high harm avoidance: Topics by Science.gov

Sample records for high harm avoidance

Tridimensional Personality Questionnaire data on alcoholic violent offenders: specific connections to severe impulsive cluster B personality disorders and violent criminality.

PubMed

Tikkanen, Roope; Holi, Matti; Lindberg, Nina; Virkkunen, Matti

2007-07-30

The validity of traditional categorical personality disorder diagnoses is currently re-evaluated from a continuous perspective, and the evolving DSM-V classification may describe personality disorders dimensionally. The utility of dimensional personality assessment, however, is unclear in violent offenders with severe personality pathology. The temperament structure of 114 alcoholic violent offenders with antisocial personality disorder (ASPD) was compared to 84 offenders without ASPD, and 170 healthy controls. Inclusion occurred during a court-ordered mental examination preceded by homicide, assault, battery, rape or arson. Participants underwent assessment of temperament with the Tridimensional Personality Questionnaire (TPQ) and were diagnosed with DSM-III-R criteria. The typical temperament profile in violent offender having ASPD comprised high novelty seeking, high harm avoidance, and low reward dependence. A 21% minority scored low in trait harm avoidance. Results, including the polarized harm avoidance dimension, are in accordance with Cloninger's hypothesis of dimensional description of ASPD. The low harm avoidance offenders committed less impulsive violence than high harm avoidance offenders. High harm avoidance was associated with comorbid antisocial personality disorder and borderline personality disorder. Results indicate that the DSM based ASPD diagnosis in alcoholic violent offenders associates with impulsiveness and high novelty seeking but comprises two different types of ASPD associated with distinct second-order traits that possibly explain differences in type of violent criminality. Low harm avoidance offenders have many traits in common with high scorers on the Hare Psychopathy Checklist-Revised (PCL-R). Results link high harm avoidance with broad personality pathology and argue for the usefulness of self-report questionnaires in clinical praxis.
Tridimensional Personality Questionnaire data on alcoholic violent offenders: specific connections to severe impulsive cluster B personality disorders and violent criminality

PubMed Central

Tikkanen, Roope; Holi, Matti; Lindberg, Nina; Virkkunen, Matti

2007-01-01

Background The validity of traditional categorical personality disorder diagnoses is currently re-evaluated from a continuous perspective, and the evolving DSM-V classification may describe personality disorders dimensionally. The utility of dimensional personality assessment, however, is unclear in violent offenders with severe personality pathology. Methods The temperament structure of 114 alcoholic violent offenders with antisocial personality disorder (ASPD) was compared to 84 offenders without ASPD, and 170 healthy controls. Inclusion occurred during a court-ordered mental examination preceded by homicide, assault, battery, rape or arson. Participants underwent assessment of temperament with the Tridimensional Personality Questionnaire (TPQ) and were diagnosed with DSM-III-R criteria. Results The typical temperament profile in violent offender having ASPD comprised high novelty seeking, high harm avoidance, and low reward dependence. A 21% minority scored low in trait harm avoidance. Results, including the polarized harm avoidance dimension, are in accordance with Cloninger's hypothesis of dimensional description of ASPD. The low harm avoidance offenders committed less impulsive violence than high harm avoidance offenders. High harm avoidance was associated with comorbid antisocial personality disorder and borderline personality disorder. Conclusion Results indicate that the DSM based ASPD diagnosis in alcoholic violent offenders associates with impulsiveness and high novelty seeking but comprises two different types of ASPD associated with distinct second-order traits that possibly explain differences in type of violent criminality. Low harm avoidance offenders have many traits in common with high scorers on the Hare Psychopathy Checklist-Revised (PCL-R). Results link high harm avoidance with broad personality pathology and argue for the usefulness of self-report questionnaires in clinical praxis. PMID:17662159
Exploring the Relationship between Experiential Avoidance, Coping Functions and the Recency and Frequency of Self-Harm

PubMed Central

Sayal, Kapil; Townsend, Ellen

2016-01-01

This study investigated the relationship between experiential avoidance, coping and the recency and frequency of self-harm, in a community sample (N = 1332, aged 16–69 years). Participants completed online, self-report measures assessing self-harm, momentary affect, experiential avoidance and coping in response to a recent stressor. Participants who had self-harmed reported significantly higher levels of experiential avoidance and avoidance coping, as well as lower levels of approach, reappraisal and emotional regulation coping, than those with no self-harm history. Moreover, more recent self-harm was associated with lower endorsement of approach, reappraisal and emotion regulation coping, and also higher levels of both avoidance coping and experiential avoidance. Higher experiential avoidance and avoidance coping also predicted increased lifetime frequency of self-harm. Conversely, increased approach and reappraisal coping were associated with a decreased likelihood of high frequency self-harm. Although some of the effects were small, particularly in relation to lifetime frequency of self-harm, overall our results suggest that experiential avoidance tendency may be an important psychological factor underpinning self-harm, regardless of suicidal intent (e.g. including mixed intent, suicidal intent, ambivalence), which is not accounted for in existing models of self-harm. PMID:27442036
Harm avoidance and disability in old age.

PubMed

Wilson, Robert S; Buchman, Aron S; Arnold, Steven E; Shah, Raj C; Tang, Yuxiao; Bennett, David A

2006-01-01

The relation of personality to disability in old age is not well understood. The authors examined the relation of harm avoidance, a trait indicating a tendency to worry, fear uncertainty, be shy, and tire easily, to disability in a group of 474 older persons without dementia. Participants completed the 35-item Harm Avoidance scale. Disability was assessed with the Rosow-Breslau scale, a self-report measure of physical mobility. Performance-based tests of lower limb functions were also administered from which composite measures of gait, balance, and strength were derived. In a logistic regression model controlled for age, sex, education, and lower limb function, persons with high levels of harm avoidance were nearly three times as likely to report mobility limitations as persons with low levels, and these effects largely reflected fatigability and fear of uncertainty. The association of harm avoidance with disability was not explained or modified by frailty, physical activity, depressive symptoms, neuroticism, extraversion, or cognition. The results suggest that harm avoidance is associated with disability in old age.
Trait and state aspects of harm avoidance and its implication for treatment in major depressive disorder, dysthymic disorder, and depressive personality disorder.

PubMed

Abrams, Kelley Yost; Yune, Sook Kyeong; Kim, Seog Ju; Jeon, Hong Jin; Han, Soo Jung; Hwang, Jaeuk; Sung, Young Hoon; Lee, Kyung Jin; Lyoo, In Kyoon

2004-06-01

The authors evaluated the trait/state issues of harm avoidance in depressive-spectrum disorders and its predictive potential for antidepressant response. Subjects with Diagnostic and Statistical Manual of Mental Disorders (4th edn; DSM-IV) major depressive disorder (n = 39), dysthymic disorder (n = 37), depressive personality disorder (n = 39), and healthy control subjects (n = 40) were evaluated with the Temperament and Character Inventory and the 17-item Hamilton Depression Rating Scale (HDRS-17) at baseline and after a 12 week antidepressant treatment period. Higher harm avoidance scores predicted lesser improvement in subjects with dysthymic disorder and major depressive disorder, as determined by lesser decrease in HDRS-17 scores. Mean harm avoidance scores in depressed subjects were consistently greater than those in healthy controls, controlling for age, gender and diagnosis. Mean harm avoidance scores decreased significantly in all depressive-spectrum disorders after treatment, but still remained higher than harm avoidance scores in control subjects. The present study reports that harm avoidance is a reliable predictor of antidepressant treatment in subjects with major depressive disorder and dysthymic disorder and that harm avoidance is both trait- and state-dependent in depressive-spectrum disorders.
Relationship between temperament, character and the autistic trait in parents of children with autistic spectrum disorder.

PubMed

Kadak, Muhammed Tayyib; Demirel, Ömer Faruk; Gökalp, Burcu; Erdoğdu, Zeynep; Demirel, Ayşegül

2015-01-01

Previous studies have revealed distinct features of autism, with higher harm avoidance and lower reward dependence and novelty seeking. It is assumed that high harm avoidance, and low novelty seeking, reward dependence, cooperativeness, and self-directedness are related with the broad autism phenotype, as seen in autistic individuals. This study examined the association between the Temperament and Character Inventory (TCI) and the Autism Spectrum Quotient (AQ), in parents of children with ASD. There was significant correlation between total AQ and total harm avoidance, cooperativeness, and self-directedness (p < 0.05). In the stepwise analysis, self-directedness and education emerged significantly (F(2,67) = 19.71, p < .005). This model modestly explained 35% of variance (Adjusted R(2) = .350). Our findings suggest that self-directedness may be an autistic trait.
The psychological costs and benefits of being highly persistent: personality profiles distinguish mood disorders from anxiety disorders.

PubMed

Cloninger, C Robert; Zohar, Ada H; Hirschmann, Schmuel; Dahan, Dana

2012-02-01

The personality trait of Persistence is highly valued by conscientious overachievers, but it has both psychological costs and benefits. The interactions among multiple personality factors influencing the development of mood and anxiety disorders have been confounded in prior clinical samples, but can be disentangled in terms of their underlying brain circuitry and influence on perception of emotional stimuli. 285 individuals who represented the full range of personality variation in a large sample of adult volunteers from the general community of Israel were selected for follow-up by psychiatric interviews, cognitive testing, and medical examinations. The Temperament and Character Inventory (TCI) measured profiles of traits that distinguished individuals with diagnoses of mood and/or anxiety disorders using linear discriminant analysis and non-linear profile analysis. High Harm Avoidance and low Self-directedness strongly distinguished people with mood and/or anxiety disorders from those with neither. High Persistence distinguished people with only anxiety disorders from those with mood disorders. High Persistence was associated with greater health and happiness overall, but also led to more negative emotions than in people with low Persistence unless they were both unusually tolerant of frustration (i.e., low in Harm Avoidance) and self-accepting of personal limitations (i.e. high in Self-directedness). Subjects were volunteers over 40 years of age at assessment. People who are highly persistent (i.e., persevering, ambitious, perfectionistic) are more likely to have anxiety disorders than mood disorders, even when they have other traits increasing risk for both (i.e., high Harm Avoidance and low Self-directedness). High Persistence increases both positive and negative emotions in most people. However, high Persistence reduces negative emotions and increases positive emotions if a person is easy-going (i.e., "happy-go-lucky" when low in both Harm Avoidance and Self-directedness). Copyright © 2011 Elsevier B.V. All rights reserved.
The harm-benefit tradeoff in "bad deal" trials.

PubMed

Nycum, Gillian; Reid, Lynette

2007-12-01

This paper examines the nature of the harm-benefit tradeoff in early clinical research for interventions that involve remote possibility of direct benefit and likelihood of direct harms to research participants with fatal prognoses, by drawing on the example of gene transfer trials for glioblastoma multiforme. We argue that the appeal made by the component approach to clinical equipoise fails to account fully for the nature of the harm-benefit tradeoff-individual harm for social benefit-that would be required to justify such research. An analysis of what we label "collateral affective benefits," such as the experience of hope or exercise of altruism, shows that the existence of these motivations reinforces rather than mitigates the necessity of justification by reference to social benefit. Evaluations of social benefit must be taken seriously in the research ethics review process to avoid the exploitation of research participants' motivations of hope or altruism and to avoid the possibility of inadvertent exploitation of high-risk research participants and the harms that would associate with such exploitation.
[Familial transmission of depression: the importance of harm avoidance].

PubMed

Ulrich, I; Stopsack, M; Spitzer, C; Grabe, H-J; Freyberger, H J; Barnow, S

2011-09-01

Previous research about the aetiology of depression has analysed how depression-associated personality traits influence familial transmission. Using the community-based sample of the Greifswald Family Study, we investigated longitudinally to which extent the temperament factor harm avoidance influences the correlation between parent's depression and the depression of their offspring (with regard to possible sex differences). To test this familial transmission a structural equation model was conducted with the data of 193 children (mean age 19.5, SD=2.41) and their biological parents. Depression was assessed with structured clinical interviews, and harm avoidance with Cloninger's Temperament and Character Inventory (TCI, JTCI). The harm avoidance scores of the mothers were significantly correlated with the harm avoidance scores of their children, but the correlation of the father's and children's scores did not reach significance. The extent of harm avoidance at the first assessment of the 14-year-old children predicted depression 5 years later. These results indicate the importance of personality as a vulnerability marker for developing affective disorders. The results are discussed with respect to prevention programmes for children and parents with depression, especially if they exhibit strongly avoidant or anxious behaviour.
Sensory-processing sensitivity in social anxiety disorder: Relationship to harm avoidance and diagnostic subtypes

PubMed Central

Hofmann, Stefan G.; Bitran, Stella

2007-01-01

Sensory-processing sensitivity is assumed to be a heritable vulnerability factor for shyness. The present study is the first to examine sensory-processing sensitivity among individuals with social anxiety disorder. The results showed that the construct is separate from social anxiety, but it is highly correlated with harm avoidance and agoraphobic avoidance. Individuals with a generalized subtype of social anxiety disorder reported higher levels of sensory-processing sensitivity than individuals with a non-generalized subtype. These preliminary findings suggest that sensory-processing sensitivity is uniquely associated with the generalized subtype of social anxiety disorder. Recommendations for future research are discussed. PMID:17241764
The differential relationship between mental contamination and the core dimensions of contact contamination fear.

PubMed

Melli, Gabriele; Bulli, Francesco; Carraresi, Claudia; Tarantino, Federica; Gelli, Simona; Poli, Andrea

2017-01-01

Two types of contamination fear are recognized: contact and mental contamination. Contact contamination appears to be motivated both by harm avoidance and disgust avoidance. This study aimed to examine the relationships between disgust propensity, mental contamination and contact contamination while differentiating between harm avoidance and disgust avoidance in contact contamination. 169 OCD patients completed a set of questionnaires assessing mental contamination, contact contamination, disgust propensity, OCD, anxiety and depression. 1) Contact contamination based on disgust avoidance was more strongly associated with mental contamination and disgust propensity than contact contamination based on harm avoidance; 2) mental contamination significantly predicted contact contamination based on disgust avoidance, while it did not predict contact contamination based on harm avoidance; 3) mental contamination had a significant mediational role in the relationship between disgust propensity and contact contamination motivated by disgust avoidance. Mental contamination plays a role in contact contamination fear when disgust is primarily experienced. Copyright © 2016 Elsevier Ltd. All rights reserved.
The Relationship between Personality, Sense of Efficacy, and Stress in Korean Teachers.

PubMed

Park, Subin; Song, Yul-Mai; Ko, Guy-Nueo; Jhung, Kyungun; Ha, Kyooseob; Lee, Young-Ryeol; Kim, Yeni

2016-09-01

Several studies have linked teachers' personality characteristics and sense of efficacy to stress. However, investigating the relationship between these three constructs in this context was limited. This study aims to investigate the relationship between personality, sense of efficacy and perceived stress among Korean teachers. A total of 137 teachers working in elementary, middle, and high schools located in Seoul, South Korea were recruited for the study. The participants were administered Temperament and Character Inventory, Teacher's Sense of Efficacy Scale (TSES), and Perceived Stress Scale. The TSES was negatively correlated with harm avoidance and positively correlated with persistence, self-directedness, cooperativeness, and self-transcendence. Perceived stress was positively correlated with harm avoidance and negatively correlated with persistence and self-directedness. The path analysis showed that harm avoidance directly predicted perceived stress (β=0.37, 95% CI=0.21-0.53, p=0.002), and self-directedness and persistence predicted one's sense of efficacy (β=0.18, 95% CI=0.01-0.39 and β=0.31, 95% CI=0.10-0.47), which predicted perceived stress (β=-0.21, 95% CI=-0.39 to -0.02). The results of the present study indicate that harm avoidance might be associated with stress-proneness, while persistence, self-directedness, and sense of efficacy might act as protective resources against stress in Korean teachers.
Childhood physical abuse, non-suicidal self-harm and attempted suicide amongst regular injecting drug users.

PubMed

Darke, Shane; Torok, Michelle

2013-12-01

Childhood physical abuse (CPA), non-suicidal self-harm and attempted suicide are all highly prevalent amongst injecting drug users (IDU). This paper reported on the association of CPA with self-harm and attempted suicide. Cross-sectional study, with 300 IDU administered a structured interview examining the prevalence of CPA, non-suicidal self-harm and suicide attempts. CPA was reported by 74.3%, and severe CPA by 40.3%. A history of non-suicidal self-harm was reported by 23.7%, and 25.7% had attempted suicide. Non-suicidal self-harm preceded the suicide attempt in 83.3% of cases where both had occurred. Independent correlates of non-suicidal self-harm were: female gender (OR 3.62), avoided home due to conflict (OR 2.28) and more extensive polydrug use (OR 1.32). Independent correlates of attempted suicide were: severe CPA (OR 3.18), frequent CPA (OR 2.54), avoided home due to conflict (OR 3.95), female gender (OR 2.99), a positive screen for Conduct Disorder (OR 3.53), and more extensive polydrug use (OR 1.52). Those presenting to treatment agencies are highly likely to have a history of CPA, that may still influence their behaviours. Screening for histories of CPA and non-suicidal self-harm appears warranted when determining suicide risk for this population. At the population level, reductions in the rate of CPA, could possibly reduce the rate of subsequent suicidality. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
The Relationship between Personality, Sense of Efficacy, and Stress in Korean Teachers

PubMed Central

Park, Subin; Song, Yul-Mai; Ko, Guy-Nueo; Jhung, Kyungun; Ha, Kyooseob; Lee, Young-Ryeol

2016-01-01

Several studies have linked teachers' personality characteristics and sense of efficacy to stress. However, investigating the relationship between these three constructs in this context was limited. This study aims to investigate the relationship between personality, sense of efficacy and perceived stress among Korean teachers. A total of 137 teachers working in elementary, middle, and high schools located in Seoul, South Korea were recruited for the study. The participants were administered Temperament and Character Inventory, Teacher's Sense of Efficacy Scale (TSES), and Perceived Stress Scale. The TSES was negatively correlated with harm avoidance and positively correlated with persistence, self-directedness, cooperativeness, and self-transcendence. Perceived stress was positively correlated with harm avoidance and negatively correlated with persistence and self-directedness. The path analysis showed that harm avoidance directly predicted perceived stress (β=0.37, 95% CI=0.21–0.53, p=0.002), and self-directedness and persistence predicted one's sense of efficacy (β=0.18, 95% CI=0.01–0.39 and β=0.31, 95% CI=0.10–0.47), which predicted perceived stress (β=-0.21, 95% CI=-0.39 to -0.02). The results of the present study indicate that harm avoidance might be associated with stress-proneness, while persistence, self-directedness, and sense of efficacy might act as protective resources against stress in Korean teachers. PMID:27757136
Psychological but not vasomotor symptoms are associated with temperament and character traits.

PubMed

Kokras, N; Papadopoulos, L; Zervas, I M; Spyropoulou, A; Stamatelopoulos, K; Rizos, D; Creatsa, M; Augoulea, A; Papadimitriou, G N; Lambrinoudaki, I

2014-08-01

Recent evidence suggests that climacteric symptoms may be intensified by specific temperament and personality traits in postmenopausal women. In this study we investigate Cloninger's model of personality in relation to menopausal symptoms. One-hundred and seventy peri- and postmenopausal women consecutively recruited from a menopause clinic of an academic hospital completed the Cloninger's Temperament and Character Inventory (TCI-140) which measures four dimensions of temperament: Harm avoidance, Novelty seeking, Reward dependence and Persistence, as well as three dimensions of character: Self-directedness, Cooperativeness, and Self-transcendence. Menopausal somatic, vasomotor and psychological symptoms were also assessed using the Greene Climacteric Scale. In comparison to the norms of the Greek general population, postmenopausal women presented lower scores in Novelty seeking and Reward dependence and higher scores in Persistence, Self-directedness, Cooperativeness and Self-transcendence. Higher harm avoidance (the inclination to avoid potential punishment, be shy and fearful of uncertainty) significantly correlated with anxiety and depressive symptoms while lower Self-directedness (the ability to have the willpower to adapt to or overcome any changes) correlated with depressive symptoms only. By multivariate regression analysis, higher Harm avoidance and lower Self-directedness were independently associated with the presence of depressive symptoms. No significant associations were observed between TCI-140 traits and somatic or vasomotor symptoms. Our findings indicate that most temperament and character traits according to Cloninger's model in peri- and postmenopausal women varied significantly as compared to the general population. Among several traits, high Harm avoidance and low Self-directedness were most strongly associated with psychological climacteric distress but not with somatic and vasomotor symptoms.
Personality as a risk factor for illicit opioid use and a protective factor for illicit opioid dependence.

PubMed

Zaaijer, Eline R; Bruijel, Jessica; Blanken, Peter; Hendriks, Vincent; Koeter, Maarten W J; Kreek, Mary Jeanne; Booij, Jan; Goudriaan, Anna E; van Ree, Jan M; van den Brink, Wim

2014-12-01

Most studies investigating the role of personality as a risk factor for the development of opioid dependence compare dependent opioid users with healthy controls who never used heroin. In order to understand the potential protective role of personality, it is crucial to compare illicit opioid users who never became dependent with dependent opioid users. This study aims to examine the role of personality as a risk factor for opioid use and as a protective factor for the development of opioid dependence. Comparing personality factors between three groups: (1) 161 never-dependent illicit opioid users who have been using illicit opioids but never became opioid dependent; (2) 402 dependent opioid users in methadone maintenance treatment or heroin-assisted treatment; and (3) 135 healthy controls who never used heroin. Personality was assessed with a short version of Cloninger's Temperament and Character Inventory. Never-dependent opioid users reported more Novelty Seeking and Harm Avoidance and less Self-Directedness and Cooperativeness than healthy controls and more Reward Dependence and Self-Directedness, and less Harm Avoidance than dependent opioid users. Furthermore, never-dependent opioid users reported more Self-Transcendence than both dependent opioid users and healthy controls. Never-dependent opioid users may have started to use opioids partly due to their tendency to seek novel and/or spiritual experiences (high Novelty Seeking, high Self-Transcendence) and their tendency to avoid aversive stimuli (high Harm Avoidance), whereas they may have been protected against the development of dependence by their need for social approval (high Reward Dependence) and their self-efficacy (high Self-Directedness). Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Borderline Personality Disorder and Deliberate Self-Harm: Does Experiential Avoidance Play a Role?

ERIC Educational Resources Information Center

Chapman, Alexander L.; Specht, Matthew W.; Cellucci, Tony

2005-01-01

The theory that borderline personality disorder (BPD) is associated with experiential avoidance, and that experiential avoidance mediates the association between BPD and deliberate, nonsuicidal self-harm was examined. Female inmate participants (N = 105) were given structured diagnostic assessments of BPD, as well as several measures of…
Temperament and character profiles in bipolar I, bipolar II and major depressive disorder: Impact over illness course, comorbidity pattern and psychopathological features of depression.

PubMed

Zaninotto, Leonardo; Souery, Daniel; Calati, Raffaella; Di Nicola, Marco; Montgomery, Stuart; Kasper, Siegfried; Zohar, Joseph; Mendlewicz, Julien; Robert Cloninger, C; Serretti, Alessandro; Janiri, Luigi

2015-09-15

Studies comparing temperament and character traits between patients with mood disorders and healthy individuals have yielded variable results. The Temperament and Character Inventory (TCI) was administered to 101 bipolar I (BP-I), 96 bipolar II (BP-II), 123 major depressive disorder (MDD) patients, and 125 HS. A series of generalized linear models were performed in order to: (a) compare the TCI dimensions across groups; (b) test any effect of the TCI dimensions on clinical features of mood disorders; and (c) detect any association between TCI dimensions and the psychopathological features of a major depressive episode. Demographic and clinical variables were also included in the models as independent variables. Higher Harm Avoidance was found in BP-II and MDD, but not in BP-I. Higher Self-Transcendence was found in BP-I. Our models also showed higher Self-Directedness in HS, either vs MDD or BP-II. No association was found between any TCI dimension and the severity of symptoms. Conversely, a positive association was found between Harm Avoidance and the overall burden of depressive episodes during lifetime. The cross-sectional design and the heterogeneity of the sample may be the main limitations of our study. In general, our sample seems to support the view of a similar profile of temperament and character between MDD and BP-II, characterized by high Harm Avoidance and low Self-Directedness. In contrast, patients with BP-I only exhibit high Self-Transcendence, having a near-normal profile in terms of Harm Avoidance or Self-Directedness. Copyright © 2015 Elsevier B.V. All rights reserved.
Adolescents' Deliberate Self-Harm, Interpersonal Stress, and the Moderating Effects of Self-Regulation: A Two-Wave Longitudinal Analysis

ERIC Educational Resources Information Center

Jutengren, Goran; Kerr, Margaret; Stattin, Hakan

2011-01-01

The predictive effects of peer victimization and harsh parenting on deliberate self-harm were examined. As derived from the experiential avoidance model, the study also tested whether these links were moderated by individual self-regulation approaches. Data were collected at two points in time from 880 junior high school students (mean age =…
An atypical anxious-impulsive pattern of social anxiety disorder in an adult clinical population.

PubMed

Mörtberg, Ewa; Tillfors, Maria; van Zalk, Nejra; Kerr, Margaret

2014-08-01

An atypical subgroup of Social Anxiety Disorder (SAD) with impulsive rather than inhibited traits has recently been reported. The current study examined whether such an atypical subgroup could be identified in a clinical population of 84 adults with SAD. The temperament dimensions harm avoidance and novelty seeking of the Temperament and Character Inventory, and the Liebowitz Social Anxiety Scale were used in cluster analyses. The identified clusters were compared on depressive symptoms, the character dimension self-directedness, and treatment outcome. Among the six identified clusters, 24% of the sample had atypical characteristics, demonstrating mainly generalized SAD in combination with coexisting traits of inhibition and impulsivity. As additional signs of severity, this group showed low self-directedness and high levels of depressive symptoms. We also identified a typically inhibited subgroup comprising generalized SAD with high levels of harm avoidance and low levels of novelty seeking, with a similar clinical severity as the atypical subgroup. Thus, higher levels of harm avoidance and social anxiety in combination with higher or lower levels of novelty seeking and low self-directedness seem to contribute to a more severe clinical picture. Post hoc examination of the treatment outcome in these subgroups showed that only 20 to 30% achieved clinically significant change. © 2014 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

Temperament, character, and suicidality among Croatian war veterans with posttraumatic stress disorder.

PubMed

Jakšić, Nenad; Aukst-Margetić, Branka; Marčinko, Darko; Brajković, Lovorka; Lončar, Mladen; Jakovljević, Miro

2015-03-01

The occurrence of suicidal thoughts and behaviors is rather frequent among war veterans, particularly those suffering from posttraumatic stress disorder (PTSD). Understanding factors present within these individuals that increase suicide risk may inform prevention efforts. The present study aimed to determine whether the dimensions of temperament and character are associated with various aspects of suicidality among Croatian war veterans with PTSD. A sample of 72 Croatian male war veterans (mean age 52.33 years) diagnosed with PTSD was gathered at the National Center for Psychotrauma between May and October 2014. The participants completed the Temperament and Character Inventory - Revised (TCI-R) and the Suicidal Behaviors Questionnaire - Revised (SBQ-R). Zero-order analyses revealed that temperament dimension Harm avoidance and character dimension Self-directedness were moderately associated with the total risk for suicide (i.e., the SBQ-R total score), while Persistence and Cooperativeness showed significant but weaker relations. Different dimensions of suicidality were associated with different personality traits. Harm Avoidance was shown to be significantly increased among the subgroup of war veterans with high suicidal risk. Notwithstanding some limitations of this study, these findings could help extend our understanding of the elevated suicide risk in war veterans with PTSD. Detection of individuals displaying high Harm Avoidance and low Self-Directedness might facilitate prevention of suicidal behaviors in this population.
Immediate effects on adult drinkers of exposure to alcohol harm reduction advertisements with and without drinking guideline messages: experimental study.

PubMed

Wakefield, Melanie A; Brennan, Emily; Dunstone, Kimberley; Durkin, Sarah J; Dixon, Helen G; Pettigrew, Simone; Slater, Michael D

2018-06-01

To compare the immediate effects on drinkers of television advertisements focusing upon short- versus long-term harms with and without low-risk drinking guidelines. Between-participants on-line experiment, with random assignment to view: (a) alcohol product advertisements (ALC control); (b) advertisements unrelated to alcohol (NON-ALC control); (c) advertisements featuring short-term harms (STH) of alcohol; (d) advertisements featuring STH plus a STH guideline (STH+G); (e) advertisements featuring long-term harms (LTH); or (f) advertisements featuring LTH plus a LTH guideline (LTH+G). Australia, 2016. A total of 3718 drinkers aged 18-64 years (48.5% male). Post-exposure likelihood that participants provided a correct estimate of drinking levels associated with short- and long-term harms; post-exposure intentions to avoid alcohol or reduce consumption. After exposure to STH+G or LTH+G advertisements, participants were more likely to estimate correctly rather than overestimate drinking levels associated with harm, compared with those exposed to STH (P < 0.001) and LTH advertisements without guidelines, respectively (P = 0.019) and ALC control (STH+G, P < 0.001; LTH+G, P < 0.001) and NON-ALC control conditions (STH+G, P < 0.001; LTH+G, P = 0.011). Drinkers exposed to STH conditions were more likely to intend to reduce next-week alcohol consumption than those exposed to ALC control (both P < 0.001) and NON-ALC control conditions (STH, P = 0.001; STH+G, P < 0.001); a similar pattern was observed for intentions to avoid alcohol. Drinkers exposed to LTH conditions were also more likely than drinkers exposed to ALC or NON-ALC controls to intend to avoid and reduce alcohol in the next week. Additionally, drinkers exposed to LTH+G were more likely to intend to reduce drinking than those exposed to LTH advertisements without guidelines (P = 0.022). Response patterns for low- and high-risk drinkers by condition were similar. Alcohol harm television advertisements increase intentions to reduce alcohol consumption among both low- and high-risk drinkers. The addition of low-risk drinking guidelines can enhance these effects for advertisements featuring long-term harms and improve estimates of both short- and long-term harmful drinking levels. © 2018 Society for the Study of Addiction.
Synthesis of porous inorganic hollow fibers without harmful solvents.

PubMed

Shukla, Sushumna; de Wit, Patrick; Luiten-Olieman, Mieke W J; Kappert, Emiel J; Nijmeijer, Arian; Benes, Nieck E

2015-01-01

A route for the fabrication of porous inorganic hollow fibers with high surface-area-to-volume ratio that avoids harmful solvents is presented. The approach is based on bio-ionic gelation of an aqueous mixture of inorganic particles and sodium alginate during wet spinning. In a subsequent thermal treatment, the bio-organic material is removed and the inorganic particles are sintered. The method is applicable to the fabrication of various inorganic fibers, including metals and ceramics. The route completely avoids the use of organic solvents, such as N-methyl-2-pyrrolidone, and additives associated with the currently used fiber fabrication methods. In addition, it inherently avoids the manifestation of so-called macro voids and allows the facile incorporation of additional metal oxides in the inorganic hollow fibers. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
The Hundred Person Wellness Project and Google's Baseline Study: medical revolution or unnecessary and potentially harmful over-testing?

PubMed

Diamandis, Eleftherios P

2015-01-09

The Hundred Person Wellness Project is an ambitious pilot undertaking, which aims to intensely monitor 100 individuals over 10 months. Patients with abnormal findings will be treated, in hopes that this early intervention will avoid, or delay, symptomatic disease. Google's "Baseline Study" is of similar scope and will enroll 10,000 people over 2 to 3 years. I here speculate that these approaches will likely not be effective in preventing disease, but instead, lead to unnecessary and potentially harmful interventions. Examples from the cancer screening experience over the last 30 years are provided, which show that intensive testing may uncover indolent disease or incidental findings which, when treated, may cause more harm than good. Additional examples show that aggressive treatments for cancer and other diseases do not always lead to better patient outcomes. I conclude that the recent advances in omics provide us with unprecedented opportunities for high content clinical testing, but such testing should be used with caution to avoid the harmful consequences of over-diagnosis and over-treatment. Despite the detailed rebuttals by Hood and colleagues in another commentary in BMC Medicine, time will show the actual benefits and harms of these ambitious initiatives.
Cloninger's temperament and character dimension of personality in patients with asthma.

PubMed

Gulec, Medine Yazici; Gulec, Huseyin; Oztuna, Funda; Kose, Samet

2010-01-01

Psychosocial factors have been implicated as being important in the onset and/or exacerbation of asthma. This study was performed to evaluate the personality profiles of asthma patients. Ninety-five asthmatic, 98 psoriatic patients, and 96 healthy controls completed the Temperament and Character Inventory (TCI), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI). The relationships between asthma illness duration, asthma severity score, depression, anxiety, and temperament and character personality variables were evaluated. Asthmatic patients had significantly higher mean scores on the BAI, Harm Avoidance, Persistence, and Self-transcendence dimensions and lower scores on the BDI, Novelty Seeking, and Reward Dependence dimensions of the TCI than the psoriatic patients. Significant group effect was found for the BDI and BAI scores in between groups. Significant differences in TCI scores were found across groups except for Persistence and Self-transcendence. Post hoc tests revealed significantly lower Novelty Seeking, higher Harm Avoidance, lower Reward Dependence, and higher Self-transcendence scores in patients with asthma. Regression analysis revealed a significant effect between duration of illness and Persistence and Self-transcendence. Illness severity had a significant effect on the Harm Avoidance. Anxiety scores had significant effect on the Harm Avoidance, Self-directedness, and Self-transcendence. Depression scores had no significant effect on any of the TCI dimensions. Asthmatic patients can be distinguished by a specific pattern of temperament (low NS) and character (high ST) dimensions and compared with both psoriatic patients and healthy controls. Illness duration is associated with ST scores, and illness severity is associated with HA.
Viewing the Personality Traits Through a Cerebellar Lens: a Focus on the Constructs of Novelty Seeking, Harm Avoidance, and Alexithymia.

PubMed

Petrosini, Laura; Cutuli, Debora; Picerni, Eleonora; Laricchiuta, Daniela

2017-02-01

The variance in the range of personality trait expression appears to be linked to structural variance in specific brain regions. In evidencing associations between personality factors and neurobiological measures, it seems evident that the cerebellum has not been up to now thought as having a key role in personality. This paper will review the most recent structural and functional neuroimaging literature that engages the cerebellum in personality traits, as novelty seeking and harm avoidance, and it will discuss the findings in the context of contemporary theories of affective and cognitive cerebellar function. By using region of interest (ROI)- and voxel-based approaches, we recently evidenced that the cerebellar volumes correlate positively with novelty seeking scores and negatively with harm avoidance scores. Subjects who search for new situations as a novelty seeker does (and a harm avoiding does not do) show a different engagement of their cerebellar circuitries in order to rapidly adapt to changing environments. The emerging model of cerebellar functionality may explain how the cerebellar abilities in planning, controlling, and putting into action the behavior are associated to normal or abnormal personality constructs. In this framework, it is worth reporting that increased cerebellar volumes are even associated with high scores in alexithymia, construct of personality characterized by impairment in cognitive, emotional, and affective processing. On such a basis, it seems necessary to go over the traditional cortico-centric view of personality constructs and to address the function of the cerebellar system in sustaining aspects of motivational network that characterizes the different temperamental traits.
Altered striatal circuits underlie characteristic personality traits in Parkinson's disease.

PubMed

Ishii, Toru; Sawamoto, Nobukatsu; Tabu, Hayato; Kawashima, Hidekazu; Okada, Tomohisa; Togashi, Kaori; Takahashi, Ryosuke; Fukuyama, Hidenao

2016-09-01

Patients with Parkinson's disease (PD) have been suggested to share personality traits characterised by low novelty-seeking and high harm-avoidance. Although a link between novelty-seeking and dopamine is hypothesised, the link is not fully supported by 6-[(18)F]fluoro-L-dopa positron emission tomography (PET) studies. Meanwhile, tractography studies with magnetic resonance imaging (MRI) link personality to the connectivity of the striatum in healthy subjects. Here, we investigated neurochemical and anatomical correlates of characteristic personality traits in PD. Sixteen PD patients and 28 healthy controls were assessed using the Temperament and Character Inventory. All patients and 17 randomly selected controls were scanned with 2β-carbomethoxy-3β-(4-fluorophenyl)-[N-(11)C-methyl]tropane ([(11)C]CFT) PET to measure striatal dopamine transporter availability. All subjects were scanned with MRI to evaluate the connectivity of the striatum using probabilistic tractography. PET findings revealed no correlation of novelty-seeking and harm-avoidance with [(11)C]CFT uptake in patients or controls. Novelty-seeking correlated positively with the connectivity strength of the striatum with the hippocampus and amygdala in both patients and controls. Harm-avoidance and the fibre connectivity strength of the striatum including ventral area with the amygdala correlated negatively in patients and positively in controls, which differed significantly between the groups. Our data support the notion that the fibre connectivity of the striatum with limbic and frontal areas underlies the personality profile. Furthermore, our findings suggest that higher harm-avoidance in PD is linked to alterations of the network, including the nucleus accumbens and amygdala.
[Effects of anxiety and the COMT gene on cortical evoked potentials and performance effectiveness of selective attention].

PubMed

Alfimova, M V; Golimbet, V E; Lebedeva, I S; Korovaĭtseva, G I; Lezheĭko, T V

2014-01-01

We studied influence of the anxiety-related trait Harm Avoidance and the COMT gene, which is an important modulator of prefrontal functioning, on event-related potentials in oddball paradigm and performance effectiveness of selective attention. For 50 individuals accuracy and time of searching words among letters at any desired rate and then under an instruction to perform the task as quickly and accurate as possible were measured. Scores on the Harm Avoidance scale from Cloninger's Temperament and Character Inventory, N100 and P300 parameters, and COMTVa1158Met genotypes were obtained for them as well. Searching accuracy and time were mainly related to N100 amplitude. The COMT genotype and Harm Avoidance did not affect N100 amplitude; however, the N100 amplitude modulated their effects on accuracy and time dynamics. Harm Avoidance was positively correlated with P300 latency. The results suggest that anxiety and the COMT gene effects on performance effectiveness of selective attention depend on cognitive processes reflected in N100 parameters.
Sexually dimorphic effects of oxytocin receptor gene (OXTR ) variants on Harm Avoidance.

PubMed

Stankova, Trayana; Eichhammer, Peter; Langguth, Berthold; Sand, Philipp G

2012-07-30

Recent research has suggested that oxytocin receptor gene (OXTR) variants may account for individual differences in social behavior, the effects of stress and parenting styles. Little is known, however, on a putative role of the gene in heritable temperamental traits. We addressed effects of two common OXTR variants, rs237900 and rs237902, on personality dimensions in 99 healthy subjects using the Temperament and Character Inventory. When sex was controlled for and an OXTR genotype*sex interaction term was included in the regression model, 11% of the variance in Harm Avoidance could be explained (uncorrected p ≤ 0.01). Female carriers of the minor alleles scored highest, and a novel A217T mutation emerged in the most harm avoidant male participant. Findings lend support to a modulatory effect of common OXTR variants on Harm Avoidance in healthy caucasian women and invite resequencing of the gene in anxiety phenotypes to identify more explanatory functional variation.
How to tell a happy from an unhappy schizotype: personality factors and mental health outcomes in individuals with psychotic experiences.

PubMed

Alminhana, Letícia O; Farias, Miguel; Claridge, Gordon; Cloninger, Claude R; Moreira-Almeida, Alexander

2017-01-01

It is unclear why some individuals reporting psychotic experiences have balanced lives while others go on to develop mental health problems. The objective of this study was to test if the personality traits of harm avoidance, self-directedness, and self-transcendence can be used as criteria to differentiate healthy from unhealthy schizotypal individuals. We interviewed 115 participants who reported a high frequency of psychotic experiences. The instruments used were the Temperament and Character Inventory (140), Structured Clinical Interview for DSM-IV, and the Oxford-Liverpool Inventory of Feelings and Experiences. Harm avoidance predicted cognitive disorganization (β = 0.319; t = 2.94), while novelty seeking predicted bipolar disorder (β = 0.136, Exp [β] = 1.146) and impulsive non-conformity (β = 0.322; t = 3.55). Self-directedness predicted an overall decrease in schizotypy, most of all in cognitive disorganization (β = -0.356; t = -2.95) and in impulsive non-conformity (β = -0.313; t = -2.83). Finally, self-transcendence predicted unusual experiences (β = 0.256; t = 2.32). Personality features are important criteria to distinguish between pathology and mental health in individuals presenting high levels of anomalous experiences (AEs). While self-directedness is a protective factor, both harm avoidance and novelty seeking were predictors of negative mental health outcomes. We suggest that the impact of AEs on mental health is moderated by personality factors.
32 CFR 632.5 - Use of firearms.

Code of Federal Regulations, 2010 CFR

2010-07-01

... not fire if shots are likely to harm innocent bystanders. (3) Since warning shots could harm innocent bystanders, avoid firing them. However, when lesser degrees of force have failed, the law enforcement or.... If able to avoid hazards to innocent persons in these cases, fire warning shots. (4) Aim to disable...
Impact of temperament on depression and anxiety symptoms and depressive disorder in a population-based birth cohort.

PubMed

Nyman, Emma; Miettunen, Jouko; Freimer, Nelson; Joukamaa, Matti; Mäki, Pirjo; Ekelund, Jesper; Peltonen, Leena; Järvelin, Marjo-Riitta; Veijola, Juha; Paunio, Tiina

2011-06-01

The aim of this study was to characterize at the population level how innate features of temperament relate to experience of depressive mood and anxiety, and whether these symptoms have separable temperamental backgrounds. The study subjects were 4773 members of the population-based Northern Finland Birth Cohort 1966, a culturally and genetically homogeneous study sample. Temperament was measured at age 31 using the temperament items of the Temperament and Character Inventory and a separate Pessimism score. Depressive mood was assessed based on a previous diagnosis of depressive disorder or symptoms of depression according to the Hopkins Symptom Check List - 25. Anxiety was assessed analogously. High levels of Harm avoidance and Pessimism were related to both depressive mood (effect sizes; d=0.84 and d=1.25, respectively) and depressive disorder (d=0.68 and d=0.68, respectively). Of the dimensions of Harm avoidance, Anticipatory worry and Fatigability had the strongest effects. Symptoms of depression and anxiety showed very similar underlying temperament patterns. Although Harm avoidance and Pessimism appear to be important endophenotype candidates for depression and anxiety, their potential usefulness as endophenotypes, and whether they meet all the suggested criteria for endophenotypes will remain to be confirmed in future studies. Personality characteristics of Pessimism and Harm avoidance, in particular its dimensions Anticipatory worry and Fatigability, are strongly related to symptoms of depression and anxiety as well as to depressive disorder in this population. These temperamental features may be used as dimensional susceptibility factors in etiological studies of depression, which may aid in the development of improved clinical practice. Copyright © 2011 Elsevier B.V. All rights reserved.
Strategies for an effective tobacco harm reduction policy in Indonesia

PubMed Central

Nurwidya, Fariz; Takahashi, Fumiyuki; Baskoro, Hario; Hidayat, Moulid; Yunus, Faisal; Takahashi, Kazuhisa

2014-01-01

Tobacco consumption is a major causative agent for various deadly diseases such as coronary artery disease and cancer. It is the largest avoidable health risk in the world, causing more problems than alcohol, drug use, high blood pressure, excess body weight or high cholesterol. As countries like Indonesia prepare to develop national policy guidelines for tobacco harm reduction, the scientific community can help by providing continuous ideas and a forum for sharing and distributing information, drafting guidelines, reviewing best practices, raising funds, and establishing partnerships. We propose several strategies for reducing tobacco consumption, including advertisement interference, cigarette pricing policy, adolescent smoking prevention policy, support for smoking cessation therapy, special informed consent for smokers, smoking prohibition in public spaces, career incentives, economic incentives, and advertisement incentives. We hope that these strategies would assist people to avoid starting smoking or in smoking cessation. PMID:25518881
Neuroendocrine responses to fenfluramine and its relationship to personality in alcoholism.

PubMed

Weijers, H G; Wiesbeck, G A; Jakob, F; Böning, J

2001-01-01

This study investigates the relationship between personality and serotonergic reactivity in alcohol dependence. Personality characteristics were assessed according to the Temperament and Character model of Cloninger, the five-factor model of McCrae and Costa, Zuckerman's Sensation Seeking as well as Eysenck's impulsiveness/venturesomeness. Placebo-controlled prolactin response to the serotonin (5-HT) reuptake inhibitor/releaser fenfluramine served as an indicator for the reactivity of serotonergic neurotransmission. Forty abstinent alcohol-dependent men were subdivided into high and low prolactin responders according to their level of neuroendocrine response. High responders were characterized by decreased harm avoidance while their extraversion and venturesomeness scores were increased in comparison to low responders. The data demonstrates that harm avoidance on the one hand and extraversion/venturesomeness on the other are inversely correlated to serotonergic neurotransmission. These results support a specific relationship between personality traits and the serotonergic system.
School Bullying: Tools for Avoiding Harm and Liability

ERIC Educational Resources Information Center

McGrath, Mary Jo

2006-01-01

Every hour of every day, students experience bullying and harassment at school by their peers. The immediate and long-term impact on the victims' learning capabilities, emotional health, and self-esteem is staggering. " School Bullying: Tools for Avoiding Harm and Liability" tackles this critical problem with an easy-to-use framework that guides…
Self-Harm

MedlinePlus

... value. Skipping classes to change bandages or avoiding social occasions to prevent people from seeing your scars is a sign that your habit is negatively affecting work and relationships. Why People Self-harm Self-harm is not a mental illness, but ...
Association between A218C polymorphism of the tryptophan-hydroxylase-1 gene, harm avoidance and binge eating behavior in bulimia nervosa.

PubMed

Monteleone, Palmiero; Tortorella, Alfonso; Martiadis, Vassilis; Serino, Ismene; Di Filippo, Carmela; Maj, Mario

2007-06-21

Genes involved in serotonin transmission are likely involved in the biological predisposition to bulimia nervosa. We investigated whether the A218C polymorphism of the tryptophan-hydroxylase-1 gene was associated to bulimia nervosa and/or to some phenotypic aspects of the disorder. One hundred eighty Caucasian women (91 patients with bulimia nervosa and 89 healthy controls) were enrolled into the study. They underwent a blood sample collection for A218C polymorphism of the tryptophan-hydroxylase-1 genotyping and a clinical evaluation assessing comorbidity for Axis I and II psychiatric disorders, harm avoidance personality dimension and bulimic symptoms. The distribution of both tryptophan-hydroxylase-1 A218C genotypes and alleles did not significantly differ between patients and controls. Bulimic women with the AA genotype exhibited a more severe binge eating behavior and higher harm avoidance scores than those with CC genotype. These findings support the idea that tryptophan-hydroxylase-1 A218C polymorphism does not play a part in the genetic susceptibility to bulimia nervosa, but it seems to be involved in predisposing bulimic patients to a more disturbed eating behavior and higher harm avoidance.
Harm avoidance in adolescents modulates late positive potentials during affective picture processing.

PubMed

Zhang, Wenhai; Lu, Jiamei; Ni, Ziyin; Liu, Xia; Wang, Dahua; Shen, Jiliang

2013-08-01

Research in adults has shown that individual differences in harm avoidance (HA) modulate electrophysiological responses to affective stimuli. To determine whether HA in adolescents modulates affective information processing, we collected event-related potentials from 70 adolescents while they viewed 90 pictures from the Chinese affective picture system. Multiple regressions revealed that HA negatively predicted late positive potential (LPP) for positive pictures and positively predicted for negative pictures; however, HA did not correlate with LPP for neutral pictures. The results suggest that at the late evaluative stage, high-HA adolescents display attentional bias to negative pictures while low-HA adolescents display attentional bias to negative pictures. Moreover, these dissociable attentional patterns imply that individual differences in adolescents' HA modulate the late selective attention mechanism of affective information. Copyright © 2013. Published by Elsevier Ltd.
Improving the evidence base for services working with youth at-risk of involvement in the criminal justice system: developing a standardised program approach.

PubMed

Knight, Alice; Maple, Myfanwy; Shakeshaft, Anthony; Shakehsaft, Bernie; Pearce, Tania

2018-04-16

Young people who engage in multiple risk behaviour (high-risk young people) such as substance abuse, antisocial behaviour, low engagement in education and employment, self-harm or suicide ideation are more likely to experience serious harms later in life including homelessness, incarceration, violence and premature death. In addition to personal disadvantage, these harms represent an avoidable social and economic cost to society. Despite these harms, there is insufficient evidence about how to improve outcomes for high-risk young people. A key reason for this is a lack of standardisation in the way in which programs provided by services are defined and evaluated. This paper describes the development of a standardised intervention model for high-risk young people. The model can be used by service providers to achieve greater standardisation across their programs, outcomes and outcome measures. To demonstrate its feasibility, the model is applied to an existing program for high-risk young people. The development and uptake of a standardised intervention model for these programs will help to more rapidly develop a larger and more rigorous evidence-base to improve outcomes for high-risk young people.
What's the Harm? The Coverage of Ethics and Harm Avoidance in Research Methods Textbooks

ERIC Educational Resources Information Center

Dixon, Shane; Quirke, Linda

2018-01-01

Methods textbooks play a role in socializing a new generation of researchers about ethical research. How do undergraduate social research methods textbooks portray harm, its prevalence, and ways to mitigate harm to participants? We conducted a content analysis of ethics chapters in the 18 highest-selling undergraduate textbooks used in sociology…

Temperament affects sympathetic nervous function in a normal population.

PubMed

Kim, Bora; Lee, Jae-Hon; Kang, Eun-Ho; Yu, Bum-Hee

2012-09-01

Although specific temperaments have been known to be related to autonomic nervous function in some psychiatric disorders, there are few studies that have examined the relationship between temperaments and autonomic nervous function in a normal population. In this study, we examined the effect of temperament on the sympathetic nervous function in a normal population. Sixty eight healthy subjects participated in the present study. Temperament was assessed using the Korean version of the Cloninger Temperament and Character Inventory (TCI). Autonomic nervous function was determined by measuring skin temperature in a resting state, which was recorded for 5 minutes from the palmar surface of the left 5th digit using a thermistor secured with a Velcro® band. Pearson's correlation analysis and multiple linear regression were used to examine the relationship between temperament and skin temperature. A higher harm avoidance score was correlated with a lower skin temperature (i.e. an increased sympathetic tone; r=-0.343, p=0.004) whereas a higher persistence score was correlated with a higher skin temperature (r=0.433, p=0.001). Hierarchical linear regression analysis revealed that harm avoidance was able to predict the variance of skin temperature independently, with a variance of 7.1% after controlling for sex, blood pressure and state anxiety and persistence was the factor predicting the variance of skin temperature with a variance of 5.0%. These results suggest that high harm avoidance is related to an increased sympathetic nervous function whereas high persistence is related to decreased sympathetic nervous function in a normal population.
Temperament Affects Sympathetic Nervous Function in a Normal Population

PubMed Central

Kim, Bora; Lee, Jae-Hon; Kang, Eun-Ho

2012-01-01

Objective Although specific temperaments have been known to be related to autonomic nervous function in some psychiatric disorders, there are few studies that have examined the relationship between temperaments and autonomic nervous function in a normal population. In this study, we examined the effect of temperament on the sympathetic nervous function in a normal population. Methods Sixty eight healthy subjects participated in the present study. Temperament was assessed using the Korean version of the Cloninger Temperament and Character Inventory (TCI). Autonomic nervous function was determined by measuring skin temperature in a resting state, which was recorded for 5 minutes from the palmar surface of the left 5th digit using a thermistor secured with a Velcro® band. Pearson's correlation analysis and multiple linear regression were used to examine the relationship between temperament and skin temperature. Results A higher harm avoidance score was correlated with a lower skin temperature (i.e. an increased sympathetic tone; r=-0.343, p=0.004) whereas a higher persistence score was correlated with a higher skin temperature (r=0.433, p=0.001). Hierarchical linear regression analysis revealed that harm avoidance was able to predict the variance of skin temperature independently, with a variance of 7.1% after controlling for sex, blood pressure and state anxiety and persistence was the factor predicting the variance of skin temperature with a variance of 5.0%. Conclusion These results suggest that high harm avoidance is related to an increased sympathetic nervous function whereas high persistence is related to decreased sympathetic nervous function in a normal population. PMID:22993530
Temperament and character as schizophrenia-related endophenotypes in non-psychotic siblings.

PubMed

Smith, Matthew J; Cloninger, C Robert; Harms, Michael P; Csernansky, John G

2008-09-01

Quantitative endophenotypes are needed to better understand the pathogenesis of schizophrenia. The psychobiological model of temperament and character suggests that personality traits are heritable and regulated by brain systems influencing schizophrenia susceptibility. Thus, measures of temperament and character may serve as schizophrenia-related endophenotypes in individuals with schizophrenia and their non-psychotic siblings. Individuals with schizophrenia (n=35), their non-psychotic siblings (n=34), controls (n=63), and their siblings (n=56) participated in a study of the clinical, neurocognitive and neuromorphological characteristics of schizophrenia. A mixed-model approach assessed group differences on the Temperament and Character Inventory (TCI). Neurocognitive deficits and psychopathology were correlated with the TCI. Configurations of TCI domains were examined using a generalized linear model. Individuals with schizophrenia and their non-psychotic siblings had higher harm avoidance than controls and their siblings. Individuals with schizophrenia had lower self-directedness and cooperativeness, and higher self-transcendence than their non-psychotic siblings, controls, and the siblings of controls. Neurocognition was not related to temperament and character in individuals with schizophrenia or either control group. In non-psychotic siblings, self-directedness and cooperativeness were correlated with working memory and crystallized IQ. Evidence supports harm avoidance as a schizophrenia-related endophenotype. An increased risk of schizophrenia may be associated with asociality (configured as high harm avoidance and low reward dependence), schizotypy (configured as low self-directedness, low cooperativeness, and high self-transcendence), and neurocognitive deficits (poor executive functioning, working/episodic memory, attention, and low IQ). The non-psychotic siblings demonstrated features of a mature character profile including strong crystallized IQ, which may confer protection against psychopathology.
A positive relationship between harm avoidance and brain nicotinic acetylcholine receptor availability.

PubMed

Storage, Steven; Mandelkern, Mark A; Phuong, Jonathan; Kozman, Maggie; Neary, Meaghan K; Brody, Arthur L

2013-12-30

Prior research indicates that disturbance of cholinergic neurotransmission reduces anxiety, leading to the hypothesis that people with heightened cholinergic function have a greater tendency toward anxiety-like and/or harm-avoidant behavior. We sought to determine if people with elevated levels of harm avoidance (HA), a dimension of temperament from the Temperament and Character Inventory (TCI), have high α4β2* nicotinic acetylcholine receptor (nAChR) availability. Healthy adults (n=105; 47 non-smokers and 58 smokers) underwent bolus-plus-continuous infusion positron emission tomography (PET) scanning using the radiotracer 2-[18F]fluoro-3-(2(S)azetidinylmethoxy) pyridine (abbreviated as 2-FA). During the uptake period of 2-FA, participants completed the TCI. The central study analysis revealed a significant association between total HA and mean nAChR availability, with higher total HA scores being linked with greater nAChR availability. In examining HA subscales, both 'Fear of Uncertainty' and 'Fatigability' were significant, based on higher levels of these characteristics being associated with greater nAChR availabilities. This study adds to a growing body of knowledge concerning the biological basis of personality and may prove useful in understanding the pathophysiology of psychiatric disorders (such as anxiety disorders) that have similar characteristics to HA. Study findings may indicate that heightened cholinergic neurotransmission is associated with increased anxiety-like traits. Published by Elsevier Ireland Ltd.
A positive relationship between harm avoidance and brain nicotinic acetylcholine receptor availability

PubMed Central

Storage, Steven; Mandelkern, Mark A.; Phuong, Jonathan; Kozman, Maggie; Neary, Meaghan K.; Brody, Arthur L.

2013-01-01

Prior research indicates that disturbance of cholinergic neurotransmission reduces anxiety, leading to the hypothesis that people with heightened cholinergic function have a greater tendency toward anxiety-like and/or harm-avoidant behavior. We sought to determine if people with elevated levels of harm avoidance (HA), a dimension of temperament from the Temperament and Character Inventory (TCI), have high α4β2* nicotinic acetylcholine receptor (nAChR) availability. Healthy adults (n = 105; 47 non-smokers and 58 smokers) underwent bolus-plus-continuous infusion positron emission tomography (PET) scanning using the radiotracer 2-[18F]fluoro-3-(2(S)azetidinylmethoxy) pyridine (abbreviated as 2-FA). During the uptake period of 2-FA, participants completed the TCI. The central study analysis revealed a significant association between total HA and mean nAChR availability, with higher total HA scores being linked with greater nAChR availability. In examining HA subscales, both ‘Fear of Uncertainty’ and ‘Fatigability’ were significant, based on higher levels of these characteristics being associated with greater nAChR availabilities. This study adds to a growing body of knowledge concerning the biological basis of personality and may prove useful in understanding the pathophysiology of psychiatric disorders (such as anxiety disorders) that have similar characteristics to HA. Study findings may indicate that heightened cholinergic neurotransmission is associated with increased anxiety-like traits. PMID:24148908
Serotonin selectively influences moral judgment and behavior through effects on harm aversion

PubMed Central

Crockett, Molly J.; Clark, Luke; Hauser, Marc D.; Robbins, Trevor W.

2010-01-01

Aversive emotional reactions to real or imagined social harms infuse moral judgment and motivate prosocial behavior. Here, we show that the neurotransmitter serotonin directly alters both moral judgment and behavior through increasing subjects’ aversion to personally harming others. We enhanced serotonin in healthy volunteers with citalopram (a selective serotonin reuptake inhibitor) and contrasted its effects with both a pharmacological control treatment and a placebo on tests of moral judgment and behavior. We measured the drugs' effects on moral judgment in a set of moral 'dilemmas' pitting utilitarian outcomes (e.g., saving five lives) against highly aversive harmful actions (e.g., killing an innocent person). Enhancing serotonin made subjects more likely to judge harmful actions as forbidden, but only in cases where harms were emotionally salient. This harm-avoidant bias after citalopram was also evident in behavior during the ultimatum game, in which subjects decide to accept or reject fair or unfair monetary offers from another player. Rejecting unfair offers enforces a fairness norm but also harms the other player financially. Enhancing serotonin made subjects less likely to reject unfair offers. Furthermore, the prosocial effects of citalopram varied as a function of trait empathy. Individuals high in trait empathy showed stronger effects of citalopram on moral judgment and behavior than individuals low in trait empathy. Together, these findings provide unique evidence that serotonin could promote prosocial behavior by enhancing harm aversion, a prosocial sentiment that directly affects both moral judgment and moral behavior. PMID:20876101
Serotonin selectively influences moral judgment and behavior through effects on harm aversion.

PubMed

Crockett, Molly J; Clark, Luke; Hauser, Marc D; Robbins, Trevor W

2010-10-05

Aversive emotional reactions to real or imagined social harms infuse moral judgment and motivate prosocial behavior. Here, we show that the neurotransmitter serotonin directly alters both moral judgment and behavior through increasing subjects' aversion to personally harming others. We enhanced serotonin in healthy volunteers with citalopram (a selective serotonin reuptake inhibitor) and contrasted its effects with both a pharmacological control treatment and a placebo on tests of moral judgment and behavior. We measured the drugs' effects on moral judgment in a set of moral 'dilemmas' pitting utilitarian outcomes (e.g., saving five lives) against highly aversive harmful actions (e.g., killing an innocent person). Enhancing serotonin made subjects more likely to judge harmful actions as forbidden, but only in cases where harms were emotionally salient. This harm-avoidant bias after citalopram was also evident in behavior during the ultimatum game, in which subjects decide to accept or reject fair or unfair monetary offers from another player. Rejecting unfair offers enforces a fairness norm but also harms the other player financially. Enhancing serotonin made subjects less likely to reject unfair offers. Furthermore, the prosocial effects of citalopram varied as a function of trait empathy. Individuals high in trait empathy showed stronger effects of citalopram on moral judgment and behavior than individuals low in trait empathy. Together, these findings provide unique evidence that serotonin could promote prosocial behavior by enhancing harm aversion, a prosocial sentiment that directly affects both moral judgment and moral behavior.
Temperament and character traits in major depressive disorder: influence of mood state and recurrence of episodes.

PubMed

Nery, Fabiano G; Hatch, John P; Nicoletti, Mark A; Monkul, E Serap; Najt, Pablo; Matsuo, Koji; Cloninger, C Robert; Soares, Jair C

2009-01-01

The objective of this study was to compare personality traits between major depressive disorder (MDD) patients and healthy comparison subjects (HC) and examine if personality traits in patients are associated with specific clinical characteristics of the disorder. Sixty MDD patients (45 depressed, 15 remitted) were compared to 60 HC using the Temperament and Character Inventory. Analysis of covariance, with age and gender as covariates, was used to compare the mean Temperament and Character Inventory scores among the subject groups. Depressed MDD patients scored significantly higher than HC on novelty seeking, harm avoidance, and self-transcendence and lower on reward dependence, self-directedness, and cooperativeness. Remitted MDD patients scored significantly lower than HC only on self-directedness. Comorbidity with anxiety disorder had a main effect only on harm avoidance. Harm avoidance was positively correlated with depression intensity and with number of episodes. Self-directedness had an inverse correlation with depression intensity. MDD patients present a different personality profile from HC, and these differences are influenced by mood state and comorbid anxiety disorders. When considering patients who have been in remission for some time, the differences pertain to few personality dimensions. Cumulated number of depressive episodes may result in increased harm avoidance. (c) 2009 Wiley-Liss, Inc.
Looking for trouble? Diagnostics expanding disease and producing patients.

PubMed

Hofmann, Bjørn

2018-05-23

Novel tests give great opportunities for earlier and more precise diagnostics. At the same time, new tests expand disease, produce patients, and cause unnecessary harm in overdiagnosis and overtreatment. How can we evaluate diagnostics to obtain the benefits and avoid harm? One way is to pay close attention to the diagnostic process and its core concepts. Doing so reveals 3 errors that expand disease and increase overdiagnosis. The first error is to decouple diagnostics from harm, eg, by diagnosing insignificant conditions. The second error is to bypass proper validation of the relationship between test indicator and disease, eg, by introducing biomarkers for Alzheimer's disease before the tests are properly validated. The third error is to couple the name of disease to insignificant or indecisive indicators, eg, by lending the cancer name to preconditions, such as ductal carcinoma in situ. We need to avoid these errors to promote beneficial testing, bar harmful diagnostics, and evade unwarranted expansion of disease. Accordingly, we must stop identifying and testing for conditions that are only remotely associated with harm. We need more stringent verification of tests, and we must avoid naming indicators and indicative conditions after diseases. If not, we will end like ancient tragic heroes, succumbing because of our very best abilities. © 2018 John Wiley & Sons, Ltd.
What are school leavers' priorities for festival preparation?

PubMed

Hutton, Alison; Cusack, Lynette; Zannettino, Lana; Shaefer, Sarah J M; Verdonk, Naomi; Arbon, Paul

2015-01-01

This paper reports on the findings from a qualitative research study that explored how young people prepared to minimise and/or avoid alcohol-related harm while attending a Schoolies Festival (SF). SFs are mass gatherings at which young people (schoolies) celebrate their graduation from high school. The attendance of schoolies, in various Australian communities, ranges between 10 000 and 30 000 individuals during the event. The literature suggests that schoolies are at higher than normal risk of harm at SF from misuse of alcohol, unsafe sex, aggressive behaviour, and other risk-taking factors. As a result of these concerns, SF organisers developed an infrastructure that treats alcohol-related harm, and provides on-site care (first aid stations) by St John Ambulance staff. This study used focus groups to identify strategies used by schoolies to avoid alcohol-related harm during SFs. Data revealed that schoolies did not actively seek health information before attending the event and did not display an interest in doing so. It is important to note that schoolies planned to use alcohol to celebrate and have a good time. Therefore a harm minimisation approach with a focus on providing the necessary infrastructure at SFs to minimise the dangers associated with excess alcohol use is important. Schoolies indicated that they had no desire for information about the hazards of alcohol ingestion. If any health messages were to be used by health authorities, it would be far more appropriate to promote the message of 'take care of your mate', to contribute to building a supportive environment at the event. This may be of more benefit to minimise harm at SFs than funding other health messages.
The Precautionary Principle and the Tolerability of Blood Transfusion Risks.

PubMed

Kramer, Koen; Zaaijer, Hans L; Verweij, Marcel F

2017-03-01

Tolerance for blood transfusion risks is very low, as evidenced by the implementation of expensive blood tests and the rejection of gay men as blood donors. Is this low risk tolerance supported by the precautionary principle, as defenders of such policies claim? We discuss three constraints on applying (any version of) the precautionary principle and show that respecting these implies tolerating certain risks. Consistency means that the precautionary principle cannot prescribe precautions that it must simultaneously forbid taking, considering the harms they might cause. Avoiding counterproductivity requires rejecting precautions that cause more harm than they prevent. Proportionality forbids taking precautions that are more harmful than adequate alternatives. When applying these constraints, we argue, attention should not be restricted to harms that are human caused or that affect human health or the environment. Tolerating transfusion risks can be justified if available precautions have serious side effects, such as high social or economic costs.
Increased body mass index associated with increased harm avoidance and decreased self-directedness in Japanese women.

PubMed

Suzuki, Akihito; Kamata, Mitsuhiro; Matsumoto, Yoshihiko; Shibuya, Naoshi; Otani, Koichi

2009-03-01

Previous studies have suggested that body mass index (BMI) is related to personality traits, and that there may be gender specificity in this relationship. In the present study, the association between BMI and the 7 dimensions of the Temperament and Character Inventory was investigated in 567 Japanese healthy volunteers, with special attention on gender effects. Height and weight were self-reported, and BMI was calculated from these values. In the multiple regression analyses, higher BMI was related to higher scores of harm avoidance (p < 0.05) and lower scores of self-directedness (p < 0.01) in women, whereas BMI was not related to any Temperament and Character Inventory dimension in men. The present study suggests that increasing BMI is associated with increased harm avoidance and decreased self-directedness in women but not in men in healthy subjects.
GAD65 Promoter Polymorphism rs2236418 Modulates Harm Avoidance in Women via Inhibition/Excitation Balance in the Rostral ACC.

PubMed

Colic, Lejla; Li, Meng; Demenescu, Liliana Ramona; Li, Shija; Müller, Iris; Richter, Anni; Behnisch, Gusalija; Seidenbecher, Constanze I; Speck, Oliver; Schott, Björn H; Stork, Oliver; Walter, Martin

2018-05-30

Anxiety disorders are common and debilitating conditions with higher prevalence in women. However, factors that predispose women to anxiety phenotypes are not clarified. Here we investigated potential contribution of the single nucleotide polymorphism rs2236418 in GAD2 gene to changes in regional inhibition/excitation balance, anxiety-like traits, and related neural activity in both sexes. One hundred and five healthy individuals were examined with high-field (7T) multimodal magnetic resonance imaging (MRI); including resting-state functional MRI in combination with assessment of GABA and glutamate (Glu) levels via MR spectroscopy. Regional GABA/Glu levels in anterior cingulate cortex (ACC) subregions were assessed as mediators of gene-personality interaction for the trait harm avoidance and moderation by sex was tested. In AA homozygotes, with putatively lower GAD2 promoter activity, we observed increased intrinsic neuronal activity and higher inhibition/excitation balance in pregenual ACC (pgACC) compared with G carriers. The pgACC drove a significant interaction of genotype, region, and sex, where inhibition/excitation balance was significantly reduced only in female AA carriers. This finding was specific for rs2236418 as other investigated single nucleotide polymorphisms of the GABA synthesis related enzymes ( GAD1 , GAD2 , and GLS ) were not significant. Furthermore, only in women there was a negative association of pgACC GABA/Glu ratios with harm avoidance. A moderated-mediation model revealed that pgACC GABA/Glu also mediated the association between the genotype variant and level of harm avoidance, dependent on sex. Our data thus provide new insights into the neurochemical mechanisms that control emotional endophenotypes in humans and constitute predisposing factors for the development of anxiety disorders in women. SIGNIFICANCE STATEMENT Anxiety disorders are among the most common and burdensome psychiatric disorders, with higher prevalence rates in women. The causal mechanisms are, however, poorly understood. In this study we propose a neurobiological basis that could help to explain female bias of anxiety endophenotypes. Using magnetic resonance brain imaging and personality questionnaires we show an interaction of the genetic variation rs2236418 in the GAD2 gene and sex on GABA/glutamate (Glu) balance in the pregenual anterior cingulate cortex (pgACC), a region previously connected to affect regulation and anxiety disorders. The GAD2 gene polymorphism further influenced baseline neuronal activity in the pgACC. Importantly, GABA/Glu was shown to mediate the relationship between the genetic variant and harm avoidance, however, only in women. Copyright © 2018 the authors 0270-6474/18/385068-11$15.00/0.
Temperament and Character as Schizophrenia-Related Endophenotypes in Non-psychotic Siblings

PubMed Central

Smith, Matthew J.; Cloninger, C. Robert; Harms, Michael P.; Csernansky, John G.

2008-01-01

Background Quantitative endophenotypes are needed to better understand the pathogenesis of schizophrenia. The psychobiological model of temperament and character suggests that personality traits are heritable and regulated by brain systems influencing schizophrenia susceptibility. Thus, measures of temperament and character may serve as schizophrenia-related endophenotypes in individuals with schizophrenia and their non-psychotic siblings. Methods Individuals with schizophrenia (n=35), their non-psychotic siblings (n=34), controls (n=63), and their siblings (n=56) participated in a study of the clinical, cognitive and neuromorphological characteristics of schizophrenia. A mixed-model approach assessed group differences on the Temperament and Character Inventory (TCI). Neurocognitive deficits and psychopathology were correlated with the TCI. Configurations of TCI domains were examined using a generalized linear model. Results Individuals with schizophrenia and their siblings had higher harm avoidance than controls and their siblings. Individuals with schizophrenia had lower self-directedness and cooperativeness, and higher self-transcendence than their non-psychotic siblings, controls, and the siblings of controls. Neurocognition was not related to temperament and character in individuals with schizophrenia or either control group. In non-psychotic siblings, self-directedness and cooperativeness were correlated with working memory and crystallized IQ. Conclusion Evidence supports harm avoidance as a schizophrenia-related endophenotype. An increased risk of schizophrenia may be associated with asociality (configured as high harm avoidance and low reward dependence), schizotypy (configured as low self-directedness, low cooperativeness, and high self-transcendence), and neurocognitive deficits (poor executive functioning, working/episodic memory, attention, and low IQ). The non-psychotic siblings demonstrated features of a mature character profile including strong crystallized IQ, which may confer protection against psychopathology. PMID:18718739
Cruel to be kind but not cruel for cash: Harm aversion in the dictator game.

PubMed

Perera, Pri; Canic, Emina; Ludvig, Elliot A

2016-06-01

People regularly take prosocial actions, making individual sacrifices for the greater good. Similarly, people generally avoid causing harm to others. These twin desires to do good and avoid harm often align, but sometimes they can diverge, creating situations of moral conflict. Here, we examined this moral conflict using a modified dictator game. Participants chose how much money to allocate away from a recipient who was designated as an orphan, creating a sense of harm. This money was then reallocated to either the participant or a charity. People were strongly prosocial: they allocated more money away from the orphan for charity than for themselves. Furthermore, people left more money with the orphan when the harm was framed as a means (taking) than as a side effect (splitting). As is predicted by dual-process theories of moral decision making, response times were longer with the take action and were positively correlated with the amount taken from the orphan. We concluded that just as people take positive actions for the greater good, they are similarly more willing to cause harm when it benefits others rather than themselves.
High strength-high conductivity Cu--Fe composites produced by powder compaction/mechanical reduction

DOEpatents

Verhoeven, John D.; Spitzig, William A.; Gibson, Edwin D.; Anderson, Iver E.

1991-08-27

A particulate mixture of Cu and Fe is compacted and mechanically reduced to form an "in-situ" Cu-Fe composite having high strength and high conductivity. Compaction and mechanical reduction of the particulate mixture are carried out at a temperature and time at temperature selected to avoid dissolution of Fe into the Cu matrix particulates to a harmful extent that substantially degrades the conductivity of the Cu-Fe composite.
School Avoidance: Tips for Concerned Parents

MedlinePlus

... Threats of physical harm (as from a school bully) Actual physical harm Tips for Concerned Parents: As ... the classroom. If a problem like a school bully or an unreasonable teacher is the cause of ...
Depression and anxiety mediate the relationship between temperament and character and psychotic-like experiences in healthy subjects.

PubMed

Prochwicz, Katarzyna; Gawęda, Łukasz

2016-12-30

In this study we examined the hypothesis that depression and anxiety may mediate the relationship between personality traits and both positive and negative psychotic-like experiences (PLEs) in healthy adults. The Community Assessment of Psychic Experiences (CAPE) scale, Temperament and Character Inventory (TCI), Beck Depression Inventory (BDI) and State and Trait Anxiety Inventory (STAI) were administered to 492 healthy individuals. Multiple stepwise regression and mediation analyses were performed to examine whether depressive and anxiety symptoms influence the relationship between the TCI dimensions and positive and negative PLEs. Self-transcendence, persistence, novelty-seeking and self-directedness significantly predicted positive PLEs; self-directedness and harm avoidance were predictable for negative PLEs. Self-transcendence, self-directedness, persistence and harm avoidance also predicted the distress caused by positive PLEs, whereas self-directedness and harm avoidance predicted distress raised by negative PLEs. Depressive symptoms and the state of anxiety partially mediated the linkage between self-directedness and positive PLEs, and between self-directedness, harm avoidance and negative PLEs. Our findings confirm that the personality pattern influences both positive and negative PLEs as well as distress caused by experiencing positive and negative PLEs, and they indicate that certain personality traits may influence the development of PLEs via the emotional pathway of heightened depression and anxiety. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Responses of Earthworm to Aluminum Toxicity in Latosol

Treesearch

Jia-En Zhang; Jiayu Yu; Ying Ouyang; Huaqin Xu

2012-01-01

Excess aluminum (Al) in soils due to acid rain leaching is toxic to water resources and harmful to soil organisms and plants. This study investigated adverse impacts of Al levels upon earthworms (Eisenia fetida) from the latosol (acidic red soil). Laboratory experiments were performed to examine the survival and avoidance of earthworms from high Al...
Genetics of Taste and Smell: Poisons and Pleasures

PubMed Central

Reed, Danielle Renee; Knaapila, Antti

2012-01-01

Eating is dangerous. While food contains nutrients and calories that animals need to produce heat and energy, it may also contain harmful parasites, bacteria, or chemicals. To guide food selection, the senses of taste and smell have evolved to alert us to the bitter taste of poisons and the sour taste and off-putting smell of spoiled foods. These sensory systems help people and animals to eat defensively, and they provide the brake that helps them avoid ingesting foods that are harmful. But choices about which foods to eat are motivated by more than avoiding the bad; they are also motivated by seeking the good, such as fat and sugar. However, just as not everyone is equally capable of sensing toxins in food, not everyone is equally enthusiastic about consuming high-fat, high-sugar foods. Genetic studies in humans and experimental animals strongly suggest that the liking of sugar and fat is influenced by genotype; likewise, the abilities to detect bitterness and the malodors of rotting food are highly variable among individuals. Understanding the exact genes and genetic differences that affect food intake may provide important clues in obesity treatment by allowing caregivers to tailor dietary recommendations to the chemosensory landscape of each person. PMID:21036327

A definition and ethical evaluation of overdiagnosis.

