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Sample records for abuse emergency exists

  1. Emerging drugs of abuse.

    PubMed

    Nelson, Michael E; Bryant, Sean M; Aks, Steven E

    2014-02-01

    Many new emerging drugs of abuse are marketed as legal highs despite being labeled "not for human consumption" to avoid regulation. The availability of these substances over the Internet and in "head shops" has lead to a multitude of emergency department visits with severe complications including deaths worldwide. Despite recent media attention, many of the newer drugs of abuse are still largely unknown by health care providers. Slight alterations of the basic chemical structure of substances create an entirely new drug no longer regulated by current laws and an ever-changing landscape of clinical effects. The purity of each substance with exact pharmacokinetic and toxicity profiles is largely unknown. Many of these substances can be grouped by the class of drug and includes synthetic cannabinoids, synthetic cathinones, phenethylamines, as well as piperazine derivatives. Resultant effects generally include psychoactive and sympathomimetic-like symptoms. Additionally, prescription medications, performance enhancing medications, and herbal supplements are also becoming more commonly abused. Most new drugs of abuse have no specific antidote and management largely involves symptom based goal directed supportive care with benzodiazepines as a useful adjunct. This paper will focus on the history, epidemiology, clinical effects, laboratory analysis, and management strategy for many of these emerging drugs of abuse.

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

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.5 How is an emergency determined to exist? (a) In making a decision as to whether a mental health or substance abuse emergency exists for... mental health and/or substance abuse services are overwhelmed or unable to meet the existing...

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

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.5 How is an emergency determined to exist? (a) In making a decision as to whether a mental health or substance abuse emergency exists for... mental health and/or substance abuse services are overwhelmed or unable to meet the existing...

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

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.5 How is an emergency determined to exist? (a) In making a decision as to whether a mental health or substance abuse emergency exists for... mental health and/or substance abuse services are overwhelmed or unable to meet the existing...

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

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.5 How is an emergency determined to exist? (a) In making a decision as to whether a mental health or substance abuse emergency exists for... mental health and/or substance abuse services are overwhelmed or unable to meet the existing...

  6. 42 CFR 51d.5 - How is an emergency determined to exist?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... HEALTH AND SUBSTANCE ABUSE EMERGENCY RESPONSE PROCEDURES § 51d.5 How is an emergency determined to exist? (a) In making a decision as to whether a mental health or substance abuse emergency exists for... mental health and/or substance abuse services are overwhelmed or unable to meet the existing...

  7. Emergency department evaluation of child abuse.

    PubMed

    Leetch, Aaron N; Woolridge, Dale

    2013-08-01

    Child abuse presents commonly to emergency departments. Emergency providers are confronted with medical, social, and legal dilemmas with each case. A solid understanding of the definitions and risk factors of victims and perpetrators aids in identifying abuse cases. Forensic examination should be performed only after the child is medically stable. Emergency providers are mandatory reporters of a reasonable suspicion of abuse. The role of the emergency provider is to identify abuse, facilitate a thorough investigation, treat medical needs, protect the patient, provide an unbiased medical consultation to law enforcement, and to provide an ethical testimony if called to court.

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

    PubMed

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

    2009-07-01

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

  9. Child sexual abuse: the emergency department response.

    PubMed

    Ricci, L R

    1986-06-01

    Each child who presents with a suspicion of sexual abuse must have immediate access to a complete medical evaluation performed by a competent and knowledgeable examiner. This evaluation should include, at a minimum, a history, a complete physical examination with a detailed genital examination, treatment of identified medical problems, and collection of evidence. It is not appropriate to perform a cursory examination simply because there was a time delay between the abuse and the examination or because the history is suspect. Each sexual abuse workup must be medically and forensically complete. In addition, each child presenting with suggestive complaints should have sexual abuse strongly considered in the differential diagnosis. A report to the appropriate social and legal agencies is indicated even if the suspicion cannot be confirmed. If sexually abused children are to be examined in hospital emergency departments, a protocol should be developed to ensure rapid, thorough, uniform, and caring evaluation. With planning, preparation, and education, most current inadequacies in the emergency medical assessment of sexually abused children can be resolved so that child victims receive sensitive and comprehensive medical care.

  10. Emergency biochemistry services--are they abused?

    PubMed

    Smith, A D; Shenkin, A; Dryburgh, F J; Morgan, H G

    1982-09-01

    An out-of-hours emergency biochemistry service, which allows access by all medical practitioners of varying experience within a hospital, can lead to overuse or even abuse of limited and costly facilities. When the workload increases, problems of staffing a voluntary (but paid) working rota may emerge. An industrial dispute involving medical laboratory scientific officers (MLSOs) caused the role of the emergency service to be examined and alternative regulating mechanisms to be tested. Experience at Glasgow Royal Infirmary between 1974 and 1981 has been reviewed. From 1977 to 1979, when clinicians (usually junior) arranged analyses directly with the MLSOs, test numbers increased by about 26% per annum. This was not associated with any concomitant increase in the range of analyses offered. During a five-week period in 1980, consultant clinicians had to contact a consultant clinical biochemist to arrange all emergency analyses, and test numbers were reduced to 13% of the previous levels. Subsequently, all requests for emergency analyses were made by clinicians to laboratory medical staff, and test numbers fell to approximately 60% of 1979 levels. This requesting system is now firmly established. Continued vigilance is required to maintain the reduced level of requesting, but too great a limitation on emergency requests may cause less efficient patient management. Senior clinical staff should be encouraged to take greater responsibility for the use of emergency laboratory services.

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  12. Methamphetamine abuse and emergency department utilization.

    PubMed Central

    Richards, J R; Bretz, S W; Johnson, E B; Turnipseed, S D; Brofeldt, B T; Derlet, R W

    1999-01-01

    Methamphetamine (MAP) abuse continues to increase worldwide, based on morbidity, mortality, drug treatment, and epidemiologic studies and surveys. MAP abuse has become a significant health care, environmental, and law enforcement problem. Acute intoxication often results in agitation, violence, and death. Chronic use may lead to infection, heart failure, malnutrition, and permanent psychiatric illness. MAP users frequently use the emergency department (ED) for their medical care. Over a 6-month period we studied the demographics, type, and frequency of medical and traumatic problems in 461 MAP patients presenting to our ED, which serves an area noted for high levels of MAP production and consumption. Comparison was made to the general ED population to assess use patterns. MAP patients were most commonly Caucasian males who lacked health insurance. Compared to other ED patients during this time, MAP patients used ambulance transport more and were more likely to be admitted to the hospital. There was a significant association between trauma and MAP use in this patient population. Our data suggest MAP users utilize prehospital and hospital resources at levels higher than the average ED population. Based on current trends, we can expect more ED visits by MAP users in the future. PMID:10344172

  13. Analytical toxicology of emerging drugs of abuse--an update.

    PubMed

    Meyer, Markus R; Peters, Frank T

    2012-12-01

    The steady increase of new drugs of abuse on the illicit drug market is a great challenge for analytical toxicologists. Because most of these new drugs or drug classes are not included in established analytical methods targeting classic drugs of abuse, analytical procedures must be adapted or new procedures must be developed to cover such new compounds. This review summarizes procedures for analysis of these drugs of abuse published from January 2009 to January 2012 covering the following classes of emerging drugs of abuse as follows: β-keto-amphetamines, pyrrolidinophenones, tryptamines, and synthetic cannabinoids.

  14. [Screening for child abuse at emergency rooms is useful].

    PubMed

    Affourtit, M J; Korfage, I J; Louwers, E C F M

    2016-01-01

    In the Netherlands screening of child abuse is obligatory at emergency departments. In spite of the modest detection rate, in our opinion there is sufficient evidence and reason to continue screening.

  15. Co-Existent Fruit Machine Addiction and Solvent Abuse in Adolescence: A Cause for Concern?

    ERIC Educational Resources Information Center

    Griffiths, Mark

    1994-01-01

    Data from study of gambling cross-addictions highlighted 16 agencies reporting that fruit machine gambling was specifically associated with some form of psychoactive substance abuse. Largest subgroup was cross-addictions involving solvent abuse and fruit machine gambling. Concluded that co-existence of fruit machine addiction and solvent abuse…

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

    PubMed

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

    2017-01-01

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

  17. Emerging drugs of abuse: current perspectives on synthetic cannabinoids

    PubMed Central

    Debruyne, Danièle; Le Boisselier, Reynald

    2015-01-01

    New psychoactive drugs that have appeared over the last decade are typically dominated by cathinones and synthetic cannabinoids (SCs). SCs have been emerging as recreational drugs because they mimic the euphoria effect of cannabis while still being legal. Sprayed on natural herb mixtures, SCs have been primarily sold as “herbal smoking blends” or “herbal incense” under brand names like “Spice” or “K2”. Currently, SCs pure compounds are available from websites for the combination with herbal materials or for the use in e-cigarettes. For the past 5 years, an ever increasing number of compounds, representative of different chemical classes, have been promoted and now represent a large assortment of new popular drugs of abuse, which are difficult to properly identify. Their legal status varies by country with many government institutions currently pushing for their control. The in vitro binding to CB1/CB2 receptors is usually well-known and considerable differences have been found in the CB1 versus CB2 selectivity and potency within the different SCs, with several structure-activity relations being evident. Desired effects by CB1 agonist users are relaxation/recreative, however, cardiovascular, gastrointestinal, or psychiatric/neurological side effects are commonly reported. At present there is no specific antidote existing if an overdose of designer drugs was to occur, and no curative treatment has been approved by health authorities. Management of acute toxic effects is mainly symptomatic and extrapolated from experience with cannabis. PMID:26543389

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2014-11-07

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

  2. [Substance abuse and the emergency department: a current problem].

    PubMed

    Amigó Tadín, Montserrat

    2005-09-01

    Alcohol, tobacco, heroin, cocaine and benzodiazepines, in that order, are the most common substance addictions in Spain. The medical problems caused both by chronic medical pathologies associated with their consumption and by overdoses and withdrawal syndromes, are frequently seen in emergency departments. Knowledge of substance abuse and addiction--how it is caused, the behaviour and pathology it produces--are essential to enable nurses to determine the attitudes to adopt the skills necessary to manage patients with problems of substance.

  3. Utility of a child abuse screening guideline in an urban pediatric emergency department.

    PubMed

    Higginbotham, Nicole; Lawson, Karla A; Gettig, Kelly; Roth, Jodie; Hopper, Emily; Higginbotham, Eric; George, Timothy M; Maxson, Todd; Edwards, George; Garcia, Nilda M

    2014-03-01

    Previous studies have found racial and socioeconomic status bias in the way clinicians screen for and detect child abuse in patients presenting to the emergency department. We hypothesized that implementing a guideline for screening would attenuate this bias. An algorithm for child abuse screening in patients younger than 1 year presenting with fractures was developed for a pediatric trauma center emergency department. Data were collected 1.5 years before and after implementation of the algorithm to investigate implementation success. Data were compared before and after the implementation of the algorithm using χ and univariate logistic regression analysis. The characteristics of patients with fractures were similar before and after the algorithm implementation. Implementation of the algorithm was related to a significant increase in algorithm required screenings: skeletal survey (p < 0.001), urinalysis (p < 0.001), and transaminase levels (p < 0.001). The racial composition of those screened did not change after the implementation of the protocol. Children with government-subsidized or no insurance were more likely to be screened for child abuse via skeletal survey before the algorithm implementation compared with those with private insurance (odds ratio, 2.7; 95% confidence interval, 1.2-6.0; p = 0.017). This relationship did not exist after the algorithm implementation (odds ratio, 1.2; 95% confidence interval, 0.56-2.46; p = 0.66). Final determination of child abuse was related to insurance status both before and after the algorithm implementation. A child abuse screening algorithm was successfully implemented in an urban trauma center. After implementation, screening was no longer associated with socioeconomic status of the patient's family, although final determination of child abuse still was. Additional research is needed to determine utility of unbiased screening on patient outcomes. Therapeutic study, level IV.

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

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

    PubMed

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

    2016-05-01

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

  7. Interprofessional program to provide emergency sheltering to abused elders.

    PubMed

    Heck, Lauri; Gillespie, Gordon L

    2013-01-01

    Abuse of senior citizens should be paradoxical in a civilized society; however, the U.S. Government Accountability Office reports that 14.1% of noninstitutionalized older adults experienced some type of abuse within the previous year. This is suspected to be an underestimation of the number of abuses reported. In a society where the older population is predicted to increase significantly, it is likely that the number of cases for abused elders will increase proportionately. Through the success of advocacy groups to raise awareness of child and domestic partner abuse, funding has been channeled to shelter these abuse victims. The same cannot be said for elders who are abused. Providing shelter in a safe, secure, medically appropriate environment, free from violence, for an older adult is essential. This article describes a community's collaborative health planning process to respond to elder abuse and develop a program to shelter elders experiencing abuse or suspected abuse.

  8. Emerging drugs of abuse: clinical and legal considerations.

    PubMed

    Aoun, Elie G; Christopher, Paul P; Ingraham, James W

    2014-06-02

    Over the past several decades, nontraditional drugs of abuse, including bath salts, synthetic cannabinoids, and salvia, have increased in popularity and use. Despite this fact, they remain unfamiliar to many healthcare providers. Commonly marketed as "legal highs," these substances are being used for their desired neuropsychiatric effects, taking advantage of their accessibility, low cost, variable legality, and limited detection on traditional urine drug screens. Similar to traditional drugs of abuse, these substances have varying degrees of toxicity and may lead to potentially adverse effects, ranging from benign to life threatening. This paper offers a review of three of the more widely-used emerging drugs (or classes of drugs): bath salts, synthetic cannabinoids, and salvia. For each we review its history and development, the neurochemical basis for its clinical effects, the nature and route of ingestion, the range of desired effects, potential toxicities, diagnostic and therapeutic approaches, as well as social and legal considerations. [Full text available at http://rimed.org/rimedicaljournal-2014-06.asp, free with no login].

  9. Preventing Growth Hormone Abuse: An Emerging Health Concern.

    ERIC Educational Resources Information Center

    White, George L.; And Others

    1989-01-01

    Facts about growth hormone abuse should be incorporated into substance abuse components of health education curriculums. Sources, uses, and dangers associated with human growth hormones are discussed. A sample lesson plan is included. (IAH)

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

    PubMed Central

    Kuhn, Dr. Cynthia

    2015-01-01

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

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

    PubMed

    Kuhn, Cynthia

    2015-09-01

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

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

    PubMed Central

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

    2014-01-01

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

  13. A profile of substance abusers using the emergency services in a tertiary care hospital in Sikkim.

    PubMed

    Bhalla, Akhil; Dutta, Sanjiba; Chakrabarti, Amit

    2006-10-01

    Sikkim, a state in Northeast India with a population of more than 500,000 and inhabited by indigenous population of Lepchas, Bhutias and Nepalis, lies in the foothills of the Himalayas sharing borders with Tibet, Nepal and Bhutan. Northeast India is a major source of injection drug users (IDUs) and associated HIV/AIDS. Alcohol use is traditionally prevalent in Sikkim and recently, IDU behaviour has also been reported, although systematic information on epidemiology and treatment availability of substance abuse in Sikkim is not available. To study the sociodemographic and drug use profile of substance abusers using the emergency services in a tertiary care hospital. A retrospective chart review was used. Patients with history of current drug use seeking emergency services for any medical or surgical consequence incident to substance abuse from July 2000 to June 2005 (60 months) were included in the study. Data were generated from emergency case register, hospital records and case sheets. SPSS 10.0 was used for data analysis. Out of 54 patients seeking emergency services with substance abuse (1.16% of all psychiatric consultations), alcohol abusers were 77.8% and other opioid abusers 14.8%. Prevalence of IDU was 16.66%. Common opioids abused were dextrpropoxyphene and pentazocine, both analgesics. A significant number of patients (46.3%) had a history of >20 days/month frequency of abuse. Median of duration of abuse with all drugs was 12 years, while that with IDU population was 3 years. Alcohol withdrawal was the commonest cause (57.4%) of reporting to the emergency. Psychiatric comorbidity was found among 7.4%. Commonest medications used were chlordiazepoxide and clonidine, for withdrawal and naltrexone, for substitution. No standardized treatment protocol for substitution treatment was available. This is an initial attempt to study the sociodemographic and drug use profile of substance abusers in Sikkim. Demographic and socioeconomic characteristics of substance

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  16. Evaluation of the Cooperative Emergency Substance Abuse Prevention Training Program, 1991-1992. OER Report.

    ERIC Educational Resources Information Center

    Weich, Leah; Philip, Radhika

    The 1991-1992 Cooperative Emergency Substance Abuse Prevention Program was the first year of a two-year program in Community School District 3 in New York City. The overall objectives of the program were to provide staff training in the knowledge and skills necessary to carry out substance abuse prevention education, to make available to students…

  17. Emergency Department Trends from the Drug Abuse Warning Network, Preliminary Estimates January-June 2002. Drug Abuse Warning Network Series.

    ERIC Educational Resources Information Center

    Substance Abuse and Mental Health Services Administration (DHHS/PHS), Rockville, MD. Office of Applied Studies.

    This publication presents estimates of drug-related emergency department (ED) episodes from the Drug Abuse Warning Network (DAWN) from 1994 through the first half of 2001. DAWN is an ongoing, national data system that collects information on drug-related visits to EDs from a national probability sample of hospitals. This publication marks a major…

  18. Emergency Department Visits Involving Misuse and Abuse of the Antipsychotic Quetiapine: Results from the Drug Abuse Warning Network (DAWN)

    PubMed Central

    Mattson, Margaret E; Albright, Victoria A; Yoon, Joanna; Council, Carol L

    2015-01-01

    Case reports in medical literature suggest that the atypical antipsychotic quetiapine, a medication not previously considered to have abuse potential, is now being subject to misuse and abuse (MUA; ie, taken when not prescribed for them or used in a way other than instructed by their health professional). Here we present systematic, nationally representative data from the 2005 to 2011 Drug Abuse Warning Network (DAWN) for prevalence of emergency department (ED) visits among the U.S. general population involving quetiapine and related to MUA, suicide attempts, and adverse reactions. Nationally, quetiapine-related ED visits increased 90% between 2005 and 2011, from 35,581 ED visits to 67,497. DAWN data indicate that when used without medical supervision for recreational/self-medication purposes, quetiapine poses health risks for its users, especially among polydrug users and women. These findings suggest that the medical and public health communities should increase vigilance concerning this drug and its potential for MUA. PMID:26056465

  19. Aggression and recent substance abuse: absence of association in psychiatric emergency room patients.

    PubMed

    Dhossche, D M

    1999-01-01

    Substance abuse has been linked to aggression in community and psychiatric samples. A retrospective chart review in 311 consecutive psychiatric emergency room patients was conducted to assess the association of substance abuse and aggression in an acute psychiatric setting. Various indices of substance abuse, including positive urine toxicology for alcohol, cocaine, and/or cannabis, were not associated with aggressive behavior. Patients with positive toxicology for cocaine were less frequently aggressive than cocaine-negative patients. Among aggressive patients, the presence of psychotic symptoms was the most important factor associated with admission. These findings suggest that aggression is not a common acute manifestation of recent substance abuse in psychiatric emergency room patients. Selection factors in this population and the specifics of an acute psychiatric setting may obscure the association, if any. Acute psychosis seems to have a more important role in this setting. Future studies should focus on the prevention and early treatment of aggression in psychotic emergency room patients.

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

    PubMed

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

    2015-07-01

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

  1. [Drugs of abuse acute intoxication in paediatric emergencies].

    PubMed

    García-Algar, O; Papaseit, E; Velasco, M; López, N; Martínez, L; Luaces, C; Vall, O

    2011-06-01

    Documented cases show that acute drugs of abuse intoxication in children usually is the Fritz clinical evidence of a chronic exposure. Published clinical reports of drugs of abuse acute poisonings in children are reviewed, above all those with an underlying chronic exposure to the same or another substance. Biological matrices and exposure biomarkers useful in toxicology analysis in Paediatrics are reviewed. In toxicology, biomarkers refer to original parental substances and its metabolites and matrices refer to body substances where biomarkers are detected. In these matrices acute and chronic (previous days, weeks or months) exposures can be detected. Hair analysis has become the gold standard of drugs of abuse chronic exposure. Recommendation includes to confirm previous chronic exposure to drugs of abuse by hair analysis of children and their parents. This protocol must be applied in all cases with suspicion of acute drugs of abuse intoxication, parental consumption and/or children living in a risk environment. Copyright © 2010 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

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

    PubMed

    Ansari, Sereena; Boyle, Adrian

    2017-02-01

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

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

    PubMed

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

    2010-01-01

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

  4. New and Emerging Occupations in Existence in Kentucky.

    ERIC Educational Resources Information Center

    Taylor, Angela

    This report provides information from a project that surveyed new and emerging, technical, and nontraditional occupations in Kentucky. The information is intended for use by those developing and conducting programs to serve displaced homemakers. First, a definition of new and emerging occupations in Kentucky is provided. Next, survey information…

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

    PubMed

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

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

  6. Young Victims Telling their Stories of Sexual Abuse in the Emergency Department.

    PubMed

    Hassan, Mona; Gary, Faye A; Hotz, Renee; Killion, Cheryl; Vicken, Totten

    2015-01-01

    Among young children, child sexual abuse is a common type of maltreatment. Child sexual abuse (CSA) is an important national public health problem that has a devastating impact on the emotional and psychological makeup of the child, family, and society. The purpose of this analysis is to explore the young victim's own stories of disclosure of child sexual abuse and is an exploratory case study using reported assault histories of victims of CSA between the ages of 6 and 14, taken in the immediate wake of the assault. The data were extracted from the hospital records of child victims treated in an emergency department between 2006 and 2010. This qualitative research, using thematic analysis, explored the stories of sexual abuse for children as told by them. Two themes emerged regarding the experience of sex abuse and the immediate outcomes on the children: (1) Abuse Circumstances, which included the child's level of awareness of child sexual abuse, predisposing factors, and the perpetrator's preparation (physical, behavioral, and verbal tactics), and (2) Physical/Psychological Suffering associated with disclosure. These have important implications for all service and health care providers.

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

    PubMed Central

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

    2015-01-01

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

  8. 78 FR 40479 - Declaration That Circumstances Exist Justifying Authorization of Emergency Use of All Oral...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-05

    ... Emergency Use of All Oral Formulations of Doxycycline Accompanied by Emergency Use Information AGENCY... circumstances exist justifying the authorization of emergency use of all oral formulations of doxycycline... emergency use of all oral formulations of doxycycline accompanied by emergency use information subject to...

  9. Assessment of nerve agent exposure: existing and emerging methods.

    PubMed

    Langenberg, Jan P; van der Schans, Marcel J; Noort, Daan

    2009-07-01

    The perceived threat of the use of nerve agents by terrorists against civilian targets implies the need for methods for point-of-care (POC) diagnosis. This review presents an overview of methods that are currently available for the assessment of exposure to nerve agents. Since these methods are mostly MS based, they require complex and expensive equipment and well-trained personnel and, consequently, they are not very suitable for rapid POC diagnosis. However, new technologies are emerging that allow, among others, immunochemical detection of acetylcholinesterase inhibited by nerve agents. Also, lab-on-a-chip methodologies are under development. It is anticipated that MS methods will be suitable for POC diagnosis within a few years, due to the miniaturization of equipment and the emergence of methodologies that enable mass spectrometric analysis with little sample pretreatment and that are potentially fieldable, such as direct analysis in real time and desorption electrospray ionization MS.

  10. Child abuse inventory at emergency rooms: CHAIN-ER rationale and design.

    PubMed

    Sittig, Judith S; Uiterwaal, Cuno S P M; Moons, Karel G M; Nieuwenhuis, Edward E S; van de Putte, Elise M

    2011-10-18

    Child abuse and neglect is an important international health problem with unacceptable levels of morbidity and mortality. Although maltreatment as a cause of injury is estimated to be only 1% or less of the injured children attending the emergency room, the consequences of both missed child abuse cases and wrong suspicions are substantial. Therefore, the accuracy of ongoing detection at emergency rooms by health care professionals is highly important. Internationally, several diagnostic instruments or strategies for child abuse detection are used at emergency rooms, but their diagnostic value is still unknown. The aim of the study 'Child Abuse Inventory at Emergency Rooms' (CHAIN-ER) is to assess if active structured inquiry by emergency room staff can accurately detect physical maltreatment in children presenting at emergency rooms with physical injury. CHAIN-ER is a multi-centre, cross-sectional study with 6 months diagnostic follow-up. Five thousand children aged 0-7 presenting with injury at an emergency room will be included. The index test - the SPUTOVAMO-R questionnaire- is to be tested for its diagnostic value against the decision of an expert panel. All SPUTOVAMO-R positives and a 15% random sample of the SPUTOVAMO-R negatives will undergo the same systematic diagnostic work up, which consists of an adequate history being taken by a pediatrician, inquiry with other health care providers by structured questionnaires in order to obtain child abuse predictors, and by additional follow-up information. Eventually, an expert panel (reference test) determines the true presence or absence of child abuse. CHAIN-ER will determine both positive and negative predictive value of a child abuse detection instrument used in the emergency room. We mention a benefit of the use of an expert panel and of the use of complete data. Conducting a diagnostic accuracy study on a child abuse detection instrument is also accompanied by scientific hurdles, such as the lack of an

  11. Volume overview: Working with assumptions. Existing and emerging approaches for improved program design, monitoring and evaluation.

    PubMed

    Nkwake, Apollo M; Morrow, Nathan

    2016-12-01

    This volume attempts to systematically capture the state of practice, highlight commonalities linking existing and emerging approaches to assumption-making and evaluation. It tries to organize existing and emerging knowledge, tools and terminology into an emergent but useful typology for working with assumptions and complexity in program designs, monitoring and evaluation.

  12. Food colors: Existing and emerging food safety concerns.

    PubMed

    Oplatowska-Stachowiak, Michalina; Elliott, Christopher T

    2017-02-11

    Food colors are added to different types of commodities to increase their visual attractiveness or to compensate for natural color variations. The use of these additives is strictly regulated in the European Union, the United States, and many other countries worldwide. There is a growing concern about the safety of some commonly used legal food colorants and there is a trend to replace the synthetic forms with natural products. Additionally, a number of dyes with known or suspected genotoxic or carcinogenic properties have been shown to be added illegally to foods. Robust monitoring programs based on reliable detection methods are required to assure the food is free from harmful colors. The aim of this review is to present an up to date status of the various concerns arising from use of color additives in food. The most important food safety concerns in the field of food colors are lack of uniform regulation concerning legal food colors worldwide, possible link of artificial colors to hyperactive behavior, replacement of synthetic colors with natural ones, and the presence of harmful illegal dyes-both known but also new, emerging ones in food. The legal status of food color additives in the EU, United States, and worldwide is summarized. The reported negative health effects of both legal and illegal colors are presented. The European Rapid Alert System for Food and Feed notifications and US import alerts concerning food colors are analyzed and trends in fraudulent use of color additives identified. The detection methods for synthetic colors are also reviewed.

  13. Abuse

    MedlinePlus

    ... member, a trusted teacher, a doctor, or a school or religious youth counselor. Many teachers and counselors have training in how to recognize and report abuse. Telephone and online directories list local child abuse and family violence hotline numbers that you can call for help. ...

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

    PubMed

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

    2014-01-01

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

  15. Existing and Emerging Technologies for Point-of-Care Testing

    PubMed Central

    St John, Andrew; Price, Christopher P

    2014-01-01

    The volume of point-of-care testing (PoCT) has steadily increased over the 40 or so years since its widespread introduction. That growth is likely to continue, driven by changes in healthcare delivery which are aimed at delivering less costly care closer to the patient’s home. In the developing world there is the challenge of more effective care for infectious diseases and PoCT may play a much greater role here in the future. PoCT technologies can be split into two categories, but in both, testing is generally performed by technologies first devised more than two decades ago. These technologies have undoubtedly been refined and improved to deliver easier-to-use devices with incremental improvements in analytical performance. Of the two major categories the first is small handheld devices, providing qualitative or quantitative determination of an increasing range of analytes. The dominant technologies here are glucose biosensor strips and lateral flow strips using immobilised antibodies to determine a range of parameters including cardiac markers and infectious pathogens. The second category of devices are larger, often bench-top devices which are essentially laboratory instruments which have been reduced in both size and complexity. These include critical care analysers and, more recently, small haematology and immunology analysers. New emerging devices include those that are utilising molecular techniques such as PCR to provide infectious disease testing in a sufficiently small device to be used at the point of care. This area is likely to grow with many devices being developed and likely to reach the commercial market in the next few years. PMID:25336761

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

    ERIC Educational Resources Information Center

    American Coll. of Emergency Physicians, Dallas, TX.

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

  17. Existing and Emerging Best Practices for Ocean Observation

    NASA Astrophysics Data System (ADS)

    Pearlman, J.; Buttigieg, P. L.; Simpson, P.; Arko, R. A.; Garello, R.; Pissierssens, P.

    2016-12-01

    Best practices emerge from experience, usually at the local level - in universities, private and public research institutions and other organizations. Large programs such as the European FixO3 for fixed mooring observations or IOOS in the USA for data management may document best practices and urge propagation of techniques. Sometimes communities come together under projects such as the Ocean Data Interoperability Project (ODIP), AtlantOS or international organizations such as the UNESCO IODE or GOOS to create a forum for discussing, recommending and documenting observation and data practices. On the whole the process is fragmented and results are difficult to sustain. From this perspective, several projects and organizations such as ODIP, IODE and AtlantOS are working in collaboration with Ocean Networks Canada, IOOS and selected European projects to address means of improved access to documented best practices and a way to provide the observing community with a compendium that can be sustained for use in training new oceanographers and data scientists and also providing references for experts that are working across disciplines. Where practical, a solution should reach across science communities and networks to support multi-disciplinary applications The initial challenge is to create a base for efficient discovery of documented best practices and getting sufficient documentation in the first place. Working across disciplines, this becomes both a question of appropriate vocabularies and some means for a scientist to understand the background, provenance (including any certification) and value of a best practice. New approaches to semantics and Linked Data, and increasing use of persistent identifiers such as Open Researcher and Contributor IDs (ORCIDs) and International Geo Sample Numbers (IGSNs), will facilitate distributed search across repositories. The approach must be scalable and easy for users to engage so provision of best practice documentation has a low

  18. Abuse experiences, substance use, and reproductive health in women seeking care at an emergency department.

    PubMed

    Sutherland, Melissa A; Fantasia, Heidi Collins; McClain, Natalie

    2013-07-01

    Abuse experiences can have negative health consequences for women. Many women present to the emergency department for episodic, nonemergent care and may have unique needs as survivors of abuse. The purpose of this study was to describe child sexual abuse experiences, intimate partner violence, substance use, and reproductive health outcomes in a sample of adult women who were seeking care from a rural emergency department to better understand the health care needs of this unique population. One hundred forty-five adult women (18-45 years old) were recruited at an emergency department in the southeastern United States. Questionnaires were used to assess for demographic characteristics, history of child sexual abuse (CSA), intimate partner violence, reproductive health, and substance use. In the sample, 42.8% of women (n = 62) reported a positive history of CSA and 34.7% of women (n = 49) experienced intimate partner physical violence during the past year. More than 46% of the women (n = 65) had harmful drinking patterns in the past year and more than 50% reported some type of substance use in the past 3 months. Women who experienced CSA had a significantly greater number of lifetime sexual partners, were more likely to report pain with sexual intercourse, and were more likely to report a medical history of an abnormal Papanicolaou smear. The women in this sample had high rates of abuse, harmful drinking patterns, and substance use and were at risk for sexually transmitted infections. Through screening for lifetime violence, including sexual violence, emergency nurses can be an important liaison between women who have experienced CSA and appropriate referrals within the health care system. Copyright © 2013 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2015-03-01

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

  3. Caffeinated Alcoholic Beverages – An Emerging Trend in Alcohol Abuse

    PubMed Central

    Franklin, Kelle M; Hauser, Sheketha R; Bell, Richard L.; Engleman, Eric A

    2014-01-01

    Alcohol use disorders are pervasive in society and their impact affects quality of life, morbidity and mortality, as well as individual productivity. Alcohol has detrimental effects on an individual’s physiology and nervous system, and is associated with disorders of many organ and endocrine systems impacting an individual’s health, behavior, and ability to interact with others. Youth are particularly affected. Unfortunately, adolescent usage also increases the probability for a progression to dependence. Several areas of research indicate that the deleterious effects of alcohol abuse may be exacerbated by mixing caffeine with alcohol. Some behavioral evidence suggests that caffeine increases alcohol drinking and binge drinking episodes, which in turn can foster the development of alcohol dependence. As a relatively new public health concern, the epidemiological focus has been to establish a need for investigating the effects of caffeinated alcohol. While the trend of co-consuming these substances is growing, knowledge of the central mechanisms associated with caffeinated ethanol has been lacking. Research suggests that caffeine and ethanol can have additive or synergistic pharmacological actions and neuroadaptations, with the adenosine and dopamine systems in particular implicated. However, the limited literature on the central effects of caffeinated ethanol provides an impetus to increase our knowledge of the neuroadaptive effects of this combination and their impact on cognition and behavior. Research from our laboratories indicates that an established rodent animal model of alcoholism can be extended to investigate the acute and chronic effects of caffeinated ethanol. PMID:25419478

  4. Development of the pretreatment readiness scale for substance abusers: modification of an existing motivation assessment.

    PubMed

    Rapp, Richard C; Xu, J; Carr, Carey A; Lane, D Tim; Redko, Cristina; Carlson, Robert G

    2008-01-01

    The Texas Christian University-Treatment Motivation Assessment (TCU-TMA) was originally developed to assess motivation among in-treatment opiod users. Numerous studies of in-treatment substance abusers in a variety of settings have confirmed the three factors present in the scale, including Problem Recognition, Desire For Help, and Treatment Readiness. The goal of the present study was to examine the factor structure of the TCU-TMA in a sample of 367 pretreatment substance abusers assessed at a centralized intake unit who had not yet entered treatment. Exploratory and confirmatory factor analyses led to the development of the Pretreatment Readiness Scale (PRS) that, like the TCU-TMA, contained Problem Recognition and Treatment Readiness factors. Desire for Change replaced Desire for Help in the new scale and Treatment Reluctance indicated mixed feelings about entering treatment. The implications of these findings on developing interventions for the pretreatment group will be discussed.

  5. Hospital Based Emergency Department Visits Attributed to Child Physical Abuse in United States: Predictors of In-Hospital Mortality

    PubMed Central

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

    2014-01-01

    Objectives To describe nationally representative outcomes of physical abuse injuries in children necessitating Emergency Department (ED) visits in United States. The impact of various injuries on mortality is examined. We hypothesize that physical abuse resulting in intracranial injuries are associated with worse outcome. Materials and Methods We performed a retrospective analysis of the Nationwide Emergency Department Sample (NEDS), the largest all payer hospital based ED database, for the years 2008–2010. All ED visits and subsequent hospitalizations with a diagnosis of “Child physical abuse” (Battered baby or child syndrome) due to various injuries were identified using ICD-9-CM (International Classification of Diseases, 9th Revision, Clinical Modification) codes. In addition, we also examined the prevalence of sexual abuse in this cohort. A multivariable logistic regression model was used to examine the association between mortality and types of injuries after adjusting for a multitude of patient and hospital level factors. Results Of the 16897 ED visits that were attributed to child physical abuse, 5182 (30.7%) required hospitalization. Hospitalized children were younger than those released treated and released from the ED (1.9 years vs. 6.4 years). Male or female partner of the child’s parent/guardian accounted for >45% of perpetrators. Common injuries in hospitalized children include- any fractures (63.5%), intracranial injuries (32.3%) and crushing/internal injuries (9.1%). Death occurred in 246 patients (13 in ED and 233 following hospitalization). Amongst the 16897 ED visits, 1.3% also had sexual abuse. Multivariable analyses revealed each 1 year increase in age was associated with a lower odds of mortality (OR = 0.88, 95% CI = 0.81–0.96, p<0.0001). Females (OR = 2.39, 1.07–5.34, p = 0.03), those with intracranial injuries (OR = 65.24, 27.57–154.41, p<0.0001), or crushing/internal injury (OR = 4.98, 2.24–11.07, p<0

  6. Findings in older children with abusive head injury: does shaken-child syndrome exist?

    PubMed

    Salehi-Had, Hani; Brandt, James D; Rosas, Angela J; Rogers, Kristen K

    2006-05-01

    Shaken-baby syndrome (SBS) has been hypothesized to occur after shaking by an adult during the first 2 years of life. We wondered whether it is possible to achieve rotational forces sufficient to cause SBS-like injuries in children >2 years of age. The present study describes cases of child abuse in older children who presented with the classic ophthalmologic and intracranial findings of SBS. In this case series, 4 cases of older children (2.5-7 years old; 11.8-22 kg) who died from abusive head injuries and who had diffuse retinal hemorrhages identified antemortem were selected for review. The cases were abstracted from hospital charts, records from autopsies, coroners' and district attorneys' offices, and court transcripts. In all 4 cases the history provided by the primary caregiver did not match the severity of the injuries. Three case subjects presented with patterned bruises. Multilayered retinal hemorrhages and acute subdural hematoma were observed in all 4 cases. At autopsy, diffuse axonal injury was evident in 3 of the 4 cases; all 4 cases had optic nerve sheath hemorrhages. None of the victims had skeletal fractures on radiologic examination or at autopsy. This case series demonstrates that it is possible to observe SBS-like retinal and central nervous system findings in the older and heavier child. Our findings underscore the need for providers to consider intentional shaking as a mechanism of injury in the evaluation of abusive head injury in older children.

