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Sample records for addiction shared care

  1. Shared care and boundaries:

    Winthereik, Brit Ross

    2008-01-01

    Purpose – The paper seeks to examine how an online maternity record involving pregnant women worked as a means to create shared maternity care. Design/methodology/approach – Ethnographic techniques have been used. The paper adopts a theoretical/methodological framework based on science and techno......Purpose – The paper seeks to examine how an online maternity record involving pregnant women worked as a means to create shared maternity care. Design/methodology/approach – Ethnographic techniques have been used. The paper adopts a theoretical/methodological framework based on science...... and technology studies. Findings – The paper shows how a version of “the responsible patient” emerges from the project which is different from the version envisioned by the project organisation. The emerging one is concerned with the boundary between primary and secondary sector care, and not with the boundary...... of responsibilities entailed in shared care projects. Rather than seeking to connect all actors in an unbounded space, shared care might instead suggest a space for patients and professionals to experiment with new roles and responsibilities. Practical implications – When designing coordination tools for health care...

  2. Shared Care in Diabetes?

    Bødker, Keld

    2006-01-01

    The Danish National Board of Health has recently released a report that is intended to mark the start of a new project to establish it support for shared care in diabetes. In this paper I raise a number of concerns where lack of attention towards participation from prospective users constitute...

  3. Shared Oral Care

    Hede, Børge; Elmelund Poulsen,, Johan; Christophersen, Rasmus;

    2014-01-01

    Shared Oral Care - Forebyggelse af orale sygdomme på plejecentre Introduktion og formål: Mangelfuld mundhygiejne hos plejekrævende ældre er et alment og veldokumenteret sundhedsproblem, der kan føre til massiv udvikling af tandsygdomme, og som yderligere kan være medvirkende årsag til alvorlige...

  4. Information Sharing for Care Coordination

    Amir, Ofra; Grosz, Barbara J.; Stern, Roni; Sanders, Lee M.

    2013-01-01

    Teamwork and care coordination are of increasing importance to health care delivery and patient safety and health. This paper describes our initial work on developing agents that are able to make intelligent information sharing decisions to support a diverse, evolving team of care providers in constructing and maintaining a shared plan that operates in uncertain environments and over a long time horizon.

  5. To Share or To Care

    Øelund, Sine Marie; Granlien, Maren Fich; Koch, Louise Baunsgaard

    2006-01-01

    In recent years ‘shared care’ has been a popular topic in the Danish health services, especially in relation to chronic diseases. Shared care aims at creating coherent treatment of the patient through close collaboration and shared responsibilities across sectorial boundaries. In practice this vision is not always carried out. We have undertaken a comparative analysis of the circumstances for and the results of the implementation process of two database registration systems for...

  6. Shared care in prostate cancer

    Lund, Anette Svarre; Lund, Lars; Jønler, Morten;

    2016-01-01

    OBJECTIVE: The aim of this study was to investigate 3 year follow-up in patients with stable prostate cancer (PCa) managed in a shared care program by general practitioners (GPs) in collaboration with urological departments. PCa patients who have undergone curative treatment or endocrine therapy...... require long-term follow-up. Until recently, follow-up has primarily been managed by urologists at hospital-based outpatient clinics. However, new organizational strategies are needed to meet the needs of the growing number of elderly, comorbid cancer patients. These new organizational strategies target...

  7. A standardized message for supporting shared care.

    Branger, P. J.; van 't Hooft, A.; Duisterhout, J.S.; Lei, J.

    1994-01-01

    As health care becomes more complex, interest in the benefits of coordination of care has increased. Especially patients that are being treated jointly by more than one physician (shared care), are vulnerable to adverse effects resulting from inadequate coordination and communication. We describe a study in which care providers support shared care by using computer-based patient records for data storage, and structured electronic data interchange as a means of communication. In this study, we...

  8. Shared and unique mechanisms underlying binge eating disorder and addictive disorders.

    Schulte, Erica M; Grilo, Carlos M; Gearhardt, Ashley N

    2016-03-01

    Scientific interest in "food addiction" is growing, but the topic remains controversial. One critique of "food addiction" is its high degree of phenotypic overlap with binge eating disorder (BED). In order to examine associations between problematic eating behaviors, such as binge eating and "food addiction," we propose the need to move past examining similarities and differences in symptomology. Instead, focusing on relevant mechanisms may more effectively determine whether "food addiction" contributes to disordered eating behavior for some individuals. This paper reviews the evidence for mechanisms that are shared (i.e., reward dysfunction, impulsivity) and unique for addiction (i.e., withdrawal, tolerance) and eating disorder (i.e., dietary restraint, shape/weight concern) frameworks. This review will provide a guiding framework to outline future areas of research needed to evaluate the validity of the "food addiction" model and to understand its potential contribution to disordered eating. PMID:26879210

  9. A standardized message for supporting shared care.

    Branger, P J; van 't Hooft, A; Duisterhout, J S; van der Lei, J

    1994-01-01

    As health care becomes more complex, interest in the benefits of coordination of care has increased. Especially patients that are being treated jointly by more than one physician (shared care), are vulnerable to adverse effects resulting from inadequate coordination and communication. We describe a study in which care providers support shared care by using computer-based patient records for data storage, and structured electronic data interchange as a means of communication. In this study, we are aiming at the development and implementation of protocols for shared care. PMID:7949972

  10. Technology Mediated Information Sharing (Monitor Sharing) in Primary Care Encounters

    Asan, Onur

    2013-01-01

    The aim of this dissertation study was to identify and describe the use of electronic health records (EHRs) for information sharing between patients and clinicians in primary-care encounters and to understand work system factors influencing information sharing. Ultimately, this will promote better design of EHR technologies and effective training…

  11. Challenges for IT-supported shared care

    Granlien, Maren Fich; Simonsen, Jesper

    2007-01-01

    : (1) Poor integration with the general practitioners' existing IT systems; (2) low compatibility with general practitioners' work ethic; (3) and discrepancy between the number of diabetes patients and the related need for shared care. We conclude that development of IT-supported shared care must......Purpose: To investigate the circumstances as to why it is so difficult in the primary care sector to implement IT based infrastructures supporting shared care. Case study: The qualitative analysis includes two separate case studies of IT-supported shared care implemented in two different regions of...... Denmark throughout 2005. The study comprises 21 interviews and 35 hours of observations. The data were analysed through a coding process that led to the emergence of three main challenges impeding the organisational implementation of IT-supported shared care. Discussion and conclusion: The two cases faced...

  12. IT-Support for Shared Care

    Bansler, Jørgen P.; Havn, Erling C.; Kensing, Finn

    2005-01-01

    This paper describes work-in-progress to explore how informa-tion and communication technologies (ICT) can be designed and implemented to provide effective support of shared care programs. The purpose of the project is to develop generic models of shared care applications as well as organizational...

  13. Integrating rheumatology care in the community: can shared care work?

    Anita YN Lim

    2015-08-01

    Full Text Available Introduction: Singapore's rapidly ageing population and chronic disease burden at public hospital specialist clinics herald a silver tsunami. In Singapore, “right siting” aims to manage stable chronic disease in primary care at a lower cost. To improve the quality of rheumatology care, we created shared care between rheumatologist and family physician to reduce hospital visits.Methods: Clinical practice improvement methodology was used to structure shared care of stable patients between hospital rheumatologists and eleven community family physicians; one ran a hospital clinic. A case manager coordinated the workflow.Results: About 220 patients entered shared care over 29 months. Patients without hospital subsidies (private patients and private family physicians independently predicted successful shared care, defined as one cycle of alternating care.Discussion: Our shared care model incorporated a case manager, systematic workflows, patient selection criteria, willing family physician partners and rheumatologists in the absence of organizational integration. Health care affordability impacts successful shared care. Government subsidy hindered right siting to private primary care.Conclusions: Financing systems in Singapore, at health policy level, must allow transfer of hospital subsidies to primary care, both private and public, to make it more affordable than hospital care. Structural integration will create a seamless continuum between hospital and primary care.

  14. Integrating rheumatology care in the community: can shared care work?

    Anita YN Lim

    2015-08-01

    Full Text Available Introduction: Singapore's rapidly ageing population and chronic disease burden at public hospital specialist clinics herald a silver tsunami. In Singapore, “right siting” aims to manage stable chronic disease in primary care at a lower cost. To improve the quality of rheumatology care, we created shared care between rheumatologist and family physician to reduce hospital visits. Methods: Clinical practice improvement methodology was used to structure shared care of stable patients between hospital rheumatologists and eleven community family physicians; one ran a hospital clinic. A case manager coordinated the workflow. Results: About 220 patients entered shared care over 29 months. Patients without hospital subsidies (private patients and private family physicians independently predicted successful shared care, defined as one cycle of alternating care. Discussion: Our shared care model incorporated a case manager, systematic workflows, patient selection criteria, willing family physician partners and rheumatologists in the absence of organizational integration. Health care affordability impacts successful shared care. Government subsidy hindered right siting to private primary care. Conclusions: Financing systems in Singapore, at health policy level, must allow transfer of hospital subsidies to primary care, both private and public, to make it more affordable than hospital care. Structural integration will create a seamless continuum between hospital and primary care.

  15. Internet addictive individuals share impulsivity and executive dysfunction with alcohol-dependent patients

    Zhenhe eZhou

    2014-08-01

    Full Text Available Internet addiction disorder (IAD should belong to a kind of behavioral addiction. Previous studies indicated that there are many similarities in the neurobiology of behavior and substance addictions. Up to date, although individuals with IAD have difficulty suppressing their excessive online behaviors in real life, little is known about the patho-physiological and cognitive mechanisms responsible for IAD. Neuropsychological test studies have contributed significantly to our understanding of the effect of IAD on the cognitive function. The purpose of the present study was to examine whether Internet addictive individuals share impulsivity and executive dysfunction with alcohol-dependent individuals. Participants include 22 Internet addictive individuals, 22 alcohol-dependent patients (AD and 22 normal controls (NC. All participants were measured with BIS- 11, go/no-go task, WCST and Digit span task under the same experimental condition. Results showed that BIS-11 scores, false alarm rate, the total response errors, perseverative errors, failure to maintain set of IAD and AD group were significantly higher than that of NC group, and hit rate, percentage of conceptual level responses, the number of categories completed, forwards scores and backwards scores of IAD and AD group were significantly lower than that of NC group, however, no differences in above variables between IAD group and AD group were observed. These results revealed that the existence of impulsivity, deficiencies in executive function and working memory in an IAD and an AD sample, namely, Internet addictive individuals share impulsivity and executive dysfunction with alcohol-dependent patients.

  16. Sharing is Caring? Not Quite

    van Welsum, Desirée

    2016-01-01

    Fast evolving cloud-computing platforms that enable new business models, combined with a rapid uptake in digital technologies by consumers and a change in consumer behavior and preferences have enabled the emergence of a so-called ‘sharing economy’. With new start-ups offering all kinds of services springing up every day, there was soon talk of the ‘Uber of everything’ or ‘the uberification of the service economy.’ But these technology enabled business models also raise a numbe...

  17. Shared responsibility for children in care

    Schwartz, Ida

    2014-01-01

    The responsibility of children in care is shared by a number of professionals placed in different contexts. Parents are responsible for the “big issues” in these children’s lives, while many professionals are involved in the children´s everyday life across home, residential home, schools and...... institutions. These groups of professionals contribute to the children’s everyday lives according to historically developed divisions of responsibility. It is a daily challenge to professionals, how they jointly support children in care so the children can be part of children´s communities in the places where...... they live. Children in care are among the most disadvantaged groups in our society and currently there is much concern for how these children can achieve the same “life chances” as other kids. Studies have revealed that children in care as adults do not achieve the same educational and social...

  18. Addiction.

    Naim-Feil, Jodie; Zangen, Abraham

    2013-01-01

    Drug and alcohol addiction is a debilitating disorder characterized by persistent drug-seeking behaviors despite negative physiological, medical, or social consequences. Neurobiological models of addiction propose that the reinforcing effects of addictive drugs are associated with altered neurotransmission within the reward 'mesocorticolimbic' circuitry in the brain. Immense efforts are therefore designed to target the mesocorticolimbic circuitry in attenuating drug dependence and addiction-related behaviors. Yet, to date, most addiction treatments have demonstrated only limited success in reducing addiction-related behaviors. Accumulating and compelling evidence suggests that novel nonsurgical brain stimulation techniques, such as transcranial magnetic stimulation and transcranial direct current stimulation, could serve as promising tools for indexing altered neurotransmission associated with repetitive drug use, and moreover, may hold therapeutic potential for the treatment of drug dependence and addiction-related behaviors. This chapter reviews and discusses the current and potential applications of such techniques in the study and treatment of addiction; we focus on a number of common drugs of abuse, including nicotine, alcohol, cocaine, cannabis, and ecstasy. PMID:24112928

  19. Designing Shared Electronic Records for Chronic Care

    Bansler, Jørgen Peter; Havn, Erling C.; Mønsted, Troels

    This paper reports preliminary findings from an ongoing research project on the development of IT support for communication and information sharing across institutional and professional boundaries within the Danish healthcare system. The project focuses on the treatment of patients with implanted...... ICDs (implantable cardioverter-defibrillator). These are chronic patients who usually see several different healthcare providers on a regular basis. The main findings so far are: (1) Most of the data produced and recorded as part of the care process are context-specific and often difficult to interpret...

  20. Cocaine Addiction in Mothers: Potential Effects on Maternal Care and Infant Development

    Strathearn, Lane; Mayes, Linda C.

    2010-01-01

    Maternal cocaine addiction is a significant public health issue particularly affecting children, with high rates of reported abuse, neglect and foster care placement. This review examines both preclinical and clinical evidence for how cocaine abuse may impact maternal care and infant development, exploring brain, behavioral and neuroendocrine mechanisms. There is evidence that cocaine may affect infant development both directly, via in utero exposure, and indirectly via alterations in maternal care. Two neural systems known to play an important role in both maternal care and cocaine addiction are the oxytocin and dopamine systems, mediating social and reward-related behaviors and stress reactivity. These same neural mechanisms may also be involved in the infant’s development of vulnerability to addiction. Understanding the neuroendocrine pathways involved in maternal behavior and addiction may help facilitate earlier, more effective interventions to help substance abusing mothers provide adequate care for their infant, and perhaps prevent the intergenerational transmission of risk. PMID:20201853

  1. Cocaine addiction in mothers: potential effects on maternal care and infant development.

    Strathearn, Lane; Mayes, Linda C

    2010-02-01

    Maternal cocaine addiction is a significant public health issue particularly affecting children, with high rates of reported abuse, neglect, and foster care placement. This review examines both preclinical and clinical evidence for how cocaine abuse may affect maternal care and infant development, exploring brain, behavioral, and neuroendocrine mechanisms. There is evidence that cocaine affects infant development both directly, via in utero exposure, and indirectly via alterations in maternal care. Two neural systems known to play an important role in both maternal care and cocaine addiction are the oxytocin and dopamine systems, mediating social and reward-related behaviors and stress reactivity. These same neural mechanisms may also be involved in the infant's development of vulnerability to addiction. Understanding the neuroendocrine pathways involved in maternal behavior and addiction may help facilitate earlier, more effective interventions to help substance-abusing mothers provide adequate care for their infant and perhaps prevent the intergenerational transmission of risk. PMID:20201853

  2. Usage Analysis of a Shared Care Planning System

    Warren, Jim; Gu, Yulong; Humphrey, Gayl

    2012-01-01

    We examined the content of electronically mediated communications in a trial of shared care planning (SCP) for long-term condition management. Software supports SCP by sharing patient records and care plans among members of the multidisciplinary care team (with patient access). Our analysis focuses on a three-month period with 73 enrolled patients, 149 provider-assigned tasks, 64 clinical notes and 48 care plans with 162 plan elements. Results show that content of notes entries is often relat...

  3. Sharing best practice in stoma care nursing.

    Willams, Julia

    A problem shared is a problem halved; a very poignant proverb that forms the essence of this year's World Council of Enterostomal Therapists (WCET) UK conference in Coventry. Sharing experiences from practice is invalid if clinical practice is to grow and develop. It raises awareness, offering the opportunity to question and review practice. Sharing practice offers opportunities to enquiring minds. PMID:19797996

  4. Integrating addiction treatment into primary care using mobile health technology: protocol for an implementation research study

    Quanbeck, Andrew R.; Gustafson, David H.; Marsch, Lisa A.; McTavish, Fiona; Brown, Randall T.; Mares, Marie-Louise; Johnson, Roberta; Glass, Joseph E.; Atwood, Amy K.; McDowell, Helene

    2014-01-01

    Background Healthcare reform in the United States is encouraging Federally Qualified Health Centers and other primary-care practices to integrate treatment for addiction and other behavioral health conditions into their practices. The potential of mobile health technologies to manage addiction and comorbidities such as HIV in these settings is substantial but largely untested. This paper describes a protocol to evaluate the implementation of an E-Health integrated communication technology del...

  5. Buprenorphine Treatment for Opioid Addiction in the Primary Care Setting: Predictors of Treatment Success and Failure

    Drago, Joshua

    2015-01-01

    Buprenorphine is a partial mu-opioid agonist with well-demonstrated efficacy in the medical treatment of opioid addiction. Little is known about which patients respond successfully to treatment with buprenorphine. To help answer this question, we performed a retrospective cohort analysis of 160 patients who received outpatient buprenorphine therapy for opioid addiction at MGH Charlestown HealthCare Center. We gathered information on 36 observable patient characteristics, and searched for vari...

  6. Shared geriatric mental health care in a rural community

    Sullivan, MP; Parenteau, P; Dolansky, D; Leon, S.; Le Clair, JK

    2007-01-01

    Introduction: A pilot project in shared mental health care was initiated to explore opportunities to increase the capacity of the rural primary care system as a resource for older people with mental health needs. This was done within a framework for the delivery of best practices in geriatric mental health outreach. Methods: Shared-care strategies combining education and clinical consultation between mentor psychiatrists and family physicians were implemented and then evaluated after one year...

  7. Challenges for IT-supported shared care: a qualitative analyses of two shared care initiatives for diabetes treatment in Denmark

    Maren Fich Granlien; Jesper Simonsen

    2007-01-01

    Purpose: To investigate the circumstances as to why it is so difficult in the primary care sector to implement IT based infrastructures supporting shared care. Case study: The qualitative analysis includes two separate case studies of IT-supported shared care implemented in two different regions of Denmark throughout 2005. The study comprises 21 interviews and 35 hours of observations. The data were analysed through a coding process that led to the emergence of three main challenges impeding ...

  8. Use or Misuse? : Addiction Care Practitioners’ Perceptions of Substance Use and Treatment

    Samuelsson, Eva

    2015-01-01

    The aim of this thesis has been to study boundary-making in addiction care practitioner’s perceptions of substance use and treatment. The four papers are based on three data collections in Swedish outpatient addiction care: a) a survey conducted in 2006 (n=655), b) a factorial survey using randomly constructed vignettes conducted in 2011 (n=474), and c) a focus group interview study from 2013 (n=30) with a sample of the respondents from the factorial survey. The analyses show that practitione...

  9. Internet Addictive Individuals Share Impulsivity and Executive Dysfunction with Alcohol-Dependent Patients

    Zhenhe Zhou

    2014-01-01

    Internet addiction disorder (IAD) should belong to a kind of behavioral addiction. Previous studies indicated that there are many similarities in the neurobiology of behavior and substance addictions. Up to date, although individuals with IAD have difficulty in suppressing their excessive online behaviors in real life, little is known about the patho-physiological and cognitive mechanisms responsible for IAD. Neuropsychological test studies have contributed significantly to our understanding ...

  10. Interdisciplinary Shared Governance in Ambulatory Care: One Health System's Journey.

    Powers, Sharon; Bacon, Cynthia Thornton

    2016-01-01

    The implementation of shared governance structures in acute care has illustrated the positive relationship between shared decision making and nurse empowerment and positive nurse and patient outcomes. Little is known, however, about interdisciplinary shared governance, and even less is known about shared governance in ambulatory care. This article details one health system's experience with the implementation of an interdisciplinary shared governance structure in ambulatory care over a 4-year period. The authors report lessons learned, positive health system outcomes that resulted including improved communication, better preparedness for accreditation visits, improved assessment of fall risk, and a streamlined documentation system. Also discussed are mechanisms to enhance sustainability of the structure and discussion of future opportunities and challenges. PMID:27259130

  11. Shared Decision Making: Improving Care for Children with Autism

    Golnik, Allison; Maccabee-Ryaboy, Nadia; Scal, Peter; Wey, Andrew; Gaillard, Philippe

    2012-01-01

    We assessed the extent to which parents of children with autism spectrum disorder report that they are engaged in shared decision making. We measured the association between shared decision making and (a) satisfaction with care, (b) perceived guidance regarding controversial issues in autism spectrum disorder, and (c) perceived assistance…

  12. Shared services: strengthening early care and education

    Louise Stoney; Naman Libbie Poppick

    2010-01-01

    Early learning lasts a lifetime. We now have a strong body of evidence that learning is especially significant in the first five years of life and affects brain architecture for years to come.1 That’s why high-quality early care and education (ECE) is vital for children’s academic and social success.2 And given that more than 60 percent of U.S. mothers of children younger than 5 years old are working and that 73 percent of those children are regularly in child care, making sure that ECE is a ...

  13. Treating Opioid Addiction With Buprenorphine-Naloxone in Community-Based Primary Care Settings

    Mintzer, Ira L.; Eisenberg, Mark; Terra, Maria; MacVane, Casey; Himmelstein, David U.; Woolhandler, Steffie

    2007-01-01

    PURPOSE Office-based treatment of opioid addiction with a combination of buprenorphine and naloxone was approved in 2002. Efficacy of this treatment in nonresearch clinical settings has not been studied. We examined the efficacy and practicality of buprenorphine-naloxone treatment in primary care settings.

  14. Supporting shared care for diabetes patients. The synapses solution.

    Toussaint, P. J.; Kalshoven, M.; Ros, M.; van der Kolk, H.; Weier, O.

    1997-01-01

    In this paper we discuss the construction of a Federated Health Care Record server within the context of the European R&D project Synapses. We describe the system using the five ODP viewpoints. From an analysis of the business process to be supported by the distributed system (the shared care for diabetes patients) requirements for the server are derived. PMID:9357655

  15. Despite Resources From The ACA, Most States Do Little To Help Addiction Treatment Programs Implement Health Care Reform

    Andrews, Christina; Abraham, Amanda; Grogan, Colleen M.; Pollock, Harold A.; Bersamira, Clifford; Humphreys, Keith; Friedmann, Peter

    2015-01-01

    The Affordable Care Act (ACA) dramatically expands health insurance for addiction treatment and provides unprecedented opportunities for service growth and delivery model reform. Yet most addiction treatment programs lack the staffing and technological capabilities to respond successfully to ACA-driven system change. In light of these challenges, we conducted a national survey to examine how Single State Agencies for addiction treatment—the state governmental organizations charged with overse...

  16. Cocaine Addiction in Mothers: Potential Effects on Maternal Care and Infant Development

    Strathearn, Lane; Mayes, Linda C.

    2010-01-01

    Maternal cocaine addiction is a significant public health issue particularly affecting children, with high rates of reported abuse, neglect and foster care placement. This review examines both preclinical and clinical evidence for how cocaine abuse may impact maternal care and infant development, exploring brain, behavioral and neuroendocrine mechanisms. There is evidence that cocaine may affect infant development both directly, via in utero exposure, and indirectly via alterations in materna...

  17. Is there a shared neurobiology between aggression and Internet addiction disorder?

    Hahn, Changtae; Kim, Dai-Jin

    2014-01-01

    Purpose: Evidences indicate that Internet addiction disorder (IAD) has a higher risk of developing aggression and violent behavior. A few correlation studies between IAD and aggression have implicated a common biological mechanism. However, neurobiological approaches to IAD and aggression have not yet been studied. Methods: A literature search for studies for Internet addiction disorder or aggression was performed in the PubMed database and we selected articles about neurobiology of IAD or ag...

  18. A narrative review of binge eating and addictive behaviors: Shared associations with seasonality and personality factors

    Caroline eDavis

    2013-12-01

    Full Text Available Binge eating disorder (BED and seasonal affective disorder (SAD were first described as clinically-relevant conditions in very close temporal proximity a few decades ago. Both disorders have a higher prevalence rate in woman than in men, are characterized by a high proneness-to-stress and manifest heightened responsiveness to high-calorie, hyper-palatable foods. In recent years, a compelling body of evidence suggests that foods high in sugar and fat have the potential to alter brain reward circuitry in a manner similar to that seen when addictive drugs like alcohol and heroin are consumed in excess. These findings have led to suggestions that some cases of compulsive overeating may be understood as an addiction to sweet, fatty, and salty foods. In this paper, it is proposed that high seasonality is a risk factor for binge eating, especially in those characterized by anxious and impulsive personality traits – associations that could only occur in an environment with a superfluity of, and easy access to, rich and tasty foods. Given the well-established links between binge eating and addiction disorders (22-24 for reviews, it is also suggested that seasonality, together with the same high-risk psychological profile, exacerbates the likelihood of engaging in a broad range of addictive behaviors. Data from a community sample (n=412 of adults tested these models using linear regression procedures. Results confirmed that symptoms of binge eating and other addictive behaviors were significantly inter-correlated, and that seasonality, gender, and addictive personality traits were strong statistical predictors of the variance in binge-eating scores. Seasonality and addictive personality traits also accounted for a significant proportion of the variance in the measure of addictive behaviors. Conclusions are discussed in the context of brain reward mechanisms, motivational alternations in response to chronic over-consumption, and their relevance for the

  19. Knowledge sharing behaviour and intensive care nurse innovation: the moderating role of control of care quality

    Li-Ying, Jason; Paunova, Minna; Egerod, Ingrid

    2016-01-01

    of the questionnaire were used – one designed for nurse employees and the other for the managing nurse(s). An ordinary least squares regression analysis was used to test the hypotheses. Results Different aspects of knowledge sharing affect innovation differently, depending on the strength of the control of care......Aims This study investigates the influence of intensive care unit nurses’ knowledge sharing behaviour on nurse innovation, given different conditions of care quality control. Background Health-care organisations face an increasing pressure to innovate while controlling care quality. We have little...... insight on how the control of care quality interacts with the knowledge sharing behaviour of intensive care nurses to affect their innovative behaviours. Methods We developed a multi-source survey study of more than 200 intensive care nurses at 22 intensive care units of 17 Danish hospitals. Two versions...

  20. Shared Care Contributions to Self-Care and Quality of Life in Chronic Cardiac Patients.

    Sebern, Margaret; Brown, Roger; Flatley-Brennan, Patricia

    2016-07-01

    Shared care is an interpersonal interaction system composed of communication, decision making, and reciprocity; it is used by patients and family caregivers (care dyads) to exchange social support. This study's purpose was to describe the contributions of shared care to outcomes for individuals with cardiac disease. A secondary data analysis was used to answer the following questions. What is the association between elements of shared care and patient outcomes? Do dyad perceptions of shared care differentially contribute to patient outcomes? Participants in this study were 93 individuals with a cardiac disease and 93 family caregivers. Composite index structured equation modeling was the analytic tool. Caregiver communication and reciprocity were related to patient mental quality of life. Patient communication and reciprocity were related to their own mental and physical quality of life and self-care confidence. Findings from this study contribute a better understanding of how care dyads are integral to patient outcomes. PMID:26864996

  1. Shared parenting or shared care?:Learning from children's experiences of a post-divorce shared care arrangement

    Davies, Hayley

    2015-01-01

    This article examines three issues raised by three primary-aged siblings experiencing a post-divorce shared parenting arrangement. It argues that the conceptualisation of shared parenting in academic and policy discourse concentrates on parent-child relationships, overlooks children's relationships with siblings, and fails to fully recognise the social and material resources necessary for shared parenting arrangements to work. It suggests that current policy discourse takes for granted that s...

  2. [Assertive community treatment: promoting engagement with care of people suffering severe addiction].

    Morandi, Stéphane; Silva, Benedetta; Monnat, Martine; Bonsack, Charles

    2016-06-01

    Despite the increasing number of specialized addiction services and the constant deployment of health care resources, a coordinated needs-based treatment is not always available for people with severe drugs and/or alcohol problems. Too often the involved health care professionals feel helpless and overwhelmed by the complexity of the situation. In order to promote the treatment engagement of the hard-to-reach substance users, a multidisciplinary mobile team project for addiction (SIMA) was developed in Lausanne, Switzerland, in 20174. This paper describes the model of intervention, the profile of the population followed during the first year of intervention and illustrates, through two clinical cases, the advantages of this approach. PMID:27451516

  3. Predictors of retention in treatment in a tertiary care de-addiction center

    Majumder, Pradipta; Sarkar, Siddharth; Gupta, Rishab; Patra, Bichitra Nanda; Balhara, Yatan Pal Singh

    2016-01-01

    Context: Retention in treatment can improve the outcomes of patients with substance use disorders. Aims: This study aimed to assess the predictors of treatment retention in a set of patients admitted with substance use disorders. Setting and Design: This record-based study was conducted among consecutive patients discharged from the inpatient unit of a tertiary care de-addiction facility in Northern India. Materials and Methods: Patients were classified as being retained in treatment or drop-...

  4. Improving haemophilia patient care through sharing best practice.

    de Moerloose, Philippe; Arnberg, Daniel; O'Mahony, Brian; Colvin, Brian

    2015-10-01

    At the 2014 Annual Congress of the European Haemophilia Consortium (EHC) held in Belfast, Northern Ireland, Pfizer initiated and funded a satellite symposium entitled: 'Improving Patient Care Through Sharing Best Practice'. Co-chaired by Brian Colvin (Pfizer Global Innovative Pharma Business, Rome, Italy) and Brian O'Mahony [President of the EHC, Brussels, Belgium], the symposium provided an opportunity to consider patient care across borders, to review how patient advocacy groups can successfully engage with policymakers in healthcare decision-making and to discuss the importance of patient involvement in data collection to help shape the future environment for people with haemophilia. Professor Philippe de Moerloose (University Hospitals and Faculty of Medicine of Geneva, Switzerland) opened the session by discussing the gap between the haemophilia management guidelines and the reality of care for many patients living in Europe, highlighting the importance of sharing of best practice and building a network of treaters and patient organisations to support the improvement of care across Europe. Daniel Arnberg (SCISS AB, Hägersten, Sweden) reviewed the health technology assessment process conducted in Sweden, the first for haemophilia products, as a case study, focusing on the role of the patient organisation. Finally, Brian O'Mahony reflected on the central role of patients as individuals and also within patient organisations in shaping the future of haemophilia care. PMID:26338268

  5. Electronic Health Record in Continuous Shared Health Care

    Hanzlíček, Petr; Zvárová, Jana; Zvára, K.; Bureš, V.; Špidlen, Josef

    2005-01-01

    Roč. 11, - (2005), s. 1-6. ISSN 1727-1983. [EMBEC'05. European Medical and Biomedical Conference /3./. Prague, 20.11.2005-25.11.2005] R&D Projects: GA AV ČR 1ET200300413 Institutional research plan: CEZ:AV0Z10300504 Keywords : electronic health record * shared health care * information technology Subject RIV: BD - Theory of Information

  6. Internet gaming addiction: current perspectives.

    Kuss, Daria J

    2013-01-01

    In the 2000s, online games became popular, while studies of Internet gaming addiction emerged, outlining the negative consequences of excessive gaming, its prevalence, and associated risk factors. The establishment of specialized treatment centers in South-East Asia, the US, and Europe reflects the growing need for professional help. It is argued that only by understanding the appeal of Internet gaming, its context, and neurobiologic correlates can the phenomenon of Internet gaming addiction be understood comprehensively. The aim of this review is to provide an insight into current perspectives on Internet gaming addiction using a holistic approach, taking into consideration the mass appeal of online games, the context of Internet gaming addiction, and associated neuroimaging findings, as well as the current diagnostic framework adopted by the American Psychiatric Association. The cited research indicates that the individual's context is a significant factor that marks the dividing line between excessive gaming and gaming addiction, and the game context can gain particular importance for players, depending on their life situation and gaming preferences. Moreover, the cultural context is significant because it embeds the gamer in a community with shared beliefs and practices, endowing their gaming with particular meaning. The cited neuroimaging studies indicate that Internet gaming addiction shares similarities with other addictions, including substance dependence, at the molecular, neurocircuitry, and behavioral levels. The findings provide support for the current perspective of understanding Internet gaming addiction from a disease framework. The benefits of an Internet gaming addiction diagnosis include reliability across research, destigmatization of individuals, development of efficacious treatments, and the creation of an incentive for public health care and insurance providers. The holistic approach adopted here not only highlights empirical research that

  7. The core of love when caring for patients suffering from addiction.

    Thorkildsen, Kari M; Eriksson, Katie; Råholm, Maj-Britt

    2015-06-01

    Drug addiction is a serious health problem. The aim of this study was to gain an understanding of the core of love when caring for patients suffering from addiction. The study had a hermeneutical approach. Four nurses working at a detoxification unit were interviewed. Data were interpreted using a hermeneutical text interpretation based on Gadamer's hermeneutics. The results revealed the core of love in four dimensions: love as an inner driving force, searching for the human being behind the addiction, faith in the inner power of human beings and love as a movement of giving and receiving. The hermeneutical interpretation revealed the core of love as sacrifice, showing that sacrifice is an ethical dimension and that sacrifice involves searching for the patient's ontological suffering. Sacrifice is connected to faith, and faith in love is decisive for a life without drugs. Sacrifice involves being mutual gifts to one another, a self-reinforcing motion of sacrifice that energizes the nurses to go on with their work. PMID:25250789

  8. Sweet preference, sugar addiction and the familial history of alcohol dependence: shared neural pathways and genes.

    Fortuna, Jeffrey L

    2010-06-01

    Contemporary research has shown that a high number of alcohol-dependent and other drug-dependent individuals have a sweet preference, specifically for foods with a high sucrose concentration. Moreover, both human and animal studies have demonstrated that in some brains the consumption of sugar-rich foods or drinks primes the release of euphoric endorphins and dopamine within the nucleus accumbens, in a manner similar to some drugs of abuse. The neurobiological pathways of drug and "sugar addiction" involve similar neural receptors, neurotransmitters, and hedonic regions in the brain. Craving, tolerance, withdrawal and sensitization have been documented in both human and animal studies. In addition, there appears to be cross sensitization between sugar addiction and narcotic dependence in some individuals. It has also been observed that the biological children of alcoholic parents, particularly alcoholic fathers, are at greater risk to have a strong sweet preference, and this may manifest in some with an eating disorder. In the last two decades research has noted that specific genes may underlie the sweet preference in alcohol- and drug-dependent individuals, as well as in biological children of paternal alcoholics. There also appears to be some common genetic markers between alcohol dependence, bulimia, and obesity, such as the A1 allele gene and the dopamine 2 receptor gene. PMID:20648910

  9. Bridging between professionals in perinatal care: towards shared care in the Netherlands.

    Posthumus, A G; Schölmerich, V L N; Waelput, A J M; Vos, A A; De Jong-Potjer, L C; Bakker, R; Bonsel, G J; Groenewegen, P; Steegers, E A P; Denktaş, S

    2013-12-01

    Relatively high perinatal mortality rates in the Netherlands have required a critical assessment of the national obstetric system. Policy evaluations emphasized the need for organizational improvement, in particular closer collaboration between community midwives and obstetric caregivers in hospitals. The leveled care system that is currently in place, in which professionals in midwifery and obstetrics work autonomously, does not fully meet the needs of pregnant women, especially women with an accumulation of non-medical risk factors. This article provides an overview of the advantages of greater interdisciplinary collaboration and the current policy developments in obstetric care in the Netherlands. In line with these developments we present a model for shared care embedded in local 'obstetric collaborations'. These collaborations are formed by obstetric caregivers of a single hospital and all surrounding community midwives. Through a broad literature search, practical elements from shared care approaches in other fields of medicine that would suit the Dutch obstetric system were selected. These elements, focusing on continuity of care, patient centeredness and interprofessional teamwork form a comprehensive model for a shared care approach. By means of this overview paper and the presented model, we add direction to the current policy debate on the development of obstetrics in the Netherlands. This model will be used as a starting point for the pilot-implementation of a shared care approach in the 'obstetric collaborations', using feedback from the field to further improve it. PMID:23229171

  10. Continuity of Care: Sharing the Medication Treatment Plan.

    Spahni, Stéphane

    2016-01-01

    The shared medication treatment plan is a key element for supporting the continuity of care. Indeed a substantial amount of emergency hospitalization is linked to medication - 5% to 10% according to some studies. Methods and tools helping all healthcare providers to have a better knowledge of the complete medication plan are therefore required in order to limit side effects linked to an insufficient knowledge of what the patient is taking. The workshop intends to present various initiatives and open the discussion about the limits, pros and cons of various initiatives. PMID:27332315

  11. Interrelation of Preventive Care Benefits and Shared Costs under the Affordable Care Act (ACA

    Robert Dixon

    2014-08-01

    Full Text Available With the implementation of the Affordable Care Act (ACA, access to insurance and coverage of preventive care services has been expanded. By removing the barrier of shared costs for preventive care, it is expected that an increase in utilization of preventive care services will reduce the cost of chronic diseases. Early detection and treatment is anticipated to be less costly than treatment at full onset of chronic conditions. One concern of early detection of disease is the cost to treat. In reality, the confluence of early detection may result in greater overall expenditures. Even with improved access to preventive care benefits, cost-sharing of other health services remains a major component of insurance plans. In order to treat identified conditions or diseases, cost-sharing comes into play. With the greater adoption of cost-sharing insurance plans, expenditures on the part of enrollee are anticipated to rise. Once the healthcare recipients realize the implication of early identification and resultant treatment costs, enrollment in preventive care may decline. Healthcare legislation and regulation should consider the full spectrum of care and the microeconomic costs associated with preventive treatment. Although the system at large may not realize the immediate impact, behavioral shifts on the part of healthcare consumers may alter healthcare. Rather than the current status quo of treating presenting conditions, preventive treatment is largely anticipated to require more resources and may impact the consumer’s financial capacity. This report will explore how these two concepts are co-dependent, and highlight the need for continued reform.

  12. Pilot study of records of shared care for people with mental illnesses.

    Essex, B; Doig, R; Renshaw, J

    1990-01-01

    OBJECTIVE--To develop and evaluate a record of shared care to be held by the patient designed to increase the effectiveness of long term care of patients with severe mental illness. DESIGN--Questionnaires completed by medical staff, community psychiatric nurse, and patients to evaluate the shared care record. SETTING--General practices, a psychiatric outpatient clinic, and a mental health resource centre in south east London. PATIENTS--84 Patients held shared care records over an 18 month per...

  13. Shared psychological characteristics that are linked to aggression between patients with Internet addiction and those with alcohol dependence

    Hwang, Jae Yeon; Choi, Jung-Seok; Gwak, Ah Reum; Jung, Dawn; Choi, Sam-Wook; Lee, Jaewon; Lee, Jun-Young; Jung, Hee Yeon; Kim, Dai Jin

    2014-01-01

    Background Internet addiction (IA) is considered as one of behavioral addictions. Although common neurobiological mechanisms have been suggested to underlie behavioral addiction and substance dependence, few studies have directly compared IA with substance dependence, such as alcohol dependence (AD). Methods We compared patients with IA, AD, and healthy controls (HC) in terms of the Five Factor Model of personality and with regard to impulsiveness, anger expression, and mood to explore psycho...

  14. The Effects Of Cost-Sharing In Health Care: What Do We Know From Empirical Evidence?

    Carrieri Vincenzo

    2010-01-01

    Political and academic debate about cost-sharing in health care is becoming very popular because of the massive health care expenditure growth. In this paper, we aim to validate the use of cost-sharing in health care by assessing the effects that different policies of cost-sharing have produced around the world. We review, then, several empirical papers dealing with cost-sharing effects with respect to three main issues: moral hazard-contrast, redistributive effects and health care cost-conta...

  15. Internet gaming addiction: current perspectives

    Kuss DJ

    2013-11-01

    Full Text Available Daria J KussPsychology Research and Behavior Management, Birmingham City University, Birmingham, UKAbstract: In the 2000s, online games became popular, while studies of Internet gaming addiction emerged, outlining the negative consequences of excessive gaming, its prevalence, and associated risk factors. The establishment of specialized treatment centers in South-East Asia, the US, and Europe reflects the growing need for professional help. It is argued that only by understanding the appeal of Internet gaming, its context, and neurobiologic correlates can the phenomenon of Internet gaming addiction be understood comprehensively. The aim of this review is to provide an insight into current perspectives on Internet gaming addiction using a holistic approach, taking into consideration the mass appeal of online games, the context of Internet gaming addiction, and associated neuroimaging findings, as well as the current diagnostic framework adopted by the American Psychiatric Association. The cited research indicates that the individual's context is a significant factor that marks the dividing line between excessive gaming and gaming addiction, and the game context can gain particular importance for players, depending on their life situation and gaming preferences. Moreover, the cultural context is significant because it embeds the gamer in a community with shared beliefs and practices, endowing their gaming with particular meaning. The cited neuroimaging studies indicate that Internet gaming addiction shares similarities with other addictions, including substance dependence, at the molecular, neurocircuitry, and behavioral levels. The findings provide support for the current perspective of understanding Internet gaming addiction from a disease framework. The benefits of an Internet gaming addiction diagnosis include reliability across research, destigmatization of individuals, development of efficacious treatments, and the creation of an incentive

  16. Focusing on Patient Safety: the Challenge of Securely Sharing Electronic Medical Records in Complex Care Continuums.

    Key, Diana; Ferneini, Elie M

    2015-09-01

    The Patient Protection and Affordable Care Act's (PPACA) regulated approach to inclusive provision of care will increase the challenge health care administrators face ensuring secure communication and secure sharing of electronic medical records between divisions and care subcontractors. This analysis includes a summary overview of the PPACA; the Health Care and Education Reconciliation Act (HCERA) of 2010; and required Essential Health Benefits (EHB). The analysis integrates an overview of how secure communication and secure sharing of electronic medical records will be essential to clinical outcomes across complex care continuums; as well as the actionable strategies health care leadership can employ to overcome associated IT security challenges. PMID:26506680

  17. Implementation of a shared care guideline for back pain: Effect on unnecessary referrals

    Fleuren, M.; Dusseldorp, E.; Bergh, S. van den; Vlek, H.; Wildschut, J.; Akker, E. van den; Wijkel, D.

    2010-01-01

    Objective: To determine the effect of the implementation of a shared care guideline for the lumbosacral radicular syndrome (LRS) on unnecessary early referrals and the duration of the total diagnostic procedure. Design: Introduction of shared care guideline in November 2005. Pre-test in 2005 (April

  18. Using Poetry Writing and Sharing to Promote Student Empathy and Caring.

    Saunders, Mitzi M; Kowalski, Sonya L

    2015-01-01

    A poetry writing activity revealed both empathy and caring among nursing students. Using course readings to identify a topic, students created and shared their poems in an online format. The poems and students' reactions concur with existing literature that poetry writing and sharing reveals empathy and caring. Suggestions for using a poetry writing activity in nursing education are included. PMID:26465628

  19. A needs assessment of the number of comprehensive addiction care physicians required in a Canadian setting.

    McEachern, Jasmine

    2016-05-13

    Medical professionals adequately trained to prevent and treat substance use disorders are in short supply in most areas of the world. Whereas physician training in addiction medicine can improve patient and public health outcomes, the coverage estimates have not been established. We estimated the extent of the need for medical professionals skilled in addiction medicine in a Canadian setting.

  20. A systematic review of contemporary models of shared HIV care and HIV in primary care in high-income settings.

    Mapp, Fiona; Hutchinson, Jane; Estcourt, Claudia

    2015-12-01

    HIV shared care is uncommon in the UK although shared care could be a beneficial model of care. We review the literature on HIV shared care to determine current practice and clinical, economic and patient satisfaction outcomes. We searched MEDLINE, EMBASE, NICE Evidence, Cochrane collaboration, Google and websites of the British HIV Association, Aidsmap, Public Health England, World Health Organization and Terrence Higgins Trust using relevant search terms in August 2014. Studies published after 2000, from healthcare settings comparable to the UK that described links between primary care and specialised HIV services were included and compared using principles of the Critical Appraisal Skills Programme and Authority, Accuracy, Coverage, Objectivity, Date, Significance frameworks. Three of the nine included models reported clinical or patient satisfaction outcomes but data collection and analyses were inadequate. None reported economic outcomes although some provided financial costings. Facilitators of shared care included robust clinical protocols, training and timely communication. Few published examples of HIV shared care exist and quality of evidence is poor. There is no consistent association with improved clinical outcomes, cost effectiveness or acceptability. Models are context specific, driven by local need, although some generalisable features could inform novel service delivery. Further evaluative research is needed to determine optimal components of shared HIV care. PMID:25804421

  1. Federal Parity In The Evolving Mental Health And Addiction Care Landscape.

    Barry, Colleen L; Goldman, Howard H; Huskamp, Haiden A

    2016-06-01

    The intent of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 is to eliminate differences between health insurance coverage of mental health and substance use disorder benefits and coverage of medical or surgical benefits. The Affordable Care Act significantly extended the reach of the Wellstone-Domenici law by applying it to new insurance markets. We summarize the evolution of legislative and regulatory actions to bring about federal insurance parity. We also summarize available evidence on how the Wellstone-Domenici law has contributed to addressing insurance discrimination; rectifying market inefficiencies due to adverse selection; and altering utilization, spending, and health outcomes for people with mental health and substance use disorders. In addition, we highlight important gaps in knowledge about how parity has been implemented, describe the groups still lacking parity-level coverage, and make recommendations on steps to improve the likelihood that the Wellstone-Domenici law will fulfill the aims of its architects. PMID:27269016

  2. A conceptual framework for interprofessional shared decision making in home care: Protocol for a feasibility study

    Murray Mary-Anne; Fraser Kimberley; Dumont Serge; Desroches Sophie; Brière Nathalie; Stacey Dawn; Légaré France; Sales Anne; Aubé Denise

    2011-01-01

    Abstract Background Shared decision making (SDM) is fundamental to informed consent and client-centered care. So far, SDM frameworks have been limited to the client-physician dyad, even though care is increasingly delivered by interprofessional (IP) teams. IP collaboration is especially essential in home care, one of health care's most rapidly growing areas. This study will assess whether it is possible to practice SDM in IP home care. Methods/Design We will use a qualitative case study and a...

  3. Nurse-led shared care diabetes projects : lessons from the nurses' viewpoint

    Eijkelberg, Irmgard M J G; Spreeuwenberg, Cor; Wolffenbuttel, Bruce H R; van Wilderen, Loek J G P; Mur-Veeman, Ingrid M

    2003-01-01

    This paper explores the experiences of four nurse practitioners specialised in diabetes care, in the development and implementation of two Dutch nurse-led shared care projects to improve quality of care. The focus is on the impeding factors involved. The nurses' views are compared to those of the 38

  4. A needs assessment of the number of comprehensive addiction care physicians required in a Canadian setting

    McEachern, Jasmine; Ahamad, Keith; Nolan, Seonaid; Mead, Annabel; Wood, Evan; Klimas, Jan

    2016-01-01

    Objective: Medical professionals adequately trained to prevent and treat substance use disorders are in short supply in most areas of the world. Whereas physician training in addiction medicine can improve patient and public health outcomes, the coverage estimates have not been established. We estimated the extent of the need for medical professionals skilled in addiction medicine in a Canadian setting. Methods: We used Monte-Carlo simulations to generate medians and 95% credibility intervals...

  5. Shared care between specialised psychiatric services and primary care: The experiences and expectations of General Practitioners in Ireland.

    Agyapong, Vincent Israel Opoku

    2012-04-17

    Objective. The study aims to explore the views of General Practitioners in Ireland on shared care between specialised psychiatric services and primary care. Method. A self-administered questionnaire was designed and posted to 400 randomly selected General Practitioners working in Ireland. Results. Of the respondents, 189 (94%) reported that they would support a general policy on shared care between primary care and specialised psychiatric services for patients who are stable on their treatment. However, 124 (61.4%) reported that they foresaw difficulties for patients in implementing such a policy including: a concern that primary care is not adequately resourced with allied health professionals to support provision of psychiatric care (113, 53.2%); a concern this would result in increased financial burden on some patients (89, 48.8%); a lack of adequate cooperation between primary care and specialised mental health services (84, 41.8%); a concern that some patients may lack confidence in GP care (55, 27.4%); and that primary care providers are not adequately trained to provide psychiatric care (29, 14.4% ). Conclusion. The majority of GPs in Ireland would support a policy of shared care of psychiatric patients; however they raise significant concerns regarding practical implications of such a policy in Ireland.

  6. Couples' provision of informal care for parents and parents-in-law: far from sharing equally?

    Henz, Ursula

    2009-01-01

    This study examines whether and how couples share the provision of informal care for their parents. Four waves of the British General Household Survey contain cross-sectional information about caring for parents and parents-in-law. Descriptive and multivariate analyses were conducted on 2214 couples that provided parent care. The findings emphasise married men’s contribution to informal caring for the parental generation and at the same time demonstrate the limits of their involvement. Spouse...

  7. When do they care to share? : How manufacturers make contracted service partners share knowledge

    de Vries, J.; Schepers, J.; van Weele, A.; van der Valk, W.

    2014-01-01

    Manufacturing firms that outsource customer-facing services, risk losing touch with their customers and thereby forfeit valuable market and customer-related knowledge. To maintain informed and competitive, the manufacturer's customer-facing service partners should engage in knowledge sharing and tra

  8. Developing Shared Learning in Multiprofessional Health Care Education: For Whose Benefit?

    Atkins, Josephine M.; Walsh, Rosemary S.

    1997-01-01

    A literature review and study of a baccalaureate health care education program examined approaches to shared learning. The study recommended that the value of multidisciplinary collaboration be extended to all stakeholders, including consumers, administrators, and policymakers. (SK)

  9. Infotech. Cyber security. Health care learns to share scares and solutions.

    Colias, Mike

    2004-05-01

    Health care information technology leaders and others are coming together to share scary experiences and develop best practices to guard against crippling computer viruses, scheming hackers and other cyber threats. PMID:15192882

  10. The ephemeral accountable care organization-an unintended consequence of the Medicare shared savings program.

    Harvey, H Benjamin; Gowda, Vrushab; Gazelle, G Scott; Pandharipande, Pari V

    2014-02-01

    A fundamental element of health care payment reform under the Affordable Care Act is the development of Accountable Care Organizations (ACOs). The ACO model employs shared-risk contracts to better align the interests of health care providers and payers with the intent of driving efficiency and quality in care. The Medicare Shared Savings Program is the most popular of the Medicare ACO programs, with over 200 health systems across the nation participating at this time. However, a pitfall in the way that the Medicare Shared Savings Program is structured, specifically the benchmarking and rebasing method, could make it difficult for even top-performing ACOs to achieve sustained success, thereby threatening the long-term viability of the program. In this paper, we present this pitfall to the radiology community as well as potential solutions that can be considered by CMS moving forward. PMID:24360903

  11. What do practitioners think? A qualitative study of a shared care mental health and nutrition primary care program

    Jann Paquette-Warren

    2006-10-01

    Full Text Available Objective: To develop an in-depth understanding of a shared care model from primary mental health and nutrition care practitioners with a focus on program goals, strengths, challenges and target population benefits. Design: Qualitative method of focus groups. Setting/Participants: The study involved fifty-three practitioners from the Hamilton Health Service Organization Mental Health and Nutrition Program located in Hamilton, Ontario, Canada. Method: Six focus groups were conducted to obtain the perspective of practitioners belonging to various disciplines or health care teams. A qualitative approach using both an editing and template organization styles was taken followed by a basic content analysis. Main findings: Themes revealed accessibility, interdisciplinary care, and complex care as the main goals of the program. Major program strengths included flexibility, communication/collaboration, educational opportunities, access to patient information, continuity of care, and maintenance of practitioner and patient satisfaction. Shared care was described as highly dependent on communication style, skill and expertise, availability, and attitudes toward shared care. Time constraint with respect to collaboration was noted as the main challenge. Conclusion: Despite some challenges and variability among practices, the program was perceived as providing better patient care by the most appropriate practitioner in an accessible and comfortable setting.

