Sample records for abuse emergency exists

  1. 42 CFR 51d.5 - How is an emergency determined to exist?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Section 51d.5 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS MENTAL...? (a) In making a decision as to whether a mental health or substance abuse emergency exists for... mental health and/or substance abuse services are overwhelmed or unable to meet the existing mental...

  2. 42 CFR 51d.5 - How is an emergency determined to exist?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Section 51d.5 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS MENTAL...? (a) In making a decision as to whether a mental health or substance abuse emergency exists for... mental health and/or substance abuse services are overwhelmed or unable to meet the existing mental...

  3. 42 CFR 51d.5 - How is an emergency determined to exist?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Section 51d.5 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS MENTAL...? (a) In making a decision as to whether a mental health or substance abuse emergency exists for... mental health and/or substance abuse services are overwhelmed or unable to meet the existing mental...

  4. 42 CFR 51d.5 - How is an emergency determined to exist?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Section 51d.5 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS MENTAL...? (a) In making a decision as to whether a mental health or substance abuse emergency exists for... mental health and/or substance abuse services are overwhelmed or unable to meet the existing mental...

  5. Predictors of Intention of Reporting Child Abuse among Emergency Nurses.

    PubMed

    Lee, Hye-Mi; Kim, Ji-Soo

    The current study investigates predictors of intention of reporting child abuse among emergency nurses in Korea. A descriptive cross-sectional design was used. Data were collected from 200 emergency nurses in eight general hospitals in Korea through a questionnaire that asked about their general characteristics, knowledge about child abuse, perceived behavioral control, experiences of child abuse cases and reporting, and attitude toward child abuse. Multiple regression analysis indicated that attitude toward child abuse was the most influential predictor of the intention of reporting child abuse among Korea's emergency nurses. Knowledge about child abuse, and perceived behavioral control were also significant influencing predictors of reporting intention. These variables explained 22.1% of the variances in the intention of reporting child abuse among emergency nurses. Reporting child abuse has not yet been established as a professional responsibility among Korea's emergency nurses. Increasing the level of awareness of the characteristics of child abuse and encouraging communication among nurses about the responsibility to report suspected child abuse will increase nurses' confidence to report. Training for reporting child abuse should be implemented in the near future to improve emergency nurses' understanding of child abuse. A support program is also needed to help emergency nurses build confidence in reporting child abuse as a professional responsibility. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. [Clinical management of child and adolescent psychiatric emergencies in patients with substance abuse disorders].

    PubMed

    Coronel, Pablo A

    2017-01-01

    This paper addresses the problem of substance abuse disorders in child and adolescent patients within its frequent psychiatric emergency setting. It describes the clinical features that defne the high complexity of these cases, the current state of knowledge regarding clinical management of child and adolescent psychiatric emergencies in patients with substance abuse disorders, and the available treatment strategies in the metropolitan area of Buenos Aires, Argentina. Finally, this article delves into the existence of a metropolitan addiction treatment network, its community outreach and the obstacles it has to conquer in order to attain the international standards for the treatment of substance abuse disorders.

  7. [Suspected child abuse in paediatric emergency service].

    PubMed

    Sabaté Rotés, A; Sancosmed Ron, M; Cebrián Rubio, R; Canet Ponsa, M; Martín González, M

    2009-07-01

    To describe the epidemiology of child abuse in an emergency department of a tertiary paediatric hospital. Descriptive and retrospective study from January 2008 to January 2006 including patients less than sixteen years of age who were suspected of being abused during the examination in the emergency department. Child maltreatment was 0.07% of all paediatric emergencies (45% physical abuse, 35% sexual abuse and 20% neglect). Mean age of 6 years old, with no gender differences. 86% were suspected of maltreatment. An adult living with the child was suspected in 67% of cases. Social and judicial procedures were activated. A total of 24 children were admitted, 14 under medical criteria and the rest in order to protect the child; 2 had serious neurological consequences and one died. Eight patients were discharged to social service care centres. We believe it is necessary to improve the pediatrician's knowledge of child abuse and to create specialized units.

  8. Residents' Experiences of Abuse and Harassment in Emergency Departments.

    PubMed

    Sadrabad, Akram Zolfaghari; Bidarizerehpoosh, Farahnaz; Farahmand Rad, Reza; Kariman, Hamid; Hatamabadi, Hamidreza; Alimohammadi, Hossein

    2016-04-21

    The widespread epidemic of emerging abuse in Emergency Departments (ED) toward residents generates negative effects on the residents' health and welfare. The purpose of this study was to determine and highlight the high prevalence of abuse and harassment toward Emergency residents. In 2011, a multi-institutional, cross-sectional study was conducted at seven Emergency Residencies of central hospitals in Iran. Residents were asked about their age, marital status, postgraduate year (PGY) levels, and work experiences before residency. Prevalence of abuse in four categories was evaluated: verbal abuse; verbal and physical threat; physical assault and sexual harassment; and by whom. The data were analyzed by SPSS version 17.0 (SPSS, Inc., Chicago, IL, USA). Two hundred fifteen of the 296 residents (73%) completed the survey. The prevalence of any type of abuse experienced was 89%; 43% of residents experienced verbal and physical threats, 10% physical assault, and 31% sexual harassment. Verbal abuse and verbal and physical threats without the use of weapons were higher in men in comparison with women (p< .04). Women were more likely than men to encounter sexual harassment (31% vs. 7%, p< .01). Among the sexual harassment categories, sexual jokes (51%) were the most prevalent between residents. Junior residents (PGY-1) were more likely to experience abuse than senior residents (PGY-2 and PGY-3; p< .01). Patients and their companions were the main agents of abusive behaviors. Abuse and harassment during residency in ED are highly prevalent. Educational programs and effective preventive measures against this mistreatment are urgently required. © The Author(s) 2016.

  9. Drug Abuse on College Campuses: Emerging Issues. Issues in Prevention

    ERIC Educational Resources Information Center

    Higher Education Center for Alcohol, Drug Abuse, and Violence Prevention, 2012

    2012-01-01

    This "Issues in Prevention" focuses on emerging issues concerning drug abuse on college campuses. This issue contains the following articles: (1) Drug Abuse Trends; (2) Q&A With Jim Lange; (3) Bath Salts; (4) Refuse to Abuse; (5) Related Federal Resource; and (6) Higher Education Center Resources.

  10. Barriers in detecting elder abuse among emergency medical technicians.

    PubMed

    Reingle Gonzalez, Jennifer M; Cannell, M Brad; Jetelina, Katelyn K; Radpour, Sepeadeh

    2016-09-02

    Elder abuse and neglect are highly under-reported in the United States. This may be partially attributed to low incidence of reporting among emergency medical technicians' (EMTs), despite state-mandated reporting of suspected elder abuse. Innovative solutions are needed to address under-reporting. The objective was to describe EMTs' experience detecting and reporting elder abuse. Qualitative data were collected from 11 EMTs and 12 Adult Protective Services (APS) caseworkers that participated in one of five semi-structured focus groups. Focus group data were iteratively coded by two coders. Findings suggest a number of barriers prevent EMTs from reporting elder abuse to APS. Participants suggested that limited training on elder abuse detection or reporting has been provided to them. EMTs suggested that training, creation of an automated reporting system or brief screening tool could be used to enhance EMT's ability to detect and communicate suspected cases of elder abuse to APS. Results from the present study suggest that EMTs may be uniquely situated to serve as elder abuse and neglect surveillance personnel. EMTs are eager to work with APS to address the under-reporting of elder abuse and neglect, but training is minimal and current reporting procedures are time-prohibitive given their primary role as emergency healthcare providers. Future studies should seek to translate these findings into practice by identifying specific indicators predictive of elder abuse and neglect for inclusion on an automated reporting instrument for EMTs.

  11. Diagnosis of Elder Abuse in US Emergency Departments

    PubMed Central

    Evans, Christopher S.; Hunold, Katherine M.; Rosen, Tony; Platts-Mills, Timothy F.

    2016-01-01

    OBJECTIVE To estimate the proportion of visits to United States emergency departments (EDs) receiving a diagnosis of elder abuse using two nationally representative datasets. DESIGN Retrospective cross-sectional analysis. SETTING U.S. ED visits recorded in either the 2012 Nationwide Emergency Department Sample (NEDS), or the 2011 National Hospital Ambulatory Medical Care Survey (NHAMCS). PARTICIPANTS All ED visits by patients aged 60 years and older. MEASUREMENTS The primary outcome was elder abuse as defined by ICD-9-CM diagnosis codes. The proportion of visits with elder abuse was estimated using survey weights. Odds ratios (OR) were calculated to identify patient demographics and common ED diagnoses associated with elder abuse. RESULTS In 2012, NEDS contained 6,723,667 ED visits by older adults, representing an estimated 29,056,673 ED visits. Elder abuse was diagnosed in an estimated 3,846 visits, corresponding to a weighted diagnosis period prevalence of elder abuse in U.S. EDs of 0.013% (95% Confidence Interval (CI) 0.012– 0.015%). Neglect and physical abuse were the most common types diagnosed, accounting for 32.9% and 32.2% of cases, respectively. Multivariable analysis showed increased weighted odds of elder abuse diagnosis in females (OR 1.95, 95% CI 1.68–2.26), and patients with contusion (OR 2.91, 95% CI 2.36–3.57), urinary tract infection (OR 2.21, 95% CI 1.84–2.65), or septicemia (OR 1.92, 95% CI 1.44–2.55). In the 2011 NHAMCS dataset, zero cases of elder abuse were recorded among the 5,965 older adult ED visits. CONCLUSION Among US ED visits by older adults, the proportion of visits receiving a diagnosis of elder abuse is at least two orders of magnitude lower than the estimated prevalence in the population. Efforts to improve the identification of elder abuse in EDs may be warranted. PMID:27753066

  12. Child Abuse: An Emerging Social Priority

    ERIC Educational Resources Information Center

    Antler, Stephen

    1978-01-01

    In recent years, child abuse has emerged as a social priority of national importance, largely through physicians' efforts to make it so. Grafting a medical approach onto what has been a social work concern has had serious, perhaps unfortunate, consequences for social work policy, practice, and education. (Author)

  13. Diagnostic Coding of Abuse Related Fractures at Two Children's Emergency Departments

    ERIC Educational Resources Information Center

    Somji, Zeeshanefatema; Plint, Amy; McGahern, Candice; Al-Saleh, Ahmed; Boutis, Kathy

    2011-01-01

    Objectives: Pediatric fractures suspicious for abuse are often evaluated in emergency departments (ED), although corresponding diagnostic coding for possible abuse may be lacking. Thus, the primary objective of this study was to determine the proportion of fracture cases investigated in the ED for abuse that had corresponding International…

  14. Diagnosis of Elder Abuse in U.S. Emergency Departments.

    PubMed

    Evans, Christopher S; Hunold, Katherine M; Rosen, Tony; Platts-Mills, Timothy F

    2017-01-01

    To estimate the proportion of visits to U.S. emergency departments (EDs) in which a diagnosis of elder abuse is reached using two nationally representative datasets. Retrospective cross-sectional analysis. U.S. ED visits recorded in the 2012 Nationwide Emergency Department Sample (NEDS) or the 2011 National Hospital Ambulatory Medical Care Survey (NHAMCS). All ED visits of individuals aged 60 and older. The primary outcome was elder abuse defined according to International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes. The proportion of visits with elder abuse was estimated using survey weights. Odds ratios (ORs) were calculated to identify demographic characteristics and common ED diagnoses associated with elder abuse. In 2012, NEDS contained information on 6,723,667 ED visits of older adults, representing an estimated 29,056,673 ED visits. Elder abuse was diagnosed in an estimated 3,846 visits, corresponding to a weighted diagnosis period prevalence of elder abuse in U.S. EDs of 0.013% (95% confidence interval (CI) = 0.012-0.015%). Neglect and physical abuse were the most common types diagnosed, accounting for 32.9% and 32.2% of cases, respectively. Multivariable analysis showed greater weighted odds of elder abuse diagnosis in women (odds ratio (OR) = 1.95, 95% CI = 1.68-2.26) and individuals with contusions (OR = 2.91, 95% CI = 2.36-3.57), urinary tract infection (OR = 2.21, 95% CI = 1.84-2.65), and septicemia (OR = 1.92, 95% CI = 1.44-2.55). In the 2011 NHAMCS dataset, no cases of elder abuse were recorded for the 5,965 older adult ED visits. The proportion of U.S. ED visits by older adults receiving a diagnosis of elder abuse is at least two orders of magnitude lower than the estimated prevalence in the population. Efforts to improve the identification of elder abuse in EDs may be warranted. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  15. Nephrotoxic Effects of Common and Emerging Drugs of Abuse

    PubMed Central

    Pendergraft, William F.; Herlitz, Leal C.; Thornley-Brown, Denyse; Rosner, Mitchell

    2014-01-01

    The kidneys can be injured in diverse ways by many drugs, both legal and illegal. Novel associations and descriptions of nephrotoxic effects of common and emerging drugs of abuse have appeared over the past several years. Anabolic androgenic steroids, illicitly used by athletes and others for decades to increase muscle mass and decrease body fat, are emerging as podocyte toxins given recent descriptions of severe forms of FSGS in long-term abusers. Synthetic cannabinoids, a new group of compounds with marijuana-like effects, recently became popular as recreational drugs and have been associated with an atypical form of AKI. 3,4-Methylenedioxymethamphetamine, commonly known as ecstasy, is a widely used synthetic recreational drug with mood-enhancing properties and a constellation of toxicities that can result in death. These toxic effects include hyperthermia, hypotonic hyponatremia due to its arginine vasopressin secretagogue–like effects, rhabdomyolysis, and cardiovascular collapse. Cocaine, a serotonin-norepinephrine-dopamine reuptake inhibitor that serves as an illegal stimulant, appetite suppressant, and anesthetic, also causes vasoconstriction and rhabdomyolysis. Recent adulteration of much of the world’s supply of cocaine with levamisole, an antihelminthic agent with attributes similar to but distinct from those of cocaine, appears to have spawned a new type of ANCA-associated systemic vasculitis. This review discusses the nephrotoxic effects of these common and emerging drugs of abuse, of which both community and health care providers should become aware given their widespread abuse. Future investigation into pathogenetic mechanisms associated with these drugs is critical and may provide a window into ways to lessen and even prevent the nephrotoxic effects of these drugs of abuse and perhaps allow a deeper understanding of the nephrotoxicities themselves. PMID:25035273

  16. Surveillance of emerging drugs of abuse in Hong Kong: validation of an analytical tool.

    PubMed

    Tang, Magdalene H Y; Ching, C K; Tse, M L; Ng, Carol; Lee, Caroline; Chong, Y K; Wong, Watson; Mak, Tony W L

    2015-04-01

    To validate a locally developed chromatography-based method to monitor emerging drugs of abuse whilst performing regular drug testing in abusers. Cross-sectional study. Eleven regional hospitals, seven social service units, and a tertiary level clinical toxicology laboratory in Hong Kong. A total of 972 drug abusers and high-risk individuals were recruited from acute, rehabilitation, and high-risk settings between 1 November 2011 and 31 July 2013. A subset of the participants was of South Asian ethnicity. In total, 2000 urine or hair specimens were collected. Proof of concept that surveillance of emerging drugs of abuse can be performed whilst conducting routine drug of abuse testing in patients. The method was successfully applied to 2000 samples with three emerging drugs of abuse detected in five samples: PMMA (paramethoxymethamphetamine), TFMPP [1-(3-trifluoromethylphenyl)piperazine], and methcathinone. The method also detected conventional drugs of abuse, with codeine, methadone, heroin, methamphetamine, and ketamine being the most frequently detected drugs. Other findings included the observation that South Asians had significantly higher rates of using opiates such as heroin, methadone, and codeine; and that ketamine and cocaine had significantly higher detection rates in acute subjects compared with the rehabilitation population. This locally developed analytical method is a valid tool for simultaneous surveillance of emerging drugs of abuse and routine drug monitoring of patients at minimal additional cost and effort. Continued, proactive surveillance and early identification of emerging drugs will facilitate prompt clinical, social, and legislative management.

  17. Nephrotoxic effects of common and emerging drugs of abuse.

    PubMed

    Pendergraft, William F; Herlitz, Leal C; Thornley-Brown, Denyse; Rosner, Mitchell; Niles, John L

    2014-11-07

    The kidneys can be injured in diverse ways by many drugs, both legal and illegal. Novel associations and descriptions of nephrotoxic effects of common and emerging drugs of abuse have appeared over the past several years. Anabolic androgenic steroids, illicitly used by athletes and others for decades to increase muscle mass and decrease body fat, are emerging as podocyte toxins given recent descriptions of severe forms of FSGS in long-term abusers. Synthetic cannabinoids, a new group of compounds with marijuana-like effects, recently became popular as recreational drugs and have been associated with an atypical form of AKI. 3,4-Methylenedioxymethamphetamine, commonly known as ecstasy, is a widely used synthetic recreational drug with mood-enhancing properties and a constellation of toxicities that can result in death. These toxic effects include hyperthermia, hypotonic hyponatremia due to its arginine vasopressin secretagogue-like effects, rhabdomyolysis, and cardiovascular collapse. Cocaine, a serotonin-norepinephrine-dopamine reuptake inhibitor that serves as an illegal stimulant, appetite suppressant, and anesthetic, also causes vasoconstriction and rhabdomyolysis. Recent adulteration of much of the world's supply of cocaine with levamisole, an antihelminthic agent with attributes similar to but distinct from those of cocaine, appears to have spawned a new type of ANCA-associated systemic vasculitis. This review discusses the nephrotoxic effects of these common and emerging drugs of abuse, of which both community and health care providers should become aware given their widespread abuse. Future investigation into pathogenetic mechanisms associated with these drugs is critical and may provide a window into ways to lessen and even prevent the nephrotoxic effects of these drugs of abuse and perhaps allow a deeper understanding of the nephrotoxicities themselves. Copyright © 2014 by the American Society of Nephrology.

  18. Screening and detection of elder abuse: Research opportunities and lessons learned from emergency geriatric care, intimate partner violence, and child abuse.

    PubMed

    Beach, Scott R; Carpenter, Christopher R; Rosen, Tony; Sharps, Phyllis; Gelles, Richard

    2016-01-01

    This article provides an overview of elder abuse screening and detection methods for community-dwelling and institutionalized older adults, including general issues and challenges for the field. Then, discussions of applications in emergency geriatric care, intimate partner violence (IPV), and child abuse are presented to inform research opportunities in elder abuse screening. The article provides descriptions of emerging screening and detection methods and technologies from the emergency geriatric care and IPV fields. We also discuss the variety of potential barriers to effective screening and detection from the viewpoint of the older adult, caregivers, providers, and the health care system, and we highlight the potential harms and unintended negative consequences of increased screening and mandatory reporting. We argue that research should continue on the development of valid screening methods and tools, but that studies of perceived barriers and potential harms of elder abuse screening among key stakeholders should also be conducted.

  19. Resident experience of abuse and harassment in emergency medicine: ten years later.

    PubMed

    Li, Siu Fai; Grant, Kelly; Bhoj, Tanuja; Lent, Gretchen; Garrick, Jocelyn Freeman; Greenwald, Peter; Haber, Marc; Singh, Malini; Prodany, Karla; Sanchez, Leon; Dickman, Eitan; Spencer, James; Perera, Tom; Cowan, Ethan

    2010-02-01

    In 1995, a Society for Academic Emergency Medicine in-service survey reported high rates of verbal and physical abuse experienced by Emergency Medicine (EM) residents. We sought to determine the prevalence of abuse and harassment 10 years later to bring attention to these issues and determine if there has been a change in the prevalence of abuse over this time period. To determine the prevalence of abuse and harassment in a sample of EM residencies. We conducted a cross-section survey of EM residents from 10 residencies. EM residents were asked about their experience with verbal abuse, verbal threats, physical threats, physical attacks, sexual harassment, and racial harassment; and by whom. The primary outcome of the study was the prevalence of abuse and harassment as reported by EM residents. There were 196 of 380 residents (52%) who completed the survey. The prevalence of any type of abuse experienced was 91%; 86% of residents experienced verbal abuse, 65% verbal threats, 50% physical threats, 26% physical attacks, 23% sexual harassment, and 26% racial harassment. Women were more likely than men to encounter sexual harassment (37% [38/102] vs. 8% [7/92]; p < 0.001). Racial harassment was not limited to minorities (23% [16/60] for Caucasians vs. 26% [29/126] for non-Caucasians; p = 0.59). Senior residents were more likely to have encountered verbal and physical abuse. Only 12% of residents formally reported the abuse they experienced. Abuse and harassment during EM residency continues to be commonplace and is underreported. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  20. Emergency department-based interventions for women suffering domestic abuse: a critical literature review.

    PubMed

    Ansari, Sereena; Boyle, Adrian

    2017-02-01

    Domestic abuse represents a serious public health and human rights concern. Interventions to reduce the risk of abuse include staff training and standardized documentation improving detection and adherence to referral pathways. Interventional studies have been conducted in primary care, maternity and outpatient settings. Women disclosing abuse in emergency departments differ from women attending other healthcare settings, and it is unclear whether these interventions can be transferred to the emergency care setting. This review examines interventional studies to evaluate the effectiveness of emergency department-based interventions in reducing domestic abuse-related morbidity. Medline, EMBASE, CINAHL, PsycINFO and Cochrane Library were searched, according to prespecified selection criteria. Study quality was assessed using the Jadad scale. Of 273 search results, nine were eligible for review. Interventions involving staff training demonstrated benefits in subjective measures, such as staff knowledge regarding abuse, but no changes in clinical practice, based on detection and referral rates. When staff training was implemented in conjunction with supporting system changes - for example, standardized documentation for assessment and referral - clinically relevant improvements were noted. Interventions centred around staff training are insufficient to bring about improvements in the management and, thus, outcome of patients suffering abuse. Instead, system changes, such as standardized documentation and referral pathways, supported by training, may bring about beneficial changes. It remains uncertain whether surrogate outcomes employed by most studies translate to changes in abuse-related morbidity: the ultimate goal.

  1. Understanding management and support for domestic violence and abuse within emergency departments: A systematic literature review from 2000-2015.

    PubMed

    Hinsliff-Smith, Kathryn; McGarry, Julie

    2017-12-01

    To identify, review and critically evaluate published empirical studies concerned with the prevalence, management and support for survivors of domestic violence and abuse who present at emergency department. Domestic violence and abuse is a global phenomenon with a wealth of studies that explore the different aspects of the issue including the economic, social and health effects on survivors and on society as a whole. Emergency department is widely recognised as one healthcare facility where domestic violence and abuse survivors will often disclose domestic violence and abuse. In the UK, National Institute of Clinical Excellence produced guidelines in 2014 requiring all sectors of health care and those they work alongside to recognise support and manage survivors of domestic violence and abuse. Whilst there is an increasing body of research on domestic violence and abuse, limited synthesised work has been conducted in the context of domestic violence and abuse within emergency department. This review encompasses empirical studies conducted in emergency department for screening interventions, management and support for domestic violence and abuse patients including prevalence. This review included studies that included emergency department staff, emergency department service users and domestic violence and abuse survivors. A systematic approach across five electronic bibliographic databases found 35 studies meeting the inclusion criteria published between 2000-2015. From the 35 studies, four descriptive overarching themes were identified (i) prevalence of domestic violence and abuse in emergency department, (ii) use of domestic violence and abuse screening tools and emergency department interventions, (iii) current obstacles for staff working in emergency department and (iv) emergency department users and survivor perspectives. Having knowledgeable and supportive emergency department staff can have a positive benefit for the longer-term health of the domestic

  2. Rural-Urban Disparities in Child Abuse Management Resources in the Emergency Department

    ERIC Educational Resources Information Center

    Choo, Esther K.; Spiro, David M.; Lowe, Robert A.; Newgard, Craig D.; Hall, Michael Kennedy; McConnell, Kenneth John

    2010-01-01

    Purpose: To characterize differences in child abuse management resources between urban and rural emergency departments (EDs). Methods: We surveyed ED directors and nurse managers at hospitals in Oregon to gain information about available abuse-related resources. Chi-square analysis was used to test differences between urban and rural EDs.…

  3. Socio-demographic and clinical profile of substance abuse patients admitted to an emergency department in Ankara, Turkey.

    PubMed

    Avci, Sema; Sarikaya, Ridvan; Kavak, Nezih; Özmen, Fatma Nihal; Aydin, Macit; Arslan, Engin Deniz; Büyükcam, Fatih

    2017-01-16

    Illicit drug abuse is an important health problem around the world. Cannabis is the most commonly used illicit drug, followed by amphetamines, opioids, and cocaine. In this study, we searched the socio-demographic features of drug abusers admitted to an emergency department. The study was performed in the emergency department of an education and training hospital in Ankara, Turkey. The socio-demographic features, substances commonly consumed, and the reason for the patients' presentation were recorded. The mean age of patients was 28.3±9.2. Of those under study, 93.3% were male; 68.7% were discharged from the emergency department after a short observation period; and 10.4% were hospitalized. The median age of the patients' first experience with illicit substances was 19 (4-56). Illicit drug use remains a significant medical health problem, not only in Turkey but also around the world. Abusers frequently seek emergency services, complaining of various symptoms, but generally do not mention their substance abuse. Emergency physicians must ask patients if they use abuse drugs.

  4. The Impact of High-Profile Sexual Abuse Cases in the Media on a Pediatric Emergency Department.

    PubMed

    Flannery, Dustin D; Stephens, Clare L; Thompson, Amy D

    2016-01-01

    High-profile media cases of sexual abuse may encourage disclosures of abuse from victims of unrelated assaults and also influence parental concerns, leading to increased emergency department visits. In the region of the study authors' institution, there are two recent high-profile sexual abuse cases with media coverage: Earl Bradley, a Delaware pediatrician, and Jerry Sandusky, a Pennsylvania college football coach. This is a retrospective cohort study of children evaluated for sexual abuse at a pediatric emergency department. Patients were classified as either presenting during a media period or non-media period. The media periods were one-month periods immediately following breaking news reports, when the cases were highly publicized in the media. The non-media periods were the 12-month periods directly preceding the first reports. The median number of emergency department visits per month during a non-media period was 9 visits (interquartile range 6-10). There were 11 visits in the month following the Sandusky case and 13 visits following the Bradley case. There was no statistical difference in number of emergency department visits for sexual abuse between the periods (p = .09). These finding have implications regarding use of resources in pediatric EDs after high-profile sexual abuse cases.

  5. Emergency Medical Services Perspectives on Identifying and Reporting Victims of Elder Abuse, Neglect, and Self-Neglect.

    PubMed

    Rosen, Tony; Lien, Cynthia; Stern, Michael E; Bloemen, Elizabeth M; Mysliwiec, Regina; McCarthy, Thomas J; Clark, Sunday; Mulcare, Mary R; Ribaudo, Daniel S; Lachs, Mark S; Pillemer, Karl; Flomenbaum, Neal E

    2017-10-01

    Emergency Medical Services (EMS) providers, who perform initial assessments of ill and injured patients, often in a patient's home, are uniquely positioned to identify potential victims of elder abuse, neglect, or self-neglect. Despite this, few organized programs exist to ensure that EMS concerns are communicated to or further investigated by other health care providers, social workers, or the authorities. To explore attitudes and self-reported practices of EMS providers surrounding identification and reporting of elder mistreatment. Five semi-structured focus groups with 27 EMS providers. Participants reported believing they frequently encountered and were able to identify potential elder mistreatment victims. Many reported infrequently discussing their concerns with other health care providers or social workers and not reporting them to the authorities due to barriers: 1) lack of EMS protocols or training specific to vulnerable elders; 2) challenges in communication with emergency department providers, including social workers, who are often unavailable or not receptive; 3) time limitations; and 4) lack of follow-up when EMS providers do report concerns. Many participants reported interest in adopting protocols to assist in elder protection. Additional strategies included photographically documenting the home environment, additional training, improved direct communication with social workers, a dedicated location on existing forms or new form to document concerns, a reporting hotline, a system to provide feedback to EMS, and community paramedicine. EMS providers frequently identify potential victims of elder abuse, neglect, and self-neglect, but significant barriers to reporting exist. Strategies to empower EMS providers and improve reporting were identified. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Emergence of Sex Differences in the Development of Substance Use and Abuse during Adolescence

    PubMed Central

    Kuhn, Dr. Cynthia

    2015-01-01

    Substance use and abuse begins during adolescence. Male and female adolescent humans initiate use at comparable rates, but males increase use faster. In adulthood, more men than women use and abuse addictive drugs. However, some women progress more rapidly from initiation of use to entry into treatment. In animal models, adolescent males and females consume addictive drugs similarly. However, reproductively mature females acquire self-administration faster, and in some models, escalate use more. Sex/gender differences exist in neurobiologic factors mediating both reinforcement (dopamine, opioids) and aversiveness (CRF, dynorphin), as well as intrinsic factors (personality, psychiatric co-morbidities) and extrinsic factors (history of abuse, environment especially peers and family) which influence the progression from initial use to abuse., Many of these important differences emerge during adolescence, and are moderated by sexual differentiation of the brain. Estradiol effects which enhance both dopaminergic and CRF-mediated processes contribute to the female vulnerability to substance use and abuse. Testosterone enhances impulsivity and sensation seeking in both males and females. Several protective factors in females also influence initiation and progression of substance use including hormonal changes of pregnancy as well as greater capacity for self-regulation and lower peak levels of impulsivity/sensation seeking. Same sex peers represent a risk factor more for males than females during adolescence, while romantic partners increase risk for women during this developmental epoch. In summary, biologic factors, psychiatric co-morbidities as well as personality and environment present sex/gender-specific risks as adolescents begin to initiate substance use. PMID:26049025

  7. Emergence of sex differences in the development of substance use and abuse during adolescence.

    PubMed

    Kuhn, Cynthia

    2015-09-01

    Substance use and abuse begin during adolescence. Male and female adolescent humans initiate use at comparable rates, but males increase use faster. In adulthood, more men than women use and abuse addictive drugs. However, some women progress more rapidly from initiation of use to entry into treatment. In animal models, adolescent males and females consume addictive drugs similarly. However, reproductively mature females acquire self-administration faster, and in some models, escalate use more. Sex/gender differences exist in neurobiologic factors mediating both reinforcement (dopamine, opioids) and aversiveness (CRF, dynorphin), as well as intrinsic factors (personality, psychiatric co-morbidities) and extrinsic factors (history of abuse, environment especially peers and family) which influence the progression from initial use to abuse. Many of these important differences emerge during adolescence, and are moderated by sexual differentiation of the brain. Estradiol effects which enhance both dopaminergic and CRF-mediated processes contribute to the female vulnerability to substance use and abuse. Testosterone enhances impulsivity and sensation seeking in both males and females. Several protective factors in females also influence initiation and progression of substance use including hormonal changes of pregnancy as well as greater capacity for self-regulation and lower peak levels of impulsivity/sensation seeking. Same sex peers represent a risk factor more for males than females during adolescence, while romantic partners increase risk for women during this developmental epoch. In summary, biologic factors, psychiatric co-morbidities as well as personality and environment present sex/gender-specific risks as adolescents begin to initiate substance use. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Cognitive impairment associated with cocaine use: The role of co-existent alcohol abuse/dependence.

    PubMed

    Blanco-Presas, Laura; Moreno-Alcázar, Ana; Alonso-Lana, Silvia; Salvador, Raymond; Pomarol-Clotet, Edith; McKenna, Peter

    2018-05-29

    Cocaine abuse has been reported as leading to impaired cognitive function. However, cocaine abusers commonly also abuse alcohol, which can itself produce cognitive impairment. This study, therefore, aimed to examine the potential confounding effect of alcohol abuse on neuropsychological test performance in cocaine and alcohol abusing individuals, comparing them with individuals who abused alcohol alone and non-abusing controls. Nineteen cocaine abusers who also met DSM-IV criteria for alcohol abuse/dependence (14 m, 5f; mean age 38.65 ± 3.83) and 20 matched individuals who met criteria for alcohol abuse/dependence alone (12 m, 8f; mean age 38.19 ± 4.82) were administered a battery of neuropsychological tests covering executive function, memory, language and visual/visuospatial function after two to four weeks of abstinence. Nineteen matched healthy controls (8 m, 11f; mean age 37.01 ± 5.98) were also tested. Both the cocaine + alcohol group and the alcohol group performed significantly more poorly than the healthy controls on the executive (ESs 2.13 and 2.57) and memory tests (ESs 0.58 and 1.06). The findings were similar for language (ESs 0.92 and 1.69), where the cocaine + alcohol abusers additionally performed significantly better than the alcohol abusers. Both patient groups were impaired on two of the five tests of visual/visuospatial function, with better performance by the cocaine + alcohol group on one of them. Chronic cocaine abuse does not appear from this study to be associated with cognitive impairment over and above that which can be attributed to co-existent alcohol abuse. Copyright © 2018 Elsevier B.V. All rights reserved.

  9. Child abuse training and knowledge: a national survey of emergency medicine, family medicine, and pediatric residents and program directors.

    PubMed

    Starling, Suzanne P; Heisler, Kurt W; Paulson, James F; Youmans, Eren

    2009-04-01

    The objective of this study was to determine the level of knowledge, comfort, and training related to the medical management of child abuse among pediatrics, emergency medicine, and family medicine residents. Surveys were administered to program directors and third-year residents at 67 residency programs. The resident survey included a 24-item quiz to assess knowledge regarding the medical management of physical and sexual child abuse. Sites were solicited from members of a network of child abuse physicians practicing at institutions with residency programs. Analyzable surveys were received from 53 program directors and 462 residents. Compared with emergency medicine and family medicine programs, pediatric programs were significantly larger and more likely to have a medical provider specializing in child abuse pediatrics, have faculty primarily responsible for child abuse training, use a written curriculum for child abuse training, and offer an elective rotation in child abuse. Exposure to child abuse training and abused patients was highest for pediatric residents and lowest for family medicine residents. Comfort with managing child abuse cases was lowest among family medicine residents. On the knowledge quiz, pediatric residents significantly outperformed emergency medicine and family medicine residents. Residents with high knowledge scores were significantly more likely to come from larger programs and programs that had a center, provider, or interdisciplinary team that specialized in child abuse pediatrics; had a physician on faculty responsible for child abuse training; used a written curriculum for child abuse training; and had a required rotation in child abuse pediatrics. By analyzing the relationship between program characteristics and residents' child abuse knowledge, we found that pediatric programs provide far more training and resources for child abuse education than emergency medicine and family medicine programs. As leaders, pediatricians must

  10. The complexities of elder abuse.

    PubMed

    Roberto, Karen A

    2016-01-01

    Elder abuse is a growing societal concern, affecting at least 1 in 10 older Americans. Researchers and practitioners alike consistently assert that a dramatic discrepancy exists between the prevalence rates of elder abuse and the number of elder abuse cases reported. As a field of study, recognition and understanding of elder abuse is still emerging. Comparing findings of a small, but growing, body of literature on perceived and substantiated cases of elder abuse is challenging because there is no uniform term or agreed-upon definition used among state governments, researchers, health care and service providers, and advocates. This article summarizes current understanding of elder abuse, including what constitutes elder abuse, risk factors for elder abuse, perpetrators of elder abuse, and outcomes of elder abuse. Issues associated with the detection of elder abuse and intervention strategies for victims of abuse are addressed. In the final section, potential roles and contributions of psychologists for advancing elder abuse research, professional practice, and policy development are highlighted. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  11. Rural-urban disparities in child abuse management resources in the emergency department.

    PubMed

    Choo, Esther K; Spiro, David M; Lowe, Robert A; Newgard, Craig D; Hall, Michael Kennedy; McConnell, Kenneth John

    2010-01-01

    To characterize differences in child abuse management resources between urban and rural emergency departments (EDs). We surveyed ED directors and nurse managers at hospitals in Oregon to gain information about available abuse-related resources. Chi-square analysis was used to test differences between urban and rural EDs. Multivariate analysis was performed to examine the association between a variety of hospital characteristics, in addition to rural location, and presence of child abuse resources. Fifty-five Oregon hospitals were surveyed. A smaller proportion of rural EDs had written abuse policies (62% vs 95%, P= .006) or on-site child abuse advocates (35% vs 71%, P= .009). Thirty-two percent of rural EDs had none of the examined abuse resources (vs 0% of urban EDs, P= .01). Of hospital characteristics studied in the multivariate model, only rural location was associated with decreased availability of child abuse resources (OR 0.19 [95% CI, 0.05-0.70]). Rural EDs have fewer resources than urban EDs for the management of child abuse. Other studied hospital characteristics were not associated with availability of abuse resources. Further work is needed to identify barriers to resource utilization and to create resources that can be made accessible to all ED settings. © 2010 National Rural Health Association.

  12. Child Abuse and Neglect: Critical First Steps in Response to a National Emergency.

    ERIC Educational Resources Information Center

    United States Advisory Board on Child Abuse and Neglect, Washington, DC.

    The need for a national strategy on child abuse and neglect has reached crisis proportions. This report declares child abuse and neglect a national emergency and presents the key elements of a national response to this crisis. Following an executive summary, the report is divided into three parts. Part 1, "The Need for a National Strategy on…

  13. [Systematic detection of physical child abuse at emergency rooms].

    PubMed

    Sittig, J S; Uiterwaal, C S P M; Moons, K G M; Russel, I M B; Nievelstein, R A J; Nieuwenhuis, E E S; van de Putte, E M

    2016-01-01

    The aim of our diagnostic accuracy study Child Abuse Inventory at Emergency Rooms (CHAIN-ER) was to establish whether a widely used checklist accurately detects or excludes physical abuse among children presenting to ERs with physical injury. A large multicentre study with a 6-month follow-up in 4 ERs in The Netherlands. Participants were 4290 children aged 0-7 years, attending the ER because of physical injury. All children were systematically tested with an easy-to-use child abuse checklist (index test). A national expert panel (reference standard) retrospectively assessed all children with positive screens and a 15% random sample of the children with negative screens for physical abuse, using additional information, namely, an injury history taken by a paediatrician, information provided by the general practitioner, youth doctor and social services by structured questionnaires, and 6-month follow-up information. Our main outcome measure was physical child abuse; secondary outcome measure was injury due to neglect and need for help. 4253/4290 (99%) parents agreed to follow-up. At a prevalence of 0.07% (3/4253) for inflicted injury by expert panel decision, the positive predictive value of the checklist was 0.03 (95% CI 0.006 to 0.085), and the negative predictive value 1.0 (0.994 to 1.0). There was 100% (93 to 100) agreement about inflicted injury in children, with positive screens between the expert panel and child abuse experts. Rare cases of inflicted injury among preschool children presenting at ERs for injury are very likely captured by easy-to-use checklists, but at very high false-positive rates. Subsequent assessment by child abuse experts can be safely restricted to children with positive screens at very low risk of missing cases of inflicted injury. Because of the high false positive rate, we do advise careful prior consideration of cost-effectiveness and clinical and societal implications before de novo implementation.

  14. Analysis of contextual variables in the evaluation of child abuse in the pediatric emergency setting.

    PubMed

    Almeida, Ana Nunes de; Ramos, Vasco; Almeida, Helena Nunes de; Escobar, Carlos Gil; Garcia, Catarina

    This article comprises a sample of abuse modalities observed in a pediatric emergency room of a public hospital in the Lisbon metropolitan area and a multifactorial characterization of physical and sexual violence. The objectives are: (1) to discuss the importance of social and family variables in the configuration of both types of violence; (2) to show how physical and sexual violence have subtypes and internal diversity. A statistical analysis was carried out in a database (1063 records of child abuse between 2004 and 2013). A form was applied to cases with suspected abuse, containing data on the child, family, abuse episode, abuser, medical history, and clinical observation. A factorial analysis of multiple correspondence was performed to identify patterns of association between social variables and physical and sexual violence, as well as their internal diversity. The prevalence of abuse in this pediatric emergency room was 0.6%. Physical violence predominated (69.4%), followed by sexual violence (39.3%). Exploratory profiles of these types of violence were constructed. Regarding physical violence, the gender of the abuser was the first differentiating dimension; the victim's gender and age range were the second one. In the case of sexual violence, the age of the abuser and co-residence with him/her comprised the first dimension; the victim's age and gender comprised the second dimension. Patterns of association between victims, family contexts, and abusers were identified. It is necessary to alert clinicians about the importance of social variables in the multiple facets of child abuse. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  15. Hospital based emergency department visits attributed to child physical abuse in United States: predictors of in-hospital mortality.

    PubMed

    Allareddy, Veerajalandhar; Asad, Rahimullah; Lee, Min Kyeong; Nalliah, Romesh P; Rampa, Sankeerth; Speicher, David G; Rotta, Alexandre T; Allareddy, Veerasathpurush

    2014-01-01

    To describe nationally representative outcomes of physical abuse injuries in children necessitating Emergency Department (ED) visits in United States. The impact of various injuries on mortality is examined. We hypothesize that physical abuse resulting in intracranial injuries are associated with worse outcome. We performed a retrospective analysis of the Nationwide Emergency Department Sample (NEDS), the largest all payer hospital based ED database, for the years 2008-2010. All ED visits and subsequent hospitalizations with a diagnosis of "Child physical abuse" (Battered baby or child syndrome) due to various injuries were identified using ICD-9-CM (International Classification of Diseases, 9th Revision, Clinical Modification) codes. In addition, we also examined the prevalence of sexual abuse in this cohort. A multivariable logistic regression model was used to examine the association between mortality and types of injuries after adjusting for a multitude of patient and hospital level factors. Of the 16897 ED visits that were attributed to child physical abuse, 5182 (30.7%) required hospitalization. Hospitalized children were younger than those released treated and released from the ED (1.9 years vs. 6.4 years). Male or female partner of the child's parent/guardian accounted for >45% of perpetrators. Common injuries in hospitalized children include- any fractures (63.5%), intracranial injuries (32.3%) and crushing/internal injuries (9.1%). Death occurred in 246 patients (13 in ED and 233 following hospitalization). Amongst the 16897 ED visits, 1.3% also had sexual abuse. Multivariable analyses revealed each 1 year increase in age was associated with a lower odds of mortality (OR = 0.88, 95% CI = 0.81-0.96, p < 0.0001). Females (OR = 2.39, 1.07-5.34, p = 0.03), those with intracranial injuries (OR = 65.24, 27.57-154.41, p<0.0001), or crushing/internal injury (OR = 4.98, 2.24-11.07, p<0.0001) had higher odds of mortality compared to their male counterparts. In this

  16. Elder Abuse Identification in the Prehospital Setting: An Examination of State Emergency Medical Services Protocols.

    PubMed

    Namboodri, Brooke L; Rosen, Tony; Dayaa, Joseph A; Bischof, Jason J; Ramadan, Nadeem; Patel, Mehul D; Grover, Joseph; Brice, Jane H; Platts-Mills, Timothy F

    2018-03-22

    To describe statewide emergency medical service (EMS) protocols relating to identification, management, and reporting of elder abuse in the prehospital setting. Cross-sectional analysis. Statewide EMS protocols in the United States. Publicly available statewide EMS protocols identified from published literature, http://EMSprotocols.org, and each state's public health website. Protocols were reviewed to determine whether elder abuse was mentioned, elder abuse was defined, potential indicators of elder abuse were listed, management of older adults experiencing abuse was described, and instructions regarding reporting were provided. EMS protocols for child abuse were reviewed in the same manner for the purpose of comparison. Of the 35 publicly available statewide EMS protocols, only 14 (40.0%) mention elder abuse. Of protocols that mention elder abuse, 6 (42.9%) define elder abuse, 10 (71.4%) describe indicators of elder abuse, 8 (57.1%) provide instruction regarding management, and 12 (85.7%) provide instruction regarding reporting. Almost twice as many states met each of these metrics for child abuse. Statewide EMS protocols for elder abuse vary in regard to identification, management, and reporting, with the majority of states having no content on this subject. Expansion and standardization of protocols may increase the identification of elder abuse. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

  17. Building workforce capacity to detect and respond to child abuse and neglect cases: A training intervention for staff working in emergency settings in Vietnam.

    PubMed

    Flemington, Tara; Fraser, Jennifer

    2017-09-01

    Too many children are brought to hospital emergency departments on numerous occasions before they are recognised as victims of child abuse and neglect. For this reason, improving knowledge and response behaviors of emergency staff at all levels is likely to have a significant impact on better outcomes. An Australian based training programme was the first of its kind to address this issue in a Vietnamese Emergency Department. Titled 'Safe Children Vietnam', the programme aimed to improve knowledge, attitudes and reporting behaviors concerning child abuse in the emergency setting. A pre-post test design was used to evaluate the impact of 'Safe Children Vietnam' on emergency staff knowledge, attitudes and intentions to report child abuse and neglect. Emergency staff including doctors, nurses and healthcare staff (n=116) participated in the clinical training programme. Linear Mixed Model analyses showed that on programme completion, they were more likely to recognise serious cases of all types of abuse. The 'Safe Children Vietnam' programme was effective at improving emergency staff knowledge of child abuse and neglect. A systems wide approach may be necessary to impact on emergency staff attitudes towards reporting cases of abuse. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Children with burns referred for child abuse evaluation: Burn characteristics and co-existent injuries.

    PubMed

    Pawlik, Marie-Christin; Kemp, Alison; Maguire, Sabine; Nuttall, Diane; Feldman, Kenneth W; Lindberg, Daniel M

    2016-05-01

    Intentional burns represent a serious form of physical abuse that must be identified to protect children from further harm. This study is a retrospectively planned secondary analysis of the Examining Siblings To Recognize Abuse (ExSTRA) network data. Our objective was to describe the characteristics of burns injuries in children referred to Child Abuse Pediatricians (CAPs) in relation to the perceived likelihood of abuse. We furthermore compare the extent of diagnostic investigations undertaken in children referred to CAPs for burn injuries with those referred for other reasons. Within this dataset, 7% (215/2890) of children had burns. Children with burns were older than children with other injuries (median age 20 months vs. 10 months). Physical abuse was perceived as likely in 40.9% (88) and unlikely in 59.1% (127). Scalds accounted for 52.6% (113) and contact burns for 27.6% (60). Several characteristics of the history and burn injury were associated with a significantly higher perceived likelihood of abuse, including children with reported inflicted injury, absent or inadequate explanation, hot water as agent, immersion scald, a bilateral/symmetric burn pattern, total body surface area ≥10%, full thickness burns, and co-existent injuries. The rates of diagnostic testing were significantly lower in children with burns than other injuries, yet the yield of skeletal survey and hepatic transaminases testing were comparable between the two groups. This would imply that children referred to CAPs for burns warrant the same level of comprehensive investigations as those referred for other reasons. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  19. Imaging Findings in Elder Abuse: A Role for Radiologists in Detection.

    PubMed

    Wong, Natalie Z; Rosen, Tony; Sanchez, Allen M; Bloemen, Elizabeth M; Mennitt, Kevin W; Hentel, Keith; Nicola, Refky; Murphy, Kieran J; LoFaso, Veronica M; Flomenbaum, Neal E; Lachs, Mark S

    2017-02-01

    Emergency department assessment represents a critical but often missed opportunity to identify elder abuse, which is common and has serious consequences. Among emergency care providers, diagnostic radiologists are optimally positioned to raise suspicion for mistreatment when reviewing imaging of geriatric injury victims. However, little literature exists describing relevant injury patterns, and most radiologists currently receive neither formal nor informal training in elder abuse identification. We present 2 cases to begin characterisation of the radiographic findings in elder abuse. Findings from these cases demonstrate similarities to suspicious findings in child abuse including high-energy fractures that are inconsistent with reported mechanisms and the coexistence of acute and chronic injuries. Specific injuries uncommon to accidental injury are also noted, including a distal ulnar diaphyseal fracture. We hope to raise awareness of elder abuse among diagnostic radiologists to encourage future large-scale research, increased focus on chronic osseous findings, and the addition of elder abuse to differential diagnoses. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  20. Resource Manual for Alcohol and Other Drug Abuse Education in Emergency Medicine.

    ERIC Educational Resources Information Center

    American Coll. of Emergency Physicians, Dallas, TX.

    The curriculum guide and bibliography identifies the minimum skills, knowledge, and attitudes that emergency physicians should have relative to drug and alcohol abuse and identifies appropriate educational materials and strategies for medical schools to include in their training programs. Objectives were based on 73 survey responses from medical…

  1. Fatal child abuse in Japan: does a trend exist toward tougher sentencing?

    PubMed

    Nambu, Saori; Nasu, Ayako; Nishimura, Shigeru; Nishimura, Akiyoshi; Fujiwara, Satoshi

    2011-07-01

    It has been pointed out in Japan that criminal punishment in domestic homicide cases, especially in fatal child abuse cases, tends to be more lenient than in public homicide cases that occur outside the home. In recent news accounts of fatal child abuse cases, however, the media has reported that court-imposed sentences have tended to be stricter every year. Using the online databases of three major Japanese newspapers, we collected articles about fatal child abuse cases that had been published from January 2008 to December 2009. We analyzed these articles to determine, whether a tendency towards tougher penalties, as was put forward by the media, actually exists at present time in the criminal system in Japan. We found 24 cases, out of which 20 involved only one offender and 4 involved two offenders. These 28 offenders comprised nine biological fathers, 11 biological mothers, and eight other male relatives of the child victims. We found that the sentences handed down by the court clearly tended to be more lenient for female offenders. A new system of criminal jurisprudence, the so-called saiban-in system wherein citizens serve as "lay judges" in criminal trials involving serious crimes, was implemented in Japan at the start of 2009. Each, district court has gradually adopted this new system after a preparation period of approximately five years starting in 2004. Many figures in the Japanese media predicted that the gap between social expectations and court sentences for sanction against domestic homicide cases would be filled with the present transitional period of the Japanese criminal system. However, the present study found no significant difference in the laws regarding sentencing in fatal child abuse cases before and after the preparation period of the saiban-in system.

  2. Support and monitoring of families after child abuse detection based on parental characteristics at the Emergency Department.

    PubMed

    Diderich, H M; Pannebakker, F D; Dechesne, M; Buitendijk, S E; Oudesluys-Murphy, A M

    2015-03-01

    The 'Hague Protocol' enables professionals at the adult Emergency Department (ED) to detect child abuse based on three parental characteristics: (i) suicide attempt or self-harm, (ii) domestic violence or (iii) substance abuse, and to refer them to the Reporting Centre for Child Abuse and Neglect (RCCAN). This study investigates what had happened to the families three months after this referral. ED referrals based on parental characteristics (N = 100) in which child abuse was confirmed after investigation by the RCCAN were analysed. Information was collected regarding type of child abuse, reason for reporting, duration of problems prior to the ED referral, previous involvement of support services or other agencies, re-occurrence of the problems and outcome of the RCCAN monitoring according to professionals and the families. Of the 100 referred cases, 68 families were already known to the RCCAN, the police or family support services, prior to the ED referral. Of the 99 cases where information was available, existing support was continued or intensified in 31, a Child Protection Services (CPS) report had to be made in 24, new support was organized for 27 cases and in 17 cases support was not necessary, because the domestic problems were already resolved. Even though the RCCAN is mandated to monitor all referred families after three months, 31 cases which were referred internally were not followed up. Before referral by the ED two thirds of these families were already known to organizations. Monitoring may help provide a better, more sustained service and prevent and resolve domestic problems. A national database could help to link data and to streamline care for victims and families. We recommend a Randomized Controlled Trial to test the effectiveness of this Protocol in combination with the outcomes of the provided family support. © 2014 John Wiley & Sons Ltd.

  3. Screening injured children for physical abuse or neglect in emergency departments: a systematic review.

    PubMed

    Woodman, J; Lecky, F; Hodes, D; Pitt, M; Taylor, B; Gilbert, Ruth

    2010-03-01

    Screening markers are used in emergency departments (EDs) to identify children who should be assessed for possible physical abuse and neglect. We conducted three systematic reviews evaluating age, repeat attendance and injury type as markers for physical abuse or neglect in injured children attending EDs. We included studies comparing markers in physically abused or neglected children and non-abused injured children attending ED or hospital. We calculated likelihood ratios (LRs) for age group, repeat attendance and injury type (head injury, bruises, fractures, burns or other). Given the low prevalence of abuse or neglect, we considered that an LR of 10 or more would be clinically useful. All studies were poor quality. Infancy increased the risk of physical abuse or neglect in severely injured or admitted children (LRs 7.7-13.0, 2 studies) but was not strongly associated in children attending the ED (LR 1.5, 95% CI: 0.9, 2.8; one study). Repeat attendance did not substantially increase the risk of abuse or neglect and may be confounded by chronic disease and socio-economic status (LRs 0.8-3.9, 3 studies). One study showed no evidence that the type of injury substantially increased the risk of physical abuse or neglect in severely injured children. There was no evidence that any of the markers (infancy, type of injury, repeated attendance) were sufficiently accurate (i.e. LR >or= 10) to screen injured children in the ED to identify those requiring paediatric assessment for possible physical abuse or neglect. Clinicians should be aware that among injured children at ED a high proportion of abused children will present without these characteristics and a high proportion of non-abused children will present with them. Information about age, injury type and repeat attendances should be interpreted in this context.

  4. Drug abuse-related accidents leading to emergency department visits at two medical centers.

    PubMed

    Chen, Isaac Chun-Jen; Hung, Dong-Zong; Hsu, Chi-Ho; Wu, Ming-Ling; Deng, Jou-Fang; Chang, Chin-Yu; Shih, Hsin-Chin; Liu, Chen-Chi; Wang, Chien-Ying; Wen, Yi-Szu; Wu, Jackson Jer-Kan; Huang, Mu-Shun; Yang, Chen-Chang

    2012-05-01

    Drug abuse is becoming more prevalent in Taiwan, as evidenced by increasing reports of drug trafficking and drug abuse-related criminal activity, and the wide use of more contemporary illicit drugs. Consequently, drug abuse-related accidents are also expected to occur with greater frequency. However, no study has yet specifically evaluated the prevalence, pattern, and outcomes of drug abuse-related accidents among patients visiting emergency departments (EDs) in Taiwan. We conducted an ambidirectional study with patients who visited the EDs of Taipei Veterans General Hospital (TVGH) and China Medical University Hospital (CMUH) due to drug abuse-related accidents from January 2007 through September 2009. Information on the patients' baseline characteristics and clinical outcomes was collected and analyzed. During the study period, a total of 166 patients visited the EDs of one of the two study hospitals due to drug abuse-related accidents. This yielded a prevalence of drug abuse of 0.1% among all patients visiting the ED due to accident and/or trauma. Fifty-six out of the 166 patients visited the ED at TVGH, most patients being between 21 and 40 years old. Opioids (41.1%) were the drugs most commonly abused by the patients, followed by benzodiazepines (32.1%). More than two-thirds of the patients (n=38, 67.9%) required hospitalization, and three patients died (5.4%). In contrast, 110 patients with drug abuse-related accidents visited the ED at CMUH during the study period. Most of these subjects had abused benzodiazepines (69.1%), were between 21 and 40 years old, and were female. Fewer than one-fifth of the patients (n=19, 17.3%) required hospitalization, with no deaths reported. There were significant between-hospital differences in terms of patient gender, drugs of choice, injury mechanisms, method and time of the ED visit, triage levels, and need for hospitalization. Although the prevalence of drug abuse-related accidents was low, and only three patient deaths

  5. Emergency Department Presentations for Injuries in Older Adults Independently Known to be Victims of Elder Abuse

    PubMed Central

    Rosen, Tony; Bloemen, Elizabeth M.; LoFaso, Veronica M.; Clark, Sunday; Flomenbaum, Neal; Lachs, Mark S.

    2015-01-01

    Background Elder abuse is under-recognized by Emergency Department (ED) providers, largely due to challenges distinguishing between abuse and accidental trauma. Objective To describe patterns and circumstances surrounding elder abuse-related and potentially abuse-related injuries in ED patients independently known to be physical elder abuse victims. Methods ED utilization of community-dwelling victims of physical elder abuse in New Haven, CT from 1981-1994 was analyzed previously. Cases were identified using Elderly Protective Services data matched to ED records. 66 ED visits were judged to have high probability of being related to elder abuse and 244 of indeterminate probability. We re-examined these visits to assess whether they occurred due to injury. We identified and analyzed in detail 31 injury-associated ED visits from 26 patients with high probability of being related to elder abuse and 108 visits from 57 patients with intermediate probability and accidental injury. Results Abuse-related injuries were most common on upper extremities (45% of visits) and lower extremities (32%), with injuries on head or neck noted in 13 visits (42%). Bruising was observed in 39% of visits, most commonly on upper extremities. 42% of purportedly accidental injuries had suspicious characteristics, with the most common suspicious circumstance being injury occurring >1 day prior to presentation and the most common suspicious injury pattern being maxillofacial injuries. Conclusion Victims of physical elder abuse commonly have injuries on upper extremities, head, and neck. Suspicious circumstances and injury patterns may be identified and are commonly present when victims of physical elder abuse present with purportedly accidental injuries. PMID:26810019

  6. Emergency Department Presentations for Injuries in Older Adults Independently Known to be Victims of Elder Abuse.

    PubMed

    Rosen, Tony; Bloemen, Elizabeth M; LoFaso, Veronica M; Clark, Sunday; Flomenbaum, Neal E; Lachs, Mark S

    2016-03-01

    Elder abuse is under-recognized by emergency department (ED) providers, largely due to challenges distinguishing between abuse and accidental trauma. To describe patterns and circumstances surrounding elder abuse-related and potentially abuse-related injuries in ED patients independently known to be physical elder abuse victims. ED utilization of community-dwelling victims of physical elder abuse in New Haven, CT from 1981-1994 was analyzed previously. Cases were identified using Elderly Protective Services data matched to ED records. Sixty-six ED visits were judged to have high probability of being related to elder abuse and 244 were of indeterminate probability. We re-examined these visits to assess whether they occurred due to injury. We identified and analyzed in detail 31 injury-associated ED visits from 26 patients with high probability of being related to elder abuse and 108 visits from 57 patients with intermediate probability and accidental injury. Abuse-related injuries were most common on upper extremities (45% of visits) and lower extremities (32%), with injuries on head or neck noted in 13 visits (42%). Bruising was observed in 39% of visits, most commonly on upper extremities. Forty-two percent of purportedly accidental injuries had suspicious characteristics, with the most common suspicious circumstance being injury occurring more than 1 day prior to presentation, and the most common suspicious injury pattern being maxillofacial injuries. Victims of physical elder abuse commonly have injuries on the upper extremities, head, and neck. Suspicious circumstances and injury patterns may be identified and are commonly present when victims of physical elder abuse present with purportedly accidental injuries. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Reimbursement and Insurance Coverage in Cases of Suspected Sexual Abuse in the Emergency Department.

    ERIC Educational Resources Information Center

    Kupfer, Gary M.; Giardino, Angelo P.

    1995-01-01

    Emergency department charts of 186 suspected preadolescent victims of sexual abuse (SSA) were compared with 623 patients evaluated for upper limb fracture. Hospital costs of SSA patients were more often and to a greater degree underwritten by the hospital itself because of lower reimbursement and a higher percentage of uninsured and publicly…

  8. Pathway from child sexual and physical abuse to risky sex among emerging adults: the role of trauma-related intrusions and alcohol problems.

    PubMed

    Walsh, Kate; Latzman, Natasha E; Latzman, Robert D

    2014-04-01

    Some evidence suggests that risk reduction programming for sexual risk behaviors (SRB) has been minimally effective, which emphasized the need for research on etiological and mechanistic factors that can be addressed in prevention and intervention programming. Childhood sexual and physical abuse have been linked with SRB among older adolescents and emerging adults; however, pathways to SRB remain unclear. This study adds to the literature by testing a model specifying that traumatic intrusions after early abuse may increase risk for alcohol problems, which in turn may increase the likelihood of engaging in various types of SRB. Participants were 1,169 racially diverse college students (72.9% female, 37.6% black/African-American, and 33.6% white) who completed anonymous questionnaires assessing child abuse, traumatic intrusions, alcohol problems, and sexual risk behavior. The hypothesized path model specifying that traumatic intrusions and alcohol problems account for associations between child abuse and several aspects of SRB was a good fit for the data; however, for men, stronger associations emerged between physical abuse and traumatic intrusions and between traumatic intrusions and alcohol problems, whereas for women, alcohol problems were more strongly associated with intent to engage in risky sex. Findings highlight the role of traumatic intrusions and alcohol problems in explaining paths from childhood abuse to SRB in emerging adulthood, and suggest that risk reduction programs may benefit from an integrated focus on traumatic intrusions, alcohol problems, and SRB for individuals with abuse experiences. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.

  9. Abusive supervision and subordinate performance: Instrumentality considerations in the emergence and consequences of abusive supervision.

    PubMed

    Walter, Frank; Lam, Catherine K; van der Vegt, Gerben S; Huang, Xu; Miao, Qing

    2015-07-01

    Drawing from moral exclusion theory, this article examines outcome dependence and interpersonal liking as key boundary conditions for the linkage between perceived subordinate performance and abusive supervision. Moreover, it investigates the role of abusive supervision for subordinates' subsequent, objective work performance. Across 2 independent studies, an experimental scenario study (N = 157; Study 1) and a time-lagged field study (N = 169; Study 2), the negative relationship between perceived subordinate performance and abusive supervision was found to hinge on a supervisor's outcome dependence on subordinates but not on a supervisor's liking of subordinates. Furthermore, Study 2 demonstrated (a) a negative association between abusive supervision and subordinates' subsequent objective performance and (b) a conditional indirect effect of perceived performance on subsequent objective performance, through abusive supervision, contingent on the degree of outcome dependence, although these relationships did not reach conventional significance levels when controlling for prior objective performance. All in all, the findings highlight the role of instrumentality considerations in relation to abusive supervision and promote new knowledge on both origins and consequences of such supervisory behavior. (c) 2015 APA, all rights reserved).

  10. Advancing Prevention Research on Child Abuse, Youth Violence, and Domestic Violence: Emerging Strategies and Issues

    ERIC Educational Resources Information Center

    Guterman, Neil B.

    2004-01-01

    Prevention research on the related problems of child abuse, youth violence, and domestic violence has grown at an accelerating pace in recent years. In this context, a set of shared methodological issues has emerged as investigators seek to advance the interpersonal violence prevention knowledge base. This article considers some of the persistent…

  11. Existing and Emerging Payment and Delivery Reforms in Cardiology

    PubMed Central

    Farmer, Steven A.; Darling, Margaret L.; George, Meaghan; Casale, Paul N.; Hagan, Eileen; McClellan, Mark B.