PubMed

Carter, Stacy M; Degeling, Chris; Doust, Jenny; Barratt, Alexandra

2016-07-08

Overdiagnosis is an emerging problem in health policy and practice: we address its definition and ethical implications. We argue that the definition of overdiagnosis should be expressed at the level of populations. Consider a condition prevalent in a population, customarily labelled with diagnosis A. We propose that overdiagnosis is occurring in respect of that condition in that population when (1) the condition is being identified and labelled with diagnosis A in that population (consequent interventions may also be offered); (2) this identification and labelling would be accepted as correct in a relevant professional community; but (3) the resulting label and/or intervention carries an unfavourable balance between benefits and harms. We identify challenges in determining and weighting relevant harms, then propose three central ethical considerations in overdiagnosis: the extent of harm done, whether harm is avoidable and whether the primary goal of the actor/s concerned is to benefit themselves or the patient, citizen or society. This distinguishes predatory (avoidable, self-benefiting), misdirected (avoidable, other-benefiting) and tragic (unavoidable, other-benefiting) overdiagnosis; the degree of harm moderates the justifiability of each type. We end with four normative challenges: (1) methods for adjudicating between professional standards and identifying relevant harms and benefits should be procedurally just; (2) individuals, organisations and states are differently responsible for addressing overdiagnosis; (3) overdiagnosis is a matter for distributive justice: the burdens of both overdiagnosis and its prevention could fall on the least-well-off; and (4) communicating about overdiagnosis risks harming those unaware that they may have been overdiagnosed. These challenges will need to be addressed as the field develops. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Feasibility and Safety of a Virtual Reality Dodgeball Intervention for Chronic Low Back Pain: A Randomized Clinical Trial

PubMed Central

Thomas, James S.; France, Christopher R.; Applegate, Megan E.; Leitkam, Samuel T.; Walkowski, Stevan

2016-01-01

Whereas the fear-avoidance model of chronic low back pain (CLBP) posits a generic avoidance of movement that is perceived as threatening, we have repeatedly shown that individuals with high fear and CLBP specifically avoid flexion of the lumbar spine. Accordingly, we developed a virtual dodgeball intervention designed to elicit graded increases in lumbar spine flexion while reducing expectations of fear and harm by engaging participants in a competitive game that is both entertaining and distracting. We recruited 52 participants (48% female) with CLBP and high fear of movement and randomized them to either a game group (n=26) or a control group (n=26). All participants completed a pregame baseline and a follow up assessment (4–6 days later) of lumbar spine motion and expectations of pain and harm during standardized reaches to high (easier), middle, and low (hardest to reach) targets. For three consecutive days, participants in the game group completed 15 minutes of virtual dodgeball between baseline and follow up. For the standardized reaching tests, there were no significant effects of group on changes in lumbar spine flexion, expected pain, or expected harm. However, virtual dodgeball was effective at increasing lumbar flexion within and across gameplay sessions. Participants reported strong positive endorsement of the game, no increases in medication use, pain, or disability, and no adverse events. Although these findings indicate that very brief exposure to this game did not translate to significant changes outside the game environment, this was not surprising given that graded exposure therapy for fear of movement among individuals with low back pain typically last 8–12 sessions. Given the demonstration of safety, feasibility and ability to encourage lumbar flexion within gameplay, these findings provide support for a clinical trial wherein the treatment dose is more consistent with traditional graded-exposure approaches to CLBP. PMID:27616607
High strength-high conductivity Cu-Fe composites produced by powder compaction/mechanical reduction

DOEpatents

Verhoeven, J.D.; Spitzig, W.A.; Gibson, E.D.; Anderson, I.E.

1991-08-27

A particulate mixture of Cu and Fe is compacted and mechanically reduced to form an ''in-situ'' Cu-Fe composite having high strength and high conductivity. Compaction and mechanical reduction of the particulate mixture are carried out at a temperature and time at temperature selected to avoid dissolution of Fe into the Cu matrix particulates to a harmful extent that substantially degrades the conductivity of the Cu-Fe composite. 5 figures.
Weighing up the benefits and harms of a new anti-cancer drug: a survey of Australian oncologists.

PubMed

Chim, L; Salkeld, G; Stockler, M R; Mileshkin, L

2015-08-01

Little is known about the relative importance that oncologists attribute to the benefits and harms of anti-cancer drugs when considering treatment options with their patients. To quantify the trade-offs made between overall survival, progression-free survival and adverse effects. A web-based survey elicited importance weights for the benefits and harms of bevacizumab or everolimus. Combining the importance weights with trial-based probabilities produced a score and ranking for each treatment option. A total of 40 responses was received for the bevacizumab scenario and 32 for the everolimus scenario. All respondents regarded overall survival and progression-free survival as the most important attributes - more important than avoiding the potential harms regardless of drugs. Among the potential harms, respondents allocated the highest mean importance weight to gastrointestinal (GI) perforation and rated absolute improvement in overall survival as 1.6 times and 2.3 times as important as avoiding GI perforation in the two versions of the bevacizumab scenario respectively. For the everolimus scenario, stomatitis and pneumonitis were allocated the highest mean importance weights with absolute improvement in overall survival rated as 2.2 times as important as avoiding stomatitis/pneumonitis. All 40 respondents (100%) favoured treatment option with bevacizumab to no bevacizumab based on respondents' determined weights for treatment attributes. The converse was found for everolimus with 22 (69%) of respondents preferring the 'no everolimus' option. Oncologists' preferences over the benefits and harms of treatment do, when combined with evidence of effect, influence treatment decisions for anti-cancer drugs. © 2015 Royal Australasian College of Physicians.
A meta-analysis of temperament in eating disorders.

PubMed

Atiye, Minna; Miettunen, Jouko; Raevuori-Helkamaa, Anu

2015-03-01

Although suggested as an important contributor to the development and maintenance of eating disorders, temperament has not previously been studied adopting a meta-analytical approach. We therefore pooled data (N = 14 studies; N = 3315 cases, N = 3395 controls) on Cloninger's temperament traits (novelty seeking, harm avoidance, reward dependence and persistence) in anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED) and eating disorders not otherwise specified. Persistence was significantly higher than in the controls in all eating disorders except for BED the highest levels being observed in AN. Correspondingly, the highest effect sizes for harm avoidance were seen in AN. Novelty seeking was significantly elevated relative to the controls only in BN. Harm avoidance was significantly lower, and reward dependence was significantly higher in individuals who had recovered from AN than in those who remained ill. Future studies with a longitudinal design are needed to explore the temporal relationships between eating disorders and temperament traits. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.
Women's Benefits and Harms Trade-Offs in Breast Cancer Screening: Results from a Discrete-Choice Experiment.

PubMed

Sicsic, Jonathan; Pelletier-Fleury, Nathalie; Moumjid, Nora

2018-01-01

Over the past decade, the benefits and harms balance of breast cancer (BC) screening has been widely debated. To elicit women's trade-offs between the benefits and harms of BC screening and to analyze the main determinants of these trade-offs. A discrete-choice experiment with seven attributes depicting BC screening programs including varying levels of BC mortality, overdiagnosis, and false-positive result was used. Eight hundred twelve women aged 40 to 74 years with no personal history of BC recruited by a survey institute and representative of the French general population (age, socioeconomic level, and geographical location) completed the discrete-choice experiment. Preference heterogeneity was investigated using generalized multinomial logit models from which individual trade-offs were derived, and their main determinants were assessed using generalized linear models. Screening acceptance rates under various benefits and harms ratios were simulated on the basis of the distribution of individual preferences. The women would be willing to accept on average 14.1 overdiagnosis cases (median = 9.6) and 47.8 false-positive results (median = 27.2) to avoid one BC-related death. After accounting for preference heterogeneity, less than 50% of women would be willing to accept 10 overdiagnosis cases for one BC-related death avoided. Screening acceptance rates were higher among women with higher socioeconomic level and lower among women with poor health. Women are sensitive to both the benefits and the harms of BC screening and their preferences are highly heterogeneous. Our study provides useful results for public health authorities and clinicians willing to improve their recommendations of BC screening on the basis of women's preferences. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
Intervening in the psychopath's brain.

PubMed

Glannon, Walter

2014-02-01

Psychopathy is a disorder involving personality and behavioral features associated with a high rate of violent aggression and recidivism. This paper explores potential psychopharmacological therapies to modulate dysfunctional neural pathways in psychopaths and reduce the incidence of their harmful behavior, as well as the ethical and legal implications of offering these therapies as an alternative to incarceration. It also considers whether forced psychopharmacological intervention in adults and children with psychopathic traits manifesting in violent behavior can be justified. More generally, the paper addresses the question of how to weigh the psychopath's presumptive right to non-interference in his brain and mind against the public interest in avoiding harm.
Feasibility and Safety of a Virtual Reality Dodgeball Intervention for Chronic Low Back Pain: A Randomized Clinical Trial.

PubMed

Thomas, James S; France, Christopher R; Applegate, Megan E; Leitkam, Samuel T; Walkowski, Stevan

2016-12-01

Whereas the fear-avoidance model of chronic low back pain (CLBP) posits a generic avoidance of movement that is perceived as threatening, we have repeatedly shown that individuals with high fear and CLBP specifically avoid flexion of the lumbar spine. Accordingly, we developed a virtual dodgeball intervention designed to elicit graded increases in lumbar spine flexion while reducing expectations of fear and harm by engaging participants in a competitive game that is entertaining and distracting. We recruited 52 participants (48% female) with CLBP and high fear of movement and randomized them to either a game group (n = 26) or a control group (n = 26). All participants completed a pregame baseline and a follow-up assessment (4-6 days later) of lumbar spine motion and expectations of pain and harm during standardized reaches to high (easier), middle, and low (hardest to reach) targets. For 3 consecutive days, participants in the game group completed 15 minutes of virtual dodgeball between baseline and follow-up. For the standardized reaching tests, there were no significant effects of group on changes in lumbar spine flexion, expected pain, or expected harm. However, virtual dodgeball was effective at increasing lumbar flexion within and across gameplay sessions. Participants reported strong positive endorsement of the game, no increases in medication use, pain, or disability, and no adverse events. Although these findings indicate that very brief exposure to this game did not translate to significant changes outside the game environment, this was not surprising because graded exposure therapy for fear of movement among individuals with low back pain typically last 8 to 12 sessions. Because of the demonstration of safety, feasibility, and ability to encourage lumbar flexion within gameplay, these findings provide support for a clinical trial wherein the treatment dose is more consistent with traditional graded exposure approaches to CLBP. This study of a virtual reality dodgeball intervention provides evidence of feasibility, safety, and utility to encourage lumbar spine flexion among individuals with CLBP and high fear of movement. Copyright Â© 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.
On balance: weighing harms and benefits in fundamental neurological research using nonhuman primates.

PubMed

Arnason, Gardar; Clausen, Jens

2016-06-01

One of the most controversial areas of animal research is the use of nonhuman primates for fundamental research. At the centre of the controversy is the question of whether the benefits of research outweigh the harms. We argue that the evaluation of harms and benefits is highly problematic. We describe some common procedures in neurological research using nonhuman primates and the difficulties in evaluating the harm involved. Even if the harm could be quantified, it is unlikely that it could be meaningfully aggregated over different procedures, let alone different animals. A similar problem arises for evaluating benefits. It is not clear how benefits could be quantified, and even if they could be, values for different aspects of expected benefits cannot be simply added up. Sorting harms and benefits in three or four categories cannot avoid the charge of arbitrariness and runs the risk of imposing its structure on the moral decision. The metaphor of weighing or balancing harms and benefits is inappropriate for the moral decision about whether to use nonhuman primates for research. Arguing that the harms and benefits in this context are incommensurable, we suggest describing the moral consideration of harms and benefits as a coherent trade-off. Such a decision does not require commensurability. It must be well-informed about the suffering involved and the potential benefits, it must be consistent with the legal, regulatory and institutional framework within which it is made, and it must cohere with other judgments in relevant areas.
Genetics of taste and smell: poisons and pleasures.

PubMed

Reed, Danielle Renee; Knaapila, Antti

2010-01-01

Eating is dangerous. While food contains nutrients and calories that animals need to produce heat and energy, it may also contain harmful parasites, bacteria, or chemicals. To guide food selection, the senses of taste and smell have evolved to alert us to the bitter taste of poisons and the sour taste and off-putting smell of spoiled foods. These sensory systems help people and animals to eat defensively, and they provide the brake that helps them avoid ingesting foods that are harmful. But choices about which foods to eat are motivated by more than avoiding the bad; they are also motivated by seeking the good, such as fat and sugar. However, just as not everyone is equally capable of sensing toxins in food, not everyone is equally enthusiastic about consuming high-fat, high-sugar foods. Genetic studies in humans and experimental animals strongly suggest that the liking of sugar and fat is influenced by genotype; likewise, the abilities to detect bitterness and the malodors of rotting food are highly variable among individuals. Understanding the exact genes and genetic differences that affect food intake may provide important clues in obesity treatment by allowing caregivers to tailor dietary recommendations to the chemosensory landscape of each person. Copyright © 2010 Elsevier Inc. All rights reserved.
Anxiety and inattention as predictors of achievement in early elementary school children.

PubMed

Grills-Taquechel, Amie E; Fletcher, Jack M; Vaughn, Sharon R; Denton, Carolyn A; Taylor, Pat

2013-01-01

The objective of this study was to examine the relations among anxiety, inattention, and math/reading achievement, as well as the mediating/moderating role of inattention in the anxiety-achievement association both concurrently and longitudinally. Participants included 161 ethnically diverse children (aged 6-8) and their teachers. At the middle and end of first grade (approximately 5 months apart), students completed measures of anxiety and achievement while their teachers completed a measure of inattention. For the concurrent analyses, greater harm avoidance anxiety was associated with better attention, which was in turn related to better achievement. For the longitudinal analyses, mid-year inattention interacted with harm avoidance and separation anxiety to predict end of year reading fluency. For those rated as more attentive, greater separation anxiety symptoms were associated with decreased fluency performance while greater harm avoidance symptoms were associated with increased performance. Findings were discussed in terms of the importance of considering socioemotional variables in the study of children's academic achievement and the potential utility of early anxiety prevention/intervention programs, especially for children experiencing academic difficulties who also show internalizing behaviors.
Anxiety and Inattention as Predictors of Achievement in Early Elementary School Children

PubMed Central

Fletcher, Jack M.; Vaughn, Sharon R.; Denton, Carolyn A.; Taylor, Pat

2012-01-01

The objective of this study was to examine the relations among anxiety, inattention, and math/reading achievement, as well as the mediating/moderating role of inattention in the anxiety-achievement association both concurrently and longitudinally. Participants included 161 ethnically diverse children (aged 6–8) and their teachers. At the middle and end of first-grade (approximately 5 months apart), students completed measures of anxiety and achievement while their teachers completed a measure of inattention. For the concurrent analyses, greater harm avoidance anxiety was associated with better attention, which was in turn related to better achievement. For the longitudinal analyses, mid-year inattention interacted with harm avoidance and separation anxiety to predict end of year reading fluency. For those rated as more attentive, greater separation anxiety symptoms were associated with decreased fluency performance while greater harm avoidance symptoms were associated with increased performance. Findings were discussed in terms of the importance of considering socioemotional variables in the study of children’s academic achievement and the potential utility of early anxiety prevention/intervention programs, especially for children experiencing academic difficulties who also show internalizing behaviors. PMID:22764776
Child Temperament, Maternal Parenting Behavior, and Child Social Functioning

PubMed Central

Baer, Julie; Schreck, Meghan; Rettew, David C.; Harder, Valerie S.; Ayer, Lynsay; Albaugh, Matthew D.; Crehan, Eileen T.; Kuny-Slock, Ana V.; Hudziak, James J.

2014-01-01

We examined child temperament, maternal parenting, and the effects of their interactions with each other on child social functioning. A total of 355 children aged 5–18 years old (54% male; mean age=10.8) were evaluated. Regression equations were used to test models of the main and interactive effects of temperament and maternal parenting behavior on the Social Problems and Social Competence Subscales of the Child Behavior Checklist (CBCL), a questionnaire assessing internalizing and externalizing behavior problems in children ages 4 to 18. Higher levels of child Novelty Seeking and Harm Avoidance and lower levels of Persistence were significantly associated with poorer social functioning. When accounting for child temperament, neither maternal parenting nor the interaction between maternal parenting and child temperament were significantly associated with social functioning. However, the interaction between maternal positive involvement and harm avoidance trended toward significance, such that at higher levels of harm avoidance, more extreme levels of maternal positive involvement were related to lower levels of social functioning. Further research on the interplay between child temperament and parenting across different stages of development is warranted. PMID:26085784
High-Temperature Adhesives for Thermally Stable Aero-Assist Technologies

NASA Technical Reports Server (NTRS)

Eberts, Kenneth; Ou, Runqing

2013-01-01

Aero-assist technologies are used to control the velocity of exploration vehicles (EVs) when entering Earth or other planetary atmospheres. Since entry of EVs in planetary atmospheres results in significant heating, thermally stable aero-assist technologies are required to avoid the high heating rates while maintaining low mass. Polymer adhesives are used in aero-assist structures because of the need for high flexibility and good bonding between layers of polymer films or fabrics. However, current polymer adhesives cannot withstand temperatures above 400 C. This innovation utilizes nanotechnology capabilities to address this need, leading to the development of high-temperature adhesives that exhibit high thermal conductivity in addition to increased thermal decomposition temperature. Enhanced thermal conductivity will help to dissipate heat quickly and effectively to avoid temperature rising to harmful levels. This, together with increased thermal decomposition temperature, will enable the adhesives to sustain transient high-temperature conditions.
Exploring the Relationship between Experiential Avoidance, Alcohol Use Disorders, and Alcohol-Related Problems among First-Year College Students

ERIC Educational Resources Information Center

Levin, Michael E.; Lillis, Jason; Seeley, John; Hayes, Steven C.; Pistorello, Jacqueline; Biglan, Anthony

2012-01-01

Objective: This study explored the relationship of experiential avoidance (eg, the tendency to avoid, suppress, or otherwise control internal experiences even when doing so causes behavioral harm) to alcohol use disorders and alcohol-related problems. Participants: Cross-sectional data were collected from 240 undergraduate college students in…
42 CFR 441.468 - Service plan elements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Optional Self-Directed Personal Assistance Services Program § 441.468 Service plan elements. (a) The... identification of risks that may pose harm to the participant along with a written individualized backup plan for... planning for avoiding, risks that may pose harm to a participant. (c) All of the State's applicable...
42 CFR 441.468 - Service plan elements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Optional Self-Directed Personal Assistance Services Program § 441.468 Service plan elements. (a) The... identification of risks that may pose harm to the participant along with a written individualized backup plan for... planning for avoiding, risks that may pose harm to a participant. (c) All of the State's applicable...
42 CFR 441.468 - Service plan elements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Optional Self-Directed Personal Assistance Services Program § 441.468 Service plan elements. (a) The... identification of risks that may pose harm to the participant along with a written individualized backup plan for... planning for avoiding, risks that may pose harm to a participant. (c) All of the State's applicable...
42 CFR 441.468 - Service plan elements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Optional Self-Directed Personal Assistance Services Program § 441.468 Service plan elements. (a) The... identification of risks that may pose harm to the participant along with a written individualized backup plan for... planning for avoiding, risks that may pose harm to a participant. (c) All of the State's applicable...
Temperament and character modify risk of drug addiction and influence choice of drugs.

PubMed

Milivojevic, Dragan; Milovanovic, Srdjan D; Jovanovic, Minja; Svrakic, Dragan M; Svrakic, Nenad M; Svrakic, Slobodan M; Cloninger, C Robert

2012-01-01

Drug addiction and alcoholism involve a complex etiopathogenesis with a variable degree of risk contributions from the host (person), environment, and addictive substances. In this work, temperament and character features of individuals addicted to opiates or alcohol are compared with normal controls to study personality factors in the overall risk for drug addiction. The study was done in a permissive environment, with easy access to alcohol and heroin, which facilitated analyses of personality factors in drug choice. Participants included 412 consecutive patients (312 opiate addicts, 100 alcohol addicts) treated at the Specialized Hospital for Chemical Dependency in Belgrade, Serbia, and a community sample of 346 controls. Opiate addicts manifested antisocial temperament configuration (high Novelty Seeking, low Reward Dependence) coupled with high Self-transcendence (ie, susceptibility to fantasy and imagination). Alcohol addicts manifested sensitive temperament configuration (high Novelty Seeking coexisting with high Harm Avoidance). Immature personality was observed far more frequently in opiate addicts than in alcoholics or normals. Novelty Seeking appears to be a general risk factor for drug addiction. High Harm Avoidance appears to channel individuals with high Novelty Seeking towards alcoholism. Immature character traits and probable Personality Disorder increase the risk of illegal drugs. Based on equivalent research in nonpermissive environments, at least a portion of our opiate addicts could have developed alcoholism instead in environments with more limited access to opiates. Personality factors provide useful guidelines for preventive work with young individuals with personality risk factors for drug addiction. Copyright © American Academy of Addiction Psychiatry.

Needs and fears of young people presenting at accident and emergency department following an act of self-harm: secondary analysis of qualitative data.

PubMed

Owens, Christabel; Hansford, Lorraine; Sharkey, Siobhan; Ford, Tamsin

2016-03-01

Presentation at an accident and emergency (A&E) department is a key opportunity to engage with a young person who self-harms. The needs of this vulnerable group and their fears about presenting to healthcare services, including A&E, are poorly understood. To examine young people's perceptions of A&E treatment following self-harm and their views on what constitutes a positive clinical encounter. Secondary analysis of qualitative data from an experimental online discussion forum. Threads selected for secondary analysis represent the views of 31 young people aged 16-25 with experience of self-harm. Participants reported avoiding A&E whenever possible, based on their own and others' previous poor experiences. When forced to seek emergency care, they did so with feelings of shame and unworthiness. These feelings were reinforced when they received what they perceived as punitive treatment from A&E staff, perpetuating a cycle of shame, avoidance and further self-harm. Positive encounters were those in which they received 'treatment as usual', i.e. non-discriminatory care, delivered with kindness, which had the potential to challenge negative self-evaluation and break the cycle. The clinical needs of young people who self-harm continue to demand urgent attention. Further hypothesis testing and trials of different models of care delivery for this vulnerable group are warranted. © The Royal College of Psychiatrists 2016.
Harm avoiders suppress motor resonance to observed immoral actions

PubMed Central

Candidi, Matteo; Sforza, Anna Laura; Aglioti, Salvatore Maria

2015-01-01

Motor resonance (MR) contingent upon action observation is thought to occur largely automatically. Although recent studies suggest that this process is not completely impervious to top-down modulations, much less is known on the possible role of the moral connotation of observed action goal in modulating MR. Here, we explored whether observing actions with different moral connotations modulates MR and whether any modulation depends on the onlookers’ personality. To this aim, we recorded motor potentials evoked by single-pulse transcranial magnetic stimulation from hand muscles of participants who were watching images of a model performing hand actions with the same postures and low-level goals (i.e. grasping an object) but with different moral connotations (‘stealing a wallet’ vs ‘picking up a notepaper’). Participants’ personality traits were measured using the temperament and character inventory. Results show a selective suppression of corticospinal excitability during observation of immoral actions in individuals with high scores in harm avoidance, a personality trait characterized by excessive worrying and fearfulness. Thus, a combination of dispositional (personality traits) and situational (morality of an action) variables appears to influence MR with the observed actions. PMID:24526183
Exposure to community violence and self-harm in California: A multi-level, population-based, case-control study.

PubMed

Matthay, Ellicott C; Farkas, Kriszta; Skeem, Jennifer; Ahern, Jennifer

2018-06-07

Self-harm is a leading cause of morbidity and mortality. Exposure to community violence is an important and potentially modifiable feature of the social environment that may affect self-harm, but studies to date are limited in the samples and outcomes examined. We conducted a population-based, nested case-control study. Cases were all deaths and hospital visits due to self-harm in California, 2006-2013. We frequency-matched California resident population-based controls from the American Community Survey to cases on age, gender, race/ethnicity, and year of survey/injury. We assessed past-year community violence using deaths and hospital visits due to interpersonal violence in the community of residence. We estimated risk-difference parameters that were defined to avoid extrapolation and to capture associations between changes in the distribution of community violence and the population-level risk of self-harm. After adjustment for confounders, setting past-year community violence to the lowest monthly levels observed within each community over the study period was associated with a 30.1 (95% CI: 29.6 to 30.5) per 100,000 persons per year lower risk of nonfatal self-harm, but no difference in the risk of fatal self-harm. Associations for a parameter corresponding to a hypothetical violence prevention intervention targeting high-violence communities indicated a 5% decrease in self-harm at the population level. In sensitivity analyses, results were robust. This study strengthens evidence on the relationship between community violence and self-harm. Future research should investigate reasons for differential associations by age and gender and whether community violence prevention programs have meaningful impacts on self-harm.
Temperament and character personality profile in relation to suicidal ideation and suicide attempts in major depressed patients.

PubMed

Conrad, Rupert; Walz, Frank; Geiser, Franziska; Imbierowicz, Katrin; Liedtke, Reinhard; Wegener, Ingo

2009-12-30

To prevent suicidal behaviour, it is important to better understand those personality traits associated with suicidal ideation and suicide attempts. A sample of 394 consecutive major depressed outpatients admitted to Bonn University Hospital was subdivided into three groups: Lifetime suicide attempters (N=32; 8.1%), suicide ideators (N=133) and patients without suicide ideation (N=229). Psychodiagnostic measures embraced the Temperament and Character Inventory (TCI), the Symptom Checklist-90-R and the Hamilton Depression Rating Scale. Suicide attempters and ideators showed higher scores on emotional distress and depression. Analysis of covariance (covariates: age, gender, depression) revealed that suicide attempters score higher on the temperament dimension harm avoidance compared with non-attempters. Suicide ideators could be distinguished from non-ideators by character dimensions in terms of lower self-directedness and higher self-transcendence. Our findings suggest that high harm avoidance is a personality trait associated with suicide attempt in major depression, whereas low self-directedness and high self-transcendence are related to suicidal ideation. As temperament dimensions represent the "emotional core" and character dimensions the "cognitive core" of personality, we discuss whether Cloninger's psychobiological model might be helpful to distinguish between non-suicide ideators, patients who do think about suicide, and patients initiating suicidal behaviour.
Tridimensional personality questionnaire: assessment in patients with social phobia and a control group.

PubMed

Kim, S W; Hoover, K M

1996-02-01

We administered the Tridimensional Personality Questionnaire to 40 control subjects and to 47 social phobia patients who met Structured Clinical Interview for DSM-III-R (SCID) criteria for social phobia and participated in a multicenter treatment study. Multiple comparisons with Bonferroni correction showed a significant increase in total Harm Avoidance scale scores and all four subscale scores for the social phobia group. On a Reward Dependence subscale that measures persistence versus irresoluteness the mean was significantly lower in the social phobia group than the control group. Present findings extend an earlier report of increased Harm Avoidance in major depressive disorder and other clinical diagnostic groups.
Premorbid personality in chronic fatigue syndrome as determined by the Temperament and Character Inventory.

PubMed

Fukuda, Sanae; Kuratsune, Hirohiko; Tajima, Seiki; Takashima, Shoko; Yamagutchi, Kouzi; Nishizawa, Yoshiki; Watanabe, Yasuyoshi

2010-01-01

Using the Temperament and Character Inventory (TCI), we examined personality characteristics in patients with chronic fatigue syndrome (CFS) compared with healthy control subjects, and CFS patients with and without psychiatric diseases. There have been no previous reports assessing personality in CFS patients using the TCI. A total of 211 CFS patients and 90 control subjects completed the TCI and the Chalder Fatigue Scale questionnaires. Compared with control subjects, CFS patients demonstrated significantly lower premorbid Novelty Seeking, and higher Harm Avoidance and persistence. The fatigue score for CFS patients with psychiatric diseases was higher than that for CFS patients without psychiatric diseases. Patients with CFS with psychiatric diseases showed lower premorbid Self-Directedness when compared with CFS patients without psychiatric diseases. The fatigue score was negatively correlated with premorbid Self-Directedness and Cooperativeness, and positively correlated with Harm Avoidance among CFS patients. This study supported the stereotyped image of CFS patients as perfectionists, which is similar to the Persistence score, and neurotics, which is similar to the Harm Avoidance score. Patients displaying greater neuroticisms and poorer social and communication skills, similar to the Self-Directedness and Cooperativeness scores, tend to have intercurrent psychiatry diseases and show more severe symptoms of CFS.
Spatial filter with volume gratings for high-peak-power multistage laser amplifiers

NASA Astrophysics Data System (ADS)

Tan, Yi-zhou; Yang, Yi-sheng; Zheng, Guang-wei; Shen, Ben-jian; Pan, Heng-yue; Liu, Li

2010-08-01

The regular spatial filters comprised of lens and pinhole are essential component in high power laser systems, such as lasers for inertial confinement fusion, nonlinear optical technology and directed-energy weapon. On the other hand the pinhole is treated as a bottleneck of high power laser due to harmful plasma created by the focusing beam. In this paper we present a spatial filter based on angular selectivity of Bragg diffraction grating to avoid the harmful focusing effect in the traditional pinhole filter. A spatial filter consisted of volume phase gratings in two-pass amplifier cavity were reported. Two-dimensional filter was proposed by using single Pi-phase-shifted Bragg grating, numerical simulation results shown that its angular spectrum bandwidth can be less than 160urad. The angular selectivity of photo-thermorefractive glass and RUGATE film filters, construction stability, thermal stability and the effects of misalignments of gratings on the diffraction efficiencies under high-pulse-energy laser operating condition are discussed.
[Application criteria of the precautionary principle].

PubMed

Moccaldi, R

2011-01-01

The precautionary principle, according to the European Commission (February 2, 2000) must be applied when there is a possibility of a danger to humans, animals and/or environment health, i.e. when the potential harmful effects have been identified by a scientific and objective evaluation, but this evaluation does not allow the risk to be determined with sufficient certainty. However this principle has been invoked, without the identification, even partial, of harmful effects, to justify preventive and protective measures deemed necessary by policy maker mainly due to a high (but unjustified) risk perception by the population. We analyze the examples of the limits imposed by Italian legislation for the protection from EMF, and measures of "prudent avoidance" in the use of mobile phones.
Glucocorticosteroid-free versus glucocorticosteroid-containing immunosuppression for liver transplanted patients.

PubMed

Fairfield, Cameron; Penninga, Luit; Powell, James; Harrison, Ewen M; Wigmore, Stephen J

2018-04-09

Liver transplantation is an established treatment option for end-stage liver failure. Now that newer, more potent immunosuppressants have been developed, glucocorticosteroids may no longer be needed and their removal may prevent adverse effects. To assess the benefits and harms of glucocorticosteroid avoidance (excluding intra-operative use or treatment of acute rejection) or withdrawal versus glucocorticosteroid-containing immunosuppression following liver transplantation. We searched the Cochrane Hepato-Biliary Group Controlled Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Science Citation Index Expanded and Conference Proceedings Citation Index - Science, Literatura Americano e do Caribe em Ciencias da Saude (LILACS), World Health Organization International Clinical Trials Registry Platform, ClinicalTrials.gov, and The Transplant Library until May 2017. Randomised clinical trials assessing glucocorticosteroid avoidance or withdrawal versus glucocorticosteroid-containing immunosuppression for liver transplanted people. Our inclusion criteria stated that participants should have received the same co-interventions. We included trials that assessed complete glucocorticosteroid avoidance (excluding intra-operative use or treatment of acute rejection) versus short-term glucocorticosteroids, as well as trials that assessed short-term glucocorticosteroids versus long-term glucocorticosteroids. We used RevMan to conduct meta-analyses, calculating risk ratio (RR) for dichotomous variables and mean difference (MD) for continuous variables, both with 95% confidence intervals (CIs). We used a random-effects model and a fixed-effect model and reported both results where a discrepancy existed; otherwise we reported only the results from the fixed-effect model. We assessed the risk of systematic errors using 'Risk of bias' domains. We controlled for random errors by performing Trial Sequential Analysis. We presented our results in a 'Summary of findings' table. We included 17 completed randomised clinical trials, but only 16 studies with 1347 participants provided data for the meta-analyses. Ten of the 16 trials assessed complete postoperative glucocorticosteroid avoidance (excluding intra-operative use or treatment of acute rejection) versus short-term glucocorticosteroids (782 participants) and six trials assessed short-term glucocorticosteroids versus long-term glucocorticosteroids (565 participants). One additional study assessed complete post-operative glucocorticosteroid avoidance but could only be incorporated into qualitative analysis of the results due to limited data published in an abstract. All trials were at high risk of bias. Only eight trials reported on the type of donor used. Overall, we found no statistically significant difference for mortality (RR 1.15, 95% CI 0.93 to 1.44; low-quality evidence), graft loss including death (RR 1.15, 95% CI 0.90 to 1.46; low-quality evidence), or infection (RR 0.88, 95% CI 0.73 to 1.05; very low-quality evidence) when glucocorticosteroid avoidance or withdrawal was compared with glucocorticosteroid-containing immunosuppression. Acute rejection and glucocorticosteroid-resistant rejection were statistically significantly more frequent when glucocorticosteroid avoidance or withdrawal was compared with glucocorticosteroid-containing immunosuppression (RR 1.33, 95% CI 1.08 to 1.64; low-quality evidence; and RR 2.14, 95% CI 1.13 to 4.02; very low-quality evidence). Diabetes mellitus and hypertension were statistically significantly less frequent when glucocorticosteroid avoidance or withdrawal was compared with glucocorticosteroid-containing immunosuppression (RR 0.81, 95% CI 0.66 to 0.99; low-quality evidence; and RR 0.76, 95% CI 0.65 to 0.90; low-quality evidence). We performed Trial Sequential Analysis for all outcomes. None of the outcomes crossed the monitoring boundaries or reached the required information size. Hence, we cannot exclude random errors from the results of the conventional meta-analyses. Many of the benefits and harms of glucocorticosteroid avoidance or withdrawal remain uncertain because of the limited number of published randomised clinical trials, limited numbers of participants and outcomes, and high risk of bias in the trials. Glucocorticosteroid avoidance or withdrawal appears to reduce diabetes mellitus and hypertension whilst increasing acute rejection, glucocorticosteroid-resistant rejection, and renal impairment. We could identify no other benefits or harms of glucocorticosteroid avoidance or withdrawal. Glucocorticosteroid avoidance or withdrawal may be of benefit in selected patients, especially those at low risk of rejection and high risk of hypertension or diabetes mellitus. The optimal duration of glucocorticosteroid administration remains unclear. More randomised clinical trials assessing glucocorticosteroid avoidance or withdrawal are needed. These should be large, high-quality trials that minimise the risk of random and systematic error.
Weight loss in combat sports: physiological, psychological and performance effects.

PubMed

Franchini, Emerson; Brito, Ciro José; Artioli, Guilherme Giannini

2012-12-13

The present article briefly reviews the weight loss processes in combat sports. We aimed to discuss the most relevant aspects of rapid weight loss (RWL) in combat sports. This review was performed in the databases MedLine, Lilacs, PubMed and SciELO, and organized into sub-topics: (1) prevalence, magnitude and procedures, (2) psychological, physiological and performance effects, (3) possible strategies to avoid decreased performance (4) organizational strategies to avoid such practices. There was a high prevalence (50%) of RWL, regardless the specific combat discipline. Methods used are harmful to performance and health, such as laxatives, diuretics, use of plastic or rubber suits, and sauna. RWL affects physical and cognitive capacities, and may increase the risk of death. Recommendations during different training phases, educational and organizational approaches are presented to deal with or to avoid RWL.
The Strategic Dialogue on Tobacco Harm Reduction: a vision and blueprint for action in the US

PubMed Central

Zeller, Mitchell; Hatsukami, Dorothy

2016-01-01

The issues related to tobacco harm reduction continue to challenge the tobacco control research and policy communities. The potential for combusting tobacco products to reduce exposure and risk remains largely unknown, but this has not stopped manufacturers from offering such products making these claims. The role of oral tobacco products in a harm reduction regimen has also been a source of dialogue and debate. Within the last few years, major cigarette manufacturing companies have begun selling smokeless products for the first time, claiming to target current cigarette smokers. Other cigarette manufacturers are also offering smokeless products in markets around the world. The harm reduction debate has at times been divisive. There has been no unifying set of principles or goals articulated to guide tobacco control efforts. In particular, the research needs are extraordinarily high in order to drive evidence-based policy in this area and avoid the mistakes made with “light” cigarettes. This paper discusses recommendations from a strategic dialogue held with key, mostly US-based tobacco control researchers and policy makers to develop a strategic vision and blueprint for research, policy and communications to reduce the harm from tobacco for the US. Short-term and long-term objectives are described. PMID:19240228
The impact of stress on financial decision-making varies as a function of depression and anxiety symptoms.

PubMed

Robinson, Oliver J; Bond, Rebecca L; Roiser, Jonathan P

2015-01-01

Stress can precipitate the onset of mood and anxiety disorders. This may occur, at least in part, via a modulatory effect of stress on decision-making. Some individuals are, however, more resilient to the effects of stress than others. The mechanisms underlying such vulnerability differences are nevertheless unknown. In this study we attempted to begin quantifying individual differences in vulnerability by exploring the effect of experimentally induced stress on decision-making. The threat of unpredictable shock was used to induce stress in healthy volunteers (N = 47) using a within-subjects, within-session design, and its impact on a financial decision-making task (the Iowa Gambling Task) was assessed alongside anxious and depressive symptomatology. As expected, participants learned to select advantageous decks and avoid disadvantageous decks. Importantly, we found that stress provoked a pattern of harm-avoidant behaviour (decreased selection of disadvantageous decks) in individuals with low levels of trait anxiety. By contrast, individuals with high trait anxiety demonstrated the opposite pattern: stress-induced risk-seeking (increased selection of disadvantageous decks). These contrasting influences of stress depending on mood and anxiety symptoms might provide insight into vulnerability to common mental illness. In particular, we speculate that those who adopt a more harm-avoidant strategy may be better able to regulate their exposure to further environmental stress, reducing their susceptibility to mood and anxiety disorders.
Interactions between child and parent temperament and child behavior problems.

PubMed

Rettew, David C; Stanger, Catherine; McKee, Laura; Doyle, Alicia; Hudziak, James J

2006-01-01

Few studies of temperament have tested goodness-of-fit theories of child behavior problems. In this study, we test the hypothesis that interactions between child and parent temperament dimensions predict levels of child psychopathology after controlling for the effects of these dimensions individually. Temperament and psychopathology were assessed in a total of 175 children (97 boys, 78 girls; mean age, 10.99 years; SD, 3.66 years) using composite scores from multiple informants of the Junior Temperament and Character Inventory and the Achenbach System of Empirically Based Assessment. Parent temperament was assessed using the adult version of the Temperament and Character Inventory. Statistical analyses included multiple regression procedures to assess the contribution of child-parent temperament interactions after controlling for demographic variables, other types of child psychopathology, and the individual Temperament and Character Inventory and Junior Temperament and Character Inventory dimensions. Interactions between child and parent temperament dimensions predicted higher levels of externalizing, internalizing, and attention problems over and above the effects of these dimensions alone. Among others, the combination of high child novelty seeking with high maternal novelty was associated with child attention problems, whereas the combination of high child harm avoidance and high father harm avoidance was associated with increased child internalizing problems. Many child temperament dimensions also exerted significant effects independently. The association between a child temperament trait and psychopathology can be dependent upon the temperament of parents. These data lend support to previous theories of the importance of goodness-of-fit.
Reproductive freedom and risk.

PubMed

Benatar, David

2006-10-01

It is widely recognized that one person's freedom may be limited to prevent harm to another (non-consenting) person. It is curious, therefore, that where a right to reproductive freedom is recognized, there is considerable reticence to limit or override it in cases where reproduction harms those people who are brought into existence. I argue that this is inappropriate. If there should be no right to inflict a harm in non-reproductive contexts then there should be no right to inflict an equivalent harm in reproductive contexts. Because of the long history of bias and arbitrary discrimination in curtailments of reproductive freedom, I suggest how bias might be avoided in deciding how severe a harm must be to defeat a right to reproductive freedom.
The cost of harm and savings through safety: using simulated patients for leadership decision support.

PubMed

Denham, Charles R; Guilloteau, Franck R

2012-09-01

The ultimate objective of this program is to provide an approach to understanding and communicating health-care harm and cost to compel health-care provider leadership teams to vote "yes" to investments in patient safety initiatives, with the confidence that clinical, financial, and operational performance will be improved by such programs. Through a coordinated combination of literature evaluations, careful mapping of high impact scenarios using simulated patients and consensus review of clinical, operational, and financial factors, we confirmed value in such approaches to decision support information for hospital leadership teams to invest in patient safety projects. The study resulted in the following preliminary findings: ·Communication between hospital quality and finance departments can be much improved by direct collaborative relationships through regular meetings to help both clarify direct costs, indirect costs, and the savings of waste and harm to patients by avoidance of infections. ·Governance leaders and the professional administrative leaders should consider establishing the structures and systems necessary to act on risks and hazards as they evolve to deploy resources to areas of harm and risk. ·Quality and Infection Control Professionals can best wage their war on healthcare waste and harm by keeping abreast of the latest literature regarding the latest measures, standards, and safe practices for healthcare-acquired infections and hospital-acquired conditions. ·Regular reviews of patients with health-careYassociated infections, with direct attention to the attributable cost of treatment and how financial waste and harm to patients may be avoided, may provide hospital leaders with new insights for improvement. ·If hospitals developed their own risk scenarios to determine impact of harm and waste from hospital-acquired conditions in addition to impact scenarios for specific processes through technology and process innovations, they would have more clear guidance for improvement efforts. ·Tools such as impact calculators, performance models, and simulated patient trajectories are no more tied to the reality of running a hospital or treating a patient as jet simulator metrics are to taking a real flight with real weather and real aircraftVthey provide a view to enhance decision making but do NOT provide the answers. The final result of this project was to demonstrate a prototype leadership decision-support investment model approach that addresses clinical, operational, and financial performance for typical hospitals.
To Feel or Not to Feel When My Group Harms Others? The Regulation of Collective Guilt as Motivated Reasoning.

PubMed

Sharvit, Keren; Brambilla, Marco; Babush, Maxim; Colucci, Francesco Paolo

2015-09-01

Four studies tested the proposition that regulation of collective guilt in the face of harmful ingroup behavior involves motivated reasoning. Cognitive energetics theory suggests that motivated reasoning is a function of goal importance, mental resource availability, and task demands. Accordingly, three studies conducted in the United States and Israel demonstrated that high importance of avoiding collective guilt, represented by group identification (Studies 1 and 3) and conservative ideological orientation (Study 2), is negatively related to collective guilt, but only when mental resources are not depleted by cognitive load. The fourth study, conducted in Italy, demonstrated that when justifications for the ingroup's harmful behavior are immediately available, the task of regulating collective guilt and shame becomes less demanding and less susceptible to resource depletion. By combining knowledge from the domains of motivated cognition, emotion regulation, and intergroup relations, these cross-cultural studies offer novel insights regarding factors underlying the regulation of collective guilt. © 2015 by the Society for Personality and Social Psychology, Inc.
Potentiation of the early visual response to learned danger signals in adults and adolescents

PubMed Central

Howsley, Philippa; Jordan, Jeff; Johnston, Pat

2015-01-01

The reinforcing effects of aversive outcomes on avoidance behaviour are well established. However, their influence on perceptual processes is less well explored, especially during the transition from adolescence to adulthood. Using electroencephalography, we examined whether learning to actively or passively avoid harm can modulate early visual responses in adolescents and adults. The task included two avoidance conditions, active and passive, where two different warning stimuli predicted the imminent, but avoidable, presentation of an aversive tone. To avoid the aversive outcome, participants had to learn to emit an action (active avoidance) for one of the warning stimuli and omit an action for the other (passive avoidance). Both adults and adolescents performed the task with a high degree of accuracy. For both adolescents and adults, increased N170 event-related potential amplitudes were found for both the active and the passive warning stimuli compared with control conditions. Moreover, the potentiation of the N170 to the warning stimuli was stable and long lasting. Developmental differences were also observed; adolescents showed greater potentiation of the N170 component to danger signals. These findings demonstrate, for the first time, that learned danger signals in an instrumental avoidance task can influence early visual sensory processes in both adults and adolescents. PMID:24652856
Clinical practice guidelines for the diagnosis and management of osteoporosis. Scientific Advisory Board, Osteoporosis Society of Canada.

PubMed Central

1996-01-01

OBJECTIVE: To recommend clinical practice guidelines for the assessment of people at risk for osteoporosis, and for effective diagnosis and management of the condition. OPTIONS: Screening and diagnostic methods: risk-factor assessment, clinical evaluation, measurement of bone mineral density, laboratory investigations. Prophylactic and corrective therapies: calcium and vitamin D nutritional supplementation, physical activity and fall-avoidance techniques, ovarian hormone therapy, bisphosphonate drugs, other drug therapies. Pain-management medications and techniques. OUTCOMES: Prevention of loss of bone mineral density and fracture; increased bone mass; and improved quality of life. EVIDENCE: Epidemiologic and clinical studies and reports were examined, with emphasis on recent randomized controlled trials. Clinical practice in Canada and elsewhere was surveyed. Availability of treatment products and diagnostic equipment in Canada was considered. VALUES: Cost-effective methods and products that can be adopted across Canada were considered. A high value was given to accurate assessment of fracture risk and osteoporosis, and to increasing bone mineral density, reducing fractures and fracture risk and minimizing side effects of diagnosis and treatment. BENEFITS, HARMS AND COSTS: Proper diagnosis and management of osteoporosis minimize injury and disability, improve quality of life for patients and reduce costs to society. Rationally targeted methods of screening and diagnosis are safe and cost effective. Harmful side effects and costs of recommended therapies are minimal compared with the harms and costs of untreated osteoporosis. Alternative therapies provide a range of choices for physicians and patients. RECOMMENDATIONS: Population sets at high risk should be identified and then the diagnosis confirmed through bone densitometry. Dual-energy x-ray absorptiometry is the preferred measurement technique. Radiography can be adjunct when indicated. Calcium and vitamin D nutritional supplementation should be at currently recommended levels. Patients should be counselled in fall-avoidance techniques and exercises. Immobilization should be avoided. Guidelines for management of acute pain are listed. Ovarian hormone therapy is the therapy of choice for osteoporosis prevention and treatment in postmenopausal women. Bisphosphonates are an alternative therapy for women with established osteoporosis who cannot or prefer not to take ovarian hormone therapy. PMID:8873639
Low back pain patients' responses to videos of avoided movements.

PubMed

Pincus, T; Henderson, J

2013-02-01

Fear avoidance (FA) has been identified as a risk factor for poor prognosis and a target for intervention in patients with low back pain (LBP), but the mechanisms involved need clarification. Experimental studies would benefit from the use of carefully developed and controlled stimuli representing avoided movements in back pain, and matched stimuli of movements to provide a credible control stimuli. Existing stimuli depicting avoided movements in LBP are static, do not include a set of control stimuli and do not control for possible systematic observer biases. Two studies were carried out aiming to develop and test LBP patients' responses to videos of models depicting commonly avoided movements associated with back pain, and those associated with a control condition, wrist pain. Two samples of LBP patients rated how much pain and harm each movement would cause them. They also reported how often they avoided the movement. The findings from the first study (n = 99) indicate that using videos of commonly avoided movements in low back pain is viable, and that movements associated with wrist pain provide an acceptable control stimuli. Participants in the second study (n = 85) consistently rated movements depicted by females as causing more harm, and more frequently avoided than the same movements depicted by males. The use of video stimuli could advance research into the processes associated with FA through experimental paradigms. However, although small, the model gender effects should be carefully considered. © 2012 European Federation of International Association for the Study of Pain Chapters.
High-Throughput Non-Contact Vitrification of Cell-Laden Droplets Based on Cell Printing

NASA Astrophysics Data System (ADS)

Shi, Meng; Ling, Kai; Yong, Kar Wey; Li, Yuhui; Feng, Shangsheng; Zhang, Xiaohui; Pingguan-Murphy, Belinda; Lu, Tian Jian; Xu, Feng

2015-12-01

Cryopreservation is the most promising way for long-term storage of biological samples e.g., single cells and cellular structures. Among various cryopreservation methods, vitrification is advantageous by employing high cooling rate to avoid the formation of harmful ice crystals in cells. Most existing vitrification methods adopt direct contact of cells with liquid nitrogen to obtain high cooling rates, which however causes the potential contamination and difficult cell collection. To address these limitations, we developed a non-contact vitrification device based on an ultra-thin freezing film to achieve high cooling/warming rate and avoid direct contact between cells and liquid nitrogen. A high-throughput cell printer was employed to rapidly generate uniform cell-laden microdroplets into the device, where the microdroplets were hung on one side of the film and then vitrified by pouring the liquid nitrogen onto the other side via boiling heat transfer. Through theoretical and experimental studies on vitrification processes, we demonstrated that our device offers a high cooling/warming rate for vitrification of the NIH 3T3 cells and human adipose-derived stem cells (hASCs) with maintained cell viability and differentiation potential. This non-contact vitrification device provides a novel and effective way to cryopreserve cells at high throughput and avoid the contamination and collection problems.

High-Throughput Non-Contact Vitrification of Cell-Laden Droplets Based on Cell Printing

PubMed Central

Shi, Meng; Ling, Kai; Yong, Kar Wey; Li, Yuhui; Feng, Shangsheng; Zhang, Xiaohui; Pingguan-Murphy, Belinda; Lu, Tian Jian; Xu, Feng

2015-01-01

Cryopreservation is the most promising way for long-term storage of biological samples e.g., single cells and cellular structures. Among various cryopreservation methods, vitrification is advantageous by employing high cooling rate to avoid the formation of harmful ice crystals in cells. Most existing vitrification methods adopt direct contact of cells with liquid nitrogen to obtain high cooling rates, which however causes the potential contamination and difficult cell collection. To address these limitations, we developed a non-contact vitrification device based on an ultra-thin freezing film to achieve high cooling/warming rate and avoid direct contact between cells and liquid nitrogen. A high-throughput cell printer was employed to rapidly generate uniform cell-laden microdroplets into the device, where the microdroplets were hung on one side of the film and then vitrified by pouring the liquid nitrogen onto the other side via boiling heat transfer. Through theoretical and experimental studies on vitrification processes, we demonstrated that our device offers a high cooling/warming rate for vitrification of the NIH 3T3 cells and human adipose-derived stem cells (hASCs) with maintained cell viability and differentiation potential. This non-contact vitrification device provides a novel and effective way to cryopreserve cells at high throughput and avoid the contamination and collection problems. PMID:26655688
Temperament traits in suicidal and non-suicidal mood disorder patients in Taiwan.

PubMed

Liu, Shen-Ing; Huang, Yu-Hsin; Wu, Ying-Hui; Huang, Kuo-Yang; Huang, Hui-Chun; Sun, Fang-Ju; Huang, Chiu-Ron; Sung, Ming-Ru; Huang, Yo-Ping

2017-07-01

Suicide is a major social and clinical problem in Asia. Although studies have suggested that personality traits are possible risk factors for suicide, no study has been conducted among Chinese to compare the temperament traits of suicidal and non-suicidal mood disorder patients with those of healthy controls. This study compared temperament traits of two patient groups, those with a mood disorder who have attempted suicide (n=204), and those with a mood disorder who have not attempted suicide (n=160), and compared the traits of these patients to those of healthy controls (n=178), assessed by Cloninger's Tridimensional Personality Questionnaire and the Brown-Goodwin Aggression Inventory. Patients with suicidal attempts had significantly higher novelty seeking and aggression scores than healthy controls and patients without suicidal attempts. Two groups of patients with mood disorder had significantly higher harm avoidance scores than the healthy controls. However, patients with suicidal attempts did not have higher harm avoidance scores than patients without suicidal attempts. This study confirms findings that harm avoidance and mood disorder are related, and extends them by suggesting that those with a mood disorder and suicide attempts have higher novelty seeking and lifetime aggression scores than those without suicidal attempt, either patients or healthy controls. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.
Weight loss in combat sports: physiological, psychological and performance effects

PubMed Central

2012-01-01

Background The present article briefly reviews the weight loss processes in combat sports. We aimed to discuss the most relevant aspects of rapid weight loss (RWL) in combat sports. Methods This review was performed in the databases MedLine, Lilacs, PubMed and SciELO, and organized into sub-topics: (1) prevalence, magnitude and procedures, (2) psychological, physiological and performance effects, (3) possible strategies to avoid decreased performance (4) organizational strategies to avoid such practices. Results There was a high prevalence (50%) of RWL, regardless the specific combat discipline. Methods used are harmful to performance and health, such as laxatives, diuretics, use of plastic or rubber suits, and sauna. RWL affects physical and cognitive capacities, and may increase the risk of death. Conclusion Recommendations during different training phases, educational and organizational approaches are presented to deal with or to avoid RWL. PMID:23237303
Psychometric properties of revised Thought-Action Fusion questionnaire (TAF-R) in an Iranian population.

PubMed

Pourfaraj, Majid; Mohammadi, Nourallah; Taghavi, Mohammadreza

2008-12-01

The purpose of this study is to examine the psychometric properties of Thought-Action Fusion revised scale (TAF-R; Amir, N., freshman, M., Ramsey, B., Neary, E., & Brigidi, B. (2001). Thought-action fusion in individuals with OCD symptoms. Behaviour Research and Therapy, 39, 765-776) in a sample of 565 (321 female) students of Shiraz university. The results of factor analysis with using varimax rotation yielded eight factors that explained 80% variances of total scale. These factors are labeled: moral TAF, responsibility for positive thoughts, likelihood negative events, likelihood positive events, responsibility for negative thoughts, responsibility for harm avoidance, likelihood harm avoidance and likelihood self, respectively. The reliability coefficients of total scale are calculated by two methods: internal consistency and test-retest, which were 0.81 and 0.61, respectively. Concurrent validity showed that TAF-R scores positively and significantly correlate with responsibility, guilt and obsessive-compulsive symptoms. Confirming the expectations, there were people with high obsessive-compulsive symptoms having higher TAF-R scores than those with low symptoms. Moreover, subscales-total correlations showed that the correlations between subscales were low, but subscales correlating with total score of TAF-R were moderated.
Harms to “Others” and the Selection Against Disability View

PubMed Central

2017-01-01

Abstract In recent years, the question of whether prospective parents might have a moral obligation to select against disability in their offspring has piqued the attention of many prominent philosophers and bioethicists, and a large literature has emerged surrounding this question. Rather than looking to the most common arguments given in support of a positive response to the abovementioned question, such as those focusing on the harms disability may impose on the child created, duties and role-specific obligations, and impersonal ‘harms’, a less commonly made set of arguments is focused upon which looks to the harms that a decision not to select against disability may impose on others. Three different possible arguments supporting a limited duty of disability avoidance are thus identified and subsequently explored: harms to parents themselves, harms to existing family members, and harms to other existing members of society. PMID:28180274
Genetic harm: bitten by the body that keeps you?

PubMed

Kahn, Jeffrey P

1991-10-01

... We must attempt to explain, how, if ever, our existence may harm us. To address this and the other questions raised, I propose to examine what constitutes harm and whether it makes sense to say that our genetic makeup may harm us. To do this I will describe three approaches to the problem of describing the status of negative effects our genes have upon us, which I have named the "technical harm" view, the "constitutive" view, and the "harmful conditions" view. On the technical harm view, the standard definitions of harm are applied to genetic disposition in an attempt to couch genetic defects or flaws in terms of harming. The constitutive view rejects applying the concept of harm to genetic disposition on the grounds that it is impossible to separate genetic disposition from individual identity. Lastly, the harmful conditions view, which I conclude is the most successful of the three, focuses on the tendency of certain genetic dispositions to cause harm in the future and thus avoids what I will argue are the "context" shortcomings of the other two approaches. To conclude the discussion I will very briefly analyze the ramifications of a harmful conditions view for the concept of genetic disease and the prospects for genetic counseling, gene therapy, and reproductive decision making.
Personality traits in patients with Parkinson's disease: assessment and clinical implications.

PubMed

Poletti, Michele; Bonuccelli, Ubaldo

2012-06-01

This study reviews empirical evidence on the association between personality traits and Parkinson's disease (PD), with a twofold aim. First, to better identify non-motor symptoms, such as affective symptoms and personality changes, that could help to define the pre-motor phase of PD; second, to better understand the neurobiological bases of personality traits, a goal that is not fully accomplished by a purely anatomical approach. A literature review was performed on studies of personality traits in PD patients, in electronic databases ISI Web of Knowledge, Medline and PsychInfo, conducted in July 2011. We found evidence that the existence of a characteristic premorbid personality profile of PD patients is not actually sustained by robust empirical evidence, mainly due to the methodological bias of the retrospective assessment of personality; PD patients present a personality profile of low novelty seeking and high harm avoidance. We concluded that the definition of a pre-motor phase of PD, based on non-motor symptoms, should search for the presence of concomitant affective disorders and for a positive psychiatric history for affective disorders rather than for a typical personality profile or personality changes. The low novelty seeking profile is probably related to the dopaminergic deficit, while the high harm avoidance profile is probably associated with the presence of affective disorders. Clinical implications of these findings, in regard to personality assessment and pharmacological treatments in PD, are also discussed.
In Your Face: Risk of Punishment Enhances Cognitive Control and Error-Related Activity in the Corrugator Supercilii Muscle.

PubMed

Lindström, Björn R; Mattsson-Mårn, Isak Berglund; Golkar, Armita; Olsson, Andreas

2013-01-01

Cognitive control is needed when mistakes have consequences, especially when such consequences are potentially harmful. However, little is known about how the aversive consequences of deficient control affect behavior. To address this issue, participants performed a two-choice response time task where error commissions were expected to be punished by electric shocks during certain blocks. By manipulating (1) the perceived punishment risk (no, low, high) associated with error commissions, and (2) response conflict (low, high), we showed that motivation to avoid punishment enhanced performance during high response conflict. As a novel index of the processes enabling successful cognitive control under threat, we explored electromyographic activity in the corrugator supercilii (cEMG) muscle of the upper face. The corrugator supercilii is partially controlled by the anterior midcingulate cortex (aMCC) which is sensitive to negative affect, pain and cognitive control. As hypothesized, the cEMG exhibited several key similarities with the core temporal and functional characteristics of the Error-Related Negativity (ERN) ERP component, the hallmark index of cognitive control elicited by performance errors, and which has been linked to the aMCC. The cEMG was amplified within 100 ms of error commissions (the same time-window as the ERN), particularly during the high punishment risk condition where errors would be most aversive. Furthermore, similar to the ERN, the magnitude of error cEMG predicted post-error response time slowing. Our results suggest that cEMG activity can serve as an index of avoidance motivated control, which is instrumental to adaptive cognitive control when consequences are potentially harmful.
In Your Face: Risk of Punishment Enhances Cognitive Control and Error-Related Activity in the Corrugator Supercilii Muscle

PubMed Central

Lindström, Björn R.; Mattsson-Mårn, Isak Berglund; Golkar, Armita; Olsson, Andreas

2013-01-01

Cognitive control is needed when mistakes have consequences, especially when such consequences are potentially harmful. However, little is known about how the aversive consequences of deficient control affect behavior. To address this issue, participants performed a two-choice response time task where error commissions were expected to be punished by electric shocks during certain blocks. By manipulating (1) the perceived punishment risk (no, low, high) associated with error commissions, and (2) response conflict (low, high), we showed that motivation to avoid punishment enhanced performance during high response conflict. As a novel index of the processes enabling successful cognitive control under threat, we explored electromyographic activity in the corrugator supercilii (cEMG) muscle of the upper face. The corrugator supercilii is partially controlled by the anterior midcingulate cortex (aMCC) which is sensitive to negative affect, pain and cognitive control. As hypothesized, the cEMG exhibited several key similarities with the core temporal and functional characteristics of the Error-Related Negativity (ERN) ERP component, the hallmark index of cognitive control elicited by performance errors, and which has been linked to the aMCC. The cEMG was amplified within 100 ms of error commissions (the same time-window as the ERN), particularly during the high punishment risk condition where errors would be most aversive. Furthermore, similar to the ERN, the magnitude of error cEMG predicted post-error response time slowing. Our results suggest that cEMG activity can serve as an index of avoidance motivated control, which is instrumental to adaptive cognitive control when consequences are potentially harmful. PMID:23840356
The Use of Protective Behaviors in Relation to Gambling Among College Students

PubMed Central

Lostutter, Ty W.; Lewis, Melissa A.; Cronce, Jessica M.; Neighbors, Clayton; Larimer, Mary E.

2012-01-01

The purpose of the current study was to evaluate a measure of gambling protective behaviors and examine the relationship between indices of gambling behavior, including frequency, quantity and problem severity, and the use of gambling protective behaviors. Undergraduates from a large public university (N = 4,014) completed a web-based screening survey comprising measures of gambling and health behaviors, from which those who gambled within the past 6-months (n = 1,922, 48% of the entire sample) were invited to complete the baseline assessment, including the Gambling Protective Behavior Scale (GPBS). The GPBS was determined to have two subscales, primarily consisting of harm reduction strategies that reduce the money or time spent on gambling, or avoidance strategies that help to minimize engagement in gambling activities. Hierarchical multiple regressions found participants’ sex moderated the relationship between use of protective behavioral strategies and gambling outcomes. However, effects were in the opposite direction to those hypothesized. Specifically, because women gambled less, had lower gambling problem severity, and reported more frequent use of gambling avoidance protective behaviors, the relationship between use of gambling protective behaviors and gambling outcomes was stronger for men than women. Men who used more avoidance strategies gambled less frequently compared to men who used fewer avoidance strategies. Similarly, men who used more harm reduction strategies spent fewer dollars on gambling and had lower scores on gambling problem severity compared to men using fewer harm reduction strategies for women these relationships were less pronounced. Implications of incorporating specific gambling protective behavioral strategies into prevention and treatment programs are discussed. PMID:23224712
Psychometric properties of the Greek TCI-R and its clinical correlates: schizotypy and the self-regulation of affective and cognitive functioning.

PubMed

Giakoumaki, Stella G; Karagiannopoulou, Leda; Rózsa, Sándor; Zouraraki, Chrysoula; Karamaouna, Penny; Cloninger, C Robert

2016-01-01

Background. The revised Temperament and Character Inventory (TCI-R) measures Cloninger's psychobiological model of personality. The average effects of individual temperament and character traits have been associated with schizotypy and with impaired regulation of affect and cognition. We extended prior research by testing predictions about the association of specific multidimensional configurations of temperament and character traits on schizotypy, affect balance, and self-perceived cognitive functioning. Method. A well-educated sample of native Greeks (N = 483), completed a new Greek translation of the TCI-R, as well as the Schizotypal Personality Questionnaire (SPQ), the Positive/Negative Affect Schedule (PANAS) and the Cognitive Failures Questionnaire (CFQ). The factor structure of the TCI-R was examined with exploratory and confirmatory tests. Associations between reported measures were examined with correlational and regression analyses. Results. The TCI-R had good psychometric properties as expected from studies in other countries. As predicted, specific configurations of temperament and character were associated with schizotypy, negative affect balance, and cognitive lapses. The "Borderline/Explosive temperament" (high Novelty Seeking, high Harm Avoidance, low Reward Dependence), "Schizotypal/Disorganized character" (low Self-directedness, low Cooperativeness, high Self-transcendence), and "Low Ego Strength/Fragile" profile (high Harm Avoidance, low Persistence, low Self-Directedness) were each strongly associated with higher stereotypy, negative affect balance (low positive affect and high negative affect), and subjective cognitive lapses compared to their contrast groups. Discussion. Multidimensional TCI profiles are strongly related to individual differences in schizotypy and self-reported regulation of affect and cognition. The Greek translation of the TCI-R is psychometrically sound and useful for clinical assessment and research.
Psychometric properties of the Greek TCI-R and its clinical correlates: schizotypy and the self-regulation of affective and cognitive functioning

PubMed Central

Karagiannopoulou, Leda; Rózsa, Sándor; Zouraraki, Chrysoula; Karamaouna, Penny; Cloninger, C. Robert

2016-01-01

Background. The revised Temperament and Character Inventory (TCI-R) measures Cloninger’s psychobiological model of personality. The average effects of individual temperament and character traits have been associated with schizotypy and with impaired regulation of affect and cognition. We extended prior research by testing predictions about the association of specific multidimensional configurations of temperament and character traits on schizotypy, affect balance, and self-perceived cognitive functioning. Method. A well-educated sample of native Greeks (N = 483), completed a new Greek translation of the TCI-R, as well as the Schizotypal Personality Questionnaire (SPQ), the Positive/Negative Affect Schedule (PANAS) and the Cognitive Failures Questionnaire (CFQ). The factor structure of the TCI-R was examined with exploratory and confirmatory tests. Associations between reported measures were examined with correlational and regression analyses. Results. The TCI-R had good psychometric properties as expected from studies in other countries. As predicted, specific configurations of temperament and character were associated with schizotypy, negative affect balance, and cognitive lapses. The “Borderline/Explosive temperament” (high Novelty Seeking, high Harm Avoidance, low Reward Dependence), “Schizotypal/Disorganized character” (low Self-directedness, low Cooperativeness, high Self-transcendence), and “Low Ego Strength/Fragile” profile (high Harm Avoidance, low Persistence, low Self-Directedness) were each strongly associated with higher stereotypy, negative affect balance (low positive affect and high negative affect), and subjective cognitive lapses compared to their contrast groups. Discussion. Multidimensional TCI profiles are strongly related to individual differences in schizotypy and self-reported regulation of affect and cognition. The Greek translation of the TCI-R is psychometrically sound and useful for clinical assessment and research. PMID:27019787
European breast cancer service screening outcomes: a first balance sheet of the benefits and harms.

PubMed

Paci, Eugenio; Broeders, Mireille; Hofvind, Solveig; Puliti, Donella; Duffy, Stephen William

2014-07-01

A recent comprehensive review has been carried out to quantify the benefits and harms of the European population-based mammographic screening programs. Five literature reviews were conducted on the basis of the observational published studies evaluating breast cancer mortality reduction, breast cancer overdiagnosis, and false-positive results. On the basis of the studies reviewed, the authors present a first estimate of the benefit and harm balance sheet. For every 1,000 women screened biennially from ages 50 to 51 years until ages 68 to 69 years and followed up until age 79 years, an estimated seven to nine breast cancer deaths are avoided, four cases are overdiagnosed, 170 women have at least one recall followed by noninvasive assessment with a negative result, and 30 women have at least one recall followed by invasive procedures yielding a negative result. The chance of a breast cancer death being avoided by population-based mammography screening of appropriate quality is more than that of overdiagnosis by screening. These outcomes should be communicated to women offered service screening in Europe. ©2014 American Association for Cancer Research.
Linking an Anxiety-Related Personality Trait to Cardiac Autonomic Regulation in Well-Defined Healthy Adults: Harm Avoidance and Resting Heart Rate Variability.

PubMed

Kao, Lien-Cheng; Liu, Yu-Wen; Tzeng, Nian-Sheng; Kuo, Terry B J; Huang, San-Yuan; Chang, Chuan-Chia; Chang, Hsin-An

2016-07-01

Anxiety trait, anxiety and depression states have all been reported to increase risks for cardiovascular disease (CVD), possibly through altering cardiac autonomic regulation. Our aim was to investigate whether the relationship between harm avoidance (HA, an anxiety-related personality trait) and cardiac autonomic regulation is independent of anxiety and depression states in healthy adults. We recruited 535 physically and mentally healthy volunteers. Participants completed the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI) and Tri-dimensional Personality Questionnaire. Participants were divided into high or low HA groups as discriminated by the quartile value. Cardiac autonomic function was evaluated by measuring heart rate variability (HRV). We obtained the time and frequency-domain indices of HRV including variance (total HRV), the low-frequency power (LF; 0.05-0.15 Hz), which may reflect baroreflex function, the high-frequency power (HF; 0.15-0.40 Hz), which reflects cardiac parasympathetic activity, as well as the LF/HF ratio. The BDI and HA scores showed associations with HRV parameters. After adjustment for the BDI scores and other control variables, HA is still associated with reduced variance, LF and HF power. Compared with the participants with low HA, those with high HA displayed significant reductions in variance, LF and HF power and a significant increase in their LF/HF ratio. This study highlights the independent role of HA in contributing to decreased autonomic cardiac regulation in healthy adults and provides a potential underlying mechanism for anxiety trait to confer increased risk for CVD.
Linking an Anxiety-Related Personality Trait to Cardiac Autonomic Regulation in Well-Defined Healthy Adults: Harm Avoidance and Resting Heart Rate Variability

PubMed Central

Kao, Lien-Cheng; Liu, Yu-Wen; Tzeng, Nian-Sheng; Kuo, Terry B. J.; Huang, San-Yuan

2016-01-01

Objective Anxiety trait, anxiety and depression states have all been reported to increase risks for cardiovascular disease (CVD), possibly through altering cardiac autonomic regulation. Our aim was to investigate whether the relationship between harm avoidance (HA, an anxiety-related personality trait) and cardiac autonomic regulation is independent of anxiety and depression states in healthy adults. Methods We recruited 535 physically and mentally healthy volunteers. Participants completed the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI) and Tri-dimensional Personality Questionnaire. Participants were divided into high or low HA groups as discriminated by the quartile value. Cardiac autonomic function was evaluated by measuring heart rate variability (HRV). We obtained the time and frequency-domain indices of HRV including variance (total HRV), the low-frequency power (LF; 0.05–0.15 Hz), which may reflect baroreflex function, the high-frequency power (HF; 0.15–0.40 Hz), which reflects cardiac parasympathetic activity, as well as the LF/HF ratio. Results The BDI and HA scores showed associations with HRV parameters. After adjustment for the BDI scores and other control variables, HA is still associated with reduced variance, LF and HF power. Compared with the participants with low HA, those with high HA displayed significant reductions in variance, LF and HF power and a significant increase in their LF/HF ratio. Conclusion This study highlights the independent role of HA in contributing to decreased autonomic cardiac regulation in healthy adults and provides a potential underlying mechanism for anxiety trait to confer increased risk for CVD. PMID:27482240
Long-term avoidance memory formation is associated with a transient increase in mushroom body synaptic complexes in leaf-cutting ants

PubMed Central

Falibene, Agustina; Roces, Flavio; Rössler, Wolfgang

2015-01-01

Long-term behavioral changes related to learning and experience have been shown to be associated with structural remodeling in the brain. Leaf-cutting ants learn to avoid previously preferred plants after they have proved harmful for their symbiotic fungus, a process that involves long-term olfactory memory. We studied the dynamics of brain microarchitectural changes after long-term olfactory memory formation following avoidance learning in Acromyrmex ambiguus. After performing experiments to control for possible neuronal changes related to age and body size, we quantified synaptic complexes (microglomeruli, MG) in olfactory regions of the mushroom bodies (MBs) at different times after learning. Long-term avoidance memory formation was associated with a transient change in MG densities. Two days after learning, MG density was higher than before learning. At days 4 and 15 after learning—when ants still showed plant avoidance—MG densities had decreased to the initial state. The structural reorganization of MG triggered by long-term avoidance memory formation clearly differed from changes promoted by pure exposure to and collection of novel plants with distinct odors. Sensory exposure by the simultaneous collection of several, instead of one, non-harmful plant species resulted in a decrease in MG densities in the olfactory lip. We hypothesize that while sensory exposure leads to MG pruning in the MB olfactory lip, the formation of long-term avoidance memory involves an initial growth of new MG followed by subsequent pruning. PMID:25904854
Psychotherapy Training on Psychological Mindedness in a Japanese Nurse Population: Effects and Personality Correlates

PubMed Central

Saito, Tomomi; Takeda, Satoru; Yamagishi, Yukiko; Kubo, Reiko; Kitamura, Toshinori

2017-01-01

Aims and objective: The aim of this study was to determine whether the training would influence the psychological mindedness of nurses and midwives. In addition, we explored the relationship of the change of psychological mindedness before and after the training and the correlation with their personality traits. Background: It is important for perinatal health professionals such as nurses and midwives to acquire intervention skills such as psychotherapy and counselling techniques. We think that one of the essential requisites is psychological mindedness. Method: A total of 45 perinatal health professionals who participated in the postpartum depression prevention programme were distributed a set of questionnaires including the Psychological Mindedness Scale (PMS) and Temperament and Character Inventory (TCI) at the beginning and end of the training. Results: The PMS scores increased significantly after the training. A structured equation modelling suggested that PMS and self-directedness predicted each other whereas PMS predicted low harm avoidance. Conclusion: These findings indicate that the psychological mindedness of nurses and midwives could be advanced by a course of training and that this could be supported by high self-directedness. The harm avoidance trait may be reduced by increased psychological mindedness. Relevance to clinical practice: Nurses and nursing students are apt to psychological skill training in the advancement of psychological mindedness. PMID:28786921
Compulsive buying disorder clustering based on sex, age, onset and personality traits.

PubMed

Granero, Roser; Fernández-Aranda, Fernando; Baño, Marta; Steward, Trevor; Mestre-Bach, Gemma; Del Pino-Gutiérrez, Amparo; Moragas, Laura; Mallorquí-Bagué, Núria; Aymamí, Neus; Goméz-Peña, Mónica; Tárrega, Salomé; Menchón, José M; Jiménez-Murcia, Susana

2016-07-01

In spite of the revived interest in compulsive buying disorder (CBD), its classification into the contemporary nosologic systems continues to be debated, and scarce studies have addressed heterogeneity in the clinical phenotype through methodologies based on a person-centered approach. To identify empirical clusters of CBD employing personality traits, as well as patients' sex, age and the age of CBD onset as indicators. An agglomerative hierarchical clustering method defining a combination of the Schwarz Bayesian Information Criterion and log-likelihood was used. Three clusters were identified in a sample of n=110 patients attending a specialized CBD unit a) "male compulsive buyers" reported the highest prevalence of comorbid gambling disorder and the lowest levels of reward dependence; b) "female low-dysfunctional" mainly included employed women, with the highest level of education, the oldest age of onset, the lowest scores in harm avoidance and the highest levels of persistence, self-directedness and cooperativeness; and c) "female highly-dysfunctional" with the youngest age of onset, the highest levels of comorbid psychopathology and harm avoidance, and the lowest score in self-directedness. Sociodemographic characteristics and personality traits can be used to determine CBD clusters which represent different clinical subtypes. These subtypes should be considered when developing assessment instruments, preventive programs and treatment interventions. Copyright © 2016 Elsevier Inc. All rights reserved.
Relationship between Personality Traits and Endogenous Analgesia: The Role of Harm Avoidance.

PubMed

Nahman-Averbuch, Hadas; Yarnitsky, David; Sprecher, Elliot; Granovsky, Yelena; Granot, Michal

2016-01-01

Whether psychological factors such as anxiety and pain catastrophizing levels influence the expression of endogenous analgesia in general and, more specifically, the conditioned pain modulation (CPM) response is still under debate. It may be assumed that other psychological characteristics also play a role in the CPM response. The neurotransmitters serotonin, dopamine, and norepinephrine are involved both in CPM, as well as personality traits such as harm avoidance (HA), novelty seeking (NS), and reward dependence (RD), which can be obtained by the Tridimensional Personality Questionnaire (TPQ). However, the associations between these traits (HA, NS, and RD) with endogenous analgesia revealed by CPM have not yet been explored. Healthy middle-age subjects (n = 28) completed the TPQ, Spielberger's State Anxiety Inventory, and the Pain Catastrophizing Scale and were assessed for CPM paradigms using thermal phasic temporal summation as the "test stimulus" and hand immersion into hot water bath (CPM water) or contact heat (CPM contact) for "conditioning stimulus." Higher levels of HA were associated with less-efficient CPM responses obtained by both paradigms: CPM water (r = 0.418, P = 0.027) and CPM contact (r = 0.374, P = 0.050). However, NS and RD were not associated with the other measurements. No significant relationship was observed between state anxiety and pain catastrophizing levels and the CPM responses. The relationship between the capacity of endogenous analgesia and the tendency to avoid aversive experience can be explained by mutual mechanisms involving similar neurotransmitters or brain areas. These findings illuminate the key role of harm avoidance obtained by the TPQ in determining the characteristics of pain modulation profile. © 2014 World Institute of Pain.
Extremely Preterm Infant Skin Care: A Transformation of Practice Aimed to Prevent Harm.

PubMed

Johnson, Deanna E

2016-10-01

The skin of extremely preterm infants is underdeveloped and has poor barrier function. Skin maintenance interventions initiated in the neonatal intensive care unit (NICU) have immediate and lifelong implications when the potential for infection, allergen sensitization, and altered aesthetic outcomes are considered. In addition, the high-level medical needs of extremely preterm infants demand skin-level medical interventions that too often result in unintended skin harm. We describe the use of a harm prevention, or consequence-centered, approach to skin care, which facilitates safer practice for extremely premature infants. Neonatal and pediatric Advanced Practice Registered Nurses (APRN) came together for monthly meetings to review the evidence around best skin care practices for extremely preterm infants, with an emphasis on reduction of skin harm. Findings were focused on the population of interest and clinical implementation strategies. Skin care for extremely preterm infants remains overlooked by current literature. However, clinical practice pearls were extracted and applied in a manner that promotes safer skin care practices in the NICU. Gentle adhesives, such as silicone tapes and hydrogel-backed electrodes, can help to reduce medical adhesive-related skin injuries. Diaper wipes are not appropriate for use among extremely preterm infants, as many ingredients may contain potential allergens. Skin cleansers should be pH neutral to the skin and the prophylactic use of petrolatum-based emollients should be avoided. Further exploration and understanding of skin care practices that examine issues of true risk versus hypothetical risk of harm.

