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  • ISSN: 2373-9363
    Early Online
    Volume 6, Issue 1
    Research Article
    Ephrem Desta, Mathiwos Soboka, Desta Workneh, and Bosena Tebeje Gashaw*
    Background: The use of substances, especially by medical interns may have an impact on behavior, safety and efficiency of the future doctors. However, despite a growing number of substance users, little attention has been given by the research community in Ethiopia. This study examined the prevalence of substance use and associated factors among medical intern students.
    Materials and methods: A cross sectional study design was employed in all medical interns of Jimma University enrolled in the year of 2014/2015, using census survey data collection method. Analysis was done using descriptive statistics and chi-square test on SPSS version 20:0 soft ware. P-value less than 0.05 considered statistically significant.
    Results: The life time, in the last 12 months and current prevalence of substance use was 48.4, 47.8, and 43.0%, respectively; and the major reasons reported were: to get personal pleasure, peer pressure and to get relief from tension. Ethnicity (X2, 8.04; P=0.04), religion (X2, 31.05; P = 0.001), having friends who use substance/s (X2, 32.07; P = 0.001), were significantly associated with the current use of substance/s. Likewise, residence (X2, 5.00; P= 0.02), ethnicity (X2, 8.06; P= 0.04), having friends who use substance/s (X2, 40.32; P < 0.001) and coming from an area where substance/s is/are commonly used (X2, 5.15; P = 0.02), were significantly associated with the lifetime use of substances.
    Conclusion: The prevalence of substance use among intern students was considerably high. Early exposure to substances often predicts future substance use, abuse and dependence with its medical, psycho-social and economic consequences. This necessitates strategic interventions aimed at reducing this problem without delay.
    Graham Barr, Leanne Scott*, and Peter Collins
    This paper develops a measure of player vulnerability in games of chance where the player has control over betting strategy. The measure was specifically developed in a completely general form for the game of Roulette as played on electronic betting terminals, but can be applied to other games of chance. In the case of Roulette, the metric captures both the quantum of bet and, crucially, the specific type of bet. The generalised form of the measure accommodates any chosen bet that can be placed in Roulette. The paper gives the derivation of the measure, which is termed Vulnerability to Large Losses (VLL), and demonstrates the interpretation of VLL in a probabilistic context, indicating how it captures the notion of player vulnerability. The use of the VLL measure as a means of tracking and characterising the betting behaviour of individual gamblers is demonstrated. The VLL measure allows one to track the playing behaviour of a gambler over the course of an extended session of gambling and allows one to see how their playing style varies across time. It can then be used to directly interrogate a variety of propositions about gambling strategies or behaviour, and it is postulated that VLL has excellent potential to be used as a general metric to monitor player betting behaviour across time for a range of betting games.
    Editorial
    Brian L. Ackerman*
    There are 2 fundamentally different and opposing parts of our psyches, one of which is healthy, the other is unhealthy. In order to become mentally and spiritually well, we have to become aware of our 'double nature', which I refer to as learning to see double, and then create a hierarchy between the two sides, such that our unhealthy psyches are relegated to a one-down, subservient position to our healthy psyches.
    Short Communication
    Christine E. Barron*, Jessica Moore, Grayson Baird, Erica Hardy, Amy Goldberg
    Child sex trafficking (CST) victims are at risk for HIV infection due to a convergence of both social and biological factors. However, sparse recommendations and guidelines exist for providers on the provision of HIV non-occupational post-exposure prophylaxis (nPEP) for CST patients. We evaluated whether pediatricians would provide HIV nPEP in a clinical vignette where a patient disclosed ongoing involvement in CST. Participants were relatively divided regarding whether they would provide HIV nPEP; 58.8% responded yes and 41.2% responded no. This highlights the need for medical guidelines to address the complex and case specific considerations of providing nPEP to these victims.
