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Sample records for abuse liability assessment

  1. A proactive nonclinical drug abuse and dependence liability assessment strategy: a sponsor perspective.

    PubMed

    Swedberg, Michael D B

    2013-09-01

    This paper outlines a strategy and process for proactive nonclinical assessment of drug abuse and dependence liability of new compounds intended for clinical use. Documentation of the potential for causing abuse and dependence liability is required for registration of a new drug; hence, proactive timing and planning of these studies allows for appropriate documentation of nonclinical as well as clinical data in time for registration. In cases for which an abuse and dependence liability label may not be acceptable, a proactive approach to abuse and dependence liability assessment allows for replacement of selected compounds at an early stage of development, thereby saving time and resources and avoiding late attrition. PMID:23907375

  2. Principles of laboratory assessment of drug abuse liability and implications for clinical development

    PubMed Central

    Carter, Lawrence P.; Griffiths, Roland R.

    2009-01-01

    Abuse liability testing plays an important role in informing drug development, regulatory processes, and clinical practice. This paper describes the current “gold standard” methodologies that are used for laboratory assessments of abuse liability in non-human and human subjects. Particular emphasis is given to procedures such as non-human drug discrimination, self-administration, and physical dependence testing, and human dose effect abuse liability studies that are commonly used in regulatory submissions to governmental agencies. The potential benefits and risks associated with the inclusion of measures of abuse liability in industry-sponsored clinical trials is discussed. Lastly, it is noted that many factors contribute to patterns of drug abuse and dependence outside of the laboratory setting and positive or negative signals in abuse liability studies do not always translate to high or low levels of actual abuse or dependence. Well-designed patient and physician education, pharmacovigilance, and postmarketing surveillance can reduce the diversion and misuse of drugs with abuse liability and can effectively foster the protection and promotion of public health. PMID:19443137

  3. Principles of assessment of abuse liability: US legal framework and regulatory environment.

    PubMed

    Rocha, Beatriz A

    2013-09-01

    Identifying the abuse potential of drug products in the premarketing and postmarketing environment has been a critical component in the implementation of drug abuse control laws worldwide. In the US, the Controlled Substances Act of 1970 (CSA) is a comprehensive federal law enacted to prevent the abuse or diversion of substances with abuse liability or addiction potential (for present purposes, these terms are used interchangeably). Under the jurisdiction of the Drug Enforcement Administration, the law applies to the manufacture and distribution of narcotics and other drug substances with potential of abuse. The CSA classifies substances with abuse potential into schedules I-V based on the substance's risk of diversion or abuse, and thus provides a legal framework for the assessment of abuse liability of New Molecular Entities. When the Food and Drug Administration reviews the safety and efficacy of a New Drug Application it also determines whether the drug has potential for abuse, and if so, will begin the process to schedule the drug under the CSA. As the assessment of abuse potential is a critical component of a marketing application, pharmaceutical companies (sponsors) bear the responsibility of generating a comprehensive preclinical and clinical data package for regulators to review and make decisions on labeling and the corresponding postmarketing surveillance. Recent regulatory guidelines adopted in the European Union (EU) (2006), Canada (2007), and USA (2010) provide recommendations to sponsors on preclinical and clinical methodologies for the assessment of abuse potential. This paper reviews the legal framework of the assessment of abuse liability and scheduling of controlled substances in the USA and describes the current global regulatory environment and the challenges that sponsors and regulators face when assessing abuse liability of New Molecular Entities, from the early stages of development through the late stages, review, and approval. PMID

  4. Preclinical assessment of abuse liability of biologics: In defense of current regulatory control policies.

    PubMed

    Gauvin, David V; Zimmermann, Zachary J; Baird, Theodore J

    2015-10-01

    Current regulatory policies of both the US Food and Drug Administration and Drug Enforcement Administration do not delineate automatic exceptions for biologics with respect to preclinical assessments for abuse liability of all new entities. As defined in current guidance documents and drug control policies, an exception may be given upon thorough review of available data, therapeutic target and in consultation with the Controlled Substances Staff within the Center for Drug Evaluation and Research of the FDA, but a blanket exception for all biological entities is not currently available. We review the abuse liability testing of four known biologics with definitive positive abuse liability signals in the three core abuse liability assays, self-administration, drug discrimination, and dependence potential described in the FDA draft guidance document. Interestingly, while all four examplars have positive abuse liability signals in all three assays, two of these biologics are controlled under the Comprehensive Drug Abuse and Control Act (CSA, 1970) and the other two are not currently controlled. Admittedly, these four biologics are small molecule entities. However, there is no reference to "molecular size" in the legally-binding statutory definition of biologics under the FD&C act or in the Controlled Substances Act. Neither of these drug control policy mandates have a bifurcated control status in which to make exceptions based solely on molecular size. With the current pharmaceutical focus on new technologies, such as "Trojan Horses", targeting the active transport of large molecule entities directly into the CNS, an argument to automatically exempt new molecular entities solely on molecular size is untenable. We argue that for the safety and health of general public the current regulatory control status be maintained until definitive criteria for exceptions can be identified and amended to both the FD&CA and CSA, if warranted. PMID:26107292

  5. Assessment of the Abuse Liability of Synthetic Cannabinoid Agonists JWH-030, JWH-175, and JWH-176

    PubMed Central

    Tampus, Reinholdgher; Yoon, Seong Shoon; de la Peña, June Bryan; Botanas, Chrislean Jun; Kim, Hee Jin; Seo, Joung-Wook; Jeong, Eun Ju; Jang, Choon Gon; Cheong, Jae Hoon

    2015-01-01

    The emergence and use of synthetic cannabinoids have greatly increased in recent years. These substances are easily dispensed over the internet and on the streets. Some synthetic cannabinoids were shown to have abuse liability and were subsequently regulated by authorities. However, there are compounds that are still not regulated probably due to the lack of abuse liability studies. In the present study, we assessed the abuse liability of three synthetic cannabinoids, namely JWH-030, JWH-175, and JWH-176. The abuse liability of these drugs was evaluated in two of the most widely used animal models for assessing the abuse potential of drugs, the conditioned place preference (CPP) and self-administration (SA) test. In addition, the open-field test was utilized to assess the effects of repeated (7 days) treatment and abrupt cessation of these drugs on the psychomotor activity of animals. Results showed that JWH-175 (0.5 mg/kg), but not JWH-030 or JWH-176 at any dose, significantly decreased the locomotor activity of mice. This alteration in locomotor activity was only evident during acute exposure to the drug and was not observed during repeated treatment and abstinence. Similarly, only JWH-175 (0.1 mg/kg) produced significant CPP in rats. On the other hand, none of the drugs tested was self-administered by rats. Taken together, the present results indicate that JWH-175, but not JWH-030 and JWH-176, may have abuse potential. More importantly, our findings indicate the complex psychopharmacological effects of synthetic cannabinoids and the need to closely monitor the production, dispensation, and use of these substances. PMID:26535085

  6. 76 FR 62419 - Science of Abuse Liability Assessment; Public Workshop

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-07

    ... Health; and the College on Problems of Drug Dependence (CPDD) at the Temple University School of Medicine..., Twinbrook Station. Contact Person: Ellen B. Geller, CPDD, Temple University School of Medicine, 3400 North... abuse potential during clinical trials. The deadline for submitting comments about this public...

  7. Abuse Liability Assessment of Tobacco Products Including Potential Reduced Exposure Products (PREPs)

    PubMed Central

    Carter, Lawrence P.; Stitzer, Maxine L.; Henningfield, Jack E.; O'Connor, Rich J.; Cummings, K. Michael; Hatsukami, Dorothy K.

    2009-01-01

    The harm produced by tobacco products is a result of frequent use of a highly toxic product. Reducing the adverse public health impact of tobacco products might be most effectively achieved by reducing the likelihood of their use and the toxicity of the products. Products that retain some characteristics of cigarettes, but have been altered with the intention of reducing toxicity have been referred to as modified risk tobacco products or potential reduced exposure products (MRTP/PREPS). Evaluation of their content, emission, and toxicity is discussed in other articles in this special issue. Here, we discuss the methodology that has been used to examine the likelihood of abuse or addiction. Abuse liability assessment (ALA) methodology has been used by the Food and Drug Administration (FDA) and other drug regulatory agencies world-wide for decades to assess the risks posed by a wide variety of pharmacologically active substances. ALA is routinely required among other evaluations of safety during the premarket assessment of new drugs, and is continually adapted to meet the challenges posed by new drug classes and drug formulations. In the 2009 law giving FDA regulation over tobacco products, FDA is now required to evaluate new tobacco products including MRTP/PREPs to determine their risk for abuse and toxicity at the population level. This paper describes the traditional tools and methods of ALA that can be used to evaluate new tobacco and nicotine products including MRTP/PREPs. Such ALA data could contribute to the scientific foundation on which future public policy decisions are based. PMID:19959676

  8. Clinical laboratory assessment of the abuse liability of an electronic cigarette

    PubMed Central

    Vansickel, Andrea R; Weaver, Michael F; Eissenberg, Thomas

    2012-01-01

    Aims To provide an initial abuse liability assessment of an electronic cigarette (EC) in current tobacco cigarette smokers. Design The first of four, within-subject sessions was an EC sampling session that involved six, 10-puff bouts (30s interpuff interval) with each bout separated by 30-mins. In the remaining three sessions participants made choices between 10 EC puffs and varying amounts of money, 10 EC puffs and a varying number of own brand cigarette (OB) puffs, or 10 OB puffs and varying amounts of money using the multiple-choice procedure (MCP). The MCP was completed six times at 30-min intervals, and one choice was randomly reinforced at each trial. Setting Clinical laboratory. Participants Twenty current tobacco cigarette smokers. Measurements Sampling session outcome measures included plasma nicotine, cardiovascular response, and subjective effects. Choice session outcome was the crossover value on the MCP. Findings: EC use resulted in significant nicotine delivery, tobacco abstinence symptom suppression, and increased product acceptability ratings. On the MCP, participants chose to receive 10 EC puffs over an average of $1.06 or 3 OB puffs and chose 10 OB puffs over an average of $1.50 (p<.003). Conclusions Electronic cigarettes can deliver clinically significant amounts of nicotine and reduce cigarette abstinence symptoms and appear to have lower potential for abuse relative to traditional tobacco cigarettes, at least under certain laboratory conditions. PMID:22229871

  9. Comparative abuse liability of GHB and ethanol in humans.

    PubMed

    Johnson, Matthew W; Griffiths, Roland R

    2013-04-01

    Gamma-hydroxybutyric acid (GHB; sodium oxybate) is approved for narcolepsy symptom treatment, and it is also abused. This study compared the participant-rated, observer-rated effects, motor/cognitive, physiological, and reinforcing effects of GHB and ethanol in participants with histories of sedative (including alcohol) abuse. Fourteen participants lived on a residential unit for ∼1 month. Sessions were conducted Monday through Friday. Measures were taken before and repeatedly up to 24 hours after drug administration. Participants were administered GHB (1, 2, 4, 6, 8, and 10 g/70 kg), ethanol (12, 24, 48, 72, 96, and 120 g/70 kg), or placebo in a double-blind, within-subjects design. For safety, GHB and ethanol were administered in an ascending dose sequence, with placebos and both drugs intermixed across sessions. The sequence for each drug was stopped if significant impairment or intolerable effects occurred. Only 9 and 10 participants received the full dose range for GHB and ethanol, respectively. The highest doses of GHB and ethanol showed onset within 30 minutes, with peak effects at 60 minutes. GHB effects dissipated between 4 and 6 hours, whereas ethanol effects dissipated between 6 and 8 hours. Dose-related effects were observed for both drugs on a variety of measures assessing sedative drug effects, abuse liability, performance impairment, and physiological effects. Within-session measures of abuse liability were similar between the two drugs. However, postsession measures of abuse liability, including a direct preference test between the highest tolerated doses of each drug, suggested somewhat greater abuse liability for GHB, most likely as a result of the delayed aversive ethanol effects (e.g., headache). PMID:23421353

  10. Comparative abuse liability of GHB and ethanol in humans

    PubMed Central

    Johnson, Matthew W.; Griffiths, Roland R.

    2013-01-01

    Gamma-hydroxybutyric acid (GHB; sodium oxybate) is approved for narcolepsy symptom treatment, and it is also abused. This study compared the participant-rated, observer-rated effects, motor/cognitive, physiological, and reinforcing effects of GHB and ethanol in participants with histories of sedative (including alcohol) abuse. Fourteen participants lived on a residential unit for ~1 month. Sessions were conducted Monday through Friday. Measures were taken before, and repeatedly up to 24 hours after drug administration. Participants were administered GHB (1, 2, 4, 6, 8, and 10 g/70kg), ethanol (12, 24, 48, 72, 96, and 120 g/70kg), or placebo in a double-blind, within-subjects design. For safety, GHB and ethanol were administered in an ascending dose sequence, with placebos and both drugs intermixed across sessions. The sequence for each drug was stopped if significant impairment or intolerable effects occurred. Only 9 and 10 participants received the full dose range for GHB and ethanol, respectively. The highest doses of GHB and ethanol showed onset within 30 minutes, with peak effects at 60 minutes. GHB effects dissipated between 4 and 6 hours, while ethanol effects dissipated between 6 and 8 hours. Dose-related effects were observed for both drugs on a variety of measures assessing sedative drug effects, abuse liability, performance impairment, and physiological effects. Within-session measures of abuse liability were similar between the two drugs. However, post-session measures of abuse liability, including a direct preference test between the highest tolerated doses of each drug, suggested somewhat greater abuse liability for GHB, due most likely to the delayed aversive ethanol effects (e.g., headache). PMID:23421353

  11. Animal models to assess the abuse liability of tobacco products: effects of smokeless tobacco extracts on intracranial self-stimulation

    PubMed Central

    Harris, Andrew C.; Tally, Laura; Schmidt, Clare E.; Muelken, Peter; Stepanov, Irina; Saha, Subhrakanti; Vogel, Rachel Isaksson; LeSage, Mark G.

    2015-01-01

    Background Preclinical models are needed to inform regulation of tobacco products by the Food and Drug Administration (FDA). Typically, animal models of tobacco addiction involve exposure to nicotine alone or nicotine combined with isolated tobacco constituents (e.g., minor alkaloids). The goal of this study was to develop a model using extracts derived from tobacco products that contain a range of tobacco constituents to more closely model product exposure in humans. Methods This study compared the addiction-related effects of nicotine alone and nicotine dose-equivalent concentrations of aqueous smokeless tobacco extracts on intracranial self-stimulation (ICSS) in rats. Extracts were prepared from Kodiak Wintergreen, a conventional product, or Camel Snus, a potential “modified risk tobacco product”. Binding affinities of nicotine alone and extracts at various nicotinic acetylcholine receptor (nAChR) subtypes were also compared. Results Kodiak and Camel Snus extracts contained levels of minor alkaloids within the range of those shown to enhance nicotine’s behavioral effects when studied in isolation. Nonetheless, acute injection of both extracts produced reinforcement-enhancing (ICSS threshold-decreasing) effects similar to those of nicotine alone at low to moderate nicotine doses, as well as similar reinforcement-attenuating/aversive (ICSS threshold-increasing) effects at high nicotine doses. Extracts and nicotine alone also had similar binding affinity at all nAChRs studied. Conclusions Relative nicotine content is the primary pharmacological determinant of the abuse liability of Kodiak and Camel Snus as measured using ICSS. These models may be useful to compare the relative abuse liability of other tobacco products and to model FDA-mandated changes in product performance standards. PMID:25561387

  12. Abuse liability profile of three substituted tryptamines.

    PubMed

    Gatch, Michael B; Forster, Michael J; Janowsky, Aaron; Eshleman, Amy J

    2011-07-01

    The abuse liability profile of three synthetic hallucinogens, N,N-diisopropyltryptamine (DIPT), 5-N,N-diethyl-5-methoxytryptamine (5-MeO-DET), and 5-methoxy-α-methyltryptamine (5-MeO-AMT), was tested in rats trained to discriminate hallucinogenic and psychostimulant compounds, including cocaine, methamphetamine, 3,4-methylenedioxymethylamphetamine (MDMA), lysergic acid diethylamide (LSD), (-)-2,5-dimethoxy-4-methylamphetamine (DOM), and dimethyltryptamine (DMT). Because abused hallucinogens act at 5-hydroxytryptamine 1A (5-HT(1A)) and 5-HT(2A) receptors, and abused psychostimulants act at monoamine transporters, binding and functional activities of DIPT, 5-MeO-DET, and 5-MeO-AMT at these sites were also tested. DIPT fully substituted in rats trained to discriminate DMT (ED(50) = 1.71 mg/kg) and DOM (ED(50) = 1.94 mg/kg), but produced only 68% LSD-appropriate responding. 5-MeO-DET fully substituted for DMT (ED(50) = 0.41 mg/kg) and produced 59% MDMA-appropriate responding. 5-MeO-AMT did not fully substitute for any of the training drugs, but produced 67% LSD-appropriate responding. None of the compounds produced substitution in rats trained to discriminate cocaine or methamphetamine. All three compounds showed activity at 5-HT(1A) and 5-HT(2A) receptors as well as blockade of reuptake by the serotonin transporter. In addition, 5-MeO-AMT produced low levels of serotonin release and low potency blockade of dopamine uptake. DIPT, 5-MeO-DET, and 5-MeO-AMT produced behavioral and receptor effects similar to those of abused hallucinogens, but were not similar to those of psychostimulants. DIPT and 5-MeO-DET may have abuse liability similar to known hallucinogens and may be hazardous because high doses produced activity and lethality. PMID:21474568

  13. Abuse Liability Profile of Three Substituted Tryptamines

    PubMed Central

    Forster, Michael J.; Janowsky, Aaron; Eshleman, Amy J.

    2011-01-01

    The abuse liability profile of three synthetic hallucinogens, N,N-diisopropyltryptamine (DIPT), 5-N,N-diethyl-5-methoxytryptamine (5-MeO-DET), and 5-methoxy-α-methyltryptamine (5-MeO-AMT), was tested in rats trained to discriminate hallucinogenic and psychostimulant compounds, including cocaine, methamphetamine, 3,4-methylenedioxymethylamphetamine (MDMA), lysergic acid diethylamide (LSD), (−)-2,5-dimethoxy-4-methylamphetamine (DOM), and dimethyltryptamine (DMT). Because abused hallucinogens act at 5-hydroxytryptamine 1A (5-HT1A) and 5-HT2A receptors, and abused psychostimulants act at monoamine transporters, binding and functional activities of DIPT, 5-MeO-DET, and 5-MeO-AMT at these sites were also tested. DIPT fully substituted in rats trained to discriminate DMT (ED50 = 1.71 mg/kg) and DOM (ED50 = 1.94 mg/kg), but produced only 68% LSD-appropriate responding. 5-MeO-DET fully substituted for DMT (ED50 = 0.41 mg/kg) and produced 59% MDMA-appropriate responding. 5-MeO-AMT did not fully substitute for any of the training drugs, but produced 67% LSD-appropriate responding. None of the compounds produced substitution in rats trained to discriminate cocaine or methamphetamine. All three compounds showed activity at 5-HT1A and 5-HT2A receptors as well as blockade of reuptake by the serotonin transporter. In addition, 5-MeO-AMT produced low levels of serotonin release and low potency blockade of dopamine uptake. DIPT, 5-MeO-DET, and 5-MeO-AMT produced behavioral and receptor effects similar to those of abused hallucinogens, but were not similar to those of psychostimulants. DIPT and 5-MeO-DET may have abuse liability similar to known hallucinogens and may be hazardous because high doses produced activity and lethality. PMID:21474568

  14. Effects of cold pressor pain on the abuse liability of intranasal oxycodone in male and female prescription opioid abusers

    PubMed Central

    Lofwall, Michelle R.; Nuzzo, Paul A.; Walsh, Sharon L.

    2012-01-01

    Background Approximately 1.9 million persons in the U.S. have prescription opioid use disorders often with concomitant bodily pain, but systematic data on the impact of pain on abuse liability of opioids is lacking. The purpose of this study was to determine whether pain alters the intranasal abuse liability of oxycodone, a commonly prescribed and abused analgesic, in males and females. Methods Sporadic prescription opioid abusers (10 females, 10 males) participated in this mixed (between and within-subject), randomized inpatient study. Experimental sessions (n=6) tested intranasal placebo, oxycodone 15 or 30 mg/70 kg during cold pressor testing (CPT) and a warm water control. Observer- and subject-rated drug effect measures, analgesia, physiologic and cognitive effects were assessed. Results The CPT significantly increased blood pressure, heart rate, pain, stress, and “opiate desire” compared to the no-pain control but did not alter opioid liking, high or street value. Intranasal oxycodone produced effects within 10 minutes, significantly decreasing pain and significantly increasing subjective measures of abuse liability (e.g., high). Females had higher ratings of street value, high, and liking for one or both active doses. Conclusions The CPT was a reliably painful and stressful stimulus that did not diminish the abuse liability of intranasal Oxycodone®. Females were more sensitive to oxycodone on several abuse liability measures that warrant further follow-up. Snorting oxycodone rapidly produced psychoactive effects indicative of substantial abuse liability. PMID:22209386

  15. Civil Liability for Failing to Report Child Abuse.

    ERIC Educational Resources Information Center

    Lehto, Neil J.

    1977-01-01

    The article examines the Landeros decision (which ruled that a doctor who fails to report a child abuse victim can be held liable for subsequent injuries inflicted on the child) and discusses three theories of proving civil liability for the failure to report child abuse victims. Addressed are the following topics: the problem of child abuse and…

  16. Abuse Liability of the Dietary Supplement Dimethylamylamine

    PubMed Central

    Dolan, Sean B.; Gatch, Michael B.

    2014-01-01

    Background Dimethylamylamine (DMAA) is a component of many dietary supplements and has recently been associated with numerous adverse effects, prompting the US military and World Anti-Doping Agency to ban its use as a supplement. The current study aimed to elucidate the abuse liability profile of DMAA. Methods Dose-response studies of DMAA were performed with Swiss-Webster mice in locomotor and conditioned place-preference assays. The discriminative stimulus effects of DMAA were investigated in Sprague-Dawley rats trained to discriminate either cocaine or methamphetamine from saline. Results DMAA produced dose-dependent locomotor depression and fully substituted for cocaine and partially substituted for methamphetamine. In the conditioned place-preference assay, DMAA produced an inverted-U-shaped dose-response curve, with intermediate doses producing significant place preference. Conclusions The cocaine- and methamphetamine-like discriminative stimulus effects and the conditioned place preference produced by DMAA suggest that is has potential for abuse. These findings in combination with reports of substantial adverse effects of DMAA in humans suggest that control of DMAA may warrant further consideration. PMID:25481853

  17. Electronic cigarettes: abuse liability, topography and subjective effects

    PubMed Central

    Evans, Sarah E; Hoffman, Allison C

    2014-01-01

    Objective To review the available evidence evaluating the abuse liability, topography, subjective effects, craving and withdrawal suppression associated with e-cigarette use in order to identify information gaps and provide recommendations for future research. Methods Literature searches were conducted between October 2012 and January 2014 using five electronic databases. Studies were included in this review if they were peer-reviewed scientific journal articles evaluating clinical laboratory studies, national surveys or content analyses. Results A total of 15 peer-reviewed articles regarding behavioural use and effects of e-cigarettes published between 2010 and 2014 were included in this review. Abuse liability studies are limited in their generalisability. Topography (consumption behaviour) studies found that, compared with traditional cigarettes, e-cigarette average puff duration was significantly longer, and e-cigarette use required stronger suction. Data on e-cigarette subjective effects (such as anxiety, restlessness, concentration, alertness and satisfaction) and withdrawal suppression are limited and inconsistent. In general, study data should be interpreted with caution, given limitations associated with comparisons of novel and usual products, as well as the possible effects associated with subjects’ previous experience/inexperience with e-cigarettes. Conclusions Currently, very limited information is available on abuse liability, topography and subjective effects of e-cigarettes. Opportunities to examine extended e-cigarette use in a variety of settings with experienced e-cigarette users would help to more fully assess topography as well as behavioural and subjective outcomes. In addition, assessment of ‘real-world’ use, including amount and timing of use and responses to use, would clarify behavioural profiles and potential adverse health effects. PMID:24732159

  18. Liabilities of a physician confronted with child abuse.

    PubMed

    Vansweevelt, Thierry

    2013-06-01

    Several research questions raises when physicians are confronted with a possible case of child abuse. First, there is a problem of professional secrecy. In most European countries, physicians have the right to speak when confronted with a state of emergency. In other countries, physicians have a duty to speak and alert the police when the life or physical integrity of a person is at stake. A second topic to be discussed involves the possible liability of physicians who do not report child abuse. By not reporting a case of possible child abuse, the physician is respecting the family life of the parents, even though the child might continue to suffer damages. Third and essentially, I analyse the possible liability of physicians who do inform the prosecutor ofa suspected child abuse. Specific criteria are elaborated to establish negligence when physicians report child abuse to the prosecutor. PMID:23984493

  19. Relative abuse liability of hypnotic drugs: a conceptual framework and algorithm for differentiating among compounds.

    PubMed

    Griffiths, Roland R; Johnson, Matthew W

    2005-01-01

    Hypnotic drugs, including benzodiazepine receptor ligands, barbiturates, antihistamines, and melatonin receptor ligands, are useful in treating insomnia, but clinicians should consider the relative abuse liability of these drugs when prescribing them. Two types of problematic hypnotic self-administration are distinguished. First, recreational abuse occurs when medications are used purposefully for the subjective "high." This type of abuse usually occurs in polydrug abusers, who are most often young and male. Second, chronic quasi-therapeutic abuse is a problematic use of hypnotic drugs in which patients continue long-term use despite medical recommendations to the contrary. Relative abuse liability is defined as an interaction between the relative reinforcing effects (i.e., the capacity to maintain drug self-administration behavior, thereby increasing the likelihood of nonmedical problematic use) and the relative toxicity (i.e., adverse effects having the capacity to harm the individual and/or society). An algorithm is provided that differentiates relative likelihood of abuse and relative toxicity of 19 hypnotic compounds: pentobarbital, methaqualone, diazepam, flunitrazepam, lorazepam, GHB (gamma-hydroxybutyrate, also known as sodium oxybate), temazepam, zaleplon, eszopiclone, triazolam, zopiclone, flurazepam, zolpidem, oxazepam, estazolam, diphenhydramine, quazepam, tra-zodone, and ramelteon. Factors in the analysis include preclinical and clinical assessment of reinforcing effects, preclinical and clinical assessment of withdrawal, actual abuse, acute sedation/memory impairment, and overdose lethality. The analysis shows that both the likelihood of abuse and the toxicity vary from high to none across these compounds. The primary clinical implication of the range of differences in abuse liability is that concern about recreational abuse, inappropriate long-term use, or adverse effects should not deter physicians from prescribing hypnotics when clinically

  20. Conference on abuse liability and appeal of tobacco products: conclusions and recommendations.

    PubMed

    Henningfield, Jack E; Hatsukami, Dorothy K; Zeller, Mitch; Peters, Ellen

    2011-07-01

    The rate of initiation and progression to dependence and premature mortality are higher for tobacco products than for any other dependence producing substance. This is not explained simply by the addictiveness ("abuse liability") or by enticing product designs ("product appeal") alone, but rather by both of these factors in combination with marketing and social influences that also influence "product appeal". A working meeting of leading experts in abuse liability (AL) and product appeal was convened to examine how these disciplines could be more effectively applied to the evaluation of tobacco products for the purposes of regulation that would include setting standards for designs and contents intended to reduce the risk of initiation and dependence. It was concluded that abuse liability assessment (ALA) is a validated approach to testing pharmaceutical products but has not been extensively applied to tobacco products: such application has demonstrated feasibility, but special challenges include the diverse range of products, product complexity, and the absence of satisfactory placebo products. Consumer testing for product appeal is widely used by consumer product marketers as well as by researchers in their efforts to understand consumer product preferences and use but has not been extensively applied to tobacco products except by the tobacco industry. Recommendations for testing, methods development, and research were developed. A major recommendation was that tobacco products should be tested for AL and product appeal, and the results integrated and evaluated so as to more accurately predict risk of initiation, dependence, and persistence of use. PMID:21376479

  1. Abuse liability measures for use in analgesic clinical trials in patients with pain: IMMPACT recommendations.

    PubMed

    O'Connor, Alec B; Turk, Dennis C; Dworkin, Robert H; Katz, Nathaniel P; Colucci, Robert; Haythornthwaite, Jennifer A; Klein, Michael; O'Brien, Charles; Posner, Kelly; Rappaport, Bob A; Reisfield, Gary; Adams, Edgar H; Balster, Robert L; Bigelow, George E; Burke, Laurie B; Comer, Sandra D; Cone, Edward; Cowan, Penney; Denisco, Richard A; Farrar, John T; Foltin, Richard W; Haddox, J David; Hertz, Sharon; Jay, Gary W; Junor, Roderick; Kopecky, Ernest A; Leiderman, Deborah B; McDermott, Michael P; Palmer, Pamela P; Raja, Srinivasa N; Rauschkolb, Christine; Rowbotham, Michael C; Sampaio, Cristina; Setnik, Beatrice; Smith, Shannon M; Sokolowska, Marta; Stauffer, Joseph W; Walsh, Sharon L; Zacny, James P

    2013-11-01

    Assessing and mitigating the abuse liability (AL) of analgesics is an urgent clinical and societal problem. Analgesics have traditionally been assessed in randomized clinical trials (RCTs) designed to demonstrate analgesic efficacy relative to placebo or an active comparator. In these trials, rigorous, prospectively designed assessment for AL is generally not performed. The Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) convened a consensus meeting to review the available evidence and discuss methods for improving the assessment of the AL of analgesics in clinical trials in patients with pain. Recommendations for improved assessment include: (1) performing trials that include individuals with diverse risks of abuse; (2) improving the assessment of AL in clinical trials (eg, training study personnel in the principles of abuse and addiction behaviors, designing the trial to assess AL outcomes as primary or secondary outcome measures depending on the trial objectives); (3) performing standardized assessment of outcomes, including targeted observations by study personnel and using structured adverse events query forms that ask all subjects specifically for certain symptoms (such as euphoria and craving); and (4) collecting detailed information about events of potential concern (eg, unexpected urine drug testing results, loss of study medication, and dropping out of the trial). The authors also propose a research agenda for improving the assessment of AL in future trials. PMID:24148704

  2. Conference on Abuse Liability and Appeal of Tobacco Products: Conclusions and Recommendations*

    PubMed Central

    Hatsukami, Dorothy K.; Zeller, Mitch; Peters, Ellen

    2011-01-01

    The rate of initiation and progression to dependence and premature mortality are higher for tobacco products than for any other dependence producing substance. This is not explained simply by the addictiveness (“abuse liability”) or by enticing product designs (“product appeal”) alone, but rather by both of these factors in combination with marketing and social influences that also influence “product appeal”. A working meeting of leading experts in abuse liability (AL) and product appeal was convened to examine how these disciplines could be more effectively applied to the evaluation of tobacco products for the purposes of regulation that would include setting standards for designs and contents intended to reduce the risk of initiation and dependence. It was concluded that abuse liability assessment (ALA) is a validated approach to testing pharmaceutical products but has not been extensively applied to tobacco products: such application has demonstrated feasibility, but special challenges include the diverse range of products, product complexity, and the absence of satisfactory placebo products. Consumer testing for product appeal is widely used by consumer products marketers as well as by researchers in their efforts to understand consumer product preferences and use but has not been extensively applied to tobacco products except by the tobacco industry. Recommendations for testing, methods development, and research were developed. A major recommendation was that tobacco products should be tested for AL and product appeal, and the results integrated and evaluated so as to more accurately predict risk of initiation, dependence, and persistence of use. PMID:21376479

  3. Relative abuse liability of prescription opioids compared to heroin in morphine-maintained heroin abusers

    PubMed Central

    Comer, Sandra D; Sullivan, Maria A; Whittington, Robert A; Vosburg, Suzanne K; Kowalczyk, William J

    2013-01-01

    Abuse of prescription opioid medications has increased dramatically in the U.S. during the past decade, as indicated by a variety of epidemiological sources. However, few studies have systematically examined the relative reinforcing effects of commonly abused opioid medications. The current double-blind, placebo-controlled inpatient study was designed to compare the effects of intravenously delivered fentanyl (0, 0.0625, 0.125, 0.187, and 0.250 mg/70 kg), oxycodone (0, 6.25, 12.5, 25, and 50 mg/70 kg), morphine (0, 6.25, 12.5, 25, and 50 mg/70 kg), buprenorphine (0, 0.125, 0.5, 2, and 8 mg/70 kg), and heroin (0, 3.125, 6.25, 12.5, and 25 mg/70 kg) in morphine-maintained heroin abusers (N=8 completers maintained on 120 mg per day oral morphine in divided doses [30 mg q.i.d.]). All of the participants received all of the drugs tested; drugs and doses were administered in non-systematic order. All of the drugs produced statistically significant, dose-related increases in positive subjective ratings, such as “I feel a good drug effect” and “I like the drug.” In general, the order of potency in producing these effects, from most to least potent, was: fentanyl > buprenorphine ≥ heroin > morphine = oxycodone. In contrast, buprenorphine was the only drug that produced statistically significant increases in ratings of “I feel a bad drug effect” and it was the only drug that was not self-administered above placebo levels at any dose tested. These data suggest that the abuse liability of buprenorphine in heroin-dependent individuals may be low, despite the fact that it produces increases in positive subjective ratings. The abuse liabilities of fentanyl, morphine, oxycodone, and heroin, however, appear to be similar under these experimental conditions. PMID:17581533

  4. Toward quantifying the abuse liability of ultraviolet tanning: A behavioral economic approach to tanning addiction.

    PubMed

    Reed, Derek D; Kaplan, Brent A; Becirevic, Amel; Roma, Peter G; Hursh, Steven R

    2016-07-01

    Many adults engage in ultraviolet indoor tanning despite evidence of its association with skin cancer. The constellation of behaviors associated with ultraviolet indoor tanning is analogous to that in other behavioral addictions. Despite a growing literature on ultraviolet indoor tanning as an addiction, there remains no consensus on how to identify ultraviolet indoor tanning addictive tendencies. The purpose of the present study was to translate a behavioral economic task more commonly used in substance abuse to quantify the "abuse liability" of ultraviolet indoor tanning, establish construct validity, and determine convergent validity with the most commonly used diagnostic tools for ultraviolet indoor tanning addiction (i.e., mCAGE and mDSM-IV-TR). We conducted a between-groups study using a novel hypothetical Tanning Purchase Task to quantify intensity and elasticity of ultraviolet indoor tanning demand and permit statistical comparisons with the mCAGE and mDSM-IV-TR. Results suggest that behavioral economic demand is related to ultraviolet indoor tanning addiction status and adequately discriminates between potential addicted individuals from nonaddicted individuals. Moreover, we provide evidence that the Tanning Purchase Task renders behavioral economic indicators that are relevant to public health research. The present findings are limited to two ultraviolet indoor tanning addiction tools and a relatively small sample of high-risk ultraviolet indoor tanning users; however, these pilot data demonstrate the potential for behavioral economic assessment tools as diagnostic and research aids in ultraviolet indoor tanning addiction studies. PMID:27400670

  5. Assessment of hepatotoxic liabilities by transcript profiling

    SciTech Connect

    Ruepp, Stefan . E-mail: stefan.ruepp@roche.com; Boess, Franziska; Suter, Laura; Vera, Maria Cristina de; Steiner, Guido; Steele, Thomas; Weiser, Thomas; Albertini, Silvio

    2005-09-01

    Male Wistar rats were treated with various model compounds or the appropriate vehicle controls in order to create a reference database for toxicogenomics assessment of novel compounds. Hepatotoxic compounds in the database were either known hepatotoxicants or showed hepatotoxicity during preclinical testing. Histopathology and clinical chemistry data were used to anchor the transcript profiles to an established endpoint (steatosis, cholestasis, direct acting, peroxisomal proliferation or nontoxic/control). These reference data were analyzed using a supervised learning method (support vector machines, SVM) to generate classification rules. This predictive model was subsequently used to assess compounds with regard to a potential hepatotoxic liability. A steatotic and a non-hepatotoxic 5HT{sub 6} receptor antagonist compound from the same series were successfully discriminated by this toxicogenomics model. Additionally, an example is shown where a hepatotoxic liability was correctly recognized in the absence of pathological findings. In vitro experiments and a dog study confirmed the correctness of the toxicogenomics alert. Another interesting observation was that transcript profiles indicate toxicologically relevant changes at an earlier timepoint than routinely used methods. Together, these results support the useful application of toxicogenomics in raising alerts for adverse effects and generating mechanistic hypotheses that can be followed up by confirmatory experiments.

  6. Liability.

    ERIC Educational Resources Information Center

    Hollander, Patricia A.

    This chapter on liability covers a number of cases alleging negligence by colleges, universities, and university hospitals filed by patients and injured students. Liability issues are also part of defamation of character suits. Oral statements are known as slander, while written statements which defame are called libel. In certain situations,…

  7. Abuse and Dependence Liability of Benzodiazepine-Type Drugs: GABAA Receptor Modulation and Beyond

    PubMed Central

    Licata, Stephanie C.; Rowlett, James K.

    2008-01-01

    Benzodiazepine-type drugs (benzodiazepines and the newer non-benzodiazepines) are similar to older sedative/hypnotic drugs, such as the barbiturates, in that they act at the GABAA receptor (9, 188). Unfortunately, benzodiazepine-type drugs also retain the liability for abuse and dependence associated with the earlier anxiolytics (133, 208). Action at GABAA receptors likely plays a key role in both the therapeutic as well as abuse-related effects of this important class of drugs. While the extent to which therapeutic efficacy and abuse potential can be dissociated is not yet understood fully, the biochemical processes underlying these behavioral effects are even less understood. A more comprehensive understanding of the etiology of benzodiazepine-type drug-induced abuse and dependence is likely to provide information that can inform drug development strategies to help design anxiolytics and hypnotics that have maximum clinical benefit with reduced abuse potential. Thus, this review will explore issues related to the abuse and dependence potential of benzodiazepine-type drugs and the role that GABAA receptors play in this phenomenon. Further, this review will discuss putative intracellular events that may occur as a result of the interaction between benzodiazepine-type drugs and GABAA receptors, and how those events may ultimately give rise to the abuse-related behaviors associated with these drugs. PMID:18295321

  8. Assessing the abuse potential of methylphenidate in nonhuman and human subjects: a review.

    PubMed

    Kollins, S H; MacDonald, E K; Rush, C R

    2001-03-01

    Methylphenidate (MPH) is widely used for the treatment of Attention Deficit Hyperactivity Disorder (ADHD) in children, adolescents, and adults. Methylphenidate is clearly effective for the treatment of ADHD, but there is controversy as to whether it has significant abuse potential like other psychostimulants (e.g., D-amphetamine and cocaine). In general, the drug is believed to be abused at rates much lower than those for other stimulants. The present review examines studies that investigated the behavioral pharmacological profile of methylphenidate and discusses how results from these studies address its abuse liability. Using MEDLINE search terms methylphenidate, drug discrimination, reinforcement, self-administration, subjective effects, subject-rated effects, abuse potential, and abuse liability, along with a review of the references from identified articles, 60 studies were located in which the reinforcing, discriminative-stimulus, or subjective effects of methylphenidate were directly assessed in nonhumans or humans. Forty-eight (80.0%) of the studies reviewed indicate that methylphenidate either functions in a manner similar to D-amphetamine or cocaine (e.g., functions as a reinforcer, substitutes fully in drug discrimination experiments), or produces a pattern of subjective effects suggestive of abuse potential. The results are discussed as they pertain to factors that may account for the apparent discrepancy in abuse rates between methylphenidate and other stimulants, including characterization of actual abuse rates, defining abuse and misuse, pharmacokinetic factors, and validity of abuse liability assays. PMID:11325419

  9. The Liability of Colleges and Universities for Fraud, Waste, and Abuse in Federally Funded Grants and Projects.

    ERIC Educational Resources Information Center

    Gordon, Steven D.

    1996-01-01

    The federal government's war on fraud, waste, and abuse in expenditure of federal funds has reached college campuses. Institutions that fail to heed this development are vulnerable to harsh sanctions. They must tighten accounting practices and recognize their liability for fraudulent practices of faculty and students. Internal investigations and…

  10. 12 CFR 308.167 - Notice of assessment of liability.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Corporation incurred the loss. (b) Contents of Notice. (1) The Notice of Assessment of Liability shall set... Corporation's good faith estimate of the amount of loss it has incurred or anticipates incurring; (iii) A statement of the method by which the estimated loss was calculated; (iv) A proposed order directing...

  11. 12 CFR 308.167 - Notice of assessment of liability.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Corporation incurred the loss. (b) Contents of Notice. (1) The Notice of Assessment of Liability shall set... Corporation's good faith estimate of the amount of loss it has incurred or anticipates incurring; (iii) A statement of the method by which the estimated loss was calculated; (iv) A proposed order directing...

  12. 12 CFR 308.167 - Notice of assessment of liability.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Corporation incurred the loss. (b) Contents of Notice. (1) The Notice of Assessment of Liability shall set... Corporation's good faith estimate of the amount of loss it has incurred or anticipates incurring; (iii) A statement of the method by which the estimated loss was calculated; (iv) A proposed order directing...

  13. Dimethyltryptamine (DMT): prevalence, user characteristics and abuse liability in a large global sample.

    PubMed

    Winstock, Adam R; Kaar, Stephen; Borschmann, Rohan

    2014-01-01

    This paper presents original research on prevalence, user characteristics and effect profile of N,N-dimethyltryptamine (DMT), a potent hallucinogenic which acts primarily through the serotonergic system. Data were obtained from the Global Drug Survey (an anonymous online survey of people, many of whom have used drugs) conducted between November and December 2012 with 22,289 responses. Lifetime prevalence of DMT use was 8.9% (n=1980) and past year prevalence use was 5.0% (n=1123). We explored the effect profile of DMT in 472 participants who identified DMT as the last new drug they had tried for the first time and compared it with ratings provided by other respondents on psilocybin (magic mushrooms), LSD and ketamine. DMT was most often smoked and offered a strong, intense, short-lived psychedelic high with relatively few negative effects or "come down". It had a larger proportion of new users compared with the other substances (24%), suggesting its popularity may increase. Overall, DMT seems to have a very desirable effect profile indicating a high abuse liability that maybe offset by a low urge to use more. PMID:24284475

  14. Risk Assessment in Child Sexual Abuse Cases

    ERIC Educational Resources Information Center

    Levenson, Jill S.; Morin, John W.

    2006-01-01

    Despite continuing improvements in risk assessment for child protective services (CPS) and movement toward actuarial prediction of child maltreatment, current models have not adequately addressed child sexual abuse. Sexual abuse cases present unique and ambiguous indicators to the investigating professional, and risk factors differ from those…

  15. The effect of repeated intramuscular alfentanil injections on experimental pain and abuse liability indices in healthy males

    PubMed Central

    Tompkins, D. Andrew; Smith, Michael T.; Bigelow, George E.; Moaddel, Ruin; Venkata, S.L. Vatem; Strain, Eric C.

    2013-01-01

    Objective Opioid-induced hyperalgesia (OIH), increased sensitivity to noxious stimuli following repeated opioid exposures, has been demonstrated in pre-clinical studies. However, there is no accepted, prospective model of OIH following repeated opioid exposures currently available in humans. This study assessed a potential prospective OIH model. Methods Double-blind intramuscular (IM) injections of a short-acting opioid, (alfentanil 15 mcg/kg; N=8) were compared to active placebo (diphenhydramine 25 mg; N=3) on cold and pressure pain testing and standard abuse liability measures in eight 10-hour sessions (1 injection/session) over 4–5 weeks in healthy pain-free males. Decreases from session baseline pain threshold (PThr) and tolerance (PTol) were calculated to represent hyperalgesia, and were assessed both within and across sessions. Results Mean decreases in cold PTol were seen in the alfentanil group at 180 minutes (−3.8 seconds, +/−26.5) and 480 minutes (−1.63 seconds, +/−31.5) after drug administration. There was a trend for differences between conditions on cold PThr hyperalgesia but not for pressure PThr. Alfentanil participants had greater mean ratings on LIKING and HIGH visual analog scales at peak effects (30 minutes), but these scores did not change across sessions. Discussion Repeated alfentanil exposures over 4–5 weeks resulted in within session decreases in cold pain tolerance from baseline but these differences were not substantially different from diphenhydramine controls. The results did not support the phenomenon of OIH in this model, although definitive conclusions regarding the existence of OIH in humans likely requires a larger sample size or an alternative model. PMID:23446076

  16. ASSESSING PHENOTYPIC CORRELATION THROUGH THE MULTIVARIATE PHYLOGENETIC LATENT LIABILITY MODEL

    PubMed Central

    Cybis, Gabriela B.; Sinsheimer, Janet S.; Bedford, Trevor; Mather, Alison E.; Lemey, Philippe; Suchard, Marc A.

