Newberger, Eli H.; Hyde, James N., Jr.
This paper summarizes data and experience with child abuse pertinent to child health practice. It goal is to foster sound and rational medical management. Because of the complex origins of child abuse, however, and of the institutional and social changes which shall have to accompany excellent practice if child abuse is effectively to be treated…
Ozechowski, Timothy J.; Waldron, Holly Barrett
In any given year, only about 10% of the nearly two million adolescents exhibiting substance abuse or dependence in the United States receive substance abuse treatment. Given this state of affairs, it is unlikely that the massive effort and expenditure of resources over the past decade on developing, testing, and disseminating effective treatments for adolescent substance abuse can have an appreciable impact on the prevalence of substance use disorders among the adolescent population. In order to substantially diminish the pervasive gap between levels of need for and utilization of adolescent substance abuse treatment, specialized assertive outreach strategies may be needed. This paper outlines a framework for assertive outreach for adolescents with substance use disorders, and proposes specific types of strategies for identifying and enrolling such adolescents into treatment. Implications for practice and policy pertaining to adolescent substance abuse treatment service delivery are considered. PMID:18690540
Sexual abuse is a problem of epidemic proportions in the United States. Given the sheer numbers of sexually abused children, it is vital for pediatric nurse practitioners to understand both short-term and long-term consequences of sexual abuse. Understanding consequences of sexual abuse can assist the pediatric nurse practitioner in anticipating the physical and mental health needs of patients and also may assist in the identification of sexual abuse victims. Sexual abuse typically does not occur in isolation. Implications for practice will be discussed.
Barringer, Alexandra; Hunter, Bronwyn A; Salina, Doreen D; Jason, Leonard A
Programs for women with substance abuse and criminal justice histories often incorporate empowerment and social support into service delivery systems. Women's empowerment research has focused on the relationship between women's personal identities and the larger sociopolitical context, with an emphasis on how community-based resources are critical for promoting well-being. Social support often protects against negative outcomes for individuals who live with chronic stress. However, few studies have evaluated community resource knowledge and empowerment among marginalized women or how social support might strengthen or weaken this relationship. This study investigated resource knowledge, social support, and empowerment among 200 minority women in substance abuse recovery who had recent criminal justice involvement. Results indicated that resource knowledge was related to empowerment and belonging social support marginally moderated this relationship. In addition, education level increased and current involvement in the criminal justice system decreased empowerment. Implications for research, practice, and policy are discussed.
Chang, Janet; Rhee, Siyon; Berthold, S. Megan
This study examines the characteristics and patterns of child maltreatment among Cambodian refugee families in Los Angeles and assesses the implications for child welfare practice with Cambodian refugee families. Data were extracted from 243 active Cambodian case files maintained by the Los Angeles County Department of Children and Family Services…
Myers, Bronwyn; Burnhams, Nadine Harker; Fakier, Nuraan
Although outcomes monitoring and the collection of other performance data holds benefits for service managers and policy makers, the extent to which these data are collected by South African substance abuse service providers is unknown. To describe (i) the extent to which substance abuse service providers in South Africa monitor and evaluate their…
Drug abuse appears destined to become an exacerbating cultural phenomenon despite intrinsic dangers to the abuser and accelerating costs to society. Dentists cannot afford to ignore the problem or its sequelae either in terms of their personal involvement or in terms of the clinical implications of such a practice for their patients. Abuse of agents, such as opioids and amphetamines, by the dental practitioner leads to devastating personal, social, and professional consequences. The abuser jeopardizes his or her reputation, family relationships, professional practice, and, not uncommonly, his or her very life through accidental overdose of drugs or by suicide. Nitrous oxide abuse is particularly prevalent among dentists and, although producing no psychological dependence, may result in long-term myeloneuropathy and physical disability making continued dental practice impossible. The dentist's responsibilities in this area lie within clinical and social domains. Clinically, the dentist must (1) learn to detect those physical and behavioral signs in patients that are indicators of drug abuse; (2) become familiar with tactics employed by drug abusers to obtain drugs for themselves or for further criminal diversion, and be prepared to defend against such tactics; (3) understand and make clinical allowance for therapeutic complications that may arise in the treatment of drug-abuse patients. The dentist's social role as an informed, concerned, and empathic counselor in matters of drug abuse must be assumed as a personal imperative and not viewed as an intellectual abstraction. Whenever we are made aware of the drug-related devastation or death of a friend, colleague, or student, we discern the immediacy of an ethical responsibility of social dimensions, so eloquently expressed over 350 years ago, by John Donne in his "Devotions XVII": "No man is an island, ... Any man's death diminishes me, because I am involved in Mankind; And therefore never send to know for whom the
Barter, Christine; Stanley, Nicky
This paper provides a narrative review of the knowledge on inter-personal violence and abuse (IPVA) in adolescents' intimate relationships. It draws on the authors' own research, published reviews, and a rapid review on IPVA victimization and mental health outcomes for adolescents. The research reviewed identified associations between adolescent IPVA and substance misuse, depressive symptoms and PTSD, eating disorders and suicidal thinking, and behaviour in young people. Generally, girls appeared more likely to report severe mental health outcomes than boys. Adolescents rarely disclose IPVA to adults and delivering preventative programmes that promote knowledge and help seeking may offer a means of building on young people's tendency to seek help from friends. These preventative interventions, usually delivered in schools, need to be closely linked to support services for adolescents who disclose abuse. While there are some practice examples of emerging interventions for both victims and perpetrators of adolescent IPVA, there is as yet little robust evidence regarding their effectiveness.
Research on the incidence, etiology and substance abuse treatment needs of lesbian, bisexual and transgender (LBT) women is limited. Most research indicates higher levels of alcohol and drug abuse among these populations compared to their heterosexual counterparts, with recent research indicating that substance abuse is a particular concern for transgender individuals and an increasing problem among younger LBT individuals. Risk factors and reasons for substance abuse among sexual minority women are similar to those of heterosexual women, yet are substantially complicated by issues of family rejection and lack of social support, stigma and minority stress, as well as abuse and harassment. Historically, substance abuse prevention, early intervention, and clinical treatment programs were designed to meet the needs of the sexual majority population with relatively few programs designed to incorporate the specific needs of sexual minorities. This article reviews findings from previous studies and utilizes new data collected from community-based and residential substance abuse treatment programs to (1) examine issues relevant to LBT women and substance use, and (2) make recommendations for tailoring substance abuse treatment programs to meet the needs of these populations.
This article provides an overview on prescription drug abuse and highlights a number of related legislative bills introduced during the 112th Congress in response to this growing epidemic. Prescription drug abuse has emerged as the nation's fastest growing drug problem. Although prescription drugs have been used effectively and appropriately for decades, deaths from prescription pain medicine in particular have reached epidemic proportions. Bills related to prescription drug abuse introduced during the 112th Congress focus on strengthening provider and consumer education, tracking and monitoring prescription drug abuse, improving data collection on drug overdose fatalities, combating fraud and abuse in Medicare and Medicaid programs, reclassifying drugs to make them more difficult to prescribe and obtain, and enforcing stricter penalties for individuals who operate scam pain clinics and sell pain pills illegitimately. This article underscores the importance of a multifaceted approach to combating prescription drug abuse and concludes with implications for nursing.
The Continuum of Disclosure: Exploring Factors Predicting Tentative Disclosure of Child Sexual Abuse Allegations During Forensic Interviews and the Implications for Practice, Policy, and Future Research.
Anderson, Gwendolyn D
When a child sexual abuse investigation ensues, many children do not disclose readily to professionals. Defining disclosure beyond the disclosure versus nondisclosure dichotomy is essential, yet little research exists on factors associated with a continuum of disclosure, including active and tentative disclosure. Through the coding of 196 forensic interviews using content analysis and subsequent regression analysis, findings suggest that children of color, children abused by adults, unintentional initial disclosure, and those lacking family support were more likely to tentatively disclose in this study. Implications include a need to understand tentative disclosure as part of a normal continuum of disclosure within court proceedings and investigations of abuse allegations.
Jaffee, Sara R.; Christian, Cindy W.
Each year within the US alone over 770,000 children are victimized by abuse and neglect (US Department of Health and Human Services, 2010), and this figure is likely to underestimate the extent of the problem. Researchers have long recognized that maltreatment has adverse effects on children's mental health and academic achievement. Studies of…
Pickard, Hanna; Fazel, Seena
Purpose of review To review recent research on the relationship between substance abuse, crime, violence and mental illness, and suggest how this research could aid forensic psychiatrists, psychologists and other mental health professionals in assessing and managing risk, and balancing patient care and public protection. Recent findings Substance abuse in mentally ill forensic psychiatric patients should be considered an important risk factor for violence and re-offending. Summary Improved treatment for substance abuse in forensic psychiatric patients and other mentally disordered offenders together with the offer of monitored abstinence as a condition of leave or discharge could be usefully considered as a means of reducing and managing risk. This may improve patient care by addressing mental health needs and increasing opportunity and likelihood of successful re-integration into the community and better life prospects; protect the public by reducing risk of re-offending and offering real time monitoring and potential intervention when risk is heightened; and help forensic psychiatrists strike a balance between patient care and public protection, potentially alleviating some of the difficulty and anxiety that decisions to grant leave or discharge can create. PMID:23722099
Recognition of elder abuse and neglect among health care professionals has been a relatively recent phenomenon. Each year, millions of elderly persons suffer as the result of abuse and neglect. Their quality of life is severely jeopardized in the form of worsened functional status and progressive dependency, poorly rated self-health, feelings of helplessness, and from the vicious cycle of social isolation, stress and further psychologic decline. Other medical implications of abuse and neglect include higher health systems use in the form of frequent ER visits, higher hospitalization, and higher nursing home placement; most importantly, it is an independent predictor for higher mortality. Physicians are well situated in detecting and reporting suspected cases and taking care of the frail elders who are victims of abuse and neglect, but there are barriers on the individual level, and there is a broader need for system change. Through education, training, and reinforcement, there are strategies to get health care professionals more involved and provide effective management protocols and guidelines for us to advocate for our patients in the current epidemic of elder abuse and neglect.
Leach, M. M.; Bethune, C.
Millions of adults have been sexually abused. Patients often confide in their family physicians concerning their abuse. Physicians must understand their own issues surrounding sexual abuse and its sequelae before they attempt to treat sexually abused patients. The PLISSIT model offers a practical guide for assisting abused adult patients. PMID:8924817
Lazenbatt, Anne; Greer, Jean
This article debates the issues involved in safeguarding and protecting children in maternity services and offers implications for professional practice. Midwives and other staff who work as members of the maternity team have a safeguarding role to play in the identification of babies and children who have been abused, or are at risk of abuse, and…
Schulden, Jeffrey D; Lopez, Marsha F; Compton, Wilson M
Research on the epidemiology of illicit drug use disorders provides continued critical insights into the distribution and determinants of drug use and drug use disorders in the United States. This research serves as a foundation for understanding the etiology of these disorders, helping to disentangle the complex interrelationship of developmental, genetic, and environmental risk and protective factors. Building on an understanding of this research in substance abuse epidemiology, it is important for clinicians to understand the unique trends in drug use in the overall communities that they serve and the unique risk factors for given individuals. The generally high prevalence of substance use disorders, along with their high comorbidity with other psychiatric disorders and with the HIV epidemic, make prevention, evaluation, and referral for treatment for drug abuse an important part of routine clinical practice in a range of clinical settings, including primary care, psychiatric, and emergency department settings. Ongoing efforts to ensure insurance coverage parity for the treatment of mental health and substance use disorders offer the promise of continued improvements in the integration and availability of such services in the broader US health care system.
Page, Richard C.; Myrick, Robert D.
This study investigated the attitudes of 85 imprisoned drug abusers. The responses of the subjects on the activity, evaluative, and potency scales of a semantic differential were analyzed. Implications for counseling are discussed. (Author)
Meinck, Franziska; Cluver, Lucie D; Boyes, Mark E; Mhlongo, Elsinah L
There is now conclusive evidence of the major and long-lasting negative effects of physical and sexual abuse on children. Within Africa, studies consistently report high rates of child abuse, with prevalence as high as 64%. However, to date, there has been no review of factors associated with physical and sexual child abuse and polyvictimization in Africa. This review identified 23 quantitative studies, all of which showed high levels of child abuse in varying samples of children and adults. Although studies were very heterogeneous, a range of correlates of abuse at different levels of the Model of Ecologic Development were identified. These included community-level factors (exposure to bullying, sexual violence, and rural/urban location), household-level factors (poverty, household violence, and non-nuclear family), caregiver-level factors (caregiver illness in particular AIDS and mental health problems, caregiver changes, family functioning, parenting, caregiver-child relationship, and substance abuse), and child-level factors (age, disability, physical health, behavior, and gender). These findings identify key associated factors that are potential foci of child abuse prevention interventions. In addition, there is a clear need for further rigorous longitudinal research into predictive factors and culturally relevant interventions.
Fein, George; Di Sclafani, Victoria
Cerebral reserve capacity (or functional reserve) refers to the brain's ability to maintain function when confronted by degenerative processes. Functional reserve can be estimated by several associated measures, including premorbid brain size, premorbid IQ, and level of education attained. There is accumulating evidence that the magnitude of reserve capacity is important in determining the onset and progression of the clinical manifestations of neurodegenerative brain diseases. Normal aging also whittles away at this cerebral reserve, and there may be a consequent unmasking of morbid effects that was not clinically evident when this compensatory reserve was sufficient. We review the evidence supporting this model for a number of degenerative brain processes, including Alzheimer's disease, presenile dementia, HIV dementia, aging, and chronic (multiyear) substance abuse. The concept of cerebral functional reserve has important implications for alcohol and drug abuse morbidity. First, given the high genetic contribution to substance abuse, there is an increased likelihood that the parents of substance abusers were substance abusers themselves. Substance abuse during pregnancy can inhibit brain growth, resulting in reduced brain size and reduced reserve capacity (and therefore less ability to compensate for loss of function later in life). Second, substance abuse is often coupled with poverty, and both substance abuse and poverty are associated with some of the same conditions that reduce brain growth. Finally, we comment on the most important public health implication of the cerebral reserve capacity model (vis-à-vis addiction).
Sikes, April; Hays, Danica G.
Many adults are exposed to maltreatment during their childhood. As a result, they may experience long-term negative outcomes in a range of developmental areas. The purpose of this article was to examine the social, physical, and mental health consequences of child abuse in adulthood. Implications for counseling practice are provided.
Illicit drugs are used regularly by 14.5 million Americans. By identifying patients who abuse substances, the nurse will be better able to provide for the treatment interventions needed and omit ineffective treatment interventions. The patient will benefit by receiving timely and appropriate care. To identify substance abusers, the nurse must know effects of commonly abused drugs, their routes of administration, withdrawal signs, and the physical assessments that should be performed. The most common drugs abused are narcotics, depressants, antidepressants, anti-anxiety drugs, stimulants, hallucinogens, and marijuana.
Bahali, Kayhan; Akçan, Ramazan; Tahiroglu, Aysegul Y; Avci, Ayse
The purpose of this study was to determine the socio-demographic characteristics of sexually abused children. The records of 101 cases of child sexual abuse (CSA) were retrospectively evaluated. Socio-demographic characteristics of the victims, type of sexual abuse, and psychiatric diagnosis were studied. Of the victims, 56.4% (n = 57) were female and 43.6% (n = 44) were male. The mean age was 9.57 +/- 3.5, with a range of 4-17 years. Ninety-three (92.1%) of the victims had been admitted as part of the legal process. The majority (66.3%) of the victims had been abused by an acquaintance, while 33.7% had been abused by a stranger. Anal or vaginal penetration was reported in 48.5% of the cases. Post-traumatic stress disorder was the most common (54.5%) psychiatric diagnosis established after sexual abuse. Descriptive data related to the abused children and an understanding of the consequences of CSA will help authorities in planning prevention.
Bala, Neeru; Kaur, Gagandeep; Attri, Joginder Pal; Singh, Manjit; Thakur, Millind; Jain, Payal
Substance abuse has crossed all social, economic, and geographic borders and is spreading its fangs in each and every sphere of society irrespective of age, gender, caste, creed, and religion. These days, we encounter several patients of substance dependence who visit different hospitals for elective surgical procedures or in emergency (e.g., roadside accidents and with various complications associated with substance abuse). These patients at that time may be either addicted to them or are intoxicated by them or on de addiction treatment. Acute or chronic use of these drugs affect the respiratory, cardiovascular, central nervous, renal, hematological, and hepatic system variably in individuals thus due to diverse clinical presentations a complete understanding of the path physiology and anesthetic implications of drug abuse is essential to tailor a safe anesthetic plan for these high-risk group of patients. PMID:26712964
Bala, Neeru; Kaur, Gagandeep; Attri, Joginder Pal; Singh, Manjit; Thakur, Millind; Jain, Payal
Substance abuse has crossed all social, economic, and geographic borders and is spreading its fangs in each and every sphere of society irrespective of age, gender, caste, creed, and religion. These days, we encounter several patients of substance dependence who visit different hospitals for elective surgical procedures or in emergency (e.g., roadside accidents and with various complications associated with substance abuse). These patients at that time may be either addicted to them or are intoxicated by them or on de addiction treatment. Acute or chronic use of these drugs affect the respiratory, cardiovascular, central nervous, renal, hematological, and hepatic system variably in individuals thus due to diverse clinical presentations a complete understanding of the path physiology and anesthetic implications of drug abuse is essential to tailor a safe anesthetic plan for these high-risk group of patients.
Elder abuse, sometime called elder mistreatment or elder maltreatment, includes psychological, physical, and sexual abuse, neglect (caregiver neglect and self-neglect), and financial exploitation. Evidence suggests that 1 out of 10 older adult experiences some form of elder abuse, and only 1 of out 25 cases are actually reported to social services agencies. At the same time, elder abuse is associated with significant morbidity and premature mortality. Despite these findings, there is a great paucity in research, practice, and policy dealing with the pervasive issues of elder abuse. Through my experiences as a American Political Sciences Association Congressional Policy Fellow/Health and Aging Policy Fellow working with Administration on Community Living (ACL) (Previously known at Administration on Aging (AoA)) for the last two years, I will describe the major functions of the ACL; and highlight on two major pieces of federal legislation: The Older Americans Act (OAA) and the Elder Justice Act (EJA). Moreover, I will highlight major research gaps and future policy relevant research directions for the field of elder abuse. PMID:23110488
Kim, Kihyun; Trickett, Penelope K.; Putnam, Frank W.
Objective: The primary goal of this study was to explore the relationship between childhood sexual abuse and parenting practices among non-offending mothers of sexually abused girls. Guided by a developmental-ecological perspective of parenting, several models with different potential pathways starting from the mothers' childhood experiences of…
This discussion of child abuse in children with disabilities focuses on teachers' rights and responsibilities for reporting abuse and the need to overcome barriers to reporting abuse. Recommendations to protect teachers from unwarranted allegations of abuse are also given, including creating an open classroom environment, distinguishing between…
Mueser, Kim T.; And Others
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…
Spence, Richard T., Ed.; DiNitto, Diana M., Ed.; Straussner, Shulamith Lala Ashenberg, Ed.
This book offers helping professionals an introduction to the neurobiological aspects of substance abuse. It presents the basic information on the subject, including the various neurobiological theories of addiction, and places them in a psychosocial context. In addition to connecting the theoretical information with practical applications, the…
Explores the ways in which shifting meanings of childhood and constructions of sexually abused children and the structuring of team practice pose problems for multidisciplinary team members. Argues that understanding child sexual abuse and developing community-based practice approaches must be informed by broader perspectives. Suggests a model of…
... 17 Commodity and Securities Exchanges 1 2012-04-01 2012-04-01 false Prohibition on fraud, manipulation, and other abusive practices. 23.410 Section 23.410 Commodity and Securities Exchanges COMMODITY... Prohibition on fraud, manipulation, and other abusive practices. (a) It shall be unlawful for a swap dealer...
... 17 Commodity and Securities Exchanges 1 2013-04-01 2013-04-01 false Prohibition on fraud, manipulation, and other abusive practices. 23.410 Section 23.410 Commodity and Securities Exchanges COMMODITY... Prohibition on fraud, manipulation, and other abusive practices. (a) It shall be unlawful for a swap dealer...
... 17 Commodity and Securities Exchanges 1 2014-04-01 2014-04-01 false Prohibition on fraud, manipulation, and other abusive practices. 23.410 Section 23.410 Commodity and Securities Exchanges COMMODITY... Prohibition on fraud, manipulation, and other abusive practices. (a) It shall be unlawful for a swap dealer...
Wade, Jay C.
Examines factors--such as unemployment, economic deprivation, racism, issues pertaining to gender roles--and their contribution to substance abuse in African American men. Specifically reviews the use of alcohol, opiates, crack, and cocaine. Argues that a biopsychosocial model offers the best framework in conceptualizing substance abuse and…
Anetzberger, Georgia J.; And Others
A comparison group study of abusing and nonabusing caregivers suggested a correlation between alcohol use and violence against elderly parents. Findings reveal that abusers were more likely than nonabusers to drink, to become intoxicated, and to be identified as having a drinking problem. Policy and practice implications are discussed. (Author)
Lopez-Patton, Maria; Kumar, Mahendra; Jones, Deborah; Fonseca, Marla; Kumar, Adarsh M; Nemeroff, Charles B
Methamphetamine (METH) has become one of the most widely abused drugs in South Florida, particularly among MSM who may or may not be HIV seropositive. High rates of childhood trauma have been reported among HIV-infected MSM (Chartier et al., 2010), but, the association of childhood trauma, and mood disorders with methamphetamine use in HIV-infected men, has not been comprehensively explored. A better understanding of the association between these factors could improve existing substance abuse treatment intervention strategies and medical treatment programs (e.g., medication adherence; Carrico, 2010) to enhance positive health outcomes for male meth abusers living with the psychological consequences of childhood abuse. This study, as part of a larger study, examined the occurrence of childhood trauma and depression in a group of HIV seropositive METH abusing MSM. Significantly higher levels of depression symptom severity were found among METH users relative to non-METH users (p < .001). Irrespective of HIV status, METH users also reported higher frequencies of emotional, physical and sexual child abuse relative to non-METH users (p < .001). Among meth users, depression was predicted by childhood emotional neglect. These results suggest that childhood maltreatment may be implicated in the development of emotional distress (e.g., depression) and higher prevalence of methamphetamine/drug abuse in this population. These findings have important implications for substance abuse interventions, specifically targeting METH addiction among MSM. Addressing childhood trauma and depression may play a key role in enhancing the effectiveness of interventions for methamphetamine addiction.
Cahalane, Hilary; Parker, Gemma; Duff, Simon
There is a dearth of current empirical research exploring the experiences of nonoffending partners, or women whose partners have perpetrated child sexual abuse. Existing literature is dated and focuses disproportionately on intrafamilial abuse. This research explores how nonoffending partners construct and understand their experiences using thematic analysis within a social constructionist framework. Findings indicate that discovery of a partner's sexual offending is a profoundly distressing experience. It can inhibit a woman's ability to process the broader implications of her partner's behavior, including issues of risk, the impact on the victim, and the additional protective responsibilities she must adopt in the future. Implications for future research and clinical practice are discussed.
... member, a trusted teacher, a doctor, or a school or religious youth counselor. Many teachers and counselors have training in how to recognize and report abuse. Telephone and online directories list local child abuse and family violence hotline numbers that you can call for help. ...
Underwood, Lee; Stewart, Sarah E.; Castellanos, Anita M.
The sexual traumatization of female adolescents is becoming increasingly visible in the counseling field. This paper will outline the prevalence of sexual abuse on female adolescents with emphasis on effective practices used in the field. In addition, implications for counselors and counselor educators will be discussed. Multicultural…
Yalisove, Daniel L.
Most current substance abuse counselor certification education curricula do not include a systematic introduction to alcohol and substance abuse research. I believe that such an introduction would enhance counselor cooperation in research to practice efforts that are currently underway. In this paper I give a brief history of alcoholism and…
Dinehart, Laura; Kenny, Maureen C.
This study sought to assess child abuse knowledge and reporting practices of a diverse sample of early care and education (ECE) practitioners. One hundred and thirty-seven practitioners in the state of Florida completed the "Early Childhood Educators Child Abuse Questionnaire." Results revealed that only a minority of participants have…
Hibbard, R A; Hartman, G
To replicate and explore the associations of drawing genitalia on a human figure, child-rearing practices, and a history of alleged sexual abuse, we designed a cross-sectional study of 109 alleged child sexual abuse victims, ages 3 through 8 years, and a group of 109 comparison children matched for age, sex, race, and socioeconomic status but with no history of abuse. A standardized format was used to collect drawings, administer the Peabody Picture Vocabulary Test, and gather background data on medical, developmental, and child-rearing issues. Seven alleged sexual abuse victims and one comparison child spontaneously drew genitalia (p = 0.02, one-tailed Fisher Exact Test, estimated relative risk 7.96). No differences in drawing maturity (Draw-A-Man score) were identified, although Peabody Picture Vocabulary Test scores were higher in comparison children (82.1 vs. 91.0, p less than 0.01). Neither drawing genitalia nor history of alleged sexual abuse were significantly associated with histories of medical problems, enuresis, encopresis, urinary tract infection, or child-rearing practices related to sleeping, nudity, bathing, sexual abuse education, or exposure to sexually explicit materials. The similar patterns of child-rearing practices in both samples should make professionals cautious in attributing allegations of abuse to specific child-rearing practices. This study confirms our previous report that the presence of genitalia spontaneously drawn on a child's drawing of a human figure is associated with alleged sexual abuse.
Haug, Nancy A.; Shopshire, Michael; Tajima, Barbara; Gruber, Valerie; Guydish, Joseph
This research was conducted at a Substance Abuse Forum designed to address local community needs by focusing on Evidence-Based Practices (EBPs) in addiction treatment. The purpose of the study was to assess substance abuse treatment professionals' readiness to adopt EBPs, experience with EBPs, and attitudes toward EBPs, as well as agency support…
Kawsar, M; Long, S; Srivastava, O P
Joint examination by doctors with complementary skills and screening for sexually transmitted infections (STIs) are recommended in children who may have been sexually abused or have been found to have an STI. Our study showed that criminal proceedings were more likely to be brought in cases with physical signs of sexual abuse. It could be difficult to prove whether sexual abuse had taken place or not with microbiological evidence alone, in the absence of other evidence. Significance of viral STIs in the context of sexual abuse should be evaluated carefully. The review of our practice re-enforced the importance of joint examination of children with suspected STIs.
... people to control their actions. Certain types of personality disorders or mental illness might also interfere with ... self-control. Of course, not everyone with a personality disorder or mental illness becomes abusive. Fortunately, people ...
... Stages Early-Stage Caregiving Middle-Stage Caregiving Late-Stage Caregiving Behaviors Aggression & Anger Anxiety & Agitation Depression Hallucinations Memory Loss & Confusion Repetition Sleep Issues & Sundowning Suspicion & Delusions Wandering Abuse Start Here ...
Elder abuse, also called elder mistreatment or elder maltreatment, includes psychological, physical, and sexual abuse, neglect (caregiver neglect and self-neglect), and financial exploitation. Evidence suggests that 1 out of 10 older adults experiences some form of elder abuse, and only a fraction of cases are actually reported to social services agencies. At the same time, elder abuse is independently associated with significant morbidity and premature mortality. Despite these findings, there is a great paucity in research, practice, and policy dealing with this pervasive issue. In this paper, I review the epidemiology of elder abuse as well as key practical issues in dealing with the cases of elder abuse. Through my experiences as a Congressional Policy Fellow/National Health and Aging Policy Fellow, I highlight key previsions on 2 major federal legislations dealing with the issues of elder abuse: Older Americans Act (OAA) and Elder Justice Act (EJA). Lastly, I highlight major research gaps and future policy relevant research directions to advance the field of elder abuse. Interdisciplinary and community-based efforts are needed to devise effective strategies to detect, treat, and prevent elder abuse in our increasingly diverse aging populations. Collective advocacy and policy advances are needed to create a national infrastructure to protect the vulnerable older adults.
Elder abuse, also called elder mistreatment or elder maltreatment, includes psychological, physical, and sexual abuse, neglect (caregiver neglect and self-neglect), and financial exploitation. Evidence suggests that 1 out of 10 older adults experiences some form of elder abuse, and only a fraction of cases are actually reported to social services agencies. At the same time, elder abuse is independently associated with significant morbidity and premature mortality. Despite these findings, there is a great paucity in research, practice, and policy dealing with this pervasive issue. In this paper, I review the epidemiology of elder abuse as well as key practical issues in dealing with the cases of elder abuse. Through my experiences as a Congressional Policy Fellow/National Health and Aging Policy Fellow, I highlight key previsions on 2 major federal legislations dealing with the issues of elder abuse: Older Americans Act (OAA) and Elder Justice Act (EJA). Lastly, I highlight major research gaps and future policy relevant research directions to advance the field of elder abuse. Interdisciplinary and community-based efforts are needed to devise effective strategies to detect, treat, and prevent elder abuse in our increasingly diverse aging populations. Collective advocacy and policy advances are needed to create a national infrastructure to protect the vulnerable older adults. PMID:24270215
Cramer, E; McFarlane, J; Parker, B; Soeken, K; Silva, C; Reel, S
To examine violent pornography use and associated violence against women, an ethnically stratified sample of 198 abused women were asked about their partners' use of pornographic materials, and if they had been asked or forced to look at, act out, or pose for pornographic scenes or pictures. Overall, 40.9% of the women reported the abuser used pornographic material, with the proportion significantly higher for Whites (58.7%), compared to Blacks (27.1%) or Hispanics (38.5%). When groups were formed according to the abuser's use of pornography and associated involvement of the woman, violence scores as measured on the Index of Spouse Abuse, Danger Assessment, and Severity of Violence Against Women scales were significantly higher (p = <.001) for women reporting the abuser requested or forced her to look at, act out, or pose for pornographic scenes. Severity of violence was not related simply to whether or not the abused used pornography. This analysis is a beginning step toward understanding how pornography influences woman abuse.
Novac, Andrei; Iosif, Anamaria M.; Groysman, Regina; Bota, Robert G.
Sensorineural hearing loss is an infrequently recognized side effect of pain medication abuse. Chronic pain patients treated with opiates develop different degrees of tolerance to pain medications. In many cases, the tolerance becomes the gateway to a variety of cycles of overuse and unmasking of significant psychiatric morbidity and mortality. An individualized approach utilizing combined treatment modalities (including nonopiate pharmaceuticals) is expected to become the norm. Patients can now be provided with multidisciplinary care that addresses an individual’s psychiatric, social, and medical needs, which requires close cooperation between physicians of varying specialties. This report describes a patient who experienced hearing loss from hydrocodone/acetaminophen abuse. PMID:26835162
Myers, Jane E.; Shelton, Barbara
Explores violence against the elderly in the home and in institutions. Includes areas of physical violence, neglect, financial exploitation and psychological abuse by caretakers, and whether these caretakers are family members, relatives, or persons employed to care for the frail, older adult. Explores the role counselors can play in addressing…
Lipinska, Gosia; Timol, Ridwana; Thomas, Kevin G F
Sleep is disrupted during active use of methamphetamine (MA), during withdrawal from the drug, and during abstinence from its use. However, relatively little is known about possible mediatory functions of disrupted sleep in the emergence, manifestation, and maintenance of cognitive and affective symptoms of MA abuse. We hypothesise that sleep functions as a mediator for stimulant drug effects. Specifically, we propose that objectively-measured sleep parameters can be used to explain some of the variability in the experience and presentation of memory deficits and emotion dysregulation in MA abusers. After describing how important healthy sleep is to unimpaired cognitive and affective functioning, we review literature describing how sleep is disrupted in MA abuse. Then, we provide a conceptual framework for our hypothesis by explaining the relationship between MA abuse, sleep disruption, memory deficits, emotion dysregulation, and changes in reward-related brain networks. We conclude by discussing implications of the hypothesis for research and treatment.
Plant, Malcolm; van Schaik, Paul; Gullone, Eleonora; Flynn, Clifton
Whereas the majority of previous research conducted on animal abuse has been in environments where animal abuse is rarely evidenced, the current study investigated the ramifications of animal abuse in an environment wherein the national culture creates an ethos of the "social acceptability" of animal abuse in society. Two survey studies were conducted with adolescent participants, to investigate the role played by several factors in the prediction of animal abuse in this age group. In Study 1, with samples from two different national cultures (101 from Germany and 169 from Romania; 143 boys/135 girls; age 13 to 17), animal abuse was negatively associated with affective empathy and national culture; more frequent animal abuse was found in Romania. Affective empathy fully mediated the association between gender and animal abuse. Specifically, girls were found to be higher in affective empathy; in turn, participants who were higher in affective empathy committed less animal abuse. Witnessing animal abuse was also predictive of engaging in animal abuse, but not independent of national culture. In Study 2, 15-year-old males (n = 21) and females (n = 39) took part, 29 from rural and 31 from urban locations in Romania. Rural adolescents were more likely to abuse animals and had higher exposure to domestic violence, which (in turn) was associated with more animal abuse. The implications of these findings in a society where animal abuse is encouraged and enacted on a national scale are discussed.
Hahm, Hyeouk Chris; Chang, Stephanie Tzu-Han; Tong, Hui Qi; Meneses, Michelle Ann; Yuzbasioglu, Rojda Filiz; Hien, Denise
Purpose The purpose of this paper is to provide a review of the current literature uncovering specific factors associated with self-harm and suicidality among young Asian American women, as well as to present the Fractured Identity Model as a framework for understanding these factors. This paper offers concrete suggestions for the development of culturally competent interventions to target suicidality, substance abuse, and mental illness among young Asian American women. Design/methodology/approach Empirical studies and theory-based papers featured in peer-reviewed journals between 1990 and 2014 were identified through scholarly databases, such as PubMed, MEDLINE, PsycINFO, JSTOR, and Google Scholar. Findings We identified several factors associated with suicidality among young Asian American women: (1) family dynamics, or having lived in a household where parents practice “disempowering parenting styles,” (2) substance use/abuse, and (3) untreated mental illness(es), which are exacerbated by the stigma and shame attached to seeking out mental health services. The Fractured Identity Model by Hahm et al. (2014) is presented as a possible pathway from disempowering parenting to suicidal and self-harm behaviors among this population, with substance abuse playing a significant mediating role. Research limitations/implications – Our review focused on Asian American women, substance use among Asian Americans, and mental health among Asian Americans. Literature that focused on Asians living in Asia or elsewhere outside of the USA was excluded from this review; the review was limited to research conducted in the USA and written in the English language. Practical implications The complex interplay among Asian American culture, family dynamics, gender roles/expectations, and mental health justifies the development of a suicide and substance abuse intervention that is tailored to the culture- and gender-specific needs of Asian Pacific Islander young women. It is
Shafe, S; Hutchinson, G
ABSTRACT Aim: To provide information on the possible influence of cultural practices in perpetuating child sexual abuse and to examine documented examples of these cultural influences. Methods: A computer literature search was done of Medline, Science Direct, PSYCInfo, Embase and PubMed for keywords. There were also manual searches in the library of journals that are not accessible online. Keywords for searches included: sexual abuse, child abuse, psychopathology, name of countries (eg Jordan, China and Morocco), culture and cultural practices. Results: There is documented evidence of cultural practices that continue to fuel the persistently high level of child sexual abuse across the globe. The definition has evolved to now include simple genital-genital and non-genital contact such as oral-genital contacts, exhibitionism and pornography. Conclusions: Cultural practices are no longer restricted to one geographical collection of people due to migratory influence, as these practices may also spread to different groups who intermingle. There are few empirical studies of child sexual abuse in the Caribbean, but one factor that could be used as a proxy is age of first sexual activity. The World Bank reports that this age is youngest in the Caribbean and is likely to be significantly influenced by child sexual abuse. PMID:25803380
Parra-Cardona, José Rubén; Meyer, Emily; Schiamberg, Lawrence; Post, Lori
There is a scarcity of theoretical frameworks capable of describing precursors and dynamics associated with elder abuse and neglect in Latino families. The present manuscript seeks to address this gap in the literature by presenting an integrative theoretical framework that fosters an ecological and cultural understanding of elder abuse and neglect among Latinos. The proposed model rests on the premise that Latino families caring for elder adults have the ability to adapt to the demands of aging only if they are supported by nurturing environments. The usefulness of the model is threefold. First, the proposed model describes elder abuse and neglect as multifactorial phenomena and identifies specific risk factors associated with the etiology and maintenance of elder abuse and neglect in Latino families. Second, the model provides clinical applications, including reflections about the therapists' need to extend their scope of practice beyond traditional family therapy interventions. A brief case study is presented that illustrates the clinical application of the model with a Latino family. Implications for future research are discussed.
Baldwin, Norma; Spencer, Nick
Reviews the association between material deprivation and child abuse and considers the implications of this association for preventive strategies. It is concluded that communitywide strategies aimed at supporting all care providers are more likely to succeed than those based on at-risk groups. (SLD)
Gamma-hydroxybutyric acid (GHB) has become increasingly popular on the campuses of American colleges and universities. In this paper, the characteristics of GHB and the effects of both voluntary and involuntary abuse are described. Further, implications for prevention efforts related to involuntary GHB ingestion and GHB-facilitated rape are…
Larsen, Carly D.; Sandberg, Jonathan G.; Harper, James M.; Bean, Roy
This study examined the relationship between self-reported childhood physical and sexual abuse, romantic relationship quality, possible gender differences, and clinical implications. Three hundred thirty-eight women and 296 men who sought services at a university mental health clinic in the northeast region of the United States completed a…
Klein, Carolina A; Kandel, Surendra
The Internet has increasingly become an intrinsic part of everyday life, offering countless possibilities for education, services, recreation, and more. In fact, an entire virtual life within the digitalized World Wide Web is possible and common among many Internet users. Today's psychiatrists must therefore incorporate this dimension of human life into clinical practice, to achieve an adequate assessment of the tools and risks available to the patient. We focus on the Internet as a portal for the trade of and access to substances of abuse. We review the legal regulations that may inform care and standards of practice and analyze the difficulties that arise in assessment and monitoring of the current situation. We consider the potential impact of Internet-based narcotics trade on addiction morbidities and the practice of clinical psychiatry, as well as on the potential legal implications that the forensic expert may face.
Chouliara, Z; Karatzias, T; Gullone, A
Research on survivors' experiences of recovering from childhood sexual abuse (CSA) has been limited and focused on those with severe mental health difficulties. This study elicited experiences of recovery from CSA in male and female survivors who have/have not utilized mental health services. The tangible end-point was to propose a theoretical model of personally meaningful recovery. This is a qualitative study, which utilized semi-structured individual interviews following the critical incident technique. Transcripts were analysed using Interpretative Phenomenological Analysis to identify recurrent themes. A total 22 adult survivors of CSA. Main themes identified were: The Affected Self, Factors Hindering Recovery, Factors Enhancing Recovery, The Hurdles of Recovery and the Recovering Self. The affected self included: lack of boundary awareness and self-blame, over self-reliance, over-vigilance and guilt, shame, aloneness and social stigma. The recovering self was characterized by increasing confidence, assertiveness, ability to self-care and self-acceptance, and by embracing vulnerability. These findings have potentially major implications for clinical practice, service provision, policy development and professional training in this field. The importance of disclosure in the healing process seemed paramount and can have major implications for current service protocols.
Baime, David S.; Mullin, Christopher M.
In recent months, some legislators, government agency officials, segments of the media, and campus administrators have called attention to perceived and proven instances of abuse of the federal student financial assistance programs. Concerns have focused on students enrolling in courses primarily to secure student financial aid funds rather than…
Describes the system developed by the Quincy District Office of the Illinois Department of Children and Family Service for the identification of child abuse cases and the delivery of the services and treatment required by the parents and their children. (Author/SDH)
Tommasello, Anthony C
Pharmacists, the most accessible of health care professionals, are well positioned to help prevent and treat substance use disorders and should prepare themselves to perform these functions. New research improves our knowledge about the pharmacological and behavioral risks of drug abuse, supports the clinical impression that drug dependence is associated with long-lasting neurochemical changes, and demonstrates effective pharmacological treatments for certain kinds of drug dependencies. The profession is evolving. Pharmacists are engaging in new practice behaviors such as helping patients manage their disease states. Collaborative practice agreements and new federal policies set the stage for pharmacists to assist in the clinical management of opioid and other drug dependencies. Pharmacists need to be well informed about issues related to addiction and prepared not only to screen, assess, and refer individual cases and to collaborate with physicians caring for chemically dependent patients, but also to be agents of change in their communities in the fight against drug abuse. At the end of this article the pharmacist will be better able to: 1. Explain the disease concept of chemical dependence 2. Gather the information necessary to conduct a screen for chemical dependence 3. Inform patients about the treatment options for chemical dependence 4. Locate resources needed to answer questions about the effects of common drugs of abuse (alcohol, marijuana, narcotics, "ecstasy", and cocaine) 5. Develop a list of local resources for drug abuse treatment 6. Counsel parents who are concerned about drug use by their children 7. Counsel individuals who are concerned about drug use by a loved one. 8. Counsel individuals who are concerned about their own drug use PMID:15169544
This review article examined the gender symmetry debate in light of recent research relating to the feminist and family research perspectives on intimate partner violence, providing a context for rethinking perpetrator programs. The concept of coercive control is considered as an explanatory factor in an attempt to integrate the feminist and family research perspectives. The limited effectiveness of perpetrator programs is examined. Research highlighting potential factors that could improve the effectiveness of perpetrator programs is introduced, followed by a discussion of the rejection-abuse cycle, one attempt to incorporate current research into a more inclusive program. The rejection-abuse cycle identifies a pattern of perpetrator behavior, which links rejection, threat to self, defense against threat, and abuse. Finally, suggestions for changing perpetrator programs are elaborated, incorporating past research, which would make them appropriate for both male and female perpetrators. These implications are contextualized within a meta-theory to provide greater clarity for the development of future perpetrator programs.