    Review Article
    Ezio Carboni*, Elena Carboni, and Dragana Jadzic
    Although the relevant research investment in understanding the mechanism of action of cocaine and its role in altering brain circuits and behaviour, an efficacious therapy for cocaine addiction has not been found yet. Thus, cocaine use, dependence, abuse and addiction are still a relevant health, social, and economical problem. Cocaine interacts with three different monoamine transporters and increases the extracellular level of dopamine, norepinephrine and serotonin in many brain areas as well in periphery. The aim of this review is to evaluate the interaction of cocaine with the dopamine transporter (DAT) but also with the norepinephrine transporter (NET) and the serotonin transporter (SERT) in several brain areas. In addition, it will be discussed some of the receptor interaction the are involved in the complex alteration of brain circuitry that in turns produces the feeling and the behaviours sought by addicted. The areas that will be considered are: i) the prefrontal cortex (PFC), being the area in which the process of decision making is elaborated; ii) the NAcc shell because its involvement in the reinforcing and motivational properties of cocaine; iii) the bed nucleus of stria terminal is (BNST), due to its involvement in the stress response and in the relapse of cocaine consumption. It will be also considered the effect of prenatal exposure to cocaine and the target role of monoamine transporters in the search of a therapy for cocaine addiction.
    Review Article
    Donald E. Nowak Jr*
    This review looks at research from 1991 to the present in regard to college student-athlete gambling addiction and disorder issues with an emphasis on prevalence rates, motivations, and comorbid disorders as well as NCAA national studies and derivative research. Subsets of the college student-athlete population, namely, minority athletes are also examined. PsycINFO, PsycARTICLES, ERIC, SPORTDiscus, MEDLINE, and Dissertation Abstracts International (ProQuest) were searched for possible contributions to this review. Student-athletes and male student-athletes in particular, are vulnerable to disordered gambling problems, which, if not addressed by university administration and athletic departments, can result in severe negative consequences for the student-athlete. The research shows, for the most part, that student-athletes have a higher rate of pathological gambling than non-athletes, though the rate of normal gambling behavior is about the same. Additionally, it appears that athletes in certain high profile team sports (football, basketball, etc.) as well as athletes belonging to a minority group are more likely to report problems with gambling than their counterparts. Recommendations for working with student-athletes with a gambling disorder as well as directions for future research in this burgeoning area are offered, including screening for the disorder by mental health professionals and counselors, as well as training for coaches and financial aid personnel.
    Research Article
    Michael J. Mello*, Julie R. Bromberg, Hale Wills, Barbara A. Gaines, Garry Lapidus, Megan L. Ranney, Anthony Spirito, Christina Parnagian, and Janette Baird
    Introduction: Alcohol screening, brief intervention and referral to treatment is mandated within the level 1 pediatric trauma center. However, data on the prevalence of alcohol and drug use among admitted pediatric trauma patients is limited. Our study objective was to describe substance use and related negative consequences in admitted adolescent trauma patients across three pediatric level 1 trauma centers.
    Methods: This surveillance study was nested within a study on electronically delivered parenting skills education to parents of admitted adolescents (12-17 years) screening positive for alcohol or drug use. Enrolled adolescents completed baseline assessments to examine demographics, substance use and related negative consequences. Thirty-seven parent-adolescent dyads enrolled in the intervention study.
    Results: Participants were eligible if they received a positive CRAFFT score or a positive biological screen for alcohol or drug use at time of the hospital admission. Of those enrolled into the study, 9 (24%) reported no substance use in the prior 12 months in our assessment battery. Of the remaining 28 patients, 6 (16%) reported using only alcohol, 10 (27%) only marijuana, 9 (24%) both alcohol and marijuana, and 3 (8%) alcohol and marijuana with other drugs in the past 12 months. Negative consequences reported varied between those who reported alcohol use only and those who reported marijuana use only with physical consequences of use most often being reported by those using alcohol (hangover, vomiting), and psychosocial consequences (getting into trouble with parents, doing something later regret) by those who used only marijuana.
    Conclusion: These findings support the use of laboratory screening and screening questionnaires for all adolescent trauma admissions to capture a complete picture of alcohol and drug use.
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