Personality and attempted suicide. Analysis of anger, aggression and impulsivity.

PubMed

Giegling, Ina; Olgiati, Paolo; Hartmann, Annette M; Calati, Raffaella; Möller, Hans-Jürgen; Rujescu, Dan; Serretti, Alessandro

2009-12-01

Suicide is one of the leading causes of death worldwide, mortality from suicide being approximately 2%. Attempted suicide appears to be a major risk factor for suicide completion. Anger, aggression and impulsivity are personality traits associated with suicide attempt. In this study we analysed a part of a previously reported sample in order to test anger, impulsivity and temperament/character scales as predictors of aggression and self-aggression in suicide attempters and to compare anger- and aggression-related traits between impulsive and premeditated suicide attempts as well as between violent and non-violent suicide methods. One-hundred-eleven consecutively admitted inpatients with a lifetime history of attempted suicide were assessed for anger (State-Trait Anger Expression Inventory, STAXI), aggression (Questionnaire for Measuring Factors of Aggression, FAF) and temperament/character (Temperament and Character Inventory, TCI). Higher aggression scores, as measured by FAF, were predicted by being male, meeting criteria for borderline personality disorder and having higher angry temperament scores as assessed by STAXI; low cooperativeness was also associated with aggression but not after controlling for STAXI scales. TCI dimensions associated with self-aggression were high harm avoidance, high impulsivity and low self-directedness; state anger, inwardly directed anger and inhibition of aggression were also predictors of self-aggression. In conclusion, impulsivity and harm avoidance have emerged as temperament dimensions independently associated with self-aggressive tendencies in personality. Such interactions could explain the correlation between temperament and suicidality but further research is needed. Anger and self-directedness appear to have some effects on suicide attempt.
Eye Injuries in Sports

MedlinePlus

... 90% of them can be avoided. Basketball and baseball cause the most eye injuries, followed by water ... to the sun or harmful objects. Examples include baseball, basketball, hockey, football, soccer, rugby, and lacrosse. Outdoor ...
Refining boat electrofishing equipment to improve consistency and reduce harm to fish

USGS Publications Warehouse

Miranda, L.E.

2005-01-01

A major concern with electrofishing is the standardization of sampling equipment and methods, particularly when collections are used to monitor spatial and temporal changes in fish communities. Standardization can not only ensure that stock assessment is consistent - that is, the data collected over time and space have equal meaning and are not influenced by differences in gear or gear application - but also reduce injury by constraining power to ranges that are likely to immobilize fish but unlikely to harm them. Standardization of electrofishing equipment requires adjusting power output to keep constant the amount of power transferred to fish in diverse water conditions. In this study, the power level thresholds required to immobilize and injure fish under controlled laboratory conditions were identified for various size-species combinations and applied to establish power minima and maxima suitable for successful and safe boat electrofishing. The target settings identified allowed survival of 99.4% of the fish collected and held for 2-3 h during field trials; all the mortalities were small fish (???53 mm long). The standardization procedure described herein may be adapted to single boats or fleets and can promote consistency in electrofishing, although it does not completely avoid harm to fish. Because electrofishing is an active capture method applied to changing microenvironments, complete standardization and total avoidance of harm to individual fish are not feasible with present technology, but standardization of controllable variables is advisable.
Prenatal Care

MedlinePlus

... and prescription medicines you are using. These include dietary or herbal supplements. Some medicines are not safe during pregnancy. At the same time, stopping medicines you need also can be harmful. Avoid contact with toxic substances or materials at ...
Personality traits as risk factors of depression and anxiety among Japanese students.

PubMed

Matsudaira, Tomomi; Kitamura, Toshinori

2006-01-01

The aim of this study is to examine the effects of personality (temperament and character) on specific depression and specific anxiety. A total of 541 Japanese undergraduates were investigated by using the Temperament and Character Inventory (TCI) and the Hospital Anxiety and Depression (HAD) scale. Hierarchical multiple regression analyses demonstrated that specific depression was predicted by lower Reward-Dependence, Persistence, Self-Directedness, Cooperativeness, and Self-Transcendence; specific anxiety was predicted by higher Novelty-Seeking, Harm-Avoidance, Persistence, and Self-Transcendence, and lower Self-Directedness. Immaturity of Self-Directedness is a risk factor for negative affectivity. Immaturity of all character dimensions is a risk factor for specific depression. The relationship between Harm-Avoidance and depression in previous studies may be linked partly to somatic symptoms that were deliberately eliminated in the HAD scale.
Personality Traits and Comorbidity in Adults With ADHD.

PubMed

Instanes, Johanne Telnes; Haavik, Jan; Halmøy, Anne

2016-10-01

To assess personality traits using the Temperament and Character Inventory (TCI) in a group of 63 previously diagnosed ADHD patients and 68 population controls and investigate the impact of common comorbid psychiatric disorders on these personality measures. Psychiatric comorbidity was assessed with the Mini International Neuropsychiatric Interview Plus and personality traits by the TCI. The patient group had significantly higher scores on the TCI dimensions Harm avoidance and Novelty seeking compared with the control group. However, when adjusting for comorbid anxiety and depressive disorder, the ADHD group no longer showed higher Harm avoidance than the control group. The difference in Novelty seeking between the patient and control groups was correlated with lifetime diagnosis of antisocial personality disorder (ASPD). It is important to take comorbid psychiatric disorders into account while investigating personality traits in ADHD. © The Author(s) 2013.
Brain derived neurotrophic factor gene (BDNF) and personality traits: the modifying effect of season of birth and sex.

PubMed

Kazantseva, A; Gaysina, D; Kutlumbetova, Yu; Kanzafarova, R; Malykh, S; Lobaskova, M; Khusnutdinova, E

2015-01-02

Personality traits are complex phenotypes influenced by interactions of multiple genetic variants of small effect and environmental factors. It has been suggested that the brain derived neurotrophic factor gene (BDNF) is involved in personality traits. Season of birth (SOB) has also been shown to affect personality traits due to its influences on brain development during prenatal and early postnatal periods. The present study aimed to investigate the effects of BDNF on personality traits; and the modifying effects of SOB and sex on associations between BDNF and personality traits. A sample of 1018 young adults (68% women; age range 17-25years) of Caucasian origin from the Russian Federation was assessed on personality traits (Novelty Seeking, Harm Avoidance, Reward Dependence, Persistence, Self-directedness, Cooperativeness, Self-transcendence) with the Temperament and Character Inventory-125 (TCI-125). Associations between personality traits and 12 BDNF SNPs were tested using linear regression models. The present study demonstrated the effect of rs11030102 on Persistence in females only (PFDR=0.043; r(2)=1.3%). There were significant interaction effects between Val66Met (rs6265) and SOB (PFDR=0.048, r(2)=1.4%), and between rs2030323 and SOB (PFDR=0.042, r(2)=1.3%), on Harm Avoidance. Our findings provide evidence for the modifying effect of SOB on the association between BDNF and Harm Avoidance, and for the modifying effect of sex on the association between BDNF and Persistence. Copyright © 2014 Elsevier Inc. All rights reserved.
The association between fear of cancer recurrence and quality of life among Chinese cancer survivors: main effect hypothesis and buffering hypothesis.

PubMed

Cho, Dalnim; Lu, Qian

2017-09-01

The aim of the present study is to examine whether fear of cancer recurrence (FCR) is related to health-related quality of life (HRQOL) among Chinese cancer survivors, an understudied population (i.e., main effect hypothesis). Also, we investigated whether the FCR-HRQOL link is moderated by two coping strategies, avoidance and positive reappraisal (i.e., buffering hypothesis). This is a cross-sectional study conducted among 238 Chinese cancer survivors in Beijing. Participants completed a set of questionnaires including FCR, coping, and HRQOL. FCR was related to lower physical, psychological, social, and spiritual well-beings, even when demographics, cancer-related factors, and coping were taken into account. There was only one moderation effect between FCR and avoidance coping. Surprisingly, the detrimental effect of FCR on spiritual well-being was lessened among those with high avoidance coping such that the negative association between FCR and spiritual well-being was only found in those with low avoidance coping and not among those with high avoidance coping. Findings largely supported the main effect hypothesis. FCR was associated with diverse domains of HRQOL among Chinese cancer survivors. The buffering hypothesis was largely not supported in this population. Rather, in some cases, the effects of FCR and coping strategies on HRQOL were independent. Thus, ways to attenuate the harmful effects of FCR on HRQOL among Chinese cancer survivors remain unresolved. It is urgent and timely that future studies focus on FCR and HRQOL in this population.
Head and Neck Cancer and the Elderly Patient.

PubMed

Cervenka, Brian P; Rao, Shyam; Bewley, Arnaud F

2018-05-22

Management of head and neck cancer in the elderly patient is particularly challenging given the high morbidity associated with treatment. Surgery, radiotherapy, and chemotherapy have all been demonstrated as effective in older patients; however, older patients are more susceptible to treatment-induced toxicity, which can limit the survival benefits of certain interventions. This susceptibility is better associated with the presence of multiple comorbidities and decreasing functional status than with age alone. Screening tools allow for risk stratification, treatment deintensification, and even treatment avoidance in patients who are deemed at high-risk of being harmed by standard therapy. Copyright © 2018 Elsevier Inc. All rights reserved.
[Cyclosporine A in the treatment of autoimmune hepatitis in the child: a case report].

PubMed

Ben Halima, Nabil; Chaabouni, Melek; Karray, Abderrahmen; Krichen, Anas; Masmoudi, Hatem; Jlidi, Rachid; Triki, Ali

2002-09-01

The current immunosuppressive treatment of patients with autoimmune hepatitis consists of prednisone and azathioprine. High doses of prednisone used to obtain the remission of the disease are associated with serious adverse effects. To avoid harmful consequences of prednisone, we proposed to treat patients with oral cyclosporine to obtain the remission of the inflammatory process. This case and review of the cases in the literature show that cyclosporine can induce remission of liver disease in children with autoimmune hepatitis, with few and well tolerated adverse effects.
Temporal indiscriminateness: the case of cluster bombs.

PubMed

Cavanaugh, T A

2010-03-01

This paper argues that the current stock of anti-personnel cluster bombs are temporally indiscriminate, and, therefore, unjust weapons. The paper introduces and explains the idea of temporal indiscriminateness. It argues that to honor non-combatant immunity-in addition to not targeting civilians-one must adequately target combatants. Due to their high dud rate, cluster submunitions fail to target combatants with sufficient temporal accuracy, and, thereby, result in avoidable serious harm to non-combatants. The paper concludes that non-combatant immunity and the principle of discrimination require a moratorium on the use of current cluster munitions.
The best argument against kidney sales fails.

PubMed

Semrau, Luke

2015-06-01

Simon Rippon has recently argued against kidney markets on the grounds that introducing the option to vend will result in many people, especially the poor, being subject to harmful pressure to vend. Though compelling, Rippon's argument fails. What he takes to be a single phenomenon-social and legal pressure to vend-is actually two. Only one of these forms of pressure is, by Rippon's own account, harmful. Further, an empirically informed view of the regulated market suggests that this harmful pressure is easily avoided. Thus, the harm that is the lynchpin of Rippon's opposition is neither a necessary feature of the market nor is it likely to play a significant role in its operation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Informal alcohol in Malawi: stakeholder perceptions and policy recommendations.

PubMed

Limaye, Rupali J; Rutkow, Lainie; Rimal, Rajiv N; Jernigan, David H

2014-02-01

Through the eyes of those involved in the alcohol policy-making process in Malawi, we explored the role of informal (non-commercial) alcohol in rural communities, its harmful effects, and implications for appropriate national policy. Harms included early drinking initiation, violence, and sexual risk exposure. Informants suggested that policy should address informal alcohol's content, selling times, and easy access. Because most informal alcohol producers are women who rely upon sales for subsistence, policies must avoid limiting women's economic opportunities while protecting community health.
All weather collision avoidance for unmanned aircraft systems

NASA Astrophysics Data System (ADS)

Contarino, Mark

2010-04-01

For decades, military and other national security agencies have been denied unfettered access to the National Air Space (NAS) because their unmanned aircraft lack a highly reliable and effective collision avoidance capability. The controlling agency, the Federal Aviation Administration, justifiably demands "no harm" to the safety of the NAS. To overcome the constraints imposed on Unmanned Aircraft Systems (UAS) use of the NAS, a new, complex, conformable collision avoidance system has been developed - one that will be effective in all flyable weather conditions, overcoming the shortfalls of other sensing systems, including radar, lidar, acoustic, EO/IR, etc., while meeting form factor and cost criteria suitable for Tier II UAS operations. The system also targets Tier I as an ultimate goal, understanding the operational limitations of the smallest UASs may require modification of the design that is suitable for Tier II and higher. The All Weather Sense and Avoid System (AWSAS) takes into account the FAA's plan to incorporate ADS-B (out) for all aircraft by 2020, and it is intended to make collision avoidance capability available for UAS entry into the NAS as early as 2013. When approved, UASs can fly mission or training flights in the NAS free of the constraints presently in place. Upon implementation this system will achieve collision avoidance capability for UASs deployed for national security purposes and will allow expansion of UAS usage for commercial or other civil purposes.
Habitat selection for parasite-free space by hosts of parasitic cowbirds

USGS Publications Warehouse

Forsman, J.T.; Martin, T.E.

2009-01-01

Choice of breeding habitat can have a major impact on fitness. Sensitivity of habitat choice to environmental cues predicting reproductive success, such as density of harmful enemy species, should be favored by natural selection. Yet, experimental tests of this idea are in short supply. Brown-headed cowbirds Molothrus ater commonly reduce reproductive success of a wide diversity of birds by parasitizing their nests. We used song playbacks to simulate high cowbird density and tested whether cowbird hosts avoid such areas in habitat selection. Host species that made settlement decisions during manipulations were significantly less abundant in the cowbird treatment as a group. In contrast, hosts that settled before manipulations started and non-host species did not respond to treatments. These results suggest that hosts of cowbirds can use vocal cues to assess parasitism risk among potential habitat patches and avoid high risk habitats. This can affect community structure by affecting habitat choices of species with differential vulnerability.
Identifying patient fear-avoidance beliefs by physical therapists managing patients with low back pain.

PubMed

Calley, Darren Q; Jackson, Steven; Collins, Heather; George, Steven Z

2010-12-01

Cross-sectional. To evaluate the accuracy with which physical therapists identify fear-avoidance beliefs in patients with low back pain by comparing therapist ratings of perceived patient fear-avoidance to the Fear-Avoidance Beliefs Questionnaire (FABQ), Tampa Scale of Kinesiophobia 11-item (TSK-11), and Pain Catastrophizing Scale (PCS). To compare the concurrent validity of therapist ratings of perceived patient fear-avoidance and a 2-item questionnaire on fear of physical activity and harm, with clinical measures of fear-avoidance (FABQ, TSK-11, PCS), pain intensity as assessed with a numeric pain rating scale (NPRS), and disability as assessed with the Oswestry Disability Questionnaire (ODQ). The need to consider psychosocial factors for identifying patients at risk for disability and chronic low back pain has been well documented. Yet the ability of physical therapists to identify fear-avoidance beliefs using direct observation has not been studied. Eight physical therapists and 80 patients with low back pain from 3 physical therapy clinics participated in the study. Patients completed the FABQ, TSK-11, PCS, ODQ, NPRS, and a dichotomous 2-item fear-avoidance screening questionnaire. Following the initial evaluation, physical therapists rated perceived patient fear-avoidance on a 0-to-10 scale and recorded 2 influences on their ratings. Spearman correlation and independent t tests determined the level of association of therapist 0-to-10 ratings and 2-item screening with fear-avoidance and clinical measures. Therapist ratings of perceived patient fear-avoidance had fair to moderate interrater reliability (ICC2,1 = 0.663). Therapist ratings did not strongly correlate with FABQ or TSK-11 scores. Instead, they unexpectedly had stronger associations with ODQ and PCS scores. Both 2-item screening questions were associated with FABQ-physical activity scores, while the fear of physical activity question was also associated with FABQ-work, TSK-11, PCS, and ODQ scores. Therapists' ratings of perceived patient fear-avoidance were not associated with self-reported fear-avoidance scores, showing a potential disconnect between therapist judgments and commonly used fear-avoidance measures. Instead, therapist ratings had small but statistically significant correlations with pain catastrophizing and disability, findings that may support therapists' inability to discriminate fear-avoidance from these other factors. The 2-item screening questions based on fear of physical activity and harm showed potential to identify elevated FABQ physical activity scores. Differential diagnosis, level 2b.
Psychobiology and treatment of borderline personality disorder.

PubMed

Cloninger, C Robert

2002-04-01

Borderline personality disorder can be characterized in terms of a profile of abnormal deviations on multiple personality dimensions using the temperament and character inventory (TCI). Borderline patients show poor character development, including low TCI self-directedness (irresponsible, blaming) and low TCI cooperativeness (hostile, intolerant). Their temperament is explosive or unstable due to a combination of high TCI harm avoidance (anxious, shy), high TCI novelty seeking (impulsive, quick-tempered), and low reward dependence (cold, aloof). Consequently they are usually dysthymic with an admixture of anxiety and anger, and regulate their social problems and intense emotions in immature ways. Genetic and psychobiological studies have led to identification of biological correlates of each of the TCI dimensions of personality, including individual differences in regional brain activity, psychophysiological variables, neuroendocrine abnormalities and specific gene polymorphisms. Each dimension of personality involves complex non-linear interaction of multiple genetic and environmental factors and, in turn, each personality dimension interacts with the others in influencing the way an individual directs and adapts to his or her life experiences. Systematic clinical trials have shown that these personality variables predict the response to pharmacological and psychotherapeutic treatments. For example, high harm avoidance and low self-directedness predict slower response and more rapid relapse with both antidepressants and cognitive-behavioral therapy. Treatment with drugs and/or psychotherapy can be individually matched to the patient's profile of temperament and character traits, rather than treating a heterogeneous group of patients as if they had a discrete, homogeneous illness. Fundamental change in cognitive schemas depends on attention to all aspects of character, especially self-transcendence, which has previously been neglected in cognitive-behavioral therapy. Personality integration requires non-resistance to our natural intuitive awareness, rather than intensified intellectual and emotional defenses.
Variation between hospitals in inpatient admission practices for self-harm patients and its impact on repeat presentation.

PubMed

Carroll, R; Corcoran, P; Griffin, E; Perry, I; Arensman, E; Gunnell, D; Metcalfe, C

2016-11-01

Self-harm patient management varies markedly between hospitals, with fourfold differences in the proportion of patients who are admitted to a medical or psychiatric inpatient bed. The current study aimed to investigate whether differences in admission practices are associated with patient outcomes (repeat self-harm) while accounting for differences in patient case mix. Data came from the National Self-Harm Registry Ireland. A prospective cohort of 43,595 self-harm patients presenting to hospital between 2007 and 2012 were included. As well as conventional regression analysis, instrumental variable (IV) methods utilising between hospital differences in rates of hospital admission were used in an attempt to gain unbiased estimates of the association of admission with risk of repeat self-harm. The proportion of self-harm patients admitted to a medical bed varied from 10 to 74 % between hospitals. Conventional regression and IV analysis suggested medical admission was not associated with risk of repeat self-harm. Psychiatric inpatient admission was associated with an increased risk of repeat self-harm in both conventional and IV analyses. This increased risk persisted in analyses stratified by gender and when restricted to self-poisoning patients only. No strong evidence was found to suggest medical admission reduces the risk of repeat self-harm. Models of health service provision that encourage prompt mental health assessment in the emergency department and avoid unnecessary medical admission of self-harm patients appear warranted. Psychiatric inpatient admission may be associated with a heightened risk of repeat self-harm in some patients, but these findings could be biased by residual confounding and require replication.
Collaborative Modeling of the Benefits and Harms Associated With Different U.S. Breast Cancer Screening Strategies.

PubMed

Mandelblatt, Jeanne S; Stout, Natasha K; Schechter, Clyde B; van den Broek, Jeroen J; Miglioretti, Diana L; Krapcho, Martin; Trentham-Dietz, Amy; Munoz, Diego; Lee, Sandra J; Berry, Donald A; van Ravesteyn, Nicolien T; Alagoz, Oguzhan; Kerlikowske, Karla; Tosteson, Anna N A; Near, Aimee M; Hoeffken, Amanda; Chang, Yaojen; Heijnsdijk, Eveline A; Chisholm, Gary; Huang, Xuelin; Huang, Hui; Ergun, Mehmet Ali; Gangnon, Ronald; Sprague, Brian L; Plevritis, Sylvia; Feuer, Eric; de Koning, Harry J; Cronin, Kathleen A

2016-02-16

Controversy persists about optimal mammography screening strategies. To evaluate screening outcomes, taking into account advances in mammography and treatment of breast cancer. Collaboration of 6 simulation models using national data on incidence, digital mammography performance, treatment effects, and other-cause mortality. United States. Average-risk U.S. female population and subgroups with varying risk, breast density, or comorbidity. Eight strategies differing by age at which screening starts (40, 45, or 50 years) and screening interval (annual, biennial, and hybrid [annual for women in their 40s and biennial thereafter]). All strategies assumed 100% adherence and stopped at age 74 years. Benefits (breast cancer-specific mortality reduction, breast cancer deaths averted, life-years, and quality-adjusted life-years); number of mammograms used; harms (false-positive results, benign biopsies, and overdiagnosis); and ratios of harms (or use) and benefits (efficiency) per 1000 screens. Biennial strategies were consistently the most efficient for average-risk women. Biennial screening from age 50 to 74 years avoided a median of 7 breast cancer deaths versus no screening; annual screening from age 40 to 74 years avoided an additional 3 deaths, but yielded 1988 more false-positive results and 11 more overdiagnoses per 1000 women screened. Annual screening from age 50 to 74 years was inefficient (similar benefits, but more harms than other strategies). For groups with a 2- to 4-fold increased risk, annual screening from age 40 years had similar harms and benefits as screening average-risk women biennially from 50 to 74 years. For groups with moderate or severe comorbidity, screening could stop at age 66 to 68 years. Other imaging technologies, polygenic risk, and nonadherence were not considered. Biennial screening for breast cancer is efficient for average-risk populations. Decisions about starting ages and intervals will depend on population characteristics and the decision makers' weight given to the harms and benefits of screening. National Institutes of Health.
Negligence: What Is It? How Can It Be Avoided?

ERIC Educational Resources Information Center

Carpenter, Linda Jean; Acosta, R. Vivian

1982-01-01

The physical educator or athletic coach needs to be aware of negligence in relation to the possible athletic injuries of students. The four legal components of negligence--duty, breach, cause, and harm--are discussed. (JN)

Female sex workers and the social context of workplace violence in Tijuana, Mexico.

PubMed

Katsulis, Yasmina; Lopez, Vera; Durfee, Alesha; Robillard, Alyssa

2010-09-01

Gender-based violence in the workplace impacts the physical and emotional wellbeing of sex workers and may lead to other health problems, such as PTSD and depression, drug abuse, and a greater likelihood of sexually transmitted infections. This study examines the social context of workplace violence and risk avoidance in the context of legal regulations meant to reduce harms associated with the industry. Ethnographic research, including 18 months of extended field observations and interviews with 190 female sex workers, is used to illustrate how sex workers in Tijuana, Mexico, experience and manage workplace violence. Multiple subthemes emerge from this analysis, including deciding where to work, working with a third party, avoiding theft, and dealing with police. These findings support the idea that the risk of violence is part of a larger "hierarchy of risk" that can result in a "tradeoff" of harms.
Motivation, working memory, and decision making: a cognitive-motivational theory of personality vulnerability to alcoholism.

PubMed

Finn, Peter R

2002-09-01

This article presents a cognitive-motivational theory (CMT) of the mechanisms associated with three basic dimensions of personality vulnerability to alcoholism, impulsivity/novelty seeking, harm avoidance, and excitement seeking. CMT describes the interrelationships between activity in basic motivational systems and attentional, decision-making and working memory processes as the mechanisms associated with variation in each personality trait. Impulsivity/novelty seeking reflects activity in both appetitive and inhibitory motivational systems, greater attention to reward cues, and increased emotional reactivity to reward and frustration. Harm avoidance reflects individual differences in fearfulness and activity in specific inhibitory systems. Excitement seeking reflects the need to engage in appetitive behaviors in less predictable environments to experience positive affect. CMT also describes the impact of working memory and the specific motivational processes underlying each trait dimension on the dynamics of decision making from the perspective of decision field theory.
Altered 5-HT2A Receptor Binding after Recovery from Bulimia-Type Anorexia Nervosa: Relationships to Harm Avoidance and Drive for Thinness

PubMed Central

Bailer, Ursula F; Price, Julie C; Meltzer, Carolyn C; Mathis, Chester A; Frank, Guido K; Weissfeld, Lisa; McConaha, Claire W; Henry, Shannan E; Brooks-Achenbach, Sarah; Barbarich, Nicole C; Kaye, Walter H

2015-01-01

Several lines of evidence suggest that a disturbance of serotonin neuronal pathways may contribute to the pathogenesis of anorexia nervosa (AN) and bulimia nervosa (BN). This study applied positron emission tomography (PET) to investigate the brain serotonin 2A (5-HT2A) receptor, which could contribute to disturbances of appetite and behavior in AN and BN. To avoid the confounding effects of malnutrition, we studied 10 women recovered from bulimia-type AN (REC AN–BN, >1 year normal weight, regular menstrual cycles, no binging, or purging) compared with 16 healthy control women (CW) using PET imaging and a specific 5-HT2A receptor antagonist, [18F]altanserin. REC AN–BN women had significantly reduced [18F]altanserin binding potential relative to CW in the left subgenual cingulate, the left parietal cortex, and the right occipital cortex. [18F]altanserin binding potential was positively related to harm avoidance and negatively related to novelty seeking in cingulate and temporal regions only in REC AN–BN subjects. In addition, REC AN–BN had negative relationships between [18F]altanserin binding potential and drive for thinness in several cortical regions. In conclusion, this study extends research suggesting that altered 5-HT neuronal system activity persists after recovery from bulimia-type AN, particularly in subgenual cingulate regions. Altered 5-HT neurotransmission after recovery also supports the possibility that this may be a trait-related disturbance that contributes to the pathophysiology of eating disorders. It is possible that subgenual cingulate findings are not specific for AN–BN, but may be related to the high incidence of lifetime major depressive disorder diagnosis in these subjects. PMID:15054474
When winning is everything.

PubMed

Malhotra, Deepak; Ku, Gillian; Murnighan, J Keith

2008-05-01

In the heat of competition, executives can easily become obsessed with beating their rivals. This adrenaline-fueled emotional state, which the authors call competitive arousal, often leads to bad decisions. Managers can minimize the potential for competitive arousal and the harm it can inflict by avoiding certain types of interaction and targeting the causes of a win-at-all-costs approach to decision making. Through an examination of companies such as Boston Scientific and Paramount, and through research on auctions, the authors identified three principal drivers of competitive arousal: intense rivalry, especially in the form of one-on-one competitions; time pressure, found in auctions and other bidding situations, for example; and being in the spotlight--that is, working in the presence of an audience. Individually, these factors can seriously impair managerial decision making; together, their consequences can be dire, as evidenced by many high-profile business disasters. It's not possible to avoid destructive competitions and bidding wars completely. But managers can help prevent competitive arousal by anticipating potentially harmful competitive dynamics and then restructuring the deal-making process. They can also stop irrational competitive behavior from escalating by addressing the causes of competitive arousal. When rivalry is intense, for instance, managers can limit the roles of those who feel it most. They can reduce time pressure by extending or eliminating arbitrary deadlines. And they can deflect the spotlight by spreading the responsibility for critical competitive decisions among team members. Decision makers will be most successful when they focus on winning contests in which they have a real advantage--and take a step back from those in which winning exacts too high a cost.
A sib-pair study of the Temperament and Character Inventory scales in major depression.

PubMed

Farmer, Anne; Mahmood, Arshad; Redman, Kate; Harris, Tanya; Sadler, Stephanie; McGuffin, Peter

2003-05-01

Certain aspects of the personality may be associated with the vulnerability to develop depression. A sib-pair method has been used to examine the familiality of the 7 scales of the Temperament and Character Inventory (TCI) and whether this could be related to the genetic vulnerability to develop depression. Probands with depression and their nearest-aged siblings from Wales were compared with healthy control probands and their nearest-aged siblings on the TCI and measures of depressed mood. All 7 scales of the TCI were familial, and scores on 6 of the scales were similar to US population scores. However, the Welsh subjects' scores on the self-transcendence scale were markedly lower than the US mean, suggesting strong cultural or national influences on this measure. Harm avoidance scores were substantially influenced by current and past depression, but this scale also showed stable traitlike characteristics that are likely related to the genetic vulnerability to depression. Novelty seeking and self-directedness were also partly state-dependent and were negatively correlated with low mood; high scorers may be resilient to the development of depression. High reward dependence may also protect against the development of depression and is unrelated to mood state. The cooperativeness, persistence, and self-transcendence scales appear to have a limited relationship with the development of depression. Harm avoidance, reward dependence, novelty seeking, and self-directedness have traitlike characteristics that are related to the familiality of depression. Cooperativeness, self-transcendence, and persistence are also familial, but this appears to be unrelated to depression.
The dopamine transporter gene may not contribute to susceptibility and the specific personality traits of amphetamine dependence.

PubMed

Tzeng, Nian-Sheng; Lu, Ru-Band; Yeh, Hui-Wen; Yeh, Yi-Wei; Huang, Chang-Chih; Yen, Che-Hung; Kuo, Shin-Chang; Chen, Chun-Yen; Chang, Hsin-An; Ho, Pei-Shen; Cheng, Serena; Shih, Mei-Chen; Huang, San-Yuan

2015-04-01

A substantial amount of evidence suggests that dysfunction of the dopamine transporter may be involved in the pathophysiology of amphetamine dependence (AD). The aim of this study was to examine whether the dopamine transporter gene (DAT1, SLC6A3) is associated with development of AD and whether this gene influences personality traits in patients with AD. Eighteen polymorphisms of the DAT1 gene were analyzed in a case-control study that included 909 Han Chinese men (568 patients with AD and 341 control subjects). The patients fulfilled the DSM-IV-TR criteria for AD. The Tridimensional Personality Questionnaire (TPQ) was used to assess personality traits and to examine the association between these traits and DAT1 gene variants. A weak association was found between the rs27072 polymorphism and development of AD, but these borderline associations were unconfirmed by logistic regression and haplotype analysis. Although harm avoidance and novelty seeking scores were significantly higher in patients than in controls, DAT1 polymorphisms did not influence these scores. This study suggests that high harm avoidance and novelty seeking personality traits may be a risk factor for the development of AD. However, the DAT1 gene may not contribute to AD susceptibility and specific personality traits observed in AD among Han Chinese men. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
The relationship between temperament and character in conversion disorder and comorbid depression.

PubMed

Erten, Evrim; Yenilmez, Yelda; Fistikci, Nurhan; Saatcioglu, Omer

2013-05-01

The aim of this study was to compare conversion disorder patients with healthy controls in terms of temperament and character, and to determine the effect of these characteristics on comorbid depression, based on the idea that conversion disorder patients may have distinctive temperament and character qualities. The study involved 58 patients diagnosed with conversion disorder, based on the DSM-IV diagnostic criteria, under observation at the Bakırköy Psychiatric and Neurological Disorders Outpatient Center, Istanbul. The patients were interviewed with a Structured Clinical Interview (SCID-I) and 57 healthy volunteers, matched for age, sex and education level, were interviewed with a Structured Clinical Interview for people without a psychiatric disorder (SCID-I/NP). All the participants completed a sociodemographic form, the Hamilton Depression Rating Scale, the Hamilton Anxiety Scale and the Temperament and Character Inventory. The conversion disorder patients displayed more harm avoidance (P<.001), more impulsivity (P<.01) and more sentimentality (P<.01) than the healthy controls, but were less persistent (P<.05). In terms of character qualities, conversion disorder patients had high self-transcendence (P<.05), but were inadequate in terms of self-directedness (P<.001) and took on less responsibility (P<.05) than the healthy controls. Conversion disorder patients are significantly different from healthy controls on temperament and character measures of harm avoidance, persistence, self-transcendence and self-directedness. Copyright © 2013 Elsevier Inc. All rights reserved.
Normative data and factorial structure of the Turkish version of the Temperament and Character Inventory.

PubMed

Kose, Samet; Sayar, Kemal; Kalelioglu, Ulgen; Aydin, Nazan; Celikel, Feryal Cam; Gulec, Huseyin; Ak, Ismail; Kirpinar, Ismet; Cloninger, C Robert

2009-01-01

Cloninger's dimensional psychobiological model of personality accounts for both normal and abnormal variation in 2 major personality components: temperament and character. Here, we examined the psychometric properties of the Turkish version of the Temperament and Character Inventory (TCI) in a healthy Turkish population, obtaining normative data for the Turkish TCI. The study was conducted in healthy volunteers at both Karadeniz Technical University School of Medicine and Atatürk University School of Medicine (n = 683). The Turkish sample had significantly lower mean scores on Novelty Seeking and Reward Dependence and higher mean scores on Harm Avoidance than the American sample. The Turkish sample had significantly lower scores on Self-Directedness, Cooperativeness, and Self-Transcendence. Self-Directedness and Harm Avoidance, Cooperativeness and Reward Dependence, and Cooperativeness and Self-Directedness were intercorrelated. The Cronbach coeficients were between 0.60 and 0.85 on temperament dimensions, and between 0.82 and 0.83 on character dimensions. The lowest Cronbach coefficients were found in Reward Dependence (0.60) and Persistence (0.62). A principal axis factor analysis with a 4-factor solution revealed the highest loadings on Novelty Seeking and Harm Avoidance and relatively weaker loadings on Reward Dependence and Persistence. A 3-factor solution for character subscales indicated the highest loadings on Cooperativeness and Self-Transcendence. The factorial structure was consistent with Cloninger's 7-factor model of personality, and test-retest indicated a good stability of scores over time. The reliability and factorial validity of the Turkish version of the TCI are therefore supported.
Neural mechanisms of oxytocin receptor gene mediating anxiety-related temperament.

PubMed

Wang, Junping; Qin, Wen; Liu, Bing; Zhou, Yuan; Wang, Dawei; Zhang, Yunting; Jiang, Tianzi; Yu, Chunshui

2014-09-01

A common variant (rs53576) of the OXTR gene has been implicated in a number of socio-emotional phenotypes, such as anxiety-related behavior. Previous studies have demonstrated that A-allele carriers have higher levels of physiological and dispositional stress reactivity and depressive symptomatology compared to those with the GG genotype, but the mediating neural mechanisms remain poorly understood. We combined voxel-based morphometry and resting-state functional connectivity analyses in a large cohort of healthy young Chinese Han individuals to test the hypothesis that the OXTR gene polymorphism influences an anxiety-related temperamental trait, as assessed by the harm avoidance subscale from the Tridimensional Personality Questionnaire via modulating the gray matter volume and resting-state functional connectivity of the brain, especially the limbic system. We revealed that female subjects with the AA genotype showed increased harm avoidance scores relative to G-carrier females. We also found that, compared to female individuals with the GG/GA genotype, female individuals with the AA genotype exhibited significantly smaller amygdala volumes bilaterally (especially the centromedial subregion), with a trend of allele-load-dependence. Compared to female individuals with the GG/GA genotype, female subjects with the AA genotype demonstrated reduced resting-state functional coupling between the prefrontal cortex and amygdala bilaterally, also with an allele-load-dependent trend. Furthermore, the magnitude of prefrontal-amygdala coupling in the left hemisphere was positively correlated with harm avoidance scores in female subjects. Our findings highlight a possible neural pathway by which a naturally occurring variation of the OXTR gene may affect an anxiety-related temperamental trait in female subjects by modulating prefrontal-amygdala functional connectivity.
Self-mutilation and suicide attempts: relationships to bipolar disorder, borderline personality disorder, temperament and character.

PubMed

Joyce, Peter R; Light, Katrina J; Rowe, Sarah L; Cloninger, C Robert; Kennedy, Martin A

2010-03-01

Self-mutilation has traditionally been associated with borderline personality disorder, and seldom examined separately from suicide attempts. Clinical experience suggests that self-mutilation is common in bipolar disorder. A family study was conducted on the molecular genetics of depression and personality, in which the proband had been treated for depression. All probands and parents or siblings were interviewed with a structured interview and completed the Temperament and Character Inventory. Fourteen per cent of subjects interviewed reported a history of self-mutilation, mostly by wrist cutting. Self-mutilation was more common in bipolar I disorder subjects then in any other diagnostic groups. In multiple logistic regression self-mutilation was predicted by mood disorder diagnosis and harm avoidance, but not by borderline personality disorder. Furthermore, the relatives of non-bipolar depressed probands with self-mutilation had higher rates of bipolar I or II disorder and higher rates of self-mutilation. Sixteen per cent of subjects reported suicide attempts and these were most common in those with bipolar I disorder and in those with borderline personality disorder. On multiple logistic regression, however, only mood disorder diagnosis and harm avoidance predicted suicide attempts. Suicide attempts, unlike self-mutilation, were not familial. Self-mutilation and suicide attempts are only partially overlapping behaviours, although both are predicted by mood disorder diagnosis and harm avoidance. Self-mutilation has a particularly strong association with bipolar disorder. Clinicians need to think of bipolar disorder, not borderline personality disorder, when assessing an individual who has a history of self-mutilation.
Clinicians' Need for an Ecological Approach to Violence Reduction.

PubMed

Lee, Bandy X; Young, John L

2018-01-01

We now know that harmful social policies, such as those that deny health care to some people, can generate structural violence and be far more harmful than any type of direct violence. A health professional who engages in public health promotion must thus consider the adverse effects of structural violence generated by bad policies. On this view, the dictum, "first, do no harm," can be interpreted as a mandate to protect patients from injustice. Health care professionals' responsibilities extend to motivating policies that prevent avoidable deaths and disabilities. As we exist within an ecology, we must each recognize our responsibility to care for one another and for the larger human community. © 2018 American Medical Association. All Rights Reserved.
Functional network organizations of two contrasting temperament groups in dimensions of novelty seeking and harm avoidance.

PubMed

Kyeong, Sunghyon; Kim, Eunjoo; Park, Hae-Jeong; Hwang, Dong-Uk

2014-08-05

Novelty seeking (NS) and harm avoidance (HA) are two major dimensions of temperament in Cloninger׳s neurobiological model of personality. Previous neurofunctional and biological studies on temperament dimensions of HA and NS suggested that the temperamental traits have significant correlations with cortical and subcortical brain regions. However, no study to date has investigated the functional network modular organization as a function of the temperament dimension. The temperament dimensions were originally proposed to be independent of one another. However, a meta-analysis based on 16 published articles found a significant negative correlation between HA and NS (Miettunen et al., 2008). Based on this negative correlation, the current study revealed the whole-brain connectivity modular architecture for two contrasting temperament groups. The k-means clustering algorithm, with the temperamental traits of HA and NS as an input, was applied to divide the 40 subjects into two temperament groups: 'high HA and low NS' versus 'low HA and high NS'. Using the graph theoretical framework, we found a functional segregation of whole brain network architectures derived from resting-state functional MRI. In the 'high HA and low NS' group, the regulatory brain regions, such as the prefrontal cortex (PFC), are clustered together with the limbic system. In the 'low HA and high NS' group, however, brain regions lying on the dopaminergic pathways, such as the PFC and basal ganglia, are partitioned together. These findings suggest that the neural basis of inhibited, passive, and inactive behaviors in the 'high HA and low NS' group was derived from the increased network associations between the PFC and limbic clusters. In addition, supporting evidence of topological differences between the two temperament groups was found by analyzing the functional connectivity density and gray matter volume, and by computing the relationships between the morphometry and function of the brain. Copyright © 2014 Elsevier B.V. All rights reserved.
Taking action on developmental toxicity: Scientists’ duties to protect children

PubMed Central

2012-01-01

Background Although adaptation and proper biological functioning require developmental programming, pollutant interference can cause developmental toxicity or DT. Objectives This commentary assesses whether it is ethical for citizens/physicians/scientists to allow avoidable DT. Methods Using conceptual, economic, ethical, and logical analysis, the commentary assesses what major ethical theories and objectors would say regarding the defensibility of allowing avoidable DT. Results The commentary argues that (1) none of the four major ethical theories (based, respectively, on virtue, natural law, utility, or equity) can consistently defend avoidable DT because it unjustifiably harms, respectively, individual human flourishing, human life, the greatest good, and equality. (2) Justice also requires leaving “as much and as good” biological resources for all, including future generations possibly harmed if epigenetic change is heritable. (3) Scientists/physicians have greater justice-based duties, than ordinary/average citizens, to help stop DT because they help cause it and have greater professional abilities/opportunities to help stop it. (4) Scientists/physicians likewise have greater justice-based duties, than ordinary/average citizens, to help stop DT because they benefit more from it, given their relatively greater education/consumption/income. The paper shows that major objections to (3)-(4) fail on logical, ethical, or scientific grounds, then closes with practical suggestions for implementing its proposals. Conclusions Because allowing avoidable DT is ethically indefensible, citizens---and especially physicians/scientists---have justice-based duties to help stop DT. PMID:22963689
Taking action on developmental toxicity: scientists' duties to protect children.

PubMed

Shrader-Frechette, Kristin

2012-09-10

Although adaptation and proper biological functioning require developmental programming, pollutant interference can cause developmental toxicity or DT. This commentary assesses whether it is ethical for citizens/physicians/scientists to allow avoidable DT. Using conceptual, economic, ethical, and logical analysis, the commentary assesses what major ethical theories and objectors would say regarding the defensibility of allowing avoidable DT. The commentary argues that (1) none of the four major ethical theories (based, respectively, on virtue, natural law, utility, or equity) can consistently defend avoidable DT because it unjustifiably harms, respectively, individual human flourishing, human life, the greatest good, and equality. (2) Justice also requires leaving "as much and as good" biological resources for all, including future generations possibly harmed if epigenetic change is heritable. (3) Scientists/physicians have greater justice-based duties, than ordinary/average citizens, to help stop DT because they help cause it and have greater professional abilities/opportunities to help stop it. (4) Scientists/physicians likewise have greater justice-based duties, than ordinary/average citizens, to help stop DT because they benefit more from it, given their relatively greater education/consumption/income. The paper shows that major objections to (3)-(4) fail on logical, ethical, or scientific grounds, then closes with practical suggestions for implementing its proposals. Because allowing avoidable DT is ethically indefensible, citizens---and especially physicians/scientists---have justice-based duties to help stop DT.
An investigation into the psychobiology of social phobia: personality domains and serotonergic function.

PubMed

Chatterjee, S; Sunitha, T A; Velayudhan, A; Khanna, S

1997-06-01

The aim of the present study was to explore a psychobiological perspective in the aetiology of social phobia. The emphasis was on serotonergic function and personality. A total of 20 social phobics according to ICD-10 DCR criteria were assessed with the Schedule for Clinical Assessment in Neuropsychiatry and the International Personality Disorder Examination. They were compared with an age-matched normal population with regard to scores on the Fear of Negative Evaluation Scale, the Social Avoidance and Distress Scale, the Temperament and Character Inventory, and platelet 5HT2 receptor function. Other Axis-I disorders and cluster C personality disorders were frequently encountered. The social phobia group was characterized by high levels of harm avoidance, and low levels of novelty seeking, co-operativeness and self-directedness. Platelet 5HT2 receptor density did not differentiate between the groups, but was associated with severity of social phobia. An integrated psychobiological model is presented.
"It's not rocket science, what I do": Self-directed harm reduction strategies among drug using ethno-racially diverse gay and bisexual men.

PubMed

Greenspan, Nicole R; Aguinaldo, Jeffrey P; Husbands, Winston; Murray, James; Ho, Peter; Sutdhibhasilp, Noulmook; Cedano, José; Lau, Chris; Gray, Trevor; Maharaj, Rajendra

2011-01-01

Research on harm reduction has typically focused on broad-based or organisational strategies such as needle exchange and opiate substitute programmes. Less attention has been paid to the self-directed harm reduction practices of substance users themselves. Few studies have focused on sexual minority populations such as gay and bisexual men and fewer still on the marginalised groups that constitute these populations. This paper identifies self-directed harm reduction strategies among substance using ethno-racially diverse gay and bisexual men. This article presents findings from the Party Drugs Study in Toronto's gay dance club scene, a community-based qualitative study in Toronto, Canada. We present a thematic analysis of interviews with 43 gay and bisexual men from diverse ethno-racial backgrounds about their substance use in the gay dance club scene. We identify five self-directed harm reduction strategies: rationing, controlling or avoiding mixing, controlling quality, maintaining a healthy lifestyle, and following guidelines during substance use. We discuss our findings in relation to prior research and to critical theory. We suggest that drug users' awareness of possible harm, and their personal investment in harm reduction, constitute a viable platform from which community-based and public health organisations may promote and strengthen harm reduction among gay and bisexual men from ethno-racially diverse backgrounds. Copyright © 2010 Elsevier B.V. All rights reserved.
Into Thin Air.

ERIC Educational Resources Information Center

Kennedy, Mike

2001-01-01

Shows how schools are working to avoid the types of equipment, supplies, and maintenance practices that harm indoor air quality. Simple steps to maintaining a cleaner indoor air environment are highlighted as are steps to reducing the problem air quality and the occurrence of asthma. (GR)
Personality and PTSD II: personality assessment of PTSD-diagnosed Vietnam veterans using the cloninger tridimensional personality questionnaire (TPQ).

PubMed

Richman, H; Frueh, B C

1997-01-01

Examined Tridimensional Personality Questionnaire (TPQ) responses of 53 Vietnam veterans with Combat-Related Posttraumatic stress disorder. When compared with normative data, veterans were found to be high on harm avoidance (HA), low on reward dependence (RD), and high on novelty seeking (NS). High HA and high NS scores were predictive of increased PTSD symptom severity as assessed by the MMPI-2 PK (PTSD)scale, Mississippi Combat Scale for PTSD (M-PTSD), and Beck Depression Inventory (BDI). Low RD was associated with higher scores on both the MMPI-2 PK and M-PTSD scales. The observed "high HA-low RD-high NS" TPQ configuration is consistent with previous research findings/clinical observations, and provides insights into a pattern of dysfunctional personality traits often observed in this population.
How Social Care Beneficiaries in Poland Rate Relative Harmfulness of Various Tobacco and Nicotine-Containing Products.

PubMed

Milcarz, Marek; Polańska, Kinga; Bak-Romaniszyn, Leokadia; Kaleta, Dorota

2017-09-07

The aim of the study was to examine how social care beneficiaries rate the relative harmfulness of tobacco/nicotine-containing products compared to traditional cigarettes. This information is crucial for the development of effective tobacco control strategies targeting disadvantaged populations. The cross-sectional study covered 1817 respondents who were taking advantage of social aid services offered by the local social care institutions in the Piotrkowski district, via face-to-face interviews. The linear regression analysis indicated that relative to women, men consider slim cigarettes, smokeless tobacco and e-cigarettes to be more harmful than traditional cigarettes ( p < 0.05). The smokers of traditional cigarettes reported menthol cigarettes to be less harmful than traditional cigarettes, relative to the non-smokers ( p = 0.05). The current results demonstrate that social care beneficiaries are not aware of the fact that some products are less harmful than others. Education concerning tobacco/nicotine products should include advice on how to reduce the adverse health effects of smoking (e.g., avoiding inhalation of combusted products), while driving the awareness that no nicotine-containing products are safe.
How Social Care Beneficiaries in Poland Rate Relative Harmfulness of Various Tobacco and Nicotine-Containing Products

PubMed Central

Milcarz, Marek; Polańska, Kinga; Bak-Romaniszyn, Leokadia; Kaleta, Dorota

2017-01-01

The aim of the study was to examine how social care beneficiaries rate the relative harmfulness of tobacco/nicotine-containing products compared to traditional cigarettes. This information is crucial for the development of effective tobacco control strategies targeting disadvantaged populations. The cross-sectional study covered 1817 respondents who were taking advantage of social aid services offered by the local social care institutions in the Piotrkowski district, via face-to-face interviews. The linear regression analysis indicated that relative to women, men consider slim cigarettes, smokeless tobacco and e-cigarettes to be more harmful than traditional cigarettes (p < 0.05). The smokers of traditional cigarettes reported menthol cigarettes to be less harmful than traditional cigarettes, relative to the non-smokers (p = 0.05). The current results demonstrate that social care beneficiaries are not aware of the fact that some products are less harmful than others. Education concerning tobacco/nicotine products should include advice on how to reduce the adverse health effects of smoking (e.g., avoiding inhalation of combusted products), while driving the awareness that no nicotine-containing products are safe. PMID:28880223

[Substance use, affective problems and personality traits: test of two association models].

PubMed

Chakroun, N; Doron, J; Swendsen, J

2004-01-01

The International Consortium of Psychiatric Epidemiology has confirmed the high comorbidity in community-drawn samples between substance use disorders and anxiety or depression. In the same way, associations between substance use and specific personality traits (such as novelty seeking, harm avoidance or antisocial personality) have also been extensively documented. Self-medication and social deviance are among the most commonly evoked explanatory models for these forms of comorbidity, and are based on findings that affective disorders and specific personality traits often precede the onset of substance use disorders. The self-medication model postulates that an individual chooses a specific substance according to its psychopharmacologic action on the given psychological state of the person. By contrast, the social deviance model posits that this form of comorbidity is due to the fact that persons consuming certain substances may have affective or personality characteristics that are more severe or more deviant than non-consumers (or than consumers of socially well-accepted substances). In this way, the individual does not use a particular substance to assuage pre-existing disorders but, due to a more deviant personality, is less influenced by social norms and may more easily turn to using illicit substances or to polyconsumption. However, a major limitation of the current scientific literature concerning tests of these models is that previous investigations have been based in overwhelming majority on clinical populations. The examination only of clinical samples renders difficult the identification of causal (or primary) risk factors for the emergence of substance use disorders from the potential consequences of substance use itself. The goal of the current study was therefore to simultaneously compare both models of association using a non clinical population of substance users. In addition to selecting subjects based on use (rather than abuse or dependence), multiple comparisons were corrected with a Bonferroni adjustment. A two-phase sampling plan was used with post-stratification on substances use. In the first stage, an initial sample of 685 students was pre-selected based on responses to a battery of self-questionnaires, including information concerning recent consumption of substances (alcohol, cannabis, cocaine, heroin, acid, solvents, and so on), anxiety levels measured by the State and Trait Anxiety Inventory (STAI, Spielberger, 1983) and depression levels evaluated by the Center of Epidemiologic Studies Depression Scale (CES-D, Radloff, 1977). Based on responses to these questionnaires, 98 subjects were selected in the second phase to compose four groups of substance users: non consumers (those who did not use any substance during the last month); consumers of alcohol only, consumers of cannabis (with or without alcohol) and consumers of other illicit substances (with or without cannabis or alcohol). These subjects were then invited to participate in a brief laboratory-based meeting where they completed the Temperament and Character Inventory (TCI, Cloninger, 1992), which assessed different personality characteristics such as novelty seeking (NS), harm avoidance (HA) or antisocial personality disorder (APD). The hypotheses concerning self-medication were tested by multiple logistic regression by comparing each group of substance consumption to the non-consumer group relative to levels of anxiety, depression and scores of novelty seeking and harm avoidance. The social deviance model was tested by ANOVAs using contrasts which allowed for a test of a linear tendency across the four groups of consumption relative to each of the personality traits (novelty seeking, harm avoidance and antisocial personality). Results of multiple logistic regressions showed no difference between non-consumers and any group of consumers with regard to anxiety, depression and harm avoidance. However, consumers of other illicit substances significantly differed from non-consumers for novelty seeking trait (qOR=8.4; p<0.05). Results of the ANOVA also showed no differences between the four groups with regard to scores of harm avoidance and level of antisocial personality but again a comparison of novelty seeking scores was significant, F(94)=6.46, p<0.05. Moreover, the contrast method demonstrated that novelty seeking scores increased linearly and significantly (p<0.001) from the group of non-consumers to the group of the consumers of the most deviant substances. The results obtained in this non-clinical sample are in favor of social deviance model which posits that the personality trait of novelty seeking is associated to the consumption of the most illicit and deviant substances (such as heroin or cocaine). On the other hand, no support was found for the hypothesis of self-medication which assumes that specific substances should be particularly associated with specific psychological characteristics or vulnerabilities.
Altered avoidance behavior of young black ducks fed cadmium

USGS Publications Warehouse

Heinz, G.H.; Haseltine, S.D.; Sileo, L.

1983-01-01

Pairs of adult black ducks (Anas rubripes) were fed a diet containing 0, 4 or 40 ppm cadmium as cadmium chloride. One-week-old ducklings that had been fed thc same dietary concentrations of cadmium as had their parents were tested for avoidance of a fright stimulus. Ducklings fed 4 ppm cadmium ran significantly farther from the stimulus than did controls or ducklings fed 40 ppm cadmium. Such an alteration in behavior could have harmful effects on wild birds.
New evidence of heterogeneity in social anxiety disorder: defining two qualitatively different personality profiles taking into account clinical, environmental and genetic factors.

PubMed

Binelli, C; Muñiz, A; Sanches, S; Ortiz, A; Navines, R; Egmond, E; Udina, M; Batalla, A; López-Sola, C; Crippa, J A; Subirà, S; Martín-Santos, R

2015-01-01

To study qualitatively different subgroups of social anxiety disorder (SAD) based on harm avoidance (HA) and novelty seeking (NS) dimensions. One hundred and forty-two university students with SAD (SCID-DSM-IV) were included in the study. The temperament dimensions HA and NS from the Cloninger's Temperament and Character Inventory were subjected to cluster analysis to identify meaningful subgroups. The identified subgroups were compared for sociodemographics, SAD severity, substance use, history of suicide and self-harm attempts, early life events, and two serotonin transporter gene polymorphisms (5-HTTLPR and STin2.VNTR). Two subgroups of SAD were identified by cluster analysis: a larger (61% of the sample) inhibited subgroup of subjects with "high-HA/low-NS", and a smaller (39%) atypical impulsive subgroup with high-moderate HA and NS. The two groups did not differ in social anxiety severity, but did differ in history of lifetime impulsive-related-problems. History of suicide attempts and self-harm were as twice as frequent in the impulsive subgroup. Significant differences were observed in the pattern of substance misuse. Whereas subjects in the inhibited subgroup showed a greater use of alcohol (P=0.002), subjects in the impulsive subgroup showed a greater use of substances with a high-sensation-seeking profile (P<0.001). The STin2.VNTR genotype frequency showed an inverse distribution between subgroups (P=0.005). Our study provides further evidence for the presence of qualitatively different SAD subgroups and the propensity of a subset of people with SAD to exhibit impulsive, high-risk behaviors. Copyright © 2014 Elsevier Masson SAS. All rights reserved.
About the EPA Plan to Certify Applicators in Indian Country

EPA Pesticide Factsheets

Restricted use pesticides (RUPs) require special care to avoid harming human health or the environment. They can only be sold to or used by certified applicators. The EPA Plan applies to certified applicators who intend to apply RUPs in Indian Country.
29 CFR 825.220 - Protection for employees who request leave or otherwise assert FMLA rights.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., reinstatement, promotion, or any other relief tailored to the harm suffered (see § 825.400(c)). “Interfering... to preclude the taking of leave; (3) Reducing hours available to work in order to avoid employee...
Temperament features in adolescents with ego-syntonic or ego-dystonic obsessive-compulsive symptoms.

PubMed

Marchesi, Carlo; Ampollini, Paolo; DePanfilis, Chiara; Maggini, Carlo

2008-09-01

The present study evaluated whether different patterns of temperament may predict a different threshold of acceptability of obsessive-compulsive (OC) symptoms in adolescents. OC symptomatology was detected with the Leyton Obsessional Inventory-Child Version (LOI-CV) and temperament was assessed using the tridimensional personality questionnaire in 2,775 high-school students. According to the LOI-CV scores, the adolescents were classified as high interference (interfering, ego-dystonic symptoms) (HI), supernormal (noninterfering, ego-syntonic symptoms) (Sn) and controls (C) HI were 119 (4.3%), Sn 85 (3.1%) and C 2,571 (92.6%). The best predictor of belonging to HI or Sn groups was the temperament configuration of high Harm Avoidance (HA) and high Persistence (P). The feature that mainly distinguishes the two symptomatic groups were Novelty Seeking (NS) levels. Our data suggest that people characterized by pessimistic worry in anticipation of future problems, passive avoidant behaviour, rapid fatigability (high HA) and irresoluteness, ambitiousness, perseverance, perfectionism, enduring feelings of frustration (high P) might develop OC symptoms. Whether OC symptoms become ego-syntonic or ego-dystonic seems to mainly depend on NS levels: low NS might protect people (with the prevention of "exploratory and active behaviours" that may elicit loss of control on symptoms) from the development of interfering OC symptoms.
Protecting worker and public health during responses to catastrophic disasters-learning from the World Trade Center experience.

PubMed

Newman, David M

2014-11-01

Despite incremental lessons learned since 9/11, responder and community health remain at unnecessary risk during responses to catastrophic disasters, as evidenced during the BP Deepwater Horizon spill and Hurricanes Katrina, Rita, and Sandy. Much of the health harm that occurs during disaster response, as distinct from during the disaster event itself, is avoidable. Protection of public health should be an integral component of disaster response, which should "do no additional harm." This commentary examines how challenges and gaps the World Trade Center response resulted in preventable occupational and environmental health harm. It proposes changes in disaster response policies to better protect the health of rescue and recovery workers, volunteers, and impacted worker and residential communities. © 2014 Wiley Periodicals, Inc.
The cost-effectiveness and public health benefit of nalmefene added to psychosocial support for the reduction of alcohol consumption in alcohol-dependent patients with high/very high drinking risk levels: a Markov model

PubMed Central

Laramée, Philippe; Brodtkorb, Thor-Henrik; Rahhali, Nora; Knight, Chris; Barbosa, Carolina; François, Clément; Toumi, Mondher; Daeppen, Jean-Bernard; Rehm, Jürgen

2014-01-01

Objectives To determine whether nalmefene combined with psychosocial support is cost-effective compared with psychosocial support alone for reducing alcohol consumption in alcohol-dependent patients with high/very high drinking risk levels (DRLs) as defined by the WHO, and to evaluate the public health benefit of reducing harmful alcohol-attributable diseases, injuries and deaths. Design Decision modelling using Markov chains compared costs and effects over 5 years. Setting The analysis was from the perspective of the National Health Service (NHS) in England and Wales. Participants The model considered the licensed population for nalmefene, specifically adults with both alcohol dependence and high/very high DRLs, who do not require immediate detoxification and who continue to have high/very high DRLs after initial assessment. Data sources We modelled treatment effect using data from three clinical trials for nalmefene (ESENSE 1 (NCT00811720), ESENSE 2 (NCT00812461) and SENSE (NCT00811941)). Baseline characteristics of the model population, treatment resource utilisation and utilities were from these trials. We estimated the number of alcohol-attributable events occurring at different levels of alcohol consumption based on published epidemiological risk-relation studies. Health-related costs were from UK sources. Main outcome measures We measured incremental cost per quality-adjusted life year (QALY) gained and number of alcohol-attributable harmful events avoided. Results Nalmefene in combination with psychosocial support had an incremental cost-effectiveness ratio (ICER) of £5204 per QALY gained, and was therefore cost-effective at the £20 000 per QALY gained decision threshold. Sensitivity analyses showed that the conclusion was robust. Nalmefene plus psychosocial support led to the avoidance of 7179 alcohol-attributable diseases/injuries and 309 deaths per 100 000 patients compared to psychosocial support alone over the course of 5 years. Conclusions Nalmefene can be seen as a cost-effective treatment for alcohol dependence, with substantial public health benefits. Trial registration numbers This cost-effectiveness analysis was developed based on data from three randomised clinical trials: ESENSE 1 (NCT00811720), ESENSE 2 (NCT00812461) and SENSE (NCT00811941). PMID:25227627
Personality dimensions in bulimia nervosa, binge eating disorder, and obesity.

PubMed

Peterson, Carol B; Thuras, Paul; Ackard, Diann M; Mitchell, James E; Berg, Kelly; Sandager, Nora; Wonderlich, Stephen A; Pederson, Melissa W; Crow, Scott J

2010-01-01

The purpose of this investigation was to examine differences in personality dimensions among individuals with bulimia nervosa, binge eating disorder, non-binge eating obesity, and a normal-weight comparison group as well as to determine the extent to which these differences were independent of self-reported depressive symptoms. Personality dimensions were assessed using the Multidimensional Personality Questionnaire in 36 patients with bulimia nervosa, 54 patients with binge eating disorder, 30 obese individuals who did not binge eat, and 77 normal-weight comparison participants. Participants with bulimia nervosa reported higher scores on measures of stress reaction and negative emotionality compared to the other 3 groups and lower well-being scores compared to the normal-weight comparison and the obese samples. Patients with binge eating disorder scored lower on well-being and higher on harm avoidance than the normal-weight comparison group. In addition, the bulimia nervosa and binge eating disorder groups scored lower than the normal-weight group on positive emotionality. When personality dimensions were reanalyzed using depression as a covariate, only stress reaction remained higher in the bulimia nervosa group compared to the other 3 groups and harm avoidance remained higher in the binge eating disorder than the normal-weight comparison group. The higher levels of stress reaction in the bulimia nervosa sample and harm avoidance in the binge eating disorder sample after controlling for depression indicate that these personality dimensions are potentially important in the etiology, maintenance, and treatment of these eating disorders. Although the extent to which observed group differences in well-being, positive emotionality, and negative emotionality reflect personality traits, mood disorders, or both, is unclear, these features clearly warrant further examination in understanding and treating bulimia nervosa and binge eating disorder.
Temperament traits and psychopathy in a group of patients with antisocial personality disorder.

PubMed

Basoglu, Cengiz; Oner, Ozgur; Ates, Alpay; Algul, Ayhan; Bez, Yasin; Ebrinc, Servet; Cetin, Mesut

2011-01-01

The Psychopathy Checklist Revised (PCL-R) and Temperament and Character Inventory (TCI) have been used extensively in research of personality disorders; however, no previous study has investigated the relation between psychopathy factors and temperament and character traits in patients with antisocial personality disorder (ASPD). Our aim was to fill this gap in the literature. The PCL-R Factor scores and the TCI temperament and character scores were evaluated in 68 men with ASPD and 65 healthy male controls. The ASPD cases had significantly higher PCL-R Factor 1, Factor 2, and Total scores, as well as significantly higher TCI Novelty Seeking and Harm Avoidance scores, whereas the control group had higher TCI Reward Dependence, Persistence, Self-Directedness, and Cooperativeness scores. Correlation analysis revealed that, in the whole study group, PCL-R Factor 1, Factor 2, and Total scores were positively correlated with Novelty Seeking and Harm Avoidance scores and negatively correlated with Reward Dependence, Persistence, Self-Directedness, and Cooperativeness scores. When each group was analyzed separately, the correlations were not significant. Regression analysis supported the main findings. Our results showed that both PCL-R Factor 1 score, which is claimed to reflect "core psychopathy," and PCL-R Factor 2 score, which reflects criminal behaviors, were positively correlated with Novelty Seeking and Harm Avoidance and were negatively correlated with Reward Dependence in the whole sample. The reduced variance of PCL-R in each group might lead to nonsignificant associations within groups. Without the subjects with severe psychopathy in the present study, it might not be possible to show the association. Copyright © 2011 Elsevier Inc. All rights reserved.
Emotion regulation in disordered eating: Psychometric properties of the Difficulties in Emotion Regulation Scale among Spanish adults and its interrelations with personality and clinical severity

PubMed Central

Wolz, Ines; Agüera, Zaida; Granero, Roser; Jiménez-Murcia, Susana; Gratz, Kim L.; Menchón, José M.; Fernández-Aranda, Fernando

2015-01-01

Objective: The aims of the study were to (1) validate the Difficulties in Emotion Regulation Scale (DERS) in a sample of Spanish adults with and without eating disorders, and (2) explore the role of emotion regulation difficulties in eating disorders (ED), including its mediating role in the relation between key personality traits and ED severity. Methods: One hundred and thirty four patients (121 female, mean age = 29 years) with anorexia nervosa (n = 30), bulimia nervosa (n = 54), binge eating (n = 20), or Other Specified Feeding or Eating Disorders (n = 30) and 74 healthy control participants (51 female, mean age = 21 years) reported on general psychopathology, ED severity, personality traits and difficulties in emotion regulation. Exploratory and confirmatory factor analyses were conducted to examine the psychometrics of the DERS in this Spanish sample (Aim 1). Additionally, to examine the role of emotion regulation difficulties in ED (Aim 2), differences in emotion regulation difficulties across eating disorder subgroups were examined and structural equation modeling was used to explore the interrelations among emotion regulation, personality traits, and eating disorder severity. Results: Results support the validity and reliability of the DERS within this Spanish adult sample and suggest that this measure has a similar factor structure in this sample as in the original sample. Moreover, emotion regulation difficulties were found to differ as a function of eating disorder subtype and to mediate the relation between two specific personality traits (i.e., high harm avoidance and low self-directedness) and ED severity. Conclusions: Personality traits of high harm avoidance and low self-directedness may increase vulnerability to ED pathology indirectly, through emotion regulation difficulties. PMID:26175710
Increased prevalence of anxiety-associated personality traits in patients with Cushing's disease: a cross-sectional study.

PubMed

Dimopoulou, C; Ising, M; Pfister, H; Schopohl, J; Stalla, G K; Sievers, C

2013-01-01

Chronic hypercortisolism in Cushing's disease (CD) has been suggested to contribute to an altered personality profile in these patients. We aimed to test this hypothesis and attempted to determine the effects of disease- and treatment-related factors that might moderate an altered personality in CD. We assessed 50 patients with CD (74% biochemically controlled) and compared them to 60 patients with non-functioning pituitary adenomas (NFPA) and 100 age- and gender-matched mentally healthy controls. Personality was measured by two standardized personality questionnaires, TPQ (Cloninger personality questionnaire) and EPQ-RK (Eysenck personality questionnaire-RK). Compared to mentally healthy controls, CD patients reported significantly less novelty-seeking behaviour, including less exploratory excitability and less extravagance. On harm avoidant subscales, they presented with more anticipatory worries and pessimism, higher fear of uncertainty, shyness with strangers, fatigability and asthenia. Moreover, CD patients appeared to be less extraverted, more neurotic and socially desirable. CD patients differed from NFPA patients in terms of higher neuroticism scores, and NFPA patients did not show altered novelty-seeking behaviour or extraversion. In the subgroup analysis, CD patients with persistent hypercortisolism displayed significantly higher fear of uncertainty, fatigability and asthenia, indicating high harm avoidance in total, than those in biochemical remission. Patients with CD showed a distinct pattern of personality traits associated with high anxiety in combination with traits of low externalizing behaviour. Such personality changes should be taken into account in the diagnosis and treatment of CD patients, as they might interfere with the patient-physician communication and/or challenge the patients' social and psychological functioning. Copyright © 2012 S. Karger AG, Basel.
Torts.

ERIC Educational Resources Information Center

Thurston, Paul W.

Decisions made by federal and state courts during 1983 concerning the liability of schools, school districts, school boards, or school employees in tort cases are reported in this chapter. Torts are civil causes of action based on noncontractual legal responsibilities that individuals have to avoid harming or injuring another's person, property,…
HealthLines for Pregnancy …healthy eating, exercising, and 10 more handy sources of information

MedlinePlus

... keeping your healthy eating habits on track. Certain foods and beverages can harm your baby if you eat or ... health care provider for a complete list of foods and beverages to avoid. Generally, you should not consume: Alcohol . ...
Evaluating Claims to Avoid Pseudoscientific and Unproven Practices in Special Education

ERIC Educational Resources Information Center

Travers, Jason C.

2017-01-01

Special education professionals are charged with using evidence-based practices, but various unproven, disproven, and pseudoscientific interventions continue to proliferate. Unproven and ineffective interventions emerge and are adopted for various reasons. Ineffective interventions are inevitably harmful and require professionals to adopt a…
[Attachment styles, childhood and adult traumatic experiences, mental states and methods of suicide attempts among psychiatrically treated women].

PubMed

Mandal, Eugenia; Zalewska, Karolina

2012-01-01

The purpose of this study was to explore any particular personality traits and psychosocial conditions of suicidal attempts among women, especially their adult attachment styles, harmful social experiences in childhood, adult live events and mental states directly leading to suicidal effort and methods of suicide. A group of 35 psychiatrically treated women who attempted suicide were submitted to the study. The following measures were used: Attachment Style Test, structured psychological interview. Women, who attempted suicide mainly described their attachment style as avoidant; the types of problems they reported as being significant were: experiences of violence in their childhood, loss of members of their families, suicide of their relatives in their adulthood, being the victims of marital violence; those women mainly felt social rejection and overdosed medications when trying to commit suicide. Parasuicides were characterised by avoidant attachment style and had a variety of traumatic and harmful experiences during their lifetime, that established their victimisation process and the wish of auto-destruction.
An alternative view of psychological well-being in cardiac rehabilitation: Considering temperament and character.

PubMed

Carless, David; Douglas, Kitrina; Fox, Kenneth; McKenna, Jim

2006-09-01

Research suggests that personality is related to recovery from cardiac events, yet few conceptions of personality provide hope or possibility of improvement for patients with the least adaptive personality types. Psychobiological theory of personality has potential in this regard, but, to date, no research has investigated temperament and character in cardiac settings. To explore relationships between temperament, character and psychological well-being among cardiac patients. Self-report questionnaires were distributed to a convenience sample of 81 cardiac patients to obtain data on personality (TCI [Cloninger CR, Przybeck T, Svrakic D, & Wetzel RD. The Temperament and Character Inventory (TCI): A guide to its development and use. St Louis (MO), Center for Psychobiology of Personality, Washington University;1994]), anxiety and depression (HADS [Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67(6): 361-70]) and satisfaction with life [Diener E, Emmons RA, Larsen RJ, Griffin S. The satisfaction with life scale. J Pers Assess 1985;49(1):71-5]. The interaction of two personality dimensions (harm avoidance and self-directedness) was significantly related to measures of psychological well-being. Patients with low self-directedness combined with high harm avoidance reported significantly higher levels of anxiety, depression and lower levels of satisfaction with life. This exploratory study suggests that psychobiological theory of personality may be useful for practitioners in cardiac rehabilitation seeking to identify patients at risk of poor psychological well-being.
Teamwork, Communication, Formula-One Racing and the Outcomes of Cardiac Surgery

PubMed Central

Merry, Alan F.; Weller, Jennifer; Mitchell, Simon J.

2014-01-01

Abstract: Most cardiac units achieve excellent results today, but the risk of cardiac surgery is still relatively high, and avoidable harm is common. The story of the Green Lane Cardiothoracic Unit provides an exemplar of excellence, but also illustrates the challenges associated with changes over time and with increases in the size of a unit and the complexity of practice today. The ultimate aim of cardiac surgery should be the best outcomes for (often very sick) patients rather than an undue focus on the prevention of error or adverse events. Measurement is fundamental to improving quality in health care, and the framework of structure, process, and outcome is helpful in considering how best to achieve this. A combination of outcomes (including some indicators of important morbidity) with key measures of process is advocated. There is substantial evidence that failures in teamwork and communication contribute to inefficiency and avoidable harm in cardiac surgery. Minor events are as important as major ones. Six approaches to improving teamwork (and hence outcomes) in cardiac surgery are suggested. These are: 1) subspecialize and replace tribes with teams; 2) sort out the leadership while flattening the gradients of authority; 3) introduce explicit training in effective communication; 4) use checklists, briefings, and debriefings and engage in the process; 5) promote a culture of respect alongside a commitment to excellence and a focus on patients; 6) focus on the performance of the team, not on individuals. PMID:24779113
Teamwork, communication, formula-one racing and the outcomes of cardiac surgery.

PubMed

Merry, Alan F; Weller, Jennifer; Mitchell, Simon J

2014-03-01

Most cardiac units achieve excellent results today, but the risk of cardiac surgery is still relatively high, and avoidable harm is common. The story of the Green Lane Cardiothoracic Unit provides an exemplar of excellence, but also illustrates the challenges associated with changes over time and with increases in the size of a unit and the complexity of practice today. The ultimate aim of cardiac surgery should be the best outcomes for (often very sick) patients rather than an undue focus on the prevention of error or adverse events. Measurement is fundamental to improving quality in health care, and the framework of structure, process, and outcome is helpful in considering how best to achieve this. A combination of outcomes (including some indicators of important morbidity) with key measures of process is advocated. There is substantial evidence that failures in teamwork and communication contribute to inefficiency and avoidable harm in cardiac surgery. Minor events are as important as major ones. Six approaches to improving teamwork (and hence outcomes) in cardiac surgery are suggested. These are: 1) subspecialize and replace tribes with teams; 2) sort out the leadership while flattening the gradients of authority; 3) introduce explicit training in effective communication; 4) use checklists, briefings, and debriefings and engage in the process; 5) promote a culture of respect alongside a commitment to excellence and a focus on patients; 6) focus on the performance of the team, not on individuals.
Towards better patient care: drugs to avoid.

PubMed

2013-04-01

Common sense dictates that one should choose tried and tested drugs with proven, concrete benefits that outweigh their adverse effects. Many new drugs are approved each year, often despite a lack of solid evidence that they are any better than existing treatments. Worse, some are approved despite being less effective or more harmful than current options. Massive promotion is used to ensure that such drugs achieve a positive image in the eyes of healthcare professionals and patients. Renowned "opinion leaders" intervene in their favour at conferences and in specialist media, and their opinions are further propagated by specialists in the field. Finally, campaigns in the lay media are used to highlight the target illness, encouraging patients to request a prescription. New data sometimes show that older, initially promising drugs are less effective or more harmful than first thought. For all these reasons, many drugs that are now present on the market are more harmful than beneficial and should be avoided. Unfortunately, negative assessment data and warnings are often drowned in the flood of promotion and advertising. Front-line healthcare professionals who are determined to act in their patients' best interests can find themselves swimming against a tide of specialist opinion, marketing authorisation, and reimbursement decisions. By leaving drugs that are more harmful than beneficial on the market and contenting themselves with simple half-measures, healthcare authorities are failing in their duty to protect patients. Prescrire, a journal funded solely by its subscribers, does not seek to do the work of health authorities, and does not have the means to do so. Prescrire's goal is simply to help healthcare professionals provide better care. The following text lists the principal drugs that we consider more harmful than beneficial, based on our reviews published between 2010 and 2012 in our French edition. These drugs should not be used. Patients and healthcare professionals should reassess ongoing treatments and, if necessary, replace these drugs with proven treatments. Without waiting for the authorities to remove them from the market in a timely manner, as the accumulation of data showing that they are more harmful than beneficial would require.