    2016-01-01

    Understanding which phenotypic traits are consistently correlated throughout evolution is a highly pertinent problem in modern evolutionary biology. Here, we propose a multivariate phylogenetic latent liability model for assessing the correlation between multiple types of data, while simultaneously controlling for their unknown shared evolutionary history informed through molecular sequences. The latent formulation enables us to consider in a single model combinations of continuous traits, discrete binary traits, and discrete traits with multiple ordered and unordered states. Previous approaches have entertained a single data type generally along a fixed history, precluding estimation of correlation between traits and ignoring uncertainty in the history. We implement our model in a Bayesian phylogenetic framework, and discuss inference techniques for hypothesis testing. Finally, we showcase the method through applications to columbine flower morphology, antibiotic resistance in Salmonella, and epitope evolution in influenza. PMID:27053974

  17. Dopamine transporter-dependent and -independent striatal binding of the benztropine analog JHW 007, a cocaine antagonist with low abuse liability

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The benztropine analog JHW 007 displays high affinity for the dopamine transporter (DAT), but unlike typical DAT ligands, has relatively low abuse liability and blocks effects of cocaine,including its self-administration. To determine sites responsible for the cocaine-antagonist effects of JHW 007, ...

  18. A Strategy for Local Drug Abuse Assessment. Technical Paper.

    ERIC Educational Resources Information Center

    Green, John O.

    This paper provides a model to assist local program planners, administrators, and other decisionmakers in the assessment of local drug abuse conditions and problems. The model presents data on which to base everyday judgments about drug abuse, to plan for drug abuse services, and to allocate limited resources on local levels. Drug abuse indicators…

  19. Urgent Medical Assessment after Child Sexual Abuse

    ERIC Educational Resources Information Center

    Palusci, Vincent J.; Cox, Edward O.; Shatz, Eugene M.; Schultze, Joel M.

    2006-01-01

    Background: Immediate medical assessment has been recommended for children after sexual abuse to identify physical injuries, secure forensic evidence, and provide for the safety of the child. However, it is unclear whether young children seen urgently within 72 hours of reported sexual contact would have higher frequencies of interview or…

  20. Risk evaluation and mitigation strategies for drugs with abuse liability: public interest, special interest, conflicts of interest, and the industry perspective.

    PubMed

    Wright, Curtis; Schnoll, Sidney; Bernstein, David

    2008-10-01

    Risk evaluation and mitigation strategies (REMS) formerly known as Risk Minimization Action Plans (RiskMAPs) are a regulatory technique for dealing with anticipated risks of new medications and are especially important for new drugs with abuse potential. This paper describes the origin and history of risk-management plans for drugs that might be abused, the proper use of these plans in minimizing the risk to the public, and the special difficulties inherent in managing risks for drugs with abuse potential. Drugs with abuse liability are distinctive since the risks inherent in manufacture and distribution include not only risks to patients prescribed the medications, but also risks to the general public including subgroups in the population not intended to get the drug and who receive no medical benefit from the medication. The crafting of risk-management plans intended to protect nonpatient populations is unique for these products. The content, extent, and level of intensity of these plans affect areas of medical ethics, civil liability, and criminal prosecution. The need for risk-management plans for drugs with abuse liability can potentially act as a deterrent to investment and is a factor in decisions concerning the development of new medications for the treatments of pain, ADHD, anxiety disorders, and addictions. This paper provides a framework for moving the process of REMS development forward and criteria for evaluating the probity and adequacy of such programs. PMID:18991964

  1. Abuse liability of flupirtine revisited: implications of spontaneous reports of adverse drug reactions.

    PubMed

    Gahr, Maximilian; Freudenmann, Roland W; Connemann, Bernhard J; Hiemke, Christoph; Schönfeldt-Lecuona, Carlos

    2013-12-01

    Early studies suggested that the centrally acting non-opioid and non-steroidal analgesic flupirtine (FLP) has no potential for abuse. However, FLP's agonistic effects at the GABAA receptor might prime addictive behaviors, and literature provides some anecdotal reports on FLP abuse/dependence. To shed more light on this topic we acquired and evaluated data obtained from a national German pharmacovigilance database. We analyzed all reports of FLP abuse/dependence that were recorded in the database of the German Federal Institute for Drugs and Medical Devices (BfArM). A total of n = 48 reports of FLP abuse/dependence could be identified (mean age 45 years, 62.5% female). First reports were submitted to BfArM in 1991 with increasing numbers of annual reports from the year 2006 on. Mean daily FLP dosage was 805 mg (range 200-3,000 mg). Current or previous substance abuse/dependence was reported in 21% and 17%, respectively. Mean duration of FLP abuse/dependence until report to BfArM was 23 months (range 1-84 months). Withdrawal syndromes after discontinuation of FLP were reported in n = 9 (19%). Our findings strengthen the hypothesis that FLP features a potential to cause addictive behaviors. Female sex, age >40 years, and long-term FLP-treatment may be possible risk factors for the development of FLP abuse/dependence. PMID:24037995

  2. Abuse liability of buprenorphine-naloxone tablets in untreated IV drug users.

    PubMed

    Alho, Hannu; Sinclair, David; Vuori, Erkki; Holopainen, Antti

    2007-04-17

    Buprenorphine (Subutex) is widely abused in Finland. A combination of buprenorphine plus naloxone (Suboxone) has been available since late 2004, permitting a comparison of the abuse of the two products among untreated intravenous (IV) users. A survey was distributed to attendees at a Helsinki needle exchange program over 2-weeks in April, 2005, At least 30% were returned anonymously. Survey variables included: years of prior IV opioid abuse, years of buprenorphine abuse, frequency, dosage, route of administration and reasons for use, concomitant IV abuse of other substances and amount paid on the street for both buprenorphine and buprenorphine+naloxone. Buprenorphine was the most frequently used IV drug for 73% of the respondents. More than 75% said they used IV buprenorphine to self-treat addiction or withdrawal. Most (68%) had tried the buprenorphine+naloxone combination IV, but 80% said they had a "bad" experience. Its street price was less than half that of buprenorphine alone. The buprenorphine+naloxone combination appears to be a feasible tool, along with easier access to addiction treatment, for decreasing IV abuse of buprenorphine. PMID:17055191

  3. Endomorphin analog analgesics with reduced abuse liability, respiratory depression, motor impairment, tolerance, and glial activation relative to morphine.

    PubMed

    Zadina, James E; Nilges, Mark R; Morgenweck, Jenny; Zhang, Xing; Hackler, Laszlo; Fasold, Melita B

    2016-06-01

    Opioids acting at the mu opioid receptor (MOR) are the most effective analgesics, however adverse side effects severely limit their use. Of particular importance, abuse liability results in major medical, societal, and economic problems, respiratory depression is the cause of fatal overdoses, and tolerance complicates treatment and increases the risk of side effects. Motor and cognitive impairment are especially problematic for older adults. Despite the host of negative side effects, opioids such as morphine are commonly used for acute and chronic pain conditions. Separation of analgesia from unwanted effects has long been an unmet goal of opioid research. Novel MOR agonist structures may prove critical for greater success. Here we tested metabolically stable analogs of the endomorphins, endogenous opioids highly selective for the MOR. Compared to morphine, the analogs showed dramatically improved analgesia-to-side-effect ratios. At doses providing equal or greater antinociception than morphine in the rat, the analogs showed reduced a) respiratory depression, b) impairment of motor coordination, c) tolerance and hyperalgesia, d) glial p38/CGRP/P2X7 receptor signaling, and e) reward/abuse potential in both conditioned place preference and self-administration tests. Differential effects on glial activation indicate a mechanism for the relative lack of side effects by the analogs compared to morphine. The results suggest that endomorphin analogs described here could provide gold standard pain relief mediated by selective MOR activation, but with remarkably safer side effect profiles compared to opioids like morphine. PMID:26748051

  4. Evaluating the Risk of Child Abuse: The Child Abuse Risk Assessment Scale (CARAS)

    ERIC Educational Resources Information Center

    Chan, Ko Ling

    2012-01-01

    The present study developed the Child Abuse Risk Assessment Scale (CARAS), an actuarial instrument for the assessment of the risk of physical child abuse. Data of 2,363 Chinese parents (47.7% male) living in Hong Kong were used in the analyses. Participants were individually interviewed with a questionnaire assessing their perpetration of child…

  5. State Liability for Abuse in Primary Schools: Systemic Failure and "O'Keeffe" v. "Hickey"

    ERIC Educational Resources Information Center

    O'Mahony, Conor

    2009-01-01

    Due to the historical arrangement between Church and State, the Irish State has always discharged its duty to provide for free primary education exclusively through the provision of funding to privately owned and managed schools. Consequently, in "O'Keeffe" v. "Hickey," where a woman sued the State in respect of sex abuse she suffered when in…

  6. Abuse liability, behavioral pharmacology, and physical-dependence potential of opioids in humans and laboratory animals: lessons from tramadol

    PubMed Central

    Epstein, David H.; Preston, Kenzie L.; Jasinski, Donald R.

    2010-01-01

    Assessment of abuse potential of opioid analgesics has a long history in both laboratory animals and humans. This article reviews the methods used in animals and in humans and then presents the data collected in the evaluation of tramadol, an atypical centrally acting opioid analgesic approved for marketing in the United States in 1998. Finally, data on the abuse of tramadol from postmarketing surveillance and case reports are presented. The consistency between animal and human study results and the predictive value of both are discussed. Overall, there was substantial agreement between animal and human data, with each having predictive value. Nonetheless, it is suggested that abuse-potential screening of new medications would benefit from an organized, integrated cross-species program. PMID:16497429

  7. Parents of minors who have sexually abused: legal liability and clinical interventions.

    PubMed

    Oz, Sheri

    2013-01-01

    While children and adolescents generally do not have the right to vote, marry, or sign contracts independently, they are often held responsible for their crimes. In spite of this, some parents of minor victims file civil suits against parents of the youth responsible for the harm. The courts must then decide to what extent, if any, parents are legally liable when their minor children commit offenses. Since parents are essential to the successful rehabilitation of minors who have sexually offended, the impact of legal liability on parental engagement in therapy must be examined. This article will explore the conflicting issues of age, legal responsibility, parental responsibility, and therapeutic effectiveness in the Israeli context and propose a means for resolution. PMID:23350541

  8. Screening and Assessing Adolescent Substance Abuse: A Primer for Counselors.

    ERIC Educational Resources Information Center

    Schwartz, Robert C.; Smith, Shannon D.

    2003-01-01

    Adolescent substance abuse is an increasing problem in U. S. society. This article provides an overview of adolescent substance abuse, screening, and assessment strategies; contact information related to specific assessment instruments; and information regarding ethic important to consider during the assessment process. (Contains 16 references and…

  9. The abuse liability of the NMDA receptor antagonist-benzodiazepine (tiletamine-zolazepam) combination: evidence from clinical case reports and preclinical studies.

    PubMed

    de la Peña, June Bryan; Cheong, Jae Hoon

    2016-08-01

    The tiletamine-zolazepam (TZ) combination is an anaesthetic drug commonly used in veterinary medicine. It is an equal amount combination of tiletamine, a dissociative anaesthetic pharmacologically classified as an N-methyl-D-aspartate (NMDA) receptor antagonist, and zolazepam, a benzodiazepine tranquilizer. There are concerns regarding the safety profile of this drug combination due to incidents of human misuse/abuse. In this paper, we discuss the abuse liability of this drug combination based on currently available scientific evidence. We performed an in-depth search of medical and scientific literature and found seven reported cases of human abuse of the TZ combination, two of which resulted in fatal outcomes. In most of these cases, drug administration was intentional indicating that the TZ combination was abused by humans. This finding is bolstered by the results of preclinical studies showing that the TZ combination produces rewarding effects in rats, although manifested only in pretreated subjects. Further studies revealed that the addictive effects of the TZ combination are influenced by pre-exposure to other psychoactive drugs. Pre-exposure to ketamine, diazepam, propofol, or ethanol facilitated the expression of the rewarding effects of the TZ combination. These findings support the hypothesis that the TZ combination was and can be used as a substitute or replacement drug. Altogether, the compiled evidence indicates that the TZ combination can potentially be abused by humans. Thus, careful use, dispensation, and monitoring of the TZ combination and associated substances are strongly advocated. Copyright © 2016 John Wiley & Sons, Ltd. PMID:27341080

  10. A Multidisciplinary Approach to Assessing the Abused Youngster.

    ERIC Educational Resources Information Center

    Rotatori, Anthony F.; And Others

    1984-01-01

    Discusses ways of gathering social, medical, educational, intellectual, and personality data, and points out research needs. Two tables provide, respectively, an abuse data recording form and names and sources of training materials for the identification, assessment, and prevention of abuse of young children. (RH)

  11. Assessment and Treatment of Sexually Abused Children and Adolescents.

    ERIC Educational Resources Information Center

    King, H. Elizabeth; And Others

    These papers on child and adolescent sexual abuse address the psychological consequences, psychological assessment techniques, and clinical issues in group therapy with sexually abused girls. In the first paper. H. Elizabeth King discusses the psychological consequences of sexual assault and incest on minors particularly in regard to family…

  12. Assessing the Probability of Abuse of the Elderly.

    ERIC Educational Resources Information Center

    Hwalek, Melanie; And Others

    Investigators and service providers have indicated the need for a tool to identify elderly victims of abuse and neglect. Identifying factors related to the risk of elder abuse/neglect can be useful in planning services and targeting limited resources for preventing future problems. A 93-item Risk Assessment Tool was created and over 100 risk…

  13. A Model for Assessing the Liability of Seemingly Correct Software

    NASA Technical Reports Server (NTRS)

    Voas, Jeffrey M.; Voas, Larry K.; Miller, Keith W.

    1991-01-01

    Current research on software reliability does not lend itself to quantitatively assessing the risk posed by a piece of life-critical software. Black-box software reliability models are too general and make too many assumptions to be applied confidently to assessing the risk of life-critical software. We present a model for assessing the risk caused by a piece of software; this model combines software testing results and Hamlet's probable correctness model. We show how this model can assess software risk for those who insure against a loss that can occur if life-critical software fails.

  14. TAT assessment of object relations: implications for child abuse.

    PubMed

    Ornduff, S R

    1997-01-01

    Several recent empirical studies have documented impaired object relations in victims of childhood maltreatment. The consistency of these findings, despite sampling and other methodological differences, highlights the applicability of object relations theory to the study of abuse sequelae. This article illustrates the use of the Social Cognition and Object Relations Scales (SCORS) in the clinical assessment of maltreated children by applying it to selected Thematic Apperception Test (TAT) stories of a sexually abused girl, a physically abused girl, and a distressed but nonabused peer. Diagnostic and treatment implications are discussed. PMID:9066175

  15. Physically Abusive Fathers and Risk Assessment

    ERIC Educational Resources Information Center

    Coohey, Carol

    2006-01-01

    Objective: The purpose of this study is to identify factors that predict recidivism among families in which the father is the perpetrator of physical abuse and to compare these factors to the factors that investigators believe are related to higher risk. Method: A case-comparison design was used to understand risk among 137 predominantly Caucasian…

  16. Assessment of the Abuse Potential of the Orexin Receptor Antagonist, Suvorexant, Compared With Zolpidem in a Randomized Crossover Study.

    PubMed

    Schoedel, Kerri A; Sun, Hong; Sellers, Edward M; Faulknor, Janice; Levy-Cooperman, Naama; Li, Xiaodong; Kennedy, William P; Cha, Jang-Ho; Lewis, Nicole M; Liu, Wen; Bondiskey, Phung; McCrea, Jacqueline B; Panebianco, Deborah L; Troyer, Matthew D; Wagner, John A

    2016-08-01

    Suvorexant is a dual orexin receptor antagonist approved in the United States and Japan for the treatment of insomnia at a maximum dose of 20 mg. This randomized double-blind crossover study evaluated the abuse potential of suvorexant in 36 healthy recreational polydrug users with a history of sedative and psychedelic drug use. Single doses of suvorexant (40, 80, and 150 mg: 2-7.5 × maximum dose), zolpidem (15 and 30 mg: 1.5-3 × maximum dose), and placebo were administered, with a 10-day washout between treatments. Subjective and objective measures, including visual analog scales (VASs), Addiction Research Center Inventory, and cognitive/psychomotor tests, were evaluated for 24-hour postdose. Suvorexant had significantly greater peak effects on "drug liking" VAS (primary endpoint) than placebo. Although effects of suvorexant on abuse potential measures were generally similar to zolpidem, they remained constant across doses, whereas zolpidem often had greater effects at higher doses. Suvorexant (all doses) had significantly fewer effects than zolpidem 30 mg on secondary measures, such as "high" VAS, Bowdle VAS, and Addiction Research Center Inventory morphine-benzedrine group. The overall incidence of abuse-related adverse events, such as euphoric mood and hallucination, was numerically lower with suvorexant than zolpidem. In agreement with its classification as a schedule IV drug, suvorexant demonstrated abuse potential, compared with placebo. The abuse potential was similar to zolpidem using certain measures, but with a reduced incidence of abuse-related adverse events. Although this suggests that the overall abuse liability of suvorexant may be lower than zolpidem, the actual abuse rates will be assessed with the postmarketing experience. PMID:27253658

  17. Adolescent substance abuse. Assessment in the office.

    PubMed

    Dias, Philomena J

    2002-04-01

    There are no gold-standard tests for evaluating a teen suspected of abusing substances. Awareness of the high prevalence of substance abuse in youth, a high index of suspicion, and a firm desire to be a part of the solution are all that is required to address the problem of substance abuse in youth. In an age of "dotcoms" and societal complexity that fosters an emotionally "disconnected" atmosphere by uniting adolescents only by what they buy, plug into, click on, or blast away, teens need trusted medical homes where caring pediatricians are available to give youth accurate and authoritative facts and care to help them build inner resilience and connect them to the pain and hurt of the people in their lives. Until now, the "three strikes and you're out" maxim has been applied in medical care. This maxim may work for baseball, Clintonomics, and practical office management strategies but is not recommended for addressing the needs of substance using or abusing youth who are prey to advertising strategies. The size of the marketing and advertising budgets of the alcohol and cigarette industries is an indication of the relentless marketing directed toward vulnerable youth. Pediatricians would be doing teens a disservice if they fail to countermand this marketing effect by not using the "rule of seven"--the "seven 'S' screen," seven education attempts, seven different ways over 7 years, and persistence over seven attempts of chemically dependent adolescents to quit. It has been said by Osler that "These are our methods--to carefully observe the phenomena of life in all its stages, to cultivate the reasoning of the faculty so as to be able to know the true from the false. This is our work--to prevent disease, to relieve suffering, to heal the sick," and provide HOPE always. PMID:11993283

  18. Supervised extensions of chemography approaches: case studies of chemical liabilities assessment

    PubMed Central

    2014-01-01

    Chemical liabilities, such as adverse effects and toxicity, play a significant role in modern drug discovery process. In silico assessment of chemical liabilities is an important step aimed to reduce costs and animal testing by complementing or replacing in vitro and in vivo experiments. Herein, we propose an approach combining several classification and chemography methods to be able to predict chemical liabilities and to interpret obtained results in the context of impact of structural changes of compounds on their pharmacological profile. To our knowledge for the first time, the supervised extension of Generative Topographic Mapping is proposed as an effective new chemography method. New approach for mapping new data using supervised Isomap without re-building models from the scratch has been proposed. Two approaches for estimation of model’s applicability domain are used in our study to our knowledge for the first time in chemoinformatics. The structural alerts responsible for the negative characteristics of pharmacological profile of chemical compounds has been found as a result of model interpretation. PMID:24868246

  19. Supervised extensions of chemography approaches: case studies of chemical liabilities assessment.

    PubMed

    Ovchinnikova, Svetlana I; Bykov, Arseniy A; Tsivadze, Aslan Yu; Dyachkov, Evgeny P; Kireeva, Natalia V

    2014-01-01

    Chemical liabilities, such as adverse effects and toxicity, play a significant role in modern drug discovery process. In silico assessment of chemical liabilities is an important step aimed to reduce costs and animal testing by complementing or replacing in vitro and in vivo experiments. Herein, we propose an approach combining several classification and chemography methods to be able to predict chemical liabilities and to interpret obtained results in the context of impact of structural changes of compounds on their pharmacological profile. To our knowledge for the first time, the supervised extension of Generative Topographic Mapping is proposed as an effective new chemography method. New approach for mapping new data using supervised Isomap without re-building models from the scratch has been proposed. Two approaches for estimation of model's applicability domain are used in our study to our knowledge for the first time in chemoinformatics. The structural alerts responsible for the negative characteristics of pharmacological profile of chemical compounds has been found as a result of model interpretation. PMID:24868246

  20. Abuse

    MedlinePlus

    ... also may fall prey to strangers who take advantage of their cognitive impairment. Types of abuse Signs ... property) to his or her disadvantage or the advantage of someone else Sexual abuse: touching, fondling or ...

  1. Alcohol Abuse on a College Campus: A Needs Assessment.

    ERIC Educational Resources Information Center

    Walfish, Steven; And Others

    1981-01-01

    This paper reports the results of a needs assessment study conducted by a university-based alcohol abuse prevention project. Results suggest that students are experiencing numerous difficulties in the physical, educational, legal, and psychological areas due to their use of alcoholic beverages. Implications for prevention and intervention…

  2. Confidence and Professional Judgment in Assessing Children's Risk of Abuse

    ERIC Educational Resources Information Center

    Regehr, Cheryl; Bogo, Marion; Shlonsky, Aron; LeBlanc, Vicki

    2010-01-01

    Objective: Child welfare agencies have moved toward standardized risk assessment measures to improve the reliability with which child's risk of abuse is predicted. Nevertheless, these tools require a degree of subjective judgment. Research to date has not substantially investigated the influence of specific context and worker characteristics on…

  3. Assessing Sexual Abuse/Attack Histories with Bariatric Surgery Patients

    ERIC Educational Resources Information Center

    Mahony, David

    2010-01-01

    This study assessed sexual abuse/attack histories in 537 bariatric surgery patients using the PsyBari. The prevalence rates found were lower (15.5%, 19.3% of women, 5.2% of men) than other studies that used bariatric surgery patients but consistent with studies that used nonbariatric obese subjects. Furthermore, bariatric surgery patients who…

  4. Risk Assessment in Child Sexual Abusers Working With Children.

    PubMed

    Turner, Daniel; Rettenberger, Martin; Yoon, Dahlnym; Klein, Verena; Eher, Reinhard; Briken, Peer

    2016-09-01

    Child sexual abuse occurring in a child- or youth-serving institution or organization has attracted great public and scientific attention. In light of the particular personal and offense-related characteristics of men who have abused children within such an institution or organization, it is of special importance to evaluate the predictive performance of currently applied risk assessment instruments in this offender population. Therefore, the present study assessed the risk ratings and predictive performance of four risk assessment instruments and one instrument assessing protective factors concerning any, violent and sexual recidivism in child sexual abusers working with children (CSA-W) in comparison with extra-familial child sexual abusers (CSA-E) and intra-familial child sexual abusers (CSA-I). The results indicate that CSA-W mostly recidivate with a sexual offense. Although all included risk measures seem to function with CSA-W, the Static-99 seems to be the instrument that performs best in predicting sexual recidivism in CSA-W. CSA-W had the most protective factors measured with the Structured Assessment of PROtective Factors (SAPROF). While the SAPROF could not predict desistance from recidivism in CSA-W, it predicted desistance from any recidivism in all CSA. As CSA-W frequently hold many indicators for pedophilic sexual interests but only a few for antisocial tendencies, it can be suggested that CSA-W are at an increased risk for sexual recidivism and thus risk measures especially designed for sexual recidivism work best in CSA-W. Nevertheless, CSA-W also hold many protective factors; however, their impact on CSA-W is not clear yet and needs further study. PMID:25527631

  5. Does the Transmissible Liability Index (TLI) Assessed in Late Childhood Predict Suicidal Symptoms at Young Adulthood?

    PubMed Central

    Cornelius, Jack R.; Kirisci, Levent; Reynolds, Maureen; Vanyukov, Michael; Tarter, Ralph

    2015-01-01

    Objective Our previous work demonstrated that the Transmissible Liability Index (TLI), an instrument designed as an index of liability for substance use disorder (SUD), is associated with risk of substance use disorder. This longitudinal study assessed whether TLI measured in 10–12 year olds (late childhood) predicts suicidal behavior from age 12–14 (preadolescence) to age 25 (young adulthood). We hypothesized that TLI would predict number and severity of suicide attempts. Methods Subjects were sons of men who had lifetime history of SUD (N=250), called the High Average Risk (HAR) group, and sons of men with no lifetime history of a SUD (N=250), called the Low Average Risk (LAR) group. The TLI was delineated at baseline (age 10–12), and age-specific versions were administered at 12–14, 16, 19, 22, and 25 years of age. Results TLI was significantly associated with number and severity of lifetime suicide attempts. Conclusions These findings confirm the hypothesis that TLI assessed at late childhood is a predictor of frequency and severity of suicidal behavior from preadolescence to young adulthood. PMID:25699562

  6. An approach to assessing elder abuse and neglect in the dental office.

    PubMed

    Osei, Anthony D

    2009-07-01

    Elder abuse and neglect is a complex phenomenon with no clear markers identified as both reliable and valid in the dental operatory. Applying the concepts and definition of abuse and attention to risk factors for abuse could lead the clinician, as the head of the care team to situations where abuse of an elder could be suspected. Once abuse is suspected, direct questioning and comprehensive assessment of an elders' physical, emotional, and emotional state could be recorded as part of social history in their dental records. A multidisciplinary team approach is encouraged to combat elder abuse. In Texas, state statutes on suspected abuse mandate reporting to appropriate Adult Protective Services within your region with stipulated penalties for failure to report suspected abuse or neglect. Elder abuse hotlines are (800) 252-5400 or (512) 834-3784 (elder abuse domestic or community). PMID:19753814

  7. Drug abuse in Nepal: a rapid assessment study.

    PubMed

    Chatterjee, A; Uprety, L; Chapagain, M; Kafle, K

    1996-01-01

    A rapid assessment of drug abuse in Nepal was conducted at different sites, including eight municipalities in the five development regions of the country. To interview various groups of key informants, such methods as semi-structured interviews, in-depth interviews and focus group discussions were used. A snowball sampling strategy for respondents who were drug abusers and a judgemental sampling strategy for the non-drug-using key informants were applied. About one fifth of the sample was recruited from the treatment centres and the rest from the community. Drug abusers in prison were interviewed, and secondary data from treatment centres and prisons analysed. The study revealed that the sample of drug abusers had a mean age of 23.8 years and was overwhelmingly male. Most respondents lived with their families and were either unemployed or students. About 30 per cent of the sample was married. A large majority of the sample had a family member or a close relative outside the immediate family who smoked or drank alcohol and a friend who smoked, drank or used illicit drugs. Apart from tobacco and alcohol, the major drugs of abuse were cannabis, codeine-containing cough syrup, nitrazepam tablets, buprenor-phine injections and heroin (usually smoked, rarely injected). The commonest sources of drugs were other drug-using friends, cross-border supplies from India or medicine shops. The commonest source of drug money was the family. There has been a clear trend towards the injection of buprenorphine by abusers who smoke heroin or drink codeine cough syrup. The reasons cited for switching to injections were the unavailability and rising cost of non-injectable drugs and the easy availability and relative cheapness of injectables. About a half of the injecting drug users (IDUs) commonly reported sharing injecting equipment inadequately cleaned with water. Over a half of IDUs reported visiting needle-exchange programmes at two of the study sites where such programmes were

  8. True and False Allegations of Child Sexual Abuse: Assessment and Case Management.

    ERIC Educational Resources Information Center

    Ney, Tara, Ed.

    This book addresses the clinical, legal, and ethical issues arising in child sexual abuse cases; the assessment and case management of allegations; research issues; and practice recommendations. Chapter titles are as follows: "Assessing Allegations in Child Sexual Abuse: An Overview" (Tara Ney); "The Nature of Allegations of Child Sexual Abuse"…

  9. The treatment of chronic insomnia: drug indications, chronic use and abuse liability. Summary of a 2001 New Clinical Drug Evaluation Unit meeting symposium.

    PubMed

    Mendelson, Wallace B; Roth, Thomas; Cassella, James; Roehrs, Timothy; Walsh, James K; Woods, James H; Buysse, Daniel J; Meyer, Roger E

    2004-02-01

    This paper summarizes a group of presentations and panel discussions on chronic insomnia at the 2001 NCDEU meeting. The presentations and discussions focused on the twin issues of efficacy and concerns of abuse liability with long-term hypnotic therapy. The panel concluded that insomnia may be an epidemiological marker for a variety of difficulties including accidents, increased health care utilization and subsequent development of major depression. Whether or not treatment of insomnia will prevent these long-term problems has not yet been determined. Since the mid-1980s there has been a rapid rise in the off-label use of antidepressants, particularly trazodone, for treating insomnia. Some participants expressed concern at the lack of data for this practice, particularly the absence of dose-response and tolerance information, and noted that the small amount of efficacy data available is not encouraging. Similarly, there are minimal data to support the use of antihistamines as sleep aids; moreover, their side effect profile and interactions with other drugs may be under appreciated. The limited data available on nightly long-term usage of the newer non-benzodiazepine hypnotics, primarily of six-months' duration, suggest an absence of tolerance, but more data for both nightly and non-nightly administration are needed. Insomniacs tend to show therapy-seeking, rather than drug-seeking behavior, and patients without histories of drug abuse are unlikely to self-escalate dosage of currently available hypnotics. There is fairly good agreement on the characteristics of an ideal hypnotic. All currently available agents, while effective and safe, do not achieve this ideal. The next few years are likely to see the appearance of a variety of agents with new and promising mechanisms of action. PMID:15062207

  10. [Medical expert assessment in civil and criminal law from the legal liability viewpoint].

    PubMed

    Kümper, H J

    1996-11-01

    In view of the wide range of liability claims, expert medical reports constitute part of the basis of the work of liability insurers. However, the very different qualifications of experts often present the so-called "corporate physician" with great problems, since some expert reports are hardly acceptable, as the author discovered during many years of study of a large number of liability files. In addition, the most striking and frequently occurring criteria are discussed. PMID:9064928

  11. Effects of the delta-opioid agonist SNC80 on the abuse liability of methadone in rhesus monkeys: a behavioral economic analysis

    PubMed Central

    Banks, Matthew L.; Roma, Peter G.; Folk, John E.; Rice, Kenner C.

    2012-01-01

    Rationale Delta-opioid agonists enhance the antinociceptive efficacy of methadone and other mu-opioid agonists. However, relatively little is known about the degree to which delta agonists might enhance the abuse-related effects of mu agonists. Objective This study used a behavioral economic approach to examine effects of the delta agonist SNC80 [(+)-4-[(αR)-α-((2S,5R)-4-allyl-2,5-dimethyl-1-piperazinyl)-3-methoxy-benzyl]-N,N-diethylbenzamide] on the reinforcing effects of methadone in a drug self-administration assay. Interactions between SNC80 and cocaine were also examined for comparison. Methods Rhesus monkeys (n=4), surgically implanted with indwelling intravenous catheters, were tested in two phases. In phase 1, drug self-administration dose-effect curves for methadone (0.0032–0.1 mg/kg/injection (inj)) and cocaine (0.0032–0.32 mg/kg/inj) alone were determined under a fixed-ratio 10 (FR 10) schedule of reinforcement. In phase 2, FR values were increased every 3 days (FR 1–FR 1800) during availability of methadone alone (0.032 mg/kg/inj) and in combination with varying proportions of SNC80 (0.1:1, 0.3:1, and 0.9:1 SNC80/methadone) or of cocaine alone (0.032 mg/kg/inj) and in combination with varying proportions of SNC80 (0.33:1, 1:1, and 3:1 SNC80/ cocaine). Demand curves related drug intake to FR price, and measures of reinforcement were derived. Results Methadone and cocaine alone each functioned as a reinforcer. SNC80 did not alter measures of reinforcement for either methadone or cocaine. Conclusions SNC80 at proportions previously shown to enhance methadone-induced antinociception did not enhance the abuse-related effects of methadone. These results support the proposition that delta agonists may selectively enhance mu agonist analgesic effects without enhancing mu agonist abuse liability. PMID:21369752

  12. Providing long term care for sex offenders: liabilities and responsibilities.

    PubMed

    Corson, Tyler Rogers; Nadash, Pamela

    2013-11-01

    The high risk for recidivism among sex offenders who need long term care (LTC) raises serious issues when they are cared for alongside frail, vulnerable adults. LTC providers must balance offenders' right to access care with other residents' right to be free from abuse and must assess and manage the risks associated with admitting offenders. This article identifies sources of legal liability that derive from sex offender management and discusses the need for the LTC community to develop reasonable, balanced guidance on how best to mitigate the risks associated with sex offenders, protect the rights of all residents, and reduce provider liabilities. PMID:24094899

  13. Assessment of drug abuser treatment needs in Rhode Island.

    PubMed Central

    McAuliffe, W E; Breer, P; Ahmadifar, N W; Spino, C

    1991-01-01

    BACKGROUND. Rhode Island's Division of Substance Abuse asked us to assess the State's drug treatment needs and make recommendations regarding its treatment system for the next three years. METHODS. We used a statewide telephone drug use survey of 5,176 households supplemented by drug-related hospital discharges, Division of Drug Control statistics, and interviews with providers, state officials, and out-of-state experts. Drug abuse was measured with items from the Diagnostic Interview Schedule. Abusers were asked if they were receiving or wanted to receive treatment. RESULTS. Survey responses, used to estimate the unmet need for drug treatment, indicated a need to triple drug treatment services. Regression models using survey data indicated that the treatment network was overly centralized in the Providence area. Interviews with state officials, clinicians, and out-of-state experts provided material for recommendations on reimbursement policy, treatment mix, quality assurance, and cost containment. CONCLUSIONS. The RI Department of Health's certificate-of-need program adopted our overall recommendation for tripling the drug treatment system as its guideline in evaluating proposals for new treatment facilities. With State funding of a new adolescent center and expansion of outpatient slots in the private sector, this recommendation has now been fully implemented. PMID:1847277

  14. Development of the System on the Internet for Pre-Assessment of Child Abuse Prevention

    NASA Astrophysics Data System (ADS)

    Honma, Satoru; Wakamatsu, Hidetoshi; Ueda, Reiko

    Some assessments have been applied to find possible factors that might lead to child abuse. PACAP is a new method proposed by Ueda and others as a pre-assessment of the concerning child abuse, which reduces its false-positive misclassification. The Internet PACAP is developed to reduce the laborious work of nurses and health care workers for the necessary processing and classifying the scores of the pre-assessment. The present system is expected to prevent the child abuse more effectively.

  15. Evaluation of WIN 55,212-2 self-administration in rats as a potential cannabinoid abuse liability model

    PubMed Central

    Lefever, Timothy W.; Marusich, Julie A.; Antonazzo, Kateland R.; Wiley, Jenny L.

    2014-01-01

    Because Δ9-tetrahydrocannabinol (THC) has been a false negative in rat intravenous self-administration procedures, evaluation of the abuse potential of candidate cannabinoid medications has proved difficult. One lab group has successfully trained self-administration of the aminoalkylindole WIN55,212-2 in rats; however, their results have not been independently replicated. The purpose of this study was to extend their model by using a within-subjects design, with the goal of establishing a robust method suitable for substitution testing of other cannabinoids. Male Long-Evans rats were trained to self-administer WIN55,212-2 (0.01 mg/kg/infusion) on a fixed ratio 3 schedule. Dose-effect curves for WIN55,212-2 were determined, followed by vehicle substitution and a dose-effect curve with THC. WIN55,212-2 self-administration was acquired; however, substitution with THC did not maintain responding above vehicle levels. Dose-dependent attenuation by rimonabant confirmed CB1 receptor mediation of WIN55,212-2’s reinforcing effects. Vehicle substitution resulted in a session-dependent decrease in responding (i.e., extinction). While this study provides systematic replication of previous studies, lack of substitution with THC is problematic and suggests that WIN55,212-2 self-administration may be of limited usefulness as a screening tool for detection of the reinforcing effects of potential cannabinoid medications. Clarification of underlying factors responsible for failure of THC to maintain self-administration in cannabinoid-trained rats is needed. PMID:24412835

  16. Evaluation of WIN 55,212-2 self-administration in rats as a potential cannabinoid abuse liability model.

    PubMed

    Lefever, Timothy W; Marusich, Julie A; Antonazzo, Kateland R; Wiley, Jenny L

    2014-03-01

    Because Δ(9)-tetrahydrocannabinol (THC) has been a false negative in rat intravenous self-administration procedures, the evaluation of the abuse potential of candidate cannabinoid medications has proved difficult. One lab group has successfully trained self-administration of the aminoalkylindole WIN55,212-2 in rats; however, their results have not been independently replicated. The purpose of this study was to extend their model by using a within-subjects design, with the goal of establishing a robust method suitable for substitution testing of other cannabinoids. Male Long-Evans rats were trained to self-administer WIN55,212-2 (0.01 mg/kg/infusion) on a fixed ratio 3 schedule. Dose-effect curves for WIN55,212-2 were determined, followed by vehicle substitution and a dose-effect curve with THC. WIN55,212-2 self-administration was acquired; however, substitution with THC did not maintain responding above vehicle levels. Dose-dependent attenuation by rimonabant confirmed CB1 receptor mediation of WIN55,212-2's reinforcing effects. Vehicle substitution resulted in a session-dependent decrease in responding (i.e., extinction). While this study provides systematic replication of previous studies, lack of substitution with THC is problematic and suggests that WIN55,212-2 self-administration may be of limited usefulness as a screening tool for detection of the reinforcing effects of potential cannabinoid medications. Clarification of underlying factors responsible for failure of THC to maintain self-administration in cannabinoid-trained rats is needed. PMID:24412835

  17. Mental health consequences of intimate partner abuse: a multidimensional assessment of four different forms of abuse.

    PubMed

    Mechanic, Mindy B; Weaver, Terri L; Resick, Patricia A

    2008-06-01

    Battered women are exposed to multiple forms of intimate partner abuse. This article explores the independent contributions of physical violence, sexual coercion, psychological abuse, and stalking on symptoms of posttraumatic stress disorder (PTSD) and depression among a sample of 413 severely battered, help-seeking women. The authors test the unique effects of psychological abuse and stalking on mental health outcomes, after controlling for physical violence, injuries, and sexual coercion. Mean scores for the sample fall into the moderate to severe range for PTSD and within the moderate category for depression scores. Hierarchical regressions test the unique effects of stalking and psychological abuse, after controlling for physical violence, injuries, and sexual coercion. Psychological abuse and stalking contribute uniquely to the prediction of PTSD and depression symptoms, even after controlling for the effects of physical violence, injuries, and sexual coercion. Results highlight the importance of examining multiple dimensions of intimate partner abuse. PMID:18535306

  18. Colposcopic genital findings in prepubertal girls assessed for sexual abuse.

    PubMed Central

    Hobbs, C J; Wynne, J M; Thomas, A J

    1995-01-01

    After the introduction of the colposcope for the examination of children suspected of being sexually abused in Leeds, a study was undertaken to describe the findings in detail. A total of 109 consecutive prepubertal girls, mean age 70.4 months were assessed including colposcopic genital and anal examination, and peer group review of reports and photographs. Fifty nine children had signs consistent with blunt force penetrating trauma (hymenal transection/major notch, scar, or hymenal attenuation). Transections were encountered most commonly at 6 o'clock (directly posterior). In 46 the hymenal orifice was gaping with thigh abduction only and in 47 the hymenal orifice transverse diameter was greater than 4 mm on labial separation. Overall, physical findings were commonly present and in only two cases were no signs recorded. Non-specific and frequent findings included patterns of labial and introital reddening. Supportive hymenal signs including swelling, rounding of edge, thickening, distortion, and loss of symmetry were common. Labial fusion was present in 20. Urethral dilatation with labial separation was noted in 14. Physical findings including normality are consistent with abuse and even minor anogenital signs as well as negative findings should be documented. Colposcopy and photography are valuable tools in peer review, teaching, and case management. PMID:8554370

  19. Colposcopic genital findings in prepubertal girls assessed for sexual abuse.

    PubMed

    Hobbs, C J; Wynne, J M; Thomas, A J

    1995-11-01

    After the introduction of the colposcope for the examination of children suspected of being sexually abused in Leeds, a study was undertaken to describe the findings in detail. A total of 109 consecutive prepubertal girls, mean age 70.4 months were assessed including colposcopic genital and anal examination, and peer group review of reports and photographs. Fifty nine children had signs consistent with blunt force penetrating trauma (hymenal transection/major notch, scar, or hymenal attenuation). Transections were encountered most commonly at 6 o'clock (directly posterior). In 46 the hymenal orifice was gaping with thigh abduction only and in 47 the hymenal orifice transverse diameter was greater than 4 mm on labial separation. Overall, physical findings were commonly present and in only two cases were no signs recorded. Non-specific and frequent findings included patterns of labial and introital reddening. Supportive hymenal signs including swelling, rounding of edge, thickening, distortion, and loss of symmetry were common. Labial fusion was present in 20. Urethral dilatation with labial separation was noted in 14. Physical findings including normality are consistent with abuse and even minor anogenital signs as well as negative findings should be documented. Colposcopy and photography are valuable tools in peer review, teaching, and case management. PMID:8554370

  20. The 'Maltreatment and Abuse Chronology of Exposure' (MACE) scale for the retrospective assessment of abuse and neglect during development.

    PubMed

    Teicher, Martin H; Parigger, Angelika

    2015-01-01

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

  1. Outcome Expectancies of Partner Abuse: Assessing Perpetrators' Expectancies and Their Associations with Readiness to Change, Abuse, and Relevant Problems

    ERIC Educational Resources Information Center

    Meis, Laura A.; Murphy, Christopher M.; Winters, Jamie J.

    2010-01-01

    Concerns about low motivation to change among perpetrators of intimate partner violence (IPV) have heightened interest employing behavior change models with this population. In the present investigation, a new scale was developed, the Outcome Expectancies for Partner Abuse (OEPA) Scale, assessing the negative and positive outcome expectancies of…

  2. Relationships Between Tobacco Abuse and Self-Assessment of Health.

    PubMed

    Gawlikowska-Sroka, A; Dzięciołowska-Baran, E; Szczurowski, J

    2016-01-01

    Smoking cigarettes negatively influences the functioning of the body. Among other effects, it has an important impact on the respiratory system, circulation, and behavior. It leads to morphological and physiological changes in organs and tissues, so it can change mood. The aim of this study was to assess the relationships between tobacco abuse and self-assessment of health. The survey was conducted among Polish (243) and foreign (80) medical students at the Pomeranian Medical University in Szczecin, Poland. The study was based on a survey questionnaire of the authors' own design, comprising open and multi-choice questions. Our questionnaire was based on the international standard questionnaire from the Health Behavior in School-Aged Children study (Currie et al. 2009). 80 % of students surveyed were free of any chronic diseases. The results showed that only 23 % of the women and 20 % of the men assessed their health as very good, over 60 % as good, and the remaining at lower levels. We did not observe significant differences between smokers and non-smokers. Physical activity in both groups was generally assessed as good or sufficient. We did not observe significant differences between groups in the incidence of headache, abdominal pain, or vertigo. Significant differences were found in the intake of painkillers. PMID:26801152

  3. Lessons learned from the EG&G consolidated hazardous waste subcontract and ESH&Q liability assessment process

    SciTech Connect

    Fix, N.J.

    1995-03-01

    Hazardous waste transportation, treatment, recycling, and disposal contracts were first consolidated at the Idaho National Engineering Laboratory in 1992 by EG&G Idaho, Inc. At that time, disposition of Resource, Conservation and Recovery Act hazardous waste, Toxic Substance Control Act waste, Comprehensive Environmental Response, Compensation, and Liability Act hazardous substances and contaminated media, and recyclable hazardous materials was consolidated under five subcontracts. The wastes were generated by five different INEL M&O contractors, under the direction of three different Department of Energy field offices. The consolidated contract reduced the number of facilities handling INEL waste from 27 to 8 qualified treatment, storage, and disposal facilities, with brokers specifically prohibited. This reduced associated transportation costs, amount and cost of contractual paperwork, and environmental liability exposure. EG&G reviewed this approach and proposed a consolidated hazardous waste subcontract be formed for the major EG&G managed DOE sites: INEL, Mound, Rocky Flats, Nevada Test Site, and 10 satellite facilities. After obtaining concurrence from DOE Headquarters, this effort began in March 1992 and was completed with the award of two master task subcontracts in October and November 1993. In addition, the effort included a team to evaluate the apparent awardee`s facilities for environment, safety, health, and quality (ESH&Q) and financial liability status. This report documents the evaluation of the process used to prepare, bid, and award the EG&G consolidated hazardous waste transportation, treatment, recycling, and/or disposal subcontracts and associated ESH&Q and financial liability assessments; document the strengths and weaknesses of the process; and propose improvements that would expedite and enhance the process for other DOE installations that used the process and for the re-bid of the consolidated subcontract, scheduled for 1997.