Hammerschlag, M. R.
Sexually transmitted diseases (STDs) may be transmitted during sexual assault. In children, the isolation of a sexually transmitted organism may be the first indication that abuse has occurred. Although the presence of a sexually transmissible agent from a child beyond the neonatal period is suggestive of sexual abuse, exceptions do exist. In this review I discuss the issues of the transmissibility and diagnosis of STDs in the context of child sexual abuse. Rectal or genital infection with Chlamydia trachomatis among young children may be the result of perinatally acquired infection and may persist for as long as 3 years. A major problem with chlamydia testing in the context of suspected sexual abuse in children has been the inappropriate use of non-culture tests. Although the new generation of nucleic acid amplification tests have shown high sensitivity and specificity with genital specimens from adults, data on use of these tests on any site in children are practically non-existent. Bacterial vaginosis (BV) has been identified among children who have been abused and among those who have not been abused. However, many of the methods used to diagnose BV in adults have not been evaluated in children. Recent studies of perinatal infection with human papillomavirus (HPV) have been inconclusive. HPV DNA has been detected at various sites in children who have not been abused. The relation to the development of clinically apparent genital warts is unclear. Although HIV can be acquired through sexual abuse in children, the exact risk to the child and which children should be screened is still controversial. PMID:9849550
Gallo-Silver, Les; Anderson, Christopher M; Romo, Jaime
The health care literature describes treatment challenges and recommended alterations in practice procedures for female survivors of childhood sexual abuse, a subtype of adverse childhood experiences. Currently, there are no concomitant recommendations for best clinical practices for male survivors of childhood sexual abuse or other adverse clinical experiences. Anecdotal information suggests ways physicians can address the needs of adult male survivors of childhood sexual abuse by changes in communication, locus of control, and consent/permission before and during physical examinations and procedures. The intent of this article is to act as a catalyst for improved patient care and more research focused on the identification and optimal responses to the needs of men with adverse childhood experiences in the health care setting. PMID:25106042
Alves, Anabela C.; Sousa, Rui M.; Fernandes, Sandra; Cardoso, Elisabete; Carvalho, Maria Alice; Figueiredo, Jorge; Pereira, Rui M. S.
Project-Based Learning (PBL) has been implemented in the first year of the Industrial Engineering and Management programme at the University of Minho, Portugal, since 2004/2005. The purpose of this paper is to analyse and discuss teachers' experiences in PBL in this programme and to explore its implications for student learning and for teaching practices in higher education. For data collection, the research method used was written narratives to these teachers, at the end of the PBL semester. Findings suggest that teachers express a positive view of PBL as a learning approach. They identify student motivation and engagement, along with a better understanding of the application of concepts in real-life situations, as important outcomes of the project for students. Besides this, teachers also highlight the importance of the development of transversal skills by students throughout the project. Recommendations for future work and implications for practice will also be discussed.
Ige, Olusimbo K.; Fawole, Olufunmilayo I.
This study examined parents' perceptions of child sexual abuse as well as prevention practices in an urban community in southwest Nigeria. Questionnaires were collected from 387 parents and caregivers of children younger than 15 years of age. Results showed that many parents felt CSA was a common problem in the community, and most parents…
Hovey, Angela; Stalker, Carol A.; Schachter, Candice L.; Teram, Eli; Lasiuk, Gerri
Many survivors of child sexual abuse who engage in psychotherapy also experience physical health problems. This article summarizes the findings of a multiphased qualitative study about survivors' experiences in healthcare settings. The study informed the development of the "Handbook on Sensitive Practice for Health Care Practitioners: Lessons…
Hyde, C; Bentovim, A; Monck, E
The clinical implications of the results of a treatment outcome study are presented for 47 sexually abused children and adolescents attending a specialist psychiatric facility. The children and their nonabusing parents or caregivers were randomly assigned to contrasting treatment programs. The treatment focused on family members allocating blame for the abuse appropriately, optimizing family relationships, and dealing with causes and effects of the abuse. Clinicians rated the children and the mothers on 12 family treatment aims before and after treatment; on the same occasion additional standardized measures were used to assess behavior and mental state of the children and mental state of the mothers. On the standardized measures mothers made more significant progress than their children in the year of treatment, but there were no effects of type of treatment on the progress made by mothers or children. By contrast, clinical ratings suggested that those following the additional group work made better progress than those following the treatment without group work. The implications of these results for the clinical programs are discussed.
Horsford, Sheena R; Parra-Cardona, José Rubén; Schiamberg, Larry; Post, Lori A
Despite the rapid growth of the elderly African American population in the U.S., elder abuse and neglect in African American families continue to be underdeveloped areas of study. This article presents an ecological and culturally informed framework for the study of elder abuse in African American populations. The model was developed based on Bronfenbrenner's Human Ecological Theory. The model identifies risk factors associated with different systems that have an influence on the lives of African American families. Cultural protective factors also are identified in the model. The model is intended to provide an understanding of elder abuse and neglect in African American families by considering the influence of contextual factors such as the legacy of slavery, social exclusion, and structural segregation and racism. Specific suggestions for practice are proposed according to cultural strengths of African American communities as well as the ecological premises of the model.
Steine, I M; Zayats, T; Stansberg, C; Pallesen, S; Mrdalj, J; Håvik, B; Soulé, J; Haavik, J; Milde, A M; Skrede, S; Murison, R; Krystal, J; Grønli, J
Sexual abuse contributes to the development of multiple forms of psychopathology, including anxiety and depression, but the extent to which genetics contributes to these disorders among sexual abuse victims remains unclear. In this translational study, we first examined gene expression in the brains of rodents exposed to different early-life conditions (long, brief or no maternal separation). Hypothesizing that genes revealing changes in expression may have relevance for psychiatric symptoms later in life, we examined possible association of those genes with symptoms of anxiety and depression in a human sample of sexual abuse victims. Changes in rodent brain gene expression were evaluated by means of correspondence and significance analyses of microarrays by comparing brains of rodents exposed to different early-life conditions. Tag single-nucleotide polymorphisms (SNPs) of resulting candidate genes were genotyped and tested for their association with symptoms of anxiety and depression (Hospital Anxiety and Depression Scale) in a sample of 361 sexual abuse victims, using multinomial logistic regression. False discovery rate was applied to account for multiple testing in the genetic association study, with q-value of 0.05 accepted as significant. We identified four genes showing differential expression among animals subjected to different early-life conditions as well as having potential relevance to neural development or disorders: Notch1, Gabrr1, Plk5 and Zfp644. In the human sample, significant associations were observed for two NOTCH1 tag SNPs: rs11145770 (OR=2.21, q=0.043) and rs3013302 (OR=2.15, q=0.043). Our overall findings provide preliminary evidence that NOTCH1 may be implicated in the susceptibility to anxiety and depression among sexual abuse victims. The study also underscores the potential importance of animal models for future studies on the health consequences of early-life stress and the mechanisms underlying increased risk for psychiatric
Moreira, Lilian Hortale de Oliveira; Loyola, Cristina Maria Douat
The characteristics of involuntary psychiatric commitment (IPI) may cause implications on the nursing/patient relationship. The objectives of this study were to list the forms of nursing care delivered to psychiatric patients, according to the type of commitment; analyze the reaction of the nursing team towards the IPI patient, and discuss on the implications that IPI have on the practice o psychiatric nursing. A field research was performed with the nursing team of a psychiatric institution in Rio de Janeiro. After 50 hours of participant observation and 9 of focal group meetings, we found that the teams are concerned with the clinical evolution of the patients. No references of the nursing team to the IPI patient were observed. There are no records or actions of any kind that would suggest a specific look towards this type of patient. Nursing professionals are not able to clearly identify this type of patient, thus the care is provided as per the patient's needs or requests.
There is increasing recognition that domestic abuse takes place outside the heteronormative paradigm of social life. This paper presents a discussion of the findings of doctoral research which explores trans people's experiences of domestic abuse, their social care needs and whether these are met by domestic abuse agencies. This paper foregrounds debate on the intersections of domestic abuse, trans communities and social care provision as this research, and previous studies, suggests that trans survivors do not seek out or benefit from social care intervention. Qualitative data, collected via narrative interviews, were collected during 2012 from participants mainly located in the United Kingdom (two participants were based in the United States). A total of 24 interviews were undertaken with trans people (n = 15) and social care practitioners (n = 9). Data were examined using a voice-centred relational technique. The findings reveal that barriers are multiple and complex but work could be undertaken to encourage help-seeking behaviours. Barriers include expectations of a transphobic response and 'Othering' practices; lack of entitlement felt by trans people; lack of knowledge/misunderstandings about trans social care needs; heteronormative bias of existing services; and practitioner attitudes fixed to notions about gender as binary. The paper ends by proposing a framework for practice with trans survivors which incorporates a person-centred, narrative approach.
Sofhauser, Cynthia D
In order to present the state of the science of hostility among and across disciplines, a review of the literature was completed. The knowledge gained may influence nursing practice. Scholarly works from nursing, medical and basic sciences, psychology, sociology, education, philosophy, business, communication, and criminology were reviewed. Similar patterns in the use of the concept were discovered. The patterns revealed five themes: hostility as a health-risk factor, hostility as a factor in family relationships, hostility as a factor in perceived challenge, hostility as a factor in criminal behavior, and hostility as a factor in the workplace. Based on the knowledge gained about hostility, implications for nursing practice related to changing the hostile working environment for nurses were suggested using modeling and role-modeling nursing theory.
Osterling, Kathy Lemon; Austin, Michael J
As child welfare systems across the country face the problem of parental substance abuse, there is an increasing need to understand the types of treatment approaches that are most effective for substance-abusing parents in the child welfare system-the majority of whom are mothers. This structured review of the literature focuses on evidence related to two areas: (1) individual-level interventions designed to assist mothers and women in addressing their substance abuse problems, and (2) system-level interventions designed to improve collaboration and coordination between the child welfare system and the alcohol and other drug system. Overall, research suggests the following program components may be effective with substance-abusing women with children: (1) Women-centered treatment that involves children, (2) Specialized health and mental health services, (3) Home visitation services, (4) Concrete assistance, (5) Short-term targeted interventions, and (6) Comprehensive programs that integrate many of these components. Research also suggests that promising collaborative models between the child welfare system (CWS) and the alcohol and other drug (AOD) system typically include the following core elements: (1) Out-stationing AOD workers in child welfare offices, (2) Joint case planning, (3) Using official committees to guide collaborative efforts, (4) Training and cross-training, (5) Using protocols for sharing confidential information, and (6) Using dependency drug courts. Although more rigorous research is needed on both individual-level and system-level substance abuse interventions for parents involved in the child welfare system, the integration of individual-level interventions and system-level approaches is a potentially useful practice approach with this vulnerable population.
Jobe-Shields, Lisa; Swiecicki, Carole C.; Fritz, Darci R.; Stinnette, Jessica S.; Hanson, Rochelle F.
Caregiver mental health is a known correlate of parenting practices, and recent research indicated that parental depression following childhood sexual abuse disclosure is associated with concurrent parenting difficulties. The present study extended this line of research by investigating posttraumatic stress symptoms and depression in a sample of caregivers (N=96) of children who experienced sexual abuse recruited from a Children’s Advocacy Center, as well as parenting practices reported by both caregivers and their children (Mean age = 10.79 years, SD = 3.29; 79% female). Twenty four percent of caregivers met criteria for presumptive clinical depression, clinically significant posttraumatic stress, or both. Results indicated elevated caregiver-reported inconsistent parenting in the context of clinically significant distress across symptom groups; children reported particularly elevated inconsistent parenting for caregivers with posttraumatic stress only. Caregiver depression was associated with low self-reported positive parenting and caregiver involvement, in addition to self-reported inconsistencies. Directions for future research are offered to further elucidate the relationships between caregiver mental health and parenting practices following childhood sexual abuse. PMID:26808966
Jobe-Shields, Lisa; Swiecicki, Carole C; Fritz, Darci R; Stinnette, Jessica S; Hanson, Rochelle F
Caregiver mental health is a known correlate of parenting practices, and recent research indicated that parental depression following childhood sexual abuse disclosure is associated with concurrent parenting difficulties. The present study extended this line of research by investigating posttraumatic stress symptoms and depression in a sample of caregivers (N = 96) of children who experienced sexual abuse recruited from a child advocacy center as well as parenting practices reported by both caregivers and their children (mean age = 10.79 years, SD = 3.29; 79% female). Twenty-four percent of caregivers met criteria for presumptive clinical depression, clinically significant posttraumatic stress, or both. Results indicated elevated caregiver-reported inconsistent parenting in the context of clinically significant distress across symptom groups; children reported particularly elevated inconsistent parenting for caregivers with posttraumatic stress only. Caregiver depression was associated with low self-reported positive parenting and caregiver involvement in addition to self-reported inconsistencies. Directions for future research are offered to further elucidate the relationships between caregiver mental health and parenting practices following childhood sexual abuse.
Tai, Betty; Straus, Michele M.; Liu, David; Sparenborg, Steven; Jackson, Ron; McCarty, Dennis
The National Institute on Drug Abuse established the National Drug Abuse Treatment Clinical Trials Network (CTN) in 1999 to improve the quality of addiction treatment using science as the vehicle. The network brings providers from community-based drug abuse treatment programs and scientists from university-based research centers together in an alliance that fosters bi-directional communication and collaboration. Collaboration enhanced the relevance of research to practice and facilitated the development and implementation of evidence-based treatments in community practice settings. The CTN’s 20 completed trials tested pharmacological, behavioral, and integrated treatment interventions for adolescents and adults; more than 11,000 individuals participated in the trials. This paper reviews the rationale for the CTN, describes the translation of its guiding principles into research endeavors, and anticipates the future evolution of clinical research within the Network. PMID:20307794
Wyatt, Stephen A; Vilensky, William; Manlandro, James J; Dekker, Michael A
Substance use disorders (SUDs) have had a major impact on the health of the US population during the past decade. Osteopathic physicians have an important role among those who can make a positive impact on this problem. This article reviews the nature of the problem, how the osteopathic medical profession is currently addressing it, and a current strategy for improvement endorsed by the American Osteopathic Academy of Addiction Medicine. Early in 2004, the Office of National Drug Control Policy-backed by the US Surgeon General, the Center for Substance Abuse Treatment, the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism, and the National Highway Traffic Safety Administration-has requested improvement in physician education on this health problem. This request culminated in the Office of National Drug Control Policy's establishing the Leadership Conference on Medical Education in Substance Abuse in December 2004. The osteopathic medical profession is represented in this critical review and formulation of recommendations for improving education on substance use disorders for the undergraduate, graduate, and practicing physician.
Ronald, P J; Witcomb, J C; Robertson, J R; Roberts, J J; Shishodia, P C; Whittaker, A
Responsibility for many of the problems of intravenous drug abuse and human immunodeficiency virus (HIV) infection lies with community care agencies, such as general practitioners, community psychiatric and district nurses and drug agencies. It is in general practice that this burden is most clearly observed, given that general practitioners are in charge of the day-to-day care of patients. In an attempt to quantify this workload in an inner city practice with 11,200 patients, data were gathered from several sources relating to drug use and HIV infection. The study identified 432 patients who had consulted with problems of drug abuse and/or HIV infection over the period 1981-90. Among this group of patients 161 (37%) were HIV antibody positive. Among 191 drug abusers who were still registered with the practice in 1990 dihydrocodeine was the most commonly prescribed substitute treatment (130 patients) and only nine patients were prescribed methadone. Forty seven per cent of drug users continued to inject drugs occasionally. However, analysis of urine samples revealed that there was a shift away from injecting mainly heroin to multiple drug use, including benzodiazepines, usually originating from prescribed sources. Drug abusers who were HIV positive consulted their general practitioner significantly more often over one year than those who were not (mean 24.9 versus 15.8 consultations, P < 0.01). However, there was no significant difference between these two groups in terms of days spent in hospital. A total of 61 patients were referred to a community psychiatric nurse over an eight month period.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1419244
Pickering, Carolyn E Z; Ridenour, Kimberly; Salaysay, Zachary
Elder abuse and neglect (EA/N) affects over 1 million older adults each year, and disproportionately affects persons with dementia and older women. Home healthcare professionals are in an advantageous position to assess for, identify, and report EA/N. Lack of knowledge on EA/N risk factors, assessment tools, and mandatory reporting guidelines often prevent professionals from identifying and reporting EA/N. This article provides practical guidance on EA/N risk factors, assessment tools, and reporting responsibilities that can easily be implemented in practice.
Lynch, Patrick D.
This article defines psychological abuse of students in school settings and describes legal aspects of the problem, particularly with respect to possible action in negligence. The following four categories of psychological abuse are examined: verbal abuse, refusal to communicate, physical acts (and sexual abuse) that cause psychological damage,…
This paper reviews theory and research on client classification and their processing in various organizational settings, with emphasis on drug abusers. Implications are drawn in terms of developing a better model of the social psychology of institutional life, and diagnostic-screening units more serviceable to needs of clients. (Author)
Hull, Lynn; May, James; Farrell-Moore, Dawn; Svikis, Dace S
In the late-1980s and early-1990s, much attention in America was focused on cocaine abuse. In particular, the effects of prenatal cocaine use on mothers and infants were in the news spotlight. Risks of adverse effects prompted funding for novel treatment programs. More recently, media attention has shifted elsewhere, and specialized treatment resources have grown scarce. This redirection of funding is unfortunate, as social stigma and fear of legal consequences continue to encourage cocaine-abusing pregnant women to hide drug use and avoid prenatal care. The purpose of this article is to summarize the most prominent adverse maternal and fetal/infant effects associated with prenatal cocaine use; review treatment options, focusing on comprehensive care programs of the 1990s as well as recent research on evidence-based practices and their applicability to pregnant women; and highlight the population of prenatal cocaine-abusing women uninterested in treatment, with a focus on promising strategies to promote drug abstinence and other positive health behaviors.
Childhood sexual abuse can have big implications for a woman both physically and psychologically during childbearing. There are aspects of midwifery practice such as vaginal examinations which can have devastating effects for survivors of childhood abuse because of their similarities to sexual abuse. There are steps which can be taken by student midwives and midwives alike to not only prevent the re-traumatisation of the survivors of childhood sexual abuse but empower them through their pregnancy and birthing experience. This article is based on a presentation to fellow students in which Stephanie Marriott examined the issues.
Monaco, Nanci M.; Gaier, Eugene L.
Discusses the differential incidence of male versus female reports of sexual abuse through hotlines and solicited reports. Reports occurred after the institution of a child abuse prevention program for 1,920 children K-12. (RJC)
Page, Richard C.; Sanders, John, Jr.
Investigated the need for counseling services among imprisoned, female drug abusers. Responses of inmates with drug abuse problems to a questionnaire were analyzed to show kinds of problems they have which counseling may help to alleviate. (Author)
Guerrero, Erick G
The field of cultural competence is shifting its primary emphasis from enhancement of counselors' skills to management, organizational policy, and processes of care. This study examined managers' characteristics associated with adoption of culturally competent practices in the nation's outpatient substance abuse treatment field. Findings indicate that in 1995, supervisors' cultural sensitivity played the most significant role in adopting practices, such as matching counselors and clients based on race and offering bilingual services. Staff's exposure to cross-cultural training increased from 1995 to 2005. In this period, positive associations were found between managers' cultural sensitivity and connection with the community and staff receiving cross-cultural training and the number of training hours completed. However, exposure to and investment in this training were negatively correlated with managers' formal education. Health administration policy should consider the extent to which the decision makers' education, community involvement, and cultural sensitivity contribute to building culturally responsive systems of care.
Guerrero, Erick G.
The field of cultural competence is shifting its primary emphasis from enhancement of counselors' skills to management, organizational policy and processes of care. This study examined managers' characteristics associated with adoption of culturally competent practices in the nation's outpatient substance abuse treatment field. Findings indicate that in 1995 supervisors' cultural sensitivity played the most significant role in adopting practices, such as matching counselors and clients based on race and offering bilingual services. Staff's exposure to cross-cultural training increased from 1995 to 2005. In this time period, positive associations were found between managers' cultural sensitivity and connection with the community and staff receiving cross-cultural training and the number of training hours completed. However, exposure to and investment in this training were negatively correlated with managers' formal education. Health administration policy should consider the extent to which decision makers' education, community involvement and cultural sensitivity contributes to building culturally responsive systems of care. PMID:20727703
Davis, Catherine M; Riley, Anthony L
Drugs of abuse are typically discussed in terms of their rewarding effects and how these effects mediate drug taking. However, these drugs produce aversive effects that could have an important role in the overall acceptability of a drug and its likelihood of being self-administered. Rewarding and aversive effects, then, could be interpreted as separate behavioral effects, with the balance of the two determining overall drug acceptability. Interestingly, the role of aversive effects on drug acceptability in the self-administration preparation has received limited attention in this context. This chapter examines the aversive effects of drugs and discusses their role in drug taking. If these aversive effects serve a protective function, manipulations that alter or decrease these effects could have implications for drug taking. Several factors have been reported to alter conditioned taste aversion (CTA) learning, a preparation used in the assessment of the aversive effects of drugs in general. Two of these factors, drug history and strain, are reviewed here. By reviewing these, we intend to demonstrate the protective nature of aversive effects in the initiation and escalation of drug taking and to provide evidence that reductions in aversive effects could produce changes in patterns of drug self-administration that could lead to an increased vulnerability to abuse drugs by altering the reward-aversion balance. The aim of this chapter is not to question the importance of rewarding effects in self-administration but rather to provide evidence that aversive effects are an important factor that needs to be considered in discussions of drug-taking behavior.
Lynch, Wendy J; Nicholson, Katherine L; Dance, Mario E; Morgan, Richard W; Foley, Patricia L
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.
Hazler, Richard J.; Denham, Sharon A.
Discusses social isolation as a major factor in determining how youth are increasingly put at risk for both immediate and lifelong difficulties and examines three at-risk situations that counselors face to better understand the origins and implications affecting assessment and interventions. Presents practical implications for how school and…
Stout, Karen A.
This chapter describes the challenges and practical barriers community colleges face when implementing comprehensive reform, exploring how reforms are leading to some improvements but not often scaled improvements.
McEachern, Adriana G.
Sexual abuse of individuals with disabilities occurs in alarming proportions, although the prevalence and incidence of such abuse is difficult to determine. Although all states maintain statistics on child sexual abuse, the rate of victimization for individuals with disabilities is not specific. This paper reviews several studies conducted on…
Alves, Anabela C.; Sousa, Rui M.; Fernandes, Sandra; Cardoso, Elisabete; Carvalho, Maria Alice; Figueiredo, Jorge; Pereira, Rui M. S.
Project-Based Learning (PBL) has been implemented in the first year of the Industrial Engineering and Management programme at the University of Minho, Portugal, since 2004/2005. The purpose of this paper is to analyse and discuss teachers' experiences in PBL in this programme and to explore its implications for student learning and for teaching…
Bradley, Joshua M.; Werth, James L., Jr.; Hastings, Sarah L.
The professional literature related to social justice has increased, but there has been little discussion of the practical issues and implications associated with social advocacy. However, adding new roles will result in new considerations for counseling psychologists. The need to be attuned to how the practical aspects of advocacy intersect with…
Spertus, Ilyse L.; Yehuda, Rachel; Wong, Cheryl M.; Halligan, Sarah; Seremetis, Stephanie V.
Objective: There were two aims to this study: first to examine whether emotional abuse and neglect are significant predictors of psychological and somatic symptoms, and lifetime trauma exposure in women presenting to a primary care practice, and second to examine the strength of these relationships after controlling for the effects of other types…
McElroy, Erika M.; Rodriguez, Christina M.
Objective: Utilizing the conceptual framework of the Social Information Processing (SIP) model ([Milner, 1993] and [Milner, 2000]), associations between cognitive risk factors and child physical abuse risk and maladaptive discipline style and practices were examined in an at-risk population. Methods: Seventy-three mothers of 5-12-year-old…
Cecil, Charlotte A M; Smith, Rebecca G; Walton, Esther; Mill, Jonathan; McCrory, Eamon J; Viding, Essi
Childhood maltreatment is a key risk factor for poor mental and physical health. Recently, variation in epigenetic processes, such as DNA methylation, has emerged as a potential pathway mediating this association; yet, the extent to which different forms of maltreatment may be characterized by unique vs shared epigenetic signatures is currently unknown. In this study, we quantified DNA methylation across the genome in buccal epithelial cell samples from a high-risk sample of inner-city youth (n = 124; age = 16-24; 53% female), 68% of whom reported experiencing at least one form of maltreatment while growing up. Our analyses aimed to identify methylomic variation associated with exposure to five major types of childhood maltreatment. We found that: (i) maltreatment types differ in the extent to which they associate with methylomic variation, with physical exposures showing the strongest associations; (ii) many of the identified loci are annotated to genes previously implicated in stress-related outcomes, including psychiatric and physical disorders (e.g. GABBR1, GRIN2D, CACNA2D4, PSEN2); and (iii) based on gene ontology analyses, maltreatment types not only show unique methylation patterns enriched for specific biological processes (e.g. physical abuse and cardiovascular function), but also share a 'common' epigenetic signature enriched for biological processes related to neural development and organismal growth. A stringent set of sensitivity analyses were also run to identify high-confidence associations. Together, findings lend novel insights into epigenetic signatures of childhood abuse and neglect, point to novel potential biomarkers for future investigation and support a molecular link between maltreatment and poor health outcomes. Nevertheless, it will be important in future to replicate findings, as the use of cross-sectional data and high rates of polyvictimization in our study make it difficult to fully disentangle the shared vs unique epigenetic
Douglass, Richard L.
Reviews six studies of neglect and abuse of elderly persons in their homes. All of these investigations agree that a substantial but undocumented problem of domestic neglect and abuse exists; variety and severity of mistreatment ranges from reasonably benign to very severe, and causal theories are numerous. (WAS)
Substance use and abuse are problematic in the lives of adolescents, including interpersonal problems and scholastic problems. Risk for substance use has commonly been assessed at the individual level. This paper examines risk of adolescent substance abuse as a variable impacted by environmental or contextual factors surrounding the individual.…
Tarakeshwar, Nalini; Fox, Ashley; Ferro, Carol; Khawaja, Shazia; Kochman, Arlene; Sikkema, Kathleen J.
A qualitative study was conducted with 28 women who are human immunodeficiency virus (HIV)-positive and have experienced childhood sexual abuse (CSA) in order to examine (1) the challenges generated by the experience of sexual abuse and related coping strategies, (2) the impact of the HIV diagnosis on their coping strategies, and (3) the links…
This article reviews the use of several valuation methods as they relate to drug abuse and places them within the context of U.S. policy. First, cost-of-illness (COI) studies are reviewed and their limitations discussed. Second, three additional economic methods of valuing drug abuse are reviewed, including cost-effectiveness analysis (CEA),…
Patterson, Latofia; Templeton, Mary Anne
The purpose of this article is to review the literature on the comorbidity of substance abuse and psychiatric disorder. The paper examines the medical, psychosocial, and vocational rehabilitation concerns associated with substance abuse and psychiatric disorder comorbidity. A greater emphasis is placed on vocational concerns and the role of…
Johnson, Kimberly; Quanbeck, Andrew; Maus, Adam; Gustafson, David H; Dearing, James W
Understanding influence networks among substance abuse treatment clinics may speed the diffusion of innovations. The purpose of this study was to describe influence networks in Massachusetts, Michigan, New York, Oregon, and Washington and test two expectations, using social network analysis: (1) Social network measures can identify influential clinics; and (2) Within a network, some weakly connected clinics access out-of-network sources of innovative evidence-based practices and can spread these innovations through the network. A survey of 201 clinics in a parent study on quality improvement provided the data. Network measures and sociograms were obtained from adjacency matrixes created by UCINet. We used regression analysis to determine whether network status relates to clinics' adopting innovations. Findings suggest that influential clinics can be identified and that loosely linked clinics were likely to join the study sooner than more influential clinics but were not more likely to have improved outcomes than other organizations. Findings identify the structure of influence networks for SUD treatment organizations and have mixed results on how those structures impacted diffusion of the intervention under study. Further study is necessary to test whether use of knowledge of the network structure will have an effect on the pace and breadth of dissemination of innovations.
Cepeda, Nicholas J.; Coburn, Noriko; Rohrer, Doug; Wixted, John T.; Mozer, Michael C,; Pashler, Harold
More than a century of research shows that increasing the gap between study episodes using the same material can enhance retention, yet little is known about how this so-called distributed practice effect unfolds over nontrivial periods. In two three-session laboratory studies, we examined the effects of gap on retention of foreign vocabulary,…
Guckes, Lucille; Elkins, Robert
Recent brain research demonstrates that the left hemisphere of the brain processes information in a linear, organized way. The right hemisphere processes the same information as a whole, with a focus on nonverbal, spatial components. Current educational practice is inordinately skewed to develop only the left hemisphere of the brain. Data from…
Reyna, Valerie F.; Fagerlin, Angela; Lipkus, Isaac; Peters, Ellen
Background Low numeracy is pervasive and constrains informed patient choice, reduces medication compliance, limits access to treatments, impairs risk communication, and affects medical outcomes; therefore, it is incumbent upon providers to minimize its adverse effects. Purpose We provide an overview of research on health numeracy and discuss its implications in clinical contexts. Conclusions Low numeracy cannot be reliably inferred on the basis of patients’ education, intelligence, or other observable characteristics. Objective and subjective assessments of numeracy are available in short forms and could be used to tailor health communication. Low scorers on these assessments are subject to cognitive biases, irrelevant cues (e.g., mood), and sharper temporal discounting. Because prevention of the leading causes of death (e.g., cancer and cardiovascular disease) depends on taking action now to prevent serious consequences later, those low in numeracy are likely to require more explanation of risk to engage in prevention behaviors. Visual displays can be used to make numerical relations more transparent, and different types of displays have different effects (e.g., greater risk avoidance). Ironically, superior quantitative processing seems to be achieved by focusing on qualitative gist and affective meaning, which has important implications for empowering patients to take advantage of the evidence in evidence-based medicine. PMID:18677452
Stem cell policy discussions frequently confuse embryonic and fetal sources of stem cells, and label untested, non-reproductive cloning as "therapeutic." Such misnomers distract attention from significant practical and ethical implications: accelerated research agendas tend to be supported at the expense of physical risks to women, theological implications in a multi-faith community, informed consent for participation in research, and treatment decisions altered by unrealistic expectations.
Gahr, Maximilian; Freudenmann, Roland W; Connemann, Bernhard J; Hiemke, Christoph; Schönfeldt-Lecuona, Carlos
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.
Maas, Adolf K
The ever-growing complexity of veterinary laws compounds the problem for the exotic pet practice. Issues of possession, treatment, vaccination, and ethics shape the legal landscape for the veterinarian, and as new problems develop, new legislation will be created. Only by learning and understanding the current laws and regulations of the jurisdiction can a practitioner hope to keep abreast of the changes and additions as they occur and to minimize the risk of liability.
It is becoming clear that there is a genetic component to drug abuse. Family studies, adoption studies, and critical twin studies have all pointed to some genetic vulnerability or risk factors for an individual to abuse psychoactive drugs depending on certain psychopathologies in the biological parents and/or parents` own drug use. The question for the next generation of research at the National Institute on Drug Abuse (NIDA) is to apply the rapidly developing technology in molecular genetics in an effort to determine the candidate genes contributing to the risk. 19 refs.
Tsingos, Cherie; Bosnic-Anticevich, Sinthia; Smith, Lorraine
Pharmacy students require critical-thinking and problem-solving skills to integrate theory learned in the classroom with the complexities of practice, yet many pharmacy students fall short of acquiring these skills.(1-2) Reflective practice activities encourage learning from the student's own experiences and those of others, and offer a possible solution for the integration of knowledge-based curricula with the ambiguities of practice, as well as enhance communication and collaboration within a multidisciplinary team. Although reflective practices have been embraced elsewhere in health professions education, their strengths and shortcomings need to be considered when implementing such practices into pharmacy curricula. This review provides an overview of the evolution of theories related to reflective practice, critically examines the use of reflective tools (such as portfolios and blogs), and discusses the implications of implementing reflective practices in pharmacy education.
Bosnic-Anticevich, Sinthia; Smith, Lorraine
Pharmacy students require critical-thinking and problem-solving skills to integrate theory learned in the classroom with the complexities of practice, yet many pharmacy students fall short of acquiring these skills.1-2 Reflective practice activities encourage learning from the student’s own experiences and those of others, and offer a possible solution for the integration of knowledge-based curricula with the ambiguities of practice, as well as enhance communication and collaboration within a multidisciplinary team. Although reflective practices have been embraced elsewhere in health professions education, their strengths and shortcomings need to be considered when implementing such practices into pharmacy curricula. This review provides an overview of the evolution of theories related to reflective practice, critically examines the use of reflective tools (such as portfolios and blogs), and discusses the implications of implementing reflective practices in pharmacy education. PMID:24558286
This study reports the prevalence of child (CSA) and adult (ASA) sexual abuse among 535 African American HIV serodiscordant couples from four major United State cities, and its relationship to personal and couple related vulnerabilities and HIV risk factors. As part of a randomized, clinical trial, CSA and ASA histories were obtained through face-to-face interviews. Results indicate that HIV positive women were significantly more likely to report one kind of abuse (32.32%), either before or since age 18 or both (32.6%). HIV-positive men (34.9%) were significantly more likely to report CSA than HIV-negative men (22.0%). Overall, 72% of couples reported that one or both had CSA histories. These findings underscore the heightened emotional vulnerability, and STI and HIV transmission risk taking practices, associated with sexual abuse. Sexual abuse histories among couples should be assessed to better understand how these histories may contribute to couples dynamics and risk-taking practices.
Guy, Richard; Byrne, Bruce
Although neuroscience studies have provided us with an increasingly detailed picture of the basis for learning and memory, very little of this information has been applied within the area of teaching practice. We suggest that a better understanding of neuroscience may offer significant advantages for educators. In this context, we have considered recent studies in the neuroscience of learning and memory, with particular emphasis on working and semantic memory, and also suggest that neuroscience research into self-referential networks may improve our understanding of the learning process. Finally, we propose that advances in understanding the neural basis for metacognition may encourage the development of new perspectives that may help us to motivate students to learn about their own learning processes.
Mowbray, Carol T.; Oyserman, Daphna
Reviews published research on the effects of parental mental illness diagnosis or symptoms on childhood substance abuse. Risk and protective factors for developing a substance use or related disorder in these children are summarized. Recommendations for substance abuse prevention in children of parents with mental illness are presented and used to…
Stahmer, Aubyn C.; Sutton, Danielle Thorp; Fox, Lise; Leslie, Laurel K.
Each year nearly 900,000 cases of child abuse and neglect are substantiated in the United States, with the highest rates of maltreatment occurring among infants and toddlers. Children exposed to maltreatment are at increased risk of developmental delay. The Child Abuse Prevention and Treatment Act specifies that children under age 3 with…
Poteat, V. Paul; Russell, Stephen T.
In this article, we consider recent advances in scholarship on homophobic bullying, and implications for policy and practice. We first consider toward whom homophobic behavior is directed, drawing attention to the nuances among LGBT youth, and the realities of homophobic bullying for heterosexual or straight youth. We review the correlates or…
Arora, Ranjit Kaur
Explores equal opportunities policies in the United Kingdom with specific reference to issues of gender and race in education, and examines the practical and political implications of these policies for educational institutions. Considers the interplay of sexism and racism affecting Black women in Britain, especially in their employment as…
National League for Nursing, New York, NY. Dept. of Practical Nursing Programs.
Papers on "Current Issues and Their Implications for Practical Nurse Programs" included in the document were authored by Margaret McLaughlin, Ruth B. Edelson, and Kenneth G. Skaggs. Summaries of presentations by Robert M. Morgan and Helen K. Powers are also included. (JK)
Despite an underlying inclusion agenda, sexuality equality remains a low priority in education. Review of literature suggests the marginalization of sexual minority young people (SMYP) in schools. This study explores educational psychologists' (EPs') constructions of sexuality and the implications for practice. Discursive psychology was used to…
Lee, Tony Szu-Hsien; Chen, Yu-Pei; Chang, Chun-Wei
Studies have documented that the perceived self-efficacy of attempts to engage in safer behavior is critical for the prevention of blood-borne diseases, including hepatitis C and HIV. The aim of this study was to examine gender differences in the perceived self-efficacy of safer HIV-related behavior among heroin and amphetamine abusers. Of the eligible participants from Taiwan prisons, 1622 polydrug users voluntarily agreed to complete a questionnaire regarding HIV risks. Participants had to be polydrug abusers (amphetamines and heroin), 18 years or older, sexually experienced, and literate. The questionnaire addressed background information, drug abuse, sexual behavior, and perceived self-efficacy in drug- and sex-related HIV risk situations. Twenty-four percent of respondents were HIV positive. Compared to men, women started illicit drug use at a younger age and were less likely to share syringes. Women also tended to have their first sexual coitus at an older age and were less likely to use a condom in their last sexual encounter. Men were more likely to have multiple sexual partners in the past 6 months. Results from a multinomial logistic regression indicate that gender, age, their interaction, age of first sexual encounter, HIV knowledge, condom use at last sexual encounter, and multiple sexual partners were associated with perceived self-efficacy of condom use. Results also show that gender, HIV serostatus, HIV knowledge, condom use at last sexual encounter, and sharing needles at last injection were associated with perceived self-efficacy in not sharing needles. The findings provide evidence for gender differences among polydrug abusers in Taiwan regarding perceived self-efficacy in adopting HIV prevention practices. Findings also provide evidence that knowledge about HIV transmission is related to perceived self-efficacy in promoting safe behavior. To raise polydrug abusers' perceived self-efficacy, gender and HIV/AIDS education must be taken into
Wolfe, David A.
This book examines the role child abuse plays within a victim's individual development from childhood through their adult life. It begins by describing the different types of child abuse, prevalence rates, and risk factors. It also describes four types of child maltreatment that include: physical abuse, neglect, sexual abuse, and emotional abuse.…
Marnewick, J C; van Zyl, A W
The abuse of both licit and illicit substances by the general population affects at least one in ten people. Research shows that the oral healthcare worker has at least the same prevalence of substance abuse, perhaps even higher. The emergence of prescription drug abuse is one of the most worrying and dangerous aspects for the healthcare worker, due to ease of access to such drugs. According to the United Nations, prescription drug abuse is amongst the top three practices of substance abuse. We have an obligation to incorporate the evidence of substance abuse among oral healthcare professionals in our undergraduate dental curricula in order to combat this phenomenon. As the stress of daily survival in single practitioner practices increase, so will the danger of substance abuse. This may lead to impairment of the healthcare worker and ultimately loss of registration. It will take a combined effort from organised dentistry and academic institutions to establish a national strategy to ensure we address this important issue at undergraduate level and provide support at practitioner level. This paper will deal with substance abuse and the implications of impairment it holds for the oral healthcare worker.
Yalçın, Murat; Aparcı, Mustafa; Eroğlu, Murat; Işılak, Zafer; Özmen, Namık
Background: Osborn wave, typically associated with hypothermia, is currently referred to as one of the J wave syndromes due to its clinical potential to develop lethal cardiac arrhythmia; it may rarely be observed in a non-hypothermic setting such as cannabis abuse. Case Report: In this paper, we presented two young cases who presented to the emergency services with unconsciousness, drowsiness, and hypoxia, and also J wave on electrocardiography (ECG) due to Bonsai abuse. Conclusion: Osborn wave may be a significant criterion to initiate close monitoring in a coronary care unit, with supportive treatment and mechanical ventilation as necessary in those patients who abuse Bonsai. PMID:28251030
Ugen, Kenneth E; Nyland, Susan B
The recreational use of legal and illegal drugs has significant effects on immune responses and can potentially modulate susceptibility to infection by a number of pathogens. A number of agents including cannabinoids (marijuana), cocaine opiates, amphetamines, nicotine and alcohol were demonstrated to have potentially adverse effects on the susceptibility to infections, mediated most likely, by adverse effects on immunity. As such, these drugs of abuse could have significant and potentially adverse effects on the vaccination efficacy of a number of vaccines currently on the market and on potential experimental vaccines currently in the pipeline. This review will present an overview on how drugs of abuse potentially impacts immune responses and vaccination efficacy. The emphasis of this review will be the effects of opiate abuse, as exemplified by injecting/intravenous drug users (IDU), on HIV/AIDS and its potential impact on vaccine efficacy trials against this devastating infection/syndrome.
Bloom, Sarah E; Lambert, Joseph M
During the maintenance stages of differential reinforcement of alternative responding (DRA), failure to reinforce alternative responses could result in a resurgence of problem behavior. However, translational work done with arbitrary human responses suggests that teaching individuals to emit multiple alternative responses in sequential order may facilitate the resurgence of appropriate, rather than problem, behavior. This paper discusses the practical implications of serial DRA training on problem and appropriate behavior resurgence, as presented in the preceding article, "Serial Alternative Response Training As Intervention for Target Response Resurgence." Clinical scenarios as well as implications for self-advocacy and acceptability of behavioral interventions are considered.
Hirst, Sandra P; Penney, Tasha; McNeill, Susan; Boscart, Veronique M; Podnieks, Elizabeth; Sinha, Samir K
A systematic review of the literature was conducted to identify effective approaches to preventing and addressing abuse and neglect of older adults within health care settings in Canada. The review was conducted using databases searched from January 2000-April-May 2013. Additionally, expert panel members submitted article citations from personal archives. Two research associates (NRA) screened each title and abstract for inclusion. After inter-rater reliability was determined between the NRAs (Kappa score of 0.76), the records were divided, appraised, and data extracted independently. The review resulted in 62 studies that focused on identifying, assessing, and responding to abuse and neglect of older adults; education, prevention, and health promotion strategies; and organizational and system-level supports to prevent and respond to abuse and neglect. Abuse and neglect of older adults remains under-explored in terms of evidence-based studies; consequently, further research in all of the areas described in the results is needed.