Individual correlates of self-stigma in patients with anxiety disorders with and without comorbidities

PubMed Central

Ociskova, Marie; Prasko, Jan; Kamaradova, Dana; Grambal, Ales; Sigmundova, Zuzana

2015-01-01

Background A number of psychiatric patients experience stigma connected to prejudices about mental disorders. It has been shown that stigma is most harmful when it is internalized. Most of the studies were performed on individuals either with psychoses or with mood disorders, and hence, there are almost no studies with other diagnostic categories. The goals of this research were to identify factors that are significantly related to self-stigma in patients with anxiety disorders and to suggest possible models of causality for these relationships. Methods A total of 109 patients with anxiety disorders and possible comorbid depressive or personality disorders, who were admitted to the psychotherapeutic department participated in this study. All patients completed several psychodiagnostic methods, ie, the Internalized Stigma of Mental Illness Scale, Temperament and Character Inventory-Revised Version, Adult Dispositional Hope Scale, Dissociative Experiences Scale, Beck Anxiety Inventory, Beck Depression Inventory-Second Edition, and Clinical Global Impression (also completed by the senior psychiatrist). Results The overall level of self-stigma was positively associated with a comorbid personality disorder, more severe symptomatology, more intense symptoms of anxiety and depression, and higher levels of dissociation and harm avoidance. Self-stigma was negatively related to hope, reward dependence, persistence, self-directedness, and cooperativeness. Multiple regression analysis showed that the most significant factors connected to self-stigma are harm avoidance, the intensity of depressive symptoms, and self-directedness. Two models of causality were proposed and validated. It seems that the tendency to dissociate in stress increases the probability of development of self-stigma, and this relationship is entirely mediated by avoidance of harm. Conversely, self-directedness lowers the probability of occurrence of self-stigma, and this effect is partly mediated by hope. Conclusion Patients with anxiety disorders accompanied with or without comorbid depressive or personality disorders may suffer from self-stigma. Individuals with greater sensitivity to rejection and other socially aversive stimuli are prone to the development of self-stigma. Other personality factors, such as hopeful thinking and self-acceptance serve as factors promoting resilience concerning self-stigma. PMID:26229471
[A cross sectional study of passive smoking of non-smoking women and analysis of influence factors on women passive smoking].

PubMed

Han, Jing-Xiu; Ma, Ling; Zhang, Hong-Wei; Liu, Xi; Zheng, Su-hua; Gan, De-kun; Fang, Jun

2006-09-01

To fund out the state of passive smoking of non-smoking women and search for measures of controlling women passive smoking. 3500 non-smoking women in Beijing, Shanghai, Chengdu city were interviewed. Analyses were performed by chi2 test Fisher test and ANOVA test. 92.7% passive smoking women exposure to ETS at home, 40.8% at workplace. 38.9% exposed to ETS from birthday, and 42.3% from 18 - 30 age. The average exposure time of passive smoking is (1.17 +/- 1.10) hours per day. The proportion of passive-smoking time over 2 hours at home is higher than work place. In passive-smoking group, the proportion of 30 - 50 age group, secondary education, married, merchant/service, principal of units, and manufacture/transport workers were higher than non-smoking group. 97.5% think that passive smoking is harmful to health, and the proportion of thinking passive smoking has severe harm to health in non-passive-smoking group is higher than passive-smoking group. 70.0% open windows when someone smokes around her, but only 16.9% ask the smokers do not smoke around her forwardly. Suppose that someone were smoking around yourself, the consciousness of avoiding passive smoking forwardly in non-passive-smoking group is stronger than passive-smoking group. 95.1% believe the content of smoking-harm propagandized by medium. The main places of controlling passive smoking are the home and the department, commerce, service, and manufacture/ transport workplace. The rate of passive smoking was influenced by the consciousness of the serious level of harms by passive smoking. Propagandizing the serious harm of passive smoking by medium and strengthening the consciousness of avoiding passive smoking were one of feasible measures to lower the rate of smoking and passive smoking.
Satisfaction with quality of life varies with temperament types of patients with schizophrenia.

PubMed

Ritsner, Michael; Farkas, Herman; Gibel, Anatoly

2003-10-01

We sought to explore the relationships of three temperament factors with domain-specific subjective quality of life (QOL) of patients with schizophrenia. Ninety patients with schizophrenia were evaluated using the Quality of Life Enjoyment and Life Satisfaction Questionnaire, the Tridimensional Personality Questionnaire, the Positive and Negative Syndromes Scale, the Distress Scale for Adverse Symptoms, the Insight and Treatment Attitudes Questionnaire, the Insight Self-Report Scale, and standardized questionnaires for self-reported emotional distress and stress process-related variables. Predictors of domain-specific QOL were identified using multiple regression techniques. Temperament factors explain 6% to 16% of variability in QOL domain scores among patients with schizophrenia after controlling for the remaining variables (emotional distress, social support, self-esteem, avoidance coping, age, side effects, and depression). We found that higher levels of novelty seeking are associated with better general QOL, physical health, and more positive subjective feelings, whereas higher levels of reward dependence are related to better satisfaction from social relationships. Higher levels of harm avoidance are associated with poorer satisfaction with general activities, and medication. Thus, temperament factors, as assessed by the Tridimensional Personality Questionnaire, substantially influence satisfaction with life quality in schizophrenia. Novelty seeking, reward dependence, and harm avoidance are associated with different domains of QOL.
Individual variation in the neural processes of motor decisions in the stop signal task: the influence of novelty seeking and harm avoidance personality traits.

PubMed

Hu, Jianping; Lee, Dianne; Hu, Sien; Zhang, Sheng; Chao, Herta; Li, Chiang-Shan R

2016-06-01

Personality traits contribute to variation in human behavior, including the propensity to take risk. Extant work targeted risk-taking processes with an explicit manipulation of reward, but it remains unclear whether personality traits influence simple decisions such as speeded versus delayed responses during cognitive control. We explored this issue in an fMRI study of the stop signal task, in which participants varied in response time trial by trial, speeding up and risking a stop error or slowing down to avoid errors. Regional brain activations to speeded versus delayed motor responses (risk-taking) were correlated to novelty seeking (NS), harm avoidance (HA) and reward dependence (RD), with age and gender as covariates, in a whole brain regression. At a corrected threshold, the results showed a positive correlation between NS and risk-taking responses in the dorsomedial prefrontal, bilateral orbitofrontal, and frontopolar cortex, and between HA and risk-taking responses in the parahippocampal gyrus and putamen. No regional activations varied with RD. These findings demonstrate that personality traits influence the neural processes of executive control beyond behavioral tasks that involve explicit monetary reward. The results also speak broadly to the importance of characterizing inter-subject variation in studies of cognition and brain functions.
A Review of Existing Relational Aggression Programs: Strengths, Limitations, and Future Directions

ERIC Educational Resources Information Center

Leff, Stephen S.; Waasdorp, Tracy Evian; Crick, Nicki R.

2010-01-01

Research suggests that involvement in relational aggression is associated with serious adjustment problems, including concurrent and future social maladjustment (e.g., problematic friendships; rejection), internalizing problems (e.g., depressive symptoms), and school avoidance. Despite the burgeoning literature focusing on the harmful and damaging…
Interviewing Children: Reporter Guide

ERIC Educational Resources Information Center

Carr, Sarah

2012-01-01

Interviewing children is a critical element of the education reporter's daily work. However, practices for gaining access and avoiding harm and embarrassment vary widely depending on the news organization and individual reporter in question. This document aims to provide journalists with broad guidelines, but it stops short of advocating for the…
Risk Factors of Suicidal Ideations and Attempts in Talented, At-Risk Girls

ERIC Educational Resources Information Center

Hull-Blanks, Elva E.; Kerr, Barbara A.; Robinson Kurpius, Sharon E.

2004-01-01

The purpose of the present study was to investigate the relationships among suicidality, substance use, self-esteem, family structure, and eight personality characteristics (harm avoidance, impulsivity, aggression, social recognition, cognitive structure, succorance, abasement, and achievement) with 337 talented, at-risk, adolescent girls. Results…
Health Benefits and Adverse Effects of a Gluten-Free Diet in Non–Celiac Disease Patients

PubMed Central

Niland, Benjamin

2018-01-01

Gluten-related diseases such as celiac disease and gluten ataxia are rare conditions, affecting less than 1% of the population in the United States. Despite the rarity of these diseases, there have been significant increases in the adoption of a gluten-free lifestyle and the consumption of gluten-free foods in the United States over the last 3 decades. More than $15.5 billion were spent on retail sales of gluten-free foods in 2016. The gluten-free diet is driven by multiple factors, including social and traditional media coverage, aggressive consumer-directed marketing by manufacturers and retail outlets, and reports in the medical literature and mainstream press of the clinical benefits of gluten avoidance. Individuals may restrict gluten from their diets for a variety of reasons, such as improvement of gastrointestinal and nongastrointestinal symptoms, as well as a perception that gluten is potentially harmful and, thus, restriction represents a healthy lifestyle. Emerging evidence shows that gluten avoidance may be beneficial for some patients with gastrointestinal symptoms, such as those commonly encountered with irritable bowel syndrome. However, high-quality evidence supporting gluten avoidance for physical symptoms or diseases other than those specifically known to be caused by immune-mediated responses to gluten is neither robust nor convincing. In fact, gluten avoidance may be associated with adverse effects in patients without proven gluten-related diseases. This article provides insight regarding gluten avoidance patterns and effects on patients without gluten-related diseases, and highlights concerns surrounding gluten avoidance in the absence of a gluten-mediated immunologic disease. PMID:29606920
Health Benefits and Adverse Effects of a Gluten-Free Diet in Non-Celiac Disease Patients.

PubMed

Niland, Benjamin; Cash, Brooks D

2018-02-01

Gluten-related diseases such as celiac disease and gluten ataxia are rare conditions, affecting less than 1% of the population in the United States. Despite the rarity of these diseases, there have been significant increases in the adoption of a gluten-free lifestyle and the consumption of gluten-free foods in the United States over the last 3 decades. More than $15.5 billion were spent on retail sales of gluten-free foods in 2016. The gluten-free diet is driven by multiple factors, including social and traditional media coverage, aggressive consumer-directed marketing by manufacturers and retail outlets, and reports in the medical literature and mainstream press of the clinical benefits of gluten avoidance. Individuals may restrict gluten from their diets for a variety of reasons, such as improvement of gastrointestinal and nongastrointestinal symptoms, as well as a perception that gluten is potentially harmful and, thus, restriction represents a healthy lifestyle. Emerging evidence shows that gluten avoidance may be beneficial for some patients with gastrointestinal symptoms, such as those commonly encountered with irritable bowel syndrome. However, high-quality evidence supporting gluten avoidance for physical symptoms or diseases other than those specifically known to be caused by immune-mediated responses to gluten is neither robust nor convincing. In fact, gluten avoidance may be associated with adverse effects in patients without proven gluten-related diseases. This article provides insight regarding gluten avoidance patterns and effects on patients without gluten-related diseases, and highlights concerns surrounding gluten avoidance in the absence of a gluten-mediated immunologic disease.
Today's epidemics in children: possible relations to environmental pollution and suggested preventive measures.

PubMed

van den Hazel, Peter; Zuurbier, Moniek; Babisch, Wolfgang; Bartonova, Alena; Bistrup, Marie Louise; Bolte, Gabriele; Busby, Chris; Butter, Maureen; Ceccatelli, Sandra; Fucic, Aleksandra; Hanke, Wojtec; Johansson, Carolina; Kohlhuber, Martina; Leijs, Marike; Lundqvist, Christofer; Moshammer, Hanns; Naginiene, Rima; Preece, Alan; Ronchetti, Roberto; Salines, Georges; Saunders, Margaret; Schoeters, Greet; Stilianakis, Nikolaos; ten Tusscher, Gavin; Koppe, Janna G

2006-10-01

Facts and hypotheses on the relationship between some children's diseases or disorders and external stressors during the developmental stage of a child, both prenatally and postnatally are described in literature. In this paper the following changes in patterns and causes of the main childhood illnesses are summarized and recommendations for actions are made. Prematurity. Intra-uterine growth restriction. Testicular dysgenesis syndrome. Type I and Type II diabetes. Asthma, atopy and hay fever. Autism. Attention deficit hyperactivity disorder (ADHD). Learning disabilities. Cancer. Obesity. Hearing problems. Literature provides a growing amount of information on changing patterns in childhood diseases. The following recommendations for action are formulated: Immediate research on endocrine disrupters in relation to prematurity. Diabetes: avoid Maillard Compounds in liquid baby food and in food in general: promote breastfeeding. Asthma: avoid exposure to smoking, the use of chemical household products, dioxin and dioxin-like chemicals, and avoid air pollution with high levels of particulate matter, especially around conception, during pregnancy and in the first years of life. Autism: more research on incidence and causes. ADHD and learning disabilities: more research on prevalence and causes. Preventions: 1) preconception counselling to avoid potentially harmful substances; 2) controlling and further lowering levels of polychlorinated biphenyls, lead and methyl mercury. Cancer: promote breastfeeding, carry out research into effects of foetal exposure to internal fission-product radionuclides. Obesity: stop smoking in pregnancy, avoid parental obesity, longer night sleep. Hearing problems: lower noise levels in discothèques, promote the day-evening-night level to avoid noise (longer night sleep).
Playing Hockey, Riding Motorcycles, and the Ethics of Protection

PubMed Central

2012-01-01

Ice hockey and motorcycle riding are increasingly popular activities in the United States that are associated with high risks of head and facial injuries. In both, effective head and facial protective equipment are available. Yet the debates about safety policies regarding the use of head protection in these activities have taken different forms, in terms of the influence of epidemiological data as well as of the ethical concerns raised. I examine these debates over injury prevention in the context of leisure activities, in which the public health duty to prevent avoidable harm must be balanced with the freedom to assume voluntary risks. PMID:23078472
Annual verifications--a tick-box exercise?

PubMed

Walker, Gwen; Williams, David

2014-09-01

With the onus on healthcare providers and their staff to protect patients against all elements of 'avoidable harm' perhaps never greater, Gwen Walker, a highly experienced infection prevention control nurse specialist, and David Williams, MD of Approved Air, who has 30 years' experience in validation and verification of ventilation and ultraclean ventilation systems, examine changing requirements for, and trends in, operating theatre ventilation. Validation and verification reporting on such vital HVAC equipment should not, they argue, merely be viewed as a 'tick-box exercise'; it should instead 'comprehensively inform key stakeholders, and ultimately form part of clinical governance, thus protecting those ultimately named responsible for organisation-wide safety at Trust board level'.
Trade and health: how World Trade Organization (WTO) law affects alcohol and public health.

PubMed

Baumberg, Ben; Anderson, Peter

2008-12-01

The alcohol field is becoming more aware of the consequences of world trade law for alcohol policies. However, there is a need for greater clarity about the different effects of trade on alcohol-related harm. A comprehensive review of all literature on alcohol and world trade [including World Trade Organization (WTO) disputes on alcohol], supported by a more selective review of other relevant cases, academic reports and the grey literature on trade and health. The burden of WTO law on alcohol policies depends upon the type of policy in question. Purely protectionist policies are likely to be struck down, which may lead to increases in alcohol-related harm. Partly protectionist and partly health-motivated policies are also at risk of being struck down. However, purely health-motivated policies are likely to be defended by the WTO-and to the extent that policy makers misunderstand this, they are needlessly avoiding effective ways of reducing alcohol-related harm. WTO agreements contain genuine and substantial risks to alcohol policies, and various ways of minimizing future risks are suggested. However, the 'chilling effect' of mistakenly overestimating these constraints should be avoided. Health policy makers should decide on which policies to pursue based primarily on considerations of effectiveness, ethics and politics rather than legality. As long as any effect of these policies on trade is minimized, they are overwhelmingly likely to win any challenges at the WTO.
Avoiding harm and supporting autonomy are under-prioritised in cancer-screening policies and practices.

PubMed

Parker, Lisa; Carter, Stacy; Williams, Jane; Pickles, Kristen; Barratt, Alexandra

2017-11-01

The ethical principles of avoiding harm and supporting autonomy are relevant to cancer-screening policy. We argue that more attention needs to be given to implementing them. Cancer screening may deliver excessive harms due to low-value or outdated screening programs and from poorly communicated screening options that leave people with heavy burdens of decision-making. Autonomy is inadequately supported due to limited opportunities for people to understand downsides of screening and because of institutional and societal pressures in favour of screening. Members of screening policy committees may have differing ideas about the goals of screening or have conflicts of interest that prevent them from addressing policy questions in a neutral way. We recommend the following: 1. Committees should be required to discern and discuss the values of individual members and the wider public; 2. Committee membership and voting procedures should be more carefully constructed to reduce the likelihood that committee members' interests are placed above public interests; 3. Committees should explain their policy decisions with reference to values as well as evidence, so that values considered in decision-making can be interrogated and challenged if necessary. These changes would increase the likelihood that cancer-screening policy decisions are in keeping with public views about what is important. Copyright © 2017 Elsevier Ltd. All rights reserved.
Randomized pilot trial of a cognitive-behavioral alcohol, self-harm, and HIV prevention program for teens in mental health treatment.

PubMed

Esposito-Smythers, Christianne; Hadley, Wendy; Curby, Timothy W; Brown, Larry K

2017-02-01

Adolescents with mental health conditions represent a high-risk group for substance use, deliberate self-harm (DSH), and risky sexual behavior. Mental health treatment does not uniformly decrease these risks. Effective prevention efforts are needed to offset the developmental trajectory from mental health problems to these behaviors. This study tested an adjunctive cognitive-behavioral family-based alcohol, DSH, and HIV prevention program (ASH-P) for adolescents in mental healthcare. A two group randomized design was used to compare ASH-P to an assessment only control (AO-C). Participants included 81 adolescents and a parent. Assessments were completed at pre-intervention as well as 1, 6, and 12-months post-enrollment, and included measures of family-based mechanisms and high-risk behaviors. ASH-P relative to AO-C was associated with greater improvements in most family process variables (perceptions of communication and parental disapproval of alcohol use and sexual behavior) as well as less DSH and greater refusal of sex to avoid a sexually transmitted infection. It also had a moderate (but non-significant) effect on odds of binge drinking. No differences were found in suicidal ideation, alcohol use, or sexual intercourse. ASH-P showed initial promise in preventing multiple high-risk behaviors. Further testing of prevention protocols that target multiple high-risk behaviors in clinical samples is warranted. Copyright © 2016 Elsevier Ltd. All rights reserved.
Beyond Behavioral Inhibition: A Computer Avatar Task Designed to Assess Behavioral Inhibition Extends to Harm Avoidance.

PubMed

Allen, Michael Todd; Jameson, Molly M; Myers, Catherine E

2017-01-01

Personality factors such as behavioral inhibition (BI), a temperamental tendency for avoidance in the face of unfamiliar situations, have been identified as risk factors for anxiety disorders. Personality factors are generally identified through self-report inventories. However, this tendency to avoid may affect the accuracy of these self-report inventories. Previously, a computer based task was developed in which the participant guides an on-screen "avatar" through a series of onscreen events; performance on the task could accurately predict participants' BI, measured by a standard paper and pencil questionnaire (Adult Measure of Behavioral Inhibition, or AMBI). Here, we sought to replicate this finding as well as compare performance on the avatar task to another measure related to BI, the harm avoidance (HA) scale of the Tridimensional Personality Questionnaire (TPQ). The TPQ includes HA scales as well as scales assessing reward dependence (RD), novelty seeking (NS) and persistence. One hundred and one undergraduates voluntarily completed the avatar task and the paper and pencil inventories in a counter-balanced order. Scores on the avatar task were strongly correlated with BI assessed via the AMBI questionnaire, which replicates prior findings. Females exhibited higher HA scores than males, but did not differ on scores on the avatar task. There was a strong positive relationship between scores on the avatar task and HA scores. One aspect of HA, fear of uncertainty was found to moderately mediate the relationship between AMBI scores and avatar scores. NS had a strong negative relationship with scores on the avatar task, but there was no significant relationship between RD and scores on the avatar task. These findings indicate the effectiveness of the avatar task as a behavioral alternative to self-report measures to assess avoidance. In addition, the use of computer based behavioral tasks are a viable alternative to paper and pencil self-report inventories, particularly when assessing anxiety and avoidance.
It's Hard To Keep Creativity Alive in Many Children.

ERIC Educational Resources Information Center

Winebrenner, Susan

2001-01-01

Suggestions are given to parents for encouraging creativity in children such as: respecting "wild and wacky" questions and responses, helping children understand the difference between making up tales and telling harmful lies, creating environments in which mistakes are not only valued but encouraged, and avoiding making comparisons in direct or…
76 FR 28060 - Regional Habitat Conservation Plan, Hays County, TX

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-13

... alternative features the acquisition of a modestly sized, pre-determined preserve system and limits the amount... under Alternative B, this alternative involves a conservation program that utilizes a pre-determined..., adaptive management, and other strategies designed to avoid and minimize harm to the covered species and...
Functional Connectivity in Frequency-Tagged Cortical Networks During Active Harm Avoidance

PubMed Central

Miskovic, Vladimir; Príncipe, José C.; Keil, Andreas

2015-01-01

Abstract Many behavioral and cognitive processes are grounded in widespread and dynamic communication between brain regions. Thus, the quantification of functional connectivity with high temporal resolution is highly desirable for capturing in vivo brain function. However, many of the commonly used measures of functional connectivity capture only linear signal dependence and are based entirely on relatively simple quantitative measures such as mean and variance. In this study, the authors used a recently developed algorithm, the generalized measure of association (GMA), to quantify dynamic changes in cortical connectivity using steady-state visual evoked potentials (ssVEPs) measured in the context of a conditioned behavioral avoidance task. GMA uses a nonparametric estimator of statistical dependence based on ranks that are efficient and capable of providing temporal precision roughly corresponding to the timing of cognitive acts (∼100–200 msec). Participants viewed simple gratings predicting the presence/absence of an aversive loud noise, co-occurring with peripheral cues indicating whether the loud noise could be avoided by means of a key press (active) or not (passive). For active compared with passive trials, heightened connectivity between visual and central areas was observed in time segments preceding and surrounding the avoidance cue. Viewing of the threat stimuli also led to greater initial connectivity between occipital and central regions, followed by heightened local coupling among visual regions surrounding the motor response. Local neural coupling within extended visual regions was sustained throughout major parts of the viewing epoch. These findings are discussed in a framework of flexible synchronization between cortical networks as a function of experience and active sensorimotor coupling. PMID:25557925
A critical analysis of user satisfaction surveys in addiction services: opioid maintenance treatment as a representative case study.

PubMed

Trujols, Joan; Iraurgi, Ioseba; Oviedo-Joekes, Eugenia; Guàrdia-Olmos, Joan

2014-01-01

Satisfaction with services represents a key component of the user's perspective, and user satisfaction surveys are the most commonly used approach to evaluate the aforementioned perspective. The aim of this discursive paper is to provide a critical overview of user satisfaction surveys in addiction treatment and harm reduction services, with a particular focus on opioid maintenance treatment as a representative case. We carried out a selective critical review and analysis of the literature on user satisfaction surveys in addiction treatment and harm reduction services. Most studies that have reported results of satisfaction surveys have found that the great majority of users (virtually all, in many cases) are highly satisfied with the services received. However, when these results are compared to the findings of studies that use different methodologies to explore the patient's perspective, the results are not as consistent as might be expected. It is not uncommon to find that "highly satisfied" patients report significant problems when mixed-methods studies are conducted. To understand this apparent contradiction, we explored two distinct (though not mutually exclusive) lines of reasoning, one of which concerns conceptual aspects and the other, methodological questions. User satisfaction surveys, as currently designed and carried out in addiction treatment and harm reduction services, do not significantly help to improve service quality. Therefore, most of the enthusiasm and naiveté with which satisfaction surveys are currently performed and interpreted - and rarely acted on in the case of nonoptimal results - should be avoided. A truly participatory approach to program evaluation is urgently needed to reshape and transform patient satisfaction surveys.

Heightened Sensitivity to Reward and Punishment in Anorexia Nervosa

PubMed Central

Jappe, Leah M.; Frank, Guido K.W.; Shott, Megan E.; Rollin, Michael D.H.; Pryor, Tamara; Hagman, Jennifer O.; Yang, Tony T.; Davis, Elizabeth

2011-01-01

Objective To test whether women with Anorexia Nervosa (AN) have increased sensitivity to punishing or rewarding stimuli, behaviors that could drive high self-control and anxious, avoidant behaviors. Method Sixty-four women completed the study: 33 control women (CW, mean age 19.7 years) and 31 AN (mean age 19.6 years). Participants completed diagnostic exams, questionnaires for eating disorder severity and personality, as well as the Sensitivity to Punishment/Sensitivity to Reward Questionnaire (SPSRQ). Results AN scored higher than CW on SPSRQ sensitivity to punishment (p<0.00001) and sensitivity to reward (p=0.005). AN women without anxiety or depression continued to have increased SPSRQ scores compared to CW. Conclusion This is the first study comparing the SPSRQ in AN and CW. Results suggest that reward and punishment sensitivity are increased in AN and could be potential trait markers. It is possible that harm-avoidant, anxious behaviors in AN are related to this heightened sensitivity. PMID:21472750
The cost of harmful alcohol use in South Africa.

PubMed

Matzopoulos, R G; Truen, S; Bowman, B; Corrigall, J

2014-02-01

The economic, social and health costs associated with alcohol-related harms are important measures with which to inform alcohol management policies and laws. This analysis builds on previous cost estimates for South Africa. We reviewed existing international best-practice costing frameworks to provide the costing definitions and dimensions. We sourced data from South African costing literature or, if unavailable, estimated costs using socio-economic and health data from secondary sources. Care was taken to avoid possible causes of cost overestimation, in particular double counting and, as far as possible, second-round effects of alcohol abuse. The combined total tangible and intangible costs of alcohol harm to the economy were estimated at 10 - 12% of the 2009 gross domestic product (GDP). The tangible financial cost of harmful alcohol use alone was estimated at R37.9 billion, or 1.6% of the 2009 GDP. The costs of alcohol-related harms provide a substantial counterbalance to the economic benefits highlighted by the alcohol industry to counter stricter regulation. Curtailing these costs by regulatory and policy interventions contributes directly and indirectly to social well-being and the economy. CONCLUSIONS; Existing frameworks that guide the regulation and distribution of alcohol frequently focus on maximising the contribution of the alcohol sector to the economy, but should also take into account the associated economic, social and health costs. Current interventions do not systematically address the most important causes of harm from alcohol, and need to be informed by reliable evidence of the ongoing costs of alcohol-related harms.
Functional impairment matters in the screening and diagnosis of gaming disorder

PubMed Central

Billieux, Joël; King, Daniel L.; Higuchi, Susumu; Achab, Sophia; Bowden-Jones, Henrietta; Hao, Wei; Long, Jiang; Lee, Hae Kook; Potenza, Marc N.; Saunders, John B.; Poznyak, Vladimir

2017-01-01

This commentary responds to Aarseth et al.’s (in press) criticisms that the ICD-11 Gaming Disorder proposal would result in “moral panics around the harm of video gaming” and “the treatment of abundant false-positive cases.” The ICD-11 Gaming Disorder avoids potential “overpathologizing” with its explicit reference to functional impairment caused by gaming and therefore improves upon a number of flawed previous approaches to identifying cases with suspected gaming-related harms. We contend that moral panics are more likely to occur and be exacerbated by misinformation and lack of understanding, rather than proceed from having a clear diagnostic system. PMID:28816514
Means of atmospheric air pollution reduction during drilling wells

NASA Astrophysics Data System (ADS)

Shkitsa, L.; Yatsyshyn, T.; Lyakh, M.; Sydorenko, O.

2016-08-01

The process of drilling oil and gas wells is the source of air pollution through drilling mud evaporation containing hazardous chemical substances. The constructive solution for cleaning device of downhole tool that contains elements covering tube and clean the surface from the mud in the process of rising from the well is offered. Inside the device is filled with magnetic fluid containing the substance neutralizing hazardous substances. The use of the equipment proposed will make it possible to avoid penetration of harmful substances into the environment and to escape the harmful effects of aggressive substances for staff health and increase rig's fire safety.
Functional impairment matters in the screening and diagnosis of gaming disorder.

PubMed

Billieux, Joël; King, Daniel L; Higuchi, Susumu; Achab, Sophia; Bowden-Jones, Henrietta; Hao, Wei; Long, Jiang; Lee, Hae Kook; Potenza, Marc N; Saunders, John B; Poznyak, Vladimir

2017-09-01

This commentary responds to Aarseth et al.'s (in press) criticisms that the ICD-11 Gaming Disorder proposal would result in "moral panics around the harm of video gaming" and "the treatment of abundant false-positive cases." The ICD-11 Gaming Disorder avoids potential "overpathologizing" with its explicit reference to functional impairment caused by gaming and therefore improves upon a number of flawed previous approaches to identifying cases with suspected gaming-related harms. We contend that moral panics are more likely to occur and be exacerbated by misinformation and lack of understanding, rather than proceed from having a clear diagnostic system.
Trace elements: implications for nursing.

PubMed

Hayter, J

1980-01-01

Although most were unknown a few years ago, present evidence indicates that at least 25 trace elements have some pertinence to health. Unlike vitamins, they cannot be synthesized. Some trace elements are now considered important only because of their harmful effects but traces of them may be essential. Zinc is especially important during puberty, pregnancy and menopause and is related to protein metabolism. Both fluoride and cadmium accumulate in the body year after year. Cadmium is positively correlated with several chronic diseases, especially hypertension. It is obtained from smoking and drinking soft water. Silicon, generally associated with silicosis, may be necessary for healthy bone and connective tissue. Chromium, believed to be the glucose tolerance factor, is obtained from brewer's yeast, spices, and whole wheat products. Copper deficiency may be implicated in a wide range of cardiovascular and blood related disorders. Either marginal deficiencies or slight excesses of most trace elements are harmful. Nurses should instruct patients to avoid highly refined foods, fad diets, or synthetic and fabricated foods. A well balanced and varied diet is the best safeguard against trace element excesses or deficiencies.
Relationships of alcohol use, stress, avoidance coping, and other factors with mental health in a highly educated workforce.

PubMed

Koopman, Cheryl; Wanat, Stanley F; Whitsell, Shelly; Westrup, Darrah; Matano, Robert A

2003-01-01

The relationships of drinking, stress, life satisfaction, coping style, and antidepressant use to mental health were examined in a highly educated workforce. This study used a one-time mail-out, mail-back cross-sectional survey design to examine the relationships of mental health with three kinds of stress (life events, work stress, home stress); two kinds of life satisfaction (work and home); use of avoidance coping; and antidepressant use. This study was conducted at a large worksite in northern California in which the workforce was comprised of predominantly highly educated employees. Questionnaires were mailed to a random sample of 10% of 8567 employees, and 504 were completed and returned by participants (59%). Complete data were provided by 460 participants (53%). Respondents completed the Mental Health Index, the Alcohol Use Disorders Identification Test (AUDIT), and measures of coping style, work and home stress and satisfaction, stressful life events, and antidepressant use. Mean Mental Health Index scores were at the 32nd percentile of the U.S. population-based norms, with low percentile values associated with worse mental health. Using multiple regression analysis, the factors examined in this study were significantly related to Mental Health Index scores as the dependent variable [F(16, 443) = 27.41, p < .001, adjusted overall R2 = .48]. Poor mental health scores were significantly related to the following: age (p < .05); screening positively for current harmful or hazardous drinking (p < .05); having high levels of stress at work (p < .05) or home (p < .01); experiencing dissatisfaction with work (p < .001) or home life (p = .01); engaging in avoidance coping (p < .001); and using antidepressants (p < .001). Employees currently using antidepressants had significantly more outpatient medical and mental health visits, indicating higher health costs. Furthermore, mental health status was also significantly related to the interactions between several pairs of these variables: education and gender, age and job stress, home satisfaction and work stress, home satisfaction and avoidance coping, and home satisfaction and use of antidepressants. Mental health status was poorer on average in a highly educated workforce compared with general U.S. norms. Most of the factors that were found to be associated with poorer mental health were ones that are potentially modifiable, such as experiencing more stress and less satisfaction in work and home life and engaging in current hazardous or harmful drinking. The findings that mental health is worse among individual employees who exhibit combinations of these factors suggest that we need to better understand possible effects of these factors in the context of one another. As interpretation of these results may be limited by the single worksite that participated in this study, future research should re-examine these relationships in other worksites varying from this one in geography and demographic characteristics.
Steroid avoidance or withdrawal for kidney transplant recipients.

PubMed

Haller, Maria C; Royuela, Ana; Nagler, Evi V; Pascual, Julio; Webster, Angela C

2016-08-22

Steroid-sparing strategies have been attempted in recent decades to avoid morbidity from long-term steroid intake among kidney transplant recipients. Previous systematic reviews of steroid withdrawal after kidney transplantation have shown a significant increase in acute rejection. There are various protocols to withdraw steroids after kidney transplantation and their possible benefits or harms are subject to systematic review. This is an update of a review first published in 2009. To evaluate the benefits and harms of steroid withdrawal or avoidance for kidney transplant recipients. We searched the Cochrane Kidney and Transplant Specialised Register to 15 February 2016 through contact with the Information Specialist using search terms relevant to this review. All randomised and quasi-randomised controlled trials (RCTs) in which steroids were avoided or withdrawn at any time point after kidney transplantation were included. Assessment of risk of bias and data extraction was performed by two authors independently and disagreement resolved by discussion. Statistical analyses were performed using the random-effects model and dichotomous outcomes were reported as relative risk (RR) and continuous outcomes as mean difference (MD) with 95% confidence intervals. We included 48 studies (224 reports) that involved 7803 randomised participants. Of these, three studies were conducted in children (346 participants). The 2009 review included 30 studies (94 reports, 5949 participants). Risk of bias was assessed as low for sequence generation in 19 studies and allocation concealment in 14 studies. Incomplete outcome data were adequately addressed in 22 studies and 37 were free of selective reporting.The 48 included studies evaluated three different comparisons: steroid avoidance or withdrawal compared with steroid maintenance, and steroid avoidance compared with steroid withdrawal. For the adult studies there was no significant difference in patient mortality either in studies comparing steroid withdrawal versus steroid maintenance (10 studies, 1913 participants, death at one year post transplantation: RR 0.68, 95% CI 0.36 to 1.30) or in studies comparing steroid avoidance versus steroid maintenance (10 studies, 1462 participants, death at one year after transplantation: RR 0.96, 95% CI 0.52 to 1.80). Similarly no significant difference in graft loss was found comparing steroid withdrawal versus steroid maintenance (8 studies, 1817 participants, graft loss excluding death with functioning graft at one year after transplantation: RR 1.17, 95% CI 0.72 to 1.92) and comparing steroid avoidance versus steroid maintenance (7 studies, 1211 participants, graft loss excluding death with functioning graft at one year after transplantation: RR 1.09, 95% CI 0.64 to 1.86). The risk of acute rejection significantly increased in patients treated with steroids for less than 14 days after transplantation (7 studies, 835 participants: RR 1.58, 95% CI 1.08 to 2.30) and in patients who were withdrawn from steroids at a later time point after transplantation (10 studies, 1913 participants, RR 1.77, 95% CI 1.20 to 2.61). There was no evidence to suggest a difference in harmful events, such as infection and malignancy, in adult kidney transplant recipients. The effect of steroid withdrawal in children is unclear. This updated review increases the evidence that steroid avoidance and withdrawal after kidney transplantation significantly increase the risk of acute rejection. There was no evidence to suggest a difference in patient mortality or graft loss up to five year after transplantation, but long-term consequences of steroid avoidance and withdrawal remain unclear until today, because prospective long-term studies have not been conducted.
Cystic fibrosis carrier screening in Veneto (Italy): an ethical analysis.

PubMed

Bruni, Tommaso; Mameli, Matteo; Pravettoni, Gabriella; Boniolo, Giovanni

2012-08-01

A recent study by Castellani et al. (JAMA 302(23):2573-2579, 2009) describes the population-level effects of the choices of individuals who underwent molecular carrier screening for cystic fibrosis (CF) in Veneto, in the northeastern part of Italy, between 1993 and 2007. We discuss some of the ethical issues raised by the policies and individual choices that are the subject of this study. In particular, (1) we discuss the ethical issues raised by the acquisition of genetic information through antenatal carrier testing; (2) we consider whether by choosing to procreate naturally these couples can harm the resulting child and/or other members of society, and what the moral implications of such harm would be; (3) we consider whether by choosing to avoid natural procreation carrier couples can harm current or future individuals affected by cystic fibrosis; (4) we discuss whether programs that make carrier testing available can be considered eugenic programs.
[Psychiatric treatment of deliberate self-harm in the out-of-hours services].

PubMed

Walby, Fredrik A; Ness, Ewa

2009-04-30

Patients who harm themselves are often considered difficult to treat. There are no evidence-based approaches available for the emergency setting. General practitioners should nevertheless be able to offer interventions directed towards emotional needs in self-harm patients. In this article we suggest how to intervene in such situations. Based on experience from Oslo psychiatric out-of-hours service and with elements from Dialectic Behavioural Therapy, we present a five-step model for treatment of these patients in an out-of-hours service within the primary health care services. The aim of this model is to bring the patient out of the acute crisis and to arrange for further treatment. Assessment, validation or confirmation, problem-solving, avoiding unnecessary hospitalisation, and focus on continuing established treatment, are important elements in the proposed intervention. This can all be carried out in 60 - 90 min. The model may be suitable for training general practitioners to meet and care for patients with self-harm behaviour in the out-hours-services. We have positive experience with the intervention, but systematic research is necessary to assess the effect of the model.
Method to generate a pulse train of few-cycle coherent radiation

DOE PAGES

Garcia, Bryant; Hemsing, Erik; Raubenheimer, Tor; ...

2016-09-06

We develop a method to generate a long pulse train of few-cycle coherent radiation by modulating an electron beam with a high power laser. The large energy modulation disperses the beam in a radiating undulator and leads to the production of phase-locked few-cycle coherent radiation pulses. These pulses are produced at a high harmonic of the modulating laser, and are longitudinally separated by the modulating laser wavelength. Here, we discuss an analytical model for this scheme and investigate the temporal and spectral properties of this radiation. This model is compared with numerical simulation results using the unaveraged code Puffin. Wemore » examine various harmful effects and how they might be avoided, as well as a possible experimental realization of this scheme.« less
Personality trait interactions in parents of patients with borderline personality disorder: a controlled study using the Temperament and Character Inventory.

PubMed

Fassino, Secondo; Amianto, Federico; Gastaldi, Filippo; Abbate-Daga, Giovanni; Brambilla, Francesca; Leombruni, Paolo

2009-01-30

Family environment is a pathogenic factor of borderline personality disorder (BPD). However, the personality traits of patients with BPD and their parents have never been assessed using the same instrument and then examined for relationships. In the present study, we explored the temperament and character traits of BPD patients and their parents to investigate possible interactions. In total, 56 patients with BPD and their parents were evaluated with the Temperament and Character Inventory (TCI) and compared with 53 control families. Discriminant and correlation analyses indicated that subjects with BPD displayed higher levels of novelty seeking, harm avoidance, and self-transcendence and lower levels of self-directedness than control subjects. Their fathers displayed higher levels of novelty seeking and lower levels of persistence and self-directedness, and their mothers displayed lower levels of self-directedness compared with levels in control parents. In BPD families, temperament and character traits displayed high levels of discriminatory power. Novelty seeking in offspring with borderline personality disorder was significantly correlated with their mothers' novelty seeking and their fathers' self-transcendence. Self-directedness in borderline offspring was significantly correlated with both their mothers' and fathers' novelty seeking, and their self-transcendence was significantly correlated with their mothers' novelty seeking and harm avoidance. The different correlational pattern for borderline and control families is discussed. Characteristic personality patterns were found in BPD offspring and in both parents. The relationship between personality traits of borderline offspring and those of their parents may be related to both genetic transmission and family dynamics. Ramifications for treatment are discussed.
Harm avoidance and persistence are associated with somatoform disorder psychopathology: A study in Taiwan.

PubMed

Huang, Wei-Lieh; Chen, Tzu-Ting; Chen, I-Ming; Chang, Li-Ren; Lin, Yu-Hsuan; Liao, Shih-Cheng; Gau, Susan Shur-Fen

2016-05-15

Whether personality features affect the development of somatoform disorders and their psychopathologies is an important issue. Aim of this study was to resolve this issue by comparing indicators of psychopathology and personality features in subjects with somatoform disorders and healthy controls. This study recruited 148 subjects with somatoform disorders and 146 healthy controls. The severity of psychopathology was measured with the Patient Health Questionnaire-15 (PHQ-15), Health Anxiety Questionnaire (HAQ), Beck Depression Inventory-II (BDI-II), and Beck Anxiety Inventory (BAI). The Tridimensional Personality Questionnaire (TPQ) was used to assess personality features. Demographic data, psychopathology indicators, and TPQ scores were compared between groups. Correlation and multivariate linear regression analysis were used to identify the personality dimensions or demographic variables associated with psychopathology. The somatoform group had lower novelty seeking (NS) and reward dependence (RD) and higher harm avoidance (HA) and severity of psychopathologies. Multiple regression analysis revealed that fatigability, persistence, gender, and education level were predictive of PHQ-15; HA, educational level, persistence, and dependence were predictive of HAQ; HA, persistence, education level, and NS were predictive of BDII-II; and fatigability, education level, persistence, and anticipatory worry were predictive of BAI. The development of somatoform disorders was associated with fatigability, age, residence location, education level, and attachment. The limitations include heterogeneity of the diagnosis, the high proportion of undifferentiated somatoform disorder, and the cross-sectional study design. HA/fatigability, persistence, and education level are associated with each type of psychopathology. Fatigability is a powerful predictor of somatoform disorder development. Copyright © 2016. Published by Elsevier B.V.
Potential Nematode Alarm Pheromone Induces Acute Avoidance in Caenorhabditis elegans.

PubMed

Zhou, Ying; Loeza-Cabrera, Mario; Liu, Zheng; Aleman-Meza, Boanerges; Nguyen, Julie K; Jung, Sang-Kyu; Choi, Yuna; Shou, Qingyao; Butcher, Rebecca A; Zhong, Weiwei

2017-07-01

It is crucial for animal survival to detect dangers such as predators. A good indicator of dangers is injury of conspecifics. Here we show that fluids released from injured conspecifics invoke acute avoidance in both free-living and parasitic nematodes. Caenorhabditis elegans avoids extracts from closely related nematode species but not fruit fly larvae. The worm extracts have no impact on animal lifespan, suggesting that the worm extract may function as an alarm instead of inflicting physical harm. Avoidance of the worm extract requires the function of a cGMP signaling pathway that includes the cGMP-gated channel TAX-2/TAX-4 in the amphid sensory neurons ASI and ASK. Genetic evidence indicates that the avoidance behavior is modulated by the neurotransmitters GABA and serotonin, two common targets of anxiolytic drugs. Together, these data support a model that nematodes use a nematode-specific alarm pheromone to detect conspecific injury. Copyright © 2017 by the Genetics Society of America.
Youth Assets and Sexual Risk Behavior: Differences between Male and Female Adolescents

ERIC Educational Resources Information Center

Mueller, Trisha; Gavin, Lorrie; Oman, Roy; Vesely, Sara; Aspy, Cheryl; Tolma, Eleni; Rodine, Sharon

2010-01-01

Youth internal assets and external resources are protective factors that can help youth avoid potentially harmful behaviors. This study investigates how the relationship between youth assets or resources and two sexual risk behaviors (ever had sex and birth control use) varied by gender. Data were collected through in-home interviews from…
Economic incentives for oak woodland preservation and conservation

Treesearch

Rosi Dagit; Cy Carlberg; Christy Cuba; Thomas Scott

2015-01-01

Numerous ordinances and laws recognize the value of oak trees and woodlands, and dictate serious and expensive consequences for removing or harming them. Unfortunately, the methods used to calculate these values are equally numerous and often inconsistent. More important, these ordinances typically lack economic incentives to avoid impacts to oak woodland values...
Report: Drinking Water Contamination in Flint, Michigan, Demonstrates a Need to Clarify EPA Authority to Issue Emergency Orders to Protect the Public

EPA Pesticide Factsheets

Report #17-P-0004, Oct 20, 2016. To avoid future public health harm through drinking water contamination, the EPA needs to clarify for its employees how its emergency authority can and should be used to intervene in a public health threat.
Strategies for Dealing with Stress: Taking Care of Yourself.

ERIC Educational Resources Information Center

Gmelch, Walter H.

University department chairs need to manage stress to their advantage. Myths pertaining to stress include: (1) stress is harmful; (2) stress should be avoided; (3) stress correlates with level of responsibility; (4) stress is predominantly a male phenomenon; and (5) there is one appropriate coping method. The Chair Stress Cycle provides a broad…
Embracing Excellence: A Positive Approach to Ethical Decision Making

ERIC Educational Resources Information Center

Hinz, Lisa D.

2011-01-01

Ethics courses may provoke fear and uncertainty in art therapy students and practitioners if taught from a risk management perspective, which focuses on reducing therapist exposure to risk and avoiding harm to clients. In contrast, a positive ethical approach fosters empowerment, embraces limits, and enhances trust between art therapists and their…
Professional Decisions and Ethical Values in Medical and Law Students.

ERIC Educational Resources Information Center

Rezler, Agnes G.; And Others

1990-01-01

This project evaluated and compared the values used by medical and law students when dealing with ethical dilemmas in the practice of law and medicine. The Professional Decisions and Values Test was given to 77 medical students and 92 law students. Differences were noted on beneficence, professional responsibility, and harm avoidance. (MLW)

Anger and aggression problems in veterans are associated with an increased acoustic startle reflex.

PubMed

Heesink, Lieke; Kleber, Rolf; Häfner, Michael; van Bedaf, Laury; Eekhout, Iris; Geuze, Elbert

2017-02-01

Anger and aggression are frequent problems in deployed military personnel. A lowered threshold of perceiving and responding to threat can trigger impulsive aggression. This can be indicated by an exaggerated startle response. Fifty-two veterans with anger and aggression problems (Anger group) and 50 control veterans were tested using a startle experiment with 10 startle probes and 10 prepulse trials, presented in a random order and with a random interval between the trials. Predictors (demographics, Trait Anger, State Anger, Harm Avoidance and Anxious Arousal) for the startle response within the Anger group were tested. Increased EMG responses were found to the startle probes in the Anger Group compared to the Control group, but not to the prepulse trials. Furthermore, Harm Avoidance and State Anger predicted the increased startle reflex within the Anger group, whereas Trait Anger was negatively related to the startle reflex. These findings indicate that threat reactivity is increased in anger and aggression problems. These problems are not only caused by an anxious predisposition, the degree of anger also predicts the startle reflex. Copyright © 2016 Elsevier B.V. All rights reserved.
Reward Dependence and Harm Avoidance among Patients with Binge-Purge Type Eating Disorders.

PubMed

Gat-Lazer, Sigal; Geva, Ronny; Gur, Eitan; Stein, Daniel

2017-05-01

The Cloninger's Psychobiological Model of Temperament and Character includes temperamental dimensions such as reward dependence (RD) and harm avoidance (HA). Studies of RD differentiate between sensitivity to reward (SR) versus to punishment (SP). We investigated the interrelationship between HA and RD in acutely ill patients with binge/purge (B/P) type eating disorders (EDs) and following symptomatic stabilization. Fifty patients with B/P EDs were assessed at admission to inpatient treatment, 36 of whom were reassessed at discharge. Thirty-six controls were similarly assessed. Participants completed Tridimensional Personality Questionnaire (TPQ), Sensitivity to Punishment and Sensitivity to Reward Questionnaire (SPSRQ), and took the Gambling Task. Patients with B/P EDs had higher TPQ-RD and lower TPQ-HA accompanied by lower SPSRQ-SR and SPSRQ-SP. SPSRQ-SP correlated positively and negatively with TPQ-HA and TPQ-RD, respectively. Combination of lower TPQ-HA, lower SPSRQ-SP, and greater risk-taking inclination may maintain disordered eating in patients with B/P EDs. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
Stability of attachment-related anxiety and avoidance and their relationships with the five-factor model and the psychobiological model of personality.

PubMed

Picardi, Angelo; Caroppo, Emanuele; Toni, Alessandro; Bitetti, Daniela; Di Maria, Giuseppe

2005-09-01

The stability of attachment-related anxiety and avoidance and their relationship with influential personality models are issues worth further investigation. Studying discriminant validity with respect to aspects of personality deemed as prevalently heritable, such as temperament, is particularly important. Our aims were to examine the stability of attachment dimensions and to study their relationship with psychological distress, the Big Five factors, and temperament and character dimensions. The Experiences in Close Relationships (ECR) questionnaire, the State-Trait Anxiety Inventory (STAI), the Zung depression scale (ZDS), the Temperament and Character Inventory (TCI-125), and the Big Five Questionnaire (BFQ) were administered to 222 undergraduate and graduate students. After 1 month, 115 participants completed again the ECR, the STAI, and the ZDS. Attachment-related anxiety was modestly correlated with depression and anxiety, while attachment-related avoidance was modestly correlated with depression. The test-retest reliability of ECR scores was high. Changes in attachment-related anxiety were not related to changes in depression or anxiety, and changes in attachment-related avoidance were modestly correlated with changes in depression. In separate multiple regression models also including gender and age, attachment-related anxiety was correlated with harm avoidance, reward dependence, low novelty seeking, low self-directedness and low cooperativeness; low energy/extraversion and low emotional stability; attachment-related avoidance was correlated with low reward dependence and tended to be correlated with low self-directedness. These findings corroborate the reliability and the convergent and discriminant validity of the ECR, and support the notion that the attachment dimensions are only modestly related to psychological distress and are not redundant with constructs developed within influential personality models such as the five-factor model and the psychobiological model.
Research on natural frequency based on modal test for high speed vehicles

NASA Astrophysics Data System (ADS)

Ma, Guangsong; He, Guanglin; Guo, Yachao

2018-04-01

High speed vehicle as a vibration system, resonance generated in flight may be harmful to high speed vehicles. It is possible to solve the resonance problem by acquiring the natural frequency of the high-speed aircraft and then taking some measures to avoid the natural frequency of the high speed vehicle. Therefore, In this paper, the modal test of the high speed vehicle was carried out by using the running hammer method and the PolyMAX modal parameter identification method. Firstly, the total frequency response function, coherence function of the high speed vehicle are obtained by the running hammer stimulation test, and through the modal assurance criterion (MAC) to determine the accuracy of the estimated parameters. Secondly, the first three order frequencies, the pole steady state diagram of the high speed vehicles is obtained by the PolyMAX modal parameter identification method. At last, the natural frequency of the vibration system was accurately obtained by the running hammer method.
Lasers in orthodontics

PubMed Central

Nalcaci, Ruhi; Cokakoglu, Serpil

2013-01-01

Many types of dental lasers are currently available that can be efficiently used for soft and hard tissue applications in the field of orthodontics. For achieving the desired effects in the target tissue, knowledge of laser characteristics such as power, wavelength and timing, is necessary. Laser therapy is advantageous because it often avoids bleeding, can be pain free, is non-invasive and is relatively quick. The high cost is its primary disadvantage. It is very important to take the necessary precautions to prevent possible tissue damage when using laser dental systems. Here, we reviewed the main types and characteristics of laser systems used in dental practice and discuss the applications of lasers in orthodontics, harmful effects and laser system safety. PMID:24966719
The cost-effectiveness and public health benefit of nalmefene added to psychosocial support for the reduction of alcohol consumption in alcohol-dependent patients with high/very high drinking risk levels: a Markov model.

PubMed

Laramée, Philippe; Brodtkorb, Thor-Henrik; Rahhali, Nora; Knight, Chris; Barbosa, Carolina; François, Clément; Toumi, Mondher; Daeppen, Jean-Bernard; Rehm, Jürgen

2014-09-16

To determine whether nalmefene combined with psychosocial support is cost-effective compared with psychosocial support alone for reducing alcohol consumption in alcohol-dependent patients with high/very high drinking risk levels (DRLs) as defined by the WHO, and to evaluate the public health benefit of reducing harmful alcohol-attributable diseases, injuries and deaths. Decision modelling using Markov chains compared costs and effects over 5 years. The analysis was from the perspective of the National Health Service (NHS) in England and Wales. The model considered the licensed population for nalmefene, specifically adults with both alcohol dependence and high/very high DRLs, who do not require immediate detoxification and who continue to have high/very high DRLs after initial assessment. We modelled treatment effect using data from three clinical trials for nalmefene (ESENSE 1 (NCT00811720), ESENSE 2 (NCT00812461) and SENSE (NCT00811941)). Baseline characteristics of the model population, treatment resource utilisation and utilities were from these trials. We estimated the number of alcohol-attributable events occurring at different levels of alcohol consumption based on published epidemiological risk-relation studies. Health-related costs were from UK sources. We measured incremental cost per quality-adjusted life year (QALY) gained and number of alcohol-attributable harmful events avoided. Nalmefene in combination with psychosocial support had an incremental cost-effectiveness ratio (ICER) of £5204 per QALY gained, and was therefore cost-effective at the £20,000 per QALY gained decision threshold. Sensitivity analyses showed that the conclusion was robust. Nalmefene plus psychosocial support led to the avoidance of 7179 alcohol-attributable diseases/injuries and 309 deaths per 100,000 patients compared to psychosocial support alone over the course of 5 years. Nalmefene can be seen as a cost-effective treatment for alcohol dependence, with substantial public health benefits. This cost-effectiveness analysis was developed based on data from three randomised clinical trials: ESENSE 1 (NCT00811720), ESENSE 2 (NCT00812461) and SENSE (NCT00811941). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Temperament, character, and suicide attempts in unipolar and bipolar mood disorders.

PubMed

Jylhä, Pekka J; Rosenström, Tom; Mantere, Outi; Suominen, Kirsi; Melartin, Tarja K; Vuorilehto, Maria S; Holma, Mikael K; Riihimäki, Kirsi A; Oquendo, Maria A; Keltikangas-Järvinen, Liisa; Isometsä, Erkki T

2016-02-01

Personality features may indicate risk for both mood disorders and suicidal acts. How dimensions of temperament and character predispose to suicide attempts remains unclear. Patients (n = 597) from 3 prospective cohort studies (Vantaa Depression Study [VDS], Jorvi Bipolar Study [JoBS], and Vantaa Primary Care Depression Study [PC-VDS]) were interviewed at baseline, at 18 months, and, in VDS and PC-VDS, at 5 years (1997-2003). Personality was measured with the Temperament and Character Inventory-Revised (TCI-R), and follow-up time spent in major depressive episodes (MDEs) as well as lifetime (total) and prospectively ascertained suicide attempts during the follow-up were documented. Overall, 219 patients had 718 lifetime suicide attempts; 88 patients had 242 suicide attempts during the prospective follow-up. The numbers of both the total and prospective suicide attempts were associated with low self-directedness (β = -0.266, P = .004, and β = -0.294, P < .001, respectively) and high self-transcendence (β = 0.287, P = .002, and β = 0.233, P = .002, respectively). Total suicide attempts were linked to high novelty seeking (β = 0.195, P = .05). Prospective, but not total, suicide attempts were associated with high harm avoidance (β = 0.322, P < .001, and β = 0.184, P = .062, respectively) and low reward dependence (β = -0.274, P < .001, and β = -0.134, P = .196, respectively), cooperativeness (β = -0.181, P = .005, and β = -0.096, P = .326, respectively), and novelty seeking (β = -0.137, P = .047). No association remained significant when only prospective suicide attempts during MDEs were included. After adjustment was made for total time spent in MDEs, only high persistence predicted suicide attempts (β = 0.190, P < .05). Formal mediation analyses of harm avoidance and self-directedness on prospectively ascertained suicide attempts indicated significant mediated effect through time at risk in MDEs, but no significant direct effect. Among mood disorder patients, suicide attempt risk is associated with temperament and character dimensions. However, their influence on predisposition to suicide attempts is likely to be mainly indirect, mediated by more time spent in depressive episodes. © Copyright 2016 Physicians Postgraduate Press, Inc.
A self-harm series and its relationship with childhood adversity among adolescents in mainland China: a cross-sectional study.

PubMed

Han, Azhu; Wang, Gengfu; Xu, Geng; Su, Puyu

2018-02-01

Self-harm (SH) is an emerging problem among Chinese adolescents. The present study aimed to measure the prevalence of SH behaviours and to explore the relationship between childhood adversity and different SH subtypes among Chinese adolescents. A total of 5726 middle school students were randomly selected in three cities of Anhui province, China, using a stratified cluster sampling method. SH was categorized into five subtypes (highly lethal self-harm, less lethal self-harm with visible tissue damage, self-harm without visible tissue damage, self-harmful behaviours with latency damage and psychological self-harm). Multivariate logistic regression was used to explore the relationships between childhood adversity and different subtypes of adolescent SH. The prevalence rates of highly lethal self-harm, less lethal self-harm with visible tissue damage, self-harm without visible tissue damage, self-harmful behaviours with latency damage and psychological self-harm were 6.1, 20.4, 32.0, 20.0 and 23.0%, respectively. Childhood sexual abuse and physical peer victimization were associated with each SH subtype with adjusted odds ratios (AORs) ranging from 1.23 to 1.76. Highly lethal self-harm was associated with childhood physical peer victimization, sexual abuse, emotional abuse, and emotional neglect. The less lethal SH subtypes (i.e., less lethal self-harm with visible tissue damage, self-harm without visible tissue damage, self-harmful behaviours with latency damage and psychological self-harm) were associated with childhood peer victimization, family life stress event scores and childhood sexual abuse. A high prevalence of SH exists among Chinese adolescents. The association of childhood adversity with SH merits serious attention in both future research and preventive interventions.
Doubt in the Insula: Risk Processing in Obsessive-Compulsive Disorder

PubMed Central

Luigjes, Judy; Figee, Martijn; Tobler, Philippe N.; van den Brink, Wim; de Kwaasteniet, Bart; van Wingen, Guido; Denys, Damiaan

2016-01-01

Extensive cleaning or checking of patients with obsessive-compulsive disorder (OCD) are often interpreted as strategies to avoid harm and as an expression of the widespread belief that OCD patients are more risk-averse. However, despite its clinical significance, the neural basis of risk attitude in OCD is unknown. Here, we investigated neural activity during risk processing using functional magnetic resonance imaging and simultaneously assessed risk attitude using a separate behavioral paradigm in OCD patients with different symptoms versus healthy controls (HCs). We found opposite insula responses to high versus low risk in OCD patients compared to HCs: a positive correlation between insula activity and risk-aversion in patients versus a negative correlation in controls. Although OCD patients overall were not more risk-averse than controls, there were differences between subgroups of OCD patients: patients with doubt/checking symptoms were more risk-averse than other patients. Taken together, OCD patients show a reversed pattern of risk processing by the insula compared to HCs. Moreover, the data suggest that increased activation of the insula signals an abnormal urge to avoid risks in the subpopulation of OCD patients with doubt and checking symptoms. These results indicate a role for the insula in excessive risk-avoidance relevant to OCD. PMID:27378883
A critical analysis of user satisfaction surveys in addiction services: opioid maintenance treatment as a representative case study

PubMed Central

Trujols, Joan; Iraurgi, Ioseba; Oviedo-Joekes, Eugenia; Guàrdia-Olmos, Joan

2014-01-01

Background Satisfaction with services represents a key component of the user’s perspective, and user satisfaction surveys are the most commonly used approach to evaluate the aforementioned perspective. The aim of this discursive paper is to provide a critical overview of user satisfaction surveys in addiction treatment and harm reduction services, with a particular focus on opioid maintenance treatment as a representative case. Methods We carried out a selective critical review and analysis of the literature on user satisfaction surveys in addiction treatment and harm reduction services. Results Most studies that have reported results of satisfaction surveys have found that the great majority of users (virtually all, in many cases) are highly satisfied with the services received. However, when these results are compared to the findings of studies that use different methodologies to explore the patient’s perspective, the results are not as consistent as might be expected. It is not uncommon to find that “highly satisfied” patients report significant problems when mixed-methods studies are conducted. To understand this apparent contradiction, we explored two distinct (though not mutually exclusive) lines of reasoning, one of which concerns conceptual aspects and the other, methodological questions. Conclusion User satisfaction surveys, as currently designed and carried out in addiction treatment and harm reduction services, do not significantly help to improve service quality. Therefore, most of the enthusiasm and naiveté with which satisfaction surveys are currently performed and interpreted – and rarely acted on in the case of nonoptimal results – should be avoided. A truly participatory approach to program evaluation is urgently needed to reshape and transform patient satisfaction surveys. PMID:24482571
Alternative Medications for Medications Included in the Use of High-Risk Medications in the Elderly and Potentially Harmful Drug–Disease Interactions in the Elderly Quality Measures

PubMed Central

Hanlon, Joseph T.; Semla, Todd P.; Schmader, Kenneth E.

2016-01-01

The National Committee for Quality Assurance (NCQA) and the Pharmacy Quality Alliance (PQA) use the American Geriatrics Society (AGS) Beers Criteria to designate the quality measure Use of High-Risk Medications in the Elderly (HRM). The Centers for Medicare and Medicaid Services (CMS) use the HRM measure to monitor and evaluate the quality of care provided to Medicare beneficiaries. NCQA additionally uses the AGS Beers Criteria to designate the quality measure Potentially Harmful Drug–Disease Interactions in the Elderly. Medications included in these measures may be harmful to elderly adults, negatively affect a health care plan’s quality ratings, and be denied as a health care plan drug benefit. Prescribers, pharmacists, patients, and health care plans may benefit from evidence-based alternative medication treatments to avoid these problems. Therefore the goal of this work was to develop a list of alternative medications to those included in the two measures. The authors conducted a comprehensive literature review for 2000 to 2014 and a search of their personal files. From the evidence, they prepared a list of drug-therapy alternatives with supporting references. A reference list of non-pharmacological approaches was also provided when appropriate. NCQA, PQA, the 2015 AGS Beers Criteria panel, and the Executive Committee of the AGS reviewed the drug therapy alternatives and nonpharmacological approaches. Recommendations by these groups were incorporated into the final list of alternatives. The final product of drug-therapy alternatives to medications included in the two quality measures and some nonpharmacological resources will be useful to health professionals, consumers, payers, and health systems that care for older adults. PMID:26447889
Traditional beliefs and practices in the postpartum period in Fujian Province, China: a qualitative study

PubMed Central

Raven, Joanna H; Chen, Qiyan; Tolhurst, Rachel J; Garner, Paul

2007-01-01

Background Zuo yuezi is the month postpartum in China associated with a variety of traditional beliefs and practices. We explored the current status of zuo yuezi from social, cultural and western medical perspectives. Methods We interviewed family members (36) and health workers (8) in Fujian Province, selecting one rural and one rapidly developing urban county. We asked about their traditional beliefs and their behaviour postpartum. We used a framework approach to identify main themes. We categorised reported behaviour against their probable effects on health, drawing on Western standards. Results Respondents reported that zuo yuezi was commonly practiced in urban and rural families to help the mother regain her strength and protect her future health. Zuo yuezi included: dietary precautions, such as eating more food and avoiding cold food; behavioural precautions, such as staying inside the home, avoiding housework and limiting visitors; hygiene precautions, such as restricting bathing and dental hygiene; and practices associated with infant feeding, including supplementary feeding and giving honeysuckle herb to the infant. Respondents reported that the main reasons for adhering to these practices were respect for tradition, and following the advice of elders. Categorised against Western medical standards, several zuo yuezi practices are beneficial, including eating more, eating protein rich food, avoiding housework, and daily vulval and perineal hygiene. A few are potentially harmful, including giving honeysuckle herb, and avoiding dental hygiene. Some women reported giving infants supplementary feeds, although zuo yuezi emphasises breast feeding. Conclusion Zuo yuezi is an important ritual in Fujian. In medical terms, most practices are beneficial, and could be used by health staff to promote health in this period. Further research on reported potentially harmful practices, such as supplements to breast feeding, is needed. PMID:17584930
Anxiety Symptoms in African American Youth: The Role of Puberty and Biological Sex

ERIC Educational Resources Information Center

Carter, Rona

2015-01-01

This study examined the effects of pubertal status, pubertal timing (actual and perceived), and youth biological sex on symptom dimensions of anxiety (i.e., social, separation, harm avoidance, physical) in African Americans (n = 252; ages 8-12). For girls, results indicated that pubertal status and timing (actual) exerted similar effects for some…
Virtual Reality for Life Skills Education: Program Evaluation

ERIC Educational Resources Information Center

Vogel, Jennifer; Bowers, Clint; Meehan, Cricket; Hoeft, Raegan; Bradley, Kristy

2004-01-01

A program evaluation was completed for a Virtual Reality (VR) pilot project intended to aid deaf children in learning various life skills which they may be at risk of not adequately learning. Such skills include crossing the street safely, exiting a building during a fire drill, and avoiding situations in which strangers may harm them. The VR was…
Protecting Your Computer from Viruses

ERIC Educational Resources Information Center

Descy, Don E.

2006-01-01

A computer virus is defined as a software program capable of reproducing itself and usually capable of causing great harm to files or other programs on the same computer. The existence of computer viruses--or the necessity of avoiding viruses--is part of using a computer. With the advent of the Internet, the door was opened wide for these…
Hydrogen Storage Experiments for an Undergraduate Laboratory Course--Clean Energy: Hydrogen/Fuel Cells

ERIC Educational Resources Information Center

Bailey, Alla; Andrews, Lisa; Khot, Ameya; Rubin, Lea; Young, Jun; Allston, Thomas D.; Takacs, Gerald A.

2015-01-01

Global interest in both renewable energies and reduction in emission levels has placed increasing attention on hydrogen-based fuel cells that avoid harm to the environment by releasing only water as a byproduct. Therefore, there is a critical need for education and workforce development in clean energy technologies. A new undergraduate laboratory…
Dealing with Organizational Silos with Communities of Practice and Human Resource Management

ERIC Educational Resources Information Center

Forsten-Astikainen, Riitta; Hurmelinna-Laukkanen, Pia; Lämsä, Tuija; Heilmann, Pia; Hyrkäs, Elina

2017-01-01

Purpose: Organizational silos that build on the existing organizational structures are often considered to have negative effects in the form of focus on private narrow objectives and organizational fragmentation. To avoid such harmful outcomes, competence management is called for, and in this, the human resources (HR) function takes a key role.…
Child Sexual Abuse Prevention: Psychoeducational Groups for Preschoolers and Their Parents

ERIC Educational Resources Information Center

Kenny, Maureen

2009-01-01

Teaching parents and their young children about ways to avoid harm can be accomplished with much success in a group setting. Parents as Teachers of Safety (PaTS) is a multi-family educational group which instructs families on environmental and personal body safety rules, with an emphasis on improving knowledge and skills related to sexual abuse…
Burnout in Japanese residents and its associations with temperament and character.

PubMed

Miyoshi, Ryoei; Matsuo, Hisae; Takeda, Ryuichiro; Komatsu, Hiroyuki; Abe, Hiroshi; Ishida, Yasushi

2016-12-01

High risk of burnout in healthcare workers has long been recognized. However, there are no methods to predict vulnerability to burnout. We examined whether temperament and character are associated with burnout and depressive state in residents by using the Temperament and Character Inventory (TCI). The TCI was used for residents at the beginning of clinical training and then the Maslach Burnout Inventory-General Survey (MBI-GS) and the Self-Rating Depression Scale (SDS) were administered at the beginning of clinical training and after four and ten months. Participants were 85 residents who started clinical training after graduating from the University of Miyazaki Hospital in April 2012 and 2013. After ten months, 23.5% of participants were newly identified with burnout using the MBI-GS and 15.3% of participants were newly diagnosed with depressive state using the SDS. We found that residents with high Cooperativeness were significantly more prone to burnout and that residents with high Harm Avoidance and low Self-Directedness were significantly more prone to depressive states. Our results suggest that the TCI can predict not only the risk for future depressive state but also the risk for future burnout. We feel it is important for the resident education system to identify residents with these temperament and character traits and to help high-risk residents avoid burnout and depressive state. Copyright © 2016 Elsevier B.V. All rights reserved.
[Arterial hypertension secondary to endocrine disorders].

PubMed

Minder, Anna; Zulewski, Henryk

2015-06-01

Endocrine hypertension offers a potentially curative therapy if the underlying cause is identified and treated accordingly. In contrast to the high prevalence of arterial hypertension especially in the elderly, the classical endocrine causes remain a rare entity. Among patients with arterial hypertension the prevalence of Cushing's syndrome or pheochromocytoma is less than 1%. Primary hyperaldosteronism is more frequent with a reported prevalence of up to 9%. In order to avoid unnecessary, costly and potentially harmful evaluations and therapies due to the limited sensitivity and specificity of the critical endocrine tests it is mandatory to limit the exploration for endocrine causes to preselected patients with high pretest probability for an endocrine disorder. Younger age at manifestation of arterial hypertension or drug resistant hypertension together with other clinical signs of an endocrine disorder should raise the suspicion and prompt the appropriate evaluation.

Design of a Micro Cable Tunnel Inspection Robot

NASA Astrophysics Data System (ADS)

Song, Wei; Liu, Lei; Zhou, Xiaolong; Wang, Chengjiang

2016-11-01

As the ventilation system in cable tunnel is not perfect and the environment is closed, it is easy to accumulate toxic and harmful gas. It is a serious threat to the life safety of inspection staff. Therefore, a micro cable tunnel inspection robot is designed. The whole design plan mainly includes two parts: mechanical structure design and control system design. According to the functional requirements of the tunnel inspection robot, a wheel arm structure with crawler type is proposed. Some sensors are used to collect temperature, gas and image and transmit the information to the host computer in real time. The result shows the robot with crawler wheel arm structure has the advantages of small volume, quick action and high performance-price ratio. Besides, it has high obstacle crossing and avoidance ability and can adapt to a variety of complex cable tunnel environment.
Scheduling the Stork: Media Portrayals of Women's and Physicians' Reasons for Elective Cesarean Delivery.

PubMed

Campo-Engelstein, Lisa; Howland, Lauren E; Parker, Wendy M; Burcher, Paul

2015-06-01

Media interest in cesarean delivery has grown in recent years driven both by rising cesarean delivery rates and the decision by the American College of Obstetrics and Gynecology (ACOG) to permit elective cesarean (EC) delivery. A content analysis of United States newspaper and magazine articles from 2000 to 2013 (n = 131 articles) was completed to understand how the news media portrays ECs. The majority of articles (71.8%) emphasized reasons to support women having an EC, while 38.2 percent of the articles exhibited themes of physician support for ECs. Relatively few articles mentioned reasons against ECs either from the women's perspective (11.5%) or the practitioners' (3.8%). The most common themes given for women choosing ECs were convenience/scheduling (48.9%), avoidance of pain or fear of labor (29.8%), and physical harm to women from vaginal birth (17.6%). Doctors' perspectives were less prevalent in the media than women's perspectives, but when mentioned they were almost exclusively in support of ECs for reasons including avoiding malpractice (28.2%), avoiding physical harm to the woman or baby (16.8%), and timing/scheduling (14.5%). Media coverage suggests ECs are widely accepted by both women and doctors, with women choosing an EC mainly for convenience/scheduling and fear. However, 43 percent of doctors surveyed by ACOG said they were not willing to perform the procedure, and surveys report that mothers rarely request an EC. © 2015 Wiley Periodicals, Inc.
[Arson and pyromania, update 2015].

PubMed

Palix, J

2015-09-16

While the fire constitutes a threat and provokes avoidance by the entire animal world, its control as lighting and maintenance is inseparable from the history of humankind. For 1% of the population that use is turned to harm, repeatedly and without objective reason, responding to the historical definition of pyromania. The profile of arsonists does not appear to be different from that of the general criminal population: alcohol abuse, nicotine, marijuana and antisocial personality do not make fire setters a special case. However positive fire experience lived in childhood, emotional avoidance and expertise in fire settings' control seems to be specific, as recidivism risk below that of the general criminal population.
The association between harm avoidance personality traits and self-reported concussion history in South African rugby union players.

PubMed

Mc Fie, Sarah; Abrahams, Shameemah; Patricios, Jon; Suter, Jason; Posthumus, Michael; September, Alison V

2018-01-01

Personality traits have been proposed to affect the risk of sports concussion, but evidence is limited. Cloninger's Tridimensional Personality Questionnaire (TPQ) measures novelty seeking, harm avoidance (HA), and reward dependence traits. The aim of this study was to investigate the relationship between TPQ scores and concussion history in rugby union players. Cross-sectional study. Rugby players from high schools, senior amateur clubs, and professional teams provided a self-reported concussion history and completed the TPQ. Participants reporting no previous concussions formed the control group, while participants reporting concussion formed the case group. A one-way analysis of covariance, with age as a covariate, was used to examine the differences in TPQ scores between groups. Of the 309 participants, 54% reported a minimum of one concussion (junior: 47%; amateur: 52%; professional: 72%). HA scores were significantly higher in junior players without a history of concussion compared to cases (p=0.006). Specifically, the junior control group had higher "anticipatory worry" (p=0.009) and "fear of uncertainty" (p=0.008). In contrast, the professional control group had lower HA scores than cases (p=0.009), while the amateur cohort displayed no differences between control and case groups. This study identified a novel association between HA and concussion in rugby players, adding evidence to the role of personality in a multifactorial risk-model of concussion. The findings suggest that lower HA may lead to increased dangerous play in youth rugby, influencing concussion susceptibility. Contrasting associations in the professional cohort suggest further research is required to understand the role of personality in concussion. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Resting state low-frequency fluctuations in prefrontal cortex reflect degrees of harm avoidance and novelty seeking: an exploratory NIRS study

PubMed Central

Nakao, Takashi; Matsumoto, Tomoya; Shimizu, Daisuke; Morita, Machiko; Yoshimura, Shinpei; Northoff, Georg; Morinobu, Shigeru; Okamoto, Yasumasa; Yamawaki, Shigeto

2013-01-01

Harm avoidance (HA) and novelty seeking (NS) are temperament dimensions defined by Temperament and Character Inventory (TCI), respectively, reflecting a heritable bias for intense response to aversive stimuli or for excitement in response to novel stimuli. High HA is regarded as a risk factor for major depressive disorder and anxiety disorder. In contrast, higher NS is linked to increased risk for substance abuse and pathological gambling disorder. A growing body of evidence suggests that patients with these disorders show abnormality in the power of slow oscillations of resting-state brain activity. It is particularly interesting that previous studies have demonstrated that resting state activities in medial prefrontal cortex (MPFC) are associated with HA or NS scores, although the relation between the power of resting state slow oscillations and these temperament dimensions remains poorly elucidated. This preliminary study investigated the biological bases of these temperament traits by particularly addressing the resting state low-frequency fluctuations in MPFC. Regional hemodynamic changes in channels covering MPFC during 5-min resting states were measured from 22 healthy participants using near-infrared spectroscopy (NIRS). These data were used for correlation analyses. Results show that the power of slow oscillations during resting state around the dorsal part of MPFC is negatively correlated with the HA score. In contrast, NS was positively correlated with the power of resting state slow oscillations around the ventral part of MPFC. These results suggest that the powers of slow oscillation at rest in dorsal or ventral MPFC, respectively, reflect the degrees of HA and NS. This exploratory study therefore uncovers novel neural bases of HA and NS. We discuss a neural mechanism underlying aversion-related and reward-related processing based on results obtained from this study. PMID:24381545
Quality of life of patients who undergo breast reconstruction after mastectomy: effects of personality characteristics.

PubMed

Bellino, Silvio; Fenocchio, Marina; Zizza, Monica; Rocca, Giuseppe; Bogetti, Paolo; Bogetto, Filippo

2011-01-01

Reconstruction after mastectomy has become an integral part of breast cancer treatment. The effects of psychological factors on quality of life after reconstruction have been poorly investigated. The authors examined clinical and personality characteristics related to quality of life in patients receiving reconstructive surgery. All patients received immediate reconstruction and were evaluated in the week before tissue expander implantation (T0) with a semistructured interview for demographic and clinical characteristics, the Temperament and Character Inventory, the Inventory of Interpersonal Problems, the Short Form Health Survey, the Severity Item of the Clinical Global Impression, the Hamilton Depression Rating Scale, and the Hamilton Anxiety Rating Scale. Assessment with the Short Form was repeated 3 months after expander placement (T1). Statistics were calculated with univariate regression and analysis of variance. Significant variables were included in a multiple regression analysis to identify factors related to the change T1-T0 of the mean of the Short Form-transformed scores. Results were significant when p was less than or equal to 0.05. Fifty-seven women were enrolled. Results of multiple regression analysis showed that the Temperament and Character Inventory personality dimension harm avoidance and the Inventory of Interpersonal Problems domain vindictive/self-centered were significantly and independently related to the change in Short Form mean score. Personality dimensions and patterns of interpersonal functioning produce significant effects on patients' quality of life during breast reconstruction. Patients with high harm avoidance are apprehensive and doubtful. Restoration of body image could help them to reduce social anxiety and insecurity. Vindictive/self-centered patients are resentful and aggressive. Breast reconstruction could symbolize the conclusion of a reparative process and fulfill the desire of revenge on cancer.
Patient safety in thoracic surgery and European Society of Thoracic Surgeons checklist.