  7. Potential Child Abuse Screening in Emergency Department; a Diagnostic Accuracy Study

    PubMed Central

    Dinpanah, Hossein; Akbarzadeh Pasha, Abazar

    2017-01-01

    Introduction: Designing a tool that can differentiate those at risk of child abuse with great diagnostic accuracy is of great interest. The present study was designed to evaluate the diagnostic accuracy of Escape instrument in triage of at risk cases of child abuse presenting to emergency department (ED). Method: The present diagnostic accuracy study performed on 6120 of the children under 16 years old presented to ED during 3 years, using convenience sampling. Confirmation by the child abuse team (pediatrician, a social worker, and a forensic physician) was considered as the gold standard. Screening performance characteristics of Escape were calculated using STATA 21. Results: 6120 children with the mean age of 2.19 ± 1.12 years were screened (52.7% girls). 137 children were suspected victims of child abuse. Based on child abuse team opinion, 35 (0.5%) children were confirmed victims of child abuse. Sensitivity, specificity, positive and negative likelihood ratio and positive and negative predictive values of this test with 95% CI were 100 (87.6 – 100), 98.3 (97.9 – 98.6), 25.5 (18.6 – 33.8), 100 (99.9 – 100), 0.34 (0.25 – 0.46), and 0 (0 – NAN), respectively. Area under the ROC curve was 99.2 (98.9 – 99.4). Conclusion: It seems that Escape is a suitable screening instrument for detection of at risk cases of child abuse presenting to ED. Based on the results of the present study, the accuracy of this screening tool is 99.2%, which is in the excellent range. PMID:28286815

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

    PubMed Central

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

    2014-01-01

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

  9. Comprehensive Emergency Services: A System Designed to Care for Children in Crisis. Neglected and Abused by Their Family, Neglected and Abused by Their Community.

    ERIC Educational Resources Information Center

    National Center for Comprehensive Emergency Services, Nashville, TN.

    Described is the Comprehensive Emergency Services (CES) program, a system of coordinated services designed to meet emergency needs of neglected, dependent, and abused children and their families. In an introductory section, the program's development, objectives, and system attributes are covered. Explained in section II are the following…

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

    PubMed

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

    2016-04-01

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

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

    PubMed

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

    2017-07-13

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

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

    PubMed

    Hinsliff-Smith, Kathryn; McGarry, Julie

    2017-04-12

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2017-01-16

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

  15. Biosampling strategies for emerging drugs of abuse: towards the future of toxicological and forensic analysis.

    PubMed

    Mercolini, Laura; Protti, Michele

    2016-10-25

    The term "new psychoactive substances" refers to emerging drugs of abuse whose chemical structure and psychoactive effects are similar to other already known compounds, often providing a "legal" alternative to internationally regulated drugs and mostly available via on-line retail sites. There are several categories of new psychoactive substances, such as synthetic cannabinoids, cathinone analogues, phenethylamines, tryptamines, and the need to identify and quantify an unprecedented and growing number of new compounds represents a unique challenge for toxicological and forensic analysis. The purpose of this review is to highlight biosampling, sample preparation and analysis of the most important classes of emerging drugs of abuse in biological matrices, focusing on alternatives to classical blood and urine "in tube" approach, still representing the standard routine for bioanalysis, despite inherent flaws regarding handling, stability and process feasibility. Chromatographic techniques coupled to mass spectrometry are usually exploited to identify and quantify new psychoactive substances; due to their high sensitivity and selectivity, it is possible to determine low concentrations not only in plasma and urine, but also in alternative matrices like dried blood spots, oral fluid, hair, other body fluids and tissues. Current literature on analytical methodologies applied to these samples is still limited and a more thorough validation is often required, including a comparison among the results obtained from conventional approaches and from innovative strategies, in order to determine their actual suitability. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. 78 FR 14592 - Proposed Extension of Existing Information Collection; Emergency Mine Evacuation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-06

    ... Safety and Health Administration Proposed Extension of Existing Information Collection; Emergency Mine... opportunity to comment on proposed and continuing collections of information in accordance with the Paperwork... information collection for 30 CFR 48.3, Training plans; time of submission; where filed; information...

  17. The complexities of elder abuse.

    PubMed

    Roberto, Karen A

    2016-01-01

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

  18. Do multiple hydrological steady states exist and emerge under stochastic daily forcing?

    NASA Astrophysics Data System (ADS)

    Peterson, T. J.; Western, A. W.; Argent, R. M.

    2012-12-01

    Recent work has shown that including positive feedbacks in hydrological models can result in complex behavior with multiple steady states (henceforth attractors) and a finite resilience from a single parameter set. More generally, this is typical of systems with positive feedbacks. However, a limitation of past studies is that multiple attractors were identified using mean annual or monthly forcing. Considering that most hydrological fluxes do not operate at such large time scales, it remains an open question whether multiple hydrological attractors can exist when a catchment is subject to stochastic daily forcing. To explore this question, this paper summarizes three recently submitted WRR papers (Peterson et al. 2012a, 2012b, 2012c) to ask if multiple hydrological attractors can emerge under stochastic daily forcing; and if they emerge, can daily forcing cause a catchment to switch between them. Using a hill-slope Boussinesq-vadose zone semi-distributed model, the attractors were quantified using a new limit-cycle continuation technique (LCC) that up-scaled climate forcing from daily to monthly (model and limit-cycle code is freely available). Multiple attractors were found to exist; but over a narrower range of parameter values compared with that using monthly mean forcing. This suggested that multiple attractors may exist in fewer catchments. To explore if stochastic daily forcing can switch a catchment to both attractors, time-integration simulations under daily stochastic forcing where conducted at a range of saturated lateral conductivity values. Somewhat surprisingly, the emergence (under stochastic forcing) of attractors differed significantly from the attractors that existed (from LCC). Specifically, attractors were found to exist but never emerge; both attractors may exist and both may emerge; and only one attractor may exist and a second temporary attractor may emerge only during certain periods of stochastic forcing. The latter indicates that more

  19. Pre-existence and emergence of drug resistance in HIV-1 infection.

    PubMed Central

    Bonhoeffer, S; Nowak, M A

    1997-01-01

    Antiviral treatment of HIV-1 infection often fails because of the rapid emergence of resistant virus within weeks of the start of therapy. This raises the question of whether resistant viruses pre-exist in drug-naive patients or whether it is produced after the start of therapy. Here we compare the likelihood of pre-existence with the likelihood of production of resistant virus during therapy. We show that provided resistant virus pre-exists, then a stronger therapy may lead to a greater initial reduction of virus load, but will also cause a faster rise of resistant virus. In this case the total benefit of treatment is independent of the degree of inhibition of sensitive virus. If, on the other hand, resistant mutants do not pre-exist, then the emergence of resistance during treatment depends on the efficacy of the drug. If the drug is sufficiently potent to eradicate sensitive virus, then the probability that resistant mutants first appear during therapy is smaller than the probability that they existed before therapy. If the drug cannot eradicate the sensitive virus, then after sufficiently long time resistant mutants will appear. However, mutants that are unlikely to pre-exist may taken long time to appear. PMID:9178534

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

    PubMed

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

    2015-05-01

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

  1. Epidemiology of illicit and abused drugs in the general population, emergency department drug-related episodes, and arrestees.

    PubMed

    Rouse, B A

    1996-08-01

    National trends in substance abuse are presented: the civilian noninstitutionalized general population; drug-related emergency department episodes; and booked arrestees. Major metropolitan differences are also noted. This study was based on the primary national data systems for these groups: The Substance Abuse and Mental Health Services Administration (SAMHSA) National Household Survey on Drug Abuse, SAMHSA's Drug Abuse Warning Network (DAWN), and the National Institute of Justice Drug Use Forecasting (DUF) system. While the most prevalent drug differed in the three data sources, all three showed recent increases in marijuana. Despite the general decline in drug use seen in the general population, both the number of drug-related cases in the DAWN system and the drug use detected in the DUF arrestees showed recent increases.

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

    NASA Technical Reports Server (NTRS)

    Azarbar, Bahman

    1990-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Azarbar, Bahman

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

  4. Using poison center exposure calls to predict prescription opioid abuse and misuse-related emergency department visits.

    PubMed

    Davis, Jonathan M; Severtson, Stevan G; Bucher-Bartelson, Becki; Dart, Richard C

    2014-01-01

    Prescription drug abuse is a critical problem in the USA and has been linked to more deaths than automobile accidents. Despite this growing epidemic, the USA lacks a timely early warning system. Poison centers (PCs) have the potential to act as sentinel reporting entities for prescription drug abuse and misuse due to near-real-time data reporting and abundant coverage in the USA. Data from the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS®) System PC program were compared with data from the Drug Abuse Warning Network (DAWN) from 2004 through 2010. Population rates of PC call mentions regarding abuse and misuse of prescription opioids were compared with population rates of emergency department visit mentions of the same using linear regression. Products included in the analysis were the following: buprenorphine, fentanyl, hydrocodone, hydromorphone, methadone, morphine, and oxycodone. The strength of association between RADARS System PC data and DAWN emergency department visits regarding all opioids in aggregate was strong (R² = 0.81, p < 0.001). The correlations between the two programs at the drug class level also were strong for buprenorphine, hydrocodone, hydromorphone, methadone, and oxycodone (all R² > 0.70, all p < 0.01), significant for fentanyl (p = 0.05), and moderate for morphine (p = 0.09). Data on prescription opioid drug abuse from the RADARS System PC program correlates well with emergency room data from DAWN. Due to timeliness of data, geographic coverage and strong associations with other warning systems, PC data can be used for sentinel reporting on prescription drug abuse and misuse in the USA. Copyright © 2013 John Wiley & Sons, Ltd.

  5. Recognizing abuse.

    PubMed

    Davidhizar, R; Newman-Giger, J

    1996-01-01

    After years as a taboo topic, abuse has come "out of the closet" and is being talked about openly in society. Yet, while abuse in the workplace is being confronted, abuse within families still often goes unrecognized by outsiders, including by nurses. Failure of nurses to recognize abuse is unfortunate since frequently they are the first point of contact with the victim of abuse in the emergency room, clinic and home. Understanding and insight into the problem of family violence by nurses is critical in addressing this problem. Knowledge is crucial in planning strategies that will have the long-lasting effect of decreasing the cycle of abuse in families.

  6. Exercise for Hypertension: A Prescription Update Integrating Existing Recommendations with Emerging Research.

    PubMed

    Pescatello, Linda S; MacDonald, Hayley V; Lamberti, Lauren; Johnson, Blair T

    2015-11-01

    Hypertension is the most common, costly, and preventable cardiovascular disease risk factor. Numerous professional organizations and committees recommend exercise as initial lifestyle therapy to prevent, treat, and control hypertension. Yet, these recommendations differ in the components of the Frequency, Intensity, Time, and Type (FITT) principle of exercise prescription (Ex Rx); the evidence upon which they are based is only of fair methodological quality; and the individual studies upon which they are based generally do not include people with hypertension, which are some of the limitations in this literature. The purposes of this review are to (1) overview the professional exercise recommendations for hypertension in terms of the FITT principle of Ex Rx; (2) discuss new and emerging research related to Ex Rx for hypertension; and (3) present an updated FITT Ex Rx for adults with hypertension that integrates the existing recommendations with this new and emerging research.

  7. Feasibility of Tablet Computer Screening for Opioid Abuse in the Emergency Department

    PubMed Central

    Weiner, Scott G.; Horton, Laura C.; Green, Traci C.; Butler, Stephen F.

    2015-01-01

    Introduction Tablet computer-based screening may have the potential for detecting patients at risk for opioid abuse in the emergency department (ED). Study objectives were a) to determine if the revised Screener and Opioid Assessment for Patients with Pain (SOAPP®-R), a 24-question previously paper-based screening tool for opioid abuse potential, could be administered on a tablet computer to an ED patient population; b) to demonstrate that >90% of patients can complete the electronic screener without assistance in <5 minutes and; c) to determine patient ease of use with screening on a tablet computer. Methods This was a cross-sectional convenience sample study of patients seen in an urban academic ED. SOAPP®-R was programmed on a tablet computer by study investigators. Inclusion criteria were patients ages ≥18 years who were being considered for discharge with a prescription for an opioid analgesic. Exclusion criteria included inability to understand English or physical disability preventing use of the tablet. Results 93 patients were approached for inclusion and 82 (88%) provided consent. Fifty-two percent (n=43) of subjects were male; 46% (n=38) of subjects were between 18–35 years, and 54% (n=44) were >35 years. One hundred percent of subjects completed the screener. Median time to completion was 148 (interquartile range 117.5–184.3) seconds, and 95% (n=78) completed in <5 minutes. 93% (n=76) rated ease of completion as very easy. Conclusions It is feasible to administer a screening tool to a cohort of ED patients on a tablet computer. The screener administration time is minimal and patient ease of use with this modality is high. PMID:25671003

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

    PubMed

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

    2011-07-11

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

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

    PubMed Central

    2011-01-01

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

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

    PubMed

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

    2016-01-01

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

  11. Ruptured Mycotic Common Femoral Artery Pseudoaneurysm: Fatal Pulmonary Embolism after Emergency Stent-Grafting in a Drug Abuser

    PubMed Central

    Kalogirou, Thomas E.; Giagtzidis, Ioakeim T.; Papazoglou, Konstantinos O.

    2014-01-01

    The rupture of a mycotic femoral artery pseudoaneurysm in an intravenous drug abuser is a limb- and life-threatening condition that necessitates emergency intervention. Emergency stent-grafting appears to be a viable, minimally invasive alternative, or a bridge, to subsequent open surgery. Caution is required in cases of suspected concomitant deep vein thrombosis in order to minimize the possibility of massive pulmonary embolism during stent-grafting, perhaps by omitting stent-graft postdilation or by inserting an inferior vena cava filter first. We describe the emergency endovascular management, in a 60-year-old male intravenous drug abuser, of a ruptured mycotic femoral artery pseudoaneurysm, which was complicated by a fatal pulmonary embolism. PMID:25593530

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

    Tien, Yu-Yu; Hsia, Renee Y.

    2016-01-01

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

  14. Elder abuse: a review.

    PubMed

    Kleinschmidt, K C

    1997-10-01

    Elder abuse exists in many forms: physical, emotional, financial, and sexual; neglect; and self-neglect. As many as 2.5 million older people are abused each year, and the number of cases will likely increase as this population grows. Elder abuse receives less attention than other forms of domestic violence, and fewer than 10% of cases are reported. Although all states have legislation addressing elder abuse, financial support for evaluation and protective services is lacking. Most states have mandatory reporting; however, it may infringe on the autonomy of competent geriatric individuals. Physicians infrequently report elder abuse because they are not familiar with reporting laws, fear offending patients, are concerned with time limitations, and believe they do not have appropriate evaluation skills. Victims often have low self-esteem, blame themselves for the abuse, and do not want to admit their vulnerabilities or betray their families. The "caregiver stress hypothesis," which suggests abuse stems from caregiver stress and resentment resulting from chronic care of dependent geriatric patients, is a misconception. Abuse is actually better correlated with the emotional and financial dependence of the caregivers on the geriatric victims. Older patients are most commonly abused by the people with whom they live. Older men and women have similar per capita abuse rates. Assessment and management should be supportive without assigning blame and should focus on both the patient and the caregiver. Patients in immediate danger should be hospitalized or placed in emergency shelters. Suspected abuse should be reported directly to the appropriate state agency, which can provide a thorough long-term assessment.

  15. The impact of the addition of an acupuncture treatment program to an existing metro-Dade County outpatient substance abuse treatment facility.

    PubMed

    Konefal, J; Duncan, R; Clemence, C

    1994-01-01

    There are several varieties of treatment facilities and modalities for dealing with substance abuse. In this study, the addition of acupuncture treatments to the usual care program at an existing county-based substance abuse treatment clinic was tested. Men and women who voluntarily attended the clinic or who were remanded by the court to attend were randomized to receive usual care, usual care plus frequent urine testing, or usual care plus frequent urine testing and acupuncture treatments. Clients who received acupuncture treatments in addition to the usual care and frequent urine testing became clean (as measured by negative urine tests) in 57% of the time required for the frequent urine testing group. Difficulties experienced included low counselor compliance with the protocol and a high drop-out rate, indicating that further research is necessary; however, this study demonstrates that acupuncture can be a feasible and effective addition to existing drug treatment programs.

  16. Elder abuse and neglect: definitions, epidemiology, and approaches to emergency department screening.

    PubMed

    Bond, Michael C; Butler, Kenneth H

    2013-02-01

    Elder abuse and neglect is estimated to affect approximately 700,000 to 1.2 million elderly people a year with an estimated annual cost of tens of billions of dollars. Despite the large population at risk, its significant morbidity and mortality, and substantial cost to society, elder abuse continues to be underrecognized and underreported. This article aims to increase the awareness of elder abuse by reviewing the demographics, epidemiology, and risk factors of elder abuse, followed by a discussion of screening tools and ways to increase awareness and reporting.

  17. Tackling the Phenomenon of Elder Abuse in Italy: A Review of Existing Legislation and Policies as a Learning Resource

    ERIC Educational Resources Information Center

    Melchiorre, Maria Gabriella; Chiatti, Carlos; Lamura, Giovanni

    2012-01-01

    In Italy, data and information on prevalence and characteristics of elder abuse are very limited, and a specific legal and policy framework is lacking. Some articles of the Penal Code refer to the larger context of violence against disadvantaged groups, and some general support services not specifically dedicated to this issue are managed by local…

  18. Tackling the Phenomenon of Elder Abuse in Italy: A Review of Existing Legislation and Policies as a Learning Resource

    ERIC Educational Resources Information Center

    Melchiorre, Maria Gabriella; Chiatti, Carlos; Lamura, Giovanni

    2012-01-01

    In Italy, data and information on prevalence and characteristics of elder abuse are very limited, and a specific legal and policy framework is lacking. Some articles of the Penal Code refer to the larger context of violence against disadvantaged groups, and some general support services not specifically dedicated to this issue are managed by local…

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

    PubMed Central

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

    2015-01-01

    Background The prevalence of marijuana (MJ) use among youth and its legalization for medical or recreational use has intensified public health endeavors of understanding MJ effects on brain structure and function. Studies indicate that MJ use is related to impaired cognitive performance, and altered functional brain activation and chemistry in adolescents and adults, but MJ effects on brain morphology in emerging adults are less understood. Methods 15 MJ users (age 21.8±3.6, 2 females) and 15 non-using (NU) participants (age 22.3±3.5, 2 females) were included, demographically matched on age, education and alcohol use. High-resolution structural MR images were acquired at 3 Tesla. Cortical thickness (CT) and volumetric analyses were performed using Freesurfer. A priori regions of interest (ROI) included orbitofrontal and cingulate cortices, amygdala, hippocampus and thalamus. Results Whole brain CT analysis did not find significant group differences in a priori ROIs but revealed MJ users had significantly less CT (i.e., thinness) in right fusiform gyrus (rFG) compared to NU (p<0.05). Thalamic volume was significantly smaller in MJ users compared to NU (right, p=0.05; left, p=0.01) and associated with greater non-planning (p<0.01) and overall impulsivity (p=0.04). There were no other group volume differences. Conclusions RFG cortical thinness and smaller thalamic volume in emerging adults is associated with MJ abuse. Furthermore, smaller thalamic volume associated with greater impulsivity contributes to growing evidence that the thalamus is neurobiologically perturbed by MJ use. Collectively, altered thalamic and rFG structural integrity may interfere with their known roles in regulating visuoperceptual and object information processing. PMID:26249265

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

    PubMed

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

    2015-10-01

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

  1. Current clinical aspects of drug-facilitated sexual assaults in sexually abused victims examined in a forensic emergency unit.

    PubMed

    Marc, Bernard

    2008-04-01

    Sexual assault is defined as any undesired physical contact of a sexual nature perpetrated against another person and is a prevalent problem presenting at emergency departments, emergency forensic medicine units, and rape crisis centres worldwide. Drug-facilitated sexual assault (DFSA) is a complex problem that is encountered with increasing frequency. But this problem is often underrepresented because most DFSAs are not reported by the frightened victims or are diagnosed as an acute drug or alcohol intoxication, thereby bypassing sexual abuse diagnosis and appropriate care. Proper care must be taken to ensure the chain of custody. Emergency physicians need to be aware of the phenomenon and work together with reference emergency forensic medicine units and rape crisis centres, which are capable of taking care of the male and female victims of sexual abuse. If no attention is given to the risk of DFSA, then toxicological samples (urine, blood, hair) and other biologic evidence may remain unidentified and semen, vaginal secretions, and vaginal epithelial cells cannot be genetically typed by a crime laboratory. This article reports the main clinical aspects of DFSA encountered in emergency departments at the beginning of the 21st century and the experience of an emergency forensic medicine unit based at a hospital (Compiègne, France). Guidelines are proposed for clinical examination of DFSA victims, clinical forensic medical examination, and accurate samplings for further toxicological and biological evidence.

  2. Comparative assessment of the environmental sustainability of existing and emerging perchlorate treatment technologies for drinking water.

    PubMed

    Choe, Jong Kwon; Mehnert, Michelle H; Guest, Jeremy S; Strathmann, Timothy J; Werth, Charles J

    2013-05-07

    Environmental impacts of conventional and emerging perchlorate drinking water treatment technologies were assessed using life cycle assessment (LCA). Comparison of two ion exchange (IX) technologies (i.e., nonselective IX with periodic regeneration using brines and perchlorate-selective IX without regeneration) at an existing plant shows that brine is the dominant contributor for nonselective IX, which shows higher impact than perchlorate-selective IX. Resource consumption during the operational phase comprises >80% of the total impacts. Having identified consumables as the driving force behind environmental impacts, the relative environmental sustainability of IX, biological treatment, and catalytic reduction technologies are compared more generally using consumable inputs. The analysis indicates that the environmental impacts of heterotrophic biological treatment are 2-5 times more sensitive to influent conditions (i.e., nitrate/oxygen concentration) and are 3-14 times higher compared to IX. However, autotrophic biological treatment is most environmentally beneficial among all. Catalytic treatment using carbon-supported Re-Pd has a higher (ca. 4600 times) impact than others, but is within 0.9-30 times the impact of IX with a newly developed ligand-complexed Re-Pd catalyst formulation. This suggests catalytic reduction can be competitive with increased activity. Our assessment shows that while IX is an environmentally competitive, emerging technologies also show great promise from an environmental sustainability perspective.

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

    PubMed

    Mackey, Tim K; Nayyar, Gaurvika

    2017-05-01

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

  4. Clusters of microRNAs emerge by new hairpins in existing transcripts.

    PubMed

    Marco, Antonio; Ninova, Maria; Ronshaugen, Matthew; Griffiths-Jones, Sam

    2013-09-01

    Genetic linkage may result in the expression of multiple products from a polycistronic transcript, under the control of a single promoter. In animals, protein-coding polycistronic transcripts are rare. However, microRNAs are frequently clustered in the genomes of animals, and these clusters are often transcribed as a single unit. The evolution of microRNA clusters has been the subject of much speculation, and a selective advantage of clusters of functionally related microRNAs is often proposed. However, the origin of microRNA clusters has not been so far explored. Here, we study the evolution of microRNA clusters in Drosophila melanogaster. We observed that the majority of microRNA clusters arose by the de novo formation of new microRNA-like hairpins in existing microRNA transcripts. Some clusters also emerged by tandem duplication of a single microRNA. Comparative genomics show that these clusters are unlikely to split or undergo rearrangements. We did not find any instances of clusters appearing by rearrangement of pre-existing microRNA genes. We propose a model for microRNA cluster evolution in which selection over one of the microRNAs in the cluster interferes with the evolution of the other linked microRNAs. Our analysis suggests that the study of microRNAs and small RNAs must consider linkage associations.

  5. Lessons Learned for Follow-up Phone Booster Counseling Calls with Substance Abusing Emergency Department Patients

    PubMed Central

    Donovan, Dennis M.; Hatch-Maillette, Mary A.; Phares, Melissa M.; McGarry, Ernest; Peavy, K. Michelle; Taborsky, Julie

    2014-01-01

    Background Post-visit “booster” sessions have been recommended to augment the impact of brief interventions delivered in the Emergency Department (ED). This paper, which focuses on implementation issues, presents descriptive information and interventionists’ qualitative perspectives on providing brief interventions over the phone, challenges, “lessons learned”, and recommendations for others attempting to implement adjunctive booster calls. Method Attempts were made to complete two 20-minute telephone “booster” calls within a week following a patient’s ED discharge with 425 patients who screened positive for and had recent problematic substance use other than alcohol or nicotine. Results Over half (56.2%) of participants completed the initial call; 66.9% of those who received the initial call also completed the second call. Median number of attempts to successfully contact participants for the first and second calls was 4 and 3, respectively. Each completed call lasted an average of about 22 minutes. Common challenges/barriers identified by booster callers included unstable housing, limited phone access, unavailability due to additional treatment, lack of compensation for booster calls, and booster calls coming from an area code different than the participants’ locale and from someone other than ED staff. Conclusions Specific recommendations are presented with respect to implementing a successful centralized adjunctive booster call system. Future use of booster calls might be informed by research on contingency management (e.g., incentivizing call completions), smoking cessation quitlines, and phone-based continuing care for substance abuse patients. Future research needs to evaluate the incremental benefit of adjunctive booster calls on outcomes over and above that of brief motivational interventions delivered in the ED setting. PMID:25534151

  6. Lessons learned for follow-up phone booster counseling calls with substance abusing emergency department patients.

    PubMed

    Donovan, Dennis M; Hatch-Maillette, Mary A; Phares, Melissa M; McGarry, Ernest; Peavy, K Michelle; Taborsky, Julie

    2015-03-01

    Post-visit "booster" sessions have been recommended to augment the impact of brief interventions delivered in the emergency department (ED). This paper, which focuses on implementation issues, presents descriptive information and interventionists' qualitative perspectives on providing brief interventions over the phone, challenges, "lessons learned", and recommendations for others attempting to implement adjunctive booster calls. Attempts were made to complete two 20-minute telephone "booster" calls within a week following a patient's ED discharge with 425 patients who screened positive for and had recent problematic substance use other than alcohol or nicotine. Over half (56.2%) of participants completed the initial call; 66.9% of those who received the initial call also completed the second call. Median number of attempts to successfully contact participants for the first and second calls were 4 and 3, respectively. Each completed call lasted an average of about 22 minutes. Common challenges/barriers identified by booster callers included unstable housing, limited phone access, unavailability due to additional treatment, lack of compensation for booster calls, and booster calls coming from an area code different than the participants' locale and from someone other than ED staff. Specific recommendations are presented with respect to implementing a successful centralized adjunctive booster call system. Future use of booster calls might be informed by research on contingency management (e.g., incentivizing call completions), smoking cessation quitlines, and phone-based continuing care for substance abuse patients. Future research needs to evaluate the incremental benefit of adjunctive booster calls on outcomes over and above that of brief motivational interventions delivered in the ED setting. Copyright © 2015 Elsevier Inc. All rights reserved.

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

    SciTech Connect

    Lupattelli, Tommaso; Garaci, Francesco Giuseppe; Basile, Antonio; Minnella, Daniela Paola; Casini, Andrea; Clerissi, Jacques

    2009-03-15

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

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

    PubMed

    Partridge, Bradley; Affleck, Julia

    2017-08-01

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

  9. Antiviral therapies against Ebola and other emerging viral diseases using existing medicines that block virus entry

    PubMed Central

    Long, Jason; Wright, Edward; Molesti, Eleonora; Temperton, Nigel; Barclay, Wendy

    2015-01-01

    Emerging viral diseases pose a threat to the global population as intervention strategies are mainly limited to basic containment due to the lack of efficacious and approved vaccines and antiviral drugs. The former was the only available intervention when the current unprecedented Ebolavirus (EBOV) outbreak in West Africa began. Prior to this, the development of EBOV vaccines and anti-viral therapies required time and resources that were not available. Therefore, focus has turned to re-purposing of existing, licenced medicines that may limit the morbidity and mortality rates of EBOV and could be used immediately. Here we test three such medicines and measure their ability to inhibit pseudotype viruses (PVs) of two EBOV species, Marburg virus (MARV) and avian influenza H5 (FLU-H5). We confirm the ability of chloroquine (CQ) to inhibit viral entry in a pH specific manner. The commonly used proton pump inhibitors, Omeprazole and Esomeprazole were also able to inhibit entry of all PVs tested but at higher drug concentrations than may be achieved in vivo. We propose CQ as a priority candidate to consider for treatment of EBOV. PMID:26069727

  10. Treatment of Systemic Sclerosis-related Interstitial Lung Disease: A Review of Existing and Emerging Therapies.

    PubMed

    Volkmann, Elizabeth R; Tashkin, Donald P

    2016-11-01

    Although interstitial lung disease accounts for the majority of deaths of patients with systemic sclerosis, treatment options for this manifestation of the disease are limited. Few high-quality, randomized, controlled trials exist for systemic sclerosis-related interstitial lung disease, and historically, studies have favored the use of cyclophosphamide. However, the benefit of cyclophosphamide for this disease is tempered by its complex adverse event profile. More recent studies have demonstrated the effectiveness of mycophenolate for systemic sclerosis-related interstitial lung disease, including Scleroderma Lung Study II. This review highlights the findings of this study, which was the first randomized controlled trial to compare cyclophosphamide with mycophenolate for the treatment of systemic sclerosis-related interstitial lung disease. The results reported in this trial suggest that there is no difference in treatment efficacy between mycophenolate and cyclophosphamide; however, mycophenolate appears to be safer and more tolerable than cyclophosphamide. In light of the ongoing advances in our understanding of the pathogenic mechanisms underlying interstitial lung disease in systemic sclerosis, this review also summarizes novel treatment approaches, presenting clinical and preclinical evidence for rituximab, tocilizumab, pirfenidone, and nintedanib, as well as hematopoietic stem cell transplantation and lung transplantation. This review further explores how reaching a consensus on appropriate study end points, as well as trial enrichment criteria, is central to improving our ability to judiciously evaluate the safety and efficacy of emerging experimental therapies for systemic sclerosis-related interstitial lung disease.

  11. Abortive Spontaneous Egg Activation: An Emerging Biological Threat for the Existence of Mammals.

    PubMed

    Prasad, Shilpa; Tiwari, Meenakshi; Chaube, Shail K

    2017-03-02

    Mammals are important for balancing the natural ecosystem, but in the past few decades, several species have rapidly been entered under threatened category worldwide. The environmental changes, loss of natural habitats, human activities, and thereby stress are responsible for a gradual decline in reproductive outcome. Stress induces generation of reactive oxygen species (ROS). High physiological level of ROS drives abortive spontaneous egg activation (SEA), while beyond the physiological level causes oxidative stress (OS). The OS induces apoptosis and deteriorates egg quality that limits reproductive outcome. The reduced reproductive outcome is one of the major causes for gradual decline in population size of several mammalian species. Despite having several conservation programs, a gradual decline in species reproductive outcome and their population size is the serious concern for the existence of threatened mammalian species. Thus, it is important to identify and prevent the underlying causes responsible for abortive SEA, which could be an emerging problem for several mammalian species that are threatened or at the verge of extinction.

  12. Value of systematic detection of physical child abuse at emergency rooms: a cross-sectional diagnostic accuracy study.

    PubMed

    Sittig, Judith S; Uiterwaal, Cuno S P M; Moons, Karel G M; Russel, Ingrid M B; Nievelstein, Rutger A J; Nieuwenhuis, Edward E S; van de Putte, Elise M

    2016-03-22

    The aim of our diagnostic accuracy study Child Abuse Inventory at Emergency Rooms (CHAIN-ER) was to establish whether a widely used checklist accurately detects or excludes physical abuse among children presenting to ERs with physical injury. A large multicentre study with a 6-month follow-up. 4 ERs in The Netherlands. 4290 children aged 0-7 years attending the ER because of physical injury. All children were systematically tested with an easy-to-use child abuse checklist (index test). A national expert panel (reference standard) retrospectively assessed all children with positive screens and a 15% random sample of the children with negative screens for physical abuse, using additional information, namely, an injury history taken by a paediatrician, information provided by the general practitioner, youth doctor and social services by structured questionnaires, and 6-month follow-up information. Physical child abuse. Injury due to neglect and need for help. 4253/4290 (99%) parents agreed to follow-up. At a prevalence of 0.07% (3/4253) for inflicted injury by expert panel decision, the positive predictive value of the checklist was 0.03 (95% CI 0.006 to 0.085), and the negative predictive value 1.0 (0.994 to 1.0). There was 100% (93 to 100) agreement about inflicted injury in children, with positive screens between the expert panel and child abuse experts. Rare cases of inflicted injury among preschool children presenting at ERs for injury are very likely captured by easy-to-use checklists, but at very high false-positive rates. Subsequent assessment by child abuse experts can be safely restricted to children with positive screens at very low risk of missing cases of inflicted injury. Because of the high false positive rate, we do advise careful prior consideration of cost-effectiveness and clinical and societal implications before de novo implementation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence

  13. Value of systematic detection of physical child abuse at emergency rooms: a cross-sectional diagnostic accuracy study

    PubMed Central

    Sittig, Judith S; Uiterwaal, Cuno S P M; Moons, Karel G M; Russel, Ingrid M B; Nievelstein, Rutger A J; Nieuwenhuis, Edward E S; van de Putte, Elise M

    2016-01-01

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

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

    PubMed

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

    2014-04-01

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

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

    PubMed

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

    2015-04-01

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

  16. National Analysis of Differences among Substance Abuse Treatment Outcomes: College Student and Nonstudent Emerging Adults

    ERIC Educational Resources Information Center

    Sahker, Ethan; Acion, Laura; Arndt, Stephan

    2015-01-01

    Objective: To discover differences between student and nonstudent substance abuse treatment demographics, treatment characteristics, and outcomes. Participants: Conducted February 2014, clients without prior treatment admissions, aged 18-24, not in methadone maintenance therapy, and in nonintensive and ambulatory intensive outpatient treatment…

  17. National Analysis of Differences among Substance Abuse Treatment Outcomes: College Student and Nonstudent Emerging Adults

    ERIC Educational Resources Information Center

    Sahker, Ethan; Acion, Laura; Arndt, Stephan

    2015-01-01

    Objective: To discover differences between student and nonstudent substance abuse treatment demographics, treatment characteristics, and outcomes. Participants: Conducted February 2014, clients without prior treatment admissions, aged 18-24, not in methadone maintenance therapy, and in nonintensive and ambulatory intensive outpatient treatment…

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

    PubMed

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

    2014-10-10

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

  19. 78 FR 41062 - Agency Information Collection Activities: Existing Collection; Emergency Extension

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-09

    ... From the Federal Register Online via the Government Publishing Office EQUAL EMPLOYMENT OPPORTUNITY... Paperwork Reduction Act, the Equal Employment Opportunity Commission (EEOC or Commission) announces that it... Employment Opportunity Commission. ACTION: Notice of Information Collection--Emergency Extension without...

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

    PubMed

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

    2012-04-01

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

  1. Elder abuse.

    PubMed

    Benton, D; Marshall, C

    1991-11-01

    Elder abuse encompasses physical, psychological, and financial abuse and also includes the violation of an individual's rights, or social abuse. Detection of elder abuse is often obstructed by the denial or shame of the abused older adult and the denial or improper assessment by health care professionals. The ethical struggle professionals face when they suspect abuse may also impede assessment or intervention. Preliminary data on etiologic factors related to elder abuse suggest that misinformation, the caregiver's lack of understanding of the needs of older adults, social isolation, a history of dysfunctional family relationships, and the psychopathologic factors of the caregiver are salient factors for understanding elder abuse. In addition, caregiver burden related to the care of the impaired elder and other external life events is a risk factor for elder abuse. Self-neglect is the type of elder abuse most often reported and the most difficult to handle, because older adults have a right to refuse services. Home care providers often face practical and ethical dilemmas in cases of self-neglect. When making an assessment for elder abuse, it is best to use a multidisciplinary approach. In addition to physical indicators (bruises, malnutrition, fractures), attention must be paid to the social, family, and sexual history of the patient. The psychological history of the patient and caregiver is also important. Reporting laws exist in all states, and health care practitioners must become familiar with the laws in their states. Awareness of elder abuse by professionals working in home care is essential, because the failure to detect abuse can interfere with interventions and in some cases lead to death.

  2. Intravenous drug abusers attending an inner city accident and emergency department.

    PubMed Central

    Makower, R M; Pennycook, A G; Moulton, C

    1992-01-01

    In a 3-month prospective study, intravenous drug abusers represented 1.14% of all new attendances at Glasgow Royal Infirmary. They generated a significant workload and were often difficult to identify. A very high proportion required surgery or other invasive procedures. The clinical and epidemiological characteristics of the patients were often unexpected. The risks to staff and other implications for the A&E department are discussed. PMID:1567526

  3. On the Learning Curve: The Emerging Evidence Supporting Cognitive-Behavioral Therapies for Adolescent Substance Abuse

    PubMed Central

    Waldron, Holly Barrett; Kaminer, Yifrah

    2007-01-01

    Aims Cognitive–behavioral therapy (CBT) approaches to intervention for adolescent substance use disorders has been limited and formal controlled clinical efficacy trials have been rare. Moreover, the early literature on the efficacy of CBT for adolescent substance abuse has been characterized by significant methodological limitations. Recent innovations in the treatment of adolescent substance abuse and the recent completion of several randomized clinical trials has brightened the picture with respect to establishing the empirical support for CBT. The aim of this review is to integrate the findings from controlled trials of CBT for adolescent substance abuse. Method Studies representing randomized clinical trials were reviewed using criteria provided by Lonigan et al. and Nathan & Gorman as a guide. Findings and conclusions Despite some prominent differences in design and methodology, the studies reviewed provide consistent empirical evidence that group and individual CBT are associated with significant and clinically meaningful reductions in adolescent substance use. The evidence for the efficacy of group therapy is particularly important, countering the assertion that aggregating problem youths into group treatment settings is associated with iatrogenic effects. The findings from the randomized trials reviewed represent significant developments in treatment outcome research and lay the foundation for validating CBT for adolescent substance use disorders. Future research directions include improving short- and long-term outcomes, enhancing treatment motivation and engagement, and identifying mechanisms and processes associated with positive change, especially for youths with comorbid conditions. PMID:15488108

  4. On the learning curve: the emerging evidence supporting cognitive-behavioral therapies for adolescent substance abuse.

    PubMed

    Waldron, Holly Barrett; Kaminer, Yifrah

    2004-11-01

    Cognitive-behavioral therapy (CBT) approaches to intervention for adolescent substance use disorders has been limited and formal controlled clinical efficacy trials have been rare. Moreover, the early literature on the efficacy of CBT for adolescent substance abuse has been characterized by significant methodological limitations. Recent innovations in the treatment of adolescent substance abuse and the recent completion of several randomized clinical trials has brightened the picture with respect to establishing the empirical support for CBT. The aim of this review is to integrate the findings from controlled trials of CBT for adolescent substance abuse. Studies representing randomized clinical trials were reviewed using criteria provided by Lonigan et al. and Nathan & Gorman as a guide. Despite some prominent differences in design and methodology, the studies reviewed provide consistent empirical evidence that group and individual CBT are associated with significant and clinically meaningful reductions in adolescent substance use. The evidence for the efficacy of group therapy is particularly important, countering the assertion that aggregating problem youths into group treatment settings is associated with iatrogenic effects. The findings from the randomized trials reviewed represent significant developments in treatment outcome research and lay the foundation for validating CBT for adolescent substance use disorders. Future research directions include improving short- and long-term outcomes, enhancing treatment motivation and engagement, and identifying mechanisms and processes associated with positive change, especially for youths with comorbid conditions.