Tai, Betty; Sparenborg, Steven; Liu, David; Straus, Michele
The National Drug Abuse Treatment Clinical Trials Network (CTN) has faced many challenges over its first eleven years. This review explores some of these challenges and the paths the CTN took to meet these challenges, including: designing clinical trials that reflect the CTN’s mission and changing public health needs, finding the synergies in the varied expertise of clinical treatment providers and academic researchers, promoting evidence-based practices and expanding the Network into mainstream medical practices to reach a broader patient population. Included in this exploration are specific examples from CTN clinical trials. PMID:24474852
Haeseler, Lisa Ann
The intention of this article is to illuminate the developmental coping experiences of children of domestic violence abuse whether observed and/or experienced, and the impact upon school discourse at the elementary school level. It is aimed at providing school professionals with insights into their roles and responsibilities in the area of…
Griffiths, R R; Brady, J V; Snell, J D
A quantitative ratio measure was developed which permitted comparisons between the reinforcing and anorectic potency of eight phenylethylamine anorectics and cocaine in laboratory baboons. The ordering of these compounds based upon this ratio bears a reasonable correspondence to clinical drug evaluations. The measure may provide information for preclinical evaluation of relative abuse potential of anorectic drugs.
Flaherty, Christopher W.; Sutphen, Richard D.; Ely, Gretchen E.
Truancy is associated with an array of negative social consequences, including poor school performance, delinquency, and dropout. Numerous individual, family, school, and community risk factors associated with truancy are also associated with adolescent substance abuse. However, little is known about substance use patterns among court-adjudicated…
Scholes, Laura; Jones, Christian; Stieler-Hunt, Colleen; Rolfe, Ben; Pozzebon, Kay
In response to the diverse number of child sexual abuse (CSA) prevention programs currently implemented in school contexts, this paper examines key considerations for selecting such initiatives and the multiplicity of understandings required to inform facilitation of contextually relevant prevention curriculum. First, the paper examines concerns…
Birtel, Michèle D; Wood, Lisa; Kempa, Nancy J
Individuals with substance abuse may suffer from severe public and internalized stigma. Little is known about how social support can reduce stigma and improve mental health and well-being for them. This research examined how perceived stigma influences individuals in treatment for substance abuse, and whether internalized stigma and shame are mechanisms which link social support with better mental health and well-being. Sixty-four participants in treatment for substance abuse (alcohol, drugs), aged between 18 and 64, completed an online survey measuring perceived stigma, internalized stigma, shame, perceived social support, and mental health and well-being (self-esteem, depression and anxiety, sleep). We found that perceived stigma was associated with lower self-esteem, higher depression and anxiety, and poorer sleep. Furthermore, perceived social support followed the opposite pattern, and was associated with higher self-esteem, lower depression and anxiety, and better sleep. The effects of perceived stigma and of perceived social support on our outcome measures were mediated by internalized stigma and by internalized shame. Helping individuals with substance abuse to utilize their social support may be fruitful for combatting the negative impact of internalized stigma and shame on mental health and well-being.
Rigg, Khary K.; Murphy, John W.
Although studies on the initiation of substance abuse abound, the body of literature on prescription opioid abuse (POA) etiology is small. Little is known about why and how the onset of POA occurs, especially among high-risk populations. In this study we aimed to fill this important knowledge gap by exploring the POA initiation experiences of 90 prescription opioid abusers currently in treatment and their narrative accounts of the circumstances surrounding their POA onset. This research was conducted within a storyline framework, which operates on the premise that the path to drug abuse represents a biography or a process rather than a static condition. Audiotapes of in-depth interviews were transcribed, coded, and thematically analyzed. Analyses revealed the presence of four trajectories leading to POA. This study adds to the limited research on POA etiology by not only illuminating the psychosocial factors that contribute to POA onset, but also by situating initiation experiences within broader life processes. The study findings provide crucial insights to policymakers and interventionists in identifying who is at risk for POA, and more important, when and how to intervene most efficaciously. PMID:23656723
Brown, William J; Basil, Michael D; Bocarnea, Mihai C
When Mark McGwire broke Roger Maris's home run record in September of 1998, he was instantly declared an American hero and held up as a positive role model for teenagers and young adults. The extensive media attention focused on McGwire made the general public aware of his use of a muscle-building dietary supplement, Androstenedione. It also increased the public's awareness of McGwire's public service to prevent child abuse. The present research assesses audience involvement with McGwire through parasocial interaction and identification, and the effects of that involvement on audience knowledge of and attitudes toward Androstenedione and child abuse prevention. Results indicate parasocial interaction with an athlete regarded as a public role model likely leads to audience identification with that person, which in turn promotes certain attitudes and beliefs. In this case, parasocial interaction and identification with Mark McGwire was strongly associated with knowledge of Androstenedione, intended use of the supplement, and concern for child abuse. Implications of this research for featuring celebrities in health communication campaigns are discussed.
... to: What is Elder Abuse? Elder Abuse and Substance Abuse Substance abuse has been identified as the most frequently cited ... victim and/or the perpetrator who has the substance abuse problem. Substance abuse is believed to be a ...
Weise, Kathryn L; Daly, Barbara J
Clinical ethics consultants represent a multidisciplinary group of scholars and practitioners with varied training backgrounds, who are integrated into a medical environment to assist in the provision of ethically supportable care. Little has been written about the degree to which such consultants are accountable for the patient care outcome of the advice given. We propose a model for examining degrees of internally motivated accountability that range from restricted to unbounded accountability, and support balanced accountability as a goal for practice. Finally, we explore implications of this model for training of clinical ethics consultants from diverse academic backgrounds, including those disciplines that do not have a formal code of ethics relating to clinical practice.
Yavner, S B
The success of any dental practice depends, among other factors, on the critical role of staff employees. In order to encourage desired staff behaviors, incentive systems can be designed for employee dentists, assistants/hygienists and managers. A survey of dental franchises was conducted in 1987 for the purpose of examining their incentive control systems. The specific incentives employed by these dental franchises for their employees are analyzed. The implications of these incentive systems used by dental franchise organizations for all dental practices are then discussed.
McPake, Barbara; Russo, Giuliano; Hipgrave, David; Hort, Krishna; Campbell, James
Making progress towards universal health coverage (UHC) requires that health workers are adequate in numbers, prepared for their jobs and motivated to perform. In establishing the best ways to develop the health workforce, relatively little attention has been paid to the trends and implications of dual practice - concurrent employment in public and private sectors. We review recent research on dual practice for its potential to guide staffing policies in relation to UHC. Many studies describe the characteristics and correlates of dual practice and speculate about impacts, but there is very little evidence that is directly relevant to policy-makers. No studies have evaluated the impact of policies on the characteristics of dual practice or implications for UHC. We address this lack and call for case studies of policy interventions on dual practice in different contexts. Such research requires investment in better data collection and greater determination on the part of researchers, research funding bodies and national research councils to overcome the difficulties of researching sensitive topics of health systems functions.
Kelly, Peter J; Deane, Frank P; Lovett, Megan J
There is considerable discrepancy between what is considered evidence-based practice (EBP) and what is actually delivered in substance abuse treatment settings. The Theory of Planned Behavior (TpB) is a well-established model that may assist in better understanding clinician's intentions to use EBPs. A total of 106 residential substance abuse workers employed by The Salvation Army participated in the current study. The workers completed an anonymous survey that assessed attitudes toward EBP and examined the constructs within the TpB. A linear regression analysis was used to predict clinicians' intentions to use EBPs. Overall, the model accounted for 41% of the variance in intentions, with attitudes, subjective norms, and perceived behavioral control all significant predictors. The discussion highlights the potential for social reinforcement in the workplace to promote the implementation of EBPs.
Michel, Mary Ellen; Pintello, Denise A; Subramaniam, Geetha
Substance abuse is a leading cause of death and disability throughout the world. The mission of the National Institute on Drug Abuse (NIDA) is to lead the United States in bringing the power of science to bear on drug abuse and addiction. This charge has two critical components: (a) strategic support of research across a broad range of disciplines and (b) rapid, effective dissemination of research results that can improve prevention and treatment efforts, with potential to inform policy. The NIDA Clinical Trials Network and the Blending Initiative are critical elements of this strategy, and the social work field is poised to use these resources to expand its role in the dissemination and implementation of NIDA's mission.
Negus, S. Stevens; Katrina Schrode, KA; Stevenson, Glenn W.
Mu opioid receptor agonists are clinically valuable as analgesics; however, their use is limited by high abuse liability. Kappa opioid agonists also produce antinociception, but they do not produce mu agonist-like abuse-related effects, suggesting that they may enhance the antinociceptive effects and/or attenuate the abuse-related effects of mu agonists. To evaluate this hypothesis, the present study examined interactions between the mu agonist fentanyl and the kappa agonist U69,593 in three behavioral assays in rhesus monkeys. In an assay of schedule-controlled responding, monkeys responded under a fixed-ratio 30 (FR 30) schedule of food presentation. Fentanyl and U69,593 each produced rate-decreasing effects when administered alone, and mixtures of 0.22:1, 0.65:1 and 1.96:1 U69,593/fentanyl usually produced subadditive effects. In an assay of thermal nociception, tail withdrawal latencies were measured from water heated to 50°C. Fentanyl and U69,593 each produced dose-dependent antinociception, and effects were additive for all mixtures. In an assay of drug self-administration, rhesus monkeys responded for i.v. drug injection, and both dose and FR values were manipulated. Fentanyl maintained self-administration, whereas U69,593 did not. Addition of U69,593 to fentanyl produced a proportion-dependent decrease in both rates of fentanyl self-administration and behavioral economic measures of the reinforcing efficacy of fentanyl. Taken together, these results suggest that simultaneous activation of mu and kappa receptors, either with a mixture of selective drugs or with a single drug that targets both receptors, may reduce abuse liability without reducing analgesic effects relative to selective mu agonists administered alone. PMID:18837635
Calderon, Tina M; Williams, Dionna W; Lopez, Lillie; Eugenin, Eliseo A; Cheney, Laura; Gaskill, Peter J; Veenstra, Mike; Anastos, Kathryn; Morgello, Susan; Berman, Joan W
In human immunodeficiency virus-1 (HIV) infected individuals, substance abuse may accelerate the development and/or increase the severity of HIV associated neurocognitive disorders (HAND). It is proposed that CD14(+)CD16(+) monocytes mediate HIV entry into the central nervous system (CNS) and that uninfected and infected CD14(+)CD16(+) monocyte transmigration across the blood brain barrier (BBB) contributes to the establishment and propagation of CNS HIV viral reservoirs and chronic neuroinflammation, important factors in the development of HAND. The effects of substance abuse on the frequency of CD14(+)CD16(+) monocytes in the peripheral circulation and on the entry of these cells into the CNS during HIV neuropathogenesis are not known. PBMC from HIV infected individuals were analyzed by flow cytometry and we demonstrate that the frequency of peripheral blood CD14(+)CD16(+) monocytes in HIV infected substance abusers is increased when compared to those without active substance use. Since drug use elevates extracellular dopamine concentrations in the CNS, we examined the effects of dopamine on CD14(+)CD16(+) monocyte transmigration across our in vitro model of the human BBB. The transmigration of this monocyte subpopulation is increased by dopamine and the dopamine receptor agonist, SKF 38393, implicating D1-like dopamine receptors in the increase in transmigration elicited by this neurotransmitter. Thus, elevated extracellular CNS dopamine may be a novel common mechanism by which active substance use increases uninfected and HIV infected CD14(+)CD16(+) monocyte transmigration across the BBB. The influx of these cells into the CNS may increase viral seeding and neuroinflammation, contributing to the development of HIV associated neurocognitive impairments.
García, Antonio Verdejo; Torrecillas, Francisca López; de Arcos, Francisco Aguilar; García, Miguel Pérez
Our study examined the relation between neuropsychological impairment of executive functions and explanatory styles, according to the Abramson model of learned helplessness in humans, in a sample of substance abusers. Thirty-eight polysubstance abusers were assessed during an abstinence period using a selective neuropsychological battery for the evaluation of the executive functions, as well as the Attributional Style Questionnaire (ASQ) for the assessment of the three dimensions of explanatory style: Internality-Externality, Stability-Instability and Globality-Specificity. Multiple regression analyses showed significant relationships among performance on different neuropsychological tasks sensitive to executive functions and characteristic cognitive styles. The results showed the performance on cognitive flexibility and response inhibition tasks is directly related to making more internal attributions for positive situations, and inversely related to the appearance of more stable attributions for negative events. Likewise, adequate performance on working memory tasks was related to development of more global attributions for failures. These results are partially congruent with the learned helplessness model and particularly relevant for the clinical management of substance abusers and the success on the treatment and rehabilitation of these subjects.
Swanson, J M; Volkow, N D
When used to treat children with Attention Deficit Hyperactivity Disorder, methylphenidate (MPH) acts primarily by blocking the dopamine (DA) transporter (DAT) and increasing extracellular DA in the striatum. This is strikingly similar to the mechanism of action of cocaine, a primary stimulant drug of abuse. When administered intravenously, MPH like cocaine has reinforcing effects (euphoria) at doses that exceed a DAT blockade threshold of 60%. When administered orally at clinical doses, the pharmacological effects of MPH also exceed this threshold, but reinforcing effects rarely occur. Here we discuss the pharmacokinetic properties of MPH in serum (and in brain) that differ for oral and intravenous routes of administration and the importance of acute tolerance in determining pharmacodynamic effects in clinical use and illegal abuse. We suggest that intravenous administration of MPH mimics the rapid phasic cell firing of DA neurons, which may be a critical factor associated with reinforcing effects and abuse, while oral administration of MPH mimics the tonic DA cell firing, which may be a critical factor associated with clinical effects.
Fox, Helen C; Sinha, Rajita
Extensive research indicates that chronic substance abuse disrupts stress and reward systems of the brain. Gender variation within these stress-system alterations, including the impact of sex hormones on these changes, may influence sex-specific differences in both the development of, and recovery from, dependency. As such, gender variations in stress-system function may also provide a viable explanation for why women are markedly more vulnerable than men to the negative consequences of drug use. This article therefore initially reviews studies that have examined gender differences in emotional and biophysiological changes to the stress and reward system following the acute administration of drugs, including cocaine, alcohol, and nicotine. The article then reviews studies that have examined gender differences in response to various types of stress in both healthy and drug-abusing populations. Studies examining the impact of sex hormones on these gender-related responses are also reported. The implications of these sex-specific variations in stress and reward system function are discussed in terms of both comorbid psychopathology and treatment outcome.
Alon, Sara; Berg-Warman, Ayelet
Successful handling of elder abuse and neglect requires various interventions. This article presents findings from an evaluation study of a model for intervention implemented in three municipalities in Israel. Data from 558 older adults, exposed to abuse and treated through the program, and interviews with victims, abusers, and professionals revealed that improvement was achieved in 66% of the cases. In 20% of the cases, the abuse was stopped. The most widespread type of intervention consisted of individual counseling. Legal intervention yielded the highest rate of improvement (82%). Provision of supportive services for victims of neglect was found to be most effective (82% of improvement in the situation).
CHEN, JONATHAN H; GOLDSTEIN, MARY K; ASCH, STEVEN M; ALTMAN, RUSS B
Automatically data-mining clinical practice patterns from electronic health records (EHR) can enable prediction of future practices as a form of clinical decision support (CDS). Our objective is to determine the stability of learned clinical practice patterns over time and what implication this has when using varying longitudinal historical data sources towards predicting future decisions. We trained an association rule engine for clinical orders (e.g., labs, imaging, medications) using structured inpatient data from a tertiary academic hospital. Comparing top order associations per admission diagnosis from training data in 2009 vs. 2012, we find practice variability from unstable diagnoses with rank biased overlap (RBO)<0.35 (e.g., pneumonia) to stable admissions for planned procedures (e.g., chemotherapy, surgery) with comparatively high RBO>0.6. Predicting admission orders for future (2013) patients with associations trained on recent (2012) vs. older (2009) data improved accuracy evaluated by area under the receiver operating characteristic curve (ROC-AUC) 0.89 to 0.92, precision at ten (positive predictive value of the top ten predictions against actual orders) 30% to 37%, and weighted recall (sensitivity) at ten 2.4% to 13%, (P<10−10). Training with more longitudinal data (2009-2012) was no better than only using recent (2012) data. Secular trends in practice patterns likely explain why smaller but more recent training data is more accurate at predicting future practices. PMID:26776186
Johnson, Regina Jones; Rew, Lynn; Sternglanz, R. Weylin
This study explored the gender differences in sexual self-concept, personal resources for sexual health, safe sex behaviors, and risky sexual behaviors among homeless adolescents with and without histories of sexual abuse. Data for this secondary analysis were collected in 2003 to 2004 in the first phase of a larger repeated-measures sexual health…
Noll, Douglas E.; Harvey, Linda
This article will present the restorative justice model and examine how the restorative justice philosophy and process can be applied to clergy-perpetrated sexual abuse and religious sexual misconduct to resolve legal claims and allow the process of healing to begin. Restorative justice is a holistic approach to criminal, civil, and church law…
Tapia, Maria I.; Schwartz, Seth J.; Prado, Guillermo; Lopez, Barbara; Pantin, Hilda
Objective: The objective of the present article is to review and discuss Familias Unidas, an empirically supported, family-based, culturally specific drug abuse and HIV prevention intervention for Hispanic immigrant adolescents and their families. Method: The authors focus on engagement and retention as well as on intervention delivery.…
Dore, Martha Morrison; Doris, Joan M.
Examined relationship between program involvement, status of addiction treatment, and outcomes for caregivers and children participating in a placement prevention program for substance-abusing mothers and other primary caregivers reported for child maltreatment. Findings indicated that nearly half the participants were able to complete addiction…
Van Wormer, Katherine
The following questions are addressed: Why should general social work students need to know about alcoholism/addiction, chemical dependency? What skills are required for assessment of chemical dependency intervention? How can the social work curriculum provide adequate training for work with substance abusers? (Author/MH)
Courtois, Christine A.
Provides an overview of the positions taken by both sides in the dispute of "false memory." Then presents major findings of several professional task forces charged with reviewing the controversy and arriving at recommendations for research, clinical practice, and forensic practice regarding delayed recall of memories for sexual abuse.…
This paper addresses the importance of the concept of ideology in community work. The implications of a Marxist approach to ideology in community practice are analyzed in terms of the concepts of problematization (P. Freire, 1979) and consciousness-raising (J. Barreiro, 1976), illustrating the point with some examples. The traditional Marxist perspective is also examined in relation to the perspectives of social constructionism (I. Ibáñez, 1996), cultural studies (A. McRobbie, 1992), post-Marxism (E. Laclau & C. Mouffe, 1985), and feminism (D. Haraway, 1991). It is argued that the concepts of hegemony and habitus (P. Bourdieu, 1985) can be useful to community social psychology theory and practice. A "situated perspective"--in which it is possible to dialogue from different "subject positions," and articulate transformation and political action--is argued. The implications of this shifting in the concept of ideology by means of theoretical developments outside social communitypsychology can help to define the external (outside) agent's position in community practice.
Clark, H W
In FY 1993 and FY 1995, the federal government awarded 27 five-year grants that supported 35 residential treatment projects for substance-abusing pregnant and postpartum women and their children. These projects provided comprehensive culturally and gender-specific treatment. Preliminary aggregated data collected in a national cross-site evaluation of 24 of these projects are encouraging with respect to infant mortality and morbidity, treatment retention and completion rates, and behavioral changes in the participating mothers at six months postdischarge. Local evaluations reflect other benefits of treatment. Cost data are expected to demonstrate the efficiencies and benefits of these projects compared to no treatment.
Vance, David; Larsen, Kirsten I; Eagerton, Gregory; Wright, Mary A
Optimal cognitive functioning is necessary to successfully negotiate one's environment, yet medical conditions can interfere with brain health, thus negatively impacting cognitive functioning. Such comorbidities include hypertension, heart disease, diabetes, depression, and HIV, as well as others. The physiological properties of these comorbidities can reduce one's cognitive reserve and limit one's cognitive efficiency. This article provides an overview of a few common comorbidities known to affect cognitive functioning and addresses ways in which cognitive functioning may be ameliorated and protected or mitigated in lieu of cognitive declines in such clinical populations. Implications for nursing practice and research are posited.
Avena, Nicole M; Bocarsly, Miriam E; Hoebel, Bartley G; Gold, Mark S
The obesity epidemic has led to the postulation that highly palatable foods may be "addictive" for some individuals. This idea is supported by the fact that there are overlaps in brain circuitry that underlie addictive behavior as well as overeating. In this paper, we discuss the utility of the concept of "food addiction" as it may relate to treating certain disordered eating behaviors. Using criteria set forth in the DSM-IV for substance-use disorders, we review data that have emerged from animal models suggesting that overeating, in the form of binge eating, fits some of the criteria for substance abuse. Further, we discuss preclinical data revealing that the addiction-like behavioral changes observed in response to overeating are concomitant with neurochemical changes that are similar to those observed in response to drugs of abuse. With this background and evidence in mind, we conclude this article with a discussion as to how "food addiction" research may translate into clinical strategies and pharmaceutical treatments useful in curtailing overeating.
Pharmacogenetics seeks to elucidate the variations in individual's genetic sequences in order to better understand the differences seen in pharmacokinetics, drug metabolism, and efficacy between patients. This area of research is rapidly accelerating, aided by the use of novel and more economical molecular technologies. A substantial evidence base is being generated with the hopes that in the future it may be used to generate personalised treatment regimens in order to improve patient comfort and safety and reduce incidences of morbidity and mortality. Anaesthetics is an area of particular interest in this field, with previous research leading to better informed practice, specifically with regards to pseudocholinesterase deficiency and malignant hyperthermia. In this review, recent pharmacogenetic data pertaining to anaesthetic drugs will be presented and possible future applications and implications for practice will be discussed. PMID:26779337
Manchikanti, Laxmaiah; Hirsch, Joshua A
Rapidly rising health care costs over the decades have prompted the application of business practices to medicine with goals of improving the efficiency, restraining expenses, and increasing quality. Average health insurance premiums and individual contributions for family coverage have increased approximately 120% from 1999 to 2008. Health care spending in the United States is stated to exceed 4 times the national defense, despite the wars in Iraq and Afghanistan. The U.S. health care system has been blamed for inefficiencies, excessive administrative expenses, inflated prices, inappropriate waste, and fraud and abuse. While many people lack health insurance, others who do have health insurance allegedly receive care ranging from superb to inexcusable. In criticism of health care in the United States and the focus on savings, methodologists, policy makers, and the public in general seem to ignore the major disadvantages of other global health care systems and the previous experiences of the United States to reform health care. Health care reform is back with the Obama administration with great expectations. It is also believed that for the first time since 1993, momentum is building for policies that would move the United States towards universal health insurance. President Obama has made health care a central part of his domestic agenda, with spending and investments in Children's Health Insurance Program (CHIP), American Recovery and Reinvestment Act of 2009, and proposed 2010 budget. It is the consensus now that since we have a fiscal emergency, Washington is willing to deal with the health care crisis. Many of the groups long opposed to reform, appear to be coming together to accept a major health care reform. Reducing costs is always at the center of any health care debate in the United States. These have been focused on waste, fraud, and abuse; administrative costs; improving the quality with health technology information dissemination; and excessive
Selective primary prevention programs for child abuse and neglect depend on risk screening instruments that have the goal of systematically identifying families who can profit most from early help. Based on a systematic review of longitudinal studies, a set of established risk factors for early child abuse and neglect is presented. Nearly half of the items included in screening instruments can be seen as validated. Available studies indicate a high sensitivity of risk screening instruments. Positive predictive values, however, are low. Overall, the use of risk screening instruments in the area of primary prevention for families at risk represents a feasible method, as long as stigmatizing effects can be avoided and participating families also benefit beyond preventing endangerment.
Winhusen, Theresa M.; Somoza, Eugene C.; Lewis, Daniel F.; Kropp, Frankie; Theobald, Jeff; Elkashef, Ahmed
Background. There is a strong association between crack/cocaine use and increased sexual risk behavior, but little research on the efficacy of HIV education for decreasing such behavior in crack/cocaine-addicted individuals in substance abuse treatment. Method. Datasets from two cocaine dependence trials including either one or three HIV education sessions, respectively, were analyzed for changes over time in the proportion of participants practicing safe sex. A pooled dataset from two earlier trials not offering HIV education was also analyzed. Results. We included 83 participants from the 1-session trial and 65 participants from the 3-session trial. Both sets of participants evidenced a significant increase in the proportion of participants having safe sex with casual partners. Participants in the 3-session HIV education study also evidenced a significant increase in the proportion of participants having safe sex with regular partners. In the trials without HIV education, no change in safe sex practices was found, and change in condom use was observed only among female participants. Conclusions. These findings are consistent with recommendations that HIV education/counseling should be provided to individuals in substance abuse treatment. A randomized controlled trial to confirm these results may be warranted. This trial is registered with NCT00033033, NCT00086255, NCT00015106, and NCT00015132. PMID:25938124
Ehlers-Danlos syndrome is a heterogeneous group of heritable connective tissue disorders characterized by increased fragility of various non-ossified tissues. It is usually ascertained due to abnormal skin texture, scarring complications, vascular fragility, or chronic symptoms, such as fatigue and musculoskeletal pain. Sometimes, Ehlers-Danlos syndrome remains undetected until the patient, usually in the pediatric age, shows extensive or severe mucocutaneous injuries after only minor traumas. In this scenario, the misdiagnosis of Ehlers-Danlos syndrome with child abuse is a possibility, as occasionally reported in the literature. Recently, more attention was posed by lay people between the possible association of Ehlers-Danlos syndrome and bone fragility. Literature and personal experience show a strong association between Ehlers-Danlos syndrome, generalized joint hypermobility and reduced bone mass density in older children and adults, especially fertile women. The existence of a true increased risk of fracture in Ehlers-Danlos syndrome is still a matter of debate in children and adults with little and conflicting evidence. In case of suspected child abuse, Ehlers-Danlos syndrome is certainly on the differential for bruising, especially in EDS types with marked cutaneous and capillary involvement. In suspected child abuse cases, careful examination of the index case and her/his extended family is routine, as well as exclusion of other disorders such as osteogenesis imperfecta. The hypothesis of Ehlers-Danlos syndrome as an alternative explanation for infantile fractures remains speculative.
Corporate practices, such as advertising, public relations, lobbying, litigation, and sponsoring scientific research, have a significant impact on the health of the people in the United States. Recently, health professionals and advocates have created a new scope of practice that aims to modify corporate practices that harm health. This article describes how corporate policies influence health and reviews recent health campaigns aimed at changing corporate behavior in six industries selected for their central role in the U.S. economy and their influence on major causes of mortality and morbidity. These are the alcohol, automobile, food, gun, pharmaceutical, and tobacco industries. The article defines corporate disease promotion and illustrates the range of public health activities that have emerged to counter such corporate behaviors. It analyzes the role of health professionals, government, and advocacy groups in these campaigns and assesses the implications of this domain for health education practice and research.
Fernández-Montalvo, Javier; López-Goñi, José J; Arteaga, Alfonso; Cacho, Raúl; Azanza, Paula
This study explored the prevalence of victims of abuse and the therapeutic progression among women who sought treatment for drug addiction. A sample of 180 addicted Spanish women was assessed. Information was collected on the patients' lifetime history of abuse (psychological, physical, and/or sexual), socio-demographic factors, consumption variables, and psychological symptoms. Of the total sample, 74.4% (n = 134) of the addicted women had been victims of abuse. Psychological abuse affected 66.1% (n = 119) of the patients, followed by physical abuse (51.7%; n = 93) and sexual abuse (31.7%; n = 57). Compared with patients who had not been abused, the addicted women with histories of victimization scored significantly higher on several European version of the Addiction Severity Index (EuropASI) and psychological variables. Specifically, physical abuse and sexual abuse were related to higher levels of severity of addiction. Regarding therapeutic progression, the highest rate of dropout was observed among victims of sexual abuse (63.5%; n = 33), followed by victims of physical abuse (48.9%; n = 23). Multivariate analysis showed that medical and family areas of the EuropASI, as well as violence problems and suicide ideation, were the main variables related to physical and/or sexual abuse. Moreover, women without abuse and with fewer family problems presented the higher probability of treatment completion. The implications of these results for further research and clinical practice are discussed.
Chen, Billy T; Hopf, F Woodward; Bonci, Antonello
In an ever-changing environment, animals must learn new behavioral strategies for the successful procurement of food, sex, and other needs. Synaptic plasticity within the mesolimbic system, a key reward circuit, affords an animal the ability to adapt and perform essential goal-directed behaviors. Ironically, drugs of abuse can also induce synaptic changes within the mesolimbic system, and such changes are hypothesized to promote deleterious drug-seeking behaviors in lieu of healthy, adaptive behaviors. In this review, we will discuss drug-induced neuroadaptations in excitatory transmission in the ventral tegmental area and the nucleus accumbens, two critical regions of the mesolimbic system, and the possible role of dopamine receptors in the development of these neuroadaptations. In particular, we will focus our discussion on recent studies showing changes in AMPA receptor function as a common molecular target of addictive drugs, and the possible behavioral consequences of such neuroadaptations.
Lockwood, R; Arkow, P
The role of the veterinary forensic pathologist in the investigation of animal abuse or neglect can go beyond documenting the condition of animals presented as evidence. Although animal cruelty is a moral concern and a crime in itself, law enforcement response to such crimes is often enhanced by the recognition that crimes against animals can be both indicators of other ongoing crimes against people and predictors of the potential for interpersonal violence. An understanding of common motives underlying animal cruelty can aid the pathologist in asking appropriate questions. The authors review the forms of pathology evidence commonly seen in various presentations of animal cruelty. Understanding these forms of evidence can help the pathologist describe findings that can be significant for assessing the potential risks the alleged perpetrator may pose to other animals and humans.
Levenson, Jill S; Willis, Gwenda M; Vicencio, Claudia P
Persons with potentially harmful sexual interests such as attraction to minors are unlikely to seek or receive treatment before a sexual offense has been committed. The current study explored barriers to help-seeking in a sample of 372 individuals in treatment for sexual offending. Results revealed that the shame and secrecy resulting from stigma associated with pedophilic interests often prevented our respondents from seeking professional counseling, and only about 20% tried to talk to anyone about their sexual interests prior to their arrest. Barriers to seeking and receiving psychological services included concerns about confidentiality, fears of social and legal consequences, personal shame or confusion about the problem, affordability, and challenges finding competent therapists who were adequately equipped to help them. Understanding and ultimately reducing obstacles to help-seeking can improve the quality of life for people with harmful sexual interests and potentially prevent sexual abuse of children or other vulnerable individuals.
Blackson, T C; Tarter, R E; Martin, C S; Moss, H B
The impact on family dysfunction and child behavior problems of difficult affective temperament in fathers and sons was investigated. In preadolescent sons of both substance-abusing and non-substance-abusing fathers, temperament was found to mediate the relationship between family history of substance abuse and family dysfunction.
The paper presents the multi-factorial problem of sexual abuse of children within their families, provides definitions of relevant terms (incest, sexual abuse, sexual misuse, molestation, sexual assault, rape), reviews the epidemiology of sexual abuse and its effects, and traces development of a Sexual Abuse Resource Team in a rural/resort New…
Coller, Janet K; Hutchinson, Mark R
In the past two decades a trickle of manuscripts examining the non-neuronal central nervous system immune consequences of the drugs of abuse has now swollen to a significant body of work. Initially, these studies reported associative evidence of central nervous system proinflammation resulting from exposure to the drugs of abuse demonstrating key implications for neurotoxicity and disease progression associated with, for example, HIV infection. However, more recently this drug-induced activation of central immune signaling is now understood to contribute substantially to the pharmacodynamic actions of the drugs of abuse, by enhancing the engagement of classical mesolimbic dopamine reward pathways and withdrawal centers. This review will highlight the key in vivo animal, human, biological and molecular evidence of these central immune signaling actions of opioids, alcohol, cocaine, methamphetamine, and 3,4-methylenedioxymethamphetamine (MDMA). Excitingly, this new appreciation of central immune signaling activity of drugs of abuse provides novel therapeutic interventions and opportunities to identify 'at risk' individuals through the use of immunogenetics. Discussion will also cover the evidence of modulation of this signaling by existing clinical and pre-clinical drug candidates, and novel pharmacological targets. Finally, following examination of the breadth of central immune signaling actions of the drugs of abuse highlighted here, the current known common immune signaling components will be outlined and their impact on established addiction neurocircuitry discussed, thereby synthesizing a common neuroimmune hypothesis of addiction.
Jung, Hyunzee; Herrenkohl, Todd I; Lee, Jungeun Olivia; Klika, J Bart; Skinner, Martie L
Analyses tested hypotheses that pertain to direct and indirect effects of parent-reported physical and emotional abuse on later self-reported criminal behavior in a sample of 356 adults of a longitudinal study of more than 30 years. Childhood antisocial behavior was included in analyses as a potential mediator. Physical abuse only predicted adult crime indirectly through childhood antisocial behavior, whereas emotional abuse predicted adult outcome both directly and indirectly. Chronicity of physical abuse was indirectly related to later crime in a subsample test for those who had been physically abused (n=318), whereas chronicity of emotional abuse was neither directly nor indirectly related to adult crime in a test of those who had been emotionally abused (n=225). Implications for future research and practice are discussed.
Jung, Hyunzee; Herrenkohl, Todd I.; Lee, Jungeun Olivia; Klika, J. Bart; Skinner, Martie L.
Analyses tested hypotheses that pertain to direct and indirect effects of parent-reported physical and emotional abuse on later self-reported criminal behavior in a sample of 356 adults of a longitudinal study of more than 30 years. Childhood antisocial behavior was included in analyses as a potential mediator. Physical abuse only predicted adult crime indirectly through childhood antisocial behavior, whereas emotional abuse predicted adult outcome both directly and indirectly. Chronicity of physical abuse was indirectly related to later crime in a subsample test for those who had been physically abused (n = 318), whereas chronicity of emotional abuse was neither directly nor indirectly related to adult crime in a test of those who had been emotionally abused (n = 225). Implications for future research and practice are discussed. PMID:26439922
Noll, Douglas E; Harvey, Linda
This article will present the restorative justice model and examine how the restorative justice philosophy and process can be applied to clergy-perpetrated sexual abuse and religious sexual misconduct to resolve legal claims and allow the process of healing to begin. Restorative justice is a holistic approach to criminal, civil, and church law violations, allowing all aspects of an offense to be addressed in one process. Unlike retributive justice prevalent in the traditional legal system, restorative justice seeks to make things right while focusing on healing for the victim-survivor and offender and accountability by the church representatives.
Lee, Jayoung; Wallace, Sam; Puig, Ana; Choi, Bo Young; Nam, Suk Kyung; Lee, Sang Min
This study empirically tested and compared three different models of factor structure with a sample of therapists working with sexual offenders, survivors of sexual abuse, or both. Results indicated that a modified five-factor model was the most appropriate. Practical implications for sexual offender/abuse survivor therapists are discussed.…
Attention-deficit hyperactivity disorder (ADHD) is a common disorder in children that frequently persists into adulthood. Studies have found that substance use disorders (SUD) are seen more commonly in those with ADHD than the general population. Although treatment with stimulant medications has been shown to be effective for individuals with ADHD, concern about the use of these agents in this population persists. This review article highlights the research in this area with a focus on the treatment of individuals who present with concomitant ADHD and SUD. Although stimulants can be abused, studies have shown that adolescents who are prescribed stimulants for ADHD have lower rates of SUD than those who are not treated with stimulants. It may be particularly difficult to evaluate adults for the diagnosis of ADHD when SUD is a co-morbid factor. Studies show that 20--30% of adults presenting with SUD have concomitant ADHD and approximately 20--40% of adults with ADHD have histories of SUD. Therefore, it is critical to perform careful diagnostic interviews to discern if patients have either or both of these disorders. Many clinical experts suggest that adults with ADHD and active SUD be treated for the SUD until a period of sobriety persists prior to initiation of specific treatment for ADHD. Since individuals with ADHD and active SUD are more likely to have more severe SUD and a worse prognosis, this approach may not serve many patients, as they relapse prior to obtaining ADHD treatment. Therefore, research has been directed towards determining if the treatment of ADHD with stimulant medications can be safe and effective for the individual with active SUD and concomitant ADHD. An initial trial of methylphenidate in a population of adults with active cocaine dependence and ADHD indicates that this is the case. Individuals with ADHD and SUD can present difficult diagnostic and therapeutic challenges. It appears that the most effective treatment option is to create a
Logan, T K; Cole, Jennifer
This study examined a range of sexually abusive acts women with protective orders against violent partners experienced using three groups: (a) women who never experience stalking or rape by the violent partner; (b) women who experienced stalking but who had never been raped by the violent partner; and (c) women who were stalked and raped by the violent partner. Findings suggest that women in violent relationships experienced a wide range of sexually abusive experiences and that there is a significant association of partner stalking and partner sexual abuse beyond rape. Implications for practice and future research are discussed.
Haroun, Nasra; Dunn, Laura; Haroun, Ansar; Cadenhead, Kristin S
Over the last decade schizophrenia researchers have turned their attention to earlier identification in the prodromal period of illness. A greater understanding of both risk and protective factors can lead to improved prevention and treatment strategies in this vulnerable population. This research, however, has far-reaching ethical implications. One year follow-up data from 50 individuals who met established criteria for a prodromal state is used to illustrate ethical issues that directly affect clinicians and future research strategies. At 1-year follow-up, the psychotic transition rate was 13%, but it increased in subsequent years with smaller sample sizes. One-half developed an affective psychosis. The converted sample was older (p > 0.05) than the nonconverted sample and more likely to have a premorbid history of substance abuse, as well as higher clinical ratings on “subsyndromal” psychotic items (delusional thinking, suspiciousness, and thought disorder). Despite a lack of conversion, the nonconverted sample remained symptomatic and had a high rate of affective and anxiety disorders with evidence of functional disability. This conversion rate is relatively low compared to similar studies at 1 year. Specific risk factors were identified, but these findings need to be replicated in a larger cohort. By examining the rate of conversion and nonconversion in this sample as an example, we hope to contribute to the discussion of implications for clinical practice and the direction of future research in the schizophrenia prodrome. Finally, our data strengthen the evidence base available to inform the discussion of ethical issues relevant to this important research area. PMID:16207892
Gallimberti, Luigi; Buja, Alessandra; Chindamo, Sonia; Lion, Camilla; Terraneo, Alberto; Marini, Elena; Gomez Perez, Luis Javier; Baldo, Vincenzo
The aim of the present study was to assess the prevalence by gender of substance use and misuse in late childhood and early adolescence. A survey was conducted in 2013–2014 at primary and secondary schools of Padova, Veneto region, North-East Italy, on a sample of 171 pupils in 5th grade and 1325 in 6th to 8th grade. Among the 8th graders, more than one in three males and one in four females had experimented with smoking, and more than half the boys and nearly half the girls had experience of alcohol. In this same age group, almost two in three males and one in three females had used energy drinks, and nearly 5% of the boys had experience of marijuana and/or stimulant drugs. In addition, almost one in four of the male students in 8th grade had experimented with three of these substances. The middle school years should be identified as the first period at risk concerning the use of these drugs. Prevention programs should begin in early adolescence, focusing on delaying the use or abuse of any of the “gateway drugs.” PMID:26844161
Angell, Peter J; Chester, Neil; Sculthorpe, Nick; Whyte, Greg; George, Keith; Somauroo, John
The use of performance-enhancing and social drugs by athletes raises a number of ethical and health concerns. The World Anti-Doping Agency was constituted to address both of these issues as well as publishing a list of, and testing for, banned substances in athletes. Despite continuing methodological developments to detect drug use and associated punishments for positive dope tests, there are still many athletes who choose to use performance and image enhancing drugs. Of primary concern to this review are the health consequences of drug use by athletes. For such a large topic we must put in place delimitations. Specifically, we will address current knowledge, controversies and emerging evidence in relation to cardiovascular (CV) health of athletes taking drugs. Further, we delimit our discussion to the CV consequences of anabolic steroids and stimulant (including amphetamines and cocaine) use. These drugs are reported in the majority of adverse findings in athlete drug screenings and thus are more likely to be relevant to the healthcare professionals responsible for the well-being of athletes. In detailing CV health issues related to anabolic steroid and stimulant abuse by athletes we critique current research evidence, present exemplar case studies and suggest important avenues for on-going research. Specifically we prompt the need for awareness of clinical staff when assessing the potential CV consequences of drug use in athletes.
Levi-Minzi, Maria A; Surratt, Hilary L
HIV-related stigma has a major impact on quality of life and health among people living with HIV and AIDS (PLWHA). This study examines demographic, mental health, behavioral, contextual, and HIV care-related correlates of HIV stigma among 503 substance abusing PLWHA. Stigma was measured with the HIV Internalized Stigma Measure which has four subscales: stereotypes about HIV, self-acceptance, disclosure concerns, and social relationships. Severe substance dependence (55.3%) and depression (54.7%) were associated with higher HIV stigma across all domains. 49.9% of the sample reported antiretroviral (ARV) medication diversion (the unlawful sale and trading of ARV medications); diverters endorsed significantly higher stigma related to disclosure. 54.1% of the sample reported ≥95% ARV adherence; these individuals reported significantly lower stigma for self-acceptance, disclosure, and social relationships. Multivariate linear regression showed that depression and social support demonstrated significant main effects across stigma domains. Findings suggest that interventions to decrease HIV related stigma may be an important component of initiatives to increase engagement in HIV care.
