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Search Results: 1 - 10 of 268484 matches for " Kevin E. O’Grady "
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HIV Sexual and Drug-Use Risk in Drug-Dependent Pregnant Patients in Comprehensive Drug Treatment
Hendrée E. Jones,Wendee M. Wechsberg,Kevin E. O'Grady,Michelle Tuten
International Journal of Family Medicine , 2011, DOI: 10.1155/2011/872638
Abstract: This secondary analysis study investigated HIV sexual and drug-use risk in drug-dependent pregnant patients over the first month postrandomization to reinforcement-based treatment (RBT) ( ) or usual care (UC) ( ). Analysis of primary outcomes had indicated that RBT participants spent significantly longer time in treatment and recovery housing than UC participants. The present study examined the ability of 9 risk markers—age, race, estimated gestational age at treatment entry, lifetime substance abuse treatment episodes, history of prostitution charges, history of serious depression, current heroin injection status, current housing status, and current partner substance use—to predict changes in HIV risks. Sexual risk declined for participant subgroups with prostitution-charge histories and unstable housing. Drug-use risk declined for heroin injectors and nondepressed participants. A relationship was found between number of lifetime drug treatment episodes and sexual and drug-use risk. The role of risk markers in the response of drug-dependent pregnant women to drug treatment require attention. 1. Introduction Substance-abusing women in their reproductive years have relatively high HIV seroprevalence rates [1]. Perinatal transmission of HIV accounts for 90% of pediatric HIV infection [2]. Thus, women with substance use disorders who are also pregnant are an important population to reach for both preventive interventions and treatment [3]. Drug abuse treatment itself has been shown to serve as a protective factor for HIV drug use risks and has been shown to prevent HIV in nonpregnant patients. These results come primarily through reduction of HIV drug-risk behavior [4, 5]. As yet these same results have not been reported in pregnant women. Moreover, to the best of our knowledge, the use of drug abuse treatment to reduce HIV sexual risk behaviors has been inconsistent in nonpregnant patients and has not been shown in pregnant women. Although comprehensive addiction treatment programs for substance-abusing pregnant women have been shown to result in improved maternal and neonatal outcomes compared to no treatment [6], considerably less attention has been focused on examining the impact that comprehensive drug abuse treatment provided during pregnancy may have on reducing HIV sexual and drug-risk behaviors. In fact, to our knowledge, no empirical study has examined the extent to which comprehensive treatment for drug dependence given to drug-dependent pregnant women can reduce either or both primary sources of HIV risk (that is, sexual and drug-risk
A Comparison of Buprenorphine + Naloxone to Buprenorphine and Methadone in the Treatment of Opioid Dependence during Pregnancy: Maternal and Neonatal Outcomes
Ingunn O. Lund,Gabriele Fischer,Gabrielle K. Welle-Strand,Kevin E. OGrady
Substance Abuse: Research and Treatment , 2013,
Abstract:
Female partners of opioid-injecting men in the Republic of Georgia: an initial characterization
Lund Ingunn O,Kirtadze Irma,Otiashvili David,OGrady Kevin E
Substance Abuse Treatment, Prevention, and Policy , 2012, DOI: 10.1186/1747-597x-7-46
Abstract: Background HIV and Hepatitis C virus (HCV) infections are strongly related to injection drug use in the Republic of Georgia. Little information is available about HIV and HCV status, sexual risk, support for their partner, and risk for physical violence among the female partners of opioid-injecting men in the Republic of Georgia, many of whom may not be using drugs, yet may be at high risk of being infected with HIV and HCV from their drug-using partners. Methods In order to better understand the risks for females whose partners are injecting drugs, the present study conducted an initial investigation of the non-substance-using female partners of 40 opioid-injecting men who were participating in a clinical trial examining the feasibility and efficacy of a 22-week comprehensive intervention that paired behavioral treatment with naltrexone. The 40 female partners were assessed at their male partners’ study intake. Results The female sample was 32.3 years old (SD=6.7), 37 (93%) were married, with 15.5 years of education. A majority reported at least partial employment the majority of the time during the past 3 years, with only one woman reported being unemployed most of the time during the past 3 years. They self-reported they were 3% HIV-positive and 8% HCV-positive. Their HIV sex risk scores indicated a relatively low risk. However, only 4 (10%) women reported using a condom most of the time while having sex and 15 (38%) report not having had sex during the last 30 days. Experiences of interpersonal violence were common, with 42% reporting physical abuse by their partner during the last year and 48% reporting feeling unsafe in their current relationship. Conclusions The alarmingly high rate of failure to use barrier protection methods, together with the high percentage who did not know their HIV and HCV status, suggest that it may be beneficial to include non-substance-using female partners in prevention programs along with their partners to reduce the risk of HIV and HCV spreading from the population of injection-drug–using males into the general population. [This secondary analysis study was funded by an international supplement to the parent randomized clinical trial “Treating the Partners of Drug Using Pregnant Women: Stage II (HOPE)”. ClinicalTrials.gov Identifier: NCT00496990.]