  5. 75 FR 6392 - Agency Information Collection Activities: Existing Collection; Emergency Extension

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-09

    ... change: Local Union Report (EEO-3). SUMMARY: In accordance with the Paperwork Reduction Act, the Equal... Management and Budget (OMB) a request for an emergency extension of the Local Union Report (EEO-3), on... collected information from local unions on the EEO-3 form since 1966 (biennially since 1985). Overview of...

  6. 75 FR 18833 - Agency Information Collection Activities: Existing Collection; Emergency Extension

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-13

    ... change: Local Union Report (EEO-3). SUMMARY: In accordance with the Paperwork Reduction Act, the Equal... Management and Budget (OMB) a request for a 90-day emergency extension of the Local Union Report (EEO-3), to... collected information from local unions on the EEO-3 form since 1966 (biennially since 1985). Overview of...

  7. 75 FR 63179 - Agency Information Collection Activities: Existing Collection; Emergency Extension

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-14

    ... Change: Local Union Report (EEO-3). SUMMARY: In accordance with the Paperwork Reduction Act, the Equal... Management and Budget (OMB) a request for a 90-day emergency extension of the Local Union Report (EEO-3), to... collected information from local unions on the EEO-3 form since 1966 (biennially since 1985). Overview of...

  8. 75 FR 40829 - Agency Information Collection Activities: Existing Collection; Emergency Extension

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-14

    ... change: Local Union Report (EEO-3). SUMMARY: In accordance with the Paperwork Reduction Act, the Equal... Management and Budget (OMB) a request for a 90-day emergency extension of the Local Union Report ] (EEO-3... collected information from local unions on the EEO-3 form since 1966 (biennially since 1985). Overview of...

  9. The Acute Care Nurse Practitioner: challenging existing boundaries of emergency nurses in the United Kingdom.

    PubMed

    Norris, Tracey; Melby, Vidar

    2006-03-01

    This study explored the opinions of nurses and doctors working in emergency departments towards the development of the Acute Care Nurse Practitioner service in the United Kingdom. Studies carried out in the United States and Canada suggest that the Acute Care Nurse Practitioner can have a positive impact on the critically ill or injured patients' experiences in the emergency department. This role is well developed in the United States and Canada, but is still in its infancy in the United Kingdom. A descriptive, exploratory design incorporating questionnaires (n = 98) and semi-structured interviews (n = 6) was employed. The sample included nurses and doctors from seven emergency departments and minor injury units. Respondents felt it was important for the Acute Care Nurse Practitioner to have obtained a specialist nurse practitioner qualification and that the Acute Care Nurse Practitioner should retain a clinical remit. While participants seemed comfortable with nurses undertaking traditional advanced skills such as suturing, reluctance was displayed with other advanced skills such as needle thoracocentesis. Three main themes were identified from the interviews: inter-professional conflict, autonomy and the need for the Acute Care Nurse Practitioner. Doctors were reluctant to allow nurses to practise certain additional advanced skills and difficulties appear to be centred on the autonomy and other associated inter-professional conflicts with the role of the Acute Care Nurse Practitioner. Nurses and doctors identified a need for the Acute Care Nurse Practitioner, but the blurring of boundaries between doctors and nurses can result in inter-professional conflict unless this is addressed prior to the introduction of such advanced practitioners. Relevance to clinical practice. As the role of the emergency nurse diversifies and expands, this study re-affirms the importance of inter-professional collaboration when seeking approval for role expansions in nursing.

  10. Experimental evidence for emergent facilitation: promoting the existence of an invertebrate predator by killing its prey.

    PubMed

    Huss, Magnus; Nilsson, Karin A

    2011-05-01

    1. Recent theoretical insights have shown that predator species may help each other to persist by size-selective foraging on a shared prey. By feeding on a certain prey stage, a predator may induce a compensatory response in another stage of the same prey species, thereby favouring other predators; a phenomenon referred to as emergent facilitation. 2. To test whether emergent facilitation may occur in a natural system, we performed an enclosure experiment where we mimicked fish predation by selectively removing large zooplankton and subsequently following the response of the invertebrate predator Bythotrephes longimanus. 3. Positive responses to harvest were observed in the biomass of juvenile individuals of the dominant zooplankton Holopedium gibberum and in Bythotrephes densities. Hence, by removing large prey, we increased the biomass of small prey, i.e. stage-specific biomass overcompensation was present in the juvenile stage of Holopedium. This favoured Bythotrephes, which preferentially feed on small Holopedium. 4. We argue that the stage-specific overcompensation occurred as a result of increased per capita fecundity of adult Holopedium and as a result of competitive release following harvest. If shown to be common, emergent facilitation may be a major mechanism behind observed predator extinctions and patterns of predator invasions.

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

    PubMed

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

    2016-03-01

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

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

    PubMed

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

    2014-07-01

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

  13. The relationships among personality, social support, and resilience of abused nurses at emergency rooms and psychiatric wards in Taiwan.

    PubMed

    Hsieh, Hsiu-Fen; Chang, Shu-Chen; Wang, Hsiu-Hung

    2017-01-01

    The aim of the authors in this study was to identify factors associated with resilience that helped abused nurses face and cope with violent events. The data for this cross-sectional study were collected from June 2013 to December 2013; 272 participants were recruited from emergency rooms and psychiatric wards in four hospitals in central Taiwan. Among these participants, 230 (84.6%) met the inclusion criterion and completed all questionnaires; 69 (30%) of them reported having experienced only verbal violence; 46 (20%) reported having experienced only physical violence, and 115 (50%) reported having experienced a combination of verbal and physical violence. The following were positively associated with resilience score: having a college education or greater (exp((β)()) = 1.045, p = .018), extraversion (exp((β)()) = 1.012 per unit increase in the score, p < .001), family support (exp((β)()) = 1.004 per unit increase in the score, p = .031), peer support (exp((β)()) = 1.008 per unit increase in the score, p = .006), and lower level of neuroticism (exp((β)()) = 0.983 per unit increase in the score, p < .001); 43.6% of the variance in resilience was explained by the variables assessed. Adequate support and advanced education are important for abused nurses to enhance their resilience.

  14. Intimate partner violence, depressive symptoms, and immigration status: does existing advocacy intervention work on abused immigrant women in the Chinese community?

    PubMed

    Wong, Janet Y H; Tiwari, Agnes; Fong, Daniel Y T; Yuen, K H; Humphreys, Janice; Bullock, Linda

    2013-07-01

    Advocacy intervention has been shown to be efficacious at reducing depressive symptoms in women who suffer from intimate partner violence (IPV). However, the intervention effect among abused immigrant women has not been well studied. This study compares the demographic and psychosocial characteristics between abused immigrant and nonimmigrant women, and evaluates the impact of immigration status on the efficacy of an advocacy intervention in reducing depressive symptoms and improving perceived social support. Two hundred abused Chinese women recruited from a local community center in Hong Kong were randomized to receive either the advocacy intervention or usual care. The advocacy intervention was found to be effective at reducing depressive symptoms and improving social support for abused Chinese nonimmigrant women, but the same effects were not seen for abused immigrant women. The findings provide essential insights into the need for developing targeted and efficacious advocacy interventions for abused immigrant women. Effective services to address abused immigrant women's needs were also suggested.

  15. Existing and emerging high impact invasive species are characterized by higher functional responses than natives.

    PubMed

    Alexander, Mhairi E; Dick, Jaimie T A; Weyl, Olaf L F; Robinson, Tamara B; Richardson, David M

    2014-02-01

    Predicting ecological impacts of invasive species and identifying potentially damaging future invaders are research priorities. Since damage by invaders is characterized by their depletion of resources, comparisons of the 'functional response' (FR; resource uptake rate as a function of resource density) of invaders and natives might predict invader impact. We tested this by comparing FRs of the ecologically damaging 'world's worst' invasive fish, the largemouth bass (Micropterus salmoides), with a native equivalent, the Cape kurper (Sandelia capensis), and an emerging invader, the sharptooth catfish (Clarias gariepinus), with the native river goby (Glossogobius callidus), in South Africa, a global invasion hotspot. Using tadpoles (Hyperolius marmoratus) as prey, we found that the invaders consumed significantly more than natives. Attack rates at low prey densities within invader/native comparisons reflected similarities in predatory strategies; however, both invasive species displayed significantly higher Type II FRs than the native comparators. This was driven by significantly lower prey handling times by invaders, resulting in significantly higher maximum feeding rates. The higher FRs of these invaders are thus congruent with, and can predict, their impacts on native communities. Comparative FRs may be a rapid and reliable method for predicting ecological impacts of emerging and future invasive species.

  16. Hepatitis-B Infections among the Injection Drug Abusers: An Emerging Risk in Public Health, Bangladesh.

    PubMed

    Hossain, K J; Nandi, A K

    2015-10-01

    The objective of the study was to determine the incidence of Hepatitis-B (HBV) infection among the injection drugs abusers (IDUs). The research work was a cross-sectional study. A total of 400 IDUs were selected from July 2012 to June 2013 at the Outpatient Department of the Central Drug Addiction Treatment Center, Tejgaon, Dhaka, Bangladesh. They were selected consecutively following the purposive sampling method on the basis of defined selection criteria. Research instruments were a pre-tested interviewer questionnaire and blood specimen. Results showed that 79.70%(315) of the IDUs were found literate and 20.3%(85) illiterate. In present occupation, majority of them 60.5%(242) had no work and 39.5%(158) specific occupation. The mean age of them was 27.9±6.4 years. In marital status, 46.5%(186) were unmarried, 20.7%(83) married after addiction and 30.3%(121) married before addiction. Majority of the IDUs 75.2%(289) started their addiction with cannabis. In addition to injection drugs use, all of them were multiple drug abusers. In response to the sharing of needle, 35.7%(143) of the IDUs shared needle uncommonly and 64.3%(257) did not shared it at all. Ninety-three percent (372) of them were heterosexual and polygamous having extramarital sex with multiple partners. The quality of sex-partners was wife, friends, brothel & hotel based sex sellers and street sex sellers. Majority of IDUs {82.0%(328)} did not use condom at all and 15.5(62) sold blood several times in their lifetime. Seven percent {7.0%(28)} injection drug abusers had been suffering from hepatitis-B virus (HBV) infection. HBV infection was found to be significantly (p≥0.05) associated with the quality of sex partners and number of sex partners, and age and marital status. There is no significant association with sharing of needle particularly occasional sharing of needle. Altering the behaviors of IDUs, especially their sexual lifestyles, drug habit, using of disposable syringe without sharing of

  17. Gender-related sexual abuse experiences reported by children who were examined in an emergency department.

    PubMed

    Hassan, Mona; Killion, Cheryl; Lewin, Linda; Totten, Vicken; Gary, Faye

    2015-06-01

    The purpose of this study was to examine the experiences of sexual abuse by 95 children of two gender groups to determine differences in their reported sexual exploits by perpetrators. Significant differences between female and male children were reported. Male child-victims experienced more anal penetration by penis (54.5%, 10.7% respectively) and finger (27.3%, 2.7% respectively), however; female child-victims experienced more mouth contact to their genitalia (22.7%, 10.0% respectively) and body kisses (47.9%, 9.1% respectively). A more gender-specific approach could help to facilitate prevention, and produce better outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. The relationship between child maltreatment and substance abuse treatment outcomes among emerging adults and adolescents.

    PubMed

    Garner, Bryan R; Hunter, Brooke D; Smith, Douglas C; Smith, Jane Ellen; Godley, Mark D

    2014-01-01

    Emerging adulthood is the period of greatest risk for problematic substance use. The primary aim of the current study was to examine the relationship between a broad measure of child maltreatment and several key outcomes for a large clinical sample of emerging adults (n = 858) and adolescents (n = 2,697). The secondary aim was to examine the extent to which the relationship between child maltreatment and treatment outcomes differed between emerging adults and adolescents. Multilevel latent growth curve analyses revealed emerging adults and adolescents who experienced child maltreatment reported significantly greater reductions over time on several treatment outcomes (e.g., substance use, substance-related problems, and emotional problems). Overall, analyses did not support differential relationships between child maltreatment and changes over time in these substance use disorder treatment outcomes for emerging adults and adolescents. The one exception was that although emerging adults with child maltreatment did reduce their HIV risk over time, their improvements were not as great as were the improvements in HIV risk reported by adolescents who had experienced child maltreatment.

  19. The Relationship Between Child Maltreatment and Substance Abuse Treatment Outcomes Among Emerging Adults and Adolescents

    PubMed Central

    Garner, Bryan R.; Hunter, Brooke D.; Smith, Douglas C.; Smith, Jane Ellen; Godley, Mark D.

    2015-01-01

    Emerging adulthood is the period of greatest risk for problematic substance use. The primary aim of the current study was to examine the relationship between a broad measure of child maltreatment and several key outcomes for a large clinical sample of emerging adults (n = 858) and adolescents (n = 2,697). The secondary aim was to examine the extent to which the relationship between child maltreatment and treatment outcomes differed between emerging adults and adolescents. Multilevel latent growth curve analyses revealed emerging adults and adolescents who experienced child maltreatment reported significantly greater reductions over time on several treatment outcomes (e.g., substance use, substance-related problems, and emotional problems). Overall, analyses did not support differential relationships between child maltreatment and changes over time in these substance use disorder treatment outcomes for emerging adults and adolescents. The one exception was that although emerging adults with child maltreatment did reduce their HIV risk over time, their improvements were not as great as were the improvements in HIV risk reported by adolescents who had experienced child maltreatment. PMID:25125233

  20. Existing and emerging technologies that exploit sulfur cycling bacteria in subsurface petroleum reservoir microbial communities (Invited)

    NASA Astrophysics Data System (ADS)

    Hubert, C. R.

    2013-12-01

    Fossil fuels remain by far our most important energy resources, providing around 90% of global primary energy supply. In the coming decadal transition between petroleum reliance and a more sustainable energy future we must increasingly view our vital petroleum reserves as microbial ecosystems that can be engineered to responsibly and creatively meet the energy needs of societies worldwide. In this way, the bioenergy agenda must interface with the traditional geoenergy industry and the challenges it faces. Bioengineering and deep biosphere geomicrobiology focus on the ecophysiology and biogeography of microorganisms in subsurface habitats including marine sediments and petroleum reservoirs. Understanding microbial communities in fossil fuel deposits will allow their distribution and catalytic potential to be exploited as geobiotechnologies that target known problem areas including sulfur cycle management related to biodesulfurization of heavy oils and reservoir souring control via nitrate injection, as well as promising emerging directions such as understanding subsurface geofluid dispersal vectors that could enable microbes to be used as bio-indicators in offshore oil and gas exploration. Results related to different research themes within contemporary petroleum geomicrobiology and bioengineering at Newcastle University will be presented with a focus on microorganisms involved in sulfur cycling that are commonly detected in different oil field microbial communities including mesophilic sulfide-oxidizing Epsilonproteobacteria and thermophilic sulfate-reducers belonging to the genus Desulfotomaculum.

  1. A Web-Based Platform for Designing Vaccines against Existing and Emerging Strains of Mycobacterium tuberculosis

    PubMed Central

    Dhanda, Sandeep Kumar; Vir, Pooja; Singla, Deepak; Gupta, Sudheer; Kumar, Shailesh

    2016-01-01

    Development of an effective vaccine against drug-resistant Mycobacterium tuberculosis (Mtb) is crucial for saving millions of premature deaths every year due to tuberculosis. This paper describes a web portal developed for assisting researchers in designing vaccines against emerging Mtb strains using traditional and modern approaches. Firstly, we annotated 59 genomes of Mycobacterium species to understand similarity/dissimilarity between tuberculoid, non-tuberculoid and vaccine strains at genome level. Secondly, antigen-based vaccine candidates have been predicted in each Mtb strain. Thirdly, epitopes-based vaccine candidates were predicted/discovered in above antigen-based vaccine candidates that can stimulate all arms of immune system. Finally, a database of predicted vaccine candidates at epitopes as well at antigen level has been developed for above strains. In order to design vaccine against a newly sequenced genome of Mtb strain, server integrates three modules for identification of strain-, antigen-, epitope-specific vaccine candidates. We observed that 103522 unique peptides (9mers) had the potential to induce an antibody response and/or promiscuous binder to MHC alleles and/or have the capability to stimulate T lymphocytes. In summary, this web-portal will be useful for researchers working on designing vaccines against Mtb including drug-resistant strains. Availability: The database is available freely at http://crdd.osdd.net/raghava/mtbveb/. PMID:27096425

  2. Taking on Substance Abuse in the Emergency Room: One Hospital's SBIRT Story

    ERIC Educational Resources Information Center

    Parker, Gary; Libart, Dane; Fanning, Linda; Higgs, Tracy; Dirickson, Cathy

    2012-01-01

    Screening for alcohol and drugs seems to be gaining traction and is becoming more commonplace in the healthcare setting. With emergency departments often being a point of contact for many individuals needing healthcare services, it makes sense to provide screening for substance misuse within this setting. The purpose of this paper is to share how…

  3. Taking on Substance Abuse in the Emergency Room: One Hospital's SBIRT Story

    ERIC Educational Resources Information Center

    Parker, Gary; Libart, Dane; Fanning, Linda; Higgs, Tracy; Dirickson, Cathy

    2012-01-01

    Screening for alcohol and drugs seems to be gaining traction and is becoming more commonplace in the healthcare setting. With emergency departments often being a point of contact for many individuals needing healthcare services, it makes sense to provide screening for substance misuse within this setting. The purpose of this paper is to share how…

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

    PubMed

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

    2016-06-08

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

  5. [Detection of child abuse: missed opportunities in emergency rooms in Rio de Janeiro, Brazil].

    PubMed

    Moura, Anna Tereza Miranda Soares de; Moraes, Claudia Leite; Reichenheim, Michael Eduardo

    2008-12-01

    Emergency rooms require special consideration since their often-distressful routines may hamper the detection and handling of family violence cases. This study estimated the magnitude of violence against children reported by users of two emergency hospitals in Rio de Janeiro, Brazil. It also evaluated the degree of underreporting by contrasting the present findings to cases reported routinely. 524 parents/guardians of children under 12 treated at the hospitals from January to March 2005 were interviewed. Twelve-month prevalence of family violence was measured with the Conflict Tactics Scales: Parent-Child (CTSPC). All cases reported by staff and officially recorded in the preceding year were identified. Prevalence of psychological aggression, negligence, and physical violence were 94.8% (95%CI: 92.9-96.2), 60.3% (95%CI: 55.9-64.7), and 47.2% (95%CI: 42.7-51.8), respectively. However, the corresponding prevalence rates according to routinely reported information were 0.007% (95%CI: 0.003-0.013), 0.24% (95%CI: 0.22-0.27), and 0.03% (95%CI: 0.02-0.04). This striking difference suggests that case identification and strategies to report violence against children in emergency rooms need to be reevaluated.

  6. [Acquired drives. The cortical mechanism responsible to the emergence and development of social existence].

    PubMed

    József, Knoll

    2007-10-01

    when any group of cortical neurons will be influenced by enhancer substances on the level already inseparable from conscious perception. Thus, as the totality of the cortical neurons belonging to Group 3 or 4 works continuously on an unconscious level, there is a steadily operating, chaotic background noise in the human telencephalon. Even in the active state ("fight or flight" behavior, goal-seeking), when the actually dominant drive determines the rational goal to be reached, the noise is suppressed, but cannot cease to exist. But it never endangers the function of the actually dominant innate or acquired drive. From this situation it follows that the rational brain activity is necessarily amalgamated with an irrational brain activity and we live through every moment of our life experiencing the totality of order and chaos in our brain. Human society the maintenance of which has always required the proper manipulation of the brain of its members still finds itself in a state of development. It seeks its final equilibrium: namely, that state in which behavioral modification induced by the home/school/society triad will be based, from birth until death, on the exact knowledge of the natural laws that keep the brain and its self going. In this way, members of the community will understand that simultaneity of order and chaos in their brain is the physiological reality that determines human activity, and will consciously try to find the acquired drives that optimally fit their natural endowments. For the time being those who have been lucky enough to acquire the best fitting drives in due time, in the early uphill period of life, have had fair chances for success and happiness. In contrast, those who for any reason have missed this opportunity will remain frustrated and look for 'ersatz'. It seems reasonable to conclude that order and chaos are of equal importance in our brain. Without the ability to adapt ourselves to the concrete (science), we would not be able to

  7. Sexual Abuse

    MedlinePlus

    Navigation Physical Abuse Sexual Abuse Domestic Violence Psychological Abuse Financial Abuse Neglect Critical Issues What Communities Can Do The Role of Professionals and Concerned Citizens Help for Victims ...

  8. Physical Abuse

    MedlinePlus

    Navigation Physical Abuse Sexual Abuse Domestic Violence Psychological Abuse Financial Abuse Neglect Critical Issues What Communities Can Do The Role of Professionals and Concerned Citizens Help for Victims ...

  9. Elder Abuse and Substance Abuse

    MedlinePlus

    ... to: What is Elder Abuse? Elder Abuse and Substance Abuse Substance abuse has been identified as the most frequently cited ... victim and/or the perpetrator who has the substance abuse problem. Substance abuse is believed to be a ...

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

    PubMed

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

    2014-12-01

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

  11. Prognosis for Emergency Physician with substance abuse recovery: 5-year outcome study.

    PubMed

    Rose, John S; Campbell, Michael; Skipper, Gregory

    2014-02-01

    Emergency physicians (EPs) are reported to have a higher rate of substance use disorder (SUD) than most specialties, although little is known about their prognosis. We examined the outcomes of emergency physician compared to other physicians in the treatment of substance use disorders in Physician Health Programs (PHP). This study used the dataset from a 5-year, longitudinal, cohort study involving 904 physicians with diagnoses of SUD consecutively admitted to one of 16 state PHPs between 1995 and 2001. We compared 56 EPs to 724 other physicians. Main outcome variables were rates of relapse, successful completion of monitoring, and return to clinical practice. EPs had a higher than expected rate of SUD (odds ratio [OR] 2.7 confidence interval [CI]: 2.1-3.5, p<0.001). Half of each group (49% of EPs and 50% of the others) enrolled in a PHP due to alcohol-related problems. Over a third of each group (38% of EPs and 34% of the others) enrolled due to opioid use. During monitoring by the PHPs, 13% of EPs had at least one positive drug test compared to 22% of the other physicians; however, this difference was not significant (p=0.13). At the end of the 5-year follow-up period, 71% of EPs and 64% of other physicians had completed their contracts and were no longer required to be monitored (OR 1.4 [CI: 0.8-2.6], p = 0.31). The study found that the proportion of EPs (84%) continuing their medical practice was generally as high as that of other physicians (72%) (OR 2.0 [CI: 1.0-4.1], p = 0.06). In the study EPs did very well in the PHPs with an 84% success rate in completion and return to clinical practice at 5 years. Of the 3 outcome variables measured, rates of relapse, successful completion of monitoring, and return to clinical practice, EPs had a high rate of success on all variables compared to the other physician cohort. These data support the conclusion that EM physicians do well following treatment of SUD with monitoring in PHPs and generally return to the practice

  12. [Child abuse].

    PubMed

    V Essen, H; Schlickewei, W; Dietz, H-G

    2005-02-01

    Child abuse is most often diagnosed by an emergency doctor on call who sometimes "feels" more than knows what he is confronted with. He should nevertheless always take a medical history and make a physical and radiological examination. X-ray imaging and an ophthalmologic retinal examination are the most important diagnostic steps. Typical findings are multiple and/or dorsal rib fractures, complex skull fractures, physeal fractures, all fractures within the first 12 months, multiple fractures in different localisations and stages of healing, all injuries with uncommon distributions, all patterned bruises, immersion burns, intramural hematoma and every unexplained loss of consciousness. The first step towards victim protection is always the removal of the abused child from its caregivers by admitting it to hospital, as 95% of all cases of reported child abuse take place within the child's family.

  13. Can we better use existing and emerging computing hardware to embed activity coefficient predictions in complex atmospheric aerosol models?

    NASA Astrophysics Data System (ADS)

    Topping, David; Alibay, Irfan; Ruske, Simon; Hindriksen, Vincent; Noisternig, Michael

    2016-04-01

    To predict the evolving concentration, chemical composition and ability of aerosol particles to act as cloud droplets, we rely on numerical modeling. Mechanistic models attempt to account for the movement of compounds between the gaseous and condensed phases at a molecular level. This 'bottom up' approach is designed to increase our fundamental understanding. However, such models rely on predicting the properties of molecules and subsequent mixtures. For partitioning between the gaseous and condensed phases this includes: saturation vapour pressures; Henrys law coefficients; activity coefficients; diffusion coefficients and reaction rates. Current gas phase chemical mechanisms predict the existence of potentially millions of individual species. Within a dynamic ensemble model, this can often be used as justification for neglecting computationally expensive process descriptions. Indeed, on whether we can quantify the true sensitivity to uncertainties in molecular properties, even at the single aerosol particle level it has been impossible to embed fully coupled representations of process level knowledge with all possible compounds, typically relying on heavily parameterised descriptions. Relying on emerging numerical frameworks, and designed for the changing landscape of high-performance computing (HPC), in this study we show that comprehensive microphysical models from single particle to larger scales can be developed to encompass a complete state-of-the-art knowledge of aerosol chemical and process diversity. We focus specifically on the ability to capture activity coefficients in liquid solutions using the UNIFAC method, profiling traditional coding strategies and those that exploit emerging hardware.

  14. Can EO afford big data - an assessment of the temporal and monetary costs of existing and emerging big data workflows

    NASA Astrophysics Data System (ADS)

    Clements, Oliver; Walker, Peter

    2014-05-01

    The cost of working with extremely large data sets is an increasingly important issue within the Earth Observation community. From global coverage data at any resolution to small coverage data at extremely high resolution, the community has always produced big data. This will only increase as new sensors are deployed and their data made available. Over time standard workflows have emerged. These have been facilitated by the production and adoption of standard technologies. Groups such as the International Organisation for Standardisation (ISO) and the Open Geospatial Consortium (OGC) have been a driving force in this area for many years. The production of standard protocols and interfaces such as OPeNDAP, Web Coverage Service (WCS), Web Processing Service (WPS) and the newer emerging standards such as Web Coverage Processing Service (WCPS) have helped to galvanise these workflows. An example of a traditional workflow, assume a researcher wants to assess the temporal trend in chlorophyll concentration. This would involve a discovery phase, an acquisition phase, a processing phase and finally a derived product or analysis phase. Each element of this workflow has an associated temporal and monetary cost. Firstly the researcher would require a high bandwidth connection or the acquisition phase would take too long. Secondly the researcher must have their own expensive equipment for use in the processing phase. Both of these elements cost money and time. This can make the whole process prohibitive to scientists from the developing world or "citizen scientists" that do not have the processing infrastructure necessary. The use of emerging technologies can help improve both the monetary and time costs associated with these existing workflows. By utilising a WPS that is hosted at the same location as the data a user is able to apply processing to the data without needing their own processing infrastructure. This however limits the user to predefined processes that are made

  15. A survey of existing and emerging technologies for external detection of liquid leaks at the Hanford Site

    SciTech Connect

    Lewis, R.E.; Teel, S.S.

    1994-10-01

    During the history of the Hanford Site, many structures were built that stored and transported liquids used for the production mission; some of these structures are still active. Active structures include underground storage tanks retention basins, and pipes and pipelines. Many of the liquids stored and transported in these structures are potentially hazardous to human health and the environment. Any leakage of liquids from active structures, has the added potential to mobilize contaminants in the unsaturated zone. Therefore, it is beneficial to monitor these structures for leaks. The purpose of tills report is to catalog existing and emerging technologies that have potential for the external monitoring of liquid leaks. The report will focus primarily on the needs at the Hanford Site tank farms that are located in the 200 Areas, but will also be relevant to other Hanford Site facilities. Leak detection systems, both external and internal, are currently used at some Hanford facilities. This report focuses on the detection of leaks as they migrate into the soils surrounding the facilities.

  16. Existence and functionality of emergency obstetric care services at district level in Kenya: theoretical coverage versus reality.

    PubMed

    Echoka, Elizabeth; Kombe, Yeri; Dubourg, Dominique; Makokha, Anselimo; Evjen-Olsen, Bjørg; Mwangi, Moses; Byskov, Jens; Olsen, Øystein Evjen; Mutisya, Richard

    2013-03-25

    The knowledge on emergency obstetric care (EmOC) is limited in Kenya, where only partial data from sub-national studies exist. The EmOC process indicators have also not been integrated into routine health management information system to monitor progress in safe motherhood interventions both at national and lower levels of the health system. In a country with a high maternal mortality burden, the implication is that decision makers are unaware of the extent of need for life-saving care and, therefore, where to intervene. The objective of the study was to assess the actual existence and functionality of EmOC services at district level. This was a facility-based cross-sectional study. Data were collected from 40 health facilities offering delivery services in Malindi District, Kenya. Data presented are part of the "Response to accountable priority setting for trust in health systems" (REACT) study, in which EmOC was one of the service areas selected to assess fairness and legitimacy of priority setting in health care. The main outcome measures in this study were the number of facilities providing EmOC, their geographical distribution, and caesarean section rates in relation to World Health Organization (WHO) recommendations. Among the 40 facilities assessed, 29 were government owned, seven were private and four were voluntary organisations. The ratio of EmOC facilities to population size was met (6.2/500,000), compared to the recommended 5/500,000. However, using the strict WHO definition, none of the facilities met the EmOC requirements, since assisted delivery, by vacuum or forceps was not provided in any facility. Rural-urban inequities in geographical distribution of facilities were observed. The facilities were not providing sufficient life-saving care as measured by caesarean section rates, which were below recommended levels (3.7% in 2008 and 4.5% in 2009). The rates were lower in the rural than in urban areas (2.1% vs. 6.8%; p < 0.001 ) in 2008 and (2.7% vs

  17. Existence and functionality of emergency obstetric care services at district level in Kenya: theoretical coverage versus reality

    PubMed Central

    2013-01-01

    Background The knowledge on emergency obstetric care (EmOC) is limited in Kenya, where only partial data from sub-national studies exist. The EmOC process indicators have also not been integrated into routine health management information system to monitor progress in safe motherhood interventions both at national and lower levels of the health system. In a country with a high maternal mortality burden, the implication is that decision makers are unaware of the extent of need for life-saving care and, therefore, where to intervene. The objective of the study was to assess the actual existence and functionality of EmOC services at district level. Methods This was a facility-based cross-sectional study. Data were collected from 40 health facilities offering delivery services in Malindi District, Kenya. Data presented are part of the “Response to accountable priority setting for trust in health systems” (REACT) study, in which EmOC was one of the service areas selected to assess fairness and legitimacy of priority setting in health care. The main outcome measures in this study were the number of facilities providing EmOC, their geographical distribution, and caesarean section rates in relation to World Health Organization (WHO) recommendations. Results Among the 40 facilities assessed, 29 were government owned, seven were private and four were voluntary organisations. The ratio of EmOC facilities to population size was met (6.2/500,000), compared to the recommended 5/500,000. However, using the strict WHO definition, none of the facilities met the EmOC requirements, since assisted delivery, by vacuum or forceps was not provided in any facility. Rural–urban inequities in geographical distribution of facilities were observed. The facilities were not providing sufficient life-saving care as measured by caesarean section rates, which were below recommended levels (3.7% in 2008 and 4.5% in 2009). The rates were lower in the rural than in urban areas (2.1% vs. 6

  18. Developmental pathways to adolescent cannabis abuse and dependence: child maltreatment, emerging personality, and internalizing versus externalizing psychopathology.

    PubMed

    Oshri, Assaf; Rogosch, Fred A; Burnette, Mandi L; Cicchetti, Dante

    2011-12-01

    Child maltreatment is strongly associated with adolescent psychopathology and substance abuse and dependence. However, developmental processes unfolding from childhood into adolescence that delineate this trajectory are not well understood. The current study used path analysis in a structural equation modeling framework to examine multiple mediator models, including ego control, ego resiliency, and internalizing and externalizing symptoms to investigate this developmental process. Participants were 415 children, assessed across 3 waves of data, (i.e., at ages 7 to 9, 10 to 12, and 13 to 15). The sample included maltreated (n = 259) and nonmaltreated (n = 156) children; groups were comparable in sociodemographic characteristics. Findings support an transactional-ecological model by revealing a developmental sequence in which severity of early childhood maltreatment potentiates less adaptive childhood personality functioning, followed by externalizing problems in preadolescence, and ultimately adolescent cannabis abuse and dependence symptoms. A developmental pathway from child maltreatment to adolescent cannabis abuse and dependence symptoms via personality and preadolescent internalizing problems was not supported. Understanding developmental pathways by which maltreatment experiences increase risk for substance abuse and dependence symptoms in youth has far-reaching implications for the treatment and prevention of substance use disorders.

  19. Developmental Pathways to Adolescent Cannabis Abuse and Dependence: Child Maltreatment, Emerging Personality, and Internalizing versus Externalizing Psychopathology

    PubMed Central

    Oshri, Assaf; Rogosch, Fred A.; Burnette, Mandi; Cicchetti, Dante

    2011-01-01

    Child maltreatment is strongly associated with adolescent psychopathology and substance abuse and dependence (Clark, Thatcher, & Martin, 2010; Ellis & Wolfe, 2009). However, developmental processes unfolding from childhood into adolescence that delineate this trajectory are not well understood. The current study uses path analysis in a structural equation modeling framework to examine multiple mediator models, including ego control, ego resiliency, and internalizing and externalizing symptoms to investigate this developmental process. Participants were 415 children, assessed across three waves of data, (i.e., at ages 7 to 9, 10 to 12, and 13 to 15). The sample included maltreated (n = 259) and nonmaltreated (n = 156) children; groups were comparable in sociodemographic characteristics. Findings support an ecological-transactional model by revealing a developmental sequence in which severity of early childhood maltreatment potentiates less adaptive childhood personality functioning, followed by externalizing problems in preadolescence, and ultimately adolescent cannabis abuse and dependence symptoms. A developmental pathway from child maltreatment to adolescent cannabis abuse and dependence symptoms via personality and preadolescent internalizing problems was not supported. Understanding developmental pathways by which maltreatment experiences increase risk for substance abuse and dependence symptoms in youth has far-reaching implications for the treatment and prevention of substance use disorders. PMID:21534646

  20. Prenatal Exposure to Substances of Abuse: An Evaluation of the Drug Free Schools and Communities Act Emergency Grants Program.

    ERIC Educational Resources Information Center

    New York City Board of Education, Brooklyn, NY. Office of Research, Evaluation, and Assessment.

    A program was developed and implemented to train early childhood educators in two New York City school districts in how to identify and refer students who have been prenatally exposed to drugs or alcohol. Two substance abuse prevention and intervention specialists implemented the program, training 88 teachers in 4 schools. At the end of the…

  1. 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…

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

    PubMed

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

    2016-03-01

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

  3. Schizophrenia and substance abuse.

    PubMed

    Smith, J; Hucker, S

    1994-07-01

    Recent research from North America has demonstrated higher than expected rates of drug and alcohol abuse among the seriously mentally ill. Schizophrenics appear to be particularly susceptible to the negative effects of substance abuse. These include psychiatric and social complications, with antisocial behaviour, particularly violence emerging as one of the most worrying features. This review examines the strength of the association and explores the possible explanations for the apparent link between schizophrenia, substance abuse and violence. The literature was searched using Medline, supplemented with a manual literature search. Very few articles specifically approached the problem of violence among substance abusing schizophrenics, but over 80 papers were identified which were helpful in exploring the link between dangerous behaviour and substance abuse by schizophrenics. While there is circumstantial evidence to support the hypothesis that schizophrenics who abuse drugs or alcohol are at an increased risk of behaving violently, longitudinal studies are required to facilitate a better understanding of the mediating mechanisms.

  4. Does racism harm health? Did child abuse exist before 1962? On explicit questions, critical science, and current controversies: an ecosocial perspective.

    PubMed

    Krieger, Nancy

    2008-09-01

    Research on racism as a harmful determinant of population health is in its infancy. Explicitly naming a long-standing problem long recognized by those affected, this work has the potential to galvanize inquiry and action, much as the 1962 publication of the Kempe et al. scientific article on the "battered child syndrome" dramatically increased attention to-and prompted new research on-the myriad consequences of child abuse, a known yet neglected social phenomenon. To further work on connections between racism and health, the author addresses 3 interrelated issues: (1) links between racism, biology, and health; (2) methodological controversies over how to study the impact of racism on health; and (3) debates over whether racism or class underlies racial/ethnic disparities in health.

  5. Does racism harm health? Did child abuse exist before 1962? On explicit questions, critical science, and current controversies: an ecosocial perspective.

    PubMed

    Krieger, Nancy

    2003-02-01

    Research on racism as a harmful determinant of population health is in its infancy. Explicitly naming a long-standing problem long recognized by those affected, this work has the potential to galvanize inquiry and action, much as the 1962 publication of the Kempe et al. scientific article on the "battered child syndrome" dramatically increased attention to-and prompted new research on-the myriad consequences of child abuse, a known yet neglected social phenomenon. To further work on connections between racism and health, the author addresses 3 interrelated issues: (1) links between racism, biology, and health; (2) methodological controversies over how to study the impact of racism on health; and (3) debates over whether racism or class underlies racial/ethnic disparities in health.

  6. Elder Abuse

    MedlinePlus

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

  7. Drug Abuse

    MedlinePlus

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

  8. Child Abuse

    MedlinePlus

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

  9. The Satanic Ritual Abuse Controversy.

    ERIC Educational Resources Information Center

    Putnam, Frank W.

    1991-01-01

    The issues raised by Jonker and Jonker-Bakker and Young et al (EC 601 187-188) illustrate a major controversy dividing the child abuse community, the alleged existence of a conspiracy of satanic, ritual, sexual abuse of children. No evidence is found to support claims that large numbers of babies and children are being sacrificed or abused in…

  10. The contribution of health anxiety to retrospectively-recalled emergency department visits within a sample of patients in residential substance abuse treatment.