Surgical smoke presents a serious health hazard, but perioperative nurses' compliance with smoke evacuation recommendations is not consistent. I investigated key indicators for compliance with electrosurgical smoke evacuation recommendations based on nurses' individual innovativeness characteristics, perceptions of the attributes of smoke evacuation recommendations, and organizational innovativeness characteristics. The study findings provide implications for improving nurses' compliance with smoke evacuation recommendations. Individual innovativeness characteristics, including nurses' knowledge and training, were most strongly linked to smoke evacuation compliance. The key indicators that promote surgical smoke evacuation can provide direction to guide the content of education programs and help identify the personnel and settings that are most in need of this information. Barriers to compliance included lack of equipment, physician resistance, noise, and staff member complacency. Vendor demonstrations on the ease of smoke evacuation device use can show nurses that smoke evacuation is compatible with nursing practice. Facility leaders should provide smoke evacuation policies that are easy to understand and should enforce these policies.
Surgical smoke presents a serious health hazard, but perioperative nurses' compliance with smoke evacuation recommendations is not consistent. I investigated key indicators for compliance with electrosurgical smoke evacuation recommendations based on nurses' individual innovativeness characteristics, perceptions of the attributes of smoke evacuation recommendations, and organizational innovativeness characteristics. The study findings provide implications for improving nurses' compliance with smoke evacuation recommendations. Individual innovativeness characteristics, including nurses' knowledge and training, were most strongly linked to smoke evacuation compliance. The key indicators that promote surgical smoke evacuation can provide direction to guide the content of education programs and help identify the personnel and settings that are most in need of this information. Barriers to compliance included lack of equipment, physician resistance, noise, and staff member complacency. Vendor demonstrations on the ease of smoke evacuation device use can show nurses that smoke evacuation is compatible with nursing practice. Facility leaders should provide smoke evacuation policies that are easy to understand and should enforce these policies.
Covell, Christine L; Sidani, Souraya
Due to rising costs of healthcare, determining how registered nurses and knowledge resources influence the quality of patient care is critical. Studies that have investigated the relationship between nursing knowledge and outcomes have been plagued with conceptual and methodological issues. This has resulted in limited empirical evidence of the impact of nursing knowledge on patient or organizational outcomes. The nursing intellectual capital theory was developed to assist with this area of inquiry. Nursing intellectual capital theory conceptualizes the sources of nursing knowledge available within an organization and delineates its relationship to patient and organizational outcomes. In this article, we review the nursing intellectual capital theory and discuss its implications for research and practice. We explain why the theory shows promise for guiding research on quality work environments and how it may assist with administrative decision-making related to nursing human resource management and continuing professional development.
Roberts, Susan; Vanstone, Maurice
There is a dearth of research on sexual abuse perpetrated by educators. Although the problem is receiving increasing attention, little emphasis has been placed on abuse directed at younger schoolchildren and on offenders' accounts of this form of abuse. Here, we attempt to address this gap in knowledge by exploring the narratives of five convicted, imprisoned male child sexual abusers, each of whom worked with children in educational settings in the United Kingdom. We draw on four themes that emerged from detailed interviews with offenders, namely: the power of reputation, authority and control, the "front of invulnerability," and disclosure of abuse. We conclude by considering the implications of our work for policy and practice.
Sexual abuse is a problem of epidemic proportions in the United States. Pediatric nurse practitioners (PNPs) are at the forefront of providing care to children and families. The PNP is in a unique position to educate patients and families regarding sexual abuse and dispel common myths associated with sexual abuse. One such myth is that a normal ano-genital examination is synonymous with the absence of sexual abuse. This article will provide primary care providers, including PNPs, with a framework for understanding why a normal ano-genital examination does not negate the possibility of sexual abuse/assault. Normal ano-genital anatomy, changes that occur with puberty, and physical properties related to the genitalia and anus will be discussed. Photos will provide visualization of both normal variants of the pre-pubertal hymen and genitalia as well as changes that occur with puberty. Implications for practice for PNPs will be discussed.
Oates, R. Kim
This book is intended to provide an overview of current knowledge about child abuse rather than a focus on one particular professional viewpoint or facet of the problem. Introductory and concluding chapters address the definition of child abuse and neglect, why it occurs, and what happens to abused children. Chapters 3, 4, and 5 explore physical…
Recent years have witnessed a growing debate about the role of attachment theory in the treatment of maltreated children. Many professional organizations have issued statements against physically restraining children as some attachment therapists promote; however, often lost in these debates is the fundamental issue of what attachment theory and research proposes as the appropriate form of treatment. Given that these attachment therapies are often directed toward maltreated children, it becomes critical for clinicians working with abused and neglected children to understand these issues and recognize unethical and dangerous treatments. This article provides a summary of the theoretical and empirical bases for the use of attachment theory in the treatment of maltreated school-age children, an examination of the ways questionable approaches to treatment have misinterpreted and misapplied attachment theory, and a conceptualization of attachment-based intervention grounded in current theory and research.
Horton, E. Gail; Diaz, Naelys; Peluso, Paul R.; Mullaney, Donald; Weiner, Michael; McIlveen, John W.
This study explored the relationships between trauma, posttraumatic stress disorder symptoms, dissociation, and lifetime heroin use among inpatient clients who abused substances. Results indicate important implications for practice and directions for future research. (Contains 1 figure and 1 table.)
Koehn, Corinne; Cutcliffe, John R.
This study used a grounded theory method to explore how counselors inspire hope in clients struggling with substance abuse. Findings from 10 participants revealed that hope inspiration occurred in 3 phases and consisted of several categories of hope-inspiring processes. Implications for counseling practice, counselor education, and research are…
Heinrich, Carolyn J.; Fournier, Elizabeth
Changes in funding, clientele, and treatment practices of public and privately owned substance abuse treatment programs, compelled in part by increased cost containment pressures, have prompted researchers' investigations of the implications of organizational form for treatment programs. These studies primarily probe associations between ownership…
Slade, Mike; Amering, Michaela; Farkas, Marianne; Hamilton, Bridget; O'Hagan, Mary; Panther, Graham; Perkins, Rachel; Shepherd, Geoff; Tse, Samson; Whitley, Rob
An understanding of recovery as a personal and subjective experience has emerged within mental health systems. This meaning of recovery now underpins mental health policy in many countries. Developing a focus on this type of recovery will involve transformation within mental health systems. Human systems do not easily transform. In this paper, we identify seven mis-uses ("abuses") of the concept of recovery: recovery is the latest model; recovery does not apply to "my" patients; services can make people recover through effective treatment; compulsory detention and treatment aid recovery; a recovery orientation means closing services; recovery is about making people independent and normal; and contributing to society happens only after the person is recovered. We then identify ten empirically-validated interventions which support recovery, by targeting key recovery processes of connectedness, hope, identity, meaning and empowerment (the CHIME framework). The ten interventions are peer support workers, advance directives, wellness recovery action planning, illness management and recovery, REFOCUS, strengths model, recovery colleges or recovery education programs, individual placement and support, supported housing, and mental health trialogues. Finally, three scientific challenges are identified: broadening cultural understandings of recovery, implementing organizational transformation, and promoting citizenship.
Calsyn, Donald A; Hatch-Maillette, Mary A; Meade, Christina S; Tross, Susan; Campbell, Aimee N C; Beadnell, Blair
Heterosexual anal intercourse (HAI) is an understudied risk behavior among women and men in substance abuse treatment. Rates of HAI for women (n = 441) and men (n = 539) were identified for any, main and casual partners. More men (32.8 %) than women (27.1 %) reported engaging in HAI in the previous 90 days. These rates are higher than those reported for both men (6.0-15.9 %) and women (3.5-13.0 %) ages 25-59 in the National Survey of Sexual Health and Behavior. Men were significantly more likely to report HAI with their casual partners (34.1 %) than women (16.7 %). In a logistic regression model generated to identify associations between HAI and variables previously shown to be related to high risk sexual behavior, being younger, bisexual, and White were significantly associated with HAI. For men, having more sex partners was also a significant correlate. HAI is a logical target for increased focus in HIV prevention interventions.
The article discusses the key findings in recent research dealing narrative abilities in children with and without language implications. The implications of research findings for narrative assessment and intervention are discussed.
This brochure outlines the substance abuse policy for students at the Philadelphia College of Osteopathic Medicine (PCOM/Pennsylvania). Noted are the dangers of substance abuse during the stressful time of medical training and later for the doctor and clients during professional practice. The policy's five goals are briefly stated. Described next…
Kim, Kihyun; Trickett, Penelope K; Putnam, Frank W
The present study sought to document an example of how childhood sexual abuse and attachment representation interact while contributing to the trait anxiety of nonoffending mothers following the disclosure of their daughters' sexual abuse. The study sample consisted of 57 ethnically diverse mothers of sexually abused girls aged 6 to 16 and 47 mothers of comparison girls who were matched with the abused girls on age, socioeconomic status, and family constellation. Results indicate that the mothers' representations of past attachment relationships with their own fathers were differentially related to their current attachment styles, depending on their daughters' childhood sexual abuse status. The representation of past attachment relationships with peers had both main and protective effects on the mothers' trait anxiety symptoms. The relevance of attachment perspectives to adjustment among these mothers and intergenerational process in childhood sexual abuse are discussed, and implications for future research and clinical practices are identified.
Crespi, Tony D.; Rueckert, Quentin H.
Clinicians involved in family therapy are increasingly concerned with the impact of parental alcoholism on individual development and family functioning. With more than 20 million adults raised within an alcoholic family, and with widespread problems associated with parental alcoholism, clinicians providing family treatment have a potentially…
Reeves, Elizabeth A; Woods-Giscombé, Cheryl L
Despite extensive evidence supporting the health benefits of breastfeeding, significant disparities exist between rates of breastfeeding among African American women and women of other races. Increasing rates of breastfeeding among African American women can contribute to the improved health of the African American population by decreasing rates of infant mortality and disease and by enhancing cognitive development. Additionally, higher rates of breastfeeding among African American women could foster maternal-child bonding and could contribute to stronger families, healthier relationships, and emotionally healthier adults. The purpose of this article is twofold: (a) to use the social-ecological model to explore the personal, socioeconomic, psychosocial, and cultural factors that affect the infant feeding decision-making processes of African American women and (b) to discuss the implications of these findings for clinical practice and research to eliminate current disparities in rates of breastfeeding.
Grayson, Joann, Ed.; Bartlette, Don
Literature indicating high rates of abuse in this population is reviewed, as is literature indicating high rates of developmental disabilities in child victims of abuse. Problems in data collecting practices are noted. Reasons for these children's greater risk for abuse are identified, including child attributes, stress, parent vulnerabilities,…
California State Office of the Attorney General, Sacramento. Crime Prevention Center.
Intended to heighten public awareness and provide practical information to professionals, this handbook defines and describes child abuse (including sexual abuse) and its associated signs and injuries. The societal and family environments in which child abuse most typically occurs are described, and the California penal code sections pertaining to…
Hyman, S. E.
Many of the comfortable and relatively simple models of the nature of mental disorders, their causes and their neural substrates now appear quite frayed. Gone is the idea that symptom clusters, course of illness, family history and treatment response would coalesce in a simple way to yield valid diagnoses. Also too simple was the concept, born of early pharmacological successes, that abnormal levels of one or more neurotransmitters would satisfactorily explain the pathogenesis of depression or schizophrenia. Gone is the notion that there is a single gene that causes any mental disorder or determines any behavioural variant. The concept of the causative gene has been replaced by that of genetic complexity, in which multiple genes act in concert with non-genetic factors to produce a risk of mental disorder. Discoveries in genetics and neuroscience can be expected to lead to better models that provide improved representation of the complexity of the brain and behaviour and the development of both. There are likely to be profound implications for clinical practice. The complex genetics of risk should reinvigorate research on the epidemiology and classification of mental disorders and explain the complex patterns of disease transmission within families. Knowledge of the timing of the expression of risk genes during brain development and of their function should not only contribute to an understanding of gene action and the pathophysiology of disease but should also help to direct the search for modifiable environmental risk factors that convert risk into illness. The function of risk genes can only become comprehensible in the context of advances at the molecular, cellular and systems levels in neuroscience and the behavioural sciences. Genetics should yield new therapies aimed not just at symptoms but also at pathogenic processes, thus permitting the targeting of specific therapies to individual patients. PMID:10885164
... mistreatment may be Physical, sexual, or emotional abuse Neglect or abandonment Financial abuse - stealing of money or belongings Possible signs of elder abuse include unexplained bruises, burns, and injuries. There ...
... or puts a child at risk of harm. Child abuse can be physical, sexual or emotional. Neglect, or not providing for a child's needs, is also a form of abuse. Most abused children suffer greater emotional than physical ...
... abuse also plays a role in many major social problems, such as drugged driving, violence, stress, and child abuse. Drug abuse can lead to homelessness, crime, and missed work or problems with keeping a ...
Dunst, Carl J.
The article includes a practical definition of evidence-based practices, examples of different types of practice-based research syntheses, 3 models for conceptualizing evidence-based early childhood intervention, and a description of the implications of the definition, syntheses, and models of early childhood intervention for personnel…
Griffiths, R R; Weerts, E M
Drug reinforcement may represent the primary behavioral-pharmacological mechanism underlying two types of problematic use of benzodiazepines--recreational abuse by polydrug abusers and inappropriate chronic use by patients. High dose polydrug abuse for the purpose of getting high is readily recognized as a significant social problem. Inappropriate chronic benzodiazepine use is more subtle but relatively common: for anxiolytics, 36% of past-year users (3% of the adult population in the US) report using these drugs for 4 consecutive months or longer. The risks of such long-term use are much better documented than the benefits. This paper provides a current review of various problems that have been identified with the long-term use and the recreational abuse of benzodiazepines, including memory impairment, risk of accidents, falls and hip fractures in the elderly, a withdrawal syndrome, brain damage, overuse in the elderly, overuse by chronic pain patients, overuse by alcoholics and recreational abuse among alcoholics and polydrug abusers. A comprehensive review of the literature on benzodiazepine reinforcing effects in humans and laboratory animals is also provided. Drug self-administration studies in humans and laboratory animals provide models of both types of problematic benzodiazepine use. Recreational abuse of benzodiazepines has been modeled in human research with polydrug abusers and in laboratory animal studies, which show that the reinforcing effect of benzodiazepines is intermediate relative to other sedative compounds and is increased in subjects with histories of previous sedative drug self-administration. The problem of inappropriate long-term use of benzodiazepines by people without histories of drug abuse has been partially modeled in human studies showing that benzodiazepines function as reinforcers in subjects with anxiety, insomnia, and histories of moderate alcohol consumption, and in preclinical studies showing stable, low-rate benzodiazepine self
Larios, Sandra E.; Wright, Serena; Jernstrom, Amanda; Lebron, Dorothy; Sorensen, James L.
Substance abuse disproportionately impacts American Indian/Alaska Native (AI/AN) communities in the United States. For the increasing numbers of AI/AN individuals who enter and receive treatment for their alcohol or other drug problem it is imperative that the service they receive be effective. This study used qualitative methodology to examine attitudes toward evidence-based practices, also known as evidence-based treatments (EBTs) in minority-serving substance abuse treatment programs in the San Francisco Bay area. Twenty-two interviews were conducted in the study, of which seven were with program directors and substance abuse counselors at two urban AI/AN focused sites. These clinics were more likely than other minority-focused programs to have experience with research and knowledge about adapting EBTs. Only in the AI/AN specific sites did an issue arise concerning visibility, that is, undercounting AI/AN people in national and state databases. Similar to other minority-focused programs, these clinics described mistrust, fear of exploitation from the research community, and negative attitudes towards EBTs. The underutilization of EBTs in substance abuse programs is prevalent and detrimental to the health of patients who would benefit from their use. Future research should explore how to use this research involvement and experience with adaptation to increase the adoption of EBTs in AI/AN serving clinics. PMID:22400469
Kagoda, Alice Merab; Sentongo, John
Practicing teachers are partners in preparation of teacher trainees. However, little is known about their perceptions of the teacher trainees they receive every year in their schools. Ninety three practicing teachers from twenty schools participated in this study. The objectives were to find out the practicing teachers' perceptions of teacher…
Pearl, Art, Ed.; Pryor, Caroline R., Ed.
This book presents the findings of eleven teacher educators as they examine the meaning of democracy and its application to classroom practice. There is a shared belief among all contributors to this volume: that incorporating democratic practice into teacher education is an essential requirement to introducing democratic practices in K-12…
de Oliveira, Carlos Eduardo Coral; Oda, Julie Massayo Maeda; Ariza, Carolina Batista; Guembarovski, Roberta Losi; Hirata, Bruna Karina Banin; de Almeida, Felipe Campos; André, Nayara Delgado; Fungaro, Maria Helena Pelegrinelli; Watanabe, Maria Angelica Ehara
Objectives: To provide a review of published literature regarding genetic polymorphism of serotonin transporter gene, named as 5-HTTLPR, and its potential role as a susceptibility marker for ethanol abuse in childhood and adolescence. Methods: A literature review of several databases was conducted with the following keywords: 5-HTTLPR, children or adolescents or teenagers, susceptibility, alcohol or ethanol, abuse or misuse. Results: Alcohol interacts with serotonergic synaptic transmission in several ways, and the reduced availability of serotonin transporters might foster brain dysfunction, driving to alcohol abuse. The initial use of ethanol in children and adolescents is determined primarily by environmental influences, whereas the establishment of drinking patterns is strongly controlled by genetic factors. Functional polymorphic variants in the promoter region of the 5-HTTLPR gene have age-dependent effects in alcohol abuse. This polymorphism, mapped to the 5′ region of the SLC6A4, is a variable number of tandem repeats (VNTR) and involves a direct repeat of 20–23 base pairs GC-rich sequences, comprising a short (S) allele, consisting of 14 repeats, and a long (L) allele, with 16 repeats. Additional variants have been described, although their influences on childhood and adolescence ethanol use are not clear. Conclusion: The influence of the 5-HTTLPR allelic variants in children and adolescent misuse of alcohol might be considered for clinical management, preventing long-term behavior problem. Identifying genetic markers associated to the potential alcohol misuse or abuse could be useful in guiding management and formulating effective coping strategies. PMID:27047556
Pedrick-Cornell, Claire; Gelles, Richard J.
Discusses problems of definition of elderly abuse. Examines data and research on the rates of elderly abuse and factors found related to elderly abuse. Critiques theories developed to explain the abuse of the elderly. Presents recommendations for research and practice. (RC)
Ruth-Sahd, Lisa A
Reflective practice has become part of the discourse of nursing education classrooms, conferences, and journals, and are popular features of nursing continuing education programs. Yet, the idea of reflective practice has become increasingly more disparate. This critical analysis examines data-based studies and provides an overview of reflective practice, discusses common themes that emerged from the studies, and identifies implications for reflective practice in the field of nursing education.
Fernández-Montalvo, Javier; López-Goñi, José J; Arteaga, Alfonso
This study explored the prevalence of a history as victims of abuse among patients who sought outpatient treatment for drug addiction. A sample of 252 addicted patients was assessed. Information was collected on the patients' lifetime history of abuse (psychological, physical, and/or sexual abuse), sociodemographic factors, consumption factors, psychopathological factors, and personality variables. Drug-addicted patients who present a lifelong history of abuse were compared with patients who were not abused. Of the total sample, 46% of the patients (n = 115) who were addicted to drugs had been victims of abuse. There was a statistically significant difference between the victimization rates of men (37.8%) and women (79.6%). Moreover, for some variables, significant differences were observed between patients who had been abused and those who had not. Compared with patients who had not been abused, the addicted patients with a history of victimization scored significantly higher on several European Addiction Severity Index, Millon Clinical Multiaxial Inventory-II, and maladjustment variables but not on the Symptom Checklist-90-Revised. The current results indicate that patients who present a lifelong history of abuse exhibit both a more severe addiction than patients who were not abused and several comorbidities. The implications of these results for further research and clinical practice are discussed.
Collins, Frank L; Leffingwell, Thad R; Belar, Cynthia D
A movement advocating the use of evidence-based practice (EBP) is increasingly influencing health care and the practice of psychology. Thus, teaching evidence-based practice in psychology (EBPP) is critical to the preparation of future health service psychologists. In this article, the authors address common myths associated with EBP, propose core components involved in teaching EBPP, and describe an example of how such training can be incorporated into a professional psychology education and training curriculum.
Reynolds, Anna R; Bolin, B Levi; Stoops, William W; Rush, Craig R
The discriminative and subjective effects of drugs in humans are related, but the full extent of this relationship remains to be determined. To further explore this relationship, a retrospective analysis was conducted on data from six studies completed in our laboratory that used identical procedures. The relationship between the discriminative and subjective effects of a range of doses of D-amphetamine (i.e. 2.5-15 mg) was examined using correlational analyses. Significant correlations with discrimination performance were observed on 15 of 20 items from the Drug-Effect Questionnaire across a range of qualities [e.g. Pay For (a positive effect indicative of abuse potential) and Active (a stimulant-like effect)], but the magnitude of these relationships was modest (r<0.52). The current findings demonstrate that diverse subjective effects contribute to the discriminative effects of D-amphetamine and indicate that the former are a more practical means to assess the abuse potential of drugs. Although these procedures are fundamentally related in that they rely on the presence of an interoceptive drug state, they differ in the dimension(s) of the interoceptive effects that participants must quantify. The simultaneous use of drug discrimination and subjective effects may, therefore, reveal complimentary aspects of drug effects that underlie their potential for abuse.
Williams, Timothy P.; Binagwaho, Agnes; Betancourt, Theresa S.
Objective: To illuminate the different manifestations of transactional sexual exploitation and abuse among Rwanda's children in order to inform effective responses by policies, programs, and communities. Method: Qualitative data was collected during April and May 2010. One-hundred and thirty-nine adults (56% female) and 52 children (60% female)…
Kennair, Nicola; Mellor, David
A recent focus of research and clinical practice has been on the issue of abuse of parents by their children (parent abuse). This paper reviews the literature on this phenomenon. While parent abuse falls under the umbrella of family violence, it appears to be qualitatively different from other forms of intra-family abuse. Research has primarily focused on prevalence rates and the characteristics of perpetrators and victims. While various factors such as gender, age, emotional attachment to parents, race/ethnicity, socioeconomic status, family stress and parenting style and structure have been associated with parent abuse, findings are equivocal. Etiological models are general and untested, and treatment approaches lack empirical support. It is concluded that more rigorous and extensive research is required in order to provide a deeper understanding of this complex issue, and to inform treatment approaches.
Katz, Lilian G.
While the development of children's self-esteem is a worthwhile goal in early education, many practices designed to reach this goal may instead be encouraging narcissism. Such practices include those that direct children's attention to their own inner gratifications, or encourage children to believe their specialness is dependent on trivial…
This article explores the implications of young learners' dispositions towards the use of digital technologies in contemporary early childhood settings. It is proposed that young learners have grown up in very different social conditions from previous generations, mainly through the saturation of digital technologies, in particular computers. This…
Withrow, Rebecca L.
Counselors and early interventionists increasingly serve Spanish-speaking families. Yet, often, cultural accommodations merely imply use of interpreters or bilingual providers. Cultural competence requires self-awareness and understanding the client's community and specific risk and resiliency factors. Implications for serving clients of Latino…
Mayer, Richard E.
This paper reviews eight articles on the implications of styles research contained in this special issue of "Learning and Individual Differences". Three of the papers present original research on topics such as the nature of visualizer cognitive style and intuitive cognitive style. Five of the papers offer reviews or analyses of styles research,…
Espin, Oliva M.
Examines the psychological implications of the migratory process on Latin American women in the United States, addressing issues of gender roles, acculturation, language, loss, and grief, that are frequently presented by Latinas in psychotherapy. Interprets these issues as reflective of stresses created by the migratory process, and suggests ways…
In the design of a recirculating aquaculture system five life-supporting issues should be considered which include aeration, degasification, circulation, biofiltration, and clarification. The implications associated with choosing a pumped system versus an airlift system to address these issues was e...
Moring, Camilla; Lloyd, Annemaree
Introduction: This paper considers practice theory and the analytical implications of using this theoretical approach in information literacy research. More precisely the aim of the paper is to discuss the translation of practice theoretical assumptions into strategies that frame the analytical focus and interest when researching workplace…
Zweig, Janine M; Dank, Meredith; Yahner, Jennifer; Lachman, Pamela
To date, little research has documented how teens might misuse technology to harass, control, and abuse their dating partners. This study examined the extent of cyber dating abuse-abuse via technology and new media-in youth relationships and how it relates to other forms of teen dating violence. A total of 5,647 youth from ten schools in three northeastern states participated in the survey, of which 3,745 reported currently being in a dating relationship or having been in one during the prior year (52 % were female; 74 % White). Just over a quarter of youth in a current or recent relationship said that they experienced some form of cyber dating abuse victimization in the prior year, with females reporting more cyber dating abuse victimization than males (particularly sexual cyber dating abuse). One out of ten youth said that they had perpetrated cyber dating abuse, with females reporting greater levels of non-sexual cyber dating abuse perpetration than males; by contrast, male youth were significantly more likely to report perpetrating sexual cyber dating abuse. Victims of sexual cyber dating abuse were seven times more likely to have also experienced sexual coercion (55 vs. 8 %) than were non-victims, and perpetrators of sexual cyber dating abuse were 17 times more likely to have also perpetrated sexual coercion (34 vs. 2 %) than were non-perpetrators. Implications for practice and future research are discussed.
Harris, Barbara A
Environment has long been a primary concern in nursing, beginning with Nightingale's attention to the power of the environment to heal. Policy is a dimension of the practice environment with great potential to influence patients' health. In this column, a practice vignette illustrates some of the barriers to nurses' awareness of policy-as-environment. Characteristics of conceptualizations of environment, arising from nursing science, that have potential to surmount barriers and increase awareness are identified. Creative attention to conceptualizing policy-as-environment is urged as a way to encourage nurses to consider policy activity as a satisfying aspect of practice.
Collier, Scott; Gavriel, Mardell
A nonprofit primary care, substance abuse and mental health treatment provider that operates nine separate residential treatment facilities in both northern and southern California began allowing clients to keep their mobile phones while in treatment. From the advent of mobile phone technology and its widespread adoption through early 2013, the organization prohibited clients from having phones while in treatment. Calls to and from clients needed to be made and received at the house phone. After years of enforcing the policy with diminished success as phones became cheaper, smaller, and more prevalent, agency leadership decided to experiment with allowing the clients to keep their phones while in treatment. Elopement data as they relate to the policy are examined along with data from staff interviews about its implementation and impact. Results show that elopements resulting from being caught with a mobile phone were eliminated and some clients were able to be returned to treatment using the devices. All seven (100%) of the interviewees were supportive of the new policy and thought it should be continued. The impact of the policy on clinical disruptions, lost/stolen property liability, and confidentiality issues are discussed.
Wooten, Kevin C.; Cobb, Anthony T.
Asserts that formal theories of justice and fairness should be integrated into career development theory and practice. Provides a framework using the constructs of distributive, procedural, and interactional justice. (SK)
Davidhizar, R; Newman-Giger, J
After years as a taboo topic, abuse has come "out of the closet" and is being talked about openly in society. Yet, while abuse in the workplace is being confronted, abuse within families still often goes unrecognized by outsiders, including by nurses. Failure of nurses to recognize abuse is unfortunate since frequently they are the first point of contact with the victim of abuse in the emergency room, clinic and home. Understanding and insight into the problem of family violence by nurses is critical in addressing this problem. Knowledge is crucial in planning strategies that will have the long-lasting effect of decreasing the cycle of abuse in families.
Farh, Crystal I C; Chen, Zhijun
We conceptualize a multilevel framework that examines the manifestation of abusive supervision in team settings and its implications for the team and individual members. Drawing on Hackman's (1992) typology of ambient and discretionary team stimuli, our model features team-level abusive supervision (the average level of abuse reported by team members) and individual-level abusive supervision as simultaneous and interacting forces. We further draw on team-relevant theories of social influence to delineate two proximal outcomes of abuse-members' organization-based self-esteem (OBSE) at the individual level and relationship conflict at the team level-that channel the independent and interactive effects of individual- and team-level abuse onto team members' voice, team-role performance, and turnover intentions. Results from a field study and a scenario study provided support for these multilevel pathways. We conclude that abusive supervision in team settings holds toxic consequences for the team and individual, and offer practical implications as well as suggestions for future research on abusive supervision as a multilevel phenomenon. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
As an exemplar of bottom-up progressive social experimentation, HUSK provides opportunities to examine how innovative practice is supported and challenged in bureaucratic settings. In this analysis the author uses a sensemaking lens to identify critical issues and questions for those seeking to promote progressive change initiative in social welfare systems. Findings identify essential organizational and managerial supports needed to support service user voice and participation and reinforce the importance of reflexivity in practice and research.
Eyler, Amy A; Blanck, Heidi M; Gittelsohn, Joel; Karpyn, Allison; McKenzie, Thomas L; Partington, Susan; Slater, Sandy J; Winters, Meghan
There is growing interest in the use of physical activity and nutrition environmental measures by both researchers and practitioners. Built environment assessment methods and tools range from simple to complex and encompass perceived, observed, and geographic data collection. Even though challenges in tool selection and use may exist for non-researchers, there are opportunities to incorporate these measures into practice. The aims of this paper are to (1) describe examples of built environment assessment methods and tools in the practice context; (2) present case studies that outline successful approaches for the use of built environment assessment tools and data among practitioners; and (3) make recommendations for both research and practice. As part of the Built Environment Assessment Training Think Tank meeting in July 2013, experts who work with community partners gathered to provide input on conceptualizing recommendations for collecting and analyzing built environment data in practice and research. The methods were summarized in terms of perceived environment measures, observational measures, and geographic measures for physical activity and food environment assessment. Challenges are outlined and case study examples of successful use of assessments in practice are described. Built environment assessment tools and measures are important outside the research setting. There is a need for improved collaboration between research and practice in forming partnerships for developing tools, collecting and analyzing data, and using the results to work toward positive environmental changes.
Witte, Susan S.; Batsukh, Altantsetseg; Chang, Mingway
SUMMARY This study examines HIV/STI risk behaviors, alcohol abuse, intimate partner violence, and psychological distress among 48 female sex workers in Mongolia to inform the design of a gender-specific, HIV/STI prevention intervention for this population. Quantitative findings demonstrate that over 85% of women reported drinking alcohol at harmful levels; 70% reported using condoms inconsistently with any sexual partner; 83% reported using alcohol before engaging in sex with paying partners, and 38% reported high levels of depression. Focus group findings provide contextual support and narrative descriptions for the ways that poverty, alcohol abuse, interpersonal violence, and cultural norms that stigmatize and marginalize women are intertwined risk factors for STIs, including HIV, among these vulnerable women. PMID:20391057
Johnson, Bruce D.; Golub, Andrew; McCabe, James
The New York City Police Department (NYPD) has made enforcement of laws against disorder and quality-of-life offenses a central part of their policing strategy. Concomitantly, New York City (NYC) experienced a renaissance in orderliness, cleanliness, tourism, real estate value, and crime reduction, although other problems such as poverty, unemployment, drug abuse, racial tensions and homelessness persist. This paper examines quality-of-life policing practices in NYC, describes the philosophical underpinnings, explores the critical response to the program and presents lessons of potential relevance to other policing organizations in the U.S. and around the world. PMID:20368765
Johnson, Bruce D; Golub, Andrew; McCabe, James
The New York City Police Department (NYPD) has made enforcement of laws against disorder and quality-of-life offenses a central part of their policing strategy. Concomitantly, New York City (NYC) experienced a renaissance in orderliness, cleanliness, tourism, real estate value, and crime reduction, although other problems such as poverty, unemployment, drug abuse, racial tensions and homelessness persist. This paper examines quality-of-life policing practices in NYC, describes the philosophical underpinnings, explores the critical response to the program and presents lessons of potential relevance to other policing organizations in the U.S. and around the world.
... seniors who are not abused. What are the indicators? Indicators are signs or clues that abuse has ... clusters of indicators that suggest a problem. Physical indicators Sprains, dislocations, fractures, or broken bones Burns from ...
... Who may be abusing inhalants?The most common abusers of inhalants are teenagers, especially those who are ... to your child about the dangers of trying drugs can help him or her make the right ...
... 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 ...
-based treatments to other salient issues such as building the necessary research evidence (including incorporating American Indian and Alaska Native cultural values into clinical practice) and developing the human and infrastructural resources to support the use of this evidence may be far more effective for advancing efforts to improve substance abuse services for American Indian and Alaska Native communities. PMID:21679438
Wing, R R
Look AHEAD (Action for Health in Diabetes) was a randomized clinical trial designed to examine the long-term health effects of weight loss in overweight and obese individuals with type 2 diabetes. The primary result was that the incidence of cardiovascular events over a median follow-up of 9.6 years was not reduced in the Intensive Lifestyle Group relative to the control group. This finding is discussed, with emphasis on its implications for design of trials and clinical treatment of obese persons with type 2 diabetes.
Wing, Rena R.
Look AHEAD was a randomized clinical trial designed to examine the long-term health effects of weight loss in overweight and obese individuals with type 2 diabetes. The primary result was that the incidence of cardiovascular events over a median follow up of 9.6 years was not reduced in the intensive lifestyle group relative to the control group. This finding is discussed, with emphasis on its implications for design of clinical trials and clinical treatment of obese people with type 2 diabetes. PMID:24853636
Branch, William T., Jr.; And Others
The problems encountered, diagnostic procedures performed, and treatments prescribed in dermatology were studied in a primary care practice and in a dermatology clinic. It is proposed that the findings of this study be the basis for designing a curriculum in dermatology for residents in primary care medicine. (Author/MLW)
Peer, Kimberly S; McClendon, Ronald C
OBJECTIVE: To discuss cognitive and sociocultural learning theory literature related to athletic training instructional and evaluation strategies while providing support for the application of these practices in the didactic and clinical components of athletic training education programs. DATA SOURCES: We searched Educational Resources Information Center (ERIC) and Education Abstracts from 1975-2001 using the key words social cognitive, sociocultural learning theory, constructivism, and athletic training education. Current literature in the fields of educational psychology and athletic training education provides the foundation for applying theory to practice with specific emphasis on the theoretic framework and application of sociocultural learning theory strategies in athletic training education. DATA SYNTHESIS: Athletic training educators must have a strong fundamental knowledge of learning theory and a commitment to incorporate theory into educational practice. We integrate literature from both fields to generate practical strategies for using sociocultural learning theory in athletic training education. CONCLUSIONS/RECOMMENDATIONS: Social cognitive and sociocultural learning theory advocates a constructive, self-regulated, and goal-oriented environment with the student at the center of the educational process. Although a shift exists in athletic training education toward more active instructional strategies with the implementation of competency-based education, many educational environments are still dominated by traditional didactic instructional methods promoting student passivity. As athletic training education programs strive to increase accountability, educators in the field must critically analyze teaching and evaluation methods and integrate new material to ensure that learning is maximized.
Openshaw, Kristi P.; Schultz, Jared C.; Millington, Michael J.
Rehabilitation counselor education is experiencing an explosion of knowledge, which is becoming increasingly difficult to organize and disseminate to students. Communities of practice, a form of social learning, provide a way to organize and disseminate information. Distance-based education programs are increasing within the field of…
This qualitative ethnographic study examines five American teenagers' historical and current digitally-mediated multiliteracy practices within digital popular culture. The participants included three male and two female students of a private high school in the Midwestern United States. The study is framed by the notion that literacy is a socially,…
Mikawa, James K.; And Others
Among 190 Hispanic Americans in Nevada, condom use as an AIDS prevention measure appeared to be a male prerogative associated with "being the one who buys the condoms" (mostly males) and machismo practices such as protection of women. Adherence to Hispanic cultural traits was related to education and acculturation. (SV)
Vail, Teresa M.
The purpose of this study was to inquire into the ways in which participation in physical science professional development impacts science teachers' professional learning and ultimately their practice over time. This study strove to provide a greater understanding of teachers' processes as they engage in professional learning and make changes in…
Hillman's (2001) simple affirmation that "an idea of beauty is useful, functional, practical" is one this article attempts to pursue with teacher researchers in mind, based on the belief that to move from the "re"pression of beauty to its "ex"pression--or, at the very least, to its articulation--will enlighten rather than distract individuals. The…
Purpose: This paper reflects upon the practice of Argentine rural extensionists working in the extension public system through the process of identifying different rural extensionists' types of mindsets and comparing them with transfer of technology extension approach, dialogical processes of horizontal knowledge exchange, participatory…
The school leader's behaviors are inspired by theories, and theories are intrinsic to practice. This paper provides an overview of an emerging perspective in educational administration, critical theory. The paper first highlights the philosophies of Immanuel Kant, Fichte, Hegel, Marx, and the Frankfurt School. It then discusses critical theory…
Diemer, Matthew A.; Ali, Saba Rasheed
Although social class plays a salient and significant role in career development and occupational attainment, social class is underrepresented in vocational psychology theory, scholarship, and practice. Vocational psychologists are in a unique position to meet the career development needs of persons from all social classes by integrating a fuller…
Lane, Kenneth E.; And Others
Addresses the practical requirements in providing barrier-free access to schools. Special attention is given to the requirements of the Americans with Disabilities Act. Outlines requirements for the following areas: (1) parking, passenger loading, and building access; (2) corridors, elevators, and stairs; (3) classrooms; (4) restrooms; (5)…
Foreman, Susan; Seligman, Linda
Discusses legal and developmental aspects of adolescent abuse, as distinguished from child abuse. The role of the school counselor in identifying and counseling abused adolescents and their families is discussed and several forms of intervention and support services are described. (JAC)
Evans, Elizabeth; Anglin, M. Douglas; Urada, Darren; Yang, Joy
Operative for nearly a decade, California's voter-initiated Proposition 36 program offers many offenders community-based substance abuse treatment in lieu of likely incarceration. Research has documented program successes and plans for replication have proliferated, yet very little is known about how the Proposition 36 program works or practices for achieving optimal program outcomes. In this article, we identify policies and practices that key stakeholders perceive to be most responsible for the successful delivery of court-supervised substance abuse treatment to offenders under Proposition 36. Data was collected via focus groups conducted with 59 county stakeholders in six high-performing counties during 2009. Discussion was informed by seven empirical indicators of program performance and outcomes and was focused on identifying and describing elements contributing to success. Program success was primarily attributed to four strategies, those that: (1) fostered program engagement, monitored participant progress, and sustained cooperation among participants; (2) cultivated buy-in among key stakeholders; (3) capitalized on the role of the court and the judge; and (4) created a setting which promoted a high-quality treatment system, utilization of existing resources, and broad financial and political support for the program. Goals and practices for implementing each strategy are discussed. Findings provide a “promising practices” resource for Proposition 36 program evaluation and improvement and inform the design and study of other similar types of collaborative justice treatment efforts. PMID:20965568
Bowman, Katherine Gail; Ryberg, Jacalyn Wickline; Becker, Heather
The purpose of this study is to compare Mexican American adolescent mothers with and without childhood sexual abuse (CSA) histories to examine the influence of CSA on dissociation, selection of infant feeding method, and intimate parenting anxiety. Participants are 78 English-speaking adolescents between 15 and 19 years of age and recruited from…
Hansen, Karen Kirhofer; Prince, Jeffrey S.; Nixon, G. William
Objective: To evaluate the utility of oblique chest views in the diagnosis of rib fractures when used as a routine part of the skeletal survey performed for possible physical abuse. Methods: Oblique chest views have been part of the routine skeletal survey protocol at Primary Children's Medical Center since October 2002. Dictated radiology reports…
Simple Summary There is increasing acceptance of the links between animal abuse and aggressive or antisocial behaviours toward humans. Nevertheless, researchers and other professionals continue to call for methodologically sound empirical research amongst claims that current animal abuse research is methodologically limited. Below, I argue that current conceptualizations of antisocial and aggressive human behavior logically incorporate animal abuse. Given that the body of empirical evidence available to support of theories of antisocial and aggressive behaviour is large and sound, conceptualization of animal abuse as an aggressive behaviour rather than a behaviour that is somehow different, enables us to confidently promote putting current understanding into practice. Abstract This paper reviews current findings in the human aggression and antisocial behaviour literature and those in the animal abuse literature with the aim of highlighting the overlap in conceptualisation. The major aim of this review is to highlight that the co-occurrence between animal abuse behaviours and aggression and violence toward humans can be logically understood through examination of the research evidence for antisocial and aggressive behaviour. From examination through this framework, it is not at all surprising that the two co-occur. Indeed, it would be surprising if they did not. Animal abuse is one expression of antisocial behaviour. What is also known from the extensive antisocial behaviour literature is that antisocial behaviours co-occur such that the presence of one form of antisocial behaviour is highly predictive of the presence of other antisocial behaviours. From such a framework, it becomes evident that animal abuse should be considered an important indicator of antisocial behaviour and violence as are other aggressive and antisocial behaviours. The implications of such a stance are that law enforcement, health and other professionals should not minimize the presence of
Dupont, Robert I.; And Others
A decade of professional research on drug abuse has produced both an abundance of materials and a vocabulary that is not shared by planners, clinicians, and policy makers. This handbook compiles the major developments of the period and their treatment and research implications in a style intended to be understood by all three types of…
Corporate practices, such as advertising, public relations, lobbying, litigation, and sponsoring scientific research, have a significant impact on the health of the people in the United States. Recently, health professionals and advocates have created a new scope of practice that aims to modify corporate practices that harm health. This article…
Newton, Paul; Riveros, Augusto
In this article, we argue for a study of educational administration centered on an "ontology of practices." This is an initial proposal for thinking about and conceptualizing practices in educational administration. To do this, first, we explore how practices are constituted and how they configure the social realities of practitioners.…
Weinfurt, Kevin P.; Bollinger, Juli M.; Brelsford, Kathleen M.; Crayton, Travis J.; Topazian, Rachel J.; Kass, Nancy E.; Beskow, Laura M.; Sugarman, Jeremy
Background Comparative effectiveness research (CER) and pragmatic clinical trials commonly test interventions that are in routine use and pose minimal incremental risk or burdens to patients who participate in this research. The objective of this study was to elicit the range of patients’ views and opinions regarding a variety of different types of research on usual medical practices, especially notification and authorization for them. Methods We conducted twelve focus groups with adults in five U.S. cities—six focus groups addressing CER (“CER groups”) and six groups addressing research involving hospital operations and clinician interventions (“Operations groups”). Participants discussed hypothetical research studies and potential methods of notifying patients and obtaining their authorization to participate. Group discussions were recorded, transcribed, and coded to identify patients’ views related to research on standard medical practice. Results A total of ninety six people participated. Twelve key themes emerged from participants’ discussions of the hypothetical research studies; these themes were then grouped into four general categories: clinical care; notification and authorization; communication; and conduct and design of research. The desire to be actively notified and asked was more prominent with regard to CER studies than with regard to Operations studies. Conclusions Our data suggest that effective policy and guidance will involve balancing different patients’ interests and potentially different sets of interests for different types of research studies on usual medical practices. PMID:27800531
Klainberg, Marilyn B; McCrink, Andrea; Eckardt, Patricia; Schecter, Rose; Bongiorno, Anne; Sedhom, Laila
From Harvard to high school, concern related to academic misconduct, specifically cheating and its impact on societal issues, has become a great concern for educational communities. While a significant number of studies on ethical behaviors in practice in other professions such as business have been published, little research exists on registered nurses in practice. Even fewer studies have, for registered nurses, addressed if there is an association between perceived academic misconduct as students and perceived unethical behaviors in the workplace. The purpose of this study was to determine the relationship between perceptions of registered professional nurses' (RNs) current workplace behaviors and the RNs' retrospective perceptions of their academic misconduct as students. A convenience sample of 1 66 RNs enrolled in master's degree programs at four university schools of nursing completed questionnaires regarding their beliefs and behaviors. The outcome of this study was significant. Results revealed a strong relationship between unethical behaviors of the RN in practice and their prior academic misconduct when they were students.