Initial Feasibility and Acceptability of a Comprehensive Intervention for Methamphetamine-Using Pregnant Women in South Africa
Hendrée E. Jones,Bronwyn Myers,Kevin E. OGrady,Stefan Gebhardt,Gerhard B. Theron,Wendee M. Wechsberg
Psychiatry Journal , 2014, DOI: 10.1155/2014/929767
Abstract: The purpose of the present study was to determine the feasibility, acceptability, and initial efficacy of a women-focused intervention addressing methamphetamine use and HIV sexual risk among pregnant women in Cape Town, South Africa. A two-group randomized pilot study was conducted, comparing a women-focused intervention for methamphetamine use and related sexual risk behaviors to a psychoeducational condition. Participants were pregnant women who used methamphetamine regularly, had unprotected sex in the prior month, and were HIV-negative. Primary maternal outcomes were methamphetamine use in the past 30 days, frequency of unprotected sexual acts in the past 30 days, and number of antenatal obstetrical appointments attended. Primary neonatal outcomes were length of hospital stay, birth weight, and gestational age at delivery. Of the 57 women initially potentially eligible, only 4 declined to participate. Of the 36 women who were eligible and enrolled, 92% completed all four intervention sessions. Women in both conditions significantly reduced their methamphetamine use and number of unprotected sex acts. Therefore, delivering comprehensive interventions to address methamphetamine use and HIV risk behaviors among methamphetamine-using pregnant women is feasible in South Africa. Further testing of these interventions is needed to address methamphetamine use in this vulnerable population. 1. Introduction Substance use during pregnancy is a critical health care concern. In Cape Town, South Africa, high rates of methamphetamine use have been found among women of childbearing age [1–3], including pregnant women [4]. Methamphetamine use is associated with several deleterious short- and long-term physical and psychological effects. A wide variety of physical effects have been associated with methamphetamine use, including respiratory and cardiac problems, palpitations, tremors, convulsions, stroke, and an increased risk of death [5]. Furthermore, its use is associated with risky sexual activities that place women at risk for acquiring HIV [1, 3, 6]. Psychological effects can be pronounced and include hallucinations, delusions, paranoia, and amphetamine psychosis [7]. Methamphetamine use has a high dependence risk and an extended withdrawal period, with frequent relapse. Prenatal stimulant exposure has been associated with being born small for gestational age [8], a risk factor for later developmental problems [9, 10] and poorer neurobehavioral outcomes [11]. Nonetheless, there are no substance use treatment models in South Africa that are tailored to address
High school drinking mediates the relationship between parental monitoring and college drinking: A longitudinal analysis
Amelia M Arria, Vanessa Kuhn, Kimberly M Caldeira, Kevin E O'Grady, Kathryn B Vincent, Eric D Wish
Substance Abuse Treatment, Prevention, and Policy , 2008, DOI: 10.1186/1747-597x-3-6
Abstract: A longitudinal cohort of 1,253 male and female students, ages 17 to 19, attending a large, public, mid-Atlantic university was studied at two time points. First, data on high school parental monitoring and alcohol consumption were gathered via questionnaire during the summer prior to college entry. Second, during the first year of college, past-year alcohol consumption was measured via a personal interview. Multiple regression models tested the relationship between parental monitoring and past year alcohol use (i.e., number of drinks per drinking day).Holding constant demographics, SAT score, and religiosity, parental monitoring had a significant protective effect on both high school and college drinking level. However, the association between parental monitoring and college drinking level became non-significant once high school drinking level was held constant.While parental monitoring did not directly influence college alcohol consumption, evidence for mediation was observed, whereby parental monitoring had an indirect influence on college drinking through reductions in high school drinking. Initiatives that promote effective parenting might be an important strategy to curb high-risk drinking among older adolescents. More research is needed to understand the nature and degree of parent-child communication that is necessary to extend the protective influence of parents into the college years.Underage alcohol consumption has received a significant amount of attention as a major public health concern [1]. High risk drinking in adolescence is associated with a variety of adverse consequences, including motor vehicle injury and death, suicide, sexual assault, high-risk sexual activity, and neurodevelopmental impairment [2-7]. Drinking in early adolescence is also known to increase the risk for alcohol dependence [8,9].While drinking alcohol in college is often seen as an expected rite of passage, heavy drinking among college students adversely affects students' health,