PubMed

Novoa, Nuria M

2015-04-01

Improving patient safety seems to be a new interesting clinical subject but, in fact, it is no new. It has to do with one of the oldest ethical principles of our profession: curing and not harming. The important research that has been done in a short period of time has brought in new insight to this complex area that is fast developing. The creation of safety managing systems will allow coordinating efforts from very different, although complementary, areas to create real safety culture and safety climate in every organization. In the surgical settings, teamwork is basic to provide good quality of care. Safety leaders in every team have an important role in establishing priorities, summarizing proposals, coordinating efforts, launching new initiatives and transmitting that safety efforts are worth taken. Preparedness and anticipation are key points for avoiding most of the diverse types of patient harm that can occur. As has been published, a great number of errors can be avoided simply using crosscheck based on specialized checklist that reviews every important detail of the procedure. This strategy has been demonstrated very useful at other high risk industries such as aviation, nuclear or food management. The Safe Surgery Saves Lives program launched in 2002 by the WHO has taught us that improvement is possible using a simple checklist. More complex and detail checklist can be more adequate for more complex procedures and settings. The proposed ESTS checklist reviews different areas of possible error in deeper detail allowing the finest adjustment of the patient before the skin incision. It has been recently released to the general thoracic community and monitors its use and usefulness has to be warrantied.
The olfactory neuron AWC promotes avoidance of normally palatable food following chronic dietary restriction

PubMed Central

Olofsson, Birgitta

2014-01-01

Changes in metabolic state alter foraging behavior and food preference in animals. Here, I show that normally attractive food becomes repulsive to Caenorhabditis elegans if animals are chronically undernourished as a result of alimentary tract defects. This behavioral plasticity is achieved in two ways: increased food leaving and induction of aversive behavior towards food. A particularly strong food avoider is defective in the chitin synthase that makes the pharyngeal lining. Food avoidance induced by underfeeding is mediated by cGMP signaling in the olfactory neurons AWC and AWB, and the gustatory neurons ASJ and ASK. Food avoidance is enhanced by increased population density and is reduced if the animals are unable to correctly interpret their nutritional state as a result of defects in the AMP kinase or TOR/S6kinase pathways. The TGF-β/DBL-1 pathway suppresses food avoidance and the cellular basis for this is distinct from its role in aversive olfactory learning of harmful food. This study suggests that nutritional state feedback via nutrient sensors, population size and olfactory neurons guides food preference in C. elegans. PMID:24577446
The Role of Employee Whistleblowing and Raising Concerns in an Organizational Learning Culture – Elusive and Laudable?

PubMed Central

Jones, Aled

2016-01-01

It is inevitable that healthcare workers throughout their careers will witness actual or potential threats to patient safety in the course of their work. Some of these threats will result in serious harm occurring to others, whilst at other times such threats will result in minimal harm, or a ‘near miss’ where harm is avoided at the last minute. Despite organizations encouraging employees to ‘speak up’ about such threats, healthcare systems globally struggle to engage their staff to do so. Even when staff do raise concerns they are often ignored by those with a responsibility to listen and act. Learning how to create the conditions where employees continuously raise and respond to concerns is essential in creating a continuous and responsive learning culture that cherishes keeping patients and employees safe. Workplace culture is a real barrier to the creation of such a learning system but examples in healthcare exist from which we can learn. PMID:26673654
Substance abuse and developments in harm reduction.

PubMed

Cheung, Y W

2000-06-13

A drug is a substance that produces a psychoactive, chemical or medicinal effect on the user. The psychoactive effect of mood-altering drugs is modulated by the user's perception of the risks of drug use, his or her ability to control drug use and the demographic, socioeconomic and cultural context. The ability to control drug use may vary along a continuum from compulsive use at one end to controlled use at the other. The "drug problem" has been socially constructed, and the presence of a moral panic has led to public support for the prohibitionist approach. The legalization approach has severely attacked the dominant prohibitionist approach but has failed to gain much support in society because of its extreme libertarian views. The harm reduction approach, which is based on public health principles, avoids the extremes of value-loaded judgements on drug use and focuses on the reduction of drug-related harm through pragmatic and low-threshold programs. This approach is likely to be important in tackling the drug problem in the 21st century.
Substance abuse and developments in harm reduction

PubMed Central

Cheung, Y W

2000-01-01

A drug is a substance that produces a psychoactive, chemical or medicinal effect on the user. The psychoactive effect of mood-altering drugs is modulated by the user's perception of the risks of drug use, his or her ability to control drug use and the demographic, socioeconomic and cultural context. The ability to control drug use may vary along a continuum from compulsive use at one end to controlled use at the other. The "drug problem" has been socially constructed, and the presence of a moral panic has led to public support for the prohibitionist approach. The legalization approach has severely attacked the dominant prohibitionist approach but has failed to gain much support in society because of its extreme libertarian views. The harm reduction approach, which is based on public health principles, avoids the extremes of value-loaded judgements on drug use and focuses on the reduction of drug-related harm through pragmatic and low-threshold programs. This approach is likely to be important in tackling the drug problem in the 21st century. PMID:10870502
Selecting for Disabilities: Selection Versus Modification.

PubMed

Shaw, Joshua

2018-04-01

This essay considers one argument used to defend parents who use preimplantation genetic diagnosis (PGD) to select for deafness and other disabilities. Some bioethicists have argued that a distinction should be drawn between genetically modifying embryos to possess disabilities and using PGD to select embryos that already present markers of them, and that the former is unethical because it inflicts avoidable harms onto the resulting children, whereas the latter is permissible because it allows children with potentially impaired abilities to exist. This essay raises doubts about whether a meaningful moral distinction can be drawn between modification and selection. Arguments which distinguish modification from selection can be understood in two ways. One is to read them as presenting a No Harm, No Foul argument. Another is to read them as presenting a Harming Versus Letting Be argument. Neither succeeds, however, either in establishing a meaningful moral distinction between modification and selection, or in showing that the second is morally permissible in contradistinction to the first.
Don't just do something, stand there! The value and art of deliberate clinical inertia.

PubMed

Keijzers, Gerben; Cullen, Louise; Egerton-Warburton, Diana; Fatovich, Daniel M

2018-04-01

It can be difficult to avoid unnecessary investigations and treatments, which are a form of low-value care. Yet every intervention in medicine has potential harms, which may outweigh the potential benefits. Deliberate clinical inertia is the art of doing nothing as a positive response. This paper provides suggestions on how to incorporate deliberate clinical inertia into our daily clinical practice, and gives an overview of current initiatives such as 'Choosing Wisely' and the 'Right Care Alliance'. The decision to 'do nothing' can be complex due to competing factors, and barriers to implementation are highlighted. Several strategies to promote deliberate clinical inertia are outlined, with an emphasis on shared decision-making. Preventing medical harm must become one of the pillars of modern health care and the art of not intervening, that is, deliberate clinical inertia, can be a novel patient-centred quality indicator to promote harm reduction. © 2018 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.
Moral Distress, Workplace Health, and Intrinsic Harm.

PubMed

Weber, Elijah

2016-05-01

Moral distress is now being recognized as a frequent experience for many health care providers, and there's good evidence that it has a negative impact on the health care work environment. However, contemporary discussions of moral distress have several problems. First, they tend to rely on inadequate characterizations of moral distress. As a result, subsequent investigations regarding the frequency and consequences of moral distress often proceed without a clear understanding of the phenomenon being discussed, and thereby risk substantially misrepresenting the nature, frequency, and possible consequences of moral distress. These discussions also minimize the intrinsically harmful aspects of moral distress. This is a serious omission. Moral distress doesn't just have a negative impact on the health care work environment; it also directly harms the one who experiences it. In this paper, I claim that these problems can be addressed by first clarifying our understanding of moral distress, and then identifying what makes moral distress intrinsically harmful. I begin by identifying three common mistakes that characterizations of moral distress tend to make, and explaining why these mistakes are problematic. Next, I offer an account of moral distress that avoids these mistakes. Then, I defend the claim that moral distress is intrinsically harmful to the subject who experiences it. I conclude by explaining how acknowledging this aspect of moral distress should reshape our discussions about how best to deal with this phenomenon. © 2015 John Wiley & Sons Ltd.
Physician Burnout: Resilience Training is Only Part of the Solution.

PubMed

Card, Alan J

2018-05-01

Physicians and physician trainees are among the highest-risk groups for burnout and suicide, and those in primary care are among the hardest hit. Many health systems have turned to resilience training as a solution, but there is an ongoing debate about whether that is the right approach. This article distinguishes between unavoidable occupational suffering (inherent in the physician's role) and avoidable occupational suffering (systems failures that can be prevented). Resilience training may be helpful in addressing unavoidable suffering, but it is the wrong treatment for the organizational pathologies that lead to avoidable suffering- and may even compound the harm doctors experience. To address avoidable suffering, health systems would be better served by engaging doctors in the co-design of work systems that promote better mental health outcomes. © 2018 Annals of Family Medicine, Inc.
Exploring the Association of Deliberate Self-Harm With Emotional Relief Using a Novel Implicit Association Test

PubMed Central

Gratz, Kim L.; Chapman, Alexander L.; Dixon-Gordon, Katherine L.; Tull, Matthew T.

2017-01-01

Despite the growing consensus that negative reinforcement in the form of emotional relief plays a key role in the maintenance of deliberate self-harm (DSH), most of the research in this area has relied exclusively on self-report measures of the perceived motives for and emotional consequences of DSH. Thus, the primary aim of this study was to extend extant research on the role of emotional relief in DSH by examining the strength of the association of DSH with emotional relief using a novel version of the Implicit Association Test (IAT). The strength of the DSH-relief association among both participants with (vs. without) DSH and self-harming participants with (vs. without) BPD, as well as its associations with relevant clinical constructs (including DSH characteristics, self-reported motives for DSH, BPD pathology, and emotion dysregulation and avoidance) were examined in a community sample of young adults (113 with recent recurrent DSH; 135 without DSH). As hypothesized, results revealed stronger associations between DSH and relief among participants with versus without DSH, as well as among DSH participants with versus without BPD. Moreover, the strength of the DSH-relief association was positively associated with DSH frequency and versatility (both lifetime and at 6-month follow-up), BPD pathology, emotion dysregulation, experiential avoidance, and self-reported emotion relief motives for DSH. Findings provide support for theories emphasizing the role of emotional relief in DSH (particularly among individuals with BPD), as well as the construct validity, predictive utility, and incremental validity (relative to self-reported emotion relief motives) of this IAT. PMID:26147069
Safe separation distance score: A new metric for evaluating wildland firefighter safety zones using lidar

Treesearch

Michael J. Campbell; Philip E. Dennison; Bret W. Butler

2016-01-01

Safety zones are areas where firefighters can retreat to in order to avoid bodily harm when threatened by burnover or entrapment from wildland fire. At present, safety zones are primarily designated by firefighting personnel as part of daily fire management activities. Though critical to safety zone assessment, the effectiveness of this approach is inherently limited...
Indoctrination and Social Context: A System-Based Approach to Identifying the Threat of Indoctrination and the Responsibilities of Educators

ERIC Educational Resources Information Center

Taylor, Rebecca M.

2017-01-01

Debates about indoctrination raise fundamental questions about the ethics of teaching. This paper presents a philosophical analysis of indoctrination, including 1) an account of what indoctrination is and why it is harmful, and 2) a framework for understanding the responsibilities of teachers and other educational actors to avoid its negative…
Identifying and integrating helpful and harmful religious beliefs into psychotherapy.

PubMed

Rosenfield, George W

2010-12-01

The 2 main roles of the psychotherapist involve identifying and understanding the client's problems/strengths and treating problems. Suggestions are offered to guide addressing or avoiding religious beliefs in both roles. Types of religious beliefs that contribute to distress, particularly for youth, are identified and treatment options are offered. (PsycINFO Database Record (c) 2010 APA, all rights reserved).
Diagnostic Efficiency of the Child and Parent Versions of the Multidimensional Anxiety Scale for Children

ERIC Educational Resources Information Center

Villabo, Marianne; Gere, Martina; Torgersen, Svenn; March, John S.; Kendall, Philip C.

2012-01-01

The objective of this study is to evaluate the psychometrics and clinical efficiency of the Multidimensional Anxiety Scale for Children (MASC), which measures physical symptoms, harm avoidance, social anxiety, and separation/panic. Using a sample of 190 treatment-seeking Norwegian youth (aged 7-13 years, M[subscript age] = 10.3 years, 62.1% male),…

The influence of personality traits on smokers' affect, withdrawal and cessation intervention outcome.

PubMed

Cui, Yong; Tang, Rui; Lam, Cho Y; Cinciripini, Paul M; Robinson, Jason D

2016-03-01

The personality traits of harm avoidance (HA), novelty seeking (NS), and reward dependence (RD), as measured by the Tridimensional Personality Questionnaire (TPQ), have been linked to smoking behavior. The extent to which these traits are associated with smoking withdrawal and cessation outcome is unclear. We sought to address this question among 131 treatment-seeking smokers who were randomly assigned to either a smoking cessation treatment (four 30-min behavioral counseling sessions) or a control condition. We found that HA was positively associated with baseline depressive symptoms, baseline negative affect, and post-quit withdrawal, and negatively associated with positive affect at both baseline and post-quit. Additionally, we found that smokers with higher HA scores were more likely to be abstinent. NS was negatively associated with post-quit positive affect and positively associated with post-quit negative affect and withdrawal. RD was not found to be related to any outcome measures. Our findings suggest that, despite experiencing greater baseline and post-quit negative affect, smokers higher in trait harm avoidance are more likely to quit smoking. The treatment and theoretical ramifications of these findings are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.
Reward and loss anticipation in panic disorder: An fMRI study.

PubMed

Held-Poschardt, Dada; Sterzer, Philipp; Schlagenhauf, Florian; Pehrs, Corinna; Wittmann, Andre; Stoy, Meline; Hägele, Claudia; Knutson, Brian; Heinz, Andreas; Ströhle, Andreas

2018-01-30

Anticipatory anxiety and harm avoidance are essential features of panic disorder (PD) and may involve deficits in the reward system of the brain, in particular in the ventral striatum. While neuroimaging studies on PD have focused on fearful and negative affective stimulus processing, no investigations have directly addressed deficits in reward and loss anticipation. To determine whether the ventral striatum shows abnormal neural activity in PD patients during anticipation of loss or gain, an event-related functional magnetic resonance imaging experiment using a monetary incentive delay task was employed in 10 patients with PD and 10 healthy controls. A repeated-measures ANOVA to identify effects of group (PD vs. Control) and condition (anticipation of loss vs. gain vs. neutral outcome) revealed that patients with PD showed significantly reduced bilateral ventral striatal activation during reward anticipation but increased activity during loss anticipation. Within the patient group, the degree of activation in the ventral striatum during loss-anticipation was positively correlated with harm avoidance and negatively correlated with novelty seeking. These findings suggest that behavioural impairments in panic disorder may be related to abnormal neural processing of motivational cues. Copyright © 2017 Elsevier B.V. All rights reserved.
How to prevent overdiagnosis.

PubMed

Chiolero, Arnaud; Paccaud, Fred; Aujesky, Drahomir; Santschi, Valérie; Rodondi, Nicolas

2015-01-01

Overdiagnosis is the diagnosis of an abnormality that is not associated with a substantial health hazard and that patients have no benefit to be aware of. It is neither a misdiagnosis (diagnostic error), nor a false positive result (positive test in the absence of a real abnormality). It mainly results from screening, use of increasingly sensitive diagnostic tests, incidental findings on routine examinations, and widening diagnostic criteria to define a condition requiring an intervention. The blurring boundaries between risk and disease, physicians' fear of missing a diagnosis and patients' need for reassurance are further causes of overdiagnosis. Overdiagnosis often implies procedures to confirm or exclude the presence of the condition and is by definition associated with useless treatments and interventions, generating harm and costs without any benefit. Overdiagnosis also diverts healthcare professionals from caring about other health issues. Preventing overdiagnosis requires increasing awareness of healthcare professionals and patients about its occurrence, the avoidance of unnecessary and untargeted diagnostic tests, and the avoidance of screening without demonstrated benefits. Furthermore, accounting systematically for the harms and benefits of screening and diagnostic tests and determining risk factor thresholds based on the expected absolute risk reduction would also help prevent overdiagnosis.
The association of major depressive episode and personality traits in patients with fibromyalgia

PubMed Central

de Melo Santos, Danyella; Lage, Laís Verderame; Jabur, Eleonora Kehl; Kaziyama, Helena Hideko Seguchi; Iosifescu, Dan V; de Lucia, Mara Cristina Souza; Fráguas, Renério

2011-01-01

INTRODUCTION: Personality traits have been associated with primary depression. However, it is not known whether this association takes place in the case of depression comorbid with fibromyalgia. OBJECTIVE: The authors investigated the association between a current major depressive episode and temperament traits (e.g., harm avoidance). METHOD: A sample of 69 adult female patients with fibromyalgia was assessed with the Temperament and Character Inventory. Psychiatric diagnoses were assessed with the Mini-International Neuropsychiatric Interview severity of depressive symptomatology with the Beck Depression Inventory, and anxiety symptomatology with the IDATE-state and pain intensity with a visual analog scale. RESULTS: A current major depressive episode was diagnosed in 28 (40.5%) of the patients. They presented higher levels of harm avoidance and lower levels of cooperativeness and self-directedness compared with non-depressed patients, which is consistent with the Temperament and Character Inventory profile of subjects with primary depression. However, in contrast to previous results in primary depression, no association between a major depressive episode and self-transcendence was found. CONCLUSIONS: The results highlight specific features of depression in fibromyalgia subjects and may prove important for enhancing the diagnosis and prognosis of depression in fibromyalgia patients. PMID:21808861
The "weakest link" as an indicator of cognitive vulnerability differentially predicts symptom dimensions of anxiety in adolescents in China.

PubMed

Wang, Junyi; Wang, Danyang; Cui, Lixia; McWhinnie, Chad M; Wang, Li; Xiao, Jing

2017-08-01

This multiwave longitudinal study examined the cognitive vulnerability-stress component of hopelessness theory to differentially predict symptom dimensions of anxiety using a "weakest link" approach in a sample of adolescents from Hunan Province, China. Baseline and 6-month follow-up data were obtained from 553 middle-school students. During an initial assessment, participants completed measures of assessing their weakest links, anxious symptoms, and the occurrence of stress. Participants subsequently completed measures assessing stress, and anxious symptoms one a month for six months. Higher weakest link scores were associated with greater increases in the harm avoidance and separation anxiety/panic dimensions, but not the physical or social anxiety dimension, of anxious symptoms following stress in Chinese adolescents. These results support the applicability of the "weakest link" approach, derived from hopelessness theory, in Chinese adolescents. Weakest link scores as cognitive vulnerability factors may play a role in the development of anxious symptoms, especially in the cognitive dimensions (e.g., harm avoidance and separation anxiety/panic). Our findings also have potential value in explaining the effectiveness of cognitive relevant therapy in treating the cognitive dimensions of anxious symptoms. Copyright © 2017 Elsevier Ltd. All rights reserved.
Personality traits and violent behavior: a comparison between psychopathic and non-psychopathic male murderers.

PubMed

de Pádua Serafim, Antonio; de Barros, Daniel Martins; Bonini Castellana, Gustavo; Gorenstein, Clarice

2014-11-30

The relationship between psychopathy and traits of temperament and character in a specific population of criminals, such as murderers, has not been sufficiently investigated. This study assesses the relationship between psychopathy and temperament and character traits in murderers. The sample consisted of 118 men divided into three groups: psychopathic murderers (N=40), non-psychopathic murderers (N=40) and 38 non-psychopathic non-criminals (controls). All individuals were evaluated by Psychopathy Checklist Revised (PCL-R) and The Temperament and Character Inventory (TCI). Psychopathic murderers presented higher scores than the other two groups in PCL-R; both criminal groups presented higher scores than non-psychopathic non-criminals. Psychopathic murderers showed lower scores than non-psychopathic murderers on Harm Avoidance, Reward Dependence, Persistence, Self-Directness and Cooperativeness. There was no difference between murderers groups regarding Novelty Seeking and Self-transcendence. In all TCI personality traits psychopathic and non-psychopathic murderers showed scores lower than controls, except Harm Avoidance for non-psychopathic murderers. In conclusion, most personality traits assessed by TCI were associated with psychopathy, while Novelty Seeking and Self-transcendence were associated with homicidal behavior independently of the psychopathy. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
The role of the harm avoidance personality in depression and anxiety during the medical internship.

PubMed

Chen, Ching-Yen; Lin, Sheng-Hsuan; Li, Peng; Huang, Wei-Lieh; Lin, Yu-Hsuan

2015-01-01

To determine whether physicians with harm avoidance (HA) personality traits were more prone to developing increased anxiety and depression during the medical internship. A prospective longitudinal study of 74 medical interns was carried out using repeated measures of symptoms of anxiety and depression with the Beck Anxiety and Depression Inventories (BAI and BDI) before, at the 3rd, 6th, and 12th months during the internship, and 2 weeks after the internship was completed. Baseline personality was assessed by the Tridimensional Personality Questionnaire with 3 dimensions: novelty-seeking, HA, and reward dependence (RD). Levels of both depression and anxiety increased (6.4 and 3.4 on scores for BDI and BAI, respectively) during the internship and returned to baseline 2 weeks after it ended. HA scores were significantly correlated with depression and anxiety (0.3 scores on both the BDI and the BAI) and the scores for RD were significantly correlated with anxiety but not with depression. The interaction of HA and point in internship showed no significant differences. Internship plays a major role in the increase in depression and anxiety. A HA personality was also associated with the development of both depression and anxiety.
The Role of the Harm Avoidance Personality in Depression and Anxiety During the Medical Internship

PubMed Central

Chen, Ching-Yen; Lin, Sheng-Hsuan; Li, Peng; Huang, Wei-Lieh; Lin, Yu-Hsuan

2015-01-01

Abstract To determine whether physicians with harm avoidance (HA) personality traits were more prone to developing increased anxiety and depression during the medical internship. A prospective longitudinal study of 74 medical interns was carried out using repeated measures of symptoms of anxiety and depression with the Beck Anxiety and Depression Inventories (BAI and BDI) before, at the 3rd, 6th, and 12th months during the internship, and 2 weeks after the internship was completed. Baseline personality was assessed by the Tridimensional Personality Questionnaire with 3 dimensions: novelty-seeking, HA, and reward dependence (RD). Levels of both depression and anxiety increased (6.4 and 3.4 on scores for BDI and BAI, respectively) during the internship and returned to baseline 2 weeks after it ended. HA scores were significantly correlated with depression and anxiety (0.3 scores on both the BDI and the BAI) and the scores for RD were significantly correlated with anxiety but not with depression. The interaction of HA and point in internship showed no significant differences. Internship plays a major role in the increase in depression and anxiety. A HA personality was also associated with the development of both depression and anxiety. PMID:25590843
Bond Strength Mechanism of Fly Ash Based Geopolymer Mortars: A Review

NASA Astrophysics Data System (ADS)

Zailani, W. W. A.; Abdullah, M. M. A. B.; Razak, R. A.; Zainol, M. R. R. M. A.; Tahir, M. F. M.

2017-11-01

Geopolymer possess many excellent properties such as high compressive and bond strength, long term durability, better acid resistance and also known as a “Sustainable Material” due to its low carbon emission and low energy consumption. Thus, it is a good opportunity to develop and explore not only for cement and concrete but also as geopolymeric repair materials. This reviews showed that good bonding properties between geopolymeric repair material and concrete substrate is important in order to acquire an enhanced resistance against penetration of harmful substances and avoiding respalling of the repair material by understanding the bonding behaviour. Bond strength depends to the properties of the repair materials itself and also the surface preparations of concrete substrate.
KrioBlast TM as a New Technology of Hyper-fast Cryopreservation of Cells and Tissues. Part I. Thermodynamic Aspects and Potential Applications in Reproductive and Regenerative Medicine.

PubMed

Katkov, I I; Bolyukh, V F; Sukhikh, G T

2018-03-01

Kinetic (dynamic) vitrification is a promising trend in cryopreservation of biological materials because it allows avoiding the formation of lethal intracellular ice and minimizes harmful effects of highly toxic penetrating cryoprotectants. A uniform cooling protocol and the same instruments can be used for practically all types of cells. In modern technologies, the rate of cooling is essentially limited by the Leidenfrost effect. We describe a novel platform for kinetic vitrification of biological materials KrioBlast TM that realizes hyper-fast cooling and allows overcoming the Leidenfrost effect. This opens prospects for creation of a novel technology of cell cryopreservation for reproductive and regenerative medicine.
A Canadian framework for applying the precautionary principle to public health issues.

PubMed

Weir, Erica; Schabas, Richard; Wilson, Kumanan; Mackie, Chris

2010-01-01

The precautionary principle has influenced environmental and public health policy. It essentially states that complete evidence of a potential risk is not required before action is taken to mitigate the effects of the potential risk. The application of precaution to public health issues is not straightforward and could paradoxically cause harm to the public's health when applied inappropriately. To avoid this, we propose a framework for applying the precautionary principle to potential public health risks. The framework consists of ten guiding questions to help establish whether a proposed application of the precautionary principle on a public health matter is based on adequacy of the evidence of causation, severity of harm and acceptability of the precautionary measures.
The conflict between randomized clinical trials and the therapeutic obligation.

PubMed

Gifford, F

1986-11-01

The central dilemma concerning randomized clinical trials (RCTs) arises out of some simple facts about causal methodology (RCTs are the best way to generate the reliable causal knowledge necessary for optimally-informed action) and a prima facie plausible principle concerning how physicians should treat their patients (always do what it is most reasonable to believe will be best for the patient). A number of arguments related to this in the literature are considered. Attempts to avoid the dilemma fail. Appeals to informed consent and mechanisms for minimizing the resulting harm are important for policy, but informed consent is problematic and mechanisms for minimization of harm do not address the dilemma. Appeals to some sort of contract model of justification are promising and illuminating.
Community-based harm reduction substance abuse treatment with methamphetamine-using men who have sex with men.

PubMed

Carrico, Adam W; Flentje, Annesa; Gruber, Valerie A; Woods, William J; Discepola, Michael V; Dilworth, Samantha E; Neilands, Torsten B; Jain, Jennifer; Siever, Michael D

2014-06-01

Harm reduction approaches endeavor to assist individuals with avoiding the most detrimental consequences of risk taking behaviors, but limited research has documented the outcomes of harm reduction substance abuse treatment. In total, 211 methamphetamine-using men who have sex with men (MSM) enrolled in two outcome studies of substance abuse treatment programs that were implementing an evidence-based, cognitive-behavioral intervention (i.e., the Matrix Model) from a harm reduction perspective. Study 1 (N = 123) examined changes in self-reported substance use, Addiction Severity Index (ASI) composite scores, and HIV care indicators over a 12-month follow-up. Study 2 (N = 88) assessed changes in substance use, sexual risk taking, and HIV care indicators over a 6-month follow-up. Participants in study 1 reported reductions in cocaine/crack use as well as decreases in the ASI drug and employment composite scores. Among HIV-positive participants in study 1 (n = 75), 47 % initiated or consistently utilized anti-retroviral therapy and this was paralleled by significant increases in self-reported undetectable HIV viral load. Study 2 participants reported reductions in methamphetamine use, erectile dysfunction medication use in combination with other substances, and sexual risk-taking behavior while using methamphetamine. Participants in both studies reported concurrent increases in marijuana use. Taken together, these studies are among the first to observe that clients may reduce stimulant use and concomitant sexual risk-taking behavior during harm reduction substance abuse treatment. Randomized controlled trials are needed to examine the differential effectiveness of harm reduction and abstinence-based approaches to substance abuse treatment.
Perception of electronic cigarettes in the general population: does their usefulness outweigh their risks?

PubMed Central

Martínez-Sánchez, Jose M; Fu, Marcela; Martín-Sánchez, Juan Carlos; Ballbè, Montse; Saltó, Esteve; Fernández, Esteve

2015-01-01

Objective To describe and compare the perceptions of the general population about the harmful effects of electronic cigarettes (e-cigarettes) on users and on those passively exposed to e-cigarettes and the perceptions about e-cigarette usefulness for reducing or eliminating tobacco smoking. Design, setting, and participants We analysed cross-sectional data from a longitudinal study of a representative sample of the general adult (≥16 years) population of Barcelona, Spain (336 men and 400 women). The fieldwork was conducted between May 2013 and February 2014. We computed the percentages, adjusted OR and their corresponding 95% CI among participants with some awareness of e-cigarettes (79.2% of the sample). Primary and secondary outcome measures We assessed the perception about harmfulness for e-cigarette users and for passively exposed non-e-cigarette users, as well as the perception of usefulness for smokers of cigarette cessation and reduction. Results In this sample, 40.1% thought that e-cigarettes had a harmful effect on users, and 27.1% thought that e-cigarettes had a harmful effect on passively exposed bystanders (p<0.001). Particularly, more never-smokers perceived that e-cigarettes had harmful effects on passively exposed bystanders than current smokers (34.4% vs 20.6%; OR=1.93, 95% CI 1.02 to 3.63). More people perceived e-cigarettes as being useful for reducing smoking than for quitting (50.6% vs 29.9%, p<0.001), as well as for reducing smoking than as being harmful to users (50.6% vs 40.1%, p=0.044). Discussion The perception that e-cigarettes are useful for reducing tobacco consumption was more prevalent than the perception that e-cigarettes are harmful to users and to those passively exposed to e-cigarettes. Advertisements and messages about the use of e-cigarettes and their harmful effects should be regulated and based on scientific evidence to avoid creating erroneous ideas about their use. PMID:26534735
Octanol-water partition coefficients for predicting the effects of tannins in ruminant nutrition.

PubMed

Mueller-Harvey, Irene; Mlambo, Victor; Sikosana, Joe L N; Smith, Tim; Owen, Emyr; Brown, Ron H

2007-07-11

Tannins can cause beneficial or harmful nutritional effects, but their great diversity has until now prevented a rational distinction between tannin structures and their nutritional responses. An attempt has been made to study this problem by examining the octanol-water solubilities of tannins. A relatively simple HPLC method has been developed for screening mixtures of plant tannins for their octanol-water partition coefficients (Kow coefficients). Tannins were isolated from the fruits and leaves of different Acacia, Calliandra, Dichrostachys, and Piliostigma species, which are known to produce beneficial or harmful effects. The Kow coefficients of these tannins ranged from 0.061 to 13.9, average coefficients of variation were 9.2% and recoveries were 107%. Acacia nilotica fruits and leaves had the highest Kow coefficients, that is, 2.0 and 13.9, respectively. These A. nilotica products also have high concentrations of tannins. The combined effects of high octanol solubilities and high tannin concentrations may explain their negative effects on animal nutrition and health. It is known that compounds with high octanol solubilities are more easily absorbed into tissues, and it is, therefore, proposed that such compounds are more likely to cause toxicity problems especially if consumed in large quantities. According to the literature, tannins in human foods tend to have low Kow coefficients, and this was confirmed for the tannins in Piliostigma thonningii fruits. Therefore, unconventional feeds or browse products should be screened not only for their tannin concentrations but also for low octanol-water partition coefficients in order to identify nutritionally safe feeds and to avoid potentially toxic feeds.
Green reduction of graphene oxide via Lycium barbarum extract

NASA Astrophysics Data System (ADS)

Hou, Dandan; Liu, Qinfu; Cheng, Hongfei; Zhang, Hao; Wang, Sen

2017-02-01

The synthesis of graphene from graphene oxide (GO) usually involves toxic reducing agents that are harmful to human health and the environment. Here, we report a facile approach for effective reduction of GO, for the first time, using Lycium barbarum extract as a green and natural reducing agent. The morphology and de-oxidation efficiency of the reduced graphene were characterized and results showed that Lycium barbarum extract can effectively reduce GO into few layered graphene with a high carbon to oxygen ratio (6.5), comparable to that of GO reduced by hydrazine hydrate (6.6). The possible reduction mechanism of GO may be due to the active components existing in Lycium barbarum fruits, which have high binding affinity to the oxygen containing groups to form their corresponding oxides and other by-products. This method avoided the use of any nocuous chemicals, thus facilitating the mass production of graphene and graphene-based bio-materials.
High Voltage Discharge Profile on Soil Breakdown Using Impulse Discharge

NASA Astrophysics Data System (ADS)

Fajingbesi, F. E.; Midi, N. S.; Elsheikh, E. M. A.; Yusoff, S. H.

2017-06-01

Grounding terminals are mandatory in electrical appliance design as they provide safety route during overvoltage faults. The soil (earth) been the universal ground is assumed to be at zero electric potential. However, due to properties like moisture, pH and available nutrients; the electric potential may fluctuate between positive and negative values that could be harmful for internally connected circuits on the grounding terminal. Fluctuations in soil properties may also lead to current crowding effect similar to those seen at the emitters of semiconductor transistors. In this work, soil samples are subjected to high impulse voltage discharge and the breakdown characteristics was profiled. The results from profiling discharge characteristics of soil in this work will contribute to the optimization of grounding protection system design in terms of electrode placement. This would also contribute to avoiding grounding electrode current crowding, ground potential rise fault and electromagnetic coupling faults.
Personality dimensions of opiate addicts.

PubMed

Vukov, M; Baba-Milkic, N; Lecic, D; Mijalkovic, S; Marinkovic, J

1995-02-01

A survey of 80 opiate addicts included in a detoxification program was conducted at the Institute on Addictions in Belgrade. In addition to a dependence diagnosis and mental disorders based on DSM-III-R, we applied a Tridimensional Personality Questionnaire (TPQ) that measures the 3 major personality dimensions: novelty-seeking (NS), harm avoidance (HA) and reward dependence (RD). When compared with a control group (a sample of Yugoslav undergraduate students), the opiate addicts demonstrate significantly high NS dimension as well as significant divergences of HA and RD subscales. The surveyed opiate addicts demonstrate a high percentage of personality disorders specifically in cluster B. The personality dimensions of opiate addicts showed certain temperament traits, such as: impulsiveness, shyness with strangers, fear of uncertainty and dependence. NS, HA and RD determined by temperament specifics may be an etiological factor in forming of a personality disorder, an affective disorder as well as of a drug choice.
Apparatus and method for high temperature viscosity and temperature measurements

DOEpatents

Balasubramaniam, Krishnan; Shah, Vimal; Costley, R. Daniel; Singh, Jagdish P.

2001-01-01

A probe for measuring the viscosity and/or temperature of high temperature liquids, such as molten metals, glass and similar materials comprises a rod which is an acoustical waveguide through which a transducer emits an ultrasonic signal through one end of the probe, and which is reflected from (a) a notch or slit or an interface between two materials of the probe and (b) from the other end of the probe which is in contact with the hot liquid or hot melt, and is detected by the same transducer at the signal emission end. To avoid the harmful effects of introducing a thermally conductive heat sink into the melt, the probe is made of relatively thermally insulative (non-heat-conductive) refractory material. The time between signal emission and reflection, and the amplitude of reflections, are compared against calibration curves to obtain temperature and viscosity values.
Risk factors for suicide in Taiwanese college students.

PubMed

Gau, Susan Shur-Fen; Chen, Ying-Yeh; Tsai, Fang-Ju; Lee, Ming-Been; Chiu, Yen-Nan; Soong, Wei-Tsuen; Hwu, Hai-Gwo

2008-01-01

The authors investigated the personality characteristics, psychopathology, parenting style, and family function among Taiwanese college students with high, moderate, and low suicidal risks. The sample included 2,919 first-year college students (1,414 men, 1,505 women) from a university in Taipei, Taiwan. A self-administered questionnaire assessed domains covering demographics, personality, psychopathology, frequency of substance use, parenting style, family functioning, and suicidal behaviors. The authors used mixed models for data analysis. The authors observed a positive linear trend between increased suicidal tendency and levels of neuroticism, harm avoidance, novelty seeking, psychopathology, and parenting styles of low affection, overprotection, and authoritarian controlling. Use of tobacco and alcohol and impaired family adaptation and cohesion were associated with high and moderate suicidal risks. Personality, psychopathology, substance use, and familial factors are important correlates of suicidal risks among college students in Taiwan. Optimal suicide prevention strategies in the college setting should incorporate the multiple facets of suicidal risks.

What a Shock: No Apoptosis without Heat Shock Protein 90α | Center for Cancer Research

Cancer.gov

Apoptosis, also known as programmed cell death, consists of a series of reactions designed to systematically chop up a cell and its contents. The process is used to eliminate specific cells during development or to remove old or damaged cells without harming any surrounding cells. Since cancer cells can develop mechanisms to avoid apoptosis, researchers may be able to identify
Agent-based model for rural-urban migration: A dynamic consideration

NASA Astrophysics Data System (ADS)

Cai, Ning; Ma, Hai-Ying; Khan, M. Junaid

2015-10-01

This paper develops a dynamic agent-based model for rural-urban migration, based on the previous relevant works. The model conforms to the typical dynamic linear multi-agent systems model concerned extensively in systems science, in which the communication network is formulated as a digraph. Simulations reveal that consensus of certain variable could be harmful to the overall stability and should be avoided.
Communication errors in radiology - Pitfalls and how to avoid them.

PubMed

Waite, Stephen; Scott, Jinel Moore; Drexler, Ian; Martino, Jennifer; Legasto, Alan; Gale, Brian; Kolla, Srinivas

2018-06-07

Communication failures are a common cause of patient harm and malpractice claims against radiologists. In addition to overt communication breakdowns among providers, it is also important to address the quality of communication to optimize patient outcomes. In this review, we describe common communication failures and potential solutions providing a framework for radiologists to improve health care delivery. Copyright © 2018. Published by Elsevier Inc.
Ecopedagogy and Citizenship in the Age of Globalisation: Connections between Environmental and Global Citizenship Education to Save the Planet

ERIC Educational Resources Information Center

Misiaszek, Greg William

2015-01-01

Teaching the connections between environmentally-harmful acts and social conflict is essential but is often ignored in education. This article presents two ways in which these are not taught because of the policies of those who benefit from the ignorance of these connections: first, the avoidance of teaching global-local connectivity and second,…
When not to avoid inbreeding.

PubMed

Kokko, Hanna; Ots, Indrek

2006-03-01

Avoidance of incestuous matings is widely reported across many animal taxa, and the adaptive value of such behavior is explained through inbreeding depression. However, an old and somewhat neglected theoretical result predicts that inbred matings offer another, positive effect on the inclusive fitness of parents: an individual who mates with a relative will help that relative to spread genes identical by descent. This benefit can be substantial, if the additional mating achieved by the relative does not harm his mating success otherwise, and in the context of selfing in plants the phenomenon is well known. Here, we develop a model that derives expected values of inbreeding tolerance, that is, the magnitude of inbreeding depression that is required to make individuals avoid inbreeding, for different animal life histories and parental investment patterns. We also distinguish between simultaneous and sequential mate choice, and show that inbreeding tolerance should often be remarkably high in the latter scenario in particular, although egalitarian parental care will lead to lower tolerance. There is a mismatch between theory and data: the almost complete lack of cases where individuals prefer to mate incestuously is at odds with a large overlap between the predicted range of inbreeding tolerance and estimates of inbreeding depression found in nature. We discuss four different solutions to this enigma, and suggest that inbreeding tolerance, where it is found, should not always be attributed to a simple constraint that has prevented finding any other mate.
An overview of flywheel energy systems with HTS bearings

NASA Astrophysics Data System (ADS)

Wolsky, A. M.

2002-05-01

Passive magnetic bearings incorporating permanent magnets and ReBaCuO, together with carbon fibre, offer the possibility of increasing the stored, volumetric energy density of FES and unprecedentedly low idling loss of FES. Its stored energy need only satisfy customers' needs for the time it takes to bring on conventional 'back-up'. The FES itself must come up to power quickly enough to avoid any disruption in the customer's operation (e.g., continuous industrial processes involving fragile materials, for example paper forming). Such customers do not care about the price of electricity nearly as much as they care about not ruining their product, damaging their machines or having 'clean ups' that stop or slow output. Firms that engage in electronic commerce and/or telecommunications also value uninterruptible power. Another set of potential customers (construction, electric railroads) may wish to avoid fluctuations in their electrical supply or they may wish to avoid causing harm to others who may hold them liable for poor power quality. Finally, real time prices (e.g., every 15 s) and real time commands, disseminated via internet, and distributed storage might enable reduced system generation costs. Generators and FES makers would have to cooperate to make this feasible. Now, the central techno-economic challenge is to build a high-power, low-loss motor generator that reaches full power in a very short time.
"This is a question we have to ask everyone": asking young people about self-harm and suicide.

PubMed

O'Reilly, M; Kiyimba, N; Karim, K

2016-10-01

WHAT IS KNOWN ON THE SUBJECT?: An essential part of the mental health assessment is to evaluate the risk of harm to self. Fundamentally this involves asking directly about self-harming behaviour and suicidal thoughts or urges, but practitioners often find it difficult to open up these conversations. This evaluation of risk is particularly important as self-harm and suicidal thoughts are frequently found in young people who attend mental health services. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Young people are not always routinely asked directly about self-harm or suicidal thoughts when they are assessed. There are two ways that mental health practitioners introduce this topic: first, by building up to it by initially asking about general feelings, and second by stating that it is a requirement to ask everyone. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: These questions should not be avoided by mental health practitioners just because they are difficult. We offer suggestions as to how to ask questions about self-harm and suicide based on real-world practice. Introduction Questions about self-harm and suicide are essential in risk assessments with children and young people, yet little is known about how mental health practitioners do this. Aim The core aim was to examine how questions about self-harm and suicidal ideation are asked in real-world practice. Method A qualitative design was employed to analyse 28 video-recorded naturally occurring mental health assessments in a child and adolescent mental health service. Data were analysed using conversation analysis (CA). Results In 13 cases young people were asked about self-harm and suicide, but 15 were not. Analysis revealed how practitioners asked these questions. Two main styles were revealed. First was an incremental approach, beginning with inquiries about emotions and behaviours, building to asking about self-harm and suicidal intent. Second was to externalize the question as being required by outside agencies. Discussion The study concluded that the design of risk questions to young people had implications for how open they were to engaging with the practitioner. Implications for practice The study has implications for training and practice for psychiatric nurses and other mental health practitioners in feeling more confident in communicating with young people about self-harm and suicidal ideation. © 2016 John Wiley & Sons Ltd.
Harmful or helpful: perceived solicitous and facilitative partner responses are differentially associated with pain and sexual satisfaction in women with provoked vestibulodynia.

PubMed

Rosen, Natalie O; Bergeron, Sophie; Glowacka, Maria; Delisle, Isabelle; Baxter, Mary Lou

2012-09-01

Provoked vestibulodynia (PVD) is a highly prevalent vulvovaginal pain condition that negatively affects women's emotional, sexual, and relationship well-being. Recent studies have investigated the role of interpersonal variables, including partner responses. We examined whether solicitous and facilitative partner responses were differentially associated with vulvovaginal pain and sexual satisfaction in women with PVD by examining each predictor while controlling for the other. One hundred twenty-one women (M age = 30.60, SD = 10.53) with PVD or self-reported symptoms of PVD completed the solicitous subscale of the spouse response scale of the Multidimensional Pain Inventory, and the facilitative subscale of the Spouse Response Inventory. Participants also completed measures of pain, sexual function, sexual satisfaction, trait anxiety, and avoidance of pain and sexual behaviors (referred to as "avoidance"). Dependent measures were the (i) Pain Rating Index of the McGill Pain Questionnaire with reference to pain during vaginal intercourse and (ii) Global Measure of Sexual Satisfaction Scale. Controlling for trait anxiety and avoidance, higher solicitous partner responses were associated with higher vulvovaginal pain intensity (β = 0.20, P = 0.03), and higher facilitative partner responses were associated with lower pain intensity (β = -0.20, P = 0.04). Controlling for sexual function, trait anxiety, and avoidance, higher facilitative partner responses were associated with higher sexual satisfaction (β = 0.15, P = 0.05). Findings suggest that facilitative partner responses may aid in alleviating vulvovaginal pain and improving sexual satisfaction, whereas solicitous partner responses may contribute to greater pain. © 2012 International Society for Sexual Medicine.
Knowing when to seek anger: Psychological health and context-sensitive emotional preferences.

PubMed

Kim, Min Y; Ford, Brett Q; Mauss, Iris; Tamir, Maya

2015-01-01

According to hedonic approaches to psychological health, healthy individuals should pursue pleasant and avoid unpleasant emotions. According to instrumental approaches, however, healthy individuals should pursue useful and avoid harmful emotions, whether pleasant or unpleasant. We sought to reconcile these approaches by distinguishing between preferences for emotions that are aggregated across contexts and preferences for emotions within specific contexts. Across five days, we assessed daily confrontational and collaborative demands and daily preferences for anger and happiness. Somewhat consistent with hedonic approaches, when averaging across contexts, psychologically healthier individuals wanted to feel less anger, but not more happiness. Somewhat consistent with instrumental approaches, when examined within contexts, psychologically healthier individuals wanted to feel angrier in more confrontational contexts, and some wanted to feel happier in more collaborative contexts. Thus, although healthier individuals are motivated to avoid unpleasant emotions over time, they are more motivated to experience them when they are potentially useful.
Respecting Intent and Dispelling Stereotypes by Reducing Unintended Pregnancy.

PubMed

Johnsen, Dawn

2015-01-01

In "Expectant Fathers, Abortion, and Embryos," Dara Purvis evaluates the concepts of intent and gender stereotypes in connection with "expectational fathers" in the related contexts of abortion and assisted reproductive technologies. This comment seeks to build upon Purvis's own analysis to obviate her concern that abortion discourse promotes harmful stereotypes of men as disinterested fathers. To the contrary, for men — no less than for women — a desire to avoid or terminate pregnancy is fully consistent with loving and shared parenthood of existing or future children. The same individuals who choose to become parents at other times in their long reproductive lives will use contraception and have abortions. In fact, most women who have abortions already have children. Policies that empower men and women to avoid unintended pregnancy are the sensible, win-win, front-line approach to avoid disputes over abortion. © 2015 American Society of Law, Medicine & Ethics, Inc.
Tips and techniques for engaging and managing the reluctant, resistant or hostile young person.

PubMed

McCutcheon, Louise K; Chanen, Andrew M; Fraser, Richard J; Drew, Lorelle; Brewer, Warrick

2007-10-01

Creating a collaborative doctor-patient relationship is the bedrock upon which effective treatments are delivered. The interaction between normal developmental changes and psychopathology can present particular challenges to clinicians attempting to assess and treat young people. Assuming an attitude in which young people are seen to be doing their best, rather than being deliberately difficult or manipulative, can help clinicians avoid a controlling or punitive relationship and can facilitate collaborative problem solving. Stigma, denial and avoidance, ambivalence, hopelessness and coercion are potential threats to engagement and must be addressed specifically. Challenging patients, such as the reluctant, resistant, aggressive, self-harming or intoxicated patient require specific management strategies that can be learned.
Suicidal ideation versus suicidal obsession: a case report.

PubMed

Wetzler, Alzbeta Juven; Elias, Rachela; Fostick, Leah; Zohar, Joseph

2007-07-01

This case report illustrates the relationship between stress and obsessive-compulsive disorder (OCD) by describing an unusual case of OCD sequelae following a suicide attempt. The patient is a 29-year-old married woman who suffered a major depressive episode without OCD and tried to commit suicide by drinking household cleaner. Following the attempt, violent obsessive thoughts of harming herself and others emerged along with avoidance behavior. After exposure therapy, there was a decrease in her obsessive thoughts, less anxiety, and no avoidance behavior. This report highlights not only the existence of "posttraumatic obsession" but also the importance of accurate interpretation of suicidal preoccupation, leading to the diagnosis of OCD rather then suicidal ideation secondary to depression.
Behavioural genetics: why eugenic selection is preferable to enhancement.

PubMed

Savulescu, Julian; Hemsley, Melanie; Newson, Ainsley; Foddy, Bennett

2006-01-01

Criminal behaviour is but one behavioural tendency for which a genetic influence has been suggested. Whilst this research certainly raises difficult ethical questions and is subject to scientific criticism, one recent research project suggests that for some families, criminal tendency might be predicted by genetics. In this paper, supposing this research is valid, we consider whether intervening in the criminal tendency of future children is ethically justifiable. We argue that, if avoidance of harm is a paramount consideration, such an intervention is acceptable when genetic selection is employed instead of genetic enhancement. Moreover, other moral problems in avoiding having children with a tendency to criminal behaviour, such as the prospect of social discrimination, can also be overcome.
Islamic views on artificial nutrition and hydration in terminally ill patients.

PubMed

Alsolamy, Sami

2014-02-01

Withholding and withdrawing artificial nutrition and hydration from terminally ill patients poses many ethical challenges. The literature provides little information about the Islamic beliefs, attitudes, and laws related to these challenges. Artificial nutrition and hydration may be futile and reduce quality of life. They can also harm the terminally ill patient because of complications such as aspiration pneumonia, dyspnea, nausea, diarrhea, and hypervolemia. From the perspective of Islam, rules governing the care of terminally ill patients are derived from the principle that injury and harm should be prevented or avoided. The hastening of death by the withdrawal of food and drink is forbidden, but Islamic law permits the withdrawal of futile, death-delaying treatment, including life support. Nutritional support is considered basic care and not medical treatment, and there is an obligation to provide nutrition and hydration for the dying person unless it shortens life, causes more harm than benefit, or is contrary to an advance directive that is consistent with Islamic law. The decision about withholding or withdrawing artificial nutrition and hydration from the terminally ill Muslim patient is made with informed consent, considering the clinical context of minimizing harm to the patient, with input from the patient, family members, health care providers, and religious scholars. © 2012 John Wiley & Sons Ltd.
Radial extracorporeal shock wave treatment harms developing chicken embryos

PubMed Central

Kiessling, Maren C.; Milz, Stefan; Frank, Hans-Georg; Korbel, Rüdiger; Schmitz, Christoph

2015-01-01

Radial extracorporeal shock wave treatment (rESWT) has became one of the best investigated treatment modalities for cellulite, including the abdomen as a treatment site. Notably, pregnancy is considered a contraindication for rESWT, and concerns have been raised about possible harm to the embryo when a woman treated with rESWT for cellulite is not aware of her pregnancy. Here we tested the hypothesis that rESWT may cause serious physical harm to embryos. To this end, chicken embryos were exposed in ovo to various doses of radial shock waves on either day 3 or day 4 of development, resembling the developmental stage of four- to six-week-old human embryos. We found a dose-dependent increase in the number of embryos that died after radial shock wave exposure on either day 3 or day 4 of development. Among the embryos that survived the shock wave exposure a few showed severe congenital defects such as missing eyes. Evidently, our data cannot directly be used to draw conclusions about potential harm to the embryo of a pregnant woman treated for cellulite with rESWT. However, to avoid any risks we strongly recommend applying radial shock waves in the treatment of cellulite only if a pregnancy is ruled out. PMID:25655309
Injection Drug Users' Perceived Barriers to Using Self-Initiated Harm Reduction Strategies.

PubMed

Bonar, Erin E; Rosenberg, Harold

2014-08-01

Increasing the frequency with which injecting drug users (IDUs) engage in self-initiated harm reduction strategies could improve their health, but few investigations have examined IDUs' perceived barriers to engaging in these behaviors. We interviewed 90 IDUs recruited from needle exchanges to assess: a) perceived obstacles to their use of two specific harm reduction strategies (i.e., test shots and pre-injection skin cleaning) designed to reduce two unhealthy outcomes (i.e., overdose and bacterial infections, respectively) and b) their use of other risk-reduction practices. The most frequently cited barrier for both test shots and skin cleaning was being in a rush to inject one's drugs. Other, less commonly cited barriers were strategy-specific (e.g., buying drugs from a known dealer as a reason not to do a test shot; not having access to cleaning supplies as a reason not to clean skin). Regarding other risk reduction practices, participants' most frequently reported using new or clean injecting supplies and avoiding sharing needles and injecting supplies. Some, but not all, of the barriers generated by participants in our study were similar to those frequently reported in other investigations, perhaps due to differences in the type of sample recruited or in the harm reduction behaviors investigated.
Injection Drug Users’ Perceived Barriers to Using Self-Initiated Harm Reduction Strategies

PubMed Central

Rosenberg, Harold

2014-01-01

Introduction and Aims Increasing the frequency with which injecting drug users (IDUs) engage in self-initiated harm reduction strategies could improve their health, but few investigations have examined IDUs’ perceived barriers to engaging in these behaviors. Method We interviewed 90 IDUs recruited from needle exchanges to assess: a) perceived obstacles to their use of two specific harm reduction strategies (i.e., test shots and pre-injection skin cleaning) designed to reduce two unhealthy outcomes (i.e., overdose and bacterial infections, respectively) and b) their use of other risk-reduction practices. Results The most frequently cited barrier for both test shots and skin cleaning was being in a rush to inject one’s drugs. Other, less commonly cited barriers were strategy-specific (e.g., buying drugs from a known dealer as a reason not to do a test shot; not having access to cleaning supplies as a reason not to clean skin). Regarding other risk reduction practices, participants’ most frequently reported using new or clean injecting supplies and avoiding sharing needles and injecting supplies. Discussion and Conclusions Some, but not all, of the barriers generated by participants in our study were similar to those frequently reported in other investigations, perhaps due to differences in the type of sample recruited or in the harm reduction behaviors investigated. PMID:25419201
Negative and positive externalities in intergroup conflict: exposure to the opportunity to help the outgroup reduces the inclination to harm it.

PubMed

Weisel, Ori

2015-01-01

Outgroup hate, in the context of intergroup conflict, can be expressed by harming the outgroup, but also by denying it help. Previous work established that this distinction-whether the externality on the outgroup is negative or positive-has an important effect on the likelihood of outgroup hate emerging as a motivation for individual participation in intergroup conflict. The current work uses a within-subject design to examine the behavior of the same individuals in intergroup conflict with negative and positive externalities on the outgroup. Each participant made two choices, one for each type of externality, and the order was counter balanced. The main results are that (1) behavior is fairly consistent across negative and positive externalities, i.e., the tendency to display outgroup hate by harming the outgroup is correlated with the tendency to display outgroup hate by avoiding to help the outgroup; (2) People are reluctant to harm the outgroup after being exposed to the opportunity to help it; (3) Groupness-the degree to which people care about their group and its well-being-is related to outgroup hate only when participants encounter the opportunity to harm the outgroup first (before they encounter the opportunity to help it). In this setting the relationship between groupness and outgroup hate spilled over to the subsequent interaction, where it was possible to help the outgroup. When the opportunity to help the outgroup was encountered first, groupness was not related to outgroup hate.
Negative and positive externalities in intergroup conflict: exposure to the opportunity to help the outgroup reduces the inclination to harm it

PubMed Central

Weisel, Ori

2015-01-01

Outgroup hate, in the context of intergroup conflict, can be expressed by harming the outgroup, but also by denying it help. Previous work established that this distinction—whether the externality on the outgroup is negative or positive—has an important effect on the likelihood of outgroup hate emerging as a motivation for individual participation in intergroup conflict. The current work uses a within-subject design to examine the behavior of the same individuals in intergroup conflict with negative and positive externalities on the outgroup. Each participant made two choices, one for each type of externality, and the order was counter balanced. The main results are that (1) behavior is fairly consistent across negative and positive externalities, i.e., the tendency to display outgroup hate by harming the outgroup is correlated with the tendency to display outgroup hate by avoiding to help the outgroup; (2) People are reluctant to harm the outgroup after being exposed to the opportunity to help it; (3) Groupness—the degree to which people care about their group and its well-being—is related to outgroup hate only when participants encounter the opportunity to harm the outgroup first (before they encounter the opportunity to help it). In this setting the relationship between groupness and outgroup hate spilled over to the subsequent interaction, where it was possible to help the outgroup. When the opportunity to help the outgroup was encountered first, groupness was not related to outgroup hate. PMID:26582994
Perceived harmfulness predicts nonmedical use of prescription drugs among college students: Interactions with sensation-seeking

PubMed Central

Arria, Amelia M.; Caldeira, Kimberly M.; Vincent, Kathryn B.; O'Grady, Kevin E.; Wish, Eric D.

2008-01-01

This study describes the level of perceived harmfulness of nonmedical prescription stimulant and analgesic use in a sample of college students, and examines the prospective relationship between perceived harmfulness and subsequent nonmedical use. In addition, we explore whether the association between perceived harmfulness and nonmedical use varies by level of sensation-seeking. Personal interviews, including questions on sensation-seeking and drug use, were conducted with 1,253 first-year college students. Participants were then followed-up twice at six-month intervals. Perceived harmfulness of nonmedical use of prescription drugs was assessed at six months via a web-based survey. At the 12-month follow-up interview, drug use was again assessed. Students who never had the opportunity to use prescription drugs nonmedically were excluded from all analyses. Results revealed that one in four students perceived a great risk of harm from occasional nonmedical use of prescription stimulants (25.2%) and analgesics (27.8%). As expected, low perceived harmfulness and high sensation-seeking were independently associated with increased risk of nonmedical use, holding constant demographic characteristics. The protective effect of high perceived harmfulness could be seen at all levels of sensation-seeking with one important exception: among high sensation-seekers, perceived harmfulness was not related to nonmedical use of prescription analgesics. Perceived harmfulness appears to distinguish nonmedical users from non-users, given the opportunity to use. Increasing perceived harmfulness may be a viable prevention strategy for most students, but alternative approaches might need to be developed that are tailored to high sensation-seekers. PMID:18633709

Definition and outcome of a curriculum to prevent disordered eating and body-shaping drug use.

PubMed

Elliot, Diane L; Moe, Esther L; Goldberg, Linn; DeFrancesco, Carol A; Durham, Melissa B; Hix-Small, Hollie

2006-02-01

Almost one half of male and female students participate in high school-sponsored athletics, and high school also is a time when classroom health promotion curricula are less effective. The Athletes Training and Learning to Avoid Steroids is a sport team-centered drug-use prevention program for male high school athletes, which has been shown to reduce alcohol and illicit drug use. Just as anabolic steroid use is associated with male athletes, female sport participants may be at a greater risk for disordered eating and body-shaping drug use. Extending sport team-centered programs to young women athletes required defining and ranking factors related to developing those harmful behaviors. Survey results from a cross-sectional cohort of female middle and high school student athletes were used to identify and prioritize potential curriculum components, including mood and self-esteem, norms of behavior, perceptions of healthy body weight, effects of media depictions of women, and societal pressures to be thin. The derived sport team-centered program was prospectively assessed among a second group of female student athletes from 18 high schools, randomized to receive the intervention or the usual care control condition. The Athletes Targeting Healthy Exercise and Nutrition Alternatives (ATHENA) intervention is a scripted, coach-facilitated, peer-led 8-session program, which was incorporated into a team's usual training activities. The ATHENA program significantly altered the targeted risk factors and reduced ongoing and new use of diet pills and body-shaping substances (amphetamines, anabolic steroids, and sport supplements). These findings illustrate the utility of a structured process to define curriculum content, and the program's positive results also confirm the sport team's potential as a vehicle to effectively deter health-harming behaviors.
[An investigation on self-harm episodes and their relationship with suicidal psychology and behaviors in 2713 college students].

PubMed

Su, Pu-Yu; Hao, Jia-Hu; Huang, Zhao-Hui; Tao, Fang-Biao

2010-11-01

To investigate the episodes and influencing factors on self-harm and to explore the relationship between self-harm episodes and suicidal psychology and behaviors in college students. Four universities were selected using cluster sampling method in Anqing city and Chaohu city. Totally, 2713 college students completed this survey. Data were analyzed by Pearson Chi-square and logistic regression. In the last six months, rates of highly lethal self-harm, less lethal self-harm with visible tissue damage, self-injury without visible tissue damage, self-harmful behaviors with latency damage, other self-harmful behaviors with menticide were 1.9%, 5.5%, 15.3%, 21.2% and 17.0% respectively. The total rate of self-harm was 31.3%. 73.1% of the students with self harmful experiences had the above mentioned behaviors more than 3 times in the last six months. The top 3 reasons for taking self-harm actions were: having learning problems (43.1%), failed love affairs (25.0%) and having conflicts with others (23.9%). There were different influencing factors among different kinds of self-harm episodes. Depression was the risk factor of self-harm. The higher score of having high self-esteem was the protective factor of all kinds of self-harm actions except highly lethal ones. Higher score of difficulties in identifying feelings was one of the risk factors. The rates of suicidal psychology and behaviors in students with self-harm were significantly higher than those in students without those behaviors. Result from linear χ(2) test indicated that the graveness of tissue damage of self-harm was higher along with the rates of suicidal psychology and behaviors (P < 0.01). Among 2713 college students, about 1/3 adolescents having experienced self-harm in the last 6 months, many with repeated ones. Depression and difficulties in identifying feelings were the two risk factors while self-esteem was the protective factor related to most of the self-harm cases.
Maternal drug use: evaluation of risks to breast-fed infants.

PubMed

Kirksey, A; Groziak, S M

1984-01-01

This paper, based on a review of the literature, evaluates the risks to infants of maternal drug use during lactation. The potential harm of a particular drug to the breastfed infant is related both to the complex mechanism of milk synthesis and secretion and the mode of passage of the drug from plasma into milk. The 1st part of the paper discusses mammary cell and milk synthesis, milk secretion and composition, the mode of passage of drugs into milk, and factors influencing drug concentrations in milk. Drug concentrations in milk are dependent on 6 major factors: drug dosage, proportion bound in plasma, molecular weight, lipid solubility, degree of ionization, and pH difference between plasma and milk. Drugs that are weak acids are ionized to a greater extent and are more protein-bound than weak alkaline drugs. The 2nd part of the paper evaluates the risks to breastfed infants of selected pharmacons. Some categories of drugs that contain pharmacons that should be limited or avoided by nursing mothers are alkylating agents, analgesics and anti-inflammatory agents, anticoagulants, anticonvulsants, anti-infective agents, central nervous system stimulants, hormones, laxatives, minerals, provitamins, psychotherapeutic agents, thyroid affecting agents, and vitamins. The following precautions are suggested to minimize the risks of potentially harmful pharmacons: 1) all unnecessary medications should be avoided by nrusing mothers; 2) if medication is necessary during lactation, drug dosage should be controlled and the infant should be monitored for adverse symptoms; 3) drugs should be administered shortly after breastfeeding and the interval prolonged before the next feeding; and 4) if the infant must be fed soon after a potentially harmful drug has been taken by the mother, bottle feeding is recommended.
Self-harm.

PubMed

Skegg, Keren

The term self-harm is commonly used to describe a wide range of behaviours and intentions including attempted hanging, impulsive self-poisoning, and superficial cutting in response to intolerable tension. As with suicide, rates of self-harm vary greatly between countries. 5-9% of adolescents in western countries report having self-harmed within the previous year. Risk factors include socioeconomic disadvantage, and psychiatric illness--particularly depression, substance abuse, and anxiety disorders. Cultural aspects of some societies may protect against suicide and self-harm and explain some of the international variation in rates of these events. Risk of repetition of self-harm and of later suicide is high. More than 5% of people who have been seen at a hospital after self-harm will have committed suicide within 9 years. Assessment after self-harm includes careful consideration of the patient's intent and beliefs about the lethality of the method used. Strong suicidal intent, high lethality, precautions against being discovered, and psychiatric illness are indicators of high suicide risk. Management after self-harm includes forming a trusting relationship with the patient, jointly identifying problems, ensuring support is available in a crisis, and treating psychiatric illness vigorously. Family and friends may also provide support. Large-scale studies of treatments for specific subgroups of people who self-harm might help to identify more effective treatments than are currently available. Although risk factors for self-harm are well established, aspects that protect people from engaging in self-harm need to be further explored.
High-Volume Repeaters of Self-Harm.

PubMed

Ness, Jennifer; Hawton, Keith; Bergen, Helen; Waters, Keith; Kapur, Navneet; Cooper, Jayne; Steeg, Sarah; Clarke, Martin

2016-11-01

Repetition of self-harm is common and is strongly associated with suicide. Despite this, there is limited research on high-volume repetition. To investigate individuals with high-volume repeat self-harm attendances to the emergency department (ED), including their patterns of attendance and mortality. Data from the Multicentre Study of Self-Harm in England were used. High-volume repetition was defined as ⩾15 attendances within 4 years. An attendance timeline was constructed for each high-volume repeater (HVR) and the different patterns of attendance were explored using an executive sorting task and hierarchical cluster analysis. A small proportion of self-harm patients are HVRs (0.6%) but they account for a large percentage of self-harm attendances (10%). In this study, the new methodological approach resulted in three types of attendance patterns. All of the HVRs had clusters of attendance and a greater proportion died from external causes compared with non-HVRs. The approach used in this study offers a new method for investigating this problem that could have both clinical and research benefits. The need for early intervention is highlighted by the large number of self-harm episodes per patient, the clustered nature of attendances, and the higher prevalence of death from external causes.
Avoiding the unintended consequences of growth in medical care: how might more be worse?

PubMed

Fisher, E S; Welch, H G

1999-02-03

The United States has experienced dramatic growth in both the technical capabilities and share of resources devoted to medical care. While the benefits of more medical care are widely recognized, the possibility that harm may result from growth has received little attention. Because harm from more medical care is unexpected, findings of harm are discounted or ignored. We suggest that such findings may indicate a more general problem and deserve serious consideration. First, we delineate 2 levels of decision making where more medical care may be introduced: (1) decisions about whether or not to use a discrete diagnostic or therapeutic intervention and (2) decisions about whether to add system capacity, eg, the decision to purchase another scanner or employ another physician. Second, we explore how more medical care at either level may lead to harm. More diagnosis creates the potential for labeling and detection of pseudodisease--disease that would never become apparent to patients during their lifetime without testing. More treatment may lead to tampering, interventions to correct random rather than systematic variation, and lower treatment thresholds, where the risks outweigh the potential benefits. Because there are more diagnoses to treat and more treatments to provide, physicians may be more likely to make mistakes and to be distracted from the issues of greatest concern to their patients. Finally, we turn to the fundamental challenge--reducing the risk of harm from more medical care. We identify 4 ways in which inadequate information and improper reasoning may allow harmful practices to be adopted-a constrained model of disease, excessive extrapolation, a missing level of analysis, and the assumption that more is better.
In situ dc oxygen‐discharge cleaning system for optical elements

DOE Office of Scientific and Technical Information (OSTI.GOV)

Koide, Tsuneharu; Shidara, Tetsuo; Tanaka, Kenichiro

1989-07-15

In situ dc oxygen‐discharge cleaning arrangements have been developed at the Photon Factory for the removal of carbon contamination from optical surfaces. A high cleaning rate could be achieved by producing an oxygen plasma close to the optical elements with special care taken to avoid any harmful effects from the discharge; contaminant carbon was completely removed within a few hours, at most. This short exposure time and the use of dry oxygen gas resulted in a restoration of the original ultrahigh vacuum without a bakeout. Results with a Seya‐Namioka beamline for gas‐phase experiments showed a flux enhancement amounting to amore » factor of 50, and results with a grasshopper beamline showed a nearly complete recovery of the light intensity, even at the carbon K edge.« less
Vaginismus: heightened harm avoidance and pain catastrophizing cognitions.

PubMed

Borg, Charmaine; Peters, Madelon L; Schultz, Willibrord Weijmar; de Jong, Peter J

2012-02-01

Catastrophic appraisal of experienced pain may promote hypervigilance and intense pain, while the personality trait of harm avoidance (HA) might prevent the occurrence of correcting such experiences. Women inflicted with vaginismus may enter a self-perpetuating downward spiral of increasing avoidance of (anticipated) pain. In vaginismus the anticipation of pain may give rise to catastrophic pain ideation. This may establish hypervigilance toward painful sexual stimuli, which consequently results in negative appraisal of sexual cues. This process could impair genital and sexual responding, intensify pain and trigger avoidance, which in turn may contribute to the onset and persistence of symptoms in vaginismus and to certain extent also in dyspareunia. To investigate whether women suffering from vaginismus are characterized by heightened levels of habitual pain catastrophic cognitions, together with higher levels of HA. This study consisted of three groups: a lifelong vaginismus group (N = 35, mean age = 28.4; standard deviation [SD] = 5.8), a dyspareunia group (N = 33, mean age = 26.7; SD = 6.8), and women without sexual complaints (N = 54, mean age = 26.5; SD = 6.7). HA scale of Cloninger's tridimensional personality questionnaire, and the pain catastrophizing scale. Specifically women inflicted with vaginismus showed significantly heightened levels of catastrophic pain cognitions compared with the other two groups, as well as significant enhanced HA vs. the control group, and a trend vs. the dyspareunia group. Both traits were shown to have cumulative predictive validity for the presence of vaginismus. This study focused on the personality traits of catastrophizing pain cognitions and HA in women with lifelong vaginismus. Our findings showed that indeed, women suffering from vaginismus are characterized by trait of HA interwoven with habitual pain catastrophizing cognitions. This study could help in the refinement of the current conceptualization and might shed light on the already available treatment options for women with vaginismus. © 2011 International Society for Sexual Medicine.
Should we really avoid giving oxygen to mothers with concerning fetal heart rate patterns?

PubMed

Garite, Thomas J; Nageotte, Michael P; Parer, Julian T

2015-04-01

We challenge a provocative article entitled "Oxygen for intrauterine resuscitation: of unproved benefit and potentially harmful" by Hamel et al in the August issue of the Journal. The authors contend there is no good evidence that oxygen administration to the mother of a fetus with a concerning fetal heart rate pattern prevents acidosis and that in theory such oxygen administration may actually or potentially do harm to the fetus. It is clear that oxygen is administered quite often to women in labor, especially to those with category II fetal heart rate patterns and, because more than 80% of women in labor have these patterns and the majority of these patterns are unlikely to be associated with significant fetal hypoxia, that such oxygen administration is greatly overused. We describe in this article evidence that oxygen given to the mother actually does improve fetal oxygenation, especially in hypoxemic fetuses, and make arguments that there really is no substantial evidence that, except in theory, maternal oxygen administration causes any harm to the fetus. Copyright © 2015 Elsevier Inc. All rights reserved.
The Role of Employee Whistleblowing and Raising Concerns in an Organizational Learning Culture - Elusive and Laudable?: Comment on "Cultures of Silence and Cultures of Voice: The Role of Whistleblowing in Healthcare Organisations".

PubMed

Jones, Aled

2015-10-05

It is inevitable that healthcare workers throughout their careers will witness actual or potential threats to patient safety in the course of their work. Some of these threats will result in serious harm occurring to others, whilst at other times such threats will result in minimal harm, or a 'near miss' where harm is avoided at the last minute. Despite organizations encouraging employees to 'speak up' about such threats, healthcare systems globally struggle to engage their staff to do so. Even when staff do raise concerns they are often ignored by those with a responsibility to listen and act. Learning how to create the conditions where employees continuously raise and respond to concerns is essential in creating a continuous and responsive learning culture that cherishes keeping patients and employees safe. Workplace culture is a real barrier to the creation of such a learning system but examples in healthcare exist from which we can learn. © 2016 by Kerman University of Medical Sciences.
The health fraud battle. Education is the best defense.

PubMed

Johnson, G C; Gottesman, R A

1989-06-01

Despite the regulatory and educational efforts of the Food and Drug Administration and other agencies and organizations, large numbers of American consumers continue to be fooled by unsubstantiated "miracle cure" claims made by manufacturers of fraudulent medical products. Physicians who are familiar with the language of health fraud advertising and product labels may be able to help patients avoid unnecessary expense, false hope, and physical and emotional harm.
Shrink-Fit Solderable Inserts Seal Hermetically

NASA Technical Reports Server (NTRS)

Croucher, William C.

1992-01-01

Shrink-fit stainless-steel insert in aluminum equipment housing allows electrical connectors to be replaced by soldering, without degrading hermeticity of housing or connector. Welding could destroy electrostatic-sensitive components and harm housing and internal cables. Steel insert avoids problems because connector soldered directly to it rather than welded to housing. Seals between flange and housing, and between connector and flange resistant to leaks, even after mechanical overloading and thermal shocking.
Simulation as an ethical imperative and epistemic responsibility for the implementation of medical guidelines in health care.

PubMed

Garbayo, Luciana; Stahl, James

2017-03-01

Guidelines orient best practices in medicine, yet, in health care, many real world constraints limit their optimal realization. Since guideline implementation problems are not systematically anticipated, they will be discovered only post facto, in a learning curve period, while the already implemented guideline is tweaked, debugged and adapted. This learning process comes with costs to human health and quality of life. Despite such predictable hazard, the study and modeling of medical guideline implementation is still seldom pursued. In this article we argue that to systematically identify, predict and prevent medical guideline implementation errors is both an epistemic responsibility and an ethical imperative in health care, in order to properly provide beneficence, minimize or avoid harm, show respect for persons, and administer justice. Furthermore, we suggest that implementation knowledge is best achieved technically by providing simulation modeling studies to anticipate the realization of medical guidelines, in multiple contexts, with system and scenario analysis, in its alignment with the emerging field of implementation science and in recognition of learning health systems. It follows from both claims that it is an ethical imperative and an epistemic responsibility to simulate medical guidelines in context to minimize (avoidable) harm in health care, before guideline implementation.
Do spirituality and religiousness differ with regard to personality and recovery from depression? A follow-up study.

PubMed

Mihaljevic, Sanea; Aukst-Margetic, Branka; Karnicnik, Snjezana; Vuksan-Cusa, Bjanka; Milosevic, Milan

2016-10-01

The studies show that both spirituality and religiousness are protective for mental health. Personality is related with course and outcome of depression, as well as spirituality and religiousness, and their relations toward to recovery from depression are underresearched. This study followed influence of spirituality and religiousness on course and outcome of depression in patients with depressive episode, controlled for personality dimensions. The patients were assessed with self-report measures of depression (Beck Depression Inventory), spirituality (WHO-Quality of Life-Spiritual, Religious, Personal Beliefs), religiousness (Duke University Religion Index) and personality (Temperament and Character Inventory). Ninety nine patients finished a year long follow up. Higher spirituality influenced recovery of depression in patients with depressive episode, but religiousness did not show to be significant predictor of recovery for depression. Dimension harm avoidance was significant predictor of improvement of depression in all points of measurement. Some limitations of this research are small sample size, usage of the self-report measures of depression in follow-up period, and the predominantly Catholic affiliation of the participants that can impact the generalizability of our data to other denominations. Spirituality and dimension harm avoidance are significant predictors of recovery from depression during a year long follow up. Copyright © 2016 Elsevier Inc. All rights reserved.
Multiple resistance to carcinogens and xenobiotics: P-glycoproteins as universal detoxifiers.

PubMed

Efferth, Thomas; Volm, Manfred

2017-07-01

The detoxification of toxic substances is of general relevance in all biological systems. The plethora of exogenous xenobiotic compounds and endogenous toxic metabolic products explains the evolutionary pressure of all organisms to develop molecular mechanisms to detoxify and excrete harmful substances from the body. P-glycoprotein and other members of the ATP-binding cassette (ABC) transporter family extrude innumerous chemical compounds out of cells. Their specific expression in diverse biological contexts cause different phenotypes: (1) multidrug resistance (MDR) and thus failure of cancer chemotherapy, (2) avoidance of accumulation of carcinogens and prevention of carcinogenesis in healthy tissues, (3) absorption, distribution, metabolization and excretion (ADME) of pharmacological drugs in human patients, (4) protection from environmental toxins in aquatic organisms (multi-xenobiotic resistance, MXR). Hence ABC-transporters may have opposing effects for organismic health reaching from harmful in MDR of tumors to beneficial for maintenance of health in MXR. While their inhibition by specific inhibitors may improve treatment success in oncology and avoid carcinogenesis, blocking of ABC-transporter-driven efflux by environmental pollutants leads to ecotoxicological consequences in marine biotopes. Poisoned seafood may enter the food-chain and cause intoxications in human beings. As exemplified with ABC-transporters, joining forces in interdisciplinary research may, therefore, be a wise strategy to fight problems in human medicine and environmental sciences.
Increasing rates of self-harm among children, adolescents and young adults: a 10-year national registry study 2007-2016.