  4. Assessment for self-blame and trauma symptoms during the medical evaluation of suspected sexual abuse.

    PubMed

    Melville, John D; Kellogg, Nancy D; Perez, Nadia; Lukefahr, James L

    2014-05-01

    The purpose of this study was to describe behavioural and emotional symptoms and to examine the effect of abuse-related factors, family responses to disclosure, and child self-blame on these symptoms in children presenting for medical evaluations after disclosure of sexual abuse. A retrospective review was conducted of 501 children ages 8-17. Trauma symptoms were determined by two sets of qualitative measures. Abstracted data included gender, ethnicity, and age; severity of abuse and abuser relationship to child; child responses regarding difficulty with sleep, school, appetite/weight, sadness, or self-harm, parent belief in abuse disclosure, and abuse-specific self-blame; responses to the Trauma Symptom Checklist in Children-Alternate; and the parent's degree of belief in the child's sexual abuse disclosure. Overall, 83% of the children had at least one trauma symptom; 60% had difficulty sleeping and one-third had thoughts of self-harm. Child age and abuse severity were associated with 3 of 12 trauma symptoms, and abuse-specific self-blame was associated with 10 trauma symptoms, after controlling for other variables. The children of parents who did not completely believe the initial disclosure of abuse were twice as likely to endorse self-blame as children of parents who completely believed the initial disclosure. Screening for behavioural and emotional problems during the medical assessment of suspected sexual abuse should include assessment of self-blame and family responses to the child's disclosures. In addition, parents should be informed of the importance of believing their child during the initial disclosure of abuse and of the impact this has on the child's emotional response to the abuse. PMID:24630439

  5. The effectiveness of an abuse assessment protocol in public health prenatal clinics.

    PubMed Central

    Wiist, W H; McFarlane, J

    1999-01-01

    OBJECTIVES: This study evaluated whether incorporation of an abuse assessment protocol into the routine procedures of the prenatal clinics of a large urban public health department led to increased referral for and assessment, identification, and documentation of abuse. METHODS: Evaluation was conducted at 3 matched prenatal clinics serving a total of 12,000 maternity patients per year. Two clinics used the abuse protocol and 1 did not. An audit was performed at the clinics on a randomly selected sample of 540 maternity patient charts for the 15 months before the protocol was initiated and of 540 records for the 15 months after the protocol was introduced. Ninety-six percent of the patients represented in the sample were Latina. RESULTS: At the clinics using the protocol, abuse assessment increased from 0 to 88%. Detection of abuse increased from 0.8% to 7%. There were no changes at the comparison clinic. CONCLUSIONS: Incorporation of an abuse assessment protocol into the routine procedures of public health department prenatal clinics increases the assessment, identification, and documentation of and referral for abuse among pregnant women. An abuse protocol should be a routine part of maternity care. PMID:10432909

  6. Personality Assessment Screener, Childhood Abuse, and Adult Partner Violence in African American Women Using Primary Care.

    PubMed

    Porcerelli, John H; Hurrell, Kristen; Cogan, Rosemary; Jeffries, Keturah; Markova, Tsveti

    2015-12-01

    This study assessed the relationship between psychopathology with the Personality Assessment Screener (PAS) and childhood physical and sexual abuse and adult physical and sexual partner violence in a primary care sample of 98 urban-dwelling African American women. Patients completed the PAS, the Childhood Trauma Questionnaire, and the Conflict Tactics Scale. The PAS total score significantly correlated with all measures of childhood and adult abuse. Stepwise regression analyses revealed that PAS element scores of Suicidal Thinking and Hostile Control significantly predicted a history of childhood physical abuse; Suicidal Thinking, Hostile Control, and Acting Out significantly predicted a history of childhood sexual abuse; Suicidal Thinking, Negative Affect, and Alienation significantly predicted current adult partner physical violence; and Psychotic Features, Alcohol Problems, and Anger Control significantly predicted current adult sexual partner violence. The PAS appears to be a useful measure for fast-paced primary care settings for identifying patients who need a more thorough assessment for abuse. PMID:26374084

  7. Assessing dietary intake of drug abusing Hispanic adults with and without HIV infection

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Drug abuse is an important risk factor for Human Immunodeficiency Virus (HIV) among Hispanics in the Northeastern United States and both drug abuse and HIV are associated with nutritional deficiencies. The selection of a dietary assessment method most appropriate for Hispanic adults with/without HIV...

  8. Training Needs for Substance Abuse Treatment and Assessment among Rehabilitation Counselors: California State Project

    ERIC Educational Resources Information Center

    Ong, Lee Za; Lee, Dal-Yob; Cha, Grace; Arokiasamy, Charles

    2008-01-01

    One hundred rehabilitation counselors in California reported that about 90% of consumers with whom they worked with had substance abuse and cooccurring issues, yet about half rated their graduate training in substance abuse treatment and assessment as poor and their practices as marginally proficient. The correlation analysis revealed that…

  9. Editorial: Assessment Issues and Long-Term Effects of Childhood Abuse and Neglect.

    ERIC Educational Resources Information Center

    Jones, David P. H.

    1997-01-01

    This editorial reviews and comments on three recent studies: two on assessment issues or areas of diagnostic difficulty for pediatricians concerned with child abuse and neglect, and one on the long-term effects of childhood abuse and experiences of early attachment. (DB)

  10. Assessment of AIDS Risk among Treatment Seeking Drug Abusers.

    ERIC Educational Resources Information Center

    Black, John L.; And Others

    Intravenous (IV) drug abusers are at risk for contracting transmittable diseases such as acquired immunodeficiency syndrome (AIDS) and hepatitis B. This study was conducted to investigate the prevalence of risk behaviors for acquiring and transmitting AIDS and hepatitis B among treatment-seeking drug abusers (N=168). Subjects participated in a…

  11. The Duke Endowment Child Abuse Prevention Initiative: A Midpoint Assessment

    ERIC Educational Resources Information Center

    Daro, Deborah; Huang, Lee Ann; English, Brianna

    2009-01-01

    The Duke Endowment launched its Child Abuse Prevention Initiative in 2002 by funding two program sites, the Durham Family Initiative in Durham, North Carolina, and Strong Communities in Greenville, South Carolina. Both sites aimed to reduce rates of child abuse, improve parenting practices and behaviors, strengthen community service systems, and…

  12. Assessment, Prevention, and Intervention for Abuse among Individuals with Disabilities

    ERIC Educational Resources Information Center

    Wilczynski, Susan M.; Connolly, Sarah; Dubard, Melanie; Henderson, Amanda; Mcintosh, David

    2015-01-01

    Individuals with disabilities are at increased risk for abuse by their parents, caretakers, and the staff who are entrusted with their care as well as from the general population. Many individuals with disabilities have cognitive or communication impairments that place them at even higher risk for abuse. These limitations also make it more…

  13. Prescription Opioid Abuse and Dependence: Assessment Strategies for Counselors

    ERIC Educational Resources Information Center

    Weigel, Daniel J.; Donovan, Kimberly A.; Krug, Kevin S.; Dixon, Wayne A.

    2007-01-01

    The authors review the article "Prescription Drug Use and Abuse: Risk Factors, Red Flags, and Prevention Strategies" (J. H. Isaacson, J. A. Hopper, D. P. Alford, & T. Parran, 2005), which provides an overview of the recent increase in prescription opioid abuse and dependence from the physician's perspective. In the present article, the authors…

  14. International study of expert judgment on therapeutic use of benzodiazepines and other psychotherapeutic medications: IV. Therapeutic dose dependence and abuse liability of benzodiazepines in the long-term treatment of anxiety disorders.

    PubMed

    Uhlenhuth, E H; Balter, M B; Ban, T A; Yang, K

    1999-12-01

    Despite decades of relevant basic and clinical research, active debate continues about the appropriate extent and duration of benzodiazepine use in the treatment of anxiety and related disorders. The primary basis of the controversy seems to be concern among clinicians, regulators, and the public about the dependence potential and the abuse liability of benzodiazepines. This article reports systematically elicited judgments on these issues by a representative panel of 73 internationally recognized experts in the pharmacotherapy of anxiety and depressive disorders, a panel which was constituted by a multistage process of peer nomination. The criterion for inclusion at each stage was the nomination by at least two peers as one of the "professionally most respected physicians of the world with extensive experience and knowledge in the pharmacotherapy of anxiety and depressive disorders." Sixty-six respondents (90%) completed a comprehensive questionnaire covering a wide range of topics relevant to the therapeutic use of benzodiazepines and other medications that might be used for the same purposes. Overall, the expert panel judged that benzodiazepines pose a higher risk of dependence and abuse than most potential substitutes but a lower risk than older sedatives and recognized drugs of abuse. There was little consensus about the relative risk of dependence and abuse among the benzodiazepines. Differences between benzodiazepines with shorter and longer half-lives in inducing withdrawal symptoms are much less clear during tapered than during abrupt discontinuation. There was little agreement about the most important factors contributing to withdrawal symptoms and failure to discontinue benzodiazepines. The pharmacologic properties of the medication may be the most important contributors to withdrawal symptoms. In contrast, the clinical characteristics of the patient may be the most important contributors to failure to discontinue medication. The experts' judgment seems

  15. Information Sharing in the Process Control Systems Forum Assessing Liability Issues

    SciTech Connect

    Ray Fink

    2005-10-01

    The Process Control Systems Forum (http://www.pcsforum.org) is an open, collaborative, voluntary forum established by the Department of Homeland Security. The purpose of the Forum is to accelerate the development of technology that will enhance the security, safety, and reliability of process control systems (PCS) and supervisory control and data acquisition (SCADA) systems. It is intended as a venue for technologists from user sectors, vendors, and academia. The Forum is not a standards body. Within the Forum, there is a variety of working groups and interest groups that are focused on specific subject areas. One such Interest Group is addressing how to create a ''safe zone'' for critical information sharing. This Interest Group is concerned with topics such as: trade-offs between maintaining security and sharing best practices; secure mechanisms for sharing of critical information; legal issues associated with sharing information; institutional impediments to sharing best practices and relevant incidents; finding a meaningful manner of exchange for sharing process control security events, incidents, audit logs, etc.; and creating a database of relevant industrial cyber events. The purpose of this white paper is to address liability issues that might arise from sharing of critical information such as recommended ''best practices''. There is a concern that by publishing ''best practices'' or similar information, the Forum or its members might be inadvertently assuming some liability. The following scenarios illustrate the concerns about potential liability.

  16. Gender, Relationships, and Elder Abuse: Assessing Aggression in Mother-Daughter Dyads.

    PubMed

    Pickering, Carolyn E Z; Pieters, Huibrie C; Mentes, Janet C; Moon, Ailee; Phillips, Linda R

    2015-01-01

    The older adult population is growing rapidly, and with it comes a national concern for elder abuse. Elder abuse is an intentional act of harm or failure to provide care by a person in a trusted relationship with the elder. One relationship is often overlooked in both research and clinical practice as having special significance for elder abuse-that of the adult daughter-elderly mother. However, recent studies suggest that there are gender differences in the use of aggression, which challenge standard assessments of abuse and may be important for assessing mother-daughter relationships. In this narrative review article, the authors review the relevant literature on female-to-female aggression, with an emphasis on its application to mother-daughter relationships and elder abuse. Measurement tools are evaluated in light of the state of the science. The authors conclude with specific recommendations for clinical practice. PMID:26115361

  17. Children's memory and the assessment of possible child sex abuse.

    PubMed

    Fundudis, T

    1989-05-01

    Memory is part of a knowledge base which interacts with cognition and also represents a "preservation of experience" (Piaget & Inhelder, 1973). Children's memory ability is better in relation to recognition than to free recall and is inclined to be poor in relation to specific details involving times, dates and locations (episodic memory). Younger children, therefore, usually need to be given the opportunity to relate their version of events in their own way (script memory), following which the interviewer may pose specific, simple and unambiguous questions for both aiding the child and clarifying any inconsistencies in their responses. The use of concrete forms of communication such as dolls, drawings and other play materials is a valuable aid, but the interviewer needs to guard against the biasing influence of suggestion and leading statements and questions. What children remember does not differ in essence from what adults remember. How much children remember depends on age, language and conceptual level of development, and on the form in which their memory is questioned, as well as on the style and manner of the interviewer's use of his or her authority. Where memory may be of vital importance to the management of the child's case, as in physical and sexual abuse, it is important that a proper psychometric assessment of the child's cognitive abilities and evaluation of the child's psychological maturity be carried out (Jones & McQuiston, 1988). Until fairly recently, the role of the child's memory in the interview situation has tended to be overlooked. However, with the increasing demands on professionals to address the worrying problem of child abuse, the role of memory has been thrown into more important focus, with some advance in our appreciation of it. Nevertheless, much more research remains to be done on the subject. Meanwhile, our aim should be, as some researchers have pointed out, to adopt acceptable retrieval techniques that maximize the accuracy and

  18. Rorschach assessment of psychological functioning in sexually abused girls.

    PubMed

    Leifer, M; Shapiro, J P; Martone, M W; Kassem, L

    1991-02-01

    We measured psychological functioning in a group of 79 Black females between the ages of 5 and 16 and a comparison group of nonabused girls using the Rorschach. In addition to Exner's (1985) Comprehensive System, the Elizur (1949) Rorschach Content Test Scale (RCT), the Mutuality of Autonomy Scale (MOA; Urist, 1977; Urist & Shill, 1982), and the Barrier and Penetration Scales (Fisher & Cleveland, 1968) were used. Sexually abused girls were found to show more disturbed thinking, to experience a higher level of stress relative to their adaptive abilities, to describe human relationships more negatively, and to show more preoccupation with sexuality than the comparison group. The distress experienced by the victimized children was more related to internal mediating variables then to abuse characteristics. Sexually abused girls who are cognitively and emotionally active also experienced high levels of distress compared to abused girls who are psychologically constricted. PMID:2002437

  19. Substance abuse, conduct disorder and crime: assessment in a juvenile detention house in Istanbul, Turkey.

    PubMed

    Copur, Mazlum; Turkcan, Ahmet; Erdogmus, Meral

    2005-04-01

    The purpose of the present study was to determine the rate of substance abuse in the juvenile detention house and to determine the relationship between crime and substance abuse and conduct disorder. Two hundred and thirty cases in the biggest juvenile detention house in Istanbul, Turkey were assessed according to Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM-IV) criteria. Law files and data of crime were examined. A total of 80 out of 230 juvenile detainees (34.8%) were found to have substance abuse excluding nicotine and alcohol. The substances abused in preferential order were cannabis (72.5%), volatile substances (21.3% bally and 3.7% thinner; 25%) and sedative hypnotic drugs and biperidents (2.5%). The rate of conduct disorder was 46.3% in substance abusers and 25.3% in the others (odds ratio: 2.536). The rate of substance abuse was 48.5% in the juveniles who had committed multiple crimes and 14.1% in the others (odds ratio: 5.735). The study shows that conduct disorder was very high in juvenile detainees. Conduct disorder was higher in substance-abusing than in non-abusing juvenile detainees. Substance-abusing juvenile detainees were found to have a higher detention rate than non-abusing juvenile detainees. There was a close relation between conduct disorder and substance abuse and multiple crimes. In the light of these results, diagnosis and treatment for conduct disorder in juvenile detainees are of great importance. PMID:15823160

  20. Substance Abuse Intensive Outpatient Programs: Assessing the Evidence

    PubMed Central

    McCarty, Dennis; Braude, Lisa; Dougherty, Richard H.; Daniels, Allen S.; Ghose, Sushmita Shoma; Delphin-Rittmon, Miriam E.

    2014-01-01

    Objective Substance abuse intensive outpatient programs (IOPs) are direct services for people with substance use disorders or co-occurring mental and substance use disorders who do not require medical detoxification or 24-hour supervision. IOPs are alternatives to inpatient and residential treatment. They are designed to establish psychosocial supports and facilitate relapse management and coping strategies. This article assesses their evidence base. Methods Authors searched major databases: PubMed, PsycINFO, Applied Social Sciences Index and Abstracts, Sociological Abstracts, Social Services Abstracts, Published International Literature on Traumatic Stress, the Educational Resources Information Center, and the Cumulative Index to Nursing and Allied Health Literature. They identified 12 individual studies and one review published between 1995 and 2012. They chose from three levels of research evidence (high, moderate, and low) based on benchmarks for the number of studies and quality of their methodology. They also described the evidence of service effectiveness. Results Based on the quality of trials, diversity of settings, and consistency of outcomes, the level of evidence for IOP research was considered high. Multiple randomized trials and naturalistic analyses compared IOPs with inpatient or residential care; these types of services had comparable outcomes. All studies reported substantial reductions in alcohol and drug use between baseline and follow-up. However, substantial variability in the operationalization of IOPs and outcome measures was apparent. Conclusions IOPs are an important part of the continuum of care for alcohol and drug use disorders. They are as effective as inpatient treatment for most individuals seeking care. Public and commercial health plans should consider IOP treatment as a covered health benefit. Standardization of the elements included in IOPs may improve their quality and effectiveness. PMID:24445620

  1. Multimethod assessment of depression in sexually abused girls.

    PubMed

    Shapiro, J P; Leifer, M; Martone, M W; Kassem, L

    1990-01-01

    This study measured depression in sexually abused Black girls using the Children's Depression Inventory (Kovacs & A. T. Beck, 1977), the Internalization scale of the Child Behavior Checklist (Achenbach & Edelbrock, 1983), and the Rorschach Depression Index (Exner, 1986). There were no significant correlations between these self-report, behavior observation (by parental report), and projective measures. The abused subjects had high scores on the behavior observation and Rorschach scales. Consistent with past research, negative results were obtained with the self-report instrument. We suggest that the low scores on self-report measures of distress produced by sexually abused children may be the result of guardedness or defensiveness rather than a genuinely low level of dysphoria in this population. There were no significant relations between abuse characteristics and scores on the depression measures. Scores on Rorschach measures of organizational activity (Zf) and available coping resources (EA) were generally positively related to depression within the abuse group and negatively related to depression within the control group. PMID:2231244

  2. Assessing knowledge of elder financial abuse: a first step in enhancing prosecutions.

    PubMed

    Gibson, Sheri C; Greene, Edie

    2013-01-01

    Financial exploitation by a family member is the most common form of elder mistreatment; yet, it is a difficult crime to detect and prosecute. Psychologists have traditionally assisted prosecutors by assessing decisional capacity and opining in court whether an alleged victim was able to consent to the contested transactions. This article proposes and evaluates a novel form of psychological expertise in financial abuse trials-social framework testimony to reeducate jurors who are misinformed about aspects of this largely hidden crime. Findings suggest that, as in cases of child and spousal abuse, social framework testimony on the general dispositional and situational factors inherent in elder financial abuse may enhance prosecutions. PMID:23473298

  3. Interpretations of Colposcopic Photographs: Evidence for Competence in Assessing Sexual Abuse?

    ERIC Educational Resources Information Center

    Brayden, Robert M.; And Others

    1991-01-01

    Seventy physicians and two nurse practitioners rated colposcopic photographs. Results showed that leaders in the field of child sexual abuse assessment made significantly more accurate assessments than pediatricians, pediatric and family practice residents, and intern physicians. Predictors of agreement with standard assessments, although weak,…

  4. Tort Liability.

    ERIC Educational Resources Information Center

    Hudgins, H. C., Jr.

    This chapter summarices and analyzes all state supreme court and federal court decisions as well as other significant court decisions involving the tort liability of school districts and school personnel. The cases discussed are generally limited to those decided during 1974 and reported in the General Digest on or before March 1, 1975. In his…

  5. Risk based in vitro performance assessment of extended release abuse deterrent formulations.

    PubMed

    Xu, Xiaoming; Gupta, Abhay; Al-Ghabeish, Manar; Calderon, Silvia N; Khan, Mansoor A

    2016-03-16

    High strength extended release opioid products, which are indispensable tools in the management of pain, are associated with serious risks of unintentional and potentially fatal overdose, as well as of misuse and abuse that might lead to addiction. The issue of drug abuse becomes increasingly prominent when the dosage forms can be readily manipulated to release a high amount of opioid or to extract the drug in certain products or solvents. One approach to deter opioid drug abuse is by providing novel abuse deterrent formulations (ADF), with properties that may be viewed as barriers to abuse of the product. However, unlike regular extended release formulations, assessment of ADF technologies are challenging, in part due to the great variety of formulation designs available to achieve deterrence of abuse by oral, parenteral, nasal and respiratory routes. With limited prior history or literature information, and lack of compendial standards, evaluation and regulatory approval of these novel drug products become increasingly difficult. The present article describes a risk-based standardized in-vitro approach that can be utilized in general evaluation of abuse deterrent features for all ADF products. PMID:26784976

  6. Elder Abuse.

    PubMed

    Lachs, Mark S; Pillemer, Karl A

    2015-11-12

    Because older victims of abuse tend to be isolated, their interactions with physicians are important opportunities to recognize abuse and intervene. This review explores the manifestations of elder abuse and the role of multidisciplinary teams in its assessment and management. PMID:26559573

  7. Minimizing liability during internal investigations.

    PubMed

    Morris, Cole

    2010-01-01

    Today's security professional must appreciate the potential landmines in any investigative effort and work collaboratively with others to minimize liability risks, the author points out. In this article he examines six civil torts that commonly arise from unprofessionally planned or poorly executed internal investigations-defamation, false imprisonment. intentional infliction of emotional distress, assault and battery, invasion of privacy, and malicious prosecution and abuse of process. PMID:20873494

  8. Retrospective Assessment of Childhood Sexual and Physical Abuse: A Comparison of Scaled and Behaviorally Specific Approaches

    ERIC Educational Resources Information Center

    DiLillo, David; Fortier, Michelle A.; Hayes, Sarah A.; Trask, Emily; Perry, Andrea R.; Messman-Moore, Terri; Fauchier, Angele; Nash, Cindy

    2006-01-01

    This study compared retrospective reports of childhood sexual and physical abuse as assessed by two measures: the Childhood Trauma Questionnaire (CTQ), which uses a Likert-type scaling approach, and the Computer Assisted Maltreatment Inventory (CAMI), which employs a behaviorally specific means of assessment. Participants included 1,195…

  9. Behavioral and Psychological Assessment of Child Sexual Abuse in Clinical Practice

    ERIC Educational Resources Information Center

    Malhotra, Savita; Biswas, Parthasarathy

    2006-01-01

    This paper discusses the behavioral and psychological assessment of Child Sexual Abuse (CSA) in clinical practice. Following a brief introduction regarding definition and etiology of CSA and discussion on issues of behavioral/psychological consequences of CSA, the paper reviews the various approaches towards behavioral/psychological assessment in…

  10. Training Needs of Rehabilitation Counselors concerning Alcohol and Other Drugs Abuse Assessment and Treatment

    ERIC Educational Resources Information Center

    Ong, Lee Za; Cardoso, Elizabeth; Chan, Fong; Chronister, Julie; Chou, Chih Chin

    2007-01-01

    Forty-two rehabilitation counselors participated in a study regarding perceived training needs concerning alcohol and other drug abuse (AODA) treatment and assessment. Participants reported that 85% of consumers with whom they worked had AODA issues, yet over half rated their graduate training in AODA treatment and assessment as poor, and their…

  11. Practitioner Review: The Victims and Juvenile Perpetrators of Child Sexual Abuse -- Assessment and Intervention

    ERIC Educational Resources Information Center

    Vizard, Eileen

    2013-01-01

    Background: The assessment of victims of child sexual abuse (CSA) is now a recognized aspect of clinical work for both CAMH and adult services. As juvenile perpetrators of CSA are responsible for a significant minority of the sexual assaults on other children, CAMH services are increasingly approached to assess these oversexualized younger…

  12. Analog assessment of frustration tolerance: association with self-reported child abuse risk and physiological reactivity.

    PubMed

    Rodriguez, Christina M; Russa, Mary Bower; Kircher, John C

    2015-08-01

    Although frustration has long been implicated in promoting aggression, the potential for poor frustration tolerance to function as a risk factor for physical child abuse risk has received minimal attention. Instead, much of the extant literature has examined the role of anger in physical abuse risk, relying on self-reports of the experience or expression of anger, despite the fact that this methodology is often acknowledged as vulnerable to bias. Therefore, the present investigation examined whether a more implicit, analog assessment of frustration tolerance specifically relevant to parenting would reveal an association with various markers of elevated physical child abuse risk in a series of samples that varied with regard to age, parenting status, and abuse risk. An analog task was designed to evoke parenting-relevant frustration: the task involved completing an unsolvable task while listening to a crying baby or a toddler's temper tantrum; time scores were generated to gauge participants' persistence in the task when encountering such frustration. Across these studies, low frustration tolerance was associated with increased physical child abuse potential, greater use of parent-child aggression in discipline encounters, dysfunctional disciplinary style, support for physical discipline use and physical discipline escalation, and increased heart rate. Future research directions that could better inform intervention and prevention programs are discussed, including working to clarify the processes underlying frustration intolerance and potential interactive influences that may exacerbate physical child abuse. PMID:25796290

  13. Exploring the Factor Structure of a Recovery Assessment Measure among Substance-Abusing Youth

    PubMed Central

    Gonzales, Rachel; Hernandez, Mayra; Douglas, Samantha B.; Yu, Chong Ho

    2016-01-01

    To date, the measurement of recovery in the field of substance abuse is limited. Youth recovery from substance abuse is an important area to consider given the complexities of such issues. The Recovery Assessment Scale (RAS) has been validated with mental health patient populations, however its measurement characteristics have not been examined for individuals in substance abuse treatment. The current study explored the factor structure of the RAS with a sample of 80 substance abusing youth who participated in a pilot aftercare study (Mage 20.5, SD = 3.5; 71.3% male). Reliability analysis showed an internal consistency of α = .90 for the entire RAS measure among the youth sample. Results of exploratory factor analysis identified the following four factors: personal determination, skills for recovery, self-control in recovery, and social support/moving beyond recovery among the substance abusing youth sample. The RAS also demonstrated sound convergent and divergent validity in comparison to other validated measures of functioning, sobriety, and wellbeing. Collectively, results support that the RAS has adequate psychometric properties for measuring recovery among substance abusing youth. PMID:26134600

  14. Typologies of Prescription Opioid Use in a Large Sample of Adults Assessed for Substance Abuse Treatment

    PubMed Central

    Green, Traci C.; Black, Ryan; Grimes Serrano, Jill M.; Budman, Simon H.; Butler, Stephen F.

    2011-01-01

    Background As a population, non-medical prescription opioid users are not well-defined. We aimed to derive and describe typologies of prescription opioid use and nonmedical use using latent class analysis in an adult population being assessed for substance abuse treatment. Methods Latent class analysis was applied to data from 26,314 unique respondents, aged 18-70, self-reporting past month use of a prescription opioid out of a total of 138,928 cases (18.9%) collected by the Addiction Severity Index-Multimedia Version (ASI-MV®), a national database for near real-time prescription opioid abuse surveillance. Data were obtained from November 2005 through December 2009. Substance abuse treatment, criminal justice, and public assistance programs in the United States submitted data to the ASI-MV database (n = 538). Six indicators of the latent classes derived from responses to the ASI-MV, a version of the ASI modified to collect prescription opioid abuse and chronic pain experience. The latent class analysis included respondent home ZIP code random effects to account for nesting of respondents within ZIP code. Results A four-class adjusted latent class model fit best and defined clinically interpretable and relevant subgroups: Use as prescribed, Prescribed misusers, Medically healthy abusers, and Illicit users. Classes varied on key variables, including race/ethnicity, gender, concurrent substance abuse, duration of prescription opioid abuse, mental health problems, and ASI composite scores. Three of the four classes (81% of respondents) exhibited high potential risk for fatal opioid overdose; 18.4% exhibited risk factors for blood-borne infections. Conclusions Multiple and distinct profiles of prescription opioid use were detected, suggesting a range of use typologies at differing risk for adverse events. Results may help clinicians and policy makers better focus overdose and blood-borne infection prevention efforts and intervention strategies for prescription

  15. Revision of the Word Association Test for assessing associations of patients reporting satanic ritual abuse in childhood.

    PubMed

    Leavitt, F; Labott, S M

    1998-11-01

    A growing number of psychiatric patients report satanic ritual abuse, prompting research into this controversial area. In the current study, the Word Association Test (WAT) was modified to assess experience with satanic abuse. Pilot work resulted in norms for two domains: normative and satanic. Female psychiatric patients were compared on their associations in two studies. Based on a sexual history, they were grouped into those reporting sexual abuse, those reporting satanic ritual abuse (SRA), and those without a history of sexual abuse (controls). In both studies, SRA patients gave significantly more total associations, significantly fewer normative associations, and significantly more satanic associations than did the other two groups. These results suggest that an experience base is shared by individuals reporting SRA that is not found in individuals who do not report satanic abuse (even if they do report sexual abuse). The implications of these findings are discussed from the perspective of arguments advanced by advocates and critics of SRA. PMID:9811130

  16. Identifying and assessing the risk of opioid abuse in patients with cancer: an integrative review

    PubMed Central

    Carmichael, Ashley-Nicole; Morgan, Laura; Del Fabbro, Egidio

    2016-01-01

    Background The misuse and abuse of opioid medications in many developed nations is a health crisis, leading to increased health-system utilization, emergency department visits, and overdose deaths. There are also increasing concerns about opioid abuse and diversion in patients with cancer, even at the end of life. Aims To evaluate the current literature on opioid misuse and abuse, and more specifically the identification and assessment of opioid-abuse risk in patients with cancer. Our secondary aim is to offer the most current evidence of best clinical practice and suggest future directions for research. Materials and methods Our integrative review included a literature search using the key terms “identification and assessment of opioid abuse in cancer”, “advanced cancer and opioid abuse”, “hospice and opioid abuse”, and “palliative care and opioid abuse”. PubMed, PsycInfo, and Embase were supplemented by a manual search. Results We found 691 articles and eliminated 657, because they were predominantly non cancer populations or specifically excluded cancer patients. A total of 34 articles met our criteria, including case studies, case series, retrospective observational studies, and narrative reviews. The studies were categorized into screening questionnaires for opioid abuse or alcohol, urine drug screens to identify opioid misuse or abuse, prescription drug-monitoring programs, and the use of universal precautions. Conclusion Screening questionnaires and urine drug screens indicated at least one in five patients with cancer may be at risk of opioid-use disorder. Several studies demonstrated associations between high-risk patients and clinical outcomes, such as aberrant behavior, prolonged opioid use, higher morphine-equivalent daily dose, greater health care utilization, and symptom burden. PMID:27330340

  17. Substance abuse and crime: considerations for a comprehensive forensic assessment.

    PubMed

    Esbec, Enrique; Echeburúa, Enrique

    2016-01-01

    There is a strong link between drug use and crime, but this relationship is complex. Drug use does not necessarily lead to an increase in crimes, such as theft, rape or assault, even among regular users or addicts. However, in cases of individuals who consume drugs excessively and commit crimes, both factors are linked. Poverty, personality disorders, social and cultural variables, relationships with other users and previous incarceration or drug use are all factors. These issues play an important role in understanding the risk of crime and drug use. Most addicts should be held liable for most criminal behaviour motivated by addiction, but that addiction can, in some cases, affect one's capacity for self-control over one's actions. This paper examines the current response of the Spanish Criminal Justice System to various aspects of drug abuse, focusing on court decisions related with the nature and enforcement of drug laws. It also addresses aspects of criminal responsibility for drug abuse and drug-related crimes and suggests legislation on drugs, sentencing alternatives for drug offenses, and drug treatment options. Expert evidence plays a crucial role in this area in the court. PMID:26990390

  18. THE LIABILITY FORMS OF THE MEDICAL PERSONNEL.

    PubMed

    Bărcan, Cristian

    2015-01-01

    Current legislation, namely Law no. 95/2006 on healthcare reform in the medical malpractice domain stipulates that medical staff can be held accountable in the following forms: disciplinary liability, administrative liability, civil liability and criminal liability. Each form of legal liability presents its features, aspects that are found mainly in the procedural rules. However, the differences between the various legal forms of liability are not met only in the procedural rules but also in their effects and consequences. It is necessary to know what the procedure for disciplinary responsibility, administrative liability, civil liability, or criminal liability is. In addition to the differentiation determined by the consequences that may arise from the different forms of legal liability, it is important to know the competent authorities to investigate a case further and the solutions which various public institutions can take regarding the medical staff. Depending on the type of legal liability, authorities have a specialized authority. If the Disciplinary Committee is encountered at the College of Physicians, it may not intervene in cases before the monitoring and competence for malpractice cases Committee. The latter two committees cannot intervene directly in the legal assessment of civil or criminal cases, as no criminal investigation authorities cannot intervene in strictly civilian cases. Therefore, the importance of knowing the competent institutions is imperative. PMID:26978868

  19. Exploratory Assessments of Child Abuse: Children's Responses to Interviewer's Questions across Multiple Interview Sessions

    ERIC Educational Resources Information Center

    Patterson, Tess; Pipe, Margaret-Ellen

    2009-01-01

    Objective: The present study extends field research on interviews with young children suspected of having been abused by examining multiple assessment interviews designed to be inquisitory and exploratory, rather than formal evidential or forensic interviews. Methods: Sixty-six interviews with 24 children between the ages of 3 and 6 years who were…

  20. Assessing Abuse Risk beyond Self-Report: Analog Task of Acceptability of Parent-Child Aggression

    ERIC Educational Resources Information Center

    Rodriguez, Christina M.; Russa, Mary Bower; Harmon, Nancy

    2011-01-01

    Objectives: The present investigation reports on the development and initial validation of a new analog task, the Parent-Child Aggression Acceptability Movie Task (P-CAAM), intended to assess respondents' acceptance of parent-child aggression, including both physical discipline and physical abuse. Methods: Two independent samples were utilized to…

  1. The Substance Abuse Counseling Needs of Women in the Criminal Justice System: A Needs Assessment Approach

    ERIC Educational Resources Information Center

    Laux, John M.; Dupuy, Paula J.; Moe, Jeffry L.; Cox, Jane A.; Lambert, Eric; Ventura, Lois A.; Williamson, Celia; Benjamin, Barbaranne J.

    2008-01-01

    The authors assessed the substance abuse counseling needs of women in the criminal justice system using interviews (n = 304) and surveys (n = 1,170). On the basis of the results, the authors call for gender-specific treatment as well as family-oriented support for women who are mothers.

  2. Multidimensional Assessment of Resilience in Mothers Who Are Child Sexual Abuse Survivors

    ERIC Educational Resources Information Center

    Wright, Margaret O'Dougherty; Fopma-Loy, Joan; Fischer, Stephanie

    2005-01-01

    Objective: There has been relatively little attention given to positive adaptation following childhood sexual abuse (CSA), and typically such resilience has been explored primarily in the intrapersonal domain. This study explored questions about later resilience following CSA within a multidimensional framework by assessing resilience across…

  3. Forensic Child Sexual Abuse Evaluations: Assessing Subjectivity and Bias in Professional Judgements

    ERIC Educational Resources Information Center

    Everson, Mark D.; Sandoval, Jose Miguel

    2011-01-01

    Objectives: Evaluators examining the same evidence often arrive at substantially different conclusions in forensic assessments of child sexual abuse (CSA). This study attempts to identify and quantify subjective factors that contribute to such disagreements so that interventions can be devised to improve the reliability of case decisions. Methods:…

  4. Residential Treatment for Sexually Abusive Youth: An Assessment of Treatment Outcomes

    ERIC Educational Resources Information Center

    Jones, Christopher D.; Chancey, Roy; Lowe, Laura A.; Risler, Edwin A.

    2010-01-01

    Objective: This research study assesses the effectiveness of participation in a multimodal/holistic residential treatment program on changing deviant sexual interests and functional impairment among sexually abusive youth. Method: A one-group pretest posttest design was utilized to examine pretest (intake) and posttest (discharge) scores for 58…

  5. Elder Abuse and Neglect: Assessment Tools, Interventions, and Recommendations for Effective Service Provision

    ERIC Educational Resources Information Center

    Imbody, Bethany; Vandsburger, Etty

    2011-01-01

    With our communities rapidly aging, there is always a clear need for greater knowledge on how to serve elders. Professionals must be able to recognize cases of abuse and neglect and provide appropriate follow up services. Through reviewing recent literature, this paper surveys existing assessment tools and interventions, describes characteristics…

  6. Using Benefit-Cost Analysis to Assess Child Abuse Prevention and Intervention Programs.

    ERIC Educational Resources Information Center

    Plotnick, Robert D.; Deppman, Laurie

    1999-01-01

    Presents a case for using benefit-cost analysis to structure evaluations of child-abuse prevention and intervention programs. Presents the basic concept of benefit-cost analysis, its application in the context of assessing these types of child welfare programs, and limitations on its application to social service programs. (Author)

  7. A Life History Assessment of Early Childhood Sexual Abuse in Women

    ERIC Educational Resources Information Center

    Vigil, Jacob M.; Geary, David C.; Byrd-Craven, Jennifer

    2005-01-01

    Life history theory provided a framework for examining the relations among child sexual abuse (CSA), childhood adversity, and patterns of reproductive development and behavior. A community survey that assessed CSA, life history variables (e.g., age of menarche), and social and family background was administered to 623 women (mean age=26.9 years).…

  8. Prescription Opioid Abuse and Diversion in an Urban Community: The Results of an Ultra- Rapid Assessment

    PubMed Central

    Inciardi, James A.; Surratt, Hilary L.; Cicero, Theodore J.; Beard, Ronald A.

    2009-01-01

    Objective Prescription drug diversion is a topic about which comparatively little is known, and systematic information garnered from prescription drug abusers and dealers on the specific mechanisms of diversion is extremely limited. Design A pilot ultra-rapid assessment was carried out in Wilmington, Delaware, during December 2006 to better understand the scope and dynamics of prescription drug abuse and diversion. This involved focus groups with prescription drug abusers, and key informant interviews with police, regulatory officials, prescription drug dealers, and pill brokers. Results The primary sources of prescription drugs on the street were the elderly, pain patients, and doctor shoppers, as well as pill brokers and dealers who work with all of the former. The popularity of prescription drugs in the street market was rooted in the abusers’ perceptions of these drugs as: 1) less stigmatizing; 2) less dangerous; and, 3) less subject to legal consequences than illicit drugs. For many, the abuse of prescription opioids also appeared to serve as a gateway to heroin use. Conclusion The diversion of prescription opioids might be reduced through physician education focusing on: 1) recognizing that a patient is misusing and/or diverting prescribed medications; 2) considering a patient’s risk for opioid misuse before initiating opioid therapy; and, 3) understanding the variation in the abuse potential of different opioid medications currently on the market. Patient education also appears appropriate in the areas of safeguarding medications, disposal of unused medications, and understanding the consequences of manipulating physicians and selling their medications. PMID:19416440

  9. 1999 ESH&Q Liability Assessment Report of Envirocare of Utah, Inc. Clive, Utah

    SciTech Connect

    Trump, D. E.; Vilord, C. E.

    1999-07-01

    This report contains the results of an environment, safety, health, and quality (ESH&Q) assessment of the treatment technologies and treatment-related operations that was conducted of Envirocare of Utah, Inc. (EOU). EOU is a lowlevel radioactive and mixed Resource Conservation and Recovery Act (RCRA)- regulated haz.ardous low-level radioactive waste (mixed low-level waste) treatment/disposal facility located near Clive, Utah. An ESH&Q assessment of the EOU Clive, Utah facility treatment technologies and related treatment operations was conducted in mid-April 1999. The assessment was required as part of the technical evaluation of proposals received by Lockheed Martin Idaho Technologies Company (LMITCO) for modification of a mixed low-level radioactive waste disposal subcontract (No.K79-180572). The EOU Clive, Utah facility is proposed as a potential treatment/disposal facility for mixed low-level radioactive waste regulated under the RCRA and the Atomic Energy Act

  10. Assessing administrative costs of mental health and substance abuse services.

    PubMed

    Broyles, Robert W; Narine, Lutchmie; Robertson, Madeline J

    2004-05-01

    Increasing competition in the market for mental health and substance abuse MHSA services and the potential to realize significant administrative savings have created an imperative to monitor, evaluate, and control spending on administrative functions. This paper develops a generic model that evaluates spending on administrative personnel by a group of providers. The precision of the model is demonstrated by examining a set of data assembled from five MHSA service providers. The model examines a differential cost construction derived from inter-facility comparisons of administrative expenses. After controlling for the scale of operations, the results enable MHSA programs to control the efficiency of administrative personnel and related rates of compensation. The results indicate that the efficiency of using the administrative complement and the scale of operations represent the lion's share of the total differential cost. The analysis also indicates that a modest improvement in the use of administrative personnel results in substantial cost savings, an increase in the net cash flow derived from operations, an improvement in the fiscal performance of the provider, and a decline in opportunity costs that assume the form of foregone direct patient care. PMID:15379386

  11. 26 CFR 301.6305-1 - Assessment and collection of certain liability.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...— (i) The assessed amount; (ii) The name, social security number, and last known address of the... 452(b) of title IV of the Social Security Act as amended (relating to collection of child and spousal..., pursuant to section 452 of title IV of the Social Security Act as amended, a revolving fund which shall...

  12. Behavioral economics of drug self-administration and drug abuse policy.

    PubMed Central

    Hursh, S R

    1991-01-01

    The concepts of behavioral economics have proven useful for understanding the environmental control of overall levels of responding for a variety of commodities, including reinforcement by drug self-administration. These general concepts are summarized for application to the analysis of drug-reinforced behavior and proposed as the basis for future applications. This behavioral agenda includes the assessment of abuse liability, the assay of drug-reinforcer interactions, the design of drug abuse interventions, and the formulation of drug abuse public policy. These separate domains of investigation are described as part of an overall strategy for designing model projects to control drug use and testing public policy initiatives. PMID:1955823

  13. Base Rates, Multiple Indicators, and Comprehensive Forensic Evaluations: Why Sexualized Behavior Still Counts in Assessments of Child Sexual Abuse Allegations

    ERIC Educational Resources Information Center

    Everson, Mark D.; Faller, Kathleen Coulborn

    2012-01-01

    Developmentally inappropriate sexual behavior has long been viewed as a possible indicator of child sexual abuse. In recent years, however, the utility of sexualized behavior in forensic assessments of alleged child sexual abuse has been seriously challenged. This article addresses a number of the concerns that have been raised about the…

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

    PubMed Central

    Teicher, Martin H.; Parigger, Angelika

    2015-01-01

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

  15. Assessment of ToxCast Phase II for Mitochondrial Liabilities Using a High-Throughput Respirometric Assay.

    PubMed

    Wills, Lauren P; Beeson, Gyda C; Hoover, Douglas B; Schnellmann, Rick G; Beeson, Craig C

    2015-08-01

    Previous high-throughput screens to identify mitochondrial toxicants used immortalized cell lines and focused on changes in mitochondrial membrane potential, which may not be sufficient and do not identify different types of mitochondrial dysfunction. Primary cultures of renal proximal tubule cells (RPTC) were examined with the Seahorse Extracellular Flux Analyzer to screen 676 compounds (5 μM; 1 h) from the ToxCast Phase II library for mitochondrial toxicants. Of the 676 compounds, 19 were classified as cytotoxicants, 376 were electron transport chain (ETC) inhibitors, and 5 were uncouplers. The remaining 276 compounds were examined after a 5-h exposure to identify slower acting mitochondrial toxicants. This experiment identified 3 cytotoxicants, 110 ETC inhibitors, and 163 compounds with no effect. A subset of the ToxCast Phase II library was also examined in immortalized human renal cells (HK2) to determine differences in susceptibility to mitochondrial toxicity. Of the 131 RPTC ETC inhibitors tested, only 14 were ETC inhibitors in HK2 cells. Of the 5 RPTC uncouplers, 1 compound was an uncoupler in HK2 cells. These results demonstrate that 73% (491/676) of the compounds in the ToxCast Phase II library compounds exhibit RPTC mitochondrial toxicity, overwhelmingly ETC inhibition. In contrast, renal HK2 cells are markedly less sensitive and only identified 6% of the compounds as mitochondrial toxicants. We suggest caution is needed when studying mitochondrial toxicity in immortalized cell lines. This information will provide mechanisms and chemical-based criteria for assessing and predicting mitochondrial liabilities of new drugs, consumer products, and environmental agents. PMID:25926417

  16. Assessment of ToxCast Phase II for Mitochondrial Liabilities Using a High-Throughput Respirometric Assay

    PubMed Central

    Wills, Lauren P.; Beeson, Gyda C.; Hoover, Douglas B.; Schnellmann, Rick G.; Beeson, Craig C.

