Science.gov

Sample records for 747-100b sud 747-200b

  1. 76 FR 30253 - Airworthiness Directives; The Boeing Company Model 747-100, 747-100B, 747-100B SUD, 747-200B, 747...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-25

    ...-16532 (75 FR 78591, ] December 16, 2010), currently requires adding two new indicator lights on a... Model 747-100, 747- 100B, 747-100B SUD, 747-200B, 747-200C, 747-200F, 747-300, 747SR, and 747SP Series... requires those actions for Model 747-100, 747-100B, 747-100B SUD, 747-200B, 747-200C, 747-200F,...

  2. 76 FR 19278 - Airworthiness Directives; The Boeing Company Model 747-100, 747-100B, 747-100B SUD, 747-200B, 747...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-07

    ...-15-10, Amendment 39-15139 (72 FR 41438, July 30, 2007), for all Boeing Model 747 airplanes. A correction of that AD was published in the Federal Register on September 21, 2007 (72 FR 53923), which...'' under the DOT Regulatory Policies and Procedures (44 FR 11034, February 26, 1979), (3) Will not...

  3. 76 FR 34625 - Airworthiness Directives; The Boeing Company Model 747-100, 747-100B, 747-100B SUD, 747-200B, 747...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-14

    ... AD 2010-23-13 Amendment 39-16502 (75 FR 68688, November 9, 2009), for Model 757 airplanes, and are... Procedures (44 FR 11034, February 26, 1979), (3) Will not affect intrastate aviation in Alaska, and (4) Will.... We are proposing this AD to prevent flammable fluid from leaking onto the engine exhaust...

  4. 75 FR 18446 - Airworthiness Directives; The Boeing Company Model 747-100, 747-100B, 747-100B SUD, 747-200B, 747...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-12

    ... 14, 2001, we issued AD 2001-26-09, amendment 39-12573 (66 FR 66734, December 27, 2001), applicable to... Procedures (44 FR 11034, February 26, 1979), and 3. Will not have a significant economic impact, positive or... assemblies in the ECS with burned Boeing Material Specification (BMS) 8-39 polyurethane foam insulation....

  5. 75 FR 38007 - Airworthiness Directives; The Boeing Company Model 747-100, 747-100B, 747-100B SUD, 747-200B, 747...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-01

    ... Federal Register on April 12, 2010 (75 FR 18446). That NPRM proposed to require reworking or replacing... ``significant rule'' under DOT Regulatory Policies and Procedures (44 FR 11034, February 26, 1979), and (3) Will... (BMS) 8-39 polyurethane foam insulation. This proposed AD also results from a report from the...

  6. 75 FR 3150 - Airworthiness Directives; The Boeing Company Model 747-100, 747-100B, 747-100B SUD, 747-200B, 747...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-20

    ... as of February 24, 2010. On January 29, 2007 (72 FR 1427, January 12, 2007), the Director of the... 39 to include an AD that supersedes AD 2007-01-15, amendment 39-14887 (72 FR 1427, January 12, 2007... on September 18, 2009 (74 FR 47897). That NPRM proposed to continue to require repetitive...

  7. 75 FR 9760 - Airworthiness Directives; The Boeing Company Model 747-100, 747-100B, 747-100B SUD, 747-200B, 747...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-04

    ... FR 42807). That NPRM proposed to require one-time detailed and high frequency eddy current... 2004-07-22, Amendment 39-13566 (69 FR 18250, April 7, 2004), AD 2004-07-22 R1, Amendment 39-13566 (69 FR 24063, May 3, 2004), or AD 2006-10-16 Amendment 39-14600 (71 FR 28570, May 17, 2006) be...

  8. 75 FR 37997 - Airworthiness Directives; The Boeing Company Model 747-100, 747-100B, 747-100B SUD, 747-200B, 747...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-01

    ... jettison pumps, and the center tank scavenge pump, as applicable, with new relays having a ground fault... Federal Register on October 13, 2009 (74 FR 52431). That NPRM proposed to require replacing the power control relays for the main tank fuel boost pumps and jettison pumps, and the center tank scavenge...

  9. 75 FR 61337 - Airworthiness Directives; The Boeing Company Model 747-100, 747-100B, 747-100B SUD, 747-200B, 747...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-05

    ... 39 to include an AD to supersede AD 2001-16-02, amendment 39- 12370 (66 FR 41440, August 8, 2001... Register on November 20, 2009 (74 FR 60215). That NPRM proposed to continue to require repetitive... Policies and Procedures (44 FR 11034, February 26, 1979); and (3) Will not have a significant...

  10. 75 FR 39185 - Airworthiness Directives; The Boeing Company Model 747-100, 747-100B, 747-100B SUD, 747-200B, 747...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-08

    ... 2007-19-19, Amendment 39-15210 (72 FR 53939, September 21, 2007), for certain Boeing Model 747-100, 747... accomplished the terminating action required by AD 2001-15-02, Amendment 39-12336 (66 FR 37884, July 20, 2001... investigative and corrective actions specified in Part 7 of the Accomplishment Instructions of Boeing...

  11. 76 FR 13067 - Airworthiness Directives; The Boeing Company Model 747-100, 747-100B, 747-100B SUD, 747-200B, 747...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-10

    ..., amendment 39-15210 (72 FR 53939, September 21, 2007). That AD applies to the specified products. The NPRM was published in the Federal Register on July 8, 2010 (75 FR 39185). That NPRM proposed to continue to... Policies and Procedures (44 FR 11034, February 26, 1979), (3) Will not affect intrastate aviation in...

  12. 75 FR 20792 - Airworthiness Directives; The Boeing Company Model 747-100, 747-100B, 747-100B SUD, 747-200B, 747...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-21

    ... must receive comments on this proposed AD by June 7, 2010. ADDRESSES: You may send comments by any of... rule'' under the DOT Regulatory Policies and Procedures (44 FR 11034, February 26, 1979), and 3. Will.... Comments Due Date (a) We must receive comments by June 7, 2010. Affected ADs (b) None. Applicability...

  13. 75 FR 52907 - Airworthiness Directives; The Boeing Company Model 747-100, 747-100B, 747-100B SUD, 747-200B, 747...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-30

    ... airplanes. That original NPRM was published in the Federal Register on January 31, 2008 (73 FR 5768). That... 12866, 2. Is not a ``significant rule'' under the DOT Regulatory Policies and Procedures (44 FR 11034... lap joints and butt joints, around external doublers and antennas, and at locations where...

  14. 75 FR 39818 - Airworthiness Directives; The Boeing Company Model 747-100, 747-100B, 747-100B SUD, 747-200B, 747...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-13

    ... was published in the Federal Register on April 21, 2010 (75 FR 20792). That NPRM proposed to require... ``significant rule'' under DOT Regulatory Policies and Procedures (44 FR 11034, February 26, 1979), and (3) Will... in a rapid loss of cabin pressure. DATES: This AD is effective August 17, 2010. The Director of...

  15. 75 FR 27424 - Airworthiness Directives; The Boeing Company Model 747-100, 747-100B, 747-100B SUD, 747-200B, 747...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-17

    ... on July 13, 1994 (59 FR 30277, June 13, 1994). Table 3--Material Previously Incorporated by Reference... listed in the AD as of June 21, 2010. On July 13, 1994 (59 FR 30277, June 13, 1994), the Director of the... 39 to include an AD that supersedes AD 94-12-04, Amendment 39- 8932 (59 FR 30277, June 13, 1994)....

  16. 75 FR 78591 - Airworthiness Directives; The Boeing Company Model 747-100, 747-100B, 747-100B SUD, 747-200B, 747...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-16

    ... incorporation by reference of a certain other publication listed in this AD as of June 12, 2008 (73 FR 25977... Register on October 1, 2010 (75 FR 60661). That supplemental NPRM proposed to require adding two new... ``significant rule'' under DOT Regulatory Policies and Procedures (44 FR 11034, February 26, 1979), (3) Will...

  17. 75 FR 70868 - Airworthiness Directives; The Boeing Company Model 747-100, 747-100B, 747-100B SUD, 747-200B, 747...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-19

    ...., Washington, DC 20590. Hand Delivery: Deliver to Mail address above between 9 a.m. and 5 p.m., Monday through..., Amendment 39-16367 (75 FR 39804, July 13, 2010), that applies to certain Model 757 airplanes, Model 767...). The intent of this second inspection is for quality assurance purposes. This clarification has...

  18. 75 FR 60661 - Airworthiness Directives; The Boeing Company Model 747-100, 747-100B, 747-100B SUD, 747-200B, 747...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-01

    ... was published in the Federal Register on October 16, 2008 (73 FR 61369). That original NPRM proposed... 12866, 2. Is not a ``significant rule'' under the DOT Regulatory Policies and Procedures (44 FR 11034... Flight Manual (AFM) Boeing requests that the original NPRM be revised to add a requirement to...

  19. 75 FR 61985 - Airworthiness Directives; Boeing Model 747-100, 747-100B, 747-100B SUD, 747-200B, 747-200F, 747...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-07

    ... 12866, (2) Is not a ``significant rule'' under DOT Regulatory Policies and Procedures (44 FR 11034... certain equipment on the flight deck door. This AD was prompted by reports that the current design of the flight deck door is defective. We are issuing this AD to prevent failure of this equipment, which...

  20. 75 FR 3658 - Airworthiness Directives; The Boeing Company Model 747-100, 747-100B, 747-100B SUD, 747-200B, 747...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-22

    ... the crew oxygen system to melt or burn, causing oxygen system leakage and smoke or fire. DATES: We... Order 12866, 2. Is not a ``significant rule'' under the DOT Regulatory Policies and Procedures (44 FR... crew oxygen system to melt or burn, resulting in oxygen system leakage and smoke or fire. Compliance...

  1. 75 FR 47208 - Airworthiness Directives; The Boeing Company Model 747-100, 747-100B, 747-100B SUD, 747-200B, 747...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-05

    ..., causing oxygen system leakage and smoke or fire. DATES: This AD is effective September 9, 2010. The... Register on January 22, 2010 (75 FR 3658). That NPRM proposed to require inspecting to verify the part... potential consequence of an oxygen-fed fire in the vicinity of the flightcrew station. We do not agree....

  2. 75 FR 3147 - Airworthiness Directives; The Boeing Company Model 747-100B SUD, -200B, -300, -400, and -400D...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-20

    ... 26, 2003, as of August 30, 2005 (70 FR 43020, July 26, 2005). ADDRESSES: For service information..., amendment 39-14197 (70 FR 43020, July 26, 2005). The existing AD applies to certain Model 747-100B SUD... 14, 2009 (74 FR 33928). That NPRM proposed to require repetitive inspections for cracking in...

  3. 75 FR 38404 - Airworthiness Directives; The Boeing Company Model 747-100B, 747-200B, 747-200F, 747-300, 747-400...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-02

    ... 2010-01-10, Amendment 39-16168 (75 FR 3150, January 20, 2010), applicable to certain Model 747-100, 747... Executive Order 12866, (2) Is not a ``significant rule'' under DOT Regulatory Policies and Procedures (44 FR... sides of the strut front spar chord for cracks and fractures at each strut location, and...

  4. 76 FR 38074 - Airworthiness Directives; The Boeing Company Model 747-100, 747-100B, 747-200B, 747-200C, 747...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-29

    ... On October 1, 1990, we issued AD 90-21-17, amendment 39-6768 (55 FR 41510, October 12, 1990), for... ``significant rule'' under the DOT Regulatory Policies and Procedures (44 FR 11034, February 26, 1979); and 3... amendment 39-6768 (55 FR 41510, October 12, 1990) and adding the following new AD: The Boeing...

  5. 77 FR 21422 - Airworthiness Directives; The Boeing Company Airplanes

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-10

    ...We are superseding an existing airworthiness directive (AD) for all The Boeing Company Model 747-100, 747-100B, 747-100B SUD, 747- 200B, 747-200C, 747-200F, 747-300, 747-400, 747-400D, 747-400F, 747SR, and 747SP series airplanes. That AD currently requires an inspection of the No. 2 and No. 3 windows on the left and right sides of the airplane to determine their part numbers, related......

  6. 78 FR 72561 - Airworthiness Directives; The Boeing Company Airplanes

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-03

    ...We are adopting a new airworthiness directive (AD) for certain The Boeing Company Model 747-100, 747-100B, 747-100B SUD, 747-200B, 747-200C, 747-200F, 747-300, 747-400, 747-400D, 747-400F, 747SR, and 747SP series airplanes. This AD was prompted by a report of a disbonded doubler and a skin crack in section 41 of the fuselage, and multiple reports of cracked or missing fastener heads. This AD......

  7. 78 FR 40050 - Airworthiness Directives; The Boeing Company Airplanes

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-03

    ...We propose to supersede an existing airworthiness directive (AD) that applies to certain The Boeing Company Model 747-100, 747- 100B, 747-100B SUD, 747-200B, 747-200C, 747-200F, 747-300, 747-400, 747-400D, 747-400F, 747SR, and 747SP series airplanes. The existing AD currently requires repetitive inspections for wear damage and cracks of the fuselage skin in the interface area of the vertical......

  8. 77 FR 5195 - Airworthiness Directives; The Boeing Company Airplanes

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-02

    ...We are revising an earlier proposed airworthiness directive (AD) for all Model 747-100B SUD, 747-300, 747-400, and 747-400D series airplanes; and Model 747-200B series airplanes having a stretched upper deck. The original NPRM would have superseded an existing AD that currently requires repetitively inspecting for cracking or discrepancies of the fasteners in the tension ties, shear webs, and......

  9. 75 FR 22514 - Airworthiness Directives; The Boeing Company Model 747-200B Series Airplanes

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-29

    ... Executive Order 12866, (2) Is not a ``significant rule'' under DOT Regulatory Policies and Procedures (44 FR... joints at stringer 6 on the left and right sides from station (STA) 340 to STA 400, a one- time general... cracking at an earlier time than expected. Previously, no inspections of this area were recommended...

  10. 75 FR 35356 - Airworthiness Directives; The Boeing Company Model 747-100, 747-200B, and 747-200F Series Airplanes

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-22

    ... rapid decompression of the airplane and inability of the structure to carry fail-safe loads. DATES: We... inability of the structure to carry fail-safe loads. On June 2, 1994, we issued AD 94-12-09, Amendment 39... structure to carry fail-safe loads. Actions Since Existing AD Was Issued Since we issued AD 94-12-09 and...

  11. 75 FR 61977 - Airworthiness Directives; The Boeing Company Model 747-100, 747-200B, and 747-200F Series Airplanes

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-07

    ... and inability of the structure to carry fail-safe loads. DATES: This AD becomes effective November 12... decompression of the airplane and the inability of the structure to carry fail-safe loads. Compliance (f) You..., Amendment 39- 6653 (55 FR 28600, July 12, 1990), and AD 94-12-09, Amendment 39-8937 (59 FR 30285, June...

  12. 75 FR 10669 - Airworthiness Directives; The Boeing Company Model 747-100, 747-200B, 747-300, and 747SR Series...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-09

    ... FR 48882). That supplemental NPRM proposed to require installation of a closeout panel and moisture... 12866, (2) Is not a ``significant rule'' under DOT Regulatory Policies and Procedures (44 FR 11034... contamination in the electrical and electronic units in the main equipment center. We are issuing this AD...

  13. 76 FR 24349 - Airworthiness Directives; The Boeing Company Model 747-200B, -300, -400, -400D, and -400F Series...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-02

    ..., 2010 (75 FR 69612). That NPRM proposed to require an inspection to determine the part number of the mid... 12866, (2) Is not a ``significant rule'' under DOT Regulatory Policies and Procedures (44 FR 11034... right access doors of the spring beam mid-pivot bolt assembly for the No. 1 strut were...

  14. 75 FR 69612 - Airworthiness Directives; The Boeing Company Model 747-200B, -300, -400, -400D, and -400F Series...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-15

    ... 12866, 2. Is not a ``significant rule'' under the DOT Regulatory Policies and Procedures (44 FR 11034... bolt assembly. This proposed AD results from a report that the left and right spring beam mid-pivot... bolt assemblies on the spring beam on the outboard struts. Incorrectly installed bolt assemblies...

  15. Una visita en Sud America

    NASA Astrophysics Data System (ADS)

    1982-09-01

    Oisfrute de una estadfa en el Hotel La Silla, el mejor hotel de Sud America con su tan unica atmosfera extraterrestre! Los espera su calificado personal de experimentados hoteleros, jefes de cocina, etc., ansiosos todos de satisfacer sus deseos hasta el mas mfnimo detalle. Naturalmente nuestro espacioso restaurant de tres estrellas ofrece un completo surtido de exquisitas comidas y deliciosos tragos (conocedores usualmente eligen "Oelicia Orion" 0 "Centauro Especial"). EI servicio cempleto durante 24 horas incluye nuestra ya mundialmente famosa "Cena de medianoche para los miradores de estrellas", por eso - no olvide: No pierda la oportunidad de una estadfa en EL HOTEL LA SILLA - una experiencia maravillosa!

  16. Validity of global physical and emotional SUDS.

    PubMed

    Tanner, Barry A

    2012-03-01

    Despite the wide-spread use of Subjective Units of Discomfort Scales, or SUDS, to measure anxiety to specific stimuli, little information has been published on the validity of such scales and even less on their use as global measures of emotional and physical discomfort. Data was examined for 182 consecutive admissions to a psychology clinic to determine the relationship of self-rating of emotional and physical discomfort to one another and of the emotional self-rating to the clinician rating of general functioning (GAF). As expected, patients' ratings of their emotional discomfort were significantly higher than ratings of their physical discomfort (t = 9.077, p < .001). Emotional SUDS were significantly and negatively related to clinicians' GAF ratings (r = - 0.439, p < .001), indicating that the two ratings measured related global constructs. Data for the 53 patients who also completed the MMPI-2 was drawn from the larger sample to determine the nature of the relationship between SUDS and two measures of general emotional distress, with patients' SUDS significantly related to both the A scale (r = 0.351, p < .05) and the neurotic index (r = 0.366, p < .01). Finally, there was a significant decrease in the emotional SUDS (t = 4.686, p < .001) but not the physical SUDS (t = 0.788, p = .434) after 3 months of psychotherapy. The data supports SUDS as global measures of both physical and emotional discomfort. PMID:22038278

  17. A cost comparison of traditional drainage and SUDS in Scotland.

    PubMed

    Duffy, A; Jefferies, C; Waddell, G; Shanks, G; Blackwood, D; Watkins, A

    2008-01-01

    The Dunfermline Eastern Expansion (DEX) is a 350 ha mixed development which commenced in 1996. Downstream water quality and flooding issues necessitated a holistic approach to drainage planning and the site has become a European showcase for the application of Sustainable Urban Drainage Systems (SUDS). However, there is minimal data available regarding the real costs of operating and maintaining SUDS to ensure they continue to perform as per their design function. This remains one of the primary barriers to the uptake and adoption of SUDS. This paper reports on what is understood to be the only study in the UK where actual costs of constructing and maintaining SUDS have been compared to an equivalent traditional drainage solution. To compare SUDS costs with traditional drainage, capital and maintenance costs of underground storage chambers of analogous storage volumes were estimated. A whole life costing methodology was then applied to data gathered. The main objective was to produce a reliable and robust cost comparison between SUDS and traditional drainage. The cost analysis is supportive of SUDS and indicates that well designed and maintained SUDS are more cost effective to construct, and cost less to maintain than traditional drainage solutions which are unable to meet the environmental requirements of current legislation. PMID:18496012

  18. SARS Coronavirus-unique Domain (SUD): Three-domain Molecular Architecture in Solution and RNA Binding

    PubMed Central

    Johnson, Margaret A.; Chatterjee, Amarnath; Neuman, Benjamin W.; Wüthrich, Kurt

    2010-01-01

    The nonstructural protein 3 (nsp3) of the severe acute respiratory syndrome coronavirus (SARS-CoV) includes a “SARS-unique region” (SUD) consisting of three globular domains separated by short linker peptide segments. This paper reports NMR structure determinations of the C-terminal domain (SUD-C) and of a two-domain construct (SUD-MC) containing the middle domain (SUD-M) and the C-terminal domain, and NMR data on the conformational states of the N-terminal domain (SUD-N) and the SUD-NM two-domain construct. Both SUD-N and SUD-NM are monomeric and globular in solution, and in SUD-NM there is high mobility in the two-residue interdomain linking sequence, with no preferred relative orientation of the two domains. SUD-C adopts a frataxin-like fold and has structural similarity to DNA-binding domains of DNA-modifying enzymes. The structures of both SUD-M (previously determined) and SUD-C (from the present study) are maintained in SUD-MC, where the two domains are flexibly linked. Gel shift experiments showed that both SUD-C and SUD-MC bind to single-stranded RNA and recognize purine bases more strongly than pyrimidine bases, whereby SUD-MC binds to a more restricted set of purine-containing RNA sequences than SUD-M. NMR chemical shift perturbation experiments with observation of the 15N-labeled proteins further resulted in the delineation of the RNA binding sites, i.e., in SUD-M a positively charged surface area with a pronounced cavity, and in SUD-C several residues of an antiparallel β-sheet. Overall, the present data provide evidence for molecular mechanisms involving concerted actions of SUD-M and SUD-C, which result in specific RNA-binding that might be unique to the SUD, and thus to the SARS-CoV. PMID:20493876

  19. Sustainable Urban Drainage Systems (SUDS) treatment train assessment tool.

    PubMed

    Jefferies, C; Duffy, A; Berwick, N; McLean, N; Hemingway, A

    2009-01-01

    This paper outlines a rationale and scoring system for the stormwater treatment train assessment tool (STTAT) which is a proposed regulatory tool for Sustainable Urban Drainage Systems (SUDS). STTAT provides guidance and regulatory consistency for developers about the requirements of planners and the Scottish Environment Protection Agency (SEPA). The tool balances the risks of pollution to the receiving water body with the treatment provided in a treatment train. It encourages developers to take SUDS into account early, avoiding any misunderstanding of SUDS requirements at the planning stage of a development. A pessimistic view on pollution risks has been adopted since there may be a change of land use on the development in the future. A realistic view has also been taken of maintenance issues and the 'survivability' of a SUDS component. The development of STTAT as a response to the requirements of the Water Framework Directive is explored, the individual scores being given in tabular format for receiving water and catchment risks. Treatment scores are proposed for single SUDS components as well as multiple components within treatment trains. STTAT has been tested on a range of sites, predominantly in Scotland where both development and receiving water information was known. The operational tool in use by SEPA is presented. PMID:19717910

  20. Smart SUDS: recognising the multiple-benefit potential of sustainable surface water management systems.

    PubMed

    Jose, Roshni; Wade, Rebecca; Jefferies, Chris

    2015-01-01

    How can we make sustainable urban drainage systems (SUDS) smart? SUDS help us to manage surface water runoff from urban environments but they are capable of delivering much more. This paper looks beyond the water quantity and quality improvement functions of SUDS and investigates the multiple benefits that can be gained by implementing smart SUDS solutions. This work provides a new perspective, using methodologies not normally associated with SUDS research, to determine multiple benefits. The outputs of the work can potentially assist decision-makers, designer and planners in recognising the potential for multiple benefits that can be delivered by SUDS. The ecosystem services (ES) associated with a large redevelopment in Dundee, Scotland, UK, are identified and a public perception study together with public participatory geographical information system (PPGIS) methods was used to confirm the goods and benefits of the SUDS. The paper presents findings on the public perception of SUDS as they provide cultural benefits such as recreation, aesthetics and biodiversity. The results show that greenspace is important when choosing a location, and willingness to pay for greenspace is high in this area. This paper concludes that SUDS provide multi-functional benefits in relation to the ES, thereby justifying the cachet of being termed Smart SUDS. PMID:25633948

  1. Transmission of Neglect in Substance Abuse Families: The Role of Child Dysregulation and Parental SUD.

    ERIC Educational Resources Information Center

    Dunn, Marija G.; Mezzich, Ada; Janiszewski, Susan; Kirisci, Levent; Tarter, Ralph E.

    2001-01-01

    Paternal and maternal models of transmission of child neglect were tested separately in offspring of men with a substance use disorder (SUD). Child dysregulation was independently related to neglect severity. SUD in the mother directly correlated with severity of neglectful parenting. (Contains 51 references and 2 tables.) (GCP)

  2. 78 FR 14719 - Airworthiness Directives; The Boeing Company Airplanes

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-07

    ...We propose to adopt a new airworthiness directive (AD) for all The Boeing Company Model 747SP series airplanes, and certain The Boeing Company Model 747-100B SUD and 747-300 series airplanes. This proposed AD was prompted by an evaluation by the design approval holder (DAH) indicating that the fuselage skin just above certain lap splice locations is subject to widespread fatigue damage (WFD).......

  3. Program to convert SUDS2ASC files to a single binary SEGY file

    USGS Publications Warehouse

    Goldman, Mark

    2000-01-01

    This program, SUDS2SEGY, converts and combines ASCII files created using SUDS2ASC Version 2.60, to a single SEGY file. SUDS2ASC has been used previously to create an ASCII file of three-component seismic data for an individual recording station. However, many seismic processing packages have difficulty reading in ASCII data. In addition, it may be cumbersome to process a separate file for each recording station, particularly if traces from different recording stations contain a different number of data samples and/or a different start time. This new program - SUDS2SEGY - combines these recording station files into a single SEGY file. In addition, SUDS2SEGY normalizes the trace times so that each trace starts at a given time and consists of a fixed number of samples. This normalization allows seismic data from many different stations to be read in as a single "data gather". SUDS2SEGY also produces a report summarizing the offset and maximum absolute amplitude for each component in a station file. These data are output separately to an ASCII file and can be subsequently input to a plotting package.

  4. The best management of SuDS treatment trains: a holistic approach.

    PubMed

    Bastien, Nicolas; Arthur, Scott; Wallis, Stephen; Scholz, Miklas

    2010-01-01

    The use of Sustainable Drainage Systems (SuDS) or Best Management Practice (BMP) is becoming increasingly common. However, rather than adopting the preferred "treatment train" implementation, many developments opt for end of pipe control ponds. This paper discusses the use of SuDS in series to form treatment trains and compares their potential performance and effectiveness with end of pipe solutions. Land-use, site and catchment characteristics have been used alongside up-to-date guidance, Infoworks CS and MUSIC to determine whole-life-costs, land-take, water quality and water quantity for different SuDS combinations. The results presented show that the use of a treatment train allows approaches differing from the traditional use of single SuDS, either source or "end of pipe", to be proposed to treat and attenuate runoff. The outcome is a more flexible solution where the footprint allocated to SuDS, costs and water quality can be managed differently to satisfy more efficiently the holistically stakeholders' objectives. PMID:20057113

  5. Comorbidity of ADHD and Substance Use Disorder (SUD): A Neuroimaging Perspective

    ERIC Educational Resources Information Center

    Frodl, Thomas

    2010-01-01

    Introduction: ADHD has a high comorbidity with substance use disorders (SUD). Both diseases have profound social, psychological, and economic consequences and are therefore highly relevant for health systems. The high comorbidity indicates some shared underlying neurobiological substrates. Knowing these substrates may increase the understanding of…

  6. Integrated and Holistic Treatment Approach to PTSD and SUD: A Synergy

    ERIC Educational Resources Information Center

    Weis, Melanie

    2010-01-01

    Individuals living with posttraumatic stress disorder (PTSD) and addiction experience a complex and dynamic interaction of symptoms from both diagnoses. However, heretofore, each diagnosis has been approached as if it were a separate treatment consideration. Therefore, an individual may be treated for either a substance use disorder (SUD) or PTSD,…

  7. A Validity Study of the Subjective Unit of Discomfort (SUD) Score.

    ERIC Educational Resources Information Center

    Kaplan, David M.; And Others

    1995-01-01

    Explores the validity of the Subjective Unit of Discomfort (SUD), which monitors changes in anxiety levels during the application of systematic desensitization to phobias, by correlating it with established instruments of the state of anxiety. Given the limitation of the absence of an anxiety-provoking situation, this study provides empirical data…

  8. The SARS-Unique Domain (SUD) of SARS Coronavirus Contains Two Macrodomains That Bind G-Quadruplexes

    PubMed Central

    Tan, Jinzhi; Vonrhein, Clemens; Smart, Oliver S.; Bricogne, Gerard; Bollati, Michela; Kusov, Yuri; Hansen, Guido; Mesters, Jeroen R.; Schmidt, Christian L.; Hilgenfeld, Rolf

    2009-01-01

    Since the outbreak of severe acute respiratory syndrome (SARS) in 2003, the three-dimensional structures of several of the replicase/transcriptase components of SARS coronavirus (SARS-CoV), the non-structural proteins (Nsps), have been determined. However, within the large Nsp3 (1922 amino-acid residues), the structure and function of the so-called SARS-unique domain (SUD) have remained elusive. SUD occurs only in SARS-CoV and the highly related viruses found in certain bats, but is absent from all other coronaviruses. Therefore, it has been speculated that it may be involved in the extreme pathogenicity of SARS-CoV, compared to other coronaviruses, most of which cause only mild infections in humans. In order to help elucidate the function of the SUD, we have determined crystal structures of fragment 389–652 (“SUDcore”) of Nsp3, which comprises 264 of the 338 residues of the domain. Both the monoclinic and triclinic crystal forms (2.2 and 2.8 Å resolution, respectively) revealed that SUDcore forms a homodimer. Each monomer consists of two subdomains, SUD-N and SUD-M, with a macrodomain fold similar to the SARS-CoV X-domain. However, in contrast to the latter, SUD fails to bind ADP-ribose, as determined by zone-interference gel electrophoresis. Instead, the entire SUDcore as well as its individual subdomains interact with oligonucleotides known to form G-quadruplexes. This includes oligodeoxy- as well as oligoribonucleotides. Mutations of selected lysine residues on the surface of the SUD-N subdomain lead to reduction of G-quadruplex binding, whereas mutations in the SUD-M subdomain abolish it. As there is no evidence for Nsp3 entering the nucleus of the host cell, the SARS-CoV genomic RNA or host-cell mRNA containing long G-stretches may be targets of SUD. The SARS-CoV genome is devoid of G-stretches longer than 5–6 nucleotides, but more extended G-stretches are found in the 3′-nontranslated regions of mRNAs coding for certain host-cell proteins involved

  9. Assessment of undiscovered oil and gas resources of the Sud Province, north-central Africa

    USGS Publications Warehouse

    Brownfield, M.E.; Klett, T.R.; Schenk, C.J.; Charpentier, R.R.; Cook, T.A.; Pollastro, R.M.; Tennyson, M.E.

    2011-01-01

    The Sud Province located in north-central Africa recently was assessed for undiscovered, technically recoverable oil, natural gas, and natural gas liquids resources as part of the U.S. Geological Survey's (USGS) World Oil and Gas Assessment. Using a geology-based assessment methodology, the USGS estimated mean volumes of 7.31 billion barrels of oil, 13.42 trillion cubic feet of natural gas, and 353 million barrels of natural gas liquids.

  10. Evidence of traffic-related pollutant control in soil-based sustainable urban drainage systems (SUDS).

    PubMed

    Napier, F; Jefferies, C; Heal, K V; Fogg, P; Arcy, B J D; Clarke, R

    2009-01-01

    SUDS are being increasingly employed to control highway runoff and have the potential to protect groundwater and surface water quality by minimising the risks of both point and diffuse sources of pollution. While these systems are effective at retaining polluted solids by filtration and sedimentation processes, less is known of the detail of pollutant behaviour within SUDS structures. This paper reports on investigations carried out as part of a co-ordinated programme of controlled studies and field measurements at soft-engineered SUDS undertaken in the UK, observing the accumulation and behaviour of traffic-related heavy metals, oil and PAHs. The field data presented were collected from two extended detention basins serving the M74 motorway in the south-west of Scotland. Additional data were supplied from an experimental lysimeter soil core leaching study. Results show that basin design influences pollutant accumulation and behaviour in the basins. Management and/or control strategies are discussed for reducing the impact of traffic-related pollutants on the aqueous environment. PMID:19587419

  11. Use of geological mapping tools to improve the hydraulic performance of SuDS.

    PubMed

    Bockhorn, Britta; Klint, Knud Erik Strøyberg; Jensen, Marina Bergen; Møller, Ingelise

    2015-01-01

    Most cities in Denmark are situated on low permeable clay rich deposits. These sediments are of glacial origin and range among the most heterogeneous, with hydraulic conductivities spanning several orders of magnitude. This heterogeneity has obvious consequences for the sizing of sustainable urban drainage systems (SuDS). We have tested methods to reveal geological heterogeneity at field scale to identify the most suitable sites for the placement of infiltration elements and to minimize their required size. We assessed the geological heterogeneity of a clay till plain in Eastern Jutland, Denmark measuring the shallow subsurface resistivity with a geoelectrical multi-electrode system. To confirm the resistivity data we conducted a spear auger mapping. The exposed sediments ranged from clay tills over sandy clay tills to sandy tills and correspond well to the geoelectrical data. To verify the value of geological information for placement of infiltration elements we carried out a number of infiltration tests on geologically different areas across the field, and we observed infiltration rates two times higher in the sandy till area than in the clay till area, thus demonstrating that the hydraulic performance of SuDS can be increased considerably and oversizing avoided if field geological heterogeneity is revealed before placing SuDS. PMID:26442491

  12. Multifunctional benefits of SuDS: techno-economic evaluation of decentralised solutions for urban water management

    NASA Astrophysics Data System (ADS)

    Mijic, Ana; Ossa-Moreno, Juan; Smith, Karl M.

    2016-04-01

    The increased frequency of extreme weather events associated with climate change poses a significant threat to the integrity and function of critical urban infrastructure - rail, road, telecommunications, power and water supply/sewerage networks. A key threat within the United Kingdom (UK) is the increased risk of pluvial flooding; the conventional approach of channeling runoff to an outfall has proven to be unsustainable during severe storm events. Green infrastructure, in the form of Sustainable Urban Drainage Systems (SuDS), has been proposed as a means of minimising the risk of pluvial flooding. However, despite their technical performance, SuDS uptake in the UK has not reached its full capacity yet, mostly due to reasons that go beyong the engineering realm. This work investigated the strategic role of SuDS retrofit in managing environmental risks to urban infrastructure in London at a catchment level, through an economic appraisal of multifunctional benefits. It was found that by including the multifunctional benefits of SuDS, the economic feasibility of the project improves considerably. The case study has also shown a mechanism towards achieving wider-scale SuDS retrofit, whereby the investments are split amongst multiple stakeholder groups by highlighting the additional benefits each group derives. Groups include water utilities and their users, local government and critical infrastructure owners. Finally, limitations to the existing cost-benefit methdology in the UK were identified, and recommendations made regarding incentives and governmental regulations to enhance the uptake of SuDS in London. The proposed methodology provides compelling and robust, cost-benefit based evidence of SUDS' effectiveness within the flood risk management planning framework, but also with regard to the additional benefits of Nature Based Solutions in urban environments.

  13. The management of urban surface water flood risks: SUDS performance in flood reduction from extreme events.

    PubMed

    Viavattene, C; Ellis, J B

    2013-01-01

    The need to improve the urban drainage network to meet recent urban growth and the redevelopment of old industrial and commercial areas provides an opportunity for managing urban surface water infrastructure in a more sustainable way. The use of sustainable urban drainage systems (SUDS) can reduce urban surface water flooding as well as the pollution impact of urban discharges on receiving waters. However, these techniques are not yet well known by many stakeholders involved in the decision-making process, or at least the evidence of their performance effectiveness may be doubted compared with more traditional engineering solutions often promoted by existing 1D/2D drainage models. The use of geographic information systems (GIS) in facilitating the inter-related risk analysis of sewer surface water overflows and urban flooding as well as in better communication with stakeholders is demonstrated in this paper. An innovative coupled 1D/2D urban sewer/overland flow model has been developed and tested in conjunction with a SUDS selection and location tool (SUDSLOC) to enable a robust management approach to surface water flood risks and to improve the resilience of the urban drainage infrastructure. The paper demonstrates the numerical and modelling basis of the integrated 1D/2D and SUDSLOC approach and the working assumptions and flexibility of the application together with some limitations and uncertainties. The role of the SUDSLOC modelling component in quantifying flow, and surcharge reduction benefits arising from the strategic selection and location of differing SUDS controls are also demonstrated for an extreme storm event scenario. PMID:23128626

  14. Post-mortem whole-exome sequencing (WES) with a focus on cardiac disease-associated genes in five young sudden unexplained death (SUD) cases.

    PubMed

    Neubauer, Jacqueline; Haas, Cordula; Bartsch, Christine; Medeiros-Domingo, Argelia; Berger, Wolfgang

    2016-07-01

    Sudden death of healthy young adults in the absence of any medical reason is generally categorised as autopsy-negative sudden unexplained death (SUD). Approximately 30 % of all SUD cases can be explained by lethal sequence variants in cardiac genes causing disturbed ion channel functions (channelopathies) or minimal structural heart abnormalities (cardiomyopathies). The aim of this study was to perform whole-exome sequencing (WES) in five young SUD cases in order to identify potentially disease-causing mutations with a focus on 184 genes associated with cardiac diseases or sudden death. WES analysis enabled the identification of damaging-predicted cardiac sequence alterations in three out of five SUD cases. Two SUD victims carried disease-causing variants in long QT syndrome (LQTS)-associated genes (KCNH2, SCN5A). In a third case, WES identified variants in two genes involved in mitral valve prolapse and thoracic aortic aneurism (DCHS1, TGFβ2). The genome of a fourth case carried several minor variants involved in arrhythmia pointing to a multigene influence that might have contributed to sudden death. Our results confirm that post-mortem genetic testing in SUD cases in addition to the conventional autopsy can help to identify familial cardiac diseases and can contribute to the identification of genetic risk factors for sudden death. PMID:26846766

  15. Rainfall-Runoff Simulations to Assess the Potential of SuDS for Mitigating Flooding in Highly Urbanized Catchments.

    PubMed

    Jato-Espino, Daniel; Charlesworth, Susanne M; Bayon, Joseba R; Warwick, Frank

    2016-01-01

    Sustainable Urban Drainage Systems (SuDS) constitute an alternative to conventional drainage when managing stormwater in cities, reducing the impact of urbanization by decreasing the amount of runoff generated by a rainfall event. This paper shows the potential benefits of installing different types of SuDS in preventing flooding in comparison with the common urban drainage strategies consisting of sewer networks of manholes and pipes. The impact of these systems on urban water was studied using Geographic Information Systems (GIS), which are useful tools when both delineating catchments and parameterizing the elements that define a stormwater drainage system. Taking these GIS-based data as inputs, a series of rainfall-runoff simulations were run in a real catchment located in the city of Donostia (Northern Spain) using stormwater computer models, in order to compare the flow rates and depths produced by a design storm before and after installing SuDS. The proposed methodology overcomes the lack of precision found in former GIS-based stormwater approaches when dealing with the modeling of highly urbanized catchments, while the results demonstrated the usefulness of these systems in reducing the volume of water generated after a rainfall event and their ability to prevent localized flooding and surcharges along the sewer network. PMID:26805864

  16. Rainfall–Runoff Simulations to Assess the Potential of SuDS for Mitigating Flooding in Highly Urbanized Catchments

    PubMed Central

    Jato-Espino, Daniel; Charlesworth, Susanne M.; Bayon, Joseba R.; Warwick, Frank

    2016-01-01

    Sustainable Urban Drainage Systems (SuDS) constitute an alternative to conventional drainage when managing stormwater in cities, reducing the impact of urbanization by decreasing the amount of runoff generated by a rainfall event. This paper shows the potential benefits of installing different types of SuDS in preventing flooding in comparison with the common urban drainage strategies consisting of sewer networks of manholes and pipes. The impact of these systems on urban water was studied using Geographic Information Systems (GIS), which are useful tools when both delineating catchments and parameterizing the elements that define a stormwater drainage system. Taking these GIS-based data as inputs, a series of rainfall–runoff simulations were run in a real catchment located in the city of Donostia (Northern Spain) using stormwater computer models, in order to compare the flow rates and depths produced by a design storm before and after installing SuDS. The proposed methodology overcomes the lack of precision found in former GIS-based stormwater approaches when dealing with the modeling of highly urbanized catchments, while the results demonstrated the usefulness of these systems in reducing the volume of water generated after a rainfall event and their ability to prevent localized flooding and surcharges along the sewer network. PMID:26805864

  17. sud1+ targets cyclin-dependent kinase-phosphorylated Cdc18 and Rum1 proteins for degradation and stops unwanted diploidization in fission yeast

    PubMed Central

    Jallepalli, Prasad V.; Tien, Deborah; Kelly, Thomas J.

    1998-01-01

    In the fission yeast Schizosaccharomyces pombe, S phase is limited to a single round per cell cycle through cyclin-dependent kinase phosphorylation of critical replication factors, including the Cdc18 replication initiator protein. Because defects in Cdc18 phosphorylation lead to a hyperstable and hyperactive form of Cdc18 that promotes high levels of overreplication in vivo, we wished to identify the components of the Cdc18 proteolysis pathway in fission yeast. In this paper we describe one such component, encoded by the sud1+ gene. sud1+ shares homology with the budding yeast CDC4 gene and is required to prevent spontaneous re-replication in fission yeast. Cells lacking sud1+ accumulate high levels of Cdc18 and the CDK inhibitor Rum1, because they cannot degrade these two key cell cycle regulators. Through genetic analysis we show that hyperaccumulation of Rum1 contributes to re-replication in Δsud1 cells, but is not the cause of the defect in Cdc18 proteolysis. Rather, Sud1 itself is associated with the ubiquitin pathway in fission yeast and binds to Cdc18 in vivo. Most importantly, Sud1-Cdc18 binding requires prior phosphorylation of the Cdc18 polypeptide at CDK consensus sites. These results provide a biochemical mechanism for the phosphorylation-dependent degradation of Cdc18 and other cell cycle regulators, including Rum1. Evolutionary conservation of the Sud1/CDC4 pathway suggests that phosphorylation-coupled proteolysis may be a general feature of nearly all eukaryotic cell cycles. PMID:9653157

  18. Controls on ground water chemistry in the central Couloir Sud Rifain, Morocco.

    PubMed

    Benaabidate, Lahcen; Fryar, Alan E

    2010-01-01

    Irrigation, urbanization, and drought pose challenges for the sustainable use of ground water in the central Couloir sud rifain, a major agricultural region in north-central Morocco, which includes the cities of Fès and Meknès. The central Couloir is underlain by unconfined and confined carbonate aquifers that have suffered declines in hydraulic head and reductions in spring flow in recent decades. Previous studies have surveyed ground water flow and water quality in wells and springs but have not comprehensively addressed the chemistry of the regional aquifer system. Using graphical techniques and saturation index calculations, we infer that major ion chemistry is controlled (1) in the surficial aquifer by cation exchange, calcite dissolution, mixing with deep ground water, and possibly calcite precipitation and (2) in the confined aquifer and warm springs by calcite dissolution, dolomite dissolution, mixing with water that has dissolved gypsum and halite, and calcite precipitation. Analyses of (2)H and (18)O indicate that shallow ground water is affected by evaporation during recharge (either of infiltrating precipitation or return flow), whereas deep ground water is sustained by meteoric recharge with little evaporation. Mechanisms of recharge and hydrochemical evolution are broadly consistent with those delineated for similar regional aquifer systems elsewhere in Morocco and in southern Spain. PMID:19210561

  19. Influence of biofilms on heavy metal immobilization in sustainable urban drainage systems (SuDS).

    PubMed

    Feder, Marnie; Phoenix, Vernon; Haig, Sarah; Sloan, William; Dorea, Caetano; Haynes, Heather

    2015-01-01

    This paper physically and numerically models the influence of biofilms on heavy metal removal in a gravel filter. Experimental flow columns were constructed to determine the removal of Cu, Pb and Zn by gabbro and dolomite gravel lithologies with and without natural biofilm from sustainable urban drainage systems (SuDS). Breakthrough experiments showed that, whilst abiotic gravel filters removed up to 51% of metals, those with biofilms enhanced heavy metal removal by up to a further 29%, with Cu removal illustrating the greatest response to biofilm growth. An advection-diffusion equation successfully modelled metal tracer transport within biofilm columns. This model yielded a permanent loss term (k) for metal tracers of between 0.01 and 1.05, correlating well with measured data from breakthrough experiments. Additional 16S rRNA clone library analysis of the biofilm indicated strong sensitivity of bacterial community composition to the lithology of the filter medium, with gabbro filters displaying Proteobacteria dominance (54%) and dolomite columns showing Cyanobacteria dominance (47%). PMID:25982923

  20. Off-line efficiency measurements of the microwave discharge source (MIDAS) at the Laboratorio Nazionale del Sud

    NASA Astrophysics Data System (ADS)

    Gammino, S.; Ciavola, G.; Celona, L.; Torrisi, L.; Castro, M.; Chines, F.; Marletta, S.; Messina, E.; Qin, J.; Wang, Z.

    1998-02-01

    The aim of the EXCYT project at the Laboratorio Nazionale del Sud (LNS) is the production of radioactive beams, and for this we need to carry out the ionization of recoils produced in a target with as high an efficiency as possible. In order to obtain efficient positive ionization the microwave discharge ion source (MIDAS) has been designed to be followed by a charge exchange canal. A prototype of this source has been designed, built, and tested at the LNS and a description of this source is presented in this article along with the preliminary results and a design of the final version.

  1. Making Space for Water: A review of SUstainable Drainage systems (SUDs) in a rural/urban area of Newcastle upon Tyne, UK.

    NASA Astrophysics Data System (ADS)

    Quinn, Paul; Tellier, Sebastien; Wilkinson, Mark

    2010-05-01

    Expansion of the city of Newcastle included a new development of over 3000 houses and an associated commercial area on agricultural land. The development firmly signed up to the notion that the new estate should adhere to full SUDs design and implementation. In essence there should be no loss of floodplain capacity, the total runoff from the new housing should not increase flood risk downstream and benefits to ecology, recreation and amenity should be fully maximised. Credit must be given to Newcastle City Council, the Environment Agency, the local water company and the developers themselves as a full set of large scale SUDs now exist and they are clearly an asset to the city. However, such a large scale landscape engineering endeavour has not been without direct and indirect problems. This paper reviews some of the experiences, problems and lessons learnt from SUDs implementation, the function of SUDs during flood events and the perception of SUDs by the public. During the life of the project several older estates close to the new development suffered from two major flood events; including foul water inundation, the drowning out of sewer overflows and intense flash flooding. These floods at first gave rise to the public perception that the new development had caused the flooding. During a research project entitled 'making space for water', the instrumentation of the river in the area and the SUDs took place. The hydrological data this produced has given rise to a mixture of positive and negative aspects of SUDs implementation. The cause of one flood was due to the drowning out of key sewer overflows by locally generated by urban flood flow arising from an upstream estate. The second flood was caused by a 48 hour storm event giving rise to high runoff from the rural area again drowning out key sewer overflows. The SUDs were found to perform well during storm events and do not increase runoff from the new estates. The main fundamental complaint is that despite such

  2. Personal recovery in individuals diagnosed with substance use disorder (SUD) and co-occurring attention deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD).

    PubMed

    Kronenberg, Linda M; Verkerk-Tamminga, Roeliene; Goossens, Peter J J; van den Brink, Wim; van Achterberg, Theo

    2015-08-01

    The process of personal recovery in people diagnosed with substance use disorder and comorbid attention deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD) was mapped. Four general themes representing four consecutive stages in the recovery process were identified in both client groups: (1) crisis and diagnosis; (2) dealing with agitation, symptoms, and burden; (3) reorganization of life; and (4) meaningful life. However, the personal recovery outcomes and the need for support were different for the two clients groups. Based on these findings, mental health nurses can offer recovery supporting care tailored to the challenging needs of these clients. For the SUD+ADHD group, overall, a coaching attitude is preferred. For the SUD+ASD group, overall, instructional, supportive and directive attitude is needed. PMID:26165980

  3. Un cas de leishmaniose féline disséminée dans le sud de la France

    PubMed Central

    Pocholle, E.; Reyes-Gomez, E.; Giacomo, A.; Delaunay, P.; Hasseine, L.; Marty, P.

    2012-01-01

    Cet article rapporte un cas de leishmaniose féline disséminée chez un chat (Felis catus) de 14 ans, séropositif pour le FIV et vivant dans les Alpes-Maritimes (sud de la France). Le chat présente des papules érythémateuses ulcérées sur la face et l’encolure, et une lésion proliférative ulcérée sur l’oreille gauche. C’est l’examen histopathologique des lésions cutanées qui permet le diagnostic d’une leishmaniose disséminée, associée à un carcinome épidermoïde de l’oreille. 100 mg d’allopurinol administrés une fois par jour per os pendant quatre mois ont permis la rémission totale des lésions cutanées. Des prélèvements post mortem ont révélé la persistance du parasite dans l’organisme après six mois de traitement. Cet article discute de la sensibilité du chat à la leishmaniose et de son rôle potentiel de réservoir. PMID:22314243

  4. Maximizing Effectiveness Trials in PTSD and SUD Through Secondary Analysis: Benefits and Limitations Using the National Institute on Drug Abuse Clinical Trials Network "Women and Trauma" Study as a Case Example.

    PubMed

    Hien, Denise A; Campbell, Aimee N C; Ruglass, Lesia M; Saavedra, Lissette; Mathews, Abigail G; Kiriakos, Grace; Morgan-Lopez, Antonio

    2015-09-01

    Recent federal legislation and a renewed focus on integrative care models underscore the need for economical, effective, and science-based behavioral health care treatment. As such, maximizing the impact and reach of treatment research is of great concern. Behavioral health issues, including the frequent co-occurrence of substance use disorders (SUD) and posttraumatic stress disorder (PTSD), are often complex, with a myriad of factors contributing to the success of interventions. Although treatment guides for comorbid SUD/PTSD exist, most patients continue to suffer symptoms following the prescribed treatment course. Further, the study of efficacious treatments has been hampered by methodological challenges (e.g., overreliance on "superiority" designs (i.e., designs structured to test whether or not one treatment statistically surpasses another in terms of effect sizes) and short term interventions). Secondary analyses of randomized controlled clinical trials offer potential benefits to enhance understanding of findings and increase the personalization of treatment. This paper offers a description of the limits of randomized controlled trials as related to SUD/PTSD populations, highlights the benefits and potential pitfalls of secondary analytic techniques, and uses a case example of one of the largest effectiveness trials of behavioral treatment for co-occurring SUD/PTSD conducted within the National Drug Abuse Treatment Clinical Trials Network (NIDA CTN) and producing 19 publications. The paper concludes with implications of this secondary analytic approach to improve addiction researchers' ability to identify best practices for community-based treatment of these disorders. Innovative methods are needed to maximize the benefits of clinical studies and better support SUD/PTSD treatment options for both specialty and non-specialty healthcare settings. Moving forward, planning for and description of secondary analyses in randomized trials should be given equal

  5. The SUD1 Gene Encodes a Putative E3 Ubiquitin Ligase and Is a Positive Regulator of 3-Hydroxy-3-Methylglutaryl Coenzyme A Reductase Activity in Arabidopsis[C][W

    PubMed Central

    Doblas, Verónica G.; Amorim-Silva, Vítor; Posé, David; Rosado, Abel; Esteban, Alicia; Arró, Montserrat; Azevedo, Herlander; Bombarely, Aureliano; Borsani, Omar; Valpuesta, Victoriano; Ferrer, Albert; Tavares, Rui M.; Botella, Miguel A.

    2013-01-01

    The 3-hydroxy-3-methylglutaryl-CoA reductase (HMGR) enzyme catalyzes the major rate-limiting step of the mevalonic acid (MVA) pathway from which sterols and other isoprenoids are synthesized. In contrast with our extensive knowledge of the regulation of HMGR in yeast and animals, little is known about this process in plants. To identify regulatory components of the MVA pathway in plants, we performed a genetic screen for second-site suppressor mutations of the Arabidopsis thaliana highly drought-sensitive drought hypersensitive2 (dry2) mutant that shows decreased squalene epoxidase activity. We show that mutations in SUPPRESSOR OF DRY2 DEFECTS1 (SUD1) gene recover most developmental defects in dry2 through changes in HMGR activity. SUD1 encodes a putative E3 ubiquitin ligase that shows sequence and structural similarity to yeast Degradation of α factor (Doα10) and human TEB4, components of the endoplasmic reticulum–associated degradation C (ERAD-C) pathway. While in yeast and animals, the alternative ERAD-L/ERAD-M pathway regulates HMGR activity by controlling protein stability, SUD1 regulates HMGR activity without apparent changes in protein content. These results highlight similarities, as well as important mechanistic differences, among the components involved in HMGR regulation in plants, yeast, and animals. PMID:23404890

  6. Design of the axial beam line for the injection of high intensity beams into the Laboratorio Nazionale del Sud superconducting cyclotron

    NASA Astrophysics Data System (ADS)

    Gammino, S.; Ciavola, G.

    1996-03-01

    At Laboratorio Nazionale del Sud the superconducting electron cyclotron resonance source SERSE will be used as injector for the K-800 Superconducting Cyclotron which in the future will provide the intense light ion beams to be used as primary beams for the radioactive beam project EXCYT. The goal is to inject and accelerate a few pμA of fully stripped carbon and oxygen into the cyclotron with an emittance as close as possible to the typical acceptance of the cyclotron, which should be in the order of 50π mm mrad. The study of the beam line has been carried out by taking into account both the phase space growth due to space charge and the aberrations inside the magnets. The design has been based on the results of different codes (TRANSPORT, GIOSP, PARMILA). A few details on the diagnostics will also be given. The assembly of the beam line is scheduled for the summer of 1996, just before the transfer of the source SERSE from Grenoble to Catania.

  7. Integrated non-invasive remote-sensing techniques and field survey for the geoarchaeological study of the Sud Lípez mining district, Bolivia

    NASA Astrophysics Data System (ADS)

    Deroin, Jean-Paul; Téreygeol, Florian; Cruz, Pablo; Guillot, Ivan; Méaudre, Jean-Charles

    2012-08-01

    New investigations have been carried out in the framework of a joint French-Argentine project dealing with the mineral resources and the metal production in the Andean plateau from the 10th to the 18th century. Geoarchaeology of the Sud Lípez, southern Bolivia, is revisited using multisource remote-sensing data including archive data from the 1960s and recent very high resolution (VHR) data simultaneously acquired with field work. The detailed geological mapping of the area is allowed by the field survey complemented by the multispectral and VHR data. The emphasis is on integrating all the geological features such as morphologies, petrology of the volcanics, lithology of the volcano-sedimentary rocks, regional and local faulting, veins, hydrothermally altered rocks, etc. GeoEye-1, which features the most advanced technology ever used in a civilian remote-sensing system, allows the detailed mapping of the archaeological remains that are particularly numerous at San Antonio de Lípez, with shallow pits, shafts connected in depth with adits, and large slag areas. Particularly, the plan of three old miners' villages has been drawn and its accuracy has been evaluated.

  8. Laboratory based experiments to assess the use of green and food based compost to improve water quality in a Sustainable Drainage (SUDS) device such as a swale.

    PubMed

    Charlesworth, S M; Nnadi, E; Oyelola, O; Bennett, J; Warwick, F; Jackson, R; Lawson, D

    2012-05-01

    Many tonnes of compost are generated per year due to door step composting of both garden and kitchen waste. Whilst there are commercial outlets for the finer grade of compost (<10mm) in plant nurseries, there is little demand for the coarser material (>25 mm). This paper reports part of a WRAP-sponsored (Waste Resources Action Programme) study which investigated the potential for green (GC) and mixed green and food (MC) composts to be incorporated into Sustainable Drainage (SUDS) devices such as swales, and replace the topsoil (TS) onto which turf is laid or grass seed distributed. However, it is not known whether compost can replace TS in terms of pollutant remediation, both the trapping of polluted particulates and in dealing with hydrocarbons such as oil, but also from a biofilm development and activity perspective. Using laboratory based experiments utilising leaching columns and an investigation of microbiological development in the composts studied, it was found that many of the differences in performance between MC and GC were insignificant, whilst both composts performed better in terms of pollutant retention than TS. Mixed compost in particular could be used in devices where there may be oil spillages, such as the lorry park of a Motorway Service Area due to its efficiency in degrading oil. Samples of GC and MC were found to contain many of the bacteria and fungi necessary for an active and efficient biofilm which would be an argument in their favour for replacement of TS and incorporation in swales. PMID:22449416

  9. Éthique de la recherche en santé mondiale : la relation Nord-Sud, quel partenariat pour quelle justice sociale ?

    PubMed

    Godard, Béatrice; Hunt, Matthew; Moube, Zéphirin

    2014-03-01

    La recherche en santé mondiale s'inscrit dans une volonté de mobiliser des connaissances au service d'interventions et de politiques publiques pour l'atteinte équitable du bien-être commun, notamment en matière de santé. Elle joue un rôle primordial en ce sens, en favorisant l'implication des communautés et leur autonomisation et de nombreuses lignes directrices supportent un tel partenariat. Néanmoins, certains enjeux éthiques sont liés au financement de la recherche, aux environnements de recherche, à la priorisation des problématiques de recherche, aux mécanismes d'évaluation éthique posent souvent un problème de justice sociale au niveau de la redistribution des ressources et de la reconnaissance des différences culturelles. Comment alors déterminer quelle est la façon « idéale » d'agir en tenant compte de la globalité des individus et du pluralisme culturel des sociétés pour « bien faire », pour satisfaire l'exigence de l'équité? Une réflexion et une démarche éthique demeurent essentielles, ainsi qu'un dialogue entre les chercheurs du Nord et du Sud, et leurs autres partenaires que sont les décideurs, les responsables locaux et les communautés. Un tel dialogue, établi dans un continuum du développement de projets de recherche à leur pérennité, peut grandement contribuer à limiter les problèmes de justice sociale et à viser un développement plus égalitaire des savoirs scientifiques. Plusieurs chercheurs se sont déjà engagés dans cette voie, et leurs initiatives devraient être encouragées pour mettre les nouveaux savoirs au service des populations. PMID:24594489

  10. Expeditions INDIEN-SUD-1 &2 : Variations of the Antarctic Circumpolar Current (ACC) and of the Austral ocean in the Kerguelen sector during the Deglaciation and the last Climatic Cycles

    NASA Astrophysics Data System (ADS)

    Mazaud, Alain; Michel, Elisabeth; Crosta, Xavier; Eynaud, Frederique; Paterne, Martine; Bout-Roumazeilles, Viviane; Jaccard, Samuel

    2015-04-01

    IndienSud-1 and 2 expeditions aboard the RV Marion-Dufresne were conducted in 2011 and 2012 in the Kerguelen sector of the South Indian Ocean. Objectives are to document past ocean circulation changes, in particular the variations of the Antarctic Circumpolar Current (ACC), as well as oceanic temperature variability and frontal movement, during the last climatic cycles, with a focus on the last deglaciation. Sedimentary archives collected with the Casq and Calypso coring systems of the RV Marion-Dufresne allow producing high-resolution, well-dated sedimentary records. Comparaisons with exisiting records from other ocean-continental-glaciological archives allow examining the mechanisms involved, with a close attention paid to the temporal phasing between ocean and atmosphere proxy records, at both regional- and hemispheric scales. Past Changes in the intensity of the ACC are investigated using environmental magnetism methods, which trace amount and size of sedimentary magnetic grains. Oxygen isotopes and foraminifera faunal assemblages trace hydrological and temperature changes, while vertical mixing is documented by δ13C. A precise age scale will be derived from 14C ages determinations, augmented by regional correlations (magnetic susceptibility) to well-dated cores in the same area, thanks to a tephrochronological study of the marine cores and peat cores from the Kerguelen archipelago. Results document a stronger ACC current during glacial intervals than during interglacials over at least the last 600 kyrs. This pattern is opposite to observations of flow of the NADW branch (WBUC) south of Greenland in the North Atlantic Ocean. It suggests an inter-hemispheric antiphasing between ACC and NADW at Milankovitch timescales, with a strong circulation in the deep North Atlantic when the ACC is weak, and vice versa (thus with an ACC correlated with the GNAIW intensity). During the last deglaciation, temperature and vertical mixing increased prior to changes in the ACC

  11. CHIMERA Multidetector at Laboratori Nazionali del Sud

    SciTech Connect

    Aiello, S.; Anzalone, A.; Baldo, M.; Barna, R.; Campisi, M.g.; Cardella, G.; Cavallaro, Sl., Amico, V.D.; De Filippo, E.; DePasquale, D.; Femino, S.; Geraci, E.; Giustolisi, F.; Guazzoni, P.; Iacono-Manno, C.M.; Italiano, A.; Lanzalone, G.; Lanzano, G.; LoNigro, S.; Lombardo, U.; Manfredi, G.; Pagano, A.; Papa, M.; Pirrone, S.; Politi, G.; Porto, F.; Sambataro, S.; Sperduto, M.L.; Sutera, C.M.; Zetta, L.

    2000-12-31

    The installation of CHIMERA multidetector, designed in order to study central collisions in heavy ion reactions at intermediate energy, is going on at LNS and the first experiment with the forward part (688 telescopes) is running since May 1999. The aim of this contribution is to present the status of the project.

  12. 76 FR 41669 - Airworthiness Directives; B/E Aerospace, Continuous Flow Passenger Oxygen Mask Assembly, Part...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-15

    ... products. That NPRM published in the Federal Register on February 23, 2011 (76 FR 9984). That NPRM proposed... ``significant rule'' under DOT Regulatory Policies and Procedures (44 FR 11034, February 26, 1979), (3) Will not... (72 FR 71210, December 17, 2007), for certain Boeing Model 747-200B, 747-300, and 747-400...

  13. Predicted airframe noise levels

    NASA Astrophysics Data System (ADS)

    Raney, J. P.

    1980-09-01

    Calculated values of airframe noise levels corresponding to FAA noise certification conditions for six aircraft are presented. The aircraft are: DC-9-30; Boeing 727-200; A300-B2 Airbus; Lockheed L-1011; DC-10-10; and Boeing 747-200B. The prediction methodology employed is described and discussed.

  14. 76 FR 58722 - Airworthiness Directives; the Boeing Company Airplanes

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-22

    ... 2006-01-07, Amendment 39-14446 (71 FR 1947, January 12, 2006), for certain Model 747-100, 747-100B, 747... airplane. Actions Since Existing AD Was Issued The preamble to AD 2006-01-07, Amendment 39 14446 (71 FR... Information AD 2006-01-07, Amendment 39-14446 (71 FR 1947, January 12, 2006), refers to Boeing...

  15. 78 FR 14469 - Airworthiness Directives; The Boeing Company Airplanes

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-06

    ..., Amendment 39-16442 (75 FR 61337, October 5, 2010). If any crack is found during any inspection required by... 2010-20-08, Amendment 39-16442 (75 FR 61337, October 5, 2010), for certain Model 747-100, 747-100B, 747... in depressurization of the airplane in flight. Actions Since Existing AD (75 FR 61337, October...

  16. 76 FR 9984 - Airworthiness Directives; B/E Aerospace, Continuous Flow Passenger Oxygen Mask Assembly, Part...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-23

    ..., amendment 39-15308 (72 FR 71210, December 17, 2007), for certain Boeing Model 747-200B, 747-300, and 747-400...-08, amendment 39-15460 (73 FR 19982, April 14, 2008), for certain Boeing Model 757-200, 757-200CB...-35-0028, dated April 9, 2007; AD 2008-12-05, amendment 39-15548 (73 FR 32996, June 11, 2008),...

  17. [Patient's course requiring NIPPV in Centre Hospitalier Lyon-Sud].

    PubMed

    Freymond, N; Perrot, E; Regal, O; Fayet, J M; Ragué, P; Mottard, N; Wallet, F

    2016-02-01

    Non-invasive positive pressure ventilation (NIPPV) has become a major therapeutic of acute respiratory failure. Thanks to technical progress, its use has become widespread in intensive care units and now in emergency and pneumology departments, for indications recognized and validated as decompensation of chronic obstructive pulmonary disease and acute cardiogenic pulmonary edema. Patients with this conditions transit in the hospital, from the emergency or pulmonology departments, sometimes through intensive care units. Knowledge of the NIPPV, its indications, contraindications, terms of use and surveillance requires trained teams. This training covers not only the technical but also the hardware, multiple ventilation modes, and interfaces. Other indications being evaluated, such as ventilation in the perioperative period, also require coordination between different actors. The establishment of a specific group of thinking and working around the NIPPV is clearly needed, allowing teams of hospital (emergency department, intensive care unit, pulmonology, anesthesia) to work together. This work deals with different areas: training, equipment, condition of receiving patients in the different services within the constraints of personnel and equipment. In this article, we trace the point of view of each of the professionals in this group and some of the actions implemented. PMID:25727659

  18. Assessment and Diagnosis of the Substance Use Disorders (SUDs).

    ERIC Educational Resources Information Center

    Evans, William N.

    1998-01-01

    A brief history of Substance Use Disorders in the Diagnostic and Statistical Manual of Mental Disorders is presented, and the symptoms of substance dependence are presented. Substance dependence is distinguished from substance abuse. Assessment instruments, including laboratory tests and interviews for diagnosing substance use disorders, are…

  19. SU-D-210-04: Using Radiotherapy Biomaterials to Brand and Track Deadly Cancer Cells

    SciTech Connect

    Altundal, Y; Sajo, E; Ngwa, W

    2015-06-15

    Purpose: Metastasis accounts for over 90% of all cancer associated suffering and death and arguably presents the most formidable challenges in cancer management. The detection of metastatic or rare circulating tumor cells (CTCs) in blood or lymph nodes remains a formidable technological challenge. In this study, we investigated the time needed to label each cancer cell in-situ (right at the source tumor) with sufficient number of GNPs that will allow enhanced non-invasive detection via photoacoustic imaging in the lymph nodes. Such in-situ labeling can be achieved via sustained release of the GNPs from Radiotherapy (RT) biomaterials (e.g. fiducials, spacers) coated/loaded with the GNP. Methods: The minimum concentration (1000 GNPs/cell for 50nm GNPs) to detect GNPs with photoacoustic imaging method was experimentally measured by Mallidi et al. and fixed at the tumor sub-volume periphery. In this work, the GNPs were assumed to diffuse from a point source, placed in the middle of a 2–3cm tumor, with an initial concentration of 7–30 mg/g. The time required to label the cells with GNPs was calculated by solving the three dimensional diffusion-reaction equation analytically. The diffusion coefficient of 10nm GNPs was experimentally determined previously. Stokes-Einstein equation was used to calculate the diffusion coefficients for other sizes (2–50nm) of GNPs. The cellular uptake rate constants for several sizes of GNPs were experimentally measured by Jin et al. Results: The time required to label the cells was found 0.635–15.91 days for 2–50nm GNPs with an initial concentration of 7 mg/g GNPs in a 2 cm tumor; 1.379–34.633 days for 2–50nm GNPs with an initial concentration of 30 mg/g GNPs in a 3cm tumor. Conclusion: Our results highlight new potential for labeling CTCs with GNPs released from smart RT biomaterials (i.e. fiducials or spacers loaded with the GNP) towards enhanced non-invasive imaging/detection via photoacoustic imaging.

  20. SU-D-210-03: Limited-View Multi-Source Quantitative Photoacoustic Tomography

    SciTech Connect

    Feng, J; Gao, H

    2015-06-15

    Purpose: This work is to investigate a novel limited-view multi-source acquisition scheme for the direct and simultaneous reconstruction of optical coefficients in quantitative photoacoustic tomography (QPAT), which has potentially improved signal-to-noise ratio and reduced data acquisition time. Methods: Conventional QPAT is often considered in two steps: first to reconstruct the initial acoustic pressure from the full-view ultrasonic data after each optical illumination, and then to quantitatively reconstruct optical coefficients (e.g., absorption and scattering coefficients) from the initial acoustic pressure, using multi-source or multi-wavelength scheme.Based on a novel limited-view multi-source scheme here, We have to consider the direct reconstruction of optical coefficients from the ultrasonic data, since the initial acoustic pressure can no longer be reconstructed as an intermediate variable due to the incomplete acoustic data in the proposed limited-view scheme. In this work, based on a coupled photo-acoustic forward model combining diffusion approximation and wave equation, we develop a limited-memory Quasi-Newton method (LBFGS) for image reconstruction that utilizes the adjoint forward problem for fast computation of gradients. Furthermore, the tensor framelet sparsity is utilized to improve the image reconstruction which is solved by Alternative Direction Method of Multipliers (ADMM). Results: The simulation was performed on a modified Shepp-Logan phantom to validate the feasibility of the proposed limited-view scheme and its corresponding image reconstruction algorithms. Conclusion: A limited-view multi-source QPAT scheme is proposed, i.e., the partial-view acoustic data acquisition accompanying each optical illumination, and then the simultaneous rotations of both optical sources and ultrasonic detectors for next optical illumination. Moreover, LBFGS and ADMM algorithms are developed for the direct reconstruction of optical coefficients from the acoustic data. Jing Feng and Hao Gao were partially supported by the NSFC (#11405105), the 973 Program (#2015CB856000) and the Shanghai Pujiang Talent Program (#14PJ1404500)

  1. SU-D-213-06: Dosimetry of Modulated Electron Radiation Therapy Using Fricke Gel Dosimeter

    SciTech Connect

    Gawad, M Abdel; Elgohary, M; Hassaan, M; Emam, M; Desouky, O; Eldib, A; Ma, C

    2015-06-15

    Purpose: Modulated electron radiation therapy (MERT) has been proposed as an effective modality for treatment of superficial targets. MERT utilizes multiple beams of different energies which are intensity modulated to deliver optimized dose distribution. Energy independent dosimeters are thus needed for quantitative evaluations of MERT dose distributions and measurements of absolute doses delivered to patients. Thus in the current work we study the feasibility of Fricke gel dosimeters in MERT dosimetry. Methods: Batches of radiation sensitive Fricke gel is fabricated and poured into polymethyl methacrylate cuvettes. The samples were irradiated in solid water phantom and a thick layer of bolus was used as a buildup. A spectrophotometer system was used for measuring the color changes (the absorbance) before and after irradiation and then we calculate net absorbance. We constructed calibration curves to relate the measured absorbance in terms of absorbed dose for all available electron energies. Dosimetric measurements were performed for mixed electron beam delivery and we also performed measurement for segmented field delivery with the dosimeter placed at the junction of two adjacent electron beams of different energies. Dose measured by our gel dosimetry is compared to that calculation from our precise treatment planning system. We also initiated a Monte Carlo study to evaluate the water equivalence of our dosimeters. MCBEAM and MCSIM codes were used for treatment head simulation and phantom dose calculation. PDDs and profiles were calculated for electron beams incident on a phantom designed with 1cm slab of Fricke gel. Results: The calibration curves showed no observed energy dependence with all studied electron beam energies. Good agreement was obtained between dose calculated and that obtained by gel dosimetry. Monte Carlo results illustrated the tissue equivalency of our Gel dosimeters. Conclusion: Fricke Gel dosimeters represent a good option for the dosimetric quality assurance prior to MERT application.

  2. 78 FR 52568 - TUV SUD America, Inc.: Modification of Scope of Recognition

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-23

    ...)), Secretary of Labor's Order No. 1-2012 (77 FR 3912, Jan. 25, 2012), and 29 CFR 1910.7. Signed at Washington... notice, OSHA is issuing a notification deleting three test standards from the scope of recognition of the... and select ``N'' in the ``A to Z Index'' located at the top of the Web page). Copies of this...

  3. SU-D-304-02: Magnetically Focused Proton Irradiation of Small Field Targets

    SciTech Connect

    McAuley, GA; Slater, JM; Slater, JD; Wroe, AJ

    2015-06-15

    Purpose: To investigate the use of magnetic focusing for small field proton irradiations. It is hypothesized that magnetic focusing will provide significant dose distribution benefits over standard collimated beams for fields less than 10 mm diameter. Methods: Magnets consisting of 24 segments of radiation hard samarium-cobalt adhered into hollow cylinders were designed and manufactured. Two focusing magnets were placed on a positioning track on our Gantry 1 treatment table. Proton beams with energies of 127 and 157 MeV, 15 and 30 mm modulation, and 8 mm initial diameters were delivered to a water tank using single-stage scattering. Depth dose distributions were measured using a PTW PR60020 diode detector and transverse profiles were measured with Gafchromic EBT3 film. Monte Carlo simulations were also performed - both for comparison with experimental data and to further explore the potential of magnetic focusing in silica. For example, beam spot areas (based on the 90% dose contour) were matched at Bragg depth between simulated 100 MeV collimated beams and simulated beams focused by two 400 T/m gradient magnets. Results: Preliminary experimental results show 23% higher peak to entrance dose ratios and flatter spread out Bragg peak plateaus for 8 mm focused beams compared with uncollimated beams. Monte Carlo simulations showed 21% larger peak to entrance ratios and a ∼9 fold more efficient dose to target delivery compared to spot-sized matched collimated beams. Our latest results will be presented. Conclusion: Our results suggest that rare earth focusing magnet assemblies could reduce skin dose and beam number while delivering dose to nominally spherical radiosurgery targets over a much shorter time compared to unfocused beams. Immediate clinical applications include those associated with proton radiosurgery and functional radiosurgery of the brain and spine, however expanded treatment sites can be also envisaged.

  4. SU-D-304-07: Application of Proton Boron Fusion Reaction to Radiation Therapy

    SciTech Connect

    Jung, J; Yoon, D; Shin, H; Kim, M; Suh, T

    2015-06-15

    Purpose: we present the introduction of a therapy method using the proton boron fusion reaction. The purpose of this study is to verify the theoretical validity of proton boron fusion therapy using Monte Carlo simulations. Methods: After boron is accumulated in the tumor region, the emitted from outside the body proton can react with the boron in the tumor region. An increase of the proton’s maximum dose level is caused by the boron and only the tumor cell is damaged more critically. In addition, a prompt gamma ray is emitted from the proton boron reaction point. Here we show that the effectiveness of the proton boron fusion therapy (PBFT) was verified using Monte Carlo simulations. Results: We found that a dramatic increase by more than half of the proton’s maximum dose level was induced by the boron in the tumor region. This increase occurred only when the proton’s maximum dose point was located within the boron uptake region (BUR). In addition, the 719 keV prompt gamma ray peak produced by the proton boron fusion reaction was positively detected. Conclusion: This therapy method features the advantages such as the application of Bragg-peak to the therapy, the accurate targeting of tumor, improved therapy effects, and the monitoring of the therapy region during treatment.

