Laux, John M.; Piazza, Nick J.; Salyers, Kathleen; Roseman, Christopher P.
The sensitivity of the Substance Abuse Subtle Screening Inventory-3 (SASSI-3) was examined among substance-dependent adults enrolled in a family drug court. The SASSI-3 had a high sensitivity rate with this population, even across varying levels of motivation to change. (Contains 2 tables.)
Hill, Tara M.; Laux, John M.; Stone, Gregory; Dupuy, Paula; Scott, Holly
Rasch analysis of the Substance Abuse Subtle Screening Inventory-3 (SASSI-3; F. G. Miller & Lazowski, 1999) indicated that the SASSI-3 meets fundamental measurement properties; however, the authors of the current study recommend the elimination of nonfunctioning items and the improvement of response options for the face valid scales to…
Juhnke, Gerald A.; Coll, Kenneth M.; Peters, Scott W.
This article presents an interview with Frank Miller, a renowned addictions assessment authority who jointly initiated the updated Substance Abuse Subtle Screening Inventory (SASSI) versions and helped establish the inventories in the addictions assessment mainstream. Among other things, Miller describes how he began working at the SASSI Institute…
Burck, Andrew M.; Laux, John M.; Harper, Holly; Ritchie, Martin
Claims that the Substance Abuse Subtle Screening Inventory-3 (SASSI-3; F. G. Miller & L. E. Lazowski, 1999) defeats defensiveness have not been independently verified. This study investigates the SASSI-3's ability to discriminate faking (faking good, problem denial; faking good, claiming extreme virtue; faking bad) from standard answering.…
Tenegra, Johnny C; Leebold, Bobby
One of the more prevalent and often undiagnosed problems seen by primary care clinicians is substance misuse. Resulting in increased morbidity and mortality, loss of productivity, and increased health care costs, substance misuse in our society remains a significant public health issue. Primary care physicians are on the front lines of medical care, and as such, are in a distinctive position to recognize potential problems in this area and assist. This article outlines office-based screening approaches and strategies for managing and treating this complex issue confronting primary care.
Jimerson, Steven D; Musick, Sarah
Several states have proposed laws that urine drug screening be performed as a part of qualifying for public assistance. At least one state (Florida) has passed such a law, and several other states are considering similar laws. The Oklahoma Commission on Children and Youth created a committee to study laws and policies regarding the use of illegal drugs while pregnant. To get a better understanding of drug screening and pregnancy, 151 consecutive obstetrical patients receiving Medicaid were screened at their initial obstetrical visit by verbal and written questionnaire's concerning the use of alcohol, nicotine, and other illicit\\dangerous drugs; in addition a urine drug screen for the use of illicit or dangerous drugs was performed. The patient histories regarding the use of dangerous or illicit substances was reviewed and compared with the urine drug screens performed at the same visit. The authors note that when studied the incidence of substance abuse has been similar in patient population receiving public assistance and patient populations with traditional insurance. Oklahoma is one of 13 states with laws requiring mandatory reporting of substance abuse in pregnancy or the exposure of the newborn to illicit substances.
Neale, Anne Victoria; And Others
Elder abuse is recognized as an under-detected and under-reported social problem. Difficulties in detecting elder abuse are compounded by the lack of a standardized, psychometrically valid instrument for case finding. The development of the Hwalek-Sengstock Elder Abuse Screening Test (H-S/EAST) followed a larger effort to identify indicators and…
There are many barriers to screening for alcohol and drug abuse. Screening, brief intervention, and referral to treatment (SBIRT) principles can be used in identifying and helping patients with substance abuse problems. This article introduces SBIRT, discusses barriers to implementation, and reviews current practice recommendations.
Lewis, Bonnie Yegidis
Describes development, psychometric properties, and applications of the Wife Abuse Inventory (WAI). Preliminary reliability and validity data, based on 50 cases, are presented for this screening device designed to predict which women are at risk of being abused by their spouses. Potential applications of the WAI are suggested. (NRB)
Meisels, Samuel J.
Analyzes the uses and abuses of the Gesell School Readiness Screening Tests and similar tests. First, discusses developmental screening and readiness tests, then focuses on the Gesell tests, specifically addressing their validity and questioning their current uses. Discusses implications of using readiness tests for assigning children to…
Hwalek, Melanie A.; Sengstock, Mary C.
Recently more attention has been focused on elder abuse, with laws enacted requiring reporting of this crime. Since service providers often do not recognize elder abuse, a validated screening tool for elder abuse is needed. A screening tool called the Hwalek-Sengstock Elder Abuse Screening Protocol has been developed and is currently being…
Liebschutz, Jane M.; Finley, Erin P.; Braslins, Phillip G.; Christiansen, Demian; Horton, Nicholas J.; Samet, Jeffrey H.
Objectives We evaluated the prevalence of the sexually transmitted infections (STIs) chlamydia and gonorrhea in clients at a methadone maintenance program and a residential detoxification program. Methods We collected urine specimens for chlamydia and gonorrhea ligase chain reaction testing and assessed sexual, substance abuse and STI histories. Results Of 700 subject assessments, 490 occurred among detoxification clients and 210 in methadone maintenance. Chlamydia trachomatis was detected in 5/700 (0.9, 95% CI = 0.1–1.8%) and Neisseria gonorrhoeae in none. All chlamydia infected subjects were recruited from the detoxification program. Subjects reported high risk sexual behavior: 17% reported commercial sex exchange, and 22% reported inconsistent condom use with multiple sexual partners during the prior 2 months. Conclusion Based on prevalence in Boston, MA, universal screening for STI in substance abuse treatments programs is not warranted. However, routine screening for younger substance abusers and in communities with high prevalence should be considered. PMID:12681529
... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Screening for risk of victimization and... ELIMINATION ACT NATIONAL STANDARDS Standards for Lockups Screening for Risk of Sexual Victimization and Abusiveness § 115.141 Screening for risk of victimization and abusiveness. (a) In lockups that are...
Hewitt, Sandra K.; Arrowood, Alice A.
Presents a systematic touch exploration format for screening child abuse. The technique involves simple drawings with child participation that review forms of touching in a child's life and screens for physical and emotional abuse as well. Comparisons between screening outcomes and completed case conclusions indicate a bias toward underreporting…
Tamplin de Poinsot, Nan
Describes a self-portrait assignment inspired by the work of Frida Kahlo. Discusses Frida Kahlo's artwork and use of surrealist and symbolist views. States that each student had to incorporate personal symbolism in the portrait to convey a message about him or herself in a subtle manner. (CMK)
... screening shall consider prior acts of sexual abuse, prior convictions for violent offenses, and history of prior institutional violence or sexual abuse, as known to the agency, in assessing residents for risk of... abuse, or receipt of additional information that bears on the resident's risk of sexual victimization...
... screening shall consider prior acts of sexual abuse, prior convictions for violent offenses, and history of prior institutional violence or sexual abuse, as known to the agency, in assessing residents for risk of... abuse, or receipt of additional information that bears on the resident's risk of sexual victimization...
behavior). The syntax of SUBTLE is a prefix version of the language of predicate calculus and is identical to that used by MRS [Genesereth, Greiner, Smith...detect incompleteness or inconsistency. For further information on SHAM, the reader should see [ Grinberg and Lark]. Chapter 2 of this manual describes...execution continues at the next sequential statement. (CONDITION <pred> <then>) which is identical to the first form except that there is no <else> function
... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Medical and mental health screenings... § 115.381 Medical and mental health screenings; history of sexual abuse. (a) If the screening pursuant... follow-up meeting with a medical or mental health practitioner within 14 days of the intake screening....
... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Medical and mental health screenings... Care § 115.81 Medical and mental health screenings; history of sexual abuse. (a) If the screening... follow-up meeting with a medical or mental health practitioner within 14 days of the intake screening....
... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Medical and mental health screenings... Care § 115.81 Medical and mental health screenings; history of sexual abuse. (a) If the screening... follow-up meeting with a medical or mental health practitioner within 14 days of the intake screening....
... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Medical and mental health screenings... § 115.381 Medical and mental health screenings; history of sexual abuse. (a) If the screening pursuant... follow-up meeting with a medical or mental health practitioner within 14 days of the intake screening....
... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Medical and mental health screenings... § 115.381 Medical and mental health screenings; history of sexual abuse. (a) If the screening pursuant... follow-up meeting with a medical or mental health practitioner within 14 days of the intake screening....
... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Medical and mental health screenings... Care § 115.81 Medical and mental health screenings; history of sexual abuse. (a) If the screening... follow-up meeting with a medical or mental health practitioner within 14 days of the intake screening....
Harris, Sion Kim; Louis-Jacques, Jennifer; Knight, John R
Substance use is the most common health risk behavior among adolescents and is one of the greatest threats to their current and future health. Universal screening of adolescents in general medical settings can be instrumental in identifying substance use early, before further problems develop and when BIs are more likely to be effective. Screening in and of itself may have some therapeutic effect. Brief screening tools feasible for use by busy medical offices to quickly and reliably assess adolescent risk for a substance use disorder now are available. A recent study found that a physician-conducted CRAFFT screen interview required an average of 74 seconds to complete, whereas a computer self-administered version took an average of 49 seconds. The CRAFFT and AUDIT tools currently have the most evidence for validity among adolescents, whereas the validity of other widely used tools such as DAST-10, NIDA-modified ASSIST (Alcohol, Smoking and Substance Involvement Screening Test), and ultra-brief screens (AUDIT-C, single-item screens) has yet to be established for adolescents. Studies are needed to identify effective strategies to promote universal adolescent screening and the use of valid screening tools in general medical settings. One statewide (Massachusetts) study found that although most (86%) primary care physicians seeing adolescents reported screening adolescents for substance use annually, only 1 in 3 reported using a validated tool (the CRAFFT). The remaining physicians reporting using informal screening procedures, their own questionnaire, or the CAGE. Computerization of screening and integration into the electronic health record appear to be promising strategies to promote universal screening and standardized use of valid screening tools. Increasing adolescent screening rates necessitates supporting physicians' ability to respond effectively to the screen results. To that end, recent evidence-informed practice guides from the AAP and NIAAA provide a
Bond, Michael C; Butler, Kenneth H
Elder abuse and neglect is estimated to affect approximately 700,000 to 1.2 million elderly people a year with an estimated annual cost of tens of billions of dollars. Despite the large population at risk, its significant morbidity and mortality, and substantial cost to society, elder abuse continues to be underrecognized and underreported. This article aims to increase the awareness of elder abuse by reviewing the demographics, epidemiology, and risk factors of elder abuse, followed by a discussion of screening tools and ways to increase awareness and reporting.
... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Screening for risk of victimization and abusiveness. 115.41 Section 115.41 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Adult Prisons and Jails Screening for Risk of...
... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Screening for risk of victimization and abusiveness. 115.41 Section 115.41 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Adult Prisons and Jails Screening for Risk of...
... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Screening for risk of victimization and abusiveness. 115.41 Section 115.41 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Adult Prisons and Jails Screening for Risk of...
Hayek, Shady N; Wibbenmeyer, Lucy A; Kealey, Lyn Dee H; Williams, Ingrid M; Oral, Resmiye; Onwuameze, Obiora; Light, Timothy D; Latenser, Barbara A; Lewis, Robert W; Kealey, Gerald P
Abuse by burning is estimated to occur in 1 to 25% of children admitted with burn injuries annually. Hair and urine toxicology for illicit drug exposure may provide additional confirmatory evidence for abuse. To determine the impact of hair and urine toxicology on the identification of child abuse, we performed a retrospective chart review of all pediatric patients admitted to our burn unit. The medical records of 263 children aged 0 to 16 years of age who were admitted to our burn unit from January 2002 to December 2007 were reviewed. Sixty-five children had suspected abuse. Of those with suspected abuse, 33 were confirmed by the Department of Health and Human Services and comprised the study group. Each of the 33 cases was randomly matched to three pediatric (0-16 years of age) control patients (99). The average annual incidence of abuse in pediatric burn patients was 13.7+/-8.4% of total annual pediatric admissions (range, 0-25.6%). Age younger than 5 years, hot tap water cause, bilateral, and posterior location of injury were significantly associated with nonaccidental burn injury on multivariate analysis. Thirteen (39.4%) abused children had positive ancillary tests. These included four (16%) skeletal surveys positive for fractures and 10 (45%) hair samples positive for drugs of abuse (one patient had a fracture and a positive hair screen). In three (9.1%) patients who were not initially suspected of abuse but later confirmed, positive hair test for illicit drugs was the only indicator of abuse. Nonaccidental injury can be difficult to confirm. Although inconsistent injury history and burn injury pattern remain central to the diagnosis of abuse by burning, hair and urine toxicology offers a further means to facilitate confirmation of abuse.
Dinpanah, Hossein; Akbarzadeh Pasha, Abazar
Introduction: Designing a tool that can differentiate those at risk of child abuse with great diagnostic accuracy is of great interest. The present study was designed to evaluate the diagnostic accuracy of Escape instrument in triage of at risk cases of child abuse presenting to emergency department (ED). Method: The present diagnostic accuracy study performed on 6120 of the children under 16 years old presented to ED during 3 years, using convenience sampling. Confirmation by the child abuse team (pediatrician, a social worker, and a forensic physician) was considered as the gold standard. Screening performance characteristics of Escape were calculated using STATA 21. Results: 6120 children with the mean age of 2.19 ± 1.12 years were screened (52.7% girls). 137 children were suspected victims of child abuse. Based on child abuse team opinion, 35 (0.5%) children were confirmed victims of child abuse. Sensitivity, specificity, positive and negative likelihood ratio and positive and negative predictive values of this test with 95% CI were 100 (87.6 – 100), 98.3 (97.9 – 98.6), 25.5 (18.6 – 33.8), 100 (99.9 – 100), 0.34 (0.25 – 0.46), and 0 (0 – NAN), respectively. Area under the ROC curve was 99.2 (98.9 – 99.4). Conclusion: It seems that Escape is a suitable screening instrument for detection of at risk cases of child abuse presenting to ED. Based on the results of the present study, the accuracy of this screening tool is 99.2%, which is in the excellent range. PMID:28286815
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.
Boothroyd, Roger A; Peters, Roger H; Armstrong, Mary I; Rynearson-Moody, Sarah; Caudy, Michael
The Simple Screening Instrument for Substance Abuse (SSI-SA) is gaining widespread use as a self-report measure of substance abuse; yet, little information exists regarding the instrument's psychometric properties. This study examined the SSI's psychometric properties within a population of 6,664 adult Medicaid enrollees in Florida, who responded to a survey conducted as part of a statewide evaluation of Medicaid services. The SSI-SA had excellent internal consistency (.85). Evidence of the SSI's validity was strong; SSI-SA scores distinguished among individuals with and without substance abuse needs and were significantly correlated with a measure of functioning in daily living. Using the recommended SSI-SA cutoff score of 4 or higher to indicate the presence of a substance abuse problem, the SSI-SA had respectable sensitivity (.82) and specificity (.90).
... shall be assessed during an intake screening and upon transfer to another facility for their risk of... minimum, the following criteria to assess residents for risk of sexual victimization: (1) Whether the... prior institutional violence or sexual abuse, as known to the agency, in assessing residents for risk...
Kita, Sachiko; Haruna, Megumi; Hikita, Naoko; Matsuzaki, Masayo; Kamibeppu, Kiyoko
This study develops a Japanese version of the Woman Abuse Screening Tool, comprising two simple questions, to examine its accuracy and validity. A cohort study involving women in the third trimester of pregnancy and one month after childbirth was conducted in an antenatal clinic in a Tokyo suburb. The Japanese versions of the Index of Spouse Abuse and Hospital Anxiety and Depression Scale were used to examine the cut-off point, accuracy, and validity of the Woman Abuse Screening Tool. Results showed that the tool demonstrated good accuracy (sensitivity 66.7-71.4%, specificity 89.7%), using an alternative cut-off point (i.e. responses of "some tension" or "some difficulty" [2 points] for one item and "a lot of tension" or "great difficulty" [1 point] for the other), and good concurrent, convergent, and predictive validity. The results indicated that the Woman Abuse Screening Tool could be useful in Japanese perinatal health settings, as an initial screening tool to detect intimate partner violence efficiently and effectively during pregnancy.
Baldwin, Julie A.; Johnson, Rhonda M.; Gotz, Nina K.; Wayment, Heidi A.; Elwell, Kristan
The authors conducted a needs assessment among students and health-care providers of a southwestern university health center with the goal of developing health-care -provider training addressing substance-abuse screening and intervention. They collected data from focus groups of undergraduate students and structured interviews and questionnaires…
Wissenbach, Dirk K; Meyer, Markus R; Remane, Daniela; Philipp, Anika A; Weber, Armin A; Maurer, Hans H
Today, immunoassays and several chromatographic methods are in use for drug screening in clinical and forensic toxicology and in doping control. For further proof of the authors' new metabolite-based liquid chromatography-mass spectrometry (LC-MS(n)) screening concept, the detectability of drugs of abuse and their metabolites using this screening approach was studied. As previously reported, the corresponding reference library was built up with MS(2) and MS(3) wideband spectra using a LXQ linear ion trap with electrospray ionization in the positive mode and full scan information-dependent acquisition. In addition to the parent drug spectra recorded in methanolic solution, metabolite spectra were identified after protein precipitation of urine from rats after administration of the corresponding drugs and added to the library. This consists now of data of over 900 parent compounds, including 87 drugs of abuse, and of over 2,300 metabolites and artifacts, among them 436 of drugs of abuse. Recovery, process efficiency, matrix effects, and limits of detection for selected drugs of abuse were determined using spiked human urine, and the resulting data have been acceptable. Using two automatic data evaluation tools (ToxID and SmileMS), the intake of 54 of the studied drugs of abuse could be confirmed in urine samples of drug users after protein precipitation and LC separation. The following drugs classes were covered: stimulants, designer drugs, hallucinogens, (synthetic) cannabinoids, opioids, and selected benzodiazepines. The presented LC-MS(n) method complements the well-established gas chromatography-mass spectroscopy procedure in the authors' laboratory.
Cleak, Helen; Schofield, Margot J; Axelsen, Lauren; Bickerdike, Andrew
Family mediation is mandated in Australia for couples in dispute over separation and parenting as a first step in dispute resolution, except where there is a history of intimate partner violence. However, validation of effective well-differentiated partner violence screening instruments suitable for mediation settings is at an early phase of development. This study contributes to calls for better violence screening instruments in the mediation context to detect a differentiated range of abusive behaviors by examining the reliability and validity of both established scales, and newly developed scales that measured intimate partner violence by partner and by self. The study also aimed to examine relationships between types of abuse, and between gender and types of abuse. A third aim was to examine associations between types of abuse and other relationship indicators such as acrimony and parenting alliance. The data reported here are part of a larger mixed method, naturalistic longitudinal study of clients attending nine family mediation centers in Victoria, Australia. The current analyses on baseline cross-sectional screening data confirmed the reliability of three subscales of the Conflict Tactics Scale (CTS2), and the reliability and validity of three new scales measuring intimidation, controlling and jealous behavior, and financial control. Most clients disclosed a history of at least one type of violence by partner: 95% reported psychological aggression, 72% controlling and jealous behavior, 50% financial control, and 35% physical assault. Higher rates of abuse perpetration were reported by partner versus by self, and gender differences were identified. There were strong associations between certain patterns of psychologically abusive behavior and both acrimony and parenting alliance. The implications for family mediation services and future research 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. ...
Gesink, Dionne; Nattel, Lilian
Objective The childhood sexual abuse (CSA) survivor population is substantial and survivors have been identified as part of the population who were under-screened or never-screened for breast, cervical and colon cancer. Our objective was to learn CSA survivor perspectives on, and experiences with, breast, cervical and colon cancer screening with the intention of generating recommendations to help healthcare providers improve cancer screening participation. Design A pragmatic constructivist qualitative study involving individual, semistructured, in-depth interviews was conducted in January 2014. Thematic analysis was used to describe CSA survivor perspectives on cancer screening and identify potential facilitators for screening. Participants A diverse purposive sample of adult female CSA survivors was recruited. The inclusion criteria were: being a CSA survivor, being in a stable living situation, where stable meant able to meet one's financial needs independently, able to maintain supportive relationships, having participated in therapy to recover from past abuse, and living in a safe environment. 12 survivors were interviewed whose ages ranged from the early 40s to mid-70s. Descriptive saturation was reached after 10 interviews. Setting Interviews were conducted over the phone or Internet. CSA survivors were primarily from urban and rural Ontario, but some resided elsewhere in Canada and the USA. Results The core concept that emerged was that compassionate care at every level of the healthcare experience could improve cancer screening participation. Main themes included: desire for holistic care; unique needs of patients with dissociative identity disorder; the patient-healthcare provider relationship; appointment interactions; the cancer screening environment; and provider assumptions about patients. Conclusions Compassionate care can be delivered by: building a relationship; practising respect; focusing attention on the patient; not rushing the appointment
Lenk, Kathleen M; Erickson, Darin J; Winters, Ken C; Nelson, Toben F; Toomey, Traci L
We examine the prevalence of screening for student alcohol misuse/abuse among 333 U.S. colleges via a survey of campus leaders. We also use latent class modeling to identify classes of colleges based on screening practices. We found that most colleges conduct screening after a student is involved in an alcohol-related incident, and about 50% of colleges screen students at regular health care visits. Legal, health care, and housing staff are trained in screening at nearly all colleges; other key personnel were trained at about one third of colleges. We identified four classes of colleges: 62% of colleges fit in a class that had many screening components in place, 9% in a class with very limited services, and the remainder (29%) fit in 2 middle classes. Although most colleges had many alcohol misuse/abuse screening components in place, more than one third show need for improvement in how, where, and when screening is conducted.
... 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 ...
Iskandar, Livia; Braun, Kathryn L; Katz, Alan R
Intimate Partner Violence (IPV) is a global public health problem. IPV prevalence in Indonesia has been estimated to be less than 1%, based on reported cases. It is likely that IPV prevalence is underreported in Indonesia, as it is in many other countries. Screening for IPV has been found to increase IPV identification, but no screening tools are in use in Indonesia. The aim of this study was to test the translated Woman Abuse Screening Tool (WAST) for detecting IPV in Indonesia. The WAST was tested against a diagnostic interview by a trained psychologist on 240 women attending two Primary Health Centers in Jakarta. IPV prevalence and the reliability, sensitivity, and specificity of the WAST were estimated. Prevalence of IPV by diagnostic interview was 36.3%, much higher than published estimates. The most common forms of IPV identified were psychological (85%) and physical abuse (24%). Internal reliability of the WAST was high (α = .801). A WAST score of 13 (out of 24) is the recommended cutoff for identifying IPV, but only 17% of the Indonesian sample scored 13 or higher. Test sensitivity of the WAST with a cutoff score of 13 was only 41.9%, with a specificity of 96.8%. With a cutoff score of 10, the sensitivity improved to 84.9%, while the specificity decreased to 61.0%. Use of the WAST with a cutoff score of 10 provides good sensitivity and reasonable specificity and would provide a much-needed screening tool for use in Indonesia. Although a lower cutoff would yield a greater proportion of false positives, most of the true cases would be identified, increasing the possibility that women experiencing abuse would receive needed assistance.
Iskandar, Livia; Braun, Kathryn L.; Katz, Alan R.
Intimate Partner Violence (IPV) is a global public health problem. IPV prevalence in Indonesia has been estimated to be less than 1%, based on reported cases. It is likely that IPV prevalence is underreported in Indonesia, as it is in many other countries. Screening for IPV has been found to increase IPV identification, but no screening tools are in use in Indonesia. The aim of this study was to test the translated Woman Abuse Screening Tool (WAST) for detecting IPV in Indonesia. The WAST was tested against a diagnostic interview by a trained psychologist on 240 women attending two Primary Health Centers in Jakarta. IPV prevalence and the reliability, sensitivity, and specificity of the WAST were estimated. Prevalence of IPV by diagnostic interview was 36.3%, much higher than published estimates. The most common forms of IPV identified were psychological (85%) and physical abuse (24%). Internal reliability of the WAST was high (α = .801). A WAST score of 13 (out of 24) is the recommended cutoff for identifying IPV, but only 17% of the Indonesian sample scored 13 or higher. Test sensitivity of the WAST with a cutoff score of 13 was only 41.9%, with a specificity of 96.8%. With a cutoff score of 10, the sensitivity improved to 84.9%, while the specificity decreased to 61.0%. Use of the WAST with a cutoff score of 10 provides good sensitivity and reasonable specificity and would provide a much-needed screening tool for use in Indonesia. Although a lower cutoff would yield a greater proportion of false positives, most of the true cases would be identified, increasing the possibility that women experiencing abuse would receive needed assistance. PMID:25012952
Di Rosa, Mirko; Barbabella, Francesco; Barbini, Norma; Chiatti, Carlos
Introduction. Elder abuse is often a hidden phenomenon and, in many cases, screening practices are difficult to implement among older people with dementia. The Caregiver Abuse Screen (CASE) is a useful tool which is administered to family caregivers for detecting their potential abusive behavior. Objectives. To validate the Italian version of the CASE tool in the context of family caregiving of older people with Alzheimer's disease (AD) and to identify risk factors for elder abuse in Italy. Methods. The CASE test was administered to 438 caregivers, recruited in the Up-Tech study. Validity and reliability were evaluated using Spearman's correlation coefficients, principal-component analysis, and Cronbach's alphas. The association between the CASE and other variables potentially associated with elder abuse was also analyzed. Results. The factor analysis suggested the presence of a single factor, with a strong internal consistency (Cronbach's alpha = 0.86). CASE score was strongly correlated with well-known risk factors of abuse. At multivariate level, main factors associated with CASE total score were caregiver burden and AD-related behavioral disturbances. Conclusions. The Italian version of the CASE is a reliable and consistent screening tool for tackling the risk of being or becoming perpetrators of abuse by family caregivers of people with AD. PMID:28265571
Garcia-Jimenez, Sara; Heredia-Lezama, Karina; Bilbao-Marcos, Fernando; Fuentes-Lara, Griselda; Monroy-Noyola, Antonio; Deciga-Campos, Myrna
Drug abuse among college students is characterized by lower academic performance and long-term negative consequences. Screening to detect students at high risk of consuming drugs is of primary importance to insure early identification and appropriate levels of care. As a result, this study aimed to determine the current or past use of drug abuse through a questionnaire applied to a student population at the Universidad Autónoma del Estado de Morelos. The results were confirmed by immunoanalysis and gas chromatography of urine. We interviewed 181 students aged 15 to 21 (gender was not considered in this study), and urine samples were collected for analytical analysis. For detection of metabolites Delta9-THCA-A and benzoylecgonine from marijuana and cocaine, respectively, a homogenous enzymatic inmmunoanalysis was used; subsequent samples were analyzed by a mass spectrometer with quadrupole detector. Seven samples of the total (181) did not completely fit the inclusion criteria and were eliminated. The results showed 0.50% and 1.16% positive samples for benzoylecgonine and Delta9-THCA-A, respectively. These results are not different from those of the National Questionnaire on Addiction. We can establish a program for detecting drug consumption in our students. This kind of study is important in order to implement programs that can help us to decrease the abuse of drugs in our college population.
Weiner, Scott G.; Horton, Laura C.; Green, Traci C.; Butler, Stephen F.
Introduction Tablet computer-based screening may have the potential for detecting patients at risk for opioid abuse in the emergency department (ED). Study objectives were a) to determine if the revised Screener and Opioid Assessment for Patients with Pain (SOAPP®-R), a 24-question previously paper-based screening tool for opioid abuse potential, could be administered on a tablet computer to an ED patient population; b) to demonstrate that >90% of patients can complete the electronic screener without assistance in <5 minutes and; c) to determine patient ease of use with screening on a tablet computer. Methods This was a cross-sectional convenience sample study of patients seen in an urban academic ED. SOAPP®-R was programmed on a tablet computer by study investigators. Inclusion criteria were patients ages ≥18 years who were being considered for discharge with a prescription for an opioid analgesic. Exclusion criteria included inability to understand English or physical disability preventing use of the tablet. Results 93 patients were approached for inclusion and 82 (88%) provided consent. Fifty-two percent (n=43) of subjects were male; 46% (n=38) of subjects were between 18–35 years, and 54% (n=44) were >35 years. One hundred percent of subjects completed the screener. Median time to completion was 148 (interquartile range 117.5–184.3) seconds, and 95% (n=78) completed in <5 minutes. 93% (n=76) rated ease of completion as very easy. Conclusions It is feasible to administer a screening tool to a cohort of ED patients on a tablet computer. The screener administration time is minimal and patient ease of use with this modality is high. PMID:25671003
Keeshin, Brooks R.; Campbell, Kristine
Objectives: To identify the incidence of self-reported physical and sexual child abuse among homeless youth, the self-perceived effects of past abuse, and current interest in treatment for past abuse among homeless youth with histories of abuse. Methods: Homeless and street-involved persons aged 18-23 filled out a questionnaire and participated in…
... abused and, when appropriate, shall take necessary steps to mitigate any such danger to the detainee. (b... their risk of being sexually abused by other detainees or sexually abusive toward other detainees. (c..., physical, or developmental disability; (2) The age of the detainee; (3) The physical build and...
... abused and, when appropriate, shall take necessary steps to mitigate any such danger to the detainee. (b... their risk of being sexually abused by other detainees or sexually abusive toward other detainees. (c..., physical, or developmental disability; (2) The age of the detainee; (3) The physical build and...
Phillips, Jane Ellen; Bogema, Stuart; Fu, Paul; Furmaga, Wieslaw; Wu, Alan H B; Zic, Vlasta; Hammett-Stabler, Catherine
Signify ER Drug Screen Test (Signify ER) and Triage Drug of Abuse Panel plus TCA (Triage DOA Panel) rapid drug screening devices were compared at four laboratories. Both assay systems are point of care immunoassays, measuring phencyclidine, barbiturates, amphetamine, cocaine metabolite, methamphetamine, tricyclic antidepressants, opiates, marijuana metabolite, and benzodiazepines in human urine. The performance of these two assay systems, including a cutoff verification and cross-reactivity using spiked urine specimens and accuracy using clinical urine samples, was investigated. The cutoff verification study showed that the Signify ER had 95.4% precision for all drugs tested at concentrations of 50%, 75%, 125%, 150%, and 200% of cutoffs compared to 90% precision obtained with Triage DOA Panel. Accuracy studies testing 53 negative urine samples demonstrated that both Signify ER and Triage DOA Panel have 100% specificity. Testing of 693 positive urine samples demonstrated that Signify ER and Triage DOA Panel have sensitivities of 99.8% and 99.3%, respectively, with an accuracy of 99.9% and 99.6%. A total of 527 compounds were tested for the cross-reactivity study. Eighty-seven structurally related drugs and metabolites were found to cross-react with at least one of the nine tests of the Signify ER. Four hundred forty structurally unrelated compounds that can be found in human urine were shown not to cross-react with the Signify ER. In terms of operating characteristics, the Signify ER device is simpler since only a single pipetting step is required, and reaction completed within 8 min.
Perera-Diltz, Dilani M.; Perry, Justin C.
In this study (N = 137), although 70.8% of participants reported no current substance use and 42.3% reported never using, the Adolescent Substance Abuse Subtle Screening Inventory (SASSI-A2; Miller & Lazowski, 2001) screened 39.41% of the participants for a high level of probability of having a substance-related disorder. SASSI-A2 classified more…
van Stel, Henk F.; Verheij, Theo JM; Houben, Michiel L.; Russel, Ingrid MB; Nieuwenhuis, Edward ES; van de Putte, Elise M.
Objectives To assess the diagnostic value of the screening instrument SPUTOVAMO-R2 (checklist, 5 questions) for child abuse at Out-of-hours Primary Care locations (OPC), by comparing the test outcome with information from Child Protection Services (CPS). Secondary, to determine whether reducing the length of the checklist compromises diagnostic value. Methods All children (<18 years) attending one of the participating OPCs in the region of Utrecht, the Netherlands, in a year time, were included. The checklist is an obligatory field in the electronic patient file. CPS provided data on all checklist positives and a sample of 5500 checklist negatives (dataset). The checklist outcome was compared with a report to CPS in 10 months follow up after the OPC visit. Results The checklist was filled in for 50671 children; 108 (0.2%) checklists were positive. Within the dataset, 61 children were reported to CPS, with emotional neglect as the most frequent type of abuse (32.8%). The positive predictive value (PPV) of the checklist for child abuse was 8.3 (95% CI 3.9–15.2). The negative predictive value (NPV) was 99.1 (98.8–99.3), with 52 false negatives. When the length of the checklist was reduced to two questions closely related to the medical process (SPUTOVAMO-R3), the PPV was 9.1 (3.7–17.8) and the NPV 99.1 (98.7–99.3). These two questions are on the injury in relation to the history, and the interaction between child and parents. Conclusions The checklist SPUTOVAMO-R2 has a low detection rate of child abuse within the OPC setting, and a high false positive rate. Therefore, we recommend to use the shortened checklist only as a tool to increase the awareness of child abuse and not as a diagnostic instrument. PMID:28045904
Runyan, Desmond K.; Dunne, Michael P.; Zolotor, Adam J.
The "World Report on Children and Violence", (Pinheiro, 2006) was produced at the request of the UN Secretary General and the UN General Assembly. This report recommended improvement in research on child abuse. ISPCAN representatives took this charge and developed 3 new instruments. We describe this background and introduce three new measures…
Kelly, Deanna L.; Myers, Carol S.; Abrams, Michael T.; Feldman, Stephanie; Park, Junyong; McMahon, Robert P.; Shim, Joo-Cheol
Osteoporosis is a major public health concern. Substance abuse and psychosis may be risk factors, however frequency of screening and disease risk in women with psychotic disorders and substance use disorder (SUD) remains unknown. Methods This study examined rates (FY 2005) of osteoporosis screening and disease risk in Medicaid enrolled women aged 50 to 64 (N=18,953). Four diagnostic groups were characterized: 1) Psychosis; 2) SUD; 3) Major mood disorder and 4) Controls. The interaction of psychosis and SUD on screening and disease prevalence of osteoporosis was tested. Results The prevalence of osteoporosis across the entire population was 6.7%. Four percent of those without an osteoporosis diagnosis received osteoporosis screening with no notable differences between psychosis and controls. Those with SUD, however, had a significant reduction in screening compared to controls (OR=0.61, 95% CI 0.40–0.91, p=0.016). Women with a major mood disorder were more likely to have osteoporosis in their administrative record (OR=1.32, 95% CI=1.03–1.70, p=0.028) compared to controls. Those who were dually diagnosed (SUD and psychosis) in the oldest ages (55–64 years) had a markedly higher prevalence of osteoporosis compared to controls (OR=6.4 CI 1.51–27.6, p=0.012), whereas this interaction (SUD and psychosis) was not significant in the entire population over age 49. Conclusions Osteoporosis screening in the Medicaid population is significantly lower for women with SUD, after adjusting for age, race and Medicaid enrollment category. The prevalence of osteoporosis appears markedly elevated in those with major mood disorders and those over age 55 dually diagnosed with schizophrenia and SUD. PMID:20533029
Kohler, Isabelle; Schappler, Julie; Rudaz, Serge
The combination of capillary electrophoresis (CE) and mass spectrometry (MS) is particularly well adapted to bioanalysis due to its high separation efficiency, selectivity, and sensitivity; its short analytical time; and its low solvent and sample consumption. For clinical and forensic toxicology, a two-step analysis is usually performed: first, a screening step for compound identification, and second, confirmation and/or accurate quantitation in cases of presumed positive results. In this study, a fast and sensitive CE-MS workflow was developed for the screening and quantitation of drugs of abuse in urine samples. A CE with a time-of-flight MS (CE-TOF/MS) screening method was developed using a simple urine dilution and on-line sample preconcentration with pH-mediated stacking. The sample stacking allowed for a high loading capacity (20.5% of the capillary length), leading to limits of detection as low as 2 ng mL(-1) for drugs of abuse. Compound quantitation of positive samples was performed by CE-MS/MS with a triple quadrupole MS equipped with an adapted triple-tube sprayer and an electrospray ionization (ESI) source. The CE-ESI-MS/MS method was validated for two model compounds, cocaine (COC) and methadone (MTD), according to the Guidance of the Food and Drug Administration. The quantitative performance was evaluated for selectivity, response function, the lower limit of quantitation, trueness, precision, and accuracy. COC and MTD detection in urine samples was determined to be accurate over the range of 10-1000 ng mL(-1) and 21-1000 ng mL(-1), respectively.
Chen, Chung-Yu; Shen, Chien-Chun; Yang, Tzung-Jie; Chang, Yan-Zin; Lee, Maw-Rong
An integrated method of liquid chromatography-heated electrospray ionization/tandem mass spectrometry was evaluated for high throughput screening of various abused drugs in urine. Chromatographic analysis was performed on a C18 reverse phase column using a linear gradient of 10mM ammonium acetate containing 0.1% formic acid-methanol as mobile phase and the total separation time was 7 min. A simple and rapid sample preparation method used was by passing urine samples through a 0.22 microm PVDF syringe filter. The detection limits of the studied abused drugs in urine were from 0.6 ng mL(-1) (ketamine) to 9.0 ng mL(-1) (norcodeine). According to the results, the linear range was from 1 to 1200 ng mL(-1) with relative standard deviation (R.S.D.s) value below 14.8% (intra-day) and 24.6% (inter-day). The feasibility of applying the proposed method to determine various abused drugs in real samples was examined by analyzing urine samples from drug-abused suspects. The abused drugs including ketamines and amphetamines were detected in suspected urine samples. The results demonstrate the suitability of LC-HESI-MS/MS for high throughput screening of the various abused drugs in urine.
Health Questionnaire (PHQ-9) for depression,29 Generalized Anxiety Disorder screen (GAD-7),30 and the Brief Traumatic Brain Injury Screen (BTBIS).31...brief measure for assessing generalized anxiety disorder : the GAD-7. Arch Intern Med 2006; 166: 1092–7. 31. Schwab K, Baker G, Ivins B, Sluss-Tiller M
Lam, Lap Po; Leung, Wing Cheong; Ip, Patrick; Chow, Chun Bong; Chan, Mei Fung; Ng, Judy Wai Ying; Sing, Chu; Lam, Ying Hoo; Mak, Wing Lai Tony; Chow, Kam Ming; Chin, Robert Kien Howe
We assessed the Chinese version of the Drug Abuse Screening Test (DAST-10) for identifying illicit drug use during pregnancy among Chinese population. Chinese pregnant women attending their first antenatal visit or their first unbooked visit to the maternity ward were recruited during a 4-month study period in 2011. The participants completed self-administered questionnaires on demographic information, a single question on illicit drug use during pregnancy and the DAST-10. Urine samples screened positive by the urine Point-of-Care Test were confirmed by gas chromatography-mass spectrometry. DAST-10 performance was compared with three different gold standards: urinalysis, self-reported drug use, and evidence of drug use by urinalysis or self-report. 1214 Chinese pregnant women participated in the study and 1085 complete DAST-10 forms were collected. Women who had used illicit drugs had significantly different DAST-10 scores than those who had not. The sensitivity of DAST-10 for identify illicit drug use in pregnant women ranged from 79.2% to 33.3% and specificity ranged from 67.7% to 99.7% using cut-off scores from ≥1 to ≥3. The ~80% sensitivity of DAST-10 using a cut-off score of ≥1 should be sufficient for screening of illicit drug use in Chinese pregnant women, but validation tests for drug use are needed. PMID:26091290
Siddhanta, Soumik; Wróbel, Maciej S; Barman, Ishan
Surface enhanced Raman spectroscopy (SERS) has emerged as a promising technique for the rapid and ultrasensitive detection of molecular species such as drugs of abuse in biofluids. Yet, it remains a significant challenge to create a viable screening tool for multiple drug classes, owing to the lack of affinity of certain species for the SERS substrate and to the matrix interference in complex media. Here we report a protein tethering SERS approach, which blends plasmonic enhancement with facile drug binding, to engineer a rapid, label-free and versatile screening tool for narcotics. By exploiting the known binding attributes of human serum albumin, we determine the effective concentration of narcotics present in solution through differential enhancement of the spectral markers. In conjunction with chemometric methods, this approach not only enables unambiguous recognition of different drug classes, such as barbiturates, opiates, amphetamines and benzodiazepines, but also offers a lower limit of detection in comparison to direct SERS application. Through molecular docking simulations, we probe the mechanistic underpinnings of the protein tethering approach paving the way for narcotic detection in clinical samples in the near future.
Pitts, Sarah; Shrier, Lydia A
Adolescent substance use is common and is associated with serious mental, physical, and social risks, warranting systematic screening in the primary care setting. It is important for clinicians to become familiar with Screening, Brief Intervention, and Referral to Treatment (SBIRT), including administration of validated screening tools to identify level of risk associated with substance use and application of appropriate brief interventions. Positive reinforcement and brief advice is indicated for those adolescents with no or minimal risk for a substance use disorder. Providing a brief intervention using motivational interviewing strategies with subsequent close clinical follow-up is warranted when an adolescent meets criteria for a mild to moderate substance use disorder. Referral to treatment is recommended in cases of severe substance use. Immediate action, including breaking confidentiality, may be necessary when an adolescent's behavior raises acute safety concerns. Making time to interview adolescents alone is essential. It is also important to review the limitations of confidentiality with patients and parents/guardians and offer them strategies to discuss sensitive issues with their adolescents. Available resources for adolescents, parents/guardians, and clinicians regarding the risks of adolescent substance use and evidence-based treatment options can be used to support implementation of SBIRT in adolescent primary care.
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.
... 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 ...
For patients with dementia, abuse ranges from subtle scams to outright physical violence. As dementia progresses, abuse escalates. The stages of dementia--mild cognitive impairment, mild dementia, moderate dementia, and severe dementia--lend themselves to varied presentations of abuse. Knowing which types of abuse are more prominent at each stage aids the clinician in anticipating risk of abuse and patient and caregiver needs. Interviewing the victim is crucial in uncovering, documenting, and intervening in an abuse situation. A clinician who is skilled in drawing out the facts while remaining supportive of the patient is key in ending the victimization.
Chepyala, Divyabharathi; Tsai, I-Lin; Liao, Hsiao-Wei; Chen, Guan-Yuan; Chao, Hsi-Chun; Kuo, Ching-Hua
room temperature and -80°C. The reported method provides a new direction for abused drug screening using DBS.
... Valium, Serepax, Rohypnol, etc.) h. Hallucinogens (LSD, acid, mushrooms, PCP, Special K, etc.) i. Opioids (heroin, morphine, ... Valium, Serepax, Rohypnol, etc.) h. Hallucinogens (LSD, acid, mushrooms, PCP, Special K, etc.) i. Opioids (heroin, morphine, ...
Tsai, I-Lin; Weng, Te-I; Tseng, Yufeng J; Tan, Happy Kuy-Lok; Sun, Hsiao-Ju; Kuo, Ching-Hua
An ultra-high-performance liquid chromatography--quadrupole time-of-flight mass spectrometry (UHPLC-QTOF-MS) method for the screening and confirmation of 62 drugs of abuse and their metabolites in urine was developed in this study. The most commonly abused drugs, including amphetamines, opioids, cocaine, benzodiazepines (BZDs) and barbiturates, and many other new and emerging abused drugs, were selected as the analytes for this study. Urine samples were diluted 5-fold with deionized water before analysis. Using a superficially porous micro-particulate column and an acetic acid-based mobile phase, 54 basic and 8 acidic analytes could be detected within 15 and 12 min in positive and negative ionization modes, respectively. The MS collision energies for the 62 analytes were optimized, and their respective fragmentation patterns were constructed in the in-house library for confirmatory analysis. The coefficients of variation of the intra- and inter-day precision of the analyte responses all were <17.39%. All analytes, except barbital, showed matrix effects of 77-121%. The limits of detection of the 62 analytes were between 2.8 and 187.5 ng/mL, which were lower than their respective cut-off concentrations (20-500 ng/mL). Ten urine samples from patients undergoing methadone treatment were analyzed by the developed UHPLC-QTOF-MS method, and the results were compared with the immunoassay method.