    2015-01-01

    Previous high-throughput screens to identify mitochondrial toxicants used immortalized cell lines and focused on changes in mitochondrial membrane potential, which may not be sufficient and do not identify different types of mitochondrial dysfunction. Primary cultures of renal proximal tubule cells (RPTC) were examined with the Seahorse Extracellular Flux Analyzer to screen 676 compounds (5 μM; 1 h) from the ToxCast Phase II library for mitochondrial toxicants. Of the 676 compounds, 19 were classified as cytotoxicants, 376 were electron transport chain (ETC) inhibitors, and 5 were uncouplers. The remaining 276 compounds were examined after a 5-h exposure to identify slower acting mitochondrial toxicants. This experiment identified 3 cytotoxicants, 110 ETC inhibitors, and 163 compounds with no effect. A subset of the ToxCast Phase II library was also examined in immortalized human renal cells (HK2) to determine differences in susceptibility to mitochondrial toxicity. Of the 131 RPTC ETC inhibitors tested, only 14 were ETC inhibitors in HK2 cells. Of the 5 RPTC uncouplers, 1 compound was an uncoupler in HK2 cells. These results demonstrate that 73% (491/676) of the compounds in the ToxCast Phase II library compounds exhibit RPTC mitochondrial toxicity, overwhelmingly ETC inhibition. In contrast, renal HK2 cells are markedly less sensitive and only identified 6% of the compounds as mitochondrial toxicants. We suggest caution is needed when studying mitochondrial toxicity in immortalized cell lines. This information will provide mechanisms and chemical-based criteria for assessing and predicting mitochondrial liabilities of new drugs, consumer products, and environmental agents. PMID:25926417

  17. Is it possible to assess the impact of abuse on children with pervasive developmental disorders?

    PubMed

    Howlin, P; Clements, J

    1995-08-01

    Although it is now recognized that children may exhibit widespread symptoms of stress following exposure to abuse or neglect, the impact of traumatic experiences on children with pervasive developmental disorders has received little attention. The present paper describes a strategy devised to assess the long-term effects of abuse on a group of children who had attended a specialist autistic school where physical and emotional mistreatment of pupils was well documented. Because most of the children had very limited communication skills, the evidence relied heavily on retrospective parental reports. Despite the problems inherent in using such data it was possible to derive reliable measures that could be used to test hypotheses about predicted patterns of behavioral change, based on work with other children who have been abused. In most cases, too, parental reports could be corroborated by information from other sources. Consistent patterns in both the nature and timing of behavioral disturbances were found, which seemed to relate specifically to the period of abuse at the school. PMID:7592248

  18. Uses and Abuses of Education Assessment in Brazil

    ERIC Educational Resources Information Center

    Schwartzman, Simon

    2013-01-01

    Starting in the 1970s, Brazil developed a very complex system of quantitative assessments of education at all levels, making extensive use of statistical information and tests, in an effort to improve and maintain the quality of its education. However, with some exceptions, particularly at the graduate level, Brazilian education standards remain…

  19. Assessing state substance abuse prevention infrastructure through the lens of CSAP's Strategic Prevention Framework.

    PubMed

    Piper, Douglas; Stein-Seroussi, Al; Flewelling, Robert; Orwin, Robert G; Buchanan, Rebecca

    2012-02-01

    Although the organizational structures and operating procedures of state substance abuse prevention systems vary substantially across states, there is scant empirical research regarding approaches for rigorous assessment of system attributes and which attributes are most conducive to overall effectiveness. As one component of the national cross-site evaluation of the SPF State Incentive Grant Program (SPF SIG), an instrument was developed to assess state substance abuse prevention system infrastructure in order to measure infrastructure change and examine the role of state infrastructure in achieving prevention-related outcomes. In this paper we describe the development of this instrument and summarize findings from its baseline administration. As expected, states and territories were found to vary substantially with respect seven key characteristics, or domains, of state prevention infrastructure. Across the six domains that were assessed using numeric ratings, states scored highest on data systems and lowest on strategic planning. Positive intercorrelations were observed among these domains, indicating that states with high capacity on one domain generally have relatively high capacity on other domains as well. The findings also suggest that state prevention infrastructure development is linked to both funding from state government and the presence of a state interagency coordinating body with decision-making authority. The methodology and baseline findings presented will be used to inform the ongoing national cross-site evaluation of the SPF SIG and may provide useful information to guide further research on state substance abuse prevention infrastructure. PMID:22054526

  20. The legal system, insurance, and health care. What can be done about the liability problem? An ECRI technology management assessment.

    PubMed

    1986-01-01

    Health care providers are currently experiencing a malpractice "crisis" that, in some regions and for some medical specialties, is as serious as the one that occurred a decade ago. Whether providers themselves, the insurance industry, or lawyers and the legal system are seen as responsible for today's crisis depends primarily on the observer. However, evidence indicates that, in health care, negligence by those who provide services (physicians and hospital personnel) is a more important factor in the health care liability crisis than is so for other sectors of society that also face liability-insurance problems (e.g., municipal governments, light aircraft manufacturers, ski-slope operators). While physicians and hospitals can participate in legislative efforts to achieve tort reform and more stringent regulation of liability insurers, this study suggests that they will have more success in reducing malpractice insurance premium rates by concentrating instead on improving the quality of patient care. Towards this end, a number of specific actions are outlined, ranging from greater use of patient-care protocols and algorithms to increased activity by state medical licensing and disciplinary boards. PMID:10276862

  1. A Population-Based Assessment of Human Rights Abuses Committed Against Ethnic Albanian Refugees From Kosovo

    PubMed Central

    Iacopino, Vincent; Frank, Martina W.; Bauer, Heidi M.; Keller, Allen S.; Fink, Sheri L.; Ford, Doug; Pallin, Daniel J.; Waldman, Ronald

    2001-01-01

    Objectives. This study assessed patterns of displacement and human rights abuses among Kosovar refugees in Macedonia and Albania. Methods. Between April 19 and May 3, 1999, 1180 ethnic Albanian refugees living in 31 refugee camps and collective centers in Macedonia and Albania were interviewed. Results. The majority (68%) of participants reported that their families were directly expelled from their homes by Serb forces. Overall, 50% of participants saw Serb police or soldiers burning the houses of others, 16% saw Serb police or soldiers burn their own home, and 14% witnessed Serb police or soldiers killing someone. Large percentages of participants saw destroyed mosques, schools, or medical facilities. Thirty-one percent of respondents reported human rights abuses committed against their household members, including beatings, killings, torture, forced separation and disappearances, gunshot wounds, and sexual assault. Conclusions. The present findings confirm that Serb forces engaged in a systematic and brutal campaign to forcibly expel the ethnic Albanian population of Kosovo. In the course of these mass deportations, Serb forces committed widespread abuses of human rights against ethnic Albanians. PMID:11726386

  2. Development of a Questionnaire to Assess Drug Abuse among High School Students of Isfahan Province, Iran: An Action Research

    PubMed Central

    Geramian, Nahid; Gharaat, Leila; Taheri, Shohreh Akhavan; Mohebpour, Fatemeh; Nahvizadeh, Mahmonir; Farajzadegan, Ziba; Heidari, Kamal

    2014-01-01

    Background: Considering the problem of drug abuse in Iran especially in adolescents and the youth, recent alterations in drug abuse rate and its trend, the necessity to have local information about this problem, applied research has a determining role in management of this problem and making proper decisions. Therefore, the current study was conducted to develop a questionnaire to assess the status of drug abuse among high school students of Isfahan Province, Iran. Methods: This cross-sectional study was conducted out in 2009 in 20 cities of Isfahan Province. A researcher-made questionnaire was developed to determine knowledge, attitude, and practice of high school students regarding addictive drugs and their associated causes. This was accomplished by recruiting 7137 students who were selected by multistage random cluster sampling. Results: The designed questionnaire identified the status quo of drug abuse according to age, gender, and different cities of Isfahan Province. We also accessed information about the type of abused drug, the most common causes of drug abuse for the first time, the most important causes of drug abuse, mean age of abusers and mean age at the first abuse, common time and locations of drug abuse, and the most common routes of drug abuse according to gender as well as urban and rural areas of Isfahan Province. Reliability of the questionnaire, based on the calculated Cronbach's alpha coefficient, was 77% considering a cut-off point of 0.07. Conclusions: According to the obtained results, the designed questionnaire is capable to assess the drug abuse status among high school students of Isfahan Province. Regarding the importance of teenage years in forming the future behaviors of adolescents and the opportunities provided at schools, it is prudent to pay more attention to interventions in this age group in order to increase their knowledge and correct their attitude toward illegal drugs and strengthening their confidence in this regard. These

  3. Research design considerations for clinical studies of abuse-deterrent opioid analgesics: IMMPACT recommendations

    PubMed Central

    Turk, Dennis C.; O’Connor, Alec B.; Dworkin, Robert H.; Chaudhry, Amina; Katz, Nathaniel P.; Adams, Edgar H.; Brownstein, John S.; Comer, Sandra D.; Dart, Richard; Dasgupta, Nabarun; Denisco, Richard A.; Klein, Michael; Leiderman, Deborah B.; Lubran, Robert; Rappaport, Bob A.; Zacny, James P.; Ahdieh, Harry; Burke, Laurie B.; Cowan, Penney; Jacobs, Petra; Malamut, Richard; Markman, John; Michna, Edward; Palmer, Pamela; Peirce-Sandner, Sarah; Potter, Jennifer S.; Raja, Srinivasa N.; Rauschkolb, Christine; Roland, Carl L.; Webster, Lynn R.; Weiss, Roger D.; Wolf, Kerry

    2013-01-01

    Opioids are essential to the management of pain in many patients, but they also are associated with potential risks for abuse, overdose, and diversion. A number of efforts have been devoted to the development of abuse-deterrent formulations of opioids to reduce these risks. This article summarizes a consensus meeting that was organized to propose recommendations for the types of clinical studies that can be used to assess the abuse deterrence of different opioid formulations. Due to the many types of individuals who may be exposed to opioids, an opioid formulation will need to be studied in several populations using various study designs in order to determine its abuse-deterrent capabilities. It is recommended that the research conducted to evaluate abuse deterrence should include studies assessing: (1) abuse liability; (2) the likelihood that opioid abusers will find methods to circumvent the deterrent properties of the formulation; (3) measures of misuse and abuse in randomized clinical trials involving pain patients with both low risk and high risk of abuse; and (4) post-marketing epidemiological studies. PMID:22770841

  4. Research design considerations for clinical studies of abuse-deterrent opioid analgesics: IMMPACT recommendations.

    PubMed

    Turk, Dennis C; O'Connor, Alec B; Dworkin, Robert H; Chaudhry, Amina; Katz, Nathaniel P; Adams, Edgar H; Brownstein, John S; Comer, Sandra D; Dart, Richard; Dasgupta, Nabarun; Denisco, Richard A; Klein, Michael; Leiderman, Deborah B; Lubran, Robert; Rappaport, Bob A; Zacny, James P; Ahdieh, Harry; Burke, Laurie B; Cowan, Penney; Jacobs, Petra; Malamut, Richard; Markman, John; Michna, Edward; Palmer, Pamela; Peirce-Sandner, Sarah; Potter, Jennifer S; Raja, Srinivasa N; Rauschkolb, Christine; Roland, Carl L; Webster, Lynn R; Weiss, Roger D; Wolf, Kerry

    2012-10-01

    Opioids are essential to the management of pain in many patients, but they also are associated with potential risks for abuse, overdose, and diversion. A number of efforts have been devoted to the development of abuse-deterrent formulations of opioids to reduce these risks. This article summarizes a consensus meeting that was organized to propose recommendations for the types of clinical studies that can be used to assess the abuse deterrence of different opioid formulations. Because of the many types of individuals who may be exposed to opioids, an opioid formulation will need to be studied in several populations using various study designs to determine its abuse-deterrent capabilities. It is recommended that the research conducted to evaluate abuse deterrence should include studies assessing: (1) abuse liability, (2) the likelihood that opioid abusers will find methods to circumvent the deterrent properties of the formulation, (3) measures of misuse and abuse in randomized clinical trials involving pain patients with both low risk and high risk of abuse, and (4) postmarketing epidemiological studies. PMID:22770841

  5. Prediction of pH dependent absorption using in vitro, in silico, and in vivo rat models: Early liability assessment during lead optimization.

    PubMed

    Saxena, Ajay; Shah, Devang; Padmanabhan, Shweta; Gautam, Shashyendra Singh; Chowan, Gajendra Singh; Mandlekar, Sandhya; Desikan, Sridhar

    2015-08-30

    Weakly basic compounds which have pH dependent solubility are liable to exhibit pH dependent absorption. In some cases, a subtle change in gastric pH can significantly modulate the plasma concentration of the drug and can lead to sub-therapeutic exposure of the drug. Evaluating the risk of pH dependent absorption and potential drug-drug interaction with pH modulators are important aspects of drug discovery and development. In order to assess the risk around the extent of decrease in the systemic exposure of drugs co-administered with pH modulators in the clinic, a pH effect study is carried out, typically in higher species, mostly dog. The major limitation of a higher species pH effect study is the resource and material requirement to assess this risk. Hence, these studies are mostly restricted to promising or advanced leads. In our current work, we have used in vitro aqueous solubility, in silico simulations using GastroPlus™ and an in vivo rat pH effect model to provide a qualitative assessment of the pH dependent absorption liability. Here, we evaluate ketoconazole and atazanavir with different pH dependent solubility profiles and based on in vitro, in silico and in vivo results, a different extent of gastric pH effect on absorption is predicted. The prediction is in alignment with higher species and human pH effect study results. This in vitro, in silico and in vivo (IVISIV) correlation is then extended to assess pH absorption mitigation strategy. The IVISIV predicts pH dependent absorption for BMS-582949 whereas its solubility enhancing prodrug, BMS-751324 is predicted to mitigate this liability. Overall, the material requirement for this assessment is substantially low which makes this approach more practical to screen multiple compounds during lead optimization. PMID:25960252

  6. Pathways to cannabis abuse: A multi-stage model from cannabis availability, cannabis initiation, and progression to abuse

    PubMed Central

    Gillespie, Nathan A; Neale, Michael C; Kendler, Kenneth S

    2009-01-01

    Aims Although previous twin studies have modelled the association between drug initiation and abuse, none has included the obvious risk factor of drug availability. Our aim is to determine whether the genetic and environmental risk factors for cannabis availability also generate variation in cannabis initiation and/or progression to DSM-IV symptoms of abuse. Design We used multi-stage modelling, also known as causal-common-contingent (CCC) analysis, to partition the genetic and environmental factors into common and stage-specific components. Participants This report is based on data collected from 1767 adult males from the Mid Atlantic Twin Registry. Measurements The twins participated in two structured interviews which included clinical and non-clinical measures of cannabis abuse as well as retrospective assessments of perceived cannabis availability between ages 8 and 25. Findings Cannabis availability explained almost all of the shared environmental risks in cannabis initiation and abuse. The influence of availability on the symptoms of abuse was indirect and mediated entirely by cannabis initiatio Conclusion These findings have begun to elucidate the causal processes underlying the liability to drug use and abuse in terms of putative risk factors. Specifically, our results show that the latent shared environmental factors in cannabis initiation and abuse can be explained by measured aspects of the shared environment - those responsible for variation in cannabis availability. PMID:19207351

  7. Factors impacting the assessment of maternal culpability in cases of alleged fetal abuse.

    PubMed

    McCoy, Monica L

    2003-01-01

    These studies explored attitudes toward maternal culpability in cases of alleged fetal abuse. In experiment one, general culpability for the use of various substances during pregnancy was assessed as well as the impact of other potentially relevant factors. One hundred and twenty students completed the survey. Participants overwhelmingly supported treating drug use by pregnant women as a criminal offense. With regard to the assessment of more specific questions, the lack of consensus regarding what factors effect culpability is striking. Experiment two examined the possible impact of the mothers' race (White or Black) and social class (Poor or Middle class) on the assessment of culpability. One hundred and sixty-four community members responded to a survey sent to randomly selected persons in upstate South Carolina. The results indicate that at least in response to a brief, written, case scenario, neither race nor social class make a large impact on participants' sanction recommendations. PMID:15022861

  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. 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 ...

  10. Assessment of a novel module for training dental students in child abuse recognition and reporting.

    PubMed

    Shapiro, Michael C; Anderson, O Roger; Lal, Shantanu

    2014-08-01

    This study assessed the merits of introducing a novel, online interactive training module designed to positively engage dental students and teach them to recognize and report signs of child abuse and neglect. The study aimed to determine if the online training module educated the students equivalently or better than a lecture presentation of the same content. Seventy-two students from Columbia University College of Dental Medicine's class of 2015 (90 percent of the class) agreed to participate and were randomly assigned to either a traditional lecture-based presentation or the online training module. Study participants were given a twenty-question multiple-choice pretest on their knowledge of child abuse recognition and reporting prior to the start of the study. The same instrument was administered as a posttest. At the end of the training, questionnaires were also given to both groups to assess students' perceptions of the two educational methodologies. The results showed that the interactive online training module was more effective than the lecture-based method. Results of the posttest comparison of the two groups were statistically significant (p<0.05) in favor of the online training group. Additionally, the students reported that the interactive online training module was engaging and a helpful resource, but on average they did not prefer it as a total replacement for the lecture-based approach. PMID:25086150

  11. Assessment and treatment of abuse risk in opioid prescribing for chronic pain.

    PubMed

    Jamison, Robert N; Serraillier, Juliana; Michna, Edward

    2011-01-01

    Opioid analgesics provide effective treatment for noncancer pain, but many physicians have concerns about adverse effects, tolerance, and addiction. Misuse of opioids is prominent in patients with chronic back pain and early recognition of misuse risk could help physicians offer adequate patient care while implementing appropriate levels of monitoring to reduce aberrant drug-related behaviors. In this review, we discuss opioid abuse and misuse issues that often arise in the treatment of patients with chronic back pain and present an overview of assessment and treatment strategies that can be effective in improving compliance with the use of prescription opioids for pain. Many persons with chronic back pain have significant medical, psychiatric and substance use comorbidities that affect treatment decisions and a comprehensive evaluation that includes a detailed history, physical, and mental health evaluation is essential. Although there is no "gold standard" for opioid misuse risk assessment, several validated measures have been shown to be useful. Controlled substance agreements, regular urine drug screens, and interventions such as motivational counseling have been shown to help improve patient compliance with opioids and to minimize aberrant drug-related behavior. Finally, we discuss the future of abuse-deterrent opioids and other potential strategies for back pain management. PMID:22110936

  12. Assessment and Treatment of Abuse Risk in Opioid Prescribing for Chronic Pain

    PubMed Central

    Jamison, Robert N.; Serraillier, Juliana; Michna, Edward

    2011-01-01

    Opioid analgesics provide effective treatment for noncancer pain, but many physicians have concerns about adverse effects, tolerance, and addiction. Misuse of opioids is prominent in patients with chronic back pain and early recognition of misuse risk could help physicians offer adequate patient care while implementing appropriate levels of monitoring to reduce aberrant drug-related behaviors. In this review, we discuss opioid abuse and misuse issues that often arise in the treatment of patients with chronic back pain and present an overview of assessment and treatment strategies that can be effective in improving compliance with the use of prescription opioids for pain. Many persons with chronic back pain have significant medical, psychiatric and substance use comorbidities that affect treatment decisions and a comprehensive evaluation that includes a detailed history, physical, and mental health evaluation is essential. Although there is no “gold standard” for opioid misuse risk assessment, several validated measures have been shown to be useful. Controlled substance agreements, regular urine drug screens, and interventions such as motivational counseling have been shown to help improve patient compliance with opioids and to minimize aberrant drug-related behavior. Finally, we discuss the future of abuse-deterrent opioids and other potential strategies for back pain management. PMID:22110936

  13. Interviewing Children Versus Tossing Coins: Accurately Assessing the Diagnosticity of Children’s Disclosures of Abuse

    PubMed Central

    LYON, THOMAS D.; AHERN, ELIZABETH C.; SCURICH, NICHOLAS

    2014-01-01

    We describe a Bayesian approach to evaluating children’s abuse disclosures and review research demonstrating that children’s disclosure of genital touch can be highly probative of sexual abuse, with the probative value depending on disclosure spontaneity and children’s age. We discuss how some commentators understate the probative value of children’s disclosures by: confusing the probability of abuse given disclosure with the probability of disclosure given abuse, assuming that children formally questioned about sexual abuse have a low prior probability of sexual abuse, misstating the probative value of abuse disclosure, and confusing the distinction between disclosure and nondisclosure with the distinction between true and false disclosures. We review interviewing methods that increase the probative value of disclosures, including interview instructions, narrative practice, noncontingent reinforcement, and questions about perpetrator/caregiver statements and children’s reactions to the alleged abuse. PMID:22339423

  14. [Perspectives in medical liability].

    PubMed

    Pizarro W, Carlos

    2008-04-01

    The progressive increase of medical negligence law suits requires an updated analysis of the current situation of medical liability in Chile. The application of a new criminal procedure will avoid criminal prosecution of doctors, transferring to the civil courts the pecuniary sanctions for malpractice. Medical negligence and damage inflicted by doctors that require compensation are explained. The most likely evolution of medical liability is proposed, through an increase in civil liability insurance and the necessary standardization of rules applicable to professional liability. PMID:18769798

  15. Towards a common framework for assessing the activity and associations of groups who sexually abuse children

    PubMed Central

    Cockbain, Ella; Brayley, Helen; Sullivan, Joe

    2013-01-01

    Extensive social psychological research emphasises the importance of groups in shaping individuals’ thoughts and actions. Within the child sexual abuse (CSA) literature criminal organisation has been largely overlooked, with some key exceptions. This research was a novel collaboration between academia and the UK's Child Exploitation and Online Protection Centre (CEOP). Starting from the premise that the group is, in itself, a form of social situation affecting abuse, it offers the first systematic situational analysis of CSA groups. In-depth behavioural data from a small sample of convicted CSA group-offenders (n = 3) were analysed qualitatively to identify factors and processes underpinning CSA groups’ activities and associations: group formation, evolution, identity and resources. The results emphasise CSA groups’ variability, fluidity and dynamism. The foundations of a general framework are proposed for researching and assessing CSA groups and designing effective interventions. It is hoped that this work will stimulate discussion and development in this long-neglected area of CSA, helping to build a coherent knowledge-base. PMID:26494978

  16. Adult protective services and animal welfare: should animal abuse and neglect be assessed during adult protective services screening?

    PubMed

    Peak, Terry; Ascione, Frank; Doney, Jylisa

    2012-01-01

    Past research has examined links among animal abuse, child maltreatment, and intimate partner violence and demonstrated the importance of addressing the needs of both human and animal victims. We hypothesized that there might be a similar link between animal abuse and older adult welfare issues. As a first step in the earlier research was the development of a screening protocol that shed light on the link between domestic violence and animal abuse, we decided to follow a similar route to explore this new topic by asking state government representatives about their experiences, if any, with this topic. Here we report the results of a national survey of state Adult Protective Services agencies regarding their protocols for assessing animal welfare issues in the context of older adult maltreatment. We also describe a model assessment protocol we developed in collaboration with the Utah Division of Aging and Adult Services. PMID:22206511

  17. Risk assessment of the health liabilities from exposure to toxic metals found in the composted material of Air Force municipal solid waste. Master's thesis

    SciTech Connect

    Merrymon, T.L.

    1993-09-01

    This thesis assesses the risk of the health liabilities from exposure to toxic metals found in the composted material of Air Force municipal solid waste (MSW). The goal is to determine the probability that the composted MSW could be a health hazard if it were used as a soil amendment. The research limited the assessment of the exposure risk to heavy metals found in raw MSW and its resulting compost. The thesis uses reviews of present literature to examine the food and soil ingestion exposure pathways. These pathways are assessed using the heavy metal concentrations found in MSW compost and the soil-plant partition coefficients of vegetables grown in soil mixed with sewage sludge or soil irrigated with sewage sludge or soil irrigated with sewage sludge leachate. The recommendation resulting from this research is that the Air Force should not use MSW composting as part of its future solid waste management plan. This alternative to landfilling contains a chronic health risk that is greater than the Environmental Protection Agency's guideline. If the Air Force would use MSW composting in the future, it may endanger Air Force personnel and others who use the compost created from Air Force MSW. Risk assessment, Heavy metals, Recycling municipal solid waste, Pollution, Composting.

  18. A Video-Simulated Stress Procedure for Abusive Parents: Multi-Modal Assessment of Parental Tolerance, Arousal, and Coping.

    ERIC Educational Resources Information Center

    Wolfe, David A.; LaRose, Louise

    Child abuse involves more than the use of corporal punishment with a child. Investigators have measured parents' emotional reactivity and attributions in relation to aversive child behavior. A "video recall" procedure has been used for assessing affective responding of adults engaged in marital conflict and has been valid for obtaining…

  19. Reading between the Lines: Implicit Assessment of the Association of Parental Attributions and Empathy with Abuse Risk

    ERIC Educational Resources Information Center

    Rodriguez, Christina M.; Cook, Anne E.; Jedrziewski, Chezlie T.

    2012-01-01

    Objective: Researchers in the child maltreatment field have traditionally relied on explicit self-reports to study factors that may exacerbate physical child abuse risk. The current investigation evaluated an implicit analog task utilizing eye tracking technology to assess both parental attributions of child misbehavior and empathy. Method: Based…

  20. Multi-Informant Assessment of Anxiety regarding Ano-Genital Examinations for Suspected Child Sexual Abuse (CSA)

    ERIC Educational Resources Information Center

    Scribano, Philip V.; Hornor, Gail; Rhoda, Dale; Curran, Sherry; Stevens, Jack

    2010-01-01

    Objective: Given the commonly held belief that physical examinations for child sexual abuse (CSA) are very distressing, our primary objective was to evaluate anxiety during these assessments using the Multidimensional Anxiety Score for Children (MASC-10). A second objective was to compare self-reported anxiety to parental report using the MASC-10…

  1. Elder Abuse and Substance Abuse

    MedlinePlus

    ... Additional Resources Return to: What is Elder Abuse? Elder Abuse and Substance Abuse Substance abuse has been identified ... the most frequently cited risk factor associated with elder abuse and neglect. It may be the victim and/ ...

  2. Assessment of family history of substance abuse for preventive interventions with patients experiencing chronic pain: A quality improvement project.

    PubMed

    Pestka, Elizabeth; Nash, Virginia; Evans, Michele; Cronin, Joan; Bee, Susan; King, Susan; Osborn, Kristine; Gehin, Jessica; Weis, Karen; Loukianova, Larissa

    2016-04-01

    This quality improvement project demonstrates that RN Care Managers, in a chronic pain programme, can assess for a family history of substance abuse in 5-10 min. Information informs treatment based on specific high risk criteria. Benefits include heightened awareness of the genetic and environmental risks associated with a family history of substance abuse, an opportunity to participate in motivational interventions to prevent or minimize consequences of substance use disorders, and likely substantial overall health-care cost savings. PMID:25963926

  3. The importance of assessing for abuse and neglect in children with chronic health conditions referred for neuropsychological evaluation.

    PubMed

    Olson, Katie; Jacobson, Kristin K

    2014-01-01

    Chronic childhood illnesses have been demonstrated to negatively impact family functioning by introducing new or additive stress on all members of the family system, as well as by increasing financial burden and social isolation. Although these factors have not necessarily been shown to have a direct causal effect on increased rates of abuse in children with chronic illnesses, these children have nonetheless been demonstrated to be at greater risk for neglect and physical and sexual abuse. Children with chronic health care needs are increasingly likely to be referred for neuropsychological evaluation. Thorough assessment of maltreatment would be a valuable addition to all neuropsychological evaluations of children presenting with chronic health conditions. PMID:24236944

  4. A Structured Method of Assessing Dynamic Risk Factors among Sexual Abusers with Intellectual Disabilities

    ERIC Educational Resources Information Center

    McGrath, Robert J.; Livingston, Joy A.; Falk, Gail

    2007-01-01

    The nature and severity of dynamic risk factors among a group of 87 adult male sexual abusers with intellectual disabilities were examined as was the psychometric properties of a new scale designed to measure these risk factors. The Treatment Intervention and Progress Scale for Sexual Abusers with Intellectual Disabilities (TIPS-ID) is composed of…

  5. Reducing Child Abuse 20% by 1990: Preliminary Assessment. Working Paper Number 843.

    ERIC Educational Resources Information Center

    Daro, Deborah; And Others

    In October 1985, the Board of the National Committee for the Prevention of Child Abuse (NCPCA) adopted a goal and extablished a plan to reduce child abuse 20 percent by 1990. With data collected through March 1990, this document reports progress made toward realizing objectives articulated in the NCPCA's 5-year plan. After an overview in Section…

  6. A Multimodal Assessment of Behavioral and Cognitive Deficits in Abused and Neglected Preschoolers.

    ERIC Educational Resources Information Center

    Hoffman-Plotkin, Debbie; Twentyman, Craig T.

    1984-01-01

    Multiple measures of social and cognitive functioning were obtained to investigate whether abused and neglected children demonstrate serious psychological disturbances following instances of child maltreatment. Participants were 42 preschool children who had a previous history of physical abuse, serious neglect, or no maltreatment. (Author/RH)

  7. Interviewing Children versus Tossing Coins: Accurately Assessing the Diagnosticity of Children's Disclosures of Abuse

    ERIC Educational Resources Information Center

    Lyon, Thomas D.; Ahern, Elizabeth C.; Scurich, Nicholas

    2012-01-01

    We describe a Bayesian approach to evaluating children's abuse disclosures and review research demonstrating that children's disclosure of genital touch can be highly probative of sexual abuse, with the probative value depending on disclosure spontaneity and children's age. We discuss how some commentators understate the probative value of…

  8. Evaluating and Training Substance Abuse Counselors: A Pilot Study Assessing Standardized Patients as Authentic Clients

    ERIC Educational Resources Information Center

    Fussell, Holly E.; Lewy, Colleen S.; McFarland, Bentson H.

    2009-01-01

    Clinician training and supervision are needed to transfer evidence-based practices to community-based treatment organizations. Standardized patients (SPs) are used for clinician training and evaluating. However, to be effective for substance abuse counselors, SPs must realistically portray substance abuse treatment clients. The current study…

  9. Safety and Liability.

    ERIC Educational Resources Information Center

    Berthelot, Ronald J.; And Others

    1982-01-01

    This series of five articles highlights Pensacola Junior College's occupational safety course, involving simulated emergencies, Florida's standards for teacher liability, electrical safety in the classroom and laboratory, color coding for machine safety, and Florida industrial arts safety instructional materials. (SK)

  10. Psychometrics and Cross-Cultural Comparisons of the Illustration-Based Assessment of Liability and Exposure to Substance Use and Antisocial Behavior© for Children

    PubMed Central

    Ridenour, Ty A.; Minnes, Sonia; Maldonado-Molina, Mildred M.; Reynolds, Maureen D.; Tarter, Ralph E.; Clark, Duncan B.

    2011-01-01

    Elementary school-age child report instruments that do not require reading or interviews are lacking. In four samples, psychometric estimates for 5- to 9-year-olds were obtained for the Assessment of Liability and Exposure to Substance use and Antisocial behavior© (ALEXSA©), a child-report instrument that can be completed even by illiterate children. Invariance between minority groups vs Caucasians also was tested. Samples were: high-risk, low SES African-Americans (n=337), youth of varied ethnicities experiencing chronic stress (n=209), Mexican migrants in a reading remediation program (n=45), and U.S. twins (42 pairs) who were nearly all Caucasian. Validity criteria consisted of child-, parent-, teacher- and research evaluator-ratings on previously developed research and clinical instruments. Replicating results with older samples, ALEXSA factors had adequate or better reliabilities and demonstrated validity in all four studies. Ethnic invariance was found except for differences that were expected due to migrant's after-school program. In sum, psychometrics of the ALEXSA were supported for 5- to 9-year-olds of varied races/ethnicities, risk levels and academic skills. PMID:22866171

  11. Child abuse and performance task assessments of executive functions in boys.

    PubMed

    Mezzacappa, E; Kindlon, D; Earls, F

    2001-11-01

    We examined executive functions using performance tasks in 126 boys aged 6 to 16 years. who attended public schools and therapeutic schools for children with emotional and behavioral problems. Children were further grouped based on the presence or absence of substantiated abuse histories. Based on their abuse histories and schools of origin, children were classified as Therapeutic, Abused (TA, N = 25). Therapeutic, Nonabused (TN, N = 52), and Public School (PS, N = 48). Controlling IQ and medication status, we compared children in the three groups on teacher ratings of behavior, on experimenter observations of behavior during testing, and on performance tasks challenging the capacities to inhibit an act in progress, and to passively avoid responses associated with adverse consequences. We examined mean group differences in symptoms, behaviors, and task performance, as well as differential age-dependent changes in these dimensions. Independent of abuse history, therapeutic school children demonstrated comparable levels of internalizing and externalizing symptoms, and comparable levels of redirections to task during testing-sessions, that were significantly higher than those of the public school children. Both groups of therapeutic school children also showed comparable overall performance on the capacities to inhibit an act in progress, and to passively avoid responses associated with adverse consequences that were poorer than the performance of children from the public school. Children with histories of substantiated abuse showed diminished improvement with increasing age in the capacity to passively avoid responses associated with adverse consequences when compared not only to the public school children, but also to the children from the therapeutic schools without histories of abuse. Our findings complement reports of behavioral observations of abused children, and reports associating child abuse with altered cognitive development in other areas of competence

  12. Grounding the Management of Liabilities in the Risk Analysis Framework

    ERIC Educational Resources Information Center

    Phillips, Peter W. B.; Smyth, Stuart

    2007-01-01

    Discussions of socioeconomic liability and compensation must necessarily start from an understanding of the socioeconomic, legal, and scientific basis for identifying, assessing, managing, and apportioning blame for hazards related to innovations. Public discussions about the nature of the liability challenge related to genetically modified (GM)…

  13. 75 FR 4400 - Draft Guidance for Industry on Assessment of Abuse Potential of Drugs; Availability

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-27

    ... central nervous system, drugs that are chemically or pharmacologically similar to other drugs with known... Abuse (NIDA), as described in a Memorandum of Understanding (MOU) of March 8, 1985 (50 FR 9518). When...

  14. Assessment of the sexually abused female children admitted to a tertiary care hospital: Eight year experience

    PubMed Central

    Mollamahmutoglu, Leyla; Uzunlar, Ozlem; Kahyaoglu, Inci; Ozyer, Sebnem; Besli, Mustafa; Karaca, Mujdegul

    2014-01-01

    Objective: To discuss the medical, social and legal characteristics of the child sexual abuse and to provide a perspective for gynecologists on this topic. Methods: A retrospective analysis was carried out of the medicolegal records of female children below the age of 18 referred to a tertiary teaching hospital and diagnosed as being exposed to sexual abuse within the family between the years of 2004 to 2012. Results: One hundred and thirty-nine cases were diagnosed as being exposed to sexual abuse during the 8 year period, 23 of them (16.5%) had been involved in sexual abuse within the family. Eleven out of 23 had been admitted as part of a legal process while the rest were reported by a third person. Conclusion: Since sexual abuse within the family is a taboo in Islamic societies, the diagnosis can take a long time. Recognition of sexually abused children, providing early performance of medicolegal examinations, and applying standardized medical guidelines are essential to protect these children. PMID:25225535

  15. Threat Assessment Teams: A Model for Coordinating the Institutional Response and Reducing Legal Liability when College Students Threaten Suicide

    ERIC Educational Resources Information Center

    Penven, James C.; Janosik, Steven M.

    2012-01-01

    Increasing numbers of college students with mental health issues are enrolling in college. If these students threaten suicide they present serious legal issues for college officials. Lack of communication and coordination of a response to these students exacerbates the issue. Threat assessment teams can serve as mechanisms to coordinate the…

  16. Understanding the neurobiology, assessment, and treatment of substances of abuse and dependence: a guide for the critical care nurse.

    PubMed

    Genung, Vanessa

    2012-03-01

    What do I as a critical care nurse do? Nurses, by virtue of being trained in health promotion, and also because they interact with patients, families, and communities, have firsthand opportunities to play an active role in practicing primary prevention. To avoid the first occurrence of substance abuse, assess community need, assess facility needs, and identify potential risk. Identify the magnitude of the problem. Intervene early with the youth and at-risk populations. Refer patients and their families to mental health specialists. Provide education to patients, families, communities. To reduce occurrences of substance abuse, practicing secondary prevention requires prompt action in the earliest moments of recognizing a problem and directing patients to early intervention and rehabilitation. Screening your patients, providing brief education, and prompt referral constitutes early intervention. To retard the progress of the disease, practice tertiary prevention by providing education, counseling, and support to the afflicted in achieving and maintaining sobriety through medication compliance and rehabilitative group and counseling work. The goal of intervention in the lives of substance abusers is to stop drug use, avoid relapse, and sustain recovery. After years of research, NIDA has identified 13 fundamental principles to effective drug abuse treatment. 1. Addiction is a complex but treatable disease that affects brain function and behavior. 2. No single treatment is appropriate for everyone. 3. Treatment needs to be readily available. 4. Effective treatment attends to multiple needs of the individual, not just his or her drug abuse. 5. Remaining in treatment for an adequate period of time is critical. 6. Counseling--individual and/or group--and other behavioral therapies are the most commonly used forms of drug abuse treatment. 7. Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral

  17. Substance Abuse among High-Risk Sexual Offenders: Do Measures of Lifetime History of Substance Abuse Add to the Prediction of Recidivism over Actuarial Risk Assessment Instruments?

    ERIC Educational Resources Information Center

    Looman, Jan; Abracen, Jeffrey

    2011-01-01

    There has been relatively little research on the degree to which measures of lifetime history of substance abuse add to the prediction of risk based on actuarial measures alone among sexual offenders. This issue is of relevance in that a history of substance abuse is related to relapse to substance using behavior. Furthermore, substance use has…

  18. Child Abuse and Neglect in New York Mental Hygiene Facilities: An Assessment of Reports Filed Prior to Implementation of New York's Child Abuse Prevention Act of 1985.

    ERIC Educational Resources Information Center

    New York State Commission on Quality of Care for the Mentally Disabled, Albany.

    The pilot study reported in this document reviewed existing child abuse and neglect reports in mental health and mental retardation residential facilities in the state of New York. The study found that the annual reporting rate of abuse and neglect in these facilities was more than two times higher than for the state as a whole; it also found…

  19. Updated Guidelines for the Medical Assessment and Care of Children Who May Have Been Sexually Abused.

    PubMed

    Adams, Joyce A; Kellogg, Nancy D; Farst, Karen J; Harper, Nancy S; Palusci, Vincent J; Frasier, Lori D; Levitt, Carolyn J; Shapiro, Robert A; Moles, Rebecca L; Starling, Suzanne P

    2016-04-01

    The medical evaluation is an important part of the clinical and legal process when child sexual abuse is suspected. Practitioners who examine children need to be up to date on current recommendations regarding when, how, and by whom these evaluations should be conducted, as well as how the medical findings should be interpreted. A previously published article on guidelines for medical care for sexually abused children has been widely used by physicians, nurses, and nurse practitioners to inform practice guidelines in this field. Since 2007, when the article was published, new research has suggested changes in some of the guidelines and in the table that lists medical and laboratory findings in children evaluated for suspected sexual abuse and suggests how these findings should be interpreted with respect to sexual abuse. A group of specialists in child abuse pediatrics met in person and via online communication from 2011 through 2014 to review published research as well as recommendations from the Centers for Disease Control and Prevention and the American Academy of Pediatrics and to reach consensus on if and how the guidelines and approach to interpretation table should be updated. The revisions are based, when possible, on data from well-designed, unbiased studies published in high-ranking, peer-reviewed, scientific journals that were reviewed and vetted by the authors. When such studies were not available, recommendations were based on expert consensus. PMID:26220352

  20. [Basic features of medical liability].

    PubMed

    Niksić, Sasa

    2008-01-01

    Medical liability is one of the most important parts of law that regulates health services. Although there are different types of liability in the field of medicine (criminal responsibility, disciplinary proceedings) civil law liability holds central position. Civil law liability in medicine (medical liability) is probably more important than criminal responsibility and disciplinary proceedings because of the number of cases in comparison to the criminal responsibility and impact of the consequences in comparison to the disciplinary proceedings. Medical liability is governed by a (general) tort law. Therefore medical liability exists only if conditions for civil law liability are met. When considering medical liability it is necessary to emphasize that tortfeasor will not be liable only because victim sustained the damage, but if all conditions for liability are met. Medical liability will arise if actions of physician are not conducted lege artis or in a breach of the duty of care. In some cases of medical liability legal sources are directly applicable (informed consent). General tort law is also applicable on decisions in the respect of the damages. PMID:19146185

  1. Nonoffending Guardian Assessment of Hospital-Based Sexual Abuse/Assault Services for Children.

    PubMed

    Du Mont, Janice; Macdonald, Sheila; Kosa, Daisy; Smith, Tanya

    2016-01-01

    In circumstances in which child sexual abuse/assault is suspected, pediatric guidelines recommend referral to services such as multidisciplinary hospital-based violence treatment centers, for specialized medical treatment, forensic documentation, and counseling. As little is known about how such services are perceived, the objective of this case report was to measure the satisfaction of nonoffending guardians of child sexual abuse/assault victims who presented for care at Ontario's hospital-based sexual assault treatment centers. Of the 1,136 individuals who reported sexual abuse/assault and were enrolled in a province-wide service evaluation, 58 were 11 years old and younger. Thirty-three guardians completed a survey. Ratings of care were overwhelmingly positive, with 97% of respondents indicating that they would recommend these services. Nonetheless, it is important to evaluate these pediatric sexual assault services frequently to ensure ongoing optimal, family-centered care. PMID:26910267

  2. Methodological issues in the assessment of substance use phenotypes.

    PubMed

    Neale, Michael C; Aggen, Steven H; Maes, Hermine H; Kubarych, Thomas S; Schmitt, J Eric

    2006-06-01

    The measurement of behavior is inherently problematic, and this is especially true of substance use and abuse phenotypes. The contingent nature of many assessments, such that symptoms of abuse and dependence cannot be obtained from those who have not initiated substance use, presents special difficulties. Furthermore, it is not clear whether individual differences in liability to use, abuse and dependence are best characterized as dimensions or classes or a combination of both. This article outlines research designs and methods suitable for quantifying liability to substance use. The value of data collected from relatives is emphasized in this context, as they permit identification of models normally compromised because data on, e.g., substance dependence symptoms, are systematically missing in those who have not initiated use of the substance in question. PMID:16723188

  3. Managing 'tail liability'.

    PubMed

    Frese, Richard C; Weber, Ryan J

    2013-11-01

    To reduce and control their level of tail liability, hospitals should: Utilize a self-insurance vehicle; Consider combined limits between the hospital and physicians; Communicate any program changes to the actuary, underwriter, and auditor; Continue risk management and safety practices; Ensure credit is given to the organization's own medical malpractice program. PMID:24340649

  4. Legal Liabilities of Administrators.

    ERIC Educational Resources Information Center

    Underwood, Julie

    This chapter of "Principles of School Business Management" discusses the implications of several court cases for legal issues affecting the role of the school business official. The issues addressed include civil rights, negligence, contracts, criminal liability, tuition and fees, and student records. The chapter opens with a brief overview of…

  5. Effects of the δ opioid agonist AZD2327 upon operant behaviors and assessment of its potential for abuse.

    PubMed

    Hudzik, T J; Pietras, M R; Caccese, R; Bui, K H; Yocca, F; Paronis, C A; Swedberg, M D B

    2014-09-01

    AZD2327 is a brain-penetrant agonist at δ opioid receptors which has antidepressant and anxiolytic properties in a wide array of animal models. As part of the preclinical safety pharmacology assessment, a number of studies were conducted in order to characterize its behavioral effects and its potential for abuse, in order to enable testing in humans. AZD2327 produced only modest effects when tested in a multiple fixed-ratio differential reinforcement of low rate schedule in rats, and did not enhance the rate-suppressing effects of ethanol in the procedure. In a suppressed responding test, AZD2327 only reduced rates of unpunished responding. In drug discrimination studies, AZD2327 produced partial or no generalization from known drugs of abuse. In primates trained to self-administer cocaine, substitution with AZD2327 did not result in appreciable self-administration of AZD2327, indicating that it does not behave as a positive reinforcer under the present conditions. Following termination of repeated administration of AZD2327, no signs of physical dependence (withdrawal) were noted. Overall, the data suggest that AZD2327 does not possess a high potential for abuse, and appears to have only subtle behavioral effects as measured by operant behaviors. PMID:24857840

  6. Elder Abuse

    MedlinePlus

    ... Physical, sexual, or emotional abuse Neglect or abandonment Financial abuse - stealing of money or belongings Possible signs ... may be a sudden change in the person's financial situation. Elder abuse will not stop on its ...

  7. Elder Abuse

    MedlinePlus

    ... facilities 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, ...

  8. Child Abuse

    MedlinePlus

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

  9. Childhood Sexual Abuse, Adult Psychiatric Morbidity, and Criminal Outcomes in Women Assessed by Medium Secure Forensic Service

    ERIC Educational Resources Information Center

    Dolan, Mairead; Whitworth, Helen

    2013-01-01

    There is little literature on childhood sexual abuse in women seen by forensic services. A cohort of 225 cases of women seen by forensic services in a medium secure unit in the UK were examined, and childhood sexual abuse and non-childhood sexual abuse cases were compared. Over half the sample had a history of childhood sexual abuse, and 5.6% of…

  10. Anatomical Dolls: Their Use in Assessment of Children Who May Have Been Sexually Abused

    ERIC Educational Resources Information Center

    Faller, Kathleen Coulborn

    2005-01-01

    This article examines anatomical dolls in interviews of children who may have been sexually abused from three perspectives. The article summarizes research findings on anatomical dolls, discusses advantages and disadvantages of using them, and describes endorsed doll uses. Although additional, ecologically-valid research is needed on anatomical…

  11. Assessing the Accuracy of a Child's Account of Sexual Abuse: A Case Study.

    ERIC Educational Resources Information Center

    Orbach, Yael; Lamb, Michael E.