PubMed

Griffin, Eve; McMahon, Elaine; McNicholas, Fiona; Corcoran, Paul; Perry, Ivan J; Arensman, Ella

2018-05-02

Rates of hospital-treated self-harm are highest among young people. The current study examined trends in rates of self-harm among young people in Ireland over a 10-year period, as well as trends in self-harm methods. Data from the National Self-Harm Registry Ireland on presentations to hospital emergency departments (EDs) following self-harm by those aged 10-24 years during the period 2007-2016 were included. We calculated annual self-harm rates per 100,000 by age, gender and method of self-harm. Poisson regression models were used to examine trends in rates of self-harm. The average person-based rate of self-harm among 10-24-year-olds was 318 per 100,000. Peak rates were observed among 15-19-year-old females (564 per 100,000) and 20-24-year-old males (448 per 100,000). Between 2007 and 2016, rates of self-harm increased by 22%, with increases most pronounced for females and those aged 10-14 years. There were marked increases in specific methods of self-harm, including those associated with high lethality. The findings indicate that the age of onset of self-harm is decreasing. Increasing rates of self-harm, along with increases in highly lethal methods, indicate that targeted interventions in key transition stages for young people are warranted.
The Importance of the Montreal Protocol in Protecting the Earth's Hydroclimate

NASA Astrophysics Data System (ADS)

Seager, R.; Wu, Y.; Polvani, L. M.

2012-12-01

The 1987 Montreal Protocol regulating emissions of ozone depleting chlorofluorocarbons (CFCs) was motivated primarily by the harm to human health and ecosystems arising from increased exposure to ultraviolet-B (UV-B) radiation associated with depletion from the ozone layer. It is now known that the Montreal Protocol has reduced global warming since CFCs are greenhouse gases (GHGs). In this paper we show that the Montreal Protocol also significantly protects the Earth's hydroclimate, even though this was also not a motivating factor in the decision-making that led to the Protocol. General Circulation Model (GCM) results show that in the coming decade (2020-29), under the 'World Avoided' scenario of no regulations on CFC emissions, the subtropical dry zones would in general get drier, and the middle and high latitude regions wetter. This change is similar, in both pattern and magnitude, to that in the coming decade caused by projected increases in carbon dioxide concentrations. This implies that because of the Montreal Protocol, and the ozone depletion and global warming associated with CFCs thus avoided, the hydrological cycle changes in the coming decade will be significantly less than what they otherwise would have been.
[Impact of eating psychopathology, obsessive-compulsion and depression on self-harm behavior in patients with eating disorders].

PubMed

Kong, Seong Sook

2009-08-01

The purpose of the study was to investigate psychological factors such as eating psychopathology, depression, and obsessive-compulsion that might influence self-harm behavior in patients with eating disorders. Patients with eating disorders (n=135) who visited "M" clinic for eating disorders participated in the study. Data were collected from March to August 2007 using the Eating Disorder Inventory-2, Beck Depression Inventory, Maudsley Obsessional-Compulsive Inventory, and Self-Harm Inventory (SHI). The participants scored high on self-harm as well as on depression and obsessive-compulsion. On the SHI, a high frequency of self harm behavior such as 'torturing self with self-defeating thoughts', 'abused alcohol', 'hit self', and 'suicide attempt' were found for the participants. There were significant correlations between most eating psychopathology variables, depression, obsessive-compulsion, and self-harm behavior. 'Interoceptive awareness' (eating psychopathology), depression, and 'checking' (obsessive-compulsion) were significant predictors of self-harm behavior. Future interventions for patients with eating disorders should focus on assessing the possibility of self-harm and suicidal attempts, especially in those patients with high levels of eating psychopathology, depression, or obsessive-compulsion. Early intervention for depression and obsessive-compulsion could contribute to preventing self-harm and suicide in patients with eating disorders.
Investigating the role of executive attentional control to self-harm in a non-clinical cohort with borderline personality features

PubMed Central

Drabble, Jennifer; Bowles, David P.; Barker, Lynne Ann

2014-01-01

Self-injurious behavior (or self-harm) is a frequently reported maladaptive behavior in the general population and a key feature of borderline personality disorder (BPD). Poor affect regulation is strongly linked to a propensity to self-harm, is a core component of BPD, and is linked with reduced attentional control abilities. The idea that attentional control difficulties may provide a link between BPD, negative affect and self-harm has yet to be established, however. The present study explored the putative relationship between levels of BPD features, three aspects of attentional/executive control, affect, and self-harm history in a sample of 340 non-clinical participants recruited online from self-harm forums and social networking sites. Analyses showed that self-reported levels of BPD features and attentional focusing predicted self-harm incidence, and high attentional focusing increased the likelihood of a prior self-harm history in those with high BPD features. Ability to shift attention was associated with a reduced likelihood of self-harm, suggesting that good attentional switching ability may provide a protective buffer against self-harm behavior for some individuals. These attentional control differences mediated the association between negative affect and self-harm, but the relationship between BPD and self-harm appears independent. PMID:25191235
Invasive Fungal Infections Acquired from Contaminated Food or Nutritional Supplements: A Review of the Literature.

PubMed

Benedict, Kaitlin; Chiller, Tom M; Mody, Rajal K

2016-07-01

Fungi are an integral part of the natural environment and, therefore, play many roles in relation to food: some fungi are used in food production, some are food sources themselves, and some are agents of food spoilage. Some fungi that contaminate food can also be harmful to human health. The harmful but noninfectious health consequences of mycotoxins have been well-characterized, but the extent to which fungi in food pose a risk for invasive infections is unknown. We conducted a literature review to identify cases of invasive fungal infections (IFIs) believed to have resulted from ingestion or inhalation of food, beverages, or dietary supplements (excluding Saccharomyces infections). We identified 11 publications describing cases or small outbreaks of IFIs related to foods or beverages and three describing IFIs related to dietary supplements. These food-associated IFIs were predominantly mold infections, and the few yeast infections were associated with dairy products. Suspected foodborne IFIs appear to be rare, but are increasingly described in the electronically searchable literature. They are associated with a variety of foods, are due to a variety of fungal pathogens, and primarily occur in persons with immunosuppressive conditions or other predisposing factors. Various guidelines for high-risk patients recommend avoidance of certain food products that may contain high levels of fungi, but further work is needed to evaluate the effectiveness of these restrictive diets in preventing fungal infections. The relationships between food spoilage, food insecurity, and IFI risk are another area that may warrant further exploration.

Significance of Intratracheal Instillation Tests for the Screening of Pulmonary Toxicity of Nanomaterials.

PubMed

Morimoto, Yasuo; Izumi, Hiroto; Yoshiura, Yukiko; Fujisawa, Yuri; Fujita, Katsuhide

Inhalation tests are the gold standard test for the estimation of the pulmonary toxicity of respirable materials. Intratracheal instillation tests have been used widely, but they yield limited evidence of the harmful effects of respirable materials. We reviewed the effectiveness of intratracheal instillation tests for estimating the hazards of nanomaterials, mainly using research papers featuring intratracheal instillation and inhalation tests centered on a Japanese national project. Compared to inhalation tests, intratracheal instillation tests induced more acute inflammatory responses in the animal lung due to a bolus effect regardless of the toxicity of the nanomaterials. However, nanomaterials with high toxicity induced persistent inflammation in the chronic phase, and nanomaterials with low toxicity induced only transient inflammation. Therefore, in order to estimate the harmful effects of a nanomaterial, an observation period of 3 months or 6 months following intratracheal instillation is necessary. Among the endpoints of pulmonary toxicity, cell count and percentage of neutrophil, chemokines for neutrophils and macrophages, and oxidative stress markers are considered most important. These markers show persistent and transient responses in the lung from nanomaterials with high and low toxicity, respectively. If the evaluation of the pulmonary toxicity of nanomaterials is performed in not only the acute but also the chronic phase in order to avoid the bolus effect of intratracheal instillation and inflammatory-related factors that are used as endpoints of pulmonary toxicity, we speculate that intratracheal instillation tests can be useful for screening for the identification of the hazard of nanomaterials through pulmonary inflammation.
Economic and health risk trade-offs of swim closures at a Lake Michigan beach

USGS Publications Warehouse

Rabinovici, Sharyl M.; Bernknopf, Richard L.; Wein, Anne M.; Coursey, Don L.; Whitman, Richard L.

2004-01-01

This paper presents a framework for analyzing the economic, health, and recreation implications of swim closures related to high fecal indicator bacteria (FIB) levels. The framework utilizes benefit transfer policy analysis to provide a practical procedure for estimating the effectiveness of recreational water quality policies. Evaluation criteria include the rates of intended and unintended management outcomes, whether the chosen protocols generate closures with positive net economic benefits to swimmers, and the number of predicted illnesses the policy is able to prevent. We demonstrate the framework through a case study of a Lake Michigan freshwater beach using existing water quality and visitor data from 1998 to 2001. We find that a typical closure causes a net economic loss among would-be swimmers totaling $1274-37 030/ day, depending on the value assumptions used. Unnecessary closures, caused by high indicator variability and a 24-h time delay between when samples are taken and the management decision can be made, occurred on 14 (12%) out of 118 monitored summer days. Days with high FIB levels when the swim area is open are also common but do relatively little economic harm in comparison. Also, even if the closure policy could be implemented daily and perfectly without error, only about 42% of predicted illnesses would be avoided. These conclusions were sensitive to the relative values and risk preferences that swimmers have for recreation access and avoiding health effects, suggesting a need for further study of the impacts of recreational water quality policies on individuals.
[Risk assessment for the development of occupational diseases among railroad workers].

PubMed

Kaptsov, V A; Pankova, V B; Stepanov, S A; Belikova, N A

1998-01-01

An attempt was made to asses the actual risk of occupational diseases among various railway specialists having harmful and adverse working conditions. The risk was found to be high, suggesting that there are harmful and extremely harmful working conditions and high undetection of patients with occupational diseases.
Self-Harm among Young People Detained in the Youth Justice System in Sri Lanka.

PubMed

Hettiarachchi, Lushan V; Kinner, Stuart A; Tibble, Holly; Borschmann, Rohan

2018-01-26

Self-harm is prevalent in incarcerated adults, yet comparatively few studies of self-harm in detained youth (and even fewer in low- and middle-income countries) have been published. We examined the prevalence and correlates of self-harm in a sample of 181 young people (mean age 15.0 years, SD = 2.3) detained in the youth justice system in Sri Lanka. Structured face-to-face questionnaires assessed demographic characteristics, family and social background, substance use, self-harm history (including frequency, method, and intention), bullying victimization, physical and sexual abuse (victimization and perpetration), and exposure to self-harm/suicide by others. Seventy-seven participants (43%) reported a lifetime history of self-harm, 19 of whom (25%) who reported doing so with suicidal intent. Fifty participants (65% of those with a history of self-harm) reported engaging in self-harm impulsively, with no prior planning. A history of self-harm was associated with being female, prior sexual abuse victimization, prior exposure to self-harm by friends, and a lifetime history of self-harm ideation. High rates of substance use, bullying victimization, parental incarceration, and exposure to suicide were reported across the sample. Young people detained in the youth justice system in Sri Lanka are a vulnerable group with high rates of self-harm, substance use, and psychosocial risk factors. Strategies for identifying and preventing self-harm, and targeted psychological interventions designed specifically to address impulsivity, may contribute to more positive outcomes in this marginalised population.
Self-Harm among Young People Detained in the Youth Justice System in Sri Lanka

PubMed Central

Hettiarachchi, Lushan V.; Kinner, Stuart A.; Tibble, Holly

2018-01-01

Self-harm is prevalent in incarcerated adults, yet comparatively few studies of self-harm in detained youth (and even fewer in low- and middle-income countries) have been published. We examined the prevalence and correlates of self-harm in a sample of 181 young people (mean age 15.0 years, SD = 2.3) detained in the youth justice system in Sri Lanka. Structured face-to-face questionnaires assessed demographic characteristics, family and social background, substance use, self-harm history (including frequency, method, and intention), bullying victimization, physical and sexual abuse (victimization and perpetration), and exposure to self-harm/suicide by others. Seventy-seven participants (43%) reported a lifetime history of self-harm, 19 of whom (25%) who reported doing so with suicidal intent. Fifty participants (65% of those with a history of self-harm) reported engaging in self-harm impulsively, with no prior planning. A history of self-harm was associated with being female, prior sexual abuse victimization, prior exposure to self-harm by friends, and a lifetime history of self-harm ideation. High rates of substance use, bullying victimization, parental incarceration, and exposure to suicide were reported across the sample. Young people detained in the youth justice system in Sri Lanka are a vulnerable group with high rates of self-harm, substance use, and psychosocial risk factors. Strategies for identifying and preventing self-harm, and targeted psychological interventions designed specifically to address impulsivity, may contribute to more positive outcomes in this marginalised population. PMID:29373512
Menopausal hormone therapy for primary prevention: why the USPSTF is wrong.

PubMed

Langer, R D; Simon, J A; Pines, A; Lobo, R A; Hodis, H N; Pickar, J H; Archer, D F; Sarrel, P M; Utian, W H

2017-10-01

The US Preventive Services Task Force (USPSTF) Draft Recommendation statement on Menopausal Hormone Therapy: Primary Prevention for Chronic Diseases, released in May 2017, perpetuates a major disconnect between the primary population affected, women within roughly 10 years of menopause, and the data cited. Furthermore, major elements of the evidence relied upon have been misinterpreted or misstated, particularly in regard to coronary heart disease and breast cancer, for which there is no statistically significant evidence of harm. As currently drafted, the recommendations reiterate the USPSTF statements of 2012, 2005 and 2002, and will perpetuate egregious harm to the public health. In an attempt to avoid that outcome and to facilitate a return to rational discourse regarding menopausal hormone therapy, an ad hoc group of experts in menopausal health submitted this comprehensive response to the USPSTF.
Feminist and community psychology ethics in research with homeless women.

PubMed

Paradis, E K

2000-12-01

This paper presents a feminist and community psychology analysis of ethical concerns that can arise throughout the process of doing research with women who are homeless. The unique contexts of the lives of women who are homeless demand that researchers redefine traditional ethical constructs such as consent, privacy, harm, and bias. Research that fails to do this may perpetuate the stereotyping, marginalization, stigmatization, and victimization homeless women face. Feminist and community research ethics must go beyond the avoidance of harm to an active investment in the well-being of marginalized individuals and communities. Using feminist and community psychology ethics, this paper addresses some common problems in research with women who are homeless, and argues for the transformation of research from a tool for the advancement of science into a strategy for the empowerment of homeless women and their communities.
Avoidance of unconventional oil wells and roads exacerbates habitat loss for grassland birds in the North American great plains

USGS Publications Warehouse

Thompson, Sarah J.; Johnson, Douglas H.; Nieumuth, Neal; Ribic, Christine

2015-01-01

Oil development in the Bakken shale region has increased rapidly as a result of new technologies and strong demand for fossil fuel. This region also supports a particularly high density and diversity of grassland bird species, which are declining across North America. We examined grassland bird response to unconventional oil extraction sites (i.e. developed with hydraulic fracturing and horizontal drilling techniques) and associated roads in North Dakota. Our goal was to quantify the amount of habitat that was indirectly degraded by oil development, as evidenced by patterns of avoidance by birds. Grassland birds avoided areas within 150 m of roads (95% CI: 87–214 m), 267 m of single-bore well pads (95% CI: 157–378 m), and 150 m of multi-bore well pads (95% CI: 67–233 m). Individual species demonstrated variable tolerance of well pads. Clay-colored sparrows (Spizella pallida) were tolerant of oil-related infrastructure, whereas Sprague's pipit (Anthus spragueii) avoided areas within 350 m (95% CI: 215–485 m) of single-bore well pads. Given these density patterns around oil wells, the potential footprint of any individual oil well, and oil development across the region, is greatly multiplied for sensitive species. Efforts to reduce new road construction, concentrate wells along developed corridors, combine numerous wells on multi-bore pads rather than build many single-bore wells, and to place well pads near existing roads will serve to minimize loss of suitable habitat for birds. Quantifying environmental degradation caused by oil development is a critical step in understanding how to better mitigate harm to wildlife populations.
Encouraging Maternal Sacrifice: How Regulations Governing the Consumption of Pharmaceuticals During Pregnancy Prioritize Fetal Safety over Maternal Health and Autonomy.

PubMed

Donley, Greer

Pregnant women are routinely faced with the stressful decision of whether to consume needed medications during their pregnancies. Because the risks associated with pharmaceutical drug consumption during pregnancy are largely unknown, pregnant women both inadvertently consume dangerous medications and avoid needed drugs. Both outcomes are harmful to pregnant women and their fetuses. This unparalleled lack of drug safety information is a result of ill-conceived, paternalistic regulations in two areas of the law: regulations governing ethical research in human subjects and regulations that dictate the required labels on drugs. The former categorizes pregnant women as "vulnerable" and thus precludes them from most medical research. The result is that ninety-one percent of drugs lack any reliable safety information for pregnant consumers. The latter currently requires all drug labels to encourage drug avoidance during pregnancy, despite ample evidence that avoiding needed medications can harm pregnant women. On June 30, 2015, new pregnancy labeling regulations took effect. Though these regulations make important improvements, they continue to treat pregnant women unlike any population, including other unique subpopulations, such as children. As a result, the new regulations do not fix the problem of over-warning pregnant women about the risks of drug consumption. This article questions the legitimacy of both regulations and suggests three reforms for how to improve access to vital safety information: (1) amend the regulations governing ethical research in human subjects to reclassify pregnant women as non-vulnerable adults; (2) create incentives to generate safety data in pregnant women by granting a period of market exclusivity for drug companies that invest in this research; and (3) make the FDA pregnancy labeling regulations consistent with the routine FDA practice of requiring the display of balanced, human data on risk.
Are there temperament differences between major depression and dysthymic disorder in adolescent clinical outpatients?

PubMed

Dinya, Elek; Csorba, Janos; Grósz, Zsofia

2012-05-01

The aim of the study was to explore possible differences in temperament and character dimensions between 2 monodiagnostic adolescent groups of depression, namely, one with a present episode of major depression and subjects with the other being their dysthymic peers. From a multisite Western Hungarian sample of consecutively referred 14- to 18-year-old new psychiatric adolescent outpatients, 2 groups were compared: group I, n = 56 (9 males, 47 females), with major depressive disorder (MDD) and group II, n = 27 (6 males, 21 females), with a diagnosis of dysthymic disorder (DD). All other comorbid diagnoses including bipolar and double depression (MDD + DD) cases were excluded. Present suicide events, if the attempter had an underlying diagnosis of depression, were not causes for exclusion. Assessment methods used were the adapted Hungarian versions of the Mini International Neuropsychiatric Interview and the Junior Temperament (Cloninger) Character Inventory. The only difference between the major depressive and dysthymic adolescents was harm avoidance, adolescents with major depression having a higher level practice of harm avoidance, whereas the temperament type of MDD vs DD seems to differ only in the aspect of avoiding painful stress. Expectations regarding a worse degree of self-directedness and lower levels of persistence and cooperativeness in the MDD sample were not proved. No essential temperament differences were found between the 2 adolescent depressive groups. Scarce differences between temperament qualities of MDD and DD may support Akiskal's continuum theory of depressive disorders. More research and the use of closer clinical personality typologies are warranted to explore possible personality trait differences (if they exist) between clinical diagnostic groups of adolescent patients. Copyright © 2012 Elsevier Inc. All rights reserved.
The importance of correct patient positioning in theatres and implications of mal-positioning.

PubMed

Adedeji, Rimi; Oragui, Emeka; Khan, Wasim; Maruthainar, Nimalan

2010-04-01

Patient positioning in theatre pertains to how a patient is transferred and positioned for a specific procedure. Patient safety is a central focus of care within the NHS and every healthcare practitioner must ensure that patients are protected from harm where possible. Mal-positioning of the patient has important implications in terms of associated problems of pressure sores, nerve compressions, deep vein thrombosis and compartment syndrome, and should be avoided.
Al Qaeda and U.S. Policy: Middle East and Africa

DTIC Science & Technology

2016-08-11

states that, “the tensions between AQ and ISIL escalated in a number of regions during 2015 and likely resulted in increased violence in several parts...the two groups clashed frequently, leading Zawahiri to issue appeals for unity and a halt to intra-jihadist violence . On February 3, 2014, Zawahiri...avoid targeting their enemies in public spaces such as mosques and markets , where an attack could harm other Muslims or noncombatants. In September
Integrated Performance Criteria for Housing and Building Hazard Mitigation.

DTIC Science & Technology

1984-07-01

PAGES . Washington, D.C. 20472 15 14. MONITORING AGENCY NAME A ADORESS(If dil fnt from Controlling Ofice) IS. SECURITY CLASS. (of this report...not harm their neighbors In doing so. I As another example, In the case of fire, It would seem that initial attention was given to controlling flame...Francisco Earthquake. From there, efforts moved toward avoiding and controlling fires at the level of Individual structures, and more recently, of spaces
High-precision and low-cost vibration generator for low-frequency calibration system

NASA Astrophysics Data System (ADS)

Li, Rui-Jun; Lei, Ying-Jun; Zhang, Lian-Sheng; Chang, Zhen-Xin; Fan, Kuang-Chao; Cheng, Zhen-Ying; Hu, Peng-Hao

2018-03-01

Low-frequency vibration is one of the harmful factors that affect the accuracy of micro-/nano-measuring machines because its amplitude is significantly small and it is very difficult to avoid. In this paper, a low-cost and high-precision vibration generator was developed to calibrate an optical accelerometer, which is self-designed to detect low-frequency vibration. A piezoelectric actuator is used as vibration exciter, a leaf spring made of beryllium copper is used as an elastic component, and a high-resolution, low-thermal-drift eddy current sensor is applied to investigate the vibrator’s performance. Experimental results demonstrate that the vibration generator can achieve steady output displacement with frequency range from 0.6 Hz to 50 Hz, an analytical displacement resolution of 3.1 nm and an acceleration range from 3.72 mm s-2 to 1935.41 mm s-2 with a relative standard deviation less than 1.79%. The effectiveness of the high-precision and low-cost vibration generator was verified by calibrating our optical accelerometer.
Self-harm and suicide in adolescents.

PubMed

Hawton, Keith; Saunders, Kate E A; O'Connor, Rory C

2012-06-23

Self-harm and suicide are major public health problems in adolescents, with rates of self-harm being high in the teenage years and suicide being the second most common cause of death in young people worldwide. Important contributors to self-harm and suicide include genetic vulnerability and psychiatric, psychological, familial, social, and cultural factors. The effects of media and contagion are also important, with the internet having an important contemporary role. Prevention of self-harm and suicide needs both universal measures aimed at young people in general and targeted initiatives focused on high-risk groups. There is little evidence of effectiveness of either psychosocial or pharmacological treatment, with particular controversy surrounding the usefulness of antidepressants. Restriction of access to means for suicide is important. Major challenges include the development of greater understanding of the factors that contribute to self-harm and suicide in young people, especially mechanisms underlying contagion and the effect of new media. The identification of successful prevention initiatives aimed at young people and those at especially high risk, and the establishment of effective treatments for those who self-harm, are paramount needs. Copyright © 2012 Elsevier Ltd. All rights reserved.
A higher sensory brain region is involved in reversing reinforcement-induced vocal changes in a songbird.

PubMed

Canopoli, Alessandro; Herbst, Joshua A; Hahnloser, Richard H R

2014-05-14

Many animals exhibit flexible behaviors that they can adjust to increase reward or avoid harm (learning by positive or aversive reinforcement). But what neural mechanisms allow them to restore their original behavior (motor program) after reinforcement is withdrawn? One possibility is that motor restoration relies on brain areas that have a role in memorization but no role in either motor production or in sensory processing relevant for expressing the behavior and its refinement. We investigated the role of a higher auditory brain area in the songbird for modifying and restoring the stereotyped adult song. We exposed zebra finches to aversively reinforcing white noise stimuli contingent on the pitch of one of their stereotyped song syllables. In response, birds significantly changed the pitch of that syllable to avoid the aversive reinforcer. After we withdrew reinforcement, birds recovered their original song within a few days. However, we found that large bilateral lesions in the caudal medial nidopallium (NCM, a high auditory area) impaired recovery of the original pitch even several weeks after withdrawal of the reinforcing stimuli. Because NCM lesions spared both successful noise-avoidance behavior and birds' auditory discrimination ability, our results show that NCM is not needed for directed motor changes or for auditory discriminative processing, but is implied in memorizing or recalling the memory of the recent song target. Copyright © 2014 the authors 0270-6474/14/347018-09$15.00/0.
The link between negative emotions and eating disorder behaviour in patients with anorexia nervosa.

PubMed

Espeset, Ester M S; Gulliksen, Kjersti S; Nordbø, Ragnfrid H S; Skårderud, Finn; Holte, Arne

2012-11-01

Several theoretical models suggest that deficits in emotional regulation are central in the maintenance of anorexia nervosa (AN). Few studies have examined how patients view the relationship between negative affect and anorectic behaviour. We explored how patients with AN manage the aversive emotions sadness, anger, fear and disgust, and how they link these experiences to their eating disorder behaviours. Qualitative data were collected through semi-structured interviews with 14 women aged 19-39 years diagnosed with AN (DSM-IV). Interviews were analyzed using Grounded Theory methods. The participants tended to inhibit expression of sadness and anger in interpersonal situations and reported high levels of anger towards themselves, self-disgust and fear of becoming fat. Different emotions were managed by means of specific eating disorder behaviours. Sadness was particularly linked to body dissatisfaction and was managed through restrictive eating and purging. Anger was avoided by means of restrictive eating and purging and released through anorectic self-control, self-harm and exercising. Fear was linked to fear of fatness and was managed through restrictive eating, purging and body checking. Participants avoided the feeling of disgust by avoiding food and body focused situations. Treatment models of eating disorders highlight the significance of working with emotional acceptance and coping in this patient group. Knowledge about how patients understand the relationships between their negative emotions and their anorectic behaviour may be an important addition to treatment programmes for AN. Copyright © 2012 John Wiley & Sons, Ltd and Eating Disorders Association.
Temperament and character profiles are associated with depression outcome in psychiatric secondary care patients with harmful drinking.

PubMed

Paavonen, Vesa; Luoto, Kaisa; Lassila, Antero; Leinonen, Esa; Kampman, Olli

2018-04-07

Temperament and character profiles have been associated with depression outcome and alcohol abuse comorbidity in depressed patients. How harmful alcohol use modifies the effects of temperament and character on depression outcome is not well known. Knowledge of these associations could provide a method for enhancing more individualized treatment strategies for these patients. We screened 242 depressed patients with at least moderate level of depressive symptoms. The Alcohol Use Disorders Identification Test (AUDIT) was used for identifying patients with marked alcohol use problems (AUP, AUDIT≥11). After 6 weeks of antidepressive treatment 173 patients were assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS), and the Temperament and Character Inventory (TCI-R). Outcome of depression (MADRS scores across three follow-up points at 6 weeks, 6 months and 24 months) was predicted with AUP, gender, and AUP x Gender and AUP x Time interactions together with temperament and character dimension scores in a linear mixed effects model. Poorer outcome of depression (MADRS scores at 6 weeks, 6 months and 24 months) was predicted by AUP × Time interaction (p = 0.0002) together with low Reward Dependence (p = 0.003). Gender and all other temperament and character traits were non-significant predictors of the depression outcome in the mixed effects model. Possibly due to the modifying effect of alcohol use problems, high Reward Dependence was associated with better depression treatment outcome at 6 months. Harm Avoidance and Self-Directedness did not predict depression outcome when alcohol use problems were controlled. Copyright © 2018 Elsevier Inc. All rights reserved.
The need for evidence-based, non-drug medicine.

PubMed

Ventegodt, Søren; Orr, Gary; Merrick, Joav

2011-11-04

Evidence-based medicine (EBM) is defined as "the integration of best research evidence with clinical expertise and patient values." EBM is based on three equally important key factors: i) the best available scientific evidence; ii) the physician's experience and intuition; and, iii) the preferences and values of the patient. EBM uses a hierarchy of evidence and critical appraisal of the sources, which makes it possible to balance high quality evidence with documented effectiveness. A treatment that is more safe and effective, but less well documented may very well be the treatment of choice. Ethics (not putting the patient at risk of harm with a treatment if this can be avoided at all) is an important part of EBM. Many pharmaceutical drugs have a number needed to treat (NNT) of approximately 20 [NNT=20, confidence interval CI (5-50)] and the number needed to harm is less well understood and documented. The adverse effect profile of pharmacological agents can be more harmful than non-drug medicine. Most EBM-treatments are likely to be non-drug treatments in the future. There are six steps to the practice of EBM: i) the patients and the physician must work together to define the problem; ii) the patients and the physician must explore the patient's values and preferences; iii) the information about the possible alternative medical interventions must be discussed and critically appraised; iv) the best, relevant evidence must be applied to the patient as a treatment or cure; v) together, the patient and the physician must evaluate how useful the intervention was; and vi) if the intervention did not help sufficiently, the process must begin again. In this review, we explain, in our opinion, how non-drug EBM should be practiced.
Tobacco Road Finland - how did an accepted pleasure turn into an avoidable risk behaviour?

PubMed

Hakkarainen, Pekka

2013-12-01

Smoking was once defined as an appropriate recreational substance or life comfort, but is now understood as a serious health risk and a public health problem important enough to be controlled by society. In this article the changed social position and development of tobacco regulations in Finland are studied from a perspective of social constructionism. The emergence of recent tobacco controls can be seen as a process whereby tobacco came to be defined as a social problem. I will argue that there were three primary definitions which played a decisive role in this process. Put in historical order, these three definitions contained (1) claims about harms to smokers, (2) claims about harms to others, and (3) claims about tobacco as a highly addictive drug. These conceptions together drove a complementary and mutually reinforcing re-conception of tobacco harms. Consequently, the emergence of these definitions led to the founding of new institutions, practices, and treatments. The leading value in the claim-making process was public health, which transferred the state's interest away from fiscal revenues towards lowering the costs caused by tobacco diseases. Correspondingly, medical science and medical doctors gained a position as the leading authority in the defining the tobacco issue. The latest conceptual innovation is the idea of a tobacco-free Finland by 2040, representing a strategy of 'de-normalising' tobacco use. The reversal in the social and cultural position of tobacco, which in Finland went from one extreme to another, was not based on pressure created by any wider social movements or organised tobacco-specific citizens groups, as in some other countries, but rather by a state health administration supported by a relatively small network of tobacco control advocates. Copyright © 2013 Elsevier Ltd. All rights reserved.

"I'd only let you down": Guilt proneness and the avoidance of harmful interdependence.

PubMed

Wiltermuth, Scott S; Cohen, Taya R

2014-11-01

Five studies demonstrated that highly guilt-prone people may avoid forming interdependent partnerships with others whom they perceive to be more competent than themselves, as benefitting a partner less than the partner benefits one's self could trigger feelings of guilt. Highly guilt-prone people who lacked expertise in a domain were less willing than were those low in guilt proneness who lacked expertise in that domain to create outcome-interdependent relationships with people who possessed domain-specific expertise. These highly guilt-prone people were more likely than others both to opt to be paid on their performance alone (Studies 1, 3, 4, and 5) and to opt to be paid on the basis of the average of their performance and that of others whose competence was more similar to their own (Studies 2 and 5). Guilt proneness did not predict people's willingness to form outcome-interdependent relationships with potential partners who lacked domain-specific expertise (Studies 4 and 5). It also did not predict people's willingness to form relationships when poor individual performance would not negatively affect partner outcomes (Study 4). Guilt proneness therefore predicts whether, and with whom, people develop interdependent relationships. The findings also demonstrate that highly guilt-prone people sacrifice financial gain out of concern about how their actions would influence others' welfare. As such, the findings demonstrate a novel way in which guilt proneness limits free-riding and therefore reduces the incidence of potentially unethical behavior. Lastly, the findings demonstrate that people who lack competence may not always seek out competence in others when choosing partners.
How sacrifice impacts the giver and the recipient: insights from approach-avoidance motivational theory.

PubMed

Impett, Emily A; Gere, Judith; Kogan, Aleksandr; Gordon, Amie M; Keltner, Dacher

2014-10-01

This study investigated how sacrificing for approach versus avoidance goals shapes the giver's and the recipient's emotions and relationship quality. A sample of 80 dating couples participated in a three-part study in which they discussed sacrifice in the laboratory (Part 1), reported on their daily sacrifices for 14 days (Part 2), and completed a follow-up survey 3 months later (Part 3). When partners discussed a sacrifice they had made for approach goals, they experienced greater relationship quality, whereas when they discussed a sacrifice they had made for avoidance goals, they experienced poorer relationship quality. These effects were replicated with outside observer reports. On days when partners sacrificed for approach goals, both partners experienced increased relationship quality, but on days when people sacrificed for avoidance goals, the giver experienced decreased relationship quality. These effects were mediated by positive and negative emotions, respectively. Approach sacrifice goals predicted increases in relationship quality and avoidance sacrifice goals predicted decreases in relationship quality, as reported by both partners 3 months later. Sacrifice per se does not help or harm relationships, but the goals that people pursue when they give up their own interests can critically shape the quality of intimate bonds. © 2013 Wiley Periodicals, Inc.
Responsiveness and minimal clinically important changes for the Tampa Scale of Kinesiophobia after lumbar fusion during cognitive behavioral rehabilitation.

PubMed

Monticone, Marco; Ambrosini, Emilia; Rocca, Barbara; Foti, Calogero; Ferrante, Simona

2017-06-01

The Tampa Scale of Kinesiophobia (TSK) is a commonly-used measure for the assessment of fear of movement beliefs in chronic complaints, but its responsiveness in subjects after lumbar fusion has been never reported. Evaluating the responsiveness and minimal clinically important differences (MCIDs) for the TSK and its subscales after lumbar fusion. Population-based cohort study. Secondary care rehabilitation hospital. In-patients undergoing rehabilitation after lumbar fusion. At the beginning and end of a four-week motor and cognitive-behavioral rehabilitation program, 180 patients completed the TSK. After the intervention, the global perceived effect (GPE) was analyzed to produce a dichotomous outcome (improved vs. stable). Responsiveness for the TSK and its subscales were calculated by distribution (effect size [ES], standardized response mean [SRM]) and anchor-based methods (receiver operating characteristics (ROC) curves; correlations between change scores of the TSK and its subscales and GPE). ROC curves were also used to compute MCID values. The ES ranged from 1.63 to 1.77 and the SRM from 1.25 to 1.39 for TSK and its subscales. The ROC analyses revealed a value of area under the curve (0.999 [95% CI: 0.978; 1.000], 0.998 [95% CI: 0.975; 1.000], 0.990 [95% CI: 0.962; 0.999] for the TSK, Harm and Activity Avoidance subscales, respectively). MCID values greater than 6 (95% CI: >5; >6), 4 (95% CI: >3; >5), and 2 (95% CI: >2; >2) were achieved for the TSK, Harm and Activity Avoidance subscales, respectively. Correlations between change scores of the TSK and its subscales and GPE were high (0.786-0.830). The TSK and its subscales were sensitive in detecting clinical changes in subjects undergoing rehabilitation after lumbar fusion. The obtained MCID values will help in the design of future randomized controlled trials and in the interpretation of the clinical impact of a rehabilitation program after lumbar fusion.
"Better safe than sorry": a qualitative content analysis of participant's perspectives of fall-related concerns and balance in older women with osteoporosis after balance training.

PubMed

Halvarsson, Alexandra; Ståhle, Agneta; Halén, Carolina; Roaldsen, Kirsti Skavberg

2015-07-03

To explore how older women with osteoporosis perceive fall-related concerns and balance in daily life after having participated in balance training. Explorative study. Semi-structured interviews were conducted with 19 women (66-84 years), with osteoporosis recruited from an ongoing RCT; participants were asked about their perceived fall-related concerns and balance. Interviews were taped and transcribed verbatim. Data were analyzed using inductive qualitative content analysis. One underlying theme emerged: "Internalized risk perception related to experience of bodily fragility", and three manifest categories: empowerment, safety and menace. A dynamic process between the categories was found, in which contextual and personal factors influenced perceptions of fall-related concerns and balance, i.e. winter season may lead a person who is highly empowered and/or uses active strategies into a situation of perception of menace and avoidance of activity. To cope with the fragility caused by osteoporosis informants had an internalized risk perception that protected them against possible threats and harm. Informants perceived improved empowerment and self-efficacy after participation in balance training. They resumed activities and became more active and independent in daily life using safety precautions and fall-prevention strategies. Depending on contextual factors, some situations still invoked fear and led to avoidance. Implication for Rehabilitation Risk awareness protecting against possible threats and harms seems to be internalized in older women living with osteoporosis. When designing fall prevention programs, it is important to recognize that contextual and personal factors have a major influence on how older women with osteoporosis perceive fall-related concerns and balance. Perception of fragility and risk seems to be a significant problem for older women with osteoporosis and health-care providers should encourage their patients to participate in tailored balance training programs to overcome these concerns.
Peripheral coding of taste

PubMed Central

Liman, Emily R.; Zhang, Yali V.; Montell, Craig

2014-01-01

Five canonical tastes, bitter, sweet, umami (amino acid), salty and sour (acid) are detected by animals as diverse as fruit flies and humans, consistent with a near universal drive to consume fundamental nutrients and to avoid toxins or other harmful compounds. Surprisingly, despite this strong conservation of basic taste qualities between vertebrates and invertebrates, the receptors and signaling mechanisms that mediate taste in each are highly divergent. The identification over the last two decades of receptors and other molecules that mediate taste has led to stunning advances in our understanding of the basic mechanisms of transduction and coding of information by the gustatory systems of vertebrates and invertebrates. In this review, we discuss recent advances in taste research, mainly from the fly and mammalian systems, and we highlight principles that are common across species, despite stark differences in receptor types. PMID:24607224
Role of impulsivity and other personality dimensions in attempted suicide with self-poisoning among children and adolescents.

PubMed

Ghanem, Mohamed; Gamaluddin, Hany; Mansour, Mona; Samiee', Afaf Abdel; Shaker, Nermin Mahmoud; El Rafei, Heba

2013-01-01

The objective of this study was to clarify the role of impulsivity and personality dimensions in attempted suicide among youth. The study included 120 youths who attempted suicide and 100 matched controls. Attempters of suicide had higher total scores and subscales of impulsivity than controls. They had higher novelty seeking, harm avoidance, and reward dependence scores, lower scores on persistence, self-directedness, and cooperativeness. A total of 77.5% of suicide attempters had psychiatric disorders compared to 2% of controls. Main factors predicting the occurrence of suicidal attempts were the presence of psychiatric disorder, impulsivity, stressful life events, and high reward dependence of suicide attempters. The study supports that impulsivity and personality traits play an important role in youth suicide independently or as a part of other interacting factors.
/ital In/ /ital situ/ dc oxygen-discharge cleaning system for optical elements

DOE Office of Scientific and Technical Information (OSTI.GOV)

Koide, T.; Shidara, T.; Tanaka, K.

1989-07-01

/ital In/ /ital situ/ dc oxygen-discharge cleaning arrangements have been developed at the Photon Factory for the removal of carbon contamination from optical surfaces. A high cleaning rate could be achieved by producing an oxygen plasma close to the optical elements with special care taken to avoid any harmful effects from the discharge; contaminant carbon was completely removed within a few hours, at most. This short exposure time and the use of dry oxygen gas resulted in a restoration of the original ultrahigh vacuum without a bakeout. Results with a Seya-Namioka beamline for gas-phase experiments showed a flux enhancement amountingmore » to a factor of 50, and results with a grasshopper beamline showed a nearly complete recovery of the light intensity, even at the carbon /ital K/ edge.« less
Characteristics of Stress and Suicidal Ideation in the Disclosure of Sexual Orientation among Young French LGB Adults.

PubMed

Charbonnier, Elodie; Dumas, Florence; Chesterman, Adam; Graziani, Pierluigi

2018-02-07

Lesbians, gays, and bisexual people (LGB) present high levels of suicidal ideation. The disclosure of sexual orientation is a stressful experience which presents a high suicide risk. Research has not paid sufficient attention to stress during this disclosure in order to understand suicide among LGB people. The aims of this study were to investigate: (1) the characteristics of stress during this revelation, more precisely cognitive appraisal, emotions, and coping; and (2) associations between these characteristics and suicidal ideation. A total of 200 LGB young adults answered the "Stressful situation assessment questionnaire", focusing on the most stressful disclosure of sexual orientation they have ever experienced. Avoidance coping is a good predictor of suicidal ideation, and mediates the association between primary appraisal (risk "Harm myself and others") and suicidal ideation. Our study illustrates the need to better understand stress during the disclosure of sexual orientation to prevent and care for suicide risk among LGB young adults.
Characteristics of Stress and Suicidal Ideation in the Disclosure of Sexual Orientation among Young French LGB Adults

PubMed Central

Charbonnier, Elodie; Dumas, Florence; Chesterman, Adam; Graziani, Pierluigi

2018-01-01

Background: Lesbians, gays, and bisexual people (LGB) present high levels of suicidal ideation. The disclosure of sexual orientation is a stressful experience which presents a high suicide risk. Research has not paid sufficient attention to stress during this disclosure in order to understand suicide among LGB people. The aims of this study were to investigate: (1) the characteristics of stress during this revelation, more precisely cognitive appraisal, emotions, and coping; and (2) associations between these characteristics and suicidal ideation. Method: A total of 200 LGB young adults answered the “Stressful situation assessment questionnaire”, focusing on the most stressful disclosure of sexual orientation they have ever experienced. Results: Avoidance coping is a good predictor of suicidal ideation, and mediates the association between primary appraisal (risk “Harm myself and others”) and suicidal ideation. Conclusions: Our study illustrates the need to better understand stress during the disclosure of sexual orientation to prevent and care for suicide risk among LGB young adults. PMID:29414915
Treatment dropout in drug-addicted women: are eating disorders implicated?

PubMed

Bonfà, F; Cabrini, S; Avanzi, M; Bettinardi, O; Spotti, R; Uber, E

2008-06-01

A high prevalence of eating disorders among drug-addicted female patients has been noted, and it could be associated to psychopathological underlying factors. Our aim was to assess eating disorder traits in women approaching a residential program for drug addiction. We hypothesized that these traits would correlate to more general psychopathological factors, and would influence treatment relapse. A sample of 204 substance dependent women attending a residential treatment was screened for psychopathological indices, and follow-up data were obtained at the end of the treatment. Clients had a high risk for eating disorders (15%), and lifetime prevalence was even higher (20%). Disordered eating was associated to psychopathological distress, in particular harm avoidance resulted significantly lower (p=0.005), evoking higher unresponsiveness to danger. Drug addiction treatment outcome is associated to completion of defined programs, and eating disorder was a key covariable in determining treatment relapse or success (p=0.03). Clinicians should be aware of this potential co-morbidity, and concurrent treatments should be attempted, in order to prevent symptomatic shifting.
Fast rail corrugation detection based on texture filtering

NASA Astrophysics Data System (ADS)

Xiao, Jie; Lu, Kaixia

2018-02-01

The condition detection of rails in high-speed railway is one of the important means to ensure the safety of railway transportation. In order to replace the traditional manual inspection, save manpower and material resources, and improve the detection speed and accuracy, it is of great significance to develop a machine vision system for locating and identifying defects on rails automatically. Rail defects exhibit different properties and are divided into various categories related to the type and position of flaws on the rail. Several kinds of interrelated factors cause rail defects such as type of rail, construction conditions, and speed and/or frequency of trains using the rail. Rail corrugation is a particular kind of defects that produce an undulatory deformation on the rail heads. In high speed train, the corrugation induces harmful vibrations on wheels and its components and reduces the lifetime of rails. This type of defects should be detected to avoid rail fractures. In this paper, a novel method for fast rail corrugation detection based on texture filtering was proposed.
Venomous spiders, snakes, and scorpions in the United States.

PubMed

Holve, Steve

2009-04-01

Venomous bites and stings are complex poisonings that have local and systemic effects. Mild envenomations can be treated with supportive care. Severe envenomations can be treated definitively with species-specific antivenom, although the use of these products has potential risk of immediate and a more delayed onset form of hypersensitivity reactions. Consultation with a toxicologist is recommended to help guide therapy. Field treatments such as tourniquets and incision likely cause more harm than benefit and should be avoided.
Do no harm: toward contextually appropriate psychosocial support in international emergencies.

PubMed

Wessells, Michael G

2009-11-01

In the aftermath of international emergencies caused by natural disasters or armed conflicts, strong needs exist for psychosocial support on a large scale. Psychologists have developed and applied frameworks and tools that have helped to alleviate suffering and promote well-being in emergency settings. Unfortunately, psychological tools and approaches are sometimes used in ways that cause unintended harm. In a spirit of prevention and wanting to support critical self-reflection, the author outlines key issues and widespread violations of the do no harm imperative in emergency contexts. Prominent issues include contextual insensitivity to issues such as security, humanitarian coordination, and the inappropriate use of various methods; the use of an individualistic orientation that does not fit the context and culture; an excessive focus on deficits and victimhood that can undermine empowerment and resilience; the use of unsustainable, short-term approaches that breed dependency, create poorly trained psychosocial workers, and lack appropriate emphasis on prevention; and the imposition of outsider approaches. These and related problems can be avoided by the use of critical self-reflection, greater specificity in ethical guidance, a stronger evidence base for intervention, and improved methods of preparing international humanitarian psychologists. Copyright 2009 by the American Psychological Association
Daring the Foolish to Take Darwin Tests: The Ethical Double Bind of Betting On Natural Hazards

NASA Astrophysics Data System (ADS)

Halpern, J. B.

2017-12-01

While couched in the framework of concentrating minds betting on natural hazards carries an ethical cost. When children dare each other to do risky things parents know that when such dares are taken harm frequently occurs. Giving those who claim that there is no hazard financial reasons to avoid ameliorative actions or to double down in support of their public stance requires a moral calculation. Challenging the conclusions of those who accept such bets while denying danger will lead them to attempt to save face by increasing risk to themselves or others. Thus such wagers, whether person to person or on betting markets, require balancing between alerting the opposing party and others to the risks of not taking action, the associated scientific consensus and the possible harmful outcomes of the bets themselves. This talk will describe strategies for minimizing potential harm while maximizing the instructive component of climate bets. Best practices include having the bet rest on a technical issue that can be authoritatively resolved in a short time. Unfortunately the nature of natural hazard risks makes it difficult to meet all of these criteria, but those making such bets should be aware of the ethical double bind
The role of ethics in shale gas policies.

PubMed

de Melo-Martín, Inmaculada; Hays, Jake; Finkel, Madelon L

2014-02-01

The United States has experienced a boom in natural gas production due to recent technological innovations that have enabled natural gas to be produced from unconventional sources, such as shale. There has been much discussion about the costs and benefits of developing shale gas among scientists, policy makers, and the general public. The debate has typically revolved around potential gains in economics, employment, energy independence, and national security as well as potential harms to the environment, the climate, and public health. In the face of scientific uncertainty, national and international governments must make decisions on how to proceed. So far, the results have been varied, with some governments banning the process, others enacting moratoria until it is better understood, and others explicitly sanctioning shale gas development. These policies reflect legislature's preferences to avoid false negative errors or false positive ones. Here we argue that policy makers have a prima facie duty to minimize false negatives based on three considerations: (1) protection from serious harm generally takes precedence over the enhancement of welfare; (2) minimizing false negatives in this case is more respectful to people's autonomy; and (3) alternative solutions exist that may provide many of the same benefits while minimizing many of the harms. © 2013.
Temperament and character traits associated with the use of alcohol, cannabis, cocaine, benzodiazepines, and hallucinogens: evidence from a large Brazilian web survey.

PubMed

Schneider, Ricardo; Ottoni, Gustavo L; de Carvalho, Hudson W; Elisabetsky, Elaine; Lara, Diogo R

2015-01-01

To evaluate how personality traits are associated with occasional use, abuse, and dependence of alcohol, cannabis, cocaine, benzodiazepines, and hallucinogens in a large availability sample of adults via online questionnaires. The sample consisted of 8,646 individuals (24.7% men and 75.3% women) who completed an anonymous web survey. Involvement with drugs and temperament/character traits were assessed through the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and the Temperament and Character Inventory - Revised (TCI-R), respectively. Interactions among variables were analyzed using MANOVA with Bonferroni adjustment. Novelty seeking was the trait most associated with increased involvement with alcohol, cannabis, and cocaine. There was a significant association between harm avoidance and benzodiazepine use. Persistence was lower in cannabis-, benzodiazepine-, and cocaine-dependent subjects, as well as in hallucinogen abusers. Self-directedness was reduced in dependents of all drug classes. No strong relationships were found between other temperament or character dimensions and the severity of drug use. Novelty seeking was associated with increased involvement with all drugs studied in this sample, although to a lesser extent with benzodiazepines and hallucinogens. The temperament and character profile for benzodiazepine use was different from that of other drugs due to the relationship with higher harm avoidance and self-transcendence and lower self-directedness.
The association of Internet addiction symptoms with anxiety, depression and self-esteem among adolescents with attention-deficit/hyperactivity disorder.

PubMed

Yen, Cheng-Fang; Chou, Wen-Jiun; Liu, Tai-Ling; Yang, Pinchen; Hu, Huei-Fan

2014-10-01

The aims of this study were to examine the associations of the severity of Internet addiction symptoms with various dimensions of anxiety (physical anxiety symptoms, harm avoidance, social anxiety, and separation/panic) and depression symptoms (depressed affect, somatic symptoms, interpersonal problems, and positive affect) and self-esteem among adolescents diagnosed with attention-deficit/hyperactivity disorder (ADHD) in Taiwan. A total of 287 adolescents aged between 11 and 18 years who had been diagnosed with ADHD participated in this study. Their severity of Internet addiction symptoms was assessed using the Chen Internet Addiction Scale. Anxiety and depression symptoms and self-esteem were assessed using the Taiwanese version of the Multidimensional Anxiety Scale for Children (MASC-T), the Center for Epidemiological Studies Depression Scale (CES-D), and the Rosenberg Self-Esteem Scale (RSES), respectively. The association between the severity of Internet addiction symptoms and anxiety and depression symptoms and self-esteem were examined using multiple regression analyses. The results indicated that higher physical symptoms and lower harm avoidance scores on the MASC-T, higher somatic discomfort/retarded activity scores on the CES-D, and lower self-esteem scores on the RSES were significantly associated with more severe Internet addiction symptoms. Prevention and intervention programs for Internet addiction in adolescents with ADHD should take anxiety, depression, and self-esteem into consideration. Copyright © 2014 Elsevier Inc. All rights reserved.
The association between bodily anxiety symptom dimensions and the scales of the Revised NEO Personality Inventory and the Temperament and Character Inventory.

PubMed

Kristensen, Ann Suhl; Mortensen, Erik Lykke; Mors, Ole

2009-01-01

The association between anxiety disorders and different measures of personality has been extensively studied to further the understanding of etiology, course, and treatment, and to possibly prevent the development of anxiety disorders. We have proposed a hierarchical model of bodily anxiety symptoms with 1 second-order severity factor and 5 first-order factors: cardio-respiratory, gastro-intestinal, autonomic, vertigo, and tension. The aim of this study was to investigate whether personality traits were differentially related to distinct symptom subdimensions or exclusively related to the general severity factor. Structural equation modeling of data on 120 patients with a primary diagnosis of social phobia and 207 patients with a primary diagnosis of panic disorder was used to examine the association between anxiety symptom dimensions and the scales of the Temperament and Character Inventory and of the Revised NEO Personality Inventory. When both sets of personality measures were simultaneously modeled as predictors, the Revised NEO Personality Inventory scales, neuroticism and extraversion, remained significantly associated with the severity factor, whereas the association between the Temperament and Character Inventory dimensions, harm avoidance and novelty seeking, and the severity factor became nonsignificant. Harm avoidance was negatively associated with the vertigo first-order factor, whereas neuroticism was negatively associated with the cardio-respiratory first-order factor, indicating that personality factors may be differentially related to specific anxiety subdimensions.
Decision making of heavy cannabis users on the Iowa Gambling Task: stronger association with THC of hair analysis than with personality traits of the Tridimensional Personality Questionnaire.

PubMed

Hermann, Derik; Leménager, Tagrid; Gelbke, Jan; Welzel, Helga; Skopp, Gisela; Mann, Karl

2009-01-01

It is unclear whether impairment in decision making, measured by the Iowa Gambling Task (IGT), in addiction is substance-induced or the consequence of personality structure. Analysis of the IGT, the Tridimensional Personality Questionnaire (TPQ) and cannabinoids in hair and urine were performed in 13 cannabis users and matched controls. Hair Delta(9)-tetrahydrocannabinol (THC) correlated negatively with the last subtrial (cards 80-100) of the IGT (R = -0.67). In all participants (n = 26) the TPQ dimension, harm avoidance, correlated negatively with the total IGT score (R = -0.46). The last IGT-subtrial correlated with adventure seeking (R = 0.43), harm avoidance (R = -0.39) and reward dependence (R = -0.44). The last subtrial gives information on whether a participant has learned the IGT strategy. Multiple regression confirmed the impact of THC on the last subtrial, whereas TPQ personality traits did not additionally explain variance. Former indications of the IGT performance depending on the amount of cannabis consumed were replicated with an objective measurement of chronic cannabis consumption (hair THC). Multiple regression analysis argues for a stronger impact of chronic THC consumption than personality traits, but does not provide a causal relationship. Other factors (e.g. genetic) may also play a role. 2009 S. Karger AG, Basel.
Temperament and character dimensions in male patients with substance use disorders: Differences relating to psychiatric comorbidity.

PubMed

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

2016-03-30

Previous research has not considered the influence of the Comorbid Mental Disorder (CMD) among Substance Use Disorders (SUD) patients. We explored the possible differences in personality dimensions among SUD patients taking into account their CMD (Schizophrenia, SZ; Bipolar Disorder, BD; Major Depressive Disorder, MDD); and elucidated clinical factors related to personality dimensions according to the CMD. The Temperament and Character Inventory Revised was used to assess a sample of 102 SUD male patients, considered in three groups according to their CMD: SUD+SZ (N=37), SUD+BD (N=30) and SUD+MDD (N=35). SUD+BD patients had the highest levels of Novelty Seeking and Persistence, SUD+SZ patients showed the highest levels of Harm Avoidance, and SUD+MDD patients reported a lower level of Self-transcendence. Novelty Seeking was positively associated with severity of addiction for SUD+BD; Harm Avoidance was positively associated with psychiatric symptoms for SUD+SZ; and the age of SUD onset was positively linked to Cooperativeness for SUD+BD and to Self-transcendence for SUD+MDD. The different personality characteristics associated to the type of CMD among SUD patients are related to several clinical variables. Interventions in these patients should be tailored according the personality traits that could influence treatment outcomes and patients' prognoses. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Empowerment through agency-promoting dialogue: an explicit application of harm reduction theory to reframe HIV test counseling.

PubMed

Mattson, M

2000-01-01

The counseling that accompanies HIV testing can be an important prevention tool for encouraging people to practice safer sex to avoid AIDS, but there is scant research about how HIV test counseling operates in practice. This article critiques the current Centers for Disease Control and Prevention (CDC) protocol for HIV test counseling for not being genuinely client centered and ignoring the unique needs of clients and offers an alternative approach that adapts and explicitly applies the tenets of harm reduction theory (HRT). Excerpts from actual HIV test counseling sessions illustrate both the weaknesses in the current approach to HIV test counseling and project how the alternative theoretical perspective offered could provide counseling that encourages agency-promoting and empowering dialogue. The implications for the development of HRT as a health communication heuristic and a practical training and evaluation strategy are discussed along with limitations and future research directions.
The Dangers of Electrosurgical Smoke to Operating Room Personnel: A Review.

PubMed

Bree, Kevin; Barnhill, Spencer; Rundell, William

2017-11-01

A 2007 study in the United Kingdom showed that three of 98 surgeons surveyed admitted using dedicated smoke extractors; 72% of respondents believed inadequate precautions were in place to protect staff from the potential dangers of electrosurgical smoke. Surgical smoke contains harmful chemicals (e.g., hydrogen cyanide, acetylene, and butadiene) that can circumvent standard masks used in the operating room (OR). In addition, bacteria and viruses can be transmitted through this smoke. The topic of electrosurgical smoke is important to occupational health nurses not only because of their responsibility to protect workers, but also because they, like other health care providers, may be exposed to smoke routinely. The authors of this review recommend the regular use of smoke evacuation in ORs and avoidance of electrosurgery whenever possible to protect OR personnel from the potential long-term harmful effects of electrosurgical smoke.
Euthanasia is not medical treatment.

PubMed

Boudreau, J Donald; Somerville, Margaret A

2013-01-01

The public assumes that if euthanasia and assisted suicide were to be legalized they would be carried out by physicians. In furthering critical analysis, we supplement the discourse in the ethics and palliative care literature with that from medical education and evolving jurisprudence. Both proponents and opponents agree that the values of respect for human life and for individuals' autonomy are relevant to the debate. Advocates of euthanasia and assisted suicide give priority to the right to personal autonomy and avoid discussions of harmful impacts of these practices on medicine, law and society. Opponents give priority to respect for life and identify such harmful effects. These both require euthanasia to remain legally prohibited. Proposals are emerging that if society legalizes euthanasia it should not be mandated to physicians. The impact of characterizing euthanasia as 'medical treatment' on physicians' professional identity and on the institutions of medicine and law should be examined in jurisdictions where assisted suicide and euthanasia have been de-criminalized.
Employers should disband employee weight control programs.

PubMed

Lewis, Alfred; Khanna, Vikram; Montrose, Shana

2015-02-01

American corporations continue to expand wellness programs, which now reach an estimated 90% of workers in large organizations, yet no study has demonstrated that the main focus of these programs-weight control-has any positive effect. There is no published evidence that large-scale corporate attempts to control employee body weight through financial incentives and penalties have generated savings from long-term weight loss, or a reduction in inpatient admissions associated with obesity or even long-term weight loss itself. Other evidence contradicts the hypothesis that population obesity rates meaningfully retard economic growth or manufacturing productivity. Quite the contrary, overscreening and crash dieting can impact employee morale and even harm employee health. Therefore, the authors believe that corporations should disband or significantly reconfigure weight-oriented wellness programs, and that the Affordable Care Act should be amended to require such programs to conform to accepted guidelines for harm avoidance.
Evolutionary aspects of anxiety disorders.

PubMed

Price, John S

2003-09-01

DANGER AND HARM ARE AVOIDED BY STRATEGIC DECISIONS MADE AT ALL THREE LEVELS OF THE TRIUNE FOREBRAIN: rational (neomammalian), emotional (paleomammalian), and instinctive (reptilian). This applies also to potential harm from conspecifics, which leads to a choice between escalating and de-escalating strategies. Anxiety is a component of de-escalating strategies mediated by the paleomammalian and reptilian forebrains. When the neomammalian (rational) brain fails to deal with the threat of conspecific danger, these more primitive de-escalating strategies may be activated and may present as anxiety disorders. The capacity for concealment of anxiety and other forms of negative affect has also evolved, and excessive concealment may lead to psychopaihology by breaking the negative feedback loop of excessive motivation, leading to impaired performance, leading to signals of distress, and leading to reduced exhortation to succeed on the part of parents and teachers; this situation is illustrated by a model based on the Yerkes-Dodson law.
Evolutionary aspects of anxiety disorders

PubMed Central

Price, John S.

2003-01-01

Danger and harm are avoided by strategic decisions made at all three levels of the triune forebrain: rational (neomammalian), emotional (paleomammalian), and instinctive (reptilian). This applies also to potential harm from conspecifics, which leads to a choice between escalating and de-escalating strategies. Anxiety is a component of de-escalating strategies mediated by the paleomammalian and reptilian forebrains. When the neomammalian (rational) brain fails to deal with the threat of conspecific danger, these more primitive de-escalating strategies may be activated and may present as anxiety disorders. The capacity for concealment of anxiety and other forms of negative affect has also evolved, and excessive concealment may lead to psychopaihology by breaking the negative feedback loop of excessive motivation, leading to impaired performance, leading to signals of distress, and leading to reduced exhortation to succeed on the part of parents and teachers; this situation is illustrated by a model based on the Yerkes-Dodson law. PMID:22033473
Not all pustules are infective in nature: acute generalised exanthematous pustulosis causing pustular eruptions in an elderly woman.

PubMed

Kwah, Y C; Leow, Y H

2005-07-01

Acute generalised exanthematous pustulosis (AGEP) is an adverse drug reaction that can occur in any age group. It is commonly mistaken as pustular psoriasis or cutaneous infection, resulting in unnecessary commencement of medications such as methotrexate and antibiotics that can cause harm to the patient or interact and adversely affect the efficacy of other medications. Early diagnosis of AGEP avoids unnecessary investigations and treatment, which not only can harm the patient but also escalate health care, as the condition is self-limiting. This case report illustrates AGEP secondary to Cefaclor occurring in a 72-year-old Chinese woman. Although the literature has documented the occurrence of AGEP with Cefaclor, the unique feature of this case is the occurrence of AGEP following repeated uneventful courses of Cefaclor. This case highlights that AGEP must never be forgotten in the work-up for pustular eruptions in an elderly patient.
Participants' responsibilities in clinical research.

PubMed

Resnik, David B; Ness, Elizabeth

2012-12-01

Discussions on the ethics and regulation of clinical research have a great deal to say about the responsibilities of investigators, sponsors, research institutions and institutional review boards, but very little about the responsibilities of research participants. In this article, we discuss the responsibilities of participants in clinical research. We argue that competent adult participants are responsible for complying with study requirements and fulfilling other obligations they undertake when they make an informed choice to enroll in a study. These responsibilities are based on duties related to promise-keeping, avoiding harm to one's self or others, beneficence and reciprocity. Investigators and research staff should inform participants about their responsibilities during the consent process, and should stress the importance of fulfilling study requirements. They should address any impediments to compliance, and they may provide participants with financial incentives for meeting study requirements. In very rare cases, coercive measures may be justified to prevent immanent harm to others resulting from non-compliance with study requirements.
Temperament and character profile of patients with fibromyalgia.

PubMed

Gencay-Can, Asli; Can, Serdar Suleyman

2012-12-01

Personality may play an important role in the development and initiation of fibromyalgia (FM). It may also be used for individualized treatment planning. We aimed to assess personality profiles of FM patients and to evaluate the association of personality profiles with education, symptom severity, depression, anxiety, and functioning. Forty-two female patients with FM and 48 healthy female controls were enrolled in the study. We assessed personality profiles of FM patients using the Temperament and Character Inventory (TCI). Spearman's rank correlation coefficient was used to detect the correlation between the TCI and education, symptom severity, depression, anxiety, and functioning. FM patients had significantly higher harm avoidance (HA) and self-transcendence (ST) scores, and lower self-directedness (SD) scores than those in the healthy controls. High HA scores were related to impaired functioning, depression, and anxiety symptoms. A negative correlation has been found between SD scores and depression scores. The study suggests that FM patients have distinctive temperament and character profile compared with healthy controls. FM patients tend to have high HA, high ST, and low SD scores.
The treatment of iron deficiency without anaemia (in otherwise healthy persons).

PubMed

Clénin, German E

2017-06-21

Iron deficiency is the most widespread and frequent nutritional disorder in the world. It affects a high proportion of children and women in developing countries and is also significantly prevalent in the industrialised world, with a clear predominance in adolescents and menstruating females. Iron is essential for optimal cognitive function and physical performance, not only as a binding site of oxygen but also as a critical constituent of many enzymes. Therefore iron deficiency at all its levels - nonanaemic iron deficiency, iron deficiency with microcytosis or hypochromia and iron deficiency anaemia - should be treated. In the presence of normal stores, however, preventative iron administration is inefficient, has side effects and seems to be harmful. In symptomatic patients with fatigue or in a population at risk for iron deficiency (adolescence, heavy or prolonged menstruation, high performance sport, vegetarian or vegan diet, eating disorder, underweight), a baseline set of blood tests including haemoglobin concentration, haematocrit, mean cellular volume, mean cellular haemoglobin, percentage of hypochromic erythrocytes and serum ferritin levels are important to monitor iron deficiency. To avoid false negative results (high ferritin levels in spite of iron deficiency), an acute phase reaction should be excluded by history and measurement of C-reactive protein. An algorithm leads through this diagnostic process and the decision making for a possible treatment. For healthy males and females aged >15 years, a ferritin cut-off of 30 µg/l is appropriate. For children from 6-12 years and younger adolescents from 12-15 years, cut-offs of 15 and 20 µg/l, respectively, are recommended. As a first step in treatment, counselling and oral iron therapy are usually combined. Integrating haem and free iron regularly into the diet, looking for enhancers and avoiding inhibitors of iron uptake is beneficial. In order to prevent reduced compliance, mainly as a result of gastrointestinal side effects of oral treatment, the use of preparations with reasonable but not excessive elemental iron content (28-50 mg) seems appropriate. Only in exceptional cases will an intravenous injection be necessary (e.g., concomitant disease needing urgent treatment, repeated failure of first-step therapy).To measure the success of treatment, the basic blood tests should be repeated after 8 to 10 weeks. Patients with repeatedly low ferritin will benefit from intermittent oral substitution to preserve iron stores and from long term follow-up, with the basic blood tests repeated every 6 or 12 months to monitor iron stores. Long-term daily oral or intravenous iron supplementation in the presence of normal or even high ferritin values is, however, not recommended and is potentially harmful.
Invasive Fungal Infections Acquired from Contaminated Food or Nutritional Supplements: A Review of the Literature

PubMed Central

Benedict, Kaitlin; Chiller, Tom M.; Mody, Rajal K.

2017-01-01

Fungi are an integral part of the natural environment and, therefore, play many roles in relation to food: some fungi are used in food production, some are food sources themselves, and some are agents of food spoilage. Some fungi that contaminate food can also be harmful to human health. The harmful but noninfectious health consequences of mycotoxins have been well-characterized, but the extent to which fungi in food pose a risk for invasive infections is unknown. We conducted a literature review to identify cases of invasive fungal infections (IFIs) believed to have resulted from ingestion or inhalation of food, beverages, or dietary supplements (excluding Saccharomyces infections). We identified 11 publications describing cases or small outbreaks of IFIs related to foods or beverages and three describing IFIs related to dietary supplements. These food-associated IFIs were predominantly mold infections, and the few yeast infections were associated with dairy products. Suspected foodborne IFIs appear to be rare, but are increasingly described in the electronically searchable literature. They are associated with a variety of foods, are due to a variety of fungal pathogens, and primarily occur in persons with immunosuppressive conditions or other predisposing factors. Various guidelines for high-risk patients recommend avoidance of certain food products that may contain high levels of fungi, but further work is needed to evaluate the effectiveness of these restrictive diets in preventing fungal infections. The relationships between food spoilage, food insecurity, and IFI risk are another area that may warrant further exploration. PMID:27074753
"Just Advil": Harm reduction and identity construction in the consumption of over-the-counter medication for chronic pain.

PubMed

Eaves, Emery R

2015-12-01

Direct-to-consumer marketing has sparked ongoing debate concerning whether ads empower consumers to be agents of their own care or shift greater control to the pharmaceutical industry. Ads for over-the-counter (OTC) medications in particular portend to offer simple, harmless solutions for meeting the demands of social life. Rather than join the longstanding debate between consumer agency and social control in pharmaceutical advertising, I approach self-medication with over-the-counter (OTC) analgesics using Harm Reduction as a framework. From this perspective, consumption of OTC analgesics by chronic pain sufferers is a means of seeking some level of relief while also avoiding the stigma associated with prescription pain medication. Qualitative methods are used to analyze data from two sources: (1) semi-structured qualitative interviews with 95 participants in a trial examining the effectiveness of Traditional Chinese Medicine for Temporomandibular Disorders (TMD) from 2006 to 2011 in Tucson, AZ and Portland, OR; and (2) print, online, and television advertisements for three major brands of OTC pain medication. Participants described their use of OTC medications as minimal, responsible, and justified by the severity of their pain. OTC medication advertising, while ostensibly ambiguous and targeting all forms of pain, effectively lends support to the consumption of these medications as part of the self-projects of chronic pain sufferers, allowing them to reconcile conflicting demands for pain relief while being stoic and maintaining a positive moral identity. Describing OTC medication as "just over-the-counter" or "not real pain medication," sufferers engage in ideological harm reduction, distinguishing themselves from "those people who like taking pain medication" while still seeking relief. Justifying one's use of OTC medication as minimal and "normal," regardless of intake, avoids association with the addictive potential of prescription pain medications and aligns the identity of the chronic pain sufferer with a culturally sanctioned identity as stoic bearer of pain. Copyright © 2015 Elsevier Ltd. All rights reserved.
“Just Advil”: Harm reduction and identity construction in the consumption of Over-The-Counter medication for chronic pain Social Science & Medicine

PubMed Central

2015-01-01

Direct-to-consumer marketing has sparked ongoing debate concerning whether ads empower consumers to be agents of their own care or shift greater control to the pharmaceutical industry. Ads for over-the-counter (OTC) medications in particular portend to offer simple, harmless solutions for meeting the demands of social life. Rather than join the longstanding debate between consumer agency and social control in pharmaceutical advertising, I approach self-medication with over-the-counter (OTC) analgesics using Harm Reduction as a framework. From this perspective, consumption of OTC analgesics by chronic pain sufferers is a means of seeking some level of relief while also avoiding the stigma associated with prescription pain medication. Qualitative methods are used to analyze data from two sources: (1) semi-structured qualitative interviews with 95 participants in a trial examining the effectiveness of Traditional Chinese Medicine for Temporomandibular Disorders (TMD) from 2006 to 2011 in Tucson, AZ and Portland, OR; and (2) print, online, and television advertisements for three major brands of OTC pain medication. Participants described their use of OTC medications as minimal, responsible, and justified by the severity of their pain. OTC medication advertising, while ostensibly ambiguous and targeting all forms of pain, effectively lends support to the consumption of these medication as part of the self-projects of chronic pain sufferers, allowing them to reconcile conflicting demands for pain relief while being stoic and maintaining a positive moral identity. Describing OTC medication as “just over-the-counter” or “not real pain medication,” sufferers engage in ideological harm reduction, distinguishing themselves from “those people who like taking pain medication” while still seeking relief. Justifying one’s use of OTC medication as minimal and “normal,” regardless of intake, avoids association with the addictive potential of prescription pain medications and aligns the identity of the chronic pain sufferer with a culturally sanctioned identity as stoic bearer of pain. PMID:26517291
Effects of the "affectionless control" parenting style on personality traits in healthy subjects.

PubMed

Otani, Koichi; Suzuki, Akihito; Oshino, Shingo; Ishii, Genki; Matsumoto, Yoshihiko

2009-01-30

The effects of the affectionless control (AC) parenting style on personality traits were studied in 414 Japanese healthy subjects. Perceived parental rearing was assessed by the Parental Bonding Instrument, which comprises care and protection factors, and personality traits were assessed by the Temperament and Character Inventory, which has seven dimensions. Parental rearing was classified into four types, i.e., optimal parenting (high care/low protection), affectionate constraint (high care/high protection), neglectful parenting (low care/low protection), and AC (low care/high protection). Males with maternal AC showed significantly higher harm avoidance (HA) scores and lower scores of persistence and cooperativeness than those with maternal optimal parenting. Females with maternal AC showed significantly higher HA scores and lower self-directedness scores than those with maternal optimal parenting. Paternal AC was not significantly related to any personality score. In females, the interaction between paternal rearing and maternal rearing was significant; the effect of maternal AC on HA scores was strongest when combined with paternal neglectful parenting. The present study suggests that the AC type parenting by mothers is associated with specific personality traits, especially high HA, in healthy subjects.
Use of the Analytic Hierarchy Process for Medication Decision-Making in Type 2 Diabetes

PubMed Central

Maruthur, Nisa M.; Joy, Susan M.; Dolan, James G.; Shihab, Hasan M.; Singh, Sonal

2015-01-01

Aim To investigate the feasibility and utility of the Analytic Hierarchy Process (AHP) for medication decision-making in type 2 diabetes. Methods We conducted an AHP with nine diabetes experts using structured interviews to rank add-on therapies (to metformin) for type 2 diabetes. During the AHP, participants compared treatment alternatives relative to eight outcomes (hemoglobin A1c-lowering and seven potential harms) and the relative importance of the different outcomes. The AHP model and instrument were pre-tested and pilot-tested prior to use. Results were discussed and an evaluation of the AHP was conducted during a group session. We conducted the quantitative analysis using Expert Choice software with the ideal mode to determine the priority of treatment alternatives. Results Participants judged exenatide to be the best add-on therapy followed by sitagliptin, sulfonylureas, and then pioglitazone. Maximizing benefit was judged 21% more important than minimizing harm. Minimizing severe hypoglycemia was judged to be the most important harm to avoid. Exenatide was the best overall alternative if the importance of minimizing harms was prioritized completely over maximizing benefits. Participants reported that the AHP improved transparency, consistency, and an understanding of others’ perspectives and agreed that the results reflected the views of the group. Conclusions The AHP is feasible and useful to make decisions about diabetes medications. Future studies which incorporate stakeholder preferences should evaluate other decision contexts, objectives, and treatments. PMID:26000636
Evaluation of a novel risk assessment method for self-harm associated with Borderline Personality Disorder.

PubMed

Rao, Sathya; Broadbear, Jillian H; Thompson, Katherine; Correia, Anna; Preston, Martin; Katz, Paul; Trett, Robert

2017-10-01

Borderline personality disorder (BPD) is associated with frequent self-harm and suicidal behaviours. This study compared physician-assessed self-harm risk and intervention choice according to a (i) standard risk assessment and (ii) BPD-specific risk assessment methods. Forty-five junior and senior mental health physicians were assigned to standard or BPD-specific risk training groups. The assessment utilized a BPD case vignette containing four scenarios describing high/low lethality self-harm and chronic/new patterns of self-harm behaviour. Participants chose from among four interventions, each corresponding to a risk category. Standard and BPD-specific groups were alike in their assessment of self-harm risk. Divergence occurred on intervention choice for assessments of low lethality, chronic risk ( p<.01) and high lethality, chronic risk ( p<.005). Overall, psychiatrists were more likely than their junior colleagues to correctly assess risk and management options. Although standard and BPD-specific methods are well aligned for assessing self harm-associated risk, BPD-specific training raised awareness of BPD-appropriate interventions, particularly in the context of chronic patterns of self-harm behaviour. Wider dissemination of BPD-specific risk training may enhance the confidence of mental health clinicians in identifying the nature of self-harm risk as well as the most clinically appropriate interventions for clients with BPD.
[Possibilities and limitations of fiscal policies as health instruments: taxes on harmful consumption. SESPAS Report 2010].

PubMed

López Nicolás, Angel; Viudes de Velasco, Arántzazu

2010-12-01

This article discusses the possibilities of indirect taxation as a mechanism that alters the relative prices of goods and services and hence encourages citizens to adopt healthy lifestyles. We review the case of smoking and unhealthy diet. These two cases were chosen because these are the two lifestyle factors with the greatest impact on morbidity and mortality in Spain and because they highlight the possibilities of tax policy (smoking) and its limitations (unhealthy diet). After discussion of these issues, we recommend gradually increasing the level of the minimum special tax on cigarettes and avoiding erosion of its value by inflation, as well as aligning the level of the minimum special tax on fine cut tobacco with that borne by cigarettes, to avoid the already perceived shift of demand toward the former variety. The main recommendation for the case of unhealthy diet is to obtain a more solid evidence base than that currently available on the relationship between food prices and body mass index in Spain. The scarce evidence available for the USA nevertheless suggests that the possibilities of price-based policies to reduce the problems of overweight and obesity are highly limited. Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.
[Multiple chemical sensitivity: Clinical evaluation of the severity and psychopathological profile].

PubMed

Lago Blanco, Eva; Puiguriguer Ferrando, Jordi; Rodríguez Enríquez, Mónica; Agüero Gento, Laura; Salvà Coll, Joan; Pizà Portell, Maria Rosa

2016-02-05

Multiple chemical sensitivity (MCS) is a multisystem disorder of controversial etiology, affecting some subjects when exposed to chemicals at no harmful concentrations. The objective of this paper is to describe the epidemiological, clinical and psychological features of a sample of patients with MCS for further specific group treatment. Descriptive study of patients diagnosed with MCS in a toxicology unit. We administered the Quick Environmental Exposure and Sensitivity Inventory, the structured interview SCID-II, the anxiety scale HAS and the type A personality test, PCTA. Seventy-three patients were included. The mean age was 52,6 years (range 33-77; SD 9.29). Sixty-six were females (90.4%). Fifty-three percent were classified as i-ii and ii grade. Sixty-one patients (83%) presented some type of comorbidity, mainly chronic pain, fibromyalgia and chronic fatigue. They exhibited higher levels of anxiety (average score of 19.2), prevalence of phobic-avoidant traits of personality and type A behavior in 31.1%. MCS affects middle-aged women with comorbidities (chronic pain, fibromyalgia and chronic fatigue) and high anxiety and avoidance behaviors. This preliminary analysis should help provide a specific therapeutic approach to these patients. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.
What a Shock: No Apoptosis without Heat Shock Protein 90α | Center for Cancer Research

Cancer.gov

Apoptosis, also known as programmed cell death, consists of a series of reactions designed to systematically chop up a cell and its contents. The process is used to eliminate specific cells during development or to remove old or damaged cells without harming any surrounding cells. Since cancer cells can develop mechanisms to avoid apoptosis, researchers may be able to identify new targets to combat cancer by better understanding the details of the apoptotic process.
Harmful Effects of Synthetic Surface-Active Detergents against Atopic Dermatitis.