Since the beginning of the year the Law on Patient Rights ("Patientenrechtegesetz")has been in force and has to be obeyed in anesthesiological practice.It has especially specific consequences for the patient information about all possible risks. The present article takes a look at specific problems, such as the content of the information about the risks, the delegation of the conversation with the patient, the information about the risks in the case of an inability to consent or in the case of foreign-speaking patients and -last but not least - the documentation.
Heinzelmann, Nora; Ugazio, Giuseppe; Tobler, Philippe N.
This paper considers the practical question of why people do not behave in the way they ought to behave. This question is a practical one, reaching both into the normative and descriptive domains of morality. That is, it concerns moral norms as well as empirical facts. We argue that two main problems usually keep us form acting and judging in a morally decent way: firstly, we make mistakes in moral reasoning. Secondly, even when we know how to act and judge, we still fail to meet the requirements due to personal weaknesses. This discussion naturally leads us to another question: can we narrow the gap between what people are morally required to do and what they actually do? We discuss findings from neuroscience, economics, and psychology, considering how we might bring our moral behavior better in line with moral theory. Potentially fruitful means include nudging, training, pharmacological enhancement, and brain stimulation. We conclude by raising the question of whether such methods could and should be implemented. PMID:22783157
Ham, R K
This paper is a summary of observations and trends regarding landfill practice based on a fifteen state, four-and-a-half month tour of facilities and professionals involved in municipal solid waste management, supplemented by 25 years of experience in the field. Modern landfills tend to be well designed and operated, with an emphasis on containment of waste and products of decomposition through liner systems and cover design, plus good operating practice. Forces leading to our concept of modern landfills are based on a history of inadequate landfills and their impacts, and on long-term liability issues, but also stem from a lack of responsibility by the public and their representatives for handling their own waste. While modern landfills incorporate many improvements over previous facilities, the driving forces shaping landfill design now and in the future are unfortunately not based on sound technical and managerial principals and could lead to future problems. The trend to drier landfills, thereby prolonging decomposition, is of special concern in this regard.
Picó, Yolanda; Andres-Costa, M. Jesus; Andreu, Vicente
Drugs of abuse are continuously discharged into wastewaters due to human excretion as parent compounds and/or secondary metabolites after consumption or accidental disposal into the toilets. (Boles and Wells,2010). Incomplete removal of these compounds during wastewater treatment results in their release to the environment. Pollution by illicit drug residues at very low concentrations is generalized in populated areas, with potential risks for human health and the environment. The impact of treated wastewater effluent on the quality of receiving waters can be evaluated performing an investigated performing an ecotoxicological risk assessment calculating the risk quotient (RQ) of the drugs of abuse level observed. In addition, back-calculation from the concentration of illicit drug in the influents of wastewater treatment plants (WWTPs) provides an important tool for estimating its local consumption (Daughton 2001). Sampling campaigns were in three years, 2011 (March 9th to 15th), 2012 (April 17th to May 1st) and 2013 (March 6th to 12th) in influents and effluents from 3 Wastewater Treatment Plants (WWTPs), Pinedo I, Pinedo II and Quart-Benàger, that treats most of the wastewater of Valencia City and its surrounding towns. Cocaine (COC), amphetamine (AMP), methamphetamine (MAMP), ecstasy (MDMA) and ketamine (KET), Benzoylecgonine (BE), 6-acethylmorphine (6-MAM), and 11-nor-9-carboxy-delta9-tetrahydrocannabinol (THC-COOH) were analyzed using mass spectrometry techniques such as liquid chromatography triple quadrupole mass spectrometry (LC-QqQ-MS/MS) Illicit drugs were extracted using solid phase extraction (SPE) and determined by liquid chromatography tandem mass spectrometry (LC-MS/MS) in positive ionization with an electrospray ionization source (ESI). The determination of drugs of abuse in the influent of the selected WWTP shows that all compounds were detected in 100% of influents from Pinedo I, Pinedo II and Quart-Benàger in samples analyzed during three years
Fairbank, 1991; Brady, Killeen, Saladin , Dansky, & Becker, 1994; Brown, Recupero, & Stout, 1995; Brown, Stout, & Mueller, 1999; Ruzek, Polusny, & Abueg...in addressing a client’s willingness to change ( Saladin , Brady, Dansky, & Kilpatrick, 1995). One study conducted by Brown, Stout, and Gannon-Rowley...4, 549-560. Brady, K., Killeen, T., Saladin , M., Dansky, B., & Becker, S. (1994). Comorbid substance abuse and posttraumatic stress disorder
Medical abortion using methotrexate and misoprostol and manual vacuum aspiration are two new methods for pregnancy termination during the first 8 weeks of gestation. Compared to the regimen of mifepristone (RU 486) and misoprostol, both methods offer high rates of complete abortion and acceptability to users. Limitations of the new two-drug regimen compared with mifepristone include a longer time to effect abortion, transient gastrointestinal side effects, and risk of potential teratogenicity from methotrexate's cytotoxicity. Compared to standard surgical abortion, both methods allow women to avoid surgery, are more privately performed, and may be more easily accessible. The safety of first-trimester abortion provided by nurse practitioners and physician assistants has been established. Whether midwives and either new method to their practices depends on several factors. These include obtaining appropriate training, overcoming legal restrictions, and meeting professional and personal challenges inherent in providing early abortion care.
Balbis, S; Roatta, S; Guiot, C
In clinical practice, blood velocity estimations from Doppler examination of curved vascular segments are normally different from those of nearby straight segments. The observed "accelerations," sometimes considered as a sort of stochastic disturbances, can actually be related to very specific physical effects due to vessel curvature (i.e., the development of nonaxial velocity [NAV] components) and the spreading of the axial velocity direction in the Doppler sample volume with respect to the insonation axis. The relevant phenomena and their dependence on the radius of curvature of the vessels and on the insonation angle are investigated with a beam-vessel geometry as close as possible to clinical setting, with the simplifying assumptions of steady flow, mild vessel curvature, uniform ultrasonic beam and complete vessel insonation. The insonation angles that minimize the errors are provided on the basis of the study results.
O'Connell, Karyn E; Mikkola, Amy M; Stepanek, Aaron M; Vernet, Andyna; Hall, Christopher D; Sun, Chia C; Yildirim, Eda; Staropoli, John F; Lee, Jeannie T; Brown, Diane E
Hematologic parameters are important markers of disease in human and veterinary medicine. Biomedical research has benefited from mouse models that recapitulate such disease, thus expanding knowledge of pathogenetic mechanisms and investigative therapies that translate across species. Mice in health have many notable hematologic differences from humans and other veterinary species, including smaller erythrocytes, higher percentage of circulating reticulocytes or polychromasia, lower peripheral blood neutrophil and higher peripheral blood and bone marrow lymphocyte percentages, variable leukocyte morphologies, physiologic splenic hematopoiesis and iron storage, and more numerous and shorter-lived erythrocytes and platelets. For accurate and complete hematologic analyses of disease and response to investigative therapeutic interventions, these differences and the unique features of murine hematopathology must be understood. Here we review murine hematology and hematopathology for practical application to translational investigation. PMID:25926395
Thackeray, Rosemary; Neiger, Brad L
The landscape of sending and receiving information has changed dramatically in the past 25 years. The communication process is changing from being unidirectional to multidirectional as consumers are becoming active participants by creating, seeking, and sharing information using a variety of channels and devices. The purpose of this article is to describe how this shift in the communication process- where gatekeepers control the creation and content of information and consumers are less active recipients to one that reflects a multidirectional and more dynamic process with participative consumers-will affect the social marketing process. This shift in communication does not represent an option for social marketers so much as a necessity. As professionals respond to this evolving communication model, the practice of social marketing can remain vibrant as a relevant consumer-oriented approach to behavior change.
Duschl, Richard A.; Gitomer, Drew H.
Frameworks that seek to understand how knowledge restructuring occurs and how to build a learning environment that facilitates this restructuring raise important philosophical, psychological and pedagogical questions and issues about how conceptual change occurs and what characteristics of knowledge growth ought to be a part of curricula and learning environments. Implicit in emphasizing the how is a shift in science educations' perspective from one that embraces scientists' ways of knowing as the dominant objective towards one that favors positioning the learner for the next step. This change in perspective and approach represents a radical and complex departure from common practice. This article advances a piecemeal model of the character and mechanism of restructuring and then describes a model of educational practice designed to facilitate this form of restructuring. We argue that a piecemeal developmental perspective of conceptual change would offer quite different criteria for deciding what to teach and how to teach. The adoption of conceptual change teaching models implies teacher empowerment of a kind we have yet to fully understand. Empowering teachers with appropriate philosophical and psychological models for the selection and the sequencing of instructional tasks would aid in their describing and prescribing effective or meaningful learning strategies. Central to this educational model is a broadened and integrated view of assessment and instruction that we are calling a portfolio culture. The essential characteristic of this culture is that it creates opportunities for teachers and students to confront and develop their scientific understanding and to equip students with the tools necessary to take increased responsibility for their own restructuring, to assess for themselves what might be the next steps.
Ritterbusch, Amy E
This paper presents the participatory visual research design and findings from a qualitative assessment of the social impact of bazuco and inhalant/glue consumption among street youth in Bogotá, Colombia. The paper presents the visual methodologies our participatory action research (PAR) team employed in order to identify and overcome the stigmas and discrimination that street youth experience in society and within state-sponsored drug rehabilitation programmes. I call for critical reflection regarding the broad application of the terms 'participation' and 'participatory' in visual research and urge scholars and public health practitioners to consider the transformative potential of PAR for both the research and practice of global public health in general and rehabilitation programmes for street-based substance abuse in Colombia in particular. The paper concludes with recommendations as to how participatory visual methods can be used to promote social inclusion practices and to work against stigma and discrimination in health-related research and within health institutions.
Penzo, Jeanine A.; Harvey, Pat
Parents who are raising children with mental illness struggle with feelings of grief and loss. Kubler-Ross' (1969) stages of grieving (denial, anger, bargaining, depression, and acceptance) are examined as experienced by parents raising children with chronic mental illness. Practice implications for social workers who are working with children and…
Delfs, Caitlin H.; Frampton, Sarah E.
Recent literature reviews have highlighted the need to better understand the relation between speaker and listener behavior when teaching learners with autism spectrum disorder (ASD). The current paper outlines the practical implications of evaluating the emergence of tact and listener behavior during instruction for the opposite relation, as…
Roessler, Richard T.; Schriner, Kay Fletcher
Results from an employment concerns questionnaire completed by selected groups of people with disabilities (mental retardation, epilepsy, physical disabilities, learning disabilities, and head injuries) are discussed in terms of public policy and rehabilitation practice implications. Recommendations are couched in behavior analysis terms (i.e.,…
Durkee, David; Brant, Stephen; Nevin, Pete; Odell, Annette; Williams, Godfried; Melomey, Divina; Roberts, Hedley; Imafidon, Chris; Perryman, Roy; Lopes, Anna
This paper examines the practical implications for teachers wishing to incorporate e-learning and Web 2.0 technologies into their pedagogy. The authors concentrate on applied didactical scenarios and the impacts of e-learning innovations. The methods applied stem from grounded theory and action research. An analytical framework was derived by…
Horridge, Patricia; Richards, Mary Lynne
The Sproles Consumer Interests and Priorities questionnaire was administered to 3,036 home economists. Awareness of social implications of clothing, correlated positively with fashion awareness and clothing economic practices. Results suggest that persons exhibiting substantial awareness of social importance of clothing also tend to evidence…
NOREEN, DAVID SHELDON
THIS STUDY EXAMINED GROWTH MOTIVATION AS A DEVELOPING CONCEPT AND AS A THEORETICAL CONSTRUCT, AND THE IMPLICATIONS OF THIS THEORY FOR ADULT EDUCATION THEORY AND PRACTICE. SPECIAL ATTENTION WAS GIVEN TO THE THEORETICAL CONSTRUCTS OF ABRAHAM MASLOW, TO THE NATURE OF GROWTH MOTIVATION CONCEPTS IN GENERAL, AND TO FORMS OF SELF UNDERSTANDING AND…
Wozniak, Robert H.
The implications of Soviet psychoeducational research on learning disabilities (LD) and its relevance to American research and practice are discussed. The first section provides an overview of the general perspective of Soviet special education, with particular reference to LD and its relationship to Soviet psychology and philosophy. The second…
Levitt, Steven R.
This study explores cultural factors affecting international team dynamics and the implications for industry practice and higher education. Despite decades of studying and experience with cultural diversity, international work groups continue to be challenged by ethnocentrism and prejudices. Central to the context is that cultural differences in…
Rodriguez, Rachel; And Others
This newsletter supplement is devoted to the theme of domestic violence affecting migrant women. It contains four articles describing programs providing violence prevention education to migrant women and children. "Family Violence and Migrant Women: Implications for Practice" (Rachel Rodriguez) discusses the social isolation of migrant women;…
Nguyen, Tuyen D
Immigrant Asian youth's five cultural-identity stages and their challenges are examined. Theological significance in working with immigrant Asian youth is also the focus of this article. The essay concludes with implications for pastoral counseling practice, with respect to culturally sensitive effective therapeutic treatment of immigrant Asian youth and their families.
Strohman, Gregory J.
This dissertation attempts to motivate, derive and imply potential uses for a generalized perceptual theory of musical harmony called psychoacoustic entropy theory. This theory treats the human auditory system as a physical system which takes acoustic measurements. As a result, the human auditory system is subject to all the appropriate uncertainties and limitations of other physical measurement systems. This is the theoretic basis for defining psychoacoustic entropy. Psychoacoustic entropy is a numerical quantity which indexes the degree to which the human auditory system perceives instantaneous disorder within a sound pressure wave. Chapter one explains the importance of harmonic analysis as a tool for performance practice. It also outlines the critical limitations for many of the most influential historical approaches to modeling harmonic stability, particularly when compared to available scientific research in psychoacoustics. Rather than analyze a musical excerpt, psychoacoustic entropy is calculated directly from sound pressure waves themselves. This frames psychoacoustic entropy theory in the most general possible terms as a theory of musical harmony, enabling it to be invoked for any perceivable sound. Chapter two provides and examines many widely accepted mathematical models of the acoustics and psychoacoustics of these sound pressure waves. Chapter three introduces entropy as a precise way of measuring perceived uncertainty in sound pressure waves. Entropy is used, in combination with the acoustic and psychoacoustic models introduced in chapter two, to motivate the mathematical formulation of psychoacoustic entropy theory. Chapter four shows how to use psychoacoustic entropy theory to analyze the certain types of musical harmonies, while chapter five applies the analytical tools developed in chapter four to two short musical excerpts to influence their interpretation. Almost every form of harmonic analysis invokes some degree of mathematical reasoning
Bukowski, John; Nicolich, Mark; Lewis, R. Jeffrey
Traditional risk-assessment theory assumes the existence of a threshold for non-cancer health effects. However, a recent trend in environmental regulation rejects this assumption in favor of non-threshold linearity for these endpoints. This trend is driven largely by two related concepts: (1) a theoretical assumption of wide-ranging human sensitivity, and (2) inability to detect thresholds in epidemiologic models. Wide-ranging sensitivity assumes a subpopulation with extreme background vulnerability, so that even trivial environmental exposures are hazardous to someone somewhere. We use examples from the real world of clinical medicine to show that this theoretical assumption is inconsistent with the biology of mammalian systems and the realities of patient care. Using examples from particulate-matter air-pollution research, we further show that failure to reject linearity is usually driven by statistical rather than biological considerations, and that nonlinear/threshold models often have a similar or better fit than their linear counterparts. This evidence suggests the existence of practical, real-world thresholds for most chemical exposures. PMID:23930098
Ferreira, Arthur Sá; Lopes, Agnaldo José
Chinese medicine practitioners apply the differentiation reasoning for decision-making. The wide scope of Chinese medicine intervention provides coverage of methods and techniques with applications to primary, secondary and tertiary levels of prevention. The rapid evolution of mathematical and computational techniques allowed the implementation of several models for pattern differentiation that were tested for several physiologic systems. Concurrently, it is argued that pattern differentiation might improve the efficacy of either traditional or conventional medical interventions. This article reviewed the influence of pattern differentiation into clinical practice organized by medical field: general pattern differentiation; genitourinary (recurrent cystitis); cardiovascular (coronary heart disease; arterial hypertension; angina pectoris); neurology (stroke); surgery; metabolic (diabetes mellitus); hepatic (cirrhosis); gastrointestinal (chronic superficial gastritis); orthopedic (low back pain; rheumatoid arthritis; cervical spondylosis; elbow arthritis); oncology (gastric mucosal dysplasia; lung cancer); gynecologic and obstetric manifestations (nausea and vomiting). The reviewed studies presented achievements that have contributed to the integration of Chinese medicine and evidence-based medicine in the treatment of many mild and severe diseases. Target diseases considered as major public health problems were also investigated and the results are promising regarding the possibility to treat guided by pattern differentiation.
Chambers, R; Longhurst, R; Bradley, D; Feachem, R
This paper reports on a conference on seasonal dimensions to rural poverty. Presentations included specialised papers on climate, energy balance, vital events, individual tropical diseases, nutrition, rural economy, and women, and also multi-disciplinary case studies of tropical rural areas from the Gambia, Nigeria, Mali, Kenya, Tanzania, India and Bangladesh. While care is needed in generalising, the evidence suggested that for agriculturalists in the tropics, the worst times of year are the wet seasons, typically marked by a concurrence of food shortages, high demands for agricultural work, high exposure to infection especially diarrhoeas, malaria, and skin diseases, loss of body weight, low birth weights, high neonatal mortality, poor child care, malnutrition, sickness and indebtedness. In this season, poor and weak people, especially women, are vulnerable to deprivation and to becoming poorer and weaker. Seasonal analysis is easily left out in rural planning. When applied, it suggests priorities in research, and indicates practical policy measures for health, for the family, for agriculture, and for government planning and administration.
Brown, Britta; Roehl, Kelly; Betz, Melanie
Many new enteral nutrition (EN) formulas have been created over the past several decades with a variety of intended uses. Although each is intended to promote improved outcomes, research is often unclear and, in many cases, conflicting. It is important to note that EN products are considered medical foods by the U.S. Food and Drug Administration and therefore do not have to complete premarket review or approval and are not regulated to the same extent as pharmaceuticals. While standard EN formulas are designed to meet the basic macro- and micronutrient requirements of individuals who cannot meet nutrition needs orally, specialty EN products have been developed to exhibit pharmacologic properties, such as immune-enhancing formulas containing arginine, glutamine, nucleotides, and ω-3 fatty acids. With the vast number of products available, rising costs of healthcare, and the drive toward evidence-based practice, it is imperative that clinicians carefully consider research regarding use of specialty formulas, paying close attention to the quality, patient population, clinical end points, and cost to patient and/or facility.
Georgiades, Savvas Daniel
This exploratory research examined adjustment challenges, resiliencies, attitudes, emotional health, economic stability, criminal involvement, victimization and service experiences, and some cultural propensities of Greek Immigrants (GIs) in Australia using a convenient multi-generational sample (n = 123; response rate = .5). Data were collected via surveys, telephone, and personal-interviews in four major Australian cities. Among other things, the study revealed that Greek identity and cultural customs are often significant to first generation GIs. Adjustment challenges upon entry include primarily language, housing, and transportation difficulties, nostalgia for relatives and the motherland, unfamiliarity with socio-cultural systems, unemployment, money challenges, and lack of friendships. Christian faith, the extended family, family values and traditions, cultural pride for ancient Greek achievements, and a hard 'work ethic' are notable resiliencies that support GIs in their struggles and solidify their pursuit for happiness and success. Financial concerns, aging, and nostalgia for relatives and the motherland were the primary causes of socio-emotional instability. Attitudinal differences in the respondents based on age, gender, and socio-economic status, cross-cultural comparisons, and recommendations for culturally-sensitive practice with GIs are analyzed and methodological limitations illuminated. Future research needs in the field are also highlighted.
Bukowski, John; Nicolich, Mark; Lewis, R Jeffrey
Traditional risk-assessment theory assumes the existence of a threshold for non-cancer health effects. However, a recent trend in environmental regulation rejects this assumption in favor of non-threshold linearity for these endpoints. This trend is driven largely by two related concepts: (1) a theoretical assumption of wide-ranging human sensitivity, and (2) inability to detect thresholds in epidemiologic models. Wide-ranging sensitivity assumes a subpopulation with extreme background vulnerability, so that even trivial environmental exposures are hazardous to someone somewhere. We use examples from the real world of clinical medicine to show that this theoretical assumption is inconsistent with the biology of mammalian systems and the realities of patient care. Using examples from particulate-matter air-pollution research, we further show that failure to reject linearity is usually driven by statistical rather than biological considerations, and that nonlinear/threshold models often have a similar or better fit than their linear counterparts. This evidence suggests the existence of practical, real-world thresholds for most chemical exposures.
Multiple myeloma (MM) is a heterogeneous, clonal disorder of the plasma cells originating from the B-cell line. The diagnosis and monitoring of MM requires routine measurement of biomarkers such as serum protein electrophoresis, urine protein electrophoresis, serum free light chains, among others. Prognostic models such as the Durie-Salmon staging system and International Staging System are available and account for the disease burden. Advanced biomarker and genetic testing includes cytogenetics, fluorescent in situ hybridization, and gene expression profiling to estimate the aggressiveness of the disease and personalize the patient's treatment. Future goals of therapy will be to achieve minimal residual disease (MRD), which incorporates biomarkers and genomic data. MRD testing might provide a better estimate of the depth of response to therapy and overall survival. A robust genomic program of research is still needed to provide additional information for the best MM care practices and to gain new strategies to treat the disease, in particular, in the relapsed and/or refractory setting.
Fisher, Jacklin E; Happell, Brenda
The introduction of evidence-based practice (EBP) and the hierarchical approach to evidence it engenders within research and evaluation has aroused controversy in the mental health professions. The aim of this paper is to present a critique of EBP with a specific relationship to mental health nursing. It will be argued that in its current form, EBP presents a potential impediment to the facilitation of consumer participation in mental health services and to the recovery model. The need for the consumer voice and the importance of the lived experience of mental illness are not readily reconciled with a strong scientific paradigm that promotes detachment and objectivity. The importance of evidence in contemporary mental health care will also be acknowledged and discussed in light of the current climate of increased consumer knowledge, fiscal constraint, and extensive social criticism of mental health-care services. The current approach to EBP requires reconstruction to support the consumer-focused nature of mental health nursing, and to facilitate the implementation of a recovery model for mental health care.
Bédard, Anne-Marie; Maheux, Jérôme; Lévesque, Daniel; Samaha, Anne-Noël
Drug abuse and addiction are excessively common in schizophrenia. Chronic antipsychotic treatment might contribute to this comorbidity by inducing supersensitivity within the brain's dopamine system. Dopamine supersensitivity can enhance the incentive motivational properties of reward cues, and reward cues contribute to the maintenance and severity of drug addiction. We have shown previously that rats withdrawn from continuous haloperidol (HAL) treatment (via subcutaneous minipump) develop dopamine supersensitivity and pursue reward cues more vigorously than HAL-naive rats following an amphetamine (AMPH) challenge. Atypical antipsychotic drugs are thought to be less likely than typicals to produce dopamine supersensitivity. Thus, we compared the effects of HAL and the atypical antipsychotic olanzapine (OLZ) on the pursuit of reward cues. Rats were trained to associate a light-tone cue with water then treated with HAL or OLZ. Following antipsychotic withdrawal, we assessed AMPH-induced enhancement of lever pressing for the cue. Withdrawal from HAL, but not from OLZ, enhanced this effect. HAL, but not OLZ, also enhanced AMPH-induced psychomotor activation and c-fos mRNA expression in the caudate-putamen. Thus, prior HAL, but not OLZ, enhanced conditioned reward following an AMPH challenge, and this was potentially linked to enhanced behavioral sensitivity to AMPH and AMPH-induced engagement of the caudate-putamen. These findings suggest that HAL, but not an atypical like OLZ, modifies reward circuitry in ways that increase responsiveness to reward cues. Because enhanced responsiveness to reward cues can promote drug-seeking behavior, it should be investigated whether atypical antipsychotics might be a preferential option in schizophrenic patients at risk for drug abuse or addiction.
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…
Chan, B; Anderson, G; Dales, R E
OBJECTIVE: To describe growth and regional variation in the use of spirometry (flow studies) in Ontario. DESIGN: Retrospective analysis of Ontario Health Insurance Plan (OHIP) fee-for-service billing data for spirometry from the 1989-90 to 1994-95 fiscal years. SETTING: Physicians' office practices in Ontario. OUTCOME MEASURES: Number of flow studies and associated expenditures, number and specialty of physicians performing flow studies and the distribution of their billings, number of studies per capita by age group of patients, expenditures by region and measures of variation among regions. RESULTS: In 1994-95, $14.13 million was spent on flow studies in Ontario. This expenditure increased by 36.9% from 1989-90 to 1994-95, exceeding the overall growth rate of 20.8% for all expenditures under OHIP. Expenditure growth was driven by an increase in the number of physicians performing spirometry rather than a higher volume of services performed per physician. The substitution of flow-volume loops, for which the fee is higher, for simple spirograms also contributed to expenditure growth. There were wide regional variations in spirometry utilization. A small number of general practitioners and family physicians accounted for much of the regional variation. CONCLUSIONS: The rapid growth in spirometry utilization may stem from the diffusion of inexpensive spirometers in physicians' offices and from increased awareness of guidelines promoting the use of flow measurements. However, the wide regional variation in utilization may indicate either incomplete implementation of spirometry guidelines or lack of direction on the appropriate frequency of spirometry use. Clearer, evidence-based guidelines and an implementation strategy are needed. Also required is further study of possible inadequate access to spirometry in low-use regions and inappropriate use in high-use regions, where spirometry use is concentrated among a small number of physicians. PMID:9012717
Hong, Jun Sung; Kral, Michael J; Espelage, Dorothy L; Allen-Meares, Paula
This article provides an ecological framework for understanding adolescent-initiated parent abuse. We review research on adolescent-initiated parent abuse, identifying sociodemographic characteristics of perpetrators and victims (e.g., gender, age, race/ethnicity, and socioeconomic status [SES]). Bronfenbrenner's  ecological systems theory is applied, which examines the risk and protective factors for adolescent-initiated parent abuse within micro- (maltreatment, domestic violence, parenting behavior and disciplinary strategies), meso- (peer influence), exo- (media influence), macro- (gender role socialization), and chronosystem (change in family structure) levels. Findings from our review suggest that older and White children are significantly more likely to abuse their parents. Females are selective in the target of their aggression, while males target family members in general. Mothers are significantly more likely to be abused than fathers. However, researchers also report variations in the association between SES and parent abuse. Domestic violence and child maltreatment are risk factors, while findings on parenting behavior and disciplinary strategies are mixed. Peer influence, exposure to media violence, gender role socialization, and change in family structure can potentially increase the risk of parent abuse. Practice and research implications are also discussed. An ecological systems framework allows for an examination of how various contexts interact and influence parent abuse behavior, and can provide needed directions for further research.
Bonhomme, Jean; Shim, Ruth S; Gooden, Richard; Tyus, Dawn; Rust, George
Opioid abuse and addiction have increased in frequency in the United States over the past 20 years. In 2009, an estimated 5.3 million persons used opioid medications nonmedically within the past month, 200000 used heroin, and approximately 9.6% of African Americans used an illicit drug. Racial and ethnic minorities experience disparities in availability and access to mental health care, including substance use disorders. Primary care practitioners are often called upon to differentiate between appropriate, medically indicated opioid use in pain management vs inappropriate abuse or addiction. Racial and ethnic minority populations tend to favor primary care treatment settings over specialty mental health settings. Recent therapeutic advances allow patients requiring specialized treatment for opioid abuse and addiction to be managed in primary care settings. The Drug Addiction Treatment Act of 2000 enables qualified physicians with readily available short-term training to treat opioid-dependent patients with buprenorphine in an office-based setting, potentially making primary care physicians active partners in the diagnosis and treatment of opioid use disorders. Methadone and buprenorphine are effective opioid replacement agents for maintenance and/or detoxification of opioid-addicted individuals. However, restrictive federal regulations and stigmatization of opioid addiction and treatment have limited the availability of methadone. The opioid partial agonist-antagonist buprenorphine/naloxone combination has proven an effective alternative. This article reviews the literature on differences between buprenorphine and methadone regarding availability, efficacy, safety, side-effects, and dosing, identifying resources for enhancing the effectiveness of medication-assisted recovery through coordination with behavioral/psychological counseling, embedded in the context of recovery-oriented systems of care.
Mitchell, Gail J
The author of this paper examines emerging implications of holding ideas about evidence and evidence-based practice. Evidence has a very specific role in the delivery of safe clinical care, but it is creating a serious problematic for the practice of nursing. It is proposed that: evidence-based practice be re-situated or reconstructed as a collective and organizational responsibility and not the responsibility of individual nurses in practice; nurses re-focus on articulating a more ethical foundation for praxis, one that emerges from nursing philosophy and one that is co-constituted with persons/families/groups; and nurse leaders and educators establish teaching-learning and practice environments that enable a peer-to-peer process of critical review and curious inquiry of available evidence in the contexts of shared work.
Phillips, Lindsay A.
This qualitative analysis explores the role of substance abuse in reentry from prison to society. Participants who recidivated (N = 20) in an urban prison system identified substance abuse as their primary reason for recidivism. Treatment implications are discussed.
Parenting and family life are fundamental social constructs in human society and in law and public policy. Family structures and support systems provide important economic and psychological advantages for parents as well as for their children. Stigma toward lesbian and gay parents often marginalize individuals in these families and restrict family members' full expression of social citizenship, humanity, and personhood. Stigma directly contributes to increased risk for substance abuse, anxiety, and depressive illness among both parents and children. This article reviews the relevant policy literature to deconstruct the impacts of stigma on the psychological health and well-being of sexual minority parents so that psychiatric/mental health nurses and other health care providers can identify and counter these effects in their practices and advocate for policy improvements.
Milton, Constance L
Paradigms contain theoretical structures to guide scientific disciplines. Since ancient times, Cartesian dualism has been a prominent philosophy incorporated in the practice of medicine. The discipline of nursing has continued the body-mind emphasis with similar paradigmatic thinking and theories of nursing that separate body and mind. Future trends for paradigm and nursing theory development are harkening to former ways of thinking. In this article the author discusses the origins of Cartesian dualism and implications for its current usage. The author shall illuminate what it potentially means to engage in dualism in nursing and discuss possible ethical implications for future paradigm and theory development in nursing.
Hegarty, Kelsey L
Very strong links exist between abuse and depression in clinical practice. Abuse and depression often coexist in the victims and perpetrators of abuse. In nursing practice, responding to patients, particularly women, presenting with depression or depressive symptoms requires an understanding of the underlying and perhaps hidden issues of abuse and violence. Women who have experienced trauma often are diagnosed with depression, when in fact they have symptoms more consistent with posttraumatic stress disorder. Furthermore, depression often improves over time, when women manage to escape the abuse and violence in the relationship.
Gitterman, Alex; Knight, Carolyn
The realities of contemporary social work practice often push social workers toward a deficit-focused orientation. The article begins with an overview of the major tenets of resiliency and adversarial growth theories and related research findings. We suggest that the group modality epitomizes the application of resiliency theory and adversarial…
... for pornography is also sexual abuse. Most sexual abusers know the child they abuse. They may be ... friends, neighbors or babysitters. About one-third of abusers are related to the child. Most abusers are ...
Kent, Lindsey; And Others
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…
Al-Darraji, Haider Abdulrazzaq Abed; Wong, Kee Cheong; Yeow, David Gan Eng; Fu, Jeannia Jiani; Loeliger, Kelsey; Paiji, Christopher; Kamarulzaman, Adeeba; Altice, Frederick L
People who use drugs (PWUD) represent a key high risk group for tuberculosis (TB). The prevalence of both latent TB infection (LTBI) and active disease in drug treatment centers in Malaysia is unknown. A cross-sectional convenience survey was conducted to assess the prevalence and correlates of LTBI among attendees at a recently created voluntary drug treatment center using a standardized questionnaire and tuberculin skin testing (TST). Participants (N=196) were mostly men (95%), under 40 (median age=36 years) and reported heroin use immediately before treatment entry (75%). Positive TST prevalence was 86.7%. Nine (4.6%) participants were HIV-infected. Previous arrest/incarcerations (AOR=1.1 for every entry, p<0.05) and not being HIV-infected (AOR=6.04, p=0.03) were significantly associated with TST positivity. There is an urgent need to establish TB screening and treatment programs in substance abuse treatment centers and to tailor service delivery to the complex treatment needs of patients with multiple medical and psychiatric co-morbidities.
Sales, Amos, Ed.
This book focuses on the identification of practical knowledge and skills needed for counseling individuals with substance abuse problems. It is a resource for practitioners, students, and faculty in school counseling, rehabilitation counseling, mental health counseling, school psychology, or social work in recognizing, preventing, and treating…
Shepherd-McMullen, Cassandra; Mearns, Jack; Stokes, Julie E; Mechanic, Mindy B
This study explored the relationships among psychological abuse, attitudes about intimate partner violence (IPV), negative mood regulation expectancies (NMRE), and coping. Participants were 126 female college students in dating, cohabitating, or married relationships within the previous year. In one single session, they completed self-report scales measuring IPV, NMRE, and coping. Results indicated that women reporting higher levels of psychological abuse reported less negative attitudes toward IPV, engaged in less-active coping responses, and had lower NMRE. Psychological abuse was a significant predictor of avoidant coping, while NMRE significantly predicted both active and avoidant coping. In addition, the interaction of NMRE × Psychological abuse added incremental prediction of avoidant coping. Implications for research and practice are discussed.
Ball, Samuel; Bachrach, Ken; DeCarlo, Jacqueline; Farentinos, Chris; Keen, Melodie; McSherry, Terence; Polcin, Douglas; Snead, Ned; Sockriter, Richard; Wrigley, Paulen; Zammarelli, Lucy; Carroll, Kathleen
The successful dissemination of empirically supported addiction therapies to community providers requires an appreciation of the characteristics of those practitioners who might be willing participants in this process of technology transfer. Clinicians (N = 66) from 11 community treatment programs associated with six research-clinic partnerships of the National Drug Abuse Clinical Trials Network volunteered to be trained in Motivational Interviewing or Motivational Enhancement Therapy (MET/MI) and were assessed prior to training. The sample of clinicians was heterogeneous in education and credentials, had a high level of counseling experience, reported using a wide range of counseling techniques and orientations, but had limited prior exposure to MET/MI or to the use of treatment manuals of empirically supported therapies. In general, many of the clinicians reported beliefs and techniques that were consistent with their stated theoretical orientation and recovery status. Relatively few participants reported relying on one dominant orientation or set of techniques.
Bowman, Katherine Gail; Ryberg, Jacalyn Wickline; Becker, Heather
The purpose of this study is to compare Mexican American adolescent mothers with and without childhood sexual abuse (CSA) histories to examine the influence of CSA on dissociation, selection of infant feeding method, and intimate parenting anxiety. Participants are 78 English-speaking adolescents between 15 and 19 years of age and recruited from the southwestern United States. Nearly one third of the sample ( n = 24, 30.77%) reports CSA histories. There is no correlation between CSA history and intimate parenting anxiety, no difference between breast-feeding and formula-feeding mothers in CSA severity, and intimate parenting anxiety does not predict dissociation. These findings are inconsistent with previous research. Supportive resources may explain the inconsistency and play a role in adolescent mothers' responses to CSA. Further research is necessary to explore these possibilities.
Milton, Constance L
Rules in games are fundamental to the ethics of practice. Rules provide a context or space where a game is defined and played. Throughout human life, games may be formalized with written and unwritten rules. Imaginations may be sparked in the creative structuring of new, informal games. Formal and informal rules can serve to provide direction for what may be viewed as decorum and appropriate behavior with professional groups. In this column, the author illuminates possible ethical meanings for rule-making and breaking with implications for nursing practice and education from a nursing theoretical perspective.
systemic vascular resistance), while elderly patients are hypodynamic (increased heart rate, decreased cardiac output and decreased systemic vascular...resistance). By the time elderly patients are seen, massive volume deficits may exist, requiring hemodynamic monitoring to differentiate pump...TITLE AND SUBTITLE 5. FUNDING NUMBERS Implications for Advanced Nursing Practice in the Patient with Heat Stress 6. AUTHOR(S) Patricia A Skelton S 7
Mawritz, Mary B; Dust, Scott B; Resick, Christian J
The current study draws on the transactional theory of stress to propose that employees cope with hostile work environments by engaging in emotion-based coping in the forms of organization-directed deviance and psychological withdrawal. Specifically, we propose that supervisors' hostile organizational climate perceptions act as distal environmental stressors that are partially transmitted through supervisors' abusive actions and that conscientiousness moderates the proposed effects. First, we hypothesize that supervisor conscientiousness has a buffering effect by decreasing the likelihood of abusive supervision. Second, we hypothesize that highly conscientious employees cope differently from less conscientious employees. Among a sample of employees and their immediate supervisors, results indicated that while hostile climate perceptions provide a breeding ground for destructive behaviors, conscientious individuals are less likely to respond to perceived hostility with hostile acts. As supervisor conscientious levels increased, supervisors were less likely to engage in abusive supervision, which buffered employees from the negative effects of hostile climate perceptions. However, when working for less conscientious supervisors, employees experienced the effects of perceived hostile climates indirectly through abusive supervision. In turn, less conscientious employees tended to cope with the stress of hostile environments transmitted through abusive supervision by engaging in acts of organization-directed deviance. At the same time, all employees, regardless of their levels of conscientiousness, tended to cope with their hostile environments by psychologically withdrawing. Theoretical and practical implications are discussed.
Ryan, Joseph P.; Marsh, Jeanne C.; Testa, Mark F.; Louderman, Richard
Alcohol and other drug abuse is a major problem for children and families involved with public child welfare. Substance abuse compromises appropriate parenting practices and increases the risk of child maltreatment. A substantial proportion of substantiated child abuse and neglect reports involve parental substance abuse. Once in the system,…
Olaore, Augusta; Olaore, Israel
Parental notification policies and practices have been found to reduce alcohol and drug use at universities in the United States of America. This study examined the status of parental notification policy and practice at a faith-based private university in Nigeria for students involved with alcohol use. The study revealed that the absence of a…
Myers, Laura L.; Wodarski, John S.
In today's climate, it is becoming increasingly important to provide social work students with practice knowledge on research-supported social work interventions. CSWE has placed greater emphasis on using research-based knowledge to inform and guide social work practice, and the field has recognized the value of adhering to the evidence-based…
Jiménez-Aleixandre, María Pilar
In the last two decades science studies and science education research have shifted from an interest in products (of science or of learning), to an interest in processes and practices. The focus of this paper is on students' engagement in epistemic practices (Kelly in Teaching scientific inquiry: Recommendations for research and implementation. Sense Publishers, Rotterdam, pp 99-117, 2008), or on their practical epistemologies (Wickman in Sci Educ 88(3):325-344, 2004). In order to support these practices in genetics classrooms we need to take into account domain-specific features of the epistemology of genetics, in particular issues about determinism and underdetermination. I suggest that certain difficulties may be related to the specific nature of causality in genetics, and in particular to the correspondence between a given set of factors and a range of potential effects, rather than a single one. The paper seeks to bring together recent developments in the epistemology of biology and of genetics, on the one hand, with science education approaches about epistemic practices, on the other. The implications of these perspectives for current challenges in learning genetics are examined, focusing on students' engagement in epistemic practices, as argumentation, understood as using evidence to evaluate knowledge claims. Engaging in argumentation in genetics classrooms is intertwined with practices such as using genetics models to build explanations, or framing genetics issues in their social context. These challenges are illustrated with studies making part of our research program in the USC.