Dunne, Michael P.; Zolotor, Adam J.; Runyan, Desmond K.; Andreva-Miller, Inna; Choo, Wan Yuen; Dunne, Simon K.; Gerbaka, Bernard; Isaeva, Oksana; Jain, Dipty; Kasim, Mohd Sham; Macfarlane, Bonnie; Mamyrova, Nurgul; Ramirez, Clemencia; Volkova, Elena; Youssef, Randa
Objectives: To gain consensus among an ethnically and linguistically diverse group of international child protection experts on the structure and content of a new survey tool for retrospective measurement of child abuse, and to determine the performance of the instrument through an international field trial with young adults. Methods: The…
Muehlbauer, Melissa; Crane, Patricia A
Elder abuse and neglect is a critical health care issue that must be brought to the attention of health care providers and older adults' family members. Adults older than 65 who live at home or in long-term care facilities may be at risk for abuse. Nurses should be aware of the causes, screening questions, symptoms of abuse, and resources in the community. Armed with information and a better understanding about the issue, nurses can minimize the devastating effects of abuse on older adults and their families.
Babor, Thomas F.; McRee, Bonnie G.; Kassebaum, Patricia A.; Grimaldi, Paul L.; Ahmed, Kazi; Bray, Jeremy
Screening, Brief Intervention, and Referral to Treatment (SBIRT) is a comprehensive and integrated approach to the delivery of early intervention and treatment services through universal screening for persons with substance use disorders and those at risk. This paper describes research on the components of SBIRT conducted during the past 25 years,…
Krasowski, Matthew D; Pizon, Anthony F; Siam, Mohamed G; Giannoutsos, Spiros; Iyer, Manisha; Ekins, Sean
Background Laboratory tests for routine drug of abuse and toxicology (DOA/Tox) screening, often used in emergency medicine, generally utilize antibody-based tests (immunoassays) to detect classes of drugs such as amphetamines, barbiturates, benzodiazepines, opiates, and tricyclic antidepressants, or individual drugs such as cocaine, methadone, and phencyclidine. A key factor in assay sensitivity and specificity is the drugs or drug metabolites that were used as antigenic targets to generate the assay antibodies. All DOA/Tox screening immunoassays can be limited by false positives caused by cross-reactivity from structurally related compounds. For immunoassays targeted at a particular class of drugs, there can also be false negatives if there is failure to detect some drugs or their metabolites within that class. Methods Molecular similarity analysis, a computational method commonly used in drug discovery, was used to calculate structural similarity of a wide range of clinically relevant compounds (prescription and over-the-counter medications, illicit drugs, and clinically significant metabolites) to the target ('antigenic') molecules of DOA/Tox screening tests. These results were compared with cross-reactivity data in the package inserts of immunoassays marketed for clinical testing. The causes for false positives for phencyclidine and tricyclic antidepressant screening immunoassays were investigated at the authors' medical center using gas chromatography/mass spectrometry as a confirmatory method. Results The results illustrate three major challenges for routine DOA/Tox screening immunoassays used in emergency medicine. First, for some classes of drugs, the structural diversity of common drugs within each class has been increasing, thereby making it difficult for a single assay to detect all compounds without compromising specificity. Second, for some screening assays, common 'out-of-class' drugs may be structurally similar to the target compound so that they
Courant, Frédérique; Pinel, Gaud; Bichon, Emmanuelle; Monteau, Fabrice; Antignac, Jean-Philippe; Le Bizec, Bruno
Beta-agonist compounds can be misused in food-producing animals for growth promoting purposes. Efficient methods based on mass spectrometry detection have been developed to ensure the control of such veterinary drug residues. Nevertheless, the use of "cocktails" composed of mixtures of low amounts of several substances as well as the synthesis of new compounds of unknown structure prevent efficient prevention. To circumvent those problems, new analytical tools able to detect such abuse are today mandatory. In this context, metabolomics may represent a new emerging strategy for investigating the global physiological effects associated to a family of substances and therefore, to suspect the administration of beta-agonists (either "cocktails" or unknown compounds). As a first demonstration of feasibility, an untargeted metabolomic approach based on liquid chromatography coupled to high resolution mass spectrometry measurements was developed and made it possible to highlight metabolic modifications in urine consecutively to a clenbuterol administration. By the means of chemometrics, those metabolic differences were used to build predictive models able to suspect clenbuterol administration in calves. This new approach may be considered of valuable interest to overcome current limitations in the control of growth promoters' abuse, with promising perspectives in terms of screening.
Hadidi, Kamal A
A sensitive and rapid method for the simultaneous determination of three commonly abused anticholinergic drugs in Jordan; trihexyphenidyl, procyclidine, and biperiden in plasma and urine has been developed using solid phase extraction and GC-MS. Linearity was established from therapeutic to fatal concentrations of the three drugs; 5-300 ng/ml in plasma, with correlation coefficient r(2) > or = 0.9978 and 10-800 ng/ml in urine r(2) > or = 0.9993. Recoveries were in the range of 86-92% and intra-day and inter-day relative standard deviations (n = 6) were in the range of 6.6-10.3% for the three drugs at three different concentrations in plasma and urine. The base peak m/z 98 for trihexyphenidyl, m/z 84 for procyclidine, and m/z 98 and 218 for biperiden, and m/z 339 for papaverine (internal standard) were monitored at selective ion monitoring; their retention times were 8.10, 8.67 and 8.92 min, respectively, and 14.79 min for the internal standard with analysis time of 16.75 min. The limit of detection of 0.5 ng/ml was attained for trihexyphenidyl and procyclidine, while for biperiden 2.0 and 1.0 ng/ml in spiked plasma and urine, respectively. This method has been applied to forensic and authentic samples taken from abuser and patients using these drugs. The method will offer the clinicians and the legal authority the right diagnosis regarding the anticholinergic involved in any case of abuse with less than 1 h per sample (plasma or urine) from the time of receiving.
... 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 ...
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…
Davis, Randall; Libon, David J.; Au, Rhoda; Pitman, David; Penney, Dana L.
The Digital Clock Drawing Test is a fielded application that provides a major advance over existing neuropsychological testing technology. It captures and analyzes high precision information about both outcome and process, opening up the possibility of detecting subtle cognitive impairment even when test results appear superficially normal. We describe the design and development of the test, document the role of AI in its capabilities, and report on its use over the past seven years. We outline its potential implications for earlier detection and treatment of neurological disorders. We also set the work in the larger context of the THink project, which is exploring multiple approaches to determining cognitive status through the detection and analysis of subtle behaviors. PMID:27066307
Davis, Randall; Libon, David J.; Au, Rhoda; Pitman, David; Penney, Dana L.
The Digital Clock Drawing Test is a fielded application that provides a major advance over existing neuropsychological testing technology. It captures and analyzes high precision information about both outcome and process, opening up the possibility of detecting subtle cognitive impairment even when test results appear superficially normal. We describe the design and development of the test, document the role of AI in its capabilities, and report on its use over the past seven years. We outline its potential implications for earlier detection and treatment of neurological disorders. We also set the work in the larger context of the THink project, which is exploring multiple approaches to determining cognitive status through the detection and analysis of subtle behaviors. PMID:27066295
Jagerdeo, Eshwar; Schaff, Jason E
We present a UPLC(®)-High Resolution Mass Spectrometric method to simultaneously screen for nineteen benzodiazepines, twelve opiates, cocaine and three metabolites, and three "Z-drug" hypnotic sedatives in both blood and urine specimens. Sample processing consists of a high-speed, high-temperature enzymatic hydrolysis for urine samples followed by a rapid supported liquid extraction (SLE). The combination of ultra-high resolution chromatography with high resolution mass spectrometry allows all 38 analytes to be uniquely detected with a ten minute analytical run. Limits of detection for all target analytes are 3ng/mL or better, with only 0.3mL of specimen used for analysis. The combination of low sample volume with fast processing and analysis makes this method a suitable replacement for immunoassay screening of the targeted drug classes, while providing far superior specificity and better limits of detection than can routinely be obtained by immunoassay.
Hernández, Diana; Feaster, Daniel J.; Gooden, Lauren; Douaihy, Antoine; Mandler, Raul; Erickson, Sarah J.; Kyle, Tiffany; Haynes, Louise; Schwartz, Robert; Das, Moupali; Metsch, Lisa
Substance users are at increased risk for HIV and HCV infection. Still, many substance use treatment programs (SUTP) fail to offer HIV/HCV testing. The present secondary analysis of screening data from a multi-site randomized trial of rapid HIV testing examines self-reported HIV/HCV testing patterns and serostatus of 2,473 SUTP patients in 12 community-based sites that had not previously offered on-site testing. Results indicate that most respondents screened for the randomized trial tested more than a year prior to intake for HIV (52%) and HCV (38%). Prevalence rates were 3.6% and 30% for HIV and HCV, respectively. The majority of participants that were HIV (52.2%) and HCV-positive (40.5%) reported having been diagnosed within the last one to five years. Multivariable logistic regression showed that members of high-risk groups were more likely to have tested. Bundled HIV/HCV testing and linkage to care issues are recommended for expanding testing in community-based SUTP settings. PMID:25952768
Boettcher, M; Haenseler, E; Hoke, C; Nichols, J; Raab, D; Domke, I
Abuscreen OnLine assays for drugs of abuse screening in urine have recently been developed for use on Hitachi 917 analyzers (Roche Diagnostics GmbH). The assays are based on the kinetic interaction of microparticles as measured by changes in light transmission. Drug in a sample inhibits the formation of particle aggregates and diminishes absorbance change increases. It was the goal of this study to evaluate precision and comparability of the new asssys with CEDIA drugs of abuse tests on Hitachi 917 in different laboratories (three European and three US). The assays were calibrated in the nonlinear mode with four to six standards (semiquantitative application). Initial within-run (21 replicates, four labs) and between-day (10 days, two labs) imprecision studies using Abuscreen OnLine tests and commercial negative (0.5 x cut-off) and positive (1.5 x cut-off) controls revealed the following median CVs [withinrun neg./pos. control/between-day neg./pos. control]: amphetamines 1.9/1.3/3.4/2.4, barbiturates 3.0/1.6/3.9/3.1, benzodiazepines 4.7/1.5/6.3/3.0, cocaine metabolite 1.8/0.9/2.4/1.7, methadone 5.4/1.6/5.5/2.2, opiates 5.5/2.8/5.3/2.7, THC 8.9/4.8/21.8/12.1. CVs < 10% were obtained for the THC test using controls with concentrations closer to the cut-off. An identical set of 170 GC/MS analyzed urine samples was distributed to the six laboratories and measured with Abuscreen OnLine tests on Hitachi 917. The median values for each individual sample were calculated and compared with the results obtained on individual Hitachi 917 analyzers by Passing-Bablok regression analysis. A good agreement between the laboratories was found with less than +/- 11% slope deviation and intercepts below 7% of the cut-off except for benzodiazepines (one slope 17%, one slope--26%) and THC (one slope 34%, one slope--18%). The comparability with CEDIA tests was analyzed by concordance plots using randomized routine samples in three laboratories. The following results were obtained in one
Berg, Jon Andsnes; Schjøtt, Jan; Fossan, Kjell O; Riedel, Bettina
Purpose The cloned enzyme donor immunoassay (CEDIA) for buprenorphine is applied for both urine drugs-of-abuse screening and compliance monitoring. Sensitivity, specificity, and optimal cutoff of this assay have differed between studies. This may indicate that cross-reactivity has to be taken into account during assay evaluation. We therefore investigated the performance of the CEDIA buprenorphine assay for use in our patient population and explored the impact of cross-reactivity on assay accuracy. Methods The CEDIA buprenorphine assay and high-performance liquid chromatography–tandem mass spectrometry were employed to analyze drugs-of-abuse in urine samples from a healthy drug-naïve male volunteer after intake of two tablets of a prescription drug containing 400 mg paracetamol +30 mg codeine phosphate, and in urine samples (n=2,272) from drug-addicted patients. Receiver operating characteristic analyses were performed to express the diagnostic accuracy of the CEDIA buprenorphine assay. Results CEDIA buprenorphine was positive in one urine sample from the drug-naïve person after intake of the prescription drug. Twenty-five (1.1%) of the patient urine samples were positive for buprenorphine by CEDIA, but negative by high-performance liquid chromatography–tandem mass spectrometry. Codeine, morphine, and their respective metabolites were prevalent in samples that were false positive for buprenorphine. The specificity of the CEDIA buprenorphine assay increased to 99.7% when the cutoff was increased from 5 ng/mL to 10 ng/mL. Conclusion Intake of a therapeutic dose of codeine can yield a false-positive CEDIA buprenorphine result. Additive effects from metabolites of codeine contribute to cross-reactivity in concentrations much lower than listed in the manufacturer’s cross-reactivity guide. Raising the cutoff from 5 ng/mL to 10 ng/mL increased the diagnostic accuracy. Clinicians should be informed about the risk of false-positive results with the CEDIA
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.
Oschwald, Mary; Renker, Paula; Hughes, Rosemary B.; Arthur, Anne; Powers, Laurie E.; Curry, Mary Ann
To increase safety and minimize the risk of interpersonal violence, it is critical that women with disabilities and Deaf women have an opportunity to identify whether or not abuse is happening in their lives. Awareness and knowledge of what constitutes abusive behaviors is an essential first step in addressing interpersonal violence. This article…
... 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 ...
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)
Matsumoto, David; Hwang, Hyisung C
Most studies on judgments of facial expressions of emotion have primarily utilized prototypical, high-intensity expressions. This paper examines judgments of subtle facial expressions of emotion, including not only low-intensity versions of full-face prototypes but also variants of those prototypes. A dynamic paradigm was used in which observers were shown a neutral expression followed by the target expression to judge, and then the neutral expression again, allowing for a simulation of the emergence of the expression from and then return to a baseline. We also examined how signal and intensity clarities of the expressions (explained more fully in the Introduction) were associated with judgment agreement levels. Low-intensity, full-face prototypical expressions of emotion were judged as the intended emotion at rates significantly greater than chance. A number of the proposed variants were also judged as the intended emotions. Both signal and intensity clarities were individually associated with agreement rates; when their interrelationships were taken into account, signal clarity independently predicted agreement rates but intensity clarity did not. The presence or absence of specific muscles appeared to be more important to agreement rates than their intensity levels, with the exception of the intensity of zygomatic major, which was positively correlated with agreement rates for judgments of joy.
... 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…
Griest, K J; Zumwalt, R E
Drowning as a form of subtle fatal child abuse is difficult to distinguish from accidental immersion or from sudden unexpected natural death when the circumstances of immersion are concealed. Homicidal drownings are unwitnessed, usually occurring in the home, and the victims are young, either infants or toddlers. Accidental drownings are more likely to involve toddlers or older children in public areas such as swimming pools, drainage ditches, lakes, and rivers. This is especially true in rural areas. In cities, bathtubs remain a major site of accidental childhood drownings. Perpetrators of deliberate drownings often fit the sociopathologic profile of a child abuser. Because there is often a survival interval between immersion and death, pathologic findings consistent with postimmersion syndrome suggest the cause of death. Foreign material in the lungs, if immersion was other than in clear tap water, and injuries of the face are other positive correlating factors. A thorough investigation of the circumstances and cooperation between the investigating agency and the pathologist are essential to determine the correct manner of death in these cases.
Screening analysis for medicinal drugs and drugs of abuse in whole blood using ultra-performance liquid chromatography time-of-flight mass spectrometry (UPLC-TOF-MS)--toxicological findings in cases of alleged sexual assault.
Birkler, Rune Isak Dupont; Telving, Rasmus; Ingemann-Hansen, Ole; Charles, Annie Vesterby; Johannsen, Mogens; Andreasen, Mette Findal
An ultra-performance liquid chromatography time-of-flight mass spectrometry (UPLC-TOF-MS) method for simultaneous screening of 46 medicinal drugs and drugs of abuse in whole blood was developed and validated. The method includes most of the commonly used and abused drugs such as amphetamines, cocaine, benzodiazepines, and opioids. Chromatographic separation of the targeted drugs was achieved using a Waters ACQUITY UPLC coupled to a Waters Micromass LCT Premier XE time-of-flight mass spectrometer. The total chromatographic run time was 13.5 min injection to injection. The estimated method LOQ is in the range of 0.06-27 ng/g, which is below the therapeutic levels for each of the drugs analyzed but LSD. The extraction recovery ranged from 6% to 197% with median value 95% and mean value 82%. Matrix effect ranged from 81% suppression to 29% enhancement of the signals compared to signals obtained in the absence of biological matrix. The method was tested on 55 authentic forensic toxicology samples confirming the same positive results as found using the routine analytical procedures as well as some additional compounds. Recently there has been considerable attention paid to drug-facilitated sexual assault and the toxicological findings in these cases. As part of a pilot study to investigate the prevalence of medicinal drugs, drugs of abuse, and alcohol in victims of alleged sexual assault, biological specimens were obtained from 167 victims being examined at the Sexual Assault Center in Aarhus, Denmark. The obtained blood samples were analyzed using the novel screening method supported by additional analyses for e.g. THC and alcohol. 124 victims reported they have been drinking alcohol prior to the assault (74%). Alcohol analyses revealed 59 positive findings (48%). 35 of the cases were found positive for one or more drugs excluding alcohol (21%). 20 of the victims reported they have been subject to a drug-facilitated sexual assault (12%). For the victims suspecting drug
Johnson, Charles F.; Coury, Daniel L.
Two case histories illustrate the difficulty in evaluating abuse/neglect in children with bleeding problems such as hemophilia. Discussed are guidelines for diagnosis and prevention of abuse, including: screening techniques, the need for protection from environmental trauma, parental stress, evaluation of parents' disciplinary methods, and the…
... 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 ...
Himelhoch, Seth; Goldberg, Richard; Calmes, Christine; Medoff, Deborah; Slade, Eric; Dixon, Lisa; Gallucci, Gerard; Rosenberg, Stanley
Background: To assess rates of screening and testing of HIV and HCV among those with serious mental illness and co-occurring substance use disorders. Methods: One hundred fifty-three people with serious mental illness and co-occurring substance use disorders completed measures and were screened for HIV and HCV. Results: Six percent were HIV…
Raffa, Robert B.; Pergolizzi, Joseph V.; Muñiz, Edmundo; Taylor, Robert; Pergolizzi, Jason
Prescription opioid formulations designed to resist or deter abuse are an important step in reducing opioid abuse. In creating these new formulations, the paradigm of drug development target should be introduced. Biological targets relating to the nature of addiction may pose insurmountable hurdles based on our current knowledge and technology, but products that use behavioral targets seem logical and feasible. The population of opioid abusers is large and diverse so behavioral targets are more challenging than they appear at first glance. Furthermore, we need to find ways to correlate behavioral observations of drug liking to actual use and abuse patterns. This may involve revisiting some pharmacodynamic concepts in light of drug effect rather than peak concentration. In this paper we present several new opioid analgesic agents designed to resist or deter abuse using physical barriers, the inclusion of an opioid agonist or antagonist, an aversive agent, and a prodrug formulation. Further, this paper also provides insight into the challenges facing drug discovery in this field. Designing and screening for opioids intended to resist or deter abuse is an important step to meet the public health challenge of burgeoning prescription opioid abuse. PMID:23213510
[Prophylaxis of substance abuse in the Armed Forces: organization and performance of screening. Problem of substance dependence disorders is the actual for many countries in the world and affects on health of servicemen].
Fisun, A Ia; Kuvshinov, K É; Shamreĭ, V K; Alekseev, V V; Goncharenko, A Iu; Pastushenkov, A V; Tikhenko, V V
Due to this fact specialists underline the necessity of implementation of constant drug testing system of servicemen. The most effective researches individuals suffering from substance abuse are sample and control survey. Promising areas of prevention of addictive disease include the use of modem technologies for early detection of drug narcotic drugs and psychotropic substances, using the psychophysiological and laboratory techniques. The most common rapid laboratory procedure is the use of test strips (tablets) based immunoassay analysis. To facilitate the evaluation of the results is increasingly incorporated hardware and software systems based on photometric detection. The work done on the testing of such complexes allowed us to determine the algorithm of screening soldiers to assess the effectiveness of various hardware and software systems and identify promising technologies to identify individuals with addictive disorders.
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.
... 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 ...
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.
Yang, Yongping; Sharan, Shyam K
The bacteriophage lambda recombination system has proven to be a valuable tool for engineering bacterial artificial chromosomes (BAC). Due to its high efficiency, subtle alterations in the BACs can be generated using oligonucleotides as targeting vectors. Since no selection marker is used, recombinant clones are identified utilizing a selective PCR screening method. However, occasionally the selective PCR screening is not feasible. We describe here a two-step 'hit and fix' method that can be reliably used for generating any subtle alteration in BACs using short denatured PCR fragments as targeting vectors. In the first step of this method, 6-20 nucleotides are changed around the base where the mutation has to be generated. In the second step, these altered nucleotides are reverted to the original sequence and simultaneously a subtle alteration is introduced. Since in each step several nucleotides are changed, PCR primers specific for such alterations can be designed. This two-step method provides a simple and efficient tool for generating subtle alterations in BACs that can be very valuable for functional analysis of genes.
Hoover, Robert M; Polson, Michol
Elder mistreatment includes intentional or neglectful acts by a caregiver or trusted person that harm a vulnerable older person. It can occur in a variety of settings. One out of 10 older adults experiences some form of abuse or neglect by a caregiver each year, and the incidence is expected to increase. Although the U.S. Preventive Services Task Force found insufficient evidence that screening for elder abuse reduces harm, physicians in most states have professional and legal obligations to appropriately diagnose, report, and refer persons who have been abused. Screening or systematic inquiry can detect abuse. A detailed medical evaluation of patients suspected of being abused is necessary because medical and psychiatric conditions can mimic abuse. Signs of abuse may include specific patterns of injury. Interviewing patients and caregivers separately is helpful. Evaluation for possible abuse should include assessment of cognitive function. The Elder Abuse Suspicion Index is validated to screen for abuse in cognitively intact patients. A more detailed two-step process is used to screen patients with cognitive impairment. The National Center on Elder Abuse website provides detailed, state-specific reporting and resource information for family physicians.
This article discusses violence in relation to women's reproductive and sexual rights in Africa. Two types of violent behaviors are defined. One type is defined as a straightforward, aggressive act of brutality inflicted on one person by another, which may range from battery to rape, and which may occur domestically or be inflicted by a stranger. The other type of violent behavior is the violation of rights or denial of rights, which often operates not only on personal, but also on societal or cultural levels. These definitions allow us to address the record of violence against women in a broad social and political context in which not only men but women and society as a whole act to perpetuate systems resulting in various forms of abuse. In Africa, the strong patriarchal tradition with the economic mode of more formal and systematic, less centralized commerce makes it virtually impossible for a woman to move, act, or think freely. The most damaging type of sexual violence against women centers on the lack of control that women are allowed over their fertility. Denial of reproductive rights, services and information acts as pervasive form of violence, with significant consequences. Women face both the threats of direct bodily violence from strangers and within their own homes; and the exposure to the risk of HIV infection and other sexually transmitted diseases, of unwanted and unplanned pregnancy, and of unsafe abortion due to the violation of women's basic human rights.
McElroy, Linda Provus
This paper reviews factors in the professional neglect of multiple personality disorder (MPD) and sexual abuse in childhood, as well as recent diagnostic developments in childhood dissociative disorders. The identification of subtle dissociative symptomatology in children is illustrated, and two case examples are presented. (Author)
Alimonti, Andrea; Carracedo, Arkaitz; Clohessy, John G; Trotman, Lloyd C; Nardella, Caterina; Egia, Ainara; Salmena, Leonardo; Sampieri, Katia; Haveman, William J; Brogi, Edi; Richardson, Andrea L; Zhang, Jiangwen; Pandolfi, Pier Paolo
Cancer susceptibility has been attributed to at least one heterozygous genetic alteration in a tumor suppressor gene (TSG). It has been hypothesized that subtle variations in TSG expression can promote cancer development. However, this hypothesis has not yet been definitively supported in vivo. Pten is a TSG frequently lost in human cancer and mutated in inherited cancer-predisposition syndromes. Here we analyze Pten hypermorphic mice (Pten(hy/+)), expressing 80% normal levels of Pten. Pten(hy/+) mice develop a spectrum of tumors, with breast tumors occurring at the highest penetrance. All breast tumors analyzed here retained two intact copies of Pten and maintained Pten levels above heterozygosity. Notably, subtle downregulation of Pten altered the steady-state biology of the mammary tissues and the expression profiles of genes involved in cancer cell proliferation. We present an alterative working model for cancer development in which subtle reductions in the dose of TSGs predispose to tumorigenesis in a tissue-specific manner.
Dong, Xinqi; Simon, Melissa A; Gorbien, Martin
This study aims to investigate the prevalence of elder abuse and neglect in an urban Chinese population. A cross-sectional study was performed in a major urban medical center in NanJing, China. A total of 412 participants completed the survey and 145 (35%) participants screened positive for elder abuse and neglect. The mean age of the victims was 69 years and 59% were male. Caregiver neglect was the most common form of abuse, followed by financial exploitation, psychological abuse, physical abuse, sexual abuse, and abandonment. Thirty-six percent of the victims suffered multiple forms of abuse and neglect. In the logistical regression analyses of the data, female gender, lower education and lower income were demographic risk factors associated with elder abuse and neglect. A better understanding of these and additional risk factors associated with elder abuse and neglect in older Chinese people is needed.
Wille, Sarah M R; Samyn, Nele; Ramírez-Fernández, Maria del Mar; De Boeck, Gert
Driving under the influence of drugs is a major problem worldwide. At the moment, several countries have adopted a 'per se' legislation to address this problem. One of the key elements in the enforcement process is the possibility of rapid on-site screening tests to take immediate administrative measures. In this study, the reliability of three oral fluid screening devices (Mavand RapidSTAT, Securetec Drugwipe-5(+), and Dräger DrugTest 5000) was assessed by comparing their on-site results with confirmatory GC-MS plasma analysis. Our results demonstrate that for amphetamine screening, the oral fluid on-site devices on the market today are certainly sensitive enough. RapidSTAT, Drugwipe-5(+), and DrugTest 5000 demonstrated respectively a sensitivity of 93%, 100% and 92% for amphetamine/MDMA. For cocaine screening, sensitivities of 75%, 78% and 67% were obtained for the RapidSTAT, Drugwipe-5(+), and DrugTest 5000 devices, respectively. The studied devices were able to detect about 70% of all cannabis users in a roadside setting. However, a newer version of the DrugTest 5000 test cassette demonstrated a sensitivity of 93%, indicating an increased detection of Delta(9)-tetrahydrocannabinol using 'new generation' oral fluid screening tests with lowered cut-offs. Due to these promising results police officers and judicial experts are keen to use oral fluid screening devices. They believe that their ease of use and diminished amount of false positive results in comparison with urine screening will lead to more roadside tests and more appropriate juridical measures.
... 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 ...
View south along subtle ridgeline across a pile of removed gravestones to Doughty-Beck monument, another gravestone pile, and Mill Street houses. - Mount Zion Cemetery/ Female Union Band Cemetery, Bounded by 27th Street right-of-way N.W. (formerly Lyons Mill Road), Q Street N.W., & Mill Road N.W., Washington, District of Columbia, DC
Burns, Andrew; Darling, Nancy
Describes the effect of peer influence, a more subtle form of peer pressure, on adolescent behavior. Suggests three ways principals can intervene to make peer influence a positive force in the school: Provide positive information, involve all students, and group students differently. (PKP)
Evans, Alvin; Chun, Edna
This article draws upon insights from Edna Chun and Alvin Evans' forthcoming book "Bridging the Diversity Divide: Globalization and Reciprocal Empowerment in Higher Education." Despite apparent signs of progress in diversity within higher education, deeper cultural change must occur within academe to erode and eliminate subtle behavioral and…
College students (n=241) completed Millon Clinical Multiaxial Inventory (MCMI) under different instructional sets. Found index of differential endorsement of subtle and obvious MCMI items to discriminate more strongly than MCMI Validity Scale between subjects instructed to answer honestly and subjects instructed to fake good, fake bad, or portray…
Hazen, Andrea L.; Baker-Ericzén, Mary J.; Landsverk, John; Horwitz, Sarah McCue
Abstract Background The perinatal period provides unique opportunities to identify and intervene with the co-occurrence of perinatal depression, intimate partner violence (IPV), and substance use problems. Psychosocial screening recommended for women seen in maternal child health settings tends to target single rather than multiple risk factors; there is limited research examining the co-occurrence of these issues especially in racially and ethnically diverse women across the perinatal period. These analyses explore the relationships of sociodemographic, psychosocial, and behavioral characteristics in a large, diverse sample of women. Method Women receiving perinatal services at routinely scheduled visits, including the 6-week postpartum visit, were recruited from 10 community obstetric/gynecologic clinics. Data were collected on perinatal depression, IPV, maternal substance use, and sociodemographic characteristics by bilingual, bicultural research assistants. Results A total of 1868 women were screened, 1526 (82%) Latina, 1099 (58.8%) interviewed in Spanish; 20.4% (n=382) screened positive for depressive symptoms based on an Edinburgh Postnatal Depression Scale score of 10 or above, 20.9% reported harmful drinking, 4.3% reported drug use, 23% reported substance use problems, and 3.5% reported current or recent IPV. Women who were Black, Asian, Pacific Islander, or other race/ethnicity had greater odds for depressive symptoms relative to women who were Hispanic or Latino (odds ratio [OR]=1.81, p=0.005). Women reporting substance use problems (OR=2.37, p<0.0001) and IPV (OR=3.98, p<0.0001) had higher odds for depressive symptoms. Conclusion In a predominately Latina sample, 1 in 5 mothers (20.4%) screened positive for depressive symptoms and over one third (36.7%) reported one or more psychosocial issues during the perinatal period. Screening for multiple risk factors rather than just one can help clinicians tailor interventions for the successful management of
Evans, Elizabeth A; Sullivan, Maria A
Background Rates of prescription drug abuse have reached epidemic proportions. Large-scale epidemiologic surveys of this under-recognized clinical problem have not included antidepressants despite their contribution to morbidity and mortality. The purpose of this review is to look specifically at the misuse of antidepressants and how this behavior may fit into the growing crisis of nonmedical use of prescription drugs. Methods We conducted a comprehensive search on PubMed, Medline, and PsycINFO using the search terms “antidepressant”, “abuse”, “misuse”, “nonmedical use”, “dependence”, and “addiction”, as well as individual antidepressant classes (eg, “SSRI”) and individual antidepressants (eg, “fluoxetine”) in various combinations, to identify articles of antidepressant misuse and abuse. Results A small but growing literature on the misuse and abuse of antidepressants consists largely of case reports. Most cases of antidepressant abuse have occurred in individuals with comorbid substance use and mood disorders. The most commonly reported motivation for abuse is to achieve a psychostimulant-like effect. Antidepressants are abused at high doses and via a variety of routes of administration (eg, intranasal, intravenous). Negative consequences vary based upon antidepressant class and pharmacology, but these have included seizures, confusion, and psychotic-like symptoms. Conclusion The majority of individuals prescribed antidepressants do not misuse the medication. However, certain classes of antidepressants do carry abuse potential. Vulnerable patient populations include those with a history of substance abuse and those in controlled environments. Warning signs include the presence of aberrant behaviors. Physicians should include antidepressants when screening for risky prescription medication use. When antidepressant misuse is detected, a thoughtful treatment plan, including referral to an addiction specialist, should be developed and
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
Peter W. Carr; K.M. Fuller; D.R. Stoll; L.D. Steinkraus; M.S. Pasha; Glenn G. Hardin
A new approach has been developed by modifying a conventional gradient elution liquid chromatograph for the high throughput screening of biological samples to detect the presence of regulated intoxicants. The goal of this work was to improve the speed of a gradient elution screening method over current approaches by optimizing the operational parameters of both the column and the instrument without compromising the reproducibility of the retention times, which are the basis for the identification. Most importantly, the novel instrument configuration substantially reduces the time needed to re-equilibrate the column between gradient runs, thereby reducing the total time for each analysis. The total analysis time for each gradient elution run is only 2.8 minutes, including 0.3 minutes for column reequilibration between analyses. Retention times standard calibration solutes are reproducible to better than 0.002 minutes in consecutive runs. A corrected retention index was adopted to account for day-to-day and column-to-column variations in retention time. The discriminating power and mean list length were calculated for a library of 47 intoxicants and compared with previous work from other laboratories to evaluate fast gradient elution HPLC as a screening tool.
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…
Bird, P E; Harrington, D T; Barillo, D J; McSweeney, A; Shirani, K Z; Goodwin, C W
An estimated 2 million people a year are victims of elder abuse, which ranges from neglect and mistreatment to physical abuse. By the year 2020, a full 22% of the population will be aged 65 or older. This demographic explosion demands that we identify and protect those at risk. To investigate the incidence of elder abuse or neglect (EAN) and to determine clinician awareness of associated risk factors, we conducted a 1-year retrospective review of thermally injured patients aged 60 or older. Data included age, total body surface area burned, mechanism of injury, length of hospital stay, mortality, abuse or neglect risk factors, and referral to the appropriate social agency. We found that our elderly patients (n = 28) were poorly screened for EAN. While 64% to 96% of patients were screened for cognitive impairment, overall health, and financial resources, none were screened for risk factors of emotional isolation. None of the patient's caregivers, including any spouses, roommates, or guardians, were screened for risk factors of substance abuse, familial violence, dependency needs, or external stresses. With the use of available data, we were able to place 11 patients on the following levels of abuse or neglect: 1) low risk for abuse; 2) self-neglect; 3) neglect; and 4) abuse. By this scale, 7 patients (64%) were victims of self-neglect, 3 patients (27%) were victims of neglect, and 1 patient (9%) was a victim of abuse. Adult Protective Services intervened in 2 cases. Recognizing that all cases of EAN should be preventable, we cannot accept the socioeconomic impact of this entity. The 11 patients identified as victims of neglect, self-neglect, or abuse accounted for 135 hospital days and 8 fatalities. Before we can address EAN, health care personnel must be made aware of the problem and routine screening for risk factors must be implemented. The true incidence of EAN is likely underestimated because health care providers have difficulty recognizing its features. A
Jain, Raka; Verma, Arpita
The steady increase of inhalant abuse is a great challenge for analytical toxicologists. This review describes an overview of inhalant abuse including the extent of the problem, types of products abused, modes of administration, pharmacology and effects of inhalants, the role of laboratory, interpretation of laboratory results and clinical considerations. Regular laboratory screening for inhalant abuse as well as other substance abuse and health risk behaviors must be a part of standard clinical care. PMID:26957863
Edmonds, Emily C; Delano-Wood, Lisa; Galasko, Douglas R; Salmon, David P; Bondi, Mark W
The NIA-AA criteria for "preclinical" Alzheimer's disease (AD) propose a staging method in which AD biomarkers follow an invariable temporal sequence in accordance with the amyloid cascade hypothesis. However, recent findings do not align with the proposed temporal sequence and "subtle cognitive decline," which has not been definitively operationalized, may occur earlier than suggested in preclinical AD. We aimed to define "subtle cognitive decline" using sensitive and reliable neuropsychological tests, and to examine the number and sequence of biomarker abnormalities in the Alzheimer's Disease Neuroimaging Initiative (ADNI). 570 cognitively normal ADNI participants were classified based on NIA-AA criteria and separately based on the number of abnormal biomarkers/cognitive markers associated with preclinical AD that each individual possessed. Results revealed that neurodegeneration alone was 2.5 times more common than amyloidosis alone at baseline. For those who demonstrated only one abnormal biomarker at baseline and later progressed to mild cognitive impairment/AD, neurodegeneration alone was most common, followed by amyloidosis alone or subtle cognitive decline alone, which were equally common. Findings suggest that most individuals do not follow the temporal order proposed by NIA-AA criteria. We provide an operational definition of subtle cognitive decline that captures both cognitive and functional decline. Additionally, we offer a new approach for staging preclinical AD based on number of abnormal biomarkers, without regard to their temporal order of occurrence. This method of characterizing preclinical AD is more parsimonious than the NIA-AA staging system and does not presume that all patients follow a singular invariant expression of the disease.
Bulling, T.B.; Breyer, J.A.
High-resolution paleogeographic maps depicting the depositional history of the Reklaw 1 interval provide a basis for prospecting for subtle traps in the updip Reklaw trend in south Texas. The Reklaw 1 interval began with sand being carried southwest by longshore currents to form the barrier bar that forms the reservoir in Atkinson field. The hydrocarbons are trapped by the updip pinch-out of barrier-bar sand into lagoonal mud. Stratigraphic traps similar to Atkinson field could be present along depositional strike if the sand in the field were part of a more extensive-bar system. After the barrier bar formed, distributary-mouth bars prograded seaward depositing the bar-finger sands that are the reservoirs in Hysaw and Flax fields. Subtle structural traps could be present where small down-to-the-north faults associated with the Sample fault system cut the bar-finger sands downdip from the established production. Farther down paleoslope, the distributary channels began to bifurcate and the distributary-mouth bar coalesced to form a broad delt-front sheet sand. Burnell, Hondo Creek, and Runge West fields produce from this sheet sand near the unstable shelf margin. A rapid rise in relative sea level terminated deposition of the Reklaw 1 interval. Many of the oil and gas fields remaining to be discovered in the United States are in mature petroleum provinces where much of the remaining oil and gas probably resides in subtle traps. High-resolution paleogeographic maps may be a key to finding these subtle traps.
... 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 ...
Moss-Racusin, Corinne A; Dovidio, John F; Brescoll, Victoria L; Graham, Mark J; Handelsman, Jo
Despite efforts to recruit and retain more women, a stark gender disparity persists within academic science. Abundant research has demonstrated gender bias in many demographic groups, but has yet to experimentally investigate whether science faculty exhibit a bias against female students that could contribute to the gender disparity in academic science. In a randomized double-blind study (n = 127), science faculty from research-intensive universities rated the application materials of a student-who was randomly assigned either a male or female name-for a laboratory manager position. Faculty participants rated the male applicant as significantly more competent and hireable than the (identical) female applicant. These participants also selected a higher starting salary and offered more career mentoring to the male applicant. The gender of the faculty participants did not affect responses, such that female and male faculty were equally likely to exhibit bias against the female student. Mediation analyses indicated that the female student was less likely to be hired because she was viewed as less competent. We also assessed faculty participants' preexisting subtle bias against women using a standard instrument and found that preexisting subtle bias against women played a moderating role, such that subtle bias against women was associated with less support for the female student, but was unrelated to reactions to the male student. These results suggest that interventions addressing faculty gender bias might advance the goal of increasing the participation of women in science.
Alimonti, Andrea; Carracedo, Arkaitz; Clohessy, John G; Trotman, Lloyd C; Nardella, Caterina; Egia, Ainara; Salmena, Leonardo; Sampieri, Katia; Haveman, William J; Brogi, Edi; Richardson, Andrea L; Zhang, Jiangwen; Pandolfi, Pier Paolo
Cancer susceptibility has been attributed to at least one heterozygous genetic alteration in a tumor suppressor gene (TSG)1. It has been hypothesized that subtle variations in TSG expression can promote cancer development2,3. However, this hypothesis has not yet been definitively supported in vivo. PTEN is a TSG frequently lost in human cancer and mutated in inherited cancer-predisposition syndromes4. Here, we analyze Pten hypermorphic mice (Ptenhy/+), expressing 80% normal levels of Pten. Ptenhy/+ mice develop a spectrum of tumors, with breast tumors occurring at the highest penetrance. All breast tumors analyzed here retained two intact copies of Pten and maintained Pten levels above heterozygosis. Notably, subtle downregulation of Pten altered the steady-state biology of the mammary tissues and the expression profiles of genes involved in cancer cell proliferation. We present an alterative working model for cancer development in which subtle reductions in the dose of TSGs predispose to tumorigenesis in a tissue-specific manner. PMID:20400965
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.
Goldberg, Adele E.
Much has been written about the unlikelihood of innate, syntax-specific, universal knowledge of language (Universal Grammar) on the grounds that it is biologically implausible, unresponsive to cross-linguistic facts, theoretically inelegant, and implausible and unnecessary from the perspective of language acquisition. While relevant, much of this discussion fails to address the sorts of facts that generative linguists often take as evidence in favor of the Universal Grammar Hypothesis: subtle, intricate, knowledge about language that speakers implicitly know without being taught. This paper revisits a few often-cited such cases and argues that, although the facts are sometimes even more complex and subtle than is generally appreciated, appeals to Universal Grammar fail to explain the phenomena. Instead, such facts are strongly motivated by the functions of the constructions involved. The following specific cases are discussed: (a) the distribution and interpretation of anaphoric one, (b) constraints on long-distance dependencies, (c) subject-auxiliary inversion, and (d) cross-linguistic linking generalizations between semantics and syntax. PMID:26858662
Poggi, Giulia; Boretius, Susann; Möbius, Wiebke; Moschny, Nicole; Baudewig, Jürgen; Ruhwedel, Torben; Hassouna, Imam; Wieser, Georg L.; Werner, Hauke B.; Goebbels, Sandra
Subtle white matter abnormalities have emerged as a hallmark of brain alterations in magnetic resonance imaging or upon autopsy of mentally ill subjects. However, it is unknown whether such reduction of white matter and myelin contributes to any disease‐relevant phenotype or simply constitutes an epiphenomenon, possibly even treatment‐related. Here, we have re‐analyzed Mbp heterozygous mice, the unaffected parental strain of shiverer, a classical neurological mutant. Between 2 and 20 months of age, Mbp+/‐ versus Mbp+/+ littermates were deeply phenotyped by combining extensive behavioral/cognitive testing with MRI, 1H‐MR spectroscopy, electron microscopy, and molecular techniques. Surprisingly, Mbp‐dependent myelination was significantly reduced in the prefrontal cortex. We also noticed a mild but progressive hypomyelination of the prefrontal corpus callosum and low‐grade inflammation. While most behavioral functions were preserved, Mbp+/‐ mice exhibited defects of sensorimotor gating, as evidenced by reduced prepulse‐inhibition, and a late‐onset catatonia phenotype. Thus, subtle but primary abnormalities of CNS myelin can be the cause of a persistent cortical network dysfunction including catatonia, features typical of neuropsychiatric conditions. GLIA 2016;64:2025–2040 PMID:27470661
Dervilly-Pinel, Gaud; Rambaud, Lauriane; Sitthisack, Parina; Monteau, Fabrice; Hewitt, S Armstrong; Kennedy, D Glenn; Le Bizec, Bruno
17β-Nandrolone (17β-NT) is one of the most frequently misused anabolic steroids in meat producing animals. As a result of its extensive metabolism combined with the possibility of interferences with other endogenous compounds, detection of its illegal use often turns out to be a difficult issue. In recent years, proving the illegal administration of 17β-NT became even more challenging since the presence of endogenous presence of 17β-NT or some of its metabolite in different species was demonstrated. In bovines, 17α-NT can occur naturally in the urine of pregnant cows and recent findings reported that both forms can be detected in injured animals. Because efficient control must both take into account metabolic patterns and associated kinetics of elimination, the purpose of the present study was to investigate further some estranediols (5α-estrane-3β,17β-diol (abb), 5β-estrane-3α,17β-diol (bab), 5α-estrane-3β,17α-diol (aba), 5α-estrane-3α,17β-diol (aab) and 5β-estrane-3α,17α-diol (baa)) as particular metabolites of 17β-NT on a large number of injured (n=65) or pregnant (n=40) bovines. Whereas the metabolites abb, bab, aba and baa have previously been detected in urine up to several days after 17β-NT administration, the present study showed that some of the isomers abb (5α-estrane-3β,17β-diol) and bab (5β-estrane-3α,17β-diol) could not be detected in injured or pregnant animals, even at very low levels. This result may open a new way for the screening of anabolic steroid administration considering these 2 estranediols as biomarkers to indicate nandrolone abuse in cattle.