  12. Sharing, displacing, caring : towards an ecology of contribution

    Altés Arlandis, Alberto

    2013-01-01

    The optimism emanating from the opening quote, which I fundamentally share, confronts a grim landscape of universal cynicism, toxic capitalism and liberal, fake ethics. Those seem to be the reigning kings of the world we live in. Or in other words, shit-is-fucked-up-and-bullshit. The sentence, as found in the placards of some of the Occupy protesters, can be read in different ways. On the one hand,  one could see it as the epitome of modern cynicism, which Sloterdijk has famously described as...

  13. A demonstration of shared decision making in primary care highlights barriers to adoption and potential remedies

    Friedberg, M.W.; Busum, K. Van; Wexler, R.; Bowen, M.; Schneider, E.C.

    2013-01-01

    Recent developments in health reform related to the passage of the Affordable Care Act and ensuing regulations encourage delivery systems to engage in shared decision making, in which patients and providers together make health care decisions that are informed by medical evidence and tailored to the

  14. Developing patient-centered teams: The role of sharing stories about patients and patient care.

    Bennett, Ariana H; Hassinger, Jane A; Martin, Lisa A; Harris, Lisa H; Gold, Marji

    2015-09-01

    Research indicates that health care teams are good for staff, patients, and organizations. The characteristics that make teams effective include shared objectives, mutual respect, clarity of roles, communication, trust, and collaboration. We were interested in examining how teams develop these positive characteristics. This paper explores the role of sharing stories about patients in developing patient-centered teams. Data for this paper came from 1 primary care clinic as part of a larger Providers Share Workshop study conducted by the University of Michigan. Each workshop included 5 facilitated group sessions in which staff met to talk about their work. This paper analyzes qualitative data from the workshops. Through an iterative process, research team members identified major themes, developed a coding scheme, and coded transcripts for qualitative data analysis. One of the most powerful ways group members connected was through sharing stories about their patients. Sharing clinical cases and stories helped participants bond around their shared mission of patient-centered care, build supportive relationships, enhance compassion for patients, communicate and resolve conflict, better understand workflows and job roles, develop trust, and increase morale. These attributes highlighted by participants correspond to those documented in the literature as important elements of teambuilding and key indicators of team effectiveness. The sharing of stories about patients seems to be a promising tool for positive team development in a primary care clinical setting and should be investigated further. PMID:26348238

  15. Robotic surgery in urological oncology: patient care or market share?

    Kaye, Deborah R; Mullins, Jeffrey K; Carter, H Ballentine; Bivalacqua, Trinity J

    2015-01-01

    Surgical robotic use has grown exponentially in spite of limited or uncertain benefits and large costs. In certain situations, adoption of robotic technology provides value to patients and society. In other cases, however, the robot provides little or no increase in surgical quality, with increased expense, and, therefore, does not add value to health care. The surgical robot is expensive to purchase, maintain and operate, and can contribute to increased consumerism in relation to surgical procedures, and increased reliance on the technology, thus driving future increases in health-care expenditure. Given the current need for budget constraints, the cost-effectiveness of specific procedures must be evaluated. The surgical robot should be used when cost-effective, but traditional open and laparoscopic techniques also need to be continually fostered. PMID:25535000

  16. Electronic Health Record for Continuous Shared Health Care

    Hanzlíček, Petr; Zvárová, Jana

    2005-01-01

    Roč. 9, - (2005), s. 275-280. ISSN 1335-2393. [YBERC 2005. Young Biomedical Engineers and Researchers Conference. Stará Lesná, 13.07.2005-15.07.2005] R&D Projects: GA AV ČR 1ET200300413 Institutional research plan: CEZ:AV0Z10300504 Keywords : information society * telemedicine * electronic health record * digital signature * personal data protection * biomedical informatics Subject RIV: FQ - Public Health Care, Social Medicine

  17. Sharing, caring, and surveilling: an actor-partner interdependence model examination of Facebook relational maintenance strategies.

    McEwan, Bree

    2013-12-01

    Abstract Relational maintenance is connected to high quality friendships. Friendship maintenance behaviors may occur online via social networking sites. This study utilized an Actor-Partner Interdependence Model to examine how Facebook maintenance and surveillance affect friendship quality. Bryant and Marmo's (2012) Facebook maintenance scale was evaluated, revealing two factors: sharing and caring. Facebook surveillance was also measured. For friendship satisfaction and liking, significant positive actor and partner effects emerged for caring; significant negative actor, partner, and interaction effects emerged for sharing; and significant positive actor effects emerged for surveillance. For friendship closeness, significant positive actor effects emerged for caring and surveillance. PMID:23962125

  18. Shared care and implementation of a pediatric clinical pathway

    Langfrits, Mette Sørensen; Thomsen, RW; Rubak, Jens Mørck; Høst, Arne; Rubak, Sune Leisgaard Mørck

    and children with uncontrolled asthma should be followed at the pediatrics department. Study 2) An increased overall proportion of children with well-controlled asthma. Study 3) Favorable changes in the use of asthma medication. Study 4) Self-reported higher quality of life among children with asthma...... either at a hospital specialist out-patient clinic at the pediatrics department at Viborg hospital or at one of 100 GPs in the Viborg area. At baseline the involved health care professionals participated in an introduction to the clinical pathway and treatment guide. Furthermore the clinical pathway and...... supported by Folkesundhed i Midten. We sincerely thank Lars G. Hansen (Head of Department of Pediatrics, Viborg Hospital) for his help and participation....

  19. [Part I. End-stage chronic organ failures: a position paper on shared care planning. The Integrated Care Pathway].

    Gristina, Giuseppe R; Orsi, Luciano; Carlucci, Annalisa; Causarano, Ignazio R; Formica, Marco; Romanò, Massimo

    2014-01-01

    In Italy the birth rate decrease together with the continuous improvement of living conditions on one hand, and the health care progress on the other hand, led in recent years to an increasing number of patients with chronic mono- or multi-organ failures and in an extension of their life expectancy. However, the natural history of chronic failures has not changed and the inescapable disease's worsening at the end makes more rare remissions, increasing hospital admissions rate and length of stay. Thus, when the "end-stage" get close clinicians have to engage the patient and his relatives in an advance care planning aimed to share a decision making process regarding all future treatments and related ethical choices such as patient's best interests, rights, values, and priorities. A right approach to the chronic organ failures end-stage patients consists therefore of a careful balance between the new powers of intervention provided by the biotechnology and pharmacology (intensive care), both with the quality of remaining life supplied by physicians to these patients (proportionality and beneficence) and the effective resources rationing and allocation (distributive justice). However, uncertainty still marks the criteria used by doctors to assess prognosis of these patients in order to make decisions concerning intensive or palliative care. The integrated care pathway suggested in this position paper shared by nine Italian medical societies, has to be intended as a guide focused to identify end-stage patients and choosing for them the best care option between intensive treatments and palliative care. PMID:24553592

  20. Evaluation of care services provided to female patients by Drug Addiction Department: a national explorative survey

    M. Zermiani; M. Gomma; G. Serpelloni

    2013-01-01

    Background: Drug abusing women are one of the key customers due to their vulnerability directly linked to biological, genetics, psychological and social characteristics. Objectives: This is an exploratory research aimed to determine what are the most significant factors that would improve the access to the Drug Addiction Department and their adherence. Material and Methods: A 16 item self-administered questionnaire was assembled. Each item was scored on a 1 to 7 scale (Likert scale). The ques...

  1. Shared Care in Basic Level Palliative Home Care: Organizational and Interpersonal Challenges

    Neergaard, Mette Asbjørn; Olesen, Frede; Jensen, Anders Bonde;

    2010-01-01

    Little is known about the existing barriers to cooperation among health professionals in basic level palliative care for terminally ill patients with cancer in primary health care.......Little is known about the existing barriers to cooperation among health professionals in basic level palliative care for terminally ill patients with cancer in primary health care....

  2. Confronting evidence: individualised care and the case for shared decision-making.

    Ryan, P

    2014-11-01

    In many clinical scenarios there exists more than one clinically appropriate intervention strategy. When these involve subjective trade-offs between potential benefits and harms, patients\\' preferences should inform decision-making. Shared decision-making is a collaborative process, where clinician and patient reconcile the best available evidence with respect for patients\\' individualized care preferences. In practice, clinicians may be poorly equipped to participate in this process. Shared decision-making is applicable to many conditions including stable coronary artery disease, end-of-life care, and numerous small decisions in chronic disease management. There is evidence of more clinically appropriate care patterns, improved patient understanding and sense of empowerment. Many trials reported a 20% reduction in major surgery in favour of conservative treatment, although demand tends to increase for some interventions. The generalizability of international evidence to Ireland is unclear. Considering the potential benefits, there is a case for implementing and evaluating shared decision-making pilot projects in Ireland.

  3. Predictors of Shared Decision Making and Level of Agreement between Consumers and Providers in Psychiatric Care

    Fukui, Sadaaki; Salyers, Michelle P.; Matthias, Marianne S.; Collins, Linda; Thompson, John; Coffman, Melinda; Torrey, William C.

    2013-01-01

    The purpose of this study was to quantitatively examine elements of shared decision making (SDM), and to establish empirical evidence for factors correlated with SDM and the level of agreement between consumer and provider in psychiatric care. Transcripts containing 128 audio-recorded medication check-up visits with eight providers at three community mental health centers were rated using the Shared Decision Making scale, adapted from Braddock’s Informed Decision Making Scale (Braddock et al....

  4. Shared Decision Making and Effective Physician-Patient Communication: The Quintessence of Patient-Centered Care

    Huy Ming Lim

    2015-03-01

    Full Text Available The Institute of Medicine’s (IOM 2001 landmark report, Crossing the Quality Chasm: A New Health System for the 21st Century, identified patient-centeredness as one of the fundamental attributes of quality health care, alongside safety, effectiveness, timeliness, efficiency, and equity. The IOM defined patient-centeredness as “providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions.” This concept of patient-centered care represents a paradigm shift from the traditional disease-oriented and physician-centered care, grounding health care in the subjective experience of illness and the needs and preferences of individual patients rather than the evaluation and treatment of diseases which emphasizes on leveraging clinical expertise and evidence derived from population-based studies. Regrettably, despite the ubiquitous talk about patient-centered care in modern health care, shared decision-making and effective physician-patient communication—the two cruxes of patient-centered care—are yet to become the norms. Strategies to promote and enhance shared decision-making and effective communication between clinicians and patients should be rigorously implemented to establish a health care system that truly values patients as individuals and turn the rhetoric of patient-centered care into reality.

  5. Shared care management of patients with type 2 diabetes across the primary and secundary Health care sectors

    Munch, Lene; Bennich, Birgitte Bøcher; Arreskov, Anne B;

    2016-01-01

    of this study is to test if T2D patients (who are at intermediate risk of or are already having incipient diabetic complications) jointly managed by a hospital-based outpatient clinic and general practitioners (shared care programme) have a non-inferior outcome compared to an established programme...... in a specialised (hospital based) outpatient diabetes clinic. Methods The study is designed as a randomised controlled trial. The shared care model will be tested during a period of 3 years, with data collection at baseline and at 12, 24 and 36 months. All patients will be offered four medical visits a year......Background The prevalence of type 2 diabetes (T2D) is growing globally and hospital-based outpatient clinics are burdened with increasing numbers of patients. To ensure high quality treatment and care, it is necessary to structurally reorganise the management of patients with T2D. The objective...

  6. The perceived impact of interprofessional information sharing on young people about their sexual health care

    Hyde, Abbey; Fullerton, Deirdre; Lohan, Maria; Dunne, Laura; Macdonald, Geraldine; McKeown, Caroline; Healy, Maria; Howlin, Frances

    2016-01-01

    This paper presents the results from an analysis of data from service-providers and young adults who were formerly in state care about how information about the sexual health of young people in state care (YPISC) is managed. In particular, the analysis focuses on the perceived impact of information sharing between professionals on young people. Twenty two service-providers from a range of professions including social work, nursing and psychology, and 19 young people aged 18-22 years who were ...

  7. Care to Share? Social innovation through low-budget, high impact welfare technologies

    Asboe, Mark; Grönvall, Erik; Lassen, Henry Michael

    2011-01-01

    The Western welfare model is under pressure and finding new ways of providing care is a key issue to maintain a reasonable service level for elderly people spending their last years at a nursing home. Personal care at nursing homes tends to (quite reasonably) have high priority at the expense of...... successful implementation of more costly technologies. We present a concept named Care to Share? that seeks to bring together professional and family initiated care and that assists in the articulation work of social activities in a nursing home....... social activities, thus creating situations where a number of elderly people experience loneliness. This paper presents ongoing work that focuses on developing Information and Communication Technology (ICT) for nursing homes that brings together professional care activities and family initiated care. We...

  8. Market-Based Health Care in Specialty Surgery: Finding Patient-Centered Shared Value.

    Smith, Timothy R; Rambachan, Aksharananda; Cote, David; Cybulski, George; Laws, Edward R

    2015-10-01

    : The US health care system is struggling with rising costs, poor outcomes, waste, and inefficiency. The Patient Protection and Affordable Care Act represents a substantial effort to improve access and emphasizes value-based care. Value in health care has been defined as health outcomes for the patient per dollar spent. However, given the opacity of health outcomes and cost, the identification and quantification of patient-centered value is problematic. These problems are magnified by highly technical, specialized care (eg, neurosurgery). This is further complicated by potentially competing interests of the 5 major stakeholders in health care: patients, doctors, payers, hospitals, and manufacturers. These stakeholders are watching with great interest as health care in the United States moves toward a value-based system. Market principles can be harnessed to drive costs down, improve outcomes, and improve overall value to patients. However, there are many caveats to a market-based, value-driven system that must be identified and addressed. Many excellent neurosurgical efforts are already underway to nudge health care toward increased efficiency, decreased costs, and improved quality. Patient-centered shared value can provide a philosophical mooring for the development of health care policies that utilize market principles without losing sight of the ultimate goals of health care, to care for patients. PMID:26308640

  9. Gambling Addiction

    ... Can I Help a Friend Who Cuts? Gambling Addiction KidsHealth > For Teens > Gambling Addiction Print A A ... worth my time?" "What are the risks?" Gambling Addiction Some people have a higher chance of becoming ...

  10. The benefits of respectful interactions: fluid alliancing and inter-occupational information sharing in primary care.

    DiCicco-Bloom, Barbara; DiCicco-Bloom, Benjamin

    2016-07-01

    Though inter-occupational interactions in health care have been the focus of increasing attention, we still know little about how such interactions shape information sharing in clinical settings. This is particularly true in primary care where research on teams and collaboration has been based on individual perceptions of work (using surveys and interviews) rather than observing the interactions that directly mediate the inter-occupational flow of information. To explore how interactions shape information sharing, we conducted a secondary analysis of ethnographic data from 27 primary care practices. Ease of information sharing among nurses and doctors is linked to the degree to which practices feature respectful interactions, with practices in the sample falling into one of three categories (those with low, uneven, and high degrees of respectful interactions). Those practices with the highest degree of respectful interactions demonstrate what we describe as fluid-alliancing: flexible interactions between individuals from different occupational groups in which bidirectional information sharing occurs for the benefit of patients and the efficacy of the practice community. We conclude by arguing that this process unlocks the strengths of all practice members, and that leadership should encourage respectful interactions to augment organisational efficacy and the ability of individual practice members to provide quality patient care. PMID:27363598

  11. Interprofessionalism and shared decision-making in primary care: a stepwise approach towards a new model

    Legare, F.; Stacey, D.; Pouliot, S.; Gauvin, F.P.; Desroches, S.; Kryworuchko, J.; Dunn, S.; Elwyn, G.; Frosch, D.; Gagnon, M.P.; Harrison, M.B.; Pluye, P.; Graham, I.D.

    2011-01-01

    Most shared decision-making (SDM) models within healthcare have been limited to the patient-physician dyad. As a first step towards promoting an interprofessional approach to SDM in primary care, this article reports how an interprofessional and interdisciplinary group developed and achieved consens

  12. Shared care in mental illness: A rapid review to inform implementation

    Kelly Brian J

    2011-11-01

    Full Text Available Abstract Background While integrated primary healthcare for the management of depression has been well researched, appropriate models of primary care for people with severe and persistent psychotic disorders are poorly understood. In 2010 the NSW (Australia Health Department commissioned a review of the evidence on "shared care" models of ambulatory mental health services. This focussed on critical factors in the implementation of these models in clinical practice, with a view to providing policy direction. The review excluded evidence about dementia, substance use and personality disorders. Methods A rapid review involving a search for systematic reviews on The Cochrane Database of Systematic Reviews and Database of Abstracts of Reviews of Effects (DARE. This was followed by a search for papers published since these systematic reviews on Medline and supplemented by limited iterative searching from reference lists. Results Shared care trials report improved mental and physical health outcomes in some clinical settings with improved social function, self management skills, service acceptability and reduced hospitalisation. Other benefits include improved access to specialist care, better engagement with and acceptability of mental health services. Limited economic evaluation shows significant set up costs, reduced patient costs and service savings often realised by other providers. Nevertheless these findings are not evident across all clinical groups. Gains require substantial cross-organisational commitment, carefully designed and consistently delivered interventions, with attention to staff selection, training and supervision. Effective models incorporated linkages across various service levels, clinical monitoring within agreed treatment protocols, improved continuity and comprehensiveness of services. Conclusions "Shared Care" models of mental health service delivery require attention to multiple levels (from organisational to individual

  13. Engagement and Substance Dependence in a Primary Care-Based Addiction Treatment Program for People Infected with HIV and People at High-Risk for HIV Infection.

    Walley, Alexander Y; Palmisano, Joseph; Sorensen-Alawad, Amy; Chaisson, Christine; Raj, Anita; Samet, Jeffrey H; Drainoni, Mari-Lynn

    2015-12-01

    To improve outcomes for people with substance dependence and HIV infection or at risk for HIV infection, patients were enrolled in a primary care-based addiction treatment program from 2008-2012 that included a comprehensive substance use assessment, individual and group counseling, addiction pharmacotherapy and case management. We examined whether predisposing characteristics (depression, housing status, polysubstance use) and an enabling resource (buprenorphine treatment) were associated with engagement in the program and persistent substance dependence at 6 months. At program enrollment 61% were HIV-infected, 53% reported heroin use, 46% reported alcohol use, 37% reported cocaine use, and 28% reported marijuana use in the past 30 days, 72% reported depression, 19% were homeless, and 53% had polysubstance use. Within 6-months 60% had been treated with buprenorphine. Engagement (defined as 2 visits in first 14 days and 2 additional visits in next 30 days) occurred in 64%; 49% had substance dependence at 6-months. Receipt of buprenorphine treatment was associated with engagement (Adjusted Odds Ratio (AOR) 8.32 95% CI: 4.13-16.77). Self-reported depression at baseline was associated with substance dependence at 6-months (AOR 3.30 95% CI: 1.65-6.61). Neither housing status nor polysubstance use was associated with engagement or substance dependence. The FAST PATH program successfully engaged and treated patients in a primary care-based addiction treatment program. Buprenorphine, a partial opioid agonist, was a major driver of addiction treatment engagement. Given depression's association with adverse outcomes in this clinical population, including mental health treatment as part of integrated care holds potential to improve addiction treatment outcomes. PMID:26298399

  14. Developing new models of shared primary and specialist HIV care in the UK: a survey of current practice.

    Hutchinson, Jane; Sutcliffe, Loma J; Williams, Andy J; Estcourt, Claudia S

    2016-07-01

    HIV care in the UK is led by hospital-based specialists with limited general practitioner (GP) involvement. As GPs have expertise in some non-microbial HIV-associated co-morbidities (e.g. cardiovascular disease), and more people are disclosing their HIV status to their GPs, there could be benefits in sharing HIV care. We describe contemporary models of shared HIV care in relevant developed world settings to inform future shared HIV care in the UK. An interview survey of key informants was used to explore experiences and models of shared care, and identify promoting and inhibiting factors. We interviewed ten key informants from six shared care models. There were three broad categories of shared care, with varying degrees of GP involvement. Strong clinical leadership in primary care, good professional relationships and communication, and tailored GP training were facilitators. Barriers included stigma, confidentiality concerns, and low prevalence of HIV outside major conurbations. Contemporary shared HIV care models have emerged organically and seem to work when grounded in good collaboration between a small number of dedicated GPs and specialist units. We propose two models for further study which may only be feasible in high HIV caseload practices. User acceptability, clinical and cost effectiveness must be considered. PMID:26113516

  15. Challenges for IT-supported shared care: a qualitative analyses of two shared care initiatives for diabetes treatment in Denmark “I'll never use it” (GP5).

    Granlien, Maren Fich; Simonsen, Jesper

    2007-01-01

    Purpose To investigate the circumstances as to why it is so difficult in the primary care sector to implement IT based infrastructures supporting shared care. Case study The qualitative analysis includes two separate case studies of IT-supported shared care implemented in two different regions of Denmark throughout 2005. The study comprises 21 interviews and 35 hours of observations. The data were analysed through a coding process that led to the emergence of three main challenges impeding th...

  16. SHARING IS CARING: A DATA EXCHANGE FRAMEWORK FOR CO-LOCATED MOBILE APPS

    Joseph Milazzo

    2014-08-01

    Full Text Available Data sharing between mobile apps that are co-located in a smartphone may lead to synergistic benefits to the user especially in the health-care domain. Mobile apps that monitor and control user behavior can interact to engage the user into a healthy schedule over a long term. In the current app development paradigm, apps are being developed individually and agnostic of each other. To enable interaction between apps in secure manner, collaboration between developers is needed, which can be problematic on many levels. Current approaches to app integration require large code modifications to reap the benefits of shared data such as requiring developers to provide APIs or ensuring security through elaborate measures. In order to promote app interaction, this paper proposes a non-invasive secure interface for data sharing between mobile apps. A separate app, called the Health-Dev data manager, acts as a registry to allow apps to register database tables to be shared. Two health monitoring apps are developed to evaluate the sharing framework and different methods of data integration between apps. The health monitoring apps have shown non-invasive solutions can provide data sharing functionality without large code modifications and collaboration between developers.

  17. Sharing clinical information across care settings: the birth of an integrated assessment system

    Henrard Jean-Claude

    2009-04-01

    Full Text Available Abstract Background Population ageing, the emergence of chronic illness, and the shift away from institutional care challenge conventional approaches to assessment systems which traditionally are problem and setting specific. Methods From 2002, the interRAI research collaborative undertook development of a suite of assessment tools to support assessment and care planning of persons with chronic illness, frailty, disability, or mental health problems across care settings. The suite constitutes an early example of a "third generation" assessment system. Results The rationale and development strategy for the suite is described, together with a description of potential applications. To date, ten instruments comprise the suite, each comprising "core" items shared among the majority of instruments and "optional" items that are specific to particular care settings or situations. Conclusion This comprehensive suite offers the opportunity for integrated multi-domain assessment, enabling electronic clinical records, data transfer, ease of interpretation and streamlined training.

  18. A Requirement Engineering Framework for Electronic Data Sharing of Health Care Data Between Organizations

    Liu, Xia; Peyton, Liam; Kuziemsky, Craig

    Health care is increasingly provided to citizens by a network of collaboration that includes multiple providers and locations. Typically, that collaboration is on an ad-hoc basis via phone calls, faxes, and paper based documentation. Internet and wireless technologies provide an opportunity to improve this situation via electronic data sharing. These new technologies make possible new ways of working and collaboration but it can be difficult for health care organizations to understand how to use the new technologies while still ensuring that their policies and objectives are being met. It is also important to have a systematic approach to validate that e-health processes deliver the performance improvements that are expected. Using a case study of a palliative care patient receiving home care from a team of collaborating health organizations, we introduce a framework based on requirements engineering. Key concerns and objectives are identified and modeled (privacy, security, quality of care, and timeliness of service). And, then, proposed business processes which use new technologies are modeled in terms of these concerns and objectives to assess their impact and ensure that electronic data sharing is well regulated.

  19. Primary care provider perceptions of intake transition records and shared care with outpatient cardiac rehabilitation programs

    Jamnik Veronica

    2011-09-01

    Full Text Available Abstract Background While it is recommended that records are kept between primary care providers (PCPs and specialists during patient transitions from hospital to community care, this communication is not currently standardized. We aimed to assess the transmission of cardiac rehabilitation (CR program intake transition records to PCPs and to explore PCPs' needs in communication with CR programs and for intake transition record content. Method 144 PCPs of consenting enrollees from 8 regional and urban Ontario CR programs participated in this cross-sectional study. Intake transition records were tracked from the CR program to the PCP's office. Sixty-six PCPs participated in structured telephone interviews. Results Sixty-eight (47.6% PCPs received a CR intake transition record. Fifty-eight (87.9% PCPs desired intake transition records, with most wanting it transmitted via fax (n = 52, 78.8%. On a 5-point Likert scale, PCPs strongly agreed that the CR transition record met their needs for providing patient care (4.32 ± 0.61, with 48 (76.2% reporting that it improved their management of patients' cardiac risk. PCPs rated the following elements as most important to include in an intake transition record: clinical status (4.67 ± 0.64, exercise test results (4.61 ± 0.52, and the proposed patient care plan (4.59 ± 0.71. Conclusions Less than half of intake transition records are reaching PCPs, revealing a large gap in continuity of patient care. PCP responses should be used to develop an evidence-based intake transition record, and procedures should be implemented to ensure high-quality transitional care.

  20. Terminal Versus Advanced Cancer: Do the General Population and Health Care Professionals Share a Common Language?

    Kim, Sang Hyuck; Shin, Dong Wook; Kim, So Young; Yang, Hyung Kook; Nam, Eunjoo; Jho, Hyun Jung; Ahn, Eunmi; Cho, Be Long; Park, Keeho; Park, Jong-Hyock

    2015-01-01

    Purpose Many end-of-life care studies are based on the assumption that there is a shared definition of language concerning the stage of cancer. However, studies suggest that patients and their families often misperceive patients’ cancer stages and prognoses. Discrimination between advanced cancer and terminal cancer is important because the treatment goals are different. In this study, we evaluated the understanding of the definition of advanced versus terminal cancer of the general populatio...

  1. SHARING IS CARING: A DATA EXCHANGE FRAMEWORK FOR CO-LOCATED MOBILE APPS

    Joseph Milazzo; Priyanka Bagade; Ayan Banerjee; Gupta, Sandeep K. S.

    2014-01-01

    Data sharing between mobile apps that are co-located in a smartphone may lead to synergistic benefits to the user especially in the health-care domain. Mobile apps that monitor and control user behavior can interact to engage the user into a healthy schedule over a long term. In the current app development paradigm, apps are being developed individually and agnostic of each other. To enable interaction between apps in secure manner, collaboration between developers is needed, w...

  2. The Impact of Medicaid Disproportionate Share Hospital Payment on Provision of Hospital Uncompensated Care

    Hsieh, Hui-Min; Bazzoli, Gloria J.

    2012-01-01

    This study examines the association between hospital uncompensated care (UC) and reductions in Medicaid Disproportionate Share Hospital (DSH) payments resulting from the 1997 Balanced Budget Act. Data on California hospitals from 1996 to 2003 were examined using two-stage least squares with a first-differencing model to control for potential feedback effects. Our findings suggest that not-for-profit hospitals did reduce UC provision in response to reductions in Medicaid DSH, but the response ...

  3. A conceptual framework for interprofessional shared decision making in home care: Protocol for a feasibility study

    Murray Mary-Anne

    2011-01-01

    Full Text Available Abstract Background Shared decision making (SDM is fundamental to informed consent and client-centered care. So far, SDM frameworks have been limited to the client-physician dyad, even though care is increasingly delivered by interprofessional (IP teams. IP collaboration is especially essential in home care, one of health care's most rapidly growing areas. This study will assess whether it is possible to practice SDM in IP home care. Methods/Design We will use a qualitative case study and a quantitative survey to capture the macro, meso and micro levels of stakeholders in home care. The case study will follow the knowledge-to-action process framework to evaluate the work of an IP home care team at a Quebec City health center. Sources of data will include one-on-one interviews with patients, family caregivers or surrogates and significant others, and administrators; a focus group of home care health professionals; organizational documents; and government policies and standards. The interview guide for the interviews and the focus group will explore current practices and clinical problems addressed in home care; factors that could influence the implementation of the proposed IP approach to SDM; the face and content validity of the approach; and interventions to facilitate the implementation and evaluation of the approach. The survey will ask 300 health professionals working in home care at the health center to complete a questionnaire based on the Theory of Planned Behaviour that measures their intentions to engage in an IP approach to SDM. We will use our analysis of the individual interviews, the focus group and the survey to elaborate a toolkit for implementing an IP approach to SDM in home care. Finally, we will conduct a pilot study in Alberta to assess the transferability of our findings. Discussion We believe that developing tools to implement IP SDM in home care is essential to strengthening Canada's healthcare system and furthering

  4. Sharing personal health information via service-oriented computing: a case of long-term care.

    Lin, Yung-Hsiu; Chen, Rong-Rong; Guo, Sophie Huey-Ming; Chiang, Su-Chien; Chang, Her-Kun

    2012-12-01

    Sharing personal health information among healthcare providers is a crucial business process not only for saving limited healthcare resources but also for increasing patient's healthcare quality. Building an effective personal health information sharing process from established healthcare systems is a challenge in terms of coordination different business operations among healthcare providers and restructuring technical details existed in different healthcare information systems. This study responds this challenge with a service-oriented approach and develops a business software application to describe how the challenge can be alleviated from both managerial and technical perspectives. The software application in this study depicts personal health information sharing process among different providers in a long-term care setting. The information sharing scenario is based on an industrial initiative, such as Integrating the Healthcare Enterprise (IHE) from healthcare domain and the technologies for implementing the scenario are Web Service technologies from Service-oriented computing paradigm. The implementation in this study can inform healthcare researchers and practitioners applying technologies from service-oriented computing to design and develop healthcare collaborative systems to meet the increasing need for personal health information sharing. PMID:22366977

  5. Continuity of care in addictions treatment: the role of advocacy and coordination in case management.

    Graham, K; Timney, C B; Bois, C; Wedgerfield, K

    1995-11-01

    Although advocacy and coordination are recognized as important aspects of the addictions treatment process, little research has been done in these areas. The present study examined advocacy and coordination at two programs where the mandate was assessment, referral, and case management. Both programs spent a similar proportion of client-related effort on advocacy and/or coordination (about 25% of contact time, accounting for about half of contacts made regarding clients). The majority of advocacy and coordination contacts were with other agencies about clients (the remainder with family and friends of clients). A framework for advocacy and coordination was developed that allowed contacts to be categorized into mutually exclusive advocacy or coordination activities. Advocacy was defined as any activity undertaken to obtain something for clients; coordination involved the giving or receiving of information regarding specific clients. Sources of variability in the provision of advocacy and coordination were found between the programs that could be attributed to differences between the systems within which the programs operated, as well as differences in program clientele. In terms of client characteristics, it was found that females were more likely than males to receive advocacy; those over 65 years were most likely to receive both advocacy and coordination; those who were referred by school or employer or by corrections were most likely to receive coordination; those with no prior treatment were most likely to receive advocacy; and self-referrals and those who had had prior treatment were most likely to receive neither advocacy nor coordination. Receiving advocacy or coordination was not found to reduce the need by clients for other case management services, such as supportive counseling. The findings are discussed in terms of the need for knowledge regarding highly variable aspects of treatment such as advocacy and coordination. New research approaches (as taken in

  6. Day Hospital and Residential Addiction Treatment: Randomized and Nonrandomized Managed Care Clients

    Witbrodt, Jane; Bond, Jason; Kaskutas, Lee Ann; Weisner, Constance; Jaeger, Gary; Pating, David; Moore, Charles

    2007-01-01

    Male and female managed care clients randomized to day hospital (n=154) or community residential treatment (n=139) were compared on substance use outcomes at 6 and 12 months. To address possible bias in naturalistic studies, outcomes were also examined for clients who self-selected day hospital (n=321) and for clients excluded from randomization…

  7. Integrating addiction medicine training into medical school and residency curricula

    Klimas, Jan; Rieb, Launette; Bury, Gerard; Muench, John; O’Toole, Thomas; Rieckman, Traci; Cullen, Walter

    2015-01-01

    Background: The Affordable Care Act (2010) brings an opportunity to increase the integration of addiction treatment into the health care system. With the anticipated expansion of addiction care services in primary care, challenges, such as workforce training, can be expected. This presentation discusses challenges and opportunities for addiction medicine training of primary care professionals in Ireland, Canada and Portland, OR. Objectives: To explore ideas for integrating addiction medic...

  8. Professional centred shared decision making: Patient decision aids in practice in primary care

    Murtagh Madeleine J

    2008-01-01

    Full Text Available Abstract Background Patient decision aids are increasingly regarded as important components of clinical practice that enable shared decision making (SDM and evidence based patient choice. Despite broad acceptance of their value, there remains little evidence of their successful implementation in primary care settings. Methods Health care practitioners from five general practice surgeries in northern England participated in focus group sessions around the themes of patient decision aids, patient and practitioner preferences and SDM. Participants included general practitioners (n = 19, practice nurses (n = 5 and auxiliary staff (n = 3. Transcripts were analysed using a framework approach. Results We report a practitioners' discussion of the current impetus towards sharing decisions and their perspectives on barriers to SDM, and b the implementation of patient decision aids in practice and impediments such as lack of an evidence base and time available in consultations. Conclusion We demonstrate two orientations to sharing decisions: practitioner-centred and patient-centred with the former predominating. We argue that it is necessary to rethink the changes required in practice for the implementation of SDM.

  9. Addiction-as-a-kind hypothesis

    Ylikoski, Petri; Pöyhönen, Samuli

    2015-01-01

    The psychiatric category of addiction has recently been broadened to include new behaviors. This has prompted critical discussion about the value of a concept that covers so many different substances and activities. Many of the debates surrounding the notion of addiction stem from different views concerning what kind of a thing addiction fundamentally is. In this essay, we put forward an account that conceptualizes different addictions as sharing a cluster of relevant properties (the syndrome...

  10. Binge Eating Disorder and Food Addiction

    Gearhardt, Ashley N.; White, Marney A.; POTENZA, MARC N.

    2011-01-01

    Binge eating disorder (BED) shares many characteristics with addictive behaviors (e.g., diminished control, continued use despite negative consequences), and a body of scientific literature is building to support addiction conceptualizations of problematic eating. Despite similarities, BED and “food addiction” may represent unique yet overlapping conditions. Although the exploration of food addiction is relatively new, understanding the relationship between food addiction and BED may be infor...

  11. Overcoming Addiction

    Full Text Available ... as an addiction. And it seems to be one of the hardest addictions to overcome. Bill Saxby: ... who smoke are first and foremost individuals and one thing we've learned is that there's not ...

  12. Overcoming Addiction

    Full Text Available ... but it was only ten years ago that the Surgeon General identified cigarette smoking as an addiction. And it seems to be one of the hardest addictions to overcome. Bill Saxby: My name ...

  13. Relationships of Shared Decision Making with Parental Perceptions of Child Mental Health Functioning and Care.

    Butler, Ashley M; Weller, Bridget; Titus, Courtney

    2015-11-01

    Experts encourage parents and practitioners to engage in shared decision making (SDM) to provide high quality child mental health care. However, little is known regarding SDM among families of children with common mental health conditions. The objectives of this study were to examine associations between parental report of SDM and parental perceptions of (a) receiving child mental health care and (b) child mental health functioning. We analyzed cross-sectional data on children with a common mental health condition (attention-deficit hyperactivity disorder, oppositional-defiant or conduct disorder, anxiety, or depression) from the 2009/2010 National Survey of Children with Special Healthcare Needs (N = 9,434). The primary independent variable was parent-reported SDM, and the dependent variables were parental perception of (a) their child receiving all needed mental health care (b) their children's impairment in school attendance and extracurricular activity participation, and (c) severity of their children's mental health condition. Multivariate logistic and multinomial regression analyses were conducted. Greater parent-reported SDM was associated with parental perceptions of receiving all needed child mental health care and children not having school or extracurricular impairment. Greater SDM was also associated with perceptions of children having a mild mental health condition compared to children having a moderate or severe condition. Findings provide a basis for future longitudinal and intervention studies to examine the benefit of SDM for improving parental perceptions of the quality of child mental health care and mental health functioning among children with common mental health conditions. PMID:25577238

  14. [Work addiction].

    Mentzel, G

    1979-01-01

    The symptomatology of workaholism (work addiction) was presented in the form of a questionnaire and compared with other forms of addiction, especially alcoholism. Then a case was used as example to illustrate the development of the illness and its psychodynamics. The therapy procedure was also briefly explained. Moreover the psychodynamics of workaholism (work addiction) are described, once again in comparison to other addictions. Finally the author gives general guidelines for therapy. PMID:452731

  15. Predictors of shared decision making and level of agreement between consumers and providers in psychiatric care.

    Fukui, Sadaaki; Salyers, Michelle P; Matthias, Marianne S; Collins, Linda; Thompson, John; Coffman, Melinda; Torrey, William C

    2014-05-01

    The purpose of this study was to quantitatively examine elements of shared decision making (SDM), and to establish empirical evidence for factors correlated with SDM and the level of agreement between consumer and provider in psychiatric care. Transcripts containing 128 audio-recorded medication check-up visits with eight providers at three community mental health centers were rated using the Shared Decision Making scale, adapted from Braddock's Informed Decision Making Scale (Braddock et al. 1997, 1999, 2008). Multilevel regression analyses revealed that greater consumer activity in the session and greater decision complexity significantly predicted the SDM score. The best predictor of agreement between consumer and provider was "exploration of consumer preference," with a four-fold increase in full agreement when consumer preferences were discussed more completely. Enhancing active consumer participation, particularly by incorporating consumer preferences in the decision making process appears to be an important factor in SDM. PMID:23299226

  16. The Role of International Nomenclatures and Standards in Travel Shared Health Care

    Přečková, Petra; Zvárová, Jana

    Istanbul: EFMI, 2009 - (Mihalas, G.; Saka, O.; Mazzoleni, T.; Blobel, B.; Pharow, P.; Gülkesen, K.), s. 162-169. (European Notes in Medical Informatics. 5-1). ISSN 1861-3179. [EFMI STC 2009 & TurkMIA Medical Informatics '09. Antalya (TR), 12.12.2009-15.12.2009] R&D Projects: GA MŠk(CZ) 1M06014 Institutional research plan: CEZ:AV0Z10300504 Keywords : medical informatics * classification systems * shared health care Subject RIV: IN - Informatics, Computer Science

  17. [Online addictive disease].

    Neuenschwander, Martin

    2014-10-01

    Digital media are indispensable in school, profession, family and leisure time. 1 to 6 % of all users show dsyfunctional ans addictive patterns, first of all in online and "social" media. In Switzerland over 80 % of young people own a smartphone and "pocket internet". Time of interaction with online-media (hours/day), as well as peer group pattern are markers for risk of addiction. Active music making and sports are protective factors. Family physicians are important in early recognition of "internet addictive disease". Care-givers with special experience in this field are often successful in reducing time of harmful interaction with the internet. Internet addictive disease is not yet classified in ICD and DSM-5 lists, even though it is an increasing reality. PMID:25257114

  18. Team behavioral norms: a shared vision for a healthy patient care workplace.

    Parsons, Mickey L; Clark, Paul; Marshall, Michelle; Cornett, Patricia A

    2007-01-01

    Leaders are bombarded with healthy workplace articles and advice. This article outlines a strategy for laying the foundation for healthy patient care workplaces at the pivotal unit level. This process facilitates the nursing unit staff to create and implement a shared vision for staff working relationships. Fourteen acute care hospital units, all participants in a healthy workplace intervention, were selected for this analysis because they chose team behavioral norms as a top priority to begin to implement their vision for a desired future for their units, a healthy workplace. These units developed specific team behavioral norms for their expectations of each other. The findings revealed 3 major norm themes and attributes: norms for effective communication, positive attitude, and accountability. Attributes of each norm are described to assist nurses to positively influence their core unit work culture. PMID:17579304

  19. A critical narrative analysis of shared decision-making in acute inpatient mental health care.

    Stacey, Gemma; Felton, Anne; Morgan, Alastair; Stickley, Theo; Willis, Martin; Diamond, Bob; Houghton, Philip; Johnson, Beverley; Dumenya, John

    2016-01-01

    Shared decision-making (SDM) is a high priority in healthcare policy and is complementary to the recovery philosophy in mental health care. This agenda has been operationalised within the Values-Based Practice (VBP) framework, which offers a theoretical and practical model to promote democratic interprofessional approaches to decision-making. However, these are limited by a lack of recognition of the implications of power implicit within the mental health system. This study considers issues of power within the context of decision-making and examines to what extent decisions about patients' care on acute in-patient wards are perceived to be shared. Focus groups were conducted with 46 mental health professionals, service users, and carers. The data were analysed using the framework of critical narrative analysis (CNA). The findings of the study suggested each group constructed different identity positions, which placed them as inside or outside of the decision-making process. This reflected their view of themselves as best placed to influence a decision on behalf of the service user. In conclusion, the discourse of VBP and SDM needs to take account of how differentials of power and the positioning of speakers affect the context in which decisions take place. PMID:26833106

  20. The Counseling, Self-Care, Adherence Approach to Person-Centered Care and Shared Decision Making: Moral Psychology, Executive Autonomy, and Ethics in Multi-Dimensional Care Decisions.

    Herlitz, Anders; Munthe, Christian; Törner, Marianne; Forsander, Gun

    2016-08-01

    This article argues that standard models of person-centred care (PCC) and shared decision making (SDM) rely on simplistic, often unrealistic assumptions of patient capacities that entail that PCC/SDM might have detrimental effects in many applications. We suggest a complementary PCC/SDM approach to ensure that patients are able to execute rational decisions taken jointly with care professionals when performing self-care. Illustrated by concrete examples from a study of adolescent diabetes care, we suggest a combination of moral and psychological considerations to support the claim that standard PCC/SDM threatens to systematically undermine its own goals. This threat is due to a tension between the ethical requirements of SDM in ideal circumstances and more long-term needs actualized by the context of self-care handled by patients with limited capacities for taking responsibility and adhere to their own rational decisions. To improve this situation, we suggest a counseling, self-care, adherence approach to PCC/SDM, where more attention is given to how treatment goals are internalized by patients, how patients perceive choice situations, and what emotional feedback patients are given. This focus may involve less of a concentration on autonomous and rational clinical decision making otherwise stressed in standard PCC/SDM advocacy. PMID:26756477

  1. Implementation methods of medical image sharing for collaborative health care based on IHE XDS-I profile.

    Zhang, Jianguo; Zhang, Kai; Yang, Yuanyuan; Sun, Jianyong; Ling, Tonghui; Wang, Mingqing; Bak, Peter

    2015-10-01

    IHE XDS-I profile proposes an architecture model for cross-enterprise medical image sharing, but there are only a few clinical implementations reported. Here, we investigate three pilot studies based on the IHE XDS-I profile to see whether we can use this architecture as a foundation for image sharing solutions in a variety of health-care settings. The first pilot study was image sharing for cross-enterprise health care with federated integration, which was implemented in Huadong Hospital and Shanghai Sixth People's Hospital within the Shanghai Shen-Kang Hospital Management Center; the second pilot study was XDS-I-based patient-controlled image sharing solution, which was implemented by the Radiological Society of North America (RSNA) team in the USA; and the third pilot study was collaborative imaging diagnosis with electronic health-care record integration in regional health care, which was implemented in two districts in Shanghai. In order to support these pilot studies, we designed and developed new image access methods, components, and data models such as RAD-69/WADO hybrid image retrieval, RSNA clearinghouse, and extension of metadata definitions in both the submission set and the cross-enterprise document sharing (XDS) registry. We identified several key issues that impact the implementation of XDS-I in practical applications, and conclude that the IHE XDS-I profile is a theoretically good architecture and a useful foundation for medical image sharing solutions across multiple regional health-care providers. PMID:26835497

  2. Shared decision-making in the care of individuals with diabetes.

    Serrano, V; Rodriguez-Gutierrez, R; Hargraves, I; Gionfriddo, M R; Tamhane, S; Montori, V M

    2016-06-01

    People with diabetes often live with other chronic conditions and lead complicated lives. Determining what is the best management decision for a patient requires consideration of each individual's personal, social and biomedical context, what he or she values, the reasons he or she has to value the available options, and the relative contribution of each option in terms of benefits, harms, costs and inconveniences. Empathic conversations between patients and clinicians to diagnose the patient situation that necessitates action and the range of evidence-based actions that best address the situation, so-called shared decision-making, are essential to the personalized care of people with diabetes. The aim of the present review was to present key elements of shared decision-making and propose three different approaches for its application. The first approach focuses on transferring information to patients so that they can make decisions. The second approach, choice, focuses on cultivating the individual's ability to give voice to which choice is best for them. The third approach, conversation, establishes an empathic conversational environment through which the individual with diabetes and their clinician think and talk through how to address the problems of living with diabetes and related illnesses. These approaches are manifest in the design of evidence-based decision aids created to support shared decision-making. In randomized trials, decision aids can efficiently improve patient's knowledge, satisfaction, risk awareness, decisional conflict and involvement. Further research, however, is needed to better understand when and how to promote the empathic conversations, patient, clinician and service and policy contexts necessary to routinely implement shared decision-making in different at scale healthcare systems. In the interim, sufficient evidence and tools exist for persons with diabetes and their clinicians to gain expertise in making decisions together. PMID

  3. Exercise addiction

    Lichtenstein, Mia Beck; Christiansen, Erik; Elklit, Ask;

    2014-01-01

    Exercise addiction is characterized by excessive exercise patterns with potential negative consequences such as overuse injuries. The aim of this study was to compare eating disorder symptoms, quality of life, personality traits and attachments styles in exercisers with and without indications of...... exercise addiction. A case-control study with 121 exercisers was conducted. The exercisers were categorized into an addiction group (n=41) or a control group (n=80) on the basis of their responses to the Exercise Addiction Inventory. The participants completed the Eating Disorder Inventory 2, the Short......-Form 36, the NEO Personality Inventory Revised and the Adult Attachment Scale. The addiction group scored higher on eating disorder symptoms, especially on perfectionism but not as high as eating disorder populations. The characteristic personality traits in the addiction group were high levels of...

  4. Phenomenology and treatment of behavioural addictions.

    Grant, Jon E; Schreiber, Liana R N; Odlaug, Brian L

    2013-05-01

    Behavioural addictions are characterized by an inability to resist an urge or drive resulting in actions that are harmful to oneself or others. Behavioural addictions share characteristics with substance and alcohol abuse, and in areas such as natural history, phenomenology, and adverse consequences. Behavioural addictions include pathological gambling, kleptomania, pyromania, compulsive buying, compulsive sexual behaviour, Internet addiction, and binge eating disorder. Few studies have examined the efficacy of pharmacological and psychological treatment for the various behavioural addictions, and therefore, currently, no treatment recommendations can be made. PMID:23756285

  5. [Trial of information sharing for home-based patient care using Cybozu Live , a cloud-based groupware].

    Asahina, Kan

    2011-12-01

    Home-based patient care involves several different care services of specialties, so that it is crucial to share patient information effectively among the caregivers. To overcome the problems with conventional means for storing and sharing information, we introduced Cybozu Live , a cloud-based groupware provided for free of charge. As a result, the amount of information shared increased while telephone and facsimile transactions dramatically decreased. A questionnaire survey revealed that the caregivers generally appreciated the use of this groupware; they felt that more information was needed for tasks while the load of using telephone and facsimile is minimal. We found the followings through our experiences: 1 ) Simply sharing information can largely contribute to supporting patients and their families; 2 ) Awareness of patients, families and caregivers is more important in the homecare information sharing than are numerical data; 3 ) Effective information sharing creates a sense of togetherness of the team beyond mere co-operation among the staff; 4 ) Effective information sharing provides learning opportunities for caregivers; and 5 ) An appropriate tool such as Cybozu Live is needed for effective information sharing. PMID:22189308

  6. [Sharing patient information using iPads in the introduction of IT for home medical care-construction of a network for home care].

    Morishima, Atsutomo; Kijima, Yasuaki

    2012-12-01

    In hospitals, information technology(IT)has been a natural part of care for some time. However, IT has not yet been widely introduced into home care. While performing home care, healthcare providers must carry numerous patients' medical records, and are unable to share the information included in those records with other providers. Thus, we introduced the system of sharing patient information using iPads. This system enables access to patient information regardless of time and place. In addition, we can share information such as X-ray images and computed tomography(CT)scans between different clinics. Thus, we are able to give clearer instructions to patients and other providers in a smoother way. This system could be used to construct a network for home care. In the future, we could aim to share patient information within a much wider network, including families and other kinds of organizations, for optimal care. This system will aid in the development of IT use in home care. PMID:23268884

  7. Barriers to shared decision making in mental health care:qualitative study of the Joint Crisis Plan for psychosis

    Farrelly, Simone; Lester, Helen; Rose, Diana; Birchwood, Max; Marshall, Max; Waheed, Waquas; Henderson, R. Claire; Szmukler, George; Thornicroft, Graham

    2016-01-01

    BackgroundDespite increasing calls for shared decision making (SDM), the precise mechanisms for its attainment are unclear. Sharing decisions in mental health care may be especially complex. Fluctuations in service user capacity and significant power differences are particular barriers.Objective and designWe trialled a form of facilitated SDM that aimed to generate patients' treatment preferences in advance of a possible relapse. The ‘Joint Crisis Plan’ (JCP) intervention was trialled in four...

  8. A frailty instrument for primary care: findings from the Survey of Health, Ageing and Retirement in Europe (SHARE).

    Romero-Ortuno, Roman

    2010-01-01

    A frailty paradigm would be useful in primary care to identify older people at risk, but appropriate metrics at that level are lacking. We created and validated a simple instrument for frailty screening in Europeans aged ≥50. Our study is based on the first wave of the Survey of Health, Ageing and Retirement in Europe (SHARE, http:\\/\\/www.share-project.org), a large population-based survey conducted in 2004-2005 in twelve European countries.

  9. Trauma and addiction: Implications for practice

    Misouridou, Evdokia

    2016-01-01

    Introduction: Trauma is common in many individuals who face addiction problems and their families while the risk of secondary traumatic stress disorder for professionals working in the addiction field has been recently recognized. Aim: The aim of the present paper was to enhance understanding of the continuing effects of trauma and its impact in the lives of addicted individuals, their families and the mental health care professionals who strive to provide support and care for them. M...

  10. Overcoming Addiction

    Full Text Available Announcer: It's been well-known for a long time that smoking is bad for your health, but it was only ten years ago that the Surgeon General identified cigarette smoking as an addiction. And it seems to be one of the hardest addictions ...

  11. [DGRW update: alcohol addiction].

    Vogelgesang, M

    2011-10-01

    First, epidemiological data and socioeconomic consequences of alcohol addiction are summarized. Research findings, in particular in intervention and evaluation, from 2009-2011 in the field of alcohol addiction treatment are then discussed concerning their relevance for rehabilitation practice. The search was based on PubMed and PSYNDEX. The interventions most frequently evaluated and found most effective in alcohol addiction treatment are cognitive-behavioural interventions. Further topics dealt with are: pharmacological relapse prevention; technologically based therapies (e. g. e-therapy); systemic interventions; 12-steps; effectiveness of addiction treatment as confirmed in large-scale catamnestic studies; treatment of addiction and comorbidity; various subgroups (like elderly people and women); as well as other new and interesting developments such as rehab case management, dovetailing of medical and vocational interventions, stepped-care interventions, rehab management category groups as well as a new focus on individual treatment experiences and the pre-eminence of the therapeutic relationship. Finally, priority areas of future research are described. PMID:21976262

  12. [Gambling addiction].