    PubMed

    Fergus, Thomas A; Bardeen, Joseph R; Gratz, Kim L; Fulton, Jessica J; Tull, Matthew T

    2015-01-01

    With the burden of emergency department (ED) use increasing, research examining the factors associated with ED visits among individuals who use the ED most frequently is needed. Given that substance use is strongly linked to ED visits, this study sought to examine the factors associated with greater ED visits among patients with substance use disorders (SUD). More precisely, we examined whether health anxiety incrementally contributes to the prediction of ED visits for medical care among adult patients (N = 118) in a residential substance abuse disorder treatment facility. As predicted, health anxiety was significantly positively correlated with ED visits during the past year. Furthermore, health anxiety remained a significant predictor of ED visits after accounting for sociodemographic variables, frequency of substance use, and physical health status. These results suggest that health anxiety may contribute to increased ED visits for medical care among individuals with SUD.

  11. Interaction between an emerging flux region and a pre-existing fan-spine dome observed by IRIS and SDO

    NASA Astrophysics Data System (ADS)

    Jiang, Fayu; Zhang, Jun; Yang, Shuhong

    2016-04-01

    We present multi-wavelength observations of a fan-spine dome in the active region NOAA 11996 with the Interface Region Imaging Spectrograph (IRIS) and the Atmospheric Imaging Assembly on board the Solar Dynamics Observatory (SDO) on March 9, 2014. The destruction of the fan-spine topology owing to the interaction between its magnetic fields and an nearby emerging flux region (EFR) is firstly observed. The line-of-sight magnetograms from the Helioseismic and Magnetic Imager on board the SDO reveal that the dome is located on the mixed magnetic fields, with its rim rooted in the redundant positive polarity surrounding the minority parasitic negative fields. The fan surface of the dome consists of a filament system and recurring jets are observed along its spine. The jet occurring around 13:54 UT is accompanied with a quasi-circular ribbon that brightens in the clockwise direction along the bottom rim of the dome, which may indicate an occurrence of slipping reconnection in the fan-spine topology. The EFR emerges continuously and meets with the magnetic fields of the dome. Magnetic cancellations take place between the emerging negative polarity and the outer positive polarity of the dome's fields, which lead to the rise of the loop connecting the EFR and brightenings related to the dome. A single Gaussian fit to the profiles of the IRIS SI IV 1394 Å line is used in the analysis. It appears that there are two rising components along the slit, except for the rise in the line-of-sight direction. The cancellation process repeats again and again. Eventually the fan-spine dome is destroyed and a new connectivity is formed. We suggest that magnetic reconnection between the EFR and the magnetic fields of the fan-spine dome in the process is responsible for the destruction of the dome.

  12. Comparison of dehydroepiandrosterone (DHEA) and pregnanolone with existing pharmacotherapies for alcohol abuse on ethanol- and food-maintained responding in male rats.

    PubMed

    Hulin, Mary W; Lawrence, Michelle N; Amato, Russell J; Weed, Peter F; Winsauer, Peter J

    2015-03-01

    The present study compared two putative pharmacotherapies for alcohol abuse and dependence, dehydroepiandrosterone (DHEA) and pregnanolone, with two Food and Drug Administration (FDA)-approved pharmacotherapies, naltrexone and acamprosate. Experiment 1 assessed the effects of different doses of DHEA, pregnanolone, naltrexone, and acamprosate on both ethanol- and food-maintained responding under a multiple fixed-ratio (FR)-10 FR-20 schedule, respectively. Experiment 2 assessed the effects of different mean intervals of food presentation on responding for ethanol under a FR-10 variable-interval (VI) schedule, whereas Experiment 3 assessed the effects of a single dose of each drug under a FR-10 VI-80 schedule. In Experiment 1, all four drugs dose-dependently decreased response rate for both food and ethanol, although differences in the rate-decreasing effects were apparent among the drugs. DHEA and pregnanolone decreased ethanol-maintained responding more potently than food-maintained responding, whereas the reverse was true for naltrexone. Acamprosate decreased responding for both reinforcers with equal potency. In Experiment 2, different mean intervals of food presentation significantly affected the number of food reinforcers obtained per session; however, changes in the number of food reinforcements did not significantly affect responding for ethanol. Under the FR-10 VI-80 schedule in Experiment 3, only naltrexone significantly decreased both the dose of alcohol presented and blood ethanol concentration (BEC). Acamprosate and pregnanolone had no significant effects on any of the dependent measures, whereas DHEA significantly decreased BEC, but did not significantly decrease response rate or the dose presented. In summary, DHEA and pregnanolone decreased ethanol-maintained responding more potently than food-maintained responding under a multiple FR-10 FR-20 schedule, and were more selective for decreasing ethanol self-administration than either naltrexone or

  13. Comparison of dehydroepiandrosterone (DHEA) and pregnanolone with existing pharmacotherapies for alcohol abuse on ethanol- and food-maintained responding in male rats

    PubMed Central

    Hulin, Mary W.; Lawrence, Michelle N.; Amato, Russell J.; Weed, Peter F.; Winsauer, Peter J.

    2015-01-01

    The present study compared two putative pharmacotherapies for alcohol abuse and dependence, dehydroepiandrosterone (DHEA) and pregnanolone, with two Food and Drug Administration (FDA)-approved pharmacotherapies, naltrexone and acamprosate. Experiment 1 assessed the effects of different doses of DHEA, pregnanolone, naltrexone, and acamprosate on both ethanol- and food-maintained responding under a multiple fixed-ratio (FR)-10 FR-20 schedule, respectively. Experiment 2 assessed the effects of different mean intervals of food presentation on responding for ethanol under an FR-10 variable-interval (VI) schedule, whereas Experiment 3 assessed the effects of a single dose of each drug under a FR-10 VI-80 schedule. In Experiment 1, all four drugs dose-dependently decreased response rate for both food and ethanol, although differences in the rate-decreasing effects were apparent among the drugs. DHEA and pregnanolone decreased ethanol-maintained responding more potently than food-maintained responding, whereas the reverse was true for naltrexone. Acamprosate decreased responding for both reinforcers with equal potency. In Experiment 2, different mean intervals of food presentation significantly affected the number of food reinforcers obtained per session; however, changes in the number of food reinforcements did not significantly affect responding for ethanol. Under the FR-10 VI-80 schedule in Experiment 3, only naltrexone significantly decreased both the dose of alcohol presented and blood ethanol concentration (BEC). Acamprosate and pregnanolone had no significant effects on any of the dependent measures, whereas DHEA significantly decreased BEC, but did not significantly decrease response rate or the dose presented. In summary, DHEA and pregnanolone decreased ethanol-maintained responding more potently than food-maintained responding under a multiple FR-10 FR-20 schedule, and were more selective for decreasing ethanol self-administration than either naltrexone or

  14. Psychological Distress in Abused, Chemically Dependent Adolescents.

    ERIC Educational Resources Information Center

    Cavaiola, Alan A.; Schiff, Matthew M.

    2000-01-01

    Study assessed whether differences exist in levels of psychological distress in abused, chemically dependent adolescents when compared to non-abused counterparts, and non-abused, non-chemically dependent adolescents. Results indicated abused adolescents demonstrated more severe levels of distress, and earlier onset of alcohol and drug use.…

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  17. Integration of an Emerging Highly Sensitive Optical CO2 Sensor for Ocean Monitoring on an Existing Data Acquisition System SeaKeeper 1000 (trademark)

    DTIC Science & Technology

    2012-09-30

    be deployed in geat numbers to autonomously monitor the overall patterns of CO2 emissions and ocean acidification . OBJECTIVES  Meet the...Integration of an Emerging Highly Sensitive Optical CO2 Sensor for Ocean Monitoring on an Existing Data Acquisition System SeaKeeper 1000TM Annual...challenging requirements for ocean pCO2 monitoring using an innovative sensor design based on high sensitivity fluorescence detection.  Assemble the system

  18. Integration of an Emerging Highly Sensitive Optical CO2 Sensor for Ocean Monitoring on an Existing Data Acquisition System SeaKeeper 1000(TM)

    DTIC Science & Technology

    2011-09-30

    be deployed in geat numbers to autonomously monitor the overall patterns of CO2 emissions and ocean acidification . OBJECTIVES  Meet the...Integration of an Emerging Highly Sensitive Optical CO2 Sensor for Ocean Monitoring on an Existing Data Acquisition System SeaKeeper 1000TM Annual...challenging requirements for ocean pCO2 monitoring using an innovative sensor design based on high sensitivity fluorescence detection.  Assemble the system

  19. Inhalant abuse.

    PubMed

    Williams, Janet F; Storck, Michael

    2007-05-01

    Inhalant abuse is the intentional inhalation of a volatile substance for the purpose of achieving an altered mental state. As an important, yet-underrecognized form of substance abuse, inhalant abuse crosses all demographic, ethnic, and socioeconomic boundaries, causing significant morbidity and mortality in school-aged and older children. This clinical report reviews key aspects of inhalant abuse, emphasizes the need for greater awareness, and offers advice regarding the pediatrician's role in the prevention and management of this substance abuse problem.

  20. Women's experience of being interviewed about abuse: a qualitative systematic review.

    PubMed

    Snyder, B L

    2016-11-01

    WHAT IS KNOWN ON THE SUBJECT?: There is disagreement about the costs and benefits of asking women about their abuse experiences in practice and research settings. No known meta-syntheses have been conducted to evaluate the qualitative data that exist on the experiences of women being asked about their abuse. WHAT THIS PAPER ADDS TO THE EXISTING KNOWLEDGE?: This review adds robust qualitative evidence that interviewing women about their abuse experiences can be a beneficial and healing experience for them. Mental health nurses are in an ideal position to create a therapeutic environment to interview women about their abuse experiences. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses are strongly encouraged to ask about and document abuse in all of their interviews and assessments, as well as act as advocates and discuss reported abuse within their interdisciplinary teams, to provide individualized, trauma-informed care. The mental health nurse should listen attentively, avoid judgement, offer reassurance, make appropriate referrals and provide resources for women, including those with both past and current abuse histories. Nurses are strongly encouraged to ask about abuse in all settings in which they encounter women, including in psychiatric and mental health settings. Introduction Collections of quantitative data exist outlining the costs and benefits of asking female research participants about their abuse experiences; however, no known meta-syntheses have been conducted to evaluate the qualitative data that exist on the experiences of women being asked about their abuse. Aim/Question The purpose of this qualitative systematic review was to analyse and interpret qualitative findings regarding asking women about their abuse experiences with the intention of understanding risks and benefits. Method The sample (N = 11) was derived from an expansive search of peer-reviewed literature using multidisciplinary electronic databases. Qualitative findings

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

    DTIC Science & Technology

    2006-03-01

    as family violence and substance abuse . This study advances existing research by using the Army’s unique data resources to simultaneously study...experiencing violence and/or substance abuse and establish best practices for coordinating multiple service delivery for these families. Researchers...hypothesize significant overlap of child abuse , spouse abuse , and/or substance abuse in Army families experiencing violence , and that Army and civilian

  2. Predictors of Return Visits Among Insured Emergency Department Mental Health and Substance Abuse Patients, 2005–2013

    PubMed Central

    Lee, Sangil; Herrin, Jeph; Bobo, William V.; Johnson, Ryan; Sangaralingham, Lindsey R.; Campbell, Ronna L.

    2017-01-01

    Introduction Our goal was to describe the pattern and identify risk factors of early-return ED visits or inpatient admissions following an index mental health and substance abuse (MHSA)-related ED visit in the United States. Methods We performed a retrospective cohort study using Optum Labs Data Warehouse, a nationally representative database containing administrative claims data on privately insured and Medicare Advantage enrollees. Authors identified patients presenting to an ED with a primary diagnosis of MHSA between 2005 and 2013 who were discharged home. Study inclusion required continuous insurance enrollment for the 12 months preceding and the 31 days following the index ED visit. During the study period we included only the first ED visit for each patient. Results A total of 49,672 (14.2%) had a return visit to the ED or had a hospitalization within 30 days following discharge. Mean time to the next ED visit or inpatient admission was 11.7 days. An increased age (age 65+ vs. age <18 years; OR 1.65, 95% CI [1.57 to 1.74]), chronic medical comorbidities (Hwang comorbidity 5+ vs 0; OR 1.31, 95% CI [1.27 to 1.35]), prior ED and inpatient utilization (4+ visits vs 0 visits; OR 5.59, 95% CI [5.41 to 5.78]) were associated with return visits within 30 days following discharge. Conclusion In an analysis of nearly 350,000 ED visits for MHSA, 14.2 % of patients returned to the ED or hospital within 30 days. This study identified a number of factors associated with return visits for acute care. PMID:28874941

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

    ERIC Educational Resources Information Center

    Villas, Paul

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

  4. Abusive Relationships

    MedlinePlus

    ... relationships and friendships. Emotional abuse (stuff like teasing, bullying, and humiliating others) can be difficult to recognize ... How to Break Up Respectfully Abuse Dealing With Bullying Date Rape Getting Over a Break-Up Posttraumatic ...

  5. Adolescent Abuse.

    ERIC Educational Resources Information Center

    Foreman, Susan; Seligman, Linda

    1983-01-01

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

  6. Substance Abuse Treatment Facility Locator

    MedlinePlus

    ... Phone number Apply Clear Cancel Show per page Substance Abuse & Mental Health Services Emergency Mental Health Services All / ... Reverse   Persons with co-occurring mental and substance abuse disorders   Lesbian, gay, bisexual, or transgender (LGBT) ...

  7. Child Abuse or Osteogenesis Imperfecta?

    MedlinePlus

    Child Abuse or Osteogenesis Imperfecta? A child is brought into the emergency room with a fractured leg. The parents are unable to explain how ... the fractures is not child abuse. It is osteogenesis imperfecta , or OI. OI is a genetic disorder characterized ...

  8. Predicting the Abuse Liability of Entactogen-Class, New and Emerging Psychoactive Substances via Preclinical Models of Drug Self-administration.

    PubMed

    Aarde, Shawn M; Taffe, Michael A

    2016-12-02

    Animal models of drug self-administration are currently the gold standard for making predictions regarding the relative likelihood that a recreational drug substance will lead to continued use and addiction. Such models have been found to have high predictive accuracy and discriminative validity for a number of drug classes including ethanol, nicotine, opioids, and psychostimulants such as cocaine and methamphetamine. Members of the entactogen class of psychostimulants (drugs that produce an "open mind state" including feelings of interpersonal closeness, intimacy and empathy) have been less frequently studied in self-administration models. The prototypical entactogen 3,4-methylenedioxymethamphetamine (MDMA; "Ecstasy") supports self-administration but not with the same consistency nor with the same efficacy as structurally related drugs amphetamine or methamphetamine. Consistent with these observations, MDMA use is more episodic in the majority of those who use it frequently. Nevertheless, substantial numbers of MDMA users will meet the criteria for substance dependence at some point in their use history. This review examines the currently available evidence from rodent self-administration studies of MDMA and two of the new and emerging psychoactive substances (NPS) that produce entactogen type neuropharmacological responses - mephedrone (4-methylmethcathinone; 4MMC; "meow meow") and methylone (3,4-methylenedioxymethcathinone). Overall, the current evidence predicts that these NPS entactogens have enhanced abuse liability compared with MDMA.

  9. Antibiotic resistance and growth of the emergent pathogen Escherichia albertii on raw ground beef stored under refrigeration, abuse, and physiological temperature.

    PubMed

    Perez, Keila L; Alam, M Jahangir; Castillo, Alejandro; Taylor, T Matthew

    2013-01-01

    Escherichia albertii is an emerging gram-negative facultative rod that has been implicated in multiple cases of human diarrheal disease, particularly in young children. When biochemical and other typing methods have been used, this organism has often been misidentified due to similarities with other members of the family Enterobacteriaceae. Isolates have been reported to be capable of producing attachment and effacement lesions via the synthesis of intimin, cytolethal distending toxin, and a variant form of Shiga toxin. The purposes of this study were to characterize the antibiotic resistance characteristics and the growth of individual strains of E. albertii on raw ground beef at different storage temperatures. Nalidixic acid-resistant strains of E. albertii were inoculated onto raw ground beef to a target of 4.0 log CFU/g, and samples were then aerobically incubated at 5, 22, or 35°C for various time periods prior to microbiological enumeration of the pathogen on lactose-free MacConkey agar containing 50 mg of nalidixic acid per liter and 0.5% L-rhamnose. Antibiotic resistance was determined using a broth microdilution assay. E. albertii did not grow at 5°C, with populations declining slowly over 14 days of refrigerated storage. Strains of the organism grew well under abusive storage, increasing by 2.5 to 3.1 log CFU/g and 4.1 to 4.3 log CFU/g after 24 h at 22 and 35°C, respectively. All strains were resistant to tetracycline but were sensitive to tested cephalosporins and chloramphenicol. Resistance to penicillin was observed, but susceptibility to other members of the b -lactam group, including ampicillin, amoxicillin, and clavulanic acid, was recorded. E. albertii represents an emerging pathogen with a probable foodborne transmission route. Future research should focus on verifying food process measures able to inactivate the pathogen.

  10. Emergency surgery data and documentation reporting forms for sudden-onset humanitarian crises, natural disasters and the existing burden of surgical disease.

    PubMed

    Burkle, Frederick M; Nickerson, Jason W; von Schreeb, Johan; Redmond, Anthony D; McQueen, Kelly A; Norton, Ian; Roy, Nobhojit

    2012-12-01

    Following large-scale disasters and major complex emergencies, especially in resource-poor settings, emergency surgery is practiced by Foreign Medical Teams (FMTs) sent by governmental and non-governmental organizations (NGOs). These surgical experiences have not yielded an appropriate standardized collection of data and reporting to meet standards required by national authorities, the World Health Organization, and the Inter-Agency Standing Committee's Global Health Cluster. Utilizing the 2011 International Data Collection guidelines for surgery initiated by Médecins Sans Frontières, the authors of this paper developed an individual patient-centric form and an International Standard Reporting Template for Surgical Care to record data for victims of a disaster as well as the co-existing burden of surgical disease within the affected community. The data includes surgical patient outcomes and perioperative mortality, along with referrals for rehabilitation, mental health and psychosocial care. The purpose of the standard data format is fourfold: (1) to ensure that all surgical providers, especially from indigenous first responder teams and others performing emergency surgery, from national and international (Foreign) medical teams, contribute relevant and purposeful reporting; (2) to provide universally acceptable forms that meet the minimal needs of both national authorities and the Health Cluster; (3) to increase transparency and accountability, contributing to improved humanitarian coordination; and (4) to facilitate a comprehensive review of services provided to those affected by the crisis.

  11. Concealment of Child Sexual Abuse in Sports

    ERIC Educational Resources Information Center

    Hartill, Mike

    2013-01-01

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

  12. An Unusual Case of Baclofen Abuse

    PubMed Central

    Das, Soumitra; Palappalllil, Dhanya Sasidharan; Purushothaman, Sumesh Thoppil; Rajan, Varun

    2016-01-01

    Baclofen was initially used for the treatment of spastic conditions. Last decade has seen its emergence as a treatment of profound interest in alcohol dependence, opiates and cocaine abuse, and tobacco addiction. However, the published literature on baclofen abuse is sparse. Here, we report a patient with baclofen abuse. PMID:27833235

  13. Concealment of Child Sexual Abuse in Sports

    ERIC Educational Resources Information Center

    Hartill, Mike

    2013-01-01

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

  14. Inhalant abuse

    PubMed Central

    Baydala, L

    2010-01-01

    Inhalant abuse – also known as volatile substance abuse, solvent abuse, sniffing, huffing and bagging – is the deliberate inhalation of a volatile substance to achieve an altered mental state. Inhalant abuse is a worldwide problem that is especially common in individuals from minority and marginalized populations, and is strongly correlated with the social determinants of health. It often affects younger children, compared with other forms of substance abuse, and crosses social and ethnic boundaries. Inhalants are pharmacologically diverse products that are selected for their low price, legal and widespread availability, and ability to rapidly induce euphoria. Chronic abuse is associated with serious and often irreversible effects. Widespread screening and early referrals to treatment programs have resulted in significant improvements in the mental, physical and social conditions of those affected. The present statement reviews critical aspects of inhalant abuse, highlighting new information and data that pertain to Aboriginal children and youth, and provides recommendations for treatment and prevention. PMID:21886449

  15. Substance Abuse in the Military

    MedlinePlus

    ... Charts Emerging Trends and Alerts Alcohol Club Drugs Cocaine Hallucinogens Heroin Inhalants Marijuana MDMA (Ecstasy/Molly) Methamphetamine ... Drugs Anabolic Steroids Cigarettes and Other Tobacco Products Cocaine Cough and Cold Medicine Abuse Electronic Cigarettes (e- ...

  16. Use of Antiretroviral HIV Post-Exposure Prophylaxis in Sexually Abused Children and Adolescents Treated in an Inner-City Pediatric Emergency Department

    ERIC Educational Resources Information Center

    Fajman, Nancy; Wright, Richelle

    2006-01-01

    Background: In 2002, Georgia had the United States' eighth highest number of persons living with AIDS. Human immunodeficiency virus (HIV) transmission as a result of sexual abuse is uncommon but definitely occurs. In certain circumstances of sexual abuse, antiretroviral post-exposure prophylaxis (ARV-PEP) has been suggested as a means to decrease…

  17. Use of Antiretroviral HIV Post-Exposure Prophylaxis in Sexually Abused Children and Adolescents Treated in an Inner-City Pediatric Emergency Department

    ERIC Educational Resources Information Center

    Fajman, Nancy; Wright, Richelle

    2006-01-01

    Background: In 2002, Georgia had the United States' eighth highest number of persons living with AIDS. Human immunodeficiency virus (HIV) transmission as a result of sexual abuse is uncommon but definitely occurs. In certain circumstances of sexual abuse, antiretroviral post-exposure prophylaxis (ARV-PEP) has been suggested as a means to decrease…

  18. Using molecular similarity to highlight the challenges of routine immunoassay-based drug of abuse/toxicology screening in emergency medicine

    PubMed Central

    Krasowski, Matthew D; Pizon, Anthony F; Siam, Mohamed G; Giannoutsos, Spiros; Iyer, Manisha; Ekins, Sean

    2009-01-01

    Background Laboratory tests for routine drug of abuse and toxicology (DOA/Tox) screening, often used in emergency medicine, generally utilize antibody-based tests (immunoassays) to detect classes of drugs such as amphetamines, barbiturates, benzodiazepines, opiates, and tricyclic antidepressants, or individual drugs such as cocaine, methadone, and phencyclidine. A key factor in assay sensitivity and specificity is the drugs or drug metabolites that were used as antigenic targets to generate the assay antibodies. All DOA/Tox screening immunoassays can be limited by false positives caused by cross-reactivity from structurally related compounds. For immunoassays targeted at a particular class of drugs, there can also be false negatives if there is failure to detect some drugs or their metabolites within that class. Methods Molecular similarity analysis, a computational method commonly used in drug discovery, was used to calculate structural similarity of a wide range of clinically relevant compounds (prescription and over-the-counter medications, illicit drugs, and clinically significant metabolites) to the target ('antigenic') molecules of DOA/Tox screening tests. These results were compared with cross-reactivity data in the package inserts of immunoassays marketed for clinical testing. The causes for false positives for phencyclidine and tricyclic antidepressant screening immunoassays were investigated at the authors' medical center using gas chromatography/mass spectrometry as a confirmatory method. Results The results illustrate three major challenges for routine DOA/Tox screening immunoassays used in emergency medicine. First, for some classes of drugs, the structural diversity of common drugs within each class has been increasing, thereby making it difficult for a single assay to detect all compounds without compromising specificity. Second, for some screening assays, common 'out-of-class' drugs may be structurally similar to the target compound so that they

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

    PubMed

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

    2007-01-01

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

  20. Feasibility of integrating a clinical decision support tool into an existing computerized physician order entry system to increase seasonal influenza vaccination in the emergency department.

    PubMed

    Venkat, Arvind; Chan-Tompkins, Noreen H; Hegde, Gajanan G; Chuirazzi, David M; Hunter, Roger; Szczesiul, Jillian M

    2010-08-23

    While emergency department (ED) seasonal influenza vaccination programs are feasible, reported implementation barriers include added staffing requirements to identify eligible patients and getting busy ED personnel to order and provide vaccination. We present a prospective, observational trial of integrating a clinical decision support tool into an existing ED computerized physician order entry (CPOE) system to increase ED seasonal influenza vaccination without added staffing resources, the operational barriers identified to program implementation, the revenue generated and data on opportunities for future quality improvement. Compared to the comparable pre-protocol period, ED influenza vaccination rose by 17.5% with a resultant profit margin of 34.5%. Copyright 2010 Elsevier Ltd. All rights reserved.

  1. Community characteristics associated with elder abuse.

    PubMed

    Jogerst, G J; Dawson, J D; Hartz, A J; Ely, J W; Schweitzer, L A

    2000-05-01

    To help define the relationship between elder abuse rates and counties' demographics, healthcare resources, and social service characteristics. County-level data from Iowa were analyzed to test the association between county characteristics and rates of elder abuse between 1984 and 1993 using univariate correlation analysis and stagewise linear regression. Ninety-nine counties in Iowa. Iowa residents aged 65 years and older. County-level population-adjusted numbers of abused elderly, abused children, children in poverty, high school dropouts, physicians and other healthcare providers, hospital beds, social workers and caseworkers in the Department of Human Services (DHS). Community characteristics that had a positive association with rates of reported or substantiated elder abuse at the P < .001 level were population density, children in poverty, and reported child abuse. Lower substantiated elder abuse rates were associated at P < .05 with higher community rates of high school dropouts, number of chiropractors, and number of nurse practitioners. After adjusting for number of DHS caseworkers and reported child abuse rates (a surrogate for workload) a district effect persists for substantiated elder abuse cases (P = .002). County demographics are risk factors for reported and substantiated elder abuse. The strongest risk factor for reported elder abuse was reported child abuse. The difference in districts may reflect differences in resources and/or differing characteristics of caseworkers who substantiate elder abuse. The risk factors may reflect conditions that influence the amount of elder abuse or the detection of existing elder abuse.

  2. Development of the scale of economic abuse.

    PubMed

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

    2008-05-01

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

  3. Inhalant Abuse

    MedlinePlus

    ... to every organ over time.Also, if your child abuses inhalants, he or she is likely to try ... How can I start a discussion about inhalant abuse with my child? Other organizationsNational Inhalant Prevention Coalition (NIPC)National Institute ...

  4. Fetal Abuse.

    ERIC Educational Resources Information Center

    Kent, Lindsey; And Others

    1997-01-01

    Five cases of fetal abuse by mothers suffering from depression are discussed. Four of the women had unplanned pregnancies and had considered termination of the pregnancy. Other factors associated with fetal abuse include pregnancy denial, pregnancy ambivalence, previous postpartum depression, and difficulties in relationships. Vigilance for…

  5. Fetal Abuse.

    ERIC Educational Resources Information Center

    Kent, Lindsey; And Others

    1997-01-01

    Five cases of fetal abuse by mothers suffering from depression are discussed. Four of the women had unplanned pregnancies and had considered termination of the pregnancy. Other factors associated with fetal abuse include pregnancy denial, pregnancy ambivalence, previous postpartum depression, and difficulties in relationships. Vigilance for…

  6. Aminorex poisoning in cocaine abusers.

    PubMed

    Karch, Steven B; Mari, Francesco; Bartolini, Viola; Bertol, Elisabetta

    2012-07-26

    Levamisole is found in more than 80% of illicit cocaine seized within United States borders. Percentages are somewhat lower in Europe. In 2009, controlled in vivo studies demonstrated that horses metabolize levamisole to aminorex. Earlier this year our laboratory demonstrated that the same conversion occurs in man. Levamisole itself causes aplastic anemia and numerous reports have begun to appear in the literature, but the conversion of levamisole to aminorex is of much more concern. Aminorex ingestion was responsible for a five-year epidemic (1967-1972) of idiopathic pulmonary hypertension (IPH) confined to Switzerland, Austria, and Germany, the only countries where aminorex had been marketed as an anorectic. The incidence of IPH reverted to normal levels as soon as aminorex was withdrawn. In most cases onset of symptoms in IPH began after six to nine months of aminorex use, with average dosage ranges of 10 to 40 mg per day. The outcome was almost uniformly fatal. The conversion rate of levamisole to aminorex has not been established, but given the high daily intake of cocaine by many abusers, it seems likely that many of them will have ingested enough contaminated cocaine to ultimately cause IPH. Until the disease is well established, the symptoms of IHP are vague, and existing drug registries specifically exclude drug abusers, making it difficult to track these cases. This review is intended to draw attention to what may be a slowly emerging new epidemic.

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    ERIC Educational Resources Information Center

    Sengstock, Mary C.; And Others

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  10. Abusive Relationships

    MedlinePlus

    ... Break Up Respectfully Abuse Sexual Harassment and Sexual Bullying Love and Romance Getting Over a Break-Up Dealing With Bullying Posttraumatic Stress Disorder Sexual Attraction and Orientation Teens ...

  11. Optimization of Installation, Operation and Maintenance at Offshore Wind Projects in the U.S.: Review and Modeling of Existing and Emerging Approaches

    SciTech Connect

    Baldock, Nick; Sevilla, Fernando; Redfern, Robin; Storey, Alexis; Kempenaar, Anton; Elkinton, Chris

    2014-12-19

    The United States Department of Energy (DOE) awarded a grant to GL Garrad Hassan (GL GH) to investigate the logistics, opportunities, and costs associated with existing and emerging installation and operation and maintenance (O&M) activities at offshore wind projects as part of the DOE’s program to reduce barriers facing offshore wind project development in the United States (U.S.). This report (the Report) forms part of Subtopic 5.3 “Optimized Installation, Operation and Maintenance Strategies Study” which in turn is part of the “Removing Market Barriers in U.S. Offshore Wind” set of projects for the DOE. The purpose of Subtopic 5.3 is to aid and facilitate informed decision-making regarding installation and O&M during the development, installation, and operation of offshore wind projects in order to increase efficiency and reduce the levelized cost of energy (LCoE). Given the large area of U.S. territorial waters, the generally higher mean wind speeds offshore, and the proximity to the coast of many large U.S. cities, offshore wind power has the potential to become a significant contributor of energy to U.S. markets. However, for the U.S. to ensure that the development of offshore wind energy projects is carried out in an efficient and cost-effective manner, it is important to be cognizant of the current and emerging practices in both the domestic and international offshore wind energy industries. The U.S. can harness the experience gained globally and combine this with the skills and assets of an already sizeable onshore wind industry, as well as the resources of a mature offshore oil and gas industry, to develop a strong offshore wind sector. The work detailed in this report is aimed at assisting with that learning curve, particularly in terms of offshore specific installation and O&M activities. This Report and the Installation and O&M LCoE Analysis Tool, which were developed together by GL GH as part of this study, allow readers to identify, model

  12. The relationship between abuse and depression.

    PubMed

    Hegarty, Kelsey L

    2011-12-01

    Very strong links exist between abuse and depression in clinical practice. Abuse and depression often coexist in the victims and perpetrators of abuse. In nursing practice, responding to patients, particularly women, presenting with depression or depressive symptoms requires an understanding of the underlying and perhaps hidden issues of abuse and violence. Women who have experienced trauma often are diagnosed with depression, when in fact they have symptoms more consistent with posttraumatic stress disorder. Furthermore, depression often improves over time, when women manage to escape the abuse and violence in the relationship.

  13. Understanding cycles of abuse: A multimotive approach.

    PubMed

    Simon, Lauren S; Hurst, Charlice; Kelley, Ken; Judge, Timothy A

    2015-11-01

    Fundamental to the definition of abusive supervision is the notion that subordinates are often victims of a pattern of mistreatment (Tepper, 2000). However, little research has examined the processes through which such destructive relational patterns emerge. In this study, we draw from and extend the multimotive model of reactions to interpersonal threat (Smart Richman & Leary, 2009) to formulate and test hypotheses about how employees' emotional and behavioral responses may ameliorate or worsen supervisors' abuse. To test this model, we collected 6 waves of data from a sample of 244 employees. Results revealed reciprocal relationships between abusive supervision and both supervisor-directed counterproductive behavior and supervisor-directed avoidance. Whereas the abusive supervision--counterproductive behavior relationship was partially driven by anger, the abusive supervision--avoidance relationship was partially mediated by fear. These findings suggest that some may find themselves in abusive relationships, in part, because their own reactions to mistreatment can, perhaps unknowingly, reinforce abusive behavior.

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

    PubMed

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

    2017-02-01

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

  15. Death of an abuser: does the memory linger on?

    PubMed

    Monahan, Kathleen

    2003-01-01

    Although the fields of bereavement and traumatology regarding childhood physical and sexual abuse have developed simultaneously, little information exists regarding the issues of bereavement for a sexual abuse survivor when the decedent was the abuser. This article is a case study that examines the reactions, themes, and attributions that individuals experience regarding the loss of a relative who was sexually abusive to them during childhood and discusses the impact of that abuse on the bereavement process.

  16. Maid abuse.

    PubMed

    Murty, O P

    2009-07-01

    Domestic maid violence is an assault and coercive behaviour, which mainly includes physical, psychological and at times sexual too, by employer or household members of employer against a person hired as a domestic help. Maid abuse is well known but poorly documented in scientific literature. This is an important global issue. In this article, two illustrated cases of maid abuse are discussed. Their employers allegedly subjected both the victims to physical and psychological trauma. The physical examination of the victims showed poor state of clothing, nutrition, and presence of injuries of different duration. The bruises were irregular to patterned, and were inflicted by beating. Both cases had eczematous contact dermatitis over palms and soles, paronechia, and sub-ungal fungal infection due to unprotected working in wet conditions. In both cases, external ears were deformed like cauliflowers due to repeated trauma. All cases had multiple injuries of varying duration. In this paper, medico-legal and social issues related to maid abuse are also discussed in detail. A possible solution to minimise maid abuse is also suggested. This paper highlights and document maid abuse.

  17. Child Sexual Abuse

    MedlinePlus

    ... Vietnamese Sexual Abuse No. 9; Updated November 2014 Child sexual abuse has been reported up to 80,000 times ... sexual abuse can be devastating to the child. Child sexual abuse can take place within the family, by a ...

  18. Child Sexual Abuse

    MedlinePlus

    ... Enter ZIP code here Enter ZIP code here Child Sexual Abuse Public This section is for Veterans, General Public, Family, & Friends Child Sexual Abuse What is child sexual abuse? Child sexual abuse ...

  19. Shame and guilt in men exposed to childhood sexual abuse: a qualitative investigation.

    PubMed

    Dorahy, Martin J; Clearwater, Ken

    2012-01-01

    This study examined the experiences of shame and guilt in adult males sexually abused as children. Seven participants attending a service for male sexual abuse completed measures of shame, guilt, dissociation, and childhood trauma history and subsequently participated in a focus group. All participants experienced childhood sexual abuse in the "severe" range and showed elevated scores for shame, guilt, and dissociation. Four superordinate themes with associated subordinate themes emerged: (a) self-as-shame (foundations of self-as-shame, fear of exposure, temporary antidote: connection), (b) pervasiveness and power of doubt and denial (from others, from self, consequences of incredulity), (c) uncontrollability (of problems after disclosure, of rage, of intrusions and emotional pain), and (d) dissociation. Results are discussed with reference to the existing literature and the emerging "self-as-shame" construct, which appeared to encapsulate participants' view of themselves.

  20. New drugs of abuse.

    PubMed

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

    2015-02-01

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

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

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 10 2014-01-01 2014-01-01 false Fraud, waste and abuse. 1806.303 Section 1806... BANK ENTERPRISE AWARD PROGRAM Terms and Conditions of Assistance § 1806.303 Fraud, waste and abuse. Any person who becomes aware of the existence or apparent existence of fraud, waste, or abuse of assistance...

  2. 12 CFR 1805.812 - Fraud, waste and abuse.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 10 2014-01-01 2014-01-01 false Fraud, waste and abuse. 1805.812 Section 1805..., waste and abuse. Any person who becomes aware of the existence or apparent existence of fraud, waste or abuse of assistance provided under this part should report such incidences to the Office of Inspector...

  3. 12 CFR 1805.812 - Fraud, waste and abuse.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 7 2011-01-01 2011-01-01 false Fraud, waste and abuse. 1805.812 Section 1805..., waste and abuse. Any person who becomes aware of the existence or apparent existence of fraud, waste or abuse of assistance provided under this part should report such incidences to the Office of Inspector...

  4. 12 CFR 1806.303 - Fraud, waste and abuse.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 9 2012-01-01 2012-01-01 false Fraud, waste and abuse. 1806.303 Section 1806... BANK ENTERPRISE AWARD PROGRAM Terms and Conditions of Assistance § 1806.303 Fraud, waste and abuse. Any person who becomes aware of the existence or apparent existence of fraud, waste, or abuse of assistance...

  5. 12 CFR 1808.627 - Fraud, waste and abuse.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 10 2014-01-01 2014-01-01 false Fraud, waste and abuse. 1808.627 Section 1808....627 Fraud, waste and abuse. Any person who becomes aware of the existence or apparent existence of fraud, waste or abuse of any Guarantee, Bond, Bond Loan or Secondary Loan provided under this interim...

  6. 12 CFR 1806.303 - Fraud, waste and abuse.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 9 2013-01-01 2013-01-01 false Fraud, waste and abuse. 1806.303 Section 1806... BANK ENTERPRISE AWARD PROGRAM Terms and Conditions of Assistance § 1806.303 Fraud, waste and abuse. Any person who becomes aware of the existence or apparent existence of fraud, waste, or abuse of assistance...

  7. 12 CFR 1806.303 - Fraud, waste and abuse.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 7 2011-01-01 2011-01-01 false Fraud, waste and abuse. 1806.303 Section 1806... BANK ENTERPRISE AWARD PROGRAM Terms and Conditions of Assistance § 1806.303 Fraud, waste and abuse. Any person who becomes aware of the existence or apparent existence of fraud, waste, or abuse of assistance...

  8. 12 CFR 1805.812 - Fraud, waste and abuse.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 9 2013-01-01 2013-01-01 false Fraud, waste and abuse. 1805.812 Section 1805..., waste and abuse. Any person who becomes aware of the existence or apparent existence of fraud, waste or abuse of assistance provided under this part should report such incidences to the Office of Inspector...