    2017-01-01

    IMPORTANCE Recent health care reforms aim to increase patient access, reduce costs, and improve health care quality as payers turn to payment reform for greater value. Cardiologists need to understand emerging payment models to succeed in the evolving payment landscape. We review existing payment and delivery reforms that affect cardiologists, present 4 emerging examples, and consider their implications for clinical practice. OBSERVATIONS Public and commercial payers have recently implemented payment reforms and new models are evolving. Most cardiology models are modified fee-for-service or address procedural or episodic care, but population models are also emerging. Although there is widespread agreement that payment reform is needed, existing programs have significant limitations and the adoption ofnew programs has been slow. New payment reforms address some of these problems, but many details remain undefined. CONCLUSIONS AND RELEVANCE Early payment reforms were voluntary and cardiologists’ participation is variable. However, conventional fee-for-service will become less viable, and enrollment in new payment models will be unavoidable. Early participation in new payment models will allow clinicians to develop expertise in new care pathways during a period of relatively lower risk. PMID:27851858

  12. Attitudes Toward Computer Interventions for Partner Abuse and Drug Use Among Women in the Emergency Department

    PubMed Central

    Choo, Esther; Ranney, Megan; Wetle, Terrie; Morrow, Kathleen; Mello, Michael; Squires, Daniel; Tapé, Chantal; Garro, Aris; Zlotnick, Caron

    2014-01-01

    Background Drug use and partner abuse often coexist among women presenting to the emergency department (ED). Technology offers one solution to the limited time and expertise available to address these problems. Aims The aims of this study were to explore womens’ attitudes about use of computers for screening and intervening in drug use and partner abuse. Methods Seventeen adult women with recent histories of partner abuse and drug use were recruited from an urban ED to participate in one-on-one semi-structured interviews. A coding classification scheme was developed and applied to the transcripts by two independent coders. The research team collaboratively decided upon a thematic framework and selected illustrative quotes. Results Most participants used computers and/or mobile phones frequently and reported high self-efficacy with them. Women described emotional difficulty and shame around partner abuse experiences and drug use; however, they felt that reporting drug use and partner abuse was easier and safer through a computer than face-to-face with a person, and that advice from a computer about drug use or partner abuse was acceptable and accessible. Some had very positive experiences completing screening assessments. However, participants were skeptical of a computer’s ability to give empathy, emotional support or meaningful feedback. The ED was felt to be an appropriate venue for such programs, as long as they were private and did not supersede clinical care. Conclusions Women with partner abuse and drug use histories were receptive to computerized screening and advice, while still expressing a need for the empathy and compassion of a human interaction within an intervention. PMID:26167133

  13. Not Just Academics: Paths of Longitudinal Effects From Parent Involvement to Substance Abuse in Emerging Adulthood.

    PubMed

    Hayakawa, Momoko; Giovanelli, Alison; Englund, Michelle M; Reynolds, Arthur J

    2016-04-01

    By the 12th grade, half of American adolescents have abused an illicit drug at least once (Johnston et al., 2015). Although many substance misuse prevention programs exist, we propose an alternative mechanism for reducing substance use. There is evidence that parent involvement is related to reductions in children's behavior problems which then predict later substance abuse. We examine the Child-Parent Center (CPC) program, an early childhood intervention, as a strategy to impact substance abuse. We conducted a path analysis from CPC to parent involvement through early adolescent problem behaviors and competencies to young adult substance abuse. Participants (N = 1,203; 51.5% female; 93.8% African-American) were assessed from age 3 to 26 years. CPC participation initiates a pathway to increased parent involvement and expectations, which positively impact adolescents' competencies and problem behaviors, lowering rates of substance abuse. Through early childhood education, increasing early parental involvement and expectations can alter life-course outcomes by providing children with a foundation for positive behaviors and encouraging adaptive functioning in adolescence. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  14. Against the Odds: The Impact of Woman Abuse on Maternal Response to Disclosure of Child Sexual Abuse

    ERIC Educational Resources Information Center

    Alaggia, Ramona; Turton, Jennifer V.

    2005-01-01

    Although the co-occurrence of woman abuse and child sexual abuse is high little research exists exploring the impact of woman abuse on maternal response to child sexual abuse (CSA). Findings from two qualitative studies indicate the form of woman abuse to have differential impact on maternal response. Mothers who were abused in non-physical ways,…

  15. Elder Abuse Awareness Module.

    ERIC Educational Resources Information Center

    Goettler, Darla

    The Elder Abuse Prevention Project sponsored by the Seniors' Education Centre, University Extension, University of Regina (Saskatchewan, Canada) emerged from a provincial workshop held by the Centre in 1989. The workshop was designed to examine possible avenues for addressing elder abuse issues in Saskatchewan. The purposes of the project were to…

  16. Alcohol involvement in opioid pain reliever and benzodiazepine drug abuse-related emergency department visits and drug-related deaths - United States, 2010.

    PubMed

    Jones, Christopher M; Paulozzi, Leonard J; Mack, Karin A

    2014-10-10

    The abuse of prescription drugs has led to a significant increase in emergency department (ED) visits and drug-related deaths over the past decade. Opioid pain relievers (OPRs) and benzodiazepines are the prescription drugs most commonly involved in these events. Excessive alcohol consumption also accounts for a significant health burden and is common among groups that report high rates of prescription drug abuse. When taken with OPRs or benzodiazepines, alcohol increases central nervous system depression and the risk for overdose. Data describing alcohol involvement in OPR or benzodiazepine abuse are limited. To quantify alcohol involvement in OPR and benzodiazepine abuse and drug-related deaths and to inform prevention efforts, the Food and Drug Administration (FDA) and CDC analyzed 2010 data for drug abuse-related ED visits in the United States and drug-related deaths that involved OPRs and alcohol or benzodiazepines and alcohol in 13 states. The analyses showed alcohol was involved in 18.5% of OPR and 27.2% of benzodiazepine drug abuse-related ED visits and 22.1% of OPR and 21.4% of benzodiazepine drug-related deaths. These findings indicate that alcohol plays a significant role in OPR and benzodiazepine abuse. Interventions to reduce the abuse of alcohol and these drugs alone and in combination are needed.

  17. Verbal abuse and physical assault in the emergency department: Rates of violence, perceptions of safety, and attitudes towards security.

    PubMed

    Partridge, Bradley; Affleck, Julia

    2017-08-01

    Emergency Department (ED) workers are prone to occupational violence, however the extent and impact of this may not be evenly felt across all roles in the ED. Explore: 1) the rate of verbal abuse and physical assaults experienced by ED staff, 2) perceptions of safety, 3) attitudes towards security officers, and 4) formal reporting of incidents. 330 ED workers were surveyed at four public hospitals in one metropolitan health service district in Queensland, Australia, including 179 nurses, 83 medical staff, 44 administration staff, 14 allied health, and 9 operational. Nurses were more likely to have been physically assaulted in the last six months and were less likely to feel safe. Most ED staff across all roles experienced verbal abuse. Nurses were better than medical staff at reporting instances of occupational violence although overall reporting across all roles was low. Staff who thought that security officers respond to incidents quickly and are a visible presence in the ED were more likely to feel safe in the ED. Workers in the ED, particularly nurses, experience high rates of verbal abuse and physical aggression and there may be a case for having designated security guards in the ED. Copyright © 2017 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.

  18. Increased Screening for Child Physical Abuse in Emergency Departments in a Regional Trauma System: Response to a Sentinel Event.

    PubMed

    Wilkins, Ginger G; Ball, Jane; Mann, N Clay; Nadkarni, Milan; Meredith, J Wayne

    2016-01-01

    A pediatric patient was assaulted while being treated at a Level 1 pediatric trauma center, prompting a Centers for Medicare & Medicaid Services site visit. The process of screening for physical abuse and protection of patients was reevaluated and revised, and a new guideline was implemented and shared with referral hospitals. During this same time period, 13 referral hospitals participated in an unrelated federally funded study determining the impact of recognition and care of injured children in states with and without a pediatric emergency care facility recognition program. A pre-post study analysis revealed that screening for abuse doubled during this time period.

  19. Sibling sexual abuse: why don't we talk about it?

    PubMed

    Yates, Peter

    2017-08-01

    To explore two hypotheses for explaining why there is little written about sibling sexual abuse and to raise awareness of the subject in order better to protect children and to facilitate sensitive patient care. While there is no universal agreement over its definition, sibling sexual abuse is acknowledged internationally as a prevalent form of child sexual abuse but tends not to be recognised by health professionals. It is also under-represented within the literature in comparison with other forms of intrafamilial sexual abuse. Understanding why this is may help to illuminate the potential barriers to effective professional responses. Two explanations which emerge strongly are the existence of a sibling incest taboo and a prevailing belief that sibling sexual behaviour is largely harmless. Discursive position paper. The paper examines the two hypotheses through exploration of the extant literature on sibling incest and sibling sexual abuse. Sibling sexual abuse accounts for a significant minority of child sexual abuse and has the potential to be as harmful as sexual abuse by a parent. An abhorrence at the thought of sibling sexual activity and a prevailing view of its harmlessness may hinder nurses' detection of and appropriate responses to sibling sexual abuse, but do not provide convincing explanations for the dearth of literature. Instead, a deeply held perspective of sibling relationships as non-abusive offers a more profound explanation. A knowledge of sibling sexual abuse and its consequences are important both for the effective protection of children and the sensitive and appropriate treatment of patients who present with a variety of physical and mental health concerns. A perspective that sibling relationships are non-abusive provides a deeper level of understanding of the powerful obstacles to raising awareness of and responding appropriately to this form of abuse. © 2016 John Wiley & Sons Ltd.

  20. 75 FR 31787 - Agency Information Collection Activities: Existing Collection; Emergency Extension

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-04

    ... EQUAL EMPLOYMENT OPPORTUNITY COMMISSION Agency Information Collection Activities: Existing Collection; Emergency Extension AGENCY: Equal Employment Opportunity Commission. ACTION: Notice of... Paperwork Reduction Act, the Equal Employment Opportunity Commission (EEOC or Commission) announces that it...

  1. 12 CFR 1806.303 - Fraud, waste and abuse.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Fraud, waste and abuse. 1806.303 Section 1806... BANK ENTERPRISE AWARD PROGRAM Terms and Conditions of Assistance § 1806.303 Fraud, waste and abuse. Any person who becomes aware of the existence or apparent existence of fraud, waste, or abuse of assistance...

  2. Racial-Ethnic Disparities in Opioid Prescriptions at Emergency Department Visits for Conditions Commonly Associated with Prescription Drug Abuse.

    PubMed

    Singhal, Astha; Tien, Yu-Yu; Hsia, Renee Y

    2016-01-01

    Prescription drug abuse is a growing problem nationally. In an effort to curb this problem, emergency physicians might rely on subjective cues such as race-ethnicity, often unknowingly, when prescribing opioids for pain-related complaints, especially for conditions that are often associated with drug-seeking behavior. Previous studies that examined racial-ethnic disparities in opioid dispensing at emergency departments (EDs) did not differentiate between prescriptions at discharge and drug administration in the ED. We examined racial-ethnic disparities in opioid prescription at ED visits for pain-related complaints often associated with drug-seeking behavior and contrasted them with conditions objectively associated with pain. We hypothesized a priori that racial-ethnic disparities will be present among opioid prescriptions for conditions associated with non-medical use, but not for objective pain-related conditions. Using data from the National Hospital Ambulatory Medical Care Survey for 5 years (2007-2011), the odds of opioid prescription during ED visits made by non-elderly adults aged 18-65 for 'non-definitive' conditions (toothache, back pain and abdominal pain) or 'definitive' conditions (long-bone fracture and kidney stones) were modeled. Opioid prescription at discharge and opioid administration at the ED were the primary outcomes. We found significant racial-ethnic disparities, with non-Hispanic Blacks being less likely (adjusted odds ratio ranging from 0.56-0.67, p-value < 0.05) to receive opioid prescription at discharge during ED visits for back pain and abdominal pain, but not for toothache, fractures and kidney stones, compared to non-Hispanic whites after adjusting for other covariates. Differential prescription of opioids by race-ethnicity could lead to widening of existing disparities in health, and may have implications for disproportionate burden of opioid abuse among whites. The findings have important implications for medical provider education

  3. Interventions targeting substance abuse among women survivors of intimate partner abuse: a meta-analysis.

    PubMed

    Fowler, Dawnovise N; Faulkner, Monica

    2011-12-01

    In this article, meta-analytic techniques are used to examine existing intervention studies (n = 11) to determine their effects on substance abuse among female samples of intimate partner abuse (IPA) survivors. This research serves as a starting point for greater attention in research and practice to the implementation of evidence-based, integrated services to address co-occurring substance abuse and IPA victimization among women as major intersecting public health problems. The results show greater effects in three main areas. First, greater effect sizes exist in studies where larger numbers of women experienced current IPA. Second, studies with a lower mean age also showed greater effect sizes than studies with a higher mean age. Lastly, studies with smaller sample sizes have greater effects. This research helps to facilitate cohesion in the knowledge base on this topic, and the findings of this meta-analysis, in particular, contribute needed information to gaps in the literature on the level of promise of existing interventions to impact substance abuse in this underserved population. Published by Elsevier Inc.

  4. Child Sexual Abuse in Zimbabwe.

    PubMed

    Mantula, Fennie; Saloojee, Haroon

    2016-01-01

    Although child sexual abuse is a significant public health problem globally, its incidence, prevention, and management is less well described in resource-poor settings. In poorer settings prevention initiatives assume even more importance since resources for managing abused children are severely limited. This article examines the current status of policy and practice related to the prevention of child sexual abuse in Zimbabwe. It identifies implementation challenges and highlights opportunities that could be embraced to reduce CSA in Zimbabwe, based on evidence synthesized from recent work. Although Zimbabwe has a well-established legal and regulatory framework to protect children from child sexual abuse, implementation of existing policies is weak. Financial, human, and material resource constraints are frequently cited to explain limited prevention activity. Effective strategies for the prevention of child sexual abuse should focus on implementing existing legislation, targeting schoolchildren, and getting community involvement. A dedicated budget would help entrench these strategies, but gains can be achieved even in the absence of this.

  5. Concealment of Child Sexual Abuse in Sports

    ERIC Educational Resources Information Center

    Hartill, Mike

    2013-01-01

    When the sexual abuse of children is revealed, it is often found that other nonabusing adults were aware of the abuse but failed to act. During the past twenty years or so, the concealment of child sexual abuse (CSA) within organizations has emerged as a key challenge for child protection work. Recent events at Pennsylvania State University (PSU)…

  6. DRUG ABUSE WARNING NETWORK (DAWN) DATABASE

    EPA Science Inventory

    The Drug Abuse Warning Network (DAWN) is an ongoing drug abuse data collection system sponsored by SAMHSA's Office of Applied Studies. DAWN collects data from: (1) hospital emergency departments (EDs) and (2) medical examiners (MEs). The DAWN ED component relies on a nationally r...

  7. Emergency Stent Grafting After Unsuccessful Surgical Repair of a Mycotic Common Femoral Artery Pseudoaneurysm in a Drug Abuser

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lupattelli, Tommaso, E-mail: tommaso.lupattelli@multimedica.i; Garaci, Francesco Giuseppe; Basile, Antonio

    Mycotic false aneurysm caused by local arterial injury from attempted intravenous injections in drug addicts remains a challenging clinical problem. The continued increase in drug abuse has resulted in an increased incidence of this problem, particularly in high-volume urban centres. In the drug-abusing population, mycotic arterial pseudoaneurysms most often occur because of missed venous injection and are typically seen in the groin, axilla, and antecubital fossa. Mycotic aneurysms may lead to life-threatening haemorrhage, limb loss, sepsis, and even death. Any soft-tissue swelling in the vicinity of a major artery in an intravenous drug abuser should be suspected of being amore » false aneurysm until proven otherwise and should prompt immediate referral to a vascular surgeon for investigation and management. We report a case of rupturing mycotic pseudoaneurysm of the left common femoral artery treated by surgical resection followed by vessel reconstruction with autologous material. Unfortunately, at the time of discharge a sudden leakage from the vein graft anastomosis occurred, with subsequent massive bleeding, and required emergent endovascular covered stenting. To the best of our knowledge, this is the first reported case of femoral artery bleeding in a drug abuser treated by stent graft placement.« less

  8. Types of abuse and risk factors associated with elder abuse.

    PubMed

    Simone, Lacher; Wettstein, Albert; Senn, Oliver; Rosemann, Thomas; Hasler, Susann

    2016-01-01

    Detecting elder abuse is challenging because it is a taboo, and many cases remain unreported. This study aimed to identify types of elder abuse and to investigate its associated risk factors. Retrospective analyses of 903 dossiers created at an Independent Complaints Authority for Old Age in the Canton of Zurich, Switzerland, from January 1, 2008 to October 31, 2012. Characteristics of victims and perpetrators, types of abuse, and associated risk factors related to the victim or the perpetrator were assessed. Bi- and multivariate analysis were used to identify abuse and neglect determinants. A total of 150 cases reflected at least one form of elder abuse or neglect; 104 cases were categorised as abuse with at least one type of abuse (overall 135 mentions), 46 cases were categorised as neglect (active or passive). Psychological abuse was the most reported form (47%), followed by financial (35%), physical (30%) and anticonstitutional abuse (18%). In 81% of the 150 cases at least two risk factors existed. In 13% no associated risk factor could be identified. Compared with neglect, elders with abuse were less likely to be a nursing home resident than living at home (odds ratio [OR] 0.02, 95% confidence interval [CI] 0.00-0.19). In addition, they were more likely to be cohabiting with their perpetrators (OR 18.01, 95% CI 4.43-73.19). For the majority of the reported elder abuse cases at least two associated risk factors could be identified. Knowledge about these red flags and a multifaceted strategy are needed to identify and prevent elder abuse.

  9. Active surveillance of abused and misused prescription opioids using poison center data: a pilot study and descriptive comparison.

    PubMed

    Hughes, Alice A; Bogdan, Gregory M; Dart, Richard C

    2007-01-01

    Prescription opioids are abused throughout the United States. Several monitoring programs are in existence, however, none of these systems provide up-to-date information on prescription opioid abuse. This article describes the use of poison centers as a real-time, geographically specific, surveillance system for prescription opioid abuse and compares our system with an existing prescription drug abuse monitoring program, the Drug Abuse Warning Network (DAWN). Data were collected from eight geographically dispersed poison centers for a period of twelve months. Any call involving buprenorphine, fentanyl, hydrocodone, hydromorphone, methadone, morphine, and oxycodone was considered a case. Any case coded as intentional exposure (abuse, intentional misuse, suicide, or intentional unknown) was regarded as misuse and abuse. Comparative data were obtained from DAWN. Poison center rates of abuse and misuse were highest for hydrocodone at 3.75 per 100,000 population, followed by oxycodone at 1.81 per 100,000 population. DAWN emergency department (ED) data illustrate a similar pattern of abuse with most mentions involving hydrocodone and oxycodone. Poison center data indicate that people aged 18 to 25 had the highest rates of abuse. DAWN reported the majority of ED mentions among 35 to 44-year-olds. Geographically, Kentucky had the uppermost rates of abuse and misuse for all opioids combined at 20.69 per 100,000 population. CONCLUSIONS. Comparing poison center data to DAWN yielded mostly comparable results, including hydrocodone as the most commonly mentioned drug. Our results suggest poison center data can be used as an indicator for prescription opioid abuse and misuse and can provide timely, geographically specific information on prescription drug abuse.

  10. Risk factors for child abuse: quantitative correlational design.

    PubMed

    Ben-Natan, Merav; Sharon, Ira; Barbashov, Polina; Minasyan, Yulia; Hanukayev, Isabella; Kajdan, David; Klein-Kremer, Adi

    2014-01-01

    The aim of this research study is to identify risk factors typical of different types of suspected child abuse reported at a hospital. The study was based on 114 cases of children for whom some type of abuse was reported. Physical abuse was the most frequently reported of all types of suspected child abuse. Most victims of sexual abuse were female and at least half the cases of neglect and physical abuse were attributed to parents. Most cases were identified in the emergency room by nurses. Children older than 10 were more susceptible to physical abuse and neglect. © 2014.

  11. Nullified: women's perceptions of being abused in health care.

    PubMed

    Swahnberg, Katarina; Thapar-Björkert, Suruchi; Berterö, Carina

    2007-09-01

    In a study performed with The NorVold Abuse Questionnaire (NorAQ) among Nordic gynecological patients, the prevalence of lifetime abuse in health care (AHC) was 13 - 28%. In the present study we chose a qualitative approach. Our aim was to develop a more in-depth understanding of AHC; as experienced by female Swedish patients. Qualitative interviews with 10 Swedish gynecological patients who had experienced AHC. The interviews were analyzed through Grounded Theory. Saturation was reached after six interviews. In the analyses four categories emerged which explain what AHC meant to the participating women: felt powerless, felt ignored, experienced carelessness, and experienced non-empathy. To be nullified is the core category that theoretically binds the four categories together. The women's narratives described intensive current suffering even though the abusive event had taken place several years ago. The fact that AHC exists is a critical dilemma for an institution that has the society's commission to cure and/or to alleviate pain and suffering. In their narratives, women described the experience of 'being nullified', a core category that embodies AHC.

  12. Kratom, an Emerging Drug of Abuse: A Case Report of Overdose and Management of Withdrawal.

    PubMed

    Diep, Jack; Chin, David Tian; Gupta, Somdatta; Syed, Faraz; Xiong, Ming; Cheng, Jianguo

    2018-04-15

    Kratom is an herb indigenous to Southeast Asia with psychoactive opioid compounds, often used as a treatment for chronic pain or opiate withdrawal symptoms. It is legally and readily available via Internet sales and has been identified as an emerging drug of abuse in the United States. Kratom use has been associated with psychosis, seizures, and even death. At lower doses, kratom acts as a stimulant, while at higher doses, it produces analgesia and euphoria. Here, we describe the successful management of kratom overdose and withdrawal in a young man with negative toxicology screens.

  13. Kratom, an Emerging Drug of Abuse: A Case Report of Overdose and Management of Withdrawal.

    PubMed

    Diep, Jack; Chin, David Tian; Gupta, Somdatta; Syed, Faraz; Xiong, Ming; Cheng, Jianguo

    2017-10-26

    Kratom is an herb indigenous to Southeast Asia with psychoactive opioid compounds, often used as a treatment for chronic pain or opiate withdrawal symptoms. It is legally and readily available via Internet sales and has been identified as an emerging drug of abuse in the United States. Kratom use has been associated with psychosis, seizures, and even death. At lower doses, kratom acts as a stimulant, while at higher doses, it produces analgesia and euphoria. Here, we describe the successful management of kratom overdose and withdrawal in a young man with negative toxicology screens.

  14. Intergenerational Transmission of Abuse of Incarcerated Fathers: A Study of the Measurement of Abuse

    ERIC Educational Resources Information Center

    Ball, Jeremy D.

    2009-01-01

    Research on the intergenerational transmission of abuse hypothesis often only examined the "existence" of abuse. The current study utilizes retrospective recalls of incarcerated male defendants (N = 414), using questions formulated from the modified Conflict Tactics Scales. Five logistic regression models are run, representing a different physical…

  15. Substance abuse and mental health visits among adolescents presenting to US emergency departments.

    PubMed

    Fahimi, Jahan; Aurrecoechea, Adrian; Anderson, Erik; Herring, Andrew; Alter, Harrison

    2015-05-01

    The objectives of the study were to identify factors associated with adolescent emergency department (ED) visits for substance abuse, including those complicated by mental health (dual diagnosis), and to analyze their effect on ED length of stay (LOS) and disposition. We performed a secondary analysis of ED visits by adolescents (age, 11-24) using the National Hospital Ambulatory Medical Care Survey (1997-2010) to identify visits for mental health, substance use, and dual diagnosis. Univariate and multivariate statistics were used to analyze demographic and visit-level factors, factors associated with substance use and dual diagnosis visits, as well as the effects of substance use and mental health conditions on ED LOS and disposition. Substance use and mental health accounted for 2.1% and 4.3% of all adolescent visits, respectively, with 20.9% (95% confidence interval [CI], 18.3%-23.5%) of substance abuse visits complicated by mental health. The factors significantly associated with substance use include the following: male sex, urban location, West region, ambulance arrival, night and weekend shift, anxiety disorders, mood disorders, and psychotic disorders. Additional LOS was 89.77 minutes for mental health, 71.33 minutes for substance use, and 139.97 minutes for dual diagnosis visits, as compared with visits where these conditions were not present. Both mental health and substance use were associated with admission/transfer as compared with other dispositions as follows: mental health odds ratio (OR), 5.93 (95% CI, 5.14-6.84); illicit drug use OR, 3.56 (95% CI 2.72-4.64); and dual diagnosis OR, 6.86 (95% CI, 4.67-10.09). Substance abuse and dual diagnosis are common among adolescent ED visits and are strongly associated with increased use of prehospital resources, ED LOS, and need for hospitalization.

  16. Older persons' views and experience of elder abuse in South Western Nigeria: a community-based qualitative survey.

    PubMed

    Cadmus, Eniola Olubukola; Owoaje, Eme Theodora; Akinyemi, Oluwaseun Oladapo

    2015-06-01

    Conventionally, existing information on elder abuse has been institution based, professionally driven, and in high-income countries. This study addresses the prevailing gap in knowledge through direct consultation of older persons in the community about their perceptions of elder abuse. Eight focus group discussions were carried out among males and females aged 60 years and above in a rural and an urban community in south western Nigeria. Data were transcribed and analyzed based on emergent themes. Findings from the study show that the perception of abuse by the respondents included the standard typologies except sexual abuse as well as societal issues such as disrespect and lack of recognition. Our study revealed a high level of awareness and experience of elder abuse among the participants in both communities. Effective social welfare and health services aided by targeted government policies are needed to improve the quality of life of the elderly. © The Author(s) 2014.

  17. Promoting successful collaborations between domestic violence and substance abuse treatment service sectors: a review of the literature.

    PubMed

    Macy, Rebecca J; Goodbourn, Melissa

    2012-10-01

    Women who experience intimate partner violence (IPV) victimization are more likely to struggle with substance abuse problems than are women who do not experience IPV. Given the connection between IPV victimization and substance abuse, recommended practices urge collaboration between domestic violence service agencies and substance abuse treatment agencies to provide comprehensive services for women with these co-occurring problems. However, domestic violence and substance abuse services have unique histories of development that have led to distinct ways of service delivery. To promote successful collaborations, service providers and researchers are developing strategies to foster relationships across the two service sectors. The authors conducted a review of this emerging body of knowledge with the aim of assembling recommendations for strategies to foster collaboration between domestic violence and substance abuse services. The authors identified 15 documents for review inclusion and our analysis established 5 categories of documents. Findings yield key collaboration strategies and recommended service models. In addition, the review determined the existence of considerable challenges to promoting collaborative relationships between domestic violence and substance abuse treatment service sectors.

  18. Abuse of Disabled Children in Ghana

    ERIC Educational Resources Information Center

    Kassah, Alexander Kwesi; Kassah, Bente Lilljan Lind; Agbota, Tete Kobla

    2012-01-01

    Even though disabled children are targets of various forms of abuse, such issues remain mostly undocumented open secrets in many countries including Ghana. The article is based on a qualitative data provided by three key informants. Six stories emerged from the data and are discussed in terms of four main forms of abuse. Labelling theories are…

  19. The Cycle of Abuse: When Victims Become Offenders.

    PubMed

    Plummer, Malory; Cossins, Annie

    2016-07-19

    Various psychological theories exist in the literature to explain the behavior of men who commit child sex offences, including the belief that child sexual abuse (CSA) is a predisposing factor for the transition from victim to offender. These theories are, however, unable to explain the fact that while most victims of CSA are female, most perpetrators of CSA are male. The sex specificity of CSA in terms of victims and offenders suggests that the experience of CSA and its psychosocial effects may be different for boys, compared to girls. We hypothesize that CSA experiences may involve risk factors that affect the development of sexually abusive behavior for boys, rather than girls. Our aim was to determine whether the literature provides evidence of a cycle of abuse from victim to offender, and, if so, to document its characteristics. We undertook a comprehensive literature review of studies on both victims and offenders, including studies which revealed the following: age of onset of CSA, duration of abuse, gender of the abuser, the relationship between victim and abuser, grooming behaviors, the types and severity of abuse, and disclosure of abuse. While we found no evidence for the existence of a cycle of abuse for female CSA victims, we discovered evidence to support the existence of a cycle of abuse for male CSA victims who had experienced particular abuse characteristics. As an original contribution to the literature, we identified four factors that may be associated with a boy's transition from victim to offender as well as the methodological issues to be addressed in future research. Based on criminological theories, we argue that these four factors share a common theme, that is, that they represent experiences of power (for the abuser) and powerlessness (for the victim). © The Author(s) 2016.

  20. Disrespect, harassment, and abuse

    PubMed Central

    Miedema, Baukje; Easley, Julie; Fortin, Pierrette; Hamilton, Ryan; Tatemichi, Sue

    2009-01-01

    ABSTRACT OBJECTIVE To examine harassment and abusive encounters between family physicians and their patients or colleagues in the workplace. DESIGN Qualitative case study using semistructured interviews. SETTING Province of New Brunswick. PARTICIPANTS Forty-eight family physicians from across the province. METHODS A collective case-study approach was developed, with 24 cases of 2 individuals per case. Cases were selected based on sex, location (urban or rural), language (French or English), and number of years since medical school graduation (< 10 years, 10 to 20 years, or > 20 years). Physicians were interviewed in either French or English. Participants were recruited using the College of Physicians and Surgeons of New Brunswick’s physician directory. Based on the rates of response and participation, some cases were overrepresented, while others were not completed. All interviews were audiotaped, transcribed verbatim, and analyzed thematically using a categorical aggregation approach. A coding scheme for the thematic analysis was developed by the research team before the interviews were transcribed. MAIN FINDINGS Although the original intent of this study was to examine the work environment of family physicians in light of the increasing number of women entering the profession, harassment and abusive encounters in the workplace emerged as a main theme. These encounters ranged from minor to severe. Minor abusive encounters included disrespectful behaviour and verbal threats by patients, their families, and occasionally colleagues. More severe forms of harassment involved physical threats, physical encounters, and stalking. Demanding patients, such as heavy drug users, were often seen as threatening. Location of practice, years in practice, and sex of the physician seemed to affect abusive encounters—young, female, rural physicians appeared to experience such encounters most often. CONCLUSION Abusive encounters in the workplace are concerning. It is essential to

  1. Detecting child abuse based on parental characteristics: does the Hague Protocol cause parents to avoid the emergency department?

    PubMed

    Diderich, Hester M; Fekkes, Minne; Dechesne, Mark; Buitendijk, Simone E; Oudesluys-Murphy, Anne Marie

    2015-04-01

    The Hague Protocol is used by professionals at the adult Emergency Departments (ED) in The Netherlands to detect child abuse based on three parental characteristics: (1) domestic violence, (2) substance abuse or (3) suicide attempt or self-harm. After detection, a referral is made to the Reporting Center for Child Abuse and Neglect (RCCAN). This study investigates whether implementing this Protocol will lead parents to avoid medical care. We compared the number of patients (for whom the Protocol applied) who attended the ED prior to implementation with those attending after implementation. We conducted telephone interviews (n = 14) with parents whose children were referred to the RCCAN to investigate their experience with the procedure. We found no decline in the number of patients, included in the Protocol, visiting the ED during the 4 year implementation period (2008-2011). Most parents (n = 10 of the 14 interviewed) were positive and stated that they would, if necessary, re-attend the ED with the same complaints in the future. ED nurses and doctors referring children based on parental characteristics do not have to fear losing these families as patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Sudden unexpected infant death: differentiating natural from abusive causes in the emergency department.

    PubMed

    Bechtel, Kirsten

    2012-10-01

    Sudden unexpected infant deaths (SUIDs) are deaths in infants younger than 12 months that occur suddenly, unexpectedly, and without obvious cause in the emergency department (ED). Sudden infant death syndrome, the leading cause of SUID in the United States, is much more common, but fatal child abuse and neglect have been sometimes mistaken for sudden infant death syndrome. The distinction between these 2 entities can only be made after a thorough investigation of the scene, interview of caregivers, and a complete forensic autopsy. Development of ED guidelines for the reporting and evaluation of SUID, in collaboration with the local medical examiner and child death review teams, will enable ED practitioners to collect important information in a compassionate manner that will be valuable to the investigating personnel.

  3. Physical, psychological, sexual, and systemic abuse of children with disabilities in East Africa: Mapping the evidence.

    PubMed

    Winters, Niall; Langer, Laurenz; Geniets, Anne

    2017-01-01

    Children with disabilities (CWDs) are at a higher risk of being maltreated than are typical children. The evidence base on the abuse of children with disabilities living in low- and middle-income countries is extremely limited but the problem is particularly acute in East Africa. We don't know the types of evidence that exist on this topic. This problem is compounded by the fact that key indicators of disability, such as reliable prevalence rates, are not available currently. This paper addresses this serious problem by mapping the existing evidence-base to document the coverage, patterns, and gaps in existing research on the abuse of children with disabilities in East Africa. An evidence map, following systematic review guidelines, was conducted and included a systematic search, transparent and structured data extraction, and critical appraisal. Health and social science databases (Medline, EMBASE, PsychInfo, Taylor&Francis, Web of Science, and SAGE) were systematically searched for relevant studies. A substantive grey literature search was also conducted. All empirical research on the abuse of CWDs in East Africa was eligible for inclusion: Data on abuse was systematically extracted and the research evidence, following critical appraisal, mapped according to the type of abuse and disability condition, highlighting gaps and patterns in the evidence-base. 6005 studies were identified and screened, of which 177 received a full-text assessment. Of these, 41 studies matched the inclusion criteria. By mapping the available data and reports and systematically assessing their trustworthiness and relevance, we highlight significant gaps in the available evidence base. Clear patterns emerge that show a major data gap and lack of research on sexual abuse of children with disabilities and an identifiable lack of methodological quality in many relevant studies. These make the development of a concerted and targeted research effort to tackle the abuse of children with

  4. A Profile of Elder Abuse and Neglect in Tennessee.

    ERIC Educational Resources Information Center

    Villas, Paul

    A survey of 35 cases of reported abuse to individuals aged 60 and older in the state of Tennessee sought to determine demographic characteristics of the abused, perpetrators of elder abuse and neglect, types of abuse that occur, and any existence of relationships in elder abuse and neglect between urban and rural counties and eastern and western…

  5. 78 FR 14592 - Proposed Extension of Existing Information Collection; Emergency Mine Evacuation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-06

    ... DEPARTMENT OF LABOR Mine Safety and Health Administration [OMB Control No. 1219-0141] Proposed Extension of Existing Information Collection; Emergency Mine Evacuation AGENCY: Mine Safety and Health... requirements on respondents can be properly assessed. Currently, the Mine Safety and Health Administration is...

  6. Development of the scale of economic abuse.

    PubMed

    Adams, Adrienne E; Sullivan, Cris M; Bybee, Deborah; Greeson, Megan R

    2008-05-01

    Economic abuse is part of the pattern of behaviors used by batterers to maintain power and control over their partners. However, no measure of economic abuse exists. This study describes the development of the Scale of Economic Abuse, which was designed to fill this gap. Interviews were conducted with 103 survivors of domestic abuse, each of whom responded to measures of economic, physical, and psychological abuse as well as economic hardship. Results provide evidence for the reliability and validity of the scale. This study is an important first step toward understanding the extent and impact of economic abuse experienced by survivors.

  7. 12 CFR 1805.812 - Fraud, waste and abuse.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Fraud, waste and abuse. 1805.812 Section 1805.812 Banks and Banking COMMUNITY DEVELOPMENT FINANCIAL INSTITUTIONS FUND, DEPARTMENT OF THE TREASURY..., waste and abuse. Any person who becomes aware of the existence or apparent existence of fraud, waste or...

  8. Emerging drugs of abuse: current perspectives on substituted cathinones

    PubMed Central

    Paillet-Loilier, Magalie; Cesbron, Alexandre; Le Boisselier, Reynald; Bourgine, Joanna; Debruyne, Danièle

    2014-01-01

    for addiction and abuse in users. In case of overdose, no specific antidote exists and no curative treatment has been approved by health authorities. Therefore, management of acute toxic effects is mainly extrapolated from experience with cocaine/amphetamines. PMID:24966713

  9. Content Analysis of Measures for Identification of Elder Abuse.

    ERIC Educational Resources Information Center

    Sengstock, Mary C.; And Others

    Measures designed to detect elder abuse lack uniformity as a result of having been designed in isolation. To develop and test a uniform index for the identification of elder abuse victims, an analysis of existing abuse identification instruments was conducted. Initially, seven elder abuse identification measures were content analyzed, resulting in…

  10. Exploring the controversy in child abuse pediatrics and false accusations of abuse.

    PubMed

    Gabaeff, Steven C

    2016-01-01

    There is a controversy in child abuse pediatrics between an established corps of child abuse pediatricians aligned with hospital colleagues and law enforcement, and a multi-specialty challenger group of doctors and other medical professionals working with public interest lawyers. The latter group questions the scientific validity of the core beliefs of child abuse pediatricians and believes that there are a substantial number of false accusations of abuse occurring. An unproven primary hypothesis, crafted around 1975 by a small group of pediatricians with an interest in child abuse, lies at the foundation of child abuse pediatrics. With no scientific study, it was hypothesized that subdural hemorrhage (SDH) and retinal hemorrhage (RH) were diagnostic of shaking abuse. That hypothesis became the so-called "shaken baby syndrome." Through the period 1975-1985, in a coordinated manner, these child abuse specialists coalesced under the American Academy of Pediatrics and began working with district attorneys and social workers, informing them of the ways in which their hypothesis could be applied to prosecutions of child abuse and life-altering social service interventions. In a legal context, using then-prevailing evidentiary rules which treated scientific expert testimony as valid if it was "generally accepted" in the field, they represented falsely that there was general acceptance of their hypothesis and therefore it was valid science. As the ability to convict based on this unproven prime hypothesis (SDH and RH equals abuse) increased, some defense attorneys were professionally compelled by their own doubts to reach out to experts from other fields with experience with SDH and RH, trauma, and biomechanics, for second opinions. Medical and legal challenges to the established thinking soon emerged, based on both old and new evidenced-based literature. As the intensity of the controversy increased, the probability of false accusation became more apparent and the need

  11. Secondary School Experiences of Male Recovering Substance Abusers

    ERIC Educational Resources Information Center

    Maher, Rebecca C.

    2012-01-01

    Problem: Adolescents who begin abusing substances, including alcohol, prescription drugs, and illegal drugs often fail in school suffering life-altering consequences (Cox, Zhang, Johnson, & Bender, 2007). While plentiful research exists on substance abuse, there is a dearth of research on the school experiences of recovering substance abusers.…

  12. Theories and measures of elder abuse.

    PubMed

    Abolfathi Momtaz, Yadollah; Hamid, Tengku Aizan; Ibrahim, Rahimah

    2013-09-01

    Elder abuse is a pervasive phenomenon around the world with devastating effects on the victims. Although it is not a new phenomenon, interest in examining elder abuse is relatively new. This paper aims to provide an overview of the aetiological theories and measures of elder abuse. The paper briefly reviews theories to explain causes of elder abuse and then discusses the most commonly used measures of elder abuse. Based on the reviewed theories, it can be concluded that elder abuse is a multifactorial problem that may affect elderly people from different backgrounds and involve a wide variety of potential perpetrators, including caregivers, adult children, and partners. The review of existing measurement instruments notes that many different screening and assessment instruments have been developed to identify elders who are at risk for or are victims of abuse. However, there is a real need for more measurements of elder abuse, as the current instruments are limited in scope. © 2013 The Authors. Psychogeriatrics © 2013 Japanese Psychogeriatric Society.

  13. Modern History of Child Sexual Abuse Awareness: Cycles of Discovery and Suppression.

    ERIC Educational Resources Information Center

    Olafson, Erna; And Others

    1993-01-01

    Over 150 years, public and professional awareness of child sexual abuse has emerged and been suppressed repeatedly. Research now indicates the prevalence of sexual abuse and its injurious impact on human development, but in the contemporary mental health professions, courts, and media, a backlash has emerged against the latest discovery of child…

  14. Typology for Parents of Abused Children.

    ERIC Educational Resources Information Center

    Sloan, Michael P.; Meier, John H.

    This paper reports an effort to classify parents of abused children according to existing and new typologies derived from parents' psychopathological personality profiles. Several previously reported typologies for abusive parents are reviewed and elaborated. In addition, reference is given to data and insights gained from an ongoing study of 50…

  15. NEURODEVELOPMENTAL BIOLOGY ASSOCIATED WITH CHILDHOOD SEXUAL ABUSE

    PubMed Central

    De Bellis, Michael D.; Spratt, Eve G.; Hooper, Stephen R.

    2013-01-01

    Child maltreatment appears to be the single most preventable cause of mental illness and behavioral dysfunction in the US. There are few published studies examining the developmental and the psychobiological consequences of sexual abuse. There are multiple mechanisms through which sexual abuse can cause PTSD, activate biological stress response systems, and contribute to adverse brain development. This article will critically review the psychiatric problems associated with maltreatment and the emerging biologic stress system research with a special emphasis on what is known about victimization by sexual abuse. PMID:21970646

  16. A hypothesized model of Korean women's responses to abuse.

    PubMed

    Choi, Myunghan; Harwood, Jake

    2004-07-01

    Many abused married Korean women have a strong desire to leave their abusive husbands but remain in the abusive situations because of the strong influence of their sociocultural context. The article discusses Korean women's responses to spousal abuse in the context of patriarchal, cultural, and social exchange theory. Age, education, and income as component elements share common effects on the emergent variable, sociostructural power. Gender role attitudes, traditional family ideology, individualism/collectivism, marital satisfaction, and marital conflict predict psychological-relational power as a latent variable. Sociostructural, patriarchal, cultural, and social exchange theories are reconceptualized to generate the model of Korean women's responses to abuse.

  17. Emergency Management of Sexually Abused Children. The Role of the Pediatric Resident.

    ERIC Educational Resources Information Center

    Orr, Donald P.; Prietto, Susan V.

    1979-01-01

    A program for the initial pediatric evaluation and management of sexually abused children is offered as one possible model for other training centers. Cases of 100 sexually abused children (mean age 9.2 years) seen by pediatric residents are reviewed. Journal availability: American Medical Association, 535 North Dearborn Street, Chicago, Illinois…

  18. Physical and Emotional Abuse of Primary School Children by Teachers

    ERIC Educational Resources Information Center

    Theoklitou, D.; Kabitsis, N.; Kabitsi, A.

    2012-01-01

    The existence of child abuse is unfortunately a reality of contemporary society. Although various organizations and researchers have been making progress in the struggle against abuse, it has not been decisively dealt with thus far. Most of the research on abuse has focused on the abuse of children in their family environment. Objective: The aim…

  19. Prescription drug abuse: problem, policies, and implications.

    PubMed

    Phillips, Janice

    2013-01-01

    This article provides an overview on prescription drug abuse and highlights a number of related legislative bills introduced during the 112th Congress in response to this growing epidemic. Prescription drug abuse has emerged as the nation's fastest growing drug problem. Although prescription drugs have been used effectively and appropriately for decades, deaths from prescription pain medicine in particular have reached epidemic proportions. Bills related to prescription drug abuse introduced during the 112th Congress focus on strengthening provider and consumer education, tracking and monitoring prescription drug abuse, improving data collection on drug overdose fatalities, combating fraud and abuse in Medicare and Medicaid programs, reclassifying drugs to make them more difficult to prescribe and obtain, and enforcing stricter penalties for individuals who operate scam pain clinics and sell pain pills illegitimately. This article underscores the importance of a multifaceted approach to combating prescription drug abuse and concludes with implications for nursing. Copyright © 2013. Published by Mosby, Inc.

  20. Beyond Munchausen by proxy: a proposed conceptualization for cases of recurring, unsubstantiated sexual abuse allegations.

    PubMed

    Lindahl, Mary W

    2009-01-01

    In the emerging literature, cases involving recurring, unsubstantiated allegations of child sexual abuse have generally been categorized as Munchausen by proxy. Recent scholars have recommended restricting the label to the original conceptualization, involving purposeful deception motivated by psychological needs for medical attention. This leaves many cases unclassified that do not fit the Munchausen by proxy criteria, involve significant risks to the child, and ultimately fall outside of existing structures for Child Protective Services/legal intervention. This paper presents a reconceptualization of such cases, proposing to label them "recurring sexual abuse allegation" cases. Defining the set of cases more clearly can aid child protection workers in their management and encourage research on prevalence, consequences to children, treatment strategies, and needed legal reforms.

  1. Understanding elder abuse in family practice

    PubMed Central

    Yaffe, Mark J.; Tazkarji, Bachir

    2012-01-01

    Abstract Objective To discuss what constitutes elder abuse, why family physicians should be aware of it, what signs and symptoms might suggest mistreatment of older adults, how the Elder Abuse Suspicion Index might help in identification of abuse, and what options exist for responding to suspicions of abuse. Sources of information MEDLINE, PsycINFO, and Social Work Abstracts were searched for publications in English or French, from 1970 to 2011, using the terms elder abuse, elder neglect, elder mistreatment, seniors, older adults, violence, identification, detection tools, and signs and symptoms. Relevant publications were reviewed. Main message Elder abuse is an important cause of morbidity and mortality in older adults. While family physicians are well placed to identify mistreatment of seniors, their actual rates of reporting abuse are lower than those in other professions. This might be improved by an understanding of the range of acts that constitute elder abuse and what signs and symptoms seen in the office might suggest abuse. Detection might be enhanced by use of a short validated tool, such as the Elder Abuse Suspicion Index. Conclusion Family physicians can play a larger role in identifying possible elder abuse. Once suspicion of abuse is raised, most communities have social service or law enforcement providers available to do additional assessments and interventions. PMID:23242889

  2. The Response to Conjugal Violence in Substance Abuse Treatment Settings.

    ERIC Educational Resources Information Center

    Brown, Thomas G.; Caplan, Thomas; Seraganian, Peter; Werk, Annette

    The linkage between conjugal violence and substance abuse is well established. The evidence suggests that little coordination exists among the therapeutic communities positioned to treat co-existing problems. A survey was conducted in Quebec with professionals representing 57 substance abuse treatment centers, 38 of which were public. Questions…

  3. Domestic abuse awareness and recognition among primary healthcare professionals and abused women: a qualitative investigation.

    PubMed

    Bradbury-Jones, Caroline; Taylor, Julie; Kroll, Thilo; Duncan, Fiona

    2014-11-01

    To investigate the dynamics of domestic abuse awareness and recognition among primary healthcare professionals and abused women. Domestic abuse is a serious, public health issue that crosses geographical and demographic boundaries. Health professionals are well placed to recognise and respond to domestic abuse, but empirical evidence suggests that they are reluctant to broach the issue. Moreover, research has shown that women are reluctant to disclose abuse. A two-phase, qualitative study was conducted in Scotland. Twenty-nine primary health professionals (midwives, health visitors and general practitioners) participated in the first phase of the study, and 14 abused women took part in phase two. Data were collected in 2011. Semi-structured, individual interviews were conducted with the health professionals, and three focus groups were facilitated with the abused women. Data were analysed using a framework analysis approach. Differing levels of awareness of the nature and existence of abuse are held by abused women and primary healthcare professionals. Specifically, many women do not identify their experiences as abusive. A conceptual representation of domestic abuse - the "abused women, awareness, recognition and empowerment' framework - arising from the study - presents a new way of capturing the complexity of the disclosure process. Further research is necessary to test and empirically validate the framework, but it has potential pedagogical use for the training and education of health professionals and clinical use with abused women. The framework may be used in clinical practice by nurses and other health professionals to facilitate open discussion between professionals and women. In turn, this may empower women to make choices regarding disclosure and safety planning. © 2014 John Wiley & Sons Ltd.

  4. Sexual, Physical, Verbal/Emotional Abuse and Unexplained Chest Pain

    ERIC Educational Resources Information Center

    Eslick, Guy D.; Koloski, Natasha A.; Talley, Nicholas J.

    2011-01-01

    Objectives: Approximately one third of patients with non cardiac chest pain (NCCP) report a history of abuse, however no data exists on the prevalence of abuse among people with unexplained chest pain in the general population. We aimed to determine if there is a relationship between childhood sexual, physical, emotional abuse and unexplained…

  5. MMPI subtypes for cocaine abusers.

    PubMed

    Craig, R J; Olson, R

    1992-01-01

    The MMPIs of 104 cocaine abusers in treatment were subjected to a hierarchical cluster analysis and two basic profile types emerged. Type I consisted of a spike on Pd and a subspike on Hyp, reflecting a rebellious, acting out character-disordered style with narcissistic traits. Type II consisted of a high-ranging, floating profile consisting of marked elevations on F, Sc, Dep, Pt, Pd, and Pa, reflecting a psychiatric patient who concurrently abused cocaine. These findings were contrasted to other MMPI typological studies, and the similarities and differences were discussed.

  6. When good times go bad: managing 'legal high' complications in the emergency department.

    PubMed

    Caffrey, Charles R; Lank, Patrick M

    2018-01-01

    Patients can use numerous drugs that exist outside of existing regulatory statutes in order to get "legal highs." Legal psychoactive substances represent a challenge to the emergency medicine physician due to the sheer number of available agents, their multiple toxidromes and presentations, their escaping traditional methods of analysis, and the reluctance of patients to divulge their use of these agents. This paper endeavors to cover a wide variety of "legal highs," or uncontrolled psychoactive substances that may have abuse potential and may result in serious toxicity. These agents include not only some novel psychoactive substances aka "designer drugs," but also a wide variety of over-the-counter medications, herbal supplements, and even a household culinary spice. The care of patients in the emergency department who have used "legal high" substances is challenging. Patients may misunderstand the substance they have been exposed to, there are rarely any readily available laboratory confirmatory tests for these substances, and the exact substances being abused may change on a near-daily basis. This review will attempt to group legal agents into expected toxidromes and discuss associated common clinical manifestations and management. A focus on aggressive symptom-based supportive care as well as management of end-organ dysfunction is the mainstay of treatment for these patients in the emergency department.

  7. A child sexual abuse research project: a brief endnote.

    PubMed

    Roberts, Susan; Vanstone, Maurice

    2014-01-01

    There is a dearth of research on sexual abuse perpetrated by educators. Although the problem is receiving increasing attention, little emphasis has been placed on abuse directed at younger schoolchildren and on offenders' accounts of this form of abuse. Here, we attempt to address this gap in knowledge by exploring the narratives of five convicted, imprisoned male child sexual abusers, each of whom worked with children in educational settings in the United Kingdom. We draw on four themes that emerged from detailed interviews with offenders, namely: the power of reputation, authority and control, the "front of invulnerability," and disclosure of abuse. We conclude by considering the implications of our work for policy and practice.

  8. Exploring the relationship between child physical abuse and adult dating violence using a causal inference approach in an emerging adult population in South Korea.

    PubMed

    Jennings, Wesley G; Park, MiRang; Richards, Tara N; Tomsich, Elizabeth; Gover, Angela; Powers, Ráchael A

    2014-12-01

    Child maltreatment is one of the most commonly examined risk factors for violence in dating relationships. Often referred to as the intergenerational transmission of violence or cycle of violence, a fair amount of research suggests that experiencing abuse during childhood significantly increases the likelihood of involvement in violent relationships later, but these conclusions are primarily based on correlational research designs. Furthermore, the majority of research linking childhood maltreatment and dating violence has focused on samples of young people from the United States. Considering these limitations, the current study uses a rigorous, propensity score matching approach to estimate the causal effect of experiencing child physical abuse on adult dating violence among a large sample of South Korean emerging adults. Results indicate that the link between child physical abuse and adult dating violence is spurious rather than causal. Study limitations and implications are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. 75 FR 11552 - National Institute on Drug Abuse; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-11

    ... Substance Abuse Provider Training Through Emerging Technologies (5544). Date: April 27, 2010. Time: 9:30 a.m... . (Catalogue of Federal Domestic Assistance Program Nos. 93.279, Drug Abuse and Addiction Research Programs...

  10. Utilization of emergency and hospital services among individuals in substance abuse treatment

    PubMed Central

    2014-01-01

    Background To examine risk factors for use of hospital services among racial and ethnic minority clients in publicly funded substance abuse treatment in Los Angeles County, California. We explored cross-sectional annual data (2006 to 2009) from the Los Angeles County Participant Reporting System for adult participants (n = 73,251) who received services from treatment programs (n = 231). Methods This retrospective analysis of county admission data relied on hierarchical linear negative binomial regression models to explore number of hospital visits, accounting for clients nested in programs. Client data were collected during personal interviews at admission. Findings Our findings support previous work that noted increased use of emergency rooms among individuals suffering from mental health- and substance use-related issues and extend the knowledge base by highlighting other important features such as treatment need, i.e., residential compared to outpatient treatment. Conclusions These findings have implications for health care policy in terms of the need to increase prevention services and reduce costly hospitalization for a population at significant risk of co-occurring mental and physical disorders. PMID:24708866

  11. Elder abuse in Chinese populations: a global review.

    PubMed

    Dong, XinQi

    2015-01-01

    This review focuses on the epidemiology of elder abuse in the global Chinese population with respect to its prevalence, risk factors, and consequences, as well as the perceptions of elder abuse. Evidence revealed that elder abuse and its subtypes are common among the global Chinese population with prevalence ranging from 0.2% to 64%. Younger age, lower income levels, depression, cognitive impairment, and lack of social support were consistently associated with self-reported elder abuse. Caregiver burden was a constant risk factor for the proclivity to elder abuse by caregivers. The adverse health outcomes of elder abuse included suicidal ideation and psychological stress. Some primary research gaps exist: such as, lack of consistency in measurements and recall periods, insufficient studies on the causal relationships between potential risk factors and elder abuse, consequences of elder abuse, and possible interventions. In order to reduce the risk of elder abuse in the global Chinese population, collaboration is encouraged among researchers, health care professionals, social service providers, and policy makers.

  12. Gender differences in discharge dispositions of emergency department visits involving drug misuse and abuse-2004-2011.

    PubMed

    Manuel, Jennifer I; Lee, Jane

    2017-05-30

    Drug use-related visits to the emergency department (ED) can undermine discharge planning and lead to recurrent use of acute services. Yet, little is known about where patients go post discharge. We explored trends in discharge dispositions of drug-involved ED visits, with a focus on gender differences. We extracted data from the 2004-2011 Drug Abuse Warning Network, a national probability sample of drug-related visits to hospital EDs in the U.S. We computed weighted multinomial logistic regression models to estimate discharge dispositions over time and to examine associations between gender and the relative risk of discharge dispositions, controlling for patient characteristics. The final pooled sample included approximately 1.2 million ED visits between 2004 and 2011. Men accounted for more than half (57.6%) of all ED visits involving drug misuse and abuse. Compared with women, men had a greater relative risk of being released to the police/jail, being referred to outpatient detox or other treatment, and leaving against medical advice than being discharged home. The relative risk of being referred to outpatient detox/drug treatment than discharged home increased over time for men versus women. Greater understanding of gender-based factors involved in substance-related ED visits and treatment needs may inform discharge planning and preventive interventions.

  13. The Impact of Sexual Abuse on Sexual Identity Formation in Gay Men

    ERIC Educational Resources Information Center

    Brady, Stephen

    2008-01-01

    Emerging data suggests that as children, gay males have an increased risk for physical and sexual abuse. Anecdotal evidence suggests that a significant subset of children abused by clergy identify as gay as adults. However, we know very little about the impact of clergy-perpetrated sexual abuse in childhood on the development and psychosocial…

  14. Pulse Check: Trends in Drug Abuse, Mid-Year 2000.

    ERIC Educational Resources Information Center

    Meth, Marcia; Chalmers, Rebecca; Bassin, Gail

    This report serves as a source of information on drug abuse and drug markets. It aims to describe drug-abusing populations; emerging drugs; new routes of administration; varying use patterns; changing demand for treatment; drug-related criminal activity; and shifts in supply and distribution patterns. It is not designed to be used as a law…

  15. Physical abuse in the era of financial crisis in Greece.

    PubMed

    Kontos, Michael; Moris, Demetrios; Davakis, Spyridon; Schizas, Dimitrios; Pikoulis, Emmanouil; Liakakos, Theodoros

    2017-04-01

    Greece is suffering an economic recession of enormous magnitude, but whether its health has deteriorated as a result, has not yet been well established. We aim to present and analyze differences in demographics and clinical distribution of patients victims of physical abuse examined at the surgical emergency room in an Academic institution in the era of financial crisis. A retrospective database analysis of all patients that were examined to surgical emergency room (ER), between January 1st 2008 and December 31st 2014, was conducted. We only analyzed and evaluated data for the years 2008 to 2014. The number of patients being examined in the ER in 2011 was higher compared with that of 2014 and to 2008 respectively (P<0.05). There was an increase of the total cases of physical abuse (P<0.05). The majority of cases examined for physical abuse were men, with a constant tendency of increasing number of women abused throughout the years of crisis. Financial crisis seems to have a multivariable effect on epidemiology and clinical diversity of the patients, victims of physical abuse, being examined in the ER.

  16. The effect of pre-existing affect on the sexual responses of women with and without a history of childhood sexual abuse.

    PubMed

    Rellini, Alessandra H; Elinson, Samantha; Janssen, Erick; Meston, Cindy M

    2012-04-01

    Women with a history of childhood sexual abuse (CSA) are at greater risk for experiencing sexual problems in their adult lives. Yet, little is known about the possible role of cognitive and affective mechanisms in the development of sexual arousal difficulties in this population. This study investigated the role of pre-existing affect (affect prior to exposure to sexual stimuli) on genital responses, subjective sexual arousal, and affect elicited during the presentation of erotic film excerpts in a community sample of 25 women with and 25 women without a history of CSA. The CSA group showed greater pre-existing negative affect and smaller genital responses to the erotic film stimuli compared to the NSA group. Findings support a moderating effect of CSA, in that pre-existing negative affect was associated with strength of genital responses in the NSA but not in the CSA group. The results did not support a mediation model of pre-existing negative affect as an explanation for smaller physiological sexual responses in the CSA group. Taken together, the findings suggest that pre-existing affect may be more relevant for women with no history of CSA and call for more research on factors implicated in impaired sexual responses in women with a history of CSA.

  17. The emerging problem of physical child abuse in South Korea.

    PubMed

    Hahm, H C; Guterman, N B

    2001-05-01

    South Korea has had remarkably high incidence and prevalence rates of physical violence against children, yet the problem has received only limited public and professional attention until very recently. This article represents the first attempt in English to systematically analyze South Korea's recent epidemiological studies on child maltreatment. Discussed are sociocultural factors that have contributed both to delays in child protection laws and a low public awareness of the problem of child abuse. The article highlights methodological issues concerning the definition of physical abuse in South Korea and the complex attitudes toward violence. It also examines the role of the Korean women's movement in the reform of family laws and the recent establishment of new child protection legislation. Suggestions for future directions for the problem of child maltreatment within South Korea are presented.

  18. The evolving high: new designer drugs of abuse.

    PubMed

    Pourmand, A; Armstrong, P; Mazer-Amirshahi, M; Shokoohi, H

    2014-10-01

    Over the past decade, emerging drugs of abuse and synthetic derivatives of more traditional agents have flooded the market. While Europe was the first to experience a surge in the use of drugs such as synthetic cathinones and cannabinoids, poison centers throughout the United States have seen a dramatic rise in calls related to these new designer drugs of abuse. In the majority of cases, care is largely supportive but significant medical and traumatic complications may occur. Providers must be aware of the ever-changing trends in abuse, so that they may optimally care for poisoned patients. © The Author(s) 2014.

  19. Predictors of Depressive Symptoms among Inpatient Substance Abusers

    ERIC Educational Resources Information Center

    Diaz, Naelys; Green, Diane; Horton, Eloise G.

    2009-01-01

    The existing literature indicates high comorbidity rates between depressive disorders and substance abuse disorders. Despite these elevated rates, there is limited empirical work devoted to understanding predictors of depressive symptoms among substance abusers. The aim of this study was to examine the effect of spirituality, believing in God's…

  20. Evaluation of an innovative tool for child sexual abuse education.

    PubMed

    Davis, Deborah Winders; Pressley-McGruder, Gloria; Jones, V Faye; Potter, Deborah; Rowland, Michael; Currie, Melissa; Gale, Bruce

    2013-01-01

    Child sexual abuse poses a serious threat to public health and is often unreported, unrecognized, and untreated. Prevention, early recognition, and treatment are critically important to reduce long-term effects. Little data are available on effective methods of preventing child sexual abuse. The current research demonstrates a unique approach to promoting awareness and stimulating discussion about child sexual abuse. Qualitative methods have rarely been used to study child sexual abuse prevention. Qualitative inductive analyses of interviews from 20 key informants identified both positive and negative assessments with six emergent themes. The themes revealed inherent tensions in using narrative accounts to represent the complex cultural context within which child sexual abuse occurs. More research is needed, but the program shows potential as a methodology to raise awareness of child sexual abuse.

  1. Infant feeding experiences of women who were sexually abused in childhood.

    PubMed

    Wood, Karen; Van Esterik, Penny

    2010-04-01

    To explore the effects of childhood sexual abuse (CSA) on women's breastfeeding and infant feeding decisions and experiences. Qualitative, participatory study using semistructured in-depth interviews. Tamara's House, a healing centre for women who were sexually abused in childhood, located in Saskatoon, Sask. Six mothers who were sexually abused in childhood. In-depth interviews were conducted and transcribed verbatim. Thematic analysis was iterative and participatory. The emerging themes that resulted from initial analysis by the researchers were presented at a meeting held jointly with academics, survivors, and professionals in the field to achieve consensus. Throughout the process, findings were considered in relation to related literature on breasts, breastfeeding, and CSA. History of CSA complicated the women's infant feeding decisions and experiences. For 2 women, birthing and breastfeeding facilitated healing from the effects of the abuse. Shame, touch, breasts, dissociation, medical care, and healing emerged as analytic themes. A history of CSA can affect a woman's experience of breastfeeding, including acting as a trigger for remembering or reexperiencing the abuse. Women who were sexually abused as children need to experience a sense of safety, acceptance, sensitivity, and understanding. Physicians need to be aware of the effects of CSA on infant feeding and women's health, and might need to be trained in a sensitive-practice approach to working with patients who were sexually abused as children.

  2. The Medical Analysis of Child Sexual Abuse Images

    ERIC Educational Resources Information Center

    Cooper, Sharon W.

    2011-01-01

    Analysis of child sexual abuse images, commonly referred to as pornography, requires a familiarity with the sexual maturation rating of children and an understanding of growth and development parameters. This article explains barriers that exist in working in this area of child abuse, the differences between subjective and objective analyses,…

  3. 45 CFR 152.27 - Fraud, waste, and abuse.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Fraud, waste, and abuse. 152.27 Section 152.27 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS PRE-EXISTING CONDITION INSURANCE PLAN PROGRAM Oversight § 152.27 Fraud, waste, and abuse. (a) Procedures. The...

  4. 45 CFR 152.27 - Fraud, waste, and abuse.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Fraud, waste, and abuse. 152.27 Section 152.27 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS PRE-EXISTING CONDITION INSURANCE PLAN PROGRAM Oversight § 152.27 Fraud, waste, and abuse. (a) Procedures. The...

  5. 45 CFR 152.27 - Fraud, waste, and abuse.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Fraud, waste, and abuse. 152.27 Section 152.27 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS PRE-EXISTING CONDITION INSURANCE PLAN PROGRAM Oversight § 152.27 Fraud, waste, and abuse. (a) Procedures. The...

  6. 45 CFR 152.27 - Fraud, waste, and abuse.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Fraud, waste, and abuse. 152.27 Section 152.27 Public Welfare Department of Health and Human Services REQUIREMENTS RELATING TO HEALTH CARE ACCESS PRE-EXISTING CONDITION INSURANCE PLAN PROGRAM Oversight § 152.27 Fraud, waste, and abuse. (a) Procedures. The...

  7. 45 CFR 152.27 - Fraud, waste, and abuse.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Fraud, waste, and abuse. 152.27 Section 152.27 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS PRE-EXISTING CONDITION INSURANCE PLAN PROGRAM Oversight § 152.27 Fraud, waste, and abuse. (a) Procedures. The...

  8. Psychosocial problems of children whose parents visit the emergency department due to intimate partner violence, substance abuse or a suicide attempt.