... HUMAN SERVICES National Institutes of Health National Institute on Drug Abuse; Notice of Closed Meeting... Committee: National Institute on Drug Abuse Special Emphasis Panel; Profile Screening and Predictive..., Office of Extramural Affairs, National Institute on Drug Abuse, NIH, DHHS, Room 4227, MSC 9550,...
Rohrer, Doug; Pashler, Harold; Harris, Christine R
A number of researchers have reported studies showing that subtle reminders of money can alter behaviors and beliefs that are seemingly unrelated to money. In 1 set of studies published in this journal, Caruso, Vohs, Baxter, and Waytz (2013) found that incidental exposures to money led subjects to indicate greater support for inequality, socioeconomic differences, group-based discrimination, and free market economies. We conducted high-powered replication attempts of these 4 money priming effects and found no evidence of priming (weighted Cohen's d = 0.03). We later learned that Caruso et al. also found several null effects in their line of research that were not reported in the original article. In addition, the money priming effect observed in the first study of Caruso et al. was included in the Many Labs Replication Project (Klein et al., 2014), and only 1 of the 36 labs was able to find the effect.
Rather, Gulam Mohmad; Gupta, Munishwar Nath
Three phase partitioning consists of precipitation of proteins due to simultaneous presence of ammonium sulphate and t-butanol. The technique has been successfully used for purification and refolding of proteins. There are however indications that the structures of proteins subjected to three phase partitioning are different from native structure of proteins. Taking several proteins, the present work examines the structural changes in proteins by comparing their thermal stabilities, secondary structure contents, surface hydrophobicities, hydrodynamic radii and solubilities in the presence of ammonium sulphate. The results show that while the nature or extent of structural changes may vary, in all the cases the changes are rather subtle and not drastic in nature. Hence, the technique can be safely used for protein purification and refolding.
García-Herranz, Manuel; Olivera, Fernando; Haya, Pablo; Alamán, Xavier
People interact with each other in many levels of attention, intention and meaning. This Interaction Continuum is used daily to deal with different contexts, adapting the interaction to communication needs and available resources. Nevertheless, computer-supported interaction has mainly focused on the most direct, explicit and intrusive types of human to human Interaction such as phone calls, emails, or video conferences. This paper presents the results of exploring and exploiting the potentials of undemanding interaction mechanisms, paying special attention to subtle communication and background interaction. As we argue the benefits of this type of interaction for people with special needs, we present a theoretical framework to define it and propose a proof of concept based on Augmented Objects and a color codification mechanism. Finally, we evaluate and analyze the strengths and limitations of such approach with people with cognitive disabilities. PMID:23012573
Goyer, R A
Although the toxicity of lead was recognized centuries ago, concern was restricted to overt symptoms: colic, encephalopathy, anemia, or renal disease. Two major reasons for lack of progress in restricting toxicity were that interest was limited to occupational exposures and there was lack of awareness of specific biochemical or metabolic effects. Identification of subclinical effects has been possible the last 15 or 20 years because of the development of sensitive measures to detect cognitive and behavioral changes that are not apparent clinically and because of methods to measure the reduced activity of heme enzymes. This progress was driven by basic and clinical research that resulted in a better understanding of cellular toxicology. The new awareness prompted the lowering of acceptable occupational exposures, as measured by blood lead from 80 to 40 to 60 micrograms/dL range, and the establishment of maximum recommended exposures in children to a blood lead level of 25 micrograms/dL. Lowering the lead content in gasoline has been accomplished by a nearly 50% decrease in average blood levels of persons in the United States (NHANES II data). Current research implicates lead as a contributing etiologic factor in a number of common diseases affecting large portions of the population such as subtle cognitive and neurological deficits, hypertension, congenital malformations, immunotoxicity, and deficits in growth and development. For each of these disorders there may be multiple etiologic factors; the scientific challenge is to develop sensitive methodology to detect the specific role of lead. Other potential subtle health effects include the influence of small amounts of lead on cell proliferation and lead as a cofactor in carcinogenesis.(ABSTRACT TRUNCATED AT 250 WORDS) Images FIGURE 1. PMID:2205487
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
Summarizes a study of 225 cases between 1990 and 1994 involving sexual abuse or harassment complaints against teachers. Interviews revealed how districts respond to complaints and the most effective preventive policies and procedures. School districts with rare occurrences screen prospective employees, have strong and clear policies, educate staff…
Khodakarami, N; Naji, H; Dashti, M G; Yazdjerdi, M
We carried out a descriptive analysis on the pregnancy outcome in 313 pregnant women abused, 160 non-abused). Abuse was statistically significantly correlated with mean weight gain during pregnancy, mean frequency of the prenatal care, prolonged labour (dystocia), premature rupture of membrane, low mean birth weight and mean gestational age at birth. Given the high likelihood that a woman will access health care services during her pregnancy, physicians providing prenatal care are in a strategic position to screen for partner abuse.
... 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. ...
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…
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…
Yan, Han; Li, Denghua; Lu, Kun; Zhu, Xiangwei; Zhang, Yajie; Yang, Yanlian; Wei, Zhixiang
Conjugated polymers are promising replacements for their inorganic counterparts in photovoltaics due to their low cost, ease of processing, and straightforward thin film formation. New materials have been able to improve the power conversion efficiency of photovoltaic cells up to 8%. However, rules for rational material design are still lacking, and subtle chemical structure variations usually result in large performance discrepancies. The present paper reports a detailed study on the crystalline structure, morphology, and in situ optoelectronic properties of blend films of polythiophene derivatives and [6,6]-phenyl C61-butyric acid methyl ester by changing the alkyl side chain length and position of polythiophene. The correlation among the molecular structure, mesoscopic morphology, mesoscopic optoelectronic property and macroscopic device performance (highest efficiency above 4%) was directly established. Both solubility and intermolecular interactions should be considered in rational molecular design. Knowledge obtained from this study can aid the selection of appropriate processing conditions that improve blend film morphology, charge transport property, and overall solar cell efficiency.
Rodil, Iván F.; Lohrer, Andrew M.; Thrush, Simon F.
It is important to understand the consequences of low level disturbances on the functioning of ecological communities because of the pervasiveness and frequency of this type of environmental change. In this study we investigated the response of a heterogeneous, subtidal, soft-sediment habitat to small experimental additions of organic matter and calcium carbonate to examine the sensitivity of benthic ecosystem functioning to changes in sediment characteristics that relate to the environmental threats of coastal eutrophication and ocean acidification. Our results documented significant changes between key biogeochemical and sedimentary variables such as gross primary production, ammonium uptake and dissolved reactive phosphorus flux following treatment additions. Moreover, the application of treatments affected relationships between macrofauna communities, sediment characteristics (e.g., chlorophyll a content) and biogeochemical processes (oxygen and nutrient fluxes). In this experiment organic matter and calcium carbonate showed persistent opposing effects on sedimentary processes, and we demonstrated that highly heterogeneous sediment habitats can be surprisingly sensitive to subtle perturbations. Our results have important biological implications in a world with relentless anthropogenic inputs of atmospheric CO2 and nutrients in coastal waters. PMID:24312332
Rak, R.; Drożdż, S.; Kwapień, J.; Oświecimka, P.
The conventional formal tool to detect effects of the financial persistence is in terms of the Hurst exponent. A typical corresponding result is that its value comes out close to 0.5, as characteristic for geometric Brownian motion, with at most small departures from this value in either direction depending on the market and on the time scales involved. We study the high frequency price changes on the American and on the German stock markets. For both corresponding indices, the Dow Jones and the DAX respectively, the Hurst exponent analysis results in values close to 0.5. However, by decomposing the market dynamics into pairs of steps such that an elementary move up (down) is followed by another move up (down) and explicitly counting the resulting conditional probabilities we find values typically close to 60%. This effect of persistence is particularly visible on the short time scales ranging from 1 up to 3 minutes, decreasing gradually to 50% and even significantly below this value on the larger time scales. We also detect some asymmetry in persistence related to the moves up and down, respectively. This indicates a subtle nature of the financial persistence whose characteristics escape detection within the conventional Hurst exponent formalism.
Menke, Douglas B
Homologous recombination in embryonic stem (ES) cells offers an exquisitely precise mechanism to introduce targeted modifications to the mouse genome. This ability to produce specific alterations to the mouse genome has become an essential tool for the analysis of gene function and the development of mouse models of human disease. Of the many thousands of mouse alleles that have been generated by gene targeting, the majority are designed to completely ablate gene function, to create conditional alleles that are inactivated in the presence of Cre recombinase, or to produce reporter alleles that label-specific tissues or cell populations (Eppig et al., 2012, Nucleic Acids Res 40:D881-D886). However, there is a variety of powerful motivations for the introduction of subtle targeted mutations (STMs) such as point mutations, small deletions, or small insertions into the mouse genome. The introduction of STMs allows the ablation of specific transcript isoforms, permits the functional investigation of particular domains or amino acids within a protein, provides the ability to study the role of specific sites with in cis-regulatory elements, and can result in better mouse models of human genetic disorders. In this review, I examine the current strategies that are commonly used to introduce STMs into the mouse genome and highlight new gene targeting technologies, including TALENs and CRISPR/Cas, which are likely to influence the future of gene targeting in mice.
Simons, C J P; Wichers, M; Derom, C; Thiery, E; Myin-Germeys, I; Krabbendam, L; van Os, J
It has been suggested that genes impact on the degree to which minor daily stressors cause variation in the intensity of subtle paranoid experiences. The objective of the present study was to test the hypothesis that catechol-O-methyltransferase (COMT) Val(158)Met and brain-derived neurotrophic factor (BDNF) Val(66)Met in part mediate genetic effects on paranoid reactivity to minor stressors. In a general population sample of 579 young adult female twins, on the one hand, appraisals of (1) event-related stress and (2) social stress and, on the other hand, feelings of paranoia in the flow of daily life were assessed using momentary assessment technology for five consecutive days. Multilevel regression analyses were used to examine moderation of daily life stress-induced paranoia by COMT Val(158)Met and BDNF Val(66)Met genotypes. Catechol-O-methyltransferase Val carriers displayed more feelings of paranoia in response to event stress compared with Met carriers. Brain-derived neurotrophic factor Met carriers showed more social-stress-induced paranoia than individuals with the Val/Val genotype. Thus, paranoia in the flow of daily life may be the result of gene-environment interactions that can be traced to different types of stress being moderated by different types of genetic variation.
Fleury, Mark E.; Boardman, Kendrick C.; Swartz, Melody A.
Cell response to extracellular cues is often driven by gradients of morphogenetic and chemotactic proteins, and therefore descriptions of how such gradients arise are critical to understanding and manipulating these processes. Many of these proteins are secreted in matrix-binding form to be subsequently released proteolytically, and here we explore how this feature, along with small dynamic forces that are present in all tissues, can affect pericellular protein gradients. We demonstrate that 1), pericellular gradients of cell-secreted proteins can be greatly amplified when secreted by the cell in matrix-binding form as compared to a nonmatrix-interacting form; and 2), subtle flows can drive significant asymmetry in pericellular protein concentrations and create transcellular gradients that increase in the direction of flow. This study thus demonstrates how convection and matrix-binding, both physiological characteristics, combine to allow cells to create their own autologous chemotactic gradients that may drive, for example, tumor cells and immune cells into draining lymphatic capillaries. PMID:16603487
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.
Barclay, Rebecca P; Hilt, Robert J
Integrated care is a way to improve the prevention, identification, and treatment of mental health difficulties, including substance abuse, in pediatric care. The pediatrician's access, expertise in typical development, focus on prevention, and alignment with patients and families can allow successful screening, early intervention, and referral to treatment. Successful integrated substance abuse care for youth is challenged by current reimbursement systems, information exchange, and provider role adjustment issues, but these are being addressed as comfort with this care form and resources to support its development grow.
At concentration levels well below those which cause death and injury to soil invertebrates, a toxic chemical plume may yet effectively damage a soil ecosystem by triggering avoidance behavior among sensitive invertebrates as they move along the concentration gradient. The result may be a soil ecosystem lacking the benefits of effective nutrient cycling and mineralization which a thriving invertebrate population provides. While determining actual detection limits of invertebrates for chemical gradients in soils is experimentally difficult, theoretical calculations have suggested that such limits may be extremely low, and hence many organisms may sense and avoid concentrations of chemicals far below levels commonly considered acceptable. The minimum gradient (G) that can be detected by a receptor depends on the receptor radius (R), the chemical concentration (C), the diffusion constant of the chemical (D), the velocity of the organism (v), and the time over which the receptor integrates the chemical signal (t). In addition, the characteristics of that gradient are determined by interactions between the chemical and the soil particles (sorption/desorption), and advection through the pore spaces. The example of lead (Pb), a neurotoxic metal with demonstrated behavioral effects on the free-living nematode Caenorhabditis elegans, is used to model a chemical migrating through a soil. Based on experimentally determined Pb concentrations which elicited avoidance behavior in nematodes, and sorption characteristics of defined Pb-soil systems, the minimum detectable gradient (G) produced by a solubilized Pb plume in several soils was modeled. The results predict maximum allowable Pb levels in a soil if a healthy invertebrate community is desired, and suggest areas for further research into the subtle behavioral effects of environmental toxicants ore sensitive invertebrates.
Angstman, Nicholas B.; Frank, Hans-Georg; Schmitz, Christoph
As a widely used and studied model organism, Caenorhabditis elegans worms offer the ability to investigate implications of behavioral change. Although, investigation of C. elegans behavioral traits has been shown, analysis is often narrowed down to measurements based off a single point, and thus cannot pick up on subtle behavioral and morphological changes. In the present study videos were captured of four different C. elegans strains grown in liquid cultures and transferred to NGM-agar plates with an E. coli lawn or with no lawn. Using an advanced software, WormLab, the full skeleton and outline of worms were tracked to determine whether the presence of food affects behavioral traits. In all seven investigated parameters, statistically significant differences were found in worm behavior between those moving on NGM-agar plates with an E. coli lawn and NGM-agar plates with no lawn. Furthermore, multiple test groups showed differences in interaction between variables as the parameters that significantly correlated statistically with speed of locomotion varied. In the present study, we demonstrate the validity of a model to analyze C. elegans behavior beyond simple speed of locomotion. The need to account for a nested design while performing statistical analyses in similar studies is also demonstrated. With extended analyses, C. elegans behavioral change can be investigated with greater sensitivity, which could have wide utility in fields such as, but not limited to, toxicology, drug discovery, and RNAi screening. PMID:27065825
Nodine, Calvin F.; Mello-Thoms, Claudia; Weinstein, Susan P.; Kundel, Harold L.; Toto, Lawrence C.
Women who undergo regular mammographic screening afford mammographers a unique opportunity to compare current mammograms with prior exams. This comparison greatly assists mammographers in detecting early breast cancer. A question that commonly arises when a cancer is detected under regular periodic screening conditions is whether the caner is new, or was it missed on the prior exam? This is a difficult question to answer by retrospective analysis, because knowledge of the status of the current exam biases the interpretation of the prior exam. To eliminate this bias and provide some degree of objectivity in studying this question, we looked at whether experienced mammographers who had no prior knowledge of a set of test cases fixated on potential cancer-containing regions on mammograms from cases penultimate to cancer detection. The results show that experienced mammographers cannot recognize most malignant cancers selected by retrospective analysis.
Saikia, Anku Moni; Mahanta, Neelakshi; Mahanta, Ajaya; Deka, Ashok Jyoti; Kakati, Arupjyoti
Background: In spite of tremendous impact on health, elder abuse is still an underreported and unrecognized issue. Objectives: To assess the prevalence of abuse among community dwelling elderly and to identify the various risk factors. Materials and Methods: This community-based cross-sectional study was conducted in 10 randomly selected wards of Guwahati city. A total of 331 elderly (60 years and above) were interviewed. Abuse was screened by Hwalek-Sengstock Elder Abuse Screening Test (H-S EAST). Results: The study revealed 9.31% prevalence. Neglect was the most common type of abuse reported. Age, sex, socioeconomic status, living status, and functional status were found to be significantly associated with abuse. Conclusion: Abuse is prevalent among elderly population. PMID:26435603
Background Early detection of abused children could help decrease mortality and morbidity related to this major public health problem. Several authors have proposed tools to screen for child maltreatment. The aim of this systematic review was to examine the evidence on accuracy of tools proposed to identify abused children before their death and assess if any were adapted to screening. Methods We searched in PUBMED, PsycINFO, SCOPUS, FRANCIS and PASCAL for studies estimating diagnostic accuracy of tools identifying neglect, or physical, psychological or sexual abuse of children, published in English or French from 1961 to April 2012. We extracted selected information about study design, patient populations, assessment methods, and the accuracy parameters. Study quality was assessed using QUADAS criteria. Results A total of 2 280 articles were identified. Thirteen studies were selected, of which seven dealt with physical abuse, four with sexual abuse, one with emotional abuse, and one with any abuse and physical neglect. Study quality was low, even when not considering the lack of gold standard for detection of abused children. In 11 studies, instruments identified abused children only when they had clinical symptoms. Sensitivity of tests varied between 0.26 (95% confidence interval [0.17-0.36]) and 0.97 [0.84-1], and specificity between 0.51 [0.39-0.63] and 1 [0.95-1]. The sensitivity was greater than 90% only for three tests: the absence of scalp swelling to identify children victims of inflicted head injury; a decision tool to identify physically-abused children among those hospitalized in a Pediatric Intensive Care Unit; and a parental interview integrating twelve child symptoms to identify sexually-abused children. When the sensitivity was high, the specificity was always smaller than 90%. Conclusions In 2012, there is low-quality evidence on the accuracy of instruments for identifying abused children. Identified tools were not adapted to screening because of
Ermertcan, Aylin Turel; Ertan, Pelin
Child abuse is a major public health problem all over the world. There are four major types of abuse: physical abuse, sexual abuse, emotional abuse and neglect. The most common manifestations of child abuse are cutaneous and their recognition; and differential diagnosis is of great importance. Clinicians, especially dermatologists, should be alert about the skin lesions of child abuse. In the diagnosis and management of child abuse, a multidisciplinary approach with ethical and legal procedures is necessary. In this manuscript, cutaneous manifestations of physical, sexual, emotional abuse and neglect are reviewed and discussed.
Congress of the U.S., Washington, DC. House Committee on Education and Labor.
The booklet presents the report of the U.S. House of Representatives Committee on Education and Labor regarding the 1983 Child Abuse Amendments to the Child Abuse Prevention and Treatment Act and the Child Abuse Prevention and Treatment and Adoption Reform Act of 1978. The Amendment expands the definition of child abuse to include abuse by…
Lewis, O'Dene; Kumar, Rajan; Yeruva, Sri Lakshmi Hyndavi; Curry, Bryan H.
Amphetamine abuse is a global problem. The cardiotoxic manifestations like acute myocardial infarction (AMI), heart failure, or arrhythmia related to misuse of amphetamine and its synthetic derivatives have been documented but are rather rare. Amphetamine-related AMI is even rarer. We report two cases of men who came to emergency department (ED) with chest pain, palpitation, or seizure and were subsequently found to have myocardial infarction associated with the use of amphetamines. It is crucial that, with increase in amphetamine abuse, clinicians are aware of this potentially dire complication. Patients with low to intermediate risk for coronary artery disease with atypical presentation may benefit from obtaining detailed substance abuse history and urine drug screen if deemed necessary. PMID:26998366
Sinha, Archana; Lewis, O'Dene; Kumar, Rajan; Yeruva, Sri Lakshmi Hyndavi; Curry, Bryan H
Amphetamine abuse is a global problem. The cardiotoxic manifestations like acute myocardial infarction (AMI), heart failure, or arrhythmia related to misuse of amphetamine and its synthetic derivatives have been documented but are rather rare. Amphetamine-related AMI is even rarer. We report two cases of men who came to emergency department (ED) with chest pain, palpitation, or seizure and were subsequently found to have myocardial infarction associated with the use of amphetamines. It is crucial that, with increase in amphetamine abuse, clinicians are aware of this potentially dire complication. Patients with low to intermediate risk for coronary artery disease with atypical presentation may benefit from obtaining detailed substance abuse history and urine drug screen if deemed necessary.
Dubowitz, Howard; Bennett, Susan
Child maltreatment includes physical abuse and neglect, and happens in all countries and cultures. Child maltreatment usually results from interactions between several risk factors (such as parental depression, stress, and social isolation). Physicians can incorporate methods to screen for risk factors into their usual appointments with the family. Detection of physical abuse is dependent on the doctor's ability to recognise suspicious injuries, such as bruising, bite marks, burns, bone fractures, or trauma to the head or abdomen. Neglect is the most common form of child maltreatment in the USA. It can be caused by insufficient parental knowledge; intentional negligence is rare. Suspected cases of child abuse should be well documented and reported to the appropriate public agency which should assess the situation and help to protect the child.
Hovanitz, Christine A.; And Others
Investigated the relationship between the Minnesota Multiphasic Personality Inventory paranoia subtle, neutral, and obvious subscales and criteria presumed to reflect various paranoid characteristics in a sample of male college students (N=100). Results showed that both the obvious and subtle Pa Items predicted various criteria. (Author/JAC)
Sutter, M E; Chenoweth, J; Albertson, T E
The incidence of drug abuse with alternative agents is increasing. The term "alternative drugs of abuse" is a catch-all term for abused chemicals that do not fit into one of the classic categories of drugs of abuse. The most common age group abusing these agents range from 17 to 25 years old and are often associated with group settings. Due to their diverse pharmacological nature, legislative efforts to classify these chemicals as a schedule I drug have lagged behind the development of new alternative agents. The potential reason for abuse of these agents is their hallucinogenic, dissociative, stimulant, anti-muscarinic, or sedative properties. Some of these drugs are easily obtainable such as Datura stramonium (Jimson Weed) or Lophophora williamsii (Peyote) because they are natural plants indigenous to certain regions. The diverse pharmacology and clinical effects of these agents are so broad that they do not produce a universal constellation of signs and symptoms. Detailed physical exams are essential for identifying clues leading one to suspect an alternative drug of abuse. Testing for the presence of these agents is often limited, and even when available, the results do not return in a timely fashion. Intoxications from these agents pose unique challenges for health care providers. Physician knowledge of the physiological effects of these alternative agents and the local patterns of drug of abuse are important for the accurate diagnosis and optimal care of poisoned patients. This review summarizes the current knowledge of alternative drugs of abuse and highlights their clinical presentations.
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.
Mura, P; Saussereau, E; Brunet, B; Goullé, J-P
In France, workplace testing of drugs of abuse and psychotropic drugs is rarely performed; meanwhile it is a major public health problem. Furthermore, France is the European country that has been associated with the highest increase of the use of drugs of abuse, particularly cannabis. So workplace biological screening of drugs of abuse and of psychotropic drugs exposure is of major concern. New analytical techniques have been developed during the last years. The authors will consider analytical screening of drugs of abuse and particularly the comparison of analytical techniques applied to urine and saliva. The advantages and the disadvantages of these two matrices will be considered. Urinary and blood quantification will be reviewed, but also the interest of hair testing to explore chronic exposure. The research of psychotropic drugs in biological fluids is also a part of this paper. New analytical trends are promising and complete analysis of these substances will be soon routinely possible in blood using a single spot test.
Boyd, Carol J.; McCabe, Sean Esteban; Cranford, James A.; Young, Amy
OBJECTIVES Our goals were to (1) determine adolescents' motivations (reasons) for engaging in the nonmedical (illicit) use of 4 classes of prescription medications and (2) examine whether motivations were associated with a higher risk for substance abuse problems. RESPONDENTS The 2005 sample (N = 1086) was derived from one ethnically diverse school district in southeastern Michigan and included 7th- through 12th-grade students. METHODS Data were collected by using a self-administered, Web-based survey that included questions about drug use and the motivations to engage in nonmedical use of prescription medication. RESULTS Twelve percent of the respondents had engaged in nonmedical use of opioid pain medications in the past year: 3% for sleeping, 2% as a sedative and/or for anxiety, and 2% as stimulants. The reasons for engaging in the nonmedical use of prescription medications varied by drug classification. For opioid analgesics, when the number of motives increased, so too did the likelihood of a positive Drug Abuse Screening Test score. For every additional motive endorsed, the Drug Abuse Screening Test increased by a factor of 1.8. Two groups of students were compared (at-risk versus self-treatment); those who endorsed multiple motivations for nonmedical use of opioids (at-risk group) were significantly more likely to have elevated Drug Abuse Screening Test scores when compared with those who were in the self-treatment group. Those in the at-risk group also were significantly more likely to engage in marijuana and alcohol use. CONCLUSION The findings from this exploratory study warrant additional research because several motivations for the nonmedical use of prescription medications seem associated with a greater likelihood of substance abuse problems. PMID:17142533
Culberson, John W; Ziska, Martin
One quarter of the prescription drugs sold in the United States are used by the elderly, often for problems such as chronic pain, insomnia, and anxiety. The prevalence of abuse may be as high as 11 percent with female gender, social isolation, depression, and history of substance abuse increasing risk. Screening instruments for prescription drug abuse have not been validated in the geriatric population. Benzodiazepines, opiate analgesics, and some skeletal muscle relaxants may result in physical dependence; however, tolerance, withdrawal syndrome, and dose escalation may be less common in the older patient. Lower doses may decrease the risk of abuse and dependence; however, fear of abuse often results in a failure to adequately treat symptoms such as anxiety, pain, and insomnia.
Day, Suzanne; Fox, Jolene; Majercik, Sarah; Redmond, Floresha K; Pugh, Mary; Bledsoe, Joseph
The purpose of this study was to design and implement a domestic violence (DV) screening protocol. Trauma patients meeting inclusion criteria (hospitalized > 48 hours) were given a four question DV screen. If abuse was found, a comprehensive DV questionnaire followed. Barriers to screening and results were recorded. Compliance during the pilot test showed 23 of 157 (14.6%) admitted patients were screened. In the implementation year, 446 of 721 (61.9%) were screened. During the 10-month follow-up, 499 of 619 (80.6%) patients were screened. Lack of social work resources was the primary barrier to screening, but compliance increased and was maintained after the study period.
Soden, A. M.; Shipton, Z. K.; Lunn, R. J.; Pytharouli, S.; Kirkpatrick, J. D.
brittle deformation does not appear to have reactivated the main fault, as no open fractures are observed cutting the fault core or fault walls. Fracture data is generally collected using 2D transects and/or boreholes. Surveys center on the main brittle fault and their extent defined by fault attribute scaling relationships. The open fractures in this study are localised on ductile shears across a range of scales; from a brittle fault >30m long in a 20-30 meter wide shear zone to meter scale en-echelon fractures on centimeter wide ductile shears. These occur outside the limit of the fault zone as defined by decreasing joint density from the fault, thus unlikely to be identified by typical fracture surveys. Nor would seismic surveys identify these meter scale structures. Rather the observation of 10's meter scale faults would lead to standard fracture population attributes being assumed. Our work suggests that when considering the distribution of fractures in crystalline rocks subtle heterogeneities should be taken into account as possible sites for the development of significant brittle deformation structures.
Kos, Liborka; Shwayder, Tor
Dermatologists and child abuse are not frequently associated in the minds of most physicians. Yet the most common manifestations of child abuse are cutaneous. This article reviews cutaneous manifestations of physical abuse, including bruises, lacerations, abrasions, human bites, and burns. It also discusses ways that dermatologists can differentiate abusive injuries from accidental ones as well as from the many dermatologic conditions that can mimic child abuse. Finally, we review what actions the dermatologist should take when suspecting abuse in a patient.
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…
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)
Thorne, Craig R.; DeBlassie, Richard R.
Cummings (1979), citing evidence from the National Institute of Drug Abuse, reports that one of every eleven adult Americans suffers from a severe addictive problem. Drug addiction is epidemic among teenagers; one of every six teenagers suffers from a severe addictive problem. This paper focuses on adolescent drug/substance abuse. (Author)
Burns, Jarrett M; Boyer, Edward W
Abuse of antitussive preparations is a continuing problem in the United States and throughout the world. Illicit, exploratory, or recreational use of dextromethorphan and codeine/promethazine cough syrups is widely described. This review describes the pharmacology, clinical effects, and management of toxicity from commonly abused antitussive formulations. PMID:24648790
Wilford, B B
An estimated 3% of the United States population deliberately misuse or abuse psychoactive medications, with severe consequences. According to the National Institute on Drug Abuse, more than half of patients who sought treatment or died of drug-related medical problems in 1989 were abusing prescription drugs. Physicians who contribute to this problem have been described by the American Medical Association as dishonest--willfully misprescribing for purposes of abuse, usually for profit; disabled by personal problems with drugs or alcohol; dated in their knowledge of current pharmacology or therapeutics; or deceived by various patient-initiated fraudulent approaches. Even physicians who do not meet any of these descriptions must guard against contributing to prescription drug abuse through injudicious prescribing, inadequate safeguarding of prescription forms or drug supplies, or acquiescing to the demands or ruses used to obtain drugs for other than medical purposes. PMID:2349801
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.
Albertson, Timothy E
The use of recreational drugs of abuse continues to expand without limitations to national boundaries, social status, race, or education. Beyond the prevalence of illicit drug use and dependence, their contribution to the global burden of disease and death are large and troubling. All medical providers should be aware of the evolving drugs of abuse and their medical and social consequences. In addition to heroin and stimulants such as cocaine and methamphetamine, new designer stimulants called "bath salts" and cannabinoids called "spice," along with the abuse of prescription drugs and volatile substances, are now widely recognized problems in many societies. The wide variety and continuingly expanding clinical manifestations of toxicity of recreational drugs of abuse is not widely appreciated by clinicians. This edition attempts to summarize six major classes of drugs of abuse and their clinical effects with special emphasis on their immunological and respiratory effects.
Arancibia-Martini, Héctor; Ruiz, Miguel Á; Blanco, Amalio; Cárdenas, Manuel
Given the current debate over the distinction between subtle and blatant prejudice, this study provides new evidence regarding problems with the construct validity of the Pettigrew and Meertens' Blatant and Subtle Prejudice Scale. To assess these issues, an existing data sample of 896 Chilean participants collected in 2010 was reanalyzed. The main analysis method used was a confirmatory factor analysis. The model that best represented the original theory (a model of two correlated second-order factors) had an improper solution due to the unidentified model. The scale has substantial psychometric problems, and it was not possible to distinguish between subtle and blatant prejudice.
Bryner, Jodi K.; Wang, Uerica K.; Hui, Jenny W.; Bedodo, Merilin; MacDougall, Conan; Anderson, Ilene B.
Objectives To analyze the trend of dextromethorphan abuse in California and to compare these findings with national trends. Design A 6-year retrospective review. Setting California Poison Control System (CPCS), American Association of Poison Control Centers (AAPCC), and Drug Abuse Warning Network (DAWN) databases from January 1, 1999, to December 31, 2004. Participants All dextromethorphan abuse cases reported to the CPCS, AAPCC, and DAWN. The main exposures of dextromethorphan abuse cases included date of exposure, age, acute vs long-term use, coingestants, product formulation, and clinical outcome. Main Outcome Measure The annual proportion of dextromethorphan abuse cases among all exposures reported to the CPCS, AAPCC, and DAWN databases. Results A total of 1382 CPCS cases were included in the study. A 10-fold increase in CPCS dextromethorphan abuse cases from 1999 (0.23 cases per 1000 calls) to 2004 (2.15 cases per 1000 calls) (odds ratio, 1.48; 95% confidence interval, 1.43–1.54) was identified. Of all CPCS dextromethorphan abuse cases, 74.5% were aged 9 to 17 years; the frequency of cases among this age group increased more than 15-fold during the study (from 0.11 to 1.68 cases per 1000 calls). Similar trends were seen in the AAPCC and DAWN databases. The highest frequency of dextromethorphan abuse occurred among adolescents aged 15 and 16 years. The most commonly abused product was Coricidin HBP Cough & Cold Tablets. Conclusions Our study revealed an increasing trend of dextromethorphan abuse cases reported to the CPCS that is paralleled nationally as reported to the AAPCC and DAWN. This increase was most evident in the adolescent population. PMID:17146018
Williams, Robert J; Goodale, Leslie A; Shay-Fiddler, Michele A; Gloster, Susan P; Chang, Samuel Y
The prevalence of methylphenidate and dextroamphetamine misuse and abuse was examined in 450 adolescents referred for substance abuse treatment. Twenty three percent reported nonmedical use of these substances and six percent were diagnosed as methylphenidate or dextroamphetamine abusers. Abuse was more common in individuals who were out of school and had an eating disorder. Methylphenidate and dextroamphetamine abuse appears to be much less common than abuse of most other substances. It does occur, however, and parents and schools need to exert greater control over the dispensing of these medications. Physicians are advised to prescribe non-stimulant medications (eg, bupropion) when treating attention deficit hyperactivity disorder in substance-abusing individuals.
Pompili, Maurizio; Serafini, Gianluca; Innamorati, Marco; Dominici, Giovanni; Ferracuti, Stefano; Kotzalidis, Giorgio D.; Serra, Giulia; Girardi, Paolo; Janiri, Luigi; Tatarelli, Roberto; Sher, Leo; Lester, David
Suicide is an escalating public health problem, and alcohol use has consistently been implicated in the precipitation of suicidal behavior. Alcohol abuse may lead to suicidality through disinhibition, impulsiveness and impaired judgment, but it may also be used as a means to ease the distress associated with committing an act of suicide. We reviewed evidence of the relationship between alcohol use and suicide through a search of MedLine and PsychInfo electronic databases. Multiple genetically-related intermediate phenotypes might influence the relationship between alcohol and suicide. Psychiatric disorders, including psychosis, mood disorders and anxiety disorders, as well as susceptibility to stress, might increase the risk of suicidal behavior, but may also have reciprocal influences with alcohol drinking patterns. Increased suicide risk may be heralded by social withdrawal, breakdown of social bonds, and social marginalization, which are common outcomes of untreated alcohol abuse and dependence. People with alcohol dependence or depression should be screened for other psychiatric symptoms and for suicidality. Programs for suicide prevention must take into account drinking habits and should reinforce healthy behavioral patterns. PMID:20617037
Ambadar, Zara; Schooler, Jonathan W; Cohn, Jeffrey F
Most studies investigating the recognition of facial expressions have focused on static displays of intense expressions. Consequently, researchers may have underestimated the importance of motion in deciphering the subtle expressions that permeate real-life situations. In two experiments, we examined the effect of motion on perception of subtle facial expressions and tested the hypotheses that motion improves affect judgment by (a) providing denser sampling of expressions, (b) providing dynamic information, (c) facilitating configural processing, and (d) enhancing the perception of change. Participants viewed faces depicting subtle facial expressions in four modes (single-static, multi-static, dynamic, and first-last). Experiment 1 demonstrated a robust effect of motion and suggested that this effect was due to the dynamic property of the expression. Experiment 2 showed that the beneficial effect of motion may be due more specifically to its role in perception of change. Together, these experiments demonstrated the importance of motion in identifying subtle facial expressions.
Durall, John K.
Defines child abuse, including the three categories: physical, sexual, and psychological. Presents characteristics and behaviors of each type of abuse, and long-term effects. Discusses how to handle abuse that occurs at camp, and the effects on the camp. Sidebars present abuse statistics, 15 activities that promote psychological wellness, and 8…
Woika, Shirley; Bowersox, Carissa
Teachers and teachers-in-training are mandated reporters; they are legally required to report any suspected child abuse or neglect. This article describes: (1) How to file a report; (2) How prevalent child abuse is; (3) What abuse is; (4) What it means to be a mandated reporter; (5) When the report should be made; and (6) What to do if abuse is…
Goforth, Harold W; Murtaugh, Reed; Fernandez, Francisco
Neurologic aspects of drug abuse vary. This article explains the general nature of drug abuse, identifies the physiologic effects of certain drugs, and briefly describes the neurobiology of addiction. This article also reviews available treatment options for those addicted to substances of abuse, and clarifies common misconceptions, including the differences between tolerance, abuse, and addiction.
Seng, Julia S; Sperlich, Mickey; Low, Lisa Kane
Our objective was to address the gap in knowledge about the extent to which perinatal mental health and risk behaviors are associated with childhood and adult experiences of abuse that arises because of barriers to screening and disclosure about past and current abuse. Survey data from an ongoing study of the effects of posttraumatic stress on childbearing were used to describe four groups of nulliparous women: those with no abuse history, adult abuse only, childhood abuse only, and abuse that occurred during both periods. The rates of abuse history disclosure were higher in the research context than in the clinical settings. Mental health morbidity and risk behaviors occurred in a dose-response pattern with cumulative abuse exposure. Rates of current posttraumatic stress disorder ranged from 4.1% among those never abused to 11.4% (adult only), 16.0% (childhood only), and 39.2% (both periods). Women abused during both periods also were more likely to be using tobacco (21.5%) and drugs (16.5%) during pregnancy. We conclude that mental health and behavioral risk sequelae affect a significant portion of both childhood and adult abuse survivors in prenatal care. The integration into the maternity setting of existing evidence-based interventions for the mental health and behavioral sequelae of abuse is needed.
Lubman, D I; Yücel, M; Lawrence, A J
Experimentation with volatile substances (inhalants) is common during early adolescence, yet limited work has been conducted examining the neurobiological impact of regular binge use during this key stage of development. Human studies consistently demonstrate that chronic use is associated with significant toxic effects, including neurological and neuropsychological impairment, as well as diffuse and subtle changes in white matter. However, most preclinical research has tended to focus on acute exposure, with limited work examining the neuropharmacological or toxicological mechanisms underpinning these changes or their potential reversibility with abstinence. Nevertheless, there is growing evidence that commonly abused inhalants share common cellular mechanisms, and have similar actions to other drugs of abuse. Indeed, the majority of acute behavioural effects appear to be underpinned by changes in receptor and/or ion channel activity (for example, GABAA, glycine and 5HT3 receptor activation, NMDA receptor inhibition), although nonspecific interactions can also arise at high concentrations. Recent studies examining the effects of toluene exposure during the early postnatal period are suggestive of long-term alterations in the function of NMDA and GABAA receptors, although limited work has been conducted investigating exposure during adolescence. Given the critical role of neurotransmitter systems in cognitive, emotional and brain development, future studies will need to take account of the substantial neuromaturational changes that are known to occur in the brain during childhood and adolescence, and to specifically investigate the neuropharmacological and toxicological profile of inhalant exposure during this period of development. PMID:18332858
Li, Xiaowen; Shen, Baohua; Jiang, Zheng; Huang, Yi; Zhuo, Xianyi
A novel analytical toxicology method has been developed for the analysis of drugs of abuse in human urine by using a high resolution and high mass accuracy hybrid linear ion trap-Orbitrap mass spectrometer (LTQ-Orbitrap-MS). This method allows for the detection of different drugs of abuse, including amphetamines, cocaine, opiate alkaloids, cannabinoids, hallucinogens and their metabolites. After solid-phase extraction with Oasis HLB cartridges, spiked urine samples were analysed by HPLC/LTQ-Orbitrap-MS using an electrospray interface in positive ionisation mode, with resolving power of 30,000 full width at half maximum (FWHM). Gradient elution off of a Hypersil Gold PFP column (50mm×2.1mm) allowed to resolve 65 target compounds and 3 internal standards in a total chromatographic run time of 20min. Validation of this method consisted of confirmation of identity, selectivity, linearity, limit of detection (LOD), lowest limits of quantification (LLOQ), accuracy, precision, extraction recovery and matrix effect. The regression coefficients (r(2)) for the calibration curves (LLOQ - 100ng/mL) in the study were ≥0.99. The LODs for 65 validated compounds were better than 5ng/ml except for 4 compounds. The relative standard deviation (RSD), which was used to estimate repeatability at three concentrations, was always less than 15%. The recovery of extraction and matrix effects were above 50 and 70%, respectively. Mass accuracy was always better than 2ppm, corresponding to a maximum mass error of 0.8 millimass units (mmu). The accurate masses of characteristic fragments were obtained by collisional experiments for a more reliable identification of the analytes. Automated data analysis and reporting were performed using ToxID software with an exact mass database. This procedure was then successfully applied to analyse drugs of abuse in a real urine sample from subject who was assumed to be drug addict.
Ethical issues in screening of victims of sexual abuse for infection with the human immunodeficiency virus (HIV) are raised in response to Gellert (EC 222 881). It is concluded that widescale HIV testing of child victims of sexual abuse is not justified by the available information. (DB)
... Treatment of HIV and HVC Infections in Drug Abusing Populations (8907). Date: January 13, 2012. Time: 1 p.m...; Smokescreen: Genetic Screening Tool for Tobacco Dependence and Treatment Approaches (7783). Date: January 19....: 93.279, Drug Abuse and Addiction Research Programs, National Institutes of Health, HHS)...
... Z) Hepatitis HIV Mental Health Mental Health Home Suicide Prevention Substance Abuse Military Sexual Trauma PTSD Research ( ... include: PTSD and anxiety. Depression and thoughts of suicide. Sexual anxiety and disorders, including having too many ...
Canadian reports and legislation are reviewed to highlight the school's role in prevention and reporting of suspicions of child sexual abuse. The vulnerability of handicapped children and child pornography are two areas of victimization emphasized. (Author/DB)
... Loss Surgery? A Week of Healthy Breakfasts Shyness Cough & Cold Medicine Abuse KidsHealth > For Teens > Cough & Cold ... Someone Quit? Avoiding DXM Why Do People Use Cough and Cold Medicines to Get High? There's an ...
... oxycodone, hydrocodone, fentanyl, and tramadol. The illegal drug heroin is also an opioid. Some opioids are made ... NAS). Opioid abuse may sometimes also lead to heroin use, because some people switch from prescription opioids ...
The abuse of synthetic cathinones, widely known as bath salts, has been increasing since the mid-2000s. These substances are derivatives of the naturally occurring compound cathinone, which is the primary psychoactive component of khat. The toxicity of synthetic cathinones includes significant sympathomimetic effects, as well as psychosis, agitation, aggression, and sometimes violent and bizarre behavior. Mephedrone and methylenedioxypyrovalerone are currently the predominantly abused synthetic cathinones. PMID:23869180
... Activities Importance of Newborn Screening Newborn Screening and Molecular Biology Branch Pulse Oximetry Screening for CCHDs Sickle Cell Disease Laboratory SCID Quality Assurance Training and Resources ...