  9. 12 CFR 1805.812 - Fraud, waste and abuse.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 9 2012-01-01 2012-01-01 false Fraud, waste and abuse. 1805.812 Section 1805..., waste and abuse. Any person who becomes aware of the existence or apparent existence of fraud, waste or abuse of assistance provided under this part should report such incidences to the Office of Inspector...

  10. 12 CFR 1806.303 - Fraud, waste and abuse.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  11. Utility of the cumulative stress and mismatch hypotheses in understanding the neurobiological impacts of childhood abuse and recent stress in youth with emerging mental disorder.

    PubMed

    Paquola, Casey; Bennett, Maxwell R; Hatton, Sean N; Hermens, Daniel F; Lagopoulos, Jim

    2017-03-03

    Childhood abuse has an enduring impact on the brain's stress system. Whether the effects of childhood abuse and adulthood stress are additive (cumulative stress hypothesis) or interactive (mismatch hypothesis) is widely disputed, however. The primary aim of this study was to test the utility of the cumulative stress and mismatch hypotheses in understanding brain and behaviour. We recruited 64 individuals (aged 14-26) from a specialised clinic for assessment and early intervention of mental health problems in young people. A T1-weighted MRI, a resting state fMRI and clinical assessment were acquired from each participant. Grey matter estimates and resting state functional connectivity (rsFC) of the hippocampus, amygdala and anterior cingulate cortex (ACC) were determined using segmentation and seed-to-voxel rsFC analyses. We explored the effects of childhood abuse and recent stress on the structure and function of the regions of interest within general linear models. Worse psychiatric symptoms were significantly related to higher levels of life time stress. Individuals with mismatched childhood and recent stress levels had reduced left hippocampal volume, reduced ACC-ventrolateral prefrontal cortex rsFC and greater ACC-hippocampus rsFC, compared to individuals with matched childhood and recent stress levels. These results show specific utility of the cumulative stress hypothesis in understanding psychiatric symptomatology and of the mismatch hypothesis in modelling hippocampal grey matter, prefrontal rsFC, and prefrontal-hippocampal rsFC. We provide novel evidence for the enduring impact of childhood abuse on stress reactivity in a clinical population, and demonstrate the distinct effects of stress in different systems. Hum Brain Mapp, 2017. © 2017 Wiley Periodicals, Inc.

  12. Eating disorders and sexual abuse.

    PubMed

    Molinari, E

    2001-06-01

    This review examines the current debate on the role that sexual and physical abuse may play in predisposing to eating disorders in women. Despite some discordant opinions, clinicians agree that the experience of abuse in early childhood may be important for understanding the complex genesis of the eating disorders of some women. Three groups of studies are presented: those in which no connections emerge between sexual abuse and eating disorders, those in which a strong link is present and those in which the results refer to a multifactorial interpretative model. Some of the main symptoms, such as reactualization of the trauma, dissociation, personality disorders, pathological relationship with food, distortion of body image, suicide attempts and self-inflicted punishment that victims of abuse and eating disordered subjects share are examined.

  13. Abuse of Disabled Children in Ghana

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  14. Abuse of Disabled Children in Ghana

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  15. Forensic odontology, part 5. Child abuse issues.

    PubMed

    Hinchliffe, J

    2011-05-14

    Child abuse, child maltreatment, non-accidental injury and child homicide: all terms that are hard to believe exist in the 21st civilised century, but non-accidental injury of children is a major problem, crossing all socioeconomic, ethnic and educational groups, and is happening all over the world. Available statistics on child abuse and deaths related to abuse are frightening, and as many cases are not reported, actual numbers are likely to be much higher. This paper aims to increase understanding of child abuse issues and encourage the dental team to be alert to the possibility of abuse, recognise the physical injuries and make referrals to the appropriate agency if necessary. In child abuse cases physical injuries to the head and facial area are common while other types of abuse are less visible but are damaging to a vulnerable child in other ways. Keeping children safe is a shared responsibility and a top priority for all of us.

  16. Abusive Relationships

    MedlinePlus

    ... advice. loveisrespect.org : 1-866-331-9474 National Domestic Violence Hotline : 1-800-799-SAFE (7233) National Sexual ... Rape National Latino Alliance for the Elimination of Domestic Violence If you’re concerned about abusive relationships, here’s ...

  17. Common presentations of elder abuse in health care settings.

    PubMed

    Powers, James S

    2014-11-01

    Health care professionals encounter elder abuse in the community and in medical offices, emergency rooms, hospitals, and long-term care facilities. Keen awareness of risk factors for elder abuse and the variety of presentations in different health settings helps promote detection, treatment, and prevention of elder abuse. Published by Elsevier Inc.

  18. Review of Randomized Controlled Trials on Psychological Interventions in Child Sexual Abuse: Current Status and Emerging Needs in the Indian Context

    PubMed Central

    Choudhary, Vandana; Satapathy, Sujata; Sagar, Rajesh

    2016-01-01

    Child sexual abuse (CSA) is a critical, psychologically traumatic and sometimes life-threatening incident often associated with sequel of adverse physical, behavioral, and mental health consequences. Factors such as developmental age of the child, severity of abuse, closeness to the perpetrator, availability of medico-legal-social support network and family care, gender stereotypes in the community complicate the psychological trauma. Although the research on the effects of CSA as well as psychological intervention to reduce the victimization and promote the mental health of the child is in its infancy stage in India, the global research in the past three decades has progressed much ahead. A search was performed using MEDLINE, PubMed, PsycINFO, and Google Scholar from 1984 to 2015 and only 17 randomized controlled trials (RCTs) out of 96 potentially relevant studies were included. While nonspecific therapies covering a wide variety of outcome variables were prominent till 1999s, the trend changed to specific and focused forms of trauma-focused therapies in next one-and-half decades. Novel approaches to psychological interventions have also been witnessed. One intervention (non-RCT) study on effects on general counseling has been reported from India. PMID:27570336

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

    PubMed

    Phillips, Janice

    2013-01-01

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

  20. Substance abuse and oral health: an overview.

    PubMed

    van Zyl, A W

    2014-02-01

    Substance abuse is a worldwide phenomenon. It is on the increase in most countries and claims the lives of millions every year. Substance abuse may involve licit and illicit drugs, with licit substances claiming more lives than illicit drugs. Illicit substance abuse is on the increase, especially with new drugs emerging on the world market every year. These new drugs appear faster than scientific studies can keep pace in determining their possible detrimental influences on health. Many abused drugs do have oral health complications. For this reason, it is important for dentists to have a thorough knowledge of the oral environment to be able to detect any abnormalities, regardless of what the underlying cause may be. Due to the nature of illicit substance abuse, reliable information and science is hard to come by. This overview will focus on the direct consequences for oral health, whilst acknowledging that substance abuse may also have direct and indirect influences on general health.

  1. Drug abuse and addiction.

    PubMed

    Nessa, A; Latif, S A; Siddiqui, N I; Hussain, M A; Hossain, M A

    2008-07-01

    Among the social and medical ills of the twentieth century, substance abuse ranks as on one of the most devastating and costly. The drug problem today is a major global concern including Bangladesh. Almost all addictive drugs over stimulate the reward system of the brain, flooding it with the neurotransmitter dopamine. That produces euphoria and that heightened pleasure can be so compelling that the brain wants that feeling back again and again. However repetitive exposure induces widespread adaptive changes in the brain. As a consequence drug use may become compulsive. An estimated 4.7% of the global population aged 15 to 64 or 184 million people, consume illicit drug annually. Heroin use alone is responsible for the epidemic number of new cases of HIV/AIDS, Hepatitis and drug addicted infant born each year. Department of narcotic control (DNC) in Bangladesh reported in June 2008 that about 5 million drug addicts in the country & addicts spend at least 17 (Seventeen) billion on drugs per year. Among these drug addicts, 91% are young and adolescents population. Heroin is the most widely abused drugs in Bangladesh. For geographical reason like India, Pakistan and Myanmar; Bangladesh is also an important transit root for internationally trafficking of illicit drug. Drug abuse is responsible for decreased job productivity and attendance increased health care costs, and escalations of domestic violence and violent crimes. Drug addiction is a preventable disease. Through scientific advances we now know much more about how exactly drugs work in the brain, and we also know that drug addiction can be successfully treated to help people stop abusing drugs and resume their productive lives. Most countries have legislation designed to criminalize some drugs. To decrease the prevalence of this problem in our setting; increase awareness, promoting additional research on abused and addictive drugs, and exact implementation of existing laws are strongly recommended. We should

  2. Spousal Abuse

    PubMed Central

    Gullattee, Alyce C.

    1979-01-01

    Spouse abuse is being discussed and agonized over more frequently than in past years. Although interpousal and intrafamilial violence have been behaviors of note and considerable consequence, they have been attributable, almost exclusively, to the lower socioeconomic classes. Many hypotheses have been proposed concerning the etiology of violence. The author discusses some of the more general sociopolitical theories of violence and proposes three areas of significant moment to behaviorists. PMID:439165

  3. Definition and functions of health unified command and emergency operations centers for large-scale bioevent disasters within the existing ICS.

    PubMed

    Burkle, Frederick M; Hsu, Edbert B; Loehr, Michael; Christian, Michael D; Markenson, David; Rubinson, Lewis; Archer, Frank L

    2007-11-01

    The incident command system provides an organizational structure at the agency, discipline, or jurisdiction level for effectively coordinating response and recovery efforts during most conventional disasters. This structure does not have the capacity or capability to manage the complexities of a large-scale health-related disaster, especially a pandemic, in which unprecedented decisions at every level (eg, surveillance, triage protocols, surge capacity, isolation, quarantine, health care staffing, deployment) are necessary to investigate, control, and prevent transmission of disease. Emerging concepts supporting a unified decision-making, coordination, and resource management system through a health-specific emergency operations center are addressed and the potential structure, function, roles, and responsibilities are described, including comparisons across countries with similar incident command systems.

  4. Environmental Assessment for Conversion of the Existing Aero Club Runway to Emergency Helipad for David Grant Medical Center Travis Air Force Base, Fairfield, California

    DTIC Science & Technology

    2010-07-01

    Travis Air Force Base, Fairfield, California Contract No. GS-10F-132K Delivery Order No. FA4427-08-F-0133 Submitted to U. S. Air Force Center for...Engineering and the Environment Travis Air Force Base, California July 2010 2485 Natomas Park Drive Suite 600 Sacramento, CA 95833 Report...Club Runway to Emergency Helipad for David Grant Medical Center Travis Air Force Base, Fairfield, California 5a. CONTRACT NUMBER 5b. GRANT NUMBER

  5. Is there a risk for the aquatic environment due to the existence of emerging organic contaminants in treated domestic wastewater? Greece as a case-study.

    PubMed

    Thomaidi, Vasiliki S; Stasinakis, Athanasios S; Borova, Viola L; Thomaidis, Nikolaos S

    2015-01-01

    The ecological threat associated with emerging pollutants detected in wastewater was estimated in country level. Treated wastewater was analyzed for pharmaceuticals and illicit drugs; whereas the concentrations of all emerging contaminants determined in Greek Sewage Treatment Plants were recorded through literature review. Toxicity data was collected after literature review or using ECOSAR and risk quotients (RQs) were calculated for treated wastewater and 25 Greek rivers, for 3 different aquatic organisms (fish, daphnia magna, algae). According to the results, monitoring data was available for 207 micropollutants belonging to 8 different classes. RQ>1 was calculated for 30 compounds in secondary treated wastewater. Triclosan presented RQ>1 (in algae) for all studied rivers; decamethylcyclopentasilane (in daphnia magna), caffeine (in algae) and nonylphenol (in fish) presented RQ>1 in rivers with dilution factors (DF) equal or lower to 1910, 913 and 824, respectively. The class of emerging contaminants that present the greatest threat due to single or mixture toxicity was endocrine disrupters. The mixture of microcontaminants seems to pose significant ecological risk, even in rivers with DF equal to 2388. Future national monitoring programs should include specific microcontaminants that seem to possess environment risk to surface water.

  6. Child Abuse: Definition.

    ERIC Educational Resources Information Center

    Wilson, Timothy L.-Y.

    The purpose of this paper was to elaborate on the definitions of child abuse in order to improve the understanding of child abuse. The definitions given by the U.S. House Joint Committee on Child Abuse in the Child Abuse Prevention and Treatment Act, and in research by Holden (1984), are cited. These definitions refer to the nature of abusive acts…

  7. Delayed identification of pediatric abuse-related fractures.

    PubMed

    Ravichandiran, Nisanthini; Schuh, Suzanne; Bejuk, Marta; Al-Harthy, Nesrin; Shouldice, Michelle; Au, Hosanna; Boutis, Kathy

    2010-01-01

    Because physicians may have difficulty distinguishing accidental fractures from those that are caused by abuse, abusive fractures may be at risk for delayed recognition; therefore, the primary objective of this study was to determine how frequently abusive fractures were missed by physicians during previous examinations. A secondary objective was to determine clinical predictors that are associated with unrecognized abuse. Children who were younger than 3 years and presented to a large academic children's hospital from January 1993 to December 2007 and received a diagnosis of abusive fractures by a multidisciplinary child protective team were included in this retrospective review. The main outcome measures included the proportion of children who had abusive fractures and had at least 1 previous physician visit with diagnosis of abuse not identified and predictors that were independently associated with missed abuse. Of 258 patients with abusive fractures, 54 (20.9%) had at least 1 previous physician visit at which abuse was missed. The median time to correct diagnosis from the first visit was 8 days (minimum: 1; maximum: 160). Independent predictors of missed abuse were male gender, extremity versus axially located fracture, and presentation to a primary care setting versus pediatric emergency department or to a general versus pediatric emergency department. One fifth of children with abuse-related fractures are missed during the initial medical visit. In particular, boys who present to a primary care or a general emergency department setting with an extremity fracture are at a particularly high risk for delayed diagnosis.

  8. [Oral manifestations in the abused child].

    PubMed

    García Ballesta, C; Cegarra Beltri, M; Cabrerizo Merino, M C

    1989-10-01

    In this essay the authors study a problem which has been considered a "social illness" pediatric the one about child abuse, talking under the oral manifestations point of view. In this way due to the relative frequency of this appearance, the odontopediatric, must known before a traumatism orofacial, the possible existence of child abuse.

  9. Predicting risky sexual behavior in emerging adulthood: examination of a moderated mediation model among child sexual abuse and adult sexual assault victims.

    PubMed

    Littleton, Heather L; Grills, Amie E; Drum, Katherine B

    2014-01-01

    Although having a sexual victimization history is associated with engaging in sexual risk behavior, the mechanisms whereby sexual victimization increases risk behavior are unclear. This study examined use of sex as an affect regulation strategy as a mediator of the relationship between depressive symptoms and sexual risk behavior among 1,616 sexually active college women as well as examined having a history of child sexual abuse (CSA), adolescent/adult sexual assault (ASA), or both (CSA/ASA) as moderators. Results supported the mediated model as well as moderated mediation, where depressive symptoms were more strongly associated with use of sex as an affect regulation strategy among ASA victims, and sex as an affect regulation strategy was more strongly related to sexual risk behavior for CSA/ASA victims.

  10. Over-the-counter medicine abuse – a review of the literature

    PubMed Central

    2013-01-01

    Background: The sale of over-the-counter (OTC) medicines from pharmacies can help individuals self-manage symptoms. However, some OTC medicines may be abused, with addiction and harms being increasingly recognised. This review describes the current knowledge and understanding of OTC medicine abuse. Approach: Comprehensive search of international empirical and review literature between 1990 and 2011. Findings: OTC medicine abuse was identified in many countries and although implicated products varied, five key groups emerged: codeine-based (especially compound analgesic) medicines, cough products (particularly dextromethorphan), sedative antihistamines, decongestants and laxatives. No clear patterns relating to those affected or their experiences were identified and they may represent a hard-to-reach group, which coupled with heterogeneous data, makes estimating the scale of abuse problematic. Associated harms included direct physiological or psychological harm (e.g. opiate addiction), harm from another ingredient (e.g. ibuprofen-related gastric bleeding) and associated social and economic problems. Strategies and interventions included limiting supplies, raising public and professional awareness and using existing services and Internet support groups, although associated evaluations were lacking. Terminological variations were identified. Conclusions: OTC medicine abuse is a recognised problem internationally but is currently incompletely understood. Research is needed to quantify scale of abuse, evaluate interventions and capture individual experiences, to inform policy, regulation and interventions. PMID:23525509

  11. HCV Drug Resistance Challenges in Japan: The Role of Pre-Existing Variants and Emerging Resistant Strains in Direct Acting Antiviral Therapy

    PubMed Central

    Chayama, Kazuaki; Hayes, C. Nelson

    2015-01-01

    Sustained virological response (SVR) rates have increased dramatically following the approval of direct acting antiviral (DAA) therapies. While individual DAAs have a low barrier to resistance, most patients can be successfully treated using DAA combination therapy. However, DAAs are vulnerable to drug resistance, and resistance-associated variants (RAVs) may occur naturally prior to DAA therapy or may emerge following drug exposure. While most RAVs are quickly lost in the absence of DAAs, compensatory mutations may reinforce fitness. However, the presence of RAVs does not necessarily preclude successful treatment. Although developments in hepatitis C virus (HCV) therapy in Asia have largely paralleled those in the United States, Japan’s July 2014 approval of asunaprevir plus daclatasvir combination therapy as the first all-oral interferon-free therapy was not repeated in the United States. Instead, two different combination therapies were approved: sofosbuvir/ledipasvir and paritaprevir/ritonavir/ombitasvir/dasabuvir. This divergence in treatment approaches may lead to differences in resistance challenges faced by Japan and the US. However, the recent approval of sofosbuvir plus ledipasvir in Japan and the recent submissions of petitions for approval of paritaprevir/ritonavir plus ombitasvir suggest a trend towards a new consensus on emerging DAA regimens. PMID:26473914

  12. Counselor Attitudes of Effectiveness with Sexually Abused Men.

    PubMed

    Paul, John; Paul, William

    2016-11-01

    There is a shortage of research about sexually abused men. Even less research exists about helping professionals that treat them. This study offers a window into counselors' attitudes and beliefs of effectiveness with sexually abused men. Findings from a conjoint analysis indicate a need for more male specific sexual abuse training, more direct therapeutic experience with sexually abused men, more male counselors, and more counselors with an awareness of a personal sexual abuse history. The resulting factor ordering of counselor attitudes of effectiveness is a preliminary guide to institute training and practices for professionals who work with sexually abused men.

  13. How to Handle Abuse

    MedlinePlus

    ... them. Another word for hurting someone is "abuse." Child abuse (say: ah-BYOOS) can affect all kinds of ... a babysitter, teacher, coach, or a bigger kid. Child abuse can happen anywhere — at home, school, childcare, or ...

  14. Substance Abuse/Use

    MedlinePlus

    ... Substance Abuse/Use Subscribe Translate Text Size Print Substance Abuse/Use How Are Alcohol and Drug Use Related ... or transmitting HIV is to stop using drugs . Substance abuse treatment programs can help you do this. Many ...

  15. Child Sexual Abuse

    MedlinePlus

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

  16. 45 CFR 152.27 - Fraud, waste, and abuse.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Fraud, waste, and abuse. 152.27 Section 152.27...-EXISTING CONDITION INSURANCE PLAN PROGRAM Oversight § 152.27 Fraud, waste, and abuse. (a) Procedures. The... applicable or allowable), and promptly report to HHS incidences of waste, fraud, and abuse, and to...

  17. 45 CFR 152.27 - Fraud, waste, and abuse.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Fraud, waste, and abuse. 152.27 Section 152.27...-EXISTING CONDITION INSURANCE PLAN PROGRAM Oversight § 152.27 Fraud, waste, and abuse. (a) Procedures. The... applicable or allowable), and promptly report to HHS incidences of waste, fraud, and abuse, and to...

  18. 45 CFR 152.27 - Fraud, waste, and abuse.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Fraud, waste, and abuse. 152.27 Section 152.27...-EXISTING CONDITION INSURANCE PLAN PROGRAM Oversight § 152.27 Fraud, waste, and abuse. (a) Procedures. The... applicable or allowable), and promptly report to HHS incidences of waste, fraud, and abuse, and to...

  19. 45 CFR 152.27 - Fraud, waste, and abuse.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Fraud, waste, and abuse. 152.27 Section 152.27...-EXISTING CONDITION INSURANCE PLAN PROGRAM Oversight § 152.27 Fraud, waste, and abuse. (a) Procedures. The... applicable or allowable), and promptly report to HHS incidences of waste, fraud, and abuse, and to...

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  1. Secondary School Experiences of Male Recovering Substance Abusers

    ERIC Educational Resources Information Center

    Maher, Rebecca C.

    2012-01-01

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

  2. After Abuse: Child Coping Patterns and Social Work Intervention.

    ERIC Educational Resources Information Center

    Timberlake, Elizabeth M.

    The hypothesis that abused children develop a life style of overt expression of aggression and depression was examined in a study of 56 physically abused first grade children who were placed in foster care due to parental physical abuse. As no test instrument existed, the Childhood Social Functioning Inventory was developed, pretested, and used to…

  3. Secondary School Experiences of Male Recovering Substance Abusers

    ERIC Educational Resources Information Center

    Maher, Rebecca C.

    2012-01-01

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

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  5. After Abuse: Child Coping Patterns and Social Work Intervention.

    ERIC Educational Resources Information Center

    Timberlake, Elizabeth M.

    The hypothesis that abused children develop a life style of overt expression of aggression and depression was examined in a study of 56 physically abused first grade children who were placed in foster care due to parental physical abuse. As no test instrument existed, the Childhood Social Functioning Inventory was developed, pretested, and used to…

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

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Fraud, waste, and abuse. 152.27 Section 152.27...-EXISTING CONDITION INSURANCE PLAN PROGRAM Oversight § 152.27 Fraud, waste, and abuse. (a) Procedures. The... applicable or allowable), and promptly report to HHS incidences of waste, fraud, and abuse, and to...

  7. Pattern and Trend of Substance Abuse in Eastern Rural Iran: A Household Survey in a Rural Community

    PubMed Central

    Ziaaddini, Hasan; Ziaaddini, Tayebeh

    2013-01-01

    Introduction and Aim. Substance abuse imposes hazards on human health in all biopsychosocial aspects. Limited studies exist on epidemiology of substance abuse and its trend in rural areas. The present study aimed to compare substance abuse in one of the rural areas of southeast Iran, in a 12-year period (2000 and 2012). Design and Methods. In a household survey conducted in 2012, in Dashtkhak/Kerman, 1200 individuals above 12 years of age completed a questionnaire to determine their frequency of substance abuse. The questionnaire included the following three areas: demographic characteristics, frequency of substance abuse and ease of access to various drugs. Results. Among 900 completed questionnaires, majority of the participants (61.8%) were below 30 years of age and among them 54.4% were male. Cigarette (17.0%), opium (15.7%) and opium residue (9.0%) were the most frequent substances abused on a daily basis. Based on the participant's opinion, we conclude that the ease of access to cigarette, waterpipe and opium contributed to their increase in consumption compared with earlier years. Discussion and Conclusion. The steady rise in substance abuse in rural communities demands immediate attention and emergency preventive measures from policy makers. PMID:24804141

  8. Response of emergency rooms to victims of interpersonal violence.

    PubMed

    Bell, C C; Jenkins, E J; Kpo, W; Rhodes, H

    1994-02-01

    This study explored whether emergency rooms in a metropolitan county had standard procedures or offered services that address the needs of victims of interpersonal violence. Fifty hospital emergency rooms (75 percent of the facilities eligible to participate in the survey) responded to a 55-item questionnaire about their handling of victims of interpersonal violence. Emergency rooms generally relied on patient self-reports to determine whether a patient is a victim of violence. Standard operating procedures for reporting cases to state agencies and referrals for additional services were most likely to exist for areas in which hospitals' response is mandated by law, such as sexual assault and child abuse. In addition, three-fourths of the hospitals had procedures for dealing with elder abuse, an area in which reporting is strongly encouraged. Most direct services received by victims were not specifically targeted to them but were services offered to the general emergency room population. The most frequent referrals were to rape advocacy groups and battered women's groups. The hospitals were most likely to respond to victims in areas in which their actions were mandated by law, such as sexual assault and child abuse, or strongly recommended, such as elder abuse. The majority of emergency rooms do not conduct adequate epidemiological surveillance of injuries resulting from interpersonal violence. Protocols, services, and referrals for victims of family violence, peer violence, and other forms of interpersonal violence should be mandated by law or by standards of treatment.

  9. Governance and Risk Management of Network and Information Security: The Role of Public Private Partnerships in Managing the Existing and Emerging Risks

    NASA Astrophysics Data System (ADS)

    Navare, Jyoti; Gemikonakli, Orhan

    Globalisation and new technology has opened the gates to more security risks. As the strategic importance of communication networks and information increased, threats to the security and safety of communication infrastructures, as well as information stored in and/or transmitted increased significantly. The development of the self replicating programmes has become a nightmare for Internet users. Leading companies, strategic organisations were not immune to attacks; they were also "hacked" and overtaken by intruders. Incidents of recent years have also shown that national/regional crisis may also trigger cyber attacks at large scale. Experts forecast that cyber wars are likely to take the stage as tension mounts between developed societies. New risks such as cyber-attacks, network terrorism and disintegration of traditional infrastructures has somewhat blurred the boundaries of operation and control. This paper seeks to consider the risk management and governance and looking more specifically at implications for emerging economies.

  10. The need for evidence-based research ethics: a review of the substance abuse literature.

    PubMed

    Anderson, Emily E; DuBois, James M

    2007-01-12

    Participants in substance abuse research may be vulnerable for multiple reasons. International research ethics guidelines and policy statements require that researchers provide extra protections when conducting research with vulnerable subjects, but it is uncertain which measures best protect vulnerable individuals. Concerns about vulnerability have been translated into only the vaguest regulatory requirements, and very little empirical data exist to guide researchers and ethics review committee members who want to protect participants. This article reviews two bodies of substance abuse research ethics literature. First, "normative" articles, that is, articles that discuss ethical issues that may arise in substance abuse research, are discussed. The resulting taxonomy of ethical issues then guides a review of empirical studies on issues like the informed consent process and the use of financial incentives in substance abuse research. While the ethical issues in substance abuse research are numerous and well-documented, the evidentiary base for addressing these issues is inadequate. If any one major theme emerged from the existing studies, it is that many well-intentioned, protectionist concerns--about recruitment incentives, consent comprehension, and drug administration studies--are not supported by empirical data. While these findings are at best tentative, they suggest how research on research ethics might ultimately benefit participants.

  11. Methamphetamine abuse.

    PubMed

    Winslow, Bradford T; Voorhees, Kenton I; Pehl, Katherine A

    2007-10-15

    Methamphetamine is a stimulant commonly abused in many parts of the United States. Most methamphetamine users are white men 18 to 25 years of age, but the highest usage rates have been found in native Hawaiians, persons of more than one race, Native Americans, and men who have sex with men. Methamphetamine use produces a rapid, pleasurable rush followed by euphoria, heightened attention, and increased energy. Possible adverse effects include myocardial infarction, stroke, seizures, rhabdomyolysis, cardiomyopathy, psychosis, and death. Chronic methamphetamine use is associated with neurologic and psychiatric symptoms and changes in physical appearance. High-risk sexual activity and transmission of human immunodeficiency virus are also associated with methamphetamine use. Use of methamphetamine in women who are pregnant can cause placental abruption, intrauterine growth retardation, and preterm birth, and there can be adverse consequences in children exposed to the drug. Treatment of methamphetamine intoxication is primarily supportive. Treatment of methamphetamine abuse is behavioral; cognitive behavior therapy, contingency management, and the Matrix Model may be effective. Pharmacologic treatments are under investigation.

  12. Alcohol abuse in sickle cell disease: the Pisces Project.

    PubMed

    Levenson, James L; McClish, Donna K; Dahman, Bassam A; Penberthy, Lynne T; Bovbjerg, Viktor E; Aisiku, Imoigele P; Roseff, Susan D; Smith, Wally R

    2007-01-01

    Alcohol abuse is common in patients with chronic painful medical disorders, but it has not been studied in sickle cell disease (SCD). In a prospective cohort study of SCD adults, 31.4% were identified as abusing alcohol. There were no significant differences between alcohol abusers and nonabusers on demographics, biological variables, depression, anxiety, measures of crisis and noncrisis pain, or opioid use, but abusers reported more pain relief from opioids than nonabusers did. Alcohol abusers had fewer unscheduled clinic visits, emergency room visits, hospital days, and any health care utilization for SCD, but this was only significant for emergency room visits. Quality of life was similar between both groups, except that alcohol abusers unexpectedly had better overall physical summary scores. Alcohol abusers were more likely to report coping by ignoring pain, diverting attention, and using particular self-statements.

  13. Emergence of RET rearrangement co-existing with activated EGFR mutation in EGFR-mutated NSCLC patients who had progressed on first- or second-generation EGFR TKI.

    PubMed

    Klempner, Samuel J; Bazhenova, Lyudmila A; Braiteh, Fadi S; Nikolinakos, Petros G; Gowen, Kyle; Cervantes, Claudia M; Chmielecki, Juliann; Greenbowe, Joel R; Ross, Jeffrey S; Stephens, Philip J; Miller, Vincent A; Ali, Siraj M; Ou, Sai-Hong Ignatius

    2015-09-01

    The gatekeeper mutation T790M mutation is the responsible for the majority of the resistance to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) in patients with EGFR-mutated non-small cell lung cancer (NSCLC). Other previously described resistance mechanisms include HER2 amplification, MET amplification, PIK3CA mutation, epithelial-mesenchymal transition (EMT), small cell transformation have also been identified. However other resistance mechanisms remains to be discovered. Hybrid-capture based comprehensive genomic profiling (CGP) was performed on pre- and post-EGFR TKI progression EGFR-mutated NSCLC tumor samples during routine clinical care. We identify two paired pre- and post-EGFR TKI progression EGFR-mutated NSCLC patient tumor samples where both post EGFR TKI samples harbored in-frame CCDC6-RET rearrangements but not in the pre-EGFR TKI tumor samples. Furthermore analysis of the clinical database revealed one additional NCOA4-RET rearrangement co-existing with activated EGFR mutation in an EGFR-mutated NSCLC patient who had progressed on afatinib. None of the known resistance mechanisms to EGFR TKI including EGFR T790M, EGFR amplification, HER2 amplification, MET amplification, PIK3CA mutation, BRAF mutation, EMT or small cell transformation was identified in the three post progression samples that now harbored RET rearrangements. This is the first report of RET rearrangement co-existing with activated EGFR mutations in EGFR-mutated patients who had progressed on either first- or second generation EGFR TKI. As such, RET rearrangement may serve as a potential resistance mechanism to EGFR TKI in EGFR-mutated NSCLC. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  14. Elder Abuse in a Developing Area in Bolivia.

    PubMed

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

    2015-10-06

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

  15. Emerging and existing mechanisms co-operate in generating diverse β-lactam resistance phenotypes in geographically dispersed and genetically disparate Pseudomonas aeruginosa strains.

    PubMed

    Martinez, Elena; Pérez, Javier Escobar; Márquez, Carolina; Vilacoba, Elisabet; Centrón, Daniela; Leal, Aura L; Saavedra, Carlos; Saavedra, Sandra Y; Tovar, Catalina; Vanegas, Natasha; Stokes, H W

    2013-09-01

    β-Lactam resistance in Pseudomonas aeruginosa clinical isolates is driven by a number of mechanisms. Whilst several are understood, how they act co-operatively in pathogenic strains is less clear. In some isolates, resistance profiles cannot always be explained by identifying the common resistance-determining pathways, suggesting that other mechanisms may be important. Pathogenic P. aeruginosa isolates from four countries were characterised by PCR. Quantitative expression analysis was also assessed for the activity of several pathways that influence antibiotic resistance, and culture experiments were conducted to test how random transposition of the insertion sequence IS26 during growth may influence resistance to some antibiotics. In most strains, antibiotic resistance was being driven by changes in multiple pathways and by the presence or absence of genes acquired by lateral gene transfer. Multiple mechanisms of resistance were prevalent in strains from all of the countries examined, although regional differences in the type of interacting mechanisms were apparent. Changes in chromosomal pathways included overexpression of AmpC and two efflux pumps. Also, gain or loss of IS26 at some chromosomal locations, most notably oprD, could influence resistance to carbapenems. IS26-related resistance was found in strains from Argentina and geographically linked Uruguay, but not in strains from either Colombia or Australia. Pseudomonas aeruginosa pathogenic strains are evolving to become multidrug-resistant in more complex ways. This is being influenced by single strains acquiring changes in numerous known pathways as well as by newly emerging resistance mechanisms in this species. Copyright © 2013 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.

  16. Parent Abuse: A Review

    ERIC Educational Resources Information Center

    Kennair, Nicola; Mellor, David

    2007-01-01

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

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

    ERIC Educational Resources Information Center

    Ball, Jeremy D.

    2009-01-01

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

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

    ERIC Educational Resources Information Center

    Ball, Jeremy D.

    2009-01-01

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

  19. Use or Abuse? A Qualitative Study of Emergency Physicians' Views on Use of Observation Stays at Three Hospitals in the United States and England.

    PubMed

    Martin, Graham P; Wright, Brad; Ahmed, Azeemuddin; Banerjee, Jay; Mason, Suzanne; Roland, Damian

    2017-03-01

    Accumulating evidence has shown increasing use of observation stays for patients presenting to emergency departments and requiring diagnostic evaluation or time-limited treatment plans, but critics suggest that this expansion arises from hospitals' concerns to maximize revenue and shifts costs to patients. Perspectives of physicians making decisions to admit, observe, or discharge have been absent from the debate. We examine the views of emergency physicians in the United States and England on observation stays, and what influences their decisions to use observation services. We undertook in-depth, qualitative interviews with a purposive sample of physicians in 3 hospitals across the 2 countries and analyzed these using an approach based on the constant-comparison method. Limitations include the number of sites, whose characteristics are not generalizable to all institutions, and the reliance on self-reported interview accounts. Physicians used observation status for the specific presentations for which it is well evidenced but acknowledged administrative and financial considerations in their decisionmaking. They also highlighted an important role for observation not described in the literature: as a "safe space," relatively immune from the administrative gaze, where diagnostic uncertainties, sociomedical problems, and medicolegal challenges could be contained. Observation status increases the options available to admitting physicians in a way that they valued for its potential benefits to patient safety and quality of care, but some of these have been neglected in the literature to date. Reform to observation status should address these important but previously unacknowledged functions. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  20. NEURODEVELOPMENTAL BIOLOGY ASSOCIATED WITH CHILDHOOD SEXUAL ABUSE

    PubMed Central

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

    2013-01-01

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

  1. Abuse in health care: a concept analysis.

    PubMed

    Brüggemann, Adrianus Jelmer; Wijma, Barbro; Swahnberg, Katarina

    2012-03-01

    To analyse the concept of abuse in health care. This analysis also covers how abuse in health care is different from the related concepts of medical error, patient satisfaction and personal identity threat. Abuse in health care is an emerging concept in need of a clear analysis and definition. At the same time, boundaries to the related concepts are not demarcated. Concept analysis as developed by Walker and Avant. The databases Cumulative Index to Nursing and Allied Health Literature, Medline, and Google Scholar were used to obtain articles published between 1997 and 2009. A total of eleven articles are referred to on abuse in health care, four on medical error, six on patient satisfaction and three on personal identity threat. Abuse in health care is defined by patients' subjective experiences of encounters with the health care system, characterized by devoid of care, where patients suffer and feel they lose their value as human beings. The events are most often unintended. We also found differences with the aforementioned related concepts: medical error does not share the patients' perspective, and patient satisfaction does not offer room for patients' abusive experiences. The concept of personal identity threat shares all attributes with abuse in health care, but it lacks an antecedent that signifies the social structures underlying the phenomenon. Abuse in health care covers a phenomenon that has severe consequences but is invisible if seen from a medical error or patient satisfaction perspective. © 2011 The Authors. Scandinavian Journal of Caring Sciences © 2011 Nordic College of Caring Science.

  2. Substance abuse among oral healthcare workers.

    PubMed

    Marnewick, J C; van Zyl, A W

    2014-05-01

    The abuse of both licit and illicit substances by the general population affects at least one in ten people. Research shows that the oral healthcare worker has at least the same prevalence of substance abuse, perhaps even higher. The emergence of prescription drug abuse is one of the most worrying and dangerous aspects for the healthcare worker, due to ease of access to such drugs. According to the United Nations, prescription drug abuse is amongst the top three practices of substance abuse. We have an obligation to incorporate the evidence of substance abuse among oral healthcare professionals in our undergraduate dental curricula in order to combat this phenomenon. As the stress of daily survival in single practitioner practices increase, so will the danger of substance abuse. This may lead to impairment of the healthcare worker and ultimately loss of registration. It will take a combined effort from organised dentistry and academic institutions to establish a national strategy to ensure we address this important issue at undergraduate level and provide support at practitioner level. This paper will deal with substance abuse and the implications of impairment it holds for the oral healthcare worker.

  3. Financing of substance abuse treatment services.

    PubMed

    Horgan, C M; Merrick, E L

    2001-01-01

    The financing of treatment for substance abuse problems has differed from the rest of financing of health care in part because of the dominant role of the public sector as the payer of services. Nonetheless, the rise of managed care has affected substance abuse treatment services as well as the rest of the health care system. Alternative payment mechanisms are one important component of some managed care approaches. Behavioral health carve-outs are another managed care development that has affected substance abuse services. In this chapter, salient features of financing for substance abuse treatment are reviewed within the conceptual framework of payers (purchasers and intermediaries), providers, and consumers. Existing literature on substance abuse treatment financing is summarized, while recognizing that much remains to be researched.

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

    PubMed

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

    2014-11-01

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

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

    PubMed

    Macy, Rebecca J; Goodbourn, Melissa

    2012-10-01

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

  6. 12 CFR 1805.812 - Fraud, waste and abuse.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  7. Prescription drug abuse among prisoners in rural Southwestern Virginia.