    PubMed

    Hoytema van Konijnenburg, E M M; van der Lee, J H; Teeuw, A H; Lindeboom, R; Brilleslijper-Kater, S N; Sieswerda-Hoogendoorn, T; van Goudoever, J B; Lindauer, R J L

    2017-05-01

    High levels of maltreatment are found in children who are identified because their parents visit the emergency department due to partner violence, substance abuse or suicide attempt. However, it is unknown if these children experience psychosocial problems. This study aims to assess their levels of post-traumatic stress, anxiety, depression, behavioural problems and health-related quality of life. A cross-sectional study was conducted in six hospitals. All consecutive families of which a parent visited the emergency department due to partner violence, substance abuse or suicide attempt between 1 July 2012 and 1 March 2014 with children aged 1.5-17 years were approached for participation. Parents and children aged 8 years and older filled out questionnaires measuring post-traumatic stress [13-item version of Children's Revised Impact of Event Scale (CRIES-13)], anxiety, depression (Revised Child Anxiety and Depression Scale), behavioural problems [Child Behavior Checklist (CBCL) and Youth Self-Report (YSR)] and health-related quality of life (PedsQL). Scores of participants were compared with reference data obtained in children in similar age ranges from representative Dutch community samples (CRIES-13, Revised Child Anxiety and Depression Scale, PedsQL and CBCL) and to a normed cutoff score (CRIES-13). Of 195 eligible families, 89 (46%) participated in the study. Participating children did not score different from community children, both on child-reported and parent-reported instruments. Standardized mean differences of total sum scores were 0 (CRIES-13 and CBCL 1.5-5), 0.1 (YSR), 0.2 (CBCL 6-18) and -0.3 (PedsQL) and not statistically different from community children. Thirty-five percent of the participating children scored above the cutoff score on the CRIES-13, indicating post-traumatic stress disorder, but this difference was not statistically significant from community children (mean difference 8%; 95% CI -4-22%). We found no differences in psychosocial

  9. Teachers' Knowledge and Beliefs About Child Sexual Abuse.

    PubMed

    Márquez-Flores, María Mercedes; Márquez-Hernández, Verónica V; Granados-Gámez, Genoveva

    2016-07-01

    Child sexual abuse is one of the main types of abuse still to be addressed within the field of education, yet the education system itself can serve as a primary tool for its prevention. A better understanding of teachers' knowledge and beliefs about child sexual abuse will allow us to establish key starting points from which to utilize the system for prevention. Four hundred and fifty teachers participated in this study, completing a questionnaire regarding their knowledge and beliefs about child sexual abuse. The study revealed that over half the teachers, 65.3% (n = 294), had never received any type of training in child sexual abuse education and that the majority were not familiar with methods of identifying child sexual abuse, 90.7% (n = 279). Various mistaken beliefs were identified among the participating teachers, such as pathological profiles of abusers, that the vast majority of child sexual abuse implies violent behavior, and that there cannot be abusers the same age as the victim. These results indicate that knowledge deficiencies do exist about child sexual abuse among teachers and highlight the need for training in this field.

  10. National Training Course. Emergency Medical Technician. Paramedic. Instructor's Lesson Plans. Module X. Medical Emergencies.

    ERIC Educational Resources Information Center

    National Highway Traffic Safety Administration (DOT), Washington, DC.

    This instructor's lesson plan guide on medical emergencies is one of fifteen modules designed for use in the training of emergency medical technicians (paramedics). Ten units of study are presented: (1) diabetic emergencies; (2) anaphylactic reactions; (3) exposure to environmental extremes; (4) alcoholism and drug abuse; (5) poisoning and…

  11. Exploring gender and elder abuse from the perspective of professionals.

    PubMed

    Weeks, Lori; Dupuis-Blanchard, Suzanne; Arseneault, Rina; MacQuarrie, Colleen; Gagnon, Danie; LeBlanc, Ginette Marie

    2018-01-01

    We conducted an online survey of professionals working in two Canadian provinces to learn about their knowledge of elder abuse from a gender-based perspective. A total of 169 professionals (90% women) completed a survey in either French or English. Five topic areas emerged from the analysis: the influence of gender on the risk of abuse; types of abuse detected; knowledge gaps; capacity to respond to gender-based abuse; and awareness of resources. To gain further insight into these results, we conducted three focus groups with a total of 24 professionals. Professionals held relatively little recognition of, or knowledge about, gender related to elder abuse. Our results indicate the need to develop educational and awareness raising opportunities for professionals who work with abused older adults in both French and English to identify and respond to the unique needs of older women and men.

  12. Opioid addiction, diversion, and abuse in chronic and cancer pain.

    PubMed

    Kata, Vijay; Novitch, Matthew B; Jones, Mark R; Anyama, Best O; Helander, Erik M; Kaye, Alan D

    2018-06-01

    The primary cause of overdose death in the United States is related to pharmaceutical opioids. A few particular populations that struggle with adverse outcomes related to opioid abuse are those in palliative care, those with chronic pain, and those receiving pain treatments secondary to cancer or chemotherapy. There have been massive efforts to decrease the use of opioid abuse in patient care in a gestalt manner, but palliative care provides unique challenges in applying these reduction tactics used by other specialties. We explore behavioral interventions, provider education, alternative pain management techniques, postmarketing surveillance, and abuse-deterrent formulas as emerging methods to counteract opioid abuse in these populations.

  13. Cortical thinness and volume differences associated with marijuana abuse in emerging adults.

    PubMed

    Mashhoon, Y; Sava, S; Sneider, J T; Nickerson, L D; Silveri, M M

    2015-10-01

    The prevalence of marijuana (MJ) use among youth and its legalization for medical or recreational use has intensified public health endeavors of understanding MJ effects on brain structure and function. Studies indicate that MJ use is related to impaired cognitive performance, and altered functional brain activation and chemistry in adolescents and adults, but MJ effects on brain morphology in emerging adults are less understood. Fifteen MJ users (age 21.8±3.6, 2 females) and 15 non-user (NU) participants (age 22.3±3.5, 2 females) were included, demographically matched on age, education and alcohol use. High-resolution structural MR images were acquired at 3Tesla. Cortical thickness (CT) and volumetric analyses were performed using Freesurfer. A priori regions of interest (ROI) included orbitofrontal and cingulate cortices, amygdala, hippocampus and thalamus. Whole brain CT analysis did not result in significant group differences in a priori ROIs but revealed MJ users had significantly less CT (i.e., thinness) in right fusiform gyrus (rFG) compared to NU (p<0.05). Thalamic volume was significantly smaller in MJ users compared to NU (right, p=0.05; left, p=0.01) and associated with greater non-planning (p<0.01) and overall impulsivity (p=0.04). There were no other group differences. RFG cortical thinness and smaller thalamic volume in emerging adults is associated with MJ abuse. Furthermore, smaller thalamic volume associated with greater impulsivity contributes to growing evidence that the thalamus is neurobiologically perturbed by MJ use. Collectively, altered thalamic and rFG structural integrity may interfere with their known roles in regulating visuoperceptual and object information processing. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  14. The Role of Education in Drug Abuse Programs.

    ERIC Educational Resources Information Center

    Richardson, Sandra C.

    A 1984 survey of teachers and principals revealed that the respondents considered the use of drugs and alcohol to be the worst type of discipline problem they had experienced. While the significance of the drug and alcohol abuse problem in schools supports the existence of drug abuse prevention programs in the schools, several practical reasons…

  15. Relationships and Betrayal among Young Women: Theoretical Perspectives on Adolescent Dating Abuse

    PubMed Central

    Burton, Candace W.; Halpern-Felsher, Bonnie; Rankin, Sally H.; Rehm, Roberta S.; Humphreys, Janice C.

    2010-01-01

    AIMS Adolescent dating abuse is not specifically described by any current nursing theory, and this paper presents discussion of some existing theories that could inform a nursing theory of adolescent dating abuse. To account for the effects of gender, this discussion is limited to young women. BACKGROUND Adolescent dating abuse is an important and understudied international issue for nursing. Theoretical frameworks can support development of nursing scholarship for such issues. No single theory yet exists within nursing to explain the experiences and health ramifications of dating abuse among young women. DATA SOURCES A summary table of theories is provided. Literature was gathered via database search and bibliographic snowballing from reference lists of relevant articles. Included literature dates from 1982 through 2010. DISCUSSION Theories of relationship formation and function are discussed, including attachment, investment, feminist and gender role conflict theories. Betrayal trauma theory is considered as a mechanism of injury following an abusive dating experience. IMPLICATIONS FOR NURSING Gender, relationship, and adolescence combine in a complex developmental moment for young women. To improve nursing care for those at risk for or in the throes of abusive relationships, it is critical to develop specific nursing approaches to understanding these relationships. CONCLUSION Existing theories related to relationship and traumatic experiences can be combined in the development of a nursing theory of adolescent dating abuse among young women. PMID:21261691

  16. Relationships and betrayal among young women: theoretical perspectives on adolescent dating abuse.

    PubMed

    Burton, Candace W; Halpern-Felsher, Bonnie; Rankin, Sally H; Rehm, Roberta S; Humphreys, Janice C

    2011-06-01

    Adolescent dating abuse is not specifically described by any current nursing theory, and this article presents discussion of some existing theories that could inform a nursing theory of adolescent dating abuse. To account for the effects of gender, this discussion is limited to young women. Adolescent dating abuse is an important and understudied international issue for nursing. Theoretical frameworks can support development of nursing scholarship for such issues. No single theory yet exists in nursing to explain the experiences and health ramifications of dating abuse among young women. A summary table of theories is provided. Literature was gathered via database search and bibliographic snowballing from reference lists of relevant articles. Included literature dates from 1982 through 2010. Theories of relationship formation and function are discussed, including attachment, investment, feminist and gender role conflict theories. Betrayal trauma theory is considered as a mechanism of injury following an abusive dating experience. Gender, relationship and adolescence combine in a complex developmental moment for young women. To improve nursing care for those at risk for or in the throes of abusive relationships, it is critical to develop specific nursing approaches to understanding these relationships. Existing theories related to relationship and traumatic experiences can be combined in the development of a nursing theory of adolescent dating abuse among young women. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

  17. Exploring family environment characteristics and multiple abuse experiences among homeless youth.

    PubMed

    Ferguson, Kristin M

    2009-11-01

    This qualitative study used data from the Social Enterprise Intervention (SEI) pilot study, a comprehensive vocational training program with integrated clinical services for homeless youth. In-depth interviews were conducted with 28 homeless youth participating in the SEI study to explore their perceptions of family environment characteristics and abuse experiences. The constant comparative method was used to analyze transcripts from in-depth interviews with the youth participants. Emergent themes related to family characteristics include home instability, abandonment, and caregiver substance abuse. Abuse-related subthemes include intrafamilial abuse, caregiver abuse, rejection, and deprecation by caregivers. Grounded theory is used to interpret findings and develop working hypotheses to guide future studies of multitype maltreatment among homeless youth.

  18. Intentional Misuse and Abuse of Loperamide: A New Look at a Drug with "Low Abuse Potential".

    PubMed

    Borron, Stephen W; Watts, Susan H; Tull, Jonathan; Baeza, Salvador; Diebold, Stephanie; Barrow, Alison

    2017-07-01

    Despite its opioid properties, loperamide has long been thought to have low abuse potential due to its poor absorption from the gastrointestinal tract and limited potential to cross the blood-brain barrier. A recent patient reportedly taking loperamide to avoid heroin withdrawal symptoms, at doses approximately 100 times those recommended, directed our attention to this issue. 1) Investigate number of cases of intentional loperamide abuse and misuse reported to poison centers between 2009 and 2015; 2) Compile reports of clinical effects of loperamide abuse; and 3) Search for evidence of increasing Internet interest in the central opioid effects of loperamide. For the years 2009 thru 2015, we reviewed exposure calls related to misuse/abuse of loperamide in the Texas Poison Center Network's database and the National Poison Data System. We used Google trend analysis to detect evidence of increased Internet interest in the illicit use of loperamide. Between 2009 and 2015, the number of misuse/abuse calls related to loperamide alone nearly doubled, with about one-third of cases occurring in teens and young adults in their 20s. Of particular concern are reports of significant cardiotoxic effects (∼18% of cases), including conduction defects and various dysrhythmias, sometimes leading to death. Google Trends analysis demonstrates an increasing number of searches for "loperamide high" and "loperamide withdrawal" beginning in 2011. Loperamide misuse/abuse seems to be on the rise. Given its propensity to induce conduction disturbances and dysrhythmias at very high doses, emergency physicians should be vigilant for this form of drug abuse. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. When good times go bad: managing ‘legal high’ complications in the emergency department

    PubMed Central

    Caffrey, Charles R; Lank, Patrick M

    2018-01-01

    Patients can use numerous drugs that exist outside of existing regulatory statutes in order to get “legal highs.” Legal psychoactive substances represent a challenge to the emergency medicine physician due to the sheer number of available agents, their multiple toxidromes and presentations, their escaping traditional methods of analysis, and the reluctance of patients to divulge their use of these agents. This paper endeavors to cover a wide variety of “legal highs,” or uncontrolled psychoactive substances that may have abuse potential and may result in serious toxicity. These agents include not only some novel psychoactive substances aka “designer drugs,” but also a wide variety of over-the-counter medications, herbal supplements, and even a household culinary spice. The care of patients in the emergency department who have used “legal high” substances is challenging. Patients may misunderstand the substance they have been exposed to, there are rarely any readily available laboratory confirmatory tests for these substances, and the exact substances being abused may change on a near-daily basis. This review will attempt to group legal agents into expected toxidromes and discuss associated common clinical manifestations and management. A focus on aggressive symptom-based supportive care as well as management of end-organ dysfunction is the mainstay of treatment for these patients in the emergency department. PMID:29302196

  20. Elder Abuse in a Developing Area in Bolivia.

    PubMed

    Carmona-Torres, Juan Manuel; López-Soto, Pablo Jesús; Coimbra-Roca, Ana Isabel; Gálvez-Rioja, Ruth Mary; Goergen, Thomas; Rodríguez-Borrego, M Aurora

    2015-10-06

    In many parts of the world, elder abuse happens almost unnoticed. Until recently, this serious social problem was hidden from public view and was regarded as an essentially private matter. However, there is growing evidence that elder abuse is an important problem of public health and in the society. The objective of this study is to determine the degree of abuse of elder and vulnerable people in the families and communities of Eastern Bolivia. With this end in mind, we conducted a cross-sectional descriptive study with a sample size of 210 60-year-old people coming from different health care areas. Elder Abuse Suspicion Index (EASI) and Yaffe's Evaluation Form of Social Work were used. An abuse rate of 39% of the older adults was identified. The most common type of abuse observed was psychological abuse (32.4% of cases), followed by neglect (21.9%). Children were identified as triggers of the abuse in 66.7% of cases of abuse. The prevalence of elder abuse was similar to the prevalence of other types of abuse that exist in Bolivia, such as the gender-based abuse. Also, this prevalence is comparable to other developing countries and European countries. The profile of abused older adult is as follows: woman, widow, 70 years old, incomplete primary education, without an occupation, and an average of 4.59 children. The information obtained shows that dysfunctional families have a higher percentage of elder abuse. © The Author(s) 2015.

  1. Substance abuse among nurses--defining the issue.

    PubMed

    Dunn, Debra

    2005-10-01

    The prevalence of substance abuse in the nurse population is believed to parallel that in the general population (i.e. approximately 10%). Nurses with substance abuse problems need help. They are in danger of harming patients, the facility's reputation, the nursing profession, and themselves. The consequences of not reporting concerns can be far worse than those of reporting the issue. Part one of this two-part series discusses how society views addiction and the nursing profession, signs and symptoms of substance abuse, reasons nurses should report an impaired colleague, the code of silence that exists among nurses, and board of nursing jurisdiction.

  2. Hiding behind the Cloth: Child Sexual Abuse and the Catholic Church

    ERIC Educational Resources Information Center

    Dale, Kathryn A.; Alpert, Judith L.

    2007-01-01

    The existence of child sexual abuse within the Catholic Church has shocked many. In this article, the authors review the history of child sexual abuse in the church, the recent events that brought this tragedy into societal consciousness, and the efforts by the church to conceal the abuse. Two sources of empirical literature, the general…

  3. Lie as narrative truth in abused adopted adolescents.

    PubMed

    Wilkinson, S; Hough, G

    1996-01-01

    Two case examples of abused adopted adolescents are discussed to highlight tension within the treatment relationship when the therapist is expected to accept without question a clearly unbelievable story. These examples illustrate how the lies of such youths can function as narrative truth. The unbelievable tales that emerge in the therapeutic work effectively alter the adolescents' perceptions about the perplexing loss of continuity, both internal and external, that occurred when they were removed from their homes. Characters in the stories represent fragmented self- and object-representations as victim, abuser, rescuer, and passive onlooker. Counterparts to the patient as victim, abuser, rescuer, and passive onlooker can be recognized in the therapist's subjective responses. If the therapist can use countertransference to inform an understanding of the treatment process, an appreciation emerges that the truth of the lie is in its impact. Decisions about how to intervene can then be crafted. The second separation-individuation intrinsic to adolescent development is understood to provide a ripe opportunity for this working-through process.

  4. [Substance abuse and toxicity. Fetal drug syndrome].

    PubMed

    Rodé, Magdolna

    2003-08-10

    24% of the 16 years old adolescents have already consumed so called substances suitable for abuse. We must make children, teachers, parents, lawyers, priests, physicians and family aware of the effects and outcomes of drug use. This is just one of the many similar unsolved problems of society like AIDS and smoking. It is imperative that education for healthy lifestyle should be thought at every level of social life. Fighting against the hard problems emerging from drug abuse must be continuously kept on the right place in teaching medicine and in our everyday activity.

  5. Substance Abuse among Drivers of Motor Vehicle Collisions

    PubMed Central

    Derakhshanfar, Hojjat; Kalantari Meibodi, Mohamad; Kariman, Hamid; Arhamidolatabadi, Ali; Safari, Saeed

    2012-01-01

    Background: Motor vehicle collisions (MVC) comprise a majority cause of referral to the emergency department (ED). A large proportion of MVC appear to be preventable, if more effective measures against driving after substance abuse can be implemented. Objective: This study was aimed to investigate the prevalence of substance abuse among drivers of MVC, following road traffic accidents (RTA). Materials and Methods: This case-control research was conducted from July to October 2007. One hundred MVC drivers admitted in the ED were included as the case group and 110 hospitalized patients, due to nontraumatic causes were used as controls. History of substances abused was obtained and urine samples were tested for opium in both groups. Finally the history and laboratory results of the groups were compared using SPSS 18. Results: Of the 100 patients in the case group, 39 (39%) were positive for substance abuse (100% males). On the other hand, 49 (44.5%) patients in the control group had positive history or laboratory findings of substance abuse (73.9% male). Opioids were the most common agent abused in both groups. There was no significant difference between two groups regarding the prevalence of substance abuse (P = 0.92). Conclusions: The prevalence of substance abuse is high among victims of road traffic injury but in equal proportion to the control group. Health education and counseling is needed to reduce substance abuse in the general population although it was not significantly related to the cause of RTA. PMID:24829889

  6. Parenting in Females Exposed to Intimate Partner Violence and Childhood Sexual Abuse

    ERIC Educational Resources Information Center

    Jaffe, Anna E.; Cranston, Christopher C.; Shadlow, Joanna O.

    2012-01-01

    Child sexual abuse and intimate partner violence may have a significant impact on parenting. The current study expands on existing research by examining the effects of child sexual abuse and intimate partner violence on parenting styles and parenting self-efficacy. In women from a parenting intervention program (n = 20), child sexual abuse was…

  7. OPPIDUM surveillance program: 20 years of information on drug abuse in France.

    PubMed

    Frauger, Elisabeth; Moracchini, Christophe; Le Boisselier, Reynald; Braunstein, David; Thirion, Xavier; Micallef, Joëlle

    2013-12-01

    It is important to assess drug abuse liability in 'real life' using different surveillance systems. Some are based on specific population surveys, such as individuals with drug abuse or dependence, or under opiate maintenance treatment, because this population is very familiar with drugs and is more likely to divert or abuse them. In France, an original surveillance system based on this specific population and called 'Observation of illegal drugs and misuse of psychotropic medications (OPPIDUM) survey' was set up in 1990 as the first of its kind. The aim of this article is to describe this precursor of French drug abuse surveillance using different examples, to demonstrate its ability to effectively give health authorities and physicians interesting data on drug abuse. OPPIDUM is an annual, cross-sectional survey that anonymously collects information on abuse and dependence observed in patients recruited in specialized care centers dedicated to drug dependence. From 1990 to 2010, a total of 50,734 patients were included with descriptions of 102,631 psychoactive substance consumptions. These data have outlined emergent behaviors such as the misuse of buprenorphine by intravenous or nasal administration. It has contributed to assess abuse liability of emergent drugs such as clonazepam or methylphenidate. This surveillance system was also able to detect the decrease of flunitrazepam abuse following implementation of regulatory measures. OPPIDUM's twenty years of experience clearly demonstrate that collection of valid and useful data on drug abuse is possible and can provide helpful information for physicians and health authorities. © 2013 The Authors Fundamental and Clinical Pharmacology © 2013 Société Française de Pharmacologie et de Thérapeutique.

  8. Perception of Physical Child Abuse Among Parents and Professionals in a French Emergency Department.

    PubMed

    Bailhache, Marion; Alioum, Ahmadou; Salmi, Louis-Rachid

    2017-04-01

    France has not prohibited all forms of corporal punishment, and the point at which an act is regarded as physical abuse is not clearly determined. The aim of our study was to compare perception of a caregiver's violent behavior toward his child by professionals and parents in an emergency department and determine characteristics associated with that perception. A cross-sectional study was conducted from November 2013 to October 2014 in the emergency department of the pediatric university hospital in Bordeaux, France. An anonymous self-administered questionnaire, including vignettes describing hypothetical situations of violent interaction between a parent and child, and items related to sociodemographic and family characteristics, was administered to professionals and parents. Vignettes included varying child's age and behavior, frequency of caregiver's behavior, hitting with/without an object, and targeted child's body part. Violent behavior was restricted to hitting for reasons of feasibility. Respondents were asked to rate the acceptability of situations on a 100-mm visual analog scale. Analyses were multivariate mixed Poisson regressions. A total of 1,001 participants assessed the vignettes. Participants were predominantly females (64%), married or living with a partner (87%), with a median age of 34 years. Professionals assessed vignettes as acceptable significantly more than parents (mean rating 2.8 times higher; p < .001). For both professionals and parents, all vignette characteristics were significantly associated with acceptability. Parents who had a child below 1 year old, those who had visited an emergency department many times in the past year, and those who had fewer children were less tolerant. Such findings indicate the need for additional research to better appreciate consequences and severity of violent behavior toward children, and the need to educate parents and professionals.

  9. Emergency Physician Utilization of Alcohol/Substance Screening, Brief Advice and Discharge: A 10-Year Comparison.

    PubMed

    Broderick, Kerryann B; Kaplan, Bonnie; Martini, Dyllon; Caruso, Emily

    2015-10-01

    In 2007, of the 130 million emergency department (ED) visits, ∼ 38 million were due to injury, and of those, 1.9 million involved alcohol. The emergency department is a pivotal place to implement Screening, Brief Intervention, and Referral to Treatment (SBIRT) due to the high number of patients presenting with alcohol/substance abuse risk factors or related injuries. This study compares two surveys, approximately 11 years apart, of emergency physicians nationwide which assesses the use of validated screening tools, the availability of community resources for alcohol/substance abuse treatment, and the prevailing attitudes of emergency physicians regarding Screening and Brief Intervention for alcohol/substance abuse. We performed cross-sectional anonymous surveys of 1500 emergency physicians drawn from American College of Emergency Physicians members. The survey results were compared for time interval change. The two surveys had comparable response rates. The median percentage of patients screened for alcohol/substance abuse in 1999 was 15%, vs. 20% in 2010. In 2010, 26% of emergency physicians had a formal screening tool, and the majority used Cut-down, Annoyed, Guilty, Eye-opener (85%). In 2010, a statistically significant increase in the number of emergency physicians said they would "always" or "almost always" use discharge instructions that were specific for alcohol/substance abuse, if available, vs. 1999. Few emergency physicians screen for alcohol/substance abuse despite evidence that screening and brief intervention is effective. Emergency physicians are receptive to the use of discharge material. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. [Child abuse in the family].

    PubMed

    De Almeida, Helena Nunes; André, Isabel Margarida; De Almeida, Ana Nunes

    2002-01-01

    : abuse of the embryo, foetus or new-born child, and sexual abuse. In Portugal the existence of various forms of poverty (whether in material or educational terms), and the lack of family support services and mechanisms, are of particular significance. And tied in with this structural aspect there is the significant factor of alcoholism, which in the sample under investigation is statistically much more significant than drug addiction.

  11. [Intra and extra-familiar sexual abuse].

    PubMed

    Taveira, Francisco; Frazão, Sofia; Dias, Ricardo; Matos, Eduarda; Magalhães, Teresa

    2009-01-01

    The sexual abuse of a child or young person constitutes a major social and public health problem and there is recent evidence that intra-familial (IF) sexual abuses are more serious in their consequences than extra-familial (EF). However, there are no studies on this phenomenon in Portugal. Thus, the aim of the present study is to contribute to a better characterization of these types of abuses and to identify possible differences between IF and EF cases. A retrospective study was preformed based on medico-legal reports related to victims below the age of 18, suspected of being sexually abused (n = 764), corresponding to 67% of the total of observed sexual crimes. Results revealed that 34.9% of the abuses are IF and they show statistically significant differences when compared to EF cases. These are due to the following factors found in IF situations: a) lower victim age; b) closeness between victim and abuser; c) abusers with a higher rate of previous sexual abuse; d) sexual practices of reduced physical intrusion; e) decreased physical violence but increased emotional violence; f) greater delay between last abuse and the forensic exam; g) reduced number of injuries or biological evidence (none in the great majority of the cases). Results point out the existence of several characteristics in IF abuse that have been identified as factors that influence the severity of the abuse consequences. Among them are: a) lower victim age; b) greater proximity to the abuser; c) increased amount of emotional violence. These factors account for the reduced visibility of this kind of cases and therefore explain their delayed disclosure and diagnosis. The association of this fact with the reduced intrusiveness of this sort of practice and the consequent decrease in number of injuries and other evidence leads to a marked reduction of the number of cases where evidence of the abuse can be found by physical examination alone. The above aspects underlie the need of using different

  12. Screening Children for Abuse and Neglect: A Review of the Literature.

    PubMed

    Hoft, Mary; Haddad, Lisa

    Child abuse and neglect occur in epidemic numbers in the United States and around the world, resulting in major physical and mental health consequences for abused children in the present and future. A vast amount of information is available on the signs and symptoms and short- and long-term consequences of abuse. A limited number of instruments have been empirically developed to screen for child abuse, with most focused on physical abuse in the context of the emergency department, which have been found to be minimally effective and lacking rigor. This literature review focuses on physical, sexual, and psychological abuse and neglect, occurring in one or multiple forms (polyabuse). A systematic, in-depth analysis of the literature was conducted. This literature review provides information for identifying children who have been abused and neglected but exposes the need for a comprehensive screening instrument or protocol that will capture all forms of child abuse and neglect. Screening needs to be succinct, user-friendly, and amenable for use with children at every point of care in the healthcare system.

  13. Portuguese-speaking women voice their opinions: using their words to teach about wife abuse.

    PubMed

    Barata, Paula C; McNally, Mary Jane; Sales, Isabel; Stewart, Donna E

    2005-01-01

    This study examined Portuguese-speaking women's definitions of wife abuse and beliefs about appropriate responses to abuse. The goals were to determine the breadth of definitions and to examine cultural stereotyping. This information was sought in an effort to design education strategies in the Portuguese-speaking community. One-on-one semistructured interviews were conducted with 163 Portuguese-speaking women living in Toronto, Canada. The participants' open-ended answers were first coded using Qualitative Software Research NUDIST and then narrowed and grouped. Responses were then tagged by group label to generate descriptive statistics using Statistical Package for Social Sciences. Participants defined wife abuse broadly with respect to kind, prevalence, and severity. Six themes for abuse emerged: physical, psychological, sexual, financial, patriarchal, and infidelity. Participants provided various responses to what women should do and actually do in response to abuse. Most participants believed that Portuguese-speaking women should leave their husbands and/or seek help for the abuse, but that they actually remain quiet about the abuse and take very little action. Their responses and explanations demonstrate that they hold stereotypes about their culture. The range of definitions reported by participants suggests that a continuum of wife abuse, using Portuguese-speaking women's own words, can be created to educate them about how abusive acts are linked and used to maintain control over women. The differences that emerged with respect to appropriate responses to abuse suggest that it may be important to challenge Portuguese-speaking women about the cultural stereotypes that they hold to help them see patriarchy as widespread rather than particular to their culture.

  14. History of past sexual abuse in married observant Jewish women.

    PubMed

    Yehuda, Rachel; Friedman, Michelle; Rosenbaum, Talli Y; Labinsky, Ellen; Schmeidler, James

    2007-11-01

    The authors examined instances of past sexual abuse and related demographic characteristics in the self-reports of a select group of married observant Jewish women. Orthodox Jewish married women (N=380) ages 19 to 58 responded to advertisements asking them to complete an anonymous questionnaire about sexual experiences, including sexual abuse. Sexual abuse was reported by 26% of the respondents surveyed, with 16% reporting abuse occurring by the age of 13. More ultra-Orthodox Jews reported abuse than modern-Orthodox Jews. Women who were raised observant reported significantly less childhood sexual abuse than those who became observant later in life. Sexual abuse was associated with increased treatment-seeking for depression, marital counseling, or other emotional or psychological problems. While observant Jewish women live in a culture defined by a high degree of adherence to specific laws of conduct, including rules designed to regulate sexual contact, sexual abuse of various types still exists among them.

  15. Special Considerations for Substance Abuse Intervention with Latino Youth

    ERIC Educational Resources Information Center

    Goldbach, Jeremy T.; Thompson, Sanna J.; Holleran Steiker, Lori K.

    2011-01-01

    Nearly 10% of Latino youth who are twelve and older are in need of substance abuse treatment for alcohol or illicit drug use. Ethnic differences exist with regard to susceptibility to drug use, attitudes regarding drugs, and drug resistance strategies. The failure of some substance abuse prevention programs can be traced in part to their lack of…

  16. College students and use of K2: an emerging drug of abuse in young persons

    PubMed Central

    2011-01-01

    Background K2 or "spice" has emerged as a popular legal alternative to marijuana among adolescents and young adults. However, no data has been published assessing prevalence of and associations with ever K2 use in any population. This study's aims were to examine prevalence of ever K2 use among a sample of college students, to determine characteristics of persons who use K2, and to access the association between K2 and other drug use. Findings Ever use of K2 was reported by 69 (8%) of the sample of 852 college students. Response rate was 36%. Bivariate and multivariate analyses assessed whether sociodemographic characteristics and other drug use were associated with ever use of K2. Ever use of K2 was reported by 69 (8%) of the sample. Among these 69 individuals, 61 (88%) had used a cigarette and 25 (36%) had used a hookah to smoke K2. In multivariate analyses, K2 use was more common in males (vs. females, adjusted Odds Ratio (aOR) = 2.0, 95% Confidence Interval (CI) = 1.2-3.5, p = 0.01) and 1st or 2nd year college students (vs. 3rd year or above, aOR = 2.4, 95% CI = 1.2-5.0, p = 0.02). Conclusions Ever use of K2 in this sample was higher than ever use of many other drugs of abuse that are commonly monitored in adolescents and young adults. Although DEA had banned five synthetic cannabinoids recently, clinicians and public health officials concerned with substance abuse in youth should be aware of and monitor the use of this drug in college students over time. PMID:21745369

  17. Client counseling in orthopedic emergencies.

    PubMed

    Brackenridge, S S; Kirby, B M; Johnson, S W

    1995-09-01

    Important client communication issues associated with most orthopedic emergencies are addressed. Information on client communication and support, providing a prognosis, discussing economic concerns, discharge planning, euthanasia, and client grief is presented. The issue of animal abuse as a cause of orthopedic emergencies also is examined.

  18. New drugs of abuse.

    PubMed

    Rech, Megan A; Donahey, Elisabeth; Cappiello Dziedzic, Jacqueline M; Oh, Laura; Greenhalgh, Elizabeth

    2015-02-01

    Drug abuse is a common problem and growing concern in the United States, and over the past decade, novel or atypical drugs have emerged and have become increasingly popular. Recognition and treatment of new drugs of abuse pose many challenges for health care providers due to lack of quantitative reporting and routine surveillance, and the difficulty of detection in routine blood and urine analyses. Furthermore, street manufacturers are able to rapidly adapt and develop new synthetic isolates of older drugs as soon as law enforcement agencies render them illegal. In this article, we describe the clinical and adverse effects and purported pharmacology of several new classes of drugs of abuse including synthetic cannabinoids, synthetic cathinones, salvia, desomorphine, and kratom. Because many of these substances can have severe or life-threatening adverse effects, knowledge of general toxicology is key in recognizing acute intoxication and overdose; however, typical toxidromes (e.g., cholinergic, sympathomimetic, opioid, etc.) are not precipitated by many of these agents. Medical management of patients who abuse or overdose on these drugs largely consists of supportive care, although naloxone may be used as an antidote for desomorphine overdose. Symptoms of aggression and psychosis may be treated with sedation (benzodiazepines, propofol) and antipsychotics (haloperidol or atypical agents such as quetiapine or ziprasidone). Other facets of management to consider include treatment for withdrawal or addiction, nutrition support, and potential for transmission of infectious diseases. © 2014 Pharmacotherapy Publications, Inc.

  19. Patterns of Partners' Abusive Behaviors as Reported by Latina and Non-Latina Survivors

    ERIC Educational Resources Information Center

    Glass, Nancy; Perrin, Nancy; Hanson, Ginger; Mankowski, Eric; Bloom, Tina; Campbell, Jacquelyn

    2009-01-01

    This study builds on the existing knowledge of risk factors for lethal intimate partner violence (IPV) and typologies of IPV abusers by exploring patterns of abusive partners' behaviors among known risk factors for intimate partner femicide (i.e., murder of women) and determines if groups of survivors with similar patterns of abusive behaviors…

  20. Borderline personality disorder in youth: The prospective impact of child abuse on non-suicidal self-injury and suicidality.

    PubMed

    Kaplan, Cynthia; Tarlow, Naomi; Stewart, Jeremy G; Aguirre, Blaise; Galen, Gillian; Auerbach, Randy P

    2016-11-01

    Borderline personality disorder (BPD) is characterized by greater engagement in non-suicidal self-injury (NSSI) and suicidality. The aim of the study is to test whether the occurrence of child abuse contributes to these high-risk behaviors in BPD youth. BPD female youth aged 13-21years with (n=29) and without (n=29) a history of child abuse were administered clinical interviews assessing diagnostic history, child abuse, NSSI and suicidality (i.e., ideation, plans, and attempts). NSSI and suicidality were subsequently reevaluated at the 1- and 2-month follow-up assessments. Several findings emerged. First, relative to BPD youth without abuse, the abuse group reported greater past NSSI; however, no significant differences emerged in the follow-up period. Second, the occurrence of child abuse was associated with a 5-fold increase in the rate of lifetime suicide attempts relative to the no abuse group and additionally, prospectively predicted suicide ideation (but not attempts). Last, exploratory analyses indicated that the co-occurrence of physical and sexual abuse was associated with greater past NSSI and suicidality as compared to the no abuse and sexual abuse only participants. As a whole, child abuse - particularly co-occurring physical and sexual abuse - increases risk for NSSI and suicidality among BPD youth, which may have important treatment implications in this high-risk population. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. An upward compatible spectrum sharing architecture for existing, actively planned and emerging mobile satellite systems

    NASA Technical Reports Server (NTRS)

    Azarbar, Bahman

    1990-01-01

    Existing and actively planned mobile satellite systems are competing for a viable share of the spectrum allocated by the International Telecommunications Union (ITU) to the satellite based mobile services in the 1.5/1.6 GHz range. The limited amount of spectrum available worldwide and the sheer number of existing and planned mobile satellite systems dictate the adoption of an architecture which will maximize sharing possibilities. A viable sharing architecture must recognize the operational needs and limitations of the existing systems. Furthermore, recognizing the right of access of the future systems as they will emerge in time, the adopted architecture must allow for additional growth and be amenable to orderly introduction of future systems. An attempt to devise such a sharing architecture is described. A specific example of the application of the basic concept to the existing and planned mobile satellite systems is also discussed.

  2. Using Administrative Data for Longitudinal Substance Abuse Research

    PubMed Central

    Evans, Elizabeth; Grella, Christine E.; Murphy, Debra A.; Hser, Yih-Ing

    2008-01-01

    The utilization of administrative data in substance abuse research has become more widespread than ever. This selective review synthesizes recent extant research from 31 articles to consider what has been learned from using administrative data to conduct longitudinal substance abuse research in four overlapping areas: (1) service access and utilization, (2) underrepresented populations, (3) treatment outcomes, and (4) cost analysis. Despite several notable limitations, administrative data contribute valuable information, particularly in the investigation of service system interactions and outcomes among substance abusers as they unfold and influence each other over the long term. This critical assessment of the advantages and disadvantages of using existing administrative data within a longitudinal framework should stimulate innovative thinking regarding future applications of administrative data for longitudinal substance abuse research purposes. PMID:18679805

  3. Evaluation of child maltreatment in the emergency department setting: an overview for behavioral health providers.

    PubMed

    Leetch, Aaron N; Leipsic, John; Woolridge, Dale P

    2015-01-01

    Emergency providers are confronted with medical, social, and legal dilemmas with each case of possible child maltreatment. Keeping a high clinical suspicion is key to diagnosing latent abuse. Child abuse, especially sexual abuse, is best handled by a multidisciplinary team including emergency providers, nurses, social workers, and law enforcement trained in caring for victims and handling forensic evidence. The role of the emergency provider in such cases is to identify abuse, facilitate a thorough investigation, treat medical needs, protect the patient, provide an unbiased medical consultation to law enforcement, and provide an ethical testimony if called to court. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Men of Mexican Origin Who Abuse Women: A Qualitative Study.

    PubMed

    Montalvo-Liendo, Nora; Matthews, Debra W; Gilroy, Heidi; Nava, Angeles; Gangialla, Christyn

    2018-03-01

    Current literature indicates that intimate partner violence is a complex phenomenon that exists worldwide. However, little is known about why some men of Mexican origin abuse women. This descriptive study was conducted to understand the experiences of men of Mexican origin who abuse their intimate partners. A qualitative research design was used to conduct this study in a south Texas border community adjacent to the United States-Mexico border. This study builds on existing research and furthers the knowledge related to the factors contributing to intimate partner violence, including cultural factors. The results also reinforce the negative impacts of intimate partner violence on children and the family structure. Further research is needed to support the development of a culturally appropriate prevention and intervention program for men of Mexican origin who abuse women and their families.

  5. Prenatal drug exposure effects on subsequent vulnerability to drug abuse.

    PubMed

    Glantz, Meyer D; Chambers, Jessica Campbell

    2006-01-01

    Research has shown that both prenatal alcohol and tobacco exposure are associated with increased risk of significant adverse medical, developmental, and behavioral outcomes including substance abuse. Research on the outcomes of prenatal exposure to illicit drugs (PNDE) has also found increased physical and behavioral problems for gestationally drug-exposed children. However, a clear picture has not emerged on whether the consequences of PNDE are independent from those associated with having a substance abusing parent and whether PNDE increases vulnerability to drug abuse. Because of its typical co-occurrence with factors inherent in having a drug-abusing parent, PNDE is at least a marker of significant increased risk for a range of negative outcomes including greater vulnerability to substance abuse. Although a review of the relevant research literatures indicates that the direct consequences of PNDE appear to be generally both subtle and nonglobal, PNDE does appear to have negative developmental and behavioral outcomes, and there is evidence that it is a modest direct contributor to increased substance abuse vulnerability.

  6. Parental Substance Abuse and Child Well-Being: A Consideration of Parents' Gender and Coresidence

    ERIC Educational Resources Information Center

    Osborne, Cynthia; Berger, Lawrence M.

    2009-01-01

    Parental substance abuse is associated with adverse health and developmental outcomes for children. Existing research, however, has not fully explored the relative magnitude of the associations between maternal, paternal, and both parents' substance abuse and child outcomes, nor has it examined these associations in regard to substance abuse among…

  7. Universal problems during residency: abuse and harassment.

    PubMed

    Nagata-Kobayashi, Shizuko; Maeno, Tetsuhiro; Yoshizu, Misaki; Shimbo, Takuro

    2009-07-01

    Perceived abuse or harassment during residency has a negative impact on residents' health and well-being. This issue pertains not only to Western countries, but also to those in Asia. In order to launch strong international preventive measures against this problem, it is necessary to establish the generality and cultural specificity of this problem in different countries. Therefore, we investigated mistreatment among resident doctors in Japan. In 2007, a multi-institutional, cross-sectional survey was conducted at 37 hospitals. A total of 619 residents (409 men, 210 women) were recruited. Prevalence of mistreatment in six categories was evaluated: verbal abuse; physical abuse; academic abuse; sexual harassment; gender discrimination, and alcohol-associated harassment. In addition, alleged abusers, the emotional effects of abusive experiences, and reluctance to report the abuse to superiors were investigated. Male and female responses were statistically compared using chi-square analysis. A total of 355 respondents (228 men, 127 women) returned a completed questionnaire (response rate 57.4%). Mistreatment was reported by 84.8% of respondents (n = 301). Verbal abuse was the most frequently experienced form of mistreatment (n = 256, 72.1%), followed by alcohol-associated harassment (n = 184, 51.8%). Among women, sexual harassment was also often reported (n = 74, 58.3%). Doctors were most often reported as abusers (n = 124, 34.9%), followed by patients (n = 77, 21.7%) and nurses (n = 61, 17.2%). Abuse was reported to have occurred most frequently during surgical rotations (n = 98, 27.6%), followed by rotations in departments of internal medicine (n = 76, 21.4%), emergency medicine (n = 41, 11.5%) and anaesthesia (n = 40, 11.3%). Very few respondents reported their experiences of abuse to superiors (n = 36, 12.0%). The most frequent emotional response to experiences of abuse was anger (n = 84, 41.4%). Mistreatment during residency is a universal phenomenon. Deliberation

  8. Parents' Opinion About a Routine Head-to-Toe Examination of Children as a Screening Instrument for Child Abuse and Neglect in Children Visiting the Emergency Department.

    PubMed

    Teeuw, Arianne Hélène; Hoytema van Konijnenburg, Eva M; Sieswerda-Hoogendoorn, Tessa; Molenaar, Sjaak; Heymans, Hugo S; van Rijn, Rick R

    2016-03-01

    To improve detection of child abuse and neglect (CAN), many emergency departments use screening methods. Apart from diagnostic accuracy, possible harms of screening methods are important to consider, especially because most children are not abused and do not benefit from screening. We performed a systematic literature review to assess parents' opinions about CAN screening, in which we could only include 7 studies, all reporting that the large majority of participating parents favor screening. Recently, a complete physical examination (called "top-toe" inspection [TTI], a fully undressed inspection of the child) was implemented as a CAN screening method at the emergency department of a teaching hospital in The Netherlands. This study describes parents' opinions about the TTI. We used a questionnaire to assess parents' opinions about the TTI of their children when visiting the emergency department. During the study period, 1000 questionnaires were distributed by mail. In total, 372 questionnaires were returned (37%). A TTI was performed for 194 children (52%). The overall attitude of parents whose children underwent a TTI was positive; 77.3% of the respondents found the TTI acceptable, and 1.5% (N = 3) found it unacceptable. Seventy percent of the respondents agreed with the theorem that all children who visit the emergency department should have a TTI performed, and 7.3% (N = 14) disagreed. Contrary to what is commonly believed, both in our systematic literature review and in our questionnaire study, the majority of participating parents agree with screening for CAN in general and with the TTI specifically. Sharing the results of this study with ED personnel and policy makers could take away prejudices about perceived disagreement of parents, thereby improving implementation of and adherence to CAN screening. Copyright © 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  9. The economic impact of alcohol abuse and alcoholism.

    PubMed Central

    Burke, T R

    1988-01-01

    The economic effects of alcohol abuse are as damaging to the nation as the health effects, affecting the family, the community, and persons of all ages. Underaged drinking is interfering with children's development, affecting the nation's ability to respond to economic challenge in the future. The college aged may be the most difficult to educate about alcohol abuse because of drinking patterns established at an early age and susceptibility to advertising inducements. Health care costs for families with an alcoholic member are twice those for families without one, and up to half of all emergency room admissions are alcohol related. Fetal alcohol syndrome is one of the top three known causes of birth defects, and is totally preventable. Alcohol abuse and alcoholism are estimated to have cost the nation $117 billion in 1983, while nonalcoholic drug abuse that year cost $60 billion. Costs of alcohol abuse are expected to be $136 billion a year by 1990, mostly from lost productivity and employment. Between 6 and 7 million workers are alcoholic, with an undetermined loss of productivity, profits, and competitiveness of American business. Alcohol abuse contributes to the high health care costs of the elderly beneficiaries of Federal health financing programs. Heavily affected minorities include blacks, Hispanics, and Native Americans. Society tends to treat the medical and social consequences of alcohol abuse, rather than its causes. Although our experience with the consequences of alcohol abuse is greater than that for any other drug, public concern for its prevention and treatment is less than for other major illnesses or abuse of other drugs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3141948

  10. Utilizing Online Training for Child Sexual Abuse Prevention: Benefits and Limitations

    ERIC Educational Resources Information Center

    Paranal, Rechelle; Thomas, Kiona Washington; Derrick, Christina

    2012-01-01

    The prevalence of child sexual abuse demands innovative approaches to prevent further victimization. The online environment provides new opportunities to expand existing child sexual abuse prevention trainings that target adult gatekeepers and allow for large scale interventions that are fiscally viable. This article discusses the benefits and…

  11. Geriatric forensics - Part 2 "Prevalence of elder abuse and their potential forensic markers among medical and dental patients".

    PubMed

    Mattoo, Khurshid A; Garg, Rishabh; Kumar, Shalabh

    2015-01-01

    This study is a continuation of the earlier studies and has been extended to investigate the potential forensic markers of elder abuse. To determine the prevalence of elder abuse in various outpatient departments (OPDs). To study the associated parameters related to the abuser and the abused. To determine the existence of potential forensic markers of elder abuse. The subjects were randomly selected from the medical and the dental OPDs of the university. Eight hundred and thirty two elderly subjects in the age range 40-60 years were interviewed using a questionnaire to determine the existence of elder abuse. The subjects were investigated and examined for weight, nutrition and hydration, vital signs, habits, existing visual and auditory capabilities, medications, disclosure of wills/deeds, signs of depression, and documented cleanliness. The mini-mental state examination, the Geriatric Depression Scale, the Clock drawing test, and the Brief Psychiatric Rating Scale were used to determine the potential forensic markers. Mean values in percentage were determined by dividing the number of determined subjects by the total number of subjects for that parameter. About 37% in medical and 41% in dental OPDs were found to have suffered from abuse, mostly in the age group 60-70 years. Females received more abuse and a combination of son and daughter-in-law constituted most abusers. Various potential markers of elder abuse and neglect investigated among the elder abuse victims included depression (89%), signs of improper feeding (83%), changes in personal hygiene (69%), need for medical/dental treatment (78%), medication misuse (67%), changes in wills/deeds (26%), decubiti (10%), bruises (17%), skin tears (27%), and confusion (23%). Elder abuse exists in one or more forms in both medical and dental OPDs among both males and females in all age groups.

  12. Childhood physical abuse and aggression: Shame and narcissistic vulnerability.

    PubMed

    Keene, Amanda C; Epps, James

    2016-01-01

    This study examined narcissistic vulnerability and shame-proneness as potential mediators between childhood physical abuse (CPA) and adult anger and aggression. Participants were 400 undergraduate students, 134 of whom had a history of CPA. All participants completed self-report questionnaires assessing history of CPA, shame-proneness, narcissistic vulnerability, physical aggression, trait anger, and hostility. Results indicated abused participants were more angry and aggressive and experienced higher levels of shame-proneness and narcissistic vulnerability than nonabused participants. Multiple mediation analyses showed that narcissistic vulnerability, but not shame-proneness, partially mediated the relation between abuse and physical aggression. However, narcissistic vulnerability and shame-proneness both emerged as partial mediators between abuse and the anger and hostility variables. These findings suggest that narcissistic vulnerability and shame-proneness may function as mediators of adjustment following childhood maltreatment. Study limitations and recommendations for future research are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Unrecognized magic mushroom abuse in a 28-year-old man.

    PubMed

    McClintock, Ryan L; Watts, David J; Melanson, Scott

    2008-10-01

    A 28-year-old man with a history of drug and alcohol abuse presented multiple times to the hospital over 2 months with an elusive constellation of symptoms, resolving spontaneously in each instance. This patient required a high level of care for management and stabilization, including 3 emergency department visits, 2 medical floor admissions, and 1 intensive care unit admission. In both the emergency department and inpatient setting, all laboratory and imaging study results, including gas chromatography/mass spectrophotometry of the urine, were negative/normal. A definitive diagnosis eluded multiple emergency medicine, critical care, and consulting physicians. His symptoms included altered mental status, vomiting, diaphoresis, and mydriasis. The patient later admitted using mushrooms to a nurse. In the absence of confirmatory testing, but supported by exclusionary and anecdotal data, we believe that our patient's symptoms are consistent with Psilocybe mushroom toxicity. We feel that had this been considered initially, the correct diagnosis would have led to a better utilization of resources, and we want to remind emergency physicians of the possibility of mushroom abuse in any similar clinical setting.

  14. Prior childhood sexual abuse in mothers of sexually abused children.

    PubMed

    Oates, R K; Tebbutt, J; Swanston, H; Lynch, D L; O'Toole, B I

    1998-11-01

    To see if mothers who were sexually abused in their own childhood are at increased risk of their children being sexually abused and to see if prior sexual abuse in mothers affects their parenting abilities. Sixty-seven mothers whose children had been sexually abused by others and 65 control mothers were asked about sexual abuse in their own childhood. The sexually abused children of mothers who had been sexually abused in their own childhood were compared with the sexually abused children of mothers who had not suffered child sexual abuse as children. Comparisons were made on self-esteem, depression and behavior in the children. Thirty-four percent of mothers of sexually abused children gave a history of sexual abuse in their own childhoods, compared with 12% of control mothers. Assessment of the sexually abused children for self-esteem, depression and behavior at the time of diagnosis, after 18 months and after 5 years showed no difference in any of these measures at any of the three time intervals between those whose mothers had suffered child sexual abuse and those whose mothers had not been abused. In this study, sexual abuse in a mother's own childhood was related to an increased risk of sexual abuse occurring in the next generation, although prior maternal sexual abuse did not effect outcome in children who were sexually abused.

  15. Youth Alcohol Use and Dating Abuse Victimization and Perpetration: A Test of the Relationships at the Daily Level in a Sample of Pediatric Emergency Department Patients Who Use Alcohol

    ERIC Educational Resources Information Center

    Rothman, Emily F.; Stuart, Gregory L.; Winter, Michael; Wang, Na; Bowen, Deborah J.; Bernstein, Judith; Vinci, Robert

    2012-01-01

    Objective: This study retrospectively examined the daily-level associations between youth alcohol use and dating abuse (DA) victimization and perpetration for a 6-month period. Method: Timeline Followback (TLFB) interview data were collected from 397 urban emergency department patients, ages 17 to 21 years. Patients were eligible if they reported…

  16. Psychiatric disorders, spouse abuse and child abuse.

    PubMed

    Bland, R C; Orn, H

    1986-01-01

    The results of 2000 standardized psychiatric diagnostic interviews of randomly selected adult household residents of Edmonton showed that having had any psychiatric diagnosis increased the risk for being involved in spouse and child abuse, particularly for those with alcohol abuse/dependence plus anti-social personality or depression. Altogether 56% of spouse abusers and 69% of child abusers had a lifetime psychiatric diagnosis.

  17. Elder abuse.

    PubMed

    Kurrle, Susan

    2004-10-01

    Elder abuse is a common and yet often unrecognised problem in our community. With up to 5% of the community dwelling older population being victims of abuse, the general practitioner has a pivotal role in identifying this abuse. This article provides an outline of the definition of elder abuse, describes the types of abuse seen and the reasons for occurrence of abuse. It summarises the role of the GP in the identification and management of abuse and provides guidance on intervention strategies. Case studies are used to illustrate the issues discussed. Elder abuse is defined as any pattern of behaviour which causes physical, psychological, financial or social harm to an older person. The role of the GP in identifying abuse is critical. The vast majority of older people visit their GP at least once a year, and the GP often has a long standing relationship with their patient and the patient's family. They are therefore ideally placed to identify elder abuse.

  18. Core data elements tracking elder sexual abuse.

    PubMed

    Hanrahan, Nancy P; Burgess, Ann W; Gerolamo, Angela M

    2005-05-01

    Sexual abuse in the older adult population is an understudied vector of violent crimes with significant physical and psychological consequences for victims and families. Research requires a theoretical framework that delineates core elements using a standardized instrument. To develop a conceptual framework and identify core data elements specific to the older adult population, clinical, administrative, and criminal experts were consulted using a nominal group method to revise an existing sexual assault instrument. The revised instrument could be used to establish a national database of elder sexual abuse. The database could become a standard reference to guide the detection, assessment, and prosecution of elder sexual abuse crimes as well as build a base from which policy makers could plan and evaluate interventions that targeted risk factors.

  19. Selective attention to facial emotion in physically abused children.

    PubMed

    Pollak, Seth D; Tolley-Schell, Stephanie A

    2003-08-01

    The ability to allocate attention to emotional cues in the environment is an important feature of adaptive self-regulation. Existing data suggest that physically abused children overattend to angry expressions, but the attentional mechanisms underlying such behavior are unknown. The authors tested 8-11-year-old physically abused children to determine whether they displayed specific information-processing problems in a selective attention paradigm using emotional faces as cues. Physically abused children demonstrated delayed disengagement when angry faces served as invalid cues. Abused children also demonstrated increased attentional benefits on valid angry trials. Results are discussed in terms of the influence of early adverse experience on children's selective attention to threat-related signals as a mechanism in the development of psychopathology.

  20. The Drug Abuse Screening Test preserves its excellent psychometric properties in psychiatric patients evaluated in an emergency setting.

    PubMed

    Giguère, Charles-Édouard; Potvin, Stéphane

    2017-01-01

    Substance use disorders (SUDs) are significant risk factors for psychiatric relapses and hospitalizations in psychiatric populations. Unfortunately, no instrument has been validated for the screening of SUDs in psychiatric emergency settings. The Drug Abuse Screening Test (DAST) is widely used in the addiction field, but is has not been validated in that particular context. The objective of the current study is to examine the psychometric properties of the DAST administered to psychiatric populations evaluated in an emergency setting. The DAST was administered to 912 psychiatric patients in an emergency setting, of which 119 had a SUD (excluding those misusing alcohol only). The internal consistency, the construct validity, the test-retest reliability and the predictive validity (using SUD diagnoses) of the DAST were examined. The convergent validity was also examined, using a validated impulsivity scale. Regarding the internal consistency of the DAST, the Cronbach's alpha was 0.88. The confirmatory factor analysis showed that the DAST has one underlying factor. The test-retest reliability analysis produced a correlation coefficient of 0.86. ROC curve analyses produced an area under the curve of 0.799. Interestingly, a sex effect was observed. Finally, the convergent validity analysis showed that the DAST total score is specifically correlated with the sensation seeking dimension of impulsivity. The results of this validation study shows that the DAST preserves its excellent psychometric properties in psychiatric populations evaluated in an emergency setting. These results should encourage the use of the DAST in this unstable clinical situation. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Cognitive and Emotional Differences between Abusive and Non-Abusive Fathers

    ERIC Educational Resources Information Center

    Francis, Karen J.; Wolfe, David A.

    2008-01-01

    Objective: Abusive fathers perpetrate a substantial portion of child physical abuse. Despite this, little is known about how they differ from non-abusive fathers. This study compared a broad range of cognitive and affective factors between physically abusive and non-abusive fathers. Methods: Abusive (n = 24) and non-abusive (n = 25) fathers…

  2. College students and use of K2: an emerging drug of abuse in young persons.

    PubMed

    Hu, Xingdi; Primack, Brian A; Barnett, Tracey E; Cook, Robert L

    2011-07-11

    K2 or "spice" has emerged as a popular legal alternative to marijuana among adolescents and young adults. However, no data has been published assessing prevalence of and associations with ever K2 use in any population. This study's aims were to examine prevalence of ever K2 use among a sample of college students, to determine characteristics of persons who use K2, and to access the association between K2 and other drug use. Ever use of K2 was reported by 69 (8%) of the sample of 852 college students. Response rate was 36%. Bivariate and multivariate analyses assessed whether sociodemographic characteristics and other drug use were associated with ever use of K2. Ever use of K2 was reported by 69 (8%) of the sample. Among these 69 individuals, 61 (88%) had used a cigarette and 25 (36%) had used a hookah to smoke K2. In multivariate analyses, K2 use was more common in males (vs. females, adjusted Odds Ratio (aOR)=2.0, 95% Confidence Interval (CI)=1.2-3.5, p=0.01) and 1st or 2nd year college students (vs. 3rd year or above, aOR=2.4, 95% CI=1.2-5.0, p=0.02). Ever use of K2 in this sample was higher than ever use of many other drugs of abuse that are commonly monitored in adolescents and young adults. Although DEA had banned five synthetic cannabinoids recently, clinicians and public health officials concerned with substance abuse in youth should be aware of and monitor the use of this drug in college students over time. © 2011 Hu et al; licensee BioMed Central Ltd.

  3. The health visitor's role in the identification of domestic abuse.

    PubMed

    Litherland, Rachel

    2012-08-01

    Internationally, domestic abuse is a significant public health issue in terms of imposing physical and psychological distress upon victims, having a detrimental impact upon parenting and causing psychological problems for victim's children. Figures identify that one in four UK women experience domestic abuse. However, it is acknowledged that reported rates are gross underestimates of true figures and that multiple barriers exist that inhibit domestic abuse identification. This paper reviews the literature to explore these barriers and ascertain evidence-based strategies that will help practitioners to identify domestic abuse more effectively. Particular attention is paid to domestic abuse screening tools, as research suggests their use increases disclosure rates. The paper concludes that routine and recurrent enquiry using a screening tool, information giving to all women, knowledgeable staff and supportive environments, are all potential facilitators to identification.

  4. Towards the development of a screening tool to enhance the detection of elder abuse and neglect by emergency medical technicians (EMTs): a qualitative study.

    PubMed

    Cannell, M Brad; Jetelina, Katelyn K; Zavadsky, Matt; Gonzalez, Jennifer M Reingle

    2016-06-01

    To develop a screening tool to enhance elder abuse and neglect detection and reporting rates among emergency medical technicians (EMTs). Our primary aim was to identify the most salient indicators of elder abuse and neglect for potential inclusion on a screening tool. We also sought to identify practical elements of the tool that would optimize EMT uptake and use in the field, such as format, length and number of items, and types of response options available. Qualitative data were collected from 23 EMTs and Adult Protective Services (APS) caseworkers that participated in one of five semi-structured focus groups. Focus group data were iteratively coded by two coders using inductive thematic identification and data reduction. Findings were subject to interpretation by the research team. EMTs and APS caseworks identified eight domains of items that might be included on a screening tool: (1) exterior home condition; (2) interior living conditions; (3) social support; (4) medical history; (5) caregiving quality; (6) physical condition of the older adult; (7) older adult's behavior; and, (8) EMTs instincts. The screening tool should be based on observable cues in the physical or social environment, be very brief, easily integrated into electronic charting systems, and provide a decision rule for reporting guidance to optimize utility for EMTs in the field. We described characteristics of a screening tool for EMTs to enhance detection and reporting of elder abuse and neglect to APS. Future research should narrow identified items and evaluate how these domains positively predict confirmed cases of elder abuse and neglect.

  5. A literature review of findings in physical elder abuse.

    PubMed

    Murphy, Kieran; Waa, Sheila; Jaffer, Hussein; Sauter, Agnes; Chan, Amanda

    2013-02-01

    To review the medical literature for reports on the types of physical injuries in elder abuse with the aim of eliciting patterns that will aid its detection. The databases of PubMed, CINAHL, EMBASE, and TRIP were searched from 1975 to March 2012 for articles that contained the following phrases: "physical elder abuse," "older adult abuse," "elder mistreatment," "geriatric abuse," "geriatric trauma," and "nonaccidental geriatric injury." Distribution and description of injuries in physical elder abuse from case-control studies, cross-sectional studies, case series, and case reports as seen at autopsy, in hospital emergency departments, or in medicolegal reports were tabulated and summarized. A review of 9 articles from a total of 574 articles screened yielded 839 injuries. The anatomic distribution in these was as follows: upper extremity, 43.98%; maxillofacial, dental, and neck, 22.88%; skull and brain, 12.28%; lower extremity, 10.61%; and torso, 10.25%. Two-thirds of injuries that occur in elder abuse are to the upper extremity and maxillofacial region. The social context in which the injuries takes place remains crucial to accurate identification of abuse. This includes a culture of violence in the family; a demented, debilitated, or depressed and socially isolated victim; and a perpetrator profile of mental illness, alcohol or drug abuse, or emotional and/or financial dependence on the victim. Copyright © 2013 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

  6. Social Resource Characteristics and Adolescent Substance Abuse Relapse.

    ERIC Educational Resources Information Center

    Vik, Peter W.; And Others

    1992-01-01

    Examined social resource network characteristics of adolescent substance abusers (n=19). Perceived similarity to one's social network emerged as important moderator of whether social network provided support to remain abstinent or elevated risk for relapse. Increased perceived support predicted continued posttreatment abstinence when recovering…

  7. Negative Interpersonal Interactions and Dating Abuse Perpetration: The Mediating Role of Dispositional Forgivingness.

    PubMed

    Garthe, Rachel C; Griffin, Brandon J; Worthington, Everett L; Goncy, Elizabeth A; Sullivan, Terri N; Coleman, Jennifer A; Davis, Don E; Kwakye-Nuako, Charlotte O; Mokushane, Thapelo; Makola, Solomon; Anakwah, Nkansah

    2017-06-01

    Theory and research suggest that an individual's negative interactions with his or her parents or romantic partner are associated with the perpetration of dating abuse. Research is beginning to explore the role of forgivingness within abusive romantic relationships, and these preliminary findings suggest that dispositional forgivingness might mediate the relations between negative interpersonal interactions and dating abuse. The current study assessed negative interactions with one's parents and one's romantic partner, the frequency of dating abuse perpetration, and dispositional forgivingness of others and oneself among a sample of emerging adults in college ( n = 421). Dispositional forgivingness of others was negatively associated with the perpetration of emotional/verbal dating abuse and threatening behaviors, and it mediated relations between negative interpersonal interactions and dating abuse perpetration. Our findings suggest that the tendency to forgive others may explain why some individuals who experience negative interpersonal interactions with parents or romantic partners do not escalate to perpetration of abuse within their romantic relationships. Implications for future research and application are discussed.

  8. The Student-Teacher Relationship Quality of Abused Children

    PubMed Central

    Haskett, Mary E.; Hawkins, Amy L.

    2016-01-01

    Considering the association between children’s quality of relationships with teachers and their academic adjustment, information pertaining to how abused children are functioning in their relationships with teachers could be useful in promoting their academic success— yet there has been limited research in this area. The purpose of this study was to use cluster analyses to explore within-group differences in relational schemas and quality of student-teacher relationships for 70 abused children. Two clusters of abused children emerged, and as hypothesized, there were significant differences in student-teacher relationships for the two clusters. The cluster with more positive relational schemas had less conflict and less dependency reported by their teachers compared to the cluster with negative relational schemas. However, there were no differences between the clusters in terms of closeness with teachers. Implications for practice in schools is discussed. PMID:28713179

  9. Labor analgesia for the drug abusing parturient: is there cause for concern?

    PubMed

    Kuczkowski, Krzysztof M

    2003-09-01

    Drug abuse has crossed geographic, economic and social borders, and it remains one of the major problems facing our society today. The prevalence of recreational drug abuse among young adults (including women) has increased markedly over the past two decades. Nearly 90% of drug abusing women are of childbearing age. Consequently, it is not surprising to find pregnant women with a history of drug addiction. Obstetricians and obstetric anesthesiologists become involved in the care of drug abusing patients either in emergency situations, such as placental abruption, uterine rupture or fetal distress, or in more controlled situations, such as request for labor analgesia. The diverse clinical manifestations of maternal substance abuse may result in life-threatening complications and significantly impact the peripartum care of these patients. Obstetricians & Gynecologists, Family Physicians. After completion of this article, the reader will be able to list the most commonly abused substances during pregnancy, to describe the various effects of particular substances on pregnancy including the mechanism of desired effect for various substances, and to outline the obstetric anesthesia recommendations for the various substances abused during pregnancy.

  10. [Current situation of and the political measures for drug abuse/dependence].