    Böning, J; Meyer, G; Hayer, T

    2013-05-01

    Extensive coherent clinical, psychopathological, neurobiological and genetic similarities with substance-related addictions justify the forthcoming classification of gambling addiction under the new category "Substance Use and Addictive Disorders" in the DSM-5. Thus, gambling addiction can be regarded as the prototype of behavioral addiction. In general it should be kept in mind that isolated gambling forms are associated with varying addictive potential due to specific situational and structural game characteristics. High rates of indebtedness, suicidality, social isolation and gambling-related crime often accompany pathological gambling. As a consequence gambling addiction represents a mental disorder with a significant economic burden. In Germany 12-month prevalence rates for problem gambling in adulthood range from 0.24 % to 0.64  % and for pathological gambling from 0.20 % to 0.56 %. Because gambling products rank among the so-called demeriting (i.e. potentially harmful) social activities, player and youth protection measures to prevent gambling disorders and associated crime should be best regulated as a state monopoly. PMID:23529775

  13. Applying incentive sensitization models to behavioral addiction

    Rømer Thomsen, Kristine; Fjorback, Lone; Møller, Arne;

    2014-01-01

    The incentive sensitization theory is a promising model for understanding the mechanisms underlying drug addiction, and has received support in animal and human studies. So far the theory has not been applied to the case of behavioral addictions like Gambling Disorder, despite sharing clinical...... symptoms and underlying neurobiology. We examine the relevance of this theory for Gambling Disorder and point to predictions for future studies. The theory promises a significant contribution to the understanding of behavioral addiction and opens new avenues for treatment....

  14. Where Caring Is Sharing: Evolving Ethical Considerations in Tuberculosis Prevention Among Healthcare Workers.

    Boulanger, Renaud F; Hunt, Matthew R; Benatar, Solomon R

    2016-05-15

    In many settings, the dedication of healthcare workers (HCWs) to the treatment of tuberculosis exposes them to serious risks. Current ethical considerations related to tuberculosis prevention in HCWs involve the threat posed by comorbidities, issues of power and space, the implications of intersectoral collaborations, (de)professionalization, just remuneration, the duty to care, and involvement in research. Emerging ethical considerations include mandatory vaccination and the use of geolocalization services and information technologies. The following exploration of these various ethical considerations demonstrates that the language of ethics can fruitfully be deployed to shed new light on policies that have repercussions on the lives of HCWs in underresourced settings. The language of ethics can help responsible parties get a clearer sense of what they owe HCWs, particularly when these individuals are poorly compensated, and it shows that it is essential that HCWs' contribution be acknowledged through a shared commitment to alleviate ethically problematic aspects of the environments within which they provide care. For this reason, there is a strong case for the community of bioethicists to continue to take greater interest both in the micro-level (eg, patient-provider interactions) and macro-level (eg, injustices that occur as a result of the world order) issues that put HCWs working in areas with high tuberculosis prevalence in ethically untenable positions. Ultimately, appropriate responses to the various ethical considerations explored here must vary based on the setting, but, as this article shows, they require thoughtful reflection and courageous action on the part of governments, policy makers, and managers responsible for national responses to the tuberculosis epidemic. PMID:27118857

  15. An Interactive Web Tool for Facilitating Shared Decision-Making in Dementia-Care Networks: A Field Study

    Span, M.; Smits, C.; Jukema, J.; Groen-van de Ven, L.M.; Janssen, R.; Vernooij-Dassen, M.; Eefsting, J.; Hettinga, M.

    2015-01-01

    BACKGROUND: An interactive web tool has been developed for facilitating shared decision-making in dementia-care networks. The DecideGuide provides a chat function for easier communication between network members, a deciding together function for step-by-step decision-making, and an individual opinio

  16. Food Addiction: Its Prevalence and Significant Association with Obesity in the General Population

    Pardis Pedram; Danny Wadden; Peyvand Amini; Wayne Gulliver; Edward Randell; Farrell Cahill; Sudesh Vasdev; Alan Goodridge; Carter, Jacqueline C.; Guangju Zhai; Yunqi Ji; Guang Sun

    2013-01-01

    BACKGROUND: 'Food addiction' shares a similar neurobiological and behavioral framework with substance addiction. However whether, and to what degree, 'food addiction' contributes to obesity in the general population is unknown. OBJECTIVES: to assess 1) the prevalence of 'food addiction' in the Newfoundland population; 2) if clinical symptom counts of 'food addiction' were significantly correlated with the body composition measurements; 3) if food addicts were significantly more obese than con...

  17. Sharing but not caring: dark matter and the baryon asymmetry of the universe

    Bernal, Nicolás; Fong, Chee Sheng; Fonseca, Nayara

    2016-09-01

    We consider scenarios where Dark Matter (DM) particles carry baryon and/or lepton numbers, which can be defined if there exist operators connecting the dark to the visible sector. As a result, the DM fields become intimately linked to the Standard Model (SM) ones and can be maximally asymmetric just like the ordinary matter. In particular, we discuss minimal scenarios where the DM is a complex scalar or a Dirac fermion coupled to operators with nonzero baryon and/or lepton numbers, and that consist of only SM fields. We consider an initial asymmetry stored in either the SM or the DM sector; the main role of these operators is to properly share the asymmetry between the two sectors, in accordance with observations. After the chemical decoupling, the DM and SM sectors do not care about each other as there is only an ineffective communication between them. Once the DM mass is specified, the Wilson coefficients of these operators are fixed by the requirement of the correct transfer of the asymmetry. We study the phenomenology of this framework at colliders, direct detection and indirect detection experiments. In particular, the LHC phenomenology is very rich and can be tested in different channels such as the two same-sign leptons with two jets, monojet and monojet with a monolepton.

  18. Sharing but not Caring: Dark Matter and the Baryon Asymmetry of the Universe

    Bernal, Nicolás; Fonseca, Nayara

    2016-01-01

    We consider scenarios where Dark Matter (DM) particles carry baryon and/or lepton numbers, which can be defined if there exist operators connecting the dark to the visible sector. As a result, the DM fields become intimately linked to the Standard Model (SM) ones and can be maximally asymmetric just like the ordinary matter. In particular, we discuss minimal scenarios where the DM is a complex scalar or a Dirac fermion coupled to operators with nonzero baryon and/or lepton numbers, and that consist of only SM fields. We consider an initial asymmetry stored in either the SM or the DM sector; the main role of these operators is to properly $share$ the asymmetry between the two sectors, in accordance with observations. After the chemical decoupling, the DM and SM sectors do $not$ $care$ about each other as there is only an ineffective communication between them. Once the DM mass is specified, the Wilson coefficients of these operators are fixed by the requirement of the correct transfer of the asymmetry. We stud...

  19. Improving the informational continuity of care in diabetes mellitus treatment with a nationwide Shared EHR system: Estimates from Austrian claims data

    Rinner, C.; Sauter, S; Endel, G.; Heinze, G; Thurner, S; Klimek, P.; Duftschmid, G

    2016-01-01

    Purpose Shared Electronic Health Record (EHR) systems, which provide a health information exchange (HIE) within a community of care, were found to be a key enabler of informational continuity of diabetes mellitus (DM) care. Quantitative analyses of the actual contribution of Shared EHR systems to informational continuity of care are rare. The goal of this study was to quantitatively analyze (i) the degree of fragmentation of DM care in Austria as an indicator for the need for HIE, and (ii...

  20. Overcoming Addiction

    Full Text Available ... been well-known for a long time that smoking is bad for your health, but it was ... years ago that the Surgeon General identified cigarette smoking as an addiction. And it seems to be ...

  1. Overcoming Addiction

    Full Text Available ... a habit, it's addictive. The sad part is after you've smoked as long as I do you ... that's definitely up there. Within a few hours after you quit, that will start to come down. Bill: ...

  2. Policy Progress for Physician Treatment of Opiate Addiction

    Merrill, Joseph O

    2002-01-01

    Medical treatment of heroin addiction with methadone and other pharmacotherapies has important benefits for individuals and society. However, regulatory policies have separated this treatment from the medical care system, limiting access to care and contributing to the social stigma of even effective addiction pharmacotherapy. Increasing problems caused by heroin addiction have added urgency to the search for policies and programs that improve the access to and quality of opiate addiction tre...

  3. [Cocaine addiction].

    Pitchot, W; Scantamburlo, G; Pinto, E; Karila, L

    2013-01-01

    Cocaine is the second most commonly used illicit drug after cannabis in the general population. Cocaine is a powerful stimulating agent of the central nervous system and a highly addictogenic drug. Somatic and psychiatric consequences of cocaine addiction are major and clinically relevant. The increasing consumption of cocaine and the importance of its consequences justify an update of our knowledge about cocaine addiction. PMID:23888579

  4. Dealing with Addiction

    ... I Help a Friend Who Cuts? Dealing With Addiction KidsHealth > For Teens > Dealing With Addiction Print A ... is even harder. What Are Substance Abuse and Addiction? The difference between substance abuse and addiction is ...

  5. Brain and Addiction

    ... Teens / Drug Facts / Brain and Addiction Brain and Addiction Print Your Brain Your brain is who you ... is taken over and over. What Is Drug Addiction? Addiction is a chronic brain disease that causes ...

  6. Role of Family Milieu in Tobacco Addiction: A Study in a Tertiary-care Institution in India

    Dwivedi, Shridhar; Aggarwal, Amitesh; Singh, Nishant; Aggarwal, Sourabh; Sharma, Vishal

    2013-01-01

    Use of tobacco is singularly responsible for most cases of cancer and coronary artery disease (CAD). Efforts to stop tobacco-use need to be guided by social circumstances. It is believed that family milieu may play a role in tobacco addiction. We studied the prevalence and pattern of tobacco-use in families of 50 consecutive tobacco-user patients who presented to a tobacco-cessation clinic and compared with age- and gender-matched controls (non-users of tobacco). The tobacco-use rates were si...

  7. Addiction Treatment Within U.S. Correctional Facilities: Bridging the Gap Between Current Practice and Evidence-Based Care.

    Wakeman, Sarah E; Rich, Josiah D

    2015-01-01

    The United States leads the world in creating prisoners. This epidemic of incarceration is largely due to the "War on Drugs," which has resulted in criminalization of the disease of addiction. Half of prisoners have an active substance use disorder yet a minority receives formal treatment. Opioid agonist maintenance is among the most effective treatments for opioid use disorder. Maintenance treatment reduces illicit opioid use, crime, recidivism, and cost, yet few correctional facilities provide this lifesaving treatment. Increased access to opioid agonist maintenance as well as reexamination of drug policy is necessary to address this costly and morbid incarceration epidemic. PMID:26076211

  8. Health-care data collecting, sharing, and using in Thailand, China mainland, South Korea, Taiwan, Japan, and Malaysia.

    Aljunid, Syed Mohamed; Srithamrongsawat, Samrit; Chen, Wen; Bae, Seung Jin; Pwu, Raoh-Fang; Ikeda, Shunya; Xu, Ling

    2012-01-01

    This article sought to describe the health-care data situation in six selected economies in the Asia-Pacific region. Authors from Thailand, China mainland, South Korea, Taiwan, Japan, and Malaysia present their analyses in three parts. The first part of the article describes the data-collection process and the sources of data. The second part of the article presents issues around policies of data sharing with the stakeholders. The third and final part of the article focuses on the extent of health-care data use for policy reform in these different economies. Even though these economies differ in their economic structure and population size, they share some similarities on issues related to health-care data. There are two main institutions that collect and manage the health-care data in these economies. In Thailand, China mainland, Taiwan, and Malaysia, the Ministry of Health is responsible through its various agencies for collecting and managing the health-care data. On the other hand, health insurance is the main institution that collects and stores health-care data in South Korea and Japan. In all economies, sharing of and access to data is an issue. The reasons for limited access to some data are privacy protection, fragmented health-care system, poor quality of routinely collected data, unclear policies and procedures to access the data, and control on the freedom on publication. The primary objective of collecting health-care data in these economies is to aid the policymakers and researchers in policy decision making as well as create an awareness on health-care issues for the general public. The usage of data in monitoring the performance of the heath system is still in the process of development. In conclusion, for the region under discussion, health-care data collection is under the responsibility of the Ministry of Health and health insurance agencies. Data are collected from health-care providers mainly from the public sector. Routinely collected data are

  9. Share your story, shape your care: engaging the diverse and disperse population of Northwestern Ontario in healthcare priority setting.

    Shields, Kristin; DuBois-Wing, Gwen; Westwood, Ellis

    2010-01-01

    In 2009, the North West Local Health Integration Network hosted Share Your Story, Shape Your Care, an innovative community engagement initiative. Over 800 residents and health service providers in Northwestern Ontario participated and identified healthcare priorities, reacted to proposed strategies and shared ideas and stories. Primarily web-based (with a Choicebook, message board, blog and YouTube video), paper copies and conversation guides supported informed and reflective participation. This project enabled community-level participation in healthcare, supporting local planning and decision-making, and was awarded the inaugural Innovation Using Technology Award by the International Association for Public Participation. PMID:20523159

  10. Neuroscience of Internet Pornography Addiction: A Review and Update.

    Love, Todd; Laier, Christian; Brand, Matthias; Hatch, Linda; Hajela, Raju

    2015-01-01

    Many recognize that several behaviors potentially affecting the reward circuitry in human brains lead to a loss of control and other symptoms of addiction in at least some individuals. Regarding Internet addiction, neuroscientific research supports the assumption that underlying neural processes are similar to substance addiction. The American Psychiatric Association (APA) has recognized one such Internet related behavior, Internet gaming, as a potential addictive disorder warranting further study, in the 2013 revision of their Diagnostic and Statistical Manual. Other Internet related behaviors, e.g., Internet pornography use, were not covered. Within this review, we give a summary of the concepts proposed underlying addiction and give an overview about neuroscientific studies on Internet addiction and Internet gaming disorder. Moreover, we reviewed available neuroscientific literature on Internet pornography addiction and connect the results to the addiction model. The review leads to the conclusion that Internet pornography addiction fits into the addiction framework and shares similar basic mechanisms with substance addiction. Together with studies on Internet addiction and Internet Gaming Disorder we see strong evidence for considering addictive Internet behaviors as behavioral addiction. Future research needs to address whether or not there are specific differences between substance and behavioral addiction. PMID:26393658

  11. Neuroscience of Internet Pornography Addiction: A Review and Update

    Love, Todd; Laier, Christian; Brand, Matthias; Hatch, Linda; Hajela, Raju

    2015-01-01

    Many recognize that several behaviors potentially affecting the reward circuitry in human brains lead to a loss of control and other symptoms of addiction in at least some individuals. Regarding Internet addiction, neuroscientific research supports the assumption that underlying neural processes are similar to substance addiction. The American Psychiatric Association (APA) has recognized one such Internet related behavior, Internet gaming, as a potential addictive disorder warranting further study, in the 2013 revision of their Diagnostic and Statistical Manual. Other Internet related behaviors, e.g., Internet pornography use, were not covered. Within this review, we give a summary of the concepts proposed underlying addiction and give an overview about neuroscientific studies on Internet addiction and Internet gaming disorder. Moreover, we reviewed available neuroscientific literature on Internet pornography addiction and connect the results to the addiction model. The review leads to the conclusion that Internet pornography addiction fits into the addiction framework and shares similar basic mechanisms with substance addiction. Together with studies on Internet addiction and Internet Gaming Disorder we see strong evidence for considering addictive Internet behaviors as behavioral addiction. Future research needs to address whether or not there are specific differences between substance and behavioral addiction. PMID:26393658

  12. Neuroscience of Internet Pornography Addiction: A Review and Update

    Todd Love

    2015-09-01

    Full Text Available Many recognize that several behaviors potentially affecting the reward circuitry in human brains lead to a loss of control and other symptoms of addiction in at least some individuals. Regarding Internet addiction, neuroscientific research supports the assumption that underlying neural processes are similar to substance addiction. The American Psychiatric Association (APA has recognized one such Internet related behavior, Internet gaming, as a potential addictive disorder warranting further study, in the 2013 revision of their Diagnostic and Statistical Manual. Other Internet related behaviors, e.g., Internet pornography use, were not covered. Within this review, we give a summary of the concepts proposed underlying addiction and give an overview about neuroscientific studies on Internet addiction and Internet gaming disorder. Moreover, we reviewed available neuroscientific literature on Internet pornography addiction and connect the results to the addiction model. The review leads to the conclusion that Internet pornography addiction fits into the addiction framework and shares similar basic mechanisms with substance addiction. Together with studies on Internet addiction and Internet Gaming Disorder we see strong evidence for considering addictive Internet behaviors as behavioral addiction. Future research needs to address whether or not there are specific differences between substance and behavioral addiction.

  13. Prevention under the Affordable Care Act (ACA: Has the ACA Overpromised and under Delivered?; Comment on “Interrelation of Preventive Care Benefits and Shared Costs under the Affordable Care Act (ACA”

    Carol Molinari

    2014-08-01

    Full Text Available This policy brief discusses preventive care benefits and cost-sharing included in health insurance provisions of the Affordable Care Act (ACA legislation and highlights some consequences to Americans and the country in terms of healthcare costs and value.

  14. Comparing cost-sharing practices for pharmaceuticals and health care services among four central European countries

    Baji, Petra; Boncz, Imre; Jenei, György; Gulácsi, László

    2012-01-01

    The paper reviews the existing cost-sharing practices in four Central European countries namely the Czech Republic, Hungary, Poland and Slovakia focusing on patient co-payments for pharmaceuticals and services covered by the social health insurance. The aim is to examine the role of cost-sharing arrangements and to evaluate them in terms of efficiency, equity and public acceptance to support policy making on patient payments in Central Europe. Our results suggest that the share of out-of-pock...

  15. Shared decision-making in mental health care - A user perspective on decisional needs in community-based services

    Grim, Katarina; Rosenberg, David; Svedberg, Petra; Schön, Ulla-Karin

    2016-01-01

    Background: Shared decision-making (SDM) is an emergent research topic in the field of mental health care and is considered to be a central component of a recovery-oriented system. Despite the evidence suggesting the benefits of this change in the power relationship between users and practitioners, the method has not been widely implemented in clinical practice.Objective: The objective of this study was to investigate decisional and information needs among users with mental illness as a prere...

  16. 76 FR 67801 - Medicare Program; Medicare Shared Savings Program: Accountable Care Organizations

    2011-11-02

    ... All Inclusive Care for the Elderly PACFs Post-Acute Care Facilities PCMH Patient Centered Medical Home... Condition Category HCPCS Healthcare Common Procedure Coding System HHAs Home Health Agencies HICN Health... within section 3022 of the Affordable Care Act is in section I.B. of the proposed rule (see 76 FR...

  17. [Sharing information of urological cancer patient in terminal stage using Cybozulive® for home medical care].

    Yumura, Yasushi; Hattori, Yusuke; Gobara, Ayako; Takamoto, Daiji; Yasuda, Kengo; Nakamura, Masafumi; Noguchi, Kazumi; Asahina, Kan; Kamijo, Takeo

    2014-09-01

    It is very important to share patient information because home patient care involves several different specialties of care. We introduced Cybozulive ® , a cloud-based free groupware, for 14 terminal-stage patients with urological cancer to share information among doctors and co-medical staff. This system enables access to patient information regardless of time and place. Of the 14 patients (mean age 74.4 years), 11 died of cancer. The average period in which Cybozulive® was used for the patients was 210 days. The average number of entries to the electronic bulletin board in this period was 88.4. We were able to obtain more information about the patients from the website. There was no difference in the average number of times that the patient consulted the out patient clinic before and after the introduction of Cybozulive® (before 7.0 ; after 6.3). After introduction of this system, eleven patients were hospitalized in our department 21 times. Eighteen of these 21 times, since we had acquired patient information from the website beforehand, there was a quick response for management of the emergency admission. This system could be used to construct a network for home care and may be helpful for sharing patient information in homecare. PMID:25293794

  18. Maternal Cocaine Addiction: Correlates and Consequences.

    Hawley, Theresa Lawton

    This study investigated the effects of cocaine addiction on mothers' ability to care for their children. The population interviewed included 25 cocaine-addicted mothers in a drug treatment center and a comparison group of 25 mothers of children in a Head Start program. Each mother was questioned about: (1) her pregnancy with a specific child…

  19. Medication-assisted therapy for opioid addiction

    Tai, Betty; Saxon, Andrew J.; Ling, Walter

    2013-01-01

    The “Medication-Assisted Therapy for Opioid Addiction” session was chaired by Dr. Betty Tai and had three presenters. The presenters (and their topics) were: Dr. Andrew J. Saxon (Methadone and Buprenorphine for Treatment of Opioid Addiction and HIV Risk Reduction), Dr. Walter Ling (Opioid Antagonist Treatment for Opioid Addiction), and Dr. Betty Tai (Chronic Care Model for Substance Use Disorder).

  20. [Exercise addiction].

    Petit, A; Lejoyeux, M

    2013-01-01

    Socially valorised, sport like other forms of behaviour, can take on an addictive aspect. A review of the English and French literatures from 1979 to 2012 was conducted, using PubMed, Google Scholar, EMBASE, and PsycInfo, using the following key words alone or combined :sport, dependence, exercise, addiction. Exercise dependence is defined as a craving for physical activity that leads to extreme exercise intensity and generates physiological and psychological symptoms. Measurement scales have been proposed to make the diagnosis. No epidemiological studies have examined the prevalence of exercise dependence in the general population, although some studies suggest a frequency ranging from 10 to 80%. Disorders begin with a search for pleasure in physical effort, which then gives way to an obsession for sport resulting in a need to practice a sport more and more frequently and intensely. This addiction is more common among alcohol and illicit drug addicts than among the general population, while the rate of eating disorders can reach 40%. Personality traits most often associated are perfectionism, extraversion, and sensation seeking, while possible links between sporting activity and intensive doping will be discussed. PMID:23888586

  1. Heroin Addiction

    ... collaborations that involve scientists working together with public health and safety personnel will help overcome barriers to adoption of these proven effective treatments. These advances will have a global impact not just on heroin addiction but on the spread of HIV, particularly ...

  2. Overcoming Addiction

    Full Text Available ... be one of the hardest addictions to overcome. Bill Saxby: My name is Bill Saxby. I'm 63 years old and I've smoked for 50 years, at least. Announcer: Bill is an electrician. He has tried to quit ...

  3. Tobacco Addiction

    ... Those cravings have less to do with nicotine addiction and more to do with the habit of smoking. Will I gain weight when I quit? Some people gain a few pounds. Other people lose weight. The main reason some people gain weight is because they eat more food as a substitute for smoking. You can avoid ...

  4. [Drug addiction: A link between sexuality and maternal desire].

    Rosenblum, O

    2006-10-01

    If addictions lead to a strategy in order to delay the access to adult sexuality, addiction to heroin satisfies some needs which annihilate one's own sexual desire. This investment in addiction reduces fertility because of the difficulty of drug-addict women to care of their body. A specific taking charge with the help of drug substitutes can lead to the introduction of a sponsorship for the future parents. PMID:17000128

  5. "Shared care"--et integreret samarbejde om patientforløb på tvaers af sektorgraenserne. Det moderne sundhedsvaesen samarbejder

    Rubak, Sune L M; Mainz, Jan; Rubak, Jens M

    2002-01-01

    Shared care programmes have been introduced in Denmark for areas, such as diabetes, asthma, and dementia. Over a three-year period, the communication and co-operation between the health sectors have improved. Specific demands on hospital referral and discharge letters have resulted in improved...... implementation of shared care research programmes with specific end points is very extensive. Only 10 per cent of the present studies have specific end points, and 75 per cent of these show positive effects of shared care programmes. The GP Consulting System in Denmark has proved most useful in the progress of...

  6. Examination of neural systems sub-serving facebook "addiction".

    Turel, Ofir; He, Qinghua; Xue, Gui; Xiao, Lin; Bechara, Antoine

    2014-12-01

    Because addictive behaviors typically result from violated homeostasis of the impulsive (amygdala-striatal) and inhibitory (prefrontal cortex) brain systems, this study examined whether these systems sub-serve a specific case of technology-related addiction, namely Facebook "addiction." Using a go/no-go paradigm in functional MRI settings, the study examined how these brain systems in 20 Facebook users (M age = 20.3 yr., SD = 1.3, range = 18-23) who completed a Facebook addiction questionnaire, responded to Facebook and less potent (traffic sign) stimuli. The findings indicated that at least at the examined levels of addiction-like symptoms, technology-related "addictions" share some neural features with substance and gambling addictions, but more importantly they also differ from such addictions in their brain etiology and possibly pathogenesis, as related to abnormal functioning of the inhibitory-control brain system. PMID:25489985

  7. Genes and (common pathways underlying drug addiction.

    Chuan-Yun Li

    2008-01-01

    Full Text Available Drug addiction is a serious worldwide problem with strong genetic and environmental influences. Different technologies have revealed a variety of genes and pathways underlying addiction; however, each individual technology can be biased and incomplete. We integrated 2,343 items of evidence from peer-reviewed publications between 1976 and 2006 linking genes and chromosome regions to addiction by single-gene strategies, microrray, proteomics, or genetic studies. We identified 1,500 human addiction-related genes and developed KARG (http://karg.cbi.pku.edu.cn, the first molecular database for addiction-related genes with extensive annotations and a friendly Web interface. We then performed a meta-analysis of 396 genes that were supported by two or more independent items of evidence to identify 18 molecular pathways that were statistically significantly enriched, covering both upstream signaling events and downstream effects. Five molecular pathways significantly enriched for all four different types of addictive drugs were identified as common pathways which may underlie shared rewarding and addictive actions, including two new ones, GnRH signaling pathway and gap junction. We connected the common pathways into a hypothetical common molecular network for addiction. We observed that fast and slow positive feedback loops were interlinked through CAMKII, which may provide clues to explain some of the irreversible features of addiction.

  8. Food addiction and neuroimaging.

    Zhang, Yi; von Deneen, Karen M; Tian, Jie; Gold, Mark S; Liu, Yijun

    2011-01-01

    Obesity has become a serious epidemic and one of the leading global health problems. However, much of the current debate has been fractious, and etiologies of obesity have been attributed to eating behavior (i.e. fast food consumption), personality, depression, addiction or genetics. One of the interesting new hypotheses for explaining the development of obesity involves a food addiction model, which suggests that food is not eaten as much for survival as pleasure and that hedonic overeating is relevant to both substance-related disorders and eating disorders. Accumulating evidence has shown that there are a number of shared neural and hormonal pathways as well as distinct differences in these pathways that may help researchers discover why certain individuals continue to overeat despite health and other consequences, and becomes more and more obese. Functional neuroimaging studies have further revealed that pleasant smelling, looking, and tasting food has reinforcing characteristics similar to drugs of abuse. Many of the brain changes reported for hedonic eating and obesity are also seen in various types of addictions. Most importantly, overeating and obesity may have an acquired drive similar to drug addiction with respect to motivation and incentive craving. In both cases, the desire and continued satisfaction occur after early and repeated exposure to stimuli. The acquired drive for eating food and relative weakness of the satiety signal would cause an imbalance between the drive and hunger/reward centers in the brain and their regulation. In the current paper, we first provide a summary of literature on food addition from eight different perspectives, and then we proposed a research paradigm that may allow screening of new pharmacological treatment on the basis of functional magnetic resonance imaging (fMRI). PMID:21492080

  9. Cue-induced craving for Internet among Internet addicts.

    Niu, Geng-Feng; Sun, Xiao-Jun; Subrahmanyam, Kaveri; Kong, Fan-Chang; Tian, Yuan; Zhou, Zong-Kui

    2016-11-01

    Intense craving is a core feature of addictive disorder, and cue-induced craving is believed to be a key factor in the maintenance and relapse of addictive behaviors. With the rapid development of the Internet, Internet addiction has become a widespread behavioral problem accompanied by many negative effects. This study used the cue-reactivity paradigm to examine cue-induced craving for the Internet among Internet addicts and non-addicts. Participants were exposed to Internet-related words, and asked to report their craving for the Internet. Results indicated that Internet-related words aroused cue-induced craving for the Internet among both Internet addicts and non-addicts; however, the craving was more intense among Internet addicts. These results suggest that craving may not be a unipolar, all or none state found only in addicts, but may also be present among non-addicts. They indicate that Internet-related words may be able to induce craving for the Internet, and that Internet addiction and other addictions may share similar underlying mechanisms. This finding has important implications for designing interventions for Internet addiction. PMID:27305097

  10. Market Share and Price in Dutch Home Care: Market Power or Quality?.

    Mosca, I.; Pomp, M.; Shestalova, V.

    2007-01-01

    A change of legislation in 2004 of the Dutch Exceptional Medical Expenses Act (EMEA) allowed for more competition among suppliers of home care. The new law made it possible for the 32 regional healthcare purchasing agencies to contract suppliers selectively and to negotiate over prices and quality. Since, at least in some regions, one or two providers dominate the market, there are concerns about the effect of providers' market power on the pricing of home care services. This paper tries to a...

  11. Drug Addiction

    Justinova, Zuzana; Panlilio, Leigh V; Goldberg, Steven R.

    2009-01-01

    Many drugs of abuse, including cannabinoids, opioids, alcohol and nicotine, can alter the levels of endocannabinoids in the brain. Recent studies show that release of endocannabinoids in the ventral tegmental area can modulate the reward-related effects of dopamine and might therefore be an important neurobiological mechanism underlying drug addiction. There is strong evidence that the endocannabinoid system is involved in drug-seeking behavior (especially behavior that is reinforced by drug-...

  12. Understanding Drug Use and Addiction

    ... Use and Addiction DrugFacts: Understanding Drug Use and Addiction Email Facebook Twitter Revised August 2016 Many people ... addiction and lead productive lives. What Is drug addiction? Addiction is a chronic disease characterized by drug ...

  13. Shared Medical Appointments: A Promising Innovation to Improve Patient Engagement and Ease the Primary Care Provider Shortage.

    Stults, Cheryl D; McCuistion, Mary H; Frosch, Dominick L; Hung, Dorothy Y; Cheng, Peter H; Tai-Seale, Ming

    2016-02-01

    The Affordable Care Act has extended coverage for uninsured and underinsured Americans, but it could exacerbate existing problems of access to primary care. Shared medical appointments (SMAs) are one way to improve access and increase practice productivity, but few studies have examined the patient's perspective on participation in SMAs. To understand patient experiences, 5 focus group sessions were conducted with a total of 30 people in the San Francisco Bay Area. The sessions revealed that most participants felt that they received numerous tangible and intangible benefits from SMAs, particularly enhanced engagement with other patients and physicians, learning, and motivation for health behavior change. Most importantly, participants noted changes in the power dynamic during SMA visits as they increasingly saw themselves empowered to impart information to the physician. Although SMAs improve access, engagement with physicians and other patients, and knowledge of patients' health, they also help to ease the workload for physicians. (Population Health Management 2016;19:11-16). PMID:26090793

  14. Shared decision-making after implementation of the Chronic Care Modell (CCM)- an evaluative approach

    Holm, Anne Lise; Lyberg, Anne Marit; Berggren, Ingela; Severinsson, Ingeborg Elisabeth

    2014-01-01

    Background: In paternalistic models, healthcare providers’ responsibility is to decide what is best for patients. The main concern is that such models fail to respect patient autonomy and do not promote patient responsibility. Aim: To evaluate mental healthcare team members’ perceptions of their own role in encouraging elderly persons to participate in shared decision-making after implementation of the CCM. The CCM is not an explanatory theory, but an evidence-based guideline and synthesis...

  15. Shared decision making in chronic care in the context of evidence based practice in nursing

    Friesen-Storms, JH; Bours, GJ; van der Weijden, T; Beurskens, AJ

    2015-01-01

    In the decision-making environment of evidence-based practice, the following three sources of information must be integrated: research evidence of the intervention, clinical expertise, and the patient’s values. In reality, evidence-based practice usually focuses on research evidence (which may be translated into clinical practice guidelines) and clinical expertise without considering the individual patient’s values. The shared decision-making model seems to be helpful in the integration of th...

  16. An economic analysis of the national shared Emergency Care Summary in Scotland.

    Jones, Tom; Dobrev, Alexander; Cameron, Jonathan; Morris, Libby; Stroetmann, Karl A; Stroetmann, Veli N

    2009-01-01

    The Emergency Care Summary (ECS) in Scotland provides essential clinical and demographic information about patients needing unscheduled or emergency care. Information about patients' medications, adverse drug reactions and allergies is transferred twice every day from GP systems to the ECS. Access is then available to authorised health-care professionals at the national help line, at out-of-hours services and in accident and emergency departments. An economic analysis of the ECS implementation showed that annual benefits exceeded annual costs after about seven years. Approximately 77% of the benefits were non-financial and 23% from redeployed finance. No cash savings were planned and none were realised. As ECS utilisation increased from 2006, the net benefits became positive. This relationship between utilisation and net benefits is a common feature of successful e-health investment. PMID:19364894

  17. Neuroimaging in nuclear medicine: drug addicted brain

    Addiction to illicit drugs in one of today's most important social issues. Most addictive drugs lead to irreversible parenchymal changes in the human brain. Neuroimaging data bring to light the pharmacodynamics and pharmacokinetics of the abused drugs, and demonstrate that addiction is a disease of the brain. Continuous researches better illustrate the neurochemical alterations in brain function, and attempt to discover the links to consequent behavioral changes. Newer hypotheses and theories follow the numerous results, and more rational methods of approaching therapy are being developed. Substance abuse is on the rise in Korea, and social interest in the matter as well. On the other hand, diagnosis and treatment of drug addiction is still very difficult, because how the abused substance acts in the brain, or how it leads to behavioral problems in not widely known. Therefore, understanding the mechanism of drug addiction can improve the process of diagnosing addict patients, planning therapy, and predicting the prognosis . Neuroimaging approaches by nuclear medicine methods are expected to objectively judge behavioral and neurochemical changes, and response to treatment. In addition, as genes associated with addictive behavior are discovered, functional nuclear medicine images will aid in the assessment of individuals. Reviewing published literature on neuroimaging regarding nuclear medicine is expected to be of assistance to the management of drug addict patients. What's more, means of applying nuclear medicine to the care of drug addict patients should be investigated further

  18. Neuroimaging in nuclear medicine: drug addicted brain

    Chung, Yong-An; Kim, Dae-Jin [The Catholic University of Korea, Seoul (Korea, Republic of)

    2006-02-15

    Addiction to illicit drugs in one of today's most important social issues. Most addictive drugs lead to irreversible parenchymal changes in the human brain. Neuroimaging data bring to light the pharmacodynamics and pharmacokinetics of the abused drugs, and demonstrate that addiction is a disease of the brain. Continuous researches better illustrate the neurochemical alterations in brain function, and attempt to discover the links to consequent behavioral changes. Newer hypotheses and theories follow the numerous results, and more rational methods of approaching therapy are being developed. Substance abuse is on the rise in Korea, and social interest in the matter as well. On the other hand, diagnosis and treatment of drug addiction is still very difficult, because how the abused substance acts in the brain, or how it leads to behavioral problems in not widely known. Therefore, understanding the mechanism of drug addiction can improve the process of diagnosing addict patients, planning therapy, and predicting the prognosis . Neuroimaging approaches by nuclear medicine methods are expected to objectively judge behavioral and neurochemical changes, and response to treatment. In addition, as genes associated with addictive behavior are discovered, functional nuclear medicine images will aid in the assessment of individuals. Reviewing published literature on neuroimaging regarding nuclear medicine is expected to be of assistance to the management of drug addict patients. What's more, means of applying nuclear medicine to the care of drug addict patients should be investigated further.

  19. Ensuring safe access to medication for palliative care while preventing prescription drug abuse: innovations for American inner cities, rural areas, and communities overwhelmed by addiction

    Francoeur RB

    2011-09-01

    Full Text Available Richard B FrancoeurSchool of Social Work, Adelphi University, Garden City, NY, USA; Center for the Psychosocial Study of Health and Illness, Columbia University, New York, NY, USAAbstract: This article proposes and develops novel components of community-oriented programs for creating and affording access to safe medication dispensing centers in existing retail pharmacies and in permanent or travelling pharmacy clinics that are guarded by assigned or off-duty police officers. Pharmacists at these centers would work with police, medical providers, social workers, hospital administrators, and other professionals in: planning and overseeing the safe storage of controlled substance medications in off-site community safe-deposit boxes; strengthening communication and cooperation with the prescribing medical provider; assisting the prescribing medical provider in patient monitoring (checking the state prescription registry, providing pill counts and urine samples; expanding access to lower-cost, and in some cases, abuse-resistant formulations of controlled substance medications; improving transportation access for underserved patients and caregivers to obtain prescriptions; and integrating community agencies and social networks as resources for patient support and monitoring. Novel components of two related community-oriented programs, which may be hosted outside of safe medication dispensing centers, are also suggested and described: (1 developing medication purchasing cooperatives (ie, to help patients, families, and health institutions afford the costs of medications, including tamper- or abuse-resistant/deterrent drug formulations; and (2 expanding the role of inner-city methadone maintenance treatment programs in palliative care (ie, to provide additional patient monitoring from a second treatment team focusing on narcotics addiction, and potentially, to serve as an untapped source of opioid medication for pain that is less subject to abuse

  20. [Digital Game Addiction Among Adolescents and Younger Adults: A Current Overview].

    Yalçın Irmak, Aylin; Erdoğan, Semra

    2016-01-01

    The games that adolescents and young people used to play in the play grounds and on the streets have been replaced in recent years with cyber games played in front of the computer on the internet or in game arcades. This changing culture has particularly brought up the concept of "digital game addiction", a condition that stems from the steadily growing passion for digital games and their excessived and uncontrolled usage among adolescents and young people. Game addiction in the psychiatry literature has been described as an impulse control disorder characterized by the symptoms such as "the inability to control the time spent on game-playing", "a loss of interest in other activities", "continuing to play despite the adverse effects" and "feeling psychologically deprived when not being able to play"."Although digital game addiction has not been accepted by psychiatric authorities as a psychiatric disorder yet, the increasing psychiatry referrals due to the problems accompanying this disorder, the efforts of families to seek support and solutions, the evidence that similarities with other types of addiction have been revealed by researchers, as well as the current prevalence rates are all factors that suggest the existence of important of the examination of issue. Despite the discussions about the digital game addiction, the literature on the subject is increasing. This article offers an overview of digital game-playing behavior in the light of current literature, seeking to share its findings with health care professionals. PMID:27370064

  1. 76 FR 19527 - Medicare Program; Medicare Shared Savings Program: Accountable Care Organizations

    2011-04-07

    ... and is a strategy that can help transform the current payment system by rewarding providers for... complications. An ACO will be proactive by reaching out to patients with reminders and advice that can help them.... Definition of Primary Care Services 3. Prospective vs. Retrospective Beneficiary Assignment to...

  2. Shared Data Reveal the Invisible Achievement Gap of Students in Foster Care

    WestEd, 2014

    2014-01-01

    At any given time, tens of thousands of children and youth in the U.S. are in the foster care system. Many have been abused, neglected, or abandoned, and they face a challenging journey of uncertainty, often not knowing where they will live next, where they will go to school, or whether they will have contact with friends and relatives. Child…

  3. Sharing the caring : State, family and gender equality in parental leave policy

    Widener, Anmarie J.

    2006-01-01

    Parental leave policies give parents a temporary leave from employment in order to care for a child. Secondary aims are to increase women’s attachment to the labour force as well as supporting gender equal roles in paid and unpaid work. This study researched parent satisfaction of parental leave p

  4. Collaborative care in the addiction management of alcohol, illicit drugs and hypnotics and tranquilizers in the Belgian working population

    Van Royen, Kathleen; Remmen, Roy; Vanmeerbeek, Marc; Peremans, Lieve

    2012-01-01

    Background: General practitioners (GPs) and occupational physicians (OPs) play an important role in detecting and managing substance abuse in the working population. Their collaboration is critical in coordinating care, facilitate a quicker rehabilitation and shorten sickleave. A systematic literature search was performed according to the ADAPTE-framework to explore if guidelines exist for collaboration between GPs and OPs in substance abuse management. Method: International guidelines reg...

  5. Do Breast Cancer Patients Tested in the Oncology Care Setting Share BRCA Mutation Results with Family Members and Health Care Providers?

    Susan T. Vadaparampil

    2012-01-01

    Full Text Available BRCA genetic test results provide important information to manage cancer risk for patients and their families. Little is known on the communication of genetic test results by mutation status with family members and physicians in the oncology care setting. As part of a longitudinal study evaluating the impact of genetic counseling and testing among recently diagnosed breast cancer patients, we collected patients' self-reported patterns of disclosure. Descriptive statistics characterized the sample and determined the prevalence of disclosure of BRCA test results to family members and physicians. Of 100 patients who completed the baseline and the 6-month followup survey, 77 reported pursuing testing. The majority shared test results with female first-degree relatives; fewer did with males. Participants were more likely to share results with oncologists compared to surgeons, primary care physicians, or other specialty physicians. These findings suggest that while breast cancer patients may communicate results to at-risk female family members and their medical oncologist, they may need education and support to facilitate communication to other first-degree relatives and providers.

  6. An interactive web tool for facilitating shared decision-making in dementia-care networks: a field study

    Marijke eSpan

    2015-07-01

    Full Text Available BackgroundAn interactive web tool has been developed for facilitating shared decision-making in dementia-care networks. The DecideGuide provides a chat function for easier communication between network members, a deciding together function for step-by-step decision-making, and an individual opinion function for eight dementia-related life domains. The aim of this study was to gain insight in the user friendliness of the DecideGuide, user acceptance and satisfaction, and participants’ opinion of the DecideGuide for making decisions.Materials and methodsA 5-month field study included four dementia-care networks (19 participants in total. The data derived from structured interviews, observations, and information that participants logged in the DecideGuide. Structured interviews took place at the start, middle, and end of the field study with people with dementia, informal caregivers, and case managers. Results1. The user friendliness of the chat and individual opinion functions was adequate for case managers and most informal caregivers. Older participants, with or without dementia, had some difficulties using a tablet and the DecideGuide. The deciding together function does not yet provide adequate instructions for all. The user interface needs simplification. 2. User acceptance and satisfaction: everybody liked the chat’s easy communication, handling difficult issues for discussion, and the option of individual opinions. 3. The DecideGuide helped participants structure their thoughts. They felt more involved and shared more information about daily issues than before. ConclusionParticipants found the DecideGuide valuable in decision-making. The chat function seems powerful in helping members engage with one another constructively. Such engagement is a prerequisite for making shared decisions. Regardless of participants’ use of the tool, they saw the DecideGuide's added value.

  7. Behavioural addiction-A rising tide?

    Chamberlain, Samuel R; Lochner, Christine; Stein, Dan J; Goudriaan, Anna E; van Holst, Ruth Janke; Zohar, Joseph; Grant, Jon E

    2016-05-01

    The term 'addiction' was traditionally used in relation to centrally active substances, such as cocaine, alcohol, or nicotine. Addiction is not a unitary construct but rather incorporates a number of features, such as repetitive engagement in behaviours that are rewarding (at least initially), loss of control (spiralling engagement over time), persistence despite untoward functional consequences, and physical dependence (evidenced by withdrawal symptoms when intake of the substance diminishes). It has been suggested that certain psychiatric disorders characterized by maladaptive, repetitive behaviours share parallels with substance addiction and therefore represent 'behavioural addictions'. This perspective has influenced the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which now has a category 'Substance Related and Addictive Disorders', including gambling disorder. Could other disorders characterised by repetitive behaviours, besides gambling disorder, also be considered 'addictions'? Potential examples include kleptomania, compulsive sexual behaviour, 'Internet addiction', trichotillomania (hair pulling disorder), and skin-picking disorder. This paper seeks to define what is meant by 'behavioural addiction', and critically considers the evidence for and against this conceptualisation in respect of the above conditions, from perspectives of aetiology, phenomenology, co-morbidity, neurobiology, and treatment. Research in this area has important implications for future diagnostic classification systems, neurobiological models, and novel treatment directions. PMID:26585600

  8. Sharing the caring: State, family and gender equality in parental leave policy

    Widener, Anmarie J.

    2006-01-01

    Parental leave policies give parents a temporary leave from employment in order to care for a child. Secondary aims are to increase women’s attachment to the labour force as well as supporting gender equal roles in paid and unpaid work. This study researched parent satisfaction of parental leave policies in the United States of America and the Netherlands. Mothers and fathers were individually interviewed face to face regarding satisfaction with family leave polices, if and why they did or di...

  9. A Frailty Instrument for primary care: findings from the Survey of Health, Ageing and Retirement in Europe (SHARE

    Romero-Ortuno Roman

    2010-08-01

    Full Text Available Abstract Background A frailty paradigm would be useful in primary care to identify older people at risk, but appropriate metrics at that level are lacking. We created and validated a simple instrument for frailty screening in Europeans aged ≥50. Our study is based on the first wave of the Survey of Health, Ageing and Retirement in Europe (SHARE, http://www.share-project.org, a large population-based survey conducted in 2004-2005 in twelve European countries. Methods Subjects: SHARE Wave 1 respondents (17,304 females and 13,811 males. Measures: five SHARE variables approximating Fried's frailty definition. Analyses (for each gender: 1 estimation of a discreet factor (DFactor model based on the frailty variables using LatentGOLD®. A single DFactor with three ordered levels or latent classes (i.e. non-frail, pre-frail and frail was modelled; 2 the latent classes were characterised against a biopsychosocial range of Wave 1 variables; 3 the prospective mortality risk (unadjusted and age-adjusted for each frailty class was established on those subjects with known mortality status at Wave 2 (2007-2008 (11,384 females and 9,163 males; 4 two web-based calculators were created for easy retrieval of a subject's frailty class given any five measurements. Results Females: the DFactor model included 15,578 cases (standard R2 = 0.61. All five frailty indicators discriminated well (p N = 10,420; 66.9%, pre-frail (N = 4,025; 25.8%, and frail (N = 1,133; 7.3%. Relative to the non-frail class, the age-adjusted Odds Ratio (with 95% Confidence Interval for mortality at Wave 2 was 2.1 (1.4 - 3.0 in the pre-frail and 4.8 (3.1 - 7.4 in the frail. Males: 12,783 cases (standard R2 = 0.61, all frailty indicators had p N = 10,517; 82.3%, pre-frail (N = 1,871; 14.6%, and frail (N = 395; 3.1%; age-adjusted OR (95% CI for mortality: 3.0 (2.3 - 4.0 in the pre-frail, 6.9 (4.7 - 10.2 in the frail. Conclusions The SHARE Frailty Instrument has sufficient construct and

  10. The Scottish Emergency Care Summary – an evaluation of a national shared record system aiming to improve patient care: technology report

    Libby MM Morris

    2013-12-01

    Full Text Available Background In Scotland, out-of-hours calls are all triaged by the National Health Service emergency service (NHS24 but the clinicians receiving calls have no direct access to patient records.Objective To improve the safety of patient care in unscheduled consultations when the usual primary care record is not available.Technology The Emergency Care Summary (ECS is a record system offering controlled access to medication and adverse reactions details for nearly every person registered with a general practice in Scotland. It holds a secure central copy of these parts of the GP practice record and is updated automatically twice daily. It is accessible under specified unplanned clinical circumstances by clinicians working in out-of-hours organisations, NHS24 and accident and emergency departments if they have consent from the patient and a current legitimate relationship for that patient’s care.Application We describe the design of the security model, management of data quality, deployment, costs and clinical benefits of the ECS over four years nationwide in Scotland, to inform the debate on the safe and effective sharing of health data in other nations.Evaluation Forms were emailed to 300 NHS24 clinicians and 81% of the 113 respondents said that the ECS was helpful or very helpful and felt that it changed their clinical management in 20% of cases.Conclusion The ECS is acceptable to patients and helpful for clinicians and is used routinely for unscheduled care when normal medical records are unavailable. Benefits include more efficient assessment and reduced drug interaction, adverse reaction and duplicate prescribing.

  11. Fathers sharing about early parental support in health-care - virtual discussions on an Internet forum.

    Salzmann-Erikson, Martin; Eriksson, Henrik

    2013-07-01

    Becoming a father is a life changing event and this transition is associated with various emotions. Educational activities aimed at new parents are important in healthcare parental support (HCPS). HCPS has been critiqued for its predominant focus on mothers, while the needs of fathers seem to have been downplayed. As a result, fathers often turn to Internet-based forums for support. As virtual discussions and mutual support among fathers take place in cyberspace, it is important to monitor these forums to observe the ways in which the fathers discuss HCPS. The aim of this study is to explore the ways in which new fathers visiting an Internet-based forum for fathers communicated their experiences of HCPS. A netnographic method consisting of six steps was used to gather and analyse the data. The findings show that fathers shared with one another their experiences of the attitudes expressed by HCPS workers as well as their own attitudes towards HCPS. The attitudes of HCPS workers that were directed towards the fathers were perceived as highly personal and individual, while fathers described their attitudes towards the HCPS in general terms, towards HCPS as a system. Overall, the fathers described HCPS as a valuable confirmatory support that eased their worries concerning sudden infant death syndrome (SIDS), colic, weight gain, fever and teething. Although the fathers expressed gratitude towards HCPS, they also shared their negative experiences, such as feeling invisible, disregarded and insulted. In fact, the twofold attitudes that exist in the relationship between the fathers and HCPS can act as a barrier rather than being a confirmatory support. We recommend that HCPS adopts a broader approach using more targeted and strategic didactic methods for supporting fathers in the growth of their own personal awareness, as such an approach would offer a competitive and professional alternative to the support offered in informal experience-based Internet forums. PMID

  12. [Part II. Scientific evidence in end-stage chronic organ failure. A position paper on shared care planning].

    Gristina, Giuseppe R; Orsi, Luciano; Carlucci, Annalisa; Causarano, Ignazio R; Formica, Marco; Romanò, Massimo

    2014-01-01

    The therapeutic options related to chronic organ failure are interconnected to the variability of human biological responses and the personal history and choices of the chronically ill patient on one hand, and with the variable human answers to therapies on the other hand. All these aspects may explain the small number and low quality of studies aimed to define the clinical criteria useful in identifying end-stage chronically ill patients, as highlighted through the 2012-2013 Medline survey performed by the task force. These results prevented the grading of scientific evidence. However, taking into account the evidence based medicine definition, the task force believes the clinical reasoning and the individual experience of clinicians as well as the patients and families preferences cannot be replaced "tout court" with a strict methodological research. Accordingly, the working method selected by the task force members was to draw up a set of clinical parameters based on the available scientific literature, submitting it to a peer review process carried out by an expert panel. This paper discusses a set of clinical parameters included in the clinical decision-making algorithm and shared by nine medical societies. For each chronic organ failure these clinical parameters should be intended not as a rigid cutoff system to make a choice between two selected care options (intensive vs palliative), rather as the starting point for a joint and careful consideration regarding the opportunity to adopt the clinical decision-making algorithm care proposed in Part I. PMID:24553593

  13. Social network site addiction - an overview.

    Andreassen, Cecilie Schou; Pallesen, Ståle

    2014-01-01

    Research into frequent, excessive, and compulsive social network activity has increased the last years, in which terms such as "social network site addiction" and "Facebook addiction" have been used interchangeably. The aim of this review is to offer more knowledge and better understanding of social network site addiction (SNS-addiction) among researchers as well as clinicians by presenting a narrative overview of the research field in terms of definition, measurement, antecedents, consequences, and treatment as well as recommendations for future research efforts. Seven different measures of SNS-addiction have been developed, although they have to a very little extent been validated against each other. The small number of studies conducted so far on this topic suggests that SNS-addiction is associated with health-related, academic, and interpersonal problems/issues. However such studies have relied on a simple cross-sectional study design. It is therefore hard to draw any conclusions about potential causality and long-term effects at this point, beyond hypothetical speculations. Empirical studies suggest that SNS-addiction is caused by dispositional factors (e.g., personality, needs, self-esteem), although relevant explanatory socio-cultural and behavioral reinforcement factors remain to be empirically explored. No well-documented treatment for SNS-addiction exists, but knowledge gained from Internet addiction treatment approaches might be transferable to SNS-addiction. Overall, the research on this topic is in its infancy, and as such the SNS-addiction construct needs further conceptual and empirical exploration. There is a great demand for studies using careful longitudinal designs and studies which include objective measures of both behavior and health based on broad representative samples. PMID:24001298

  14. Etiology of Food Addiction

    Öyekçin, Demet Güleç; Deveci, Artuner

    2012-01-01

    Food addiction is a new topic of focus in the scientific literature. Food intake might be concerned as food addiction in some cases, especially in obese cases and over-eaters. Addiction like behaviours are commonly observed mong these people. Recent animal, epidemiological, clinical and genetic studies partly shows the clinical validity of food addiction while the neurobiological studies focused on the similarity between the reward systems present in obesity and drug addiction. However some ...