    1999-01-01

    This study examined the accuracy of a 13-year-old girl's account of a sexually abusive incident. Information given by the victim was compared with an audiotaped record. Over 50% of information reported by the victim was corroborated by the audio record and 64% was confirmed by more than one source. (Author/CR)

  12. The Assessment of Intimate Partner Violence in Spanish Women: The Index of Spouse Abuse

    ERIC Educational Resources Information Center

    Plazaola-Castano, Juncal; Ruiz-Perez, Isabel; Escriba-Aguir, Vicenta; Montero-Pinar, Isabel; Vives-Cases, Carmen

    2011-01-01

    We aimed to analyze the internal consistency and construct validity of the Spanish version of the Index of Spouse Abuse (ISA) in a representative sample of 8,995 women attending general practice in Spain in 2006-2007. The factor structure analysis shows that the ISA measures four intimate partner violence (IPV) dimensions: emotional, physical, and…

  13. Assessment of Factors Resulting in Abuse Evaluations in Young Children with Minor Head Trauma

    ERIC Educational Resources Information Center

    Anderst, James D.

    2008-01-01

    Objective: The primary objective was to determine which of the examined factors prompted physicians to initiate a further abuse evaluation in young children with minor head injury. The recording of important historical elements in the charts of these patients was also evaluated. Methods: Charts of 349 children less than 3 years of age with minor…

  14. Emerging Strategies for Risk Assessment of Sexually Abusive Youth: Theory, Controversy, and Practice

    ERIC Educational Resources Information Center

    Prescott, David P.

    2004-01-01

    Clinicians and other professionals evaluating, managing, and treating sexually abusive youth are frequently called upon to offer judgments regarding risk for sexual reoffense. There are currently no empirically validated methods for accurately classifying risk among this population. Therefore, those faced with this task have an obligation to…

  15. Drug abuse

    MedlinePlus

    ... abuse References American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders . 5th ed. Arlington, VA: American Psychiatric Publishing. 2013. Weiss RD. Drugs of abuse. In: Goldman ...

  16. Preventing Alcohol and Drug Abuse through Programs at the Workplace. WBGH Worksite Wellness Series.

    ERIC Educational Resources Information Center

    Walsh, Diana Chapman; Kelleher, Susan E.

    Alcohol and drug abuse have serious physical, psychological, and social consequences, and employees who abuse alcohol and/or drugs ultimately reduce their companies' profits. Employee substance abuse leads to reduced productivity as well as to increased absenteeism, health care and health insurance costs, and liability claims against employers of…

  17. Assessment of a formulation designed to be crush-resistant in prescription opioid abusers

    PubMed Central

    Vosburg, Suzanne K.; Jones, Jermaine D.; Manubay, Jeanne M.; Ashworth, Judy B.; Benedek, Irma H.; Comer, Sandra D.

    2013-01-01

    Background The extent of intranasal and intravenous prescription opioid abuse has led to the development of formulations that are difficult to crush. The purpose of the present studies was to examine whether experienced prescription opioid abusers (individuals who were using prescription opioids for non-medical purposes regardless of how they were obtained) were able to prepare a formulation of oxymorphone hydrochloride ER 40 mg designed to be crush-resistant (DCR) for intranasal (Study 1) or intravenous abuse (Study 2), utilizing a non-crush-resistant formulation of oxymorphone (40 mg; OXM) as a positive control. Methods No drug was administered in these studies. Participants were provided with DCR and OXM tablets in random order and asked to prepare them for abuse with tools/solutions that they had previously requested. The primary outcome for Study 1 was particle size distribution, and the primary outcome for Study 2 was percent yield of active drug in the extracts. Other descriptive variables were examined to better understand potential responses to these formulations. Results Fewer DCR than OXM particles were smaller than 1.705 mm (9.8% vs. 97.7%), and thus appropriate for analyses. Percent yield of active drug in extract was low and did not differ between the two formulations (DCR: 1.95%; OXM: 1.29%). Most participants were not willing to snort (92%) or inject (84%) the tampered products. Participants indicated that they found less relative value in the DCR than the OXM formulation across both studies. Conclusions Although there are safety issues associated with formulations that gel, these data suggest that the oxymorphone DCR formulations may be a promising technology for reducing opioid abuse. PMID:22721679

  18. Comparison of antidepressant-like and abuse-related effects of phencyclidine in rats

    PubMed Central

    Hillhouse, Todd M.; Porter, Joseph H.; Negus, S. Stevens

    2014-01-01

    NMDA receptor antagonists such as ketamine have emerged as novel candidate treatments for major depressive disorder, but abuse potential of these agents is a concern. The NMDA antagonist phencyclidine has known abuse liability but undefined efficacy as an antidepressant. To further evaluate the relationship between antidepressant-like and abuse-related effects of NMDA antagonists, this study evaluated the effects of phencyclidine (1.0-10.0 mg/kg) in male Sprague-Dawley rats responding under two procedures that have been used to assess antidepressant-like effects [differential-reinforcement-of-low-rate (DRL) 72 s schedule of food reinforcement; N=9] and abuse-related drug effects [intracranial self-stimulation (ICSS); N=6]. Under the DRL 72 s schedule, phencyclidine (10.0 mg/kg) increased reinforcers and decreased responses without shifting the peak location of the interresponse time (IRT) distribution. Ketamine (10.0 mg/kg) also increased reinforcers and decreased responses, but unlike phencyclidine, it produced a rightward shift in the peak location of the IRT distribution. The 10.0 mg/kg phencyclidine dose that decreased DRL 72 s responding also decreased rates of ICSS for 50 min after its administration; however, abuse-related ICSS facilitation was observed at later times (100-300 min) or after a lower phencyclidine dose (3.2 mg/kg). These results suggest that phencyclidine produces weaker antidepressant-like effects, but stronger abuse-related effects than ketamine in these procedures. PMID:25315690

  19. The use and abuse of attachment theory in clinical practice with maltreated children, part I: diagnosis and assessment.

    PubMed

    Allen, Brian

    2011-01-01

    Debate has ensued regarding the appropriate assessment and diagnosis for school-age children who display severe behavioral problems as a result of previous abuse and neglect within the primary attachment relationship. The current nomenclature recognizes reactive attachment disorder and some clinicians have suggested broader categories of attachment disorder. These attempts at classification are often criticized on empirical grounds; however, often lost in these criticisms is the fact that that these diagnostic approaches often misapply attachment theory and research. This article summarizes the original contributions of John Bowlby and other attachment researchers to our understanding of child development, examines misguided attempts to apply attachment theory to the diagnosis and assessment of maltreated children, and offers a diagnostic conceptualization and assessment recommendations consistent with the available attachment research. PMID:21288931

  20. Becoming Heroes: Teachers Can Help Abused Children.

    ERIC Educational Resources Information Center

    Bancroft, Sharon

    1997-01-01

    Teachers can provide an effective counterbalance to the effects of an abusive home. They should not allow their skeptical attitudes, fear of liability, defensiveness about discipline, or religious and political affiliations to cloud their perceptions. Teachers can help hurting children by attending to their basic needs for warmth and security,…

  1. Qualitative and quantitative assessments of HAART adherence of substance-abusing women.

    PubMed

    Powell-Cope, G M; White, J; Henkelman, E J; Turner, B J

    2003-04-01

    This study was set up to examine factors affecting adherence to highly active antiretroviral therapy (HAART) by substance abusing women and to conduct a pilot study of a reminder device intervention. Three focus groups totaling 24 HIV-positive women developed priority lists of issues affecting adherence. Another group of 24 HIV-positive women received a timer-reminder with structured interviews on adherence at baseline and two monthly follow up intervals. Focus groups described key barriers to HAART adherence as substance abuse, forgetting, feeling ill, others' negative attitudes, obtaining refills and confidentiality. Primary disadvantages to HAART were side effects, pill-taking schedule and burden of taking medications. Facilitators included reminders (e.g. pill boxes) and spirituality. After receiving the reminder, missing a dose was less common (p < 0.05) due to sleeping through dose, being busy and feeling too good while a favourable trend (p = 0.07) was seen for change in daily routine and having too many pills to take. Although well accepted, the reminder did not affect the proportion missing a dose in the past two weeks: baseline (33%), first follow-up (30%) and second follow-up (30%). Forgetting to take HAART was only one of many cited barriers to adherence in these HIV-positive women; well-received reminder devices did not affect adherence. To improve substance-abusing women's adherence, multidimensional interventions are warranted. PMID:12856345

  2. A national survey of child advocacy center directors regarding knowledge of assessment, treatment referral, and training needs in physical and sexual abuse.

    PubMed

    Wherry, Jeffrey N; Huey, Cassandra C; Medford, Elizabeth A

    2015-01-01

    Mental health services are a core component of child advocacy centers in the United States. Child advocacy center directors were surveyed about (a) trauma and posttraumatic stress disorder; (b) referral criteria for treatment of abuse victims; (c) evidence-based treatments for abused children; (d) reliable, valid, and normed measures helpful in assessment; and (e) training needs. Directors accurately identified posttraumatic stress disorder symptoms, but additional symptoms were misidentified. Directors identified best practices for assessment and treatment, but they misidentified non-evidence-based practices. Primary reasons for referral for services included severity of abuse and emotional response of the child. However, referrals based on assessment findings were not a high priority. Directors expressed some training needs for staff consistent with issues identified in the study. PMID:25942286

  3. Ecological momentary assessment of the effects of craving and affect on risk for relapse during substance abuse treatment.

    PubMed

    Moore, Todd M; Seavey, Amanda; Ritter, Kathrin; McNulty, James K; Gordon, Kristina C; Stuart, Gregory L

    2014-06-01

    The primary goals of this study were to use ecological momentary assessment (EMA) to examine the extent to which proximal factors (cravings and affect) were temporally associated with relapse, and to assess the role of distal factors (e.g., coping styles) in moderating these associations. We also examined whether using EMA procedures impacted relapse rates. A sample of 100 male (n = 66) and female (n = 34) patients entering outpatient treatment for substance abuse completed a baseline assessment of substance dependence, stress, social support, coping styles, family history of substance abuse, and self-efficacy. Half of the participants were randomly assigned to receive training in using a handheld computer to respond to 3 random prompts each day for 4 months regarding cravings, affect, and substance use. All participants completed 2- and 4-month follow-up assessments of substance use. Results showed that using EMA procedures did not influence relapse rates. Hierarchical linear modeling showed that individuals who reported an increase in cravings on a given prompt were 14 times more likely to report relapse on the subsequent prompt than individuals who did not experience an increase in cravings. In addition, women, older individuals, and individuals who use distraction and disengagement as coping styles were at increased risk for relapse when experiencing an increase in cravings. Individuals who use acceptance as a coping style were at decreased risk for relapse when experiencing an increase in cravings. The study highlights the importance of tailoring treatments to address the needs of particular individuals and risk factors. PMID:24128286

  4. Abusive head trauma among children in Alaska: a population-based assessment

    PubMed Central

    Parrish, Jared; Baldwin-Johnson, Cathy; Volz, Margaret; Goldsmith, Yvonne

    2013-01-01

    Background Serious physical abuse resulting in a traumatic brain injury (TBI) has been implicated as an underreported cause of infant mortality. Nearly 80% of all abusive head trauma (AHT) occurs among children <2 years of age, with infants experiencing an incidence nearly 8 times that of 2-year olds. Objective This study describes the validation of the CDC Pediatric Abusive Head Trauma (PAHT) definitions when applied to a multi-source database at the state level and provides a robust annual incidence estimate of AHT among children <2 years of age in Alaska. Design AHT cases among children residing in Alaska during 2005–2010 were identified by applying the PAHT coding schema to a multi-source database which included vital death records, the Violent Death Reporting System (AK-VDRS), the Maternal Infant Mortality Review – Child Death Review (MIMR-CDR), the Alaska Trauma Registry (ATR), the inpatient Hospital Discharge Database (HDD) and Medicaid claims. Using these data, we calculated statewide AHT annual incidence rates. Results The databases with the highest case capture rates were the ATR and Medicaid systems, both at 51%, followed by HDD at 38%. Combined, the ATR, HDD and Medicaid systems captured 91% of all AHT cases. The linkage and use of the PAHT definitions yielded an estimated sensitivity of 91% and specificity of 98%. During the study period, we detected an annual average incidence of 34.4 cases per 100,000 children aged <2 years (95% CI 25.1, 46.1) and a case fatality proportion of 22% (10/45). Among the AHT cases, 82% were infants. Significant differences (p < 0.05) in AHT were noted by age and race, but not by sex. Conclusions In Alaska, applying the CDC PAHT definition to the multi-source database enabled us to capture 49% more AHT cases than any of the individual database used in this analysis alone. PMID:23986886

  5. Hair and urine testing to assess drugs of abuse consumption in couples undergoing assisted reproductive technology (ART).

    PubMed

    Pichini, Simona; De Luca, Roberto; Pellegrini, Manuela; Marchei, Emilia; Rotolo, Maria Concetta; Spoletini, Roberta; D'Aloja, Paola; Pacifici, Roberta; Mortali, Claudia; Scaravelli, Giulia

    2012-05-10

    For the first time in Europe hair and urine testing have been applied to assess drugs of abuse consumption in couples undergoing assisted reproductive technology and the eventual association of toxic habits with other lifestyle, health status and sociodemographic factors was also investigated. Couples attending five assisted reproduction centers in Rome were invited to join the study. When they presented at the Centre for the visit, they were asked to answer a structured questionnaire concerning sociodemographic characteristics and lifestyle habits, and at the same time to provide hair and urine samples. Hair and urine testing for drugs of abuse, urinary profile of principal endogenous steroids involved in fertility process (testosterone, epitestosterone, androsterone, etiocholanolone and dehydroepiandrosterone) and of alcohol and tobacco smoke biomarkers were performed with validated methodologies. Of the 594 enrolled individuals (297 couples), 352 (164 couples and 24 single individuals from the couple) completed the questionnaire and gave both hair and urine samples, apart from 3 bald men, who only gave urine samples. Urine testing showed an overall 4.8% (17 individuals) positivity to drugs of abuse: 4.2% to cannabinoids, 1.4% to cocaine and 0.85% to both drugs. Results of 4cm segment hair samples testing matched those from urine samples. Thus, taking together, results of urine and hair testing confirmed repeated use of cannabis, cocaine and both drugs in 3.7, 0.85 and 0.57% examined individuals, respectively. Drug consumers were in a statistically higher percentage active smokers and alcohol drinkers, less prone to physical activity and with a trend towards higher weight than non consumers. Finally, repeated drug consumption was associated with significant lower concentration of urinary testosterone in males and of urinary dehydroepiandrosterone in females. The findings of the present study confirm the suitability of urine testing to disclose recent drugs of

  6. Legal issues in environmental contractor liability

    SciTech Connect

    Slap, A.J.

    1994-12-31

    Business is booming for environmental professionals. Increasingly, environmental consultants and engineers are called upon by property owners and government agencies to clean up contaminated sites, assess environmental risk for potential purchasers and lenders, and investigate the extent of contamination prior to a real estate purchase. But these activities are not risk-free for the environmental professional. To the contrary, there are many ways for a remediation or site assessment to go awry. Risks that the remediation contractor face include the possibility that activities on the site may actually cause or contribute to further releases of the hazardous substances sought to be remediated. Because environmental professionals many times face substantial risk in performing their jobs, it is necessary that they understand and appreciate the potential liabilities when something does go wrong, and how to best protect themselves. This article describes the types of legal theories that could be brought against environmental professionals and how to best protect yourself from such liability.

  7. The Adolescent Sexual Abuser Project (ASAP) Assessment Measures-Dutch Revised Version: A Comparison of Personality Characteristics between Juvenile Sex Offenders, Juvenile Perpetrators of Non-Sexual Violent Offences and Non-Delinquent Youth in the Netherlands

    ERIC Educational Resources Information Center

    van Outsem, Ron; Beckett, Richard; Bullens, Ruud; Vermeiren, Robert; van Horn, Joan; Doreleijers, Theo

    2006-01-01

    In this paper, the Adolescent Sexual Abuser Project (ASAP) assessment pack-Dutch Revised Version (ASAP-D) is presented. The ASAP-D is an assessment instrument which measures the personality characteristics that are generally considered relevant in the literature for the development and perpetuation of sexually abusive behaviour in juveniles. After…

  8. The Role of Key Informants and Direct Patient Interviews in Epidemiological Studies of Substance Abuse

    PubMed Central

    Cicero, Theodore J.; Ellis, Matthew S.; Paradis, Alethea; Ortbal, Zachary

    2010-01-01

    Purpose The present study was undertaken to assess the degree to which key informants’ perceptions of relative abuse liability of opioids in their communities correspond to actual drug use in their patients. Methods Key Informants (N=49), and their patients (N=738) were asked to complete anonymous, independent paper surveys about perceived or actual abuse of nine targeted opioid drugs: buprenorphine, fentanyl, heroin, hydrocodone, hydromorphone, methadone, morphine, oxycodone and tramadol. Results There was a strong correspondence (R=.98) between KI rankings of relative abuse of opioids in their patient population and the actual rank order calculated from their patient’s selection of a primary euphorigenic opioid. The patient surveys not only validated the KI’s conclusions, but also provided a great deal of important information about the nature of the abuse patterns. Notably, significant co-morbidity was found in the patient population: 55% had a history of psychiatric problems; chronic pain of moderate intensity was common; 67% were nicotine dependent; and 43% were diagnosed alcoholics. Discussion Our results demonstrate that KI’s perceived rank order of drugs of choice correlated almost perfectly with their patients’ choice of a primary drug. These data suggest that key informants, as they have for decades in epidemiological research, provide a reliable, high-level view of substance abuse in their catchment area. As such, KIs provide valid and reliable information on scope and patterns of abuse, but if more detail is required about the characteristics of abuse, such as that required for FDA-mandated Risk Evaluation and Mitigation Strategies (REMS), then direct interviews with the abusers themselves seem more appropriate. PMID:21351313

  9. [Tort Liability and School Transportation.

    ERIC Educational Resources Information Center

    Franke, Allyn J.

    School districts, school employees, bus companies contracted by districts, and bus company employees could be involved in court litigation over student injury and student civil rights related to school bus transportation. Civil rights insurance should be added to general liability insurance and motor vehicle liability insurance. Students must be…

  10. Childhood sexual abuse, adult psychiatric morbidity, and criminal outcomes in women assessed by medium secure forensic service.

    PubMed

    Dolan, Mairead; Whitworth, Helen

    2013-01-01

    There is little literature on childhood sexual abuse in women seen by forensic services. A cohort of 225 cases of women seen by forensic services in a medium secure unit in the UK were examined, and childhood sexual abuse and non-childhood sexual abuse cases were compared. Over half the sample had a history of childhood sexual abuse, and 5.6% of this group were victims of a subsequent sexual assault in adulthood. The perpetrators were all male. The majority of intrafamilial cases resulted in victims being raised in environments outside the family home. Childhood sexual abuse was associated with later relationship, educational, and occupational difficulties. Significant associations were also seen with personality disorder, self-harm, and substance misuse. Treating services need to recognize the potential importance of childhood sexual abuse in their models of care given the complexity of the association between childhood sexual abuse and psychosocial needs and its impact on successful rehabilitation. PMID:23428151

  11. 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 ...

  12. The Evaluation of Franco-Quebec Victims of Child Sexual Abuse and Their Mothers: The Implementation of a Standard Assessment Protocol.

    ERIC Educational Resources Information Center

    Wright, John; Friedrich, William N.; Cyr, Mireille; Theriault, Chantal; Perron, Alain; And Others

    1998-01-01

    This study evaluated a standard assessment protocol with 48 Franco-Quebec victims of child sexual abuse and 40 nonoffending mothers. The protocol was favorably received by child protection service workers, supervisors, mothers, and victims. Among specific results were that the rate of symptom-free children was lower (19%) and that of…

  13. Assessing the Effectiveness of the NICHD Investigative Interview Protocol when Interviewing French-Speaking Alleged Victims of Child Sexual Abuse in Quebec

    ERIC Educational Resources Information Center

    Cyr, Mireille; Lamb, Michael E.

    2009-01-01

    Objectives: The study was designed to assess the effectiveness of the flexibly structured NICHD Investigative Interview Protocol for child sexual abuse (CSA) investigative interviews by police officers and mental health workers in Quebec. The NICHD Protocol was designed to operationalize "best practice" guidelines and to help forensic interviewers…

  14. Assessing the efficacy of melatonin to curtail benzodiazepine/Z drug abuse.

    PubMed

    Cardinali, Daniel P; Golombek, Diego A; Rosenstein, Ruth E; Brusco, Luis I; Vigo, Daniel E

    2016-07-01

    The abuse of benzodiazepine (BZP) and Z drugs has become, due to the tolerance and dependence they produce, a serious public health problem. Thirty years ago, we demonstrated in experimental animals the interaction of melatonin with central BZD receptors, and in 1997 we published the first series of elderly patients who reduced BZP consumption after melatonin treatment. Almost every single neuron in the hypothalamic suprachiasmatic nuclei (SCN), the central pacemaker of the circadian system, contains γ-aminobutyric acid (GABA) and many results in animals point out to a melatonin interaction with GABA-containing neurons. In addition, central-type BZD antagonism, that obliterates GABAA receptor function, blunted most behavioral effects of melatonin including sleep. Melatonin is involved in the regulation of human sleep. This is supported by the temporal relationship between the rise of plasma melatonin levels and sleep propensity as well as by the sleep-promoting effects of exogenously administered melatonin. Both meta-analyses and consensus agreements give support to the therapeutic use of melatonin in sleep disorders. This action is attributed to MT1 and MT2 melatoninergic receptors localized in the SCN, as well as in other brain areas. This review discusses available data on the efficacy of melatonin to curtail chronic BZD/Z drug use in insomnia patients. A major advantage is that melatonin has a very safe profile, it is usually remarkably well tolerated and, in some studies, it has been administered to patients at very large doses and for long periods of time, without any potentiality of abuse. Further studies on this application of melatonin are warranted. PMID:26438969

  15. Drug Abuse

    MedlinePlus

    ... as drugged driving, violence, stress, and child abuse. Drug abuse can lead to homelessness, crime, and missed work or problems with keeping a job. It harms unborn babies and destroys families. There are different types of treatment for drug abuse. But the best is to prevent drug ...

  16. Child Abuse

    MedlinePlus

    ... or become violent. An older child may use drugs or alcohol, try to run away or abuse others. Child abuse is a serious problem. If you suspect a child is being abused or neglected, call the police or your local child welfare agency.

  17. Substance Abuse

    ERIC Educational Resources Information Center

    Rowe, Cynthia L.; Liddle, Howard A.

    2003-01-01

    Liddle and Dakof's (1995) comprehensive review of the status of family-based treatment for drug abuse concluded that this modality offered a "promising, but not definitive" approach to treating drug abuse among adolescents and adults. Less than a decade later, significant progress can be seen in the treatment of drug abuse problems using…

  18. Emerging Issues in Special Education Tort Liability: Implications for Special Educators and Teacher Trainers.

    ERIC Educational Resources Information Center

    McAfee, James K.

    1987-01-01

    Critical issues in tort liability that confront special educators and teacher trainers include malpractice (failure to learn), misdiagnosis, immunity, impact of a handicap on standard of care, confidentiality, access to emergency medical services, the use of aversive consequences, child abuse and corporal punishment, and school violence.…

  19. Physical Abuse Among Depressed Women

    PubMed Central

    Scholle, Sarah Hudson; Rost, Kathryn M; Golding, Jacqueline M

    1998-01-01

    OBJECTIVE To provide estimates of physical abuse and use of health services among depressed women in order to inform efforts to increase detection and treatment of physical abuse. DESIGN Retrospective assessment of abuse and health services use over 1 year in a cohort of depressed women. SETTING Statewide community sample from Arkansas. PARTICIPANTS We recruited 303 depressed women through random-digit-dial screening. MEASUREMENTS AND MAIN RESULTS Exposure to physical abuse based on the Conflict Tactics Scale, multi-informant estimate of health and mental health services. Over half of the depressed women (55.2%) reported experiencing physical abuse as adults, with 14.5% reporting abuse during the study year. Women abused as adults had significantly more severe depressive symptoms, more psychiatric comorbidity, and more physical illnesses than nonabused women. After controlling for sociodemographic and severity-of-illness factors, recently abused, depressed women were much less likely to receive outpatient care for mental health problems as compared to other depressed women (odds ratio [OR] 0.3;p = .013), though they were more likely to receive health care for physical problems (OR 5.7, p = .021). CONCLUSIONS Because nearly all depressed women experiencing abuse sought general medical rather than mental health care during the year of the study, primary care screening for physical abuse appears to be a critical link to professional help for abused, depressed women. Research is needed to inform primary care guidelines about methods for detecting abuse in depressed women. PMID:9754516

  20. USING THE PARENT-INFANT RELATIONSHIP GLOBAL ASSESSMENT SCALE TO IDENTIFY CAREGIVER-INFANT/TODDLER DYADS WITH ABUSIVE RELATIONSHIP PATTERNS IN SIX EUROPEAN COUNTRIES.

    PubMed

    Hatzinikolaou, Kornilia; Karveli, Vassiliki; Skoubourdi, Aggeliki; Zarokosta, Foteini; Antonucci, Gianluca; Visci, Giovanni; Calheiros, Maria Manuela; MagalhÃes, Eunice; Essau, Cecilia; Allan, Sharon; Pithia, Jayshree; Walji, Fahreen; Ezpeleta, Lourdes; Perez-Robles, Ruth; Fanti, Kostas A; Katsimicha, Evita; Hadjicharambous, Maria-Zoe; Nikolaidis, George; Reddy, Vasudevi

    2016-07-01

    The study examined whether the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood, Revised Edition (DC: 0-3R; ZERO TO THREE, 2005) Parent-Infant Relationship Global Assessment Scale (PIR-GAS) is applicable to six European countries and contributes to the identification of caregiver-infant/toddler dyads with abusive relationship patterns. The sample consisted of 115 dyads with children's ages ranging from 1 to 47 months. Sixty-four dyads were recruited from community settings without known violence problems, and 51 dyads were recruited from clinical settings and already had been identified with violence problems or as being at risk for violence problems. To classify the dyads on the PIR-GAS categories, caregiver-child interactions were video-recorded and coded with observational scales appropriate for child age. To test whether the PIR-GAS allows for reliable identification of dyads with abusive relationship patterns, PIR-GAS ratings were compared with scores on the the International Society for the Prevention of Child Abuse and Neglect's (ISPCAN) Child Abuse Screening Tool-Parental Version (ICAST-P; D.K. Runyan et al., ), a questionnaire measuring abusive parental disciplinary practices. It was found that PIR-GAS ratings differentiated between the general and the clinical sample, and the dyads with abusive patterns of relationship were identified by both the PIR-GAS and the ICAST-P. Interrater reliability for the PIR-GAS ranged from moderate to excellent. The value of a broader use of tools such as the DC: 0-3R to promote early identification of families at risk for infant and toddler abuse and neglect is discussed. PMID:27351372

  1. Prescription Opioid Abuse: Challenges and Opportunities for Payers

    PubMed Central

    Katz, Nathaniel P.; Birnbaum, Howard; Brennan, Michael J.; Freedman, John D.; Gilmore, Gary P.; Jay, Dennis; Kenna, George A.; Madras, Bertha K.; McElhaney, Lisa; Weiss, Roger D.; White, Alan G.

    2013-01-01

    Objective Prescription opioid abuse and addiction are serious problems with growing societal and medical costs, resulting in billions of dollars of excess costs to private and governmental health insurers annually. Though difficult to accurately assess, prescription opioid abuse also leads to increased insurance costs in the form of property and liability claims, and costs to state and local governments for judicial, emergency, and social services. This manuscript’s objective is to provide payers with strategies to control these costs, while supporting safe use of prescription opioid medications for patients with chronic pain. Method A Tufts Health Care Institute Program on Opioid Risk Management meeting was convened in June 2010 with private and public payer representatives, public health and law enforcement officials, pain specialists, and other stakeholders to present research, and develop recommendations on solutions that payers might implement to combat this problem. Results While protecting access to prescription opioids for patients with pain, private and public payers can implement strategies to mitigate financial risks associated with opioid abuse, using internal strategies, such as formulary controls, claims data surveillance, and claims matching; and external policies and procedures that support and educate physicians on reducing opioid risks among patients with chronic pain. Conclusion Reimbursement policies, incentives, and health technology systems that encourage physicians to use universal precautions, to consult prescription monitoring program (PMP) data, and to implement Screening, Brief Intervention, and Referral to6Treatment protocols, have a high potential to reduce insurer risks while addressing a serious public health problem. PMID:23725361

  2. Does Living with a Substance Abusing Father Increase Substance Abuse Risk in Male Offspring? Impact on Individual, Family, School, and Peer Vulnerability Factors.

    ERIC Educational Resources Information Center

    Tarter, Ralph E.; Schultz, Katie; Kirisci, Levent; Dunn, Marija

    2001-01-01

    Examined whether risk of drug abuse in offspring of fathers with substance use disorders differs with respect to presence or absence of the father. Concluded increased risk for substance abuse in offspring of separated parents due to the combination of the transmission of more severe liability from the father, and fewer resources available to the…

  3. 40 CFR 267.147 - Liability requirements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... obtaining liability insurance as specified in 40 CFR 264.147(a)(1). (5) Financial test for liability... 40 CFR 264.147(j). (2) Surety bond for liability coverage. An owner or operator may meet the requirements of this section by obtaining a surety bond for liability coverage as specified in 40 CFR...

  4. Medical liability reform crisis 2008.

    PubMed

    Weinstein, Stuart L

    2009-02-01

    The crisis of medical liability has resulted in drastic increases in insurance premiums and reduced access for patients to specialty care, particularly in areas such as obstetrics/gynecology, neurosurgery, and orthopaedic surgery. The current liability environment neither effectively compensates persons injured from medical negligence nor encourages addressing system errors to improve patient safety. The author reviews trends across the nation and reports on the efforts of an organization called "Doctors for Medical Liability Reform" to educate the public and lawmakers on the need for solutions to the chaotic process of adjudicating medical malpractice claims in the United States. PMID:18989732

  5. Assessment of substance abusers on the MCMI-III and the Rorschach.

    PubMed

    Vanem, Per-Christian; Krog, Dag; Hartmann, Ellen

    2008-02-01

    We examined 60 substance abusers (SA) on the Millon Clinical Multiaxial Inventory-III (MCMI-III; Millon, 1994) and on eight Rorschach variables from the Comprehensive System (CS; Exner, 2003). On the MCMI-III, SA scored above the cutoff for clinical significance (M > or = BR 70) on Drug Dependence (94.77), Antisocial (82.95), Depressive (74.33), Self-Defeating (71.48), and Alcohol Dependence (70.70). On seven of the CS variables (M+,o,u, XA%, X-%, WSum6Lv2%, M-%, SumT%, and Pure H%) the scores of the SAs suggested significant more psychopathology compared to the scores of 60 university students, whereas the SA's scores on six of these variables (M+,o,u, XA%, X-%, WSum6Lv2%, SumT%, and Pure H%) suggested significantly less psychopathology compared to the scores of 36 schizophrenics. The effect sizes for the significant differences were in the small, medium and large range (d= 0.31 to d= 1.87). PMID:18190406

  6. Assessment and treatment of mood disorders in the context of substance abuse.

    PubMed

    Tolliver, Bryan K; Anton, Raymond F

    2015-06-01

    Recognition and management of mood symptoms in individuals using alcohol and/or other drugs represent a daily challenge for clinicians in both inpatient and outpatient treatment settings. Diagnosis of underlying mood disorders in the context of ongoing substance abuse requires careful collection of psychiatric history, and is often critical for optimal treatment planning and outcomes. Failure to recognize major depression or bipolar disorders in these patients can result in increased relapse rates, recurrence of mood episodes, and elevated risk of completed suicide. Over the past decade, epidemiologic research has clarified the prevalence of comorbid mood disorders in substance-dependent individuals, overturning previous assumptions that depression in these patients is simply an artifact of intoxication and/or withdrawal, therefore requiring no treatment. However, our understanding of the bidirectional relationships between mood and substance use disorders in terms of their course(s) of illness and prognoses remains limited. Like-wise, strikingly little treatment research exists to guide clinical decision making in co-occurring mood and substance use disorders, given their high prevalence and public health burden. Here we overview what is known and the salient gaps of knowledge where data might enhance diagnosis and treatment of these complicated patients. PMID:26246792

  7. Integrating legal liabilities in nanomanufacturing risk management.

    PubMed

    Mohan, Mayank; Trump, Benjamin D; Bates, Matthew E; Monica, John C; Linkov, Igor

    2012-08-01

    Among other things, the wide-scale development and use of nanomaterials is expected to produce costly regulatory and civil liabilities for nanomanufacturers due to lingering uncertainties, unanticipated effects, and potential toxicity. The life-cycle environmental, health, and safety (EHS) risks of nanomaterials are currently being studied, but the corresponding legal risks have not been systematically addressed. With the aid of a systematic approach that holistically evaluates and accounts for uncertainties about the inherent properties of nanomaterials, it is possible to provide an order of magnitude estimate of liability risks from regulatory and litigious sources based on current knowledge. In this work, we present a conceptual framework for integrating estimated legal liabilities with EHS risks across nanomaterial life-cycle stages using empirical knowledge in the field, scientific and legal judgment, probabilistic risk assessment, and multicriteria decision analysis. Such estimates will provide investors and operators with a basis to compare different technologies and practices and will also inform regulatory and legislative bodies in determining standards that balance risks with technical advancement. We illustrate the framework through the hypothetical case of a manufacturer of nanoscale titanium dioxide and use the resulting expected legal costs to evaluate alternative risk-management actions. PMID:22717005

  8. Self Concept of Adolescent Sexual Abuse Victims.

    ERIC Educational Resources Information Center

    Orr, Donald P.; Downes, Maureen C.

    1985-01-01

    To assess the self-concept and psychological profile associated with sexual abuse, 20 young female victims evaluated in a sexual abuse clinic completed the Offer Self-Image Questionnaire. (Author/LMO)

  9. 26 CFR 1.752-1 - Treatment of partnership liabilities.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... definitions apply: (1) Recourse liability defined. A partnership liability is a recourse liability to the extent that any partner or related person bears the economic risk of loss for that liability under § 1.752-2. (2) Nonrecourse liability defined. A partnership liability is a nonrecourse liability to...

  10. Assessing Primary School Student-Teachers' Pedagogic Implementations in Child Sexual Abuse Protection Education

    ERIC Educational Resources Information Center

    Goldman, Juliette D. G.; Bradley, Graham L.

    2011-01-01

    Teacher-educators need ways of assessing the adequacy of university curriculum and the extent to which student-teachers meet learning objectives. One potentially useful tool is Anderson and Krathwohl's (Addison Wesley Longman, New York, 2001) theoretical framework, which can be applied to assess student-teachers' knowledge types and their…

  11. Strength-Based Assessment of Adolescents Who Abuse Drugs: Implications for Helping High-Risk Youth

    ERIC Educational Resources Information Center

    Cosden, Merith; Panteleakos, Frances; Gutierrez, Lisa; Barazani, Sivan; Gottheil, Elisa

    2004-01-01

    Strength-based assessments were designed to assess more completely the outcomes for youth having academic and behavioral problems in the schools. This approach has gained appeal among those working with adolescents who have serious behavior problems, such as those involved in drug use and related delinquent behavior. Traditional assessment…

  12. Drugs of abuse in maternal hair and paired neonatal meconium: an objective assessment of foetal exposure to gestational consumption.

    PubMed

    Joya, Xavier; Marchei, Emilia; Salat-Batlle, Judith; García-Algar, Oscar; Calvaresi, Valeria; Pacifici, Roberta; Pichini, Simona

    2016-08-01

    In a prospective sample of 80 mother-infant dyads, we investigated whether drugs of abuse in maternal hair measured during the pregnancy trimesters were also present in neonatal meconium. Principal drugs of abuse were analyzed in the three consecutive maternal hair segments and meconium samples by ultra-performance liquid chromatography tandem mass spectrometry assay. Of the 80 mothers, 32 (40%) presented one or more hair shafts with at least one of the analyzed drugs of abuse and/or its metabolites. The drug of abuse with a higher prevalence in our study population was methamphetamine: 19 mothers had methamphetamine in one or more hair segments (59.4%). The second most detected drug of abuse was cocaine; nine mothers presented cocaine in one or more hair segments (28.1%). Nineteen pregnant women consumed at least one drug of abuse during the first trimester, ten continued consuming drugs of abuse during the second trimester; and nine consumed until the end of pregnancy. Five of the nine newborns from mothers who consumed drugs during the whole pregnancy showed drugs of abuse in meconium samples. Newborns from the 23 remaining mothers with one or two hair shafts positive to drugs of abuse did not present drugs in their meconium. Indeed from these results, it seems that discontinuous and/or sporadic consumption during pregnancy could produce a negligible transplacental passage and hence negative results in meconium. Furthermore, the role of placenta in the metabolism and excretion of drugs of abuse is still to be precisely investigated. Copyright © 2015 John Wiley & Sons, Ltd. PMID:26627903

  13. The malpractice liability crisis.

    PubMed

    Brenner, R James; Smith, John J

    2004-01-01

    Most medical malpractice cases are tried under the civil tort of negligence and are often triggered by adverse outcomes. These proceedings are aimed primarily at determining whether the conduct of a health care provider was reasonable. Such legal actions have mostly been subject to state jurisdiction. Increasingly, a number of factors are converging that are threatening the continued practice of medicine in some states and hence patients' access to care. These include higher amounts of monetary damages awarded to successful plaintiffs, consequent rising malpractice premiums, and the threatened economic insolvency of medical liability insurance carriers as a result of the broader economic downturn. The result is a serious public health dilemma. The national scope of the problem has been considered a crisis, which has prompted unprecedented federal legislative proposals directed toward providing new and preemptive parameters for capitated noneconomic damages, restrictions on certain civil procedures affecting lawsuit outcomes, and methods for attorney compensation, which some states have either not previously addressed or found unconstitutional. A survey of different states' problems and common issues should assist the reader in understanding the nature of the crisis and proposed solutions. PMID:17411514

  14. Study protocol for promoting respectful maternity care initiative to assess, measure and design interventions to reduce disrespect and abuse during childbirth in Kenya

    PubMed Central

    2013-01-01

    Background Increases in the proportion of facility-based deliveries have been marginal in many low-income countries in the African region. Preliminary clinical and anthropological evidence suggests that one major factor inhibiting pregnant women from delivering at facility is disrespectful and abusive treatment by health care providers in maternity units. Despite acknowledgement of this behavior by policy makers, program staff, civil society groups and community members, the problem appears to be widespread but prevalence is not well documented. Formative research will be undertaken to test the reliability and validity of a disrespect and abuse (D&A) construct and to then measure the prevalence of disrespect and abuse suffered by clinic clients and the general population. Methods/design A quasi-experimental design will be followed with surveys at twelve health facilities in four districts and one large maternity hospital in Nairobi and areas before and after the introduction of disrespect and abuse (D&A) interventions. The design is aimed to control for potential time dependent confounding on observed factors. Discussion This study seeks to conduct implementation research aimed at designing, testing, and evaluating an approach to significantly reduce disrespectful and abusive (D&A) care of women during labor and delivery in facilities. Specifically the proposed study aims to: (i) determine the manifestations, types and prevalence of D&A in childbirth (ii) develop and validate tools for assessing D&A (iii) identify and explore the potential drivers of D&A (iv) design, implement, monitor and evaluate the impact of one or more interventions to reduce D&A and (v) document and assess the dynamics of implementing interventions to reduce D&A and generate lessons for replication at scale. PMID:23347548

  15. The Child Abuse Storm Scale: Part 2--Presumed Abusive.

    ERIC Educational Resources Information Center

    Strickland, Jim

    1999-01-01

    Presents the Child Abuse Storm Scale as a method for assessing the potential for false reports of child abuse resulting in prosecutions. Focuses on the prosecutorial techniques that contribute to false-report errors. Maintains that safeguarding the separation of the responsibilities of protective service workers and therapists from…

  16. Development of a personalized bidirectional text messaging tool for HIV adherence assessment and intervention among substance abusers.

    PubMed

    Ingersoll, Karen; Dillingham, Rebecca; Reynolds, George; Hettema, Jennifer; Freeman, Jason; Hosseinbor, Sharzad; Winstead-Derlega, Chris

    2014-01-01

    We describe the development of a two-way text messaging intervention tool for substance users who are non-adherent with HIV medications, and examine message flow data for feasibility and acceptability. The assessment and intervention tool, TxText, is fully automated, sending participants mood, substance use, and medication adherence queries by text message. Participants respond, the tool recognizes the category of response, and sends the personalized intervention message that participants designed in return. In 10months, the tool sent 16,547 messages (half initial, half follow-up) to 31 participants assigned to the TxText condition, who sent 6711 messages in response to the initial messages. Response rates to substance use (n=2370), medication (n=2918) and mood (n=4639) queries were 67, 69, and 64%, respectively. Responses indicating medication adherence, abstinence from substances, and good moods were more common than negative responses. The TxText tool can send messages daily over a 3month period, receive responses, and decode them to deliver personalized affirming or intervention messages. While we await the outcomes of a pilot randomized trial, the process analysis shows that TxText is acceptable and feasible for substance abusers with HIV, and may serve as a complement to HIV medical care. PMID:24029625

  17. Analysis of drugs of abuse by online SPE-LC high resolution mass spectrometry: communal assessment of consumption.

    PubMed

    Heuett, Nubia V; Ramirez, Cesar E; Fernandez, Adolfo; Gardinali, Piero R

    2015-04-01

    An online SPE-LC-HRMS method was developed to monitor the consumption of 18 drugs of abuse (DOAs) including amphetamines, opioids, cocainics, cannabinoids, lysergics, and their corresponding metabolites in a well characterized college campus setting via wastewater analysis. Filtered and diluted (10×) sewage water samples (5 mL inj.) were automatically pre-concentrated and analyzed in 15 min using a Thermo EQuan MAX online SPE system equipped with a HyperSep™ Retain PEP (20×2.1 mm×12 μm) SPE column and a Hypersil Gold™ aQ (150×2.1 mm×3 μm) analytical column. A Q Exactive™ Hybrid Quadrupole-Orbitrap HRMS was used in full scan mode (R=140,000) for positive identification, and quantitation of target compounds. Method detection limits for all analytes ranged between 0.6 and 1.7 ng/L in sewage. A total of 14 DOAs were detected from two different locations (dorms and main college campus) within a one-year period. Most frequently detected drugs throughout the entire study were amphetamine (>96%) and THC's metabolite 11-nor-9-carboxy-Δ-9-THC (>100%) with maximum concentrations of 5956 and 2413 ng/L respectively. Daily doses per 1000 people were determined in order to assess consumption of THC, amphetamine, heroin and cocaine, in both dorms and main campus. PMID:25553546

  18. Screening Spouse Abusers for Child Abuse Potential.

    ERIC Educational Resources Information Center

    Milner, Joel S.; Gold, Ruth G.

    1986-01-01

    Investigated the ability of the Child Abuse Potential Inventory to screen for child abuse in a group of spouse abusers. The completed, valid protocols revealed that 36.5 percent of the spouse abusers had elevated child abuse scores, while only 9.1 percent of the nonabusers had elevated abuse scores. (Author/BL)

  19. Developmental epidemiology of drug use and abuse in adolescence and young adulthood: Evidence of generalized risk

    PubMed Central

    Palmer, R.H.C.; Young, S.E.; Hopfer, C.J.; Corley, R.P.; Stallings, M.C.; Crowley, T.J.; Hewitt, J.K.

    2009-01-01

    Past studies highlight a narrowing gender gap and the existence of a shared etiology across substances of abuse; however, few have tested developmental models using longitudinal data. We present data on developmental trends of alcohol, tobacco, and marijuana use, abuse and dependence assessed during adolescence and young adulthood in a community-based Colorado twin sample of 1733 respondents through self-report questionnaires and structured psychiatric interviews. Additionally, we report on the rates of multiple substance use and disorders at each developmental stage, and the likelihood of a substance use disorder (SUD; i.e., abuse or dependence) diagnosis in young adulthood based on adolescent drug involvement. Most notably, we evaluate whether the pattern of multiple substance use and disorders and likelihood ratios across substances support a model of generalized risk. Lastly, we evaluate whether the ranked magnitudes of substance-specific risk match the addiction liability ranking. Substance use and SUDs are developmental phenomena, which increase from adolescence to young adulthood with fewand inconsistent gender differences. Adolescents and young adults are not specialized users, but rather tend to use or abuse multiple substances increasingly with age. Risk analyses indicated that progression toward a SUD for any substance was increased with prior involvement with any of the three substances during adolescence. Despite the high prevalence of alcohol use, tobacco posed the greatest substance-specific risk for developing subsequent problems. Our data also confirm either a generalized risk or correlated risk factors for early onset substance use and subsequent development of SUDs. PMID:19250776

  20. 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…

  1. Sexual abuses.

    PubMed

    Abel, G G; Rouleau, J L

    1995-03-01

    The sexual abuses described in this article are occurring so frequently that they constitute a public health problem. Superficially they appear to be quite dissimilar because they involve individuals of different ages, different settings, and different power relationships. Basic to each of them, however, is an absence of consent by the victim and the misuse of power by the perpetrator in order to accomplish the abuse. We now have an adequate understanding of each of these abuses and it is now time to make a concerted effort to stop these abuses. This will require the combined efforts of the education of the public, improved identification of the abuses, treatment of the victims, and an appropriate criminal justice response combined with treatment of the perpetrator. PMID:7761302

  2. Assessment of radionuclide retardation: uses and abuses of natural analogue studies

    NASA Astrophysics Data System (ADS)

    McKinley, Ian G.; Russell Alexander, W.