    PubMed

    Wada, Kiyoshi; Ozaki, Shigeru; Kondo, Ayumi

    2008-04-01

    More than 10 years has passed since 1995 when the third epidemic of methamphetamine abuse started in Japan. We are now still in the third epidemic of methamphetamine abuse, thought the current situation of drug abuse/dependence has obviously changed from previously. Considering several kinds of nationwide surveys and censuses, the authors summarized the change as follows: a) obvious decrease in solvent abuse/dependence, b) stabilization of methamphetamine abuse/dependence, c) increase in abuse of such drugs as cannabis or MDMA which don't have high potential to cause drug-induced psychosis, and d) emergence of non-regulatory drugs represented by designer drugs. These imply the change a) from "hard drugs" to "soft drugs", b) from Japanese unique situation which is symbolized by solvent abuse to Western situation which is symbolized by cannabis abuse, and c) from "illicit drugs" to "non-regulatory drugs". These characteristics reveal that there is the limitation to the Japanese Government policy which has tried to control the drug issue mainly as criminal cases for many years and that it is time now to change its policy. The authors stress the necessities of development of medical treatment targeting drug dependence and of its social support system.

  11. Elder Abuse: Systematic Review and Implications for Practice.

    PubMed

    Dong, Xin Qi

    2015-06-01

    This article is based on the lecture for the 2014 American Geriatrics Society Outstanding Scientific Achievement for Clinical Investigation Award. Elder abuse is a global public health and human rights problem. Evidence suggests that elder abuse is prevalent, predictable, costly, and sometimes fatal. This review will highlight the global epidemiology of elder abuse in terms of its prevalence, risk factors, and consequences in community populations. The global literature in PubMed, MEDLINE, PsycINFO, BIOSIS, Science Direct, and Cochrane Central was searched. Search terms included elder abuse, elder mistreatment, elder maltreatment, prevalence, incidence, risk factors, protective factors, outcomes, and consequences. Studies that existed only as abstracts, case series, or case reports or recruited individuals younger than 60; qualitative studies; and non-English publications were excluded. Tables and figures were created to highlight the findings: the most-detailed analyses to date of the prevalence of elder abuse according to continent, risk and protective factors, graphic presentation of odds ratios and confidence intervals for major risk factors, consequences, and practical suggestions for health professionals in addressing elder abuse. Elder abuse is common in community-dwelling older adults, especially minority older adults. This review identifies important knowledge gaps, such as a lack of consistency in definitions of elder abuse; insufficient research with regard to screening; and etiological, intervention, and prevention research. Concerted efforts from researchers, community organizations, healthcare and legal professionals, social service providers, and policy-makers should be promoted to address the global problem of elder abuse. © 2015, Copyright the Author Journal compilation © 2015, The American Geriatrics Society.

  12. The Relationship Between Sexual Abuse and Risky Sexual Behavior Among Adolescent Boys: A Meta-Analysis

    PubMed Central

    Homma, Yuko; Wang, Naren; Saewyc, Elizabeth; Kishor, Nand

    2016-01-01

    Purpose Childhood and adolescent sexual abuse has been shown to lead to increased odds of sexual behaviors that lead to sexually transmitted infections and early pregnancy involvement. Research, meta-analyses, and interventions, however, have focused primarily on girls and young women who have experienced abuse, yet some adolescent boys are also sexually abused. We performed a meta-analysis of the existing studies to assess the magnitudes of the link between a history of sexual abuse and each of three risky sexual behaviors among adolescent boys in North America. Methods The three outcomes were a) unprotected sexual intercourse, b) multiple sexual partners, and c) pregnancy involvement. Weighted mean effect sizes were computed from 10 independent samples, from nine studies published between 1990 and 2011. Results Sexually abused boys were significantly more likely than non-abused boys to report all three risky sexual behaviors. Weighted mean odds ratios were 1.91 for unprotected intercourse, 2.91 for multiple sexual partners, and 4.81 for pregnancy involvement. Conclusions Our results indicate that childhood and adolescent sexual abuse can substantially Influence sexual behavior in adolescence among male survivors. To improve sexual health for all adolescents, even young men, we should strengthen sexual abuse prevention initiatives, raise awareness about male sexual abuse survivors’ existence and sexual health issues, improve sexual health promotion for abused young men, and screen all people, regardless of gender, for a history of sexual abuse. PMID:22727072

  13. Child Abuse

    MedlinePlus

    ... puts a child at risk of harm. Child abuse can be physical, sexual or emotional. Neglect, or not providing for a child's needs, is also a form of abuse. Most abused children suffer greater emotional than physical damage. An abused child may become ...

  14. Parenting in females exposed to intimate partner violence and childhood sexual abuse.

    PubMed

    Jaffe, Anna E; Cranston, Christopher C; Shadlow, Joanna O

    2012-01-01

    Child sexual abuse and intimate partner violence may have a significant impact on parenting. The current study expands on existing research by examining the effects of child sexual abuse and intimate partner violence on parenting styles and parenting self-efficacy. In women from a parenting intervention program (n = 20), child sexual abuse was related to lower parenting self-efficacy and more permissive parenting. In women at a domestic violence shelter (n = 45), child sexual abuse was related to current sexual coercion of the partner, and authoritative parenting was related to higher parenting self-efficacy. These results indicate that having a history of child sexual abuse should be taken into consideration when dealing with mothers in violent relationships.

  15. Anti-Drug Abuse Strategy Report. State of New York. 1993 Update.

    ERIC Educational Resources Information Center

    New York Governor's Office, Albany. Statewide Anti-Drug Abuse Council.

    Research shows a clear link between drug and alcohol use and crime and violence. This report describes progress made in 1993 as a result of New York State's anti-drug abuse agenda and priorities for 1994. Efforts exist in three complementary areas: prevention (preventing people from being involved in substance abuse); treatment (treating those who…

  16. Substance abuse associated with elder abuse in the United States.

    PubMed

    Jogerst, Gerald J; Daly, Jeanette M; Galloway, Lara J; Zheng, Shimin; Xu, Yinghui

    2012-01-01

    Substance abuse by either victim or perpetrator has long been associated with violence and abuse. Sparse research is available regarding elder abuse and its association with substance abuse. The objective of this study was to evaluate the association of state-reported domestic elder abuse with regional levels of substance abuse. Census demographic and elder abuse data were sorted into substate regions to align with the substance use treatment-planning regions for 2269 US counties. From the 2269 US counties there were 229 substate regions in which there were 213,444 investigations of abuse. For the other Ns (reports and substantiations) there were fewer counties and regions. See first sentence of data analyses and first sentence of results. Elder abuse report rates ranged from .03 to .41% (80 regions), investigation rates .001 to .34% (229 regions), and substantiation rates 0 to .22% (184 regions). Elder abuse investigations and substantiations were associated with various forms of substance abuse. Higher investigation rates were significantly associated with a higher rate of any illicit drug use in the past month, a lower median household income, lower proportion of the population graduated high school, and higher population of Hispanics. Higher substantiation rates were significantly associated with higher rate of illicit drug use in the past month and higher population of Hispanics. It may be worthwhile for administrators of violence programs to pay particular attention to substance abuse among their clients and in their community's environment, especially if older persons are involved. Measures of documented elder abuse at the county level are minimal. To be able to associate substance abuse with elder abuse is a significant finding, realizing that the substance abuse can be by the victim or the perpetrator of elder abuse.

  17. The economic impact of alcohol abuse and alcoholism.

    PubMed

    Burke, T R

    1988-01-01

    The economic effects of alcohol abuse are as damaging to the nation as the health effects, affecting the family, the community, and persons of all ages. Underaged drinking is interfering with children's development, affecting the nation's ability to respond to economic challenge in the future. The college aged may be the most difficult to educate about alcohol abuse because of drinking patterns established at an early age and susceptibility to advertising inducements. Health care costs for families with an alcoholic member are twice those for families without one, and up to half of all emergency room admissions are alcohol related. Fetal alcohol syndrome is one of the top three known causes of birth defects, and is totally preventable. Alcohol abuse and alcoholism are estimated to have cost the nation $117 billion in 1983, while nonalcoholic drug abuse that year cost $60 billion. Costs of alcohol abuse are expected to be $136 billion a year by 1990, mostly from lost productivity and employment. Between 6 and 7 million workers are alcoholic, with an undetermined loss of productivity, profits, and competitiveness of American business. Alcohol abuse contributes to the high health care costs of the elderly beneficiaries of Federal health financing programs. Heavily affected minorities include blacks, Hispanics, and Native Americans. Society tends to treat the medical and social consequences of alcohol abuse, rather than its causes. Although our experience with the consequences of alcohol abuse is greater than that for any other drug, public concern for its prevention and treatment is less than for other major illnesses or abuse of other drugs. Alcohol abuse is a problem being given high priority within the Department in an effort to create a national agenda on the issue and to try to impart a greater sense of urgency about the problems. Ways are being explored to integrate alcoholism activities into more Departmental programs. Employee assistance programs for alcohol

  18. Screening for childhood physical and sexual abuse among outpatient substance abusers.

    PubMed

    Simpson, T L; Westerberg, V S; Little, L M; Trujillo, M

    1994-01-01

    Research demonstrates that substance-abusing individuals report substantially higher rates of childhood sexual and physical abuse than the general population. This study sought to test a method of identifying substance-abusing clients with histories of childhood sexual and/or physical abuse and to explore the differences between those reporting childhood abuse and those not. Files of substance abusing clients from two distinct time periods were examined for reports of childhood abuse. At Time 1 (n = 399) clients were not systematically asked about experiences of childhood abuse, and at Time 2 (n = 305) clients were routinely asked about this issue. Results indicate that significantly more male and female clients disclosed childhood abuse at Time 2. Additionally, male clients reporting childhood abuse appeared more distressed than those not reporting abuse; female clients reporting childhood abuse did not appear more distressed than their counterparts.

  19. Child Sexual Abuse Prevention Education: A review of School Policy and Curriculum Provision in Australia

    ERIC Educational Resources Information Center

    Walsh, Kerryann; Berthelsen, Donna; Nicholson, Jan M.; Brandon, Leisa; Stevens, Judyann; Rachele, Jerome N.

    2013-01-01

    The past four decades have seen increasing public and professional awareness of child sexual abuse. Congruent with public health approaches to prevention, efforts to eliminate child sexual abuse have inspired the emergence of prevention initiatives which can be provided to all children as part of their standard school curriculum. However,…

  20. Missed Fractures in Infants Presenting to the Emergency Department With Fussiness.

    PubMed

    Kondis, Jamie S; Muenzer, Jared; Luhmann, Janet D

    2017-08-01

    The aim of this study was to evaluate incidence of prior fussy emergency visits in infants with subsequently diagnosed fractures suggestive of abuse. This was a retrospective chart review of infants younger than 6 months who presented to the pediatric emergency department (ED) between January 1, 2006, and December 31, 2011. Inclusion criteria included age 0 to 6 months, discharge diagnosis including "fracture," "broken" (or break), or "trauma" or any child abuse diagnosis or chief complaint of "fussy" or "crying" as documented in the electronic medical record by the triage nurse. Three thousand seven hundred thirty-two charts were reviewed, and 279 infants with fractures were identified. Eighteen (6.5%) of 279 infants had a prior ED visit for fussiness without an obvious source. Of these, 2 had a witnessed event causing their fracture, and therefore the fracture was not considered concerning for abuse. The remaining 16 had fractures concerning for abuse. Mean age was 2.5 (SD, 1.2) months. Fifteen (83%) of 18 infants were 3 months or younger at the time of the fussy visit. The mean interval between the first and second ED visits was 27 days (median, 20 days). Thirty-nine percent were evaluated by a pediatric emergency medicine-trained physician during their initial fussy visit, whereas 78% were evaluated by pediatric emergency medicine-trained physician during their subsequent visit. Most common injuries were multiple types of fractures followed by extremity and rib fractures. Fractures concerning for child abuse are an important cause of unexplained fussiness in infants presenting to the pediatric ED. A high index of suspicion is essential for prompt diagnosis and likely prevention of other abuse.

  1. [The Process of Healing Child Physical Abuse: Sprouting and Twining].

    PubMed

    Chang, Hsin-Yi; Feng, Jui-Ying; Tseng, Ren-Mei

    2018-06-01

    Child physical abuse impacts the physical and psychological health of survivors. Healing child abuse is an essential process that helps survivors reorganize the meaning of the trauma and pursue a normal life. Considering the trauma of child physical abuse within the social context allows the experiences of individual survivors to be reflected in their process of healing. To explore the social interaction and construction process of healing experienced by survivors of child physical abuse. A qualitative research design using grounded theory was applied. Purposive and theoretical sampling was used to recruit survivors of childhood physical abuse who had experienced healing. Semi-structured, in-depth interviews were used and data were analyzed using open, axial, and selective coding. The process of healing child physical abuse in this study was a process of sprouting and twining. Three core categories emerged: thriving, relationships, and ethics. The healing process was analogous to a seed growing in poor soil, sprouting out from the ground, and striving to live by seeking support. The survivors constantly established interactive relationships with their selves and with others and struggled to keep family bonds grounded and growing within the frame of ethics. The healing process of sprouting and twining for child physical abuse survivors in Taiwan integrates thriving, relationships, and ethics. Professionals working with child-physical-abuse survivors must recognize conflicts in ethics. Strategies should be developed to assist survivors to cope with the impact of childhood trauma in order to facilitate the healing process.

  2. The relationship between sexual abuse and risky sexual behavior among adolescent boys: a meta-analysis.

    PubMed

    Homma, Yuko; Wang, Naren; Saewyc, Elizabeth; Kishor, Nand

    2012-07-01

    Childhood and adolescent sexual abuse has been shown to lead to increased odds of sexual behaviors that lead to sexually transmitted infections and early pregnancy involvement. Research, meta-analyses, and interventions, however, have focused primarily on girls and young women who have experienced abuse, yet some adolescent boys are also sexually abused. We performed a meta-analysis of the existing studies to assess the magnitudes of the link between a history of sexual abuse and each of the three risky sexual behaviors among adolescent boys in North America. The three outcomes were (a) unprotected sexual intercourse, (b) multiple sexual partners, and (c) pregnancy involvement. Weighted mean effect sizes were computed from ten independent samples, from nine studies published between 1990 and 2011. Sexually abused boys were significantly more likely than nonabused boys to report all three risky sexual behaviors. Weighted mean odds ratios were 1.91 for unprotected intercourse, 2.91 for multiple sexual partners, and 4.81 for pregnancy involvement. Our results indicate that childhood and adolescent sexual abuse can substantially influence sexual behavior in adolescence among male survivors. To improve sexual health for all adolescents, even young men, we should strengthen sexual abuse prevention initiatives, raise awareness about male sexual abuse survivors' existence and sexual health issues, improve sexual health promotion for abused young men, and screen all people, regardless of gender, for a history of sexual abuse. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  3. Teachers' Attitudes toward Reporting Child Sexual Abuse: Problems with Existing Research Leading to New Scale Development

    ERIC Educational Resources Information Center

    Walsh, Kerryann; Rassafiani, Mehdi; Mathews, Ben; Farrell, Ann; Butler, Des

    2010-01-01

    This paper details a systematic literature review identifying problems in extant research relating to teachers' attitudes toward reporting child sexual abuse and offers a model for new attitude scale development and testing. Scale development comprised a five-phase process grounded in contemporary attitude theories, including (a) developing the…

  4. Association of Drug Abuse and Child Abuse.

    ERIC Educational Resources Information Center

    Jaudes, Paula Kienberger; And Others

    1995-01-01

    Children born to mothers who used illicit drugs during pregnancy were assessed for subsequent abuse or neglect. Of the 513 children exposed inutero to drugs, 102 were substantiated as abused or neglected. Infants exposed inutero to drugs had a higher than expected risk of subsequent abuse compared to children in the general population. (Author/SW)

  5. Adolescent tramadol use and abuse in Egypt.

    PubMed

    Bassiony, Medhat M; Salah El-Deen, Ghada M; Yousef, Usama; Raya, Yasser; Abdel-Ghani, Mohamed M; El-Gohari, Hayam; Atwa, Samar A

    2015-05-01

    Tramadol abuse liability is underestimated and the evidence of abuse and dependence is emerging. It has many health and social consequences especially in adolescents. Tramadol abuse has not been well studied in Egypt. The aim of this study was to estimate the prevalence and associated correlates of tramadol use and abuse among school students in Egypt. A total of 204 students, aged 13-18 years, from six schools in Zagazig, Egypt, were screened for tramadol use using The Drug Use Disorders Identification Test and a urine screen for tramadol. The prevalence of tramadol use was 8.8% among school students and the average age at onset of tramadol use was 16.5 ± 1.1. Some 83% of the users were using tramadol alone while the rest (17%) were using a combination of tramadol, alcohol, and cannabis. Two-thirds of these students started with tramadol as the first drug after the onset of tobacco smoking. Over one third of tramadol users had drug-related problems and 6% had dependence. There was a significant association between tramadol use and older age, male gender, and smoking. Drug-related problems were negatively correlated with age at onset of tramadol use. Tramadol use was common among adolescents and over one third of tramadol users had drug-related problems. Population-based longitudinal studies are needed to investigate tramadol use and the possible role of tramadol as a gateway drug in the development of substance abuse in Egypt.

  6. The Genesis of Pedophilia: Testing the "Abuse-to-Abuser" Hypothesis.

    ERIC Educational Resources Information Center

    Fedoroff, J. Paul; Pinkus, Shari

    1996-01-01

    This study tested three versions of the "abuse-to-abuser" hypothesis by comparing men with personal histories of sexual abuse and men without sexual abuse histories. There was a statistically non-significant trend for assaulted offenders to be more likely as adults to commit genital assaults on children. Implications for the abuse-to-abuser…

  7. Identifying and responding to gaps in domestic abuse services for older women.

    PubMed

    Shiel, Rebecca

    2016-07-01

    Domestic abuse is widespread and indiscriminate. Older women living with domestic abuse report more health-related concerns than any other group, and demonstrate a higher incidence of significant mental health issues. Research suggests that older women who have experienced domestic abuse are not having their psychological and physical support needs met by existing services. This article examines the physical and mental health issues that older women face as a result of abusive relationships, and the barriers to seeking help. Multidisciplinary healthcare professionals can facilitate the therapeutic engagement of older women living with domestic abuse. Refuges and related interventions are limited in terms of the support they can offer, however, research suggests that developing a stepped approach, tailored to suit older women's needs, could be beneficial.

  8. Domestic violence and abuse: an exploration and evaluation of a domestic abuse nurse specialist role in acute health care services.

    PubMed

    McGarry, Julie

    2017-08-01

    The aim of this study was to explore the experiences of clinical staff in responding to disclosure of domestic violence and abuse, and to evaluate the effectiveness of training and support provided by a dedicated Domestic Abuse Nurse Specialist across one acute National Health Service Trust in the UK. The impact of domestic violence and abuse is well documented and is far reaching. Health care professionals have a key role to play in the effective identification and management of abuse across a range of settings. However, there is a paucity of evidence regarding the constituents of effective support for practitioners within wider nonemergency hospital-based services. A qualitative approach semi-structured interviews (n = 11) with clinical staff based in one acute care Trust in the UK. Interviews were informed by an interview guide and analysed using the Framework approach. The organisation of the nurse specialist role facilitated a more cohesive approach to management at an organisational level with training and ongoing support identified as key facets of the role by practitioners. Time constraints were apparent in terms of staff training and this raises questions with regard to the status continuing professional development around domestic violence and abuse. Domestic violence and abuse continues to exert a significant and detrimental impact on the lives and health of those who encounter abuse. Health care services in the UK and globally are increasingly on the frontline in terms of identification and management of domestic violence and abuse. This is coupled with the growing recognition of the need for adequate support structures to be in place to facilitate practitioners in providing effective care for survivors of domestic violence and abuse. This study provides an approach to the expansion of existing models and one which has the potential for further exploration and application in similar settings. © 2016 John Wiley & Sons Ltd.

  9. [Self-reported substance abuse related emergencies: frequency and nature].

    PubMed

    Schäfer, G; Smoltczyk, H; Dengler, W; Buchkremer, G

    2000-04-01

    The aim of this study was to estimate the frequency and nature of self-reported and drug-related emergencies. 47 patients of a ward for opiate detoxification were interviewed about their experiences with drug-related emergencies. Typical categories had to be found like overdoses, seizures, accidents and suicide attempts respectively. 68% had own experience with drug-related emergency. A majority suffered opiate overdose with different extensions as unconsciousness or breath-depression. Alcohol and polydrug use was associated with overdose. Drug-related accidents were only reported by men. Half the number of drug-related emergencies were treated in hospital. Most emergencies occurred alone either in a home environment or outside. Harm reduction interventions like observed user rooms should be established. Furthermore other strategies to reduce the number of emergencies as sharing naloxon or resuscitation programs in wards for detoxification could also be an effective method to prevent near fatal or fatal overdoses in dependent subjects.

  10. Decreased frontal white-matter volume in chronic substance abuse.

    PubMed

    Schlaepfer, Thomas E; Lancaster, Eric; Heidbreder, Rebecca; Strain, Eric C; Kosel, Markus; Fisch, Hans-Ulrich; Pearlson, Godfrey D

    2006-04-01

    There is quite a body of work assessing functional brain changes in chronic substance abuse, much less is known about structural brain abnormalities in this patient population. In this study we used magnetic resonance imaging (MRI) to determine if structural brain differences exist in patients abusing illicit drugs compared to healthy controls. Sixteen substance abusers who abused heroin, cocaine and cannabis but not alcohol and 16 age-, sex- and race-matched controls were imaged on a MRI scanner. Contiguous, 5-mm-thick axial slices were acquired with simultaneous T2 and proton density sequences. Volumes were estimated for total grey and white matter, frontal grey and white matter, ventricles, and CSF using two different methods: a conventional segmentation and a stereological method based on the Cavalieri principle. Overall brain volume differences were corrected for by expressing the volumes of interest as a percentage of total brain volume. Volume measures obtained with the two methods were highly correlated (r=0.65, p<0.001). Substance abusers had significantly less frontal white-matter volume percentage than controls. There were no significant differences in any of the other brain volumes measured. This difference in frontal lobe white matter might be explained by a direct neurotoxic effect of drug use on white matter, a pre-existing abnormality in the development of the frontal lobe or a combination of both effects. This last explanation might be compelling based on the fact that newer concepts on shared aspects of some neuropsychiatric disorders focus on the promotion and inhibition of the process of myelination throughout brain development and subsequent degeneration.

  11. Reinforcer Pathology: The Behavioral Economics of Abuse Liability Testing.

    PubMed

    Bickel, W K; Snider, S E; Quisenberry, A J; Stein, J S

    2017-02-01

    Understanding the abuse liability of novel drugs is critical to understanding the risk these new compounds pose to society. Behavioral economics, the integration of psychology and economics, can be used to predict abuse liability of novel substances. Here, we describe the behavioral economic concept of reinforcer pathology and how it may predict the use of novel drugs in existing drug-users and initiation of use in the drug-naive. © 2016 American Society for Clinical Pharmacology and Therapeutics.

  12. Something for pain: Responsible opioid use in emergency medicine.

    PubMed

    Strayer, Reuben J; Motov, Sergey M; Nelson, Lewis S

    2017-02-01

    The United States is currently experiencing a public health crisis of opioid addiction, which has its genesis in an industry marketing effort that successfully encouraged clinicians to prescribe opioids liberally, and asserted the safety of prescribing opioids for chronic non-cancer pain, despite a preponderance of evidence demonstrating the risks of dependence and misuse. The resulting rise in opioid use has pushed drug overdose deaths in front of motor vehicle collisions to become the leading cause of accidental death in the country. Emergency providers frequently treat patients for complications of opioid abuse, and also manage patients with acute and chronic pain, for which opioids are routinely prescribed. Emergency providers are therefore well positioned to both prevent new cases of opioid misuse and initiate appropriate treatment of existing opioid addicts. In opioid-naive patients, this is accomplished by a careful consideration of the likelihood of benefit and harm of an opioid prescription for acute pain. If opioids are prescribed, the chance of harm is reduced by matching the number of pills prescribed to the expected duration of pain and selecting an opioid preparation with low abuse liability. Patients who present to acute care with exacerbations of chronic pain or painful conditions associated with opioid misuse are best managed by treating symptoms with opioid alternatives and encouraging treatment for opioid addiction. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Abuse Characteristics and Psychiatric Consequences Associated with Online Sexual Abuse.

    PubMed

    Say, Gökçe Nur; Babadağı, Zehra; Karabekiroğlu, Koray; Yüce, Murat; Akbaş, Seher

    2015-06-01

    The current study examined the rate and psychiatric correlates of sexual abuse involving the use of digital technologies by the offender in a wide sample of juvenile victims. Sociodemographic, abuse, and psychiatric characteristics of 662 sexually abused children and adolescents were evaluated. Of these, 93 reported that digital devices were used by the offender in several ways to facilitate the sexual abuse. The offender-victim relationship was initiated through the Internet in 39 victims. Involvement of digital technologies in sexual abuse was significantly associated with penetrative and recurrent form of sexual abuse commited by multiple offenders with coexisting violence. Additionally, victims of sexual abuse with a digital component were 4.21 times more likely to develop any psychopathology, 3.77 times more likely to have depression, and 2.14 times more likely to have post-traumatic stress disorder as a result of sexual abuse. These results indicated that the offender's use of digital technology may aid the initiation and facilitation of the sexual abuse of youths and may relate to more severe outcomes. This study revealed the importance of raising the awareness of professionals and the community about the potential risks associated with digital technologies and sexual abuse. Mental health professionals should consider this additional form of victimization, especially when dealing with sexual abuse victims.

  14. Recent and Past Intimate Partner Abuse and HIV Risk Among Young Women

    PubMed Central

    Teitelman, Anne M.; Ratcliffe, Sarah J.; Dichter, Melissa E.; Sullivan, Cris M.

    2011-01-01

    Objective To examine the associations between past intimate partner abuse experienced during adolescence (verbal and physical), recent intimate partner abuse (verbal, physical, and sexual), and HIV risk (as indicated by lack of condom use) for sexually active young adult women in relationships with male partners. Design Secondary data analysis of waves II and III of the National Longitudinal Study of Adolescent Health (Add Health). Setting The Add Health Study is a longitudinal, in-home survey of a nationally representative sample of adolescents. Sample Analyses involved 2,058 sexually active young adult women. Main Outcome Measures HIV risk was measured by consistent condom use over the past 12 months. Results Physical and verbal abuse experienced in adolescence were associated with physical/verbal abuse experienced in young adulthood. Young, sexually active women experiencing no abuse in their relationships were more likely to consistently use condoms in the past 12 months than were their abused counterparts. Conclusion A causal pathway may exist between prior abuse, current abuse, and HIV risk. PMID:18336447

  15. Multiple approaches to understanding and preventing elder abuse: Introduction to the cross-disciplinary National Institutes of Health workshop.

    PubMed

    Saylor, Katherine Witte

    2016-01-01

    On October 30, 2015, the National Institutes of Health (NIH) convened a workshop, "Multiple Approaches to Understanding and Preventing Elder Abuse," in Bethesda, Maryland. The workshop brought together experts from across disciplines to discuss research challenges, opportunities, and lessons learned from other fields. Participants included experts in elder abuse, child abuse, intimate partner violence (IPV), emergency medicine, and neuroscience. In this special issue of the Journal of Elder Abuse and Neglect, participants address topics explored before, during, and after the day-long workshop.

  16. Prescription Drug Abuse

    MedlinePlus

    ... drug abuse. And it's illegal, just like taking street drugs. Why Do People Abuse Prescription Drugs? Some people abuse prescription drugs ... common risk of prescription drug abuse is addiction . People who abuse ... as if they were taking street drugs. That's one reason most doctors won't ...

  17. Elder Abuse

    MedlinePlus

    ... homes. The mistreatment may be Physical, sexual, or emotional abuse Neglect or abandonment Financial abuse - stealing of money or belongings Possible signs of elder abuse include unexplained bruises, burns, and injuries. There ...

  18. Cardiovascular Complications of Acute Amphetamine Abuse

    PubMed Central

    Bazmi, Elham; Mousavi, Farinaz; Giahchin, Leila; Mokhtari, Tahmineh; Behnoush, Behnam

    2017-01-01

    Objectives This study aimed to evaluate cardiovascular complications among patients who abuse amphetamines. Methods This cross-sectional study took place between April 2014 and April 2015 among 3,870 patients referred to the Toxicology Emergency Department of Baharlou Hospital, Tehran University of Medical Sciences, Tehran, Iran. Those with clinical signs of drug abuse and positive urine screening tests were included in the study, while cases of chronic abuse were excluded. Cardiac complications were evaluated via electrocardiography (ECG) and transthoracic echocardiography. Results A total of 230 patients (5.9%) had a history of acute amphetamine abuse and positive urine tests. Of these, 32 patients (13.9%) were <20 years old and 196 (85.2%) were male. In total, 119 (51.7%) used amphetamine and methamphetamine compounds while 111 (48.3%) used amphetamines with morphine or benzodiazepines. The most common ECG finding was sinus tachycardia (43.0%), followed by sinus tachycardia plus a prolonged QT interval (34.3%). Mean creatine kinase-MB and troponin I levels were 35.9 ± 4.3 U/mL and 0.6 ± 0.2 ng/mL, respectively. A total of 60 patients (26.1%) were admitted to the Intensive Care Unit. The majority (83.3%) of these patients had normal echocardiography results. The mean aortic root diameter (ARD) was 27.2 ± 2.8 mm. Abnormalities related to the ARD were found in 10 patients (16.7%), three of whom subsequently died. Conclusion According to these findings, cardiac complications were common among Iranian patients who abuse amphetamines, although the majority of patients had normal echocardiography and ECG findings. PMID:28417026

  19. Cognitive and emotional differences between abusive and non-abusive fathers.

    PubMed

    Francis, Karen J; Wolfe, David A

    2008-12-01

    Abusive fathers perpetrate a substantial portion of child physical abuse. Despite this, little is known about how they differ from non-abusive fathers. This study compared a broad range of cognitive and affective factors between physically abusive and non-abusive fathers. Abusive (n=24) and non-abusive (n=25) fathers completed standard measures assessing their experience and expression of anger, mental health, parenting stress, and their empathy and perceptions of children's socio-emotional signals. Abusive fathers differed from comparisons on almost all constructs. They experienced more anger and were more likely to express that anger aggressively. They reported more mental health concerns (such as depression, hostility, and paranoid ideation), more stress in parenting, and significantly less empathy for their children. They were also more likely to perceive children's emotional expressions as depicting negative emotions, such as anger and disgust. Abusive fathers struggle with a myriad of difficulties that likely contribute to their problematic parenting. These difficulties are both inter- and intra-personal in nature. The findings suggest that abusive fathers require comprehensive assessment that includes mental health screening. Interventions should be selected carefully to target abusive fathers' high levels of negative affect and negative perceptions. Treatment strategies should address problems related to parenting style (e.g., managing stress and interpretation of children's socioemotional signals) as well as their personal adjustment (e.g., cognitive behavioral strategies for regulating affect and cognitive distortions).

  20. The elder physical abuse reflected in judicial authorities in Eskisehir.

    PubMed

    Karbeyaz, Kenan; Çelikel, Adnan

    2017-11-01

    Elder abuse is a health and human rights problem that may occur among every race and ethnic group all around the world. This study aims at describing all cases of physical abuse of elderly which have been reported to, and investigated by Eskisehir - a western city of Turkey. Physical abuse incidents above 65 years of age which were evaluated by the Eskisehir Council of Forensic Medicine for expert witness opinion during 5year period between 01.01.2010 and 12.31.2014 are examined in this descriptive, cross-sectional study. 253 cases are found and evaluated in the scope of the study. It is determined that all aggressors are the acquaintance of the victim, and for 114 cases (45.1%) the aggressor is the victim's son. It is found that only investigation procedures of cases are completed, but no protection and rehabilitation program has been issued. In conclusion, it is determined that elder victims are abused by family members and relatives who are mostly the care givers. It is seen that emergency physicians play a great role in the detection of abuse. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Psychiatric emergencies.

    PubMed

    Schorr, S J; Richardson, D

    1995-06-01

    Psychiatric emergencies can arise during pregnancy and the puerperium. When faced with a gravida presenting with the symptoms of an acute psychiatric illness, the obstetrician must consider the possibilities of organic disorders and substance abuse before initiating psychotropic therapy with the consulting psychiatrist. Generally, patients with psychiatric illness have difficulty caring for themselves and hospitalization may be indicated at least initially. Emotional support, a quiet environment, and psychotherapy are often the most important aspects of treatment. Suicide gestures should always be taken seriously. Immediate psychiatric consultation is imperative. Finally, anyone caring for pregnant women should be aware of the possibility of domestic violence. Pregnant women are unlikely to volunteer information about an abusive situation. Detection hinges on willingness of the physician to ask probing questions.

  2. Are nurses verbally abused? A cross-sectional study of nurses at a university hospital, Eastern Province, Saudi Arabia

    PubMed Central

    Al-Shamlan, Nouf A.; Jayaseeli, Nithya; Al-Shawi, Moneera M.; Al-Joudi, Abdullah S.

    2017-01-01

    BACKGROUND: Workplace violence against health-care workers is a significant problem worldwide. Nurses are at a higher risk of exposure to violence. Studies available in Saudi Arabia are few. OBJECTIVES: The objective of the study was to estimate the prevalence of verbal abuse of nurses at King Fahd Hospital of the University (KFHU) in Khobar, Saudi Arabia, and to identify consequences and the demographic and work-related characteristics associated with it. MATERIALS AND METHODS: This cross-sectional study of 391 nurses by total sample was conducted between November and December 2015, using a modified self-administered questionnaire developed by the World Health Organization. Data was entered, and analyzed using SPSS Version 16.0. The descriptive statistics were reported using frequency and percentages for all categorical variables. Chi-squared tests or Fisher's Exact test, as appropriate, were performed to test the associations of verbal abuse with the demographic and work-related characteristics of the participants. Variables with p < 0.05 were considered significant. Logistic regression analysis performed to determine association between verbal abuse and independent variables. RESULTS: In a period of 1 year before the study, about three out of ten nurses experienced verbal abuse (30.7%). In the majority of cases, the victims did not report the incidents, mostly because they believed that reporting would yield no positive results. Logistic regression analysis revealed that male nurses, nurses in the emergency department, and nurses who indicated that there were procedures for reporting violence in their workplace were more vulnerable to workplace verbal abuse. CONCLUSION: Workplace verbal abuse is a significant challenge in KFHU. For decision makers, it is rather disturbing that a lot of cases go unreported even though procedures for reporting exist. Implementation of an efficient transparent reporting system that provides follow-up investigations is mandatory. In

  3. Exploration and validation of clusters of physically abused children.

    PubMed

    Sabourin Ward, Caryn; Haskett, Mary E

    2008-05-01

    Cluster analysis was used to enhance understanding of heterogeneity in social adjustment of physically abused children. Ninety-eight physically abused children (ages 5-10) were clustered on the basis of social adjustment, as measured by observed behavior with peers on the school playground and by teacher reports of social behavior. Seventy-seven matched nonabused children served as a comparison sample. Clusters were validated on the basis of observed parental sensitivity, parents' self-reported disciplinary tactics, and children's social information processing operations (i.e., generation of solutions to peer relationship problems and attributions of peer intentions in social situations). Three subgroups of physically abused children emerged from the cluster analysis; clusters were labeled Socially Well Adjusted, Hanging in There, and Social Difficulties. Examination of cluster differences on risk and protective factors provided substantial evidence in support of the external validity of the three-cluster solution. Specifically, clusters differed significantly in attributions of peer intent and in parenting (i.e., sensitivity and harshness of parenting). Clusters also differed in the ways in which they were similar to, or different from, the comparison group of nonabused children. Results supported the contention that there were clinically relevant subgroups of physically abused children with potentially unique treatment needs. Findings also pointed to the relevance of social information processing operations and parenting context in understanding diversity among physically abused children. Pending replication, findings provide support for the importance of considering unique treatment of needs among physically abused children. A singular approach to intervention is unlikely to be effective for these children. For example, some physically abused children might need a more intensive focus on development of prosocial skills in relationships with peers while the

  4. Cocaine Abuse: The Evolution from Coca Leaves to Freebase.

    ERIC Educational Resources Information Center

    Forno, Joseph J.; And Others

    1981-01-01

    Describes historical and sociological patterns of cocaine use. Discusses cocaine as an example of a new drug abuse trend as users search for new ways of using old drugs in ways that produce enhanced euphoria. Describes the use of cocaine freebase and emergency treatment of cocaine toxicity. (Author)

  5. Receptive language and educational attainment for sexually abused females.

    PubMed

    Noll, Jennie G; Shenk, Chad E; Yeh, Michele T; Ji, Juye; Putnam, Frank W; Trickett, Penelope K

    2010-09-01

    The objective of this study was to test whether the experience of childhood sexual abuse is associated with long-term receptive language acquisition and educational attainment deficits for females. Females with substantiated familial childhood sexual abuse (n=84) and a nonabused comparison group (n=102) were followed prospectively for 18 years. Receptive language ability was assessed at 6 time points across distinct stages of development, including childhood, adolescence, and young adulthood. Rates of high school graduation and total educational attainment were assessed during young adulthood. Hierarchical linear modeling revealed that receptive language did not differ between the groups at the initial assessment point in childhood; however, a significant group by time interaction was observed across development with abused females (1) acquiring receptive language at a significantly slower rate throughout development and (2) achieving a lower overall maximum level of proficiency. Significant differences in receptive language scores emerged as early as midadolescence. In addition, abused females reported significantly lower rates of high school graduation and lower overall educational attainment when compared with their nonabused peers. Exposure to childhood sexual abuse may be a significant risk factor for cognitive performance and achievement deficits for victims. These findings have particular public health relevance given the high prevalence of sexual abuse and that poor cognitive functioning and low levels of educational attainment can contribute to continued adversity throughout the life course. Early intervention may assist victims in improving cognitive functioning, altering deleterious trajectories, and promoting greater life successes.

  6. Adolescent Abuse.

    ERIC Educational Resources Information Center

    Foreman, Susan; Seligman, Linda

    1983-01-01

    Discusses legal and developmental aspects of adolescent abuse, as distinguished from child abuse. The role of the school counselor in identifying and counseling abused adolescents and their families is discussed and several forms of intervention and support services are described. (JAC)

  7. Drug Abuse

    MedlinePlus

    ... drugs, including opioids Drug abuse also plays a role in many major social problems, such as drugged driving, violence, stress, and child abuse. Drug abuse can lead to homelessness, crime, and missed work or problems with keeping a job. It harms ...

  8. Surveillance and uncertainty: community pharmacy responses to over the counter medicine abuse.

    PubMed

    Cooper, Richard

    2013-05-01

    The sale of over-the-counter (OTC) medicines from community pharmacies offers important opportunities for members of the public to access medicines and self-treat conditions. They are increasingly recognised, however, as having the potential for abuse and harm despite their perceived relative safety. This study reports on a qualitative study that explored the experiences and views of community pharmacy staff in relation to current practices and concerns, management and support relating to OTC medicine abuse. Semi-structured interviews were undertaken with a purposive sample of ten pharmacists and seven medicines counter assistants in the United Kingdom. Analysis of interviews indicated that a range of medicines was implicated, including opiates, sedative antihistamines, laxatives and decongestants. A surveillance role was apparent for assistants, who placed emphasis on regulations, procedure and monitoring frequency of purchases to manage abuse, with referral on to pharmacists. Frequency of purchase was central to assistants' definition of those suspected of OTC medicine abuse, which pharmacists also utilised as well as a distinction between intentional abuse and unintentional medicine misuse. A lack of information about customers, easy access to, and poor communication between community pharmacies were emergent barriers to pharmacists providing more support. Many appeared uncertain of referral options or how pharmacists could effectively stop the problem of abuse. The commercial environment was a particular concern, in relation to customer expectations, medicine advertising and easy access to different community pharmacies. A key tension emerged between providing medicine supplies that permitted consumer freedom, with the needs of healthcare professionals to understand more about those consumers qua patients. Policy implications include the need for improved knowledge for community pharmacy staff about signposting to relevant services, increased awareness of who

  9. Substance abuse among Iranian high school students.

    PubMed

    Momtazi, Saeed; Rawson, Richard

    2010-05-01

    In this study, we reviewed data on drug use among high school students in Iran. Published epidemiological studies in international and domestic journals show that drug use/abuse is a serious mental health problem in Iran. There is cultural support for opium in Iran and also there is cultural tolerance for tobacco smoking, especially as water pipe smoking in Iranian families. Alcohol, opium and cannabis are the most frequently used illicit drugs, but there are new emerging problems with anabolic steroids, ecstasy and stimulant substances, such as crystal methamphetamine. There is a serious drug abuse problem among Iranian high school students. It could be due to role modeling by parents - mainly fathers - and also cultural tolerance of some substances. Early onset of tobacco smoking, with a daily use rate between 4.4 and 12.8% in high school students, is an important risk factor for other drug abuse problems. Use of all types of drugs, except prescription drugs, is more prevalent among boys. Alcohol is the most frequently abused substance, with a lifetime rate of at least 9.9%. Lifetime rates of opiate use - mostly opium - was between 1.2 and 8.6% in different parts of the country. As drug abuse is a frequent problem among Iranian high school students, it is necessary to design and implement drug prevention programs to protect them. Such programs, including life skills training and drug education, have been operating in recent years for Iranian students from kindergarten to the university level.

  10. Substance Abuse among Iranian High School Students

    PubMed Central

    Momtazi, Saeed; Rawson, Richard A.

    2015-01-01

    Purpose of review In this study, we reviewed data on drug use among high school students in Iran. Recent findings Published epidemiological studies in international and domestic journals show that drug use/abuse is a serious mental health problem in Iran. There is cultural support for opium in Iran, and also there is cultural tolerance for tobacco smoking, especially as water pipe smoking, in Iranian families. Alcohol, opium, and cannabis are the most frequently used illicit drugs, but there are new emerging problems with anabolic steroids, ecstasy, and stimulant substances, such as crystal methamphetamine. Summary There is serious drug abuse problem among Iranian high school students. It could be due to role-modeling by parents – mainly fathers – and also cultural tolerance of some substances. Early onset of tobacco smoking, with a daily use rate between 4.4% and 12.8% in high school students, is an important risk factor for other drug abuse problems. Use of all types of drugs, except prescription drugs, is more prevalent among boys. Alcohol is the most frequently abused substance, with a lifetime rate of at least 9.9%. Lifetime rates of opiate use – mostly opium – were between 1.2 an 8.6% in different parts of the country. As drug abuse is a frequent problem among Iranian high school students, it is necessary to design and implement drug prevention programs to protect them. Such programs, including life skills training and drug education, have been operating in recent years for Iranian students from kindergarten to the university level. PMID:20308905

  11. Characteristics of High-Cost Patients Diagnosed with Opioid Abuse.

    PubMed

    Shei, Amie; Rice, J Bradford; Kirson, Noam Y; Bodnar, Katharine; Enloe, Caroline J; Birnbaum, Howard G; Holly, Pamela; Ben-Joseph, Rami

    2015-10-01

    patients classified as high-cost patients accounted for approximately two thirds of the total health care costs of patients diagnosed with opioid abuse. Compared with lower-cost patients, high-cost patients were older (42.5 vs. 36.1; P  less than  0.001) and more likely to be female (55.9% vs. 42.9%; P  less than  0.001). They had a higher comorbidity burden at baseline, as reflected in the Charlson Comorbidity Index (0.8 vs. 0.2; P  less than  0.001), and rates of conditions such as chronic pulmonary disease (12.9% vs. 5.6%; P  less than  0.001) and mild/moderate diabetes (8.4% vs. 3.4%; P  less than  0.001). High-cost patients also had higher rates of nonopioid substance abuse diagnoses (12.4% vs. 8.9%; P  less than  0.001) and psychotic disorders (26.5% vs. 13.6%; P  less than  0.001). In the observation period, high-cost patients continued to have higher rates of nonopioid substance abuse diagnoses (53.0% vs. 47.2%; P  less than  0.001) and psychotic disorders (67.1% vs. 47.5%; P  less than  0.001). In addition, they had greater medical resource use across all places of service (i.e., inpatient, emergency department, outpatient, drug/alcohol rehabilitation facility, and other) compared with lower-cost patients. The mean observation period health care costs of high-cost patients was $89,177 compared with $11,653 for lower-cost patients (P  less than  0.001). High-cost patients had higher medical costs linked to claims with an opioid abuse diagnosis in absolute terms, but the share of total medical costs attributed to such claims was lower among high-cost patients than among lower-cost patients. While many baseline characteristics were found to have a statistically significant (P  less than  0.05) association with observation period health care costs, only 27.3% of the variation in observation period health care costs was explained by patient characteristics in the baseline period. This study found that the costliest patients

  12. Childhood Abuse, Nonsuicidal Self-Injury, and Suicide Attempts: An Exploration of Gender Differences in Incarcerated Adults.

    PubMed

    Power, Jenelle; Gobeil, Renee; Beaudette, Janelle N; Ritchie, Mary B; Brown, Shelley L; Smith, Hayden P

    2016-12-01

    The relationship between types of childhood abuse, suicide attempts, and nonsuicidal self-injury (NSSI) was examined in a sample of 415 incarcerated adults (268 men, 147 women). Men and women were equally likely to experience childhood abuse, although women were more likely to report sexual abuse and men were more likely to report emotional neglect. Sexual abuse was the only type of abuse found to predict NSSI and suicide attempts in women. For men, physical abuse and physical neglect were significant predictors of NSSI and suicide attempts, respectively. Gender differences exist and should be examined in future research in this area. © 2016 The American Association of Suicidology.

  13. Sexual Abuse Prevention: A Misguided Focus

    ERIC Educational Resources Information Center

    Rowe, Robert N.

    2006-01-01

    Although the propensity for child abuse is shared among adults of all occupations and economic strata, this article is concerned mainly with child care professionals. Whatever the case may be, the result is the same: tragic violation of the trust that should exist between child and adult. What can be done to correct the situation? In this article…

  14. Psychiatric Disorders of Children Living with Drug-Abusing, Alcohol-Abusing, and Non-Substance-Abusing Fathers.

    ERIC Educational Resources Information Center

    Kelley, Michelle L.; Fals-Stewart, William

    2004-01-01

    Objective: The present study examined lifetime psychiatric disorders and current emotional and behavioral problems of 8- to 12-year-old children living with drug-abusing (DA) fathers compared to children living in demographically matched homes with alcohol-abusing (AA) or non-substance-abusing fathers. Method: Children's lifetime psychiatric…

  15. Disrespect, harassment, and abuse: all in a day's work for family physicians.

    PubMed

    Miedema, Baukje; Easley, Julie; Fortin, Pierrette; Hamilton, Ryan; Tatemichi, Sue

    2009-03-01

    To examine harassment and abusive encounters between family physicians and their patients or colleagues in the workplace. Qualitative case study using semistructured interviews. Province of New Brunswick. Forty-eight family physicians from across the province. A collective case-study approach was developed, with 24 cases of 2 individuals per case. Cases were selected based on sex, location (urban or rural), language (French or English), and number of years since medical school graduation (< 10 years, 10 to 20 years, or > 20 years). Physicians were interviewed in either French or English. Participants were recruited using the College of Physicians and Surgeons of New Brunswick's physician directory. Based on the rates of response and participation, some cases were overrepresented, while others were not completed. All interviews were audiotaped, transcribed verbatim, and analyzed thematically using a categorical aggregation approach. A coding scheme for the thematic analysis was developed by the research team before the interviews were transcribed. Although the original intent of this study was to examine the work environment of family physicians in light of the increasing number of women entering the profession, harassment and abusive encounters in the workplace emerged as a main theme. These encounters ranged from minor to severe. Minor abusive encounters included disrespectful behaviour and verbal threats by patients, their families, and occasionally colleagues. More severe forms of harassment involved physical threats, physical encounters, and stalking. Demanding patients, such as heavy drug users, were often seen as threatening. Location of practice, years in practice, and sex of the physician seemed to affect abusive encounters--young, female, rural physicians appeared to experience such encounters most often. Abusive encounters in the workplace are concerning. It is essential to address these issues of workplace harassment and abuse in order to protect

  16. Shared reality of the abusive and the vulnerable: the experience of aging for parents living with abusive adult children coping with mental disorder.

    PubMed

    Band-Winterstein, Tova; Smeloy, Yael; Avieli, Hila

    2014-11-01

    Increasing numbers of aging parents are finding themselves in the role of caregiver for their mentally ill adult child due to global deinstitutionalization policy. The aim of this paper is to describe the daily aging experience of parents abused by an adult child with mental disorder and the challenges confronting them in this shared reality. Data collection was performed through in-depth semi-structured interviews with 16 parents, followed by content analysis. Three major themes emerged: (a) old age as a platform for parent's vulnerability facing ongoing abuse; (b) "whose needs come first?" in a shared reality of abusive and vulnerable protagonists; (c) changes in relationship dynamics. Old age becomes an arena for redefined relationships combining increased vulnerability, needs of both sides, and its impact on the well-being of the aging parents. This calls for better insights and deeper understanding in regard to intervention with such families.

  17. The long-term health consequences of child physical abuse, emotional abuse, and neglect: a systematic review and meta-analysis.

    PubMed

    Norman, Rosana E; Byambaa, Munkhtsetseg; De, Rumna; Butchart, Alexander; Scott, James; Vos, Theo

    2012-01-01

    Child sexual abuse is considered a modifiable risk factor for mental disorders across the life course. However the long-term consequences of other forms of child maltreatment have not yet been systematically examined. The aim of this study was to summarise the evidence relating to the possible relationship between child physical abuse, emotional abuse, and neglect, and subsequent mental and physical health outcomes. A systematic review was conducted using the Medline, EMBASE, and PsycINFO electronic databases up to 26 June 2012. Published cohort, cross-sectional, and case-control studies that examined non-sexual child maltreatment as a risk factor for loss of health were included. All meta-analyses were based on quality-effects models. Out of 285 articles assessed for eligibility, 124 studies satisfied the pre-determined inclusion criteria for meta-analysis. Statistically significant associations were observed between physical abuse, emotional abuse, and neglect and depressive disorders (physical abuse [odds ratio (OR) = 1.54; 95% CI 1.16-2.04], emotional abuse [OR = 3.06; 95% CI 2.43-3.85], and neglect [OR = 2.11; 95% CI 1.61-2.77]); drug use (physical abuse [OR = 1.92; 95% CI 1.67-2.20], emotional abuse [OR = 1.41; 95% CI 1.11-1.79], and neglect [OR = 1.36; 95% CI 1.21-1.54]); suicide attempts (physical abuse [OR = 3.40; 95% CI 2.17-5.32], emotional abuse [OR = 3.37; 95% CI 2.44-4.67], and neglect [OR = 1.95; 95% CI 1.13-3.37]); and sexually transmitted infections and risky sexual behaviour (physical abuse [OR = 1.78; 95% CI 1.50-2.10], emotional abuse [OR = 1.75; 95% CI 1.49-2.04], and neglect [OR = 1.57; 95% CI 1.39-1.78]). Evidence for causality was assessed using Bradford Hill criteria. While suggestive evidence exists for a relationship between maltreatment and chronic diseases and lifestyle risk factors, more research is required to confirm these relationships. This overview of the evidence suggests a causal relationship between non-sexual child

  18. Substance abuse prevention in Cape Town's peri-urban settlements: local health trainers' perspectives

    PubMed Central

    Puljević, Cheneal; Learmonth, Despina

    2014-01-01

    South Africa currently experiences high levels of alcohol and other drug (AOD) abuse. As a result there is a need for the initiation of regional AOD abuse prevention programmes with a specific focus on youth prevention strategies. The Medical Knowledge Institute (MKI) is a non-profit organisation which develops and facilitates health information workshops to members of disadvantaged peri-urban communities in South Africa. This research investigated the views of eight local MKI health trainers on factors contributing to AOD abuse in their communities. Although the expected focus of the discussion was on prevention strategies and effective interventions, the trainers placed more emphasis on the individual and community factors influencing AOD abuse. The themes which emerged through the research included: status, government, (di)stress, gender, recreation, consequences and community. This research holds significance as it has the potential to assist further development of community-based AOD prevention workshops and to guide public health policy and service development for AOD abuse. PMID:25750776

  19. Monoclonal antibody form and function: manufacturing the right antibodies for treating drug abuse.

    PubMed

    Peterson, Eric; Owens, S Michael; Henry, Ralph L

    2006-05-26

    Drug abuse continues to be a major national and worldwide problem, and effective treatment strategies are badly needed. Antibodies are promising therapies for the treatment of medical problems caused by drug abuse, with several candidates in preclinical and early clinical trials. Monoclonal antibodies can be designed that have customized affinity and specificity against drugs of abuse, and because antibodies can be designed in various forms, in vivo pharmacokinetic characteristics can be tailored to suit specific clinical applications (eg, long-acting for relapse prevention, or short-acting for overdose). Passive immunization with antibodies against drugs of abuse has several advantages over active immunization, but because large doses of monoclonal antibodies may be needed for each patient, efficient antibody production technology is essential. In this minireview we discuss some of the antibody forms that may be effective clinical treatments for drug abuse, as well as several current and emerging production systems that could bridge the gap from discovery to patient use.

  20. General Population Norms about Child Abuse and Neglect and Associations with Childhood Experiences

    ERIC Educational Resources Information Center

    Bensley, L.; Ruggles, D.; Simmons, K.W.; Harris, C.; Williams, K.; Putvin, T.; Allen, M.

    2004-01-01

    Background:: A variety of definitions of child abuse and neglect exist. However, little is known about norms in the general population as to what constitutes child abuse and neglect or how perceived norms may be related to personal experiences. Methods:: We conducted a random-digit-dialed telephone survey of 504 Washington State adults.…

  1. The Abuse of Dextromethorphan-Based Cough Syrup: A Pilot Study of the Community of Waynesboro, Pennsylvania.

    ERIC Educational Resources Information Center

    Momodou, N. Darboe; And Others

    1996-01-01

    Discusses the emergence of a new type of abused drug, dextromethorphan, which is used in cough syrup. Presents the results of the first phase of a comprehensive investigation of this phenomenon in the Waynesboro, Pa. school district. Survey data indicate abuse of cough syrup has increased over the years and is increasingly perceived as a problem…

  2. Sexual abuses.

    PubMed

    Abel, G G; Rouleau, J L

    1995-03-01

    The sexual abuses described in this article are occurring so frequently that they constitute a public health problem. Superficially they appear to be quite dissimilar because they involve individuals of different ages, different settings, and different power relationships. Basic to each of them, however, is an absence of consent by the victim and the misuse of power by the perpetrator in order to accomplish the abuse. We now have an adequate understanding of each of these abuses and it is now time to make a concerted effort to stop these abuses. This will require the combined efforts of the education of the public, improved identification of the abuses, treatment of the victims, and an appropriate criminal justice response combined with treatment of the perpetrator.

  3. Spouse Abuse, Child Abuse, and Substance Abuse Among Army Facilities: Co-Occurrence, Correlations and Service Delivery Issues

    DTIC Science & Technology

    2006-03-01

    refer spouse abuse or child abuse offenders with identified alcohol or other drug involvement to the on-base counseling center for a substance...abuse assessment. The military’s response to combat substance abuse involves a combination of education, prevention, random testing for illicit drug ...data from three Army sources: the Army Central Registry (ACR), the Drug and Alcohol Management Information System (DAMIS), and Army personnel data

  4. Sexual abuse, family violence, and female delinquency: findings from a longitudinal study.

    PubMed

    Herrera, Veronica M; McCloskey, Laura Ann

    2003-06-01

    The current study examines the effects of three forms of childhood victimization on self-reported delinquency and aggression in adolescent girls. These analyses are based on a longitudinal sample of 141 mother-daughter pairs participating in a study about marital violence and child development. When the children were school aged, mothers and children provided reports describing (a) child exposure to marital violence, (b) escalated physical abuse against the child, and (c) child sexual abuse. Children were followed up into adolescence and re-interviewed. Self-reports of delinquency (violent and nonviolent), running away, and violence against parents were collected. Results indicate that out of the three forms of victimization, child sexual abuse emerged as the strongest predictor of girls' violent and nonviolent criminal behavior. Girls with a history of physical abuse in childhood were most likely to assault their parents. Witnessing marital violence failed to contribute further to delinquency, beyond the adverse association with childhood sexual abuse. Findings highlight a unique avenue for delinquency in girls via childhood sexual exploitation.

  5. Early detection and prevention of domestic violence using the Women Abuse Screening Tool (WAST) in primary health care clinics in Malaysia.

    PubMed

    Yut-Lin, Wong; Othman, Sajaratulnisah

    2008-01-01

    Despite being an emergent major public health problem, little research has been done on domestic violence from the perspectives of early detection and prevention. Thus, this cross-sectional study was conducted to identify domestic violence among female adult patients attending health centers at the primary care level and to determine the relationship between social correlates of adult patients and domestic violence screening and subsequent help/health-seeking behavior if abused. Face-to-face interviews were conducted with 710 female adult patients from 8 health centers in Selangor who matched the inclusion criteria and consented to participate in the study, using a structured questionnaire that included adaptation of a validated 8-item Women Abuse Screening Tool (WAST). Statistical tests showed significant differences in ethnicity, income, and education between those screened positive and those screened negative for domestic violence. Of the participants, 92.4% reported that during consultations, doctors had never asked them whether they were abused by their husband/partner. Yet, 67.3% said they would voluntarily tell the doctor if they were abused by their husband/partner. The findings indicate that primary care has an important role in identifying domestic violence by applying the WAST screening tool, or an appropriate adaptation, with women patients during routine visits to the various health centers. Such assessment for abuse could be secondary prevention for the abused women, but more important, it will serve as primary prevention for nonabused women. This approach not only will complement the existing 1-stop crisis center policy by the Ministry of Health that copes with crisis intervention but also will spearhead efforts toward prevention of domestic violence in Malaysia.

  6. Elder Physical Abuse and Failure to Report Cases: Similarities and Differences in Case Type and the Justice System's Response

    ERIC Educational Resources Information Center

    Payne, Brian K.

    2013-01-01

    Treated initially as a social problem, elder abuse has only recently been criminalized. The criminalization of elder abuse involves penalizing offenders for actively abusing offenders as well as for violating mandatory reporting laws. Mandatory reporting laws exist to encourage professionals to report suspected cases of elder abuse. In this study,…

  7. Parent-child aggression: association with child abuse potential and parenting styles.

    PubMed

    Rodriguez, Christina M

    2010-01-01

    The present investigation predicted that greater use of corporal punishment as well as physical maltreatment would be associated with child abuse potential and selected parenting styles. Three independent studies were examined, two with community samples and a third with a clinical at-risk sample of parents. Parents across all studies anonymously completed the Child Abuse Potential Inventory, the Parent-Child Conflict Tactics Scale to assess physical discipline and maltreatment, as well as the Parenting Scale to measure dysfunctional parenting styles. Findings support that overall parent-child aggression, as well as physical maltreatment behaviors specifically, were associated with child abuse potential. Parent-child aggression was also related to dysfunctional parenting styles, particularly an overreactive, authoritarian parenting style. Permissive parenting was also identified as potentially associated with physical maltreatment, although the findings regarding such lax parenting styles are less clear. Intriguing findings emerged regarding the connection of psychological aggression to both child abuse potential and dysfunctional parenting style. Child abuse potential was also associated with dysfunctional parenting style, particularly harsh, overreactive approaches. Recommendations for future study with at-risk samples and additional research on permissive parenting and psychological aggression are discussed.

  8. An unusual presentation of inhalant abuse with dissociative amnesia.

    PubMed

    Miller, Paul W; Mycyk, Mark B; Leikin, Jerrold B; Ruland, Sean D

    2002-02-01

    A 38-y-old male with occult inhalant abuse underwent an 18-mo evaluation for presumed seizure disorder. Although past medical history was significant for alcohol abuse, his wife confirmed a 6-y histoy of abstinence. His seizures were characterized as episodes of unconsciousness preceded by a feeling of "things slowing down". No muscular activity was witnessed during these episodes, and upon regaining consciousness the patient had slurred speech, disorientation, dissociative amnesia, and bizarre behavior that resolved spontaneously. Despite 4 emergency department visits, 4 hospital admissions, 5 neurologic and 7 psychiatric outpatient evaluations, extensive work-up was non-diagnostic. These episodes recurred until his wife found him huffing trichloroethylene. Questioning of the patient revealed that huffing always preceded these episodes and that he started huffing after discontinuing alcohol. The patient underwent addiction treatment. Toxic inhalants should be suspected as a substitute drug of abuse in patients attempting abstention. Disorientation clinically similar to dissociative amnesia can occur following loss of consciousness during an episode of trichloroethylene use.

  9. Substance abuse as a symptom of childhood sexual abuse.

    PubMed

    Teusch, R

    2001-11-01

    The recovery process of a 37-year-old woman with adult onset posttraumatic stress disorder (PTSD) is presented. The patient had suffered childhood sexual abuse and had self-medicated for many years with drugs and alcohol to maintain the dissociation of memories of abuse and to facilitate interpersonal functioning. Upon onset of PTSD, the patient's substance abuse became a full-blown addiction that was highly resistant to treatment. It became evident that her substance abuse symbolically repeated her traumatization. In reexperiencing the affects associated with her earlier trauma (despair, denial, shame, and helplessness) as part of her substance abuse and in the transference, the patient was able to gain mastery over these affects and, subsequently, was able to achieve a stable recovery from both illnesses.

  10. Other Drugs of Abuse

    MedlinePlus

    ... People Abuse » Other Drugs of Abuse Other Drugs of Abuse Listen There are many other drugs of abuse, ... and Rehab Resources About the National Institute on Drug Abuse (NIDA) | About This Website Tools and Resources | Contact ...

  11. Self-Esteem and Attitudes toward Love in Abused and Non-Abused Women.

    ERIC Educational Resources Information Center

    Chambliss, Catherine; And Others

    This study sought to identify personality differences in abused versus non-abused women. Abused women (N=25) were from several centers for abused women and non-abused women (N=39) were students in evening psychology classes. All subjects completed Rubin's Love Scale, the abbreviated Dominance and Romanticism Scale, Rosenberg's Self-Esteem Scale,…

  12. Comparing policies for children of parents attending hospital emergency departments after intimate partner violence, substance abuse or suicide attempt.

    PubMed

    Hoytema van Konijnenburg, Eva M M; Diderich, Hester M; Teeuw, Arianne H; Klein Velderman, Mariska; Oudesluys-Murphy, Anne Marie; van der Lee, Johanna H

    2016-03-01

    To improve identification of child maltreatment, a new policy ('Hague protocol') was implemented in hospitals in The Netherlands, stating that adults attending the hospital emergency department after intimate partner violence, substance abuse or a suicide attempt should be asked whether they care for children. If so, these children are referred to the Reporting Center for Child Abuse and Neglect (RCCAN), for assessment and referrals to support services. An adapted, hospital-based version of this protocol ('Amsterdam protocol') was implemented in another region. Children are identified in the same manner, but, instead of a RCCAN referral, they are referred to the pediatric outpatient department for an assessment, including a physical examination, and referrals to services. We compared results of both protocols to assess how differences between the protocols affect the outcomes on implementation, detection of child maltreatment and referrals to services. Furthermore, we assessed social validity and results of a screening physical examination. We included 212 families from the Amsterdam protocol (cohort study with reports by pediatric staff and parents) and 565 families from the Hague protocol (study of RCCAN records and telephone interviews with parents). We found that the RCCAN identified more maltreatment than pediatric staff (98% versus at least 51%), but referrals to services were similar (82% versus 80% of the total sample) and parents were positive about both interventions. Physical examination revealed signs of maltreatment in 5%. We conclude that, despite the differences, both procedures can serve as suitable methods to identify and refer children at risk for maltreatment. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. [Ethics in pediatric emergencies: Care access, communication, and confidentiality].

