Optimizing Contingency Management With Methamphetamine-Using Men Who Have Sex With Men

Among men who have sex with men (MSM), methamphetamine use is associated with multiple, overlapping syndemic conditions including increased risk for HIV seroconversion and onward HIV transmission. Contingency management (CM) is an evidence-based behavioral intervention implemented to curb methamphetamine use and optimize HIV/AIDS prevention among MSM in San Francisco since 2003. We conducted a program evaluation to document the evolution of this 12-week CM program to include delivery of brief, individual counseling incorporating motivational interviewing and behavioral skills. A drop-in group delivered concurrently with CM urine-screening visits also provides peer support as well as referrals for other social and medical services. From December 2011–October 2013, a total of 131 clients enrolled in the CM program and provided a median of 22 urine samples (Interquartile Range = 10–34) that were nonreactive for methamphetamine. Findings support the feasibility and acceptability of integrating individual and group counseling with community-based CM for methamphetamine-using MSM.     

Finding Sunshine on a Cloudy Day: A Positive Affect Intervention for Co-Occurring Methamphetamine Use and HIV

Among sexual minority men (i.e., gay, bisexual, and other men who have sex with men) living with HIV, those who use methamphetamine experience profound health disparities. Affect Regulation Treatment to Enhance Methamphetamine Intervention Success (ARTEMIS) is an evidence-based, 5-session, individually delivered positive affect intervention adapted for sexual minority men living with HIV who use methamphetamine. ARTEMIS was designed to amplify the benefits of evidence-based substance use interventions such as contingency management (CM) with this high-priority population. Delivering ARTEMIS during CM has been shown to assist participants in reducing stimulant use, increasing positive affect, and achieving durable reductions in HIV viral load. We describe the theoretical underpinnings of the ARTEMIS intervention, provide details of the training and session protocols with a case example, and discuss implications for future applications in research and clinical settings.     

The influence of the built environment on pedestrians’ perceptions of attractiveness,safety and security

Perceptions of the walking environment can encourage or discourage walking for transport. However, the influence of the built environment (BE) on pedestrians’ perceptions of the walking environment has not been fully understood. To address this gap, the present research investigates how BE characteristics of a suburban walking environment are associated with the perceptions of attractiveness (i.e., pleasantness, friendliness), safety, and security. Using a cross-sectional design, 995 participants reported their perceptions about the attractiveness, safety, and security of different suburban BE scenarios in Brisbane (Australia). Univariate and bivariate random effect ordered probit models were estimated to identify the associations between BE characteristics and perceived attractiveness, safety, and security whilst controlling for psychosocial factors. Results indicated that perceived attractiveness (i.e., pleasantness and friendliness) was higher for recreational areas than residential land use. Women perceived the walking environment as more pleasant with trees. The perception of safety was higher for recreational and vacant land compared to residential areas. Young pedestrians perceived that the likelihood of being assaulted/robbed/harassed at night was lower if they walked through an area with commercial and mixed land use. Women pedestrians perceived that the corresponding risk at night was higher in recreational areas. Overall, the findings suggest that urban design strategies such as increasing land use diversity and providing adequate trees enhance perceived environmental attractiveness, safety, and security, ultimately resulting in more walking for transport.     

Unsafety on two wheels,or social prejudice? Proxying behavioral reports on bicycle and e-scooter riding safety – A mixed-methods study

The use of non-motorized transportation and micro-mobility is increasing in many cities. Bicycle riding and e-scooter use are now more common and affordable than ever. However, users of these devices face certain key issues. These include their own risky behaviors as well as involvement in conflicts with other road users. Self-report data may not adequately capture these behaviors and interactions. Despite this, more objective data (i.e., how third parties perceive these users’ road behaviors) is scarce. Aims: This study aimed to understand whether e-scooter riders have comparable or different riding behaviors than cyclists. This was investigated using a mixed-method study. Methods: This paper is divided into two sub-studies. In Study 1, 950 Spanish non-cyclists and non-e-scooter riders (mean age 31.98 ± 13.27 years; 55.3% female) provided external ratings (proxies) regarding the perceived behaviors of bicycle and e-scooter riders. In Study 2, collective Rapid Assessment Processes (RAPs; n = 23) were used to develop qualitative configurations of some of the key risky behaviors highlighted in Study 1. Results: There were significant differences in the perceived errors and violations rated by proxies for both types of riders (with e-scooter riders perceived as having higher rates of risky behaviors). However, there were also structural differences in the effects of external raters’ risk perceptions, traffic rule knowledge, and traffic incidents with two-wheeled riders on how they rated the behaviors. Conclusion: The results of both studies suggest that external raters’ perceptions provide further understanding of the causes, dynamics, and conflicts related to road behaviors performed by certain groups of road users. This is particularly apparent when there is no clear legislation and information on safe riding in urban areas. In this sense, improving infrastructure could promote safer interactions. Finally, road safety education could focus on promoting safer practices and interactions in order to improve how others perceive riders’ behavior.     

Narcissism, Perfectionism, and Self-Termination from Treatment in Outpatient Cocaine Users

This study examines perfectionism in individuals with a Diagnostic and Statistical Manual-IV, Text Revised [American Psychiatric Association, 2000. Diagnostic and statistical manual of mental disorders (4th ed.). Text revision (DSM-TV-TR). Washington, DC: American Psychiatric Association] diagnosis of Narcissistic Personality Disorder and a coexisting diagnosis of cocaine abuse or dependence. Participating clients were treated in outpatient settings that provided cognitive-behavioral therapy. Clients were administered Hewitt and Flett's (1991b) [Journal of Personality and Social Psychology, 60, 456-470] Multidimensional Perfectionism Scale prior to treatment. Scores for dimensions of perfectionism were compared with those obtained from cocaine abusers in treatment with diagnoses of Antisocial Personality or Affective Disorder. Clients with Narcissistic Personality Disorder were characterized by relatively higher levels of other-oriented and socially prescribed perfectionism. Survival analysis suggests that self-termination from treatment by cocaine-abusing clients with a diagnosis of Narcissistic Disorder is related to high levels of other-oriented perfectionism. The clinical implications and limits of this study are discussed.     

The detection of vulnerable road users by younger and older drivers

The detection of vulnerable road users (VRUs), especially under time constraints, may be impaired in elderly drivers, due to their visual and cognitive decline. This represents a major concern for road safety. The objective of the present study was to investigate the effect of aging on the detection of VRUs. A further aim was to investigate the impact of external factors on VRU detection. Twenty-two young adults, 20 younger-old adults, and 32 older-old adults were included in the study. A series of photographs were displayed for 500 ms. Participants were asked to detect the VRU, which could be a motorcyclist, a cyclist, or a pedestrian. The VRU was located at one of two distances (near/far), one of two locations (off-centered/centered), and in two car-DRL (daytime running lights) environments (on/off). The ability to correctly detect a VRU was measured. An eye-tracker was used to record eye movements. The main findings showed that VRU-detection performance decreased with aging, even in the younger-old group (ages 55–68). The ability to correctly detect a VRU by older-old adults was poorer particularly when the VRU was a motorcyclist or a cyclist. As a whole, the older-old adults made more fixations to correctly detect the VRU than the other two age groups did. Moreover, the visual angle between the gaze of the participant’s last fixation and the target in the older-old group was lower than in the other two groups, particularly when the VRU was off-centered. This finding suggests that older-old adults compensated for their visual-field decline by doing more visual exploration than the other two groups did to correctly detect the VRU. The results are discussed with regards to age-related cognitive and visual deficits.Word count: 279.