This study aimed to investigate the presence of the false consensus effect (FCE) in relation to nurses' self-reported use of universal or standard precautions (UPs) and risk-related beliefs. The study also aimed to investigate the accuracy of estimated consensus. The sample consisted of nurses (N = 301) from a variety of specialities. Through self-report questionnaires, respondents were presented with a list of 10 behaviours and beliefs (of which eight were used in the analysis). They were asked to indicate whether they performed the behaviour or held the belief, and, separately, to estimate the percentage of peers who would do so. Independent sample t-tests (comparing "subscribers" with "non-subscribers" to each behaviour or belief) revealed a significant FCE on all items: subscribers always estimated a significantly greater consensus for the position than did non-subscribers. Significant deviation from accuracy was found on all items, and significant differences were found on seven of the eight items between subscribers and non-subscribers in their deviations from accuracy. In addition to theoretical implications, the results are discussed in terms of the implications for educational intervention.
Abstract Aims Release from prison is a high‐risk period for mortality. We examined the impact of opioid substitution therapy ( OST ), for opioid dependence during and after incarceration, upon mortality post‐release. Design A cohort was formed of all opioid‐dependent people who entered OST between 1985 and 2010 and who, following first OST entry, were released from prison at least once between 2000 and 2012. We linked data on OST history, court and prison records and deaths. Setting N ew S outh W ales ( NSW ), A ustralia. Participants A total of 16 453 people released from prison 60 161 times. Measurements Crude mortality rates ( CMR s) were calculated according to OST retention; multivariable C ox regressions for post‐release periods were undertaken to examine the association between OST exposure (a time‐dependent variable) and mortality post‐release, for which covariates were updated per‐release. Findings There were 100 978 person‐years ( PY ) post‐release; 1050 deaths occurred. Most received OST while incarcerated (76.5%); individuals were receiving OST in 51% of releases. Lowest post‐release mortality was among those continuously retained in OST post‐release CMR 4 weeks post‐release = 6.4 per 1000 PY ; 95% confidence interval ( CI ) = 5.2, 7.8, highest among those with no OST ( CMR = 36.7 per 1000 PY ; 95% CI = 28.8, 45.9). Multi‐factorial models showed OST exposure in the 4 weeks post‐release reduced hazard of death by 75% (adjusted hazard ratio 0.25; 95% CI = 0.12, 0.53); OST receipt in prison had a short‐term protective effect that decayed quickly across time. Conclusion In N ew S outh W ales, A ustralia, opioid substitution therapy in prison and post‐release appears to reduce mortality risk in the immediate post‐release period.
To determine the prevalence and correlates of violent victimisation among homeless people in inner‐Sydney. Cross‐sectional design. Clients of a shelter for homeless, substance‐using adults were interviewed about their drug use, mental health and violent victimisation in the previous 12 months. Logistic regression was used to identify factors associated with victimisation. Participants reported complex drug use histories and high levels of depression, post‐traumatic stress disorder (PTSD) and schizophrenia or other psychotic disorders. Forty‐eight per cent of participants reported past year victimisation. In univariate analyses, being female, schizophrenia/psychotic disorder, PTSD, depression and regular use of psychostimulants were associated with increased risk of victimisation. In multivariate analyses, regular use of psychostimulants (odds ratio [95% CI] 5.07 [1.53‐16.84]), schizophrenia or other psychotic disorder (3.13 [1.24‐7.9], and depression (2.65 [1.07‐6.59]) were associated with increased risk of victimisation. This sample of homeless, substance‐using adults experienced high levels of violence. People with poor mental health and regular psychostimulant users were at greater risk of victimisation. A longitudinal study to determine whether victimisation prolongs homelessness is warranted. Clinical staff working with homeless populations need to be aware of the likelihood of past and future victimisation and its effects on mental health. Homeless persons may benefit from learning to identify risk situations for victimisation and how to de‐escalate potentially violent situations.