PubMed

Deguchi, Hajime; Aoyama, Riho; Takahashi, Hideaki; Isobe, Yoshinari; Tsutsumi, Yutaka

2015-01-01

We report herein two cases of intractable atopic dermatitis successfully treated by simply avoiding the contact with surface-active detergents in the daily life and living. The detergents were closely related to the exacerbation and remission of the disease. Steroid ointment was no longer used. We discuss that the removal of horny layer lipids by surface-active detergents accelerates the transepidermal water loss and disturbs the barrier function of the epidermis and thus is intimately involved in the pathogenesis of atopic dermatitis.

A critical examination of factors that might encourage secrecy

NASA Astrophysics Data System (ADS)

Tough, Allen

1987-10-01

Seven factors that may encourage a government to keep secret a signal from extraterrestrial intelligence are critically examined. These factors are: (1) belief that people may panic; (2) fear of a negative impact on religion, science, and culture; (3) embarrassment; (4) individual and national competitive urges; (5) avoiding a harmful premature reply; (6) a national trade or military advantage; and (7) fear of a Trojan horse. Steps that can be taken to alleviate the most significant of these factors are considered.
Best practices in managing child and adolescent behavioral health emergencies.

PubMed

Feuer, Vera; Rocker, Joshua; Saggu, Babar M; Andrus, Jason M

2018-01-01

Behavioral health emergencies most commonly present as depression, suicidal behavior, aggression, and severe disorganization. Emergency clinicians should avoid relying solely on past medical history or previous psychiatric diagnoses that might prematurely rule out medical pathologies. Treatments for behavioral health emergencies consist of de-escalation interventions aimed at preventing agitation, aggression, and harm. This issue reviews medical pathologies and underlying causes that can result in psychiatric presentations and summarizes evidence-based practices to evaluate, manage, and refer patients with behavioral health emergencies.
Harm Reduction for the Prevention of Youth Gambling Problems: Lessons Learned From Adolescent High-Risk Behavior Prevention Programs

ERIC Educational Resources Information Center

Dickson, Laurie M.; Derevensky, Jeffrey L.; Gupta, Rina

2004-01-01

Despite the growing popularity of the harm reduction approach in the field of adolescent alcohol and substance abuse, a harm reduction approach to prevention and treatment of youth problem gambling remains largely unexplored. This article poses the question of whether the harm reduction paradigm is a promising approach to the prevention of…
[Employees health education--challenges according to the educational level].

PubMed

Korzeniowska, Elzbieta; Puchalski, Krzysztof

2012-01-01

Article addresses the problem of increasing Polish employees health education effectiveness according to the differences in educational level. Research model assume that effective method of developing recommendations improving the health education will synthesise scientific findings regarding methodology of conducting such education and knowledge about needs of two target groups: low and high educated employees. Educational solutions were searched in publications related to: health education, andragogy, propaganda and direct marketing. The empirical material used to characterize two target groups came from four research (qualitative and quantitative) conducted by the National Centre for Workplace Health Promotion (Nofer Institute of Occupational Medicine) in 2007-2010. Low educated employees' health education should be focused on increasing responsibility for health and strengthening their self-confidence according to the introduction of healthy lifestyle changes. To achieve these goals, important issue is to build their motivation to develop knowledge about taking care of health. In providing such information we should avoid the methods associated with school. Another important issue is creating an appropriate infrastructure and conditions facilitating the change of harmful behaviors undertaken at home and in the workplace. According to high-educated employees a challenge is to support taking health behaviors--although they are convinced it is important for their health, such behaviors are perceived as a difficult and freedom restriction. Promoting behavior change techniques, avoiding prohibitions in the educational messages and creating favorable climate for taking care of health in groups they participate are needed.
The relation of appraisal, coping efforts, and acuteness of trauma to PTS symptoms among former political prisoners.

PubMed

Kanninen, Katri; Punamäki, Raija-Leena; Qouta, Samir

2002-06-01

We examined how trauma-specific appraisals and coping efforts mediate between traumatic experiences, acuteness of trauma, and length of imprisonment and posttraumatic stress symptoms (PTS) among 103 Palestinian former political prisoners. The findings provide support for both direct and mediated models of trauma. The acuteness of trauma (time since release), appraisal of prison experience as harmful and involving loss, and use of both emotion- and problem-focused coping efforts were associated with high levels of PTS symptoms. Torture and ill-treatment had a direct association with intrusion, and recent release from prison with avoidance symptoms. Acuteness of trauma turned out to be important in the coping and symptom association: emotion-focused coping was associated with a low level of PTS symptoms in the long run, whereas problem-focused coping was associated with a low level of PTS symptoms in the short run.
Oxidative Stress in Placenta: Health and Diseases

PubMed Central

Wu, Fan; Tian, Fu-Ju; Lin, Yi

2015-01-01

During pregnancy, development of the placenta is interrelated with the oxygen concentration. Embryo development takes place in a low oxygen environment until the beginning of the second trimester when large amounts of oxygen are conveyed to meet the growth requirements. High metabolism and oxidative stress are common in the placenta. Reactive oxidative species sometimes harm placental development, but they are also reported to regulate gene transcription and downstream activities such as trophoblast proliferation, invasion, and angiogenesis. Autophagy and apoptosis are two crucial, interconnected processes in the placenta that are often influenced by oxidative stress. The proper interactions between them play an important role in placental homeostasis. However, an imbalance between the protective and destructive mechanisms of autophagy and apoptosis seems to be linked with pregnancy-related disorders such as miscarriage, preeclampsia, and intrauterine growth restriction. Thus, potential therapies to hold oxidative stress in leash, promote placentation, and avoid unwanted apoptosis are discussed. PMID:26693479
Eating disorders and major depression: role of anger and personality.

PubMed

Giovanni, Abbate-Daga; Carla, Gramaglia; Enrica, Marzola; Federico, Amianto; Maria, Zuccolin; Secondo, Fassino

2011-01-01

This study aimed to evaluate comorbidity for MD in a large ED sample and both personality and anger as clinical characteristics of patients with ED and MD. We assessed 838 ED patients with psychiatric evaluations and psychometric questionnaires: Temperament and Character Inventory, Eating Disorder Inventory-2, Beck Depression Inventory, and State-Trait Anger Expression Inventory. 19.5% of ED patients were found to suffer from comorbid MD and 48.7% reported clinically significant depressive symptomatology: patients with Anorexia Binge-Purging and Bulimia Nervosa were more likely to be diagnosed with MD. Irritable mood was found in the 73% of patients with MD. High Harm Avoidance (HA) and low Self-Directedness (SD) predicted MD independently of severity of the ED symptomatology, several clinical variables, and ED diagnosis. Assessing both personality and depressive symptoms could be useful to provide effective treatments. Longitudinal studies are needed to investigate the pathogenetic role of HA and SD for ED and MD.
Psychological Effects of the Threat of Nuclear War

PubMed Central

Kiraly, S. J.

1986-01-01

Systematic studies are emerging on the prevailing harmful psychological effect of the threat of nuclear war. The most recent surveys have identified populations which are particularly vulnerable. Anxiety was found to be a factor in criminal behavior, and threat of nuclear war to be a factor in anxiety. Psychiatric morbidity has been correlated with work deprivation and threat of annihilation. Many studies have focused on children, finding that anxiety about social issues is high, but that cynicism and apathy set in rapidly. Conclusions from such studies show that denial and avoidance are some of the worst results, since they are a barrier to meaningful reaction. The most vulnerable groups are children, adolescents, the unemployed, and those responsible for the welfare of others. Appropriate action is seen to be acknowledgement of fear and disillusionment as valid feelings, education towards a stronger sense of reality, and mobilization of goal-directed activity. PMID:21274254
Treatment of Fever After Stroke: Conflicting Evidence

PubMed Central

Wrotek, Sylwia E.; Kozak, Wieslaw E.; Hess, David C.; Fagan, Susan C.

2014-01-01

Approximately 50% of patients hospitalized for stroke develop fever. In fact, experimental evidence suggests that high body temperature is significantly correlated to initial stroke severity, lesion size, mortality, and neurologic outcome. Fever occurring after stroke is associated with poor outcomes. We investigated the etiology of fever after stroke and present evidence evaluating the efficacy and safety of interventions used to treat stroke-associated fever. Oral antipyretics are only marginally effective in lowering elevated body temperature in this population and may have unintended adverse consequences. Nonpharmacologic approaches to cooling have been more effective in achieving normothermia, but whether stroke outcomes can be improved remains unclear. We recommend using body temperature as a biomarker and a catalyst for aggressive investigation for an infectious etiology. Care must be taken not to exceed the new standard of a maximum acetaminophen does of 3 g/day to avoid patient harm. PMID:22026396
Environmental impact of TBT: the French experience.

PubMed

Alzieu, C

2000-08-21

The deleterious effects of TBT released by antifouling paints were first documented in Arcachon Bay (France) at the end of the 1970s. As a result of the high level of water contamination, the production of Pacific oysters was severely affected by a complete lack of reproduction and the appearance of calcification anomalies which were responsible for a strong decline in the marketable value of the remaining stock. Regulations that had been successively adopted from January 1982 had positive effects on the recovery of the oyster grounds by reducing ambient water concentrations. Most antifouling paints act by releasing toxicants into the water which avoid the fixation of the organisms responsible for fouling. The use of these paints results in significant inputs of biocides in the waters. The harmful effects on non-target organisms were first evidenced in the bay of Arcachon (France) where the most acute disturbances were recorded following tributyltin (TBT) contamination.
Fever in sepsis.

PubMed

Schortgen, F

2012-11-01

Fever is a common symptom of sepsis usually believed to predict better survival. Experimental data suggest that body temperature elevation may slow micro-organism growth and enhance host immune responses. In patients with sepsis, however, the high energy cost of fever may exacerbate the life-threatening situation. Fever control is widely used in the ICU, mainly in patients with infections. The efficacy of antipyretic drugs in lowering body temperature remains uncertain, however, and all antipyretics have well known adverse effects. Surface cooling methods are efficient but require sedation to avoid the harmful effects of shivering. A recent controlled trial in patients with septic shock suggests that external cooling for fever control may diminish vasopressor requirements and improve early survival. In this review, we examine the benefits and risks of fever and of controlled normothermia. The fever control modalities that provide the best risk/benefit ratio in sepsis are discussed.
HIP OSTEOARTHRITIS AND WORK

PubMed Central

Harris, E Clare; Coggon, David

2016-01-01

Epidemiological evidence points strongly to a hazard of hip osteoarthritis from heavy manual work. Harmful exposures may be reduced by elimination or redesign of processes and use of mechanical aids. Reducing obesity might help to protect workers whose need to perform heavy lifting cannot be eliminated. Particularly high relative risks have been reported in farmers, and hip osteoarthritis is a prescribed occupational disease in the UK for long-term employees in agriculture. Even where it is not attributable to employment, hip osteoarthritis impacts importantly on capacity to work. Factors that may influence work participation include the severity of disease, the physical demands of the job, age, and the size of the employer. Published research does not provide a strong guide to the timing of return to work following hip arthroplasty for osteoarthritis, and it is unclear whether patients should avoid heavy manual tasks in their future employment. PMID:26612242
The Texas Advanced Directive Law: Unfinished Business.

PubMed

Kapottos, Michael; Youngner, Stuart

2015-01-01

The Texas Advance Directive Act allows physicians and hospitals to overrule patient or family requests for futile care. Purposefully not defining futility, the law leaves its determination in specific cases to an institutional process. While the law has received several criticisms, it does seem to work constructively in the cases that come to the review process. We introduce a new criticism: While the law has been justified by an appeal to professional values such as avoiding harm to patients, avoiding the provision of unseemly care, and good stewardship of medical resources, it is applied incompletely. It allows physicians and institutional committees to refuse "futile" treatments desired by patients and families while at the same time providing no way of regulating physicians who recommend or even push "futile" treatments in similar cases. In this sense, the TADA is incomplete on its own terms.
Self-harm as a risk factor for inpatient aggression among women admitted to forensic psychiatric care.

PubMed

Selenius, Heidi; Leppänen Östman, Sari; Strand, Susanne

2016-10-01

Inpatient aggression among female forensic psychiatric patients has been shown to be associated with self-harm, that is considered to be a historical risk factor for violence. Research on associations between previous or current self-harm and different types of inpatient aggression is missing. The aim of this register study was to investigate the prevalence of self-harm and the type of inpatient aggression among female forensic psychiatric inpatients, and to study whether the patients' self-harm before and/or during forensic psychiatric care is a risk factor for inpatient aggression. Female forensic psychiatric patients (n = 130) from a high security hospital were included. The results showed that 88% of the female patients had self-harmed at least once during their life and 57% had been physically and/or verbally aggressive towards staff or other patients while in care at the hospital. Self-harm before admission to the current forensic psychiatric care or repeated self-harm were not significantly associated with inpatient aggression, whereas self-harm during care was significantly associated with physical and verbal aggression directed at staff. These results pointed towards self-harm being a dynamic risk factor rather than a historical risk factor for inpatient aggression among female forensic psychiatric patients. Whether self-harm is an individual risk factor or a part of the clinical risk factor 'Symptom of major mental illness' within the HCR-20V3 must be further explored among women. Thus, addressing self-harm committed by female patients during forensic psychiatric care seems to be important in risk assessments and the management of violence, especially in reducing violence against staff in high-security forensic psychiatric services.
Harm reduction with pharmacotherapy for homeless people with alcohol dependence: Protocol for a randomized controlled trial

PubMed Central

Collins, Susan E.; Saxon, Andrew J.; Duncan, Mark H.; Smart, Brian F.; Merrill, Joseph O.; Malone, Daniel K.; Jackson, T. Ron; Clifasefi, Seema L.; Joesch, Jutta; Ries, Richard K.

2014-01-01

Background Interventions requiring abstinence from alcohol are neither preferred by nor shown to be highly effective with many homeless individuals with alcohol dependence. It is therefore important to develop lower-threshold, patient-centered interventions for this multimorbid and high-utilizing population. Harm-reduction counseling requires neither abstinence nor use reduction and pairs a compassionate style with patient-driven goal-setting. Extended-release naltrexone (XR-NTX), a monthly injectable formulation of an opioid receptor antagonist, reduces craving and may support achievement of harm-reduction goals. Together, harm-reduction counseling and XR-NTX may support alcohol harm reduction and quality-of-life improvement. Aims Study aims include testing: a) the relative efficacy of XR-NTX and harm-reduction counseling compared to a community-based, supportive-services-as-usual control, b) theory-based mediators of treatment effects, and c) treatment effects on publicly funded service costs. Methods This RCT involves four arms: a) XR-NTX+harm-reduction counseling, b) placebo+harm-reduction counseling, c) harm-reduction counseling only, and d) community-based, supportive-services-as-usual control conditions. Participants are currently/formerly homeless, alcohol dependent individuals (N=300). Outcomes include alcohol variables (i.e., craving, quantity/frequency, problems and biomarkers), health-related quality of life, and publicly funded service utilization and associated costs. Mediators include 10-point motivation rulers and the Penn Alcohol Craving Scale. XR-NTX and harm-reduction counseling are administered every 4 weeks over the 12-week treatment course. Follow-up assessments are conducted at weeks 24 and 36. Discussion If found efficacious, XR-NTX and harm-reduction counseling will be well-positioned to support reductions in alcohol-related harm, decreases in costs associated with publicly funded service utilization, and increases in quality of life among homeless, alcohol-dependent individuals. PMID:24846619
Harm reduction with pharmacotherapy for homeless people with alcohol dependence: protocol for a randomized controlled trial.

PubMed

Collins, Susan E; Saxon, Andrew J; Duncan, Mark H; Smart, Brian F; Merrill, Joseph O; Malone, Daniel K; Jackson, T Ron; Clifasefi, Seema L; Joesch, Jutta; Ries, Richard K

2014-07-01

Interventions requiring abstinence from alcohol are neither preferred by nor shown to be highly effective with many homeless individuals with alcohol dependence. It is therefore important to develop lower-threshold, patient-centered interventions for this multimorbid and high-utilizing population. Harm-reduction counseling requires neither abstinence nor use reduction and pairs a compassionate style with patient-driven goal-setting. Extended-release naltrexone (XR-NTX), a monthly injectable formulation of an opioid receptor antagonist, reduces craving and may support achievement of harm-reduction goals. Together, harm-reduction counseling and XR-NTX may support alcohol harm reduction and quality-of-life improvement. Study aims include testing: a) the relative efficacy of XR-NTX and harm-reduction counseling compared to a community-based, supportive-services-as-usual control, b) theory-based mediators of treatment effects, and c) treatment effects on publicly funded service costs. This RCT involves four arms: a) XR-NTX+harm-reduction counseling, b) placebo+harm-reduction counseling, c) harm-reduction counseling only, and d) community-based, supportive-services-as-usual control conditions. Participants are currently/formerly homeless, alcohol dependent individuals (N=300). Outcomes include alcohol variables (i.e., craving, quantity/frequency, problems and biomarkers), health-related quality of life, and publicly funded service utilization and associated costs. Mediators include 10-point motivation rulers and the Penn Alcohol Craving Scale. XR-NTX and harm-reduction counseling are administered every 4weeks over the 12-week treatment course. Follow-up assessments are conducted at weeks 24 and 36. If found efficacious, XR-NTX and harm-reduction counseling will be well-positioned to support reductions in alcohol-related harm, decreases in costs associated with publicly funded service utilization, and increases in quality of life among homeless, alcohol-dependent individuals. Copyright © 2014 Elsevier Inc. All rights reserved.
Nutritive Supplements - Help or Harm for Breast Cancer Patients?

PubMed

Muenstedt, Karsten; El-Safadi, Samer

2010-01-01

SUMMARY: Considerable numbers of patients and physicians believe that micronutrients may be useful with respect to prevention and treatment of breast cancer. However, the analysis of the literature shows that basic information on nutritional demands in cancer patients is lacking. It is unknown whether there is an increased demand of micro-nutrients in cancer patients in general and if there is an even more increased demand during the various types of treatment. As a result, there are only limited positive findings. Higher calcium intake in premenopausal women and higher intake of vitamin D seem to be able to lower breast cancer incidence. Vitamin E (800 IU per day) was found to have a modest effect on hot flashes during tamoxifen treatment. However, there are potential side effects especially when micronutrients are administered in high or very high doses. There is increasing evidence that dose-effect relationships are not linear but U-shaped. It seems that two thresholds exist for adverse effect, one at low doses for undersupply, and another at high doses for toxicity. Thus, arbitrary high-dose administration of micronutrients should be avoided. Supplementation of normal doses seems to be safe and acceptable from the medical point of view.
Validation and normative studies of the Brazilian Portuguese and American versions of the Temperament and Character Inventory - Revised (TCI-R).

PubMed

Goncalves, Daniel Maffasioli; Cloninger, C Robert

2010-07-01

The Temperament and Character Inventory (TCI) was first described in 1993. It was designed to measure the character and temperament dimensions of Cloninger's model of personality using a true-false response format. The revised TCI (TCI-R) uses a five-point-Likert format and has multiple subscales for persistence to improve its reliability. We tested the clinical validity of an original Brazilian-Portuguese translation of the TCI-R. The 595 volunteers completed the BrP version of TCI-R, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Satisfaction with Life Scale (SWLS). The internal consistency was satisfactory for all dimensions (Cronbach alpha coefficients above 0.7). The cumulative variances for temperament and character were 58% and 60%. BAI was positively correlated with harm avoidance and negatively with persistence, self-directedness and cooperativeness. SWLS was correlated negatively with harm avoidance and positively with self-directedness and cooperativeness. The congruence coefficients between each facet of BrP TCI-R and the US TCI-R original data were 95% or higher (except NS1). The main limitation of this study is the convenience sampling. The BrP version of the TCI-R had good psychometric properties regardless of the cultural and educational backgrounds of subjects. The present study supported the validity of the BrP translation of the TCI-R, which encourages its use in both clinical and general community samples.
ASSOCIATIONS BETWEEN HOUSEHOLD AND NEIGHBORHOOD INCOME AND ANXIETY SYMPTOMS IN YOUNG ADOLESCENTS

PubMed Central

Vine, Michaela; Vander Stoep, Ann; Bell, Janice; Rhew, Isaac C.; Gudmundsen, Gretchen; McCauley, Elizabeth

2013-01-01

Background A better understanding of the role of both family- and neighborhood-level socioeconomic characteristics in the development of anxiety disorders is important for identifying salient target populations for intervention efforts. Little research has examined the question of whether associations between anxiety and socioeconomic status (SES) differ depending upon the level at which SES is measured or way in which anxiety manifests. We studied associations between both household- and neighborhood-level income and four different manifestations of anxiety in a community sample of young adolescents. Methods We conducted a cross-sectional analysis of data on 498 subjects aged 11–13 from a cohort study of Seattle-area middle school students. Generalized estimating equations were used to examine the association between both annual household income and neighborhood median income and each of four anxiety subscale scores from the multidimensional anxiety scale for children (MASC): physical symptoms, harm avoidance, social anxiety, and separation/panic anxiety. Results A negative association was found between household income and scores on two of the four MASC subscales—physical symptoms and separation/panic anxiety. In contrast, at equivalent levels of household income, adolescents living in higher income neighborhoods reported higher physical and harm avoidance symptom scores. Conclusion The role that SES plays in the development of childhood anxiety appears to be complex and to differ depending on the specific type of anxiety that is manifest and whether income is evaluated at the household or neighborhood level. PMID:22581412
Understanding and addressing the Schoolies phenomenon.

PubMed

Pettigrew, Simone; Biagioni, Nicole; Daube, Mike; Jones, Sandra C; Chikritzhs, Tanya; Kirby, Gary

2015-04-01

This study qualitatively explored Western Australian school leavers' alcohol-related experiences during the Schoolies period to generate insights for the purpose of intervention design. This is in the context of an impending change in the age of Western Australian students completing secondary school which, for the first time, will see around half being of legal age to purchase alcohol. Fifty-four 18-21-year-olds provided reflections via an emailed introspection on their experiences in the immediate post-school period. This provided access to the views of those who chose to attend events and consume large amounts of alcohol, those who attended events but refrained from excessive alcohol consumption, and those who elected to either avoid Schoolies events or engage in alternative celebrations. The data were coded and analysed using NVivo10. Three primary themes were identified that related to the perceived role of alcohol during Schoolies, the range of associated rite-of-passage rituals, and the strategies used by some Leavers to avoid alcohol and its consequences during the Schoolies period. Students and parents constitute important target groups for interventions designed to address alcohol-related harms during Schoolies. In the WA context, legislation on secondary supply and controlled purchase, as recommended by health and police authorities, could reduce harms that are likely to result from the change in the age of school leavers. Suggestions for alternative pastimes to promote to school leavers are provided. © 2015 Public Health Association of Australia.

The temperament and character traits in patients with major depressive disorder and bipolar affective disorder with and without suicide attempt.

PubMed

Erić, Anamarija Petek; Erić, Ivan; Ćurković, Mario; Dodig-Ćurković, Katarina; Kralik, Kristina; Kovač, Vlatka; Filaković, Pavo

2017-06-01

Suicide and mood disorders (especially major depressive disorder (MDD) and bipolar affective disorder (BD)) represent a significant global health burden. Major depressive disorder and bipolar affective disorder have been associated with increased risk for suicide. Some specific suicide risk factors might be found in underlying individual personality traits. Specific personality features may predispose an individual to mood disorders (MDD or BD) hence increased suicide risk. The specificity of this research is in the assessment of personality features during the acute phase of illness immediately after suicide attempt which resulted in psychiatric inpatient treatment. The study included 119 unrelated Caucasian participants with MDD-severe depressive episode without psychotic symptoms (MDD) and BD-severe depressive episode without psychotic symptoms (BD-sDE). Both groups of patients with MDD and BD-sDE were divided into the suicide attempters and non-suicidal group. The diagnoses of the severe depressive episode without psychotic symptoms in major depressive disorder (MDD; F32.2) and bipolar disorder (BD-sDE; F31.4) were made according to ICD-10 (WHO 1992) diagnostic criteria. Methods of suicide attempts were also assessed according to ICD-10 and a self-report questionnaire, the Temperament and Character Inventory (TCI) was applied. The participants who exhibited suicide attempt had significantly higher scores on harm-avoidance (HA) (p<0.001), significantly lower score on persistence (PS) (p=0.037) and lower score, however not statistically significant, on novelty-seeking (NS) (p=0.319) regarding temperament dimensions. In character dimensions, the patients with suicidal attempt had significantly lower scores on self-directedness (SD) (p<0.001) and significantly lower scores on cooperativeness (CO) (p=0.001). Patients who had suicide attempt may have some significantly different personality traits than non-suicidal patients with mood disorders. The combination of high harm-avoidance (HA) and low self-directedness (SD) may be specific for depressive episode while the combination of high HA, novelty-seeking (NS), and self-transcendence (ST) with low SD may be related to suicide attempts during the depressive episode in bipolar disorder. The novelty-seeking (NS), self-transcendence (ST) and self-directedness (SD) may be specific for suicidal group of bipolar patients.
“Is a cure in my sight?” Multi-stakeholder perspectives on phase I choroideremia gene transfer clinical trials

PubMed Central

Benjaminy, Shelly; MacDonald, Ian; Bubela, Tania

2014-01-01

Purpose: Ocular gene transfer clinical trials are raising patient hopes for the treatment of choroideremia – a blinding degenerative retinopathy. Phase I choroideremia gene transfer trials necessitate communicating about the risks of harm and potential benefits with patients while avoiding the sensationalism that has historically undermined this field of translational medicine. Methods: We conducted interviews between June 2011 and June 2012 with 6 choroideremia patient advocates, 20 patients, and 15 clinicians about their hopes for benefits, perceived risks of harm, and hopes for the time frame of clinical implementation of choroideremia gene transfer. Results: Despite the safety focus of phase I trials, participants hoped for direct visual benefits with evident discrepancies between stakeholder perspectives about the degree of visual benefit. Clinicians and patient advocates were concerned by limited patient attention to risks of harm. Interviews revealed confusion about the time frames for the clinical implementation of choroideremia gene transfer and patient urgency to access gene transfer within a limited therapeutic window. Conclusion: Differences in stakeholder perspectives about choroideremia gene transfer necessitate strategies that promote responsible communications about choroideremia gene transfer and aid in its translation. Strategies should counter historical sensationalism associated with gene transfer, promote informed consent, and honor patient hope while grounding communications in current clinical realities. PMID:24071795
Reduced graphene oxide-mediated Z-scheme BiVO4/CdS nanocomposites for boosted photocatalytic decomposition of harmful organic pollutants.

PubMed

Clament Sagaya Selvam, N; Kim, Yeong Gyeong; Kim, Dong Jin; Hong, Won-Hwa; Kim, Woong; Park, Sung Hyuk; Jo, Wan-Kuen

2018-09-01

The efficient photocatalytic degradation of harmful organic pollutants (isoniazid (ISN) and 1,4-dioxane (DX)) via the Z-scheme electron transfer mechanism was accomplished using a photostable composite photocatalyst consisting of BiVO 4 , CdS, and reduced graphene oxide (RGO). Compared to their pristine counterparts, the RGO-mediated Z-scheme CdS/BiVO 4 (CdS/RGO-BiVO 4 ) nanocomposites exhibited superior degradation activities, mainly attributed to the prolonged charge separation. RGO was found to be involved in visible-light harvesting and acted as a solid-state electron mediator at the CdS/BiVO 4 interface to realize an effective Z-scheme electron transfer pathway, avoid photocatalyst self-oxidation, and lengthen the life span of charge carriers. The results of reactive species scavenging experiments, photoluminescence measurements, and transient photocurrent measurements, as well as the calculated band potentials of the synthesized photocatalysts, supported the Z-scheme electron/hole pair separation mechanism. Additionally, the intermediates formed during the degradation of ISN and DX were identified, and a possible fragmentation pattern was proposed. This systematic work aims to develop photostable Z-scheme composites as unique photocatalytic systems for the efficient removal of harmful organic pollutants. Copyright © 2018 Elsevier B.V. All rights reserved.
Don't look now! Oculomotor avoidance as a conditioned disgust response.

PubMed

Armstrong, Thomas; McClenahan, Laura; Kittle, Jody; Olatunji, Bunmi O

2014-02-01

Pavlovian conditioning paradigms have revealed fear learning tendencies that may be implicated in the etiology and maintenance of anxiety disorders. Given the prominence of disgust in certain anxiety disorders, it may be fruitful to study disgust learning in addition to fear learning. The present study utilized eye tracking to examine the effects of disgust conditioning on attentional bias, a phenomenon that characterizes anxiety disorders. Participants completed either a disgust condition, in which a face (conditioned stimulus; CS+) was paired with videos of individuals vomiting (unconditioned stimulus; US), or a negative condition in which a face was paired with videos of individuals being harmed in motor-vehicle accidents. Eye movements were used to measure attentional biases related to the USs and the CSs. In line with prior research, attentional avoidance was observed for the disgust CS+. However, this effect did not reach significance until after extinction and was linked to self-reported disgust postacquisition, yet decoupled from self-reported disgust postextinction. Attentional avoidance of the CS+ was not found in the negative condition, and postextinction differences in attentional bias for the CS+ between conditions were found to be mediated by differences in attentional bias for the US, as only the disgust US elicited attentional avoidance. Also, individual differences in disgust sensitivity were found to be associated with attentional avoidance of the disgust US, and this effect was mediated by self-reported disgust in response to the US. Further, disgust sensitivity was associated with attentional avoidance of the disgust CS+, and this effect was mediated by attentional avoidance of the disgust US. These findings provide new insight into a complex pattern of relations between disgust, evaluative learning, and attention that may have implications for the etiology and maintenance of certain anxiety disorders. PsycINFO Database Record (c) 2014 APA, all rights reserved.
Ambulance attendances resulting from self-harm after release from prison: a prospective data linkage study.

PubMed

Borschmann, Rohan; Young, Jesse T; Moran, Paul; Spittal, Matthew J; Heffernan, Ed; Mok, Katherine; Kinner, Stuart A

2017-10-01

Incarcerated adults are at high risk of self-harm and suicide and remain so after release into the community. The aims of this study were to estimate the number of ambulance attendances due to self-harm in adults following release from prison, and to identify factors predictive of such attendances. Baseline surveys with 1309 adults within 6 weeks of expected release from prison between 2008 and 2010 were linked prospectively with state-wide correctional, ambulance, emergency department, hospital and death records in Queensland, Australia. Associations between baseline demographic, criminal justice and mental health-related factors, and subsequent ambulance attendances resulting from self-harm, were investigated using negative binomial regression. During 4691 person-years of follow-up (median 3.86 years per participant), there were 2892 ambulance attendances in the community, of which 120 (3.9%) were due to self-harm. In multivariable analyses, being Indigenous [incidence rate ratio (IRR): 2.10 (95% CI 1.14-3.86)], having previously been hospitalised for psychiatric treatment [IRR: 2.65 (95% CI 1.44-4.87)], being identified by prison staff as being at risk of self-harm whilst incarcerated [IRR: 2.12 (95% CI 1.11-4.06)] and having a prior ambulance attendance due to self-harm [IRR: 3.16 (95% CI 1.31-7.61)] were associated with self-harm attendances. Ambulance attendances resulting from self-harm following release from prison are common and represent an opportunity for tertiary intervention for self-harm. The high prevalence of such attendances, in conjunction with the strong association with prior psychiatric problems, reinforces the importance of providing appropriate ambulance staff training in the assessment and management of self-harm, and mental health problems more broadly, in this vulnerable population.
Examining spatial patterns of selection and use for an altered predator guild

USGS Publications Warehouse

Organ, John F.; Mumma, Matthew; Holbrook, Joseph D.; Rayl, Nathaniel D.; Zieminski, Christopher J.; Fuller, Todd K.; Mahoney, Shane P.; Waits, Lisette P.

2017-01-01

Anthropogenic disturbances have altered species’ distributions potentially impacting interspecific interactions. Interference competition is when one species denies a competing species access to a resource. One mechanism of interference competition is aggression, which can result in altered space-use of a subordinate species due to the threat of harm, otherwise known as a ‘landscape of fear’. Alternatively, subordinates might outcompete dominant species in resource-poor environments via a superior ability to extract resources. Our goal was to evaluate spatial predictions of the ‘landscape of fear’ hypothesis for a carnivore guild in Newfoundland, Canada, where coyotes recently immigrated. Native Newfoundland carnivores include red foxes, Canada lynx, and black bears. We predicted foxes and lynx would avoid coyotes because of their larger size and similar dietary niches. We used scat-detecting dogs and genetic techniques to locate and identify predator scats. We then built resource selection functions and tested for avoidance by incorporating predicted values of selection for the alternative species into the best supported models of each species. We found multiple negative relationships, but notably did not find avoidance by foxes of areas selected by coyotes. While we did find that lynx avoided coyotes, we also found a reciprocal relationship. The observed patterns suggest spatial partitioning and not coyote avoidance, although avoidance could still be occurring at different spatial or temporal scales. Furthermore, Newfoundland’s harsh climate and poor soils may swing the pendulum of interspecific interactions from interference competition to exploitative competition, where subordinates outcompete dominant competitors through a superior ability to extract resources.
Examining spatial patterns of selection and use for an altered predator guild.

PubMed

Mumma, Matthew A; Holbrook, Joseph D; Rayl, Nathaniel D; Zieminski, Christopher J; Fuller, Todd K; Organ, John F; Mahoney, Shane P; Waits, Lisette P

2017-12-01

Anthropogenic disturbances have altered species' distributions potentially impacting interspecific interactions. Interference competition is when one species denies a competing species access to a resource. One mechanism of interference competition is aggression, which can result in altered space-use of a subordinate species due to the threat of harm, otherwise known as a 'landscape of fear'. Alternatively, subordinates might outcompete dominant species in resource-poor environments via a superior ability to extract resources. Our goal was to evaluate spatial predictions of the 'landscape of fear' hypothesis for a carnivore guild in Newfoundland, Canada, where coyotes recently immigrated. Native Newfoundland carnivores include red foxes, Canada lynx, and black bears. We predicted foxes and lynx would avoid coyotes because of their larger size and similar dietary niches. We used scat-detecting dogs and genetic techniques to locate and identify predator scats. We then built resource selection functions and tested for avoidance by incorporating predicted values of selection for the alternative species into the best supported models of each species. We found multiple negative relationships, but notably did not find avoidance by foxes of areas selected by coyotes. While we did find that lynx avoided coyotes, we also found a reciprocal relationship. The observed patterns suggest spatial partitioning and not coyote avoidance, although avoidance could still be occurring at different spatial or temporal scales. Furthermore, Newfoundland's harsh climate and poor soils may swing the pendulum of interspecific interactions from interference competition to exploitative competition, where subordinates outcompete dominant competitors through a superior ability to extract resources.
Alcohol and older people: A systematic review of barriers, facilitators and context of drinking in older people and implications for intervention design.

PubMed

Kelly, Sarah; Olanrewaju, Olawale; Cowan, Andy; Brayne, Carol; Lafortune, Louise

2018-01-01

Harmful alcohol consumption in older people has increased and effective approaches to understanding and addressing this societal concern are needed. Systematic review of qualitative studies in older populations (55+ years) to identify barriers, facilitators or context of drinking in older people. Multiple databases (MEDLINE, EMBASE, PsycINFO, CINAHL, CENTRAL, Social Sciences Citation Index, York Centre for Reviews and Dissemination, Cochrane database and grey literature) were searched from 2000 to February 2017 for studies in English, from OECD countries using MeSH terms and text words relating to alcohol combined with older age terms. Study quality was assessed using NICE methodology. The review is reported according to PRISMA. Drinking in older people is strongly linked to social engagement and there is scepticism about the health risks of alcohol. Drinking was also linked to difficulties such as social isolation, illness or bereavement. Alcohol can be related to routines and identity. However, older people often regulate their own drinking and strategies that emphasise the life experience of older people to drink wisely could be helpful. To be effective societal approaches need to take into account contexts of risks for harmful drinking. The evidence supports a strong social role for drinking alcohol which should be taken into account in any policy development with the potential benefits of social participation for cognitive health. Approaches to reducing alcohol use in older people need to avoid paradoxical harm, with a need for approaches that reduce harm from drinking alcohol but retain the benefit of socialising.
Side effects are incompletely reported among systematic reviews in gastroenterology.

PubMed

Mahady, Suzanne E; Schlub, Timothy; Bero, Lisa; Moher, David; Tovey, David; George, Jacob; Craig, Jonathan C

2015-02-01

Systematic reviews are an integral component of evidence-based health care. However, little is known on how well they report the potential harms of interventions. We assessed the reporting of harms in recently published systematic reviews of interventions relevant to clinical gastroenterology. We identified all systematic reviews of randomized trials of gastroenterology interventions published from 2008 to 2012 in highly cited gastroenterology and general medical journals. We adapted the Consolidated Standards of Reporting Trials guidelines for harms and assessed qualitative and quantitative parameters of harms reporting. Regression analyses determined predictors of more comprehensive harms reporting. In total, 78 systematic reviews were identified, with 72 published in gastroenterology journals and six in general medical journals. Overall, one in three systematic reviews (26/78, 33%) did not refer to harms of the intervention anywhere in the article. Less than half of the studies included adverse events as an outcome measure, and data on absolute rates of adverse events were only provided in 28%. Most (65%) did not include any figures or tables on adverse event; however, all included these on efficacy outcomes (mean, 3 and range, 1-7). Regression analyses indicated that the use of reporting guidelines was significantly associated with better harms reporting (P = 0.04). The reporting of harms in gastroenterology systematic reviews is largely inadequate and highly asymmetrical compared with the reporting of benefits. We suggest that review authors routinely assess both efficacy and harms outcomes of an intervention and that reporting guidelines specifically targeting harms reporting be developed. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.
Prevalence of gambling-related harm provides evidence for the prevention paradox.

PubMed

Browne, Matthew; Rockloff, Matthew J

2018-05-23

Background The prevention paradox (PP) describes a situation in which a greater number of cases of a disease-state come from low-risk members of a population, because they are more prevalent than high-risk members. Past research has provided only tangential and disputed evidence to support the application of the PP to gambling-related harm. Aims To assess whether the PP applies to gambling, the prevalence of a large set (72) of diverse harmful consequences from gambling was examined across four risk categories for problem gambling, including no-risk, low-risk, moderate-risk, and problem-gambling. Methods Respondents who had gambled on non-lottery forms in the past 6 months completed an online survey (N = 1,524, 49.4% male). The data were weighted to the known prevalence of gambling problems in the Victorian community. Results The prevalence of gambling harms, including severe harms, was generally higher in the combined categories of lower risk categories compared to the high-risk problem-gambling category. There were some notable exceptions, however, for some severe and rare harms. Nevertheless, the majority of harms in the 72-item list, including serious harms such as needing temporary accommodation, emergency welfare assistance, experiencing separation or end of a relationship, loss of a job, needing to sell personal items, and experiencing domestic violence from gambling, were more commonly associated with lower risk gamblers. Conclusion Many significant harms are concentrated outside the ranks of gamblers with a severe mental health condition, which supports a public-health approach to ameliorating gambling-related harm.
Low-, medium- and high-dose steroids with or without aminocaproic acid in adult hematopoietic SCT patients with diffuse alveolar hemorrhage.

PubMed

Rathi, N K; Tanner, A R; Dinh, A; Dong, W; Feng, L; Ensor, J; Wallace, S K; Haque, S A; Rondon, G; Price, K J; Popat, U; Nates, J L

2015-03-01

Diffuse alveolar hemorrhage (DAH) is a poorly understood complication of transplantation carrying a high mortality. Patients commonly deteriorate and require intensive care unit (ICU) admission. Treatment with high-dose steroids and aminocaproic acid (ACA) has been suggested. The current study examined 119 critically ill adult hematopoietic transplant patients treated for DAH. Patients were subdivided into low-, medium- and high-dose steroid groups with or without ACA. All groups had similar baseline characteristics and severity of illness scores. Primary objectives were 30, 60, 100 day, ICU and hospital mortality. Overall mortality (n=119) on day 100 was high at 85%. In the steroids and ACA cohort (n=82), there were no significant differences in 30, 60, 100, day, ICU and hospital mortality between the dosing groups. In the steroids only cohort (n=37), the low-dose steroid group had a lower ICU and hospital mortality (P=0.02). Adjunctive treatment with ACA did not produce differences in outcomes. In the multivariate analysis, medium- and high-dose steroids were associated with a higher ICU mortality (P=0.01) as compared with the low-dose group. Our data suggest that treatment strategies may need to be reanalyzed to avoid potentially unnecessary and potentially harmful therapies.
On legalizing abortion: an open letter from Mexico's Christian Women's Collective.

PubMed

1993-01-01

In Mexico City the Christian Women's Collective's open letter to the Catholic Church is a response to the Catholic bishops' threats of excommunication of lawmakers in Chiapas State, Mexico, who may have approved a bill legalizing abortion. The bishops maintain that God is a just and merciful God who loves women and suffers with them. The Collective cannot ignore the 2 million women, 1.72 million of whom are Catholics, who undergo illegal abortions annually in Mexico. They tend to be poor and in a union and to have large families. The Collective does not advocate abortion, but recognized that almost all women who have had an abortion were not at all happy to do so. Instead they suffer depression, solitude, shame, and pain. In addition to the moral punishment, these women are at high risk of dying (150,000-200,000 women die annually from illegal abortions). Economic circumstances, health problems, rape, and abandonment threaten their lives, so abortion is a last resort. The Collective maintains that the Catholic Church must understand that God empathized with women's pain, and in sending Jesus, has become one with humanity. The Church must seriously consider this sorrowful and very complex situation and reflect on the circumstances leading to abortion rather than condemn it. It must realize that by choosing abortion women want to avoid harm in those cases where pregnancy could cause death, avoid injustice when rape caused the pregnancy, or avoid giving birth to an infant that society or family cannot sustain. The present adverse and unjust situation contributing to unwanted pregnancy and illegal abortion is a social sin. The Catholic Church needs to build a new pastoral program with women at its center emphasizing sexuality, maternity, and contraception. Indeed, confronting the true social, moral, and political causes of abortion, and avoiding punishment, incarceration, or excommunication will resolve the issue.
Deliberate self-harm in 15-year-old adolescents: a pilot study with a modified version of the Deliberate Self-Harm Inventory.

PubMed

Lundh, Lars-Gunnar; Karim, Jessica; Quilisch, Eva

2007-02-01

The purpose of the present study was to investigate the rate of deliberate self-harm in 15-year-old Swedish adolescents, gender differences in this behavior, and possible associations with self-esteem and mindfulness. For this purpose, we developed a simplified version of Gratz's (2001) Deliberate Self-Harm Inventory (DSHI), and carried out a pilot study with 123 adolescents from three different schools in southern Sweden. The results showed that 65.9% of the adolescents reported having engaged in some kind of deliberate self-harm at least once; 41.5% reported at least one kind of self-harm more than once; and 13.8% reported at least one kind of deliberate self-harm behavior "many times". Although there were no overall gender differences in self-harm, the girls reported significantly more of cutting wrists, arms and other body areas than the boys. High rates of deliberate self-harm were associated with low self-esteem and low mindfulness.
Lower cortisol level in response to a psychosocial stressor in young females with self-harm.

PubMed

Plener, Paul L; Zohsel, Katrin; Hohm, Erika; Buchmann, Arlette F; Banaschewski, T; Zimmermann, Ulrich S; Laucht, Manfred

2017-02-01

Self-harm is highly prevalent in adolescence, often serving an emotion regulation function. Social stressors such as bullying are associated with self-harm. The neurobiological background of the relationship between social stressors and self-harm needs to be further understood to inform prevention and therapy. Participants were members of an epidemiological cohort study. 130 female participants underwent the Trier Social Stress Test (TSST) at age 19. Of them, 21 reported a history of self-harm as assessed by the Youth Self Report. Psychiatric diagnoses were recorded. Participants with a history of self-harm showed significantly lower blood cortisol levels throughout the TSST. Early psychosocial adversity did not significantly differ between groups with and without self-harm, with self-harming participants reporting more childhood adversities. These results add to the limited field of studies showing an altered HPA axis activity in females with self-harm. Future studies need to address the causal mechanisms behind this association. Copyright © 2016 Elsevier Ltd. All rights reserved.
Suicide After Deliberate Self-Harm in Adolescents and Young Adults.

PubMed

Olfson, Mark; Wall, Melanie; Wang, Shuai; Crystal, Stephen; Bridge, Jeffrey A; Liu, Shang-Min; Blanco, Carlos

2018-04-01

Among adolescents and young adults with nonfatal self-harm, our objective is to identify risk factors for repeated nonfatal self-harm and suicide death over the following year. A national cohort of patients in the Medicaid program, aged 12 to 24 years ( n = 32 395), was followed for up to 1 year after self-harm. Cause of death information was obtained from the National Death Index. Repeat self-harm per 1000 person-years and suicide deaths per 100 000 person-years were determined. Hazard ratios (HRs) of repeat self-harm and suicide were estimated by Cox proportional hazard models. Suicide standardized mortality rate ratios were derived by comparison with demographically matched general population controls. The 12-month suicide standardized mortality rate ratio after self-harm was significantly higher for adolescents (46.0, 95% confidence interval [CI]: 29.9-67.9) than young adults (19.2, 95% CI: 12.7-28.0). Hazards of suicide after self-harm were significantly higher for American Indians and Alaskan natives than non-Hispanic white patients (HR: 4.69, 95% CI: 2.41-9.13) and for self-harm patients who initially used violent methods (HR: 18.04, 95% CI: 9.92-32.80), especially firearms (HR: 35.73, 95% CI: 15.42-82.79), compared with nonviolent self-harm methods (1.00, reference). The hazards of repeat self-harm were higher for female subjects than male subjects (HR: 1.25, 95% CI: 1.18-1.33); patients with personality disorders (HR: 1.55, 95% CI: 1.42-1.69); and patients whose initial self-harm was treated in an inpatient setting (HR: 1.65, 95% CI: 1.49-1.83) compared with an emergency department (HR: 0.62, 95% CI: 0.55-0.69) or outpatient (1.00, reference) setting. After nonfatal self-harm, adolescents and young adults were at markedly elevated risk of suicide. Among these high-risk patients, those who used violent self-harm methods, particularly firearms, were at especially high risk underscoring the importance of follow-up care to help ensure their safety. Copyright © 2018 by the American Academy of Pediatrics.
Assessing university students' self-efficacy to employ alcohol-related harm reduction strategies.

PubMed

Rosenberg, Harold; Bonar, Erin E; Hoffmann, Erica; Kryszak, Elizabeth; Young, Kathleen M; Kraus, Shane W; Ashrafioun, Lisham; Bannon, Erin E; Pavlick, Michelle

2011-01-01

Develop and evaluate key psychometric properties of a self-report questionnaire specifically designed to assess student drinkers' self-confidence to employ a variety of strategies intended to reduce unhealthy consequences of high-risk drinking. Four hundred ninety-eight participants rated their confidence (from "not at all confident" to "completely confident") to employ 17 harm reduction strategies when drinking. Factor analysis and internal consistency reliability analyses indicated that the 17 items constitute a single scale with good test-retest reliability. Consistent with other research examining previous use of such strategies, women in our sample reported significantly higher harm reduction self-efficacy than did men. Harm reduction self-efficacy was also associated with reported number of high-risk drinking episodes in the previous 2 weeks. This brief and easily administered questionnaire holds promise as a clinical tool to identify individuals with low harm reduction self-efficacy and as an outcome measure for health promotion and educational interventions.
Sunlight exposure: Do health benefits outweigh harm?

PubMed

Razzaque, Mohammed S

2018-01-01

Vitamin D is a fat-soluble vitamin whose levels within the body are elevated following sunlight exposure. Numerous studies have shown that sunlight exposure can provide protection to a wide variety of diseases, ranging from different types of tumors to hypertension to type 1 diabetes to multiple sclerosis. Moreover, studies have shown that avoiding sunlight may influence the initiation and progression of some of these diseases. Avoidance of sunlight, coupled with the inclination towards consuming supplements, is becoming the primary choice to obtain vitamin D. The purpose of this article is to present evidences from published literature, to show that the expected benefits of vitamin D supplements are minimized by the potential risk of cardiovascular events and beyond. Since hypovitaminosis D status usually reflects reduced sunlight exposure, the obvious primary replacement should be safe sunlight exposure, and not exogenous supplements. Copyright © 2016 Elsevier Ltd. All rights reserved.
Ethical Guidelines for Computer Security Researchers: "Be Reasonable"

NASA Astrophysics Data System (ADS)

Sassaman, Len

For most of its existence, the field of computer science has been lucky enough to avoid ethical dilemmas by virtue of its relatively benign nature. The subdisciplines of programming methodology research, microprocessor design, and so forth have little room for the greater questions of human harm. Other, more recently developed sub-disciplines, such as data mining, social network analysis, behavioral profiling, and general computer security, however, open the door to abuse of users by practitioners and researchers. It is therefore the duty of the men and women who chart the course of these fields to set rules for themselves regarding what sorts of actions on their part are to be considered acceptable and what should be avoided or handled with caution out of ethical concerns. This paper deals solely with the issues faced by computer security researchers, be they vulnerability analysts, privacy system designers, malware experts, or reverse engineers.
An analysis of the teratagenic effects that could possibly be due to alcohol consumption by pregnant mothers.

PubMed

Chaudhuri, J D

2000-10-01

It can be concluded that alcohol is definitely harmful to the developing fetus. The effect can manifest in various ways, the most extreme of which is a condition called Fetal Alcohol Syndrome (FAS). The diagnosis of maternal alcoholism leading onto cases of FAS is difficult due to absence of accurate diagnostic tests. The diagnosis of FAS in a child is easier by a proper examination. There is no specific treatment of FAS in a child. The only management is by institution of corrective and rehabilitative measures. The exact mechanism of the teratogenic action of alcohol is not known. It is probably due to the harmful effect of alcohol on the epiblast layer of the bilaminar germ disc. In the absence of adequate knowledge regarding FAS, not much can be done to remedy the deleterious effects of alcohol. Hence, a word of advice to all pregnant women is to avoid drinking during pregnancy.
Resilience and Vulnerability to the Psychological Harm From Flooding: The Role of Social Cohesion.

PubMed

Greene, Giles; Paranjothy, Shantini; Palmer, Stephen R

2015-09-01

We examined the role of social cohesion as a component of vulnerability and resilience to the psychological distress of flooding. A survey collected data from 2238 individuals living in flood-affected areas of England (South Yorkshire and Worcestershire) in 2007. We used Bayesian structural equation modeling to assess factors relating to the latent variables of resilience (years in area, family nearby, and social cohesion) and vulnerability (disruption of essential services, flood risk, and previous flood experience). Flooding was strongly associated with poor mental health; however, resilience factors (associated with the ability to cope with natural disasters), but not vulnerability, were strongly associated with a reduction in psychological distress. Resilience and social cohesion were important influences on the risk of developing poor mental health following flooding. Increasing resilience of communities by strengthening social cohesion through measures that increase civic participation and changing land use should be considered as potentially inexpensive and effective defenses against avoidable mental harm that will result from increased climate instability.

Tobacco and areca nut chewing--reproductive impairments: an overview.

PubMed

Kumar, Sunil

2013-04-01

A large number of people are using smokeless tobacco and areca nut worldwide. Sufficient data on tobacco smoking have harmful effect on human health and reproduction is available. However, data on the smokeless tobacco and areca nut use on human reproduction is scanty. This overview is an attempt to compose on the consumption of smokeless tobacco and areca nut on human reproduction and some relevant experimental data were also included. The existing studies suggest that tobacco and areca nut chewing alone, together or with other ingredients had reproductive toxic potential. Pregnant women using smokeless tobacco during pregnancy also had adverse effect on pregnancy and its outcome. Thus pregnant women must avoid consumption of any mixture containing areca nut and tobacco in order to protect the pregnancy and outcome. The data suggest that smokeless tobacco use is also harmful as smoking for reproduction and use of areca nut might have further compounded the problem. Copyright © 2012 Elsevier Inc. All rights reserved.
Should Providers Discuss Breastfeeding With Women Living With HIV in High-Income Countries? An Ethical Analysis.

PubMed

Johnson, Grace; Levison, Judy; Malek, Janet

2016-11-15

As men and women with human immunodeficiency virus (HIV) are living longer, healthier lives and having children, many questions regarding reproduction in the context of HIV arise. One question is whether breastfeeding is an option for mothers living with HIV. The established recommendation is that women living with HIV in high-income countries avoid breastfeeding. However, some women may still choose to breastfeed for a variety of personal, social, or cultural reasons. Nonmaleficence ("do no harm") must be weighed against maternal autonomy. We propose that providers caring for women in this situation are ethically justified in discussing breastfeeding as a reasonable, though inferior, option. Providers should pursue a shared decision-making approach, engaging in open conversations to learn about the mother's preferences and values, providing education about risks and benefits of various feeding options, and together with the mother formulating a plan to ensure the best possible outcome for the mother and baby. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.
A comparison of Tridimensional Personality Questionnaire dimensions in bipolar disorder and unipolar depression.

PubMed

Young, L T; Bagby, R M; Cooke, R G; Parker, J D; Levitt, A J; Joffe, R T

1995-09-29

The harm avoidance (HA) personality dimension has been hypothesized to be a vulnerability factor for unipolar depression (UD) but not for bipolar disorder (BD). The reported difference on HA scores between these diagnostic groups may have been compromised by the assessment of BD patients who had not fully recovered. To test the diagnostic specificity of elevated HA scores and to elucidate whether assumptions about differences between patients with UD or BD might be attributed to the lingering effects of mood state, the Tridimensional Personality Questionnaire (TPQ) was administered to recovered patients with either BD or UD and a nonpatient comparison group. Both patient groups scored higher on the HA dimension than the nonpatient comparison group, but the patient groups did not differ from one another on this dimension. Moreover, novelty seeking (NS) scores were elevated in subjects with BD compared with both UD patients and nonpatient subjects. These results suggest that high HA scores may be associated with a mood disorder diagnosis, whereas high NS scores may be associated with the BD subtype.
Immunotherapy for Alzheimer's disease: DNA- and protein-based epitope vaccines.

PubMed

Davtyan, Hayk; Petrushina, Irina; Ghochikyan, Anahit

2014-01-01

Active immunotherapy for Alzheimer's disease (AD) is aimed to induce antibodies specific to amyloid-beta (Aβ) that are capable to reduce the level of Aβ in the CNS of Alzheimer's disease patients. First clinical trial AN-1792 that was based on vaccination with full-length Aβ42 showed that safe and effective AD vaccine should induce high titers of anti-Aβ antibodies without activation of harmful autoreactive T cells. Replacement of self-T cell epitope with foreign epitope, keeping self-B cell epitope intact, may allow to induce high titers of anti-Aβ antibodies while avoiding the activation of T cells specific to Aβ. Here we describe the protocols for evaluation of AD DNA- or multiple antigenic peptide (MAP)-based epitope vaccines composed of Aβ(1-11) B cell epitope fused to synthetic T cell epitope PADRE (Aβ(1-11)-PADRE). All protocols could be used for testing any epitope vaccine constructed in your lab and composed of other T cell epitopes using the appropriate peptides in tests for evaluation of humoral and cellular immune responses.
The Effect of Disgust and Fear Modeling on Children’s Disgust and Fear for Animals

PubMed Central

2014-01-01

Disgust is a protective emotion associated with certain types of animal fears. Given that a primary function of disgust is to protect against harm, increasing children’s disgust-related beliefs for animals may affect how threatening they think animals are and their avoidance of them. One way that children’s disgust beliefs for animals might change is via vicarious learning: by observing others responding to the animal with disgust. In Experiment 1, children (ages 7–10 years) were presented with images of novel animals together with adult faces expressing disgust. Children’s fear beliefs and avoidance preferences increased for these disgust-paired animals compared with unpaired control animals. Experiment 2 used the same procedure and compared disgust vicarious learning with vicarious learning with fear faces. Children’s fear beliefs and avoidance preferences for animals again increased as a result of disgust vicarious learning, and animals seen with disgust or fear faces were also rated more disgusting than control animals. The relationship between increased fear beliefs and avoidance preferences for animals was mediated by disgust for the animals. The experiments demonstrate that children can learn to believe that animals are disgusting and threatening after observing an adult responding with disgust toward them. The findings also suggest a bidirectional relationship between fear and disgust with fear-related vicarious learning leading to increased disgust for animals and disgust-related vicarious learning leading to increased fear and avoidance. PMID:24955571
Balancing safety and harm for older adults with dementia in rural emergency departments: healthcare professionals' perspectives.

PubMed

Hunter, Kathleen F; Parke, Belinda; Babb, Maureen; Forbes, Dorothy; Strain, Laurel

2017-01-01

The emergency department (ED) is a potentially harmful environment for older adults with dementia, and rural EDs face unique challenges in providing care to this population. The purpose of this study was to understand safety and harm in rural ED transitional care for community dwelling older adults with dementia from the perspective of healthcare professionals (HCPs). An interpretive, descriptive exploratory design from a social ecological perspective was used. Using purposive and snowball sampling, HCPs were recruited from two rural hospital EDs in two Canadian provinces. Data collection involved participant interviews using a semi-structured interview guide. Audio-recorded interviews were transcribed, transcripts coded, and themes identified using constant comparative analysis with thematic coding. A total of 12 HCPs, seven from one province and five from the other, participated in the study. HCPs worked directly in the ED or consulted in the ED from hospital-based social work, rehabilitation and community liaison services. Three themes were identified: physical environment (space, design and equipment), work environment (pressure to perform) and practice environment (family, knowledge and processes). A conceptual model was developed to illustrate how HCPs worked to balance safety and harm for older patients with dementia within a milieu created by the overlapping and synergistically interacting environments. HCPs in rural EDs working at the interface of hospital and community constantly attempt to balance promoting safety and avoiding harm for older adults with dementia. Participants perceived safety broadly, understanding that the consequences of the milieu were created through an interaction between physical, work and practice environments. These consequences related to the physical, cognitive and emotional wellbeing of older adults with dementia and their caregivers. Within the practice environment, participants identified a 'rural advantage' that was tied to their knowledge of community and the people with dementia and their caregivers who sought care in the participating EDs. However, familiarity can be a double-edged sword and to minimize potential harm healthcare professionals must seek input from caregivers regarding altered functional status, and policies to change triage to include gerontological knowledge and create elder-friendly rural ED environments are needed.
Risk Factors for Repetition of Self-Harm: A Systematic Review of Prospective Hospital-Based Studies

PubMed Central

Larkin, Celine; Di Blasi, Zelda; Arensman, Ella

2014-01-01

Background Self-harm entails high costs to individuals and society in terms of suicide risk, morbidity and healthcare expenditure. Repetition of self-harm confers yet higher risk of suicide and risk assessment of self-harm patients forms a key component of the health care management of self-harm patients. To date, there has been no systematic review published which synthesises the extensive evidence on risk factors for repetition. Objective This review is intended to identify risk factors for prospective repetition of self-harm after an index self-harm presentation, irrespective of suicidal intent. Data sources PubMed, PsychInfo and Scirus were used to search for relevant publications. We included cohort studies which examining factors associated with prospective repetition among those presenting with self-harm to emergency departments. Journal articles, abstracts, letters and theses in any language published up to June 2012 were considered. Studies were quality-assessed and synthesised in narrative form. Results A total of 129 studies, including 329,001 participants, met our inclusion criteria. Some factors were studied extensively and were found to have a consistent association with repetition. These included previous self-harm, personality disorder, hopelessness, history of psychiatric treatment, schizophrenia, alcohol abuse/dependence, drug abuse/dependence, and living alone. However, the sensitivity values of these measures varied greatly across studies. Psychological risk factors and protective factors have been relatively under-researched but show emerging associations with repetition. Composite risk scales tended to have high sensitivity but poor specificity. Conclusions Many risk factors for repetition of self-harm match risk factors for initiation of self-harm, but the most consistent evidence for increased risk of repetition comes from long-standing psychosocial vulnerabilities, rather than characteristics of an index episode. The current review will enhance prediction of self-harm and assist in the efficient allocation of intervention resources. PMID:24465400
[Can the cannabis-prohibition be supported by medical evidence ?

PubMed

Zullino, Daniele; Thorens, Gabriel; Ferreira, Pedro; Rudolf, Aron; Wiesbeck, Gerhard; Cattacin, Sandro

2018-06-06

Currently, important issues around laws on regulation of cannabis use lead to reflect on the prohibition, which is still in force in most countries. The present article attempts to demonstrate by explaining the concepts of the principle of harm, legal paternalism and the precautionary principle that prohibition of cannabis cannot be justified medically. One of the main elements highlighted is that the prohibition does not allow to avoid the consumption and the damages due to cannabis use and that these principles (people should restrain from using cannabis) cannot be applied.
Energy drinks: potions of illusion.

PubMed

Bedi, Nidhi; Dewan, Pooja; Gupta, Piyush

2014-07-01

Energy drinks are widely consumed by adolescents as these claim to improve performance, endurance and alertness. Recent reports have shown that there are no real health benefits of these drinks. On the contrary, certain adverse effects due to energy drinks have come to the forefront, casting a big question-mark on their safety and utility. This review discusses the present status of energy drinks, their active ingredients and their safety. We conclude that energy drinks, despite having some short pleasant effects, can be harmful for the body and are best avoided.
Management of Intracranial Hypertension

PubMed Central

Rangel-Castillo, Leonardo; Gopinath, Shankar; Robertson, Claudia S.

2008-01-01

Effective management of intracranial hypertension involves meticulous avoidance of factors that precipitate or aggravate increased intracranial pressure. When intracranial pressure becomes elevated, it is important to rule out new mass lesions that should be surgically evacuated. Medical management of increased intracranial pressure should include sedation, drainage of cerebrospinal fluid, and osmotherapy with either mannitol or hypertonic saline. For intracranial hypertension refractory to initial medical management, barbiturate coma, hypothermia, or decompressive craniectomy should be considered. Steroids are not indicated and may be harmful in the treatment of intracranial hypertension resulting from traumatic brain injury. PMID:18514825
Ethics in family violence research: cross-cultural issues.

PubMed

Fontes, L A

1998-01-01

This article examines ethical issues in cross-cultural research on family violence. It suggests ways for researchers to increase understanding and avoid abuses of power. Special attention to informed consent, definition of the sample, composition of the research team, research methods, and potential harm and benefit are considered key to designing ethical cross-cultural research. The discussion is illustrated with examples from the literature and from the author's experiences conducting research on sexual abuse in a shanty town in Chile and with Puerto Ricans in the U.S.
Food faddism in pediatrics.

PubMed

Sinatra, F R

1984-01-01

An understanding of the nutritional requirements of healthy, growing infants and children is required to guide parents in appropriate feeding practices which are consistent with their chosen life styles. Among the several prevalent types of food faddism are some that are not harmful or can beneficial, such as breast-feeding, others than can be of long-term benefit but that have limitations in infants and children, and others that can affect infants and children adversely. Those wishing to feed their children unconventional diets should have such diets carefully evaluated to avoid deficiencies of essential nutrients.
Best practices in managing child and adolescent behavioral health emergencies [digest].

PubMed

Feuer, Vera; Rocker, Joshua; Saggu, Babar M; Andrus, Jason M; Wormley, Molly

2018-01-22

Behavioral health emergencies most commonly present as depression, suicidal behavior, aggression, and severe disorganization. Emergency clinicians should avoid relying solely on past medical history or previous psychiatric diagnoses that might prematurely rule out medical pathologies. Treatments for behavioral health emergencies consist of de-escalation interventions aimed at preventing agitation, aggression, and harm. This issue reviews medical pathologies and underlying causes that can result in psychiatric presentations and summarizes evidence-based practices to evaluate, manage, and refer patients with behavioral health emergencies. [Points & Pearls is a digest of Pediatric Emergency Medicine Practice].
[The evaluation of the stress coping styles and emotional intelligence in psychiatrically treated adolescent patients with deliberate self-harm in relation to chosen clinical features].

PubMed

Gmitrowicz, Agnieszka; Szczepaniak, Anna; Jabłkowska-Górecka, Karolina

2012-01-01

The primary goal of the study was an evaluation of the dominating stress coping styles in adolescent patients with self-harm records, who were psychiatrically treated, taking into account the level of their emotional intelligence vs. the psychiatric diagnosis, the type of motives and decision involved in self-harming and the presence of suicidal attempts (SA) in the past. The secondary goal included an analysis of the correlations between particular stress coping skills and the level of emotional intelligence. The reported studies involved self-harming patients aged of 13-18 years during their psychiatric hospitalisation (n=31). The applied tools included the Coping Inventory for Stressful Situations (CISS) and the Two-Dimensional Inventory of Emotional Intelligence (DINEMO). An evaluation of the correlation between stress coping styles and the levels of emotional intelligence in the studied group and the types of mental disorders did not reveal any significant differences between the evaluated subgroups. Patients, who confirmed an instrumental motive, obtained statistically significantly higher scores on the task-oriented scale vs. those who performed the acts of DSH for reactive or pathological reasons. Taking into consideration the type of decision, involved in self-harming acts, did not show any differences in the stress coping styles of the patients, however, those patients, who had planned an act of DSH, achieved statistically significantly higher scores in the OTHERS scale of the DINEMO. Patients with DSH and with SA in the past (77% studied group), achieved similar results in CISS and DINEMO vs. the self-harming patients without SA in the past. In the study group, one statistically significant correlation was demonstrated between CISS--the avoidance-oriented style--and the I in DINEMO. 1. Patients with DSH records and without SA constitute a fairly uniform group with regards to stress coping styles, taking into account the type of psychic disorders and the urgency of self-harm decision. 2. Their use of the task-oriented style may be associated with instrumental auto-aggression. 3. DSH may be a non-verbal form of communicating other problems to others. 4. Adolescents, who perform the acts of self-harm, are endangered by suicidal attempts, regardless of their stress coping styles or the level of their emotional intelligence. 5. A development of constructive stress coping skills against strong emotional reactions is a recommended method in the therapy of patients with DSH.
Smoking and Alcohol Drinking Related to Experience of Harmful Shops among Korean Adolescents.

PubMed

Kim, Jinyoung; Sohn, Aeree

2014-06-01

This study was conducted in order to determine any correlation between experience of harmful shops and adolescent smoking and alcohol drinking in middle and high school students. The survey was conducted using a self-administered questionnaire online via the homepage of the Ministry of Education student Health Information Center; 1888 and 1563 questionnaires were used for middle and high school students, respectively, for a total of 3451 questionnaires in the final analysis. The collected data were processed using SPSS version 21.0 and examined using frequency analysis and hierarchical linear regression. In this research, 8.3% of all participants were found to have experienced smoking and 17.0% alcohol drinking. Regarding the types of harmful shops, 81.8% said they had been to a gaming place; 21.2% to a lodging place; 16.0% to a sex and entertainment place; and 6.8% to a harmful sex industry location. Sociodemographic variables had a significant effect on adolescent smoking and alcohol drinking. Regarding environmental variables, a significant difference was observed for living with parents and school location. Among adolescent experience of harmful shops, both smoking and alcohol drinking showed a significant association with harmful sex industry locations. National government-level management and supervision on this issue will be necessary to prevent adolescent access to harmful shops, along with more studies exploring methods for implementation of policies with more systematic control of harmful shops.
Minors, Moral Psychology, and the Harm Reduction Debate: The Case of Tobacco and Nicotine.

PubMed

Kozlowski, Lynn T

2017-12-01

Harm reduction debates are important in health policy. Although it has been established that morality affects policy, this article proposes that perspectives from moral psychology help to explain the challenges of developing evidence-based policy on prohibition-only versus tobacco/nicotine harm reduction for minors. Protecting youth from tobacco is critical, especially since tobacco/nicotine products are legal for adults, who usually begin using when young. Although cigarettes and other combustibles are the deadliest tobacco products, other products such as smokeless tobacco and electronic cigarettes, though unsafe, are upward of 90 percent less harmful than cigarettes. Disgust at contaminating the "purity" of youth, especially "good," low-risk youth, with any tobacco/nicotine products opposes harm reduction, as does contempt for violating so-called community values and disrespecting authority. Support for harm reduction arises from anger at failing to provide reduced harm to "bad," high-risk individuals and denying them the "liberty" to decide. Fast-thinking, moral-emotional intuitions are supported by rationalizations arising from slow-thinking processes. The recognition of such moral psychological influences and the efforts to minimize their impact may help lead to amelioration and compromise. This example from tobacco control, with divided concerns for low-risk and high-risk youth, can be applied to other harm reduction versus prohibition-only policies directed at minors. Copyright © 2017 by Duke University Press.
Safe prescribing: a titanic challenge

PubMed Central

Routledge, Philip A

2012-01-01

The challenge to achieve safe prescribing merits the adjective ‘titanic’. The organisational and human errors leading to poor prescribing (e.g. underprescribing, overprescribing, misprescribing or medication errors) have parallels in the organisational and human errors that led to the loss of the Titanic 100 years ago this year. Prescribing can be adversely affected by communication failures, critical conditions, complacency, corner cutting, callowness and a lack of courage of conviction, all of which were also factors leading to the Titanic tragedy. These issues need to be addressed by a commitment to excellence, the final component of the ‘Seven C's’. Optimal prescribing is dependent upon close communication and collaborative working between highly trained health professionals, whose role is to ensure maximum clinical effectiveness, whilst also protecting their patients from avoidable harm. Since humans are prone to error, and the environments in which they work are imperfect, it is not surprising that medication errors are common, occurring more often during the prescribing stage than during dispensing or administration. A commitment to excellence in prescribing includes a continued focus on lifelong learning (including interprofessional learning) in pharmacology and therapeutics. This should be accompanied by improvements in the clinical working environment of prescribers, and the encouragement of a strong safety culture (including reporting of adverse incidents as well as suspected adverse drug reactions whenever appropriate). Finally, members of the clinical team must be prepared to challenge each other, when necessary, to ensure that prescribing combines the highest likelihood of benefit with the lowest potential for harm. PMID:22738396
A Non-linear Predictive Model of Borderline Personality Disorder Based on Multilayer Perceptron.

PubMed

Maldonato, Nelson M; Sperandeo, Raffaele; Moretto, Enrico; Dell'Orco, Silvia

2018-01-01

Borderline Personality Disorder is a serious mental disease, classified in Cluster B of DSM IV-TR personality disorders. People with this syndrome presents an anamnesis of traumatic experiences and shows dissociative symptoms. Since not all subjects who have been victims of trauma develop a Borderline Personality Disorder, the emergence of this serious disease seems to have the fragility of character as a predisposing condition. Infect, numerous studies show that subjects positive for diagnosis of Borderline Personality Disorder had scores extremely high or extremely low to some temperamental dimensions (harm Avoidance and reward dependence) and character dimensions (cooperativeness and self directedness). In a sample of 602 subjects, who have had consecutive access to an Outpatient Mental Health Service, it was evaluated the presence of Borderline Personality Disorder using the semi-structured interview for the DSM IV-TR personality disorders. In this population we assessed the presence of dissociative symptoms with the Dissociative Experiences Scale and the personality traits with the Temperament and Character Inventory developed by Cloninger. To assess the weight and the predictive value of these psychopathological dimensions in relation to the Borderline Personality Disorder diagnosis, a neural network statistical model called "multilayer perceptron," was implemented. This model was developed with a dichotomous dependent variable, consisting in the presence or absence of the diagnosis of borderline personality disorder and with five covariates. The first one is the taxonomic subscale of dissociative experience scale, the others are temperamental and characterial traits: Novelty-Seeking, Harm-Avoidance, Self-Directedness and Cooperativeness. The statistical model, that results satisfactory, showed a significance capacity (89%) to predict the presence of borderline personality disorder. Furthermore, the dissociative symptoms seem to have a greater influence than the character traits in the borderline personality disorder e disease. In conclusion, the results seem to indicate that to borderline personality disorder development, contribute both psychic factors, such as temperament and character traits, and environmental factors, such as traumatic events capable of producing dissociative symptoms. These factors interact in a nonlinear way in producing maladaptive behaviors typical of this disorder.
Self-harm in patients with schizophrenia spectrum disorders.

PubMed

Mork, Erlend; Mehlum, Lars; Barrett, Elizabeth A; Agartz, Ingrid; Harkavy-Friedman, Jill M; Lorentzen, Steinar; Melle, Ingrid; Andreassen, Ole A; Walby, Fredrik A

2012-01-01

This study describes the prevalence, clinical characteristics, and gender profile of self-harm in a cross-sectional sample of 388 patients with schizophrenia spectrum disorders. All patients were interviewed and assessed with respect to lifetime self-harm and relevant clinical variables. An overall of 49% of the patients reported self-harm which was associated with female gender, having had a depressive episode, younger age at psychosis onset, alcohol abuse or dependence, current suicidality, awareness of illness, and low adherence to prescribed medication. Higher awareness of having a mental disorder was associated with self-harm in men only, while emotional dysregulation was associated with self-harm in women only. We conclude that while self-harm in patients with schizophrenia spectrum disorders is highly prevalent in both genders, risk factors in men and women differ in several important ways.
Drinking by professional Australian Football League (AFL) players: prevalence and correlates of risk.

PubMed

Dietze, Paul M; Fitzgerald, John L; Jenkinson, Rebecca A

2008-11-03

To examine self-reported patterns of alcohol consumption and experience of alcohol-related harms among professional Australian Football League (AFL) players. Cross-sectional survey of player alcohol consumption and self-reported alcohol-related harms among members of all 16 professional AFL clubs. Data relating to the 2006 football year were collected between 25 July and 30 August 2006 at regular football training sessions using a self-administered structured questionnaire. Risky/high-risk drinking for long- and short-term harm at different times of the year; Alcohol Use Disorders Identification Test (AUDIT) score. 582 AFL players completed the questionnaire (an 83% response rate). Alcohol consumption varied at different times of the year. During the playing season (approximately 22 weeks), the level of risky/high-risk consumption for long-term harm in AFL players (11/564 [2%]) was typically lower than in age-matched Australian men in the general population (15%). However, risky/high-risk consumption for long-term harm was higher in AFL players during the end-of-season period (approximately 2 weeks) (303/561 [54%]) and vacation period (6-8 weeks) (231/559 [41%]) than in age-matched Australian men. Risky/high-risk drinking for short-term harm on a monthly basis was frequent at all times of the year (eg, 395/560 [71%] in the pre-season period). The mean AUDIT score was 8.8 (95% CI, 8.4 to 9.1; range, 0 to 36). Reports of harmful effects of drinking and negative consequences, such as getting involved in a fight (physical or verbal) while drinking (146/556 [26%]), were common. Risky/high-risk consumption for short-term harm on a monthly basis was associated with a variety of player characteristics, such as usually drinking in public locations (odds ratio, 1.55 [95% CI, 1.02 to 2.35]). AUDIT score was associated with variables such as marital status, with married players scoring more than two points lower (95% CI, - 3.58 to - 0.58) than single players. Formal club rules on alcohol consumption had little effect on outcome measures. Drinking among AFL players is intricately related to time of year. This seasonal drinking pattern requires the development of specific club and league strategies to minimise drinking-related harms to players.

From Childhood Trauma to Self-Harm: An Investigation of Theoretical Pathways among Female Prisoners.