    PubMed

    Benoit, J; Berdah, L; Carlier-Gonod, A; Guillou, T; Kouche, C; Patte, M; Schneider, M; Talcone, S; Chappuy, H

    2015-05-01

    Children suffer most from today's increasing precariousness. In France, access to care is available for all children through various structures and existing measures. The support for foreign children is overseen by specific legislation often unfamiliar to caregivers. Pediatric emergencies, their location, organization, actors, and patient flow are a particular environment that is not always suitable to communication and may lead to situations of abuse. Communication should not be forgotten because of the urgency of the situation. The place of the child in the dialogue is often forgotten. Considering the triangular relationship, listening to the child and involving the parents in care are the basis for a good therapeutic alliance. Privacy and medical confidentiality in pediatric emergencies are governed by law. However, changes in treatments and medical practices along with the variety of actors involved imply both individual and collective limitations, to the detriment of medical confidentiality. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  14. Abuse of Amphetamines and Structural Abnormalities in Brain

    PubMed Central

    Berman, Steven; O’Neill, Joseph; Fears, Scott; Bartzokis, George; London, Edythe D.

    2009-01-01

    We review evidence that structural brain abnormalities are associated with abuse of amphetamines. A brief history of amphetamine use/abuse, and evidence for toxicity is followed by a summary of findings from structural magnetic resonance imaging (MRI) studies of human subjects who had abused amphetamines and children who were exposed to amphetamines in utero. Evidence comes from studies that used a variety of techniques that include manual tracing, pattern matching, voxel-based, tensor-based, or cortical thickness mapping, quantification of white matter signal hyperintensities, and diffusion tensor imaging. Ten studies compared controls to individuals who were exposed to methamphetamine. Three studies assessed individuals exposed to 3-4-methylenedioxymethamphetamine (MDMA). Brain structural abnormalities were consistently reported in amphetamine abusers, as compared to control subjects. These included lower cortical gray matter volume and higher striatal volume than control subjects. These differences might reflect brain features that could predispose to substance dependence. High striatal volumes might also reflect compensation for toxicity in the dopamine-rich basal ganglia. Prenatal exposure was associated with striatal volume that was below control values, suggesting that such compensation might not occur in utero. Several forms of white matter abnormality are also common, and may involve gliosis. Many of the limitations and inconsistencies in the literature relate to techniques and cross-sectional designs, which cannot infer causality. Potential confounding influences include effects of pre-existing risk/protective factors, development, gender, severity of amphetamine abuse, abuse of other drugs, abstinence, and differences in lifestyle. Longitudinal designs in which multimodal datasets are acquired and are subjected to multivariate analyses would enhance our ability to provide general conclusions regarding the associations between amphetamine abuse and brain

  15. Xylazine intoxication in humans and its importance as an emerging adulterant in abused drugs: A comprehensive review of the literature.

    PubMed

    Ruiz-Colón, Kazandra; Chavez-Arias, Carlos; Díaz-Alcalá, José Eric; Martínez, María A

    2014-07-01

    Xylazine is not a controlled substance; it is marketed as a veterinary drug and used as a sedative, analgesic and muscle relaxant. In humans, it could cause central nervous system depression, respiratory depression, bradycardia, hypotension, and even death. There have been publications of 43 cases of xylazine intoxication in humans, in which 21 (49%) were non-fatal scenarios and 22 (51%) resulted in fatalities. Most of the non-fatal cases required medical intervention. Over recent years xylazine has emerged as an adulterant in recreational drugs, such as heroin or speedball (a cocaine and heroin mixture). From the 43 reported cases, 17 (40%) were associated with the use of xylazine as an adulterant of drugs of abuse. Its chronic use is reported to be associated with physical deterioration and skin ulceration. Literature shows some similar pharmacologic effects between xylazine and heroin in humans. These similar pharmacologic effects may create synergistic toxic effects in humans. Therefore, fatalities among drug users may increase due to the use of xylazine as an adulterant. Xylazine alone has proven harmful to humans and even more when it is combined with drugs of abuse. A comprehensive review of the literature of non-fatal and fatal xylazine intoxication cases including those in which the substance was used as adulterant is presented, in order to increase the awareness in the forensic community, law enforcement, and public health agencies. Published by Elsevier Ireland Ltd.

  16. Sexual Abuse in Cameroon: A Four-Year-Old Girl Victim of Rape in Buea Case Study.

    PubMed

    Chishugi, John; Franke, Trixy

    2016-01-01

    A young girl was brought to the emergency unit after suffering sexual abuse by an older male. Additional abuses against women and girls include physical beating, forced marriage, female genital mutilation, breast ironing, widow's rites, psychological abuse, and discrimination in education, finance, employment, and legal access. Cameroon has adopted strategies aimed at eliminating violence against women, including ratification of international policies, penal codes, and support of local and international efforts that promote women; however, many of the laws remain in name only and are rarely enforced, given women's lack of financial access to quality lawyers and an unsympathetic male-dominated police force. Underreporting and culturally accepted abuses remain a challenge, too, as the country seeks to understand the extent of abuses and how to effectively fight against them. A complete paradigm shift in cultural attitude toward the female gender is required for abuses to cease.

  17. Economic Abuse as an Invisible Form of Domestic Violence: A Multicountry Review.

    PubMed

    Postmus, Judy L; Hoge, Gretchen L; Breckenridge, Jan; Sharp-Jeffs, Nicola; Chung, Donna

    2018-01-01

    The predominant perception of intimate partner violence (IPV) as constituting physical violence can still dominate, particularly in research and media reports, despite research documenting multiple forms of IPV including sexual violence occurring between intimate partners and various forms of psychological and emotional abuse. One frequently hidden or "invisible" form of abuse perpetrated within intimate partner relationships is economic abuse, also referred to as financial abuse in much of the literature. While the links between gendered economic insecurity and economic abuse are emerging, there remains a lack of consistency about definitions within the United States and globally, as there is no agreed upon index with which to measure economic abuse. As such, the purpose of this article is to review and analyze the global literature focused on either economic or financial abuse to determine how it is defined and what measures are used to capture its prevalence and impact. The 46 peer-reviewed articles that met all inclusion criteria for analysis came from a range of countries across six continents. Our review found that there is growing clarity and consistency of terminologies being used in these articles and found some consistency in the use of validated measures. Since this research is in its "infancy," we need to have stronger collaborative efforts to use similar measures and terminology. Part of that collaborative effort is to consider how language and cultural differences may play a part in our understanding of economic abuse.

  18. Psychological Abuse, Mental Health, and Acceptance of Dating Violence Among Adolescents.

    PubMed

    Temple, Jeff R; Choi, Hye Jeong; Elmquist, JoAnna; Hecht, Michael; Miller-Day, Michelle; Stuart, Gregory L; Brem, Meagan; Wolford-Clevenger, Caitlin

    2016-08-01

    Existing literature indicates that acceptance of dating violence is a significant and robust risk factor for psychological dating abuse perpetration. Past work also indicates a significant relationship between psychological dating abuse perpetration and poor mental health. However, no known research has examined the relationship between acceptance of dating violence, perpetration of dating abuse, and mental health. In addition to exploring this complex relationship, the present study examines whether psychological abuse perpetration mediates the relationship between acceptance of dating violence and mental health (i.e., internalizing symptoms of depression, anxiety, and hostility). Three waves of longitudinal data were obtained from 1,042 ethnically diverse high school students in Texas. Participants completed assessments of psychological dating abuse perpetration, acceptance of dating violence, and internalizing symptoms (hostility and symptoms of anxiety and depression). As predicted, results indicated that perpetration of psychological abuse was significantly associated with acceptance of dating violence and all internalizing symptoms. Furthermore, psychological abuse mediated the relationship between acceptance of dating violence and internalizing symptoms. Findings from the present study suggest that acceptance of dating violence is an important target for the prevention of dating violence and related emotional distress. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  19. Women's Perceptions of Power and Control in Sexual Abuse Counseling

    ERIC Educational Resources Information Center

    Koehn, Corinne V.

    2007-01-01

    Fifty women who were sexually abused as children were interviewed regarding their perceptions of helpful and hindering counseling behaviors. The critical incident technique was the methodology used. One major category that emerged from the data was Approach to Power and Control. This category comprised eight subcategories: (1) flexibility with…

  20. The ‘Maltreatment and Abuse Chronology of Exposure’ (MACE) Scale for the Retrospective Assessment of Abuse and Neglect During Development

    PubMed Central

    Teicher, Martin H.; Parigger, Angelika

    2015-01-01

    There is increasing interest in childhood maltreatment as a potent stimulus that may alter trajectories of brain development, induce epigenetic modifications and enhance risk for medical and psychiatric disorders. Although a number of useful scales exist for retrospective assessment of abuse and neglect they have significant limitations. Moreover, they fail to provide detailed information on timing of exposure, which is critical for delineation of sensitive periods. The Maltreatment and Abuse Chronology of Exposure (MACE) scale was developed in a sample of 1051 participants using item response theory to gauge severity of exposure to ten types of maltreatment (emotional neglect, non-verbal emotional abuse, parental physical maltreatment, parental verbal abuse, peer emotional abuse, peer physical bullying, physical neglect, sexual abuse, witnessing interparental violence and witnessing violence to siblings) during each year of childhood. Items included in the subscales had acceptable psychometric properties based on infit and outfit mean square statistics, and each subscale passed Andersen’s Likelihood ratio test. The MACE provides an overall severity score and multiplicity score (number of types of maltreatment experienced) with excellent test-retest reliability. Each type of maltreatment showed good reliability as did severity of exposure across each year of childhood. MACE Severity correlated 0.738 with Childhood Trauma Questionnaire (CTQ) score and MACE Multiplicity correlated 0.698 with the Adverse Childhood Experiences scale (ACE). However, MACE accounted for 2.00- and 2.07-fold more of the variance, on average, in psychiatric symptom ratings than CTQ or ACE, respectively, based on variance decomposition. Different types of maltreatment had distinct and often unique developmental patterns. The 52-item MACE, a simpler Maltreatment Abuse and Exposure Scale (MAES) that only assesses overall exposure and the original test instrument (MACE-X) with several

  1. The Long-Term Health Consequences of Child Physical Abuse, Emotional Abuse, and Neglect: A Systematic Review and Meta-Analysis

    PubMed Central

    Norman, Rosana E.; Byambaa, Munkhtsetseg; De, Rumna; Butchart, Alexander; Scott, James; Vos, Theo

    2012-01-01

    Background Child sexual abuse is considered a modifiable risk factor for mental disorders across the life course. However the long-term consequences of other forms of child maltreatment have not yet been systematically examined. The aim of this study was to summarise the evidence relating to the possible relationship between child physical abuse, emotional abuse, and neglect, and subsequent mental and physical health outcomes. Methods and Findings A systematic review was conducted using the Medline, EMBASE, and PsycINFO electronic databases up to 26 June 2012. Published cohort, cross-sectional, and case-control studies that examined non-sexual child maltreatment as a risk factor for loss of health were included. All meta-analyses were based on quality-effects models. Out of 285 articles assessed for eligibility, 124 studies satisfied the pre-determined inclusion criteria for meta-analysis. Statistically significant associations were observed between physical abuse, emotional abuse, and neglect and depressive disorders (physical abuse [odds ratio (OR) = 1.54; 95% CI 1.16–2.04], emotional abuse [OR = 3.06; 95% CI 2.43–3.85], and neglect [OR = 2.11; 95% CI 1.61–2.77]); drug use (physical abuse [OR = 1.92; 95% CI 1.67–2.20], emotional abuse [OR = 1.41; 95% CI 1.11–1.79], and neglect [OR = 1.36; 95% CI 1.21–1.54]); suicide attempts (physical abuse [OR = 3.40; 95% CI 2.17–5.32], emotional abuse [OR = 3.37; 95% CI 2.44–4.67], and neglect [OR = 1.95; 95% CI 1.13–3.37]); and sexually transmitted infections and risky sexual behaviour (physical abuse [OR = 1.78; 95% CI 1.50–2.10], emotional abuse [OR = 1.75; 95% CI 1.49–2.04], and neglect [OR = 1.57; 95% CI 1.39–1.78]). Evidence for causality was assessed using Bradford Hill criteria. While suggestive evidence exists for a relationship between maltreatment and chronic diseases and lifestyle risk factors, more research is required to confirm these

  2. A phenomenological exploration of reflections on lived space by child sexual abusers.

    PubMed

    Garrett, Linda H

    2010-12-01

    Child sexual abusers may be better understood by phenomenological exploration of reflections on childhood lived space. Child sexual abusers often suffer from child sexual abuse, physical abuse, and neglect in their childhood lived space. These experiences may be considered a limitation or deformation of the child's lived space, resulting in a distorted self view that contributes to adult behavior. Child sexual abuse is not a new phenomenon; it is a problem that has existed throughout history but has rarely enjoyed the publicity and concern of recent times. Child sexual abusers' reflections on their lived space during childhood were explored by interviewing eight incarcerated child sexual abusers in a US correctional center. Van Manen's descriptive-interpretive theoretical process was used to guide abusers' existential reflections on their childhood lived space. van Manen's phenomenological method is dynamic and was used to organize and analyze data into essential categorical themes, one of which is "failure to root." While the viewpoint is retrospective, participants in this study provided unique perspectives on childhood reflections on lived space. These experiences, as reported by the participants, could be used to assist child victims to cope and to guide nursing practice, education, and future research related to Healthy People 2010's Goal 15 (Healthy People 2010, n.d.).

  3. Grassroots responsiveness to human rights abuse: history of the Washtenaw Interfaith Coalition for Immigrant Rights.

    PubMed

    Sanders, Laura; Martinez, Ramiro; Harner, Margaret; Harner, Melanie; Horner, Pilar; Delva, Jorge

    2013-04-01

    The purpose of this article is to discuss how a community agency based in Washtenaw County, the Washtenaw Interfaith Coalition for Immigration Rights (WICIR), emerged in response to increasing punitive immigration practices and human rights abuses toward the Latino community. The article discusses how WICIR is engaged in advocacy, community education on immigration issues, and political action toward a more humane immigration reform. Detailed examples of human rights abuses and the WICIR activities described in response to the abuses serve as illustrations of social work advocacy, education, and policy formulation that affect the general public, policymakers, and law enforcement officials.

  4. Emergency medicine and psychiatry agreement on diagnosis and disposition of emergency department patients with behavioral emergencies.

    PubMed

    Douglass, Amy M; Luo, John; Baraff, Larry J

    2011-04-01

    The objective was to determine the level of agreement between emergency physicians (EPs) and consulting psychiatrists in their diagnosis and disposition of emergency department (ED) patients with behavioral emergencies. The authors conducted a prospective study at a university teaching hospital ED with an annual census of approximately 45,000 patients. During study hours, each time a psychiatric consultation was requested, the emergency medicine (EM) and consulting psychiatry residents were asked to fill out similar short questionnaires concerning their diagnoses and disposition decisions after they consulted with their attending physicians. EM and psychiatry residents were blinded to the other's assessment of the patient. Residents were asked about their evaluation of patients regarding: 1) psychiatric assessments, 2) if the patients presented a danger to themselves or others or were gravely disabled, and 3) the need for emergency psychiatric hospitalization. A total of 408 resident physician pairs were enrolled in the study. Patients ranged in age from 5 to 92 years, with a median age of 31 years; 50% were female. The most common psychiatric assessments, as evaluated by either EPs, consulting psychiatrists, or both, were mood disorder (66%), suicidality (57%), drug/alcohol abuse (26%), and psychosis (25%). Seventy-three percent were admitted for acute psychiatric hospitalization. Agreement between EPs and psychiatrists was 67% for presence of mood disorder, 82% for suicidality, 82% for drug/alcohol abuse, 85% for psychosis, and 85% for grave disability. There was 67% agreement regarding patient eligibility for involuntary psychiatric hold. EPs felt confident enough to make disposition decisions 87% of the time; for these patients there was 76% agreement with consulting psychiatrists about the final disposition decision. The 67% agreement between EPs and consulting psychiatrists regarding need for involuntary hold, and 76% agreement regarding final disposition

  5. Characteristics of lesbian, gay, bisexual, and transgender individuals entering substance abuse treatment.

    PubMed

    Cochran, Bryan N; Cauce, Ana Mari

    2006-03-01

    Previous research has suggested that lesbian, gay, bisexual, and transgender (LGBT) individuals enter treatment for substance abuse with more severe problems than heterosexual individuals. However, methodological difficulties, particularly the difficulty of obtaining a representative sample, have limited the ability to draw conclusions about LGBT individuals who receive services for substance abuse. This study took advantage of a unique opportunity to examine a representative sample of openly LGBT clients receiving publicly funded substance abuse treatment by using data gathered by treatment providers in Washington State. Baseline differences between openly LGBT and heterosexual clients were compared in a variety of domains. Results demonstrated that openly LGBT clients enter treatment with more severe substance abuse problems, greater psychopathology, and greater medical service utilization when compared with heterosexual clients. When the analyses were stratified based on sex, different patterns of substance use and associated psychosocial characteristics emerged for the LGBT clients. Implications for provision of appropriate services and recommendations to treatment agencies are discussed in this article.

  6. Determinants of hospital-based substance abuse treatment programs.

    PubMed

    Bell, R

    1994-01-01

    Experts agree that treatment is the best solution to substance abuse problems. As the societywide problem of drug and alcohol dependence increases, so does the need for treatment programs. Research has shown that many hospitals have entered into the substance abuse treatment program business because a need for quality programs exists and because an alcohol and a substance abuse treatment product line has the potential for increasing sagging revenues. This article addresses the question of what types of hospitals are likely to engage in providing inpatient and/or outpatient treatment programs. The results indicate that organizational size (measured by the number of beds) is the best predictor of treatment service provision for both inpatient and outpatient settings, with larger hospitals being more likely to provide substance abuse programs. A need for additional chemical dependency treatment programs does not appear to be the primary motivating factor for hospitals developing this service. Rather, it seems hospitals provide these programs for other reasons--as part of providing a full array of services, as an average toward achieving organizational goals, as a means of sustaining a competitive advantage, or as a strategy for maintaining the same level of service as the competition.

  7. Hidden Abuse within the Home: Recognizing and Responding to Sibling Abuse

    ERIC Educational Resources Information Center

    Stutey, Diane; Clemens, Elysia V.

    2015-01-01

    Sibling abuse is a serious phenomenon in our society that often goes unaddressed. Victims of sibling abuse experience psychological effects similar to those of child abuse (Caspi, 2012; Wiehe, 2002). The purpose of this article is to provide school counselors with a definition of sibling abuse and a five-step model to recognize and respond. A…

  8. Culturally competent substance abuse treatment with transgender persons.

    PubMed

    Nuttbrock, Larry A

    2012-01-01

    Transgender individuals are misunderstood and inadequately treated in many conventional substance abuse treatment programs. This article reviews current concepts regarding the definition and diversity of transgenderism and summarizes the existing literature on the prevalence and correlates of substance use in transgendered populations. Examples of culturally competent and gender-sensitive treatment in specialized settings are cited, with a call to extend these initiatives throughout the gamut of service venues that engage transgender individuals. Cultural competence combined with gender sensitivity should improve the effectiveness of substance abuse treatment for transgender individuals and will contribute to the goal of providing effective services in an increasingly diverse society.

  9. Emergency Department Frequent Utilization for Non-Emergent Presentments: Results from a Regional Urban Trauma Center Study.

    PubMed

    Behr, Joshua G; Diaz, Rafael

    2016-01-01

    First, to test a model of the drivers of frequent emergency department utilization conceptualized as falling within predisposing, enabling, and need dimensions. Second, to extend the model to include social networks and service quality as predictors of frequent utilization. Third, to illustrate the variation in thresholds that define frequent utilization in terms of the number of emergency department encounters by the predictors within the model. Primary data collection over an eight week period within a level-1 trauma urban hospital's emergency department. Representative randomized sample of 1,443 adult patients triaged ESI levels 4-5. Physicians and research staff interviewed patients as they received services. Relationships with the outcome variable, utilization, were tested using logistic regression to establish odds-ratios. 70.6 percent of patients have two or more, 48.3 percent have three or more, 25.3 percent have four or more, and 14.9 percent have five or more emergency department visits within 12 months. Factors associated with frequent utilization include gender, race, poor mental health, mental health drugs, prescription drug abuse, social networks, employment, perceptions of service quality, seriousness of condition, persistence of condition, and previous hospital admittance. Interventions targeting associated factors will change global emergency department encounters, although the mutability varies. Policy interventions to address predisposing factors such as substance abuse or access to mental health treatment as well as interventions that speak to enabling factors such as promoting the resiliency of social networks may result in decreased frequency of emergency department utilization.

  10. The Case for Individualized Goal Attainment Scaling Measurement in Elder Abuse Interventions.

    PubMed

    Burnes, David; Lachs, Mark S

    2017-01-01

    Research available to inform the development of effective community-based elder abuse protective response interventions is severely limited. Elder abuse intervention research is constrained by a lack of research capacity, including sensitive and responsive outcome measures that can assess change in case status over the course of intervention. Given the heterogeneous nature of elder abuse, standard scales can lack the flexibility necessary to capture the diverse range of individually relevant issues across cases. In this paper, we seek to address this gap by proposing the adaptation and use of an innovative measurement strategy-goal attainment scaling-in the context of elder protection. Goal attainment scaling is an individualized, client-centered outcome measurement approach that has the potential to address existing measurement challenges constraining progress in elder abuse intervention research. © The Author(s) 2015.

  11. 28 CFR 115.182 - Access to emergency medical services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... medical services. (a) Detainee victims of sexual abuse in lockups shall receive timely, unimpeded access to emergency medical treatment. (b) Treatment services shall be provided to the victim without... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Access to emergency medical services. 115...

  12. 28 CFR 115.182 - Access to emergency medical services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... medical services. (a) Detainee victims of sexual abuse in lockups shall receive timely, unimpeded access to emergency medical treatment. (b) Treatment services shall be provided to the victim without... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Access to emergency medical services. 115...

  13. 28 CFR 115.182 - Access to emergency medical services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... medical services. (a) Detainee victims of sexual abuse in lockups shall receive timely, unimpeded access to emergency medical treatment. (b) Treatment services shall be provided to the victim without... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Access to emergency medical services. 115...

  14. Impulsivity as a mechanism linking child abuse and neglect with substance use in adolescence and adulthood.

    PubMed

    Oshri, Assaf; Kogan, Steve M; Kwon, Josephine A; Wickrama, K A S; Vanderbroek, Lauren; Palmer, Abraham A; MacKillop, James

    2018-05-01

    Emerging developmental perspectives suggest that adverse rearing environments promote neurocognitive adaptations that heighten impulsivity and increase vulnerability to risky behavior. Although studies document links between harsh rearing environments and impulsive behavior on substance use, the developmental hypothesis that impulsivity acts as mechanism linking adverse rearing environments to downstream substance use remains to be investigated. The present study investigated the role of impulsivity in linking child abuse and neglect with adult substance use using data from (a) a longitudinal sample of youth (Study 1, N = 9,421) and (b) a cross-sectional sample of adults (Study 2, N = 1,011). In Study 1, the links between child abuse and neglect and young adult smoking and marijuana use were mediated by increases in adolescent impulsivity. In Study 2, indirect links between child abuse and neglect and substance use were evidenced via delayed reward discounting and impulsivity traits. Among impulsivity subcomponents, robust indirect effects connecting childhood experiences to cigarette use emerged for negative urgency. Negative urgency, positive urgency, and sensation seeking mediated the effect of child abuse and neglect on cannabis and alcohol use. Results suggest that child abuse and neglect increases risk for substance use in part, due to effects on impulsivity. Individuals with adverse childhood experiences may benefit from substance use preventive intervention programs that target impulsive behaviors.

  15. Abuse Is Abuse: The Influence of Type of Abuse, Victim Age, and Defendant Age on Juror Decision Making.

    PubMed

    Sheahan, Chelsea L; Pica, Emily; Pozzulo, Joanna D

    2017-09-01

    The purpose of the current study was to examine the role of victim age, defendant age, and type of abuse on mock juror decision making. Mock jurors ( N = 556) read a trial transcript in which a soccer coach was accused of sexual abuse or physical abuse against a player. The victim's age (child, adolescent, or young adult), the defendant's age (young, middle age, or older adult), and the type of abuse (sexual or physical) were varied. Mock jurors provided a dichotomous and continuous verdict and rated their perceptions of the victim and the defendant. Although no differences on mock jurors' dichotomous verdict were found due to victim age, defendant age, or type of abuse, mock jurors provided higher guilt ratings when the abuse was sexual and both the victim and defendant were described as young adults. Similarly, mock jurors rated the victim more positively when the victim was described as a young adult (vs. child) for both sexual and physical abuse cases, and rated the defendant more positively when the victim was described as a child compared with young adult in sexual abuse cases. These findings suggest that mock jurors were largely influenced by victim age, particularly when the victim was described as an adult compared with a child.

  16. [Gynecological clinical study in girls and adolescent victims of sexual abuse].

    PubMed

    Sam Soto, Selene; Gayón Vera, Eduardo; García Piña, Corina A

    2008-07-01

    In spite of a very important under-registration, sexual abuse represents a social and public health problem worldwide. In Mexico, estimated prevalence of sexual abuse in women is 17.3%, half of them in youngsters under 15 years old. Most of cases have a late gynecological evaluation, due to a delay in a formal complaint. Gynecologist or pediatrician are the specialists who most frequently perform the genital examination of girls suspected of sexual abuse, due to this a complete knowledge of the topic is necessary in order to make an accurate diagnosis, register the physical findings and give prompt medical and psychological treatment as well as follow up to the patient. Despite the low risk of acquiring a sexually transmitted infection, it is important to evaluate the use of prophylactic treatment and the prevention of unwanted pregnancy with emergency contraception. Big efforts are being made by preventive programs on sexual abuse, sexually transmitted infections and unwanted pregnancy, all of which are serious problems in Mexican children and youths, and should constitute a fundamental part of the public politics on sexual health.

  17. The management of abuse: 2. Child abuse.

    PubMed

    Panesear, Jaspel; Sinha, Karen Juggins Sonia; Acharya, Preeti; Jafar, Hima; Bower, Elizabeth J; Harrison, Victoria E; Newton, J Tim

    2006-09-01

    The role of the GDP and the dental team in the recognition and management of child abuse is discussed. Information on the current legislation and protocols for referral are provided. This paper discusses child abuse and offers information and practical advice for the dental team.

  18. [Child psychiatric assessment and the debate regarding the abuse of abuse].

    PubMed

    Fegert, J M

    1995-03-01

    The current discussion on false allegations in sexual abuse cases has led to a polarization in the views expressed about the credibility of children. Some authors even speak of a "child sexual accuse syndrome" or of a "sexual abuse allegation in divorce" (SAID) syndrome. A phenomenological analysis of the multiple reasons for misinterpretations is presented. Instead of stressing the importance only of false positives in child sexual abuse questions, an attempt is made to describe reasons for false negatives. Based on a retrospective analysis of 50 consecutive child psychiatric experts in connection with court cases, there does not appear to be an increase in false accusations. Rather, only about one third of the cases even involved suspected sexual abuse. Sexual abuse allegations were much more frequent in girls than in boys. Of 20 abuse allegations we judge four to be false allegations. In only one of these cases, that of an adolescent girl who had been abused in childhood, was the false allegation intended.

  19. Alcohol abuse as a risk factor for and consequence of child abuse.

    PubMed

    Widom, C S; Hiller-Sturmhöfel, S

    2001-01-01

    The relationship between child abuse and the use or abuse of alcohol has two aspects. First, some findings have indicated that parental alcohol abuse may be associated with the physical or sexual abuse of children. Research findings in this area remain inconsistent, however. Second, the experience of being abused as a child may increase a person's risk for alcohol-related problems as an adult. This relationship has best been demonstrated in women who had been victims of childhood abuse. Several factors most likely contribute to or influence this relationship, including coping skills; antisocial behavior; and psychological problems, such as posttraumatic stress disorder.

  20. Community partnership to affect substance abuse among Native American adolescents.

    PubMed

    Lowe, John; Liang, Huigang; Riggs, Cheryl; Henson, Jim; Elder, Tribal

    2012-09-01

    Substance abuse is one of the nation's primary health concerns. Native American youth experience higher rates of substance abuse than other youth. There is little empirical evidence that exists concerning the use of culturally-based interventions among Native American adolescents. This study used a community-based participatory research approach to develop and evaluate an innovative school-based cultural intervention targeting substance abuse among a Native American adolescent population. A two-condition quasi-experimental study design was used to compare the Cherokee Talking Circle (CTC) culturally-based intervention condition (n = 92) with the Be A Winner Standard Education (SE) condition (n = 87). Data were collected at pre-intervention, immediate post-intervention, and 90-day post-intervention using the Cherokee Self-Reliance Questionnaire, Global Assessment of Individual Needs - Quick, and Written Stories of Stress measures. Significant improvements were found among all measurement outcomes for the CTC culturally-based intervention. The data provide evidence that a Native American adolescent culturally-based intervention was significantly more effective for the reduction of substance abuse and related problems than a noncultural-based intervention. This study suggests that cultural considerations may enhance the degree to which specific interventions address substance abuse problems among Native American adolescents.

  1. Emergency department documentation of alleged excessive use of force.

    PubMed

    Strote, Jared; Verzemnieks, Erik; Walsh, Mimi

    2013-12-01

    Patients' complaints of excessive use of force (EUOF) by police occur frequently in emergency departments (EDs). Limited, if any, education or guidelines exist for documenting alleged EUOF despite extensive instruction for other forms of potential abuse or assault. Our objective was to examine the documentation by ED staff when patients complained of EUOF. A retrospective cohort design was used, identifying every use of force over a 1-year period by a single law enforcement agency that was followed by an ED visit within 24 hours. Charts were then analyzed for complaints of excessive force. For these cases, documentation was evaluated using standards for other forms of abuse and assault. Of 187 ED visits, 32 (17%) involved patients who were unable to give a history and 20 (11%) had nontrauma evaluations only. Of the remaining 135, there were 13 documented complaints (10%) of EUOF. Of these, 8 complaints (62%) described the mechanism of injury completely and 10 complaints (77%) had a complete description of the injury. No charts discussed whether the examination was consistent with the history. Inappropriate subjective terminology was used in 7 charts (54%), and the police description of events was described as fact in 7 charts (54%). Guilt was assigned in 5 charts (39%). In one ED, EUOF complaints were not documented to the standards for other forms of alleged assault and abuse. There may be a benefit to further education and guidelines on how to deal with ED presentations of EUOF.

  2. Inhalant abuse of computer cleaner manifested as angioedema.

    PubMed

    Kurniali, Peter C; Henry, Letitia; Kurl, Rita; Meharg, Joseph V

    2012-01-01

    Inhalant abuse is the intentional inhalation of chemical vapors or volatile substance to achieve a euphoric effect. Although no statistical data are reported yet, inhalant abuse is potentially life-threatening and has resulted in a wide range of toxic effects such as central nervous system depression, seizures, aspiration, cardiac arrhythmia, asphyxiation, hypoxia, metabolic acidosis, and sudden death among others. We are reporting a 25-year-old white man who was brought to the emergency department after inhaling aerosolized computer-cleaning spray composed of difluoroethane. He was found to have marked upper and lower lip facial swelling consistent with angioedema. The patient also had a prolonged QT interval, mild inspiratory stridor, but no urticaria. In this case, we believe the difluoroethane-related angioedema represents either idiopathic or bradykinin-induced angioedema.

  3. Child Sexual Abuse

    MedlinePlus

    Sexual abuse is one form of child abuse. It includes a wide range of actions between a child ... to children or pressuring them for sex is sexual abuse. Using a child for pornography is also sexual ...

  4. Psychological abuse, mental health, and acceptance of dating violence among adolescents

    PubMed Central

    Temple, Jeff R.; Choi, Hye Jeong; Elmquist, JoAnna; Hecht, Michael; Miller-Day, Michelle; Stuart, Gregory L.; Brem, Meagan; Wolford-Clevenger, Caitlin

    2016-01-01

    Purpose Existing literature indicates that acceptance of dating violence is a significant and robust risk factor for psychological dating abuse perpetration. Past work also indicates a significant relationship between psychological dating abuse perpetration and poor mental health. However, no known research has examined the relationship between acceptance of dating violence, perpetration of dating abuse, and mental health. In addition to exploring this complex relationship, the current study examines whether psychological abuse perpetration mediates the relationship between acceptance of dating violence and mental health (i.e., internalizing symptoms of depression, anxiety, and hostility). Methods Three waves of longitudinal data were obtained from 1,042 ethnically diverse high school students in Texas. Participants completed assessments of psychological dating abuse perpetration, acceptance of dating violence, and internalizing symptoms (hostility, and symptoms of anxiety and depression). Results As predicted, results indicated that perpetration of psychological abuse was significantly associated with acceptance of dating violence and all internalizing symptoms. Furthermore, psychological abuse mediated the relationship between acceptance of dating violence and internalizing symptoms. Conclusions Findings from the current study suggest that acceptance of dating violence is an important target for the prevention of dating violence and related emotional distress. Implications and Contribution Study findings indicate that perpetration of psychological abuse is significantly associated with acceptance of dating violence and select mental health variables (i.e., anxiety, depression, hostility). Moreover, psychological abuse perpetration mediated the relationship between acceptance of dating violence and internalizing symptoms. To be effective in preventing mental health problems, interventions may benefit from targeting acceptance and perpetration of dating violence

  5. Choosing to Live or Die: Online Narratives of Recovering from Methamphetamine Abuse.

    PubMed

    Obong'o, Christopher O; Alexander, Adam C; Chavan, Prachi P; Dillon, Patrick J; Kedia, Satish K

    2017-01-01

    The goal of this study is to explore motivating factors for recovering from methamphetamine abuse. The source of data was 202 anonymous letters and stories submitted to an online support platform for methamphetamine users. Qualitative data were analyzed in Dedoose software using grounded theory methodology. Ten primary motivating factors for recovering from methamphetamine abuse were identified and mapped onto four constructs from the Health Belief Model: (1) perceived susceptibility (learning from others and learning from self); (2) perceived severity (fear of death and declining health); (3) perceived benefits (reconnecting with family, reconnecting with society, and recovering self-esteem); and (4) cues to action (hitting rock bottom, finding God, and becoming pregnant). By using data from an online support group and categorizing emerging themes within a theoretical framework, findings from this study provide a comprehensive understanding of factors involved in recovery from methamphetamine abuse and offer further insights in developing theoretically informed interventions for methamphetamine users. This study suggests the utility of online platforms for obtaining anonymous but unique experiences about drug abuse and recovery. Findings may benefit healthcare professionals, counselors, and researchers by helping to develop theoretically informed interventions for methamphetamine abuse.

  6. Glutamatergic neurometabolites during early abstinence from chronic methamphetamine abuse.

    PubMed

    O'Neill, Joseph; Tobias, Marc C; Hudkins, Matthew; London, Edythe D

    2014-10-31

    The acute phase of abstinence from methamphetamine abuse is critical for rehabilitation success. Proton magnetic resonance spectroscopy has detected below-normal levels of glutamate+glutamine in anterior middle cingulate of chronic methamphetamine abusers during early abstinence, attributed to abstinence-induced downregulation of the glutamatergic systems in the brain. This study further explored this phenomenon. We measured glutamate+glutamine in additional cortical regions (midline posterior cingulate, midline precuneus, and bilateral inferior frontal cortex) putatively affected by methamphetamine. We examined the relationship between glutamate+glutamine in each region with duration of methamphetamine abuse as well as the depressive symptoms of early abstinence. Magnetic resonance spectroscopic imaging was acquired at 1.5 T from a methamphetamine group of 44 adults who had chronically abused methamphetamine and a control group of 23 age-, sex-, and tobacco smoking-matched healthy volunteers. Participants in the methamphetamine group were studied as inpatients during the first week of abstinence from the drug and were not receiving treatment. In the methamphetamine group, small but significant (5-15%, P<.05) decrements (vs control) in glutamate+glutamine were observed in posterior cingulate, precuneus, and right inferior frontal cortex; glutamate+glutamine in posterior cingulate was negatively correlated (P<.05) with years of methamphetamine abuse. The Beck Depression Inventory score was negatively correlated (P<.005) with glutamate+glutamine in right inferior frontal cortex. Our findings support the idea that glutamatergic metabolism is downregulated in early abstinence in multiple cortical regions. The extent of downregulation may vary with length of abuse and may be associated with severity of depressive symptoms emergent in early recovery. © The Author 2015. Published by Oxford University Press on behalf of CINP.

  7. Bath salts and synthetic cathinones: An emerging designer drug phenomenon

    PubMed Central

    German, Christopher L.; Fleckenstein, Annette E.; Hanson, Glen R.

    2014-01-01

    The synthetic cathinones are an emerging class of designer drugs abused for psychostimulant and hallucinogenic effects similar to cocaine, methylenedioxymethamphetamine (MDMA), or other amphetamines. Abuse of synthetic cathinones, frequently included in products sold as ‘bath salts’, became prevalent in early 2009, leading to legislative classification throughout Europe in 2010 and schedule I classification within the United States in 2011. Recent pre-clinical and clinical studies indicate dysregulation of central monoamine systems are a principal mechanism of synthetic cathinone action and presumably underlie the behavioral effects and abuse liability associated with these drugs. This review provides insight into the development of synthetic cathinones as substances of abuse, current patterns of their abuse, known mechanisms of their action and toxicology, and the benefits and drawbacks of their classification. PMID:23911668

  8. Monitoring Technology Misuse & Abuse: A Five-Step Plan for Creating a Digital Citizenship Program in Your School

    ERIC Educational Resources Information Center

    Ribble, Mike S.; Bailey, Gerald D.

    2004-01-01

    Over the last two years, it has become evident that a behavior pattern of misuse and abuse with respect to technology is beginning to emerge in society. This outbreak of technology misuse and abuse is documented in continual news coverage on TV, in newspapers and on the Internet--both inside and outside of schools. The endless list of misuse and…

  9. The elder abuse and neglect phenomenon in the ultra-Orthodox Jewish society: social workers' perspectives.

    PubMed

    Band-Winterstein, Tova

    2018-02-13

    In the last 30 years, elder abuse and neglect has been recognized as a social and health-related problem. The aim of this paper is to describe the phenomenon of elder abuse and neglect in a separatist faith-based society (ultra-Orthodox Jewish society-UOJS). A qualitative-phenomenological study with 28 social workers who underwent in-depth semi-structured interviews based on an interview guide consisting of the following items: visibility of the elder abuse and neglect phenomenon in the ultra-Orthodox society, and dilemmas and sensitive issues that arise when working with this population. Three main themes emerged: (1) Between the commandment to honor one's parents and concealment patterns: Cultural barriers to exposing the abuse and neglect phenomenon; (2) "Life is demanding:" The unique expression of abusive and neglectful behavior in the UOJS; (3) Culturally related dilemmas when intervening with cases of elder abuse and neglect. Ultra-Orthodox Jewish cultural belief is a differentiating component in the context of elder abuse and neglect. Social workers need to develop a deep understanding of the unique characteristics of the phenomenon and cultural sensitivity to cope with it to address the well-being of older ultra-Orthodox Jews.

  10. Staff experience and understanding of working with abused women suffering from mental illness.

    PubMed

    Bengtsson-Tops, A; Saveman, B-I; Tops, D

    2009-09-01

    The phenomenon of abused women with mental illness is often unrecognised by staff working within welfare services. This may be explained by staff members' attitudes, insecurity or lack of awareness. Today, there are shortcomings in the knowledge of staff members' experiences and interpretations of abuse against women suffering from mental illness. The aim of this qualitative study was to describe how staff members experience and understand their work with abused women suffering from mental illness. Thematic interviews were conducted with 13 staff members from various welfare services. Data were subject to content analysis. The findings showed that working with abused women was experienced as ambiguous and painful and made the staff act pragmatically. Feelings of ambiguity were mainly related to the lack of theoretical frameworks for interpreting why women with mental illness are exposed to abuse. Painful experiences involved intertwined feelings of distress, frustration, worthlessness, ambivalence and powerlessness. These were all feelings that emerged in the direct encounters with the abused women. In response to the abused women's comprehensive needs, staff members acted pragmatically, implying networking without any sanction from the leaders of the organisation, compliance with routines and taking action in here-and-now situations. By acting pragmatically, staff members could achieve concrete results through their interventions. It is concluded that staff members, working with abused women with mental illness, are in a vulnerable situation and in need of formally accepted and implemented support and legitimacy as well as theoretical knowledge regarding causes and consequences of abuse in this particular group of women.

  11. Child Sexual Abuse

    MedlinePlus

    ... No child is prepared to cope with repeated sexual stimulation. Even a two or three year old, who ... abuse. Some signs can only be detected on physical exam by a physician. Sexual abuse can also include noncontact abuse, such as ...

  12. Metabolism of designer drugs of abuse.

    PubMed

    Staack, Roland F; Maurer, Hans H

    2005-06-01

    Abuse of designer drugs is widespread among young people, especially in the so-called "dance club scene" or "rave scene", worldwide. Severe and even fatal poisonings have been attributed to the consumption of such drugs of abuse. However, in contrast to new medicaments, which are extensively studied in controlled clinical studies concerning metabolism, including cytochrome P450 isoenzyme differentiation, and further pharmacokinetics, designer drugs are consumed without any safety testing. This paper reviews the metabolism of new designer drugs of abuse that have emerged on the black market during the last years. Para-methoxyamphetamine (PMA), para-methoxymethamphetamine (PMMA) and 4-methylthioamphetamine (4-MTA), were taken into consideration as new "classical" amphetamine-derived designer drugs. Furthermore, N-benzylpiperazine (BZP), 1-(3, 4-methylenedioxybenzyl)piperazine (MDBP), 1-(3-trifluoromethylphenyl)piperazine (TFMPP), 1-(3-chlorophenyl)piperazine (mCPP) and 1-(4-methoxyphenyl)piperazine (MeOPP) were taken into consideration as derivatives of the class of piperazine-derived designer drugs, as well as alpha-pyr-rolidinopropiophenone (PPP), 4'-methoxy-alpha-pyrrolidinopropiophenone (MOPPP), 3', 4'-methylenedioxy-alpha-pyrrolidino-propiophenone (MDPPP), 4'-methyl-alpha-pyrrolidinopropiophenone (MPPP), and 4'-methyl-alpha-pyrrolidinoexanophenone (MPHP) as derivatives of the class of alpha-pyrrolidinophenone-derived designer drugs. Papers describing identification of in vivo or in vitro human or animal metabolites and cytochrome P450 isoenzyme dependent metabolism have been considered and summarized.

  13. How the Medical Culture Contributes to Coworker-Perpetrated Harassment and Abuse of Family Physicians

    PubMed Central

    Miedema, Baukje; MacIntyre, Leslie; Tatemichi, Sue; Lambert-Lanning, Anita; Lemire, Francine; Manca, Donna; Ramsden, Vivian

    2012-01-01

    PURPOSE Harassment and abuse in the workplace of family physicians has been associated with higher levels of stress, increased consumption of alcohol, and higher risk for developing mental health problems. Few studies have examined issues contributing to abusive encounters in the workplace of family physicians. METHODS For the overall study we used a mixed methods design, which included a cross-sectional survey of a randomly selected sample of active family physicians from the database of the College of Family Physicians of Canada and telephone interviews with those who reported experiencing work related harassment and abuse in the last year. The data presented here arise from the qualitative interviews of the study, which were analyzed thematically. RESULTS The interview arm of the study included 23 female and 14 male participants. The major themes that emerged from the study were (1) modeling of abusive behaviors, (2) status hierarchy among various medical disciplines, (3) shortage of physicians, and (4) lack of transparent policies and follow-up procedures after abusive encounters. The results are discussed using the broken window theory. CONCLUSION Many family physicians experience harassing and abusive encounters during their training or in the workplace. The current medical culture appears to contribute to harassment and abuse in the workplace of family physicians in Canada. We described the components that intentionally or unintentionally facilitate abusive behavior in the medical culture. PMID:22412002

  14. How the medical culture contributes to coworker-perpetrated harassment and abuse of family physicians.

    PubMed

    Miedema, Baukje; MacIntyre, Leslie; Tatemichi, Sue; Lambert-Lanning, Anita; Lemire, Francine; Manca, Donna; Ramsden, Vivian

    2012-01-01

    Harassment and abuse in the workplace of family physicians has been associated with higher levels of stress, increased consumption of alcohol, and higher risk for developing mental health problems. Few studies have examined issues contributing to abusive encounters in the workplace of family physicians. For the overall study we used a mixed methods design, which included a cross-sectional survey of a randomly selected sample of active family physicians from the database of the College of Family Physicians of Canada and telephone interviews with those who reported experiencing work related harassment and abuse in the last year. The data presented here arise from the qualitative interviews of the study, which were analyzed thematically. The interview arm of the study included 23 female and 14 male participants. The major themes that emerged from the study were (1) modeling of abusive behaviors, (2) status hierarchy among various medical disciplines, (3) shortage of physicians, and (4) lack of transparent policies and follow-up procedures after abusive encounters. The results are discussed using the broken window theory. Many family physicians experience harassing and abusive encounters during their training or in the workplace. The current medical culture appears to contribute to harassment and abuse in the workplace of family physicians in Canada. We described the components that intentionally or unintentionally facilitate abusive behavior in the medical culture.

  15. Sexual maturation and control issues among sexually abused and non-abused anorexia patients.

    PubMed

    Walsh, J; Burns, F

    2000-09-01

    To assess the relative salience of the maintenance of control and the avoidance of sexual maturation as sources of motivation for maintaining pathological eating behaviours among sexually abused anorexic patients. A two-factor mixed experimental design was employed. Three independent groups (sexually abused anorexics (N = 12); non-abused anorexics (N = 9); non-anorexic/non-abused controls (N = 12)) constituted the between-subjects factor. Allocation to abuse/non-abuse group was dependent upon replies to a questionnaire-based measure of unwanted sexual experience. The within-subjects factor comprised three conditions in which words of various colours were presented to participants for colour-naming (Stroop, 1935). The conditions were represented by lists of neutral words, sexual maturation words, and control-related words. Two trials were carried out in each condition and mean response times were measured. Within-group analyses revealed that interference was greater from sexual maturation words than from control-related words among the sexually-abused anorexics, but of equal magnitude among non-abused counterparts. Between-groups analyses found that abused patients experienced marginally greater cognitive interference from sexual maturation words than the non-abused patients. Theoretically, support is offered for elaborated schematic models of cognitive processing. Clinically, treatment interventions may need to pay particular attention to issues of sexual maturation among sexually abused anorexic patients.

  16. Minimum Knowledge and Skills Objectives for Alcohol and Other Drug Abuse Teaching.

    ERIC Educational Resources Information Center

    American Psychiatric Association, Hartford, CT.

    This publication brings together statements concerning the minimum knowledge and skills objectives in alcohol and other drug abuse determined by the professional organizations of six medical specialties: pediatrics; emergency medicine; obstetrics and gynecology; psychiatry; general internal medicine; and family medicine for undergraduate,…

  17. Sexual Anxiety and Eroticism Predict the Development of Sexual Problems in Youth With a History of Sexual Abuse

    PubMed Central

    Simon, Valerie A.; Feiring, Candice

    2017-01-01

    Youth with confirmed histories of sexual abuse (N = 118) were followed longitudinally to examine associations between their initial sexual reactions to abuse and subsequent sexual functioning. Participants were interviewed at abuse discovery (ages 8 through 15) and again 1 and 6 years later. Eroticism and sexual anxiety emerged as distinct indices of abuse-specific sexual reactions and predicted subsequent sexual functioning. Eroticism was associated with indicators of heightened sexuality, including more sexual risk behavior and views of sexual intimacy focused on partners’ needs. Sexual anxiety was associated with indicators of diminished sexuality, including few sexual partners and avoidant views of sexual intimacy. Age at abuse discovery moderated some associations, suggesting that the timing of abuse-specific reactions affects trajectories of sexual development. Findings point to the need for a developmental approach to understanding how abuse-specific sexual reactions disrupt sexual development and the need for early interventions promoting healthy sexual development. PMID:18408212

  18. Using in vitro models for expression profiling studies on ethanol and drugs of abuse.

    PubMed

    Thibault, Christelle; Hassan, Sajida; Miles, Michael

    2005-03-01

    The use of expression profiling with microarrays offers great potential for studying the mechanisms of action of drugs of abuse. Studies with the intact nervous system seem likely to be most relevant to understanding the mechanisms of drug abuse-related behaviours. However, the use of expression profiling with in vitro culture models offers significant advantages for identifying details of cellular signalling actions and toxicity for drugs of abuse. This study discusses general issues of the use of microarrays and cell culture models for studies on drugs of abuse. Specific results from existing studies are also discussed, providing clear examples of relevance for in vitro studies on ethanol, nicotine, opiates, cannabinoids and hallucinogens such as LSD. In addition to providing details on signalling mechanisms relevant to the neurobiology of drugs of abuse, microarray studies on a variety of cell culture systems have also provided important information on mechanisms of cellular/organ toxicity with drugs of abuse. Efforts to integrate genomic studies on drugs of abuse with both in vivo and in vitro models offer the potential for novel mechanistic rigor and physiological relevance.

  19. Psychological abuse, substance abuse distress, dissatisfaction with friendships, and incident psychiatric problems.

    PubMed

    Sheikh, Mashhood Ahmed

    2018-05-01

    The aim of this study was to assess the mediating role of dissatisfaction with friendships in adulthood in the associations between psychological abuse in childhood, substance abuse distress in childhood, and incident psychiatric problems (IPPs) in adulthood over 13 years of follow-up. We used data collected from 1994 to 2008 within the framework of the Tromsø Study (N = 9502), a representative, longitudinal, prospective cohort study. Poisson regression analysis was used to assess the associations between psychological abuse, substance abuse distress, dissatisfaction with friendships in adulthood, and IPPs in adulthood. Indirect effects and proportion mediated (%) were assessed with the difference-in-coefficients method. Psychological abuse (relative risk [RR] = 1.66, 95% confidence interval [CI]: 1.45-1.89) and substance abuse distress in childhood (RR = 1.38, 95% CI: 1.18-1.62) were associated with an increased risk of dissatisfaction with friendships in adulthood. Dissatisfaction with friendships in adulthood was associated with an increased risk of IPPs in adulthood (RR = 1.71, 95% CI: 1.33-2.20). Moreover, dissatisfaction with friendships in adulthood mediated 9.31% (95% CI: 4.25-14.57) of the association between psychological abuse in childhood and IPPs in adulthood, and 9.17% (95% CI: 4.35-16.33) of the association between substance abuse distress in childhood and IPPs in adulthood. Dissatisfaction with friendships in adulthood mediates a minor proportion of the associations between psychological abuse, substance abuse distress, and IPPs in adulthood. Interventions aimed at decreasing dissatisfaction with friendships may dampen some of the effect of psychological abuse and substance abuse distress in childhood on IPPs in adulthood. Copyright © 2018 Elsevier Inc. All rights reserved.

  20. Comparative study on perceived abuse and social neglect among rural and urban geriatric population.

    PubMed

    Kaur, Jaspreet; Kaur, Jasbir; Sujata, N

    2015-01-01

    Elder abuse and social neglect are unrecognized problem. Many forms of elder abuse exist including physical, psychological, financial, sexual and social neglect. Social neglect is experienced by elderly through loss of friends and family members. Comparison of perceived abuse and social neglect among elderly residing in selected rural and urban areas. Study setting was a rural area Pohir and urban area Jamalpur of district Ludhiana. A sample of 200 subjects (100 subjects each from rural and urban area respectively) of age 60 years and above was drawn by cluster sampling technique and interview method was used to collect data by using Likert scale. Descriptive and inferential statistics were carried out with SPSS package. Results of the present study revealed that perceived physical abuse (25%) was higher among elderly residing in rural and it was found significantly higher among female elderly who were illiterate, widow/widower and partially dependent on caregiver whereas perceived psychological abuse (71%), financial abuse (37%) and social neglect (74%) were higher among elderly residing in urban. A significant association was found between psychological abuse and educational status, which inferred that as the level of education increases perception of psychological abuse also increases. The perceived financial abuse was significantly higher among male elderly who were financially independent. It was concluded that social neglect was most common, followed by psychological abuse and financial abuse among elderly residing in urban whereas physical abuse was more prevalent among elderly residing in rural.

  1. Racial differences in treatment effect among men in a substance abuse and domestic violence program.

    PubMed

    Scott, Melanie C; Easton, Caroline J

    2010-11-01

    It is unclear whether racial differences in treatment effect exist for individuals in substance abuse and domestic violence programs. This study examined racial differences in treatment effect among substance dependent Caucasian and African-American male intimate partner violence (IPV) offenders court mandated to an integrated substance abuse and domestic violence treatment. From baseline to completion of treatment (week 12), 75 participants (39 Caucasian; 36 African-American) were assessed on demographics, substance use, legal characteristics, and use of violence (physical, verbal, and psychological). African-American men served more months incarcerated in their life than Caucasian men. Both groups showed decreases in their use of physical violence and alcohol abuse over treatment. Caucasian men also showed a decrease in their use of verbal abuse. At treatment completion, both groups showed a reduction in physical abuse and alcohol abuse. Caucasian men showed a reduction in their use of verbal abuse, but African-American men did not. Substance dependent African-American male IPV offenders may benefit from interventions that thoroughly target communication skills in addition to issues of substance abuse and IPV to reduce use of verbal abuse and improve treatment outcomes among African American men.

  2. A review on the prevalence and measurement of elder abuse in the community.

    PubMed

    Sooryanarayana, Rajini; Choo, Wan-Yuen; Hairi, Noran N

    2013-10-01

    Aging is a rising phenomenon globally and elder abuse is becoming increasingly recognized as a health and social problem. This review aimed to identify the prevalence of elder abuse in community settings, and discuss issues regarding measurement tools and strategies to measure elderly abuse by systematically reviewing all community-based studies conducted worldwide. Articles on elder abuse from 1990 to 2011 were reviewed. A total of 1,832 articles referring to elders residing at home either in their own or at relatives' houses were searched via CINAHL and MEDLINE electronic databases, in addition to a hand search of the latest articles in geriatric textbooks and screening references, choosing a total of 26 articles for review. Highest prevalence was reported in developed countries, with Spain having 44.6% overall prevalence of suspicion of abuse and developing countries exhibiting lower estimates, from 13.5% to 28.8%. Physical abuse was among the least encountered, with psychological abuse and financial exploitation being the most common types of maltreatment reported. To date, there is no single gold standard test to ascertain abuse, with numerous tools and different methods employed in various studies, coupled with varying definitions of thresholds for age. Current evidences show that elder abuse is a common problem in both developed and developing countries. It is important that social, health care, and legal systems take these findings into consideration in screening for abuse or reforming existing services to protect the health and welfare of the elderly.

  3. Alienation and Domestic Abuse: How Abused Women Cope with Loneliness

    ERIC Educational Resources Information Center

    Arokach, Ami

    2006-01-01

    This study explored the manner in which abused women cope with loneliness. Eighty women, victims of domestic abuse, were compared to 84 women from the general population who have had no history of abusive relationships. A 34-item yes/no loneliness questionnaire was utilized in order to compare the "beneficial" ways of coping with loneliness in the…

  4. Stress- and glucocorticoid-induced priming of neuroinflammatory responses: potential mechanisms of stress-induced vulnerability to drugs of abuse.

    PubMed

    Frank, Matthew G; Watkins, Linda R; Maier, Steven F

    2011-06-01

    Stress and stress-induced glucocorticoids (GCs) sensitize drug abuse behavior as well as the neuroinflammatory response to a subsequent pro-inflammatory challenge. Stress also predisposes or sensitizes individuals to develop substance abuse. There is an emerging evidence that glia and glia-derived neuroinflammatory mediators play key roles in the development of drug abuse. Drugs of abuse such as opioids, psychostimulants, and alcohol induce neuroinflammatory mediators such as pro-inflammatory cytokines (e.g. interleukin (IL)-1β), which modulate drug reward, dependence, and tolerance as well as analgesic properties. Drugs of abuse may directly activate microglial and astroglial cells via ligation of Toll-like receptors (TLRs), which mediate the innate immune response to pathogens as well as xenobiotic agents (e.g. drugs of abuse). The present review focuses on understanding the immunologic mechanism(s) whereby stress primes or sensitizes the neuroinflammatory response to drugs of abuse and explores whether stress- and GC-induced sensitization of neuroimmune processes predisposes individuals to drug abuse liability and the role of neuroinflammatory mediators in the development of drug addiction. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. [Prevalence of sexual abuse in students and its relation with drug abuse].

    PubMed

    Ramos-Lira, L; Saldívar-Hernández, G; Medina-Mora, M E; Rojas-Guiot, E; Villatoro-Velázquez, J

    1998-01-01

    To determine the prevalence of sexual abuse among high school (secondary and preparatory) students, male and female, throughout Mexico, and its relationship with drug abuse. Data were obtained from the National Survey of Drug Use in Schools applied in November and December, 1991. A total of 61,779 students, 51.8% men and 47.1% women, with a mean age of 14.4 years completed the self-applied questionnaire. Sexual abuse was explored from the perspective of the abusers and of the victims. The prevalence of sexual abuse in adolescent victims was 4.3% and no statistically significant differences were found between sexes. The prevalence of sexual aggressors was 2.5%. Men coerced someone else in a higher proportion than women. Adolescent women experienced sexual abuse at a younger age than men and they also reported a higher percentage of intrafamily abuse. Men reported friends as the most frequent aggressors. Victims and aggressors of both sexes reported a significantly higher drug consumption than students without these antecedents. The differences in the experience of sexual abuse between men and women are described. In particular, the fact that sexual abuse in men mainly occurs outside the family sphere, while in women it is mainly within the family and at a younger age than in men. Additionally, the need for further research focusing on the consequences on mental health of infantile and adolescent sexual abuse and drug consumption is emphasized, considering the characteristics of each gender.

  6. Elder Abuse among African Americans

    ERIC Educational Resources Information Center

    Tauriac, Jesse J.; Scruggs, Natoschia

    2006-01-01

    Perceptions of extreme, moderate, and mild forms of elder abuse among African-American women (n=25) and men (n=10) were examined. African-American respondents emphasized physical abuse when giving examples of extremely abusive behavior. Along with physical abuse, verbal abuse was the most frequently identified form of abuse, and was significantly…

  7. Substance abuse and cancer.

    PubMed

    Moussas, G I; Papadopoulou, A G

    2017-01-01

    . Specific components have been identified in tobacco, which are considered to be carcinogenic and responsible for tumor development in various sites. Moreover, complicated psychiatric problems arise due to substance abuse in cancer patients, either in the context of pain treatment, or under pre-existing dependence. The rational use of opioid analgesics, when it is medically required as suggested by the health professionals specialized in the treatment of acute pain in cancer patients, could be a therapeutic option. Substance abuse reduces treatment compliance, worsens cancer prognosis and seems to be a negative factor for the quality of life of these patients. Current literature highlights the importance of appropriate psychiatric interventions to address substance abuse in cancer patients.

  8. Childhood sexual abuse and substance abuse treatment utilization among substance-dependent incarcerated women.

    PubMed

    Peltan, Jessica R; Cellucci, Tony

    2011-10-01

    Incarcerated women have high rates of substance abuse problems and trauma. A variety of variables may influence whether these women seek help or are referred for substance abuse problems. This study reports an exploratory project on service utilization among incarcerated substance-dependent women (N = 40) in southeastern Idaho. Using self-report and interview tools, most participants reported some substance abuse treatment history, although extent and types of treatment varied. Most of the women also reported some type of childhood abuse. Age, income, and consequences of alcohol and other drug use related positively to substance abuse treatment. However, severity of childhood sexual abuse and current trauma symptoms were negatively correlated with substance abuse treatment episodes. These women may use substances to cope with childhood trauma or may not perceive the substance abuse system as responsive to their co-occurring trauma symptoms. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. Influence of alcohol and other substances of abuse at the time of injury among patients in a Norwegian emergency department.

    PubMed

    Bakke, Eirin; Bogstrand, Stig Tore; Normann, Per Trygve; Ekeberg, Øivind; Bachs, Liliana

    2016-06-08

    The presence of alcohol or other substances of abuse in blood or urine from injured patients is often used as a proxy for substance influence at the time of injury. The aim of this study was to obtain an estimate of substance influence at the time of injury based on blood concentrations of alcohol and other substances of abuse, and to explore the relationship between the substance prevalence at the time of admittance to the hospital and the actual influence at the time of the injury. The study included all adult patients admitted to the emergency department of a university hospital during 1 year (n = 996). Quantification in blood was done by an enzymatic method for alcohol, and by liquid chromatography-mass spectrometry or gas chromatography-mass spectrometry for 28 other substances of abuse. Concentrations of alcohol and other substances in blood at the time of injury were calculated. The degree of influence was assessed on the basis of the calculated blood concentrations, with a threshold of influence set at a blood alcohol concentration (BAC) of 0.05 %, or a substance concentration leading to an influence similar to that of a BAC of 0.05 %. A total of 324 patients (32.5 %) were determined to be under the influence at the time of injury. In comparison, 394 patients (39.6 %) had one or more substances above the cut-off limit in blood at the time of admittance to the hospital. Alcohol was the most prevalent substance causing influence at 25.9 %. Among patients with violence-related injuries, almost 75 % were under the influence of alcohol and/or substances. Patients under the influence were younger, and men were more often under the influence than women. More patients were under the influence at nighttime and during weekends than at daytime and on weekdays. About one third of the injured patients were determined to be under the influence at the time of injury, with alcohol being the most prevalent substance causing influence. Approximately 98 % of the

  10. Emergency Department Frequent Utilization for Non-Emergent Presentments: Results from a Regional Urban Trauma Center Study

    PubMed Central

    2016-01-01

    Objectives First, to test a model of the drivers of frequent emergency department utilization conceptualized as falling within predisposing, enabling, and need dimensions. Second, to extend the model to include social networks and service quality as predictors of frequent utilization. Third, to illustrate the variation in thresholds that define frequent utilization in terms of the number of emergency department encounters by the predictors within the model. Data Source Primary data collection over an eight week period within a level-1 trauma urban hospital’s emergency department. Study Design Representative randomized sample of 1,443 adult patients triaged ESI levels 4–5. Physicians and research staff interviewed patients as they received services. Relationships with the outcome variable, utilization, were tested using logistic regression to establish odds-ratios. Principal Findings 70.6 percent of patients have two or more, 48.3 percent have three or more, 25.3 percent have four or more, and 14.9 percent have five or more emergency department visits within 12 months. Factors associated with frequent utilization include gender, race, poor mental health, mental health drugs, prescription drug abuse, social networks, employment, perceptions of service quality, seriousness of condition, persistence of condition, and previous hospital admittance. Conclusions Interventions targeting associated factors will change global emergency department encounters, although the mutability varies. Policy interventions to address predisposing factors such as substance abuse or access to mental health treatment as well as interventions that speak to enabling factors such as promoting the resiliency of social networks may result in decreased frequency of emergency department utilization. PMID:26784515

  11. Coercive control and abused women's decisions about their pets when seeking shelter.

    PubMed

    Hardesty, Jennifer L; Khaw, Lyndal; Ridgway, Marcella D; Weber, Cheryl; Miles, Teresa

    2013-09-01

    The importance of pets in families, especially during major life stressors, is well documented. Research suggests links between pet ownership and intimate partner violence (IPV). This study explored abused women's decisions about pets when seeking help from a shelter. Interviews were conducted with 19 women who were pet owners. Using grounded theory methods, two patterns emerged surrounding abusers' treatment of pets, bonds to pets, women's decisions about pets upon seeking shelter, and future plans for pets. The presence of coercive control was central to these patterns. Women also discussed their experiences with and needs from shelter professionals and veterinarians with implications for practice.