  5. SU-D-16A-07: Photobleaching Predicts Necrosis in Interstitial PDT

    SciTech Connect

    Kim, M; Finlay, J; Liu, B; Zhu, T

    2014-06-01

    Purpose: Dosimetry for PDT has proven to be a challenge thus far, and for prediction of PDT outcome, a singlet oxygen model based on fundamental photophysical parameters has been developed. Previously, the photobleaching effect of photosensitizers was taken into account in the singlet oxygen explicit dosimetry model; here we report of direct measurements of photobleaching in the same model to assess the conditions under which implicit dosimetry using photobleaching can serve as an intermediate surrogate for PDT damage. Methods: Fluorescence spectra were measured interstitially in sensitized mouse tumors prior to after irradiation via a cylindrical diffuser. Photobleaching was determined by the relative decrease in fluorescence amplitude from the initial pre-treatment measurement. Spectra were analyzed by singular value decomposition to determine the photosensitizer concentration. Different photosensitizers were used to see the effect of photobleaching on PDT outcome and the impact of fluence on photobleaching. The drugs used were BPD (at two drug-light intervals), HPPH, and Photofrin. PDT outcome was determined by tumor necrosis radii measured upon sectioning and staining of treated tumors. Results: Post-PDT photosentizer concentrations were compared to initial pre-PDT photosensitizer concentrations, and the decrease was greater with a higher fluence measured during treatment. Furthermore, photobleaching and necrosis radius were found to be positively correlated. The relationship between photobleaching and necrosis radius is sensitizer-dependent, however the differences among sensitizers can be understood in terms of their respective photophysical parameters. Conclusions: Photobleaching is predictive of PDT outcome, but a comprehensive singlet oxygen model, has the potential to further improve the prediction of PDT outcome and the understanding of implicit dosimetry.

  6. SU-D-9A-03: STAMP: Simulator for Texture Analysis in MRI/PET

    SciTech Connect

    Laberge, S; Vallieres, M; Levesque, I R.; El Naqa, I

    2014-06-01

    Purpose: To develop a convenient simulation platform to facilitate PET/MR image analysis with the prospect of gaining a better understanding of the influence of acquisition parameters on PET/MRI textural features. The simulation platform is demonstrated by showing textural variations of a representative case study using different image acquisition parameters. Methods: The simulation platform is composed of MRI simulators JEMRIS and SIMRI to achieve simulations of customized MRI sequences on sample tumor models. The PET simulator GATE is used to get 2D and 3D Monte Carlo acquisitions of voxelized PET sources using a phantom geometry and a customized scanner architecture. The platform incorporates a series of graphical user interfaces written in Matlab. Two GUIs are used to facilitate communication with the simulation executables installed on a computer cluster. A third GUI is used to collect and display the clinical and simulated images, as well as fused PET/MRI images, and perform computation of textural features.To illustrate the capabilities of this platform, one FDG-PET and T1-weighted (T1w) digitized tumor models were generated from clinical images of a soft-tissue sarcoma patient. Numerically simulated MR images were produced using 3 different echo times (TE) and 5 different repetition times (TR). PET 2D images were simulated using an OSEM algorithm with 1 to 32 iterations and a post-reconstruction Gaussian filter of 0, 2, 4 or 6 mm width. Results: STAMP was successfully used to produce numerically simulated FDG-PET and MRI images, and to calculate their corresponding textures. Three typical textures (GLCM-Contrast, GLSZM-ZSV and NGTDM-Coarseness) were found to vary by a range of 45% on average compared to reference scanning conditions in the case of FDG-PET, and by a range of 40% in the case of T1w MRI. Conclusion: We have successfully developed a Matlab-based simulation platform to facilitate PET/MRI texture image analysis for outcome prediction.

  7. SU-D-18A-04: Quantifying the Ability of Tumor Tracking to Spare Normal Tissue

    SciTech Connect

    Burger, A; Buzurovic, I; Hurwitz, M; Williams, C; Lewis, J; Mishra, P; Seco, J

    2014-06-01

    Purpose: Tumor tracking allows for smaller tissue volumes to be treated, potentially reducing normal tissue damage. However, tumor tracking is a more complex treatment and has little benefit in some scenarios. Here we quantify the benefit of tumor tracking for a range of patients by estimating the dose of radiation to organs at risk and the normal tissue complication probability (NTCP) for both standard and tracking treatment plans. This comparison is performed using both patient 4DCT data and extended Cardiac-Torso (XCAT) digital phantoms. Methods: We use 4DCT data for 10 patients. Additionally, we generate digital phantoms with motion derived from measured patient long tumor trajectories to compare standard and tracking treatment plans. The standard treatment is based on the average intensity projection (AIP) of 4DCT images taken over a breath cycle. The tracking treatment is based on doses calculated on images representing the anatomy at each time point. It is assumed that there are no errors in tracking the target. The NTCP values are calculated based on RTOG guidelines. Results: The mean reduction in the mean dose delivered was 5.5% to the lungs (from 7.3 Gy to 6.9 Gy) and 4.0% to the heart (from 12.5 Gy to 12.0 Gy). The mean reduction in the max dose delivered was 13% to the spinal cord (from 27.6 Gy to 24.0 Gy), 2.5% to the carina (from 31.7 Gy to 30.9 Gy), and 15% to the esophagus (from 69.6 Gy to 58.9 Gy). The mean reduction in the probability of 2nd degree radiation pneumonitis (RP) was 8.7% (3.1% to 2.8%) and the mean reduction in the effective volume was 6.8% (10.8% to 10.2%). Conclusions: Tumor tracking has the potential to reduce irradiation of organs at risk, and consequentially reduce the normal tissue complication probability. The benefits vary based on the clinical scenario. This study is supported by Varian Medical Systems, Inc.

  8. SU-D-18A-05: Assessing Elekta MLC Tracking Performance

    SciTech Connect

    Glitzner, M; Crijns, S; Lagendijk, J; Raaymakers, B

    2014-06-01

    Purpose: To investigate the technical feasibility of using Elekta MLCs in tracked radiotherapy, specifically to show the capability of an Agility MLC to follow model tumor trajectories using object tracking. The system performance of the MLC is to be assessed via dosimetric experiments and temporal response measures. Methods: The system observer in the tracking cascade consisted of a camera serving for this proof of concept; Images of a moving object were acquired continuously and decorrelated for the position information, which was fed forward to the RT computer controlling the MLC via an interface provided by Elekta. The 1D motion (in the direction of the leaves) was induced by a CIRS motion controller. Additionally, the aperture position was observed by means of the light field of the linac. Calculating the phase between aperture and object yielded the mean aperture lag for the current setup. The object was restricted to sinusoidal motion with a period of 10s. For dosimetry, GafChromic radiosensitive film was irradiated with a total dose of 1000MU using an aperture size of 40mm and a motion range of 30mm. Results: Object tracking can substantially reconstruct the geometric dose response of a static target. In the dynamic case, dose is smeared out into the legs of the static distribution, leading to a reduced plateau and increased FWHM of 5mm, compared to the static width of 38mm. The time-lag between object and aperture was determined to be approximately 300ms for the current set-up. Conclusion: We demonstrated a tracking experiment performed on a clinical Elekta linear accelator for the first time. Observed profile variations show the dosimetric impact of tracked delivery. The determined lag is a valuable descriptor for a future tracking cascade employing predictor filters. The performed experiments are generic and possible predecessors for future applications with MR-Linac or ultrasound probes. Conflict of interest: this project is partly funded by Elekta.

  9. Dismantling of the 904 Cell at the HAO/Sud Facility - 13466

    SciTech Connect

    Vaudey, C.E.; Crosnier, S.; Renouf, M.; Gaspard, N.; Pinot, L.

    2013-07-01

    La Hague facility, in France, is the spent fuel recycling plant wherein a part of the fuel coming from some of the French, German, Belgian, Swiss, Dutch and Japanese nuclear reactors is reprocessed before being recycled in order to separate certain radioactive elements. The facility has been successively handled by the CEA (1962-1978), Cogema (1978-2006), and AREVA NC (since 2006). La Hague facility is composed of 3 production units: The UP2-400 production unit started to be operated in 1966 for the reprocessing of UNGG metal fuel. In 1976, following the dropout of the graphite-gas technology by EDF, an HAO workshop to reprocess the fuel from the light water reactors is affiliated and then stopped in 2003. - UP2-400 is partially stopped in 2002 and then definitely the 1 January 2004 and is being dismantled - UP2-800, with the same capacity than UP3, started to be operated in 1994 and is still in operation. And UP3 - UP3 was implemented in 1990 with an annual reprocessing capacity of 800 tons of fuel and is still in operation The combined licensed capacity of UP2-800 and UP3 is 1,700 tons of used fuel. (authors)

  10. SU-D-16A-06: Modeling Biological Effects of Residual Uncertainties For Stereotactic Radiosurgery

    SciTech Connect

    Ma, L; Larson, D; McDermott, M; Sneed, P; Sahgal, A

    2014-06-01

    Purpose: Residual uncertainties on the order of 1-2 mm are frequently observed when delivering stereotactic radiosurgery via on-line imaging guidance with a relocatable frame. In this study, a predictive model was developed to evalute potentiral late radiation effects associated with such uncertainties. Methods: A mathematical model was first developed to correlate the peripherial isodose volume with the internal and/or setup margins for a radiosurgical target. Such a model was then integrated with a previoulsy published logistic regression normal tissue complication model for determining the symptomatic radiation necrosis rate at various target sizes and prescription dose levels. The model was tested on a cohort of 15 brain tumor and tumor resection cavity patient cases and model predicted results were compared with the clinical results reported in the literature. Results: A normalized target diameter (D{sub 0}) in term of D{sub 0} = 6V/S, where V is the volume of a radiosurgical target and S is the surface of the target, was found to correlate excellently with the peripheral isodose volume for a radiosurgical delivery (logarithmic regression R{sup 2} > 0.99). The peripheral isodose volumes were found increase rapidly with increasing uncertainties levels. In general, a 1-mm residual uncertainties as calculated to result in approximately 0.5%, 1%, and 3% increases in the symptomatic radiation necrosis rate for D{sub 0} = 1 cm, 2 cm, and 3 cm based on the prescription guideline of RTOG 9005, i.e., 21 Gy to a lesion of 1 cm in diameter, 18 Gy to a lesion 2 cm in diameter, and 15 Gy to a lesion 3 cm in diameter respectively. Conclusion: The results of study suggest more stringent criteria on residual uncertainties are needed when treating a large target such as D{sub 0}≤ 3 cm with stereotactic radiosurgery. Dr. Ma and Dr. Sahgal are currently serving on the board of international society of stereotactic radiosurgery (ISRS)

  11. SU-D-213-01: Transparent Photon Detector For The Online Monitoring Of IMRT Beams

    SciTech Connect

    Delorme, R; Arnoud, Y; Fabbro, R; Boyer, B; Rossetto, O; Gallin-Martel, L; Gallin-Martel, M; Pelissier, A; Fonteille, I

    2015-06-15

    Purpose: An innovative Transparent Detector for Radiotherapy (TraDeRa) has been developed. The detector aims at real-time monitoring of modulated beam ahead of the patient during delivery sessions, with a field cover up to 40×40 cm {sup 2}. Methods: TraDeRa consists in a pixelated matrix of ionization chambers with a patented electrodes design. An in-house designed specific integrated circuit allows to extract the signal and provides a real-time map of beam intensity and shape, at the linac pulse-scale. The measurements under irradiation are made with a 6 MV clinical X-Ray beam. Dose calculations are performed with the Monte Carlo code PENELOPE, modeling the full accelerator head and the TraDeRa detector. Results: A 2 % attenuation of the beam was measured in the presence of TraDeRa and the PENELOPE dosimetric study showed no significant modification of the photon beam properties. TraDeRa detects error leaf position as small as 1 mm compared to a reference field, for both static and modulated fields. In addition, measurements are accurate over a large dynamic range from low intensity signals, as inter-leaves leaks, to very high intensities as obtained on the medical line of the European Synchrotron Radiation Facility. The detector is fully operational for conventional and high dose rate beams as FFF modes (up to 2400 MU/min). Conclusion: The current version of TraDeRa shows promising results for IMRT quality assurance (QA), allowing pulse-scale monitoring of the beam and high sensitivity for errors detection. The attenuation is small enough not to hinder the irradiation while keeping the beam upstream of the patient under constant control. A final prototype under development will include 1600 independent electrodes, half of them with a high resolution centered on the beam axis. This compact detector provides an independent set of measurements for a better QA. Funding support : This work was supported by the LABEX PRIMES (ANR-11-LABX-0063) of Universite de Lyon, within the program “Investissements d’Avenir” (ANR-11-IDEX-0007) operated by the French National Research Agency (ANR) and within the project “INSPIRA” operated by the OSEO institution.

  12. Impact of Relapse Predictors on Psychosocial Functioning of SUD Youth One Year after Treatment

    ERIC Educational Resources Information Center

    Anderson, Kristen G.; Ramo, Danielle E.; Schulte, Marya T.; Cummins, Kevin; Brown, Sandra A.

    2008-01-01

    This investigation examined how personal, environmental and substance use factors predicted psychosocial functioning for youth with alcohol and drug problems. Four hundred twenty-four adolescents (M = 15.9, SD = 1.3) completed comprehensive assessments, including personal characteristics (e.g., Axis I diagnosis, motivation, self-esteem),…

  13. Highlighting the Impacts of North-South Research Collaboration among Canadian and Southern Higher Education Partners (Principaux impacts des collaborations de recherche Nord-Sud entre les partenaires des etablissements d'enseignement superieur du Canada et du Sud)

    ERIC Educational Resources Information Center

    Association of Universities and Colleges of Canada, 2006

    2006-01-01

    The Association of Universities and Colleges of Canada (AUCC) felt it was timely to create an academic forum in which university researchers have the opportunity to engage with their peers and relevant stakeholders and document the impacts of their North-South research collaboration in a peer-reviewed publication. The Association achieved this by…

  14. Impact of Adolescent Alcohol and Drug Use on Neuropsychological Functioning in Young Adulthood: 10-Year Outcomes

    ERIC Educational Resources Information Center

    Hanson, Karen L.; Medina, Krista Lisdahl; Padula, Claudia B.; Tapert, Susan F.; Brown, Sandra A.

    2011-01-01

    Because of ongoing neuromaturation, youth with chronic alcohol/substance use disorders (AUD/SUD) are at risk for cognitive decrements during young adulthood. We prospectively examined cognition over 10 years based on AUD/SUD history. Youth (N = 51) with no AUD/SUD history (n = 14), persisting AUD/SUD (n = 18), or remitted AUD/SUD (n = 19) were…

  15. Enfants autochtones et apprentissage: la corporalité comme langage en Amérique du Sud tropicale

    NASA Astrophysics Data System (ADS)

    da Silva, Aracy Lopes

    1999-05-01

    In this article on the cultural context of children's learning processes among the indigenous peoples of tropical South America, the author aims to show how in these cultures the human body offers a language and a mechanism central to the process of production, elaboraton and transmission of knowledge, skills and emotions. She works from the assumption that the construction of a child's identity is a process which takes place in the body, creating a synthesis of social, cosmological, psychological, emotional and cognitive meanings. In constructing an ethnography of the Akwe~-Xavante and Akwe~-Xerente peoples of central Brazil, the author refers to recent anthropological debates on the cosmology and outlook of the indigenous peoples of this region, as well as to the literature of the new discipline known as "anthropology of the child".

  16. SU-D-12A-06: A Comprehensive Parameter Analysis for Low Dose Cone-Beam CT Reconstruction

    SciTech Connect

    Lu, W; Yan, H; Gu, X; Jiang, S; Jia, X; Bai, T; Zhou, L

    2014-06-01

    Purpose: There is always a parameter in compressive sensing based iterative reconstruction (IR) methods low dose cone-beam CT (CBCT), which controls the weight of regularization relative to data fidelity. A clear understanding of the relationship between image quality and parameter values is important. The purpose of this study is to investigate this subject based on experimental data and a representative advanced IR algorithm using Tight-frame (TF) regularization. Methods: Three data sets of a Catphan phantom acquired at low, regular and high dose levels are used. For each tests, 90 projections covering a 200-degree scan range are used for reconstruction. Three different regions-of-interest (ROIs) of different contrasts are used to calculate contrast-to-noise ratios (CNR) for contrast evaluation. A single point structure is used to measure modulation transfer function (MTF) for spatial-resolution evaluation. Finally, we analyze CNRs and MTFs to study the relationship between image quality and parameter selections. Results: It was found that: 1) there is no universal optimal parameter. The optimal parameter value depends on specific task and dose level. 2) There is a clear trade-off between CNR and resolution. The parameter for the best CNR is always smaller than that for the best resolution. 3) Optimal parameters are also dose-specific. Data acquired under a high dose protocol require less regularization, yielding smaller optimal parameter values. 4) Comparing with conventional FDK images, TF-based CBCT images are better under a certain optimally selected parameters. The advantages are more obvious for low dose data. Conclusion: We have investigated the relationship between image quality and parameter values in the TF-based IR algorithm. Preliminary results indicate optimal parameters are specific to both the task types and dose levels, providing guidance for selecting parameters in advanced IR algorithms. This work is supported in part by NIH (1R01CA154747-01)

  17. SU-D-201-06: Random Walk Algorithm Seed Localization Parameters in Lung Positron Emission Tomography (PET) Images

    SciTech Connect

    Soufi, M; Asl, A Kamali; Geramifar, P

    2015-06-15

    Purpose: The objective of this study was to find the best seed localization parameters in random walk algorithm application to lung tumor delineation in Positron Emission Tomography (PET) images. Methods: PET images suffer from statistical noise and therefore tumor delineation in these images is a challenging task. Random walk algorithm, a graph based image segmentation technique, has reliable image noise robustness. Also its fast computation and fast editing characteristics make it powerful for clinical purposes. We implemented the random walk algorithm using MATLAB codes. The validation and verification of the algorithm have been done by 4D-NCAT phantom with spherical lung lesions in different diameters from 20 to 90 mm (with incremental steps of 10 mm) and different tumor to background ratios of 4:1 and 8:1. STIR (Software for Tomographic Image Reconstruction) has been applied to reconstruct the phantom PET images with different pixel sizes of 2×2×2 and 4×4×4 mm{sup 3}. For seed localization, we selected pixels with different maximum Standardized Uptake Value (SUVmax) percentages, at least (70%, 80%, 90% and 100%) SUVmax for foreground seeds and up to (20% to 55%, 5% increment) SUVmax for background seeds. Also, for investigation of algorithm performance on clinical data, 19 patients with lung tumor were studied. The resulted contours from algorithm have been compared with nuclear medicine expert manual contouring as ground truth. Results: Phantom and clinical lesion segmentation have shown that the best segmentation results obtained by selecting the pixels with at least 70% SUVmax as foreground seeds and pixels up to 30% SUVmax as background seeds respectively. The mean Dice Similarity Coefficient of 94% ± 5% (83% ± 6%) and mean Hausdorff Distance of 1 (2) pixels have been obtained for phantom (clinical) study. Conclusion: The accurate results of random walk algorithm in PET image segmentation assure its application for radiation treatment planning and diagnosis.

  18. SU-D-9A-06: 3D Localization of Neurovascular Bundles Through MR-TRUS Registration in Prostate Radiotherapy

    SciTech Connect

    Yang, X; Rossi, P; Ogunleye, T; Jani, A; Curran, W; Liu, T

    2014-06-01

    Purpose: Erectile dysfunction (ED) is the most common complication of prostate-cancer radiotherapy (RT) and the major mechanism is radiation-induced neurovascular bundle (NVB) damage. However, the localization of the NVB remains challenging. This study's purpose is to accurately localize 3D NVB by integrating MR and transrectal ultrasound (TRUS) images through MR-TRUS fusion. Methods: T1 and T2-weighted MR prostate images were acquired using a Philips 1.5T MR scanner and a pelvic phase-array coil. The 3D TRUS images were captured with a clinical scanner and a 7.5 MHz biplane probe. The TRUS probe was attached to a stepper; the B-mode images were captured from the prostate base to apex at a 1-mm step and the Doppler images were acquired in a 5-mm step. The registration method modeled the prostate tissue as an elastic material, and jointly estimated the boundary condition (surface deformation) and the volumetric deformations under elastic constraint. This technique was validated with a clinical study of 7 patients undergoing RT treatment for prostate cancer. The accuracy of our approach was assessed through the locations of landmarks, as well as previous ultrasound Doppler images of patients. Results: MR-TRUS registration was successfully performed for all patients. The mean displacement of the landmarks between the post-registration MR and TRUS images was 1.37±0.42 mm, which demonstrated the precision of the registration based on the biomechanical model; and the NVB volume Dice Overlap Coefficient was 92.1±3.2%, which demonstrated the accuracy of the NVB localization. Conclusion: We have developed a novel approach to improve 3D NVB localization through MR-TRUS fusion for prostate RT, demonstrated its clinical feasibility, and validated its accuracy with ultrasound Doppler data. This technique could be a useful tool as we try to spare the NVB in prostate RT, monitor NBV response to RT, and potentially improve post-RT potency outcomes.

  19. SU-D-19A-03: Monte Carlo Investigation of the Mobetron to Perform Modulated Electron Beam Therapy

    SciTech Connect

    Emam, I; Eldib, A; Hosini, M; AlSaeed, E; Ma, C

    2014-06-01

    Purpose: Modulated electron radiotherapy (MERT) has been proposed as a mean of delivering conformal dose to shallow tumors while sparing distal structures and surrounding tissues. In intraoperative radiotherapy (IORT) utilizing Mobetron, an applicator is placed as closely as possible to the suspected cancerous tissues to be treated. In this study we investigate the characteristics of Mobetron electron beams collimated by an in-house prospective electron multileaf collimator (eMLC) and its feasibility for MERT. Methods: IntraOp Mobetron™ dedicated to perform radiotherapy during surgery was used in the study. It provides several energies (6, 9 and 12 MeV). Dosimetry measurements were performed to obtain percentage depth dose curves (PDD) and profiles for a 10-cm diameter applicator using the PTW MP3/XS 3D-scanning system and the semiflex ion chamber. MCBEAM/MCSIM Monte Carlo codes were used for the treatment head simulation and phantom dose calculation. The design of an electron beam collimation by an eMLC attached to the Mobetron head was also investigated using Monte Carlo simulations. Isodose distributions resulting from eMLC collimated beams were compared to that collimated using cutouts. The design for our Mobetron eMLC is based on our previous experiences with eMLCs designed for clinical linear accelerators. For Mobetron the eMLC is attached to the end of a spacer-mounted rectangular applicator at 50 cm SSD. Steel will be used as the leaf material because other materials would be toxic and will not be suitable for intraoperative applications. Results: Good agreement (within 2%) was achieved between measured and calculated PDD curves and profiles for all available energies. Dose distributiosn provided by the eMLC showed reasonable agreement (∼3%/1mm) with those obtained by conventional cutouts. Conclusion: Monte Carlo simulations are capable of modeling Mobetron electron beams with a reliable accuracy. An eMLC attached to the Mobteron treatment head will allow better treatment options with those machines.

  20. SU-D-201-03: Imaging Cellular Pharmacokinetics of 18F-FDG in Inflammatory/Stem Cells

    SciTech Connect

    Zaman, R; Tuerkcan, S; Mahmoudi, M; Toshinobu, T; Kosuge, H; Yang, P; Chin, F; McConnell, M; Xing, L

    2015-06-15

    Purpose: Atherosclerosis is a progressive inflammatory condition that underlies coronary artery disease (CAD)—the leading cause of death in the USA. Thus, understating the metabolism of inflammatory cells can be a valuable tool for investigating CAD. To the best of our knowledge, we are the first to successfully investigate the pharmacokinetics of [18F]fluoro-deoxyglucose (18F-FDG) uptake in a single macrophages and compared with induced pluripotent stem cells (iPSCs) and mesenchymal stem cells (MSCs) with a novel imaging technique, radioluminescence microscopy, initially developed for cancer imaging. Methods: Live cells were cultured sparsely on Matrigel in a glass-bottom dish and starved for 1 hour before incubation with 250 microCi of 18F-FDG for 45 minutes. Excess radiotracer was removed using DMEM medium without glucose. Before imaging, DMEM (1 mL) was added to the cell culture and a 100 microm-thin CdWO4 scintillator plate was placed on top of the cells. Light produced following beta decay was imaged with a highly sensitive inverted microscope (LV200, Olympus) fitted with a 40x/1.3 high-NA oil objective, and an EM-CCD camera. The images were collected over 18,000 frames with 4×4 binning (1200 MHz EM Gain, 300ms exposure). Custom-written software was developed in MATLAB for image processing (Figure 1). For statistical analysis 10 different region-of-interests (ROIs) were selected for each cell type. Results: Figures 2A–2B show bright-field/fusion images for all three different cell types. The relationship between cell-to-cell comparisons was found to be linear for macrophages unlike iPSCs and MSCs, which were best fitted with moving or rolling average (Figure 2C). The average observed decay of 18F-FDG in a single cell of MSCs per second (0.067) was 20% and 36% higher compared to iPSCs (0.054) and macrophages (0.043), respectively (Figure 2D). Conclusion: MSCs was found to be 2–3x more sensitive to glucose molecule despite constant parameters for each cell type examined.

  1. SU-D-19A-07: Dosimetric Comparison of HDR Plesiotherapy and Electron Beam Therapy for Superficial Lesions

    SciTech Connect

    Mitchell, A; Jacob, D; Andreou, K; Raben, A; Chen, H; Koprowski, C; Mourtada, F

    2014-06-01

    Purpose: Large superficial (skin, soft tissue sarcoma) lesions located on curved areas are hard to treat with electrons. The Freiburg Flap (Nucletron, Netherlands) is a flexible mesh style surface which can be easily shaped to fit curved surfaces for reproducible HDR fraction delivery. To understand the fundamental dosimetric differences, a dosimetric comparison was made between HDR plesiotherapy (Freiburg applicator for lesions over 4cm) and external electron beam radiotherapy over cases with varying target curvature (both stylized and clinical cases). Methods: Four stylized cases with variable complexity were created using artificial DICOM axial CT slices and RT structures (a square and three curved structures on a 4.5cm radius cylinder). They were planned using Oncentra v4.3 and exported to Pinnacle v9.6 for electrons planning. The HDR source dwell positions were optimized for the best coverage of the targets using graphical optimization. Electron treatment plans were created in Pinnacle using the same CT and RT structures of three HDR cases with surface lesions previously treated with the Freiburg flap. The En face electron plans used 6-12 MeV electrons and 0.5–1 cm bolus was added to increase surface dose. The electron plans were prescribed to an isodose line to conform to the target. Results: For all lesions, the average target dose coverage was similar (D90ave of 100% for HDR vs 101% for electrons). For lesions with high curvature, the HDR coverage was better (D90 102% vs D90 97% for electron). For all cases, adjacent structures high dose region was lower for HDR than electrons (D1cc 100% for HDR vs D1cc 111% for electrons). Conclusion: HDR plesiotherapy offers excellent target conformity for superficial targets similar to electrons. However, for lesions with complex curved surfaces, HDR has the advantage to achieve better dose distributions using graphical optimization to spare adjacent normal tissue while maximizing target coverage.

  2. SU-D-12A-02: DeTECT, a Method to Enhance Soft Tissue Contrast From Mega Voltage CT

    SciTech Connect

    Sheng, K; Gou, S; Qi, S

    2014-06-01

    Purpose: MVCT images have been used on TomoTherapy system to align patients based on bony anatomies but its usefulness for soft tissue registration, delineation and adaptive radiation therapy is severely limited due to minimal photoelectric interaction and prominent presence of noise resulting from low detector quantum efficiency of megavoltage x-rays. We aim to utilize a non-local means denoising method and texture analysis to recover the soft tissue information for MVCT. Methods: A block matching 3D (BM3D) algorithm was adapted to reduce the noise while keeping the texture information of the MVCT images. BM3D is an imaging denoising algorithm developed from non-local means methods. BM3D additionally creates 3D groups by stacking 2D patches by the order of similarity. 3D denoising operation is then performed. The resultant 3D group is inversely transformed back to 2D images. In this study, BM3D was applied to MVCT images of a CT quality phantom, a head and neck and a prostate patient. Following denoising, imaging texture was enhanced to create the denoised and texture enhanced CT (DeTECT). Results: The original MVCT images show prevalent noise and poor soft tissue contrast. By applying BM3D denoising and texture enhancement, all MVCT images show remarkable improvements. For the phantom, the contrast to noise ratio for the low contrast plug was improved from 2.2 to 13.1 without compromising line pair conspicuity. For the head and neck patient, the lymph nodes and vein in the carotid space inconspicuous in the original MVCT image becomes highly visible in DeTECT. For the prostate patient, the boundary between the bladder and the prostate in the original MVCT is successfully recovered. Both results are visually validated by kVCT images of the corresponding patients. Conclusion: DeTECT showed the promise to drastically improve the soft tissue contrast of MVCT for image guided radiotherapy and adaptive radiotherapy.

  3. SU-D-19A-04: Parameter Characterization of Electron Beam Monte Carlo Phase Space of TrueBeam Linacs

    SciTech Connect

    Rodrigues, A; Yin, F; Wu, Q; Sawkey, D

    2014-06-01

    Purpose: For TrueBeam Monte Carlo simulations, Varian does not distribute linac head geometry and material compositions, instead providing a phase space file (PSF) for the users. The PSF has a finite number of particle histories and can have very large file size, yet still contains inherent statistical noises. The purpose of this study is to characterize the electron beam PSF with parameters. Methods: The PSF is a snapshot of all particles' information at a given plane above jaws including type, energy, position, and directions. This study utilized a preliminary TrueBeam PSF, of which validation against measurement is presented in another study. To characterize the PSF, distributions of energy, position, and direction of all particles are analyzed as piece-wise parameterized functions of radius and polar angle. Subsequently, a pseudo PSF was generated based on this characterization. Validation was assessed by directly comparing the true and pseudo PSFs, and by using both PSFs in the down-stream MC simulations (BEAMnrc/DOSXYZnrc) and comparing dose distributions for 3 applicators at 15 MeV. Statistical uncertainty of 4% was limited by the number of histories in the original PSF. Percent depth dose (PDD) and orthogonal (PRF) profiles at various depths were evaluated. Results: Preliminary results showed that this PSF parameterization was accurate, with no visible differences between original and pseudo PSFs except at the edge (6 cm off axis), which did not impact dose distributions in phantom. PDD differences were within 1 mm for R{sub 7} {sub 0}, R{sub 5} {sub 0}, R{sub 3} {sub 0}, and R{sub 1} {sub 0}, and PRF field size and penumbras were within 2 mm. Conclusion: A PSF can be successfully characterized by distributions for energy, position, and direction as parameterized functions of radius and polar angles; this facilitates generating sufficient particles at any statistical precision. Analyses for all other electron energies are under way and results will be included in the presentation.

  4. SU-D-18A-07: Towards 6-Degree-Of-Freedom Real-Time Motion Management in Cancer Radiotherapy

    SciTech Connect

    Huang, C.Y.; Keall, P; Nasehi Tehrani, J; Booth, J

    2014-06-01

    Purpose: Lung tumor motion has been identified as a major issue that deteriorates treatment efficacy for radiotherapy, especially for SBRT. As tighter PTV margins are applied due to translational compensation, tumor rotation will become the dominant factor limiting tumor targeting accuracy. This is the world-first study quantifies lung tumor rotation by utilizing kV images with fiducial markers and a step towards 6-degree-of-freedom real-time cancer radiotherapy. Methods: Three or four gold coils were implanted as tumor surrogates in 3 lung cancer patients. 50 fractions of 8- minute, 10 Hz 4D CBCT projections were acquired for the patients immediately prior or after radiotherapy. The fiducial marker positions are segmented, reconstructed and used to determine tumour rotation by the iterative closest point algorithm. Different data acceptance and filtering methods were applied to accept data or smooth the marker trajectory. Results: The average rotation angles around the left/ right (LR), superior/inferior (SI), anterior/posterior (AP) rotations were found to be 0.8±4.2, -0.8±4.5 and 1.7±3.1 degrees respectively. For 28% of the treatment time, the lung tumors rotated more than 5° around the SI axis. Respiration-induced rotational motion was detected in 2 of the 3 lung patients. This can be explained by the patient developed atelectasis during the treatment period. Interestingly, no heart beating component of rotation was observed in the power spectrum. Different rotational types were observed within the patient cohort with large variations in the magnitude of the rotation between patients. Conclusions: For the first time, continuous tumor rotation has been measured for lung patients with gold fiducial markers. Tumors were found to undergo rotations of more than 5° for almost a third of the total treatment time. The study also demonstrated the feasibility of using continuously kV images for real-time lung tumour motion adaptive radiotherapy which can potentially reduce treatment margins and side effects. The authors acknowledge the financial support of an NHMRC Australia Fellowship.

  5. SU-D-17A-07: Development and Evaluation of a Prototype Ultrasonography Respiratory Monitoring System for 4DCT Reconstruction

    SciTech Connect

    Yan, P; Cheng, S; Chao, C; Jain, A

    2014-06-01

    Purpose: Respiratory motion artifacts are commonly seen in the abdominal and thoracic CT images. A Real-time Position Management (RPM) system is integrated with CT simulator using abdominal surface as a surrogate for tracking the patient respiratory motion. The respiratory-correlated four-dimensional computed tomography (4DCT) is then reconstructed by GE advantage software. However, there are still artifacts due to inaccurate respiratory motion detecting and sorting methods. We developed an Ultrasonography Respiration Monitoring (URM) system which can directly monitor diaphragm motion to detect respiratory cycles. We also developed a new 4DCT sorting and motion estimation method to reduce the respiratory motion artifacts. The new 4DCT system was compared with RPM and the GE 4DCT system. Methods: Imaging from a GE CT scanner was simultaneously correlated with both the RPM and URM to detect respiratory motion. A radiation detector, Blackcat GM-10, recorded the X-ray on/off and synchronized with URM. The diaphragm images were acquired with Ultrasonix RP system. The respiratory wave was derived from diaphragm images and synchronized with CT scanner. A more precise peaks and valleys detection tool was developed and compared with RPM. The motion is estimated for the slices which are not in the predefined respiratory phases by using block matching and optical flow method. The CT slices were then sorted into different phases and reconstructed, compared with the images reconstructed from GE Advantage software using respiratory wave produced from RPM system. Results: The 4DCT images were reconstructed for eight patients. The discontinuity at the diaphragm level due to an inaccurate identification of phases by the RPM was significantly improved by URM system. Conclusion: Our URM 4DCT system was evaluated and compared with RPM and GE 4DCT system. The new system is user friendly and able to reduce motion artifacts. It also has the potential to monitor organ motion during therapy.

  6. SU-D-18C-01: A Novel 4D-MRI Technology Based On K-Space Retrospective Sorting

    SciTech Connect

    Liu, Y; Yin, F; Cai, J

    2014-06-01

    Purpose: Current 4D-MRI techniques lack sufficient temporal/spatial resolution and consistent tumor contrast. To overcome these limitations, this study presents the development and initial evaluation of an entirely new framework of 4D-MRI based on k-space retrospective sorting. Methods: An important challenge of the proposed technique is to determine the number of repeated scans(NR) required to obtain sufficient k-space data for 4D-MRI. To do that, simulations using 29 cancer patients' respiratory profiles were performed to derive the relationship between data acquisition completeness(Cp) and NR, also relationship between NR(Cp=95%) and the following factors: total slice(NS), respiratory phase bin length(Lb), frame rate(fr), resolution(R) and image acquisition starting-phase(P0). To evaluate our technique, a computer simulation study on a 4D digital human phantom (XCAT) were conducted with regular breathing (fr=0.5Hz; R=256×256). A 2D echo planer imaging(EPI) MRI sequence were assumed to acquire raw k-space data, with respiratory signal and acquisition time for each k-space data line recorded simultaneously. K-space data was re-sorted based on respiratory phases. To evaluate 4D-MRI image quality, tumor trajectories were measured and compared with the input signal. Mean relative amplitude difference(D) and cross-correlation coefficient(CC) are calculated. Finally, phase-sharing sliding window technique was applied to investigate the feasibility of generating ultra-fast 4D-MRI. Result: Cp increased with NR(Cp=100*[1-exp(-0.19*NR)], when NS=30, Lb=100%/6). NR(Cp=95%) was inversely-proportional to Lb (r=0.97), but independent of other factors. 4D-MRI on XCAT demonstrated highly accurate motion information (D=0.67%, CC=0.996) with much less artifacts than those on image-based sorting 4D-MRI. Ultra-fast 4D-MRI with an apparent temporal resolution of 10 frames/second was reconstructed using the phase-sharing sliding window technique. Conclusions: A novel 4D-MRI technology based on k-space sorting has been successfully developed and evaluated on the digital phantom. Framework established can be applied to a variety of MR sequences, showing great promises to develop the optimal 4D-MRI technique for many radiation therapy applications. NIH (1R21CA165384-01A1)

  7. SU-D-207-01: Markerless Respiratory Motion Tracking with Contrast Enhanced Thoracic Cone Beam CT Projections

    SciTech Connect

    Chao, M; Yuan, Y; Rosenzweig, K; Lo, Y; Brousmiche, S

    2015-06-15

    Purpose: To develop a novel technique to enhance the image contrast of clinical cone beam CT projections and extract respiratory signals based on anatomical motion using the modified Amsterdam Shroud (AS) method to benefit image guided radiation therapy. Methods: Thoracic cone beam CT projections acquired prior to treatment were preprocessed to increase their contrast for better respiratory signal extraction. Air intensity on raw images was firstly estimated and then applied to correct the projections to generate new attenuation images that were subsequently improved with deeper anatomy feature enhancement through taking logarithm operation, derivative along superior-inferior direction, respectively. All pixels on individual post-processed two dimensional images were horizontally summed to one column and all projections were combined side by side to create an AS image from which patient’s respiratory signal was extracted. The impact of gantry rotation on the breathing signal rendering was also investigated. Ten projection image sets from five lung cancer patients acquired with the Varian Onboard Imager on 21iX Clinac (Varian Medical Systems, Palo Alto, CA) were employed to assess the proposed technique. Results: Application of the air correction on raw projections showed that more than an order of magnitude of contrast enhancement was achievable. The typical contrast on the raw projections is around 0.02 while that on attenuation images could greater than 0.5. Clear and stable breathing signal can be reliably extracted from the new images while the uncorrected projection sets failed to yield clear signals most of the time. Conclusion: Anatomy feature plays a key role in yielding breathing signal from the projection images using the AS technique. The air correction process facilitated the contrast enhancement significantly and attenuation images thus obtained provides a practical solution to obtaining markerless breathing motion tracking.

  8. An environmental tracers approach to characterize groundwater recharge within a carbonate coastal aquifer (Corse-du-Sud, France)

    NASA Astrophysics Data System (ADS)

    Garel, Emilie; Huneau, Frederic; Khoumeri, Beatrice; Travi, Yves

    2013-04-01

    Bonifacio is a coastal city, highly touristic, located in the southest part of Corsica Island. One million people visit the city in July and August, whereas 3000 inhabitants live throughout the year. Bonifacio lies on a small limestone plateau with a potential aquifer poorly understood. Actually there is a strong need to characterize the hydrogeological behavior for the reason that the economic development of the region is highly dependent of the groundwater supply potential. The Miocene sedimentary basin of Bonifacio has an area of 25 km2 with a depth up to 250 m in the center. It is based and surrounded by a Hercynian granitic substratum. The basin is open to the Mediterranean Sea on its south and east sides. The formation is calcareous-sandstone and is divided in 3 sedimentary units. The upper unit is highly calcareous and sandstone with a pseudo-karstic morphology, the intermediary unit is more silty-sandstone than the last but less than the unit from below. To establish a conceptual model of the groundwater flows of the Bonifacio aquifer, a hydrochemical (major ions, δ18O, δ2H, 3H) and hydrodynamic investigation was carried out on 12 wells, 1 spring and 1 river since May 2011. Vertical recharge is dominant in the centre of the aquifer where unsaturated zone is thicker, while on the aquifer boundaries with the granitic area, lateral flow was significant. Environmental tracers approach had clearly showed the important role of the boundaries conditions for the groundwater flow behavior of the aquifer of Bonifacio and the necessity of an investigation larger than the aquifer itself due to its limited spatial extension.

  9. SU-D-304-03: Small Field Proton Dosimetry Using MicroDiamond and Gafchromic Film

    SciTech Connect

    Andersen, A; Das, I; Coutinho, L

    2015-06-15

    Purpose: Certain dosimetric characteristics continue to make proton beam therapy an appealing modality for cancer treatment. The proton Bragg peak allows for conformal radiation dose delivery to the target while reducing dose to normal tissue and organs. As field sizes become very small the benefit of the Bragg peak is diminished due to loss of transverse equilibrium along the central beam axis. Furthermore, aperture scattering contributes additional dose along the central axis. These factors warrant the need for accurate small field dosimetry. In this study small field dosimetry was performed using two different methods. Methods: Small field dosimetry measurements were performed using a PTW microdiamond detector and Gafchromic EBT2 film for aperture sizes ranging from 0.5cm to 10cm and a proton range in water of 10cm to 27cm. The measurements were analyzed and then compared to each other and to reference dosimetry data acquired with a Markus chamber. Results: A decrease in normalized output is observed at small field sizes and at larger ranges in water using both measurement methods. Also, a large variation is observed between the output measurements by microdiamond and film at very small field sizes. At the smallest aperture, normalized output ranged from 0.16 to 0.72 and the percent difference between both measurement methods ranged from 36% to 70% depending on proton range. At field sizes above 5cm the film and microdiamond agree within 3%. Conclusion: Although both measurement methods exhibit a general decrease in output factor at small field sizes, dosimetric measurements for small fields using these two methods can vary significantly. Dosimetry under standard conditions is not sufficient to correctly model the dose distributions and outputs factors for small field sizes, additional small field measurements should be performed.

  10. SU-D-12A-04: Investigation of a 2D Antiscatter Grid for Flat Panel Detectors

    SciTech Connect

    Altunbas, C; Kavanagh, B; Miften, M; Zhong, Y; Shaw, C

    2014-06-01

    Purpose: To improve CT number accuracy and contrast sensitivity, a novel 2D antiscatter grid (ASG) for flat panel detector (FPD) based CBCT imaging was evaluated. Experiments were performed to characterize the scatter rejection and contrast sensitivity performance of ASG. The reduction in primary transmission for various ASG geometries was also evaluated by a computational model. Methods: The 2D ASG design was based on multi-hole collimators used in Nuclear Medicine. It consisted of abutted hexagon shaped apertures with 2.5 mm pitch and 32 mm height, and separated by 0.25 mm thick lead septa. Scatter-to-primary ratio (SPR), contrast-to-noise ratio (CNR), and mean primary transmission were measured using a benchtop FPD/x-ray source system. Acrylic slabs of varying thicknesses were imaged with a contrast-detail phantom to measure CNR and SPR under different scatter conditions. Primary transmission was also measured by averaging pixel values in flood field images without the phantom. We additionally explored variation of primary transmission with pitch and septum thickness using a computational model of our ASG. Results: Our 2D ASG reduced the SPR from 3.3 to 0.12, and improved CNR by 50% in 20 cm thick slab phantom projections acquired at 120 kVp. While the measured primary transmission was 72.8%, our simulations show that primary transmission can be increased to 86% by reducing the septum thickness to 0.1 mm. Primary transmission further increases to 93% if septum thickness of 0.1 mm is used in conjunction with an increased pitch of 4 mm. Conclusion: The 2D ASG appears to be a promising scatter rejection device, offering both superior scatter rejection and improved contrast sensitivity. Though its lead footprint reduced primary transmission, our work shows that optimization of aperture pitch and septum thickness can significantly improve the primary transmission.

  11. SU-D-303-03: Impact of Uncertainty in T1 Measurements On Quantification of Dynamic Contrast Enhanced MRI

    SciTech Connect

    Aryal, M; Cao, Y

    2015-06-15

    Purpose: Quantification of dynamic contrast enhanced (DCE) MRI requires native longitudinal relaxation time (T1) measurement. This study aimed to assess uncertainty in T1 measurements using two different methods. Methods and Materials: Brain MRI scans were performed on a 3T scanner in 9 patients who had low grade/benign tumors and partial brain radiotherapy without chemotherapy at pre-RT, week-3 during RT (wk-3), end-RT, and 1, 6 and 18 months after RT. T1-weighted images were acquired using gradient echo sequences with 1) 2 different flip angles (50 and 150), and 2) 5 variable TRs (100–2000ms). After creating quantitative T1 maps, average T1 was calculated in regions of interest (ROI), which were distant from tumors and received a total of accumulated radiation doses < 5 Gy at wk-3. ROIs included left and right normal Putamen and Thalamus (gray matter: GM), and frontal and parietal white matter (WM). Since there were no significant or even a trend of T1 changes from pre-RT to wk-3 in these ROIs, a relative repeatability coefficient (RC) of T1 as a measure of uncertainty was estimated in each ROI using the data pre-RT and at wk-3. The individual T1 changes at later time points were evaluated compared to the estimated RCs. Results: The 2-flip angle method produced small RCs in GM (9.7–11.7%) but large RCs in WM (12.2–13.6%) compared to the saturation-recovery (SR) method (11.0–17.7% for GM and 7.5–11.2% for WM). More than 81% of individual T1 changes were within T1 uncertainty ranges defined by RCs. Conclusion: Our study suggests that the impact of T1 uncertainty on physiological parameters derived from DCE MRI is not negligible. A short scan with 2 flip angles is able to achieve repeatability of T1 estimates similar to a long scan with 5 different TRs, and is desirable to be integrated in the DCE protocol. Present study was supported by National Institute of Health (NIH) under grant numbers; UO1 CA183848 and RO1 NS064973.

  12. Destination Raval Sud: A Visual Ethnography on Pedagogy, Aesthetics, and the Spatial Experience of Growing Up Urban

    ERIC Educational Resources Information Center

    Trafi-Prats, Laura

    2009-01-01

    This article focuses on issues of childhood identity and urban environment. It discusses how a performance art pedagogy inspired by nomadic and relational aesthetics can provide a framework to promote creative learning experiences that address migratory conditions and forms of public alienation lived by young people today. As Lefebvre (1991)…

  13. SU-D-19A-02: Electron and Photon Absorbed Fractions for Tumors of Varying Sizes and Compositions

    SciTech Connect

    Olguin, E; Bolch, W

    2014-06-01

    Purpose: To calculate absorbed fractions for mono-energetic photons and electrons in tumors of varying compositions using Monte Carlo simulations in MCNPX. Although tumor dosimetry has been previously investigated, these studies are very limited as they only consider absorbed fractions for soft-tissue tumors. Methods: The tumors were modeled as spheres with radii ranging from 0.10 cm to 6.0 cm and with compositions varying from 100% soft tissue to 100% bone. The energies of both the photons and electrons were varied from 10 keV to 10 MeV and were homogenously distributed throughout the tumor volume. Furthermore, this investigation addresses the issue of spherical versus elliptical tumors. Both prolate and oblate spheroid tumors of different compositions were modeled, and absorbed fractions were calculated for various electron and photon energies. Results: The data clearly shows an absorbed fraction dependence on tumor composition. For example, a soft-tissue model for a 3 MeV electron emitted in a 1 cm diameter bone tumor would have an 83% error, and this same assumption for a 500 keV photon would yield a 74% error. Ultimately, empirical fits were created for each of the five material compositions in order to facilitate the absorbed fraction calculation, requiring only the tumor size and particle energy. Furthermore, the data shows that absorbed fractions for moderate spheroids can be well approximated by spherical tumors of equal mass to within 8%, but in the extreme cases where the spheroid resembles more of a disk, the errors can be as high as 30%. Conclusion: This comprehensive data set is most valuable for nuclear medicine dosimetry because it incorporates particle type, particle energy, tumor size, and tumor composition. Although mono-energetic particles were modeled, absorbed fractions and S-values may be calculated for any radionuclide via linear interpolation, as long as the particle energies or spectra are known.

  14. SU-D-303-01: Spatial Distribution of Bone Metastases In Metastatic Castrate-Resistant Prostate Cancer

    SciTech Connect

    Perk, T; Bradshaw, T; Harmon, S; Perlman, S; Liu, G; Jeraj, R

    2015-06-15

    Purpose: Identification of metastatic bone lesions is critical in prostate cancer, where treatments may be more effective in patients with fewer lesions. This study aims characterize the distribution and spread of bone lesions and create a probability map of metastatic spread in bone. Methods: Fifty-five metastatic castrate-resistant prostate cancer patients received up to 3 whole-body [F-18]NaF PET/CT scans. Lesions were identified by physician on PET/CT and contoured using a threshold of SUV>15. An atlas-based segmentation method was used to create CT regions, which determined skeletal location of lesions. Patients were divided into 3 groups with low (N<40), medium (40100) numbers of lesions. A combination of articulated and deformable registrations was used to register the skeletal segments and lesions of each patient to a single skeleton. All the lesion data was then combined to make a probability map. Results: A total of 4038 metastatic lesions (mean 74, range 2–304) were identified. Skeletal regions with highest occurrence of lesions included ribs, thoracic spine, and pelvis with 21%, 19%, and 15% of the total number lesions and 8%, 18%, and 31 % of the total lesion volume, respectively. Interestingly, patients with fewer lesions were found to have a lower proportion of lesions in the ribs (9% in low vs. 27% in high number of lesions). Additionally, the probability map showed specific areas in the spine and pelvis where over 75% of patients had metastases, and other areas in the skeleton with a less than 2% of metastases. Conclusion: We identified skeletal regions with higher incidence of metastases and specific sub-regions in the skeleton that had high or low probability of occurrence of metastases. Additionally, we found that metastatic lesions in the ribs and skull occur more commonly in advanced disease. These results may have future applications in computer-aided diagnosis. Funding from the Prostate Cancer Foundation.

  15. SU-D-207-04: GPU-Based 4D Cone-Beam CT Reconstruction Using Adaptive Meshing Method

    SciTech Connect

    Zhong, Z; Gu, X; Iyengar, P; Mao, W; Wang, J; Guo, X

    2015-06-15

    Purpose: Due to the limited number of projections at each phase, the image quality of a four-dimensional cone-beam CT (4D-CBCT) is often degraded, which decreases the accuracy of subsequent motion modeling. One of the promising methods is the simultaneous motion estimation and image reconstruction (SMEIR) approach. The objective of this work is to enhance the computational speed of the SMEIR algorithm using adaptive feature-based tetrahedral meshing and GPU-based parallelization. Methods: The first step is to generate the tetrahedral mesh based on the features of a reference phase 4D-CBCT, so that the deformation can be well captured and accurately diffused from the mesh vertices to voxels of the image volume. After the mesh generation, the updated motion model and other phases of 4D-CBCT can be obtained by matching the 4D-CBCT projection images at each phase with the corresponding forward projections of the deformed reference phase of 4D-CBCT. The entire process of this 4D-CBCT reconstruction method is implemented on GPU, resulting in significantly increasing the computational efficiency due to its tremendous parallel computing ability. Results: A 4D XCAT digital phantom was used to test the proposed mesh-based image reconstruction algorithm. The image Result shows both bone structures and inside of the lung are well-preserved and the tumor position can be well captured. Compared to the previous voxel-based CPU implementation of SMEIR, the proposed method is about 157 times faster for reconstructing a 10 -phase 4D-CBCT with dimension 256×256×150. Conclusion: The GPU-based parallel 4D CBCT reconstruction method uses the feature-based mesh for estimating motion model and demonstrates equivalent image Result with previous voxel-based SMEIR approach, with significantly improved computational speed.

  16. SU-D-204-01: Dual-Energy Calibration for Breast Density Measurement Using Spectral Mammography

    SciTech Connect

    Ding, H; Cho, H; Kumar, N; Sennung, D; Molloi, S

    2015-06-15

    Purpose: To investigate the feasibility of minimizing the systematic errors in dual-energy breast density quantification induced by the use of tissue-equivalent plastic phantoms as the calibration basis materials. Methods: Dual-energy calibration using tissue-equivalent plastic phantoms was performed on a spectral mammography system based on scanning multi-slit Si strip photon-counting detectors. The plastic phantom calibration used plastic water and adipose-equivalent phantoms as the basis materials, which have different x-ray attenuation properties compared to water and lipid in actual breast tissue. Two methods were used to convert the dual-energy decomposition measurements in plastic phantom thicknesses into true water and lipid basis. The first method was based entirely on the theoretical x-ray attenuation coefficients of the investigated materials in the mammographic energy range. The conversion matrix was determined from least-squares fitting of the target material using the reported attenuation coefficients of water and lipid. The second method was developed based on experimental calibrations, which measured the low-and high-energy signals of pure water and lipid of known thicknesses. A non-linear rational function was used to correlate the decomposed thicknesses to the known values, so that the conversion coefficients can be determined. Both methods were validated using independent measurements of water and lipid mixture phantoms. The correlation of the dual-energy decomposition measurements and the known values were studied with linear regression analysis. Results: There was an excellent linear correlation between the converted water thicknesses and the known values. The slopes of the linear fits were determined to be 0.63 and 1.03 for the simulation and experimental results, respectively. The non-linear fitting in the experimental approach reduced the root-mean-square (RMS) errors from approximately 3.4 mm to 1.5 mm. Conclusion: The results suggested that conversion of the dual-energy measurements into water and lipid thicknesses minimized the systematic errors in tissue decomposition studies.

  17. SU-D-213-02: Characterization of the Effect of a New Commercial Transmission Detector On Radiotherapy Beams

    SciTech Connect

    Cheung, J; Morin, O

    2015-06-15

    Purpose: To evaluate the influence of a new commercial transmission detector on radiotherapy beams of various energies. Methods: A transmission detector designed for online treatment monitoring was characterized on a TrueBeam STx linear accelerator with 6MV, 6FFF, 10MV, and 10FFF beams. Measurements of beam characteristics including percentage depth doses (PDDs), inplane and crossplane off-axis profiles at different depths, transmission factors, and skin dose were acquired at field sizes of 3×3cm, 5×5m, 10×10cm, and 20×20cm at 100cm and 80cm source-to-surface distance (SSD). All measurements were taken with and without the transmission detector in the path of the beam. A CC04 chamber was used for all profile and transmission factor measurements. Skin dose was assessed at 100cm, 90cm, and 80cm SSD and using a variety of detectors (Roos and Markus parallel-plate chambers, and OSLD). Results: The PDDs showed small differences between the unperturbed and perturbed beams for both 100cm and 80cm SSD (≤4mm dmax difference and <1.2% average profile difference). The differences were larger for the flattened beams and at larger field sizes. The off-axis profiles showed similar trends. The penumbras looked similar with and without the transmission detector. Comparisons in the central 80% of the profile showed a maximum average (maximum) profile difference between all field sizes of 0.756% (1.535%) and 0.739% (3.682%) for 100cm and 80cm SSD, respectively. The average measured skin dose at 100cm (80cm) SSD for 10×10cm field size was <4% (<35%) dose increase for all energies. For 20×20cm field size, this value increased to <10% (≤45%). Conclusion: The transmission detector has minimal effect on the clinically relevant radiotherapy beams for IMRT and VMAT (field sizes 10×10cm and less). For larger field sizes, some perturbations are observable which would need to be assessed for clinical impact. The authors of this publication has research support from IBA Dosimetry.

  18. SU-D-201-01: Attenuation of PET/CT Gantries with 511 KeV Photons

    SciTech Connect

    Busse, N

    2015-06-15

    Purpose: PET shielding requires the use of large amounts of lead because of the penetrating nature of 511 keV photons. While the uptake rooms generally require the thickest lead, the scan room often requires substantial shielding. Attenuation by the PET/CT gantry is normally assumed to be zero, but may be significant in directions perpendicular to the scanner axis. Methods: A 5 mL tube was filled with between 14.7 and 20.5 mCi of F-18 and inserted into a phantom (70 cm NEMA PET Scatter Phantom). Exposure rates were recorded at several distances and 15° intervals with a pressurized ionization chamber (Ludlum 9DP) both with the phantom outside the gantry and centered in the CT and PET acquisition positions. These measurements were repeated with three scanners: Siemens Biograph TruePoint 6, GE Optima 560, and Philips Gemini 64. Measurements were decay corrected and normalized to exposure rates outside the gantry to calculate percent transmission. Results: Between 45° to 135° (measured from the patient bed at 0°), average transmission was about 20% for GE, 35% for Philips, and 30% for Siemens. The CT gantry was roughly twice as attenuating as the PET gantry at 90° for all three manufacturers, with about 10% transmission through the CT gantry and 20% through the PET gantry. Conclusion: The Philips system is a split-gantry and therefore has a narrower angle of substantial attenuation. For the GE and Siemens systems, which are single-gantry design, transmission was relatively constant once the angle was sufficient to block line-of-sight from the phantom. While the patient may spend a greater fraction of time at the PET position of the scanner, transmission characteristics of the two components are similar enough to be treated collectively. For shielding angles between 45° and 135°, a reasonably conservative assumption would be to assume gantry transmission of 50%.

  19. Rupture politique et enseignement de l'histoire en Afrique du Sud: Les manuels de l'enseignement primaire

    NASA Astrophysics Data System (ADS)

    Carpentier, Claude

    2000-07-01

    In all parts of the world, the teaching of history, because of its important ideological dimension, tends to be influenced by social and political changes. The recent upheavals in South Africa have confronted the nation with so many new tasks that it is difficult to decide which of them should have priority. These tasks include the establishing of a new educational curriculum which, paradoxically, no longer includes the subject of history as such. Instead, history is subsumed under the human and social sciences. This article analyses the content of history text books from the primary level upwards and from the 1980s to the most recent publications. On this basis it attempts to assess the extent and limits of the changes within a political setting marked by a tension between the historic struggle for equality and justice and the constraints imposed by the functioning of a liberal economy within the context of the globalization of modern capitalism. The considerable changes in the content of these books seem to be based on two different theoretical models: the multicultural model embodied in the idea of the "rainbow nation"; and the notion of the universality of humanity, transcending the diversity of cultures and confirmed by the findings of archaeology. While these two models can be a basis on which to refute racial inequality, they are not used to combat other forms of inequality, in particular social inequality.

  20. Dermatomyosite du sujet âgé: étude de 4 observations dans le sud tunisien

    PubMed Central

    Frikha, Faten; Snoussi, Mouna; Salah, Raida Ben; Saidi, Noura; Kaddour, Neila; Bahloul, Zouhir

    2012-01-01

    La dermatomyosite (DM) touche essentiellement l’adolescent et l’adulte jeune, elle est très rare chez le sujet âgé, le plus souvent associée à des complications iatrogènes et à une pathologie cancéreuse. Nous avons étudié les caractéristiques de la DM du sujet âgé à travers une étude rétrospective dans laquelle nous avons comparé 4 patients âgés de plus de 65 ans au début de la myosite avec 40 sujets jeunes. PMID:23308331

  1. SU-D-12A-05: Iterative Reconstruction Techniques to Enable Intrinsic Respiratory Gated CT in Mice

    SciTech Connect

    Sun, T; Sun, N; Tan, S; Liu, Y; Mistry, N

    2014-06-01

    Purpose: Longitudinal studies of lung function in mice need the ability to image different phases of ventilation in free-breathing mice using retrospective gating. However, retrospective gating often produces under-sampled and uneven angular samples, resulting in severe reconstruction artifacts when using traditional FDK based reconstruction algorithms. We wanted to demonstrate the utility of iterative reconstruction method to enable intrinsic respiratory gating in small-animal CT. Methods: Free-breathing mice were imaged using a Siemens Inveon PET/micro-CT system. Evenly distributed projection images were acquired at 360 angles. Retrospective respiratory gating was performed using an intrinsic marker based on the average intensity in a region covering the diaphragm. Projections were classified into 4 and 6 phases (finer temporal resolution) resulting in 138 and 67 projections respectively. Reconstruction was carried out using 3 Methods: conventional FDK, iterative penalized least-square (PWLS) with total variation (TV), and PWLS with edge-preserving penalty. The performance of the methods was compared using contrast-to-noise (CNR) in a region of interest (ROI). Line profile through a specific region was plotted to evaluate the preserving of edges. Results: In both the cases with 4 and 6 phases, inadequate and non-uniform angular sampling results in artifacts using conventional FDK. However, such artifacts are minimized using both the iterative methods. Using both 4 and 6 phases, the iterative techniques outperformed FDK in terms of CNR and maintaining sharp edges. This is further evidenced especially with increased artifacts using FDK for 6 phases. Conclusion: This work indicates fewer artifacts and better image details can be achieved with iterative reconstruction methods in non-uniform under-sampled reconstruction. Using iterative methods can enable free-breathing intrinsic respiratory gating in small-animal CT. Further studies are needed to compare the computational complexity for large datasets.

  2. Palladium, platinum, rhodium, ruthenium, and iridium in chromitites from the Massif du Sud and Tiebaghi massif, New Caledonia.

    USGS Publications Warehouse

    Page, N.J.; Cassard, D.; Haffty, J.

    1982-01-01

    The massive and disseminated podiform chromitites from 43 mines and other occurrences in the area contain up to (in ppb) Pd 9, Pt 45, Rh 31, Ir 410 and Ru 1300. The possble origins of the chromitites are discussed. -K.A.R.

  3. SU-D-9A-07: Imaging Dose and Cancer Risk in Image-Guided Radiotherapy of Cancers

    SciTech Connect

    Zhou, L; Bai, S; Zhang, Y; Ming, X; Zhang, Y; Deng, J

    2014-06-01

    Purpose: To systematically evaluate the imaging doses and cancer risks associated with various imaging procedures involving ionizing radiation during image-guided radiotherapy of an increasingly large number of cancer patients. Methods: 141 patients (52 brain cases, 47 thoracic cases, 42 abdominal cases, aged 3 to 91 years old) treated between October 2009 and March 2010 were included in this IRB-approved retrospective study. During the whole radiotherapy course, each patient underwent at least one type of imaging procedures, i.e., kV portal, MV portal and kVCBCT, besides CT simulations. Based on Monte Carlo modeling and particle transport in human anatomy of various dimensions, the correlations between the radiation doses to the various organs-at-risk (OARs) at the head, the thoracic and the abdominal regions and one's weight, circumference, scan mAs and kVp have been obtained and used to estimate the radiation dose from a specific imaging procedure. The radiation-induced excess relative risk (ERR) was then estimated with BEIR VII formulism based on one's gender, age and radiation dose. 1+ ERR was reported in this study as relative cancer risk. Results: For the whole cohort of 141 patients, the mean imaging doses from various imaging procedures were 8.3 cGy to the brain, 10.5 cGy to the lungs and 19.2 cGy to the red bone marrow, respectively. Accordingly, the cancer risks were 1.140, 1.369 and 2.671, respectively. In comparison, MV portal deposited largest doses to the lungs while kVCBCT delivered the highest doses to the red bone marrow. Conclusion: The compiled imaging doses to a patient during his/her treatment course were patient-specific and site-dependent, varying from 1.2 to 263.5 cGy on average, which were clinically significant and should be included in the treatment planning and overall decision-making. Our results indicated the necessity of personalized imaging to maximize its clinical benefits while reducing the associated cancer risks. Sichuan University Scholarship.

  4. SU-D-12A-07: Optimization of a Moving Blocker System for Cone-Beam Computed Tomography Scatter Correction

    SciTech Connect

    Ouyang, L; Yan, H; Jia, X; Jiang, S; Wang, J; Zhang, H

    2014-06-01

    Purpose: A moving blocker based strategy has shown promising results for scatter correction in cone-beam computed tomography (CBCT). Different parameters of the system design affect its performance in scatter estimation and image reconstruction accuracy. The goal of this work is to optimize the geometric design of the moving block system. Methods: In the moving blocker system, a blocker consisting of lead strips is inserted between the x-ray source and imaging object and moving back and forth along rotation axis during CBCT acquisition. CT image of an anthropomorphic pelvic phantom was used in the simulation study. Scatter signal was simulated by Monte Carlo calculation with various combinations of the lead strip width and the gap between neighboring lead strips, ranging from 4 mm to 80 mm (projected at the detector plane). Scatter signal in the unblocked region was estimated by cubic B-spline interpolation from the blocked region. Scatter estimation accuracy was quantified as relative root mean squared error by comparing the interpolated scatter to the Monte Carlo simulated scatter. CBCT was reconstructed by total variation minimization from the unblocked region, under various combinations of the lead strip width and gap. Reconstruction accuracy in each condition is quantified by CT number error as comparing to a CBCT reconstructed from unblocked full projection data. Results: Scatter estimation error varied from 0.5% to 2.6% as the lead strip width and the gap varied from 4mm to 80mm. CT number error in the reconstructed CBCT images varied from 12 to 44. Highest reconstruction accuracy is achieved when the blocker lead strip width is 8 mm and the gap is 48 mm. Conclusions: Accurate scatter estimation can be achieved in large range of combinations of lead strip width and gap. However, image reconstruction accuracy is greatly affected by the geometry design of the blocker.

  5. SU-D-18C-06: Initial Experience with Implementing MRI Safety Guidelines for Patients with Pacemakers - Medical Physicist Perspective

    SciTech Connect

    James, J; Place, V; Panda, A; Edmonson, H; Felmlee, J; Pooley, R

    2014-06-01

    Purpose: Several institutions have developed MRI guidelines for patients with MR-unsafe or MR-conditional pacemakers. Here we highlight the role of a medical physicist in implementing these guidelines for non-pacemaker dependent patients. Guidelines: Implementing these guidelines requires involvement from several medical specialties and a strong collaboration with the site MRI supervisor to develop a structured workflow. A medical physicist is required to be present during the scan to supervise the MR scanning and to maintain a safety checklist that ensures: 1) uninterrupted patient communication with the technologist, 2) continuous patient physiologic monitoring (e.g. blood pressure and electrocardiography) by a trained nurse, 3) redundant patient vitals monitoring (e.g. pulse oximetry) due to the possibility of in vivo electrocardiography reading fluctuations during image acquisition. A radiologist is strongly recommended to be available to review the images before patients are discharged from the scanner. Pacemaker MRI should be restricted to 1.5T field strength. The MRI sequences should be optimized by the physicist with regards to: a) SAR: limited to <1.5 W/Kg for MR-unsafe pacemakers in normal operating mode, b) RF exposure time: <30 min, c) Coils: use T/R coils but not restricted to such, d) Artifacts: further optimization of sequences whenever image quality is compromised due to the pacemaker. In particular, cardiac, breast and left-shoulder MRIs are most susceptible to these artifacts. Possible strategies to lower the SAR include: a) BW reduction, 2) echo-train-length reduction, 3) increase TR, 4) decrease number of averages, 5) decrease flip angle, 6) reduce slices and/or a combination of all the options. Conclusion: A medical physicist in collaboration with the MR supervisor plays an important role in the supervision/implementation of safe MR scanning of pacemaker patients. Developing and establishing a workflow has enabled our institution to scan over 30 patients with pacemakers without complications, including 3 cardiac MR exams.

  6. 76 FR 64944 - Notice of Agreements Filed

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-19

    ...: Hamburg-Sud (``HSDG''); Alianca Navegacao e Logistica Ltda. e CIA (``Alianca''); Compania Sud Americana de...-010. Title: Maritime Credit Agreement. Parties: Alianca Navegacao e Logistica Ltda. & Cia.;...

  7. The relationship between parental mental illness and/or substance use disorder on adolescent substance use disorder: Results from a nationally representative survey.

    PubMed

    Ali, Mir M; Dean, David; Hedden, Sarra L

    2016-08-01

    This study examines the relationship between parental comorbid mental illness and substance use disorder (SUD) and adolescent SUD. Nationally representative parent-child data pooled over six years from the National Survey on Drug Use and Health (NSDUH) was utilized in this study. Multivariable regression analysis was conducted to determine whether adolescents living with parents who have mental health disorders and/or substance use disorder are themselves more likely to have SUD while controlling for potential confounding variables. The results show that comorbid AMI-SUD in mothers is significantly associated with adolescent SUD after controlling for potential confounders. However, comorbid AMI-SUD in fathers is not associated with adolescent SUD when other controls are included in the model. The association of parental comorbid AMI-SUD with adolescent SUD indicates that parental behavioral health treatment may be a preventive measure to protect their children and may function as an important deterrent to adolescent SUD. PMID:27070095

  8. Temperament and character dimensions in male patients with substance use disorders: Differences relating to psychiatric comorbidity.

    PubMed

    Marquez-Arrico, Julia E; López-Vera, Silvia; Prat, Gemma; Adan, Ana

    2016-03-30

    Previous research has not considered the influence of the Comorbid Mental Disorder (CMD) among Substance Use Disorders (SUD) patients. We explored the possible differences in personality dimensions among SUD patients taking into account their CMD (Schizophrenia, SZ; Bipolar Disorder, BD; Major Depressive Disorder, MDD); and elucidated clinical factors related to personality dimensions according to the CMD. The Temperament and Character Inventory Revised was used to assess a sample of 102 SUD male patients, considered in three groups according to their CMD: SUD+SZ (N=37), SUD+BD (N=30) and SUD+MDD (N=35). SUD+BD patients had the highest levels of Novelty Seeking and Persistence, SUD+SZ patients showed the highest levels of Harm Avoidance, and SUD+MDD patients reported a lower level of Self-transcendence. Novelty Seeking was positively associated with severity of addiction for SUD+BD; Harm Avoidance was positively associated with psychiatric symptoms for SUD+SZ; and the age of SUD onset was positively linked to Cooperativeness for SUD+BD and to Self-transcendence for SUD+MDD. The different personality characteristics associated to the type of CMD among SUD patients are related to several clinical variables. Interventions in these patients should be tailored according the personality traits that could influence treatment outcomes and patients' prognoses. PMID:26921044

  9. SU-D-12A-01: An Inter-Projection Interpolation (IPI) Approach for the Synchronized Moving Grid (SMOG) to Reduce Dose in Cone Beam CT

    SciTech Connect

    Zhang, H; Kong, V; Jin, J; Ren, L

    2014-06-01

    Purpose: Synchronized moving grid is a promising technique to reduce scatter and ghost artifacts in cone beam computed tomography (CBCT). However, it requires 2 projections in the same gantry angle to obtain full information due to signal blockage by the grid. We proposed an inter-projection interpolation (IPI) method to estimate blocked signals, which may reduce the scan time and the dose. This study aims to provide a framework to achieve a balance between speed, dose and image quality. Methods: The IPI method is based on the hypothesis that an abrupt signal in a projection can be well predicted by the information in the two immediate neighboring projections if the gantry angle step is small. The study was performed on a Catphan and a head phantom. The SMOG was simulated by erasing the information (filling with “0”) of the areas in each projection corresponding to the grid. An IPI algorithm was applied on each projection to recover the erased information. FDK algorithm was used to reconstruct CBCT images for the IPI-processed projections, and compared with the original image in term of signal to noise ratio (SNR) measured in the whole reconstruction image range. The effect of gantry angle step was investigated by comparing the CBCT images from projection sets of various gantry intervals, with IPI-predicted projections to fill the missing projection in the interval. Results: The IPI procession time was 1.79s±0.53s for each projection. SNR after IPI was 29.0db and 28.1db for the Catphan and head phantom, respectively, comparing to 15.3db and 22.7db for an inpainting based interpolation technique. SNR was 28.3, 28.3, 21.8, 19.3 and 17.3 db for gantry angle intervals of 1, 1.5, 2, 2.5 and 3 degrees, respectively. Conclusion: IPI is feasible to estimate the missing information, and achieve an reasonable CBCT image quality with reduced dose and scan time. This study is supported by NIH/NCI grant 1R01CA166948-01.

  10. SU-D-210-06: Feasibility for Monitoring the Head of the Pancreas Motion Through a Surrogate Using Ultrasound During Radiation Therapy Delivery

    SciTech Connect

    Omari, E; Noid, G; Ehlers, C; Erickson, B; Quiroz, F; Li, X; Cooper, D; Lachaine, M

    2015-06-15

    Purpose: Substantial target motion during the delivery of radiation therapy (RT) for pancreatic cancer is well recognized as a major limiting factor on RT effectiveness. The aim of this work is to monitor intra-fractional motion of the pancreas using ultrasound during RT delivery. Methods: Transabdominal Ultrasound B-mode images were collected from 5 volunteers using a research version of the Clarity Autoscan System (Elekta). The autoscan transducer with center frequency of 5 MHz was utilized for the scans. Imaging parameters were adjusted to acquire images at the desired depth with good contrast and a wide sweep angle. Since well-defined boundaries of the pancreas can be difficult to find on ultrasound B-mode images, the portal vein was selected as a surrogate for motion estimation of the head of the pancreas. The selection was due to its anatomical location posterior to the neck of the pancreas and close proximity to the pancreas head. The portal vein was contoured on the ultrasound images acquired during simulation using the Clarity Research AFC Workstation software. Volunteers were set up in a similar manner to the simulation for their monitoring session and the ultrasound transducer was mounted on an arm fixed to the couch. A video segment of the portal vein motion was captured. Results: The portal vein was visualized and segmented. Successful monitoring sessions of the portal vein were observed. In addition, our results showed that the ultrasound transducer itself reduces breathing related motion. This is analogous to the use of a compression plate to suppress respiration motion during thorax or abdominal irradiation. Conclusion: We demonstrate the feasibility of tracking the pancreas through the localization of the portal vein using abdominal ultrasound. This will allow for real-time tracking of the intra-fractional motion to justify PTV-margin and to account for unusual motions, thus, improving normal tissue sparing. This research was funding in part by Elekta Inc.

  11. SU-D-201-02: Prediction of Delivered Dose Based On a Joint Histogram of CT and FDG PET Images

    SciTech Connect

    Park, M; Choi, Y; Cho, A; Hwang, S; Cha, J; Lee, N; Yun, M

    2015-06-15

    Purpose: To investigate whether pre-treatment images can be used in predicting microsphere distribution in tumors. When intra-arterial radioembolization using Y90 microspheres was performed, the microspheres were often delivered non-uniformly within the tumor, which could lead to an inefficient therapy. Therefore, it is important to estimate the distribution of microspheres. Methods: Early arterial phase CT and FDG PET images were acquired for patients with primary liver cancer prior to radioembolization (RE) using Y90 microspheres. Tumor volume was delineated on CT images and fused with FDG PET images. From each voxel (3.9×3.9×3.3 mm3) in the tumor, the Hounsfield unit (HU) from the CT and SUV values from the FDG PET were harvested. We binned both HU and SUV into 11 bins and then calculated a normalized joint-histogram in an 11×11 array.Patients also underwent a post-treatment Y90 PET imaging. Radiation dose for the tumor was estimated using convolution of the Y90 distribution with a dose-point kernel. We also calculated a fraction of the tumor volume that received a radiation dose great than 100Gy. Results: Averaged over 40 patients, 55% of tumor volume received a dose greater than 100Gy (range : 1.1 – 100%). The width of the joint histogram was narrower for patients with a high dose. For patients with a low dose, the width was wider and a larger fraction of tumor volume had low HU. Conclusion: We have shown the pattern of joint histogram of the HU and SUV depends on delivered dose. The patterns can predict the efficacy of uniform intra-arterial delivery of Y90 microspheres.