... 5th ed. Arlington, VA: American Psychiatric Publishing. 2013. Weiss RD. Drugs of abuse. In: Goldman L, ... Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the ...
... Break Up Respectfully Abuse Sexual Harassment and Sexual Bullying Love and Romance Getting Over a Break-Up Dealing With Bullying Posttraumatic Stress Disorder Sexual Attraction and Orientation Teens ...
Du Mont, Janice; Kosa, Daisy; Macdonald, Sheila; Elliot, Shannon; Yaffe, Mark
Objective As a critical step in advancing a comprehensive response to elder abuse built on existing forensic nursing-led hospital-based programmes, we developed a list of skills-based competencies for use in an Elder Abuse Nurse Examiner curriculum. Participants and setting Programme leaders of 30 hospital-based forensic nursing-led sexual assault and domestic violence treatment centres. Primary and secondary outcome measures 149 verbatim recommendations for components of an elder abuse response were identified from a systematic scoping review. In 2 online Delphi consensus survey rounds, these components of care were evaluated by an expert panel for their overall importance to the elder abuse intervention under development and for their appropriateness to the scope of practice of an elder abuse nurse examiner. The components retained after evaluation were translated into skills-based competencies using Bloom's Taxonomy of Learning and, using the Nominal Group Technique, were subsequently reviewed and revised by a subset of members of the expert panel in a consensus meeting. Results Of the 148 recommendations evaluated, 119 were rated as important and achieved consensus or high level of agreement. Of these, 101 were determined to be within the scope of practice of an Elder Abuse Nurse Examiner and were translated into skills-based competencies. Following review and revision by meeting experts, 47 final competencies were organised by content into 5 metacompetencies: documentation, legal and legislative issues; interview with older adult, caregiver and other relevant contacts; assessment; medical and forensic examination; and case summary, discharge plan and follow-up care. Conclusions We determined the skills-based competencies of importance to training forensic nurse examiners to respond to elder abuse in the context of a hospital-based intervention. These findings may have implications for violence and abuse treatment programmes with a forensic nursing component
Pons, Francisco; de Rosnay, Marc; Bender, Patrick K; Doudin, Pierre-André; Harris, Paul L; Giménez-Dasí, Marta
Children's affective experiences and cognitive abilities have an impact on emotion understanding. However, their relative contribution, as well as the possibility of an interaction between them, has rarely been examined. The aim of the present study was to evaluate the influence of severe abuse and learning difficulties on simple and complex components of emotion understanding in late childhood and early adolescence. A total of 28 older children and young adolescents were selected for the study. Half of the participants had suffered from severe abuse, and half of these abused children additionally had learning disabilities. The remaining half of the sample had no history of abuse but were matched with the abused children on learning difficulties, age and gender. The participants' emotion understanding was assessed with the Test of Emotion Comprehension (TEC). Results showed that (a) learning difficulties but not abuse had an impact on emotion understanding, (b) there was no interaction effect of abuse and learning difficulties on emotion understanding, and (b) the observed effects of learning difficulties were most apparent for the understanding of relatively complex components of emotion and not for simple components. The results are discussed in terms of their theoretical and practical implications.
Lindhiem, Oliver; Shaffer, Anne; Kolko, David J
In the parent intervention outcome literatures, discipline practices are generally quantified as absolute frequencies or, less commonly, as relative frequencies. These differences in methodology warrant direct comparison as they have critical implications for study results and conclusions among treatments targeted at reducing parental aggression and harsh discipline. In this study, we directly compared the absolute frequency method and the relative frequency method for quantifying physically aggressive, psychologically aggressive, and nonaggressive discipline practices. Longitudinal data over a 3-year period came from an existing data set of a clinical trial examining the effectiveness of a psychosocial treatment in reducing parental physical and psychological aggression and improving child behavior (N = 139). Discipline practices (aggressive and nonaggressive) were assessed using the Conflict Tactics Scale. The two methods yielded different patterns of results, particularly for nonaggressive discipline strategies. We suggest that each method makes its own unique contribution to a more complete understanding of the association between parental aggression and intervention effects.
Loughlin, Michael; Lewith, George; Falkenberg, Torkel
Scientism is a philosophy which purports to define what the world 'really is'. It adopts what the philosopher Thomas Nagel called 'an epistemological criterion of reality', defining what is real as that which can be discovered by certain quite specific methods of investigation. As a consequence all features of experience not revealed by those methods are deemed 'subjective' in a way that suggests they are either not real, or lie beyond the scope of meaningful rational inquiry. This devalues capacities that (we argue) are in fact essential components of good reasoning and virtuous practice. Ultimately, the implications of scientism for statements of value undermine value-judgements essential for science itself to have a sound basis. Scientism has implications, therefore, for ontology, epistemology and also for which claims we can assert as objective truths about the world. Adopting scientism as a world view will have consequences for reasoning and decision-making in clinical and other contexts. We analyse the implications of this approach and conclude that we need to reject scientism if we are to avoid stifling virtuous practice and to develop richer conceptions of human reasoning.
Szapocznik, José; Williams, Robert A.
This article describes a systematic program of research that focuses on Brief Strategic Family Therapy (BSFT) and the adaptations that were developed based on BSFT principles. The culture-specific origins of BSFT are reviewed, as well as its broader applications to the field of family therapy. Research is reviewed demonstrating that BSFT is a promising family-based approach to treating Hispanic youth behavior problems and drug abuse. Treatment innovations are described that address the combination of intergenerational and cultural differences that occur among youths and their Hispanic parents. Programmatic work is described that challenges basic principles of family therapy by expanding BSFT to a One Person modality and a strategic engagement procedure. Both of these novel approaches are intended to add tools to therapists’ repertoire in working with difficult-to-engage families. A preview discussion of results is presented from a randomized clinical trial that is an application of an ecosystemic prevention version of BSFT. The implications of the work of the Center for Family Studies are discussed in the context of the broader service system. Ultimately, this article articulates a way of thinking about adolescent problem behavior, its social interactional determinants, and a range of theoretically consistent family-centered strategies that attempt to change social ecological processes that impact adolescent developmental trajectories. PMID:11227062
Gold, Jason; Sullivan, Margaret Wolan; Lewis, Michael
Objective While the relationship between abusive parenting and violent delinquency has been well established, the cognitive and emotional processes by which this occurs remains relatively unidentified. The objective of this work is to apply a conceptual model linking abusive parenting to the conversion of shame into blaming others and therefore to violent delinquency. Methods A retrospective study of 112 adolescents (90 male; 22 female; ages 12 to 19 years; M = 15.6; SD = 1.4) who were incarcerated in a juvenile detention facility pending criminal charges, completed measures of exposure to abusive and nonabusive discipline, expressed and converted shame, and violent delinquency. Results Findings tend to confirm the conceptual model. Subjects who converted shame (i.e., low expressed shame, high blaming others) tended to have more exposure to abusive parenting and showed more violent delinquent behavior than their peers who showed expressed shame. Subjects who showed expressed shame (i.e., high expressed shame, low blaming others) showed less violent delinquency than those who showed converted shame. Conclusions Abusive parenting impacts delinquency directly and indirectly through the effects of shame that is converted. Abusive parenting leads to the conversion of shame to blaming others, which in turn leads to violent delinquent behavior. Practice implications For juvenile offenders, the conversion of shame into blaming others appears to contribute to pathological outcomes in relation to trauma. Translation of this work into clinical practice is recommended. PMID:21783253
Baly, Andrew R
This study gathered data by interviewing women who had left abusive relationships. Analysis of the discursive resources used by participants indicated that their constructions of the abusive situation were influenced by wider social and cultural discourses. Some of these maintained participants in their abusive relationships and gave rise to dilemmas that reduced their ability to deal with the situation. Other discourses promoted self-reliant ways of behaving. These helped participants to leave the abusive situation and encouraged a self-construction of personal strength and agency. The role of social discourses in how women deal with abuse and the implications of this are discussed.
Burgess, Ann Wolbert; Welner, Michael; Willis, Danny G.
Sexual abuse by educators has become an increasingly noted type of sexual abuse, especially among adolescents, for two reasons. First, there is a potential for these cases to be silent and prolonged and second, when disclosed, the forensic implications usually include both criminal and/or civil sanctions. For forensic case evaluations,…
Owens, Allessia P; Bartunek, Jean M
Objective To examine how leading clinical journals report research findings, aiming to assess how they frame their implications for medical practice and to compare that literature's patterns with those of the management literature. Data Source Clinically relevant research articles from three leading clinical journals (N Engl J Med, JAMA, and Ann Intern Med). Methods Review of wording of a sequential sample from 2010, with categorisation, comparison among journals, and comparison with management literature. Results Clinical journals usually state that one approach did or did not differ from another approach (35 of 51 articles, 68.6%), but they recommended a specific course of action (‘therefore, x should be done’) in just 25.5%. One article gave instruction on how to implement the changes. Two-thirds of the reports called for further research. Half used tentative language. Management research articles nearly always specified who should use the information and drew from over 60 types of potential users, whereas the clinical literature named the audience in only 23.5% of clinicians. Conclusions Authors and editors of the clinical literature could test being more clear and direct in presenting implications of research findings for practice, including stating when the findings do not justify changes in practice. PMID:21450773
Hardesty, Jennifer L; Khaw, Lyndal; Ridgway, Marcella D; Weber, Cheryl; Miles, Teresa
The importance of pets in families, especially during major life stressors, is well documented. Research suggests links between pet ownership and intimate partner violence (IPV). This study explored abused women's decisions about pets when seeking help from a shelter. Interviews were conducted with 19 women who were pet owners. Using grounded theory methods, two patterns emerged surrounding abusers' treatment of pets, bonds to pets, women's decisions about pets upon seeking shelter, and future plans for pets. The presence of coercive control was central to these patterns. Women also discussed their experiences with and needs from shelter professionals and veterinarians with implications for practice.
Harris, Kenneth J; Harvey, Paul; Booth, Samantha L
This study examines predictors of abusive employee behavior toward coworkers. We examined two personality variables, negative affectivity and political skill, and two situational relationship variables-team member exchange and coworker relationship conflict. We tested our hypotheses with data obtained from a sample of 232 working employees. We found that political skill and team member exchange were negatively related to coworker abuse, whereas negative affectivity and relationship conflict were positively related. Additionally, we found statistical support for the negative affectivity-relationship conflict, political skill-team member exchange, and political skill-relationship conflict interactions. Practical implications and directions for future research are provided.
... Enter ZIP code here Enter ZIP code here Child Sexual Abuse Public This section is for Veterans, General Public, Family, & Friends Child Sexual Abuse What is child sexual abuse? Child sexual abuse ...
Gans, Jeremy; Falco, Mathea; Schackman, Bruce R.; Winters, Ken C.
Aims: To examine the quality of screening and assessment practices at some of the most highly regarded adolescent substance use treatment programs in the United States. Methods: Between March and September 2005, telephone surveys were administered to directors of highly regarded programs. Several different publications and databases were then used…
Dillon, R; von Winterfeldt, D
This article examines the implications of a 10 gauss (G) occupational threshold limit value (TLV) on the work practices of a utility that must maintain and repair 500 and 230 kV transmission lines. Three work practices are compared: bare-handed work with live lines (the current practice at the example utility), use of hot sticks, and de-energizing lines prior to work. Bare-handed work with live lines leads to occasional exceedances of the 10 G TLV. Use of hot sticks and de-energizing lines eliminate these exceedances, but they do so at a price. Both practices increase the job duration and, as a result, may increase occupational injury risks. The annual costs for the current live-line, bare-handed practice is approximately $175,000. Use of hot sticks increases this annual cost of maintenance and repair by 30 to 55%. De-energizing lines can increase annual costs by $4 million to $14 million, due to the need for adding additional electricity generation during the planned outages. De-energizing lines also increases the risk to service reliability slightly.
Schilling, Samantha; Christian, Cindy W
This article provides an overview of child physical abuse and neglect, and describes the magnitude of the problem and the triggers and factors that place children at risk for abuse and neglect. After examining the legal and clinical definitions of child abuse and neglect, common clinical outcomes and therapeutic strategies are reviewed, including the lifelong poor physical and mental health of victims and evidence-supported treatment interventions. Mandated reporting laws, and facilitating collaboration among child welfare, judicial, and health care systems are considered. Important tools and resources for addressing child maltreatment in clinical practice are discussed, and future approaches posited.
Colvin, Marianna L; Pruett, Jana A; Young, Stephen M; Holosko, Michael J
Using archival data, this case study systematically examines telephone calls received by a regional sexual assault hotline in the Southeastern United States over a 5-year period. A stratified random sample (n = 383) reveals that hotline staff require diversity and depth in knowledge and skills, demonstrated by the hotline's primary use as a crisis service, combined with notable use by long-term survivors. Findings include the utility of the hotline by survivors and community stakeholders, categories of assault, the time gap between incidents occurring and contacting the hotline, call severity and urgency, and services and referrals provided. Implications for training, practice, and future research are discussed.
Benishek, Lois A.; Morrow, Susan L.
Estimates indicate that 1 in 4 women and 1 in 7 men have been sexually abused as children. These statistics may be underestimated based on anecdotal information relayed by many therapists who specialize in working with survivors of childhood sexual abuse. Effects of childhood sexual abuse have far reaching implications for the survivors' abilities…
Carlson, Bonnie E; Stromwall, Layne K; Lietz, Cynthia A
Increasing numbers of women are found in the military, and they are now performing roles very similar to those of male service members. More returning servicewomen and veterans have been exposed to stressful and traumatic experiences, such as combat and difficult living circumstances, and military sexual trauma is common. These experiences have been found to be associated with adverse mental health outcomes, posttraumatic stress disorder, depression, and substance abuse in particular. Comorbidity rates are also high. In addition, more veterans are returning with injuries, including traumatic brain injuries. Although more women veterans of Operation Enduring Freedom and Operation Iraqi Freedom are seeking health services at Veterans Administration facilities, many are not. Thus, community-based social workers need to be familiar with the needs of this growing population to serve them effectively. Use of empirically supported assessment instruments and screening for military sexual trauma are recommended. Recommended interventions include the use of evidence-supported practices, such as cognitive-behavioral treatment, and offering assistance to enhance social support among women veterans.
V Essen, H; Schlickewei, W; Dietz, H-G
Child abuse is most often diagnosed by an emergency doctor on call who sometimes "feels" more than knows what he is confronted with. He should nevertheless always take a medical history and make a physical and radiological examination. X-ray imaging and an ophthalmologic retinal examination are the most important diagnostic steps. Typical findings are multiple and/or dorsal rib fractures, complex skull fractures, physeal fractures, all fractures within the first 12 months, multiple fractures in different localisations and stages of healing, all injuries with uncommon distributions, all patterned bruises, immersion burns, intramural hematoma and every unexplained loss of consciousness. The first step towards victim protection is always the removal of the abused child from its caregivers by admitting it to hospital, as 95% of all cases of reported child abuse take place within the child's family.
Spitzer, William J; Davidson, Kay W
Major economic, political, demographic, social, and operational system factors are prompting evolutionary changes in health care delivery. Of particular significance, the "graying of America" promises new challenges and opportunities for health care social work. At the same time, the Patient Protection and Affordable Care Act of 2010, evolution of Accountable Care Organizations, and an emphasis on integrated, transdisciplinary, person-centered care represent fundamental shifts in service delivery with implications for social work practice and education. This article identifies the aging shift in American demography, its impact on health policy legislation, factors influencing fundamentally new service delivery paradigms, and opportunities of the profession to address the health disparities and care needs of an aging population. It underscores the importance of social work inclusion in integrated health care delivery and offers recommendations for practice education.
This article proposes that Pargament's theory of religious coping can be a theoretical beacon to spiritually sensitive social work practice. It begins with a discussion of the raison d'être of spiritually sensitive social work, which is examined as being able to cast a holistic and positive glow on social work. Then it provides an overview and a critique of Pargament's theory, emphasising that the theory offers a fuller and more impartial picture of religious coping. In addition, it explores the implications of Pargament's theory for spiritually sensitive social work practice with religious clients in terms of engagement, assessment and intervention. This article concludes by discussing how social work practitioners can avoid the pitfalls and limitations of Pargament's theory. PMID:27559234
This article proposes that Pargament's theory of religious coping can be a theoretical beacon to spiritually sensitive social work practice. It begins with a discussion of the raison d'être of spiritually sensitive social work, which is examined as being able to cast a holistic and positive glow on social work. Then it provides an overview and a critique of Pargament's theory, emphasising that the theory offers a fuller and more impartial picture of religious coping. In addition, it explores the implications of Pargament's theory for spiritually sensitive social work practice with religious clients in terms of engagement, assessment and intervention. This article concludes by discussing how social work practitioners can avoid the pitfalls and limitations of Pargament's theory.
Fonseca, Ana Catarina; Ferro, José M
Cerebrovascular disorders contribute to the morbidity and disability associated with illicit drug use. Drug abusers have an increased risk of both hemorrhagic and ischemic stroke. In geographic areas with a high prevalence of illicit drug use, drug abuse is a frequent cause of stroke in the young adult. The illicit drugs more commonly associated with stroke are psychomotor stimulants, such as amphetamine and cocaine. Less commonly implicated are opioids and psychotomimetic drugs, including cannabis. Toxicology screening for illicit drugs should be done in young patients with stroke with no obvious cause, or if suggested by history or examination. Although in some patients the mechanism of stroke is identified using neuroimaging and other modern diagnostic tools, in a sizeable fraction of cases the mechanism of stroke remains unclear. Further studies are needed to elucidate the role of hemodynamic and immunologic mechanisms in these cases.
The increase in drug abuse in South Africa has had major social implications in the country. Problems associated with drug dependency are poverty, unemployment, a heavier burden on the health care system, the disintegration of family systems and drug-related crimes. Another area of concern is the link between drug abuse and child abuse. While…
Fisher, William H; Clark, Robin; Baxter, Jeffrey; Barton, Bruce; O'Connell, Elizabeth; Aweh, Gideon
Persons who abuse or are dependent on opioids are at elevated risk for arrest. Co-occurring behavioral health problems may exacerbate that risk, although the extent of any such increase has not been described. This study examines such risk factors among 40,238 individuals with a diagnosis of opioid abuse or dependence who were enrolled in the Massachusetts Medicaid program in 2010. Medicaid data were merged with statewide arrest data to assess the effects of co-existing mental illness, substance abuse, and previous arrests on arrest during 2010. Persons with serious mental illnesses (psychotic and bipolar disorders) and those with two or more pre-2010 arrests had significantly increased greater odds of arrest. We believe this to be the first study examining effects of co-occurring risk factors on arrest in a large population with opioid dependency/abuse. These findings identify predictors of arrest that could be used to design interventions targeting specific co-occurring risk factors.
SCHRÖDER-BUTTERFILL, ELISABETH; FITHRY, TENGKU SYAWILA
The provision of physical care is a sensitive matter in all cultures and is circumscribed by moral injunctions and personal preferences. Research on Western cultures has shown care networks to be narrow subsets of people’s wider networks and revealed dependence to be deeply undermining of full personhood. In non-Western societies these issues have received little attention, although it is sometimes assumed that care provision and dependence are much less problematic. This paper uses longitudinal ethnographic data from two ethnic groups in rural Indonesia to compare care preferences and practices in old age and to examine the implications of care dependence. The groups manifest varying degrees of daughter preference in care and differ in the extent to which notions of shame and avoidance prohibit cross-gender intimate care and care by ‘non-blood’ relatives. Demographic and social constraints often necessitate compromises in actual care arrangements (e.g. dependence on in-laws, neighbours or paid carers), not all of which are compatible with quality care and a valued identity. We argue that by probing the norms and practices surrounding care provision in different socio-cultural settings, it becomes possible to arrive at a deeper understanding of kinship, personhood and sociality. These insights are not only of sociological interest but have implications for people’s vulnerability to poor quality care in old age. PMID:24518962
Wright, Nat M J; Tompkins, Charlotte N E; Sheard, Laura
Women are over-represented as the recipients of injections of illicit drugs and are often injected by their intimate partners. This study used qualitative research to explore women drug users' experiences of abuse from intimate partners when being injected with illicit drugs. In-depth interviews were conducted with 45 women drug users in the city of Leeds and the area of North Nottinghamshire, UK. The practice of peer injecting illicit drugs places women recipients at risk of physical, economic and emotional abuse from their male intimate partner injectors. However, this was not a universal feature. In trusting, supportive intimate partner relationships peer injecting took place through reciprocal arrangements. Moving away from peer injecting was technically and emotionally difficult for women and rarely straightforward. The implications of the work are discussed as clinicians and wider drug service staff should be aware of the possibility of abuse and enquire about peer injecting when consulting with women injecting drug users. However, clinicians should avoid working within a simplistic clinical framework that views all peer injecting as intrinsically abusive. More research is needed to provide evidence for best practice. Until then, generic principles of best practice management of intimate partner abuse could apply, including enhancing women's motivation to effect change in an abusive situation.
Little, Allison Dare
A modern form of abuse of children by parents and foster parents is to use the identity of children in their care for their own financial benefit, such as accessing their unused social security numbers to secure credit. This article reviews examples and implications of this identity theft.
... bruises, while behavioral indicators are ways victims and abusers act or interact with each other. Some of the indicators listed below can be explained by other causes (e.g. inappropriate or unusual behavior may signal dementia or drug interactions) and no single indicator can be taken ...
Gorman, E M; Carroll, R T
Substance use continues to be closely associated with both HIV infection and treatment considerations in all at-risk populations. Among those groups heretofore not well characterized epidemiologically or clinically are those dual-risk men who have sex with other men (MSM) and use and/or inject drugs. Of particular current concern with regard to drug-using MSM is the growth in popularity of a group of recreational or so-called party drugs associated with specific social and sexual environments and networks. Chief among these drugs are hallucinogens, such as MDMA, ketamine, and GHB, and stimulants, such as cocaine, amphetamines, and methamphetamine. Increased methamphetamine use by MSM is particularly alarming because of its reported associations with high-risk injecting and sexual behaviors. Preliminary data are reported from an ethnographic exploration of MSM methamphetamine users in the Pacific Northwest of the United States. Case studies drawn from the data illustrate the complex and variable patterns of methamphetamine use among MSM. Finally, implications for nursing are discussed, and "upstream nursing" is suggested as a means of patient advocacy for HIV nurses working with substance-using populations.
Lea, Susan J; Lynn, Nick
This study investigated the social construction of domestic abuse by police officers, specifically in the context of arguments presented to the prosecutor for a decision on whether to proceed with or discontinue the case. Nineteen police files were examined with a particular focus on the MG3, the "Report to Crown Prosecutors for Charging Decision." Access to such sensitive material is usually denied to researchers; therefore, this study offers unusual insights into the treatment of victims and perpetrators of interpersonal violence by the police. Discourse analysis revealed three dominant speech genres: impartiality, credibility, and the "real" victim. These genres separately and in interaction served to construct domestic abuse cases in ways that did not support the victim's account. The "dialogic reverberations" of these findings are discussed and the implications of the work for research and practice are considered.
Thompson, Elaine Adams
Considerable evidence shows that the management of complex problems of and related to substance abuse and addictions require comprehensive approaches based on solid research. Nonetheless, timely and widespread dissemination of research findings remains uncommon, hindering nursing practice, impeding the health of individuals and families, and imposing untoward costs for society. Shifts in science paradigms underscore the need for efficient and effective interdisciplinary research teams to carry out innovative research within a translational science framework. This means that early career investigators will need the knowledge and skills to conduct research as part of an interdisciplinary team and to contribute systematically to translational research in the area of substance abuse and addictions. This brief report describes a nursing research training program sponsored by the National Institute on Drug Abuse that evolved into an interdisciplinary program administrated within a school of nursing. Factors conducive to program development are described, along with the structure and elements of the program and examples of the scholars' projects and accomplishments. The common benefits of interdisciplinary research training for both predoctoral and postdoctoral research scholars include consistent exposure to new and alternative scientific models and methodological approaches as well as endurance of cross-discipline network connections. Benefits and challenges of this program carry implications for the design of future nursing research training programs in the field of substance abuse and addictions.
There is concern that people with dementia may be at particular risk of elder abuse however there is little data to confirm such fears. This paper presents findings from an up-dated investigation of secondary sources of data about the abuse of older people with dementia in England conducted in 2013. There are many sources of data about poor care, abuse and neglect of people with dementia in care home and hospital settings but these are collected for different purposes and hard to link. The article discusses the ways in which dementia care practitioners may be able to make the most of existing data.
Bina, Rena; Yum, Joohee; Hall, Diane M. Harnek; Sowbel, Lynda; Mollette, Angela; Jani, Jayshree; Smith-Osborne, Alexa
As frontline mental health care providers, social workers need to be prepared to confront and properly manage substance abuse issues in practice. This study examined predictors of recent master of social work (MSW) graduates' perceptions of preparedness to practice in the area of substance abuse. A cross-sectional design was used, and 232 recent…
Udeigwe, Theophilus K; Teboh, Jasper M; Eze, Peter N; Stietiya, M Hashem; Kumar, Vipan; Hendrix, James; Mascagni, Henry J; Ying, Teng; Kandakji, Tarek
Globally, much weight is currently being placed on agriculture to provide food for the growing population as well as feedstock for the bioenergy industry. Unfortunately, the intensification of agricultural operations to satisfy these growing needs has been associated with a number of environmental and human health risks. A review of publications on the subject was conducted and emphasis was placed on articles focusing on agriculture, environment, and public health as well as their interactions. Supporting information was also gathered from publications of various agricultural and environmental agencies. Agricultural practices with potential negative implications on the environment and human health were identified broadly as: (a) utilization of biosolids and animal manures, (b) use of agricultural chemicals, (c) management of post-harvest residue, (d) irrigation, and (e) tillage operations. Soil, water, and air contamination by nutrients, heavy metals, pathogens, and pesticides, as well as air contamination by particulate matters, noxious gases, and pathogens were among the leading environmental impacts. Some of the human-health impacts identified included neurological and reproductive defects, cardiovascular risks, cancers and other diseases (of kidney, liver, lung, and skin), skin allergies, gastroenteritis, and methemoglobinemia. Continual awareness on the impacts of the reviewed agricultural practices on environmental quality and human health and the implementation of experimentally-backed best management practices in agricultural systems remain indispensable.
Common infrastructures and platforms are required for international collaborations in large-scale human genomic research and policy development, such as the Global Alliance for Genomics and Health and the ‘ELSI 2.0’ initiative. Such initiatives may require international harmonization of ethical and regulatory requirements. To enable this, however, a greater understanding of issues and practices that relate to the ethical, legal and social implications (ELSI) of genomic research will be needed for the different countries and global regions involved in such research. Here, we review the ELSI practices and regulations for genomic research in six East Asian countries (China, Indonesia, Japan, Singapore, South Korea and Taiwan), highlighting the main similarities and differences between these countries, and more generally, in relation to Western countries. While there are significant differences in ELSI practices among these East Asian countries, there is a consistent emphasis on advancing genomic science and technology. In addition, considerable emphasis is placed on informed consent for participation in research, whether through the contribution of tissue samples or personal information. However, a higher level of engagement with interested stakeholders and the public will be needed in some countries. PMID:24944586
Choprapawon, C; Chunsutiwat, S; Kachondham, Y; Weiss, M G
A cultural study of diarrhoeal illness was conducted using the Explanatory Model Interview for Cultural Assessment (EMIC) to compare two socioeconomically distinct subdistricts of central Thailand and to determine the practical implications of illness-related perceptions, beliefs and practices. Subjects specified 12 terms for diarrhoeal illnesses that were grouped into four locally meaningful groups, namely, tong-sia, a non-specific term for diarrhoea, bid, associated with colicky abdominal pain, ahiwa, referring to severe illness, often cholera; and taae-tua, diarrhoea associated with milestones of growth and development. To compare pre-existing beliefs and practices with the experience of caretakers when actually confronted with an episode of illness, we inquired about each of the terms and about index cases in subsequent interviews over the course of a six-month surveillance period. Patterns of distress, perceived causes, and preferences for help seeking and treatment elicited by the EMIC identified cultural features of the four groups of diarrhoeal illness. Perceived causes of diarrhoea associated with sanitation, hygiene and infection, which most respondents considered preventable, were prominent explanations for three of the four categories, and the fourth was viewed as a normal feature of growth and development, rather than medical illness. We discuss these and other findings with reference to use of ORS and other issues related to the prevention and control of diarrhoeal illness, concluding with recommendations for public health policy and research.
Polcin, Douglas L
Communities throughout the U.S. are struggling to find solutions for serious and persistent homelessness. Alcohol and drug problems can be causes and consequences of homelessness, as well as co-occurring problems that complicate efforts to succeed in finding stable housing. Two prominent service models exist, one known as "Housing First" takes a harm reduction approach and the other known as the "linear" model typically supports a goal of abstinence from alcohol and drugs. Despite their popularity, the research supporting these models suffers from methodological problems and inconsistent findings. One purpose of this paper is to describe systematic reviews of the homelessness services literature, which illustrate weaknesses in research designs and inconsistent conclusions about the effectiveness of current models. Problems among some of the seminal studies on homelessness include poorly defined inclusion and exclusion criteria, inadequate measures of alcohol and drug use, unspecified or poorly implemented comparison conditions, and lack of procedures documenting adherence to service models. Several recent papers have suggested broader based approaches for homeless services that integrate alternatives and respond better to consumer needs. Practical considerations for implementing a broader system of services are described and peer managed recovery homes are presented as examples of services that address some of the gaps in current approaches. Three issues are identified that need more attention from researchers: 1) improving upon the methodological limitations in current studies, 2) assessing the impact of broader based, integrated services on outcome, and 3) assessing approaches to the service needs of homeless persons involved in the criminal justice system.
Koehn, Corinne V
Fifty women who were sexually abused as children were interviewed regarding their perceptions of helpful and hindering counseling behaviors. The critical incident technique was the methodology used. One major category that emerged from the data was Approach to Power and Control. This category comprised eight subcategories: (1) flexibility with agenda; (2) willingness to offer choices; (3) response to criticism; (4) response to client as an equal or with honor; (5) sexual interest; (6) approach to client's suggestions; (7) expectations regarding forgiveness; and (8) consultation with alter identities. Implications for counseling practice, research, and counselor education are discussed.
Gullattee, Alyce C.
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
The history of Minimally Invasive Surgery in the thorax is one of evolution, not revolution. The concept of video-assisted thoracic surgery (VATS) to greatly reduce the trauma of chest operations was born over two decades ago. Since then, it has undergone a series of step-wise modifications and improvement. The original practice of three access ports in a ‘baseball diamond’ pattern was modified to suit operational needs, and gradually developed into ‘next generation’ approaches, including Needlescopic and 2-port VATS. The logical, incremental progression has culminated in the Uniportal VATS approach which has stirred considerable interest within the field of Thoracic Surgery in recent years. This measured, evolutionary process has significant implications on how the surgeon should approach, master and realize the full potential of the Uniportal technique. This article gives a précis of the evolutionary history of minimally invasive thoracic surgery, and highlights the lessons it provides about its future. PMID:25379198
Corstens, Dirk; Longden, Eleanor; McCarthy-Jones, Simon; Waddingham, Rachel; Thomas, Neil
The international Hearing Voices Movement (HVM) is a prominent mental health service-user/survivor movement that promotes the needs and perspectives of experts by experience in the phenomenon of hearing voices (auditory verbal hallucinations). The main tenet of the HVM is the notion that hearing voices is a meaningful human experience, and in this article, we discuss the historical growth and influence of the HVM before considering the implications of its values for research and practice in relation to voice-hearing. Among other recommendations, we suggest that the involvement of voice-hearers in research and a greater use of narrative and qualitative approaches are essential. Challenges for implementing user-led research are identified, and avenues for future developments are discussed. PMID:24936088
Issa, Amalia M
An important current trend in health care is the move toward personalized medicine. Personalized medicine includes diagnostic and therapeutic interventions, with risk defined through genetics. The key paradigm shift brought about by the advent of personalized medicine is the increased use of in vitro genomic diagnostics. These tests offer the potential of being able to predict which patients are likely to respond to a particular drug, or which patients are likely to develop adverse reactions to a drug. The focus of this paper is the use of genomic diagnostics, and how the increasing development and translation into clinical practice of diagnostic--drug combination products will be adopted into health care delivery. The meaning of value and how to measure it is considered from different perspectives. A novel framework for evaluating the value of genomic diagnostics is proposed. Finally, the implications for regulatory approval and policy are discussed using an illustrative case study.
Legarda, Stella B; McMahon, Doreen; Othmer, Siegfried; Othmer, Sue
Trends in alternative medicine use by American health care consumers are rising substantially. Extensive literature exists reporting on the effectiveness of neurofeedback in the treatment of autism, closed head injury, insomnia, migraine, depression, attention deficit hyperactivity disorder, epilepsy, and posttraumatic stress disorder. We speculated that neurofeedback might serve as a therapeutic modality for patients with medically refractory neurological disorders and have begun referring patients to train with clinical neurofeedback practitioners. The modality is not always covered by insurance. Confident their child's medical and neurological needs would continue to be met, the parents of 3 children with epilepsy spectrum disorder decided to have their child train in the modality. The children's individual progress following neurofeedback are each presented here. A proposed mechanism and practice implications are discussed.
Lisowska, P; Daly, B
Epilepsy is a chronic condition which affects about 1% of the population. It is important that the dental team is aware of the management of epileptic seizures and epileptic syndromes including recent advances in seizure management. As people with epilepsy often get a warning aura before seizures begin, the management of the condition has increasingly involved measures to prevent the seizure, once the aura has begun. Vagus nerve stimulation therapy (VNST) in epilepsy involves the use of an implantable electronic device and is being increasingly used in the UK to control severe treatment resistant epilepsy. As a result, more patients will be presented to clinicians in the primary healthcare setting and hospital services with these devices in place. Members of the dental team need to understand the principles of epilepsy control, how VNST is used in the management of intractable epilepsy, how the VNST system operates and the implications of VNST use for dental practice including medical devices, interactions and safety features.
Ling, Walter; Rawson, Richard; Shoptaw, Steve; Ling, Walter
Preliminary implications for evidence-based treatments and future practice may be drawn from new research findings that inspire a fresh view of methamphetamine dependence and associated medical consequences. Current user populations include increasingly impacted subgroups (ie, youths, women, men who have sex with men, and rural residents); complex consequences of methamphetamine abuse among these subgroups require additional efforts involving contextual understanding of characteristics and needs to develop effective treatments. The neurobiological data on cellular activity of methamphetamine taken with findings from neuroimaging studies indicate potential targets for pharmacologic interventions. In early trials, several candidate medications--bupropion, modafinil, and, to a lesser extent, baclofen--have shown promise in treating aspects of methamphetamine dependence, including aiding memory function necessary to more effectively participate in and benefit from behavioral therapies. Clinicians and researchers must interact to efficiently address the problems of methamphetamine dependence, a major drug problem in the United States and the world.
DeMatteo, David; Marczyk, Geoffrey; Pich, Michele
In Atkins v. Virginia 2002, the U.S. Supreme Court held that the Eighth Amendment prohibits executing offenders who are mentally retarded. Rather than adopting a uniform definition of mental retardation, the court charged each state with defining mental retardation in a manner that enforces the constitutional restriction. An unanswered question is how states define mental retardation after Atkins, which has implications for capital defendants and forensic evaluators who conduct capital mitigation evaluations. This project identified the statutory definitions of mental retardation in each state, and grouped the definitions based on consistency with accepted clinical criteria for mental retardation. Results show that definitions of mental retardation vary considerably by state. The large majority of states, both overall and specifically among death penalty states, use criteria for mental retardation that are not entirely consistent with accepted clinical standards. As such, it is not clear whether the majority of states are effectuating the intent of Atkins. The implications of these findings for both policy and practice are discussed.
Zapata, Mara; Gallard, Alejandro J.
Beliefs and attitudes resulting from the unique life experiences of teachers frame interactions with learners promoting gender equity or inequity and the reproduction of social views about knowledge and power as related to gender. This study examines the enactment of a female science teacher's pedagogy (Laura), seeking to understand the implications of her beliefs and attitudes, as framed by her interpretations and daily manifestations, as she interacts with students. Distinct influences inform the conceptual framework of this study: (a) the social organization of society at large, governed by understood and unspoken patriarchy, present both academically and socially; (b) the devaluing of women as "knowers" of scientific knowledge as defined by a western and male view of science; (c) the marginalization or "feminization" of education and pedagogical knowledge. The findings reflect tensions between attitudes and beliefs and actual teacher practice suggesting the need for awareness within existing or new teachers about their positions as social agents and the sociological implications related to issues of gender within which we live and work, inclusive of science teaching and learning.
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…
Perkins, Elizabeth B; Oser, Carrie B
Substance abuse counselors who work with offenders are facing increasing caseloads, which puts them at higher risk of job frustration. The purpose of this study was to explore differences between substance abuse counselors employed in prison versus community settings in terms of level of organizational support and job frustration. This study also investigated whether organizational support was associated with job frustration after controlling for counselor characteristics and workplace setting. This was accomplished utilizing data that were collected from 267 counselors as part of the Criminal Justice Drug Abuse Treatment Studies research cooperative. Results indicated that counselors employed in community settings, as compared with those employed in prisons, are more likely to report higher levels of perceived organizational support. In addition, ordinal logistic regression results reveal that counselors who are non-White and have greater levels of organizational support have less job frustration, after controlling for counselor characteristics and workplace setting. The researches to practice implications are discussed.
Perkins, Elizabeth B.; Oser, Carrie B.
Substance abuse counselors who work with offenders are facing increasing caseloads which puts them at higher risk for job frustration. The purpose of this study was to explore differences between substance abuse counselors employed in prison versus community settings in terms of level of organizational support and job frustration. This study also investigated whether organizational support was associated with job frustration after controlling for counselor characteristics and workplace setting. This was accomplished utilizing data that was collected from 267 counselors as part of the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) research cooperative. Results indicated that counselors employed in community settings, as compared to those employed in prisons, are more likely to report higher levels of perceived organizational support. In addition, ordinal logistic regression results reveal that counselors who are non-white and have greater levels of organizational support have less job frustration, after controlling for counselor characteristics and workplace setting. The research to practice implications are discussed. PMID:23525175
Santa-Sosa, Eileen J; Steer, Robert A; Deblinger, Esther; Runyon, Melissa K
Parenting may be one mechanism by which depression in nonoffending mothers impacts child emotional and behavioral adjustment after sexual abuse. This study examined the relationship between self-reported maternal depression and parenting behaviors by nonoffending mothers of children who experienced sexual abuse. The participants were 204 nonoffending biological mother-child pairs recruited from a clinic providing services for children who experienced sexual abuse. The mothers completed pretreatment self-report measures of demographic information, depression, and parenting behaviors. Children (7 to 17 years) completed a measure of mothers' parenting behaviors. Mothers with clinically high levels of self-reported depression employed more inconsistent parenting behavior and provided poorer monitoring/supervision of their children than mothers without clinically high levels of self-reported depression. Implications for clinical practice and future research are discussed.
Through feminist research in the study of sport, the issue of child sexual abuse has been driven onto the agenda of sports organisations, resulting in considerable practical reform (Brackenridge, 2001). However, the flip-side to this development is that the experience of sexually abused males has been largely ignored. In 1990, Struve claimed, "a…
Alexander, Randell A.
This volume is the first of a two-part special issue detailing state of the art practice in medical issues around child sexual abuse. The six articles in this issue explore methods for medical history evaluation, the rationale for when sexual examinations should take place, specific hymenal findings that suggest a child has been sexually abused,…
Kelly, Shirley; Remley, Theodore P., Jr.