  12. Sexual abuse and violence among adolescent girls in Botswana: a mental health perspective.

    PubMed

    Seloilwe, Esther Salang; Thupayagale-Tshweneagae, Gloria

    2009-07-01

    The presence of sexual abuse among societies in Botswana is a phenomenon whose occurrence is usually denied albeit the police report on it and legal frameworks have been established to combat it. Several factors influence the concealment of sexual abuse among adolescent girls, which includes cultural factors and social status of the perpetrators. This paper espouses the concept of sexual abuse among adolescent girls, the existence of the problem, its magnitude, the factors that increase vulnerability to violence and abuse, and how these factors intersect with HIV and AIDS. Two case studies using a discovery method were used to explore the phenomenon under the study. The findings of the study indicated that sexual abuse and violence have profound mental health consequences including guilt, anxiety, depression and anger. Future research is suggested to explore this problem on a wider scale and develop interventions that can assist victims and perpetrators to cope with the situation.

  13. Children's disclosures of sexual abuse: learning from direct inquiry.

    PubMed

    Schaeffer, Paula; Leventhal, John M; Asnes, Andrea Gottsegen

    2011-05-01

    Published protocols for forensic interviewing for child sexual abuse do not include specific questions about what prompted children to tell about sexual abuse or what made them wait to tell. We, therefore, aimed to: (1) add direct inquiry about the process of a child's disclosure to a forensic interview protocol; (2) determine if children will, in fact, discuss the process that led them to tell about sexual abuse; and (3) describe the factors that children identify as either having led them to tell about sexual abuse or caused them to delay a disclosure. Forensic interviewers were asked to incorporate questions about telling into an existing forensic interview protocol. Over a 1-year period, 191 consecutive forensic interviews of child sexual abuse victims aged 3-18 years old in which children spoke about the reasons they told about abuse or waited to tell about abuse were reviewed. Interview content related to the children's reasons for telling or for waiting to tell about abuse was extracted and analyzed using a qualitative methodology in order to capture themes directly from the children's words. Forensic interviewers asked children about how they came to tell about sexual abuse and if children waited to tell about abuse, and the children gave specific answers to these questions. The reasons children identified for why they chose to tell were classified into three domains: (1) disclosure as a result of internal stimuli (e.g., the child had nightmares), (2) disclosure facilitated by outside influences (e.g., the child was questioned), and (3) disclosure due to direct evidence of abuse (e.g., the child's abuse was witnessed). The barriers to disclosure identified by the children were categorized into five groups: (1) threats made by the perpetrator (e.g., the child was told (s)he would get in trouble if (s)he told), (2) fears (e.g., the child was afraid something bad would happen if (s)he told), (3) lack of opportunity (e.g., the child felt the opportunity to

  14. Elder abuse and neglect: challenges and directions for legal reform.

    PubMed

    Breedon, Laura

    2010-09-01

    The last two decades have heralded an increased community and professional awareness of the phenomenon of elder abuse and the challenges it poses to the enjoyment of the human rights of some older people. The contemporary Australian legal system provides many of the components of a framework required to assist in the promotion of the rights of the elderly and in the prevention and remedy of elder abuse. This framework acts in concert with health and community services dedicated to the advancement of health and wellbeing into old age. In the future, the acknowledgment and adoption of international legal principles which are directed to the needs of the elderly, the reform of existing domestic legislation and the development of new elder-specific statutes may all impact upon the incidence and consequences of elder abuse. To date, no Australian jurisdiction has adopted a legislative regime targeted specifically at the issues confronting older Australians who may be vulnerable to abuse and neglect. This column looks at some of the options for legal reform in this area.

  15. The Role of Gender in Officially Reported Intimate Partner Abuse

    ERIC Educational Resources Information Center

    Melton, Heather C.; Sillito, Carrie Lefeve

    2012-01-01

    The role of gender in intimate partner abuse (IPA) perpetration and victimization has been debated for the last several decades. Two perspectives have emerged regarding this debate. Researchers from the family violence perspective argue that men and women are violent at near equal rates and call for a reframing of the issue from one of woman…

  16. Preventing Drug Abuse among American Indian Young People.

    ERIC Educational Resources Information Center

    Beauvais, Fred

    The three-part report summarizes existing research on drug abuse in American Indian communities, suggests ways to combat the problem, and describes many different kinds of drugs and their effects. In Part I, much recent research is cited. Although methodology and results vary greatly, the research clearly points to a serious drug problem in many…

  17. Physical Spouse Abuse in a 28-Week-Pregnant Woman: A Case Report.

    PubMed

    Memarian, Azadeh; Ameri, Maryam; Shakeri, Mozhgan; Mehrpisheh, Shahrokh

    2016-05-01

    In some relationships, pregnancy is a risk factor for intimate partner violence (IPV). We present a case of a 34-year-old, 28-week-pregnant woman who was admitted to the emergency department with multiple traumas due to IPV. Her husband had hit her with a power cable after abusing methamphetamine. There were multiple ecchymoses and lacerations on her body. On questioning, the patient revealed a low socioeconomic status. The couple had been married for five years, and the abuse began 11 months earlier, after the husband became addicted to methamphetamines. In this instance of abuse, the husband was suspicious of the wife's pregnancy and believed that the child had been fathered by another man. Her husband's methamphetamine abuse had resulted in previous incidences of non-physical IPV, but, in the present incident, the combination of abuse coupled with partner jealousy resulted in physical abuse. During admission, there were no significant changes to the patient's health, and the fetus was deemed to be healthy and unharmed. After discharge, the patient decided to divorce her abusive husband. Screening and counseling for interpersonal and domestic violence is especially recommended during pregnancy to protect the mother and her fetus. In Iranian civil law, IPV is regarded as "osr-o-haraj" or severe and intolerable hardship, and women may cite it as grounds for divorce in cases such as spousal drug addiction and certain forms of spousal abuse. When intimate partner assault is repeated and petition for khula is presented to the courts, the court can order the man to divorce his wife and, if he refuses, the court judge can grant the khula without the husband's consent.

  18. An Experimental Study of Implicit Racial Bias in Recognition of Child Abuse.

    PubMed

    Rojas, Mary; Walker-Descartes, Ingrid; Laraque-Arena, Danielle

    2017-05-01

    We evaluated whether implicit racial bias influences pediatricians' suspicion of child abuse. Child abuse experts developed 9 injury vignettes. Pediatricians (N = 342) were randomly assigned one of 2 versions to rate for suspicion of abuse, with the child's race in each vignette varying between white and black. Data were collected online and anonymously. There were no statistically significant differences in suspicion for an abuse-related injury based on the race of the child. We adjusted for pediatrician race/ethnicity, years since graduation, location, and gender and did not find race effects. We demonstrated an experimental approach to study the influence of implicit racial bias on recognition of child abuse. Though we failed to find an effect, it is too early to conclude that none exists. The relationship among human cognition, behavior, and healthcare disparities is complex. Studies are needed that incorporate diverse approaches, clinical contexts and scenarios, patient and physician characteristics, and validated measures if we are to understand how it might be used to reduce healthcare disparities.

  19. A prospective investigation of borderline personality disorder in abused and neglected children followed up into adulthood.

    PubMed

    Widom, Cathy Spatz; Czaja, Sally J; Paris, Joel

    2009-10-01

    Child abuse has been implicated as a risk factor for borderline personality disorder (BPD), yet few prospective longitudinal studies exist. The current study examined whether 500 individuals with documented cases of childhood physical and sexual abuse and neglect were at elevated risk of BPD in adulthood, compared to 396 demographically similar control children. Results indicated that significantly more abused and/or neglected children overall met criteria for BPD as adults, compared to controls, as did physically abused and neglected children. Having a parent with alcohol/drug problems and not being employed full-time, not being a high school graduate, and having a diagnosis of drug abuse, major depressive disorder, and posttraumatic stress disorder were predictors of BPD and mediated the relationship between childhood abuse/neglect and adult BPD. These results call attention to a heightened risk of BPD in physically abused and neglected children and the need to consider multiple pathways to BPD.

  20. Elder physical abuse.

    PubMed

    Young, Lisa M

    2014-11-01

    Physical abuse of the elderly is a significant public health concern. The true prevalence of all types is unknown, and under-reporting is known to be significant. The geriatric population is projected to increase dramatically over the next 10 years, and the number of abused individuals is projected to increase also. It is critical that health care providers feel competent in addressing physical elder abuse. This article presents cases illustrating the variety of presenting symptoms that may be attributed to physical elder abuse. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Role of the laboratory in the evaluation of suspected drug abuse.

    PubMed

    Gold, M S; Dackis, C A

    1986-01-01

    Despite the high incidence of substance abuse, it remains a common cause of misdiagnosis. In patients who have abused or who are currently abusing drugs, symptoms of a psychiatric illness may be mimicked by either the drug's presence or absence. The laboratory can aid in making a differential diagnosis and eliminating drugs from active consideration as a cause of psychosis, depression, mania, and personality changes. Treatment planning and prevention of serious medical consequences often rest on the accuracy of the admission drug screen. Testing is widely used to assess improvement in substance abuse in both inpatient and outpatient settings. In occupational settings, testing has been used as an early indicator that a problem exists and as a successful prevention tool. The appropriate use of analytic technology in drug abuse testing requires an understanding of available test methodologies. These include drug screens by thin-layer chromatography, comprehensive testing using enzyme immunoassay, and computer-assisted gas chromatography-mass spectrometry (GC-MS). Testing for specific drugs considered likely causes or precipitants of "psychiatric" complaints is available with enzyme assays, radioimmunoassay, or definitive forensic-quality testing using GC-MS.

  2. Oxford House: Deaf-Affirmative Support for Substance Abuse Recovery

    ERIC Educational Resources Information Center

    Alvarez, Josefina; Adebanjo, Aderonke M.; Davidson, Michelle K.; Jason, Leonard A.; Davis, Margaret I.

    2006-01-01

    Deaf individuals seeking substance abuse recovery are less likely to have access to treatment and aftercare services because of a lack of culturally and linguistically specific programs and insufficient information about existing services. Previous research indicates that Oxford House, a network of resident-run recovery homes, serves a diverse…

  3. Child Abuse: Growth Failure, IQ Deficit, and Learning Disability.

    ERIC Educational Resources Information Center

    Money, John

    1982-01-01

    The author reviews research on early deprivation and neglect and recounts his own experience with children whose dwarfism is attributed to abuse or neglect. The existence of specific learning disability and diminished IQ in many of these children is cited. The author suggests further attention to the problem. (CL)

  4. Prevention of Methamphetamine Abuse: Can Existing Evidence Inform Community Prevention?

    ERIC Educational Resources Information Center

    Birckmayer, Johanna; Fisher, Deborah A.; Holder, Harold D.; Yacoubian, George S.

    2008-01-01

    Little research exists on effective strategies to prevent methamphetamine production, distribution, sales, use, and harm. As a result, prevention practitioners (especially at the local level) have little guidance in selecting potentially effective strategies. This article presents a general causal model of methamphetamine use and harms that…

  5. Establishing "abuse-deterrence equivalence" for generic abuse-deterrent opioid formulations: A proposed development framework.

    PubMed

    Setnik, Beatrice; Cone, Edward J

    2016-01-01

    Abuse-deterrent formulations are one strategy for mitigating the epidemic of prescription opioid abuse. Regulatory guidance documents describe the requirements for developing abuse-deterrent formulations of novel drugs and formulations; however, they do not address "abuse-deterrence equivalence" for generic formulations. As generics may be produced with different excipients and formulations compared to reference drugs, differences in their properties may impact their abuse-deterrent features. Currently, it is unclear what specific studies are needed to support generic abuse-deterrence claims. This commentary outlines several recommendations on the in vitro and in vivo testing required, including the conditions for conducting a human abuse potential study.

  6. Measuring Economic Abuse in the Lives of Survivors: Revising the Scale of Economic Abuse.

    PubMed

    Postmus, Judy L; Plummer, Sara-Beth; Stylianou, Amanda M

    2016-05-01

    Recent attention has been given by researchers to understanding how abusers use economic abuse strategies. Unfortunately, limited measures are available to accurately understand the prevalence of economic abuse in the lives of survivors. Recently, researchers created the 28-item Scale of Economic Abuse (SEA) but further validation is needed. This article describes the psychometric evaluation of the SEA through confirmatory and exploratory factor analyses using data collected with 120 survivors of abuse. The findings provide evidence for the reliability and validity of the SEA-12 as a shorter instrument to measure economic abuse as a distinct form of abuse. © The Author(s) 2015.

  7. Comparative study on perceived abuse and social neglect among rural and urban geriatric population

    PubMed Central

    Kaur, Jaspreet; Kaur, Jasbir; Sujata, N.

    2015-01-01

    Context: Elder abuse and social neglect are unrecognized problem. Many forms of elder abuse exist including physical, psychological, financial, sexual and social neglect. Social neglect is experienced by elderly through loss of friends and family members. Aim: Comparison of perceived abuse and social neglect among elderly residing in selected rural and urban areas. Settings and Design: Study setting was a rural area Pohir and urban area Jamalpur of district Ludhiana. Subjects and Methods: A sample of 200 subjects (100 subjects each from rural and urban area respectively) of age 60 years and above was drawn by cluster sampling technique and interview method was used to collect data by using Likert scale. Statistical Analysis: Descriptive and inferential statistics were carried out with SPSS package. Results: Results of the present study revealed that perceived physical abuse (25%) was higher among elderly residing in rural and it was found significantly higher among female elderly who were illiterate, widow/widower and partially dependent on caregiver whereas perceived psychological abuse (71%), financial abuse (37%) and social neglect (74%) were higher among elderly residing in urban. A significant association was found between psychological abuse and educational status, which inferred that as the level of education increases perception of psychological abuse also increases. The perceived financial abuse was significantly higher among male elderly who were financially independent. Conclusion: It was concluded that social neglect was most common, followed by psychological abuse and financial abuse among elderly residing in urban whereas physical abuse was more prevalent among elderly residing in rural. PMID:26816425

  8. Pediatric mental health emergencies in the emergency medical services system. American College of Emergency Physicians.

    PubMed

    Dolan, Margaret A; Mace, Sharon E

    2006-10-01

    Emergency departments (EDs) are vital in the management of pediatric patients with mental health emergencies (MHE). Pediatric MHE are an increasing part of emergency medical practice because EDs have become the safety net for a fragmented mental health infrastructure which is experiencing critical shortages in services in all sectors. EDs must safely, humanely, and in a culturally and developmentally appropriate manner manage pediatric patients with undiagnosed and known mental illnesses including those with mental retardation, autistic spectrum disorders, attention deficit hyperactivity disorder (ADHD), and those experiencing a behavioral crisis. EDs also manage patients with suicidal ideation, depression, escalating aggression, substance abuse, post traumatic stress disorder, maltreatment, and those exposed to violence and unexpected deaths. EDs must address not only the physical but also the mental health needs of patients during and after mass casualty incidents and disasters. The American Academy of Pediatrics and the American College of Emergency Physicians support the following actions: advocacy for increased mental health resources, including improved pediatric mental health tools for the ED, increased mental health insurance coverage, adequate reimbursement at all levels; acknowledgment of the importance of the child's medical home, and promotion of education and research for mental health emergencies.

  9. Adolescent relationship abuse and reproductive and sexual coercion among teens.

    PubMed

    Miller, Elizabeth; McCauley, Heather L

    2013-10-01

    Adolescent relationship abuse (ARA) involves a range of coercive and violent behaviours in romantic or consensual relationships. ARA is prevalent and is associated with multiple poor reproductive and sexual health outcomes, especially for adolescent girls. Recent studies and reviews of ARA research point to the prevalence of ARA, health consequences of ARA and the contribution of social and cultural norms to ARA perpetration, all of which can inform how to address ARA more effectively with adolescents. Emerging research on reproductive and sexual coercion among adolescents and technology-based abuse is directly relevant to the reproductive and sexual healthcare of adolescents. Current findings underscore the extent to which young, reproductive-aged women may particularly benefit from more effective methods to address ARA. In line with recent American Congress of Obstetricians and Gynecologists recommendations, clinicians should assess for and counsel their adolescent female patients about how ARA and reproductive and sexual coercion may influence adolescent girls' reproductive health. Recent evidence also highlights that ARA manifests in ways that may be less recognizable to clinicians, such as cyber dating abuse. Finally, ARA prevention and intervention efforts should continue to promote gender equity and address the social and cultural norms that shape adolescent girls' experiences of abuse.

  10. Development of a Child Abuse Checklist to Evaluate Prehospital Provider Performance.

    PubMed

    Alphonso, Aimee; Auerbach, Marc; Bechtel, Kirsten; Bilodeau, Kyle; Gawel, Marcie; Koziel, Jeannette; Whitfill, Travis; Tiyyagura, Gunjan Kamdar

    2017-01-01

    To develop and provide validity evidence for a performance checklist to evaluate the child abuse screening behaviors of prehospital providers. Checklist Development: We developed the first iteration of the checklist after review of the relevant literature and on the basis of the authors' clinical experience. Next, a panel of six content experts participated in three rounds of Delphi review to reach consensus on the final checklist items. Checklist Validation: Twenty-eight emergency medical services (EMS) providers (16 EMT-Basics, 12 EMT-Paramedics) participated in a standardized simulated case of physical child abuse to an infant followed by one-on-one semi-structured qualitative interviews. Three reviewers scored the videotaped performance using the final checklist. Light's kappa and Cronbach's alpha were calculated to assess inter-rater reliability (IRR) and internal consistency, respectively. The correlation of successful child abuse screening with checklist task completion and with participant characteristics were compared using Pearson's chi squared test to gather evidence for construct validity. The Delphi review process resulted in a final checklist that included 24 items classified with trichotomous scoring (done, not done, or not applicable). The overall IRR of the three raters was 0.70 using Light's kappa, indicating substantial agreement. Internal consistency of the checklist was low, with an overall Cronbach's alpha of 0.61. Of 28 participants, only 14 (50%) successfully screened for child abuse in simulation. Participants who successfully screened for child abuse did not differ significantly from those who failed to screen in terms of training level, past experience with child abuse reporting, or self-reported confidence in detecting child abuse (all p > 0.30). Of all 24 tasks, only the task of exposing the infant significantly correlated with successful detection of child abuse (p < 0.05). We developed a child abuse checklist that demonstrated strong

  11. Parent Abuse: A Review

    ERIC Educational Resources Information Center

    Kennair, Nicola; Mellor, David

    2007-01-01

    A recent focus of research and clinical practice has been on the issue of abuse of parents by their children (parent abuse). This paper reviews the literature on this phenomenon. While parent abuse falls under the umbrella of family violence, it appears to be qualitatively different from other forms of intra-family abuse. Research has primarily…

  12. The Abuse-Related Beliefs Questionnaire for Survivors of Childhood Sexual Abuse

    ERIC Educational Resources Information Center

    Ginzburg, Karni; Arnow, Bruce; Hart, Stacey; Gardner, William; Koopman, Cheryl; Classen, Catherine C.; Giese-Davis, Janine; Spiegel, David

    2006-01-01

    Objective: To evaluate the psychometric properties of a new measure, the Abuse-Related Beliefs Questionnaire (ARBQ), designed to assess abuse-related beliefs among adult survivors of childhood sexual abuse (CSA). Study 1 examined the structure of the scale, and Study 2 evaluated its reliability and validity. Method: One hundred and seventy female…

  13. Physical abuse, smoking, and substance use during pregnancy: prevalence, interrelationships, and effects on birth weight.

    PubMed

    McFarlane, J; Parker, B; Soeken, K

    1996-05-01

    To establish the singular and combined occurrence of physical abuse, smoking, and substance use (i.e., alcohol and illicit drugs) during pregnancy and its effect on birth weight. Prospective cohort analysis. Urban public prenatal clinics. 414 African American, 412 Hispanic, and 377 white pregnant women. Occurrence of physical abuse was 16%; smoking, 29.5%; and alcohol/illicit drug use, 11.9%. Significant relationships existed between physical abuse and smoking for African American and white women. For African American women, 33.7% of women who were not abused smoked, versus 49.5% of women who were abused (chi 2 = 8.21; df = 1; p < 0.005). Alcohol/illicit drug use was 20.8% for nonabused women compared with 42.1% for abused women (chi 2 = 18.18; df = 1; p < 0.001). For white women, 46.6% of women who were not abused smoked, versus 59.6% of those who were abused (chi 2 = 5.22; df = 1; p < 0.005). As a triad, physical abuse, smoking, and alcohol/ illicit drug use were significantly related to birth weight (F[3, 1040] = 30.19, p < 0.001). Physical abuse during pregnancy is common, readily detected with a five-question screen, and associated with significantly higher use of tobacco, alcohol, and illicit drugs. Clinical protocols that integrate assessment and intervention for physical abuse, smoking, and substance use are essential for preventing further abuse and improving smoking and substance cessation rates.

  14. [An AIDS-related cognitive map in a sample of drug abusers in Buenos Aires City].

    PubMed

    Kornblit, A L; Bilyk, A

    1990-01-01

    This paper is an approach to AIDS as a topic among a drug abusers sample of the city of Buenos Aires. Research was carried out on the basis of a qualitative methodology. In an attempt at surveying opinions and attitudes of such a sample as regards AIDS (i.e. subjects' cognitive map), 21 drug abusers from three different rehabilitation programs operating in the B.A. area were interviewed. On the basis of the research performed, the authors elaborate communication strategies among drug abusers that would be helpful for authorities engaged in AIDS prevention to adopt. To boost a strategy likely to break up the AIDS-drug association existing in the mind of many an abuser would be highly advisable so that a separation be settled between both representations, thus giving drug abusers a higher motivation for self-care practice.

  15. Disgusted by Sexual Abuse: Exploring the Association Between Disgust Sensitivity and Posttraumatic Stress Symptoms Among Mothers of Sexually Abused Children.

    PubMed

    van Delft, Ivanka; Finkenauer, Catrin; Tybur, Joshua M; Lamers-Winkelman, Francien

    2016-06-01

    Nonoffending mothers of sexually abused children often exhibit high levels of posttraumatic stress (PTS) symptoms. Emerging evidence suggests that trait-like individual differences in sensitivity to disgust play a role in the development of PTS symptoms. One such individual difference, disgust sensitivity, has not been examined as far as we are aware among victims of secondary traumatic stress. The current study examined associations between disgust sensitivity and PTS symptoms among mothers of sexually abused children (N = 72). Mothers completed the Impact of Event Scale-Revised and the Three Domain Disgust Scale (Tybur, Lieberman, & Griskevicius, 2009). More than one third of mothers scored above a suggested cutoff (mean score = 1.5) for high levels of PTS symptoms. Hierarchical linear regression analysis results indicated that sexual disgust sensitivity (β = .39, p = .002) was associated with PTS symptoms (R(2) = .18). An interaction analysis showed that sexual disgust sensitivity was associated with maternal PTS symptoms only when the perpetrator was not biologically related to the child (β = -.32, p = .047; R(2) = .28). Our findings suggested that sexual disgust sensitivity may be a risk factor for developing PTS symptoms among mothers of sexually abused children. Copyright © 2016 International Society for Traumatic Stress Studies.

  16. Neglected child with substance abuse leading to child abuse: a case report.

    PubMed

    Subramanian, E M G; Subhagya, B; Muthu, M S; Sivakumar, N

    2005-06-01

    Child abuse and neglect is any interaction or lack of interaction between a caregiver and a child resulting in nonaccidental harm to the child's physical and developmental state. Substance abuse is ingestion of any drug, which is capable of altering the mental functioning eventually leading to addiction. This paper presents a case report of a 12-year-old neglected girl with substance abuse for which she was physically abused by her mother.

  17. A review of existing and emerging digital technologies to combat the global trade in fake medicines.

    PubMed

    Mackey, Tim K; Nayyar, Gaurvika

    2017-05-01

    The globalization of the pharmaceutical supply chain has introduced new challenges, chief among them, fighting the international criminal trade in fake medicines. As the manufacture, supply, and distribution of drugs becomes more complex, so does the need for innovative technology-based solutions to protect patients globally. Areas covered: We conducted a multidisciplinary review of the science/health, information technology, computer science, and general academic literature with the aim of identifying cutting-edge existing and emerging 'digital' solutions to combat fake medicines. Our review identified five distinct categories of technology including mobile, radio frequency identification, advanced computational methods, online verification, and blockchain technology. Expert opinion: Digital fake medicine solutions are unifying platforms that integrate different types of anti-counterfeiting technologies as complementary solutions, improve information sharing and data collection, and are designed to overcome existing barriers of adoption and implementation. Investment in this next generation technology is essential to ensure the future security and integrity of the global drug supply chain.

  18. Development and preliminary validation of a leadership competency instrument for existing and emerging allied health professional leaders.

    PubMed

    Ang, Hui-Gek; Koh, Jeremy Meng-Yeow; Lee, Jeffrey; Pua, Yong-Hao

    2016-02-19

    No instruments, to our knowledge, exist to assess leadership competency in existing and emerging allied health professional (AHP) leaders. This paper describes the development and preliminary exploration of the psychometric properties of a leadership competency instrument for existing and emerging AHP leaders and examines (i) its factor structure, (ii) its convergent validity with the Leadership Practices Inventory (LPI), and (iii) its discriminative validity in AHPs with different grades. During development, we included 25 items in the AHEAD (Aspiring leaders in Healthcare-Empowering individuals, Achieving excellence, Developing talents) instrument. A cross-sectional study was then conducted in 106 high-potential AHPs from Singapore General Hospital (34 men and 72 women) of different professional grades (49 principal-grade AHPs, 41 senior-grade AHPs, and 16 junior-grade AHPs) who completed both AHEAD and LPI instruments. Exploratory factor analysis was used to test the theoretical structure of AHEAD. Spearman correlation analysis was performed to evaluate the convergent validity of AHEAD with LPI. Using proportional odds regression models, we evaluated the association of grades of AHPs with AHEAD and LPI. To assess discriminative validity, the c-statistics - a measure of discrimination - were derived from these ordinal models. As theorized, factor analysis suggested a two-factor solution, where "skills" and "values" formed separate factors. Internal consistency of AHEAD was excellent (α-values > 0.88). Total and component AHEAD and LPI scores correlated moderately (Spearman ρ-values, 0.37 to 0.58). The c-index for discriminating between AHP grades was higher for AHEAD than for the LPI (0.76 vs. 0.65). The factorial structure of AHEAD was generally supported in our study. AHEAD showed convergent validity with the LPI and outperformed the LPI in terms of discriminative validity. These results provide initial evidence for the use of AHEAD to assess leadership

  19. Racial Differences in Treatment Effect among Men in a Substance Abuse and Domestic Violence Program

    PubMed Central

    Scott, Melanie C.; Easton, Caroline J.

    2013-01-01

    Background It isunclear whether racial differences in treatment effect exist for individuals in substance abuse and domestic violence programs. Objectives This study examined racial differences in treatment effect among substance dependent Caucasian and African-American male intimate partner violence (IPV) offenders court mandated to an integrated substance abuse and domestic violence treatment. Methods From baseline to completion of treatment (week 12), 75 participants (39 Caucasian; 36 African-American) were assessed on demographics, substance use, legal characteristics, and use of violence (physical, verbal, and psychological). Results African-American men served more months incarcerated in their life than Caucasian men. Both groups showed decreases in their use of physical violence and alcohol abuse over treatment. Caucasian men also showed a decrease in their use of verbal abuse. Conclusions and Scientific Significance At treatment completion, both groups showed a reduction in physical abuse and alcohol abuse. Caucasian men showed a reduction in their use of verbal abuse, but African-American men did not. Substance dependent African-American male IPV offenders may benefit from interventions that thoroughly target communication skills in addition to issues of substance abuse and IPV to reduce use of verbal abuse and improve treatment outcomes among African American men. PMID:20936990

  20. The CAT: A Gender-Inclusive Measure of Controlling and Abusive Tactics.

    PubMed

    Hamel, John; Jones, Daniel N; Dutton, Donald G; Graham-Kevan, Nicola

    2015-01-01

    Research has consistently found that partner violence, defined as physical abuse between married, cohabitating, or dating partners, is not the only type of abuse with long-term deleterious effects on victims. Male and female victims alike report that emotional abuse, along with controlling behaviors, are often as or more traumatic. Existing instruments used to measure emotional abuse and control have either been limited to male-perpetrated behaviors, as conceived in the well-known Duluth "Power and Control" wheel, or field tested on dating or general population samples. This study discusses the genesis and evolution of a gender-inclusive instrument, the Controlling and Abusive Tactics (CAT) Questionnaire, which was field tested on males and females with both a clinical and general population sample. For perpetration, a preliminary comparison across gender found no significant differences across gender for the great majority of items, with women reporting significantly higher rates on 9 items, and men reporting significantly higher rates on 6 items. Women reported higher rates of received abuse than men on 28 of 30 items in which gender differences were found to be significant, but both males and females reported higher victimization than perpetration rates on all items. Exploratory and confirmatory factor analyses resulted in the CAT-2, a valid and reliable instrument appropriate for clinical use by treatment providers as well as for research purposes.

  1. Abuse and neglect of American Indian children: findings from a survey of federal providers.

    PubMed

    Piasecki, J M; Manson, S M; Biernoff, M P; Hiat, A B; Taylor, S S; Bechtold, D W

    1989-01-01

    Child abuse and neglect is of growing concern in many American Indian and Alaska Native communities. The present paper represents one attempt to add to the existing, albeit sparse, knowledge base concerning the abuse and neglect of American Indian children. It reports the results of a survey of federal human service providers in which the subject of child abuse and neglect in Indian communities figured prominently. The study took place at several locations in Arizona and New Mexico. Data were obtained using the key-informant method from 55 federal service providers who identified 1,155 children, from birth to 21 years for inclusion in the survey. Children were included if they were currently in mental health treatment, if they were in need of mental health treatment, or if they were known to have been abused or neglected. Particular emphasis was given in the data collection to abuse- and neglect-related factors such as living arrangements, familial disruption, psychiatric symptoms, substance abuse, and school adjustment. The patterns evident in this sample closely resemble those trends identified among abused and/or neglected children in the general population. Sixty-seven percent of the sample was described as neglected or abused. The presence of abuse and/or neglect was strongly related to severe levels of chaos in the family. Children who were described as both abused and neglected had more psychiatric symptoms, greater frequency of having run away or been expelled, and greater frequency of drug use.

  2. 44 CFR 16.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...: Existing facilities. 16.150 Section 16.150 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT... accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the... facilities accessible to and usable by individuals with handicaps; (2) In the case of historic preservation...

  3. Impact of traumatic events on posttraumatic stress disorder among Danish survivors of sexual abuse in childhood.

    PubMed

    Elklit, Ask; Christiansen, Dorte M; Palic, Sabina; Karsberg, Sidsel; Eriksen, Sara Bek

    2014-01-01

    Childhood sexual abuse can be extremely traumatic and lead to lifelong symptomatology. The present study examined the impact of several demographic, abuse, and psychosocial variables on posttraumatic stress disorder severity among a consecutive sample of treatment-seeking, adult child sexual abuse survivors (N = 480). The child sexual abuse sample was characterized by severe trauma exposure, insecure attachment, and significant traumatization, with an estimated 77% suffering from posttraumatic stress disorder, more than twice the level of the comparison group. Regression analyses revealed risk factors associated with the development of posttraumatic stress disorder in which the strongest predictors being additional traumas, negative affectivity, and somatization. The findings add to existing research confirming the stressful nature of child sexual abuse and the variables that contribute to the development and severity of posttraumatic stress disorder.

  4. Comorbid depression and substance abuse among safety-net clients in Los Angeles: a community participatory study.

    PubMed

    Chang, Evelyn T; Wells, Kenneth B; Gilmore, James; Tang, Lingqi; Morgan, Anna U; Sanders, Starr; Chung, Bowen

    2015-03-01

    Depression and substance abuse are common among low-income adults from racial-ethnic minority groups who receive services in safety-net settings, although little is known about how clients differ by service setting. This study examined characteristics and service use among depressed, low-income persons from minority groups in underresourced communities who did and did not have a substance abuse history. The study used cross-sectional baseline client data (N=957) from Community Partners in Care, an initiative to improve depression services in Los Angeles County. Clients with probable depression (eight-item Patient Health Questionnaire) from substance abuse programs were compared with depressed clients with and without a history of substance abuse from primary care, mental health, and social and community programs. Sociodemographic, health status, and services utilization variables were examined. Of the 957 depressed clients, 217 (23%) were from substance abuse programs; 269 (28%) clients from other sectors had a substance abuse history, and 471 (49%) did not. Most clients from substance abuse programs or with a substance abuse history were unemployed and impoverished, lacked health insurance, and had high rates of arrests and homelessness. They were also more likely than clients without a substance abuse history to have depression or anxiety disorders, psychosis, and mania and to use emergency rooms. Clients with depression and a substance abuse history had significant psychosocial stressors and high rates of service use, which suggests that communitywide approaches may be needed to address both depression and substance abuse in this safety-net population.

  5. The Forced Marriage of Minors: A Neglected Form of Child Abuse.

    PubMed

    Kopelman, Loretta M

    2016-03-01

    The forced marriage of minors is child abuse, consequently duties exist to stop them. Yet over 14 million forced marriages of minors occur annually in developing countries. The American Bar Association (ABA) concludes that the problem in the US is significant, widespread but largely ignored, and that few US laws protect minors from forced marriages. Although their best chance of rescue often involves visits to health care providers, US providers show little awareness of this growing problem. Strategies discussed to stop forced marriages include recommendations from the UN, the ABA, and the UK. The author anticipates and responds to criticisms that first, no duty to intervene exists without better laws and practice guidelines; and second, that such marriages are not child abuse in traditions where parental rights or familism allegedly justify them. © 2016 American Society of Law, Medicine & Ethics.

  6. La Mancha Negra: Substance Abuse, Violence, and Sexual Risks Among Hispanic Males

    PubMed Central

    Gonzalez-Guarda, Rosa Maria; Ortega, Johis; Vasquez, Elias P.; De Santis, Joseph

    2011-01-01

    Hispanics are disproportionately affected by substance abuse, intimate partner violence, and HIV. Although the relationship between these conditions has been documented in the literature, few studies have explored the intersection of these health problems and their culture-related risk factors in an integrative manner. The purpose of this study is to explore the experiences that Hispanic heterosexual males in South Florida have with substance abuse, violence, and risky sexual behaviors. Three focus groups with a total of 25 Hispanic adult men are completed and analyzed using grounded theory. Three core categories emerge from the data. These include la cuna de problemas sociales (the cradle of social problems), ramas de una sola mata (branches from one same tree), and la mancha negra (the black stain). This study suggests that substance abuse, violence, and risky sexual behaviors are linked conditions with common cultural and socioenvironmental risk factors and consequences. PMID:19915207

  7. Stress management for adult survivors of childhood sexual abuse: a holistic inquiry.

    PubMed

    Wilson, Debra Rose

    2010-02-01

    Among the many sequelae of childhood sexual abuse is a maladaptive response to stress. Stress has been linked to a reduction in the immune system's ability to resist disease. The purpose of this exploratory mixed-method study is to examine the experience of stress management training for 35 adult survivors of childhood sexual abuse. Data gathered for analysis include pre- and postintervention saliva samples for sIgA, Ways of Coping Questionnaire, and a postintervention qualitative interview. Stress management strategies enhance immunity (increase in salivary immunoglobulin A, p < .05) and coping (less distancing, p < .001; less escape-avoidance, p < .001; more planful problem solving, p < .01; and more positive reappraisal, p < .001). Grounded theory analysis finds three themes emerging: hypervigilance , an outward-focused hyperawareness; somatic detachment, a lack of inward focus on self; and healing pathway, the process of healing from the abuse. Healing is possible.

  8. National Analysis of Differences among Substance Abuse Treatment Outcomes: College Student and Nonstudent Emerging Adults

    ERIC Educational Resources Information Center

    Sahker, Ethan; Acion, Laura; Arndt, Stephan

    2015-01-01

    Objective: To discover differences between student and nonstudent substance abuse treatment demographics, treatment characteristics, and outcomes. Participants: Conducted February 2014, clients without prior treatment admissions, aged 18-24, not in methadone maintenance therapy, and in nonintensive and ambulatory intensive outpatient treatment…

  9. Substance abuse prevention intervention research with Hispanic populations.

    PubMed

    Castro, Felipe González; Barrera, Manuel; Pantin, Hilda; Martinez, Charles; Felix-Ortiz, Maria; Rios, Rebeca; Lopez, Vera A; Lopez, Cristy

    2006-09-01

    Selected studies with specific relevance to substance abuse prevention interventions with Hispanic youth and families were examined to identify prior findings and emerging issues that may guide the design of future substance abuse prevention intervention research and its implementation with Hispanic populations. The origins of prevention research and role of risk and protective factors are examined, including culturally-specific risk and protective factors for Hispanic populations. Correlational studies, non-experimental interventions, and randomized controlled trials were examined for the period of 1974-2003. The literature search yielded 15 articles selected for this review that exhibited adequate methodological rigor. An added search for more recent studies identified three additional articles, for a total of 18 prevention intervention articles that were reviewed. Theoretical and methodological issues and recommendations are presented for future research aimed at improving the efficacy and effectiveness of future prevention intervention studies and their cultural relevance for Hispanic populations.

  10. Abortive Spontaneous Egg Activation: An Emerging Biological Threat for the Existence of Mammals.

    PubMed

    Prasad, Shilpa; Tiwari, Meenakshi; Chaube, Shail K

    2017-06-01

    Mammals are important for balancing the natural ecosystem, but in the past few decades, several species have rapidly been entered under threatened category worldwide. The environmental changes, loss of natural habitats, human activities, and thereby stress are responsible for a gradual decline in reproductive outcome. Stress induces generation of reactive oxygen species (ROS). High physiological level of ROS drives abortive spontaneous egg activation (SEA), while beyond the physiological level causes oxidative stress (OS). The OS induces apoptosis and deteriorates egg quality that limits reproductive outcome. The reduced reproductive outcome is one of the major causes for gradual decline in population size of several mammalian species. Despite having several conservation programs, a gradual decline in species reproductive outcome and their population size is the serious concern for the existence of threatened mammalian species. Thus, it is important to identify and prevent the underlying causes responsible for abortive SEA, which could be an emerging problem for several mammalian species that are threatened or at the verge of extinction.

  11. A systematic review of randomized controlled trials of interventions designed to decrease child abuse in high-risk families

    PubMed Central

    Levey, Elizabeth J.; Gelaye, Bizu; Bain, Paul; Rondon, Marta B.; Borba, Christina P.C.; Henderson, David C.; Williams, Michelle A.

    2017-01-01

    Child abuse is a global problem, and parents with histories of childhood abuse are at increased risk of abusing their offspring. The objective of this systematic review is to provide a clear overview of the existing literature of randomized controlled trials evaluating the effectiveness of interventions to prevent child abuse. PubMed, PsychINFO, Web of Science, Sociological Abstracts, and CINAHL were systematically searched and expanded by hand search. This review includes all randomized controlled trials (RCTs) of interventions designed to prevent abuse among mothers identified as high-risk. Of the eight studies identified, only three found statistically significant reductions in abuse by any measure, and only two found reductions in incidents reported to child protective services. While much has been written about child abuse in high-risk families, few RCTs have been performed. Only home visitation has a significant evidence base for reducing child abuse, and the findings vary considerably. Also, data from low- and middle-income countries are limited. PMID:28110205

  12. Substance abuse intervention for health care workers: a preliminary report.

    PubMed

    Lapham, S C; Chang, I; Gregory, C

    2000-05-01

    The Workplace Managed Care Cooperative Agreement project targets 3,300 health care professionals in hospital, specialty clinic, and primary care settings located in metropolitan New Mexico communities. This project will evaluate whether enhancements to existing substance abuse prevention/early intervention programs can prevent the onset of risky drinking, reduce prevalence of risky drinking, better identify employees who abuse alcohol and drugs, and improve employee wellness. This article describes one such enhancement (Project WISE [Workplace Initiative in Substance Education]), implemented at Lovelace Health Systems. Project WISE includes relatively low-cost elements such as substance abuse awareness training, information on how to reduce drinking, and brief motivational counseling. Evaluation will consist of baseline comparisons of the intervention and comparison sites, a process evaluation, a qualitative analysis using focus groups, and an outcome evaluation using health and work records. Methodological challenges, solutions, and implications for researchers undertaking similar projects are presented.

  13. The Prevalence of Bruising Among Infants in Pediatric Emergency Departments

    PubMed Central

    Pierce, Mary Clyde; Magana, Julia N.; Kaczor, Kim; Lorenz, Douglas J.; Meyers, Gabriel; Bennett, Berkeley L.; Kanegaye, John T.

    2015-01-01

    Objective Bruising can indicate abuse for infants. Bruise prevalence among infants in the Pediatric Emergency Department (PED) setting is unknown. Our objective was to determine prevalence of bruising, associated chief complaints (CC), and frequency of abuse evaluations in previously healthy infants presenting to PEDs. Methods We conducted a prospective, observational, multi-center study of infants ≤12 months old presenting to PEDs. Structured sampling was utilized. Pediatric Emergency Medicine (PEM) clinicians performed complete skin examinations to screen for bruising. Study investigators documented skin findings, date of visit, patient's age, CC, and abuse evaluation. The primary outcome was prevalence of bruising. Secondary outcomes were prevalence of bruising based on CC and frequency of abuse evaluation. Point estimates of bruise prevalence and differences in bruise prevalence between patient subgroups were calculated with 95% confidence intervals (CI). Results Bruising was identified in 88 of 2488 infants (3.5%, 95% CI: [2.9%, 4.4%]). Rates of bruising for infants ≤5 and >5 months old were 1.3% and 6.4%, respectively (difference 5.1%, 95% CI: [3.6%, 6.8%]). For infants ≤5 months old, 83% of bruising was associated with a trauma CC and only 0.2% of infants presenting with a medical CC had bruising. PEM clinicians obtained abuse evaluations on 23% of infants with bruising and that rate increased to 50% for infants ≤ 5 months of age. Conclusions Bruising prevalence in children ≤ 12 months of age evaluated in PEDs was low, increased within age strata, and was most often associated with a trauma CC. Most bruised infants did not undergo an abuse evaluation. PMID:26233923

  14. Adverse childhood events, substance abuse, and measures of affiliation.

    PubMed

    Zlotnick, Cheryl; Tam, Tammy; Robertson, Marjorie J

    2004-08-01

    Adverse childhood events may influence later behaviors, including adulthood substance use and social affiliation. Studies have noted high prevalence rates of adverse childhood experiences and adulthood substance abuse among homeless adults. Using an existing longitudinal, countywide probability sample of 397 homeless adults, we examine the relationships among adverse childhood events on adulthood substance use, and the relationship of these variables to affiliation. Almost 75% of the sample had experienced an adverse childhood event. Path analysis indicated adulthood substance abuse mediated the inverse relationship between adverse childhood events and two measures of adulthood affiliation. Thus, although there is a relationship between adverse childhood events and adulthood substance use, it is adulthood substance use that determines most aspects of affiliation.

  15. Wife Abuse and the Wife Abuser: Review and Recommendations.

    ERIC Educational Resources Information Center

    Carden, Ann D.

    1994-01-01

    Reviews clinical, theoretical, and empirical literature on wife abuse/abusers. Presents historical and contextual information, overview of domestic violence, prevalence data, and descriptions of evolution and current status of public and professional awareness and response. Proposes integrative model for understanding etiologic, dynamic, and…

  16. Examining Physical and Sexual Abuse Histories as Correlates of Suicide Risk Among Firefighters.

    PubMed

    Hom, Melanie A; Matheny, Natalie L; Stanley, Ian H; Rogers, Megan L; Cougle, Jesse R; Joiner, Thomas E

    2017-12-01

    Research indicates that physical and sexual abuse are associated with increased suicide risk; however, these associations have not been investigated among firefighters-an occupational group that has been shown to be at elevated suicide risk. This study examined whether physical and sexual abuse histories are associated with (a) career suicide ideation, plans, and attempts; and (b) current suicide risk (controlling for theoretically relevant symptoms) in this occupational group. A sample of 929 U.S. firefighters completed self-report surveys that assessed lifetime history of physical and sexual abuse; career suicide ideation, plans, and attempts; current suicide risk; and theoretically relevant symptoms. Logistic regression analyses revealed that individuals who reported a history of physical abuse were significantly more likely to report career suicide ideation, adjusted odds ratio [AOR] = 6.12, plans, AOR = 13.05, and attempts, AOR = 23.81, than those who did not. A similar pattern of findings emerged for individuals who reported a sexual abuse history, AORs = 7.83, 18.35, and 29.58 respectively. Linear regression analyses revealed that physical and sexual abuse histories each significantly predicted current suicide risk, even after controlling for theoretically relevant symptoms and demographics, pr 2 = .07 and .06, respectively. Firefighters with a history of physical and/or sexual abuse may be at increased risk for suicidal thoughts and behaviors. A history of physical and sexual abuse were each significantly correlated with current suicide risk in this population, even after accounting for the effects of theoretically relevant symptoms. Thus, when conceptualizing suicide risk among firefighters, factors not necessarily related to one's firefighter career should be considered. Copyright © 2017 International Society for Traumatic Stress Studies.

  17. Emotional Closeness with Perpetrators and Amnesia for Child Sexual Abuse

    ERIC Educational Resources Information Center

    Schultz, Tammy; Passmore, J. Lawrence; Yoder, C. Y.

    2003-01-01

    Over the past decade, a contentious debate regarding delayed memories of childhood sexual abuse (CSA) has existed. In order to address this debate, 240 female participants completed questions about CSA, the Dissociative Experience Scale (Bernstein & Putnam, 1986), Perceived Emotional Closeness with Perpetrator Scale (Schultz, Passmore, &…

  18. Fetal Abuse.

    ERIC Educational Resources Information Center

    Kent, Lindsey; And Others

    1997-01-01

    Five cases of fetal abuse by mothers suffering from depression are discussed. Four of the women had unplanned pregnancies and had considered termination of the pregnancy. Other factors associated with fetal abuse include pregnancy denial, pregnancy ambivalence, previous postpartum depression, and difficulties in relationships. Vigilance for…

  19. Pharmacy waste, fraud, and abuse in health care reform.

    PubMed

    Carpenter, Laura A; Edgar, Zachary; Dang, Christopher

    2011-01-01

    To describe the new Medicare and Medicaid waste, fraud, and abuse provisions of the Affordable Care Act (H. R. 3590) and Health Care and Education Affordability Reconciliation Act of 2010 (H. R. 4872), the preexisting law modified by H. R. 3590 and H. R. 4872, and applicable existing and proposed regulations. Waste, fraud, and abuse are substantial threats to the efficiency of the health care system. To combat these activities, the Department of Health and Human Services and Centers for Medicare & Medicaid Services promulgate and enforce guidelines governing the proper assessment and billing for Medicare and Medicaid services. These guidelines have a number of provisions that can catch even well-intentioned providers off guard, resulting in substantial fines. H. R. 3590 and H. R. 4872 augment preexisting waste, fraud, and abuse laws and regulations. This article reviews the new waste, fraud, and abuse laws and regulations to apprise pharmacists of the substantial changes affecting their practice. H. R. 3590 and H. R. 4872 modify screening requirements for providers; modify liability and penalties for the antikickback statute, federal False Claims Act, remuneration, and Stark Law; and create or extend auditing and management programs. Properly navigating these changes will be important in keeping pharmacies in compliance.

  20. Hispanic Women’s Experiences With Substance Abuse, Intimate Partner Violence, and Risk for HIV

    PubMed Central

    Gonzalez-Guarda, Rosa Maria; Vasquez, Elias P.; Urrutia, Maria T.; Villarruel, Antonia M.; Peragallo, Nilda

    2011-01-01

    Hispanic females are disproportionately affected by substance abuse, intimate partner violence, and HIV. Despite these disparities, research describing the cultural and gender-specific experiences of Hispanic women with regard to these conditions is lacking. The purpose of this study is to describe the experiences that Hispanic community-dwelling women have with regard to substance abuse, violence, and risky sexual behaviors. Eight focus groups with 81 women were conducted. A bilingual, bicultural moderator asked women open-ended questions regarding the experiences that Hispanic women have with these conditions. Focus groups were audiotaped, transcribed, translated, verified, and then analyzed using qualitative content analysis. Participants discussed substance abuse, violence, and risky sexual behaviors interchangeably, often identifying common risk factors associated with these. Nevertheless, intimate partner violence was the most salient of conditions discussed. Three major themes emerged from the analysis: Transplantadas en otro mundo (Uprooted in another world), El criador de abuso (The breeding ground of abuse), and Rompiendo el silencio (Breaking the silence). This study supports the importance of addressing substance abuse, violence, and risk for HIV in an integrated manner and stresses the importance of addressing associated cultural factors (e.g., acculturation, machismo) in interventions targeting Hispanics. PMID:21191036

  1. Dextromethorphan Abuse in Adolescence

    PubMed Central

    Bryner, Jodi K.; Wang, Uerica K.; Hui, Jenny W.; Bedodo, Merilin; MacDougall, Conan; Anderson, Ilene B.

    2008-01-01

    Objectives To analyze the trend of dextromethorphan abuse in California and to compare these findings with national trends. Design A 6-year retrospective review. Setting California Poison Control System (CPCS), American Association of Poison Control Centers (AAPCC), and Drug Abuse Warning Network (DAWN) databases from January 1, 1999, to December 31, 2004. Participants All dextromethorphan abuse cases reported to the CPCS, AAPCC, and DAWN. The main exposures of dextromethorphan abuse cases included date of exposure, age, acute vs long-term use, coingestants, product formulation, and clinical outcome. Main Outcome Measure The annual proportion of dextromethorphan abuse cases among all exposures reported to the CPCS, AAPCC, and DAWN databases. Results A total of 1382 CPCS cases were included in the study. A 10-fold increase in CPCS dextromethorphan abuse cases from 1999 (0.23 cases per 1000 calls) to 2004 (2.15 cases per 1000 calls) (odds ratio, 1.48; 95% confidence interval, 1.43–1.54) was identified. Of all CPCS dextromethorphan abuse cases, 74.5% were aged 9 to 17 years; the frequency of cases among this age group increased more than 15-fold during the study (from 0.11 to 1.68 cases per 1000 calls). Similar trends were seen in the AAPCC and DAWN databases. The highest frequency of dextromethorphan abuse occurred among adolescents aged 15 and 16 years. The most commonly abused product was Coricidin HBP Cough & Cold Tablets. Conclusions Our study revealed an increasing trend of dextromethorphan abuse cases reported to the CPCS that is paralleled nationally as reported to the AAPCC and DAWN. This increase was most evident in the adolescent population. PMID:17146018

  2. 76 FR 3628 - Agency Information Collection Activities: Existing Collection; Emergency Extension

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-20

    ... Collection; Emergency Extension AGENCY: Equal Employment Opportunity Commission. ACTION: Notice of Information Collection--Emergency Extension Without Change: Local Union Report (EEO-3). SUMMARY: In accordance... Division, 131 M Street, NE., Room 4SW30F, Washington, DC 20507; (202) 663-4958 (voice) or (202) 663-7063...

  3. Abuse-deterrent formulations, an evolving technology against the abuse and misuse of opioid analgesics.

    PubMed

    Schaeffer, Tammi

    2012-12-01

    The increased use of opioid pain medication has been mirrored by the increased misuse and abuse of these drugs. As part of a multidisciplinary approach to this epidemic, pharmaceutical companies, with the encouragement of the Food and Drug Administration, have increased the development of abuse-deterrent formulations. While all have the goal of treating pain while mitigating misuse and abuse, there are different technologies utilized to impart the abuse-deterrent properties. The goal of this paper is to review the basis of abuse-deterrent formulations, the different types and approaches of some of the abuse-deterrent products, and their current regulatory status in the USA.

  4. Growing up with Parental Alcohol Abuse: Exposure to Childhood Abuse, Neglect, and Household Dysfunction.

    ERIC Educational Resources Information Center

    Dube, Shanta R.; Anda, Robert F.; Felitti, Vincent J.; Croft, Janet B.; Edwards, Valerie J.; Giles, Wayne H.

    2001-01-01

    A study involving 8,629 adults examined the association between parental alcohol abuse and child abuse, neglect, and other household dysfunction. Compared to households without alcohol abuse, the adjusted odds ratio for each category of adverse childhood experience was 2 to 13 times higher if parents abused alcohol. (Contains references.) (CR)

  5. 42 CFR 51d.4 - What information is required in the application?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.4 What information is...'s designee, that a mental health or substance abuse emergency exists, as well as a written statement..., the principal elected official, or such officer's or official's designee, that a mental health or...

  6. 42 CFR 51d.4 - What information is required in the application?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.4 What information is...'s designee, that a mental health or substance abuse emergency exists, as well as a written statement..., the principal elected official, or such officer's or official's designee, that a mental health or...

  7. 42 CFR 51d.4 - What information is required in the application?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.4 What information is...'s designee, that a mental health or substance abuse emergency exists, as well as a written statement..., the principal elected official, or such officer's or official's designee, that a mental health or...

  8. 42 CFR 51d.4 - What information is required in the application?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.4 What information is...'s designee, that a mental health or substance abuse emergency exists, as well as a written statement..., the principal elected official, or such officer's or official's designee, that a mental health or...

  9. 42 CFR 51d.4 - What information is required in the application?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... GRANTS MENTAL HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.4 What information is...'s designee, that a mental health or substance abuse emergency exists, as well as a written statement..., the principal elected official, or such officer's or official's designee, that a mental health or...

  10. Inhalant Abuse and Dextromethorphan.

    PubMed

    Storck, Michael; Black, Laura; Liddell, Morgan

    2016-07-01

    Inhalant abuse is the intentional inhalation of a volatile substance for the purpose of achieving an altered mental state. As an important, yet underrecognized form of substance abuse, inhalant abuse crosses all demographic, ethnic, and socioeconomic boundaries, causing significant morbidity and mortality in school-aged and older children. This review presents current perspectives on epidemiology, detection, and clinical challenges of inhalant abuse and offers advice regarding the medical and mental health providers' roles in the prevention and management of this substance abuse problem. Also discussed is the misuse of a specific "over-the-counter" dissociative, dextromethorphan. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Utilization of communication technology by patients enrolled in substance abuse treatment

    PubMed Central

    McClure, Erin A.; Acquavita, Shauna; Harding, Emily; Stitzer, Maxine

    2012-01-01

    Background Technology-based applications represent a promising method for providing efficacious, widely available interventions to substance abuse treatment patients. However, limited access to communication technology (i.e., mobile phones, computers, internet, and e-mail) could significantly impact the feasibility of these efforts, and little is known regarding technology utilization in substance abusing populations. Methods A survey was conducted to characterize utilization of communication technology in 266 urban, substance abuse treatment patients enrolled at eight drug-free, psychosocial or opioid-replacement therapy clinics. Results Survey participants averaged 41 years of age and 57% had a yearly household income of less than $15,000. The vast majority reported access to a mobile phone (91%), and to SMS text messaging (79%). Keeping a consistent mobile phone number and yearly mobile contract was higher for White participants, and also for those with higher education, and enrolled in drug-free, psychosocial treatment. Internet, e-mail, and computer use was much lower (39–45%), with younger age, higher education and income predicting greater use. No such differences existed for the use of mobile phones however. Conclusions Concern regarding the digital divide for marginalized populations appears to be disappearing with respect to mobile phones, but still exists for computer, internet, and e-mail access and use. Results suggest that mobile phone and texting applications may be feasibly applied for use in program-client interactions in substance abuse treatment. Careful consideration should be given to frequent phone number changes, access to technology, and motivation to engage with communication technology for treatment purposes. PMID:23107600

  12. Utilization of communication technology by patients enrolled in substance abuse treatment.

    PubMed

    McClure, Erin A; Acquavita, Shauna P; Harding, Emily; Stitzer, Maxine L

    2013-04-01

    Technology-based applications represent a promising method for providing efficacious, widely available interventions to substance abuse treatment patients. However, limited access to communication technology (i.e., mobile phones, computers, internet, and e-mail) could significantly impact the feasibility of these efforts, and little is known regarding technology utilization in substance abusing populations. A survey was conducted to characterize utilization of communication technology in 266 urban, substance abuse treatment patients enrolled at eight drug-free, psychosocial or opioid-replacement therapy clinics. Survey participants averaged 41 years of age and 57% had a yearly household income of less than $15,000. The vast majority reported access to a mobile phone (91%), and to SMS text messaging (79%). Keeping a consistent mobile phone number and yearly mobile contract was higher for White participants, and also for those with higher education, and enrolled in drug-free, psychosocial treatment. Internet, e-mail, and computer use was much lower (39-45%), with younger age, higher education and income predicting greater use. No such differences existed for the use of mobile phones however. Concern regarding the digital divide for marginalized populations appears to be disappearing with respect to mobile phones, but still exists for computer, internet, and e-mail access and use. Results suggest that mobile phone and texting applications may be feasibly applied for use in program-client interactions in substance abuse treatment. Careful consideration should be given to frequent phone number changes, access to technology, and motivation to engage with communication technology for treatment purposes. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  13. Screening for substance abuse in women's health: a public health imperative.

    PubMed

    Goodman, Daisy J; Wolff, Kristina B

    2013-01-01

    Alcohol and drug use is a significant public health problem with particular implications for the health and safety of women. Women who abuse these substances are more likely to have untreated depression and anxiety and are at higher risk for intimate partner violence, homelessness, incarceration, infectious disease, and unplanned pregnancy. Substance abuse during pregnancy places both mother and fetus at risk for adverse perinatal outcomes. Data regarding the prevalence of substance abuse in women are conflicting and difficult to interpret. On the clinical level, strong arguments exist against routine urine drug testing and in favor of the use of validated instruments to screen women for drug and alcohol use both in primary women's health care and during pregnancy. A number of sex-specific screening tools are available for clinicians, some of which have also been validated for use during pregnancy. Given the risks associated with untreated substance abuse and dependence in women, the integration of drug and alcohol screening into daily clinical practice is imperative. This article reviews screening tools available to providers in both the prenatal and primary women's health care settings and addresses some of the challenges raised when women screen positive for drug and alcohol abuse. © 2013 by the American College of Nurse-Midwives.

  14. The Association Between Childhood Abuse and Elder Abuse Among Chinese Adult Children in the United States.

    PubMed

    Dong, XinQi; Li, Ge; Simon, Melissa A

    2017-07-01

    The previous researchers have postulated that an abused child may abuse his or her abuser parent when the parent is getting old, also known as the intergenerational transmission of violence. However, few studies use data to support this model, and it has yet to be examined in the U.S. Chinese community. This study aims to examine the association between childhood abuse and elder abuse reported by Chinese adult children in the United States. Guided by a community-based participatory research approach, 548 Chinese adult children aged 21 years and older participated in this study. Childhood abuse was assessed by four-item Hurt-Insult-Threaten-Scream (HITS) scale. Elder abuse was assessed by a 10-item instrument derived from the Caregiver Abuse Screen (CASE). Logistic regression analysis was performed. Childhood abuse was associated with caregiver abuse screen results (odds ratio = 1.92, 95% confidence interval = 1.24-2.95). Being physically hurt (r = .13, p < .01), insulted (r = .15, p < .001), threatened (r = .12, p < .01), and screamed at (r = .18, p < .001) as a child were significantly correlated with caregiver abuse screen results. This study suggests that childhood abuse is associated with increased risk of elder abuse among Chinese adult children in the United States. Longitudinal research should be conducted to explore the mechanisms through which childhood abuse and its subtypes links with elder abuse. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. Estimating Local Child Abuse.

    ERIC Educational Resources Information Center

    Ards, Sheila

    1989-01-01

    Three conceptual approaches to estimating local child abuse rates using the National Incidence Study of Child Abuse and Neglect data set are evaluated. All three approaches yield estimates of actual abuse cases that exceed the number of reported cases. (SLD)

  16. Effects of a Culturally Informed Intervention on Abused, Suicidal African American Women

    PubMed Central

    Taha, Farah; Zhang, Huaiyu; Snead, Kara; Jones, Ashley D.; Blackmon, Brittane; Bryant, Rachel J.; Siegelman, Asher E.; Kaslow, Nadine J.

    2014-01-01

    Background This study examined 1) the relative efficacy of a culturally-sensitive empowerment group intervention (Nia) aimed at increasing three protective factors—self-esteem, hopefulness, and effectiveness of obtaining resources—versus treatment as usual (TAU) for low-income, abused African American women who recently had attempted suicide and 2) the impact of participants’ readiness to change with regard to their abusive relationship and suicidal behavior on their levels of each protective factor in the two conditions. Methods The sample included 89 African American women who reported intimate partner violence (IPV) exposure and a recent suicide attempt. Results Multivariate general linear modeling revealed that those in Nia showed greater improvements in self-esteem, but not in hopefulness or effectiveness of obtaining resources. However, significant interactions emerged in which participants that were “less ready to change” (i.e., earlier in the stages of change process) their IPV situation and suicidal behavior endorsed greater levels of hopefulness and perceived effectiveness of obtaining resources, respectively, following Nia. Conclusion Findings suggest that abused, suicidal African American women who are more reluctant initially to changing their abusive situation and suicidal behavior may benefit from even a brief, culturally-informed intervention. PMID:25403027

  17. Effects of a culturally informed intervention on abused, suicidal African American women.

    PubMed

    Taha, Farah; Zhang, Huaiyu; Snead, Kara; Jones, Ashley D; Blackmon, Brittane; Bryant, Rachel J; Siegelman, Asher E; Kaslow, Nadine J

    2015-10-01

    This study examined (a) the relative efficacy of a culturally sensitive empowerment group intervention (Nia) aimed at increasing 3 protective factors-self-esteem, hopefulness, and effectiveness of obtaining resources-versus treatment as usual (TAU) for low-income, abused African American women who recently had attempted suicide and (b) the impact of participants' readiness to change with regard to their abusive relationship and suicidal behavior on their levels of each protective factor in the 2 conditions. The sample included 89 African American women who reported intimate partner violence (IPV) exposure and a recent suicide attempt. Multivariate general linear modeling revealed that those in Nia showed greater improvements in self-esteem, but not in hopefulness or effectiveness of obtaining resources. However, significant interactions emerged in which participants who were "less ready to change" (i.e., earlier in the stages of change process) their IPV situation and suicidal behavior endorsed greater levels of hopefulness and perceived effectiveness of obtaining resources, respectively, following Nia. Findings suggest that abused, suicidal African American women who are more reluctant initially to changing their abusive situation and suicidal behavior may benefit from even a brief, culturally informed intervention. (c) 2015 APA, all rights reserved).

  18. Substance abuse and child maltreatment.

    PubMed

    Wells, Kathryn

    2009-04-01

    Pediatricians and other medical providers caring for children need to be aware of the dynamics in the significant relationship between substance abuse and child maltreatment. A caregiver's use and abuse of alcohol, marijuana, heroin, cocaine, methamphetamine, and other drugs place the child at risk in multiple ways. Members of the medical community need to understand these risks because the medical community plays a unique and important role in identifying and caring for these children. Substance abuse includes the abuse of legal drugs as well as the use of illegal drugs. The abuse of legal substances may be just as detrimental to parental functioning as abuse of illicit substances. Many substance abusers are also polysubstance users and the compounded effect of the abuse of multiple substances may be difficult to measure. Often other interrelated social features, such as untreated mental illness, trauma history, and domestic violence, affect these families.

  19. Child sexual abuse, attachment style, and depression: the role of the characteristics of abuse.

    PubMed

    Cantón-Cortés, David; Cortés, María Rosario; Cantón, José

    2015-02-01

    The aim of the current study was to examine the effects of secure, avoidant, and anxious attachment styles on depressive symptomatology in child sexual abuse (CSA) among young female adult victims. The role of attachment style was studied by considering possible interactive effects with the type of abuse, the relationship with the perpetrator, and the continuity of abuse. Participants were 168 female victims of CSA. Information about the abuse was obtained from a self-reported questionnaire. Attachment style was assessed with the Attachment Style Measure (ASM), and the Beck Depression Inventory (BDI) was used to assess depressive symptomatology. Secure and anxious attachment styles were correlated with low and high depression scores respectively. The effects of attachment style were stronger in cases where the abuse consisted of oral sex/penetration, a non-family member as perpetrator, and in isolated, compared with continued, abuse. These results confirm that characteristics of CSA (type of abuse, relationship with the perpetrator, and continuity of abuse) can affect the impact of attachment style on depressive symptomatology. © The Author(s) 2014.