  15. Epigenetics and addiction.

    Cadet, J L; McCoy, M T; Jayanthi, S

    2016-05-01

    Addictions are public health menaces. However, despite advances in addiction research, the cellular or molecular mechanisms that cause transition from recreational use to addiction remain to be elucidated. We have recently suggested that addiction may be secondary to long-term epigenetic modifications that determine the clinical course of substance use disorders. A better understanding of epigenetic mechanisms in animal models that mimic human conditions should help to usher in a new area of drug development against addiction. PMID:26841306

  16. Etiology of Food Addiction

    Demet Gulec Oyekcin; Artuner Deveci

    2012-01-01

    Food addiction is a new topic of focus in the scientific literature. Food intake might be concerned as food addiction in some cases, especially in obese cases and over-eaters. Addiction like behaviours are commonly observed mong these people. Recent animal, epidemiological, clinical and genetic studies partly shows the clinical validity of food addiction while the neurobiological studies focused on the similarity between the reward systems present in obesity and drug addiction. However some s...

  17. Pharmacy Students’ Attitudes About Treating Patients With Alcohol Addiction After Attending a Required Mutual Support Group

    Neville, Michael W.

    2014-01-01

    Objective. To implement required attendance at mutual support groups for addiction recovery as a pharmacy skills laboratory exercise, and to evaluate how attendance affected pharmacy students’ attitudes about caring for patients with addiction.

  18. Eight reasons payer interoperability and data sharing are essential in ACOs. Interoperability standards could be a prerequisite to measuring care.

    Mookencherry, Shefali

    2012-01-01

    It makes strategic and business sense for payers and providers to collaborate on how to take substantial cost out of the healthcare delivery system. Acting independently, neither medical groups, hospitals nor health plans have the optimal mix of resources and incentives to significantly reduce costs. Payers have core assets such as marketing, claims data, claims processing, reimbursement systems and capital. It would be cost prohibitive for all but the largest providers to develop these capabilities in order to compete directly with insurers. Likewise, medical groups and hospitals are positioned to foster financial interdependence among providers and coordinate the continuum of patient illnesses and care settings. Payers and providers should commit to reasonable clinical and cost goals, and share resources to minimize expenses and financial risks. It is in the interest of payers to work closely with providers on risk-management strategies because insurers need synergy with ACOs to remain cost competitive. It is in the interest of ACOs to work collaboratively with payers early on to develop reasonable and effective performance benchmarks. Hence, it is essential to have payer interoperability and data sharing integrated in an ACO model. PMID:22352172

  19. Chronic pain, substance abuse and addiction.

    Compton, Peggy; Athanasos, Peter

    2003-09-01

    Health care professionals face numerous challenges in assessing and treating chronic pain patients with a substance abuse history. Societal perspectives on morality and criminality, imprecise addiction terminology, litigation fears, and genuine concern for a patient's relapse into or escalation of substance abuse result in unrelieved and under-relieved pain in precisely the population that--as increasing evidence indicates--is generally intolerant of pain. Before adequate pain relief can occur in chronic pain patients with current or past substance abuse issues, it is imperative that the clinician recognize addiction as a disease with known symptoms and treatments. Further, the clinician must realize the difference between true addiction and similar conditions, so the patient's condition can be monitored and regulated properly. Although clinicians are often reluctant to medicate with opioids, it is always best to err on the side of adequate pain relief. Withholding opioids from chronic pain patients in order to avoid the onset or relapse of addiction is contrary to the growing body of evidence and results only in unnecessary pain for the patient. Chronic pain in patients with a history of addictive disease can be treated successfully with opiate analgesia; it just requires caution and careful monitoring of medication use. If addiction is treated as a known risk when providing opioid analgesia to a recovering addict, its development can be minimized while pain relief is provided. PMID:14567207

  20. Do marmosets care to share? Oxytocin treatment reduces prosocial behavior toward strangers.

    Mustoe, Aaryn C; Cavanaugh, Jon; Harnisch, April M; Thompson, Breanna E; French, Jeffrey A

    2015-05-01

    Cooperatively-breeding and socially-monogamous primates, like marmosets and humans, exhibit high levels of social tolerance and prosociality toward others. Oxytocin (OXT) generally facilitates prosocial behavior, but there is growing recognition that OXT modulation of prosocial behavior is shaped by the context of social interactions and by other motivational states such as arousal or anxiety. To determine whether prosociality varies based on social context, we evaluated whether marmoset donors (Callithrix penicillata) preferentially rewarded pairmates versus opposite-sex strangers in a prosocial food-sharing task. To examine potential links among OXT, stress systems, and prosociality, we evaluated whether pretrial cortisol levels in marmosets altered the impact of OXT on prosocial responses. Marmosets exhibited spontaneous prosociality toward others, but they did so preferentially toward strangers compared to their pairmates. When donor marmosets were treated with marmoset-specific Pro(8)-OXT, they exhibited reduced prosociality toward strangers compared to marmosets treated with saline or consensus-mammalian Leu(8)-OXT. When pretrial cortisol levels were lower, marmosets exhibited higher prosociality toward strangers. These findings demonstrate that while marmosets show spontaneous prosocial responses toward others, they do so preferentially toward opposite-sex strangers. Cooperative breeding may be associated with the expression of prosociality, but the existence of a pair-bond between marmoset partners appears to be neither necessary nor sufficient for the expression of spontaneous prosocial responses. Furthermore, high prosociality toward strangers is significantly reduced in marmosets treated with Pro(8)-OXT, suggesting that OXT does not universally enhance prosociality, but, rather OXT modulation of prosocial behavior varies depending on social context. PMID:25934057

  1. Training the next generation of providers in addiction medicine.

    Rasyidi, Ernest; Wilkins, Jeffery N; Danovitch, Itai

    2012-06-01

    Within the United States there exists a profound discrepancy between the significant public health problem of substance abuse and the access to treatment for addicted individuals. Part of the insufficient access to treatment is a function of relatively low levels or professional experts in addiction medicine. Part of the low levels of professional addiction experts is the result of inadequate addiction medicine training of medical students and residents. This article outlines deficits in addiction medicine training among medical students and residents, yet real change in the addiction medicine training process will always be subject to the complexity of producing alterations across multiple credentialing institutions as well as the keen competition between educators for “more time” for their particular subject. Other hurdles include the broad-based issue of stigma regarding alcoholism and other substance abuse that likely impact all systems that regulate physician addiction medicine training. As noted in the discussion of psychiatry residency, even psychiatry residents manifest stigma regarding substance abusing patients. Five currently active processes may allow for fundamental change to the inertia in physician addiction medicine training while also potentially impacting stigma: 1. We appear to be at the beginning of the integration of addiction into traditional medicine through the formation of a legitimized addiction medicine subspecialty. 2. The training of primary care trainees and practitioners in the use of SBIRT is accelerating, thus creating another process of addiction integration into traditional medicine. 3. The PCMH is being established as a model for primary care 4. The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) became effective for group health care plan years beginning on or after July 1, 2010; thereby, substance abuse benefits and cost are to be the same as general medical or surgical

  2. Addiction Counsellors in the Republic of Ireland: Exploring the Emergence of a New Profession

    Butler, Shane

    2011-01-01

    This article reviews the emergence and expansion of addiction counselling as a specialist form of professional practice with problem drinkers and drug users in Ireland, over the past 30 years. It sees addiction counselling as having its roots in a widely shared disenchantment with the "medical model" of addiction treatment, and identifies the main…

  3. Advancing theories, models and measurement for an interprofessional approach to shared decision making in primary care: a study protocol

    Frosch Dominick

    2008-01-01

    Full Text Available Abstract Background Shared decision-making (SDM is defined as a process by which a healthcare choice is made by practitioners together with the patient. Although many diagnostic and therapeutic processes in primary care integrate more than one type of health professional, most SDM conceptual models and theories appear to be limited to the patient-physician dyad. The objectives of this study are to develop a conceptual model and propose a set of measurement tools for enhancing an interprofessional approach to SDM in primary healthcare. Methods/Design An inventory of SDM conceptual models, theories and measurement tools will be created. Models will be critically assessed and compared according to their strengths, limitations, acknowledgement of interprofessional roles in the process of SDM and relevance to primary care. Based on the theory analysis, a conceptual model and a set of measurements tools that could be used to enhance an interprofessional approach to SDM in primary healthcare will be proposed and pilot-tested with key stakeholders and primary healthcare teams. Discussion This study protocol is informative for researchers and clinicians interested in designing and/or conducting future studies and educating health professionals to improve how primary healthcare teams foster active participation of patients in making health decisions using a more coordinated approach.

  4. Age-related aspects of addiction

    Koechl, Birgit; Unger, Annemarie; Fischer, Gabriele

    2012-01-01

    Research has shown that substance use, abuse and addiction are not limited to a specific age group. Problems related to substance addiction are an important cause of morbidity in the population aged 65 and above, especially the abuse of prescription drugs and legal substances. A lack of evidence-based studies and tailored treatment options for the aging population is evident. Appropriate and effective health-care is an important goal to improve health-related quality of life of elderly people...

  5. Internet Gaming Addiction: A Technological Hazard

    Sachdeva; Verma

    2015-01-01

    Introduction The Internet is considered a beneficial tool in research, communication, and information. Still, its excessive and prolonged use has the potential of causing addiction. The presentation of this technological hazard may range from a mild socio-personal distress to a gross disorganization in behavior and self-care. No reported study on Internet gaming addiction is available from India. Case Presentation We reported a ca...

  6. Treatment Approaches for Drug Addiction

    ... for Drug Addiction DrugFacts: Treatment Approaches for Drug Addiction Email Facebook Twitter Revised July 2016 NOTE: This ... treatment options in your state. What is drug addiction? Drug addiction is a chronic disease characterized by ...

  7. Behavioral addictions: a novel challenge for psychopharmacology.

    Marazziti, Donatella; Presta, Silvio; Baroni, Stefano; Silvestri, Stefano; Dell'Osso, Liliana

    2014-12-01

    Although addictive syndromes have been traditionally related to substance-use disorders, during the last few decades a novel addictive group, including the so-called "behavioral or no-drug addictions," has been recognized and has attracted increasing attention for its relevant social impact. This group includes pathological gambling, compulsive shopping, TV/Internet/social network/videogame addictions, workaholism, sex and relationship addictions, orthorexia, and overtraining syndrome. Substance and behavioral addictions show similar phenomenological features, such as craving, dependence, tolerance, and abstinence, and perhaps they share a common possible pathophysiology. It is, however, controversial whether all or at least some of them should be considered real disorders or just normal, albeit extreme, behaviors. The aim of this article is to review current data on pharmacological treatment of behavioral addictions. As no specific and validated treatment algorithms are currently available, only an improved knowledge on their psychopathological, clinical, and neurobiological features may have relevant implications for more focused preventive and therapeutic strategies. PMID:24589040

  8. Etiology of Food Addiction

    Demet Gulec Oyekcin

    2012-06-01

    Full Text Available Food addiction is a new topic of focus in the scientific literature. Food intake might be concerned as food addiction in some cases, especially in obese cases and over-eaters. Addiction like behaviours are commonly observed mong these people. Recent animal, epidemiological, clinical and genetic studies partly shows the clinical validity of food addiction while the neurobiological studies focused on the similarity between the reward systems present in obesity and drug addiction. However some studies still emphasizes the differences between two. The aim of this article was to review clinical and biological aspects of etiological perspectives of food addiction via available clinical, preclinical and genetic studies.

  9. Addictions Neuroclinical Assessment: A Neuroscience-Based Framework for Addictive Disorders.

    Kwako, Laura E; Momenan, Reza; Litten, Raye Z; Koob, George F; Goldman, David

    2016-08-01

    This article proposes a heuristic framework for the Addictions Neuroclinical Assessment that incorporates key functional domains derived from the neurocircuitry of addiction. We review how addictive disorders (ADs) are presently diagnosed and the need for new neuroclinical measures to differentiate patients who meet clinical criteria for addiction to the same agent while differing in etiology, prognosis, and treatment response. The need for a better understanding of the mechanisms provoking and maintaining addiction, as evidenced by the limitations of current treatments and within-diagnosis clinical heterogeneity, is articulated. In addition, recent changes in the nosology of ADs, challenges to current classification systems, and prior attempts to subtype individuals with ADs are described. Complementary initiatives, including the Research Domain Criteria project, that have established frameworks for the neuroscience of psychiatric disorders are discussed. Three domains-executive function, incentive salience, and negative emotionality-tied to different phases in the cycle of addiction form the core functional elements of ADs. Measurement of these domains in epidemiologic, genetic, clinical, and treatment studies will provide the underpinnings for an understanding of cross-population and temporal variation in addictions, shared mechanisms in addictive disorders, impact of changing environmental influences, and gene identification. Finally, we show that it is practical to implement such a deep neuroclinical assessment using a combination of neuroimaging and performance measures. Neuroclinical assessment is key to reconceptualizing the nosology of ADs on the basis of process and etiology, an advance that can lead to improved prevention and treatment. PMID:26772405

  10. Assessing the Efficiency Level of Separation Centers Dormitories related to the separation center for students with addicted parents that lack competency to take care of their children

    Molouk Khadem Ashkezari

    2003-01-01

    Addiction to drugs is one of the social problems the negative consequences of which are not merely limited to the addicted person. On the other hand, such negative consequences will also overshadow the person’s family and society and inflicts irreparable damage on them. Such consequences may in some cases lead to the perpetration of crimes such as child abuse in the family. In this way the family will no longer remain as a safe place for the child and the child will start doing misdeeds, beco...

  11. Preferences and experiences of chronically ill and disabled patients regarding shared decision-making: does the type of care to be decided upon matter?

    Brink-Muinen, A. van den; Spreeuwenberg, P.; Rijken, M.

    2011-01-01

    OBJECTIVE: (1) To describe the importance chronically ill and disabled patients attach to involvement in decision-making when various care types are considered, and (2) to analyse the degree to which these patients are involved in shared decision-making (SDM) regarding these care types, and whether their involvement reflects the importance they attach to SDM. METHODS: The study sample consisted of 812 chronically ill and disabled patients who experienced a situation of decision-making during ...

  12. Motivation and Self-Regulation in Addiction: A Call for Convergence

    Köpetz, Cătălina E.; Lejuez, Carl W.; Wiers, Reinout W.; Kruglanski, Arie W

    2013-01-01

    Addiction models have frequently invoked motivational mechanisms to explain the initiation and maintenance of addictive behaviors. However, in doing so, these models have emphasized the unique characteristics of addictive behaviors and overlooked the commonalities that they share with motivated behaviors in general. As a consequence, addiction research has failed to connect with and take advantage of promising and highly relevant advances in motivation and self-regulation research. The presen...

  13. Diffusion tensor imaging reveals thalamus and posterior cingulate cortex abnormalities in internet gaming addicts

    Dong, Guangheng; DeVito, Elise; Huang, Jie; Du, XiaoXia

    2012-01-01

    Internet gaming addiction (IGA) is increasingly recognized as a widespread disorder with serious psychological and health consequences. Diminished white matter integrity has been demonstrated in a wide range of other addictive disorders which share clinical characteristics with IGA. Abnormal white matter integrity in addictive populations has been associated with addiction severity, treatment response and cognitive impairments. This study assessed white matter integrity in individuals with in...

  14. [Internet addiction].

    Nakayama, Hideki; Higuchi, Susumu

    2015-09-01

    Internet technologies have made a rapid progress, bringing convenience to daily life. On the other hand, internet use disorder and internet addiction (IA) have become reportedly serious health and social problems. In 2013, internet gaming disorder criteria have been proposed in the section of Conditions for Further Study of DSM-5. Existing epidemiological studies by questionnaire methods have reported that the prevalence of IA ranges between 2.8% and 9.9% among youths in Japan. Attention deficit hyperactivity disorder (ADHD), sleeping disorders, depression, obsessive compulsive disorder, and phobic anxiety disorder are extremely common comorbid mental disorders with IA. Some psychotherapies (e.g., cognitive behavioral therapy, motivational interviewing) and medical treatments (e.g., antidepressant drugs, methylphenidate) for comorbid mental disorders as well as rehabilitation (e.g., treatment camp) are effective for IA remission. However, some serious cases of IA may be difficult to treat, and prevention is very important. In future, the prevention, rehabilitations and treatments for IA will be more required in Japan. PMID:26394521

  15. Thai men’s experiences of alcohol addiction and treatment

    Hanpatchaiyakul, Kulnaree; Eriksson, Henrik; Kijsompon, Jureerat; Östlund, Gunnel

    2014-01-01

    Background: Men are overrepresented with regard to alcohol addiction and in terms of alcohol treatment worldwide. In Thailand, alcohol consumption continues to rise, but few of those afflicted with alcohol addiction attend alcohol treatment programs, even though there is universal care for all. No comprehensive studies have been done on men’s experiences with addiction and alcohol treatment programs in Thailand.Objective: The aim of this study was to explore men’s experiences in terms of the ...

  16. Related Addictive Disorders.

    Buck, Tina; Sales, Amos

    This paper provides an overview of addiction related to substance abuse. It provides basic information, prevalence, diagnostic criteria, assessment tools, and treatment issues for eating disorders, compulsive gambling, sex addictions, and work addictions. Eating disorders such as anorexia nervosa and bulimia nervosa, especially affect adolescents.…

  17. Shared care or nurse consultations as an alternative to rheumatologist follow-up for rheumatoid arthritis (RA) outpatients with stable low disease-activity RA

    Sørensen, Jan; Primdahl, J; Horn, Hc;

    2014-01-01

    Objectives: To compare the cost-effectiveness of three types of follow-up for outpatients with stable low-activity rheumatoid arthritis (RA). Method: In total, 287 patients were randomized to either planned rheumatologist consultations, shared care without planned consultations, or planned nurse...

  18. Women and drug addiction: a historical perspective.

    Kandall, Stephen R

    2010-04-01

    The history of women and addiction in America extends back more than 150 years. Although the true epidemiology of women and addiction has always been difficult to determine, the spectrum of female addicts extends well beyond those women who make sensationalistic headlines by "abandoning" or "battering" their children. Historically, female addiction has been largely the result of inappropriate overmedication practices by physicians and pharmacists, media manipulation, or individuals own attempts to cope with social or occupational barriers preventing equality and self-fulfillment. From the mid-nineteenth century, uneasy tolerance, social ostracism, vilification, persecution, and legal prosecution have grudgingly, but not completely, given way to more humane treatment opportunities in the setting of more enlightened comprehensive care. PMID:20407971

  19. Sharing is Caring

    Sanderhoff, Merete

    70 Jahre nach dem Tod eines Urhebers werden dessen Werke zu öffentlichem geistigem Eigentum, sie sind gemeinfrei und gehören somit dem Publikum. Damit sind nicht nur mittelalterliche Texte, sondern auch Bücher und Werke aus dem 20. Jahrhundert frei. Die Digitalisierung hat dem Umgang mit diesen W...

  20. [Parte III. Ethical and juridical aspects in end-stage chronic organ failures. A position paper on a shared care planning].

    Barbisan, Camillo; Casonato, Carlo; Palermo Fabris, Elisabetta; Piccinni, Mariassunta; Zatti, Paolo

    2014-01-01

    The specific target of an experts panel was to assess in terms of law and ethics the compliance of a new specific decision making algorithm described in the position paper proposed by the Gruppo di Lavoro Insufficienze Croniche d'Organo, with the main goal of the position paper consisting in the shared care planning process. The following specific aspects were assessed by the experts: a) the impact on case law and statute law of a new clinical pathway shared by scientific societies in light of good clinical practice and scientific evidence; b) the relevance of all tools useful to identify the appropriateness of care pathways, recognizing responsibilities and decision-making skills related to the end of life choices made by all stakeholders involved (healthcare professionals, patients and their beloved ones); c) the consistency of the healthcare professionals duties proposed in the position paper with the Italian legal order; d) the opportunity to take into account the role of all healthcare providers involved in care relationship; e) the consistency of the definition of patient rights at the end of life as proposed in the position paper with the Italian legal order and the relevance in this context of simultaneous palliative care; f) the relevance of shared care planning and its consistency with the proposed operative tools; g) the relevance of the conscientious objection issue and the compliance of management tools proposed in the position paper with the results of ethical and legal considerations; h) considerations about available resources allocation. PMID:24553594

  1. The Addiction Psychiatrist as Dual Diagnosis Physician: A Profession in Great Need and Greatly Needed

    Chambers, R. Andrew

    2013-01-01

    Addiction is the number one cause of premature illness and death in the U.S., especially among people with mental illness. Yet American medicine lacks sufficient workforce capacity, expertise, training, infrastructure, and research to support treatment for people with co-occurring addictions and mental illness. This essay argues that the addiction psychiatrist is essential in dual diagnosis care.

  2. Addiction is Not a Natural Kind

    Jeremy Michael Pober

    2013-10-01

    Full Text Available I argue that addiction is not an appropriate category to support generalizations for the purposes of scientific prediction. That is, addiction is not a natural kind. I discuss the Homeostatic Property Cluster theory of kinds, according to which members of a kind share a cluster of properties generated by a common mechanism or set of mechanisms. Leading accounts of addiction in literature fail to offer a mechanism that explains addiction across substances. I discuss popular variants of the disease conception and demonstrate that at least one class of substances that fails to confirm a major prediction of each account. When no mechanism can be found to explain the occurrence of the relevant properties in members of a category, the HPC view suggests that we revise our categories. I discuss options offered by the HPC view, including category revision and category replacement. I then conclude that talk of addiction as a prediction-supporting category should be replaced with categories such as ‘S-addiction’ and ‘T-addiction,’ where S and T are substances or sets of substances of abuse, as these categories are genuine natural kinds.

  3. Naltrexone: A Pan-Addiction Treatment?

    Aboujaoude, Elias; Salame, Wael O

    2016-08-01

    Addiction is a major public health problem with few efficacious and safe treatments. The goal of this review is to provide an evidence-based assessment of the therapeutic role of the opioid antagonist naltrexone across the addiction spectrum-substance-based and behavioral. The PubMed database was searched for randomized, placebo-controlled clinical trials that investigated the oral or intramuscular long-acting formulation of naltrexone in substance use disorders or behavioral addictions such as pathological gambling, kleptomania, and trichotillomania. Thirty-nine efficacy studies were retrieved, covering alcohol use disorder (n = 22), opioid use disorder (n = 6), nicotine use disorder (n = 5), stimulant use disorder (n = 2), gambling disorder (n = 2), trichotillomania (n = 1), and kleptomania (n = 1). Despite the very different presentations within and between both addiction categories, the data, as a whole, show consistency in favor of naltrexone's relative efficacy and safety. Given the potential benefit and good tolerability revealed in the studies, the high morbidity associated with addiction, and the dearth of alternate treatments, naltrexone would seem like an underutilized treatment option. Further, naltrexone's seemingly broad anti-addiction efficacy supports a shared role for brain opioid pathways in the pathophysiology of addiction, broadly defined. More studies investigating the efficacy and tolerability of naltrexone and other opioid modulators are warranted. Studies should also further examine the effect of combining psychotherapy with naltrexone, as well as the potential role of naltrexone in treating comorbid addictions. PMID:27401883

  4. Shared medical appointments for children and adolescents with type I diabetes: perspectives and experiences of patients, parents, and health care providers

    Noordman J

    2012-06-01

    Full Text Available Arlene Mejino,1 Janneke Noordman,1 Sandra van Dulmen1–31Netherlands Institute for Health Services Research (NIVEL, Utrecht, The Netherlands; 2Radboud University Nijmegen Medical Centre, Department of Primary and Community Care, Nijmegen, The Netherlands; 3Department of Health Science, Buskerud University College, Drammen, NorwayAims: This study examined the perspectives and experiences of patients, parents, and health care providers with shared medical appointments (SMAs for children and adolescents with type 1 diabetes. Specifically studied were reasons to attend SMAs, perceived differences between SMAs and individual medical appointments, patient-valued health care aspects, and providers' performance.Methods: Fifty-two patients, 8 parents, and 36 health care providers participated. Perspectives on SMAs were assessed with questionnaires and an online focus group. Data was analyzed using descriptive statistics.Results: Health care providers had work-related reasons to conduct SMAs. Patients and parents primarily valued the presence of other patients during SMAs. According to health care providers and patients, a higher or similar amount of information was discussed during SMAs as opposed to individual appointments, respectively. SMAs did contain more discussion about lifestyle. Most consultation aspects considered important by the patients were performed by their health care providers. Patient satisfaction with SMAs did tend to decrease after 3 months. Parents were somewhat more critical about SMAs.Conclusions: Health care providers, patients, and parents were generally positive about SMAs. Future studies should examine the impact of the presence of parents and different health care providers during SMAs, and that of differences in patient age, type of insulin treatment, and disease-related problems.Keywords: child, adolescent, diabetes mellitus type 1, pediatrics, shared medical appointment

  5. Addiction and Will

    Brian eJohnson

    2013-09-01

    Full Text Available ADDICTION AND WILLA hypothesis about the neurobiological bases of drive, drive reduction and will in addictive illness is presented. Drive reduction seems to require both SEEKING and gratification. Will is the everyday term for our experience of drives functioning within us. Addictive drugs take over the will by altering neurotransmission in the SEEKING system. As a result of this biological change, psychological defenses are arrayed that allow partial gratification and reduce anxiety about the consequences of drug use. Repeated partial gratification of the addictive drive creates a cathexis to the drug and the drug seller. It also keeps the addicted person in a permanent state of SEEKING.The cathexis to the drug and drug seller creates a difficult situation for psychoanalytic therapists. The actively addicted patient will have one set of feelings for the analyst, and a split off set of feelings for the drug dealer. Addictive neuroses, which feature a split transference, are contrasted with Freud’s concept of transference and narcissistic neuroses. For treatment of an actively addicted patient, the treater must negotiate the split transference. By analyzing the denial system the relationship with the drug dealer ends and the hostility involved in addictive behavior enters the transference where it can be interpreted.Selling drugs that take over the will is a lucrative enterprise. The addictive drug industry, about the size of the oil and gas industry worldwide, produces many patients in need of treatment. The marketers of addictive drugs understand the psychology of inducing initial ingestion of the drugs, and of managing their addicted populations. The neuropsychoanalytic understanding of addiction might be used to create more effective public health interventions to combat this morbid and mortal illness.

  6. Internet Addiction and Other Behavioral Addictions.

    Jorgenson, Alicia Grattan; Hsiao, Ray Chih-Jui; Yen, Cheng-Fang

    2016-07-01

    The Internet is increasingly influential in the lives of adolescents. Although there are many positives, there are also risks related to excessive use and addiction. It is important to recognize clinical signs and symptoms of Internet addiction (compulsive use, withdrawal, tolerance, and adverse consequences), treat comorbid conditions (other substance use disorders, attention deficit hyperactivity disorder, anxiety, depression, and hostility), and initiate psychosocial interventions. More research on this topic will help to provide consensus on diagnostic criteria and further clarify optimal management. PMID:27338971

  7. How addicts think about addiction and community problems?

    Meysamie, A; B. Faramarzi; K Holakouie Naieni

    2006-01-01

    Background: addiction and drug abuse have many risk factors in community and individual attitude; also causes much diversity in community perception and attitude toward addiction. Methods: in this study we assessed attitude toward an addict in 42 addict men and asked about problems in their community and recreational behaviors. They were residents of a rural area in Babol city. In the control group we assessed the same parameters in 268 non addicts in the same area. All of the addicts have be...

  8. What is addiction?

    Kranzler, Henry R; Li, Ting-Kai

    2008-01-01

    This issue of Alcohol Research & Health examines addiction to multiple substances--that is, combined dependence on alcohol and other drugs (AODs), including marijuana, cocaine, and opioids. It seems fitting, then, to begin the issue with a look at what constitutes "addiction." The Oxford English Dictionary (pp. 24-25) traces the term addiction to Roman law, under which addiction was a "formal giving over by sentence of court; hence, a dedication of person to a master." This notion of relinquishment of control by the addicted person is the central feature of many lay and professional definitions of the term. The study of addictive behavior crosses several disciplines, including, among others, behavioral neuroscience, epidemiology, genetics, molecular biology, pharmacology, psychology, psychiatry, and sociology. Articles in this issue examine aspects of AOD use disorders from the perspective of some of these varied disciplines. PMID:23584810

  9. Causes of Internet Addiction Disorder

    2008-01-01

    The Internet Addiction Disorder diagnostic manual approved by psychologists on November 8 divides Internet addiction into five categories,which are addiction to online games,pornography,social networking,Internet information and Internetshopping.

  10. Does Addiction Run in Families?

    ... runs in some families. Addiction runs in ours." Matt's family has a history of addiction. He realizes ... may be more likely to become addicted. Read Matt's story About the National Institute on Drug Abuse ( ...

  11. An evaluation of the impact of patient cost sharing for antihypertensive medications on adherence, medication and health care utilization, and expenditures

    Pesa JA

    2012-01-01

    Full Text Available Jacqueline A Pesa1, Jill Van Den Bos2, Travis Gray2, Colleen Hartsig2, Robert Brett McQueen3, Joseph J Saseen3, Kavita V Nair31Janssen Scientific Affairs, LLC, Louisville, CO, USA; 2Milliman, Inc, Denver, CO, USA; 3University of Colorado Anschutz Medical Campus, Aurora, CO, USAObjective: To assess the impact of patient cost-sharing for antihypertensive medications on the proportion of days covered (PDC by antihypertensive medications, medical utilization, and health care expenditures among commercially insured individuals assigned to different risk categories.Methods: Participants were identified from the Consolidated Health Cost Guidelines (CHCG database (January 1, 2006–December 31, 2008 based on a diagnosis (index claim for hypertension, continuous enrollment ≥12 months pre- and post-index, and no prior claims for antihypertensive medications. Participants were assigned to: low-risk group (no comorbidities, high-risk group (1+ selected comorbidities, or very high-risk group (prior hospitalization for 1+ selected comorbidities. The relationship between patient cost sharing and PDC by antihypertensive medications was assessed using standard linear regression models, controlling for risk group membership, and various demographic and clinical factors. The relationship between PDC and health care service utilization was subsequently examined using negative binomial regression models.Results: Of the 28,688 study patients, 66% were low risk. The multivariate regression model supported a relationship between patient cost sharing per 30-day fill and PDC in the following year. For every US$1.00 increase in cost sharing, PDC decreased by 1.1 days (P < 0.0001. Significant predictors of PDC included high risk, older age, gender, Charlson Comorbidity Index score, geography, and total post-index insurer- and patient-paid costs. An increase in PDC was associated with a decrease in all-cause and hypertension-related inpatient, outpatient, and emergency

  12. [Neurobiology of behavioral addictions].

    Kiefer, F; Fauth-Bühler, M; Heinz, A; Mann, K

    2013-05-01

    Reward learning represents a crucial mechanism in the acquisition and maintenance of addictive behavior. The underlying neurobiological foundations and associated neurobiological pathways are identified in this review and similarities between substance abuse and behavioral addictions will be discussed. In the second section current neuroimaging findings on neurobiological mechanisms of pathological gambling and computer and internet addiction are discussed. The main focuses are on changes in neurocognitive processes, such as cue reactivity, reward and punishment processing and behavioral control. PMID:23632569

  13. Anti-addiction vaccines

    Shen, Xiaoyun; Orson, Frank M.; Kosten, Thomas R.

    2011-01-01

    Despite intensive efforts to eradicate it, addiction to both legal and illicit drugs continues to be a major worldwide medical and social problem. Anti-addiction vaccines can produce the antibodies to block the effects of these drugs on the brain, and have great potential to ameliorate the morbidity and mortality associated with illicit drug intoxications. This review provides a current overview of anti-addiction vaccines that are under clinical trial and pre-clinical research evaluation. It ...

  14. CIMP Internet Addiction Guideline

    Azizah Zainudin; Marina Md Din; Marini Othman

    2013-01-01

    Nowadays, Internet addiction has become a major problem to the university students. The purpose of this study is to present a guideline to helps people to overcome their Internet addiction especially for students. There were 653 university students (341 females and 312 males) from five different universities in Malaysia have completed related survey. The survey questionnaires were taken from Young?s Addiction Scale (1996) and some questions were created by the researcher. In this paper, there...

  15. Addiction and will.

    Johnson, Brian

    2013-01-01

    A hypothesis about the neurobiological bases of drive, drive reduction and will in addictive illness is presented. Drive reduction seems to require both SEEKING and gratification. Will is the everyday term for our experience of drives functioning within us. Addictive drugs take over the will by altering neurotransmission in the SEEKING system. As a result of this biological change, psychological defenses are arrayed that allow partial gratification and reduce anxiety about the consequences of drug use. Repeated partial gratification of the addictive drive creates a cathexis to the drug and the drug seller. It also keeps the addicted person in a permanent state of SEEKING. The cathexis to the drug and drug seller creates a difficult situation for psychoanalytic therapists. The actively addicted patient will have one set of feelings for the analyst, and a split off set of feelings for the drug dealer. Addictive neuroses, which feature a split transference, are contrasted with Freud's concept of transference and narcissistic neuroses. For treatment of an actively addicted patient, the treater must negotiate the split transference. By analyzing the denial system the relationship with the drug dealer ends and the hostility involved in addictive behavior enters the transference where it can be interpreted. Selling drugs that take over the will is a lucrative enterprise. The addictive drug industry, about the size of the oil and gas industry worldwide, produces many patients in need of treatment. The marketers of addictive drugs understand the psychology of inducing initial ingestion of the drugs, and of managing their addicted populations. The neuropsychoanalytic understanding of addiction might be used to create more effective public health interventions to combat this morbid and mortal illness. PMID:24062657

  16. Healthcare providers' intentions to engage in an interprofessional approach to shared decision-making in home care programs: A mixed methods study

    Légaré, France; Stacey, Dawn; Brière, Nathalie; Fraser, Kimberley; Desroches, Sophie; Dumont, Serge; Sales, Anne; Puma, Carole; Aubé, Denise

    2013-01-01

    In an interprofessional approach to shared decision-making (IP-SDM), an interprofessional team collaborates in identifying best options and helps patients determine their preferences, enabling them to take more control over the treatment plan. However, little is known about fostering IP-SDM in Canada's healthcare system. Therefore, we sought to evaluate health professionals' intentions to engage in IP-SDM in home care and explore the factors associated with this intention. A total of 272 elig...

  17. A randomised translational trial of lifestyle intervention using a 3-tier shared care approach on pregnancy outcomes in Chinese women with gestational diabetes mellitus but without diabetes

    Yang, Xilin; Tian, Huiguang; Zhang, Fuxia; Zhang, Cuiping; Li, Yi; Leng, Junhong; Wang, Leishen; Liu, Gongsu; Dong, Ling; Yu, Zhijie; Hu, Gang; Chan, Juliana CN

    2014-01-01

    Background There are no randomised controlled trials to demonstrate whether lifestyle modifications can improve pregnancy outcomes of gestational diabetes mellitus (GDM) diagnosed by the International Association of Diabetes and Pregnancy Study Group’s (IADPSG) criteria. We tested the effectiveness of lifestyle modifications implemented in a 3-tier’s shared care (SC) on pregnancy outcomes of GDM. Methods Between December 2010 and October 2012, we randomly assigned 700 women with IADPSG-define...

  18. Health Literacy, Numeracy, and Graphical Literacy Among Veterans in Primary Care and Their Effect on Shared Decision Making and Trust in Physicians

    Rodríguez, Vanessa; Andrade, Allen D.; García-Retamero, Rocio; Anam, Ramanakumar; Rodríguez, Remberto; Lisigurski, Miriam; SHARIT, JOSEPH; Ruiz, Jorge G.

    2013-01-01

    Studies reveal high levels of inadequate health literacy and numeracy in African Americans and older veterans. The authors aimed to investigate the distribution of health literacy, numeracy, and graph literacy in these populations. They conducted a cross-sectional survey of veterans receiving outpatient care and measured health literacy, numeracy, graph literacy, shared decision making, and trust in physicians. In addition, the authors compared subgroups of veterans using analyses of covarian...

  19. 2013 Update in addiction medicine for the generalist

    Gordon, Adam J.; Bertholet, Nicolas; McNeely, Jennifer; Starrels, Joanna L.; Tetrault, Jeanette M.; Walley, Alexander Y.

    2013-01-01

    Increasingly, patients with unhealthy alcohol and other drug use are being seen in primary care and other non-specialty addiction settings. Primary care providers are well positioned to screen, assess, and treat patients with alcohol and other drug use because this use, and substance use disorders, may contribute to a host of medical and mental health harms. We sought to identify and examine important recent advances in addiction medicine in the medical literature that have implications for t...

  20. What Is Addiction?

    Kranzler, Henry R.; Li, Ting-Kai

    2008-01-01

    This issue of Alcohol Research & Health examines addiction to multiple substances—that is, combined dependence on alcohol and other drugs (AODs), including marijuana, cocaine, and opioids. It seems fitting, then, to begin the issue with a look at what constitutes “addiction.” The Oxford English Dictionary (pp. 24–25) traces the term addiction to Roman law, under which addiction was a “formal giving over by sentence of court; hence, a dedication of person to a master.” This notion of relinquis...

  1. Review of current researches on internet addiction

    Internet addiction (IA) is a mental illness emerged in recent years with increasing use of computer and internet. The serious consequences such as mental and physical illness and social function impairment caused by IA have attracted extensive attention of the whole society. IA affects human beings at a high prevalence all over the world which has highlighted the importance of prevention and treatment of IA. Although there is still debate about definition of IA, increasing evidences including the result from genetic research,neurobiology study and clinical manifestation show that IA may share the same mechanisms with substance addiction, and be probably classified as behavioral addiction which is represented by pathological gambling. However, since the study on IA is yet on the initial stage and neuro biological research on IA is still limited, more reliable investigations especially neuro biological research remains uppermost in this area. (authors)

  2. Balancing motherhood and drug addiction: the transition to parenthood of addicted mothers.

    Silva, Sofia A; Pires, António P; Guerreiro, Cristina; Cardoso, Antónia

    2013-03-01

    This is a study about balancing motherhood and drug addiction, during the transition to parenthood. Few studies have dealt with the parental experience of drug-addicted mothers. The participants included 24 drug-addicted mothers, on methadone, with ages 25-42 and with children 1-32 months of age. Semi-structured interviews were conducted and analyzed according to Grounded Theory. The mothers' main concern was the ambivalence they felt towards pregnancy/motherhood and drug addiction, which was associated with strong feelings of guilt. Confronted with this ambivalence their maternal role becomes merely functional. They focus on providing the basic care to the child, but show little willingness to talk or play. Social support, especially from the partner seems to have a positive role. PMID:22544158

  3. Moving toward comprehensive acute heart failure risk assessment in the emergency department: the importance of self-care and shared decision making.

    Collins, Sean P; Storrow, Alan B

    2013-08-01

    Nearly 700,000 emergency department (ED) visits were due to acute heart failure (AHF) in 2009. Most visits result in a hospital admission and account for the largest proportion of a projected $70 billion to be spent on heart failure care by 2030. ED-based risk prediction tools in AHF rarely impact disposition decision making. This is a major factor contributing to the 80% admission rate for ED patients with AHF, which has remained unchanged over the last several years. Self-care behaviors such as symptom monitoring, medication taking, dietary adherence, and exercise have been associated with decreased hospital readmissions, yet self-care remains largely unaddressed in ED patients with AHF and thus represents a significant lost opportunity to improve patient care and decrease ED visits and hospitalizations. Furthermore, shared decision making encourages collaborative interaction between patients, caregivers, and providers to drive a care path based on mutual agreement. The observation that “difficult decisions now will simplify difficult decisions later” has particular relevance to the ED, given this is the venue for many such issues. We hypothesize patients as complex and heterogeneous as ED patients with AHF may need both an objective evaluation of physiologic risk as well as an evaluation of barriers to ideal self-care, along with strategies to overcome these barriers. Combining physician gestalt, physiologic risk prediction instruments, an evaluation of self-care, and an information exchange between patient and provider using shared decision making may provide the critical inertia necessary to discharge patients home after a brief ED evaluation. PMID:24159563

  4. Pleasure and Addiction

    Jeanette Marie Kennett

    2013-09-01

    Full Text Available What is the role and value of pleasure in addiction? Foddy and Savalescu (2010 have claimed that substance use is just pleasure-oriented behaviour. They describe addiction as ‘strong appetites toward pleasure’ and argue that addicts suffer in significant part because of strong social and moral disapproval of lives dominated by pleasure seeking. But such lives, they claim, can be autonomous and rational. The view they offer is largely in line with the choice model and opposed to a disease model of addiction. Foddy and Savulescu are sceptical of self-reports that emphasize the ill effects of addiction such as loss of family and possessions, or that claim an absence of pleasure after tolerance sets in. Such reports they think are shaped by social stigma which makes available a limited set of socially approved addiction narratives. We will not question the claim that a life devoted to pleasure can be autonomously chosen. Nor do we question the claim that the social stigma attached to the use of certain drugs increases the harm suffered by the user. However our interviews with addicts (as philosophers rather than health professionals or peers reveal a genuinely ambivalent and complex relationship between addiction, value and pleasure. Our subjects did not shy away from discussing pleasure and its role in use. But though they usually valued the pleasurable properties of substances, and this played that did not mean that they valued an addictive life. Our interviews distinguished changing attitudes towards drug related pleasures across the course of substance use, including diminishing pleasure from use over time and increasing resentment at the effects of substance use on other valued activities. In this paper we consider the implications of what drug users say about pleasure and value over the course of addiction for models of addiction.

  5. Addiction Counseling Accreditation: CACREP's Role in Solidifying the Counseling Profession

    Hagedorn, W. Bryce; Culbreth, Jack R.; Cashwell, Craig S.

    2012-01-01

    In this article, the authors discuss the Council for Accreditation of Counseling and Related Educational Programs' (CACREP) role in furthering the specialty of addiction counseling. After sharing a brief history and the role of counselor certification and licensure, the authors share the process whereby CACREP developed the first set of…

  6. Internet Addiction and Psychopathology

    Koc, Mustafa

    2011-01-01

    This study examined the relationships between university students' internet addiction and psychopathology in Turkey. The study was based on data drawn from a national survey of university students in Turkey. 174 university students completed the SCL-90-R scale and Addicted Internet Users Inventory. Results show that students who use internet six…

  7. Addiction: Choice or compulsion?

    EdmundHenden

    2013-08-01

    Full Text Available Normative thinking about addiction has traditionally been divided between, on the one hand, a medical model which sees addiction as a disease characterized by compulsive and relapsing drug use over which the addict has little or no control and, on the other, a moral model which sees addiction as a choice characterized by voluntary behaviour under the control of the addict. Proponents of the former appeal to evidence showing that regular consumption of drugs causes persistent changes in the brain structures and functions known to be involved in the motivation of behavior. On this evidence, it is often concluded that becoming addicted involves a transition from voluntary, chosen drug use to non-voluntary compulsive drug use. Against this view, proponents of the moral model provide ample evidence that addictive drug use involves voluntary chosen behaviour. In this article we argue that although they are right about something, both views are mistaken. We present a third model that neither rules out the view of addictive drug use as compulsive, nor that it involves voluntary chosen behavior.

  8. Internet Addiction among Adolescence

    Sargin, Nurten

    2012-01-01

    Each innovation brings along many risks. One of the risks related with the Internet use is Internet addiction. The aim of this study is to examine Internet addiction in adolescence in terms of gender, Internet access at home and grades. The research design used was survey method. The study population consisted of second stage students attending…

  9. Attitudes about Addiction: A National Study of Addiction Educators

    Broadus, Angela D.; Hartje, Joyce A.; Roget, Nancy A.; Cahoon, Kristy L.; Clinkinbeard, Samantha S.

    2010-01-01

    The following study, funded by the National Institute of Drug Abuse (NIDA), utilized the "Addiction Belief Inventory" (ABI; Luke, Ribisl, Walton, & Davidson, 2002) to examine addiction attitudes in a national sample of U.S. college/university faculty teaching addiction-specific courses (n = 215). Results suggest that addiction educators view…

  10. [Functional neuroimaging of addiction].

    Takahashi, Hidehiko

    2015-09-01

    Positron emission tomography studies investigating dopamine release by drug or reward demonstrated blunted dopamine release in relation to addiction to psychostimulants such as cocaine and amphetamine. However, recent studies reported that nicotine and gambling addiction showed opposite results. Several factors such as illness stage or neurotoxicity of substances could be considered for this discrepancy. Behavioral addiction such as gambling disorder is a good target of neuroimaging because it is free from overt neurotoxicity. However, even in gambling disorder, the results of fMRI studies investigating neural response to reward are mixed. Neuroimaging together with taking the various backgrounds of patients into account should contribute not only to a better understanding of the neurobiology of addiction but also to the development of more effective and individually tailored treatment strategies for addiction. PMID:26394506

  11. Association between forgone care and household income among the elderly in five Western European countries – analyses based on survey data from the SHARE-study

    Stirbu Irina

    2009-03-01

    Full Text Available Abstract Background Studies on the association between access to health care and household income have rarely included an assessment of 'forgone care', but this indicator could add to our understanding of the inverse care law. We hypothesize that reporting forgone care is more prevalent in low income groups. Methods The study is based on the 'Survey of Health, Ageing and Retirement in Europe (SHARE', focusing on the non-institutionalized population aged 50 years or older. Data are included from France, Germany, Greece, Italy and Sweden. The dependent variable is assessed by the following question: During the last twelve months, did you forgo any types of care because of the costs you would have to pay, or because this care was not available or not easily accessible? The main independent variable is household income, adjusted for household size and split into quintiles, calculating the quintile limits for each country separately. Information on age, sex, self assessed health and chronic disease is included as well. Logistic regression models were used for the multivariate analyses. Results The overall level of forgone care differs considerably between the five countries (e.g. about 10 percent in Greece and 6 percent in Sweden. Low income groups report forgone care more often than high income groups. This association can also be found in analyses restricted to the subsample of persons with chronic disease. Associations between forgone care and income are particularly strong in Germany and Greece. Taking the example of Germany, forgone care in the lowest income quintile is 1.98 times (95% CI: 1.08–3.63 as high as in the highest income quintile. Conclusion Forgone care should be reduced even if it is not justified by an 'objective' need for health care, as it could be an independent stressor in its own right, and as patient satisfaction is a strong predictor of compliance. These efforts should focus on population groups with particularly high

  12. Role of Self-help Group in Substance Addiction Recovery

    Das, Prangya Paramita Priyadarshini

    2012-11-01

    Background: The Narcotics Anonymous (NA)/Alcoholic Anonymous(AA) is based on the philosophy of self-help, where the former addicts and recovering addicts share experiences, provide emotional support and do active monitoring through mentoring. In mentoring, a former addict with longer duration of drug-free life acts as a guide to the newly recovering addict. Objective: The objective was to study the effect of involvement in self help group upon addictís level of depression, functional social support, and anxiety. Method: The size of the sample was 60. 30 addicts were taken from rehabilitation centre and 30 were taken from self-help groups. ANOVA was used to analyze the result. Result: In all the criteria it was found that there exists a significant impact of Self-help group. Conclusion: Self-help group provide clients with a social network of individuals with similar problems and experiences, since most of these individuals may be isolated from society due to the social stigma attached to their addictions. The transition from being help recipients to being helpers enables recovering addicts to build their self-confidence and feelings of being wanted and desired in society, which facilitates their self-confidence and positive self-esteem.

  13. Addiction and Pain Medicine

    Douglas Gourlay

    2005-01-01

    Full Text Available The adequate cotreatment of chronic pain and addiction disorders is a complex and challenging problem for health care professionals. There is great potential for cannabinoids in the treatment of pain; however, the increasing prevalence of recreational cannabis use has led to a considerable increase in the number of people seeking treatment for cannabis use disorders. Evidence that cannabis abuse liability is higher than previously thought suggests that individuals with a history of substance abuse may be at an increased risk after taking cannabinoids, even for medicinal purposes. Smoked cannabis is significantly more reinforcing than other cannabinoid administration methods. In addition, it is clear that the smoked route of cannabis delivery is associated with a number of adverse health consequences. Thus, there is a need for pharmaceutical-grade products of known purity and concentration using delivery systems optimized for safety. Another factor that needs to be considered when assessing the practicality of prescribing medicinal cannabinoids is the difficulty in differentiating illicit from prescribed cannabinoids in urine drug testing. Overall, a thorough assessment of the risk/benefit profile of cannabinoids as they relate to a patient’s substance abuse history is suggested.

  14. Psychosocial correlates of Internet addiction among Jordanian university students.

    Alzayyat, Abdulkarim; Al-Gamal, Ekhlas; Ahmad, Muayyad M

    2015-04-01

    Internet addiction is a significant international mental health problem among university students. The purpose of the current study was to investigate the correlation of Internet addiction with university students' characteristics in Jordan using a descriptive, correlational, cross-sectional design. The Internet Addiction Test, Beck Depression Inventory, and Multidimensional Scale of Perceived Social Support were administered to a random sample of 587 undergraduate university students. The findings demonstrated that university year level, student age, depression, and family support were significant correlates of Internet addiction. The current study should raise awareness in nurses and other health care providers that Internet addiction is a potential mental health problem for this student population. The findings from the current study will help develop appropriate interventions for these students and inform future research. PMID:25800688

  15. Healthcare providers' intentions to engage in an interprofessional approach to shared decision-making in home care programs: a mixed methods study.

    Légaré, France; Stacey, Dawn; Brière, Nathalie; Fraser, Kimberley; Desroches, Sophie; Dumont, Serge; Sales, Anne; Puma, Carole; Aubé, Denise

    2013-05-01

    In an interprofessional approach to shared decision-making (IP-SDM), an interprofessional team collaborates in identifying best options and helps patients determine their preferences, enabling them to take more control over the treatment plan. However, little is known about fostering IP-SDM in Canada's healthcare system. Therefore, we sought to evaluate health professionals' intentions to engage in IP-SDM in home care and explore the factors associated with this intention. A total of 272 eligible home care providers completed a questionnaire based on the theory of planned behavior. Eight managers and one healthcare team caring for the frail elderly were interviewed about possible barriers and facilitators. Analysis involved descriptive statistics and multivariate analysis of quantitative data and content analysis of qualitative data. On a scale of - 3 (strongly disagree) to +3 (strongly agree), the mean intention to engage in IP-SDM was positive (1.42 ± 1.39). The intention was influenced by the following theory-based determinants (R(2) = 57%; p ≤ 0.002), i.e. cognitive attitude (p turnover. Facilitators included team cohesion and shared tools. Future programs implementing IP-SDM could address these barriers and facilitators. PMID:23394265

  16. How prevalent is 'food addiction'?

    Adrian eMeule

    2011-11-01

    Full Text Available Increasing evidence suggests that binge eating-related disorders could be related to addiction-like eating patterns due to the addictive potential of hyperpalatable foods. Subsequently, important implications have been derived for treatment of those disorders and even political actions. However, studies on the prevalence of food addiction are rare. Few recent studies investigated addictive eating in children, adolescents, and adults. This mini-review presents these first attempts to assess addictive eating and how prevalent addictive eating patterns were in the respective studies. It is concluded that the prevalence of food addiction is increased in obese individuals and even more so in obese patients with binge eating disorder. However, prevalence of food addiction is not sufficient to account for the obesity epidemic. Conversely, an arguably high prevalence of food addiction can also be found in under-, normal-, and overweight individuals. Future studies may investigate which factors are associated with addictive eating in non-obese individuals.