    PubMed

    Wunsch, Martha J; Nakamoto, Kent; Goswami, Anil; Schnoll, Sidney H

    2007-01-01

    Non-medical use of prescription medications is on the rise across the U.S., particularly in rural areas. In this study of 233 prisoners and probationers in southwestern Virginia, we add to an emerging profile of individuals abusing prescription medications. In this retrospective review of 2000-2004 augmented Addiction Severity Index data, those abusing prescription medications reported increased illicit drug and alcohol abuse, poly-drug abuse, psychiatric problems, and arrests for property crimes. Forty percent reported abuse of OxyContin, a drug implicated in a number of deaths in this region. Compared to non-users, OxyContin users were younger, more likely to be female, and more likely to abuse benzodiazepines, methadone, cocaine, and heroin. Longevity of abuse of these other drugs belies suggestions that OxyContin was acting as a "gateway" drug leading naïve users into addiction and risk of death.

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

    PubMed

    Gabaeff, Steven C

    2016-01-01

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

  9. Substance Abuse in Rural Areas

    MedlinePlus

    ... Guide Rural Health Topics & States Topics View more Substance Abuse in Rural Areas Substance abuse has long been ... are some options to reduce it? What is substance abuse and what are the signs of substance abuse? ...

  10. Cough and Cold Medicine Abuse

    MedlinePlus

    ... Home » Publications » DrugFacts » Cough and Cold Medicine Abuse Cough and Cold Medicine Abuse Email Facebook Twitter Revised ... syrup is sometimes diverted for abuse. How Are Cough and Cold Medicines Abused? Cough and cold medicines ...

  11. What is Elder Abuse?

    MedlinePlus

    ... Resources and Links National Elder Abuse Incidence Study Domestic Violence in Later Life What If I Suspect ... Demonstrations (PPHF) Elder Justice Innovation Grants Late Life Domestic Violence World Elder Abuse Awareness Day State Grants ...

  12. Prescription Drug Abuse

    MedlinePlus

    ... what the doctor prescribed, it is called prescription drug abuse. It could be Taking a medicine that ... purpose, such as getting high Abusing some prescription drugs can lead to addiction. These include opioids, sedatives, ...

  13. Child abuse - physical

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/001552.htm Child abuse - physical To use the sharing features on this page, please enable JavaScript. Physical child abuse is a serious problem. Here are some facts: ...

  14. Prescription Drug Abuse

    MedlinePlus

    ... substances, including alcohol and tobacco Family history of substance abuse problems Younger age, especially the teens or early ... assistance program, which may offer counseling services for substance abuse problems You may be embarrassed to ask for ...

  15. Antecedents of child abuse.

    PubMed

    Altemeier, W A; O'Connor, S; Vietze, P M; Sandler, H M; Sherrod, K B

    1982-05-01

    The qualities of parents who batter their children have been determined by interviewing known abusers. Because most studies lack controls and because family characteristics may be changed by abuse, a prospective study was instituted. Fourteen hundred low-income mothers were interviewed in a prenatal clinic, and the characteristics of 23 reported for abuse within two years were compared to the characteristics of the remaining mothers. The predominant antecedents of child abuse were: unwanted pregnancy, aggressive tendencies, and aberrant childhood nurture in which disturbed family relationships were more important than outright abuse. Abusive mother had slightly less self-esteem. Factors which increased exposure between parents and children seemed to increase risk for abuse. In contrast to retrospective findings, abusive mothers did not differ in support available from others, age, education, isolation, family alcohol or drug problems, and expectations of child development.

  16. Preventing Abuse and Neglect

    MedlinePlus

    ... Whether or not you've experienced domestic or child abuse personally, you probably know that it can have ... and Neglect - The Essentials Latest Content Signs of Child Abuse August 5, 2017 @ 10:21 PM | 4 Min ...

  17. Elder Abuse FAQS

    MedlinePlus

    ... of older Americans Prev Play Pause Next Elder abuse is a complex issue that intersects with many ... You are a front line defender against elder abuse. Everyone has a role in preventing and combatting ...

  18. Alcoholism and Alcohol Abuse

    MedlinePlus

    ... distress and harm. It includes alcoholism and alcohol abuse. Alcoholism, or alcohol dependence, is a disease that ... alcohol to feel the same effect With alcohol abuse, you are not physically dependent, but you still ...

  19. Students and Drug Abuse

    ERIC Educational Resources Information Center

    Todays Educ, 1969

    1969-01-01

    Introduction to "Students and Drug Abuse, prepared by the Public Information Branch and Center for Studies of Narcotic and Drug Abuse, National Institute of Mental Health, in cooperation with the staff of Today's Education.

  20. Students and Drug Abuse

    ERIC Educational Resources Information Center

    Todays Educ, 1969

    1969-01-01

    Introduction to "Students and Drug Abuse, prepared by the Public Information Branch and Center for Studies of Narcotic and Drug Abuse, National Institute of Mental Health, in cooperation with the staff of Today's Education.

  1. How safe is emergency contraception?

    PubMed

    Norris Turner, Abigail; Ellertson, Charlotte

    2002-01-01

    Emergency contraception is used to prevent pregnancy after unprotected sex but before pregnancy begins. Currently, women can use emergency contraception by taking higher doses of the active ingredients found in ordinary oral contraceptive pills [either combined estrogen-progestogen (progestin) or progestogen-only formulations], or by having providers insert copper-bearing intrauterine devices (IUDs). The antiprogestogen mifepristone also has an excellent efficacy and safety profile as emergency contraception, but it is currently available for this indication only in China. Many studies have documented providers' and women's fears about the individual and public health safety risks of emergency contraception. Some of these concerns include potentially increased risks of cardiovascular events (including arterial and venous disease), worries about possible effects on future fertility, feared teratogenic consequences following method failure or inadvertent use during pregnancy, exaggerated or extreme fears of adverse tolerability, and concerns about drug interactions with other medications. Wider public health questions include feared reductions in the use of ongoing, more effective contraception, possible 'abuse' of emergency contraception through overly frequent use, and potential increases in risky sexual encounters (owing to the existence of a back-up, postcoital method) and therefore in rates of sexually transmitted infections, including HIV/AIDS. These fears can each be generally allayed. Direct and indirect investigations of emergency contraception in the biomedical and social science literature, the extensively documented safety profile of ordinary oral contraceptives, and more than 30 years of clinical experience since hormonal emergency contraception was first described, give strong evidence for its safety. This review confirms declarations by the World Health Organization and the US Food and Drug Administration, and shows that emergency contraception has an

  2. Child Abuse: Educator's Responsibilities. Revised.

    ERIC Educational Resources Information Center

    California State Office of the Attorney General, Sacramento. Crime Prevention Center.

    This document presents the educator with a guide to child abuse. A section defining child abuse examines the issues of physical abuse, physical neglect, sexual abuse, and emotional maltreatment. Areas discussed for these types of abuse include abuse indicators, location of injury, history, behavioral indicators, and types of injury. Incestuous and…

  3. Elder Abuse among African Americans

    ERIC Educational Resources Information Center

    Tauriac, Jesse J.; Scruggs, Natoschia

    2006-01-01

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

  4. Elder Abuse among African Americans

    ERIC Educational Resources Information Center

    Tauriac, Jesse J.; Scruggs, Natoschia

    2006-01-01

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

  5. Child Abuse: Educator's Responsibilities. Revised.

    ERIC Educational Resources Information Center

    California State Office of the Attorney General, Sacramento. Crime Prevention Center.

    This document presents the educator with a guide to child abuse. A section defining child abuse examines the issues of physical abuse, physical neglect, sexual abuse, and emotional maltreatment. Areas discussed for these types of abuse include abuse indicators, location of injury, history, behavioral indicators, and types of injury. Incestuous and…

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

    PubMed

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

    2015-10-01

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

  7. [Upgrade on alcohol abuse].

    PubMed

    Bordini, L; Riboldi, L

    2010-01-01

    Problematic use of alcohol configures an element of interest in the context of preventive interventions aimed to ensuring the performance of any work in safety conditions. To contrast the acute alcohol abuse in the workplace the existing legislation provides alcoholimeters controls and prohibition of recruitment and administration of alcohol. Recent legislation (D.Lgs. 81/08) establishes health surveillance for alcohol dependence and appears still incomplete and difficult to apply. Clinical diagnostic tools available to the physician for alcohol dependence identification are well-defined and recently improved thanks to new laboratory markers with high sensitivity and specificity (CDT) and self-administered questionnaires. In this contest we are awaiting for legislative action to specify conditions and procedures for inspections in the workplace in order to face the problem of alcohol dependence without excessive bureaucracy and with more attention to preventive aspects.

  8. Substance Abuse. Policy Statement.

    ERIC Educational Resources Information Center

    National Collaboration for Youth, Washington, DC.

    This paper presents the policy statement on substance abuse from the National Collaboration for Youth (NCY). The policy statement section lists programs and activities supported by the NCY. A section on background includes a statement of the issue of substance abuse. Areas examined in this section include alcohol abuse and drunk driving among…

  9. Elder Abuse Awareness Project.

    ERIC Educational Resources Information Center

    Doyle, Kathleen; Morrow, Marilyn J.

    1985-01-01

    The Elder Abuse Awareness Project was undertaken: (1) to determine the incidence of abuse and neglect in seven Illinois counties; and (2) to develop, produce, and distribute educational materials on elder abuse for the service provider and for senior citizens. Results are presented and discussed. (MT)

  10. Elder Abuse in Japan

    ERIC Educational Resources Information Center

    Arai, Mizuho

    2006-01-01

    Perceptions of elder abuse were examined in Japanese women (n =100) and men (n =46). Japanese women and men both emphasized physical aggression, followed by neglect and blaming, when giving examples of extremely abusive behavior. Physical aggression was also the most frequently mentioned type of moderate elder abuse, followed by neglect, economic…

  11. Elder Abuse Awareness Project.

    ERIC Educational Resources Information Center

    Morrow, Marilyn J.; Doyle, Kathleen

    The Elder Abuse Awareness Project was developed to determine the incidence of abuse and neglect of elderly people in several rural counties in central Illinois. A primary purpose of the study was to survey service providers as to their actual encounters with elder abuse and neglect. Each provider was asked about warning signs or cues that were…

  12. Elder Abuse in Japan

    ERIC Educational Resources Information Center

    Arai, Mizuho

    2006-01-01

    Perceptions of elder abuse were examined in Japanese women (n =100) and men (n =46). Japanese women and men both emphasized physical aggression, followed by neglect and blaming, when giving examples of extremely abusive behavior. Physical aggression was also the most frequently mentioned type of moderate elder abuse, followed by neglect, economic…

  13. Violence against Women: Safety Planning for Abusive Situations

    MedlinePlus

    ... abuser Discuss how to deal with emergencies Suggest safe places to go, such as a shelter or the home of a friend or family member where your abuser might not look Help you learn ... Hotline at 800-799-SAFE (7233) or TDD 800-787-3224. You can ...

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

    ERIC Educational Resources Information Center

    Meth, Marcia; Chalmers, Rebecca; Bassin, Gail

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

  15. Predictors of Abused Wives Own Level of Violence.

    ERIC Educational Resources Information Center

    Brown, Joanne; Wampold, Bruce E.

    Spouse abuse has emerged as an extensive social issue. Although many studies have examined characteristics of abused wives, there has been a dearth of literature examining the relationship between victim and perpetrator levels of aggression. The purpose of this study was to explore those variables that are related to female victims' own level of…

  16. Child abuse and physical health in adulthood.

    PubMed

    Afifi, Tracie O; MacMillan, Harriet L; Boyle, Michael; Cheung, Kristene; Taillieu, Tamara; Turner, Sarah; Sareen, Jitender

    2016-03-16

    A large literature exists on the association between child abuse and mental health, but less is known about associations with physical health. The study objective was to determine if several types of child abuse were related to an increased likelihood of negative physical health outcomes in a nationally representative sample of Canadian adults. Data are from the 2012 Canadian Community Health Survey-Mental Health (n = 23,395). The study sample was representative of the Canadian population aged 18 or older. Child physical abuse, sexual abuse, and exposure to intimate partner violence were assessed in relation to self-perceived general health and 13 self-reported, physician-diagnosed physical conditions. All child abuse types were associated with having a physical condition (odds ratios = 1.4 to 2.0) and increased odds of obesity (odds ratios = 1.2 to 1.4). Abuse in childhood was associated with arthritis, back problems, high blood pressure, migraine headaches, chronic bronchitis/emphysema/COPD, cancer, stroke, bowel disease, and chronic fatigue syndrome in adulthood, even when sociodemographic characteristics, smoking, and obesity were taken into account (odds ratios = 1.1 to 2.6). Child abuse remained significantly associated with back problems, migraine headaches, and bowel disease when further adjusting for mental conditions and other physical conditions (odds ratios = 1.2 to 1.5). Sex was a significant moderator between child abuse and back problems, chronic bronchitis/emphysema/COPD, cancer, and chronic fatigue syndrome, with slightly stronger effects for women than men. Abuse in childhood was associated with increased odds of having 9 of the 13 physical conditions assessed in this study and reduced self-perceived general health in adulthood. Awareness of associations between child abuse and physical conditions is important in the provision of health care.

  17. Integrating translational neuroscience to improve drug abuse treatment for adolescents.

    PubMed

    Boyce, Cheryl Anne; Lynne-Landsman, Sarah D

    2013-06-01

    Adolescence is an exciting and challenging period of maturation, rapid brain development, and developmental changes in neurobiological, neurocognitive, and neurobehavioral processes. Although behavioral therapies available for adolescent substance abuse have increased, effectiveness research in this area lags considerably behind that of clinical research on treatment for drug-abusing adults. Behavioral treatment approaches show significant promise for treating drug-abusing adolescents, but many have not incorporated innovations in neuroscience on brain development, cognitive processes, and neuroimaging. Linking developmental neuroscience with behavioral treatments can create novel drug abuse interventions and increase the effectiveness of existing interventions for substance-abusing adolescents. Contemporary research on brain development, cognition, and neuroscience is ripe for translation to inform developmentally sensitive drug abuse treatments for adolescents. Neuroscientists and interventionists are challenged to build mutual collaborations for integration of neuroscience and drug abuse treatment for adolescents. 2013 APA, all rights reserved

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

    PubMed

    Winters, Niall; Langer, Laurenz; Geniets, Anne

    2017-01-01

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

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

    PubMed Central

    2017-01-01

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

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

    PubMed

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

    2009-01-01

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

  1. Prevalence and Overlap of Childhood and Adult Physical, Sexual, and Emotional Abuse: A Descriptive Analysis of Results from the Boston Area Community Health (BACH) Survey

    PubMed Central

    Chiu, Gretchen R.; Lutfey, Karen E.; Litman, Heather J.; Link, Carol L.; Hall, Susan A.; McKinlay, John B.

    2012-01-01

    Abuse is associated with a wide variety of health problems, yet comprehensive population-based data are scant. Existing literature focuses on a single type of abuse, population, or lifestage. Using a racially/ethnically diverse community-based sample, we document the prevalence of physical, emotional, and sexual abuse by lifestage and gender; assess variation in abuse by socio-demographics; establish overlap of abuses; and examine childhood abuse relationships with abuse in adulthood. Prevalence of abuse ranges from 15% to 27%; women report more adulthood emotional abuse and lifetime sexual abuse than men; reports of abuse can vary by race/ethnicity and poverty status, particularly in women; there is overlap between types of abuse; and a history of childhood abuse is associated with a greater risk of abuse as an adult. PMID:23862305

  2. Inhalant Abuse and Dextromethorphan.

    PubMed

    Storck, Michael; Black, Laura; Liddell, Morgan

    2016-07-01

    Inhalant abuse is the intentional inhalation of a volatile substance for the purpose of achieving an altered mental state. As an important, yet underrecognized form of substance abuse, inhalant abuse crosses all demographic, ethnic, and socioeconomic boundaries, causing significant morbidity and mortality in school-aged and older children. This review presents current perspectives on epidemiology, detection, and clinical challenges of inhalant abuse and offers advice regarding the medical and mental health providers' roles in the prevention and management of this substance abuse problem. Also discussed is the misuse of a specific "over-the-counter" dissociative, dextromethorphan.

  3. Use of prescription opioids with abuse-deterrent technology to address opioid abuse.

    PubMed

    Michna, Edward; Kirson, Noam Y; Shei, Amie; Birnbaum, Howard G; Ben-Joseph, Rami

    2014-08-01

    , Medicaid, uninsured). Some patients switched to other ER/LA opioids without abuse-deterrent technology or discontinued ER/LA opioid treatment when their existing ER treatment was reformulated. Rates of opioid abuse were higher among patients who switched to other ER/LA opioids or discontinued ER/LA opioid treatment, suggesting that abusers may seek more easily abuseable alternatives such as prescription opioids without abuse-deterrent technology.

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

    ERIC Educational Resources Information Center

    Brady, Stephen

    2008-01-01

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

  5. Recurrent Syncope following Substance Abuse; a Case Report

    PubMed Central

    Salehi, Forod; Hassanzadeh Taheri, Mohammad Mehdi; Riasi, HamidReza; Mehrpour, Omid

    2017-01-01

    Drug abuse is considered as the most common poisoning in the world. Stimulants agent especially amphetamines and methamphetamines are among important abused substances. Different types of neurologic, psychiatric, respiratory, gastrointestinal, and cardiogenic complications have been reported to be related to methamphetamine consumption. Some of these substances could cause dysrhythmias which is the most prevalent etiology of cardiogenic syncope. Ecstasy, as one of the most commonly abused drugs, is known as a cause of cardiac dysrhythmias. Here we report a young boy who was admitted into the emergency department following three syncope attacks. All cardiac and neurologic assessments were normal; and finally ecstasy abuse was detected as the main etiology of syncopes. PMID:28286854

  6. Recurrent Syncope following Substance Abuse; a Case Report.

    PubMed

    Salehi, Forod; Hassanzadeh Taheri, Mohammad Mehdi; Riasi, HamidReza; Mehrpour, Omid

    2017-01-01

    Drug abuse is considered as the most common poisoning in the world. Stimulants agent especially amphetamines and methamphetamines are among important abused substances. Different types of neurologic, psychiatric, respiratory, gastrointestinal, and cardiogenic complications have been reported to be related to methamphetamine consumption. Some of these substances could cause dysrhythmias which is the most prevalent etiology of cardiogenic syncope. Ecstasy, as one of the most commonly abused drugs, is known as a cause of cardiac dysrhythmias. Here we report a young boy who was admitted into the emergency department following three syncope attacks. All cardiac and neurologic assessments were normal; and finally ecstasy abuse was detected as the main etiology of syncopes.

  7. Prevalence of childhood sexual abuse among Malaysian paramedical students.

    PubMed

    Singh, H S; Yiing, W W; Nurani, H N

    1996-06-01

    There has been increasing awareness that sexual abuse of children is a problem in Malaysia. Existing data is based on notification of cases. Population based studies are required to plan services for sexually abused children. This study utilized trainee paramedical staff as a community population to determine the prevalence of childhood sexual abuse. An anonymous, self-administered questionnaire was given to student nurses and trainee medical assistants at the Ipoh School of Nursing and Hospital Bahagia Medical Assistant Training School. Questionnaires were distributed directly to all students in a classroom setting and retrieved after a 30-minute interval. Information collected included questions on personal experiences of sexual abuse. Sexual abuse was defined as rape, sodomy, molestation, or exhibitionism occurring to a child less than 18 years of age. Six hundred and sixteen students participated in the study; 6.8% of the students admitted to having been sexually abused in their childhood, 2.1% of males and 8.3% of females. Of those abused, 69% reported sexual abuse involving physical contact, 9.5% of whom experienced sexual intercourse. The age at first abuse was < 10 years in 38.1% of the cases; 59.5% were repeatedly abused and 33.3% had more than one abuser. Of the abusers, 71.4% were known to the respondent, 14.2% of whom were brothers, 24.5% relatives, and 24.5% a family friend. Further, 28.9% of all students knew of an individual who had been sexually abused as a child. While this population may not be entirely reflective of the community, this study does provide an indication of the prevalence of sexual abuse in Malaysian children. The prevalence figures in this study are lower than those reported in industrialized countries and this may reflect local sociocultural limitations in reporting abuse.

  8. Group treatment of adult male inpatients abused as children.

    PubMed

    Zaidi, L Y

    1994-10-01

    Recent research indicates that childhood abuse experiences characterize a large subset of psychiatric inpatients. This paper presents a time-limited pilot group developed for adult male abuse survivors in an inpatient setting using: (1) techniques adapted from the existing literature on treatment of abuse survivors; and (2) approaches deriving from the interface of theory and current manifestations of distress. The eclectic therapeutic approach incorporated psychoeducational, cognitive, behavioral, and art therapy techniques presented below in a session-by-session format.

  9. [The physician, the drug abuser and drug abuse].

    PubMed

    Størksen, P

    1990-09-20

    Drug abusers have a low tolerance for unpleasant and painful emotions and experience a need for chemical relief through use of narcotics, tranquilizers and analgesics. Physicians may show a tendency to comply with their request for such drugs, partly because they give way under pressure (threats, violence) and partly because of their own unconscious need for acceptance and appreciation from the patients. The use of prescribed drugs may inspire an illusion that drug therapy is a "solution" and withdraw attention from other therapies. The prescription of medicaments may represent an extension of already existing abuse. Physicians must be aware of these problems of prescription and of the problems connected to patients' use of threats and violence.

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

    PubMed

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

    2013-01-01

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

  11. The meaning of child abuse for nurses in Taiwan.

    PubMed

    Feng, Jui-Ying; Jezewski, Mary Ann; Hsu, Tsung-Wei

    2005-04-01

    The purpose of this study was to explore nurses' experiences and perspectives regarding child abuse in Taiwan. Semistructured interviews with Taiwanese nurses were audiotaped and transcribed verbatim for this descriptive study. The method of category development proposed by the grounded theory method was used to develop categorical themes that reflected the nurses' experiences and perspectives. From the 18 registered nurses interviewed, four major categorical themes emerged that were integral to nurses' experiences working with abused children: the meaning of child abuse, conflict, feeling frustrated, and nurses' roles. Findings provide a base for understanding child abuse from the perspectives of nurses and a beginning understanding of interventions needed to improve identification and reporting of child abuse in Taiwan. Although nurses have considerable awareness and concern about child abuse, additional education related to this issue is needed.

  12. Universal problems during residency: abuse and harassment.

    PubMed

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

    2009-07-01

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

  13. Skin manifestations of child abuse.

    PubMed

    Ermertcan, Aylin Turel; Ertan, Pelin

    2010-01-01

    Child abuse is a major public health problem all over the world. There are four major types of abuse: physical abuse, sexual abuse, emotional abuse and neglect. The most common manifestations of child abuse are cutaneous and their recognition; and differential diagnosis is of great importance. Clinicians, especially dermatologists, should be alert about the skin lesions of child abuse. In the diagnosis and management of child abuse, a multidisciplinary approach with ethical and legal procedures is necessary. In this manuscript, cutaneous manifestations of physical, sexual, emotional abuse and neglect are reviewed and discussed.

  14. Evaluation of quetiapine abuse and misuse reported to poison centers.

    PubMed

    Klein-Schwartz, Wendy; Schwartz, Elana K; Anderson, Bruce D

    2014-01-01

    There are case reports of abuse of quetiapine, but no studies address quetiapine abuse or misuse. Most literature on the population that abuses quetiapine describes an older age group with previous substance abuse history, many of whom are in jail. The objective of this study was to evaluate national poison center data on misuse/abuse of quetiapine. A retrospective study of American Association of Poison Control Centers National Poison Data System data from 2005 to 2011 on single substance quetiapine exposures coded as intentional misuse or abuse and followed to known outcome was performed. Data were evaluated for age, toxicity, management sites, treatments, and medical outcomes. There were 3116 cases meeting inclusion criteria; reason was misuse in 1948 cases and abuse in 1168 cases. The median age was 23 years. Misuse was reported most often in adults, whereas abuse occurred most frequently in adolescents. The male-to-female ratio was 1.7 for abuse and 1.0 for misuse. There were no deaths. Moderate or major toxicity occurred in 23.7% and 27.1% of misuse and abuse cases, respectively. Seventy-six percent were treated in the emergency department and/or received medical admission. Misuse was more common than abuse, except in adolescents for whom abuse was more frequent. Although outcomes were generally good, significant toxicity occurred in 25% of cases and more than 75% of the patients were treated in the emergency department and/or received medical admission. The consequences of nonmedical use of quetiapine are serious in some patients.

  15. Child Abuse Amendments of 1983.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Committee on Education and Labor.

    The booklet presents the report of the U.S. House of Representatives Committee on Education and Labor regarding the 1983 Child Abuse Amendments to the Child Abuse Prevention and Treatment Act and the Child Abuse Prevention and Treatment and Adoption Reform Act of 1978. The Amendment expands the definition of child abuse to include abuse by…

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

    PubMed

    Plummer, Malory; Cossins, Annie

    2016-07-19

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

  17. Socio-demographic characteristics, clinical profile and prevalence of existing mental illness among suicide attempters attending emergency services at two hospitals in Hawassa city, South Ethiopia: a cross-sectional study.

    PubMed

    Ayehu, Moges; Solomon, Tarekegn; Lemma, Kinfe

    2017-01-01

    Suicide is a major public health problem worldwide. It contributes for more than one million deaths each year. Since previous suicidal attempt was considered as the best predictor of future suicide, identifying factors behind suicidal attempt are helpful to design suicide prevention strategies. The aim of this study was to assess socio-demographic characteristics, clinical profile and prevalence of existing mental illness among patients presenting with suicidal attempt to emergency services of general hospitals in South Ethiopia. We conducted a cross-sectional study on patients presenting with complications of suicidal attempt to emergency departments of two general hospitals in Hawassa city from November, 2014 to August, 2015. Data was collected using semi-structured questionnaire which contained socio-demographic and clinical variables. The Mini International Neuropsychiatric Interview version 5 (MINI PLUs) was used to assess the prevalence of existing mental illness among study participants. Data was entered and analyzed using IBM SPSS statistics 21 software package. A total of 96 individuals were assessed, of whom 56 (58.3%) were females. The mean age of study participants was 21.5 (8.0) years. The majority, 75 (78.1%), of the study participants were aged below 25 years. Ingesting pesticide poisons and corrosive agent were used by the majority to attempt suicide. Mental illness was found in only three (3.1%) of the study participants. Impulsivity (the time between decision to attempt suicide and the actual attempt of less than 5 min) was reported by 30 (31.2%) of the study participants, of whom 18 (60%) were males. Males were found three times more likely to attempt suicide impulsively than women (COR = 3.0, 95% CI 1.2-7.3). Quarreling with family members, facing financial crisis, and having unplanned and unwanted pregnancy were reported by the majority of study participants as immediate reasons to attempt suicide. The presence of stressful life events and

  18. The Role of Education in Drug Abuse Programs.

    ERIC Educational Resources Information Center

    Richardson, Sandra C.

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

  19. The Medical Analysis of Child Sexual Abuse Images

    ERIC Educational Resources Information Center

    Cooper, Sharon W.

    2011-01-01

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

  20. Special Considerations for Substance Abuse Intervention with Latino Youth

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  1. The Medical Analysis of Child Sexual Abuse Images

    ERIC Educational Resources Information Center

    Cooper, Sharon W.

    2011-01-01

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

  2. Substance Abuse in Rural African-American Populations.

    ERIC Educational Resources Information Center

    Dawkins, Marvin P.; Williams, Mary M.

    More research into illicit substance abuse in rural African-American communities is needed. The existing literature indicates that patterns of use for licit substances (alcohol and cigarettes) are either similar for rural Blacks and Whites or lower for Blacks. However, the negative health and social consequences of smoking and abusive drinking are…

  3. Abuse of Women with Disabilities: State of the Science.

    ERIC Educational Resources Information Center

    Hassouneh-Phillips, Dena; Curry, Mary Ann

    2002-01-01

    Women with disabilities experience abuse at similar or higher rates than women in the general population. To promote awareness of this problem, this article offers a brief overview of the general domestic violence literature and a critical review of existing research regarding the abuse of women with disabilities. Offers an overview of practical…

  4. Predictors of Depressive Symptoms among Inpatient Substance Abusers

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  5. The Role of Education in Drug Abuse Programs.

    ERIC Educational Resources Information Center

    Richardson, Sandra C.

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

  6. Predictors of Depressive Symptoms among Inpatient Substance Abusers

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  7. Special Considerations for Substance Abuse Intervention with Latino Youth

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  8. PTSD and Substance Abuse

    DTIC Science & Technology

    2014-10-01

    AD_________________ Award Number: W81XWH-10-2-0074 TITLE: PTSD and Substance Abuse PRINCIPAL...PTSD and Substance Abuse 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-10-2-0074 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Dr. Lisa M...Board, Substance Abuse and Rehabilitation 2011-pres. Editorial Board, Psychological Trauma: Theory, Research, Practice, and Policy 2014-pres

  9. PTSD and Substance Abuse

    DTIC Science & Technology

    2012-07-01

    W81XWH1020074 TITLE: PTSD and Substance Abuse PRINCIPAL INVESTIGATOR: Lisa Najavits, Ph.D. CONTRACTING...1 August 2011 – 31 July 2012 4. TITLE AND SUBTITLE PTSD and Substance Abuse 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-10...months as we then dropped Fort Jackson as a site due 6 to a change in our site PI’s role there (no longer having oversight of the substance abuse

  10. Elder abuse and neglect.

    PubMed

    Muehlbauer, Melissa; Crane, Patricia A

    2006-11-01

    Elder abuse and neglect is a critical health care issue that must be brought to the attention of health care providers and older adults' family members. Adults older than 65 who live at home or in long-term care facilities may be at risk for abuse. Nurses should be aware of the causes, screening questions, symptoms of abuse, and resources in the community. Armed with information and a better understanding about the issue, nurses can minimize the devastating effects of abuse on older adults and their families.

  11. Alternative drugs of abuse.

    PubMed

    Sutter, M E; Chenoweth, J; Albertson, T E

    2014-02-01

    The incidence of drug abuse with alternative agents is increasing. The term "alternative drugs of abuse" is a catch-all term for abused chemicals that do not fit into one of the classic categories of drugs of abuse. The most common age group abusing these agents range from 17 to 25 years old and are often associated with group settings. Due to their diverse pharmacological nature, legislative efforts to classify these chemicals as a schedule I drug have lagged behind the development of new alternative agents. The potential reason for abuse of these agents is their hallucinogenic, dissociative, stimulant, anti-muscarinic, or sedative properties. Some of these drugs are easily obtainable such as Datura stramonium (Jimson Weed) or Lophophora williamsii (Peyote) because they are natural plants indigenous to certain regions. The diverse pharmacology and clinical effects of these agents are so broad that they do not produce a universal constellation of signs and symptoms. Detailed physical exams are essential for identifying clues leading one to suspect an alternative drug of abuse. Testing for the presence of these agents is often limited, and even when available, the results do not return in a timely fashion. Intoxications from these agents pose unique challenges for health care providers. Physician knowledge of the physiological effects of these alternative agents and the local patterns of drug of abuse are important for the accurate diagnosis and optimal care of poisoned patients. This review summarizes the current knowledge of alternative drugs of abuse and highlights their clinical presentations.

  12. Child Abuse: The Hidden Bruises

    MedlinePlus

    ... 5; Updated November 2014 The statistics on physical child abuse are alarming. It is estimated hundreds of thousands ... Physical abuse is not the only kind of child abuse. Many children are also victims of neglect, or ...

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

    PubMed

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

    2016-07-01

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

  14. Toxic Knowledge: Self-Alteration Through Child Abuse Work.

    PubMed

    Sigad, Laura I; Davidov, Jonathan; Lev-Wiesel, Rachel; Eisikovits, Zvi

    2016-02-01

    The purpose of the present article is to examine the multiple ways in which the private lives of professionals are affected by involvement with child abuse intervention and prevention. Using a descriptive-phenomenological perspective and 40 in-depth interviews with professionals to present a model based on qualitative data, we studied the ways in which child abuse professionals conceptualize, understand, and integrate their experiences into their personal and family lives. We find that the process of internalizing child abuse knowledge occurs in two domains: One affirms or denies the existence of the phenomenon; the other concerns the strategies used to contend with the effects of working in abuse. Knowledge of child abuse is toxic, in the sense that it serves as a catalyst leading to the alteration of one's self-perception and parental identity. We present a typology of self-alteration resulting from child abuse knowledge and describe the mechanism of this change.

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    ERIC Educational Resources Information Center

    Osborne, Cynthia; Berger, Lawrence M.

    2009-01-01

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    ERIC Educational Resources Information Center

    Dale, Kathryn A.; Alpert, Judith L.

    2007-01-01

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

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

    ERIC Educational Resources Information Center

    Osborne, Cynthia; Berger, Lawrence M.

    2009-01-01

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

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  2. Cutaneous manifestations of child abuse.

    PubMed

    Kos, Liborka; Shwayder, Tor

    2006-01-01

    Dermatologists and child abuse are not frequently associated in the minds of most physicians. Yet the most common manifestations of child abuse are cutaneous. This article reviews cutaneous manifestations of physical abuse, including bruises, lacerations, abrasions, human bites, and burns. It also discusses ways that dermatologists can differentiate abusive injuries from accidental ones as well as from the many dermatologic conditions that can mimic child abuse. Finally, we review what actions the dermatologist should take when suspecting abuse in a patient.

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

    ERIC Educational Resources Information Center

    Olafson, Erna; And Others

    1993-01-01

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

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

    ERIC Educational Resources Information Center

    Olafson, Erna; And Others

    1993-01-01

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

  5. Domestic Abuse in Behshahr, Iran

    PubMed Central

    Rahmatian, Ali Akbar; Hosseini, Seyyed Ali Asghar

    2015-01-01

    Background: The United Nations in a resolution defined abuse as any violent act that is primarily or exclusively committed against females and results in physical, sexual and psychological harm. Objectives: The aim of this research was to study the contributing factors of husband’s violence against females residing in the city of Behshahr, Iran. Materials and Methods: We distributed a specifically designed questionnaire among 380 married females aged between 15 and 65 years. According to the Morgan table, the subjects were randomly selected from a list of 301000 females. Demographic data and data on spouse abuse were then analyzed using the SPSS software, Spearman and Pearson correlation coefficients. According to Cronbach’s alpha, the reliability of the questionnaire was 0.96. Results: All of the females reported at least one form of violence within the past year, with R square 0.20, indicating that the independent variable can explain 20% of the violence against females. years of marriage, female’s education, male’s addiction and the number of children each had their share in the explanation of violence against females. Conclusions: This study revealed a high prevalence of domestic violence in the sample population. Violence existed among all ages, social categories and male occupational groups, and also involved both employed and unemployed females. The situation regarding domestic abuse is similar worldwide. PMID:26834799

  6. Battling Sexual Abuse

    ERIC Educational Resources Information Center

    Dessoff, Alan

    2010-01-01

    From costly lawsuits on behalf of victims to negative media coverage, districts can face potentially devastating consequences as a result of sexual abuse of their students by district employees. This article offers a few tips on how to battle sexual abuse particularly in school districts. The author stresses that by adopting strong policies that…

  7. Special Issue: Substance Abuse.

    ERIC Educational Resources Information Center

    Fuhrmann, Barbara S., Ed.; Washington, Craig S., Ed.

    1984-01-01

    Presents ten articles about substance abuse: its effects, consequences, and strategies for intervention. Describes specific group therapy techniques and presents both a court service designed for assisting juveniles with drug/alcohol offenses, and a school-based substance abuse prevention program. Looks at strategies for counseling special…

  8. Drug Abuse - Now.

    ERIC Educational Resources Information Center

    Blachly, P. H., Ed.

    A review of all facets of the drug abuse problem is offered in this anthology of articles. Moral dilemmas of physicians operating treatment programs are presented at one end of the spectrum and problems of the mass media and education about drug abuse are at the other. Drugs in the military, drugs in the ghettoes, drugs in the work place, and drug…

  9. Substance Abuse Policy

    ERIC Educational Resources Information Center

    Cuzzolino, Robert

    This brochure outlines the substance abuse policy for students at the Philadelphia College of Osteopathic Medicine (PCOM/Pennsylvania). Noted are the dangers of substance abuse during the stressful time of medical training and later for the doctor and clients during professional practice. The policy's five goals are briefly stated. Described next…

  10. Factors Predisposing Drug Abuse.

    ERIC Educational Resources Information Center

    Cheney, Carl D.; Phelps, Brady J.

    The exact nature of the events which may predispose a person to substance abuse is not known. This paper provides a theoretical discussion and review which emphasizes three contexts which have been shown to predispose on individual to drug abuse: (1) prenatal exposure to a given substance; (2) environmental conditions present upon first exposure…

  11. Substance Abuse and Disability.

    ERIC Educational Resources Information Center

    Sales, Amos

    A review of the literature provides the conclusion that individuals with a disability versus those without a disability are more likely to have a substance abuse problem and less likely to get effective treatment. Data suggest 10-40% of all individuals in treatment for substance abuse have a coexisting physical or mental disability. Alcohol rates…

  12. Adolescent Substance Abuse.

    ERIC Educational Resources Information Center

    Thorne, Craig R.; DeBlassie, Richard R.

    1985-01-01

    Cummings (1979), citing evidence from the National Institute of Drug Abuse, reports that one of every eleven adult Americans suffers from a severe addictive problem. Drug addiction is epidemic among teenagers; one of every six teenagers suffers from a severe addictive problem. This paper focuses on adolescent drug/substance abuse. (Author)

  13. [Female child sexual abuse].

    PubMed

    Enyedy, Andrea; Csorba, Roland

    2017-06-01

    The prevalence of child sexual abuse is 12-13% worldwide (18% by girls, 8% by boys). The exact knowledge of sexual abuse and the spread of the adequate medical diagnosis is an essential medical, social and national requirement. In our present study we examine the medical diagnosis of female child sexual abuse. Selective literature research in the available international and domestic databases. Majority of children assessed for suspected sexual abuse have normal genital and anal findings. Contrary to popular belief, the majority of child sexual abuse is a chronic multiple event, caused by a family member. The task of the medical staff is difficult and various, due to the diagnostic challenges of child sexual abuse. The difficulties of the medical diagnosis, evaluation and therapy, the complexity of the legal proceedings and prosecution, the isolation of the profession and the victim and the issue treated like a taboo subject often lead to failure. The physicians dealing with children have suboptimal knowledge of child sexual abuse, the characteristics of victims and perpetretors, the medical diagnosis and therapy of sexual abuse and the rehabilitation of victims. Orv Hetil. 2017; 158(23): 910-917.