Investigated cause of abusive drinking among the elderly and treatment practices and counseling strategies used by professionals who serve them. Structured interviews with six practitioners who were knowledgeable about alcohol abuse among the elderly revealed consensus that alcoholism is a physiological disorder with attendant psychological and…
Kenna, George A; Nielsen, Darci M; Mello, Patricia; Schiesl, Alison; Swift, Robert M
The US FDA has approved a limited number of treatments for alcohol, nicotine and opioid dependence; however, no treatments for other abused drugs such as marijuana, cocaine or methamphetamine are approved. This review focuses on research into drug pharmacotherapies, particularly single-drug therapies, for substance abuse and dependence contributing to the most important dual substance use disorders (SUDs). Given the implications of poly-substance abuse, it is essential that clinicians and researchers be aware of potential pharmacotherapies for the treatment of dual SUDs.A substantial number of patients abuse more than one drug concurrently, complicating the treatment of SUD and leaving clinicians with few FDA-approved drug options for their patients. In this era of evidence-based medicine, such patients are typically treated with therapeutically proven medications, but in ways that are outside the scope of a drug's original indication by the FDA. Such 'off-label' prescribing has become an important therapeutic strategy for practitioners seeking treatments for other diseases in subpopulations such as paediatrics and gerontology or for medical conditions such as oncology or mental illness. Similarly, the information that most clinicians use to make their decisions for treating patients abusing multiple drugs stems from trials treating a single SUD, anecdotal experiences from their own practice or that of their colleagues, or single-case studies reported in the literature. The existing evidence suggests there are few treatments for SUDs that confer significant reductions in substance use across a broad patient population. Moreover, even fewer clinical efficacy trials have been conducted that provide evidence of therapeutic benefit for these drugs. Recognising the difficulty in making the proper drug choice for facilitating maximum treatment success, this review highlights the single drugs or drug combinations that show some potential for treating dual SUDs. This
McIntosh, Diana; Startsman, Laura F.; Perraud, Suzanne
Literature related to primary care and behavioral health integration initiatives is becoming abundant. The United States’ 2010 Patient Protection and Affordable Care Act included provisions encouraging increased collaboration of care for individuals with behavioral and physical health service needs in the public sector. There is relatively little known of Advanced Practice Registered Nurses’ (APRNs) roles with integrating primary and behavioral healthcare. The goal of this review article is to: (a) define integration of physical and behavioral healthcare and potential models; (b) answer the question as to what are effective evidence based models/strategies for integrating behavioral health and primary care; (c) explore the future role and innovations of APRNs in the integration of physical and behavioral healthcare. Results: The evidence- based literature is limited to three systematic reviews and six randomized controlled trials. It was difficult to generalize the data and the effective integration strategies varied from such interventions as care management to use of sertraline to depression management and to access. There were, though, implications for the integrated care advanced practice nurse to have roles inclusive of competencies, leadership, engagement, collaboration and advocacy. PMID:27347258
Karunamoorthi, Kaliyaperumal; Mohammed, Mubarek; Wassie, Fantahun
A study was conducted to assess the knowledge and practices of Ethiopian farmers about pesticide management: implications for human health. A pretested standardized questionnaire was administered. The results revealed that the great majority 174 (99.4%) farmers had ample awareness about pesticide impact on human health. However, various hazardous practices have also been documented. One hundred thirty-five (77.2%) farmers make use of the empty pesticide containers for various household purposes. The most frequent self-reported toxicity symptoms associated with pesticide use were headache (58.8%), salivation and vomiting (38.2%), nausea (36.5%), and sneezing (12.5%). Chi-square analysis revealed a strong association between the farmer's educational status and reported toxicity symptoms (p = .0001; χ(2) = 498.2; df = 30). Creating awareness about safe usage of pesticide is extremely vital by special orientation programs. Besides, promoting alternative pest control strategies such as use of biopesticides and integrated pest management (IPM) could be productive.
Hershenberg, Rachel; Goldfried, Marvin R
The field of psychotherapy is at an important juncture. Recent changes in the field include (a) the skeptical reception of the fifth edition of the Diagnostic and Statistical Manual and (b) NIMH's prioritization of an alternative classification system to guide translational and intervention research. Moreover, (c) the field continues to be held accountable to governmental agencies and third-party payers to demonstrate its empirical basis. Thus, psychological research as it relates to the practice of psychotherapy is at a crossroads. In this article, we provide a brief overview of several generations of psychotherapy outcome research, including the consequences that followed in the 1980s as psychotherapy research moved toward randomized controlled trials for clinical disorders. We delineate the inherent strengths and limitations of this movement and address how the NIMH has recently responded with the Research Domain Criteria (RDoC). We then address philosophical and practical implications of the emphasis on a neuroscientific conceptualization of psychological problems. Finally, we discuss opportunities for a next generation of convergent science that incorporates, rather than replaces, psychosocial variables across stages of translational research and treatment development.
Clark, Phillip G
Health and social care professionals increasingly use narrative approaches to focus on the patient and to communicate with each other. Both effective interprofessional education (IPE) and practice (IPP) require recognizing the various values and voices of different professions, how they relate to the patient's life story, and how they interact with each other at the level of the healthcare team. This article analyzes and integrates the literature on narrative to explore: self-narrative as an expression of one's professional identity; the co-creation of the patient's narrative by the professional and the patient; and the interprofessional multi-vocal narrative discourse as co-constructed by members of the healthcare team. Using a narrative approach to thinking about professional identity, provider-patient communication, and interprofessional teamwork expands our thinking about both IPE and IPP by providing new insights into the nature of professional practice based on relationships to oneself, the patient, and others on the team. How professionals define themselves, gather and present information from the patient, and communicate as members of a clinical team all have important dimensions that can be revealed by a narrative approach. Implications and conclusions for the further development of the narrative approach in IPE and IPP are offered.
This article provides direction regarding the practical implications of undertaking qualitative research within the British Army, and in particular the Defence Medical Services (DMS). Qualitative researchers must gather sufficient data to answer their research question, and guidance on using DMS healthcare professionals as the research sample is offered, including dealing with the 'gatekeepers' who control access, and the principles for creating a conducive environment to gather reliable data. Data collection is often through intensive interviewing where communication skills and personal awareness are vital to a successful study. Aids to a productive study include memo writing and listing factors that may later provide an insight into how the interviewees characterise and describe particular activities, events and groups. Guidance is offered to develop an interview schedule with questions related to each other in a seamless, meaningful way. Both the researcher's and participant's conscious and unconscious biases must be acknowledged. In this narrow and specialist field, DMS researchers need extensive knowledge of clinical practice and the military's distinctive language, characterised with nuances and abbreviations. These words portray meanings and perspectives that signpost the participants' view of their empirical world. Early identification, without having to seek clarification, means that the researcher can examine hidden assumptions in the sample's own language.
This study explores the relationships between Internet abuse (IA)--self-disclosure, online application usage, and relationship types--traditional long-distance, purely virtual, and migratory mixed-mode. An online questionnaire was administered to 2884 children and youth. According to the hypotheses, applications differed in their relationships…
Fisher, William H.; Clark, Robin; Baxter, Jeffrey; Barton, Bruce; O’Connell, Elizabeth; Aweh, Gideon
Persons who abuse opioids or are dependent on opioids are at elevated risk for arrest. Co-occurring behavioral health problems may exacerbate that risk, although the extent of any such increase has not been described. This study examines such risk factors among 40,238 individuals with a diagnosis of opioid abuse or dependence who were enrolled in the Massachusetts Medicaid program in 2010. Medicaid data were merged with statewide arrest data to assess the effects of co-existing mental illness, substance abuse, and previous arrests on arrest during 2010. Persons with serious mental illnesses (psychotic and bipolar disorders) and those with two or more pre-2010 arrests had significantly increased greater odds of arrest. We believe this to be the first study examining effects of co-occurring risk factors on arrest in a large population with opioid dependency/abuse. These findings identify predictors of arrest that could be used to design interventions targeting specific co-occurring risk factors. PMID:25012550
... Whether they're using street drugs or medications, drug abusers often have trouble at school, at home, with ... a short period of time may make a drug abuser aggressive or paranoid. Although stimulant abuse might not ...
Ng, Stella L.; Lingard, Lorelei; Hibbert, Kathryn; Regan, Sandra; Phelan, Shanon; Stooke, Rosamund; Meston, Christine; Schryer, Catherine; Manamperi, Madhushani; Friesen, Farah
Abstract Purpose: School settings are a common practice context for rehabilitation professionals; health advocacy is a common and challenging practice role for professionals in this context. This study explored how pediatric practitioners advocate for children with disabilities at school. Specifically, we examined everyday advocacy in the context of school-based support for children with disabilities. Method: Our theoretical framework and methodological approach were informed by institutional ethnography, which maps and makes visible hidden social coordinators of work processes with a view to improving processes and outcomes. We included families, educators, and health/rehabilitation practitioners from Ontario. Of the 37 consented informants, 27 were interviewed and 15 observed. Documents and texts were collected from the micro-level (e.g. clinician reports) and the macro-level (e.g. policies). Results: Pediatric practitioners' advocacy work included two main work processes: spotlighting invisible disabilities and orienteering the special education terrain. Practitioners advocated indirectly, by proxy, with common proxies being documents and parents. Unintended consequences of advocacy by proxy included conflict and inefficiency, which were often unknown to the practitioner. Conclusions: The findings of this study provide practice-based knowledge about advocacy for children with disabilities, which may be used to inform further development of competency frameworks and continuing education for pediatric practitioners. The findings also show how everyday practices are influenced by policies and social discourses and how rehabilitation professionals may enact change.Implications for RehabilitationRehabilitation professionals frequently perform advocacy work. They may find it beneficial to perform advocacy work that is informed by overarching professional and ethical guidelines, and a nuanced understanding of local processes and structures.Competency frameworks and
Waszkiewicz, Napoleon; Szajda, Sławomir Dariusz; Kępka, Alina; Szulc, Agata; Zwierz, Krzysztof
Up to 30% of all hospital admissions and health-care costs may be attributable to alcohol abuse. Ethanol, its oxidative metabolites, acetaldehyde and ROS (reactive oxygen species), non-oxidative metabolites of alcohol [e.g. FAEEs (fatty acid ethyl esters)] and the ethanol-water competition mechanism are all involved in the deregulation of glycoconjugate (glycoprotein, glycolipid and proteoglycan) metabolic processes including biosynthesis, modification, transport, secretion, elimination and catabolism. An increasing number of new alcohol biomarkers that are the result of alcohol-induced glycoconjugate metabolic errors have appeared in the literature. Glycoconjugate-related alcohol markers are involved in, or are a product of, altered glycoconjugate metabolism, e.g. CDT (carbohydrate-deficient transferrin), SA (sialic acid), plasma SIJ (SA index of apolipoprotein J), CETP (cholesteryl ester transfer protein), β-HEX (β-hexosaminidase), dolichol, EtG (ethyl glucuronide) etc. Laboratory tests based on changes in glycoconjugate metabolism are useful in settings where the co-operativeness of the patient is impaired (e.g. driving while intoxicated) or when a history of alcohol use is not available (e.g. after trauma). In clinical practice, glycoconjugate markers of alcohol use/abuse let us distinguish alcoholic from non-alcoholic tissue damage, having important implications for the treatment and management of diseases.
Norris, Gill; Williams, Steve; Adam-Smith, Derek
Two key issues thrown up by the 1999 introduction of the National Minimum Wage (NMW) in the United Kingdom are its likely impact on employers' training practices in low paying sectors of the economy and the implications for skills. Based on a study of the hospitality industry, this article assesses the limited significance of the differential,…
This study aims to examine kindergarten children's mental models of the day and night cycle and provide implications for pedagogical practices targeting space science concepts in early childhood classrooms. A total of 46 kindergartners participated in the study, their age ranging from 60 to 75 months, including 22 boys and 24 girls.…
This article describes the control-value theory of achievement emotions and its implications for educational research and practice. The theory provides an integrative framework for analyzing the antecedents and effects of emotions experienced in achievement and academic settings. It is based on the premise that appraisals of control and values are…
Feng, Ling; Newton, Derek
The concept of "harmony" was taught by the Chinese sages as the practice of acceptance, tolerance, mutual respect, equality and patience, and is now given great importance by the Chinese government in its attempts to promote the stability and sustainability of the country. The concept could have significant implications for moral…
Douglas, Graeme; McLinden, Mike; Farrell, Ann Marie; Ware, Jean; McCall, Steve; Pavey, Sue
This article considers the concept of access in the education of visually impaired children and young people, with particular reference to print literacy. The article describes implications for teaching and policy at various levels of the educational process: classroom practice; broader teaching and curriculum requirements (including service…
Jwan, Julius Ouma
This paper discusses the contrasting views of what constitutes the "best interests" of students and the implications of such perceptions for leadership practices in secondary schools in Kenya. The paper is based on a study conducted to establish the students', teachers' and principals' perceptions of democratic school leadership--in line…
Arnold, Michael L.; Biscoe, Belinda; Farmer, Thomas W.; Robertson, Dylan L.; Shapley, Kathy L.
Clearly defining what rural means has tangible implications for public policies and practices in education, from establishing resource needs to achieving the goals of No Child Left Behind in rural areas. The word "rural" has many meanings. It has been defined in reference to population density, geographic features, and level of economic…
Boren, John J., Ed.; Onken, Lisa Simon, Ed.; Carroll, Kathleen M., Ed.
The intent of this book is to present information on various counseling approaches for drug abuse used in some of the best known and most respected treatment programs in the United States. In an effort to make the comparison of the various models less difficult and to clarify how the model is applied in practice, each chapter follows a specific…
Winslow, Bradford T; Voorhees, Kenton I; Pehl, Katherine A
Methamphetamine is a stimulant commonly abused in many parts of the United States. Most methamphetamine users are white men 18 to 25 years of age, but the highest usage rates have been found in native Hawaiians, persons of more than one race, Native Americans, and men who have sex with men. Methamphetamine use produces a rapid, pleasurable rush followed by euphoria, heightened attention, and increased energy. Possible adverse effects include myocardial infarction, stroke, seizures, rhabdomyolysis, cardiomyopathy, psychosis, and death. Chronic methamphetamine use is associated with neurologic and psychiatric symptoms and changes in physical appearance. High-risk sexual activity and transmission of human immunodeficiency virus are also associated with methamphetamine use. Use of methamphetamine in women who are pregnant can cause placental abruption, intrauterine growth retardation, and preterm birth, and there can be adverse consequences in children exposed to the drug. Treatment of methamphetamine intoxication is primarily supportive. Treatment of methamphetamine abuse is behavioral; cognitive behavior therapy, contingency management, and the Matrix Model may be effective. Pharmacologic treatments are under investigation.
Plichta, Stacey B.
Extensive research indicates that intimate partner violence (IPV) poses a significant risk to the physical health of women. IPV is associated with increased mortality, injury and disability, worse general health, chronic pain, substance abuse, reproductive disorders, and poorer pregnancy outcomes. IPV is also associated with an overuse of health…
Addai, Amma B; Pandhare, Jui; Paromov, Victor; Mantri, Chinmay K; Pratap, Siddharth; Dash, Chandravanu
Epidemiologic studies suggest that cocaine abuse worsens HIV-1 disease progression. Increased viral load has been suggested to play a key role for the accelerated HIV disease among cocaine-abusing patients. The goal of this study was to investigate whether cocaine enhances proviral DNA integration as a mechanism to increase viral load. We infected CD4(+) T cells that are the primary targets of HIV-1 in vivo and treated the cells with physiologically relevant concentrations of cocaine (1 µM-100 µM). Proviral DNA integration in the host genome was measured by nested qPCR. Our results illustrated that cocaine from 1 µM through 50 µM increased HIV-1 integration in CD4(+) T cells in a dose-dependent manner. As integration can be modulated by several early postentry steps of HIV-1 infection, we examined the direct effects of cocaine on viral integration by in vitro integration assays by use of HIV-1 PICs. Our data illustrated that cocaine directly increases viral DNA integration. Furthermore, our MS analysis showed that cocaine is able to enter CD4(+) T cells and localize to the nucleus-. In summary, our data provide strong evidence that cocaine can increase HIV-1 integration in CD4(+) T cells. Therefore, we hypothesize that increased HIV-1 integration is a novel mechanism by which cocaine enhances viral load and worsens disease progression in drug-abusing HIV-1 patients.
Pandhare, Jui; Addai, Amma B; Mantri, Chinmay K; Hager, Cynthia; Smith, Rita M; Barnett, Louis; Villalta, Fernando; Kalams, Spyros A; Dash, Chandravanu
Substance abuse is a major barrier in eradication of the HIV epidemic because it serves as a powerful cofactor for viral transmission, disease progression, and AIDS-related mortality. Cocaine, one of the commonly abused drugs among HIV-1 patients, has been suggested to accelerate HIV disease progression. However, the underlying mechanism remains largely unknown. Therefore, we tested whether cocaine augments HIV-1-associated CD4(+) T-cell decline, a predictor of HIV disease progression. We examined apoptosis of resting CD4(+) T cells from HIV-1-negative and HIV-1-positive donors in our study, because decline of uninfected cells plays a major role in HIV-1 disease progression. Treatment of resting CD4(+) T cells with cocaine (up to 100 μmol/L concentrations) did not induce apoptosis, but 200 to 1000 μmol/L cocaine induced apoptosis in a dose-dependent manner. Notably, treatment of CD4(+) T cells isolated from healthy donors with both HIV-1 virions and cocaine significantly increased apoptosis compared with the apoptosis induced by cocaine or virions alone. Most important, our biochemical data suggest that cocaine induces CD4(+) T-cell apoptosis by increasing intracellular reactive oxygen species levels and inducing mitochondrial depolarization. Collectively, our results provide evidence of a synergy between cocaine and HIV-1 on CD4(+) T-cell apoptosis that may, in part, explain the accelerated disease observed in HIV-1-infected drug abusers.
Xu, Ke; Lipsky, Robert H
For more than 40 years following its approval by the Food and Drug Administration (FDA) as an anesthetic, ketamine, a non-competitive N-methyl-D-aspartic acid (NMDA) receptor antagonist, has been used as a tool of psychiatric research. As a psychedelic drug, ketamine induces psychotic symptoms, cognitive impairment, and mood elevation, which resemble some symptoms of schizophrenia. Recreational use of ketamine has been increasing in recent years. However, little is known of the underlying molecular mechanisms responsible for ketamine-associated psychosis. Recent animal studies have shown that repeated ketamine administration significantly increases NMDA receptor subunit gene expression, in particular subunit 1 (NR1 or GluN1) levels. This results in neurodegeneration, supporting a potential mechanism where up-regulation of NMDA receptors could produce cognitive deficits in chronic ketamine abuse patients. In other studies, NMDA receptor gene variants are associated with addictive behavior. Here, we focus on the roles of NMDA receptor gene subunits in ketamine abuse and ketamine psychosis and propose that full sequencing of NMDA receptor genes may help explain individual vulnerability to ketamine abuse and ketamine-associated psychosis.
Background Hepatorenal tyrosinaemia (Tyr 1) is a rare inborn error of tyrosine metabolism. Without treatment, patients are at high risk of developing acute liver failure, renal dysfunction and in the long run hepatocellular carcinoma. The aim of our study was to collect cross-sectional data. Methods Via questionnaires we collected retrospective data of 168 patients with Tyr 1 from 21 centres (Europe, Turkey and Israel) about diagnosis, treatment, monitoring and outcome. In a subsequent consensus workshop, we discussed data and clinical implications. Results Early treatment by NTBC accompanied by diet is essential to prevent serious complications such as liver failure, hepatocellular carcinoma and renal disease. As patients may remain initially asymptomatic or develop uncharacteristic clinical symptoms in the first months of life newborn mass screening using succinylacetone (SA) as a screening parameter in dried blood is mandatory for early diagnosis. NTBC-treatment has to be combined with natural protein restriction supplemented with essential amino acids. NTBC dosage should be reduced to the minimal dose allowing metabolic control, once daily dosing may be an option in older children and adults in order to increase compliance. Metabolic control is judged by SA (below detection limit) in dried blood or urine, plasma tyrosine (<400 μM) and NTBC-levels in the therapeutic range (20–40 μM). Side effects of NTBC are mild and often transient. Indications for liver transplantation are hepatocellular carcinoma or failure to respond to NTBC. Follow-up procedures should include liver and kidney function tests, tumor markers and imaging, ophthalmological examination, blood count, psychomotor and intelligence testing as well as therapeutic monitoring (SA, tyrosine, NTBC in blood). Conclusion Based on the data from 21 centres treating 168 patients we were able to characterize current practice and clinical experience in Tyr 1. This information could form the basis for
Patterson, Fiona; Zibarras, Lara Dawn
The ability to innovate is an important requirement in many organisations. Despite this pressing need, few selection systems in healthcare focus on identifying the potential for creativity and innovation and so this area has been vastly under-researched. As a first step towards understanding how we might select for creativity and innovation, this paper explores the use of a trait-based measure of creativity and innovation potential, and evaluates its efficacy for use in selection for healthcare education. This study uses a sample of 188 postgraduate physicians applying for education and training in UK General Practice. Participants completed two questionnaires (a trait-based measure of creativity and innovation, and a measure of the Big Five personality dimensions) and were also rated by assessors on creative problem solving measured during a selection centre. In exploring the construct validity of the trait-based measure of creativity and innovation, our research clarifies the associations between personality, and creativity and innovation. In particular, our study highlights the importance of motivation in the creativity and innovation process. Results also suggest that Openness to Experience is positively related to creativity and innovation whereas some aspects of Conscientiousness are negatively associated with creativity and innovation. Results broadly support the utility of using a trait-based measure of creativity and innovation in healthcare selection processes, although practically this may be best delivered as part of an interview process, rather than as a screening tool. Findings are discussed in relation to broader implications for placing more priority on creativity and innovation as selection criteria within healthcare education and training in future.
Koh, Kyungwon; Rubenstein, Ellen; White, Kelvin
Introduction: This pilot study examined how current information behaviour research addresses the implications and potential impacts of its findings. The goal was to understand what implications and contributions the field has made and how effectively authors communicate implications of their findings. Methods: We conducted a content analysis of 30…
Clatts, Michael C.; Giang, Le M.; Goldsamt, Lloyd A.; Yi, Huso
This article describes an ethno-epidemiologic study of injection-mediated behavioral risks in an out-of-treatment population of young heroin users in Hanoi, Vietnam (N=1270). Included is a preliminary epidemiologic profile of the novel use of an injection sac, a soft tissue portal that injectors in Hanoi employ as a means of gaining rapid and reliable access to a vein and also as a means of ameliorating high risk for vein damage associated with co-morbid use of Promethazine. Data from a large cross-sectional survey were used to describe behavioral and disease correlates associated with the use of an injection sac. Additionally, data from an ethnographic substudy were used to elaborate injectors' rationales for creating and employing an injection sac, and to illustrate influences of the local physical and social environment on injection practices and transmission dynamics. Implications for risk for HIV and other bloodborne pathogens are considered, including the urgent need for both structural and behavioral interventions with which to reduce injection-mediated harm. PMID:17543715
Ewens, Beverley; Hendricks, Joyce; Sundin, Deb
Background Intensive care unit survivors face many physical and psychological difficulties during their recovery following discharge from hospital. These difficulties can significantly affect their quality of life. Healthcare providers and survivors' families often do not understand what recovery means in this population, which may affect the support provided. Aim To consider the potential of the biographical method in helping to create stories that illustrate recovery in intensive care survivors and other populations. Discussion This paper identifies how the biographical approach has provided survivors with a way to uncover the hidden parts of their lives through diaries and interviews, and reveal the hidden stories of intensive care survivorship and recovery. Conclusion The application of the biographical method enabled stories to be created that identified the disruption survivors encounter as they struggle to appear recovered. Implications for practice The biographical method can illuminate experiences uncaptured by other methods. This insight into recovery journeys can help healthcare practitioners and family members to understand and recognise the need for support during recovery.
Mercieca, Cecilia; van der Horst-Bruinsma, Irene E; Borg, Andrew A
Ankylosing spondylitis (AS) is associated with several comorbidities which contribute significantly to morbidity and mortality and add to the complexity of management. In addition to the well known extra-articular manifestations and increased cardiovascular risk, several pulmonary, renal, and neurological complications which have been associated with AS deserve equal attention. Whereas a clear link has been established for some manifestations, the evidence for other associations is less clear. Interstitial lung disease, apical fibrosis, secondary infection, and ventilatory restriction from reduced chest wall movement are well known pulmonary complications; more recently an association with sleep apnoea has been suggested. Renal amyloidosis and IgA nephropathy remain a treatment challenge which may respond to anti-TNF therapy. Atlanto axial subluxation and vertebral fractures can result in serious neurological complications and are notoriously difficult to diagnose unless a high level of suspicion is maintained. Despite several reports linking AS with demyelination a true link remains to be proved. This review discusses the prevalence, pathophysiology, and management of pulmonary, renal, and neurological complications, and implications for clinical practice.
Vidal-Liñán, Leticia; Bellas, Juan
Biomarkers are required to assess the biological effects of pollutants on marine organisms in order to monitor ecosystem status, but their use is often limited by their strong variability due to environmental and/or intrinsic biological factors. Accordingly, the main aim of this work was to set up practical procedures for a battery of widely used biomarkers in mussels (Mytilus galloprovincialis). Antioxidant enzymes (catalase [CAT] and glutathione peroxidase [GPx]), a phase II detoxification enzyme (glutathione S-transferase [GST]) and a neurotransmitter catabolism enzyme (acetylcholinesterase [AChE]), were considered. Several relevant aspects were studied in order to obtain a more realistic interpretation of biomarker responses, including the calculation of the minimum sample size required to estimate the population mean with a fixed error margin, the selection of the specific organ or tissue where the enzymatic activity is higher for each biomarker, and the influence of tidal height and temperature on the basal enzymatic activity. GST and CAT activities needed a minimum sample size of 12, whereas for GPx and AChE activities a minimum sample size of 14 was required. The gills were the organ with higher GST, GPx and AChE enzymatic activities, whereas the digestive gland showed the highest CAT activity. Also, the low inter-tidal was the recommended tide level whilst no significant effect of temperature was observed on GST, GPx and CAT, and no clear pattern could be identified for AChE. The implications for environmental monitoring are discussed.
El Ansari, Walid; Oskrochi, Reza
Student satisfaction has been widely recognised as an indicator of the quality of the students' learning and teaching experience. The aim of the study was to explore the extent to which student satisfaction is influenced by 13 demographic- and educational-related variables. A cross-sectional survey was undertaken (18-item questionnaire, 1660 questionnaires). Principal component analysis categorised the 18 items into four learning and teaching dimensions. Each of the 13 variables was analysed for its influence on student satisfaction generally and on the four dimensions individually, before and after controlling for all the other variables. After controlling for all the variables, none of the demographic characteristics was associated with satisfaction. Most of the educational variables exercised their own independent and significant effects on general satisfaction and on satisfaction with the four individual dimensions. Collectively, decreased satisfaction was associated with being a pre registration, full-time student, usually with A level entry qualifications, attending term two modules whose assessment/s comprised combined strategies. Decreased satisfaction was also significantly associated with larger class sizes as regards the student numbers and with attaining lower grades in the assessments. The demographic variables were not as influential as the educational ones as regards the affects on students' satisfaction. The implications of the findings for research and practice are discussed.
Rackham, Daniel M; C Herink, Megan; Stevens, Ian G; Cardoza, Natalie M; Singh, Harleen
The U.S. Food and Drug Administration (FDA) periodically publishes Drug Safety Communications and Drug Alerts notifying health care practitioners and the general public of important information regarding drug therapies following FDA approval. These alerts can result in both positive and negative effects on patient care. Most clinical trials are not designed to detect long-term safety end points, and postmarketing surveillance along with patient reported events are often instrumental in signaling the potential harmful effect of a drug. Recently, many cardiovascular (CV) safety announcements have been released for FDA-approved drugs. Because a premature warning could discourage a much needed treatment or prompt a sudden discontinuation, it is essential to evaluate the evidence supporting these FDA alerts to provide effective patient care and to avoid unwarranted changes in therapy. Conversely, paying attention to these warnings in cases involving high-risk patients can prevent adverse effects and litigation. This article reviews the evidence behind recent FDA alerts for drugs with adverse CV effects and discusses the clinical practice implications.
This paper begins with an overview of contemporary approaches to archetype theory and notes the radical nature of certain deductions. Some argue that there is no 'archetype-as-such' as a pre-existing entity at the core of a complex driving its formation whilst the findings of current neuroscience are calling into question one very thing on which the classical theory is built--innatism. Knox's argument for image schemas raises the question as to the extent to which archetypes can be conceived in any preformationist sense. The question is then posed--to what extent can Jung's classical theory of archetypes be read in light of these current models? The case examples Jung uses to evidence the existence of archetypes, his explications of synchronicity and his own Philemon experience are then reappraised. The conclusion is drawn that it is difficult to evidence the existence of autonomous archetypes unrelated to personal affective experience. Not only would this be expected by emergent/developmental models of archetype but it can explain many of Jung's disjunctive statements about archetype constellation; the difficulties in separating personal and collective psychic content and Jung's apparent Lamarckianism. The implications of these models for theory, clinical practice and analyst training are then offered for discussion.
Evidence that some executed prisoners suffered excruciating pain has reinvigorated the ethical debate about physician participation in executions. In widely publicized litigation, death row inmates argue that participation of anesthesiologists in their execution is constitutionally required to minimize the risk of unnecessary suffering. For many years, commentators supported the ethical ban on physician participation reflected in codes of professional medical organizations. However, a recent wave of scholarship concurs with inmate advocates, urging the law to require or permit physician participation. Both the anti- and pro-physician-participation literature share a common premise: the ethics of physician participation should be analyzed independently from the moral status of capital punishment. This considerable literature implausibly divorces the ethics of physician participation from the moral status of the death penalty. Any ethical position on physician involvement requires some judgment about the moral status of capital punishment. The article examines anti- and pro-participation arguments to show that each one either is unpersuasive without discussion of the death penalty's moral status or implicitly assumes a view on the social worth of the death penalty. The article then articulates the practical implications of its arguments for both lawmakers and professional medical organizations.
McSweeney, Frances K.
Reinforcers lose their effectiveness when they are presented repeatedly. Early researchers labeled this loss of effectiveness as satiation without conducting an experimental analysis. When such an analysis is conducted, habituation provides a more precise and empirically accurate label for the changes in reinforcer effectiveness. This paper reviews some of the data that suggest that habituation occurs to repeatedly presented reinforcers. It also argues that habituation has surprisingly different implications than satiation for theory and practice in behavior analysis. For example, postulating that habituation occurs to repeatedly presented reinforcers suggests ways for maintaining the strength of an existing reinforcer and for weakening the strength of a problematic reinforcer that differ from those implied by an account in terms of satiation. An habituation account may also lead to different ways of conceptualizing the regulation of behavior. For example, habituation may be a single-process contributor to the termination of behaviors that are usually attributed to satiation (e.g., ingestive behaviors such as eating and drinking), fatigue (e.g., energetic behaviors such as running), the waning of attention (e.g., cognitive behaviors such as studying), and pharmacodynamic factors (e.g., drug taking). PMID:22478427
Mailloux, Donna L; Serin, Ralph C
Hostage takings and forcible confinements are rare phenomena within our Canadian institutions. However, when they occur they cause enormous psychological and/or physical harm. A review of the literature revealed that no previous research on hostage takings or forcible confinements in a prison setting has been published. This investigation reviewed 33 hostage-takings/forcible-confinements spanning 11 years. The incidents were classified as follows: 20 hostage takings (3 with sexual assault) and 13 forcible confinements (7 with sexual assault). Sexual assaults were always against women and 36.6% of the women were sexually assaulted. This is a violent group of offenders with a prior history of sexual and nonsexual violence as well as escapes. While a quarter of the perpetrators had a forcible confinement or hostage taking in their current conviction, half had a prior history of such incidents. Rapists were overwhelmingly implicated in incidents that resulted in a sexual assault. Most perpetrators were below the age of 30 and serving sentences of less than 10 years in medium- or maximum-security institutions. The perpetrators of these incidents are not necessarily different from the general population of offenders in terms of their dynamic needs. Although this research is primarily descriptive in nature, it offers a unique contribution to the field by providing the first comprehensive description of this group of perpetrators. These findings are discussed in terms of their relevance to policy, operational practices, and the development of screening instruments.
Carroll, Bob; Balogh, Ruth; Morbey, Hazel; Araoz, Gonzalo
Carlisle in northwest England suffered its worse floods for more than 180 years in 2005. A study, reported here, was undertaken to assess the health and social impacts of these floods via in-depth, taped individual and focus-group interviews with people whose homes had been flooded and with agency workers who helped them. Respondents spoke of physical health ailments, psychological stress, water health-and-safety issues related to the floods, and disputes with insurance and construction companies, which they felt had caused and exacerbated psychological health problems. Support workers also suffered from psychological stress. Furthermore, it was found that people had low expectations of a flood and were not prepared. The findings are presented in five sections covering flood risk awareness, water contamination issues, physical health, mental health, and impact on frontline support workers. The discussion focuses on the implications of the findings for policy and practice vis-à-vis psychological health provision, contamination issues, training and support for frontline support workers, matters relating to restoration, and preparation for flooding.
Jones, Terry L.
Topic Nursing time has relevance for those who produce it, those who receive it and those who must pay for it. Though the term nursing time may be commonly used, a common understanding of the concept within the fields of nursing and healthcare administration is lacking. Purpose The purposes of this paper are to explore the concept of nursing time and to identify implications for theory development, clinical and administrative practice, and research. Discussion Both physical and psychological forms of time are viewed as fundamental to our experience of time as social beings. Nursing time has significant intrinsic and instrumental value in nursing and healthcare. A holistic approach incorporating the physical, psychological, and sociological aspects and dimensions of nursing time is advocated. Conclusions Multiple strategies to enhance the patient experience of nursing time are warranted and should address how much time nurses spend with patients as well as how they spend that time. Patterns of overlapping and competing time structures for nurses should be identified and evaluated for their effect on physical time available for patient care and the psychological experiences of time by nurses and patients. PMID:20690994
Peel, Elizabeth; Taylor, Helen; Harding, Rosie
The needs of lesbian, gay, bisexual and trans (LGBT) people with dementia are poorly recognised. This is due partly to assumptions that all older people are heterosexual or asexual. One quarter of gay or bisexual men and half of lesbian or bisexual women have children, compared with 90% of heterosexual women and men, which means LGBT older adults are more likely to reside in care homes. Older LGBT people may be unwilling to express their sexual identities in care settings and this can affect their care. Members of older people's informal care networks must be recognised to ensure their involvement in the lives of residents in care settings continues. However, healthcare professionals may not always realise that many LGBT people rely on their families of choice or wider social networks more than on their families of origin. This article explores sociolegal issues that can arise in the care of older LGBT people with dementia, including enabling autonomy, capacity and applying legal frameworks to support their identities and relationships. It also highlights implications for practice.
We investigated whether and how a juvenile’s history of experiencing sexual abuse affects public perceptions of juvenile sex offenders in a series of 5 studies. When asked about juvenile sex offenders in an abstract manner (Studies 1 and 2), the more participants (community members and undergraduates) believed that a history of being sexually abused as a child causes later sexually abusive behavior, the less likely they were to support sex offender registration for juveniles. Yet when participants considered specific sexual offenses, a juvenile’s history of sexual abuse was not considered to be a mitigating factor. This was true when participants considered a severe sexual offense (forced rape; Study 3 and Study 4) and a case involving less severe sexual offenses (i.e., statutory rape), when a juvenile’s history of sexual abuse backfired and was used as an aggravating factor, increasing support for registering the offender (Study 3 and Study 5). Theoretical and practical implications of these results are discussed. PMID:26074717
The sale of over-the-counter (OTC) medicines from community pharmacies offers important opportunities for members of the public to access medicines and self-treat conditions. They are increasingly recognised, however, as having the potential for abuse and harm despite their perceived relative safety. This study reports on a qualitative study that explored the experiences and views of community pharmacy staff in relation to current practices and concerns, management and support relating to OTC medicine abuse. Semi-structured interviews were undertaken with a purposive sample of ten pharmacists and seven medicines counter assistants in the United Kingdom. Analysis of interviews indicated that a range of medicines was implicated, including opiates, sedative antihistamines, laxatives and decongestants. A surveillance role was apparent for assistants, who placed emphasis on regulations, procedure and monitoring frequency of purchases to manage abuse, with referral on to pharmacists. Frequency of purchase was central to assistants' definition of those suspected of OTC medicine abuse, which pharmacists also utilised as well as a distinction between intentional abuse and unintentional medicine misuse. A lack of information about customers, easy access to, and poor communication between community pharmacies were emergent barriers to pharmacists providing more support. Many appeared uncertain of referral options or how pharmacists could effectively stop the problem of abuse. The commercial environment was a particular concern, in relation to customer expectations, medicine advertising and easy access to different community pharmacies. A key tension emerged between providing medicine supplies that permitted consumer freedom, with the needs of healthcare professionals to understand more about those consumers qua patients. Policy implications include the need for improved knowledge for community pharmacy staff about signposting to relevant services, increased awareness of who
Puhl, Matthew D; Berg, Alexandra R; Bechtholt, Anita J; Coyle, Joseph T
Schizophrenia is associated with high prevalence of substance abuse. Recent research suggests that dysregulation of N-methyl-d-aspartate receptor (NMDAR) function may play a role in the pathophysiology of both schizophrenia and drug addiction, and thus, may account for this high comorbidity. Our laboratory has developed two transgenic mouse lines that exhibit contrasting NMDAR activity based on the availability of the glycine modulatory site (GMS) agonists d-serine and glycine. Glycine transporter 1 knockdowns (GlyT1(+/-)) exhibit NMDAR hyperfunction, whereas serine racemase knockouts (SR(-/-)) exhibit NMDAR hypofunction. We characterized the behavior of these lines in a cocaine-induced (20 mg/kg) conditioned place preference (CPP) and locomotor sensitization paradigm. Compared with wild-type mice, GlyT1(+/-) mice displayed hastened extinction of CPP and robust cocaine-induced reinstatement. SR(-/-) mice appeared to immediately "forget" the learned preference, because they did not exhibit cocaine-induced reinstatement and also displayed attenuated locomotor sensitization. Treatment of GlyT1(+/-) mice with gavestinel (10 mg/kg on day 1; 5 mg/kg on days 2-17), a GMS antagonist, attenuated cocaine-induced CPP and caused them to immediately "forget" the learned preference. Treatment of SR(-/-) mice with d-serine (300 mg/kg on day 1; 150 mg/kg on days 2-17) to normalize brain levels caused them to avoid the cocaine-paired side of the chamber during extinction. These results highlight NMDAR dysfunction as a possible neural mechanism underlying comorbid schizophrenia and substance abuse. Also, these findings suggest drugs that directly or indirectly activate the NMDAR GMS could be an effective treatment of cocaine abuse.
Alessi, Edward J; Kahn, Sarilee; Chatterji, Sangeeta
Numerous studies demonstrate that lesbian, gay, bisexual, and transgender (LGBT) children and youth are likely to experience abuse by peers, parents, and other adults and that these experiences correlate with a host of mental health problems. However, there is little understanding of the experiences of LGBT children and youth living in countries where social and legal protections for sexual and gender minorities are limited or nonexistent. This qualitative study used thematic analysis to explore the child and adolescent abuse experiences and their impact on the pre-migration mental health of LGBT forced migrants. We analyzed 26 interviews with individuals who obtained refugee or asylee status in the United States or Canada on the basis of sexual orientation or gender identity. Participants originated from countries in Asia, Africa, the Caribbean, Eastern Europe, Latin America, and the Middle East. Analysis revealed the following themes: abuse by parents and caregivers, abuse by peers and school personnel, having nowhere to turn, and dealing with psychological distress. Findings indicate that participants experienced severe verbal, physical, and sexual abuse throughout childhood and adolescence and that this abuse occurred at home, in school, and in the community. Furthermore, there were no resources or sources of protection available to them. Participants linked their abuse to subjective experiences of depression, anxiety, and traumatic stress, as well as suicidal ideation and suicide attempts. We conclude with implications for refugee adjudication practices, mental health care, and international policy.
Wunsch, Martha J; Nakamoto, Kent; Goswami, Anil; Schnoll, Sidney H
Non-medical use of prescription medications is on the rise across the U.S., particularly in rural areas. In this study of 233 prisoners and probationers in southwestern Virginia, we add to an emerging profile of individuals abusing prescription medications. In this retrospective review of 2000-2004 augmented Addiction Severity Index data, those abusing prescription medications reported increased illicit drug and alcohol abuse, poly-drug abuse, psychiatric problems, and arrests for property crimes. Forty percent reported abuse of OxyContin, a drug implicated in a number of deaths in this region. Compared to non-users, OxyContin users were younger, more likely to be female, and more likely to abuse benzodiazepines, methadone, cocaine, and heroin. Longevity of abuse of these other drugs belies suggestions that OxyContin was acting as a "gateway" drug leading naïve users into addiction and risk of death.
Chau, T T; Bruckard, W J; Koh, P T L; Nguyen, A V
Contact angle and the wetting behaviour of solid particles are influenced by many physical and chemical factors such as surface roughness and heterogeneity as well as particle shape and size. A significant amount of effort has been invested in order to probe the correlation between these factors and surface wettability. Some of the key investigations reported in the literature are reviewed here. It is clear from the papers reviewed that, depending on many experimental conditions such as the size of the surface heterogeneities and asperities, surface cleanliness, and the resolution of measuring equipment and data interpretation, obtaining meaningful contact angle values is extremely difficult and such values are reliant on careful experimental control. Surface wetting behaviour depends on not only surface texture (roughness and particle shape), and surface chemistry (heterogeneity) but also on hydrodynamic conditions in the preparation route. The inability to distinguish the effects of each factor may be due to the interplay and/or overlap of two or more factors in each system. From this review, it was concluded that: Surface geometry (and surface roughness of different scales) can be used to tune the contact angle; with increasing surface roughness the apparent contact angle decreases for hydrophilic materials and increases for hydrophobic materials. For non-ideal surfaces, such as mineral surfaces in the flotation process, kinetics plays a more important role than thermodynamics in dictating wettability. Particle size encountered in flotation (10-200 microm) showed no significant effect on contact angle but has a strong effect on flotation rate constant. There is a lack of a rigid quantitative correlation between factors affecting wetting, wetting behaviour and contact angle on minerals; and hence their implication for flotation process. Specifically, universal correlation of contact angle to flotation recovery is still difficult to predict from first principles
Mossbridge, Julia A.; Tressoldi, Patrizio; Utts, Jessica; Ives, John A.; Radin, Dean; Jonas, Wayne B.