PubMed

Howard, Ruth; Karatzias, Thanos; Power, Kevin; Mahoney, Adam

2017-07-01

Despite empirical evidence suggesting complex associations between childhood trauma and self-harm, there is a dearth of research investigating this association in the female prison population. The current study explored pathways to self-harm following childhood trauma, by investigating the mediating roles of Post-traumatic Stress Disorder (PTSD) symptoms, emotion regulation and dissociation, in this relationship, within a sample of 89 female prisoners. Cross-sectional, interview-format, questionnaire study within a female prison population. Measures of childhood trauma, self-harm, PTSD, emotion regulation and dissociation were administered. The majority of the sample (58.4%) reported history of self-harm. Bootstrapped mediation analyses indicated an indirect effect of emotion regulation on the relationship between childhood trauma and self-harm. An indirect effect was also found for PTSD arousal/reactivity cluster of symptoms. Multiple mediation analyses revealed that interactional effects were present for emotion regulation and arousal/reactivity, and emotion regulation and dissociation, respectively. Self-harm is highly prevalent among female prisoners. Interventions promoting emotion regulation and addressing arousal/reactivity symptoms following traumatization may provide an effective way of addressing this problem. Copyright © 2016 John Wiley & Sons, Ltd. Self-harm is highly prevalent amongst female prisoners, occurring in 58.4% of this sample. Emotion regulation and the arousal/reactivity symptom cluster of PTSD were found to mediate the relationship between childhood trauma and self-harm, both independently and simultaneously. Emotion regulation and dissociation were found to interactionally mediate this relationship. Strategies targeting emotion dysregulation and hyperarousal symptoms, amongst female prisoners who have experienced childhood trauma, may be helpful in reducing self-harming behaviours. Copyright © 2016 John Wiley & Sons, Ltd.
Increase in Self-Injury as a Method of Self-Harm in Ghent, Belgium: 1987-2013

PubMed Central

Vancayseele, Nikita; Portzky, Gwendolyn; van Heeringen, Kees

2016-01-01

Background Self-harm is a major health care problem and changes in its prevalence and characteristics can have important implications for suicide prevention. The objective was to describe trends in the epidemiology of self-harm based on emergency department (A&E departments) visits over a 26-year period in Ghent, Belgium. Methods We analyzed data on all self-harm presentations from the three large general hospitals in Ghent between 1987 and 2013. We investigated trends in prevalence (events by year per 100.000), methods and alcohol use. Results Rates of self-harm steadily decreased during the 26-year study period. In general female rates of self-harm were higher than male rates. The mean patient age was 35 years. The most commonly used method of self-harm was self-poisoning by means of an overdose of medication (80.8%), followed by cutting (10.2%) and hanging (4.2%). Psychotropics (including antidepressants, benzodiazepines, barbiturates and other tranquilizers) were the most frequently used drugs (74.5%). A proportional increase in the use of self-injurious methods in self-harm was highly significant, more specifically in the use of hanging, jumping from heights and the use of other violent methods such as the use of firearms, jumping before a moving object or other traffic related injury. Conclusion This epidemiological study showed an increase in the use of high-lethality methods in self-harm which has important implications for suicide prevention. As restrictions in the availability of these methods are difficult or impossible to achieve, prevention programmes will have to emphasize the role of thorough psychosocial assessment and adequate follow-up care of self-harm patients. PMID:27249421
Worker education level is a factor in self-compliance with dust-preventive methods among small-scale agate industrial workers.

PubMed

Aggarwal, Bhagwan D

2013-01-01

High incidences of silicosis are continuing to be reported among the agate workers of small-scale household agate processing units in the Khambhat region of Gujarat (India). The objective of this study was to investigate reasons behind the high prevalence of silicosis, and factors affecting the noncompliance with preventive methods among agate workers. The study was conducted using a questionnaire-based structured interview method among 82 agate workers in Khambhat to assess their awareness level about silicosis and preventive methods, existing morbidity, worker's attitude toward health, and the prevalence of actual use of preventive methods to avoid silica exposure. The majority of the workers (55%) were aware of silicosis and the harmful effects of silica dust exposure (72%) and knew about simple preventive methods to avoid silica dust exposure (80%), but only a minority of the workers (22%) were actually using the simple and available dust-preventive methods. Only 9% of the uneducated workers were using the preventive methods, while usage was higher among educated workers (28%), who had five or more years of schooling, and these workers had fewer health conditions or less morbidity. Gender and job duration had no effect on the usage of dust-preventive methods. The data suggest that noncompliance with use of dust-preventive methods could be the reason behind the higher prevalence of silicosis and health morbidity in agate workers, and that years of schooling plays a significant role in the increased usage and self-compliance with dust-preventive methods among agate workers.
Self-harm and suicide attempts among high-risk, urban youth in the U.S.: shared and unique risk and protective factors.

PubMed

Swahn, Monica H; Ali, Bina; Bossarte, Robert M; Van Dulmen, Manfred; Crosby, Alex; Jones, Angela C; Schinka, Katherine C

2012-01-01

The extent to which self-harm and suicidal behavior overlap in community samples of vulnerable youth is not well known. Secondary analyses were conducted of the "linkages study" (N = 4,131), a cross-sectional survey of students enrolled in grades 7, 9, 11/12 in a high-risk community in the U.S. in 2004. Analyses were conducted to determine the risk and protective factors (i.e., academic grades, binge drinking, illicit drug use, weapon carrying, child maltreatment, social support, depression, impulsivity, self-efficacy, parental support, and parental monitoring) associated with both self-harm and suicide attempt. Findings show that 7.5% of participants reported both self-harm and suicide attempt, 2.2% of participants reported suicide attempt only, and 12.4% of participants reported self-harm only. Shared risk factors for co-occurring self-harm and suicide attempt include depression, binge drinking, weapon carrying, child maltreatment, and impulsivity. There were also important differences by sex, grade level, and race/ethnicity that should be considered for future research. The findings show that there is significant overlap in the modifiable risk factors associated with self-harm and suicide attempt that can be targeted for future research and prevention strategies.
Self-Harm Behaviour in Adolescents: Body Image and Self-Esteem

ERIC Educational Resources Information Center

Oktan, Vesile

2017-01-01

This research aimed to reveal the relationship between self-harm behaviour, body image, and self-esteem, and examined whether there was a difference between the body image and self-esteem of the adolescents who exhibited self-harm behaviour and those who did not. The study was conducted with the participation of 263 high school students--143…
Self-Harm among People with Intellectual Disabilities Living in Secure Service Provision: A Qualitative Exploration

ERIC Educational Resources Information Center

Brown, Jessica; Beail, Nigel

2009-01-01

Background: Research into self-harm among people with intellectual disabilities has focused predominantly on high frequency internally maladaptive behaviour among people whose disability is severe or profound. Research into different forms of self-harm, such as cutting or burning the skin, found in those with mild intellectual disabilities;…
[Prevalence of deliberate self-harm and its relation with suicidal behaviors among students in middle schools in Beijing].

PubMed

Xing, Yi; Qiao, Yijuan; Duan, Jiali; Bai, Chengxu

2015-09-01

To understand the prevalence of deliberate self-harm in middle school students in Beijing, and explore the relationship between self-harm and suicidal behaviors. An anonymous self-administered questionnaire survey was conducted among 5 807 students selected through cluster random sampling from grade 9 to grade 12 in 16 middle schools in Beijing. Among the surveyed middle school students, 35.6% reported that they once had self-harm behaviors, 7.0% reported often had self-harm behaviors in the past 30 days before the survey. More girls reported self-harm behaviors than boys did. And the prevalence of self-harm behaviors was highest in girls in grade 8 and in boys in grade 9. The students in key senior high schools, or living with single or remarried parents were the risk population to have self-harm behaviors. Higher suicide behavior reporting rate was correlated with higher self-harm behavior reporting rate. Compared with students who reported no self-harm behaviors during the past month, the suicide behavior reporting rate in students reporting self-harm behaviors increased by 5.7-12.3 times. Deliberate self-harm behaviors were associated with suicide behaviors among middle school students in Beijing. Early psychological intervention and life education should be carried out among middle school students in order to find risk population and save their life.
Harm Reduction Agencies as a Potential Site for Buprenorphine Treatment.

PubMed

Fox, Aaron D; Chamberlain, Adam; Frost, Taeko; Cunningham, Chinazo O

2015-01-01

Harm reduction agencies complement addiction treatment by providing diverse services that improve the health of people who use drugs. Buprenorphine maintenance treatment (BMT) is an effective opioid addiction treatment that may be provided from flexible settings, potentially including harm reduction agencies. This study investigated attitudes toward different potential sites for BMT (harm reduction agencies, general medical clinics, and drug treatment programs) among harm reduction clients. Using computer-based interviews, participants indicated preferred potential site for BMT (harm reduction agency, drug treatment program, or general medical clinic), interest in BMT by potential site, motivation for treatment, and barriers to BMT. Multivariable logistic regression was used to determine factors associated with harm reduction agency preference. Of 102 opioid users, the most preferred potential site for BMT was a harm reduction agency (51%), whereas fewer preferred general medical clinics (13%), drug treatment programs (12%), or were not interested in BMT (25%). In multivariable analysis, experiencing ≥1 barrier to BMT was strongly associated with preferring harm reduction agencies (adjusted odds ratio [aOR] = 3.39, 95% confidence interval [CI]: 1.00-11.43). The potential to initiate BMT at harm reduction agencies is highly favorable among harm reduction clients, especially among those experiencing barriers to BMT. Offering BMT at harm reduction agencies could improve access to treatment, but studies are needed to determine safety and efficacy of this approach.
Maternal personality traits associated with patterns of prenatal smoking and exposure: Implications for etiologic and prevention research.

PubMed

Massey, Suena H; Reiss, David; Neiderhiser, Jenae M; Leve, Leslie D; Shaw, Daniel S; Ganiban, Jody M

2016-01-01

Little is known about the characteristics of women who smoke during pregnancy beyond demographic factors. We examined the relationship between novelty seeking, harm avoidance, and self-directedness and (a) abstinence from smoking during pregnancy and (b) average daily cigarette consumption during pregnancy. Participants were 826 birth mothers who made adoption placements in the Early Growth and Development Study and completed the Temperament and Character Inventory - Short Form, and interview-based smoking assessments 3-6 months postpartum. Never smokers (n=199), pregnancy abstainers (n=277), pregnancy light smokers (n=184), and pregnancy heavy smokers (n=166) were compared on personality dimensions and smoking-related processes. Using regression analyses we examined relationships between personality and (a) abstinence versus smoking during pregnancy; and (b) average daily cigarette consumption among lifetime smokers, controlling for nicotine dependence, birth father substance dependence, maternal antisocial behavior, and depressive symptoms during pregnancy. Smokers with higher self-directedness and lower harm avoidance were more likely to abstain during pregnancy [O.R. 1.380; 95% C.I. (1.065-1.787); B(SE)=.322(.132); p=.015] and [O.R. .713; 95% C.I. (.543-.935); B(SE)=-.339(.138); p=.014], respectively. Novelty seeking differentiated never smokers from lifetime smokers (t=-3.487; p=.001), but was not significant in multivariate models. Lifetime smokers who abstained during pregnancy reported fewer depressive symptoms relative to never smokers. Personality dimensions associated with abstinence from smoking and cigarettes per day during pregnancy may be important to consider in etiologic and intervention research. Copyright © 2015 Elsevier Inc. All rights reserved.
Sex-dependent correlations between the personality dimension of harm avoidance and the resting-state functional connectivity of amygdala subregions.

PubMed

Li, Ying; Qin, Wen; Jiang, Tianzi; Zhang, Yunting; Yu, Chunshui

2012-01-01

Harm avoidance (HA) is a personality dimension involving the tendency to respond intensely to signals of aversive stimuli. Many previous neuroimaging studies have associated HA scores with the structural and functional organization of the amygdala, but none of these studies have evaluated the correlation between HA score and amygdala resting-state functional connectivity (rsFC). Moreover, the amygdala is not a homogeneous structure, and it has been divided into several structurally and functionally distinct subregions. Investigating the associations between HA score and properties of subregions of the amygdala could greatly improve our understanding of HA. In the present study, using a large sample of 291 healthy young adults, we aimed to uncover correlations between HA scores and the rsFCs of each amygdala subregion and to uncover possible sex-based differences in these correlations. We found that subregions of the amygdala showed different rsFC patterns, which contributed differently to individual HA scores. More specifically, HA scores were correlated with rsFCs between the laterobasal amygdala subregion and temporal and occipital cortices related to emotional information input, between the centromedial subregion and the frontal cortices associated with emotional output control, and between the superficial subregion and the frontal and temporal areas involved in both functions. Moreover, significant gender-based differences were uncovered in these correlations. Our findings provide a more detailed model of association between HA scores and amygdala rsFC, extend our understanding of the connectivity of subregions of the amygdala, and confirm sex-based differences in HA associations.
Scholars’ open debate paper on the World Health Organization ICD-11 Gaming Disorder proposal

PubMed Central

Aarseth, Espen; Bean, Anthony M.; Boonen, Huub; Colder Carras, Michelle; Coulson, Mark; Das, Dimitri; Deleuze, Jory; Dunkels, Elza; Edman, Johan; Ferguson, Christopher J.; Haagsma, Maria C.; Helmersson Bergmark, Karin; Hussain, Zaheer; Jansz, Jeroen; Kardefelt-Winther, Daniel; Kutner, Lawrence; Markey, Patrick; Nielsen, Rune Kristian Lundedal; Prause, Nicole; Przybylski, Andrew; Quandt, Thorsten; Schimmenti, Adriano; Starcevic, Vladan; Stutman, Gabrielle; Van Looy, Jan; Van Rooij, Antonius J.

2017-01-01

Concerns about problematic gaming behaviors deserve our full attention. However, we claim that it is far from clear that these problems can or should be attributed to a new disorder. The empirical basis for a Gaming Disorder proposal, such as in the new ICD-11, suffers from fundamental issues. Our main concerns are the low quality of the research base, the fact that the current operationalization leans too heavily on substance use and gambling criteria, and the lack of consensus on symptomatology and assessment of problematic gaming. The act of formalizing this disorder, even as a proposal, has negative medical, scientific, public-health, societal, and human rights fallout that should be considered. Of particular concern are moral panics around the harm of video gaming. They might result in premature application of diagnosis in the medical community and the treatment of abundant false-positive cases, especially for children and adolescents. Second, research will be locked into a confirmatory approach, rather than an exploration of the boundaries of normal versus pathological. Third, the healthy majority of gamers will be affected negatively. We expect that the premature inclusion of Gaming Disorder as a diagnosis in ICD-11 will cause significant stigma to the millions of children who play video games as a part of a normal, healthy life. At this point, suggesting formal diagnoses and categories is premature: the ICD-11 proposal for Gaming Disorder should be removed to avoid a waste of public health resources as well as to avoid causing harm to healthy video gamers around the world. PMID:28033714
Scholars' open debate paper on the World Health Organization ICD-11 Gaming Disorder proposal.

PubMed

Aarseth, Espen; Bean, Anthony M; Boonen, Huub; Colder Carras, Michelle; Coulson, Mark; Das, Dimitri; Deleuze, Jory; Dunkels, Elza; Edman, Johan; Ferguson, Christopher J; Haagsma, Maria C; Helmersson Bergmark, Karin; Hussain, Zaheer; Jansz, Jeroen; Kardefelt-Winther, Daniel; Kutner, Lawrence; Markey, Patrick; Nielsen, Rune Kristian Lundedal; Prause, Nicole; Przybylski, Andrew; Quandt, Thorsten; Schimmenti, Adriano; Starcevic, Vladan; Stutman, Gabrielle; Van Looy, Jan; Van Rooij, Antonius J

2017-09-01

Concerns about problematic gaming behaviors deserve our full attention. However, we claim that it is far from clear that these problems can or should be attributed to a new disorder. The empirical basis for a Gaming Disorder proposal, such as in the new ICD-11, suffers from fundamental issues. Our main concerns are the low quality of the research base, the fact that the current operationalization leans too heavily on substance use and gambling criteria, and the lack of consensus on symptomatology and assessment of problematic gaming. The act of formalizing this disorder, even as a proposal, has negative medical, scientific, public-health, societal, and human rights fallout that should be considered. Of particular concern are moral panics around the harm of video gaming. They might result in premature application of diagnosis in the medical community and the treatment of abundant false-positive cases, especially for children and adolescents. Second, research will be locked into a confirmatory approach, rather than an exploration of the boundaries of normal versus pathological. Third, the healthy majority of gamers will be affected negatively. We expect that the premature inclusion of Gaming Disorder as a diagnosis in ICD-11 will cause significant stigma to the millions of children who play video games as a part of a normal, healthy life. At this point, suggesting formal diagnoses and categories is premature: the ICD-11 proposal for Gaming Disorder should be removed to avoid a waste of public health resources as well as to avoid causing harm to healthy video gamers around the world.
Non-suicidal Self-injury in Different Eating Disorder Types: Relevance of Personality Traits and Gender.

PubMed

Islam, Mohammed A; Steiger, Howard; Jimenez-Murcia, Susana; Israel, Mimi; Granero, Roser; Agüera, Zaida; Castro, Rita; Sánchez, Isabel; Riesco, Nadine; Menchón, José M; Fernández-Aranda, Fernando

2015-11-01

The study explored lifetime prevalence of non-suicidal self-injury (NSSI) in female and male individuals with eating disorders (ED) and compared ED symptoms, general psychopathology and personality traits across individuals with and without a history of NSSI. The incremental discriminative capacity of gender on the manifestation of lifetime NSSI was also studied. A total sample of 1649 consecutively admitted ED patients (1515 women and 134 men) participated in the current study [339 ED + NSSI (ED with NSSI) and 1310 ED - NSSI (ED without NSSI)]. Specific self-report measures were included and other clinical and psychopathological indices. The observed lifetime prevalence of NSSI was 20.6% (20.9% in women and 17.2% in men). NSSI was not associated with ED type or gender. However, ED + NSSI patients exhibited more impulsive behaviour, substance-abuse disorders and additional impulse-control disorders, were younger and had more previous treatments. Age was shown to affect the presentation of NSSI. Additionally, ED + NSSI patients exhibited more severe ED and general psychopathological symptoms and had more dysfunctional personality traits when compared with ED - NSSI. ED + NSSI was found to be positively associated with harm avoidance and self-transcendence but negatively with reward dependence, self-directedness and cooperativeness. Thus, the variables with stronger capacity to identify the presence of ED + NSSI were younger age, harm avoidance, self-directedness and self-transcendence. A lack of association between sex and ED subtype with the presence of NSSI was observed. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.
Anxiety Sensitivity and Smoking Behavior Among Trauma-Exposed Daily Smokers: The Explanatory Role of Smoking-Related Avoidance and Inflexibility.

PubMed

Bakhshaie, Jafar; Zvolensky, Michael J; Salazar, Adriana; Vujanovic, Anka A; Schmidt, Norman B

2016-01-01

Anxiety sensitivity (AS), defined as the extent to which individuals believe that anxiety-related sensations have harmful consequences, is associated with smoking processes and poorer clinical outcomes among trauma-exposed smokers. Yet the specific mechanisms underlying this association are unclear. Smoking-specific avoidance and inflexibility is a construct implicated in multiple manifestations of mood regulation that may underlie smoking behavior. The current study examined the explanatory role of smoking-specific avoidance and inflexibility in terms of the relation between AS and indices of smoking behavior among trauma-exposed smokers. The sample consisted of 217 treatment-seeking adult smokers (44% female; M age = 37.8; SD = 13.2; age range: 18-65 years), who were exposed to at least one lifetime Criterion A trauma event (Diagnostic and Statistical Manual of Mental Disorders [4th ed., text rev.; DSM-IV-TR] Criterion A for trauma exposure). Bootstrap analysis (5,000 re-samples) revealed that AS was indirectly related to the (a) number of cigarettes smoked per day, (b) number of years being a daily smoker, (c) number of failed quit attempts, and (d) heaviness of smoking index among trauma-exposed smokers through its relation with smoking-specific avoidance and inflexibility. These findings provide initial evidence suggesting that smoking-specific avoidance and inflexibility may be an important construct in better understanding AS-smoking relations among trauma-exposed smokers. Future work is needed to explore the extent to which smoking-specific avoidance and inflexibility account for relations between AS and other smoking processes (e.g., withdrawal, cessation outcome) in the context of trauma and smoking comorbidity. © The Author(s) 2015.
Testing conditions in shock-based contextual fear conditioning influence both the behavioral responses and the activation of circuits potentially involved in contextual avoidance.

PubMed

Viellard, Juliette; Baldo, Marcus Vinicius C; Canteras, Newton Sabino

2016-12-15

Previous studies from our group have shown that risk assessment behaviors are the primary contextual fear responses to predatory and social threats, whereas freezing is the main contextual fear response to physically harmful events. To test contextual fear responses to a predator or aggressive conspecific threat, we developed a model that involves placing the animal in an apparatus where it can avoid the threat-associated environment. Conversely, in studies that use shock-based fear conditioning, the animals are usually confined inside the conditioning chamber during the contextual fear test. In the present study, we tested shock-based contextual fear responses using two different behavioral testing conditions: confining the animal in the conditioning chamber or placing the animal in an apparatus with free access to the conditioning compartment. Our results showed that during the contextual fear test, the animals confined to the shock chamber exhibited significantly more freezing. In contrast, the animals that could avoid the conditioning compartment displayed almost no freezing and exhibited risk assessment responses (i.e., crouch-sniff and stretch postures) and burying behavior. In addition, the animals that were able to avoid the shock chamber had increased Fos expression in the juxtadorsomedial lateral hypothalamic area, the dorsomedial part of the dorsal premammillary nucleus and the lateral and dorsomedial parts of the periaqueductal gray, which are elements of a septo/hippocampal-hypothalamic-brainstem circuit that is putatively involved in mediating contextual avoidance. Overall, the present findings show that testing conditions significantly influence both behavioral responses and the activation of circuits involved in contextual avoidance. Copyright © 2016 Elsevier B.V. All rights reserved.
Healthcare avoidance by people who inject drugs in Bangkok, Thailand.

PubMed

Heath, A J; Kerr, T; Ti, L; Kaplan, K; Suwannawong, P; Wood, E; Hayashi, K

2016-09-01

Although people who inject drugs (IDU) often contend with various health-related harms, timely access to health care among this population remains low. We sought to identify specific individual, social and structural factors constraining healthcare access among IDU in Bangkok, Thailand. Data were derived from a community-recruited sample of IDU participating in the Mitsampan Community Research Project between July and October 2011. We assessed the prevalence and correlates of healthcare avoidance due to one's drug use using multivariate logistic regression. Among 437 participants, 112 (25.6%) reported avoiding health care because they were IDU. In multivariate analyses, factors independently associated with avoiding health care included having ever been drug tested by police [adjusted odds ratio (AOR) = 1.80], experienced verbal abuse (AOR = 3.15), been discouraged from engaging in usual family activities (AOR = 3.27), been refused medical care (AOR = 10.90), experienced any barriers to health care (AOR = 4.87) and received healthcare information and support at a drop-in centre (AOR = 1.92) (all P < 0.05). These findings highlight the need to address the broader policy environment, which perpetuates the criminalization and stigmatization of IDU, and to expand peer-based interventions to facilitate access to health care for IDU in this setting. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Azadirachtin induced larval avoidance and antifeeding by disruption of food intake and digestive enzymes in Drosophila melanogaster (Diptera: Drosophilidae).

PubMed

Bezzar-Bendjazia, Radia; Kilani-Morakchi, Samira; Maroua, Ferdenache; Aribi, Nadia

2017-11-01

Botanical insecticides are a promising alternative to reduce the harmful effects of synthetic chemicals. Among the botanical biopesticides, azadirachtin obtained from the Indian neem tree Azadirachta indica A. Juss. (Meliaceae) is probably the biorational insecticide with greatest agriculture use nowadays due to its broad insecticide activity. The current study, evaluated the lethal and sublethal effects of azadirachtin on larval avoidance, food intake and digestive enzymes of Drosophila melanogaster larvae as biological model. Azadirachtin was applied topically at two doses LD 25 (0.28μg) and LD 50 (0.67μg) on early third instars larvae. Results evaluated 24h after treatment showed that larvae exhibited significant repellence to azadirachtin and prefer keeping in untreated arenas rather than moving to treated one. In addition, azadirachtin avoidance was more marked in larvae previously treated with this compound as compared with naïf larvae (controls). Moreover, azadirachtin treatment decreased significantly the amount of larval food intake. Finally, azadirachtin reduced significantly the activity of larval α-amylase, chitinase and protease and increased the activity of lipase. This finding showed that azadirachtin induced behavioral and physiological disruption affecting the ability of the insect to digest food. This rapid installation of avoidance and long term antifeedancy might reinforce the action of azadirachtin and provide a new behavioral strategy for integrated pest management programs. Copyright © 2017 Elsevier Inc. All rights reserved.
Replacement of harmful animal use in life science education: the approach and activities of InterNICHE.

PubMed

Jukes, Nick

2004-06-01

Harmful animal use in undergraduate education is increasingly being replaced by alternatives, such as computer software, manikins and simulators, ethically sourced animal cadavers, apprentice work with animal patients, and student self-experimentation. Combinations of such alternatives can better meet teaching objectives, reduce costs and avoid the negative pedagogical and social impact of animal experimentation. Since 1988, the International Network for Humane Education (InterNICHE, formerly EuroNICHE) has been working with teachers to replace harmful animal use and has been supporting students' right to conscientious objection. This paper presents the approach, history and current activities of InterNICHE. With a vision of 100% replacement, the network aims for empowerment by networking information and providing support. It works with the belief that most teachers want investment in the best quality and most humane education possible. The forthcoming second edition of the InterNICHE book, from Guinea Pig to Computer Mouse,1 includes practical details of progressive teaching aids and approaches, as well as case studies from teachers who employ such alternatives. In 1999, InterNICHE produced the film Alternatives in Education, now available in 20 languages. Such resources are complemented by outreach trips and conferences and an Alternatives Loan System, which offers products for familiarisation and assessment. The InterNICHE website (www.interniche.org) was launched in 2001.
Rethinking maternal-fetal conflict: gender and equality in perinatal ethics.

PubMed

Harris, L H

2000-11-01

Practitioners who care for pregnant women face dilemmas when their patients use illicit drugs, reject medical recommendations, or cause fetal harm. Many ethics scholars characterize those situations as maternal-fetal conflicts. In conflict-based models, maternal rights are considered to conflict with fetal rights, or moral obligations owed to pregnant women are considered to conflict with those owed to their fetuses. I offer an alternative model of pregnancy ethics by applying relational and equality-based moral theories to situations of fetal harm by pregnant women. In this model, clinicians faced with ethical dilemmas should attempt to understand pregnant women and their decisions within their broad social networks and communities, ask how the clinician's personal standpoint influences outcomes judged to be ethical, and determine whether the clinician's ethical formulations reduce or enhance existing gender, class, or racial inequality. This model focuses on the mutual needs of pregnant women and fetuses rather than on their mutually exclusive needs. It also avoids many pitfalls of traditional ethical formulations, specifically their tendency to neglect gender-specific modes of moral reasoning, their implicit assumptions that application of universal principles like autonomy and beneficence results in objective ethical solutions, and their failure to account for the ways that projecting fetal needs perpetuates social inequalities. This model provides the ethical foundations for moving law and policy away from criminalization and toward prevention of prenatal harm.
"Avoid health warnings on all tobacco products for just as long as we can": a history of Australian tobacco industry efforts to avoid, delay and dilute health warnings on cigarettes

PubMed Central

Chapman, S; Carter, S

2003-01-01

Objective: To review critically the history of Australian tobacco industry efforts to avoid, delay, and dilute pack warnings on cigarettes. Design: Systematic keyword and opportunistic website searches of tobacco industry internal documents made available through the Master Settlement Agreement. Results: Four industry strategies and six recurrent arguments used by the industry are described, which were used to thwart the passage of three generations of health warnings (implemented in 1973, 1987, and 1995). These strategies are shown to have been associated with major delays in the implementation of the warnings and in keeping them inconspicuous, unattributed to the industry and non-specific, and particularly in delaying the use of warnings about addiction. The industry today continues to oppose warnings, which might "repel" smokers from tobacco use. Conclusions: Efforts by governments to introduce potent health warnings will be resisted by the tobacco industry. Tobacco control advocates should anticipate and counter the strategies and arguments used by the industry, which are described in this paper if they wish to maximise the use of the pack as a vehicle for raising awareness about the harms of smoking. PMID:14645944

Growing Pains: Development of the Larval Nocifensive Response in Drosophila

PubMed Central

SULKOWSKI, MIKOLAJ J.; KUROSAWA, MATHIEU S.; OX, DANIEL N.

2014-01-01

The ability to perceive and avoid harmful substances or stimuli is key to an organism’s survival. The neuronal cognate of the perception of pain is known as nociception, and the reflexive motion to avoid pain is termed the nocifensive response. As the nocifensive response is an ancient and evolutionarily conserved behavioral response to nociceptive stimuli, it is amenable to study in relatively simple and genetically tractable model systems such as Drosophila. Recent studies have taken advantage of the useful properties of Drosophila larvae to begin elucidating the neuronal connectivity and molecular machinery underlying the nocifensive response. However, these studies have primarily utilized the third-instar larval stage, and many mutations that potentially influence nociception survive only until earlier larval stages. Here we characterize the nocifensive responses of Drosophila throughout larval development and find dramatic changes in the nature of the behavior. Notably, we find that prior to the third instar, larvae are unable to perform the characteristic “corkscrew-like roll” behavior. Also, we identify an avoidance behavior consistent with a nocifensive response that is present immediately after larval hatching, representing a paradigm that may be useful in examining mutations with an early lethal phenotype. PMID:22186918
Australian adult smokers’ responses to plain packaging with larger graphic health warnings 1 year after implementation: results from a national cross-sectional tracking survey

PubMed Central

Wakefield, Melanie; Coomber, Kerri; Zacher, Meghan; Durkin, Sarah; Brennan, Emily; Scollo, Michelle

2015-01-01

Background We assessed whether the Australian plain packs with larger graphic health warnings (GHWs) achieved three specific objectives of reducing the appeal of tobacco, increasing health warning effectiveness and reducing the ability of packaging to mislead about smoking harms. Methods We compared responses from continuous cross-sectional telephone surveys of n=2176 cigarette smokers during pre-plain packaging (April–September 2012, pre-PP) with n=759 surveyed in the transition period (October–November 2012) and n=4240 during the first year of implementation (December 2012–November 2013, PP year 1), using multivariate logistic regression analyses. Results From pre-PP to PP year 1, more smokers disliked their pack (p<0.001), perceived lower pack appeal (p<0.001), lower cigarette quality (p<0.001), lower satisfaction (p<0.001) and lower value (p<0.001) and disagreed brands differed in prestige (p=0.003). There was no change in perceived differences in taste of different brands. More smokers noticed GHWs (p<0.001), attributed much motivation to quit to GHWs (p<0.001), avoided specific GHWs when purchasing (p<0.001), and covered packs (p<0.001), with no change in perceived exaggeration of harms. PP year 1 saw an increased proportion believing that brands do not differ in harmfulness (p=0.004), but no change in the belief that variants do not differ in strength or the perceived harmfulness of cigarettes compared with a year ago. Interactions signified greater change for four outcomes assessing aspects of appeal among young adults and two appeal outcomes among mid-aged adults. Conclusions The specific objectives of plain packaging were achieved and generally sustained among adult smokers up to 12 months after implementation. PMID:28407606
Men's preferences and trade-offs for prostate cancer screening: a discrete choice experiment.

PubMed

Howard, Kirsten; Salkeld, Glenn P; Patel, Manish I; Mann, Graham J; Pignone, Michael P

2015-12-01

Prostate cancer screening using prostate-specific antigen (PSA) remains controversial. In deciding about screening, men must weigh the benefits and harms: little is known about benefit: harm trade-offs men are willing to accept. The objective of this study was to assess men's preferences for PSA screening, and the trade-offs between benefits and harms men are willing to accept when deciding about screening. Preferences of 662 men aged 40-69 were assessed using a discrete choice experiment. PSA screening was described by six attributes: prostate cancer deaths, prostate cancer diagnoses, unnecessary biopsies from false-positive PSA tests, impotence, urinary incontinence/bowel problems and cost. A mixed logit model was used to examine the influence of attributes on men's preferences for PSA testing; benefit: harm trade-offs were also calculated. Men's preferences were significantly influenced by test characteristics, particularly potential mortality benefit, unnecessary biopsies and likelihood of urinary incontinence or bowel problems; preferences were also influenced by age, prior PSA testing experience and perceived risk of prostate cancer. Men were willing to accept between 65 and 233 of 10 000 extra men with unnecessary biopsies, and between 31 and 72 of 10 000 extra men with incontinence/bowel problems to avoid one prostate cancer death. Differences in valuations of attributes and trade-offs acceptable to men of different ages suggest a one size fits all approach to PSA testing, regardless of age, may not reflect men's preferences. Our results can be used by policymakers to ensure screening programmes are in line with men's preferences and by clinicians and patients to facilitate informed discussions of the most relevant benefits and downsides of PSA screening for an individual man. © 2014 John Wiley & Sons Ltd.
Is Personality Associated with Secondhand Harm from Drinking?

PubMed

Davis MacNevin, Parnell; Thompson, Kara; Teehan, Michael; Stuart, Heather; Stewart, Sherry

2017-09-01

Prior research suggests more than 70% of undergraduates have experienced harm from other students' drinking. This study built on the literature by, first, investigating whether secondhand harm cluster into latent factors that reflect distinct but related types of harm. Second, given the paucity of research examining factors that increase students' vulnerability to secondhand harm, we examined dimensions from Castellanos-Ryan and Conrod's 4-factor personality model for alcohol disorders (impulsivity [IMP], sensation seeking [SS], hopelessness [HOP], anxiety sensitivity [AS]) as predictors of secondhand harm exposure. We also investigated the possible mediating role of students' own problematic alcohol use in explaining personality-secondhand harm relationships. An online survey was administered to 1,537 first-year Canadian undergraduates (68% women). Problematic alcohol use was measured by the Alcohol Use Disorders Identification Test, and personality was measured by the Substance Use Risk Profile Scale. Eleven secondhand harm items were included. The secondhand harm clustered into 3 distinct but related factors: "strains" (e.g., interruption of sleep or study), "threats" (e.g., harassment or assault), and "interpersonal harm" (e.g., arguments with peers). Sixty-eight percent of respondents reported strains, 44% threats, and 64% interpersonal harm, and 35% reported experiencing all 3 types of harm, in the last term. All 4 personality dimensions were independently associated with greater secondhand harm exposure. HOP was directly associated with threats and interpersonal harm, and AS was directly associated with all 3 types of harm. SS and IMP were both indirectly associated with all 3 types of harm through students' own problematic alcohol use. In addition, IMP was directly related to threats. The prevalence of secondhand harm from alcohol is high among undergraduates. Findings suggest that distinct personality risks may predispose students to experience secondhand harm, albeit perhaps through different mechanisms. Implications for future research, prevention, and policy development are discussed. Copyright © 2017 by the Research Society on Alcoholism.
Predictors for repeat self-harm and suicide among older people within 12 months of a self-harm presentation.

PubMed

Cheung, Gary; Foster, Gisele; de Beer, Wayne; Gee, Susan; Hawkes, Tracey; Rimkeit, Sally; Tan, Yu Mwee; Merry, Sally; Sundram, Frederick

2017-08-01

A past history of self-harm is a significant risk factor for suicide in older people. The aims of this study are to (i) characterize older people who present with self-harm to emergency departments (EDs); and (ii) determine the predictors for repeat self-harm and suicide. Demographic and clinical data were retrospectively collected on older people (age 65+ years), who presented to seven EDs in New Zealand following an episode of self-harm between 1st July 2010 and 30th June 2013. In addition, 12-month follow-up information on repeat self-harm and suicide was collected. The sample included 339 older people (55.2% female) with an age range of 65-96 years (mean age = 75.0; SD = 7.6). Overdose (68.7%) was the most common method of self-harm. 76.4% of the self-harm cases were classified as suicide attempts. Perceived physical illness (47.8%) and family discord (34.5%) were the most common stressors. 12.7% of older people repeated self-harm and 2.1% died by suicide within 12 months. Older people who had a positive blood alcohol reading (OR = 3.87, 95% Cl = 1.35-11.12, p = 0.012) and were already with mental health services at the index self-harm (OR = 2.73, 95% Cl = 1.20-6.25, p = 0.047) were more likely to repeat self-harm/suicide within 12 months. Older people who self-harm are at very high risk of repeat self-harm and suicide. Screening and assessment for alcohol use disorders should be routinely performed following a self-harm presentation, along with providing structured psychological treatment as an adjunct to pharmacological treatment for depression and interventions to improve the person's resilience resources.
Effectiveness and cost-effectiveness of policies and programmes to reduce the harm caused by alcohol.

PubMed

Anderson, Peter; Chisholm, Dan; Fuhr, Daniela C

2009-06-27

This paper reviews the evidence for the effectiveness and cost-effectiveness of policies and programmes to reduce the harm caused by alcohol, in the areas of education and information, the health sector, community action, driving while under the influence of alcohol (drink-driving), availability, marketing, pricing, harm reduction, and illegally and informally produced alcohol. Systematic reviews and meta-analyses show that policies regulating the environment in which alcohol is marketed (particularly its price and availability) are effective in reducing alcohol-related harm. Enforced legislative measures to reduce drink-driving and individually directed interventions to already at-risk drinkers are also effective. However, school-based education does not reduce alcohol-related harm, although public information and education-type programmes have a role in providing information and in increasing attention and acceptance of alcohol on political and public agendas. Making alcohol more expensive and less available, and banning alcohol advertising, are highly cost-effective strategies to reduce harm. In settings with high amounts of unrecorded production and consumption, increasing the proportion of alcohol that is taxed could be a more effective pricing policy than a simple increase in tax.
Relationship between chronotype and temperament/character among university students.

PubMed

Lee, Kounseok; Lee, Hye-Kyung; Jhung, Kyungun; Park, Jin Young

2017-05-01

Chronotype is largely classified as being morning or evening types according to preference for daily activity and the preferred bedtime. This study examined the relationship between chronotype and temperament/character dimensions among university students. A total of 2857 participants completed the 140-item Temperament and Character Inventory-Revised Short version (TCI-RS) from a 5-score scale as well as the 13-item composite scale for morningness-eveningness (CSM). In this study, we classified chronotype as "morning," "neither," or "evening" types according to CSM scores and compared the scores in terms of 4 temperament dimensions and 3 character dimensions. The evening type showed high values for novelty seeking and harm avoidance, whereas the morning type had high scores for persistence, self-directedness, and cooperativeness. A logistic regression analysis after controlling for age and gender showed that chronotype significantly associated with persistence and novelty seeking. The results of this study suggest that chronotype is different according to gender and age and in addition, chronotype closely correlates with temperament and character. Among these, eveningness was associated with high novelty seeking, whereas morningness was associated with high persistence. Further studies are required to investigate the relationship between chronotype and temperament/character dimensions in a wider age bracket. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.
Risk profiles of personality traits for suicidality among mood disorder patients and community controls.

PubMed

Su, M-H; Chen, H-C; Lu, M-L; Feng, J; Chen, I-M; Wu, C-S; Chang, S-W; Kuo, P-H

2018-01-01

To examine the associations between personality traits and suicidal ideation (SI) and attempt (SA) in mood disorder patients and community controls. We recruited 365 bipolar, 296 major depressive disorder patients, and 315 community controls to assess their lifetime suicidality. Participants filled out self-reported personality questionnaires to collect data of personality traits, including novelty seeking (NS), harm avoidance (HA), extraversion (E), and neuroticism (N). We used logistic regression models adjusted for diagnoses to analyze combinational effects of personality traits on the risk of suicide. Additionally, radar charts display personality profiles for suicidal behaviours by groups. All personality traits were associated with the risk of suicidality with various effect size, except for E that showed protective effect. High N or HA had prominent and independent risk effects on SI and SA. Combinations of high N and low E, or high HA and NS were the risk personality profiles for suicidality. Higher N scores further distinguished SA from SI in mood disorder patients. Introvert personality traits showed independent risk effects on suicidality regardless of diagnosis status. Among high-risk individuals with suicidal thoughts, higher neuroticism tendency is further associated with increased risk of suicide attempt. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Personality profiles in adults with attention deficit hyperactivity disorder (ADHD).

PubMed

Perroud, Nader; Hasler, Roland; Golay, Nicolas; Zimmermann, Julien; Prada, Paco; Nicastro, Rosetta; Aubry, Jean-Michel; Ardu, Stefano; Herrmann, François R; Giannakopoulos, Panteleimon; Baud, Patrick

2016-06-14

Previous studies suggested that the presence of ADHD in children and young adolescents may affect the development of personality. Whether or not the persistence of ADHD in adult life is associated with distinct personality patterns is still matter for debate. To address this issue, we compared the profiles of the Temperament and Character Inventory (TCI) that assesses personality dimensions in 119 adults ADHD and 403 controls. ANCOVA were used to examine group differences (controls vs. ADHD and ADHD inattentive type vs. ADHD combined + hyperactive/impulsive types) in Temperaments and Characters. Partial correlation coefficients were used to assess correlation between TCI and expression and severity of symptoms of ADHD. High novelty seeking (NS), harm avoidance (HA) and self-transcendence (ST) scores as well as low self-directedness (SD) and cooperativeness (C) scores were associated with ADHD diagnosis. Low SD was the strongest personality trait associated with adult ADHD. Cases with the ADHD inattentive type showed higher HA and lower SD scores compared to the combined and hyperactive/impulsive types. High HA scores correlated with inattention symptoms whereas high NS and ST scores were related to hyperactive symptoms. Finally low SD and high NS were associated with increased ADHD severity. Distinct temperaments were associated with inattentive versus hyperactive/impulsive symptoms supporting the heterogeneous nature of the disorder.
[Opiate dependence type II or antisocial: Cloninger's Psychobiological Model and its usefullness in addictions].

PubMed

Benito, Ana; Haro, Gonzalo; Orengo, Teresa; González, Marisa; Fornés, Teresa; Mateu, César

2012-01-01

The aim was to analyze the relationship between Cloninger's dimensions and Personality Disorders (PD) (with DSM-IV criteria) in opiate dependents. The study was Cross-sectional. The sampling of 196 patients with opiate dependence was consecutive. All were receiving treatment in an inpatient detoxification unit. Cloninger's Temperament and Character Inventory (TCI), International Personality Disorders Examination (IPDE) and a Substance Use Questionnaire were used. Character's dimensions as Self-directness and Cooperation were related with PD when scored low. Opposite to Cloninger descriptions, high scores of Self-transcendence were related with presence of PD. Related to temperamental dimensions, cluster A was related with low scores of Reward Dependence (RD) and cluster C with high scores of Harm Avoidance (HA). Otherwise, in cluster B, while Borderline PD had high scores of Novelty Seeking (as high HA), the Antisocial PD only were related to low scores of RD. RD dimension seems useful to differ from presence or absence of Antisocial PD, also when alcohol consumption is considered. Cloninger's Model of Personality is useful in drug dependents for the definition of the different PD, as well as for probable PD's aggregation. This model also helps to create subtypes in opiate dependents as the antisocial or type II.
Accuracy of risk scales for predicting repeat self-harm and suicide: a multicentre, population-level cohort study using routine clinical data.

PubMed

Steeg, Sarah; Quinlivan, Leah; Nowland, Rebecca; Carroll, Robert; Casey, Deborah; Clements, Caroline; Cooper, Jayne; Davies, Linda; Knipe, Duleeka; Ness, Jennifer; O'Connor, Rory C; Hawton, Keith; Gunnell, David; Kapur, Nav

2018-04-25

Risk scales are used widely in the management of patients presenting to hospital following self-harm. However, there is evidence that their diagnostic accuracy in predicting repeat self-harm is limited. Their predictive accuracy in population settings, and in identifying those at highest risk of suicide is not known. We compared the predictive accuracy of the Manchester Self-Harm Rule (MSHR), ReACT Self-Harm Rule (ReACT), SAD PERSONS Scale (SPS) and Modified SAD PERSONS Scale (MSPS) in an unselected sample of patients attending hospital following self-harm. Data on 4000 episodes of self-harm presenting to Emergency Departments (ED) between 2010 and 2012 were obtained from four established monitoring systems in England. Episodes were assigned a risk category for each scale and followed up for 6 months. The episode-based repeat rate was 28% (1133/4000) and the incidence of suicide was 0.5% (18/3962). The MSHR and ReACT performed with high sensitivity (98% and 94% respectively) and low specificity (15% and 23%). The SPS and the MSPS performed with relatively low sensitivity (24-29% and 9-12% respectively) and high specificity (76-77% and 90%). The area under the curve was 71% for both MSHR and ReACT, 51% for SPS and 49% for MSPS. Differences in predictive accuracy by subgroup were small. The scales were less accurate at predicting suicide than repeat self-harm. The scales failed to accurately predict repeat self-harm and suicide. The findings support existing clinical guidance not to use risk classification scales alone to determine treatment or predict future risk.
Bipolar Disorder and the TCI: Higher Self-Transcendence in Bipolar Disorder Compared to Major Depression.

PubMed

Harley, James A; Wells, J Elisabeth; Frampton, Christopher M A; Joyce, Peter R

2011-01-01

Personality traits are potential endophenotypes for genetic studies of psychiatric disorders. One personality theory which demonstrates strong heritability is Cloninger's psychobiological model measured using the temperament and character inventory (TCI). 277 individuals who completed the TCI questionnaire as part of the South Island Bipolar Study were also interviewed to assess for lifetime psychiatric diagnoses. Four groups were compared, bipolar disorder (BP), type 1 and 2, MDD (major depressive disorder), and nonaffected relatives of a proband with BP. With correction for mood state, total harm avoidance (HA) was higher than unaffected in both MDD and BP groups, but the mood disorder groups did not differ from each other. However, BP1 individuals had higher self-transcendence (ST) than those with MDD and unaffected relatives. HA may reflect a trait marker of mood disorders whereas high ST may be specific to BP. As ST is heritable, genes that affect ST may be of relevance for vulnerability to BP.
Bipolar Disorder and the TCI: Higher Self-Transcendence in Bipolar Disorder Compared to Major Depression

PubMed Central

Harley, James A.; Wells, J. Elisabeth; Frampton, Christopher M. A.; Joyce, Peter R.

2011-01-01

Personality traits are potential endophenotypes for genetic studies of psychiatric disorders. One personality theory which demonstrates strong heritability is Cloninger's psychobiological model measured using the temperament and character inventory (TCI). 277 individuals who completed the TCI questionnaire as part of the South Island Bipolar Study were also interviewed to assess for lifetime psychiatric diagnoses. Four groups were compared, bipolar disorder (BP), type 1 and 2, MDD (major depressive disorder), and nonaffected relatives of a proband with BP. With correction for mood state, total harm avoidance (HA) was higher than unaffected in both MDD and BP groups, but the mood disorder groups did not differ from each other. However, BP1 individuals had higher self-transcendence (ST) than those with MDD and unaffected relatives. HA may reflect a trait marker of mood disorders whereas high ST may be specific to BP. As ST is heritable, genes that affect ST may be of relevance for vulnerability to BP. PMID:21789279
Influence of personality and neuropsychological ability on social functioning and self-management in bipolar disorder.

PubMed

Vierck, Esther; Joyce, Peter R

2015-10-30

A majority of bipolar patients (BD) show functional difficulties even in remission. In recent years cognitive functions and personality characteristics have been associated with occupational and psychosocial outcomes, but findings are not consistent. We assessed personality and cognitive functioning through a range of tests in BD and control participants. Three cognitive domains-verbal memory, facial-executive, and spatial memory-were extracted by principal component analysis. These factors and selected personality dimensions were included in hierarchical regression analysis to predict psychosocial functioning and the use of self-management strategies while controlling for mood status. The best determinants of good psychosocial functioning were good verbal memory and high self-directedness. The use of self-management techniques was associated with a low level of harm-avoidance. Our findings indicate that strategies to improve memory and self-directedness may be useful for increasing functioning in individuals with bipolar disorder. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Eating Disorders and Major Depression: Role of Anger and Personality

PubMed Central

Giovanni, Abbate-Daga; Carla, Gramaglia; Enrica, Marzola; Federico, Amianto; Maria, Zuccolin; Secondo, Fassino

2011-01-01

This study aimed to evaluate comorbidity for MD in a large ED sample and both personality and anger as clinical characteristics of patients with ED and MD. We assessed 838 ED patients with psychiatric evaluations and psychometric questionnaires: Temperament and Character Inventory, Eating Disorder Inventory-2, Beck Depression Inventory, and State-Trait Anger Expression Inventory. 19.5% of ED patients were found to suffer from comorbid MD and 48.7% reported clinically significant depressive symptomatology: patients with Anorexia Binge-Purging and Bulimia Nervosa were more likely to be diagnosed with MD. Irritable mood was found in the 73% of patients with MD. High Harm Avoidance (HA) and low Self-Directedness (SD) predicted MD independently of severity of the ED symptomatology, several clinical variables, and ED diagnosis. Assessing both personality and depressive symptoms could be useful to provide effective treatments. Longitudinal studies are needed to investigate the pathogenetic role of HA and SD for ED and MD. PMID:21977317
Personality and posttraumatic stress disorder among directly exposed survivors of the Oklahoma City bombing.

PubMed

North, Carol S; Abbacchi, Anna; Cloninger, C Robert

2012-01-01

Few disaster studies have specifically examined personality in association with exposure to disaster and development of posttraumatic stress disorder (PTSD). A study of survivors of the Oklahoma City bombing examined PTSD and personality measured after the disaster. In a random sample of 255 survivors from a bombing survivor registry, 151 (59%) completed both full PTSD and personality assessments using the Diagnostic Interview Schedule and the Temperament and Character Inventory, respectively. Postbombing PTSD was associated with low self-directedness and low cooperativeness, and also with high self-transcendence and harm avoidance in most configurations. Disorganized (schizotypal) character and explosive (borderline) temperament configurations were associated with PTSD; creative and autocratic character configurations were negatively associated with PTSD. Clinicians should be vigilant for PTSD among individuals with personality disorders and also be aware that personality disorders are likely to be overrepresented among people with PTSD. Treatment of PTSD may need to take into account comorbid personality disorders and personality features. Copyright © 2012 Elsevier Inc. All rights reserved.
Changing drug users' risk environments: peer health advocates as multi-level community change agents.

PubMed

Weeks, Margaret R; Convey, Mark; Dickson-Gomez, Julia; Li, Jianghong; Radda, Kim; Martinez, Maria; Robles, Eduardo

2009-06-01

Peer delivered, social oriented HIV prevention intervention designs are increasingly popular for addressing broader contexts of health risk beyond a focus on individual factors. Such interventions have the potential to affect multiple social levels of risk and change, including at the individual, network, and community levels, and reflect social ecological principles of interaction across social levels over time. The iterative and feedback dynamic generated by this multi-level effect increases the likelihood for sustained health improvement initiated by those trained to deliver the peer intervention. The Risk Avoidance Partnership (RAP), conducted with heroin and cocaine/crack users in Hartford, Connecticut, exemplified this intervention design and illustrated the multi-level effect on drug users' risk and harm reduction at the individual level, the social network level, and the larger community level. Implications of the RAP program for designing effective prevention programs and for analyzing long-term change to reduce HIV transmission among high-risk groups are discussed from this ecological and multi-level intervention perspective.
Emotional intelligence and attentional bias for threat-related emotion under stress.

PubMed

Davis, Sarah K

2018-06-01

Emotional intelligence (EI) can buffer potentially harmful effects of situational and chronic stressors to safeguard psychological wellbeing (e.g., Mikolajczak, Petrides, Coumans & Luminet, ), yet understanding how and when EI operates to promote adaptation remains a research priority. We explored whether EI (both trait and ability) modulated early attentional processing of threat-related emotion under conditions of stress. Using a dot probe paradigm, eye movement (fixation to emotive facial stimuli, relative to neutral) and manual reaction time data were collected from 161 adults aged 18-57 years (mean age = 25.24; SD = 8.81) exposed to either a stressful (failure task) or non-stressful (control) situation. Whilst emotion management ability and trait wellbeing corresponded to avoidance of negative emotion (angry and sad respectively), high trait sociability and emotionality related to a bias for negative emotions. With most effects not restricted to stressful conditions, it is unclear whether EI underscores 'adaptive' processing, which carries implications for school-based social and emotional learning programs. © 2018 Scandinavian Psychological Associations and John Wiley & Sons Ltd.
The low and declining risk of malaria in travellers to Latin America: is there still an indication for chemoprophylaxis?

PubMed Central

Behrens, Ron H; Carroll, Bernadette; Beran, Jiri; Bouchaud, Olivier; Hellgren, Urban; Hatz, Christoph; Jelinek, Tomas; Legros, Fabrice; Mühlberger, Nikolai; Myrvang, Bjørn; Siikamäki, Heli; Visser, Leo

2007-01-01

A comparison was made between local malaria transmission and malaria imported by travellers to identify the utility of national and regional annual parasite index (API) in predicting malaria risk and its value in generating recommendations on malaria prophylaxis for travellers. Regional malaria transmission data was correlated with malaria acquired in Latin America and imported into the USA and nine European countries. Between 2000 and 2004, most countries reported declining malaria transmission. Highest API's in 2003/4 were in Surinam (287.4) Guyana (209.2) and French Guiana (147.4). The major source of travel associated malaria was Honduras, French Guiana, Guatemala, Mexico and Ecuador. During 2004 there were 6.3 million visits from the ten study countries and in 2005, 209 cases of malaria of which 22 (11%) were Plasmodium falciparum. The risk of adverse events are high and the benefit of avoided benign vivax malaria is very low under current policy, which may be causing more harm than benefit. PMID:17716367
[Maxillo-facial surgery in skeletal Class II: repercussions on the temporo-mandibular joints].

PubMed

Manière-Ezvan, Armelle; Savoldelli, Charles; Busson, Floriant; Oueiss, Arlette; Orthlieb, Jean-Daniel

2016-03-01

These interventions usually aimed at the correction of the skeletal discrepancy by mandibular retrognatism with an advancement of the distal portion of the mandible after mandibular osteotomy. The position of the condyle is determined during the osteosynthesis with miniplates. Condyles are set back in relation with the supine position of the patient and the weakness of his (her) curarized muscle. All studies show that surgery of mandibular advancement causes a lateral, torque and backward movement of the condyles, all harmful to the condyles. Factors that predispose to condylar resorption are "the patient": a woman, young (between 15 and 40), high mandibular angle, with a history of temporo-mandibular disorders and surgical overload applied to the condyles. What are the possible solutions to avoid failures? Patient preparation before surgery and surgery simulation with an articulator, condylar position control during surgery, working with surgeons to achieve a condylar portion stabilization system (with the CAD), quickly set up a mobilization of the mandible by physiotherapy. © EDP Sciences, SFODF, 2016.

Cultural evolution of hinoeuma superstition controlling human mate choice: The role of half-believer.

PubMed

Hara, Makoto; Lee, Joung-Hun; Iwasa, Yoh

2015-11-21

In this study, we used a cultural dynamic model to explain the persistence of the hinoeuma superstition in traditional Japan. Men with this superstition avoid marrying women born in a hinoeuma year (or hinoeuma-women). Parents avoided childbirth during the last hinoeuma year out of the concern that their daughter would have trouble finding a husband in the future, and this resulted in a large drop in the number of babies born in 1966. A previous theoretical analysis of the hinoeuma superstition considered two alternative cultural factors: believers and nonbelievers. In the present study, we considered a third cultural factor, the half-believer. A man that is a half-believer accepts a hinoeuma-woman as his wife, but parents that are half-believers avoid childbirth during hinoeuma years. With these three cultural factors, there are two possible outcomes for the population. In the first outcome, [1] non-believers become extinct, with the population consisting of believers and half-believers; some men refuse hinoeuma-women as their mate choice, and most parents attempt to avoid childbirth during hinoeuma years. In the second outcome, [2] believers become extinct, and the remaining population consists of non-believers and half-believers; no man refuses hinoeuma-women, and some parents avoid childbirth in hinoeuma years to prevent potential harm to their daughters. If birth control fails at a steady rate, believers will become extinct eventually. The superstition is more likely to be maintained if the mother has a stronger influence on the beliefs of her children than the father. Copyright © 2015 Elsevier Ltd. All rights reserved.
Associations Between Multiple Forms of Discrimination and Tobacco Use Among People Living With HIV: The Mediating Role of Avoidance Coping.

PubMed

Crockett, Kaylee B; Rice, Whitney S; Turan, Bulent

2018-05-01

People living with HIV (PLWH) have higher levels of tobacco use compared with the general population, increasing their risk of morbidity and mortality. PLWH also face potential chronic stressors related to the stigma and discrimination associated with HIV and other characteristics (eg, race and sexual orientation). These experiences may be associated with harmful health behaviors, such as tobacco use. The purpose of the current study is to explore the psychosocial context of tobacco use in PLWH, examining avoidance coping as a mediator in the relationship between multiple forms of discrimination and tobacco use. Participants included 202 PLWH recruited from an HIV primary care clinic in Birmingham, AL, between 2013 and 2015. Participants responded to parallel items assessing experiences of discrimination related to HIV status, race, and sexual orientation, as well as items assessing avoidance coping. Data on current tobacco use were obtained from participants' clinic records. Mediation models for each form of discrimination (HIV, race and sexual orientation) adjusting for demographic variables and the other forms of discrimination were evaluated. The indirect effect of HIV-related discrimination on likelihood of tobacco use through avoidance coping was significant, suggesting that avoidance coping mediates the association between HIV-related discrimination and tobacco use. However, the indirect effects of the other forms of discrimination were not significant. Given the disparity in tobacco use in PLWH, behavioral scientists and interventionists should consider including content specific to coping with experiences of discrimination in tobacco prevention and cessation programs for PLWH.
Perceptions of the Relative Harm of Cigarettes and E-cigarettes Among U.S. Youth

PubMed Central

Ambrose, Bridget K.; Rostron, Brian L.; Johnson, Sarah E.; Portnoy, David B.; Apelberg, Benjamin J.; Kaufman, Annette R.; Choiniere, Conrad J.

2015-01-01

Background Despite progress in reducing youth smoking, adolescents remain highly susceptible to tobacco use. Of concern is whether youth perceive electronic cigarettes (e-cigarettes) as a preferable alternative to conventional cigarettes. Purpose To describe cigarette harm perception patterns among youth based on the frequency and intensity of cigarette smoking, and examine the relative harm perceptions of conventional versus e-cigarettes, using data from a large, nationally representative sample of U.S. youth. Methods Data from the 2012 National Youth Tobacco Survey (N=24,658) were analyzed in 2013 to identify patterns of cigarette harm perceptions. Multinomial logistic regression was conducted to identify associations between demographic and tobacco use characteristics and cigarette harm perception patterns. Logistic regression was conducted to examine the relationship between cigarette harm perceptions and the perception of e-cigarettes as less harmful than cigarettes for current, ever, and never cigarette smokers. Results The majority of youth (64.2%) perceived the harmfulness of cigarettes as dose-dependent. Approximately one in three students perceived e-cigarettes as less harmful than conventional cigarettes. Regardless of cigarette smoking status, ever users of e-cigarettes and those with “dose-dependent” cigarette harm perceptions consistently were more likely to perceive e-cigarettes as less harmful than conventional cigarettes. Conclusions Many youth perceive tobacco use on a continuum of harm. Youth who perceive gradations in harm—both by frequency and intensity of cigarette use and by type of product—may be particularly susceptible to e-cigarette use. PMID:25044196
Adolescent self-harm and risk factors.

PubMed

Zhang, Jixiang; Song, Jianwei; Wang, Jing

2016-12-01

This study aims to define the characteristics of adolescents who have engaged in self-harm behavior and ascertain the risk factors. From January 2013 to January 2014, 4,176 adolescents from senior middle schools in Linyi, China, were administered four questionnaire surveys to ascertain the following: incidence of self-harm behavior regarding the frequency of different self-harm behaviors by group (never/one to five times/greater than five times in the last 6 months) and then comparing the self-harm behavior of the different subgroups; symptom self-check, comparing the differences between the adolescents with self-harm behavior and without in nine subscales (somatization, obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, hostility, fear, paranoid, and psychosis); Adolescent Self-Rating Life Events Check List scores; and Egna Minnenav Barndoms Uppfostran (EMBU) scores. Multivariate logistic regression analysis was used to determine the risk factors of self-harm in adolescents. The incidence of adolescent self-harm was 27.60%; the occurrence of adolescent self-harm was closely related to their mental health status, stressful life events, and EMBU. Being female, an urban student, or an only child; having poor school performance or experiences of stressful life events, harsh parenting styles, or excessive interference; and poor mental health were the risk factors for adolescent self-harm. The incidence of adolescent self-harm was high, and their mental health status, stressful life events, and EMBU affected the occurrence of adolescent self-harm, which is an issue that needs greater attention. © 2016 John Wiley & Sons Australia, Ltd.
Defining harm reduction.

PubMed

Single, E

1995-01-01

Harm reduction attempts to reduce the adverse consequences of drug use among persons who continue to use drugs. It developed in response to the excesses of a "zero tolerance approach". Harm reduction emphasizes practical rather than idealized goals. It has been expanded from illicit drugs to legal drugs and is grounded in the evolving public health and advocacy movements. Harm reduction has proved to be effective and it has gained increasing official acceptance; for example, it is now the basis of Canada's Drug Strategy. However, the concept is still poorly defined, as virtually any drug policy or programme, even abstinence-oriented programmes, attempt to reduce drug-related harm. The principle feature of harm reduction is the acceptance of the fact that some drug users cannot be expected to cease their drug use at the present time. Harm reduction is neutral about the long term goals of intervention while according a high priority to short-term realizable goals. Harm reduction should be neutral about legalization. The essence of the concept is to ameliorate adverse consequences of drug use while, at least in the short term, drug use continues.
Depressive symptoms and self-harm among youngsters referred to child welfare: The role of trust in caregiver support and communication.

PubMed

Santens, Tara; Claes, Laurence; Diamond, Guy S; Bosmans, Guy

2018-03-01

Depressive symptoms and self-harm, i.e. non-suicidal self-injury and suicidal behaviors, are highly prevalent in youngsters involved in Child Welfare System (CWS) services. Little research investigates, however, why these CWS youngsters are at risk. We explored whether trust in caregiver support and communication about experiences with primary caregivers, are associated with CWS youngsters' depressive symptoms and/or self-harm. An anonymous online survey of 271 CWS youngsters (10-21 years of age, 57.2% female) was used to assess trust and communication, and depressive symptoms/self-harm. Results showed significant negative associations between self-reported trust in maternal and paternal support, and depressive symptoms/self-harm. Communication about experiences with one's biological mother mediated the relationship between trust in maternal support and depressive symptoms/self-harm. Furthermore, the presence of an additional trustworthy caregiver buffered the impact of low trust in maternal or paternal support on depressive symptoms/self-harm. Implications for interventions targeting CWS youngsters' depressive symptoms and self-harm are discussed. Copyright © 2018 Elsevier Ltd. All rights reserved.
Shoes for children: a review.

PubMed

Staheli, L T

1991-08-01

1. Optimum foot development occurs in the barefoot environment. 2. The primary role of shoes is to protect the foot from injury and infection. 3. Stiff and compressive footwear may cause deformity, weakness, and loss of mobility. 4. The term "corrective shoes" is a misnomer. 5. Shock absorption, load distribution, and elevation are valid indications for shoe modifications. 6. Shoe selection for children should be based on the barefoot model. 7. Physicians should avoid and discourage the commercialization and "media"-ization of footwear. Merchandising of the "corrective shoe" is harmful to the child, expensive for the family, and a discredit to the medical profession.
Examining the sexual harassment experiences of Mexican immigrant farmworking women.

PubMed

Waugh, Irma Morales

2010-03-01

This study examined sexual harassment experiences of Mexican immigrant farmworking women (n = 150) employed on California farms. Of the estimated one million California farmworkers, 78% are Latino, mostly from Mexico, and 28% are women. Unlike gender-segregated worksites of Mexico, women farmworkers in the United States labor alongside men, facilitating harassment from coworkers and supervisors. Simultaneous sexist, racist, and economic discrimination are comparable to converging lanes of automobile traffic (Crenshaw, 2000) that women, standing at the intersections, manage to avoid harm. Findings highlight how discrimination shapes women's experiences and demonstrate the need for institutional policies to protect them.
Preventing postmarketing changes in recommended doses and marketing withdrawals.

PubMed

Peck, C

2007-01-01

Recent market withdrawals of prescription drug products have brought attention to premarketing safety research. Less known but related to some drug withdrawals are postmarketing dosage changes of newly marketed drugs, including both dosage reductions and increases. These events have serious effects on patients, manufacturers, and regulatory authorities. Most of these harmful events could be avoided by intensive employment of targeted clinical pharmacology investigations to optimize dosage prior to phase III testing and regulatory approval. In this paper, the frequency and implications of postmarketing dosing changes and market withdrawals are considered in light of approaches to preventing them.
New challenges in studying nutrition-disease interactions in the developing world

PubMed Central

Prentice, Andrew M.; Gershwin, M. Eric; Schaible, Ulrich E.; Keusch, Gerald T.; Victora, Cesar G.; Gordon, Jeffrey I.

2008-01-01

Latest estimates indicate that nutritional deficiencies account for 3 million child deaths each year in less-developed countries. Targeted nutritional interventions could therefore save millions of lives. However, such interventions require careful optimization to maximize benefit and avoid harm. Progress toward designing effective life-saving interventions is currently hampered by some serious gaps in our understanding of nutrient metabolism in humans. In this Personal Perspective, we highlight some of these gaps and make some proposals as to how improved research methods and technologies can be brought to bear on the problems of undernourished children in the developing world. PMID:18382744
Ethical aspects of limiting residents' work hours.

PubMed

Wiesing, Urban

2007-09-01

The regulation of residents' work hours involves several ethical conflicts which need to be systematically analysed and evaluated. ARGUMENTS AND CONCLUSION: The most important ethical principle when regulating work hours is to avoid the harm resulting from the over-work of physicians and from an excessive division of labour. Additionally, other ethical principles have to be taken into account, in particular the principles of nonmaleficence and beneficence for future patients and for physicians. The article presents arguments for balancing the relevant ethical principles and analyses the structural difficulties that occur unavoidably in any regulation of the complex activities of physicians.
Smoking, vaping and public health: Time to be creative.

PubMed

Sweanor, David

2016-03-16

The development of policies on vaping in health care organizations (HCOs) needs to be based on a solid understanding of science and a recognition of individual rights. It should also be seen in the broader public health context of innovative alternative nicotine delivery systems playing a key role in ending the immense devastation of combustible cigarettes. Opposition to vaping based on inaccurate and incomplete information, or fear of unlikely and avoidable hypothetical unintended consequences, will invariably cause great harm to individuals, impede rather than assist the attainment of public health objectives, and unnecessarily prolong the epidemic of cigarette-caused diseases.
Single chemical entity legal highs: assessing the risk for long term harm.

PubMed

McNabb, Carolyn B; Russell, Bruce R; Caprioli, Daniele; Nutt, David J; Gibbons, Simon; Dalley, Jeffrey W

2012-12-01

A recent and dramatic increase in the emergence of novel psychoactive substances ('legal highs') has left many governments unable to provide a timely response to an increasing number of potentially harmful drugs now available to the public. In response to this rapid increase in lawful drug use, the UK government intends to implement temporary class drug orders, whereby substances with a potential for misuse and harm can be regulated for a 12 month period. During this period an investigation of the potential for harms induced by these drugs will take place. However, the short time-frame in which information must be gathered, and the paucity of data available on novel psychoactive substances, means that robust pharmacological and toxicological analyses may be replaced by extrapolating data from illegal drugs with similar chemical structures. This review explores the potential pharmacology and toxicology of past and present 'legal highs' and discusses the risks of failing to carry out in-depth scientific research on individual substances.
E-Cigarette Use among US Adolescents: Perceptions of Relative Addiction and Harm

ERIC Educational Resources Information Center

Dobbs, Page Daniel; Hammig, Bart; Henry, Leah Jean

2017-01-01

Objective: Between 2013 and 2014, past 30-day use of e-cigarettes increased from 4.5% to 13.4% among US high school students aged 9-19 years. We sought to examine the influence of perceived addiction and harm of e-cigarettes on e-cigarette use among adolescents. Design: Self-reported use and perception of harm of e-cigarettes were assessed using a…
Developing a Comprehensive Model of Intensive Care Unit Processes: Concept of Operations.

PubMed

Romig, Mark; Tropello, Steven P; Dwyer, Cindy; Wyskiel, Rhonda M; Ravitz, Alan; Benson, John; Gropper, Michael A; Pronovost, Peter J; Sapirstein, Adam

2015-04-23

This study aimed to use a systems engineering approach to improve performance and stakeholder engagement in the intensive care unit to reduce several different patient harms. We developed a conceptual framework or concept of operations (ConOps) to analyze different types of harm that included 4 steps as follows: risk assessment, appropriate therapies, monitoring and feedback, as well as patient and family communications. This framework used a transdisciplinary approach to inventory the tasks and work flows required to eliminate 7 common types of harm experienced by patients in the intensive care unit. The inventory gathered both implicit and explicit information about how the system works or should work and converted the information into a detailed specification that clinicians could understand and use. Using the ConOps document, we created highly detailed work flow models to reduce harm and offer an example of its application to deep venous thrombosis. In the deep venous thrombosis model, we identified tasks that were synergistic across different types of harm. We will use a system of systems approach to integrate the variety of subsystems and coordinate processes across multiple types of harm to reduce the duplication of tasks. Through this process, we expect to improve efficiency and demonstrate synergistic interactions that ultimately can be applied across the spectrum of potential patient harms and patient locations. Engineering health care to be highly reliable will first require an understanding of the processes and work flows that comprise patient care. The ConOps strategy provided a framework for building complex systems to reduce patient harm.
Preventing HIV transmission among Iranian prisoners: Initial support for providing education on the benefits of harm reduction practices

PubMed Central

Eshrati, Babak; Asl, Rahim Taghizadeh; Dell, Colleen Anne; Afshar, Parviz; Millson, Peggy Margaret E; Kamali, Mohammad; Weekes, John

2008-01-01

Background Harm reduction is a health-centred approach that seeks to reduce the health and social harms associated with high-risk behaviors, such as illicit drug use. The objective of this study is to determine the association between the beliefs of a group of adult, male prisoners in Iran about the transmission of HIV and their high-risk practices while in prison. Methods A cross-sectional study was conducted in 2004. The study population was a random selection of 100 men incarcerated at Rajaei-Shahr prison. The data were collected through a self-administered questionnaire. Focus group discussions were held at the prison to guide the design of the questionnaire. The relationship between components of the Health Belief Model (HBM) and prisoners' risky HIV-related behaviors was examined. Results Calculating Pearson's correlation coefficient, a significant, positive association was found between the benefit component of the HBM and prisoners not engaging in HIV high-risk behaviors. Conclusion Educational harm reduction initiatives that promote the effectiveness of strategies designed to reduce the risk of HIV transmission may decrease prisoners' high-risk behaviors. This finding provides initial support for the Iran prison system's current offering of HIV/AIDS harm reduction programming and suggests the need to offer increased education about the effectiveness of HIV prevention practices. PMID:18541032
Correlates of Suicidal Ideation and Self-harm in Early Childhood in a Cohort at Risk for Child Abuse and Neglect.

PubMed

Paul, Elise; Ortin, Ana

2017-12-27

This study provides prevalence and persistence rates of suicidal ideation and self-harm, and examines how child maltreatment types, mental health symptoms, and age 4 suicidal ideation and self-harm are associated with each suicidal outcome among 6-year-old children. Participants were 1,090 caregivers assessed when their children were 4 and 6 years old from the Longitudinal Studies of Child Abuse and Neglect. Data were collected from the Child Behavior Checklist, Parent-Child Conflict Tactics Scales, and Child Protective Services. Persistence rates within each suicidal outcome were high. Failure to provide -a physical neglect subtype- was the only maltreatment type that independently predicted self-harm. Depressive/anxious symptoms and age 4 suicidal ideation were independently associated with age 6 suicidal ideation, whereas attention problems and age 4 self-harm predicted age 6 self-harm. Our findings align with the consensus emerging from adolescent studies that risk factors associate differentially with suicidal ideation and self-harm.
Not only body weight perception but also body mass index is relevant to suicidal ideation and self-harming behavior in Japanese adolescents.

PubMed

Kinoshita, Kuni; Kinoshita, Yoshihiro; Shimodera, Shinji; Nishida, Atsushi; Inoue, Ken; Watanabe, Norio; Oshima, Norihito; Akechi, Tatsuo; Sasaki, Tsukasa; Inoue, Shimpei; Furukawa, Toshiaki A; Okazaki, Yuji

2012-04-01

Whether a low body mass index (BMI) is directly associated with a high risk of suicidal ideation or self-harming behavior in adolescents is still inconclusive. This study has, therefore, evaluated the relevance of BMI to suicidal ideation and self-harming behavior after controlling for body weight perception (BWP) and other potential confounding factors. BMI, BWP, suicidal ideation, and self-harming behavior were all assessed using a self-report questionnaire administered to 18,104 Japanese adolescents. Potential confounding factors were also evaluated. The data were then analyzed using bivariate and multivariate logistic regression. Low BMI was associated with suicidal ideation and deliberate self-harm when controlling for sex, age, drug use, emotional distress, and BWP. Low BMI may be an independent risk factor for suicidal ideation and deliberate self-harming behavior in Japanese adolescents.
Safety classification of herbal medicines used among pregnant women in Asian countries: a systematic review.

PubMed

Ahmed, Mansoor; Hwang, Jung Hye; Choi, Soojeung; Han, Dongwoon

2017-11-14

High prevalence of herbal medicines used in pregnancy and the lack of information on their safety is a public concern. Despite this, no significant research has been done regarding potential adverse effects of using herbal medicines during pregnancy, especially among developing Asian countries. Cross-sectional studies were searched up to year 2016 on PubMed/Medline and EMBASE, the data were extracted and quality of studies was assessed using the quality appraisal tool. The findings are reported in accordance to the PRISMA checklist (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Classification on safety of identified herbal medicines was done based on current scientific literature. This study included eight cross-sectional studies (2729 participants) from seven different Asian countries, of which 1283 (47.01%) women used one or more herbal medicines during pregnancy. Peppermint (22.8%), aniseed (14.7%), olibanum (12.9%), flixweed seed (12.2%) and ginger (11.5%) were the most frequently used herbal medicines. Out of the 33 identified herbal medicines, 13 were classified as safe to use, five as use with caution, eight were potentially harmful to use in pregnancy and information on seven herbal medicines was not available in the current literature. Several herbal medicines identified in this review were classified to be potentially harmful or the information regarding safety in pregnancy was missing. It is recommended that contraindicated herbal medicines should be avoided and other herbals should be taken under supervision of a qualified health care practitioner. The classification regarding safety of herbal medicines in pregnancy can be utilized to create awareness on prevention of adverse effects.
Safe prescribing: a titanic challenge.

PubMed

Routledge, Philip A

2012-10-01

The challenge to achieve safe prescribing merits the adjective 'titanic'. The organisational and human errors leading to poor prescribing (e.g. underprescribing, overprescribing, misprescribing or medication errors) have parallels in the organisational and human errors that led to the loss of the Titanic 100 years ago this year. Prescribing can be adversely affected by communication failures, critical conditions, complacency, corner cutting, callowness and a lack of courage of conviction, all of which were also factors leading to the Titanic tragedy. These issues need to be addressed by a commitment to excellence, the final component of the 'Seven C's'. Optimal prescribing is dependent upon close communication and collaborative working between highly trained health professionals, whose role is to ensure maximum clinical effectiveness, whilst also protecting their patients from avoidable harm. Since humans are prone to error, and the environments in which they work are imperfect, it is not surprising that medication errors are common, occurring more often during the prescribing stage than during dispensing or administration. A commitment to excellence in prescribing includes a continued focus on lifelong learning (including interprofessional learning) in pharmacology and therapeutics. This should be accompanied by improvements in the clinical working environment of prescribers, and the encouragement of a strong safety culture (including reporting of adverse incidents as well as suspected adverse drug reactions whenever appropriate). Finally, members of the clinical team must be prepared to challenge each other, when necessary, to ensure that prescribing combines the highest likelihood of benefit with the lowest potential for harm. © 2012 The Author. British Journal of Clinical Pharmacology © 2012 The British Pharmacological Society.

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