The FBI seizure and closure of the Silk Road has sparked a proliferation of users migrating to alternate dark web market-places to continue trade of illicit substances. The present editorial seeks to quantify the increase in retailers and explore the implications of this migration. Globally, drug markets have changed radically, with increasing use of the internet for the discussion of drugs and, more recently, the sale of drugs 1. The Federal Bureau of Investigation (FBI) seizure and closure of the Silk Road market-place on 3 October 2013 prompted immediate discussion among online forums concerning alternative market-places for the trade of illicit substances. Two alternative market-places in particular were identified: 'the Black Market Reloaded (BMR)' and 'Sheep Marketplace'. In addition to these, 6 November saw a new version of the Silk Road (Silk Road 2.0) also commence trading. These websites operate on the 'dark web' using a similar format to the Silk Road and other established online community market-places, such as e-Bay 2. The products on these market-places are similar to those sold on the Silk Road, with the notable exception of BMR, which includes firearms. Firearm sales were banned on the Silk Road. Commissioned by the Federal Government Department of Health, the Drug Trends team at the National Drug and Alcohol Research Centre (NDARC) in Sydney, Australia has been monitoring the Silk Road market-place for changes in the online availability of illicit and emerging substances since September 2012 3. This ongoing monitoring provides a unique opportunity to assess the impact of the recent closure of the Silk Road. In the wake of the closure, monitoring turned to alternative market-places and a count of total active retailers was recorded on 3 October 2013, with subsequent counts conducted weekly. From 7 November 2013, retailers operating on Silk Road 2.0 were also counted. Figure 1 shows that BMR recorded a more than twofold increase in the number of active retailers over the 6-week period, although this increase plateaued at the most recent time-point. Retailer numbers on the Sheep Marketplace, however, saw a 461% increase over the time-period, and overtook BMR as the market-place with the highest number of active retailers in the most recent time-point. The initial count of Silk Road 2.0 retailers revealed 92 active sellers, although a large amount of promotion of the new market-place on Twitter™ was observed following its opening that will likely lead to an increase in retailers in subsequent counts. Number of active retailers on the Black Market Reloaded, Sheep Marketplace and Silk Road 2.0 by date. BMR = Black Market Reloaded The closure of the Silk Road, then, has seen a proliferation in the number of active retailers on alternative dark web market-places. It would appear that the highly publicized closure of the Silk Road market-place has not shaken the confidence of consumers in the integrity of online 'dark web' market-places, nor does it appear to have had a significant impact on the online trade of illicit substances. In due course, outcomes of FBI investigations may tell a different story. Additionally, although a drop in the value of the online currency, Bitcoin 4, was observed following the closure, its value has since recovered and risen to levels higher than those seen before the closure. It would appear that dark web market-place consumers have adapted to the closure of the Silk Road in a similar fashion to the 'surface web' stores selling new psychoactive substances (NPS); when one store is closed or a drug is made illegal, others quickly appear to replace them 1, 5, 6. There is great potential for these online market-places to influence traditional street markets in terms of price, purity and availability of illicit substances. The community model employed by dark web market-places means that retailers rely upon positive feedback to drive future sales 7. Feedback largely details the purity of product, speed of delivery and the security of the packaging to avoid detection. Based on this feedback, consumers are able to make more informed choices about which substances they buy, making this an attractive alternative to traditional markets 8. The relative ease and low cost of buying online via dark web market-places may also entice consumers to purchase in larger quantities for distribution, thereby risking greater legal ramifications if caught. The speed with which the internet allows transformations to occur in drug markets poses a major challenge to law enforcement, research and public health agencies 9. This highlights the need for timely and responsive monitoring systems to continue work in this important area. Future monitoring will continue to track the growth of retailers on dark web market-places in order to assess their longevity and relative popularity, as well as the impact of changing legislation and technological advancements. None. The National Drug and Alcohol Research Centre is funded by the Australian Government Department of Health. The Department did not have any involvement in any aspect of the preparation of this manuscript.
The burden of mental and behavioural disorders in Australia has increased significantly over the last decade. The aim of the current study is to describe the hospital admission rates for mental illness over a 10-year period for primiparous mothers in the first year after birth. This is an Australian population-based descriptive study with linked data from the New South Wales Midwives Data Collection and Admitted Patients Data Collection. The study population included primiparous mothers who gave birth between 1 January 2001 and 31 December 2010. All hospital admissions with a mental health diagnosis in the first year after birth were recorded. There were 6,140 mothers (1.67%) admitted to hospital with a principal diagnosis of mental health in the first year after birth between 2001 and 2010 in New South Wales (7,884 admissions, 2.15%). The hospital admission rates increased significantly over time, particularly from 2005. The increase in hospital admissions was mainly attributed to the diagnoses of unipolar depression, adjustment disorders and anxiety disorders. This study shows that hospital admissions for mothers with a mental health diagnosis after birth in New South Wales has significantly increased in the last decade. Possible reasons for this change need to be studied further.
The 2011 NT Trends in Ecstasy and Related Drug Markets report represents the eighth year in which data has been collected in the Northern Territory (NT) on the markets for ecstasy and related drugs (ERD). The Ecstasy and related Drugs Reporting System (EDRS; formerly the Party Drugs Initiative, or PDI) is the most comprehensive and detailed study of ERD markets in the country. Using a similar methodology to the Illicit Drug Reporting System (IDRS), the EDRS monitors the price, purity and availability of ‘ecstasy’ (MDMA) and other related drugs such as methamphetamine, cocaine, gamma-hydroxy-butyrate (GHB), and ketamine. It also examines trends in the use and harms of these drugs. It utilises data from three sources: (a) surveys with regular ecstasy users (REU); (b) surveys with key experts (KE) who have contact with REU through the nature of their work; and (c) the analysis of existing data sources that contain information on ecstasy and other drugs. REU are recruited because they are considered a sentinel group to detect illicit drug trends. The information from REU is therefore not representative of ecstasy and other drug users in the general population, but is indicative of emerging trends that may warrant further monitoring.
Receptionists are an integral part of the primary care service. We aimed to discover their views on preventive medicine issues.One hundred and fifty receptionists from general practices in Sydney, Australia, completed a questionnaire on their attitudes and beliefs towards preventive medicine and brief intervention for alcohol. They were matched according to practice variables into a control, no, minimal, or maximal training and support condition. In all conditions except the control condition, receptionists received 5 minutes of initial training in implementing a brief intervention programme; the amount of ongoing support varied across conditions. Attitudes and beliefs were re-assessed 3 months later.The results indicated that when no training and support were given, receptionists developed negative views towards being involved in preventive medicine activities. When training and support were provided, these negative effects were abolished.
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