  17. Psychopharmacology of Addiction

    Tugce Toker Ugurlu

    2012-03-01

    Full Text Available Addiction is a primary, chronic, neurobiological disease, with genetic, psychosocial, and environmental factors influencing its development. Developments in the psychopharmacology of addiction is much slower than the other disciplines of psychiatry. For a long time, social and behavioral therapeutic approaches are the only choices for the treatment of addictive disorders. Disulfiram was the only pharmacological agent approved for addiction treatment until the end of 20th century. Pharmacological treatment options available for treatment have grown along with our understanding of the neurobiological mechanisms underlying the development and persistence of addiction. Several new medications like naltrexone, acamprosate, methadone and buprenoprhine have been approved for the treatment of alcohol and opioid use disorders ever since. Based on ever-increasing information about neurotransmitter and receptors, many studies have been performed concerning craving and relapse prevention in recent years. Besides many other pharmacological agents have been focus of new researches for treatment of different types of addiction. The aim of this article is to briefly review the literature on psychopharmacology of addictive disorders and recent developments in this area.

  18. The Addictive Model of Self-Harming (Non-suicidal and Suicidal) Behavior

    Blasco-Fontecilla, Hilario; Fernández-Fernández, Roberto; Colino, Laura; Fajardo, Lourdes; Perteguer-Barrio, Rosa; Leon, Jose,

    2016-01-01

    Introduction Behavioral addictions such as gambling, sun-tanning, shopping, Internet use, work, exercise, or even love and sex are frequent, and share many characteristics and common neurobiological and genetic underpinnings with substance addictions (i.e., tolerance, withdrawal, and relapse). Recent literature suggests that both non-suicidal self-injury (NSSI) and suicidal behavior (SB) can also be conceptualized as addictions. The major aim of this mini review is to review the literature...

  19. Internet addiction: A case report

    Pejović-Milovančević Milica; Popović-Deušić Smiljka; Draganić-Gajić Saveta; Lečić-Toševski Dušica

    2009-01-01

    Some addictions cannot be connected with substance abuse (pathological) gambling, video games playing, binge eating, compulsive physical activity, emotional relationship addiction, TV addiction). Since 1995, Internet addiction has been accepted as a clinical entity with profound negative effect on social, familial, educational and economical personal functioning. The diagnosis of Internet addiction could be established if the person spends more than 38 hours per week on the Internet exempting...

  20. Medicare Program; Medicare Shared Savings Program; Accountable Care Organizations--Revised Benchmark Rebasing Methodology, Facilitating Transition to Performance-Based Risk, and Administrative Finality of Financial Calculations. Final rule.

    2016-06-10

    Under the Medicare Shared Savings Program (Shared Savings Program), providers of services and suppliers that participate in an Accountable Care Organization (ACO) continue to receive traditional Medicare fee-for-service (FFS) payments under Parts A and B, but the ACO may be eligible to receive a shared savings payment if it meets specified quality and savings requirements. This final rule addresses changes to the Shared Savings Program, including: Modifications to the program's benchmarking methodology, when resetting (rebasing) the ACO's benchmark for a second or subsequent agreement period, to encourage ACOs' continued investment in care coordination and quality improvement; an alternative participation option to encourage ACOs to enter performance-based risk arrangements earlier in their participation under the program; and policies for reopening of payment determinations to make corrections after financial calculations have been performed and ACO shared savings and shared losses for a performance year have been determined. PMID:27295736

  1. How addicts think about addiction and community problems?

    A. Meysamie

    2006-07-01

    Full Text Available Background: addiction and drug abuse have many risk factors in community and individual attitude; also causes much diversity in community perception and attitude toward addiction. Methods: in this study we assessed attitude toward an addict in 42 addict men and asked about problems in their community and recreational behaviors. They were residents of a rural area in Babol city. In the control group we assessed the same parameters in 268 non addicts in the same area. All of the addicts have been using opium more than many times a week at least for recent 6 months. Data collected via a semi structured questionnaire through conversation. Results: There was a significant difference between addicts’ attitude toward toward addiction compare to non-addicts’. Both addicts and non-addicts indicated that the first three community problems in their area were unemployment, lack of recreational facilities and addiction, in respective order. Answering questions about recreational activities, both groups indicated that there were no recreational facilities in the community. Conclusion: In planning a preventive approach, there is a major role for attitude toward addiction in any community. The conflict seen in this study between addicts’ attitudes toward an addicted person and addiction as a community problem has it’s interesting feature. Recreation and physical and cultural facilities need to pay more attention as indicated by our study participants. This seems to have an important impact in prevention of many community problems as well as addiction.

  2. The Affordable Care Act and the Burden of High Cost Sharing and Utilization Management Restrictions on Access to HIV Medications for People Living with HIV/AIDS.

    Zamani-Hank, Yasamean

    2016-08-01

    The HIV/AIDS epidemic continues to be a critical public health issue in the United States, where an estimated 1.2 million individuals live with HIV infection. Viral suppression is one of the primary public health goals for People Living with HIV/AIDS (PLWHA). A crucial component of this goal involves adequate access to health care, specifically anti-retroviral HIV medications. The enactment of the Affordable Care Act (ACA) in 2010 raised hopes for millions of PLWHA without access to health care coverage. High cost-sharing requirements enacted by health plans place a financial burden on PLWHA who need ongoing access to these life-saving medications. Plighted with poverty, Detroit, Michigan, is a center of attention for examining the financial burden of HIV medications on PLWHA under the new health plans. From November 2014 to January 2015, monthly out-of-pocket costs and medication utilization requirements for 31 HIV medications were examined for the top 12 insurance carriers offering Qualified Health Plans on Michigan's Health Insurance Marketplace Exchange. The percentage of medications requiring quantity limits and prior authorization were calculated. The average monthly out-of-pocket cost per person ranged from $12 to $667 per medication. Three insurance carriers placed all 31 HIV medications on the highest cost-sharing tier, charging 50% coinsurance. High out-of-pocket costs and medication utilization restrictions discourage PLWHA from enrolling in health plans and threaten interrupted medication adherence, drug resistance, and increased risk of viral transmission. Health plans inflicting high costs and medication restrictions violate provisions of the ACA and undermine health care quality for PLWHA. (Population Health Management 2016;19:272-278). PMID:26565514

  3. Stress and addiction.

    Hildebrandt, Tom; Greif, Rebecca

    2013-09-01

    Appetitive behaviors such as substance use and eating are under significant regulatory control by the hypothalamic-pituitary adrenal (HPA) and hypothalamic pituitary gonadal (HPG) axes. Recent research has begun to examine how these systems interact to cause and maintain poor regulation of these appetitive behaviors. A range of potential molecular, neuroendocrine, and hormonal mechanisms are involved in these interactions and may explain individual differences in both risk and resilience to a range of addictions. This manuscript provides a commentary on research presented during the International Society of Psychoneuroendocrinology's mini-conference on sex differences in eating and addiction with an emphasis on how HPG and HPA axis interactions affect appetitive behaviors in classic addictions and may be used to help inform the ongoing debate about the validity of food addiction. PMID:23849597

  4. [Work: a potential addiction].

    Karila, L; Liot, K; Reynaud, M

    2010-02-01

    Although the term workaholism is widely used, there is very little consensus about its meaning. Since the seventies, workaholism has been described as a work addiction such as drug or alcohol addiction. Similarities with other addictions include craving, withdrawal, tolerance, progressive involvement, and denial. Although considerable attention has been devoted to the concept of workaholism in recent years, little empirical research has been undertaken to further the understanding of this phenomenon. The existence of different types of workaholism has been described. Questionnaires were developed to assess this concept. This heterogeneous disease has negative health, personal, family relationships and professional consequences. Many therapeutic interventions are possible for this unknown addictive trouble. The objective of this paper is to gain a better understanding and knowledge regarding the phenomenon of workaholism. Data obtained for this review are based on a Medline, EMBASE, PsycINFO, Google Scholar search of English- and French-language articles published between 1968 and 2009. PMID:20344916

  5. Food addiction: its prevalence and significant association with obesity in the general population.

    Pardis Pedram

    Full Text Available BACKGROUND: 'Food addiction' shares a similar neurobiological and behavioral framework with substance addiction. However whether, and to what degree, 'food addiction' contributes to obesity in the general population is unknown. OBJECTIVES: to assess 1 the prevalence of 'food addiction' in the Newfoundland population; 2 if clinical symptom counts of 'food addiction' were significantly correlated with the body composition measurements; 3 if food addicts were significantly more obese than controls, and 4 if macronutrient intakes are associated with 'food addiction'. DESIGN: A total of 652 adults (415 women, 237 men recruited from the general population participated in this study. Obesity was evaluated by Body Mass Index (BMI and Body Fat percentage measured by dual-energy X-ray absorptiometry. 'Food addiction' was assessed using the Yale Food Addiction Scale and macronutrient intake was determined from the Willet Food Frequency Questionnaire. RESULTS: The prevalence of 'food addiction' was 5.4% (6.7% in females and 3.0% in males and increased with obesity status. The clinical symptom counts of 'food addiction' were positively correlated with all body composition measurements across the entire sample (p<0.001. Obesity measurements were significantly higher in food addicts than controls; Food addicts were 11.7 (kg heavier, 4.6 BMI units higher, and had 8.2% more body fat and 8.5% more trunk fat. Furthermore, food addicts consumed more calories from fat and protein compared with controls. CONCLUSION: Our results demonstrated that 'food addiction' contributes to severity of obesity and body composition measurements from normal weight to obese individuals in the general population with higher rate in women as compared to men.

  6. Internal Medicine Residents' Training in Substance Use Disorders: A Survey of the Quality of Instruction and Residents' Self-Perceived Preparedness to Diagnose and Treat Addiction

    Wakeman, Sarah E.; Baggett, Meridale V.; Pham-Kanter, Genevieve; Campbell, Eric G.

    2013-01-01

    Background: Resident physicians are the direct care providers for many patients with addiction. This study assesses residents' self-perceived preparedness to diagnose and treat addiction, measures residents' perceptions of the quality of addictions instruction, and evaluates basic knowledge of addictions. Methods: A survey was e-mailed…

  7. Computer games addiction

    Nejepínský, Adam

    2010-01-01

    This bachelor thesis deals with the problem of computer games addiction. The attention is paid mainly to on-line games for more players. The purpose of this thesis was to describe this problem and to check - through questionnaire investigation - if the addiction to computer games and the impacts connected with the games really deserve excessive experts and laics attention. The thesis has two parts -- theoretical and practical ones. The theoretical part describes the possibilities of diagnosin...

  8. Glutamate Transmission in Addiction

    Kalivas, Peter W.; LaLumiere, Ryan; Knackstedt, Lori; Shen, Haowei

    2008-01-01

    Cortico-striatal glutamate transmission has been implicated in both the initiation and expression of addiction related behaviors, such as locomotor sensitization and drug seeking. While glutamate transmission onto dopamine cells in the ventral tegmental area undergoes transient plasticity important for establishing addiction-related behaviors, glutamatergic plasticity in the nucleus accumbens is critical for the expression of these behaviors. This information points to the value of exploring ...

  9. Shared pledge shared vision

    The New Partnership for Africa's Development (NEPAD) is a pledge by African leaders to eradicate poverty and to promote sustainable growth and development. NEPAD is a 'new framework of interaction with the rest of the world, including the industrialised countries and multilateral organizations.' The agenda is based on regional priorities and development plans and its implementation relies on African ownership and management. As a UN system organisation, the IAEA strongly supports the priorities identified in the Millennium Declaration and the New Partnership for Africa's Development. As a technical agency, the IAEA shares its recognized core competencies and technical expertise in support of NEPAD goals. Efforts aim at strengthening institutional capacity building in nuclear sciences and technology and promoting the sustainable application of nuclear techniques for social and economic development. The IAEA has a membership of 34 African countries. The Agency supports them under its technical cooperation programme through provision of expertise, training opportunities and equipment in priority areas identified by the countries themselves. For many African Member States, meeting basic human needs through the implementation of poverty alleviation strategies remains the top priority on the agenda for national development plans and international cooperation programmes. In the context of sustainable development, special attention is being paid to enlarging the contribution of isotopes and nuclear techniques in major areas of economic and social significance and to promoting regional cooperation in nuclear science and technology related fields. As a partner in development, the Agency has promoted and undertaken programmes to support African countries' efforts to address priority development issues particularly in the areas of health care, food and agriculture and water resources development. The IAEA technical cooperation mechanism includes support to the African Regional

  10. The treatment of perinatal addiction. Identification, intervention, and advocacy.

    Jessup, M.

    1990-01-01

    Women of reproductive age who use and abuse psychoactive drugs and alcohol present a special challenge to primary care physicians. There are compelling medical reasons for identifying and intervening with pregnant women who are addicted or have alcoholism. The teratogenicity of all drugs of abuse and alcohol, the risk of infection with the acquired immunodeficiency syndrome (AIDS), and the potential for full recovery of a pregnant woman from addiction are some of the reasons that identificati...

  11. Issues of Shared Parenting of LGBTQ Children and Youth in Foster Care: Preparing Foster Parents for New Roles

    Craig-Oldsen, Heather; Craig, J. Ann; Morton, Thomas

    2006-01-01

    Foster parents have increasingly assumed new and challenging roles during the past decade. Meeting the developmental, attachment, and grieving needs of children and youth in out of home care is challenging by itself, but can become even more difficult with the issues that arise when the child is lesbian, gay, bisexual, transgender, or questioning…

  12. The role of university hospitals as centers of excellence for shared health-care-delivery of in- and outpatients

    Problem. Health care delivery in Germany has to face severe challenges that will lead to a closer integration of services for in- and out-patients. University hospitals play an important role due to their activities in research, education and health care delivery. They are requested to promote and evaluate new means and ways for health care delivery. Methods. The Institute of Clinical Radiology at the University Hospital of the Ludwig-Maximilians-University started teleradiological services for hospitals and general practices in January 1999 in the framework of the ''Imaging services - teleradiological center of excellence''. Legal, technical and organizational prerequisites were analyzed. Results. Networks between university hospitals and general practices are not likely to solve all future problems. They will, however, increase the availability of the knowledge of experts even in rural areas and contribute to a quality ensured health care at the patients home. Future developments may lead to international co-operations and such services may be available to patients abroad. Conclusion. Legal, technical and organizational obstacles have to be overcome to create a framework for high quality telemedical applications. University hospitals will play an important role in promoting and evaluating teleradiological services. (orig.)

  13. The somatic marker theory in the context of addiction: contributions to understanding development and maintenance

    Olsen VV

    2015-07-01

    Full Text Available Vegard V Olsen,1 Ricardo G Lugo,1 Stefan Sütterlin1,2 1Section of Psychology, Lillehammer University College, Lillehammer, 2Department of Psychosomatic Medicine, Division of Surgery and Clinical Neuroscience, Oslo University Hospital – Rikshospitalet, Oslo, Norway Abstract: Recent theoretical accounts of addiction have acknowledged that addiction to substances and behaviors share inherent similarities (eg, insensitivity to future consequences and self-regulatory deficits. This recognition is corroborated by inquiries into the neurobiological correlates of addiction, which has indicated that different manifestations of addictive pathology share common neural mechanisms. This review of the literature will explore the feasibility of the somatic marker hypothesis as a unifying explanatory framework of the decision-making deficits that are believed to be involved in addiction development and maintenance. The somatic marker hypothesis provides a neuroanatomical and cognitive framework of decision making, which posits that decisional processes are biased toward long-term prospects by emotional marker signals engendered by a neuronal architecture comprising both cortical and subcortical circuits. Addicts display markedly impulsive and compulsive behavioral patterns that might be understood as manifestations of decision-making processes that fail to take into account the long-term consequences of actions. Evidence demonstrates that substance dependence, pathological gambling, and Internet addiction are characterized by structural and functional abnormalities in neural regions, as outlined by the somatic marker hypothesis. Furthermore, both substance dependents and behavioral addicts show similar impairments on a measure of decision making that is sensitive to somatic marker functioning. The decision-making deficits that characterize addiction might exist a priori to addiction development; however, they may be worsened by ingestion of substances with

  14. Creating archetypes for patient assessment with nurses to facilitate shared patient centred care in the older person

    Hussey, Pamela

    2010-01-01

    The process of what information is captured in documenting patient care assessment and how it is summarised, communicated and interpreted by nurses across different healthcare services is the main focus of this thesis. Currently in Ireland, systems within the domain of healthcare are undergoing transformation. Existing practices where health information is collected at one local health organisation level and often duplicated across differing services will not support the strategic goals of th...

  15. Opiate addiction and cocaine addiction: underlying molecular neurobiology and genetics

    Kreek, Mary Jeanne; Levran, Orna; Reed, Brian; Schlussman, Stefan D.; Zhou, Yan; Butelman, Eduardo R.

    2012-01-01

    Addictive diseases, including addiction to heroin, prescription opioids, or cocaine, pose massive personal and public health costs. Addictions are chronic relapsing diseases of the brain caused by drug-induced direct effects and persisting neuroadaptations at the epigenetic, mRNA, neuropeptide, neurotransmitter, or protein levels. These neuroadaptations, which can be specific to drug type, and their resultant behaviors are modified by various internal and external environmental factors, including stress responsivity, addict mindset, and social setting. Specific gene variants, including variants encoding pharmacological target proteins or genes mediating neuroadaptations, also modify vulnerability at particular stages of addiction. Greater understanding of these interacting factors through laboratory-based and translational studies have the potential to optimize early interventions for the therapy of chronic addictive diseases and to reduce the burden of relapse. Here, we review the molecular neurobiology and genetics of opiate addiction, including heroin and prescription opioids, and cocaine addiction. PMID:23023708

  16. The Addict in Us All

    Brendan eDill

    2014-10-01

    Full Text Available In this paper we contend that the psychology of addiction is similar to the psychology of ordinary, non-addictive temptation in important respects, and explore the ways in which these parallels can illuminate both addiction and ordinary action. The incentive salience account of addiction proposed by Robinson and Berridge (1993; 2001; 2008 entails that addictive desires are not in their nature different from many of the desires had by non-addicts; what is different is rather the way that addictive desires are acquired, which in turn affects their strength. We examine these 'incentive salience' desires, both in addicts and non-addicts, contrasting them with more cognitive desires. On this account the self-control challenge faced by addicted agents is not different in kind from that faced by non-addicted agents—though the two may, of course, differ greatly in degree of difficulty. We explore a general model of self-control for both the addict and the non-addict, stressing that self-control may be employed at three different stages, and examining the ways that it might be strengthened. This helps elucidate a general model of intentional action.

  17. Economic aspects of addiction policy.

    Maynard, A

    1986-05-01

    One definition of policy or government action in the Oxford English Dictionary is "craftiness" i.e. cunning or deceit. Such qualities have to be employed by governments because of the potential vote-losing effects of radical addiction policies. Health promotion, in relation to addictive substances such as alcohol and tobacco in particular, involves a trade-off between the costs of such policies, especially to industry (which seeks regulation to protect itself from competitors), and the benefits--improvements in the quality and length of life. Measures of such benefits (quality-adjusted life-years or QALYs) are available now to use in the evaluation of competing health promotion policies to determine their efficiency at the margin. Analysis of the market for tobacco indicates that consumption has been falling generally in the UK except among teenagers who appear to be the target of the industry's advertising and sponsorship efforts. This fall in consumption appears to be explained by health promotion rather than the active use of fiscal instruments of control. The recognition of the health effects of passive smoking and the impact of advertising and sponsorship, especially on the young, are policy areas requiring careful review and the evaluation of the costs and benefits of competing policies.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:10318048

  18. Lessons From Medicaid’s Divergent Paths On Mental Health And Addiction Services

    Andrews, Christina; Grogan, Colleen M.; Brennan, Marianne; Pollack, Harold A.

    2015-01-01

    Over the past fifty years Medicaid has taken divergent paths in financing mental health and addiction treatment. In mental health, Medicaid became the dominant source of funding and had a profound impact on the organization and delivery of services. But it played a much more modest role in addiction treatment. This is poised to change, as the Affordable Care Act is expected to dramatically expand Medicaid’s role in financing addiction services. In this article we consider the different paths ...

  19. Sleep Disturbance as a Universal Risk Factor for Relapse in Addictions to Psychoactive Substances

    Brower, Kirk J.; Perron, Brian E.

    2009-01-01

    Relapse to uncontrolled use of a psychoactive substance is arguably the single most defining characteristic of an addiction. Relapse following addiction treatment is very common with serious consequences to individuals, families, and the public system of care, making predictors of relapse a highly significant area of study. Before the turn of the century, most of the addiction treatment outcome literature focused on psychosocial predictors of relapse. More recently, investigating biological p...

  20. Video Game Use in the Treatment of Amblyopia: Weighing the Risks of Addiction

    Xu, Chaoying S.; Chen, Jessica S.; Ron A. Adelman

    2015-01-01

    Video games have surged in popularity due to their entertainment factor and, with recent innovation, their use in health care. This review explores the dual facets of video games in treating vision impairment in amblyopia as well as their potential for overuse and addiction. Specifically, this review examines video game addiction from a biopsychosocial perspective and relates the addictive qualities of video games with their use as a therapeutic treatment for amblyopia. Current literature sup...

  1. Understanding Drug Abuse and Addiction

    ... as family disintegration, loss of employment, failure in school, domestic violence, and child abuse. What Is Drug Addiction? Addiction is a chronic, often relapsing brain disease that causes compulsive drug seeking and use, despite harmful consequences ...

  2. How prevalent is 'food addiction'?

    Adrian eMeule

    2011-01-01

    Increasing evidence suggests that binge eating-related disorders could be related to addiction-like eating patterns due to the addictive potential of hyperpalatable foods. Subsequently, important implications have been derived for treatment of those disorders and even political actions. However, studies on the prevalence of food addiction are rare. Few recent studies investigated addictive eating in children, adolescents, and adults. This mini-review presents these first attempts to assess ad...

  3. Exercise rehabilitation for smartphone addiction

    Kim, Hyunna

    2013-01-01

    Internet addiction after launching smartphone is becoming serious. Therefore this paper has attempted to sketch out the diverse addiction treatment and then check the feasibility of exercise rehabilitation. The reason to addict the internet or smartphone is personalized individual characters related personal psychological and emotional factors and social environmental factors around them. We have shown that 2 discernible approaches due to 2 different addiction causes: that is behavioral treat...

  4. Thai men's experiences of alcohol addiction and treatment

    Kulnaree Hanpatchaiyakul

    2014-05-01

    Full Text Available Background: Men are overrepresented with regard to alcohol addiction and in terms of alcohol treatment worldwide. In Thailand, alcohol consumption continues to rise, but few of those afflicted with alcohol addiction attend alcohol treatment programs, even though there is universal care for all. No comprehensive studies have been done on men's experiences with addiction and alcohol treatment programs in Thailand. Objective: The aim of this study was to explore men's experiences in terms of the ‘pros and cons of alcohol consumption’ in order to identify the barriers that exist for Thai men with regard to alcohol addiction and the decision to stop drinking. Design: Purposive sampling was applied in the process of recruiting participants at an alcohol clinic in a hospital in Thailand. Thirteen men with alcohol addiction (aged 32–49 years were willing to participate and were interviewed in thematic interviews. The analysis of the data was done with descriptive phenomenology. Results: Through men's descriptions, three clusters of experiences were found that were ‘mending the body’, ‘drinking as payoff and doping related to work’, and ‘alcohol becoming a best friend’ as ways of describing the development of addiction. Conclusions: The results highlight the importance of addressing concepts of masculinity and related hegemonic ideas in order to decrease the influence of the barriers that exist for Thai men with alcohol addiction with regard to entering treatment and to stop drinking.

  5. Pro v Con Reviews: Is Food Addictive?: Obesity and addiction: neurobiological overlaps

    Volkow, N. D.; Wang, G.-J.; Tomasi, D; Baler, R. D.

    2012-01-01

    Drug addiction and obesity appear to share several properties. Both can be defined as disorders in which the saliency of a specific type of reward (food or drug) becomes exaggerated relative to, and at the expense of others rewards. Both drugs and food have powerful reinforcing effects, which are in part mediated by abrupt dopamine increases in the brain reward centres. The abrupt dopamine increases, in vulnerable individuals, can override the brain’s homeostatic control mechanisms. These par...

  6. Internet Addiction: A Logotherapeutic Approach

    Didelot, Mary J.; Hollingsworth, Lisa; Buckenmeyer, Janet A.

    2012-01-01

    Internet addiction (IA) is both the most rapidly growing addiction and the least understood addiction (Watson, 2005). For counselors, treatment issues surrounding the disease are also growing. At the forefront is the lack of understanding concerning treatment protocol to manage the challenging recovery and maintenance stages after IA behavior has…

  7. Peer Influence and Addiction Recurrence

    Paul Markdissi

    2009-01-01

    In this paper we highlight the role of peers in the recurrence of addictive behavior. To do so, we use a simple “forward looking” model with procrastination and peers influence. Our results show that while procrastination can explain the decision to postpone rehabilitation, peers influence is essential to explain the cyclical patterns of addiction-rehabilitation-addiction.

  8. [Complications of cocaine addiction].

    Karila, Laurent; Lowenstein, William; Coscas, Sarah; Benyamina, Amine; Reynaud, Michel

    2009-06-20

    Addiction is a chronic relapsing disorder characterized by repetitive and compulsive drug-seeking behavior and drug abuse despite negative health or social consequences. Cocaine addiction is a significant worldwide public health problem, which has somatic, psychological, psychiatric, socio-economic and judicial complications. Some of the most frequent complications are cardiovascular effects (acute coronary syndrome, cardiac arrhythmias, increased blood pressure); respiratory effects (fibrosis, interstitial pneumonitis, pulmonary hypertension, alveolar haemorrhage, asthma exacerbation; emphysema), neurological effects (strokes, aneurysms, seizures, headaches); risk for contracting HIV/AIDS, hepatitis B and C, sexual transmitted disease and otolaryngologic effects. Other complications are not discussed here. The vast majority of studies indicate that there are cognitive deficits induced by cocaine addiction. Attention, visual and working memories, executive functioning are affected in cocaine users. Psychiatric complications found in clinical practice are major depressive disorders, cocaine-induced paranoia, cocaine-induced compulsive foraging and panic attacks. PMID:19642439

  9. Chronic disease and recent addiction treatment utilization among alcohol and drug dependent adults

    Samet Jeffrey; Allensworth-Davies Donald; Cheng Debbie M; Larson Mary Jo; Reif Sharon; Saitz Richard

    2011-01-01

    Abstract Background Chronic medical diseases require regular and longitudinal care and self-management for effective treatment. When chronic diseases include substance use disorders, care and treatment of both the medical and addiction disorders may affect access to care and the ability to focus on both conditions. The objective of this paper is to evaluate the association between the presence of chronic medical disease and recent addiction treatment utilization among adults with substance de...

  10. Circuit breakers for addiction.

    Foy, A

    2007-05-01

    The phenomenon of addiction is complex, although its expression clinically is relatively straightforward. There is a series of neurophysiological changes that mediate changes in the mesolimbic and mesocortical systems which in turn lead to disturbances in reward mechanisms. These then act to perpetuate the cycle of intoxication and reinforcement, withdrawal, craving and compulsive use. As our understanding of the pathophysiology of this process has improved, new pharmacological agents have been developed with the potential to moderate or even reverse it. This article briefly reviews the treatment of addiction with particular reference to emerging pharmaceutical agents. PMID:17504280

  11. Drug addiction in pregnancy: disease not moral failure.

    Maguire, Denise

    2014-01-01

    Nurses have demonstrated concern for years about their interactions with pregnant women who abuse drugs. Reports of nurses' concern with substance abuse have been reported in the literature since the 1980s. As with any chronic disease, drug addiction causes physiologic changes, and the pathology that occurs in the brain drives characteristic behaviors. Research suggests that choices that addicts make are driven by pathology rather than by failure of a moral compass. This article reviews the theoretical explanations for addictive behaviors, describes the pathophysiology of drug addiction that is responsible for the predictable symptoms and behaviors exhibited by women who abuse prescription drugs and other opioids, and identifies nursing interventions to impact positive outcomes. Nurses who have a working knowledge of this disease will provide more effective nursing care to the women they encounter and are better prepared to make a difference in the lives of both women and their children. PMID:24413031

  12. Developing and user-testing Decision boxes to facilitate shared decision making in primary care - a study protocol

    Rousseau François

    2011-03-01

    Full Text Available Abstract Background Applying evidence is one of the most challenging steps of evidence-based clinical practice. Healthcare professionals have difficulty interpreting evidence and translating it to patients. Decision boxes are summaries of the most important benefits and harms of diagnostic, therapeutic, and preventive health interventions provided to healthcare professionals before they meet the patient. Our hypothesis is that Decision boxes will prepare clinicians to help patients make informed value-based decisions. By acting as primers, the boxes will enhance the application of evidence-based practices and increase shared decision making during the clinical encounter. The objectives of this study are to provide a framework for developing Decision boxes and testing their value to users. Methods/Design We will begin by developing Decision box prototypes for 10 clinical conditions or topics based on a review of the research on risk communication. We will present two prototypes to purposeful samples of 16 family physicians distributed in two focus groups, and 32 patients distributed in four focus groups. We will use the User Experience Model framework to explore users' perceptions of the content and format of each prototype. All discussions will be transcribed, and two researchers will independently perform a hybrid deductive/inductive thematic qualitative analysis of the data. The coding scheme will be developed a priori from the User Experience Model's seven themes (valuable, usable, credible, useful, desirable, accessible and findable, and will include new themes suggested by the data (inductive analysis. Key findings will be triangulated using additional publications on the design of tools to improve risk communication. All 10 Decision boxes will be modified in light of our findings. Discussion This study will produce a robust framework for developing and testing Decision boxes that will serve healthcare professionals and patients alike. It

  13. Treating Internet Addiction with Cognitive-Behavioral Therapy: A Thematic Analysis of the Experiences of Therapists

    van Rooij, Antonius J.; Zinn, Mieke F.; Schoenmakers, Tim M.; van de Mheen, Dike

    2012-01-01

    In 2009, one of the major Dutch addiction care organizations initiated a pilot program to explore the possibility of using an existing Cognitive Behavioral Therapy and Motivational Interviewing based treatment program ("Lifestyle Training") to treat internet addiction. The current study evaluates this pilot treatment program by providing a…

  14. Kidney biopsy proved diagnosis of renal disorders in a tertiary care hospital: sharing a 4 years experience

    Objective: To evaluate outcome of renal biopsies in patients at a nephrology unit of a tertiary care centre at Rawalpindi over a period of 4 years. Study Design: Retrospective and cross sectional observational study. Place and Duration of Study: Department of Nephrology, Military Hospital Rawalpindi, from 2008-2012 Methodology: The study was based upon the data of patients with different renal pathologies who underwent kidney biopsy for establishment of diagnosis. All the patients who underwent successful kidney biopsy from 2008-2012 in our hospital were included in the study. Results: A total of 235 patients underwent successful kidney biopsy (with conclusive pathological findings). Out of these, 170 (72%) were males and 65 (28%) were females and the age ranged from 06 years to 55 years, with mean age of 28.6 years among males and 31.5 years among females. Out of these 100 (42.6%) patients had mesangioproliferative glomerulonephritis, 65 (27.6%) had membranous nephropathy, 37 (15.7%) patients had focal and segmental glomerulosclerosis, 11 (4.7%) patients had IgA glomerulopathy, 7 (3%) had minimal change nephropathy whereas 15 (6.4%) patients had other causes of glomerulonephritis (including systemic illnesses, pyelonephritis, acute tubular necrosis and interstitial nephritis). Conclusion: The most common biopsy proved diagnosis in the patients with different renal disorders was mesangioproliferative glomerulonephritis and the least common was minimal change nephropathy. (author)

  15. Correlation between Resistin, Tuberculosis and Khat Addiction: A Study from South Western Province of Saudi Arabia

    Alvi, Ayesha; Fatima, Nuzhath; Jerah, Ahmed Ali; Rizwan, Mohammed; Hobani, Yahya Hasan; Sunosi, Rashad Al; Taha, Manal Mohamed El Hassan; Habiballah, Eldaw Mohamed; Agarwal, Pradeep Kumar; Abdulwahab, Siddig Ibrahim

    2015-01-01

    Tuberculosis(TB) is a disease of global significance, which accounts for a death in every 15 seconds. Recent studies shows TB is rising in certain parts of the world, and Saudi Arabia is one of them. Several factor contribute in predisposing the subjects for infection including but not limited to addiction to various compounds which have immune modulation properties, such as amphetamines and Heroin etc. Khat a plant whose leaves are chewed for its euphoric effect in east Africa and Arabian Peninsula including Saudi Arabia, is considered as mildly addictive, and its principle compound, Cathinone shares structural and functional similarity with amphetamine a known immunomodulator. Tuberculosis being a disease of immune modulation has a varied spectrum of complex interplay of proinflammatory molecules, resistin is one of them. In the present study, we try to explore the trinity of khat addiction, serum resistin level and tuberculosis by correlating the serum resistin level in non khat addicted healthy subjects, khat addicted healthy subjects, and in patients, both khat addicted and non khat addicted, with active tuberculosis. We observed significantly higher resistin level among the apparently healthy khat addicted subjects as compared to non addicted healthy controls. Thereafter, when we compare the resistin levels between khat addicted and non khat addicted TB patients we did not found significant difference between the two groups. However bacillary load was observe to be significantly higher among the khat addicted TB patient as compare to non addicted one. Validation of above results in animal model revealed dose dependant increase in bacillary growth in the Wistar rats treated with khat. Taken together these results suggest the role of khat in immune modulation albeit in the limited frame of resistin level. PMID:26448186

  16. Correlation between Resistin, Tuberculosis and Khat Addiction: A Study from South Western Province of Saudi Arabia.

    Ayesha Alvi

    Full Text Available Tuberculosis(TB is a disease of global significance, which accounts for a death in every 15 seconds. Recent studies shows TB is rising in certain parts of the world, and Saudi Arabia is one of them. Several factor contribute in predisposing the subjects for infection including but not limited to addiction to various compounds which have immune modulation properties, such as amphetamines and Heroin etc. Khat a plant whose leaves are chewed for its euphoric effect in east Africa and Arabian Peninsula including Saudi Arabia, is considered as mildly addictive, and its principle compound, Cathinone shares structural and functional similarity with amphetamine a known immunomodulator. Tuberculosis being a disease of immune modulation has a varied spectrum of complex interplay of proinflammatory molecules, resistin is one of them. In the present study, we try to explore the trinity of khat addiction, serum resistin level and tuberculosis by correlating the serum resistin level in non khat addicted healthy subjects, khat addicted healthy subjects, and in patients, both khat addicted and non khat addicted, with active tuberculosis. We observed significantly higher resistin level among the apparently healthy khat addicted subjects as compared to non addicted healthy controls. Thereafter, when we compare the resistin levels between khat addicted and non khat addicted TB patients we did not found significant difference between the two groups. However bacillary load was observe to be significantly higher among the khat addicted TB patient as compare to non addicted one. Validation of above results in animal model revealed dose dependant increase in bacillary growth in the Wistar rats treated with khat. Taken together these results suggest the role of khat in immune modulation albeit in the limited frame of resistin level.

  17. Internet addiction: A case report

    Pejović-Milovančević Milica

    2009-01-01

    Full Text Available Some addictions cannot be connected with substance abuse (pathological gambling, video games playing, binge eating, compulsive physical activity, emotional relationship addiction, TV addiction. Since 1995, Internet addiction has been accepted as a clinical entity with profound negative effect on social, familial, educational and economical personal functioning. The diagnosis of Internet addiction could be established if the person spends more than 38 hours per week on the Internet exempting online professional needs. Basic symptoms are the increased number of hours spent in front of the computer along with the Internet use, development of abstinent syndrome if the Internet access is prohibited, sleep inversion, neglect of basic social requirements and personal hygiene, many somatic symptoms developed due to prolonged sitting or monitor watching, dissocial behavior. In this paper, data about the Internet addiction are presented and a case report of an adolescent with developed Internet addiction.

  18. Extending The P4P Agenda, Part 1: How Medicare Can Improve Patient Decision Making And Reduce Unnecessary Care: An agenda for Medicare to help drive improvements through pay-for-performance and shared decision making

    Wennberg, John E.; O'Connor, Annette M; Collins, E. Dale; Weinstein, James N.

    2007-01-01

    The decision to undergo many discretionary medical treatments should be based on informed patient choice. Shared decision making is an effective strategy for achieving this goal. The Centers for Medicare and Medicaid Services (CMS) should extend its pay-for-performance (P4P) agenda to assure that all Americans have access to a certified shared decision-making process. This paper outlines a strategy to achieve informed patient choice as the standard of practice for preference-sensitive care.

  19. Behavioral addictions: an overview.

    Karim, Reef; Chaudhri, Priya

    2012-01-01

    The legitimacy of nonsubstance addictions has received increased attention from clinicians, researchers and the general population as more and more individuals report symptoms consistent with impairment of impulse control. The clinical presentation of these disorders is varied, as compulsive activities may include: gambling, eating, sex, shopping, use of the Internet or videogames or even exercising, working or falling in love. As such, there is great controversy in diagnosing, treating or even naming these conditions, as many of these behaviors are daily rituals instrumental to our ultimate survival. Historically, the phrase "impulse control disorders" described these conditions but many researchers and clinicians also use the term "behavioral addictions," "process addictions" or "impulsive-compulsive behaviors" to report behavioral pathology. This review summarizes the data of each of these behavioral addictions from epidemiology to neurobiology to treatment options. Research suggests similarities between natural and drug reward processing but clinical evidence supports the utilization of treatment modalities for these behavioral conditions that can sometimes differ from traditional drug treatment. PMID:22641961

  20. Addiction, risk, and resources.

    Allamani, Allaman

    2007-01-01

    Addiction is a contemporary social issue bound to the myth of self-control and control of the other, which is typical of the contemporary "market ideology" society. In its broad definition it includes not only the use and misuse of "substances" and addictive behaviors, but also the concept of risk. There is a continuum between "addicted behaviors" and behaviors that are not "addicted" but may induce and/or be related to both physical and psycho-social problems on a micro- to macrolevel. Different studies have documented substantial changes in the consumption of tobacco, drugs, alcoholic beverages, as well as "junk foods" during the last decades in various countries. All too often politicians, health administrators, and local providers believe that consumption prevention programs are able, per se, to effect such changes. In fact, the impact of factors such as international trade, globalization and societal values, among many others, are considered relevant. On the other hand, sufficient place must be given to national and community-based preventive initiatives. PMID:17558940

  1. The process of recovery from alcohol addiction – from the limitations and fetters to a better quality of life

    Ewa Włodarczyk

    2014-01-01

    In analyzing the broadness of Polish literature on alcoholic addiction one can conclude that the process of getting out of alcoholic addiction is fragmentarily studied and described. This article presents one of the views shared by many therapists of addiction (in Poland and abroad), which recognizes the problems of alcoholism as a disease and contains considerations around the issue of coping with them, with reference to exactly this model of understanding them. Although this perception assu...

  2. Comparing Personality Characteristics of Addicts with Non Addicts in Hamadan

    A. Heidari Pahlavian

    2003-07-01

    Full Text Available A Sizeable sector of the population in Iran continues to use substance abuse despite government efforts to prevent addiction. Present study was designed to compare personality characteristics of addicts with non addicts. One hundred and six addicts who sought treatment at addiction rehabilitation department of Hamadan , were recruited in this study. A selective control group matched for demographic variables with the first group were also requested to take part in the study. The structured clinical interview for DSM-IV and MMPI were administered. The results showed that patients in studied group represented a significantly different personality characteristics in contrast to the control group. Overal 77.8% of addicts were diagnosed as mental disorder. This figure for control group was 26.2% . Also 41.3% of addicts were diagnosed as personality disorders, while the figure for non addicts was 5.8%. High rates of mental disorders and personality problems are reported for addicts. It Seems that psychiatric symptoms and psychological vulnerabilities have important role in addictive behavior.

  3. Shared Experonments

    Vatrapu, Ravi; Suthers, Dan; Joseph, Sam

    2009-01-01

    The Shared Experonments system provides interactive services for ubiquitous real-time interactive social sharing of experiences and environments. Designed and implemented for ubiquitous high-speed wireless environments, the Shared Experonments system provides synchronous ways and means for interactive social sharing of erstwhile personal experiences while one or more persons are in remote locations. Example scenarios include sharing of experiences with friends and family while off hiking or t...

  4. Coexisting addiction and pain in people receiving methadone for addiction.

    St Marie, Barbara

    2014-04-01

    The aim of this qualitative study was to examine the narratives of people who experience chronic pain (lasting 6 months or more) and were receiving methadone for the treatment of their opiate addiction through a major methadone clinic. This paper featured the pathway of how the participants developed chronic pain and addiction, and their beliefs of how prescription opioids would impact their addiction in the future. Thirty-four participants who experienced chronic pain and received methadone for treatment of opiate addiction were willing to tell the story of their experiences. The findings in three areas are presented: (a) whether participants experienced addiction first or pain first and how their exposures to addictive substances influenced their experiences, (b) the significance of recreational drug use and patterns of abuse behaviors leading to chronic pain, and (c) participants' experiences and beliefs about the potential for abuse of prescription opioid used for treatment of pain. PMID:23858068

  5. Opiate addiction and cocaine addiction: underlying molecular neurobiology and genetics

    Kreek, Mary Jeanne; Levran, Orna; Reed, Brian; Schlussman, Stefan D.; Zhou, Yan; Butelman, Eduardo R.

    2012-01-01

    Addictive diseases, including addiction to heroin, prescription opioids, or cocaine, pose massive personal and public health costs. Addictions are chronic relapsing diseases of the brain caused by drug-induced direct effects and persisting neuroadaptations at the epigenetic, mRNA, neuropeptide, neurotransmitter, or protein levels. These neuroadaptations, which can be specific to drug type, and their resultant behaviors are modified by various internal and external environmental...

  6. Cortisol secretion patterns in addiction and addiction risk

    LOVALLO, WILLIAM R.

    2006-01-01

    Addiction to alcohol or nicotine involves altered functioning of the brain's motivational systems. Altered functioning of the hypothalamic–pituitary–adrenocortical (HPA) axis may hold clues to the nature of the motivational changes accompanying addiction and vulnerability to addiction. Alcohol and nicotine show at least three forms of interaction with HPA functioning. Acute intake of both substances causes stress-like cortisol responses. Their persistent use may dysregulate the HPA. Finally, ...

  7. The Edinburgh Addiction Cohort: recruitment and follow-up of a primary care based sample of injection drug users and non drug-injecting controls

    Kimber Jo

    2010-02-01

    Full Text Available Abstract Background Injection drug use is an important public health problem. Epidemiological understanding of this problem is incomplete as longitudinal studies in the general population are difficult to undertake. In particular little is known about early life risk factors for later drug injection or about the life course of injection once established including the influence of medical and social interventions. Methods Individuals thought to be drug injectors were identified through a single primary medical care facility in Edinburgh between 1980 and 2006 and flagged with the General Registry Office. From October 2005 - October 2007, these cases were traced and invited to undergo interview assessment covering early life experience, substance use, health and social histories. Age and sex matched controls for confirmed cases (alive and dead were later recruited through the same health facility. Controls for living cases completed the same structured interview schedule. Data were also collected on cases and controls through linkage to routine primary care records, death registrations, hospital contact statistics and police and prison records. All interviews were conducted with the knowledge and permission of the current GP. Results The initial cohort size was 814. At start of follow up 227 had died. Of the remaining 587: 20 had no contact details and 5 had embarked from the UK; 40 declined participation; 38 did not respond to invitations; 14 were excluded by their GP on health or social grounds and 22 had their contact details withheld by administrative authorities. 448 were interviewed of whom 16 denied injection and were excluded. Of 191 dead cases with medical records 4 were excluded as their records contained no evidence of injection. 5 interviewed cases died before follow up was concluded though these individuals were counted as "live" cases. 1 control per case (dead and alive was recruited. Linkage to Scottish Morbidity Records data

  8. Treatment of addiction and addiction-related behavior

    Dewey, Stephen L.; Brodie, Jonathan D.; Ashby, Jr., Charles R.

    2004-12-07

    The present invention provides a highly efficient method for treating substance addiction and for changing addiction-related behavior of a mammal suffering from substance addiction. The method includes administering to a mammal an effective amount of gamma vinylGABA or a pharmaceutically acceptable salt thereof. The present invention also provides a method of treatment of cocaine, morphine, heroin, nicotine, amphetamine, methamphetamine, or ethanol addiction by treating a mammal with an effective amount of gamma vinylGABA or a pharmaceutically acceptable salt thereof.

  9. Cortisol secretion patterns in addiction and addiction risk.

    Lovallo, William R

    2006-03-01

    Addiction to alcohol or nicotine involves altered functioning of the brain's motivational systems. Altered functioning of the hypothalamic-pituitary-adrenocortical (HPA) axis may hold clues to the nature of the motivational changes accompanying addiction and vulnerability to addiction. Alcohol and nicotine show at least three forms of interaction with HPA functioning. Acute intake of both substances causes stress-like cortisol responses. Their persistent use may dysregulate the HPA. Finally, the risk for dependence and for relapse after quitting may be associated with deficient cortisol reactivity to a variety of stressors. The HPA is regulated at the hypothalamus by diurnal and metabolic signals, but during acute emotional states, its regulation is superseded by signals from the limbic system and prefrontal cortex. This top-down organization makes the HPA responsive to inputs that reflect motivational processes. The HPA is accordingly a useful system for studying psychophysiological reactivity in persons who may vary in cognitive, emotional, and behavioral tendencies associated with addiction and risk for addiction. Chronic, heavy intake of alcohol and nicotine may cause modifications in these frontal-limbic interactions and may account for HPA response differences in seen in alcoholics and smokers. In addition, preexisting alterations in frontal-limbic interactions with the HPA may reflect addiction-proneness, as shown in studies of offspring of alcohol- and drug-abusing parents. Continuing research on the relationship between HPA function, stress responsivity, and the addictions may yield insights into how the brain's motivational systems support addictions and risk for addictions. PMID:16434116

  10. Addiction and Cognition

    Gould, Thomas J.

    2010-01-01

    The brain regions and neural processes that underlie addiction overlap extensively with those that support cognitive functions, including learning, memory, and reasoning. Drug activity in these regions and processes during early stages of abuse foster strong maladaptive associations between drug use and environmental stimuli that may underlie future cravings and drug-seeking behaviors. With continued drug use, cognitive deficits ensue that exacerbate the difficulty of establishing sustained a...

  11. [Addiction and personality].

    Franques, P; Auriacombe, M; Tignol, J

    2000-01-01

    Within the field of substance abuse, it is now widely admitted that the addictive personality does not exist. No one personality type is predisposed to addiction. The predisposition to drug dependence involves many different factors: psychological, social, familial, biological. None of these factors can be the sole determinant of drug dependence. Keeping that in mind, it is of interest to review the recent data on the relationship between personality traits or disorders and opiate and cocaine dependence. Using DSM and ICD categorical assessment, no single personality disorder emerged, instead a range of personality disorders has been evaluated in opiate and cocaine dependent subjects. Every type of personality disorders (PD) existed but cluster BPD were the most common (especially antisocial personality disorder in opiate addicts). However, it is noteworthy that a large minority to a majority of subjects did not display any king of PD. The implication of these results is that antisocial PD is probably over-diagnosed in drug dependence clinical settings. The studies reviewed failed to demonstrate that personality disorders were strong predictors of outcome in opiate or cocaine dependence. However, opiate dependent PD subjects entering treatment had more severe problems and lower retention rate than non PD subjects. But the amount of improvement was not significantly different between PD subjects and non PD subjects. This demonstrated that substance dependent PD patients could benefit from treatment whose intensity and duration must be adjusted. There is good support for the idea that Sensation Seeking trait is a vulnerability factor to substance abuse. But after dependence develops, sensation seeking is probably irrelevant to continued use of the drugs. This break between the psychopathology of vulnerability of substance abuse and the psychopathology of dependence raises the question of the existence of dramatically different factors involved in both phases of

  12. Animal Studies of Addictive Behavior

    Vanderschuren, Louk J. M. J.; Serge H Ahmed

    2013-01-01

    It is increasingly recognized that studying drug taking in laboratory animals does not equate to studying genuine addiction, characterized by loss of control over drug use. This has inspired recent work aimed at capturing genuine addiction-like behavior in animals. In this work, we summarize empirical evidence for the occurrence of several DSM-IV-like symptoms of addiction in animals after extended drug use. These symptoms include escalation of drug use, neurocognitive deficits, resistance to...

  13. Drug addiction and periodontal diseases

    Saini, Gurpreet Kaur; N D Gupta; Prabhat, K. C.

    2013-01-01

    The prevalence of drug addiction is increasing globally. Drug abuse damages many parts of the body such as oral cavity, lungs, liver, brain, heart etc., Addicts suffer from physical, psychological, emotional and behavioral problems. Their nutrition is also compromised. There is certainly an impact of all these factors on the health of periodontium. Dentists should be aware of the effects of drugs while treating the drug addicts. This article correlates the studies done on the impact of abused...

  14. A Research on Brand Addiction

    Canbaz, Serdar; Çiçek, Hüseyin; Eyidiker, Uğur

    2014-01-01

    Brand is an acknowledged concept increasing the value of a product and services as well as providing convenience to its buyer. Seller, along with availing himself, obtains a link between himself and buyer. This phenomena which we come across as an addiction turns into a kind of a sense of belonging in which buyers would under no circumstances change their ideas. Therefore the desire to create a brand and brand addiction is unavoidable. Brand addiction, in other words brand loyalty constitutes...

  15. Transcriptional Mechanisms of Drug Addiction

    Nestler, Eric J.

    2012-01-01

    Regulation of gene expression is considered a plausible mechanism of drug addiction given the stability of behavioral abnormalities that define an addicted state. Numerous transcription factors, proteins that bind to regulatory regions of specific genes and thereby control levels of their expression, have been implicated in the addiction process over the past decade or two. Here we review the growing evidence for the role played by several prominent transcription factors, including a Fos fami...

  16. STRESS COPING SKILLS IN ADDICTS

    A. Ebrahimi; SG MOOSAVI; R SAMOOEIE; A ,HASAN ZADEH

    2002-01-01

    Introduction. Stress coping skills is one of the most important factors in prediction of addictive behavior. The purpose of this study was to determine this pattern and to compare them with those of non-addicts. Methods. One hundred subjects with substance dependency and 100 non-addict subjects were selected. Both groups were matched on the basis of their socioeconomic state. Stress coping skills of study participants were examined using CS-R scale. Results. Stress coping skills in ...

