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The development of medications for the treatment of nicotine dependence in patients with schizophrenia is a public health priority due to its high prevalence rates, devastating medical consequences, and difficulty to treat. It has been hypothesized that the high prevalence of nicotine dependence among patients with schizophrenia may be due to a shared neurobiological vulnerability. This shared vulnerability has been evidenced in reports showing that nicotine improves neuropsychological deficits associated with schizophrenia such as in the P50 evoked auditory potentials, spatial working memory, and attention. The common pathophysiologic pathways of smoking and schizophrenia may serve as the basis for the pharmacological evaluation of medications for the treatment of these concurrent disorders. Currently, little research of medications for the treatment of this comorbidity has been conducted. Studies have evaluated the efficacy of smoking cessation medications in patients with schizophrenia. These include the nicotine replacement therapy (patch, nasal spray) and sustained release bupropion. Others have evaluated the anti-smoking effect of medications (e.g., clozapine, haloperidol) used for the treatment of schizophrenia. In both cases, the results have not been conclusive. Newer smoking cessation approaches such as varenicline, selegiline, rimonabant, and nicotine vaccine, among others, have yet to be tested in this population. The purpose of this article is to review the results of the studies conducted to date and propose some potential pharmacotherapies based on the current knowledge of the pathophysiology of both disorders. [ABSTRACT FROM AUTHOR]

This article examines the effect of target, perceiver, and relationship characteristics on the perceiver's assessment that the target may be HIV seropositive (HIV+). A sample of 267 persons was recruited from low income, high drug use neighborhoods. Respondents (perceivers) were asked to name people (targets) with whom they had a social, drug sharing, or sexual relationship. Perceivers described 1,640 such relationships. Perceivers were asked about the targets' age, gender, and race/ethnicity, whether the targets were good-looking, their level of trust with the target, and how long they had known them. Perceivers were then asked to evaluate the chances that the target mentioned was HIV+. Two regression models were estimated on the 1,640 relationships mentioned. Model 1 included variables reflecting only target characteristics as independent variables. Model 2 included variables reflecting target characteristics as well as variables reflecting perceivers and perceiver-target relationship characteristics. The results showed that targets that were female, younger, and good-looking were perceived as being less likely to be HIV+. However, when accounting for perceiver and relationship effects, some of the target characteristic effects disappeared. ((c) 2006 APA, all rights reserved). [ABSTRACT FROM AUTHOR]

The purpose of this study is to examine the potential effectiveness of Temporary Aid to Needy Families (TANF) in achieving the goals of self-sufficiency through 'work first' initiatives. A sample of 252 female TANF recipients was interviewed every 4 months for 1 year. Cluster analysis was used to group recipients by critical labor market variables including education, knowledge, skills, abilities (KSAs), and substance abuse. Results revealed 2 groups of recipients, 1 with significantly higher levels of education and KSAs and lower levels of substance use. The cluster with less desirable employment qualifications exhibited significantly lower employment levels. 'Work first' is a successful strategy for some recipients, but for many it is an unrealistic goal. Other strategies must be developed to address the many problems that a significant portion of recipients experience. [ABSTRACT FROM AUTHOR]

Co-occurrence of drug use and psychological disorders is prevalent in both clinical and population-based samples. Severity of drug use, including injection drug use, polydrug use, and frequency of drug use, may have negative consequences for psychological treatment outcomes. The current research examines the psychological functioning of 224 out-of-treatment drug users and demographically matched nonusers using the Brief Symptom Inventory (BSI). Results indicate that drug users are more psychologically impaired than nonusers on all 9 dimensions of the BSI. Comparisons of injectors to noninjectors and polydrug users to single-drug users reveal few differences. However, in examining the frequency of drug use, chronic drug users score higher on 7 of the 9 BSI dimensions. Our findings imply injection and polydrug use do not have as much effect on psychological functioning as compared with frequency of drug use. [ABSTRACT FROM AUTHOR]

The present study examined the independent effects of work-activity-participation status (whether a welfare recipient is required to work or is exempt from such requirements) on employment, receipt of cash welfare benefits known as Temporary Assistance for Needy Families (TANF), and psychological functioning. The sample consisted of 228 female TANF recipients, 75 of whom were chronic drug users. Participants were administered self-report instruments to measure self-perceived work skills and barriers to employment, drug use, employment-related variables, TANF receipt, and psychological functioning. Contrary to the tested study hypotheses, results show that the work mandate was not significantly related to employment and was positively related to TANF receipt. The work mandate showed no effect on psychological distress. Aside from initial psychological functioning, self-perceived employment barriers had the only significant impact on change in psychological functioning. Self-perceived office skills was a significant predictor of higher wages earned and less time to employment. It is concluded that training recipient in office skills training while continuing to address other barriers may be the best approach to accomplishing the goals of welfare reform. [ABSTRACT FROM AUTHOR]