Ferris, L E; McMain-Klein, M; Silver, L
An estimated 12% to 30% of women are assaulted by their male partners at least once during the relationship. Therefore, in their everyday practice, physicians are likely to encounter women who have suffered domestic abuse. The authors define wife abuse, outline epidemiologic aspects and discuss common signs and symptoms. In cases of suspected or confirmed abuse, it is very important for physicians to document the details of the injuries, the patient visit, any treatment and follow-up as well as to screen for associated conditions and ensure that any samples taken are not tampered with. When asked to disclose information by police or courts, physicians need to know when they are obliged to submit copies of their patients' medical records, when patient consent is required, what information should be divulged and how to defend this information in court. The authors present information about the necessary, relevant and appropriate evidence to be collected and documented for both medical and legal purposes. They also discuss the criminal justice system and the role of physicians in legal proceedings concerning wife abuse. PMID:9099172
Krolikowski, Alex M; Rinella, Mark; Ratcliff, Jennifer J
Although the negative consequences of subtle and blatant prejudice for the targets of prejudice are clear in the psychological literature, the impact of exposure to subtle and blatant prejudice on non-targets remains unclear. The current work examines how exposure to blatant and subtle sexual prejudice affects non-targets' personal endorsement of prejudice and their identification with the prejudice expresser. Results suggest that relative to exposure to blatant or neutral expressions of prejudice, exposure to subtle prejudice increased prejudice levels. Individuals were also more likely to distance from the prejudice expresser when exposed to blatant compared to subtle prejudice. The implications are discussed.
Wang, Ping; Molina, Claudia P; Maldonado, Joyce E; Bernard, David W
This report describes testing of a case of in utero drugs of abuse exposure in which discordant results were seen between urine and meconium, and between twin meconium samples. The discordance between urine and meconium could be explained by the differences in detection window, threshold concentration and screening technology, and the discordance between dizygotic twin meconium samples could be explained by the differences in drug diffusion and placental and fetal biotransformation of drugs. The meconium sample of one twin screened negative for benzodiazepines was reported positive in the confirmation assay with higher sensitivity and a lower cut-off concentration. Negative screening results of drugs of abuse should be interpreted with caution, taking into account matrix type, reactivity of drugs in the assay and cut-off concentration. If screening results are inconsistent with each other or with the clinical scenario, confirmation testing using more sensitive and specific methods with lower cut-offs is warranted.
Kodner, Charles; Wetherton, Angela
Child abuse is the third leading cause of death in children between one and four years of age, and almost 20% of child homicide victims have contact with a health care professional within a month of their death. Therefore, family physicians are in an ideal position to detect and intervene in cases of suspected child maltreatment. There is currently insufficient evidence that screening parents or guardians for child abuse reduces disability or premature death. Assessment for physical abuse involves evaluation of historical information and physical examination findings, as well as radiographic and laboratory studies, if indicated. The history should be obtained in a nonaccusatory manner and should include details of any injuries or incidents, the patient's medical and social history, and information from witnesses. The physical examination should focus on bruising patterns, injuries or findings concerning for abuse, and palpation for tenderness or other evidence of occult injury. Skeletal survey imaging is indicated for suspected abuse in children younger than two years. Imaging may be indicated for children two to five years of age if abuse is strongly suspected. Detailed documentation is crucial, and includes photographing physical examination findings. Physicians are mandated by law to report child abuse to the local child protective services or law enforcement agency. After a report is made, the child protection process is initiated, which involves a multidisciplinary team approach.
Gustin, Sylvia M; McKay, Jamie G; Petersen, Esben T; Peck, Chris C; Murray, Greg M; Henderson, Luke A
It is well established that gross prefrontal cortex damage can affect an individual's personality. It is also possible that subtle prefrontal cortex changes associated with conditions such as chronic pain, and not detectable until recent advances in human brain imaging, may also result in subtle changes in an individual's personality. In an animal model of chronic neuropathic pain, subtle prefrontal cortex changes including altered basal dendritic length, resulted in altered decision making ability. Using multiple magnetic resonance imaging techniques, we found in humans, although gray matter volume and on-going activity were unaltered, chronic neuropathic pain was associated with reduced free and bound proton movement, indicators of subtle anatomical changes, in the medial prefrontal cortex, anterior cingulate cortex and mediodorsal thalamus. Furthermore, proton spectroscopy revealed an increase in neural integrity in the medial prefrontal cortex in neuropathic pain patients, the degree of which was significantly correlated to the personality temperament of novelty seeking. These data reveal that even subtle changes in prefrontal cortex anatomy may result in a significant change in an individual's personality.
Gustin, Sylvia M.; McKay, Jamie G.; Petersen, Esben T.; Peck, Chris C.; Murray, Greg M.; Henderson, Luke A.
It is well established that gross prefrontal cortex damage can affect an individual’s personality. It is also possible that subtle prefrontal cortex changes associated with conditions such as chronic pain, and not detectable until recent advances in human brain imaging, may also result in subtle changes in an individual’s personality. In an animal model of chronic neuropathic pain, subtle prefrontal cortex changes including altered basal dendritic length, resulted in altered decision making ability. Using multiple magnetic resonance imaging techniques, we found in humans, although gray matter volume and on-going activity were unaltered, chronic neuropathic pain was associated with reduced free and bound proton movement, indicators of subtle anatomical changes, in the medial prefrontal cortex, anterior cingulate cortex and mediodorsal thalamus. Furthermore, proton spectroscopy revealed an increase in neural integrity in the medial prefrontal cortex in neuropathic pain patients, the degree of which was significantly correlated to the personality temperament of novelty seeking. These data reveal that even subtle changes in prefrontal cortex anatomy may result in a significant change in an individual’s personality. PMID:25291361
Pau-Charles, I; Darwich-Soliva, E; Grimalt, R
Child abuse is far more prevalent today than is generally recognized. Up to 90% of victims suffer physical abuse that can be observed in signs on the skin. Dermatologists are particularly qualified to identify these signs and distinguish them from other conditions that can mimic abuse. This review covers the signs of child abuse that can be observed on the skin. We discuss clues that can help differentiate between lesions caused by abuse and those that are accidental, and we describe the skin conditions that mimic physical abuse.
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.
Halphen, John M; Varas, Grace M; Sadowsky, June M
Elder abuse (physical, sexual, or psychological) and neglect (by caretakers or self-neglect) are major public health problems. Most cases are not identified by clinicians and reported to the appropriate government agencies. There are some barriers to clinician identification and reporting of cases of elder abuse or neglect. These barriers mainly result from a lack of clinician education and comfort regarding this topic. We propose that clinician understanding of the phenomenon of elder mistreatment, familiarity with a simple approach to screening and identification of cases, awareness of risk factors and warning signs, and awareness of appropriate interventions will help to eliminate these barriers and result in clinicians properly fulfilling their duty to help protect their most vulnerable elderly patients.
Reeves, Roy R; Ladner, Mark E; Perry, Candace L; Burke, Randy S; Laizer, Janet T
The potential for abuse of medications that are controlled substances is well known. Abuse of certain noncontrolled prescription drugs and over-the-counter medications also may occur. To some degree, any medication that exerts psychoactive effects may be abused if taken in high enough doses or by means that result in high serum or cerebrospinal fluid levels. Many clinicians may be unaware of the potential for abuse of these medications. This review examines evidence of the possibility of abuse of several common medications that theoretically do not have abuse potential, including cough and cold preparations, antihistamines, anticholinergics, antipsychotics, antidepressants, anticonvulsants, skeletal muscle relaxants, and antiemetics. Means by which such medications may be abused and biochemical and physiological mechanisms fostering their abuse also are discussed.
Nelson, Michael E; Bryant, Sean M; Aks, Steven E
Many new emerging drugs of abuse are marketed as legal highs despite being labeled "not for human consumption" to avoid regulation. The availability of these substances over the Internet and in "head shops" has lead to a multitude of emergency department visits with severe complications including deaths worldwide. Despite recent media attention, many of the newer drugs of abuse are still largely unknown by health care providers. Slight alterations of the basic chemical structure of substances create an entirely new drug no longer regulated by current laws and an ever-changing landscape of clinical effects. The purity of each substance with exact pharmacokinetic and toxicity profiles is largely unknown. Many of these substances can be grouped by the class of drug and includes synthetic cannabinoids, synthetic cathinones, phenethylamines, as well as piperazine derivatives. Resultant effects generally include psychoactive and sympathomimetic-like symptoms. Additionally, prescription medications, performance enhancing medications, and herbal supplements are also becoming more commonly abused. Most new drugs of abuse have no specific antidote and management largely involves symptom based goal directed supportive care with benzodiazepines as a useful adjunct. This paper will focus on the history, epidemiology, clinical effects, laboratory analysis, and management strategy for many of these emerging drugs of abuse.
Wagner, Heather; Howland, Maryhope; Mann, Traci
Objective Explicitly—as opposed to subtly—labeling a food healthy may inadvertently license people to indulge, imply that the food tastes bad, or lead to reactance. We investigated the effects of explicit and subtle health messages on individuals’ food selection in two field studies. Methods We manipulated the signs on healthy foods such that they explicitly stated that the food was healthy, subtly suggested it with an image, or did not mention health. As participants, attendees at academic conferences, approached registration tables, research assistants recorded the number and type of snacks individuals chose. Results Participants were more likely to choose the healthy food when it was labeled with the subtle health message than when it was labeled with the explicit health message, which itself was not more effective than the control message. Conclusion Subtle messages may be more useful than explicit health messages in encouraging individuals to make a healthy snack choice. PMID:24467259
Sprague, Sheila; Madden, Kim; Dosanjh, Sonia; Petrisor, Brad; Schemitsch, Emil H.; Bhandari, Mohit
Accurately identifying victims of intimate partner violence (IPV) can be a challenge for clinicians and clinical researchers. Multiple instruments have been developed and validated to identify IPV in patients presenting to health care practitioners, including the Woman Abuse Screening Tool (WAST) and the Partner Violence Screen (PVS). The purpose…
Northway, Ruth; Melsome, Melissa; Flood, Samantha; Bennett, Davey; Howarth, Joyce; Thomas, Becki
People with intellectual disabilities have a higher risk of being abused than other people, but to date research has not explored their views regarding abuse. This article reports the findings relating to one question within a participatory research study concerning the abuse of people with intellectual disabilities. This question asked what…
Krings, Franciska; Johnston, Claire; Binggeli, Steve; Maggiori, Christian
Immigrants play an increasingly important role in local labor markets. Not only do they grow steadily in number but also in cultural, educational, and skill diversity, underlining the necessity to distinguish between immigrant groups when studying discrimination against immigrants. We examined immigrant employees' subtle discrimination experiences in a representative sample in Switzerland, controlling for dispositional influences. Results showed that mainly members of highly competitive immigrant groups, from immediate neighbor countries, experienced workplace incivility and that these incivility experiences were related to higher likelihoods of perceived discrimination at work. This research confirms recent accounts that successful but disliked groups are particularly likely to experience subtle interpersonal discrimination.
Pediatricians and other medical providers caring for children need to be aware of the dynamics in the significant relationship between substance abuse and child maltreatment. A caregiver's use and abuse of alcohol, marijuana, heroin, cocaine, methamphetamine, and other drugs place the child at risk in multiple ways. Members of the medical community need to understand these risks because the medical community plays a unique and important role in identifying and caring for these children. Substance abuse includes the abuse of legal drugs as well as the use of illegal drugs. The abuse of legal substances may be just as detrimental to parental functioning as abuse of illicit substances. Many substance abusers are also polysubstance users and the compounded effect of the abuse of multiple substances may be difficult to measure. Often other interrelated social features, such as untreated mental illness, trauma history, and domestic violence, affect these families.
Anyone who has ever managed people who abuse time--whether they are chronic procrastinators or individuals who work obsessively to meet deadlines weeks in advance--knows how disruptive they can be to a business's morale and operating efficiency. But lessons in time management will have no impact on these employees. That's because real time abuse results from psychological conflict that neither a workshop nor a manager's cajoling can cure. Indeed, the time abuser's quarrel isn't even with time but rather with a brittle self-esteem and an unconscious fear of being evaluated and found wanting. This article describes four types of time abusers typically encountered in the workplace: Perfectionists are almost physically afraid of receiving feedback. Their work has to be "perfect," so they can increase their likelihood of earning a positive evaluation or at least avoid getting a negative one. Preemptives try to be in control by handing in work far earlier than they need to, making themselves unpopular and unavailable in the process. People pleasers commit to far too much work because they find it impossible to say no. Procrastinators make constant (and often reasonable-sounding) excuses to mask a fear of being found inadequate in their jobs. Managing these four types of people can be challenging, since time abusers respond differently from most other employees to criticism and approval. Praising a procrastinator when he is on time, for instance, will only exacerbate the problem, because he will fear that your expectations are even higher than before. In fact, some time abusers, like the perfectionist, may need professional treatment. This article will give you insight into why they are the way they are--and what can be done to help them manage their problems.
Shen, X Y; Orson, F M; Kosten, T R
The currently available medications for the treatment of drug abuse have had only limited success. Anti-addiction vaccines, aimed at eliciting antibodies that block the pharmacological effects of drugs, have great potential for treating drug abuse. We review the status of two vaccines that are undergoing clinical trials (for cocaine and nicotine addiction) and two that are still in preclinical development (for methamphetamine and heroin addiction). We also outline the challenges and ethical concerns associated with the development of anti-addiction vaccines and their use as future therapeutics.
The role of imaging in cases of child abuse is to identify the extent of physical injury when abuse is present and to elucidate all imaging findings that point to alternative diagnoses. Effective diagnostic imaging of child abuse rests on high-quality technology as well as a full appreciation of the clinical and pathologic alterations occurring in abused children. This statement is a revision of the previous policy published in 2000.
The abuse of older people is a significant problem, with estimates intimating that there may be over 340,000 cases per year in the United Kingdom. Despite improvements in screening and assessment to identify and treat those who are abused or at risk of abuse, the healthcare community remains preoccupied with prevalence rather than prevention. In light of the paucity of health-related research evidence to support the effectiveness of preventative measures, the application of crime prevention theory and knowledge is appropriate. Routine activity theory and situational crime prevention literature acknowledges the vulnerability of older people to abuse and the potential of any person employed as a carer to be an abuser. Preventative measures are focused on techniques that make abuse more difficult and more risky for the perpetrator and, therefore, less 'rewarding'. The regulation of healthcare support workers and increased workplace surveillance are examples of the 25 techniques of situational prevention that could be applied in a healthcare setting.
Despite the prevailing agreement among researchers that the increasing rate of elder abuse in Israel is relatively understudied, not sufficiently identified, and not appropriately addressed, literature on elderly abuse in the Israeli society remains limited. The common discourse on aging, eldercare, and elder abuse and neglect, mainly revolves…
Foynes, Melissa Ming; Freyd, Jennifer J.; DePrince, Anne P.
Objective: The current study tested several hypotheses about disclosure of childhood sexual, physical, and emotional abuse derived from Betrayal Trauma Theory [Freyd, J. J. (1996). Betrayal trauma: The logic of forgetting childhood abuse. Cambridge, MA: Harvard University Press]. We predicted that the duration of time from abuse to its disclosure…
This document provides a review of recent, state-of-the-art literature concerning the nature, extent, dynamics, and effects of child sexual abuse and examines America's preventive intervention and treatment efforts for child sexual abuse. After an extensive presentation of the problems of defining terms in sexual abuse, these topics are discussed:…
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,…
Murphy, Linda; Corte, Suzanne Della
The issue's major feature, on physical and sexual abuse of handicapped children, focuses on education and adult awareness of the problem. It has been well documented that children with handicaps are especially vulnerable to abuse. Parents or other adults who believe that abuse has occurred should first write down exactly what the child has told…
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…
... Abuse: Research, Treatment, & Program Innovations for Victims, Survivors, & Offenders, 14(4), 1-24. doi: 10.1300/J070v14n04_ ... 1996). Childhood sexual abuse and psychiatric disorder in young adulthood: Psychiatric outcomes of childhood sexual abuse. Journal ...
Schuckit, Marc A.
This paper reviews the literature and presents new data on alcohol and drug problems in older individuals. Drug abusers include users of opiates, inadvertent misusers, and deliberate abusers of nonopiates. Two to 10 percent of the elderly are alcoholic, and these are usually individuals beginning alcohol abuse after age 40. (Author)
Scorzelli, James F.
This report examines the incidence of drug abuse and the methods of treatment and prevention of drug abuse used in Southeast Asia. Countries studied include Malaysia, Singapore, Thailand, Indonesia, and the Philippines. Because of Malaysia's intensive effort to eliminate its drug abuse problem, emphasis is placed on this country's treatment and…
MacKenzie, R G; Jacobs, E A
Adolescents are at high risk for using and abusing illicit drugs. Guidelines for recognizing drug abusers are presented as well as a staging process for progression of drug use. The family physician is in an ideal position to identify young users/abusers and to assist them and their families in obtaining much needed assistance.
Ferneau, E.; Mueller, S.
The drug-abuse questionnaire used to survey college student attitudes on the subject is provided. It is identical to the alcoholism questionnaire except for word changes appropriate to the subject matter. The questionnaire consists of 40 statements about drug abuse and drug abusers, with 7 possible responses: (1) completely disagree; (2) mostly…
Parran, T V; Jasinski, D R
Data are presented from a case series of 22 patients who abused methylphenidate hydrochloride (Ritalin-SR). The abuse pattern and symptoms of toxicity were similar to that seen with cocaine hydrochloride and amphetamine sulfate addiction; yet, the morbidity and mortality seen in this case series were greater than usual for a group of patients involved in intravenous drug abuse. We describe the characteristics of the methylphenidate abuse syndrome in terms of the pharmacology of methylphenidate, the constituents of the Ritalin-SR preparation, and the disease of chemical dependence. We propose solutions to the problem of methylphenidate abuse.
Francis, Karen J.; Wolfe, David A.
Objective: Abusive fathers perpetrate a substantial portion of child physical abuse. Despite this, little is known about how they differ from non-abusive fathers. This study compared a broad range of cognitive and affective factors between physically abusive and non-abusive fathers. Methods: Abusive (n = 24) and non-abusive (n = 25) fathers…
Say, Gökçe Nur; Babadağı, Zehra; Karabekiroğlu, Koray; Yüce, Murat; Akbaş, Seher
The current study examined the rate and psychiatric correlates of sexual abuse involving the use of digital technologies by the offender in a wide sample of juvenile victims. Sociodemographic, abuse, and psychiatric characteristics of 662 sexually abused children and adolescents were evaluated. Of these, 93 reported that digital devices were used by the offender in several ways to facilitate the sexual abuse. The offender-victim relationship was initiated through the Internet in 39 victims. Involvement of digital technologies in sexual abuse was significantly associated with penetrative and recurrent form of sexual abuse commited by multiple offenders with coexisting violence. Additionally, victims of sexual abuse with a digital component were 4.21 times more likely to develop any psychopathology, 3.77 times more likely to have depression, and 2.14 times more likely to have post-traumatic stress disorder as a result of sexual abuse. These results indicated that the offender's use of digital technology may aid the initiation and facilitation of the sexual abuse of youths and may relate to more severe outcomes. This study revealed the importance of raising the awareness of professionals and the community about the potential risks associated with digital technologies and sexual abuse. Mental health professionals should consider this additional form of victimization, especially when dealing with sexual abuse victims.
Kantardjiev, Alexander A
Graphical Abstract Subtle.Nets.Finder is a workflow of algorithms for identification of subtly interacting groups in DNA/RNA/protein complexes. It is founded on detailed and sophisticated evaluation of the self-consistency in the cooperative network of residue interactions via a combination of advanced calculations (fast multipole method and statistical mechanics) supplemented with graph-theoretical procedures.
Berent, Gerald P.; Kelly, Ronald R.; Albertini, John A.; Toscano, Rose Marie
Deaf Learners' Acquisition of fundamental lexical properties of high-frequency English verbs related to transitivity and intransitivity was examined, including the subtle distinction between unergative and unaccusative verbs. A 140-item sentence acceptability rating scale was used to assess this lexical knowledge in deaf college students at two…
Poole, Ernest Andre
In this review I explore and discuss the use of micro and subtle expression training in the social sciences. These trainings, offered commercially, are designed and endorsed by noted psychologist Paul Ekman, co-author of the Facial Action Coding System, a comprehensive system of measuring muscular movement in the face and its relationship to the…
Bulling, T.P.; Breyer, J.A.
High-resolution paleogeographic maps depicting the depositional history of the Reklaw 1 interval provide a basis for prospecting for subtle traps in the updip Reklaw trend in south Texas. The Reklaw 1 interval began with sand being carried southwestward by longshore currents to form the barrier bar that became Atkinson field. The hydrocarbons were trapped by the updip pinch-out of barrier-bar sand into lagoonal mud. Stratigraphic traps similar to Atkinson field could be present along depositional strike if the sand in the field were part of an extensive barrier-bar system. After the barrier bar formed, distributary mouth bars prograded seaward, depositing the bar-finger sands that became the Hysaw and Flax fields. Subtle structural traps could be present today where small up-to-the-coast faults associated with the sample fault system cut the bar-finger sands downdip from established production. Farther down paleoslope, the distributary channels began to bifurcate and the distributary mouth bars coalesced to form a broad delta-front sheet sand. Burnell, Hondo Creek, and Runge West fields produce from this sheet sand at the unstable shelf margin. A rapid rise in relative sea level terminated the Reklaw 1 interval. Many of the oil and gas fields still to be discovered in the US are in mature petroleum provinces where much of the remaining oil and gas probably resides in subtle traps. High-resolution paleogeographic maps are the key to finding these subtle traps. 11 figures, 2 tables.
Baker, Eva L.; O'Neil, Harry
We describe some of Merl's more subtle contributions that extended beyond his own prodigious scholarly record, his high-quality teaching, and his mentoring of students. The context of our remarks on Programmatic R&D focuses on his contribution to the University of California, Los Angeles, Department of Education. Merl was the first director of…
Dong, Xin Qi; Li, Ge
Objectives This study aimed to examine the prevalence and correlates of elder abuse reported by adult children among U.S Chinese populations. Method A community-based participatory research approach was implemented. A total of 548 Chinese adult children aged 21 years and over participated in this study. Elder abuse reported by adult children was assessed using Caregiver Abuse Screen (CASE). Results This study found a prevalence of 59.8%for elder abuse among 548 adult children. Younger age (r = −0.10, p < .05), higher level of education (r = 0.20, p < .001), higher income (r = 0.14, p < .01), more years in the U.S. (r = 0.12, p < .05), not born in Mainland China (r = −0.13, p < .01), and English-speaking (r = 0.16, p < .001) were positively correlated with elder abuse reported by adult children. Discussion Elder abuse by adult children is prevalent among U.S. Chinese populations. It is necessary for researchers, health care providers and policy makers to put more attention on elder abuse by adult children. Longitudinal research is needed to explore the risk factors associated with elder abuse by adult children. Health care providers should improve detection of elder abuse and support at-risk caregivers. Policy makers may consider cultural sensitive approaches to address elder abuse. PMID:27606358
Ajduković, Marina; Sušac, Nika; Rajter, Miroslav
Aim To examine age and gender differences in the prevalence and incidence of child sexual abuse, the level of acquaintance of the child and the perpetrator, and correlations between experiencing family violence and sexual abuse on a nationally representative sample of 11, 13, and 16 years old children. Method A probabilistic stratified cluster sample included 2.62% of the overall population of children aged 11 (n = 1223), 13 (n = 1188), and 16 (n = 1233) from 40 primary and 29 secondary schools. A modified version of ISPCAN Child Abuse Screening Tool – Children's Version was used. Five items referred to child sexual abuse (CSA) for all age groups. Results In Croatia, 10.8% of children experienced some form of sexual abuse (4.8% to 16.5%, depending on the age group) during childhood and 7.7% of children experienced it during the previous year (3.7% to 11.1%, depending on the age group). Gender comparison showed no difference in the prevalence of contact sexual abuse, whereas more girls than boys experienced non-contact sexual abuse. Correlations between sexual abuse and physical and psychological abuse in the family were small, but significant. Conclusion Comparisons with international studies show that Croatia is a country with a low prevalence of CSA. The fact that the majority of perpetrators of sexual abuse are male and female peers indicates the urgent need to address risks of sexual victimization in the health education of children. PMID:24170726
United Nations Educational, Scientific, and Cultural Organization, Paris (France).
This book is a compilation of drug education and drug abuse prevention materials collected by United Nations Educational, Scientific and Cultural Organization (UNESCO) along with example of activities carried out by various countries. It opens with four introductory papers by separate authors: (1) "Prevention of Drug Dependence: A Utopian…
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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…
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…
Carmichael, Karla D.
This document is a class presentation designed to present a history of child abuse and interventions for the beginning play therapist. Attempts to understand child behavior are traced back to their roots in the fields of mental retardation and special education as early as 1799 and followed through the mental health and child guidance movements of…
Rech, Megan A; Donahey, Elisabeth; Cappiello Dziedzic, Jacqueline M; Oh, Laura; Greenhalgh, Elizabeth
Drug abuse is a common problem and growing concern in the United States, and over the past decade, novel or atypical drugs have emerged and have become increasingly popular. Recognition and treatment of new drugs of abuse pose many challenges for health care providers due to lack of quantitative reporting and routine surveillance, and the difficulty of detection in routine blood and urine analyses. Furthermore, street manufacturers are able to rapidly adapt and develop new synthetic isolates of older drugs as soon as law enforcement agencies render them illegal. In this article, we describe the clinical and adverse effects and purported pharmacology of several new classes of drugs of abuse including synthetic cannabinoids, synthetic cathinones, salvia, desomorphine, and kratom. Because many of these substances can have severe or life-threatening adverse effects, knowledge of general toxicology is key in recognizing acute intoxication and overdose; however, typical toxidromes (e.g., cholinergic, sympathomimetic, opioid, etc.) are not precipitated by many of these agents. Medical management of patients who abuse or overdose on these drugs largely consists of supportive care, although naloxone may be used as an antidote for desomorphine overdose. Symptoms of aggression and psychosis may be treated with sedation (benzodiazepines, propofol) and antipsychotics (haloperidol or atypical agents such as quetiapine or ziprasidone). Other facets of management to consider include treatment for withdrawal or addiction, nutrition support, and potential for transmission of infectious diseases.
... hurting or harming someone) might have frightened the boy or girl into staying quiet. No matter what the abuser ... suit or underwear: breasts, vagina, and bottom for girls, and penis and bottom for boys. If an adult or another kid touches a ...
Hicks, Ralph A.; Gaughan, Daniel C.
Medical, social service, and coroner reports were reviewed for 14 cases of fatal child abuse and neglect identified at a children's hospital from 1988 to 1992. Median age was 6.5 months. Six families had prior protective service involvement (though four of these had involved a sibling). The cause of death in all cases was blunt impact head injury.…
Nessa, A; Latif, S A; Siddiqui, N I; Hussain, M A; Hossain, M A
Among the social and medical ills of the twentieth century, substance abuse ranks as on one of the most devastating and costly. The drug problem today is a major global concern including Bangladesh. Almost all addictive drugs over stimulate the reward system of the brain, flooding it with the neurotransmitter dopamine. That produces euphoria and that heightened pleasure can be so compelling that the brain wants that feeling back again and again. However repetitive exposure induces widespread adaptive changes in the brain. As a consequence drug use may become compulsive. An estimated 4.7% of the global population aged 15 to 64 or 184 million people, consume illicit drug annually. Heroin use alone is responsible for the epidemic number of new cases of HIV/AIDS, Hepatitis and drug addicted infant born each year. Department of narcotic control (DNC) in Bangladesh reported in June 2008 that about 5 million drug addicts in the country & addicts spend at least 17 (Seventeen) billion on drugs per year. Among these drug addicts, 91% are young and adolescents population. Heroin is the most widely abused drugs in Bangladesh. For geographical reason like India, Pakistan and Myanmar; Bangladesh is also an important transit root for internationally trafficking of illicit drug. Drug abuse is responsible for decreased job productivity and attendance increased health care costs, and escalations of domestic violence and violent crimes. Drug addiction is a preventable disease. Through scientific advances we now know much more about how exactly drugs work in the brain, and we also know that drug addiction can be successfully treated to help people stop abusing drugs and resume their productive lives. Most countries have legislation designed to criminalize some drugs. To decrease the prevalence of this problem in our setting; increase awareness, promoting additional research on abused and addictive drugs, and exact implementation of existing laws are strongly recommended. We should
Mega, L T; Mega, J L; Mega, B T; Harris, B M
Intimate partner violence occurs often in the United States; it involves an interrelated combination of physical, sexual, and psychological abuse, usually directed against women. The psychological aspect deserves special attention because victims who lose their independence, self-esteem, and dignity tend to remain in abusive situations. The abuse is perpetrated by a domestic partner to maintain power and control in the relationship. To assert control, the abuser uses "brainwashing tactics" similar to those used on prisoners of war, hostages, or members of a cult. Common features of brainwashing include isolation, humiliation, accusation, and unpredictable attacks. The abusive environment produces real and anticipated fear, which contributes to the battered woman's belief that her situation is hopeless and that she must depend on her abuser. She develops coping strategies to deal with her oppressive environment, but eventually exhibits symptoms of "battering fatigue," similar to the battle fatigue of soldiers in combat who, like battered women, live in fear of being killed or severely injured. Recognizing the state of mind of these women can help us understand why it is difficult for them to flee their traumatic environment and why they may resort to suicide or homicide. For healthcare providers to screen and treat their patients adequately, it is imperative that they appreciate the complex and devastating psychological aspects of domestic violence.
Conason, A H; Brunstein Klomek, A; Sher, L
Eating disorders and alcohol/drug abuse are frequently comorbid. Eating-disordered patients are already at an increased risk for morbidity and mortality, so alcohol and drug use pose additional dangers for these patients. Restricting anorexics, binge eaters, and bulimics appear to be distinct subgroups within the eating-disordered population, with binge eaters and bulimics more prone to alcohol and drug use. Personality traits such as impulsivity have been linked to both bulimia nervosa and substance abuse. Many researchers have proposed that an addictive personality is an underlying trait that predisposes individuals to both eating disorders and alcohol abuse. Interviewing is generally the most useful tool in diagnosing alcohol and substance abuse disorders in individuals with eating disorders. It is essential for the physician to be non-judgmental when assessing for substance abuse disorders in this population. We discuss interviewing techniques, screening instruments, physical examination, and biological tests that can be used in evaluating patients with comorbid eating disorders and substance abuse. More studies are needed to understand psychobiological mechanisms of this comorbidity, and to develop treatments for individuals with comorbid eating disorders and substance misuse.
Norliza, C; Norni, A; Anandjit, S; Mohd Fazli, M I
This is a review of research done in the area of substance abuse in Malaysia. There were 109 articles related to substance abuse found in a search through a database dedicated to indexing all original data relevant to medicine published in Malaysia between the years 2000-2013. Only 39 articles were reviewed, and case series, case report, reviews and reports were excluded. Research reviewed include the epidemiology of substance abuse, genetics, treatment and its relation to health behaviour, and health management. Studies have shown that more males than females use drugs. There was also a high prevalence of blood-bourne virus diseases and sexually transmitted diseases among drug users. Two studies showed some genetic polymorphism (Cyp 3a4 gene and FAAH Pro129Thr) among heroin and amphetamine users respectively that may contribute to drug dependence. Study on pharmacological treatment for substance abuse were limited to methadone and it was shown to improve the quality of life of heroin dependant patients. Alternative treatments such as acupunture and spiritual approach play a role in the management of substance abuse. Data also showed that treatment centres for substance abuse are lacking facilities for screening, assessment and treatment for medical illness related to substance use, e.g. Hepatitis C and tuberculosis. Studies on the effectiveness of current drug rehabilitation centres were inconclusive.
Gareri, Joey; Klein, Julia; Koren, Gideon
Prenatal substance abuse is an ongoing concern with significant impact on neonatal health and development across socioeconomic lines. Meconium, passed by neonates during their first post-natal bowel movements, is a matrix unique to the developing fetus and contains a long history of prenatal metabolism. Over the last two decades, the use of meconium as a matrix for assessing prenatal exposure to drugs of abuse has yielded methods exhibiting higher sensitivity, easier collection, and a larger window of detection than traditional matrices. Recently, a method has been developed for the analysis of fatty acid ethyl esters in meconium as a biomarker of fetal alcohol exposure, potentially facilitating the future diagnosis of Fetal Alcohol Spectrum Disorder in situations where gestational alcohol consumption history is unknown. Screening for prenatal exposure to illicit and abused licit drugs in meconium is possible by use of a variety of immunoassay methods with conformational analysis usually occurring by GCMS or LCMS. In spite of increased sample preparation time relative to blood and urine, the long metabolic history, coupled with the ease and wide window of collection of meconium make it the ideal matrix for determining fetal drug exposure.
Herman-Smith, Robert L.
Research Findings: A 2003 amendment to the Child Abuse Prevention and Treatment Act (CAPTA) required states to develop plans to ensure that children younger than the age of 3 years who are victims of substantiated abuse or neglect have access to developmental screenings. Programs authorized under Part C of the Individuals with Disabilities…
Mathias, Ana Carolina R.; Vargens, Renata W.; Kessler, Felix H.; Cruz, Marcelo S.
There is a strong association between pathological gambling and substance abuse. The objective of this study is to identify the differences between substance abusers with and without gambling problems. A cross sectional study was conducted interviewing with Addiction Severity Index (ASI) and South Oaks Gambling Screen (SOGS), alcohol and drug…
Melville, John D; Kellogg, Nancy D; Perez, Nadia; Lukefahr, James L
The purpose of this study was to describe behavioural and emotional symptoms and to examine the effect of abuse-related factors, family responses to disclosure, and child self-blame on these symptoms in children presenting for medical evaluations after disclosure of sexual abuse. A retrospective review was conducted of 501 children ages 8-17. Trauma symptoms were determined by two sets of qualitative measures. Abstracted data included gender, ethnicity, and age; severity of abuse and abuser relationship to child; child responses regarding difficulty with sleep, school, appetite/weight, sadness, or self-harm, parent belief in abuse disclosure, and abuse-specific self-blame; responses to the Trauma Symptom Checklist in Children-Alternate; and the parent's degree of belief in the child's sexual abuse disclosure. Overall, 83% of the children had at least one trauma symptom; 60% had difficulty sleeping and one-third had thoughts of self-harm. Child age and abuse severity were associated with 3 of 12 trauma symptoms, and abuse-specific self-blame was associated with 10 trauma symptoms, after controlling for other variables. The children of parents who did not completely believe the initial disclosure of abuse were twice as likely to endorse self-blame as children of parents who completely believed the initial disclosure. Screening for behavioural and emotional problems during the medical assessment of suspected sexual abuse should include assessment of self-blame and family responses to the child's disclosures. In addition, parents should be informed of the importance of believing their child during the initial disclosure of abuse and of the impact this has on the child's emotional response to the abuse.
Koola, Maju Mathew; Qualls, Clifford; Kelly, Deanna L; Skelton, Kelly; Bradley, Bekh; Amar, Richard; Duncan, Erica J
We examined the prevalence of childhood (≤ 18 years) physical and sexual abuse reported among patients admitted to the psychiatric inpatient service and the differential rates of this abuse associated with psychiatric diagnoses. This study consisted of a retrospective chart review of 603 patients admitted to a psychiatric ward during a period of 1 year at Atlanta Veterans Affairs Medical Center who had data on childhood physical and sexual abuse. The prevalence of reported childhood physical or sexual abuse in this inpatient clinical population was 19.4% (117/603). The prevalence of reported physical abuse was 22.6% (19/84) in the women and 12.0% (62/519) in the men (p = 0.008); the prevalence of sexual abuse was 33.3% (28/84) in the women and 7.7% (40/519) in the men (p < 0.0001). More patients with depressive disorders reported sexual abuse than did those without these disorders. More patients with posttraumatic stress disorder (PTSD) reported physical and sexual abuse than did those without these disorders. Stratifying by race, sex, and diagnoses, multivariate analyses showed that the women with PTSD had a greater likelihood to report physical abuse (p = 0.03) and sexual abuse histories (p = 0.008) than did the women without PTSD. The men with substance-induced mood disorder (p = 0.01) were more likely to report physical abuse compared with the men without substance-induced mood disorder. Screening for abuse in patients with depressive disorders and PTSD is warranted to tailor individualized treatments for these patients. More research is needed to better understand the potential implications of childhood abuse on psychiatric diagnoses.
Chan, Heang-Ping; Vyborny, Carl J.; MacMahon, Heber; Metz, Charles E.; Doi, Kunio; Sickles, Edward A.
We have conducted a study to assess the effects of digitization and unsharp-mask filtering on the ability of observers to detect subtle microcalcifications in mammograms. Thirty-two conventional screen-film mammograms were selected from patient files by two experienced mammographers. Twelve of the mammograms contained a suspicious cluster of microcalcifications in patients who subsequently underwent biopsy. Twenty of the mammograms were normal cases which were initially interpreted as being free of clustered microcalcifications and did not demonstrate such on careful review. The mammograms were digitized with a high-quality Fuji image processing/simulation system. The system consists of two drum scanners with which an original radiograph can be digitized, processed by a minicomputer, and reconstituted on film. In this study, we employed a sampling aperture of 0.1 mm X 0.1 mm and a sampling distance of 0.1 mm. The density range from 0.2 to 2.75 was digitized to 1024 grey levels per pixel. The digitized images were printed on a single emulsion film with a display aperture having the same size as the sampling aperture. The system was carefully calibrated so that the density and contrast of a digitized image were closely matched to those of the original radiograph. Initially, we evaluated the effects of the weighting factor and the mask size of a unsharp-mask filter on the appearance of mammograms for various types of breasts. Subjective visual comparisons suggested that a mask size of 91 X 91 pixels (9.1 mm X 9.1 mm) enhances the visibility of microcalcifications without excessively increasing the high-frequency noise. Further, a density-dependent weighting factor that increases linearly from 1.5 to 3.0 in the density range of 0.2 to 2.5 enhances the contrast of microcalcifications without introducing many potentially confusing artifacts in the low-density areas. An unsharp-mask filter with these parameters was used to process the digitized mammograms. We conducted
Moore, C; Negrusz, N
The determination of fetal drug exposure is of great importance for the future development of the neonate. Meconium, the first fecal material excreted by the newborn is an excellent depository for drugs to which the fetus has been exposed. Correct diagnosis of drug use during pregnancy allows the child to receive specialized treatment and care, which will aid in learning behavioral development. Meconium analysis is gaining significant credibility as an alternative or an additional sample to neonatal or maternal urine, because meconium provides a longer history of drug use than urine and drug concentrations are higher. Therefore, number of false negative results is decreased. Meconium analysis is a relatively new scientific development. Reported analytical procedures and techniques for drugs and metabolites in meconium are predominantly cocaine-related, although other compounds have been studied. Meconium, a complex matrix, requires pre-treatment and the extraction of drugs using organic solvents and solid-phases is discussed. Preliminary drug screening using predominantly immunoassays and quantitative confirmatory analytical chromatographic methods, are reviewed. Drugs of abuse described include cocaine, amphetamines, phencyclidine, marijuana, opiates, nicotine, benzodiazepines and barbiturates.
Menick, D Mbassa; Ngoh, F
The twofold purpose of this study was to promote and facilitate awareness, detection and reporting of child abuse by improving the diagnostic ability of a group of pediatric care providers working in pediatric emergency rooms and to evaluate the impact of training on awareness, detection and reporting of child abuse. This study was conducted in three phases. In the first phase data were retrospectively collected for a three-month period prior to the study (May, June, and July 1996). In the second phase a training seminar about awareness, detection, and reporting of child abuse was organized from April 29 to 30, 1997 for pediatric care providers working in the pediatric emergency rooms of several facilities in Yaoundé, Cameroon. Trainees included pediatricians, general practitioners, nurses, and social workers. An oral presentation using 137-slides (visual diagnosis of physical abuse) from the American Academy of Paediatrics (1994) was used as a teaching aid. In the third phase the same data as in the first phase was prospectively collected on the same three-month period after the seminar (May, June and July 1997). As in the first phase data was collected by the same person from emergency room registers according to the WHO protocol (1994) (study of interpersonal physical abuse of children). During the first phase 39 cases of physical abuse were reported in a population 1269 consulting patients, i.e. 3.1% of the cohort. In the third phase prospective analysis of reporting following the training seminar showed that 161 cases of physical abuse were reported in a population of 1425 consulting patients, i.e., 11.3% of the cohort. The victim group (n=161) in the third phase was four-fold larger than the victim group in the first phase (n = 39). These findings suggest that the seminar achieved its main goals, i.e., to improve the diagnostic ability of the trainees and to increase detection and screening of physical abuse of children.
Orendorff, Christopher J.; Nagasubramanian, Ganesan; Fenton, Kyle R.; Allcorn, Eric
As lithium-ion battery technologies mature, the size and energy of these systems continues to increase (> 50 kWh for EVs); making safety and reliability of these high energy systems increasingly important. While most material advances for lithium-ion chemistries are directed toward improving cell performance (capacity, energy, cycle life, etc.), there are a variety of materials advancements that can be made to improve lithium-ion battery safety. Issues including energetic thermal runaway, electrolyte decomposition and flammability, anode SEI stability, and cell-level abuse tolerance continue to be critical safety concerns. This report highlights work with our collaborators to develop advanced materials to improve lithium-ion battery safety and abuse tolerance and to perform cell-level characterization of new materials.
Bosker, Wendy M.; Huestis, Marilyn A.
BACKGROUND Oral fluid (OF) is an exciting alternative matrix for monitoring drugs of abuse in workplace, clinical toxicology, criminal justice, and driving under the influence of drugs (DUID) programs. During the last 5 years, scientific and technological advances in OF collection, point-of-collection testing devices, and screening and confirmation methods were achieved. Guidelines were proposed for workplace OF testing by the Substance Abuse and Mental Health Services Administration, DUID testing by the European Union’s Driving under the Influence of Drugs, Alcohol and Medicines (DRUID) program, and standardization of DUID research. Although OF testing is now commonplace in many monitoring programs, the greatest current limitation is the scarcity of controlled drug administration studies available to guide interpretation. CONTENT This review outlines OF testing advantages and limitations, and the progress in OF that has occurred during the last 5 years in collection, screening, confirmation, and interpretation of cannabinoids, opioids, amphetamines, cocaine, and benzodiazepines. We examine controlled drug administration studies, immunoassay and chromatographic methods, collection devices, point-of-collection testing device performance, and recent applications of OF testing. SUMMARY Substance Abuse and Mental Health Services Administration approval of OF testing was delayed because questions about drug OF disposition were not yet resolved, and collection device performance and testing assays required improvement. Here, we document the many advances achieved in the use of OF. Additional research is needed to identify new bio-markers, determine drug detection windows, characterize OF adulteration techniques, and evaluate analyte stability. Nevertheless, there is no doubt that OF offers multiple advantages as an alternative matrix for drug monitoring and has an important role in DUID, treatment, workplace, and criminal justice programs. PMID:19745062
Simmons, Shannon; Suárez, Liza
There is a strong, bidirectional link between substance abuse and traumatic experiences. Teens with cooccurring substance use disorders (SUDs) and posttraumatic stress disorder (PTSD) have significant functional and psychosocial impairment. Common neurobiological foundations point to the reinforcing cycle of trauma symptoms, substance withdrawal, and substance use. Treatment of teens with these issues should include a systemic and integrated approach to both the SUD and the PTSD.
Reardon, Claudia L; Creado, Shane
Drug abuse occurs in all sports and at most levels of competition. Athletic life may lead to drug abuse for a number of reasons, including for performance enhancement, to self-treat otherwise untreated mental illness, and to deal with stressors, such as pressure to perform, injuries, physical pain, and retirement from sport. This review examines the history of doping in athletes, the effects of different classes of substances used for doping, side effects of doping, the role of anti-doping organizations, and treatment of affected athletes. Doping goes back to ancient times, prior to the development of organized sports. Performance-enhancing drugs have continued to evolve, with “advances” in doping strategies driven by improved drug testing detection methods and advances in scientific research that can lead to the discovery and use of substances that may later be banned. Many sports organizations have come to ban the use of performance-enhancing drugs and have very strict consequences for people caught using them. There is variable evidence for the performance-enhancing effects and side effects of the various substances that are used for doping. Drug abuse in athletes should be addressed with preventive measures, education, motivational interviewing, and, when indicated, pharmacologic interventions. PMID:25187752
Stephens, J.; Salorio, C.; Denckla, M.; Mostofsky, S.; Suskauer, S.