  20. Perceptions of Elder Abuse and Help-Seeking Patterns among African-American, Caucasian American, and Korean-American Elderly Women.

    ERIC Educational Resources Information Center

    Moon, Ailee; Williams, Oliver

    1993-01-01

    Used 13 scenarios to measure and compare perceptions of elder abuse and help-seeking behaviors of African-American, Caucasian American, and Korean-American elderly women. Significant group differences existed in perceptions of elder abuse with regard to six scenarios, and Korean-American women were substantially less likely to perceive given…

  1. 44 CFR 16.150 - Program accessibility: Existing facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Program accessibility: Existing facilities. 16.150 Section 16.150 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT... IN PROGRAMS OR ACTIVITIES CONDUCTED BY THE FEDERAL EMERGENCY MANAGEMENT AGENCY § 16.150 Program...

  2. Home Interactive Media: An Analysis of Potential Abusers of Privacy.

    ERIC Educational Resources Information Center

    Wegner, John M.

    1985-01-01

    Examines potential threats to privacy posed by development of unified interaction systems in the home. Applicability of existing federal laws, constitutional provisions, and regulatory actions, and the possible technical and legislative actions that may be useful in curtailing possible privacy abuses in these systems are analyzed. (Author/MBR)

  3. Abusive families and character formation.

    PubMed

    McCarthy, J B

    1990-06-01

    Family research studies confirm that abusive parents tend to be undifferentiated partners who compete with each other and with their children for attention and nurturance. More or less healthy parents make demands on children to counteract their own injured narcissism, but they do so largely without devaluation and the sadistic use of projective identification. Under sufficient stress abusive parents attack the child who fails to gratify their needs, thereby giving vent to longstanding frustrations and feelings of being threatened by the child's individuation and competency. The emotional atmosphere in such families facilitates ego deficits like those of the borderline personality as it molds the child's efforts to avoid anxiety. Devaluation, loss, and defenses against mourning partially account for depression and paranoid traits in abused youngsters. Early neglect and abuse exposes them to influential models who act out rage and primitive defenses. Some abused individuals project their rage and later become paranoid or antisocial, whereas others fragment or retain infantile defenses. The destructiveness of severe psychological abuse lies in the constriction of the experiencing self and healthy character development, together with the conditioning to repeat abusive relationships and to avoid intimacy. Achieving individuation under these circumstances entails overcoming the internalized abusive relationships and relinquishing the unconscious wish to be transformed from the abused into the abuser.

  4. Intellectual disability, sexuality and sexual abuse prevention - a study of family members and support workers.

    PubMed

    Eastgate, Gillian; Scheermeyer, Elly; van Driel, Mieke L; Lennox, Nick

    2012-03-01

    People with intellectual disability experience difficulty forming intimate relationships and are prone to sexual exploitation and abuse. This study sought information from people involved in the care of adults with intellectual disability regarding how they supported them in the areas of sexuality, relationships and abuse prevention. Semistructured interviews and focus groups were held with 28 family members and paid support workers caring for adults with intellectual disabilities. Interviews and focus groups were audio recorded, transcribed, coded and analysed qualitatively. Major themes emerging included views on sexuality and intellectual disability, consent and legal issues, relationships, sexual knowledge and education, disempowerment, exploitation and abuse, sexual health and parenting. People with intellectual disability were described as lonely, disempowered and vulnerable to abuse. The sex industry, internet and mobile telephones were identified as new forms of risk. While this study looked at the views of both family members and support workers, the sample was too small to identify any meaningful differences between the two groups.

  5. Relationships between parental alcohol abuse and social support, peer substance abuse risk and social support, and substance abuse risk among South Korean adolescents.

    PubMed

    Park, Sookyung; Kim, Haeryun; Kim, Haesung

    2009-01-01

    This study examined the roles played by parental alcohol abuse and social support, peer substance abuse risk and social support, and substance abuse risk among adolescents in South Korea. Participants were adolescents between the ages of 15 and 22 years (mean, 18), residing in Seoul city and in surrounding Kyung-gi Province. Of 259 participants, 41.3% scored 2 or more on the POSIT scale, which suggested they met the problematic criteria for substance abuse risk. Logistic regression results suggested that the influence of social support on substance abuse risk among adolescents depended on the source of support--parents or peers. These findings need to be considered in the development of intervention programs for adolescents at risk for substance abuse.

  6. Educational intervention for physicians to address the risk of opioid abuse.

    PubMed

    Pasquale, Margaret K; Sheer, Richard L; Mardekian, Jack; Masters, Elizabeth T; Patel, Nick C; Hurwitch, Amy R; Weber, Jennifer J; Jorga, Anamaria; Roland, Carl L

    To evaluate the impact of a pilot intervention for physicians to support their treatment of patients at risk for opioid abuse. Patients at risk for opioid abuse enrolled in Medicare plans were identified from July 1, 2012 to April 30, 2014 (N = 2,391), based on a published predictive model, and linked to 4,353 opioid-prescribing physicians. Patient-physician clusters were randomly assigned to one of four interventions using factorial design. Physicians received one of the following: Arm 1, patient information; Arm 2, links to educational materials for diagnosis and management of pain; Arm 3, both patient information and links to educational materials; or Arm 4, no communication. Difference-in-difference analyses compared opioid and pain prescriptions, chronic high-dose opioid use, uncoordinated opioid use, and opioid-related emergency department (ED) visits. Logistic regression compared diagnosis of opioid abuse between cases and controls postindex. Mailings had no significant impact on numbers of opioid or pain medications filled, chronic high-dose opioid use, uncoordinated opioid use, ED visits, or rate of diagnosed opioid abuse. Relative to Arm 4, odds ratios (95% CI) for diagnosed opioid abuse were Arm 1, 0.95(0.63-1.42); Arm 2, 0.83(0.55-1.27); Arm 3, 0.72(0.46-1.13). While 84.7 percent had ≥1 psychiatric diagnoses during preindex (p = 0.89 between arms), only 9.5 percent had ≥1 visit with mental health specialists (p = 0.53 between arms). Although this intervention did not affect pain-related outcomes, future interventions involving care coordination across primary care and mental health may impact opioid abuse and improve quality of life of patients with pain.

  7. Tackling the Phenomenon of Elder Abuse in Italy: A Review of Existing Legislation and Policies as a Learning Resource

    ERIC Educational Resources Information Center

    Melchiorre, Maria Gabriella; Chiatti, Carlos; Lamura, Giovanni

    2012-01-01

    In Italy, data and information on prevalence and characteristics of elder abuse are very limited, and a specific legal and policy framework is lacking. Some articles of the Penal Code refer to the larger context of violence against disadvantaged groups, and some general support services not specifically dedicated to this issue are managed by local…

  8. Orphaned and abused youth are vulnerable to pregnancy and suicide risk.

    PubMed

    Zapata, Lauren B; Kissin, Dmitry M; Bogoliubova, Olga; Yorick, Roman V; Kraft, Joan Marie; Jamieson, Denise J; Marchbanks, Polly A; Hillis, Susan D

    2013-05-01

    Little is known about the magnitude and consequences of violence against children for those living outside family care. We sought to estimate the frequency of childhood abuse and examine its association with lifetime pregnancy involvement (LPI) and past year suicide ideation among orphaned youth. We analyzed data collected via cross-sectional interviewer-administered surveys completed by 293 orphaned youth aged 16-23 years living outside of family care in St. Petersburg, Russia. We used multivariable logistic regression to estimate adjusted odds ratios (AORs) of LPI and past year suicide ideation associated with childhood physical and sexual abuse. Other risk factors were also examined (e.g., social vulnerability, sexual and substance use behaviors), and characteristics of orphaned youth with LPI and past year suicide ideation were described. The prevalence of childhood abuse was higher among females than among males (23.3% versus 15.6% for physical abuse, and 20.3% versus 5.6% for sexual abuse), as was the prevalence of LPI and past year suicide ideation among those with histories of abuse. Experiences of childhood abuse were strong risk factors for both LPI and past year suicide ideation, with significant variation by gender. While both types of abuse were significantly associated with LPI and past year suicide ideation among females, physical abuse was significantly associated with LPI and sexual abuse was associated with suicide ideation for males. Of the other characteristics examined, strong modifiable risk factors included having no one to turn to for help and no involvement in activities outside of class. Among those with LPI (n=36), nearly 20% had been pregnant or gotten someone pregnant ≥2 times, most (61.8%) reported at least one induced abortion, and current use of effective contraception was nearly non-existent. Among those with past year suicide ideation (n=30), nearly half (44.8%) reported attempting suicide. There is an urgent need for

  9. Outcry Consistency and Prosecutorial Decisions in Child Sexual Abuse Cases.

    PubMed

    Bracewell, Tammy E

    2018-05-18

    This study examines the correlation between the consistency in a child's sexual abuse outcry and the prosecutorial decision to accept or reject cases of child sexual abuse. Case-specific information was obtained from one Texas Children's Advocacy Center on all cases from 2010 to 2013. After the needed deletion, the total number of cases included in the analysis was 309. An outcry was defined as a sexual abuse disclosure. Consistency was measured at both the forensic interview and the sexual assault exam. Logistic regression was used to evaluate whether a correlation existed between disclosure and prosecutorial decisions. Disclosure was statistically significant. Partial disclosure (disclosure at one point in time and denial at another) versus full disclosure (disclosure at two points in time) had a statistically significant odds ratio of 4.801. Implications are discussed, specifically, how the different disciplines involved in child protection should take advantage of the expertise of both forensic interviewers and forensic nurses to inform their decisions.

  10. Legally protecting and compelling veterinarians in issues of animal abuse and domestic violence.

    PubMed

    Robertson, I A

    2010-06-01

    The majority of veterinarians recognise their important role and responsibility to society and animal welfare in the detection and reporting of suspected abuse of animals and humans. In spite of the existing moral, ethical, and legal duties applied to veterinarians, they face substantial barriers that prohibit them from fulfilling their professional role in handling cases of suspected abuse. With increasing public and legal attention on issues of animal welfare, the non-fulfillment of these duties places the profession and its members at considerable risk of public criticism and adverse legal accountability. The issue is raised here that the veterinary profession in New Zealand needs to provide a clear policy statement and take pro-active measures that provide practical enforceable solutions to these existing barriers and legal risks. Such an initiative will assist in ensuring that all registered members consistently fulfil their obligations, and are legally protected while doing so. Veterinary counterparts overseas already provide a legislative immunity for their veterinarians who report suspected abuse as part of a mandated duty to report. Implementation of such a duty has significant benefits for all veterinarians, including the requirement for education and effective support systems. In the absence of such a mandatory duty, intermediary measures can be introduced, demonstrating social responsibility and commitment by the profession to their existing duty of care.

  11. Child sexual abuse, links to later sexual exploitation/high-risk sexual behavior, and prevention/treatment programs.

    PubMed

    Lalor, Kevin; McElvaney, Rosaleen

    2010-10-01

    This paper reviews the literature on the nature and incidence of child sexual abuse, explores the link between child sexual abuse and later sexual exploitation, and reviews the literature on prevention strategies and effective interventions in child sexual abuse services. Our understanding of the international epidemiology of child sexual abuse is considerably greater than it was just 10 years ago, and studies from around the world are examined. Childhood sexual abuse can involve a wide number of psychological sequelae, including low self-esteem, anxiety, and depression. Numerous studies have noted that child sexual abuse victims are vulnerable to later sexual revictimization, as well as the link between child sexual abuse and later engagement in high-risk sexual behaviour. Survivors of child sexual abuse are more likely to have multiple sex partners, become pregnant as teenagers, and experience sexual assault as adults. Various models which attempt to account for this inter-relationship are presented; most invoke mediating variables such as low self-esteem, drug/alcohol use, PTSD and distorted sexual development. Prevention strategies for child sexual abuse are examined including media campaigns, school-based prevention programmes, and therapy with abusers. The results of a number of meta-analyses are examined. However, researchers have identified significant methodological limitations in the extant research literature that impede the making of recommendations for implementing existing therapeutic programmes unreservedly.

  12. The Development of a Sexual Abuse Severity Score: Characteristics of Childhood Sexual Abuse Associated with Trauma Symptomatology, Somatization, and Alcohol Abuse

    ERIC Educational Resources Information Center

    Zink, Therese; Klesges, Lisa; Stevens, Susanna; Decker, Paul

    2009-01-01

    Childhood sexual abuse (CSA) is common and is associated with both mental and physical health problems in adulthood. Using data from an age- and sex-stratified population survey of 600 Olmsted County, Minnesota, residents, a Sexual Abuse Severity Score was developed. The abuse characteristics of 156 CSA respondents were associated with…

  13. Child-Visiting and Domestic Abuse.

    ERIC Educational Resources Information Center

    Shepard, Melanie

    1992-01-01

    Explains problems with child visiting in cases of domestic abuse. Data on domestic abuse, child care concerns, and child adjustment problems were collected from 25 mothers and 22 fathers at a child visiting program serving separated and abusive families. Psychological abuse of mothers correlated with child adjustment problems. (BB)

  14. Longitudinal histories as predictors of future diagnoses of domestic abuse: modelling study

    PubMed Central

    Kohane, Isaac S; Mandl, Kenneth D

    2009-01-01

    Objective To determine whether longitudinal data in patients’ historical records, commonly available in electronic health record systems, can be used to predict a patient’s future risk of receiving a diagnosis of domestic abuse. Design Bayesian models, known as intelligent histories, used to predict a patient’s risk of receiving a future diagnosis of abuse, based on the patient’s diagnostic history. Retrospective evaluation of the model’s predictions using an independent testing set. Setting A state-wide claims database covering six years of inpatient admissions to hospital, admissions for observation, and encounters in emergency departments. Population All patients aged over 18 who had at least four years between their earliest and latest visits recorded in the database (561 216 patients). Main outcome measures Timeliness of detection, sensitivity, specificity, positive predictive values, and area under the ROC curve. Results 1.04% (5829) of the patients met the narrow case definition for abuse, while 3.44% (19 303) met the broader case definition for abuse. The model achieved sensitive, specific (area under the ROC curve of 0.88), and early (10-30 months in advance, on average) prediction of patients’ future risk of receiving a diagnosis of abuse. Analysis of model parameters showed important differences between sexes in the risks associated with certain diagnoses. Conclusions Commonly available longitudinal diagnostic data can be useful for predicting a patient’s future risk of receiving a diagnosis of abuse. This modelling approach could serve as the basis for an early warning system to help doctors identify high risk patients for further screening. PMID:19789406

  15. Experiences of Mothers Who Are Child Sexual Abuse Survivors: A Qualitative Exploration

    PubMed Central

    Cavanaugh, Courtenay E.; Harper, Bianca; Classen, Catherine C.; Palesh, Oxana; Koopman, Cheryl; Spiegel, David

    2018-01-01

    Child sexual abuse (CSA) has been associated with a number of problems affecting women over their lifespan, including difficulties with parenting. However, there is a modest number of qualitative studies examining the impact of CSA on survivors who are mothers. There is a particular need for qualitative investigations that ask survivors who are mothers general questions about the impact of CSA on their lives rather than those that specifically ask about the impact of CSA on parenting. The former approach would allow survivors to describe effects that may impact parenting, but which survivors do not consciously link to affecting their parenting. Such information may inform interventions to assist this population of survivors. This secondary data analysis examined themes revealed in interviews with 44 survivors of CSA who were mothers. Participants were seeking treatment for their CSA and completed an in-person interview where they were asked open-ended questions about the sexual abuse they experienced as a child and how their abuse affects them now as adults. The interviews were recorded, transcribed, and coded using thematic analysis. The following six themes emerged from the narratives: 1) being a parent, 2) family of origin dysfunction, 3) the impact of abuse, 4) the abuse history and response to abuse, 5) coping, and 6) hopes and desires for the future. This study highlights several ways in which CSA impacts survivors who are mothers, areas for further study, and the need for interventions to assist this population in meeting the challenges they face as mothers. PMID:26301437

  16. Child protection medical service demonstration centers in approaching child abuse and neglect in Taiwan

    PubMed Central

    Chang, Yu-Ching; Huang, Jing-Long; Hsia, Shao-Hsuan; Lin, Kuang-Lin; Lee, En-Pei; Chou, I-Jun; Hsin, Yi-Chen; Lo, Fu-Song; Wu, Chang-Teng; Chiu, Cheng-Hsun; Wu, Han-Ping

    2016-01-01

    Abstract Child abuse includes all forms of physical and emotional ill treatment, sexual abuse, neglect, and exploitation that results in actual or potential harm to the child's health, development, or dignity. In Taiwan, the Child Protection Medical Service Demonstration Center (CPMSDC) was established to protect children from abuse and neglect. We further analyzed and compared the trends and clinical characteristics of cases reported by CPMSDC to evaluate the function of CPMSDC in approaching child abuse and neglect in Taiwan. We prospectively recorded children with reported child abuse and neglect in a CPMSDC in a tertiary medical center from 2014 to 2015. Furthermore, we analyzed and compared age, gender, scene, identifying settings, time of visits, injury type, injury severity, hospital admission, hospitalization duration, and outcomes based on the different types of abuse and the different settings in which the abuse or neglect were identified. Of 361 child abuse cases (mean age 4.8 ± 5.36 years), the incidence was highest in 1- to 6-year-old children (n = 198, 54.85%). Physical abuse and neglect were predominant in males, while sexual abuse was predominant in females (P < 0.001). Neglect was most common (n = 279, 75.85%), followed by physical (n = 56, 15.51%) and sexual abuse (n = 26, 7.2%). The most common identifying setting was the emergency department (n = 320, 88.64%), with neglect being most commonly reported. Head, neck, and facial injuries were more common in physically abused children than in neglected and sexual abused children (P < 0.005), leading to longer hospitalization (P = 0.042) and a higher Injury Severity Score (P = 0.043). There were more skin injuries in neglect (P < 0.001). The mortality rate was 2.49% (n = 9). The CPMSDC could enhance the ability, alertness, and inclination of professionals to identify suspected cases of child abuse, and to increase the rate of registry. Cases of physical

  17. Child protection medical service demonstration centers in approaching child abuse and neglect in Taiwan.

    PubMed

    Chang, Yu-Ching; Huang, Jing-Long; Hsia, Shao-Hsuan; Lin, Kuang-Lin; Lee, En-Pei; Chou, I-Jun; Hsin, Yi-Chen; Lo, Fu-Song; Wu, Chang-Teng; Chiu, Cheng-Hsun; Wu, Han-Ping

    2016-11-01

    Child abuse includes all forms of physical and emotional ill treatment, sexual abuse, neglect, and exploitation that results in actual or potential harm to the child's health, development, or dignity. In Taiwan, the Child Protection Medical Service Demonstration Center (CPMSDC) was established to protect children from abuse and neglect. We further analyzed and compared the trends and clinical characteristics of cases reported by CPMSDC to evaluate the function of CPMSDC in approaching child abuse and neglect in Taiwan. We prospectively recorded children with reported child abuse and neglect in a CPMSDC in a tertiary medical center from 2014 to 2015. Furthermore, we analyzed and compared age, gender, scene, identifying settings, time of visits, injury type, injury severity, hospital admission, hospitalization duration, and outcomes based on the different types of abuse and the different settings in which the abuse or neglect were identified. Of 361 child abuse cases (mean age 4.8 ± 5.36 years), the incidence was highest in 1- to 6-year-old children (n = 198, 54.85%). Physical abuse and neglect were predominant in males, while sexual abuse was predominant in females (P < 0.001). Neglect was most common (n = 279, 75.85%), followed by physical (n = 56, 15.51%) and sexual abuse (n = 26, 7.2%). The most common identifying setting was the emergency department (n = 320, 88.64%), with neglect being most commonly reported. Head, neck, and facial injuries were more common in physically abused children than in neglected and sexual abused children (P < 0.005), leading to longer hospitalization (P = 0.042) and a higher Injury Severity Score (P = 0.043). There were more skin injuries in neglect (P < 0.001). The mortality rate was 2.49% (n = 9). The CPMSDC could enhance the ability, alertness, and inclination of professionals to identify suspected cases of child abuse, and to increase the rate of registry. Cases of physical abuse

  18. Elder Abuse Awareness Project.

    ERIC Educational Resources Information Center

    Doyle, Kathleen; Morrow, Marilyn J.

    1985-01-01

    The Elder Abuse Awareness Project was undertaken: (1) to determine the incidence of abuse and neglect in seven Illinois counties; and (2) to develop, produce, and distribute educational materials on elder abuse for the service provider and for senior citizens. Results are presented and discussed. (MT)

  19. Mimics of child abuse: Can choking explain abusive head trauma?

    PubMed

    Edwards, George A

    2015-10-01

    Choking is one of the alternative explanations of abusive head trauma in children that have been offered in courtroom testimony and in the media. Most of these explanations - including choking - are not scientifically supported. This article highlights four points. (1) The origins of choking as an explanation for intracranial and retinal hemorrhages are speculative. (2) Choking has been used in high profile court testimony as an explanation for the death of a child thought to have been abused. (3) A case report that proposes choking as an alternative explanation for the death of a child diagnosed with abusive head trauma includes omissions and misrepresentations of facts. (4) There was a decision by the editor of the journal that published the case report that it was not necessary to include all the facts of the case; moreover, the editor indicated that facts are not required when presenting an alternative explanation. The use of scientifically unsupported alternative explanations for abusive head trauma based on inaccurate and biased information constitutes further victimization of the abused child and represents a travesty of justice. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  20. Child and Spouse Abuse Report

    DTIC Science & Technology

    1987-07-11

    child abuse . (c) SPouse (C) Military Child Care (4) Involvement n previous established case of spouse abuse (d) Sbl,ng (d) Other Child Care (5...program 16.j.(2) Referred to a drug rehabilitation program 4 16.j.(3) Previous involvement in child abuse 16.j.(4) Previous involvement in spouse abuse 16...investigation, whether "unsubstantiated," "suspected," or "substantiated." 8.a. Child Abuse /Neglect. The physical injury, sexual maltreatment, emotional

  1. Trends in Mental Health and Substance Abuse Services at the Nation’s Community Health Centers: 1998–2003

    PubMed Central

    Druss, Benjamin G.; Bornemann, Thomas; Fry-Johnson, Yvonne W.; McCombs, Harriet G.; Politzer, Robert M.; Rust, George

    2008-01-01

    Objective. We examined trends in delivery of mental health and substance abuse services at the nation’s community health centers. Methods. Analyses used data from the Health Resources and Services Administration (HRSA), Bureau of Primary Care’s (BPHC) 1998 and 2003 Uniform Data System, merged with county-level data. Results. Between 1998 and 2003, the number of patients diagnosed with a mental health/substance abuse disorder in community health centers increased from 210 000 to 800 000. There was an increase in the number of patients per specialty mental health/substance abuse treatment provider and a decline in the mean number of patient visits, from 7.3 visits per patient to 3.5 by 2003. Although most community health centers had some on-site mental health/substance abuse services, centers without on-site services were more likely to be located in counties with fewer mental health/substance abuse clinicians, psychiatric emergency rooms, and inpatient hospitals. Conclusions. Community health centers are playing an increasingly central role in providing mental health/substance abuse treatment services in the United States. It is critical both to ensure that these centers have adequate resources for providing mental health/substance abuse care and that they develop effective linkages with mental health/substance abuse clinicians in the communities they serve. PMID:18687596

  2. Trends in Mental Health and Substance Abuse Services at the Nation’s Community Health Centers: 1998–2003

    PubMed Central

    Druss, Benjamin G.; Bornemann, Thomas; Fry-Johnson, Yvonne W.; McCombs, Harriet G.; Politzer, Robert M.; Rust, George

    2006-01-01

    Objective. We examined trends in delivery of mental health and substance abuse services at the nation’s community health centers. Methods. Analyses used data from the Health Resources and Services Administration (HRSA), Bureau of Primary Care’s (BPHC) 1998 and 2003 Uniform Data System, merged with county-level data. Results. Between 1998 and 2003, the number of patients diagnosed with a mental health/substance abuse disorder in community health centers increased from 210 000 to 800 000. There was an increase in the number of patients per specialty mental health/substance abuse treatment provider and a decline in the mean number of patient visits, from 7.3 visits per patient to 3.5 by 2003. Although most community health centers had some on-site mental health/substance abuse services, centers without on-site services were more likely to be located in counties with fewer mental health/substance abuse clinicians, psychiatric emergency rooms, and inpatient hospitals. Conclusions. Community health centers are playing an increasingly central role in providing mental health/substance abuse treatment services in the United States. It is critical both to ensure that these centers have adequate resources for providing mental health/substance abuse care and that they develop effective linkages with mental health/substance abuse clinicians in the communities they serve. PMID:17008573

  3. Abuse Characteristics and Individual Differences Related to Disclosing Childhood Sexual, Physical, and Emotional Abuse and Witnessed Domestic Violence.

    PubMed

    Bottoms, Bette L; Peter-Hagene, Liana C; Epstein, Michelle A; Wiley, Tisha R A; Reynolds, Carrie E; Rudnicki, Aaron G

    2016-04-01

    Many adult survivors of childhood abuse hide their victimization, avoiding disclosure that could identify perpetrators, end the abuse, and bring help to the victim. We surveyed 1,679 women undergraduates to understand disclosure of childhood sexual, physical, and emotional abuse, and, for the first time, witnessed domestic violence, which many consider to be emotionally abusive. A substantial minority of victims failed to ever disclose their sexual abuse (23%), physical abuse (34%), emotional abuse (20%), and witnessed domestic violence (29%). Overall, abuse-specific factors were better predictors of disclosure than individual-level characteristics. Disclosure of sexual abuse was related to experiencing more frequent abuse (by the same and by multiple perpetrators), being more worried about injury and more upset at the time of the abuse, and self-labeling as a victim of abuse. Disclosure of physical abuse was related to experiencing more frequent abuse (by the same and multiple perpetrators), being less emotionally close to the perpetrator, being older when the abuse ended, being more worried and upset, and self-labeling as a victim. Disclosure of emotional abuse was associated with being older when the abuse ended, and being more worried and upset. Disclosure was unrelated to victim demographic characteristics or defensive reactions (dissociative proneness, fantasy proneness, repressive coping style, and temporary forgetting), except that among physical and emotional abuse victims, repressors were less likely to disclose than non-repressors. Disclosure of witnessing domestic violence was not significantly related to any factors measured. © The Author(s) 2014.

  4. Women and substance abuse: gender, age, and cultural considerations.

    PubMed

    Stevens, Sally J; Andrade, Rosi A C; Ruiz, Bridget S

    2009-01-01

    Historically, data has shown that a smaller percentage of women use alcohol and illicit substances compared to men, and that frequency of use has been lower among women compared to use among men. Although this data on usage may be true, researchers also acknowledge that substance use among women has been a hidden issue, one not realistically acknowledged by society, especially prior to the mid-1960s. Along with this, more recent data indicates that rates of substance use among women are increasing. Factors contributing to this increase in substance abuse have begun to receive considerable attention, and recent research suggests that many issues exist that are unique to substance use among women. The purpose of this article is to discuss gender specific considerations in women's substance abuse by examining the history of substance use among women; analyzing gender-specific factors, including physiological factors, trauma-related factors, mental health issues, and cultural considerations that impact on women's substance use; articulating treatment approaches for working with substance abusing women and girls; and providing recommendations for further research in this area.

  5. Gas sniffing as a form of substance abuse.

    PubMed

    Remington, G; Hoffman, B F

    1984-02-01

    The authors review the existing literature on inhalation of gasoline fumes, highlighting the acute and chronic physical and psychological effects. The clinical picture of gas sniffing includes visual hallucinations, changes in consciousness, euphoria, nystagmus, dizziness, weakness and tremors. There is the possibility of rapid recovery, sudden death or brain damage with chronic abuse. When leaded gasoline is abused then blood and urine lead levels and erythrocytic delta-aminolevulinic acid dehydrase (ALAD) levels may be helpful. Although the treatment of acute and chronic gas sniffing syndromes is often supportive and non-specific, when lead levels are high chelated therapy is indicated including British anti-lewisite, calcium disodium versenate or D-penicillamine. We also report our findings on an isolated native Indian population where intentional gas sniffing has reached epidemic proportions. Ten percent of the total population and 25% of the children between 5 and 15 years of age had been identified as gasoline inhalation abusers. In this population, the most important etiological factors included environmental, family and cultural components. The authors emphasize the need to correct the family and social deficiencies in such communities if the incidence of gas sniffing is to be decreased.

  6. Participatory Action Research on Help-Seeking Behaviors of Self-Defined Ritual Abuse Survivors: A Brief Report.

    PubMed

    Matthew, Laurie; Barron, Ian G

    2015-01-01

    The existence of ritual abuse is the subject of much debate. Ritual abuse survivor perceptions of seeking help have not been explored, and studies have yet to utilize self-defined survivors as collaborative researchers. This study addresses both issues. Participatory action research was utilized to design a survey and semistructured interview to investigate ritual abuse survivor experience of seeking help. Sixty-eight participants completed the survey, and 22 were interviewed. A group approach to thematic analysis aided validity and reliability. Participants reported experiencing disbelief and a lack of ritual abuse awareness and help from support services. In contrast, participatory action research was reported by participants as educative and emancipatory. Future research should explore the benefits of participatory action research for survivors of different forms of oppression.

  7. A systematic review of randomized controlled trials of interventions designed to decrease child abuse in high-risk families.

    PubMed

    Levey, Elizabeth J; Gelaye, Bizu; Bain, Paul; Rondon, Marta B; Borba, Christina P C; Henderson, David C; Williams, Michelle A

    2017-03-01

    Child abuse is a global problem, and parents with histories of childhood abuse are at increased risk of abusing their offspring. The objective of this systematic review is to provide a clear overview of the existing literature of randomized controlled trials evaluating the effectiveness of interventions to prevent child abuse. PubMed, PsychINFO, Web of Science, Sociological Abstracts, and CINAHL were systematically searched and expanded by hand search. This review includes all randomized controlled trials (RCTs) of interventions designed to prevent abuse among mothers identified as high-risk. Of the eight studies identified, only three found statistically significant reductions in abuse by any measure, and only two found reductions in incidents reported to child protective services. While much has been written about child abuse in high-risk families, few RCTs have been performed. Only home visitation has a significant evidence base for reducing child abuse, and the findings vary considerably. Also, data from low- and middle-income countries are limited. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  8. Clinical implications of drug abuse epidemiology.

    PubMed

    Schulden, Jeffrey D; Lopez, Marsha F; Compton, Wilson M

    2012-06-01

    Research on the epidemiology of illicit drug use disorders provides continued critical insights into the distribution and determinants of drug use and drug use disorders in the United States. This research serves as a foundation for understanding the etiology of these disorders, helping to disentangle the complex interrelationship of developmental, genetic, and environmental risk and protective factors. Building on an understanding of this research in substance abuse epidemiology, it is important for clinicians to understand the unique trends in drug use in the overall communities that they serve and the unique risk factors for given individuals. The generally high prevalence of substance use disorders, along with their high comorbidity with other psychiatric disorders and with the HIV epidemic, make prevention, evaluation, and referral for treatment for drug abuse an important part of routine clinical practice in a range of clinical settings, including primary care, psychiatric, and emergency department settings. Ongoing efforts to ensure insurance coverage parity for the treatment of mental health and substance use disorders offer the promise of continued improvements in the integration and availability of such services in the broader US health care system.

  9. Comparison of early maladaptive schemas and parenting origins in patients with opioid abuse and non-abusers.

    PubMed

    Jalali, Mohammad Reza; Zargar, Mohammad; Salavati, Mojgan; Kakavand, Ali Reza

    2011-01-01

    The aim of this study was to examine the difference of early maladaptive schemas and parenting origins in opioid abusers and non-opioid abusers. The early maladaptive schemas and parenting origins were compared in 56 opioid abusers and 56 non-opioids abusers. Schemas were assessed by the Young Schema Questionnaire 3rd (short form); and parenting origins were assessed by the Young Parenting Inventory. Data were analyzed by multivariate analysis of variance (MANOVA). The analysis showed that the means for schemas between opioid abusers and non-opioid abusers were different. Chi square test showed that parenting origins were significantly associated with their related schemas. The early maladaptive schemas and parenting origins in opioid abusers were more than non-opioid abusers; and parenting origins were related to their Corresponding schemas.

  10. Estimating attractiveness for abuse of a not-yet-marketed "abuse-deterrent" prescription opioid formulation.

    PubMed

    Butler, Stephen F; Black, Ryan; Grimes Serrano, Jill M; Folensbee, Lesley; Chang, Alan; Katz, Nathaniel

    2010-01-01

    The present study builds on research to model abusers' perceptions of particular analgesics' attractiveness for abuse and extends these methods to derive an estimate of attractiveness for abuse of a not-yet-marketed abuse-deterrent formulation (ADF) of a prescription opioid (Remoxy), Pain Therapeutics, Inc., San Mateo, CA, and King Pharmaceuticals, Inc., Bristol, TN). In a previous study, the Opioid Attractiveness Technology Scaling (OATS) method identified, from a drug abuser's point of view, the particular features of a prescription opioid relevant to its attractiveness for recreational use. A second online sample rated the extent to which these features applied to particular products they had actually used/abused. These data were used to model the abusers' overall preference for prescription opioids they had used/abused. In the present study, this method was applied to a not-yet-marketed ADF using substance abuse counselors as proxies for prescription opioid abusers. Thirty-eight counselors were given materials describing the new ADF along with four known products. Thirty-two counselors demonstrated sufficient agreement with abusers' ratings of the overall attractiveness of these drugs. The overall model yielded a significant pseudo R(2) of 0.15 (P < 0.001), with increasing model fit based on preferred route of administration, from swallowing whole (pseudo R(2) = 0.06; P < 0.001) and best for those who preferred to inject (pseudo R(2) = 0.40; P < 0.001). Data from a cross-validation group of 16 counselors/proxies were used to calculate the OATS scores for the five rated drugs and revealed significant differences between the ADF and OxyContin (Purdue Pharma LP, Stamford, CT), Percocet (Endo Pharmaceuticals, Chadds Ford, PA), and Vicodin (Abbott Laboratories, Abbott Park, IL), but not Talwin NX (Sanofi-aventis, Bridgewater, NJ), which was identified in the prior study as a highly unattractive drug for recreational purposes. The OATS method shows promise for

  11. "Who can you tell?" Features of Arab culture that influence conceptualization and treatment of childhood sexual abuse.

    PubMed

    Haboush, Karen L; Alyan, Hala

    2013-01-01

    The literature on child sexual abuse reflects growing recognition of the manner in which culture impacts the conceptualization, experience, and treatment of such cases. Despite heightened visibility of Arab Americans within the United States, population due to recent media attention, little empirical research exists on the occurrence of child sexual abuse within this population. Arab culture is often characterized by an emphasis on collectivism and familial obligations, and such features may prove to either facilitate or impede assessment and treatment of child sexual abuse, depending on how they are manifested. In terms of reporting child sexual abuse, cultural values pertaining to shame and honor as well as the stigma attached to mental health problems may influence the response to abuse. As such, enhancing the cultural competence of the therapist is key to facilitating effective cultural practice. Empirical research is required to investigate and substantiate these concepts as they relate to child sexual abuse in Arab-American populations.

  12. Prescription Drug Abuse

    MedlinePlus

    ... what the doctor prescribed, it is called prescription drug abuse. It could be Taking a medicine that ... purpose, such as getting high Abusing some prescription drugs can lead to addiction. These include opioids, sedatives, ...

  13. The psychosocial consequences of child sexual abuse in Ethiopia: a case-control comparative analysis.

    PubMed

    Wondie, Yemataw; Zemene, Workie; Tafesse, Biruk; Reschke, Konrad; Schröder, Harry

    2011-07-01

    Child sexual abuse (CSA) continues to be a pressing public health concern around the globe. Few existing reports, however, indicate the alarming rate at which the problem is increasing in sub-Saharan Africa. The present study is designed to investigate the psychosocial consequences of sexual abuse among child survivors in Ethiopia who were abused mainly through early marriage, rape, and child prostitution. Data are collected from 318 such CSA survivors-and 318 matched, non-sexually abused, normal controls- using the Children's Impact of Traumatic Events Scale-Revised and the Rosenberg Self-Esteem Scale. The results reveal the CSA survivors to be significantly more symptomatic than the control group: They demonstrated a lower degree of social support, a lower degree of empowerment, as well as a higher degree of guilt and increased likelihood of viewing the world as dangerous. Finally, these CSA survivors show a lower degree of positive self-worth than their non-sexually abused counterparts. These findings have important implications for the formulation of appropriate preventions and interventions to be undertaken by various stakeholders ranging from family to policy makers.

  14. Tooth Decay in Alcohol Abusers Compared to Alcohol and Drug Abusers

    PubMed Central

    Dasanayake, Ananda P.; Warnakulasuriya, Saman; Harris, Colin K.; Cooper, Derek J.; Peters, Timothy J.; Gelbier, Stanley

    2010-01-01

    Alcohol and drug abuse are detrimental to general and oral health. Though we know the effects of these harmful habits on oral mucosa, their independent and combined effect on the dental caries experience is unknown and worthy of investigation. We compared 363 “alcohol only” abusers to 300 “alcohol and drug” abusers to test the hypothesis that various components of their dental caries experience are significantly different due to plausible sociobiological explanations. After controlling for the potential confounders, we observe that the “alcohol and drug” group had a 38% higher risk of having decayed teeth compared to the “alcohol only” group (P < .05). As expected, those who belonged to a higher social class (OR = 1.98; 95%  CI = 1.43–2.75) and drank wine (OR = 1.85; 95%  CI = 1.16–2.96) had a higher risk of having more filled teeth. We conclude that the risk of tooth decay among “alcohol only” abusers is significantly lower compared to “alcohol and drug” abusers. PMID:20379366

  15. Elder Abuse in Japan

    ERIC Educational Resources Information Center

    Arai, Mizuho

    2006-01-01

    Perceptions of elder abuse were examined in Japanese women (n =100) and men (n =46). Japanese women and men both emphasized physical aggression, followed by neglect and blaming, when giving examples of extremely abusive behavior. Physical aggression was also the most frequently mentioned type of moderate elder abuse, followed by neglect, economic…

  16. Substance Abuse. Policy Statement.

    ERIC Educational Resources Information Center

    National Collaboration for Youth, Washington, DC.

    This paper presents the policy statement on substance abuse from the National Collaboration for Youth (NCY). The policy statement section lists programs and activities supported by the NCY. A section on background includes a statement of the issue of substance abuse. Areas examined in this section include alcohol abuse and drunk driving among…

  17. Psychological counseling and accuracy of memory for child sexual abuse.

    PubMed

    Goodman, Gail S; Goldfarb, Deborah; Quas, Jodi A; Lyon, Alexandra

    2017-12-01

    Tens of thousands of child sexual abuse (CSA) cases are reported to authorities annually. Although some of the child victims obtain psychological counseling or therapy, controversy exists about the potential consequences for the accuracy of victims' memory of CSA, both in childhood and adulthood. Yet, delaying needed therapeutic intervention may have detrimental effects on the victims' well-being and recovery. To address this controversy, this study examined whether psychological counseling during a CSA prosecution predicts accuracy or inaccuracy of long-term memory for CSA. Participants (N = 71) were CSA victims who took part in a longitudinal study of memory and legal involvement. Data regarding participants' counseling attendance during the prosecution and details of their CSA cases were gathered throughout legal involvement and shortly thereafter (Time 1). Ten to 16 years later (Time 2), participants were questioned about a range of topics, including the alleged abuse. Time 1 counseling attendance significantly predicted more correct answers to abuse-related questions and (for corroborated cases) fewer overreporting responses at Time 2. Counseling was unrelated to underreporting responses. These results held even with other potential influences, such as abuse severity, victim-defendant relationship, posttraumatic stress disorder criteria met, testifying in the case, and delay, were statistically controlled. Although further research is needed, this study provides evidence that psychological counseling received by CSA victims during or shortly after prosecutions may improve later memory for abuse-related information. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  18. Substance abuse and criminal thinking: testing the countervailing, mediation, and specificity hypotheses.

    PubMed

    Walters, Glenn D

    2012-12-01

    The purpose of this study was to determine (a) which of 2 dimensions of criminal thinking (proactive and/or reactive) correlates with prior substance abuse; (b) whether criminal thinking mediates the relationship between prior substance abuse and recidivism; (c) if a direct relationship exists between specific drugs of abuse and specific criminal thinking styles. First, the reconstructed Proactive (Prc) and Reactive (Rrc) Criminal Thinking scores from the Psychological Inventory of Criminal Thinking Styles (PICTS; Walters, 1995) were correlated with a dichotomous measure of prior substance abuse and a continuous measure of the number of substances abused in a sample of 2877 male federal prisoners (age: M = 34.96, SD = 9.89, range = 18-84; race: 63.6% Black, 17.3% White, 17.6% Hispanic, 1.4% other). The results indicated that only the Rrc score correlated significantly with prior substance abuse when the effect of the alternative measure (Prc in the case of Rrc and Rrc in the case of the Prc) was controlled through partial correlations. Second, reactive criminal thinking was found to mediate the relationship between a history of prior substance abuse and subsequent recidivism in a subsample of 1101 inmates who were released from prison during a 1- to 76-month follow-up. Third, both specific (alcohol with cutoff; marijuana with cognitive indolence) and global (heroin, cocaine, and amphetamine with cutoff, cognitive indolence, and discontinuity) drug-criminal thinking correlations were obtained. These results suggest that reactive criminal thinking plays a potentially important role in the drug-crime relationship.

  19. Factors that predict adolescent motivation for substance abuse treatment.

    PubMed

    Battjes, Robert J; Gordon, Michael S; O'Grady, Kevin E; Kinlock, Timothy W; Carswell, Melissa A

    2003-04-01

    Many adolescent substance abusers enter treatment because of external pressures and thus lack motivation to change their behavior and engage in treatment. Because an understanding of adolescent motivation may contribute to improved treatment, an investigation of factors that predict motivation was undertaken with youth admitted to an adolescent outpatient substance abuse treatment program (N=196). At admission, these subjects received a comprehensive biopsychosocial assessment. Using multiple regression analysis, factors considered to potentially predict motivation were assessed. Of the factors examined, those that involved experiencing various negative consequences of substance use emerged as important predictors of motivation, whereas severity of substance use did not. Diminished awareness of negative consequences of use was consonant with lower motivation, suggesting the importance of interventions to help youth recognize negative consequences of their substance use. Interventions to enhance motivation are likely to become more important as the juvenile justice system increasingly refers troubled youth to treatment.

  20. Domestic violence in a university emergency department.

    PubMed

    Ernst, A A; Weiss, S J; Nick, T G; Casalletto, J; Garza, A

    2000-02-01

    We attempted to determine the prevalence and demographics of domestic violence (DV) among male and female patients in a university emergency department (ED). The validated Index of Spouse Abuse (ISA) was used. Patients aged 18 years or older seen during 28 randomly selected 4-hour shifts were eligible. Of the 97 participants in the study, 57 were female. One man and 3 women were victims of present physical DV, with 1 male and 2 female victims of present nonphysical abuse. Three of the 40 men and 22 of the 57 women had been victims of past physical violence. One man and 15 women had been victims of past nonphysical abuse. Alcohol use, suicidal ideation, family history, and psychiatric history were all strongly correlated with DV. The prevalence of DV past was significantly higher in the females. Present violence was more rare and less than that reported in other ED studies.

  1. Risk Management Post-Marketing Surveillance for the Abuse of Medications Acting on the Central Nervous System: Expert Panel Report

    PubMed Central

    Johanson, Chris-Ellyn; Balster, Robert L.; Henningfield, Jack E.; Schuster, Charles R.; Anthony, James C.; Barthwell, Andrea G.; Coleman, John J.; Dart, Richard C.; Gorodetzky, Charles W.; O’Keeffe, Charles; Sellers, Edward M.; Vocci, Frank; Walsh, Sharon L.

    2010-01-01

    The abuse and diversion of medications is a significant public health problem. This paper is part of a supplemental issue of Drug and Alcohol Dependence focused on the development of risk management plans and post-marketing surveillance related to minimizing this problem. The issue is based on a conference that was held in October, 2008. An Expert Panel was formed to provide a summary of the conclusions and recommendations that emerged from the meeting involving drug abuse experts, regulators and other government agencies, pharmaceutical companies and professional and other non-governmental organizations. This paper provides a written report of this Expert Panel. Eleven conclusions and eleven recommendations emerged concerning the state of the art of this field of research, the regulatory and public health implications and recommendations for future directions. It is concluded that special surveillance tools are needed to detect the emergence of medication abuse in a timely manner and that risk management tools can be implemented to increase the benefit to risk ratio. The scientific basis for both the surveillance and risk management tools is in its infancy, yet progress needs to be made. It is also important that the unintended consequences of increased regulation and the imposition of risk management plans be minimized. PMID:19783383

  2. Patterns of work-related intimate partner violence and job performance among abusive men.

    PubMed

    Mankowski, Eric S; Galvez, Gino; Perrin, Nancy A; Hanson, Ginger C; Glass, Nancy

    2013-10-01

    This study assesses different types of work-related intimate partner violence (IPV) perpetration and their relationship to perpetrators' work performance and employment. We determine if groups of abusive men with similar patterns of work-related IPV exist and then examine whether the patterns are related to their characteristics, job performance, and employment outcomes. Participants were 198 adult men (60% Latino, 40% non-Latino) from batterer intervention programs (BIPs) who self-reported their lifetime work-related IPV and job outcomes. Five distinct clusters were identified and named based on the pattern (predominance or absence) of different work-related abusive behaviors reported: (a) low-level tactics, (b) job interference, (c) job interference with threatened or actual violence, (d) extreme abuse without jealousy and (e) extreme abuse. Analyses revealed significant differences between the clusters on ethnicity, parental status, partner's employment status, income, education, and (among Latinos only) acculturation. The probability of men's work-related IPV substantially impacting their own job performance was nearly 4 times greater among those in the extreme abuse cluster than those in the low-level tactics cluster. These data inform the development of employee training programs and workplace policies for reducing IPV that affects the workplace.

  3. Accelerant-related burns and drug abuse: Challenging combination.

    PubMed

    Leung, Leslie T F; Papp, Anthony

    2018-05-01

    Accelerants are flammable substances that may cause explosion when added to existing fires. The relationships between drug abuse and accelerant-related burns are not well elucidated in the literature. Of these burns, a portion is related to drug manufacturing, which have been shown to be associated with increased burn complications. 1) To evaluate the demographics and clinical outcomes of accelerant-related burns in a Provincial Burn Centre. 2) To compare the clinical outcomes with a control group of non-accelerant related burns. 3) To analyze a subgroup of patients with history of drug abuse and drug manufacturing. Retrospective case control study. Patient data associated with accelerant-related burns from 2009 to 2014 were obtained from the British Columbia Burn Registry. These patients were compared with a control group of non-accelerant related burns. Clinical outcomes that were evaluated include inhalational injury, ICU length of stay, ventilator support, surgeries needed, and burn complications. Chi-square test was used to evaluate categorical data and Student's t-test was used to evaluate mean quantitative data with the p value set at 0.05. A logistic regression model was used to evaluate factors affecting burn complications. Accelerant-related burns represented 28.2% of all burn admissions (N=532) from 2009 to 2014. The accelerant group had higher percentage of patients with history of drug abuse and was associated with higher TBSA burns, ventilator support, ICU stay and pneumonia rates compared to the non-accelerant group. Within the accelerant group, there was no difference in clinical outcomes amongst people with or without history of drug abuse. Four cases were associated with methamphetamine manufacturing, all of which underwent ICU stay and ventilator support. Accelerant-related burns cause significant burden to the burn center. A significant proportion of these patients have history of drug abuse. Copyright © 2017 Elsevier Ltd and ISBI. All rights

  4. Child Abuse and Mandated Reporting

    ERIC Educational Resources Information Center

    Woika, Shirley; Bowersox, Carissa

    2013-01-01

    Teachers and teachers-in-training are mandated reporters; they are legally required to report any suspected child abuse or neglect. This article describes: (1) How to file a report; (2) How prevalent child abuse is; (3) What abuse is; (4) What it means to be a mandated reporter; (5) When the report should be made; and (6) What to do if abuse is…

  5. Current information on the scope and nature of child sexual abuse.

    PubMed

    Finkelhor, D

    1994-01-01

    Approximately 150,000 confirmed cases of child sexual abuse were reported to child welfare authorities in the United States during 1993. This number represents about 15% of the more than one million confirmed cases of all child abuse and neglect. But the true scope of this problem is better reflected in retrospective surveys of adults, and this article summarizes data from 19 of these surveys. Considerable evidence exists to show that at least 20% of American women and 5% to 10% of American men experienced some form of sexual abuse as children. The rates are somewhat lower among people born before World War II, but there is little evidence of a dramatic increase for recent generations. The studies provide little evidence that race or socioeconomic circumstances are major risk factors. They do show elevated risk for children who experienced parental inadequacy, unavailability, conflict, harsh punishment, and emotional deprivation. Adult retrospective studies are also good sources of information about the characteristics of abuse. Most sexual abuse is committed by men (90%) and by persons known to the child (70% to 90%), with family members constituting one-third to one-half of the perpetrators against girls and 10% to 20% of the perpetrators against boys. Family members constitute a higher percentage of the perpetrators in child protective agency cases because the mandate of these agencies generally precludes their involvement in extrafamily abuse. Around 20% to 25% of child sexual abuse cases involve penetration or oral-genital contact. The peak age of vulnerability is between 7 and 13. Studies of the criminal justice processing of sexual abusers suggest that, compared with other violent criminals, slightly fewer are prosecuted, but of those prosecuted, slightly more are convicted. Studies conducted in the 1980s also showed that, once convicted, relatively few sexual abusers receive sentences longer than one year, while 32% to 46% serve no jail time. Overall, there

  6. [Child abuse: an interdisciplinary management experience].

    PubMed

    Seldes, José Julio; Ziperovich, Valentina; Viota, Alejandra; Leiva, Fernanda

    2008-12-01

    Child abuse constitutes one of the most frequent forms of family violence. The following study tries to demonstrate the situation that arises in the city of Mercedes, Corrientes, Argentina, and to establish some associations about that matter. A series of 128 cases of abused children is presented, between 0 and 19 years old, attended from November 1998 to November 2002, in Moiru, Center of prevention, direction, attendance and qualification in social conducts of risk that works in Mercedes. 56% of physical abuse; 30% of sexual abuse; 10% of neglect; 3% of emotional abuse and 1% of syndrome of Münchaussen was detected, with a similar distribution by sexes in the total population. Demographic variables and certain associations in cases of physical abuse and sexual abuse are indicated. A significant association between mothers victims of domestic violence and physical abuse towards their children was demonstrated. 128 young boys and girls were seen in our center. It is considered that a significant population was treated where physical abuse and sexual abuse appears as most relevant.

  7. Elder Abuse Awareness Project.

    ERIC Educational Resources Information Center

    Morrow, Marilyn J.; Doyle, Kathleen

    The Elder Abuse Awareness Project was developed to determine the incidence of abuse and neglect of elderly people in several rural counties in central Illinois. A primary purpose of the study was to survey service providers as to their actual encounters with elder abuse and neglect. Each provider was asked about warning signs or cues that were…

  8. Use of Antiretroviral HIV Post-Exposure Prophylaxis in Sexually Abused Children and Adolescents Treated in an Inner-City Pediatric Emergency Department

    ERIC Educational Resources Information Center

    Fajman, Nancy; Wright, Richelle

    2006-01-01

    Background: In 2002, Georgia had the United States' eighth highest number of persons living with AIDS. Human immunodeficiency virus (HIV) transmission as a result of sexual abuse is uncommon but definitely occurs. In certain circumstances of sexual abuse, antiretroviral post-exposure prophylaxis (ARV-PEP) has been suggested as a means to decrease…

  9. Abuse of prescription drugs.

    PubMed Central

    Wilford, B B

    1990-01-01

    An estimated 3% of the United States population deliberately misuse or abuse psychoactive medications, with severe consequences. According to the National Institute on Drug Abuse, more than half of patients who sought treatment or died of drug-related medical problems in 1989 were abusing prescription drugs. Physicians who contribute to this problem have been described by the American Medical Association as dishonest--willfully misprescribing for purposes of abuse, usually for profit; disabled by personal problems with drugs or alcohol; dated in their knowledge of current pharmacology or therapeutics; or deceived by various patient-initiated fraudulent approaches. Even physicians who do not meet any of these descriptions must guard against contributing to prescription drug abuse through injudicious prescribing, inadequate safeguarding of prescription forms or drug supplies, or acquiescing to the demands or ruses used to obtain drugs for other than medical purposes. PMID:2349801

  10. Being emotionally abused: a phenomenological study of adult women's experiences of emotionally abusive intimate partner relationships.

    PubMed

    Queen, Josie; Nurse, Army; Brackley, Margaret H; Williams, Gail B

    2009-04-01

    The purpose of this study was to explore and describe individual perceptions, meanings, and definitions of emotional abuse through the lived experience of women who identified themselves as being emotionally abused by an intimate partner (IP). To answer the research question, "What is it like to live the life of a woman who is emotionally abused by her intimate partner?" A descriptive, phenomenological research design was undertaken. Unstructured individual interviews with 15 emotionally abused adult women resulted in the discovery of seven essential themes: captivity, defining moments, disassociation from self, fixing, mindful manipulation, relentless terror, and taking a stand. A combination of a hermeneutic approach and Diekelmann's approach to data analysis was used to explore differences in perceptions and develop essential themes that portrayed the essence of a woman's lived experience of being emotionally abused by her IP. The data also demonstrated that (1) IP emotional abuse has no prerequisite for partner rage or obvious emotional manipulation, (2) the absence of caring and respectful partner behaviors was just as powerful in creating an emotionally abusive experience as openly abusive behaviors, and (3) being emotionally abused was a life journey, encompassing multiple culminations, secondary physical and mental health symptoms, and quality of life issues that extended well beyond the immediate abuse experience.

  11. Forensic and family psychiatry in abuse dwarfism: Munchausen's syndrome by proxy, atonement, and addiction to abuse.

    PubMed

    Money, J; Annecillo, C; Hutchison, J W

    1985-01-01

    The syndrome of abuse dwarfism is characterized by gross impairment of statural and intellectual growth and social maturation while the abused child remains in the domicile of abuse. The parents collude as child abusers, and are medical impostors regarding the symptoms of abuse. The syndrome as a whole is appropriately named Munchausen's syndrome by proxy. Though the mother typically initiates abuse, she cannot give a rational explanation for doing so. In her own history there is a sin that is expiated or atoned for symbolically by the sacrifice of the child--explainable in terms of the theory of opponent-process learning. In the two cases presented, the sin was the mother's own birth out of wedlock, in one case as a sequel to incest. The child's addiction to abuse is a challenge to the program of rehabilitation. With respect to parents at risk, the data of this paper are relevant to the prevention of a predisposition toward, or the actual implementation of child abuse, though a program of prevention needs still to be formulated. The sexological relevance of this paper is that the data demonstrate that the effects of sexual abuse may be transmitted to the next generation and manifested as child abuse which is not necessarily sexual in content.

  12. Socio-demographic and Clinical Profile of Substance Abusers Attending a Regional Drug De-addiction Centre in Chronic Conflict Area: Kashmir, India.

    PubMed

    Rather, Yasir Hassan; Bashir, Wiqar; Sheikh, Ajaz Ahmad; Amin, Marya; Zahgeer, Yasir Arafat

    2013-05-01

    The menace of substance abuse is not only a socially unacceptable reality, but in its entirety is a disease and emerging as a major public health challenge. To study the socio-demographic and clinical profile of patients attending the drug de-addiction centre. A descriptive study was undertaken in a drug de-addiction centre at the Police Hospital in Srinagar, and all patients (198) who were admitted during this period were interviewed. The mean (SD) age of patients was 26.8 years (SD 7.37), and over half (56%) belonged to the lower-middle social class. Poly-substance abuse was seen in 91.9%; medicinal opioids and cannabis were the most common substances abused. Most common age of initiation was 11-20 years (76.8%), with peer pressure and relief from a negative mood state being the most common reasons given for starting the drug(s). Prevalence of a co-morbid psychiatric disorder was high, on the order of 49.5%. A high rate of volatile substance use was observed among adolescents (54.5%). A pattern of poly-substance abuse was found to be quite common in patients, and use of volatile substances at a very young age emerged as a new trend. The dreadful repercussions of substance abuse justify the urgency to evolve a comprehensive strategy.

  13. Socio-demographic and Clinical Profile of Substance Abusers Attending a Regional Drug De-addiction Centre in Chronic Conflict Area: Kashmir, India

    PubMed Central

    Rather, Yasir Hassan; Bashir, Wiqar; Sheikh, Ajaz Ahmad; Amin, Marya; Zahgeer, Yasir Arafat

    2013-01-01

    Background: The menace of substance abuse is not only a socially unacceptable reality, but in its entirety is a disease and emerging as a major public health challenge. Objective: To study the socio-demographic and clinical profile of patients attending the drug de-addiction centre. Methods: A descriptive study was undertaken in a drug de-addiction centre at the Police Hospital in Srinagar, and all patients (198) who were admitted during this period were interviewed. Results: The mean (SD) age of patients was 26.8 years (SD 7.37), and over half (56%) belonged to the lower-middle social class. Poly-substance abuse was seen in 91.9%; medicinal opioids and cannabis were the most common substances abused. Most common age of initiation was 11–20 years (76.8%), with peer pressure and relief from a negative mood state being the most common reasons given for starting the drug(s). Prevalence of a co-morbid psychiatric disorder was high, on the order of 49.5%. A high rate of volatile substance use was observed among adolescents (54.5%). Conclusion: A pattern of poly-substance abuse was found to be quite common in patients, and use of volatile substances at a very young age emerged as a new trend. The dreadful repercussions of substance abuse justify the urgency to evolve a comprehensive strategy. PMID:23966822

  14. The intersecting roles of violence, gender, and substance use in the emergency department: a research agenda.

    PubMed

    Choo, Esther K; Benz, Madeline; Rybarczyk, Megan; Broderick, Kerry; Linden, Judith; Boudreaux, Edwin D; Ranney, Megan L

    2014-12-01

    The relationship between gender, violence, and substance use in the emergency department (ED) is complex. This article examines the role of gender in the intersection of substance use and three types of violence: peer violence, intimate partner violence, and firearm violence. Current approaches to treatment of substance abuse and violence are similar across both genders; however, as patterns of violence and substance abuse differ by gender, interventions may be more effective if they are designed with a specific gender focus. © 2014 by the Society for Academic Emergency Medicine.

  15. Elder Abuse and Black Americans: Incidence, Correlates, Treatment and Prevention.

    ERIC Educational Resources Information Center

    Cazenave, Noel A.

    Existing evidence on family violence rates by age and race as well as the available data on race and physical elder abuse incidence rates suggests that because such data are not based on random or representative samples and tend to reflect a "sampling artifact" of the particular client populations served by the professionals surveyed,…

  16. Drosophila: An Emergent Model for Delineating Interactions between the Circadian Clock and Drugs of Abuse

    PubMed Central

    De Nobrega, Aliza K.

    2017-01-01

    Endogenous circadian oscillators orchestrate rhythms at the cellular, physiological, and behavioral levels across species to coordinate activity, for example, sleep/wake cycles, metabolism, and learning and memory, with predictable environmental cycles. The 21st century has seen a dramatic rise in the incidence of circadian and sleep disorders with globalization, technological advances, and the use of personal electronics. The circadian clock modulates alcohol- and drug-induced behaviors with circadian misalignment contributing to increased substance use and abuse. Invertebrate models, such as Drosophila melanogaster, have proven invaluable for the identification of genetic and molecular mechanisms underlying highly conserved processes including the circadian clock, drug tolerance, and reward systems. In this review, we highlight the contributions of Drosophila as a model system for understanding the bidirectional interactions between the circadian system and the drugs of abuse, alcohol and cocaine, and illustrate the highly conserved nature of these interactions between Drosophila and mammalian systems. Research in Drosophila provides mechanistic insights into the corresponding behaviors in higher organisms and can be used as a guide for targeted inquiries in mammals. PMID:29391952

  17. Trauma-related risk factors for substance abuse among male versus female young adults.

    PubMed

    Danielson, Carla Kmett; Amstadter, Ananda B; Dangelmaier, Ruth E; Resnick, Heidi S; Saunders, Benjamin E; Kilpatrick, Dean G

    2009-04-01

    Clinical efforts to reduce risk for Substance Use Disorders (SUDs) among young adults rely on the empirical identification of risk factors for addictive behaviors in this population. Exposure to traumatic events and Posttraumatic Stress Disorder (PTSD) have been linked with SUDs in various populations. Emerging data, particularly from adolescent samples, suggest that traumatic event exposure increases risk for SUDs for young women, but not young men. The purpose of the current study was to examine trauma-related risk factors for alcohol and drug abuse among a national sample of young adults and compare such risk factors between men and women. Participants were 1753 young adults who participated in the 7-8 year follow-up telephone-based survey to the original National Survey of Adolescents. In the full sample, 29.1% met criteria for substance abuse. Trauma-related risk factors for alcohol and drug abuse differed for men and women. Clinical implications of these results are discussed.

  18. New challenges and opportunities in managing substance abuse in Malaysia.

    PubMed

    Mazlan, Mahmud; Schottenfeld, Richard S; Chawarski, Marek C

    2006-09-01

    Until recently, Malaysia has lagged behind in the treatment of drug addiction and related disorders, despite experiencing severe drug problems. By the end of 2004, 234,000 heroin users or heroin-dependent individuals had been registered in the official government registry, but other estimates exceed 500,000 for heroin abusers in the country. Amphetamine-type stimulant abuse is also increasing and of considerable public and government concern. Among the population of drug users, HIV and other infectious diseases rates are very high. In the Western Pacific regions, Malaysia has the second highest HIV prevalence (after Vietnam) among adult populations (0.62%) and the highest proportion of HIV cases resulting from injection drug use (76.3%). Drug use and related disorders exert a heavy burden on the country's health care and legal systems. Historically, drug abusers were rehabilitated involuntarily in correctional, rather than health-care, facilities. This primarily criminal treatment approach had limited effectiveness which led to widespread public dissatisfaction and the recent introduction of medical treatments for addiction. Naltrexone was introduced in 1999; buprenorphine was introduced in 2001 and methadone in 2003. Agonist maintenance programmes were embraced rapidly by the medical community in Malaysia. Currently, over 30,000 opiate-dependent patients are treated with agonist maintenance treatments by more than 500 medical practitioners in Malaysia. Despite these recent advances, treatments for amphetamine-type stimulant abuse or dependence are underdeveloped, and diversion of agonist medications is an emerging concern.

  19. Organizational Readiness for Change in Correctional and Community Substance Abuse Programs

    ERIC Educational Resources Information Center

    Lehman, Wayne E. K.; Greener, Jack M.; Rowan-Szal, Grace A.; Flynn, Patrick M.

    2012-01-01

    Significant needs exist for increased and better substance abuse treatment services in our nation's prisons. The TCU Organizational Readiness for Change (ORC) survey has been widely used in community-based treatment programs and evidence is accumulating for relationships between readiness for change and implementation of new clinical practices.…

  20. Several unusual cases of child abuse.

    PubMed

    Palmer, H; Weston, J T

    1976-10-01

    All childhood deaths which occurred in New Mexico during 1974 and 1975 were reviewed. Nine fatal instances of abuse were identified representing the entire spectrum of physical abuse: neglect, abuse in a single episode of injury, repetitive abuse, or sexual abuse. Several cases are summarized. These are unusual either in the distribution of pathologic findings or in the problems encountered in court presentation.

