only sector in which turpentine is still used in any quantity is fine arts. To produce solvents from petroleum, the liquid is heated and gases are taken off and condensed as the temperature increases. The process is called distillation—and thus, petroleum distillates. -
Fuel Properties Comparison
Alternative Fuels Data Center Fuel Properties Comparison Compressed Liquefied Low Sulfur Gasoline/E10 Biodiesel Propane (LPG) Natural Gas Natural Gas Ethanol/E100 Methanol Hydrogen Electricity Diesel (CNG) (LNG) Chemical C4 to C12 and C8 to C25 Methyl esters of C3H8 (majority) CH4 (majority), CH4 same as CNG CH3CH2OH CH3OH H2 N/A Structure [1] Ethanol ≤ to C12 to C22 fatty acids and C4H10 C2H6 and inert with inert gasses 10% (minority) gases <0.5% (a) Fuel Material Crude Oil Crude Oil Fats and oils from A by-product of Underground Underground Corn, grains, or Natural gas, coal, Natural gas, Natural gas, coal, (feedstocks) sources such as petroleum reserves and reserves and agricultural waste or woody biomass methanol, and nuclear, wind, soybeans, waste refining or renewable renewable (cellulose) electrolysis of hydro, solar, and cooking oil, animal natural gas biogas biogas water small percentages fats, and rapeseed processing of geothermal and biomass Gasoline or 1 gal = 1.00 1 gal = 1.12 B100 1 gal = 0.74 GGE 1 lb. = 0.18 GGE 1 lb. = 0.19 GGE 1 gal = 0.67 GGE 1 gal = 0.50 GGE 1 lb. = 0.45 1 kWh = 0.030 Diesel Gallon GGE GGE 1 gal = 1.05 GGE 1 gal = 0.66 DGE 1 lb. = 0.16 DGE 1 lb. = 0.17 DGE 1 gal = 0.59 DGE 1 gal = 0.45 DGE GGE GGE Equivalent 1 gal = 0.88 1 gal = 1.00 1 gal = 0.93 DGE 1 lb. = 0.40 1 kWh = 0.027 (GGE or DGE) DGE DGE B20 DGE DGE 1 gal = 1.11 GGE 1 kg = 1 GGE 1 gal = 0.99 DGE 1 kg = 0.9 DGE Energy 1 gallon of 1 gallon of 1 gallon of B100 1 gallon of 5.66 lb., or 5.37 lb. -
Programme & Abstracts
The 57th Annual Meeting of the International Association of Forensic Toxicologists. 2nd - 6th September 2019 BIRMINGHAM, UK The ICC Birmingham Broad Street, Birmingham B1 2EA Programme & Abstracts 1 Thank You to our Sponsors PlatinUm Gold Silver Bronze 2 3 Contents Welcome message 5 Committees 6 General information 7 iCC maps 8 exhibitors list 10 Exhibition Hall 11 Social Programme 14 opening Ceremony 15 Schedule 16 Oral Programme MONDAY 2 September 19 TUESDAY 3 September 21 THURSDAY 5 September 28 FRIDAY 6 September 35 vendor Seminars 42 Posters 46 oral abstracts 82 Poster abstracts 178 4 Welcome Message It is our great pleasure to welcome you to TIAFT Gala Dinner at the ICC on Friday evening. On the accompanying pages you will see a strong the UK for the 57th Annual Meeting of scientific agenda relevant to modern toxicology and we The International Association of Forensic thank all those who submitted an abstract and the Toxicologists Scientific Committees for making the scientific programme (TIAFT) between 2nd and 6th a success. Starting with a large Young Scientists September 2019. Symposium and Dr Yoo Memorial plenary lecture by Prof Tony Moffat on Monday, there are oral session topics in It has been decades since the Annual Meeting has taken Clinical & Post-Mortem Toxicology on Tuesday, place in the country where TIAFT was founded over 50 years Human Behaviour Toxicology & Drug-Facilitated Crime on ago. The meeting is supported by LTG (London Toxicology Thursday and Toxicology in Sport, New Innovations and Group) and the UKIAFT (UK & Ireland Association of Novel Research & Employment/Occupational Toxicology Forensic Toxicologists) and we thank all our exhibitors and on Friday. -
From Sacred Plants to Psychotherapy
From Sacred Plants to Psychotherapy: The History and Re-Emergence of Psychedelics in Medicine By Dr. Ben Sessa ‘The rejection of any source of evidence is always treason to that ultimate rationalism which urges forward science and philosophy alike’ - Alfred North Whitehead Introduction: What exactly is it that fascinates people about the psychedelic drugs? And how can we best define them? 1. Most psychiatrists will define psychedelics as those drugs that cause an acute confusional state. They bring about profound alterations in consciousness and may induce perceptual distortions as part of an organic psychosis. 2. Another definition for these substances may come from the cross-cultural dimension. In this context psychedelic drugs may be recognised as ceremonial religious tools, used by some non-Western cultures in order to communicate with the spiritual world. 3. For many lay people the psychedelic drugs are little more than illegal and dangerous drugs of abuse – addictive compounds, not to be distinguished from cocaine and heroin, which are only understood to be destructive - the cause of an individual, if not society’s, destruction. 4. But two final definitions for psychedelic drugs – and those that I would like the reader to have considered by the end of this article – is that the class of drugs defined as psychedelic, can be: a) Useful and safe medical treatments. Tools that as adjuncts to psychotherapy can be used to alleviate the symptoms and course of many mental illnesses, and 1 b) Vital research tools with which to better our understanding of the brain and the nature of consciousness. Classifying psychedelic drugs: 1,2 The drugs that are often described as the ‘classical’ psychedelics include LSD-25 (Lysergic Diethylamide), Mescaline (3,4,5- trimethoxyphenylathylamine), Psilocybin (4-hydroxy-N,N-dimethyltryptamine) and DMT (dimethyltryptamine). -
UNJ February 03
Man’s Search for Ultimate Sex: Viagra® Abuse Jeffrey A. Albaugh Susan Kellogg-Spadt n an age when men aspire for “extreme” perfor- mance in all aspects of their lives, sexual per- safe, but encouraged the young man to seek medical formance is no exception. As a result, the drug advice prior to further use. Curiosity about Viagra sildenafil citrate (Viagra®) is being routinely abounds with men wondering about its ability to Iused and abused by men of all ages (who have not improve the quality and rigidity of erections, been diagnosed with erectile dysfunction) to facili- decrease the refractory period after ejaculation, and tate the ultimate sexual experience. Men might use increase libido. Danner (2001) reports that Viagra is this drug to counteract or coincide with other recre- one of the “party drugs” of our times and there are ational drugs, to improve the quality and longevity reports that it is prevalent in British nightclubs and of an already adequate erection, or to shorten the restaurants under the name “poke” (Canadian normal physiologic refractory period between erec- Medical Association, 1998). Widespread Viagra use tions. Although there is no indication or document- is also reported as a trend among gay men in the ed evidence for improved erectile function in party scene (Contemporary Sexuality, 2001; Men’s healthy young men, the use of sildenafil citrate Fitness, 2002). among this population is thought to improve erec- tile longevity and rigidity by these men. Mixing Drugs Man’s search for improved sexual function In recreational use, Viagra is being mixed with would be better served by his learning about the other street drugs such as ecstasy (methylene- arousal response cycle and the type and amount of dioxymethamphetamine), uppers (amphetamines), loveplay that might lead his partner to the greatest crystal methadone, and poppers (amyl nitrate) into level of satisfaction.