  12. SU-D-207-06: Clinical Validations of Shading Correction for Cone-Beam CT Using Planning CT as a Prior

    SciTech Connect

    Tsui, T; Zhu, L; Wei, J

    2015-06-15

    Purpose: Current cone-beam CT (CBCT) images contain severe shading artifacts mainly due to scatter, hindering their quantitative use in current radiation therapy. We have previously proposed an effective shading correction method for CBCT using planning CT (pCT) as prior knowledge. In this work, we investigate the method robustness via statistical analyses on studies of a large patient group and compare the performance with that of a state-of-the-art method implemented on the current commercial radiation therapy machine -- the Varian Truebeam system. Methods: Since radiotherapy patients routinely undergo multiple-detector CT (MDCT) scans in the planning procedure, we use the high-quality pCT as “free” prior knowledge for CBCT image improvement. The CBCT image with no correction is first spatially registered with the pCT. Primary CBCT projections are estimated via forward projections of the registered image. The low frequency errors in the projections, which stem from mainly scatter, are estimated by filtering the difference between original line integral and the estimated scatter projections. The corrected CBCT image is then reconstructed from the scatter corrected projections. The proposed method is evaluated on 40 cancer patients. Results: On all patient images, we compare errors on CT number, spatial non-uniformity (SNU) and image contrast, using pCT as the ground truth. T-tests show that our algorithm improves over the Varian method on CBCT accuracies of CT number and SNU with 90% confident. The average CT number error is reduced from 54.8 HU on the Varian method to 40.9 HU, and the SNU error is reduced from 7.7% to 3.8%. There is no obvious improvement on image contrast. Conclusion: Large-group patient studies show that the proposed pCT-based algorithm outperforms the Varian method of the Truebeam system on CBCT shading correction, by providing CBCT images with higher CT number accuracy and greater image uniformity.

  13. Enfants Autochtones et Apprentissage: la Corporalite comme Langage en Amerique du Sud Tropicale. (Indigenous Children and Learning: the Body's Language in Tropical South America.)

    ERIC Educational Resources Information Center

    da Silva, Aracy Lopes

    1999-01-01

    Shows how, among the cultures of the indigenous peoples of tropical South America, the human body offers a language and mechanism central to the process of production, elaboration, and transmission, of knowledge, skills, and emotions. Discusses recent anthropological debates and describes a new discipline known as "anthropology of the child."…

  14. SU-D-213-03: Towards An Optimized 3D Scintillation Dosimetry Tool for Quality Assurance of Dynamic Radiotherapy Techniques

    SciTech Connect

    Rilling, M; Goulet, M; Thibault, S; Archambault, L

    2015-06-15

    Purpose: The purpose of this work is to simulate a multi-focus plenoptic camera used as the measuring device in a real-time three-dimensional scintillation dosimeter. Simulating and optimizing this realistic optical system will bridge the technological gap between concept validation and a clinically viable tool that can provide highly efficient, accurate and precise measurements for dynamic radiotherapy techniques. Methods: The experimental prototype, previously developed for proof of concept purposes, uses an off-the-shelf multi-focus plenoptic camera. With an array of interleaved microlenses of different focal lengths, this camera records spatial and angular information of light emitted by a plastic scintillator volume. The three distinct microlens focal lengths were determined experimentally for use as baseline parameters by measuring image-to-object magnification for different distances in object space. A simulated plenoptic system was implemented using the non-sequential ray tracing software Zemax: this tool allows complete simulation of multiple optical paths by modeling interactions at interfaces such as scatter, diffraction, reflection and refraction. The active sensor was modeled based on the camera manufacturer specifications by a 2048×2048, 5 µm-pixel pitch sensor. Planar light sources, simulating the plastic scintillator volume, were employed for ray tracing simulations. Results: The microlens focal lengths were determined to be 384, 327 and 290 µm. A realistic multi-focus plenoptic system, with independently defined and optimizable specifications, was fully simulated. A f/2.9 and 54 mm-focal length Double Gauss objective was modeled as the system’s main lens. A three-focal length hexagonal microlens array of 250-µm thickness was designed, acting as an image-relay system between the main lens and sensor. Conclusion: Simulation of a fully modeled multi-focus plenoptic camera enables the decoupled optimization of the main lens and microlens specifications. This work leads the way to improving the 3D dosimeter’s achievable resolution, efficiency and build for providing a quality assurance tool fully meeting clinical needs. M.R. is financially supported by a Master’s Canada Graduate Scholarship from the NSERC. This research is also supported by the NSERC Industrial Research Chair in Optical Design.

  15. SU-D-18C-04: The Feasibility of Quantifying MRI Contrast Agent in Pulsatile Flowing Blood Using DCE-MRI

    SciTech Connect

    N, Gwilliam M; J, Collins D; O, Leach M; R, Orton M

    2014-06-01

    Purpose: To assess the feasibility of accurately quantifying the concentration of MRI contrast agent (CA) in pulsatile flowing blood by measuring its T{sub 1}, as is common for the purposes of obtaining a patientspecific arterial input function (AIF). Dynamic contrast enhanced (DCE) - MRI and pharmacokinetic (PK) modelling is widely used to produce measures of vascular function but accurate measurement of the AIF undermines their accuracy. A proposed solution is to measure the T{sub 1} of blood in a large vessel using the Fram double flip angle method during the passage of a bolus of CA. This work expands on previous work by assessing pulsatile flow and the changes in T{sub 1} seen with a CA bolus. Methods: A phantom was developed which used a physiological pump to pass fluid of a known T{sub 1} (812ms) through the centre of a head coil of a clinical 1.5T MRI scanner. Measurements were made using high temporal resolution sequences suitable for DCE-MRI and were used to validate a virtual phantom that simulated the expected errors due to pulsatile flow and bolus of CA concentration changes typically found in patients. Results: : Measured and virtual results showed similar trends, although there were differences that may be attributed to the virtual phantom not accurately simulating the spin history of the fluid before entering the imaging volume. The relationship between T{sub 1} measurement and flow speed was non-linear. T{sub 1} measurement is compromised by new spins flowing into the imaging volume, not being subject to enough excitations to have reached steady-state. The virtual phantom demonstrated a range of recorded T{sub 1} for various simulated T{sub 1} / flow rates. Conclusion: T{sub 1} measurement of flowing blood using standard DCE-MRI sequences is very challenging. Measurement error is non-linear with relation to instantaneous flow speed. Optimising sequence parameters and lowering baseline T{sub 1} of blood should be considered.

  16. SU-D-210-07: The Dependence On Acoustic Velocity of Medium On the Needle Template and Electronic Grid Alignment in Ultrasound QA for Prostate Brachytherapy

    SciTech Connect

    Kapoor, P; Kapoor, R; Curran, B

    2015-06-15

    Purpose: To analyze the impact on acoustic velocity (AV) of two different media (water and milk) using the needle template/electronic grid alignment test. Water, easily available, makes a good material to test the alignment of the template and grid although water’s AV (1498 m/s at 25°C) is significantly different from tissue (1540 m/s). Milk, with an AV much closer (1548 m/s) to prostate tissue, may be a good substitute for water in ultrasound quality assurance testing. Methods: Tests were performed using a Hitachi ultrasound unit with a mechanical arrangement designed to position needles parallel to the transducer. In this work, two materials – distilled water and homogenized whole milk (AVs of 1498 and 1548 m/s at 25°C) were used in a phantom to test ultrasound needle/grid alignment. The images were obtained with both materials and analyzed for their placement accuracy. Results: The needle template/electronic grid alignment tests showed displacement errors between measured and calculated values. The measurements showed displacements of 2.3mm (water) and 0.4mm (milk), and 1.6mm (water) and 0.3mm (milk) at depths of 7cm and 5cm respectively from true needle positions. The calculated results showed a displacement of 2.36 mm (water); 0.435mm (milk), and 1.66mm (water) and 0.31mm (milk) at a depth of 7cm and 5cm respectively. The displacements in the X and Y directions were also calculated. At depths of 7cm and 5cm, the (ΔX,ΔY) displacements in water were (0.829mm, 2.21mm) and (0.273mm, 1.634mm) and for milk were (0.15mm, 0.44mm) and (0.05mm, 0.302mm) respectively. Conclusion: The measured and calculated values were in good agreement for all tests. They show that milk provides superior results when performing needle template and electronic grid alignment tests for ultrasound units used in prostate brachytherapy.

  17. SU-D-19A-06: The Effect of Beam Parameters On Very High-Energy Electron Radiotherapy: A Planning Study

    SciTech Connect

    Palma, B; Bazalova, M; Qu, B; Loo, B; Maxim, P; Hardemark, B; Hynning, E

    2014-06-01

    Purpose: We evaluated the effect of very high-energy electron (VHEE) beam parameters on the planning of a lung cancer case by means of Monte Carlo simulations. Methods: We simulated VHEE radiotherapy plans using the EGSnrc/BEAMnrc-DOSXYZnrc code. We selected a lung cancer case that was treated with 6MV photon VMAT to be planned with VHEE. We studied the effect of beam energy (80 MeV, 100 MeV, and 120 MeV), number of equidistant beams (16 or 32), and beamlets sizes (3 mm, 5 mm or 7 mm) on PTV coverage, sparing of organs at risk (OARs) and dose conformity. Inverse-planning optimization was performed in a research version of RayStation (RaySearch Laboratories AB) using identical objective functions and constraints for all VHEE plans. Results: Similar PTV coverage and dose conformity was achieved by all the VHEE plans. The 100 MeV and 120 MeV VHEE plans were equivalent amongst them and were superior to the 80 MeV plan in terms of OARs sparing. The effect of using 16 or 32 equidistant beams was a mean difference in average dose of 2.4% (0%–7.7%) between the two plans. The use of 3 mm beamlet size systematically reduced the dose to all the OARs. Based on these results we selected the 100MeV-16beams-3mm-beamlet-size plan to compare it against VMAT. The selected VHEE plan was more conformal than VMAT and improved OAR sparing (heart and trachea received 125% and 177% lower dose, respectively) especially in the low-dose region. Conclusion: We determined the VHEE beam parameters that maximized the OAR dose sparing and dose conformity of the actually delivered VMAT plan of a lung cancer case. The selected parameters could be used for the planning of other treatment sites with similar size, shape, and location. For larger targets, a larger beamlet size might be used without significantly increasing the dose. B Palma: None. M Bazalova: None. B Hardemark: Employee, RaySearch Americas. E Hynning: Employee, RaySearch Americas. B Qu: None. B Loo Jr.: Research support, RaySearch, Varian. P Maxim: Research support, RaySearch, Varian.

  18. SU-D-9A-04: Brain PET/CT Imaging On a Scanner with a Large Axial Field-Of-View

    SciTech Connect

    Park, M; Gerbaudo, V; Hamberg, L; Seaver, K; Kijewski, M

    2014-06-01

    Purpose: Large axial field-of-view (FOV) PET/CT scanners are valued for high sensitivity. Brain PET image quality may depend on the head position within the FOV. We investigated the precision of activity estimation for brain PET imaging when the brain was positioned at the end (END) and in the middle (CEN) of the FOV. The additional CT dose for the CEN position was recorded. Methods: An image quality (Jaszczak) phantom and a striatal phantom were filled with F-18 and positioned in END and CEN locations. For each phantom and each location, we acquired a ∼1-hr listmode PET, rebinned the data into 10 frames with equal number of coincidence events, and reconstructed each frame using an iterative algorithm. For the striatal phantom, END and CEN were compared by drawing on each image three regions of interest (ROI) in axially separated uniform areas. The standard deviation of the activity estimation within each ROI was averaged over the 10 images. The coefficient of variation (CV) for activity estimation was calculated at each position. Image quality was assessed by inspecting the resolution bar pattern in the Jaszczak phantom at two different head positions. Results: The CV was the lowest for ROIs near the center of the FOV. For slices near the end, not only was the CV highest, but also the resolution pattern was degraded. CTDIvol summarized in the dose report indicated that the CT dose was ∼ 10% higher for CEN as compared to END position. Conclusion: Positioning the brain in the middle of the FOV in a large FOV PET/CT scanner allows more precise measurement of tracer uptake and better image quality at the cost of increased CT dose. For the end location longer scan times may minimize image quality degradation without any additional CT dose.

  19. SU-D-304-04: Pre-Clinical Feasibility Study for Intensity Modulated Grid Proton Therapy (IMgPT) Using a Newly Developed Delivery System

    SciTech Connect

    Tsiamas, P; Moskvin, V; Shin, J; Axente, M; Pirlepesov, F; Krasin, M; Merchant, T; Farr, J

    2015-06-15

    Purpose: The purpose of the current study was to characterize and evaluate intensity-modulated proton grid therapy (IMgPT) using a clinical proton beam. Methods: A TOPAS MC model of a new developmental mode (pre-clinical) of the Hitachi proton therapy system (PROBEAT) was used for simulation and characterization of proton grid therapy. TOPAS simulations of different energy ranges, depths and spot separation distances were performed. LET spectra for various energies and depths were produced with FLUKA MC code for evaluation potential interplay between planning parameters and their effect on the characterization of areas (valley) between spots. IMgPT planning aspects (spot spacing, skin dose, peak-to-valley ratios, beam selection, etc.) were evaluated for different phantom and patient cases. Raysearch software (v4.51) was used to perform the evaluation. Results: Calculated beam peak-to-valley ratios scenarios showed strong energy and depth dependence with ratios to be larger for higher energies and shallower depths. Peak-to-valley ratios for R90 range and for spot spacing of 1cm varied from 30% (E = 221.3 MeV, depth 30.6 cm) to 80% (E = 70.3 MeV, depth 4 cm). LET spectra calculations showed spectral hardening with depth, which might potential increase, spot separation distance and improve peak-to-valley ratios. IMgPT optimization, using constant spot spacing, showed skin dose reduction between peak regions of dose due to the irradiation of less skin. Single beam for bulky shallower tumors might be a potential candidate for proton grid therapy. Conclusions: Proton grid therapy using a clinical beam is a promising technique that reduces skin dose between peak regions of dose and may be suitable for the treatment of shallow tumors. IMgPT may be considered for use when bystander effects in off peak regions would be appropriate.

  20. SU-D-304-05: Validation of Low-Dose-Tail Modeling for Proton Pencil Beam Spot Scanning Using a Quality Assurance Test Pattern

    SciTech Connect

    Lin, L; Huang, S; Kang, M; Solberg, T; McDonough, J; Ainsley, C

    2015-06-15

    Purpose: The purpose of this manuscript is to demonstrate the utility of a comprehensive test pattern in validating calculation models of the low-dose tails of proton pencil beam scanning (PBS) spots. Such a pattern has been used previously for quality assurance purposes to assess spot shape and location, and for determining monitor units. Methods: In this study, a scintillation detector was used to measure the test pattern in air at isocenter for two proton beam energies (115 and 225 MeV) of two IBA universal nozzles (UN). Planar measurements were compared with calculated dose distribution based on the weighted superposition of spot profiles previously measured using a pair-magnification method. Results: Including the halo component below 1% of the central dose is shown to improve the gamma-map comparison between calculation and measurement from 94.9% to 98.4% using 2 mm/2% criteria for the 115 MeV proton beam of UN #1. In contrast, including the halo component below 1% of the central dose does not improve the gamma agreement for the 115 MeV proton beam of UN #2, due to the cutoff of the halo component at off-axis locations. When location-dependent spot profiles are used for calculation instead of spot profiles at central axis, the gamma agreement is improved from 98.0% to 99.5% using 2 mm/2% criteria. The cutoff of the halo component is smaller at higher energies, and is not observable for the 225 MeV proton beam for UN #2. Conclusion: In conclusion, the use of a comprehensive test pattern can facilitate the validation of the halo component of proton PBS spots at off axis locations. The cutoff of the halo component should be taken into consideration for large fields or PBS systems that intend to trim spot profiles using apertures. This work was supported by the US Army Medical Research and Materiel Command under Contract Agreement No. DAMD17-W81XWH-07-2-0121 and W81XWH-09-2-0174.

  1. SU-D-17A-04: The Impact of Audiovisual Biofeedback On Image Quality During 4D Functional and Anatomic Imaging: Results of a Prospective Clinical Trial

    SciTech Connect

    Keall, P; Pollock, S; Yang, J; Diehn, M; Berger, J; Graves, E; Loo, B; Yamamoto, T

    2014-06-01

    Purpose: The ability of audiovisual (AV) biofeedback to improve breathing regularity has not previously been investigated for functional imaging studies. The purpose of this study was to investigate the impact of AV biofeedback on 4D-PET and 4D-CT image quality in a prospective clinical trial. We hypothesized that motion blurring in 4D-PET images and the number of artifacts in 4D-CT images are reduced using AV biofeedback. Methods: AV biofeedback is a real-time, interactive and personalized system designed to help a patient self-regulate his/her breathing using a patient-specific representative waveform and musical guides. In an IRB-approved prospective clinical trial, 4D-PET and 4D-CT images of 10 lung cancer patients were acquired with AV biofeedback (AV) and free breathing (FB). The 4D-PET images in 6 respiratory bins were analyzed for motion blurring by: (1) decrease of GTVPET and (2) increase of SUVmax in 4-DPET compared to 3D-PET. The 4D-CT images were analyzed for artifacts by: (1) comparing normalized cross correlation-based scores (NCCS); and (2) quantifying a visual assessment score (VAS). A two-tailed paired t-test was used to test the hypotheses. Results: The impact of AV biofeedback on 4D-PET and 4D-CT images varied widely between patients, suggesting inconsistent patient comprehension and capability. Overall, the 4D-PET decrease of GTVPET was 2.0±3.0cm3 with AV and 2.3±3.9cm{sup 3} for FB (p=0.61). The 4D-PET increase of SUVmax was 1.6±1.0 with AV and 1.1±0.8 with FB (p=0.002). The 4D-CT NCCS were 0.65±0.27 with AV and 0.60±0.32 for FB (p=0.32). The 4D-CT VAS was 0.0±2.7 (p=ns). Conclusion: A 10-patient study demonstrated a statistically significant reduction of motion blurring of AV over FB for 1/2 functional 4D-PET imaging metrics. No difference between AV and FB was found for 2 anatomic 4D-CT imaging metrics. Future studies will focus on optimizing the human-computer interface and including patient training sessions for improved comprehension and capability. Supported by NIH/NCI R01 CA 093626, Stanford BioX Interdisciplinary Initiatives Program, NHMRC Australia Fellowship, and Kwanjeong Educational Foundation. GE Healthcare provided the Respiratory Gating Toolbox for 4D-PET image reconstruction. Stanford University owns US patent #E7955270 which is unlicensed to any commercial entity.

  2. Cartographie de parametres forestiers par fusion evidentielle de donnees geospatiales multi-sources: Application aux peuplements forestiers en regeneration et feuillus matures du Sud du Quebec

    NASA Astrophysics Data System (ADS)

    Mora, Brice

    2009-10-01

    Foresters are faced with difficulties to obtain sub-polygon information with the mapping methods available nowadays. The main objective of this work consisted in the development of new methods able to improve the map accuracy of regenerating forest stands and mature forest stands in the South of Quebec, Canada. The Dempster-Shafer Theory (DST) and the Dezert-Smarandache Theory (DSmT) showed their ability to integrate multiple heterogenous data sources to go further than the classical classification procedures like the maximum likelihood or the spectral unmixing, in terms of map accuracy. Improvement on the ability to map regenerating stands, passed from 82.7% with the maximum likelihood method to 91.1% with the Free DSm model with a total transfer of the mass of the "Union" class to the "Intersection" class (+ 8.4%). For the mature stands, the improvement passed from 63.8% with the K nearest neighbour to 79.5% with the DST according to a classical belief structuration and the hybrid decision rule for which the conflict threshold was fixed at 10% (+ 15.7%). Our results with DST and a bayesian belief structuration showed the difficulty to model the uncertainty in the fusion process. This is probably due to the lack of scientific knowledge about the influence of the biophysical and climatic parameters on the mapped forest stands and to the necessity to model specifically the uncertainty for each source. Our work showed concrete improvement when mapping forest stands with DST which is encouraging to continue explorating the fundamental principle of the proposed hybrid decision rule. This means a particular focus on the difference between the fused masses of each potential class after the fusion, to choose the best hypothesis. Keywords. forest mapping, Quebec, deciduous stands, regenerating stands, mature stands, data fusion, Dempster-Shafer Theory, Dezert-Smarandache Theory, hybrid decision rule

  3. SU-D-18A-01: Tumor Motion Tracking with a Regional Deformable Registration Model for Four Dimensional Radiation Treatment of Lung Cancer

    SciTech Connect

    Chao, M; Lo, Y; Yuan, Y; Sheu, R; Rosenzweig, K

    2014-06-01

    Purpose: To develop a tumor motion model from four-dimensional computed tomography (4DCT) of thoracic patients and demonstrate its impact on 4D radiation therapy simulation. Methods: A regional deformable image registration algorithm was introduced to extract tumor motion out of patient's breathing cycle. The gross target volume (GTV) was manually delineated on a selected phase of 4DCT and a subregion with 10mm margin supplemented to the GTV was created on the Eclipse treatment planning system (Varian Medical Systems, Palo Alto, CA). Together with 4DCT the structures were exported into an inhouse research platform. A free form B-Spline deformable registration was carried out to map the subregion to other respiratory phases. The displacement vector fields were employed to propagate GTV contours with which the center of mass (CoM) of the GTV was computed for each breathing phase of 4DCT. The resultant GTV motion and its volumetric shape are utilized to facilitate 4D treatment planning. Five lung cancer patients undergoing stereotactic body radiation therapy were enrolled and their 4DCT sets were included in the study. Results: Application of the algorithm to five thoracic patients indicates that clinically satisfactory outcomes were achievable with a spatial accuracy better than 2mm for GTV contour propagation between adjacent phases, and 3mm between opposite phases. The GTV CoM was found to be in the range of 2.0mm through 2.5cm, depending upon the tumor location. Compared to the traditional whole image based registration, the computation of the regional model was found to be an order of magnitude more efficient. Conclusion: A regional deformable registration model was implemented to extract tumor motion. It will have widespread application in 4D radiation treatment planning in the future to maximally utilize the available spatial-tempo information.

  4. SU-D-17A-01: Geometric and Dosimetric Evaluation of a 4D-CBCT Reconstruction Technique Using Prior Knowledge

    SciTech Connect

    Zhang, Y; Yin, F; Ren, L

    2014-06-01

    Purpose: To evaluate a 4D-CBCT reconstruction technique both geometrically and dosimetrically Methods: A prior-knowledge guided 4DC-BCT reconstruction method named the motion-modeling and free-form deformation (MM-FD) has been developed. MM-FD views each phase of the 4D-CBCT as a deformation of a prior CT volume. The deformation field is first solved by principal component analysis based motion modeling, followed by constrained free-form deformation.The 4D digital extended-cardiac- torso (XCAT) phantom was used for comprehensive evaluation. Based on a simulated 4D planning CT of a lung patient, 8 different scenarios were simulated to cover the typical on-board anatomical and respiratory variations: (1) synchronized and (2) unsynchronized motion amplitude change for body and tumor; tumor (3) shrinkage and (4) expansion; tumor average position shift in (5) superior-inferior (SI) direction, (6) anterior-posterior (AP) direction and (7) SI, AP and lateral directions altogether; and (8) tumor phase shift relative to the respiratory cycle of the body. Orthogonal-view 30° projections were simulated based on the eight patient scenarios to reconstruct on-board 4D-CBCTs. For geometric evaluation, the volume-percentage-difference (VPD) was calculated to assess the volumetric differences between the reconstructed and the ground-truth tumor.For dosimetric evaluation, a gated treatment plan was designed for the prior 4D-CT. The dose distributions were calculated on the reconstructed 4D-CBCTs and the ground-truth images for comparison. The MM-FD technique was compared with MM-only and FD-only techniques. Results: The average (±s.d.) VPD values of reconstructed tumors for MM-only, FDonly and MM-FD methods were 59.16%(± 26.66%), 75.98%(± 27.21%) and 5.22%(± 2.12%), respectively. The average min/max/mean dose (normalized to prescription) of the reconstructed tumors by MM-only, FD-only, MM-FD methods and ground-truth tumors were 78.0%/122.2%/108.2%, 13%/117.7%/86%, 58.1%/120.8%/103.6% and 57.6%/118.6%/101.8%,respectively. Conclusion: The MM-FD method provides superior reconstruction accuracy both geometrically and dosimetrically, which can potentially be used for 4D target localization, dose tracking and adaptive radiation therapy. This research is supported by grant from Varian Medical Systems.

  5. SU-D-210-05: The Accuracy of Raw and B-Mode Image Data for Ultrasound Speckle Tracking in Radiation Therapy

    SciTech Connect

    O’Shea, T; Bamber, J; Harris, E

    2015-06-15

    Purpose: For ultrasound speckle tracking there is some evidence that the envelope-detected signal (the main step in B-mode image formation) may be more accurate than raw ultrasound data for tracking larger inter-frame tissue motion. This study investigates the accuracy of raw radio-frequency (RF) versus non-logarithmic compressed envelope-detected (B-mode) data for ultrasound speckle tracking in the context of image-guided radiation therapy. Methods: Transperineal ultrasound RF data was acquired (with a 7.5 MHz linear transducer operating at a 12 Hz frame rate) from a speckle phantom moving with realistic intra-fraction prostate motion derived from a commercial tracking system. A normalised cross-correlation template matching algorithm was used to track speckle motion at the focus using (i) the RF signal and (ii) the B-mode signal. A range of imaging rates (0.5 to 12 Hz) were simulated by decimating the imaging sequences, therefore simulating larger to smaller inter-frame displacements. Motion estimation accuracy was quantified by comparison with known phantom motion. Results: The differences between RF and B-mode motion estimation accuracy (2D mean and 95% errors relative to ground truth displacements) were less than 0.01 mm for stable and persistent motion types and 0.2 mm for transient motion for imaging rates of 0.5 to 12 Hz. The mean correlation for all motion types and imaging rates was 0.851 and 0.845 for RF and B-mode data, respectively. Data type is expected to have most impact on axial (Superior-Inferior) motion estimation. Axial differences were <0.004 mm for stable and persistent motion and <0.3 mm for transient motion (axial mean errors were lowest for B-mode in all cases). Conclusions: Using the RF or B-mode signal for speckle motion estimation is comparable for translational prostate motion. B-mode image formation may involve other signal-processing steps which also influence motion estimation accuracy. A similar study for respiratory-induced motion would also be prudent. This work is support by Cancer Research UK Programme Grant C33589/A19727.

  6. SU-D-213-04: Accounting for Volume Averaging and Material Composition Effects in An Ionization Chamber Array for Patient Specific QA

    SciTech Connect

    Fugal, M; McDonald, D; Jacqmin, D; Koch, N; Ellis, A; Peng, J; Ashenafi, M; Vanek, K

    2015-06-15

    Purpose: This study explores novel methods to address two significant challenges affecting measurement of patient-specific quality assurance (QA) with IBA’s Matrixx Evolution™ ionization chamber array. First, dose calculation algorithms often struggle to accurately determine dose to the chamber array due to CT artifact and algorithm limitations. Second, finite chamber size and volume averaging effects cause additional deviation from the calculated dose. Methods: QA measurements were taken with the Matrixx positioned on the treatment table in a solid-water Multi-Cube™ phantom. To reduce the effect of CT artifact, the Matrixx CT image set was masked with appropriate materials and densities. Individual ionization chambers were masked as air, while the high-z electronic backplane and remaining solid-water material were masked as aluminum and water, respectively. Dose calculation was done using Varian’s Acuros XB™ (V11) algorithm, which is capable of predicting dose more accurately in non-biologic materials due to its consideration of each material’s atomic properties. Finally, the exported TPS dose was processed using an in-house algorithm (MATLAB) to assign the volume averaged TPS dose to each element of a corresponding 2-D matrix. This matrix was used for comparison with the measured dose. Square fields at regularly-spaced gantry angles, as well as selected patient plans were analyzed. Results: Analyzed plans showed improved agreement, with the average gamma passing rate increasing from 94 to 98%. Correction factors necessary for chamber angular dependence were reduced by 67% compared to factors measured previously, indicating that previously measured factors corrected for dose calculation errors in addition to true chamber angular dependence. Conclusion: By comparing volume averaged dose, calculated with a capable dose engine, on a phantom masked with correct materials and densities, QA results obtained with the Matrixx Evolution™ can be significantly improved. In addition, necessary correction factors are reduced, allowing for more reliable and meaningful patient-specific QA measurements.

  7. SU-D-18A-02: Towards Real-Time On-Board Volumetric Image Reconstruction for Intrafraction Target Verification in Radiation Therapy

    SciTech Connect

    Xu, X; Iliopoulos, A; Zhang, Y; Pitsianis, N; Sun, X; Yin, F; Ren, L

    2014-06-01

    Purpose: To expedite on-board volumetric image reconstruction from limited-angle kV—MV projections for intrafraction verification. Methods: A limited-angle intrafraction verification (LIVE) system has recently been developed for real-time volumetric verification of moving targets, using limited-angle kV—MV projections. Currently, it is challenged by the intensive computational load of the prior-knowledge-based reconstruction method. To accelerate LIVE, we restructure the software pipeline to make it adaptable to model and algorithm parameter changes, while enabling efficient utilization of rapidly advancing, modern computer architectures. In particular, an innovative two-level parallelization scheme has been designed: At the macroscopic level, data and operations are adaptively partitioned, taking into account algorithmic parameters and the processing capacity or constraints of underlying hardware. The control and data flows of the pipeline are scheduled in such a way as to maximize operation concurrency and minimize total processing time. At the microscopic level, the partitioned functions act as independent modules, operating on data partitions in parallel. Each module is pre-parallelized and optimized for multi-core processors (CPUs) and graphics processing units (GPUs). Results: We present results from a parallel prototype, where most of the controls and module parallelization are carried out via Matlab and its Parallel Computing Toolbox. The reconstruction is 5 times faster on a data-set of twice the size, compared to recently reported results, without compromising on algorithmic optimization control. Conclusion: The prototype implementation and its results have served to assess the efficacy of our system concept. While a production implementation will yield much higher processing rates by approaching full-capacity utilization of CPUs and GPUs, some mutual constraints between algorithmic flow and architecture specifics remain. Based on a careful analysis of the prototype performance, it will be feasible to resolve such issues through appropriate algorithmic modifications or special-purpose hardware, thus enabling target verification in seconds with the LIVE system. This work was partially supported by a research grant from Varian Medical Systems.

  8. SU-D-18C-05: Variable Bolus Arterial Spin Labeling MRI for Accurate Cerebral Blood Flow and Arterial Transit Time Mapping

    SciTech Connect

    Johnston, M; Jung, Y

    2014-06-01

    Purpose: Arterial spin labeling (ASL) is an MRI perfusion imaging method from which quantitative cerebral blood flow (CBF) maps can be calculated. Acquisition with variable post-labeling delays (PLD) and variable TRs allows for arterial transit time (ATT) mapping and leads to more accurate CBF quantification with a scan time saving of 48%. In addition, T1 and M0 maps can be obtained without a separate scan. In order to accurately estimate ATT and T1 of brain tissue from the ASL data, variable labeling durations were invented, entitled variable-bolus ASL. Methods: All images were collected on a healthy subject with a 3T Siemens Skyra scanner. Variable-bolus Psuedo-continuous ASL (PCASL) images were collected with 7 TI times ranging 100-4300ms in increments of 700ms with TR ranging 1000-5200ms. All boluses were 1600ms when the TI allowed, otherwise the bolus duration was 100ms shorter than the TI. All TI times were interleaved to reduce sensitivity to motion. Voxel-wise T1 and M0 maps were estimated using a linear least squares fitting routine from the average singal from each TI time. Then pairwise subtraction of each label/control pair and averaging for each TI time was performed. CBF and ATT maps were created using the standard model by Buxton et al. with a nonlinear fitting routine using the T1 tissue map. Results: CBF maps insensitive to ATT were produced along with ATT maps. Both maps show patterns and averages consistent with literature. The T1 map also shows typical T1 contrast. Conclusion: It has been demonstrated that variablebolus ASL produces CBF maps free from the errors due to ATT and tissue T1 variations and provides M0, T1, and ATT maps which have potential utility. This is accomplished with a single scan in a feasible scan time (under 6 minutes) with low sensivity to motion.

  9. SU-D-17A-02: Four-Dimensional CBCT Using Conventional CBCT Dataset and Iterative Subtraction Algorithm of a Lung Patient

    SciTech Connect

    Hu, E; Lasio, G; Yi, B

    2014-06-01

    Purpose: The Iterative Subtraction Algorithm (ISA) method generates retrospectively a pre-selected motion phase cone-beam CT image from the full motion cone-beam CT acquired at standard rotation speed. This work evaluates ISA method with real lung patient data. Methods: The goal of the ISA algorithm is to extract motion and no- motion components form the full reconstruction CBCT. The workflow consists of subtracting from the full CBCT all of the undesired motion phases and obtain a motion de-blurred single-phase CBCT image, followed by iteration of this subtraction process. ISA is realized as follows: 1) The projections are sorted to various phases, and from all phases, a full reconstruction is performed to generate an image CTM. 2) Generate forward projections of CTM at the desired phase projection angles, the subtraction of projection and the forward projection will reconstruct a CTSub1, which diminishes the desired phase component. 3) By adding back the CTSub1 to CTm, no motion CBCT, CTS1, can be computed. 4) CTS1 still contains residual motion component. 5) This residual motion component can be further reduced by iteration.The ISA 4DCBCT technique was implemented using Varian Trilogy accelerator OBI system. To evaluate the method, a lung patient CBCT dataset was used. The reconstruction algorithm is FDK. Results: The single phase CBCT reconstruction generated via ISA successfully isolates the desired motion phase from the full motion CBCT, effectively reducing motion blur. It also shows improved image quality, with reduced streak artifacts with respect to the reconstructions from unprocessed phase-sorted projections only. Conclusion: A CBCT motion de-blurring algorithm, ISA, has been developed and evaluated with lung patient data. The algorithm allows improved visualization of a single phase motion extracted from a standard CBCT dataset. This study has been supported by National Institute of Health through R01CA133539.

  10. SU-D-16A-03: A Radiation Pneumonitis Dose-Response Model Incorporating Non- Local Radiation-Induced Bystander Effect

    SciTech Connect

    Gordon, J; Snyder, K; Zhong, H; Chetty, I

    2014-06-01

    Purpose: Dose-response models that can reliably predict radiation pneumonitis (RP) to guide radiation therapy (RT) for lung cancer presently do not exist. A model is proposed that incorporates non-local radiationinduced bystander effect (RIBE). Methods: A single sigmoid response function, derived from published data for whole lung irradiation, relates RP probability to cumulative lung damage, regardless of fractionation scheme. Lung damage is assumed to be caused by direct local radiation damage, quantified via the linear-quadratic (LQ) model, and RIBE. Based on published data, RIBE is assumed to be activated when per-fraction dose rises above ∼0.6 Gy, but is constant with dose above that threshold. Integral RIBE damage is assumed proportional to lung volume irradiated above ∼0.6 Gy per fraction. Key model parameters include LQ α and β, and two RIBE parameters: the single-fraction probability δ of damage, and a proportionality parameter κ that relates the potential for RIBE damage to irradiated lung volume. All parameters are tentatively fitted from published data, the RIBE parameters from published RP rates for conventionally fractionated RT (CFRT) and stereotactic body RT (SBRT). Results: The model predicts dose-response curves that are consistent with clinical experience. It provides a tentative explanation for why V20 (33 fractions), V13 (20 fractions) and V5 (<10 fractions) are observed to be correlated with RP. It also provides a plausible explanation for the success of SBRT — RIBE damage increases with the number of fractions, so penalizes CFRT relative to SBRT. Conclusion: The proposed model is relatively simple, extrapolates from published data, plausibly explains several clinical observations, and produces dose-response curves that are consistent with clinical experience. While capable of elaboration, its ability to explain doseresponse experience with different fractionation schemes using a small number of assumptions and parameters is an advantage.

  11. SU-D-16A-04: Accuracy of Treatment Plan TCP and NTCP Values as Determined Via Treatment Course Delivery Simulations

    SciTech Connect

    Siebers, J; Xu, H; Gordon, J

    2014-06-01

    Purpose: To to determine if tumor control probability (TCP) and normal tissue control probability (NTCP) values computed on the treatment planning image are representative of TCP/NTCP distributions resulting from probable positioning variations encountered during external-beam radiotherapy. Methods: We compare TCP/NTCP as typically computed on the planning PTV/OARs with distributions of those parameters computed for CTV/OARs via treatment delivery simulations which include the effect of patient organ deformations for a group of 19 prostate IMRT pseudocases. Planning objectives specified 78 Gy to PTV1=prostate CTV+5 mm margin, 66 Gy to PTV2=seminal vesicles+8 mm margin, and multiple bladder/rectum OAR objectives to achieve typical clinical OAR sparing. TCP were computed using the Poisson Model while NTCPs used the Lyman-Kutcher-Bruman model. For each patient, 1000 30-fraction virtual treatment courses were simulated with each fractional pseudo- time-oftreatment anatomy sampled from a principle component analysis patient deformation model. Dose for each virtual treatment-course was determined via deformable summation of dose from the individual fractions. CTVTCP/ OAR-NTCP values were computed for each treatment course, statistically analyzed, and compared with the planning PTV-TCP/OARNTCP values. Results: Mean TCP from the simulations differed by <1% from planned TCP for 18/19 patients; 1/19 differed by 1.7%. Mean bladder NTCP differed from the planned NTCP by >5% for 12/19 patients and >10% for 4/19 patients. Similarly, mean rectum NTCP differed by >5% for 12/19 patients, >10% for 4/19 patients. Both mean bladder and mean rectum NTCP differed by >5% for 10/19 patients and by >10% for 2/19 patients. For several patients, planned NTCP was less than the minimum or more than the maximum from the treatment course simulations. Conclusion: Treatment course simulations yield TCP values that are similar to planned values, while OAR NTCPs differ significantly, indicating the need for probabilistic methods or PRVs for OAR risk assessment. Presenting author receives support from Philips Medical Systems.

  12. SU-D-207-03: Development of 4D-CBCT Imaging System with Dual Source KV X-Ray Tubes

    SciTech Connect

    Nakamura, M; Ishihara, Y; Matsuo, Y; Ueki, N; Iizuka, Y; Mizowaki, T; Hiraoka, M

    2015-06-15

    Purpose: The purposes of this work are to develop 4D-CBCT imaging system with orthogonal dual source kV X-ray tubes, and to determine the imaging doses from 4D-CBCT scans. Methods: Dual source kV X-ray tubes were used for the 4D-CBCT imaging. The maximum CBCT field of view was 200 mm in diameter and 150 mm in length, and the imaging parameters were 110 kV, 160 mA and 5 ms. The rotational angle was 105°, the rotational speed of the gantry was 1.5°/s, the gantry rotation time was 70 s, and the image acquisition interval was 0.3°. The observed amplitude of infrared marker motion during respiration was used to sort each image into eight respiratory phase bins. The EGSnrc/BEAMnrc and EGSnrc/DOSXYZnrc packages were used to simulate kV X-ray dose distributions of 4D-CBCT imaging. The kV X-ray dose distributions were calculated for 9 lung cancer patients based on the planning CT images with dose calculation grid size of 2.5 x 2.5 x 2.5 mm. The dose covering a 2-cc volume of skin (D2cc), defined as the inner 5 mm of the skin surface with the exception of bone structure, was assessed. Results: A moving object was well identified on 4D-CBCT images in a phantom study. Given a gantry rotational angle of 105° and the configuration of kV X-ray imaging subsystems, both kV X-ray fields overlapped at a part of skin surface. The D2cc for the 4D-CBCT scans was in the range 73.8–105.4 mGy. Linear correlation coefficient between the 1000 minus averaged SSD during CBCT scanning and D2cc was −0.65 (with a slope of −0.17) for the 4D-CBCT scans. Conclusion: We have developed 4D-CBCT imaging system with dual source kV X-ray tubes. The total imaging dose with 4D-CBCT scans was up to 105.4 mGy.

  13. Les unités gneissiques et la zone de cisaillement crustal du Sud-Togo (Gneissic units and crustal shear zone of South Togo)

    NASA Astrophysics Data System (ADS)

    Castaing, C.; Aregba, A.; Assih-Edeou, P.; Chevremont, P.; Godonou, K. S.; Sylvain, J. P.

    This publication is the result of recent geological mapping in Togo. An important crustal shear-zone in the South Togo is reviewed and the overall structural evolution of the area is examined in the light of current ideas on the chain. The geological evolution of the area occurred in three tectono-metamorphic stages in which the foliation developed and was folded under upper amphibolite facies conditions, with anatexis and the emplacement of granites, followed by transcurrent shearing under retrograde metamorphic conditions. The shear-zones, recognised in southeastern Togo, are the southward continuation of the great submeridian shear zones of the Hoggar and the Adrar des Iforas. They take the form of kilometres wide, blasto to ultramylonitic zones in which a mylonitic foliation indicates dextral ductile deformation under greenschist facies conditions. The ductile deformation evolves towards late cataclasis in the center of the shear zones. The geological evolution of the South Togo accords with the geotectonic framework of the internal Pan-African zones of the central Hoggar and Nigeria, where a polycyclic tectono-metamorphic history, with important granitization and late shearing appears to be the general case.

  14. Un oiseau archaïque (Énantiornithes) dans le Crétacé supérieur de Provence (Sud de la France).

    NASA Astrophysics Data System (ADS)

    Buffetaut, Eric; Mechin, Patrick; Mechin-Salessy, Annie

    2000-10-01

    A tibiotarsus of an archaic bird from the Upper Cretaceous of Fox-Amphoux (Var, southern France) is described and referred to the Enantiornithes. Taken together with other recent discoveries of Late Cretaceous birds from France, this find suggests that at the end of the Cretaceous, the European avifauna was dominated by archaic forms.

  15. SU-D-19A-01: Can Farmer-Type Ionization Chambers Be Used to Improve the Accuracy of Low-Energy Electron Beam Reference Dosimetry?

    SciTech Connect

    Muir, B R; McEwen, M R

    2014-06-01

    Purpose: To investigate the use of cylindrical Farmer-type ionization chambers to improve the accuracy of low-energy electron beam calibration. Historically, these chamber types have not been used in beams with incident energies less than 10 MeV (R{sub 5} {sub 0} < 4.3 cm) because early investigations suggested large (up to 5 %) fluence perturbation factors in these beams, implying that a significant component of uncertainty would be introduced if used for calibration. More recently, the assumptions used to determine perturbation corrections for cylindrical chambers have been questioned. Methods: Measurements are made with cylindrical chambers in Elekta Precise 4, 8 and 18 MeV electron beams. Several chamber types are investigated that employ graphite walls and aluminum electrodes with very similar specifications (NE2571, NE2505/3, FC65-G). Depth-ionization scans are measured in water in the 8 and 18 MeV beams. To reduce uncertainty from chamber positioning, measurements in the 4 MeV beam are made at the reference depth in Virtual Water™. The variability of perturbation factors is quantified by comparing normalized response of various chambers. Results: Normalized ion chamber response varies by less than 0.7 % for similar chambers at average electron energies corresponding to that at the reference depth from 4 or 6 MeV beams. Similarly, normalized measurements made with similar chambers at the reference depth in the 4 MeV beam vary by less than 0.4 %. Absorbed dose calibration coefficients derived from these results are stable within 0.1 % on average over a period of 6 years. Conclusion: These results indicate that the uncertainty associated with differences in fluence perturbations for cylindrical chambers with similar specifications is only 0.2 %. The excellent long-term stability of these chambers in both photon and electron beams suggests that these chambers might offer the best performance for all reference dosimetry applications.

  16. Rôle de l'halocinèse dans l'évolution du bassin d'Essaouira (Sud-Ouest marocain)

    NASA Astrophysics Data System (ADS)

    Mehdi, Khalid; Griboulard, Roger; Bobier, Claude

    2004-04-01

    The seismic reflection studies carried in the Essaouira Basin, intermediate zone between the High Atlas and the Atlantic Margin, show the presence of halokinetic structures that played a significant role in the evolution of the basin. Salt dynamics was controlled by the Atlantic rifting and the Atlasic orogen. These tectonic controls and the margin segmentation are responsible for the diachronism of salt movement. Halokinesis varied in time and space in the basin and was more active offshore, where autochtonous and allochtonous salt layers are present. To cite this article: K. Mehdi et al., C. R. Geoscience 336 (2004).

  17. Empreinte de l'aridité sur un paysage latéritique : une illustration fournie par le Sud-Ouest australien

    NASA Astrophysics Data System (ADS)

    Gilkes, Bob; Lee, Sam; Singh, Balbir

    2003-12-01

    The southwestern region of Australia contains the Yilgarn Craton that has been exposed to subaerial weathering since mid-Proterozoic. The gently undulating landscape experienced lateritic weathering so that today variably dissected, deep in situ isovolumetrically weathered regolith is widespread. Imposition of a more arid climate since the Miocene with the cessation of effective external drainage has resulted in substantial geochemical modification of the highly porous regolith. This vast pore volume acts as a reservoir for complex solutions that may be highly saline, extremely acid to alkaline and reducing. Diverse precipitates have formed in the regolith including widespread occurrence of silcrete, calcrete, dolocrete, ferricrete and gypcrete together with localised occurrences of pyrite, alunite, jarosite, barite, halite and other salts. Clearing of bush land for agriculture in the 20th century increased recharge so that rising chemically active groundwaters are damaging farmland and infrastructure throughout the region. To cite this article: B. Gilkes et al., C. R. Geoscience 335 (2003).

  18. Paléogéographie du Jurassique supérieur au sud du choot El Hodna, Algérie

    NASA Astrophysics Data System (ADS)

    Aissaoui, D. M.

    The Upper Jurassic outcrops as isolated mounts along the southern end of chott el Hodna, Algeria. They consist mainly on shallow platform deposited limestones immediately north (Bout Taleb) and east (Aures) of chott el Hodna, the carbonates of the same age are pelagic and deposited within basin or external platform respectively. Detailed study of Meharga-Fnoud series demonstrates that the shallow carbonate sedimentation in this sector is interrupted by periodic emersions as indicated by vadose diagenesis (birds-eyes, opened burrows, evaporite and dolomite, vadose silts etc). The proposed paleogeography locates the internal jurassic shoreline near the present southern limit of chott el Hodna. Each maximal extension of the emersion leads to the formation of a tidal flat whose origin is not associated with a reefal nor a sedimentary barrier. The emersions are mainly favored by the large dimension and the absence of significant submarine relief within the Jurassic platform. Each emersion starts in the north then progrades southwards by lateral accretions. Its progression is interrupted by deep tectonic reactivation which provokes marine transgression over the tidal flat. One of the main interest of the Jurassic paleogeography in this region concerns the association between the tidal flat and an extensive dolomitization which may transform limestones precursors into good reservoirs.

  19. Découverte d'un chevauchement d'âge quaternaire au sud de la Grande Kabylie (Algérie)

    NASA Astrophysics Data System (ADS)

    Boudiaf, Azzedine; Philip, Hervé; Coutelle, Alain; Ritz, Jean-François

    1999-03-01

    In the Maghreb, the southern border of the Kabylie (Algeria) mountains is considered as an aseismic region. The detailed study of the historical seismicity of this region shows moderate seismic activity (M 1 = 5.0) which is not coherent with the observed tectonic deformations. However, an analysis of the morphology on Landsat image, aerial photos and the topography shows Quaternary deformations in the southern side of the "Kabylie massifs" (Algeria). These deformations are interpreted as reactivation of Miocene thrust faults. The tectonic Quaternary scarps are more spectacular in the Bouira and Tazmalt region and might be associated with successive strong earthquakes (M = 7.0). Therefore, this major active thrust fault observed in this region, as in many intraplate regions, poses the problem of the long return period of seismic activity in this zone. Elsevier, Paris

  20. SU-D-204-06: Dose and Image Quality Evaluation of a Low-Dose Slot-Scanning X-Ray System for Pediatric Orthopedic Studies

    SciTech Connect

    Liu, Z; Hoerner, M; Lamoureux, R; Rill, L; Arreola, M

    2015-06-15

    Purpose: Children in early teens with scoliosis require repeated radiographic exams over a number of years. The EOS (EOS imaging S.A., Paris, France) is a novel low-dose slot-scanning digital radiographic system designed to produce full-spine images of a free-standing patient. The radiation dose and image quality characteristics of the EOS were evaluated relative to those of a Computed Radiography (CR) system for scoliosis imaging. Methods: For dose evaluation, a full-torso anthropomorphic phantom was scanned five times using the default standard clinical protocols for both the EOS and a CR system, which include both posteroanterior and lateral full-spine views. Optically stimulated luminescent dosimeters (OSLDs), also known as nanoDots™ (Landauer, Inc., Glenwood, IL), were placed on the phantom’s surface to measure entrance skin dose. To assess image quality, MTF curves were generated from sampling the noise levels within the high-contrast regions of a line-pair phantom. Vertical and horizontal distortions were measured for the square line-pair phantom with the EOS system to evaluate the effects of geometric magnification and misalignment with the indicated imaging plane. Results: The entrance skin dose was measured to be 0.4 to 1.1 mGy for the EOS, and 0.7 to 3.6 mGy for the CR study. MTF comparison shows that CR greatly outperforms the EOS, despite both systems having a limiting resolution at 1.8 line-pairs per mm. Vertical distortion was unaffected by phantom positioning, because of the EOS slot-scanning geometry. Horizontal distortion increased linearly with miscentering distance. Conclusion: The EOS system resulted in approximately 70% lower radiation dose than CR for full-spine images. Image quality was found to be inferior to CR. Further investigation is required to see if EOS system is an acceptable modality for performing clinically diagnostic scoliosis examinations.

  1. SU-D-213-05: Design, Evaluation and First Applications of a Off-Site State-Of-The-Art 3D Dosimetry System

    SciTech Connect

    Malcolm, J; Mein, S; McNiven, A; Letourneau, D; Oldham, M

    2015-06-15

    Purpose: To design, construct and commission a prototype in-house three dimensional (3D) dose verification system for stereotatic body radiotherapy (SBRT) verification at an off-site partner institution. To investigate the potential of this system to achieve sufficient performance (1mm resolution, 3% noise, within 3% of true dose reading) for SBRT verification. Methods: The system was designed utilizing a parallel ray geometry instigated by precision telecentric lenses and an LED 630nm light source. Using a radiochromic dosimeter, a 3D dosimetric comparison with our gold-standard system and treatment planning software (Eclipse) was done for a four-field box treatment, under gamma passing criteria of 3%/3mm/10% dose threshold. Post off-site installation, deviations in the system’s dose readout performance was assessed by rescanning the four-field box irradiated dosimeter and using line-profiles to compare on-site and off-site mean and noise levels in four distinct dose regions. As a final step, an end-to-end test of the system was completed at the off-site location, including CT-simulation, irradiation of the dosimeter and a 3D dosimetric comparison of the planned (Pinnacle{sup 3}) to delivered dose for a spinal SBRT treatment(12 Gy per fraction). Results: The noise level in the high and medium dose regions of the four field box treatment was relatively 5% pre and post installation. This reflects the reduction in positional uncertainty through the new design. This At 1mm dose voxels, the gamma pass rates(3%,3mm) for our in-house gold standard system and the off-site system were comparable at 95.8% and 93.2% respectively. Conclusion: This work will describe the end-to-end process and results of designing, installing, and commissioning a state-of-the-art 3D dosimetry system created for verification of advanced radiation treatments including spinal radiosurgery.

  2. SU-D-201-04: Study On the Impact of Tumor Shape and Size On Drug Delivery to Pancreatic Tumors

    SciTech Connect

    Soltani, M; Bazmara, H; Sefidgar, M; Subramaniam, R; Rahmim, A

    2015-06-15

    Purpose: Drug delivery to solid tumors can be expressed physically using transport phenomena such as convection and diffusion for the drug of interest within extracellular matrices. We aimed to carefully model these phenomena, and to investigate the effect of tumor shape and size on drug delivery to solid tumors in the pancreas. Methods: In this study, multiple tumor geometries as obtained from clinical PET/CT images were considered. An advanced numerical method was used to simultaneously solve fluid flow and solute transport equations. Data from n=45 pancreatic cancer patients with non-resectable locoregional disease were analyzed, and geometrical information from the tumors including size, shape, and aspect ratios were classified. To investigate effect of tumor shape, tumors with similar size but different shapes were selected and analyzed. Moreover, to investigate effect of tumor size, tumors with similar shapes but different sizes, ranging from 1 to 77 cm{sup 3}, were selected and analyzed. A hypothetical tumor similar to one of the analyzed tumors, but scaled to reduce its size below 0.2 cm{sup 3}, was also analyzed. Results: The results showed relatively similar average drug concentration profiles in tumors with different sizes. Generally, smaller tumors had higher absolute drug concentration. In the hypothetical tumor, with volume less than 0.2 cm{sup 3}, the average drug concentration was 20% higher in comparison to its counterparts. For the various real tumor geometries, however, the maximum difference between average drug concentrations was 10% for the smallest and largest tumors. Moreover, the results demonstrated that for pancreatic tumors the shape is not significant. The negligible difference of drug concentration in different tumor shapes was due to the minimum effect of convection in pancreatic tumors. Conclusion: In tumors with different sizes, smaller tumors have higher drug delivery; however, the impact of tumor shape in the case of pancreatic tumors is not significant.

  3. SU-D-304-06: Measurement of LET in Patient-Specific Proton Therapy Treatment Fields Using Optically Stimulated Luminescence Detectors

    SciTech Connect

    Granville, DA; Sahoo, N; Sawakuchi, GO

    2015-06-15

    Purpose: To investigate the use of optically stimulated luminescence (OSL) detectors (OSLDs) for measurements of dose-averaged linear energy transfer (LET) in patient-specific proton therapy treatment fields. Methods: We used Al{sub 2}O{sub 3}:C OSLDs made from the same material as commercially available nanoDot OSLDs from Landauer, Inc. We calibrated two parameters of the OSL signal as functions of LET in therapeutic proton beams: the ratio of the ultraviolet and blue emission intensities (UV/blue ratio) and the OSL curve shape. These calibration curves were created by irradiating OSLDs in passively scattered beams of known LET (0.96 to 3.91 keV/µm). The LET values were determined using a validated Monte Carlo model of the beamline. We then irradiated new OSLDs with the prescription dose (16 to 74 cGy absorbed dose to water) at the center of the spread-out Bragg peak (SOBP) of four patient-specific treatment fields. From readouts of these OSLDs, we determined both the UV/blue ratio and OSL curve shape parameters. Combining these parameters with the calibration curves, we were able to measure LET using the OSLDs. The measurements were compared to the theoretical LET values obtained from Monte Carlo simulations of the patient-specific treatments fields. Results: Using the UV/blue ratio parameter, we were able to measure LET within 3.8%, 6.2%, 5.6% and 8.6% of the Monte Carlo value for each of the patient fields. Similarly, using the OSL curve shape parameter, LET measurements agreed within 0.5%, 11.0%, 2.5% and 7.6% for each of the four fields. Conclusion: We have demonstrated a method to verify LET in patient-specific proton therapy treatment fields using OSLDs. The possibility of enhancing biological effectiveness of proton therapy treatment plans by including LET in the optimization has been previously shown. The LET verification method we have demonstrated will be useful in the quality assurance of such LET optimized treatment plans. DA Granville received financial support from the Natural Sciences and Engineering Research Council of Canada.

  4. SU-D-207-07: Implementation of Full/half Bowtie Filter Model in a Commercial Treatment Planning System for Kilovoltage X-Ray Imaging Dose Estimation

    SciTech Connect

    Kim, S; Alaei, P

    2015-06-15

    Purpose: To implement full/half bowtie filter models in a commercial treatment planning system (TPS) to calculate kilovoltage (kV) x-ray imaging dose of Varian On-Board Imager (OBI) cone beam CT (CBCT) system. Methods: Full/half bowtie filters of Varian OBI were created as compensator models in Pinnacle TPS (version 9.6) using Matlab software (version 2011a). The profiles of both bowtie filters were acquired from the manufacturer, imported into the Matlab system and hard coded in binary file format. A Pinnacle script was written to import each bowtie filter data into a Pinnacle treatment plan as a compensator. A kV x-ray beam model without including the compensator model was commissioned per each bowtie filter setting based on percent depth dose and lateral profile data acquired from Monte Carlo simulations. To validate the bowtie filter models, a rectangular water phantom was generated in the planning system and an anterior/posterior beam with each bowtie filter was created. Using the Pinnacle script, each bowtie filter compensator was added to the treatment plan. Lateral profile at the depth of 3cm and percent depth dose were measured using an ion chamber and compared with the data extracted from the treatment plans. Results: The kV x-ray beams for both full and half bowtie filter have been modeled in a commercial TPS. The difference of lateral and depth dose profiles between dose calculations and ion chamber measurements were within 6%. Conclusion: Both full/half bowtie filter models provide reasonable results in kV x-ray dose calculations in the water phantom. This study demonstrates the possibility of using a model-based treatment planning system to calculate the kV imaging dose for both full and half bowtie filter modes. Further study is to be performed to evaluate the models in clinical situations.

  5. SU-D-16A-02: A Novel Methodology for Accurate, Semi-Automated Delineation of Oral Mucosa for Radiation Therapy Dose-Response Studies

    SciTech Connect

    Dean, J; Welsh, L; Gulliford, S; Harrington, K; Nutting, C

    2014-06-01

    Purpose: The significant morbidity caused by radiation-induced acute oral mucositis means that studies aiming to elucidate dose-response relationships in this tissue are a high priority. However, there is currently no standardized method for delineating the mucosal structures within the oral cavity. This report describes the development of a methodology to delineate the oral mucosa accurately on CT scans in a semi-automated manner. Methods: An oral mucosa atlas for automated segmentation was constructed using the RayStation Atlas-Based Segmentation (ABS) module. A radiation oncologist manually delineated the full surface of the oral mucosa on a planning CT scan of a patient receiving radiotherapy (RT) to the head and neck region. A 3mm fixed annulus was added to incorporate the mucosal wall thickness. This structure was saved as an atlas template. ABS followed by model-based segmentation was performed on four further patients sequentially, adding each patient to the atlas. Manual editing of the automatically segmented structure was performed. A dose comparison between these contours and previously used oral cavity volume contours was performed. Results: The new approach was successful in delineating the mucosa, as assessed by an experienced radiation oncologist, when applied to a new series of patients receiving head and neck RT. Reductions in the mean doses obtained when using the new delineation approach, compared with the previously used technique, were demonstrated for all patients (median: 36.0%, range: 25.6% – 39.6%) and were of a magnitude that might be expected to be clinically significant. Differences in the maximum dose that might reasonably be expected to be clinically significant were observed for two patients. Conclusion: The method developed provides a means of obtaining the dose distribution delivered to the oral mucosa more accurately than has previously been achieved. This will enable the acquisition of high quality dosimetric data for use in dose-response studies. We would like to thank the Engineering and Physical Sciences Research Council for funding. We acknowledge support from the NIHR RM/ICR Biomedical Research Centre. RayStatation was used under an evaluation agreement with RaySearch Laboratories AB.

  6. SU-D-16A-01: A Novel Method to Estimate Normal Tissue Dose for Radiotherapy Patients to Support Epidemiologic Studies of Second Cancer Risk

    SciTech Connect

    Lee, C; Jung, J; Pelletier, C; Kim, J; Lee, C

    2014-06-01

    Purpose: Patient cohort of second cancer study often involves radiotherapy patients with no radiological images available: We developed methods to construct a realistic surrogate anatomy by using computational human phantoms. We tested this phantom images both in a commercial treatment planning system (Eclipse) and a custom Monte Carlo (MC) transport code. Methods: We used a reference adult male phantom defined by International Commission on Radiological Protection (ICRP). The hybrid phantom which was originally developed in Non-Uniform Rational B-Spline (NURBS) and polygon mesh format was converted into more common medical imaging format. Electron density was calculated from the material composition of the organs and tissues and then converted into DICOM format. The DICOM images were imported into the Eclipse system for treatment planning, and then the resulting DICOM-RT files were imported into the MC code for MC-based dose calculation. Normal tissue doses were calculation in Eclipse and MC code for an illustrative prostate treatment case and compared to each other. Results: DICOM images were generated from the adult male reference phantom. Densities and volumes of selected organs between the original phantom and ones represented within Eclipse showed good agreements, less than 0.6%. Mean dose from Eclipse and MC code match less than 7%, whereas maximum and minimum doses were different up to 45%. Conclusion: The methods established in this study will be useful for the reconstruction of organ dose to support epidemiological studies of second cancer in cancer survivors treated by radiotherapy. We also work on implementing body size-dependent computational phantoms to better represent patient's anatomy when the height and weight of patients are available.

  7. Impairment of bronchial mucociliary clearance in long-term survivors of heart/lung and double-lung transplantation. The Paris-Sud Lung Transplant Group.

    PubMed

    Herve, P; Silbert, D; Cerrina, J; Simonneau, G; Dartevelle, P

    1993-01-01

    The study objective was to investigate bronchial mucociliary clearance after heart/lung and double lung transplantation. Bronchial mucociliary clearance was measured using a noninvasive radioaerosol technique: 99mTc-labeled albumin was aerosolized using a spinning-top generator (mass median aerodynamic diameter, 7.5 mu; geometric standard deviation, 1.5 mu). Radioactivity counts were acquired during 60 min with a gamma camera. A region of interest was drawn over the right lung delineated by a 133Xe lung ventilation image. Bronchial mucociliary clearance was assessed as the percentage of decrease in radioactivity per hour calculated on time-activity curves fitted by a monoexponential model. To exclude patients with acute lung rejection, opportunistic lung infection, and obliterative bronchiolitis, all patients with transplants underwent pulmonary function tests and bronchoscopic examination before clearance measurement. Eight heart/lung and five double-lung nonsmoking transplant patients with normal lung histology were studied 19.3 +/- 4.0 mo after surgery and compared to nine normal nonsmokers. A similar proximal deposition of the aerosol was obtained in patients with transplants and normal subjects; skew values of distribution histograms of aerosol radioactivity counts were 2.1 +/- 0.2 and 1.8 +/- 0.1, respectively, and the ratios between central and peripheral 99mTc radioactivity counts were 2.4 +/- 0.1 and 2.3 +/- 0.2, respectively. No significant difference was observed in bronchial clearance values between patients with heart/lung and double-lung transplants (26.4 +/- 3.0 percent/h vs 35.9 +/- 3.5 percent/h). Conversely, bronchial clearance was significantly lower in transplant recipients (30.0 +/- 2.5 percent/h) than in normal controls (58.7 +/- 6.2 percent/h; p < 0.001). This decreased bronchial clearance can be expected to increase the risk of lung infection in long-term survivors of heart/lung and double-lung transplantation. PMID:8380268

  8. SU-D-207-05: Real-Time Intrafractional Motion Tracking During VMAT Delivery Using a Conventional Elekta CBCT System

    SciTech Connect

    Park, Yang-Kyun; Sharp, Gregory C.; Gierga, David P.; Winey, Brian A.; Ye, Sung-Joon

    2015-06-15

    Purpose: Real-time kV projection streaming capability has become recently available for Elekta XVI version 5.0. This study aims to investigate the feasibility and accuracy of real-time fiducial marker tracking during CBCT acquisition with or without simultaneous VMAT delivery using a conventional Elekta linear accelerator. Methods: A client computer was connected to an on-board kV imaging system computer, and receives and processes projection images immediately after image acquisition. In-house marker tracking software based on FFT normalized cross-correlation was developed and installed in the client computer. Three gold fiducial markers with 3 mm length were implanted in a pelvis-shaped phantom with 36 cm width. The phantom was placed on a programmable motion platform oscillating in anterior-posterior and superior-inferior directions simultaneously. The marker motion was tracked in real-time for (1) a kV-only CBCT scan with treatment beam off and (2) a kV CBCT scan during a 6-MV VMAT delivery. The exposure parameters per projection were 120 kVp and 1.6 mAs. Tracking accuracy was assessed by comparing superior-inferior positions between the programmed and tracked trajectories. Results: The projection images were successfully transferred to the client computer at a frequency of about 5 Hz. In the kV-only scan, highly accurate marker tracking was achieved over the entire range of cone-beam projection angles (detection rate / tracking error were 100.0% / 0.6±0.5 mm). In the kV-VMAT scan, MV-scatter degraded image quality, particularly for lateral projections passing through the thickest part of the phantom (kV source angle ranging 70°-110° and 250°-290°), resulting in a reduced detection rate (90.5%). If the lateral projections are excluded, tracking performance was comparable to the kV-only case (detection rate / tracking error were 100.0% / 0.8±0.5 mm). Conclusion: Our phantom study demonstrated a promising Result for real-time motion tracking using a conventional Elekta linear accelerator. MV-scatter suppression is needed to improve tracking accuracy during MV delivery. This research is funded by Motion Management Research Grant from Elekta.

  9. SU-D-204-07: Comparison of AAPM TG150 Draft Image Receptor Tests with Vendor Automated QC Tests for Five Mobile DR Units

    SciTech Connect

    Li, G; Nishino, T; Greene, T; Willis, C

    2015-06-15

    Purpose: To determine the consistency of digital detector (DR) tests recommended by AAPM TG150 and tests provided by commercially available DirectView Total Quality Tool (TQT). Methods: The DR tests recommended by the TG150 Detector Subgroup[1] were performed on 4 new Carestream DRX-Revolution and one Carestream DRX1C retrofit of a GE AMX-4 that had been in service for three years. After detector calibration, flat-field images plus images of two bar patterns oriented parallel and perpendicular to the A-C axis, were acquired at conditions recommended by TG150. Raw images were harvested and then analyzed using a MATLAB software previously validated[2,3,4]. Data were analyzed using ROIs of two different dimensions: 1) 128 x 128 ROIs matching the detector electronics; and 2) 256 x 256 ROIs, each including 4 adjacent smaller ROIs. TG150 metrics from 128 x 128 ROIs were compared to TQT metrics, which are also obtained from 128 x 128 ROIs[5]. Results: The results show that both TG150 and TQT measurements were consistent among these detectors. Differences between TG150 and TQT values appear systematic. Compared with 128 x 128 ROIs, noise and SNR non-uniformity were lower with 256 x 256 ROIs, although signal non-uniformity was similar, indicating detectors were appropriately calibrated for gain and offset. MTF of the retrofit unit remained essentially the same between 2012 and 2015, but was inferior to the new units. The older generator focal spot is smaller (0.75mm vs. 1.2mm), and the SID for acquisition is 182cm as well, so focal spot dimensions cannot explain the difference. The difference in MTF may be secondary to differences in generator X-ray spectrum or by unannounced changes in detector architecture. Further investigation is needed. Conclusion: The study shows that both TG150 and TQT tests are consistent. The numerical value of some metrics are dependent on ROI size.

  10. SU-D-9A-01: Listmode-Driven Optimal Gating (OG) Respiratory Motion Management: Potential Impact On Quantitative PET Imaging

    SciTech Connect

    Lee, K; Hristov, D

    2014-06-01

    Purpose: To evaluate the potential impact of listmode-driven amplitude based optimal gating (OG) respiratory motion management technique on quantitative PET imaging. Methods: During the PET acquisitions, an optical camera tracked and recorded the motion of a tool placed on top of patients' torso. PET event data were utilized to detect and derive a motion signal that is directly coupled with a specific internal organ. A radioactivity-trace was generated from listmode data by accumulating all prompt counts in temporal bins matching the sampling rate of the external tracking device. Decay correction for 18F was performed. The image reconstructions using OG respiratory motion management technique that uses 35% of total radioactivity counts within limited motion amplitudes were performed with external motion and radioactivity traces separately with ordered subset expectation maximization (OSEM) with 2 iterations and 21 subsets. Standard uptake values (SUVs) in a tumor region were calculated to measure the effect of using radioactivity trace for motion compensation. Motion-blurred 3D static PET image was also reconstructed with all counts and the SUVs derived from OG images were compared with SUVs from 3D images. Results: A 5.7 % increase of the maximum SUV in the lesion was found for optimal gating image reconstruction with radioactivity trace when compared to a static 3D image. The mean and maximum SUVs on the image that was reconstructed with radioactivity trace were found comparable (0.4 % and 4.5 % increase, respectively) to the values derived from the image that was reconstructed with external trace. Conclusion: The image reconstructed using radioactivity trace showed that the blurring due to the motion was reduced with impact on derived SUVs. The resolution and contrast of the images reconstructed with radioactivity trace were comparable to the resolution and contrast of the images reconstructed with external respiratory traces. Research supported by Siemens.

  11. SU-D-17A-03: 5D Respiratory Motion Model Based Iterative Reconstruction Method for 4D Cone-Beam CT

    SciTech Connect

    Gao, Y; Thomas, D; Low, D; Gao, H

    2014-06-01

    Purpose: The purpose of this work is to develop a new iterative reconstruction method for 4D cone-beam CT (CBCT) based on a published time-independent 5D respiratory motion model. The proposed method will offer a single high-resolution image at a user-selected breathing phase and the 5D motion model parameters, which could be used to generate the breathing pattern during the CT acquisition. Methods: 5D respiratory motion model was proposed for accurately modeling the motion of lung and lung tumor tissues. 4D images are then parameterized by a reference image, measured breathing amplitude, breathing rate, two time-independent vector fields that describe the 5D model parameters, and a scalar field that describes the change in HU as a function of breathing amplitude. In contrast with the traditional method of reconstructing multiple temporal image phases to reduce respiratory artifact, 5D model based method simplify the problem into the reconstruction of a single reference image and the 5D motion model parameters. The reconstruction formulation of the reference image and scalar and vector fields is a nonlinear least-square optimization problem that consists of solving the reference image and fields alternately, in which the reference image is regularized with the total variation sparsity transform and the vector fields are solved through linearizations regularized by the H1 norm. 2D lung simulations were performed in this proof-of-concept study. Results: The breathing amplitude, its rate, and the corresponding scalar and vector fields were generated from a patient case. Compared with filtered backprojection method and sparsity regularized iterative method for the phase-by-phase reconstruction, the proposed 5D motion model based method yielded improved image quality. Conclusion: Based on 5D respiratory motion model, we have developed a new iterative reconstruction method for 4D CBCT that has the potential for improving image quality while providing needed on-table motion information.

  12. SU-D-18C-02: Feasibility of Using a Short ASL Scan for Calibrating Cerebral Blood Flow Obtained From DSC-MRI

    SciTech Connect

    Wang, P; Chang, T; Huang, K; Yeh, C; Chien, C; Wai, Y; Lee, T; Liu, H

    2014-06-01

    Purpose: This study aimed to evaluate the feasibility of using a short arterial spin labeling (ASL) scan for calibrating the dynamic susceptibility contrast- (DSC-) MRI in a group of patients with internal carotid artery stenosis. Methods: Six patients with unilateral ICA stenosis enrolled in the study on a 3T clinical MRI scanner. The ASL-cerebral blood flow (-CBF) maps were calculated by averaging different number of dynamic points (N=1-45) acquired by using a Q2TIPS sequence. For DSC perfusion analysis, arterial input function was selected to derive the relative cerebral blood flow (rCBF) map and the delay (Tmax) map. Patient-specific CF was calculated from the mean ASL- and DSC-CBF obtained from three different masks: (1)Tmax< 3s, (2)combined gray matter mask with mask 1, (3)mask 2 with large vessels removed. One CF value was created for each number of averages by using each of the three masks for calibrating the DSC-CBF map. The CF value of the largest number of averages (NL=45) was used to determine the acceptable range(< 10%, <15%, and <20%) of CF values corresponding to the minimally acceptable number of average (NS) for each patient. Results: Comparing DSC CBF maps corrected by CF values of NL (CBFL) in ACA, MCA and PCA territories, all masks resulted in smaller CBF on the ipsilateral side than the contralateral side of the MCA territory(p<.05). The values obtained from mask 1 were significantly different than the mask 3(p<.05). Using mask 3, the medium values of Ns were 4(<10%), 2(<15%) and 2(<20%), with the worst case scenario (maximum Ns) of 25, 4, and 4, respectively. Conclusion: This study found that reliable calibration of DSC-CBF can be achieved from a short pulsed ASL scan. We suggested use a mask based on the Tmax threshold, the inclusion of gray matter only and the exclusion of large vessels for performing the calibration.

  13. Contribution à l'analyse des inter-relations entre activités humaines et variabilité climatique : cas du Sud forestier ivoirien

    NASA Astrophysics Data System (ADS)

    Yao, Télésphore Brou; Servat, Eric; Paturel, Jean-Emmanuel

    1998-12-01

    The South Ivorian Forest has suffered a large rainfall deficit for 25 years. At the same time, it has been noticed that the movement of the coffee and cocoa production seems concomitant with that of the isohyets during recent decades. The variations in albedo and rainfall gradient seem to be linked to the significant changes to the forest cover. These could affect precipitation locally.

  14. SU-D-201-05: Phantom Study to Determine Optimal PET Reconstruction Parameters for PET/MR Imaging of Y-90 Microspheres Following Radioembolization

    SciTech Connect

    Maughan, N; Conti, M; Parikh, P; Faul, D; Laforest, R

    2015-06-15

    Purpose: Imaging Y-90 microspheres with PET/MRI following hepatic radioembolization has the potential for predicting treatment outcome and, in turn, improving patient care. The positron decay branching ratio, however, is very small (32 ppm), yielding images with poor statistics even when therapy doses are used. Our purpose is to find PET reconstruction parameters that maximize the PET recovery coefficients and minimize noise. Methods: An initial 7.5 GBq of Y-90 chloride solution was used to fill an ACR phantom for measurements with a PET/MRI scanner (Siemens Biograph mMR). Four hot cylinders and a warm background activity volume of the phantom were filled with a 10:1 ratio. Phantom attenuation maps were derived from scaled CT images of the phantom and included the MR phased array coil. The phantom was imaged at six time points between 7.5–1.0 GBq total activity over a period of eight days. PET images were reconstructed via OP-OSEM with 21 subsets and varying iteration number (1–5), post-reconstruction filter size (5–10 mm), and either absolute or relative scatter correction. Recovery coefficients, SNR, and noise were measured as well as total activity in the phantom. Results: For the 120 different reconstructions, recovery coefficients ranged from 0.1–0.6 and improved with increasing iteration number and reduced post-reconstruction filter size. SNR, however, improved substantially with lower iteration numbers and larger post-reconstruction filters. From the phantom data, we found that performing 2 iterations, 21 subsets, and applying a 5 mm Gaussian post-reconstruction filter provided optimal recovery coefficients at a moderate noise level for a wide range of activity levels. Conclusion: The choice of reconstruction parameters for Y-90 PET images greatly influences both the accuracy of measurements and image quality. We have found reconstruction parameters that provide optimal recovery coefficients with minimized noise. Future work will include the effects of the body matrix coil and off-center measurements.