A Comparison of Buprenorphine + Naloxone to Buprenorphine and Methadone in the Treatment of Opioid Dependence during Pregnancy: Maternal and Neonatal Outcomes
Ingunn O. Lund, Gabriele Fischer, Gabrielle K. Welle-Strand, Kevin E. OGrady, Kimber Debelak, William R. Morrone and Hendrée E. Jones
Substance Abuse: Research and Treatment , 2012, DOI: 10.4137/SART.S10955
Abstract: Given that buprenorphine + naloxone is prescribed for opioid-dependent pregnant women, it is important to examine the extent to which it differs from buprenorphine alone, methadone, or methadone-assisted withdrawal on neonatal and maternal outcomes. Summary statistics on maternal and neonatal outcomes were collected from 7 previously published studies examining treatment for opioid-dependent pregnant women that represented a range of research methodologies. Outcomes from these studies were compared to the same outcomes for 10 women treated with the combined buprenorphine + naloxone product. There were no significant differences in maternal outcomes for buprenorphine + naloxone compared to buprenorphine, methadone, or methadone-assisted withdrawal. Preliminary findings suggest no significant adverse maternal or neonatal outcomes related to the use of buprenorphine + naloxone for the treatment of opioid dependence during pregnancy. However, further research should examine possible differences between buprenorphine + naloxone and buprenorphine alone or methadone in fetal physical development.
Process and Product in Cross-Cultural Treatment Research: Development of a Culturally Sensitive Women-Centered Substance Use Intervention in Georgia
Hendrée E. Jones,Irma Kirtadze,David Otiashvili,Kevin E. OGrady,Keryn Murphy,William Zule,Evgeny Krupitsky,Wendee M. Wechsberg
Journal of Addiction , 2014, DOI: 10.1155/2014/163603
Abstract: Women who inject drugs (WID) are highly marginalized and stigmatized and experience ongoing discrimination in Georgia. Few opportunities exist for WID to receive publicly funded treatment for substance use disorders. The IMEDI (Investigating Methods for Enhancing Development in Individuals) project was developed in response to the need for women-specific and women-centered treatment services. This paper described our approach to understanding the Georgian culture—and WID within that culture—so that we could integrate two interventions for substance use found effective in other Western and non-Western cultures and to outline how we refined and adapted our integrated intervention to yield a comprehensive women-centered intervention for substance use. Reinforcement Based Treatment (RBT) and the Women’s CoOp (WC) were adapted and refined based on in-depth interviews with WID () and providers of health services () to such women and focus groups [2 with WID () and 2 with health service providers ()]. The resulting comprehensive women-centered intervention, RBT+WC, was then pretested and further refined in a sample of 20?WID. Results indicated positive pre-post changes in urine screening results and perceived needs for both RBT+WC and a case management control condition. The approach to treatment adaptation and the revised elements of RBT+WC are presented and discussed. 1. Background and Aims Injection-drug-using individuals are highly marginalized, highly stigmatized, and are at increased risk for STIs, HCV, and HIV worldwide [1]. Women who inject drugs (WID) experience this same marginalization, stigmatization, and increased risk for disease—without any recognition for the need for research and service delivery focused on their unique needs [1]. WID in Georgia are likewise highly marginalized and stigmatized and experience ongoing discrimination in Georgia. Although they represent up to 10% of the adult substance-using population [2, 3], only 1–5% of drug-related service beneficiaries are women [4, 5]. The World Health Organization [1] has recently called for worldwide efforts to provide treatment services for women to meet their unique needs, including physical abuse and violence. Women in Georgia who use illicit substances commonly experience emotional abuse, physical aggression, and sexual violence [6]. Such violations are rooted in social norms and traditions and a cultural environment that supports asymmetry in gender roles and places restrictions on women’s freedom and independence [7]. Recent economic problems in Georgia have facilitated women’s rise