  17. What is sexual addiction?

    Levine, Stephen B

    2010-01-01

    Married men labeled as sexual addicts seek help after being discovered to have had broken monogamy rules for sexual behavior through their use of masturbation, pornography, cybersex, commercial sex involvement, paraphilic pursuits, or affairs. This study analyzed the sexual patterns and dynamics of 30 men who presented to 1 clinician between 2005 and 2009. Their important differences were captured by a 6-category spectrum: (a) no sexual excess beyond breaking the spouse's restrictive rules (n = 2), (b) discovery of husband's longstanding sexual secrets (n = 5), (c) new discovery of the joys of commercial sex (n = 4), (d) the bizarre or paraphilic (n = 7), (e) alternate concept of normal masculinity (n = 5), and (f) spiraling psychological deterioration (n = 7). Only the men with a spiraling psychological deterioration-about 25% of the sample with sexual issues-could reasonably be described as having a sexual addiction. This group experienced significant psychological failures before the onset of their deterioration. Another 25% were adequately defined as paraphilic. Half of the sample was not adequately described using addiction, compulsivity, impulsivity, and relationship incapacity models. The authors discuss the implications of these findings for DSM-5 and treatment. PMID:20432125

  18. Sharing Economy

    Marton, Attila; Constantiou, Ioanna; Thoma, Antonela

    De spite the hype the notion of the sharing economy is surrounded by, our understanding of sharing is surprisingly undertheorized. In this paper, we make a first step towards rem edying this state of affairs by analy sing sharing as a s ocial practice. Based on a multi ple - case study, we analyse...

  19. [The Perioperative Management of Pain in Patients Who Are Addicted to Heroin].

    Lee, Wen-Yi; Weng, Chia-Hsing; Hsu, Yu-Ping; Lin, Pao-Chen

    2015-06-01

    Heroin addicts admitted to the hospital for surgery should be treated as high-risk patients because these patients face a significantly higher risk of experiencing severe drug withdrawal symptoms and of pain management complications during hospitalization. The lack of proper pain management often suffered by heroin addicts during hospitalization has been attributed to care providers' insufficient knowledge regarding opioid medications and their addicting effects as well as fears that opioid medications may cause addiction symptoms to reemerge. The objective of this article is to illustrate the pain management process across the entire hospitalization period for heroin-addicted patients undergoing surgical procedures. This process includes management of the heroin-related physical and psychological reactions from surgery, of the mechanism of pain induced specifically from surgery, and of the heroin addiction during the surgical procedure and subsequent clinical management and nursing care. It is hoped that this article assists healthcare providers to better understand the need for the proper pain management and care of heroin-addicted surgical patients over the entire period of hospitalization and thus the enhancement of the overall quality and safety of patient care management procedures. PMID:26073959

  20. Dutch Translation and Psychometric Testing of the 9-Item Shared Decision Making Questionnaire (SDM-Q-9 and Shared Decision Making Questionnaire-Physician Version (SDM-Q-Doc in Primary and Secondary Care.

    Sumayah Rodenburg-Vandenbussche

    Full Text Available The SDM-Q-9 and SDM-Q-Doc measure patient and physician perception of the extent of shared decision making (SDM during a physician-patient consultation. So far, no self-report instrument for SDM was available in Dutch, and validation of the scales in other languages has been limited. The aim of this study was to translate both scales into Dutch and assess their psychometric characteristics.Participants were patients and their treating physicians (general practitioners and medical specialists. Patients (N = 182 rated their consultation using the SDM-Q-9, 43 physicians rated their consultations using the SDM-Q-Doc (N = 201. Acceptability, reliability (internal consistency, and the factorial structure of the instruments were determined. For convergent validity the CPSpost was used.Reliabilities of both scales were high (alpha SDM-Q-9 0.88; SDM-Q-Doc 0.87. The SDM-Q-9 and SDM-Q-Doc total scores correlated as expected with the CPSpost (SDM-Q-9: r = 0.29; SDM-Q-Doc: r = 0.48 and were significantly different between the CPSpost categories, with lowest mean scores when the physician made the decision alone. Principal Component Analyses showed a two-component model for each scale. A confirmatory factor analysis yielded a mediocre, but acceptable, one-factor model, if Item 1 was excluded; for both scales the best indices of fit were obtained for a one-factor solution, if both Items 1 and 9 were excluded.The Dutch SDM-Q-9 and SDM-Q-Doc demonstrate good acceptance and reliability; they correlated as expected with the CPSpost and are suitable for use in Dutch primary and specialised care. Although the best model fit was found when excluding Items 1 and 9, we believe these items address important aspects of SDM. Therefore, also based on the coherence with theory and comparability with other studies, we suggest keeping all nine items of the scale. Further research on the SDM-concept in patients and physicians, in different clinical settings and different

  1. Dutch Translation and Psychometric Testing of the 9-Item Shared Decision Making Questionnaire (SDM-Q-9) and Shared Decision Making Questionnaire-Physician Version (SDM-Q-Doc) in Primary and Secondary Care

    Rodenburg-Vandenbussche, Sumayah; Pieterse, Arwen H.; Kroonenberg, Pieter M.; Scholl, Isabelle; van der Weijden, Trudy; Luyten, Gre P. M.; Kruitwagen, Roy F. P. M.; den Ouden, Henk; Carlier, Ingrid V. E.; van Vliet, Irene M.; Zitman, Frans G.; Stiggelbout, Anne M.

    2015-01-01

    Purpose The SDM-Q-9 and SDM-Q-Doc measure patient and physician perception of the extent of shared decision making (SDM) during a physician-patient consultation. So far, no self-report instrument for SDM was available in Dutch, and validation of the scales in other languages has been limited. The aim of this study was to translate both scales into Dutch and assess their psychometric characteristics. Methods Participants were patients and their treating physicians (general practitioners and medical specialists). Patients (N = 182) rated their consultation using the SDM-Q-9, 43 physicians rated their consultations using the SDM-Q-Doc (N = 201). Acceptability, reliability (internal consistency), and the factorial structure of the instruments were determined. For convergent validity the CPSpost was used. Results Reliabilities of both scales were high (alpha SDM-Q-9 0.88; SDM-Q-Doc 0.87). The SDM-Q-9 and SDM-Q-Doc total scores correlated as expected with the CPSpost (SDM-Q-9: r = 0.29; SDM-Q-Doc: r = 0.48) and were significantly different between the CPSpost categories, with lowest mean scores when the physician made the decision alone. Principal Component Analyses showed a two-component model for each scale. A confirmatory factor analysis yielded a mediocre, but acceptable, one-factor model, if Item 1 was excluded; for both scales the best indices of fit were obtained for a one-factor solution, if both Items 1 and 9 were excluded. Conclusion The Dutch SDM-Q-9 and SDM-Q-Doc demonstrate good acceptance and reliability; they correlated as expected with the CPSpost and are suitable for use in Dutch primary and specialised care. Although the best model fit was found when excluding Items 1 and 9, we believe these items address important aspects of SDM. Therefore, also based on the coherence with theory and comparability with other studies, we suggest keeping all nine items of the scale. Further research on the SDM-concept in patients and physicians, in different clinical

  2. What Are the Treatments for Heroin Addiction?

    ... Facebook Twitter What are the treatments for heroin addiction? A variety of effective treatments are available for heroin addiction, including both behavioral and pharmacological (medications). Both approaches ...

  3. Tracheostomy care

    ... this page: //medlineplus.gov/ency/patientinstructions/000076.htm Tracheostomy care To use the sharing features on this ... through your nose and mouth. Caring for Your Tracheostomy Once the hole in your neck is not ...

  4. The Comparison Schema in the Successful Addiction, Unsuccessful Addiction and Non-Addiction Popular

    Anisi Khoshlahjeh; Khadejeh Abolmaali; Zahra Khoshlahjeh; Hasan Alizadeh, F; Ehsan Imani

    2010-01-01

    Objective: The purpose of this research was to compere schema in the successful addiction, unsuccessful addiction and non-addiction popular. Method: The method of the research the sample population in this study includes institutes f Birth again charity institutions in 1389. The variables like education (degree of high school), gender (only man) and age (25- ….) were controlled in three groups. The statistical sample consisted those 90 individuals who were tested by from GHQ and selected thro...

  5. Shared care or nursing consultations as an alternative to rheumatologist follow-up for rheumatoid arthritis outpatients with low disease activity--patient outcomes from a 2-year, randomised controlled trial

    Primdahl, Jette; Sørensen, Jan; Horn, Hans Christian;

    2014-01-01

    (-8.8, p=0.004). No statistically significant differences were seen in other outcome variables. CONCLUSIONS: It is safe to implement shared care and nursing consultations as alternatives to rheumatologist consultations for RA outpatients with low disease activity without deterioration in disease......OBJECTIVES: To compare patient outcomes of three regimes of follow-up care for rheumatoid arthritis (RA) outpatients with low disease activity. METHODS: RA outpatients (n=287) with Disease Activity Score (DAS28-CRP)<3.2 and Health Assessment Questionnaire<2.5 from two Danish rheumatology clinics...... were randomised to 2-year follow-up by either: (1) planned rheumatologist consultations, (2) shared care without planned consultations or (3) planned nursing consultations. The primary outcome was change in disease activity. DAS28-CRP, Health Assessment Questionnaire, visual analogue scale (VAS...

  6. Psychological and Neurobiological Correlates of Food Addiction.

    Kalon, E; Hong, J Y; Tobin, C; Schulte, T

    2016-01-01

    Food addiction (FA) is loosely defined as hedonic eating behavior involving the consumption of highly palatable foods (ie, foods high in salt, fat, and sugar) in quantities beyond homeostatic energy requirements. FA shares some common symptomology with other pathological eating disorders, such as binge eating. Current theories suggest that FA shares both behavioral similarities and overlapping neural correlates to other substance addictions. Although preliminary, neuroimaging studies in response to food cues and the consumption of highly palatable food in individuals with FA compared to healthy controls have shown differing activation patterns and connectivity in brain reward circuits including regions such as the striatum, amygdala, orbitofrontal cortex, insula, and nucleus accumbens. Additional effects have been noted in the hypothalamus, a brain area responsible for regulating eating behaviors and peripheral satiety networks. FA is highly impacted by impulsivity and mood. Chronic stress can negatively affect hypothalamic-pituitary-adrenal axis functioning, thus influencing eating behavior and increasing desirability of highly palatable foods. Future work will require clearly defining FA as a distinct diagnosis from other eating disorders. PMID:27503449

  7. A discursive analysis exploring constructions of sex addiction in clinical text and 'addict' accounts

    Briggs, James

    2014-01-01

    Introduction: Numerous accounts have been developed which portray sex addiction and the sex addict. These in turn have led to screening tools, said to be capable of accurately distinguishing the sex addict from non-addicts. However, there are a wealth of various, diverse and conflicting understandings of addiction, sexuality and sex addiction. Sex addiction also carries moral implications, leading some to argue the term is used as stigmatising label for those who deviate from a socially...

  8. Is Sensation Seeking a correlate of excessive behaviors and behavioral addictions? A detailed examination of patients with Gambling Disorder and Internet Addiction.

    Müller, K W; Dreier, M; Beutel, M E; Wölfling, K

    2016-08-30

    Sensation Seeking has repeatedly been related to substance use. Also, its role as a correlate of Gambling Disorder has been discussed although research has led to heterogeneous results. Likewise, first studies on Internet Addiction have indicated increased Sensation Seeking, to some extent contradicting clinical impression of patients suffering from internet addiction. We assessed Sensation Seeking in a clinical sample of n=251 patients with Gambling Disorder, n=243 patients with internet addiction, n=103 clients with excessive but not addictive internet use, and n=142 healthy controls. The clinical groups were further sub-divided according to the preferred type of addictive behavior (slot-machine gambling vs. high arousal gambling activities and internet gaming disorder vs. other internet-related addictive behaviors). Decreased scores in some subscales of Sensation Seeking were found among male patients compared to healthy controls with no differences between patients with Gambling Disorder and Internet Addiction. The type of preferred gambling or online activity was not related to differences in Sensation Seeking. Previous findings indicating only small associations between Sensation Seeking and Gambling Disorder were confirmed. Regarding Internet Addiction our results contradict findings from non-clinical samples. Sensation Seeking might be relevant in initiating contact to the health care system. PMID:27322843

  9. Dissecting impulsivity and its relationships to drug addictions.

    Jentsch, J David; Ashenhurst, James R; Cervantes, M Catalina; Groman, Stephanie M; James, Alexander S; Pennington, Zachary T

    2014-10-01

    Addictions are often characterized as forms of impulsive behavior. That said, it is often noted that impulsivity is a multidimensional construct, spanning several psychological domains. This review describes the relationship between varieties of impulsivity and addiction-related behaviors, the nature of the causal relationship between the two, and the underlying neurobiological mechanisms that promote impulsive behaviors. We conclude that the available data strongly support the notion that impulsivity is both a risk factor for, and a consequence of, drug and alcohol consumption. While the evidence indicating that subtypes of impulsive behavior are uniquely informative--either biologically or with respect to their relationships to addictions--is convincing, multiple lines of study link distinct subtypes of impulsivity to low dopamine D2 receptor function and perturbed serotonergic transmission, revealing shared mechanisms between the subtypes. Therefore, a common biological framework involving monoaminergic transmitters in key frontostriatal circuits may link multiple forms of impulsivity to drug self-administration and addiction-related behaviors. Further dissection of these relationships is needed before the next phase of genetic and genomic discovery will be able to reveal the biological sources of the vulnerability for addiction indexed by impulsivity. PMID:24654857

  10. Compulsivity in obsessive-compulsive disorder and addictions.

    Figee, Martijn; Pattij, Tommy; Willuhn, Ingo; Luigjes, Judy; van den Brink, Wim; Goudriaan, Anneke; Potenza, Marc N; Robbins, Trevor W; Denys, Damiaan

    2016-05-01

    Compulsive behaviors are driven by repetitive urges and typically involve the experience of limited voluntary control over these urges, a diminished ability to delay or inhibit these behaviors, and a tendency to perform repetitive acts in a habitual or stereotyped manner. Compulsivity is not only a central characteristic of obsessive-compulsive disorder (OCD) but is also crucial to addiction. Based on this analogy, OCD has been proposed to be part of the concept of behavioral addiction along with other non-drug-related disorders that share compulsivity, such as pathological gambling, skin-picking, trichotillomania and compulsive eating. In this review, we investigate the neurobiological overlap between compulsivity in substance-use disorders, OCD and behavioral addictions as a validation for the construct of compulsivity that could be adopted in the Research Domain Criteria (RDoC). The reviewed data suggest that compulsivity in OCD and addictions is related to impaired reward and punishment processing with attenuated dopamine release in the ventral striatum, negative reinforcement in limbic systems, cognitive and behavioral inflexibility with diminished serotonergic prefrontal control, and habitual responding with imbalances between ventral and dorsal frontostriatal recruitment. Frontostriatal abnormalities of compulsivity are promising targets for neuromodulation and other interventions for OCD and addictions. We conclude that compulsivity encompasses many of the RDoC constructs in a trans-diagnostic fashion with a common brain circuit dysfunction that can help identifying appropriate prevention and treatment targets. PMID:26774279

  11. Pharmacogenetic aspects of addictive behaviors

    Hejazi, Nadia S.

    2007-01-01

    Addictions are illnesses of complex causation, including inheritance and a role for gene/environment interactions. Functional alleles influencing pharmacodynamic (tissue response) and pharmacokinetic (absorption, distribution, and metabolism) play a role, but these interact with diverse environmental factors including early Ife stress, underage drug exposure, availability of addictive agents, and response to clinical interventions including pharmacotherapies. Identification of genetic factors...

  12. Comprehensive Treatment of Addictive Families.

    Schlesinger, Stephen E.; Horberg, Lawrence K.

    This article describes a practical approach to treating addictive families, designed to help them repair the damage, create more satisfying lives, and prevent long-lasting deleterious effects, commonly associated with "co-dependency" and "children of addicts." This approach is grounded in a developmental model of family recovery which was devised…

  13. Epigenetic regulation of cocaine addiction

    Martínez Martínez, Arturo

    2015-01-01

    Addiction is defined as a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences. The addictive phenotype can persist for the lenght of an individual's life, suggesting that drugs of abuse may induced long-lasting changes in the brain.

  14. Unbalanced Neuronal Circuits in Addiction

    Volkow, Nora D; Wang, Gen-Jack; Tomasi, Dardo; Baler, Ruben D.

    2013-01-01

    Through sequential waves of drug-induced neurochemical stimulation, addiction co-opts the brain's neuronal circuits that mediate reward, motivation, , to behavioral inflexibility and a severe disruption of self-control and compulsive drug intake. Brain imaging technologies have allowed neuroscientists to map out the neural landscape of addiction in the human brain and to understand how drugs modify it.

  15. STRESS COPING SKILLS IN ADDICTS

    A EBRAHIMI

    2002-06-01

    Full Text Available Introduction. Stress coping skills is one of the most important factors in prediction of addictive behavior. The purpose of this study was to determine this pattern and to compare them with those of non-addicts. Methods. One hundred subjects with substance dependency and 100 non-addict subjects were selected. Both groups were matched on the basis of their socioeconomic state. Stress coping skills of study participants were examined using CS-R scale. Results. Stress coping skills in addicts were different from those of non-addicts in most of the coping procedures. Nonaddicts reported that they used problem-focused coping and some of the emotional-focused coping strategies. In contrast, addicts shown that they used unuseful and noneffective stress coping strategies. Discussion. These data indicate that using ineffective stress coping skills is one of-the predisposing and precipitating factors in addictive behavior. It seems that stress coping skills training is necessary in prevention of addiction.

  16. Harry Potter: Agency or Addiction?

    Mills, Alice

    2010-01-01

    This article considers limitations on agency for characters in the Harry Potter novels, in particular, how far they are driven by an addictive yearning for their beloved dead. As well as Harry's yearning for his dead parents, Dumbledore's guilt, Snape's longing and Slughorn's craving can be read as evidence of addiction rather than love, while the…

  17. Epigenetic and proteomic expression changes promoted by eating addictive-like behavior

    Mancino, Samantha; Burokas, Aurelijus, 1982-; Guti??rrez Cuesta, Javier; Guti??rrez Martos, Miriam; Mart??n Garc??a, Elena, 1975-; Pucci, Mariangela; Falconi, Anastasia; D'Addario, Claudio; Maccarrone, Mauro; Maldonado, Rafael

    2015-01-01

    An increasing perspective conceptualizes obesity and overeating as disorders related to addictive-like processes that could share common neurobiological mechanisms. In the present study, we aimed at validating an animal model of eating addictive-like behavior in mice, based on the DSM-5 substance use disorder criteria, using operant conditioning maintained by highly palatable chocolate-flavored pellets. For this purpose, we evaluated persistence of food-seeking during a period of non-availabi...

  18. Animal studies of addictive behavior.

    Vanderschuren, Louk J M J; Ahmed, Serge H

    2013-04-01

    It is increasingly recognized that studying drug taking in laboratory animals does not equate to studying genuine addiction, characterized by loss of control over drug use. This has inspired recent work aimed at capturing genuine addiction-like behavior in animals. In this work, we summarize empirical evidence for the occurrence of several DSM-IV-like symptoms of addiction in animals after extended drug use. These symptoms include escalation of drug use, neurocognitive deficits, resistance to extinction, increased motivation for drugs, preference for drugs over nondrug rewards, and resistance to punishment. The fact that addiction-like behavior can occur and be studied in animals gives us the exciting opportunity to investigate the neural and genetic background of drug addiction, which we hope will ultimately lead to the development of more effective treatments for this devastating disorder. PMID:23249442

  19. Internet addiction in young people.

    Ong, Say How; Tan, Yi Ren

    2014-07-01

    In our technology-savvy population, mental health professionals are seeing an increasing trend of excessive Internet use or Internet addiction. Researchers in China, Taiwan and Korea have done extensive research in the field of Internet addiction. Screening instruments are available to identify the presence of Internet addiction and its extent. Internet addiction is frequently associated with mental illnesses such as anxiety, depression, conduct disorder and attention deficit hyperactivity disorder (ADHD). Treatment modalities include individual and group therapies, cognitive behavioural therapy (CBT), family therapy and psychotropic medications. A significant proportion of Singapore adolescents engaging in excessive Internet use are also diagnosed to have concomitant Internet addiction. Despite the presence of a variety of treatment options, future research in this area is needed to address its growing trend and to minimise its negative psychological and social impact on the individuals and their families. PMID:25142474

  20. Cocaine – Characteristics and addiction

    Katarzyna Girczys-Połedniok

    2016-08-01

    Full Text Available Cocaine use leads to health, social and legal problems. The aim of this paper is to discuss cocaine action, addicts characteristics, use patterns and consequences, as well as addiction treatment methods. A literature review was based on the Medline, PubMed, Polish Medical Bibliography databases and the Silesian Library resources. The Police and Central Statistical Office statistics, as well as the World Health Organization, the European Monitoring Centre for Drugs and Drug Addiction and the National Office for Combating Drug Addiction reports were used. Cocaine leads to mood improvement, appetite decrease, physical and intellectual activity enhancement, euphoria, inflated self-esteem, social networking ease and increased sexual desire. Cocaine hydrochloride is mainly used intranasaly, but also as intravenous and subcutaneous injections. Cocaine use and first addiction treatment fall in later age compared to other psychoactive substances. There is a high men to women ratio among addicts. There is a relationship between cocaine addiction, the presence of other disorders and genetic predisposition to addiction development. Polish reports indicate higher popularity of cocaine among people with a high economic and social status. Although Poland is a country with the low percentage of cocaine use, its popularity is growing. The consequences of cocaine use concern somatic and mental health problems, socioeconomic and legal conditions. The drug plays a role in crimes and traffic accidents. Because of the risks associated with cocaine use, it has been listed in a register of drugs attached to the Act on Counteracting Drug Addiction. Addiction treatment includes psychological, pharmacological and harm reduction strategies. Med Pr 2016;67(4:529–536

  1. Shared decision making

    ... features on this page, please enable JavaScript. Shared decision making is when health care providers and patients work together to decide ... There many test and treatment options for most health conditions. So your condition may be ... decision making helps you and your provider choose a treatment ...

  2. Childhood Food Addiction and the Family

    Carlisle, Kristy L.; Buser, Juleen K.; Carlisle, Robert M.

    2012-01-01

    Food addiction among children is a concerning issue. Few empirical studies have examined the relevance of food addiction among pediatric samples, but emerging evidence suggests that some children experience their eating patterns as addictive. The present review will discuss the issue of food addiction among children, and will also attend to the…

  3. Intertemporal bargaining in addiction.

    Ainslie, George

    2013-01-01

    The debate between disease models of addiction and moral or voluntarist models has been endless, and often echoes the equally endless debate between determinism and free will. I suggest here that part of the problem comes from how we picture the function of motivation in self-control. Quantitative experiments in both humans and non-humans have shown that delayed reward loses its effectiveness in proportion to its delay. The resulting instability of preference is best controlled by a recursive self-prediction process, intertemporal bargaining, which is the likely mechanism of both the strength and the experienced freedom of will. In this model determinism is consistent with more elements of free will than compatibilist philosophers have heretofore proposed, and personal responsibility is an inseparable, functional component of will. Judgments of social responsibility can be described as projections of personal responsibility, but normative responsibility in addiction is elusive. The cited publications that are under the author's control can be downloaded from www.picoeconomics.org. PMID:23966954

  4. Intertemporal Bargaining in Addiction

    George Ainslie

    2013-08-01

    Full Text Available The debate between disease models of addiction and moral or voluntarist models has been endless, and often echoes the equally endless debate between determinism and free will. I suggest here that part of the problem comes from how we picture the function of motivation in self-control. Quantitative experiments in both humans and nonhumans have shown that delayed reward loses its effectiveness in proportion to its delay. The resulting instability of preference is best controlled by a recursive self-prediction process, intertemporal bargaining, which is the likely mechanism of both the strength and the experienced freedom of will. In this model determinism is consistent with more elements of free will than compatibilist philosophers have heretofore proposed, and personal responsibility is an inseparable, functional component of will. Judgments of social responsibility can be described as projections of personal responsibility, but normative responsibility in addiction is elusive. The cited publications that are under the author’s control can be downloaded from www.picoeconomics.org.

  5. File sharing

    N. van Eijk

    2011-01-01

    ‘File sharing’ has become generally accepted on the Internet. Users share files for downloading music, films, games, software etc. In this note, we have a closer look at the definition of file sharing, the legal and policy-based context as well as enforcement issues. The economic and cultural impact

  6. Pain Control in the Presence of Drug Addiction.

    Vadivelu, Nalini; Lumermann, Leandro; Zhu, Richard; Kodumudi, Gopal; Elhassan, Amir O; Kaye, Alan David

    2016-05-01

    Drug addiction is present in a significant proportion of the population in the USA and worldwide. Drug addiction can occur with the abuse of many types of substances including cocaine, marijuana, stimulants, alcohol, opioids, and tranquilizers. There is a high likelihood that clinicians will encounter patients with substance abuse disorders on a regular basis with the prevalence of the use of illicit substances and the high rate of abuse of prescription drugs. The use of abuse deterrent formulations of prescription opioid agents, pill counts, and urine drug abuse screenings are all useful strategies. Optimum pain management of patients with addiction in the outpatient and inpatient setting is essential to minimize pain states. Careful selection of medications and appropriate oversight, including drug agreements, can reduce drug-induced impairments, including sleep deficits and diminished physical, social, and sexual functioning. This review, therefore, discusses the prevalence of illicit and prescription drug addiction, the challenges of achieving optimum pain control, and the therapeutic approaches to be considered in this challenging population. More research is warranted to develop improved therapies and routes of treatments for optimum pain relief and to prevent the development of central sensitization, chronic pain, and impaired physical and social functioning in patients with drug addiction. PMID:27068665

  7. The Comparison of Alexithymia and Spiritual Intelligence in Addicts, Addicts under Methadone Treatment, and Non-Addicts

    Mohammad Narimani

    2012-08-01

    Full Text Available Introduction: The purpose of the present study was to compare of the rate of alexithymia and spiritual intelligence in addicts, addicts under Methadone Treatment, and non-Addicts. Method: A causal-comparative research design was used. The study sample included 30 individuals under Methadone Treatment, 30 drug-dependent Addicted, and 30 non-addicted individuals selected by convenience sampling procedure. Toronto alexithymia scale and King's spiritual intelligence self-report inventory were administered among selected sample. Results: Findings revealed significant differences among addicted individuals and non-addicted adults also among individuals under methadone treatment and non-addicted adults in total alexithymia scores as well as on all three subscale scores. Furthermore, addicted individuals differed from those under methadone treatment in their scores on the subscale pertaining to difficulty in identifying feelings. Results also indicated differences among addicted individuals and those under methadone treatment in total spiritual intelligence and its four component scale scores, while addicted individuals differed from non-addicted individuals in total spiritual intelligence scores and only three of its component scale scores (personal meaning production, transcendental awareness, and conscious state expansion. Conclusion: Findings of this study indicate the advantages of the ability to control, emotional regulation and spiritual intelligence as a defense against addiction. By development of these characteristics addicts can be helped to gain relief from their addiction.

  8. On the road to value co-creation in health care: the role of consumers in defining the destination, planning the journey and sharing the drive.

    Janamian, Tina; Crossland, Lisa; Wells, Leanne

    2016-04-18

    The role of consumers is now extending beyond being passive health care recipients and even active participants in their own care to involvement in innovation and value co-creation in health care - from being "users and choosers" to becoming "makers and shapers" of services. For active dialogue to occur in co-creation, consumers must become equal partners with health care organisations and providers, with the focus on areas of interest to all parties. The use of value co-creation in health care involves embedding the approach across the whole health care system - from the microsystem level to the mesosystem and the entire macrosystem. PMID:27078786

  9. Sharing Graphs

    Sahasranand, K R

    2010-01-01

    Almost all known secret sharing schemes work on numbers. Such methods will have difficulty in sharing graphs since the number of graphs increases exponentially with the number of nodes. We propose a secret sharing scheme for graphs where we use graph intersection for reconstructing the secret which is hidden as a sub graph in the shares. Our method does not rely on heavy computational operations such as modular arithmetic or polynomial interpolation but makes use of very basic operations like assignment and checking for equality, and graph intersection can also be performed visually. In certain cases, the secret could be reconstructed using just pencil and paper by authorised parties but cannot be broken by an adversary even with unbounded computational power. The method achieves perfect secrecy for (2, n) scheme and requires far fewer operations compared to Shamir's algorithm. The proposed method could be used to share objects such as matrices, sets, plain text and even a heterogeneous collection of these. S...

  10. Shared leadership

    Ulhøi, John Parm; Müller, Sabine

    2012-01-01

    according to the literature review to develop a re-conceptualised and synthesized framework for managing the organizational issues associated with shared leadership on various organizational levels. The paper rectifies this by identifying the critical factors and mechanisms which enable shared leadership...... and its antecedents and outcomes, and to develop a re-conceptualized and synthesized framework of shared leadership. The paper closes with a brief discussion of avenues for future research and implications for managers.......The aim of this paper is twofold. First, this paper comprehensively will review the conceptual and empirical literature to identify such critical underlying mechanisms which enable shared or collective leadership. Second, this article identifies the antecedents and outcomes of shared leadership...

  11. Transcriptional Mechanisms of Drug Addiction

    2012-01-01

    Regulation of gene expression is considered a plausible mechanism of drug addiction given the stability of behavioral abnormalities that define an addicted state. Numerous transcription factors, proteins that bind to regulatory regions of specific genes and thereby control levels of their expression, have been implicated in the addiction process over the past decade or two. Here we review the growing evidence for the role played by several prominent transcription factors, including a Fos family protein (ΔFosB), cAMP response element binding protein (CREB), and nuclear factor kappa B (NFκB), among several others, in drug addiction. As will be seen, each factor displays very different regulation by drugs of abuse within the brain's reward circuitry, and in turn mediates distinct aspects of the addiction phenotype. Current efforts are geared toward understanding the range of target genes through which these transcription factors produce their functional effects and the underlying molecular mechanisms involved. This work promises to reveal fundamentally new insight into the molecular basis of addiction, which will contribute to improved diagnostic tests and therapeutics for addictive disorders. PMID:23430970

  12. Modeling Addictive Consumption as an Infectious Disease

    Alamar Benjamin; Glantz Stanton A.

    2006-01-01

    The dominant model of addictive consumption in economics is the theory of rational addiction. The addict in this model chooses how much they are going to consume based upon their level of addiction (past consumption), the current benefits and all future costs. Several empirical studies of cigarette sales and price data have found a correlation between future prices and consumption and current consumption. These studies have argued that the correlation validates the rational addiction model an...

  13. Gaming: from Addiction Mechanisms to Clinical Practices

    Thorens, Gabriel

    2016-01-01

    Video game addiction is the main theme of this thesis. After a brief definition of addiction, the focus is on the specific addictive properties of Internet and games. Massively multiplayer online role-playing games (MMORPGs) are described, as they tend to be the most addictive type of game, with a specific focus on World of Warcraft (WoW). Issues of diagnostic criteria for Internet addiction and Internet gaming disorder (IGD) are be presented.

  14. Genetic signatures of heroin addiction

    Chen, Shaw-Ji; Liao, Ding-Lieh; Shen, Tsu-Wang; Yang, Hsin-Chou; Chen, Kuang-Chi; Chen, Chia-Hsiang

    2016-01-01

    Abstract Heroin addiction is a complex psychiatric disorder with a chronic course and a high relapse rate, which results from the interaction between genetic and environmental factors. Heroin addiction has a substantial heritability in its etiology; hence, identification of individuals with a high genetic propensity to heroin addiction may help prevent the occurrence and relapse of heroin addiction and its complications. The study aimed to identify a small set of genetic signatures that may reliably predict the individuals with a high genetic propensity to heroin addiction. We first measured the transcript level of 13 genes (RASA1, PRKCB, PDK1, JUN, CEBPG, CD74, CEBPB, AUTS2, ENO2, IMPDH2, HAT1, MBD1, and RGS3) in lymphoblastoid cell lines in a sample of 124 male heroin addicts and 124 male control subjects using real-time quantitative PCR. Seven genes (PRKCB, PDK1, JUN, CEBPG, CEBPB, ENO2, and HAT1) showed significant differential expression between the 2 groups. Further analysis using 3 statistical methods including logistic regression analysis, support vector machine learning analysis, and a computer software BIASLESS revealed that a set of 4 genes (JUN, CEBPB, PRKCB, ENO2, or CEBPG) could predict the diagnosis of heroin addiction with the accuracy rate around 85% in our dataset. Our findings support the idea that it is possible to identify genetic signatures of heroin addiction using a small set of expressed genes. However, the study can only be considered as a proof-of-concept study. As the establishment of lymphoblastoid cell line is a laborious and lengthy process, it would be more practical in clinical settings to identify genetic signatures for heroin addiction directly from peripheral blood cells in the future study. PMID:27495086

  15. Drug addiction and social discourses

    Rita de Cássia dos Santos Canabarro

    2012-09-01

    Full Text Available This article analyzes the various discursive positions found in the phenomenon of addiction. The relations these discursive positions establish with the discourses of the master, the hysteric, the university and the capitalist are discussed. By analyzing material from clinical listening at a public outpatient drug and alcohol rehab center, it was seen that addiction can be described in different discourses. This article shows that the shift of focus from the symptom to the discursive position of the subject is an indicator for the clinical treatment of addiction.

  16. Drug addiction and periodontal diseases

    Saini, Gurpreet Kaur; Gupta, N. D.; Prabhat, K. C.

    2013-01-01

    The prevalence of drug addiction is increasing globally. Drug abuse damages many parts of the body such as oral cavity, lungs, liver, brain, heart etc., Addicts suffer from physical, psychological, emotional and behavioral problems. Their nutrition is also compromised. There is certainly an impact of all these factors on the health of periodontium. Dentists should be aware of the effects of drugs while treating the drug addicts. This article correlates the studies done on the impact of abused drugs such as alcohol, tobacco, opiates, cannabis, amphetamines etc., on general and periodontal health. PMID:24174750

  17. Shared Attention.

    Shteynberg, Garriy

    2015-09-01

    Shared attention is extremely common. In stadiums, public squares, and private living rooms, people attend to the world with others. Humans do so across all sensory modalities-sharing the sights, sounds, tastes, smells, and textures of everyday life with one another. The potential for attending with others has grown considerably with the emergence of mass media technologies, which allow for the sharing of attention in the absence of physical co-presence. In the last several years, studies have begun to outline the conditions under which attending together is consequential for human memory, motivation, judgment, emotion, and behavior. Here, I advance a psychological theory of shared attention, defining its properties as a mental state and outlining its cognitive, affective, and behavioral consequences. I review empirical findings that are uniquely predicted by shared-attention theory and discuss the possibility of integrating shared-attention, social-facilitation, and social-loafing perspectives. Finally, I reflect on what shared-attention theory implies for living in the digital world. PMID:26385997

  18. New Dimensions, New Addictions: The Internet Sex Addiction

    Silvia Sánchez Zaldívar; Itziar Iruarrizaga Díez

    2010-01-01

    The network is endless: going anywhere, finding anything, being anyone. Typing the word sex on Google gives a figure of 96 million results. The network is changing our way of communication and relation; we can construct space-time coordinates before incompatible. Internet addiction is not recognized as a disorder in DSM-IV-TR or ICD-10. Both types of Internet addiction with sexual content are cybersex and pornography. Cybersex consists in experiencing sexual stimulation while maintaining s...

  19. Comparison of Personality Characteristics and Problem Solving Styles in Addicted and Non-Addicted Men

    Mohammad Narimani; Yaghob Habibi; Saeed Rajabi

    2011-01-01

    Introduction: The present study sought to compare emotional intelligence and quality of life in addicted and non-addicted men. Method: The samples included 80 addicted and 80 non-addicted men who addicted men were selected by available sampling and non-addicted men were chosen by cloning methods according to age and marital status. For data collection, emotional intelligence scale and quality of life questionnaire were used. Variance test and Pearson correlation were used for data analysis. ...

  20. Occupation-Based Intervention for Addictive Disorders: A Systematic Review.

    Wasmuth, Sally; Pritchard, Kevin; Kaneshiro, Kellie

    2016-03-01

    Addictive disorders disrupt individuals' occupational lives, suggesting that occupational therapists can play a crucial role in addiction rehabilitation. Occupation-based interventions are those in which an occupation is performed, and occupations are defined as those activities a person engages in to structure time and create meaning in one's life. This review asked: In persons with addictive disorders, are occupation-based interventions more effective than treatment as usual in improving short and long-term recovery outcomes? A systematic literature search was performed by a medical librarian in Ovid MEDLINE, PsychINFO, Social Work Abstracts, OTSeeker, HealthSTAR, CINAHL, and ACPJournalClub. Authors screened 1095 articles for inclusion criteria (prospective outcome studies examining the effectiveness of an occupation-based intervention with a sample primarily consisting of a diagnosis of a substance-related or addictive disorder and with at least five participants), and two authors appraised the resulting 66 articles using a standard appraisal tool, yielding 26 articles for qualitative synthesis and 8 with shared outcome measures for quantitative analysis. Occupation-based interventions in the areas of work, leisure, and social participation were found to have been used to treat addictive disorders. Occupation-based interventions in the area of social participation all elicited better outcomes than their respective control/comparison groups. Not all occupation-based interventions in the area of leisure elicited better outcomes than their comparison group, but in the eight articles with shared outcome measures, quantitative analysis demonstrated leisure interventions produced larger effect sizes than social participation interventions. PMID:26738639

  1. Knowledge Sharing

    Holdt Christensen, Peter

    The concept of knowledge management has, indeed, become a buzzword that every single organization is expected to practice and live by. Knowledge management is about managing the organization's knowledge for the common good of the organization -but practicing knowledge management is not as simple as...... that. This article focuses on knowledge sharing as the process seeking to reduce the resources spent on reinventing the wheel.The article introduces the concept of time sensitiveness; i.e. that knowledge is either urgently needed, or not that urgently needed. Furthermore, knowledge sharing is...... considered as either a push or pull system. Four strategies for sharing knowledge - help, post-it, manuals and meeting, and advice are introduced. Each strategy requires different channels for sharing knowledge. An empirical analysis in a production facility highlights how the strategies can be practiced....

  2. Video Game Use in the Treatment of Amblyopia: Weighing the Risks of Addiction.

    Xu, Chaoying S; Chen, Jessica S; Adelman, Ron A

    2015-09-01

    Video games have surged in popularity due to their entertainment factor and, with recent innovation, their use in health care. This review explores the dual facets of video games in treating vision impairment in amblyopia as well as their potential for overuse and addiction. Specifically, this review examines video game addiction from a biopsychosocial perspective and relates the addictive qualities of video games with their use as a therapeutic treatment for amblyopia. Current literature supports both the identification of video game addiction as a disease, as well as the therapeutic potential of video games in clinical trials. We show the need for clinicians to be aware of the dangers associated with video game overuse and the need for future studies to examine the risks associated with their health care benefits. PMID:26339215

  3. Cocaine Addiction: Psychology and Neurophysiology.

    Gawin, Frank H.

    1991-01-01

    The clinical characteristics of cocaine addiction, cocaine abstinence symptoms, and the short-term and long-term neurochemical actions of cocaine are discussed. The relative therapeutic value of various medications and treatment programs are discussed. (KR)

  4. Relapse prevention for addictive behaviors

    George William H; Witkiewitz Katie; Hendershot Christian S; Marlatt G Alan

    2011-01-01

    Abstract The Relapse Prevention (RP) model has been a mainstay of addictions theory and treatment since its introduction three decades ago. This paper provides an overview and update of RP for addictive behaviors with a focus on developments over the last decade (2000-2010). Major treatment outcome studies and meta-analyses are summarized, as are selected empirical findings relevant to the tenets of the RP model. Notable advances in RP in the last decade include the introduction of a reformul...

  5. The epigenetic landscape of addiction

    Maze, Ian; Nestler, Eric J.

    2011-01-01

    Drug-induced alterations in gene expression throughout the reward circuitry of the brain are likely components of the persistence of the drug-addicted state. Recent studies examining the molecular mechanisms controlling drug-induced transcriptional, behavioral and synaptic plasticity have indicated a direct role for chromatin remodeling in the regulation and stability of drug-mediated neuronal gene programs, and the subsequent promulgation of addictive behaviors. In this review, we discuss re...

  6. Epigenetic Mechanisms of Drug Addiction

    Nestler, Eric J.

    2013-01-01

    Drug addiction involves potentially life-long behavioral abnormalities that are caused in vulnerable individuals by repeated exposure to a drug of abuse. The persistence of these behavioral changes suggests that long-lasting changes in gene expression, within particular regions of the brain, may contribute importantly to the addiction phenotype. Work over the past decade has demonstrated a crucial role for epigenetic mechanisms in driving lasting changes in gene expression in diverse tissues,...

  7. Imaging the Addicted Human Brain

    Fowler, Joanna S.; Volkow, Nora D.; Kassed, Cheryl A; Chang, Linda

    2007-01-01

    Modern imaging techniques enable researchers to observe drug actions and consequences as they occur and persist in the brains of abusing and addicted individuals. This article presents the five most commonly used techniques, explains how each produces images, and describes how researchers interpret them. The authors give examples of key findings illustrating how each technique has extended and deepened our knowledge of the neurobiological bases of drug abuse and addiction, and they address po...

  8. What Does Addiction Mean to Me

    Hesse, Morten

    2006-01-01

    Addiction is compulsive need for and use of a habit-forming substance. Addiction is accepted as a mental illness in the diagnostic nomenclature and results in substantial health, social and economic problems. In the diagnostic nomenclature, addiction was originally included in the personality...... disorders along with other behaviours considered deviant. But it is now considered a clinical syndrome. Addiction is multifactorially determined, with substantial genetic influence. The development of addictions is also influenced by environmental factors, and interplay between the two. In the clinical...... context, addiction puts problem substance use on the agenda, and helps focus on the difficulties associated with drug use. But the concept of addiction is also used to distance the user from addicts, and in this way, may be counter-therapeutic. The addiction concept has also had a substantial influence on...

  9. Addiction Severity Index in a chronic pain sample receiving opioid therapy

    Saffier, Kenneth; Colombo, Cynthia; Brown, David; Mundt, Marlon P.; Fleming, Michael F.

    2007-01-01

    The treatment of chronic pain with opioids remains controversial. Physicians are concerned about addiction and drug diversion, and there is limited empirical information on using opioids with chronic pain patients. This report presents data collected on the Addiction Severity Index (ASI) in a sample of patients (n=908) receiving opioids from their primary care physicians. The ASI provides clinically important information about patients receiving opioid therapy. The ASI consists of seven subsc...

  10. Management of opioid addiction with buprenorphine: French history and current management

    Poloméni P; Schwan R

    2014-01-01

    Pierre Poloméni,1 Raymund Schwan2,3 1Department of Addictology, Paris Seine Saint Denis University Hospital, AP-HP, Site René Muret Sevran, France; 2Care Center for the Treatment and Prevention of Addictions (CSAPA), Nancy University Hospital, 3General Psychiatric Division for the Greater Nancy Urban Community, Psychotherapeutic Center of Nancy, Laxou, France Abstract: The way in which opioid addiction is managed in France is unique, as it is based on the prescription o...

  11. Addiction: Beyond dopamine reward circuitry

    Volkow, N.D.; Wang, G.; Volkow, N.D.; Wang, G.-J.; Fowler, J.S.; Tomasi, D.; Telang, F.

    2011-09-13

    Dopamine (DA) is considered crucial for the rewarding effects of drugs of abuse, but its role in addiction is much less clear. This review focuses on studies that used PET to characterize the brain DA system in addicted subjects. These studies have corroborated in humans the relevance of drug-induced fast DA increases in striatum [including nucleus accumbens (NAc)] in their rewarding effects but have unexpectedly shown that in addicted subjects, drug-induced DA increases (as well as their subjective reinforcing effects) are markedly blunted compared with controls. In contrast, addicted subjects show significant DA increases in striatum in response to drug-conditioned cues that are associated with self-reports of drug craving and appear to be of a greater magnitude than the DA responses to the drug. We postulate that the discrepancy between the expectation for the drug effects (conditioned responses) and the blunted pharmacological effects maintains drug taking in an attempt to achieve the expected reward. Also, whether tested during early or protracted withdrawal, addicted subjects show lower levels of D2 receptors in striatum (including NAc), which are associated with decreases in baseline activity in frontal brain regions implicated in salience attribution (orbitofrontal cortex) and inhibitory control (anterior cingulate gyrus), whose disruption results in compulsivity and impulsivity. These results point to an imbalance between dopaminergic circuits that underlie reward and conditioning and those that underlie executive function (emotional control and decision making), which we postulate contributes to the compulsive drug use and loss of control in addiction.

  12. Moral judgment of alcohol addicts

    Mladenović Ivica

    2010-01-01

    Full Text Available Introduction. Alcoholism could represent an important factor of crime and different forms of abuse of family members (physical and emotional exist in many alcohol-addict cases, as well as characteristics of immoral behaviour. Objective. The objective of our study was to determine the predominating forms in moral judgment of alcohol addicts, and to examine whether there was any statistically significant difference in moral judgment between alcohol addicted persons and non-alcoholics from general population. Methods. The sample consisted of 62 subjects, divided into a study (alcoholics and a control group (non-alcoholics from general population. The following instruments were used: social-demographic data, AUDIT, MMPI-201, cybernetic battery of IQ tests (KOG-3 and the TMR moral reasoning test. Results. Mature forms of moral judgment prevailed in both group of subjects, alcohol addicted persons and non-alcoholics. Regarding mature forms of moral judgment (driven by emotions and cognitive non-alcoholics from the general population had higher scores, but the difference was not statistically significant. Regarding socially adapted and egocentric orientation alcohol addicted persons had higher scores. However, only regarding intuitive-irrational orientation there was a statistically significant difference in the level of moral judgment (p<0.05 between alcoholics and non-alcoholics, in favour of the alcoholics. Conclusion. Moral judgment is not a category differing alcohol addicted persons from those who are not. Nevertheless, the potential destructivity of alcoholism is reflected in lower scores regarding mature orientations in moral judgment.

  13. Addiction: Beyond dopamine reward circuitry

    Dopamine (DA) is considered crucial for the rewarding effects of drugs of abuse, but its role in addiction is much less clear. This review focuses on studies that used PET to characterize the brain DA system in addicted subjects. These studies have corroborated in humans the relevance of drug-induced fast DA increases in striatum [including nucleus accumbens (NAc)] in their rewarding effects but have unexpectedly shown that in addicted subjects, drug-induced DA increases (as well as their subjective reinforcing effects) are markedly blunted compared with controls. In contrast, addicted subjects show significant DA increases in striatum in response to drug-conditioned cues that are associated with self-reports of drug craving and appear to be of a greater magnitude than the DA responses to the drug. We postulate that the discrepancy between the expectation for the drug effects (conditioned responses) and the blunted pharmacological effects maintains drug taking in an attempt to achieve the expected reward. Also, whether tested during early or protracted withdrawal, addicted subjects show lower levels of D2 receptors in striatum (including NAc), which are associated with decreases in baseline activity in frontal brain regions implicated in salience attribution (orbitofrontal cortex) and inhibitory control (anterior cingulate gyrus), whose disruption results in compulsivity and impulsivity. These results point to an imbalance between dopaminergic circuits that underlie reward and conditioning and those that underlie executive function (emotional control and decision making), which we postulate contributes to the compulsive drug use and loss of control in addiction.

  14. Exercise rehabilitation for smartphone addiction.

    Kim, Hyunna

    2013-01-01

    Internet addiction after launching smartphone is becoming serious. Therefore this paper has attempted to sketch out the diverse addiction treatment and then check the feasibility of exercise rehabilitation. The reason to addict the internet or smartphone is personalized individual characters related personal psychological and emotional factors and social environmental factors around them. We have shown that 2 discernible approaches due to 2 different addiction causes: that is behavioral treatment and complementary treatment. In the behavioral treatment, cognitive behavioral approach (CBT) is representative methods for changing additive thoughts and behaviors. Motivational interviewing (MI) is also the brief approach for persons not ready to change their behavior. Mindfulness behavioral cognitive treatment (MBCT) also the adapted treatment based on CBT. There are different types following the emphatic point, mindfulness-based relapse prevention (MBRP) or mindfulness oriented recovery enhancement (MORE). It is apparent that therapeutic recreation, music therapy using drumming activity, and art therapy are useful complementary treatment. Exercise rehabilitation contained the systematic procedures and comprehensive activities compared to previous addiction treatments by contents and techniques. Exercise rehabilitation can treat both physical symptoms at first and mental problems in the next step. So more evidence-based exercise rehabilitation researches need to do, but it is highly probable that exercise rehab can apply for smartphone addiction. PMID:24409425

  15. Tolerance and addiction; the patient, the parent or the clinician?

    Jenkins, Ian A

    2011-07-01

    Tolerance has been recognized for some time where chronic exposure to certain drugs, particularly benzodiazepines and opioids, is associated with apparent tachyphylaxis. When these drugs are stopped or progressively reduced as in 'tapering', withdrawal symptoms may result. Tolerance and the flip side of the coin, withdrawal, are the determinants of addiction. It is increasingly apparent that tolerance can occur acutely, even within the time span of a single anesthetic for a surgical procedure. Addiction is caused by agents, foreign to the body, that provoke adaptation by homeostatic biological processes. When these agents are withdrawn, the adaptive mechanisms, devoid of substrate, take time to diminish and produce symptoms recognizable under the term of 'withdrawal'. Children may be exposed to these agents in different ways; in utero, as a result of substances that the mother ingests by enteral, parenteral or inhalational means that are transmitted to the infant via the placenta; as a result of an anesthetic for surgery; or as a result of sedation and analgesia administered to offset the stresses and trauma inherent from intensive care treatment in the neonatal intensive care unit or pediatric intensive care unit. Additionally, anesthetic and intensive care staff are exposed to powerful and addictive drugs as part of everyday practice, not simply by overt access, but also by subliminal environmental exposure. PMID:21199135

  16. Drug Addiction Treatment in the Criminal Justice System

    ... Addiction Treatment in the Criminal Justice System Drug Addiction Treatment in the Criminal Justice System Email Facebook ... Research-Based Guide provides research-based principles of addiction treatment. The 13 principles are: Drug addiction is ...

  17. End-of-life care communications and shared decision-making in Norwegian nursing homes - experiences and perspectives of patients and relatives

    Gjerberg, Elisabeth; Lillemoen, Lillian; Førde, Reidun; Pedersen, Reidar

    2015-01-01

    Background Involving nursing home patients and their relatives in end-of-life care conversations and treatment decisions has recently gained increased importance in several Western countries. However, there is little knowledge about how the patients themselves and their next-of-kin look upon involvement in end-of-life care decisions. The purpose of this paper is to explore nursing home patients’ and next-of-kin’s experiences with- and perspectives on end-of-life care conver...

  18. A Framework for the Specificity of Addictions

    Myriam Forster

    2011-08-01

    Full Text Available Research over the last two decades suggests that a wide range of substance and behavioral addictions may serve similar functions. Yet, co-occurrence of addictions has only been reported among a minority of addicts. “Addiction specificity” pertains to a phenomenon in which one pattern of addictive behaviors may be acquired whereas another is not. This paper presents the PACE model as a framework which might help explain addiction specificity. Pragmatics, attraction, communication, and expectation (PACE variables are described, which may help give some direction to future research needs in this arena.

  19. [Addiction--who is not affected?].

    Bäwert, Andjela; Fischer, Gabriele

    2005-12-01

    Addiction and addiction-related behaviour increased during the past decades. Several substances with psychoactive attributes, like opioids, cocaine or alcohol, can lead to dependence with physical and/or mental symptoms. In addition to substance-related addiction, non-substance-related dependence requires special attention. Increasing numbers of workaholics and patients suffering from internet-addiction, gambling or eating-disorders can be observed. To meet international treatment standards for addiction, diversification of therapy is necessary and, additionally, gender-related aspects in development and treatment of dependence and addiction-related behaviour are essential for state-of-the-art therapy of this patient population. PMID:16425010

  20. Cerebral edema in drug addicts

    Daruši Dragana J.