  15. Structure de socle, sismostratigraphie et héritage structural au cours du rifting au niveau de la marge d'Ifni/Tan-Tan (Maroc sud-occidental)

    NASA Astrophysics Data System (ADS)

    AbouAli, Naïma; Hafid, Mohamad; Chellaï, El Hassane; Nahim, Mohamed; Zizi, Mahmoud

    2005-10-01

    Seismic reflection profiles from the Ifni/Tan-Tan Atlantic margin of southern Morocco, interpreted in the light of well data and field geology from the Western Anti-Atlas, allowed us to establish the seismostratigraphic framework of the syn-rift series and to reveal ( i) a compressional structural style in the pre-Triassic basement similar to that established in the adjacent outcropping onshore basement but with an opposed western vergence, ( ii) the importance of inherited anterior structures in the formation of Triassic-Liassic rift structures and ( iii) an east-west propagation of these rift structures. To cite this article: N. AbouAli et al., C. R. Geoscience 337 (2005).

  16. Why clinicians do not implement integrated treatment for comorbid substance use disorder and posttraumatic stress disorder: a qualitative study

    PubMed Central

    Gielen, Nele; Krumeich, Anja; Havermans, Remco C.; Smeets, Feikje; Jansen, Anita

    2014-01-01

    Background Healthcare providers working in addiction facilities do not often implement integrated treatment of comorbid substance use disorder (SUD) and posttraumatic stress disorder (PTSD) while there is empirical evidence to do so. Objective This study aims to get insight into the views of clinicians with regard to the diagnosis and treatment of PTSD in SUD patients. Method A qualitative research method was chosen. Fourteen treatment staff members of different wards of an addiction care facility were interviewed by an independent interviewer. Results Despite acknowledging adverse consequences of trauma exposure on SUD, severe underdiagnosis of PTSD was mentioned and treatment of PTSD during SUD treatment was not supported. Obstacles related to the underestimation of PTSD among SUD patients and to the perceptions of SUD clinicians concerning the treatment of comorbid SUD/PTSD were reported. Conclusions It is concluded that SUD facilities should train their clinicians to enable them to provide for integrated treatment of SUD/PTSD. PMID:24511368

  17. Risk Factors for Borderline Personality Disorder in Treatment Seeking Patients with a Substance Use Disorder: An International Multicenter Study

    PubMed Central

    Wapp, Manuela; van de Glind, Geurt; van Emmerik-van Oortmerssen, Katelijne; Dom, Geert; Verspreet, Sofie; Carpentier, Pieter Jan; Ramos-Quiroga, Josep Antoni; Skutle, Arvid; Bu, Eli-Torlid; Franck, Johan; Konstenius, Maija; Kaye, Sharlene; Demetrovics, Zsolt; Barta, Csaba; Fatséas, Melina; Auriacombe, Marc; Johnson, Brian; Faraone, Stephen V.; Levin, Frances R.; Allsop, Steve; Carruthers, Susan; Schoevers, Robert A.; Koeter, Maarten W.J.; van den Brink, Wim; Moggi, Franz

    2016-01-01

    Borderline personality disorder (BPD) and substance use disorders (SUDs) often co-occur, partly because they share risk factors. In this international multicenter study, risk factors for BPD were examined for SUD patients. In total, 1,205 patients were comprehensively examined by standardized interviews and questionnaires on psychiatric diagnosis and risk factors, and it was found that 1,033 (85.7%) had SUDs without BPD (SUD) and 172 (14.3%) had SUD with BPD (SUD + BPD). SUD + BPD patients were significantly younger, more often females and more often diagnosed with comorbid adult attention deficit/hyperactivity disorder. SUD + BPD patients did not differ from SUD patients on most risk factors typical for SUD such as maternal use of drugs during pregnancy or parents having any SUD. However, SUD + BPD patients did have a higher risk of having experienced emotional and physical abuse, neglect, or family violence in childhood compared to SUD patients, suggesting that child abuse and family violence are BPD-specific risk factors in patients with SUDs. PMID:25832736

  18. Could a Continuous Measure of Individual Transmissible Risk be Useful in Clinical Assessment of Substance Use Disorder? Findings from the National Epidemiological Survey on Alcohol and Related Conditions*

    PubMed Central

    Ridenour, Ty A.; Kirisci, Levent; Tarter, Ralph E.; Vanyukov, Michael M.

    2011-01-01

    Objective Toward meeting the need for a measure of individual differences in substance use disorder (SUD) liability that is grounded in the multifactorial model of SUD transmission, this investigation tested to what degree transmissible SUD risk is better measured using the continuous Transmissible Liability Index (TLI) (young adult version) compared to alternative contemporary clinical methods. Method Data from 9,535 18- to 30-year-olds in the 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions, a U.S. representative sample, were used to compute TLI scores and test hypotheses. Other variables were SUDs of each DSM-IV drug class, clinical predictors of SUD treatment outcomes, treatment seeking and usage, age of onset of SUDs and substance use (SU), and eligibility for SUD clinical trials. Results TLI scores account for variation in SUD risk over and above parental lifetime SUD, conduct and antisocial personality disorder criteria and frequency of SU. SUD risk increases two- to four-fold per standard deviation increment in TLI scores. The TLI is associated with SUD treatment seeking and usage, younger age of onset of SU and SUD, and exclusion from traditional clinical trials of SUD treatment. Conclusions The TLI can identify persons with high versus low transmissible SUD risk, worse prognosis of SUD recovery and to whom extant SUD clinical trials results may not generalize. Recreating TLI scores in extant datasets facilitates etiology and applied research on the full range of transmissible SUD risk in development, treatment and recovery without obtaining new samples. PMID:21715106

  19. Demographic and Practice Characteristics of Psychiatrists who Primarily Treat Patients with Substance Use Disorders

    PubMed Central

    Montoya, Ivan D.; Herbeck, Diane M.; Svikis, Dace S.; Fitek, Diana J.; Marcus, Steven C.; Pincus, Harold A.

    2008-01-01

    This study examined the sociodemographic and practice characteristics of psychiatrists whose caseloads consist primarily of patients with Substance Use Disorders (SUD). A. survey instrument was completed by a random sample of 865 psychiatrists. Study groups were defined as high-SUD providers if psychiatrists reported having 51% or more patients with SUD (n = 92) and non-SUD providers as those who reported not having any patients with SUD (n = 128). High-SUD providers tended to be younger, more likely to graduate from international medical schools, have larger caseloads, work more hours per week, and have a higher proportion of inpatients and publicly funded patients than non-SUD providers. Results suggest that psychiatrists who primarily treat patients with SUD are in their early careers and treat patients with more clinical, psychosocial, and economic disadvantages. The implications of these findings for psychiatry training programs and policy makers will be discussed. PMID:12851014

  20. 76 FR 61704 - Notice of Agreements Filed

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-05

    ... requirement. Agreement No.: 012136. Title: HSDG/ML/MSC Space Charter Agreement. Parties: Hamburg-Sud, A.P... authorizes Hamburg-Sud and Maersk to charter space to Med Shipping in the trade between U.S. Atlantic...

  1. 76 FR 68187 - Notice of Agreements Filed

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-03

    ....gov . Agreement No.: 012034-004. Title: Hamburg Sud/Maersk Line Vessel Sharing Agreement. Parties: Hamburg-Sud and A.P. Moeller-Maersk A/S. ] Filing Party: Wayne Rohde, Esq.; Cozen O'Connor; 1627 I...

  2. 78 FR 40739 - Notice of Agreements Filed

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-08

    ...: Broward County, Florida International Terminal, LLC, and Compania Sud Americana de Vapores, S.A. (as... International Terminal, LLC, and Compania Sud Americana de Vapores, S.A. (as guarantor). Filing Party: Candace...

  3. 78 FR 55697 - Notice of Agreements Filed

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-11

    ... . Agreement No.: 012139-001. Title: OVSA/MSC Space Charter Agreement. Parties: Hamburg-Sud, MSC Mediterranean... Sud North America, Inc.; Hanjin Shipping Company, Ltd.; Hapag-Lloyd (America), Inc; Horizon Lines,...

  4. 77 FR 71192 - Notice of Agreement Filed

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-29

    ....: 012190. Title: HSDG-GWF Space Charter Agreement. Parties: Hamburg Sud and Great White Fleet Liner..., DC 20006-4007. Synopsis: The agreement authorizes Hamburg Sud to charter space to Great White...

  5. 75 FR 54884 - Notice of Agreements Filed

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-09

    ...: HLAG/HSDG Trans-Atlantic Space Charter Agreement. Parties: Hamburg Sud and Hapag-Lloyd. Filing Parties...: The agreement authorizes Hapag-Lloyd to charter space to Hamburg Sud in the trade between New York...

  6. 78 FR 53455 - Notice of Agreements Filed

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-29

    ... Space Charter Agreement. Parties: Hamburg Sud and Hapag-Lloyd AG. Filing Party: Wayne R. Rohde, Esq... Hamburg Sud to charter space to Hapag-Lloyd in the trade between the U.S. Atlantic Coast, and ports...

  7. 77 FR 74013 - Notice of Agreements Filed

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-12

    ... Agreement. Parties: Hamburg Sud and Compania Chilena De Navegacion Interoceanica, S.A. Filing Party: Wayne R... agreement authorizes Hamburg Sud to charter space to CCNI in the trade between ports in California and...

  8. Aggression, Impulsivity, and Psychopathic Traits in Combined Antisocial Personality Disorder and Substance Use Disorder

    PubMed Central

    Alcorn, Joseph L.; Gowin, Joshua L.; Green, Charles E.; Swann, Alan C.; Moeller, F. Gerard; Lane, Scott D.

    2015-01-01

    Aggression, impulsivity, and psychopathic traits are prominent in both antisocial personality disorder (ASPD) and substance use disorders (SUD), but have rarely been examined collectively. The authors' results show that all three variables were elevated in adults with comorbid ASPD/SUD, relative to SUD-only and control subjects. PMID:24026715

  9. Pathological Gambling and Substance Use Disorders

    PubMed Central

    Wareham, Justin D.; Potenza, Marc N.

    2013-01-01

    Pathological gambling (PG) has been considered as a behavioral addiction having similarities with substance use disorders (SUDs). Shared features exist in diagnostic, clinical, physiological, and behavioral domains. Current conceptualizations of addiction, as well as experimental studies of PG and SUDs, are reviewed in order to provide a perspective on the areas of convergence between addictive behaviors in PG and SUDs. PMID:20575651

  10. Does Smoking Intervention Influence Adolescent Substance Use Disorder Treatment Outcomes?

    ERIC Educational Resources Information Center

    Myers, Mark G.; Prochaska, Judith J.

    2008-01-01

    Although tobacco use is reported by the majority of substance use disordered (SUD) youth, little work has examined tobacco focused interventions with this population. The present study is an initial investigation of the effect of a tobacco use intervention on adolescent SUD treatment outcomes. Participants were adolescents in SUD treatment taking…

  11. Childhood Attention-Deficit/Hyperactivity Disorder and Future Substance Use Disorders: Comparative Meta-Analyses

    ERIC Educational Resources Information Center

    Charach, Alice; Yeung, Emanuela; Climans, Troy; Lillie, Erin

    2011-01-01

    Objective: In recent years cohort studies have examined childhood attention-deficit/hyperactivity disorder (ADHD) as a risk factor for substance use disorders (SUDs) in adolescence and young adulthood. The long-term risk is estimated for development of alcohol, cannabis, combined alcohol and psychoactive SUDs, combined SUDs (nonalcohol), and…

  12. Do Executive Function Deficits Predict Later Substance Use Disorders among Adolescents and Young Adults?

    ERIC Educational Resources Information Center

    Wilens, Timothy E.; Martelon, MaryKate; Fried, Ronna; Petty, Carter; Bateman, Clancey; Biederman, Joseph

    2011-01-01

    Objective: There is increasing interest regarding the risk and overlap of executive function deficits (EFDs) in stable cigarette smoking and substance use disorders (SUD). Therefore, we examined whether earlier EFD was a risk factor for subsequent cigarette smoking and SUD and further explored the relationship between EFD and SUD. Method: We…

  13. Attitudes toward Substance Abuse Clients: An Empirical Study of Clinical Psychology Trainees.

    PubMed

    Mundon, Chandra R; Anderson, Melissa L; Najavits, Lisa M

    2015-01-01

    Despite the high prevalence of substance use disorder (SUD) and its frequent comorbidity with mental illness, individuals with SUD are less likely to receive effective SUD treatment from mental health practitioners than SUD counselors. Limited competence and interest in treating this clinical population are likely influenced by a lack of formal training in SUD treatment. Using a factorial survey-vignette design that included three clinical vignettes and a supplementary survey instrument, we investigated whether clinical psychology doctoral students differ in their level of negative emotional reactions toward clients with SUD versus major depressive disorder (MDD); whether they differ in their attributions for SUD versus MDD; and how their negative emotional reactions and attributions impact their interest in pursuing SUD clinical work. Participants were 155 clinical psychology graduate-level doctoral students (72% female). Participants endorsed more negative emotional reactions toward clients with SUD than toward clients with MDD. They were also more likely to identify poor willpower as the cause for SUD than for MDD. More than a third reported interest in working with SUD populations. Highest levels of interest were associated with prior professional and personal experience with SUD, four to six years of clinical experience, and postmodern theoretical orientation. PMID:26375324

  14. Does ADHD Predict Substance-Use Disorders? A 10-Year Follow-up Study of Young Adults with ADHD

    ERIC Educational Resources Information Center

    Wilens, Timothy E.; Martelon, MaryKate; Joshi, Gagan; Bateman, Clancey; Fried, Ronna; Petty, Carter; Biederman, Joseph

    2011-01-01

    Objective: High rates of substance-use disorders (SUD) have been found in samples of adolescents and adults with attention-deficit/hyperactivity disorder (ADHD). Predictors of SUD in children with ADHD who are at risk for the development of SUDs remain understudied. The main aims of this study were to identify clinically meaningful characteristics…

  15. Amygdala Activation and Emotional Processing in Adolescents at Risk for Substance Use Disorders

    ERIC Educational Resources Information Center

    Lindsay, Dawn L.; Pajtek, Stefan; Tarter, Ralph E.; Long, Elizabeth C.; Clark, Duncan B.

    2014-01-01

    Studies are needed that examine neurobiological characteristics in high-risk individuals prior to substance use disorder (SUD) development. In this pilot study, 4 adolescent subjects at high risk for SUD (having at least 1 parent with an SUD) were compared with 4 adolescent reference subjects on a cortico-limbic reactivity paradigm, where they…

  16. The cognitive effects of hepatitis C in the presence and absence of a history of substance use disorder.

    PubMed

    Huckans, Marilyn; Seelye, Adriana; Parcel, Tiffany; Mull, Lisa; Woodhouse, Jonathan; Bjornson, Danell; Fuller, Bret E; Loftis, Jennifer M; Morasco, Benjamin J; Sasaki, Anna W; Storzbach, Daniel; Hauser, Peter

    2009-01-01

    The aim of the study was to determine whether infection with the hepatitis C virus (HCV) is associated with cognitive impairment beyond the effects of prevalent comorbidities and a history of substance use disorder (SUD). Adult veterans were recruited from the Portland Veterans Affairs Medical Center into three groups: (1) HCV+/SUD+ (n = 39), (2) HCV+/SUD- (n = 24), and (3) HCV-/SUD- (n = 56). SUD+ participants were in remission for > or =90 days, while SUD- participants had no history of SUD. Groups did not significantly differ in terms of rates of psychiatric or medical comorbidities. Procedures included clinical interviews, medical record reviews, and neuropsychological testing. Significant group differences were found in the domains of Verbal Memory, Auditory Attention, Speeded Visual Information Processing, and Reasoning/Mental Flexibility (p SUD- patients performed significantly worse than HCV-/SUD- controls on tests measuring verbal learning, auditory attention, and reasoning/mental flexibility, but only HCV+/SUD+ patients did worse than HCV-/SUD- controls on tests of speeded visual information processing. Results indicate that chronic HCV is associated with cognitive impairment in the absence of a history of SUD. The most robust deficits appear to be in verbal learning and reasoning/mental flexibility. (JINS, 2009, 15, 69-82.). PMID:19128530

  17. Comorbidity of Borderline Personality Disorder and Lifetime Substance Use Disorders in a Nationally Representative Sample.

    PubMed

    Carpenter, Ryan W; Wood, Phillip K; Trull, Timothy J

    2016-06-01

    Borderline personality disorder (BPD) is comorbid with substance use disorders (SUDs). However, most epidemiological work on BPD and SUDs has collapsed nonalcohol substances into a drug use disorder indicator, potentially obscuring patterns of association between BPD and individal SUDs. Using a nationally representative sample (National Epidemiologic Survey on Alcohol and Related Conditions; N = 34,481), the authors examined the association between lifetime BPD and nine lifetime SUDs. First, the authors examined the bivariate association of BPD and each SUD. BPD was associated with all nine SUDs. Second, they added relevant covariates (demographic variables, additional psychopathology) to each model. Seven SUDs remained significant. Finally, to account for shared variance across SUDs, the authors conducted a multivariate logistic regression with the nine SUDs and covariates as predictors. Alcohol, cocaine, and opiate use disorder were the only significant SUD predictors, indicating a unique association between BPD and these three SUDs. Future research should explore factors involved in the association of BPD with these specific SUDs. PMID:25893556

  18. The Treatment of Co-Occurring PTSD and Substance Use Disorders Using Trauma-Focused Exposure Therapy

    ERIC Educational Resources Information Center

    Baschnagel, Joseph S.; Coffey, Scott F.; Rash, Carla J.

    2006-01-01

    Co-morbidity between posttraumatic stress disorder (PTSD) and substance use disorders (SUD) is high and there is a need for empirically validated treatments designed to address PTSD among SUD patients. One effective PTSD treatment that may be useful in treating PTSD-SUD is exposure therapy. This paper reviews the relationship between comorbid PTSD…

  19. Parental Psychopathology and Paternal Child Neglect in Late Childhood

    ERIC Educational Resources Information Center

    Stewart, Chris; Mezzich, Ada C.; Day, Bang-Shiuh

    2006-01-01

    We aimed at determining the association of both severity of paternal and maternal substance use disorder (SUD) and psychiatric disorders with paternal child neglect severity during late childhood. The sample comprised 146 intact SUD (n=71) and non SUD (n=75) families with a 10-12 year old female or male biological offspring. The average age of…

  20. The State of Substance Abuse Treatment Training in Counseling and Counseling Psychology Programs: What Is and Is Not Happening

    ERIC Educational Resources Information Center

    Madson, Michael B.; Bethea, Angela R.; Daniel, Samantha; Necaise, Heather

    2008-01-01

    Professional counselors and counseling psychologists have much to offer in treating substance use disorders (SUDs). Yet, research consistently demonstrates that students are not receiving adequate training in SUDs. This study describes the current state of training counseling and counseling psychology students in SUDs. Results are consistent with…

  1. Suicide Attempts within 12 Months of Treatment for Substance Use Disorders

    ERIC Educational Resources Information Center

    Britton, Peter C.; Conner, Kenneth R.

    2010-01-01

    There are limited prospective data on suicide attempts (SA) during the months following treatment for substance use disorders (SUD), a period of high risk. In an analysis of the Drug Abuse Treatment Outcomes Study, a longitudinal naturalistic multisite study of treated SUDs, variables associated with SA in the 12 months following SUD treatment…

  2. Substance Abuse in Parents and Their Adolescent Offspring: The Role of Sexual Maturation and Sensation Seeking.

    ERIC Educational Resources Information Center

    Kirillova, Galina P.; Vanyukov, Michael M.; Gavaler, Judith S.; Pajer, Kathleen; Dunn, Marija; Tarter, Ralph E.

    2001-01-01

    Tests a theory positing a role of sexual maturation and behavioral self-regulation in the development of early onset substance use disorders. The rate of maturation in adolescent males across three timepoints was found to be associated with parental substance use disorder (SUD). Parental, especially maternal, SUD was related to the sons' SUD.…

  3. Testing the Drug Substitution Switching-Addictions Hypothesis

    PubMed Central

    Blanco, Carlos; Okuda, Mayumi; Wang, Shuai; Liu, Shang-Min; Olfson, Mark

    2016-01-01

    IMPORTANCE Adults who remit from a substance use disorder (SUD) are often thought to be at increased risk for developing another SUD. A greater understanding of the prevalence and risk factors for drug substitution would inform clinical monitoring and management. OBJECTIVE To determine whether remission from an SUD increases the risk of onset of a new SUD after a 3-year follow-up compared with lack of remission from an SUD and whether sociodemographic characteristics and psychiatric disorders, including personality disorders, independently predict a new-onset SUD. DESIGN, SETTING, AND PARTICIPANTS A prospective cohort study where data were drawn from a nationally representative sample of 34 653 adults from the National Epidemiologic Survey on Alcohol and Related Conditions. Participants were interviewed twice, 3 years apart (wave 1, 2001–2002; wave 2, 2004–2005). MAIN OUTCOMES AND MEASURES We compared new-onset SUDs among individuals with at least 1 current SUD at wave 1 who did not remit from any SUDs at wave 2 (n = 3275) and among individuals with at least 1 current SUD at wave 1 who remitted at wave 2 (n = 2741). RESULTS Approximately one-fifth (n = 2741) of the total sample had developed a new-onset SUD at the wave 2 assessment. Individuals who remitted from 1 SUD during this period were significantly less likely than those who did not remit to develop a new SUD (13.1% vs 27.2%, P < .001). Results were robust to sample specification. An exception was that remission from a drug use disorder increased the odds of a new SUD (odds ratio [OR] = 1.46; 95% CI, 1.11–1.92). However, after adjusting for the number of SUDs at baseline, remission from drug use disorders decreased the odds of a new-onset SUD (OR = 0.66; 95% CI, 0.46–0.95) whereas the number of baseline SUDs increased those odds (OR=1.68; 95% CI, 1.43–1.98). Being male, younger in age, never married, having an earlier age at substance use onset, and psychiatric comorbidity significantly increased

  4. Predictors of First-Onset Substance Use Disorders During the Prospective Course of Bipolar Spectrum Disorders in Adolescents

    PubMed Central

    Goldstein, Benjamin I.; Strober, Michael; Axelson, David; Goldstein, Tina R.; Gill, Mary Kay; Hower, Heather; Dickstein, Daniel; Hunt, Jeffrey; Yen, Shirley; Kim, Eunice; Ha, Wonho; Liao, Fangzi; Fan, Jieyu; Iyengar, Satish; Ryan, Neal D.; Keller, Martin B.; Birmaher, Boris

    2013-01-01

    Objective Substance use disorders (SUD) are common and problematic in bipolar disorder (BP). We prospectively examined predictors of first-onset SUD among adolescents with BP. Method Adolescents (12–17 years old; N=167) in the Course and Outcome of Bipolar Youth (COBY) study fulfilling criteria for BP-I, BP-II, or operationalized BP not otherwise specified, without SUD at intake, were included. Baseline demographic, clinical, and family history variables, and clinical variables assessed during follow-up, were examined in relation to first-onset SUD. Participants were prospectively interviewed every 38.5±22.2 weeks for an average of 4.25±2.11 years. Results First-onset SUD developed among 32% of subjects, after a mean of 2.7±2.0 years from intake. Lifetime alcohol experimentation at intake most robustly predicted first-onset SUD. Lifetime oppositional defiant disorder and panic disorder, family history of SUD, low family cohesiveness, and absence of antidepressant treatment at intake were also associated with increased risk of SUD, whereas BP subtype was not. Risk of SUD increased with increasing number of these six predictors: 54.7% of subjects with ≥3 predictors developed SUD vs. 14.1% of those with <3 predictors (Hazard Ratio 5.41 95% CI 2.7–11.0 p<0.0001). Greater hypo/manic symptom severity in the preceding 12 weeks predicted greater likelihood of SUD onset. Lithium exposure in the preceding 12 weeks predicted lower likelihood of SUD. Conclusions This study identifies several predictors of first-onset SUD in the COBY sample which, if replicated, may suggest targets of preventive interventions for SUD among youth with BP. Treatment-related findings are inconclusive and must be interpreted tentatively given the limitations of observational naturalistic treatment data. There is a substantial window of opportunity between BP and SUD onset during which preventive strategies may be employed. PMID:24074469

  5. Systematic Review of Prevalence, Correlates, and Treatment Outcomes for Chronic Non-Cancer Pain in Patients with Comorbid Substance Use Disorder

    PubMed Central

    Morasco, Benjamin J.; Gritzner, Susan; Lewis, Lynsey; Oldham, Robert; Turk, Dennis C.; Dobscha, Steven K.

    2010-01-01

    Summary Co-occurring substance use disorders (SUDs) are common among chronic pain patients. However, limited data are available to guide treatment for chronic pain patients with SUD. Recent data suggest that comorbid substance use disorders (SUDs) are common among chronic non-cancer pain (CNCP) patients; however, prevalence rates vary across studies and findings are limited regarding treatment options for CNCP patients with comorbid SUD. The purpose of this systematic review is to assess the prevalence, associated demographic and clinical characteristics, and treatment outcomes for CNCP patients with comorbid SUD. We conducted searches from Ovid MEDLINE, PsychINFO, and PubMED from 1950 through February 2010 and retrieved the references. Thirty-eight studies met inclusion criteria and provided data that addressed our key questions. Three to forty-eight percent of CNCP patients have a current SUD. There are no demographic or clinical factors that consistently differentiate CNCP patients with comorbid SUD from patients without SUD, though SUD patients appear to be at greater risk for aberrant medication-related behaviors. CNCP patients with SUD are more likely to be prescribed opioid medications and at higher doses than CNCP patients without a history of SUD. CNCP patients with comorbid SUD do not significantly differ in their responses to treatment compared to CNCP patients without SUD, though the quality of this evidence is low. Limited data are available to identify predictors of treatment outcome. Although clinical experience and research suggests that SUDs are common among CNCP patients, only limited data are available to guide clinicians who treat this population. Research is needed to increase understanding of the prevalence, correlates, and responses to treatment of CNCP patients with comorbid SUDs. PMID:21185119

  6. Low Earth Orbit Raider (LER) winged air launch vehicle concept

    NASA Technical Reports Server (NTRS)

    Feaux, Karl; Jordan, William; Killough, Graham; Miller, Robert; Plunk, Vonn

    1989-01-01

    The need to launch small payloads into low earth orbit has increased dramatically during the past several years. The Low Earth orbit Raider (LER) is an answer to this need. The LER is an air-launched, winged vehicle designed to carry a 1500 pound payload into a 250 nautical mile orbit. The LER is launched from the back of a 747-100B at 35,000 feet and a Mach number of 0.8. Three staged solid propellant motors offer safe ground and flight handling, reliable operation, and decreased fabrication cost. The wing provides lift for 747 separation and during the first stage burn. Also, aerodynamic controls are provided to simplify first stage maneuvers. The air-launch concept offers many advantages to the consumer compared to conventional methods. Launching at 35,000 feet lowers atmospheric drag and other loads on the vehicle considerably. Since the 747 is a mobile launch pad, flexibility in orbit selection and launch time is unparalleled. Even polar orbits are accessible with a decreased payload. Most importantly, the LER launch service can come to the customer, satellites and experiments need not be transported to ground based launch facilities. The LER is designed to offer increased consumer freedom at a lower cost over existing launch systems. Simplistic design emphasizing reliability at low cost allows for the light payloads of the LER.

  7. Improving PTSD/substance abuse treatment in the VA: a survey of providers.

    PubMed

    Najavits, Lisa M; Norman, Sonya B; Kivlahan, Daniel; Kosten, Thomas R

    2010-01-01

    We surveyed 205 Veterans Affairs (VA) staff on treatment of posttraumatic stress disorder (PTSD), substance use disorder (SUD), and the combination (PTSD/SUD). The survey was anonymous and VA-wide. PTSD/SUD was perceived as more difficult to treat than either disorder alone; gratification in the work was stronger than difficulty (for PTSD, SUD, and PTSD/SUD); and difficulty and gratification appeared separate constructs. Respondents endorsed views that represent expert treatment for the comorbidity; however, there was also endorsement of "myths." Thus, there is a need for more training, policy clarifications, service integration, and adaptations for veterans returning from Iraq and Afghanistan. Limitations are described. PMID:20525033

  8. Posttraumatic stress disorder and substance use disorder comorbidity in homeless adults: Prevalence, correlates, and sex differences.

    PubMed

    Torchalla, Iris; Strehlau, Verena; Li, Kathy; Aube Linden, Isabelle; Noel, Francois; Krausz, Michael

    2014-06-01

    Substance use disorders (SUDs) are highly prevalent in homeless populations, and rates are typically greater among males. Posttraumatic stress disorder (PTSD) is a common co-occurring condition among individuals with SUDs; however, little attention has been directed to examining this comorbidity in homeless populations. Although some studies indicate considerable sex differences among individuals with PTSD, it has also been suggested that sex differences in PTSD rates diminish in populations with severe SUDs. This cross-sectional study investigated SUD-PTSD comorbidity and its associations with indicators of psychosocial functioning in a sample of 500 homeless individuals from Canada. Sex-related patterns of SUD, PTSD, and their comorbidity were also examined. Males and females had similar SUD prevalence rates, but the rates of PTSD and PTSD-SUD comorbidity were higher in females. PTSD and sex were found to have significant main effects on suicidality, psychological distress, somatic symptoms, and incarceration among individuals with SUD. Sex also moderated the association of PTSD with suicide risk and psychological distress. Our results contradict assumptions that sex differences in PTSD rates attenuate in samples with severe SUDs. Organizations providing SUD treatment for homeless people should address PTSD as an integrated part of their services. SUD and integrated treatment programs may benefit from sex-specific components. PMID:23915373

  9. MULTIPLE SUBSTANCE USE DISORDERS IN JUVENILE DETAINEES

    PubMed Central

    McClelland, Gary M.; Elkington, Katherine S.; Teplin, Linda A.; Abram, Karen M.

    2009-01-01

    Objective To estimate six-month prevalence of multiple substance use disorders (SUDs) among juvenile detainees by demographic subgroups (sex, race/ethnicity, age). Method Participants were a randomly selected sample of 1829 African American, non-Hispanic white and Hispanic detainees (1172 males, 657 females, ages 10–18). Patterns and prevalence of DSM-III-R multiple SUDs were assessed using the Diagnostic Interview Schedule for Children (DISC 2.3). We used 2-tailed F- and t-tests with an alpha of 0.05 to examine combinations of SUDs by sex, race/ethnicity, and age. Results Nearly half of detainees had one or more SUDs; over 21% had two or more SUDs. The most prevalent combination of SUDs was alcohol and marijuana use disorders (17.25% females, 19.42% males). Among detainees with any SUD, almost half had multiple SUDs. Among detainees with alcohol use disorder, over 80% also had one or more drug use disorders. Among detainees with a drug use disorder, approximately 50% also had an alcohol use disorder. Conclusions Among detained youth with any SUD, multiple SUDs are the rule, not the exception. Substance abuse treatments need to target detainees with multiple SUDs who, upon release, return to communities where services are often unavailable. Clinicians can help ensure continuity of care by working with juvenile courts and detention centers. PMID:15381888

  10. Investigating the efficacy of integrated cognitive behavioral therapy for adult treatment seeking substance use disorder patients with comorbid ADHD: study protocol of a randomized controlled trial

    PubMed Central

    2013-01-01

    Background Attention deficit hyperactivity disorder (ADHD) frequently co-occurs with substance use disorders (SUD). The combination of ADHD and SUD is associated with a negative prognosis of both SUD and ADHD. Pharmacological treatments of comorbid ADHD in adult patients with SUD have not been very successful. Recent studies show positive effects of cognitive behavioral therapy (CBT) in ADHD patients without SUD, but CBT has not been studied in ADHD patients with comorbid SUD. Methods/design This paper presents the protocol of a randomized controlled trial to test the efficacy of an integrated CBT protocol aimed at reducing SUD as well as ADHD symptoms in SUD patients with a comorbid diagnosis of ADHD. The experimental group receives 15 CBT sessions directed at symptom reduction of SUD as well as ADHD. The control group receives treatment as usual, i.e. 10 CBT sessions directed at symptom reduction of SUD only. The primary outcome is the level of self-reported ADHD symptoms. Secondary outcomes include measures of substance use, depression and anxiety, quality of life, health care consumption and neuropsychological functions. Discussion This is the first randomized controlled trial to test the efficacy of an integrated CBT protocol for adult SUD patients with a comorbid diagnosis of ADHD. The rationale for the trial, the design, and the strengths and limitations of the study are discussed. Trial registration This trial is registered in http://www.clinicaltrials.gov as NCT01431235. PMID:23663651

  11. Concurrent Treatment of Substance Use and PTSD.

    PubMed

    Flanagan, Julianne C; Korte, Kristina J; Killeen, Therese K; Back, Sudie E

    2016-08-01

    Substance use disorders (SUD) and posttraumatic stress disorder (PTSD) are chronic, debilitating conditions that frequently co-occur. Individuals with co-occurring SUD and PTSD suffer a more complicated course of treatment and less favorable treatment outcomes compared to individuals with either disorder alone. The development of effective psychosocial and pharmacological interventions for co-occurring SUD and PTSD is an active and critically important area of investigation. Several integrated psychosocial treatments for co-occurring SUD and PTSD have demonstrated promising outcomes. While recent studies examining medications to treat co-occurring SUD and PTSD have yielded encouraging findings, there remain substantial gaps in the evidence base regarding the treatment of co-occurring SUD and PTSD. This review will summarize the findings from clinical trials targeting a reduction in SUD and PTSD symptoms simultaneously. These results may improve our knowledge base and subsequently enhance our ability to develop effective interventions for this complex comorbid condition. PMID:27278509

  12. Treatment Development and Feasibility Study of Family-Focused Treatment for Adolescents with Bipolar Disorder and Comorbid Substance Use Disorders

    PubMed Central

    Goldstein, Benjamin I.; Goldstein, Tina R.; Collinger, Katelyn A.; Axelson, David A.; Bukstein, Oscar G.; Birmaher, Boris; Miklowitz, David J.

    2014-01-01

    Background Comorbid substance use disorders (SUD) are associated with increased illness severity and functional impairment among adolescents with bipolar disorder (BD). Previous psychosocial treatment studies have excluded adolescents with both BD and SUD. Studies suggest that integrated interventions are optimal for adults with BD and SUD. Methods We modified family-focused treatment for adolescents with BD (FFT-A) in order to explicitly target comorbid SUD (FFT-SUD). Ten adolescents with BD who had both SUD and an exacerbation of manic, depressed, or mixed symptoms within the last 3 months were enrolled. FFT-SUD was offered as an adjunct to pharmacotherapy, with a target of 21 sessions over 12 months of treatment. The FFT-SUD manual was iteratively modified to integrate a concurrent focus on SUD. Results Six subjects completed a mid-treatment 6-month assessment (after a mean of 16 sessions was completed). Of the 10 subjects, 3 dropped out early ( after ≤ 1 session); in the case of each of these subjects, the participating parent had active SUD. No other subjects in the study had a parent with active SUD. Preliminary findings suggested significant reductions in manic symptoms and depressive symptoms and improved global functioning. Reduction in cannabis use was modest and did not reach significance. Limitations Limitations included a small sample, open treatment, concurrent medications, and no control group. Conclusions These preliminary findings suggest that FFT-SUD is a feasible intervention, particularly for youth without parental SUD. FFT-SUD may be effective in treating mood symptoms, particularly depression, despite modest reductions in substance use. Integrating motivation enhancing strategies may augment the effect of this intervention on substance use. Additional strategies, such as targeting parental substance use, may prevent early attrition. PMID:24847999

  13. Manifestations précoces du rift de Biscaye au Lias inférieur sur la marge Sud-Armoricaine (Talmont-Saint-Hilaire, Vendée, Ouest France)

    NASA Astrophysics Data System (ADS)

    Montenat, Christian; Bessonnat, Gilbert; Roy, Claude

    2006-03-01

    To the south of Les Sables-d'Olonne (Vendée, France), the Early Liassic (Hettangian) sedimentation locally begins with continental clastics (including the dinosaur footprint-bearing beds of Le Veillon) prior to the deposition of shallow marine carbonates. Subsurface data (water borehole and geophysical line) indicate frequent variations in thickness of the clastics, related to fault block pattern. Simultaneously, numerous sedimentary dyke swarms developed within the metamorphic basement. These tectonic features resulted from an Early Liassic NNE-SSW-trending extension of the basement. Mineralized zones (silicification and metal-bearing mineralization) are related to hydrothermal circulations, contemporaneous (at least in part) with the Early Liassic extension. These different events may be related to the early stage of evolution (Triassic-Liassic) of the Biscay rift. To cite this article: C. Montenat et al., C. R. Geoscience 338 (2006).

  14. Changements climatiques et variations du champ magnetique terrestre dans le sud de la Patagonie (Argentine) depuis 51 200 ans reconstitues a partir des proprietes magnetiques des sediments du lac Laguna Potrok Aike

    NASA Astrophysics Data System (ADS)

    Lise-Pronovost, Agathe

    Rock magnetism is influenced by climate and by the Earth's magnetic field. The goal of this thesis is to use the rock magnetic properties of the long sedimentary sequence from the lake Laguna Potrok Aike (106 m, 51200 cal BP) to derive paleomagnetic and paleoclimatic records in a key area of the Southern Hemisphere that is poorly documented. Laguna Potrok Aike (52°S, 70°W) is located in southeastern Patagonia (Argentina) in the path of the strong Southern Hemisphere westerly winds and in the source area of the dust deposited in Antarctica during Glacial periods. The lake geographical location is therefore ideal to reconstruct past changes in aeolian activity and climate changes in Patagonia. It is also a key location to reconstruct past changes of the geomagnetic field because the Southern Hemisphere is significantly under-documented relative to the Northern Hemisphere. In addition, the proximity of the South Atlantic Anomaly (SAA) as well as the Southern Hemisphere high flux lobes could allow identifying differences in the paleomagnetic field evolution in southern South America relative to the much more documented Northern Hemisphere. For his strong potential to provide high-resolution climatic, aeolian and paleomagnetic records beyond the last climatic transition, the maar lake Laguna Potrok Aike was drilled in the framework of the International scientific Continental Drilling Program (ICDP) for the Potrok Aike maar lake Sediment Archive Drilling prOject (PASADO). In this thesis, high-resolution rock-magnetic and physical properties are used in order to reconstruct paleoclimate and paleomagnetic records from the southernmost part of South America. In the first chapter, the full-vector paleomagnetic record (inclination, declination and relative paleointensity) derived from the sediments of Laguna Potrok Aike. A grain size influence on the relative paleointensity record (NRM/ARM) was corrected using the median destructive field of the natural remanent magnetisation (MDFNRM). Full-vector comparison of the new paleomagnetic record with other records from southern South America, elsewhere in the Southern Hemisphere, as well as dipole field models and compilations reveal similar millennial-scale variability. The Laschamp geomagnetic excursion and possibly the Mono Lake as well as the Hilina Pali excursions are recorded and suggest the global nature of these events. Nevertheless comparison with the Lake Baikal and Biwa records located on the opposite side of the globe in Siberia and Japan respectively reveals a different behaviour at ca. 46000 cal BP in Laguna Potrok Aike and in southern South America, hinting at a non-dipolar origin. In the second chapter, rock-magnetic proxies of dust and wind intensity since 51200 cal BP are constructed. The combined use of rock magnetism and grain size data allowed identifying the median destructive field of the isothermal remanent magnetisation (MDFIRM) as best reflecting silt-sized magnetite typically transported by wind in suspension over short distances. The MDF IRM displays similar variability than other wind intensity proxies derived from marine and lacustrine sediments, peat bug and speleothem records from Patagonia since the last climatic transition and from the Southern Hemisphere since 51200 cal BP. In addition, estimation of the flux of magnetite to the lake, investigation of the grain size influence on magnetic susceptibility and comparison with distal Patagonian dust records from the Southern Ocean and Antarctica indicate that the magnetic susceptibility signal from Laguna Potrok Aike is a dust record at the multi-millennial scale. In the third chapter, rock-magnetic proxies of runoff events associated with extreme precipitation and permafrost melt since 51200 cal BP are presented. The runoff events are identified by the presence of high coercivity magnetic mineral (such as hematite and goethite) which its pedogenic origin is inferred from geological, limnological, stratigraphic and climatic evidence. The runoff events are generally associated with mass movement deposits during time of enhanced lake productivity in Laguna Potrok Aike and are also coeval within the limit of the chronology to warm atmospheric conditions recorded in Antarctica. In addition, we show that the authigenic formation of iron sulfide such as greigite is strictly associated to reworked sands and tephra layers providing the required suboxic conditions and dissolved sulfate. As a whole, rock magnetism of the sediment from Laguna Potrok Aike provides a high quality full-vector paleomagnetic record as well as rock-magnetic proxies of past climate changes in southeastern Patagonia that are also associated with climate changes in Antarctica. Keywords: [Paleomagnetism, sediment magnetism, paleoclimatology, Laguna Potrok Aike, Patagonia, Southern Hemisphere, millennial- to centennial-scale variability, last Glacial period, Holocene, wind intensity].

  15. SU-D-19A-05: The Dosimetric Impact of Using Xoft Axxent® Electronic Brachytherapy Source TG-43 Dosimetry Parameters for Treatment with the Xoft 30 Mm Diameter Vaginal Applicator

    SciTech Connect

    Simiele, S; Micka, J; Culberson, W; DeWerd, L

    2014-06-01

    Purpose: A full TG-43 dosimetric characterization has not been performed for the Xoft Axxent ® electronic brachytherapy source (Xoft, a subsidiary of iCAD, San Jose, CA) within the Xoft 30 mm diameter vaginal applicator. Currently, dose calculations are performed using the bare-source TG-43 parameters and do not account for the presence of the applicator. This work focuses on determining the difference between the bare-source and sourcein- applicator TG-43 parameters. Both the radial dose function (RDF) and polar anisotropy function (PAF) were computationally determined for the source-in-applicator and bare-source models to determine the impact of using the bare-source dosimetry data. Methods: MCNP5 was used to model the source and the Xoft 30 mm diameter vaginal applicator. All simulations were performed using 0.84p and 0.03e cross section libraries. All models were developed based on specifications provided by Xoft. The applicator is made of a proprietary polymer material and simulations were performed using the most conservative chemical composition. An F6 collision-kerma tally was used to determine the RDF and PAF values in water at various dwell positions. The RDF values were normalized to 2.0 cm from the source to accommodate the applicator radius. Source-in-applicator results were compared with bare-source results from this work as well as published baresource results. Results: For a 0 mm source pullback distance, the updated bare-source model and source-in-applicator RDF values differ by 2% at 3 cm and 4% at 5 cm. The largest PAF disagreements were observed at the distal end of the source and applicator with up to 17% disagreement at 2 cm and 8% at 8 cm. The bare-source model had RDF values within 2.6% of the published TG-43 data and PAF results within 7.2% at 2 cm. Conclusion: Results indicate that notable differences exist between the bare-source and source-in-applicator TG-43 simulated parameters. Xoft Inc. provided partial funding for this work.

  16. Population distribution, land, and livelihood in South-Eastern Nigeria/La repartition de la population, les terres et le mode de vie en Nigeria du Sud-Est.

    PubMed

    Okore, A O

    1982-06-01

    This article discusses increasing population density as a proximate measure of overpopulation or population pressure, especially as it occurs in an agrarian society. The paper examines 1) population distribution in 2 Igbo states in southeastern Nigeria, relating to soil types, cultivable land, and per capita acreage under cultivation, and 2) measures adopted by individuals in these areas. Aside from Legos, Nigeria's highest population densities are in Imo state (644.3 persons/square mile) and Anambra state (477.8 persons/square mile). The absence of drought and high soil fertility may contribute to high population density, although overfarming has now occurred in some areas. 3 settlement pattern stages, colonization, consolidation, and distintegration, explain the population density variation within the 2 states. Although it is useful to examine population density in terms of soil types, cultivable land availability and land use, very little of this information is available for these states. The evidence suggests that high density areas have very little cultivable land. Some general observations on the pattern of population distribution and settlement include 1) Igbo community migration tendencies, 2) land use potentials, 3) encroachment by growing communities on farmland and the need for nonfarm earning sources, and 4) decreasing land fallowing periods. Trade, migrant labor, and land rental have become alternatives to farming in densely populated areas. Population in the Igbo region strains the land resources, but leaders argue that rapid population growth could stimulate socioeconomic development, and generate interest in new food production methods. This theory supposes that agricultural production methods can be easily changed and that virgin land is still available. Instead, in response to population pressure, young people move from the land to towns and cities, increasing urban unemployment and slum dwelling. The older people, women, and children left behind in rural villages cannot produce enough food on the available land. The author calls for a deliberate government effort to plan population control strategies. PMID:12314099

  17. SU-D-304-01: Development of An Applicator for Treating Shallow and Moving Tumors with Respiratory-Gated Spot-Scanning Proton Therapy Using Real-Time Image Guidance

    SciTech Connect

    Matsuura, T; Fujii, Y; Takao, S; Yamada, T; Matsuzaki, Y; Miyamoto, N; Shimizu, S; Shirato, H; Takayanagi, T; Fujitaka, S; Umegaki, K

    2015-06-15

    Purpose: To develop a method for treating shallow and moving tumors (e.g., lung tumors) with respiratory-gated spot-scanning proton therapy using real-time image guidance (RTPT). Methods: An applicator was developed which can be installed by hand on the treatment nozzle. The mechanical design was considered such that the Bragg peaks are placed at the patient surface while a sufficient field of view (FOV) of fluoroscopic X-rays was maintained during the proton beam delivery. To reduce the treatment time maintaining the robustness of the dose distribution with respect to motion, a mini-ridge filter (MRF) was sandwiched between two energy absorbers. The measurements were performed to obtain a data for beam modeling and to verify the spot position-invariance of a pencil beam dose distribution. For three lung cancer patients, treatment plans were made with and without the MRF and the effects of the MRF were evaluated. Next, the effect of respiratory motion on the dose distribution was investigated. Results: To scan the proton beam over a 14 x 14 cm area while maintaining the φ16 cm of fluoroscopic FOV, the lower face of the applicator was set 22 cm upstream of the isocenter. With an additional range variance of 2.2 mm and peak-to-peak distance of 4 mm of the MRF, the pencil beam dose distribution was unchanged with the displacement of the spot position. The quality of the treatment plans was not worsened by the MRF. With the MRF, the number of energy layers was reduced to less than half and the treatment time by 26–37%. The simulation study showed that the interplay effect was successfully suppressed by respiratory-gating both with and without MRF. Conclusions: The spot-scanning proton beam was successfully delivered to shallow and moving tumors within a sufficiently short time by installing the developed applicator at the RTPT nozzle.

  18. Adaptation linguistique et culturelle: L'experience des refugies d'Asie du sud-est au Quebec (Linguistic and Cultural Adaptation: The Experience of Southeast Asian Refugees in Quebec).

    ERIC Educational Resources Information Center

    Chan, Kwok B.; Dorais, Louis-Jacques

    A collection of papers, in English and French, on the adjustment processes and problems of Southeast Asian refugees in Quebec includes: "Prelude to Resettlement: A Clinical View on the Transit Camp Experience of Vietnamese Refugees" (David Loveridge, Kwok B. Chan); "Une communaute culturelle en situation de diglossie: Les Vietnamiens du Quebec"…

  19. SU-D-18A-06: Variation of Controlled Breath Hold From CT Simulation to Treatment and Its Dosimetric Impact for Left-Sided Breast Radiotherapy with a Real-Time Optical Tracking System

    SciTech Connect

    Mittauer, K; Deraniyagala, R; Li, J; Lu, B; Liu, C; Lightsey, J; Yan, G

    2014-06-01

    Purpose: Different breath-hold (BH) maneuvers (abdominal breathing vs. chest breathing) during CT simulation and treatment can lead to chest wall positional variation. The purpose of this study is to quantify the variation of active breathing control (ABC)-assisted BH and estimate its dosimetric impact for left-sided whole-breast radiotherapy with a real-time optical tracking system (OTS). Methods: Seven breast cancer patients were included. An in-house OTS tracked an infrared (IR) marker affixed over the xiphoid process of the patient at CT simulation and throughout the treatment course to measure BH variations. Correlation between the IR marker and the breast was studied for dosimetric purposes. The positional variations of 860 BHs were retrospectively incorporated into treatment plans to assess their dosimetric impact on breast and cardiac organs (heart and left anterior descending artery [LAD]). Results: The mean intrafraction variations were 2.8 mm, 2.7 mm, and 1.6 mm in the anteroposterior (AP), craniocaudal (CC), and mediolateral (ML) directions, respectively. Mean stability in any direction was within 1.5 mm. A general trend of BH undershoot at treatment relative to CT simulation was observed with an average of 4.4 mm, 3.6 mm, and 0.1 mm in the AP, CC, and ML directions, respectively. Undershoot up to 12.6 mm was observed for individual patients. The difference between the planned and delivered dose to breast targets was negligible. The average planned/delivered mean heart doses, mean LAD doses, and max LAD doses were 1.4/2.1, 7.4/15.7, and 18.6/31.0 Gy, respectively. Conclusion: Systematic undershoot was observed in ABC-assisted BHs from CT simulation to treatment. Its dosimetric impact on breast coverage was minimized with image guidance, but the benefits of cardiac organ sparing were degraded. A real-time tracking system can be used in junction with the ABC device to improve BH reproducibility.

  20. SU-D-201-07: Exploring the Utility of 4D FDG-PET/CT Scans in Design of Radiation Therapy Planning Compared with 3D PET/CT: A Prospective Study

    SciTech Connect

    Ma, C; Yin, Y

    2015-06-15

    Purpose: A method using four-dimensional(4D) PET/CT in design of radiation treatment planning was proposed and the target volume and radiation dose distribution changes relative to standard three-dimensional (3D) PET/CT were examined. Methods: A target deformable registration method was used by which the whole patient’s respiration process was considered and the effect of respiration motion was minimized when designing radiotherapy planning. The gross tumor volume of a non-small-cell lung cancer was contoured on the 4D FDG-PET/CT and 3D PET/CT scans by use of two different techniques: manual contouring by an experienced radiation oncologist using a predetermined protocol; another technique using a constant threshold of standardized uptake value (SUV) greater than 2.5. The target volume and radiotherapy dose distribution between VOL3D and VOL4D were analyzed. Results: For all phases, the average automatic and manually GTV volume was 18.61 cm3 (range, 16.39–22.03 cm3) and 31.29 cm3 (range, 30.11–35.55 cm3), respectively. The automatic and manually volume of merged IGTV were 27.82 cm3 and 49.37 cm3, respectively. For the manual contour, compared to 3D plan the mean dose for the left, right, and total lung of 4D plan have an average decrease 21.55%, 15.17% and 15.86%, respectively. The maximum dose of spinal cord has an average decrease 2.35%. For the automatic contour, the mean dose for the left, right, and total lung have an average decrease 23.48%, 16.84% and 17.44%, respectively. The maximum dose of spinal cord has an average decrease 1.68%. Conclusion: In comparison to 3D PET/CT, 4D PET/CT may better define the extent of moving tumors and reduce the contouring tumor volume thereby optimize radiation treatment planning for lung tumors.

  1. SU-D-9A-02: Relative Effects of Threshold Choice and Spatial Resolution Modeling On SUV and Volume Quantification in F18-FDG PET Imaging of Anal Cancer Patients

    SciTech Connect

    Zhao, F; Bowsher, J; Palta, M; Czito, B; Willett, C; Yin, F

    2014-06-01

    Purpose: PET imaging with F18-FDG is utilized for treatment planning, treatment assessment, and prognosis. A region of interest (ROI) encompassing the tumor may be determined on the PET image, often by a threshold T on the PET standard uptake values (SUVs). Several studies have shown prognostic value for relevant ROI properties including maximum SUV value (SUVmax), metabolic tumor volume (MTV), and total glycolytic activity (TGA). The choice of threshold T may affect mean SUV value (SUVmean), MTV, and TGA. Recently spatial resolution modeling (SRM) has been introduced on many PET systems. SRM may also affect these ROI properties. The purpose of this work is to investigate the relative influence of SRM and threshold choice T on SUVmean, MTV, TGA, and SUVmax. Methods: For 9 anal cancer patients, 18F-FDG PET scans were performed prior to treatment. PET images were reconstructed by 2 iterations of Ordered Subsets Expectation Maximization (OSEM), with and without SRM. ROI contours were generated by 5 different SUV threshold values T: 2.5, 3.0, 30%, 40%, and 50% of SUVmax. Paired-samples t tests were used to compare SUVmean, MTV, and TGA (a) for SRM on versus off and (b) between each pair of threshold values T. SUVmax was also compared for SRM on versus off. Results: For almost all (57/60) comparisons of 2 different threshold values, SUVmean, MTV, and TGA showed statistically significant variation. For comparison of SRM on versus off, there were no statistically significant changes in SUVmax and TGA, but there were statistically significant changes in MTV for T=2.5 and T=3.0 and in SUVmean for all T. Conclusion: The near-universal statistical significance of threshold choice T suggests that, regarding harmonization across sites, threshold choice may be a greater concern than choice of SRM. However, broader study is warranted, e.g. other iterations of OSEM should be considered.

  2. Nouvelles données biostratigraphiques sur la limite Cánomanien-Turonien. La coupe de Cassis (Sud-Est de la France): proposition d'un hypostratotype européen

    NASA Astrophysics Data System (ADS)

    Jolet, Patrick; Philip, Jean; Thomel, Gérard; Lopez, Gregorio; Tronchetti, Guy

    1997-11-01

    The discovery of a rich ammonite and inoceramid assemblage at the Cassis section enables the establishment of a new integrated biozonation for the Cenomanian-Turonian boundary. Four ammonite zones, four inoceramid associations and three planktonic foraminifera zones are recognized. The definitions of the traditional 'standard' ammonite and inoceramid zones/associations are discussed herein. A critical comparison with the stratotype at Pueblo (USA) supports the proposal of the Cassis sequence as a European hypostratotype of the Cenomanian-Turonian boundary.

  3. Âge 40K/ 40Ar, Carbonifère inférieur, du magmatisme basique filonien du synclinal paléozoïque de Tin Serririne, Sud-Est du Hoggar (Algérie)

    NASA Astrophysics Data System (ADS)

    Djellit, Hamou; Bellon, Hervé; Ouabadi, Aziouz; Derder, Mohamed E. M.; Henry, Bernard; Bayou, Boualem; Khaldi, Allaoua; Baziz, Kamal; Merahi, Mounir K.

    2006-07-01

    Palaeozoic formations of the Tassilis Oua-n-Ahaggar (southeastern Hoggar) include magmatic rocks in the Tin Serririne syncline. Slight contact metamorphism of the overlying bed and studies of anisotropy of magnetic susceptibility of these rocks show that the latter correspond to sills and NW-SE or north-south dykes. 40K/ 40Ar dating of separated feldspars and whole rock for one sample and of whole rock for two other samples give a mean age of 347.6±16.2Ma (at the 2- σ level), thus corresponding to a Lower Carboniferous (Tournaisian) age. Taking into account both the age of this magmatism and the stratigraphic and structural data for this region suggests that dolerites were emplaced within distensive zones that are related to the reactivation of Panafrican faults. To cite this article: H. Djellit et al., C. R. Geoscience 338 (2006).

  4. SU-D-204-05: Quantitative Comparison of a High Resolution Micro-Angiographic Fluoroscopic (MAF) Detector with a Standard Flat Panel Detector (FPD) Using the New Metric of Generalized Measured Relative Object Detectability (GM-ROD)

    SciTech Connect

    Russ, M; Ionita, C; Bednarek, D; Rudin, S

    2015-06-15

    Purpose: In endovascular image-guided neuro-interventions, visualization of fine detail is paramount. For example, the ability of the interventionist to visualize the stent struts depends heavily on the x-ray imaging detector performance. Methods: A study to examine the relative performance of the high resolution MAF-CMOS (pixel size 75µm, Nyquist frequency 6.6 cycles/mm) and a standard Flat Panel Detector (pixel size 194µm, Nyquist frequency 2.5 cycles/mm) detectors in imaging a neuro stent was done using the Generalized Measured Relative Object Detectability (GM-ROD) metric. Low quantum noise images of a deployed stent were obtained by averaging 95 frames obtained by both detectors without changing other exposure or geometric parameters. The square of the Fourier transform of each image is taken and divided by the generalized normalized noise power spectrum to give an effective measured task-specific signal-to-noise ratio. This expression is then integrated from 0 to each of the detector’s Nyquist frequencies, and the GM-ROD value is determined by taking a ratio of the integrals for the MAF-CMOS to that of the FPD. The lower bound of integration can be varied to emphasize high frequencies in the detector comparisons. Results: The MAF-CMOS detector exhibits vastly superior performance over the FPD when integrating over all frequencies, yielding a GM-ROD value of 63.1. The lower bound of integration was stepped up in increments of 0.5 cycles/mm for higher frequency comparisons. As the lower bound increased, the GM-ROD value was augmented, reflecting the superior performance of the MAF-CMOS in the high frequency regime. Conclusion: GM-ROD is a versatile metric that can provide quantitative detector and task dependent comparisons that can be used as a basis for detector selection. Supported by NIH Grant: 2R01EB002873 and an equipment grant from Toshiba Medical Systems Corporation.

  5. Un segment proximal de rampe carbonatée d'âge protérozoïque supérieur au Nord du craton d'Afrique centrale (sud-est de la République centrafricaine)

    NASA Astrophysics Data System (ADS)

    Alvarez, Philippe

    1996-01-01

    Near Bakouma (southwest Central African Republic), the ante Pan African carbonated formations are deeply karstified and overlaid by uranium and phosphorus bearing sediments, probably Eocene in age. The sedimentological study, of drilling cores allows the proposal of a carbonated ramp model for the lithological pile. This ramp was backed on to a large argilaceous continental rise with feldspathic sandy deposits. In the marine domain, pelitic sediments of the coastal plain progressively change into dolomites deposited on a dissipative beach limited by a discontinuous and partially emerged stromatolic bioherm. In the south, the stromatolic bioherms of Kassa-Limassa are interbedded in lagoonal silicified dolomites bearing evidence of evaporitic processes. Native copper is locally present in shore deposits. The progradation of the facies is southwards. This model is compared to the beach of the carbonated ramp evidenced for the Schisto-calcaire Group in Congo. The carbonated ramps of Central Africa, established before the Pan-African orogeny, can be linked to the same tectono-eustatic regressive period as the Schisto-calcaire ramp (West-Congolian Supergroup). By comparaison with the results obtained in south Congo, the age of the carbonated ramp in the north of Central Africa could be near the Precambrian-Cambrian boundary.

  6. Contribution à l'étude du métamorphisme des gisements cupro-cobaltifères stratiformes du Sud-Shaba, Zaire. Le district minier de Lwishia

    NASA Astrophysics Data System (ADS)

    Cluzel, D.

    The late precambrian copper-bearing strata of southern Shaba ('Série des mines') have undergone metamorphism during the latest proterozoic to early paleozoic times. Structural, textural and crystallochemical analysis of this metamorphic event shows a very peculair evolution. During a first phase, prior to folding, a static recrystallization is accompanied by several chemical chanes such as Na, then KMg metasomatism. This hydrothermal character is due to 'hydrostatic' stress conditions and fluid circulation linked with surrounding evaporites. During this prograde stage of metamorphism, kyanite + carbonate + sulphide paragenesis suggest low water partial pressure and high pH-low Eh conditions. Geothermometers and fluid inclusions indicate moderate to medium temperatures (300-400°C). Sparse synergetic CuCo sulphide mineralization is overconcentrated to its present disposition. A second hydrothermal event following the main folding phase is probably linked with halokinetic or halotectonic structures. It is essentially retrograde with oxidizing and low-temperature (200°C) conditions, resulting in the total leaching of evaporites and the forming of clay minerals, such as kandites or smectites.

  7. Interprétation hydrogéologique de l'aquifère des bassins sud-rifains (Maroc) : apport de la sismique réflexionHydrogeological interpretation of the southern Rifean basins aquifer (Morocco): seismic reflexion contribution

    NASA Astrophysics Data System (ADS)

    Zouhri, Lahcen; Gorini, Christian; Lamouroux, Christian; Vachard, Daniel; Dakki, Mohammed

    2003-03-01

    The aquifer of the Rharb Basin is constituted by heterogeneous material. The seismic reflexion interpretation carried out in this area, highlighted a permeable device compartmentalized in raised and subsided blocks. Depressions identified in the northern and southernmost zones are characterized by Plio-Quaternary fillings that are favourable to the hydrogeological exploitation. Two mechanisms contribute to structure the Plio-Quaternary aquifer: the Hercynian reactivation in the southernmost part, and the gravitational mechanism of the Pre-Rifean nappe. The groundwater flow and the aquifer thickening are controlled by this reactivation.

  8. Familial Influence of Substance Use Disorder on Emotional Disorder across Three Generations

    PubMed Central

    Leventhal, Adam M.; Pettit, Jeremy W.; Lewinsohn, Peter M.

    2010-01-01

    The concomitant influence of grandparental (Generation 1; G1) and parental (G2) substance use disorder (SUD) on grandchild (G3) emotional disorder (EmD) across three generations is unclear. The present study addressed this in a sample of 284 families participating in the Oregon Adolescent Depression Project. Structured clinical interviews were used to collect psychiatric history data on a community cohort of G2 individuals and their G1 parents. G2 parents rated EmD symptoms in their G3 children (M age = 5 years, SD = 2.8). Results indicated that G1 SUD was associated with increased risk of G3 EmD symptom elevations, above and beyond the influence of comorbid G1 EmD. G2 SUD was associated with a similar independent increase in risk for G3 EmD symptoms. Also, G1 SUD conferred risk for G2 SUD. Mediational tests indicated that the influence of G1 SUD on G3 EmD was transmitted via its influence on G2 SUD. G1 and G2 SUD did not interact in predicting G3 EmD; rather results suggested an additive influence. There was no evidence that the influence of G1 SUD on G3 EmD was transmitted via G2 EmD. These findings shed light on the multigenerational processes through which SUD influences EmD. PMID:20825999

  9. Greater executive and visual memory dysfunction in comorbid bipolar disorder and substance use disorder

    PubMed Central

    Marshall, David F.; Walker, Sara J.; Ryan, Kelly A.; Kamali, Masoud; Saunders, Erika F.H.; Weldon, Anne L.; Adams, Kenneth M.; McInnis, Melvin G.; Langenecker, Scott A.

    2013-01-01

    Measures of cognitive dysfunction in Bipolar Disorder (BD) have identified state and trait dependent metrics. An influence of substance abuse (SUD) on BD has been suggested. This study investigates potential differential, additive, or interactive cognitive dysfunction in bipolar patients with or without a history of SUD. Two hundred fifty-six individuals with BD, 98 without SUD and 158 with SUD, and 97 Healthy Controls (HC) completed diagnostic interviews, neuropsychological testing, and symptom severity scales. The BD groups exhibited poorer performance than the HC group on most cognitive factors. The BD with SUD exhibited significantly poorer performance than BD without SUD in visual memory and conceptual reasoning/set-shifting. In addition, a significant interaction effect between substance use and depressive symptoms was found for auditory memory and emotion processing. BD patients with a history of SUD demonstrated worse visual memory and conceptual reasoning skills above and beyond the dysfunction observed in these domains among individuals with BD without SUD, suggesting greater impact on integrative, gestalt-driven processing domains. Future research might address longitudinal outcome as a function of BD, SUD, and combined BD/SUD to evaluate neural systems involved in risk for, and effects of, these illnesses. PMID:22769049

  10. Organizing Publicly Funded Substance Use Disorder Treatment in the United States: Moving Toward a Service System Approach.

    PubMed

    Padwa, Howard; Urada, Darren; Gauthier, Patrick; Rieckmann, Traci; Hurley, Brian; Crèvecouer-MacPhail, Desirée; Rawson, Richard A

    2016-10-01

    Historically, publicly funded substance use disorder (SUD) treatment services in the United States have been disorganized and inefficient. By reconfiguring and linking services to create systems of care-services, structures, and processes that are purposively interconnected to treat SUD systematically-health systems can transform discrete service components into cohesive service systems that comprehensively and efficiently treat SUDs. In this article we: (1) articulate the potential benefits of organizing publicly funded SUD services into systems of care; (2) review basic principles underlying theories of SUD system organization; (3) describe the mix and configuration of services needed to create comprehensive, integrated systems of publicly funded SUD care; (4) elucidate how patients can flow through systems of SUD services in a clinically sound and cost-efficient manner, and; (5) propose eight steps that can be taken to create systems of care by identifying and leveraging the strengths, assets, and capacities of SUD service providers already operating within their health care systems. In July 2015, the Centers for Medicare and Medicaid Services (CMS) announced opportunities for states to redesign their Medicaid-funded SUD service systems. This paper provides considerations for SUD system design and development. PMID:27568505

  11. Attention deficit/hyperactivity disorders with co-existing substance use disorder is characterized by early antisocial behaviour and poor cognitive skills

    PubMed Central

    2013-01-01

    Background Attention Deficit/Hyperactivity Disorder (ADHD) is associated with an increased risk of co-existing substance abuse. The Swedish legislation on compulsory healthcare can be applied to persons with severe substance abuse who can be treated involuntarily during a period of six months. This context enables a reliable clinical assessment of ADHD in individuals with severe substance use disorder (SUD). Methods In the context of compulsory care for individuals with severe SUD, male patients were assessed for ADHD, co-morbid psychiatric symptoms, psychosocial background, treatment history, and cognition. The data from the ADHD/SUD group (n = 60) was compared with data from (1) a group of individuals with severe substance abuse without known ADHD (SUD group, n = 120), as well as (2) a group with ADHD from an outpatient psychiatric clinic (ADHD/Psych group, n = 107). Results Compared to the general SUD group in compulsory care, the ADHD/SUD group had already been significantly more often in compulsory care during childhood or adolescence, as well as imprisoned more often as adults. The most common preferred abused substance in the ADHD/SUD group was stimulant drugs, while alcohol and benzodiazepine abuse was more usual in the general SUD group. Compared to the ADHD/Psych group, the ADHD/SUD group reported more ADHD symptoms during childhood and performed poorer on all tests of general intellectual ability and executive functions. Conclusions The clinical characteristics of the ADHD/SUD group differed from those of both the SUD group and the ADHD/Psych group in several respects, indicating that ADHD in combination with SUD is a particularly disabling condition. The combination of severe substance abuse, poor general cognitive ability, severe psychosocial problems, including indications of antisocial behaviour, and other co-existing psychiatric conditions should be considered in treatment planning for adults with ADHD and SUD. PMID:24330331

  12. Substance Use Disorders in Individuals With Body Dysmorphic Disorder

    PubMed Central

    Grant, Jon E.; Menard, William; Pagano, Maria E.; Fay, Christina; Phillips, Katharine A.

    2008-01-01

    Background Little is known about substance use disorders (SUDs) in individuals with body dysmorphic disorder (BDD). Although studies have examined SUD comorbidity in BDD, no previous studies have examined clinical correlates of SUD comorbidity. Method We examined rates and clinical correlates of comorbid SUDs in 176 consecutive subjects with DSM-IV BDD (71% female; mean ± SD age = 32.5 ± 12.3 years). Comorbidity data were obtained with the Structured Clinical Interview for DSM-IV. BDD severity was assessed with the Yale-Brown Obsessive Compulsive Scale Modified for BDD, and delusionality (insight) was assessed with the Brown Assessment of Beliefs Scale. Quality of life and social/occupational functioning were examined using the Social Adjustment Scale, Quality of Life Enjoyment and Satisfaction Questionnaire, Medical Outcomes Study 36-Item Short-Form Health Survey, and Range of Impaired Functioning Tool. All variables were compared in BDD subjects with and without lifetime and current SUDs. Data were collected from January 2001 to June 2003. Results 48.9% of BDD subjects (N = 86) had a lifetime SUD, 29.5% had lifetime substance abuse, and 35.8% had lifetime substance dependence (most commonly, alcohol dependence [29.0%]). 17% (N = 30) had current substance abuse or dependence (9.1 % reported current substance abuse, and 9.7% reported current dependence). 68% of subjects with a lifetime SUD reported that BDD contributed to their SUD. There were far more similarities than differences between subjects with a comorbid SUD and those without an SUD, although those with a lifetime SUD had a significantly higher rate of suicide attempts (p = .004). Conclusion These preliminary results suggest that SUDs are very common in individuals with BDD. Subjects with and without a comorbid SUD were similar in most domains that were examined. PMID:15766296

  13. Male Adolescent Substance Use Disorder and Attention-Deficit Hyperactivity Disorder: A Review of the Literature

    PubMed Central

    Eme, Robert

    2013-01-01

    Approximately, one-third of male adolescents in treatment for a substance use disorder (SUD) also have an Attention-Deficit Hyperactivity Disorder (ADHD). This strongly suggests that ADHD is a major risk factor for the development of SUD which practitioners must address if they are to provide adequate treatment for adolescents with SUD/ADHD. This paper supports a causal role for ADHD in the development of SUD and examines the developmental mechanisms whereby ADHD increases risk for SUD. These mechanisms include increased risk for conduct disorder, academic failure, deviant peer affiliation, engaging in risk behaviors, and self-medication. Assessment and treatment recommendations for those comorbid for SUD/ADHD are provided. PMID:25969828

  14. TRICARE; Mental Health and Substance Use Disorder Treatment. Final rule.

    PubMed

    2016-09-01

    This final rule modifies the TRICARE regulation to reduce administrative barriers to access to mental health benefit coverage and to improve access to substance use disorder (SUD) treatment for TRICARE beneficiaries, consistent with earlier Department of Defense and Institute of Medicine recommendations, current standards of practice in mental health and addiction medicine, and governing laws. This rule seeks to eliminate unnecessary quantitative and non-quantitative treatment limitations on SUD and mental health benefit coverage and align beneficiary cost-sharing for mental health and SUD benefits with those applicable to medical/surgical benefits, expand covered mental health and SUD treatment under TRICARE to include coverage of intensive outpatient programs and treatment of opioid use disorder and to streamline the requirements for mental health and SUD institutional providers to become TRICARE authorized providers, and to develop TRICARE reimbursement methodologies for newly recognized mental health and SUD intensive outpatient programs and opioid treatment programs. PMID:27592499

  15. Bulimia nervosa and substance use disorder: similarities and differences.

    PubMed

    Ram, A; Stein, D; Sofer, S; Kreitler, S

    2008-01-01

    The purpose of this study was to compare bulimia nervosa (BN) and substance use disorders (SUD) in cognitive-motivational terms. The cognitive orientation theory was used as a framework for testing the hypothesis that the commonality between BN and SUD consists of a similar motivational disposition for eating disorders, rather than for addiction, as was previously claimed. It was expected that BN and SUD patients would differ from controls but not from each other. The participants were 31 BN, 20 SUD, and 20 healthy controls. They were administered questionnaires for assessing anxiety, depression, addiction and the cognitive orientation for eating disorders. On most parameters BN and SUD scored higher than controls but did not differ from each other except in norm beliefs. Treatment of BN should consider the similarity of BN to SUD in the pathological tendency for eating disorders. PMID:18443981

  16. Brief Report: Autism Spectrum Disorder and Substance Use Disorder: A Review and Case Study.

    PubMed

    Rengit, Ashy C; McKowen, James W; O'Brien, Julie; Howe, Yamini J; McDougle, Christopher J

    2016-07-01

    There is limited literature available on the comorbidity between autism spectrum disorder (ASD) and substance use disorder (SUD). This paper reviews existing literature and exemplifies the challenges of treating this population with a case report of an adult male with ASD and DSM-5 alcohol use disorder. This review and case study seeks to illustrate risk factors which predispose individuals with ASD to developing SUD and discuss the obstacles to and modifications of evidence-based treatments for SUD. A review of the therapeutic interventions implemented in the treatment of this young male are described to highlight potential recommendations for the general management of SUD in those with ASD. PMID:26944591

  17. Prospective Memory in Substance Abusers at Treatment Entry: Associations with Education, Neuropsychological Functioning, and Everyday Memory Lapses

    PubMed Central

    Weinborn, Michael; Woods, Steven Paul; O'Toole, Stephanie; Kellogg, Emily J.; Moyle, Jonson

    2011-01-01

    Individuals with substance use disorders (SUDs) commonly report lapses in prospective memory (PM) in their daily lives; however, our understanding of the profile and predictors of laboratory-based PM deficits in SUDs and their associations with everyday PM failures is still very preliminary. The current study examined these important questions using well-validated measures of self-report and laboratory-based PM in a mixed cohort of 53 SUD individuals at treatment entry and 44 healthy adults. Consistent with prior research, the SUD group endorsed significantly more self-cued and environmentally based PM failures in their daily lives. Moreover, the SUD group demonstrated significantly lower time-based PM performance, driven largely by cue detection errors. The effect of SUDs on PM was particularly strong among participants with fewer years of education. Within the SUD cohort, time-based PM was correlated with clinical measures assessing executive functions, retrospective memory, and psychomotor speed. Importantly, time-based PM was uniquely associated with elevated PM failures in daily lives of the SUD participants, independent of current affective distress and other neurocognitive deficits. Findings suggest that individuals with SUD are vulnerable to deficits in PM, which may in turn increase their risk for poorer everyday functioning outcomes (e.g., treatment non-compliance). PMID:21903701

  18. Social Workers and Delivery of Evidence-Based Psychosocial Treatments for Substance Use Disorders

    PubMed Central

    WELLS, ELIZABETH A.; KRISTMAN-VALENTE, ALLISON N.; PEAVY, K. MICHELLE; JACKSON, T. RON

    2013-01-01

    Social workers encounter individuals with substance use disorders (SUDs) in a variety of settings. With changes in health care policy and a movement toward integration of health and behavioral health services, social workers will play an increased role vis-a-vis SUD. As direct service providers, administrators, care managers and policy makers, they will select, deliver, or advocate for delivery of evidence-based SUD treatment practices. This paper provides an overview of effective psychosocial SUD treatment approaches. In addition to describing the treatments, the article discusses empirical support, populations for whom the treatments are known to be efficacious, and implementation issues. PMID:23731420

  19. Treatment Strategies for Co-Occurring ADHD and Substance Use Disorders

    PubMed Central

    Mariani, John J.; Levin, Frances R.