  14. Adolescent Substance Abuse.

    ERIC Educational Resources Information Center

    Thorne, Craig R.; DeBlassie, Richard R.

    1985-01-01

    Cummings (1979), citing evidence from the National Institute of Drug Abuse, reports that one of every eleven adult Americans suffers from a severe addictive problem. Drug addiction is epidemic among teenagers; one of every six teenagers suffers from a severe addictive problem. This paper focuses on adolescent drug/substance abuse. (Author)

  15. Signs of domestic abuse.

    PubMed

    Pearce, Lynne

    2017-07-13

    Essential facts The government's definition of domestic violence and abuse, published in 2016 by the Home Office, is: 'Any incident or pattern of incidents of controlling, coercive, threatening behaviour, violence or abuse between those 16 years or over who are, or have been, intimate partners or family members, regardless of gender or sexuality.'

  16. Alcoholism and Elder Abuse.

    ERIC Educational Resources Information Center

    Anetzberger, Georgia J.; And Others

    1994-01-01

    A comparison group study of abusing and nonabusing caregivers suggested a correlation between alcohol use and violence against elderly parents. Findings reveal that abusers were more likely than nonabusers to drink, to become intoxicated, and to be identified as having a drinking problem. Policy and practice implications are discussed. (Author)

  17. Antitussives and substance abuse

    PubMed Central

    Burns, Jarrett M; Boyer, Edward W

    2013-01-01

    Abuse of antitussive preparations is a continuing problem in the United States and throughout the world. Illicit, exploratory, or recreational use of dextromethorphan and codeine/promethazine cough syrups is widely described. This review describes the pharmacology, clinical effects, and management of toxicity from commonly abused antitussive formulations. PMID:24648790

  18. Authority as coercion:when authority figures abuse their positions to perpetrate child sexual abuse.

    PubMed

    Weiss, Karen

    2002-01-01

    ABSTRACT. This article discusses child sexual abuse by a person in a position of authority, such as the child's teacher, guardian, relative, sports coach, or other person with authority over a child because of his/her particular position. The article tracks the recent trend toward recognizing position of authority in both state legislation and judicial precedent. Understanding the confusion and intimidation surrounding a child's experiences as a result of being sexually abused by a person in a position of authority often explains why children often fail to report or delay in reporting such abuse. Thus, existence of a perpetrator's position of authority in a particular case of child sexual abuse should influence a court's rulings on the elements of sexual abuse or assault in particular state statutes, as well as what evidence should be admissible. Ultimately, the author concludes that all states should recognize position of authority in their child abuse statutes, that such statutes should be interpreted broadly by the courts, and, finally, that evidence of the defendant's prior acts of sexual abuse should almost always be admissible at trial.

  19. Parent abuse: a review.

    PubMed

    Kennair, Nicola; Mellor, David

    2007-10-01

    A recent focus of research and clinical practice has been on the issue of abuse of parents by their children (parent abuse). This paper reviews the literature on this phenomenon. While parent abuse falls under the umbrella of family violence, it appears to be qualitatively different from other forms of intra-family abuse. Research has primarily focused on prevalence rates and the characteristics of perpetrators and victims. While various factors such as gender, age, emotional attachment to parents, race/ethnicity, socioeconomic status, family stress and parenting style and structure have been associated with parent abuse, findings are equivocal. Etiological models are general and untested, and treatment approaches lack empirical support. It is concluded that more rigorous and extensive research is required in order to provide a deeper understanding of this complex issue, and to inform treatment approaches.

  20. Recreational drugs of abuse.

    PubMed

    Albertson, Timothy E

    2014-02-01

    The use of recreational drugs of abuse continues to expand without limitations to national boundaries, social status, race, or education. Beyond the prevalence of illicit drug use and dependence, their contribution to the global burden of disease and death are large and troubling. All medical providers should be aware of the evolving drugs of abuse and their medical and social consequences. In addition to heroin and stimulants such as cocaine and methamphetamine, new designer stimulants called "bath salts" and cannabinoids called "spice," along with the abuse of prescription drugs and volatile substances, are now widely recognized problems in many societies. The wide variety and continuingly expanding clinical manifestations of toxicity of recreational drugs of abuse is not widely appreciated by clinicians. This edition attempts to summarize six major classes of drugs of abuse and their clinical effects with special emphasis on their immunological and respiratory effects.

  1. Abuse of prescription drugs.

    PubMed Central

    Wilford, B B

    1990-01-01

    An estimated 3% of the United States population deliberately misuse or abuse psychoactive medications, with severe consequences. According to the National Institute on Drug Abuse, more than half of patients who sought treatment or died of drug-related medical problems in 1989 were abusing prescription drugs. Physicians who contribute to this problem have been described by the American Medical Association as dishonest--willfully misprescribing for purposes of abuse, usually for profit; disabled by personal problems with drugs or alcohol; dated in their knowledge of current pharmacology or therapeutics; or deceived by various patient-initiated fraudulent approaches. Even physicians who do not meet any of these descriptions must guard against contributing to prescription drug abuse through injudicious prescribing, inadequate safeguarding of prescription forms or drug supplies, or acquiescing to the demands or ruses used to obtain drugs for other than medical purposes. PMID:2349801

  2. Sexual Abuse Prevention: A Misguided Focus

    ERIC Educational Resources Information Center

    Rowe, Robert N.

    2006-01-01

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

  3. Sexual Abuse Prevention: A Misguided Focus

    ERIC Educational Resources Information Center

    Rowe, Robert N.

    2006-01-01

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

  4. Child Abuse and Deafness: An Overview

    ERIC Educational Resources Information Center

    Sebald, Ann M.

    2008-01-01

    The professional literature contains research and anecdotal information on various maltreatments affecting children and youth with and without disabilities. Unfortunately, little information exists on abused children with hearing loss. Reasons relate to a lack of quantity and quality in research on this population; challenges in conducting…

  5. Child Abuse and Neglect Thesaurus, May, 1978.

    ERIC Educational Resources Information Center

    Herner and Co., Washington, DC.

    The thesaurus contains approximately 4,000 terms used in indexing material for the National Center on Child Abuse and Neglect. It is explained that the descriptor compilation was first developed in 1975 from existing thesauri and dictionaries. Descriptors are arranged in alphabetic, permuted and group displays, and listings include references to…

  6. Amphetamine Abuse Related Acute Myocardial Infarction.

    PubMed

    Sinha, Archana; Lewis, O'Dene; Kumar, Rajan; Yeruva, Sri Lakshmi Hyndavi; Curry, Bryan H

    2016-01-01

    Amphetamine abuse is a global problem. The cardiotoxic manifestations like acute myocardial infarction (AMI), heart failure, or arrhythmia related to misuse of amphetamine and its synthetic derivatives have been documented but are rather rare. Amphetamine-related AMI is even rarer. We report two cases of men who came to emergency department (ED) with chest pain, palpitation, or seizure and were subsequently found to have myocardial infarction associated with the use of amphetamines. It is crucial that, with increase in amphetamine abuse, clinicians are aware of this potentially dire complication. Patients with low to intermediate risk for coronary artery disease with atypical presentation may benefit from obtaining detailed substance abuse history and urine drug screen if deemed necessary.

  7. Religion in child sexual abuse forensic interviews.

    PubMed

    Tishelman, Amy C; Fontes, Lisa A

    2017-01-01

    Religion is an under-studied factor affecting children's sexual victimization and their willingness to discuss such experiences. In this qualitative study, 39 child forensic interviewers and child advocacy center (CAC) directors in the United States discussed religious influences on children's sexual abuse experiences, their relationships to CACs, and their disclosures in the forensic setting. Participants reported both harmonious and dissonant interactions between religiously observant children and families on one hand and child advocacy centers on the other. Themes emerged related to abuse in religious contexts and religious justifications for abuse; clergy and religious supports for disclosures as well as suppression of disclosures; and the ways CACS accommodate religious diversity and forge collaborations with clergy. Participants discussed a wide range of religions. Recommendations for practice and research are included.

  8. Amphetamine Abuse Related Acute Myocardial Infarction

    PubMed Central

    Lewis, O'Dene; Kumar, Rajan; Yeruva, Sri Lakshmi Hyndavi; Curry, Bryan H.

    2016-01-01

    Amphetamine abuse is a global problem. The cardiotoxic manifestations like acute myocardial infarction (AMI), heart failure, or arrhythmia related to misuse of amphetamine and its synthetic derivatives have been documented but are rather rare. Amphetamine-related AMI is even rarer. We report two cases of men who came to emergency department (ED) with chest pain, palpitation, or seizure and were subsequently found to have myocardial infarction associated with the use of amphetamines. It is crucial that, with increase in amphetamine abuse, clinicians are aware of this potentially dire complication. Patients with low to intermediate risk for coronary artery disease with atypical presentation may benefit from obtaining detailed substance abuse history and urine drug screen if deemed necessary. PMID:26998366

  9. Dextromethorphan Abuse in Adolescence

    PubMed Central

    Bryner, Jodi K.; Wang, Uerica K.; Hui, Jenny W.; Bedodo, Merilin; MacDougall, Conan; Anderson, Ilene B.

    2008-01-01

    Objectives To analyze the trend of dextromethorphan abuse in California and to compare these findings with national trends. Design A 6-year retrospective review. Setting California Poison Control System (CPCS), American Association of Poison Control Centers (AAPCC), and Drug Abuse Warning Network (DAWN) databases from January 1, 1999, to December 31, 2004. Participants All dextromethorphan abuse cases reported to the CPCS, AAPCC, and DAWN. The main exposures of dextromethorphan abuse cases included date of exposure, age, acute vs long-term use, coingestants, product formulation, and clinical outcome. Main Outcome Measure The annual proportion of dextromethorphan abuse cases among all exposures reported to the CPCS, AAPCC, and DAWN databases. Results A total of 1382 CPCS cases were included in the study. A 10-fold increase in CPCS dextromethorphan abuse cases from 1999 (0.23 cases per 1000 calls) to 2004 (2.15 cases per 1000 calls) (odds ratio, 1.48; 95% confidence interval, 1.43–1.54) was identified. Of all CPCS dextromethorphan abuse cases, 74.5% were aged 9 to 17 years; the frequency of cases among this age group increased more than 15-fold during the study (from 0.11 to 1.68 cases per 1000 calls). Similar trends were seen in the AAPCC and DAWN databases. The highest frequency of dextromethorphan abuse occurred among adolescents aged 15 and 16 years. The most commonly abused product was Coricidin HBP Cough & Cold Tablets. Conclusions Our study revealed an increasing trend of dextromethorphan abuse cases reported to the CPCS that is paralleled nationally as reported to the AAPCC and DAWN. This increase was most evident in the adolescent population. PMID:17146018

  10. Peer Abuse as Child Abuse and Indications for Intervention

    ERIC Educational Resources Information Center

    Healey, Jean B.

    2005-01-01

    Peer abuse in the form of bullying is now recognised as an endemic feature of school life and in terms of impact, outcomes and intervention requirements can be equated with other forms of child abuse. It is argued in the light of data presented here that the parallels between peer abuse and more generally accepted forms of child abuse must be…

  11. Methylphenidate and dextroamphetamine abuse in substance-abusing adolescents.

    PubMed

    Williams, Robert J; Goodale, Leslie A; Shay-Fiddler, Michele A; Gloster, Susan P; Chang, Samuel Y

    2004-01-01

    The prevalence of methylphenidate and dextroamphetamine misuse and abuse was examined in 450 adolescents referred for substance abuse treatment. Twenty three percent reported nonmedical use of these substances and six percent were diagnosed as methylphenidate or dextroamphetamine abusers. Abuse was more common in individuals who were out of school and had an eating disorder. Methylphenidate and dextroamphetamine abuse appears to be much less common than abuse of most other substances. It does occur, however, and parents and schools need to exert greater control over the dispensing of these medications. Physicians are advised to prescribe non-stimulant medications (eg, bupropion) when treating attention deficit hyperactivity disorder in substance-abusing individuals.

  12. Abused Mothers’ Safety Concerns and Court Mediators’ Custody Recommendations

    PubMed Central

    Rivera, Echo A.; Zeoli, April M.; Sullivan, Cris M.

    2012-01-01

    This study adds to research on family court’s response to custody in the context of intimate partner abuse (IPA). Mediation is often used to assist family court with custody negotiation; however, debate exists in the field regarding its use when IPA exists. The following study examines experiences with court mediation among a sample of victimized mothers who divorced abusive husbands. Mixed-method data were collected from 19 women. Findings demonstrate that abuse is rarely considered in custody recommendations, as most court mediators prefer joint custody. Implications for the ongoing debate, as well as future directions for research, are discussed. PMID:23144531

  13. Adolescent tramadol use and abuse in Egypt.

    PubMed

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

    2015-05-01

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

  14. Culture and systems of oppression in abused women's lives.

    PubMed

    Phillips, D S

    1998-01-01

    Women's experiences of abuse are shaped by the social and cultural contexts in which they live. Recognition of the complex ways in which culture and systems of oppression interact, creating qualitatively different abuse experiences, is important nursing knowledge. Of particular concern are the ways in which women are constrained in their efforts to combat abuse as they experience the harsh and alienating effects of racism, sexism, classism, and other forms of social injustice. An understanding of the ways in which race and ethnicity, class, language and citizenship, religion, and culture intersect and shape women's experiences of abuse is critical to the provision of culturally competent nursing care. This understanding is the springboard from which more effective assessment and intervention strategies with vulnerable abused women of diverse backgrounds can emerge.

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

    PubMed

    Roberts, Susan; Vanstone, Maurice

    2014-01-01

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

  16. Selective breeding for differential saccharin intake as an animal model of drug abuse.

    PubMed

    Carroll, Marilyn E; Morgan, Andrew D; Anker, Justin J; Perry, Jennifer L; Dess, Nancy K

    2008-09-01

    A positive relationship between the consumption of sweetened dietary substances (e.g. saccharin and sucrose) and drug abuse has been reported in both the human and other animal literature. The proposed genetic contribution to this relationship has been based on evidence from behavioral, neurobiological, and linkage studies in heterogeneous and homogeneous animal populations. Initial work in several laboratories indicated that rodents that are selected for high alcohol consumption also display an increased preference for sweets compared with low alcohol-consuming animals. More recently, Sprague-Dawley rats have been selectively bred based on high saccharin (HiS) or low saccharin (LoS) consumption, and these lines represent an ideal opportunity to determine whether a reciprocal genetic relationship exists between the consumption of sweetened substances and self-administration of drugs of abuse. The purpose of this review is to examine a series of studies on the HiS and LoS rats for drug-seeking and drug-taking behavior using laboratory animal models that represent critical phases of drug abuse in humans. The data support the hypothesis that sweet consumption and drug self-administration are closely related and genetically influenced. Other characteristics of HiS and LoS rats are discussed as possible mediators of the genetic differences such as activity, impulsivity, novelty reactivity, stress, and emotionality. The interaction of sweet preference with biological variables related to drug abuse, such as age, sex, and hormonal influences, was considered, as they may be additive vulnerability factors with consumption of sweet substances. In the studies that are discussed, the HiS and LoS lines emerge as ideal addiction-prone and addiction-resistant models, respectively, with vulnerability or resilience factors that will inform prevention and treatment strategies for drug abuse.

  17. Child Abuse and Mandated Reporting

    ERIC Educational Resources Information Center

    Woika, Shirley; Bowersox, Carissa

    2013-01-01

    Teachers and teachers-in-training are mandated reporters; they are legally required to report any suspected child abuse or neglect. This article describes: (1) How to file a report; (2) How prevalent child abuse is; (3) What abuse is; (4) What it means to be a mandated reporter; (5) When the report should be made; and (6) What to do if abuse is…

  18. Child Abuse and Mandated Reporting

    ERIC Educational Resources Information Center

    Woika, Shirley; Bowersox, Carissa

    2013-01-01

    Teachers and teachers-in-training are mandated reporters; they are legally required to report any suspected child abuse or neglect. This article describes: (1) How to file a report; (2) How prevalent child abuse is; (3) What abuse is; (4) What it means to be a mandated reporter; (5) When the report should be made; and (6) What to do if abuse is…

  19. Encountering Child Abuse at Camp.

    ERIC Educational Resources Information Center

    Durall, John K.

    1997-01-01

    Defines child abuse, including the three categories: physical, sexual, and psychological. Presents characteristics and behaviors of each type of abuse, and long-term effects. Discusses how to handle abuse that occurs at camp, and the effects on the camp. Sidebars present abuse statistics, 15 activities that promote psychological wellness, and 8…

  20. Children's Rights Regarding Physical Abuse.

    ERIC Educational Resources Information Center

    Saidla, Debie D.

    1992-01-01

    Sees children's rights as important arena in struggle for human dignity. Asserts that flagrant violation of rights of the child occurs when he or she is abused by a parent or caretaker. Explains children's rights with regard to physical abuse, outlines various definitions of abuse, and discusses the incidence and consequences of child abuse.…

  1. Neurologic aspects of drug abuse.

    PubMed

    Goforth, Harold W; Murtaugh, Reed; Fernandez, Francisco

    2010-02-01

    Neurologic aspects of drug abuse vary. This article explains the general nature of drug abuse, identifies the physiologic effects of certain drugs, and briefly describes the neurobiology of addiction. This article also reviews available treatment options for those addicted to substances of abuse, and clarifies common misconceptions, including the differences between tolerance, abuse, and addiction.

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

    PubMed

    Dong, XinQi

    2015-01-01

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

  3. Psychiatric emergencies in the geriatric population.

    PubMed

    Borja, Ben; Borja, Czarina Santos; Gade, Swami

    2007-05-01

    Failure to recognize psychiatric conditions in any age group particularly in the elderly could lead to a very complicated clinical picture and may lead to increased health expenditures. Psychiatric emergencies can be secondary to numerous factors: geriatric depression and suicide, behavioral disturbance secondary to underlying organic conditions, substance abuse, elder abuse, and medication-induced adverse events. This article discusses mainly geriatric depression, elder abuse, and conditions emanating from iatrogenic causes.

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

    ERIC Educational Resources Information Center

    Payne, Brian K.

    2013-01-01

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

  5. Workplace abuse: finding solutions.

    PubMed

    Christmas, Kate

    2007-01-01

    The atmosphere within the work setting speaks volumes about your culture, and is often a primary factor in recruitment and retention (or turnover) of staff. Workplace tension and abuse are significant contributing factors as to why nurses are exiting workplaces--and even leaving the profession. Abuse can take many forms from inappropriate interpersonal communication to sexual harassment and even violence. Administrators should adopt a zero tolerance policy towards abusive communication. Addressing peer behavior is essential, but positive behavior must also be authentically modeled from the CNO and other nursing leaders. Raising awareness and holding individuals accountable for their behavior can lead to a safer and more harmonious work environment.

  6. An integral approach to substance abuse.

    PubMed

    Amodia, Diana S; Cano, Carol; Eliason, Michele J

    2005-12-01

    There is a pressing need in the substance abuse field for more comprehensive models of etiology and treatment that address the complex issues of addiction, including the biological, social, cultural, spiritual and developmental needs of individuals and groups. This article presents a theoretical framework for an integral approach to substance abuse that expands on the existing biopsychosocial model. One contribution of the model is an integrated approach to spirituality from a cross-cultural perspective. This integral approach examines substance abuse etiology and treatment from a four-quadrant perspective adapted from the work of Ken Wilber, and incorporates concepts from integrative medicine and transpersonal psychology/psychiatry. Implications of the model are explored.

  7. Changing patterns of "drug abuse" in the United States: connecting findings from macro- and microepidemiologic studies.

    PubMed

    Sloboda, Zili

    2002-01-01

    Trend analyses of the U.S. monitoring data systems (the National Household Survey on Drug Abuse and the Monitoring the Future Study) and of the country's surveillance program, the Community Epidemiology Work Group (CEWG), indicate that several new "drug abuse" patterns have emerged over the past several years. For adolescents, drug use rates are converging for females and males, the mean age at which youngsters initiate drug use has declined, and more young adolescents are reporting using drugs. Furthermore, emergent new drug use patterns are being observed by the CEWG. The use of drugs such as Rohypnol, the injecting of crack-cocaine, and the spread of methamphetamines by new traffickers challenge our existing knowledge and understanding of drug use and its prevention. The National Institute on Drug Abuse has funded several large longitudinal studies that follow selected children and adolescents into their twenties, and some into their thirties. This research has been a rich source of information on the determinants of initiating and continuing drug abuse. Yet the findings from the surveys have not been well explored by the longitudinal studies, nor have the findings from the longitudinal studies been used in the surveys to better understand the observed changing trends in drug use patterns. This paper addresses six issues that have been observed from the findings from analyses of data from the surveys or macroepidemiologic studies. Information from the sub-population or micro-epidemiologic studies are reviewed for possible hypotheses to explain each issue. Suggestions for further research and implications for prevention also are presented.

  8. Opioid Abuse and Addiction

    MedlinePlus

    ... oxycodone, hydrocodone, fentanyl, and tramadol. The illegal drug heroin is also an opioid. Some opioids are made ... NAS). Opioid abuse may sometimes also lead to heroin use, because some people switch from prescription opioids ...

  9. Child Sexual Abuse

    MedlinePlus

    ... War Specific to Women Types of Trauma War Terrorism Violence and Abuse Disasters Is it PTSD? Treatment ... Overview Types of Trauma Trauma Basics Disaster and Terrorism Military Trauma Violence & other Trauma Assessment Assessment Overview ...

  10. Cough & Cold Medicine Abuse

    MedlinePlus

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Cough & Cold Medicine Abuse KidsHealth > For Teens > Cough & Cold ... tos y el resfriado Why Do People Use Cough and Cold Medicines to Get High? There's an ...

  11. Safety and abuse testing

    NASA Technical Reports Server (NTRS)

    Younger, G.

    1978-01-01

    A series of abuse tests on large lithium thionyl chloride cells was initiated. Performance data obtained in testing rectangular 2,000 and 10,000 ampere-hour cells are discussed and graphically presented.

  12. Prescription Drug Abuse

    MedlinePlus

    ... abuse might not lead to physical dependence and withdrawal, the feelings these drugs give people can cause ... especially important for someone who is going through withdrawal from a CNS depressant to speak with a ...

  13. Cough & Cold Medicine Abuse

    MedlinePlus

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Cough & Cold Medicine Abuse KidsHealth > For Teens > Cough & Cold ... Someone Quit? Avoiding DXM Why Do People Use Cough and Cold Medicines to Get High? There's an ...

  14. Elder Abuse FAQS

    MedlinePlus

    ... your community with our ready-to-use, research rich elder abuse presentations and pamphlets Community ... Policies & Disclaimers Right Column Social Media For Employees Office of the Inspector General Open ...

  15. Sexual Abuse of Children.

    ERIC Educational Resources Information Center

    Csapo, Marg

    1988-01-01

    Canadian reports and legislation are reviewed to highlight the school's role in prevention and reporting of suspicions of child sexual abuse. The vulnerability of handicapped children and child pornography are two areas of victimization emphasized. (Author/DB)

  16. Sexual Abuse of Children.

    ERIC Educational Resources Information Center

    Csapo, Marg

    1988-01-01

    Canadian reports and legislation are reviewed to highlight the school's role in prevention and reporting of suspicions of child sexual abuse. The vulnerability of handicapped children and child pornography are two areas of victimization emphasized. (Author/DB)

  17. Drug and Substance Abuse

    MedlinePlus

    ... Some older adults also abuse illegal drugs, including marijuana, cocaine, hallucinogens, and injected narcotics. Some people misuse ... cancer. It also makes many diseases, such as diabetes, more complicated and disabling. How Common are Drug ...

  18. Unexpected Serious Cardiac Arrhythmias in the Setting of Loperamide Abuse.

    PubMed

    Rasla, Somwail; St Amand, Amy; Garas, Marina K; El Meligy, Amr; Minami, Taro

    2017-04-03

    Loperamide (Imodium) is a non-prescription opioid receptor agonist available over-the-counter for the treatment of diarrhea. When ingested in excessive doses, loperamide can penetrate the blood-brain barrier and is reported to produce euphoria, central nervous system and respiratory depression, and cardiotoxicity. There is an emerging trend in its use among drug abusers for its euphoric effects or for self-treatment of opioid withdrawal. We report a case of ventricular dysrhythmias associated with loperamide abuse in a 28-year-old man who substituted loperamide for the opioids that he used to abuse. [Full article available at http://rimed.org/rimedicaljournal-2017-04.asp].

  19. Synthetic cathinone abuse

    PubMed Central

    Capriola, Michael

    2013-01-01

    The abuse of synthetic cathinones, widely known as bath salts, has been increasing since the mid-2000s. These substances are derivatives of the naturally occurring compound cathinone, which is the primary psychoactive component of khat. The toxicity of synthetic cathinones includes significant sympathomimetic effects, as well as psychosis, agitation, aggression, and sometimes violent and bizarre behavior. Mephedrone and methylenedioxypyrovalerone are currently the predominantly abused synthetic cathinones. PMID:23869180

  20. Treatment of child abuse: a review of the behavioral interventions.

    PubMed

    Isaacs, C D

    1982-01-01

    Child abuse has probably existed as a social problem as long as parents and children have lived under the same roof, and in recent years it has received tremendous attention. Most of the research has focused on etiology rather than treatment, leaving large gaps in our knowledge about remediating abuse. Behavioral scientists have only begun to formulate a conceptual framework from which to work. Many theoretical questions are yet unanswered, particularly the question of what constitutes abuse. Burgess (1978) believes that conceptual problems exist because abuse falls along a continuum of parent-child relationships--a continuum that at one end might include verbal punishment (e.g., threats, ridicule) or milder forms of physical punishment (e.g., slap on the hand, spanking), and at the other end include extreme forms of physical punishment that exceed community mores (for example, hitting a child with a closed fist, scalding a child in hot water, torturing or killing a child). Thus, the question-- where does discipline stop and abuse begin?-- faces every researcher who must operationally define abuse. Identifying the consequences of abuse in a child's development is another area of inquiry that remains untreated. Most of the literature is filled with the subjective impressions of professionals speculating that abused children become the juvenile delinquents and the child abusers of the future; however, as yet no longitudinal studies have been conducted that compare the developmental outcomes of abused and non-abused children from early childhood to later adulthood. What if there were no differences? How might this influence our approaches to the treatment of abuse? Answers to these and other questions will take years of study. Increased awareness of the problem of child abuse has led to greater efforts to remediate the problem. Treatment efforts with abusive families are still in the initial stages, but, undoubtedly, information from these early programs can be the

  1. Psychiatric emergencies.

    PubMed

    Cavanaugh, S V

    1986-09-01

    Psychiatric disorders are common in medical inpatient and outpatient populations. As a result, internists commonly are the first to see psychiatric emergencies. As with all medical problems, a good history, including a collateral history from relatives and friends, physical and mental status examination, and appropriate laboratory tests help establish a preliminary diagnosis and treatment plan. Patients with suicidal ideation usually have multiple stressors in the environment and/or a psychiatric disorder (i.e., a major affective disorder, dysthymic disorder, anxiety or panic disorder, psychotic disorder, alcohol or drug abuse, a personality disorder, and/or an adjustment disorder). Of all patients who commit suicide, 70% have a major depressive disorder, schizophrenia, psychotic organic mental disorder, alcoholism, drug abuse, and borderline personality disorder. Patients who are at great risk have minimal supports, a history of previous suicide attempts, a plan with high lethality, hopelessness, psychosis, paranoia, and/or command self-destructive hallucinations. Treatment is directed toward placing the patient in a protected environment and providing psychotropic medication and/or psychotherapy for the underlying psychiatric problem. Other psychiatric emergencies include psychotic and violent patients. Psychotic disorders fall into two categories etiologically: those that have an identifiable organic factor causing the psychosis and those that have an underlying psychiatric disorder. Initially, it is essential to rule out organic pathology that is life-threatening or could cause irreversible brain damage. After such organic causes are ruled out, neuroleptic medication is indicated. If the patient is not agitated or combative, he or she may be placed on oral divided doses of neuroleptics in the antipsychotic range. Patients who are agitated or psychotic need rapid tranquilization with an intramuscular neuroleptic every half hour to 1 hour until the agitation and

  2. Drug Abuse Prevention Starts with Parents

    MedlinePlus

    ... Teen Dating & Sex Fitness Nutrition Driving Safety School Substance Abuse Young Adult Healthy Children > Ages & Stages > Teen > Substance Abuse > Drug Abuse Prevention Starts with Parents Ages & Stages ...

  3. The Cortisol Paradox of Trauma-Related Disorders: Lower Phasic Responses but Higher Tonic Levels of Cortisol Are Associated with Sexual Abuse in Childhood

    PubMed Central

    Schalinski, Inga; Elbert, Thomas; Steudte-Schmiedgen, Susann; Kirschbaum, Clemens

    2015-01-01

    Objectives Inconsistent findings exist for the activity of the hypothalamic-pituitary-adrenal (HPA) axis in patients with stress related disorders. Recent studies point towards early life stress as a potential modulator. Methods We investigated the impact of childhood sexual abuse on phasic (saliva cortisol reactivity) and tonic (hair cortisol) regulation. Furthermore, we assessed predictors on cortisol accumulation in hair. Women (N = 43) with stress-related disorders underwent a standardized assessment of idiographic adverse and traumatic experiences and psychopathology, while measuring salivary cortisol and, heart rate and blood pressure. Results Comparing women with and without childhood sexual abuse revealed lower rates of responders and distinct levels of salivary cortisol to the interview in conjunction with a lower heart rate for the abused group. Childhood adversities, traumatic experiences, and depression contributed to higher hair cortisol levels. Conclusions Our finding of lower response rate and distinct salivary cortisol pattern in individuals with childhood sexual abuse compared to individuals without early sexual abuse supports the role of environmental programming for the HPA axis. Both, childhood adversities and traumatic stress emerge as crucial factors for long-term cortisol secretion. Lower or suppressed phasic cortisol responses to trauma-related stimuli may therefore be associated with higher tonic values. Thus, early exposure to adversities may result in a biological distinct phenotype in adult patients with stress-related disorders. PMID:26317554

  4. Health care fraud and abuse.

    PubMed

    Kalb, P E

    In recent years, health care fraud and abuse have become major issues, in part because of the rising cost of health care, industry consolidation, the emergence of private "whistle-blowers," and a change in the concept of fraud to include an emerging concern about quality of care. The 3 types of conduct that are generally prohibited by health care fraud laws are false claims, kickbacks, and self-referrals. False claims are subject to several criminal, civil, and administrative prohibitions, notably the federal civil False Claims Act. Kickbacks, or inducements with the intent to influence the purchase or sale of health care-related goods or services, are prohibited under the federal Anti-Kickback statute as well as by state laws. Finally, self-referrals-the referral of patients to an entity with which the referring physician has a financial relationship-are outlawed by the Ethics in Patient Referral Act as well as numerous state statutes. Consequences of violations of these laws can include, in addition to imprisonment and fines, civil monetary penalties, loss of licensure, loss of staff privileges, and exclusion from participation in federal health care programs. Federal criminal and civil statutes are enforced by the US Department of Justice; administrative actions are pursued by the Department of Health and Human Services' Office of Inspector General; and all state actions are pursued by the individual states. In addition, private whistle-blowers may, acting in the name of the United States, file suit against an entity under the False Claims Act. Enforcement of health care fraud and abuse laws has become increasingly commonplace and now affects many mainstream providers. This trend is likely to continue.

  5. [Skin signs in child abuse].

    PubMed

    Pau-Charles, I; Darwich-Soliva, E; Grimalt, R

    2012-03-01

    Child abuse is far more prevalent today than is generally recognized. Up to 90% of victims suffer physical abuse that can be observed in signs on the skin. Dermatologists are particularly qualified to identify these signs and distinguish them from other conditions that can mimic abuse. This review covers the signs of child abuse that can be observed on the skin. We discuss clues that can help differentiate between lesions caused by abuse and those that are accidental, and we describe the skin conditions that mimic physical abuse.

  6. Nurses' intention to report child abuse in Taiwan: a test of the theory of planned behavior.

    PubMed

    Feng, Jui-Ying; Wu, Yow-Wu B

    2005-08-01

    The purposes of this study were to identify factors associated with nurses' intention to report suspected child abuse in Taiwan, and to determine the empirical adequacy of the extended theory of planned behavior (TPB) to explain nurses' intention to report child abuse. A stratified quota sampling technique was used to select registered nurses in emergency rooms, psychiatric units, and pediatric units in Taiwan. A total of 1,362 questionnaires from 1,617 nurses were used for the analyses. Structural equation modeling demonstrated that nurses' attitudes toward reporting child abuse, perceived behavioral control, subjective norms, and knowledge of the child abuse and reporting law explained 85% to 91% of the variance in nurses' intention to report child abuse for the less severe and severe child abuse cases in vignettes, respectively. The findings support the use of the extended TPB in identifying factors associated with nurses' intention to report child abuse in Taiwan.

  7. Mexican immigrant survivors of intimate partner violence: conceptualization and descriptions of abuse.

    PubMed

    Kyriakakis, Stavroula; Dawson, Beverly Araujo; Edmond, Tonya

    2012-01-01

    This phenomenological qualitative study examines intimate partner violence (IPV) experienced by a sample of 29 Mexican immigrant women residing in New York and St. Louis. The findings reveal important insights about culturally specific abuse tactics employed by batterers and the forms of abuse that are experienced as most hurtful to the survivors. Ten different abusive tactics emerged: verbal, economic, physical, sexual, and extended family abuse, social isolation, physical abuse of children, stalking and monitoring, stolen bride, and sex trafficking. Cultural values and expectations appear to be inextricably linked to how the participants characterized the severity of each of the abusive tactics as evidenced by which abusive behaviors the participants found most hurtful. The findings will help service providers have a better understanding of the role cultural context plays in the IPV experiences of Mexican immigrant women.

  8. The impact of sexual abuse on sexual identity formation in gay men.

    PubMed

    Brady, Stephen

    2008-01-01

    Emerging data suggests that as children, gay males have an increased risk for physical and sexual abuse. Anecdotal evidence suggests that a significant subset of children abused by clergy identify as gay as adults. However, we know very little about the impact of clergy-perpetrated sexual abuse in childhood on the development and psychosocial functioning of gay men. This article describes the incidence of childhood abuse in the lives of gay men and the probable impact of clergy-perpetrated sexual abuse. In the treatment of gay men sexually abused as children, including those abused by clergy, providers should use a normative frame for gay identity development such as the Homosexual Identity Formation Model. This treatment model, highlighted with case material, is also discussed.

  9. Childhood abuse and suicidality in obstetrics patients in a hospital-based urban prenatal clinic.

    PubMed

    Farber, E W; Herbert, S E; Reviere, S L

    1996-01-01

    This study reports findings from a chart review examining the relationship between self-report of a history of childhood abuse and the emergence of suicidal ideation in pregnancy in a group of patients referred for psychiatric evaluation. The relationship between history of childhood abuse and actual suicide attempts prior to the current pregnancy was also investigated. Results revealed that women reporting a history of childhood sexual abuse, physical abuse, or both were significantly more likely than those not reporting a history of abuse to evidence suicidal ideation during the pregnancy. Additionally, those reporting a history of sexual abuse or both physical and sexual abuse were more likely than those not reporting such a history to have made a suicide attempt in the past at some point prior to the current pregnancy. Interpretations and potential implications of these findings for clinical work with psychiatrically at-risk pregnant women are discussed.

  10. Childhood Emergencies

    MedlinePlus

    ... difficult to recognize, especially in the very young. Child Abuse - 5/13/2015 Protecting Children From Abuse: What ... the same page when it comes to a child food allergies - especially as kids gear up for the new school year. Drug Abuse: The Warning Signs - 6/25/2015 How can ...

  11. Abuse of medications that theoretically are without abuse potential.

    PubMed

    Reeves, Roy R; Ladner, Mark E; Perry, Candace L; Burke, Randy S; Laizer, Janet T

    2015-03-01

    The potential for abuse of medications that are controlled substances is well known. Abuse of certain noncontrolled prescription drugs and over-the-counter medications also may occur. To some degree, any medication that exerts psychoactive effects may be abused if taken in high enough doses or by means that result in high serum or cerebrospinal fluid levels. Many clinicians may be unaware of the potential for abuse of these medications. This review examines evidence of the possibility of abuse of several common medications that theoretically do not have abuse potential, including cough and cold preparations, antihistamines, anticholinergics, antipsychotics, antidepressants, anticonvulsants, skeletal muscle relaxants, and antiemetics. Means by which such medications may be abused and biochemical and physiological mechanisms fostering their abuse also are discussed.

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

    PubMed

    Sabourin Ward, Caryn; Haskett, Mary E

    2008-05-01

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

  13. Effectiveness of Inhalant Abuse Legislation.

    PubMed

    Batis, Jeffery C

    2017-01-28

    Since peaking in the 1990s, inhalant abuse has steadily decreased over the past two decades. Concurrently, nearly every state has passed legislation aimed at minimizing inhalant abuse. While males have historically been more likely to abuse inhalants than females, there is no longer a sex effect in self-reported rates of inhalant abuse. The objective of the present study is to evaluate the effect of anti-inhalant abuse legislation on self-reported rates of inhalant abuse, in high school age males and females. Beginning in 1993, the CDC's biannual Youth Risk Behavior Surveillance Survey asked respondents if they have ever used inhalants to get high. Data from these surveys were collected, along with the date of passage of anti-inhalant abuse legislation in 46 of 50 states. ANOVAs were conducted to assess the effect of legislation on self-reported inhalant abuse rates. There were no significant main effects or interactions that demonstrated that inhalant abuse rates decreased in males or females following passage of legislation aimed at decreasing inhalant abuse. Conclusion/Importance: To date, 46 of 50 states have passed laws aimed at minimizing inhalant abuse, and while inhalant abuse rates have been decreasing for the past two decades, there is no evidence that this decline is related to enactment of these laws. Further research is needed to determine the cause of the decrease in inhalant abuse. The laws may benefit from amendments to include options for treatment.

  14. A Cross-Cultural Understanding of Depression Among Abused Women.

    PubMed

    Wong, Janet Y H; Tiwari, Agnes; Fong, Daniel Y T; Bullock, Linda

    2016-10-01

    Little research has addressed depression in abused women across cultures. This review examines depression and intimate partner violence (IPV) by comparing and contrasting the IPV definitions, family dynamics, coping, and expressions of depression of women in China, Japan, India, and the United States. Findings reveal that depression is expressed differently across cultures. Somatization is commonly found in Asian countries, but it is not properly assessed by existing Westernized depression assessment tools. In addition, cultural factors were shown to shape abused women's ways of adaptive coping. Cultural awareness and sensitivity are fundamental for successful assessment and intervention for abused women with depression.