Pediatric traumatic brain injury (TBI) is a heterogeneous condition, varying in both severity and sequelae. The long-term motor deficits following severe TBI requiring inpatient rehabilitation are better established than those following milder forms of TBI. The authors examined motor performance 2 and 12 months postinjury in children without overt motor impairment using standard measures of upper limb function and the Physical and Neurological Examination for Subtle Signs (PANESS). The PANESS was sensitive to differences between children with TBI and uninjured children as well as to changes in children with TBI over time. These data suggest that subtle motor deficits are present after milder forms of TBI and, particularly those related to balance and gait, may persist even 12 months postinjury. PMID:27635631
Smith, J. M.; Blue, B.; Clancy, E.; Valeri, C. R.; Cohen, R. J.
Observations from finite-element computer models, together with analytic developments based on percolation theory have suggested that subtle fluctuations of ECG morphology might serve as an indicator diminished cardiac electrical stability. With fixed-rate atrial pacing in canines, we have previously observed a pattern of alternation in T wave energy which correlated with cardiac electrical stability. We report here on a series of 20 canine experiments in which cardiac electrical stability (measured via Ventricular Fibrillation Threshold determination) was compared to a non-degenerate, multidimensional measurement of the degree of alternating activity present in the ECG complex morphology. The decrease in cardiac electrical stability brought on by both coronary artery occlusion and systemic hypothermia was consistently accompanied by subtle alternation in ECG morphology, with the absolute degree of alternating activity being significantly (negatively) correlated with cardiac electrical stability.
Rubal, Marcos; Veiga, Puri; Reis, Pedro A; Bertocci, Iacopo; Sousa-Pinto, Isabel
We investigated effects of subtle nutrient enrichment and metal pollution on different levels of biological organization (i.e. whole assemblage, population and individual) of species-rich assemblages. We used rockpools as model system, applying a multi-factorial sampling design to test hypotheses on differences between disturbed and reference locations. Results indicated that disturbed and reference locations supported similar assemblages, as well as individual fitness-related life-traits were ineffective to discriminate between the two conditions. In contrast, assemblages responded to pollution through a reduction of the abundance of sensitive species and a proliferation of tolerant species, although these alterations were detectable only once the influence of dominant taxa was down-weighed by data transformation. Present findings suggest that, contrarily to individual level variables, assemblage structure after data transformation and patterns of distribution and abundance of differently sensitive taxa would be a powerful tool to detect effects of subtle pollution on species-rich assemblages.
Buxton, Sharon L; MacDonald, Lorraine; Tippett, Lynette J
Accurately recognizing the emotional states of others is crucial for successful social interactions and social relationships. Individuals with Parkinson's disease (PD) have shown deficits in emotional recognition abilities although findings have been inconsistent. This study examined recognition of emotions from prosody and from facial emotional expressions with three levels of subtlety, in 30 individuals with PD (without dementia) and 30 control participants. The PD group were impaired on the prosody task, with no differential impairments in specific emotions. PD participants were also impaired at recognizing facial expressions of emotion, with a significant association between how well they could recognize emotions in the two modalities, even after controlling for disease severity. When recognizing facial expressions, the PD group had no difficulty identifying prototypical Ekman and Friesen (1976) emotional faces, but were poorer than controls at recognizing the moderate and difficult levels of subtle expressions. They were differentially impaired at recognizing moderately subtle expressions of disgust and sad expressions at the difficult level. Notably, however, they were impaired at recognizing happy expressions at both levels of subtlety. Furthermore how well PD participants identified happy expressions conveyed by either face or voice was strongly related to accuracy in the other modality. This suggests dysfunction of overlapping components of the circuitry processing happy expressions in PD. This study demonstrates the usefulness of including subtle expressions of emotion, likely to be encountered in everyday life, when assessing recognition of facial expressions.
Rosch, Paul J
The concept of a "life energy" can be found in many cultures in the present time, as well as in past eras reaching back to the ancients. Variously called qi (chi), ki, the "four humors,"prana, "archaeus,"cosmic aether,"universal fluid,"animal magnetism," and "odic force," among other names, this purported biofield is beginning to yield its properties and interactions to the scientific method. Subtle energy is the term used in this chapter, which traces the recent history of subtle energy studies from Harold Saxton Burr and Björn Nordenström to Jim Oschman and Jacques Benveniste. This work takes signaling in living systems from the chemical/molecular to the physical/atomic level of communication. Effects on heart rate variability, stress response, inflammation, and the vagus nerve have been demonstrated and raise the question--Can the power of subtle energies be harnessed for health enhancement? It is fully accepted that good health depends on good communication both within the organism and between the organism and its environment. Sophisticated imaging procedures brought to bear on telomere, stem cell, and genetic research are confirming the ability of meditation and some other traditional practices to promote optimal health through stress reduction.
Stupperich, Alexandra; Strack, Micha
In an attempt to explain the relationship between psychopathy and severe violent behavior, this study associates previous animal abuse, psychopathy, and sadistic acting in forensic patients. Two topics are addressed: (i) whether previous animal abuse can be identified by a patient's Psychopathy Checklist profile and (ii) whether animal abuse statistically mediates between psychopathy and sadistic acting. In a German forensic hospital, 60 patients were investigated. Animal abuse was assessed using face-to-face interviews and the Psychopathy Checklist: Screening Version (PCL:SV), and sadistic acting was identified by file records.Discriminant analysis separated previous animal abuse (10/60) by high adolescent antisocial behavior, superficiality, lack of remorse, lack of empathy, and grandiosity. The mediation from psychopathy to sadistic acting (6/60) through animal abuse was found to be complete.The results, although sample size is limited and base rate of animal abuse and sadistic acting are low, fit with a model suggestive of animal abuse as a causal step toward sadistic crimes. Animal abuse correlates with callous, unemotional traits, and a development of sadistic crimes.
Collins, James L.; Hamlin, Willie T.; Minor, Marie A.; Knasel, Ann Lowe
Child sexual abuse was examined nationally and in the Washington, DC and Howard University Hospital area. In an attempt to describe this widespread problem, two case histories are presented which reflect some of the typical characteristics of child sexual abuse cases seen at Howard University Hospital. Pertinent literature is reviewed citing the prevalence rates and the personality and environmental factors which may contribute to the sexual abuse of children in this country. Finally, the role of the physician in identifying and treating the physical and emotional effects of child abuse are discussed. PMID:7120485
Collins, J L; Hamlin, W T; Minor, M A; Knasel, A L
Child sexual abuse was examined nationally and in the Washington, DC and Howard University Hospital area. In an attempt to describe this widespread problem, two case histories are presented which reflect some of the typical characteristics of child sexual abuse cases seen at Howard University Hospital. Pertinent literature is reviewed citing the prevalence rates and the personality and environmental factors which may contribute to the sexual abuse of children in this country. Finally, the role of the physician in identifying and treating the physical and emotional effects of child abuse are discussed.
This book provides a description for all the known radiological alterations occurring in child abuse. This allows for precise interpretation of findings by radiologists. It also helps eliminate the confusion among both clinicians and non-medical personnel involved in the diagnosis, management, and legal issues related to child abuse. CONTENTS: Introduction; Skeletal trauma: general considerations; Extremity trauma; Bony thoracic trauma; Spinal trauma; Dating fractures; Visceral trauma; Head trauma; Miscellaneous forms of abuse and neglect; The postmortem examination; Differential diagnosis of child abuse; Legal considerations; Psychosocial considerations; Technical considerations and dosimetry.
Bogue, E. G.; Riggs, R. O.
Reviews the role of institutional policy, cites frequent abuses of institutional policy, and delineates several principles of policy management (development, communication, execution and evaluation). (Author/PG)
Özcan, Neslihan Keser; Boyacıoğlu, Nur Elçin; Sertçelik, Elmas
The aim of the study was to determine the relationship between the neglect and abuse that older people were exposed to by their primary caregivers and the experiences of caregivers' burden and abuse by their charges. This descriptive, cross-sectional and correlational study was conducted with 186 individuals over the age of 65 and 136 caregivers. The data were collected using questionnaires to determine neglect and abuse experienced by both older people and caregivers, and the Zarit Burden Scale. Abuse rate of the older people and their caregivers is both high and similar. This study is to make psychiatric nursing professionals aware of the problem of elder abuse and neglect. For researchers, educators, practitioners, and policymakers in the fields of aging, health, and mental health this study provides important data about elder abuse and neglect.
Using Electronic Health Records Data for Substance Use Screening, Brief Intervention, and Referral to Treatment among Adults with Type 2 Diabetes: Design of a National Drug Abuse Treatment Clinical Trials Network Study
Wu, Li-Tzy; Brady, Kathleen T.; Spratt, Susan E.; Dunham, Ashley A.; Heidenfelder, Brooke; Batch, Bryan C.; Lindblad, Robert; VanVeldhuisen, Paul; Rusincovitch, Shelley A.; Killeen, Therese K.; Ghitza, Udi E.
Background The Affordable Care Act encourages healthcare systems to integrate behavioral and medical healthcare, as well as to employ electronic health records (EHRs) for health information exchange and quality improvement. Pragmatic research paradigms that employ EHRs in research are needed to produce clinical evidence in real-world medical settings for informing learning healthcare systems. Adults with comorbid diabetes and substance use disorders (SUDs) tend to use costly inpatient treatments; however, there is a lack of empirical data on implementing behavioral healthcare to reduce health risk in adults with high-risk diabetes. Given the complexity of high-risk patients' medical problems and the cost of conducting randomized trials, a feasibility project is warranted to guide practical study designs. Methods We describe the study design, which explores the feasibility of implementing substance use Screening, Brief Intervention, and Referral to Treatment (SBIRT) among adults with high-risk type 2 diabetes mellitus (T2DM) within a home-based primary care setting. Our study includes the development of an integrated EHR datamart to identify eligible patients and collect diabetes healthcare data, and the use of a geographic health information system to understand the social context in patients' communities. Analysis will examine recruitment, proportion of patients receiving brief intervention and/or referrals, substance use, SUD treatment use, diabetes outcomes, and retention. Discussion By capitalizing on an existing T2DM project that uses home-based primary care, our study results will provide timely clinical information to inform the designs and implementation of future SBIRT studies among adults with multiple medical conditions. PMID:26563446
Alvarez-Segura, M; Garcia-Esteve, L; Torres, A; Plaza, A; Imaz, M L; Hermida-Barros, L; San, L; Burtchen, N
The objective of this paper is to examine the association between maternal lifetime abuse and perinatal depressive symptoms. Papers included in this review were identified through electronic searches of the following databases: Pubmed Medline and Ovid, EMBASE, PsycINFO, and the Cochrane Library. Each database was searched from its start date through 1 September 2011. Keywords such as "postpartum," "perinatal," "prenatal," "depression," "violence," "child abuse," and "partner abuse" were included in the purview of MeSH terms. Studies that examined the association between maternal lifetime abuse and perinatal depression were included. A total of 545 studies were included in the initial screening. Forty-three articles met criteria for inclusion and were incorporated in this review. Quality of articles was evaluated with the Newcastle-Ottawa-Scale (NOS). This systematic review indicates a positive association between maternal lifetime abuse and depressive symptoms in the perinatal period.
Holzman, Lois; Strickland, Gloria
The STOP Abusive Behavior Syndrome (STOP ABS) Project attempts to implement a community-based discipline model for inner-city elementary schools that avoids both physical and emotional abuse by teachers and students, while contributing to the students' overall development. Prevailing disciplinary models either relate to children as objects to be…
Of 100 adolescents screened for drug use, 43% tested positive for drugs of abuse. Twenty-five percent of these adolescents entered treatment, with 8% requiring medical detoxification or inpatient treatment. Urine screening, when done for clinical rather than punitive purposes, appeared to facilitate entry into treatment. (RJM)
Senati, Massimo; Polacco, Matteo; Grassi, Vincenzo M; Carbone, Arnaldo; De-Giorgio, Fabio
Child abuse has become an increasingly serious diagnostic challenge for physicians. The clinical manifestations include malnutrition and sometimes infection. In fact, stress in children has been reported to increase corticosteroid levels. As a consequence, the thymus begins an involution process, producing a severe impairment in cellular and humoral immunity. Here, we report the case of a 7-year-old child who suffered a prolonged history of abuse and died from a systemic Pseudomonas aeruginosa infection. An initial local chronic infection propagated to the pelvic lymph nodes in an immunologically weak body and evolved into abscesses/phlegmons of the pelvic tissue, sepsis, acute respiratory distress syndrome, multiple organ failure and finally, death. Abused children have to be considered as potentially immunologically impaired patients; therefore, it is very important to screen them for opportunistic infections. Moreover, a history of unusual or recurring infections may indicate abuse, especially neglect or malnutrition. In these cases, further investigations should be conducted to determine if a protective service case should be opened. Thus, there is a need for multidisciplinary cooperation to ensure the early identification and prevention of child abuse.
Traditional medical education has not taught physicians about the long-term effects of child sexual abuse. Family physicians often feel poorly equipped to appreciate the effect of such a childhood history on current health or to recognize and treat survivors. This article links the experience of the sexually abused child to long-term effects and outlines the role of family physicians in screening and caring for survivors.
Individual cases of adult incestuous abuse have surfaced repeatedly in the lay and professional literature of the past 1.5 centuries without it occasioning systematic investigation, such as the reporting of a case series of individuals subjected to such extreme abuse. Yet substantial numbers of patients with dissociative identity disorder at the time of presentation report incestuous abuse continuing into the adult years, and for many the abuse is ongoing. Data relating to a series of 10 such incestuously abused women are presented. These patients were sexually abused from a very early age (typically from before age 3), with the manipulation of their sexual response a key component in conditioning an enduring sexualized attachment. Shame and fear were also used to ensure compliance and silence. The women, when able to speak of it, describe the induction by their paternal abuser of orgasm at an early age, typically around the age of 6. The women have high indices of self-harm and suicidality and are prone to placing themselves in dangerous reenactment scenarios. The average duration of incestuous abuse for this group of women was 31 years, and the average estimate of total episodes of sexual abuse was 3,320. Most women do not feel that they own their body and experience being "fused" to their father. Their mother was reported as an active participant in the sexual abuse or as having done nothing to protect their daughter despite seeing obvious evidence of incest. The fathers, despite a propensity to use or threaten violence, were generally outwardly productively employed, financially comfortable, and stably married and half had close church involvement. However, suicide and murder occurred within the 1st- or 2nd-degree relatives of these women at a high frequency. All 10 had been sexually abused by various groupings of individuals connected to their fathers.
Describes how barracks renovations at West Point have included the replacement of privacy partitions and screens in restrooms and locker rooms with items of high-density polyethylene (HDPE), which is more durable than metal. (EV)
Trojan, A; Beil, H W
Tilidine (Valoron) is a new strong analgesic which was introduced into the market in West Germany in 1970. In February 1978 tilidine was placed under the regulations of the German Narcotics Act because it had rapidly become an easily acquired substitute for opiates on the drug scene. Cases have become known where tilidine dependence developed during the treatment of pain in patients without any preceding addiction to other drugs. The relevant literature on tilidine is reviewed in regard to pharmacological, epidemiological and clinical aspects of tilidine dependence and abuse.
Breastfeeding is the recommended feeding method for infants. The decision to allow women to breastfeed while consuming alcohol and other drugs postpartum presents a problem for the health care provider. This article discusses the biochemical properties of various drugs as they relate to breastfeeding. Women in a methadone treatment program should be allowed to breast feed; however, more research is needed to determine the efficacy of breastfeeding when women are receiving buprenorphine. Breastfeeding should not be recommended in women who abuse heroin recreationally until more information is known about the actual amount of morphine present in the breast milk.
Al-Saadoon, Muna; Elnour, Ibtisam B; Ganesh, Anuradha
Shaken baby syndrome (SBS) is a form of abuse that is characterised by brain injury. Because of the subtle and yet debilitating neurobehavioural impairment which ensues, SBS represents a diagnostic dilemma for attending clinicians. The situation is made worse by the young age of the affected child who may not be capable of explaining what happened. SBS has been reported in many parts of the world. To our knowledge, there is a dearth of literature on the topic from Arab/Islamic countries. This article attempts to shed light on the syndrome by reviewing information on the aetiology of SBS, as well as on its diagnosis and the reasons for delayed diagnosis. The central aim of this review is to increase awareness of SBS so that enlightened policies for prevention and intervention could be developed in the region and particularly in Oman.
McFarlane, J; Wiist, W
Abuse to pregnant women is common and can result in complications to maternal and child health. Although screening and detection of abuse in primary health care settings is becoming more commonplace, intervention models that include community outreach have not been developed or tested. An advocacy model was developed and tested for pregnant abused women by melding research on advocacy programs for abused women exiting shelters with the principles of home visitation used to improve outcomes to pregnant women. Advocacy was offered by "mentor mothers," who were residents of the project's service area. The advocacy consisted of weekly social support, education, and assisted referrals to pregnant women identified as abused as part of routine screening offered at the first prenatal visit to a public health clinic. Effectiveness of the advocacy intervention was measured as contact success rate, number and type of advocacy contacts, and number and type of referrals made to the first 100 women to complete the advocacy program. The mentor mother advocates were successful in contacting the abused woman 33% of the time, regardless of whether a telephone call, home visitation, or in-person meeting was attempted. The average number of advocacy contacts was 9.2 (SD = 7.6) with the majority (74%) being via the telephone. The average number of referrals per woman was 8.6 (SD = 7.6) with the largest percentage (38%) being for medical services. Outreach advocacy as an intervention model for pregnant abused women is recommended.
Screenings are tests that look for diseases before you have symptoms. Screening tests can find diseases early, when they're easier ... Overweight and obesity Prostate cancer in men Which tests you need depends on your age, your sex, ...
... Centers Diseases + Condition Centers Mental Health Medical Library Depression Screening (PHQ-9) - Instructions The following questions are ... this tool, there is also text-only version . Depression Screening - Manual Instructions The following questions are a ...
such as poppy seeds , can lead to detectable levels of drugs in urine during an initial drug screening; the confirmatory GC/MS test can generally identify...morphine, codeine ), as methadone can be used to facilitate withdrawal. Methadone substitutes for the abused drug so the patient can cease heroin or other...chemical manipulation of either morphine or codeine . Although heroin is the most common narcotic available on the street, addicts can obtain a variety of
Horan, John J.; And Others
This third chapter in "Elementary School Counseling in a Changing World" contains five journal articles which focus on substance abuse prevention. "Perspectives on Substance Abuse Prevention" by John Horan, Andres Kerns, and Christine Olson emphasizes how important it is for children to be able to say "no" to drugs and provides a review of…
Dutton, Donald G.; Nicholls, Tonia L.; Spidel, Alicia
A review is made of female intimate abuse. It is concluded that females are as abusive as males in intimate relationships according to survey and epidemiological studies. This is especially so for younger "cohort" community samples followed longitudinally. Predictors of intimate violence with women appear to be similar to those of men; including…
Nursing skills are vital to the roles of those working with victims of domestic abuse in Nottinghamshire. Specialist nurses at Nottingham University Hospitals NHS Trust are involved in referring patients on to further support services and training hospital staff to identify and respond to signs of abuse.
... Health, or the U.S. Department of Health and Human Services. More Health News on: Memory Opioid Abuse and Addiction Recent Health News Related MedlinePlus Health Topics Memory Opioid Abuse and Addiction ... Bethesda, MD 20894 U.S. Department of Health and Human Services National Institutes of Health Page last updated ...
California State Office of the Attorney General, Sacramento. School Safety Center.
Addressing educators and citing the California Penal Code, this booklet discusses the legal responsibilities of persons in child care situations regarding incidents of suspected child abuse. Included are: (1) a definition of child abuse and neglect; (2) reporting procedures including liability of failure to report and immunity of the reporting…
Pfohl, Stephen J.
Surveys the history of social reaction to child abuse, discusses the cultural values promoting the protection of children, points out how much pediatric radiology benefited from its "discovery" of "the battered child syndrome" in the early sixties, and concludes that the labeling of child abusers as "sick" has shielded them from criminal…
Harrsi, Rachel; And Others
The relationship between substance abuse and suicide is indicated by high rate of attempted suicide among alcoholics and drug abusers, as well as increased likelihood of repeated attempts in these populations. This study reports on psychological characteristics of male drug suicide attempters who are in treatment for their addiction problem.…
Demos, George D.
Counselors, in the past few years, have had to work with a great many drug abusers. While successes are difficult to evaluate, the failures are glaringly evident. In a search for a more effective method of working with drug abusers, 12 questions were devised. These are self-evaluative and directed at the counselor. If a counselor can openly and…
Malimabe-Ramagoshi, Refilwe M.; Maree, Jacobus G.; Alexander, Daleen; Molepo, Maisha M.
This article examines the possible role played by African folk literature, taking Setswana folktales as a case in point, in justifying and perpetuating the abusive behaviour so often witnessed and decried in postmodern society. We found some evidence that certain folktales may depict real-life child abuse by adults (male and female), and, indeed,…
Okudaira, K; Yabana, T; Takahashi, H; Iizuka, H; Nakajima, K; Saito, A
There are different opinions about the cause of chronic psychiatric symptoms observed in drug abusers between Japanese and foreign psychiatrists. The Japanese seem to recognize the chronic psychosis as the result of drug abuse. In the other hand, foreigners diagnose these cases as dual diagnosis of drug abuse and psychosis. Authors studied the problem in this research. One of the authors has examined 120 inhalant abusers of all, in- and out-patients in Kanagawa Prefectural Center of Psychiatry, Serigaya Hospital from 1991 to 1995. These patients were classified into three groups: psychosis group (23 patients), dependence group (51 patients) and abuse group (46 patients) according to their clinical courses and psychiatric symptoms. The psychosis group consists of patients who showed psychiatric symptoms such as hallucination, delusion and thought disturbance for long time after detoxification. The dependence group contains patients whose inhalant dependence was severe and met DSM-4 Diagnostic Criteria for Substance Dependence, but manifested no chronic psychiatric symptoms after detoxification. The patients belonging to abuse group were at the earlier stages of inhalant abuse and had no chronic psychiatric symptoms. The average age of the first inhalant abuse was 14.7 years old in the psychosis group, 14.8 years in the dependence group and 14.7 years in the abuse group. The average years of abuse was 9.0 years in the psychosis group, and 8.5 years in the dependence group. There was little difference between these two groups. The psychosis patients manifested chronic symptoms 5.7 years on average after the first abuse of inhalants. About one forth (26.1%) of the psychosis patients and only 5.9% of the dependence patients had family history of schizophrenia. The difference was statistically significant. These results suggest that chronic psychiatric symptoms are caused not only by inhalant abuse, but also by the genetic factors of psychosis of each patient. There have
Hamamoto, D T; Rhodus, N L
Methamphetamine is a highly addictive powerful stimulant that increases wakefulness and physical activity and produces other effects including cardiac dysrhythmias, hypertension, hallucinations, and violent behavior. The prevalence of methamphetamine use is estimated at 35 million people worldwide and 10.4 million people in the United States. In the United States, the prevalence of methamphetamine use is beginning to decline but methamphetamine trafficking and use are still significant problems. Dental patients who abuse methamphetamine can present with poor oral hygiene, xerostomia, rampant caries ('Meth mouth'), and excessive tooth wear. Dental management of methamphetamine users requires obtaining a thorough medical history and performing a careful oral examination. The most important factor in treating the oral effects of methamphetamine is for the patient to stop using the drug. Continued abuse will make it difficult to increase salivary flow and hinder the patient's ability to improve nutrition and oral hygiene. Local anesthetics with vasoconstrictors should be used with care in patients taking methamphetamine because they may result in cardiac dysrhythmias, myocardial infarction, and cerebrovascular accidents. Thus, dental management of patients who use methamphetamine can be challenging. Dentists need to be aware of the clinical presentation and medical risks presented by these patients.
Looman, Jan; Abracen, Jeffrey
There has been relatively little research on the degree to which measures of lifetime history of substance abuse add to the prediction of risk based on actuarial measures alone among sexual offenders. This issue is of relevance in that a history of substance abuse is related to relapse to substance using behavior. Furthermore, substance use has been found to be related to recidivism among sexual offenders. To investigate whether lifetime history of substance abuse adds to prediction over and above actuarial instruments alone, several measures of substance abuse were administered in conjunction with the Sex Offender Risk Appraisal Guide (SORAG). The SORAG was found to be the most accurate actuarial instrument for the prediction of serious recidivism (i.e., sexual or violent) among the sample included in the present investigation. Complete information, including follow-up data, were available for 250 offenders who attended the Regional Treatment Centre Sex Offender Treatment Program (RTCSOTP). The Michigan Alcohol Screening Test (MAST) and the Drug Abuse Screening Test (DAST) were used to assess lifetime history of substance abuse. The results of logistic regression procedures indicated that both the SORAG and the MAST independently added to the prediction of serious recidivism. The DAST did not add to prediction over the use of the SORAG alone. Implications for both the assessment and treatment of sexual offenders are discussed.
Youssef, Dany; Henaine, Roland; Di Filippo, Sylvie
A 9-month-old infant presented with fever, dyspnoea, and a murmur. Echocardiography showed a mitral vegetation with significant regurgitation. Mitral valve plasty was performed on day 6, and was polymerase chain reaction positive for Kingella kingae. The cardiac outcome was favourable. This case illustrates a subtle presentation of K. kingae mitral valve infective endocarditis in a normal-cardaic infant, treated with early surgery, and the agent belonged to the HACEK (Haemophilus spp Actinobacillus actinomycetemcomitans, Capnocytophaga spp, Cardiobacterium hominis, Eikenella corrodens, and Kingella kingae) group.
Komatsu, Takanori; Kobayashi, Kazuki; Yamada, Seiji; Funakoshi, Kotaro; Nakano, Mikio
Expressing the confidence level of a system's suggestions by using speech sounds is an important cue to users of the system for perceiving how likely it is for the suggestions to be correct. We assume that expressing confidence levels by using human-like expressions would cause users to have a poorer impression of the systems than if artificial subtle expressions (ASEs) were used when the quality of the presented information does not match the expressed confidence level. We confirmed that this assumption was correct by conducting a psychological experiment.
Robinson, John W.; Brennan, Patrick C.; Mello-Thoms, Claudia; Lewis, Sarah J.
Rationale and objectives: This study investigates the influence of radiology expertise in the correct localization of lesions when radiologists are requested to complete an observer task. Specifically, the ability to detect pulmonary lesions of different subtleties is explored in relation to radiologists' reported specialty. Materials and Methods: Institutional ethics was granted. Ten radiologists (5 thoracic, 5 non-thoracic) interpreted 40 posterior-anterior (PA) chest x-rays (CXRs) consisting of 21 normal and 19 abnormal cases (solitary pulmonary nodule). The abnormal cases contained a solitary nodule with an established subtlety (subtlety 5 = obvious to subtlety 1 = extremely subtle). Radiologists read the test set and identified any pulmonary nodule using a 1-5 confidence scale (1=no pulmonary nodule to 5=highest confidence case contains a pulmonary lesion). The radiologists interpreted the image bank twice and the cases were randomized for each reader between reads. Results: The Kruskal-Wallis test identified that subtlety of nodules significantly influenced the sensitivity of nonthoracic radiologists (P=<0.0001) and thoracic radiologists (P=<0.0001). A Wilcoxon rank test demonstrated a significant difference in sensitivity for radiologist specialisation (P=0.013), with thoracic radiologists better compared to non-thoracic radiologists (mean sensitivity 0.479 and 0.389 respectively). The sensitivity of nodule detection decreased when comparing subtlety 4 to 3, 3 to 2 and 2 to 1 for non-thoracic and thoracic radiologists'with the subtlety 3 to subtlety 2 being significant (P=0.014) for non thoracic radiologists while thoracic radiologists' demonstrated a decrease but no transitions between subtlety were significant. The most noticeable, and interesting, effect was with the thoracic radiologists' with the average means of subtlety 2 and 1 being almost the same and closely comparable to level 3. Conclusion: Results from this study indicate that expertise in chest
This article analyzes how lesbian mommy bloggers in Canada are using their blogs as forums for self-expression and a means to form community, as they record their unique experiences as queer parents. Further, it argues that lesbian mommy blogging is documenting a subtle form of homophobia that exists in Canada in terms of social acceptance. Although there is legal acceptance of queer families, society has not necessarily caught up with the law. These blogs show that lesbian parents in Canada still struggle with issues of equality, including difficulties being "out," invisibility, and having to advocate for the non-birth parent.
Manchikanti, Laxmaiah; Pampati, Vidyasagar; Damron, Kim S; Beyer, Carla D; Barnhill, Renee C
Drug abuse with illicit drugs and licit drugs has been increasing steadily over the past decade. A recent National Household Survey on Drug Abuse found statistically significant increases between 2000 and 2001 in the use of multiple drugs, including marijuana, cocaine, and non-medical use of pain relievers and tranquilizers. Prescription controlled substance abuse is a major issue in chronic pain management. Various means suggested to avoid or monitor abuse in patients in treatment include urine/serum drug screening whenever requested, along with other precautions including one prescribing physician and one designated pharmacy, etc. Based on the present evidence, physicians assume that patients adhering to controlled substance agreements and without obvious dependency behavior do not abuse either illicit or licit drugs. Thus, it is accepted that there is no necessity to perform routine urine/drug testing in this specific group of the patient population. One hundred patients undergoing interventional pain management and receiving controlled substances were randomly selected for evaluation of illicit drug abuse by urine drug testing. They were selected from a total of 250 patients who were identified as non-abusers of prescription drugs. Results showed that illicit drug abuse in patients without history of controlled substance abuse was seen in 16 patients. Thirteen of the 16 patients tested positive for marijuana and 3 patients tested positive for cocaine. Only one patient tested positive for a combined use of both marijuana and cocaine. This study showed that, in an interventional pain management setting, there is significant use of illicit drugs (16%) with 13% use of marijuana and 3% use of cocaine in patients who are considered as non-abusers of prescription controlled substances and those who are adherent to controlled substance agreements. However, if cocaine is considered as a hardcore drug in contrast to marijuana, abuse of hardcore illicit drugs is only 3%.
Gratia, Pierre; Hu, Wayne; Joyce, Austin; Ribeiro, Raquel H.
Attempts to modify gravity in the infrared typically require a screening mechanism to ensure consistency with local tests of gravity. These screening mechanisms fit into three broad classes; we investigate theories which are capable of exhibiting more than one type of screening. Specifically, we focus on a simple model which exhibits both Vainshtein and kinetic screening. We point out that due to the two characteristic length scales in the problem, the type of screening that dominates depends on the mass of the sourcing object, allowing for different phenomenology at different scales. We consider embedding this double screening phenomenology in a broader cosmological scenario and show that the simplest examples that exhibit double screening are radiatively stable.
Screening for colon cancer; Colonoscopy - screening; Sigmoidoscopy - screening; Virtual colonoscopy - screening; Fecal immunochemical test; Stool DNA test; sDNA test; Colorectal cancer - screening; Rectal ...
Kruse, Fred A.
The Airborne Visible/Infrared Imaging Spectrometer (AVIRIS), flown aboard the NASA ER-2 aircraft in 1987 and 1989, used four linear arrays and four individual spectrometers to collect data simultaneously from the 224 bands in a scanned 614 pixel-wide swath perpendicular to the aircraft direction. The research had two goals. One was to evaluate the AVIRIS data. The other was to look at the subtle lithological variation at the two test sites to develop a better understanding of the regional geology and surficial processes. The geometric characteristics of the data, adequacy of the spatial resolution, and adequacy of the spectral sampling interval are evaluated. Geologic differences at the test sites were mapped. They included lithological variation caused by primary sedimentary layering, facies variation, and weathering; and subtle mineralogical differences caused by hydrothermal alterations of igneous and sedimentary rocks. The investigation used laboratory, field, and aircraft spectral measurements; known properties of geological materials; digital image processing and spectrum processing techniques; and field geologic data to evaluate the selected characteristics of the AVIRIS data.
Schweser, Ferdinand; Sommer, Karsten; Deistung, Andreas; Reichenbach, Jürgen Rainer
Quantitative susceptibility mapping (QSM) is a novel magnetic resonance-based technique that determines tissue magnetic susceptibility from measurements of the magnetic field perturbation. Due to the ill-posed nature of this problem, regularization strategies are generally required to reduce streaking artifacts on the computed maps. The present study introduces a new algorithm for calculating the susceptibility distribution utilizing a priori information on its regional homogeneity derived from gradient echo phase images and analyzes the impact of erroneous a priori information on susceptibility map fidelity. The algorithm, Homogeneity Enabled Incremental Dipole Inversion (HEIDI), was investigated with a special focus on the reconstruction of subtle susceptibility variations in a numerical model and in volunteer data and was compared with two recently published approaches, Thresholded K-space Division (TKD) and Morphology Enabled Dipole Inversion (MEDI). HEIDI resulted in susceptibility maps without streaking artifacts and excellent depiction of subtle susceptibility variations in most regions. By investigating HEIDI susceptibility maps acquired with the volunteers' heads in different orientations, it was demonstrated that the apparent magnetic susceptibility distribution of human brain tissue considerably depends on the direction of the main magnetic field.
Hong, Jun Sung; Woodford, Michael R; Long, Larry D; Renn, Kristen A
Sexual minority college students report experiencing interpersonal heterosexism, ranging from subtle insults to blatant physical violence. Such negative experiences can complicate developmental tasks common to adolescence and emerging adulthood. Studies examining the nature of heterosexism on college campuses have focused on blatant manifestations, yet subtle forms are more prevalent. Guided by ecological theory, we investigate the microsystem (e.g., perceived social support from friends, ambient heterosexism on campus), mesosystem (e.g., interaction between social support and ambient heterosexism), and macrosystem level (e.g., knowledge of gay-straight alliances on campus) covariates of interpersonal microaggressions, avoidance behaviors, verbal threats, and physical threats. Participants consisted of 530 self-identified LGBQ college students from 37 states. Regression results suggest that at the microsystem level, ambient heterosexism was positively associated with interpersonal microaggressions, avoidance behaviors, and verbal threats. At the mesosystem level, perceptions of LGBQ student support within one's institution moderated the effects of ambient heterosexism on three types of interpersonal heterosexism. At the macrosystem level, students who reported knowing that their campus had a sexual-orientation inclusive anti-discrimination policy reported encountering fewer verbal threats. Directions for future research and implications for campus programming are discussed.
Nakamura, Michio; Nishida, Toshisada
Here we consider the concept of kaluchua (a word adopted from the English "culture") in group-living animals developed by Imanishi in the 1950s. He distinguished it from bunka (the Japanese equivalent to the English "culture") because he thought that bunka had strong connotations of noble and intellectual human-like activities. Although he did not rigidly define kaluchua, his original concept of kaluchua was much broader than bunka and represented non-hereditary, acquired behavior that was acknowledged socially. However, instead of social life, complex feeding skills have often formed the central topic in the current studies of animal culture. In order to provide evidence that more subtle behavioral variations exist among wild chimpanzee (Pan troglodytes) populations, we directly compared the behaviors of two well-habituated chimpanzee groups, at Bossou and Mahale. During a 2-month stay at Bossou, M.N. (the first author) saw several behavioral patterns that were absent or rare at Mahale. Two of them, "mutual genital touch" and "heel tap" were probably customary for mature females and for mature males, respectively. "Index to palm" and "sputter" are still open to question. These subtle patterns occurred more often than tool use during the study period, suggesting that rarity is not the main reason for their being ignored. Unlike tool use, some cultural behavioral patterns do not seem to require complex skills or intellectual processes, and sometimes it is hard to explain the existence of such behaviors only in terms of function.
Batcheller, April; Cardozo, Eden; Maguire, Marcy; DeCherney, Alan H.; Segars, James
Objective To review recent data regarding subtle, but widespread epigenetic alterations in phenotypically normal offspring conceived of ART compared to offspring conceived in vivo. Design A PubMed computer search was performed to identify relevant articles. Setting Research institution. Intervention(s) None. Result(s) Studies in animals indicate that in vitro culture may be associated with widespread alterations in imprinted genes, compared to in vivo-conceived offspring. Recently, studies in humans have likewise demonstrated widespread changes in DNA methylation, including genes linked to adipocyte development, insulin signaling, and obesity in offspring conceived by ART, compared to in vivo-conceived children. Changes in multiple imprinted genes following ART were also noted in additional studies, which suggested that the diagnosis of infertility may explain the differences between in vivo-conceived and ART offspring. Conclusion(s) These data suggest that ART is associated with widespread epigenetic modifications in phenotypically normal children, and that these modifications may increase risk of adverse cardiometabolic outcomes. Further research is needed to elucidate the possible relationship between ART, genome-wide alterations in imprinted genes, and their potential relevance to subtle cardiometabolic consequences reported in ART offspring. PMID:22035969
Shin, Jacqueline C; Chang, Seah; Cho, Yang Seok
We investigated whether attention could be modulated through the implicit learning of temporal information in a rapid serial visual presentation (RSVP) task. Participants identified two target letters among numeral distractors. The stimulus-onset asynchrony immediately following the first target (SOA1) varied at three levels (70, 98, and 126 ms) randomly between trials or fixed within blocks of trials. Practice over 3 consecutive days resulted in a continuous improvement in the identification rate for both targets and attenuation of the attentional blink (AB), a decrement in target (T2) identification when presented 200-400 ms after another target (T1). Blocked SOA1s led to a faster rate of improvement in RSVP performance and more target order reversals relative to random SOA1s, suggesting that the implicit learning of SOA1 positively affected performance. The results also reveal "power law" learning curves for individual target identification as well as the reduction in the AB decrement. These learning curves reflect the spontaneous emergence of skill through subtle attentional modulations rather than general attentional distribution. Together, the results indicate that implicit temporal learning could improve high level and rapid cognitive processing and highlights the sensitivity and adaptability of the attentional system to subtle constraints in stimulus timing.
San Lucas, F. Anthony; Sivakumar, Smruthy; Vattathil, Selina; Fowler, Jerry; Vilar, Eduardo; Scheet, Paul
Motivation: The detection of subtle genomic allelic imbalance events has many potential applications. For example, identifying cancer-associated allelic imbalanced regions in low tumor-cellularity samples or in low-proportion tumor subclones can be used for early cancer detection, prognostic assessment and therapeutic selection in cancer patients. We developed hapLOHseq for the detection of subtle allelic imbalance events from next-generation sequencing data. Results: Our method identified events of 10 megabases or greater occurring in as little as 16% of the sample in exome sequencing data (at 80×) and 4% in whole genome sequencing data (at 30×), far exceeding the capabilities of existing software. We also found hapLOHseq to be superior at detecting large chromosomal changes across a series of pancreatic samples from TCGA. Availability and Implementation: hapLOHseq is available at scheet.org/software, distributed under an open source MIT license. Contact: firstname.lastname@example.org Supplementary information: Supplementary data are available at Bioinformatics online. PMID:27288500
Li, Xuqing; Liu, Xiangnan; Liu, Meiling; Wang, Cuicui; Xia, Xiaopeng
Arsenic stress induces in subtle changes in the canopy chlorophyll content (CCC). Therefore, the establishment of a spectral index that is sensitive to subtle changes in the CCC is important for monitoring crop arsenic contamination in large areas by remote sensing. Experimental sites with three contamination levels were selected and were located in Chang Chun City, Jilin City, Jilin Province, China. Arsenic stress can induce small changes in the CCC, reflecting in the crop spectrum. This study created a new index to monitor the CCC. Then, the results from the index were compared with these from other indices and the random forest model, respectively. The final purpose of this study is to find an optimal index, which is sensitive to small changes in the CCC under arsenic stress for monitoring regional CCC in rice. The results indicate that the distribution of the CCC is aligned with the distribution of the arsenic stress level and that NVI (R640, R732, and R752) is the best index for monitoring CCC. The correlation coefficient R2 between the predicated values using NVI and the measured values of canopy chlorophyll content is 0.898, which performs better than the random forest model and other indices.
Marshall, Linda L.; Rose, Patricia
Responses from 336 undergraduates revealed 75 percent of respondents had expressed threats or actual violence and 64 percent had received abuse in intimate relationship. In the sample, 30 percent had parents who abused each other; less often the mother or father had been sole abuser. Multiple regression indicated being abused as child predicted…
Deykin, Eva Y.; And Others
Interviews of 434 college students revealed that prevalence of major depressive disorder (MDD) was 6.8 percent; of alcohol abuse, 8.2 percent; and of substance abuse, 9.4 percent. Alcohol and substance abuse were associated with MDD. Substance abuse was associated with other psychiatric diagnoses as well. MDD usually preceded alcohol or substance…
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)
Agarwala, Sanjay; Agashe, Vikas M; Shetty, Vivek; Mohrir, Ganesh; Moonot, Pradeep
Background: Bisphosphonates (BPs) are the common drugs used for the treatment of postmenopausal osteoporosis. Short term benefits of the BPs are well known. However, there are concerns regarding their long term use. The aim of the study was to analyze the association between atypical femoral fractures and BP misuse/abuse as well as study the outcome of management of these fractures. Materials and Methods: A retrospective study of a prospectively studied patients who presented with atypical femoral fractures between January 2010 and August 2012 and were followed up upto June 2014. The cohort consisted of nine female patients (12 fractures) with an average age of 71 years (range 58-85 years). Analysis was done for the indications, duration of BP use, configuration of associated fractures and method of treatment. Results: The mean duration of BP use was 6.6 years (range 4-10 years). BP treatment was initiated without sufficient indication and continued without proper review and followup in most cases. Most patients did not followup and continued to consume BPs without any review by the doctors. All patients had prodromal thigh pain of various duration, which was inadequately investigated and managed before the presentation. Two cases with an incomplete fracture and no thigh pain were managed successfully with conservative treatment. The rest were treated by surgery with intramedullary nailing. The average union time was longer and two fractures went into nonunion which required further surgical intervention. Conclusion: Atypical femoral fractures appear to be strongly related to abuse of BPs. Great care is to be exercised at initiation as well as the continuation of BP therapy, and regular review is required. There is a need for improved awareness among physicians about the possibility of such fractures, and interpretation of thigh pain and radiological findings, especially if the patient has been on BPs therapy. Internal fixation for complete fractures and for
Chambliss, Catherine; And Others
This study sought to identify personality differences in abused versus non-abused women. Abused women (N=25) were from several centers for abused women and non-abused women (N=39) were students in evening psychology classes. All subjects completed Rubin's Love Scale, the abbreviated Dominance and Romanticism Scale, Rosenberg's Self-Esteem Scale,…
Gutierres, Sara E.; And Others
Reviewed the literature on female drug use/abuse and derived descriptions of the female heroin abuser and the female prescription drug abuser. Researchers suggest that problems of female drug abusers should be viewed in terms of the feminine role as well as the role of drug abuser. (BH)
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.