    2014-01-01

    Full Text Available Background/Aim. The effect of drugs leaves permanent consequences on the brain, organic in type, followed by numerous manifestations, and it significantly affects the development of mental dysfunctions. The clinicians are often given a task to estimate a patient’s personality during treatment or during experts estimate of a drug addict. The aim of this research was to determine the differences, if any, in characteristics of addicts experience and personality traits in drug addicts with or without cerebral edema. Methods. The research was conducted on a sample of 252 male drug addicts, the average age of 23.3 (SD = 4.3 years. Cerebral edema was confirmed on magnetic resonance (MR images of the brain performed during the treatment of the addicts. The participants were tested by the psychologists using Minnesota Multiphasic Personality Inventory (MMPI-201 test, and the data were processed using canonical discriminate analysis within the SPSS program. The dependent variable in the study was cerebral edema. A block of independent variables, designed for the requirements of this study, consisted of two subgroups. The first one consisted of 12 variables describing the relevant characteristics of drug abuse. The second subgroup consisted of 8 psychopathological tendencies in the personality defined by the mentioned test. Results. Cerebral edema was confirmed in 52 (20.63% of the drug addicts. The differences between the groups of drug addicts with and without cerebral edema were determined in the following: the time span of taking drugs (0.301, use of alcohol parallel with drugs (0.466, and treatment for addiction (0.603. In the drug addicts with a cerebral edema, MMPI-201 confirmed the increase in the scales for hypochondria, psychopathic deviations and psychastenia, and the decrease in the scales for schizophrenia and depression. Conclusion. Our study confirmed a possible connection between cerebral edema and personality traits in a number of the

  1. Epigenetic mechanisms of drug addiction.

    Nestler, Eric J

    2014-01-01

    Drug addiction involves potentially life-long behavioral abnormalities that are caused in vulnerable individuals by repeated exposure to a drug of abuse. The persistence of these behavioral changes suggests that long-lasting changes in gene expression, within particular regions of the brain, may contribute importantly to the addiction phenotype. Work over the past decade has demonstrated a crucial role for epigenetic mechanisms in driving lasting changes in gene expression in diverse tissues, including brain. This has prompted recent research aimed at characterizing the influence of epigenetic regulatory events in mediating the lasting effects of drugs of abuse on the brain in animal models of drug addiction. This review provides a progress report of this still early work in the field. As will be seen, there is robust evidence that repeated exposure to drugs of abuse induces changes within the brain's reward regions in three major modes of epigenetic regulation-histone modifications such as acetylation and methylation, DNA methylation, and non-coding RNAs. In several instances, it has been possible to demonstrate directly the contribution of such epigenetic changes to addiction-related behavioral abnormalities. Studies of epigenetic mechanisms of addiction are also providing an unprecedented view of the range of genes and non-genic regions that are affected by repeated drug exposure and the precise molecular basis of that regulation. Work is now needed to validate key aspects of this work in human addiction and evaluate the possibility of mining this information to develop new diagnostic tests and more effective treatments for addiction syndromes. This article is part of a Special Issue entitled 'NIDA 40th Anniversary Issue'. PMID:23643695

  2. Which foods may be addictive? The roles of processing, fat content, and glycemic load.

    Erica M Schulte

    Full Text Available We propose that highly processed foods share pharmacokinetic properties (e.g. concentrated dose, rapid rate of absorption with drugs of abuse, due to the addition of fat and/or refined carbohydrates and the rapid rate the refined carbohydrates are absorbed into the system, indicated by glycemic load (GL. The current study provides preliminary evidence for the foods and food attributes implicated in addictive-like eating.Cross-sectional.University (Study One and community (Study Two.120 undergraduates participated in Study One and 384 participants recruited through Amazon MTurk participated in Study Two.In Study One, participants (n = 120 completed the Yale Food Addiction Scale (YFAS followed by a forced-choice task to indicate which foods, out of 35 foods varying in nutritional composition, were most associated with addictive-like eating behaviors. Using the same 35 foods, Study Two utilized hierarchical linear modeling to investigate which food attributes (e.g., fat grams were related to addictive-like eating behavior (at level one and explored the influence of individual differences for this association (at level two.In Study One, processed foods, higher in fat and GL, were most frequently associated with addictive-like eating behaviors. In Study Two, processing was a large, positive predictor for whether a food was associated with problematic, addictive-like eating behaviors. BMI and YFAS symptom count were small-to-moderate, positive predictors for this association. In a separate model, fat and GL were large, positive predictors of problematic food ratings. YFAS symptom count was a small, positive predictor of the relationship between GL and food ratings.The current study provides preliminary evidence that not all foods are equally implicated in addictive-like eating behavior, and highly processed foods, which may share characteristics with drugs of abuse (e.g. high dose, rapid rate of absorption appear to be particularly associated with

  3. Successful Shared Governance Through Education.

    Brull, Stacey

    2015-01-01

    Shared governance is one way nurses can attain a healthy work environment. Having direct-care nurses involved in raising relevant clinical and operational issues and creating systematic approaches has been linked to greater levels of empowerment which is often transposed into shared governance. Nurse leaders at one hospital used a comprehensive educational strategy to implement shared governance in less than 2 years. An authoritative style of leadership and decision making does not meet the needs of today's complex health care environment; nor does it meet the needs of today's employees. The focus on a very deliberate and educational strategy for shared governance was successful in building the structures and processes needed to take a unit and division from traditional governance to shared governance in less than 2 years. PMID:26845819

  4. The "addicted" spine.

    Spiga, Saturnino; Mulas, Giovanna; Piras, Francesca; Diana, Marco

    2014-01-01

    Units of dendritic branches called dendritic spines represent more than simply decorative appendages of the neuron and actively participate in integrative functions of "spinous" nerve cells thereby contributing to the general phenomenon of synaptic plasticity. In animal models of drug addiction, spines are profoundly affected by treatments with drugs of abuse and represent important sub cellular markers which interfere deeply into the physiology of the neuron thereby providing an example of the burgeoning and rapidly increasing interest in "structural plasticity". Medium Spiny Neurons (MSNs) of the Nucleus Accumbens (Nacc) show a reduced number of dendritic spines and a decrease in TH-positive terminals upon withdrawal from opiates, cannabinoids and alcohol. The reduction is localized "strictly" to second order dendritic branches where dopamine (DA)-containing terminals, impinging upon spines, make synaptic contacts. In addition, long-thin spines seems preferentially affected raising the possibility that cellular learning of these neurons may be selectively hampered. These findings suggest that dendritic spines are affected by drugs widely abused by humans and provide yet another example of drug-induced aberrant neural plasticity with marked reflections on the physiology of synapses, system structural organization, and neuronal circuitry remodeling. PMID:25324733

  5. Pain Raises Risk of Opioid Addiction

    ... fullstory_160033.html Pain Raises Risk of Opioid Addiction Men and younger people had higher odds of ... had a 41 percent higher risk of opioid addiction than those with no pain. That increased risk ...

  6. FDA Approves Implant to Battle Opioid Addiction

    ... gov/medlineplus/news/fullstory_159050.html FDA Approves Implant to Battle Opioid Addiction Experts say steady dosing ... 26, 2016 (HealthDay News) -- A new long-acting implant that can help treat people addicted to heroin ...

  7. Behavioral Therapy, Incentives Enhance Addiction Treatment

    ... Research News From NIH Behavioral Therapy, Incentives Enhance Addiction Treatment Past Issues / Summer 2006 Table of Contents ... that people who are trying to end their addiction to marijuana can benefit from a treatment program ...

  8. Signs of Drug Abuse and Addiction

    ... Download "I feel so helpless against his addiction." Matt's brother Stephen is addicted to meth. Matt wants to help Stephen, but he isn't sure how. Read Matt's story About the National Institute on Drug Abuse ( ...

  9. [Does really sex addiction exist?].

    Echeburúa, Enrique

    2012-01-01

    Hypersexual Disorder has been proposed as a new psychiatric disorder for DSM-V, characterized by an increased frequency and intensity of sexually motivated fantasies, arousal, urges, and enacted behavior in association with an impulsivity component. Excessive appetitive and consummatory behaviors, including hypersexuality, can become a non-chemical addiction. Sexual addiction afflicts people having paraphilic or nonparaphilic behaviors associated with progressive risk-taking sexual behaviors, escalation or progression of sexual behaviors (tolerance), loss of control and significant adverse psychosocial consequences, such as unplanned pregnancy, pair-bond dysfunction, marital separation, financial problems and sexually transmitted diseases including HIV. The most common behaviors involved in sexual addiction are fantasy sex, compulsive masturbation, pornography, cybersex, voyeuristic sex, anonymous sex and multiple sexual partners. These behaviors are intended to reduce anxiety and other dysphoric affects (e.g., shame and depression). Axis I psychiatric diagnosis, especially mood disorders, psychoactive substance abuse disorders and attention deficit hyperactivity disorders, are common comorbid disorders with sexual addiction. There are significant gaps in the current scientific knowledge base regarding the clinical course, development risk factors and family history and data on women with sexual addiction are lacking. PMID:23241714

  10. Rationally Addicted to Drinking and Smoking?

    Bask, Mikael; Melkersson, Maria

    2001-01-01

    When modeling demand for addictive consumption goods, the most widely used framework is the rational addiction model proposed by Becker and Murphy (1988). In the present paper, we extend the rational addiction model to include two addictive consumption goods, alcohol and cigarettes. We estimate the aggregate demand for alcohol and cigarettes in Sweden, using aggregate annual time series on sales volumes for the period 1955-1999. OLS estimates are compared to GMM estimates allowing for possibl...

  11. The Neural Rejuvenation Hypothesis of Cocaine Addiction

    Dong, Yan; Nestler, Eric J.

    2014-01-01

    A leading hypothesis guiding current molecular and cellular research of drug addiction conceptualizes key aspects of addiction as a form of memory, in which common neuroplasticity mechanisms that mediate normal learning and memory processes are “hijacked” by exposure to drugs of abuse to produce pathologic addiction-related memories. Such addiction-related memories are particularly robust and long-lasting and once formed, less amenable to updating. Here, we propose the Neural Rejuvenation Hyp...

  12. Systems Level Neuroplasticity in Drug Addiction

    Feltenstein, Matthew W.; See, Ronald E.

    2013-01-01

    Drug addiction is a chronic relapsing disorder for which research has been dedicated to understand the various factors that contribute to development, loss of control, and persistence of compulsive addictive behaviors. In this review, we provide a broad overview of various theories of addiction, drugs of abuse, and the neurobiology involved across the addiction cycle. Specific focus is devoted to the role of the mesolimbic pathway in acute drug reinforcement and occasional drug use, the mesoc...

  13. Shifting blame: Buprenorphine prescribers, addiction treatment, and prescription monitoring in middle-class America.

    Mendoza, Sonia; Rivera-Cabrero, Allyssa S; Hansen, Helena

    2016-08-01

    Growing nonmedical prescription opioid analgesic use among suburban and rural Whites has changed the public's perception of the nature of opioid addiction, and of appropriate interventions. Opioid addiction has been recast as a biological disorder in which patients are victims of their neurotransmitters and opioid prescribers are irresponsible purveyors of dangerous substances requiring controls. This framing has led to a different set of policy responses than the "War on Drugs" that has focused on heroin trade in poor urban communities; in response to prescription opioid addiction, prescription drug monitoring programs and tamper-resistant opioid formulations have arisen as primary interventions in place of law enforcement. Through the analysis of preliminary findings from interviews with physicians who are certified to manage opioid addiction with the opioid pharmaceutical buprenorphine, we argue that an increase in prescriber monitoring has shifted the focus from addicted people to prescribers as a threat, paradoxically driving users to illicit markets and constricting their access to pharmaceutical treatment for opioid addiction. Prescriber monitoring is also altering clinical cultures of care, as general physicians respond to heightened surveillance and the psychosocial complexities of treating addiction with either rejection of opioid dependent patients, or with resourceful attempts to create support systems for their treatment where none exists. PMID:27488225

  14. Addictions as passions. Ancient wisdom for modern issues

    Moldovan S.

    2015-03-01

    Full Text Available In order to theologically explain the concept of addictive (dependent behavior as distorting processes of self-determination and will (sinful passion, the author analyzed the classic work of the Eastern Christian Orthodox traditional school represented by Maximus Confessor (VII th century CE. It is shown that the ancient model of submission of the human will in the passions fits into modern concepts of nonlinear conjugate cognitive and affective complexes within the self-determination process and the formation of addictiveness, and moreover this model is required now. The results show the failure of one-sided considerations of the voluntary/involuntary character of addiction, when neglecting the dialectic of consciousness and unconsciousness in human volition. Healing or purification of the soul takes place by refo-cusing one's love upon her unique original purpose — especially the real love for God. It seems that a careful pro-active attitude to the passions also performs important environmental function, while reconstructing the ontological meaning of love. The author summarizes his study as evidence that the cause of addictive behavior today as well as the recovery from it are the same phenomena as in ancient times.

  15. Family Functioning of Addicted and Non-Addicted Individuals: A Comparative Study

    Hosseinbor, Mohsen; Bakhshani, Nour-Mohammad; Shakiba, Mansour

    2012-01-01

    Background Family functioning is considered to have a significant impact on the beginnings and maintenance of substance use. Objectives The main purpose of this study was to examine and compare the dimensions of family functioning among addicted and non-addicted individuals. Patients and Methods In this cross-sectional study, the study sample consisted of 228 individuals, including 118 addicted and 110 non-addicted subjects. The addicted persons were recruited from patients who attended the B...

  16. The Experience of Addiction as Told by the Addicted: Incorporating Biological Understandings into Self-Story

    Hammer, Rachel R.; Dingel, Molly J; Ostergren, Jenny E.; Nowakowski, Katherine E; Koenig, Barbara A.

    2012-01-01

    How do the addicted view addiction against the framework of formal theories that attempt to explain the condition? In this empirical paper, we report on the lived experience of addiction based on 63 semi-structured, open-ended interviews with individuals in treatment for alcohol and nicotine abuse at five sites in Minnesota. Using qualitative analysis, we identified four themes that provide insights into understanding how people who are addicted view their addiction, with particular emphasis ...

  17. A Comparison of Attentional Bias Towards Drug Cues in Addicts and Non-Addicts

    Zamani, Seyedeh Narjes; Mansouri, Houri; Fazilatpour, Masoud; Shamsai, Zahra

    2014-01-01

    Background: According to recent theories on addiction, attentional bias towards drug-related stimuli plays a pivotal role in the initiation of drug abuse. Objectives: The present study attempted to investigate attentional bias towards drug-related words in addicts and non-addicts. Patients and Methods: To attain the objectives, following a causal-comparative study, a number of 15 addicts under treatment in anonymous groups, and 15 non-addicts from among students at Isfahan University were sel...

  18. Addiction to smartphone games : Using smartphone game components to create an addiction

    Holmgren, Johan

    2016-01-01

    Smartphone games are very popular and have the highest revenue of all smartphone application categories. Some even suggest that the the games can create an addiction. This addiction has however not been classified as a disorder and the components in the games that create an addiction have not been determined. This thesis had two goals. The first was to investigate and identify addictive components in smartphone games. The second goal was to use these components to develop an addictive proof o...

  19. Tobacco Addiction: 'Why Do I Smoke?' Quiz

    MENU Return to Web version Tobacco Addiction | “Why do I smoke?" Quiz Why do I smoke? If you learn the answer to this question, it will be easier to ... m hooked." In addition to having a psychological addiction to smoking, you may also be physically addicted ...

  20. A Meaning-Centered Therapy for Addictions

    Thompson, Geoff

    2012-01-01

    This article describes a treatment for addictions, based on the idea that addiction is a response to living a life that has little personal meaning. First, it presents the theory of Meaning-Centered Therapy (MCT) as developed by Paul Wong, particularly the need to understand intoxication from the addict's perspective. Next, it presents the…

  1. Real-Life Stories about Addiction Struggles

    ... turn Javascript on. Feature: Preventing Drug Abuse and Addiction Real-Life Stories About Addiction Struggles Past Issues / Fall 2011 Table of Contents “ ... VIDEO NIHSeniorHealth Videos Offer Real-Life Stories About Addiction Struggles—and Much More Many of the health ...

  2. [Workaholism, another form of addiction].

    Scheen, A J

    2013-01-01

    Workaholism belongs to the behavioural addictions, also called ((without substances)) addictions, and is rather common in our society. The differential diagnosis must distinguish a hard worker, who has pleasure in his/her job, still profits from leisure time and maintains an excellent quality of life, from a true workaholic, who is prisoner of this compulsive behaviour that has negative consequences on his mental and physical health, his social and familial relationships and finally, his work performance itself. We describe here the various typologies of this mental disorder, its mode of evolution, its diagnostic approach, its multiple negative consequences for both patient and family as well as the main principles of management based on cognitive-behavioural therapy of this disorder that may be considered as a true addiction. PMID:23888592

  3. Modeling nicotine addiction in rats.

    Caille, Stephanie; Clemens, Kelly; Stinus, Luis; Cador, Martine

    2012-01-01

    Among the human population, 15% of drug users develop a pathological drug addiction. This figure increases substantially with nicotine, whereby more than 30% of those who try smoking develop a nicotine addiction. Drug addiction is characterized by compulsive drug-seeking and drug-taking behaviors (craving), and loss of control over intake despite impairment in health, social, and occupational functions. This behavior can be accurately modeled in the rat using an intravenous self-administration (IVSA) paradigm. Initial attempts at establishing nicotine self-administration had been problematic, yet in recent times increasingly reliable models of nicotine self-administration have been developed. The present article reviews different characteristics of the nicotine IVSA model that has been developed to examine nicotine reinforcing and motivational properties in rats. PMID:22231818

  4. Substance abuse precedes Internet addiction.

    Lee, Young Sik; Han, Doug Hyun; Kim, Sun Mi; Renshaw, Perry F

    2013-04-01

    The purpose of the current study was to evaluate possible overlapping substance abuse and internet addiction in a large, uniformly sampled population, ranging in age from 13 to 18 years. Participants (N=73,238) in the current study were drawn from the 6th Korea Youth Risk Behavior Web-based Survey (KYRBWS-V) for students from 400 middle schools and 400 high schools in 16 cities within South Korea. Of adolescent internet users, 85.2% were general users (GU), 11.9% were users with potential risk for internet addiction (PR), and 3.0% were users with high risk for internet addiction (HR). There was a difference in the number of students with alcohol drinking among the GU, PR, and HR groups (20.8% vs 23.1% vs 27.4%). There was a difference in the number of students who smoked among the GS, PR, and HR groups (11.7% vs 13.5% vs 20.4%). There was a difference in the number of students with drug use among the GU, PR, and HR groups (1.7% vs 2.0% vs 6.5%). After adjusting for sex, age, stress, depressed mood, and suicidal ideation, smoking may predict a high risk for internet addiction (OR=1.203, p=0.004). In addition, drug use may predict a high risk for internet addiction (OR=2.591, psubstance abuse should be evaluated and, if found, treated in adolescents with internet addiction. PMID:23384457

  5. Filhos de dependentes químicos com fatores de risco bio-psicossociais: necessitam de um olhar especial? Children of addicted parents with bio-psychosocial risk factors: do they need a special care?

    Neliana Figlie

    2004-01-01

    -psicossociais.CONTEXT: Alcoholism and other drug addictions tend to run in the families. Children of addicted parents are more at risk of addiction and psychiatric disorders than other children. OBJECTIVE: The aim of this study was to investigate the profile of children, adolescents and families in a selective prevention service offered to the children of addicted parents, and to discuss alternatives for the assessment and treatment of this population. DESIGN: cross-sectional study. SETTING: Selective prevention service implemented in downtown district of São Paulo, with 63 parents, 54 children and 45 adolescents. MAIN MEASUREMENTS: Socio-demographic data, Procedimento de Desenhos de Família com Estórias - DF-E; Drug Use Screening Inventory (DUSI; Criteria about psychosocial stress situation in childhood; Self-Report Questionnaire SRQ-20; Family CAGE. RESULTS: Regarding to the family profile, 67% belongs to D level in socio-demographic data, with the majority of families studied having an addicted father (67%; alcohol was the most frequent substance used (75%. The SRQ-20 assessing 59% of mates, who are not addicted, with mental suffering. In children, it was observed shyness, inferiority feelings, depression, family conflict, need for warm-heartness and good level of energy that is level-headed in terms of emotional and mental areas. In adolescents, it was observed higher level of problems in DUSI areas: psychiatric disorder, social competency, family system, and leisure/recreation. CONCLUSIONS: The paper concluded the need of a specialized selective prevention service in children, adolescents and families affected by substance abuse considering that children of addicted parents are at risk of developing bio-psychosocial problems.

  6. Social Anomie and Drug Addiction

    2004-01-01

    The present article addresses the relationshop between social anomie and drug addiction and tries to show that how we can apply anomie theory to clarify the aspects of this social problem in our society. By reviewing Durkheim’s and Merton’s anomie theories and Agnew’s mental-social theory، this article attempts to show that despite of fundamental differences in these two theories، Iranian Society has an anomic situation and this situation has a high poteniality for tendency toward drug addict...

  7. Treatment of addiction and addiction-related behavior

    Dewey, Stephen L. (Manorville, NY); Brodie, Jonathan D. (Cos Cob, CT); Ashby, Jr., Charles R. (Miller Place, NY)

    2003-01-01

    The present invention provides a highly efficient method for treating substance addiction and for changing addiction-related behavior of a mammal suffering from substance addiction. The method includes administering to a mammal an effective amount of gamma vinylGABA or a pharmaceutically acceptable salt thereof. The present invention also provides a method of treatment of cocaine, morphine, heroin, nicotine, amphetamine, methamphetamine, or ethanol addiction by treating a mammal with an effective amount of gamma vinylGABA or a pharmaceutically acceptable salt thereof. In one embodiment, the method of the present invention includes administering to the mammal an effective amount of a composition which increases central nervous system GABA levels wherein the effective amount is sufficient to diminish, inhibit or eliminate behavior associated with craving or use of drugs of abuse. The composition includes GVG, gabapentin, valproic acid, progabide, gamma-hydroxybutyric acid, fengabine, cetylGABA, topiramate or tiagabine or a pharmaceutically acceptable salt thereof, or an enantiomer or a racemic mixture thereof.

  8. Case Presentations from the Addiction Academy.

    Laes, JoAn R; Wiegand, Timothy

    2016-03-01

    In this article, a case-based format is used to address complex clinical issues in addiction medicine. The cases were developed from the authors' practice experience, and were presented at the American College of Medical Toxicology Addiction Academy in 2015. Section I: Drug and Alcohol Dependence and Pain explores cases of patients with co-occurring pain and substance use disorders. Section II: Legal and Policy Issues in Substance Use Disorders highlights difficult legal and policy questions in addiction medicine. Section III: Special Populations and Addictive Disorders delves into the complexity of addiction in special populations (pregnant, pediatric, and geriatric patients). PMID:26586253

  9. A penetrative addictive for water infusion in coal seams

    2003-01-01

    The manufacturing process, characteristics, and application results of a rod-like penetrative additive (the penetrative rod)were discussed. The components and functions of the penetrative rod were studied carefully. A large number of orthogonal combinedtests were carried out and over 100 sample molds were made. Ultimately the components were decided after careful selection amongthese molds, mainly including hygroscopic major components and auxiliary material. The results of on-site practical applicationshow that such an addictive can increase the water penetrative ability effectively and has a remarkable effect on preventing dust pro-duction during coal seam excavation. The penetrating radius, the infusing velocity and the dust-preventive effect were systematicallystudied.

  10. Libraries Sharing Technology for Sharing

    Morrison, Heather; Stranack, Kevin; Mussell, Jessica

    2006-01-01

    Recent resource sharing technology developments in the western Canadian consortia, BC Electronic Library Network and COPPUL are discussed. Highlights include the shelf status project of BC ELN, combining the functionality of a union catalogue with live lookup of circulation status via Z39.50, a tagging feature for the locally developed A to Z list CJDB (CUFTS Journal Database), a locally developed federated search tool, dbwiz, the Open Journal Systems software of the Public Knowledge Project,...

  11. Sharing Death

    Sandvik, Kjetil; Refslund Christensen, Dorthe

    Web 2.0 marks a social turn in digitally mediated communication and culture, placing the media user in the role as co-producer, innovator and participant.  The term covers a variety of interactive systems which facilitates the continuous storytelling process of constructing identity; systems...... allowing creating unique and editable profiles, adding personal content and sharing it with other people in your network(s) AND systems for publishing your own life: becoming visible to others, being connected and being observed. More and more sites turn up on the Internet that facilitates the process...

  12. Association between morningness/eveningness, addiction severity and psychiatric disorders among individuals with addictions.

    Kervran, Charlotte; Fatséas, Mélina; Serre, Fuschia; Taillard, Jacques; Beltran, Virginie; Leboucher, Juliette; Debrabant, Romain; Alexandre, Jean-Marc; Daulouède, Jean-Pierre; Philip, Pierre; Auriacombe, Marc

    2015-10-30

    Studies have shown that Evening-Type (ET) subjects used more stimulating and sedative substances, and presented more psychiatric disorders than Morning-Type (MT) subject. However, there is a lack of data on the chronotype of patients with addiction. The aim of our study was to describe chronotype and associated factors in a sample of outpatients beginning treatment for addiction. Subjects were assessed with the Morningness-Eveningness questionnaire of Hörne & Ostberg, the Addiction Severity Index and the Mini International Neuropsychiatric Interview. In the 333 subjects with an addiction, 20% were MT and 32% were ET. When comparing ET to MT, multivariate analysis showed that ET was significantly associated with poly-problematic addiction, non-substance addictions, cannabis addiction, and mood disorders, but not with severity of addiction. MT was associated with antisocial personality disorder. Results suggested that chronotype was associated with specific addiction pattern and psychiatric disorders. PMID:26250146

  13. [Internet addiction--a case report].

    Pejović-Milovancević, Milica; Popović-Deusić, Smiljka; Draganić-Gajić, Saveta; Lecić-Tosevski, Dusica

    2009-01-01

    Some addictions cannot be connected with substance abuse (pathological gambling, video games playing, binge eating, compulsive physical activity, emotional relationship addiction, TV addiction). Since 1995, Internet addiction has been accepted as a clinical entity with profound negative effect on social, familial, educational and economical personal functioning. The diagnosis of Internet addiction could be established if the person spends more than 38 hours per week on the Internet exempting online professional needs. Basic symptoms are the increased number of hours spent in front of the computer along with the Internet use, development of abstinent syndrome if the Internet access is prohibited, sleep inversion, neglect of basic social requirements and personal hygiene, many somatic symptoms developed due to prolonged sitting or monitor watching, dissocial behaviour. In this paper, data about the Internet addiction are presented and a case report of an adolescent with developed Internet addiction. PMID:19370973

  14. Doctors, lies and the addiction bureaucracy.

    Dalrymple, Theodore

    2008-04-01

    Almost everything you know about heroin addiction is wrong. Not only is it wrong, but it is obviously wrong. Heroin is not highly addictive; withdrawal from it is not medically serious; addicts do not become criminals to feed their habit; addicts do not need any medical assistance to stop taking heroin; and contrary to received wisdom, heroin addiction most certainly is a moral or spiritual problem. A literary tradition dating back to De Quincey and Coleridge, and continuing up to the deeply sociopathic William Burroughs and beyond, has misled all Western societies for generations about the nature of heroin addiction. These writers' self-dramatizing and dishonest accounts of their own addiction have been accepted uncritically, and have been more influential by far in forming public attitudes than the whole of pharmacological science. As a result, a self-serving, self-perpetuating and completely useless medical bureaucracy has been set up to deal with the problem. PMID:18416920

  15. Online social networking and addiction--a review of the psychological literature.

    Kuss, Daria J; Griffiths, Mark D

    2011-09-01

    Social Networking Sites (SNSs) are virtual communities where users can create individual public profiles, interact with real-life friends, and meet other people based on shared interests. They are seen as a 'global consumer phenomenon' with an exponential rise in usage within the last few years. Anecdotal case study evidence suggests that 'addiction' to social networks on the Internet may be a potential mental health problem for some users. However, the contemporary scientific literature addressing the addictive qualities of social networks on the Internet is scarce. Therefore, this literature review is intended to provide empirical and conceptual insight into the emerging phenomenon of addiction to SNSs by: (1) outlining SNS usage patterns, (2) examining motivations for SNS usage, (3) examining personalities of SNS users, (4) examining negative consequences of SNS usage, (5) exploring potential SNS addiction, and (6) exploring SNS addiction specificity and comorbidity. The findings indicate that SNSs are predominantly used for social purposes, mostly related to the maintenance of established offline networks. Moreover, extraverts appear to use social networking sites for social enhancement, whereas introverts use it for social compensation, each of which appears to be related to greater usage, as does low conscientiousness and high narcissism. Negative correlates of SNS usage include the decrease in real life social community participation and academic achievement, as well as relationship problems, each of which may be indicative of potential addiction. PMID:22016701

  16. Sharing experiences to improve bereavement support and clinical care after stillbirth : report of the 7th annual meeting of the international stillbirth alliance

    Heazell, Alexander E. P.; Leisher, Susannah; Cregan, Mairie; Flenady, Vicki; Froen, J. Frederik; Gravensteen, Ida K.; De Groot-Noordenbos, Mariette; De Groot, Paul; Hale, Sue; Jennings, Belinda; Mcnamara, Karen; Millard, Caron; Erwich, Jan Jaap H. M.

    2013-01-01

    Stillbirth remains a global health challenge which is greatly affected by social and economic inequality, particularly the availability and quality of maternity care. The International Stillbirth Alliance (ISA) exists to raise awareness of stillbirth and to promote global collaboration in the preven

  17. Sharing Data between Child Welfare and Education to Improve Outcomes for Children and Youth in the Foster Care System. Policy Brief

    Center for the Future of Teaching and Learning, 2010

    2010-01-01

    When a child is placed in the state's foster care system because of a parent's abuse or neglect, the state--represented by teams of social workers, lawyers, judges, foster parents, and other caregivers or guardians--steps into many aspects of the parental role. Too often, though, the state's representatives are attempting to fulfill a parental…

  18. Internet Addiction: Stability and Change

    Huang, Chiungjung

    2010-01-01

    This longitudinal study examined five indices of stability and change in Internet addiction: structural stability, mean-level stability, differential stability, individual-level stability, and ipsative stability. The study sample was 351 undergraduate students from end of freshman year to end of junior year. Convergent findings revealed stability…

  19. Neurocognitive Insights in Nicotine Addiction

    M. Luijten (Maartje)

    2012-01-01

    textabstractIn the Netherlands, 27% of the population is currently smoking. Nicotine is among the most addictive substances of abuse. Thirty-two percent of the people who tried smoking develop nicotine dependence within ten year. This percentage is higher for nicotine than for other substances of ab

  20. Using Meditation in Addiction Counseling

    Young, Mark E.; DeLorenzi, Leigh de Armas; Cunningham, Laura

    2011-01-01

    Meditation has been studied as a way of reducing stress in counseling clients since the 1960s. Alcoholics Anonymous, Narcotics Anonymous, and new wave behavior therapies incorporate meditation techniques in their programs. This article identifies meditation's curative factors and limitations when using meditation in addiction settings.

  1. Femoral pseudoaneurysms in drug addicts

    Levi-Mazloum, Niels Donald; Rørdam, Peter; Jensen, L P;

    1997-01-01

    OBJECTIVE: To evaluate the outcome of treatment of femoral pseudoaneurysms in drug addicts. METHODS: The records of eight patients undergoing vascular surgery for femoral pseudoaneurysms from substance abuse identified from a vascular database were reviewed. RESULTS: Were good in four out of five...

  2. Overlapping dopaminergic pathway genetic susceptibility to heroin and cocaine addictions in African Americans.

    Levran, Orna; Randesi, Matthew; da Rosa, Joel Correa; Ott, Jurg; Rotrosen, John; Adelson, Miriam; Kreek, Mary Jeanne

    2015-05-01

    Drugs of abuse activate the mesolimbic dopaminergic pathway. Genetic variations in the dopaminergic system may contribute to drug addiction. Several processes are shared between cocaine and heroin addictions but some neurobiological mechanisms may be specific. This study examined the association of 98 single nucleotide polymorphisms in 13 dopamine-related genes with heroin addiction (OD) and/or cocaine addiction (CD) in a sample of 801 African Americans (315 subjects with OD ± CD, 279 subjects with CD, and 207 controls). Single-marker analyses provided nominally significant evidence for associations of 24 SNPs) in DRD1, ANKK1/DRD2, DRD3, DRD5, DBH, DDC, COMT and CSNK1E. A DRD2 7-SNPs haplotype that includes SNPs rs1075650 and rs2283265, which were shown to alter D2S/D2L splicing, was indicated in both addictions. The Met allele of the functional COMT Val158Met was associated with protection from OD. None of the signals remained significant after correction for multiple testing. The study results are in accordance with the results of previous studies, including our report of association of DRD1 SNP rs5326 with OD. The findings suggest the presence of an overlap in genetic susceptibility for OD and CD, as well as shared and distinct susceptibility for OD in subjects of African and European descent. PMID:25875614

  3. Hepatitis C management by addiction medicine physicians: Results from a national survey

    Litwin, Alain H.; Kunins, Hillary V.; Berg, Karina M; Federman, Alex D.; Heavner, Karyn K; Gourevitch, Marc N.; ARNSTEN, JULIA H.

    2007-01-01

    Drug users are disproportionately affected by hepatitis C virus (HCV), yet they face barriers to health care that place them at risk for levels of HCV-related care that are lower than those of nondrug users. Substance abuse treatment physicians may treat more HCV-infected persons than other generalist physicians, yet little is known about how such physicians facilitate HCV-related care. We conducted a nationwide survey of American Society of Addiction Medicine physicians (n = 320) to determin...

  4. The Share Economy: A Symposium

    John Andrew; Nordhaus, William D.

    1986-01-01

    In 1985-06, the Yale Economics Department sponsored a half-day conference on Martin Weitzman's striking proposal that sharing would be introduced into compensation arrangements. His suggestions have received wide attention in the popular press and from economists, but the organizers believed that the suggestions were sufficiently novel and promising to warrant careful scrutiny from a wide range of points of view. The conference participants therefore examined the "share economy" from the vant...

  5. Ethical issues and addiction.

    Lambert, Binta; Scheiner, Melissa; Campbell, Deborah

    2010-04-01

    The epidemic of substance abuse continues to pose a significant challenge to clinicians nationwide. Although there is a tendency to simply associate drug abuse with poverty, the problem affects every social stratum gender and race; and pregnant women are no exception. Caring for pregnant, substance-using women and their infants presents complex legal and ethical issues. Debate is ongoing about whether criminal penalties should be imposed on women based solely on their use of alcohol and other drugs during pregnancy. Furthermore, controversies persist about the rights and wishes of pregnant women versus the interests of their fetuses. For health professionals, conflict arises when the pregnant woman chooses behaviors that have the potential to harm the developing fetus. The ethical dilemma arises from competing autonomy-based and beneficence-based obligations to the maternal-fetal dyad. This chapter explores the ethics-based conflicts in the delivery of health care to drug abusing pregnant women. PMID:20407974

  6. Addiction and Women Gender Differences Concerning Drug Abuse and its Treatment

    Fatemeh Safari

    2003-05-01

    Full Text Available This article focuses on the quantitative grounds for the emergence and spread of addiction among women, its medical, social and psychological problems, impediments for the treatment of addiction among women as well as gender differences concerning drug abuse and its treatment. This article is a translation of a statistical research on addiction among women and a number of other researches. Based on conclusions drawn from the said researches, women become inclined to addiction mostly by their husbands due to their cordial relationships. Moreover, the negative attitudes of peer groups can overshadow girls and women more than boys and men. From the viewpoint of psychological disorders, the relationship between disorders resulting from psychological pressure after an incident and addiction is stronger among girls and women compared to boys and men. Addiction among women in addition to certain ailments such as malnutrition, hypertension and cancer, can expose them to dangerous diseases such as Hepatitis and AIDS. There is more possibility for addicted women to be infected with AIDS and other sexually transmitted diseases compared to men and they are more exposed to female ailments compared to other women. As far as treatment impediments are concerned, women face a greater social stigma due to their addiction compared to men. Social approach considering addicted women as an indecent person is a major impediment for their treatment. Taking care of the child is also another obstacle for their treatment. There is less possibility for women to receive support from their families for quitting their addiction compared to men. Treatment programs also unwantedly may create obstacles for the treatment of women such as financial constraints, administrative bureaucracy, concentration of treatment programs for men and lack of sensitivity towards women’s addiction. The psychological impediments to treatment include internalizing the notion that addiction is a

  7. [Value-based cancer care. From traditional evidence-based decision making to balanced decision making within frameworks of shared values].

    Palazzo, Salvatore; Filice, Aldo; Mastroianni, Candida; Biamonte, Rosalbino; Conforti, Serafino; Liguori, Virginia; Turano, Salvatore; De Simone, Rosanna; Rovito, Antonio; Manfredi, Caterina; Minardi, Stefano; Vilardo, Emmanuelle; Loizzo, Monica; Oriolo, Carmela

    2016-04-01

    Clinical decision making in oncology is based so far on the evidence of efficacy from high-quality clinical research. Data collection and analysis from experimental studies provide valuable insight into response rates and progression-free or overall survival. Data processing generates valuable information for medical professionals involved in cancer patient care, enabling them to make objective and unbiased choices. The increased attention of many scientific associations toward a more rational resource consumption in clinical decision making is mirrored in the Choosing Wisely campaign against the overuse or misuse of exams and procedures of little or no benefit for the patient. This cultural movement has been actively promoting care solutions based on the concept of "value". As a result, the value-based decision-making process for cancer care should not be dissociated from economic sustainability and from ethics of the affordability, also given the growing average cost of the most recent cancer drugs. In support of this orientation, the National Comprehensive Cancer Network (NCCN) has developed innovative and "complex" guidelines based on values, defined as "evidence blocks", with the aim of assisting the medical community in making overall sustainable choices. PMID:27093326

  8. Shared Memories?

    Wæhrens, Anne

    This paper analyses how the memory of the Holocaust has been addressed in the European Parliament from 1989 to 2009. I identify two major changes that occurred in the 1990s and after the 2004 enlargement of the European Union respectively. In the 1990s the war in Bosnia and the question of...... restitution universalised the memory of the Holocaust and made it present. The 2004 enlargement brought the memory of Soviet Communism into the Union and made it a central task to construct a community of memory that includes both the memory of the Holocaust and of Soviet Communism. The analysis also...... identifies what seems to be a political memory split between Left and Right; and it shows that the time might not be ripe for a shared European memory....

  9. From Discrimination through Exclusion to Sharing: a Moral Education Based on Care Ethics%从歧视、专属到共享:基于关怀伦理的道德教育

    胡金木

    2012-01-01

    Under care ethics, females have been recognized as moral subjects. Accorchngly, moral eclucanon has rid itself gradually of moral discrimination to women, advancing from homogenized moral equality to polarized moral equality. However, while care ethics leads females out of moral discrimination, it fails into the dilemma of moral gendering, slipping from gender discrimination to gender exclusion. To get out of the double dilemma of gen- der discrimination and gender exclusion, it must be clearly recognized that care is a universal concept of human moral education. Therefore, either care as moral value or care as form of moral education ought to be shared by both genders.%在关怀伦理的影响下,人们认识到女性的道德主体地位,道德教育也逐渐从对女性的道德歧视中走出,进而从同质化的道德平等走向差异化的道德平等。关怀伦理思想在引领女性远离道德歧视的同时,又陷入了一种道德性别化的困境,从性别歧视滑向了性别专属。道德教育若要摆脱性别歧视与性别专属的双重困境,则需要清醒地认识到关怀是人类一个普遍的道德教育概念。无论是作为一种道德价值观念的关怀,还是作为一种道德教育模式的关怀,都是男女两性所共享的。

  10. Comparison of Personality Characteristics and Problem Solving Styles in Addicted and Non-Addicted Men

    Mohammad Narimani

    2011-11-01

    Full Text Available Introduction: The present study sought to compare emotional intelligence and quality of life in addicted and non-addicted men. Method: The samples included 80 addicted and 80 non-addicted men who addicted men were selected by available sampling and non-addicted men were chosen by cloning methods according to age and marital status. For data collection, emotional intelligence scale and quality of life questionnaire were used. Variance test and Pearson correlation were used for data analysis. Findings: The results showed that there is a significant difference between emotional intelligence and quality of life of addicted and non-addicted men. In fact, the emotional intelligence and quality of life among addicted men were lower than non-addicted men. Also the results showed that there is a significant correlation between emotional intelligence and quality of life among addicts and non addicts. Conclusion: People with low emotional intelligence are more likely to do substance abuse and drug abuse lowers the quality of life of the people. It is likely to develop emotional intelligence of people in order to prevent them from getting addicted.

  11. Towards an animal model of food addiction.

    de Jong, Johannes W; Vanderschuren, Louk J M J; Adan, Roger A H

    2012-01-01

    The dramatically increasing prevalence of obesity, associated with potentially life-threatening health problems, including cardiovascular diseases and type II diabetes, poses an enormous public health problem. It has been proposed that the obesity epidemic can be explained by the concept of 'food addiction'. In this review we focus on possible similarities between binge eating disorder (BED), which is highly prevalent in the obese population, and drug addiction. Indeed, both behavioral and neural similarities between addiction and BED have been demonstrated. Behavioral similarities are reflected in the overlap in DSM-IV criteria for drug addiction with the (suggested) criteria for BED and by food addiction-like behavior in animals after prolonged intermittent access to palatable food. Neural similarities include the overlap in brain regions involved in food and drug craving. Decreased dopamine D2 receptor availability in the striatum has been found in animal models of binge eating, after cocaine self-administration in animals as well as in drug addiction and obesity in humans. To further explore the neurobiological basis of food addiction, it is essential to have an animal model to test the addictive potential of palatable food. A recently developed animal model for drug addiction involves three behavioral characteristics that are based on the DSM-IV criteria: i) extremely high motivation to obtain the drug, ii) difficulty in limiting drug seeking even in periods of explicit non-availability, iii) continuation of drug-seeking despite negative consequences. Indeed, it has been shown that a subgroup of rats, after prolonged cocaine self-administration, scores positive on these three criteria. If food possesses addictive properties, then food-addicted rats should also meet these criteria while searching for and consuming food. In this review we discuss evidence from literature regarding food addiction-like behavior. We also suggest future experiments that could

  12. New Dimensions, New Addictions: The Internet Sex Addiction

    Silvia Sánchez Zaldívar

    2010-02-01

    Full Text Available The network is endless: going anywhere, finding anything, being anyone. Typing the word sex on Google gives a figure of 96 million results. The network is changing our way of communication and relation; we can construct space-time coordinates before incompatible. Internet addiction is not recognized as a disorder in DSM-IV-TR or ICD-10. Both types of Internet addiction with sexual content are cybersex and pornography. Cybersex consists in experiencing sexual stimulation while maintaining sexual contact with other person. There is no user profile, it is a widespread behaviour and might have a positive aspect (in some communities, persons with fewer social skills, to spice sex life and a negative aspect (addiction, loss of control, marital and family problems. Sex is safe, anonymous and without complications. Internet pornography voyeurism allows the visualization of all types of practices, the use of real models not professional and to spy our behaviour through the IP code. These sexual activities on the network seems to be powered by the “Triple A” engine: accessibility, anonymity, affordability. We must assess the individual, the couples and the Internet activities. There is no proven pharmacological or psychological treatment but cognitive behavioural programs and techniques used in other addictions are helpful. There is large comorbidity. The goal of treatment refers to the adaptive use of Internet. Health professionals should be in advance and learn about this kind of behaviours, as well as to disseminate the information appropriately not launching simplistic messages, providing markers and developing studies, research and prevention programs.

  13. A narrative review of yoga and mindfulness as complementary therapies for addiction.

    Khanna, Surbhi; Greeson, Jeffrey M

    2013-06-01

    This paper reviews the philosophical origins, current scientific evidence, and clinical promise of yoga and mindfulness as complementary therapies for addiction. Historically, there are eight elements of yoga that, together, comprise ethical principles and practices for living a meaningful, purposeful, moral and self-disciplined life. Traditional yoga practices, including postures and meditation, direct attention toward one's health, while acknowledging the spiritual aspects of one's nature. Mindfulness derives from ancient Buddhist philosophy, and mindfulness meditation practices, such as gentle Hatha yoga and mindful breathing, are increasingly integrated into secular health care settings. Current theoretical models suggest that the skills, insights, and self-awareness learned through yoga and mindfulness practice can target multiple psychological, neural, physiological, and behavioral processes implicated in addiction and relapse. A small but growing number of well-designed clinical trials and experimental laboratory studies on smoking, alcohol dependence, and illicit substance use support the clinical effectiveness and hypothesized mechanisms of action underlying mindfulness-based interventions for treating addiction. Because very few studies have been conducted on the specific role of yoga in treating or preventing addiction, we propose a conceptual model to inform future studies on outcomes and possible mechanisms. Additional research is also needed to better understand what types of yoga and mindfulness-based interventions work best for what types of addiction, what types of patients, and under what conditions. Overall, current findings increasingly support yoga and mindfulness as promising complementary therapies for treating and preventing addictive behaviors. PMID:23642957

  14. Addiction to Work: A Critical Review of the Workaholism Construct and Recommendations for Assessment.

    Quinones, Cristina; Griffiths, Mark D

    2015-10-01

    Workaholism was first conceptualized in the early 1970s as a behavioral addiction, featuring compulsive use and interpersonal conflict. The current article briefly examines the empirical and theoretical literature over the past four decades. In relation to conceptualization and measurement, how the concept of workaholism has worsened from using dimensions based on anecdotal evidence, ad-hoc measures with weak theoretical foundation, and poor factorial validity of multidimensional conceptualizations is highlighted. Benefits of building on the addiction literature to conceptualize workaholism are presented (including the only instrument that has used core addiction criteria: the Bergen Work Addiction Scale). Problems estimating accurate prevalence estimates of work addiction are also presented. Individual and sociocultural risk factors, and the negative consequences of workaholism from the addiction perspective (e.g., depression, burnout, poor health, life dissatisfaction, family/relationship problems) are discussed. The current article summarizes how current research can be used to evaluate workaholism by psychiatric-mental health nurses in clinical practice, including primary care and mental health settings. PMID:26489104

  15. The Sooke Navigator project: using community resources and research to improve local service for mental health and addictions

    Anderson, J Ellen; Larke, Susan C

    2009-01-01

    Our rural BC community engaged in an innovative action research project to improve access to mental health and addiction (MHA) services for citizens and increase connections and communication between primary care, community-based providers, and the formal mental health service system. Developed by a community-based steering committee, our Navigator model is aimed at anyone with mental health and addictions issues seeking help in our region. The model includes the following services: timely ne...

  16. Sharing values, sharing a vision

    1993-12-31

    Teamwork, partnership and shared values emerged as recurring themes at the Third Technology Transfer/Communications Conference. The program drew about 100 participants who sat through a packed two days to find ways for their laboratories and facilities to better help American business and the economy. Co-hosts were the Lawrence Livermore National Laboratory and the Lawrence Berkeley Laboratory, where most meetings took place. The conference followed traditions established at the First Technology Transfer/Communications Conference, conceived of and hosted by the Pacific Northwest Laboratory in May 1992 in Richmond, Washington, and the second conference, hosted by the National Renewable Energy Laboratory in January 1993 in Golden, Colorado. As at the other conferences, participants at the third session represented the fields of technology transfer, public affairs and communications. They came from Department of Energy headquarters and DOE offices, laboratories and production facilities. Continued in this report are keynote address; panel discussion; workshops; and presentations in technology transfer.

  17. Chronic disease and recent addiction treatment utilization among alcohol and drug dependent adults

    Samet Jeffrey

    2011-10-01

    Full Text Available Abstract Background Chronic medical diseases require regular and longitudinal care and self-management for effective treatment. When chronic diseases include substance use disorders, care and treatment of both the medical and addiction disorders may affect access to care and the ability to focus on both conditions. The objective of this paper is to evaluate the association between the presence of chronic medical disease and recent addiction treatment utilization among adults with substance dependence. Methods Cross-sectional secondary data analysis of self-reported baseline data from alcohol and/or drug-dependent adults enrolled in a randomized clinical trial of a disease management program for substance dependence in primary care. The main independent variable was chronic medical disease status, categorized using the Katz Comorbidity Score as none, single condition of lower severity, or higher severity (multiple conditions or single higher severity condition, based on comorbidity scores determined from self-report. Asthma was also examined in secondary analyses. The primary outcome was any self-reported addiction treatment utilization (excluding detoxification in the 3 months prior to study entry, including receipt of any addiction-focused counseling or addiction medication from any healthcare provider. Logistic regression models were adjusted for sociodemographics, type of substance dependence, recruitment site, current smoking, and recent anxiety severity. Results Of 563 subjects, 184 (33% reported any chronic disease (20% low severity; 13% higher severity and 111 (20% reported asthma; 157 (28% reported any addiction treatment utilization in the past 3 months. In multivariate regression analyses, no significant effect was detected for chronic disease on addiction treatment utilization (adjusted odds ratio [AOR] 0.88 lower severity vs. none, 95% confidence interval (CI: 0.60, 1.28; AOR 1.29 higher severity vs. none, 95% CI: 0.89, 1.88 nor for

  18. [Addiction to cocaine and other stimulants].