    2009-01-01

    Attention-deficit hyperactivity disorder (ADHD) is a common co-occurring mental disorder among patients with substance use disorders (SUD). Clinicians must be cognizant of the complicated nature of diagnosis and treatment of ADHD when comorbid with SUD. Pharmacotherapy remains the mainstay of treatment for ADHD, although complementary psychotherapeutic approaches have been developed. Psychostimulant medications are the most commonly used medications to treat ADHD, but many clinicians are reluctant to prescribe stimulants to patients with SUD. Recommendations for treatment planning and clinical management for patients with co-occurring ADHD and SUD are discussed. PMID:17453606

  20. Psychological dysregulation, white matter disorganization and substance use disorders in adolescence

    PubMed Central

    Clark, Duncan B.; Chung, Tammy; Thatcher, Dawn L.; Pajtek, Stefan; Long, Elizabeth C.

    2011-01-01

    Aims Adolescents with substance use disorders (SUD) have difficulties with cognitive, behavioral and affective regulation. White matter (WM) disorganization has been observed in adolescents with SUD and may be related to psychological dysregulation. This study compared adolescents with SUD and control adolescents to investigate relationships among psychological dysregulation, WM disorganization, and SUD symptoms. Design Cross-sectional observation. Setting Adolescents with SUD were recruited from SUD treatment programs. Controls were recruited from the community. Participants The 55 participants were ages 14–19; 35 with SUD, 20 controls without SUD. Measurements Psychological dysregulation was characterized by the Behavior Rating Inventory of Executive Function. WM disorganization was measured by diffusion tensor imaging, and fractional anisotropy, radial diffusivity and axial diffusivity were examined within cortical regions of interest. Findings Compared to controls, SUD adolescents showed significantly greater psychological dysregulation and prefrontal and parietal WM disorganization. WM disorganization was positively correlated with psychological dysregulation and cannabis-related symptoms. In multivariate mediation models, the results were consistent with both the Neurodevelopmental Immaturity model, in which WM disorganization leads to psychological dysregulation and cannabis-related symptoms, and with the Substance Effects Model, in which cannabis-related symptoms lead to WM disorganization and psychological dysregulation. Conclusions In adolescents, substance use disorder and psychological dysregulation appear to be associated with reduced frontoparietal network white matter maturation. PMID:21752141

  1. Substance use disorders and comorbid Axis I and II psychiatric disorders among young psychiatric patients: findings from a large electronic health records database

    PubMed Central

    Wu, Li-Tzy; Gersing, Ken; Burchett, Bruce; Woody, George E.; Blazer, Dan G.

    2011-01-01

    This study examined the prevalence of substance use disorders (SUDs) among psychiatric patients aged 2–17 years in an electronic health records database (N=11,457) and determined patterns of comorbid diagnoses among patients with a SUD to inform emerging comparative effectiveness research (CER) efforts. DSM-IV diagnoses of all inpatients and outpatients at a large university-based hospital and its associated psychiatric clinics were systematically captured between 2000 and 2010: SUD, anxiety (AD), mood (MD), conduct (CD), attention deficit/hyperactivity (ADHD), personality (PD), adjustment, eating, impulse-control, psychotic, learning, mental retardation, and relational disorders. The prevalence of SUD in the 2–12-year age group (n=6,210) was 1.6% and increased to 25% in the 13–17-year age group (n=5,247). Cannabis diagnosis was the most prevalent SUD, accounting for more than 80% of all SUD cases. Among patients with a SUD (n=1,423), children aged 2–12 years (95%) and females (75–100%) showed high rates of comorbidities; blacks were more likely than whites to be diagnosed with CD, impulse-control, and psychotic diagnoses, while whites had elevated odds of having AD, ADHD, MD, PD, relational, and eating diagnoses. Patients with a SUD used more inpatient treatment than patients without a SUD (43% vs. 21%); children, females, and blacks had elevated odds of inpatient psychiatric treatment. Collectively, results add clinical evidence on treatment needs and diagnostic patterns for understudied diagnoses. PMID:21742345

  2. The Role of Pharmacotherapy in the Treatment of Adolescent Substance Use Disorders.

    PubMed

    Hammond, Christopher J

    2016-10-01

    Adolescent substance use disorders (SUDs) are a significant public health issue due to the associated morbidity, mortality, and societal cost. While effective for some adolescents, psychosocial interventions generally produce small-to-moderate reductions in substance use. Most youth relapse within 12 months of treatment. One approach to improve outcomes is through adjunctive pharmacotherapy. Medication assisted treatments have been shown to improve adult SUD treatment outcomes, and preliminary studies in adolescents suggest that combining medication with psychosocial interventions may also enhance SUD outcomes for youth. This article presents a comprehensive review and grading of the evidence from studies conducted in adolescents with SUDs. PMID:27613346

  3. Association between Substance Use Disorder Status and Pain-Related Function Following 12 Months of Treatment in Primary Care Patients with Musculoskeletal Pain

    PubMed Central

    Morasco, Benjamin J.; Corson, Kathryn; Turk, Dennis C.; Dobscha, Steven K.

    2010-01-01

    The goal of this study was to examine relationships between substance use disorder (SUD) history and 12-month outcomes among primary care patients with chronic noncancer pain (CNCP). Patients were enrolled in a randomized trial of collaborative care intervention (CCI) versus treatment-as-usual (TAU) to improve pain-related physical and emotional function. At baseline, 72 of 362 patients (20.0%) had a history of SUD. Compared to CNCP patients without SUD, those with comorbid SUD had poorer pain-related function and were more likely to meet criteria for current major depression and posttraumatic stress disorder (all p-values<0.05). Logistic regression analyses were conducted to examine whether SUD status was associated with clinically significant change over 12 months in pain-related function (30% reduction in Roland Morris Disability Questionnaire Score). The overall model was not significant in the CCI group. However, within the TAU group, participants with a SUD history were significantly less likely to show improvements in pain-related function (OR=0.30, 95% CI=0.11–0.82). CNCP patients with comorbid SUD reported greater functional impairment at baseline. Patients with SUD who received usual care were 70% less likely to have clinically significant improvements in pain-related function 12 months post-baseline, and SUD status did not impede improvement for the CCI group. Perspective Chronic non-cancer pain patients with a history of a substance use disorder (SUD) report poorer pain-related functioning and are less likely to experience clinically significant improvements from usual pain treatment. Providers should assess for SUD status and provide more intensive interventions for these patients. PMID:20851057

  4. The Effects of PTSD on Treatment Adherence, Drug Relapse, and Criminal Recidivism in a Sample of Incarcerated Men and Women

    ERIC Educational Resources Information Center

    Kubiak, Sheryl Pimlott

    2004-01-01

    Objective/Method: Given the relationship between post-traumatic stress disorder (PTSD) and substance use disorders (SUD), and the prevalence of SUD among offenders, the inattention to trauma before, during, and after incarceration is troubling. This exploratory study compared those with and without co-occurring PTSD among men (n = 139) and women…

  5. Alcohol Medical Scholars Program--A Mentorship Program for Improving Medical Education regarding Substance Use Disorders

    ERIC Educational Resources Information Center

    Neufeld, Karin J.; Schuckit, Marc A.; Hernandez-Avila, Carlos A.

    2011-01-01

    The Alcohol Medical Scholars Program (AMSP) is designed to improve medical education related to substance use disorders (SUDs) through mentorship of junior, full-time academic faculty from medical schools across the United States. Scholarship focuses on literature review and synthesis, lecture development and delivery, increasing SUD education in…

  6. Working with Children of Parents with Substance Use Disorders: Evaluation of a Course Module

    ERIC Educational Resources Information Center

    Wiechelt, Shelly A.; Okundaye, Joshua N.

    2012-01-01

    Social workers are in a position to identify the effects of substance use disorders (SUDs) on children and families and provide appropriate interventions in broad practice contexts. Unfortunately, many social workers are not trained to consider parental SUDs and their effects on children in the assessment process. A course module for training…

  7. Craving among Polysubstance-Using Adolescents

    ERIC Educational Resources Information Center

    Florsheim, Paul; Shiozaki, Teisha; Hiraoka, Regina; Tiffany, Stephen; Heavin, Sarah; Hall, Spencer; Teske, Noelle; Clegg, Carl

    2008-01-01

    The phenomenon of drug craving among adolescents with substance use disorders has been largely overlooked by addiction researchers. This study was designed to: (1) assess craving among adolescents with polysubstance use disorders (SUDs); and (2) examine the association between personality traits and craving among adolescents with SUDs. Craving was…

  8. Evidence for Substance Abuse Services and Policy Research: A Systematic Review of National Databases

    ERIC Educational Resources Information Center

    Coffey, Rosanna M.; Levit, Katharine R.; Kassed, Cheryl A.; McLellan, A. Thomas; Chalk, Mady; Brady, Thomas M.; Vandivort-Warren, Rita

    2009-01-01

    We reviewed 39 national government- and nongovernment-sponsored data sets related to substance addiction policy. These data sets describe patients with substance use disorders (SUDs), treatment providers and the services they offer, and/or expenditures on treatment. Findings indicate the availability of reliable data on the prevalence of SUD and…

  9. The effect of comorbid substance use disorders on treatment outcome for anxiety disorders.

    PubMed

    McEvoy, Peter M; Shand, Fiona

    2008-08-01

    This study examined the impact of concurrent substance use disorders (SUDs) on outcomes for psychotherapy targeting anxiety disorders. Study 1 (N=484) sought to determine the prevalence of SUDs in a sample referred to a community anxiety disorders clinic, as well as the impact of comorbid SUDs on outcomes for a subsample (n=200) completing cognitive behavior therapy (CBT). Around one-quarter (22-29%) of patients with one or two anxiety disorders met criteria for at least one SUD, but this rate was substantially higher (46%) for patients with three anxiety disorders. Concurrent SUDs were associated with higher levels of anxiety but not depression or stress, compared to those without a SUD. However, concurrent SUDs did not moderate treatment outcomes. Study 2 (N=103) focused on the impact of alcohol use on diagnosis-specific symptom measures and generic measures of distress and disability, following a course of CBT for panic disorder or social phobia. Pre-treatment alcohol use did not predict changes in panic symptoms, performance anxiety, distress, or disability, but it did predict changes in social interaction anxiety. Problem drinking per se did not have any predictive utility in terms of treatment outcome. These findings suggest that clinicians treating patients for a primary anxiety disorder and concurrent SUD can be relatively optimistic about treatment outcomes. PMID:18164585

  10. Pharmacological and clinical dilemmas of prescribing in co-morbid adult attention-deficit/hyperactivity disorder and addiction

    PubMed Central

    Pérez de los Cobos, José; Siñol, Núria; Pérez, Víctor; Trujols, Joan

    2014-01-01

    The present article reviews whether available efficacy and safety data support the pharmacological treatment of adult attention-deficit/hyperactivity disorder (ADHD) in patients with concurrent substance use disorders (SUD). Arguments for and against treating adult ADHD with active SUD are discussed. Findings from 19 large open studies and controlled clinical trials show that the use of atomoxetine or extended-release methylphenidate formulations, together with psychological therapy, yield promising though inconclusive results about short term efficacy of these drugs in the treatment of adult ADHD in patients with SUD and no other severe mental disorders. However, the efficacy of these drugs is scant or lacking for treating concurrent SUD. No serious safety issues have been associated with these drugs in patients with co-morbid SUD-ADHD, given their low risk of abuse and favourable side effect and drug–drug interaction profile. The decision to treat adult ADHD in the context of active SUD depends on various factors, some directly related to SUD-ADHD co-morbidity (e.g. degree of diagnostic uncertainty for ADHD) and other factors related to the clinical expertise of the medical staff and availability of adequate resources (e.g. the means to monitor compliance with pharmacological treatment). Our recommendation is that clinical decisions be individualized and based on a careful analysis of the advantages and disadvantages of pharmacological treatment for ADHD on a case-by-case basis in the context of active SUD. PMID:23216449

  11. Psychometric Validation of a Multidimensional Schema of Substance Use Topology: Discrimination of High and Low Risk Youth and Prediction of Substance Use Disorder.

    ERIC Educational Resources Information Center

    Kirisci, Levent; Tarter, Ralph E.

    2001-01-01

    Designs and evaluates a multidimensional schema for the assessment of alcohol, tobacco and other drug use topology. Findings illustrate the value of multidimensional assessment for identifying youth at high risk for substance use disorder (SUD) as well as for elucidating the factors contributing to the transition to suprathreshold SUD. (Contains…

  12. Neural correlates of substance abuse: Reduced functional connectivity between areas underlying reward and cognitive control

    PubMed Central

    Motzkin, Julian C.; Baskin-Sommers, Arielle; Newman, Joseph P.; Kiehl, Kent A.; Koenigs, Michael

    2014-01-01

    Substance use disorders (SUD) have been associated with dysfunction in reward processing, habit formation, and cognitive-behavioral control. Accordingly, neurocircuitry models of addiction highlight roles for nucleus accumbens, dorsal striatum, and prefrontal/anterior cingulate cortex. However, the precise nature of the disrupted interactions between these brain regions in SUD, and the psychological correlates thereof, remain unclear. Here we used magnetic resonance imaging to measure rest-state functional connectivity of three key striatal nuclei (nucleus accumbens, dorsal caudate, dorsal putamen) in a sample of 40 adult male prison inmates (n=22 diagnosed with SUD; n=18 without SUD). Relative to the non-SUD group, the SUD group exhibited significantly lower functional connectivity between the nucleus accumbens and a network of frontal cortical regions involved in cognitive control (dorsal anterior cingulate cortex, dorsolateral prefrontal cortex, and frontal operculum). There were no group differences in functional connectivity for the dorsal caudate or dorsal putamen. Moreover, the SUD group exhibited impairments in laboratory measures of cognitive-behavioral control, and individual differences in functional connectivity between nucleus accumbens and the frontal cortical regions were related to individual differences in measures of cognitive-behavioral control across groups. The strength of the relationship between functional connectivity and cognitive control did not differ between groups. These results indicate that SUD is associated with abnormal interactions between subcortical areas that process reward (nucleus accumbens) and cortical areas that govern cognitive-behavioral control. PMID:24510765

  13. Behavioral assessment of impulsivity in pathological gamblers with and without substance use disorder histories versus healthy controls

    PubMed Central

    Ledgerwood, David M.; Alessi, Sheila M.; Phoenix, Natalie; Petry, Nancy M.

    2009-01-01

    Pathological gamblers (PGs) may have high levels of impulsivity, and a correlation between substance use disorders (SUD) and impulsivity is well established. However, only a handful of studies have attempted to assess impulsivity and other impulse-spectrum traits (e.g., sensation seeking) using a variety of behavioral and self-report measures in PGs and few examined the independent impact of SUDs. We compared 30 PGs without SUD histories, 31 PGs with SUD histories and 40 control participants on self-reported impulsivity, delayed discounting, attention/memory, response inhibition, risk taking, sensation seeking and distress tolerance measures. PGs, regardless of SUD history, discounted delayed rewards at greater rates than controls. PGs also reported acting on the spur of the moment, experienced trouble planning and thinking carefully, and noted greater attention difficulties than controls. PGs with SUD took greater risks on a risk-taking task than did PGs without SUD histories, but the two groups did not differ on any other measures of impulsivity. We conclude that PGs are more impulsive than non-problem gamblers in fairly specific ways, but PGs with and without SUD histories differ on few measures. More research should focus on specific ways in which PGs exhibit impulsivity to better address impulsive behaviors in treatment. PMID:19615829

  14. Substance Use Disorders in Men Presenting to a Psychosexual Clinic

    PubMed Central

    Rajkumar, Ravi Philip

    2014-01-01

    Introduction. Substance use disorders (SUDs) are commonly associated with a variety of psychiatric disorders. Community-based studies have found a significant association between SUDs and sexual dysfunction in men, with a possible causal relation in the case of nicotine. Methods. The case records of 105 men presenting to a clinic for patients with psychosexual disorders were reviewed. Men with and without comorbid SUDs were compared in terms of demographic, clinical, and familial variables. Results. 25 of the 105 men (23.8%) had a lifetime diagnosis of SUD, and 19 (18.1%) had a current SUD. The commonest substances involved were nicotine (n = 21, 20%) and alcohol (n = 9, 9.5%). Men with comorbid SUDs were more likely to report a family history of substance dependence, particularly alcoholism. Single men with SUDs were more likely to have a comorbid mood disorder. Conclusion. SUDs, particularly nicotine and alcohol use disorders, are common comorbidities in patients with psychosexual disorders. Identifying and treating these disorders in this population are important aspects of management. PMID:25938122

  15. Reduced Functional Connectivity within the Mesocorticolimbic System in Substance Use Disorders: An fMRI Study of Puerto Rican Young Adults

    PubMed Central

    Posner, Jonathan; Amira, Leora; Algaze, Antonio; Canino, Glorisa; Duarte, Cristiane S.

    2016-01-01

    Studies of the mesocorticolimbic reward system (MCLS) and its relationship with impulsivity and substance use disorders (SUD) have largely focused on individuals from non-minority backgrounds. This represents a significant gap in the literature particularly for minority populations who are disproportionately affected by the consequences of SUD. Using resting-state functional MRI (fMRI), we examined the coherence of neural activity, or functional connectivity, within the brain’s MCLS in 28 young adult Puerto Ricans (ages 25–27) who were part of a population-based cohort study. Half of the sample lived in San Juan, Puerto Rico; the other half lived in the South Bronx, New York. At each of the two sites, half of the sample had a history of a SUD. Relative to those without SUD, individuals with SUD had decreased connectivity between the nucleus accumbens (NAcc) and several regions within the MCLS. This finding was true irrespective of study site (i.e., San Juan or South Bronx). Reduced connectivity within the MCLS was also associated with higher self-reported levels of impulsivity. Path analysis suggested a potential mechanism linking impulsivity, the MCLS, and SUD: impulsivity, potentially by chronically promoting reward seeking behaviors, may contribute to decreased MCLS connectivity, which in turn, may confer vulnerability for SUD. Expanding upon prior studies suggesting that alterations within the MCLS underlie SUD, our findings suggest that such alterations are also related to impulsivity and are present in a high-risk young minority population. PMID:27252633

  16. Does Temperament Moderate Treatment Response in Adolescent Substance Use Disorders?

    ERIC Educational Resources Information Center

    Burleson, Joseph A.; Kaminer, Yifrah

    2008-01-01

    To assess whether temperament moderates response to treatment for substance use disorders (SUD), n = 88 consecutively referred adolescents with SUD were randomized to cognitive-behavioral (CBT) or psychoeducational (PET) therapies. Principal components analyses reduced the 10-attribute Dimensions of Temperament Revised (DOTS-R) to three factors…

  17. Mapping the Clinical Complexities of Adolescents with Substance Use Disorders: A Typological Study

    ERIC Educational Resources Information Center

    Meyers, Kathleen; McDermott, Paul A.; Webb, Alicia; Hagan, Teresa Ann

    2006-01-01

    Because of the vast improvements in adolescent substance use assessment, it is widely recognized that adolescent substance use disorders (SUD) encompasses diverse drugs, patterns and etiologies and are characterized by extensive heterogeneity in other life domains. The next step in advancing adolescent SUD assessment is to classify adolescents…

  18. Temperament disturbances measured in infancy progress to substance use disorder 20 years later

    PubMed Central

    Horner, Michelle S.; Reynolds, Maureen; Braxter, Betty; Kirisci, Levent; Tarter, Ralph E.

    2016-01-01

    Objective This prospective study determined whether temperament before two years of age predicts transmissible risk for substance use disorder (SUD) up to a decade later and SUD outcome in adulthood. Method Boys between 10 and 12 years of age (N = 482) were tracked to age 22. The previously validated transmissible liability index (TLI) was administered at baseline, and temperament prior to two years of age was retrospectively rated. The Structured Clinical Interview for DSM-III-R (SCID) was administered to document presence/absence of SUD for parents at baseline and sons at age 22. Results Path analysis revealed that number of parents with SUD predicted severity of temperament disturbance in their sons which in turn predicted TLI score at age 10–12, presaging SUD. Temperament before age two did not predict SUD at age 22. The association between number of SUD parents and transmissible risk was mediated by severity of temperament disturbance. Conclusion Temperament disturbance in early childhood, reflecting quality of behavioral and emotion regulation, comprise psychological antecedents of transmissible risk for SUD. PMID:26900197

  19. Evaluation of a Substance Use Disorder Curriculum for Internal Medicine Residents

    ERIC Educational Resources Information Center

    Stein, Melissa R.; Arnsten, Julia H.; Parish, Sharon J.; Kunins, Hillary V.

    2011-01-01

    Teaching about diagnosis, treatment, and sequelae of substance use disorders (SUDs) is insufficient in most Internal Medicine residency programs. To address this, the authors developed, implemented, and evaluated a novel and comprehensive SUD curriculum for first year residents (interns) in Internal Medicine, which anchors the ensuing 3-year…

  20. Risk of Substance Use Disorders in Adolescents with Bipolar Disorder

    ERIC Educational Resources Information Center

    Wilens, Timothy E.; Biederman, Joseph; Kwon, Anne; Ditterline, Jeffrey; Forkner, Peter; Moore, Hadley; Swezey, Allison; Snyder, Lindsey; Henin, Aude; Wozniak, Janet; Faraone, Stephen V.

    2004-01-01

    Objective: Previous work in adults and youths has suggested that juvenile onset bipolar disorder (BPD) is associated with an elevated risk of substance use disorders (SUD). Considering the public health importance of this issue, the authors now report on a controlled study of adolescents with and without BPD to evaluate the risk of SUD. Method:…

  1. Video-Based Cognitive Behavioral Therapy Module as a Supplemental Treatment in a V.A. Residential Substance Use Disorder Therapeutic Community

    ERIC Educational Resources Information Center

    Scheer, David

    2012-01-01

    Substance use disorders (SUDs) are one of the most prevalent psychiatric disorders among adults in the United States. For men, SUDs have the highest lifetime prevalence (33-35.4%) of any psychiatric disorder, and, for women, the lifetime prevalence is 17.9-20% (Conway et al., 2006; Kessler et al., 1994). There are many effective treatments for SUD…

  2. A One-Session Human Immunodeficiency Virus Risk-Reduction Intervention in Adolescents with Psychiatric and Substance Use Disorders

    ERIC Educational Resources Information Center

    Thurstone, Christian; Riggs, Paula D.; Klein, Constance; Mikulich-Gilbertson, Susan K.

    2007-01-01

    Objective: To explore change in human immunodeficiency virus (HIV) risk among teens in outpatient treatment for substance use disorders (SUDs). Method: From December 2002 to August 2004, 50 adolescents (13-19 years) with major depressive disorder, conduct disorder, and one or more non-nicotine SUD completed the Teen Health Survey (THS) at the…

  3. Randomized, Controlled Trial of Atomoxetine for Attention-Deficit/Hyperactivity Disorder in Adolescents with Substance Use Disorder

    ERIC Educational Resources Information Center

    Thurstone, Christian; Riggs, Paula D.; Salomonsen-Sautel, Stacy; Mikulich-Gilbertson, Susan K.

    2010-01-01

    Objective: To evaluate the effect of atomoxetine hydrochloride versus placebo on attention-deficit/hyperactivity disorder (ADHD) and substance use disorder (SUD) in adolescents receiving motivational interviewing/cognitive behavioral therapy (MI/CBT) for SUD. Method: This single-site, randomized, controlled trial was conducted between December…

  4. Childhood Maltreatment and Conduct Disorder: Independent Predictors of Adolescent Substance Use Disorders in Youth with Attention Deficit/Hyperactivity Disorder

    ERIC Educational Resources Information Center

    De Sanctis, Virginia A.; Trampush, Joey W.; Harty, Seth C.; Marks, David J.; Newcorn, Jeffrey H.; Miller, Carlin J.; Halperin, Jeffrey M.

    2008-01-01

    Children with attention deficit/hyperactivity disorder (ADHD) are at heightened risk for maltreatment and later substance use disorders (SUDs). We investigated the relationship of childhood maltreatment and other risk factors to SUDs among adolescents diagnosed with ADHD in childhood. Eighty adolescents diagnosed with ADHD when they were 7 to 11…

  5. Suicidality in Offspring of Men with Substance Use Disorder: Is There a Common Liability?

    ERIC Educational Resources Information Center

    Cornelius, Jack; Kirisci, Levent; Tarter, Ralph E.

    2001-01-01

    The results reported herein indicate that psychological dysregulation in childhood is a risk factor for substance use disorder (SUD) but not suicidality. Offspring of men with SUD do, however, report a higher rate of suicidal ideation and attempts compared to offspring of psychiatrically normal men. (Contains 28 references and 4 tables.) (GCP)

  6. Counselor Attitudes toward and Use of Evidence-Based Practices in Private Substance Use Disorder Treatment Centers: A Comparison of Social Workers and Non-Social Workers

    ERIC Educational Resources Information Center

    Bride, Brian E.; Kintzle, Sara; Abraham, Amanda J.; Roman, Paul M.

    2012-01-01

    The purpose of this study was to examine factors that may be associated with variation in social workers' perceptions of effectiveness, perceptions of acceptability, and use of psychosocial evidence-based practices (EBPs) for the treatment of substance use disorders (SUD) in comparison to other SUD counselors who are non-social workers. A national…

  7. 75 FR 69079 - Notice of Agreements Filed

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-10

    ...: A.P. Moller-Maersk A/S; CMA CGM S.A.; Compania Chilena de Navegacion Interoceanica S.A.; Hamburg-Sud... Agreement. Parties: Compania Sud Americana De Vapores S.A. and Hoegh Autoliners AS. Filing Parties: Walter...

  8. 75 FR 80499 - Notice of Agreement Filed

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-22

    .... Moller-Maersk A/S; CMA CGM S.A.; Compania Chilena de Navegacion Interoceanica S.A.; Hamburg- Sud; Hapag...; Washington, DC 20006. Synopsis: The amendment adds Compania Sud Americana de Vapores S.A. as a party to...

  9. Clinical Characteristics and Staff Training Needs of Two Substance Use Disorder Treatment Programs Specialized for Persons with Disabilities

    ERIC Educational Resources Information Center

    Moore, Dennis; Lorber, Cathy

    2004-01-01

    The clinical aspects and staff training needs for two substance use disorder (SUD) treatment programs that serve persons with co-existing disabilities are described. The article addresses SUD prevalence among persons with disabilities and the corresponding specialized treatment needs and accommodations that may be necessary. The philosophical…

  10. The Effects of Spirituality and Religiosity on Child Neglect in Substance Use Disorder Families

    ERIC Educational Resources Information Center

    Stewart, Chris; Mezzich, Ada C.

    2006-01-01

    The role of spirituality and religiosity in neglect etiology is unknown. Further, the effects of these factors may be influenced by existing familial substance use disorder (SUD). This study examined the role of spirituality as conceptualized multidimensionally, in parental child neglect. A sample of 100 (40 SUD; 60 Control) intact families were…

  11. Exposure Therapy for Substance Abusers with PTSD: Translating Research to Practice

    ERIC Educational Resources Information Center

    Coffey, Scott F.; Schumacher, Julie A.; Brimo, Marcella L.; Brady, Kathleen T.

    2005-01-01

    Epidemiological research indicates that there is substantial comorbidity between posttraumatic stress disorder (PTSD) and substance use disorder (SUD). Moreover, there is growing evidence that having a comorbid PTSD diagnosis is associated with greater substance use problem severity and poorer outcomes from SUD treatment. In an attempt to improve…

  12. Treating Child Abuse-Related Posttraumatic Stress and Comorbid Substance Abuse in Adolescents

    ERIC Educational Resources Information Center

    Cohen, Judith A.; Mannarino, Anthony P.; Zhitova, Aren C.; Capone, Margery E.

    2003-01-01

    Objective: Child abuse is a risk factor for developing Posttraumatic Stress Disorder (PTSD) and subsequent Substance Use Disorder (SUD). The purpose of this review is to summarize current knowledge about effective treatments for adolescent abuse-related PTSD, SUD, and the co-occurrence of these conditions. Method: The literature on empirical…

  13. Posttraumatic Stress Disorder and Substance Use Disorders in College Students

    ERIC Educational Resources Information Center

    Borsari, Brian; Read, Jennifer P.; Campbell, James F.

    2008-01-01

    Research indicates that many college students report posttraumatic stress disorder (PTSD) or substance use disorder (SUD), yet there has been scant attention paid to the co-occurrence of these disorders in college students. This review examines the co-occurrence of PTSD and SUD in college students. Recommendations for counseling centers are…

  14. Integrating Treatment of Posttraumatic Stress Disorder and Substance Use Disorder

    ERIC Educational Resources Information Center

    Ford, Julian D.; Russo, Eileen M.; Mallon, Sharon D.

    2007-01-01

    Historically, administrators and clinicians have been hesitant to address posttraumatic stress disorder (PTSD) in the treatment of substance use disorders (SUDs). However, research shows that SUD treatment recruitment and outcomes may be adversely affected if co-occurring PTSD is left untreated. The authors provide guidelines for screening and…

  15. Patterns in Referral and Admission to Vocational Rehabilitation Associated with Coexisting Psychiatric and Substance-Use Disorders.

    ERIC Educational Resources Information Center

    Drebing, Charles E.; Rosenheck, Robert; Schutt, Russell; Kasprow, Wesley J.; Penk, Walter

    2003-01-01

    Studies homeless adults entering the Healthcare for Homeless Veterans program to identify whether the rate of referral and admission to vocational rehabilitation differed between adults with psychiatric disorders and those with a coexisting substance-use disorder (SUD). Participants with an SUD had an 11% greater chance of being referred to…

  16. Treatment of Adolescent Substance Use Disorders and Co-Occurring Internalizing Disorders: A Critical Review and Proposed Model

    PubMed Central

    Hulvershorn, Leslie A.; Quinn, Patrick D.; Scott, Eric L.

    2016-01-01

    Background The past several decades have seen dramatic growth in empirically supported treatments for adolescent substance use disorders (SUDs), yet even the most well-established approaches struggle to produce large or long-lasting improvements. These difficulties may stem, in part, from the high rates of comorbidity between SUDs and other psychiatric disorders. Method We critically reviewed the treatment outcome literature for adolescents with co-occurring SUDs and internalizing disorders. Results Our review identified components of existing treatments that might be included in an integrated, evidence-based approach to the treatment of SUDs and internalizing disorders. An effective program may involve careful assessment, inclusion of parents or guardians, and tailoring of interventions via a modular strategy. Conclusions The existing literature guides the development of a conceptual evidence-based, modular treatment model targeting adolescents with co-occurring internalizing and SUDs. With empirical study, such a model may better address treatment outcomes for both disorder types in adolescents. PMID:25973718

  17. Treatments for Adolescents with Comorbid Attention-Deficit/Hyperactivity Disorder and Substance Use Disorder: A Systematic Review

    PubMed Central

    Zaso, Michelle J.; Park, Aesoon; Antshel, Kevin M.

    2015-01-01

    Objective Comorbid attention-deficit/hyperactivity disorder (ADHD) and substance use disorder (SUD) presents frequently in adolescence, a developmental period that may promote the emergence of substance misuse among individuals with ADHD. Comorbid ADHD and SUD in adolescence results in significant and unique treatment challenges, necessitating examination into effective interventions. Method This systematic review examined existing research into the treatment of comorbid adolescent ADHD and SUD. Results Findings from a small number of pharmacological intervention studies suggest potential efficacy of extended-release stimulant and nonstimulant medications. Efficacy of psychotherapeutic interventions has not been systematically examined. Conclusions Current research on treatments for comorbid ADHD and SUD in adolescence is limited. Future placebo-controlled clinical trials using large samples are needed to examine the efficacy of psychotherapeutic interventions, the heightened risk of prescription stimulant misuse, and the long-term maintenance of treatment gains in this population. Clinical guidelines for the treatment of comorbid ADHD and SUD are discussed. PMID:25655767

  18. Neurobehavior disinhibition, parental substance use disorder, neighborhood quality and development of cannabis use disorder in boys☆

    PubMed Central

    Ridenour, Ty A.; Tarter, Ralph E.; Reynolds, Maureen; Mezzich, Ada; Kirisci, Levent; Vanyukov, Michael

    2009-01-01

    This prospective investigation examined the contribution of neighborhood context and neurobehavior disinhibition to the association between substance use disorder (SUD) in parents and cannabis use disorder in their sons. It was hypothesized that both neighborhood context and son’s neurobehavior disinhibition mediate this association. Two hundred and sixteen boys were tracked from ages 10–12 to age 22. The extent to which neighborhood context and neurobehavior disinhibition mediate the association between parental SUD and son’s cannabis use disorder was evaluated using structural equation modeling. The best fitting model positioned neighborhood context and neurobehavior disinhibition as mediators of the association between parental SUD and cannabis use disorder in sons. Neurobehavior disinhibition also was a mediator of the association between neighborhood context and son’s cannabis use. The implications of this pattern of association between parental SUD, neighborhood context and individual risk for SUD for improving prevention are discussed. PMID:19268495

  19. A Primer on the Genetics of Comorbid Eating Disorders and Substance Use Disorders.

    PubMed

    Munn-Chernoff, Melissa A; Baker, Jessica H

    2016-03-01

    Eating disorders (EDs) and substance use disorders (SUDs) frequently co-occur; however, the reasons for this are unclear. We review the current literature on genetic risk for EDs and SUDs, as well as preliminary findings exploring whether these classes of disorders have overlapping genetic risk. Overall, genetic factors contribute to individual differences in liability to multiple EDs and SUDs. Although initial family studies concluded that no shared familial (which includes genetic) risk between EDs and SUDs exists, twin studies suggest a moderate proportion of shared variance is attributable to overlapping genetic factors, particularly for those EDs characterized by binge eating and/or inappropriate compensatory behaviours. No adoption or molecular genetic studies have examined shared genetic risk between these classes of disorders. Research investigating binge eating and inappropriate compensatory behaviours using emerging statistical genetic methods, as well as examining gene-environment interplay, will provide important clues into the aetiology of comorbid EDs and SUDs. PMID:26663753

  20. Association among parental substance use disorder, p300 amplitude, and neurobehavioral disinhibition in preteen boys at high risk for substance use disorder.

    PubMed

    Habeych, Miguel E; Sclabassi, Robert J; Charles, Prophete J; Kirisci, Levent; Tarter, Ralph E

    2005-06-01

    The P300 amplitude of the event-related potential as a mediator of the association between parental substance use disorder (SUD) and child's neurobehavioral disinhibition was assessed. The P300 amplitude was recorded using an oddball task in sons of fathers having either lifetime SUD (n = 105) or no psychiatric disorder (n = 160). Neurobehavioral disinhibition was assessed using measures of affect regulation, behavior control, and executive cognitive function. Parental SUD and child's P300 amplitude accounted for, respectively, 16.6% and 16.8% of neurobehavioral disinhibition variance. Controlling for parental and child psychopathology, an association between parental SUD and child's P300 amplitude was not observed. It was concluded that the P300 amplitude does not mediate the association between parental SUD and child's neurobehavioral disinhibition. PMID:16011382

  1. Maintenance of Access as Demand for Substance Use Disorder Treatment Grows

    PubMed Central

    Frakt, Austin B.; Trafton, Jodie; Pizer, Steven D.

    2015-01-01

    Due to the Affordable Care Act and other recent laws and regulations, funding for substance use disorder (SUD) treatment is on the rise. In the 2000s, the Veterans Health Administration (VA) implemented several initiatives that increased funding for SUD treatment during a period of growth in demand for it. A key question is whether access to and intensity of treatment kept pace or declined. Using VA SUD treatment funding data and patient-level records to construct performance measures, we studied the relationship between funding and access during the VA expansion. Overall, we observed an increase in access to and intensity of VA SUD care associated with increased funding. The VA was able to increase funding for and expand the population to which it offered SUD treatment without diminishing internal access and intensity. PMID:25795602

  2. Reward-system effect (BAS rating), left hemispheric "unbalance" (alpha band oscillations) and decisional impairments in drug addiction.

    PubMed

    Balconi, Michela; Finocchiaro, Roberta; Canavesio, Ylenia

    2014-06-01

    The current research explored the impact of cortical frontal asymmetry (left-lateralization effect) and Behavioral Activation System (BAS) on Substance Use Disorder (SUD) in decisional processes using the Iowa Gambling Task (IGT). Forty SUD participants and forty-two controls (CG) were tested using the IGT. Behavioral responses (gain/loss options), BIS/BAS scores and lateralized alpha band modulation (LTA) were considered. The SUD group increased the tendency to opt in favor of the immediate reward (loss strategy) more than the long-term option (win strategy) compared to the CG. Secondly, higher reward-subscale scores were observed in SUD. Thirdly, SUD showed an increase in left-hemisphere activation in response to losing (with immediate reward) choices in comparison with the CG. An imbalanced left hemispheric effect related to higher BAS trait could explain this "reward bias," because these components were found to explain (through the regression analysis) the main behavioral deficits. PMID:24629323

  3. Comparison of treatment outcomes in severe personality disorder patients with or without substance use disorders: a 36-month prospective pragmatic follow-up study

    PubMed Central

    Lana, Fernando; Sánchez-Gil, Carmen; Adroher, Núria D; Pérez, Víctor; Feixas, Guillem; Martí-Bonany, Josep; Torrens, Marta

    2016-01-01

    Background Concurrent personality disorder (PD) and substance use disorder (SUD) are common in clinical practice. However, SUD is the main criterion for study exclusion in most psychotherapeutic studies of PD. As a result, data on treatment outcomes in patients with concurrent PD/SUD are scarce. Methods The study sample consisted of 51 patients diagnosed with severe PD and admitted for psychotherapeutic treatment as a part of routine mental health care. All patients were diagnosed with PD according to the Structured Clinical Interview for PD. Patients were further assessed (DSM-IV diagnostic criteria) to check for the presence of concurrent SUD, with 28 patients diagnosed with both disorders (PD-SUD). These 28 cases were then compared to the 23 patients without SUD (PD-nSUD) in terms of psychiatric hospitalizations and psychiatric emergency room (ER) visits before and during the 6-month therapeutic intervention and every 6 months thereafter for a total of 36 months. Results The baseline clinical characteristics correspond to a sample of PD patients (78% met DSM-IV criteria for borderline PD) with poor general functioning and a high prevalence of suicide attempts and self-harm behaviors. Altogether, the five outcome variables – the proportion and the number of psychiatric inpatient admissions, the number of days hospitalized, and the proportion and the number of psychiatric ER visits – improved significantly during the treatment period, and this improvement was maintained throughout the follow-up period. Although PD-SUD patients had more psychiatric hospitalizations and ER visits than PD-nSUD patients during follow-up, the differences between these two groups remained stable over the study period indicating that the treatment was equally effective in both groups. Conclusion Specialized psychotherapy for severe PD can be effectively applied in patients with concurrent PD-SUD under usual practice conditions. These findings suggest that exclusion of patients with

  4. Comorbidity of PTSD, Major Depression, and Substance Use Disorder among Adolescent Victims of the Spring 2011 Tornadoes in Alabama and Joplin, Missouri

    PubMed Central

    Adams, Zachary W.; Danielson, Carla Kmett; Sumner, Jennifer A.; McCauley, Jenna L.; Cohen, Joseph R.; Ruggiero, Kenneth J.

    2015-01-01

    Objective The purpose of this study was two-fold: (1) to estimate the prevalence of comorbid posttraumatic stress disorder (PTSD), major depressive episode (MDE), and substance use disorder (SUD), and (2) to identify risk factors for patterns of comorbidity among adolescents affected by disasters. Method A population-based sample of 2,000 adolescents (51% female; 71% Caucasian, 26% African-American) aged 12–17 years (M=14.5, SD=1.7) and their parents was recruited from communities affected by the Spring 2011 tornadoes in Alabama and Joplin, Missouri. Participants completed structured telephone interviews assessing demographic characteristics, impact of disaster, prior trauma history, DSM-IV symptoms of PTSD and MDE, and SUD symptoms. Prevalence estimates were calculated for PTSD+MDE, PTSD+SUD, MDE+SUD, and PTSD+MDE+SUD. Hierarchical logistic regression was used to identify risk factors for each comorbidity profile. Results Overall prevalence since the tornado was 3.7% for PTSD+MDE, 1.1% for PTSD+SUD, 1.0% for MDE+SUD, and 0.7% for PTSD+MDE+SUD. Girls were significantly more likely than boys to meet criteria for PTSD+MDE and MDE+SUD (ps < .05). Female gender, exposure to prior traumatic events, and persistent loss of services were significant risk factors for patterns of comorbidity. Parental injury was associated with elevated risk for PTSD+MDE. Adolescents should be evaluated for comorbid problems, including SUD, following disasters so that appropriate referrals to evidence-based treatments can be made. Conclusions Results suggest that screening procedures to identify adolescents at risk for comorbid disorders should assess demographic characteristics (gender), impact of the disaster on the family, and adolescents’ prior history of stressful events. PMID:26168094

  5. Quality of Life in Patients with Substance Use Disorders Admitted to Detoxification Compared with Those Admitted to Hospitals for Medical Disorders: Follow-Up Results

    PubMed Central

    Vederhus, John-Kåre; Pripp, Are Hugo; Clausen, Thomas

    2016-01-01

    Quality of life (QoL) in patients admitted to a general hospital was compared with those admitted to a detoxification unit for the treatment of substance use disorder (SUD). This study combines data from two separate data collections: a cross-sectional study in a general hospital unit (somatic sample, N = 519) and a follow-up study in a detoxification unit (SUD sample, N = 140). A total of 659 patients recruited during 2008–2013 were included in this study. All patients completed a generic QoL questionnaire at inclusion, and the SUD sample also completed it at the six-month follow-up. SUD patients experienced comparably low physical QoL and had significantly lower psychological, social, and existential QoL domain scores when compared with the somatic sample. Mental distress and having a SUD were the major factors explaining variations in QoL, with both influencing QoL negatively. In the SUD sample, QoL improved moderately at the six-month follow-up with less improvement for the domain relationship to a partner. To facilitate the recovery of SUD patients, clinicians must view their patients’ situation holistically and invest efforts into the different life domains affected by poor QoL. PMID:27226719

  6. Substance use in severe mental illness: self-medication and vulnerability factors.

    PubMed

    Bizzarri, Jacopo Vittoriano; Rucci, Paola; Sbrana, Alfredo; Miniati, Mario; Raimondi, Federica; Ravani, Laura; Massei, Guido Jacopo; Milani, Francesca; Milianti, Marta; Massei, Gabriele; Gonnelli, Chiara; Cassano, Giovanni Battista

    2009-01-30

    The aim of this article is to examine the onset and clinical correlates of substance use in patients with psychotic disorders. One hundred and eight inpatients and outpatients with DSM-IV psychotic disorders were evaluated with the SCI-SUBS, an instrument designed to explore the spectrum of substance use and its clinical correlates. Comparisons were made between subjects with (n=47) and without (n=61) a DSM-IV diagnosis of substance use disorder (SUD). In patients with an early onset of psychosis (<17 years), the onset of SUD was subsequent. Patients with SUD had higher substance sensitivity, higher sensation-seeking traits and were more likely to self-medicate than patients without SUD. The reasons for self-medication endorsed by patients with SUD included relieving depression, achieving or maintaining euphoria, improving self-confidence and social abilities. Our results, based on a cross-sectional study, suggest that early onset of psychosis, substance sensitivity and sensation-seeking traits represent vulnerability factors for SUD. The relationships between SUD and psychosis should be examined systematically and clarified in longitudinal studies. PMID:19054572

  7. Sex differences in substance use disorders: focus on side effects.

    PubMed

    Agabio, Roberta; Campesi, Ilaria; Pisanu, Claudia; Gessa, Gian Luigi; Franconi, Flavia

    2016-09-01

    Although sex differences in several aspects of substance use disorders (SUDs) have been identified, less is known about the importance of possible sex differences in side effects induced by substances of abuse or by medications used to treat SUDs. In the SUD field, the perception of certain subjective effects are actively sought, while all other manifestations might operationally be considered side effects. This article was aimed at reviewing sex differences in side effects induced by alcohol, nicotine, heroin, marijuana and cocaine and by medications approved for alcohol, nicotine and heroin use disorders. A large body of evidence suggests that women are at higher risk of alcohol-induced injury, liver disease, cardiomyopathy, myopathy, brain damages and mortality. The risk of tobacco-induced coronary heart disease, lung disease and health problems is higher for women than for men. Women also experience greater exposure to side effects induced by heroin, marijuana and cocaine. In addition, women appear to be more vulnerable to the side effects induced by medications used to treat SUDs. Patients with SUDs should be advised that the risk of developing health problems may be higher for women than for men after consumption of the same amount of substances of abuse. Doses of medications for SUD women should be adjusted at least according to body weight. The sex differences observed also indicate an urgent need to recruit adequate numbers of female subjects in pre-clinical and clinical studies to improve our knowledge about SUDs in women. PMID:27001402

  8. Substance use disorder patient privacy and comprehensive care in integrated health care settings.

    PubMed

    Schaper, Elizabeth; Padwa, Howard; Urada, Darren; Shoptaw, Steven

    2016-02-01

    The Affordable Care Act (ACA) expands health insurance coverage for substance use disorder (SUD) treatment, underscoring the value of improving SUD service integration in primarily physical health care settings. It is not yet known to what degree specialized privacy regulations-Code of Federal Regulations Title 42, Part 2 (42 CFR Part 2), in particular-will affect access to or the utilization and delivery of SUD treatment in primary care. In addition to exploring the emerging benefits and barriers that specialized confidentiality regulations pose to treatment in early adopting integrated health care settings, this article introduces and explicates 42 CFR Part 2 to support provider and administrator implementation of SUD privacy regulations in integrated settings. The authors also argue that, although intended to protect patients with SUD, special SUD information protection may inadvertently reinforce stigma against patients by purporting the belief that SUD is different from other health problems and must be kept private. In turn, this stigma may inhibit the delivery of comprehensive integrated care. PMID:26845493

  9. Patient and program factors that bridge the detoxification-treatment gap: a structured evidence review.

    PubMed

    Timko, Christine; Below, Maureen; Schultz, Nicole R; Brief, Deborah; Cucciare, Michael A

    2015-05-01

    Although completion of detoxification (detox) and a successful transition from detox to substance use disorder (SUD) treatment and/or mutual-help groups are associated with better SUD outcomes, many patients do not complete detox or do not receive SUD care following detox. The purpose of this structured evidence review, summarizing data extraction on a yield of 26 articles, is to identify patient, program, and system factors associated with the outcomes of completion of alcohol detox and successful transitions from alcohol detox to SUD treatment and mutual-help group participation. The review found wide variability among studies in the rates at which patients complete a detox episode (45 to 95%) and enter SUD treatment or mutual-help groups after detox (14 to 92%). Within program factors, behavioral practices that contribute to both detox completion and transitioning to SUD care after detox entail involving the patient's family and utilizing motivational-based approaches. Such practices should be targeted at younger patients, who are less likely to complete detox. Although more studies using a randomized controlled trial design are needed, the evidence suggests that barriers to detox completion and transition to SUD care can be overcome to improve patient outcomes. PMID:25530425

  10. Compulsive features in behavioral addictions: the case of pathological gambling

    PubMed Central

    el-Guebaly, Nady; Mudry, Tanya; Zohar, Joseph; Tavares, Hermano; Potenza, Marc N.

    2011-01-01

    Aims To describe, in the context of DSM-V, how a focus on addiction and compulsion is emerging in the consideration of pathological gambling (PG). Methods A systematic literature review of evidence for the proposed re-classification of PG as an addiction. Results Findings include: 1. Phenomenological models of addiction highlighting a motivational shift from impulsivity to compulsivity associated with a protracted withdrawal syndrome and blurring of the ego-syntonic/ego-dystonic dichotomy; 2. Common neurotransmitter (dopamine, serotonin) contributions to PG and substance use disorders (SUDs); 3. Neuroimaging support for shared neurocircuitries between “behavioral” and substance addictions and differences between obsessive-compulsive disorder (OCD), impulse control disorders (ICDs) and SUDs; 4. Genetic findings more closely related to endophenotypic constructs like compulsivity and impulsivity than to psychiatric disorders; 5. Psychological measures such as harm avoidance identifying a closer association between SUDs and PG than with OCD; 6. Community and pharmaco-therapeutic trials data supporting a closer association between SUDs and PG than with OCD. Adapted behavioral therapies, such as exposure therapy appear applicable to OCD, PG, or SUDs, suggesting some commonalities across disorders. Conclusions PG shares more similarities with SUDs than with OCD. Similar to the investigation of impulsivity, studies of compulsivity hold promising insights concerning the course, differential diagnosis and treatment of PG, SUDs, and OCD. PMID:21985690

  11. Dopamine and serotonin genetic risk scores predicting substance and nicotine use in attention deficit/hyperactivity disorder.

    PubMed

    Groenman, Annabeth P; Greven, Corina U; van Donkelaar, Marjolein M J; Schellekens, Arnt; van Hulzen, Kimm J E; Rommelse, Nanda; Hartman, Catharina A; Hoekstra, Pieter J; Luman, Marjolein; Franke, Barbara; Faraone, Stephen V; Oosterlaan, Jaap; Buitelaar, Jan K

    2016-07-01

    Individuals with attention deficit/hyperactivity disorder (ADHD) are at increased risk of developing substance use disorders (SUDs) and nicotine dependence. The co-occurrence of ADHD and SUDs/nicotine dependence may in part be mediated by shared genetic liability. Several neurobiological pathways have been implicated in both ADHD and SUDs, including dopamine and serotonin pathways. We hypothesized that variations in dopamine and serotonin neurotransmission genes were involved in the genetic liability to develop SUDs/nicotine dependence in ADHD. The current study included participants with ADHD (n = 280) who were originally part of the Dutch International Multicenter ADHD Genetics study. Participants were aged 5-15 years and attending outpatient clinics at enrollment in the study. Diagnoses of ADHD, SUDs, nicotine dependence, age of first nicotine and substance use, and alcohol use severity were based on semi-structured interviews and questionnaires. Genetic risk scores were created for both serotonergic and dopaminergic risk genes previously shown to be associated with ADHD and SUDs and/or nicotine dependence. The serotonin genetic risk score significantly predicted alcohol use severity. No significant serotonin × dopamine risk score or effect of stimulant medication was found. The current study adds to the literature by providing insight into genetic underpinnings of the co-morbidity of ADHD and SUDs. While the focus of the literature so far has been mostly on dopamine, our study suggests that serotonin may also play a role in the relationship between these disorders. PMID:25752199

  12. Welfare reform, employment, and drug and alcohol use among low-income women.

    PubMed

    Meara, Ellen

    2006-01-01

    In 1996 welfare reform legislation transformed income assistance for needy families by imposing work requirements, time-limited benefits, and explicit provisions allowing states to sanction recipients who fail to meet program requirements. Though they represent a minority of the welfare population, women with substance use disorders (SUDs) experience multiple, and more severe, employment barriers than other Temporary Assistance to Needy Families (TANF) recipients. This review of welfare reform, substance abuse, and employment documents the evidence to date regarding the employment patterns of women with SUDs before and after welfare reform, and proposes several topics for further research. Based on higher rates of unemployment, less work experience, and lower earnings when working, women with SUDs have worse employment records than other TANF recipients. Despite elevated employment barriers, women with SUDs left TANF after 1996 as fast as, or faster than, other women. Since the 1996 welfare reform, women with SUDs have increased their employment and earnings, but by less than similar women without SUDs. Future research should describe how specific state welfare policies relate to employment of low-income women with SUDs, how the well-being of these women and their children changes with employment, and how welfare and employment interact to affect access to health insurance among this population. PMID:16912008

  13. Treatment outcomes for substance use disorder among women of reproductive age in Massachusetts: A population-based approach

    PubMed Central

    Bernstein, Judith; Derrington, Taletha M.; Belanoff, Candice; Cabral, Howard J.; Babakhanlou-Chase, Hermik; Diop, Hafsatou; Evans, Stephen R.; Jacobs, Hilary; Kotelchuck, Milton

    2014-01-01

    Introduction Longitudinal patterns of treatment utilization and relapse among women of reproductive age with substance use disorder (SUD) are not well known. In this statewide report spanning seven years we describe SUD prevalence, SUD treatment utilization, and differences in subsequent emergency department (ED) use and post-treatment relapse rates by type of treatment: none, ‘acute only’ (detoxification/stabilization), or ‘ongoing’ services. Methods We linked a statewide dataset of hospital discharge, observation stay and ED records with SUD treatment admission records from hospitals and freestanding facilities, and birth/fetal death certificates, in Massachusetts, 2002–2008. We aggregated episodes into individual woman records, identified evidence of SUD and treatment, and tested post-treatment outcomes. Results Nearly 150,000 (8.5%) of 1.7 million Massachusetts women aged 15–49 were identified as SUD-positive. Nearly half of SUD-positive women (71,533 or 48.3%) had evidence of hospital or facility-based SUD treatment; among these, 12% received acute care/detoxification only while 88% obtained ‘ongoing’ treatment. Treatment varied by substance type; women with dual diagnosis and those with opiate use were least likely to receive ‘ongoing’ treatment. Treated women were older and less likely to have a psychiatric history or chronic illness. Women who received ‘acute only’ services were more likely to relapse (12.4% vs. 9.6%) and had a 10% higher rate of ED visits post-treatment than women receiving ‘ongoing’ treatment. Conclusions Many Massachusetts women of reproductive age need but do not receive adequate SUD treatment. ‘Ongoing’ services beyond detoxification/stabilization may reduce the likelihood of post-treatment relapse and/or reliance on the ED for subsequent medical care. PMID:25496707

  14. [Substance use disorders as a cause and consequence of childhood abuse. Basic research, therapy and prevention in the BMBF-funded CANSAS-Network].

    PubMed

    Schäfer, Ingo; Barnow, Sven; Pawils, Silke

    2016-01-01

    Substance use disorders (SUDs) belong to the most frequent behavioural consequences of childhood abuse and neglect (CAN). In community samples, about 20% of adults with experiences of abuse or neglect in childhood have a lifetime diagnosis of an SUD. About 30% of individuals seeking treatment for a post-traumatic disorder have an SUD and 24–67% of all patients in treatment for an SUD have a history of CAN. About 16% of all children and adolescents under the age of 20 in Germany grow up in families where an alcohol- and/or drug-dependence is present. The children of parents with SUDs have, in addition to other risks to their development in cognitive and psychosocial domains, an increased risk of experiencing violence and neglect. Regarding both perspectives, SUD as a cause and as a consequence of CAN, a better understanding of relevant mediators and risk factors is necessary to improve prevention and develop adequate treatments. The aims of the BMBF-funded research network CANSAS are: 1. To gain a better understanding of the relationships between these two important public health problems (basic research), 2. To provide evidence-based treatments for survivors of CAN with SUDs and to increase the awareness for the necessity to diagnose CAN in patients with SUDs in counselling and treatment facilities (research on diagnostics and therapy), 3. To improve the systematic evaluation of child welfare among children of parents with SUDs through counselling services and to promote links between addiction services and youth welfare services (prevention research and health services research). In a multidisciplinary approach, the CANSAS network brings together experts in the fields of trauma treatment, epidemiology, basic research, health services research, prevention research as well as addiction services. PMID:26497814

  15. Predictors of Non-Stabilization during the Combination Therapy of Lithium and Divalproex in Rapid Cycling Bipolar Disorder: A Post-hoc Analysis of Two Studies

    PubMed Central

    Gao, Keming; Kemp, David E.; Wang, Zuowei; Ganocy, Stephen J.; Conroy, Carla; Serrano, Marry Beth; Sajatovic, Martha; Findling, Robert L.; Calabrese, Joseph R.

    2012-01-01

    Objective To study predictors of non–stabilization (i.e., not bimodally stabilized for randomization or not randomized due to premature discontinuation) during open-label treatment with lithium and divalproex in patients with rapid-cycling bipolar disorder (RCBD) with or without comorbid recent substance use disorders (SUDs). Method Data from the open-label phase of two maintenance studies were used. The reasons for non-stabilization were compared between patients with a recent SUD and those without. Predictors for non-stabilization were explored with logistic regression analyses. Results Of 149 patients with recent SUD and 254 without recent SUD enrolled into the open-label acute stabilization phase, 21% and 24% were stabilized and randomized, respectively. Compared to those without recent SUD, patients with recent SUD were more likely to discontinue the study due to non-adherence to the protocol, 53% versus 37% (OR = 1.92) or refractory mania/hypomania, 15% versus 9% (OR = 1.87), but less likely due to refractory depression 16% versus 25% (OR = 0.58) or adverse events, 10% versus 19% (OR = 0.44). A history of recent SUDs, early life verbal abuse, female gender, and late onset of first depressive episode were associated with increased risk for non-stabilization with ORs of 1.85, 1.74, 1.10, and 1.04, respectively. Conclusions During open treatment with lithium and divalproex in patients with RCBD, a recent SUD, a lifetime history of verbal abuse, female gender, and late onset of first depression independently predicted non-stabilization. The non-stabilization for patients with SUD was related to non-adherence and refractory mania/hypomania. PMID:20581798

  16. Impact of Prior Stimulant Treatment for Attention-Deficit Hyperactivity Disorder in the Subsequent Risk for Cigarette Smoking, Alcohol, and Drug Use Disorders in Adolescent Girls

    PubMed Central

    Wilens, Timothy E.; Adamson, Joel; Monuteaux, Michael C.; Faraone, Stephen V.; Schillinger, Mary; Westerberg, Diana; Biederman, Joseph

    2009-01-01

    Objective Controversy remains over the effect of stimulant treatment on later substance use disorders (SUD). To this end, we examined the risk imparted by stimulant treatment for attention-deficit/hyperactivity disorder (ADHD) on SUD and nicotine dependence in a study of girls with ADHD. Design case-controlled, prospective, five-year follow up study. Participants adolescent girls with and without ADHD from psychiatric and pediatric sources. Setting Massachusetts General Hospital. Blinded interviewers determined all diagnoses with structure interviews. Main exposure naturalistic treatment exposure with psychostimulants for ADHD. Outcomes We modeled time to onset of SUD and smoking as a function of stimulant treatment. Results We ascertained 114 subjects with ADHD (mean age at follow-up of 16.2 yrs) with complete medication and SUD data, of which 94 (82%) subjects were treated with stimulants. There were no differences in SUD risk factors between naturalistically treated and untreated groups other than family history of ADHD. We found no increased risks for cigarette smoking or SUD associated with stimulant therapy. We found significant protective effects of stimulant treatment on the development of any SUD (N = 113; HR = 0.27 (0.125–0.60), χ2=10.57, p=0.001) and cigarette smoking (N = 111; HR = 0.28 (0.14–0.60), χ2=10.05, p=0.001) that were maintained when controlling for conduct disorder. We found no effects of time of onset or duration of stimulant therapy on subsequent SUD or cigarette smoking in ADHD subjects. Conclusions Stimulant therapy does not increase, rather reduces the risk for cigarette smoking and SUD during adolescent years in girls with ADHD. PMID:18838643

  17. Integration of substance use disorder services with primary care: health center surveys and qualitative interviews

    PubMed Central

    2014-01-01

    Background Each year, nearly 20 million Americans with alcohol or illicit drug dependence do not receive treatment. The Affordable Care Act and parity laws are expected to result in increased access to treatment through integration of substance use disorder (SUD) services with primary care. However, relatively little research exists on the integration of SUD services into primary care settings. Our goal was to assess SUD service integration in California primary care settings and to identify the practice and policy facilitators and barriers encountered by providers who have attempted to integrate these services. Methods Primary survey and qualitative interview data were collected from the population of federally qualified health centers (FQHCs) in five California counties known to be engaged in SUD integration efforts was surveyed. From among the organizations that responded to the survey (78% response rate), four were purposively sampled based on their level of integration. Interviews were conducted with management, staff, and patients (n = 18) from these organizations to collect further qualitative information on the barriers and facilitators of integration. Results Compared to mental health services, there was a trend for SUD services to be less integrated with primary care, and SUD services were rated significantly less effective. The perceived difference in effectiveness appeared to be due to provider training. Policy suggestions included expanding the SUD workforce that can bill Medicaid, allowing same-day billing of two services, facilitating easier reimbursement for medications, developing the workforce, and increasing community SUD specialty care capacity. Conclusions Efforts to integrate SUD services with primary care face significant barriers, many of which arise at the policy level and are addressable. PMID:24679108

  18. Heterogeneity of mental health service utilization and high mental health service use among women eight years after initiating substance use disorder treatment

    PubMed Central

    Evans, Elizabeth; Padwa, Howard; Li, Libo; Lin, Veronique; Hser, Yih-Ing

    2015-01-01

    Objective To determine mental health service utilization patterns among women treated for substance use disorders (SUD) and identify factors associated with patterns of high mental health service use. Methods Data were provided by 4,447 women treated for SUD in California during 2000–2002 for whom mental health services utilization records were acquired. A latent class model was fitted to women’s high use of services (≥6 services/year over 8 years). Multinomial logistic regression was used to identify predisposing, enabling, and need factors associated with utilization patterns. Results In 8 years after initiating SUD treatment, 50% of women utilized mental health services. High use probability was consistently low for most women (76.9%); for others, however, it decreased immediately following SUD treatment and then increased over time (9.3%), increased immediately following SUD treatment and then decreased (8.7%), or remained consistently high (5.1%). Consistently high services use was negatively associated with marriage (OR 0.60, p<0.05) and employment (OR 0.53, p<0.05) and positively associated with older age (OR 1.04, p<0.001), homelessness (OR 1.68, p<0.05), public assistance (OR 1.76, p<0.01), outpatient SUD treatment (OR 3.69, p<0.01), longer SUD treatment retention (OR 1.00, p<0.01), treatment desire (ORs 1.46, p<0.001), and co-occurring disorder diagnosis (ORs 2.89–44.93, p<0.001). Up to 29% of women with co-occurring mental health disorders at SUD treatment entry did not receive any mental health treatment in the subsequent 8 years. Conclusions Mental health services utilization patterns among women treated for SUD are hetereogeneous and dynamic. Understanding factors related to women’s utilization patterns may aid efforts to optimize care and ensure appropriate use of mental health services. PMID:26321439

  19. BARRIERS TO DRUG ABUSE TREATMENT FOR LATINO MIGRANTS: TREATMENT PROVIDERS’ PERSPECTIVES1

    PubMed Central

    Pagano, Anna

    2014-01-01

    This paper disseminates findings from a pilot study undertaken to learn more about treatment providers’ perceptions of treatment access barriers faced by Latino migrants with substance use disorders (SUDs) in Northern California. Semi-structured interviews were conducted with treatment providers (n=11) at 7 residential treatment programs with Spanish-language services. Interviewees identified and described three primary types of treatment barriers: language, legal, and gender-based. In response to these barriers, Latino migrants with SUDs have opened their own residential recovery houses called anexos (annexes). Collaborative efforts by community clinics and public health agencies are needed to facilitate Latino migrants’ access to SUD treatment. PMID:25176120

  20. [Autism spectrum disorder and substance use disorder: an unknown comorbidity?].

    PubMed

    Singh, S K B; Hellemans, H; Dom, G

    2012-01-01

    We describe the diagnosis and treatment of a patient with autism spectrum disorder (ASD) and substance use disorder (SUD). The patient had been given the dual diagnosis of Asperger’s disorder and SUD. On that basis the approach adopted and the treatment provided seemed appropriate. Little is known about the comorbidity of ASD and SUD and it has hardly been reported in the scientific literature or in clinical practice. Epidemiological research shows that this dual diagnosis occurs in clinical populations. A careful psychiatric diagnosis is important in order to ensure that the comorbidity is recognised at an early stage and treated in an appropriate manner. PMID:23074034

  1. Sediment transport mechanisms through the sustainable vegetated flow networks

    NASA Astrophysics Data System (ADS)

    Allen, Deonie; Haynes, Heather; Arthur, Scott

    2016-04-01

    Understanding the pollution treatment efficiency of a sustainable urban drainage (SuDS) asset or network requires the influx, transport, detention and discharge of the pollutant within the system. To date event specific monitoring of sediment (primarily total suspended solids) concentrations in the inflow and discharge from SuDS have been monitored. Long term analysis of where the sediment is transported to and the residency time of this pollutant within the SuDS asset or network have not been unraveled due to the difficulty in monitoring specific sediment particulate movement. Using REO tracing methodology, sediment particulate movement has become possible. In tracing sediment movement from an urban surface the internal residency and transportation of this sediment has illustrated SuDS asset differences in multi-event detention. Of key importance is the finding that sediment remains within the SuDS asset for extended periods of time, but that the location sediment detention changes. Thus, over multiple rainfall-runoff events sediment is seen to move through the SuDS assets and network proving the assumption that detained sediment is permanent and stationary to be inaccurate. Furthermore, mass balance analysis of SuDS sediment indicates that there is notable re-suspension and ongoing release of sediment from the SuDS over time and cumulative rainfall-runoff events. Continued monitoring of sediment deposition and concentration in suspension illustrates that sediment detention within SuDS decreases over time/multiple events, without stabilizing within a 12 month period. Repeated experiments show a consistent pattern of detention and release for the three SuDS networks monitored in Scotland. Through consideration of both rainfall and flow factors the drivers of sediment transport within the monitored SuDS have been identified. Within the limitation of this field study the key drivers to SuDS sediment detention efficiency (or transport of sediment through the system

  2. Néotectonique affectant les dépôts marins tyrrhéniens du littoral sud-est tunisien : implications pour les variations du niveau marinNeotectonics in the Tyrrhenian marine deposits of the southeastern Tunisian coast: implications for sea level changes

    NASA Astrophysics Data System (ADS)

    Bouaziz, Samir; Jedoui, Younes; Barrier, Éric; Angelier, Jacques

    2003-01-01

    Pleistocene marine deposits of so-called Tyrrhenian age in southeastern Tunisia include two lithostratigraphic units of Last Interglacial (marine isotopic substage 5e). The lower unit culminates at about +3 m above the sea level; the upper unit with Strombus bubonius culminates at +5 m. Brittle deformations affected the upper unit. The analysis of fault-slip data sets reveals a post-Tyrrhenian N020°E trending compression, consistent with joint patterns. This event induced limited vertical movements, showing that at the northeastern edge of the Saharan Platform, the coastal area of the southern Tunisia remained relatively stable since at least the Last Interglacial.

  3. Sur les possibilités de reconstitution paléo-environnementale offertes par les andosols des hautes terres tropicales. Exemple des Nilgiri (Inde du Sud)On the possibilities of palaeoenvironmental reconstitution offered by tropical highland andisols. Example of Nilgiri andisols (South India)

    NASA Astrophysics Data System (ADS)

    Caner, Laurent; Bourgeon, Gérard

    2001-12-01

    An example, from South India, shows the potentialities offered by the study of high altitude non-allophanic andisols to reconstitute the local palaeoenvironmental history. In this type of soils, organic matter is stabilised in the form of organometallic complexes that migrate downwards very slowly. Compared to the broad signal recorded by peat bogs, the soil organic matter signal appears to be more site-specific, which enables precise palaeoenvironmental studies. This application comes just when precise palaeoclimatic reconstitutions are necessary to build reliable climatic models.

  4. La grossesse extra-utérine dans une région semi-rurale en Afrique: Aspects épidémiologiques, cliniques et thérapeutiques à propos d'une série de 74 cas traités à l'Hôpital de District de Sangmelima au Sud-Cameroun

    PubMed Central

    Kenfack, Bruno; Noubom, Michel; Bongoe, Adamo; Tsatedem, Faustin Atemkeng; Ngono, Modeste; Tsague, Georges Nguefack; Mboudou, Emile

    2012-01-01

    La grossesse extra-utérine (GEU) constitue une cause fréquente de morbidité et parfois de mortalité chez les femmes en âge de procréation. Son étiologie n'est pas clairement précisée. Son tableau clinique est polymorphe et ses méthodes thérapeutiques très diversifiées. C'est dans le but d’étudier les aspects épidémiologiques cliniques et thérapeutiques dans une zone rurale à ressources limitées d'Afrique que ce travail a été réalisé. Il s'agit d'une étude descriptive transversale sur une durée de trois ans, portant sur 74 cas de GEU traités à l'Hôpital de District de Sangmelima. Le matériel utilisé était constitué d'une fiche anonyme de collecte des données, des dossiers du malade, et du registre opératoire. Au cours de la période d’étude, 2142 naissances vivantes ont été enregistrées, soit un taux de GEU de 3,45%. Les femmes non mariées et celles ayant les antécédents d'IST étaient les plus atteintes. Le délai moyen entre le début des symptômes et l'admission était de132h. L’âge gestationnel moyen au moment du diagnostic était de 8,14 semaines. Le diagnostic était clinique dans 61% des cas. L'annexe controlatérale était cliniquement normale dans 53% des cas. Le traitement était chirurgical d'emblée chez 97% des cas. Aucun décès n'a été observé. La GEU est fréquente dans cette zone rurale, les malades consultent à un stade tardif, le diagnostic est surtout clinique, et le traitement chirurgical par laparotomie. PMID:23396682

  5. Le complexe annulaire d'âge Oligocène de l'Achkal (hoggar Central, Sud Algérie) : témoin de la transition au Cénozoïque entre les magmatismes tholéitique et alcalin. Évidences par les isotopes du Sr, Nd et Pb

    NASA Astrophysics Data System (ADS)

    Maza, Mustapha; Briqueu, Louis; Dautria, Jean-Marie; Bosch, Delphine

    1998-08-01

    The Achkal Oligocene ring complex cross-cuts the Upper Eocene tholeiitic traps located on the top of the Hoggar swell. The plutonic rocks range from tholeiitic gabbros to alkali essexites, monzonites and syenites, whereas the volcanites are restricted to late peralkaline rhyolites. The affinity change linked to the large isotopic heterogeneities (from EM1 to HIMU) suggests that the parental magmas are issued from two distinct mantle sources, first lithospheric then deeper. The Achkal has recorded the magmatic evolution of the Hoggar hot spot, between Eocene and Miocene.

  6. Sur la présence d'une série molassique (de type série pourprée) au Sud-Est de l'Ahaggar (In Guezzam, Ahaggar, Algérie)Presence of molassic series ('Série pourprée' type) in the Southeast of the Ahaggar (In Guezzam, Ahaggar, Algeria)

    NASA Astrophysics Data System (ADS)

    Djellit, Hamou; Henry, Bernard; Derder, Mohamed E. M.

    In the western Ahaggar shield, the transition between the Precambrian and the Ordovician units is characterised by thick volcano-sedimentary series ('Série pourprée' of the Ahnet). This series, in part of Cambrian age, results from the demolition of the Panafrican belt. Similar series were known in grabens located between the West African craton and the Ahaggar, from the 'Adrar des Iforas', in the south, to the Ougarta belt, in the north. We describe in this study a new formation identical to the 'Série pourprée' of the Ahnet, but cropping out in the far Southeast of the Ahaggar (In Guezzam). This new datum improves the Panafrican belt configuration. To cite this article: H. Djellit et al., C. R. Geoscience 334 (2002) 789-794.

  7. Sédimentologie et évidence d'une tectonique Tardi-Hercynienne d'âge Permien Inférieur dans le bassin des Ida Ou Ziki; sud-ouest du massif ancien du Haut-Atlas (region d'Argana, Maroc)

    NASA Astrophysics Data System (ADS)

    Saber, Hafid

    1994-08-01

    The Permian Ida Ou Ziki sequence, approximately 1200 m thick, is detrital in origin. Sedimentological data clearly indicate a fluviatile environment. The palaeocurrents show that during the infilling of the basin, the detrital source region was constantly to the north. From a study of the clay minerals, based on the dominance of illite and not inconsiderable proportions of kaolinite and chlorite, a wet warm and humid climate is indicated. The Ida Ou Ziki basin has been affected by synsedimentary post-Hercynian movement. It suggests an important subsidence phase controlled by the Tirkou fault, and by disturbances affecting the lower part of the succession. Listric faults and small-scale grabens associated with slumping gave an extensional direction approximately to the NW-SE. As part of this extensional phase, the basin was subjected to a post-depositional pre-Upper Triassic northerly regional compression

  8. Du Gondwana à l'atlantique sud: les connexions du fossé de la bénoué avec les bassins du Nord-Est brésilien jusqu'à l'ouverture du golfe de Guinée au crétacé inférieur

    NASA Astrophysics Data System (ADS)

    Popoff, Michel

    The Benue trough and the intracontinental basins of Northeast Brazil are located in the African-South American mobile belt deformed during the Pan-African (or Brazilian) orogeny. The chain trends in a N-S to NNE-SSW direction. During the Late Precambrian collision stages in between the cratons of West Africa, Sao Francisco and Congo, dominant NE-SW ductile shear zones acted as limits of mobile crustal blocks on both sides of the Gulf of Guinea. This gondwanian assemblage was reworked during the installation of the West and Central African rift system under the effects of a generalized distension which led to the opening of the Equatorial domain of the South Atlantic. Phanerozoic basins became oriented according to the inherited gondwanian mega-discontinuities along which brittle tectonics was most prominent. After an initial pre-rift deformation from Late Jurassic to Eo-Cretaceous, three principal tectono-sedimentary phases in the Benue Trough and the Northeast Brazilian basins have been shown— an eo-rift phase (Neocomian to Early Barremian) of extensional brittle tectonics and basin initiation— a syn-rift I phase (Barremian to Middle Albian) of crustal stretching, local block tilting and basin installation; associated synchronous basaltic magmatism with transitional affinities is characteristic of intracontinental distensive zones. This is the period of the Medio-African and NE-Brazilian Cretaceous Great Lakes; a syn-rift II phase (Late Albian-Early Cenomanian) of a probable crustal surextension related to regional tilting. The above evolutionary stages apply to the Equatorial domain of the South Atlantic (NE Brazil, Cameroon, Nigeria up to the Ivory Coast) deformed during the Late Jurassic to Early Cretaceous. This domain represented the final gondwanian link between the Central and South Atlantic. The new evidences of well dated polyphased intra-plate deformations are contrary to the earlier views of rigid plates in the context of continental reconstructions to obtain the pre-drift fit, different from the pre-rift one. Reconsidering the scenario of the South Atlantic opening through the geological record of its continental margins, it can be noted that the axial rift propagates from the South towards the North within successive domains (Austral, Tropical and Equatorial). The continental rifting-drifting processes were thus reproduced in the adjoining domain every 20 Ma. At the limit, transfer fault zones oriented NE-SW (with Africa in its present position) accomodate a differential deformation between each domain. In the Benue Trough, a strike-slip sinistral movement with a displacement of several tens of kilometres has been estimated along a similar NE-SW direction. The trough represents the abandoned arm of a RRF triple junction which acted at the time of the refraction of the Southern South Atlantic opening into the E-W domain of the Gulf of Guinea. The present features of the African and South American continents appeared as from the uppermost Albian to Lower Cenomanian times of final crustal disruption followed by a progressive separation of the land masses along the strike-slip equatorial margins.

  9. 78 FR 3424 - Notice of Agreements Filed

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  10. Human pharmacology for addiction medicine: From evidence to clinical recommendations.