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

    PubMed

    Dunn, Debra

    2005-10-01

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

  16. [Child abuse in Cameroon: evaluation of a training course on awareness, detection, and reporting of child abuse].

    PubMed

    Menick, D Mbassa; Ngoh, F

    2005-01-01

    The twofold purpose of this study was to promote and facilitate awareness, detection and reporting of child abuse by improving the diagnostic ability of a group of pediatric care providers working in pediatric emergency rooms and to evaluate the impact of training on awareness, detection and reporting of child abuse. This study was conducted in three phases. In the first phase data were retrospectively collected for a three-month period prior to the study (May, June, and July 1996). In the second phase a training seminar about awareness, detection, and reporting of child abuse was organized from April 29 to 30, 1997 for pediatric care providers working in the pediatric emergency rooms of several facilities in Yaoundé, Cameroon. Trainees included pediatricians, general practitioners, nurses, and social workers. An oral presentation using 137-slides (visual diagnosis of physical abuse) from the American Academy of Paediatrics (1994) was used as a teaching aid. In the third phase the same data as in the first phase was prospectively collected on the same three-month period after the seminar (May, June and July 1997). As in the first phase data was collected by the same person from emergency room registers according to the WHO protocol (1994) (study of interpersonal physical abuse of children). During the first phase 39 cases of physical abuse were reported in a population 1269 consulting patients, i.e. 3.1% of the cohort. In the third phase prospective analysis of reporting following the training seminar showed that 161 cases of physical abuse were reported in a population of 1425 consulting patients, i.e., 11.3% of the cohort. The victim group (n=161) in the third phase was four-fold larger than the victim group in the first phase (n = 39). These findings suggest that the seminar achieved its main goals, i.e., to improve the diagnostic ability of the trainees and to increase detection and screening of physical abuse of children.

  17. How Do People with Intellectual Disabilities View Abuse and Abusers?

    ERIC Educational Resources Information Center

    Northway, Ruth; Melsome, Melissa; Flood, Samantha; Bennett, Davey; Howarth, Joyce; Thomas, Becki

    2013-01-01

    People with intellectual disabilities have a higher risk of being abused than other people, but to date research has not explored their views regarding abuse. This article reports the findings relating to one question within a participatory research study concerning the abuse of people with intellectual disabilities. This question asked what…

  18. How Do People with Intellectual Disabilities View Abuse and Abusers?

    ERIC Educational Resources Information Center

    Northway, Ruth; Melsome, Melissa; Flood, Samantha; Bennett, Davey; Howarth, Joyce; Thomas, Becki

    2013-01-01

    People with intellectual disabilities have a higher risk of being abused than other people, but to date research has not explored their views regarding abuse. This article reports the findings relating to one question within a participatory research study concerning the abuse of people with intellectual disabilities. This question asked what…

  19. Inhalant abuse by adolescents.

    PubMed

    Kurtzman, T L; Otsuka, K N; Wahl, R A

    2001-03-01

    The deliberate misuse of volatile substances poses a poorly recognized risk for considerable morbidity and mortality in adolescent populations worldwide. The abuse of inhalants continues to be a significant problem among our country's youth. While many household and industrial chemicals can be inhaled, glues, paints, and aerosol propellants are among the most commonly abused. Adolescents are often unaware of the health threats posed by inhalation of solvents. Inhalation can result in serious organ system dysfunction or even sudden death. This review discusses the prevalence of inhalant abuse in the United States, summarizes the various types of substances used, highlights the major physiologic effects of inhalants, and briefly discusses associated risk behaviors, prevention and medical management.

  20. Sexual Abuse Of Children

    PubMed Central

    Herbert, Carol P.

    1982-01-01

    Increasing emphasis is being placed on the identification and management of sexual abuse in children. Family physicians have a role to play in identifying and treating these children. Some common myths about sexual abuse are that assaults are made mostly by strangers, that sexual abuse is rare, and that there's nothing wrong with sex between adults and children. Indicators in the child may be physical or behavioral. In the family, indicators include fathers with low self-esteem, poor relationships with wives, tendency to be domineering and restrictive, and mothers who are passive. Immediate and longterm intervention includes legal, protective and treatment components. The essential factors in successful intervention are belief in the child's disclosure; communication of that belief to the child; and immediate protection of the child and siblings. PMID:21286177

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

    PubMed Central

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

    2015-01-01

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

  2. Mental health, demographic, and risk behavior profiles of pregnant survivors of childhood and adult abuse.

    PubMed

    Seng, Julia S; Sperlich, Mickey; Low, Lisa Kane

    2008-01-01

    Our objective was to address the gap in knowledge about the extent to which perinatal mental health and risk behaviors are associated with childhood and adult experiences of abuse that arises because of barriers to screening and disclosure about past and current abuse. Survey data from an ongoing study of the effects of posttraumatic stress on childbearing were used to describe four groups of nulliparous women: those with no abuse history, adult abuse only, childhood abuse only, and abuse that occurred during both periods. The rates of abuse history disclosure were higher in the research context than in the clinical settings. Mental health morbidity and risk behaviors occurred in a dose-response pattern with cumulative abuse exposure. Rates of current posttraumatic stress disorder ranged from 4.1% among those never abused to 11.4% (adult only), 16.0% (childhood only), and 39.2% (both periods). Women abused during both periods also were more likely to be using tobacco (21.5%) and drugs (16.5%) during pregnancy. We conclude that mental health and behavioral risk sequelae affect a significant portion of both childhood and adult abuse survivors in prenatal care. The integration into the maternity setting of existing evidence-based interventions for the mental health and behavioral sequelae of abuse is needed.

  3. Substance abuse and child maltreatment.

    PubMed

    Wells, Kathryn

    2009-04-01

    Pediatricians and other medical providers caring for children need to be aware of the dynamics in the significant relationship between substance abuse and child maltreatment. A caregiver's use and abuse of alcohol, marijuana, heroin, cocaine, methamphetamine, and other drugs place the child at risk in multiple ways. Members of the medical community need to understand these risks because the medical community plays a unique and important role in identifying and caring for these children. Substance abuse includes the abuse of legal drugs as well as the use of illegal drugs. The abuse of legal substances may be just as detrimental to parental functioning as abuse of illicit substances. Many substance abusers are also polysubstance users and the compounded effect of the abuse of multiple substances may be difficult to measure. Often other interrelated social features, such as untreated mental illness, trauma history, and domestic violence, affect these families.

  4. Child neglect and psychological abuse

    MedlinePlus

    ... or neglect, call 911. Call the Childhelp National Child Abuse Hotline (1-800-4-A-CHILD). Know that ... can/identifying/. Accessed November 21, 2014. Read More Child abuse - physical Review Date 11/20/2014 Updated by: ...

  5. Chronic time abuse.

    PubMed

    Berglas, Steven

    2004-06-01

    Anyone who has ever managed people who abuse time--whether they are chronic procrastinators or individuals who work obsessively to meet deadlines weeks in advance--knows how disruptive they can be to a business's morale and operating efficiency. But lessons in time management will have no impact on these employees. That's because real time abuse results from psychological conflict that neither a workshop nor a manager's cajoling can cure. Indeed, the time abuser's quarrel isn't even with time but rather with a brittle self-esteem and an unconscious fear of being evaluated and found wanting. This article describes four types of time abusers typically encountered in the workplace: Perfectionists are almost physically afraid of receiving feedback. Their work has to be "perfect," so they can increase their likelihood of earning a positive evaluation or at least avoid getting a negative one. Preemptives try to be in control by handing in work far earlier than they need to, making themselves unpopular and unavailable in the process. People pleasers commit to far too much work because they find it impossible to say no. Procrastinators make constant (and often reasonable-sounding) excuses to mask a fear of being found inadequate in their jobs. Managing these four types of people can be challenging, since time abusers respond differently from most other employees to criticism and approval. Praising a procrastinator when he is on time, for instance, will only exacerbate the problem, because he will fear that your expectations are even higher than before. In fact, some time abusers, like the perfectionist, may need professional treatment. This article will give you insight into why they are the way they are--and what can be done to help them manage their problems.

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

    PubMed

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

    2017-02-01

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

  7. Vaccines against drug abuse.

    PubMed

    Shen, X Y; Orson, F M; Kosten, T R

    2012-01-01

    The currently available medications for the treatment of drug abuse have had only limited success. Anti-addiction vaccines, aimed at eliciting antibodies that block the pharmacological effects of drugs, have great potential for treating drug abuse. We review the status of two vaccines that are undergoing clinical trials (for cocaine and nicotine addiction) and two that are still in preclinical development (for methamphetamine and heroin addiction). We also outline the challenges and ethical concerns associated with the development of anti-addiction vaccines and their use as future therapeutics.

  8. Diagnostic imaging of child abuse.

    PubMed

    2009-05-01

    The role of imaging in cases of child abuse is to identify the extent of physical injury when abuse is present and to elucidate all imaging findings that point to alternative diagnoses. Effective diagnostic imaging of child abuse rests on high-quality technology as well as a full appreciation of the clinical and pathologic alterations occurring in abused children. This statement is a revision of the previous policy published in 2000.

  9. Late outcome following central nervous system injury in child abuse.

    PubMed

    Perez-Arjona, Eimir; Dujovny, Manuel; DelProposto, Zachary; Vinas, Federico; Park, Hun; Lizarraga, Sandra; Park, Thomas; Diaz, Fernando G

    2003-02-01

    The object of this study was to increase our understanding of the social, clinical, radiographic and psychological consequences of child abuse after the initial insult and to describe the role of neurosurgery and other specialties in this context. A review of the literature on child abuse (using scientific journals, textbooks, and internet reports) was conducted, with special attention given to child abuse in infants. The biomechanical patterns of injury, the long-term neurological, psychological, and social outcomes and methods of rehabilitation are reviewed. Head injury associated with physical abuse carries a significantly worse clinical outcome than accidental trauma. Late findings in CT scans and MRI show evidence of cerebral atrophy in 100% and cerebral ischemia in 50% of physical abuse cases. Abuse and neglect have a strong impact in developing children, producing emotional, cognitive, and social problems that may persist throughout the rest of their lives. Outcome cannot be improved without an integrated rehabilitation strategy encompassing early field management, hospital therapy, precise targeting of educational and cognitive needs, and finally return to the community. New ancillary tests have emerged that are aimed at improving rehabilitation and illuminating the long-term physiological and functional impact of abuse.

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

    PubMed

    Fowler, Dawnovise N; Faulkner, Monica

    2011-12-01

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

  11. Family violence intervention within an emergency department: achieving change requires multifaceted processes to maximize safety.

    PubMed

    Ritchie, Miranda; Nelson, Katherine; Wills, Russell

    2009-04-01

    Family violence is common with significant long-term negative health effects. Health professionals are recognised as key providers of family violence intervention. In 2002, the Hawke's Bay District Health Board launched a Family Violence Intervention Programme in its emergency department. The intervention programme involved staff training, the development of resources and routine questioning for partner abuse within the social history for all women 16 years and over. The aim was to identify the barriers and enablers to routine questioning one year after the programme was launched to inform programme improvements. Evaluation research using semi-structured interviews; eleven staff participated in either a single or a group interview. Content and thematic analysis, with triangulation of findings was used. The interviews revealed that routine questioning for partner abuse is difficult in the emergency department. Some staff screened routinely while others only offered intervention when overt abuse was identified. Barriers, enablers and solutions revealed by participants were either personal or organisational; all had the common theme of safety. Routine questioning for partner abuse is challenging and its introduction into practice requires a systems approach to achieve change. Barriers to questioning exist and by simultaneously addressing these and implementing enablers, at an organisational and personal level, barriers are eliminated or at least minimised. A link was evident between nurses' level of comfort and their rate of questioning. A multifaceted approach focusing on safety of all concerned can support change resulting in implementation of family violence intervention in the health sector.

  12. Child Abuse and Developmental Disabilities.

    ERIC Educational Resources Information Center

    Grayson, Joann, Ed.; Bartlette, Don

    1992-01-01

    Literature indicating high rates of abuse in this population is reviewed, as is literature indicating high rates of developmental disabilities in child victims of abuse. Problems in data collecting practices are noted. Reasons for these children's greater risk for abuse are identified, including child attributes, stress, parent vulnerabilities,…

  13. Child Abuse and Cot Deaths.

    ERIC Educational Resources Information Center

    Newlands, Mary; Emery, John S.

    1991-01-01

    A search was made of confidential health department records in Great Britain for abused children, or children at risk for abuse, with siblings who had died of Sudden Infant Death Syndrome (SIDS). An association was found between child abuse and about 10 percent of deaths of children diagnosed as SIDS. (BRM)

  14. Israeli Perspectives on Elder Abuse

    ERIC Educational Resources Information Center

    Rabi, Keren

    2006-01-01

    Despite the prevailing agreement among researchers that the increasing rate of elder abuse in Israel is relatively understudied, not sufficiently identified, and not appropriately addressed, literature on elderly abuse in the Israeli society remains limited. The common discourse on aging, eldercare, and elder abuse and neglect, mainly revolves…

  15. Child Abuse: Betrayal and Disclosure

    ERIC Educational Resources Information Center

    Foynes, Melissa Ming; Freyd, Jennifer J.; DePrince, Anne P.

    2009-01-01

    Objective: The current study tested several hypotheses about disclosure of childhood sexual, physical, and emotional abuse derived from Betrayal Trauma Theory [Freyd, J. J. (1996). Betrayal trauma: The logic of forgetting childhood abuse. Cambridge, MA: Harvard University Press]. We predicted that the duration of time from abuse to its disclosure…

  16. Geriatric Alcoholism and Drug Abuse

    ERIC Educational Resources Information Center

    Schuckit, Marc A.

    1977-01-01

    This paper reviews the literature and presents new data on alcohol and drug problems in older individuals. Drug abusers include users of opiates, inadvertent misusers, and deliberate abusers of nonopiates. Two to 10 percent of the elderly are alcoholic, and these are usually individuals beginning alcohol abuse after age 40. (Author)

  17. Drug Abuse in Southeast Asia.

    ERIC Educational Resources Information Center

    Scorzelli, James F.

    This report examines the incidence of drug abuse and the methods of treatment and prevention of drug abuse used in Southeast Asia. Countries studied include Malaysia, Singapore, Thailand, Indonesia, and the Philippines. Because of Malaysia's intensive effort to eliminate its drug abuse problem, emphasis is placed on this country's treatment and…

  18. Recognizing the adolescent drug abuser.

    PubMed

    MacKenzie, R G; Jacobs, E A

    1987-03-01

    Adolescents are at high risk for using and abusing illicit drugs. Guidelines for recognizing drug abusers are presented as well as a staging process for progression of drug use. The family physician is in an ideal position to identify young users/abusers and to assist them and their families in obtaining much needed assistance.

  19. The Drug-Abuse Questionnaire.

    ERIC Educational Resources Information Center

    Ferneau, E.; Mueller, S.

    The drug-abuse questionnaire used to survey college student attitudes on the subject is provided. It is identical to the alcoholism questionnaire except for word changes appropriate to the subject matter. The questionnaire consists of 40 statements about drug abuse and drug abusers, with 7 possible responses: (1) completely disagree; (2) mostly…

  20. Abuse and the Special Child.

    ERIC Educational Resources Information Center

    Murphy, Linda; Corte, Suzanne Della

    1987-01-01

    The issue's major feature, on physical and sexual abuse of handicapped children, focuses on education and adult awareness of the problem. It has been well documented that children with handicaps are especially vulnerable to abuse. Parents or other adults who believe that abuse has occurred should first write down exactly what the child has told…

  1. Literature Review of Sexual Abuse.

    ERIC Educational Resources Information Center

    DePanfilis, Diane

    This document provides a review of recent, state-of-the-art literature concerning the nature, extent, dynamics, and effects of child sexual abuse and examines America's preventive intervention and treatment efforts for child sexual abuse. After an extensive presentation of the problems of defining terms in sexual abuse, these topics are discussed:…

  2. Child Abuse Prevention Handbook. Revised.

    ERIC Educational Resources Information Center

    California State Office of the Attorney General, Sacramento. Crime Prevention Center.

    Intended to heighten public awareness and provide practical information to professionals, this handbook defines and describes child abuse (including sexual abuse) and its associated signs and injuries. The societal and family environments in which child abuse most typically occurs are described, and the California penal code sections pertaining to…

  3. Intentional Recreational Abuse of Quetiapine Compared to Other Second-generation Antipsychotics

    PubMed Central

    Klein, Lauren; Bangh, Stacey; Cole, Jon B.

    2017-01-01

    Introduction Case reports and poison center data have demonstrated that the second-generation antipsychotic quetiapine is being obtained and used for recreational abuse. The purpose of this study was to describe the relative rates of single-substance abuse for different atypical antipsychotics and compare their demographic and clinical features. Methods We conducted a 10-year retrospective analysis of the National Poison Data System (NPDS) database (2003 – 2013). Trained nurses and pharmacists with specialty training in toxicology prospectively collect all NPDS data at poison control centers around the United States. We queried the NPDS for all cases of single-substance second-generation antipsychotic exposures coded as “intentional abuse.” The data provided by the NPDS regarding rates and clinical features of quetiapine abuse and the abuse of all other second-generation antipsychotics were compared and described descriptively. Results During the study period, 2,118 cases of quetiapine abuse and 1,379 cases of other second-generation antipsychotic abuse were identified. Quetiapine abuse was more common than the abuse of other second-generation antipsychotics, compromising 60.6% of all abuse cases during the study period. After quetiapine, the next most frequently abused medications were risperidone (530 cases, 15.2%) and olanzapine (246 cases, 7.0%). For all second-generation antipsychotics including quetiapine, central nervous system clinical effects were most common, including drowsiness, confusion, and agitation. Other serious clinical effects observed with second-generation antipsychotic abuse included hypotension, respiratory depression, and seizures. Conclusion Quetiapine abuse is relatively common, and is abused far more often than any other second-generation antipsychotic. Emergency physicians should be aware of the clinical effects that may occur after second-generation antipsychotic abuse. PMID:28210359

  4. Intravenous methylphenidate abuse. Prototype for prescription drug abuse.

    PubMed

    Parran, T V; Jasinski, D R

    1991-04-01

    Data are presented from a case series of 22 patients who abused methylphenidate hydrochloride (Ritalin-SR). The abuse pattern and symptoms of toxicity were similar to that seen with cocaine hydrochloride and amphetamine sulfate addiction; yet, the morbidity and mortality seen in this case series were greater than usual for a group of patients involved in intravenous drug abuse. We describe the characteristics of the methylphenidate abuse syndrome in terms of the pharmacology of methylphenidate, the constituents of the Ritalin-SR preparation, and the disease of chemical dependence. We propose solutions to the problem of methylphenidate abuse.

  5. Abuse in the investigation and treatment of intrafamilial child sexual abuse.

    PubMed

    Tyler, A H

    1984-01-01

    This paper examines the effects of current practice in the investigation and treatment of documented incest abusers on the offenders and families involved. Fifteen offenders attending the Utah Parents United group completed a questionnaire on the sequence of events in the investigation and prosecution of their cases and the concomitant results of the investigation on their job status, living and financial situations, family and social relationships, and media reporting of the abuse. Results indicate that there is great variability in the investigation and prosecution of incest cases and the public announcement of abuse convictions. The consequences of the abuse investigation are devastating for offender and his family in terms of job loss; need for public assistance; family disbandonment through removal of the offender, victim, or both from the family, marital separation, and foster care for nonabused siblings; changes of residence, and the public announcement of the abuse in the media. Results also show that offenders receive little, if any, social support from family or friends. Changes in the current approach to the investigation and prosecution of incest offenders are proposed and include the following: banning the publication of convictions for child abuse; streamlining the legal process so that it is consistent from case to case; and developing diversion programs as alternatives to prison for offenders. Suggested are self-help, court-ordered therapeutic programs, such as Parents United, that are designed for the treatment of families involved in child sexual abuse and incest. The desired outcomes of such a diversion program are low offender recidivism, avoidance of the offender's family being placed on welfare, less reliance on foster care placement for the offender's children, involvement of the offender's family in moving toward reunion when feasible, and the use of existing half-way houses in lieu of incarceration when necessary.

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

    PubMed Central

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

    2016-01-01

    Background Borderline personality disorder (BPD) is characterized by greater engagement in non-suicidal self-injury (NSSI) and suicidality. The aim of the study is to test whether the occurrence of child abuse contributes to these high-risk behaviors in BPD youth. Materials and methods BPD female youth aged 13–21 years with (n = 29) and without (n = 29) a history of child abuse were administered clinical interviews assessing diagnostic history, child abuse, NSSI and suicidality (i.e., ideation, plans, and attempts). NSSI and suicidality were subsequently reevaluated at the 1- and 2-month follow-up assessments. Results Several findings emerged. First, relative to BPD youth without abuse, the abuse group reported greater past NSSI; however, no significant differences emerged in the follow-up period. Second, the occurrence of child abuse was associated with a 5-fold increase in the rate of lifetime suicide attempts relative to the no abuse group and additionally, prospectively predicted suicide ideation (but not attempts). Last, exploratory analyses indicated that the co-occurrence of physical and sexual abuse was associated with greater past NSSI and suicidality as compared to the no abuse and sexual abuse only participants. Conclusion As a whole, child abuse – particularly co-occurring physical and sexual abuse – increases risk for NSSI and suicidality among BPD youth, which may have important treatment implications in this high-risk population. PMID:27649322

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

    PubMed

    Keene, Amanda C; Epps, James

    2016-01-01

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

  8. Sadistic ritual abuse. An overview in detection and management.

    PubMed

    Young, W C

    1993-06-01

    Sadistic ritual abuse, including satanic cult abuse, is emerging as a syndrome among people with severe dissociative disorders, including multiple personality disorder. This article discusses the essential features that compose the clinical picture of sadistic ritual abuse in adults, adolescents, and children. Particular attention is paid to the differences between adolescents who may have been victimized by adults in sadistic and ritualized ways and disenfranchised "teenage dabblers" who may temporarily adopt a ritualized lifestyle as a way of expressing or acting out. The article also covers guidelines for appropriate medical, pharmacologic, and referral interventions. The controversy surrounding sadistic ritual abuse is discussed thoroughly, and primary care physicians are advised of the current status of understanding and validation in this area.

  9. Influences of income, education, age, and ethnicity on physical abuse before and during pregnancy.

    PubMed

    Bohn, Diane K; Tebben, Julie G; Campbell, Jacquelyn C

    2004-01-01

    To examine the influence of socioeconomic status, education, ethnicity, and age on the prevalence of intimate partner abuse before and during pregnancy. Retrospective correlational analysis. Data were collected at six postpartum maternity settings. 1,004 women from six ethnic groups. Prevalence of intimate partner violence. 15.9% of study participants reported physical abuse by their current partner and 5.2% reported abuse during pregnancy. Decreased income, not having a high school education, and ethnicity were significantly related to current abuse and abuse during pregnancy in bivariate analyses. Having less than a high school education emerged as the most significant predictor of both abuse variables in multivariate analyses. African American and Puerto Rican women had the highest incidence of abuse in their current relationship. No significant differences were found in rates of abuse during pregnancy among women from different ethnic groups. The results of this analysis support the notion that abuse is most prevalent among the most disadvantaged women. However, it is not income per se, but rather the highly related variables of education and ethnicity that have the largest effect. Abuse occurs frequently among all women, warranting universal screening during health care encounters. Further research is needed to evaluate relationships between education, ethnicity, income, and abuse.

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

  12. Socioeconomic Resources, Gender Traditionalism, and Wife Abuse in Urban Russian Couples

    ERIC Educational Resources Information Center

    Cubbins, Lisa A.; Vannoy, Dana

    2005-01-01

    Until recently, Soviet data restrictions led to limited knowledge about wife abuse in Russia. This study adds to emerging research on Russian domestic violence by testing hypotheses derived from resource theory on the effects on wife abuse of husband's absolute resources versus spouses relative resources. Analysis of data from the 1996 National…

  13. An Ecostructural Family Therapy Approach to the Rehabilitation of the Latino Drug Abuser: History and Development.

    ERIC Educational Resources Information Center

    Scopetta, Mercedes A.

    An approach to the treatment of Hispanic (particularly Cuban) American families with drug abusing members is presented in this paper. The approach, developed by the Spanish Family Guidance Center in Miami, Florida, views dysfunctionality and drug abuse as emerging from a family's internal disorganization and ecological imbalance. In order to treat…

  14. Evaluating Alcoholism and Drug Abuse Knowledge in Medical Education: A Collaborative Project.

    ERIC Educational Resources Information Center

    Griffin, John B., Jr.

    1983-01-01

    Medical students performed less well on examinations about drug abuse problems and patient management than on traditional medical board examinations. The best knowledge was of pharmacology of drug abuse, Alcoholics Anonymous, and treatment of delirium tremens. Students knew less about metabolic and biochemical areas, emergency-room treatment, and…

  15. Evaluating Alcoholism and Drug Abuse Knowledge in Medical Education: A Collaborative Project.

    ERIC Educational Resources Information Center

    Griffin, John B., Jr.

    1983-01-01

    Medical students performed less well on examinations about drug abuse problems and patient management than on traditional medical board examinations. The best knowledge was of pharmacology of drug abuse, Alcoholics Anonymous, and treatment of delirium tremens. Students knew less about metabolic and biochemical areas, emergency-room treatment, and…

  16. Prevalence of Sexual Abuse of People with Intellectual Disabilities in Taiwan

    ERIC Educational Resources Information Center

    Pan, Shu-Man

    2007-01-01

    Although sexual abuse of people with intellectual disabilities has emerged as a major issue in the West over recent years, few researchers have examined this issue in Taiwan. The prevalence and current state of sexual abuse for people with intellectual disabilities in Taiwan were investigated here. Results of face-to-face interviews with 336…

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

    ERIC Educational Resources Information Center

    Francis, Karen J.; Wolfe, David A.

    2008-01-01

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

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

    ERIC Educational Resources Information Center

    Francis, Karen J.; Wolfe, David A.

    2008-01-01

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

  19. Effects of social desirability on students' self-reporting of partner abuse perpetration and victimization.

    PubMed

    Bell, Kathryn M; Naugle, Amy E

    2007-01-01

    Little is still known about the degree to which social desirability affects reports of partner abuse. The current study builds on existing research exploring the relationship between social desirability and partner abuse reports by analyzing 49 male and 155 female students' responses to the Revised Conflict Tactics Scale (CTS2) and the Marlowe-Crowne Social Desirability Scale (MCSDS). Sex differences were not associated with partner abuse rates, regardless of type, severity, and violence role. Women had significantly higher social desirability scores than men, and women's MCSDS scores were negatively correlated with partner abuse perpetration and victimization rates. Social desirability was a significant predictor of psychological abuse perpetration, whereas gender was a significant predictor of sexual coercion perpetration. In all partner abuse cases, however, social desirability and gender accounted for less than 10% of the variance in partner abuse reports.

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

    PubMed

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

    2009-10-01

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

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

    PubMed

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

    2015-06-01

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

  2. Greening Existing Tribal Buildings

    EPA Pesticide Factsheets

    Guidance about improving sustainability in existing tribal casinos and manufactured homes. Many steps can be taken to make existing buildings greener and healthier. They may also reduce utility and medical costs.

  3. Interpersonal types among alcohol abusers: a comparison with drug abusers.

    PubMed

    Turner, J A; Mayr, S

    1990-07-01

    Interpersonal types among alcohol abusers were examined with Calsyn, Roszell, and Anderson's (1988) nine-type system for classifying FIRO-B profiles. The frequencies of the nine FIRO-B types among a sample of 135 male veteran alcohol abusers were compared with Calsyn et al.'s (1988) previously published data for a sample of male veteran drug abusers, a normative veteran sample, and a general population sample. The alcohol abusers, like Calsyn et al.'s sample of drug abusers, were more likely to be categorized as "loners," "rebels," and "pessimists" than was the general population sample. While exhibiting preferences for interpersonal types that emphasized social withdrawal, avoidance of responsibility, and mistrust of others, both the alcohol abusers and the drug abusers were heterogeneous groups whose members demonstrated a variety of interpersonal types.

  4. Robotic tele-existence

    NASA Technical Reports Server (NTRS)

    Tachi, Susumu; Arai, Hirohiko; Maeda, Taro

    1989-01-01

    Tele-existence is an advanced type of teleoperation system that enables a human operator at the controls to perform remote manipulation tasks dexterously with the feeling that he or she exists in the remote anthropomorphic robot in the remote environment. The concept of a tele-existence is presented, the principle of the tele-existence display method is explained, some of the prototype systems are described, and its space application is discussed.

  5. CBOs Helping Inhalant Abusers.

    ERIC Educational Resources Information Center

    Rubio, Gloria

    1980-01-01

    Noting the high barrio use of inhalants, the environment often surrounding inhaling, and various treatment approaches, the article describes the programs of several Hispanic community-based organizations in Mexico, Arizona, and California which have been developed to assist inhalant abusers and their families in overcoming the habit. (SB)

  6. Handbook On Drug Abuse.

    ERIC Educational Resources Information Center

    Dupont, Robert I.; And Others

    A decade of professional research on drug abuse has produced both an abundance of materials and a vocabulary that is not shared by planners, clinicians, and policy makers. This handbook compiles the major developments of the period and their treatment and research implications in a style intended to be understood by all three types of…

  7. How to Handle Abuse

    MedlinePlus

    ... hurting or harming someone) might have frightened the boy or girl into staying quiet. No matter what the abuser ... suit or underwear: breasts, vagina, and bottom for girls, and penis and bottom for boys. If an adult or another kid touches a ...

  8. Understanding Fatal Child Abuse.

    ERIC Educational Resources Information Center

    Hicks, Ralph A.; Gaughan, Daniel C.

    1995-01-01

    Medical, social service, and coroner reports were reviewed for 14 cases of fatal child abuse and neglect identified at a children's hospital from 1988 to 1992. Median age was 6.5 months. Six families had prior protective service involvement (though four of these had involved a sibling). The cause of death in all cases was blunt impact head injury.…

  9. Abused and Traumatized Children.

    ERIC Educational Resources Information Center

    Carmichael, Karla D.

    This document is a class presentation designed to present a history of child abuse and interventions for the beginning play therapist. Attempts to understand child behavior are traced back to their roots in the fields of mental retardation and special education as early as 1799 and followed through the mental health and child guidance movements of…

  10. Educating against Drug Abuse.

    ERIC Educational Resources Information Center

    United Nations Educational, Scientific, and Cultural Organization, Paris (France).

    This book is a compilation of drug education and drug abuse prevention materials collected by United Nations Educational, Scientific and Cultural Organization (UNESCO) along with example of activities carried out by various countries. It opens with four introductory papers by separate authors: (1) "Prevention of Drug Dependence: A Utopian…

  11. Prenatal substance abuse.

    PubMed

    Gittler, J; McPherson, M

    1990-01-01

    Beginning in the middle of the 1980s, there was an alarming rise in the number of drug-exposed newborns that was directly attributable to the rise in the abuse of cocaine and its highly addictive smokeable derivative, known as crack, by pregnant women. "Crack babies" have now become a major national problem.

  12. Substance Abuse and Counseling.

    ERIC Educational Resources Information Center

    Sales, Amos, Ed.

    This book focuses on the identification of practical knowledge and skills needed for counseling individuals with substance abuse problems. It is a resource for practitioners, students, and faculty in school counseling, rehabilitation counseling, mental health counseling, school psychology, or social work in recognizing, preventing, and treating…

  13. Substance Abuse among Iranian High School Students

    PubMed Central

    Momtazi, Saeed; Rawson, Richard A.

    2015-01-01

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

  14. Emergency contraception.

    PubMed

    Grimes, David A; Raymond, Elizabeth G

    2002-08-06

    Emergency contraception is used to prevent pregnancy after a coital act not adequately protected by a regular method of contraception. In contrast to early medical abortion, emergency contraception prevents a pregnancy from starting and does not disrupt an established pregnancy. The most commonly used approaches consist of two oral doses of contraceptive steroids. The levonorgestrel-only regimen (levonorgestrel, 0.75 mg, repeated in 12 hours) appears to be more effective and better tolerated than the Yuzpe regimen (ethinyl estradiol, 100 microg, and levonorgestrel, 0.5 mg, repeated in 12 hours). In the largest randomized, controlled trial to date, levonorgestrel prevented about 85% of pregnancies that would have occurred without its use. Hormonal emergency contraception has no known medical contraindications, although it is not indicated for suspected or confirmed pregnancy. However, if hormonal emergency contraception is inadvertently taken in early pregnancy, neither the woman nor the fetus will be harmed. Nausea and vomiting associated with the Yuzpe regimen can be reduced by prophylactic use of meclizine. A strong medical and legal case exists for making hormonal emergency contraception available over the counter, as has happened in countries other than the United States. Easier access to and wider use of emergency contraception could dramatically lower the high rates of unintended pregnancy and induced abortion in the United States.

  15. Multidisciplinary collaboration reporting child abuse: a grounded theory study.

    PubMed

    Feng, Jui-Ying; Fetzer, Susan; Chen, Yi-Wen; Yeh, Lily; Huang, Mei-Chih

    2010-12-01

    The complexity of reporting child abuse requires multidisciplinary collaboration. The dynamics of a mulidisciplinary team in reporting child abuse which begins the process of child protection remains unclear. To explore the experiences and perspectives of professionals working with other disciplines when reporting child abuse. A qualitative study with grounded theory was used. Participants were recruited from hospitals, the Department of Child Welfare, and schools in Taiwan. Twenty-one professionals from four disciplines agreed to participate. The purposive sample included 5 physicians, 5 nurses, 6 social workers, and 5 teachers. Individual interviews were conducted to explore the experiences in reporting child abuse of a purposive sample of 21 professionals including physicians, nurses, social workers, and teachers. Transcripts were analyzed using a grounded theory approach. Categorical themes were developed that reflected reporters' experiences and perspectives in reporting child abuse. The professionals involved in reported child abuse are described as participants in a relay race. Four themes emerged from the interviews: running the relay race of child protection; reporters as runners with expectations of runners' characteristics and the order of runners; carrying the baton of a mandatory report described using baton characteristics while running in space and time; and team chemistry including trust of and communication with teammates. Systems that encourage and promote team building and collaboration among child abuse reporters are needed. Success in the race to report child abuse across professional disciplines includes runners' skills, speed, a light and easy to carry baton, and team chemistry. As a team of child abuse reporters, when performance is enhanced by practice, the team's success will be measured as victories in child protection. The paradigm of individual disciplines developing their own goals, designing their own training, and practicing within

  16. Childhood sexual abuse and obesity.

    PubMed

    Gustafson, T B; Sarwer, D B

    2004-08-01

    The causes of the current obesity epidemic are multifactorial and include genetic, environmental, and individual factors. One potential risk factor may be the experience of childhood sexual abuse. Childhood sexual abuse is remarkably common and is thought to affect up to one-third of women and one-eighth of men. A history of childhood sexual abuse is associated with numerous psychological sequelae including depression, anxiety, substance abuse, somatization, and eating disorders. Relatively few studies have examined the relationship between childhood sexual abuse and adult obesity. These studies suggest at least a modest relationship between the two. Potential explanations for the relationship have focused on the role of disordered eating, particularly binge eating, as well as the possible "adaptive function" of obesity in childhood sexual abuse survivors. Nevertheless, additional research on the relationship between childhood sexual abuse and obesity is clearly needed, not only to address the outstanding empirical issues but also to guide clinical care.

  17. Prevention-enhancing interactions: a Critical Interpretive Synthesis of the evidence about children who sexually abuse other children.

    PubMed

    McKibbin, Gemma; Humphreys, Cathy; Hamilton, Bridget

    2016-11-01

    There is a growing interest in English-speaking jurisdictions, including Australia, North America, Canada, the United Kingdom and New Zealand, about the prevention of sexual abuse perpetrated by children against other children. The aim of this review was to identify opportunities for research, policy and practice which could enhance the prevention agenda relating to the perpetration of sexual abuse by children through conducting a Critical Interpretive Synthesis. Eleven electronic databases were searched in the period from 22 April to 23 May 2013 and included: SocINDEX, Social Services Abstracts, Applied Social Sciences Index and Abstracts, Family and Society Studies Worldwide, Project Muse, PsychINFO, Family and Society Plus, Jstor, Expanded Academic ASAP, Web of Science and Google Scholar. Key individual journals were also searched, including Child Abuse and Neglect and the Journal of Interpersonal Violence, as well as the grey literature. The search was guided by the research question: How could the prevention agenda relating to sexual abuse perpetrated by children be enhanced? The systematic literature search yielded 3323 titles, and 34 of these papers were included in the final synthesis. The authors identified five domains operating in the evidence base: characteristics, causes, communications, interventions and treatments. A synthesising construct emerged from the review: prevention-enhancing interactions. This construct referred to the potential for enhancing the prevention agenda which exists as the evidence domains interact with one another, and with the public health model of prevention. The authors consider this review to be a timely contribution to the current agenda pertaining to sexual abuse perpetrated by children. It provides researchers, policy makers and practitioners in the field with an evidence-informed conceptualisation of opportunities for enhancing prevention work.

  18. Conceptual framework for estimating the social cost of drug abuse.

    PubMed

    French, M T; Rachal, J V; Hubbard, R L

    1991-01-01

    Drug abuse imposes costs on individuals and society. Researchers have produced several studies on a subset of tangible costs of drug abuse and other illnesses, but key tangible costs sometimes have been overlooked and, even when recognized, rarely have been estimated. An assortment of intangible costs also have received very little research attention. This study outlines a comprehensive conceptual framework for estimating the social cost of drug abuse. We address both the tangible and intangible costs for the drug-abusing and non-drug-abusing population. Our conceptual framework is based on critical reviews of new and traditional methods for estimating the costs of illness and disease including cost-of-illness methods, averting behavior methods, and utility valuation techniques. We show how the proposed methods can be combined with existing data to estimate the total social cost of drug abuse. Using social cost estimates will enable policymakers to more accurately assess the total burden of drug abuse and related problems on society.

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

    ERIC Educational Resources Information Center

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

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

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

    PubMed

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

    2013-12-01

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