Ross, Amélie; Dion, Jacinthe; Cantinotti, Michael; Collin-Vézina, Delphine; Paquette, Linda
Residential schools were the institutions, in operation from the 19th century to the late 20th century, which Indigenous children in Canada were forced to attend. The literature shows that many young people who attended these institutions were victims of neglect and abuse. Negative psychological effects resulting from child abuse have been amply documented. However, very few studies on this subject have been carried out among Canada's Indigenous Peoples. The objective of this study is to evaluate, for an Indigenous population in Quebec (Canada), the impact of residential schooling as well as self-reported experiences of sexual and physical abuse during childhood on the development of alcohol and drug use problems in adulthood. A total of 358 Indigenous participants were interviewed (164 men [45.8%] and 194 women [54.2%]). Alcoholism was evaluated using the Michigan Alcoholism Screening Test (MAST). Drug abuse was assessed with the Drug Abuse Screening Test-20 (DAST). Child abuse and residential schooling were assessed with dichotomous questions (yes/no). Among the participants, 28.5% (n=102) had attended residential schools, 35.2% (n=121) reported having experienced sexual abuse, and 34.1% (n=117) reported having experienced physical abuse before adulthood. Results of the exact logistic regression analyses indicated that residential school attendance was linked to alcohol problems, while child abuse was related to drug use problems. The results of this study highlight the importance of considering the consequences of historical traumas related to residential schools to better understand the current situation of Indigenous Peoples in Canada.
Carmichael, Ashley-Nicole; Morgan, Laura; Del Fabbro, Egidio
Background The misuse and abuse of opioid medications in many developed nations is a health crisis, leading to increased health-system utilization, emergency department visits, and overdose deaths. There are also increasing concerns about opioid abuse and diversion in patients with cancer, even at the end of life. Aims To evaluate the current literature on opioid misuse and abuse, and more specifically the identification and assessment of opioid-abuse risk in patients with cancer. Our secondary aim is to offer the most current evidence of best clinical practice and suggest future directions for research. Materials and methods Our integrative review included a literature search using the key terms “identification and assessment of opioid abuse in cancer”, “advanced cancer and opioid abuse”, “hospice and opioid abuse”, and “palliative care and opioid abuse”. PubMed, PsycInfo, and Embase were supplemented by a manual search. Results We found 691 articles and eliminated 657, because they were predominantly non cancer populations or specifically excluded cancer patients. A total of 34 articles met our criteria, including case studies, case series, retrospective observational studies, and narrative reviews. The studies were categorized into screening questionnaires for opioid abuse or alcohol, urine drug screens to identify opioid misuse or abuse, prescription drug-monitoring programs, and the use of universal precautions. Conclusion Screening questionnaires and urine drug screens indicated at least one in five patients with cancer may be at risk of opioid-use disorder. Several studies demonstrated associations between high-risk patients and clinical outcomes, such as aberrant behavior, prolonged opioid use, higher morphine-equivalent daily dose, greater health care utilization, and symptom burden. PMID:27330340
Childhood sexual abuse affects at least 18% of British women but the true figure may be far higher. Repressed memories may resurface at childbirth. Midwives need to be aware of certain behavioural tendencies which may indicate childhood sexual abuse. There are four recognised labour styles which may be adopted by abuse survivors. Extra sensitivity should be used by midwives when caring for a possible abuse survivor. Disclosure of abuse must always come from the client.
This review examines the current debate on the role that sexual and physical abuse may play in predisposing to eating disorders in women. Despite some discordant opinions, clinicians agree that the experience of abuse in early childhood may be important for understanding the complex genesis of the eating disorders of some women. Three groups of studies are presented: those in which no connections emerge between sexual abuse and eating disorders, those in which a strong link is present and those in which the results refer to a multifactorial interpretative model. Some of the main symptoms, such as reactualization of the trauma, dissociation, personality disorders, pathological relationship with food, distortion of body image, suicide attempts and self-inflicted punishment that victims of abuse and eating disordered subjects share are examined.
... Charts Emerging Trends and Alerts Alcohol Club Drugs Cocaine Hallucinogens Heroin Inhalants Marijuana MDMA (Ecstasy/Molly) Methamphetamine ... Drugs Anabolic Steroids Cigarettes and Other Tobacco Products Cocaine Cough and Cold Medicine Abuse Electronic Cigarettes (e- ...
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... physical appearance and grooming Association with known substance abusers Need for money and stealing money Persistent dishonesty ... can be done to discourage youth from using drugs and alcohol? Everyone can help educate children and ...
The therapeutic use of methylphenidate for the management of attention-deficit hyperactivity disorder in children is increasing. As therapeutic use increases, the risk increases of unintentional overdoses, medication errors, and intentional overdoses caused by abuse, misuse, or suicide gestures and attempts. Side effects during therapy, which include nervousness, headache, insomnia, anorexia, and tachycardia, increase linearly with dose. Clinical manifestations of overdoses include agitation, hallucinations, psychosis, lethargy, seizures, tachycardia, dysrhythmias, hypertension, and hyperthermia. Methylphenidate tablets can be abused orally, or they can be crushed and the powder injected or snorted. Despite its abuse potential, there is disagreement regarding the extent to which methylphenidate is being diverted from legitimate use to abuse in preteens and adolescents.
Yu, Hoi-Ying Elsie
In the United States, the nonmedical use of prescription drugs is the second most common illicit drug use, behind only marijuana. This article discusses the abuse issues with three of the most widely abused prescription drugs: opioids, central nervous system (CNS) depressants (eg, benzodiazepines), and stimulants (eg, amphetamine-dextroamphetamine and methylphenideate) in the United States. Efforts to deal with the problem are described as well.
Rhodus, Nelson L; Little, James W
Dental management for the patient who abuses drugs is always a challenge. The number of patients abusing methamphetamines appears to be increasing. The dentist needs to be aware of the clinical presentation and medical risks presented by these patients and to attempt to get the patient to seek professional help. Additionally, special attention will be necessary for the high prevalence and severity of oral manifestations including rampant caries, enamel erosion, xerostomia, bruxism, and muscle trismus.
Wilson, G.V.; Henley, M.; Valceschini, R.
The US Department of Energy/Nevada Operations Office (DOE/NV) has identified the need to design a low-level waste (LLW) closure cap for the arid conditions at the Nevada Test Site (NTS). As a result of concerns for subsidence impacting the cover, DOE/NV redesigned the LLW cover from one containing a `hard` infiltration barrier that would likely fail, to a `soft` (ET) cover that is sufficiently deep to accommodate the hydrologic problems of subsidence. An ET cover is one that does not contain hydrologic barrier layers but relies on soil-water retention and sufficient thickness to store water until evapotranspiration (ET) can remove the moisture. Subtle layering within an ET cap using the native soil could be environmentally beneficial and cost effective.
Boettcher, Claudia; Brosig, Burkhard; Zimmer, Klaus P; Wudy, Stefan A
Wolfram syndrome (also known as DIDMOAD = diabetes insipidus, diabetes mellitus, optic atrophy, deafness) is an autosomal recessive disorder characterized by the association of childhood non-immune insulin-dependent diabetes mellitus (DM) with progressive bilateral optic atrophy. Additional symptoms including signs of severe neurodegeneration and psychiatric illness are likely to evolve over time resulting in premature death. We report on two siblings of Turkish origin from our diabetes clinic who were diagnosed with Wolfram syndrome after 6 years and 2 years duration of DM, respectively. Subtle symptoms such as attitude changes, growing reading difficulties in the history of children or adolescents with antibody negative and ketone negative DM should alert the treating physician and lead to re-evaluation of the diagnosis, keeping in mind that not all juvenile DM is type 1 DM.
Saponaro, Chiara; Gaggini, Melania; Carli, Fabrizia; Gastaldelli, Amalia
Excessive accumulation of lipids can lead to lipotoxicity, cell dysfunction and alteration in metabolic pathways, both in adipose tissue and peripheral organs, like liver, heart, pancreas and muscle. This is now a recognized risk factor for the development of metabolic disorders, such as obesity, diabetes, fatty liver disease (NAFLD), cardiovascular diseases (CVD) and hepatocellular carcinoma (HCC). The causes for lipotoxicity are not only a high fat diet but also excessive lipolysis, adipogenesis and adipose tissue insulin resistance. The aims of this review are to investigate the subtle balances that underlie lipolytic, lipogenic and oxidative pathways, to evaluate critical points and the complexities of these processes and to better understand which are the metabolic derangements resulting from their imbalance, such as type 2 diabetes and non alcoholic fatty liver disease. PMID:26580649
Rubal, Marcos; Guilhermino, Lúcia M; Medina, Matías H
The study presented here searched for the level of taxonomic resolution required to detect the effects of low-level chronic pollution on estuarine meiobenthic communities. Meiofauna from two sites, with special attention to harpacticoid copepods, was analysed at different taxonomic levels of aggregation using uni- and multivariate methods. Adaptation processes that could buffer biodiversity disruptions were also considered through the analysis of fitness-related and tolerance traits in the harpacticoid copepod Paronychocamptus nanus. Results showed that uni- and multivariate analyses could be inadequate when assessing subtle anthropogenic contamination. Instead, the assessment of inter-population differences in tolerance to the main source of stress rises as a required procedure if potential effects of this type of contamination are being investigated. Specifically, a 96 h acute toxicity test performed with populations from the affected site appears as a faster and reliable general tool to assess impacts of low-level chronic pollution in estuaries.
San-Miguel, Adriana; Kurshan, Peri T.; Crane, Matthew M.; Zhao, Yuehui; McGrath, Patrick T.; Shen, Kang; Lu, Hang
Discovering mechanistic insights from phenotypic information is critical for the understanding of biological processes. For model organisms, unlike in cell culture, this is currently bottlenecked by the non-quantitative nature and perceptive biases of human observations, and the limited number of reporters that can be simultaneously incorporated in live animals. An additional challenge is that isogenic populations exhibit significant phenotypic heterogeneity. These difficulties limit genetic approaches to many biological questions. To overcome these bottlenecks, we developed tools to extract complex phenotypic traits from images of fluorescently labelled subcellular landmarks, using C. elegans synapses as a test case. By population-wide comparisons, we identified subtle but relevant differences inaccessible to subjective conceptualization. Furthermore, the models generated testable hypotheses of how individual alleles relate to known mechanisms or belong to new pathways. We show that our model not only recapitulates current knowledge in synaptic patterning but also identifies novel alleles overlooked by traditional methods. PMID:27876787
Dethier, Megan N; Ruesink, Jennifer; Berry, Helen; Sprenger, Amy G; Reeves, Blain
Biotic trends along estuarine gradients can be affected by co-varying processes ranging from large-scale oceanographic to local-scale physico-chemical effects. As a baseline for future process studies, we investigated the distinct gradients in species richness and biomass in pebble-sand shorelines along the estuarine axis of Puget Sound, and the scales of variation of some of their physical correlates. Higher richness and biomass at beaches at the more marine end of the Sound are temporally consistent and seen in all trophic groups. Variables that correlate with biotic patterns include relatively subtle increases in beach surface and sediment temperatures and decreases in nearshore salinity near the head of the estuary, but not more localized parameters such as sediment grain size or porewater salinity. To understand whether these variables are true forcing functions of community structure, we are performing experimental work.
North, Michael S.; Fiske, Susan T.
Prior work describes specific, prescriptive resource tensions between generations, comprising active Succession, passive Consumption, and symbolic Identity (SCI; North & Fiske, 2013a, 2013b). The current paper focuses on how these domains potentially drive intergenerational exclusion in work-related networking and training spheres. Studies 1a–1c—each focusing on a different SCI domain—manipulated perceived resource availability between generations, then introduced a professional networking opportunity. Across studies, scarcity reduced the likelihood of young participants’ networking engagement with older workers who violated SCI resource expectations. Study 2 impelled participants to allocate scarce training resources among three similarly qualified but different-aged employees (younger, middle-aged, and older). Older workers received the lowest such investment, particularly among younger participants—an effect driven by Succession beliefs, per mediation analyses. Overall, the findings emphasize resource tensions in driving older workers’ subtle exclusion by younger generations; minimizing such tensions will be critical for aging, increasingly intergenerational workplaces. PMID:27499555
San-Miguel, Adriana; Kurshan, Peri T.; Crane, Matthew M.; Zhao, Yuehui; McGrath, Patrick T.; Shen, Kang; Lu, Hang
Discovering mechanistic insights from phenotypic information is critical for the understanding of biological processes. For model organisms, unlike in cell culture, this is currently bottlenecked by the non-quantitative nature and perceptive biases of human observations, and the limited number of reporters that can be simultaneously incorporated in live animals. An additional challenge is that isogenic populations exhibit significant phenotypic heterogeneity. These difficulties limit genetic approaches to many biological questions. To overcome these bottlenecks, we developed tools to extract complex phenotypic traits from images of fluorescently labelled subcellular landmarks, using C. elegans synapses as a test case. By population-wide comparisons, we identified subtle but relevant differences inaccessible to subjective conceptualization. Furthermore, the models generated testable hypotheses of how individual alleles relate to known mechanisms or belong to new pathways. We show that our model not only recapitulates current knowledge in synaptic patterning but also identifies novel alleles overlooked by traditional methods.
Poole, Ernest Andre
In this review I explore and discuss the use of micro and subtle expression training in the social sciences. These trainings, offered commercially, are designed and endorsed by noted psychologist Paul Ekman, co-author of the Facial Action Coding System, a comprehensive system of measuring muscular movement in the face and its relationship to the expression of emotions. The trainings build upon that seminal work and present them in a way for either the layperson or researcher to easily add to their personal toolbox for a variety of purposes. Outlined are my experiences across the training products, how they could be used in social science research, a brief comparison to automated systems, and possible next steps.
TAXMAN, FAYE S.; CROPSEY, KAREN L.; YOUNG, DOUGLAS W.; WEXLER, HARRY
The use of screening and assessment tools to gauge substance abuse disorders and the risk for recidivism are two widely recommended practices. A national survey of adult prisons, jails, and community correctional agencies was conducted to examine the practices used to place offenders in appropriate treatment services. Study findings indicate that 58.2% of the surveyed respondents report the use of a standardized substance abuse-screening tool, and that 34.2% use an actuarial risk tool. The provision of higher intensity treatment programs, the use of standardized risk tools, and the provision of more community referral services were all independently associated with the use of a standardized substance abuse-screening tool. Because practices vary considerably, agencies desiring to improve correctional programming should consider different dissemination, implementation, and technology transfer strategies. PMID:18458758
Ghulam, Ram; Verma, Kamal; Sharma, Pankaj; Razdan, Monica; Razdan, Rahul Anand
Substance abuse is an important health problem throughout the world including India, but prevalence and pattern of abuse varies from country to country and in different types of population. Slums have their own social and economic problems so that substance abuse may be different in this population and might be related with these problems. The aim of the present study was to study the prevalence and pattern substances in slum population. Prakash Chandra Sethi Nagar slum area of Indore district was selected for the purpose of this study. In first phase of the study, first a camp was organized to sensitize local leaders, key persons, and local inhabitants about drug abuse at Chandra Prakash Sethi Nagar. After that basic information was gathered with the key persons in Chandra Prakash Sethi Nagar. In second phase by house-to-house survey, all members of the family were interviewed in detail and information was recorded on semi-structured proforma. We observed prevalence rate of 560/1000 populations, 78.2% were males, 28.2% were females, and two-third abusers were laborers (72%). In order of frequency, tobacco was the most common substance abused in 53.9% population followed by gutka (nontobacco pan masala). Other drugs in order of frequency were alcohol 46.5%, cannabis 8.9%, opiates 4.9%, sedative and hypnotic 2.0%, solvents 1.0%, and cocaine in 0.1%. Slum population has higher prevalence rates than general population. PMID:26985110
Erceg, Jelena; Saunders, Timothy E.; Girardot, Charles; Devos, Damien P.; Hufnagel, Lars; Furlong, Eileen E. M.
Deciphering the specific contribution of individual motifs within cis-regulatory modules (CRMs) is crucial to understanding how gene expression is regulated and how this process is affected by sequence variation. But despite vast improvements in the ability to identify where transcription factors (TFs) bind throughout the genome, we are limited in our ability to relate information on motif occupancy to function from sequence alone. Here, we engineered 63 synthetic CRMs to systematically assess the relationship between variation in the content and spacing of motifs within CRMs to CRM activity during development using Drosophila transgenic embryos. In over half the cases, very simple elements containing only one or two types of TF binding motifs were capable of driving specific spatio-temporal patterns during development. Different motif organizations provide different degrees of robustness to enhancer activity, ranging from binary on-off responses to more subtle effects including embryo-to-embryo and within-embryo variation. By quantifying the effects of subtle changes in motif organization, we were able to model biophysical rules that explain CRM behavior and may contribute to the spatial positioning of CRM activity in vivo. For the same enhancer, the effects of small differences in motif positions varied in developmentally related tissues, suggesting that gene expression may be more susceptible to sequence variation in one tissue compared to another. This result has important implications for human eQTL studies in which many associated mutations are found in cis-regulatory regions, though the mechanism for how they affect tissue-specific gene expression is often not understood. PMID:24391522
Kang, Dongwoo; Slomka, Piotr; Nakazato, Ryo; Cheng, Victor Y.; Min, James K.; Li, Debiao; Berman, Daniel S.; Kuo, C.-C. Jay; Dey, Damini
Visual analysis of three-dimensional (3D) Coronary Computed Tomography Angiography (CCTA) remains challenging due to large number of image slices and tortuous character of the vessels. We aimed to develop an accurate, automated algorithm for detection of significant and subtle coronary artery lesions compared to expert interpretation. Our knowledge-based automated algorithm consists of centerline extraction which also classifies 3 main coronary arteries and small branches in each main coronary artery, vessel linearization, lumen segmentation with scan-specific lumen attenuation ranges, and lesion location detection. Presence and location of lesions are identified using a multi-pass algorithm which considers expected or "normal" vessel tapering and luminal stenosis from the segmented vessel. Expected luminal diameter is derived from the scan by automated piecewise least squares line fitting over proximal and mid segments (67%) of the coronary artery, considering small branch locations. We applied this algorithm to 21 CCTA patient datasets, acquired with dual-source CT, where 7 datasets had 17 lesions with stenosis greater than or equal to 25%. The reference standard was provided by visual and quantitative identification of lesions with any >=25% stenosis by an experienced expert reader. Our algorithm identified 16 out of the 17 lesions confirmed by the expert. There were 16 additional lesions detected (average 0.13/segment); 6 out of 16 of these were actual lesions with <25% stenosis. On persegment basis, sensitivity was 94%, specificity was 86% and accuracy was 87%. Our algorithm shows promising results in the high sensitivity detection and localization of significant and subtle CCTA arterial lesions.
Kristensen, Karin; Cadenhead, Kristin S
The goal of the present study was to examine the rate of cannabis use among participants in the Cognitive Assessment and Risk Evaluation (CARE) Program, a longitudinal program for individuals who are "at risk" for developing a psychotic disorder. Cannabis abuse was assessed in 48 individuals identified as at risk for psychosis based on subsyndromal psychotic symptoms and/or family history. At 1 year follow-up, 6 of the 48 (12.5%) at risk subjects had made the transition to psychosis. Of the 32 subjects who had no use or minimal cannabis use, one subject (3.1%) converted to psychosis. Of the 16 subjects who met criteria for cannabis abuse/dependence, five (31.3%) converted to psychosis. The results show a significant association between cannabis abuse and conversion to psychosis in this sample. Nicotine use was also found to be significantly associated with later conversion. The significant associations between cannabis and nicotine abuse and conversion to psychosis in individuals at risk for schizophrenia suggest that early identification and intervention programs should screen for and provide education about the deleterious effects of these substances.
15 COST COMPARISON OF METHODS FOR DRUG ANALYSIS ................. 16 CONCLUSION AND RECOMMENDATION Suitability for Base or Hospital Laboratory...individual drugs while iminoassay levels represent the total of cross-reactive materials present which includes v -- ’ 16 metabolites as well as...Methadone 2, 33 Methaqualone 7, 8, 65 Opiates 30, 47, 52, 64 Phencyclidine 16 , 35, 40, 47, 63, 74 23 REFERENCES 1. ADAMS, R.F. Drug analysis by
Moriya, F; Chan, K M; Noguchi, T T; Wu, P Y
A reliable and sensitive screening procedure has been developed for drugs of abuse (amphetamines, cocaine metabolites, opiates, and phencyclidine [PCP]) in meconium from infants. The substances in meconium were extracted with chloroform-isopropanol (3:1) and screened by enzyme multiplied immunoassay technique (EMIT). The lower detection limits of the EMIT for benzoylecgonine, d-methamphetamine, morphine, and PCP were 250 ng/g, 730 ng/g, 110 ng/g, and 100 ng/g, respectively. This method was applied to meconium from 50 infants born to mothers suspected of using the drugs of abuse during pregnancy. Of the 50, 12 were positive for benzoylecgonine, seven for opiates, and one for PCP. The presence of benzoylecgonine and PCP in meconium was confirmed by gas chromatography/mass spectrometry and that of opiates by thin-layer chromatography. The routine analysis of meconium for drugs of abuse is recommended in cases where (A) urine can not be obtained or (B) urinalysis is negative for the substances despite a strong suspicion of maternal use of the substances during pregnancy.
Weiss, Kenneth M; Lambert, Brian W
This journal began in 1925 as the Annals of Eugenics. Much has changed since then. The original Editors' primary eugenic objective was not achieved, and eugenics justifiably became notorious for racism and gross abuse of human rights. But one founding aim was to publish advances in statistical genetics, and that objective prospered in the journal's pages from its beginning to the present day. The online availability of the original issues will be useful to those interested in the history of both eugenics and human genetics and will provide a reminder of how the careless use of genetical concepts can go astray.
WEISS, KENNETH M; LAMBERT, BRIAN W
SUMMARY This journal began in 1926 as the Annals of Eugenics. Much has changed since then. The original Editors’ primary eugenic objective was not achieved, and eugenics justifiably became notorious for racism and gross abuse of human rights. But one founding aim was to publish advances in statistical genetics, and that objective prospered in the journal’s pages from its beginning to the present day. The online availability of the original issues will be useful to those interested in the history of both eugenics and human genetics, and will provide a reminder of how the careless use of genetical concepts can go astray. PMID:21488850
Andermann, Anne; Blancquaert, Ingeborg
Abstract OBJECTIVE To provide a primer for primary care professionals who are increasingly called upon to discuss the growing number of genetic screening services available and to help patients make informed decisions about whether to participate in genetic screening, how to interpret results, and which interventions are most appropriate. QUALITY OF EVIDENCE As part of a larger research program, a wide literature relating to genetic screening was reviewed. PubMed and Internet searches were conducted using broad search terms. Effort was also made to identify the gray literature. MAIN MESSAGE Genetic screening is a type of public health program that is systematically offered to a specified population of asymptomatic individuals with the aim of providing those identified as high risk with prevention, early treatment, or reproductive options. Ensuring an added benefit from screening, as compared with standard clinical care, and preventing unintended harms, such as undue anxiety or stigmatization, depends on the design and implementation of screening programs, including the recruitment methods, education and counseling provided, timing of screening, predictive value of tests, interventions available, and presence of oversight mechanisms and safeguards. There is therefore growing apprehension that economic interests might lead to a market-driven approach to introducing and expanding screening before program effectiveness, acceptability, and feasibility have been demonstrated. As with any medical intervention, there is a moral imperative for genetic screening to do more good than harm, not only from the perspective of individuals and families, but also for the target population and society as a whole. CONCLUSION Primary care professionals have an important role to play in helping their patients navigate the rapidly changing terrain of genetic screening services by informing them about the benefits and risks of new genetic and genomic technologies and empowering them to
Jeffrey, T B; Jeffrey, L K
This paper reviews psychologic aspects of sexual abuse in female adolescents. It documents that sexual abuse is widespread, occurring at an alarming rate at all socioeconomic levels of society. It is perpetrated principally by adult men in the victim's family. Often its effects are tragic. Adolescent female sexual abuse victims are at high risk for subsequent acting out behavior, sexual promiscuity, physical and sexual abuse, anxiety, depression, low self-esteem, alcohol and drug abuse or dependence, chronic sleep disturbance, dissociative disorders, eating disorders, emotional numbing, dissociation, guilt, shame, hyperalertness, suicidal ideation, and multiple associated psychiatric disorders. Although it may appear at a surface level that sexual abuse victims recover from such abuse, follow-up studies suggest that many remain disabled long after the abuse has ended. Health care professionals should be especially cognizant of the magnitude of the impact of sexual abuse on adolescent girls and recognize the need of these patients for psychologic and medical services.
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.
For several reasons, children and youth with a disability or chronic health condition are at an increased risk of sexual abuse. Health care providers, along with parents and caregivers, need to maintain a high level of suspicion concerning possible sexual abuse of this population. Physicians especially need to advocate for policies to prevent or detect abuse in hospitals, schools and other institutional settings. Such policies include the thorough screening and monitoring of employees and volunteers; chaperoning physical examinations and treatment procedures; supervising outings; and ensuring an institutional culture that promotes patient privacy. In addition, physicians should promote patient self-awareness and empowerment, and provide early anticipatory guidance concerning sexuality, personal empowerment and abuse risks. The present document replaces the previous Canadian Paediatric Society position statement published in 1997.
Bartone, Paul T; Hystad, Sigurd W; Eid, Jarle; Brevik, John I
Alcohol abuse is a growing problem in the military, and a costly one. The present study evaluates the potential role of psychological hardiness, an individual resilience resource, to stress-related problem drinking in a military population. We assess the association of psychological hardiness and avoidance coping style with alcohol use patterns in a large national sample of Norwegian military defense personnel. Results show that low hardiness and high avoidance coping are significant predictors of alcohol abuse. Also, the challenge facet of hardiness predicts risk of alcohol abuse among respondents with recent deployment experience, and this effect is greater for those with harsh deployment experiences. Older defense workers are also at higher risk, suggesting cumulative occupational stress may take a toll. This research indicates that hardiness and avoidance coping measures may serve as useful adjunct screening tools for alcohol abuse in the military.
Ram, Anita; Chisolm, Margaret S
This commentary highlights the growing demand for substance abuse prevention and treatment, summarizes the literature regarding the current insufficiencies in substance abuse training in medical schools, and suggests strategies to address this gap in physician education. The authors describe how the combination of mandated coverage for substance abuse services and expanding treatment needs means that more physicians, regardless of their patient populations, will be faced with addressing the problem of substance use. The authors review the literature on substance abuse training in medical schools, which indicates insufficient exposure to this topic. The authors describe how current substance abuse training at medical schools is focused on transmitting scientific knowledge with relatively little education or training in attitudes and skills central to effective prevention and treatment. Given the gap between clinical need and physician education, the authors suggest several strategies for medical schools to increase training in substance abuse knowledge, attitudes, and skills, which will enhance the practice of evidence-based care. The authors posit that medical curricular reform, combined with initiatives to change clinical culture around substance abuse, will translate into improved rates of screening, shorter overall length of treatment, effective referrals for continued treatment, and increased access to care for individuals who use substances and so reduce the morbidity and mortality associated with substance use.
Vasquez, Elias Provencio; Gonzalez-Guarda, Rosa M.; De Santis, Joseph P.
The demographics of the United States are rapidly changing as a result of immigration from Latin America. Predictions indicate that by the year 2050, one of every four persons in the United States will be of Hispanic ethnicity. If health disparities relating to substance abuse and related mental health conditions among Hispanics are not fully understood and addressed, these will continue grow along with this population. The purpose of this pilot study was to describe the relationships among acculturation, depression, self-esteem, and substance abuse among a community sample of Hispanic men in South Florida (N = 164, 82 heterosexual men and 82 men who have sex with men). Standardized instruments measuring acculturation, depression, self-esteem, and substance abuse were administered in English or Spanish in a face-to-face interview format. Descriptive statistics and multiple logistic regression were used to illustrate participant characteristics and test relationships among the variables. Despite the fact that the majority of participants were more acculturated to the Hispanic culture than US culture, reported low levels of education and income, were depressed, and used substances, this group of men reported high levels of self-esteem. However, age and depression were the only predictors of substance abuse. Acculturation and self-esteem were not predictors of substance abuse. Clinicians need to be aware of the high rates of depression and substance abuse in this population and screen frequently for signs and symptoms of depression and substance abuse during health care encounters. PMID:21247274
Edwards, George A
Choking is one of the alternative explanations of abusive head trauma in children that have been offered in courtroom testimony and in the media. Most of these explanations - including choking - are not scientifically supported. This article highlights four points. (1) The origins of choking as an explanation for intracranial and retinal hemorrhages are speculative. (2) Choking has been used in high profile court testimony as an explanation for the death of a child thought to have been abused. (3) A case report that proposes choking as an alternative explanation for the death of a child diagnosed with abusive head trauma includes omissions and misrepresentations of facts. (4) There was a decision by the editor of the journal that published the case report that it was not necessary to include all the facts of the case; moreover, the editor indicated that facts are not required when presenting an alternative explanation. The use of scientifically unsupported alternative explanations for abusive head trauma based on inaccurate and biased information constitutes further victimization of the abused child and represents a travesty of justice.
Ducharme, Lori J; Chandler, Redonna K; Harris, Alex H S
The National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institute on Drug Abuse (NIDA), and Veterans Health Administration (VHA) share an interest in promoting high quality, rigorous health services research to improve the availability and utilization of evidence-based treatment for substance use disorders (SUD). Recent and continuing changes in the healthcare policy and funding environments prioritize the integration of evidence-based substance abuse treatments into primary care and general medical settings. This area is a prime candidate for implementation research. Recent and ongoing implementation projects funded by these agencies are reviewed. Research in five areas is highlighted: screening and brief intervention for risky drinking; screening and brief intervention for tobacco use; uptake of FDA-approved addiction pharmacotherapies; safe opioid prescribing; and disease management. Gaps in the portfolios, and priorities for future research, are described.
Ducharme, Lori J.; Chandler, Redonna K.; Harris, Alex H. S.
The National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institute on Drug Abuse (NIDA), and Veterans Health Administration (VHA) share an interest in promoting high quality, rigorous health services research to improve the availability and utilization of evidence-based treatment for substance use disorders (SUD). Recent and continuing changes in the healthcare policy and funding environments prioritize the integration of evidence-based substance abuse treatments into primary care and general medical settings. This area is a prime candidate for implementation research. Recent and ongoing implementation projects funded by these agencies are reviewed. Research in five areas is highlighted: screening and brief intervention for risky drinking; screening and brief intervention for tobacco use; uptake of FDA-approved addiction pharmacotherapies; safe opioid prescribing; and disease management. Gaps in the portfolios, and priorities for future research, are described. PMID:26233697
Choo, Esther; Ranney, Megan; Wetle, Terrie; Morrow, Kathleen; Mello, Michael; Squires, Daniel; Tapé, Chantal; Garro, Aris; Zlotnick, Caron
Background Drug use and partner abuse often coexist among women presenting to the emergency department (ED). Technology offers one solution to the limited time and expertise available to address these problems. Aims The aims of this study were to explore womens’ attitudes about use of computers for screening and intervening in drug use and partner abuse. Methods Seventeen adult women with recent histories of partner abuse and drug use were recruited from an urban ED to participate in one-on-one semi-structured interviews. A coding classification scheme was developed and applied to the transcripts by two independent coders. The research team collaboratively decided upon a thematic framework and selected illustrative quotes. Results Most participants used computers and/or mobile phones frequently and reported high self-efficacy with them. Women described emotional difficulty and shame around partner abuse experiences and drug use; however, they felt that reporting drug use and partner abuse was easier and safer through a computer than face-to-face with a person, and that advice from a computer about drug use or partner abuse was acceptable and accessible. Some had very positive experiences completing screening assessments. However, participants were skeptical of a computer’s ability to give empathy, emotional support or meaningful feedback. The ED was felt to be an appropriate venue for such programs, as long as they were private and did not supersede clinical care. Conclusions Women with partner abuse and drug use histories were receptive to computerized screening and advice, while still expressing a need for the empathy and compassion of a human interaction within an intervention. PMID:26167133
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.
Adams, Adrienne E; Sullivan, Cris M; Bybee, Deborah; Greeson, Megan R
Economic abuse is part of the pattern of behaviors used by batterers to maintain power and control over their partners. However, no measure of economic abuse exists. This study describes the development of the Scale of Economic Abuse, which was designed to fill this gap. Interviews were conducted with 103 survivors of domestic abuse, each of whom responded to measures of economic, physical, and psychological abuse as well as economic hardship. Results provide evidence for the reliability and validity of the scale. This study is an important first step toward understanding the extent and impact of economic abuse experienced by survivors.
Resnick, Heidi S.; Walsh, Kate; Schumacher, Julie A.; Kilpatrick, Dean G.; Acierno, Ron
To inform intervention approaches, the current study examined prevalence and comorbidity of recent use and history of abuse of alcohol, marijuana, and other illicit drugs as well as history of substance treatment among a sample of female victims of sexual assault seeking post-assault medical care. Demographic variables and prior history of assault were also examined to further identify factors relevant to treatment or prevention approaches. Participants were 255 women and adolescent girls seeking post sexual assault medical services who completed an initial follow-up assessment on average within 3 months post-assault. The majority (72.9%) reported recent substance use prior to assault, approximately 40% reported prior substance abuse history, and 12.2% reported prior substance treatment history. Prior history of assault was associated with recent drug use and history of drug abuse as well as substance treatment. Among those with prior histories of substance abuse and assault, assault preceded substance abuse onset in the majority of cases. Almost all those with prior treatment history reported recent drug or alcohol use. A portion of sexual assault survivors seen for acute medical services may benefit from facilitated referral for substance abuse treatment in addition to counseling at the time of screening. Assessment and intervention approaches should target alcohol, marijuana, and other illicit drug use and abuse. Substance use and associated impairment may serve as a rape tactic by perpetrators of assault. Substance use at the time of assault does not imply blame on the part of assault victims. Previous findings indicate that rape poses high risk of PTSD particularly among women with prior history of assault. Screening and intervention related to substance abuse should be done with recognition of the increased vulnerability it may pose with regard to assault and the high risk of PTSD within this population. PMID:23396174
Jangam, Kavita; Muralidharan, Kesavan; Tansa, K A; Aravind Raj, E; Bhowmick, Paramita
Childhood abuse has been recognized as a precursor and a maintaining factor for adult psychopathology. There are very few studies that have investigated the incidence of childhood abuse in adult women with psychiatric disorders. Hence, this current investigation is an attempt to study and compare the incidence of childhood abuse (physical, emotional and sexual) among women seeking treatment for psychiatric disorders to healthy women. Using consecutive sampling, women seeking treatment for psychiatric disorders (N=609) and a group of age-education matched healthy women (N=100) were recruited for the study from a tertiary mental health-care hospital in India. The participants were screened for childhood abuse using the ISPCAN Child Abuse Screening Tool - Retrospective (ICAST)-R (I-CAST R, International Society for the Prevention of Child Abuse and Neglect (ISPCAN) and The United Nations Children's Fund (UNICEF), 2009). Emotional abuse was significantly more common among women with psychiatric disorders compared with healthy women (p<0.05). On overall abuse, there was a trend to significance in women with psychiatric disorders compared with healthy women (p=0.07). There was no statistically significant difference between the two groups on physical and sexual abuse (all p>0.13). There was no statistically significant difference in all three types of abuse across disorder categories, though the report was more among women with severe mental disorders. Women with psychiatric disorders reported more emotional and overall abuse compared with healthy women. Sexual and physical abuse was similar in both groups. It is likely that more emotional abuse predisposes these women to psychiatric disorders.
Kelley, Michelle L.; Schroeder, Valarie M.; Cooke, Cathy G.; Gumienny, Leslie; Platter, Amanda Jeffrey; Fals-Stewart, William
Gender of the alcohol-abusing parent was examined in relation to general and romantic attachment (as measured by the Experiences in Close Relationships-Revised and the Relationship Scales Questionnaire) in female adult children of alcoholics (ACOAs; as indicated by the Children of Alcoholics Screening Test) as compared to non-ACOAs. As compared to…
Ulibarri, Monica D.; Strathdee, Steffanie A.; Lozada, Remedios; Magis-Rodriguez, Carlos; Amaro, Hortensia; O'Campo, Patricia; Patterson, Thomas L.
History of abuse has been associated with greater HIV risk among women. This study examined client-perpetrated abuse among female sex workers (FSWs) in two Mexico-U.S. border cities where HIV prevalence is rising. Among 924 FSWs, prevalence of client-perpetrated abuse was 31%. In multivariate logistic regression models, intimate partner violence, psychological distress and having drug-using clients were associated with experiencing client-perpetrated abuse. FSWs along the Mexico-U.S. border report frequently experiencing abuse from both clients and intimate partners, which may have serious mental health consequences. Our findings suggest the need for screening and gender-based violence prevention services for Mexican FSWs. PMID:24686125
Jacobson, W. Z.; Cowan, C. A.; Runkel, A. C.
Intrastratal deformation features in Cambrian-Ordovician boundary strata in southeastern Minnesota, U.S.A., may be evidence for mid-continent paleoseismicity. Deformation features are present tens of kilometers east of the Midcontinent Rift zone, and include sand blows, water escape, and convolute lamination, as well as more subtle structures indicative of sand-on-sand density contrasts. The stratigraphic interval of interest is the uppermost Jordan Formation (Furongian), a very fine- to coarse-grained quartzose sandstone, and the basal Oneota Formation (Tremadocian), a heterolithic sandstone and dolostone that grades upward into bedded dolostone. Along the Jordan-Oneota boundary, deformation features are extensive, and the result of sand liquefaction and fluidization. Upward migration of excess pore water was obstructed in places by shale drapes that locally ruptured, causing sand to be injected into overlying beds. Movement of sand in this manner created voids that were filled by a chaotic mixture of sand, shale, and pebbles that collapsed from above. Where upwardly percolating water was not confined by shale, intrastratal flow produced water escape pillars. Other deformation features are present up to ~3 m below the Jordan-Oneota boundary, in well-sorted, pure quartzose sandstone. These features are inconspicuous because of the uniform texture and minerology of the sediment, and some were previously interpreted as synsedimentary phenomena. These features are common along foreset boundaries in large-scale (>3 m) cross-strata, and include cm-scale digitate interfaces (interfingering) and in situ rounded forms interpreted as sand-on-sand boudinage. They formed from density contrasts between individual foresets within the cross-bedded sand. The top of the lower foreset was less dense but more viscous than the base of the succeeding foreset. Such contrasts were the result of subtle packing and grain size differences formed during the avalanche process during dune
Quad screen; Multiple marker screening; AFP plus; Triple screen test; AFP maternal; MSAFP; 4-marker screen; Down syndrome - quadruple; Trisomy 21 - quadruple; Turner syndrome - quadruple; Spina bifida - ...
... physical and emotional neglect, such as withholding affection; sexual and physical abuse; emotional abuse; and witnessing partner abuse. Then they examined the associations of child neglect and abuse with adult job absenteeism, unemployment, ...
Calhoun, S R; Galloway, G P; Smith, D E
Dronabinol is an oral form of delta-9-tetrahydrocannabinol indicated for treatment of anorexia associated with weight loss in individuals with AIDS, and nausea and vomiting associated with cancer chemotherapy. The authors reviewed the literature and conducted surveys and interviews among addiction medicine specialists, oncologists, researchers in cancer and HIV treatment, and law enforcement personnel to determine the abuse liability of dronabinol. There is no evidence of abuse or diversion of dronabinol. Available prescription tracking data indicates that use remains within the therapeutic dosage range over time. Healthcare professionals have detected no indication of "scrip-chasing" or "doctor-shopping" among the patients for whom they have prescribed dronabinol. Cannabis-dependent populations, such as those treated in our Clinic and seen by the addiction medicine specialists we interviewed, have demonstrated no interest in abuse of dronabinol. There is no street market for dronabinol, and no evidence of any diversion of dronabinol for sale as a street drug. Furthermore, dronabinol does not provide effects that are considered desirable in a drug of abuse. The onset of action is slow and gradual, it is at most only weakly reinforcing, and the overwhelming majority of reports of users indicate that its effects are dysphoric and unappealing. This profile of effects gives dronabinol a very low abuse potential.
Haddad, Linda G; Shotar, Ali; Younger, Janet B; Alzyoud, Sukaina; Bouhaidar, Claudia M
Objectives: Abuse against women causes a great deal of suffering for the victims and is a major public health problem. Measuring lifetime abuse is a complicated task; the various methods that are used to measure abuse can cause wide variations in the reported occurrences of abuse. Furthermore, the estimated prevalence of abuse also depends on how abuse is culturally defined. Researchers currently lack a validated Arabic language instrument that is also culturally tailored to Arab and Middle Eastern populations. Therefore, it is important to develop and evaluate psychometric properties of an Arabic language version of the newly developed NorVold Domestic Abuse Questionnaire (NORAQ). Design and methods: The five core elements of the NORAQ (emotional abuse, physical abuse, sexual abuse, current suffering of the abuse, and communication of the history of abuse to the general practitioner) were translated into Arabic, translated back into English, and pilot tested to ensure cultural sensitivity and appropriateness for adult women in the Eastern Mediterranean region. Participants were recruited from the Jordanian Ministry of Health-Maternal and Child Health Care Centers in two large cities in Jordan. Results: A self administered NORAQ was completed by 175 women who had attended the centers. The order of factors was almost identical to the original English and Swedish languages questionnaire constructs. The forced 3-factor solution explained 64.25% of the variance in the measure. The alpha reliability coefficients were 0.75 for the total scale and ranged from 0.75 to 0.77 for the subscales. In terms of the prevalence of lifetime abuse, 39% of women reported emotional abuse, 30% physical abuse, and 6% sexual abuse. Conclusion: The Arabic version of the NORAQ has demonstrated initial reliability and validity. It is a cost-effective means for screening incidence and prevalence of lifetime domestic abuse against women in Jordan, and it may be applicable to other Middle East
Heye, Anna K; Thrippleton, Michael J; Armitage, Paul A; Valdés Hernández, Maria del C; Makin, Stephen D; Glatz, Andreas; Sakka, Eleni; Wardlaw, Joanna M
There is evidence that subtle breakdown of the blood-brain barrier (BBB) is a pathophysiological component of several diseases, including cerebral small vessel disease and some dementias. Dynamic contrast-enhanced MRI (DCE-MRI) combined with tracer kinetic modelling is widely used for assessing permeability and perfusion in brain tumours and body tissues where contrast agents readily accumulate in the extracellular space. However, in diseases where leakage is subtle, the optimal approach for measuring BBB integrity is likely to differ since the magnitude and rate of enhancement caused by leakage are extremely low; several methods have been reported in the literature, yielding a wide range of parameters even in healthy subjects. We hypothesised that the Patlak model is a suitable approach for measuring low-level BBB permeability with low temporal resolution and high spatial resolution and brain coverage, and that normal levels of scanner instability would influence permeability measurements. DCE-MRI was performed in a cohort of mild stroke patients (n=201) with a range of cerebral small vessel disease severity. We fitted these data to a set of nested tracer kinetic models, ranking their performance according to the Akaike information criterion. To assess the influence of scanner drift, we scanned 15 healthy volunteers that underwent a "sham" DCE-MRI procedure without administration of contrast agent. Numerical simulations were performed to investigate model validity and the effect of scanner drift. The Patlak model was found to be most appropriate for fitting low-permeability data, and the simulations showed vp and K(Trans) estimates to be reasonably robust to the model assumptions. However, signal drift (measured at approximately 0.1% per minute and comparable to literature reports in other settings) led to systematic errors in calculated tracer kinetic parameters, particularly at low permeabilities. Our findings justify the growing use of the Patlak model in low
Heye, Anna K.; Thrippleton, Michael J.; Armitage, Paul A.; Valdés Hernández, Maria del C.; Makin, Stephen D.; Glatz, Andreas; Sakka, Eleni; Wardlaw, Joanna M.