    PubMed

    Quednow, Boris B; Herdener, Marcus

    2016-01-01

    Substance use disorders (SUD) are complex and often chronic diseases with negative health outcomes and social consequences. Pharmacological treatment options for SUD can be separated in medications for (i) intoxication, (ii) withdrawal, and (iii) reduction of use together with relapse prevention. This chapter will focus on approved or clinically established pharmacological strategies suited to manage symptoms of withdrawal, and to reduce substance use or to promote abstinence. Hereby SUD involving alcohol, nicotine, stimulants, and opioids are primarily discussed as these substances are considered most harmful for both the individual and the society. Moreover, the pharmacotherapy of SUD related to the use of cannabis, benzodiazepines, and gamma-hydroxybutyrate is also briefly reviewed. Since most approved pharmacological treatment options show only moderate effect sizes especially in the long term, the development of new treatment strategies including new drugs, new combinations of available compounds, and biomarkers for response prediction is still warranted. PMID:26822361

  11. The Mean Machine.

    ERIC Educational Resources Information Center

    McShane, Joan Braunagel

    1988-01-01

    Discusses a research project of testing detergents that resulted from students' classroom observations of and questions about water pollution and suds. Outlines procedures and responsibilities necessary for conducting the experiment. A sample student data sheet is included. (RT)

  12. Posttraumatic Stress Disorder and Co-Occurring Substance Use Disorders: Advances in Assessment and Treatment

    PubMed Central

    McCauley, Jenna L; Killeen, Therese; Gros, Daniel F.; Brady, Kathleen T.; Back, Sudie E.

    2013-01-01

    Posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) are prevalent and frequently co-occur. Comorbid PTSD/SUD is associated with a more complex and costly clinical course when compared with either disorder alone, including increased chronic physical health problems, poorer social functioning, higher rates of suicide attempts, more legal problems, increased risk of violence, worse treatment adherence, and less improvement during treatment. In response, psychosocial treatment options have increased substantially over the past decade and integrated approaches – treatments that address symptoms of both PTSD and SUD concurrently –are fast becoming the preferred model for treatment. This paper reviews the prevalence, etiology and assessment practices as well as advances in the behavioral and pharmacologic treatment of comorbid PTSD and SUDs. PMID:24179316

  13. A Review of Genome-Wide Association Studies of Stimulant and Opioid Use Disorders.

    PubMed

    Jensen, Kevin P

    2016-05-01

    Substance use disorders (SUD) are a major contributor to disability and disease burden worldwide. Risk for developing SUDs is influenced by variation in the genome. Identifying the genetic variants that influence SUD risk may help us to understand the biological mechanisms for the disorders and improve treatments. Genome-wide association studies (GWAS) have been successful in identifying many regions of the genome associated with common human disorders. Here, findings from recent GWAS of SUDs that involve illicit substances will be reviewed. Several GWAS have been reported, including studies on opioid and stimulant use disorder (cocaine and methamphetamine). Several of these GWAS report associations that are biologically interesting and statistically robust. Replication of the associations in independent samples and functional studies to understand the basis for the statistical associations will be important next steps. PMID:27606319

  14. Attention-Deficit/Hyperactivity Disorder and Risk of Substance Use Disorder: Developmental Considerations, Potential Pathways, and Opportunities for Research

    PubMed Central

    Molina, Brooke S.G.; Pelham, William E.

    2014-01-01

    Many opportunities to explain ADHD-related risk of substance use/disorder (SUD) remain available for study. We detail these opportunities by considering characteristics of children with ADHD and factors affecting their outcomes side-by-side with overlapping variables in the developmental literature on SUD etiology. Although serious conduct problems are a known contributor to ADHD-related risk of SUD, few studies have considered their emergence developmentally and in relation to other candidate mediators and moderators that could also explain risk and be intervention targets. Common ADHD-related impairments, such as school difficulties, are in need of research. Heterogeneous social impairments have the potential for predisposing, and buffering, influences. Research on neurocognitive domains should move beyond standard executive function batteries to measure deficits in the interface between cognitive control, reward, and motivation. Ultimately, maximizing prediction will depend, as it has in the SUD literature, on simultaneous consideration of multiple risk factors. PMID:24437435

  15. Neuroimaging methods for adolescent substance use disorder prevention science

    PubMed Central

    Clark, DB; Chung, T; Pajtek, S; Zhai, Z; Long, E; Hasler, B

    2013-01-01

    Magnetic resonance imaging (MRI) methods safely provide in vivo indicators of cerebral macrostructure, microstructure, and activation that can be examined in relation to substance use disorder (SUD) risks and effects. This article will provide an overview of MRI approaches, including volumetric measures, diffusion tensor imaging, functional MRI, that have been applied to studies of adolescent neuromaturation in relationship to risk phenotypes and adolescent SUD. To illustrate these applications, examples of research findings will be presented. MRI indicators have demonstrated that neurobiological maturation continues throughout adolescence. MRI research has suggested that variations in neurobiological maturation may contribute to SUD risk, and that substance use adversely influence adolescent brain development. Directly measured neurobiological variables may be viable preventive intervention targets and outcome indicators. Further research is needed to provide definitive findings on neurodevelopmental immaturity as an SUD risk and to determine the directions such observations suggest for advancing prevention science. PMID:23417665

  16. Does Smoking Intervention Influence Adolescent Substance Use Disorder Treatment Outcomes?

    PubMed Central

    Myers, Mark G.; Prochaska, Judith J.

    2009-01-01

    Although tobacco use is reported by the majority of substance use disordered (SUD) youth, little work has examined tobacco focused interventions with this population. The present study is an initial investigation of the effect of a tobacco use intervention on adolescent SUD treatment outcomes. Participants were adolescents in SUD treatment taking part in a cigarette smoking intervention efficacy study, assessed at baseline and followed up at 3- and 6-months post-intervention. Analyses compared treatment and control groups on days using alcohol and drugs and proportion abstinent from substance use at follow up assessments. Adolescents in the treatment condition reported significantly fewer days of substance use and were somewhat more likely to be abstinent at 3-month follow up. These findings suggest that tobacco focused intervention may enhance SUD treatment outcome. The present study provides further evidence for the value of addressing tobacco use in the context of treatment for adolescent SUD’s. PMID:19042327

  17. Advancing Performance Measures for Use of Medications in Substance Abuse Treatment

    PubMed Central

    Garnick, Deborah W.; Horgan, Constance M.; McCorry, Frank; Gmyrek, Amanda; Chalk, Mady; Gastfriend, David; Rinaldo, Suzanne Gelber; Albright, Joann; Capoccia, Victor; Harris, Alex; Harwood, Henrick J.; Greenberg, Pamela; Mark, Tami; Un, Huong; Oros, Marla; Stringer, Mark; Thatcher, James

    2010-01-01

    Performance measures have the potential to drive high quality health care. However, technical and policy challenges exist in developing and implementing measures to assess substance use disorder (SUD) pharmacotherapy. Of critical importance in advancing performance measures for use of SUD pharmacotherapy is recognition that different measurement approaches may be needed in the public and private sectors, and will be determined by the availability of different data collection and monitoring systems. In 2009, the Washington Circle convened a panel of nationally recognized insurers, purchasers, providers, policy makers, and researchers to address this topic. The charge of the panel was to identify opportunities and challenges in advancing use of SUD pharmacotherapy performance measures across a range of systems. This paper summarizes those findings by identifying a number of critical themes related to advancing SUD pharmacotherapy performance measures, highlighting examples from the field, and recommending actions for policy makers. PMID:20934836

  18. The Relationship Between Emotion Dysregulation and Deliberate Self-Harm Among Inpatients with Substance Use Disorders.

    PubMed

    Gratz, Kim L; Tull, Matthew T

    2010-12-01

    Despite the emphasis on the role of emotion dysregulation in deliberate self-harm (DSH), no studies have examined this association among patients with substance use disorders (SUD). This study examined if emotion dysregulation is heightened among SUD inpatients with (vs. without) DSH, and if the association between DSH and emotion dysregulation remains significant when controlling for their shared association with risk factors for both, including borderline personality disorder (BPD), posttraumatic stress disorder (PTSD), childhood abuse, and substance use severity. Findings indicate heightened emotion dysregulation among SUD patients with (vs. without) DSH, and provide evidence of a unique association between emotion dysregulation and DSH when controlling for BPD, PTSD, childhood abuse, and substance use severity. Findings also highlight the particular relevance of three dimensions of emotion dysregulation to DSH among SUD patients: limited access to effective emotion regulation strategies, difficulties engaging in goal-directed behaviors when distressed, and emotional nonacceptance. PMID:21132101

  19. Gender differences in the relationship between discrimination and substance use disorder among Latinos.

    PubMed

    Ornelas, India J; Hong, Seunghye

    2012-10-01

    Using data from the National Latino and Asian American Study collected in 2002-2003 (N = 2,554), we assessed the adjusted odds of lifetime substance use disorder (SUD) associated with report of both unfair treatment and racial/ethnic discrimination. Among men, SUD was increased for those reporting low, moderate, and high levels of unfair treatment compared to those reporting no unfair treatment and patterns were similar for racial/ethnic discrimination. Among women, only those reporting high levels of unfair treatment were at increased risk of lifetime SUD and no associations were observed between racial/ethnic discrimination and lifetime SUD. Future research should examine the role that discrimination plays in the development of substance misuse among Latinos. PMID:22950437

  20. Mindfulness Meditation for Substance Use Disorders: A Systematic Review

    PubMed Central

    Zgierska, Aleksandra; Rabago, David; Chawla, Neharika; Kushner, Kenneth; Koehler, Robert; Marlatt, Allan

    2009-01-01

    Relapse is common in substance use disorders (SUDs), even among treated individuals. The goal of this article was to systematically review the existing evidence on mindfulness meditation-based interventions (MM) for SUDs. The comprehensive search for and review of literature found over 2,000 abstracts and resulted in 25 eligible manuscripts (22 published, 3 unpublished: 8 RCTs, 7 controlled non-randomized, 6 non-controlled prospective, 2 qualitative studies, 1 case report). When appropriate, methodological quality, absolute risk reduction, number needed to treat, and effect size (ES) were assessed. Overall, although preliminary evidence suggests MM efficacy and safety, conclusive data for MM as a treatment of SUDs are lacking. Significant methodological limitations exist in most studies. Further, it is unclear which persons with SUDs might benefit most from MM. Future trials must be of sufficient sample size to answer a specific clinical question and should target both assessment of effect size and mechanisms of action. PMID:19904664

  1. 76 FR 63618 - Notice of Agreements Filed

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  3. Assessment of risk for substance use disorder consequent to consumption of illegal drugs: psychometric validation of the neurobehavior disinhibition trait.

    PubMed

    Mezzich, Ada C; Tarter, Ralph E; Feske, Ulrike; Kirisci, Levent; McNamee, Rebecca L; Day, Bang-Shiuh

    2007-12-01

    Previous research has shown that the trait neurobehavior disinhibition (ND), which consists of affect, behavior, and cognitive indicators of self-regulation, is a significant predictor of substance use disorder (SUD) between childhood and young adulthood. The authors evaluated the psychometric properties of the ND trait in 278 boys evaluated at ages 10-12 and 16 years. ND score significantly predicted SUD and outcomes that commonly manifest in tandem with SUD by age 19, such as violence, arrests, committing crime while intoxicated, and concussion injury. In addition to predictive validity, the ND trait was found to have good construct, discriminative, and concurrent validity, as well as good test-retest and internal reliability. The ND trait may be useful for detecting youths at high risk for developing SUD and related outcomes. PMID:18072833

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  5. Measurement of Mental Health in Substance Use Disorder Outpatients

    PubMed Central

    Alterman, Arthur I.; Cacciola, John S.; Dugosh, Karen L.; Ivey, Megan A.; Coviello, Donna M.

    2010-01-01

    Few studies have examined mental health (MH) attributes of substance use disorder (SUD) patients. The present study examines the internal consistency, concurrent validity, and comparative level of MH attributes (i.e., optimism, life attitudes, spirituality/religiousness, social support, positive mood, hope, and vitality) in SUD patients compared to the instrument development group. The internal consistency of optimism, spirituality/religiousness, positive mood, hope, and vitality were similar in both groups. Some subscales of the social support and life attitude measures had lower internal consistency than was found for the original samples, although internal consistency of more global constructs were comparable. SUD patients had higher positive mood, spirituality/religiousness, and hope scores, while social support, life attitudes, and optimism scores were lower than in the original sample. Correlations between MH attributes and recent life problems of SUD patients generally supported the concurrent validity of the MH measures. PMID:20708901

  6. Comorbid substance use disorders with other Axis I and II mental disorders among treatment-seeking Asian Americans, Native Hawaiians/Pacific Islanders, and mixed-race people.

    PubMed

    Wu, Li-Tzy; Blazer, Dan G; Gersing, Kenneth R; Burchett, Bruce; Swartz, Marvin S; Mannelli, Paolo

    2013-12-01

    Little is known about behavioral healthcare needs of Asian Americans (AAs), Native Hawaiians/Pacific Islanders (NHs/PIs), and mixed-race people (MRs)-the fastest growing segments of the U.S. population. We examined substance use disorder (SUD) prevalences and comorbidities among AAs, NHs/PIs, and MRs (N = 4572) in a behavioral health electronic health record database. DSM-IV diagnoses among patients aged 1-90 years who accessed behavioral healthcare from 11 sites were systematically captured: SUD, anxiety, mood, personality, adjustment, childhood-onset, cognitive/dementia, dissociative, eating, factitious, impulse-control, psychotic/schizophrenic, sleep, and somatoform diagnoses. Of all patients, 15.0% had a SUD. Mood (60%), anxiety (31.2%), adjustment (30.9%), and disruptive (attention deficit-hyperactivity, conduct, oppositional defiant, disruptive behavior diagnosis, 22.7%) diagnoses were more common than others (psychotic 14.2%, personality 13.3%, other childhood-onset 11.4%, impulse-control 6.6%, cognitive 2.8%, eating 2.2%, somatoform 2.1%). Less than 1% of children aged <12 years had SUD. Cannabis diagnosis was the primary SUD affecting adolescents aged 12-17. MRs aged 35-49 years had the highest prevalence of cocaine diagnosis. Controlling for age at first visit, sex, treatment setting, length of treatment, and number of comorbid diagnoses, NHs/PIs and MRs were about two times more likely than AAs to have ≥ 2 SUDs. Regardless of race/ethnicity, personality diagnosis was comorbid with SUD. NHs/PIs with a mood diagnosis had elevated odds of having SUD. Findings present the most comprehensive patterns of mental diagnoses available for treatment-seeking AAs, NHs/PIs, and MRs in the real-world medical setting. In-depth research is needed to elucidate intraracial and interracial differences in treatment needs. PMID:24060266

  7. A “refugee paradox” for substance use disorders?

    PubMed Central

    Vaughn, Michael G.

    2014-01-01

    Background Few, if any, studies have systematically examined the link between nativity and substance use disorders (SUD) among refugees using national samples. As such, it remains uncertain if the “immigrant paradox” for substance use can be extended to include refugees in the United States. Methods Employing data from the National Epidemiologic Survey on Alcohol and Related Conditions, we examine the lifetime prevalence of SUDs among refugees (n = 428) in contrast with non-refugee immigrants (n = 4,955) and native-born Americans (n = 29,267). We also examine the impact of gender and refugee duration on the relationship between nativity, refugee status, and SUDs. Results Refugees were between 3–6 times less likely than native-born Americans meet criteria for all SUDs examined, and significantly less likely than non-refugee immigrants to meet criteria for alcohol (AOR = 0.44, 95% CI = 0.41–0.47), cocaine (AOR = 0.54, 95% CI = 0.50–0.59), hallucinogen (AOR = 0.66, 95% CI = 0.58–0.74), and opioid/heroin (AOR = 0.62, 95% CI = 0.58–0.66) use disorders. The refugee-SUD link was significantly moderated by gender. Duration as a refugee was associated with increased risk for alcohol use disorder and decreased risk of cannabis and illicit drug use disorders. Conclusions Study findings provide evidence in support of a “refugee paradox” for SUDs among adults in the United States. Refugees are substantially less likely than native-born Americans to meet criteria for all SUDs examined and, albeit with weaker effects, significantly less likely than non-refugee immigrants to meet criteria for a variety of SUDs. PMID:24999058

  8. Substance Abuse and Trauma.

    PubMed

    Simmons, Shannon; Suárez, Liza

    2016-10-01

    There is a strong, bidirectional link between substance abuse and traumatic experiences. Teens with cooccurring substance use disorders (SUDs) and posttraumatic stress disorder (PTSD) have significant functional and psychosocial impairment. Common neurobiological foundations point to the reinforcing cycle of trauma symptoms, substance withdrawal, and substance use. Treatment of teens with these issues should include a systemic and integrated approach to both the SUD and the PTSD. PMID:27613348

  9. Age of Methylphenidate Treatment Initiation in Children with ADHD and Later Substance Abuse: Prospective Follow-Up into Adulthood

    PubMed Central

    Mannuzza, Salvatore; Klein, Rachel G.; Truong, Nhan L.; Moulton, John L.; Roizen, Erica R.; Howell, Kathryn H.; Castellanos, Francisco X.

    2010-01-01

    Objective Animal studies report that age at stimulant exposure is positively related to later drug sensitivity. This study was designed to examine whether age at initiation of stimulant treatment in children with attention deficit hyperactivity disorder (ADHD) is related to subsequent development of substance use disorder (SUD). Method Prospective longitudinal study of 176 methylphenidate-treated white boys (6–12 years) with ADHD but without conduct disorder, evaluated at mean ages 18 (94% retention) and 25 (85%), and 178 comparisons diagnosed by blinded clinicians. The Cox proportional hazards model included childhood predictor variables: age at initiation of methylphenidate treatment, total cumulative dose, treatment duration; IQ; severity of hyperactivity; socioeconomic status; also lifetime parent mental disorder. Separate models tested for four lifetime outcomes: Any SUD, Alcohol SUD, Non-Alcohol SUD, and Stimulant SUD. Other outcomes included antisocial personality disorder, mood and anxiety disorders. Results There was a significant positive relationship between age at treatment initiation and Non-Alcohol SUD. None of the predictors accounted for this association. Post-hoc analyses showed that the development of antisocial personality disorder explained the relationship between age at first methylphenidate treatment and later SUD. Even when controlling for SUD, age at stimulant treatment initiation was significantly and positively related to the later development of antisocial personality disorder. Age at first methylphenidate treatment was unrelated to mood and anxiety disorders. Conclusion Early age at initiation of methylphenidate treatment of children with ADHD does not increase risk for negative outcomes, and may have beneficial long-term effects. PMID:18381904

  10. Alcohol and Drug Use Disorders among Patients with Myocardial Infarction: Associations with Disparities in Care and Mortality

    PubMed Central

    Beck, Cynthia A.; Southern, Danielle A.; Saitz, Richard; Knudtson, Merril L.; Ghali, William A.

    2013-01-01

    Background Because alcohol and drug use disorders (SUDs) can influence quality of care, we compared patients with and without SUDs on frequency of catheterization, revascularization, and in-hospital mortality after acute myocardial infarction (AMI). Methods This study employed hospital discharge data identifying all adult AMI admissions (ICD-9-CM code 410) between April 1996 and December 2001. Patients were classified as having an SUD if they had alcohol and/or drug (not nicotine) abuse or dependence using a validated ICD-9-CM coding definition. Catheterization and revascularization data were obtained by linkage with a clinically-detailed cardiac registry. Analyses (controlling for comorbidities and disease severity) compared patients with and without SUDs for post-MI catheterization, revascularization, and in-hospital mortality. Results Of 7,876 AMI unique patient admissions, 2.6% had an SUD. In adjusted analyses mortality was significantly higher among those with an SUD (odds ratio (OR) 2.02; 95%CI: 1.10–3.69), while there was a trend toward lower catheterization rates among those with an SUD (OR 0.75; 95%CI: 0.55–1.01). Among the subset of AMI admissions who underwent catheterization, the adjusted hazard ratio for one-year revascularization was 0.85 (95%CI: 0.65–1.11) with an SUD compared to without. Conclusions Alcohol and drug use disorders are associated with significantly higher in-hospital mortality following AMI in adults of all ages, and may also be associated with decreased access to catheterization and revascularization. This higher mortality in the face of poorer access to procedures suggests that these individuals may be under-treated following AMI. Targeted efforts are required to explore the interplay of patient and provider factors that underlie this finding. PMID:24039695

  11. The Impact of Substance Abuse on Osteoporosis Screening and Risk of Osteoporosis in Women with Psychotic Disorders

    PubMed Central

    Kelly, Deanna L.; Myers, Carol S.; Abrams, Michael T.; Feldman, Stephanie; Park, Junyong; McMahon, Robert P.; Shim, Joo-Cheol

    2013-01-01

    Osteoporosis is a major public health concern. Substance abuse and psychosis may be risk factors, however frequency of screening and disease risk in women with psychotic disorders and substance use disorder (SUD) remains unknown. Methods This study examined rates (FY 2005) of osteoporosis screening and disease risk in Medicaid enrolled women aged 50 to 64 (N=18,953). Four diagnostic groups were characterized: 1) Psychosis; 2) SUD; 3) Major mood disorder and 4) Controls. The interaction of psychosis and SUD on screening and disease prevalence of osteoporosis was tested. Results The prevalence of osteoporosis across the entire population was 6.7%. Four percent of those without an osteoporosis diagnosis received osteoporosis screening with no notable differences between psychosis and controls. Those with SUD, however, had a significant reduction in screening compared to controls (OR=0.61, 95% CI 0.40–0.91, p=0.016). Women with a major mood disorder were more likely to have osteoporosis in their administrative record (OR=1.32, 95% CI=1.03–1.70, p=0.028) compared to controls. Those who were dually diagnosed (SUD and psychosis) in the oldest ages (55–64 years) had a markedly higher prevalence of osteoporosis compared to controls (OR=6.4 CI 1.51–27.6, p=0.012), whereas this interaction (SUD and psychosis) was not significant in the entire population over age 49. Conclusions Osteoporosis screening in the Medicaid population is significantly lower for women with SUD, after adjusting for age, race and Medicaid enrollment category. The prevalence of osteoporosis appears markedly elevated in those with major mood disorders and those over age 55 dually diagnosed with schizophrenia and SUD. PMID:20533029

  12. Is there heterogeneity among syndromes of substance use disorder for illicit drugs?

    PubMed Central

    Beseler, Cheryl; Jacobson, Kristen C.; Kremen, William S.; Lyons, Michael J.; Glatt, Stephen J.; Faraone, Stephen V.; Gillespie, Nathan A.; Tsuang, Ming T.

    2014-01-01

    The use of DSM criteria to evaluate liability to substance use disorders (SUDs) and to identify SUD phenotypes may not provide the sensitivity required to identify genes associated with vulnerability to SUDs. The purpose of this study is to evaluate a number of basic aspects of substance use that may be more proximal than full SUDs to risk genes, some of which may thus have greater potential utility as phenotypes in subsequent molecular genetic analyses. In this paper we present results from the first stage of our planned analyses, focusing on how individual symptoms of abuse and dependence may be used to create alternate phenotypes for SUDs. Specifically, we used factor analysis and biometrical modeling on each symptom of illicit substance abuse and dependence within different types of substances, and compared and contrasted factor patterns and heritabilities across the different substances. These analyses were carried out using a population-based sample of 3372 male–male twin pairs from the Vietnam Era Twin Registry who participated in the Harvard Twin Study of Substance Abuse. We obtained extensive data from these participants on substance use and SUDs via telephone interview in 1992, including data on the illicit substances: opiates, cocaine, cannabis, sedatives, stimulants, and psychedelics. The results indicate that: A) although a one-factor model assuming a single underlying liability for abuse and dependence symptoms and behaviors can be rejected for most substances, there is no uniform support for a two-factor model differentiating between abuse versus dependence; B) patterns of symptoms or behaviors reported by substance users vary across substances; C) not all symptoms or behaviors contribute equally to the presentation of an SUD; and D) the heritability of symptoms or behaviors of substance users varies both within and between substances. These results represent important first steps in facilitating the search for SUD-risk genes in subsequent high

  13. Questioning the Specificity of ASRS-v1.1 to Accurately Detect ADHD in Substance Abusing Populations

    ERIC Educational Resources Information Center

    Chiasson, Jean-Pierre; Stavro, Katherine; Rizkallah, Elie; Lapierre, Luc; Dussault, Maxime; Legault, Louis; Potvin, Stephane

    2012-01-01

    Objective: To assess the specificity of the Adult ADHD Self-Report Scale (ASRS-v1.1) in detecting ADHD among individuals with substance use disorders (SUDs). Method: A chart review of 183 SUD patients was conducted. Patients were screened for ADHD with the ASRS-v1.1 and were later assessed by a psychiatrist specialized in ADHD. Results: Among SUD…

  14. Satisfaction With Methadone Among Heroin-Dependent Patients With Current Substance Use Disorders During Methadone Maintenance Treatment.

    PubMed

    Perez de Los Cobos, Jose; Trujols, Joan; Siñol, Núria; Duran-Sindreu, Santiago; Batlle, Francesca

    2016-04-01

    Methadone maintenance treatment (MMT) has long been used to treat heroin-dependent patients. However, satisfaction with methadone in this patient population is unknown. The aim of this cross-sectional case-control study was to evaluate satisfaction with methadone in heroin-dependent patients with current substance use disorders (SUDs). Cases included 152 methadone-maintained patients with current SUD, requiring inpatient detoxification treatment, and controls included 33 methadone-maintained patients in sustained full remission for SUD. Satisfaction with methadone as a medication to treat heroin addiction was measured by using the Scale to Assess Satisfaction with Medications for Addiction Treatment-methadone for heroin addiction (SASMAT-METHER). The SASMAT-METHER subscales assess the following domains: personal functioning and well-being, antiaddictive effect on heroin, and antiaddictive effect on other substances. Compared with patients with remitted SUD, patients with current SUD scored lower on all SASMAT-METHER assessments. In such patients, overall SASMAT-METHER scores were independently and negatively associated with downward desired adjustment of methadone dose and days of heroin use during last month; although various sets of factors were independently associated with each of the SASMAT-METHER subscales, the only determinant of dissatisfaction on all subscales was the desire for downward adjustment of methadone dose. In summary, MMT patients with current SUD are less satisfied with methadone than MMT patients with remitted SUD. In patients with current SUD, downward desired adjustment of methadone dose and days of heroin use during last month are independently associated with overall dissatisfaction with methadone. PMID:26825608

  15. The “Younger-Sibling-at-Risk Design”: a Pilot Study of Adolescents with ADHD and an Older Sibling with Substance Use Disorder

    PubMed Central

    Donovan, Stephen J.; Levin, Frances R.

    2011-01-01

    Introduction This article introduces a “younger at-risk sibling” design to study progression from other psychopathologies to their substance use disorder (SUD) complications. The design selects not-yet-SUD adolescents with high-risk-for-SUD psychopathology only if an older sibling has SUD. This “proof of concept” pilot study examines the design’s feasibility if the younger sibling has attention deficit hyperactivity disorder (ADHD). Method Subjects were recruited from families at substance abuse treatment centers that had a non-SUD younger child with ADHD, from families at behavior disorder clinics that had a younger child with ADHD and SUD older child, and through general advertisements. Subjects were seen weekly for at least 3 months and monthly thereafter for 3 months. All were treated with open-label lisdexamfetamine dimesylate 30–70 mg per day. Outcomes explored were recruitment, compliance, diversion, ADHD improvement, and substance use interest. Results 25 families were screened, 13 evaluated, and 8 began medication. ADHD Rating Scale-IV scores obtained by parent adolescent consensus improved as expected with a stimulant. Rating forms could quantify substance use interest in subjects with some drug culture exposure but encountered a floor effect in those without. The design’s complexity and implicit commentary on family dynamics complicated recruitment but may have facilitated retention. Conclusion Sibling pairs in which the older sibling has substance use and the younger sibling has ADHD exist. Such younger siblings can be recruited into a treatment study. The design may shed light on the pathogenesis and prevention of SUD complications from ADHD and theoretically other SUD comorbidities. PMID:21517711

  16. Methylphenidate in Adults with Attention Deficit Hyperactivity Disorder and Substance Use Disorders.

    PubMed

    Simon, Nicolas; Rolland, Benjamin; Karila, Laurent

    2015-01-01

    Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopment disorder occurring during childhood. However, ADHD persists into adulthood in 45.7% of cases. The global prevalence of adult ADHD is estimated to 5.3%, with no difference between Europe and North America. ADHD is often comorbid with substance use disorder (SUD), with Odds Ratio ranges from 1.5 to 7.9, depending on the substance and the dependence level. Conversely, the prevalence of ADHD among patients with SUD is 10.8%, versus 3.8% for patients without SUD. Methylphenidate (MPH) alleviates ADHD symptoms and, as such, is currently considered as a first choice medication. MPH blocks the dopamine and norepinephrine transporters leading to an increase in extracellular dopamine. It should be noted that its subjective effects are highly dependent on the pharmacokinetic and especially on the rate of input, which highlights the importance of choosing a sustained-release formulation. Meanwhile, prescribing MPH to patients with comorbid SUD has always been challenging for clinicians. The aim of this review is to address the benefits and pitfalls of using MPH in adults with ADHD comorbid SUD, depending on each of the following types of SUD: amphetamine, cocaine, nicotine, alcohol, cannabis and opiates. Overall, due to the prevalence of ADHD in SUD and to the benefits of MPH observed in this population, and considering the mild or low side effects observed, the response to MPH treatment should be evaluated individually in adults with comorbid ADHD and SUD. The choice of the formulation should favor sustained- release MPH over immediate release MPH. Cardiovascular parameters also have to be monitored during long-term use. PMID:26088112

  17. Attention-deficit/hyperactivity disorder and substance use: symptom pattern and drug choice.

    PubMed

    Clure, C; Brady, K T; Saladin, M E; Johnson, D; Waid, R; Rittenbury, M

    1999-08-01

    While there has been much recent interest in the relationship between attention-deficit/hyperactivity disorder (ADHD) and substance use disorders (SUDs), little has been reported about ADHD diagnostic subtypes, persistence of symptoms from childhood into adulthood, and substance of choice in individuals with substance use disorders (SUD+) and comorbid ADHD. To examine the prevalence and subtypes of ADHD in a group of SUD+ individuals, 136 inpatients with an SUD diagnosis (cocaine vs. alcohol vs. cocaine/alcohol) were administered a structured interview for ADHD. Of the SUD+ individuals, 32% met criteria for ADHD, and 35% of those with a childhood diagnosis of ADHD continued to have clinically significant symptoms into adulthood. There were no significant differences in the percentage of ADHD between the SUD+ groups divided by drug choice. Of ADHD subtypes, subjects with combined and inattentive types were significantly more likely to have symptoms continue into adulthood (p < or = .05) than the hyperactive/impulsive subtype. Patients with cocaine use were more likely to have ADHD in childhood only when compared to the alcohol or cocaine-alcohol groups. The findings of this study indicate that ADHD is prevalent in treatment-seeking substance users without difference in prevalence or subtype by drug choice. PMID:10473007

  18. To Reduce or Abstain? Substance Use Goals in the Treatment of Veterans With Substance Use Disorders and Comorbid PTSD

    PubMed Central

    Lozano, Brian E.; Gros, Daniel F.; Killeen, Therese; Jaconis, Maryanne; Beylotte, Francis M.; Boyd, Stephen; Back, Sudie E.

    2016-01-01

    Background Posttraumatic stress disorder (PTSD) and substance use disorders (SUD) frequently co-occur. Previous research demonstrates the utility of goals in attaining improved SUD outcomes, however, no previous studies have examined goal choices in the context of integrated treatment for comorbid PTSD and SUD. Objectives The present study investigated correlates of treatment entry goals to either reduce or abstain from substance use. Methods Participants (N = 60) were treatment-seeking veterans with current PTSD and SUD. Participants completed self-report and clinician-rated measures of substance use, PTSD, and affective symptoms as part of a larger randomized controlled trial. Results Half (30/60) of participants endorsed a treatment entry goal to reduce substance use (reducers). Compared to participants who endorsed a treatment entry goal of abstinence (abstainers), reducers were significantly younger, more likely to be employed, more likely to have served in recent military conflicts (Operations Enduring/Iraqi Freedom), and endorsed significantly fewer symptoms of alcohol dependence. Conclusions and Scientific Significance The findings demonstrate clinically relevant differences based on treatment entry goals, suggesting that individuals are often able to choose conceivably appropriate treatment goals based, most notably, on the severity of their SUD. Collaboratively engaging patients in establishing treatment goals that are consistent with their beliefs and desires in conjunction with empirical findings is particularly relevant in the context of treatment for SUD and PTSD where many patients are ambivalent about treatment and attrition is common. PMID:26300219

  19. Hypothesizing dopaminergic genetic antecedents in schizophrenia and substance seeking behavior.

    PubMed

    Blum, Kenneth; Oscar-Berman, Marlene; Badgaiyan, Rajendra D; Palomo, Tomas; Gold, Mark S

    2014-05-01

    The dopamine system has been implicated in both substance use disorder (SUD) and schizophrenia. A recent meta-analysis suggests that A1 allele of the DRD2 gene imposes genetic risk for SUD, especially alcoholism and has been implicated in Reward Deficiency Syndrome (RDS). We hypothesize that dopamine D2 receptor (DRD2) gene Taq1 A2 allele is associated with a subtype of non-SUD schizophrenics and as such may act as a putative protective agent against the development of addiction to alcohol or other drugs of abuse. Schizophrenics with SUD may be carriers of the DRD2 Taq1 A1 allele, and/or other RDS reward polymorphisms and have hypodopaminergic reward function. One plausible mechanism for alcohol seeking in schizophrenics with SUD, based on previous research, may be a deficiency of gamma type endorphins that has been linked to schizophrenic type psychosis. We also propose that alcohol seeking behavior in schizophrenics, may serve as a physiological self-healing process linked to the increased function of the gamma endorphins, thereby reducing abnormal dopaminergic activity at the nucleus accumbens (NAc). These hypotheses warrant further investigation and cautious interpretation. We, therefore, encourage research involving neuroimaging, genome wide association studies (GWAS), and epigenetic investigation into the relationship between neurogenetics and systems biology to unravel the role of dopamine in psychiatric illness and SUD. PMID:24636783

  20. Hypothesizing Dopaminergic Genetic Antecedents in Schizophrenia and Substance Seeking Behavior

    PubMed Central

    Blum, Kenneth; Oscar-Berman, Marlene; Badgaiyan, Rajendra; Palomo, Tomas; Gold, Mark S.

    2014-01-01

    The dopamine system has been implicated in both substance use disorder (SUD) and schizophrenia. A recent meta- analysis suggests that A1 allele of the DRD2 gene imposes genetic risk for SUD, especially alcoholism and has been implicated in Reward Deficiency Syndrome (RDS). We hypothesize that dopamine D2 receptor (DRD2) gene Taq1 A2 allele is associated with a subtype of non- SUD schizophrenics and as such may act as a putative protective agent against the development of addiction to alcohol or other drugs of abuse. Schizophrenics with SUD may be carriers of the DRD2 Taq1 A1 allele, and/or other RDS reward polymorphisms and have hypodopaminergic reward function. One plausible mechanism for alcohol seeking in schizophrenics with SUD, based on previous research, may be a deficiency of gamma type endorphins that has been linked to schizophrenic type psychosis.. We also propose that alcohol seeking behavior in schizophrenics, may serve as a physiological self-healing process linked to the increased function of the gamma endorphins, thereby reducing abnormal dopaminergic activity at the nucleus accumbens (NAc). These hypotheses warrant further investigation and cautious interpretation. We, therefore, encourage research involving neuroimaging, genome wide association studies (GWAS), and epigenetic investigation into the relationship between neurogenetics and systems biology to unravel the role of dopamine in psychiatric illness and SUD. PMID:24636783

  1. Pharmacological treatment of comorbid PTSD and substance use disorder: recent progress.

    PubMed

    Sofuoglu, Mehmet; Rosenheck, Robert; Petrakis, Ismene

    2014-02-01

    Previous research has identified a strong association between posttraumatic stress disorder (PTSD) and substance use disorder (SUD), necessitating the development of treatments that address both conditions. Some pharmacotherapies are effective for the treatment of PTSD and SUD alone, however; no medications have been proven to be effective for the combination of these conditions. We review the recent advances in pharmacological treatment of comorbid PTSD and SUD. A randomized clinical trial of sertraline, a serotonin reuptake inhibitor (SSRI), did not show overall efficacy for comorbid PTSD and alcohol dependence (AD), although it may have efficacy among light drinkers. Another clinical trial demonstrated the efficacy of both disulfiram and naltrexone for the treatment of AD in individuals with PTSD. A more recent clinical trial suggested that norepinephrine uptake inhibitors may also have efficacy for the treatment of comorbid PTSD and AD. In animal and preliminary human studies, brain norepinephrine and glutamate/GABA have emerged as potential treatment targets for comorbid PTSD and SUD. Noradrenergic medications that are promising for comorbid PTSD and SUD include prazosin, guanfacine, and atomoxetine. Promising glutamate/GABA medications include topiramate, memantine, acamprosate, N-acetylcysteine (NAC), and ketamine. The safety and efficacy of these medications for the treatment of PTSD and SUD need to be tested in controlled clinical trials. PMID:24035645

  2. Social Relationships, Social Assimilation, and Substance-Use Disorders among Adult Latinos in the U.S

    PubMed Central

    Canino, Glorisa; Vega, William A.; Sribney, William M.; Warner, Lynn A.; Alegría, Margarita

    2009-01-01

    Based on social control perspectives and results from prior studies we test hypotheses about the extent to which characteristics of family and social networks are associated with substance use disorders (SUD), and whether these associations vary by sex. In this study SUD is alcohol or illicit drug abuse or dependence as defined by criteria of the Diagnostic and Statistical Manual of the American Psychiatric Association. With nationally representative data of adult Latinos from the National Latino and Asian American Survey (NLAAS), we found that respondents’ language use with family, rather than language proficiency, appears to be a more efficient proxy for social assimilation to represent differential levels of risk of SUD. SUD was positively associated with problematic family relations for men but not women, and SUD was positively associated with more frequent interactions with friends for women but not men. The results suggest that the salient features of social assimilation associated with SUD include the context of language use and transformations in family and social network relationships that differ in important ways between Latino men and women. PMID:20011228

  3. Probability and predictors of treatment-seeking for substance use disorders in the U.S

    PubMed Central

    Blanco, Carlos; Iza, Miren; Rodríguez-Fernández, Jorge Mario; Baca-García, Enrique; Wang, Shuai; Olfson, Mark

    2016-01-01

    Background Little is known about to what extent treatment-seeking behavior varies across individuals with alcohol abuse, alcohol dependence, drug abuse, and drug dependence. Methods The sample included respondents from the Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) who reported a lifetime diagnosis alcohol abuse, alcohol dependence, drug abuse, or drug dependence. Unadjusted and adjusted hazard ratios are presented for time to first treatment contact by sociodemographic characteristics and comorbid psychiatric disorders. Individuals were censored from the analyses if their condition remitted prior to seeking treatment. Results In the first year after disorder onset, rates of treatment-seeking were 13% for drug dependence, 5% for alcohol dependence, 2% for drug abuse, and 1% for alcohol abuse. The lifetime probability of seeking treatment among individuals who did not remit was also highest for drug dependence (90%), followed by drug abuse (60%), alcohol dependence (54%), and alcohol abuse (16%). Having had previous treatment contact for a substance use disorder (SUD) increased the probability of seeking treatment for another SUD. By contrast, an early age of SUD onset, belonging to an older cohort, and a higher level of education decreased the lifetime probability of treatment contact for SUD. The role of comorbid mental disorders was more complex, with some disorders increasing and other decreasing the probability of seeking treatment. Conclusions Given high rates of SUD and their substantial health and economic burden, these patterns suggest the need for innovative approaches to increase treatment access for individuals with SUD. PMID:25725934

  4. Mediating and Moderating Role of Depression, Conduct Disorder or Attention-Deficit/Hyperactivity Disorder in Developing Adolescent Substance Use Disorders: A Population-Based Study

    PubMed Central

    Yoshimasu, Kouichi; Barbaresi, William J.; Colligan, Robert C.; Voigt, Robert G.; Weaver, Amy L.; Katusic, Slavica K.

    2016-01-01

    Objective To evaluate the mediating/moderating effects of common internalizing /externalizing disorders on the association between ADHD and adolescent substance use disorders (SUD) in a population-based birth cohort. Methods Among 5718 children in the birth cohort, 343 ADHD incident cases and 712 matched controls were identified. Psychiatric diagnoses prior to age 19 were classified into DSM-IV categories. The association between ADHD and SUD was summarized (hazard ratios (HR), 95% CI). The effect of depression, CD/ODD, anxiety was evaluated separately. Results Assessment of the joint effects of ADHD and each psychiatric disorder did not support a moderating effect of these disorders on SUD on additive scale. However, the association between ADHD and SUD was partially explained by a mediating role of these psychiatric disorders. Conclusion For clinicians our results emphasize that depression (or CD/ODD) confers greater risk for SUD than ADHD alone. Early detection/treatment of SUD among adolescents with depression (or CD/ODD) is crucial regardless of ADHD. PMID:27294778

  5. Parental Substance Use History of Overweight Men and Women with Binge Eating Disorder Is Associated with Distinct Developmental Trajectories and Comorbid Mood Disorder

    PubMed Central

    Blomquist, Kerstin K.; Masheb, Robin M.; White, Marney A.; Grilo, Carlos M.

    2011-01-01

    Objective To examine the significance of parental histories of SUD in the expression of binge eating disorder (BED) and associated functioning. Method Participants were 127 overweight patients with BED assessed using diagnostic interviews. Participants were administered a structured psychiatric history interview about their parents (N=250) and completed a battery of questionnaires assessing current and historical eating and weight variables and associated psychological functioning (depression and self-esteem). Results BED patients with a parental history of SUD were significantly more likely to start binge eating before dieting, had a significantly earlier age at BED onset, and reported less time between binge eating onset and meeting diagnostic criteria for BED than patients without a parental history of SUD. In terms of psychiatric comorbidity, BED patients with a parental history of SUD were significantly more likely to meet criteria for a mood disorder. A parental history of SUD was not significantly associated with variability in current levels of binge eating, eating disorder psychopathology, or psychological functioning. Discussion Our findings suggest that a parental history of SUD is associated with certain distinct trajectories in the development of binge-eating (earlier binge onset predating dieting onset) and with elevated rates of comorbidity with mood disorders in patients with BED. PMID:21296344

  6. Decisional impairments in cocaine addiction, reward bias, and cortical oscillation "unbalance".

    PubMed

    Balconi, Michela; Finocchiaro, Roberta

    2015-01-01

    A vast amount of research has suggested that subjects with substance use disorder (SUD) might have difficulty making advantageous decisions that opt in favor of a longer-term, larger reward than an immediate, smaller reward. The current research explored the impact of reward bias and cortical frontal asymmetry (left lateralization effect) in SUD in response to a decisional task (Iowa Gambling Task). Fifty SUD participants and 40 controls (CG) were tested using the Iowa Gambling Task. Electrophysiology (electroencephalography) recording was performed during task execution. We measured left and right dorsolateral prefrontal cortex power activity. Behavioral responses (gain/loss options); frequency band modulation (asymmetry index) for delta, theta, alpha, and beta band; and cortical source localization (standardized low-resolution brain electromagnetic tomography) were considered. The SUD group opted in favor of the immediate reward option (loss) more frequently than the long-term option (gain) when compared to the CG. Secondly, SUD showed increased left-hemisphere activation in response to losing (with immediate reward) choices in comparison with the CG. The left hemispheric unbalance effect and the "reward bias" were adduced to explain the decisional impairment in SUD. PMID:25848274

  7. Neurobiological Processes in Adolescent Addictive Disorders

    PubMed Central

    Schepis, Ty S.; Adinoff, Bryon; Rao, Uma

    2008-01-01

    The purpose of this review is to summarize the neurobiological factors involved in the etiology of adolescent addiction and present evidence implicating various mechanisms in its development. Adolescents are at heightened risk for experimentation with substances, and early experimentation is associated with higher rates of SUD in adulthood. Both normative (e.g., immature frontal-limbic connections, immature frontal lobe development) and non-normative (e.g., lowered serotonergic function, abnormal hypothalamic-pituitary-adrenal axis function) neurobiological developmental factors can predispose adolescents to a heightened risk for SUD. In addition, a normative imbalance in the adolescent neurobiological motivational system may be caused by the relative underdevelopment of suppressive mechanisms when compared to stimulatory systems. These neurobiological liabilities may correspond to neurobehavioral impairments in decision-making, affiliation with deviant peers and externalizing behavior; these and other cognitive and behavioral traits converge with neurobiological factors to increase SUD risk. The progression to SUD acts as an amplifying feedback loop, where the development of SUD results in reciprocal impairments in neurobehavioral and neurobiological processes. A clearer understanding of adolescent neurobiology is a necessary step in the development of prevention and treatment interventions for adolescent SUD. PMID:18214718

  8. Enhancing response inhibition by incentive: Comparison of adolescents with and without substance use disorder

    PubMed Central

    Chung, Tammy; Geier, Charles; Luna, Beatriz; Pajtek, Stefan; Terwilliger, Robert; Thatcher, Dawn; Clark, Duncan

    2010-01-01

    Effective response inhibition is a key component of recovery from addiction. Some research suggests that response inhibition can be enhanced through reward contingencies. We examined the effect of monetary incentive on response inhibition among adolescents with and without substance use disorder (SUD) using a fast event-related fMRI antisaccade reward task. The fMRI task permits investigation of how reward (monetary incentive) might modulate inhibitory control during three task phases: cue presentation (reward or neutral trial), response preparation, and response execution. Adolescents with lifetime SUD (n=12; 100% marijuana use disorder) were gender and age-matched to healthy controls (n=12). Monetary incentive facilitated inhibitory control for SUD adolescents; for healthy controls, the difference in error rate for neutral and reward trials was not significant. There were no significant differences in behavioral performance between groups across reward and neutral trials, however, group differences in regional brain activation were identified. During the response preparation phase of reward trials, SUD adolescents, compared to controls, showed increased activation of prefrontal and oculomotor control (e.g., frontal eye field) areas, brain regions that have been associated with effective response inhibition. Results indicate differences in brain activation between SUD and control youth when preparing to inhibit a prepotent response in the context of reward, and support a possible role for incentives in enhancing response inhibition among youth with SUD. PMID:21115229

  9. A geographic information system screening tool to tackle diffuse pollution through the use of sustainable drainage systems.

    PubMed

    Todorovic, Zorica; Breton, Neil P

    2014-01-01

    Sustainable drainage systems (SUDS) offer many benefits that traditional solutions do not. Traditional approaches are unable to offer a solution to problems of flood management and water quality. Holistic consideration of the wide range of benefits from SUDS can result in advantages such as improved flood resilience and water quality enhancement through consideration of diffuse pollution sources. Using a geographical information system (GIS) approach, diffuse pollutant sources and opportunities for SUDS are easily identified. Consideration of potential SUDS locations results in source, site and regional controls, leading to improved water quality (to meet Water Framework Directive targets). The paper will discuss two different applications of the tool, the first of which is where the pollutant of interest is known. In this case the outputs of the tool highlight and isolate the areas contributing the pollutants and suggest the adequate SUDS measures to meet the required criteria. The second application is where the tool identifies likely pollutants at a receiving location, and SUDS measures are proposed to reduce pollution with assessed efficiencies. PMID:24845322

  10. Neuroimaging Risk Markers for Substance Abuse: Recent Findings on Inhibitory Control and Reward System Functioning

    PubMed Central

    Cope, Lora M.; Martz, Meghan E.; Hardee, Jillian E.

    2015-01-01

    Rates of alcohol and other drug use rise sharply throughout adolescence and peak in the early 20s. Likewise, prevalence of first-time substance use disorder (SUD) and past-year SUD both peak between ages 18–23. SUD is associated with a host of negative outcomes and is a serious health concern. Understanding the mechanisms that precede the onset and escalation of substance use is crucial in order to develop more effective prevention and intervention strategies for children and adolescents at risk for SUD. In this review, we discuss recent findings from functional neuroimaging studies in children, adolescents, and emerging adults that focus on uncovering the neural underpinnings of SUD risk. The focus is on inhibitory control and reward circuitry due to their involvement in risk-taking behaviors, which are heightened in adolescence and may facilitate substance use. We discuss convergences in the literature and highlight findings suggesting that the association between SUD risk and neurofunctioning may be moderated by age, gender, and history of substance use. Recommendations for future directions are also discussed. PMID:26236575

  11. Potential role of N-acetylcysteine in the management of substance use disorders.

    PubMed

    McClure, Erin A; Gipson, Cassandra D; Malcolm, Robert J; Kalivas, Peter W; Gray, Kevin M

    2014-02-01

    There is a clear and pressing need to expand pharmacotherapy options for substance use disorders (SUDs) in order to improve sustained abstinence outcomes. Preclinical literature has demonstrated the role of glutamate in addiction, suggesting that new targets for pharmacotherapy should focus on the restoration of glutamatergic function. Glutamatergic agents for SUDs may span multiple addictive behaviors and help demonstrate potentially overlapping mechanisms in addiction. The current review will focus specifically on N-acetylcysteine (NAC), a safe and well-tolerated glutamatergic agent, as a promising potential pharmacotherapy for the treatment of SUDs across several substances of abuse. Building on recently published reviews of the clinical efficacy of NAC across a broad range of conditions, this review will more specifically discuss NAC as a pharmacotherapy for SUDs, devoting particular attention to the safety and tolerability profile of NAC, the wealth of preclinical evidence that has demonstrated the role of glutamate dysregulation in addiction, and the limited but growing clinical literature that has assessed the efficacy of NAC across multiple substances of abuse. Preliminary clinical studies show the promise of NAC in terms of safety, tolerability, and potential efficacy for promoting abstinence from cocaine, nicotine, and cannabis. Results from randomized clinical trials have been mixed, but several mechanistic and methodological factors are discussed to refine the use of NAC in promoting abstinence and relapse prevention across several substances of abuse. Further preclinical and clinical investigation into the use of NAC for SUDs will be vital in addressing current deficits in the treatment of SUDs. PMID:24442756

  12. The cognitive effects of hepatitis C in the presence and absence of a history of substance use disorder

    PubMed Central

    Huckans, Marilyn; Seelye, Adriana; Parcel, Tiffany; Mull, Lisa; Woodhouse, Jonathan; Bjornson, Danell; Fuller, Bret E.; Loftis, Jennifer M.; Morasco, Benjamin J.; Sasaki, Anna W.; Storzbach, Daniel; Hauser, Peter

    2010-01-01

    The aim of the study was to determine whether infection with the hepatitis C virus (HCV) is associated with cognitive impairment beyond the effects of prevalent comorbidities and a history of substance use disorder (SUD). Adult veterans were recruited from the Portland Veterans Affairs Medical Center into three groups: (1) HCV+/SUD+ (n = 39), (2) HCV+/SUD− (n = 24), and (3) HCV−/SUD− (n = 56). SUD+ participants were in remission for ≥90 days, while SUD− participants had no history of SUD. Groups did not significantly differ in terms of rates of psychiatric or medical comorbidities. Procedures included clinical interviews, medical record reviews, and neuropsychological testing. Significant group differences were found in the domains of Verbal Memory, Auditory Attention, Speeded Visual Information Processing, and Reasoning/Mental Flexibility (p ≤ .05). Post hoc comparisons indicated that HCV+/SUD− patients performed significantly worse than HCV−/SUD− controls on tests measuring verbal learning, auditory attention, and reasoning/mental flexibility, but only HCV+/SUD+ patients did worse than HCV−/ SUD− controls on tests of speeded visual information processing. Results indicate that chronic HCV is associated with cognitive impairment in the absence of a history of SUD. The most robust deficits appear to be in verbal learning and reasoning/mental flexibility. (JINS, 2009, 15, 69–82.) PMID:19128530

  13. The Transition to Medication Adoption in Publicly Funded Substance Use Disorder Treatment Programs: Organizational Structure, Culture, and Resources

    PubMed Central

    Knudsen, Hannah K; Roman, Paul M

    2014-01-01

    Objective: Medications for the treatment of substance use disorders (SUDs) are not widely available in publicly funded SUD treatment programs. Few studies have drawn on longitudinal data to examine the organizational characteristics associated with programs transitioning from not delivering any pharmacotherapy to adopting at least one SUD medication. Method: Using two waves of panel longitudinal data collected over a 5-year period, we measured the transition to medication adoption in a cohort of 190 publicly funded treatment organizations that offered no SUD medications at baseline. Independent variables included organizational characteristics, medical resources, funding, treatment culture, and detailing activities by pharmaceutical companies. Results: Of 190 programs not offering SUD pharmacotherapy at baseline, 22.6% transitioned to offering at least one SUD medication at follow-up approximately 5 years later. Multivariate logistic regression results indicated that the employment of at least one physician at baseline, having a greater proportion of Medicaid clients, and pharmaceutical detailing were positively associated with medication adoption. Conclusions: Adoption of pharmacotherapy was more likely in programs that had greater medical resources, Medicaid funding, and contact with pharmaceutical companies. Given the potential expansion of Medicaid under the Affordable Care Act, patients served by publicly funded programs may gain greater access to such treatments, but research is needed to document health reform’s impact on this sector of the treatment system. PMID:24766760

  14. Enhancing response inhibition by incentive: comparison of adolescents with and without substance use disorder.

    PubMed

    Chung, Tammy; Geier, Charles; Luna, Beatriz; Pajtek, Stefan; Terwilliger, Robert; Thatcher, Dawn; Clark, Duncan B

    2011-05-01

    Effective response inhibition is a key component of recovery from addiction. Some research suggests that response inhibition can be enhanced through reward contingencies. We examined the effect of monetary incentive on response inhibition among adolescents with and without substance use disorder (SUD) using a fast event-related fMRI antisaccade reward task. The fMRI task permits investigation of how reward (monetary incentive) might modulate inhibitory control during three task phases: cue presentation (reward or neutral trial), response preparation, and response execution. Adolescents with lifetime SUD (n=12; 100% marijuana use disorder) were gender and age-matched to healthy controls (n=12). Monetary incentive facilitated inhibitory control for SUD adolescents; for healthy controls, the difference in error rate for neutral and reward trials was not significant. There were no significant differences in behavioral performance between groups across reward and neutral trials, however, group differences in regional brain activation were identified. During the response preparation phase of reward trials, SUD adolescents, compared to controls, showed increased activation of prefrontal and oculomotor control (e.g., frontal eye field) areas, brain regions that have been associated with effective response inhibition. Results indicate differences in brain activation between SUD and control youth when preparing to inhibit a prepotent response in the context of reward, and support a possible role for incentives in enhancing response inhibition among youth with SUD. PMID:21115229

  15. Effective Clinical Supervision in Substance Use Disorder Treatment Programs and Counselor Job Performance

    PubMed Central

    2013-01-01

    When mental health counselors have limited and/or inadequate training in substance use disorders (SUDs), effective clinical supervision (ECS) may advance their professional development. The purpose of the current study was to investigate whether ECS is related to the job performance of SUD counselors. Data were obtained in person via paper-and-pencil surveys from 392 matched SUD counselor-clinical supervisor dyads working in 27 SUD treatment organizations across the United States. ECS was rated by counselors and measured with five multi-item scales (i.e., sponsoring counselors’ careers, providing challenging assignments, role modeling, accepting/confirming counselors’ competence, overall supervisor task proficiency). Clinical supervisors rated counselors’ job performance, which was measured with two multi-item scales (i.e., task performance, performance within supervisory relationship). Using mixed-effects models, we found that most aspects of ECS are related to SUD counselor job performance. Thus, ECS may indeed enhance counselors’ task performance and performance within the supervisory relationship, and, as a consequence, offset limited formal SUD training. PMID:25061265

  16. Decisional impairments in cocaine addiction, reward bias, and cortical oscillation “unbalance”

    PubMed Central

    Balconi, Michela; Finocchiaro, Roberta

    2015-01-01

    A vast amount of research has suggested that subjects with substance use disorder (SUD) might have difficulty making advantageous decisions that opt in favor of a longer-term, larger reward than an immediate, smaller reward. The current research explored the impact of reward bias and cortical frontal asymmetry (left lateralization effect) in SUD in response to a decisional task (Iowa Gambling Task). Fifty SUD participants and 40 controls (CG) were tested using the Iowa Gambling Task. Electrophysiology (electroencephalography) recording was performed during task execution. We measured left and right dorsolateral prefrontal cortex power activity. Behavioral responses (gain/loss options); frequency band modulation (asymmetry index) for delta, theta, alpha, and beta band; and cortical source localization (standardized low-resolution brain electromagnetic tomography) were considered. The SUD group opted in favor of the immediate reward option (loss) more frequently than the long-term option (gain) when compared to the CG. Secondly, SUD showed increased left-hemisphere activation in response to losing (with immediate reward) choices in comparison with the CG. The left hemispheric unbalance effect and the “reward bias” were adduced to explain the decisional impairment in SUD. PMID:25848274

  17. p53 down-regulates SARS coronavirus replication and is targeted by the SARS-unique domain and PLpro via E3 ubiquitin ligase RCHY1.

    PubMed

    Ma-Lauer, Yue; Carbajo-Lozoya, Javier; Hein, Marco Y; Müller, Marcel A; Deng, Wen; Lei, Jian; Meyer, Benjamin; Kusov, Yuri; von Brunn, Brigitte; Bairad, Dev Raj; Hünten, Sabine; Drosten, Christian; Hermeking, Heiko; Leonhardt, Heinrich; Mann, Matthias; Hilgenfeld, Rolf; von Brunn, Albrecht

    2016-08-30

    Highly pathogenic severe acute respiratory syndrome coronavirus (SARS-CoV) has developed strategies to inhibit host immune recognition. We identify cellular E3 ubiquitin ligase ring-finger and CHY zinc-finger domain-containing 1 (RCHY1) as an interacting partner of the viral SARS-unique domain (SUD) and papain-like protease (PL(pro)), and, as a consequence, the involvement of cellular p53 as antagonist of coronaviral replication. Residues 95-144 of RCHY1 and 389-652 of SUD (SUD-NM) subdomains are crucial for interaction. Association with SUD increases the stability of RCHY1 and augments RCHY1-mediated ubiquitination as well as degradation of p53. The calcium/calmodulin-dependent protein kinase II delta (CAMK2D), which normally influences RCHY1 stability by phosphorylation, also binds to SUD. In vivo phosphorylation shows that SUD does not regulate phosphorylation of RCHY1 via CAMK2D. Similarly to SUD, the PL(pro)s from SARS-CoV, MERS-CoV, and HCoV-NL63 physically interact with and stabilize RCHY1, and thus trigger degradation of endogenous p53. The SARS-CoV papain-like protease is encoded next to SUD within nonstructural protein 3. A SUD-PL(pro) fusion interacts with RCHY1 more intensively and causes stronger p53 degradation than SARS-CoV PL(pro) alone. We show that p53 inhibits replication of infectious SARS-CoV as well as of replicons and human coronavirus NL63. Hence, human coronaviruses antagonize the viral inhibitor p53 via stabilizing RCHY1 and promoting RCHY1-mediated p53 degradation. SUD functions as an enhancer to strengthen interaction between RCHY1 and nonstructural protein 3, leading to a further increase in in p53 degradation. The significance of these findings is that down-regulation of p53 as a major player in antiviral innate immunity provides a long-sought explanation for delayed activities of respective genes. PMID:27519799

  18. Personality Disorders and the Persistence of Substance Use Disorders: A Reanalysis of Published NESARC Findings

    PubMed Central

    Vergés, Alvaro; Jackson, Kristina M.; Bucholz, Kathleen K.; Trull, Timothy J.; Lane, Sean P.; Sher, Kenneth J.

    2014-01-01

    The purpose of this study was to examine whether published findings regarding the association of personality disorders (PDs) with the persistence of substance use disorders (SUDs) are attributable to an artifact due to time of assessment of the PD. Two previous studies analyzed data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and found that Antisocial PD, Schizotypal PD, and Borderline PD are unique predictors of SUDs. However, a design limitation in NESARC (assessment of PDs at different waves) can potentially compromise these findings. To assess the influence of time of assessment of PDs and to identify associations that might be robust to time of assessment, we compared the association of PDs with two estimates of SUD persistence that were based on different populations at risk: 1) among those who were diagnosed with SUD at baseline, the proportion who continued to meet full criteria at follow-up (“prediction”), and 2) among those who were diagnosed with SUD at follow-up, the proportion who met full criteria at baseline (“postdiction”). Differences between prediction and postdiction revealed a robust pattern of higher odds ratios for postdiction among PDs assessed at baseline, and lower odds ratios for postdiction among PDs assessed at follow-up. All published significant associations between PDs and persistence of SUDs became non-significant in the postdiction analyses, with the exception of Obsessive-Compulsive PD predicting Nicotine Dependence persistence. The present results raise serious doubts about the validity of published findings on PDs and SUD persistence from the NESARC. Design limitations in NESARC preclude a direct comparison among PDs measured at different waves. PMID:25314264

  19. Impaired Aerobic Endurance and Muscular Strength in Substance Use Disorder Patients

    PubMed Central

    Flemmen, Grete; Wang, Eivind

    2015-01-01

    Abstract Although substance use disorder (SUD) patients are documented to have an inactive lifestyle, which is associated with cardiovascular disease, other lifestyle-related diseases and premature death, evidence regarding their aerobic endurance and muscular strength is limited. Therefore, the authors aimed to evaluate directly assessed maximal oxygen consumption, walking efficiency, as well as maximal strength in a group of SUD patients. A total of 44 SUD patients in residential treatment, 31 men (31 ± 8 years) and 13 women (34 ± 10 years), were included and completed the physical testing. The patients were compared with an age- and sex-matched reference group. Male and female SUD patients exhibited a maximal oxygen consumption of 44.6 ± 6.2 and 33.8 ± 6.6 mL· min−1 kg−1, respectively. This was significantly lower than the reference group, 15% (P = 0.03) for men and 25% (P = 0.001) for women. In addition, the SUD patients had a 13% significantly reduced walking efficiency (P = 0.02), compared with healthy controls. The impairments in aerobic endurance were accompanied by significant reductions in maximal strength of 30% (P = 0.001) and 33% (P = 0.01) for men and women, respectively. In combination, these results imply that SUD patients have impaired endurance and muscular strength compared with what is typically observed in the population, and consequently suffer a higher risk of developing cardiovascular and other lifestyle-related diseases and early death. Effective physical exercise should be advocated as an essential part of the clinical practice of SUD treatment to improve the patient's health and consequently reduce the costs because of the high use of emergency departments, hospital, and medical care. PMID:26554792

  20. Intimate Partner Violence Outcomes in Women with PTSD and Substance Use: A Secondary Analysis of NIDA Clinical Trials Network “Women and Trauma” Multi-Site Study

    PubMed Central

    Cohen, Lisa R.; Field, Craig; Campbell, Aimee N. C.; Hien, Denise A.

    2013-01-01

    Studies have shown strong associations between intimate partner violence (IPV) and both posttraumatic stress disorder (PTSD) and substance use disorders (SUD). Despite these linkages, research on the dual diagnosis of PTSD-SUD and its relationship to IPV is in an early stage, and little is known about how PTSD-SUD treatment might influence IPV outcomes. The current study is a secondary analysis of a larger NIDA Clinical Trials Network study exploring the effectiveness of two behavioral interventions for women with comorbid PTSD-SUD. Participants (n =288) were randomly assigned to Seeking Safety (SS), a cognitive-behavioral treatment that focuses on trauma and substance abuse symptoms, or to Women’s Health Education, a psychoeducational group. Logistic regressions were used to examine how treatment condition, identified risk factors and their interactions were related to IPV. Results showed that participants who were abstinent at baseline were significantly less likely to experience IPV over the 12-month follow-up period, whereas participants living with someone with an alcohol problem were significantly more likely to experience IPV over follow-up. Findings also showed that at a trend level participants with recent interpersonal trauma at baseline and higher total of lifetime trauma exposures were more likely to report IPV during follow-up. Although there was no main effect for treatment condition, a significant interaction between treatment condition and baseline abstinence was found. Participants who were abstinent at baseline and in the SS condition were significantly less likely to report IPV over follow-up. These findings indicate that an integrated treatment for PTSD and SUD was associated with significantly better IPV outcomes for a subset of individuals. The possibility that women with PTSD-SUD may differentially benefit from SS has important clinical implications. Further research examining the intersection of PTSD, SUD and IPV, and the impact of

  1. Nuclear Magnetic Resonance Structure Shows that the Severe Acute Respiratory Syndrome Coronavirus-Unique Domain Contains a Macrodomain Fold▿

    PubMed Central

    Chatterjee, Amarnath; Johnson, Margaret A.; Serrano, Pedro; Pedrini, Bill; Joseph, Jeremiah S.; Neuman, Benjamin W.; Saikatendu, Kumar; Buchmeier, Michael J.; Kuhn, Peter; Wüthrich, Kurt

    2009-01-01

    The nuclear magnetic resonance (NMR) structure of a central segment of the previously annotated severe acute respiratory syndrome (SARS)-unique domain (SUD-M, for “middle of the SARS-unique domain”) in SARS coronavirus (SARS-CoV) nonstructural protein 3 (nsp3) has been determined. SUD-M(513-651) exhibits a macrodomain fold containing the nsp3 residues 528 to 648, and there is a flexibly extended N-terminal tail with the residues 513 to 527 and a C-terminal flexible tail of residues 649 to 651. As a follow-up to this initial result, we also solved the structure of a construct representing only the globular domain of residues 527 to 651 [SUD-M(527-651)]. NMR chemical shift perturbation experiments showed that SUD-M(527-651) binds single-stranded poly(A) and identified the contact area with this RNA on the protein surface, and electrophoretic mobility shift assays then confirmed that SUD-M has higher affinity for purine bases than for pyrimidine bases. In a further search for clues to the function, we found that SUD-M(527-651) has the closest three-dimensional structure homology with another domain of nsp3, the ADP-ribose-1"-phosphatase nsp3b, although the two proteins share only 5% sequence identity in the homologous sequence regions. SUD-M(527-651) also shows three-dimensional structure homology with several helicases and nucleoside triphosphate-binding proteins, but it does not contain the motifs of catalytic residues found in these structural homologues. The combined results from NMR screening of potential substrates and the structure-based homology studies now form a basis for more focused investigations on the role of the SARS-unique domain in viral infection. PMID:19052085

  2. Psychiatric Consultation and Substance Use Disorders

    PubMed Central

    Specker, Sheila; Meller, William H.; Thurber, Steven

    2009-01-01

    Background A substantial number of patients in general hospitals will evince substance abuse problems but a majority is unlikely to be adequately identified in the referral-consultation process. This failure may preclude patients from receiving effective interventions for substance use disorders. Objectives 1. To evaluate all referred patients for possible substance use disorders. 2. To ascertain the degree of convergence between patients referred for chemical problems and the corresponding DSM diagnosis. 3. To compare demographic data for substance abusing patients and referrals not so classified. 4. To evaluate conditions concomitant with substance use disorders. Method Consecutive one-year referrals (524) to consultation-liaison psychiatric services were scrutinized for chemically-related problems by psychiatric consultants. Results Of the referrals, 176 met criteria for substance use disorders (SUD) (57% alcohol; 25% other drugs; 18% both alcohol and other drugs). Persons diagnosed with SUD tended to be younger, male, non-Caucasian, unmarried, and unemployed. They were more likely to be depressed, have liver and other gastrointestinal problems, and to have experienced traumatic events; they also tended to have current financial difficulties. Most were referred for SUD evaluation by personnel in general medicine and family practice. Following psychiatric consultation, SUD designated patients were referred mainly to substance abuse treatment programs. The only variable related to recommended inpatient versus outpatient services for individuals with SUD was the Global Assessment of Functioning Axis (GAF) with persons having lower estimated functioning more likely to be referred for inpatient interventions. Conclusions These data are similar to the results of past studies in this area. Unlike previous investigations in the domain of consultative-liaison psychiatry, financial stressors and specific consultant recommendations were included in data gathering. Although

  3. Item Response Theory analyses of DSM-IV and DSM-5 stimulant use disorder criteria in an American Indian community sample

    PubMed Central

    Gilder, David A.; Gizer, Ian R.; Lau, Philip; Ehlers, Cindy L.

    2013-01-01

    Background Native Americans experience some of the highest rates of DSM-IV stimulant dependence (SD) of all U.S. ethnic groups. This report compares DSM-IV and DSM-5 stimulant use disorder (SUD) diagnostic criteria in an American Indian community sample. Methods Demographic information, stimulant (methamphetamine or cocaine) use, and lifetime DSM-IV and DSM-5 diagnoses were assessed in 858 adult American Indians. Item Response Theory (IRT) analyses were used to assess SUD criteria in both DSM-IV and DSM-5 criteria sets along an underlying latent trait severity continuum and the effect of demographic variables on differential item functioning (DIF) in those criteria. Results The overall rate of DSM-IV SD was 33%, of DSM-IV SUD was 38%, and of DSM-5 SUD was 36% with no gender differences. All SUD symptoms in both the DSM-IV and DSM-5 datasets functioned on the moderate portion of the underlying severity continuum. “Craving” discriminated better than any other criterion at its level of severity in indicating the presence or absence of SUD. There was little DIF in groups defined by gender or any other demographic variable in either the DSM-IV or DSM-5 datasets. Conclusions These findings indicate that in this American Indian sample, diagnostic criteria for DSM-IV and DSM-5 SUD function similarly in terms of severity and DIF and that the abolition of the DSM-IV distinction between stimulant abuse and dependence in DSM-5 is warranted. PMID:24200103

  4. Childhood Risk Factors for Young Adult Substance Dependence Outcome in Offspring from Multiplex Alcohol Dependence Families: A Prospective Study

    PubMed Central

    Hill, Shirley Y.; Steinhauer, Stuart R.; Locke-Wellman, Jeannette; Ulrich, Richard

    2012-01-01

    Background Age of onset to begin drinking is a known risk factor for alcohol dependence. Factors have been identified that contribute to age of onset to begin regular drinking. These include reduced P300, increased postural sway, and personality variation. A longitudinal study spanning childhood to young adulthood provided the opportunity to determine if these same factors would predict the presence and onset of substance use disorders (SUD). Methods Multiplex families were identified through two or more alcohol-dependent brothers. Offspring from these multiplex or control families (n = 133) were followed annually during childhood. Using childhood predictors previously identified as risk factors for age of onset to begin drinking, SUD outcome by young adulthood was modeled. Results Familial risk status was a significant predictor of young adult SUD outcome as a main effect and as an interaction with P300 amplitude recorded before the age of 13. In adolescence (age 15), increased postural sway and familial risk predicted the SUD outcome by age 22. Analysis comparing the presence of one or both risk factors showed that those above the median for sway and below the median for P300 amplitude had substantially increased odds of developing SUD (odds ratio = 8.08 [confidence interval = 1.52– 42.83]). Conclusions Our findings indicate that among the factors predicting age of onset to begin regular drinking, P300 predicts SUD outcome across an 11-year span. The present findings provide the longest follow-up to date demonstrating that neurobiological factors in childhood are among the most salient predictors of young adult SUD outcome. PMID:19640504

  5. Impact of Adolescent Alcohol and Drug Use on Neuropsychological Functioning in Young Adulthood: 10-Year Outcomes

    PubMed Central

    Hanson, Karen L.; Medina, Krista Lisdahl; Padula, Claudia B.; Tapert, Susan F.; Brown, Sandra A.

    2011-01-01

    Background Alcohol and other substance use disorders (AUD/SUD) are common among youth and often continue into adulthood; therefore, the neurocognitive effects of substance use are of great concern. Because neuromaturation continues into young adulthood, youth with AUD/SUD may be at risk for lasting cognitive decrements. This study prospectively examines neuropsychological functioning over 10 years as a function of AUD/SUD history and outcomes. Methods The 51 participants consisted of 18 youth with persisting AUD/SUD, 19 youth with remitted AUD/SUD, and 14 community youth with no AUD/SUD history followed over 10 years (ages 16 to 27 on average) with neuropsychological testing and substance use interviews on 8 occasions. Neuropsychological performance from baseline to 10-year follow-up was compared between the three groups. Results Despite scoring higher than controls at intake, both AUD/SUD groups showed a relative decline in visuospatial construction at 10-year follow-up (p=.001). Regressions showed that alcohol use (β=−.33, p < .01) and drug withdrawal symptoms (β=−.31, p<.05) over follow-up were predictive of year 10 visuospatial function. Alcohol use also predicted verbal learning and memory (β=−.28, p<.05), while stimulant use predicted visual learning and memory function (β=−.33, p=.01). More recent substance use was associated with poorer executive function (β=.28, p<.05). Discussion These findings confirm prior studies suggesting that heavy, chronic alcohol and other substance use persisting from adolescence to young adulthood may produce cognitive disadvantages, primarily in visuospatial and memory abilities. Youth who chronically consume heavy quantities of alcohol and/or experience drug withdrawal symptoms may be particularly at risk for cognitive deterioration by young adulthood. PMID:21532924

  6. Addiction History Associates with the Propensity to Form Habits.

    PubMed

    McKim, Theresa H; Bauer, Daniel J; Boettiger, Charlotte A

    2016-07-01

    Learned habitual responses to environmental stimuli allow efficient interaction with the environment, freeing cognitive resources for more demanding tasks. However, when the outcome of such actions is no longer a desired goal, established stimulus-response (S-R) associations or habits must be overcome. Among people with substance use disorders (SUDs), difficulty in overcoming habitual responses to stimuli associated with their addiction in favor of new, goal-directed behaviors contributes to relapse. Animal models of habit learning demonstrate that chronic self-administration of drugs of abuse promotes habitual responding beyond the domain of compulsive drug seeking. However, whether a similar propensity toward domain-general habitual responding occurs in humans with SUDs has remained unclear. To address this question, we used a visuomotor S-R learning and relearning task, the Hidden Association between Images Task, which employs abstract visual stimuli and manual responses. This task allows us to measure new S-R association learning and well-learned S-R association execution and includes a response contingency change manipulation to quantify the degree to which responding is habit-based, rather than goal-directed. We find that people with SUDs learn new S-R associations as well as healthy control participants do. Moreover, people with an SUD history slightly outperform controls in S-R execution. In contrast, people with SUDs are specifically impaired in overcoming well-learned S-R associations; those with SUDs make a significantly greater proportion of perseverative errors during well-learned S-R replacement, indicating the more habitual nature of their responses. Thus, with equivalent training and practice, people with SUDs appear to show enhanced domain-general habit formation. PMID:26967944

  7. Longitudinal determinants of substance use disorders.

    PubMed

    Brook, Judith S; Lee, Jung Yeon; Rubenstone, Elizabeth; Finch, Stephen J; Seltzer, Nathan; Brook, David W

    2013-12-01

    Substance use and substance use disorders (SUDs) have been linked with marital discord. Relatively little is known, however, about the antecedents of SUDs, the mediators of these factors over time, or their associations with the spousal/partner relationship among urban adults. A better understanding of the longitudinal pathways to marital conflict and to SUDs should help prevention and intervention programs target their precursors within the developmental period in which they occur. The present study, therefore, examined the longitudinal predictors of an unsupportive spousal/partner relationship and SUDs among a community sample of urban African American and Puerto Rican adults from East Harlem, NY. Participants (N = 816) completed structured questionnaires at five time waves, from adolescence to adulthood (mean ages = 14, 19, 24, 29, and 32 years). Structural equation modeling examined the effects of earlier environmental and social stressors and intrapersonal and interpersonal factors on later SUDs in adulthood. There was a good fit of the structural equation model (CFI = 0.91; RMSEA = 0.06; and SRMR = 0.06), which revealed three main pathways from adolescence to the spousal/partner relationship and SUDs in adulthood. One pathway linked a weak parent-adolescent attachment relationship with the participant's psychological symptoms in emerging adulthood (p < 0.01), which in turn were related to affiliation with deviant and drug-using peers, also in emerging adulthood (p < 0.001). Peer deviance and drug use were associated with the participant's substance use in young adulthood (p < 0.001), which predicted both an unsupportive spousal/partner relationship (p < 0.05) and SUDs (p < 0.001) later in adulthood. Other pathways highlighted the continuity of psychological symptoms as related to both substance use in young adulthood (p < 0.001) and an unsupportive spousal/partner relationship in adulthood (p < 0.001). Findings

  8. CONJOINT TRAJECTORIES OF DEPRESSIVE SYMPTOMS AND DELINQUENT BEHAVIOR PREDICTING SUBSTANCE USE DISORDERS

    PubMed Central

    Brook, Judith S.; Lee, Jung Yeon; Finch, Stephen J.; Brook, David W.