    Lacoste, Jérôme; Delavenne-Garcia, Héloïse; Charles-Nicolas, Aimé; Duarte Garcia, Frederico; Jehel, Louis

    2012-12-01

    Due to many available forms (powder, pasta base, freebase and crack…) and because of multiple routes of administration (intranasal, intravenous, or smoked), cocaine has become in 30 years one of the most consumed illegal drugs worldwide, after cannabis. While the frequency of consumption decreases in North America, it continues to rise in Europe, and in some countries in South America, including Brazil, despite a growing knowledge of its specific effects, physical complications and psychiatric consequences. Elsewhere (notably in Asia and Indian Ocean), amphetamine and other stimulants (including methamphetamine), whose properties and patterns of use are very similar to those of cocaine, tend to replace it. Another amphetamine derivative, MDMA or ecstasy, is also consumed by many young people of less than 25 years, in Europe and North America, in a festive setting, with specific consequences and special procedures of care. Although there is currently no consensus for a specific medication, the most appropriate therapeutic approach seems to involve a psychosocial treatment associated with an anticraving medication, which will reduce compulsive desire to consume, in order to facilitate the psychotherapeutic and social care. However, pharmacological research remains very active, and many options are explored (GABAergic or dopaminergic agonists, amphetamine derivatives with long half-life, vaccine…), whether to treat addiction to cocaine or to methamphetamine. PMID:23021656

  19. Similarities between obesity in pets and children: the addiction model.

    Pretlow, Robert A; Corbee, Ronald J

    2016-09-01

    Obesity in pets is a frustrating, major health problem. Obesity in human children is similar. Prevailing theories accounting for the rising obesity rates - for example, poor nutrition and sedentary activity - are being challenged. Obesity interventions in both pets and children have produced modest short-term but poor long-term results. New strategies are needed. A novel theory posits that obesity in pets and children is due to 'treats' and excessive meal amounts given by the 'pet-parent' and child-parent to obtain affection from the pet/child, which enables 'eating addiction' in the pet/child and results in parental 'co-dependence'. Pet-parents and child-parents may even become hostage to the treats/food to avoid the ire of the pet/child. Eating addiction in the pet/child also may be brought about by emotional factors such as stress, independent of parental co-dependence. An applicable treatment for child obesity has been trialled using classic addiction withdrawal/abstinence techniques, as well as behavioural addiction methods, with significant results. Both the child and the parent progress through withdrawal from specific 'problem foods', next from snacking (non-specific foods) and finally from excessive portions at meals (gradual reductions). This approach should adapt well for pets and pet-parents. Pet obesity is more 'pure' than child obesity, in that contributing factors and treatment points are essentially under the control of the pet-parent. Pet obesity might thus serve as an ideal test bed for the treatment and prevention of child obesity, with focus primarily on parental behaviours. Sharing information between the fields of pet and child obesity would be mutually beneficial. PMID:27469280

  20. Hypomanic personality trait in cocaine addiction.

    Lemere, F; Smith, J W

    1990-04-01

    An analysis of 292 private patients treated for cocaine addiction showed the following. Comorbid Axis I psychiatric disorders were found in 19% and preaddiction Axis I disorders in 9% of these patients. Psychopathology at the time of treatment appeared to be more the result of than the cause of the addiction. Of these patients 63% had become addicted pursuing euphoria. A definitive nonpathologic unipolar hypomanic subtype of cocaine addict was observed in 13% of these 292 patients. This was manifested more as a trait than a disorder. This subgroup had been reasonably well adjusted, fun-loving and action oriented extroverts before their addiction. The rush and lifestyle of cocaine fit the imperatives of their personality. In a significant subtype of cocaine addict, an underlying hypomanic personality trait is ego-syntonic with the abuse of cocaine. PMID:2346798

  1. The neural rejuvenation hypothesis of cocaine addiction.

    Dong, Yan; Nestler, Eric J

    2014-08-01

    A leading hypothesis guiding current molecular and cellular research into drug addiction conceptualizes key aspects of addiction as a form of memory in which common neuroplasticity mechanisms that mediate normal learning and memory processes are 'hijacked' by exposure to drugs of abuse to produce pathologic addiction-related memories. Such addiction-related memories are particularly robust and long-lasting and once formed are less amenable to updating. Here we propose a neural rejuvenation hypothesis of cocaine addiction. According to this hypothesis, repeated exposure to drugs of abuse induces some plasticity mechanisms normally associated with brain development within the reward circuitry that mediate the highly efficient and unusually stable memory abnormalities that characterize addiction. PMID:24958329

  2. Neuroimaging for drug addiction and related behaviors

    In this review, we highlight the role of neuroimaging techniques in studying the emotional and cognitive-behavioral components of the addiction syndrome by focusing on the neural substrates subserving them. The phenomenology of drug addiction can be characterized by a recurrent pattern of subjective experiences that includes drug intoxication, craving, bingeing, and withdrawal with the cycle culminating in a persistent preoccupation with obtaining, consuming, and recovering from the drug. In the past two decades, imaging studies of drug addiction have demonstrated deficits in brain circuits related to reward and impulsivity. The current review focuses on studies employing positron emission tomography (PET), functional magnetic resonance imaging (fMRI), and electroencephalography (EEG) to investigate these behaviors in drug-addicted human populations. We begin with a brief account of drug addiction followed by a technical account of each of these imaging modalities. We then discuss how these techniques have uniquely contributed to a deeper understanding of addictive behaviors.

  3. Neuroimaging for drug addiction and related behaviors

    Parvaz, Muhammad A.; Alia-Klein, Nelly; Woicik, Patricia A.; Volkow, Nora D.; Goldstein, Rita Z.

    2012-01-01

    In this review, we highlight the role of neuroimaging techniques in studying the emotional and cognitive-behavioral components of the addiction syndrome by focusing on the neural substrates subserving them. The phenomenology of drug addiction can be characterized by a recurrent pattern of subjective experiences that includes drug intoxication, craving, bingeing, and withdrawal with the cycle culminating in a persistent preoccupation with obtaining, consuming, and recovering from the drug. In the past two decades, imaging studies of drug addiction have demonstrated deficits in brain circuits related to reward and impulsivity. The current review focuses on studies employing positron emission tomography (PET), functional magnetic resonance imaging (fMRI), and electroencephalography (EEG) to investigate these behaviors in drug-addicted human populations. We begin with a brief account of drug addiction followed by a technical account of each of these imaging modalities. We then discuss how these techniques have uniquely contributed to a deeper understanding of addictive behaviors. PMID:22117165

  4. Neuroimaging for drug addiction and related behaviors

    Parvaz M. A.; Parvaz, M.A.; Alia-Klein, N.; Woicik,P.A.; Volkow, N.D.; Goldstein, R.Z.

    2011-10-01

    In this review, we highlight the role of neuroimaging techniques in studying the emotional and cognitive-behavioral components of the addiction syndrome by focusing on the neural substrates subserving them. The phenomenology of drug addiction can be characterized by a recurrent pattern of subjective experiences that includes drug intoxication, craving, bingeing, and withdrawal with the cycle culminating in a persistent preoccupation with obtaining, consuming, and recovering from the drug. In the past two decades, imaging studies of drug addiction have demonstrated deficits in brain circuits related to reward and impulsivity. The current review focuses on studies employing positron emission tomography (PET), functional magnetic resonance imaging (fMRI), and electroencephalography (EEG) to investigate these behaviors in drug-addicted human populations. We begin with a brief account of drug addiction followed by a technical account of each of these imaging modalities. We then discuss how these techniques have uniquely contributed to a deeper understanding of addictive behaviors.

  5. Obesity and Its Relationship to Addictions: Is Overeating a Form of Addictive Behavior?

    Barry, Danielle; Clarke, Megan; Petry, Nancy M.

    2009-01-01

    Obesity is a major public health problem and notoriously difficult to treat. There are many parallels between obesity/overeating and addictions to alcohol and drugs. This paper discusses similarities between obesity and addictive disorders, including common personality characteristics, disruptive behavior syndromes, and brain mechanisms. Although there are important differences between overeating and other addictive behaviors, an addiction model of overeating may effectively inform prevention...

  6. Factors influencing alcohol and tobacco addiction among patients attending a de-addiction Centre, South India

    Prabhu, Poornima; Srinivas, Raju; Vishwanathan, Kashi; Raavi, Abhilash

    2014-01-01

    Introduction: Alcohol and tobacco consumption are highly correlated behaviors. Aim: To assess the factors influencing alcohol and tobacco addiction and their impact on personal, family, and social life among patients attending the Spandana Nursing Home and De-addiction Centre, Bangalore. The objectives are to assess the various factors leading to alcohol and tobacco addiction, to assess the influence of addiction on personal, family, and social life, and also to create awareness among the com...

  7. A 50-Year-Old Woman Addicted to Heroin: Review of Treatment of Heroin Addiction

    O’Brien, Charles P.

    2008-01-01

    Heroin addiction is a complicated medical and psychiatric issue, with well-established as well as newer modes of treatment. The case of Ms W, a 50-year-old woman with a long history of opiate addiction who has been treated successfully with methadone for 9 years and who now would like to consider newer alternatives, illustrates the complex issues of heroin addiction. The treatment of heroin addiction as a chronic disease is reviewed, including social, medical, and cultural issues and pharmaco...

  8. Behavioral Addiction versus Substance Addiction: Correspondence of Psychiatric and Psychological Views

    Seyyed Salman Alavi

    2012-01-01

    Conclusion: Similar to substance abuse prevention, programs aimed at addicted individuals and specialized training can educate adolescents about the warning signs of online addiction, in order to assist the early detection of this disorder. For prevention of behavioral addiction (such as internet addiction authorities, cultural institutions and parents should monitor the use of internet and teach to the adolescent and children, the useful and appropriate methods of internet use.

  9. The Prevalence of Food Addiction as Assessed by the Yale Food Addiction Scale: A Systematic Review

    Pursey, Kirrilly M.; Peter Stanwell; Gearhardt, Ashley N.; Clare E. Collins; Burrows, Tracy L.

    2014-01-01

    Obesity is a global issue and it has been suggested that an addiction to certain foods could be a factor contributing to overeating and subsequent obesity. Only one tool, the Yale Food Addiction Scale (YFAS) has been developed to specifically assess food addiction. This review aimed to determine the prevalence of food addiction diagnosis and symptom scores, as assessed by the YFAS. Published studies to July 2014 were included if they reported the YFAS diagnosis or symptom score and were publi...

  10. Behavioral Addiction versus Substance Addiction: Correspondence of Psychiatric and Psychological Views

    Seyyed Salman Alavi; Masoud Ferdosi; Fereshte Jannatifard; Mehdi Eslami; Hamed Alaghemandan; Mehrdad Setare

    2012-01-01

    Introduction: Behavioral science experts believe that all entities capable of stimulating a person can be addictive; and whenever a habit changes into an obligation, it can be considered as an addiction. Researchers also believe that there are a number of similarities as well as some differences between drug addiction and behavioral addiction diagnostic symptoms. The purpose of this study is to consider different approaches in this field. Methods: This is a descriptive research using conte...

  11. Assessing internet addiction using the parsimonious internet addiction components model—A preliminary study.

    Kuss, D.J.; Shorter, G.W.; Rooij, A.J. van; Griffiths, M.D.; Schoenmakers, T.M.

    2014-01-01

    Internet usage has grown exponentially over the last decade. Research indicates that excessive Internet use can lead to symptoms associated with addiction. To date, assessment of potential Internet addiction has varied regarding populations studied and instruments used, making reliable prevalence estimations difficult. To overcome the present problems a preliminary study was conducted testing a parsimonious Internet addiction components model based on Griffiths’ addiction components (Journal ...

  12. The Internet Process Addiction Test: Screening for Addictions to Processes Facilitated by the Internet

    Northrup, Jason C.; Coady Lapierre; Jeffrey Kirk; Cosette Rae

    2015-01-01

    The Internet Process Addiction Test (IPAT) was created to screen for potential addictive behaviors that could be facilitated by the internet. The IPAT was created with the mindset that the term “Internet addiction” is structurally problematic, as the Internet is simply the medium that one uses to access various addictive processes. The role of the internet in facilitating addictions, however, cannot be minimized. A new screening tool that effectively directed researchers and clinicians to the...

  13. Common Bile Duct (CBD) diameter in opium-addicted men: Comparison with non-addict controls

    Zahedi-Nejad, Nina; Narouei, Shahin; Fahimy, Farnaz

    2010-01-01

    Summary Background: Opium and its derivatives are widely abused throughout the world. Recent case reports and a few limited studies have suggested that opiates cause dilation of the common bile duct of the abusers. Material/Methods: Our case-control study, lasting 7.5 months, investigated 121 male adult addicts and 142 non-addicted controls for biliary tract diameters, using ultrasonography. The study was conducted in Bahonar Hospital in Kerman. Neither the addiction cases nor the non-addict ...

  14. Clarifying Exercise Addiction: Differential Diagnosis, Co-occurring Disorders, and Phases of Addiction

    Marilyn Freimuth; Kim, Shari R.; Sandy Moniz

    2011-01-01

    This paper sets out to clarify the unique features of exercise addiction. It begins by examining how this addiction can be distinguished from compulsions and impulse control disorders both of which, like an addiction, involve excessive behavior that creates adverse effects. Assessment of exercise addiction also requires that clinicians be attuned to other forms of excessive behavior, especially eating disorders that can co-occur with exercise. Finally in an effort to clarify exercise addictio...

  15. Treating a Sex Addict Through Marital Sex Therapy.

    Sprenkle, Douglas H.

    1987-01-01

    Views treatment of sexual addiction within context of addiction and family therapy. Presents a case of sexual addiction and explicates an intervention model which emphasizes the importance of family participation in the treatment. (Author/NB)

  16. Biology of Addiction: Drugs and Alcohol Can Hijack Your Brain

    ... External link, please review our exit disclaimer . Subscribe Biology of Addiction Drugs and Alcohol Can Hijack Your ... scientists are working to learn more about the biology of addiction. They’ve shown that addiction is ...

  17. Biopsychosocial implications of heroin addiction

    Cheng, Lai-fung, Gordon; 鄭禮鋒

    2014-01-01

    Heroin abuse is devastating to both the individual abusers and society. Owing to its ability to elicit rapid feelings of euphoria and transcendent relaxation, coupled with adverse withdrawal effects, it is one of the most addictive illicit drugs of abuse. The severe and persistent socio-economic detriment caused by heroin abuse signifies an urgent need for understanding how this substance affects abusers. Currently, scientific research into the biopsychosocial functioning of heroin abusers is...

  18. Assessing Addiction: Concepts and Instruments

    Samet, Sharon; Waxman, Rachel; Hatzenbuehler, Mark; Hasin, Deborah S.

    2007-01-01

    Efficient, organized assessment of substance use disorders is essential for clinical research, treatment planning, and referral to adjunctive services. In this article, we discuss the basic concepts of formalized assessment for substance abuse and addiction, as established by the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision, and describe six widely used structured assessment instruments. Our aim is to help researchers and clinical programs identify the ins...

  19. Molecular Mechanisms of Psychostimulant Addiction

    Jin-Chung Chen; Pei-Chun Chen; Yao-Chang Chiang

    2009-01-01

    Drug addiction represents a pathological form of neuroplasticity along with the emergenceof aberrant behaviors involving a cascade of neurochemical changes mainly in thebrain’s rewarding circuitry. The aberrant behavioral phenotypes can be assessed by an animalmodel of drug-induced behavioral sensitization, which is characterized by an initiationstage that is formed in the ventral tegmental area and a behavioral expression stage determinedmainly in the nucleus accumbens. Numerous studies duri...

  20. Addiction and the adrenal cortex

    Vinson, Gavin P; Brennan, Caroline H.

    2013-01-01

    Substantial evidence shows that the hypophyseal–pituitary–adrenal (HPA) axis and corticosteroids are involved in the process of addiction to a variety of agents, and the adrenal cortex has a key role. In general, plasma concentrations of cortisol (or corticosterone in rats or mice) increase on drug withdrawal in a manner that suggests correlation with the behavioural and symptomatic sequelae both in man and in experimental animals. Corticosteroid levels fall back to normal values in resumptio...

  1. Treating cocaine addiction with viruses

    Carrera, M. Rocio A.; Kaufmann, Gunnar F.; Mee, Jenny M.; Meijler, Michael M.; Koob, George F.; Janda, Kim D.

    2004-01-01

    Cocaine addiction continues to be a major health and social problem in the United States and other countries. Currently used pharmacological agents for treating cocaine abuse have proved inadequate, leaving few treatment options. An alternative is to use protein-based therapeutics that can eliminate the load of cocaine, thereby attenuating its effects. This approach is especially attractive because the therapeutic agents exert no pharmacodynamic action of their own and therefore have little p...

  2. Methamphetamine Cured my Cocaine Addiction

    Haile, Colin N.; De La Garza, Richard; Newton, Thomas F.

    2010-01-01

    Cocaine dependence is an enduring problem and years of research and drug development has yet to produce an efficacious pharmacotherapy. Recent clinical research suggests that chronic treatment with amphetamine-like medications produces tolerance to cocaine’s reinforcing effects and may offer a viable pharmacotherapy. Three methamphetamine-dependent participants that had been in our clinical laboratory experiments and previously addicted to cocaine are reviewed. Data obtained from initial scre...

  3. Internet gaming addiction: current perspectives

    Kuss DJ

    2013-01-01

    Daria J KussPsychology Research and Behavior Management, Birmingham City University, Birmingham, UKAbstract: In the 2000s, online games became popular, while studies of Internet gaming addiction emerged, outlining the negative consequences of excessive gaming, its prevalence, and associated risk factors. The establishment of specialized treatment centers in South-East Asia, the US, and Europe reflects the growing need for professional help. It is argued that only by understanding the appeal o...

  4. Reducing the addictiveness of cigarettes

    HENNINGFIELD, J.; Benowitz, N.; Slade, J.; Houston, T; DAVIS, R.; Deitchman, S.

    1998-01-01

    OBJECTIVE—To assess the feasibility of reducing tobacco-caused disease by gradually removing nicotine from cigarettes until they would not be effective causes of nicotine addiction.
DATA SOURCES—Issues posed by such an approach, and potential solutions, were identified from analysis of literature published by the US Food and Drug Administration (FDA) in its 1996 Tobacco Rule, comments of the tobacco industry and other institutions and individuals on the rule, review of the reference lists of ...

  5. Topical corticosteroid addiction and phobia

    Aparajita Ghosh; Sujata Sengupta; Arijit Coondoo; Amlan Kusum Jana

    2014-01-01

    Corticosteroids, one of the most widely prescribed topical drugs, have been used for about six decades till date. However, rampant misuse and abuse down the years has given the drug a bad name. Topical steroid abuse may lead to two major problems which lie at the opposing ends of the psychosomatic spectrum. Topical steroid addiction, a phenomenon that came to be recognized about a decade after the introduction of the molecule is manifested as psychological distress and rebound phenomenon on s...

  6. Acupuncture therapy for drug addiction

    Motlagh, Farid Esmaeili; Ibrahim, Fatimah; Rashid , Rusdi Abd.; SEGHATOLESLAM, Tahereh; Habil, Hussain

    2016-01-01

    Acupuncture therapy has been used to treat substance abuse. This study aims to review experimental studies examining the effects of acupuncture on addiction. Research and review articles on acupuncture treatment of substance abuse published between January 2000 and September 2014 were searched using the databases ISI Web of Science Core Collection and EBSCO’s MEDLINE Complete. Clinical trial studies on the efficacy of acupuncture therapy for substance abuse were classified according to substa...

  7. Epigenetic mechanisms in drug addiction

    Renthal, William; Nestler, Eric J.

    2008-01-01

    Changes in gene expression in brain reward regions are thought to contribute to the pathogenesis and persistence of drug addiction. Recent studies have begun to focus on the molecular mechanisms by which drugs of abuse and related environmental stimuli, such as drug-associated cues or stress, converge on the genome to alter specific gene programs. Increasing evidence suggests that these stable gene expression changes in neurons are mediated in part by epigenetic mechanisms that alter chromati...

  8. Histone Acetylation in Drug Addiction

    Renthal, William; Nestler, Eric J.

    2009-01-01

    Regulation of chromatin structure through post-translational modifications of histones (e.g. acetylation) has emerged as an important mechanism to translate a variety of environmental stimuli, including drugs of abuse, into specific changes in gene expression. Since alterations in gene expression are thought to contribute to the development and maintenance of the addicted state, recent efforts are aimed at identifying how drugs of abuse alter chromatin structure and the enzymes which regulate...

  9. Mapping Smoking Addiction Using Effective Connectivity Analysis

    Tang, Rongxiang; Razi, Adeel; Friston, Karl J.; Tang, Yi-Yuan

    2016-01-01

    Prefrontal and parietal cortex, including the default mode network (DMN; medial prefrontal cortex (mPFC), and posterior cingulate cortex, PCC), have been implicated in addiction. Nonetheless, it remains unclear which brain regions play a crucial role in smoking addiction and the relationship among these regions. Since functional connectivity only measures correlations, addiction-related changes in effective connectivity (directed information flow) among these distributed brain regions remain ...

  10. Heroin addiction: the past and future

    Robson , Noorzurani; H , Hussain; AR, Rusdi; AZ, Muhammad Muhsin

    2008-01-01

    Substance misuse, in particular heroin addiction contributes to health and social problems. Although effective medical treatment was available, earlier efforts confined the treatment of heroin addicts to in-house rehabilitation which required them to be estranged from the community and their families for 2 years. The in-house rehabilitative programme, implemented for at least three decades has produced low abstinence rates. On the other hand, being ‘away’ meant that many heroin addicts faced ...

  11. Environmental enrichment and drug addiction revised

    Marcello Solinas

    2013-01-01

    Accumulating evidence demonstrates that exposure to environmental enrichment (EE) has positive effects on drug addiction. In fact, animals exposed to EE appear less vulnerable than animals reared in standard environments (SE) to develop addiction-related behaviors. In addition, exposing already « addicted » animals to EE during periods of withdrawal dramatically reduces the risks of relapse. These findings highlight the interest of EE for the treatment of psychiatric diseases and, from a tran...

  12. Evidence-based treatments of addiction

    O'Brien, Charles P

    2008-01-01

    Both pharmacotherapy and behavioural treatment are required to relieve the symptoms of addictive disorders. This paper reviews the evidence for the benefits of pharmacotherapy and discusses mechanisms where possible. Animal models of addiction have led to some medications that are effective in reducing symptoms and improving function but they do not produce a cure. Addiction is a chronic disease that tends to recur when treatment is stopped; thus, long-term treatment is recommended.

  13. Drug Addiction as Risk for Suicide Attempts

    Dragisic, Tatjana; Dickov, Aleksandra; Dickov, Veselin; Mijatovic, Vesna

    2015-01-01

    Introduction: Suicide is closely linked to the substances use. Therefore it is very important to confirm the factors that affect the possibility of suicidal behavior. Methodology: The survey included 200 respondents; 100 heroin addicts on the substitution program that attempted suicide and 100 opiate addicts who have not attempted suicide. The evaluation included a questionnaire with socio-demographic, hereditary and addiction data, legal problems and then the Minnesota Multiphasic Personalit...

  14. [Internet addiction - between enter and escape].

    Poppe, Hubert

    2014-12-01

    Internet addiction, a non-substantial addiction, is to be regarded as a highly complex mental disorder which requires complex and diverse treatment options. Initially smiled at, it shows, if it were severe, a typical addictive behaviour pattern, similar to pathological gambling, oniomanie and workaholism. In the International Classification of mental disorders (ICD-10) only pathological gambling in the category of impulse control disorders (F63.0) is specified. PMID:25377375

  15. Neurobiologic Processes in Drug Reward and Addiction

    Adinoff, Bryon

    2004-01-01

    Neurophysiologic processes underlie the uncontrolled, compulsive behaviors defining the addicted state. These “hard-wired” changes in the brain are considered critical for the transition from casual to addictive drug use. This review of preclinical and clinical (primarily neuroimaging) studies will describe how the delineation between pleasure, reward, and addiction has evolved as our understanding of the biologic mechanisms underlying these processes has progressed. Although the mesolimbic d...

  16. Young drug addicts and the drug scene.

    Lucchini, R

    1985-01-01

    The drug scene generally comprises the following four distinct categories of young people: neophytes, addicts who enjoy a high status vis-à-vis other addicts, multiple drug addicts, and non-addicted drug dealers. It has its own evolution, hierarchy, structure and criteria of success and failure. The members are required to conform to the established criteria. The integration of the young addict into the drug scene is not voluntary in the real sense of the word, for he is caught between the culture that he rejects and the pseudo-culture of the drug scene. To be accepted into the drug scene, the neophyte must furnish proof of his reliability, which often includes certain forms of criminal activities. The addict who has achieved a position of importance in the drug world serves as a role model for behaviour to the neophyte. In a more advanced phase of addiction, the personality of the addict and the social functions of the drug scene are overwhelmed by the psychoactive effects of the drug, and this process results in the social withdrawal of the addict. The life-style of addicts and the subculture they develop are largely influenced by the type of drug consumed. For example, it is possible to speak of a heroin subculture and a cocaine subculture. In time, every drug scene deteriorates so that it becomes fragmented into small groups, which is often caused by legal interventions or a massive influx of new addicts. The fragmentation of the drug scene is followed by an increase in multiple drug abuse, which often aggravates the medical and social problems of drug addicts. PMID:4075000

  17. Molecular Mechanisms of Psychostimulant Addiction

    Jin-Chung Chen

    2009-04-01

    Full Text Available Drug addiction represents a pathological form of neuroplasticity along with the emergenceof aberrant behaviors involving a cascade of neurochemical changes mainly in thebrain’s rewarding circuitry. The aberrant behavioral phenotypes can be assessed by an animalmodel of drug-induced behavioral sensitization, which is characterized by an initiationstage that is formed in the ventral tegmental area and a behavioral expression stage determinedmainly in the nucleus accumbens. Numerous studies during past decades demonstratethat the mesocorticolimbic dopamine pathway plays an essential role in the development ofbehavioral sensitization. Moreover, a series of cellular signaling pathways and gene expressiondetermine the severity of addictive behaviors. In addition to the well-characterizeddopamine D1 receptor-mediated cAMP/protein kinase A up-regulation in the nucleus accumbens,recent reports indicate the cellular mediator dopamine- and cAMP-regulated phosphoproteinof 32 kDa (DARPP-32 and transcription regulator ΔFosB are associated with theaccumbal PKA pathway to modulate the development of behavioral sensitization. The findingof cAMP-independent and dopamine D2 receptor-mediated Akt/GSK3 in activation inthe nucleus accumbens of behaviorally sensitized animals implies that a signal cascadedown-stream of both dopamine D1 and D2 receptors comprises the mainstay of the addictionnetwork. This review outlines the cellular pathways that have been demonstrated to participatein psychostimulant addiction, focused particularly in the nucleus accumbens.

  18. Responsibility and choice in addiction.

    2002-06-01

    The treatment of patients with substance use disorders requires that providers be aware of their own views on the relative roles of personal responsibility and of forces outside personal control in the onset and progression of and recovery from these disorders. The authors review the role of responsibility for addiction from several viewpoints: biological, psychological, sociocultural, self-help, religious, and forensic. Factors that affect personal responsibility in addictive diseases include awareness of the problem, knowledge of a genetic predisposition, understanding of addictive processes, comorbid psychiatric or medical conditions, adequacy of the support network, nature of the early environment, degree of tolerance of substance abuse in the sociocultural context, and the availability of competent psychiatric, medical, and chemical dependency treatment. Factors that affect societal responsibility include degree of access to illicit drugs, society's level of tolerance of drug use, the courts' approach to deterring substance abuse (punishment versus treatment), individuals' refusal to obtain substance abuse treatment, presence of clear behavioral norms, availability of early assessment and prevention, presence of community education, and degree of access to outpatient and community treatment. PMID:12045307

  19. Nicotinic receptors in addiction pathways.

    Leslie, Frances M; Mojica, Celina Y; Reynaga, Daisy D

    2013-04-01

    Neuronal nicotinic acetylcholine receptors (nAChRs) are ligand-gated ion channels that consist of pentameric combinations of α and β subunits. These receptors are widely distributed throughout the brain and are highly expressed in addiction circuitry. The role of nAChRs in regulating neuronal activity and motivated behavior is complex and varies both in and among brain regions. The rich diversity of central nAChRs has hampered the characterization of their structure and function with use of classic pharmacological techniques. However, recent molecular approaches using null mutant mice with specific regional lentiviral re-expression, in combination with neuroanatomical and electrophysiological techniques, have allowed the elucidation of the influence of different nAChR types on neuronal circuit activity and behavior. This review will address the influence of nAChRs on limbic dopamine circuitry and the medial habenula-interpeduncular nucleus complex, which are critical mediators of reinforced behavior. Characterization of the mechanisms underlying regulation of addiction pathways by endogenous cholinergic transmission and by nicotine may lead to the identification of new therapeutic targets for treating tobacco dependence and other addictions. PMID:23247824

  20. Acupuncture therapy for drug addiction.

    Motlagh, Farid Esmaeili; Ibrahim, Fatimah; Rashid, Rusdi Abd; Seghatoleslam, Tahereh; Habil, Hussain

    2016-01-01

    Acupuncture therapy has been used to treat substance abuse. This study aims to review experimental studies examining the effects of acupuncture on addiction. Research and review articles on acupuncture treatment of substance abuse published between January 2000 and September 2014 were searched using the databases ISI Web of Science Core Collection and EBSCO's MEDLINE Complete. Clinical trial studies on the efficacy of acupuncture therapy for substance abuse were classified according to substance (cocaine, opioid, nicotine, and alcohol), and their treatment protocols, assessments, and findings were examined. A total of 119 studies were identified, of which 85 research articles addressed the efficacy of acupuncture for treating addiction. There were substantial variations in study protocols, particularly regarding treatment duration, frequency of electroacupuncture, duration of stimulation, and choice of acupoints. Contradictory results, intergroup differences, variation in sample sizes, and acupuncture placebo effects made it difficult to evaluate acupuncture effectiveness in drug addiction treatment. This review also identified a lack of rigorous study design, such as control of confounding variables by incorporating sham controls, sufficient sample sizes, reliable assessments, and adequately replicated experiments. PMID:27053944

  1. What does addiction mean to me

    Morten Hesse

    2006-03-01

    Full Text Available Addiction is compulsive need for and use of a habit-forming substance. It is accepted as a mental illness in the diagnostic nomenclature and results in substantial health, social and economic problems. In the diagnostic nomenclature, addiction was originally included in the personality disorders along with other behaviours considered deviant. But it is now considered a clinical syndrome. Addiction is multifactorially determined, with substantial genetic influence. The development of addictions is also influenced by environmental factors, and an interplay between the two. In the clinical context, addiction puts problem substance use on the agenda, and helps focus on the difficulties associated with drug use. But the concept of addiction is also used to distance the user from addicts, and in this way, may be counter-therapeutic. The addiction concept has also had a substantial influence on policy. The almost universal prohibition against drugs such as opiates, cocaine, cannabis and amphetamine has much support. But unfortunately, it has not been able to hinder the development of substance use problems. Optimism is fostered by the development of respectful ways of thinking about people with addictions, in particular, from advocates of motivational interviewing.

  2. Unraveling Exercise Addiction: The Role of Narcissism and Self-Esteem

    Antonio Bruno

    2014-01-01

    Full Text Available The aim of this study was to assess the risk of exercise addiction (EA in fitness clubs and to identify possible factors in the development of the disorder. The Exercise Addiction Inventory (EAI, the Narcissistic Personality Inventory (NPI, and the Coopersmith Self-Esteem Inventory (SEI were administered to a sample of 150 consecutive gym attenders recruited in fitness centers. Based on EAI total score, high EA risk group (HEA n=51 and a low EA risk group (LEA n=69 were identified. HEA reported significantly higher total score (mean = 20.2 versus 14.6 on the NPI scale and lower total score (mean = 32.2 versus 36.4 on the SEI scale than LEA. A stepwise regression analysis indicated that only narcissism and self-esteem total scores (F=5.66;  df=2;  P=0.006 were good predictors of days per week exercise. The present study confirms the direct and combined role of both labile self-esteem and high narcissism in the development of exercise addiction as predictive factors towards the risk of addiction. Multidisciplinary trained health care providers (physiatrists, psychologists, and psychiatrists should carefully identify potential overexercise conditions in order to prevent the potential risk of exercise addiction.

  3. Unraveling exercise addiction: the role of narcissism and self-esteem.

    Bruno, Antonio; Quattrone, Diego; Scimeca, Giuseppe; Cicciarelli, Claudio; Romeo, Vincenzo Maria; Pandolfo, Gianluca; Zoccali, Rocco Antonio; Muscatello, Maria Rosaria Anna

    2014-01-01

    The aim of this study was to assess the risk of exercise addiction (EA) in fitness clubs and to identify possible factors in the development of the disorder. The Exercise Addiction Inventory (EAI), the Narcissistic Personality Inventory (NPI), and the Coopersmith Self-Esteem Inventory (SEI) were administered to a sample of 150 consecutive gym attenders recruited in fitness centers. Based on EAI total score, high EA risk group (HEA n = 51) and a low EA risk group (LEA n = 69) were identified. HEA reported significantly higher total score (mean = 20.2 versus 14.6) on the NPI scale and lower total score (mean = 32.2 versus 36.4) on the SEI scale than LEA. A stepwise regression analysis indicated that only narcissism and self-esteem total scores (F = 5.66; df = 2; P = 0.006) were good predictors of days per week exercise. The present study confirms the direct and combined role of both labile self-esteem and high narcissism in the development of exercise addiction as predictive factors towards the risk of addiction. Multidisciplinary trained health care providers (physiatrists, psychologists, and psychiatrists) should carefully identify potential overexercise conditions in order to prevent the potential risk of exercise addiction. PMID:25405056

  4. Street "Doctory" among a Group of Heroin Addicts in India: Naturalistic Peer Learning

    Dhand, Amar

    2009-01-01

    Street "doctory" is a form of peer-based medical care performed in street settings among a group of heroin addicts in Yamuna Bazaar, New Delhi. Using participant observation and semi-structured interviews, this study describes three components of the practice, and suggests that each contained peer learning processes. First, participants conducted…

  5. Strengthening Families: What Communities Can Do To Support Families with Addictions. Action Kit, Fall 2000.

    Join Together, Boston, MA.

    Although substance abuse affects the family, the children of substance abusers suffer the most. When parents are unable to care for their children because of their untreated addiction, the children are at risk for social and health problems that include alcohol and drug use, delinquency, depression, and poor school performance. One approach to…

  6. Examining the performance of the brief addiction monitor.

    Nelson, Karl G; Young, Kevin; Chapman, Heather

    2014-04-01

    The Center for Excellence in Drug Abuse Treatment and Education (Center for Excellence in Substance Abuse Treatment and Education (CESATE; 2010). Brief Addiction Monitor: Manual of Operations. Philadelphia, PA) recently suggested that Veterans Affairs' (VA) addictions treatment programs, in order to encourage measurement based care, begin using a new measure of substance abuse, the Brief Addictions Monitor (BAM). To date, only one study Caccolia et al, 2013. Development and initial evaluation of the Brief Addiction Monitor (BAM). Journal of Substance Abuse Treatment, 44, 256-63. doi: http://dx.doi.org/10.1016/j.jsat.2012.07.013) has examined the psychometric properties of a version of this instrument. However, this study did not use the version of the BAM currently available to most VA providers via the mental health assistant software; rather, the authors reported the properties of a BAM where most of the items had continuous (or near continuous) response options. The current study seeks to provide data on the version of the BAM which uses 5 point Likert scale response options for its questions, the version available on the mental health assistant software. Based on data from more than 700 veterans enrolled in out-patient (OP) and in-patient (IP) addictions treatment programs, this study examined the factor structure, reliability, and validity of this version of the BAM. Across both groups, results suggested that the BAM lacked a reliable factor structure, in contrast to the findings from the earlier study. However, a single scale, composed of a minority of items on the BAM, showed promise. A minority of the items (five) provided valid information across both OP and IP samples when applied individually, as indicated by convergent and divergent validity comparisons with other measures of functioning; tracking changes in functioning over the course of treatment; and correlating with changes in convergent and divergent validity measures. This partially supported the

  7. Penn/VA center for studies of addiction.

    O'Brien, Charles P; McLellan, A Thomas; Childress, Anna Rose; Woody, George E

    2009-01-01

    The Penn/VA Center was founded in 1971 because of great concern over the number of Vietnam veterans returning home addicted to heroin. At that time little was known about the science of addiction, so our program from the very beginning was designed to gather data about the nature of addiction and measure the effects of available treatments. In other words, the goals were always a combination of treatment and research. This combination has continued to the present day. A human laboratory for the study of addiction phenomena such as conditioned responses was also founded in 1971. The key clinician investigators in this group have remained in the Center since the 1970s with most of the research staff continuing to work together. Important new investigators have been added over the years. Treatment was empirically based with randomized, controlled clinical trials as the gold standard for determining evidence-based treatment. The patients coming to treatment do not distinguish between abuse of alcohol and other drugs, so the treatment and research programs have always focused on all drugs including ethyl alcohol and the combination of ethyl alcohol with other drugs such as cocaine and opioids. Most of the patients coming for treatment also suffered from additional psychiatric disorders such as depression, anxiety, bipolar disorder or schizophrenia. Thus, the addiction treatment program in 1980 absorbed the rest of the VA Psychiatry Service into the Substance Abuse Program forming a new Behavioral Health Service with responsibility for over 9000 patients. The integration of substance abuse treatment with overall mental health care was the most efficient way to handle patients with complicated combinations of disorders. While this continues to be the best way to treat patients, it has proven difficult in practice. The main reason for this difficulty is that most mental health therapists whether they are psychiatrists, psychologists or social workers feel very inadequate

  8. The Need for National Credentialing Standards for Addiction Counselors

    Miller, Geri; Scarborough, Jim; Clark, Catherine; Leonard, Justin C.; Keziah, Tyler B.

    2010-01-01

    The authors review the current state of credentialing for addiction counselors in the United States and provide recommendations to the addiction counseling field regarding national standards for credentialing.

  9. CRIMINAL POLICY AND PREVENTION OF DRUG ADDICTION AMONG YOUTH

    Jadranka Ivandić Zimić

    2010-12-01

    Full Text Available Contribution of the criminal policy in the development of the integrated prevention-social policy related to drug addiction is highlyimportant because of the fact that it aims are reducing of the drug related crimes, protecting the victims and community. The paperconsiders interventions of the criminal policy into fi elds of treatment and prevention of drug addiction among youth. This relationrepresent challenge for policymakers because interconnections between different service, who do not always have the same point ofview how to approach to the problem, is strongly needed and expected. Thru the comparing of the implementation of prevention andcriminal policy in Great Britain, Netherlands, Sweden and Croatia, aim of the paper is to detected concepts and models of infl uenceof the criminal policy on the reducing use of drugs among youth and effectiveness of prevention programs. Lack of the support andsocial care for the drug addiction offenders within the criminal policy, have effects of the success of the social reintegration and appearanceof recidivism. There is a strong connection between prevention and criminal policy in the fi led of combating drug problem;on one side good prevention policy could infl uence on the reduction of number of youth who will committee drug crimes and enteredin the criminal justice system, but at the same time the criminal policy have the important role in the preventing of the drug abuse thruthe involving minor drug offenders in the treatment while there are in the criminal proceedings.

  10. Evolutionary and neuropsychological perspectives on addictive behaviors and addictive substances: relevance to the "food addiction" construct

    Davis C

    2014-01-01

    Caroline Davis School of Kinesiology and Health Science, York University, Toronto, ON, Canada Abstract: It has been argued that food cannot be "addictive", unlike conventional drugs of abuse, because it is an essential part of life. In this paper, evidence is reviewed, largely from an evolutionary psychobiological perspective, that plant-based psychoactive drugs (such as those derived from the opium poppy and the coca leaf) and gambling-related behaviors were once adaptive for huma...

  11. TYPES OF SHARES

    TĂNASE Alin-Eliodor; Traian-Ovidiu CALOTĂ

    2014-01-01

    This article focuses on equity instruments. There are presented the characteristics of ordinary and preference shares. There are described the types and characteristics of preference shares such as:cumulative preference shares, participating preference shares,convertible preference shares, callable preference shares and redeemable preference shares. Treasury shares are also described. The accounting records are based on IAS 32 Financial Instruments: Presentation. There are presented the condi...

  12. Intense, Passionate, Romantic Love: A Natural Addiction? How the Fields That Investigate Romance and Substance Abuse Can Inform Each Other.

    Fisher, Helen E; Xu, Xiaomeng; Aron, Arthur; Brown, Lucy L

    2016-01-01

    Individuals in the early stage of intense romantic love show many symptoms of substance and non-substance or behavioral addictions, including euphoria, craving, tolerance, emotional and physical dependence, withdrawal and relapse. We have proposed that romantic love is a natural (and often positive) addiction that evolved from mammalian antecedents by 4 million years ago as a survival mechanism to encourage hominin pair-bonding and reproduction, seen cross-culturally today in Homo sapiens. Brain scanning studies using functional magnetic resonance imaging support this view: feelings of intense romantic love engage regions of the brain's "reward system," specifically dopamine-rich regions, including the ventral tegmental area, also activated during drug and/or behavioral addiction. Thus, because the experience of romantic love shares reward pathways with a range of substance and behavioral addictions, it may influence the drug and/or behavioral addiction response. Indeed, a study of overnight abstinent smokers has shown that feelings of intense romantic love attenuate brain activity associated with cigarette cue-reactivity. Could socially rewarding experiences be therapeutic for drug and/or behavioral addictions? We suggest that "self expanding" experiences like romance and expanding one's knowledge, experience and self-perception, may also affect drug and/or behavioral addiction behaviors. Further, because feelings of romantic love can progress into feelings of calm attachment, and because attachment engages more plastic forebrain regions, there is a rationale for therapies that may help substance and/or behavioral addiction by promoting activation of these forebrain systems through long-term, calm, positive attachments to others, including group therapies. Addiction is considered a negative (harmful) disorder that appears in a population subset; while romantic love is often a positive (as well as negative) state experienced by almost all humans. Thus, researchers

  13. Intense, Passionate, Romantic Love: A Natural Addiction? How the Fields That Investigate Romance and Substance Abuse Can Inform Each Other

    Fisher, Helen E.; Xu, Xiaomeng; Aron, Arthur; Brown, Lucy L.

    2016-01-01

    Individuals in the early stage of intense romantic love show many symptoms of substance and non-substance or behavioral addictions, including euphoria, craving, tolerance, emotional and physical dependence, withdrawal and relapse. We have proposed that romantic love is a natural (and often positive) addiction that evolved from mammalian antecedents by 4 million years ago as a survival mechanism to encourage hominin pair-bonding and reproduction, seen cross-culturally today in Homo sapiens. Brain scanning studies using functional magnetic resonance imaging support this view: feelings of intense romantic love engage regions of the brain’s “reward system,” specifically dopamine-rich regions, including the ventral tegmental area, also activated during drug and/or behavioral addiction. Thus, because the experience of romantic love shares reward pathways with a range of substance and behavioral addictions, it may influence the drug and/or behavioral addiction response. Indeed, a study of overnight abstinent smokers has shown that feelings of intense romantic love attenuate brain activity associated with cigarette cue-reactivity. Could socially rewarding experiences be therapeutic for drug and/or behavioral addictions? We suggest that “self expanding” experiences like romance and expanding one’s knowledge, experience and self-perception, may also affect drug and/or behavioral addiction behaviors. Further, because feelings of romantic love can progress into feelings of calm attachment, and because attachment engages more plastic forebrain regions, there is a rationale for therapies that may help substance and/or behavioral addiction by promoting activation of these forebrain systems through long-term, calm, positive attachments to others, including group therapies. Addiction is considered a negative (harmful) disorder that appears in a population subset; while romantic love is often a positive (as well as negative) state experienced by almost all humans. Thus

  14. Intense, Passionate Romantic Love: A natural addiction? How the fields that investigate romance and substance abuse can inform each other

    Helen Fisher

    2016-05-01

    Full Text Available Individuals in the early stage of intense romantic love show many symptoms of substance and non-substance or behavioral addictions, including euphoria, craving, tolerance, emotional and physical dependence, withdrawal and relapse. We have proposed that romantic love is a natural (and often positive addiction that evolved from mammalian antecedents by four million years ago as a survival mechanism to encourage hominin pair-bonding and reproduction, seen cross-culturally today in Homo sapiens. Brain scanning studies using functional magnetic resonance imaging (fMRI support this view: feelings of intense romantic love engage regions of the brain’s reward system, specifically dopamine-rich regions, including the ventral tegmental area, also activated during drug and/or behavioral addiction. Thus, because the experience of romantic love shares reward pathways with a range of substance and behavioral addictions, it may influence the drug and/or behavioral addiction response. Indeed, a study of overnight abstinent smokers has shown that feelings of intense romantic love attenuate brain activity associated with cigarette cue-reactivity. Could socially rewarding experiences be therapeutic for drug and/or behavioral addictions? We suggest that self expanding experiences like romance and expanding one’s knowledge, experience and self-perception, may also affect drug and/or behavioral addiction behaviors. Further, because feelings of romantic love can progress into feelings of calm attachment, and because attachment engages more plastic forebrain regions, there is a rationale for therapies that may help substance and/or behavioral addiction by promoting activation of these forebrain systems through long-term, calm, positive attachments to others, including group therapies. Addiction is considered a negative (harmful disorder that appears in a population subset; while romantic love is often a positive (as well as negative state experienced by almost all

  15. Evolutionary and neuropsychological perspectives on addictive behaviors and addictive substances: relevance to the "food addiction" construct

    Davis C

    2014-12-01

    Full Text Available Caroline Davis School of Kinesiology and Health Science, York University, Toronto, ON, Canada Abstract: It has been argued that food cannot be "addictive", unlike conventional drugs of abuse, because it is an essential part of life. In this paper, evidence is reviewed, largely from an evolutionary psychobiological perspective, that plant-based psychoactive drugs (such as those derived from the opium poppy and the coca leaf and gambling-related behaviors were once adaptive for human health and survival in a similar manner as energy-based foods were for nourishment. "Evolutionary mismatch" viewpoints contend that certain behaviors were enhanced during the hunter-gatherer lifestyle – from which our genetic endowment had its origins – because they bestowed both survival and reproductive advantages to the species. However, in the context of advanced technology and other rapid environmental changes, these same behaviors have tended to become maladaptive and greatly overexpressed. Similar to the manufactured purification of psychotropic plant-based substances, the reward impact of processed and hyperpalatable foods, with their high levels of sugar, fat, and salt, is much increased from foods produced in nature. It is concluded therefore that what was once beneficial and necessary for our survival has been altered and ultraprocessed into edible products that may be disadvantageous and potentially addictive. Keywords: food addiction, evolution, drugs, gambling

  16. From the description of activities to the identification of risks for clinical management: a proposal of building, merging and sharing knowledge representations of care processes.

    Staccini, Pascal; Joubert, Michel; Collomp, Rémy; Quaranta, Jean-François; Fieschi, Marius

    2007-01-01

    Management of clinical processes and hospital activities takes advantage of business process reengineering methodology. It is now recognized that care process modeling must integrate the definition of goals and the assessment of risk. Two kinds of issues have been outlined: 1) the lack of an integrated model to identify and describe processes and their components according to a functional point of view; and 2) an increasing amount of documents that hospital staff members have to create, collect, index and maintain. As initial models focused only on a structural view of activities, we reviewed different sources of standards and norms to extract and classify a set of metadata aimed at describing any activity and its outcomes. The model includes links to structured terminologies to name attributes or value them. An object-oriented information model has been created and implemented to test the relevance and the feasibility of the modeling approach. Conceptually speaking, this model gives opportunity to bridge tacit and explicit knowledge. Practically speaking, limits to generalization remain partly due to the lack of a template processes database. PMID:17911723

  17. Epigenetic and Proteomic Expression Changes Promoted by Eating Addictive-Like Behavior.

    Mancino, Samantha; Burokas, Aurelijus; Gutiérrez-Cuesta, Javier; Gutiérrez-Martos, Miriam; Martín-García, Elena; Pucci, Mariangela; Falconi, Anastasia; D'Addario, Claudio; Maccarrone, Mauro; Maldonado, Rafael

    2015-11-01

    An increasing perspective conceptualizes obesity and overeating as disorders related to addictive-like processes that could share common neurobiological mechanisms. In the present study, we aimed at validating an animal model of eating addictive-like behavior in mice, based on the DSM-5 substance use disorder criteria, using operant conditioning maintained by highly palatable chocolate-flavored pellets. For this purpose, we evaluated persistence of food-seeking during a period of non-availability of food, motivation for food, and perseverance of responding when the reward was associated with a punishment. This model has allowed identifying extreme subpopulations of mice related to addictive-like behavior. We investigated in these subpopulations the epigenetic and proteomic changes. A significant decrease in DNA methylation of CNR1 gene promoter was revealed in the prefrontal cortex of addict-like mice, which was associated with an upregulation of CB1 protein expression in the same brain area. The pharmacological blockade (rimonabant 3 mg/kg; i.p.) of CB1 receptor during the late training period reduced the percentage of mice that accomplished addiction criteria, which is in agreement with the reduced performance of CB1 knockout mice in this operant training. Proteomic studies have identified proteins differentially expressed in mice vulnerable or not to addictive-like behavior in the hippocampus, striatum, and prefrontal cortex. These changes included proteins involved in impulsivity-like behavior, synaptic plasticity, and cannabinoid signaling modulation, such as alpha-synuclein, phosphatase 1-alpha, doublecortin-like kinase 2, and diacylglycerol kinase zeta, and were validated by immunoblotting. This model provides an excellent tool to investigate the neurobiological substrate underlying the vulnerability to develop eating addictive-like behavior. PMID:25944409

  18. Genetic variants associated with addictive behavior in Colombian addicted and non-addicted to heroin or cocaine

    Isaza, Carlos

    2013-03-01

    Full Text Available Objective: Determine the prevalence and compare some genetic markers involved in addictive behavior in a group of addicts to derivative of coca (cocaine/crack or heroin and a control group of non-addicted people matched for gender, age and ethnicity.Methods: A 120 addicts and 120 non-addicts Colombian male were surveyed and genotyped for 18 polymorphism of the OPRM1, DRD2, DRD4, SLC6A3, SLC6A4, ABCB1, DβH and CYP2B6 genes. For the identification of alleles markers were used mini-sequencing and fragment multiplex PCR techniques; ethnicity of cases and controls was analyzed with 61 AIMs. Results: The age of onset use of heroin or coca derivatives (cocaine/crack was 16,5±6 years and 99,2% of them consume several illicit drugs. It showed that controls and addicts belong to the same ethnic group. Significant differences between addicts and controls in relation to schooling, marital status, social security family history of substance abuse (pT ABCB1 gene (p=0,001 were found. Conclusion: The present results indicate that the VNTR-6R polymorphism of the gene SLC6A3 and the genotype 3435CC in the ABCB1 gene, are both associated with addictive behavior to heroin or cocaine.

  19. Should pathological gambling and obesity be considered addictive disorders? A factor analytic study in a nationally representative sample

    Blanco, Carlos; García-Anaya, María; Wall, Melanie; de los Cobos, José Carlos Pérez; Swierad, Ewelina; Wang, Shuai; Petry, Nancy M.

    2015-01-01

    Objective Pathological gambling (PG) is now aligned with substance use disorders in the DSM-5 as the first officially recognized behavioral addiction. There is growing interest in examining obesity as an addictive disorder as well. The goal of this study was to investigate whether epidemiological data provide support for the consideration of PG and obesity as addictive disorders. Method Factor analysis of data from a large, nationally representative sample of US adults (N=43,093), using nicotine dependence, alcohol dependence, drug dependence, PG and obesity as indicators. It was hypothesized that nicotine dependence, alcohol dependence and drug use dependence would load on a single factor. It was further hypothesized that if PG and obesity were addictive disorders, they would load on the same factor as substance use disorders, whereas failure to load on the addictive factor would not support their conceptualization as addictive disorders. Results A model with one factor including nicotine dependence, alcohol dependence, drug dependence and PG, but not obesity, provided a very good fit to the data, as indicated by CFI=0.99, TLI=0.99 and RMSEA=.01 and loadings of all indicators >0.4. Conclusion Data from this study support the inclusion of PG in a latent factor with substance use disorders but do not lend support to the consideration of obesity, as defined by BMI, as an addictive disorder. Future research should investigate whether certain subtypes of obesity are best conceptualized as addictive disorders and the shared biological and environmental factors that account for the common and specific features of addictive disorders. PMID:25769392

  20. Predictors of course satisfaction and perceived course impact of addiction nurses undertaking a postgraduate diploma in addictive behaviour.

    Rassool, G Hussein; Oyefeso, Adenekan

    2007-04-01

    The effectiveness and impact of continuing education for specialist nurses working with drug and alcohol had been poorly documented and the purpose of this study was to enhance our understanding of this process. The aims of the study were to identify predictors of course satisfaction and perceived course impact and to examine students' satisfaction with modules' learning outcomes and their applications to practice. This study was a cross-sectional survey of 46 part-time students enrolled a Postgraduate Diploma in Addictive Behaviour. Three instruments were used to measure modules' satisfaction, post-course satisfaction (PCSQ-18) and on-the-job impact (CIQ-17). The findings provided some support on the effect and impact of an educational programme on the practice development of addiction nurses. Within the multilayered hypothesis, the results indicate that expectations on the Health Education and Prevention Module were the only significant predictor of course satisfaction and Expectation of the Special Population Module was the only significant predictor of course impact on professional practice. Clinical placements have had a significant impact on professional practice of addiction nurses. Further evaluative studies need to be undertaken to examine the impact of educational programmes on its applications to clinical practice and the quality of care provided. PMID:16831495