Remediation of Heavy Metal (Cd, Cr, Cu, Co, and Ni) Ions from Kaolinite Clay Using Molecular Micelles Chelators and D-Optimum Experimental Design  [PDF]
Sayo O. Fakayode, Ashley M. Taylor, Maya McCoy, Sri Lanka Owen, Whitney E. Stapleton, Carmen Grady, David A. Pollard
Journal of Environmental Protection (JEP) , 2013, DOI: 10.4236/jep.2013.48092
Abstract:

This study investigated the potential utility of poly (sodium N-undecanoyl-L-leucyl-valinate) (poly-L-SULV), poly (sodium N-undecanoyl-L-leucyl-alanate) (poly-L-SULA), and poly (sodium N-undecanoyl-glycinate) (poly-SUG) molecular micelles (MMs) as chelators for heavy metal (Cd, Cr, Cu, Co, and Ni) ion remediation of kaolinite clay using D-optimum experimental design. D-optimum experimental design was employed to simultaneously investigate the influence of design variables such as the buffer pH, chelator concentration, and centrifuge speed to evaluate the optimum conditions and to reduce the time and cost of metal ion remediation. The partition coefficients of the metal ion concentrations between the kaolinite clay and chelator equilibrium were also evaluated. In addition, the influence of metal ion concentrations on the remediation capability of the chelators was evaluated by conducting remediation studies at four different (10 ppm, 40 ppm, 60 ppm, and 80 ppm) metal ion concentrations. In general, the results of the remediation efficiency and partition coefficients obtained in this study are highly metal ion dependent and also dependent upon the chelator used for the remediation. Specifically, the remediation efficiency of the molecular micelles was found to be comparable to or better than the corresponding remediation efficiency obtained when SDS or EDTA was used for the remediation. However, at optimum conditions, poly-SULV and poly-L-SULA molecular micelle chelators demonstrated superior remediation efficiencies for Cr, with remediation efficiency of 99.9 ± 8.7% and 99.1 ± 0.7%, respectively.

Open letter to the Italian Ministry of University and Research
Procesi C,Arbarello E,Cornalba M,O'Grady K
Forest@ , 2008,
Abstract: Open letter to the Minister of Italian University. The government should get advice from the best Italian scientists for the necessary reform of the Italian University, with special concern to crucial processes as the appointment of new professors and academic evaluation. The current government proposal for a random draw of evaluation committees in charge for the appointment of new professors is considered as a wrong solution and harmful tool for dealing with such a crucial process.
Is overexpression of HER-2 a predictor of prognosis in colorectal cancer?
Dara O Kavanagh, Gillian Chambers, Liam O' Grady, Kevin M Barry, Ronan P Waldron, Fadel Bennani, Paul W Eustace, Iqdam Tobbia
BMC Cancer , 2009, DOI: 10.1186/1471-2407-9-1
Abstract: Clinicopathological data and paraffin-embedded specimens were collected on 132 consecutive patients who underwent colorectal resections over a 24-month period at Mayo General Hospital. Twenty-six contained non-malignant disease. Her-2/neu protein overexpression was detected using immunohistochemistry (IHC). The HER-2 4B5 Ventana monoclonal antibody was used. Fluorescent insitu hybridisation (FISH) was performed using INFORM HER-2/Neu Plus. Results were correlated with established clinical and pathological predictors of outcome including TNM stage. Statistical analysis was performed using SPSS version 11.5.114 were HER-2/Neu negative using IHC, 7 showed barely perceptible positivity (1+), 9 showed moderate staining (2+) and 2 were strongly positive (3+). There was no correlation with gender, age, grade, Dukes' stage, TNM stage, time to recurrence and 5-year survival (p > 0.05). FISH was applied to all 2+ and 3+ cases as well as some negative cases selected at random. Three were amplified (2 were 3+ and 1 was 2+). Similarly, HER-2 gene overexpression did not correlate with established prognostic indicators.HER-2 protein is over expressed in 11% of colorectal cancer patients. The gene encoding HER-2 is amplified in 3% of cases. Overexpression of HER-2 is not a predictor of outcome. However, patients who over express HER-2 may respond to Herceptin therapy.Colorectal cancer is the second commonest cause of cancer-related death in the United States and the Western World [1,2]. The 5-year relative survival rate is approximately 45% demonstrating an improvement from 30 years ago when the survival rate was 30%. Modifications in adjuvant therapy have been central to this observed improvement. Cytotoxic agents such as irinotecan and oxaliplatin have improved survival while the development of monoclonal antibodies against growth factor receptors has augmented their effects. A significant improvement in the median overall survival in patients with metastatic colorectal cancer wa
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