Objective: The aim of this study was to conduct an exploratory analysis of factors associated with poor health-related quality of life (HRQOL) among opiate users at entry to low-threshold methadone treatment. Methods: The SF-36 questionnaire was administered to 145 opiate users at enrollment into low-threshold methadone maintenance programs. ANOVA and correlational analyses were performed to investigate the determinants of poor physical and mental composite summary scales (PCS and MCS) of the SF-36 among opiate users. Stepwise regression methods were also employed to fit PCS and MCS multivariate models. Results: Age, employment status, chronic medical conditions, hospitalization, emotional abuse, sexual abuse and age at first injection episode were significantly associated with PCS. Mental health problems, sexual abuse, physical abuse, the use of sedatives, the use of cocaine, the number of days of cocaine use, sedative use and multiple substance use in the past month were significantly associated with MCS. The variances in the MCS and PCS were not readily explained by any one factor. Conclusion: The multiplicity of factors influencing HRQOL of opiate users suggests the need for a range of services within the context of a methadone program, addressing primary medical care needs as well as treatment for both mental health problems and abuse issues.

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This study assessed injection-related HIV risk behavioral changes among opioid users 6 months after enrollment in low-threshold (harm reduction based) metha-done maintenance treatment (MMT) programs within needle exchange services in Kingston and Toronto, Ontario, Canada. Changes were assessed for all participants (whole cohort), participants who continued to use illicit drugs by any route (drug-using subcohort); and those who continued to inject drugs (injecting subcohort). In this prospective observational cohort study, an interviewer-administered questionnaire examining injection-related HIV risk behaviors was administered to 183 study participants at entry to treatment and 6 months later. Changes in risk behaviors were analyzed using conditional logistic regression which took into account the paired nature of the data. We found that the proportion of participants injecting drugs, sharing needles, sharing drug equipment, indirectly sharing and using shooting galleries declined with follow-up for the whole cohort. Within the drug-using subcohort, there was a decrease in the proportion of individuals who injected drugs, while within the injecting subcohort the sharing of injection equipment and the use of shooting galleries declined. Our findings suggest that low-threshold MMT programs can reduce the risk of HIV without the enforcement of abstinence-based policies.

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The aim of this study is to investigate the effects of CHO ingestion during high intensity exercise performance lasting approximately 25 min. Twelve endurance trained male cyclists (age 19-41 years; body mass 73.2 +/- 4.2 kg; VO(2)max 66.4 +/- 6.2 ml kg(-1) min(-1)) completed a simulated 16 km time trial (457 +/- 37 kJ) time trial in the lab on three occasions. Once they received a 6% carbohydrate electrolyte solution (CHO) and twice they received the same electrolyte containing placebo drink (PLA). Carbohydrate or placebo drinks were ingested 5 min before the start (4 ml kg(-1)) and at 25, 50, and 75% of completion of the time trial (1.4 ml kg(-1)). The CHO drink was a 6% sucrose-glucose-electrolyte solution. No differences were observed in the time to complete the time trials with either treatment. Time in min:s were 25:30 +/- 1:34 and 25:27 +/- 1:46 for the two placebo trials and 25:38 +/- 1:59 in the CHO trial. Power output during the time trials was also remarkably similar: 300 +/- 37 W, 301 +/- 39 W and 299 +/- 40 W, respectively. Pacing strategies and heart rate were identical in all three trials. From the two placebo trials, a coefficient of variation for this performance task was calculated to be 1.1%. Data from this study provides evidence that carbohydrate ingestion during short high intensity exercise (approximately 30 min, 85-90% VO(2)max) does not improve performance. Furthermore, this study found a very low coefficient of variation (1.1%) for a simulated 16 km time trial.

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