Background: To present four treatment models and evaluate their effectiveness in reducing HIV risk for high-risk patients. Methods: Four models are described: 1) Traditional Medical Practice Model; 2) Physician Management Model; 3) Integrated Provider-Patient Management Model; and 4) Integrated Network Treatment Model. Data from a study of 168 drug user and nonuser social networks are used to simulate the effects of each practice model on HIV transmission and seroconversion. Survey respondents described sexual and injection risk behaviors and partners for the last 30 days. An HIV risk index was computed for each individual, combining reported risk behaviors, HIV prevalence rates for partners and HIV transmission probabilities for each risk behavior. To evaluate the 4 models, 1 person from each network was selected as a 'patient' and a simulation was performed to estimate the number of network members who would seroconvert to HIV over a 10-year period as affected by prevention efforts within each model. Results: The simulation projected that 99.7 persons in the social networks studied would seroconvert over 10 years without any intervention. The Integrated Network Treatment Model produced the greatest reduction in risk, producing 12.6 fewer sero-conversions over 10 years. Conclusions: The greater the patient involvement in prevention-oriented interventions, the greater the effect. The most pronounced effect occurs when a patient's unique social network is included in the prevention effort. [ABSTRACT FROM AUTHOR]

This article examines the factors affecting the help-seeking behavior for HIV-related social services among a sample of HIV+ urban poor individuals. In particular, the article examines how financial transfers from friends and family affect the decision to seek HIV social services from public and community organizations. The effect of transfers on the help-seeking behavior is examined while controlling for sociodemographic factors, Acquired Immunodeficiency Syndrome (AIDS) status, and HIV-transmission mode. The determinants of help-seeking behavior were estimated by conducting nine logistic regressions on a sample of 501 HIV+ individuals. The results showed that financial transfers from friends and family had a negative effect on individual's help-seeking behavior for social HIV-services, especially for supportive services. The results also showed that sociodemographic factors and HIV-transmission mode were significant determinants in the help-seeking behavior for HIV-services. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This paper examines whether or not topography is a contextual variable that indirectly influences the transmission of infectious diseases. Age, gender, race/ethnicity, education level, economic status, injection drug use, and high-risk sexual behavior are known to influence infectious diseases transmission, but the effects of topography are often overlooked. DESIGN: A sample of 395 drug users were chosen from census tracts based upon a target profile of drug use behavior and demographics for the city of Houston. HIV was chosen as the infectious disease used to test this hypothesis. SETTING: Residents of 16 census tracts in Houston, Texas participated in this study. RESULTS: The findings revealed that census tracts that were 'isolated' by topographic barriers, such as bayous, parks, railroad tracks, railway yards, major thoroughfares, freeways, and unique street grids had fewer cases of HIV than census tracks that were more accessible to thru-traffic. CONCLUSION: The research findings suggest that future research studies should consider topography as being contextually related to infectious disease transmission. [ABSTRACT FROM AUTHOR]

Anecdotal accounts suggest that residency requirements often lead to denial of services at a time when HIV positive migrators are most in need of these services. However, this suspicion has never been empirically tested. Using needs assessment data collected for Harris County, Texas, this article examines eligibility and knowledge barriers faced by HIV positive recent migrators into Harris County. Results indicated that migration into the county was a significant predictor of failure to receive government-administered basic services such as food services but was not a significant predictor of failure to receive community based organization (CBO)-administered 'specialized' services targeted specifically to HIV positive individuals. Results also indicated that migration was associated with knowledge barriers for all types of services. [ABSTRACT FROM AUTHOR]

The level of sexual risk among crack cocaine uses had remained high, regardless of their level of AIDS knowledge. Consequently, researchers have advocated the use of rigorous behavioral theory in aiding epidemiological research and intervention. To test whether stage of change for 'insisting that men (besides your main partner) use condoms every time you have sex with them' was associated with behavioral attitudes, subjective norms, and self-efficacy among female crack cocaine users, a behavioral context questionnaire was administered to 61 female crack cocaine users who were recruited in the field and interviewed in an urban HIV testing center. Results indicated that all three were associated with stage of change and that self-efficacy was the variable most strongly related to stage of change. [ABSTRACT FROM AUTHOR]