    2014-01-01

    This study examines the conjoint trajectories of depressive symptoms and delinquent behavior from adolescence (age 14) into young adulthood (age 24) as predictors of substance use disorders (SUDs) in adulthood (age 32). Of the 816 participants, 52% were African American, and 48% were Puerto Rican. After we obtained the conjoint trajectory groups using Mplus, we performed logistic regression analyses using SAS to compare the Bayesian Posterior Probability (BPP) of each of the conjoint trajectory groups with the BBP of the reference conjoint trajectory group to predict SUDs. Four conjoint trajectory groups were obtained. The higher BPPs of both the high depressive symptoms and low delinquent behavior trajectory group (AOR = 3.54, p<.05) and the medium depressive symptoms and high delinquent behavior trajectory group (AOR = 10.28, p<.001), as compared with the BPP of the low depressive symptoms and low delinquent behavior trajectory group, were associated with an increased likelihood of SUDs in adulthood. These associations were maintained with control on gender, ethnicity, the use of alcohol, cigarette, and marijuana, socioeconomic status (SES) at age 14, and income and educational level at age 36. Prevention and treatment of delinquent individuals reporting SUDs might be more effective if their depressive symptoms were also addressed. Similarly, prevention and treatment of depressed individuals reporting SUDs might be more effective if their delinquent behavior was also addressed. PMID:25462648

  9. Postmortem Genetic Testing for Conventional Autopsy–Negative Sudden Unexplained Death

    PubMed Central

    Carturan, Elisa; Tester, David J.; Brost, Brian C.; Basso, Cristina; Thiene, Gaetano; Ackerman, Michael J.

    2012-01-01

    One third of autopsy-negative sudden unexplained deaths (SUDs) can be attributed to a cardiac channelopathy. Typically, paraffin-embedded tissue (PET) is the only source of DNA available for genetic analyses. We examined different DNA extraction procedures, involving 2 deparaffinization methods, 2 digestion methods, 4 laboratory-based purification methods, and 5 commercial kits. Mutational analysis involving 25 RYR2 exons was performed on PET DNA from 35 SUD cases to evaluate the feasibility of using PET DNA for genetic testing. With the best PET-DNA extraction method, an average of only two thirds of the region of interest could be evaluated. Although we initially identified 5 missense mutations in 5 of 35 SUD cases, repeated analysis failed to confirm these mutations. DNA from PET should be considered error prone and unreliable in comprehensive surveillance of SUD-associated genes. Given these shortcomings, the standard autopsy for SUD should include archiving EDTA-preserved blood or frozen tissue to facilitate postmortem genetic testing. PMID:18285261

  10. Psychopathology in Substance Use Disorder Patients with and without Substance-Induced Psychosis

    PubMed Central

    Zhornitsky, Simon; Tikàsz, Andràs; Rizkallah, Élie; Chiasson, Jean-Pierre; Potvin, Stéphane

    2015-01-01

    Background. Substance-induced psychotic disorder (SIPD) is a diagnosis constructed to distinguish substance-induced psychotic states from primary psychotic disorders. A number of studies have compared SIPD persons with primary psychotic patients, but there is little data on what differentiates substance use disorder (SUD) individuals with and without SIPD. Here, we compared psychopathology, sociodemographic variables, and substance use characteristics between SUD patients with and without SIPD. Methods. A retrospective chart review was conducted on newly admitted patients at a rehabilitation centre between 2007 and 2012. Results. Of the 379 patients included in the study, 5% were diagnosed with SIPD (n = 19) and 95% were diagnosed with SUDs without SIPD (n = 360). More SIPD patients reported using cannabis and psychostimulants, and fewer SIPD patients reported using alcohol than SUDs patients without SIPD. SIPD patients scored higher on the “schizophrenia nuclear symptoms” dimension of the SCL-90R psychoticism scale and exhibited more ClusterB personality traits than SUD patients without SIPD. Discussion. These data are consistent with previous studies suggesting that psychopathology, substance type, and sociodemographic variables play important role in the development of SIPD. More importantly, the results highlight the need for paying greater attention to the types of self-reported psychotic symptoms during the assessment of psychotomimetic effects associated with psychoactive substances. PMID:26417473

  11. College Students Rarely Seek Help Despite Serious Substance Use Problems

    PubMed Central

    Caldeira, Kimberly M.; Kasperski, Sarah J.; Sharma, Eva; Vincent, Kathryn B.; O’Grady, Kevin E.; Wish, Eric D.; Arria, Amelia M.

    2009-01-01

    The prevalence of substance use disorders (SUD) and aspects of the help-seeking process among a high-risk sample of 946 students at one large public university were assessed in personal interviews during the first three years of college. After statistically adjusting for purposive sampling, an estimated 46.8%wt of all third-year students met DSM-IV criteria for SUD involving alcohol and/or marijuana at least once. Of 548 SUD cases, 3.6% perceived a need for help with substance use problems; 16.4% were encouraged by someone else to seek help. Help-seeking was rare among SUD cases (8.8%), but significantly elevated among individuals who perceived a need (90.0%) or experienced social pressures from parents (32.5%), friends (34.2%), or another person (58.3%). Resources accessed for help included educational programs (38%), health professionals (27%), and twelve-step programs (19%). College students have high rates of substance use problems but rarely recognize a need for treatment or seek help. Results highlight the opportunity for early intervention with college students with SUD. PMID:19553064

  12. The impact of intolerance of emotional distress and uncertainty on veterans with co-occurring PTSD and substance use disorders.

    PubMed

    Banducci, Anne N; Bujarski, Sarah J; Bonn-Miller, Marcel O; Patel, Amee; Connolly, Kevin M

    2016-06-01

    The risk of developing a substance use disorder (SUD) is significantly higher among veterans with posttraumatic stress disorder (PTSD). Veterans with this co-occurrence have poorer outcomes than singly diagnosed veterans, which may be related to two risk factors: intolerance uncertainty (IU) and low tolerance of emotional distress (TED). We hypothesized low TED and high IU would independently and interactively relate to heightened PTSD symptomatology and trauma-cue elicited SUD cravings. A sample of 70 veterans (M age=50; 95% men; 65% Black) with co-occurring PTSD-SUD was recruited. The Posttraumatic Stress Disorder Checklist (PCL), Craving Questionnaire, Distress Tolerance Scale, and Intolerance of Uncertainty Scale were administered. In general, low TED and high IU were significantly correlated with the PCL total and subscale scores. When examined within regression models, low TED was associated with elevated PCL scores and trauma-cue elicited SUD cravings; IU was not. However, there was a significant interaction between IU and TED; veterans with elevated IU and low TED had higher PCL Total, Hyperarousal, and Intrusions scores. This highlights the importance of assessing TED and IU among veterans with co-occurring PTSD-SUD, as these risk factors may not only be prognostic indicators of outcomes, but also treatment targets. PMID:27004450

  13. Implementation of integrated therapies for comorbid post-traumatic stress disorder and substance use disorders in community substance abuse treatment programs

    PubMed Central

    KILLEEN, THERESE K.; BACK, SUDIE E.; BRADY, KATHLEEN T.

    2016-01-01

    Issues The high prevalence of trauma and post-traumatic stress disorder (PTSD) in individuals with substance use disorders (SUDs) presents a number of treatment challenges for community treatment providers and programs in the USA. Although several evidence-based, integrated therapies for the treatment of comorbid PTSD/SUD have been developed, rates of utilisation of such practices remain low in community treatment programs. Approach The goal of this article was to review the extant literature on common barriers that prevent adoption and implementation of integrated treatments for PTSD/SUD among substance abuse community treatment programs. Key Findings Organisational, provider-level and patient-level factors that drive practice decisions were discussed, including organisational philosophy of care policies, funding and resources, as well as provider and patient knowledge and attitudes related to implementation of new integrated treatments for comorbid PTSD and SUD. Implications and Conclusions Understanding and addressing these community treatment challenges may facilitate use of evidence-based integrated treatments for comorbid PTSD and SUD. PMID:25737377

  14. The Affordable Care Act, Substance Use Disorders, and Low-Income Clients: Implications for Social Work.

    PubMed

    McCabe, Heather A; Wahler, Elizabeth A

    2016-07-01

    Social workers are leaders in the substance abuse services field and may often work in substance use disorder (SUD) education, prevention, assessment, treatment, or resource coordination and case management roles. As the Patient Protection and Affordable Care Act (ACA) (2010) drives changes in the fields of health and behavioral health, social workers have an opportunity to lead structural changes at the micro and macro levels that will have a positive impact on low-income clients with SUDs. In this article, authors examine the current state of SUDs and health care access, the impact of the ACA on the field, and implications for social work practice and education. Social workers should seek specialized education and credentialing in SUD services, know how to help clients apply for health care coverage, and advocate for integrated substance abuse treatment and health care programs and an expansion of Medicaid in their local communities. Social workers are well positioned to be a voice for clients to ensure that the current structural changes result in a better, integrated system of care that is able to respond to the needs of low-income clients with SUDs. PMID:27501640

  15. Disparities in treatment for substance use disorders and co-occurring disorders for ethnic/racial minority youth

    PubMed Central

    Alegria, Margarita; Carson, Nicholas J.; Goncalves, Marta; Keefe, Kristen

    2012-01-01

    Objective To review the literature on racial and ethnic disparities in behavioral health services and present recent data, focusing on services for substance use disorders (SUD) and comorbid mental health disorders for children and adolescents. Method A literature review was conducted of behavioral health services for minority youth. Papers were included if specific comparisons in receipt of SUD services for youth were made by race or ethnicity. The review was organized following the Sociocultural Framework. Results Compared to non-Latino Whites with SUD, Black adolescents with SUD report receiving less specialty and informal care, while Latinos with SUD report less informal services. Potential mechanisms of racial and ethnic disparities were identified in: federal and economic health care policies and regulations; the operation of the health care system and provider organization; provider level factors; the environmental context; the operation of the community system; and patient level factors. Significant disparities reductions could be achieved by adoption of certain state policies and regulations that increase eligibility in public insurance. There is also a need to study how the organization of treatment services might lead to service disparities, particularly problems in treatment completion. Institutional and family characteristics linked to better quality of care should be explored. Since treatments appear to work well independent of race/ethnicity, translational research to bring evidence based care in diverse communities can bolster their effectiveness. Conclusions Our review suggests promising venues to reduce ethnic and racial disparities in behavioral health services for ethnic and racial minority youth. PMID:21156267

  16. The Relationship Between Eating Disorder Symptoms and Treatment Rejection among Young Adult Men in Residential Substance Use Treatment.

    PubMed

    Elmquist, JoAnna; Shorey, Ryan C; Anderson, Scott E; Temple, Jeff R; Stuart, Gregory L

    2016-01-01

    Research has demonstrated that individuals with substance use disorders (SUDs) and comorbid mental health problems evidence heightened negative consequences, including poorer treatment outcomes, a higher risk for relapse, and mortality compared to individuals with a single disorder. In this study, we focus on the comorbidity between SUDs and eating disorder (ED) symptomatology, as EDs are similarly associated with high rates of relapse, morbidity, and mortality. Of particular importance is research examining treatment rejection among individuals in treatment for SUDs with cooccurring ED symptomatology. This study seeks to add to the literature by examining treatment rejection among young adult men in residential treatment for SUDs (N = 68) with cooccurring ED symptomatology. Results from hierarchical regression analyses indicated that ED symptoms were significantly associated with treatment rejection after controlling for alcohol and drug use and problems and depression symptoms. Although this is a preliminary study, the results add to a growing body of research examining the comorbidity between SUDs and ED symptomatology. Future research examining this relationship is needed to further elucidate the treatment patterns among individuals with comorbid ED symptoms and substance use diagnoses. PMID:27257382

  17. Screening for substance use disorders in neurodevelopmental disorders: a clinical routine?

    PubMed

    Palmqvist, Margita; Edman, Gunnar; Bölte, Sven

    2014-05-01

    Evidence suggests that substance use disorders (SUD) tend to be underdiagnosed in psychiatry. The objective of this study was to investigate whether drug and alcohol screening is a clinical routine in the assessment of two prominent neurodevelopmental disorders, namely ADHD and autism spectrum disorder (ASD). We surveyed drug and alcohol screening routines in 34 general child and adolescent (only practice for adolescents, not children, was assessed) and 29 adult psychiatric outpatient departments in Stockholm County, Sweden. Structured telephone interviews mapping SUD screening procedures were conducted with department representatives in charge. Only a minority of child and adolescent departments regularly used SUD screening questionnaires (6 %) in ADHD and ASD assessment, while this was more common in adult psychiatry (55 %). Urine/blood-based toxicology tests were always used in 28 % and sometimes or in case of clinical suspicion in 38 % of the adult units. Such tests were used sometimes or in case of clinical suspicion in 15 % of the child psychiatric departments, but never routinely. Findings reveal that screening for SUD in ADHD and ASD is not an integral part of routine clinical assessments in psychiatry, although increasingly an integral part of many clinical guidelines. Thus, SUD might be underdiagnosed in neurodevelopmental disorders, which could be particularly true for child and adolescent psychiatry settings. PMID:23949101

  18. Health Care Experiences when Pain Substance Use Disorder Coexist: “Just Because I’m an Addict Doesn’t Mean I Don’t Have Pain

    PubMed Central

    St Marie, Barbara

    2015-01-01

    Objective To report the healthcare experiences of 34 individuals with coexisting substance use disorder (SUD) and chronic pain. Design Narrative inquiry qualitative study of 90-minute interviews. Setting: Midwest metropolitan methadone clinic. Subjects All individuals had SUD, were treated for SUD with methadone. They all self- identified as having pain greater than 6 months. Methods This qualitative design allowed exploration of how participants made sense of events related to living with SUD and chronic pain. Narrative inquiry gives a consistent story from the participants’ perspective and researchers can perform additional analysis using the storyline. Thematic analysis occurred of their healthcare experiences. Results Results revealed that participants (a) spoke about how they used deception to obtain opioids when their addiction was out of control, (b) were disturbed by health care providers having little understanding or ability to help them with their painful condition, (c) felt they wanted to abuse opiates again when receiving poor treatment by the health care team, (d) related what went well in their health care to help them maintain their sobriety, and (e) recommended improvements on health care interventions that included effective treatment of pain. Conclusions Coexisting chronic pain and SUD create unique health care needs by mutually activating and potentiating the other. There are very few comparable studies exploring the experiences of individuals when pain and substance use disorder coexist. The health care team can better develop treatment plans and test interventions sensitive to their unique needs when they understand the experiences of this population. PMID:25041442

  19. Impact of Substance Use Disorder on Presentation and Short-Term Course of Schizophrenia

    PubMed Central

    Chakraborty, Rudraprosad; Chatterjee, Arunima; Chaudhury, Suprakash

    2014-01-01

    The aim of the present study was to compare a cohort of schizophrenia patients with substance use disorder (SUD) with a similar cohort of schizophrenia patients without SUD with regard to sociodemographic variables, clinical variables, psychopathology, anxiety symptoms, depressive symptoms, treatment outcome, and side effect profile of drugs. A total of 143 consecutive inpatients with ICD-10 DCR diagnosis of schizophrenia were included after obtaining informed consent. Patients were evaluated by a semistructured data sheet and Maudsley Addiction Profile. They were then rated by Positive and Negative Symptoms Scale, Calgary Depression Scale, Hamilton Anxiety Rating Scale, and Brief Psychiatric Rating Scale at presentation, three weeks, and six weeks. At three weeks and six weeks, they were also evaluated by UKU Side Effect Rating Scale. Substance abuse was detected in 63.6% schizophrenia patients. Nicotine was the commonest substance followed by cannabis and alcohol. Substance users had longer untreated illness and more depressive symptoms at presentation and six-week follow-up. Dual diagnosis patients had difficulty in abstraction at three and six weeks but not at presentation. Schizophrenia patients with SUD had more depressive symptoms. SUD appeared to mask abstraction difficulties at presentation. Schizophrenia patients with SUD should be carefully assessed for presence of depression. PMID:24839596

  20. The Relationship Between Eating Disorder Symptoms and Treatment Rejection among Young Adult Men in Residential Substance Use Treatment

    PubMed Central

    Elmquist, JoAnna; Shorey, Ryan C.; Anderson, Scott E.; Temple, Jeff R.; Stuart, Gregory L.

    2016-01-01

    Research has demonstrated that individuals with substance use disorders (SUDs) and comorbid mental health problems evidence heightened negative consequences, including poorer treatment outcomes, a higher risk for relapse, and mortality compared to individuals with a single disorder. In this study, we focus on the comorbidity between SUDs and eating disorder (ED) symptomatology, as EDs are similarly associated with high rates of relapse, morbidity, and mortality. Of particular importance is research examining treatment rejection among individuals in treatment for SUDs with cooccurring ED symptomatology. This study seeks to add to the literature by examining treatment rejection among young adult men in residential treatment for SUDs (N = 68) with cooccurring ED symptomatology. Results from hierarchical regression analyses indicated that ED symptoms were significantly associated with treatment rejection after controlling for alcohol and drug use and problems and depression symptoms. Although this is a preliminary study, the results add to a growing body of research examining the comorbidity between SUDs and ED symptomatology. Future research examining this relationship is needed to further elucidate the treatment patterns among individuals with comorbid ED symptoms and substance use diagnoses. PMID:27257382

  1. Patterns of Treatment Utilization Before Suicide Among Male Veterans With Substance Use Disorders

    PubMed Central

    Conner, Kenneth R.; Roeder, Kathryn M.; Blow, Frederic C.; Austin, Karen; Valenstein, Marcia

    2012-01-01

    Objectives. We sought to describe the extent and nature of contact with the health care system before suicide among veterans with substance use disorders (SUDs). Methods. We examined all male Veterans Health Administration patients who died by suicide between October 1, 1999, and September 30, 2007, and who had a documented SUD diagnosis during the 2 years before death (n = 3132). Results. Over half (55.5%; n = 1740) of the male patients were seen during the month before suicide, and 25.4% (n = 796) were seen during the week before suicide. In examining those with a medical visit in the year before suicide (n = 2964), most of the last visits before suicide (56.6%; n = 1679) were in a general medical setting, 32.8% (n = 973) were in a specialty mental health setting, and 10.5% (n = 312) were in SUD treatment. Conclusions. Men with SUDs who died from suicide were frequently seen in the month before their death. Most were last seen in general medical settings, although a substantial minority of those with SUDs was seen in specialty mental health settings. PMID:22390610

  2. A GIS-based methodology for selecting stormwater disconnection opportunities.

    PubMed

    Moore, S L; Stovin, V R; Wall, M; Ashley, R M

    2012-01-01

    The purpose of this paper is to introduce a geographic information system (GIS)-based decision support tool that assists the user to select not only areas where (retrofit) sustainable drainage systems (SuDS) could be implemented within a large catchment (>100 ha), but also to allow discrimination between suitable SuDS techniques based on their likely feasibility and effectiveness. The tool is applied to a case study catchment within London, UK, with the aim of increasing receiving water quality by reducing combined sewer overflow (CSO) spill frequency and volume. The key benefit of the tool presented is to allow rapid assessment of the retrofit SuDS potential of large catchments. It is not intended to replace detailed site investigations, but may help to direct attention to sites that have the greatest potential for retrofit SuDS implementation. Preliminary InfoWorks CS modelling of 'global disconnections' within the case study catchment, e.g. the removal of 50% of the total impervious area, showed that CSO spill volume could be reduced by 55 to 78% during a typical year. Using the disconnection hierarchy developed by the authors, the feasibility of retrofit SuDS deployment within the case study catchment is assessed, and the implications discussed. PMID:22699330

  3. The impact of mental and substance-use disorders on employment transitions.

    PubMed

    Baldwin, Marjorie L; Marcus, Steven C

    2014-03-01

    The cyclic nature of serious mental illness (SMI) and substance-use disorders (SUD) suggests that persons with these conditions may experience high rates of transitions among employment states (full-time, part-time, and no employment). This study uses longitudinal data from two waves of the National Epidemiologic Survey of Alcoholism and Related Conditions to examine employment transitions for persons with SMI/SUD relative to a no-disorder control group. Conditional on employment status in Wave I, we estimate conditional odds ratios and marginal effects of each diagnosis on the probabilities of part-time or full-time employment in Wave II, holding constant other characteristics that influence employment decisions. The results show transitions across employment states are common for all groups but more frequent for persons with SMI/SUD than the controls. Persons with SMI are less likely, and persons with SUDs more likely, to transition out of no employment than the controls. Part-time employment is a relatively transitory state, particularly for persons with SMI/SUD, but full-time employment brings a measure of job stability to all groups. After controlling for differences in observable characteristics, the marginal effects of SMI and alcohol disorders on employment transitions are largely significant, but the effects of drug disorders are not. PMID:23784938

  4. Relations Between Pain, PTSD Symptoms, and Substance Use in Veterans

    PubMed Central

    Gros, Daniel F.; Szafranski, Derek D.; Brady, Kathleen T.; Back, Sudie E.

    2016-01-01

    Objective The frequent co-occurrence of posttraumatic stress disorder (PTSD) and chronic pain has received much attention in the literature. However, the extant literature is limited in that these investigations generally exclude patients with co-occurring substance use disorders (SUD). Thus, the present study investigated symptoms of PTSD and SUD in veterans with high and low pain symptoms. Method Veterans (N = 136) seeking treatment for comorbid symptoms of PTSD and SUD were recruited as part of a larger study. All participants completed a baseline assessment, which included a series of diagnostic interviews and self-report questionnaires measuring symptoms of pain, PTSD and SUD. Results Higher levels of self-reported pain were found to be associated with both self-reported and clinician-rated PTSD symptoms above and beyond the influence of the demographic variables. However, no reliable relations were demonstrated between substance use and pain. Conclusions Although preliminary, the findings highlight the common occurrence of chronic pain among veterans with comorbid PTSD/SUD, and the potential impact of pain on clinical presentation. The findings may help inform special considerations for assessment and treatment practices for this high-risk population. PMID:26391835

  5. Sediment management in sustainable urban drainage system ponds.

    PubMed

    Heal, K V; Hepburn, D A; Lunn, R J

    2006-01-01

    Since removal and disposal of sustainable urban drainage system (SUDS) sediment can incur high maintenance costs, assessments of sediment volumes, quality and frequency of removal are required. Sediment depth and quality were surveyed annually from 1999-2003 in three ponds and one wetland in Dunfermline, Scotland, UK. Highest sediment accumulation occurred in Halbeath Pond, in the most developed watershed and with no surface water management train. From comparison of measured potentially toxic metal concentrations (Cd, Cr, Cu, Fe, Ni, Pb, Zn) with standards, the average sediment quality should not impair aquatic ecosystems. 72-84% of the metal flux into the SUDS was estimated to be associated with coarse sediment (> 500 microm diameter) suggesting that management of coarse sediment is particularly important at this site. The timing of sediment removal for these SUDS is expected to be determined by loss of storage volume, rather than by accumulation of contaminants. If sediment removal occurs when 25% of the SUDS storage volume has infilled, it would be required after 17 years in Halbeath Pond, but only after 98 years in Linburn Pond (which has upstream detention basins). From the quality measurements, sediment disposal should be acceptable on adjacent land within the boundaries of the SUDS studied. PMID:16838706

  6. Runoff infiltration, a desktop case study.

    PubMed

    Bastien, N R P; Arthur, S; Wallis, S G; Scholz, M

    2011-01-01

    The use of sustainable drainage systems (SuDS) or best management practice is becoming increasingly common. However, rather than adopting the preferred 'treatment train' implementation, many developments opt for end-of-pipe control ponds. This paper discusses the use of SUDS in series to form treatment trains and compares their potential performance and effectiveness with end-of-pipe solutions. Land-use, site and catchment characteristics have been used alongside up-to-date guidance, Infoworks CS and MUSIC to determine whole-life-costs, land-take, water quality and quantity for different SuDS combinations. The results presented show that the use of a treatment train allows approaches differing from the traditional use of single SuDS, either source or 'end-of-pipe', to be proposed to treat and attenuate runoff. The outcome is a more flexible solution where the footprint allocated to SUDS, costs and water quality can be managed differently to fully meet stakeholder objectives. PMID:21977653

  7. Does depression and substance abuse co-morbidity affect socioeconomic status? Evidence from a prospective study of urban African Americans

    PubMed Central

    Dagher, Rada K.; Green, Kerry M.

    2014-01-01

    Studies have established a graded association between mental health and socioeconomic status (SES). However, scarce research has examined the impact of substance use disorders (SUD) and depression comorbidity on SES. We use data from the Woodlawn Study, a longitudinal cohort study, which recruited a cohort of first graders from Chicago starting 1966-1967 (N=1,242). Analyses focus on those interviewed in young adulthood and followed up through midlife. Regression analyses adjusting for childhood confounders showed that young adults with depression and SUD comorbidity had higher likelihood of having any periods of unemployment, higher likelihood of being unemployed for 3 or more months, and lower household income in midlife than those with neither disorder. Moreover, young adults with SUD without depression had higher odds of having any periods of unemployment and higher odds of being unemployed for 3 or more months than those with neither disorder. Findings point to the possibility of social selection where depression and SUD comorbidity contributes to a downward drift in SES. Clinical interventions that integrate the treatment of SUD and depression may be more effective at reducing socioeconomic disparities among minority populations. PMID:25467698

  8. Alcohol and Opioid Use Disorder in Older Adults: Neglected and Treatable Illnesses.

    PubMed

    Le Roux, Christoffel; Tang, Yilang; Drexler, Karen

    2016-09-01

    The purpose of this article is to provide an overview of alcohol use disorder (AUD) and opioid use disorder (OUD) in older adults for general psychiatrists. The rapid growth of the geriatric population in the USA has wide-ranging implications as the baby boomer generation ages. Various types of substance use disorders (SUDs) are common in older adults, and they often take a greater toll on affected older adults than on younger adults. Due to multiple reasons, SUDs in older adults are often under-reported, under-detected, and under-treated. Older adults often use substances, which leads to various clinical problems. Space limitations prevents a comprehensive review; therefore, we primarily focus on alcohol use disorder and the problem of opioid use disorder, with more emphasis given to the latter, because the opioid use epidemic in the USA has gained much attention. We reviewed the literature on the topics, integrated across geriatric psychiatry, addiction psychiatry, research, and national trends. We discuss unique vulnerabilities of older adults to SUDs with regard to management of SUDs in older adults, medication-assisted treatment (MAT), and psychosocial treatments. We encourage general psychiatrists to raise their awareness of SUDs in older adults and to provide brief intervention or referral for further assessment. PMID:27488204

  9. Genetic and Environmental Risk Factors for Illicit Substance Use and Use Disorders: Joint Analysis of Self and Co-twin Ratings

    PubMed Central

    Reichborn-Kjennerud, Ted; Neale, Michael C.; Kendler, Kenneth S.

    2014-01-01

    The specificity of genetic and environmental risk factors for illicit substance use and substance use disorders (SUD) was investigated by utilizing self and co-twin reports in 1,791 male twins. There was a high rate of comorbidity between both use of, and SUD from, different classes of illicit substances. For substance use, the model that included one common genetic, one shared environmental, and one individual-specific (i.e., unique) environmental factor, along with substance-specific effects that were attributed entirely to genetic factors fit the data best. For illicit SUD, one common genetic and one common unique environmental risk factor, and substance specific shared environmental and unique environmental risk factors were identified. Risk factors for illicit substance use and SUD are mainly non-specific to substance class. Co-twin rating of illicit substance use and SUD was a reliable source of information, and by taking account of random and systematic measurement error, environmental exposures unique to the individual were of lesser importance than found in earlier studies. PMID:24196977

  10. Animal Models and the Development of Vaccines to Treat Substance Use Disorders.

    PubMed

    Ohia-Nwoko, O; Kosten, T A; Haile, C N

    2016-01-01

    The development of pharmacotherapies for substance use disorders (SUDs) is a high priority in addiction research. At present, there are no approved pharmacotherapies for cocaine and methamphetamine use disorders, while treatments for nicotine and opioid use are moderately effective. Indeed, many of these treatments can cause adverse drug side effects and have poor medication compliance, which often results in increased drug relapse rates. An alternative to these traditional pharmacological interventions is immunotherapy or vaccines that can target substances associated with SUDs. In this chapter, we discuss the current knowledge on the efficacy of preclinical vaccines, particularly immunogens that target methamphetamine, cocaine, nicotine, or opioids to attenuate drug-induced behaviors in animal models of SUDs. We also review vaccines (and antibodies) against cocaine, nicotine, and methamphetamine that have been assessed in human clinical trials. While preclinical studies indicate that several vaccines show promise, these findings have not necessarily translated to the clinical population. Thus, continued effort to design more effective vaccine immunogens using SUD animal models is necessary in order to support the use of immunotherapy as a viable option for individuals with SUDs. PMID:27055616

  11. Family composition and symptom severity among Veterans with comorbid PTSD and substance use disorders.

    PubMed

    Jobe-Shields, Lisa; Flanagan, Julianne C; Killeen, Therese; Back, Sudie E

    2015-11-01

    Posttraumatic stress disorder (PTSD) and substance use disorders (SUD) frequently co-occur and affect a substantial proportion of military Veterans. Although the impact of parental PTSD and SUD on child development is well-documented, little is known about the influence of family composition on PTSD/SUD symptom severity. The present study investigated children in the home as an independent risk factor for symptom severity in a sample of treatment-seeking Veterans (N = 94; 92% male) with comorbid PTSD/SUD. Twenty-seven percent of the sample had minor children (age 18 or younger) living in the home. Veterans with children in the home evidenced significantly higher PTSD symptomatology as measured by the Clinical Administered PTSD Scale (CAPS; M = 82.65 vs. M = 72.17; t = -2.18; p < .05), and reported using marijuana more frequently than Veterans without children in the home (34% vs. 13% of past 60 days; t = -2.35, p < .05). In a multivariate model, having children in the home accounted for unique variance (ΔR(2) = .07) in PTSD severity after accounting for a range of covariates; however, having children in the home did not account for unique variance in substance use. Directions for future research as well as potential clinical implications for parents seeking treatment for PTSD/SUD are discussed. PMID:26132535

  12. Évolution historique du prisme littoral du lido de l'étang de Thau (Sète, Sud-Est de la France). Mise en évidence par sismique réflexion très haute résolutionHistorical evolution of the littoral prism of the Thau lagoon barrier (Sète, South-East France). Very high-resolution reflection seismic investigation.

    NASA Astrophysics Data System (ADS)

    Tessier, Bernadette; Certain, Raphaël; Barusseau, Jean-Paul; Henriet, Jean-Pierre

    2000-12-01

    Very high-resolution seismic data have been obtained recently, in the framework of the research programme PNEC (French National Programme of Coastal Environment), on the shoreline area of Sète (Mediterranean coast, South East France). These data provide an accurate picture of the internal structure of the shoreline body. Seismic results combined with data about the morphosedimentary evolution of the study area, vibrocore data and results from archaeological investigations yield clues to the historical evolution of the study area. Especially, it is pointed out that the functioning of the present-day shoreline, by comparison with the system built in classical times, is characterized by a severe reduction in sediment supply and in volumes of sand involved in the shoreline dynamics.

  13. L'évolution paléoenvironnementale des faunes de poissons du Crétacé supérieur du bassin du Tafilalt et des régions avoisinantes (Sud-Est du Maroc) : implications paléobiogéographiquesPalaeoenvironmental evolution of the fish assemblages from the Late Cretaceous of the Tafilalt basin and surrounding areas, southeastern Morocco: palaeogeographical implications

    NASA Astrophysics Data System (ADS)

    Cavin, Lionel; Boudad, Larbi; Duffaud, Sylvain; Kabiri, Lahcen; Le Lœuff, Jean; Rouget, Isabelle; Tong, Haiyan

    2001-11-01

    A critical revision of published data along with new field data allow to draw up the succession of the fish faunas from the Lower Cenomanian to the Lower Turonian in the Tafilalt basin and surrounding areas (southeast Morocco). The analysis of these faunas shows changes from freshwater to marine palaeoenvironments. The palaeogeographic distribution of some taxa is discussed. It shows that the crossing of strictly freshwater organisms between Africa and South America was likely impossible at the time of the formation of the deposits resting around the Tafilalt basin and named 'Kem Kem beds'. The Cenomano-Turonian transgression reached the Erfoud-Errachidia carbonate platform from the Central Tethys, and then connected the central Atlantic.

  14. Assessing traumatic experiences in screening for PTSD in substance use disorder patients: what is the gain in addition to PTSD symptoms?

    PubMed

    Kok, Tim; de Haan, Hein; van der Meer, Margreet; Najavits, Lisa; de Jong, Cor

    2015-03-30

    Traumatic experiences have been linked with substance use disorders (SUD) and may be an important factor in the perpetuation of SUD, even in the absence of posttraumatic stress disorder (PTSD) symptoms. The purpose of the current study was to examine the relationship between childhood trauma and substance use severity in 192 SUD inpatients. Childhood trauma was assessed using the Traumatic Experiences Checklist (TEC). With variables derived from this measure in addition to PTSD symptoms, two regression models were created with alcohol use or drug use severity as dependent variables. Alcohol severity was explained by PTSD symptoms as well as the age of trauma. Drug severity was explained solely by PTSD symptoms. The clinical value of assessing childhood trauma in determining the addiction severity appears to be limited in comparison with PTSD symptoms. PMID:25687377

  15. The functional anatomy of impulse control disorders.

    PubMed

    Probst, Catharina C; van Eimeren, Thilo

    2013-10-01

    Impulsive-compulsive disorders such as pathological gambling, hypersexuality, compulsive eating, and shopping are side effects of the dopaminergic therapy for Parkinson's disease. With a lower prevalence, these disorders also appear in the general population. Research in the last few years has discovered that these pathological behaviors share features similar to those of substance use disorders (SUD), which has led to the term "behavioral addictions". As in SUDs, the behaviors are marked by a compulsive drive toward and impaired control over the behavior. Furthermore, animal and medication studies, research in the Parkinson's disease population, and neuroimaging findings indicate a common neurobiology of addictive behaviors. Changes associated with addictions are mainly seen in the dopaminergic system of a mesocorticolimbic circuit, the so-called reward system. Here we outline neurobiological findings regarding behavioral addictions with a focus on dopaminergic systems, relate them to SUD theories, and try to build a tentative concept integrating genetics, neuroimaging, and behavioral results. PMID:23963609

  16. Rape, sex partnership, and substance use consequences in women veterans.

    PubMed

    Booth, Brenda M; Mengeling, Michelle; Torner, James; Sadler, Anne G

    2011-06-01

    The association of rape history and sexual partnership with alcohol and drug use consequences in women veterans is unknown. Midwestern women veterans (N = 1,004) completed a retrospective telephone interview assessing demographics, rape history, substance abuse and dependence, depression, and posttraumatic stress disorder (PTSD). One third met lifetime criteria for substance use disorder (SUD), half reported lifetime completed rape, a third childhood rape, one quarter in-military rape, 11% sex with women. Lifetime SUD was higher for women with rape history (64% vs. 44%). Women with women as sex partners had significantly higher rates of all measures of rape, and also lifetime substance use disorder. Postmilitary rape, sex partnership, and current depression were significantly associated with lifetime SUD in multivariate models (odds ratio = 2.3, 3.6, 2.1, respectively). Many women veterans have a high need for comprehensive mental health services. PMID:21567476

  17. Integrated Cognitive Behavioral Therapy (ICBT) For PTSD and Substance Use in Iraq and Afghanistan Veterans: A Feasibility Study

    PubMed Central

    Capone, Christy; Eaton, Erica; McGrath, Ashlee C.; McGovern, Mark P.

    2014-01-01

    Co-occurring posttraumatic stress disorder (PTSD) and substance use disorder (SUD) is prevalent in military Veterans and is associated with poorer outcomes than either disorder alone. The current pilot study examines the feasibility of delivering integrated cognitive behavioral therapy (ICBT) for co-occurring PTSD-SUD to Veterans who served in Iraq and Afghanistan. Our primary aims were testing the feasibility of engaging and retaining Veterans with a complex clinical presentation in a 12-week structured therapy. We focused on two feasibility outcomes: 1) acceptability; and 2) tolerability. We also examined clinically meaningful change in PTSD and depressive symptoms as a secondary aim. Over the course of the study, we recruited 12 eligible Veterans, 6 of whom completed ICBT. We encountered challenges related to engaging and retaining Veterans in treatment and discuss adaptations and refinements of ICBT or other integrated treatments for returning Veterans with co-occurring PTSD-SUD to increase feasibility with military Veterans. PMID:25580442

  18. Essential Ingredients for Successful Redesign of Addiction Treatment

    PubMed Central

    Gustafson, David H.

    2013-01-01

    Summary Since the passage of healthcare reform, there have been many discussions about how the mental health and substance use disorder (MH/SUD) system will need to change. Of the many components involved in a system redesign, the identification of essential ingredients is crucial to its success. In an effort to determine what essential ingredients the new MH/SUD system requires to optimally meet the needs of its customers, we convened a group of 16 multi-industrial experts who analyzed data collected from a string of 7 focus groups and 15 interviews with people dealing with or working in the SUD field. This paper summarizes the 11 essential ingredients our group identified. PMID:25243237

  19. Mindfulness Training and Stress Reactivity in Substance Abuse: Results from A Randomized, Controlled Stage I Pilot Study

    PubMed Central

    Brewer, Judson A.; Sinha, Rajita; Chen, Justin A.; Michalsen, Ravenna N.; Babuscio, Theresa A.; Nich, Charla; Grier, Aleesha; Bergquist, Keri L.; Reis, Deidre L.; Potenza, Marc N.; Carroll, Kathleen M.; Rounsaville, Bruce J.

    2011-01-01

    Background Stress is important in substance use disorders (SUDs). Mindfulness training (MT) has shown promise for stress-related maladies. No studies have compared MT to empirically-validated treatments for SUDs. Goals to assess MT compared to cognitive behavioral therapy (CBT) in substance use and treatment acceptability, and specificity of MT compared to CBT in targeting stress reactivity. Methods 36 individuals with alcohol and/or cocaine use disorders were randomly assigned to receive group MT or CBT in an outpatient setting. Drug use was assessed weekly. After treatment, responses to personalized stress provocation were measured. Results Fourteen individuals completed treatment. There were no differences in treatment satisfaction, or drug use between groups. The laboratory paradigm suggested reduced psychological and physiological indices of stress during provocation in MT compared to CBT. Conclusions This pilot study provides evidence of the feasibility of MT in treating SUDs and suggests that MT may be efficacious in targeting stress. PMID:19904666

  20. The resilience scale for adults in italy: A validation study comparing clinical substance abusers with a nonclinical sample.

    PubMed

    Bonfiglio, Natale Salvatore; Renati, Roberta; Hjemdal, Odin; Friborg, Oddgeir

    2016-06-01

    This article reports a validation study of the Italian version of the Resilience Scale for Adults (RSA), a measure designed to assess individual, family, and social resilience protective resources. The RSA was administered to a clinical (i.e., substance use disorders, or SUD; N = 437) and a nonclinical sample (N = 337). A confirmatory factor analyses supported the original 6-factor structure of the RSA in both samples. The RSA correlated positively with functional coping strategies and negatively with perceived stress and dysfunctional coping strategies. Moreover, the RSA subscales discriminated between SUD and non-SUD individuals. Factorial invariance testing also confirmed comparable psychometric properties across gender. The results confirm good psychometric properties of the Italian RSA and provide support for the construct validity of the scale. The RSA may be suited for use in studies examining natural course and intervention trials. (PsycINFO Database Record PMID:27031088

  1. Improving Access to Long-Acting Contraceptive Methods and Reducing Unplanned Pregnancy Among Women with Substance Use Disorders

    PubMed Central

    Black, Kirsten I.; Day, Carolyn A.

    2016-01-01

    Much has been written about the consequences of substance use in pregnancy, but there has been far less focus on the prevention of unintended pregnancies in women with substance use disorders (SUDs). We examine the literature on pregnancy incidence for women with SUDs, the clinical and economic benefits of increasing access to long-acting reversible contraceptive (LARC) methods in this population, and the current hurdles to increased access and uptake. High rates of unintended pregnancies and poor physical and psychosocial outcomes among women with SUDs underscore the need for increased access to, and uptake of, LARC methods among these women. A small number of studies that focused on improving access to contraception, especially LARC, via integrated contraception services predominantly provided in drug treatment programs were identified. However, a number of barriers remain, highlighting that much more research is needed in this area. PMID:27199563

  2. Optimizing Care for HIV-Infected People Who Use Drugs: Evidence-Based Approaches to Overcoming Healthcare Disparities

    PubMed Central

    Meyer, Jaimie P.; Althoff, Amy L.; Altice, Frederick L.

    2013-01-01

    Substance use disorders (SUDs) and human immunodeficiency virus (HIV) are pervasive epidemics that synergize, resulting in negative outcomes for HIV-infected people who use drugs (PWUDs). The expanding epidemiology of substance use demands a parallel evolution of the HIV specialist—beyond HIV to diagnosis and management of comorbid SUDs. The purpose of this paper is to describe healthcare disparities for HIV-infected PWUDs along each point of a continuum of care, and to suggest evidence-based strategies for overcoming these healthcare disparities. Despite extensive dedicated resources and availability of antiretroviral therapy (ART) in the United States, PWUDs continue to experience delayed HIV diagnosis, reduced entry into and retention in HIV care, delayed initiation of ART, and inferior HIV treatment outcomes. Overcoming these healthcare disparities requires integrated packages of clinical, pharmacological, behavioral, and social services, delivered in ways that are cost-effective and convenient and include, at a minimum, screening for and treatment of underlying SUDs. PMID:23797288

  3. Theater-Based Community Engagement Project for Veterans Recovering From Substance Use Disorders.

    PubMed

    Wasmuth, Sally; Pritchard, Kevin

    2016-01-01

    In this study, we examine the feasibility and acceptability of a 6-wk, interdisciplinary, occupation-based theater project for facilitating community engagement and substance use disorder (SUD) recovery in veterans. All data were collected at baseline, postintervention, and 6-wk and 6-mo follow-up intervals. Of the invited veterans, 24% consented to participate (n = 14), and 50% were retained (n = 7). Average attendance was 91%. Considerable improvements in social and occupational participation were noted at postintervention and at 6-wk follow-up but were not retained at 6 mo. No important change in self-efficacy was noted. Of the participants, 86% remained abstinent for 6 wk following the intervention. Theater provides a feasible and acceptable resource for potentially facilitating SUD recovery. Larger controlled effectiveness studies of theater are needed to examine whether robust and notable recovery outcomes in people with SUDs can be linked to participation in theater. PMID:27294989

  4. Barriers to Quitting Smoking Among Substance Dependent Patients Predict Smoking Cessation Treatment Outcome.

    PubMed

    Martin, Rosemarie A; Cassidy, Rachel N; Murphy, Cara M; Rohsenow, Damaris J

    2016-05-01

    For smokers with substance use disorders (SUD), perceived barriers to quitting smoking include concerns unique to effects on sobriety as well as usual concerns. We expanded our Barriers to Quitting Smoking in Substance Abuse Treatment (BQS-SAT) scale, added importance ratings, validated it, and then used the importance scores to predict smoking treatment response in smokers with substance use disorders (SUD) undergoing smoking treatment in residential treatment programs in two studies (n=184 and 340). Both components (general barriers, weight concerns) were replicated with excellent internal consistency reliability. Construct validity was supported by significant correlations with pretreatment nicotine dependence, smoking variables, smoking self-efficacy, and expected effects of smoking. General barriers significantly predicted 1-month smoking abstinence, frequency and heaviness, and 3-month smoking frequency; weight concerns predicted 1-month smoking frequency. Implications involve addressing barriers with corrective information in smoking treatment for smokers with SUD. PMID:26979552

  5. Sudden unexpected death in epileptics following sudden, intense, increases in geomagnetic activity: Prevalence of effect and potential mechanisms

    NASA Astrophysics Data System (ADS)

    Persinger, M. A.; Psych, C.

    1995-12-01

    Abrupt, intense increases in global geomagnetic activity during the local night may precipitate a significant proportion of sudden unexpected (or unexplained) deaths (SUD) in epileptics. Over a 2-year period SUD in healthy chronic epileptic rats occurred when the average daily geomagnetic activity exceeded 50 nT (nanoTesla) and suddenly began during local night. Other experiments demonstrated that epileptic rats displayed more spontaneous seizures per night if there had been sudden increases in geomagnetic activity. Analyses of previously published data indicated that the number of SUDs/month in a population of human epileptics was positively associated with the number of days/month when the average geomagnetic activity exceeded 50 nT. The results support the hypothesis that suppression of the nocturnal concentrations of the endogenous anticonvulsant melatonin by sudden increases in geomagnetic activity may encourage fatal cardiac arrhythmias by uncoupling the insular/amygdaloid-paraventricular hypothalamic-solitary nucleus pathways.

  6. Uptake of HIV testing in substance use disorder treatment programs that offer on-site testing.

    PubMed

    Kyle, Tiffany L; Horigian, Viviana E; Tross, Susan; Gruber, Valerie A; Pereyra, Margaret; Mandler, Raul N; Feaster, Daniel J; Metsch, Lisa R

    2015-03-01

    Increasing rates of HIV testing within substance use disorder (SUD) treatment clients is an important public health strategy for reducing HIV transmission rates. The present study examined uptake of HIV testing among 1,224 clients in five SUD treatment units that offered on-site testing in Florida, New York, and California. Nearly one-third (30 %) of the participants, who had not previously tested positive, reported not having been tested for HIV within the past 12 months. Women, African Americans, and injection drug users had a higher likelihood of having been tested within the past 12 months. The SUD treatment program was the most frequently identified location of participants' last HIV test. Despite the availability of free, on-site testing, a substantial proportion of clients were not tested, suggesting that strategies to increase uptake of testing should include addressing barriers not limited to location and cost. PMID:25074737

  7. Cue-induced Behavioral and Neural Changes among Excessive Internet Gamers and Possible Application of Cue Exposure Therapy to Internet Gaming Disorder

    PubMed Central

    Zhang, Yongjun; Ndasauka, Yamikani; Hou, Juan; Chen, Jiawen; Yang, Li zhuang; Wang, Ying; Han, Long; Bu, Junjie; Zhang, Peng; Zhou, Yifeng; Zhang, Xiaochu

    2016-01-01

    Internet gaming disorder (IGD) may lead to many negative consequences in everyday life, yet there is currently no effective treatment for IGD. Cue-reactivity paradigm is commonly used to evaluate craving for substance, food, and gambling; cue exposure therapy (CET) is applied to treating substance use disorders (SUDs) and some other psychological disorders such as pathological gambling (PG). However, no study has explored CET’s application to the treatment of IGD except two articles having implied that cues’ exposure may have therapeutic effect on IGD. This paper reviews studies on cue-induced behavioral and neural changes in excessive Internet gamers, indicating that behavioral and neural mechanisms of IGD mostly overlap with those of SUD. The CET’s effects in the treatment of SUDs and PG are also reviewed. We finally propose an optimized CET paradigm, which future studies should consider and investigate as a probable treatment of IGD. PMID:27242589

  8. Challenges and opportunities of group therapy for adolescent substance abuse: a critical review.

    PubMed

    Kaminer, Yifrah

    2005-10-01

    Group intervention has been the most commonly employed treatment modality for adolescents with substance use disorders (SUD). Evidence has been accumulating in support for the efficacy of diverse forms of group therapy that have been utilized with adolescents. It has been argued however, that aggregation of youths who display problem behavior into group interventions may, under some conditions, produce iatrogenic effects on all participants. This assertion known also as "deviancy training" and its presumed effect on treatment outcomes has created a barrier to progress regardless of the fact that it has not been tested or empirically supported in heterogeneous groups of adolescents treated for SUD. It is imperative to optimize group intervention while considering how to prevent, reduce and control, potentially iatrogenic effects associated with the aggregation of antisocial youths in heterogeneous groups. The main objective of this review is to address the challenges and opportunities regarding group treatment of adolescent SUD. PMID:16051443

  9. An impact assessment methodology for urban surface runoff quality following best practice treatment.

    PubMed

    Ellis, J Bryan; Revitt, D Michael; Lundy, Lian

    2012-02-01

    The paper develops an easy to apply desk-based semi-quantitative approach for the assessment of residual receiving water quality risks associated with urban surface runoff following its conveyance through best practice sustainable drainage systems (SUDS). The innovative procedure utilises an integrated geographical information system (GIS)-based pollution index approach based on surface area impermeability, runoff concentrations/loadings and individual SUDS treatment performance potential to evaluate the level of risk mitigation achievable by SUDS drainage infrastructure. The residual impact is assessed through comparison of the determined pollution index with regulatory receiving water quality standards and objectives. The methodology provides an original theoretically based procedure which complements the current acute risk assessment approaches being widely applied within pluvial flood risk management. PMID:22227301

  10. Reprocessing single-use devices--the equipment connection.

    PubMed

    Dunn, Debra

    2002-06-01

    This is the second in a series of three articles about reprocessing medical devices labeled as "single use" by the manufacturer. The goal of reprocessing single-use devices (SUDs) is to save money and decrease environmental pollution. Reprocessing can be performed on SUDs that have been used on other patients or opened but not used. In this article, the procedures for reprocessing (e.g., cleaning, inspecting, sterilizing, tracking, testing, validating) and establishing a reuse program are discussed. The first article of the series, published in the May 2002 issue of the Journal, discussed the ethical component of reusing SUDs. The third article, to be published in the July 2002 issue, will discuss the roles of the involved regulatory agencies and organizations guiding the process. PMID:12085405

  11. Cue-induced Behavioral and Neural Changes among Excessive Internet Gamers and Possible Application of Cue Exposure Therapy to Internet Gaming Disorder.

    PubMed

    Zhang, Yongjun; Ndasauka, Yamikani; Hou, Juan; Chen, Jiawen; Yang, Li Zhuang; Wang, Ying; Han, Long; Bu, Junjie; Zhang, Peng; Zhou, Yifeng; Zhang, Xiaochu

    2016-01-01

    Internet gaming disorder (IGD) may lead to many negative consequences in everyday life, yet there is currently no effective treatment for IGD. Cue-reactivity paradigm is commonly used to evaluate craving for substance, food, and gambling; cue exposure therapy (CET) is applied to treating substance use disorders (SUDs) and some other psychological disorders such as pathological gambling (PG). However, no study has explored CET's application to the treatment of IGD except two articles having implied that cues' exposure may have therapeutic effect on IGD. This paper reviews studies on cue-induced behavioral and neural changes in excessive Internet gamers, indicating that behavioral and neural mechanisms of IGD mostly overlap with those of SUD. The CET's effects in the treatment of SUDs and PG are also reviewed. We finally propose an optimized CET paradigm, which future studies should consider and investigate as a probable treatment of IGD. PMID:27242589

  12. Associations among Pain, Non-Medical Prescription Opioid Use, and Drug Overdose History

    PubMed Central

    Bonar, Erin E.; Ilgen, Mark A.; Walton, Maureen; Bohnert, Amy S.B.

    2014-01-01

    Background and Objective Recently, use of prescription opioids (POs) has increased; non-medical PO (NMPO) use is linked to overdose. NMPO use is common among individuals prescribed opioids for pain, and those in Substance Use Disorder (SUD) treatment with pain could be at increased risk for unintentional overdose due to NMPO use. We examined associations between pain, NMPO use, and overdose among SUD treatment patients. Methods Among 342 patients at a residential SUD treatment center, logistic regression examined the association of overdose with pain, adjusting for substance use, suicide attempts, and demographics. Results Pain was positively related to NMPO use. Heroin use, suicide attempts, pain, and NMPO use were positively associated with overdose; but NMPO use attenuated the pain-overdose relationship. Conclusions The relationship between pain and overdose among substance users may be, in part, explained by the association between pain and heavy NMPO use. PMID:24313240

  13. Alcohol and Drug Use among Patients Presenting to an Inner-city Emergency Department: A Latent Class Analysis

    PubMed Central

    Blow, Frederic C.; Walton, Maureen A.; Barry, Kristen L.; Murray, Regan L.; Cunningham, Rebecca M.; Massey, Lynn S.; Chermack, Stephen T.; Booth, Brenda M.

    2013-01-01

    The inner city Emergency Department (ED) provides a window of opportunity for screening for alcohol and other drug misuse and substance use disorders (SUDs), in order to facilitate linkage for individuals who are in need of services targeting such issues. The majority of prior work in this area has focused on alcohol use. This study used latent class analyses to characterize substance use/SUDs among adults presenting to the ED for medical complaints or injuries. Participants (n=14,557; 77% participation; 45% male; 54% African-American) completed a computerized survey assessing demographics, health functioning, and substance use/SUDs. Although injured patients were significantly more likely to use tobacco, alcohol, and marijuana, and were more likely to have an alcohol use disorder, presenting complaint was not related to other drug use/diagnoses. Five latent classes were identified: (1) non users/SUDs (65.9%) (2) binge drinkers (24.3%), (3) marijuana users/SUD (3.5%), (4) cocaine users/SUD (2.9%), and (5) poly-drug users (3.3%). Compared to class 1, participants in the other classes were younger, male, without health insurance, with poor mental health functioning, tobacco users, and had prior substance use treatment. African-Americans were most likely to be in classes 3 or 4 and employed participants were most likely to be in class 2. In comparison to class 1, classes 2 and 3 reported better physical health; class 2 was more likely to present for injury whereas class 5 was more likely to present for a medical complaint. ED-based screening and interventions approaches need to address the co-occurrence of alcohol, illicit drug, and psychoactive prescription drug use. PMID:21514734

  14. Longitudinal Association of Preference-Weighted Health-Related Quality of Life Measures and Substance Use Disorder Outcomes

    PubMed Central

    Pyne, Jeffrey M.; Tripathi, Shanti; French, Michael; McCollister, Kathryn; Rapp, Richard C.; Booth, Brenda M.

    2010-01-01

    Aim Examine the construct validity of generic preference-weighted health-related quality of life measures in a sample of patients with a substance use disorder (SUD). Design Longitudinal (baseline and six-month follow-up) data from a research study that evaluated interventions to improve linkage and engagement with SUD treatment. Setting A central intake unit that referred patients to seven SUD treatment centers in a Midwestern US metropolitan area. Participants 495 persons with a SUD. Measurements Participants completed two preference-weighted measures: self-administered Quality of Well-Being scale (QWB-SA) and standard gamble weighted Medical Outcomes Study SF-12 (SF-6D). They were also administered two clinical assessments: all seven domains of the Addiction Severity Index (ASI) and a symptom checklist based on the DSM-IV. Construct validity was determined via the relationships between disease-specific SUD and generic measures. Findings In unadjusted analyses, the QWB-SA and SF-6D change scores were significantly correlated with six ASI subscale change scores, but not with employment status. In adjusted repeated measures analyses, 3/7 ASI subscale scores were significant predictors of QWB-SA and 5/7 ASI subscale scores were significant predictors of SF-6D. Abstinence and problematic use at follow-up were significant predictors of QWB-SA and SF-6D. Effect sizes ranged from 0.352 to 0.400 for abstinence and −0.484 to −0.585 for problematic use. Conclusions Generic preference-weighted health-related quality of life measures show moderate to good associations with substance-use specific measures and in certain circumstances can be used in their stead. This study provides further support for the use of the QWB-SA and SF-6D in clinical and economic evaluations of SUD interventions. PMID:21205046

  15. Some Observations from Behavioral Economics for Consideration in Promoting Money Management among Those with Substance Use Disorders

    PubMed Central

    Chivers, Laura L.; Higgins, Stephen T.

    2016-01-01

    Background Behavioral economics research has revealed systematic biases in decision making that merit consideration in efforts to promote money management skills among those with substance use disorders (SUDs). Objectives The objective of this article was to briefly review the literature on five of those biases (i.e., hyperbolic delay discounting, defaults and preference for the status quo, loss aversion, mental accounting, and failure to account for opportunity cost) that may have particular relevance to the topic of money management. Methods Selected studies are reviewed to illustrate these biases and how they may relate to efforts to promote money management skills among those with substance use disorders. Studies were identified by searching PubMed using the terms “behavioral economics” and “substance use disorders”, reviewing bibliographies of published articles, and discussions with colleagues. Results Only one of these biases (i.e., hyperbolic delay discounting) has been investigated extensively among those with SUDs. Indeed, it has been found to be sufficiently prevalent among those with SUDs to be considered as a potential risk factor for those disorders and certainly merits careful consideration in efforts to improve money management skills in that population. There has been relatively little empirical research reported regarding the other biases among those with SUDs, although they appear to be sufficiently fundamental to human behavior and relevant to the topic of money management (e.g., loss aversion) to also merit consideration. There is precedent of effective leveraging of behavioral economics principles in treatment development for SUDs (e.g., contingency management), including at least one intervention that explicitly focuses on money management (i.e., advisor–teller money management therapy). Conclusions and Scientific Significance The consideration of the systematic biases in human decision making that have been revealed in behavioral

  16. Gender differences in the association between family conflict and adolescent substance use disorders

    PubMed Central

    McCormick, Marie C.; Normand, Sharon-Lise T.; Mimiaga, Matthew J.; Buka, Stephen L.; Gilman, Stephen E.

    2011-01-01

    Purpose The objectives of this study were: 1) to examine whether the association between childhood family conflict and the risk of substance use disorders (SUD) in adolescence differs by gender, and 2) to determine if anxious/depressive symptoms and conduct problems explain this association among adolescent males and females. Methods Data came from 1,421 children aged 10 through 16 when enrolled in the Project on Human Development in Chicago Neighborhoods. We assessed gender differences in the association between childhood family conflict and adolescent SUDs by fitting a logistic regression model that included the interaction of gender and family conflict. We also investigated whether conduct problems and anxious/depressive symptoms explained the association between family conflict and SUDs differently for males and females through gender-specific mediation analyses. Results The association between childhood family conflict and SUDs in adolescence differed by gender (p=0.04). Family conflict was significantly associated with SUDs among females (OR: 1.61; CI: 1.20, 2.15), but not among males (OR: 1.00; CI: 0.76, 1.32). The elevated risk of SUDs among females exposed to family conflict was partly explained by girls’ conduct problems but not anxious/depressive symptoms. Conclusions Females living in families with elevated levels of conflict were more likely to engage in acting out behaviors, which was associated with the development of substance use disorders. Future epidemiologic research is needed to help determine when this exposure is most problematic with respect to subsequent mental health outcomes and the most crucial time to intervene. PMID:21783052

  17. Childhood trauma among individuals with co-morbid substance use and post traumatic stress disorder.

    PubMed

    Farrugia, Philippa L; Mills, Katherine L; Barrett, Emma; Back, Sudie E; Teesson, Maree; Baker, Amanda; Sannibale, Claudia; Hopwood, Sally; Rosenfeld, Julia; Merz, Sabine; Brady, Kathleen T

    2011-11-01

    BACKGROUND: Little is known about the impact of childhood trauma (CT) on the clinical profile of individuals with co-occurring substance use disorder (SUD) and post traumatic stress disorder (PTSD). AIMS: To compare the clinical characteristics of individuals with SUD+PTSD who have a history of CT with SUD+PTSD individuals who have experienced trauma during adulthood only. METHOD: Data were collected on 103 individuals as part of a randomised controlled trial examining the efficacy of an integrated psychosocial treatment for SUD+PTSD. Participants were recruited from substance use treatment services, community referrals and advertising. Data were collected on demographic characteristics, substance use and treatment histories, lifetime trauma exposure, and current physical and mental health functioning. RESULTS: The vast majority (77%) of the sample had experienced at least one trauma before the age of 16, with 55% of those endorsing childhood sexual abuse. As expected individuals with a CT history, as compared to without, evidenced significantly longer duration of PTSD. Those with a CT history also had more extensive lifetime trauma exposure, an earlier age of first intoxication, and reported more severe substance use (e.g., a greater number of drug classes used in their lifetime, higher severity of dependence scores and greater number of drug treatment episodes). CONCLUSION: Individuals with co-morbid SUD+PTSD who have experienced CT present with a more severe and chronic clinical profile in relation to a number of trauma and substance use characteristics, when compared to individuals with adulthood only trauma histories. It is therefore important for SUD+PTSD treatment planning that CT be carefully assessed. PMID:21984884

  18. Perceived Unmet Need for Alcohol and Drug Use Treatments and Future Use of Services: Results from a Longitudinal Study*

    PubMed Central

    Mojtabai, Ramin; Crum, Rosa M.

    2012-01-01

    BACKGROUND This study assessed the association of perceived need for treatment of and perceived barriers to treatments for substance use disorder (SUD) with subsequent use of these treatments in community settings. METHODS Drawing on data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), we examined the association of perceived need and barriers to SUD treatments in waves 1 of NESARC (2001-2002; n=43,093) with the subsequent use of these treatments in the follow-up wave 2 (2004-2005; n=34,625). RESULTS Only 8.5% (n=195) of the 2,333 NESARC participants with an untreated 12-month SUD in wave 1 perceived a need for SUD treatment. Participants who reported a perceived need were more likely to use these services in follow-up than those who did not report such a need (14.8% vs. 4.9%, adjusted odds ratio [aOR]=3.16, 95% confidence intervals [CI]=1.70-5.90, P<0.001). Among participants who perceived a need, those who reported pessimistic attitudes towards treatments as a barrier were less likely than others to use services in follow-up (aOR=0.08, 95% CI=0.01-0.73, P=0.027). Other barriers, including financial barriers and stigma were not significantly associated with treatment seeking. CONCLUSIONS The findings suggest the need for a two-pronged approach to improving treatment seeking for SUD in community settings: one focusing on enhancing recognition of these disorders, the other focusing on educating potential consumers regarding the benefits of SUD treatments. PMID:22770461

  19. A comparison of psychiatric diagnoses among HIV-infected prisoners receiving combination antiretroviral therapy and transitioning to the community

    PubMed Central

    Di Paola, Angela; Altice, Frederick L; Powell, Mary Lindsay; Trestman, Robert L; Springer, Sandra A

    2014-01-01

    Background The criminal justice system (CJS), specifically prisons and jails, is ideally suited for uniform screening of psychiatric (PD) and substance use disorders (SUDs) among people living with HIV/AIDS (PLWHA), who are concentrated in these settings. By accurately diagnosing PDs and SUDs in these controlled settings, treatment can be initiated and contribute to improved continuity of care upon release. In the context of PLWHA, it may also improve combination antiretroviral treatment (cART) adherence, and reduce HIV transmission risk behaviors. Methods A retrospective data analysis was conducted by creating a cohort of PLWHA transitioning to the community from prison or jail enrolled who were enrolled in a controlled trial of directly administered antiretroviral (DAART). Participants were systematically assessed for PDs and SUDs using the Mini International Neuropsychiatric Interview (MINI), a standardized psychiatric assessment tool, and compared to diagnoses documented within the correctional medical record. Results Findings confirm a high prevalence of Axis I PDs (47.4%) and SUDs (67.1%) in PLWHA even after prolonged abstinence from alcohol and drugs. Although prevalence of PDs and SUDs were high in the medical record, there was fair to poor agreement among PDs using the MINI, making evident the potential benefit of more objective and concurrent PD assessments to guide treatment. Conclusions Additional PD diagnoses may be detected in PLWHA in CJS using supplementary and objective screening tools. By identifying and treating PDs and SUDs in the CJS, care may be improved and may ultimately contribute to healthier outcomes after community release if patients are effectively transitioned. PMID:25606368

  20. Cardiac Channel Molecular Autopsy: Insights From 173 Consecutive Cases of Autopsy-Negative Sudden Unexplained Death Referred for Postmortem Genetic Testing

    PubMed Central

    Tester, David J.; Medeiros-Domingo, Argelia; Will, Melissa L.; Haglund, Carla M.; Ackerman, Michael J.

    2012-01-01

    Objective To perform long QT syndrome and catecholaminergic polymorphic ventricular tachycardia cardiac channel postmortem genetic testing (molecular autopsy) for a large cohort of cases of autopsy-negative sudden unexplained death (SUD). Methods From September 1, 1998, through October 31, 2010, 173 cases of SUD (106 males; mean ± SD age, 18.4±12.9 years; age range, 1-69 years; 89% white) were referred by medical examiners or coroners for a cardiac channel molecular autopsy. Using polymerase chain reaction, denaturing high-performance liquid chromatography, and DNA sequencing, a comprehensive mutational analysis of the long QT syndrome susceptibility genes (KCNQ1, KCNH2, SCN5A, KCNE1, and KCNE2) and a targeted analysis of the catecholaminergic polymorphic ventricular tachycardia type 1–associated gene (RYR2) were conducted. Results Overall, 45 putative pathogenic mutations absent in 400 to 700 controls were identified in 45 autopsy-negative SUD cases (26.0%). Females had a higher yield (26/67 [38.8%]) than males (19/106 [17.9%]; P<.005). Among SUD cases with exercise-induced death, the yield trended higher among the 1- to 10-year-olds (8/12 [66.7%]) compared with the 11- to 20-year-olds (4/27 [14.8%]; P=.002). In contrast, for those who died during a period of sleep, the 11- to 20-year-olds had a higher yield (9/25 [36.0%]) than the 1- to 10-year-olds (1/24 [4.2%]; P=.01). Conclusion Cardiac channel molecular autopsy should be considered in the evaluation of autopsy-negative SUD. Several interesting genotype-phenotype observations may provide insight into the expected yields of postmortem genetic testing for SUD and assist in selecting cases with the greatest potential for mutation discovery and directing genetic testing efforts. PMID:22677073

  1. Further Evidence of an Association Between Adolescent Bipolar Disorder with Smoking and Substance Use Disorders: A Controlled Study

    PubMed Central

    Wilens, Timothy E.; Biederman, Joseph; Adamson, Joel J.; Henin, Aude; Sgambati, Stephanie; Gignac, Martin; Sawtelle, Robert; Santry, Alison; Monuteaux, Michael C.

    2008-01-01

    Background Although previous work has suggested that juvenile onset bipolar disorder (BPD) is associated with an elevated risk for cigarette smoking and substance use disorders (SUD), the literature on the subject is limited. We evaluated this association in a prospective case-control study of adolescents with and without BPD. Methods Subjects were adolescent probands with DSM-IV BPD (n=105, age 13.6±2.5 years [mean±SD]) and comparison subjects without a DSM-IV mood disorder (“controls”; n=98, age 13.7±2.1 years). Subjects and their first degree relatives were evaluated with structured psychiatric diagnostic interviews (KSADS-E for subjects younger than 18, SCID for subjects 18 and over) including diagnoses of SUD. Results Bipolar disorder was associated with a highly significant risk for any SUD, alcohol abuse and dependence, and drug abuse and dependence, and cigarette smoking, independently of Attention deficit hyperactivity disorder, multiple anxiety, and conduct disorder. The primary predictor of SUD in BPD youth was older age; other significant predictors associated with age and thereby SUD were later BPD onset, onset of mania and depressive disorders in adolescence, onset of mania before a depressive disorder, and more conduct disorder symptoms. Conclusions These findings provide strong support for the hypothesis that BPD in youth, especially when it onsets in adolescent years, is a significant risk factor for cigarette smoking and SUD independently of psychiatric comorbidity. These data highlight the need to carefully screen adolescents with BPD for cigarette and substance use. PMID:18343050

  2. Childhood ADHD and Risk for Substance Dependence in Adulthood: A Longitudinal, Population-Based Study

    PubMed Central

    Levy, Sharon; Katusic, Slavica K.; Colligan, Robert C.; Weaver, Amy L.; Killian, Jill M.; Voigt, Robert G.; Barbaresi, William J.

    2014-01-01

    Background Adolescents with attention-deficit/hyperactivity disorder (ADHD) are known to be at significantly greater risk for the development of substance use disorders (SUD) compared to peers. Impulsivity, which could lead to higher levels of drug use, is a known symptom of ADHD and likely accounts, in part, for this relationship. Other factors, such as a biologically increased susceptibility to substance dependence (addiction), may also play a role. Objective This report further examines the relationships between childhood ADHD, adolescent- onset SUD, and substance abuse and substance dependence in adulthood. Method Individuals with childhood ADHD and non-ADHD controls from the same population-based birth cohort were invited to participate in a prospective outcome study. Participants completed a structured neuropsychiatric interview with modules for SUD and a psychosocial questionnaire. Information on adolescent SUD was obtained retrospectively, in a previous study, from medical and school records. Associations were summarized using odds ratios (OR) and 95% CIs estimated from logistic regression models adjusted for age and gender. Results A total of 232 ADHD cases and 335 non-ADHD controls participated (mean age, 27.0 and 28.6 years, respectively). ADHD cases were more likely than controls to have a SUD diagnosed in adolescence and were more likely to have alcohol (adjusted OR 14.38, 95% CI 1.49–138.88) and drug (adjusted OR 3.48, 95% CI 1.38–8.79) dependence in adulthood. The subgroup of participating ADHD cases who did not have SUD during adolescence were no more likely than controls to develop new onset alcohol dependence as adults, although they were significantly more likely to develop new onset drug dependence. Conclusions Our study found preliminary evidence that adults with childhood ADHD are more susceptible than peers to developing drug dependence, a disorder associated with neurological changes in the brain. The relationship between ADHD and

  3. Efficacy of “seeking safety” in a Dutch population of traumatized substance-use disorder outpatients: study protocol of a randomized controlled trial

    PubMed Central

    2013-01-01

    Background Traumatic experiences and, more specifically, posttraumatic stress disorder (PTSD) are highly prevalent among substance use disorder (SUD) patients. This comorbidity is associated with worse treatment outcomes in substance use treatment programs and more crisis interventions. International guidelines advise an integrated approach to the treatment of trauma related problems and SUD. Seeking Safety is an integrated treatment program that was developed in the United States. The aim of the current study is to test the efficacy of this program in the Netherlands in an outpatient SUD population. Methods/Design A randomized controlled trial (RCT) will be used to test the efficacy of Seeking Safety compared to Cognitive Behavioral Therapy (CBT) in a population of SUD outpatients. Each treatment will consist of 12 group sessions. The primary outcome measure will be substance use severity. Secondary outcome measures are PTSD and trauma symptoms, coping skills, functioning, and cognitions. Questionnaires will be administered at the start of treatment, at the end of treatment (three months after the start of treatment) and at follow-up (six months after the start of treatment). Discussion This study protocol presents a RCT in which the efficacy of an integrated treatment for comorbid PTSD and SUD, Seeking Safety, is evaluated in a SUD outpatient population compared to CBT. It is expected that the intervention group will show significantly more improvement in substance use severity compared to the control group at end-of-treatment and at follow-up. Furthermore, a lower drop-out rate is expected for the intervention group. If the intervention proves to be effective, it can be implemented. A cost-effectiveness analysis will be conducted to evaluate the two treatments. Trial registration The protocol for this study is registered with the Netherlands Trial Register with number NTR3084 and approved by the local medical ethical committee (METC\\11270.haa). PMID:23735118

  4. Event-related potentials in substance use disorders: a narrative review based on articles from 1984 to 2012.

    PubMed

    Campanella, Salvatore; Pogarell, Oliver; Boutros, Nash

    2014-04-01

    Mechanisms that mediate the transition from occasional, controlled, drug use to the impaired control that characterizes severe dependence are still a matter of investigation. The etiology of substance use disorders (SUDs) is complex, and in this context of complexity, the concept of "endophenotype," has gained extensive popularity in recent years. The main aim of endophenotypes is to provide a simpler, more proximal target to discover the biological underpinnings of a psychiatric syndrome. In this view, neurocognitive and neurophysiological impairments that suggest functional impairments associated with SUDs have been proposed as possible endophenotypes. Because of its large amplitude and relatively easy elicitation, the most studied of the cognitive brain event-related potentials (ERPs), the P300 component, has been proposed as one possible candidate. However, if a P300 amplitude alteration is a common finding in SUDs, it is also observable in other psychiatric afflictions, suggesting that the associations found may just reflect a common measure of brain dysfunction. On this basis, it has been proposed that a multivariate endophenotype, based on a weighted combination of electrophysiological features, may provide greater diagnostic classification power than any single endophenotype. The rationale for investigating multiple features is to show that combining them provides extra useful information that is not available in the individual features, leading ultimately to a multivariate phenotype.The aim of the present article is to outline the potential usefulness of this kind of "combined electrophysiological procedure" applied to SUDs. We present a review of ERP studies, combining data from people with SUD, family members, and normal control subjects, to verify whether the combination of 4ERPs (P50, MMN, P300, and N400) may produce profiles of cortical anomalies induced by different types of SUD (alcohol vs cocaine vs cannabis vs heroin). PMID:24104954

  5. Can persons with a history of multiple addiction treatment episodes benefit from technology delivered behavior therapy? A moderating role of treatment history at baseline.