    1993-06-01

    Various techniques which have been reported for the in situ determination of radionuclide sorption or retardation as part of natural analogue studies have been critically assessed. In particular cases, the tacit assumptions used to derive retardation data from field observations can be shown to be questionable or, indeed, totally incorrect. Some problems identified are due to ambiguous or inconsistent use of terminology, but a fundamental error which commonly arises is the failure to distinguish between sorption and precipitation — processes which are treated quite differently in transport models. Natural analogue studies can be used to test radionuclide migration models and their associated databases, but considerable efforts are required to adequately characterise the geochemical process occurring. Without such extensive studies, the general applicability of data produced is limited and claims to derive parameters usable in repository performance assessment should be treated with considerable caution.

  3. Maternal and neonatal hair and breast milk in the assessment of perinatal exposure to drugs of abuse.

    PubMed

    Joya, Xavier; Pacifici, Roberta; Salat-Batlle, Judith; García-Algar, Oscar; Pichini, Simona

    2015-01-01

    Perinatal exposure to one or more drugs of abuse can affect the neonate temporarily or permanently. In addition to meconium, the evaluation of perinatal exposure to drugs of abuse has been achieved by testing biological matrices coming from the newborn (neonatal hair) and from the pregnant or nursing mother (maternal hair and breast milk). These matrices have the advantage of noninvasive collection and account for a sizable time window of active and passive exposure. Sensitive and specific analytical methods are required to determine minute amounts of drugs of abuse and metabolites in these matrices. The present manuscript reviews the newest analytical methods developed to detect drugs of abuse as well as ethanol biomarkers in maternal and neonatal hair and breast milk. PMID:26045006

  4. Are Child Abusers Sexually Attracted to Submissiveness? Assessment of Sex-Related Cognition With the Implicit Association Test.

    PubMed

    Kanters, Thijs; Hornsveld, Ruud H J; Nunes, Kevin L; Huijding, Jorg; Zwets, Almar J; Snowden, Robert J; Muris, Peter; van Marle, Hjalmar J C

    2016-08-01

    Child sexual abuse is associated with social anxiety, low self-esteem, and intimacy deficits. This, in combination with the core belief of a dangerous world, might suggest that child abusers are sexually attracted to submissiveness. The Implicit Association Test (IAT) was used to examine this hypothesis. Results indicated that child abusers have a stronger sexual preference for submissiveness than rapists, although there were no differences between child abusers and non-sexual offenders. Multinomial logistic regression analysis revealed that submissive-sexy associations have incremental value over child-sex associations in differentiating child abusers from other offenders. The predictive value of both implicit associations was explored by correlating IAT scores with measures for recidivism risk, aggression, and interpersonal anxiety. Child abusers with stronger child-sex associations reported higher levels of interpersonal anxiety and hostility. More research on implicit cognition in sex offenders is required for a better understanding of what these and similar implicit measures are exactly measuring and what role implicit cognition may play in sexual offending. PMID:25079778

  5. Children with burn injuries-assessment of trauma, neglect, violence and abuse

    PubMed Central

    Toon, Michael H.; Maybauer, Dirk M.; Arceneaux, Lisa L.; Fraser, John F.; Meyer, Walter; Runge, Antoinette; Maybauer, Marc O.

    2011-01-01

    Abstract: Burns are an important cause of injury to young children, being the third most frequent cause of injury resulting in death behind motor vehicle accidents and drowning. Burn injuries account for the greatest length of stay of all hospital admissions for injuries and costs associated with care are substantial. The majority of burn injuries in children are scald injuries resulting from hot liquids, occurring most commonly in children aged 0-4 years. Other types of burns include electrical, chemical and intentional injury. Mechanisms of injury are often unique to children and involve exploratory behavior without the requisite comprehension of the dangers in their environment. Assessment of the burnt child includes airway, breathing and circulation stabilization, followed by assessment of the extent of the burn and head to toe examination. The standard rule of 9s for estimating total body surface area (TBSA) of the burn is inaccurate for the pediatric population and modifications include utilizing the Lund and Browder chart, or the child's palm to represent 1% TBSA. Further monitoring may include cardiac assessment, indwelling catheter insertion and evaluation of inhalation injury with or without intubation depending on the context of the injury. Risk factors and features of intentional injury should be known and sought and vital clues can be found in the history, physical examination and common patterns of presentation. Contemporary burn management is underscored by several decades of advancing medical and surgical care however, common to all injuries, it is in the area of prevention that the greatest potential to reduce the burden of these devastating occurrences exists. PMID:21498973

  6. Animal Models of Substance Abuse and Addiction: Implications for Science, Animal Welfare, and Society

    PubMed Central

    Lynch, Wendy J; Nicholson, Katherine L; Dance, Mario E; Morgan, Richard W; Foley, Patricia L

    2010-01-01

    Substance abuse and addiction are well recognized public health concerns, with 2 NIH institutes (the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism) specifically targeting this societal problem. As such, this is an important area of research for which animal experiments play a critical role. This overview presents the importance of substance abuse and addiction in society; reviews the development and refinement of animal models that address crucial areas of biology, pathophysiology, clinical treatments, and drug screening for abuse liability; and discusses some of the unique veterinary, husbandry, and IACUC challenges associated with these models. PMID:20579432

  7. 7 CFR 1717.903 - Liability.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... for Supplemental Financing Required by 7 CFR 1710.110 § 1717.903 Liability. It is the intent of this... for lien accommodations or lien subordinations, shall not give rise to liability of any kind on...

  8. [Procedures for establishing professional liability].

    PubMed

    Budić, Nikolina

    2008-01-01

    All the greater exposure to the procedures for determining liability for the conduct of medical activity points to the need that members of the Croatian Medical Chamber know the basis for establishing liability. Therefore, it is necessary to expose the reasons why the doctors are professionals and what kind of responsibility can be determined, in which procedures it is implemented, and what are the types of possible sanctions. Croatian Medical Chamber has a special role is, as it at the same time protects the rights and represents the interests of doctors, and enforces disciplinary proceedings. PMID:19146187

  9. Elder abuse.

    PubMed

    Costa, A J

    1993-06-01

    Elder abuse is a tragedy both for the individual and for society because it occupies a pivotal position in the family life cycle of violence. Great variety exists among victims, abusers, and situations; thus, no single model is adequate to explain cause and direct treatment. Primary care physicians must be alert to the possibility of elder abuse in their patients and aware of resources within their community for managing cases once identified. Federal laws and regulations must take a proactive, long-term approach to the solution of this problem and must respect the autonomy of competent elderly patients. PMID:8356158

  10. 14 CFR 254.4 - Carrier liability.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Carrier liability. 254.4 Section 254.4 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS DOMESTIC BAGGAGE LIABILITY § 254.4 Carrier liability. On any flight segment using large...

  11. 14 CFR 254.4 - Carrier liability.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false Carrier liability. 254.4 Section 254.4 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS DOMESTIC BAGGAGE LIABILITY § 254.4 Carrier liability. On any flight segment using large...

  12. 14 CFR 254.4 - Carrier liability.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Carrier liability. 254.4 Section 254.4 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS DOMESTIC BAGGAGE LIABILITY § 254.4 Carrier liability. On any flight segment using large...

  13. 14 CFR 254.4 - Carrier liability.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Carrier liability. 254.4 Section 254.4 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS DOMESTIC BAGGAGE LIABILITY § 254.4 Carrier liability. On any flight segment using large...

  14. 14 CFR 254.4 - Carrier liability.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Carrier liability. 254.4 Section 254.4 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS DOMESTIC BAGGAGE LIABILITY § 254.4 Carrier liability. On any flight segment using large...

  15. 40 CFR 267.147 - Liability requirements.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 CFR 264.147(j). (2) Surety bond for liability coverage. An owner or operator may meet the requirements of this section by obtaining a surety bond for liability coverage as specified in 40 CFR 264.147(i... section by obtaining a letter of credit for liability coverage as specified in 40 CFR 264.147(h)....

  16. 48 CFR 28.307-2 - Liability.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Liability. 28.307-2 Section 28.307-2 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS BONDS AND INSURANCE Insurance 28.307-2 Liability. (a) Workers' compensation and employer's liability. Contractors are required to...

  17. 48 CFR 28.307-2 - Liability.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Liability. 28.307-2 Section 28.307-2 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS BONDS AND INSURANCE Insurance 28.307-2 Liability. (a) Workers' compensation and employer's liability. Contractors are required to...

  18. 33 CFR 401.23 - Liability insurance.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Liability insurance. 401.23....23 Liability insurance. (a) It is a condition of approval of an application for preclearance that the vessel is covered by liability insurance equal to or exceeding $100 per gross registered ton. (b)...

  19. 29 CFR 18.411 - Liability insurance.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 1 2011-07-01 2011-07-01 false Liability insurance. 18.411 Section 18.411 Labor Office of... OF ADMINISTRATIVE LAW JUDGES Rules of Evidence Relevancy and Its Limits § 18.411 Liability insurance... evidence of insurance against liability when offered for another purpose, such as proof of...

  20. 29 CFR 18.411 - Liability insurance.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Liability insurance. 18.411 Section 18.411 Labor Office of... OF ADMINISTRATIVE LAW JUDGES Rules of Evidence Relevancy and Its Limits § 18.411 Liability insurance... evidence of insurance against liability when offered for another purpose, such as proof of...

  1. 33 CFR 401.23 - Liability insurance.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Liability insurance. 401.23....23 Liability insurance. (a) It is a condition of approval of an application for preclearance that the vessel is covered by liability insurance equal to or exceeding $100 per gross registered ton. (b)...

  2. Liability Management for Outdoor Experiential Programs.

    ERIC Educational Resources Information Center

    White, Frank

    1995-01-01

    Outdoor experiential program providers must be aware of certain issues in order to reduce or eliminate liability claims against their organization and employees. These include liability insurance, liability education, risk control, and record keeping. Recommends that all outdoor program providers provide risk management training to employees and…

  3. Elder Abuse

    MedlinePlus

    ... to watch or be part of sexual acts. Money Matters: Financial Abuse and Healthcare Fraud After Victor’s ... the past 6 months, Victor has been taking money from their account for his own use. He ...

  4. Noninvasive assessment of the risk of tobacco abuse in oral mucosa using fluorescence spectroscopy: a clinical approach

    NASA Astrophysics Data System (ADS)

    Nazeer, Shaiju S.; Asish, Rajashekharan; Venugopal, Chandrashekharan; Anita, Balan; Gupta, Arun Kumar; Jayasree, Ramapurath S.

    2014-05-01

    Tobacco abuse and alcoholism cause cancer, emphysema, and heart disease, which contribute to high death rates, globally. Society pays a significant cost for these habits whose first demonstration in many cases is in the oral cavity. Oral cavity disorders are highly curable if a screening procedure is available to diagnose them in the earliest stages. The aim of the study is to identify the severity of tobacco abuse, in oral cavity, as reflected by the emission from endogenous fluorophores and the chromophore hemoglobin. A group who had no tobacco habits and another with a history of tobacco abuse were included in this study. To compare the results with a pathological condition, a group of leukoplakia patients were also included. Emission from porphyrin and the spectral filtering modulation effect of hemoglobin were collected from different sites. Multivariate analysis strengthened the spectral features with a sensitivity of 60% to 100% and a specificity of 76% to 100% for the discrimination. Total hemoglobin and porphyrin levels of habitués and leukoplakia groups were comparable, indicating the alarming situation about the risk of tobacco abuse. Results prove that fluorescence spectroscopy along with multivariate analysis is an effective noninvasive tool for the early diagnosis of pathological changes due to tobacco abuse.

  5. Vehicle Safety. Managing Liability Series.

    ERIC Educational Resources Information Center

    Newby, Deborah, Ed.

    This monograph discusses the safety of vehicles owned, leased, maintained, and operated by colleges and universities. First, the risks by colleges and universities is discussed. First, the risks associated with college vehicles are outlined, including the liability that comes with staff/faculty and student drivers and such special concerns as…

  6. University Liability for Sports Injuries.

    ERIC Educational Resources Information Center

    Rieder, Robert W.; Woodruff, William B., Jr.

    1993-01-01

    Analyzes sports injury claims against colleges and universities in recent years to help administrators better understand and minimize liability risks for certain curricular and cocurricular activities. Reviews court cases in areas of duty of care and negligence and proximate cause, and discusses defenses. (Author/NB)

  7. Schoolyard Ponds: Safety and Liability.

    ERIC Educational Resources Information Center

    Danks, Sharon Gamson

    2001-01-01

    Engaging, attractive schoolyard ponds provide habitat for wildlife and hold great educational promise. Reviews water safety and liability issues including mud, stagnant pond water that serves as mosquito breeding grounds, and drowning. Offers ideas for creatively addressing those issues through site planning, shallow water depth, signage and…

  8. School Liability for Student Suicides.

    ERIC Educational Resources Information Center

    Bjorklun, Eugene C.

    1996-01-01

    Schools and school personnel have moral and ethical responsibilities to take reasonable action to prevent suicides by students. Liability could be imposed if school personnel had knowledge of a student's suicidal intent and failed to take action based on that knowledge. (75 footnotes) (MLF)

  9. 77 FR 27384 - Demurrage Liability

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-10

    ....Ct. 993 (2011) (mem.). \\13\\ Demurrage Liability, EP 707 (STB served Dec. 6, 2010), 75 FR 76,496 (Dec... rulemaking (NPRM), the Board is proposing a rule establishing that a person receiving rail cars from a rail carrier for loading or unloading who detains the cars beyond the ``free time'' provided in the...

  10. Psychological Characteristics of Adolescent Males Who Have Been Sexually Abused.

    ERIC Educational Resources Information Center

    Boisso, Cynthia V.; And Others

    While female victims of sexual abuse have received increased attention, male victims continue to be overlooked. Recognition of effects of sexual abuse has been an important step in increasing identification of and treatment for victims of abuse. To assess the characteristics of male victims, sexually abused male (N=13) and female (N=16)…

  11. Predicting Abused Women With Children Who Return to a Shelter: Development and Use of a Rapid Assessment Triage Tool.

    PubMed

    McFarlane, Judith; Pennings, Jacquelyn; Liu, Fuqin; Gilroy, Heidi; Nava, Angeles; Maddoux, John A; Montalvo-Liendo, Nora; Paulson, René

    2016-02-01

    To develop a tool to predict risk for return to a shelter, 150 women with children, exiting a domestic violence shelter, were evaluated every 4 months for 24 months to determine risk factors for returning to a shelter. The study identified four risk factors, including danger for murder, woman's age (i.e., older women), tangible support (i.e., access to money, transportation), and child witness to verbal abuse of the mother. An easy to use, quick triage tool with a weighted score was derived, which can identify with 90% accuracy abused women with children most likely to return to shelters. PMID:26270386

  12. Assessing Adolescent Substance Abuse Programs with Updated Quality Indicators: The Development of a Consumer Guide for Adolescent Treatment

    PubMed Central

    Cacciola, John S.; Meyers, Kathleen; Bates, Suzanne E.; Rosenwasser, Beth; Arria, Amelia; McLellan, A. Thomas

    2013-01-01

    When adolescent substance abuse requires treatment, few parents know which treatment features are important and which treatment programs are effective. There are few resources to help them select appropriate care. We describe early work on an evaluation method and comparative treatment guide for parents based upon the premise that the quality of a program and its potential effectiveness is a function of the number and frequency of evidence-based treatment practices (EBPs) delivered. Thus, we describe the development of and measurement approach for a set of EBPs toward the goal of developing a Consumer Guide to Adolescent Substance Abuse Treatment. PMID:26417196

  13. Insomnia, Nightmare Frequency, and Nightmare Distress in Victims of Sexual Abuse: The Role of Perceived Social Support and Abuse Characteristics

    ERIC Educational Resources Information Center

    Steine, Iris M.; Krystal, John H.; Nordhus, Inger H.; Bjorvatn, Bjorn; Harvey, Allison G.; Eid, Jarle; Gronli, Janne; Milde, Anne M.; Pallesen, Stale

    2012-01-01

    In this study of victims of sexual abuse, the aim was to investigate the role of perceived social support and abuse characteristics in self-reported insomnia, nightmare frequency, and nightmare distress. Four hundred sixty Norwegian victims of sexual abuse completed a questionnaire assessing perceived social support, abuse characteristics,…

  14. The Effects of Sexual Abuse as a Child on the Risk of Mothers Physically Abusing Their Children: A Path Analysis Using Systems Theory

    ERIC Educational Resources Information Center

    Mapp, Susan C.

    2006-01-01

    Objective: The potential path from sexual abuse as a child to the current risk of physical abuse by mothers was assessed. Ontogenic variables including the experience of the parent's sexual abuse as a child and current depression or substance abuse were expected to have a greater impact on the risk of child abuse than microsystem and exosystem…

  15. The "Word Game": An Innovative Strategy for Assessing Implicit Processes in Parents at Risk for Child Physical Abuse

    ERIC Educational Resources Information Center

    Crouch, Julie L.; Irwin, Lauren M.; Wells, Brett M.; Shelton, Christopher R.; Skowronski, John J.; Milner, Joel S.

    2012-01-01

    Objective: Contemporary theories of child physical abuse (CPA) emphasize the proximal role of social cognitive processes (many of which are implicit in nature) in the occurrence of parental aggression. However, methods that allow for the systematic examination of implicit cognitive processes during the course of aggressive interactions are needed.…

  16. Supporting the Fidelity of Assessment Tools in a Statewide Multisite Residential Substance Abuse Experience for Mothers and Their Children

    ERIC Educational Resources Information Center

    Wolk, James L.; McLaughlin, Mary; Dailey, Sarah

    2006-01-01

    Subsequent to the passage of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, Georgia established 20 gender specific, 6-12 month substance abuse residential programs for TANF mothers and their children. The purpose of this paper is to discuss one aspect of these residential settings, the fidelity of the assessment…

  17. Catch-Up Growth Assessment in Long-Term Physically Neglected and Emotionally Abused Preschool Age Male Children.

    ERIC Educational Resources Information Center

    Olivan, Gonzalo

    2003-01-01

    A longitudinal study examined 20 neglected and emotionally abused boys (ages 30-42 months) who entered foster residential care and remained a year after initial placement. At placement, children showed a mild form of chronic malnutrition with growth failure. Growth failure was reversible after the first year of stay. (Contains references.)…

  18. Assessing Change in Psychosocial Functioning of Incarcerated Girls with a Substance Use Disorder: Gender Sensitive Substance Abuse Intervention

    ERIC Educational Resources Information Center

    Roberts-Lewis, Amelia C.; Welch-Brewer, Chiquitia L.; Jackson, Mary S.; Kirk, Raymond; Pharr, O. Martin

    2010-01-01

    The objective of this preliminary study was to determine the effectiveness of a female gender-specific substance abuse treatment intervention (Holistic Enrichment for At-Risk Teens, or HEART) in improving problems related to personal and social functioning. A quasi-experimental, 2-group pretest and posttest repeated measures design was used to…

  19. Longitudinal Assessment of the Effectiveness of Environmental Management and Enforcement Strategies on College Student Substance Abuse Behaviors

    ERIC Educational Resources Information Center

    Bergen-Cico, Dessa; Urtz, Anastasia; Barreto, Charmaine

    2004-01-01

    In 1998, the Higher Education Act of 1965 (HEA Reauthorization) was amended by the United States Congress, thereby encouraging the development of new strategies on college and university campuses for addressing alcohol and other drug (AOD) abuse. The HEA Reauthorization also served as a catalyst for colleges and universities to develop new…

  20. Authenticity of recovered sexual abuse memories: a Rorschach study.

    PubMed

    Leavitt, F; Labott, S M

    1996-07-01

    Distinguishing authentic abuse from false memory among adults who recover memories of childhood sexual trauma has far-reaching significance. This study initially examined 13 previously reported Rorschach signs of sexual abuse in women not abused, and women sexually abused (and not amnestic). The abuse signs were more prevalent in the abused group. A sexual abuse index composed of 8 signs correctly classified 93% of the abused, and 98% of the nonabused group. The index was then applied to women who recovered memories of abuse; some had analogues of dissociation in their protocols and others did not. Those exhibiting dissociative signs produced more signs of sexual abuse. The index classified 88% of the dissociative group as abused, but only 24% of the nondissociative group. The relevance of these findings for assessing authenticity of recovered memories is explored. PMID:8827651

  1. The Relationship between Bullying and Animal Abuse Behaviors in Adolescents: The Importance of Witnessing Animal Abuse

    ERIC Educational Resources Information Center

    Gullone, Eleonora; Robertson, Nerida

    2008-01-01

    Children's abuse of animals may be predictive of aggression towards humans. This study assessed concurrent engagement in animal abuse and bullying behaviour in 241 adolescents aged 12 to 16 years. A total of 20.6% of youths reported abusing animals at least "sometimes" and 17.8% reported bullying others on at least one occasion in the past year.…

  2. Assessment of unsuspected exposure to drugs of abuse in children from a Mediterranean city by hair testing.

    PubMed

    Pichini, Simona; Garcia-Algar, Oscar; Alvarez, Airam; Gottardi, Massimo; Marchei, Emilia; Svaizer, Fiorenza; Pellegrini, Manuela; Rotolo, Maria Concetta; Pacifici, Roberta

    2014-02-01

    Hair testing was used to investigate the prevalence of unsuspected exposure to drugs of abuse in a group of children presenting to an urban paediatric emergency department without suggestive signs or symptoms. Hair samples were obtained from 114 children between 24 months and 10 years of age attending the emergency room of Hospital del Mar in Barcelona, Spain. Hair samples from the accompanying parent were also collected. The samples were analyzed for the presence of opiates, cocaine, amphetamines, and cannabinoids by ultra-performance liquid chromatography-tandem mass spectrometry. Parental sociodemographics and possible drug of abuse history were recorded. Hair samples from twenty-three children (20.1%) were positive for cocaine (concentration range 0.15-3.81 ng/mg hair), those of thirteen children (11.4%) to cannabinoids (D9-THC concentration range 0.05-0.54 ng/mg hair), with four samples positive to codeine (0.1-0.25 ng/mg hair), one positive for 2.09 ng methadone per mg hair and one to 6-MAM (0.42 ng/mg hair) and morphine (0. 15 ng/mg hair) . In 69.5 and 69.2% of the positive cocaine and cannabinoids cases respectively, drugs was also found in the hair of accompanying parent. Parental sociodemographics were not associated with children exposure to drugs of abuse. However, the behavioural patterns with potential harmful effects for the child's health (e.g., tobacco smoking, cannabis, benzodiazepines and/or antidepressants use) were significantly higher in the parents of exposed children. In the light of the obtained results (28% overall children exposure to drugs of abuse) and in agreement with 2009 unsuspected 23% cocaine exposure in pre-school children from the same hospital, we support general hair screening to disclose exposure to drugs of abuse in children from risky environments to provide the basis for specific social and health interventions. PMID:24566054

  3. [Expert advice in liability cases].

    PubMed

    Brands, W G

    2009-05-01

    Concerning cases of liability, dentists in the future will probably have to call on expert help or act as experts on behalf of a colleague with increasing frequency. Dentists who consider acting as experts in liability cases will have to develop their expertise especially in civil law and disciplinary law. Matters which in this respect should receive special attention are: the expert must act in conformity with the law on Medical Treatment Agreement; the expert's report must make clear what the legal basis is of the report's conclusions; the legal basis must be substantially supported by the facts, conditions and findings that are mentioned in the report; the expert must act independently and refrain from subjective judgments, assumptions and unprofessional and prejudicial qualifications. PMID:19507415

  4. [Liability of the expert witness].

    PubMed

    Jansen, C

    1996-11-01

    Regarding the liability of the expert witness, is has to be differentiated between the responsibility according to the civil law and the criminal law. Responsibility in the criminal law means the punishableness for the guilty and illegal fulfillment of a criminal offense in the legal sense, while responsibility in the civil law means compensation towards another citizen. Criminal prosecution occurs ex officio. Prerequisite for prosecution in the civil law is an action of the victim. PMID:9064937

  5. Understanding elder abuse in family practice

    PubMed Central

    Yaffe, Mark J.; Tazkarji, Bachir

    2012-01-01

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

  6. Remedial Action Assessment System (RAAS): Evaluation of selected feasibility studies of CERCLA (Comprehensive Environmental Response, Compensation, and Liability Act) hazardous waste sites

    SciTech Connect

    Whelan, G. ); Hartz, K.E.; Hilliard, N.D. and Associates, Seattle, WA )

    1990-04-01

    Congress and the public have mandated much closer scrutiny of the management of chemically hazardous and radioactive mixed wastes. Legislative language, regulatory intent, and prudent technical judgment, call for using scientifically based studies to assess current conditions and to evaluate and select costeffective strategies for mitigating unacceptable situations. The NCP requires that a Remedial Investigation (RI) and a Feasibility Study (FS) be conducted at each site targeted for remedial response action. The goal of the RI is to obtain the site data needed so that the potential impacts on public health or welfare or on the environment can be evaluated and so that the remedial alternatives can be identified and selected. The goal of the FS is to identify and evaluate alternative remedial actions (including a no-action alternative) in terms of their cost, effectiveness, and engineering feasibility. The NCP also requires the analysis of impacts on public health and welfare and on the environment; this analysis is the endangerment assessment (EA). In summary, the RI, EA, and FS processes require assessment of the contamination at a site, of the potential impacts in public health or the environment from that contamination, and of alternative RAs that could address potential impacts to the environment. 35 refs., 7 figs., 1 tab.

  7. Abuse Potential of Intranasal Buprenorphine versus Buprenorphine/Naloxone in Buprenorphine-Maintained Heroin Users

    PubMed Central

    Jones, Jermaine D.; Sullivan, Maria A.; Vosburg, Suzanne K.; Manubay, Jeanne M.; Mogali, Shanthi; Metz, Verena; Comer, Sandra D.

    2014-01-01

    In spite of the clinical utility of buprenorphine, parenteral abuse of this medication has been reported in several laboratory investigations and in the real world. Studies have demonstrated lower abuse liability of the buprenorphine/naloxone combination relative to buprenorphine alone. However, clinical research has not yet examined the utility of the combined formulation to deter intranasal use in a buprenorphine-maintained population. Heroin-using volunteers (n = 12) lived in the hospital for 8–9 weeks and were maintained on each of three sublingual buprenorphine doses (2, 8, 24 mg). Under each maintenance dose, participants completed laboratory sessions during which the reinforcing and subjective effects of intranasal doses of buprenorphine (8, 16 mg), buprenorphine/naloxone (8/2, 8/8, 8/16, 16/4 mg) and controls (placebo, heroin 100 mg, naloxone 4 mg) were assessed. Intranasal buprenorphine alone typically produced increases in positive subjective effects and the 8 mg dose was self-administered above the level of placebo. The addition of naloxone dose-dependently reduced positive subjective effects and increased aversive effects. No buprenorphine/naloxone combination dose was self-administered significantly more than placebo. These data suggest that within a buprenorphine-dependent population, intranasal buprenorphine/naloxone has reduced abuse potential in comparison to buprenorphine alone. These data strongly argue in favor of buprenorphine/naloxone rather than buprenorphine alone as the more reasonable option for managing the risk of buprenorphine misuse. PMID:25060839

  8. Abuse potential of intranasal buprenorphine versus buprenorphine/naloxone in buprenorphine-maintained heroin users.

    PubMed

    Jones, Jermaine D; Sullivan, Maria A; Vosburg, Suzanne K; Manubay, Jeanne M; Mogali, Shanthi; Metz, Verena; Comer, Sandra D

    2015-07-01

    In spite of the clinical utility of buprenorphine, parenteral abuse of this medication has been reported in several laboratory investigations and in the real world. Studies have demonstrated lower abuse liability of the buprenorphine/naloxone combination relative to buprenorphine alone. However, clinical research has not yet examined the utility of the combined formulation to deter intranasal use in a buprenorphine-maintained population. Heroin-using volunteers (n = 12) lived in the hospital for 8-9 weeks and were maintained on each of three sublingual buprenorphine doses (2, 8, 24 mg). Under each maintenance dose, participants completed laboratory sessions during which the reinforcing and subjective effects of intranasal doses of buprenorphine (8, 16 mg), buprenorphine/naloxone (8/2, 8/8, 8/16, 16/4 mg) and controls (placebo, heroin 100 mg, naloxone 4 mg) were assessed. Intranasal buprenorphine alone typically produced increases in positive subjective effects and the 8 mg dose was self-administered above the level of placebo. The addition of naloxone dose dependently reduced positive subjective effects and increased aversive effects. No buprenorphine/naloxone combination dose was self-administered significantly more than placebo. These data suggest that within a buprenorphine-dependent population, intranasal buprenorphine/naloxone has reduced abuse potential in comparison to buprenorphine alone. These data strongly argue in favor of buprenorphine/naloxone rather than buprenorphine alone as the more reasonable option for managing the risk of buprenorphine misuse. PMID:25060839

  9. Initial Assessment of Stewards of Children Program Effects on Child Sexual Abuse Reporting Rates in Selected South Carolina Counties.

    PubMed

    Letourneau, Elizabeth J; Nietert, Paul J; Rheingold, Alyssa A

    2016-02-01

    Child sexual abuse (CSA) prevention programs often include a focus on increased reporting of suspected abuse, in addition to other prevention components such as helping trainees recognize suspected abusive situations. This study aimed to determine whether the Stewards of Children prevention program is associated with increased CSA reporting. Analyses examined whether rates of CSA allegations increased over time in three counties in South Carolina (SC) targeted with program dissemination efforts and whether CSA reporting trends differed between the three targeted counties and three comparison counties that did not experience substantial program dissemination. CSA allegation data were obtained by county and year for predissemination and postdissemination periods from the SC Department of Social Services. Results indicated that, for the targeted counties but not the nontargeted counties, estimated allegation rates increased significantly over time, corresponding with the onset of significant program dissemination efforts. Results also indicated significant between-groups differences in allegation trends for targeted versus nontargeted counties. These findings suggest that the Stewards prevention intervention may be associated with increased CSA allegations. However, results require replication with randomization of counties. Moreover, whether increased reporting is associated with decreased CSA incidence remains unknown. PMID:26530898

  10. The development of abused children.

    PubMed

    Oates, R K; Peacock, A; Forrest, D

    1984-10-01

    Thirty-nine children were reviewed who had suffered child abuse at an average of 5 1/2 years earlier. In comparison with a group matched for socio-economic status, the abused children performed significantly lower on the Wechsler Intelligence Scale, and were more delayed in language development and reading ability. Their teachers' assessments of behaviour showed significantly more abnormal profiles than in the comparison group. These differences could not be accounted for by the small proportion of known head-injuries in the abused group. Child abuse has long-term effects, so it is necessary that these children are thoroughly assessed at first presentation, and that they are followed with a specific programme aimed at preventing these sequelae. PMID:6510564

  11. Monoamine transporter inhibitors and substrates as treatments for stimulant abuse.

    PubMed

    Howell, Leonard L; Negus, S Stevens

    2014-01-01

    The acute and chronic effects of abused psychostimulants on monoamine transporters and associated neurobiology have encouraged development of candidate medications that target these transporters. Monoamine transporters, in general, and dopamine transporters, in particular, are critical molecular targets that mediate abuse-related effects of psychostimulants such as cocaine and amphetamine. Moreover, chronic administration of psychostimulants can cause enduring changes in neurobiology reflected in dysregulation of monoamine neurochemistry and behavior. The current review will evaluate evidence for the efficacy of monoamine transporter inhibitors and substrates to reduce abuse-related effects of stimulants in preclinical assays of stimulant self-administration, drug discrimination, and reinstatement. In considering deployment of monoamine transport inhibitors and substrates as agonist-type medications to treat stimulant abuse, the safety and abuse liability of the medications are an obvious concern, and this will also be addressed. Future directions in drug discovery should identify novel medications that retain efficacy to decrease stimulant use but possess lower abuse liability and evaluate the degree to which efficacious medications can attenuate or reverse neurobiological effects of chronic stimulant use. PMID:24484977

  12. Monoamine Transporter Inhibitors and Substrates as Treatments for Stimulant Abuse

    PubMed Central

    Howell, Leonard L.; Negus, S. Stevens

    2015-01-01

    The acute and chronic effects of abused psychostimulants on monoamine transporters and associated neurobiology have encouraged development of candidate medications that target these transporters. Monoamine transporters in general, and dopamine transporters in particular, are critical molecular targets that mediate abuse-related effects of psychostimulants such as cocaine and amphetamine. Moreover, chronic administration of psychostimulants can cause enduring changes in neurobiology reflected in dysregulation of monoamine neurochemistry and behavior. The current review will evaluate evidence for the efficacy of monoamine transporter inhibitors and substrates to reduce abuse-related effects of stimulants in preclinical assays of stimulant self-administration, drug discrimination and reinstatement. In considering deployment of monoamine transport inhibitors and substrates as agonist-type medications to treat stimulant abuse, the safety and abuse liability of the medications are an obvious concern, and this will also be addressed. Future directions in drug discovery should identify novel medications that retain efficacy to decrease stimulant use but possess lower abuse liability, and evaluate the degree to which efficacious medications can attenuate or reverse neurobiological effects of chronic stimulant use. PMID:24484977

  13. Causes of the liability insurance crisis.

    PubMed

    Harrington, S; Litan, R E

    1988-02-12

    In this article the reasons for recent dramatic premium increases for liability insurance are explored by examination of available data on industry premiums, losses, and expenses. The suggestions that the premium increases were primarily caused by collusion among insurers, cyclical behavior, or systematic errors in forecasting losses are rejected. Instead, the evidence indicates that the jump in liability insurance premiums is most plausibly due to the growth in the discounted value of expected liability losses. PMID:3340855

  14. Emotion Regulation in Sexually Abused Preschoolers.

    PubMed

    Langevin, Rachel; Cossette, Louise; Hébert, Martine

    2016-02-01

    Emotion regulation is closely related to mental health in children and adults. Low emotion regulation competencies have been found in school-aged sexually abused girls. The aim of the present study was to investigate emotion regulation competencies in sexually abused preschool girls and boys using a multi-informant approach. Emotion regulation was assessed in 62 sexually abused and 65 non-abused preschoolers using the Emotion Regulation Checklist and the MacArthur Story Stem Battery. Both parents and educators reported lower emotion regulation competencies in sexually abused preschoolers, especially boys, than in non-abused children. The narrative task completed by the children also revealed lower emotion regulation competencies in sexually abused boys. These findings could have an important impact on intervention programs offered to these at-risk children. PMID:25724803

  15. Drugs of abuse and Parkinson's disease.

    PubMed

    Mursaleen, Leah R; Stamford, Jonathan A

    2016-01-01

    The term "drug of abuse" is highly contextual. What constitutes a drug of abuse for one population of patients does not for another. It is therefore important to examine the needs of the patient population to properly assess the status of drugs of abuse. The focus of this article is on the bidirectional relationship between patients and drug abuse. In this paper we will introduce the dopaminergic systems of the brain in Parkinson's and the influence of antiparkinsonian drugs upon them before discussing this synergy of condition and medication as fertile ground for drug abuse. We will then examine the relationship between drugs of abuse and Parkinson's, both beneficial and deleterious. In summary we will draw the different strands together and speculate on the future merit of current drugs of abuse as treatments for Parkinson's disease. PMID:25816790

  16. 7 CFR 1207.365 - Personal liability.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE POTATO RESEARCH AND PROMOTION PLAN Potato Research and Promotion Plan Miscellaneous § 1207.365 Personal liability. No member of...

  17. 7 CFR 1207.365 - Personal liability.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE POTATO RESEARCH AND PROMOTION PLAN Potato Research and Promotion Plan Miscellaneous § 1207.365 Personal liability. No member of...

  18. 7 CFR 1207.365 - Personal liability.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE POTATO RESEARCH AND PROMOTION PLAN Potato Research and Promotion Plan Miscellaneous § 1207.365 Personal liability. No member of...

  19. 7 CFR 1207.365 - Personal liability.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE POTATO RESEARCH AND PROMOTION PLAN Potato Research and Promotion Plan Miscellaneous § 1207.365 Personal liability. No member of...

  20. 7 CFR 1207.365 - Personal liability.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE POTATO RESEARCH AND PROMOTION PLAN Potato Research and Promotion Plan Miscellaneous § 1207.365 Personal liability. No member of...

  1. 7 CFR 1210.361 - Personal liability.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE WATERMELON RESEARCH AND PROMOTION PLAN Watermelon Research and Promotion Plan Miscellaneous § 1210.361 Personal liability. No...

  2. 7 CFR 1210.361 - Personal liability.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE WATERMELON RESEARCH AND PROMOTION PLAN Watermelon Research and Promotion Plan Miscellaneous § 1210.361 Personal liability. No...

  3. 7 CFR 1210.361 - Personal liability.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE WATERMELON RESEARCH AND PROMOTION PLAN Watermelon Research and Promotion Plan Miscellaneous § 1210.361 Personal liability. No...

  4. 7 CFR 1210.361 - Personal liability.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE WATERMELON RESEARCH AND PROMOTION PLAN Watermelon Research and Promotion Plan Miscellaneous § 1210.361 Personal liability. No...

  5. 7 CFR 1210.361 - Personal liability.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE WATERMELON RESEARCH AND PROMOTION PLAN Watermelon Research and Promotion Plan Miscellaneous § 1210.361 Personal liability. No...

  6. Fertility rhymes with liability: medical liability in 'ART'.

    PubMed

    Raposo, Vera Lúcia

    2015-01-01

    Medical malpractice claims have been growing all over the world. Medical acts involving new technologies and complex scientific acknowledgements are especially at stake, since they look particularly threatening to patients and judges and are, effectively, potentially more risky. The reason is that, side by side with traditional medical faults, new sources of liability emerge, as for instance the exchange or misappropriation of genetic material or surplus embryos. The present study analyses some of those new medical faults with the aim of alerting health institutions and health professionals, enlightening them about the juridical consequences of those conducts and providing simple tips to avoid lawsuits and condemnations. PMID:26665349

  7. 7 CFR 1400.204 - Limited partnerships, limited liability partnerships, limited liability companies, corporations...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Limited partnerships, limited liability partnerships... AND SUBSEQUENT CROP, PROGRAM, OR FISCAL YEARS Payment Eligibility § 1400.204 Limited partnerships, limited liability partnerships, limited liability companies, corporations, and other similar...

  8. 7 CFR 1400.204 - Limited partnerships, limited liability partnerships, limited liability companies, corporations...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 10 2011-01-01 2011-01-01 false Limited partnerships, limited liability partnerships... AND SUBSEQUENT CROP, PROGRAM, OR FISCAL YEARS Payment Eligibility § 1400.204 Limited partnerships, limited liability partnerships, limited liability companies, corporations, and other similar...

  9. Genetics Home Reference: hereditary neuropathy with liability to pressure palsies

    MedlinePlus

    ... hereditary neuropathy with liability to pressure palsies hereditary neuropathy with liability to pressure palsies Enable Javascript to ... Download PDF Open All Close All Description Hereditary neuropathy with liability to pressure palsies is a disorder ...

  10. Mediator assessment, documentation, and disposition of child custody cases involving intimate partner abuse: a naturalistic evaluation of one county's practices.

    PubMed

    Beck, Connie J A; Walsh, Michele E; Mechanic, Mindy B; Taylor, Caitilin S

    2010-06-01

    The contentious and costly nature of the adversarial process for resolving child custody disputes has prompted scholars, practitioners, and policy makers to advocate for the development and implementation of less divisive forms of dispute resolution, notably, mediation. Mediation has been championed for its potential to resolve disputes with less acrimony among disputants, reduced economic costs, increased satisfaction with outcomes, and fewer adverse consequences for family members. Despite the increasing popularity, arguments have cautioned against the use of mandated mediation when intimate partner abuse (IPA) is alleged. This research documents a mediation screening process and models mediators' decision-making process as instantiated, naturally, in one jurisdiction. PMID:19412662

  11. 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…

  12. 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

  13. The Academic Consequences of Substance Use and Abuse among Adolescent Males in High School: Implications for Assessment and Intervention for Special Education Students

    ERIC Educational Resources Information Center

    Gomez-Cerrillo, Lino

    2012-01-01

    The problem of middle adolescent substance use and abuse among high school age males was examined. Financial and socio-emotional costs and rates of incidence for substance use and abuse among high school males are addressed followed by a discussion of social, environmental, and intra-psychic factors, which influence substance use and abuse. To…

  14. Psychological Assessment through Performance-Based Techniques and Self-Reports: A Case Study of a Sexually Abused Girl at Preschool Age

    ERIC Educational Resources Information Center

    Khalily, Muhammad Tahir; Hallahan, Brian

    2011-01-01

    We investigated the implicit psychological and behavioral consequences of sexual abuse in an adolescent girl who suffered child sexual abuse at preschool age in this case report. We report the manifestations of this abuse on her personality and psychological functioning using a structured clinical interview and a comprehensive psychological…

  15. Stability of drugs of abuse in oral fluid collection devices with purpose of external quality assessment schemes.

    PubMed

    Ventura, Montse; Pichini, Simona; Ventura, Rosa; Leal, Sonia; Zuccaro, Piergiorgio; Pacifici, Roberta; de la Torre, Rafael

    2009-04-01

    As the stability of drugs of abuse in oral fluid can affect drug testing results, we evaluated this parameter together with recovery for the principal drugs of abuse in two collection devices typically used to ship oral fluid samples to testing laboratories. Two different samples were prepared using Cozart Drug Detection System and Intercept oral fluid collection devices with 600 ng/mL of 6-monoacetylmorphine (6-MAM) and cocaine and 240 ng/mL of Delta-tetrahydrocannabinol (THC) and 11-nor-9-carboxy-Delta-tetrahydrocannabinol (THCCOOH). Samples were sent at ambient temperature by courier to the participating laboratories (n = 19) the same day of preparation. Samples were analyzed upon reception (about 48-72 hours after shipment). Percent coefficients of variation, calculated using robust mean and robust standard deviation, were around 30% for all analytes, except for THCCOOH in both samples (between 50% and 80%) and THC in 1 sample (50%). Percent coefficients of variation were also high (between 50% and 70%) for morphine and benzoylecgonine, formed after 6-MAM and cocaine spontaneous hydrolysis. On average, 9%-12% 6-MAM was converted to morphine and between 26% and 41% cocaine to benzoylecgonine. Good recoveries were observed for the acid metabolite of THC in both collection devices, whereas THC was always scarcely recovered. Depending on the collection device used, obtained results may confound the interpretation and estimation of blood drug concentration, given an oral fluid drug concentration and subsequent consideration of time elapsing from drug consumption. PMID:19307939

  16. 34 CFR 668.138 - Liability.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 3 2012-07-01 2012-07-01 false Liability. 668.138 Section 668.138 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION STUDENT ASSISTANCE GENERAL PROVISIONS Immigration-Status Confirmation § 668.138 Liability. (a) A student is liable for any...

  17. 7 CFR 1412.63 - Contract liability.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 10 2013-01-01 2013-01-01 false Contract liability. 1412.63 Section 1412.63... CROP REVENUE ELECTION PROGRAM FOR THE 2008 AND SUBSEQUENT CROP YEARS Contract Violations and Reduction in Payments § 1412.63 Contract liability. All signatories to a DCP or ACRE program contract...

  18. College and University Liability under Superfund.

    ERIC Educational Resources Information Center

    Manderfeld, Donald J.

    1988-01-01

    A discussion of the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 concerning responsibility for toxic waste disposal looks at college and university liability under the act, institutional defenses that could be raised under the act, and the settlement process. (MSE)

  19. Liability, Athletic Equipment, and the Athletic Trainer.

    ERIC Educational Resources Information Center

    Black, Richard

    Standards of conduct, roles, and responsibilities expected of athletic trainers should be developed and disseminated. These guidelines could be used in court to show that the athletic trainer was following basic standards if he should be charged with liability. A review of liability cases involving athletic injuries received while athletes were…

  20. 12 CFR 229.56 - Liability.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 3 2012-01-01 2012-01-01 false Liability. 229.56 Section 229.56 Banks and Banking FEDERAL RESERVE SYSTEM (CONTINUED) BOARD OF GOVERNORS OF THE FEDERAL RESERVE SYSTEM AVAILABILITY OF FUNDS AND COLLECTION OF CHECKS (REGULATION CC) Substitute Checks § 229.56 Liability. (a)...