There is evidence that subtle breakdown of the blood–brain barrier (BBB) is a pathophysiological component of several diseases, including cerebral small vessel disease and some dementias. Dynamic contrast-enhanced MRI (DCE-MRI) combined with tracer kinetic modelling is widely used for assessing permeability and perfusion in brain tumours and body tissues where contrast agents readily accumulate in the extracellular space. However, in diseases where leakage is subtle, the optimal approach for measuring BBB integrity is likely to differ since the magnitude and rate of enhancement caused by leakage are extremely low; several methods have been reported in the literature, yielding a wide range of parameters even in healthy subjects. We hypothesised that the Patlak model is a suitable approach for measuring low-level BBB permeability with low temporal resolution and high spatial resolution and brain coverage, and that normal levels of scanner instability would influence permeability measurements. DCE-MRI was performed in a cohort of mild stroke patients (n = 201) with a range of cerebral small vessel disease severity. We fitted these data to a set of nested tracer kinetic models, ranking their performance according to the Akaike information criterion. To assess the influence of scanner drift, we scanned 15 healthy volunteers that underwent a “sham” DCE-MRI procedure without administration of contrast agent. Numerical simulations were performed to investigate model validity and the effect of scanner drift. The Patlak model was found to be most appropriate for fitting low-permeability data, and the simulations showed vp and KTrans estimates to be reasonably robust to the model assumptions. However, signal drift (measured at approximately 0.1% per minute and comparable to literature reports in other settings) led to systematic errors in calculated tracer kinetic parameters, particularly at low permeabilities. Our findings justify the growing use of the Patlak model
Leliveld, Lisette M C; Düpjan, Sandra; Tuchscherer, Armin; Puppe, Birger
In the study of animal emotions, emotional valence has been found to be difficult to measure. Many studies of farm animals' emotions have therefore focussed on the identification of indicators of strong, mainly negative, emotions. However, subtle variations in emotional valence, such as those caused by rather moderate differences in husbandry conditions, may also affect animals' mood and welfare when such variations occur consistently. In this study, we investigated whether repeated moderate aversive or rewarding events could lead to measurable differences in emotional valence in young, weaned pigs. We conditioned 105 female pigs in a test arena to either a repeated startling procedure (sudden noises or appearances of objects) or a repeated rewarding procedure (applesauce, toy and straw) over 11 sessions. Control pigs were also regularly exposed to the same test arena but without conditioning. Before and after conditioning, we measured heart rate and its variability as well as the behavioural reactions of the subjects in the test arena, with a special focus on detailed acoustic analyses of their vocalisations. The behavioural and heart rate measures were analysed as changes compared to the baseline values before conditioning. A limited number of the putative indicators of emotional valence were affected by the conditioning. We found that the negatively conditioned pigs showed changes that were significantly different from those in control pigs, namely a decrease in locomotion and an increase in standing. The positively conditioned pigs, however, showed a stronger increase in heart rate and a smaller decrease in SDNN (a heart rate variability parameter indicating changes in autonomic regulation) compared to the controls. Compared to the negatively conditioned pigs, the positively conditioned pigs produced fewer vocalisations overall as well as fewer low-frequency grunts but more high-frequency grunts. The low-frequency grunts of the negatively conditioned pigs also
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Foulke, J. M.
An attempt was made to measure the response to an announcement of hypertension screening at the Goddard Space Center, to compare the results to those of previous statistics. Education and patient awareness of the problem were stressed.
Learn More about Your Child’s Development: Developmental Monitoring and Screening Taking a first step, waving “bye-bye,” and pointing to something interesting are all developmental milestones, ...
... health. Depending on your age, sex, and medical history, you may need to be screened for things like: Certain types of cancer High blood pressure or high cholesterol Diabetes Osteoporosis (weak bones) ...
Parker, Richard; Armstrong, Matthew J; Corbett, Chris; Day, Edward J; Neuberger, James M
This review focuses on alcohol and substance abuse in the context of solid-organ transplantation. Alcohol and substance abuse are common and may lead to a need for solid-organ transplantation and may also contribute to significant physical and psychologic problems that impact upon the recipient. Damaging levels of alcohol intake can occur in the absence of dependence. Alcohol or substance abuse after transplantation is associated with poor medication compliance and this may increase risk of graft loss. Intravenous drug use is associated with increased risk of infections (especially secondary to opportunistic organisms-bacterial, viral, protozoal, and others-and such infections may be more severe in the immunosuppressed), but there is only anecdotal evidence that such behavior has a worse outcome in transplant recipients. Whereas previous alcohol excess and drug use in kidney recipients are both associated with a small but statistically significantly increased risk of adverse outcomes (hazard ratio, 1.16-1.56), alcohol use within recommended guidelines after transplantation appears safe and possibly beneficial. Robust data are lacking for other organs, but those available suggest that heart transplantation is safe in individuals with a history of alcohol or substance abuse. Health specialists in drug or alcohol addiction should carefully screen all potential transplant candidates for these conditions, and where there is evidence of dependency or abuse, effective psychologic and physical treatment should be offered. Studies have shown that interventions such as psychologic intervention have improved alcohol behavior in the context of liver transplantation. Although there are no comparable studies with other solid-organ recipients, it is reasonable to expect transferable outcomes.
Hepatocellular carcinoma (HCC) is one of the most frequently diagnosed tumour diseases throughout the world. In the vast majority of cases those affected are high-risk patients with chronic viral hepatitis and/or liver cirrhosis, which means there is a clearly identifiable target group for HCC screening. With resection, transplantation, and interventional procedures for local ablation, following early diagnosis curative treatment options are available with which 5-year survival rates of over 60% can be reached. Such early diagnosis is a reality only in a minority of patients, however, and in the majority of cases the disease is already in an advanced stage at diagnosis. One of the objects of HCC screening is diagnosis in an early stage when curative treatment is still possible. Precisely this is achieved by screening, so that the proportion of patients treated with curative intent is decisively higher. There is not yet any clear evidence as to whether this leads to a lowering of the mortality of HCC. As lower mortality is the decisive indicator of success for a screening programme the benefit of HCC screening has so far been neither documented nor refuted. Nonetheless, in large regions of the world it is the practice for high-risk patients to undergo HCC screening in the form of twice-yearly ultrasound examination and determination of AFP.
Kelley, Michelle L.; Fals-Stewart, William
Objective: The present study examined lifetime psychiatric disorders and current emotional and behavioral problems of 8- to 12-year-old children living with drug-abusing (DA) fathers compared to children living in demographically matched homes with alcohol-abusing (AA) or non-substance-abusing fathers. Method: Children's lifetime psychiatric…
Kumar, Suresh; Malhotra, Anil
Brief interventions in substance abuse refer to a group of cost-effective and time efficient strategies that aim at reduction of substance use and/or harm related to substance use. They are grounded in the scientific principles of harm reduction stage of change, motivational interviewing and feasibility of community-level delivery. This review discusses the characteristics, elements, and techniques of brief interventions for abuse of alcohol, tobacco and other drugs. The available evidence for effectiveness of these strategies vis-a-vis no treatment or extended treatment is also reviewed, which clearly supports these interventions to be effective, especially for alcohol abuse but also for others It is argued that India presents a fertile ground for application of these strategies and that Indian research in this area should be a top priority. PMID:21407932
Wilson, Denise; Gonzalez-Guarda, Rosa Maria; Campbell, Jacquelyn
Abuse and violence within families is both a global and gendered health issue (World Health Organization, 2013, 2014). In fact, one in every three women have experienced violence from an intimate partner in their lifetime, presenting equity, social justice and human rights concerns across the globe (García-Moreno, Jansen, Ellsberg, Heise, & Watts, 2005). Abuse and violence in families occurs in varying forms: intimate partner violence or maltreatment of children (often referred to as domestic violence), child to mother violence, or abuse of elder family members. These cut across ethnic groups, socioeconomic levels, and family configurations, including nuclear families comprised of two parents and children as well as extended family networks. This article is protected by copyright. All rights reserved.
Hahn, Kathryn L.
Background The use of prescription opioid drugs has the potential to lead to patient abuse of these medications, addiction, and diversion. Such an abuse is associated with increased costs because of excessive healthcare utilization. Finding ways to minimize the risk for abuse and addiction can enhance patient outcomes and reduce costs to patients and to payers. Objective To review current strategies that may reduce the risk for misuse and abuse of opioid medications, which in turn can enhance patient outcomes and lower costs to health insurers and patients. Discussion Implementing approaches that will encourage the use of safe practices (universal precautions) in pain management by providers can reduce the risk for abuse and misuse associated with chronic pain medications, especially opioids. These approaches include, but are not limited to, extensive physician and patient education regarding these medications and their associated risks for abuse; the development of prescription monitoring programs to detect physician or pharmacy shopping; the detection of inappropriate prescribing and medical errors; the use of physician-patient contracts concerning opioid treatment; the requirement of presenting a photo identification to pick up an opioid prescription at the pharmacy; urine drug toxicology screening; provisions for safe disposal of unused opioids; referrals to pain and addiction specialists; and potentially encouraging the use of opioid formulations aimed at reducing abuse. Conclusion Supporting such approaches by health insurers and educating providers and patients on the risks associated with chronic pain medications can help minimize the risk of prescription opioid abuse, addiction, and diversion; reduce health services utilization associated with opioid abuse; improve patient outcomes; and reduce overall costs. PMID:25126342
Du Mont, Janice; Macdonald, Sheila; Kosa, Daisy; Elliot, Shannon; Spencer, Charmaine; Yaffe, Mark
Introduction Elder abuse, a universal human rights problem, is associated with many negative consequences. In most jurisdictions, however, there are no comprehensive hospital-based interventions for elder abuse that address the totality of needs of abused older adults: psychological, physical, legal, and social. As the first step towards the development of such an intervention, we undertook a systematic scoping review. Objectives Our primary objective was to systematically extract and synthesize actionable and applicable recommendations for components of a multidisciplinary intersectoral hospital-based elder abuse intervention. A secondary objective was to summarize the characteristics of the responses reviewed, including methods of development and validation. Methods The grey and scholarly literatures were systematically searched, with two independent reviewers conducting the title, abstract and full text screening. Documents were considered eligible for inclusion if they: 1) addressed a response (e.g., an intervention) to elder abuse, 2) contained recommendations for responding to abused older adults with potential relevance to a multidisciplinary and intersectoral hospital-based elder abuse intervention; and 3) were available in English. Analysis The extracted recommendations for care were collated, coded, categorized into themes, and further reviewed for relevancy to a comprehensive hospital-based response. Characteristics of the responses were summarized using descriptive statistics. Results 649 recommendations were extracted from 68 distinct elder abuse responses, 149 of which were deemed relevant and were categorized into 5 themes: Initial contact; Capacity and consent; Interview with older adult, caregiver, collateral contacts, and/or suspected abuser; Assessment: physical/forensic, mental, psychosocial, and environmental/functional; and care plan. Only 6 responses had been evaluated, suggesting a significant gap between development and implementation of
... Are Here: Home → Multiple Languages → All Health Topics → Child Abuse URL of this page: https://medlineplus.gov/languages/ ... V W XYZ List of All Topics All Child Abuse - Multiple Languages To use the sharing features on ...
... illicit drug users also smoke cigarettes, but many substance abuse programs do not include treatment for nicotine dependence, ... Health and Human Services. More Health News on: Drug Abuse Smoking Recent Health News Related MedlinePlus Health Topics ...
... page: https://medlineplus.gov/news/fullstory_164283.html Substance Abuse Taxes the American Workplace Survey, analysis reveal the ... 24, 2017 FRIDAY, March 24, 2017 (HealthDay News) -- Substance abuse exacts a heavy toll on the American workplace, ...
... including representative payeeship, power of attorney, or guardianship. Support groups for caregivers address the emotional demands and stresses ... Shelters Counseling for victims and abusers Crisis lines Support groups Services for Abusers Some situations can be remedied ...
Burland, J. Alexis; And Others
The records of 28 abused or severely neglected children, as reviewed and analyzed, show the importance of meeting the child's and parent's dependency needs, rather than focusing exclusively on the abuse itself. (Author/CS)
... Use alcohol or drugs Engage in high-risk sexual behaviors Get poor grades in school Have a lot ... Sexual Abuse. https://www.childwelfare.gov/can/identifying/sex_abuse.cfm. Accessed November 21, 2014.
... Old Feeding Your 1- to 2-Year-Old Cough and Cold Medicine Abuse KidsHealth > For Parents > Cough ... cough and cold medicine. Why Do Kids Abuse Cough and Cold Remedies? Before the U.S. Food and ...
... Signs of Alcohol Abuse and Addiction Signs of Alcohol Abuse and Addiction Listen ©istock.com/ KatarzynaBialasiewicz People who drink too much alcohol might forget things that happened when they were ...
Horan, John J.
This article discusses several principles derived from learning theory which aid in understanding the use and abuse of drugs and illustrates their role in behavioral group counseling, a promising new strategy for drug abuse prevention. (JC)
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
Popper, Kenneth J.; Miller, Leonard F.; Green, Michael; Haig, Susan M.; Mullins, Thomas D.
The Yellow Rail (Coturnicops noveboracencis) is among the most enigmatic and least studied North American birds. Nesting exclusively in marshes and wetlands, it breeds largely east of the Rocky Mountains in the northern United States and Canada, but there is an isolated population in southern Oregon once believed extirpated. The degree of connectivity of the Oregon population with the main population is unknown. We used mitochondrial DNA sequences (mtDNA) and six microsatellite loci to characterize the Yellow Rail's genetic structure and diversity patterns in six areas. Our mtDNA-based analyses of genetic structure identified significant population differentiation, but pairwise comparison of regions identified no clear geographic trends. In contrast, microsatellites suggested subtle genetic structure differentiating the Oregon population from those in the five regions sampled in the Yellow Rail's main breeding range. The genetic diversity of the Oregon population was also the lowest of the six regions sampled, and Oregon was one of three regions that demonstrated evidence of recent population bottlenecks. Factors that produced population reductions may include loss of wetlands to development and agricultural conversion, drought, and wildfire. At this time, we are unable to determine if the high percentage (50%) of populations having experienced bottlenecks is representative of the Yellow Rail's entire range. Further genetic data from additional breeding populations will be required for this issue to be addressed.
Doropoulos, Christopher; Roff, George; Visser, Mart-Simone; Mumby, Peter J
Community succession following disturbance depends on positive and negative interactions, the strength of which change along environmental gradients. To investigate how early succession affects coral reef recovery, we conducted an 18-month experiment in Palau, using recruitment tiles and herbivore exclusion cages. One set of reefs has higher wave exposure and had previously undergone a phase shift to macroalgae following a major typhoon, whereas the other set of reefs have lower wave exposure and did not undergo a macroalgal phase shift. Similar successional trajectories were observed at all sites when herbivores were excluded: turf algae dominated early succession, followed by shifts to foliose macroalgae and heterotrophic invertebrates. However, trajectories differed in the presence of herbivores. At low wave exposure reefs, herbivores promoted coralline algae and limited turf and encrusting fleshy algae in crevice microhabitats, facilitating optimal coral recruitment. Under medium wave exposure, relatively higher but still low coverage of turf and encrusting fleshy algae (15-25%) found in crevice microhabitats inhibited coral recruitment, persisting throughout multiple recruitment events. Our results indicate that altered interaction strength in different wave environments following disturbance can drive subtle changes in early succession that cascade to alter secondary succession to coral recruitment and system recovery.
Perea, Manuel; Gomez, Pablo
Background Several recent studies have revealed that words presented with a small increase in interletter spacing are identified faster than words presented with the default interletter spacing (i.e., w a t e r faster than water). Modeling work has shown that this advantage occurs at an early encoding level. Given the implications of this finding for the ease of reading in the new digital era, here we examined whether the beneficial effect of small increases in interletter spacing can be generalized to a normal reading situation. Methodology We conducted an experiment in which the participant’s eyes were monitored when reading sentences varying in interletter spacing: i) sentences were presented with the default (0.0) interletter spacing; ii) sentences presented with a +1.0 interletter spacing; and iii) sentences presented with a +1.5 interletter spacing. Principal Findings Results showed shorter fixation duration times as an inverse function of interletter spacing (i.e., fixation durations were briefest with +1.5 spacing and slowest with the default spacing). Conclusions Subtle increases in interletter spacing facilitate the encoding of the fixated word during normal reading. Thus, interletter spacing is a parameter that may affect the ease of reading, and it could be adjustable in future implementations of e-book readers. PMID:23082178
Underwood, Jim N; Travers, Michael J; Gilmour, James P
We utilized a spatial and temporal analyses of genetic structure, supplemented with ecological and oceanographic analysis, to assess patterns of population connectivity in a coral reef fish Chromis margaritifer among the unique and remote atolls in the eastern Indian Ocean. A subtle, but significant genetic discontinuity at 10 microsatellite DNA loci was detected between atoll systems corresponding with a low (≤ 1%) probability of advection across the hundreds of kilometers of open ocean that separates them. Thus, although genetic connections between systems are likely maintained by occasional long-distance dispersal of C. margaritifer larvae, ecological population connectivity at this spatial scale appears to be restricted. Further, within one of these atoll systems, significant spatial differentiation among samples was accompanied by a lack of temporal pairwise differentiation between recruit and adult samples, indicating that restrictions to connectivity also occur at a local scale (tens of kilometers). In contrast, a signal of panmixia was detected at the other atoll system studied. Lastly, greater relatedness and reduced genetic diversity within recruit samples was associated with relatively large differences among them, indicating the presence of sweepstakes reproduction whereby a small proportion of adults contributes to recruitment in the next generation. These results are congruent with earlier work on hard corals, suggesting that local production of larvae drives population replenishment in these atoll systems for a range of coral reef species. PMID:22822442
Wopereis, Suzan; Rubingh, Carina M.; van Erk, Marjan J.; Verheij, Elwin R.; van Vliet, Trinette; Cnubben, Nicole H. P.; Smilde, Age K.; van der Greef, Jan; van Ommen, Ben; Hendriks, Henk F. J.
Background The prevalence of overweight is increasing globally and has become a serious health problem. Low-grade chronic inflammation in overweight subjects is thought to play an important role in disease development. Novel tools to understand these processes are needed. Metabolic profiling is one such tool that can provide novel insights into the impact of treatments on metabolism. Methodology To study the metabolic changes induced by a mild anti-inflammatory drug intervention, plasma metabolic profiling was applied in overweight human volunteers with elevated levels of the inflammatory plasma marker C-reactive protein. Liquid and gas chromatography mass spectrometric methods were used to detect high and low abundant plasma metabolites both in fasted conditions and during an oral glucose tolerance test. This is based on the concept that the resilience of the system can be assessed after perturbing a homeostatic situation. Conclusions Metabolic changes were subtle and were only detected using metabolic profiling in combination with an oral glucose tolerance test. The repeated measurements during the oral glucose tolerance test increased statistical power, but the metabolic perturbation also revealed metabolites that respond differentially to the oral glucose tolerance test. Specifically, multiple metabolic intermediates of the glutathione synthesis pathway showed time-dependent suppression in response to the glucose challenge test. The fact that this is an insulin sensitive pathway suggests that inflammatory modulation may alter insulin signaling in overweight men. PMID:19242536
Jourdan, Samuel; Francis, Isolde M.; Deflandre, Benoit; Loria, Rosemary
ABSTRACT The acquisition of genetic material conferring the arsenal necessary for host virulence is a prerequisite on the path to becoming a plant pathogen. More subtle mutations are also required for the perception of cues signifying the presence of the target host and optimal conditions for colonization. The decision to activate the pathogenic lifestyle is not “taken lightly” and involves efficient systems monitoring environmental conditions. But how can a pathogen trigger the expression of virulence genes in a timely manner if the main signal inducing its pathogenic behavior originates from cellulose, the most abundant polysaccharide on earth? This situation is encountered by Streptomyces scabies, which is responsible for common scab disease on tuber and root crops. We propose here a series of hypotheses of how S. scabies could optimally distinguish whether cello-oligosaccharides originate from decomposing lignocellulose (nutrient sources, saprophyte) or, instead, emanate from living and expanding plant tissue (virulence signals, pathogen) and accordingly adapt its physiological response. PMID:28261670
Thackeray, Susan L.
It is important to train more females to support the needs of a national and global economy workforce. The purpose of this thesis is to explore the proposition of the effect subtle messaging has on a Utah young woman's future career choice. The literature review will approach the science, technology, engineering, and math (STEM) subjects with historical, psychological, and cultural vantage points. An examination of three interconnected topics of research will include a history of women in the workforce and identified barriers to STEM education and careers to identify what types of messages are delivered to women as it relates to STEM and how it influences their career interest decisions. While there are historical barriers towards women in training for and entering STEM careers, no strong evidence is identified for sustained improvement. The changing concepts of social cognitive career theory can potentially provide a framework for constructivist assumptions regarding the topic of what can focus Utah young women learners to influence their own career development and surroundings to persist into STEM careers. Interpretative Phenomenology Analysis (IPA) provides increased understanding of the experiences of how Utah young women come to their decision and what role their environment contributes to that experience. Preliminary research outcomes demonstrate that the participants describe feelings of self-efficacy along with cultural expectations that do not align with their personal goals to enter into STEM education and careers.
Ariotti, Silvia; Beltman, Joost B; Borsje, Rianne; Hoekstra, Mirjam E; Halford, William P; Haanen, John B A G; de Boer, Rob J; Schumacher, Ton N M
It is well established how effector T cells exit the vasculature to enter the peripheral tissues in which an infection is ongoing. However, less is known regarding how CTLs migrate toward infected cells after entry into peripheral organs. Recently, it was shown that the chemokine receptor CXCR3 on T cells has an important role in their ability to localize infected cells and to control vaccinia virus infection. However, the search strategy of T cells for virus-infected targets has not been investigated in detail and could involve chemotaxis toward infected cells, chemokinesis (i.e., increased motility) combined with CTL arrest when targets are detected, or both. In this study, we describe and analyze the migration of CTLs within HSV-1-infected epidermis in vivo. We demonstrate that activated T cells display a subtle distance-dependent chemotaxis toward clusters of infected cells and confirm that this is mediated by CXCR3 and its ligands. Although the chemotactic migration is weak, computer simulations based on short-term experimental data, combined with subsequent long-term imaging indicate that this behavior is crucial for efficient target localization and T cell accumulation at effector sites. Thus, chemotactic migration of effector T cells within peripheral tissue forms an important factor in the speed with which T cells are able to arrive at sites of infection.
Underwood, Jim N; Travers, Michael J; Gilmour, James P
We utilized a spatial and temporal analyses of genetic structure, supplemented with ecological and oceanographic analysis, to assess patterns of population connectivity in a coral reef fish Chromis margaritifer among the unique and remote atolls in the eastern Indian Ocean. A subtle, but significant genetic discontinuity at 10 microsatellite DNA loci was detected between atoll systems corresponding with a low (≤ 1%) probability of advection across the hundreds of kilometers of open ocean that separates them. Thus, although genetic connections between systems are likely maintained by occasional long-distance dispersal of C. margaritifer larvae, ecological population connectivity at this spatial scale appears to be restricted. Further, within one of these atoll systems, significant spatial differentiation among samples was accompanied by a lack of temporal pairwise differentiation between recruit and adult samples, indicating that restrictions to connectivity also occur at a local scale (tens of kilometers). In contrast, a signal of panmixia was detected at the other atoll system studied. Lastly, greater relatedness and reduced genetic diversity within recruit samples was associated with relatively large differences among them, indicating the presence of sweepstakes reproduction whereby a small proportion of adults contributes to recruitment in the next generation. These results are congruent with earlier work on hard corals, suggesting that local production of larvae drives population replenishment in these atoll systems for a range of coral reef species.
Chervonsky, A V; Medzhitov, R M; Denzin, L K; Barlow, A K; Rudensky, A Y; Janeway, C A
Intracellular trafficking of major histocompatibility complex (MHC) class II molecules is characterized by passage through specialized endocytic compartment(s) where antigenic peptides replace invariant chain fragments in the presence of the DM protein. These changes are accompanied by structural transitions of the MHC molecules that can be visualized by formation of compact SDS-resistant dimers, by changes in binding of mAbs, and by changes in T cell responses. We have observed that a mAb (25-9-17) that is capable of staining I-Ab on the surface of normal B cells failed to interact with I-Ab complexes with a peptide derived from the Ealpha chain of the I-E molecule but bound a similar covalent complex of I-Ab with the class II binding fragment (class II-associated invariant chain peptides) of the invariant chain. Moreover, 25-9-17 blocked activation of several I-Ab-reactive T cell hybridomas but failed to block others, suggesting that numerous I-Ab-peptide complexes acquire the 25-9-17(+) or 25-9-17(-) conformation. Alloreactive T cells were also able to discriminate peptide-dependent variants of MHC class II molecules. Thus, peptides impose subtle structural transitions upon MHC class II molecules that affect T cell recognition and may thus be critical for T cell selection and autiommunity.
Gomes, E.; Mulligan, R. P.; McNinch, J.
Localized areas with high rates of shoreline erosion on beaches, referred to as erosional hotspots, can occur near clusters of relict shore-oblique sandbars. Wave transformation and wave-driven currents over these morphological features could provide an understanding of the hydrodynamic-morphologic coupling mechanism that connects them to the occurrence of erosional hotspots. To investigate this, we use the non-hydrostatic SWASH model that phase-resolves the free surface and fluid motions throughout the water column, allowing for high resolution of wave propagation and breaking processes. In this study we apply a coupled system of nested models including SWAN over a large domain of the North Carolina shelf with smaller nested SWASH domains in areas of interest to determine the hydrodynamic processes occurring over shore oblique bars. In this presentation we focus on a high resolution grid (10 vertical layers, 10 m horizontal resolution) applied to the Duck region with model validation from acoustic wave and current data, and observations from the Coastal Lidar And Radar Imaging System (CLARIS). By altering the bathymetry input for each model run based on bathymetric surveys and comparing the predicted and observed wave heights and current profiles, the effects of subtle bathymetric perturbations have on wave refraction, wave breaking, surf zone currents and vorticity are investigated. The ability to predict wave breaking and hydrodynamics with a non-hydrostatic model may improve our understanding of surf zone dynamics in relation to morphologic conditions.
Row, Jeffrey R; Wilson, Paul J; Gomez, Celine; Koen, Erin L; Bowman, Jeff; Thornton, Daniel; Murray, Dennis L
Anthropogenically driven climatic change is expected to reshape global patterns of species distribution and abundance. Given recent links between genetic variation and environmental patterns, climate change may similarly impact genetic population structure, but we lack information on the spatial and mechanistic underpinnings of genetic-climate associations. Here, we show that current genetic variability of Canada lynx (Lynx canadensis) is strongly correlated with a winter climate gradient (i.e. increasing snow depth and winter precipitation from west-to-east) across the Pacific-North American (PNO) to North Atlantic Oscillation (NAO) climatic systems. This relationship was stronger than isolation by distance and not explained by landscape variables or changes in abundance. Thus, these patterns suggest that individuals restricted dispersal across the climate boundary, likely in the absence of changes in habitat quality. We propose habitat imprinting on snow conditions as one possible explanation for this unusual phenomenon. Coupling historical climate data with future projections, we also found increasingly diverging snow conditions between the two climate systems. Based on genetic simulations using projected climate data (2041-2070), we predicted that this divergence could lead to a threefold increase in genetic differentiation, potentially leading to isolated east-west populations of lynx in North America. Our results imply that subtle genetic structure can be governed by current climate and that substantive genetic differentiation and related ecological divergence may arise from changing climate patterns.
Offermann, Lynn R; Basford, Tessa E; Graebner, Raluca; Jaffer, Salman; De Graaf, Sumona Basu; Kaminsky, Samuel E
Workplace discrimination has grown more ambiguous, with interracial interactions often perceived differently by different people. The present study adds to the literature by examining a key individual difference variable in the perception of discrimination at work, namely individual color-blind attitudes. We examined relationships between 3 dimensions of color-blind attitudes (Racial Privilege, Institutional Discrimination, and Blatant Racial Issues) and perceptions of racial microaggressions in the workplace as enacted by a White supervisor toward a Black employee (i.e., discriminatory actions ranging from subtle to overt). Findings showed that observer views on institutional discrimination fully mediated, and blatant racial issues partially mediated, the relationships between racial group membership and the perception of workplace microaggressions. Non-Hispanic Whites endorsed color blindness as institutional discrimination and blatant racial issues significantly more than members of racioethnic minority groups, and higher levels of color-blind worldviews were associated with lower likelihoods of perceiving microaggressions. Views on racial privilege did not differ significantly between members of different racial groups or affect microaggression perceptions. Implications for organizations concerned about promoting more inclusive workplaces are discussed.
Background Meningiomas are the most common brain tumor in the adult population. This case report describes the epidemiology, the clinical presentation as well as the current treatment options for this condition. Case presentation A 49 year-old man attended a chiropractic clinic with non-specific chronic low back pain. Upon the history taking and the systems review, he reported a loss of both smell and taste for which investigations conducted by two different otolaryngologists did not yield a specific diagnosis. The patient was referred to a neurologist who ordered a computer tomography scan that eventually revealed a compression brain tumor. Brain tumors can produce a large variety of clinical presentations, such as upper motor neuron lesion symptoms, altered consciousness or vital functions which are easy to identify. However, subtle signs, such as those presented in this case, can be neglected. Conclusion Clinicians should be aware of uncommon clinical presentations including cranial nerve or neurological dysfunction and refer their patient to a specialist when detected. PMID:24490991
Kotwal, Ashwin A.; Schumm, L Philip; Kern, David W.; McClintock, Martha K.; Waite, Linda J.; Shega, Joseph W.; Huisingh-Scheetz, Megan J.; Dale, William
Most measures of cognitive function used in large-scale surveys of older adults have limited ability to detect subtle differences across cognitive domains, and standard clinical instruments are impractical to administer in general surveys. The Montreal Cognitive Assessment (MoCA) can address this need, but has limitations in a survey context. Therefore, we developed a survey-adaptation of the MoCA, called the MoCA-SA, and describe its psychometric properties in a large national survey. Using a pretest sample of older adults (n=120), we reduced MoCA administration time by 26%, developed a model to accurately estimate full MoCA scores from the MoCA-SA, and tested the model in an independent clinical sample (n=93). The validated 18-item MoCA-SA was then administered to community-dwelling adults aged 62–91 as part of the National Social life Health and Aging Project (NSHAP) Wave 2 sample (n=3,196). In NSHAP Wave 2, the MoCA-SA had good internal reliability (Cronbach α=0.76). Using item-response models, survey-adapted items captured a broad range of cognitive abilities and functioned similarly across gender, education, and ethnic groups. Results demonstrate that the MoCA-SA can be administered reliably in a survey setting while preserving sensitivity to a broad range of cognitive abilities and similar performance across demographic subgroups. PMID:25390883
Ozturk, Selcuk; Yalta, Kenan; Yetkin, Ertan
Golden ratio, which is an irrational number and also named as the Greek letter Phi (φ), is defined as the ratio between two lines of unequal length, where the ratio of the lengths of the shorter to the longer is the same as the ratio between the lengths of the longer and the sum of the lengths. The so-called formula is a mathematical ratio and there exist a variety of examples in natural and man-made structures of great beauty. Moreover, golden ratio is expressed throughout the human body in some ways, including digits, uterus, teeth, and cardiovascular system. Although the association of Fibonacci series or golden ratio with systems and organs of human being has not been assessed in depth yet, the mainstream regulation of cardiovascular system seems to be associated with golden ratio. This raises the idea that there might have been a fine and subtle regulator in our body. In this article, we aimed to elaborate the relationship between the existence of golden ratio and the human body and to discuss the golden ratio and its association with cardiovascular system.
Kachlishvili, Khatuna; Maisuradze, Gia G.; Martin, Osvaldo A.; Liwo, Adam; Vila, Jorge A.; Scheraga, Harold A.
By using local (free-energy profiles along the amino acid sequence and 13Cα chemical shifts) and global (principal component) analyses to examine the molecular dynamics of protein-folding trajectories, generated with the coarse-grained united-residue force field, for the B domain of staphylococcal protein A, we are able to (i) provide the main reason for formation of the mirror-image conformation of this protein, namely, a slow formation of the second loop and part of the third helix (Asp29–Asn35), caused by the presence of multiple local conformational states in this portion of the protein; (ii) show that formation of the mirror-image topology is a subtle effect resulting from local interactions; (iii) provide a mechanism for how protein A overcomes the barrier between the metastable mirror-image state and the native state; and (iv) offer a plausible reason to explain why protein A does not remain in the metastable mirror-image state even though the mirror-image and native conformations are at least energetically compatible. PMID:24912167
Stutey, Diane; Clemens, Elysia V.
Sibling abuse is a serious phenomenon in our society that often goes unaddressed. Victims of sibling abuse experience psychological effects similar to those of child abuse (Caspi, 2012; Wiehe, 2002). The purpose of this article is to provide school counselors with a definition of sibling abuse and a five-step model to recognize and respond. A…
Dube, Shanta R.; Anda, Robert F.; Felitti, Vincent J.; Croft, Janet B.; Edwards, Valerie J.; Giles, Wayne H.
A study involving 8,629 adults examined the association between parental alcohol abuse and child abuse, neglect, and other household dysfunction. Compared to households without alcohol abuse, the adjusted odds ratio for each category of adverse childhood experience was 2 to 13 times higher if parents abused alcohol. (Contains references.) (CR)
Davis, Norris; And Others
Examines the relationship between paternal drug abuse status and neighborhood crime rates. Although paternal drug abusing families resided in neighborhoods with higher crime rates than parental non-drug abusing families, when controlling for socioeconomic status, ethnicity, and domicile, drug abuse status was not associated with neighborhood crime…
This booklet discusses child abuse, targeting pre-teenagers and teenagers. It describes what child abuse is, why it happens, and what a teenager can do about it. These topics are covered: (1) definition of child abuse and types of child abuse; (2) differentiating between child abuse and discipline; (3) sexual abuse; (4) family types of child…
Homer, A C; Gilleard, C
OBJECTIVE--To assess the prevalence of abuse of elderly people by their carers and the characteristics of abusers and the abused. DESIGN--Information on abuse and risk factors was collected over six months from carers and patients. Risk factors were identified in the abused group and compared with those in a non-abused control group. SETTING--Carers were interviewed at home; patients were examined in the wards of Putney and Barnes geriatric hospitals, London. SUBJECTS--All patients referred from any source for respite care to the geriatric services over a six month period and their carers. MAIN OUTCOME MEASURES--Amount of physical and verbal abuse or neglect. Quantification of risk factors and correlation with the presence or absence of abuse. RESULTS--45% Of carers openly admitted to some form of abuse. Few patients admitted abuse. The most significant risk factor for physical abuse was alcohol consumption by the carer (p less than 0.001). Other significant risk factors were a poor pre-morbid relationship and previous abuse over many years. Abuse was often reciprocated and was associated with social dysfunction in many patients. Service delivery, respite care, and level of mental and physical disability were not significantly associated with abuse. CONCLUSION--The high level of abuse found in elderly patients in respite care was particularly associated with alcohol abuse and long term relationships of poor quality, which are difficult to change. Even with increased provision of services, care in the community may not be the best solution for these people. PMID:2271883
Postmus, Judy L; Plummer, Sara-Beth; Stylianou, Amanda M
Recent attention has been given by researchers to understanding how abusers use economic abuse strategies. Unfortunately, limited measures are available to accurately understand the prevalence of economic abuse in the lives of survivors. Recently, researchers created the 28-item Scale of Economic Abuse (SEA) but further validation is needed. This article describes the psychometric evaluation of the SEA through confirmatory and exploratory factor analyses using data collected with 120 survivors of abuse. The findings provide evidence for the reliability and validity of the SEA-12 as a shorter instrument to measure economic abuse as a distinct form of abuse.
Deshpande, Neha A; Lewis-O’Connor, Annie
Intimate partner violence (IPV) is defined as an actual or threatened abuse by an intimate partner that may be physical, sexual, psychological, or emotional in nature. Each year approximately 1.5 million women in the United States report some form of sexual or physical assault by an intimate partner; it is estimated that approximately 324,000 women are pregnant when violence occurs. Pregnancy may present a unique opportunity to identify and screen for patients experiencing IPV. This article provides health care practitioners and clinicians with the most current valid assessment and screening tools for evaluating pregnant women for IPV. PMID:24920977
Mehrazmay, Alireza; Karambakhsh, Alireza; Salesi, Mahmood; Heydari, Mostafa; Ahmadi, Khodabakhsh
Background: Military service is a stressful task that influences the life style of army personnel. Several factors can make soldiers less capable of coping with stressful events; so they may try to start drug abuse or increase in the amount or diversity of substance abuse. Understanding factors responsible for this misbehavior among soldiers is crucial for their commanders to modify these factors. Objectives: This study aimed to determine the predictors of change in substance abuse status in soldiers. Patients and Methods: This cross-sectional research was conducted to evaluate the substance abuse status among Iranian soldiers in 2010. The target population was the soldiers who had spent at least 3 months of their military service. Cluster sampling was done from army service garrisons in 12 provinces in Iran. A total of 3960 soldiers were selected with different levels of education and age. Data gathering was done with demographic questionnaires, Texas Christian university (TCU) drug screen II and ASI questionnaire (fifth edition). Four types of dependent variables were defined: “improvement”, “without change”, “deterioration”, and “severe deterioration”. Backward ordinal regression analysis was done and P values, OR, and SE were calculated by SPSS19 software. Results: Totally, 6.7% of soldiers improved, 82% remained without change, 6.1% deteriorated, and 5.2% severely deteriorated with regard to their substance abuse. Modifiable predictors were distance from home lower than 200 km (OR =1.54), bad relationship with commanders (OR = 1.88), service place dissatisfaction (OR = 1.39), and always feeling lonely (OR = 1.83). Non-modifiable factors were alcohol use within family and friends (P = 0.000); psychiatric drug use history (OR = 1.72); suicidal attempt history (OR = 1.31); divorce, separation, and extramarital contact (P = 0.001); unemployment (P = 0.019); leisure time dissatisfaction (P = 0.004); living alone (OR = 2.43); and substance abuse
McDaniel, Garry L.
The Texas Department of Human Services, in collaboration with 13 other public and private organizations, co-sponsored a statewide collaborative elder abuse prevention project, to prevent abuse of elderly and disabled adults. The goal of this project is to develop a comprehensive, long-range plan for the prevention of elder abuse, a method for…
Salend, Elyse; And Others
Compares 16 state elder abuse reporting statutes and analyzes their implementation. Generally, the statutes have failed to ensure consistent information about elder abuse within or across states. Neglect is more often reported than abuse and little prosecutory activity was noted. Suggestions for improving reporting policies are made. (JAC)
Examines parricide, the killing of one's parents, and its relationship to a history of child abuse. Presents profiles of parricide, considers the secrecy of child abuse, describes the psychology of parricide, discusses psychological abuse and emotional death, and examines the "child's voice." Stresses need for effective programs to…
Frank, Peter R.
After years of work in drug abuse prevention and education, the author concludes that drug abuse education has failed. He says that children need early decisionmaking opportunities to form values, and describes how drug use and abuse are promoted by intense industry advertising. (MF)
When the sexual abuse of children is revealed, it is often found that other nonabusing adults were aware of the abuse but failed to act. During the past twenty years or so, the concealment of child sexual abuse (CSA) within organizations has emerged as a key challenge for child protection work. Recent events at Pennsylvania State University (PSU)…
Therapeutic recreation is important in treating substance abuse problems. It addresses attitudes and behaviors leading to substance abuse (inability to experience pleasure or control). It encourages participation in activities that help abusers cope and obtain enjoyable states, reducing reliance on drugs. The article discusses the theory of flow…
US Department of Health and Human Services, 2006
Each State provides its own definitions of child abuse and neglect based on minimum standards set by Federal law. This fact sheet provides the answers to the following questions: (1) How is child abuse and neglect defined in Federal law?; and (2) What are the major types of child abuse and neglect? Additional resources are listed. (Contains 2…
Forrester, Mathias B
Alprazolam (Xanax) is used in the treatment of anxiety, depression, and panic attacks, and is subject to abuse. The objective of this study was to describe the patterns of alprazolam abuse and drug identification (ID) calls received by several poison control centers. Cases were alprazolam calls received by 6 poison control centers during 1998-2004. Of 25,954 alprazolam calls received, 42% were drug ID calls and 51% were human exposure calls, of which 18% were abuse calls. The number of drug ID calls and the number of abuse calls both increased during the 7-yr period. Male patients accounted for 54% of abuse calls and females for 66% of nonabuse calls. Adolescent patients comprised 43% of abuse calls but only 12% of nonabuse calls. Although the majority of both types of human exposures occurred at the patient's own residence, abuse exposures were more likely than other exposures to occur at school (9% vs. 1%) and public areas (6% vs. 1%). While abuse calls were less likely than nonabuse calls to have no adverse clinical effects (19% vs. 23%), they were more likely to have minor medical outcomes (60% vs. 50%). Alprazolam abuse in Texas appears to be increasing. Alprazolam abusers are more likely to be male and often adolescent. Alprazolam abuse as compared to other exposures is more likely to occur outside of the person's home. Alprazolam abuse is more likely to involve some sort of adverse medical outcome.
Putnam, Frank W.; And Others
This study assessed the relationships among hypnotizability, clinical dissociation and traumatic antecedents in 54 sexually abused girls, ages 6 to 15 years, and 51 matched controls. There were no significant differences in hypnotizability between abuse and control subjects. However, in the abuse group, highly hypnotizable subjects were…
Seng, Alexandra C.; Prinz, Ronald J.
Child abuse is a major social concern around the world. Important to tackling the problem is an understanding of the mechanisms contributing to abusive parenting. This article brings together research on the cognitive variables associated with abusive or high-risk parenting. Considered are dysfunctional child-centered and parent-centered…
Das, Soumitra; Palappalllil, Dhanya Sasidharan; Purushothaman, Sumesh Thoppil; Rajan, Varun
Baclofen was initially used for the treatment of spastic conditions. Last decade has seen its emergence as a treatment of profound interest in alcohol dependence, opiates and cocaine abuse, and tobacco addiction. However, the published literature on baclofen abuse is sparse. Here, we report a patient with baclofen abuse. PMID:27833235
Fulmer, Terry; Wetle, Terrie
The fact that many states have passed elder abuse reporting laws has left care providers with a dilemma. If suspected abuse is reported, the relationship between caregiver and patient may change and the family's difficulties may increase. Indicators of abuse are not easy to differentiate from health problems, especially in the frail elderly. An…
English, R. William
This paper focuses on assisting families who have been damaged by substance abuse and on constructive involvement of families to help all members cope. The four main topics are: (1) "Substance Abuse and Family Systems," including the effects of substance abuse on families and children; (2) "Theories and Approaches to Family…
Knox, Wilma J.
The present survey sought to define drug abuse, its causes, recommended treatments, treatment settings, prognosis, and personal commitment to treating drug abusers. The use of prison and courts was contrasted with hospitals, and willingness to treat drug abusers was contrasted with alcoholics. (Author)
Besteman, Karst G.
Drug abuse is not confined to the young, but if a young person between the ages of 8 and 20 can be prevented from abusing drugs, chances are that he/she will never have a serious drug problem. Drug abuse prevention means helping young people develop personal strengths and values to reduce the chance that they will hurt themselves or others by…
Flowers, Michelle; Lipsett, Lisa; Barrett, M. J.