    PubMed

    Kim, Sunny Jung; Marsch, Lisa A; Acosta, Michelle C; Guarino, Honoria; Aponte-Melendez, Yesenia

    2016-03-01

    A growing line of research has shown positive treatment outcomes from technology-based therapy for substance use disorders (SUDs). However, little is known about the effectiveness of technology-based SUD interventions for persons who already had numerous prior SUD treatments. We conducted a secondary analysis on a 12-month trial with patients (N=160) entering methadone maintenance treatment (MMT). Patients were randomly assigned to either standard MMT treatment or a model in which half of standard counseling sessions were replaced with a computer-based intervention, called Therapeutic Education System (standard+TES). Four treatment history factors at baseline, the number of lifetime SUD treatment episodes, detoxification episodes, and inpatient/outpatient treatment episodes were categorized into three levels based on their tertile points, and analyzed as moderators. Dependent variables were urine toxicology results for opioid and cocaine abstinence for 52-weeks. The standard+TES condition produced significantly better opioid abstinence than standard treatment for participants with 1) a moderate or high frequency of lifetime SUD treatment episodes, and 2) those with all three levels (low, moderate and high) of detoxification and inpatient/outpatient treatment episodes, ps<.01. The standard+TES condition enhanced cocaine abstinence compared to standard treatment among people with 1) a moderate or high frequency of lifetime SUD treatment episodes, 2) a high level of detoxification episodes, and 3) a moderate or high level of inpatient treatment history, ps<.01. We found that including technology-based behavioral therapy as part of treatment can be more effective than MMT alone, even among patients with a history of multiple addiction treatment episodes. PMID:26657820

  6. Trends in use of opioids for chronic non-cancer pain among individuals with mental health and substance use disorders: the TROUP study

    PubMed Central

    Edlund, Mark J.; Martin, Bradley C.; Devries, Andrea; Fan, Ming-Yu; Braden, Jennifer Brennan; Sullivan, Mark D.

    2010-01-01

    Objectives Use of prescription opioids for chronic pain is increasing, as is abuse of these medications, though the nature of the link between these trends is unclear. These increases may be most marked in patients with mental health (MH) and substance use disorders (SUDs). We analyzed trends between 2000 and 2005 in opioid prescribing among individuals with non-cancer pain conditions (NCPC), with and without MH and SUDs. Methods Secondary data analysis of longitudinal administrative data from two dissimilar populations: a national, commercially-insured population, and Arkansas Medicaid enrollees. We examined these opioid outcomes: (1) Rates of any prescription opioid use in the past year, (2) rates of chronic use of prescription opioids (greater than 90 days in the past year), (3) mean days supply of opioids, (4) mean daily opioid dose in morphine equivalents, and (5) percentage of total opioid dose that was Schedule II opioids. Results In 2000, among individuals with NCPC, chronic opioid use was more common among those with a MH or SUD than those without in commercially insured (8% versus 3%, p<0.001) and Arkansas Medicaid (20% versus 13%, p<0.001). Between 2000 and 2005, in commercially insured, rates of chronic opioid use increased by 34.9% among individuals with an MH or SUD, and 27.8% among individuals without these disorders. In Arkansas Medicaid chronic opioid use increased 55.4% among individuals with an MH or SUD, and 39.8% among those without. Discussion Chronic use of prescription opioids for NCPC is much higher and growing faster in patients with MH and SUDs than those without these diagnoses. Clinicians should monitor use of prescription opioids in these vulnerable groups to determine whether opioids are substituting for or interfering with appropriate mental health and substance abuse treatment. PMID:20026946

  7. The prevalence and significance of substance use disorders in bipolar type I and II disorder

    PubMed Central

    Cerullo, Michael A; Strakowski, Stephen M

    2007-01-01

    The aim of this paper is to provide a systematic review of the literature examining the epidemiology, outcome, and treatment of patients with bipolar disorder and co-occurring substance use disorders (SUDs). Articles for this review were initially selected via a comprehensive Medline search and further studies were obtained from the references in these articles. Given the lack of research in this field, all relevant studies except case reports were included. Prior epidemiological research has consistently shown that substance use disorders (SUDs) are extremely common in bipolar I and II disorders. The lifetime prevalence of SUDs is at least 40% in bipolar I patients. Alcohol and cannabis are the substances most often abused, followed by cocaine and then opioids. Research has consistently shown that co-occurring SUDs are correlated with negative effects on illness outcome including more frequent and prolonged affective episodes, decreased compliance with treatment, a lower quality of life, and increased suicidal behavior. Recent research on the causal relationship between the two disorders suggests that a subgroup of bipolar patients may develop a relatively milder form of affective illness that is expressed only after extended exposure to alcohol abuse. There has been very little treatment research specifically targeting this population. Three open label medication trials provide limited evidence that quetiapine, aripiprazole, and lamotrigine may be effective in treating affective and substance use symptoms in bipolar patients with cocaine dependence and that aripiprazole may also be helpful in patients with alcohol use disorders. The two placebo controlled trials to date suggest that valproate given as an adjunct to lithium in bipolar patients with co-occurring alcohol dependence improves both mood and alcohol use symptoms and that lithium treatment in bipolar adolescents improves mood and SUD symptoms. Given the high rate of SUD co-occurrence, more research

  8. HIV/Sexually Transmitted Infection Risk Behaviors in Delinquent Youth With Psychiatric Disorders: A Longitudinal Study

    PubMed Central

    Elkington, Katherine S.; Teplin, Linda A.; Mericle, Amy A.; Welty, Leah J.; Romero, Erin G.; Abram, Karen M.

    2009-01-01

    Objectives To examine the prevalence and persistence of 20 HIV/sexually transmitted infection (STI) sexual and drug use risk behaviors and to predict their occurrence in 4 mutually exclusive diagnostic groups of delinquent youth: (1) major mental disorders (MMD); (2) substance use disorders (SUD); (3) comorbid MMD and SUD (MMD+SUD); and (4) neither disorder. Methods At the baseline interview, HIV/STI risk behaviors were assessed in 800 juvenile detainees, aged 10 to 18 years; youth were reinterviewed approximately 3 years later. The final sample (n = 689) includes 298 females and 391 males. Results The prevalence and persistence of HIV/STI risk behaviors was high in all diagnostic groups. Youth with SUD at baseline were over 10 times more likely to be sexually active and to have vaginal sex at follow-up than youth with MMD+SUD (AOR=10.86, 95% CI=1.43–82.32; AOR=11.63, 95% CI=1.49–90.89, respectively) and four times more likely to be sexually active and to have vaginal sex than youth with neither disorder (AOR=4.20, 95% CI=1.06–16.62; AOR=4.73, 95% CI=1.21–18.50, respectively). Youth with MMD at baseline were less likely to have engaged in unprotected vaginal and oral sex at follow-up compared with youth with neither disorder (AOR=0.11, 95% CI=0.02–0.50; AOR=0.07, 95% CI=0.01–0.34, respectively), and with youth with SUD (AOR=0.10, 95% CI=0.02–0.50; OR=0.10, 95% CI=0.02–0.47, respectively). Youth with MMD+SUD were less likely (AOR=0.28, 95% CI=0.09–0.92) to engage in unprotected oral sex compared with those with neither disorder. Conclusions Irrespective of diagnostic group, delinquent youth are at great risk for HIV/STIs as they age into adulthood. SUD increases risk. Because detained youth are released after approximately 2 weeks, their risk behaviors become a community health problem. Pediatricians and child psychiatrists must collaborate with corrections professionals to develop HIV/STI interventions and ensure that programs started in detention

  9. Numerical investigation of fluid and thermal mixing during high-pressure injection

    SciTech Connect

    Horng, T.S.; Chieng, C.C.

    1987-10-01

    A computer program is developed to simulate the fluid and thermal mixing of the Electric Power Research Institute/Creare one-fifth scale test. The mass-flow-weighted skew-upwind differencing scheme (SUDS), as well as the upwind differencing scheme, and the kappa-epsilon two-equation model of turbulence in cylindrical coordinates are employed in the numerical simulation. The computational results are compared with experimental data of test numbers 42, 46, and 51 and COMMIX results. The numerical diffusion is significantly reduced by SUDS, and a satisfactory prediction is achieved.

  10. Gender Differences in Substance Use, Consequences, Motivation to Change, and Treatment Seeking in People With Serious Mental Illness

    PubMed Central

    Drapalski, Amy; Bennett, Melanie; Bellack, Alan

    2013-01-01

    Gender differences in patterns and consequences of substance use, treatment-seeking, and motivation to change were examined in two samples of people with serious mental illness (SMI) and comorbid substance use disorders (SUDs): a community sample not currently seeking substance abuse treatment (N = 175) and a treatment-seeking sample (N = 137). In both groups, women and men demonstrated more similarities in the pattern and severity of their substance use than differences. However, treatment-seeking women showed greater readiness to change their substance use. Mental health problems and traumatic experiences may prompt people with SMI and SUD to enter substance abuse treatment, regardless of gender. PMID:21174496

  11. Revisiting the concepts of risk and protective factors for understanding the etiology and development of substance use and substance use disorders: implications for prevention.

    PubMed

    Sloboda, Zili; Glantz, Meyer D; Tarter, Ralph E

    2012-01-01

    Over the past 20 years we have accumulated a greater knowledge and understanding of the genetic, neurobiological, and behavioral factors that may be associated with young people initiating the use of drugs and other substances and to progressing from use to abuse and dependence. This knowledge suggests that individuals may be "predisposed" to substance use disorders (SUD) and that the actual engagement in these behaviors depends on their environmental experiences from micro to macro levels. This paper summarizes this knowledge base and supports a developmental framework that examines the interaction of posited genetic, psychological, and neurobiological "predispositions" to SUD and those environmental influences that exacerbate this vulnerability. PMID:22676565

  12. Personality and substance dependence symptoms: modeling substance-specific traits.

    PubMed

    Grekin, Emily R; Sher, Kenneth J; Wood, Phillip K

    2006-12-01

    Personality traits related to neuroticism and disinhibition have been consistently associated with substance use disorders (SUDs). It is unclear, however, whether different personality traits predict distinct forms of substance dependence. Additionally, it is unclear whether personality traits continue to predict alcohol, drug, and tobacco dependence after controlling for comorbid antisociality and other SUDs. The current study addresses these questions by characterizing relations between personality traits and substance dependence symptoms in a longitudinal sample of 3,720 college students. Results revealed that antisociality and certain core personality traits predicted multiple types of substance pathology. In addition, several personality traits were differentially associated with alcohol, drug, and tobacco symptomatology. PMID:17176176

  13. Posttraumatic Stress Disorder and Substance Use Disorders in College Students.

    PubMed

    Borsari, Brian; Read, Jennifer P; Campbell, James F

    2008-05-01

    Research indicates that many college students report post-traumatic stress disorder (PTSD) or substance use disorder (SUD), yet there has been scant attention paid to the co-occurrence of these disorders in college students. This review examines the co-occurrence of PTSD and SUD in college students. Recommendations for counseling centers are provided regarding the assessment of this population, an overview of treatment issues, and three areas of clinical importance when working with this population: risk behaviors, interpersonal violence, and social isolation. Future directions for research are also suggested. PMID:19834572

  14. Posttraumatic Stress Disorder and Substance Use Disorders in College Students

    PubMed Central

    Borsari, Brian; Read, Jennifer P.; Campbell, James F.

    2009-01-01

    Research indicates that many college students report post-traumatic stress disorder (PTSD) or substance use disorder (SUD), yet there has been scant attention paid to the co-occurrence of these disorders in college students. This review examines the co-occurrence of PTSD and SUD in college students. Recommendations for counseling centers are provided regarding the assessment of this population, an overview of treatment issues, and three areas of clinical importance when working with this population: risk behaviors, interpersonal violence, and social isolation. Future directions for research are also suggested. PMID:19834572

  15. Cocreating a communicative space to develop a mindfulness meditation manual for women in recovery from substance abuse disorders.

    PubMed

    Lange, Bernadette

    2011-01-01

    Mindfulness-Based Stress Reduction (MBSR) programs are becoming more integrated into the treatment of persons with substance use disorders (SUDs). A focus of MBSR is to increase awareness of sensations in the body and accept them in the moment without judgment. Little is known about the readiness of women, with posttraumatic stress disorder (PTSD), and their level of comfort to participate in MBSR programs. Habermas' ideal speech situation guided a cooperative inquiry with 45 women at 3 treatment centers. Women engaged in activities of MBSR and shared opinions on how to develop a manual that would address the readiness of women with SUDs-PTSD to participate in MBSR. PMID:21822066

  16. PREFACE: International Conference on Many Particle Spectroscopy of Atoms, Molecules, Clusters and Surfaces

    NASA Astrophysics Data System (ADS)

    Dowek, Danielle; Bennani, Azzedine; Lablanquie, Pascal; Maquet, Alfred

    2008-12-01

    The 2008 edition of the International Conference on Many Particle Spectroscopy of Atoms, Molecules, Clusters and Surfaces was held in Paris from 30 June to 2 July 2008. This biennial conference alternates with the International Symposium on (e,2e), Double Photoionization and Related Topics which is a satellite of the International Conference on Photonic, Electronic and Atomic Collisions (ICPEAC) conference. Over 110 participants from 20 countries gathered to examine the latest developments in the field of radiation interactions with matter. These include electron-electron correlation effects in excitation and in single and multiple ionization of atoms, molecules, clusters and surfaces with various projectiles: electrons, photons and ions. The present proceedings gathers the contributions of invited speakers and is intended to provide a detailed state-of-the-art account of the various facets of the field. Special thanks are due to Université Paris Sud XI, CNRS, and the laboratories LCAM, LIXAM and LCPMR which provided financial support for the organization of the conference. We are also grateful to the contribution of the companies Varian and RoentDek Handels GmbH. Guest Editors: Danielle Dowek and Azzedine Bennani LCAM, Université Paris Sud XI, France Pascal Lablanquie and Alfred Maquet LCPMR, Université Pierre et Marie Curie, Paris, France INTERNATIONAL SCIENTIFIC COMMITTEE Lorenzo Avaldi, (Italy) Alexei Grum Grzhimailo, (Russia) Klaus Bartschat, (USA) Nikolai Kabachnik, (Russia) Jamal Berakdar, (Germany) Birgit Lohmann, (Australia) Nora Berrah, (USA) Don H Madison, (USA) Michael Brunger, (Australia) Francis Penent, (France) Albert Crowe, (UK) Bernard Piraux, (Belgium) Claude Dal Cappello, (France) Roberto Rivarola, (Argentina) JingKang Deng, (China) Emma Sokkel, (Ireland) Alexander Dorn, (Germany) Giovanni Stefani, (Italy) Reinhardt Dorner, (Germany) Noboru Watanabe, (Japan) François Frémont, (France) LOCAL ORGANIZING COMMITTEE Azzedine BENNANI (Chair

  17. The Need and Opportunity to Expand Substance Use Disorder Treatment in School-Based Settings

    ERIC Educational Resources Information Center

    Dennis, Michael L.; Clark, H. Westley; Huang, Larke N.

    2014-01-01

    In this paper, we explore the unmet need for substance use disorder (SUD) treatment among youth, its consequences, and the opportunity to address this gap due to the expansion of behavioral health services to school-based settings under the Parity and Affordable Care Acts. We discuss the importance of using evidence-based approaches to assessment…

  18. Disparities in Treatment for Substance Use Disorders and Co-Occurring Disorders for Ethnic/Racial Minority Youth

    ERIC Educational Resources Information Center

    Alegria, Margarita; Carson, Nicholas J.; Goncalves, Marta; Keefe, Kristen

    2011-01-01

    Objective: To review the literature on racial and ethnic disparities in behavioral health services and present recent data, focusing on services for substance use disorders (SUD) and comorbid mental health disorders for children and adolescents. Method: A literature review was conducted of behavioral health services for minority youth. Articles…

  19. The heart field effect: Synchronization of healer-subject heart rates in energy therapy.

    PubMed

    Bair, Christine Caldwell

    2008-01-01

    Recent health research has focused on subtle energy and vibrational frequency as key components of health and healing. In particular, intentional direction of bioenergy is receiving increasing scientific attention. This study investigates the effect of the healer's electromagnetic (EM) heart field upon subjects during energy healing as measured by synchronization of heart rates and scores on a Subjective Units of Distress (SUD) scale and a Profile of Mood States (POMS) inventory. A nonequivalent pretest-posttest design was used based on heart rate comparisons between healer and subject and correlated with pre-and posttest SUD and POMS scores. Subjects included those who sat within the 3- to 4-foot "strong" range of the independent variable, the healer's heart field, while performing self-application of WHEE (the wholistic hybrid derived from EMDR [eye movement desensitization and reprocessing], and EFT [emotional freedom technique]), a meridian-based tapping technique (n=50); and those who performed the same process beyond the 15- to 18-foot range of the healer's EM heart field (n=41). The dependent variables were heart rate, SUD, and POMS inventory. All subjects completed these measures within 1 hour. Study results showed statistically significant heart-rate synchronization with the intervention population. In addition, SUD and POMS scores demonstrated considerably more improvement than in the control population, indicating additional benefit beyond the meridian-based therapies, such as WHEE, alone. Additional findings and future research recommendations are presented in this article. PMID:20664147

  20. Genetically engineered synthetic miniaturized versions of Plasmodium falciparum UvrD helicase are catalytically active.

    PubMed

    Ansari, Abulaish; Tarique, Mohammed; Tuteja, Renu

    2014-01-01

    Helicases catalyze unwinding of double stranded nucleic acids in an energy-dependent manner. We have reported characterization of UvrD helicase from Plasmodium falciparum. We reported that the N-terminal and C-terminal fragments of PfUvrD contain characteristic ATPase and DNA helicase activities. Here we report the generation and characterization of a genetically engineered version of PfUvrD and its derivatives. This synthetic UvrD (sUD) contains all the conserved domains of PfUvrD but only the intervening linker sequences are shortened. sUD (∼ 45 kDa) and one of its smallest derivative sUDN1N2 (∼ 22 kDa) contain ATPase and DNA helicase activities. sUD and sUDN1N2 can utilize hydrolysis of all the NTPs and dNTPs, can also unwind blunt end duplex DNA substrate and unwind DNA duplex in 3 to 5 direction only. Some of the properties of sUD are similar to the PfUvrD helicase. Mutagenesis in the conserved motif Ia indicate that the mutants sUDM and sUDN1N2M lose all the enzyme activities, which further confirms that these activities are intrinsic to the synthesized proteins. These studies show that for helicase activity only the conserved domains are essentially required and intervening sequences have almost no role. These observations will aid in understanding the unwinding mechanism by a helicase. PMID:24608129

  1. Relationships between substance initiation sequence and further substance use: A French nationwide retrospective study.

    PubMed

    Attaiaa, Lalla-Asma; Beck, Francois; Richard, Jean-Baptiste; Marimoutou, Catherine; Mayet, Aurélie

    2016-06-01

    The Gateway theory (GT) proposes that tobacco or alcohol use lead to cannabis use, which can itself be followed by other illicit drugs (OID) onset. Aim of this study was to evaluate if the order of initiation sequence could influence further substance use. Data from a 2010 population-based survey were used (22,774 subjects aged 15-64). Using reported ages at initiations, 7 sequences were identified: initiation of tobacco only (T), cannabis or OID only, tobacco followed by cannabis (T-C), cannabis followed by tobacco (C-T), alternative 2-substance sequences, gateway sequence (T-C-OID) and 3-substance alternative sequences. Logistics regressions were performed to study the impact of sequence on further use (tobacco, alcohol, cannabis and OID), and substance use disorders (SUD) (tobacco, alcohol and cannabis). The most observed sequences were T (45.5%), T-C (20.5%), C-T (5.1%) and T-C-OID (3.5%). Further use and SUD likelihoods, whatever the substance considered, increased with the number of substances previously initiated. However, for a same number of substances initiated, current use and SUD likelihoods did not significantly vary according to sequence. Polysubstance initiation appears as a better predictor of further use and SUD than the initiation sequence, questioning the GT and being more in line with a common liability to substance use. PMID:26826476

  2. Modeling risk for child abuse and harsh parenting in families with depressed and substance-abusing parents.

    PubMed

    Kelley, Michelle L; Lawrence, Hannah R; Milletich, Robert J; Hollis, Brittany F; Henson, James M

    2015-05-01

    Children with substance abusing parents are at considerable risk for child maltreatment. The current study applied an actor-partner interdependence model to examine how father only (n=52) and dual couple (n=33) substance use disorder, as well as their depressive symptomology influenced parents' own (actor effects) and the partner's (partner effects) overreactivity in disciplinary interactions with their children, as well as their risk for child maltreatment. Parents completed the Center for Epidemiologic Studies Depression Scale (CES-D; Radloff, 1977), the overreactivity subscale from the Parenting Scale (Arnold, O'Leary, Wolff, & Acker, 1993), and the Brief Child Abuse Potential Inventory (Ondersma, Chaffin, Mullins, & LeBreton, 2005). Results of multigroup structural equation models revealed that a parent's own report of depressive symptoms predicted their risk for child maltreatment in both father SUD and dual SUD couples. Similarly, a parent's report of their own depressive symptoms predicted their overreactivity in disciplinary encounters both in father SUD and dual SUD couples. In all models, partners' depressive symptoms did not predict their partner's risk for child maltreatment or overreactivity. Findings underscore the importance of a parent's own level of depressive symptoms in their risk for child maltreatment and for engaging in overreactivity during disciplinary episodes. PMID:25724658

  3. Distinct Facets of Impulsivity Exhibit Differential Associations with Substance Use Disorder Treatment Processes: A Cross-Sectional and Prospective Investigation Among Military Veterans

    PubMed Central

    Heinz, Adrienne J.; Bui, Leena; Thomas, Katherine M.; Blonigen, Daniel M.

    2015-01-01

    Impulsivity, a multi-faceted construct characterized by rash, unplanned actions and a disregard for long-term consequences, is associated with poor substance use disorder (SUD) treatment outcomes. Little is known though about the influence of impulsivity on treatment process variables critical for initiating and maintaining behavioral change. This knowledge gap is important as different aspects of impulsivity may be susceptible to diverse cognitive, behavioral and pharmacological influences. The present study examined two distinct facets of impulsivity (lack of planning and immoderation - a proxy of urgency) as predictors of processes that impact SUD treatment success (active coping, avoidant coping, self-efficacy, and interpersonal problems). Participants were 200 Veterans who completed impulsivity and treatment process assessments upon entering a SUD treatment program and treatment process assessments at treatment discharge. Results from multivariate models revealed that lack of planning was associated with lower active coping and higher avoidant coping and interpersonal problems at intake, though not with lower self-efficacy to abstain from substances. Immoderation was associated with higher avoidant coping and lower self-efficacy to abstain from substances at intake, but not with lower active coping or higher interpersonal problems. Higher immoderation, but not lack of planning, predicted lower self-efficacy to abstain from substances at treatment discharge. These findings suggest that different facets of impulsivity confer risk for different SUD treatment process indicators and that clinicians should consider the behavioral expression of patients’ impulse control problems in treatment planning and delivery. PMID:25770869

  4. Concordance between Measures of Anxiety and Physiological Arousal Following Treatment of Panic Disorder in Adolescence

    ERIC Educational Resources Information Center

    Bacow, Terri Landon; May, Jill Ehrenreich; Choate-Summers, Molly; Pincus, Donna B.; Mattis, Sara G.

    2010-01-01

    This study examined the concordance (or synchrony/desynchrony) between adolescents' self-reports of anxiety and physiological measures of arousal (heart rate) both prior to and after treatment for panic disorder. Results indicated a decline in reported subjective units of distress (SUDS) for the treatment group only at the post-treatment…

  5. Discriminability of personality profiles in isolated and Co-morbid marijuana and nicotine users.

    PubMed

    Ketcherside, Ariel; Jeon-Slaughter, Haekyung; Baine, Jessica L; Filbey, Francesca M

    2016-04-30

    Specific personality traits have been linked with substance use disorders (SUDs), genetic mechanisms, and brain systems. Thus, determining the specificity of personality traits to types of SUD can advance the field towards defining SUD endophenotypes as well as understanding the brain systems involved for the development of novel treatments. Disentangling these factors is particularly important in highly co morbid SUDs, such as marijuana and nicotine use, so treatment can occur effectively for both. This study evaluated personality traits that distinguish isolated and co-morbid use of marijuana and nicotine. To that end, we collected the NEO Five Factor Inventory in participants who used marijuana-only (n=59), nicotine-only (n=27), both marijuana and nicotine (n=28), and in non-using controls (n=28). We used factor analyses to identify personality profiles, which are linear combinations of the five NEO Factors. We then conducted Receiver Operating Characteristics (ROC) curve analysis to test accuracy of the personality factors in discriminating isolated and co-morbid marijuana and nicotine users from each other. ROC curve analysis distinguished the four groups based on their NEO personality patterns. Results showed that NEO Factor 2 (openness, extraversion, agreeableness) discriminated marijuana and marijuana+nicotine users from controls and nicotine-only users with high predictability. Additional ANOVA results showed that the openness dimension discriminated marijuana users from nicotine users. These findings suggest that personality dimensions distinguish marijuana users from nicotine users and should be considered in prevention strategies. PMID:27086256

  6. Brief Report: Autism Spectrum Disorder and Substance Use Disorder: A Review and Case Study

    ERIC Educational Resources Information Center

    Rengit, Ashy C.; McKowen, James W.; O'Brien, Julie; Howe, Yamini J.; McDougle, Christopher J.

    2016-01-01

    There is limited literature available on the comorbidity between autism spectrum disorder (ASD) and substance use disorder (SUD). This paper reviews existing literature and exemplifies the challenges of treating this population with a case report of an adult male with ASD and DSM-5 alcohol use disorder. This review and case study seeks to…

  7. Using the Autism-Spectrum Quotient to Discriminate Autism Spectrum Disorder from ADHD in Adult Patients with and without Comorbid Substance Use Disorder

    ERIC Educational Resources Information Center

    Sizoo, Bram B.; van den Brink, Wim; Gorissen-van Eenige, Marielle; Koeter, Maarten W.; van Wijngaarden-Cremers, Patricia J. M.; van der Gaag, Rutger Jan

    2009-01-01

    It is unknown whether the Autism-spectrum quotient (AQ) can discriminate between Autism Spectrum Disorder (ASD) and Attention Deficit and Hyperactivity Disorder (ADHD) with or without comorbid Substance Use Disorder (SUD). ANOVA's were used to analyse the mean AQ (sub)scores of 129 adults with ASD or ADHD. We applied receiver operating…

  8. A Randomized Controlled Trial of Pemoline for Attention-Deficit-hyperactivity Disorder in Substance-Abusing Adolescents

    ERIC Educational Resources Information Center

    Riggs, Paula D.; Hall, Shannon K.; Mikulich-Gilbertson, Susan K.; Lohman, Michelle; Kayser, Ashley

    2004-01-01

    Objective: In adolescents with substance use disorder (SUD), comorbid attention-deficit/hyperactivity disorder (ADHD) is associated with greater severity of substance abuse, conduct problems, and worse treatment outcomes. Although many controlled trials have established the efficacy of psychostimulants, including pemoline, for ADHD in children and…

  9. Randomized Controlled Trial of Osmotic-Release Methylphenidate with Cognitive-Behavioral Therapy in Adolescents with Attention-Deficit/Hyperactivity Disorder and Substance Use Disorders

    ERIC Educational Resources Information Center

    Riggs, Paula D.; Winhusen, Theresa; Davies, Robert D.; Leimberger, Jeffrey D.; Mikulich-Gilbertson, Susan; Klein, Constance; Macdonald, Marilyn; Lohman, Michelle; Bailey, Genie L.; Haynes, Louise; Jaffee, William B.; Haminton, Nancy; Hodgkins, Candace; Whitmore, Elizabeth; Trello-Rishel, Kathlene; Tamm, Leanne; Acosta, Michelle C.; Royer-Malvestuto, Charlotte; Subramaniam, Geetha; Fishman, Marc; Holmes, Beverly W.; Kaye, Mary Elyse; Vargo, Mark A.; Woody, George E.; Nunes, Edward V.; Liu, David

    2011-01-01

    Objective: To evaluate the efficacy and safety of osmotic-release methylphenidate (OROS-MPH) compared with placebo for attention-deficit/hyperactivity disorder (ADHD), and the impact on substance treatment outcomes in adolescents concurrently receiving cognitive-behavioral therapy (CBT) for substance use disorders (SUD). Method: This was a…

  10. Developmental epidemiology of drug use and abuse in adolescence and young adulthood: Evidence of generalized risk

    PubMed Central

    Palmer, R.H.C.; Young, S.E.; Hopfer, C.J.; Corley, R.P.; Stallings, M.C.; Crowley, T.J.; Hewitt, J.K.

    2009-01-01

    Past studies highlight a narrowing gender gap and the existence of a shared etiology across substances of abuse; however, few have tested developmental models using longitudinal data. We present data on developmental trends of alcohol, tobacco, and marijuana use, abuse and dependence assessed during adolescence and young adulthood in a community-based Colorado twin sample of 1733 respondents through self-report questionnaires and structured psychiatric interviews. Additionally, we report on the rates of multiple substance use and disorders at each developmental stage, and the likelihood of a substance use disorder (SUD; i.e., abuse or dependence) diagnosis in young adulthood based on adolescent drug involvement. Most notably, we evaluate whether the pattern of multiple substance use and disorders and likelihood ratios across substances support a model of generalized risk. Lastly, we evaluate whether the ranked magnitudes of substance-specific risk match the addiction liability ranking. Substance use and SUDs are developmental phenomena, which increase from adolescence to young adulthood with fewand inconsistent gender differences. Adolescents and young adults are not specialized users, but rather tend to use or abuse multiple substances increasingly with age. Risk analyses indicated that progression toward a SUD for any substance was increased with prior involvement with any of the three substances during adolescence. Despite the high prevalence of alcohol use, tobacco posed the greatest substance-specific risk for developing subsequent problems. Our data also confirm either a generalized risk or correlated risk factors for early onset substance use and subsequent development of SUDs. PMID:19250776

  11. Characteristics of students participating in Collegiate Recovery Programs: A national survey

    PubMed Central

    Laudet, Alexandre B.; Harris, Kitty; Kimball, Thomas; Winters, Ken C.; Moberg, D. Paul

    2014-01-01

    Relapse rates are high among individuals with substance use disorders (SUD), and for young people pursuing a college education, the high rates of substance use on campus can jeopardize recovery. Collegiate Recovery Programs (CRPs) are an innovative campus-based model of recovery support that is gaining popularity but remains under-investigated. This study reports on the first nationwide survey of CRP-enrolled students (N = 486 from 29 different CRPs). Using an online survey, we collected information on background, SUD and recovery history, and current functioning. Most students (43% females, mean age = 26) had used multiple substances, had high levels of SUD severity, high rates of treatment and 12-step participation. Fully 40% smoke. Many reported criminal justice involvement and periods of homelessness. Notably, many reported being in recovery from, and currently engaging in multiple behavioral addictions-e.g., eating disorders, and sex and love addiction. Findings highlight the high rates of co-occurring addictions in this under-examined population and underline the need for treatment, recovery support programs and college health services to provide integrated support for mental health and behavioral addictions to SUD-affected young people. PMID:25481690

  12. Integrative Interventions for Men with Concurrent Substance Misuse and Trauma: Roles for Mindfulness and Masculinities

    ERIC Educational Resources Information Center

    Foster, Durwin B.; Kelly, Mary Theresa

    2012-01-01

    Men experience higher lifetime trauma rates than women, and they use and misuse substances at rates far exceeding women. Men are also reported to experience significantly higher lifetime rates of comorbid posttraumatic stress disorder (PTSD) and substance use disorder (SUD) than women. Although there is agreement in the clinical field of trauma…

  13. PTSD and Comorbid Disorders in a Representative Sample of Adolescents: The Risk Associated with Multiple Exposures to Potentially Traumatic Events

    ERIC Educational Resources Information Center

    Macdonald, Alexandra; Danielson, Carla Kmett; Resnick, Heidi S.; Saunders, Benjamin E.; Kilpatrick, Dean G.

    2010-01-01

    Objective: This study compared the impact of multiple exposures to potentially traumatic events (PTEs), including sexual victimization, physical victimization, and witnessed violence, on posttraumatic stress disorder (PTSD) and comorbid conditions (i.e., major depressive episode [MDE], and substance use [SUD]). Methods: Participants were a…

  14. Exploring Massachusetts Health Care Reform Impact on Fee-for-Service-Funded Substance Use Disorder Treatment Providers.

    PubMed

    Fields, Dail; Pruett, Jana; Roman, Paul M

    2015-01-01

    The Affordable Care Act (ACA) is forecast to increase the demand for and utilization of substance use disorder (SUD) treatment. Massachusetts implemented health reforms similar to the ACA in 2006-2007 that included expanding coverage for SUD treatment. This study explored the impact of Massachusetts health reforms from 2007 to 2010 on SUD treatment providers in Massachusetts, who relied on fee-for-service billings for more than 50% of their revenue. The changes across treatment facilities located in Massachusetts were compared to changes in other similar fee-for-service-funded SUD treatment providers in Northeast states bordering Massachusetts and in all other states across the US. From 2007-2010, the percentage changes for Massachusetts based providers were significantly different from the changes among providers located in the rest of the US for admissions, outpatient census, average weeks of outpatient treatment, residential/in-patient census, detoxification census, length of average inpatient and outpatient stays, and provision of medication-assisted treatment. Contrary to previous studies of publicly funded treatment providers, the results of this exploratory study of providers dependent on fee-for-service revenues were consistent with some predictions for the overall effects of the ACA. PMID:26514378

  15. Sudden unexplained death syndrome--a new manifestation in melioidosis?

    PubMed Central

    Yap, E. H.; Chan, Y. C.; Goh, K. T.; Chao, T. C.; Heng, B. H.; Thong, T. W.; Tan, H. C.; Thong, K. T.; Jacob, E.; Singh, M.

    1991-01-01

    The indirect haemagglutination (IHA) test using sensitized turkey erythrocytes and the indirect immunofluorescence assay (IgM-IFA) was confirmed to be sensitive in the detection of a recent or current Pseudomonas pseudomallei infection in 19 culture-confirmed Singapore melioidosis patients. All were found to have antibody titres from 4 to 32768 in the IHA test and 10 to 320 in the IgM-IFA test. When these tests were employed on sera from 16 immigrant Thai construction workers who died of sudden unexplained death syndrome (SUDS) and 73 healthy Thai fellow workers, 93.8% and 68.8% of SUDS cases had IHA titre of greater than or equal to 4 and IgM-IFA titre of greater than or equal to 10 respectively, in contrast to 39.7% and 12.3% found among healthy Thai workers. These data indicate that at the time of death, most of the SUDS patients had an active infection with P. pseudomallei, possibly resulting from reactivation of a latent infection. The aetiological role of P. pseudomallei as the major cause of SUDS is discussed. PMID:1721589

  16. Distinct facets of impulsivity exhibit differential associations with substance use disorder treatment processes: a cross-sectional and prospective investigation among military veterans.

    PubMed

    Heinz, Adrienne J; Bui, Leena; Thomas, Katherine M; Blonigen, Daniel M

    2015-08-01

    Impulsivity, a multi-faceted construct characterized by rash, unplanned actions and a disregard for long-term consequences, is associated with poor substance use disorder (SUD) treatment outcomes. Little is known though about the influence of impulsivity on treatment process variables critical for initiating and maintaining behavioral change. This knowledge gap is important as different aspects of impulsivity may be susceptible to diverse cognitive, behavioral and pharmacological influences. The present study examined two distinct facets of impulsivity (lack of planning and immoderation--a proxy of urgency) as predictors of processes that impact SUD treatment success (active coping, avoidant coping, self-efficacy, and interpersonal problems). Participants were 200 Veterans who completed impulsivity and treatment process assessments upon entering an SUD treatment program and treatment process assessments at treatment discharge. Results from multivariate models revealed that lack of planning was associated with lower active coping and higher avoidant coping and interpersonal problems at intake, though not with lower self-efficacy to abstain from substances. Immoderation was associated with higher avoidant coping and lower self-efficacy to abstain from substances at intake, but not with lower active coping or higher interpersonal problems. Higher immoderation, but not lack of planning, predicted lower self-efficacy to abstain from substances at treatment discharge. These findings suggest that different facets of impulsivity confer risk for different SUD treatment process indicators and that clinicians should consider the behavioral expression of patients' impulse control problems in treatment planning and delivery. PMID:25770869

  17. Substance Use Disorder and ADHD: Is ADHD a Particularly "Specific" Risk Factor?

    ERIC Educational Resources Information Center

    Kousha, Maryam; Shahrivar, Zahra; Alaghband-rad, Javad

    2012-01-01

    Objective: To assess the pattern of substance use disorder (SUD) in adolescents with and without history of attention-deficit/hyperactivity disorder (ADHD) using an Iranian sample in the context of a cultural background and drug availability is differing from Western countries. Method: In this case-control study, the participants were interviewed…

  18. Trajectories of Substance Use Disorders in Youth: Identifying and Predicting Group Memberships

    ERIC Educational Resources Information Center

    Lee, Chih-Yuan S.; Winters, Ken C.; Wall, Melanie M.

    2010-01-01

    This study used latent class regression to identify latent trajectory classes based on individuals' diagnostic course of substance use disorders (SUDs) from late adolescence to early adulthood as well as to examine whether several psychosocial risk factors predicted the trajectory class membership. The study sample consisted of 310 individuals…

  19. Measurement error and outcome distributions: Methodological issues in regression analyses of behavioral coding data

    PubMed Central

    Holsclaw, Tracy; Hallgren, Kevin A.; Steyvers, Mark; Smyth, Padhraic; Atkins, David C.

    2015-01-01

    Behavioral coding is increasingly used for studying mechanisms of change in psychosocial treatments for substance use disorders (SUDs). However, behavioral coding data typically include features that can be problematic in regression analyses, including measurement error in independent variables, non-normal distributions of count outcome variables, and conflation of predictor and outcome variables with third variables, such as session length. Methodological research in econometrics has shown that these issues can lead to biased parameter estimates, inaccurate standard errors, and increased type-I and type-II error rates, yet these statistical issues are not widely known within SUD treatment research, or more generally, within psychotherapy coding research. Using minimally-technical language intended for a broad audience of SUD treatment researchers, the present paper illustrates the nature in which these data issues are problematic. We draw on real-world data and simulation-based examples to illustrate how these data features can bias estimation of parameters and interpretation of models. A weighted negative binomial regression is introduced as an alternative to ordinary linear regression that appropriately addresses the data characteristics common to SUD treatment behavioral coding data. We conclude by demonstrating how to use and interpret these models with data from a study of motivational interviewing. SPSS and R syntax for weighted negative binomial regression models is included in supplementary materials. PMID:26098126

  20. The factor structure of psychiatric comorbidity among Iraq/Afghanistan-era veterans and its relationship to violence, incarceration, suicide attempts, and suicidality

    PubMed Central

    Kimbrel, Nathan A.; Calhoun, Patrick S.; Elbogen, Eric B.; Brancu, Mira; Beckham, Jean C.

    2015-01-01

    The present research examined how incarceration, suicide attempts, suicidality, and difficulty controlling violence relate to the underlying factor structure of psychiatric comorbidity among a large sample of Iraq/Afghanistan-era veterans (N = 1897). Diagnostic interviews established psychiatric diagnoses; self-report measures assessed history of incarceration, difficulty controlling violence, suicide attempts, and suicidality. A 3-factor measurement model characterized by latent factors for externalizing-substance-use disorders (SUD), distress, and fear provided excellent fit to the data. Alcohol-use disorder, drug-use disorder, and nicotine dependence were indicators on the externalizing-SUD factor. Posttraumatic stress disorder and depression were indicators on the distress factor. Panic disorder, social phobia, specific phobia, and obsessive-compulsive disorder were indicators on the fear factor. Incarceration was exclusively predicted by the externalizing-SUD factor. Difficulty controlling violence, suicidality, and suicide attempts were exclusively predicted by the distress factor. Contrary to hypotheses, the path from the externalizing/SUD factor to difficulty controlling violence was not significant. Taken together, these findings suggest that the distress factor of psychiatric comorbidity is a significant risk factor for suicidality, suicide attempts, and difficulty controlling violence and could help to explain the frequent co-occurrence of these critical outcomes among returning Iraq/Afghanistan veterans. PMID:25169889

  1. Measurement error and outcome distributions: Methodological issues in regression analyses of behavioral coding data.

    PubMed

    Holsclaw, Tracy; Hallgren, Kevin A; Steyvers, Mark; Smyth, Padhraic; Atkins, David C

    2015-12-01

    Behavioral coding is increasingly used for studying mechanisms of change in psychosocial treatments for substance use disorders (SUDs). However, behavioral coding data typically include features that can be problematic in regression analyses, including measurement error in independent variables, non normal distributions of count outcome variables, and conflation of predictor and outcome variables with third variables, such as session length. Methodological research in econometrics has shown that these issues can lead to biased parameter estimates, inaccurate standard errors, and increased Type I and Type II error rates, yet these statistical issues are not widely known within SUD treatment research, or more generally, within psychotherapy coding research. Using minimally technical language intended for a broad audience of SUD treatment researchers, the present paper illustrates the nature in which these data issues are problematic. We draw on real-world data and simulation-based examples to illustrate how these data features can bias estimation of parameters and interpretation of models. A weighted negative binomial regression is introduced as an alternative to ordinary linear regression that appropriately addresses the data characteristics common to SUD treatment behavioral coding data. We conclude by demonstrating how to use and interpret these models with data from a study of motivational interviewing. SPSS and R syntax for weighted negative binomial regression models is included in online supplemental materials. PMID:26098126

  2. Comorbid bipolar disorder and borderline personality disorder and substance use disorder.

    PubMed

    Hidalgo-Mazzei, Diego; Walsh, Emily; Rosenstein, Lia; Zimmerman, Mark

    2015-01-01

    Bipolar disorder (BD) and borderline personality disorder (BPD) are disabling and life-threatening conditions. Both disorders share relevant comorbidities, particularly the risk of having a lifetime substance use disorder (SUD). We tested the hypothesis that patients with both BD type I (BDI) or II (BDII) and BPD would have a higher rate of SUD than would patients with either disorder alone. A total of 3651 psychiatric patients were evaluated with semistructured diagnostic interviews for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, axis I and II disorders. A total of 63 patients were diagnosed with both BD and BPD, and these patients were significantly more likely to have a SUD compared with BDII patients without BPD (76% vs. 50%, χ = 9.69, p < 0.01). There were no differences when comparing the comorbid group with BPD patients without BD (76% vs. 71%, χ = 0.519, p = 0.4). The present study shows the importance of taking both BPD and BD into consideration insofar as the co-occurrence of the disorders increased the risk of having a SUD especially when compared with BDII alone. PMID:25494335

  3. German-French Case Study: Using Multi-Online Tools to Collaborate across Borders

    ERIC Educational Resources Information Center

    Brautlacht, Regina; Ducrocq, Csilla

    2013-01-01

    This paper examines how students learn to collaborate in English by participating in an intercultural project that focuses on teaching students to work together on a digital writing project using various online tools, and documents their reflections working in an intercultural context. Students from Université Paris Sud Orsay and Bonn…

  4. Modeling Risk for Child Abuse and Harsh Parenting in Families with Depressed and Substance-abusing Parents

    PubMed Central

    Kelley, Michelle L.; Lawrence, Hannah R.; Milletich, Robert R.; Hollis, Brittany F.; Henson, James M.

    2015-01-01

    Children with substance abusing parents are at considerable risk for child maltreatment. The current study applied an actor-partner interdependence model to examine how father only (n = 52) and dual couple (n = 33) substance use disorder, as well as their depressive symptomology influenced parents’ own (actor effects) and the partner's (partner effects) overreactivity in disciplinary interactions with their children, as well as their risk for child maltreatment. Parents completed the Center for Epidemiologic Studies Depression Scale (CES-D; Radloff, 1977), the overreactivity subscale from the Parenting Scale (Arnold, O'Leary, Wolff, & Acker, 1993), and the Brief Child Abuse Potential Inventory (Ondersma, Chaffin, Mullins, & LeBreton, 2005). Results of multigroup structural equation models revealed that a parent's own report of depressive symptoms predicted their risk for child maltreatment in both father SUD and dual SUD couples. Similarly, a parent's report of their own depressive symptoms predicted their overreactivity in disciplinary encounters both in father SUD and dual SUD couples. In all models, partners’ depressive symptoms did not predict their partner's risk for child maltreatment or overreactivity. Findings underscore the importance of a parent's own levels of depressive symptoms in their risk for child maltreatment and for engaging in overreactivity during disciplinary episodes. PMID:25724658

  5. Managing Chronic Pain in Adults with or in Recovery from Substance Use Disorders. Treatment Improvement Protocol (TIP) Series 54

    ERIC Educational Resources Information Center

    Substance Abuse and Mental Health Services Administration, 2012

    2012-01-01

    Chronic noncancer pain (CNCP) is common in the general population as well as in people who have a substance use disorder (SUD) (Exhibit 1-1). Chronic pain is not harmless; it has physiological, social, and psychological dimensions that can seriously harm health, functioning, and well-being. As a multidimensional condition with both objective and…

  6. A Collaborative Approach to Teaching Medical Students How to Screen, Intervene, and Treat Substance Use Disorders

    ERIC Educational Resources Information Center

    Neufeld, Karin J.; Alvanzo, Anika; King, Van L.; Feldman, Leonard; Hsu, Jeffrey H.; Rastegar, Darius A.; Colbert, Jorie M.; MacKinnon, Dean F.

    2012-01-01

    Few medical schools require a stand-alone course to develop knowledge and skills relevant to substance use disorders (SUDs). The authors successfully initiated a new course for second-year medical students that used screening, brief intervention, and referral to treatment (SBIRT) as the course foundation. The 15-hour course (39 faculty teaching…

  7. Longitudinal Examination of Medical Staff Utilization in Substance Use Disorder Treatment Organizations.

    PubMed

    Fields, Dail; Roman, Paul

    2015-12-01

    This study examined changes in utilization of medical staff within organizations specializing in treatment of patients with substance use disorder (SUD) at two points in time (2007 and 2010). Utilization was calculated as the number of hours paid weekly for psychiatrists, physicians, nurses, and other medical staff working as employees or on contract. Study data come from a longitudinal national sample of 274 substance use disorder treatment centers. Average utilization of medical staff by these SUD treatment organizations increased by 26% from 2007 to 2010. The results showed that growing SUD treatment centers that obtained more referrals from health care providers, used case managers to coordinate comprehensive approaches to patient care, provided medication assisted treatment (MAT), and that were connected more closely with hospitals made increased use of medical staff over the 2007-2010 period. In 2010, these organizations seem to have been moving in directions consistent with trends forecasted for the SUD treatment environment after implementation of the Affordable Care Act. PMID:26219681

  8. Race and Sexually Transmitted Diseases in Women With and Without Borderline Personality Disorder

    PubMed Central

    Feske, Ulrike; Angiolieri, Teresa; Gold, Melanie A.

    2011-01-01

    Abstract Background The purpose of this study was to examine the history of sexually transmitted diseases (STDs) among women with borderline personality disorder (BPD) with and without a lifetime substance use disorder (SUD) and to compare their histories to those of a group of women with a current nonpsychotic axis I disorder. Methods Two-hundred fifteen women completed the Structured Clinical Interview for DSM-IV Axis I diagnoses (SCID-I), Structured Interview for DSM-IV Personality for Axis II diagnoses (SIDP-IV), and a sexual health interview. African American women were oversampled because little is known about BPD in African American women and because they are at greater risk for STDs than non-African American women. Results Women with a lifetime SUD (especially cannabis use disorder) reported more STD risk factors and STDs than women without a lifetime SUD. BPD dimensional scores and African American race were predictors of STD, even after controlling for age, socioeconomic status (SES), SUDs, and participation in the sex trade. Conclusions Determining predictors of STDs within at-risk subpopulations may help reduce the spread of STDs and prevent HIV infection within these groups by helping providers identify women at the highest risk of infection. PMID:21219244

  9. Examining intensity and types of interagency collaboration between child welfare and drug and alcohol service providers.

    PubMed

    He, Amy S

    2015-08-01

    The co-occurrence of child maltreatment and caregiver substance use disorders (SUDs) is a pervasive problem, with an estimated two thirds of child welfare (CW) systems cases involving SUDs. Interagency collaboration between CW and drug and alcohol service (DAS) providers shows promise in improving connections to and delivery of SUD services for CW-involved families. However, interagency collaboration between CW and DAS providers continues to be difficult to achieve and little is known about organizational characteristics and contexts that influence collaboration between these two entities. Using data from the second cohort of families from the National Survey of Child and Adolescent Well-Being, this study examined national trends in interagency collaboration between CW and DAS providers and organizational factors that influence the nature and intensity of interagency collaboration. Results indicated that collaboration intensity was greater for CW agencies that reported increased caseloads and those located in more populated counties. However, collaboration intensity decreased for CW agencies located in counties with higher child poverty. Study findings have implications for policy leaders and directors of CW agencies throughout the United States, especially because collaborating with DAS providers may increase CW agencies' organizational capacity and relieve job stress related to high caseloads. Development of strategies that spur engagement in more intense and multiple types of collaboration between CW agencies and DAS providers has the potential to relieve service burden on CW staffs and expedite service delivery to CW-involved families dealing with SUDs. PMID:26188423

  10. Adolescent Substance Use in the Multimodal Treatment Study of Attention-Deficit/Hyperactivity Disorder (ADHD) (MTA) as a Function of Childhood ADHD, Random Assignment to Childhood Treatments, and Subsequent Medication

    ERIC Educational Resources Information Center

    Molina, Brooke S. G.; Hinshaw, Stephen P.; Arnold, L. Eugene; Swanson, James M.; Pelham, William E.; Hechtman, Lily; Hoza, Betsy; Epstein, Jeffery N.; Wigal, Timothy; Abikoff, Howard B.; Greenhill, Laurence L.; Jensen, Peter S.; Wells, Karen C.; Vitiello, Benedetto; Gibbons, Robert D.; Howard, Andrea; Houck, Patricia R.; Hur, Kwan; Lu, Bo; Marcus, Sue

    2013-01-01

    Objective: To determine long-term effects on substance use and substance use disorder (SUD), up to 8 years after childhood enrollment, of the randomly assigned 14-month treatments in the multisite Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder (MTA; n = 436); to test whether medication at follow-up, cumulative…

  11. Using Standardized Patients to Evaluate Screening, Brief Intervention, and Referral to Treatment (SBIRT) Knowledge and Skill Acquisition for Internal Medicine Residents

    ERIC Educational Resources Information Center

    Satterfield, Jason M.; O'Sullivan, Patricia; Satre, Derek D.; Tsoh, Janice Y.; Batki, Steven L.; Julian, Kathy; McCance-Katz, Elinore F.; Wamsley, Maria

    2012-01-01

    Comprehensive clinical competency curricula for hazardous drinking and substance use disorders (SUDs) exists for medical students, residents, and practicing health care providers. Evaluations of these curricula typically focus on learner attitudes and knowledge, although changes in clinical skills are of greater interest and utility. The authors…

  12. Health Disparities in Drug- and Alcohol-Use Disorders: A 12-Year Longitudinal Study of Youths After Detention

    PubMed Central

    Welty, Leah J.; Harrison, Anna J.; Abram, Karen M.; Olson, Nichole D.; Aaby, David A.; McCoy, Kathleen P.; Washburn, Jason J.

    2016-01-01

    Objectives. To examine sex and racial/ethnic differences in the prevalence of 9 substance-use disorders (SUDs)—alcohol, marijuana, cocaine, hallucinogen or PCP, opiate, amphetamine, inhalant, sedative, and unspecified drug— in youths during the 12 years after detention. Methods. We used data from the Northwestern Juvenile Project, a prospective longitudinal study of 1829 youths randomly sampled from detention in Chicago, Illinois, starting in 1995 and reinterviewed up to 9 times in the community or correctional facilities through 2011. Independent interviewers assessed SUDs with Diagnostic Interview Schedule for Children 2.3 (baseline) and Diagnostic Interview Schedule version IV (follow-ups). Results. By median age 28 years, 91.3% of males and 78.5% of females had ever had an SUD. At most follow-ups, males had greater odds of alcohol- and marijuana-use disorders. Drug-use disorders were most prevalent among non-Hispanic Whites, followed by Hispanics, then African Americans (e.g., compared with African Americans, non-Hispanic Whites had 32.1 times the odds of cocaine-use disorder [95% confidence interval = 13.8, 74.7]). Conclusions. After detention, SUDs differed markedly by sex, race/ethnicity, and substance abused, and, contrary to stereotypes, did not disproportionately affect African Americans. Services to treat substance abuse—during incarceration and after release—would reach many people in need, and address health disparities in a highly vulnerable population. PMID:26985602

  13. A Pilot Study of the DBT Coach: An Interactive Mobile Phone Application for Individuals with Borderline Personality Disorder and Substance Use Disorder

    ERIC Educational Resources Information Center

    Rizvi, Shireen L.; Dimeff, Linda A.; Skutch, Julie; Carroll, David; Linehan, Marsha M.

    2011-01-01

    Dialectical behavior therapy (DBT) has received strong empirical support and is practiced widely as a treatment for borderline personality disorder (BPD) and BPD with comorbid substance use disorders (BPD-SUD). Therapeutic success in DBT requires that individuals generalize newly acquired skills to their natural environment. However, there have…

  14. Does Comorbid Substance Use Disorder Exacerbate Borderline Personality Features?: A Comparison of Borderline Personality Disorder Individuals with vs. without Current Substance Dependence

    PubMed Central

    Lee, Han-Joo; Bagge, Courtney L.; Schumacher, Julie A.; Coffey, Scott F.

    2010-01-01

    There is compelling evidence that comorbid borderline personality disorder (BPD) negatively impact the clinical courses and outcomes of substance use disorders (SUD). Conversely, there is little evidence that concurrent SUD exacerbates the clinical characteristics of BPD. Thus, this study sought to examine whether the presence of current substance dependence among BPD patients would be associated with stronger BPD-relevant personality traits and behavioral characteristics. Female BPD patients without (BOR; n = 37) or with current substance dependence (BSUD; n = 19), and female non-BPD/SUD controls (CON; n = 48) were compared with respect to impulsivity, affective lability, affective intensity, externalizing behaviors, and self-harming/suicidal tendencies, taking into consideration their comorbid mood disorders, anxiety disorders, and antisocial personality disorder. Results indicated that both BOR and BSUD groups scored higher than CON in most of the measures, but BOR and BSUD failed to reveal significant group differences especially when the influence of comorbid psychopathology was removed. The overall pattern of findings remained identical even when comparing BPD patients with vs. without the diagnosis of lifetime substance dependence. Our results do not support the notion that BPD individuals with SUD display more severe BPD features than individuals with BPD alone. PMID:21116439

  15. Mapping hazard from urban non-point pollution: a screening model to support sustainable urban drainage planning.

    PubMed

    Mitchell, Gordon

    2005-01-01

    Non-point sources of pollution are difficult to identify and control, and are one of the main reasons that urban rivers fail to reach the water quality objectives set for them. Whilst sustainable drainage systems (SuDS) are available to help combat this diffuse pollution, they are mostly installed in areas of new urban development. However, SuDS must also be installed in existing built areas if diffuse loadings are to be reduced. Advice on where best to locate SuDS within existing built areas is limited, hence a semi-distributed stochastic GIS-model was developed to map small-area basin-wide loadings of 18 key stormwater pollutants. Load maps are combined with information on surface water quality objectives to permit mapping of diffuse pollution hazard to beneficial uses of receiving waters. The model thus aids SuDS planning and strategic management of urban diffuse pollution. The identification of diffuse emission 'hot spots' within a water quality objectives framework is consistent with the 'combined' (risk assessment) approach to pollution control advocated by the EU Water Framework Directive. PMID:15572076

  16. Fate of hydrocarbon pollutants in source and non-source control sustainable drainage systems.

    PubMed

    Roinas, Georgios; Mant, Cath; Williams, John B

    2014-01-01

    Sustainable drainage (SuDs) is an established method for managing runoff from developments, and source control is part of accepted design philosophy. However, there are limited studies into the contribution source control makes to pollutant removal, especially for roads. This study examines organic pollutants, total petroleum hydrocarbons (TPH) and polycyclic aromatic hydrocarbons (PAHs), in paired source and non-source control full-scale SuDs systems. Sites were selected to cover local roads, trunk roads and housing developments, with a range of SuDs, including porous asphalt, swales, detention basins and ponds. Soil and water samples were taken bi-monthly over 12 months to assess pollutant loads. Results show first flush patterns in storm events for solids, but not for TPH. The patterns of removal for specific PAHs were also different, reflecting varying physico-chemical properties. The potential of trunk roads for pollution was illustrated by peak runoff for TPH of > 17,000 μg/l. Overall there was no significant difference between pollutant loads from source and non-source control systems, but the dynamic nature of runoff means that longer-term data are required. The outcomes of this project will increase understanding of organic pollutants behaviour in SuDs. This will provide design guidance about the most appropriate systems for treating these pollutants. PMID:24569267

  17. Intraspecific variability of the essential oil of Calamintha nepeta subsp. nepeta from Southern Italy (Apulia).

    PubMed

    Negro, C; Notarnicola, S; De Bellis, L; Miceli, A

    2013-03-01

    The essential oil of 46 spontaneous plants of Calamintha nepeta (L.) Savi subsp. nepeta growing wild in Sud, Italy (Salento, Apulia), were investigated by GC/MS. Fifty-seven components were identified in the oil representing over the 98% of the total oil composition. Four chemotypes were identified: piperitone oxide, piperitenone oxide, piperitone-menthone and pulegone. PMID:22646908

  18. Substance Abuse and Dependency Risk: The Role of Peer Perceptions, Marijuana Involvement, and Attitudes toward Substance Use among College Students

    ERIC Educational Resources Information Center

    Lewis, Todd F.; Mobley, A. Keith

    2010-01-01

    Many college students are using substances at levels consistent with Substance Abuse or Dependence, yet little explanation for this phenomenon exits. The aim of this study was to explore a risk factor profile that best separates those with low and high potential for having a Substance Use Disorder (SUD). A discriminant function analysis revealed…

  19. The GSO Data Centre

    NASA Astrophysics Data System (ADS)

    Paletou, F.; Glorian, J.-M.; Génot, V.; Rouillard, A.; Petit, P.; Palacios, A.; Caux, E.; Wakelam, V.

    2015-12-01

    Hereafter we describe the activities of the Grand Sud-Ouest Data Centre operated for INSU (CNRS) by the OMP--IRAP and the Université Paul Sabatier in Toulouse, in a collaboration with the OASU--LAB in Bordeaux and OREME--LUPM in Montpellier.

  20. Ibogaine and addiction in the animal model, a systematic review and meta-analysis.

    PubMed

    Belgers, M; Leenaars, M; Homberg, J R; Ritskes-Hoitinga, M; Schellekens, A F A; Hooijmans, C R

    2016-01-01

    Ibogaine is a naturally occurring substance which has been increasingly used in the lay-scene to reduce craving and relapse in patients with substance use disorders (SUDs). Although human clinical trials on the safety and efficacy of ibogaine are lacking, animal studies do support the efficacy of ibogaine. In this systematic review and meta-analysis (MA), we summarise these animal findings, addressing three questions: (1) does ibogaine reduce addictive behaviour in animal models of SUDs?; (2) what are the toxic effects of ibogaine on motor functioning, cerebellum and heart rhythm?; (3) what are neuropharmacological working mechanisms of ibogaine treatment in animal models of SUDs? MA of 27 studies showed that ibogaine reduced drug self-administration, particularly during the first 24 h after administration. Ibogaine had no effect on drug-induced conditioned place preference. Ibogaine administration resulted in motor impairment in the first 24 h after supplementation, and cerebral cell loss even weeks after administration. Data on ibogaines effect on cardiac rhythm, as well as on its neuropharmacological working mechanisms are limited. Our results warrant further studies into the clinical efficacy of ibogaine in SUD patients in reducing craving and substance use, but close monitoring of the patients is recommended because of the possible toxic effects. In addition, more work is needed to unravel the neuropharmacological working mechanisms of ibogaine and to investigate its effects on heart rhythm. PMID:27244235

  1. 78 FR 18917 - Airworthiness Directives; The Boeing Company Airplanes

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-28

    ... Procedures (44 FR 11034, February 26, 1979), (3) Will not affect intrastate aviation in Alaska, and (4) Will... Airplanes AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of proposed rulemaking (NPRM...-100, -100B, -100B SUD, -200B, - 200C, -200F, -300, -400, -400D, -400F, and 747SR series...

  2. Psychotropic Medications and Substances of Abuse Interactions in Youth

    ERIC Educational Resources Information Center

    Kaminer, Yifrah; Goldberg, Pablo; Connor, Daniel F.

    2010-01-01

    The majority of youth with substance use disorders (SUDs) manifest one or more co-occurring psychiatric disorders. Consequently, many of these youths are being prescribed with psychotropic medications. As prescribing rates continue to increase for early-onset psychiatric disorders, potential risk for substance of abuse-psychiatric medication…

  3. Exploring Clinical Psychology Doctoral Students' Attitudes towards Adults with Substance Use Disorders

    ERIC Educational Resources Information Center

    Mundon, Chandra R.

    2013-01-01

    This study sought to determine whether clinical psychology doctoral students hold uniquely stigmatizing views of adults with substance use disorders (SUDs) compared to adults with other clinical disorders. Through the use of clinical vignettes and attitudinal measures, three hypotheses investigated clinical psychology doctoral students'…

  4. Substance misuse following Roux-en-Y gastric bypass surgery.

    PubMed

    Reslan, Summar; Saules, Karen K; Greenwald, Mark K; Schuh, Leslie M

    2014-03-01

    Post-bariatric surgery patients are overrepresented in substance abuse treatment, particularly those who have had the Roux-en-Y gastric bypass (RYGB) procedure. The severity of the substance use disorder (SUD; i.e., warranting inpatient treatment) and related consequences necessitate a better understanding of the variables associated with post-RYGB SUDs. This investigation assessed factors associated with post-RYGB substance misuse. Post-RYGB patients (N = 141; at least 24 months postsurgery) completed an online survey assessing variables hypothesized to contribute to post-RYGB SUDs. Fourteen percent of participants met criteria for postoperative substance misuse. Those with a lower percent total weight loss (%TWL) were more likely to endorse substance misuse. Family history of substance misuse was strongly associated with postoperative substance misuse. Eating-related variables including presurgical food addiction and postsurgical nocturnal eating, subjective hunger, and environmental responsiveness to food cues were also associated with a probable postoperative SUD. These findings have clinical utility in that family history of substance misuse can be easily assessed, and at-risk patients can be advised accordingly. In addition, those who endorse post-RYGB substance misuse appear to have stronger cognitive and behavioral responses to food, providing some support for the theory of behavioral substitution (or "addiction transfer"). PMID:24102253

  5. Predictors of Decision-Making on the Iowa Gambling Task: Independent Effects of Lifetime History of Substance Use Disorders and Performance on the Trail Making Test

    ERIC Educational Resources Information Center

    Barry, D.; Petry, N. M.

    2008-01-01

    Poor decision-making and executive function deficits are frequently observed in individuals with substance use disorders (SUDs), and executive deficits may contribute to poor decision-making in this population. This study examined the influence of lifetime history of an alcohol, cocaine, heroin, or polysubstance use disorder on decision-making as…

  6. 77 FR 5013 - Notice of Agreements Filed

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-01

    ... trade between U.S. West Coast ports and ports on the West Coast of Mexico and Central America. The... authorizes APL to charter space to Hamburg Sud in the trade from Asia to the U.S. Pacific Northwest. By...

  7. Substance use disorders and HIV in Vietnam since Doi Moi (Renovation): an overview.

    PubMed

    Giang, Le Minh; Ngoc, Lung Bich; Hoang, Vu Huy; Mulvey, Kevin; Rawson, Richard A

    2013-12-01

    Drawing from published and gray literature, this manuscript focuses on the following topics: (1) changing patterns of substance use and abuse in Vietnam since the early 1990s; (2) the roles of substance use in the HIV epidemic; (3) the responses of the Vietnamese government and other entities (both domestic and international) to substance use disorders (SUDs) and HIV; and (4) the current research capacity in Vietnam and ways in which furthering research in Vietnam could enrich our knowledge of the linkages between SUDs and HIV and of effective measures to reduce their public health consequences. A growing number of studies during the past two decades show dynamic and still evolving twin epidemics of SUDs and HIV in Vietnam, including a shift from consumption of opium to heroin and amphetamine-type stimulants, the concurrent use of drugs, and the increasing embrace by the government of internationally recognized effective responses (including harm reduction and methadone substitution therapy). And yet, remaining issues, such as the rapid ascendance of amphetamine-type stimulant use among the country's most vulnerable populations, the lack of effective integration of SUD and HIV services for HIV-infected drug users, and the reliance on international resources for maintaining quality services, among others, are posing challenges for building sustainable Vietnamese responses. Therefore, building local research and training capacity is a crucial foundation to meet these challenges. PMID:25278736

  8. Onset of Alcohol or Substance Use Disorders Following Treatment for Adolescent Depression

    ERIC Educational Resources Information Center

    Curry, John; Silva, Susan; Rohde, Paul; Ginsburg, Golda; Kennard, Betsy; Kratochvil, Christopher; Simons, Anne; Kirchner, Jerry; May, Diane; Mayes, Taryn; Feeny, Norah; Albano, Anne Marie; Lavanier, Sarah; Reinecke, Mark; Jacobs, Rachel; Becker-Weidman, Emily; Weller, Elizabeth; Emslie, Graham; Walkup, John; Kastelic, Elizabeth; Burns, Barbara; Wells, Karen; March, John

    2012-01-01

    Objective: This study tested whether positive response to short-term treatment for adolescent major depressive disorder (MDD) would have the secondary benefit of preventing subsequent alcohol use disorders (AUD) or substance use disorders (SUD). Method: For 5 years, we followed 192 adolescents (56.2% female; 20.8% minority) who had participated in…

  9. [GABAB receptor as therapeutic target for drug addiction: from baclofen to positive allosteric modulators].

    PubMed

    Agabio, Roberta; Colombo, Giancarlo

    2015-01-01

    The present paper summarizes experimental and clinical data indicating the therapeutic potential of the GABAB receptor agonist, baclofen, in the treatment of alcohol use disorder (AUD) and substance use disorder (SUD). Multiple preclinical studies have demonstrated the ability of baclofen to suppress alcohol drinking (including binge- and relapse-like drinking), oral alcohol self-administration, and intravenous self-administration of cocaine, nicotine, amphetamine, methamphetamine, morphine, and heroin in rodents. Some randomized, controlled trials (RCTs) and case reports support the efficacy of baclofen in suppressing alcohol consumption, craving for alcohol, and alcohol withdrawal symptomatology in alcohol-dependent patients. Data from RCTs and open studies investigating baclofen efficacy on SUD are currently less conclusive. Interest in testing high doses of baclofen in AUD and SUD treatment has recently emerged. Preclinical research has extended the anti-addictive properties of baclofen to positive allosteric modulators of the GABAB receptor (GABAB PAMs). In light of their more favourable side effect profile (compared to baclofen), GABAB PAMs may represent a major step forward in a GABAB receptor-based pharmacotherapy of AUD and SUD. PMID:26093587

  10. Characteristics of Youth Presenting to a Canadian Youth Concurrent Disorders Program: Clinical Complexity, Trauma, Adaptive Functioning and Treatment Priorities

    PubMed Central

    Catchpole, Rosalind E. H.; Brownlie, E. B.

    2016-01-01

    Objective: This study describes clinical characteristics of youth presenting for service at a Canadian youth concurrent mental health and substance use disorders (SUD) program. Method: Participants were 100 adolescents and emerging adults (aged 14–25) who attended a Canadian concurrent mental health and substance use disorders outpatient program. SUDs were assigned using the Structured Clinical Interview for DSM-IV. Self-reported mental health symptoms, trauma exposure and adaptive functioning were also assessed. Results: Eighty-three percent of participants scored over the clinical cut-off on at least one mental health scale and 33% reported at least one suicide attempt. Sixty-six percent met criteria for a current SUD; 96% met lifetime criteria. Exposure to adverse events was nearly universal (94%). Almost half of female (46%) and almost a third of male (31%) participants endorsed symptoms consistent with posttraumatic stress disorder (PTSD). Youth reported impairment and need for support in multiple domains of functioning, including school, peer, family and mental health. Substance use was least likely to be identified as a treatment priority. Conclusions: High rates of adverse events and PTSD highlight the need for trauma-informed care when providing services to this vulnerable population. Functional impairment in domains related to developmental transitions and tasks underscores the need for a developmental lens and integrated treatment that goes beyond mental health and SUD symptoms and addresses developmentally relevant domains during this transitional age. PMID:27274746

  11. Characteristics of students participating in collegiate recovery programs: a national survey.

    PubMed

    Laudet, Alexandre B; Harris, Kitty; Kimball, Thomas; Winters, Ken C; Moberg, D Paul

    2015-04-01

    Relapse rates are high among individuals with substance use disorders (SUD), and for young people pursuing a college education, the high rates of substance use on campus can jeopardize recovery. Collegiate Recovery Programs (CRPs) are an innovative campus-based model of recovery support that is gaining popularity but remains under-investigated. This study reports on the first nationwide survey of CRP-enrolled students (N = 486 from 29 different CRPs). Using an online survey, we collected information on background, SUD and recovery history, and current functioning. Most students (43% females, mean age =26) had used multiple substances, had high levels of SUD severity, high rates of treatment and 12-step participation. Fully 40% smoke. Many reported criminal justice involvement and periods of homelessness. Notably, many reported being in recovery from, and currently engaging in multiple behavioral addictions-e.g., eating disorders, and sex and love addiction. Findings highlight the high rates of co-occurring addictions in this under-examined population and underline the need for treatment, recovery support programs and college health services to provide integrated support for mental health and behavioral addictions to SUD--affected young people. PMID:25481690

  12. Multiple Substance Use Disorders in Juvenile Detainees.

    ERIC Educational Resources Information Center

    McClelland, Gary M.; Elkington, Katherine S.; Teplin, Linda A.; Abram, Karen M.

    2004-01-01

    Objective: To estimate the 6-month prevalence of multiple substance use disorders (SUDs) among juvenile detainees by demographic subgroups (sex, race/ethnicity, age). Method: Participants were a randomly selected sample of 1,829 African American, non-Hispanic white, and Hispanic detainees (1,172 males, 657 females, aged 10 to 18). Patterns and…

  13. Etiology of Substance Use Disorder in Children and Adolescents. Emerging Findings from the Center for Education and Drug Abuse Research.

    ERIC Educational Resources Information Center

    Tarter, Ralph E., Ed.; Vanyukov, Michael M., Ed.

    The mission of the Center for Education and Drug Abuse Research (CEDAR) is to delineate the etiology of Substance Use Disorder (SUD). Biobehavioral processes and environmental factors are comprehensively assessed prior to first exposure to alcohol and drugs, and subsequently during the period of substance use behavior leading ultimately to a…

  14. Reactive Effects of Self-Monitoring Anxiety.

    ERIC Educational Resources Information Center

    Hiebert, Bryan; Fox, E.E.

    1981-01-01

    Investigated the use of Wolpe's notion of subjective units of disturbance (SUDS) to monitor anxiety. Two studies were conducted to test for reactive effects of the self-monitoring. Results indicated that self-monitoring can have a positive effect on perceived anxiety level. (Author/RC)

  15. Normative Feedback and Adolescent Readiness to Change: A Small Randomized Trial

    ERIC Educational Resources Information Center

    Smith, Douglas C.; Davis, Jordan P.; Ureche, Daniel J.; Tabb, Karen M.

    2015-01-01

    For adolescents with substance use problems, it is unknown whether the provision of normative feedback is a necessary active ingredient in motivational interviewing (MI). This study investigated the impact of normative feedback on adolescents' readiness to change and perceptions of MI quality. Adolescents referred for substance use disorder (SUD)…

  16. for Residents: A Literature Review and Case Study

    ERIC Educational Resources Information Center

    Wamsley, Maria A.; Julian, Katherine A.; O'Sullivan, Patricia; Satterfield, Jason M.; Satre, Derek D.; McCance-Katz, Elinore; Batki, Steven L.

    2013-01-01

    Objectives: Resident physicians report insufficient experience caring for patients with substance use disorders (SUDs). Resident training in Screening, Brief Intervention, and Referral to Treatment (SBIRT) has been recommended. We describe the development of a standardized patient (SP) assessment to measure SBIRT skills, resident perceptions of…

  17. Diachronic Substance Use Assessment and the Emergence of Substance Use Disorders.

    ERIC Educational Resources Information Center

    Clark, Duncan B.; Pollock, Nancy K.; Mezzich, Ada; Cornelius, Jack; Martin, Christopher

    2001-01-01

    Comprehensive developmental assessment of substance involvement is a prerequisite for conducting rigorous research designed to advance understanding of the progression of substance use behavior to a substance use disorder (SUD). At the Center for Education and Drug Abuse Research, a protocol has been developed for detailed temporal assessment of…

  18. The Dysregulation Inventory: A New Scale To Assess the Risk for Substance Use Disorder.

    ERIC Educational Resources Information Center

    Mezzich, Ada C.; Tarter, Ralph E.; Giancola, Peter R.; Kirisci, Levent

    2001-01-01

    Evidence indicates that psychological dysregulation is an integral component of the liability for substance use disorder (SUD). This report discusses the rationale underlying the Dysregulation Inventory (DI), methods employed in item selection and scale construction, and preliminary results regarding psychometric properties. Results indicate that…

  19. ADHD, Substance Use Disorders, and Psychostimulant Treatment: Current Literature and Treatment Guidelines

    ERIC Educational Resources Information Center

    Kollins, Scott H.

    2008-01-01

    Objective: This review explores the relationship between ADHD and substance use disorder (SUD), factors that determine the abuse potential of psychostimulants, and strategies for identifying and treating at-risk ADHD patients. Method: This study uses a Medline review of literature. Results: Psychostimulants, such as methylphenidate and…

  20. Linking "Big" Personality Traits to Anxiety, Depressive, and Substance Use Disorders: A Meta-Analysis

    ERIC Educational Resources Information Center

    Kotov, Roman; Gamez, Wakiza; Schmidt, Frank; Watson, David

    2010-01-01

    We performed a quantitative review of associations between the higher order personality traits in the Big Three and Big Five models (i.e., neuroticism, extraversion, disinhibition, conscientiousness, agreeableness, and openness) and specific depressive, anxiety, and substance use disorders (SUD) in adults. This approach resulted in 66…