  1. 12 CFR 229.56 - Liability.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 3 2011-01-01 2011-01-01 false Liability. 229.56 Section 229.56 Banks and Banking FEDERAL RESERVE SYSTEM (CONTINUED) BOARD OF GOVERNORS OF THE FEDERAL RESERVE SYSTEM AVAILABILITY OF FUNDS AND COLLECTION OF CHECKS (REGULATION CC) Substitute Checks § 229.56 Liability. (a)...

  2. 12 CFR 229.56 - Liability.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 3 2014-01-01 2014-01-01 false Liability. 229.56 Section 229.56 Banks and Banking FEDERAL RESERVE SYSTEM (CONTINUED) BOARD OF GOVERNORS OF THE FEDERAL RESERVE SYSTEM (CONTINUED) AVAILABILITY OF FUNDS AND COLLECTION OF CHECKS (REGULATION CC) Substitute Checks § 229.56 Liability....

  3. 12 CFR 229.56 - Liability.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 3 2013-01-01 2013-01-01 false Liability. 229.56 Section 229.56 Banks and Banking FEDERAL RESERVE SYSTEM (CONTINUED) BOARD OF GOVERNORS OF THE FEDERAL RESERVE SYSTEM (CONTINUED) AVAILABILITY OF FUNDS AND COLLECTION OF CHECKS (REGULATION CC) Substitute Checks § 229.56 Liability....

  4. 12 CFR 229.56 - Liability.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Liability. 229.56 Section 229.56 Banks and Banking FEDERAL RESERVE SYSTEM (CONTINUED) BOARD OF GOVERNORS OF THE FEDERAL RESERVE SYSTEM AVAILABILITY OF FUNDS AND COLLECTION OF CHECKS (REGULATION CC) Substitute Checks § 229.56 Liability. (a)...

  5. 7 CFR 1205.347 - Personal liability.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 10 2011-01-01 2011-01-01 false Personal liability. 1205.347 Section 1205.347 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING... Cotton Research and Promotion Order Miscellaneous § 1205.347 Personal liability. No member or...

  6. 7 CFR 1205.347 - Personal liability.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 10 2014-01-01 2014-01-01 false Personal liability. 1205.347 Section 1205.347 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING... Cotton Research and Promotion Order Miscellaneous § 1205.347 Personal liability. No member or...

  7. 7 CFR 1205.347 - Personal liability.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Personal liability. 1205.347 Section 1205.347 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING... Cotton Research and Promotion Order Miscellaneous § 1205.347 Personal liability. No member or...

  8. 7 CFR 1205.347 - Personal liability.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 10 2012-01-01 2012-01-01 false Personal liability. 1205.347 Section 1205.347 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING... Cotton Research and Promotion Order Miscellaneous § 1205.347 Personal liability. No member or...

  9. 7 CFR 1205.347 - Personal liability.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 10 2013-01-01 2013-01-01 false Personal liability. 1205.347 Section 1205.347 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING... Cotton Research and Promotion Order Miscellaneous § 1205.347 Personal liability. No member or...

  10. Liability Insurance in California Public Schools.

    ERIC Educational Resources Information Center

    California State Dept. of Education, Sacramento.

    In the mid-1970s, an increased number of high-cost liability lawsuits combined with other financial difficulties insurance companies were experiencing to cause drastic increases in insurance rates for schools and a reluctance on the part of insurance carriers to provide liability coverage. Questionnaires returned by county and district school…

  11. 7 CFR 920.69 - Personal liability.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Personal liability. 920.69 Section 920.69 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Miscellaneous Provisions § 920.69 Personal liability. No member or alternate member of the committee and...

  12. Legal liability and workplace violence.

    PubMed

    Brakel, S J

    1998-01-01

    Workplace violence is a growing social problem. Some of this growth may be perceptual, reflecting our new awareness of what constitutes violence in the workplace. Furthermore, much of what falls under its current rubric does not correspond to the classic image of worker-on-worker or worker-on-employer mayhem. Nevertheless, the total number of incidents is alarmingly large; the problem is real. It is natural to consider law (i.e., legal liability) as a potential solution. Aiming the liability threat at the employer may be the most effective and efficient strategy. There are ample theories to choose from: negligence (tort) law, agency law, contract, civil rights, and regulatory law. Judges and juries appear eager to hold employers accountable for violent incidents in the workplace, sometimes in the face of other, more logical constructions of the facts or theory. One's best hope is that the fear this strikes in the hearts of employers will make for maximum preventive results. PMID:9894212

  13. Liability.

    ERIC Educational Resources Information Center

    Hollander, Patricia A.

    The author notes that this chapter deals generally with torts in higher education cases. A tort is usually defined broadly to cover most wrongful civil acts, except breach of contract, that may occur between individuals. The remedy sought in a civil tort action is compensation to the injured party for the damages suffered. The areas discussed here…

  14. Child Sexual Abuse

    MedlinePlus

    ... victim of prolonged sexual abuse usually develops low self-esteem, a feeling of worthlessness and an abnormal or ... can help abused children regain a sense of self-esteem, cope with feelings of guilt about the abuse, ...

  15. Drug abuse first aid

    MedlinePlus

    Drug abuse is the misuse or overuse of any medication or drug, including alcohol. This article discusses first ... use of these drugs is a form of drug abuse. Legitimate medications can be abused by people who ...

  16. 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 ...

  17. 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 ...

  18. Polydrug abuse: a review of opioid and benzodiazepine combination use.

    PubMed

    Jones, Jermaine D; Mogali, Shanthi; Comer, Sandra D

    2012-09-01

    This paper reviews studies examining the pharmacological interactions and epidemiology of the combined use of opioids and benzodiazepines (BZDs). A search of English language publications from 1970 to 2012 was conducted using PubMed and PsycINFO(®). Our search found approximately 200 articles appropriate for inclusion in this paper. While numerous reports indicate that the co-abuse of opioids and BZDs is ubiquitous around the world, the reasons for the co-abuse of these medications are not entirely clear. Though the possibility remains that opioid abusers are using BZDs therapeutically to self-medicate anxiety, mania or insomnia, the data reviewed in this paper suggest that BZD use is primarily recreational. For example, co-users report seeking BZD prescriptions for the purpose of enhancing opioid intoxication or "high," and use doses that exceed the therapeutic range. Since there are few clinical studies investigating the pharmacological interaction and abuse liability of their combined use, this hypothesis has not been extensively evaluated in clinical settings. As such, our analysis encourages further systematic investigation of BZD abuse among opioid abusers. The co-abuse of BZDs and opioids is substantial and has negative consequences for general health, overdose lethality, and treatment outcome. Physicians should address this important and underappreciated problem with more cautious prescribing practices, and increased vigilance for abusive patterns of use. PMID:22857878

  19. An Examination of Immunity Statutes Regarding the Liability of Recreational Youth Sport Organizations for the Pedophilic Actions of Coaches, Administrators, and Officials

    ERIC Educational Resources Information Center

    Baker, Thomas A., III; Connaughton, Daniel P.; Zhang, James J.

    2010-01-01

    Millions of children in the United States participate in youth sports. The literature demonstrates that sexual abuse is a problem in sports. This study examined voluntary immunity statutes for all 50 states and the District of Columbia with the purpose of determining potential liability for recreational youth sport organizations for the pedophilic…

  20. When love hurts: assessing the intersectionality of ethnicity, socio-economic status, parental connectedness, child abuse, and gender attitudes in juvenile violent delinquency.

    PubMed

    Lahlah, Esmah; Lens, Kim M E; Bogaerts, Stefan; van der Knaap, Leontien M

    2013-11-01

    Researchers have not yet reached agreement about the validity of several competing explanations that seek to explain ethnic differences in juvenile violent offending. Ethnicity cannot solely explain why boys with an ethnic minority background commit more (violent) crimes. By assessing the intersectionality of structural, cultural and individual considerations, both the independent effects as well as the interplay between different factors can be examined. This study shows that aforementioned factors cumulatively play a role in severe violent offending, with parental connectedness and child abuse having the strongest associations. However, since most variables interact and ethnicity is associated with those specific factors, a conclusion to be drawn is that ethnicity may be relevant as an additional variable predicting severe violent offending although indirectly. PMID:23932431

  1. Medicare fraud and abuse: implications for physicians.

    PubMed

    Thiel, D K; Friedman, R; Morriss, C H

    1988-01-01

    Since the inception of the Prospective Payment System, the physician fee freeze, and other cost-cutting measures, physicians have been approached with many income-generating opportunities relating to their practices. Unfortunately, many of these opportunities also present potential criminal and civil liability under federal Medicare anti-fraud and abuse provisions. The recent passage of the Medicare and Medicaid Program Patient Protection Act of 1987 has updated federal anti-fraud and abuse laws and expanded the sanctions which may be imposed on physicians. This article describes the types of activities prohibited by federal laws and discusses the operation of these laws in light of common joint venture, incentive, and contract arrangements frequently seen in medical practice. PMID:10302660

  2. Sexual abuse of the elderly mentally ill.

    PubMed Central

    Benbow, S. M.; Haddad, P. M.

    1993-01-01

    Sexual abuse of the elderly may occur more commonly than is recognized. Reasons for the neglect of this area and possible risk factors are discussed. A definition of elder sexual abuse is proposed, and four case histories, each of which raises various issues about the nature, detection and management of sexual abuse, are described. In the absence of procedures for dealing with elder sexual abuse, professional staff need to be open to its occurrence and to be prepared to carry out thorough, sympathetic, collaborative assessments of both parties involved where it is suspected. PMID:8290413

  3. Alcohol Abuse and Depression in Teenagers.

    ERIC Educational Resources Information Center

    King, Cheryl A.

    1993-01-01

    Examines issues of alcohol abuse and depression among teenagers, noting co-occurrence of these two problems and the special challenge co-occurrence poses for clinicians who must treat both problems aggressively. Looks at prevention of alcohol use and abuse among adolescents, considers assessment issues, and distinguishes between primary and…

  4. Child Eyewitness Testimony in Sexual Abuse Investigations.

    ERIC Educational Resources Information Center

    Mapes, Bruce E.

    Intended to help in the forensic investigation of child abuse allegations, this book explores several issues related to children's allegations of sexual abuse and subsequent testimony. Chapter 1 presents an overview of: the informational needs of child welfare agencies and the courts; the scope of the forensic assessment; and the standards and…

  5. Overlooked Issues Relevant in Sexual Abuse.

    ERIC Educational Resources Information Center

    Barham, Martha; Clark, Mary McGinn

    This paper presents clinical observations, experiences, and interventions from group psychotherapy when the main theme was molestation/sexual abuse. The findings presented are a synthesis of experiences in three areas: (1) the difficulty patients encounter when trying to disconnect with the negative effects of sexual abuse; (2) assessment and…

  6. Aging and Alcohol Abuse: Increasing Counselor Awareness

    ERIC Educational Resources Information Center

    Williams, June M.; Ballard, Mary B.; Alessi, Hunter

    2005-01-01

    Alcohol abuse in older adulthood is a rapidly growing but often hidden problem. The authors provide an overview of the issues related to older adult alcohol abuse through a discussion of physiological, psychological, and social risk factors; an examination of appropriate assessment procedures; and an overview of factors related to treatment.

  7. The physician's civil liability under Danish law.

    PubMed

    Fenger, N; Broberg, M

    1991-01-01

    The physician's liability in Danish law is based on negligence, which is assessed by the courts largely on the basis of expert opinions. Such opinions are provided primarily by the Medico-Legal Council rather than by experts selected by the parties. The evaluation of negligence is based on a "reasonable man" standard and the performance expected of a competent colleague; a hospital will be responsible for the negligence of its employees. The burden of proof generally lies with the plaintiff; negligence will not be presumed and the assessment of the evidence of negligence will be adapted to the individual situation, e.g. factors such as the degree of specialization involved, the time which the physician had at his disposal to make his decision and the resources available to him will be taken into consideration. The courts have shown themselves willing to allow for the fact that doctors differ, i.e. recognizing that there must be scope for reasonable discretion. Because the culpa principle is central, the standard applied to medical knowledge will be that which pertained at the time of the treatment. Where a non-specialist is confronted with a problem which may go beyond the knowledge of his limits and experience, he is under an obligation to refer the patient. The principle of informed consent to treatment is accepted in Danish law, but such consent will readily be considered to have been given tacitly. PMID:23511859

  8. 29 CFR 4219.11 - Withdrawal liability upon mass withdrawal.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 9 2011-07-01 2011-07-01 false Withdrawal liability upon mass withdrawal. 4219.11 Section... Redetermination of Withdrawal Liability Upon Mass Withdrawal § 4219.11 Withdrawal liability upon mass withdrawal. (a) Initial withdrawal liability. The plan sponsor of a multiemployer plan that experiences a...

  9. 29 CFR 4219.11 - Withdrawal liability upon mass withdrawal.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 9 2013-07-01 2013-07-01 false Withdrawal liability upon mass withdrawal. 4219.11 Section... Redetermination of Withdrawal Liability Upon Mass Withdrawal § 4219.11 Withdrawal liability upon mass withdrawal. (a) Initial withdrawal liability. The plan sponsor of a multiemployer plan that experiences a...

  10. 29 CFR 4219.11 - Withdrawal liability upon mass withdrawal.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 9 2012-07-01 2012-07-01 false Withdrawal liability upon mass withdrawal. 4219.11 Section... Redetermination of Withdrawal Liability Upon Mass Withdrawal § 4219.11 Withdrawal liability upon mass withdrawal. (a) Initial withdrawal liability. The plan sponsor of a multiemployer plan that experiences a...

  11. 29 CFR 4219.11 - Withdrawal liability upon mass withdrawal.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 9 2014-07-01 2014-07-01 false Withdrawal liability upon mass withdrawal. 4219.11 Section... Redetermination of Withdrawal Liability Upon Mass Withdrawal § 4219.11 Withdrawal liability upon mass withdrawal. (a) Initial withdrawal liability. The plan sponsor of a multiemployer plan that experiences a...

  12. 26 CFR 1.172-13 - Product liability losses.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... liability claims so as to become a product liability loss. (2) Product liability. (i) The term product... by section 172(b) (except subparagraph (1)(I) thereof) and the regulations thereunder. (2) Time and... 26 Internal Revenue 3 2011-04-01 2011-04-01 false Product liability losses. 1.172-13 Section...

  13. 29 CFR 4219.11 - Withdrawal liability upon mass withdrawal.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Withdrawal liability upon mass withdrawal. 4219.11 Section... Redetermination of Withdrawal Liability Upon Mass Withdrawal § 4219.11 Withdrawal liability upon mass withdrawal. (a) Initial withdrawal liability. The plan sponsor of a multiemployer plan that experiences a...

  14. 46 CFR 4.23-1 - Evidence of criminal liability.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Evidence of criminal liability. 4.23-1 Section 4.23-1... AND INVESTIGATIONS Evidence of Criminal Liability § 4.23-1 Evidence of criminal liability. If, as a result of any investigation or other proceeding conducted hereunder, evidence of criminal liability...

  15. 46 CFR 4.23-1 - Evidence of criminal liability.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Evidence of criminal liability. 4.23-1 Section 4.23-1... AND INVESTIGATIONS Evidence of Criminal Liability § 4.23-1 Evidence of criminal liability. If, as a result of any investigation or other proceeding conducted hereunder, evidence of criminal liability...

  16. 46 CFR 4.23-1 - Evidence of criminal liability.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 1 2012-10-01 2012-10-01 false Evidence of criminal liability. 4.23-1 Section 4.23-1... AND INVESTIGATIONS Evidence of Criminal Liability § 4.23-1 Evidence of criminal liability. If, as a result of any investigation or other proceeding conducted hereunder, evidence of criminal liability...

  17. 26 CFR 1.752-1 - Treatment of partnership liabilities.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 8 2011-04-01 2011-04-01 false Treatment of partnership liabilities. 1.752-1... Code § 1.752-1 Treatment of partnership liabilities. (a) Definitions. For purposes of section 752, the following definitions apply: (1) Recourse liability defined. A partnership liability is a recourse...

  18. The Welfare Effects of Medical Malpractice Liability

    PubMed Central

    Lakdawalla, Darius N.; Seabury, Seth A.

    2013-01-01

    We use variation in the generosity of local juries to identify the causal impact of medical malpractice liability on social welfare. Growth in malpractice payments contributed at most 5 percentage points to the 33% total real growth in medical expenditures from 1990-2003. On the other hand, malpractice leads to modest mortality reductions; the value of these more than likely exceeds the costs of malpractice liability. Therefore, reducing malpractice liability is unlikely to have a major impact on health care spending, and unlikely to be cost-effective over conventionally accepted values of a statistical life. PMID:23526860

  19. Childhood Sexual Abuse among University Students in Tanzania

    ERIC Educational Resources Information Center

    McCrann, Denis; Lalor, Kevin; Katabaro, Joviter Kamugisha

    2006-01-01

    Objectives: There are no prevalence data for childhood sexual abuse among Tanzanian university students. This investigation addressed this paucity. The nature of sexual abuse was also investigated. Method: Participants (N=487) from a university in Tanzania completed a questionnaire which assessed abusive childhood sexual experiences, gathering…

  20. 45 CFR 800.403 - Fraud and abuse.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 3 2013-10-01 2013-10-01 false Fraud and abuse. 800.403 Section 800.403 Public... PROGRAM Compliance § 800.403 Fraud and abuse. (a) Program required. An MSPP issuer must conduct a program to assess its vulnerability to fraud and abuse as well as to address such vulnerabilities. (b)...

  1. 45 CFR 800.403 - Fraud and abuse.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 3 2014-10-01 2014-10-01 false Fraud and abuse. 800.403 Section 800.403 Public... PROGRAM Compliance § 800.403 Fraud and abuse. (a) Program required. An MSPP issuer must conduct a program to assess its vulnerability to fraud and abuse as well as to address such vulnerabilities. (b)...

  2. Comorbidity of Schizophrenia and Substance Abuse: Implications for Treatment.

    ERIC Educational Resources Information Center

    Mueser, Kim T.; And Others

    1992-01-01

    Reviews substance abuse disorders in schizophrenia patients, including prevalence of comorbid disorders, assessment, hypothesized mechanisms underlying abuse, and clinical effects of abuse on course of illness and cognitive functioning. Outlines principles of treatment for dual-diagnosis schizophrenia patients, noting limitations of existing…

  3. Correlates of Male and Female Juvenile Offender Abuse Experiences

    ERIC Educational Resources Information Center

    Dembo, Richard; Schmeidler, James; Childs, Kristina

    2007-01-01

    This paper reports the results of developing and evaluating a classification of 315 arrested youth processed at the Hillsborough County Juvenile Assessment Center from September 1, 1994 to January 31, 1998. Youth were characterized as physically or sexually abused if they reported abuse or if they had been referred to juvenile court for abuse.…

  4. A proposed intergenerational model of substance abuse, family functioning, and abuse/neglect.

    PubMed

    Sheridan, M J

    1995-05-01

    Although the link between substance abuse and child maltreatment has been relatively well established, there is a general recognition that this is not a simple cause-effect relationship. The current study explored the relationships among substance abuse, family functioning, and abuse/neglect in a sample of incarcerated substance abusers. Data were gathered on the earlier life experiences of 81 men and women serving sentences in two maximum security prisons, including assessments of their parents' substance abuse problems; levels of family competence within their families-of-origin; their exposure, as children and adults, to physical, emotional, and sexual abuse and physical/emotional neglect; and their own levels of substance abuse. Results showed generally high percentages of parental substance abuse and abuse/neglect, and relatively low levels of family competence. Correlational analyses revealed significant direct and indirect relationships among parental substance abuse, family dynamics, and exposure to both child and adult maltreatment. These four variables were also significantly associated with respondents' own substance abuse in later life, suggesting the potential for continuation of these patterns into successive generations. An intergenerational model of these family and personal functioning variables is presented and implications for service delivery with correctional clients is discussed. PMID:7664133

  5. 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…

  6. Comparison of Early Maladaptive Schemas and Parenting Origins in Patients with Opioid Abuse and Non-Abusers

    PubMed Central

    Zargar, Mohammad; Salavati, Mojgan; Kakavand, Ali Reza

    2011-01-01

    Objective The aim of this study was to examine the difference of early maladaptive schemas and parenting origins in opioid abusers and non-opioid abusers. Method The early maladaptive schemas and parenting origins were compared in 56 opioid abusers and 56 non-opioids abusers. Schemas were assessed by the Young Schema Questionnaire 3rd (short form); and parenting origins were assessed by the Young Parenting Inventory. Results Data were analyzed by multivariate analysis of variance (MANOVA). The analysis showed that the means for schemas between opioid abusers and non-opioid abusers were different. Chi square test showed that parenting origins were significantly associated with their related schemas. Conclusion The early maladaptive schemas and parenting origins in opioid abusers were more than non-opioid abusers; and parenting origins were related to their Corresponding schemas. PMID:22952522

  7. [The criminal liability of the hospital pharmacist vs the liability of the hospital].

    PubMed

    Siracusa, Margherita; Grappasonni, Iolanda; Petrelli, Fabio

    2016-01-01

    This study proposes an analysis of the boundaries of liability of the negligent hospital pharmacist, in relation with the liability of the hospital. The conditions of departure are: the knowledge that the pharmacist works within the limits of compliance programs adopted by the hospital; the finding that, in recent times, there has been an expansion in the objective sense of liability of the pharmacist. The laudable aim of protecting the patient is well accompanied by the violation of the principle of individual criminal liability (Art. 27 of the Constitution) and practical reason for discouraging the risky assets even useful. Through the analysis of the d. lgs. n. 231/2001 regarding the corporate liability for the crime and law n. 158/2012 regarding criminal liability limited to the gross negligence of the health care, it will arrive at the conclusion about the need to recognize a liability for the organization to hospitals, limiting the liability of the hospital pharmacist to cases of chargeability/criminal liability of negligent conduct. PMID:26901366

  8. Dementia and elder abuse.

    PubMed

    Hansberry, Maria R; Chen, Elaine; Gorbien, Martin J

    2005-05-01

    Dementia and elder abuse are relatively common and under-diagnosed geriatric syndromes. A unique relationship is observed when the two entities coexist. Special issues can confound the care of the dementia patient suspected of being abused. Impaired language or motor abilities to communicate abusive situations to a third party, lack of decisional capacity to address the abusive situation, disinhibited behavior that contributes to a cycle of violence, and coincident depression of the abused elder complicate the diagnosis and management of elder abuse. Education of the caregiver and attention to caregiver stress, including depression, may prevent onset and perpetuation of abuse. PMID:15804553

  9. Liability of physicians supervising nonphysician clinicians.

    PubMed

    Paterick, Barbara B; Waterhouse, Blake E; Paterick, Timothy E; Sanbar, Sandy S

    2014-01-01

    Physicians confront a variety of liability issues when supervising nonphysician clinicians (NPC) including: (1) direct liability resulting from a failure to meet the state-defined standards of supervision/collaboration with NPCs; (2) vicarious liability, arising from agency law, where physicians are held accountable for NPC clinical care that does not meet the national standard of care; and (3) responsibility for medical errors when the NPC and physician are co-employees of the corporate enterprise. Physician-NPC co-employee relationships are highlighted because they are new and becoming predominant in existing healthcare models. Because of their novelty, there is a paucity of judicial decisions determining liability for NPC errors in this setting. Knowledge of the existence of these risks will allow physicians to make informed decisions on what relationships they will enter with NPCs and how these relationships will be structured and monitored. PMID:24873129

  10. 34 CFR 668.138 - Liability.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Liability. (a) A student is liable for any LEAP, FSEOG, Federal Pell Grant, ACG, National SMART Grant, or... relied on— (1) An output document for that student indicating that the INS has confirmed that the...

  11. 34 CFR 668.138 - Liability.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Liability. (a) A student is liable for any LEAP, FSEOG, Federal Pell Grant, ACG, National SMART Grant, or... relied on— (1) An output document for that student indicating that the INS has confirmed that the...

  12. 34 CFR 668.138 - Liability.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Liability. (a) A student is liable for any LEAP, FSEOG, Federal Pell Grant, ACG, National SMART Grant, or... relied on— (1) An output document for that student indicating that the INS has confirmed that the...

  13. 34 CFR 668.138 - Liability.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Liability. (a) A student is liable for any LEAP, FSEOG, Federal Pell Grant, ACG, National SMART Grant, or... relied on— (1) An output document for that student indicating that the INS has confirmed that the...

  14. Hereditary Neuropathy with Liability to Pressure Palsies.

    PubMed

    Choi, Hyoung Won; Kuntz, Nancy L

    2015-11-01

    Investigators from 4 pediatric hospitals in Canada analyzed the clinical presentation and electrophysiological data of 12 children with hereditary neuropathy with liability to pressure palsies (HNPP), caused by PMP22 gene deletion. PMID:26933540

  15. 7 CFR 1220.253 - Personal liability.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE SOYBEAN PROMOTION, RESEARCH, AND CONSUMER INFORMATION Soybean Promotion and Research Order Miscellaneous § 1220.253 Personal liability. No... Soybean Boards, acting pursuant to authority provided in this subpart, shall be held...

  16. 7 CFR 1220.253 - Personal liability.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE SOYBEAN PROMOTION, RESEARCH, AND CONSUMER INFORMATION Soybean Promotion and Research Order Miscellaneous § 1220.253 Personal liability. No... Soybean Boards, acting pursuant to authority provided in this subpart, shall be held...

  17. 7 CFR 1220.253 - Personal liability.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE SOYBEAN PROMOTION, RESEARCH, AND CONSUMER INFORMATION Soybean Promotion and Research Order Miscellaneous § 1220.253 Personal liability. No... Soybean Boards, acting pursuant to authority provided in this subpart, shall be held...

  18. 7 CFR 1220.253 - Personal liability.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE SOYBEAN PROMOTION, RESEARCH, AND CONSUMER INFORMATION Soybean Promotion and Research Order Miscellaneous § 1220.253 Personal liability. No... Soybean Boards, acting pursuant to authority provided in this subpart, shall be held...

  19. 7 CFR 1220.253 - Personal liability.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE SOYBEAN PROMOTION, RESEARCH, AND CONSUMER INFORMATION Soybean Promotion and Research Order Miscellaneous § 1220.253 Personal liability. No... Soybean Boards, acting pursuant to authority provided in this subpart, shall be held...

  20. 7 CFR 906.61 - Personal liability.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... liability. No member or alternate of the committee or any employee or agent thereof, shall be held... such member, alternate, agent, or employee, except for act of dishonesty, willful misconduct, or...

  1. 7 CFR 906.61 - Personal liability.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... liability. No member or alternate of the committee or any employee or agent thereof, shall be held... such member, alternate, agent, or employee, except for act of dishonesty, willful misconduct, or...

  2. Alcohol on Campus and Possible Liability.

    ERIC Educational Resources Information Center

    Buchanan, E. T.

    1983-01-01

    Reviews laws and court cases relating to alcohol and possible civil and criminal liability. Suggests a number of risk management principles, including knowledge of the law, policies forbidding hazing, fostering alcohol awareness, and discipline. (JAC)

  3. Limited liability and the public's health.

    PubMed

    Rutkow, Lainie; Teret, Stephen P

    2007-01-01

    Corporations, through their products and behaviors, exert a strong effect on the well-being of populations. Industries including firearms, motor vehicles, tobacco, and alcohol produce and market products negatively impact public health. All of these industries are composed of corporations, which are legal fictions designed to provide limited exposure to liability, through a variety of mechanisms, for their investors and directors. This means that when actions are taken on behalf of a corporate entity, the individuals responsible generally will not face personal liability for the negative results of those actions. To illustrate this point, this article considers corporate products or practices that have caused harm in varied settings, and analyzes the role that limited liability played in these cases. In addition, the article identifies ways to modify or eliminate some of the principles and practices that accompany limited liability. PMID:18076511

  4. 15 CFR 996.4 - Liability.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES QUALITY ASSURANCE AND CERTIFICATION REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES General § 996.4 Liability. The Government of the United...

  5. 15 CFR 996.4 - Liability.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES QUALITY ASSURANCE AND CERTIFICATION REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES General § 996.4 Liability. The Government of the United...

  6. Polydrug abuse: A review of opioid and benzodiazepine combination use

    PubMed Central

    Jones, Jermaine D.; Mogali, Shanthi; Comer, Sandra D.

    2012-01-01

    This paper reviews studies examining the pharmacological interactions and epidemiology of the combined use of opioids and benzodiazepines (BZD). A search of English language publications from 1970 - 2012 was conducted using PubMed and PsycINFO®. Our search found approximately 200 articles appropriate for inclusion in this paper. While numerous reports indicate that the co-abuse of opioids and BZDs is ubiquitous around the world, the reasons for the co-abuse of these medications are not entirely clear. Though the possibility remains that opioid (ab)users are using BZDs therapeutically to self-medicate anxiety, mania or insomnia, the data reviewed in this paper suggest that BZD use is primarily recreational. For example, co-users report seeking BZD prescriptions for the purpose of enhancing opioid intoxication or “high,” and use doses that exceed the therapeutic range. Since there are few clinical studies investigating the pharmacological interaction and abuse liability of their combined use, this hypothesis has not been extensively evaluated in clinical settings. As such, our analysis encourages further systematic investigation of BZD abuse among opioid users. The co-abuse of BZDs and opioids is substantial and has negative consequences for general health, overdose lethality, and treatment outcome. Physicians should address this important and underappreciated problem with more cautious prescribing practices, and increased vigilance for abusive patterns of use. PMID:22857878

  7. Medical Student Abuse During Clinical Clerkships in Japan

    PubMed Central

    Nagata-Kobayashi, Shizuko; Sekimoto, Miho; Koyama, Hiroshi; Yamamoto, Wari; Goto, Eiji; Fukushima, Osamu; Ino, Teruo; Shimada, Tomoe; Shimbo, Takuro; Asai, Atsushi; Koizumi, Shunzo; Fukui, Tsuguya

    2006-01-01

    OBJECTIVE To assess the prevalence of medical student abuse during clinical clerkships in Japan. DESIGN A cross-sectional questionnaire survey. SETTING Six medical schools in Japan. PARTICIPANTS Final year (sixth-year) and fifth-year medical students in the period from September 2003 to January 2004. From a total of 559 students solicited, 304 (54.4%) returned the questionnaire, and 276 (49.4%: 178 male and 98 female) completed it. MEASUREMENTS Prevalence of medical student abuse in 5 categories: verbal abuse, physical abuse, academic abuse, sexual harassment, and gender discrimination; differences in abusive experience between male and female students; types of alleged abusers; reporting abusive experiences to authorities; and emotional effects of abusive experiences. RESULTS Medical student abuse was reported by 68.5% of the respondents. Verbal abuse was the most frequently experienced abuse (male students 52.8%, female students 63.3%). Sexual harassment was experienced significantly more often (P<.001) by female students (54.1%) than by male students (14.6%). Faculty members were most often reported as abusers (45.2% of cases). Abuse occurred most frequently during surgical rotations (42.0% of cases), followed by internal medicine (25.1%) and anesthesia rotations (21.8%). Very few abused students reported their abusive experiences to authorities (8.5%). The most frequent emotional response to abuse was anger (27.1% of cases). CONCLUSIONS Although experience of abuse during clinical clerkships is common among medical students in Japan, the concept of “medical student abuse” is not yet familiar to Japanese. To improve the learning environment, medical educators need to take action to resolve this serious issue. PMID:16390504

  8. Child abuse and mental disorders in Canada

    PubMed Central

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

    2014-01-01

    Background: Nationally representative Canadian data on the prevalence of child abuse and its relation with mental disorders are lacking. We used contemporary, nationally representative data to examine the prevalence of 3 types of child abuse (physical abuse, sexual abuse and exposure to intimate partner violence) and their association with 14 mental conditions, including suicidal ideation and suicide attempts. Methods: We obtained data from the 2012 Canadian Community Health Survey: Mental Health, collected from the 10 provinces. Respondents aged 18 years and older were asked about child abuse and were selected for the study sample (n = 23 395). The survey had a multistage stratified cluster design (household response rate 79.8%). Results: The prevalence of any child abuse was 32% (individual types ranged from 8% to 26%). All types of child abuse were associated with all mental conditions, including suicidal ideation and suicide attempts, after adjustment for sociodemographic variables (adjusted odds ratios ranged from 1.4 to 7.9). We found a dose–response relation, with increasing number of abuse types experienced corresponding with greater odds of mental conditions. Associations between child abuse and attention deficit disorder, suicidal ideation and suicide attempts showed stronger effects for women than men. Interpretation: We found robust associations between child abuse and mental conditions. Health care providers, especially those assessing patients with mental health problems, need to be aware of the relation between specific types of child abuse and certain mental conditions. Success in preventing child abuse could lead to reductions in the prevalence of mental disorders, suicidal ideation and suicide attempts. PMID:24756625

  9. Affective responsiveness, betrayal, and childhood abuse.

    PubMed

    Reichmann-Decker, Aimee; DePrince, Anne P; McIntosh, Daniel N

    2009-01-01

    Several trauma-specific and emotion theories suggest that alterations in children's typical affective responses may serve an attachment function in the context of abuse by a caregiver or close other. For example, inhibiting negative emotional responses or expressions might help the child preserve a relationship with an abusive caregiver. Past research in this area has relied on self-report methods to discover links between affective responsiveness and caregiver abuse. Extending this literature, the current study used facial electromyography to assess affective responsiveness with 2 measures: mimicry of emotional facial expressions and affective modulation of startle. We predicted that women who reported childhood abuse by close others would show alterations in affective responsiveness relative to their peers. We tested 100 undergraduate women who reported histories of (a) childhood sexual or physical abuse by someone close, such as a parent (high-betrayal); (b) childhood abuse by someone not close (low-betrayal); or (c) no abuse in childhood (no-abuse). Especially when viewing women's emotional expressions, the high-betrayal group showed more mimicry of happy and less mimicry of angry faces relative to women who reported no- or low-betrayal abuse, who showed the opposite pattern. Furthermore, women who reported high-betrayal abuse showed less affective modulation of startle during pictures depicting men threatening women than did the other two groups. Findings suggest that, as predicted by betrayal trauma theory, women who have experienced high-betrayal abuse show alterations in automatic emotional processes consistent with caregiving-maintenance goals in an abusive environment. PMID:19585337

  10. Prevalent Intravenous Abuse of Methylphenidate Among Treatment-Seeking Patients With Substance Abuse Disorders: A Descriptive Population-Based Study

    PubMed Central

    Haraldsson, Haraldur M.; Rafnar, Bjarni O.; Sigurdsson, Engilbert; Steingrimsson, Steinn; Johannsson, Magnus; Bragadottir, Helena; Magnusson, Andres

    2015-01-01

    Objectives: Prescription rates of methylphenidate (MPH) are sharply rising in most Western countries. Although it has been reported that MPH has abuse potential, little is known about the prevalence of intravenous (IV) abuse of MPH. The aim of the study was to investigate the prevalence of IV MPH abuse among treatment-seeking IV substance abusers in Iceland. Methods: This is a descriptive population-based study using a semistructured interview assessing sociodemographics, substance abuse history, and the method of administration of 108 IV substance abusers. During 1 year, consecutively admitted adult inpatients with substance use disorder at any detoxification center in Iceland that reported any IV substance abuse in the past 30 days were invited to participate. Abuse was defined as nontherapeutic use of a substance to gain psychological or physiological effect. Results: Prevalence of any IV MPH abuse among participants was 88% in the last 30 days (95% confidence interval [CI], 0.82-0.94) and MPH was the most commonly abused substance (65%) and the preferred substance (63%). Around one third (30%) reported MPH as the first IV substance ever abused. However, among those reporting a shorter history than 10 years of IV abuse, 42% reported MPH as the first IV substance ever abused. Conclusions: This first nationwide study on IV abuse of MPH shows that it is common among treatment-seeking IV abusers in Iceland and suggests that MPH has high abuse potential. Therefore, both the use and possible abuse of MPH in those with high abuse potential should be monitored, especially in countries where MPH prescriptions rates are on the rise. PMID:25748561

  11. Psychological assessment through performance-based techniques and self-reports: a case study of a sexually abused girl at preschool age.

    PubMed

    Khalily, Muhammad Tahir; Hallahan, Brian

    2011-05-01

    We investigated the implicit psychological and behavioral consequences of sexual abuse in an adolescent girl who suffered child sexual abuse at preschool age in this case report. We report the manifestations of this abuse on her personality and psychological functioning using a structured clinical interview and a comprehensive psychological battery including the Beck Anxiety Inventory, the Beck Depression Inventory, the Standard Progressive Matrices, Rorschach Ink Blots, and the Schema Mode Inventory. These investigations were useful in formulating both a diagnosis and a management plan. The girl fulfilled diagnostic criteria for a major depressive episode and borderline personality disorder. This combination of psychological testing may be useful in establishing an accurate multiaxial diagnosis and for understanding the behavioral and psychological sequelae of child sexual abuse in similar cases. The study further suggests that schema-focused therapy is a useful therapeutic tool for individuals who have suffered child sexual abuse at an early age and who have borderline personality disorder. PMID:21660818

  12. Health and Occupational Consequences of Spouse Abuse Victimization among Male U.S. Army Soldiers

    ERIC Educational Resources Information Center

    Bell, Nicole S.

    2009-01-01

    Little is known about health and occupational outcomes of male spouse abuse victims. In all, 11,294 male spouse abuse victims with a history of spouse abuse perpetration, 3,277 victims without prior spouse abuse perpetration, and 72,855 nonvictims and nonperpetrators were followed for 12 years to assess army attrition and hospitalization risk. In…

  13. Differential Effects Associated with Self-Reported Histories of Abuse and Neglect in a College Sample.

    ERIC Educational Resources Information Center

    Loos, Mary Elizabeth; Alexander, Pamela C.

    1997-01-01

    Assesses the long-term effects of parental physical abuse, verbal abuse, and emotional neglect in a sample of 247 female and 154 male college students. Results suggest that parental physical abuse and verbal abuse predicted current anger and that emotional neglect predicted loneliness and social isolation. Paternal maltreatment predicted negative…

  14. Abuse potential of propofol used for sedation in gastric endoscopy and its correlation with subject characteristics

    PubMed Central

    Kim, Ja Hyun; Byun, Heewon

    2013-01-01

    Background Propofol has been widely used for an induction and/or maintenance of general anesthesia, or for sedation for various procedures. Although it has many ideal aspects, there have been several cases of drug abuse and addiction. The authors investigated whether there are abuse liable groups among the general population. Methods We surveyed 169 patients after gastric endoscopic examination, which used propofol as a sedative, with the Addiction Research Center Inventory (ARCI) questionnaire. Other characteristics of the patients, such as past history, smoking habits, depression, anxiety, alcohol abuse liability and sleep disturbance, were recorded by history taking and several questionnaires before the exam. Results Propofol had a high Morphine-Benzedrine Group (MBG) score (representative value for euphoria) of 6.3, which is higher than marijuana, and a Pentobarbital-Chlorpromazine-Alcohol Group (PCAG) score (representative value of sedation) of 8.1, which is lower than most opioids. The MBG score showed no statistically significant correlation between any of the characteristics of the groups. In females, the PCAG score showed a correlation with age, and in males, it showed a correlation with a sleeping problem. Conclusions Propofol had relatively high euphoria and low residual sedative effects. It had a more potent sedative effect in the female group who were young, and in the male group who had a low sleep quality index. There were differences in the abuse liability from a single exposure to propofol in the general population. Further study is needed to evaluate the abuse liability of repeated exposure. PMID:24363842

  15. The prevalence of sexual abuse among adolescents in school.

    PubMed

    Saewyc, Elizabeth M; Pettingell, Sandra; Magee, Lara L

    2003-10-01

    Sexual abuse is a profound stressor that complicates the development and health of adolescents, yet its prevalence has been difficult to estimate among adolescents in school populations. This study explored the prevalence of both incest and nonfamily abuse in 2 cohorts of adolescents in Minnesota in the 1990s (1992: N = 77374; 1998: N = 81247). Findings indicate that sexual abuse was reported by both boys and girls and among students of all ethnic groups. Approximately 10% of adolescents reported sexual abuse in each cohort, with girls 5 times more likely to report abuse than boys. Ethnic variation was minor, with African American, Native American, and Hispanic teens slightly more likely to report abuse than White or Asian American youth. School nurses should routinely assess for a history of sexual abuse in adolescents and should be prepared to provide support and referral for abused students and their families. PMID:14498771

  16. Methamphetamine/amphetamine abuse and risk of Parkinson’s disease in Utah: a population-based assessment

    PubMed Central

    Curtin, Karen; Fleckenstein, Annette E.; Robison, Reid J.; Crookston, Michael J.; Smith, Ken R.; Hanson, Glen R.

    2014-01-01

    Background Despite widespread use of methamphetamine and other amphetamine-type stimulants (METH/AMPH), little is known about the long-term medical consequences of METH/AMPH abuse and dependence. Preclinical neurotoxicity findings raise public health concerns that these stimulants may damage dopamine neurons, resulting in dopamine-related disorders such as Parkinson’s disease (PD). Methods A retrospective design was used to examine statewide medical records (1996 through 2011) linked to the Utah Population Database. Individuals 30y or older on December 31, 2011 were assigned to a METH/AMPH cohort (ICD-9-CM 304.4, 305.7, 969.7, E854.2; N=4,935), a cocaine cohort (ICD-9-CM 304.2, 305.6, 968.5, E855.2; N=1,867) or a population cohort unexposed to drugs or alcohol for control selection. A competing-risks, proportional hazards model was used to determine whether the METH/AMPH or cocaine cohorts were at increased risk of developing PD (ICD-9-CM 332.0) or PD/parkinsonism/essential tremor (PD/PT; ICD-9-CM 332.0, 332.1, 333.0, 333.1) compared to individually sex- and age-matched controls (5:1 control to case ratio; N=34,010). Results In METH/AMPH users, we observed an increased risk of PD and PD/PT (HRPD=2.8, 95%CI 1.6–4.8, P<10−3; HRPD/PT=3.1, 95%CI 1.9–4.9, P<10−4) compared to population-based controls. Conversely, cocaine users exhibited no elevated risk of PD compared to controls. Conclusions We observed a near 3-fold increased risk of PD in METH/AMPH users vs. controls which confirms prior observations and supports that PD risk in users may be higher than previous estimates. A suggestion that female and male users may differ in PD susceptibility warrants further study. PMID:25479916

  17. Mono- versus polydrug abuse patterns among publicly funded clients.

    PubMed

    Kedia, Satish; Sell, Marie A; Relyea, George

    2007-01-01

    To examine patterns of mono- versus polydrug abuse, data were obtained from intake records of 69,891 admissions to publicly funded treatment programs in Tennessee between 1998 and 2004. While descriptive statistics were employed to report frequency and patterns of mono- and polydrug abuse by demographic variables and by study years, bivariate logistic regression was applied to assess the probability of being a mono- or polydrug abuser for a number of demographic variables. The researchers found that during the study period 51.3% of admissions reported monodrug abuse and 48.7% reported polydrug abuse. Alcohol, cocaine, and marijuana were the most commonly abused substances, both alone and in combination. Odds ratio favored polydrug abuse for all but one drug category-other drugs. Gender did not affect drug abuse patterns; however, admissions for African Americans and those living in urban areas exhibited higher probabilities of polydrug abuse. Age group also appeared to affect drug abuse patterns, with higher odds of monodrug abuse among minors and adults over 45 years old. The discernable prevalence of polydrug abuse suggests a need for developing effective prevention strategies and treatment plans specific to polydrug abuse. PMID:17996066

  18. The Off-Site Plowshare and Vela Uniform Programs: Assessing Potential Environmental Liabilities through an Examination of Proposed Nuclear Projects,High Explosive Experiments, and High Explosive Construction Activities Volume 3 of 3

    SciTech Connect

    Beck Colleen M.,Edwards Susan R.,King Maureen L.

    2011-09-01

    This document presents the results of nearly six years (2002-2008) of historical research and field studies concerned with evaluating potential environmental liabilities associated with U.S. Atomic Energy Commission projects from the Plowshare and Vela Uniform Programs. The Plowshare Program's primary purpose was to develop peaceful uses for nuclear explosives. The Vela Uniform Program focused on improving the capability of detecting, monitoring and identifying underground nuclear detonations. As a result of the Project Chariot site restoration efforts in the early 1990s, there were concerns that there might be other project locations with potential environmental liabilities. The Desert Research Institute conducted archival research to identify projects, an analysis of project field activities, and completed field studies at locations where substantial fieldwork had been undertaken for the projects. Although the Plowshare and Vela Uniform nuclear projects are well known, the projects that are included in this research are relatively unknown. They are proposed nuclear projects that were not executed, proposed and executed high explosive experiments, and proposed and executed high explosive construction activities off the Nevada Test Site. The research identified 170 Plowshare and Vela Uniform off-site projects and many of these had little or no field activity associated with them. However, there were 27 projects that merited further investigation and field studies were conducted at 15 locations.