What can happen when the "monkey mind" of habitual conceptual thought is awakened to the more-than-human through attention to subtle energies and artmaking? Drawing on autoethnographic methods, we demonstrate how one graduate student's creative engagement with a tree brought animist theory to life. This paper illustrates how a…
Cárdenas Castro, Manuel
The main purpose of this study was to investigate the dimensionality of a Spanish-language version of the Blatant and Subtle Prejudice Scale via exploratory (EFA) and confirmatory factor analysis (CFA). No research has confirmed the hypothesized factor structure in Latin American countries. Using data from a random and probability survey in population of the northern area of Chile (N= 896), four models were specified: single factor model (global prejudice factor), correlated two-factor model (subtle and blatant prejudice), correlated two-factor second-order model, and single-factor second-order model. The findings indicated that the two-factor second-order model had the best fit. The corresponding alpha coefficients were .82 (subtle prejudice) and .76 (blatant prejudice). Lastly, differences were examined between
Danesh, Melissa J; Chang, Anne Lynn S
The National Research Council of the National Academies defines elder mistreatment as: (1) intentional actions that cause harm or create serious risk of harm (whether or not harm is intended) to a vulnerable elder by a caregiver or other person who stands in a trust relationship to the elder; or (2) failure by a caregiver to satisfy the elder's basic needs or to protect the elder from harm. Estimates of the prevalence of elder abuse have ranged from 2.2% to 18.4%. Dermatologists are uniquely positioned to identify and manage suspected cases of elder abuse given their expertise in distinguishing skin lesions of abuse from organic medical disease and their patient populations with strong elderly representation. This article discusses aspects of both the screening and management of elder abuse with particular relevance to dermatologists. Like physicians across medical specialties, dermatologists must be familiar with those aspects of elder abuse in screening, diagnosis, management, and reporting that are unique to their field and to those aspects that are applicable to all health care providers.
Ivanoff, Chris S; Hottel, Timothy L
Child abuse and neglect are tragic realities of American society. However, most U.S. dental schools do not provide students with adequate training to deal with the problem. This article proposes expanding the predoctoral dental curriculum with a problem-based learning model that can effectively stimulate critical thinking skills to assist graduates in screening and reporting suspected child abuse and neglect throughout their careers. The unique multicultural environment of dental school offers students an unprecedented opportunity to develop awareness about child abuse and domestic violence, while increased vigilance can potentially save innocent young lives. Educating students about proper protocol when they suspect child abuse or neglect is imperative, particularly for dental schools involving students in community sealant and other preventive programs in public schools. By expanding their curriculum to include recognition and intervention, dental schools can help break the cycle of violence and transform attitudes towards taking decisive action. Clinical curricula that have moved to private practice preceptor models are well suited to screen for child abuse. The goal is to motivate dental schools to deal with this critical issue, develop reporting protocols and procedures for appropriate response, and provide their students with consummate training.
Salwen, Jessica K; Hymowitz, Genna F; Vivian, Dina; O'Leary, K Daniel
This study sought to examine (a) a mediational model of childhood abuse, adult interpersonal abuse, and depressive symptoms and (b) the impact of weight-related teasing on rates and correlates of childhood abuse. Charts of 187 extremely obese individuals seeking psychological clearance for bariatric (weight-loss) surgery were retrospectively examined. Among the participants, 61% reported a history of childhood abuse, 30.5% reported adult interpersonal abuse, and 15% reported clinically significant depressive symptoms. Initially, the relationship between childhood abuse and current depressive symptoms was significant (p<.001). However, the introduction of adult interpersonal abuse as a mediator in the model reduced the magnitude of its significance (Sobel's test p=.01). The associations between childhood abuse and adult interpersonal abuse and between adult interpersonal abuse and depressive symptoms were significant (p<.001 and p=.002, respectively), and the model showed a good fit across multiple indices. Finally, weight-related teasing was a significant moderator in the relationship between childhood and adult interpersonal abuse. Bariatric surgery patients report elevated rates of childhood abuse that are comparable to rates in psychiatric populations (e.g., eating disorders, depression), and higher than those in community samples and other medical populations. The relationship between child abuse and depressive symptomatology may be partially explained by the presence of adult interpersonal abuse; additionally, the relationship between childhood and adult interpersonal abuse was stronger for those who did not endure weight-related teasing than for those who did.
McKirahan, J.R.; Goldstein, R.H.; Franseen, E.K.
This study analyzes the three-dimensional variability of a 20-meter-thick section of Pennsylvanian (Missourian) strata over a 600 km2 area of northeastern Kansas, USA. It hypothesizes that sea-level changes interact with subtle variations in paleotopography to influence the heterogeneity of potential reservoir systems in mixed carbonate-silidclastic systems, commonly produdng build-and-fill sequences. For this analysis, ten lithofacies were identified: (1) phylloid algal boundstone-packstone, (2) skeletal wackestone-packstone, (3) peloidal, skeletal packstone, (4) sandy, skeletal grainstone-packstone, (5) oolite grainstone-packstone, (6) Osagia-brachiopod packstone, (7) fossiliferous siltstone, (8) lenticular bedded-laminated siltstone and fine sandstone, (9) organic-rich mudstone and coal, and (10) massive mudstone. Each facies can be related to depositional environment and base-level changes to develop a sequence stratigraphy consisting of three sequence boundaries and two flooding surfaces. Within this framework, eighteen localities are used to develop a threedimensional framework of the stratigraphy and paleotopography. The studied strata illustrate the model of "build-and-fill". In this example, phylloid algal mounds produce initial relief, and many of the later carbonate and silidclastic deposits are focused into subtle paleotopographic lows, responding to factors related to energy, source, and accommodation, eventually filling the paleotopography. After initial buildup of the phylloid algal mounds, marine and nonmarine siliciclastics, with characteristics of both deltaic lobes and valley fills, were focused into low areas between mounds. After a sea-level rise, oolitic carbonates formed on highs and phylloid algal facies accumulated in lows. A shift in the source direction of siliciclastics resulted from flooding or filling of preexisting paleotopographic lows. Fine-grained silidclastics were concentrated in paleotopographic low areas and resulted in clay
Kilpatrick, Dean G.; And Others
Although the personality correlates of heroin addiction, LSD use, and marijuana smoking have been frequently investigated, relatively few data are available to describe the personality or lifestyle variables correlated with the pattern of polydrug abuse. In an attempt to gather such information, 17 polydrug users, selected from a group of 224…
Brody, Jacob A.
Demographic data suggest that alcohol abuse among the elderly will increase in proportion to the population growth of that group. Four factors which may cause the elderly to be a highly susceptible group for alcohol problems are: (1) retirement and its boredom, role changes, and financial problems; (2) increased concern with death and losses of…
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…
Lutsky, Irving; And Others
The analysis of 183 responses to a survey of former anesthesiology residents of the Medical College of Wisconsin found that 29 had been self-administered problematic substance abusers during their residencies, 23 had been alcohol dependent, and 6 had been drug dependent. More than 85 percent of respondents considered the drug policy information…
Rencken, Robert H.
This book provides a framework for understanding the dimensions (scope, taxonomy, philosophy) and dynamics (individual, familial, and societal) of child sexual abuse. The major focus is on integrated intervention strategies for any professional who must work with incomplete information. Chapter 1 provides an overview of the problem of child sexual…
Describes intervention and treatment services available to youth and adolescents with chemical abuse problems. Discusses necessary components of a comprehensive approach. Reviews research on treatment outcomes within the various types of programs along with research on the treatment models employed. (Author/LHW)
Johnson, Deborah G.
Discusses computer ethics and the use of computer networks. Topics addressed include computer hackers; software piracy; computer viruses and worms; intentional and unintentional abuse; intellectual property rights versus freedom of thought; the role of information in a democratic society; individual privacy; legislation; social attitudes; and the…
Written from a criminal justice perspective, the report on child abuse intervention provides a model system that emphasizes prompt medical treatment for the child and due process for both parents and children. The authors recommend that court action take the form of a civil proceeding whenever possible. Part I provides a framework for the…
... which can slow or stop the heart and lungs. Mixing with alcohol greatly increases this risk. Promethazine-codeine cough syrup has been linked to the overdose deaths of a few prominent musicians. Learn More For more information on abuse of ...
Dhawan, Anju; Balhara, Yatan Pal Singh; Natasha, M. Phil.
Adolescent substance abuse is a major public health concern. It is associated with an increased incidence of various psychiatric disorders like depressive disorders, anxiety disorders, attention deficit hyperactivity disorder, and conduct disorders and the relationship between mental and behavioral disorders and the substance use problems seems…
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.
Kiernan, Bette Unger; And Others
This article describes the Child Development and Parenting Program (CDP), a preventative child abuse program that assists single women who are pregnant or have preschool children to cope constructively with the problems of single parenting. The short-term goals of the program, i.e., providing education in child development and parenting skills and…
Farrell, Sarah P; Mahone, Irma H; Zerull, Lisa M; Guerlain, Stephanie; Akan, Doruk; Hauenstein, Emily; Schorling, John
The goals of this study were to develop a computer-based electronic screening tool (eScreening) and determine the feasibility of implementing eScreening for rural users of primary care. This descriptive pilot adapted existing screening measures for depression and alcohol abuse to a portable computer-based format and examined the feasibility of its adoption and use. This was a three-step design using convenience samples for (1) a focus group with providers, (2) usability testing with selected rural patients using the computerized touch screen, and (3) implementing the touch screen platform with a small sample in primary care to determine feasibility. This paper reports on Phase III, which assessed consumer response to eScreening.
Hsu, T.Y.; Gibson, L.H.; Pober, B.R.
A subtle deletion of Xp [del(X)(p22.32)]was identified by high-resolution chromosome analysis in a twelve-year-old female with short stature (<2 percentile) and Madelung deformity suggestive of Turner syndrome. The proband`s mother, who has short stature (<2 percentile) and demyelinating disorder, also showed this deletion. The maternal grandmother is of normal height and carries two normal X chromosomes. Both the patient and her mother have no other physical abnormalities and are of normal intelligence. To confirm and delineate this Xp deletion, fluorescence in situ hybridization (FISH) was performed on metaphases from the patient and her mother using probes of DXYS20 (a pseudoautosomal locus), DXS232A, and a newly isolated Xp YAC clone, YHX2, whose relative map position is unknown. Hybridization signals of DXS232A were detected on both X chromosomes, and DXYS20 and YHX2 were missing from one of the X`s of both the patient and her mother. YHX2 was thus placed distal to DXS232A (tel-DXYS20-YHX2-S232A-cen). This familial deletion with a breakpoint distal to DXS232A, which is located at -900 Kb telomeric to STS locus, appears to be the smallest Xp deletion reported thus far. Short stature is consistently associated with females carrying Xp deletions. Madelung deformity has been found in some patients with Turner syndrome or Dyschondrosteosis but it has not been reported in patients with Xp deletion. Our results suggest that the phenotype of our patient is associated with her chromosome abnormality. Due to the subtlety of the deletion identified in our patient and her mother, females presenting with short stature warrant careful clinical and cytogenetic evaluation.
Chen, Gang; Saad, Ziad S.; Adleman, Nancy E.; Leibenluft, Ellen; Cox, Robert W.
The nature of the hemodynamic response (HDR) is still not fully understood due to the multifaceted processes involved. Aside from the overall amplitude, the response may vary across cognitive states, tasks, brain regions, and subjects with respect to characteristics such as rise and fall speed, peak duration, undershoot shape, and overall duration. Here we demonstrate that the fixed-shape (FSM) or adjusted-shape (ASM) methods may fail to detect some shape subtleties (e.g., speed of rise or recovery, or undershoot). In contrast, the estimated-shape method (ESM) through multiple basis functions can provide the opportunity to identify some subtle shape differences and achieve higher statistical power at both individual and group levels. Previously, some dimension reduction approaches focused on the peak magnitude, or made inferences based on the area under the curve (AUC) or interaction, which can lead to potential misidentifications. By adopting a generic framework of multivariate modeling (MVM), we showcase a hybrid approach that is validated by simulations and real data. With the whole HDR shape integrity maintained as input at the group level, the approach allows the investigator to substantiate these more nuanced effects through the unique HDR shape features. Unlike the few analyses that were limited to main effect, two- or three-way interactions, we extend the modeling approach to an inclusive platform that is more adaptable than the conventional GLM. With multiple effect estimates from ESM for each condition, linear mixed-effects (LME) modeling should be used at the group level when there is only one group of subjects without any other explanatory variables. Under other situations, an approximate approach through dimension reduction within the MVM framework can be adopted to achieve a practical equipoise among representation, false positive control, statistical power, and modeling flexibility. The associated program 3dMVM is publicly available as part of the
Alexander-Bloch, Aaron; Clasen, Liv; Stockman, Michael; Ronan, Lisa; Lalonde, Francois; Giedd, Jay; Raznahan, Armin
While the potential for small amounts of motion in functional magnetic resonance imaging (fMRI) scans to bias the results of functional neuroimaging studies is well appreciated, the impact of in-scanner motion on morphological analysis of structural MRI is relatively under-studied. Even among “good quality” structural scans, there may be systematic effects of motion on measures of brain morphometry. In the present study, the subjects’ tendency to move during fMRI scans, acquired in the same scanning sessions as their structural scans, yielded a reliable, continuous estimate of in-scanner motion. Using this approach within a sample of 127 children, adolescents, and young adults, significant relationships were found between this measure and estimates of cortical gray matter volume and mean curvature, as well as trend-level relationships with cortical thickness. Specifically, cortical volume and thickness decreased with greater motion, and mean curvature increased. These effects of subtle motion were anatomically heterogeneous, were present across different automated imaging pipelines, showed convergent validity with effects of frank motion assessed in a separate sample of 274 scans, and could be demonstrated in both pediatric and adult populations. Thus, using different motion assays in two large non-overlapping sets of structural MRI scans, convergent evidence showed that in-scanner motion—even at levels which do not manifest in visible motion artifact—can lead to systematic and regionally specific biases in anatomical estimation. These findings have special relevance to structural neuroimaging in developmental and clinical datasets, and inform ongoing efforts to optimize neuroanatomical analysis of existing and future structural MRI datasets in non-sedated humans. PMID:27004471
Hauton, C.; Tyrrell, T.; Williams, J.
We report an investigation of the effects of increases in pCO2 on the survival, growth and molecular physiology of the neritic amphipod Gammarus locusta which has a cosmopolitan distribution in estuaries. Amphipods were reared from juvenile to mature adult in laboratory microcosms at three different levels of pH in nominal range 8.1-7.6. Growth rate was estimated from weekly measures of body length. At sexual maturity the amphipods were sacrificed and assayed for changes in the expression of genes coding for a heat shock protein (hsp70 gene) and the metabolic enzyme glyceraldehyde-3-phosphate dehydrogenase (gapdh gene). The data show that the growth and survival of this species is not significantly impacted by a decrease in sea water pH of up to 0.5 units. Quantitative real-time PCR analysis indicated that there was no significant effect of growth in acidified sea water on the sustained expression of the hsp70 gene. There was a consistent and significant increase in the expression of the gapdh gene at a pH of ~7.5 which, when combined with observations from other workers, suggests that metabolic changes may occur in response to acidification. It is concluded that sensitive assays of tissue physiology and molecular biology should be routinely employed in future studies of the impacts of sea water acidification as subtle effects on the physiology and metabolism of coastal marine species may be overlooked in conventional gross "end-point" studies of organism growth or mortality.
Dalzell, Danielle R.; Roth, Caleb C.; Bernhard, Joshua A.; Payne, Jason A.; Wilmink, Gerald J.; Ibey, Bennett L.
The cellular response to subtle membrane damage following exposure to nanosecond electric pulses (nsEP) is not well understood. Recent work has shown that when cells are exposed to nsEP, ion permeable nanopores (< 2nm) are created in the plasma membrane in contrast to larger diameter pores (> 2nm) created by longer micro and millisecond duration pulses. Macroscopic damage to a plasma membrane by a micropipette has been shown to cause internal vesicles (lysosomes) to undergo exocytosis to repair membrane damage, a calcium mediated process called lysosomal exocytosis. Formation of large pores in the plasma membrane by electrical pulses has been shown to elicit lysosomal exocytosis in a variety of cell types. Our research objective is to determine whether lysosomal exocytosis will occur in response to nanopores formed by exposure to nsEP. In this paper we used propidium iodide (PI) and Calcium Green-1 AM ester (CaGr) to differentiate between large and small pores formed in CHO-K1 cells following exposure to either 1 or 20, 600-ns duration electrical pulses at 16.2 kV/cm. This information was compared to changes in membrane organization observed by increases in FM1-43 fluorescence, both in the presence and absence of calcium ions in the outside buffer. In addition, we monitored the real time migration of lysosomes within the cell using Cellular Lights assay to tag LAMP-1, a lysosomal membrane protein. Both 1 and 20 pulses elicited a large influx of extracellular calcium, while little PI uptake was observed following a single pulse exposure. Statistically significant increases in FM1-43 fluorescence were seen in samples containing calcium suggesting that calcium-triggered membrane repair may be occurring. Lastly, density of lysosomes within cells, specifically around the nucleus, appeared to change rapidly upon nsEP stimulation suggesting lysosomal migration.
Zichel, Ran; Chearwae, Wanida; Pandey, Gouri Shankar; Golding, Basil; Sauna, Zuben E.
Therapeutic proteins are derived from complex expression/production systems, which can result in minor conformational changes due to preferential codon usage in different organisms, post-translational modifications, etc. Subtle conformational differences are often undetectable by bioanalytical methods but can sometimes profoundly impact the safety, efficacy and stability of products. Numerous bioanalytical methods exist to characterize the primary structure of proteins, post translational modifications; protein-substrate/protein/protein interactions and functional bioassays are available for most proteins that are developed as products. There are however few analytical techniques to detect changes in the tertiary structure of proteins suitable for use during drug development and quality control. For example, x-ray crystallography and NMR are impractical for routine use and do not capture the heterogeneity of the product. Conformation-sensitive antibodies can be used to map proteins. However the development of antibodies to represent sufficient epitopes can be challenging. Other limitations of antibodies include limited supply, high costs, heterogeneity and batch to batch variations in titer. Here we provide proof-of-principle that DNA aptamers to thrombin can be used as surrogate antibodies to characterize conformational changes. We show that aptamers can be used in assays using either an ELISA or a label-free platform to characterize different thrombin products. In addition we replicated a heat-treatment procedure that has previously been shown to not affect protein activity but can result in conformational changes that have serious adverse consequences. We demonstrate that a panel of aptamers (but not an antibody) can detect changes in the proteins even when specific activity is unaffected. Our results indicate a novel approach to monitor even small changes in the conformation of proteins which can be used in a routine drug-development and quality control setting
Chien, Yu-Yi; Lin, Fang-Cheng; Zao, John K.; Chou, Ching-Chi; Huang, Yi-Pai; Kuo, Heng-Yuan; Wang, Yijun; Jung, Tzyy-Ping; Shieh, Han-Ping D.
Objective. Interactive displays armed with natural user interfaces (NUIs) will likely lead the next breakthrough in consumer electronics, and brain-computer interfaces (BCIs) are often regarded as the ultimate NUI-enabling machines to respond to human emotions and mental states. Steady-state visual evoked potentials (SSVEPs) are a commonly used BCI modality due to the ease of detection and high information transfer rates. However, the presence of flickering stimuli may cause user discomfort and can even induce migraines and seizures. With the aim of designing visual stimuli that can be embedded into video images, this study developed a novel approach to induce detectable SSVEPs using a composition of red/green/blue flickering lights. Approach. Based on the opponent theory of colour vision, this study used 32 Hz/40 Hz rectangular red-green or red-blue LED light pulses with a 50% duty cycle, balanced/equal luminance and 0°/180° phase shifts as the stimulating light sources and tested their efficacy in producing SSVEP responses with high signal-to-noise ratios (SNRs) while reducing the perceived flickering sensation. Main results. The empirical results from ten healthy subjects showed that dual-colour lights flickering at 32 Hz/40 Hz with a 50% duty cycle and 180° phase shift achieved a greater than 90% detection accuracy with little or no flickering sensation. Significance. As a first step in developing an embedded SSVEP stimulus in commercial displays, this study provides a foundation for developing a combination of three primary colour flickering backlights with adjustable luminance proportions to create a subtle flickering polychromatic light that can elicit SSVEPs at the basic flickering frequency.
Zhao, Jichang; Wu, Junjie; Xu, Ke
As a social media, online social networks play a vital role in the social information diffusion. However, due to its unique complexity, the mechanism of the diffusion in online social networks is different from the ones in other types of networks and remains unclear to us. Meanwhile, few works have been done to reveal the coupled dynamics of both the structure and the diffusion of online social networks. To this end, in this paper, we propose a model to investigate how the structure is coupled with the diffusion in online social networks from the view of weak ties. Through numerical experiments on large-scale online social networks, we find that in contrast to some previous research results, selecting weak ties preferentially to republish cannot make the information diffuse quickly, while random selection can achieve this goal. However, when we remove the weak ties gradually, the coverage of the information will drop sharply even in the case of random selection. We also give a reasonable explanation for this by extra analysis and experiments. Finally, we conclude that weak ties play a subtle role in the information diffusion in online social networks. On one hand, they act as bridges to connect isolated local communities together and break through the local trapping of the information. On the other hand, selecting them as preferential paths to republish cannot help the information spread further in the network. As a result, weak ties might be of use in the control of the virus spread and the private information diffusion in real-world applications.
... HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Substance Abuse... Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Substance Abuse Prevention... Abuse and Mental Health Services, Administration's Center for Substance Abuse Prevention Drug...
... HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Substance Abuse... the Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Substance Abuse...: Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Prevention,......
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.
As for substance-related disorders, there were several differences between ICD-10 and DSM-IV, however, the concept of "dependence" had been essential for both criteria. DSM-5 published in 2013 had erased dependence. This confuses us. It is important to recognize dependence again. "Abuse" is the self-intake behavior of drug against the social norms. Repeated abuse results in dependence. Dependence is a state of loss of control against drug use due to craving. Abuse can produce "acute intoxication", and repeated abuse under dependence can produce "chronic intoxication". It is important to understand abuse, dependence and "intoxication" based on their relationship from the point of time course.
Bonugli, Rebecca; H Brackley, Margaret; Williams, Gail B; Lesser, Janna
Research indicates that women with serious mental illness (SMI) are vulnerable to sexual abuse, resulting in adverse health outcomes such as posttraumatic stress disorder (PTSD). The purpose of this pilot study was to examine the prevalence of undiagnosed PTSD among a cohort of 20 women with SMI and reporting past sexual abuse. Furthermore, the researcher sought to identify specific symptom manifestations of PTSD among women with SMI and sexual abuse histories. Finally, the feasibility of using specific data collection tools was examined. Results indicated that PTSD was not previously diagnosed or recognized in the study sample, in spite of the presence of a sexual trauma history. The screening tools were effective in identifying depression, guilt, emotional withdrawal, blunted affect, decreased psychomotor activity, suicidal ideations, sexual dysfunction, and substance abuse. Additionally, the data collection tools provided a framework for discussing sensitive issues related to sexual abuse. Implications of this pilot study suggest the need to evaluate all women with SMI and history of sexual abuse for PTSD.
Winters, Ken C.; Kaminer, Yifrah
The different established screening methodologies and comprehensive assessment techniques used in evaluating adolescents suspected of or known to have substance abuse disorders are discussed. Recommendations and suggestions for establishing standards of training and professional efficiency are also highlighted to treat adolescents with substance…
Higher Education Center for Alcohol, Drug Abuse, and Violence Prevention, 2012
According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the goal of screening in student health or other college settings is to reduce alcohol-related harm. NIAAA points out that identifying those students at greatest risk for alcohol problems is the first step in prevention. Colleges and universities have used a number of…
Fang, Yu-xia; Wang, Yan-bo; Shi, Jie; Liu, Zhi-min; Lu, Lin
Drug abuse has spread quickly since reemerging as a national problem in China in the late 1980s. The number of registered drug abusers increased from 70,000 in 1990 to more than one million by the end of 2004. In addition to opioids, abuse of 'new' types of drugs including 3,4-methylenedioxymethamphetamine (MDMA) and ketamine has spread since 1997. Illicit drug trafficking and production have swept most of southern China, and throughout the country drug abuse has caused many problems for both abusers and the community. One major drug-related problem is the spread of HIV, which has caused major social and economic damage in China. In response, the Chinese government has begun an anti-drug campaign, including legislative measures to control drug abuse. However, changing the public's attitudes toward drug abusers and breaking the link between drug use and HIV spread are equally important.
Mursaleen, Leah R; Stamford, Jonathan A
The term "drug of abuse" is highly contextual. What constitutes a drug of abuse for one population of patients does not for another. It is therefore important to examine the needs of the patient population to properly assess the status of drugs of abuse. The focus of this article is on the bidirectional relationship between patients and drug abuse. In this paper we will introduce the dopaminergic systems of the brain in Parkinson's and the influence of antiparkinsonian drugs upon them before discussing this synergy of condition and medication as fertile ground for drug abuse. We will then examine the relationship between drugs of abuse and Parkinson's, both beneficial and deleterious. In summary we will draw the different strands together and speculate on the future merit of current drugs of abuse as treatments for Parkinson's disease.
Simon, Lauren S; Hurst, Charlice; Kelley, Ken; Judge, Timothy A
Fundamental to the definition of abusive supervision is the notion that subordinates are often victims of a pattern of mistreatment (Tepper, 2000). However, little research has examined the processes through which such destructive relational patterns emerge. In this study, we draw from and extend the multimotive model of reactions to interpersonal threat (Smart Richman & Leary, 2009) to formulate and test hypotheses about how employees' emotional and behavioral responses may ameliorate or worsen supervisors' abuse. To test this model, we collected 6 waves of data from a sample of 244 employees. Results revealed reciprocal relationships between abusive supervision and both supervisor-directed counterproductive behavior and supervisor-directed avoidance. Whereas the abusive supervision--counterproductive behavior relationship was partially driven by anger, the abusive supervision--avoidance relationship was partially mediated by fear. These findings suggest that some may find themselves in abusive relationships, in part, because their own reactions to mistreatment can, perhaps unknowingly, reinforce abusive behavior.
Child abuse, child maltreatment, non-accidental injury and child homicide: all terms that are hard to believe exist in the 21st civilised century, but non-accidental injury of children is a major problem, crossing all socioeconomic, ethnic and educational groups, and is happening all over the world. Available statistics on child abuse and deaths related to abuse are frightening, and as many cases are not reported, actual numbers are likely to be much higher. This paper aims to increase understanding of child abuse issues and encourage the dental team to be alert to the possibility of abuse, recognise the physical injuries and make referrals to the appropriate agency if necessary. In child abuse cases physical injuries to the head and facial area are common while other types of abuse are less visible but are damaging to a vulnerable child in other ways. Keeping children safe is a shared responsibility and a top priority for all of us.
Deykin, E Y; Levy, J C; Wells, V
The Diagnostic Interview Schedule was employed to ascertain the prevalence of major depressive disorder (MDD), alcohol and substance abuse in a sample of 424 college students aged 16 to 19 years. Applying DSM III criteria, the prevalence of MDD was 6.8 per cent; of alcohol abuse, 8.2 per cent; and of substance abuse 9.4 per cent. Alcohol abuse was associated with MDD, but not with other psychiatric diagnoses. Substance abuse was associated both with MDD and with other psychiatric diagnoses as well. The onset of MDD almost always preceded alcohol or substance abuse suggesting the possibility of self-medication as a factor in the development of alcohol or substance abuse. PMID:3492151
Hearing levels are threatened by modern life--headsets for music, rock concerts, traffic noises, etc. It is crucial we know our hearing levels so that we can draw attention to potential problems. This exercise requires that students receive a hearing screening for their benefit as well as for making the connection of hearing to listening.
Katz, Nathaniel P.; Birnbaum, Howard; Brennan, Michael J.; Freedman, John D.; Gilmore, Gary P.; Jay, Dennis; Kenna, George A.; Madras, Bertha K.; McElhaney, Lisa; Weiss, Roger D.; White, Alan G.
Objective Prescription opioid abuse and addiction are serious problems with growing societal and medical costs, resulting in billions of dollars of excess costs to private and governmental health insurers annually. Though difficult to accurately assess, prescription opioid abuse also leads to increased insurance costs in the form of property and liability claims, and costs to state and local governments for judicial, emergency, and social services. This manuscript’s objective is to provide payers with strategies to control these costs, while supporting safe use of prescription opioid medications for patients with chronic pain. Method A Tufts Health Care Institute Program on Opioid Risk Management meeting was convened in June 2010 with private and public payer representatives, public health and law enforcement officials, pain specialists, and other stakeholders to present research, and develop recommendations on solutions that payers might implement to combat this problem. Results While protecting access to prescription opioids for patients with pain, private and public payers can implement strategies to mitigate financial risks associated with opioid abuse, using internal strategies, such as formulary controls, claims data surveillance, and claims matching; and external policies and procedures that support and educate physicians on reducing opioid risks among patients with chronic pain. Conclusion Reimbursement policies, incentives, and health technology systems that encourage physicians to use universal precautions, to consult prescription monitoring program (PMP) data, and to implement Screening, Brief Intervention, and Referral to6Treatment protocols, have a high potential to reduce insurer risks while addressing a serious public health problem. PMID:23725361
Roberts, C D
The purpose of this article was to assess the quality of data collected by the Drug Abuse Warning Network (DAWN), which reports drug abuse emergency department visits. The results of quality assurance studies at 36 sites were reviewed and interpreted. Data collection procedures are not consistent among hospitals and, along with personnel, regularly change within a hospital. Trained investigators reabstracted DAWN report forms at 24 sites and determined that only 57.4% of the cases that met DAWN case definition criteria had been reported; one of five cases had been reported at one site. The technique used in 11 (47.8%) of 23 hospitals to screen for potential DAWN cases detected only 36% of the cases found when all medical charts are examined. The investigators found discrepancies between reported and actual cases in 81.3% of the report forms reabstracted, with an average of 2.3 errors per form. Information as to the drug(s) involved was incorrect in 36.3% of the forms. Due to underreporting of drug abuse emergency department visits and poor quality data in DAWN report forms, DAWN estimates of drug activity must be viewed with caution. Furthermore, estimation of trends is risky, due to differences between emergency departments as to reporting systems and changes over time.
Decker, W J
Labeling an individual a drug abuser has serious sociologic and legal implications that only laboratory testing can effectively allay. A proper specimen (both qualitatively and quantitatively) must be obtained for analysis. Positive identification of specimen with subject is of paramount importance. The problems of specimen substitution--other people's urine, tap water, apple juice--directly impinge here, as does the possibility of drug degradation by heat, light, and microbial attack and of drug adsorption by the container and urinary sediment. Confirmation of postives indicated by screening tests (thin layer chromatography and immunoassays) by gas chromatography and/or ultraviolet spectrophotometry is, in most situations, mandatory. An effective quality control program is an absolute requirement. Even under ideal circumstances, laboratory results can sometimes wrongly indicate the abuse of drugs; and conversely, drug abuse can take place without detection by the laboratory. As in any clinical situation, laboratory tests are only a part (albeit an important one) of the entire evaluation of the individual involved.
Scott, Kevin R; Nelson, Lewis; Meisel, Zachary; Perrone, Jeanmarie
The rising toll of opioid overdoses in the past decade has been declared a prescription drug epidemic by the Centers for Disease Control. In that same period, Internet platforms, such as Facebook and Twitter, have grown exponentially, being used primarily by a population similar to new initiates of substance abuse. Researchers have utilized social media to gain insights into use patterns and prevailing attitudes about various substances. Social media has potential to enhance screening, prevention, and treatment of addiction. With future funding, they should be leveraged to advance understanding of prescription drug use and improve treatment and prevention of abuse.
Holmberg, M B
The hidden drug abuse in a stratified sample of a year cohort born in 1953 was studied by measuring the difference between drug abuse stated in interviews and registered in public health and social welfare files in 1968, 1973 and 1976. Among men who had stated high-frequency drug use in a school questionnaire in 1968 hidden drug abuse comprised two thirds of the total abuse, among women from the same group one half. In groups with lower degrees of abuse hidden drug abuse was 70-90% of the total abuse. Intravenous abuse was mostly known to public health and social welfare authorities. When trying to estimate the total number of drug abusers in an area there is reason to at least double the figures presented in case-finding studies.
Substance Abuse and Mental Health Services Administration (DHHS/PHS), Rockville, MD. Center for Substance Abuse Treatment.
This TIP is designed to teach juvenile justice, health services, education, and substance abuse treatment personnel about how to identify, screen, and assess people 11-to-21 years old who may be experiencing substance-related problems. It details warning signs of substance use disorders, when to screen, when to assess, what domains besides…
Drug abusers have a low tolerance for unpleasant and painful emotions and experience a need for chemical relief through use of narcotics, tranquilizers and analgesics. Physicians may show a tendency to comply with their request for such drugs, partly because they give way under pressure (threats, violence) and partly because of their own unconscious need for acceptance and appreciation from the patients. The use of prescribed drugs may inspire an illusion that drug therapy is a "solution" and withdraw attention from other therapies. The prescription of medicaments may represent an extension of already existing abuse. Physicians must be aware of these problems of prescription and of the problems connected to patients' use of threats and violence.
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
Wee, Corinne E; Ames, Tyler D; Le, Khoi M; Wang, Tiffany; Phieffer, Laura S; Quatman, Carmen E
Fragility fractures, or fractures occurring from a low-trauma event, are extremely prevalent among the elderly population worldwide and associated with significant mortality and morbidity. This study evaluated the relationship between FES-I Fear of Falling Survey results, self-reported activity restrictions via the SF-36 survey, and scores recorded by portable, inexpensive clinical assessment tools (CATs) during dynamic functional tasks. Low scores during these tasks may indicate functional deficits that put patients at risk for falls and subsequent fragility fractures. Forty-one subjects (20 fragility fracture patients, 21 controls without history of fragility fractures) over the age of 50 were recruited from three outpatient orthopaedic clinics. All subjects were administered a FES-I Fear of Falling Survey, a portion of an SF-36 survey, and tested using three different portable CATs: the Wii Balance Board, iPod Level Belt and Saehan Squeeze Hand Grip Dynamometer. There were several measured variables that showed a moderate correlation with Fear of Falling scores. Of note, correlations between FES-I scores and maximum hand grip strength for both the dominant hand (R= -0.302, p=0.069) and non-dominant hand (R= -0.309, p=0.059), as well as maximum anterior-posterior sway measured by the iPod Level Belt (R=0.320, p=0.056) were found to be marginally significant. In addition, the correlation between FES-I and average anterior-posterior sway was found to be significant (R=0.416, p=0.012). The Nintendo Wii and iPod Level Belt are relatively inexpensive, portable tools that can assess patients for subtle deficits during dynamic functional tasks. The results indicate that these tools can provide a more objective measure of a patient's limitations during daily activities such as walking by assigning them a numerical value and correlating this value to physical deficits that impact balance and coordination. In the future, CATs may also have a role in predicting outcomes and
Wee, Corinne E.; Ames, Tyler D.; Le, Khoi M.; Wang, Tiffany; Phieffer, Laura S.; Quatman, Carmen E.
Fragility fractures, or fractures occurring from a low-trauma event, are extremely prevalent among the elderly population worldwide and associated with significant mortality and morbidity. This study evaluated the relationship between FES-I Fear of Falling Survey results, self-reported activity restrictions via the SF-36 survey, and scores recorded by portable, inexpensive clinical assessment tools (CATs) during dynamic functional tasks. Low scores during these tasks may indicate functional deficits that put patients at risk for falls and subsequent fragility fractures. Forty-one subjects (20 fragility fracture patients, 21 controls without history of fragility fractures) over the age of 50 were recruited from three outpatient orthopaedic clinics. All subjects were administered a FES-I Fear of Falling Survey, a portion of an SF-36 survey, and tested using three different portable CATs: the Wii Balance Board, iPod Level Belt and Saehan Squeeze Hand Grip Dynamometer. There were several measured variables that showed a moderate correlation with Fear of Falling scores. Of note, correlations between FES-I scores and maximum hand grip strength for both the dominant hand (R= -0.302, p=0.069) and non-dominant hand (R= -0.309, p=0.059), as well as maximum anterior-posterior sway measured by the iPod Level Belt (R=0.320, p=0.056) were found to be marginally significant. In addition, the correlation between FES-I and average anterior-posterior sway was found to be significant (R=0.416, p=0.012). The Nintendo Wii and iPod Level Belt are relatively inexpensive, portable tools that can assess patients for subtle deficits during dynamic functional tasks. The results indicate that these tools can provide a more objective measure of a patient’s limitations during daily activities such as walking by assigning them a numerical value and correlating this value to physical deficits that impact balance and coordination. In the future, CATs may also have a role in predicting outcomes
Pope, E. C.; Ellis, R. P.; Scolamacchia, M.; Scolding, J. W. S.; Keay, A.; Chingombe, P.; Shields, R. J.; Wilcox, R.; Speirs, D. C.; Wilson, R. W.; Lewis, C.; Flynn, K. J.
Ocean acidification, caused by rising concentrations of carbon dioxide (CO2), is widely considered to be a major global threat to marine ecosystems. To investigate the potential effects of ocean acidification on the early life stages of a commercially important fish species, European sea bass (Dicentrarchus labrax), 12 000 larvae were incubated from hatch through metamorphosis under a matrix of two temperatures (17 and 19 °C) and two seawater pCO2s (400 and 750 μatm) and sampled regularly for 42 days. Calculated daily mortality was significantly affected by both temperature and pCO2, with both increased temperature and elevated pCO2 associated with lower daily mortality and a significant interaction between these two factors. There was no significant pCO2 effect noted on larval morphology during this period but larvae raised at 19 °C possessed significantly larger eyes and lower carbon:nitrogen ratios at the end of the study compared to those raised under 17 °C. These results suggest that D. labrax larvae are resilient to near-future oceanic conditions. However, when the incubation was continued to post-metamorphic (juvenile) animals (day 67-69), fish raised under a combination of 19 °C and 750 μatm pCO2 were significantly heavier and exhibited lower aerobic scopes than those incubated at 19 °C and 400 μatm. Most other studies investigating the effects of near-future oceanic conditions on the early life stages of marine fish have used incubations of relatively short durations and suggested these animals are resilient to ocean acidification. We propose the durations of these other studies may be insufficient for more subtle effects, such as those observed in this study, to become apparent. These findings may have important implications for both sea bass in a changing ocean and also for the interpretation of results from other studies that have shown resiliency in marine teleosts exposed to higher atmospheric concentrations of CO2.
Stern, A W; Smith-Blackmore, M
Animal sexual abuse (ASA) involves harm inflicted on animals for the purposes of human sexual gratification and includes such terms as bestiality, zoophilia, zoosadism, animal sexual assault, and others. The prevalence of ASA is not known, although it may be more common than is currently perceived. Veterinarians have the skills required to identify and document cases of ASA. This article reviews the terminology, legal definitions and forms of ASA, and its social and psychological context. An investigative approach is outlined, including an alternate light source examination; collection of swabs for DNA analysis; sampling vaginal washes, rectal washes, and toenails for trace evidence and biologic analyses; radiographic studies; and a complete forensic necropsy, including histopathology. Gross lesions identified in ASA victims include injuries to the anus, rectum, penis, scrotum, nipples, and vagina; the presence of foreign bodies; and abrasions, bruising, and other evidence of nonaccidental injury. Specialized procedures, including examination using alternate light sources and screening tests to identify human seminal fluid within samples from ASA victims, are of potential value but have not been validated for use in animals.
Yoo, Hyung Chol; Steger, Michael F; Lee, Richard M
This investigation describes the validation of a measure of perceived racism developed to assess racial experiences of Asian American college students. In three studies across two different regions of the United States, there was strong evidence for the validation of the 8-item Subtle and Blatant Racism Scale for Asian American College Students (SABR-A2). The subtle racism subscale refers to instances of discrimination attributable implicitly to racial bias or stereotype, whereas the blatant racism subscale refers to instances of discrimination attributable explicitly to racial bias or stereotype. The two-subscale structure of the SABR-A2 was supported by exploratory and confirmatory factor analyses and demonstrated discriminant, convergent, and incremental validity, as well as internal reliability and stability over 2 weeks.
The Visi Screen OSS-C, marketed by Vision Research Corporation, incorporates image processing technology originally developed by Marshall Space Flight Center. Its advantage in eye screening is speed. Because it requires no response from a subject, it can be used to detect eye problems in very young children. An electronic flash from a 35 millimeter camera sends light into a child's eyes, which is reflected back to the camera lens. The photorefractor then analyzes the retinal reflexes generated and produces an image of the child's eyes, which enables a trained observer to identify any defects. The device is used by pediatricians, day care centers and civic organizations that concentrate on children with special needs.
Forrester, Mathias B
Methylphenidate is a stimulant used in the treatment of attention deficit hyperactivity disorder in children and is subject to abuse. This study describes the patterns of methylphenidate abuse and drug identification (ID) calls received by several poison control centers in Texas. Cases were calls involving methylphenidate received by Texas poison control centers during 1998-2004. Drug ID and drug abuse calls were assessed by call year and geographic location. Drug abuse calls were then compared to all other human exposure (nonabuse) calls with respect to various factors. Of 6798 calls received involving methylphenidate, 35% were drug IDs and 56% human exposures. Of the human exposures, 9% involved abuse. The number of drug ID calls and drug abuse calls received per year both declined during the first part of 7-yr period but then increased. Male patients accounted for approximately 60% of both drug abuse and nonabuse calls. Adolescent patients comprised 55% of drug abuse calls and children less than 13 yr old comprised 62% of nonabuse calls. Although the majority of both types of human exposures occurred at the patient's own residence, drug abuse calls were more likely than non-abuse calls to involve exposures at school (15% vs. 6%) and public areas (3% vs. 0.4%). While drug abuse calls were less likely than nonabuse calls to present with no clinical effects (29% vs. 52%), they were more likely to show more serious medical outcomes. Methylphenidate abusers are more likely to be adolescents. Methylphenidate abuse as compared to other exposures is more likely to occur outside of the person's home and to involve more serious medical outcomes.
... vision tests are two of the most frequent evaluations, important because difficulties with these senses are often subtle, and neither parents, teachers, nor children may even recognize that a problem ...
Wang, Xingwei; Li, Lihua; Xu, Weidong; Liu, Wei; Lederman, Dror; Zheng, Bin
Current computer-aided detection (CAD) schemes for detecting mammographic masses have several limitations including high correlation with radiologists’ detection and cueing most subtle masses only on one view. To increase CAD sensitivity in cueing more subtle masses that are likely missed and/or overlooked by radiologists without increasing false-positive rates, we investigated a new case-dependent cueing method by combining the original CAD-generated detection scores with a computed bilateral mammographic density asymmetry index. Using the new method, we adaptively raise the CAD-generated scores of the regions detected on ‘high-risk’ cases to cue more subtle mass regions and reduce the CAD scores of the regions detected on ‘low-risk’ cases to discard more false-positive regions. A testing dataset involving 78 positive and 338 negative cases was used to test this adaptive cueing method. Each positive case involves two sequential examinations in which the mass was detected in ‘current’ examination and missed in ‘prior’ examination but detected in a retrospective review by radiologists. Applying to this dataset, a pre-optimized CAD scheme yielded 75% case-based and 55% region-based sensitivity on ‘current’ examinations at a false-positive rate of 0.25 per image. CAD sensitivity was reduced to 42% (case based) and 27% (region based) on ‘prior’ examinations. Using the new cueing method, case-based and region-based sensitivity could maximally increase 9% and 33% on the ‘prior’ examinations, respectively. The percentages of the masses cued on two views also increased from 27% to 65%. The study demonstrated that using this adaptive cueing method enabled us to help CAD cue more subtle cancers without increasing the false-positive cueing rate.