A recent meta-analysis of experiments from seven independent laboratories (n = 26) indicates that the human body can apparently detect randomly delivered stimuli occurring 1–10 s in the future (Mossbridge etal., 2012). The key observation in these studies is that human physiology appears to be able to distinguish between unpredictable dichotomous future stimuli, such as emotional vs. neutral images or sound vs. silence. This phenomenon has been called presentiment (as in “feeling the future”). In this paper we call it predictive anticipatory activity (PAA). The phenomenon is “predictive” because it can distinguish between upcoming stimuli; it is “anticipatory” because the physiological changes occur before a future event; and it is an “activity” because it involves changes in the cardiopulmonary, skin, and/or nervous systems. PAA is an unconscious phenomenon that seems to be a time-reversed reflection of the usual physiological response to a stimulus. It appears to resemble precognition (consciously knowing something is going to happen before it does), but PAA specifically refers to unconscious physiological reactions as opposed to conscious premonitions. Though it is possible that PAA underlies the conscious experience of precognition, experiments testing this idea have not produced clear results. The first part of this paper reviews the evidence for PAA and examines the two most difficult challenges for obtaining valid evidence for it: expectation bias and multiple analyses. The second part speculates on possible mechanisms and the theoretical implications of PAA for understanding physiology and consciousness. The third part examines potential practical applications. PMID:24723870
Fontes-Carvalho, Ricardo; Albuquerque, Aníbal
Recent studies have raised the concern that proton pump inhibitors (PPIs) could potentially interfere with clopidogrel antiplatelet effect. This association is frequent in clinical practice and is recommended by recent consensus guidelines in patients taking dual antiplatelet therapy to prevent gastrointestinal (GI) bleeding. Clopidogrel is a pro-drug which needs to be metabolized into its active metabolite, by cytochrome P450, especially by CYP2C19 isoenzyme. Various PPIs can inhibit CYP2C19, which could possibly decrease clopidogrel bioactivation process and, therefore, its antiplatelet effect. Various platelet function studies have shown that omeprazol can significantly decrease clopidogrel inhibitory effect on platelet P2Y12 receptor, leading to an increase in the number of patients who are "nonresponders" to clopidogrel. These pharmacokinetic studies also shown that this is not probably a class effect of PPIs, because they are metabolized to varying degrees by CYP2C19. The clinical impact of these observations remains uncertain, because various observational studies have shown conflicting results, and remains to demonstrate if PPIs can really increase the risk of cardiovascular events in patients taking clopidogrel. In this review we will discuss the pharmacokinetic basis underlying this drug interaction, the effect of different PPIs on platelet function tests and we will analyze in detail the potential clinical implications of using this association, both on cardiovascular and gastrointestinal events. Until further data is available, some clinical strategies can be recommended: (1) individual gastrointestinal risk assessment, with PPIs administration only to patients on dual anti-platelet therapy with additional GI risk factors; (2) preferential use of PPIs that have shown less interference with clopidogrel efficacy; (3) wide separation of PPI and clopidogrel dosing to minimize the risk of interaction (PPI may be given before breakfast and clopidogrel at
Strategic Materials Usage. Practical Implications of the Use of Aluminide Coatings for the Corrosion Protection of Superalloys in Gas Turbines. Coatings ... Aluminide protective coatings have been in use on nickel a superalloys in gas turbines with a considerable degree of As a result a considerable amount of...used for the application of aluminide coatings to superalloy substitutes are those of chemical vapour deposition (CVÜ
Cosden, M; Cortez-Ison, E
Residential programs that provide safe environments and child care can attract perinatal women into treatment. Other factors, however, may prevent some women from benefiting from these programs. Attachment theory suggests that one's early history determines the effectiveness with which one can utilize available social supports. Lower levels of program retention were predicted for women who had been sexually abused and for those who had poor early bonding. Eighty-four women in residential substance abuse treatment programs were studied. Clients who reported sexual abuse also reported lower parental care. Parental care and overprotection were inversely related, and related, in predicted directions, to perceptions of social supports. Sexual abuse alone was associated with time in treatment and the likelihood of graduation. Implications for developing effective counseling programs for women in substance abuse treatment are discussed.
Libby, Anne M.; Orton, Heather D.; Beals, Janette; Buchwald, Dedra; Manson, Spero M.; Team, AI-SUPERPFP
Objectives To examine the relationship of childhood physical and sexual abuse with reported parenting satisfaction and parenting role impairment later in life among American Indians (AIs). Methods AIs from Southwest and Northern Plains tribes who participated in a large-scale community-based study (n = 3,084) were asked about traumatic events and family history; those with children were asked questions about their parenting experiences. Regression models estimated the relationships between childhood abuse and parenting satisfaction or parenting role impairment, and tested for mediation by depression or substance use disorders. Results Lifetime substance use disorder fully mediated the relationship between childhood physical abuse and both parenting satisfaction and parenting role impairment in the Northern Plains tribe. There was only partial mediation between childhood sexual abuse and parenting role impairment in the Southwest. In both tribes, lifetime depression did not meet the criteria for mediation of the relationship between childhood abuse and the two parenting outcomes. Instrumental and perceived social support significantly enhanced parenting satisfaction; negative social support reduced satisfaction and increased the likelihood of parenting role impairment. Exposure to parental violence while growing up had deleterious effects on parenting outcomes. Mothers and fathers did not differ significantly in the relation of childhood abuse experience and later parenting outcomes. Conclusions Strong effects of social support and mediation of substance abuse disorders in the Northern Plains offer direct ways in which childhood victims of abuse could be helped to avoid negative attributes of parenting that could put their own children at risk. Practice implications Mothers were not significantly different from fathers in the relation of abusive childhood experiences and later parenting outcomes, indicating both are candidates for interventions. Strong effects of
Malik, Shaily; Khalique, Hena; Buch, Shilpa; Seth, Pankaj
The neuropathological abnormalities of human immunodeficiency virus (HIV)-1 patients abusing illicit drugs suggest extensive interactions between the two agents, thereby leading to increased rate of progression to neurodegeneration. The role of HIV-1 transactivating protein, Tat has been elucidated in mediating neuronal damage via apoptosis, a hallmark of HIV-associated dementia (HAD), however the underlying mechanisms involved in enhanced neurodegeneration by illicit drugs remain elusive. In this study, we demonstrated that morphine enhances HIV-Tat induced toxicity in human neurons and neuroblastoma cells. Enhanced toxicity by Tat and morphine was accompanied by increased numbers of TUNEL positive apoptotic neurons, elevated caspase-3 levels and decreased ratio of anti- and pro-apoptotic proteins, Bcl2/Bax. Tat and morphine together elicited high levels of reactive oxygen species that were NADPH dependent. Significant alterations in mitochondrial membrane homeostasis were also observed with co-exposure of these agents. Extensive studies of mitogen activated protein kinase (MAPK) signaling pathways revealed the involvement of c-Jun N-terminal kinase (JNK) and extracellular signal-regulated kinase-1/2 (ERK1/2) pathways in enhanced toxicity of Tat and morphine. In addition to this, we found that pre-treatment of cells with platelet derived growth factor (PDGF-BB) protected neurons from HIV-Tat and morphine induced damage. PDGF-BB alleviated ROS production, maintained mitochondrial membrane potential, decreased caspase-3 activation and hence protected the cells from undergoing apoptosis. PDGF-BB mediated protection against Tat and morphine involved the phosphatidylinositol–3 kinase (PI3K) pathway, as specific inhibitor of PI3K abrogated the protection conferred by PDGF-BB. This study demonstrates the mechanism of enhanced toxicity in human neurons subjected to co-exposure of HIV protein Tat and morphine, thus implying its importance in HIV positive drug abusers
Draucker, C B
Many American women who were sexually abused as children seek mental health services to help them heal from their abuse. An appreciation of the varied sources of trauma that may stem from a sexual abuse experience may guide clinicians in facilitating a meaningful discussion with survivors of the ways in which their childhood development and their current lives have been influenced by their sexual abuse. Therefore, the goal of this study was to provide a beginning delineation of possible sources of trauma in the abuse situation, based on the retrospective reflections of women who have survived abuse. One hundred and eighty-six survivors were asked to identify the most traumatic aspects of their abuse experience. A content analysis was performed on their written responses, and the following eight categories, reflecting different sources of trauma, were identified: abandonment, powerlessness, violence, betrayal, guilt and shame, loss of self, loss of childhood, and impact on sexual adjustment. Possible treatment implications and suggestions for future research are discussed.
Iachini, Aidyn L.; Anderson-Butcher, Dawn; Mellin, Elizabeth A.
School-based teams are central to referrals, problem solving and decision-making in school mental health (SMH). Although the use of teams in SMH appears commonplace, research on these teams, however, is much more limited in scope. Using best practice teaming principles as a conceptual framework, this exploratory study examined the purpose,…
Baca, Leonard M.
Current issues involved in the identification and assessment of Limited-English-Proficient (LEP) students being considered for special services are reviewed. Focus is on the characteristics of the at-risk LEP students, who are often placed in special education programs. A theoretical framework to guide research and practice in this field is…
Adams, Nancy E.
Evidence-based practice (EBP), like information literacy, is concerned with an individual's knowledge, skills, and attitudes relating to using information. EBP is now a professional competency in fields as diverse as social work, nursing and allied health fields, and public policy. A comparison of the Association of College and Research Libraries'…
Dell, Colleen Anne; Seguin, Maureen; Hopkins, Carol; Tempier, Raymond; Mehl-Madrona, Lewis; Dell, Debra; Duncan, Randy; Mosier, Karen
First Nations and Inuit youth who abuse solvents are one of the most highly stigmatized substance-abusing groups in Canada. Drawing on a residential treatment response that is grounded in a culture-based model of resiliency, this article discusses the cultural implications for psychiatry's individualized approach to treating mental disorders. A systematic review of articles published in The Canadian Journal of Psychiatry during the past decade, augmented with a review of Canadian and international literature, revealed a gap in understanding and practice between Western psychiatric disorder-based and Aboriginal culture-based approaches to treatment and healing from substance abuse and mental disorders. Differing conceptualizations of mental health and substance abuse are discussed from Western psychiatric and Aboriginal worldviews, with a focus on connection to self, community, and political context. Applying an Aboriginal method of knowledge translation-storytelling-experiences from front-line workers in a youth solvent abuse treatment centre relay the difficulties with applying Western responses to Aboriginal healing. This lends to a discussion of how psychiatry can capitalize on the growing debate regarding the role of culture in the treatment of Aboriginal youth who abuse solvents. There is significant need for culturally competent psychiatric research specific to diagnosing and treating First Nations and Inuit youth who abuse substances, including solvents. Such understanding for front-line psychiatrists is necessary to improve practice. A health promotion perspective may be a valuable beginning point for attaining this understanding, as it situates psychiatry's approach to treating mental disorders within the etiology for Aboriginal Peoples.
Barton, W I
A survey by the Department of Justice in 1978 of inmates of local jails in the United States found that 68% had ever used drugs like heroin, cocaine, marijuana, amphetamines, or barbiturates outside a treatment program, and without a doctor's prescription. Offenses for which relatively larger proportions of inmates reported drug use included robbery, burglary, auto theft, larceny, and drug offenses. During the month prior to jail, 44% of inmates reported using drugs. Some 21% of convicted inmates reported being under the influence of drugs at the time of an offense for which convicted. One-fourth of inmates reporting drug use had ever been enrolled in drug treatment. Treatment and rehabilitation of the drug abuser in a jail setting is discussed.
Miedema, Baukje; Hamilton, Ryan; Lambert-Lanning, Anita; Tatemichi, Sue R.; Lemire, Francine; Manca, Donna; Ramsden, Vivian R.
ABSTRACT OBJECTIVE To examine the career prevalence of abusive encounters for family physicians in Canada. DESIGN A 7-page cross-sectional mailed survey in English and French. SETTING Canada. PARTICIPANTS A total of 3802 randomly selected practising family physicians who were members of the College of Family Physicians of Canada. MAIN OUTCOME MEASURES Demographic characteristics of survey participants, career prevalence of abusive encounters, and perpetrators of abuse. MAIN FINDINGS Twenty percent (20.4%) of the surveys (n = 774) were returned. Of the respondents, 44% were men and 56% were women. Most were in private practice in urban settings. The average number of years in practice was 15. The career prevalence of abusive encounters was divided into “minor,” “major,” and “severe” incidents. Of all the respondents, 98% had experienced at least 1 incident of minor abuse, 75% had experienced at least 1 incident of major abuse, and 39% had experienced at least 1 incident of severe abuse. Using χ2 analysis, a number of demographic variables were found to be significantly associated with abuse including the physician’s race and sex. Patients were the most common perpetrators of abuse. Ninety percent of family physicians surveyed reported that they had been abused by patients, while 70% reported that they had been abused by family members of patients. CONCLUSION Approximately 2 in 5 family physicians surveyed were subjected to a considerable amount of severe abuse during practice. Abuse in the office setting might have grave consequences for the health and well-being of the victimized physicians and might hinder service retention where the risk of abuse is greatest. PMID:20228289
The phenomenon of child sexual abuse has significant implications for teachers' pre-service training and professional development. Teachers have a pedagogical role in dealing with abused children, and a legal and professional duty to report suspected child sexual abuse. Teachers require support and training to develop the specialised knowledge and…
Chandler, Nichelle; Balkin, Richard S.; Perepiczka, Michelle
This nationwide, quantitative study documented licensed counselors' perceived self-efficacy of adequately providing substance abuse services. Despite their lack of substance abuse training, counselors were highly confident in their ability to provide quality substance abuse services. Counselor training implications are discussed. (Contains 3…
Arluke, Arnold; Levin, Jack; Luke, Carter; Ascione, Frank
Criminal records of 153 animal abusers and 153 control participants were tracked and compared. Animal abusers were more likely to commit property offenses, drug offenses, and public disorder offenses. Thus, results show an association between animal abuse and a variety of antisocial behavior, but not violence alone. Implications of these findings…
Krugman, Richard D; Bross, Donald C
Neurosurgeons that see children and care for those with traumatic injury are highly likely to see cases of child abuse and neglect. That fact makes it inevitable that they will encounter the legal system. It is hoped that this article has demystified the legal process and systems that one encounters in day-to-day practice. Avoiding the diagnosis of abuse because of lack of knowledge or phobia of the legal system is hazardous to the health and well-being of children.
Keenan, Heather T; Campbell, Kristine A
Child abuse pediatricians have multiple roles in caring for abused children, including prevention, diagnosis, treatment, and, when needed, expert legal opinion. The child physical abuse consultation differs from the traditional medical consultation in that it has medical, investigative and legal audiences, all of whom have different information needs. How child abuse pediatricians approach their cases and how they document their initial inpatient consultations that will be used by such a diverse audience is currently unexplored. We used content analysis to examine 37 child physical abuse consultation notes from a national sample of child abuse pediatricians in order to understand physicians' approaches to these consultations. Three commonly used models of child physical abuse consultation were identified in the data that we named the base model, the investigative model, and the family-dynamic model. While model types overlap, each is distinguished by key features including the approach used to gather information, the information recorded, and the language used in documentation. The base model most closely mirrors the traditional medical approach; the investigative model concentrates on triangulation of sources of information; and, the family-dynamic model concentrates on physician perceptions of family relationships. The three models of consultations for child physical abuse mirror the areas of child abuse pediatrics: diagnostic, forensic and therapeutic. These models are considered in relationship to best practice from other medical specialties with forensic components.
... What Is Happening en español Cómo manejar el abuso Grown-ups are usually there to help and ... to understand the different types of abuse: physical, sexual, verbal or emotional, and neglect. Physical abuse: Physical ...
Todays Educ, 1969
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.
... their drinking causes distress and harm. It includes alcoholism and alcohol abuse. Alcoholism, or alcohol dependence, is a disease that causes ... groups. NIH: National Institute on Alcohol Abuse and Alcoholism
... from what the doctor prescribed, it is called prescription drug abuse. It could be Taking a medicine that was prescribed for someone else Taking a ... at higher doses or when taken with other medicines. NIH: National Institute on Drug Abuse
... way Uses harsh discipline Was abused as a child Alcohol or drug problems Emotional problems or mental illness ... Physical abuse - children References Berkowitz CD, Stewart ST. Child maltreatment. In: Marx JA, Hockberger RS, Walls RM, eds. ...
In this position statement it is argued that educational neuroscience must necessarily be relevant to, and therefore have implications for, both educational theory and practice. Consequently, educational neuroscientific research necessarily must embrace educational research questions in its remit.
Tauriac, Jesse J.; Scruggs, Natoschia
Perceptions of extreme, moderate, and mild forms of elder abuse among African-American women (n=25) and men (n=10) were examined. African-American respondents emphasized physical abuse when giving examples of extremely abusive behavior. Along with physical abuse, verbal abuse was the most frequently identified form of abuse, and was significantly…
California State Office of the Attorney General, Sacramento. Crime Prevention Center.
This document presents the educator with a guide to child abuse. A section defining child abuse examines the issues of physical abuse, physical neglect, sexual abuse, and emotional maltreatment. Areas discussed for these types of abuse include abuse indicators, location of injury, history, behavioral indicators, and types of injury. Incestuous and…
Stachowski, Christopher Allen
This article reviews the existing educational marketing literature in the leading tertiary educational management journals. A discussion of the implications for supporting practitioners in non-university settings is presented. (Contains 1 table.)
Richardson, Silvana F.
Part of a larger study of parents' practices regarding children's health, this report focuses on the relationship of such practices to parents' beliefs and knowledge about children's health. The study described factors influencing child health practices and sources of child health information used and preferred by parents. Also examined was the…
This study examined parents' perceptions and practices of parental involvement in their children's homework process to explore how variations in parents' perceptions might explain differences in their practices. Understanding parents' perceptions and practices of involvement is essential to increasing the effectiveness of parental involvement in…
Brower, Kirk J
Anabolic-androgenic steroids (AAS) are mainly used to treat androgen deficiency syndromes and, more recently, catabolic states such as AIDS-associated wasting. There is no evidence in the reviewed literature that AAS abuse or dependence develops from the therapeutic use of AAS. Conversely, 165 instances of AAS dependence have been reported among weightlifters and bodybuilders who, as part of their weight training regimens, chronically administered supraphysiologic doses, often including combinations of injected and oral AAS as well as other drugs of abuse. A new model is proposed in which both the "myoactive" and psychoactive effects of AAS contribute to the development of AAS dependence. The adverse consequences of AAS are reviewed, as well as their assessment by means of a history and physical, mental status examination, and laboratory testing. When patients with AAS use disorders are compared with patients with other substance use disorders, both similarities and differences become apparent and have implications for treatment.
Metsch, Lisa R; Pollack, Harold A
The 1996 Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) changed the nature, purpose, and financing of public aid. Researchers, administrators, and policymakers expressed special concern about the act's impact on low-income mothers with substance use disorders. Before PRWORA's passage, however, little was known about the true prevalence of these disorders among welfare recipients or about the likely effectiveness of substance abuse treatment interventions for welfare recipients. Subsequent research documented that substance abuse disorders are less widespread among welfare recipients than was originally thought and are less common than other serious barriers to self-sufficiency. This research also showed significant administrative barriers to the screening, assessment, and referral of drug-dependent welfare recipients. This article summarizes current research findings and examines implications for welfare reform reauthorization. PMID:15787954
Empirical Analysis of Human Capital, Learning Culture, and Knowledge Management as Antecedents to Organizational Performance: Theoretical and Practical Implications for Logistics Readiness Officer Force Development
MANAGEMENT AS ANTECEDENTS TO ORGANIZATIONAL PERFORMANCE: THEORETICAL AND PRACTICAL IMPLICATIONS FOR LOGISTICS READINESS OFFICER FORCE DEVELOPMENT...IMPLICATIONS FOR LOGISTICS READINESS OFFICER FORCE DEVELOPMENT THESIS Presented to the Faculty Department of Operational Sciences...Command In Partial Fulfillment of the Requirements for the Degree of Master of Science in Logistics Management Matt J. Cherry, BS
Watson, Gavan Peter Longley
This paper focuses on the implications of two emerging digital technologies on the act of field birding, and the implications of these objects for thinking about wild birds. While the adoption of new immaterial technologies promises to improve the ease with which birding is practiced, their use leads to new ethical considerations. Using the…
Doyle, Kathleen; Morrow, Marilyn J.
The Elder Abuse Awareness Project was undertaken: (1) to determine the incidence of abuse and neglect in seven Illinois counties; and (2) to develop, produce, and distribute educational materials on elder abuse for the service provider and for senior citizens. Results are presented and discussed. (MT)
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…
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…
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…
Burnett, Jason; Jackson, Shelly L; Sinha, Arup K; Aschenbrenner, Andrew R; Murphy, Kathleen Pace; Xia, Rui; Diamond, Pamela M
Elder abuse increases the likelihood of early mortality, but little is known regarding which types of abuse may be resulting in the greatest mortality risk. This study included N = 1,670 cases of substantiated elder abuse and estimated the 5-year all-cause mortality for five types of elder abuse (caregiver neglect, physical abuse, emotional abuse, financial exploitation, and polyvictimization). Statistically significant differences in 5-year mortality risks were found between abuse types and across gender. Caregiver neglect and financial exploitation had the lowest survival rates, underscoring the value of considering the long-term consequences associated with different forms of abuse. Likewise, mortality differences between genders and abuse types indicate the need to consider this interaction in elder abuse case investigations and responses. Further mortality studies are needed in this population to better understand these patterns and implications for public health and clinical management of community-dwelling elder abuse victims.
Minnes, Sonia; Lang, Adelaide; Singer, Lynn
Abuse of drugs by pregnant women both in the United States and worldwide has raised many questions regarding the effects of prenatal drug exposure on the developing fetus and subsequent child outcomes. Studies using the neurobehavioral teratology model have been undertaken to determine specific prenatal drug effects on cognitive and behavioral development. Here we summarize the findings of studies that have investigated the developmental effects of prenatal exposure to tobacco, marijuana, stimulants, and opiates. These studies consider the timing and amount of prenatal exposure; other drug exposures; maternal characteristics; and other health, nutritional, and environmental factors. We review treatment options for pregnant, substance-dependent women and therapeutic interventions for exposed children. PMID:22003423
Yantz, Christine L; Bauer, Lyndsey; McCaffrey, Robert J
Many states allow psychologists licensed in other jurisdictions to practice temporarily without obtaining a full license. However, both the restrictions of practice and the procedures required before practice is allowed vary extensively among states. This article examines the regulations of U.S. and Canadian territories governing temporary practice of nonresident psychologists. Current licensing laws were obtained from each state's respective psychological board or related Web sites from May to July 2004. Results highlighted vast regulatory and procedural differences for temporary practice among jurisdictions. Due to the degree of variability in each jurisdiction's regulations governing, caution must be taken so that psychologists comply with up-to-date guidelines before practicing outside of the regions in which they are licensed. The out-of-state psychologist must contact the appropriate state or provincial licensing board for guidelines and pertinent regulation.
Storck, Michael; Black, Laura; Liddell, Morgan
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.
Uwe, E A; Ekuri, E E; Asuquo, P N
Violence against women in Africa dates back to primordial society, where cultural practices such as female genital mutilation and polygamous marriages were prescribed and supervised by male-dominated social structures. Women's status has always been at high risk, since such practices are male supervised. With the upsurge of the HIV/AIDS pandemic globally, research needs to focus on such cultural practices, the dangers of such practices, and possible eradication. The present article examines the change-resistant, prevailing religious, social, and psychological barriers to change.
Mathews, Rahel; Zachariah, Rachel
Although the literature reflects that Asian Indians in the United States and globally have the highest rates of morbidity and mortality because of coronary heart disease (CHD) and diabetes, few studies have described the clinical implications in the United States. Traditional risk factors dictate practice, yet these risk factors do not fully explain the rates. Central obesity, lipoprotein (a), and insulin resistance may have a strong role. The literature suggests that proactive nursing using culturally specific clinical measures are necessary to reduce risk factors for CHD and diabetes in South Asians. Additional research and prevention strategies focused on immigrant South Asians in the United States are recommended.
Wallner, Paul E; Kupelian, Patrick; Erickson, Beth; Alektiar, Kaled M; Laszakovits, David; Henson, Tina M; Wang, Pin-Chieh; Steinberg, Michael L
In 2011, the American Board of Medical Specialties approved a pilot project submitted by the American Board of Radiology for a Focused Practice Recognition in Brachytherapy initiative. Developers had anticipated significant interest within the profession and had hoped that the project would stimulate clinical interest, research, and education in the modality. A centerpiece of the project was a National Brachytherapy Registry, which was to serve as a dynamic longitudinal database for participants and the profession. Ultimately, the project did not achieve its anticipated goals and was terminated by the American Board of Radiology in 2015. Development, implementation, problems encountered, and potential implications and solutions are discussed.
Emery, Clifton R; Thapa, Sirjana; Do, Mi Hyang; Chan, Ko Ling
Drawing on previous research on intimate partner violence, child maltreatment, and informal social control, we hypothesized relationships between child abuse severity and (1) protective informal social control of intimate partner violence (ISC_IPV) by neighbors, (2) intimate terrorism, (3) family order, and (4) the power of mothers in intimate relationships. In what we believe may be a first study of physical child abuse by parents in Nepal, we used a three stage cluster approach to draw a random sample of 300 families in Kathmandu. Random effects regression models were used to test the study hypotheses. The analyses found support for hypotheses one and two, but with an important caveat. Although observed (actual) protective ISC_IPV had the hypothesized negative association with child abuse severity, in one of our models perceived protective ISC_IPV was positively associated with child abuse severity. The models clarify that the overall direction of protective ISC_IPV appears to be negative (protective), but the positive finding is important to consider for both research and practice. A significant relationship between family order and child abuse severity was found, but the direction was negative rather than positive as in hypothesis three. Implications for neighborhood research and typological research on IPV and child maltreatment are discussed.
Teram, Eli; Stalker, Carol; Hovey, Angela; Schachter, Candice; Lasiuk, Gerri
This article extends earlier reports of an ongoing qualitative inquiry on childhood sexual abuse survivors' experiences with health professionals. In this paper, we aim to enhance understanding of male survivors' experience. While male and female participants express similar anxieties and fears about their encounters with health professionals, there are gender-based differences related to the perceptions of victimhood and manhood; guilt and shame; homophobia; disclosure of abuse; and the expression of vulnerability. The implications of these differences for sensitive health care practice are analyzed within the context of gender relationships and the differential socialization of men. Malecentric communication is proposed as a method for addressing the specific experiences of male survivors in their encounters with health professionals.
Chuang, Emmeline; Wells, Rebecca; Bellettiere, John; Cross, Theodore P
Parental substance use significantly increases risk of child maltreatment, but is often under-identified by child protective services. This study examined how agency use of standardized substance use assessments and child welfare investigative caseworker education, experience, and caseload affected caseworkers' identification of parental substance abuse treatment needs. Data are from a national probability sample of permanent, primary caregivers involved with child protective services whose children initially remained at home and whose confidential responses on two validated instruments indicated harmful substance use or dependence. Investigative caseworkers reported use of a formal assessment in over two thirds of cases in which substance use was accurately identified. However, weighted logistic regression indicated that agency provision of standardized assessment instruments was not associated with caseworker identification of caregiver needs. Caseworkers were also less likely to identify substance abuse when their caseloads were high and when caregivers were fathers. Implications for agency practice are discussed.
Hammerschlag, Margaret R.; Gaydos, Charlotte A.
Testing for sexually transmitted infections (STIs) in children presents a number of problems for the practitioner that are not usually faced when testing adults for the same infections. The identification of an STI in a child, in addition to medical implications, can have serious legal implications. The presence of an STI is often used to support the presence or allegations of sexual abuse and conversely, the identification of an STI in a child will prompt an investigation of possible abuse. The significance of the identification of a sexually transmitted agent in such children as evidence of possible child sexual abuse varies by pathogen. While culture has historically been used for the detection of STIs in cases of suspected abuse in children, the increasing use of nucleic acid amplification tests (NAATs) in adults and the increasing proliferation of second-generation tests with better sensitivity and specificity has made inroads into the use of such tests in children, especially for diagnostic and treatment purposes. Acceptance by the medicolegal system for sexual abuse cases is still controversial and more test cases will be necessary before definitive use becomes standard practice. In addition, if these assays ever become legally admissible in court, there will be recommendations that more than one NAAT assay be used in order to assure confirmation of the diagnostic result. PMID:22782828
Flentje, Annesa; Livingston, Nicholas A.; Roley, Jason; Sorensen, James L.
Objective Lesbian, gay, and bisexual (LGB) orientation predicts greater substance use, treatment utilization, and poorer mental and physical health, but health needs of LGB individuals in substance abuse treatment remain largely unknown. The purpose of this study was to identify differences in mental and physical health needs of LGB individuals in substance abuse treatment. Methods Substance abuse treatment admissions data from the County of San Francisco were used in this investigation of differences in mental and physical health problems and service utilization between LGB (n=1,441) and heterosexual individuals (n=11,770). Results LGB individuals were more likely to have mental health diagnoses (adjORs ranging from 1.86–4.00) and current mental health prescription medications (adjORs from 1.79–4.99) than heterosexual counterparts. Gay and bisexual men and bisexual women but not lesbian women, were more likely to be receiving mental health treatment. Gay men and bisexual women were more likely than heterosexual counterparts to report physical health problems. Gay and bisexual men and bisexual women but not lesbian women were more likely to be receiving health care. There were no differences between LGB individuals and heterosexual counterparts in the number of emergency room visits or hospital overnight stays. Discussion This study found that LGB individuals entering substance abuse treatment have greater mental and physical health needs than heterosexual counterparts. Implications for healthcare integration, research, and practice are discussed. PMID:26314505
Evans, Sara Z; Simons, Leslie Gordon; Simons, Ronald L
While the link between parenting and delinquency is well established, there is less consensus among scholars with regards to the processes that account for this link. The current study had two objectives. The first was to disentangle the effects of African American parents' use of corporal punishment and verbal abuse on the conduct problems of their preteen children. The second was to investigate the mechanisms that explain this relationship, such as having low self-control or a hostile view of relationships, whereby these harsh parenting practices increase a youth's involvement in problem behavior. Further, we are interested in specifically addressing how these mechanisms may operate differently for males versus females. Analyses utilized structural equation modeling and longitudinal data spanning approximately 2.5 years from a sample of 704 (54.2 % female) African American children ages 10-12. The results indicated that verbal abuse was a more important predictor of conduct problems than corporal punishment. Additionally, we found that the mechanisms that mediated the impact of verbal abuse and corporal punishment on conduct problems varied by gender. For males, most of the effect of verbal abuse was mediated by low self-control, whereas anger/frustration was the primary mediator for females. Implications of these results and directions for future study are also discussed.
Tait, Glendon R; Bates, Joanna; LaDonna, Kori A; Schulz, Valerie N; Strachan, Patricia H; McDougall, Allan; Lingard, Lorelei
Background Heart failure (HF), one of the three leading causes of death, is a chronic, progressive, incurable disease. There is growing support for integration of palliative care’s holistic approach to suffering, but insufficient understanding of how this would happen in the complex team context of HF care. This study examined how HF care teams, as defined by patients, work together to provide care to patients with advanced disease. Methods Team members were identified by each participating patient, generating team sampling units (TSUs) for each patient. Drawn from five study sites in three Canadian provinces, our dataset consists of 209 interviews from 50 TSUs. Drawing on a theoretical framing of HF teams as complex adaptive systems (CAS), interviews were analyzed using the constant comparative method associated with constructivist grounded theory. Results This paper centers on the dominant theme of system practices, how HF care delivery is reported to work organizationally, socially, and practically, and describes two subthemes: “the way things work around here”, which were commonplace, routine ways of doing things, and “the way we make things work around here”, which were more conscious, effortful adaptations to usual practice in response to emergent needs. An adaptive practice, often a small alteration to routine, could have amplified effects beyond those intended by the innovating team member and could extend to other settings. Conclusion Adaptive practices emerged unpredictably and were variably experienced by team members. Our study offers an empirically grounded explanation of how HF care teams self-organize and how adaptive practices emerge from nonlinear interdependencies among diverse agents. We use these insights to reframe the question of palliative care integration, to ask how best to foster palliative care-aligned adaptive practices in HF care. This work has implications for health care’s growing challenge of providing care to those with
Fischetti, Barbara A.; Crespi, Tony D.
Survey assesses current practice trends in the clinical supervision of school psychologists. Data indicates that while ten percent of practicing school psychologists were participating in individual and/or group clinical supervision nationwide, respondents were receiving less supervision than recommended by APA or NASP professional standards.…
Canel-Cinarbas, Deniz; Ciftci, Ayse; Bulgan, Gokce
The purpose of the present study was to explore through qualitative methodology the practice of visiting shrines, a religious practice indigenous to Turkish Muslims, and its potential mental health benefits. Thirteen individuals were interviewed at two shrines in Istanbul, Turkey. The researchers focused on visitors' presenting issues, beliefs…
Endeley, Margaret Nalova
The paper aimed at assessing the effectiveness of the teaching practice model in the University of Buea, which is different from that of other teacher education institutions in Cameroon. Teaching Practice is an important component of a teacher education programme and the quality of supervision and duration are key in achieving effectiveness which…
Zipp, Genevieve Pinto; Gentile, A. M.
Understanding how motor skills are learned influences how one teaches effective motor skill attainment. Educators must ask, "Does repetitive practice of the same task make for better performance or does contextual variability (random practice) offer some benefit when learning motor skills?" Studies on the effects of Contextual Interference may…
Garst, Barry A.; Baughman, Sarah; Franz, Nancy
Examining traditional and contemporary professional development practices of youth-serving organizations can inform practices across Extension, particularly in light of the barriers that have been noted for effectively developing the professional competencies of Extension educators. With professional development systems changing quickly,…
Dustin, Donna; Davies, Liz
Female genital cutting (FGC) is an ancient practice that affects girls and young women around the world, defining the identity of women in cultures where it is practiced. FGC is carried out for a range of social and cultural reasons. The United Kingdom as a point of inward migration receives families from countries and cultures where FGC is the…
Jaeger, Richard M.; Tesh, Anita S.
This study examined the degree and dimensions of professional satisfaction among a large, nationally-representative sample of practicing counselors. The objectives of the study included estimating the distribution of global professional satisfaction among practicing counselors; examining the relationships between counselors' global professional…
Gearing, Robin Edward; Saini, Michael; McNeill, Ted
This phenomenological study's purpose was threefold: to detail the experiences of social workers practicing in a hospital environment affected by severe acute respiratory syndrome (SARS), to describe essential themes and structures of social work practices within this crisis environment, and to explore recommendations for better preparedness to…
Jiménez-Aleixandre, María Pilar
In the last two decades science studies and science education research have shifted from an interest in products (of science or of learning), to an interest in processes and practices. The focus of this paper is on students' engagement in epistemic practices (Kelly in "Teaching scientific inquiry: Recommendations for research and…
Sprouls, Katie; Mathur, Sarup R.; Upreti, Gita
Although using higher rates of positive to negative feedback is one best practice often recommended to teachers, particularly when it comes to students experiencing behavioral problems in classroom settings, research on the use of positive feedback in classroom teaching practice has revealed inconsistent results. Research has documented…
This research review identifies parental roles and practices that have been shown to promote reading readiness, receptivity to reading instruction, and increased achievement in reading. Reviews studies of intervention and involvement programs designed to expand or alter parental practices in improving children's reading attitudes and achievement.…
Reyna, Valerie F; Farley, Frank
Crime, smoking, drug use, alcoholism, reckless driving, and many other unhealthy patterns of behavior that play out over a lifetime often debut during adolescence. Avoiding risks or buying time can set a different lifetime pattern. Changing unhealthy behaviors in adolescence would have a broad impact on society, reducing the burdens of disease, injury, human suffering, and associated economic costs. Any program designed to prevent or change such risky behaviors should be founded on a clear idea of what is normative (what behaviors, ideally, should the program foster?), descriptive (how are adolescents making decisions in the absence of the program?), and prescriptive (which practices can realistically move adolescent decisions closer to the normative ideal?). Normatively, decision processes should be evaluated for coherence (is the thinking process nonsensical, illogical, or self-contradictory?) and correspondence (are the outcomes of the decisions positive?). Behaviors that promote positive physical and mental health outcomes in modern society can be at odds with those selected for by evolution (e.g., early procreation). Healthy behaviors may also conflict with a decision maker's goals. Adolescents' goals are more likely to maximize immediate pleasure, and strict decision analysis implies that many kinds of unhealthy behavior, such as drinking and drug use, could be deemed rational. However, based on data showing developmental changes in goals, it is important for policy to promote positive long-term outcomes rather than adolescents' short-term goals. Developmental data also suggest that greater risk aversion is generally adaptive, and that decision processes that support this aversion are more advanced than those that support risk taking. A key question is whether adolescents are developmentally competent to make decisions about risks. In principle, barring temptations with high rewards and individual differences that reduce self-control (i.e., under ideal
Bagnol, Brigitte; Mariano, Esmeralda
This paper analyses two female sexual practices in Tete Province, Mozambique: (1) the practice of elongating the labia minora and (2) what is sometimes called 'dry sex' involving the insertion of natural and/or synthetic products into the vagina or the ingestion of these products orally. These practices are fundamental to the construction of female identity, eroticism and the experience of pleasure. Notions such as 'closed/open', 'dry/damp', 'hot/cold', 'heavy/light', 'life/death', 'wealth/poverty' and 'sweet/not sweet' are central to local understandings of sexual practices and reproduction. These notions may affect the women's sexual health because they influence preferences for sex without a condom. These practices may also be associated with the alteration of the vaginal flora and vaginal lesions that may make women more vulnerable to sexually transmitted infections.
Kang-Yi, Christina D; Adams, Danielle R
This systematic review aimed to (1) identify and summarize empirical studies on youth with behavioral health disorders aging out of foster care and (2) address implications for behavioral health policy, research, and practice. We identified previous studies by searching PubMed, PsycINFO, EBSCO, and ISI Citation Indexes and obtaining references from key experts in the child welfare field. A total of 28 full articles published between 1991 and 2014 were reviewed and summarized into the key areas including systems of care, disability type, transition practice area, study methods, study sample, transition outcome measures, study analysis, and study findings. Considering how fast youth who have behavioral health disorders fall through the crack as they exit foster care, one cannot understate the importance of incorporating timely and appropriate transition planning and care coordination for youth who have behavioral health disorders aging out of foster care into the usual case management performed by behavioral health systems and service providers.
Shea, Joyce; Grossman, Sheila; Wallace, Meredith; Lange, Jean
Advanced practice nurses (APRNs) have key roles in the care of patients who are nearing death and those living with a disabling chronic disease. This article describes a mixed-method formative assessment of 36 graduate nursing students' knowledge about and attitudes toward palliative care preliminary to curricular integration of the End-of-Life Nursing Education Consortium (ELNEC) graduate core modules. Students' knowledge about palliative care was assessed using the 106-item ELNEC examination. In addition, qualitative data were gathered regarding students' definitions of palliative care, the role of the APRN in palliative care, and their definitions of a "good" and "bad" death. Results revealed students' limited knowledge about palliative care. Qualitative findings indicated that most students exclusively linked palliative care with end-of-life care and believed that the treatment they provide should have the goal of prolonging life over maintaining quality of life. Implications for curriculum design, advanced practice role development, and collaboration with community health partners are discussed.
This article discusses the wider implications of a pattern of behaviour in which a parent, usually the mother, persistently presents a false story of illness or disability in the child. Such behaviour can be harmful to the child. The parent may deliberately produce symptoms of illness; the child may be exposed to unnecessary but painful and…
Fry, P. S.
Discusses counseling implications and applications of several social theories of aging. Explores effects of some rather distinct perspectives on aging, beginning with conceptualizations, research studies, and criticisms of disengagement theory, activity theory, and role theory, leading up to continuity theory and liberation perspective. Focuses on…
Thurston, A.; Van de Keere, K.; Kosack, W.; Gatt, S.; Marchal, J.; Mestdagh, N.; Schmeinck, D.; Sidor, W.; Topping, K. J.; Donnert, K.
This article examines cognitive models of peer learning in school and the implications that these models have for the teaching of science in primary schools. The article is a product of the European Commission, Socrates Comenius 2.1 funded project "The Implementation of Scientific Thinking in (Pre) Primary Schools Settings (STIPPS)" project…
Grosland, Tanetha J.
Tanetha Grosland's goal is to inform and extend the current knowledge base concerning the intersection of antiracist pedagogy and emotions, and its implications for reconceptualizing such pedagogy. Therefore, she begins by addressing some fundamental theoretical claims about antiracist education. Then utilizing two sources to contextualize…
REPRESENTATION AND SOCIAL EQUITY: PAST AND PRESENT EXPERIENCES.. ............... 103 Equity in the Military Melting Pot Black Representation in the...Vietnam The Vietnam-Era Draft in Retrospect Military Representation and Social Equity under the AVF Measures of Social Equity Implications CHAPTER V...MILITARY REPRESENTATION AND SOCIAL EQUITY: THE POLICY MAZE ........ ..................... ... 183 Benefits vs. Burdens of Military Service
Lomax, Helen Jayne
This paper provides analytic focus on the productive and editorial contexts of children and young people's image-making, making visible its implications for the analysis of photographs. Drawing on participatory research in which children and young people worked alongside researchers to create a visual narrative of their lived experiences of…
Myers, Anita M.; Gonda, Gail
The authors critically examine the research on physical activity in the elderly to assess the elderly's capacity for exercise and the benefits accruing from exercise. Lower-intensity exercise programs attract a more representative group of senior participants and overcome many barriers. Implications for program planning and efforts are discussed.…
Southern, Annie; Miller, Judi
This paper aims to examine the influence of Maori culture upon psychiatric service provision in Aotearoa/New Zealand and the implications of this for career counselling of people with experience of mental illness in Aotearoa/New Zealand. The research explored the experiences of a group of women in Aotearoa/New Zealand who have been diagnosed with…
Evans, Nancy J.
Responds to "new scholarship on women" perspective presented in previous article by Greiner, considering perspective particularly salient for student affairs educators who are responsible for conveying to future student affairs practitioners concepts associated with the new scholarship on women. Examines implications of each of six tenets of…