  19. The Off-Site Plowshare and Vela Uniform Programs: Assessing Potential Environmental Liabilities through an Examination of Proposed Nuclear Projects,High Explosive Experiments, and High Explosive Construction Activities Volume 1 of 3

    SciTech Connect

    Beck Colleen M,Edwards Susan R.,King Maureen L.

    2011-09-01

    This document presents the results of nearly six years (2002-2008) of historical research and field studies concerned with evaluating potential environmental liabilities associated with U.S. Atomic Energy Commission projects from the Plowshare and Vela Uniform Programs. The Plowshare Program's primary purpose was to develop peaceful uses for nuclear explosives. The Vela Uniform Program focused on improving the capability of detecting, monitoring and identifying underground nuclear detonations. As a result of the Project Chariot site restoration efforts in the early 1990s, there were concerns that there might be other project locations with potential environmental liabilities. The Desert Research Institute conducted archival research to identify projects, an analysis of project field activities, and completed field studies at locations where substantial fieldwork had been undertaken for the projects. Although the Plowshare and Vela Uniform nuclear projects are well known, the projects that are included in this research are relatively unknown. They are proposed nuclear projects that were not executed, proposed and executed high explosive experiments, and proposed and executed high explosive construction activities off the Nevada Test Site. The research identified 170 Plowshare and Vela Uniform off-site projects and many of these had little or no field activity associated with them. However, there were 27 projects that merited further investigation and field studies were conducted at 15 locations.

  20. The Off-Site Plowshare and Vela Uniform Programs: Assessing Potential Environmental Liabilities through an Examination of Proposed Nuclear Projects,High Explosive Experiments, and High Explosive Construction Activities Volume 2 of 3

    SciTech Connect

    Beck Colleen M.,Edwards Susan R.,King Maureen L.

    2011-09-01

    This document presents the results of nearly six years (2002-2008) of historical research and field studies concerned with evaluating potential environmental liabilities associated with U.S. Atomic Energy Commission projects from the Plowshare and Vela Uniform Programs. The Plowshare Program's primary purpose was to develop peaceful uses for nuclear explosives. The Vela Uniform Program focused on improving the capability of detecting, monitoring and identifying underground nuclear detonations. As a result of the Project Chariot site restoration efforts in the early 1990s, there were concerns that there might be other project locations with potential environmental liabilities. The Desert Research Institute conducted archival research to identify projects, an analysis of project field activities, and completed field studies at locations where substantial fieldwork had been undertaken for the projects. Although the Plowshare and Vela Uniform nuclear projects are well known, the projects that are included in this research are relatively unknown. They are proposed nuclear projects that were not executed, proposed and executed high explosive experiments, and proposed and executed high explosive construction activities off the Nevada Test Site. The research identified 170 Plowshare and Vela Uniform off-site projects and many of these had little or no field activity associated with them. However, there were 27 projects that merited further investigation and field studies were conducted at 15 locations.

  1. Vicarious liability: Is it an issue for your organization?

    PubMed

    West, John C

    2016-07-01

    Vicarious liability is a very real concern for hospitals and other health care entities. There are two forms of vicarious liability: respondeat superior (liability for an employee's actions) and agency (liability for nonemployees who appear to be the agent of the entity). Since an entity works through its employees, there is little that can be done, in most cases, to avoid respondeat superior liability. Entities need to be aware of the ways in which nonemployees can be perceived to be the entity's agent so that the appearance of agency can be prevented. There are methods to avoid vicarious liability and to deal with it should it occur. PMID:27400173

  2. Cough and Cold Medicine Abuse

    MedlinePlus

    ... and Cold Medicine Abuse DrugFacts: Cough and Cold Medicine Abuse Email Facebook Twitter Revised May 2014 Some ... diverted for abuse. How Are Cough and Cold Medicines Abused? Cough and cold medicines are usually consumed ...

  3. Randomized, double-blind, placebo-controlled and active-controlled study to assess the relative abuse potential of oxycodone HCl-niacin tablets compared with oxycodone alone in nondependent, recreational opioid users

    PubMed Central

    Webster, Lynn R; Rolleri, Robert L; Pixton, Glenn C; Sommerville, Kenneth W

    2012-01-01

    Background Abuse-deterrent formulations attempt to address public health and societal concerns regarding opioid abuse. Oxycodone HCl-niacin tablets combine oxycodone HCl with niacin and functional inactive excipients to create potential barriers to oral, intranasal, and intravenous abuse. This study compared the relative abuse potential of oral immediate-release oxycodone HCl-niacin with that of oral immediate-release oxycodone HCl and placebo in nondependent, recreational opioid users. Methods Forty-nine participants received oxycodone HCl-niacin 40/240 mg and 80/480 mg, oxycodone 40 mg and 80 mg, and placebo in a randomized, double-blind, placebo-controlled and active-controlled, five-way crossover study. Primary endpoints based on a bipolar 100 mm visual analog scale for drug liking were area under effect curve (AUE0–1h, AUE0–2h, AUE0–3h), peak disliking, and effect at 0.5 hours post-dose (E0.5h). Other endpoints included take drug again assessment, overall drug liking, and pupillometry. Results There were statistically significant differences between oxycodone HCl-niacin and oxycodone HCl doses for all primary endpoints (P < 0.0001, all comparisons), suggesting reduced abuse potential with oxycodone HCl-niacin. Take drug again and overall drug liking showed greater liking of oxycodone alone. Oxycodone HCl-niacin 80/480 mg had consistently lower liking assessments than oxycodone HCl-niacin 40/240 mg, suggesting a dose-response to the aversive effects of niacin. Opioid-related adverse events were similar for equivalent oxycodone doses. The treatment-emergent adverse events most specifically associated with oxycodone HCl-niacin (ie, skin-burning sensation, warmth, and flushing) were consistent with the expected vasocutaneous effects of niacin. No serious adverse events were reported. Conclusion Oxycodone HCl-niacin tablets may, in a dose-dependent manner, decrease the potential for oral abuse of oxycodone without unexpected adverse events or clinically

  4. Psychophysiological Reactivity in Child Sexual Abuse.

    PubMed

    Ben-Amitay, Galit; Kimchi, Nir; Wolmer, Leo; Toren, Paz

    2016-01-01

    Sexual abuse has physiological and emotional implications. The purpose of this study is to evaluate the neurobiological sequels of childhood sexual trauma by monitoring physiological variables among sexually abused girls and women compared to controls. We assessed posttrauma and traumatic life events of 35 females sexually abused in their childhood (age range 7-51 years) and 25 control females (age range 7-54 years). Electroencephalography, frontalis electromyography, electrodermal activity, and heart rate parameters were recorded while watching sets of pictures representing neutral and trauma-suggestive stimuli. A minority of participants met the Diagnostic and Statistical Manual of Mental Disorders criteria for post-traumatic stress disorder. Abused females displayed significant elevations in heart rate, electromyography, and electroencephalography while viewing allusive stimuli and elevated heart rate while viewing neutral stimuli. The dysfunctional regulation of the physiological stress system associated with child sexual abuse may endanger the victims with various stress and anxiety disorders. PMID:26934544

  5. Cough & Cold Medicine Abuse

    MedlinePlus

    ... I Help a Friend Who Cuts? Cough & Cold Medicine Abuse KidsHealth > For Teens > Cough & Cold Medicine Abuse ... DXM Why Do People Use Cough and Cold Medicines to Get High? There's an ingredient in many ...

  6. 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 narcotic painkillers, ...

  7. 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.

  8. Abuse during Pregnancy

    MedlinePlus

    ... depressed, eat unhealthy foods, or pick up bad habits such as smoking or drinking . An abusive partner may try to ... depressed, eat unhealthy foods, or pick up bad habits such as smoking or drinking . An abusive partner may try to ...

  9. Measuring abusive behaviors: is economic abuse a unique form of abuse?

    PubMed

    Stylianou, Amanda Mathisen; Postmus, Judy L; McMahon, Sarah

    2013-11-01

    Recent attention has been given by researchers to exploring economic abuse strategies used by abusers. However, little research has been conducted to understanding how to conceptualize economic abuse in relation to other forms of abuse. This article examines the factor structure of abusive items from the Scale of Economic Abuse--12 and the Abusive Behavior Inventory through confirmatory factor analyses using data collected with 457 female survivors of abuse. The findings provide evidence for conceptualizing economic abuse as a unique form of abuse moderately correlated with psychological, physical, and sexual forms of abuse. PMID:23946140

  10. Long-tail liability law reform.

    PubMed

    Freckelton, Ian

    2007-10-01

    There is a need for the law to evolve so that corporations are obliged to make proper provision for liabilities to unascertained future creditors. However, implementation of long-tail liabilities is far from straightforward and has many repercussions for both corporations and personal injury law. In October 2005 the Parliamentary Secretary to the Treasurer requested the Corporations and Markets Advisory Committee to consider a "referred proposal" designed to achieve comprehensive and principled law reform. Analysis of the referred proposal reveals many shortcomings, a number of which have been addressed by the Committee in its June 2007 Discussion Paper, Long-Tail Liabilities: The Treatment of Unascertained Future Personal Injury Claims. This editorial urges further and reflective analysis of the referred proposal and of the Committee's tentative suggestions in order to achieve a balance among the entitlements of unascertained future creditors, other known creditors, shareholders, corporations' financial viability, and the conceptual integrity of corporations law. PMID:18035836

  11. Liability for Not Using Computers in Medicine

    PubMed Central

    Watson, Bruce L.; Bernstein, Jodi M.

    1988-01-01

    The traditional legal rule used to measure the adequacy of a provider's delivery of care is the custom of other providers in the defendant's locality. However, some courts have adopted the rule of “reasonable prudence” as the measure of what custom should be. These developments suggest that courts may impose liability on providers for patient injuries caused by the absence of medical computers even where the custom of most other providers would not have required computer use. Judicial recognition of liability despite custom will depend upon a balancing of such factors as availability, risk of harm to the patient, and cost. The authors suggest that injuries caused by drug interactions and side-effects are those most vulnerable for judicial findings of liability for failure to use computers.

  12. Preventing Child Abuse

    ERIC Educational Resources Information Center

    Alvy, Kerby T.

    1975-01-01

    Focuses on two major and general approaches to analyzing the problems of child abuse; briefly discusses the prevention implications; deals with the individual physical abuse of children, with particular emphasis on the relationship between theoretical formulations of the causes of individual physical abuse and preventative programs; and, finally,…

  13. 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…

  14. 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…

  15. 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…

  16. Process liability evaluation for EUVL

    NASA Astrophysics Data System (ADS)

    Aoyama, Hajime; Tawarayama, Kazuo; Tanaka, Yuusuke; Kawamura, Daisuke; Arisawa, Yukiyasu; Uno, Taiga; Kamo, Takashi; Tanaka, Toshihiko; Itani, Toshiro; Tanaka, Hiroyuki; Nakajima, Yumi; Inanami, Ryoichi; Takai, Kosuke; Murano, Koji; Koshiba, Takeshi; Hashimoto, Kohji; Mori, Ichiro

    2009-03-01

    This paper concerns the readiness of extreme ultraviolet lithography (EUVL) for high-volume manufacture based on accelerated development in critical areas and the construction of a process liability (PL) test site that integrates results in these areas. The overall lithography performance was determined from the performance of the exposure tool, the printability obtainable with the resist, mask fabrication with accurate critical dimension (CD) control, and correction technology for mask data preparation. The EUV1 exposure tool can carry out exposure over the full field (26 mm × 33 mm) at a resolution high enough for 32-nm line-and-space patterns when Selete Standard Resist 3 (SSR3) is used. Thus, the test site was designed for the full-field exposure of various pattern sizes [half-pitch (hp) 32-50 nm]. The CD variation of the mask was found to be as good as 2.8 nm (3σ) and only one printable defect was detected. The effect of flare on CD variation is a critical issue in EUVL; so flare was compensated for based on the point spread function for the projection optics of the EUV1 and aerial simulations that took resist blur into account. The accuracy obtained when an electronic design automation (EDA) tool was used for mask resizing was found to be very good (error <= +/-2 nm). Metal wiring patterns with a size of hp 32 nm were successfully formed by wafer processing. The production readiness of EUVL based on the integration of results in these areas was evaluated by electrical tests on low-resistance tungsten wiring. The yield for the electrically open test for hp 50 nm (32-nm logic node) and hp 40 nm (22-nm logic node) were found to be over 60% and around 50%, respectively; and the yield tended to decrease as patterns became smaller. We found the PL test site to be very useful for determining where further improvements need to be made and for evaluating the production readiness of EUVL.

  17. How meaningful are heritability estimates of liability?

    PubMed Central

    Morris, Nathan J.

    2013-01-01

    It is commonly acknowledged that estimates of heritability from classical twin studies have many potential shortcomings. Despite this, in the post-GWAS era, these heritability estimates have come to be a continual source of interest and controversy. While the heritability estimates of a quantitative trait are subject to a number of biases, in this article we will argue that the standard statistical approach to estimating the heritability of a binary trait relies on some additional untestable assumptions which, if violated, can lead to badly biased estimates. The ACE liability threshold model assumes at its heart that each individual has an underlying liability or propensity to acquire the binary trait (e.g., disease), and that this unobservable liability is multivariate normally distributed. We investigated a number of different scenarios violating this assumption such as the existence of a single causal diallelic gene and the existence of a dichotomous exposure. For each scenario, we found that substantial asymptotic biases can occur, which no increase in sample size can remove. Asymptotic biases as much as four times larger than the true value were observed, and numerous cases also showed large negative biases. Additionally, regions of low bias occurred for specific parameter combinations. Using simulations, we also investigated the situation where all of the assumptions of the ACE liability model are met. We found that commonly used sample sizes can lead to biased heritability estimates. Thus, even if we are willing to accept the meaningfulness of the liability construct, heritability estimates under the ACE liability threshold model may not accurately reflect the heritability of this construct. The points made in this paper should be kept in mind when considering the meaningfulness of a reported heritability estimate for any specific disease. PMID:23867980

  18. Analysis of your professional liability insurance policy.

    PubMed

    SADUSK, J F; HASSARD, H; WATERSON, R

    1958-01-01

    The most important lessons for the physician to learn in regard to his professional liability insurance coverage are the following:1. The physician should carefully read his professional liability policy and should secure the educated aid of his attorney and his insurance broker, if they are conversant with this field.2. He should particularly read the definition of coverage and carefully survey the exclusion clauses which may deny him coverage under certain circumstances.3. If the physician is in partnership or in a group, he should be certain that he has contingent partnership coverage.4. The physician should accept coverage only from an insurance carrier of sufficient size and stability that he can be sure his coverage will be guaranteed for "latent liability" claims as the years go along-certainly for his lifetime.5. The insurance carrier offering the professional liability policy should be prepared to offer coverages up to at least $100,000/$300,000.6. The physician should be assured that the insurance carrier has claims-handling personnel and legal counsel who are experienced and expert in the professional liability field and who are locally available for service.7. The physician is best protected by a local or state group program, next best by a national group program, and last, by individual coverage.8. The physician should look with suspicion on a cancellation clause in which his policy may be summarily cancelled on brief notice.9. The physician should not buy professional liability insurance on the basis of price alone; adequacy of coverage and service and a good insurance company for his protection should be the deciding factors. PMID:13489519

  19. Search Engine Liability for Copyright Infringement

    NASA Astrophysics Data System (ADS)

    Fitzgerald, B.; O'Brien, D.; Fitzgerald, A.

    The chapter provides a broad overview to the topic of search engine liability for copyright infringement. In doing so, the chapter examines some of the key copyright law principles and their application to search engines. The chapter also provides a discussion of some of the most important cases to be decided within the courts of the United States, Australia, China and Europe regarding the liability of search engines for copyright infringement. Finally, the chapter will conclude with some thoughts for reform, including how copyright law can be amended in order to accommodate and realise the great informative power which search engines have to offer society.

  20. Trends in liability affecting technical writers

    NASA Technical Reports Server (NTRS)

    Driskill, L. P.

    1981-01-01

    Liability of technical writers for defective products is explored. Documents generated during a product's life cycle (including design memos, design tests, clinical trials, trial use reports, letters, and proposals) become relevant because they are likely to become the only available means of showing that the product was not defectively designed. These documents become the evidence that the product underwent balanced and well considered planning, development, testing, quality control, and field testing. The predicted increased involvement of technical writers in the prevention and defense of product liability claims is cited in view of a greater number of cases turning on "failure to warn".

  1. Assessment of cognitive brain function in ecstasy users and contributions of other drugs of abuse: results from an FMRI study.

    PubMed

    Jager, Gerry; de Win, Maartje M L; van der Tweel, Ingeborg; Schilt, Thelma; Kahn, Rene S; van den Brink, Wim; van Ree, Jan M; Ramsey, Nick F

    2008-01-01

    Heavy ecstasy use has been associated with neurocognitive deficits in various behavioral and brain imaging studies. However, this association is not conclusive owing to the unavoidable confounding factor of polysubstance use. The present study, as part of the Netherlands XTC Toxicity study, investigated specific effects of ecstasy on working memory, attention, and associative memory, using functional magnetic resonance imaging (fMRI). A large sample (n=71) was carefully composed based on variation in the amount and type of drugs that were used. The sample included 33 heavy ecstasy users (mean 322 pills lifetime). Neurocognitive brain function in three domains: working memory, attention, and associative memory, was assessed with performance measures and fMRI. Independent effects of the use of ecstasy, amphetamine, cocaine, cannabis, alcohol, tobacco, and of gender and IQ were assessed and separated by means of multiple regression analyses. Use of ecstasy had no effect on working memory and attention, but drug use was associated with reduced associative memory performance. Multiple regression analysis showed that associative memory performance was affected by amphetamine much more than by ecstasy. Both drugs affected associative memory-related brain activity, but the effects were consistently in opposite directions, suggesting that different mechanisms are at play. This could be related to the different neurotransmitter systems these drugs predominantly act upon, that is, serotonin (ecstasy) vs dopamine (amphetamine) systems. PMID:17460617

  2. Homicide committed by psychiatric patients: Psychiatrists' liability in Italian law cases.

    PubMed

    Terranova, Claudio; Rocca, Gabriele

    2016-01-01

    Interest in psychiatrists' professional liability in Italy has increased in recent years because of the number of medical malpractice claims. Professional liability for failure to prevent violent behaviour by psychiatric patients is particularly debated. This study describes three Italian cases in which health professionals - physicians and nurses - were found guilty of manslaughter for murders committed by psychiatric patients. Examination of the cases focuses on claims of malpractice, patients' characteristics, the circumstances of the homicide and the reasons for the court's judgment. In particular, the predictability of violent behaviour and the concept of causal links are examined in detail. The cases provide an opportunity for a study of comparative jurisprudence. The topics discussed are relevant not only to practicing psychiatrists but also to experts assessing medical liability in cases of criminal acts committed by psychiatric patients. PMID:26130750

  3. 14 CFR 221.106 - Notice of limited liability for baggage; alternative consolidated notice of liability limitations.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Limitations of Liability Airline liability for death or personal injury may be limited by the Warsaw... valuable articles. See the notice with your tickets or consult your airline or travel agent for...

  4. 40 CFR 80.23 - Liability for violations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Liability for violations. 80.23 Section 80.23 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) REGULATION OF FUELS AND FUEL ADDITIVES Controls and Prohibitions § 80.23 Liability for violations. Liability for violations of paragraphs (a) and...

  5. 40 CFR 80.23 - Liability for violations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 17 2013-07-01 2013-07-01 false Liability for violations. 80.23 Section 80.23 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) REGULATION OF FUELS AND FUEL ADDITIVES Controls and Prohibitions § 80.23 Liability for violations. Liability for violations of paragraphs (a) and...

  6. 24 CFR 330.45 - Limitation on GNMA liability.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Limitation on GNMA liability. 330... MULTICLASS SECURITIES § 330.45 Limitation on GNMA liability. Except for its guaranty, the Association undertakes no obligation and assumes no liability to any person with regard to or on account of the...

  7. 31 CFR 50.90 - Cap on annual liability.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance: Treasury 1 2014-07-01 2014-07-01 false Cap on annual liability. 50.90 Section 50.90 Money and Finance: Treasury Office of the Secretary of the Treasury TERRORISM RISK INSURANCE PROGRAM Cap on Annual Liability § 50.90 Cap on annual liability. Pursuant to Section 103 of the Act,...

  8. 31 CFR 50.90 - Cap on annual liability.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance: Treasury 1 2013-07-01 2013-07-01 false Cap on annual liability. 50.90 Section 50.90 Money and Finance: Treasury Office of the Secretary of the Treasury TERRORISM RISK INSURANCE PROGRAM Cap on Annual Liability § 50.90 Cap on annual liability. Pursuant to Section 103 of the Act,...

  9. Cost vs. Risk: Determining the Correct Liability Insurance Limit.

    ERIC Educational Resources Information Center

    Klinksiek, Glenn

    1996-01-01

    Presents a model for evaluating liability insurance limits and selecting the correct limit for an individual institution. Argues that many colleges and universities may be making overly conservative decisions that lead to the purchase of too much liability insurance. Also discusses the financial consequences of an uninsured large liability loss.…

  10. 14 CFR 291.22 - Aircraft accident liability insurance requirement.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Aircraft accident liability insurance... for All-Cargo Air Transportation § 291.22 Aircraft accident liability insurance requirement. No air... and maintains in effect aircraft accident liability coverage that meets the requirements of part...

  11. 7 CFR 276.2 - State agency liabilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 4 2010-01-01 2010-01-01 false State agency liabilities. 276.2 Section 276.2 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE FOOD STAMP AND FOOD DISTRIBUTION PROGRAM STATE AGENCY LIABILITIES AND FEDERAL SANCTIONS § 276.2 State agency liabilities. (a)...

  12. 26 CFR 1.461-2 - Contested liabilities.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... an accrual method of accounting, in 1964 contests a $100 asserted liability. In 1967 the contested...) Taxable year of deduction. If— (i) The taxpayer contests an asserted liability, (ii) The taxpayer transfers money or other property to provide for the satisfaction of the asserted liability, (iii)...

  13. 46 CFR 5.69 - Evidence of criminal liability.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Evidence of criminal liability. 5.69 Section 5.69... INVESTIGATION REGULATIONS-PERSONNEL ACTION Statement of Policy and Interpretation § 5.69 Evidence of criminal liability. Evidence of criminal liability discovered during an investigation or hearing conducted...

  14. 14 CFR 1274.916 - Liability and risk of loss.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Liability and risk of loss. 1274.916... AGREEMENTS WITH COMMERCIAL FIRMS Other Provisions and Special Conditions § 1274.916 Liability and risk of..., or indemnification of, developers of experimental aerospace vehicles. Liability and Risk of Loss...

  15. 24 CFR 1007.60 - Liability under guarantee.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Liability under guarantee. 1007.60... DEVELOPMENT SECTION 184A LOAN GUARANTEES FOR NATIVE HAWAIIAN HOUSING § 1007.60 Liability under guarantee. The liability under a guarantee provided under this section shall decrease or increase on a pro rata...

  16. 24 CFR 1007.60 - Liability under guarantee.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Liability under guarantee. 1007.60... DEVELOPMENT SECTION 184A LOAN GUARANTEES FOR NATIVE HAWAIIAN HOUSING § 1007.60 Liability under guarantee. The liability under a guarantee provided under this section shall decrease or increase on a pro rata...

  17. 46 CFR 5.69 - Evidence of criminal liability.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Evidence of criminal liability. 5.69 Section 5.69... INVESTIGATION REGULATIONS-PERSONNEL ACTION Statement of Policy and Interpretation § 5.69 Evidence of criminal liability. Evidence of criminal liability discovered during an investigation or hearing conducted...

  18. 46 CFR 5.69 - Evidence of criminal liability.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 1 2012-10-01 2012-10-01 false Evidence of criminal liability. 5.69 Section 5.69... INVESTIGATION REGULATIONS-PERSONNEL ACTION Statement of Policy and Interpretation § 5.69 Evidence of criminal liability. Evidence of criminal liability discovered during an investigation or hearing conducted...

  19. 48 CFR 252.217-7012 - Liability and insurance.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 3 2011-10-01 2011-10-01 false Liability and insurance... of Provisions And Clauses 252.217-7012 Liability and insurance. As prescribed in 217.7104(a), use the following clause: Liability and Insurance (AUG 2003) (a) The Contractor shall exercise its best efforts...

  20. 48 CFR 252.247-7007 - Liability and insurance.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 3 2011-10-01 2011-10-01 false Liability and insurance... of Provisions And Clauses 252.247-7007 Liability and insurance. As prescribed in 247.270-4(g), use the following clause: Liability and Insurance (DEC 1991) (a) The Contractor shall be— (1) Liable...

  1. 48 CFR 1452.228-70 - Liability Insurance.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Liability Insurance. 1452... Insurance. As prescribed in 1428.301, insert the following clause: Liability Insurance—Department of the... extension thereof liability insurance in form satisfactory to the Contracting Officer by an...

  2. 48 CFR 3052.217-95 - Liability and insurance (USCG).

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... CONTRACT CLAUSES Text of Provisions and Clauses 3052.217-95 Liability and insurance (USCG). As prescribed in USCG guidance at (HSAR) 48 CFR 3017.9000(a) and (b), insert the following clause: Liability and... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Liability and...

  3. 12 CFR 1270.10 - Joint and several liability.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 10 2014-01-01 2014-01-01 false Joint and several liability. 1270.10 Section... Consolidated Obligations § 1270.10 Joint and several liability. (a) In general—(1) Each and every Bank..., the joint and several liability of all of the Banks on any consolidated obligation. (b)...

  4. 12 CFR 1270.10 - Joint and several liability.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 9 2012-01-01 2012-01-01 false Joint and several liability. 1270.10 Section... Consolidated Obligations § 1270.10 Joint and several liability. (a) In general. (1) Each and every Bank..., the joint and several liability of all of the Banks on any consolidated obligation. (b)...

  5. 14 CFR 291.22 - Aircraft accident liability insurance requirement.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Aircraft accident liability insurance... for All-Cargo Air Transportation § 291.22 Aircraft accident liability insurance requirement. No air... and maintains in effect aircraft accident liability coverage that meets the requirements of part...

  6. 7 CFR 276.2 - State agency liabilities.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 4 2011-01-01 2011-01-01 false State agency liabilities. 276.2 Section 276.2 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE FOOD STAMP AND FOOD DISTRIBUTION PROGRAM STATE AGENCY LIABILITIES AND FEDERAL SANCTIONS § 276.2 State agency liabilities. Link to...

  7. 48 CFR 1452.228-70 - Liability Insurance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Liability Insurance. 1452... Insurance. As prescribed in 1428.301, insert the following clause: Liability Insurance—Department of the... extension thereof liability insurance in form satisfactory to the Contracting Officer by an...

  8. 19 CFR 141.2 - Liability for duties on reimportation.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 19 Customs Duties 2 2011-04-01 2011-04-01 false Liability for duties on reimportation. 141.2 Section 141.2 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) ENTRY OF MERCHANDISE Liability for Duties and Requirement To Enter Merchandise § 141.2 Liability for duties...

  9. 19 CFR 141.2 - Liability for duties on reimportation.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 19 Customs Duties 2 2012-04-01 2012-04-01 false Liability for duties on reimportation. 141.2 Section 141.2 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) ENTRY OF MERCHANDISE Liability for Duties and Requirement To Enter Merchandise § 141.2 Liability for duties...

  10. 14 CFR 1260.61 - Allocation of risk/liability.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 5 2012-01-01 2012-01-01 false Allocation of risk/liability. 1260.61... AGREEMENTS General Special Conditions § 1260.61 Allocation of risk/liability. Allocation of Risk/Liability..., judgment, or cost arising from the injury to or death of any person, or for damage to or loss of...

  11. 14 CFR 1260.61 - Allocation of risk/liability.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 5 2013-01-01 2013-01-01 false Allocation of risk/liability. 1260.61... AGREEMENTS General Special Conditions § 1260.61 Allocation of risk/liability. Allocation of Risk/Liability..., judgment, or cost arising from the injury to or death of any person, or for damage to or loss of...

  12. 14 CFR 1260.61 - Allocation of risk/liability.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Allocation of risk/liability. 1260.61... AGREEMENTS General Special Conditions § 1260.61 Allocation of risk/liability. Allocation of Risk/Liability..., judgment, or cost arising from the injury to or death of any person, or for damage to or loss of...

  13. 37 CFR 10.78 - Limiting liability to client.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Limiting liability to client... Office Code of Professional Responsibility § 10.78 Limiting liability to client. A practitioner shall not attempt to exonerate himself or herself from, or limit his or her liability to, a client for his or...

  14. 47 CFR 32.25 - Unusual items and contingent liabilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 2 2010-10-01 2010-10-01 false Unusual items and contingent liabilities. 32.25 Section 32.25 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES... contingent liabilities. Extraordinary items, prior period adjustments, and contingent liabilities may...

  15. 7 CFR 1770.25 - Unusual items and contingent liabilities.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 12 2010-01-01 2010-01-01 false Unusual items and contingent liabilities. 1770.25... BORROWERS Uniform System of Accounts § 1770.25 Unusual items and contingent liabilities. Extraordinary items, prior period adjustments and contingent liabilities shall be submitted to RUS for review before...

  16. 14 CFR 1274.916 - Liability and risk of loss.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 5 2012-01-01 2012-01-01 false Liability and risk of loss. 1274.916... AGREEMENTS WITH COMMERCIAL FIRMS Other Provisions and Special Conditions § 1274.916 Liability and risk of..., or indemnification of, developers of experimental aerospace vehicles. Liability and Risk of Loss...

  17. 14 CFR 1274.916 - Liability and risk of loss.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Liability and risk of loss. 1274.916 Section... WITH COMMERCIAL FIRMS Other Provisions and Special Conditions § 1274.916 Liability and risk of loss..., or indemnification of, developers of experimental aerospace vehicles. Liability and Risk of Loss...

  18. 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. PMID:27338970

  19. Child sexual abuse, attachment style, and depression: the role of the characteristics of abuse.

    PubMed

    Cantón-Cortés, David; Cortés, María Rosario; Cantón, José

    2015-02-01

    The aim of the current study was to examine the effects of secure, avoidant, and anxious attachment styles on depressive symptomatology in child sexual abuse (CSA) among young female adult victims. The role of attachment style was studied by considering possible interactive effects with the type of abuse, the relationship with the perpetrator, and the continuity of abuse. Participants were 168 female victims of CSA. Information about the abuse was obtained from a self-reported questionnaire. Attachment style was assessed with the Attachment Style Measure (ASM), and the Beck Depression Inventory (BDI) was used to assess depressive symptomatology. Secure and anxious attachment styles were correlated with low and high depression scores respectively. The effects of attachment style were stronger in cases where the abuse consisted of oral sex/penetration, a non-family member as perpetrator, and in isolated, compared with continued, abuse. These results confirm that characteristics of CSA (type of abuse, relationship with the perpetrator, and continuity of abuse) can affect the impact of attachment style on depressive symptomatology. PMID:24958133

  20. Uranium mine and mill tailings - Liabilities in the European Union

    SciTech Connect

    Hilden, Wolfgang; Murphy, Simon; Vrijen, Jan

    2007-07-01

    Available in abstract form only. Full text of publication follows: Uranium mining and milling has taken place on large scale in the Member States of the European Union (EU) for some 60 years. Although, compared to mining, milling activities are normally concentrated in fewer locations, this can still result in a relatively large number of disposal sites for the tailings, compared to other radioactive wastes. In addition these sites are also quite large, in terms of both volume and surface area. Coupled with the residual uranium in the tailings together with other radionuclides, heavy metals, chemicals etc this results in an environmental legacy continuing far into the future. Often during production no or little provision has been made for the closure, remediation and future supervision of such sites. In 1996 the European Commission funded an inventory of uranium mining and milling liabilities in nine Central and Eastern European Countries. Additionally, pilot projects were funded to carry out remediation activities at several sites. Almost ten years later the Commission has identified the need to address the situation of these large liabilities in all EU Member States and to assess the progress made in remediation of the sites, especially in view of the closure of almost all mining activities in Europe. The Commission study has identified the current tailings liabilities in Europe, their status, the future plans for these sites and the hazards that continue to be associated with them. It is clear that although considerable progress has been made in recent years, much work remains to be carried out in the areas of remediation, and ensuring the long-term safety of many of the identified objects. The paper presents the main findings of the study, as well as the challenges identified to ensure long-term safety of these wastes. (authors)

  1. The relationship between childhood abuse and psychosis for women prisoners: assessing the importance of frequency and type of victimization.

    PubMed

    Kennedy, Stephanie C; Tripodi, Stephen J; Pettus-Davis, Carrie

    2013-12-01

    This study examines the relationship between childhood victimization and self-reported current symptoms of psychosis in an incarcerated female population in the United States. Participants are 159 randomly selected women incarcerated in two North Carolina state prisons. Participants completed a battery of self-report measures to assess childhood victimization and current and lifetime experience of audio/visual hallucinations and delusions. In accordance with the dose-response model, we hypothesized a predictive relationship between severity, frequency, and type of victimization and psychosis for this sample of women prisoners. Results indicate that women who experienced multi-victimization were 2.4 times more likely to report current symptoms of psychosis than other women prisoners who experienced only physical or sexual victimization in childhood. Likewise, a one-unit increase in frequency of childhood victimization was associated with a 3.2% increased likelihood of having reported symptoms of current psychosis. These results provide support for the dose-response model hypothesis that multi-victimization is an important predictor of psychosis for the women prisoner population. Results indicate that adjusting prison-based mental health services to address the relationship of childhood victimization and symptoms of psychosis may be a key factor in improving outcomes among this population. PMID:23443760

  2. Non-Abused Preschool Children's Perception of an Anogenital Examination

    ERIC Educational Resources Information Center

    Gulla, Kari; Fenheim, Gred Eva; Myhre, Arne K.; Lydersen, Stian

    2007-01-01

    Objective: An anogenital examination is usually part of the standard medical assessment in children evaluated for suspected sexual abuse, and the emotional impact on the child has been studied. The primary aim of this study was to assess non-abused preschool children's responses to an anogenital examination. Method: One hundred and fifty-eight…

  3. Preventing and Recognizing Prescription Drug Abuse

    MedlinePlus

    ... Abuse » Preventing and recognizing prescription drug abuse Prescription Drug Abuse Email Facebook Twitter Preventing and recognizing prescription drug abuse To ensure proper medical care, patients should discuss ...

  4. 14 CFR 221.106 - Notice of limited liability for baggage; alternative consolidated notice of liability limitations.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Notice of limited liability for baggage; alternative consolidated notice of liability limitations. 221.106 Section 221.106 Aeronautics and Space OFFICE... the following statement: Notice of Limited Liability for Baggage For most international...

  5. 14 CFR 221.106 - Notice of limited liability for baggage; alternative consolidated notice of liability limitations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Notice of limited liability for baggage; alternative consolidated notice of liability limitations. 221.106 Section 221.106 Aeronautics and Space OFFICE... the following statement: Notice of Limited Liability for Baggage For most international...

  6. 14 CFR 221.106 - Notice of limited liability for baggage; alternative consolidated notice of liability limitations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false Notice of limited liability for baggage; alternative consolidated notice of liability limitations. 221.106 Section 221.106 Aeronautics and Space OFFICE... the following statement: Notice of Limited Liability for Baggage For most international...

  7. 14 CFR 221.106 - Notice of limited liability for baggage; alternative consolidated notice of liability limitations.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Notice of limited liability for baggage; alternative consolidated notice of liability limitations. 221.106 Section 221.106 Aeronautics and Space OFFICE... the following statement: Notice of Limited Liability for Baggage For most international...

  8. 7 CFR 966.90 - Personal liability.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Personal liability. 966.90 Section 966.90 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE TOMATOES GROWN IN FLORIDA...

  9. 7 CFR 1150.183 - Personal liability.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 9 2014-01-01 2013-01-01 true Personal liability. 1150.183 Section 1150.183 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; MILK), DEPARTMENT OF AGRICULTURE DAIRY PROMOTION PROGRAM Dairy Promotion and...

  10. Questions to Ask Your Liability Insurance Broker

    ERIC Educational Resources Information Center

    Neugebauer, Roger

    2006-01-01

    This paper discusses some important questions to ask an insurance broker regarding liability insurance. The author based these questions on his interviews with Kathryn Hammerback, Craig Hammer, and Mike North: (1) Are centers covered when...?; (2) How can a center director cut costs on this policy?; (3) Is this an "occurrence" or a "claims-made"…

  11. 7 CFR 932.74 - Personal liability.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Personal liability. 932.74 Section 932.74 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE OLIVES GROWN IN CALIFORNIA...

  12. 7 CFR 932.74 - Personal liability.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 8 2013-01-01 2013-01-01 false Personal liability. 932.74 Section 932.74 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; FRUITS, VEGETABLES, NUTS), DEPARTMENT OF AGRICULTURE OLIVES GROWN IN CALIFORNIA...

  13. 7 CFR 932.74 - Personal liability.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Personal liability. 932.74 Section 932.74 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE OLIVES GROWN IN CALIFORNIA...

  14. 7 CFR 932.74 - Personal liability.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 8 2014-01-01 2014-01-01 false Personal liability. 932.74 Section 932.74 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; FRUITS, VEGETABLES, NUTS), DEPARTMENT OF AGRICULTURE OLIVES GROWN IN CALIFORNIA...

  15. 7 CFR 932.74 - Personal liability.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 8 2012-01-01 2012-01-01 false Personal liability. 932.74 Section 932.74 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE OLIVES GROWN IN CALIFORNIA...

  16. Update on Liability for Sexual Harassment.

    ERIC Educational Resources Information Center

    Russo, Charles J.; Ilg, Timothy J.

    2002-01-01

    Reviews six Supreme Court decisions on sexual harassment since 1992, three of which were education cases. Suggests content of school board policy to comply with Court's sexual-harassment decisions and thus limit liability under Title IX for offenses involving students and Title VII for acts involving school personnel. (PKP)

  17. 7 CFR 906.61 - Personal liability.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 8 2014-01-01 2014-01-01 false Personal liability. 906.61 Section 906.61 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; FRUITS, VEGETABLES, NUTS), DEPARTMENT OF AGRICULTURE ORANGES AND GRAPEFRUIT GROWN IN LOWER RIO GRANDE VALLEY IN TEXAS...

  18. 7 CFR 905.88 - Personal liability.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 8 2014-01-01 2014-01-01 false Personal liability. 905.88 Section 905.88 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; FRUITS, VEGETABLES, NUTS), DEPARTMENT OF AGRICULTURE ORANGES, GRAPEFRUIT, TANGERINES, AND TANGELOS GROWN IN FLORIDA...

  19. 7 CFR 906.61 - Personal liability.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 8 2012-01-01 2012-01-01 false Personal liability. 906.61 Section 906.61 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE ORANGES AND GRAPEFRUIT GROWN IN LOWER RIO GRANDE VALLEY IN TEXAS...

  20. 7 CFR 906.61 - Personal liability.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 8 2013-01-01 2013-01-01 false Personal liability. 906.61 Section 906.61 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; FRUITS, VEGETABLES, NUTS), DEPARTMENT OF AGRICULTURE ORANGES AND GRAPEFRUIT GROWN IN LOWER RIO GRANDE VALLEY IN TEXAS...

  1. 7 CFR 905.88 - Personal liability.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 8 2012-01-01 2012-01-01 false Personal liability. 905.88 Section 905.88 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE ORANGES, GRAPEFRUIT, TANGERINES, AND TANGELOS GROWN IN FLORIDA...

  2. 7 CFR 905.88 - Personal liability.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 8 2013-01-01 2013-01-01 false Personal liability. 905.88 Section 905.88 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; FRUITS, VEGETABLES, NUTS), DEPARTMENT OF AGRICULTURE ORANGES, GRAPEFRUIT, TANGERINES, AND TANGELOS GROWN IN FLORIDA...

  3. 7 CFR 923.70 - Personal liability.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 8 2013-01-01 2013-01-01 false Personal liability. 923.70 Section 923.70 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; FRUITS, VEGETABLES, NUTS), DEPARTMENT OF AGRICULTURE SWEET CHERRIES GROWN IN...

  4. 7 CFR 923.70 - Personal liability.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Personal liability. 923.70 Section 923.70 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE SWEET CHERRIES GROWN IN...

  5. 7 CFR 923.70 - Personal liability.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 8 2014-01-01 2014-01-01 false Personal liability. 923.70 Section 923.70 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; FRUITS, VEGETABLES, NUTS), DEPARTMENT OF AGRICULTURE SWEET CHERRIES GROWN IN...

  6. 7 CFR 923.70 - Personal liability.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Personal liability. 923.70 Section 923.70 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE SWEET CHERRIES GROWN IN...

  7. Violence in the Workplace: Avoiding Institutional Liability.

    ERIC Educational Resources Information Center

    Marsh, Ranaye J.; Hall, Bradley H.

    This document is intended to provide career and technical education faculty and administrators with information on institutional liability relating to workplace violence as documented in court cases. The major legislation regarding violence in schools is summarized. Seventeen warning signs of violence are presented along with simple steps…

  8. 12 CFR 229.38 - Liability.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... deadline for return under the U.C.C., Regulation J (12 CFR part 210), or § 229.30(c) in connection with a... OF FUNDS AND COLLECTION OF CHECKS (REGULATION CC) Collection of Checks § 229.38 Liability....

  9. 12 CFR 229.38 - Liability.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... deadline for return under the U.C.C., Regulation J (12 CFR part 210), or § 229.30(c) in connection with a... OF FUNDS AND COLLECTION OF CHECKS (REGULATION CC) Collection of Checks § 229.38 Liability....

  10. 12 CFR 229.21 - Civil liability.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 3 2013-01-01 2013-01-01 false Civil liability. 229.21 Section 229.21 Banks and Banking FEDERAL RESERVE SYSTEM (CONTINUED) BOARD OF GOVERNORS OF THE FEDERAL RESERVE SYSTEM (CONTINUED) AVAILABILITY OF FUNDS AND COLLECTION OF CHECKS (REGULATION CC) Availability of Funds...

  11. 12 CFR 229.38 - Liability.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... deadline for return under the U.C.C., Regulation J (12 CFR part 210), or § 229.30(c) in connection with a... OF FUNDS AND COLLECTION OF CHECKS (REGULATION CC) Collection of Checks § 229.38 Liability....

  12. 12 CFR 229.21 - Civil liability.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 3 2012-01-01 2012-01-01 false Civil liability. 229.21 Section 229.21 Banks and Banking FEDERAL RESERVE SYSTEM (CONTINUED) BOARD OF GOVERNORS OF THE FEDERAL RESERVE SYSTEM AVAILABILITY OF FUNDS AND COLLECTION OF CHECKS (REGULATION CC) Availability of Funds and Disclosure of...

  13. 12 CFR 229.38 - Liability.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... deadline for return under the U.C.C., Regulation J (12 CFR part 210), or § 229.30(c) in connection with a...) AVAILABILITY OF FUNDS AND COLLECTION OF CHECKS (REGULATION CC) Collection of Checks § 229.38 Liability....

  14. 12 CFR 229.21 - Civil liability.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 3 2011-01-01 2011-01-01 false Civil liability. 229.21 Section 229.21 Banks and Banking FEDERAL RESERVE SYSTEM (CONTINUED) BOARD OF GOVERNORS OF THE FEDERAL RESERVE SYSTEM AVAILABILITY OF FUNDS AND COLLECTION OF CHECKS (REGULATION CC) Availability of Funds and Disclosure of...

  15. 12 CFR 229.38 - Liability.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... deadline for return under the U.C.C., Regulation J (12 CFR part 210), or § 229.30(c) in connection with a...) AVAILABILITY OF FUNDS AND COLLECTION OF CHECKS (REGULATION CC) Collection of Checks § 229.38 Liability....

  16. 12 CFR 229.21 - Civil liability.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 3 2014-01-01 2014-01-01 false Civil liability. 229.21 Section 229.21 Banks and Banking FEDERAL RESERVE SYSTEM (CONTINUED) BOARD OF GOVERNORS OF THE FEDERAL RESERVE SYSTEM (CONTINUED) AVAILABILITY OF FUNDS AND COLLECTION OF CHECKS (REGULATION CC) Availability of Funds...

  17. 7 CFR 920.69 - Personal liability.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Personal liability. 920.69 Section 920.69 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE KIWIFRUIT GROWN IN...

  18. 7 CFR 920.69 - Personal liability.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 8 2012-01-01 2012-01-01 false Personal liability. 920.69 Section 920.69 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE KIWIFRUIT GROWN IN...

  19. 7 CFR 920.69 - Personal liability.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 8 2014-01-01 2014-01-01 false Personal liability. 920.69 Section 920.69 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; FRUITS, VEGETABLES, NUTS), DEPARTMENT OF AGRICULTURE KIWIFRUIT GROWN IN...

  20. 7 CFR 920.69 - Personal liability.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 8 2013-01-01 2013-01-01 false Personal liability. 920.69 Section 920.69 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; FRUITS, VEGETABLES, NUTS), DEPARTMENT OF AGRICULTURE KIWIFRUIT GROWN IN...