  1. Access and utilisation of maternity care for disabled women who experience domestic abuse: a systematic review

    PubMed Central

    2014-01-01

    Background Although disabled women are significantly more likely to experience domestic abuse during pregnancy than non-disabled women, very little is known about how maternity care access and utilisation is affected by the co-existence of disability and domestic abuse. This systematic review of the literature explored how domestic abuse impacts upon disabled women’s access to maternity services. Methods Eleven articles were identified through a search of six electronic databases and data were analysed to identify: the factors that facilitate or compromise access to care; the consequences of inadequate care for pregnant women’s health and wellbeing; and the effectiveness of existing strategies for improvement. Results Findings indicate that a mental health diagnosis, poor relationships with health professionals and environmental barriers can compromise women’s utilisation of maternity services. Domestic abuse can both compromise, and catalyse, access to services and social support is a positive factor when accessing care. Delayed and inadequate care has adverse effects on women’s physical and psychological health, however further research is required to fully explore the nature and extent of these consequences. Only one study identified strategies currently being used to improve access to services for disabled women experiencing abuse. Conclusions Based upon the barriers and facilitators identified within the review, we suggest that future strategies for improvement should focus on: understanding women’s reasons for accessing care; fostering positive relationships; being women-centred; promoting environmental accessibility; and improving the strength of the evidence base. PMID:25029907

  2. Effects of childhood abuse on adult obesity: a systematic review and meta-analysis.

    PubMed

    Hemmingsson, E; Johansson, K; Reynisdottir, S

    2014-11-01

    Controversy exists surrounding the role of childhood abuse in obesity development. This is a meta-analysis of observational studies on the role of childhood abuse in adult obesity. Systematic searches of PubMed, PsycInfo, Medline and CINAHL resulted in 23 cohort studies (4 prospective, 19 retrospective) with n=112,708 participants, containing four abuse types (physical, emotional, sexual, general). Four studies reported dose-response effects. A random effects model was used to quantify effect sizes, meta-regression/subgroup analysis for identifying potential moderating variables and Egger's test for publication bias. Adults who reported childhood abuse were significantly more likely to be obese (odds ratio [OR]: 1.34, 95% confidence interval [CI]: 1.24-1.45, P<0.001). All four types of abuse were significantly associated with adult obesity: physical (OR: 1.28, 95% CI: 1.13-1.46), emotional (OR: 1.36, 95% CI: 1.08-1.71), sexual (OR: 1.31, 95% CI: 1.13-1.53) and general abuse (OR: 1.45, 95% CI: 1.25-1.69). Severe abuse (OR: 1.50, 95% CI: 1.27-1.77) was significantly more associated with adult obesity (P=0.043) compared with light/moderate abuse (OR: 1.13, 95% CI: 0.91-1.41). We found no significant effects of study design (prospective vs. retrospective, P=0.07), age (P=0.96) or gender (P=0.92). Publication bias was evident (Egger's test P=0.007), but effect sizes remained statistically significant in sensitivity analyses. Childhood abuse was clearly associated with being obese as an adult, including a positive dose-response association. This suggests that adverse life experiences during childhood plays a major role in obesity development, potentially by inducing mental and emotional perturbations, maladaptive coping responses, stress, inflammation and metabolic disturbances. © 2014 World Obesity.

  3. A prospective examination of whether childhood sexual abuse predicts subsequent sexual offending.

    PubMed

    Widom, Cathy Spatz; Massey, Christina

    2015-01-01

    prospective empirical evidence. These new findings suggest that early intervention programs should target children with histories of physical abuse and neglect. They also indicate that existing policies and practices specifically directed at future risk for sex offending for sexually abused children may warrant reevaluation.

  4. What causes domestic abuse and how can nurses effectively support abused women?

    PubMed

    McDowall, Holy

    Domestic abuse is a significant public health problem in the UK, primarily perpetrated against women. Nurses can play a vital role in identifying patients who have experienced abuse, and in offering them emotional, psychological and practical support. This article explores the causes of domestic abuse, and nurses' role in caring for those affected. It emphasises the need for enhanced nurse education and awareness to enable nurses to provide holistic care for women.

  5. Comparison of Family Environments of Abused versus Non-Abused Children.

    ERIC Educational Resources Information Center

    Davis, Cynthia A.; Graybill, Daniel

    1983-01-01

    Compared Moos Family Environment Scale scores from 15 physically abusive families with scores from 15 nonabusive families. Results showed that abusive families were less supportive of one another and less free to express their wants and desires, more independent, more likely to express anger and aggression, and more rigid. (JAC)

  6. Childhood panhypopituitarism presenting as child abuse: a case report and review of the literature.

    PubMed

    Marcus, Bradley J; Collins, Kim A

    2004-09-01

    Childhood panhypopituitarism may be acquired or congenital. Children with panhypopituitarism can present clinically with diabetes, growth failure, decreased bone density, and morbid obesity. In the forensic setting without the proper history, it can be misdiagnosed as child abuse or neglect. We report a case of a 3-year-old black girl who was admitted to the emergency room with apnea and subsequently died. While at the emergency department, it was discovered that the child had a fractured left hip and was severely growth retarded for age. The coroner wanted to rule out child abuse and/or neglect and requested an autopsy based on the physical findings identified by hospital staff. Significant findings at autopsy included small for age (15th percentile for age), hypoplastic brain/pituitary gland/adrenal gland/thyroid gland, abnormally formed skull with an occipital protuberance, a fractured left hip with decreased bone density, and central adiposity. Subsequent to the autopsy, it was discovered that at 6 weeks of age the child suffered from group B streptococci meningitis that resulted in panhypopituitarism. The panhypopituitarism then resulted in seizure activity, diabetes insipidus, and growth retardation. The authors hope this case report and review of the literature will assist investigators, pathologists, and clinicians in making a distinction between neglect or inflicted injury of child abuse and panhypopituitarism that can present with similar signs and symptoms.

  7. Substance Abuse Recovery after Experiencing Homelessness and Mental Illness: Case Studies of Change Over Time

    PubMed Central

    Padgett, Deborah K.; Smith, Bikki Tran; Tiderington, Emmy

    2012-01-01

    Objective This paper addresses how consumers with dual diagnosis, who were formerly homeless but are now living in supportive housing, understand their recovery from substance abuse (i.e., substance abuse or dependence). Specifically, this study examined: What can be learned about substance abuse recovery from consumers considered to be doing well; how past substance abuse fits into their present-day narratives; and how (if at all) policies of harm reduction versus abstinence are regarded as affecting recovery efforts. Methods As part of a federally-funded qualitative study, 38 individuals who met criteria for having achieved a measure of success in mental health recovery were purposively sampled from two supportive housing agencies – one using a harm reduction and the other an abstinence model. Researchers conducted in-depth interviews and used case study analysis, the latter including the development of case summaries and data matrices, to focus on substance abuse recovery in the larger context of participants’ lives. Results Recovery from substance abuse was depicted as occurring either through discrete decisions or gradual processes; achieving recovery was distinct from maintaining recovery. Emergent themes related to achievement included: (a) pivotal events and people (b) maturation, and (c) institutionalization. Central themes to maintaining recovery were: (a) housing, (b) self-help, and (c) the influence of significant others. Conclusions These findings capture a complex picture of overcoming substance abuse that largely took place outside of formal treatment and was heavily dependent on broader contexts. Equally important is that consumers themselves did not necessarily view substance abuse recovery as a defining feature of their life story. Indeed, recovery from substance abuse was seen as overcoming one adversity among many others during their troubled life courses. PMID:22962547

  8. Comparison of Abuse Experiences of Rural and Urban African American Women During Perinatal Period

    PubMed Central

    Bhandari, Shreya; Bullock, Linda F. C.; Richardson, Jeanita W.; Kimeto, Pamela; Campbell, Jacquelyn C.; Sharps, Phyllis W.

    2015-01-01

    A subsample of 12 African American women (6 urban and 6 rural) were selected from a larger longitudinal, randomized control trial, Domestic Violence Enhanced Home Visitation (DOVE-R01 900903 National Institute of Nursing Research [NINR]/National Institutes of Health [NIH]). All African American women were chosen to control for any racial- and/or race-related cultural differences that may exist among women across geographical areas. The experiences of abuse during the perinatal period are drawn from in-depth interviews conducted at five points in time during pregnancy and the post-partum period. The analysis describes three major themes that highlight the similarities and differences among rural and urban women. The main themes found were (1) types of abuse, (2) location of abuse, and (3) response to abuse. In addition, two sub-themes (a) defiance and compliance and (b) role of children were also identified. Implications for universal screening for women of reproductive age, safer gun laws, and the need for further research are discussed. PMID:25315478

  9. Update on child abuse prevention.

    PubMed

    Krugman, Scott D; Lane, Wendy G; Walsh, Christina M

    2007-12-01

    Child abuse remains a significant problem in the United States with 2.9 million reports and 825 000 indicated cases in 2005. This report will highlight recent efforts toward child abuse prevention, focusing on home visiting programs, abusive head trauma primary prevention, parent training programs, sexual abuse prevention, and the effectiveness of laws banning corporal punishment. Most home visitation programs have demonstrated a lack of effectiveness in recent randomized trials. One exception is the Nurse Family Partnership, which remains the most effective and longest enduring intervention for high-risk families. Child sexual abuse prevention programs and parent training programs need further evaluation with more rigorous methodology and outcome measures. Providing universal parent education about coping with crying infants appears to be effective in lowering the incidence of abusive head trauma. Although advocated for, further study will determine the effectiveness of laws banning corporal punishment or mandating abusive head trauma education to parents of newborns. Pediatricians play an important role in the prevention of child maltreatment. Their knowledge of the effectiveness of different programs can help guide parents toward appropriate services.

  10. Risk management and post-marketing surveillance for the abuse of medications acting on the central nervous system: expert panel report.

    PubMed

    Johanson, Chris-Ellyn; Balster, Robert L; Henningfield, Jack E; Schuster, Charles R; Anthony, James C; Barthwell, Andrea G; Coleman, John J; Dart, Richard C; Gorodetzky, Charles W; O'Keeffe, Charles; Sellers, Edward M; Vocci, Frank; Walsh, Sharon L

    2009-12-01

    The abuse and diversion of medications is a significant public health problem. This paper is part of a supplemental issue of Drug and Alcohol Dependence focused on the development of risk management plans and post-marketing surveillance related to minimizing this problem. The issue is based on a conference that was held in October 2008. An Expert Panel was formed to provide a summary of the conclusions and recommendations that emerged from the meeting involving drug abuse experts, regulators and other government agencies, pharmaceutical companies and professional and other non-governmental organizations. This paper provides a written report of this Expert Panel. Eleven conclusions and 11 recommendations emerged concerning the state of the art of this field of research, the regulatory and public health implications and recommendations for future directions. It is concluded that special surveillance tools are needed to detect the emergence of medication abuse in a timely manner and that risk management tools can be implemented to increase the benefit to risk ratio. The scientific basis for both the surveillance and risk management tools is in its infancy, yet progress needs to be made. It is also important that the unintended consequences of increased regulation and the imposition of risk management plans be minimized.

  11. The differential diagnosis of ritual abuse allegations.

    PubMed

    Bernet, W; Chang, D K

    1997-01-01

    Because psychiatrists do not have a consistent way to classify and define the forms of child abuse that may be mistaken for ritual abuse, the objective of this paper is to create a comprehensive differential diagnosis of allegations of ritual abuse. The authors reviewed 60 articles, chapters, and books that contained allegations of ritual abuse or behaviors that might be mistaken for ritual abuse, that were made by patients or caretakers. This paper clarifies the behaviors that represent or may be mistaken for ritual abuse: Cult-based ritual abuse, pseudoritualistic abuse, activities by organized satanic groups, repetitive psychopathological abuse, sexual abuse by pedophiles, child pornography portraying ritual abuse, distorted memory, false memory, false report due to a severe mental disorder, pseudologia phantastica, adolescent behavior simulating ritual abuse, epidemic hysteria, deliberate lying, and hoaxes. The differential diagnosis of allegations of ritual abuse is important in both clinical and forensic psychiatry. In some cases, it will not be possible to tell whether a particular allegation is factual or what the underlying mental processes are. It is important to separate the role of the mental health professional as therapist from the role as an expert witness in court.

  12. Sexual abuse in children - what to know

    MedlinePlus

    Sexual abuse - children ... abused before they turn 18. Sexual abuse of children is any activity that the abuser does to get sexually aroused, including: Touching a child's genitals Rubbing the abuser's genitals against a child's ...

  13. Exploring the Correlates to Depression in Elder Abuse Victims: Abusive Experience or Individual Characteristics?

    PubMed

    Santos, Ana João; Nunes, Baltazar; Kislaya, Irina; Gil, Ana Paula; Ribeiro, Oscar

    2017-09-01

    Depression and depressive symptoms have been studied both as risk factors and consequences of elder abuse, even though the most common cross-sectional design of the studies does not allow inferring cause or consequence relationships. This study estimates the proportion of older adults who screened positive for depressive symptoms among those self-reporting elder abuse and examines whether individual characteristics and/or abusive experience aspects are associated with self-reported depressive symptoms. Participants were 510 older adults self-reporting experiences of abuse in family setting enrolled in the cross-sectional victims' survey of the Aging and Violence Study. Depressive symptoms were assessed through the abbreviated version of the Geriatric Depression Scale (GDS-5). Poisson regression was used to determine the prevalence ratio (PR) of screening depressive symptoms according to individual and abusive experience covariates: sex, age group, cohabitation, perceived social support, chronic diseases, functional status, violence type, perpetrator, and number of conducts. Women (PR = 1.18, 95% confidence interval [CI] = [1.04, 1.35]) individuals perceiving low social support level (PR = 1.36, 95% CI = [1.16, 1.60]) and with long-term illness (PR = 1.17, 95% CI = [1.02, 1.33]) were found to be associated with increased risk for screening depressive symptoms. In regard to abusive experience, only the number of abusive conducts increased the PR (PR = 1.07, 95% CI = [1.05, 1.09]). Routine screening for elder abuse should include psychological well-being assessment. Interventions toward risk alleviation for both mental health problems and elder abuse should target women perceiving low social support level and with long-term illness.

  14. Personality risk factors for cocaine abuse.

    PubMed

    Yates, W R; Fulton, A I; Gabel, J M; Brass, C T

    1989-07-01

    To evaluate the role of personality in cocaine abuse, 59 adults meeting DSM-III criteria for cocaine abuse were compared to similar-aged non-cocaine alcohol abusers and community controls on a DSM-III measure of personality. Cocaine abusers were more likely than non-cocaine alcohol abusers to display narcissistic personality traits (Odds ratio 6.86, 95% CI = 4.52, 15.60). (Am J Public Health 1989; 79:891-892.

  15. Children's experiences of domestic violence and abuse: Siblings' accounts of relational coping.

    PubMed

    Callaghan, Jane E M; Alexander, Joanne H; Sixsmith, Judith; Fellin, Lisa C

    2016-10-01

    This article explores how children see their relationships, particularly their sibling relationships, in families affected by domestic violence (DV) and how relationality emerges in their accounts as a resource to build an agentic sense of self. The 'voice' of children is largely absent from the DV literature, which typically portrays them as passive, damaged and relationally incompetent. Children's own understandings of their relational worlds are often overlooked, and consequently, existing models of children's social interactions give inadequate accounts of their meaning-making-in-context. Drawn from a larger study of children's experiences of DV and abuse, this article uses two case studies of sibling relationships to explore young people's use of relational resources, for coping with violence in the home. The article explores how relationality and coping intertwine in young people's accounts and disrupts the taken-for-granted assumption that children's 'premature caring' or 'parentification' is (only) pathological in children's responses to DV. This has implications for understanding young people's experiences in the present and supporting their capacity for relationship building in the future. © The Author(s) 2015.

  16. Multimethod prediction of child abuse risk in an at-risk sample of male intimate partner violence offenders.

    PubMed

    Rodriguez, Christina M; Gracia, Enrique; Lila, Marisol

    2016-10-01

    The vast majority of research on child abuse potential has concentrated on women demonstrating varying levels of risk of perpetrating physical child abuse. In contrast, the current study considered factors predictive of physical child abuse potential in a group of 70 male intimate partner violence offenders, a group that would represent a likely high risk group. Elements of Social Information Processing theory were evaluated, including pre-existing schemas of empathy, anger, and attitudes approving of parent-child aggression considered as potential moderators of negative attributions of child behavior. To lend methodological rigor, the study also utilized multiple measures and multiple methods, including analog tasks, to predict child abuse risk. Contrary to expectations, findings did not support the role of anger independently predicting child abuse risk in this sample of men. However, preexisting beliefs approving of parent-child aggression, lower empathy, and more negative child behavior attributions independently predicted abuse potential; in addition, greater anger, poorer empathy, and more favorable attitudes toward parent-child aggression also exacerbated men's negative child attributions to further elevate their child abuse risk. Future work is encouraged to consider how factors commonly considered in women parallel or diverge from those observed to elevate child abuse risk in men of varying levels of risk. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Gender Differences in Social Reactions to Abuse Disclosures, Post-Abuse Coping, and PTSD of Child Sexual Abuse Survivors

    ERIC Educational Resources Information Center

    Ullman, S.E.; Filipas, H.H.

    2005-01-01

    Objective: This research examines the understudied issue of gender differences in disclosure, social reactions, post-abuse coping, and PTSD of adult survivors of child sexual abuse (CSA). Method: Data were collected on a cross-sectional convenience sample of 733 college students completing a confidential survey about their demographic…

  18. Affective responsiveness, betrayal, and childhood abuse.

    PubMed

    Reichmann-Decker, Aimee; DePrince, Anne P; McIntosh, Daniel N

    2009-01-01

    Several trauma-specific and emotion theories suggest that alterations in children's typical affective responses may serve an attachment function in the context of abuse by a caregiver or close other. For example, inhibiting negative emotional responses or expressions might help the child preserve a relationship with an abusive caregiver. Past research in this area has relied on self-report methods to discover links between affective responsiveness and caregiver abuse. Extending this literature, the current study used facial electromyography to assess affective responsiveness with 2 measures: mimicry of emotional facial expressions and affective modulation of startle. We predicted that women who reported childhood abuse by close others would show alterations in affective responsiveness relative to their peers. We tested 100 undergraduate women who reported histories of (a) childhood sexual or physical abuse by someone close, such as a parent (high-betrayal); (b) childhood abuse by someone not close (low-betrayal); or (c) no abuse in childhood (no-abuse). Especially when viewing women's emotional expressions, the high-betrayal group showed more mimicry of happy and less mimicry of angry faces relative to women who reported no- or low-betrayal abuse, who showed the opposite pattern. Furthermore, women who reported high-betrayal abuse showed less affective modulation of startle during pictures depicting men threatening women than did the other two groups. Findings suggest that, as predicted by betrayal trauma theory, women who have experienced high-betrayal abuse show alterations in automatic emotional processes consistent with caregiving-maintenance goals in an abusive environment.

  19. Abuse of elderly people by their carers.

    PubMed Central

    Homer, A C; Gilleard, C

    1990-01-01

    OBJECTIVE--To assess the prevalence of abuse of elderly people by their carers and the characteristics of abusers and the abused. DESIGN--Information on abuse and risk factors was collected over six months from carers and patients. Risk factors were identified in the abused group and compared with those in a non-abused control group. SETTING--Carers were interviewed at home; patients were examined in the wards of Putney and Barnes geriatric hospitals, London. SUBJECTS--All patients referred from any source for respite care to the geriatric services over a six month period and their carers. MAIN OUTCOME MEASURES--Amount of physical and verbal abuse or neglect. Quantification of risk factors and correlation with the presence or absence of abuse. RESULTS--45% Of carers openly admitted to some form of abuse. Few patients admitted abuse. The most significant risk factor for physical abuse was alcohol consumption by the carer (p less than 0.001). Other significant risk factors were a poor pre-morbid relationship and previous abuse over many years. Abuse was often reciprocated and was associated with social dysfunction in many patients. Service delivery, respite care, and level of mental and physical disability were not significantly associated with abuse. CONCLUSION--The high level of abuse found in elderly patients in respite care was particularly associated with alcohol abuse and long term relationships of poor quality, which are difficult to change. Even with increased provision of services, care in the community may not be the best solution for these people. PMID:2271883

  20. Child sexual abuse: consequences and implications.

    PubMed

    Hornor, Gail

    2010-01-01

    Sexual abuse is a problem of epidemic proportions in the United States. Given the sheer numbers of sexually abused children, it is vital for pediatric nurse practitioners to understand both short-term and long-term consequences of sexual abuse. Understanding consequences of sexual abuse can assist the pediatric nurse practitioner in anticipating the physical and mental health needs of patients and also may assist in the identification of sexual abuse victims. Sexual abuse typically does not occur in isolation. Implications for practice will be discussed. Copyright © 2010 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.

  1. Risk factors associated with domestic abuse directed at adults with disabilities in South Korea.

    PubMed

    Kim, Kyung Mee; Lee, Byung Hwa

    2016-07-01

    Most research on domestic abuse and disability has focused on women with disabilities, while research on abuse against men with disabilities and their risk factors is virtually non-existent. The purpose of this research is to understand domestic abuse experienced by people with disabilities by investigating its prevalence and risk factors. This research used the National Survey on Persons with Disabilities (2011). Using a stratified sampling method, 5259 respondents were identified to make up the final sample. Ordered logistic regression was used to verify risk factors for abuse. Risk factors for women with disabilities are age, educational attainment level, ADL, experiences of discrimination, awareness of disability discrimination, external support, and satisfaction with number of friends. Risk factors for men with disabilities are region, experiences of discrimination, awareness of disability discrimination, external support, and satisfaction with number of friends. For both women and men with disabilities, more experience of discrimination, greater awareness of disability discrimination, less external support, and less satisfaction with number of friends are associated with a higher likelihood of having experiences of abuse. Men with disabilities living in rural areas have a higher risk of abuse than those living in cities. Younger women, women with lower educational attainment, and those with lower physical functioning are more likely to have experienced abuse. Based on these findings, the authors make recommendations designed to protect people with disabilities from domestic abuse. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Comparative assessment of the environmental sustainability of existing and emerging perchlorate treatment technologies for drinking water.

    PubMed

    Choe, Jong Kwon; Mehnert, Michelle H; Guest, Jeremy S; Strathmann, Timothy J; Werth, Charles J

    2013-05-07

    Environmental impacts of conventional and emerging perchlorate drinking water treatment technologies were assessed using life cycle assessment (LCA). Comparison of two ion exchange (IX) technologies (i.e., nonselective IX with periodic regeneration using brines and perchlorate-selective IX without regeneration) at an existing plant shows that brine is the dominant contributor for nonselective IX, which shows higher impact than perchlorate-selective IX. Resource consumption during the operational phase comprises >80% of the total impacts. Having identified consumables as the driving force behind environmental impacts, the relative environmental sustainability of IX, biological treatment, and catalytic reduction technologies are compared more generally using consumable inputs. The analysis indicates that the environmental impacts of heterotrophic biological treatment are 2-5 times more sensitive to influent conditions (i.e., nitrate/oxygen concentration) and are 3-14 times higher compared to IX. However, autotrophic biological treatment is most environmentally beneficial among all. Catalytic treatment using carbon-supported Re-Pd has a higher (ca. 4600 times) impact than others, but is within 0.9-30 times the impact of IX with a newly developed ligand-complexed Re-Pd catalyst formulation. This suggests catalytic reduction can be competitive with increased activity. Our assessment shows that while IX is an environmentally competitive, emerging technologies also show great promise from an environmental sustainability perspective.

  3. Depression and anger as risk factors underlying the relationship between maternal substance involvement and child abuse potential☆

    PubMed Central

    Hien, Denise; Cohen, Lisa R.; Caldeira, Nathilee A.; Flom, Peter; Wasserman, Gail

    2013-01-01

    Objective This study examines how emotion regulation deficits in the area of anger arousal and reactivity are associated with child abuse potential in mothers with substance use and depressive disorders in order to identify targeted areas for prevention and treatment. Methods A sample of 152 urban mothers was interviewed on measures of substance use, diagnosis of depression, anger arousal and reactivity, and child abuse potential. Results Linear hierarchical regressions revealed that anger arousal and reactivity exceeded diagnostic and demographic variables in predicting maternal child abuse potential. Additionally, anger arousal and reactivity was found to be a partial mediator of the relationship between diagnostic category and child abuse potential. Conclusions Findings are discussed in relation to a multifaceted model of child abuse potential which broadens the existing literature to include an examination of depression and emotion regulation in order to more fully understand how substance use and child abuse potential are linked. Practice implications Models and approaches which help clients to manage and regulate difficult feeling states, specifically anger, could be helpful, and may be most readily applied in such populations. PMID:20170960

  4. Depression and anger as risk factors underlying the relationship between maternal substance involvement and child abuse potential.

    PubMed

    Hien, Denise; Cohen, Lisa R; Caldeira, Nathilee A; Flom, Peter; Wasserman, Gail

    2010-02-01

    This study examines how emotion regulation deficits in the area of anger arousal and reactivity are associated with child abuse potential in mothers with substance use and depressive disorders in order to identify targeted areas for prevention and treatment. A sample of 152 urban mothers was interviewed on measures of substance use, diagnosis of depression, anger arousal and reactivity, and child abuse potential. Linear hierarchical regressions revealed that anger arousal and reactivity exceeded diagnostic and demographic variables in predicting maternal child abuse potential. Additionally, anger arousal and reactivity was found to be a partial mediator of the relationship between diagnostic category and child abuse potential. Findings are discussed in relation to a multifaceted model of child abuse potential which broadens the existing literature to include an examination of depression and emotion regulation in order to more fully understand how substance use and child abuse potential are linked. Models and approaches which help clients to manage and regulate difficult feeling states, specifically anger, could be helpful, and may be most readily applied in such populations. Copyright (c) 2010. Published by Elsevier Ltd.

  5. Self-harm intentions: can they be distinguished based upon a history of childhood physical and sexual abuse?

    PubMed

    Santa Mina, Elaine E

    2010-12-01

    A non-experimental, comparative design is used to measures self-harm intention in clients with and without a history of childhood physical and sexual abuse (CP/SA) presenting to an emergency department with an episode of self-harm behaviour. The traditional suicide literature identifies the key intention concepts of wish-to-die, lethality, hopelessness, and depression. However, the trauma literature understands self-harm behaviour to be an adaptive response to CP/SA and as such possibly helpful for managing intense affect and dissociation. The findings of this study demonstrate that a CP/SA history is not a distinguishing factor in self-harm intention. Almost all participants, regardless of abuse history, gave multiple reasons for their self-harm behaviour, in addition to or other than the wish-to-die. The striking similarity between the non-abused and abused groups with regard to self-harm intention challenges clinicians to assess for the full range of intentions of people who engage in self-harm and suicidal behaviour.

  6. Substance abuse and gender differences in first episode psychosis: Impact on hospital readmissions.

    PubMed

    Crosas, Josep M; Cobo, Jesus; Ahuir, Maribel; Hernández, Carla; García, Rebeca; Pousa, Esther; Oliva, Joan-Carles; Monreal, José-Antonio; Palao, Diego J

    There have been controversial results in the study of gender differences in first episode psychosis (FEP). Substance abuse is the main existing comorbidity in FEP, and has been associated with worse prognosis and greater symptom severity. To explore gender differences in FEP in relation to drug abuse, and their relationship with hospital readmissions. Descriptive and prospective study (18 months). We included 141 patients (31.2% women), aged 26.1 years on average, mostly diagnosed with schizophreniform disorder (32.6%). A percentage of 58.9 had problematic use of drugs. Gender significant differences were found in age of onset, age at entry to the programme, marital status and cohabitation, and percentage differences were revealed in current drug abuse and frequency of consumption. Gender, duration of untreated psychosis, psychiatric history, age of onset and previous drug use were not predictors of re-entry. Hospital readmission rate was 24.8%, with no gender differences. The most common reasons for admission were abandonment of treatment (66.7%) and drug abuse (44.4%). Drug abuse was higher in the men than in the women as a reason for re-admission. There are gender differences in FEP. Men have an earlier onset of symptoms and have worse functional outcomes. Drug abuse in men is higher and represents a major cause of hospital readmission. Therapeutic interventions to prevent the effects of drug abuse are necessary from the early stages of the illness. Copyright © 2017 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Counselor Self-Abuse.

    ERIC Educational Resources Information Center

    Gladding, Samuel T.

    1991-01-01

    Defines counselor self-abuse as a phenomenon which differs from burnout, unethical behavior, and inappropriate countertransference in its underlying dynamics and some of its manifestations. Delineates the main manifestations of counselor self-abuse and outlines appropriate treatments. Emphasizes the need for further research to determine more…

  8. Schizophrenia, Substance Abuse, and Violent Crime

    PubMed Central

    Fazel, Seena; Långström, Niklas; Hjern, Anders; Grann, Martin; Lichtenstein, Paul

    2016-01-01

    Context Persons with schizophrenia are thought to be at increased risk of committing violent crime 4 to 6 times the level of general population individuals without this disorder. However, risk estimates vary substantially across studies, and considerable uncertainty exists as to what mediates this elevated risk. Despite this uncertainty, current guidelines recommend that violence risk assessment should be conducted for all patients with schizophrenia. Objective To determine the risk of violent crime among patients diagnosed as having schizophrenia and the role of substance abuse in mediating this risk. Design, Setting, and Participants Longitudinal designs were used to link data from nationwide Swedish registers of hospital admissions and criminal convictions in 1973-2006. Risk of violent crime in patients after diagnosis of schizophrenia (n = 8003) was compared with that among general population controls (n = 80 025). Potential confounders (age, sex, income, and marital and immigrant status) and mediators (substance abuse comorbidity) were measured at baseline. To study familial confounding, we also investigated risk of violence among unaffected siblings (n = 8123) of patients with schizophrenia. Information on treatment was not available. Main Outcome Measure Violent crime (any criminal conviction for homicide, assault, robbery, arson, any sexual offense, illegal threats, or intimidation). Results In patients with schizophrenia, 1054 (13.2%) had at least 1 violent offense compared with 4276 (5.3%) of general population controls (adjusted odds ratio [OR], 2.0; 95% confidence interval [CI], 1.8-2.2). The risk was mostly confined to patients with substance abuse comorbidity (of whom 27.6% committed an offense), yielding an increased risk of violent crime among such patients (adjusted OR, 4.4; 95% CI, 3.9-5.0), whereas the risk increase was small in schizophrenia patients without substance abuse comorbidity (8.5% of whom had at least 1 violent offense; adjusted OR, 1

  9. Schizophrenia, substance abuse, and violent crime.

    PubMed

    Fazel, Seena; Långström, Niklas; Hjern, Anders; Grann, Martin; Lichtenstein, Paul

    2009-05-20

    Persons with schizophrenia are thought to be at increased risk of committing violent crime 4 to 6 times the level of general population individuals without this disorder. However, risk estimates vary substantially across studies, and considerable uncertainty exists as to what mediates this elevated risk. Despite this uncertainty, current guidelines recommend that violence risk assessment should be conducted for all patients with schizophrenia. To determine the risk of violent crime among patients diagnosed as having schizophrenia and the role of substance abuse in mediating this risk. Longitudinal designs were used to link data from nationwide Swedish registers of hospital admissions and criminal convictions in 1973-2006. Risk of violent crime in patients after diagnosis of schizophrenia (n = 8003) was compared with that among general population controls (n = 80 025). Potential confounders (age, sex, income, and marital and immigrant status) and mediators (substance abuse comorbidity) were measured at baseline. To study familial confounding, we also investigated risk of violence among unaffected siblings (n = 8123) of patients with schizophrenia. Information on treatment was not available. Violent crime (any criminal conviction for homicide, assault, robbery, arson, any sexual offense, illegal threats, or intimidation). In patients with schizophrenia, 1054 (13.2%) had at least 1 violent offense compared with 4276 (5.3%) of general population controls (adjusted odds ratio [OR], 2.0; 95% confidence interval [CI], 1.8-2.2). The risk was mostly confined to patients with substance abuse comorbidity (of whom 27.6% committed an offense), yielding an increased risk of violent crime among such patients (adjusted OR, 4.4; 95% CI, 3.9-5.0), whereas the risk increase was small in schizophrenia patients without substance abuse comorbidity (8.5% of whom had at least 1 violent offense; adjusted OR, 1.2; 95% CI, 1.1-1.4; P<.001 for interaction). The risk increase among those with

  10. The correlation of childhood physical abuse history and later abuse in a group of Turkish population.

    PubMed

    Caykoylu, Ali; Ibiloglu, Aslihan O; Taner, Yasemen; Potas, Nihan; Taner, Ender

    2011-11-01

    Domestic violence is passed from one generation to the next, and it affects not only the victim but also the psychological states of the witnesses, and especially the psychosocial development of children. Studies have reported that those who have been the victim of or witnessing violence during their childhood will use violence to a greater extent as adults in their own families. This research examines the relationships between a history of childhood physical abuse, likelihood of psychiatric diagnoses, and potential for being a perpetrator of childhood physical abuse in adulthood among women who received psychiatric treatment and in the healthy population from Turkey. Estimates of the prevalence of childhood physical abuse vary depending on definition and setting. The frequency of witnessing and undergoing physical abuse within the family during childhood is much higher in the psychiatrically disordered group than the healthy controls. Childhood physical abuse history is one of the major risk factors for being an abuser in adulthood. The best indicator of physically abusing one's own children was found to be as physical abuse during the childhood period rather than psychiatric diagnosis. There is a large body of research indicating that adults who have been abused as children are more likely to abuse their own children than adults without this history. This is an important study from the point of view that consequences of violence can span generations. Further studies with different risk factor and populations will help to identify different dimensions of the problem.

  11. Parent-Child Interaction Therapy with Physically Abusive Parents: Efficacy for Reducing Future Abuse Reports

    ERIC Educational Resources Information Center

    Chaffin, Mark; Silovsky, Jane F.; Funderburk, Beverly; Valle, Linda Anne; Brestan, Elizabeth V.; Balachova, Tatiana; Jackson, Shelli; Lensgraf, Jay; Bonner, Barbara L.

    2004-01-01

    A randomized trial was conducted to test the efficacy and sufficiency of parent-child interaction therapy (PCIT) in preventing re-reports of physical abuse among abusive parents. Physically abusive parents (N=110) were randomly assigned to one of three intervention conditions: (a) PCIT, (b) PCIT plus individualized enhanced services, or (c) a…

  12. Recommendations on recognition and response to child abuse and neglect in the Indian setting.

    PubMed

    Aggarwal, Kiran; Dalwai, Samir; Galagali, Preeti; Mishra, Devendra; Prasad, Chhaya; Thadhani, Anjana

    2010-06-01

    Pediatricians are usually the first point of contact of children with the health system. Studies worldwide have shown that there is insufficient knowledge about child abuse recognition and management among health workers. Presently no uniform guidelines exist in India for pediatricians regarding the appropriate response to child abuse. As part of the Child Rights and Protection Programme (CRPP) under IAP VISION 2007 of Indian Academy of Pediatrics, a Training of Trainers Workshop on Child Rights and Protection was held in Mumbai in January 2007. It was attended by participants from all over the country. The workshop recommended developing country-specific teaching and training material. A Task force of IAP CRPP was formed and it developed a module for Training of Trainers Workshops for Pediatricians. A National Consultative Meet was held in October, 2007 at New Delhi, where the program was discussed and ratified. To train pediatricians to: recognize and respond to child abuse; engage in a multidisciplinary networking mode to deal with child abuse; and, document, record and report instances of child abuse. Guidelines for recognition and management of child abuse are presented. All pediatricians should assess suspected harm with the same thoroughness and attention as they would do with a life threatening condition. Poor management after disclosure can increase psychological damage. Pediatrician should believe, support, reassure, treat and ensure rehabilitation of victims of child abuse, keeping the best interest of the child as the primary goal.

  13. Declarative memory in abused and neglected infants.

    PubMed

    Cheatham, Carol L; Larkina, Marina; Bauer, Patricia J; Toth, Sheree L; Cicchetti, Dante

    2010-01-01

    adaptive to develop exceptional event memory so as to avoid the events that lead to abuse. Mechanisms of plasticity are responsible for the laying down of memories (Aimone, Wiles, & Gage, 2006). Thus, the higher performance seen in the abused group could be related to a preservation of brain plasticity that facilitates resilience in the face of poverty, stress, and/or trauma. Plasticity in the brains of the neglected children may be lost due to the lack of stimulation, leaving them more vulnerable to the stress of poverty and neglect. In conclusion, maltreated children have often been studied as a single group. However, it is becoming clear from research conducted by our group and others that the subtypes of maltreatment may have different developmental sequelae. It is important that we understand the differential pathways involved in the development of abused versus neglected children. As discussed in other chapters of this volume, the imitation paradigm has emerged as a valuable tool in the identification of at-risk infants and toddlers. With the data reported here, it is evident that data from the elicited imitation procedure utilized herein differentiates between the subtypes of maltreatment. Research must be conducted to further elucidate the correlates of resilience in toddlers who have been abused. A longitudinal investigation would enable investigation of the questions of continuity of the observed increase in imitative behavior and whether increased imitation has a detrimental social effect while exerting a bolstering cognitive effect.

  14. Resource Manual for Alcohol and Other Drug Abuse Education in Internal Medicine.

    ERIC Educational Resources Information Center

    Bigby, JudyAnn, Ed.; England, Susan, Ed.

    The resource manual provides guidelines and resources for individuals interested in integrating a substance abuse curriculum into existing programs for medical students and residents in internal medicine. Materials and resources appropriate for practicing physicians are also included. Three sections are: (1) a statement of minimum knowledge and…

  15. The intellectual profile of abused and neglected children in the Philippines: An analysis of SB5 IQ scores of sexually abused, physically abused and neglected children.

    PubMed

    Bengwasan, Peejay D

    2018-05-24

    Child abuse and neglect have been associated with cognitive deficits, among other effects on child development. This study explores the prediction that child abuse and neglect has an impact on Stanford-Binet Intelligence Scales 5th Edition (SB5) IQ scores, in relation to gender, age and type of abuse experienced. 300 children with experiences of abuse and neglect were included in the study, comprising 100 sexually abused, 100 physically abused and 100 neglected children. Overall, all scores on the SB5 were found to be significantly lower than the minimum average scores on the test. Verbal IQ (VIQ) scores were likewise found to be significantly lower than Nonverbal IQ (NVIQ) scores. Full Scale IQ (FSIQ) scores did not reveal heterogeneity when gender was factored in. Age and type of abuse (with a moderate effect size) on the other hand, showed significant differences among groups. Statistical analyses of SB5 Factor Index Scores revealed that abused children, in general, have significantly higher Visual-Spatial Processing (VS) and Quantitative Reasoning (QR) scores and lower scores in Knowledge (KN). There was a large effect size found in such an analysis. Age (with a large effect size), gender and type of abuse (with moderate effect sizes) give significant variations to this obtained profile. Copyright © 2018 Elsevier Ltd. All rights reserved.

  16. Lessons Learned for Follow-up Phone Booster Counseling Calls with Substance Abusing Emergency Department Patients

    PubMed Central

    Donovan, Dennis M.; Hatch-Maillette, Mary A.; Phares, Melissa M.; McGarry, Ernest; Peavy, K. Michelle; Taborsky, Julie

    2014-01-01

    Background Post-visit “booster” sessions have been recommended to augment the impact of brief interventions delivered in the Emergency Department (ED). This paper, which focuses on implementation issues, presents descriptive information and interventionists’ qualitative perspectives on providing brief interventions over the phone, challenges, “lessons learned”, and recommendations for others attempting to implement adjunctive booster calls. Method Attempts were made to complete two 20-minute telephone “booster” calls within a week following a patient’s ED discharge with 425 patients who screened positive for and had recent problematic substance use other than alcohol or nicotine. Results Over half (56.2%) of participants completed the initial call; 66.9% of those who received the initial call also completed the second call. Median number of attempts to successfully contact participants for the first and second calls was 4 and 3, respectively. Each completed call lasted an average of about 22 minutes. Common challenges/barriers identified by booster callers included unstable housing, limited phone access, unavailability due to additional treatment, lack of compensation for booster calls, and booster calls coming from an area code different than the participants’ locale and from someone other than ED staff. Conclusions Specific recommendations are presented with respect to implementing a successful centralized adjunctive booster call system. Future use of booster calls might be informed by research on contingency management (e.g., incentivizing call completions), smoking cessation quitlines, and phone-based continuing care for substance abuse patients. Future research needs to evaluate the incremental benefit of adjunctive booster calls on outcomes over and above that of brief motivational interventions delivered in the ED setting. PMID:25534151

  17. Lessons learned for follow-up phone booster counseling calls with substance abusing emergency department patients.

    PubMed

    Donovan, Dennis M; Hatch-Maillette, Mary A; Phares, Melissa M; McGarry, Ernest; Peavy, K Michelle; Taborsky, Julie

    2015-03-01

    Post-visit "booster" sessions have been recommended to augment the impact of brief interventions delivered in the emergency department (ED). This paper, which focuses on implementation issues, presents descriptive information and interventionists' qualitative perspectives on providing brief interventions over the phone, challenges, "lessons learned", and recommendations for others attempting to implement adjunctive booster calls. Attempts were made to complete two 20-minute telephone "booster" calls within a week following a patient's ED discharge with 425 patients who screened positive for and had recent problematic substance use other than alcohol or nicotine. Over half (56.2%) of participants completed the initial call; 66.9% of those who received the initial call also completed the second call. Median number of attempts to successfully contact participants for the first and second calls were 4 and 3, respectively. Each completed call lasted an average of about 22 minutes. Common challenges/barriers identified by booster callers included unstable housing, limited phone access, unavailability due to additional treatment, lack of compensation for booster calls, and booster calls coming from an area code different than the participants' locale and from someone other than ED staff. Specific recommendations are presented with respect to implementing a successful centralized adjunctive booster call system. Future use of booster calls might be informed by research on contingency management (e.g., incentivizing call completions), smoking cessation quitlines, and phone-based continuing care for substance abuse patients. Future research needs to evaluate the incremental benefit of adjunctive booster calls on outcomes over and above that of brief motivational interventions delivered in the ED setting. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. GC-MS/MS detects potential pregabalin abuse in susceptible subjects' hair.

    PubMed

    Ianni, Federica; Aroni, Kyriaki; Gili, Alessio; Sardella, Roccaldo; Bacci, Mauro; Lancia, Massimo; Natalini, Benedetto; Gambelunghe, Cristiana

    2018-06-01

    Pregabalin, a GABA analogue, binds to the alpha 2 delta subunit of voltage-dependent calcium channels. It is recognised as efficacious in pathologies such as epilepsy, neuropathic pain, and anxiety disorders. Since pregabalin prescriptions have increased worldwide, reports of its abuse have been accumulating, mainly in patients with opioid abuse disorders. The present study investigated potential pregabalin abuse by means of hair analysis, a matrix that provides valuable retrospective information. Half of the pool of 280 susceptible patients had been occasional drug users and were being monitored for driving licence renewals. The other 140 patients had a history of opiate dependency and were monitored to assess compliance with methadone therapy. In view of determining pregabalin in hair samples, it was extracted in methanol, successfully derivatised to give the ethyl chloroformate derivative, and finally pregabalin was analysed by gas chromatography-tandem mass spectrometry. Selectivity, linearity, limit of detection, limit of quantification, recovery, intra- and inter-day precision, and accuracy of the quantification procedure were appraised. Pregabalin limits of detection and quantification were 30 pg/mg and 50 pg/mg, respectively. We found 10.7% of hair samples from methadone patients and 4.29% from occasional drug users were positive to pregabalin without medical prescription. The mean pregabalin concentration in hair was higher than in consumers with medical indications (1.45 ng/mg vs 0.74 ng/mg). These results suggest that pregabalin possesses a significant abuse potential particularly among individuals attending opiate dependence services and that pregabalin abuse is a serious emerging issue, which should be carefully monitored. Copyright © 2017 John Wiley & Sons, Ltd.

  19. Holding Abusers Accountable: An Elder Abuse Forensic Center Increases Criminal Prosecution of Financial Exploitation

    ERIC Educational Resources Information Center

    Navarro, Adria E.; Gassoumis, Zachary D.; Wilber, Kathleen H.

    2013-01-01

    Purpose: Despite growing awareness of elder abuse, cases are rarely prosecuted. The aim of this study was to examine the effectiveness of an elder abuse forensic center compared with usual care to increase prosecution of elder financial abuse. Design and Methods: Using one-to-one propensity score matching, cases referred to the Los Angeles County…

  20. Erythropoietin abuse and erythropoietin gene doping: detection strategies in the genomic era.

    PubMed

    Diamanti-Kandarakis, Evanthia; Konstantinopoulos, Panagiotis A; Papailiou, Joanna; Kandarakis, Stylianos A; Andreopoulos, Anastasios; Sykiotis, Gerasimos P

    2005-01-01

    The administration of recombinant human erythropoietin (rhEPO) increases the maximum oxygen consumption capacity, and is therefore abused as a doping method in endurance sports. The detection of erythropoietin (EPO) abuse is based on direct pharmacological and indirect haematological approaches, both of which have several limitations. In addition, current detection methods cannot cope with the emerging doping strategies of EPO mimicry, analogues and gene doping, and thus novel detection strategies are urgently needed. Direct detection methods for EPO misuse can be either pharmacological approaches that identify exogenous substances based on their physicochemical properties, or molecular methods that recognise EPO transgenes or gene transfer vectors. Since direct detection with molecular methods requires invasive procedures, it is not appropriate for routine screening of large numbers of athletes. In contrast, novel indirect methods based on haematological and/or molecular profiling could be better suited as screening tools, and athletes who are suspect of doping would then be submitted to direct pharmacological and molecular tests. This article reviews the current state of the EPO doping field, discusses available detection methods and their shortcomings, outlines emerging pharmaceutical and genetic technologies in EPO misuse, and proposes potential directions for the development of novel detection strategies.

  1. 76 FR 14980 - National Institute on Alcohol Abuse and Alcoholism; National Institute on Drug Abuse; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-18

    ... Alcohol Abuse and Alcoholism; National Institute on Drug Abuse; Notice of Meeting Pursuant to section 10(a... meeting of the National Advisory Council on Alcohol Abuse and Alcoholism and the National Advisory Council.... Name of Committees: National Advisory Council on Alcohol Abuse and Alcoholism and National Advisory...

  2. Elder Abuse: A Review of the Literature.

    ERIC Educational Resources Information Center

    Giordano, Nan Hervig; Giordano, Jeffrey A.

    1984-01-01

    Reviews the literature on elder abuse and examines categories of abuse, the incidence of abuse, and characteristics of the typical abused person. Concluded that the abused person is characteristically a severely impaired woman, aged 75 and over, White, widowed, and living with relatives. (LLL)

  3. Cardiovascular reactions to psychological stress and abuse history: the role of occurrence, frequency, and type of abuse.

    PubMed

    Ginty, Annie T; Masters, Nicole A; Nelson, Eliza B; Kaye, Karen T; Conklin, Sarah M

    2017-03-01

    Extreme cardiovascular reactions to psychological stress have been associated with traumatic life experiences. Previous studies have focused on the occurrence or frequency of abuse rather than type of abuse. We examined how occurrence, frequency, and the type of abuse history are related to cardiovascular reactivity (CVR) to acute psychological stress. The study consisted of between group and continuous analyses to examine the association between occurrence, type, and frequency of abuse with cardiovascular reactions to acute psychological stress. Data from 64 participants were collected. Heart rate, systolic blood pressure, and diastolic blood pressure were measured at baseline and during a standard mental arithmetic stress task. Individuals who experienced abuse showed diminished CVR to acute psychological stress; this was driven specifically by the history of sexual abuse. Frequency of abuse did not relate to stress reactions. These findings accord with previous work suggesting a relationship between traumatic life experience and hypoarousal in physiological reactivity and extend previous findings by suggesting the relationship may be driven by sexual abuse.

  4. Assessing abuse potential of new analgesic medications following market release: an evaluation of Internet discussion of tapentadol abuse.

    PubMed

    McNaughton, Emily C; Black, Ryan A; Weber, Sarah E; Butler, Stephen F

    2015-01-01

    Research on substance abusers in treatment suggests that tapentadol, a prescription analgesic, may have relatively low abuse potential. Messages posted by recreational drug abusers on online forums were examined for amount of discussion and endorsement for abuse of tapentadol and comparator drugs. Internet messages posted between January 1, 2011 and September 30, 2012 on seven drug-abuse web forums were evaluated. Proportions of posts and unique authors discussing tapentadol were compared with eight comparator compounds. Postcontent was coded to compare endorsement for abuse of tapentadol with two comparators, one drug with high desirability for abuse and one with low desirability for abuse. A total of 1,940,121 messages posted during the study period were copied from selected web forums. The proportion of all posts discussing tapentadol (proportion = 0.0003) was significantly lower than any of the comparator compounds (range of odds ratios from 16.6 to 104.3; P < 0.001). The proportion of unique authors was also lower. Posts coded for endorsement (N =  2,117) yielded an endorsement ratio (Ero) of 2.14 for tapentadol, which was significantly lower than the highly desirable for abuse oxymorphone (ERo = 5.08; P = 0.0011) and was as low as tramadol (ERo = 1.66), which has a long-established profile of low abuse and desirability for abuse. Recreational abusers posting on web forums appear to be less interested in abusing tapentadol when compared with other, selected prescription analgesics based on the amount of discussion (i.e., fewer posts and authors mentioning tapentadol). Endorsement of the product for abuse was also low. Wiley Periodicals, Inc.

  5. Post-Traumatic Stress in Sexually Abused, Physically Abused, and Nonabused Children.

    ERIC Educational Resources Information Center

    Deblinger, Esther; And Others

    1989-01-01

    This investigation compared rates of post-traumatic stress disorder symptoms across sexually abused (N=29), physically abused (N=20), and nonabused (N=29) psychiatrically hospitalized children. Overall rates were not significantly different across groups, but significant differences were found with respect to specific symptoms, especially in…

  6. Adolescent Substance Abuse.

    ERIC Educational Resources Information Center

    Thorne, Craig R.; DeBlassie, Richard R.

    1985-01-01

    Cummings (1979), citing evidence from the National Institute of Drug Abuse, reports that one of every eleven adult Americans suffers from a severe addictive problem. Drug addiction is epidemic among teenagers; one of every six teenagers suffers from a severe addictive problem. This paper focuses on adolescent drug/substance abuse. (Author)

  7. Maternal sexual abuse of male children.

    PubMed

    Elliott, Andrew J; Peterson, Linda W

    1993-07-01

    Preview Sexual abuse of boys by their mothers is being increasingly reported and must be considered in the course of history taking and physical examination. Often there is little objective evidence of such abuse, and only a cluster of signs and risk factors may reveal the victimization. Drs Elliott and Peterson list characteristics that can help physicians identify sexually abusive mothers and sexually abused children; they also discuss how to retrieve a report of abuse from a child and assess its credibility.

  8. The Many Victims of Substance Abuse

    PubMed Central

    2007-01-01

    Substance abuse is a complicated disorder and has far reaching consequences. The victims of substance abuse extend beyond the unfortunate ones suffering from this disorder and often include family and friends. Treatment options for substance abuse are many; however, positive outcomes are not always guaranteed. Many factors play into the potential for successful treatment. Some of these include the adherence and motivation of the substance abusing patients as well as patients' surrounding environments and support systems. In this article, we present a clinical case of opioid dependence and discuss various treatment options and modalities. We will discuss different variables that may maximize positive treatment outcomes. Also a review of the current literature regarding substance abuse treatment, psychotherapy with the drug abuser, and grief therapy should the substance abusing patient die for the surviving family members will be presented. PMID:20532120

  9. "If it hurts you, then it is not a joke": adolescents' ideas about girls' and boys' use and experience of abusive behavior in dating relationships.

    PubMed

    Sears, Heather A; Byers, E Sandra; Whelan, John J; Saint-Pierre, Marcelle

    2006-09-01

    This study examined adolescents' ideas about girls' and boys' use and experience of physical and psychological abuse in heterosexual dating relationships. Canadian high school students who were enrolled in Grades 9 and 11 took part in single-gender focus groups. Eight themes emerged from the analysis. The themes highlight the importance teenagers place on context for defining specific behaviors as abusive. They also underscore gender differences in the criteria adolescents use to make these judgments, in the forms of abusive behavior teenagers typically use in a dating relationship, and in the reasons for youths' declining use of physical abuse and increasing use of psychological abuse. These views have important implications for future research and for programs targeting adolescent dating violence.

  10. Child Abuse and Developmental Disabilities.

    ERIC Educational Resources Information Center

    Grayson, Joann, Ed.; Bartlette, Don

    1992-01-01

    Literature indicating high rates of abuse in this population is reviewed, as is literature indicating high rates of developmental disabilities in child victims of abuse. Problems in data collecting practices are noted. Reasons for these children's greater risk for abuse are identified, including child attributes, stress, parent vulnerabilities,…

  11. Assessing Employee Potentials for Abuse.

    ERIC Educational Resources Information Center

    Haddock, M. Dean; McQueen, William M.

    1983-01-01

    Administered questionnaires to abusive (N=21) and nonabusive (N=21) employees to identify potential for institutional child abuse. Results corroborated earlier findings of institutional child abuse and demonstrated an attempt at developing an assessment tool needed to screen staff who are working with the developmentally disabled and children in…

  12. Israeli Perspectives on Elder Abuse

    ERIC Educational Resources Information Center

    Rabi, Keren

    2006-01-01

    Despite the prevailing agreement among researchers that the increasing rate of elder abuse in Israel is relatively understudied, not sufficiently identified, and not appropriately addressed, literature on elderly abuse in the Israeli society remains limited. The common discourse on aging, eldercare, and elder abuse and neglect, mainly revolves…

  13. Domestic abuse as a transgressive practice: understanding nurses' responses through the lens of abjection.

    PubMed

    Bradbury-Jones, Caroline; Taylor, Julie

    2013-10-01

    Domestic abuse is a worldwide public health issue with long-term health and social consequences. Nurses play a key role in recognizing and responding to domestic abuse. Yet there is considerable evidence that their responses are often inappropriate and unhelpful, such as trivializing or ignoring the abuse. Empirical studies have identified several reasons why nurses' responses are sometimes wanting. These include organizational constraints, e.g. lack of time and privacy; and interpersonal factors such as fear of offending women and lack of confidence. We propose, however, that these factors present only a partial explanation. Drawing on the work of Julia Kristeva, we suggest that alternative understandings may be derived through applying the concept of abjection. Abjection is a psychological defence against any threat (the abject) to the clean and proper self that results in rejection of the abject. Using examples from our own domestic abuse research, we contend that exposure of nurses to the horror of domestic abuse evokes a state of abjection. Domestic abuse (the abject) transgresses established social boundaries of clean and proper. Thus when exposed to patients' and clients' experiences of it, some nurses subconsciously reject domestic abuse as a possibility (abjection). They do this to protect themselves from the horror of the act, but in so doing, render themselves unable to formulate appropriate responses. Rather than understanding the practice of some nurses as wilfully neglectful or ignorant, we argue that through a state of abjection, they are powerless to act. This does not refute existing evidence about nurses' responses to domestic abuse. Rather, as a relatively unknown concept in nursing, abjection provides an additional explanatory layer that accounts for why some nurses respond the way they do. Crucially, it elucidates the need for nurses to be supported emotionally when faced with the transgressive practice of abuse. © 2013 John Wiley & Sons Ltd.

  14. Adolescent Depression, Alcohol and Drug Abuse.

    ERIC Educational Resources Information Center

    Deykin, Eva Y.; And Others

    1987-01-01

    Interviews of 434 college students revealed that prevalence of major depressive disorder (MDD) was 6.8 percent; of alcohol abuse, 8.2 percent; and of substance abuse, 9.4 percent. Alcohol and substance abuse were associated with MDD. Substance abuse was associated with other psychiatric diagnoses as well. MDD usually preceded alcohol or substance…

  15. Addressing elder abuse: the Waterloo restorative justice approach to elder abuse project.

    PubMed

    Groh, Arlene; Linden, Rick

    2011-04-01

    The Community Care Access Centre (CCAC) of Waterloo Region, in partnership with a number of other social service agencies, designed and implemented a restorative justice model applicable to older adults who have been abused by an individual in a position of trust. The project was very successful in building partnerships, as many community agencies came together to deal with the problem of elder abuse. The program also raised the profile of elder abuse in the community. However, despite intensive efforts, referrals to the restorative justice program were quite low. Because of this, the program moved to a new organizational model, the Elder Abuse Response Team (EART), which has retained the guiding philosophy of restorative justice but has broadened the mandate. The team has evolved into a conflict management system that has multiple points of entry for cases and multiple options for dealing with elder abuse. The team has developed a broad range of community partners who can facilitate referrals to the EART and also can help to provide an individualized response to each case. The transition to the EART has been successful, and the number of referrals has increased significantly. Copyright © Taylor & Francis Group, LLC

  16. Child Abuse and Neglect in Indian Families.

    ERIC Educational Resources Information Center

    Sharan, M. B.

    Conditions in India that contribute to child abuse and neglect are discussed. Sections focus on child rearing practices, discipline of children at home and in school, the nation's six million abandoned children, child sexual abuse, causes of abuse, poverty, lack of education, characteristics of abused children and their abusers, situational…

  17. Orphaned and abused youth are vulnerable to pregnancy and suicide risk☆, ☆☆

    PubMed Central

    Kissin, Dmitry M.; Bogoliubova, Olga; Yorick, Roman V.; Kraft, Joan Marie; Jamieson, Denise J.; Marchbanks, Polly A.; Hillis, Susan D.

    2015-01-01

    Objective Little is known about the magnitude and consequences of violence against children for those living outside family care. We sought to estimate the frequency of childhood abuse and examine its association with lifetime pregnancy involvement (LPI) and past year suicide ideation among orphaned youth. Methods We analyzed data collected via cross-sectional interviewer-administered surveys completed by 293 orphaned youth aged 16–23 years living outside of family care in St. Petersburg, Russia. We used multivariable logistic regression to estimate adjusted odds ratios (AORs) of LPI and past year suicide ideation associated with childhood physical and sexual abuse. Other risk factors were also examined (e.g., social vulnerability, sexual and substance use behaviors), and characteristics of orphaned youth with LPI and past year suicide ideation were described. Results The prevalence of childhood abuse was higher among females than among males (23.3% versus 15.6% for physical abuse, and 20.3% versus 5.6% for sexual abuse), as was the prevalence of LPI and past year suicide ideation among those with histories of abuse. Experiences of childhood abuse were strong risk factors for both LPI and past year suicide ideation, with significant variation by gender. While both types of abuse were significantly associated with LPI and past year suicide ideation among females, physical abuse was significantly associated with LPI and sexual abuse was associated with suicide ideation for males. Of the other characteristics examined, strong modifiable risk factors included having no one to turn to for help and no involvement in activities outside of class. Among those with LPI (n = 36), nearly 20% had been pregnant or gotten someone pregnant ≥2 times, most (61.8%) reported at least one induced abortion, and current use of effective contraception was nearly non-existent. Among those with past year suicide ideation (n = 30), nearly half (44.8%) reported attempting suicide

  18. Assessment of unsuspected exposure to drugs of abuse in children from a Mediterranean city by hair testing.

    PubMed

    Pichini, Simona; Garcia-Algar, Oscar; Alvarez, Airam; Gottardi, Massimo; Marchei, Emilia; Svaizer, Fiorenza; Pellegrini, Manuela; Rotolo, Maria Concetta; Pacifici, Roberta

    2014-02-21

    Hair testing was used to investigate the prevalence of unsuspected exposure to drugs of abuse in a group of children presenting to an urban paediatric emergency department without suggestive signs or symptoms. Hair samples were obtained from 114 children between 24 months and 10 years of age attending the emergency room of Hospital del Mar in Barcelona, Spain. Hair samples from the accompanying parent were also collected. The samples were analyzed for the presence of opiates, cocaine, amphetamines, and cannabinoids by ultra-performance liquid chromatography-tandem mass spectrometry. Parental sociodemographics and possible drug of abuse history were recorded. Hair samples from twenty-three children (20.1%) were positive for cocaine (concentration range 0.15-3.81 ng/mg hair), those of thirteen children (11.4%) to cannabinoids (D9-THC concentration range 0.05-0.54 ng/mg hair), with four samples positive to codeine (0.1-0.25 ng/mg hair), one positive for 2.09 ng methadone per mg hair and one to 6-MAM (0.42 ng/mg hair) and morphine (0. 15 ng/mg hair) . In 69.5 and 69.2% of the positive cocaine and cannabinoids cases respectively, drugs was also found in the hair of accompanying parent. Parental sociodemographics were not associated with children exposure to drugs of abuse. However, the behavioural patterns with potential harmful effects for the child's health (e.g., tobacco smoking, cannabis, benzodiazepines and/or antidepressants use) were significantly higher in the parents of exposed children. In the light of the obtained results (28% overall children exposure to drugs of abuse) and in agreement with 2009 unsuspected 23% cocaine exposure in pre-school children from the same hospital, we support general hair screening to disclose exposure to drugs of abuse in children from risky environments to provide the basis for specific social and health interventions.

  19. Assessment of Unsuspected Exposure to Drugs of Abuse in Children from a Mediterranean City by Hair Testing

    PubMed Central

    Pichini, Simona; Garcia-Algar, Oscar; Alvarez, Airam; Gottardi, Massimo; Marchei, Emilia; Svaizer, Fiorenza; Pellegrini, Manuela; Rotolo, Maria Concetta; Pacifici, Roberta

    2014-01-01

    Hair testing was used to investigate the prevalence of unsuspected exposure to drugs of abuse in a group of children presenting to an urban paediatric emergency department without suggestive signs or symptoms. Hair samples were obtained from 114 children between 24 months and 10 years of age attending the emergency room of Hospital del Mar in Barcelona, Spain. Hair samples from the accompanying parent were also collected. The samples were analyzed for the presence of opiates, cocaine, amphetamines, and cannabinoids by ultra-performance liquid chromatography-tandem mass spectrometry. Parental sociodemographics and possible drug of abuse history were recorded. Hair samples from twenty-three children (20.1%) were positive for cocaine (concentration range 0.15–3.81 ng/mg hair), those of thirteen children (11.4%) to cannabinoids (Δ9-THC concentration range 0.05–0.54 ng/mg hair), with four samples positive to codeine (0.1–0.25 ng/mg hair), one positive for 2.09 ng methadone per mg hair and one to 6-MAM (0.42 ng/mg hair) and morphine (0. 15 ng/mg hair) . In 69.5 and 69.2% of the positive cocaine and cannabinoids cases respectively, drugs was also found in the hair of accompanying parent. Parental sociodemographics were not associated with children exposure to drugs of abuse. However, the behavioural patterns with potential harmful effects for the child’s health (e.g., tobacco smoking, cannabis, benzodiazepines and/or antidepressants use) were significantly higher in the parents of exposed children. In the light of the obtained results (28% overall children exposure to drugs of abuse) and in agreement with 2009 unsuspected 23% cocaine exposure in pre-school children from the same hospital, we support general hair screening to disclose exposure to drugs of abuse in children from risky environments to provide the basis for specific social and health interventions. PMID:24566054

  20. A rationale and model for addressing tobacco dependence in substance abuse treatment.

    PubMed

    Richter, Kimber P; Arnsten, Julia H

    2006-08-14

    Most persons in drug treatment smoke cigarettes. Until drug treatment facilities systematically treat their patients' tobacco use, millions will flow through the drug treatment system, overcome their primary drug of abuse, but die prematurely from tobacco-related illnesses. This paper reviews the literature on the health benefits of quitting smoking for drug treatment patients, whether smoking causes relapse to other drug or alcohol abuse, the treatment of tobacco dependence, and good and bad times for quitting smoking among drug treatment patients. It also presents a conceptual model and recommendations for treating tobacco in substance abuse treatment, and provides references to internet and paper-copy tools and information for treating tobacco dependence. At present, research on tobacco treatment in drug treatment is in its infancy. Although few drug treatment programs currently offer formal services, many more will likely begin to treat nicotine dependence as external forces and patient demand for these services increases. In the absence of clear guidelines and attention to quality of care, drug treatment programs may adopt smoking cessation services based on cost, convenience, or selection criteria other than efficacy. Because research in this field is relatively new, substance abuse treatment professionals should adhere to the standards of care for the general population, but be prepared to update their practices with emerging interventions that have proven to be effective for patients in drug treatment.